• Crohn’s disease
• IL-23 inhibitors
• guselkumab
• inflammatory bowel disease
• mirikizumab
• risankizumab

• 503/1-002-01/503-11-001 Medical University of Lodz, Poland to Ewa Malecka-Wojciesko and Polish Society for Digestive Tract Neoplasms Prevention

• CDAI score prediction
• endoscopic score prediction
• inflammatory bowel disease (IBD)
• machine learning
• mayo score prediction
• quantitative systems pharmacology (QSP) model

• Anxiety
• Brain perfusion
• Crohn’s disease
• Diffusion magnetic resonance imaging
• Healthy controls
• Prospective comparative study

• Humans
• Crohn Disease/psychology
• Crohn Disease/complications
• Crohn Disease/diagnostic imaging
• Crohn Disease/pathology
• Male
• Female
• Prospective Studies
• Adult
• Anxiety/etiology
• Anxiety/diagnostic imaging
• Anxiety/epidemiology
• Brain/diagnostic imaging
• Brain/blood supply
• Brain/pathology
• Cerebrovascular Circulation/physiology
• Middle Aged
• Case-Control Studies
• Young Adult
• Diffusion Magnetic Resonance Imaging

• Computed tomography
• Crohn’s Disease
• Diagnostic imaging
• Endoscopy
• Ultrasonography

• Humans
• Crohn Disease/diagnostic imaging
• Male
• Female
• Adult
• Severity of Illness Index
• Multidetector Computed Tomography/methods
• Middle Aged
• Sensitivity and Specificity
• Ultrasonography/methods
• Young Adult
• Ultrasonography, Doppler, Color

• disease activity
• fecal calprotectin
• fibroblast growth factors
• inflammatory bowel disease
• malnutrition

• Crohn’s disease
• magnesium
• micronutrients
• nutritional supplementation

• Humans
• Crohn Disease/blood
• Crohn Disease/drug therapy
• Magnesium/blood
• Magnesium/administration & dosage
• Dietary Supplements
• Female
• Remission Induction
• Male
• Adult
• Magnesium Deficiency/blood
• Magnesium Deficiency/complications
• Magnesium Deficiency/drug therapy

• microbiology
• biomarkers
• gastroenterology

• Humans
• Crohn Disease/pathology
• Dysbiosis/microbiology
• RNA, Ribosomal, 16S/genetics
• Gastrointestinal Microbiome/genetics
• Microbiota
• Inflammation
• Biomarkers
• Antibodies, Monoclonal
• Leukocyte L1 Antigen Complex

• Zayed Bin Sultan Charitable and Humanitarian Foundation (ZCHF) grant, United Arab Emirates University, UAE

• Crohn’s disease
• Diffusion-weighted imaging
• Magnetic resonance imaging
• Meta-analysis

• Humans
• Crohn Disease/diagnostic imaging
• Prospective Studies
• Diffusion Magnetic Resonance Imaging
• Intestines
• Inflammation/diagnostic imaging

• Universitätsklinikum Magdeburg (8973)

• Content validity
• Crohn’s disease
• Instrument development
• Patient-reported outcomes
• Symptoms

Crohn’s disease (CD) is a chronic inflammatory bowel disease that affects a wide age range. Hence, CD patients receive a variety of drugs over their life beyond those used for CD itself. The changes to the integrity of the intestine and its drug metabolising enzymes and transporters (DMETs) can alter the oral bioavailability of drugs. However, there are other changes in systems parameters determining the fate of drugs in CD, and understanding these is essential for dose adjustment in patients with CD.

The current analysis gathered all the available clinical data on the kinetics of drugs in CD (by March 2021), focusing on orally administered small molecule drugs. A meta-analysis of the systems parameters affecting oral drug pharmacokinetics was conducted. The systems information gathered on intestine, liver and blood proteins and other physiological parameters was incorporated into a physiologically based pharmacokinetic (PBPK) platform to create a virtual population of CD patients, with a view for guiding dose adjustment in the absence of clinical data in CD.

There were no uniform trends in the reported changes in reported oral bioavailability. The nature of the drug as well as the formulation affected the direction and magnitude of variation in kinetics in CD patients relative to healthy volunteers. Even for the same drug, the reported changes in exposure varied, possibly due to a lack of distinction between the activity states of CD. The highest alteration was seen with S-verapamil and midazolam, 8.7- and 5.3-fold greater exposure, respectively, in active CD patients relative to healthy volunteers. Only one report was available on liver DMETs in CD, and indicated reduced CYP3A4 activity. In a number of reports, mRNA expression of DMETs in the ileum and colon of CD patients was measured, focussing on P-glycoprotein (p-gp) transporter and CYP3A4 enzyme, and showed contradictory results. No data were available on protein expression in duodenum and jejunum despite their dominant role in oral drug absorption.

There are currently inadequate dedicated clinical or quantitative proteomic studies in CD to enable predictive PBPK models with high confidence and adequate verification. The PBPK models for CD with the available systems parameters were able to capture the major physiological influencers and the gaps to be filled by future research. Quantification of DMETs in the intestine and the liver in CD is warranted, alongside well-defined clinical drug disposition studies with a number of index drugs as biomarkers of changes in DMETs in these patients, to avoid large-scale dedicated studies for every drug to determine the effects of disease on the drug’s metabolism and disposition and the consequential safety and therapeutic concerns.

The online version contains supplementary material available at 10.1007/s40262-022-01169-4.

• Contrast Media
• Crohn Disease/diagnostic imaging
• Humans
• Intestinal Diseases
• Iodine
• Tomography, X-Ray Computed/methods

• Agreement
• Colonoscopy
• Computed tomography enterography
• Crohn disease
• Magnetic resonance enterography

• Adult
• Crohn Disease/diagnostic imaging
• Crohn Disease/pathology
• Humans
• Magnetic Resonance Imaging/methods
• Prognosis
• Radiology
• Recurrence
• Retrospective Studies

To investigate the effect of sequential Helicobacter pylori eradication therapy on serum osteoprotegerin levels in patients with H. pylori infection and co-existing inflammatory bowel disease (IBD).

Three groups of patients were involved in this observational cross-sectional study: IBD (n = 83), H. pylori infection (HP, n = 68), and H. pylori infection with co-existing IBD (HP + IBD, n = 52). These groups were compared with a normal control group (NC, n = 50). Serum osteoprotegerin, serum bone alkaline phosphatase (BALP), and fecal calprotectin (FC) levels were measured.

Serum osteoprotegerin levels were significantly correlated with the simple endoscopic score for Crohn’s disease and Mayo score for ulcerative colitis. The receiver operating characteristic analysis of osteoprotegerin revealed high values for the area under the curve, sensitivity, and specificity. Discriminant analysis illustrated that osteoprotegerin levels significantly differentiated patients with IBD from healthy controls. Osteoprotegerin and FC levels distinguished the IBD and HP + IBD groups from the NC and HP groups.

Sequential eradication therapy did not affect serum osteoprotegerin levels in patients with H. pylori infection and co-existing IBD. Serum osteoprotegerin elevation might be a marker for IBD development in patients with past or current H. pylori infection.

• Eradication
• Helicobacter pylori
• bone alkaline phosphatase
• fecal calprotectin
• inflammatory bowel disease
• osteoprotegerin

• H3R8 asymmetric demethylation
• PRMT2
• SOCS3
• TRAF5
• colitis

• Crohn's disease
• Inflammatory bowel disease
• Multi-state model
• Panel data
• Ulcerative colitis

• Inflammatory bowel diseases
• Kazakhstan
• Prevalence

• inflammatory bowel disease
• malnutrition
• nutrition
• time of remission

• IBD
• IBD clinical

Adropin is a novel peptide mostly associated with energy homeostasis and vascular protection. To our knowledge, there are no studies that investigated its relationship with inflammatory bowel diseases (IBD). The aim of this study was to compare serum adropin levels between 55 patients with IBD (30 Ulcerative colitis (UC) patients, 25 Crohn’s disease (CD) patients) and 50 age/gender matched controls. Furthermore, we explored adropin correlations with IBD severity scores, hsCRP, fecal calprotectin, fasting glucose and insulin levels. Serum adropin levels were significantly lower in patients with IBD in comparison with the control group (2.89 ± 0.94 vs 3.37 ± 0.60 ng/mL, P = 0.002), while there was no significant difference in comparison of UC patients with CD patients (P = 0.585). Furthermore, there was a negative correlation between adropin and fecal calprotectin (r = −0.303, P = 0.025), whereas in the total study population, we found a significant negative correlation with fasting glucose levels (r = −0.222, P = 0.023). A multivariable logistic regression showed that serum adropin was a significant predictor of positive IBD status when enumerated along with baseline characteristics (OR 0.455, 95% CI 0.251–0.823, P = 0.009). Our findings imply that adropin could be involved in complex pathophysiology of IBD, but further larger scale studies are needed to address these findings.

• Adult
• Antibodies, Monoclonal/adverse effects
• Antibodies, Monoclonal/therapeutic use
• Biosimilar Pharmaceuticals/adverse effects
• Biosimilar Pharmaceuticals/therapeutic use
• Crohn Disease/drug therapy
• Double-Blind Method
• Drug Substitution
• Female
• Gastrointestinal Agents/adverse effects
• Gastrointestinal Agents/therapeutic use
• Humans
• Infliximab/adverse effects
• Infliximab/therapeutic use
• Male
• Middle Aged
• Severity of Illness Index
• Treatment Outcome
• Young Adult

• Adalimumab
• Anti-IL12/23
• Anti-TNFα
• Anti-integrin
• Certolizumab pegol
• Crohn’s disease inflammatory bowel disease
• Infliximab
• Natalizumab
• Ustekinumab
• Vedolizumab

• Antibodies, Monoclonal/therapeutic use
• Biological Products/therapeutic use
• Critical Pathways
• Crohn Disease/drug therapy
• Crohn Disease/surgery
• Humans
• Risk Factors
• Tumor Necrosis Factor-alpha/antagonists & inhibitors

• TL1 TR002388 NCATS NIH HHS

A case is reported of innocuous intestinal obstruction requiring surgical intervention that was confirmed to be Crohn’s disease histopathologically in a resource-constrained rural mission hospital in Cameroon.

A 70-year man of Kumbo origin from Northwest region of Cameroon with a history of crampy right lower-quadrant abdominal pain, non-bloody, non-mucoid diarrhea alternating with constipation presented to my institution. Abdominal examination of the patient revealed an ill-defined mass in the right iliac fossa and visible peristalsis. An abdominal computed tomographic scan and barium enema study confirmed a complex ascending colonic and cecal tumor. The patient underwent exploratory laparotomy. The intraoperative finding was a huge complex inflammatory mass involving the cecum, terminal ileum, and sigmoid colon. He subsequently had sigmoidectomy with end–to-end sigmoidorectal anastomosis and a cecal resection, and the proximal ascending colon was exteriorized because end mucoid fistula and terminal ileostomy were performed. The histopathological diagnosis confirmed Crohn’s disease. The patient subsequently received five courses of adjuvant chemotherapy consisting of azathioprine, methotrexate, mesalamine, and methylprednisolone. He had complete disease remission and subsequently had closure of ileostomy with satisfactory postoperative status. The most recent follow-up abdominal computed tomographic scan and colonoscopy revealed disease-free status. The patient is also currently receiving a maintenance dose of rectal mesalamine and oral omeprazole treatment. He has been followed every 2 months in the surgical outpatient clinic over the last 16 months with satisfactory clinical outcome.

Crohn’s disease is uncommon in Africa, and this entity is encountered sparingly. The signs and symptoms of Crohn’s disease overlap with many other abdominal disorders, such as tuberculosis, ulcerative colitis, irritable bowel syndrome, and others. Several publications in the literature describe that it is difficult to make an accurate diagnosis of this disease, despite the fact that many diagnostic armamentaria are available to suggest its presence. Most of the patients with Crohn’s disease are treated conservatively, and a few may require surgical intervention, especially those presenting with complications such as intestinal obstruction, perforations, and abscess as well as fistula formations, as seen in this index patient. Crohn’s disease is considered by many to be a very rare disease in Africa. It is interesting to know that Crohn’s disease, which affects mainly young adults, may debut at any age. The rarity and clinical curiosity of this entity suggested reporting of my patient’s case. Evidence-based up-to-date information on Crohn’s disease is also documented.

• Autoimmune disorder
• Crohn’s disease
• Granulomatous colitis
• Regional enteritis

• CT-enterography
• Crohn’s disease
• Endoscopy
• Inflammatory bowel disease
• Prognosis
• Recurrence

• Biologicals
• Crohn’s disease
• biosimilars
• discrete choice experiment
• preference

• Adult
• Aged
• Antibodies, Monoclonal/economics
• Antibodies, Monoclonal/therapeutic use
• Biosimilar Pharmaceuticals/economics
• Biosimilar Pharmaceuticals/therapeutic use
• Choice Behavior
• Crohn Disease/drug therapy
• Crohn Disease/economics
• Female
• Health Knowledge, Attitudes, Practice
• Humans
• Hungary
• Infliximab/economics
• Infliximab/therapeutic use
• Male
• Middle Aged
• Physicians
• Practice Patterns, Physicians'/statistics & numerical data
• Surveys and Questionnaires

Recently, it has been suggested an association between red cell distribution width (RDW) and Crohn's disease activity index (CDAI), but its use is not yet performed in daily clinical practice.

To determine whether RDW can be used as a marker of Crohn's disease (CD) activity.

This was a cross-sectional study including patients with CD, observed consecutively in an outpatient setting between January 1st and September 30th 2013. Blood cell indices, erythrocyte sedimentation rate (ESR), and C-reactive protein were measured. CD activity was determined by CDAI (active disease if CDAI ≥ 150). Associations were analyzed using logistic regression (SPSS version 20).

119 patients (56% female) were included in the study with a mean age of 47 years (SD 15.2). Twenty patients (17%) had active disease. The median RDW was 14.0 (13–15). There was an association between RDW and disease activity (p = 0.044). After adjustment for age and gender, this association remained consistent (OR 1.20, 95% CI 1.03–1.39, p = 0.016). It was also found that the association between RDW and disease activity was independent of hemoglobin and ESR (OR 1.36, 95% CI 1.08–1.72, p = 0.01) and of biologic therapy (OR 1.19, 95% CI 1.03–1.37, p = 0.017). A RDW cutoff of 16% had a specificity and negative predictive value for CDAI ≥ 150 of 88% and 86%, respectively.

In this study, RDW proved to be an independent and relatively specific marker of CD activity. These results may contribute to the implementation of this simple parameter, in clinical practice, aiming to help therapeutic decisions.

• Crohn Disease
• Erythrocyte Indices

• Biologics
• Breast-feeding
• Immunomodulatorsi
• Inflammatory bowel diseases
• Pregnancy

• disease activity
• endoscopy
• inflammatory bowel diseases
• magnetic resonance enterography

• Annual excHangE on the ADvances in Inflammatory Bowel Disease
• Biomarkers
• C-reactive protein
• CD
• CDAI
• CDEIS
• CRP
• CT
• Crohn's Disease Activity Index
• Crohn's Disease Endoscopic Index of Severity
• Crohn's disease
• Diagnosis
• Disease activity index
• Endoscopy
• GI
• HBI
• Harvey–Bradshaw Index
• IBD
• IBD Ahead
• IBDQ
• ISC
• Imaging
• Inflammatory Bowel Disease Questionnaire
• International Steering Committee
• MRI
• Monitoring
• QOL
• SBCE
• SBFT
• SES-CD
• Simple Endoscopic Score for Crohn's Disease
• TNF
• computed tomography
• gastrointestinal
• inflammatory bowel disease
• magnetic resonance imaging
• quality of life
• small-bowel capsule endoscopy
• small-bowel follow-through
• tumour necrosis factor

• (F)eNO
• (Fractional) exhaled nitric oxide
• Crohn's disease
• Disease activity marker
• Exhaled nitric oxide

• Adult
• C-Reactive Protein/metabolism
• Case-Control Studies
• Female
• Glutathione Peroxidase/metabolism
• Humans
• Inflammatory Bowel Diseases/enzymology
• Lipid Peroxidation
• Male
• Malondialdehyde/blood
• Middle Aged
• Oxidative Stress
• Prospective Studies
• Superoxide Dismutase/metabolism
• Young Adult

• crohn's disease
• doppler sonography
• inflammatory bowel diseases
• splanchnic hemodynamics

• Adolescent
• Adult
• Aged
• Aorta/diagnostic imaging
• Aorta/physiopathology
• Blood Flow Velocity/physiology
• Crohn Disease/diagnostic imaging
• Crohn Disease/physiopathology
• Epidemiologic Methods
• Female
• Hemodynamics
• Humans
• Irritable Bowel Syndrome/diagnostic imaging
• Irritable Bowel Syndrome/physiopathology
• Male
• Mesenteric Artery, Superior/diagnostic imaging
• Mesenteric Artery, Superior/physiopathology
• Middle Aged
• Predictive Value of Tests
• Pulsatile Flow
• Splanchnic Circulation/physiology
• Ultrasonography, Doppler, Color/methods
• Young Adult

Crohn's Disease may involve any part of GI tract leading to inflammation of all the layers of the affected bowel. The symptoms may mimc other intestinal pathologies and at times diagnosis remains a dilemma. Mostly medical therapy remains the mainstay of treatment. However surgical intervention is warranted in cases presenting with acute abdomen.

We present two such cases of acute abdomen admitted in our hospital and diagnosed as case of intestinal obstruction. Exploratory laparotomy was performed in both cases and diseased resected segments were confirmed as Crohn's Disease on histopathology.

Crohn's Disease should be kept as a differential diagnosis in patients presenting with acute abdomen especially with a long history of vague abdominal complaints.

• Crohn's disease
• gangrenous bowel
• obstruction
• stricture

• Crohn Disease/complications
• Crohn Disease/pathology
• Humans
• Intestines/pathology
• Magnetic Resonance Imaging/methods

Inflammatory Bowel Diseases (IBD) remain significant health problems in the US and worldwide. IBD is most often associated with eastern European ancestry, and is less frequently reported in other populations of African origin e.g. African Americans ('AAs'). Whether AAs represent an important population with IBD in the US remains unclear since few studies have investigated IBD in communities with a majority representation of AA patients. The Louisiana State University Health Sciences Center in Shreveport (LSUHSC-S) is a tertiary care medical center, with a patient base composed of 58% AA and 39% Caucasian (W), ideal for evaluating racial (AA vs. W) as well and gender (M vs. F) influences on IBD.

In this retrospective study, we evaluated 951 visits to LSUHSC-S for IBD (between 2000 to 2008) using non-identified patient information based on ICD-9 medical record coding (Crohn's disease 'CD'-555.0- 555.9 and ulcerative colitis 'UC'-556.0-556.9).

Overall, there were more cases of CD seen than UC. UC and CD affected similar ratios of AA and Caucasian males (M) and females (F) with a rank order of WF > WM > AAF > AAM. Interestingly, in CD, we found that annual visits per person was the highest in AA M (10.7 ± 1.7); significantly higher (* -p < 0.05) than in WM (6.3 ± 1.0). Further, in CD, the female to male (F: M) ratio in AA was significantly higher (*- p < 0.05) (1.9 ± 0.2) than in Caucasians (F:M = 1.3 ± 0.1) suggesting a female dominance in AACD; no differences were seen in UC F: M ratios.

Although Caucasians still represent the greatest fraction of IBD (~64%), AAs with IBD made up >1/3 (36.4%) of annual IBD cases from 2000-2008 at LSUHSC-S. Further studies on genetic and environments risks for IBD risk in AAs are needed to understand differences in presentation and progression in AAs and other 'non-traditional' populations.

An emerging parameter to define the effectiveness of new therapeutic agents in clinical trials, and by extension, for use in day-to-day clinical practice has been labeled mucosal healing. It has been hypothesized that complete healing of the intestinal mucosa in inflammatory bowel diseases should result in reduced disease complications, reduced hospitalization and reduced surgical treatment. By implication, the natural history of inflammatory bowel disease might then be altered. Measurement of mucosal healing, however, is largely observational, requiring repeated invasive endoscopic examinations, sometimes with mucosal biopsies. Other indirect imaging methods may play a role in this assessment along with other surrogate markers, including intestinal permeability. These measurements may have significant limitations that prohibit precise correlation with symptom-based disease activity indices in clinical trials. This likely reflects the dynamic nature of this evolving and individualized inflammatory process that tends to be focused, but not limited, to the mucosa of the intestinal tract.

• Intestinal mucosa
• Digestive system endoscopy
• Clinical trials