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New Insights into the Diagnosis and Treatment of Inflammatory Bowel...
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New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 29463

Special Issue Editors

Prof. Dr. Renata Talar-Wojnarowska

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Guest Editor
Department of Digestive Tract Diseases, Medical University of Lodz, 90-153 Łódź, Poland
Interests: inflammatory bowel diseases; ulcerative colitis; Crohn’s disease; diagnosis; treatment
Prof. Dr. Piotr Eder

E-Mail Website
Guest Editor
Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, Heliodor Święcicki Hospital, 60-355 Poznań, Poland
Interests: inflammatory bowel diseases; ulcerative colitis; Crohn’s disease; immunology; gastrointestinal endoscopy

Special Issue Information

Dear Colleagues,

Inflammatory bowel disease (IBD), consisting primarily of ulcerative colitis and Crohn’s disease, is a group of debilitating disorders characterised by chronic inflammation of the gastrointestinal tract. Recently, an improved understanding of IBD pathogenesis has led to a set of promising biomarkers of disease activity and prediction of therapeutic outcome. However, given the wide spectrum of clinical manifestations, especially in Crohn’s disease, early IBD diagnosis may be a challenge in clinical practice. Moreover, despite the progress in understanding the underlying pathogenetic mechanisms, effective therapeutic strategies are limited so far for local and systemic inflammatory clinical manifestations. It is known that, due to the chronic nature of the disease and inconsistent treatment outcomes of current anti-IBD drugs or related side effects, about half of all IBD patients still require surgical treatment.

This Special Issue of Life, entitled “New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases”, will showcase selected articles that introduce and discuss novel concepts in the diagnosis and treatment of IBD patients. Long-term, sustained remission is the ultimate goal of contemporary IBD therapy. However, the reality of available treatment involves patients losing their response to therapy or developing complications that require the cessation of medication. 

In view of these challenges, we invite researchers to contribute original research articles and reviews aimed at clinical manifestation, diagnosis, and therapeutic interventions in IBD patients.

Prof. Dr. Renata Talar-Wojnarowska
Prof. Dr. Piotr Eder
Guest Editors

Manuscript Submission Information

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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. Life is an international peer-reviewed open access monthly 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

  • inflammatory bowel disease (IBD)
  • Crohn's disease
  • ulcerative colitis
  • clinical manifestation
  • diagnosis
  • therapeutic intervention

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Published Papers (9 papers)

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Research

Jump to: Review

14 pages, 722 KiB  
Article
Perfusion Visualization during Ileal J-Pouch Formation—A Proposal for the Standardization of Intraoperative Imaging with Indocyanine Green Near-Infrared Fluorescence and a Postoperative Follow-Up in IBD Surgery
by Leonard A. Lobbes, Susanne Berns, René Warschkow, Leonard R. Schmidt, Christian Schineis, Rahel M. Strobel, Johannes C. Lauscher, Katharina Beyer and Benjamin Weixler
Life 2022, 12(5), 668; https://doi.org/10.3390/life12050668 - 30 Apr 2022
Cited by 5 | Viewed by 2085
Abstract
Background: An anastomotic leak (AL) after a restorative proctocolectomy and an ileal J-pouch increases morbidity and the risk of pouch failure. Thus, a perfusion assessment during J-pouch formation is crucial. While indocyanine green near-infrared fluorescence (ICG-NIRF) has shown potential to reduce ALs, its [...] Read more.
Background: An anastomotic leak (AL) after a restorative proctocolectomy and an ileal J-pouch increases morbidity and the risk of pouch failure. Thus, a perfusion assessment during J-pouch formation is crucial. While indocyanine green near-infrared fluorescence (ICG-NIRF) has shown potential to reduce ALs, its suitability in a restorative proctocolectomy remains unclear. We aimed to develop a standardized approach for investigating ICG-NIRF and ALs in pouch surgery. Methods: Patients undergoing a restorative proctocolectomy with an ileal J-pouch for ulcerative colitis at an IBD-referral-center were included in a prospective study in which an AL within 30 postoperative days was the primary outcome. Intraoperatively, standardized perfusion visualization with ICG-NIRF was performed and video recorded for postoperative analysis at three time points. Quantitative clinical and technical variables (secondary outcome) were correlated with the primary outcome by descriptive analysis and logistic regression. A novel definition and grading of AL of the J-pouch was applied. A postoperative pouchoscopy was routinely performed to screen for AL. Results: Intraoperative ICG-NIRF-visualization and its postoperative visual analysis in 25 patients did not indicate an AL. The anastomotic site after pouch formation appeared completely fluorescent with a strong fluorescence signal (category 2) in all cases of ALs (4 of 25). Anastomotic site was not changed. ICG-NIRF visualization was reproducible and standardized. Logistic regression identified a two-stage approach vs. a three-stage approach (Odds ratio (OR) = 20.00, 95% confidence interval [CI] = 1.37–580.18, p = 0.029) as a risk factor for ALs. Conclusion: We present a standardized, comparable approach of ICG-NIRF visualization in pouch surgery. Our data indicate that the visual interpretation of ICG-NIRF alone may not detect ALs of the pouch in all cases—quantifiable, objective methods of interpretation may be required in the future. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases)
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12 pages, 282 KiB  
Article
The Association between Temperament, Chronotype, Depressive Symptoms, and Disease Activity among Patients with Inflammatory Bowel Disease—A Cross-Sectional Pilot Study
by Łukasz Mokros, Danuta Domżał-Magrowska, Tadeusz Pietras, Kasper Sipowicz and Renata Talar-Wojnarowska
Life 2021, 11(12), 1347; https://doi.org/10.3390/life11121347 - 5 Dec 2021
Cited by 1 | Viewed by 2497
Abstract
The psychological aspect may play an important role in ulcerative colitis (UC) and Crohn’s disease (CD). The aims of this study were to explore the differences between patients with UC and CD regarding chronotype, temperament and depression, and to assess the psychological factors [...] Read more.
The psychological aspect may play an important role in ulcerative colitis (UC) and Crohn’s disease (CD). The aims of this study were to explore the differences between patients with UC and CD regarding chronotype, temperament and depression, and to assess the psychological factors mentioned as predictors of disease activity. In total, n = 37 patients with UC and n = 47 patients with CD were included in the study. They underwent a clinical assessment, including the Mayo score or Crohn Disease Activity Index (CDAI), and completed questionnaires: a sociodemographic survey, Formal Characteristics of Behavior–Temperament Inventory (FCB-TI), Chronotype Questionnaire (CQ), and the Beck Depression Index II (BDI). The Sensory Sensitivity score was higher among patients with CD than UC (p = 0.04). The emotional reactivity and endurance scores were higher among women than men with CD (p = 0.028 and p = 0.012 respectively). CQ Morningness–Eveningness (ME) correlated with Endurance (p = 0.041), Emotional Reactivity (p = 0.016), and Activity (p = 0.004). ME correlated with Rhythmicity among CD patients (p = 0.002). The Mayo score was predicted by Perseverance. The CDAI score was predicted by the BDI score. The pattern of the relationship between chronotype and temperament may differentiate patients with UC and CD. Personal disposition may play a role in the clinical assessment of patients with IBD. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases)
10 pages, 1682 KiB  
Article
Potential Salivary Markers for Differential Diagnosis of Crohn’s Disease and Ulcerative Colitis
by Kacper Nijakowski, Rafał Rutkowski, Piotr Eder, Marek Simon, Katarzyna Korybalska, Janusz Witowski and Anna Surdacka
Life 2021, 11(9), 943; https://doi.org/10.3390/life11090943 - 9 Sep 2021
Cited by 21 | Viewed by 2835
Abstract
The properties of the saliva of patients with inflammatory bowel disease (IBD) are poorly recognized. Likewise, the diagnostic potential of saliva for differentiating various forms of IBD is largely unexplored. Therefore, we compared the concentrations of several parameters in unstimulated whole mixed saliva [...] Read more.
The properties of the saliva of patients with inflammatory bowel disease (IBD) are poorly recognized. Likewise, the diagnostic potential of saliva for differentiating various forms of IBD is largely unexplored. Therefore, we compared the concentrations of several parameters in unstimulated whole mixed saliva collected in a standardized manner from patients with active IBD unresponsive to conventional therapy. The samples were received from 27 patients with Crohn’s disease (CD), 24 patients with ulcerative colitis (UC), and 51 healthy individuals. Compared to the controls, the salivary concentrations of S100A8/calprotectin, myeloperoxidase, and IgA were significantly decreased in both CD and UC patients. In addition, patients with UC had decreased levels of TNF-R1 and decreased catalase activity. Interestingly, the concentrations of myeloperoxidase and TNF-R1 showed a high differentiation potential for CD and UC (AUC = 0.690 and 0.672, respectively). All these findings are discussed in the context of host defense in the oral cavity, patients’ prior treatment regimens, and smoking habits. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases)
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Review

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13 pages, 596 KiB  
Review
The Role of Chronic Fatigue in Patients with Crohn’s Disease
by Marcin Włodarczyk, Adam Makaro, Mateusz Prusisz, Jakub Włodarczyk, Marta Nowocień, Kasper Maryńczak, Jakub Fichna and Łukasz Dziki
Life 2023, 13(8), 1692; https://doi.org/10.3390/life13081692 - 5 Aug 2023
Cited by 1 | Viewed by 2128
Abstract
Crohn’s disease (CD) is a chronic, relapsing disorder belonging to inflammatory bowel diseases (IBD). It is manifested by relapsing transmural inflammation found in any segment of the gastrointestinal tract. Chronic fatigue is a common and underrecognized symptom of CD for which the prevalence [...] Read more.
Crohn’s disease (CD) is a chronic, relapsing disorder belonging to inflammatory bowel diseases (IBD). It is manifested by relapsing transmural inflammation found in any segment of the gastrointestinal tract. Chronic fatigue is a common and underrecognized symptom of CD for which the prevalence is much higher in the population of CD patients compared to the healthy population. It stems from an intricate web of interactions between various risk factors, and its pathophysiology is still not fully understood. The implementation of routine screening and a holistic, multidisciplinary approach involving psychological support may be crucial in the management of CD patients with chronic fatigue. There is currently no single intervention aimed at decreasing fatigue alone, and its treatment is especially difficult in patients with fatigue persisting despite clinical and endoscopic remission. Extensive research is still needed in order to be able to predict, prevent, identify, and ultimately treat fatigue associated with CD. The aim of this review is to summarize the knowledge on the etiology, diagnosis, and treatment of chronic fatigue in CD patients. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases)
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11 pages, 843 KiB  
Review
Autoimmune Hemolytic Anemia in Inflammatory Bowel Disease—Report of a Case and Review of the Literature
by Aleksandar Toplicanin, Ljubisa Toncev, Vera Matovic Zaric and Aleksandra Sokic Milutinovic
Life 2022, 12(11), 1784; https://doi.org/10.3390/life12111784 - 4 Nov 2022
Cited by 3 | Viewed by 2537
Abstract
A wide spectrum of extraintestinal manifestations (EIMs) can burden patients with inflammatory bowel disease (IBD). EIMs contribute fairly to morbidity and mortality rates in IBD patients. Moreover, EIMs in IBD patients are so frequent that some suggest that IBD should be approached as [...] Read more.
A wide spectrum of extraintestinal manifestations (EIMs) can burden patients with inflammatory bowel disease (IBD). EIMs contribute fairly to morbidity and mortality rates in IBD patients. Moreover, EIMs in IBD patients are so frequent that some suggest that IBD should be approached as a systemic disorder. Anemia is very common in IBD patients. The two most common types of anemia in IBD, iron deficiency anemia and anemia of chronic disease, are extraintestinal complications. Autoimmune hemolytic anemia (AIHA) is a rare extraintestinal manifestation of IBD, more frequent in ulcerative colitis (UC) than in Crohn’s disease (CD). In this case-based review of the literature, we present a 36-year-old female patient diagnosed with Crohn’s disease (CD) and Coombs positive AIHA, complicated by pulmonary thromboembolism and successfully treated with anti-tumor necrosis factor (anti-TNF) therapy. The underlying pathophysiological mechanism of AIHA in IBD is unclear. Treatment options for AIHA in IBD patients before biologic therapy included corticosteroids alone or in combination with azathioprine (AZA), methotrexate, and surgical treatment (colectomy and/or splenectomy). Currently, biologic therapy is a promising therapeutic option, especially in corticosteroid refractory or corticosteroid-dependent IBD patients with AIHA. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases)
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20 pages, 385 KiB  
Review
Genetic Aspects of Micronutrients Important for Inflammatory Bowel Disease
by Sanja Dragasevic, Biljana Stankovic, Nikola Kotur, Aleksandra Sokic Milutinovic, Tamara Milovanovic, Milica Stojkovic Lalosevic, Maja Stojanovic, Sonja Pavlovic and Dragan Popovic
Life 2022, 12(10), 1623; https://doi.org/10.3390/life12101623 - 18 Oct 2022
Cited by 6 | Viewed by 2573
Abstract
Inflammatory bowel disease (IBD), Crohn’s disease (CD) and ulcerative colitis (UC) are complex diseases whose etiology is associated with genetic and environmental risk factors, among which are diet and gut microbiota. To date, IBD is an incurable disease and the main goal of [...] Read more.
Inflammatory bowel disease (IBD), Crohn’s disease (CD) and ulcerative colitis (UC) are complex diseases whose etiology is associated with genetic and environmental risk factors, among which are diet and gut microbiota. To date, IBD is an incurable disease and the main goal of its treatment is to reduce symptoms, prevent complications, and improve nutritional status and the quality of life. Patients with IBD usually suffer from nutritional deficiency with imbalances of specific micronutrient levels that contribute to the further deterioration of the disease. Therefore, along with medications usually used for IBD treatment, therapeutic strategies also include the supplementation of micronutrients such as vitamin D, folic acid, iron, and zinc. Micronutrient supplementation tailored according to individual needs could help patients to maintain overall health, avoid the triggering of symptoms, and support remission. The identification of individuals’ genotypes associated with the absorption, transport and metabolism of micronutrients can modify future clinical practice in IBD and enable individualized treatment. This review discusses the personalized approach with respect to genetics related to micronutrients commonly used in inflammatory bowel disease treatment. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases)
13 pages, 1042 KiB  
Review
Metabolic Bone Disorders in Children with Inflammatory Bowel Diseases
by Mariusz Olczyk, Elżbieta Czkwianianc and Anna Socha-Banasiak
Life 2022, 12(3), 423; https://doi.org/10.3390/life12030423 - 15 Mar 2022
Cited by 6 | Viewed by 2719
Abstract
In recent years, there has been a noticeable increase in the incidence of inflammatory bowel diseases in the pediatric population. Entry observations demonstrate anemia, malabsorption, deficiencies in vitamin D and calcium. These aspects, together with the systemic action of pro-inflammatory cytokines and steroid [...] Read more.
In recent years, there has been a noticeable increase in the incidence of inflammatory bowel diseases in the pediatric population. Entry observations demonstrate anemia, malabsorption, deficiencies in vitamin D and calcium. These aspects, together with the systemic action of pro-inflammatory cytokines and steroid therapy are widely recognized as factors influencing bone metabolism. Presently, however, there are very few studies that can be found in the scientific literature on metabolic disorders in patients with IBD, especially in the pediatric population as the coexistence has not been sufficiently examined and understood. This review aims to summarize the currently available literature, as well as assess which areas have information gaps and need further research. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases)
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21 pages, 661 KiB  
Review
Role of Biomarkers in the Diagnosis and Treatment of Inflammatory Bowel Disease
by Kohei Wagatsuma, Yoshihiro Yokoyama and Hiroshi Nakase
Life 2021, 11(12), 1375; https://doi.org/10.3390/life11121375 - 10 Dec 2021
Cited by 25 | Viewed by 7739
Abstract
The number of patients with inflammatory bowel disease (IBD) is increasing worldwide. Endoscopy is the gold standard to assess the condition of IBD. The problem with this procedure is that the burden and cost on the patient are high. Therefore, the identification of [...] Read more.
The number of patients with inflammatory bowel disease (IBD) is increasing worldwide. Endoscopy is the gold standard to assess the condition of IBD. The problem with this procedure is that the burden and cost on the patient are high. Therefore, the identification of a reliable biomarker to replace endoscopy is desired. Biomarkers are used in various situations such as diagnosis of IBD, evaluation of disease activity, prediction of therapeutic effect, and prediction of relapse. C-reactive protein and fecal calprotectin have a lot of evidence as objective biomarkers of disease activity in IBD. The usefulness of the fecal immunochemical test, serum leucine-rich glycoprotein, and urinary prostaglandin E major metabolite have also been reported. Herein, we comprehensively review the usefulness and limitations of biomarkers that can be used in daily clinical practice regarding IBD. To date, no biomarker is sufficiently accurate to replace endoscopy; however, it is important to understand the characteristics of each biomarker and use the appropriate biomarker at the right time in daily clinical practice. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases)
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13 pages, 656 KiB  
Review
Current Overview on the Use of Mesenchymal Stem Cells for Perianal Fistula Treatment in Patients with Crohn’s Disease
by Marcin Włodarczyk, Katarzyna Czerwińska, Jakub Włodarczyk, Jakub Fichna, Adam Dziki and Łukasz Dziki
Life 2021, 11(11), 1133; https://doi.org/10.3390/life11111133 - 25 Oct 2021
Cited by 6 | Viewed by 2632
Abstract
Perianal fistula in patients with Crohn’s disease is an extremely challenging condition. The disease tends to reoccur, and with current treatment options, a large number of patients are left with active ailment and experience major morbidity. In recent years, hopeful results regarding local [...] Read more.
Perianal fistula in patients with Crohn’s disease is an extremely challenging condition. The disease tends to reoccur, and with current treatment options, a large number of patients are left with active ailment and experience major morbidity. In recent years, hopeful results regarding local use of mesenchymal stem cells (MSCs) in perianal Crohn’s disease have been published. Although to this day there are no clear guidelines determining optimal dosage, injections frequency and culture conditions, their efficiency has proven to be much higher than conventionally used methods. According to studies, they can effectively induce as well as maintain fistula closure. This approach also avoids common side effects related to conventional surgical treatment. Full article
(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Inflammatory Bowel Diseases)
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