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Pathogenesis, Clinical Presentation and Treatment of Inflammatory Bowel Disease and Its Complications

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (25 May 2023) | Viewed by 8134

Special Issue Editor

Dr. Xiang Xue

E-Mail Website
Guest Editor
Department of Biochemistry and Molecular Biology, University of New Mexico, Albuquerque, NM 87131, USA
Interests: inflammatory bowel disease (IBD); iron metabolism; hypoxia signaling
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Crohn’s disease and ulcerative colitis are two major forms of inflammatory bowel disease (IBD). IBD has affected more than 1.6 million Americans, most of whom are diagnosed at an age younger than 35. The IBD cases are rising at an alarming speed worldwide.

The present Special Issue aims to provide significant insights towards better understanding the Pathogenesis, Clinical Presentation and Treatment of Inflammatory Bowel Disease and its Complications.

The etiology of IBD has been extensively studied, and it is known to be a combination of environmental components, genetic factors, and immune factors which will lead to the alteration of the immune response in the mucosa of the intestine.

With the great success of biologic agents such as anti-TNF-α drugs in IBD therapy, the therapeutic standard has been raised to achieve “mucosal healing”, which requires the complete repair of the intestinal mucosa.

With this Special Issue, we want to collect manuscripts that investigate the Pathogenesis, Clinical Presentation and Treatment of Inflammatory Bowel Disease and its Complications, taking advantage of the latest advanced technologies and artificial intelligence. We welcome Original Research articles, Methods and Review articles.

Dr. Xiang Xue
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • colitis
  • pathogenesis
  • machine learning
  • therapies
  • mucosal healing

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Published Papers (3 papers)

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Research

13 pages, 1110 KiB  
Article
Time Trends of Environmental and Socioeconomic Risk Factors in Patients with Inflammatory Bowel Disease over 40 Years: A Population-Based Inception Cohort 1977–2020
by Panu Wetwittayakhlang, Lorant Gonczi, Petra A. Golovics, Zsuzsanna Kurti, Tunde Pandur, Gyula David, Zsuzsanna Erdelyi, Istvan Szita, Laszlo Lakatos and Peter L. Lakatos
J. Clin. Med. 2023, 12(8), 3026; https://doi.org/10.3390/jcm12083026 - 21 Apr 2023
Cited by 5 | Viewed by 1798
Abstract
Background: Data from population-based studies investigating trends in environmental factors associated with inflammatory bowel disease (IBD) is lacking. We aimed to assess long-term time trends of environmental and socioeconomic factors in IBD patients from a well-defined population-based cohort from Veszprem, Hungary. Methods: Patients [...] Read more.
Background: Data from population-based studies investigating trends in environmental factors associated with inflammatory bowel disease (IBD) is lacking. We aimed to assess long-term time trends of environmental and socioeconomic factors in IBD patients from a well-defined population-based cohort from Veszprem, Hungary. Methods: Patients were included between 1 January 1977, and 31 December 2020. Trends of environmental and socioeconomic factors were evaluated in three periods based on the decade of diagnosis, representing different therapeutic eras: cohort-A,1977–1995; cohort-B,1996–2008 (immunomodulator era); and cohort-C, 2009–2020 (biological era). Results: A total of 2240 incident patients with IBD were included (ulcerative colitis (UC) 61.2%, male 51.2%, median age at diagnosis: 35 years (IQR 29–49)). Rates of active smoking significantly decreased over time in Crohn’s disease (CD): 60.2%, 49.9%, and 38.6% in cohorts A/B/C (p < 0.001). In UC, the rates were low and stable: 15.4%, 15.4%, and 14.5% in cohorts A/B/C (p = 0.981). Oral contraceptive use was more common in CD compared to UC (25.0% vs. 11.6%, p < 0.001). In UC, prevalence of appendectomy before diagnosis decreased over time: 6.4%, 5.5%, and 2.3% in cohorts A/B/C (p = 0.013). No significant changes were found in the socio-geographic characteristics of the IBD population (urban living: UC, 59.8%/64.8%/ 62.5% (p = 0.309) and CD, 62.5%/ 62.0%/ 59.0% (p = 0.636), in cohorts A/B/C). A greater percentage of patients had completed secondary school as the highest education level in later cohorts in both UC (42.9%/50.2%/51.6%, p < 0.001) and CD (49.2%/51.7%/59.5%, p = 0.002). A higher percentage of skilled workers (34.4%/36.2%/38.9%, p = 0.027) was found in UC, but not in CD (p = 0.454). Conclusion: The association between trends of known environmental factors and IBD is complex. Smoking has become less prevalent in CD, but no other major changes occurred in socioeconomic factors over the last four decades that could explain the sharp increase in IBD incidence. Full article
(This article belongs to the Special Issue Pathogenesis, Clinical Presentation and Treatment of Inflammatory Bowel Disease and Its Complications)
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10 pages, 3592 KiB  
Article
Causal Link between Inflammatory Bowel Disease and Fistula: Evidence from Mendelian Randomization Study
by Zongbiao Tan, Shijie Zhu, Chuan Liu, Yang Meng, Jiao Li, Jixiang Zhang and Weiguo Dong
J. Clin. Med. 2023, 12(7), 2482; https://doi.org/10.3390/jcm12072482 - 24 Mar 2023
Cited by 8 | Viewed by 2852
Abstract
Background: Previous observational studies have found that fistulas are common in Crohn’s disease (CD) and less common in ulcerative colitis (UC). However, some patients have a fistula before diagnosis. Based on retrospective analysis, it was not possible to determine whether there was a [...] Read more.
Background: Previous observational studies have found that fistulas are common in Crohn’s disease (CD) and less common in ulcerative colitis (UC). However, some patients have a fistula before diagnosis. Based on retrospective analysis, it was not possible to determine whether there was a bi-directional causal relationship between inflammatory bowel disease (IBD) and fistulas. Methods: Data were extracted from the open GWAS database; 25,042 cases and 34,915 controls were included for IBD, and 6926 cases and 30,228 controls were included for fistula. Two-sample Mendelian randomization and multivariable Mendelian randomization were used in combination to determine the causal relationship between IBD and fistula. Results: Forward MR showed that IBD increased the risk of colonic or urogenital fistula (FISTULA) (OR: 1.09, 95% CI: 1.05 to 1.13, p = 1.22 × 10−6), mainly associated with fissure and fistula of the anal and rectal regions (FISSANAL) (OR:1.10, 95% CI:1.06 to 1.14, p = 6.12 × 10−8), but not with fistulas involving the female genital tract (FEMGENFISTUL) (OR:0.97, 95% CI: 0.85 to 1.11, p = 0.669). Furthermore, both UC and CD increased the risk of FISTULA. However, after adjusting by MVMR, only CD increased the risk of FISTULA (OR: 1.06, 95% CI: 1.02 to 1.11, p = 0.004), and UC did not increase the risk of FISTULA (OR: 1.01, 95% CI: 0.95 to 1.06, p = 0.838). Reverse MR showed that fistulas did not increase the risk of IBD. Conclusion: Our study confirms it is CD, rather than UC, that casually leads to an increased risk of fistula, but fistulas do not increase the risk of IBD. Full article
(This article belongs to the Special Issue Pathogenesis, Clinical Presentation and Treatment of Inflammatory Bowel Disease and Its Complications)
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12 pages, 3235 KiB  
Article
Association between Inflammatory Bowel Disease and Iridocyclitis: A Mendelian Randomization Study
by Yang Meng, Zongbiao Tan, Chuan Liu, Weiguo Dong and Changzheng Chen
J. Clin. Med. 2023, 12(4), 1282; https://doi.org/10.3390/jcm12041282 - 6 Feb 2023
Cited by 9 | Viewed by 2593
Abstract
Background: Iridocyclitis (IC) is a common extraintestinal manifestation of inflammatory bowel disease (IBD). Observational studies showed patients with ulcerative colitis (UC) and Crohn’s disease (CD) both have a higher risk of IC. However, due to the inherent limitations of observational studies, the association [...] Read more.
Background: Iridocyclitis (IC) is a common extraintestinal manifestation of inflammatory bowel disease (IBD). Observational studies showed patients with ulcerative colitis (UC) and Crohn’s disease (CD) both have a higher risk of IC. However, due to the inherent limitations of observational studies, the association and its directionality between the two forms of IBD and IC remain undiscerned. Methods: Genetic variants for IBD and IC were selected as instruments from genome-wide association studies (GWAS) and FinnGen database as instrumental variables, respectively. A bidirectional Mendelian randomization (MR) and multivariable MR were performed successively. Three different MR methods were performed to determine the causal association, including inverse-variance weighted (IVW), MR Egger, and weighted median, whereas IVW was used as the main analysis. Different methods for sensitivity analysis were used, including MR-Egger intercept test, MR Pleiotropy RESidual Sum and Outlier test, Cochran’s Q test, and leave-one-out analysis. Results: Bidirectional MR suggested both UC and CD were positively associated with IC as a whole, acute and subacute IC, and chronic IC. However, in the MVMR analysis, only the association from CD to IC remained stable. In the reverse analysis, no association was observed from IC to UC or CD. Conclusions: Both UC and CD are associated with an increased risk of IC compared with healthy individuals. However, the association between CD and IC is stronger. In the reverse direction, patients with IC do not suffer a higher risk of UC or CD. We emphasize the importance of ophthalmic examinations for IBD patients, especially for CD patients. Full article
(This article belongs to the Special Issue Pathogenesis, Clinical Presentation and Treatment of Inflammatory Bowel Disease and Its Complications)
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