Intestinal Research

Original Articles

Anti-integrin αvβ6 autoantibody in patients with ulcerative colitis after proctocolectomy: a cross-sectional study in Japan: Tsuyoshi Yanagida, Yu Nishida, Yumie Kobayashi, Rieko Nakata, Shuhei Hosomi, Hirotsugu Maruyama, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Fumio Tanaka, Yasuhiro Fujiwara; Received October 22, 2024 Accepted February 18, 2025 Published online April 29, 2025; DOI: https://doi.org/10.5217/ir.2024.00170 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Pouchitis is a common complication in patients with ulcerative colitis (UC) following colectomy with ileal pouch-anal anastomosis (IPAA). Recent studies have identified a novel autoantibody against integrin αvβ6 in patients with UC, correlated with disease activity. This study aimed to assess the association between serum anti-integrin αvβ6 antibody levels and pouch inflammation in patients with postoperative UC.
Methods
Serum anti-integrin αvβ6 antibodies were measured using enzyme-linked immunosorbent assay in patients after IPAA, patients with UC, and controls.
Results
We examined sera from 71 subjects, including 28 patients who underwent IPAA, 23 controls, and 20 patients with mild and moderate-to-severe UC. Post-IPAA, patients with UC had higher median anti-integrin αvβ6 levels than that of controls (P<0.001) but lower than that of patients with active UC (P=0.001). Patients with pouchitis had higher antibody levels than those without (P=0.047). The receiver operating characteristics curve for anti-integrin αvβ6 showed an area under the curve of 0.724. The pouchitis activity index endoscopic sub-score was correlated with antibody levels (r= 0.48, P=0.011).
Conclusions
Serum anti-integrin αvβ6 antibody levels remain elevated in patients with UC even after total colectomy, and were significantly higher in patients with pouchitis than in those without. This antibody could be a novel and useful biomarker for the diagnosis of pouchitis and assessment of disease activity.

Citations

Citations to this article as recorded by

Clinical Value of Anti-Integrin αvβ6 Antibody Serum-Level Measurement in Inflammatory Bowel Diseases
Dorottya Angyal, Fruzsina Balogh, Lorant Gonczi, Livia Lontai, Janos P. Kosa, Nora Garam, Peter L. Lakatos, Akos Ilias
Journal of Clinical Medicine.2026; 15(3): 948. CrossRef

2,663 View
328 Download
1 Web of Science
1 Crossref

IBD

Association of colonic metaplasia of goblet cells and endoscopic phenotypes of the J pouch in patients with ulcerative colitis: a retrospective pilot study: Shintaro Akiyama, Tsubasa Onoda, Shoko Moue, Noriaki Sakamoto, Taku Sakamoto, Hideo Suzuki, Tsuyoshi Enomoto, Daisuke Matsubara, Tatsuya Oda, Kiichiro Tsuchiya; Intest Res 2024;22(1):92-103. Published online January 29, 2024; DOI: https://doi.org/10.5217/ir.2023.00105

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Mucosal adaptation of the ileum toward colonic epithelium has been reported in pouchitis in ulcerative colitis (UC); however, the clinical characteristics, endoscopic findings, and outcomes in patients with pouchitis with ileal mucosal adaptation are poorly understood.
Methods
This was a single-center retrospective study comprising UC patients treated by proctocolectomy with ileal pouch-anal anastomosis who had undergone pouchoscopy at the University of Tsukuba Hospital between 2005 and 2022. Endoscopic phenotypes were evaluated according to the Chicago classification. High-iron diamine staining (HID) was performed to identify sulfomucin (colon-type mucin)-producing goblet cells (GCs) in pouch biopsies. We compared clinical data between patients with (high HID group) and without > 10% sulfomucin-producing GCs in at least one biopsy (low HID group).
Results
We reviewed 390 endoscopic examination reports from 50 patients. Focal inflammation was the most common phenotype (78%). Five patients (10%) required diverting ileostomy. Diffuse inflammation and fistula were significant risk factors for diverting ileostomy. The median proportion of sulfomucin-producing GCs on histological analysis of 82 pouch biopsies from 23 patients was 9.9% (range, 0%–93%). The duration of disease was significantly greater in the high HID group compared to the low HID group. The median percentage of sulfomucin-producing GCs was significantly higher in patients with diffuse inflammation or fistula compared to other endoscopic phenotypes (14% vs. 6.0%, P= 0.011).
Conclusions
Greater proportions of sulfomucin-producing GCs were observed in endoscopic phenotypes associated with poor outcomes in UC, indicating patients with pouchitis showing colonic metaplasia of GCs may benefit from early interventions.

Citations

Citations to this article as recorded by

Endoscopic assessment of the J pouch in ulcerative colitis: A narrative review
Shintaro Akiyama, Edward L Barnes, Tsubasa Onoda, Naoki Ishikawa, Mamiko Shiroyama, Yuka Ito, David T Rubin, Kiichiro Tsuchiya
DEN Open.2025;[Epub] CrossRef
Prevalence and predictability of the Chicago Classification of Pouchitis in ulcerative colitis: a multicenter study in Japan
Shintaro Akiyama, Ryohei Hayashi, Takeshi Takasago, Kurando Kusunoki, Hiroki Ikeuchi, Kento Takenaka, Kazuhiro Watanabe, Kazutaka Koganei, Nobuhiro Ueno, Mikihiro Fujiya, Naoki Hosoe, Fumikazu Koyama, Yasuhisa Sakata, Motohiro Esaki, Ken Takeuchi, Makoto
Journal of Gastroenterology.2025; 60(6): 715. CrossRef
Advancements in understanding the relationship between Akkermansia muciniphila and the development of ulcerative colitis
Nie Xu, Xiaoping Xiao, Ying Ma, Jing Jing, ShiCheng Jiang, KeYong Luo, Ying Li, Miao Duan
Frontiers in Pediatrics.2025;[Epub] CrossRef
A Comparative Analysis of Clinical Symptoms and Modified Pouchitis Disease Activity Index Among Endoscopic Phenotypes of the J Pouch in Patients With Inflammatory Bowel Disease
Shintaro Akiyama, Nathaniel A Cohen, Jacob E Ollech, Cindy Traboulsi, Tina Rodriguez, Victoria Rai, Laura R Glick, Yangtian Yi, Joseph Runde, Russell D Cohen, Kinga B Skowron, Roger D Hurst, Konstantin Umanskiy, Benjamin D Shogan, Neil H Hyman, Michele A
Crohn's & Colitis 360.2024;[Epub] CrossRef

5,772 View
167 Download
4 Web of Science
4 Crossref

Review

IBD

Pouchitis in inflammatory bowel disease: a review of diagnosis, prognosis, and treatment: Shintaro Akiyama, Victoria Rai, David T. Rubin; Intest Res 2021;19(1):1-11. Published online November 5, 2020; DOI: https://doi.org/10.5217/ir.2020.00047

Abstract PDF PubReader ePub

Patients with inflammatory bowel disease (IBD) occasionally need a restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) because of medically refractory colitis or dysplasia/cancer. However, pouchitis may develop in up to 70% of patients after this procedure and significantly impair quality of life, more so if the inflammation becomes a chronic condition. About 10% of patients with IBD who develop pouchitis require pouch excision, and several risk factors of the failure have been reported. A phenotype that has features similar to Crohn’s disease may develop in a subset of ulcerative colitis patients following proctocolectomy with IPAA and is the most frequent reason for pouch failure. In this review, we discuss the diagnosis and prognosis of pouchitis, risk factors for pouchitis development, and treatment options for pouchitis, including the newer biological agents.

Citations

Citations to this article as recorded by

Research Communication: Comparative Effectiveness of Ustekinumab and Vedolizumab in the Management of Chronic Pouchitis—A Population‐Based Study
Saqr Alsakarneh, June Tome, Francis A. Farraye, Darrell S. Pardi
Alimentary Pharmacology & Therapeutics.2026; 63(3): 424. CrossRef
Research Progress in Gut Microbiota Modulation for the Treatment of Pouchitis Following Ileal Pouch-Anal Anastomosis in Ulcerative Colitis
兴宗黄
Advances in Clinical Medicine.2026; 16(02): 1360. CrossRef
Endoscopic assessment of the J pouch in ulcerative colitis: A narrative review
Shintaro Akiyama, Edward L Barnes, Tsubasa Onoda, Naoki Ishikawa, Mamiko Shiroyama, Yuka Ito, David T Rubin, Kiichiro Tsuchiya
DEN Open.2025;[Epub] CrossRef
Crohn's-like Ileal Pouch Illness and Ileal Pouch Salvage Strategies
Alex L. Huang, Marnie Abeshouse, Katherine C. Lee, Emily Rinebold, Maia Kayal, Michael C. Plietz
Clinics in Colon and Rectal Surgery.2025; 38(02): 160. CrossRef
Treatment of Chronic Pouchitis With JAK Inhibitors: Results from A Large Multicenter Database
Saqr Alsakarneh, Aakash Desai, Gursimran S Kochhar, Francis A Farraye, Jana G Hashash
Inflammatory Bowel Diseases.2025; 31(2): 597. CrossRef
Endoscopic Normalization and Transition of J-Pouch Phenotypes Over Time in Patients With Inflammatory Bowel Disease
Shintaro Akiyama, Jacob E Ollech, Nathaniel A Cohen, Cindy Traboulsi, Victoria Rai, Laura R Glick, Yangtian Yi, Joseph Runde, Russell D Cohen, Kinga B Skowron Olortegui, Roger D Hurst, Konstantin Umanskiy, Benjamin D Shogan, Neil H Hyman, Michele A Rubin,
Inflammatory Bowel Diseases.2025; 31(1): 63. CrossRef
Ileoanal Pouch–Related Fistulas: A Narrative Review
Sergio Bronze, Maia Kayal, Maria Manuela Estevinho, Sue Hahn, Sergey Khaitov, Jean-Frederic Colombel, Serre-Yu Wong
Inflammatory Bowel Diseases.2025; 31(6): 1716. CrossRef
Efficacy and Safety of Janus Kinase Inhibitors in Chronic Inflammatory Pouch Conditions: A Systematic Review and Meta-analysis
Saqr Alsakarneh, Fouad Jaber, Sandesh Parajuli, Yazan Abboud, Mohamed Abuelazm, Jana G. Hashash
American Journal of Therapeutics.2025; 32(2): e164. CrossRef
In Vitro Preliminary Evaluation of a New Rifamycin In Situ Gelling Formulation for Pouchitis Treatment
Caterina Aiello, Cinzia Quattrocchi, Rosario Musumeci, Daria Nicolosi, Giulio Petronio Petronio, Roberto Di Marco
Microbiology Research.2025; 16(2): 44. CrossRef
Pouchitis unveiled: exploring clinical features, diagnosis, and cutting-edge treatments
Francesca Lusetti, Camilla Almeida Martins Helfenberger, Munique Kurtz de Mello, Natália Sousa Freitas Queiroz
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Risk factors associated with the development of chronic pouchitis following ileal-pouch anal anastomosis surgery for ulcerative colitis
Emi Khoo, Robert Gilmore, Alison Griffin, Gerald Holtmann, Jakob Begun
World Journal of Meta-Analysis.2025;[Epub] CrossRef
Prevalence and predictability of the Chicago Classification of Pouchitis in ulcerative colitis: a multicenter study in Japan
Shintaro Akiyama, Ryohei Hayashi, Takeshi Takasago, Kurando Kusunoki, Hiroki Ikeuchi, Kento Takenaka, Kazuhiro Watanabe, Kazutaka Koganei, Nobuhiro Ueno, Mikihiro Fujiya, Naoki Hosoe, Fumikazu Koyama, Yasuhisa Sakata, Motohiro Esaki, Ken Takeuchi, Makoto
Journal of Gastroenterology.2025; 60(6): 715. CrossRef
Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative Colitis
Ji Eun Baek, Jung-Bin Park, June Hwa Bae, Min Hyun Kim, Seung Wook Hong, Sung Wook Hwang, Jong Lyul Lee, Yong Sik Yoon, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Chang Sik Yu, Suk-Kyun Yang, Sang Hyoung Park
Gut and Liver.2025; 19(3): 388. CrossRef
Galectin-3—Insights from Inflammatory Bowel Disease and Primary Sclerosing Cholangitis
Thomas Grewal, Hauke Christian Tews, Christa Buechler
International Journal of Molecular Sciences.2025; 26(13): 6101. CrossRef
Efficacy and Safety of Ustekinumab and Vedolizumab for Crohn’s Disease of the Pouch
Sunhee Park, Kian Keyashian, Andrew Ho, David Limsui, Spencer Frost, Raul Vazquez, Eleanor Yang, Joseph Ebriani, Laura Maas, Alyssa Parian, Mark Lazarev, Nimisha Parekh, Jenny S Sauk, Berkeley Limketkai
Inflammatory Bowel Diseases.2025; 31(11): 3142. CrossRef
Exploring the role of tofacitinib in managing chronic pouchitis: A systematic review and meta-analysis
Archit Garg, Vishali Moond, Mehak Bassi, Aadhithyaraman Santharaman, Luisa Recinos-Arenas, Arkady Broder
Digestive and Liver Disease.2025; 57(12): 2279. CrossRef
A Systematic Approach to the Histologic Evaluation of Terminal Ileal Biopsies
Rifat Mannan, Sanjay A. Pai
International Journal of Surgical Pathology.2025;[Epub] CrossRef
Optimizing Janus kinase inhibitor therapy for ulcerative colitis: a real-world perspective
Shintaro Akiyama
Intestinal Research.2025;[Epub] CrossRef
Treatment of Antibiotic Refractory Chronic Pouchitis With JAK Inhibitors and S1P Receptor Modulators: An ECCO CONFER Multicentre Case Series
Davide Giuseppe Ribaldone, Giulia Testa, Bram Verstockt, Tamas Molnar, Edoardo Savarino, Carsten Schmidt, Sophie Vieujean, Niels Teich, Corina Meianu, Pascal Juillerat, Nathan Grellier, Triana Lobaton
Journal of Crohn's and Colitis.2024; 18(5): 720. CrossRef
Association of colonic metaplasia of goblet cells and endoscopic phenotypes of the J pouch in patients with ulcerative colitis: a retrospective pilot study
Shintaro Akiyama, Tsubasa Onoda, Shoko Moue, Noriaki Sakamoto, Taku Sakamoto, Hideo Suzuki, Tsuyoshi Enomoto, Daisuke Matsubara, Tatsuya Oda, Kiichiro Tsuchiya
Intestinal Research.2024; 22(1): 92. CrossRef
Diagnosis and Medical Treatment of Acute and Chronic Idiopathic Pouchitis in Inflammatory Bowel Disease
Corina Meianu, Tudor Stroie, Doina Istratescu, Carmen Monica Preda, Mihai Mircea Diculescu
Medicina.2024; 60(6): 979. CrossRef
Mucosal Single-Cell Profiling of Crohn’s-Like Disease of the Pouch Reveals Unique Pathogenesis and Therapeutic Targets
Siyan Cao, Khai M. Nguyen, Kaiming Ma, Xiaotang Du, Xiuli Liu, Alina Ulezko Antonova, Richard P. Rood, Anas Gremida, Chien-Huan Chen, Alexandra Gutierrez, Deborah C. Rubin, Martin H. Gregory, Mate Gergely, Guadalupe Oliva Escudero, Katherine Huang, Natali
Gastroenterology.2024; 167(7): 1399. CrossRef
A Comparative Analysis of Clinical Symptoms and Modified Pouchitis Disease Activity Index Among Endoscopic Phenotypes of the J Pouch in Patients With Inflammatory Bowel Disease
Shintaro Akiyama, Nathaniel A Cohen, Jacob E Ollech, Cindy Traboulsi, Tina Rodriguez, Victoria Rai, Laura R Glick, Yangtian Yi, Joseph Runde, Russell D Cohen, Kinga B Skowron, Roger D Hurst, Konstantin Umanskiy, Benjamin D Shogan, Neil H Hyman, Michele A
Crohn's & Colitis 360.2024;[Epub] CrossRef
Complicaciones asociadas al reservorio ileal en colitis ulcerativa versus poliposis familiar adenomatosa: Impacto en la calidad de vida del paciente
Rodrigo Castaño Llano, Sandra Patricia Molina Meneses, Juan Darío Puerta, René Marcelo Escobar, Santiago Salazar Ochoa, Juan Esteban Puerta, Manuel Barreiro-de Acosta
Gastroenterología y Hepatología.2023; 46(1): 39. CrossRef
Antibiotics in the pathogenesis of diabetes and inflammatory diseases of the gastrointestinal tract
Aline C. Fenneman, Melissa Weidner, Lea Ann Chen, Max Nieuwdorp, Martin J. Blaser
Nature Reviews Gastroenterology & Hepatology.2023; 20(2): 81. CrossRef
Treatment of Chronic Inflammatory Pouch Conditions With Tofacitinib: A Case Series From 2 Tertiary IBD Centers in the United States
Shintaro Akiyama, Nathaniel A Cohen, Maia Kayal, Marla C Dubinsky, Jean-Frederic Colombel, David T Rubin
Inflammatory Bowel Diseases.2023; 29(9): 1504. CrossRef
Ileal reservoir-associated complications in ulcerative colitis versus familial adenomatous polyposis: Impact on patient quality of life
Rodrigo Castaño Llano, Sandra Patricia Molina Meneses, Juan Darío Puerta, René Marcelo Escobar, Santiago Salazar Ochoa, Juan Esteban Puerta, Manuel Barreiro-de Acosta
Gastroenterología y Hepatología (English Edition).2023; 46(1): 39. CrossRef
Effectiveness and safety of tofacitinib in patients with chronic pouchitis multirefractory to biologics
Mathieu Uzzan, Maria Nachury, Aurélien Amiot, Laurent Peyrin-Biroulet, Julien Kirchgesner, Yoram Bouhnik
Digestive and Liver Disease.2023; 55(8): 1158. CrossRef
Prioritization in inflammatory bowel disease therapy
Klaus R. Herrlinger, Eduard F. Stange
Expert Review of Gastroenterology & Hepatology.2023; 17(8): 753. CrossRef
Cannabis Improves Clinical Outcomes and Quality of Life in Patients With Chronic Pouchitis
Timna Naftali, Lihi Bar-Lev Schleider, Hen Kayless, Zohar Bromberg, Iris Dotan, Efrat Broide
ACG Case Reports Journal.2023; 10(8): e01131. CrossRef
Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study
Ronaldo Paolo Panganiban, Alyssa Tuan, Maxwell Hart, Mathew Pelton, Daniella Mikhail, Sarah Akhtar, Kaleb Bogale, Susan Deiling, Shouhao Zhou, Mathew D Coates, Gregory S Yochum, Walter Koltun
Crohn's & Colitis 360.2023;[Epub] CrossRef
Endoscopy of the Ileal Pouch Anal Anastomosis
Athos Bousvaros, Jill M. Zalieckas, Lori Zimmerman
Journal of Pediatric Gastroenterology and Nutrition.2023; 77(6): 691. CrossRef
Sampling and Reporting of Inflammatory Bowel Disease
Ian S. Brown, Cheng Liu, Gregory C. Miller
Advances in Anatomic Pathology.2022; 29(1): 25. CrossRef
Time to Revisit Disease Classification in Inflammatory Bowel Disease: Is the Current Classification of Inflammatory Bowel Disease Good Enough for Optimal Clinical Management?
Bram Verstockt, Brian Bressler, Helena Martinez-Lozano, Dermot McGovern, Mark S. Silverberg
Gastroenterology.2022; 162(5): 1370. CrossRef
Histopathology of Colectomy Specimens Predicts Endoscopic Pouch Phenotype in Patients with Ulcerative Colitis
Shintaro Akiyama, Jacob E. Ollech, Cindy Traboulsi, Victoria Rai, Laura R. Glick, Yangtian Yi, Joseph Runde, Andrea D. Olivas, Christopher R. Weber, Russell D. Cohen, Kinga B. Skowron Olortegui, Roger D. Hurst, Konstantin Umanskiy, Benjamin D. Shogan, Mic
Digestive Diseases and Sciences.2022; 67(8): 4020. CrossRef
Network meta-analysis: efficacy of treatment for acute, chronic, and prevention of pouchitis in ulcerative colitis
Stephanie Poo, Danujan Sriranganathan, Jonathan P Segal
European Journal of Gastroenterology & Hepatology.2022; 34(5): 518. CrossRef
When pouches cannot empty: a cohort study of the symptoms this causes, the reasons it's happening, and the treatments needed
Emmeline Nugent, James M. Church
ANZ Journal of Surgery.2022; 92(12): 3237. CrossRef
Diagnostic and Management Considerations for the IPAA With Crohn’s Disease-Like Features
Shintaro Akiyama, Emma C. Dyer, David T. Rubin
Diseases of the Colon & Rectum.2022; 65(S1): S77. CrossRef
Ileal Pouch-Anal Anastomosis in the Older Adult: a Review of Postoperative Outcomes and Pouchitis Treatment
Sabrina L. Chen, Adam S. Faye, Shannon Chang
Current Treatment Options in Gastroenterology.2022; 20(4): 564. CrossRef
Recent Advance in the Management of Dysplasia in the Ulcerative Colitis
Dong-Hoon Yang
Journal of Digestive Cancer Reports.2021; 9(2): 50. CrossRef

16,947 View
496 Download
37 Web of Science
40 Crossref

First
Prev
Page of 1
Next
Last

Search