关键词： adolescent   inflammatory bowel disease   program development   transfer   transition  

摘要： Background: Although transition guidelines have been specified in pediatric inflammatory bowel disease (IBD), few IBD centers implement these into standard care. We describe a mixed qualitative and quantitative process of developing a needs-based transition program for adolescents and young adults with IBD. Methods: We enrolled 29 adolescents with IBD, 8 young adults with IBD in adult care, 14 pediatric gastroenterologists, and 58 adult gastroenterologists to provide input into barriers to successful transition, essential patient competencies, and key targets of clinical intervention. Results: The availability and expertise of adult gastroenterologists in childhood-onset IBD were identified by pediatric providers as primary barriers to health care transfer. A medical summary containing pertinent health information was identified by adult providers as instrumental to assume patient care post transfer. Young adults with IBD identified self-advocacy, education on insurance basics, and peer mentoring as essential targets of transition support and preparation in pediatric care. Findings were used to develop educational materials, a portable medical summary, a referral database of adult gastroenterologists, and a young adult clinic geared towards transition planning. Conclusion: Involving key patient and provider stakeholders in the development of a transition program is aimed at ensuring that the individual needs of patients and their families are met. Collaboration between pediatric and adult providers is also intended to facilitate a seamless continuum from pediatric to adult health care services. Efforts to evaluate the impact of such programming on self-management in adult care are needed.

关键词： Inflammatory bowel disease   Crohn's disease   Ulcerative colitis   Gut microbiota   Microbial imbalance  

摘要： Background Inflammatory bowel disease (IBD), is a debilitating group of chronic diseases including Crohn's Disease (CD) and ulcerative colitis (UC), which causes inflammation of the gut and affects millions of people worldwide. At different taxonomic levels, the structure of the gut microbiota is significantly altered in IBD patients compared to that of healthy individuals. However, it is unclear how these IBD-affected bacterial groups are related to other common bacteria in the gut, and how they are connected across different disease conditions at the global scale. Results In this study, using faecal samples from patients with IBD, we show through diversity analysis of the microbial community structure based on the 16S rRNA gene that the gut microbiome of IBD patients is less diverse compared to healthy individuals. Furthermore, we have identified which bacterial groups change in abundance in both CD and UC compared to healthy controls. A substantial imbalance was observed across four major bacterial phyla including Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria, which together constitute > 98% of the gut microbiota. Next, we reconstructed a bacterial family co-abundance network based on the correlation of abundance profiles obtained from the public gut microbiome data of > 22,000 samples of faecal and gut biopsies taken from both diseased and healthy individuals. The data was compiled using the EBI metagenomics database (Mitchell et al. in Nucleic Acids Res 46:D726-D735, 2018). By mapping IBD-altered bacterial families to the network, we show that the bacterial families which exhibit an increased abundance in IBD conditions are not well connected to other groups, implying that these families generally do not coexist together with common gut organisms. Whereas, the bacterial families whose abundance is reduced or did not change in IBD conditions compared to healthy conditions are very well connected to other bacterial groups, suggesting they are highl

摘要： VOLUME 279 (2004) PAGES 12647–12658

摘要： Interleukin (IL)-17 is a recognised pro-inflammatory cytokine of the IL23/17 pathway, involved in the pathogenesis of several chronic inflammatory diseases (CIDs), including psoriasis (PsO), psoriatic arthritis (PsA) and ankylosing spondylitis (AS)[1]. As far as Inflammatory Bowel Diseases (IBD) are concerned, the role of IL-17 in the pathogenesis is still controversial, whereas, at the colonic mucosa level, it seems both to modulate the inflammatory response and promote wound and tissue repair[[8]]. Real-world incidence of inflammatory bowel disease among patients with other chronic inflammatory diseases treated with interleukin-17a or phosphodiesterase 4 inhibitors. [Extracted from the article]

关键词： Inflammatory bowel disease   Crohn's disease   ulcerative colitis   deep remission   outcome  

摘要： Background and aims: A multicentre, retrospective, non-interventional, patient chart review study was conducted to investigate deep (DR) and histological remission rates during maintenance therapy with biological agents in inflammatory bowel disease (IBD). Methods: We reviewed clinical, endoscopic, and histological findings, and laboratory markers such as C-reactive protein (CRP) and faecal calprotectin (FC) on average of nine years after the initiation of anti-TNF-therapy. DR was defined as no clinical symptoms (The physicians' global assessment scores;PGA = 0) with endoscopic remission (the Simple Endoscopic Score for Crohn's Disease [SES-CD] <= 2 or Mayo endoscopic subscore <= 1). Histological activity was defined as normal if only architectural alterations without cellularity changes occurred. Results: Of 117 IBD patients on maintenance therapy, 72 (62%;CD n = 55 [56%], UC n = 17 [85%]) patients were in DR. Of patients in DR, 76% were also in histological remission. 77% of patients remained on initiated biological treatment. UC patients achieved DR significantly more often than CD patients (p = .016). Both median CRP and FC levels were significantly lower in patients with DR. Conclusion: Reassuringly, almost two thirds of the IBD patients on maintenance therapy with biological agents maintained DR in the long-term, and more than two thirds of patients in DR achieved also histological remission. CD patients in DR had fewer surgical operations due to CD than patients not achieving DR.

关键词： Inflammatory bowel disease   Europe   economic development   panel data  

摘要： There is worldwide evidence that Inflammatory Bowel Disease (IBD) incidents increase over time in different regions around the world, signifying its emergence as a global disease. The available evidence implies that factors such as economic development positively affect IBD incidents, at a time when relevant surveys on other diseases support the existence of the same positive relationship between disease incidents and economic development. In this context, it is surprising that the actual empirical relationship between IBD incidents and economic development remains largely unexplored or even completely ignored by the literature. In the present work, we assess empirically the relationship between IBD incidents and economic development by analysing incidents registered in the European Crohn's and Colitis Organization's Epidemiological Committee (EpiCom) study for two consecutive years (2010-2011) based on data availability. We provide strong statistical evidence in favour of a positive relationship between IBD incidents and economic development.

关键词： Pyridin-3-ols   inflammatory bowel disease   TNF-?   adhesion   epithelial junction  

摘要： Inflammatory bowel disease (IBD) is a chronic immuno-inflammation in gastrointestinal tract. We have evaluated the activity of the compounds to inhibit the adhesion of monocytes to colon epithelial cells is triggered by a pro-inflammatory cytokine, tumour necrosis factor (TNF)-?. The in vitro activity of the compounds, 13b (an ureido-derivative), 14c, 14j, 14k, 14n (thioureido-), 18c and 18d (sulfonamido-), was in correlation with in vivo anti-colitis activity revealed as significant recovery in body- and colon-weights and colon myeloperoxidase level, a biochemical marker of inflammation reflecting neutrophil infiltration. In vivo, TNBS-induced changes in the expression of inflammatory cytokines (TNF-?, IL-6, IL-1?, IL-10, and TGF-?), NLRP3 inflammasome components (NLRP-3, Caspase-1, and IL-18), and epithelial junction molecules (E-cadherin, claudin2/3, and ZO-1) were blocked and recovered by oral administration of the compounds (1?mg/kg). Compound 14n which showed the best efficacy can be a promising lead for orally available therapeutics for pathology of IBD.

关键词： Inflammatory bowel disease   IBD   Crohn’s disease   Strictureplasty   Surgery  

摘要： The Italian Society of Colorectal Surgery (SICCR) promoted the project reported here, which consists of a position statement of Italian colorectal surgeons to address the surgical aspects of Crohn’s disease management. Members of the society were invited to express their opinions on several items proposed by the writing committee, based on evidence available in the literature. The results are presented, focusing on relevant points. The present paper is not an alternative to available guidelines; rather, it offers a snapshot of the attitudes of SICCR surgeons about the surgical treatment of Crohn’s disease. The committee was able to identify some points of major disagreement and suggested strategies to improve quality of available data and acceptance of guidelines.

关键词： K+ channel   K(2P)5.1   inflammatory bowel disease   CD4(+) T cell   hypoxia   HIF-1 alpha  

摘要： Previous studies have reported the up-regulation of the two-pore domain K+ channel K(2P)5.1 in the CD4(+) T cells of patients with multiple sclerosis (MS) and rheumatoid arthritis (RA), as well as in a mouse model of inflammatory bowel disease (IBD). However, the mechanisms underlying this up-regulation remain unclear. Inflammation-associated hypoxia is involved in the pathogenesis of autoimmune diseases, such as IBD, MS, and RA, and T cells are exposed to a hypoxic environment during their recruitment from inflamed tissues to secondary lymphoid tissues. We herein investigated whether inflammation-associated hypoxia is attributable to the increased expression and activity of K(2P)5.1 in the splenic CD4(+) T cells of chemically-induced IBD model mice. Significant increases in hypoxia-inducible factor (HIF)-1 alpha transcripts and proteins were found in the splenic CD4(+) T cells of the IBD model. In the activated splenic CD4(+) T cells, hypoxia (1.5% O-2) increased K(2P)5.1 expression and activity, whereas a treatment with the HIF inhibitor FM19G11 but not the selective HIF-2 inhibitor exerted the opposite effect. Hypoxia-exposed K(2P)5.1 up-regulation was also detected in stimulated thymocytes and the mouse T-cell line. The class III histone deacetylase sirtuin-1 (SIRT1) is a downstream molecule of HIF-1 alpha signaling. We examined the effects of the SIRT1 inhibitor NCO-01 on K(2P)5.1 transcription in activated CD4(+) T cells, and we found no significant effects on the K(2P)5.1 transcription. No acute compensatory responses of K(2P)3.1-K(2P)5.1 up-regulation were found in the CD4(+) T cells of the IBD model and the hypoxia-exposed T cells. Collectively, these results suggest a mechanism for K(2P)5.1 up-regulation via HIF-1 in the CD4(+) T cells of the IBD model.

关键词： Akkermansia   muciniphila   肠疾病   治疗  

摘要： Akkermansia muciniphila作为定植于肠道黏液层的细菌,影响着人体肠道环境。Akkermansia muciniphila在肥胖症、糖尿病等代谢性疾病中的丰度下降,而在肠易激综合征、炎症性肠病、肠道肿瘤等肠道疾病中的丰度存在差异。本文就Akkermansia muciniphila对肠道疾病的作用以及菌群治疗的展望作一综述。