关键词： COLON cancer prognosis   INFLAMMATORY bowel diseases   MEDICAL registries   CROHN'S disease   GASTROENTEROLOGISTS  

关键词： Inflammatory bowel diseases   Fecal calprotectin   Diet   Legume   Meat  

摘要： While the importance of diet in the pathogenesis of inflammatory bowel disease (IBD) is generally recognized, influence of food on the course of IBD is little understood. The purpose of this study was to assess the association between food intake and course of disease in patients with IBD. We performed a cross-sectional study on 103 adult patients (50 with active disease and 53 in remission, divided by their calprotectin level), who completed a food frequency questionnaire on their intake of several foods over 1 year. Diet, as assessed using a 146-item self-administered food frequency questionnaire, was correlated with objective evidence of disease based on fecal calprotectin levels. Legumes and potato were inversely associated with disease relapse (p value for trend 0.023) with patients in the highest quartile for legume and potato consumption carrying a 79% lower risk of active disease (adjusted OR 0.21, 95% CI 0.57-0.81). A positive association emerged between meat intake and disease relapse, the highest quartile for meat consumption coinciding with a higher risk of active disease (OR 3.61, 95% CI 1.15-11.38), though this was not significant in the adjusted analysis. No statistically significant associations were found between disease relapse and the intake of vegetables, cereals, dairy products, or fish. Our results suggest a potentially protective role of legumes and potato and a detrimental influence of meat in maintaining clinical remission in IBD patients. These findings have important public health implications, but further interventional studies will be needed to demonstrate these associations.

关键词： INFLAMMATORY bowel disease diagnosis   INFLAMMATORY bowel diseases   IMMIGRANTS -- United States   HEALTH   SENSITIVITY analysis   GASTROENTERITIS   RISK factors  

摘要： Linked Content This article is linked to Kuenzig and Benchimol and Dasmas and Schwarts et al papers. To view these articles visit https://***/10.1111/apt.14186 and https://***/10.1111/apt.14200. [ABSTRACT FROM AUTHOR]

关键词： anti-tumor necrosis factor   arthritis   extraintestinal manifestations   inflammatory bowel disease   uveitis  

摘要： Background:There is a paucity of data on extraintestinal manifestations (EIM) and their treatment in pediatric patients with inflammatory bowel disease (IBD). Methods:Since 2008, the Pediatric Swiss IBD Cohort Study has collected data on the pediatric IBD population in Switzerland. Data on 329 patients were analyzed retrospectively. Results:A total of 55 patients (16.7%) experienced 1-4 EIM (39 Crohn disease, 12 ulcerative colitis, and 4 IBD-unclassified patients). At IBD onset, presence of EIM was more frequent than in the adult population (8.5% vs 5.0%, P=0.014). EIM were more frequent in Crohn disease when compared to ulcerative colitis/IBD-unclassified (22.5% vs 10.3%, P=0.003). The most prevalent EIM were peripheral arthritis (26/329, 7.9%) and aphthous stomatitis (24/329, 7.3%). Approximately 27.6% of all EIM appeared before IBD diagnosis. Median time between IBD diagnosis and occurrence of first EIM was 1 month (-37.5-149.0). Thirty-one of the 55 patients (56.4%) were treated with 1 or more anti-tumor necrosis factor (TNF) agents. IBD patients with EIM were more likely to be treated with anti-TNF compared to those without (56.4% vs 35.0%, P=0.003). Response rates to anti-TNF depended on underlying EIM and were best for peripheral arthritis (61.5%) and uveitis (66.7%). Conclusions:In a cohort of pediatric patients with IBD, EIM were frequently encountered. In up to 30%, EIM appeared before IBD diagnosis. Knowledge of these findings may translate into an increased awareness of underlying IBD, thereby decreasing diagnostic delay. Anti-TNF for the treatment of certain EIM is effective, although a substantial proportion of new EIM may present despite ongoing anti-TNF therapy.

关键词： Ulcerative colitis   Crohn's disease   Incidence   Clinical course   South Korea  

摘要： The incidence of inflammatory bowel disease (IBD) is increasing in East Asia;however, population-based data from this region are lacking. We conducted a nationwide, population-based study to examine the incidence and disease course of IBD in South Korea. Using the National Health Insurance claims data, we collected data on patients diagnosed with IBD [10,049 with ulcerative colitis (UC) and 5595 with Crohn's disease (CD)] from 2011 to 2014. During the study period, the average annual incidence of UC was 5.0 per 10(5), while that of CD was 2.8 per 10(5). Among patients with UC, the cumulative rates of surgery 1 and 4 years after diagnosis were 1.0 and 2.0%;those among patients with CD were 9.0 and 13.9%, respectively. The 1- and 4-year cumulative rates of moderate- to high-dose corticosteroid use were, respectively, 26.6 and 45.2% among patients with UC, and 29.9 and 50.8% among those with CD. Similarly, the 1- and 4-year cumulative rates of immunomodulator use were 14.1 and 26.4% among patients with UC, and 58.3 and 76.1% among those with CD, respectively. With regard to biologic use, the 1- and 4-year cumulative rates were 3.0 and 9.0% among patients with UC, and 11.1 and 31.7% among those with CD, respectively. The recent incidence of IBD in South Korea has been the highest in East Asia. Patients who had been diagnosed recently with IBD showed lower rates of surgery and higher rates of immunomodulator and biologic use compared to those reported ever in South Korea.

关键词： Animal Model   Nicotine   Inflammation   Gene-Environment Interaction  

摘要： BACKGROUND & AIMS: The role of tobacco smoke in the etiology of inflammatory bowel disease (IBD) is unclear. We investigated interactions between genes and smoking (gene-smoking interactions) that affect risk for Crohn's disease (CD) and ulcerative colitis (UC) in a case-only study of patients and in mouse models of IBD. METHODS: We used 55 Immunochip-wide datasets that included 19,735 IBD cases (10,856 CD cases and 8879 UC cases) of known smoking status. We performed 3 meta-analyses each for CD, UC, and IBD (CD and UC combined), comparing data for never vs ever smokers, never vs current smokers, and never vs former smokers. We studied the effects of exposure to cigarette smoke in Il10(-/-) and Nod2(-/-) mice, as well as in Balb/c mice without disruption of these genes (wildtype mice). Mice were exposed to the smoke of 5 cigarettes per day, 5 days a week, for 8 weeks, in a ventilated smoking chamber, or ambient air (controls). Intestines were collected and analyzed histologically and by reverse transcription polymerase chain reaction. RESULTS: We identified 64 single nucleotide polymorphisms (SNPs) for which the association between the SNP and IBD were modified by smoking behavior (meta-analysis Wald test P < 5.0 x 10(-5);heterogeneity Cochrane Q test P>.05). Twenty of these variants were located within the HLA region at 6p21. Analysis of classical HLA alleles (imputed from SNP genotypes) revealed an interaction with smoking. We replicated the interaction of a variant in NOD2 with current smoking in relation to the risk for CD (frameshift variant fs1007insC;rs5743293). We identified 2 variants in the same genomic region (rs2270368 and rs17221417) that interact with smoking in relation to CD risk. Approximately 45% of the SNPs that interact with smoking were in close vicinity (<= 1 Mb) to SNPs previously associated with IBD;many were located near or within genes that regulate mucosal barrier function and immune tolerance. Smoking modified the disease risk of some var

关键词： Ulcerative colitis   Crohn's disease   Pregnancy   Cesarean section   Full term delivery  

摘要： The literature on interaction between pregnancy and inflammatory bowel disease (IBD) is inconsistent, and there are no reports on this aspect from Asia. This study evaluated the impact both IBD and pregnancy have on each other in a large cohort of Indian patients. In total, 514 females with ulcerative colitis (UC) or Crohn's disease (CD) aged between 18 and 45 years attending IBD clinic, at our institute, from July 2004 to July 2013 were screened, and patients with data on pregnancy status were included (n = 406). Pregnancies were categorized as either before, after or coinciding with disease onset. Long-term disease course was ascertained from prospectively maintained records. Pregnancy and fetal outcomes were recorded from antenatal records or individual interviews. Of 406 patients (UC: 336, CD: 70), 310 became pregnant (UC: 256, CD: 54), with a total of 597 pregnancies (UC: 524, CD: 73). More UC patients with pregnancies were in long-term remission than non-pregnant patients (56.7 vs. 43.4 %, p = 0.04). Long-term remission was less frequent in UC patients in whom pregnancy coincided with disease onset than patients with pregnancies before and after/pregnancy after the disease onset (41.4 vs. 62.5 %, p = 0.023). Pregnancies after the disease onset were associated with more cesarean sections and adverse fetal outcomes than pregnancies before disease onset in both UC and CD patients. Long-term disease course in UC patients was better in pregnant as compared to non-pregnant patients. Among pregnant UC patients, disease course was worst when pregnancy coincided with disease onset. Pregnancy and fetal outcomes were worse in pregnancy after disease onset than pregnancy before disease onset.

关键词： Inflammatory bowel disease   Crohn's disease   Ulcerative colitis   Colorectal cancer  

摘要： The molecular, endoscopic, and histological features of IBD-associated CRC differ from sporadic CRC. The objective of this study was to describe the prevalence, clinical features, and prognosis of IBD-associated CRC compared to patients with sporadic CRC in a US statewide population-based cohort. All newly diagnosed cases of CRC between 1996 and 2011 were obtained from Utah Cancer Registry. IBD was identified using a previously validated algorithm, from statewide databases of Intermountain Healthcare, University of Utah Health Sciences, and the Utah Population Database. Logistic regression was performed to identify risk factors associated with IBD-associated cancer and Cox regression for differences in survival. Among 12,578 patients diagnosed with CRC, 101 (0.8%) had a prior history of IBD (61 ulcerative colitis and 40 Crohn's disease). The mean age at CRC diagnosis was greater for patients without IBD than those with IBD (67.1 vs 52.8 years, P < 0.001). Individuals with IBD-associated CRC were more likely to be men (odds ratio [OR] 1.90, 95% CI 1.23-2.92), aged less than 65 years (OR 6.77, 95% CI 4.06-11.27), and have CRC located in the proximal colon (OR 2.79, 95% CI 1.85-4.20) than those with sporadic CRC. Nearly 20% of the IBD-associated CRCs had evidence of primary sclerosing cholangitis. After adjustment for age, gender, and stage at diagnosis, the excess hazard of death after CRC diagnosis was 1.7 times higher in IBD than in non-IBD patients (95% CI 1.27-2.33). The features of patients with CRC and IBD differ significantly from those without IBD and may be associated with increased mortality.

关键词： cost analysis   INTERCHANGEABILITY   Inflammatory Bowel Diseases   Byways   Biosimilar Pharmaceuticals