Intestinal Research

Original Articles

Microbiota

Relationship between the gut microbiota and bile acid composition in the ileal mucosa of Crohn’s disease: Shigeki Bamba, Osamu Inatomi, Atsushi Nishida, Masashi Ohno, Takayuki Imai, Kenichiro Takahashi, Yuji Naito, Junichi Iwamoto, Akira Honda, Naohiro Inohara, Akira Andoh; Intest Res 2022;20(3):370-380. Published online May 14, 2021; DOI: https://doi.org/10.5217/ir.2021.00054

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Background/Aims
Crosstalk between the gut microbiota and bile acid plays an important role in the pathogenesis of gastrointestinal disorders. We investigated the relationship between microbial structure and bile acid metabolism in the ileal mucosa of Crohn’s disease (CD).
Methods
Twelve non-CD controls and 38 CD patients in clinical remission were enrolled. Samples were collected from the distal ileum under balloon-assisted enteroscopy. Bile acid composition was analyzed by liquid chromatography-mass spectrometry. The gut microbiota was analyzed by 16S rRNA gene sequencing.
Results
The Shannon evenness index was significantly lower in endoscopically active lesions than in non-CD controls. β-Diversity, evaluated by the UniFrac metric, revealed a significant difference between the active lesions and non-CD controls (P=0.039). The relative abundance of Escherichia was significantly higher and that of Faecalibacterium and Roseburia was significantly lower in CD samples than in non-CD controls. The increased abundance of Escherichia was more prominent in active lesions than in inactive lesions. The proportion of conjugated bile acids was significantly higher in CD patients than in non-CD controls, but there was no difference in the proportion of primary or secondary bile acids. The genera Escherichia and Lactobacillus were positively correlated with the proportion of conjugated bile acids. On the other hand, Roseburia, Intestinibacter, and Faecalibacterium were negatively correlated with the proportion of conjugated bile acids.
Conclusions
Mucosa-associated dysbiosis and the alteration of bile acid composition were identified in the ileum of CD patients. These may play a role in the pathophysiology of ileal lesions in CD patients.

Citations

Citations to this article as recorded by

hUCMSCs Regulate Bile Acid Metabolism to Prevent Heart Failure–Induced Intestinal Injury by Inhibiting the Activation of the STAT3/NF‐κB/MAPK Signaling Pathway via TGR5
Zetian Wang, Wei Luo, Qing Wang, Chunzheng Liu, Yanshan Gong, Baitian Li, Xuejiao Zeng, Jiaqi Lin, Zehua Su, Xin Li, Yongze Yu, Zhongmin Liu, Ling Gao, Lijun Liao
Food Frontiers.2025; 6(1): 575. CrossRef
Effect of Probiotics on Improving Intestinal Mucosal Permeability and Inflammation after Surgery
Min-Jae Kim, Young Ju Lee, Zahid Hussain, Hyojin Park
Gut and Liver.2025; 19(2): 207. CrossRef
A critical review on inflammatory bowel diseases risk factors, dietary nutrients regulation and protective pathways based on gut microbiota during recent 5 years
Pengkui Xia, Tao Hou, Hong Jin, Yaqi Meng, Jing Li, Fuchao Zhan, Fang Geng, Bin Li
Critical Reviews in Food Science and Nutrition.2024; 64(24): 8805. CrossRef
Gut microbiota disparities between active Crohn's disease and healthy controls: A global systematic review
Rupa Tharu, Geetika Malik Ahlawat, Savitesh Kushwaha, Poonam Khanna
Clinical Epidemiology and Global Health.2024; 25: 101497. CrossRef
Gut microbes improve prognosis of Klebsiella pneumoniae pulmonary infection through the lung-gut axis
Yuxiu Tang, Liquan Chen, Jin Yang, Suqing Zhang, Jun Jin, Yao Wei
Frontiers in Cellular and Infection Microbiology.2024;[Epub] CrossRef
Integrated Analysis of Microbiome and Metabolome Reveals Disease-Specific Profiles in Inflammatory Bowel Diseases and Intestinal Behçet’s Disease
Yehyun Park, Jae Bum Ahn, Da Hye Kim, I Seul Park, Mijeong Son, Ji Hyung Kim, Hyun Woo Ma, Seung Won Kim, Jae Hee Cheon
International Journal of Molecular Sciences.2024; 25(12): 6697. CrossRef
Gut Bacterial Composition and Nutritional Implications in Mexican and Spanish Individuals with Inflammatory Bowel Disease Compared to Healthy Controls
Ricardo García-Gamboa, Osiris Díaz-Torres, Misael Sebastián Gradilla-Hernández, Vicente Pérez-Brocal, Andrés Moya, Marisela González-Avila
International Journal of Molecular Sciences.2024; 25(22): 11887. CrossRef
Bile acid–induced metabolic changes in the colon promote Enterobacteriaceae expansion and associate with dysbiosis in Crohn’s disease
Ravi Holani, Haggai Bar-Yoseph, Zakhar Krekhno, Antonio Serapio-Palacios, Kyung-Mee Moon, Richard G. Stacey, Katherine A. Donald, Wanyin Deng, Brian Bressler, Armando A. Magaña, Leonard J. Foster, Michael G. Atser, James D. Johnson, Barton Finlay
Science Signaling.2024;[Epub] CrossRef
Compositional changes in fecal microbiota associated with clinical phenotypes and prognosis in Korean patients with inflammatory bowel disease
Seung Yong Shin, Young Kim, Won-Seok Kim, Jung Min Moon, Kang-Moon Lee, Sung-Ae Jung, Hyesook Park, Eun Young Huh, Byung Chang Kim, Soo Chan Lee, Chang Hwan Choi
Intestinal Research.2023; 21(1): 148. CrossRef
Meta-Analysis Reveals Compositional and Functional Microbial Changes Associated with Osteoporosis
Oluwamayowa S. Akinsuyi, Luiz F. W. Roesch, Olubukola Oluranti Babalola
Microbiology Spectrum.2023;[Epub] CrossRef
Crohn’s disease: Why the ileum?
Nicolas Richard, Guillaume Savoye, Mathilde Leboutte, Asma Amamou, Subrata Ghosh, Rachel Marion-Letellier
World Journal of Gastroenterology.2023; 29(21): 3222. CrossRef
The Emerging Role of Raman Spectroscopy as an Omics Approach for Metabolic Profiling and Biomarker Detection toward Precision Medicine
Gabriel Cutshaw, Saji Uthaman, Nora Hassan, Siddhant Kothadiya, Xiaona Wen, Rizia Bardhan
Chemical Reviews.2023; 123(13): 8297. CrossRef
Current insights on the roles of gut microbiota in inflammatory bowel disease-associated extra-intestinal manifestations: pathophysiology and therapeutic targets
Yizhe Tie, Yongle Huang, Rirong Chen, Li Li, Minhu Chen, Shenghong Zhang
Gut Microbes.2023;[Epub] CrossRef
Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Kwang Woo Kim
Gut and Liver.2023; 17(6): 954. CrossRef
Evaluation of gut dysbiosis using serum and fecal bile acid profiles
Tadakuni Monma, Junichi Iwamoto, Hajime Ueda, Makoto Tamamushi, Fumio Kakizaki, Naoki Konishi, Shoichiro Yara, Teruo Miyazaki, Takeshi Hirayama, Tadashi Ikegami, Akira Honda
World Journal of Clinical Cases.2022; 10(34): 12484. CrossRef
Microbial Modulation in Inflammatory Bowel Diseases
Jongwook Yu, Jae Hee Cheon
Immune Network.2022;[Epub] CrossRef

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Endoscopy

Prototype single-balloon enteroscopy with passive bending and high force transmission improves depth of insertion in the small intestine: Yasuhiro Morita, Shigeki Bamba, Osamu Inatomi, Kenichiro Takahashi, Takayuki Imai, Masaki Murata, Masashi Ohno, Masaya Sasaki, Tomoyuki Tsujikawa, Akira Andoh; Intest Res 2020;18(2):229-237. Published online April 9, 2020; DOI: https://doi.org/10.5217/ir.2019.09150

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Background/Aims
We retrospectively analyzed Crohn’s disease (CD) patients with small intestinal strictures who underwent single-balloon enteroscopy (SBE) to ascertain whether prototype SBEs with a passive bending mechanism and high force transmission insertion tube had better insertability in the small intestine than a conventional SBE.
Methods
Among 253 CD patients who underwent SBE, we identified 94 CD patients who had undergone attempted endoscopic balloon dilatation (EBD) for small intestinal stenosis for inclusion in this study. We analyzed whether the type of scope used for their initial procedure affected the cumulative surgery-free rate. For the insertability analysis, patients who underwent SBE at least twice were divided into 3 groups according to the type of scope used: conventional SBE only, prototype SBE only, and both conventional and prototype SBEs. For each group, depth of insertion, procedure time, and number of EBDs were compared in the same patient at different time points.
Results
The success rate of EBD was 88.3%. The 5- and 10-year cumulative surgery-free rate was 75.7% and 72.8%, respectively. Cox regression analysis indicated that the factors contributing to surgery were long stricture (≥2 cm), EBD failure, and elevated Crohn’s Disease Activity Index, but not the type of scope used for EBD. The prototype SBEs significantly improved the depth of insertion (P=0.03, Wilcoxon’s signed-rank test).
Conclusions
In CD patients with small intestinal stenosis, the prototype SBEs with a passive bending mechanism and high force transmission insertion tube did not improve long-term EBD outcome but did improve deep insertability. (Clinical Trial Registration No. UMIN000037102)

Citations

Citations to this article as recorded by

Leucine-rich alpha-2 glycoprotein as a superior biomarker to C-reactive protein for detecting small bowel lesions in Crohn’s disease
Masashi Ohno, Atsushi Nishida, Akinori Otsuki, Yoshihiro Yokota, Takayuki Imai, Shigeki Bamba, Osamu Inatomi
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Role of Device-Assisted Enteroscopy in Crohn’s Disease
Giulia Catassi, Clelia Marmo, Antonio Gasbarrini, Maria Elena Riccioni
Journal of Clinical Medicine.2024; 13(13): 3919. CrossRef
Performance of Balloon-Assisted Enteroscopy for Non-ERCP Indications in Patients with Surgically Altered Gastrointestinal Anatomy
Ji Hee Song, Seong Ran Jeon, Jin Su Kim, Bo-In Lee, Jin-Oh Kim, Han Hee Lee
Digestive Diseases and Sciences.2023; 68(6): 2545. CrossRef
Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study
Yuna Kim, Jae-Hyun Kim, Eun-Ae Kang, Soo-Jung Park, Jae-Jun Park, Jae-Hee Cheon, Tae-Il Kim, Jihye Park, Seong-Ran Jeon
Diagnostics.2022; 12(4): 954. CrossRef
Intestinal stricture in Crohn's disease: A 2020 update
Xiao Xuan Lin, Yun Qiu, Xiao Jun Zhuang, Fen Liu, Xiao Min Wu, Min Hu Chen, Ren Mao
Journal of Digestive Diseases.2021; 22(7): 390. CrossRef
Factors Affecting Route Selection of Balloon-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study
Dong Hoon Baek, Seonyeong Hwang, Chang Soo Eun, Seong Ran Jeon, Jinsu Kim, Eun Ran Kim, Dong-Hoon Yang, Hyun Joo Jang, Jong Pil Im, Soo Jung Park, Sung Hoon Jung
Diagnostics.2021; 11(10): 1860. CrossRef

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Endoscopy

Efficacy and safety of cold forceps polypectomy utilizing the jumbo cup: a prospective study: Hiroshi Hasegawa, Shigeki Bamba, Kenichiro Takahashi, Masaki Murata, Taketo Otsuka, Hiroshi Matsumoto, Takehide Fujimoto, Rie Osak, Hirotsugu Imaeda, Atsushi Nishida, Hiromitsu Ban, Ayano Sonoda, Osamu Inatomi, Masaya Sasaki, Mitsushige Sugimoto, Akira Andoh; Intest Res 2019;17(2):265-272. Published online November 28, 2018; DOI: https://doi.org/10.5217/ir.2018.00103

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Background/Aims
There are few prospective studies on cold forceps polypectomy (CFP) using jumbo cup forceps. Therefore, we examined patients with diminutive polyps (5 mm or smaller) treated with CFP using jumbo cup forceps to achieve an adenoma-free colon and also assessed the safety of the procedure and the recurrence rate of missed or residual polyp after CFP by performing follow-up colonoscopy 1 year later.
Methods
We included patients with up to 5 adenomas removed at initial colonoscopy and analyzed data from a total of 361 patients with 573 adenomas. One-year follow-up colonoscopy was performed in 165 patients, at which 251 lesions were confirmed.
Results
The one-bite resection rate with CFP was highest for lesions 3 mm or smaller and decreased significantly with increasing lesion size. Post-procedural hemorrhage was observed in 1 of 573 lesions (0.17%). No perforation was noted. The definite recurrence rate was 0.8% (2/251 lesions). The probable recurrence rate, which was defined as recurrence in the same colorectal segment, was 17%. Adenoma-free colon was achieved in 55% of patients at initial resection. Multivariate analysis revealed that achievement of an adenoma-free colon was significantly associated with number of adenomas and years of endoscopic experience.
Conclusions
CFP using jumbo biopsy forceps was safe and showed a high one-bite resection rate for diminutive lesions of 3 mm or smaller. The low definite recurrence rate confirms the reliability of CFP using jumbo biopsy forceps. Number of adenomas and years of endoscopic experience were key factors in achieving an adenoma-free colon.

Citations

Citations to this article as recorded by

Behind the Ink: Unmasking Asymptomatic Micro-perforations Following Endoscopic Tattooing
Woo Suk Kim, Tasur Seen, Joel Baum, Aaron Walfish
Cureus.2025;[Epub] CrossRef
Polypectomy for Diminutive and Small Colorectal Polyps
Melissa Zarandi-Nowroozi, Roupen Djinbachian, Daniel von Renteln
Gastrointestinal Endoscopy Clinics of North America.2022; 32(2): 241. CrossRef
Cold Snare Resection of Colorectal Polyps: Updates and Recent Developments
Roupen Djinbachian, Daniel von Renteln
Current Treatment Options in Gastroenterology.2022; 20(3): 221. CrossRef
Prospective multicenter study of the efficacy and safety of cold forceps polypectomy for ≤ 6-mm non-ampullary duodenal low-grade adenomas
Hiromitsu Kanzaki, Joichiro Horii, Ryuta Takenaka, Hiroyuki Nakagawa, Kazuhiro Matsueda, Takao Tsuzuki, Masahide Kita, Yasushi Yamasaki, Takehiro Tanaka, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Jun Tomoda, Hiroyuki Okada
Endoscopy International Open.2022; 10(06): E712. CrossRef
Endoscopic resection of local recurrences of diminutive polyps by cold forceps polypectomy
Toshio Kuwai, Takuya Yamada, Tatsuya Toyokawa, Tomohiro Kudo, Naoki Esaka, Hajime Ohta, Haruhiro Yamashita, Yasuo Hosoda, Noriko Watanabe, Naohiko Harada
Scandinavian Journal of Gastroenterology.2021; 56(3): 363. CrossRef
How to Approach Small Polyps in Colon: Tips and Tricks
Sultan Mahmood, Enrik John Aguila, Asad ur Rahman, Asim Shuja, Steven Bollipo
Techniques and Innovations in Gastrointestinal Endoscopy.2021; 23(4): 328. CrossRef
Risk factors for incomplete polyp resection during colonoscopy
Weifeng Lao, Pankaj Prasoon, Gaoyang Cao, Lian Tat Tan, Sheng Dai, Giridhar Hanumappa Devadasar, Xuefeng Huang
Laparoscopic, Endoscopic and Robotic Surgery.2021;[Epub] CrossRef
Rates of Incomplete Resection of 1- to 20-mm Colorectal Polyps: A Systematic Review and Meta-Analysis
Roupen Djinbachian, Ryma Iratni, Madeleine Durand, Paola Marques, Daniel von Renteln
Gastroenterology.2020; 159(3): 904. CrossRef
Child-Pugh B or C Cirrhosis Increases the Risk for Bleeding Following Colonoscopic Polypectomy
Hosim Soh, Jaeyoung Chun, Seung Wook Hong, Seona Park, Yun Bin Lee, Hyun Jung Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jong Pil Im, Yoon Jun Kim, Joo Sung Kim, Jung-Hwan Yoon
Gut and Liver.2020; 14(6): 755. CrossRef

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IBD

Usefulness of fecal calprotectin by monoclonal antibody testing in adult Japanese with inflammatory bowel diseases: a prospective multicenter study: Shiro Nakamura, Hirotsugu Imaeda, Hiroki Nishikawa, Masaki Iimuro, Minoru Matsuura, Hideo Oka, Junsuke Oku, Takako Miyazaki, Hirohito Honda, Kenji Watanabe, Hiroshi Nakase, Akira Andoh; Intest Res 2018;16(4):554-562. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00027

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Background/Aims
Noninvasive objective monitoring is advantageous for optimizing treatment strategies in patients inflammatory bowel disease (IBD). Fecal calprotectin (FCP) is superior to traditional biomarkers in terms of assessing the activity in patients with IBD. However, there are the differences among several FCP assays in the dynamics of FCP. In this prospective multicenter trial, we investigated the usefulness of fecal FCP measurements in adult Japanese patients with IBD by reliable enzyme immunoassay using a monoclonal antibody.
Methods
We assessed the relationship between FCP levels and disease or endoscopic activity in patients with ulcerative colitis (UC, n=64) or Crohn’s disease (CD, n=46) compared with healthy controls (HCs, n=64).
Results
FCP levels in UC patients strongly correlated with the Disease Activity Index (rs=0.676, P<0.0001) and Mayo endoscopic subscore (MES; rs=0.677, P<0.0001). FCP levels were significantly higher even in patients with inactive UC or CD compared with HCs (P=0.0068, P<0.0001). The optimal cutoff value between MES 1 and 2 exhibited higher sensitivity (94.1%). FCP levels were significantly higher in active UC patients than in inactive patients (P<0.001), except those with proctitis. The Crohn’s Disease Activity Index tended to correlate with the FCP level (rs=0.283, P=0.0565).
Conclusions
Our testing method using a monoclonal antibody for FCP was well-validated and differentiated IBD patients from HCs. FCP may be a useful biomarker for objective assessment of disease activity in adult Japanese IBD patients, especially those with UC.

Citations

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Combining mechanistic modeling with machine learning as a strategy to predict inflammatory bowel disease clinical scores
Jaehee V. Shim, Markus Rehberg, Britta Wagenhuber, Piet H. van der Graaf, Douglas W. Chung
Frontiers in Pharmacology.2025;[Epub] CrossRef
Treatment escalation and de-escalation decisions in Crohn’s disease: Delphi consensus recommendations from Japan, 2021
Hiroshi Nakase, Motohiro Esaki, Fumihito Hirai, Taku Kobayashi, Katsuyoshi Matsuoka, Minoru Matsuura, Makoto Naganuma, Masayuki Saruta, Kiichiro Tsuchiya, Motoi Uchino, Kenji Watanabe, Tadakazu Hisamatsu, Akira Andoh, Shigeki Bamba, Motohiro Esaki, Mikihi
Journal of Gastroenterology.2023; 58(4): 313. CrossRef
Mucosal concentrations of N‐acetyl‐5‐aminosalicylic acid related to endoscopic activity in ulcerative colitis patients with mesalamine
Tomohiro Fukuda, Makoto Naganuma, Kaoru Takabayashi, Yuya Hagihara, Shun Tanemoto, Ena Nomura, Yusuke Yoshimatsu, Shinya Sugimoto, Kosaku Nanki, Shinta Mizuno, Yohei Mikami, Kayoko Fukuhara, Tomohisa Sujino, Makoto Mutaguchi, Nagamu Inoue, Haruhiko Ogata,
Journal of Gastroenterology and Hepatology.2020; 35(11): 1878. CrossRef
Clinical management for small bowel of Crohn’s disease in the treat-to-target era: now is the time to optimize treatment based on the dominant lesion
Kenji Watanabe
Intestinal Research.2020; 18(4): 347. CrossRef

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Case Report

Endoscopy

Magnified single-balloon enteroscopy in the diagnosis of intestinal follicular lymphoma: a case series: Kenichiro Takahashi, Shigeki Bamba, Masahiro Kawahara, Atsushi Nishida, Osamu Inatomi, Masaya Sasaki, Tomoyuki Tsujikawa, Ryoji Kushima, Mitsushige Sugimoto, Katsuyuki Kitoh, Akira Andoh; Intest Res 2018;16(4):628-634. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00003

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The objective of this study was to evaluate the magnified endoscopic findings in the diagnosis of follicular lymphoma in the small intestine in comparison with those of intestinal follicular lymphoma and lymphangiectasia. Four patients with follicular lymphoma and 3 with lymphangiectasia in the small intestine were retrospectively analyzed. A prototype magnifying singleballoon enteroscope was used. The findings of the intestinal follicular lymphoma and lymphangiectasia were retrospectively analyzed to determine the magnified endoscopic findings of follicular lymphoma in the small intestine. Opaque white granules were observed in 3 of the 4 patients with follicular lymphoma. Magnified narrow-band imaging (NBI) of the opaque white granules showed stretched microvessels, which had a diminutive tree-like appearance. The remaining patient had no opaque white granules and only displayed whitish villi. Magnified NBI observation of the whitish villi revealed the absence of marginal villus epithelium, which was confirmed by histology. The magnified NBI enteroscopy revealed the diminutive tree-like appearance on the opaque white granules and the absence of marginal villus epithelium of the whitish villi in intestinal follicular lymphoma. These findings may be useful in diagnosing follicular lymphoma.

Citations

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A case of intestinal T‐cell lymphoma, not otherwise specified, that showed characteristic findings by magnified endoscopy combined with narrow‐band imaging
Yuki Hirose, Satoshi Saito, Takanori Nishiguchi, Dai Yamazaki, Tsubasa Tateishi, Yuuichi Saito, Yukiko Komeno, Makoto Kodama, Shiho Iwamoto, Masayuki Fukata, Minako Sako
DEN Open.2024;[Epub] CrossRef
Discordance Rate and Risk Factor of Other Diagnostic Modalities for Small Bowel Tumors Detected by Device-Assisted Enteroscopy: A Korean Association for the Study of Intestinal Disease (KASID) Multicenter Study
Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong-Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon
Gut and Liver.2024; 18(4): 686. CrossRef
Predictive factors for the progression of primary localized stage small-bowel follicular lymphoma
Akihiko Sumioka, Shiro Oka, Issei Hirata, Sumio Iio, Akiyoshi Tsuboi, Hidehiko Takigawa, Ryo Yuge, Yuji Urabe, Kazuki Boda, Tomohiko Kohno, Hideharu Okanobu, Yasuhiko Kitadai, Koji Arihiro, Shinji Tanaka
Journal of Gastroenterology.2022; 57(9): 667. CrossRef

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Brief Communication

IBD

Effect of elemental diet combined with infliximab dose escalation in patients with Crohn's disease with loss of response to infliximab: CERISIER trial: Tadakazu Hisamatsu, Reiko Kunisaki, Shiro Nakamura, Tomoyuki Tsujikawa, Fumihito Hirai, Hiroshi Nakase, Kenji Watanabe, Kaoru Yokoyama, Masakazu Nagahori, Takanori Kanai, Makoto Naganuma, Hirofumi Michimae, Akira Andoh, Akihiro Yamada, Tadashi Yokoyama, Noriko Kamata, Shinji Tanaka, Yasuo Suzuki, Toshifumi Hibi, Mamoru Watanabe; Intest Res 2018;16(3):494-498. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.494

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Citations

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Frontiers in Nutrition.2025;[Epub] CrossRef
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Original Article

IBD

Trough level of infliximab is useful for assessing mucosal healing in Crohn's disease: a prospective cohort study: Akihiro Koga, Toshiyuki Matsui, Noritaka Takatsu, Yasumichi Takada, Masahiro Kishi, Yutaka Yano, Takahiro Beppu, Yoichiro Ono, Kazeo Ninomiya, Fumihito Hirai, Takashi Nagahama, Takashi Hisabe, Yasuhiro Takaki, Kenshi Yao, Hirotsugu Imaeda, Akira Andoh; Intest Res 2018;16(2):223-232. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.223

Abstract PDF Supplementary Material PubReader ePub

<b>Background/Aims</b><br/>

Decreased trough levels of infliximab (TLI) and antibodies to infliximab (ATI) are associated with loss of response (LOR) in Crohn's disease. Two prospective studies were conducted to determine whether TLI or ATI better correlates with LOR (Study 1), and whether TLI could become a predictor of mucosal healing (MH) (Study 2).

Methods

Study 1 was conducted in 108 patients, including those with LOR and remission to compare ATI and TLI in discriminating the 2 conditions based on receiver operating characteristic (ROC) curve analyses. Study 2 involved 35 patients who were evaluated endoscopically.

Results

In Study 1, there were no differences between the 2 assays in ROC curve analyses; the TLI cutoff value for LOR was 2.6 µg/mL (sensitivity, 70.9%; specificity, 79.2%), and the ATI cutoff value was 4.9 µg/mL (sensitivity, 65.5%; specificity, 67.9%). The AUROC (area under the ROC curve) of TLI was greater than that of ATI. AUROC was useful for discriminating between the 2 conditions. In Study 2, the TLI was significantly higher in the colonic MH group than in the non-MH group (2.7 µg/mL vs. 0.5 µg/mL, P=0.032).

Conclusions

TLI is better than ATI for clinically diagnosing LOR, and a correlation was observed between TLI and colonic MH.

Citations

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Statement

IBD

Predicting outcomes to optimize disease management in inflammatory bowel disease in Japan: their differences and similarities to Western countries: Taku Kobayashi, Tadakazu Hisamatsu, Yasuo Suzuki, Haruhiko Ogata, Akira Andoh, Toshimitsu Araki, Ryota Hokari, Hideki Iijima, Hiroki Ikeuchi, Yoh Ishiguro, Shingo Kato, Reiko Kunisaki, Takayuki Matsumoto, Satoshi Motoya, Masakazu Nagahori, Shiro Nakamura, Hiroshi Nakase, Tomoyuki Tsujikawa, Makoto Sasaki, Kaoru Yokoyama, Naoki Yoshimura, Kenji Watanabe, Miiko Katafuchi, Mamoru Watanabe, Toshifumi Hibi; Intest Res 2018;16(2):168-177. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.168

Abstract PDF PubReader ePub

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disease of the gastrointestinal tract, with increasing prevalence worldwide. IBD Ahead is an international educational program that aims to explore questions commonly raised by clinicians about various areas of IBD care and to consolidate available published evidence and expert opinion into a consensus for the optimization of IBD management. Given differences in the epidemiology, clinical and genetic characteristics, management, and prognosis of IBD between patients in Japan and the rest of the world, this statement was formulated as the result of literature reviews and discussions among Japanese experts as part of the IBD Ahead program to consolidate statements of factors for disease prognosis in IBD. Evidence levels were assigned to summary statements in the following categories: disease progression in CD and UC; surgery, hospitalization, intestinal failure, and permanent stoma in CD; acute severe UC; colectomy in UC; and colorectal carcinoma and dysplasia in IBD. The goal is that this statement can aid in the optimization of the treatment strategy for Japanese patients with IBD and help identify high-risk patients that require early intervention, to provide a better long-term prognosis in these patients.

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Special Review

IBD

Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: risk assessment: Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin-Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasuo Suzuki, Kentaro Sugano, Mamoru Watanabe, Toshifumi Hibi, Amarender S. Puri, Suk-Kyun Yang; Intest Res 2018;16(1):4-16. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.4

Abstract PDF PubReader ePub

Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 1 of the statements comprised 2 parts: risk of TB infection Recommendaduring anti-TNF therapy, and screening for TB infection prior to commencing anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.

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Special Review: Consensus on TB in IBD

IBD

Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 2: management: Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin-Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasuo Suzuki, Kentaro Sugano, Mamoru Watanabe, Toshifumi Hibi, Amarender S. Puri, Suk-Kyun Yang; Intest Res 2018;16(1):17-25. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.17

Abstract PDF PubReader ePub

Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 2 of the statements comprised 3 parts: management of latent TB in preparation for anti-TNF therapy, monitoring during anti-TNF therapy, and management of an active TB infection after anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.

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