关键词： China   disability index   inflammatory bowel diseases   International Classification of Functioning   Disability and Health  

摘要： Objective The inflammatory bowel disease disability index (IBD-DI) has been used to evaluate functional status for patients with inflammatory bowel diseases (IBD). The study aimed to develop a reliable Chinese version of IBD-DI (C-IBD-DI). Methods Consecutive patients with IBD and healthy controls were recruited from June 2016 to July 2017 in the First Affiliated Hospital, College of Medicine, Zhejiang University (Hangzhou, Zhejiang Province, China) to complete an inflammatory bowel disease questionnaire-32 (IBDQ-32), Hamilton's anxiety rating scale (HAMA) and Hamilton's depression rating scale-24 items (HAMD-24). The validation process included item reduction, reliability and validity tests. Results Altogether 122 patients with IBD completed the validation process. Factor analysis reduced the C-IBD-DI to 13 items. Cronbach's alpha coefficient was 0.90. The C-IBD-DI scores were correlated with IBDQ-32 score (r = -0.79, P < 0.001), HAMA (r = 0.78, P < 0.001) and HAMD-24 (r = 0.81, P < 0.001). The total score of C-IBD-DI was significantly higher in patients with active IBD than in those in remission. The intraclass correlation coefficient was 0.83 in the stable IBD group, representing a good test-retest reliability. Those with improved disease activity had a significantly lower C-IBD-DI score at the follow-up visit than at baseline. Patients with IBD had worse disability levels and quality of life than the controls, and were more likely to be anxious and depressed, especially those with active IBD. Conclusions The validated C-IBD-DI comprising 13 questions has highly acceptable reliability and validity. Multicenter studies including large sample sizes are needed to further confirm our results.

关键词： depression   pediatric inflammatory bowel disease   psychosocial screening  

摘要： Objective: Rates of youth depression are increasing, and approximately 75% of adolescents with depression go unrecognized. Research in pediatric IBD documents increased depression risk, with rates up to 25%, as well as worse adherence and treatment outcomes associated with depressive symptoms. Evidence-based psychological interventions improve the physical and emotional health of these patients, highlighting the importance of detection and treatment. Psychosocial screening has been shown to increase the accurate identification of psychosocial problems and facilitate timely psychosocial intervention. The objective of this article is to establish clinical guidelines for depression screening in youth diagnosed with IBD and to provide resources for implementation. Methods: The psychosocial screening task force group constituted of psychologists and social workers in the ImproveCareNow (ICN) learning health system reviewed research and clinical guidelines in other fields, and consulted with physicians, nurses, other psychosocial professionals, patients with IBD, and parents of children with IBD in ICN. Results/Conclusions: It is recommended that adolescents with IBD ages 12 and older be screened for depression annually. Additional practical recommendations for implementation, triage, and treatment within the pediatric gastroenterology clinic are also provided.

关键词： CARD9   inflammatory bowel disease   predisposing and protective variants   therapy  

摘要： Inflammatory bowel disease (IBD) involves a dysregulated immune response to the gut microbiota. Emerging evidence has demonstrated that dysfunctions in caspase recruitment domain-containing protein 9 (CARD9) may contribute to the pathogenesis of IBD. Interestingly, an allelic series of Card9 variants have both a common predisposing and rare protective function in IBD patients. In this review, we provide mechanistic insights into the role of the CARD9 adaptor molecule in intestinal inflammation and determine a potential CARD9-targeting therapeutic approach against IBD.

关键词： Musculoskeletal pain   central sensitization   inflammatory bowel disease  

摘要： Background Musculoskeletal conditions are well documented in inflammatory bowel disease (IBD). However, whether IBD activity influences musculoskeletal pain experiences is uncertain. Central sensitization has been proposed in patients with IBD who are suffering from persistent pain. Identification of central sensitization symptomology using the Central Sensitization Inventory (CSI) has been reported in many pain-related disorders. Aims of this study were to explore predictive relationships between IBD activity and musculoskeletal pain experiences (severity/interference), and the mediating effects of the CSI. Methods A cross-sectional online survey was performed exploring self-reported musculoskeletal pain in adults with IBD. Survey questionnaires included IBD activity indices, numeric rating scales, PROMIS Pain Interference, and the CSI. Linear regression was used to examine the relationship between active IBD and pain experiences. Simple and serial mediation analyses were used to explore mediation models: independent variable (IBD activity), dependent variables (severity/interference), and mediators (CSI/severity). Results 208 adults with IBD, 18 to 88 years of age, reported musculoskeletal pain. Regression analysis identified IBD activity as a significant predictor of worse pain severity (R-2 = 0.039, P < 0.005) and interference (R-2 = 0.067, P < 0.001). Simple mediation showed a significant indirect effect from CSI scores between IBD activity and pain severity. Serial mediation analysis showed a significant indirect effect from CSI scores and pain severity, between IBD activity and pain interference. Conclusion Active IBD demonstrated a positive association with worse musculoskeletal pain experiences. The CSI demonstrated significant mediation between active IBD and pain severity. Additionally, the CSI and pain severity demonstrated significant mediation between active IBD and pain interference. This suggests that symptoms of central sensitization significantly i

摘要： In Reply to (Meta-analysis on obesity and risk of inflammatory bowel disease: re-analysis is needed) The third issue raised refers to the association between BMI, as a continuous variable, and IBD in a dose-response analysis according to two mentioned studies.[[6], [8]] Indeed, we used the data of these studies in our meta-analysis. With regard to the dose-response analysis and continuous variable, we did not perform a linear dose-response analysis in our paper, instead, and respectfully, we conducted non-linear dose-response analyses. [Extracted from the article]

关键词： RASSF1A   LATS1   2   HIPPO pathway   Human inflammatory bowel disease   Ulcerative colitis   Crohn's disease  

摘要： The intestinal neoplastic transformation is a possible risk of chronic inflammatory bowel disease (IBD). Previous evidence in mice IBD provides a role for the RAS-association domain family tumor suppressor protein 1 A (RASSF1A), in the repairing process following mucosa epithelium damage, through cooperation with the HIPPO-signaling molecules p73, and YAP. HIPPO pathway which has been implicated in stem cell activity includes as key components for signal transduction the large tumor suppressor homology Ser/Thr kinases LATS1/2. The aim of this study was to assess immunohistochemically, using specific antibodies, the RASSF1A and LATS1/2 expression patterns in a cohort of patients with IBD including 52 ulcerative colitis (UC), 24 Crohn's disease (CD) and 24 IBD unclassified (IBD-U), compared with normal intestine from non-IBD patients (control group). The relationship between subtypes of IBD and RASSF1A and LATS1/2 expression, both individually and related to p73 and YAP/pYAP(Ser127) proteins was also investigated. Quantitative analyses of the immunohistochemical findings in mucosa cells revealed a significantly decreased expression in UC and IBD-U for RASSF1A expression and a significantly elevated expression in UC, IBD-U, and CD for LATS1/2 expression compared with normal mucosa (P < 0.05). However, ROC curve analysis showed that only LATS1/2 could differentiate IBD from control group. RASSF1A expression was significantly correlated with LATS1/2 in UC with dysplasia (P < 0.0001), and p73 in UC (P < 0.001), and IBD-U (P < 0.02). The expression of all proteins did not differ significantly between subtypes of IBD (P >= 0.05). RASSF1A-LATS1/2 co-expression was mainly observed in IBD samples. These findings suggest that tumor suppression proteins RASSF1A and LATS1/2 may be involved in the pathogenesis of human IBD and imply a potential cooperation of RASSF1A, and HIPPO signaling pathways in human bowel inflammation.

关键词： Surveillance   Guidelines   Crohn's disease   Ulcerative colitis   Interval colorectal neoplasia  

摘要： Background Factors associated with interval colorectal cancer (CRC) development in the inflammatory bowel disease (IBD) population remain unclear. Aims Among a cohort of patients with interval CRC, we aimed to evaluate IBD characteristics, colonoscopy quality indicators, and surveillance guideline adherence. Methods We performed a retrospective review of IBD- and non-IBD-associated interval CRCs diagnosed between January 2007 and December 2014 within a large US healthcare system. We evaluated risk factors for CRC among patients with IBD. We assessed adherence to surveillance guidelines according to the American Society for Gastrointestinal Endoscopy (IBD surveillance) and the US Multi-Society Task Force on Colorectal Cancer (polyp surveillance). We compared colonoscopy quality measures between patients with and without IBD. Results Among 5345 cases of colonic adenocarcinoma, we detected 15 IBD-associated cases of interval CRC and 230 non-IBD-associated cases of interval CRC. Compared to patients without IBD, IBD patients were younger (54.5 vs. 70.4 years;p < 0.0001) and experienced a shorter interval between index colonoscopy and CRC diagnosis (20.7 vs. 35.1 months;p = 0.0009). Fifty three percent (8/15) of interval CRCs in IBD patients were detected within surveillance guidelines. All IBD patients with interval CRC detected after guideline surveillance interval had high-risk features, including active inflammation, previous low-grade or indefinite dysplasia, multiple pseudopolyps on index colonoscopy, or a first-degree relative with CRC. There were no differences in colonoscopy quality measures between patients with and without IBD. Conclusions This study stresses the importance of strict short-interval surveillance for IBD patients with high-risk features, including active inflammation on index colonoscopy.

摘要： Background: Women with inflammatory bowel diseases (IBD) often receive biologicals during pregnancy to maintain disease remission. Data on outcome of vedolizumab-exposed pregnancies (VDZE) are sparse. Aims: To assess pregnancy and child outcomes of VDZE pregnancies and to compare these results to anti-TNF exposed (TNFE) or both immunomodulatory and biologic unexposed (CON IBD) pregnancies. Methods: A retrospective multicentre case-control observational study was performed. Results: VDZE group included 79 pregnancies in 73 IBD women. The TNFE and CON IBD group included 186 pregnancies (162 live births) in 164 IBD women and 184 pregnancies (163 live births) in 155 IBD women, respectively. At conception, cases more often had active disease ([VDZE: 36% vs TNFE: 17%, P = .002] and [VDZE: 36% vs CON IBD: 24%, P = .063]). No significant difference in miscarriage rates were found between groups (VDZE and TNFE: 16% vs 13%, P = .567;VDZE and CON IBD: 16% vs 10%, P = .216). In live-born infants, median gestational age and birthweight were similar between groups. Median Apgar score at birth was numerically equal. Prematurity was similar in the VDZE group compared to the control groups, even when correcting for disease activity during pregnancy. The frequency of congenital anomalies was comparable between groups as were the percentages of breastfed babies. During the first year of life, no malignancies were reported and infants' infection risk did not significantly differ between groups. Conclusion: No new safety signal was detected in VDZE pregnancies although larger, prospective studies are required for confirmation.

关键词： Inflammatory bowel disease   Prostate cancer   Immunosuppressants   Radiation therapy  

摘要： Prostate cancer is the most common cancer among men in the USA. Interestingly, recent studies suggest that patients with inflammatory bowel disease (IBD) are at increased risk of developing prostate cancer. Importantly, patients with IBD who develop prostate cancer require thoughtful care when using immunosuppressants to treat the IBD in the setting of malignancy. Further, consideration must be given to the proximity of the prostate to the gastrointestinal tract when treating with radiation where there is concern for the effects of inadvertent exposure of radiation to the diseased bowel. In general, management of immunosuppression after diagnosis of prostate cancer is contingent on the specific immunosuppressive agents, the duration of cancer remission and/or plans for cancer treatment, and the potential risks and benefits of stopping or altering the administration of those agents. Concerns that patients with IBD would have increased risk of disease exacerbation and gastrointestinal toxicity have previously limited the use of radiation. While currently no consensus has been reached regarding the safety of radiation therapy in patients with IBD, recent studies suggest that radiation therapy may be used safely in patients with IBD who develop prostate cancer, especially brachytherapy and intensity-modulated radiation therapy which may have less bowel toxicity compared to conventional methods of external beam radiation therapy. A multidisciplinary team approach including gastroenterologists, urologists, radiation oncologists, and medical oncologists should be undertaken to best treat patients with IBD and prostate cancer.