关键词： BDNF   Insomnia   psychosomatics   inflammatory bowel disease  

摘要： IntroductionBrain-derived neurotrophic factor (BDNF) plays an important role in depression and sleep disorders. It influences the inflammatory process and may affect the interactions between psychological state and gastrointestinal *** study aimed to compare BDNF concentrations in the group of Crohn’s disease (CD), ulcerative colitis (UC) patients, and healthy control (HC), as well as to correlate it with the severity of depression and insomnia.MethodsThe study included 94 inflammatory bowel disease patients (IBD, 57 CD, and 37 UC) and 26 HC. Each participant completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Athens insomnia scale (AIS), and Beck Depression Inventory (BDI). BDNF protein concertation measurements were performed using ELISA. Funding: National Science Centre, Poland-2018/31/N/NZ5/03715.ResultsCD patients had a higher serum level of BDNF (22.5 ng/mL, IQR:17.5-28.5) than UC patients (19.1 ng/mL, IQR:12.3-24.6; p=0.045). CD group had higher BDNF concentrations than HC (17.5 ng/mL, IQR:13.2-23.8; p=0.010), but no such differences were found between UC and HC groups (p=0.544). A positive correlation was found between AIS and BDNF among IBD (r=0.22, p=0.035). Additionally, patients, who obtained high BDI scores (>7 points) had lower BDNF concentrations than others (p=0.004). The patients with long sleep latency (>10 min) achieved a higher BDNF level than others (p=0.038). However. BDNF level did not correlate with PSQI results.ConclusionsBDNF serum level is increased in CD, but not in UC patients. Overall, the severity of insomnia symptoms correlates positively with BDNF levels. Future research should focus on the further explanation of those observations.

关键词： children   hypoglycaemia   inflammatory bowel disease   prevalence   type 1 diabetes  

摘要： Aim To determine the prevalence of inflammatory bowel disease (IBD) in patients with type 1 diabetes (T1D) and to characterise patients with both diseases. Methods Data of 65.147 patients with T1D <= 18 years of 379 centres in Germany and Austria participating in the DPV initiative were analysed. A total of 63 children had comorbid IBD;IBD prevalence was 0.1%. Regression models were used to analyse differences in metabolic control, acute complications and steroid intake. Results Mean BMI-SDS in patients with T1D and IBD was lower (-0.15 +/- 0.11) compared to patients with T1D only (0.27 +/- 0.00, p < .001). Patients with T1D and IBD had a significantly higher use of steroids (22% +/- 0.05% vs. 1% +/- 0.00, p < .001) and a significantly higher rate of severe hypoglycaemic events per patient year (0.33 +/- 0.07 vs. 0.16 +/- 0.00, p = .001). No differences were found in HbA1c levels, insulin dose and occurrence of DKA. Conclusion Although children and adolescents with T1D and IBD take steroids more often, they suffer from severe hypoglycaemia more frequently and have a lower BMI-SDS. These findings might be explained by chronic intestinal inflammation leading to malabsorption, malnutrition and increased severe hypoglycaemia.

关键词： COVID-19   inflammatory bowel disease   management   pandemic  

摘要： The coronavirus disease 2019 (COVID-19) outbreak emerged in December 2019 in China and rapidly spread worldwide. Inflammatory bowel disease (IBD) patients are likely to be more susceptible to viral infections, and this is significantly influenced by the type of therapy they receive. Thus, issues specifically concerning the medical treatment of IBD patients were shortly addressed at the beginning of the pandemic. However, recently available data on the occurrence and outcome of SARS-CoV-2 infection in IBD patients does not address the concerns raised at the beginning of the pandemic. Growing evidence and the rapid changes happening over the past few weeks have helped elucidate the current situation, contribute to our understanding of the disease, and many previously raised questions could now be answered. We hereby summarise available evidence regarding viral infections and IBD, focusing on SARS-CoV infections, and we provide practical recommendations related to patient management during the COVID-19 pandemic era.

关键词： Crohn&apos   s disease   epidemiology   inflammatory bowel disease   skin disease   ulcerative colitis  

摘要： Inflammatory bowel disease (IBD) presents with various extraintestinal manifestations. As part of them, various skin diseases are suggested to be related to IBD. We aimed to identify the epidemiology and risk of developing skin manifestations in patients with IBD. We used Korean insurance claims data and selected patients with IBD and age/sex-matched non-IBD subjects between 2013 and 2017 using the diagnosis code and prescription records of IBD-specific medications. The prevalence and risk of concurrent skin diseases were estimated. We identified 64 837 patients with IBD. Reactive skin eruptions including pyoderma gangrenosum and erythema nodosum were associated with IBD with highest odds ratios among three categories of reactive, inflammatory, and autoimmune skin diseases. Inflammatory skin diseases including rosacea, psoriasis, atopic dermatitis, hidradenitis suppurativa, and acne conglobata were significantly associated with IBD, but the association was less marked compared to reactive skin eruptions. The patients with IBD also had a higher risk of autoimmune skin diseases including vitiligo and alopecia areata than non-IBD subjects. We determined that IBD was related to various skin diseases including reactive, inflammatory, and autoimmune skin diseases. Considering these relationships can allow better management of patients with IBD and comorbid skin diseases.

关键词： Epigenetics in immune cells   Ulcerative colitis  

摘要： Gounari and colleagues examine how the Wnt-beta-catenin signaling axis in regulatory T cells promotes inflammatory bowel disease and colonic dysplasia. Activated beta-catenin induces epigenetic changes that alter expression of genes co-regulated by Foxp3 and TCF-1. The diversity of regulatory T (T-reg) cells in health and in disease remains unclear. Individuals with colorectal cancer harbor a subpopulation of ROR gamma t(+) T-reg cells with elevated expression of beta-catenin and pro-inflammatory properties. Here we show progressive expansion of ROR gamma t(+) T-reg cells in individuals with inflammatory bowel disease during inflammation and early dysplasia. Activating Wnt-beta-catenin signaling in human and murine T-reg cells was sufficient to recapitulate the disease-associated increase in the frequency of ROR gamma t(+) T-reg cells coexpressing multiple pro-inflammatory cytokines. Binding of the beta-catenin interacting partner, TCF-1, to DNA overlapped with Foxp3 binding at enhancer sites of pro-inflammatory pathway genes. Sustained Wnt-beta-catenin activation induced newly accessible chromatin sites in these genes and upregulated their expression. These findings indicate that TCF-1 and Foxp3 together limit the expression of pro-inflammatory genes in T-reg cells. Activation of beta-catenin signaling interferes with this function and promotes the disease-associated ROR gamma t(+) T-reg phenotype.

摘要： Enzymatically inactive tissue-type plasminogen activator (EI-tPA) does not activate fibrinolysis, but interacts with the N-methyl-o-aspartate receptor (NMDA-R) and low-density lipoprotein receptor-related protein-1 (LRP1) in macrophages to block innate immune system responses mediated by toll-like receptors. Herein, we examined the ability of EI-tPA to treat colitis in mice, induced by dextran sulfate sodium. In two separate studies, designed to generate colitis of differing severity, a single dose of EI-tPA administered after inflammation established significantly improved disease parameters. EI-tPA-treated mice demonstrated improved weight gain. Stools improved in character and became hemoccult negative. Abdominal tenderness decreased. Colon shortening significantly decreased in EI-tPA-treated mice, suggesting attenuation of irreversible tissue damage and remodeling. Furthermore, histopathologic evidence of disease decreased in the distal 25% of the colon in EI-tPA-treated mice. EI-tPA did not decrease the number of CD45-positive leukocytes or F4/80-positive macrophage-like cells detected in extracts of colons from dextran sulfate sodium-treated mice as assessed by flow cytometry. However, multiple colon cell types expressed the NMDA-R, suggesting the ability of diverse cells, including CD3-positive cells, CD103positive cells, Ly6G-positive cells, and epithelial cell adhesion molecule-positive epithelial cells to respond to EI-tPA. Mesenchymal cells that line intestinal crypts and provide barrier function expressed LRP1, thereby representing another potential target for EI-tPA. These results demonstrate that the NMDAR/LRP1 receptor system may be a target for drug development in diseases characterized by tissue damage and chronic inflammation.

关键词： Chronic Inflammatory Bowel Diseases   Sexual Dysfunction   quality of sexual life  

摘要： IntroductionImproving the quality of sexual life of patients has become a major therapeutic objective in the management of Chronic Inflammatory Bowel Diseases (CIBD).ObjectivesTo assess the prevalence of sexual dysfunction (SD) in patients with CIBD in remission and compare it to healthy controls (HC), and to determine the associated factorsMethodsThis was a cross-sectional study, conducted over 8 months, involving 36 patients with CIBD, who attended the gastroenterology outpatient of Hedi Chaker University Hospital in Sfax (Tunisia). They were compared to 36 HC. Sexual function was assessed with the “Female sexual Function Index” and the “International Index of Erectile Function”.ResultsIn the sample of CIBD, the prevalence of SD was 65.4% in women and 50% in men. Compared to controls, patients with male gender had significantly more impaired erection and orgasm (p=0.005; p=0.002 respectively), and those with female gender had significantly more impaired sexual arousal and desire (p=0.003; p=0.028 respectively). In the sample of patients, having a poor marital harmony and a fewer sexual attraction towards partner were correlated with decreased desire (p=0.017) in men and with sexual arousal (p=0.024) and decreased desire (p=0.048) in women. The number of relapses negatively affects erection (p=0.038) and orgasm (p=0.048). Depression correlated with a decreased orgasm (p=0.001) and desire (p=0.048) in men, and with a decreased sexual arousal (p=0.006) in women.ConclusionsSD is common in CIBD, hence the need for a multidisciplinary approach to allow improvement of the quality of life of these patients, and of their partners.

关键词： artificial intelligence   capsule enteroscopy   confocal laser endomicroscopy   dye-chromoendoscopy   endocytoscopy   inflammatory bowel diseases   molecular imaging   virtual chromoendoscopy  

摘要： The potential of endoscopic evaluation in the management of inflammatory bowel diseases (IBD) has undoubtedly grown over the last few years. When dealing with IBD patients, histological remission (HR) is now considered a desirable target along with symptomatic and endoscopic remission, due to its association with better long-term outcomes. Consequently, the ability of endoscopic techniques to reflect microscopic findings in vivo without having to collect biopsies has become of upmost importance. In this context, a more accurate evaluation of inflammatory disease activity and the detection of dysplasia represent two mainstay targets for IBD endoscopists. New diagnostic technologies have been developed, such as dye-less chromoendoscopy, endomicroscopy, and molecular imaging, but their real incorporation in daily practice is not yet well defined. Although dye-chromoendoscopy is still recommended as the gold standard approach in dysplasia surveillance, recent research questioned the superiority of this technique over new advanced dye-less modalities [narrow band imaging (NBI), Fuji intelligent color enhancement (FICE), i-scan, blue light imaging (BLI) and linked color imaging (LCI)]. The endoscopic armamentarium might also be enriched by new video capsule endoscopy for monitoring disease activity, and high expectations are placed on the application of artificial intelligence (AI) systems to reduce operator-subjectivity and inter-observer variability. The goal of this review is to provide an updated insight on contemporary knowledge regarding new endoscopic techniques and devices, with special focus on their role in the assessment of disease activity and colorectal cancer surveillance.

关键词： headache   inflammatory bowel disease   migraine   population study  

摘要： Objective To assess the prevalence of migraine or severe headache among US adults by inflammatory bowel disease (IBD) status. Background Emerging evidence in clinical settings suggests a higher prevalence of migraine among patients with IBD than those without IBD. Methods Data from 60,436 US adults aged >= 18 years participating in the 2015 and 2016 National Health Interview Survey (NHIS) were analyzed. The relationship between IBD status and migraine or severe headache was assessed overall and stratified by levels of selected characteristics including sex, age, race/ethnicity, education, poverty status, marital status, smoking status, obesity status, serious psychological distress, and major chronic condition status. Results Overall, the age-adjusted prevalence of migraine or severe headache was 15.4% (n = 9062) and of IBD was 1.2% (n = 862). A higher age-adjusted migraine or severe headache prevalence was reported among participants with IBD than those without IBD (28.1% vs. 15.2%, p < 0.0001). The association of migraine or severe headache with IBD remained significant overall [adjusted prevalence ratio (95% CI) = 1.59 (1.35-1.86)] and within the levels of most other selected characteristics after controlling for all other covariates. Conclusions Our results confirmed a higher prevalence of migraine or severe headache among US adults with IBD than those without. Healthcare providers might assess migraine or severe headache among patients with IBD to improve management and quality of life.