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Reply: MIND the Gap: Psychiatric Conditions in Inflammatory Bowel Disease. 回复:MIND the Gap:炎症性肠病中的精神疾病。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-05 DOI: 10.1093/ibd/izae258
Sara Massironi, Silvio Danese
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引用次数: 0
Durability of Adalimumab and Infliximab in Children With Crohn's Disease: A Nationwide Comparison From the epi-IIRN Cohort. 阿达木单抗和英夫利西单抗在儿童克罗恩病中的耐久性:来自 epi-IIRN 队列的全国性比较。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.1093/ibd/izad301
Ohad Atia, Chagit Friss, Gili Focht, Ramit Magen Rimon, Natan Ledderman, Amir Ben-Tov, Yiska Loewenberg Weisband, Eran Matz, Yuri Gorelik, Yehuda Chowers, Iris Dotan, Dan Turner

Background: In a nationwide cohort, we aimed to compare the durability of infliximab and adalimumab as first biologic treatment in children with Crohn's disease (CD), stratified as combotherapy or monotherapy.

Methods: We used data from the epi-IIRN cohort that includes all patients with inflammatory bowel diseases in Israel. Durability was defined as consistent treatment without surgery or treatment escalation. All comparisons followed stringent propensity-score matching in Cox proportional hazard models.

Results: Of the 3487 children diagnosed with CD since 2005, 2157 (62%) received biologics (1127 [52%] infliximab, 964 [45%] adalimumab and 52 [2%] vedolizumab as first biologic), representing a higher proportion than that among adults diagnosed during the same time period (5295 of 15 776 [34%]; P < .001). Time from diagnosis to initiation of biologic was shorter in pediatric-onset compared with adult-onset disease (median time during the last 3 years was 2.7 months [interquartile range 1.2-5.4] vs 5.2 months [2.6-8.9]; P < .001). The durability of adalimumab monotherapy after 1 and 5 years from initiation of treatment was better than infliximab monotherapy (79%/54% vs 67%/37%, respectively; n = 452 matched children; hazard ratio [HR], 1.7; 95% confidence interval [CI], 1.3-2.3; P < .001), while in those treated with combotherapy, durability was similar (94%/66% with infliximab vs 90%/54% with adalimumab; n = 100; HR, 1.7; 95% CI, 0.9-3.3; P = .1). Durability was higher in children treated with infliximab combotherapy vs infliximab monotherapy (87%/45% vs 75%/39%; n = 440; HR, 1.4; 95% CI, 1.1-1.8; P = .01). The durability of adalimumab monotherapy was similar to infliximab combotherapy (83%/53% vs 89%/56%, respectively; n = 238; HR, 0.9; 95% CI, 0.7-1.2; P = .4).

Conclusion: Our results support using adalimumab monotherapy as a first-line biologic in children with CD. When infliximab is used, combotherapy may be advantageous over monotherapy.

背景在一个全国性队列中,我们旨在比较英夫利昔单抗和阿达木单抗作为克罗恩病(CD)患儿首次生物治疗的耐久性,分层为联合治疗还是单一治疗:我们使用的数据来自 epi-IIRN 队列,该队列包括以色列的所有炎症性肠病患者。持续治疗的定义是在不进行手术或治疗升级的情况下坚持治疗。所有比较均遵循严格的倾向分数匹配,并采用 Cox 比例危险模型:结果:在2005年以来确诊的3487名CD患儿中,2157人(62%)接受了生物制剂治疗(1127人[52%]首次使用英夫利西单抗,964人[45%]首次使用阿达木单抗,52人[2%]首次使用维多单抗),这一比例高于同期确诊的成人(15776人中有5295人[34%];P 结论:我们的结果支持使用阿达木单抗治疗CD:我们的研究结果支持将阿达木单抗作为CD患儿的一线生物制剂。如果使用英夫利西单抗,联合疗法可能比单药疗法更有优势。
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引用次数: 0
The Clinical Interpretation of Cluster Trials. 聚类试验的临床解读。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.1093/ibd/izae256
Pavel S Roshanov, Guangyong Zou, Reena Khanna

Cluster-randomized trials randomize entire groups of participants, instead of individual participants, to different treatment arms. For certain interventions (eg, institutional policies, processes of care, treatment algorithms), these designs protect against contamination between study arms. However, cluster trials are logistically complex to implement and have unique vulnerabilities that must be evaluated for accurate interpretation. Here, we provide a general overview of the design and statistical issues in cluster trials to facilitate their interpretation by clinicians.

分组随机试验将整组参与者而不是单个参与者随机分配到不同的治疗组。对于某些干预措施(如机构政策、护理流程、治疗算法),这些设计可以防止研究臂之间的污染。然而,分组试验的实施在后勤方面非常复杂,而且有其独特的弱点,必须对这些弱点进行评估才能做出准确的解释。在此,我们将对分组试验的设计和统计问题进行总体概述,以方便临床医生对其进行解释。
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引用次数: 0
HLA-DQA1*05 Not Associated With Ustekinumab Loss of Response and Antidrug Antibodies in Ulcerative Colitis and Crohn's Disease Patients. HLA-DQA1*05与溃疡性结肠炎和克罗恩病患者乌斯特金单抗反应丧失和抗药抗体无关
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.1093/ibd/izad273
Jean-Frédéric Colombel, María D Martín-Arranz, Brigitta Brinkman, Meijian Guan, Amy Hart, Christopher Gasink
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引用次数: 0
Characteristics of Interventional Trials for Patients Living With Intestinal Stoma Registered in ClinicalTrials.gov With a Focus on Inflammatory Bowel Disease. 临床试验网(ClinicalTrials.gov)上登记的针对肠造口患者的介入性试验的特点,重点关注炎症性肠病。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.1093/ibd/izad293
Sudheer K Vuyyuru, Christopher Ma, Tanmay Sharma, Tran M Nguyen, Talat Bessissow, Neeraj Narula, Siddharth Singh, Florian Rieder, Vipul Jairath

Background: This systematic review was performed to characterize the landscape of research conducted in patients with intestinal stoma (IS) and highlight unmet needs for clinical research in Crohn's disease (CD) and IS.

Methods: We searched ClinicalTrials.gov from inception to May 25, 2022, to identify clinical trials assessing interventions in patients with an IS, as well as those with an IS and CD. Studies were grouped according to type of intervention. We excluded observational studies with no treatment arm.

Results: A total of 253 studies were included in the final analysis. Most studies investigated devices (n = 122 [48.2%]), or surgical procedures (n = 63 [24.9%]), followed by behavioral interventions (n = 30 [11.8%]), drugs (n = 20 [7.9%]), dietary interventions (n = 2 [0.8%]), skin care products (n = 2 0.8%]), and others (n = 14 [5.5%]). A total of 50.9% (n = 129) of studies had completed recruitment, enrolling 11 116 participants. Only 6 studies (surgery: n = 3; physiological studies: n = 2; drugs: n = 1) exclusively included patients with inflammatory bowel disease (IBD), and 16 studies commented that patients with IBD were excluded in their eligibility criteria. No study assessed efficacy of drugs in patients with CD and IS. Approximately one-quarter of studies (n = 65 of 253) included quality of life as an outcome measure.

Conclusion: There is a paucity of research in IBD patients with IS, with the majority focusing on devices and surgical procedures. There have been no drug trials evaluating efficacy in patients with CD and IS. There is an urgent need to identify barriers to enrollment and develop eligibility and outcome measures that enable the inclusion of patients with CD with stoma into clinical trials.

背景:本系统综述旨在描述针对肠造口术(IS)患者开展的研究情况,并强调克罗恩病(CD)和肠造口术临床研究中尚未满足的需求:本系统综述旨在描述针对肠造口术(IS)患者开展的研究情况,并强调克罗恩病(CD)和IS临床研究中尚未满足的需求:我们搜索了从开始到 2022 年 5 月 25 日的 ClinicalTrials.gov,以确定对 IS 患者以及 IS 和 CD 患者的干预措施进行评估的临床试验。研究根据干预类型进行分组。我们排除了没有治疗臂的观察性研究:最终分析共纳入了 253 项研究。大多数研究调查了设备(n = 122 [48.2%])或外科手术(n = 63 [24.9%]),其次是行为干预(n = 30 [11.8%])、药物(n = 20 [7.9%])、饮食干预(n = 2 [0.8%])、护肤品(n = 2 0.8%])和其他(n = 14 [5.5%])。共有 50.9% 的研究(n = 129)完成了招募工作,共招募了 11 116 名参与者。只有 6 项研究(手术:n = 3;生理研究:n = 2;药物:n = 1)专门纳入了炎症性肠病 (IBD) 患者,16 项研究在其资格标准中注明不包括 IBD 患者。没有一项研究评估了药物对 CD 和 IS 患者的疗效。约四分之一的研究(253 项研究中的 65 项)将生活质量作为结果测量指标:结论:针对IBD合并IS患者的研究很少,大多数研究都集中在器械和外科手术方面。目前还没有药物试验对 CD 和 IS 患者的疗效进行评估。当务之急是找出入组的障碍,并制定资格和结果衡量标准,以便将造口的 CD 患者纳入临床试验。
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引用次数: 0
Major Abdominal Surgery for Pediatric Crohn's Disease in the Anti-TNF Era: 10-Year Analysis of Data From the IBD Registry of Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition. 抗肿瘤坏死因子时代的小儿克罗恩病腹部大手术:意大利小儿胃肠病学、肝脏病学和营养学会 IBD 登记处的 10 年数据分析。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.1093/ibd/izad310
Patrizia Alvisi, Simona Faraci, Luca Scarallo, Marco Congiu, Matteo Bramuzzo, Maria Teresa Illiceto, Serena Arrigo, Claudio Romano, Giovanna Zuin, Erasmo Miele, Simona Gatti, Marina Aloi, Sara Renzo, Tamara Caldaro, Flavio Labriola, Paola De Angelis, Paolo Lionetti

Background: The natural history of Crohn's disease (CD) can result in complications requiring surgery. Pediatric data are scarce about major abdominal surgery. The IBD Registry from the Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition has been active since 2008 and collects data from major pediatric IBD centers in Italy. The aim of the present report was to explore the prevalence of major abdominal surgery among children affected by CD in an era when antitumor necrosis factor (anti-TNF-α) agents were already used so that we might appraise the incidence of surgical-related complications and identify the factors associated with postoperative disease recurrence.

Methods: We retrospectively analyzed data from patients enrolled in the registry from January 2009 to December 2018. Patients with monogenic IBD and patients undergoing surgery for perianal disease were excluded.

Results: In total, 135 of 1245 patients were identified. We report the prevalence of major abdominal surgery of 10.8%. Pediatric surgeons performed the procedure in 54.1% of cases, and a laparoscopic approach was used in 47.4% of surgical procedures. Seventeen patients (12.6%) experienced a total of 21 early postoperative complications, none of which was severe. A laparoscopic approach was the only factor negatively associated with the occurrence of postoperative complications (odds ratio, 0.22; 95% confidence interval, 0.06-0.8; P = .02). Fifty-four (40%) patients experienced postoperative endoscopic recurrence, and 33 (24.4%) of them experienced postoperative clinical recurrence. The postoperative treatment with anti-TNF-α drugs was significantly associated with a reduced risk of endoscopic recurrence (odds ratio, 0.19; 95% confidence interval, 0.05-0.79; P = .02).

Conclusion: In our cohort, the overall prevalence of major abdominal surgery was low, as well as the rate of surgical-related complications. Postoperative anti-TNF-α therapy seems be protective against endoscopic recurrence.

背景:克罗恩病(CD)的自然病史可导致需要手术的并发症。关于腹部大手术的儿科数据很少。意大利儿科胃肠病学、肝病学和营养学协会的 IBD 登记处自 2008 年起开始运作,收集了意大利主要儿科 IBD 中心的数据。本报告旨在探讨在已经使用抗肿瘤坏死因子(anti-TNF-α)药物的时代,CD患儿接受腹部大手术的发生率,从而评估手术相关并发症的发生率,并确定术后疾病复发的相关因素:我们回顾性分析了2009年1月至2018年12月登记在册的患者数据。单基因 IBD 患者和因肛周疾病接受手术的患者被排除在外:在 1245 名患者中,共确定了 135 名患者。我们的报告显示,腹部大手术的发生率为 10.8%。54.1%的病例由小儿外科医生实施手术,47.4%的手术采用腹腔镜方法。17名患者(12.6%)共经历了21次早期术后并发症,其中无严重并发症。腹腔镜方法是与术后并发症发生负相关的唯一因素(几率比为 0.22;95% 置信区间为 0.06-0.8;P = 0.02)。54例(40%)患者术后内镜复发,其中33例(24.4%)术后临床复发。术后使用抗肿瘤坏死因子-α药物治疗与内镜复发风险的降低显著相关(几率比,0.19;95% 置信区间,0.05-0.79;P = .02):在我们的队列中,腹部大手术的总体发生率以及手术相关并发症的发生率都很低。术后抗TNF-α治疗似乎对内镜复发有保护作用。
{"title":"Major Abdominal Surgery for Pediatric Crohn's Disease in the Anti-TNF Era: 10-Year Analysis of Data From the IBD Registry of Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition.","authors":"Patrizia Alvisi, Simona Faraci, Luca Scarallo, Marco Congiu, Matteo Bramuzzo, Maria Teresa Illiceto, Serena Arrigo, Claudio Romano, Giovanna Zuin, Erasmo Miele, Simona Gatti, Marina Aloi, Sara Renzo, Tamara Caldaro, Flavio Labriola, Paola De Angelis, Paolo Lionetti","doi":"10.1093/ibd/izad310","DOIUrl":"10.1093/ibd/izad310","url":null,"abstract":"<p><strong>Background: </strong>The natural history of Crohn's disease (CD) can result in complications requiring surgery. Pediatric data are scarce about major abdominal surgery. The IBD Registry from the Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition has been active since 2008 and collects data from major pediatric IBD centers in Italy. The aim of the present report was to explore the prevalence of major abdominal surgery among children affected by CD in an era when antitumor necrosis factor (anti-TNF-α) agents were already used so that we might appraise the incidence of surgical-related complications and identify the factors associated with postoperative disease recurrence.</p><p><strong>Methods: </strong>We retrospectively analyzed data from patients enrolled in the registry from January 2009 to December 2018. Patients with monogenic IBD and patients undergoing surgery for perianal disease were excluded.</p><p><strong>Results: </strong>In total, 135 of 1245 patients were identified. We report the prevalence of major abdominal surgery of 10.8%. Pediatric surgeons performed the procedure in 54.1% of cases, and a laparoscopic approach was used in 47.4% of surgical procedures. Seventeen patients (12.6%) experienced a total of 21 early postoperative complications, none of which was severe. A laparoscopic approach was the only factor negatively associated with the occurrence of postoperative complications (odds ratio, 0.22; 95% confidence interval, 0.06-0.8; P = .02). Fifty-four (40%) patients experienced postoperative endoscopic recurrence, and 33 (24.4%) of them experienced postoperative clinical recurrence. The postoperative treatment with anti-TNF-α drugs was significantly associated with a reduced risk of endoscopic recurrence (odds ratio, 0.19; 95% confidence interval, 0.05-0.79; P = .02).</p><p><strong>Conclusion: </strong>In our cohort, the overall prevalence of major abdominal surgery was low, as well as the rate of surgical-related complications. Postoperative anti-TNF-α therapy seems be protective against endoscopic recurrence.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dietary Patterns and Risk of Inflammatory Bowel Disease: A Systematic Review of Observational Studies. 饮食模式与炎症性肠病的风险:观察性研究的系统回顾》。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.1093/ibd/izad297
Zainab Khademi, Sanaz Pourreza, Anis Amjadifar, Mohammadsadegh Torkizadeh, Farshad Amirkhizi

Background: The incidence of inflammatory bowel disease (IBD) is increasing worldwide. Dietary patterns may be associated with odds of this disease. Although previous reviews have attempted to summarize the evidence in this field, the growing body of investigations prompted us to conduct an updated comprehensive systematic review.

Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to evaluate the association between dietary patterns before disease onset and the risk of IBD. PubMed, SCOPUS, and Web of Science were searched using structured keywords up to November 20, 2023.

Results: Twenty-four publications (13 case-control, 1 nested case-control, and 10 cohort studies) were included in this review. The sample size of these studies ranged from 181 to 482 887 subjects. The findings were inconsistent across the included studies, showing inverse, direct, or no association between different dietary patterns and the risk of IBD.

Conclusions: This review provides comprehensive data on the link between dietary patterns prior to IBD diagnosis and risk of this condition. The explicit finding of present review is the extent gap in our knowledge in this field. Therefore, large-scale, high-quality studies are warranted to improve our understanding of the relationship between dietary patterns and IBD risk.

背景:炎症性肠病(IBD)的发病率在全球范围内不断上升。饮食模式可能与这种疾病的发病率有关。尽管以前的综述曾试图总结这一领域的证据,但越来越多的调查促使我们进行最新的全面系统综述:我们采用系统综述和荟萃分析首选报告项目(PRISMA)指南来评估发病前饮食模式与 IBD 风险之间的关联。使用结构化关键词对 PubMed、SCOPUS 和 Web of Science 进行了检索,截止日期为 2023 年 11 月 20 日:本综述共收录了 24 篇文献(13 篇病例对照研究、1 篇嵌套病例对照研究和 10 篇队列研究)。这些研究的样本量从 181 到 482 887 个受试者不等。所纳入研究的结果不一致,显示不同饮食模式与 IBD 风险之间存在反向、直接或无关联:本综述提供了有关 IBD 诊断前饮食模式与 IBD 患病风险之间关系的全面数据。本综述的明确结论是我们在这一领域的知识存在很大差距。因此,有必要进行大规模、高质量的研究,以提高我们对膳食模式与 IBD 风险之间关系的认识。
{"title":"Dietary Patterns and Risk of Inflammatory Bowel Disease: A Systematic Review of Observational Studies.","authors":"Zainab Khademi, Sanaz Pourreza, Anis Amjadifar, Mohammadsadegh Torkizadeh, Farshad Amirkhizi","doi":"10.1093/ibd/izad297","DOIUrl":"10.1093/ibd/izad297","url":null,"abstract":"<p><strong>Background: </strong>The incidence of inflammatory bowel disease (IBD) is increasing worldwide. Dietary patterns may be associated with odds of this disease. Although previous reviews have attempted to summarize the evidence in this field, the growing body of investigations prompted us to conduct an updated comprehensive systematic review.</p><p><strong>Methods: </strong>We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to evaluate the association between dietary patterns before disease onset and the risk of IBD. PubMed, SCOPUS, and Web of Science were searched using structured keywords up to November 20, 2023.</p><p><strong>Results: </strong>Twenty-four publications (13 case-control, 1 nested case-control, and 10 cohort studies) were included in this review. The sample size of these studies ranged from 181 to 482 887 subjects. The findings were inconsistent across the included studies, showing inverse, direct, or no association between different dietary patterns and the risk of IBD.</p><p><strong>Conclusions: </strong>This review provides comprehensive data on the link between dietary patterns prior to IBD diagnosis and risk of this condition. The explicit finding of present review is the extent gap in our knowledge in this field. Therefore, large-scale, high-quality studies are warranted to improve our understanding of the relationship between dietary patterns and IBD risk.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preoperative Exclusive Enteral Nutrition Is Associated With Reduced Skin and Soft Tissue and Intra-abdominal Infections in Patients With Crohn's Disease Undergoing Intestinal Surgery: Results from a Meta-Analysis. 接受肠道手术的克罗恩病患者术前完全肠内营养与减少皮肤、软组织和腹腔内感染有关:一项 Meta 分析的结果。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.1093/ibd/izad304
Lev Krasnovsky, Andrew T Weber, Victoria Gershuni, Erica Pettke, James D Lewis

Background: Malnutrition is an independent risk factor for adverse postoperative outcomes and is common among patients with Crohn's disease (CD). The objective of this meta-analysis was to precisely quantify the association of preoperative exclusive enteral nutrition (EEN) and total parenteral nutrition (TPN) with surgical outcomes in patients undergoing intestinal surgery for CD.

Methods: PubMed, Embase, and Scopus were queried for comparative studies evaluating the impact of preoperative nutritional support on postoperative outcomes in patients undergoing surgery for CD. Random effects modeling was used to compute pooled estimates of risk difference. Heterogeneity was assessed using I2.

Results: Fourteen studies, all nonrandomized cohort studies, met inclusion criteria for studying EEN. After pooling data from 14 studies (874 EEN treated and 1044 control patients), the relative risk of intra-abdominal septic complications was decreased 2.1-fold in patients receiving preoperative EEN (relative risk 0.47, 95% confidence interval [CI], 0.35-0.63, I2 = 0.0%). After pooling data from 9 studies (638 EEN treated and 819 control patients), the risk of skin and soft tissue infection was decreased 1.6-fold (relative risk 0.63; 95% CI, 0.42-0.94, I2 = 42.7%). No significant differences were identified in duration of surgery, length of bowel resected, or operative blood loss. Among the 9 studies investigating TPN, no significant differences were identified in infectious outcomes.

Conclusions: Preoperative nutritional optimization with EEN was associated with reduced risk of infectious complications in CD patients undergoing intestinal surgery. Preoperative nutritional support with EEN should be considered for optimizing outcomes in CD patients requiring bowel resection surgery.

背景:营养不良是术后不良预后的独立风险因素,在克罗恩病(CD)患者中很常见。这项荟萃分析的目的是精确量化术前纯肠内营养(EEN)和全肠外营养(TPN)与因克罗恩病接受肠道手术的患者的手术效果之间的关系:方法:在PubMed、Embase和Scopus上查询了评估术前营养支持对CD手术患者术后效果影响的对比研究。随机效应模型用于计算风险差异的集合估计值。使用 I2 对异质性进行评估:14项研究均为非随机队列研究,符合研究EEN的纳入标准。汇总14项研究(874例EEN治疗患者和1044例对照患者)的数据后,术前接受EEN治疗的患者发生腹腔内脓毒症并发症的相对风险降低了2.1倍(相对风险0.47,95%置信区间[CI],0.35-0.63,I2 = 0.0%)。在汇总了 9 项研究(638 名接受 EEN 治疗的患者和 819 名对照组患者)的数据后,皮肤和软组织感染的风险降低了 1.6 倍(相对风险 0.63;95% 置信区间 [CI],0.42-0.94,I2 = 42.7%)。在手术持续时间、切除肠道长度或手术失血量方面没有发现明显差异。在9项调查TPN的研究中,未发现感染性结果有显著差异:结论:在接受肠道手术的 CD 患者中,使用 EEN 进行术前营养优化与降低感染并发症风险相关。需要进行肠切除手术的 CD 患者应考虑术前使用 EEN 进行营养支持,以优化治疗效果。
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引用次数: 0
The Long View: 2-Year Outcomes of Mirikizumab for Ulcerative Colitis. 从长计议:米利珠单抗治疗溃疡性结肠炎的两年疗效。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.1093/ibd/izae025
Lushen Pillay, Sreedhar Subramanian
{"title":"The Long View: 2-Year Outcomes of Mirikizumab for Ulcerative Colitis.","authors":"Lushen Pillay, Sreedhar Subramanian","doi":"10.1093/ibd/izae025","DOIUrl":"10.1093/ibd/izae025","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140059301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anti-inflammatory Effects of Bacteroidota Strains Derived From Outstanding Donors of Fecal Microbiota Transplantation for the Treatment of Ulcerative Colitis. 从粪便微生物群移植治疗溃疡性结肠炎的优秀捐赠者中提取的类菌株的抗炎作用
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.1093/ibd/izae080
Dai Ishikawa, Xiaochen Zhang, Kei Nomura, Tomoyoshi Shibuya, Mariko Hojo, Makoto Yamashita, Satoshi Koizumi, Fuhito Yamazaki, Susumu Iwamoto, Masato Saito, Keisuke Kunigo, Ryosuke Nakano, Nakayuki Honma, Itaru Urakawa, Akihito Nagahara

Background: The proportion of certain Bacteroidota species decreased in patients with ulcerative colitis, and the recovery of Bacteroidota is associated with the efficacy of fecal microbiota transplantation therapy. We hypothesized that certain Bacteroidota may advance ulcerative colitis treatment. Accordingly, we aimed to evaluate the anti-inflammatory effects of Bacteroidota strains isolated from donors.

Methods: Donors with proven efficacy of fecal microbiota transplantation for ulcerative colitis were selected, and Bacteroidota strains were isolated from their stools. The immune function of Bacteroidota isolates was evaluated through in vitro and in vivo studies.

Results: Twenty-four Bacteroidota strains were isolated and identified. Using an in vitro interleukin (IL)-10 induction assay, we identified 4 Bacteroidota strains with remarkable IL-10-induction activity. Of these, an Alistipes putredinis strain exhibited anti-inflammatory effects in a mouse model of colitis induced by sodium dextran sulfate and oxazolone. However, 16S rRNA gene-based sequencing analysis of A. putredinis cultures in the in vivo study revealed unexpected Veillonella strain contamination. A second in vitro study confirmed that the coculture exhibited an even more potent IL-10-inducing activity. Furthermore, the production of A. putredinis-induced IL-10 was likely mediated via toll-like receptor 2 signaling.

Conclusions: This study demonstrated that A. putredinis, a representative Bacteroidota species, exhibits anti-inflammatory effects in vivo and in vitro; however, the effects of other Bacteroidota species remain unexplored. Our fecal microbiota transplantation-based reverse translation approach using promising bacterial species may represent a breakthrough in microbiome drug development for controlling dysbiosis during ulcerative colitis.

背景:溃疡性结肠炎患者体内某些类杆菌的比例下降,而类杆菌的恢复与粪便微生物群移植疗法的疗效有关。我们推测,某些类杆菌可能会促进溃疡性结肠炎的治疗。因此,我们旨在评估从供体中分离出的类菌群菌株的抗炎作用:方法:筛选出粪便微生物群移植治疗溃疡性结肠炎疗效确切的供体,并从其粪便中分离出类杆菌属菌株。通过体外和体内研究评估了类杆菌的免疫功能:结果:共分离并鉴定出 24 株类杆菌。通过体外白细胞介素(IL)-10诱导试验,我们确定了 4 种具有显著 IL-10 诱导活性的类杆菌属菌株。其中,Alistipes putredinis菌株在右旋糖酐硫酸钠和恶唑酮诱导的小鼠结肠炎模型中表现出抗炎作用。然而,在体内研究中对 A. putredinis 培养物进行的基于 16S rRNA 基因的测序分析发现了意想不到的 Veillonella 菌株污染。第二次体外研究证实,这种共培养物具有更强的 IL-10 诱导活性。此外,A. putredinis 诱导的 IL-10 的产生可能是通过收费样受体 2 信号传导介导的:结论:本研究表明,A. putredinis(一种具有代表性的类杆菌属物种)在体内和体外都具有抗炎作用;然而,其他类杆菌属物种的作用仍有待探索。我们基于粪便微生物群移植的反向转化方法使用了有前景的细菌物种,这可能是微生物群药物开发的一个突破,可用于控制溃疡性结肠炎期间的菌群失调。
{"title":"Anti-inflammatory Effects of Bacteroidota Strains Derived From Outstanding Donors of Fecal Microbiota Transplantation for the Treatment of Ulcerative Colitis.","authors":"Dai Ishikawa, Xiaochen Zhang, Kei Nomura, Tomoyoshi Shibuya, Mariko Hojo, Makoto Yamashita, Satoshi Koizumi, Fuhito Yamazaki, Susumu Iwamoto, Masato Saito, Keisuke Kunigo, Ryosuke Nakano, Nakayuki Honma, Itaru Urakawa, Akihito Nagahara","doi":"10.1093/ibd/izae080","DOIUrl":"10.1093/ibd/izae080","url":null,"abstract":"<p><strong>Background: </strong>The proportion of certain Bacteroidota species decreased in patients with ulcerative colitis, and the recovery of Bacteroidota is associated with the efficacy of fecal microbiota transplantation therapy. We hypothesized that certain Bacteroidota may advance ulcerative colitis treatment. Accordingly, we aimed to evaluate the anti-inflammatory effects of Bacteroidota strains isolated from donors.</p><p><strong>Methods: </strong>Donors with proven efficacy of fecal microbiota transplantation for ulcerative colitis were selected, and Bacteroidota strains were isolated from their stools. The immune function of Bacteroidota isolates was evaluated through in vitro and in vivo studies.</p><p><strong>Results: </strong>Twenty-four Bacteroidota strains were isolated and identified. Using an in vitro interleukin (IL)-10 induction assay, we identified 4 Bacteroidota strains with remarkable IL-10-induction activity. Of these, an Alistipes putredinis strain exhibited anti-inflammatory effects in a mouse model of colitis induced by sodium dextran sulfate and oxazolone. However, 16S rRNA gene-based sequencing analysis of A. putredinis cultures in the in vivo study revealed unexpected Veillonella strain contamination. A second in vitro study confirmed that the coculture exhibited an even more potent IL-10-inducing activity. Furthermore, the production of A. putredinis-induced IL-10 was likely mediated via toll-like receptor 2 signaling.</p><p><strong>Conclusions: </strong>This study demonstrated that A. putredinis, a representative Bacteroidota species, exhibits anti-inflammatory effects in vivo and in vitro; however, the effects of other Bacteroidota species remain unexplored. Our fecal microbiota transplantation-based reverse translation approach using promising bacterial species may represent a breakthrough in microbiome drug development for controlling dysbiosis during ulcerative colitis.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Inflammatory Bowel Diseases
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