1
|
Brem O, Elisha D, Konen E, Amitai M, Klang E. Deep learning in magnetic resonance enterography for Crohn's disease assessment: a systematic review. Abdom Radiol (NY) 2024; 49:3183-3189. [PMID: 38693270 PMCID: PMC11335790 DOI: 10.1007/s00261-024-04326-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 03/15/2024] [Accepted: 04/01/2024] [Indexed: 05/03/2024]
Abstract
Crohn's disease (CD) poses significant morbidity, underscoring the need for effective, non-invasive inflammatory assessment using magnetic resonance enterography (MRE). This literature review evaluates recent publications on the role of deep learning in improving MRE for CD assessment. We searched MEDLINE/PUBMED for studies that reported the use of deep learning algorithms for assessment of CD activity. The study was conducted according to the PRISMA guidelines. The risk of bias was evaluated using the QUADAS-2 tool. Five eligible studies, encompassing 468 subjects, were identified. Our study suggests that diverse deep learning applications, including image quality enhancement, bowel segmentation for disease burden quantification, and 3D reconstruction for surgical planning are useful and promising for CD assessment. However, most of the studies are preliminary, retrospective studies, and have a high risk of bias in at least one category. Future research is needed to assess how deep learning can impact CD patient diagnostics, particularly when considering the increasing integration of such models into hospital systems.
Collapse
Affiliation(s)
- Ofir Brem
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Arrow Program for Research Education, Sheba Medical Center, Tel-Hashomer, Israel.
| | - David Elisha
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Arrow Program for Research Education, Sheba Medical Center, Tel-Hashomer, Israel
| | - Eli Konen
- Division of Diagnostic Imaging, The Chaim Sheba Medical Center, Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Amitai
- Arrow Program for Research Education, Sheba Medical Center, Tel-Hashomer, Israel
- Division of Diagnostic Imaging, The Chaim Sheba Medical Center, Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Klang
- Arrow Program for Research Education, Sheba Medical Center, Tel-Hashomer, Israel
- The Division of Data Driven and Digital Medicine (D3M), Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
2
|
Zoroddu S, Di Lorenzo B, Paliogiannis P, Mangoni AA, Carru C, Zinellu A. The association between bilirubin concentrations and inflammatory bowel disease: Insights from a systematic review and meta-analysis. Eur J Clin Invest 2024:e14281. [PMID: 38970234 DOI: 10.1111/eci.14281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/31/2024] [Accepted: 06/25/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), poses a significant challenge to health care systems because of its chronic nature and increasing global prevalence. Effective management of IBD requires accurate diagnostic tools and biomarkers. This systematic review and meta-analysis aimed to evaluate the relationship between bilirubin concentrations and IBD activity and outcomes. METHODS A comprehensive search of electronic databases identified 11 studies that included 2606 subjects with IBD and 3607 healthy controls. RESULTS Bilirubin concentrations were significantly lower in subjects with IBD when compared to controls (SMD = -0.96, 95% CI -1.21 to -0.70; p < .001). Although substantial heterogeneity was observed, sensitivity analysis confirmed the robustness of the results. Publication bias was detected, but subgroup analyses did not significantly alter the results. Meta-regression showed that age was a significant factor influencing the association between bilirubin concentrations and IBD. Subgroup analyses showed a more pronounced reduction in bilirubin concentrations in subjects with CD than those with UC. CONCLUSION This study supports the potential utility of bilirubin as a biomarker in IBD, emphasizing the need for further research to validate its clinical significance.
Collapse
Affiliation(s)
- Stefano Zoroddu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Biagio Di Lorenzo
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Panagiotis Paliogiannis
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
- Anatomic Pathology and Histology Unit, University Hospital (AOU) of Sassari, Sassari, Italy
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Medical Oncology Unit, University Hospital (AOU) of Sassari, Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| |
Collapse
|
3
|
Yarur AJ, Chiorean MV, Panés J, Jairath V, Zhang J, Rabbat CJ, Sandborn WJ, Vermeire S, Peyrin-Biroulet L. Achievement of Clinical, Endoscopic, and Histological Outcomes in Patients with Ulcerative Colitis Treated with Etrasimod, and Association with Faecal Calprotectin and C-reactive Protein: Results From the Phase 2 OASIS Trial. J Crohns Colitis 2024; 18:885-894. [PMID: 38245818 PMCID: PMC11147797 DOI: 10.1093/ecco-jcc/jjae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/20/2023] [Accepted: 01/19/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND AND AIMS Etrasimod is an oral, once-daily, selective sphingosine 1-phosphate (S1P)1,4,5 receptor modulator for the treatment of moderately to severely active ulcerative colitis [UC]. This post-hoc analysis of the phase 2 OASIS trial [NCT02447302] evaluated its efficacy for endoscopic improvement-histologic remission [EIHR] and assessed correlation between faecal calprotectin [FCP] and C-reactive protein [CRP] levels with efficacy outcomes. METHODS In total, 156 adults with moderately to severely active UC received once-daily etrasimod (1 mg [n = 52]; 2 mg [n = 50]) or placebo [n = 54] for 12 weeks. Clinical, endoscopic, and histologic variables were evaluated at baseline and Week 12. EIHR was defined as achievement of endoscopic improvement [endoscopic subscore ≤ 1, without friability] and histologic remission [Geboes score < 2.0]. Outcomes included the relationships between FCP and CRP concentration and clinical, endoscopic, and histologic variables. RESULTS Achievement of EIHR was significantly higher in patients who received etrasimod 2 mg versus placebo [19.5% vs 4.1%; Mantel-Haenszel estimated difference, 15.4%; p = 0.010]. In the etrasimod 2 mg group, median FCP and CRP levels at Week 12 were significantly lower in patients who achieved clinical remission, endoscopic improvement, histologic remission, and EIHR versus patients who did not [all p < 0.05]. An FCP concentration cutoff of 250 µg/g achieved optimum sensitivity and specificity for efficacy, including EIHR [0.857 and 0.786, respectively; κ coefficient, 0.3584]. Higher proportions of patients with FCP ≤ 250 µg/g achieved efficacy outcomes at Week 12 versus patients with FCP > 250 µg/g. CONCLUSIONS Etrasimod was effective for inducing EIHR in patients with UC. FCP and CRP may be useful, noninvasive biomarkers to monitor treatment response. CLINICALTRIALS.GOV NUMBER NCT02447302.
Collapse
Affiliation(s)
| | | | - Julián Panés
- Hospital Clinic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain
| | | | - Jinkun Zhang
- Arena Pharmaceuticals, Inc, San Diego, CA, USA, a wholly owned subsidiary of Pfizer Inc, New York, NY, USA
| | - Christopher J Rabbat
- Arena Pharmaceuticals, Inc, San Diego, CA, USA, a wholly owned subsidiary of Pfizer Inc, New York, NY, USA
| | | | | | - Laurent Peyrin-Biroulet
- INSERM, NGERE, University of Lorraine, F54000 Nancy, France
- Groupe Hospitalier Privé Ambroise Paré – Hartmann, Paris IBD Center, 92200 Neuilly-sur-Seine, France
| |
Collapse
|
4
|
Cohen-Mekelburg S, Goldstein CA, Rizvydeen M, Fayyaz Z, Patel PJ, Berinstein JA, Bishu S, Cushing-Damm KC, Kim HM, Burgess HJ. Morning light treatment for inflammatory bowel disease: a clinical trial. BMC Gastroenterol 2024; 24:179. [PMID: 38778264 PMCID: PMC11110384 DOI: 10.1186/s12876-024-03263-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) affects over 3 million Americans and has a relapsing and remitting course with up to 30% of patients experiencing exacerbations each year despite the availability of immune targeted therapies. An urgent need exists to develop adjunctive treatment approaches to better manage IBD symptoms and disease activity. Circadian disruption is associated with increased disease activity and may be an important modifiable treatment target for IBD. Morning light treatment, which advances and stabilizes circadian timing, may have the potential to improve IBD symptoms and disease activity, but no studies have explored these potential therapeutic benefits in IBD. Therefore, in this study, we aim to test the effectiveness of morning light treatment for patients with IBD. METHODS We will recruit sixty-eight individuals with biopsy-proven IBD and clinical symptoms and randomize them to 4-weeks of morning light treatment or 4-weeks of treatment as usual (TAU), with equivalent study contact. Patient-reported outcomes (IBD-related quality of life, mood, sleep), clinician-rated disease severity, and a biomarker of gastrointestinal inflammation (fecal calprotectin) will be assessed before and after treatment. Our primary objective will be to test the effect of morning light treatment versus TAU on IBD-related quality of life and our secondary objectives will be to test the effects on clinician-rated disease activity, depression, and sleep quality. We will also explore the effect of morning light treatment versus TAU on a biomarker of gastrointestinal inflammation (fecal calprotectin), and the potential moderating effects of steroid use, restless leg syndrome, and biological sex. DISCUSSION Morning light treatment may be an acceptable, feasible, and effective adjunctive treatment for individuals with active IBD suffering from impaired health-related quality of life. TRIAL REGISTRATION The study protocol was registered on ClinicalTrials.gov as NCT06094608 on October 23, 2023, before recruitment began on February 1, 2024.
Collapse
Affiliation(s)
- Shirley Cohen-Mekelburg
- Division of Gastroenterology and Hepatology, University of Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
| | | | - Muneer Rizvydeen
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Zainab Fayyaz
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Priya J Patel
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Jeffrey A Berinstein
- Division of Gastroenterology and Hepatology, University of Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Shrinivas Bishu
- Division of Gastroenterology and Hepatology, University of Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Kelly C Cushing-Damm
- Division of Gastroenterology and Hepatology, University of Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Hyungjin Myra Kim
- Consulting for Statistics, Computing and Analytics Research, University of Michigan, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Helen J Burgess
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
5
|
Tonkic A, Kumric M, Akrapovic Olic I, Rusic D, Zivkovic PM, Supe Domic D, Sundov Z, Males I, Bozic J. Growth differentiation factor-15 serum concentrations reflect disease severity and anemia in patients with inflammatory bowel disease. World J Gastroenterol 2024; 30:1899-1910. [PMID: 38659482 PMCID: PMC11036493 DOI: 10.3748/wjg.v30.i13.1899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/29/2024] [Accepted: 03/13/2024] [Indexed: 04/03/2024] Open
Abstract
BACKGROUND Population of patients with inflammatory bowel disease (IBD) is burdened by various extraintestinal manifestations which substantially contribute to greater morbidity and mortality. Growth-differentiation factor-15 (GDF-15) is often over-expressed under stress conditions, such as inflammation, malignancies, heart failure, myocardial ischemia, and many others. AIM To explore the association between GDF-15 and IBD as serum concentrations of GDF-15 were shown to be an independent predictor of poor outcomes in multiple diseases. An additional aim was to determine possible associations between GDF-15 and multiple clinical, anthropometric and laboratory parameters in patients with IBD. METHODS This cross-sectional study included 90 adult patients diagnosed with IBD, encompassing both Crohn's disease (CD) and ulcerative colitis (UC), and 67 healthy age- and sex-matched controls. All patients underwent an extensive workup, including colonoscopy with subsequent histopathological analysis. Disease activity was assessed by two independent gastroenterology consultants specialized in IBD, employing well-established clinical and endoscopic scoring systems. GDF-15 serum concentrations were determined following an overnight fasting, using electrochemiluminescence immunoassay. RESULTS In patients with IBD, serum GDF-15 concentrations were significantly higher in comparison to the healthy controls [800 (512-1154) pg/mL vs 412 (407-424) pg/mL, P < 0.001], whereas no difference in GDF-15 was found between patients with CD and UC [807 (554-1451) pg/mL vs 790 (509-956) pg/mL, P = 0.324]. Moreover, multiple linear regression analysis showed that GDF-15 levels predict CD and UC severity independent of age, sex, and C-reactive protein levels (P = 0.016 and P = 0.049, respectively). Finally, an association between GDF-15 and indices of anemia was established. Specifically, negative correlations were found between GDF-15 and serum iron levels (r = -0.248, P = 0.021), as well as GDF-15 and hemoglobin (r = -0.351, P = 0.021). Accordingly, in comparison to IBD patients with normal hemoglobin levels, GDF-15 serum levels were higher in patients with anemia (1256 (502-2100) pg/mL vs 444 (412-795) pg/mL, P < 0.001). CONCLUSION For the first time, we demonstrated that serum concentrations of GDF-15 are elevated in patients with IBD in comparison to healthy controls, and the results imply that GDF-15 might be involved in IBD pathophysiology. Yet, it remains elusive whether GDF-15 could serve as a prognostic indicator in these patients.
Collapse
Affiliation(s)
- Ante Tonkic
- Biology of Neoplasms, University of Split School of Medicine, Split 21000, Croatia
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Ivna Akrapovic Olic
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine, Split 21000, Croatia
| | - Piero Marin Zivkovic
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Daniela Supe Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Split 21000, Croatia
- Department of Health Studies, University of Split, Split 21000, Croatia
| | - Zeljko Sundov
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
- Department of Internal Medicine, University of Split School of Medicine, Split 21000, Croatia
| | - Ivan Males
- Department of Surgery, University Hospital of Split, Split 21000, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| |
Collapse
|
6
|
Hossein-Javaheri N, O’Connor K, Steinhart H, Deshpande A, Maxwell C, Huang V, Tandon P. Perceptions and Prevalence of Cannabis Use in Women With Inflammatory Bowel Disease of Reproductive Age: A Cross-Sectional Study. J Can Assoc Gastroenterol 2024; 7:204-211. [PMID: 38596807 PMCID: PMC10999762 DOI: 10.1093/jcag/gwad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Background Many patients with inflammatory bowel disease (IBD) may use cannabis for relief of symptoms. During pregnancy, however, cannabis exposure may be associated with adverse pregnancy outcomes. We aimed to determine the prevalence and perceptions of cannabis use in women with IBD. Methods Through recruitment at Mount Sinai Hospital and online platforms such as Twitter, women with IBD (age 18-45) were asked to complete anonymous surveys on demographics, cannabis use, perception of use during pregnancy, and discussing its use with healthcare providers (HCP). Categorical variables were reported as frequencies and compared across groups with the chi-square test. Results One-hundred and two pregnant patients with IBD were included in this study, 19 (18.6%) reported using cannabis. Current users were more likely to report constant pain in the last 12 months and discuss its use with their HCP. Fifty-three (52.0%) women were unsure of the specific risks associated with cannabis use during pregnancy, and only 15 (14.7%) had ever discussed its use with their HCP. Those who had discussed cannabis use with their HCP were more likely to have prior IBD-related surgery, perceive its use unsafe during pregnancy, and be more likely to be using cannabis. Conclusion Many women with IBD report uncertainty of the risks of cannabis use during pregnancy and the majority have never discussed cannabis use with their providers. With the increasing legalization of cannabis in many jurisdictions, it is imperative patients and healthcare providers discuss the risks and benefits of its use, particularly during vulnerable times such as pregnancy.
Collapse
Affiliation(s)
- Nariman Hossein-Javaheri
- Department of Internal Medicine, University at Buffalo-State University of New York, Buffalo, New York, USA
| | - Katie O’Connor
- Division of Gastroenterology and Hepatology, University Health Network/Mount Sinai Hospital, University of Toronto, Toronto, Ontario, M5G 1X5Canada
| | - Hillary Steinhart
- Division of Gastroenterology and Hepatology, University Health Network/Mount Sinai Hospital, University of Toronto, Toronto, Ontario, M5G 1X5Canada
| | - Amol Deshpande
- Department of Family and Community Medicine, Toronto Rehabilitation Institute, Quality and Innovation, University of Toronto, Ontario, Canada
| | - Cynthia Maxwell
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Ontario, Canada
| | - Vivian Huang
- Division of Gastroenterology and Hepatology, University Health Network/Mount Sinai Hospital, University of Toronto, Toronto, Ontario, M5G 1X5Canada
| | - Parul Tandon
- Division of Gastroenterology and Hepatology, University Health Network/Mount Sinai Hospital, University of Toronto, Toronto, Ontario, M5G 1X5Canada
| |
Collapse
|
7
|
Behnoush AH, Maroufi SP, Reshadmanesh T, Mohtasham Kia Y, Norouzi M, Mohammadi SM, Klisic A, Khalaji A. Circulatory resistin levels in inflammatory bowel disease: a systematic review and meta-analysis. BMC Gastroenterol 2024; 24:107. [PMID: 38486190 PMCID: PMC10941394 DOI: 10.1186/s12876-024-03199-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/11/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is a chronic relapsing-remitting systemic disease of the gastrointestinal tract with rising incidence. Studies have shown that adipocytes play a crucial role in patients with IBD by actively participating in systemic immune responses. The present study was designed to investigate the correlation between the circulatory levels of resistin, as an adipokine, and active and remission phases of IBD in comparison with healthy controls. METHODS Relevant articles were retrieved from PubMed, Embase, the Web of Science, and Scopus from inception until June 2023. Estimation of the standardized mean difference (SMD) and 95% confidence interval (CI) for comparison of plasma/serum resistin levels between IBD patients, patients in remission, and healthy controls were conducted through random-effect meta-analysis. RESULTS A total of 19 studies were included, assessing 1836 cases. Meta-analysis indicated that generally, serum/plasma resistin levels were higher in IBD patients in comparison with healthy controls (SMD 1.33, 95% CI 0.58 to 2.08, p-value < 0.01). This was true for each of the UC and CD separate analyses, as well. Moreover, it was shown that higher serum/plasma resistin levels were detected in the active phase of IBD than in the remission phase (SMD 1.04, 95% CI 0.65 to 1.42, p-value = 0.01). Finally, higher serum/plasma resistin levels were found in the remission phase compared to healthy controls (SMD 0.60, 95% CI 0.15 to 1.06, p-value < 0.01). CONCLUSION The results of this systematic review and meta-analysis support the conclusion that circulating resistin levels are increased in IBD (both UC and CD). Also, higher resistin levels were recorded in the remission phase of IBD in comparison with healthy controls. This indicates that further studies may provide valuable insights into the role of resistin in the pathogenesis of IBD.
Collapse
Affiliation(s)
- Amir Hossein Behnoush
- School of Medicine, Tehran University of Medical Sciences, Poursina St., Keshavarz Blvd, 1417613151, Tehran, Iran.
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Seyede Parmis Maroufi
- Neurosurgical Research Network, Universal Scientific Education and Research Network, Tehran University of Medical Sciences, Tehran, Iran
| | - Tara Reshadmanesh
- Student Research Center, School of Medicine, Zanjan University of Medical Science, Zanjan, Iran
| | | | - Mitra Norouzi
- Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | | | - Aleksandra Klisic
- Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
- Center for Laboratory Diagnostics, Primary Health Care Center, Podgorica, Montenegro
| | - Amirmohammad Khalaji
- School of Medicine, Tehran University of Medical Sciences, Poursina St., Keshavarz Blvd, 1417613151, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Pei J, Wang G, Li Y, Li L, Li C, Wu Y, Liu J, Tian G. Utility of four machine learning approaches for identifying ulcerative colitis and Crohn's disease. Heliyon 2024; 10:e23439. [PMID: 38148824 PMCID: PMC10750181 DOI: 10.1016/j.heliyon.2023.e23439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 12/28/2023] Open
Abstract
Objective Peripheral blood routine parameters (PBRPs) are simple and easily acquired markers to identify ulcerative colitis (UC) and Crohn's disease (CD) and reveal the severity, whereas the diagnostic performance of individual PBRP is limited. We, therefore used four machine learning (ML) models to evaluate the diagnostic and predictive values of PBRPs for UC and CD. Methods A retrospective study was conducted by collecting the PBRPs of 414 inflammatory bowel disease (IBD) patients, 423 healthy controls (HCs), and 344 non-IBD intestinal diseases (non-IBD) patients. We used approximately 70 % of the PBRPs data from both patients and HCs for training, 30 % for testing, and another group for external verification. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnosis and prediction performance of these four ML models. Results Multi-layer perceptron artificial neural network model (MLP-ANN) yielded the highest diagnostic performance than the other three models in six subgroups in the training set, which is helpful for discriminating IBD and HCs, UC and CD, active CD and remissive CD, active UC and remissive UC, non-IBD and HCs, and IBD and non-IBD with the AUC of 1.00, 0.988, 0.942, 1.00, 0.986, and 0.97 in the testing set, as well as the AUC of 1.00, 1.00, 0.773, 0.904, 1.00 and 0.992 in the external validation set. Conclusion PBRPs-based MLP-ANN model exhibited good performance in discriminating between UC and CD and revealing the disease activity; however, a larger sample size and more models need to be considered for further research.
Collapse
Affiliation(s)
- Jingwen Pei
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Sichuan 646000, China
| | - Guobing Wang
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Sichuan 646000, China
| | - Yi Li
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Sichuan 646000, China
| | - Lan Li
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Sichuan 646000, China
| | - Chang Li
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Sichuan 646000, China
| | - Yu Wu
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Sichuan 646000, China
| | - Jinbo Liu
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Sichuan 646000, China
| | - Gang Tian
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Sichuan 646000, China
| |
Collapse
|
9
|
Sridharan B, Lim HG. Advances in photoacoustic imaging aided by nano contrast agents: special focus on role of lymphatic system imaging for cancer theranostics. J Nanobiotechnology 2023; 21:437. [PMID: 37986071 PMCID: PMC10662568 DOI: 10.1186/s12951-023-02192-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
Photoacoustic imaging (PAI) is a successful clinical imaging platform for management of cancer and other health conditions that has seen significant progress in the past decade. However, clinical translation of PAI based methods are still under scrutiny as the imaging quality and clinical information derived from PA images are not on par with other imaging methods. Hence, to improve PAI, exogenous contrast agents, in the form of nanomaterials, are being used to achieve better image with less side effects, lower accumulation, and improved target specificity. Nanomedicine has become inevitable in cancer management, as it contributes at every stage from diagnosis to therapy, surgery, and even in the postoperative care and surveillance for recurrence. Nanocontrast agents for PAI have been developed and are being explored for early and improved cancer diagnosis. The systemic stability and target specificity of the nanomaterials to render its theranostic property depends on various influencing factors such as the administration route and physico-chemical responsiveness. The recent focus in PAI is on targeting the lymphatic system and nodes for cancer diagnosis, as they play a vital role in cancer progression and metastasis. This review aims to discuss the clinical advancements of PAI using nanoparticles as exogenous contrast agents for cancer theranostics with emphasis on PAI of lymphatic system for diagnosis, cancer progression, metastasis, PAI guided tumor resection, and finally PAI guided drug delivery.
Collapse
Affiliation(s)
- Badrinathan Sridharan
- Department of Biomedical Engineering, Pukyong National University, Busan, 48513, Republic of Korea
| | - Hae Gyun Lim
- Department of Biomedical Engineering, Pukyong National University, Busan, 48513, Republic of Korea.
| |
Collapse
|
10
|
Pan Y, Huang X, Zhou Z, Yang X, Li L, Gao C, Zhang Y, Zhang Y. Clinical significance of a novel uric-acid-based biomarker in the prediction of disease activity and response to infliximab therapy in Crohn's disease. Scand J Gastroenterol 2023:1-7. [PMID: 36829292 DOI: 10.1080/00365521.2023.2175181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
OBJECTIVES Crohn's disease (CD) is an inflammatory bowel disease marked by a chronic remission-relapse cycle. Biomarkers are critical to reflect the bowel wall inflammation and detect the treatment response. Here, we investigated a new index-the ratio of neutrophil to uric acid (NUR)-as a predictor of CD activity and responses to infliximab (IFX) treatment. METHODS Clinical and laboratory data were retrieved for CD patients and healthy control subjects from an electronic medical records database. Disease and endoscopic activity were determined using the Crohn's Disease Activity Index (CDAI) and Simple Endoscopic Score for Crohn's Disease (SES-CD), respectively. RESULTS We found firstly that NUR was remarkably higher in CD patients (n = 162) than controls (n = 170) (0.27 ± 0.10 vs. 0.19 ± 0.04, p < .0001). NUR was positively correlated with disease activity and prior to treatment, it was lower in CD patients who responded to IFX than in those who did not (0.25 ± 0.07 vs. 0.38 ± 0.12, p = .0019). Pre-treatment NUR was effective in predicting the patients' responses to IFX (AUC = 0.8469, p = .0034). CONCLUSION The results of this study support the utility of NUR for detecting CD activity and predicting the response to IFX treatment.
Collapse
Affiliation(s)
- Yan Pan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.,Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xijing Huang
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.,Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhou Zhou
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xue Yang
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Liangping Li
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Caiping Gao
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Yinghui Zhang
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
11
|
State M, Negreanu L. Defining the Failure of Medical Therapy for Inflammatory Bowel Disease in the Era of Advanced Therapies: A Systematic Review. Biomedicines 2023; 11:biomedicines11020544. [PMID: 36831079 PMCID: PMC9953124 DOI: 10.3390/biomedicines11020544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The expansion of advanced therapies for inflammatory bowel disease created a lag between the development of these new therapies and their incorporation and use in daily practice. At present, no clear definitions for treatment optimization, treatment failure or criteria to abandon therapy are available. We aimed to centralize criteria for a nonresponse to all available molecules and to summarize guideline principles for treatment optimization. METHODS We conducted a systematic review of studies that reported criteria for the treatment response to all advanced therapies (infliximab, adalimumab, golimumab, ustekinumab, vedolizumab and tofacitinib) in patients with inflammatory bowel disease. RESULTS Across trials, criteria for a response of both patients with ulcerative colitis and Crohn's disease are heterogenous. Investigators use different definitions for clinical and endoscopic remission, and endoscopic response and outcomes are assessed at variable time points. Current society guidelines provide heterogenous recommendations on treatment optimization. Most available data on loss of response concern anti-TNF molecules, and newer therapies are not included in the guidelines. CONCLUSION The lack of clear definitions and formal recommendations provide the premise for empirical treatment strategies and premature abandonment of therapies.
Collapse
Affiliation(s)
- Monica State
- Department 5, Internal Medicine—Gastroenterology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Lucian Negreanu
- Department 5, Internal Medicine—Gastroenterology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Emergency University Hospital, 050098 Bucharest, Romania
- Correspondence:
| |
Collapse
|
12
|
Wang Z, Yang F, Zhang W, Xiong K, Yang S. Towards in vivo photoacoustic human imaging: shining a new light on clinical diagnostics. FUNDAMENTAL RESEARCH 2023. [DOI: 10.1016/j.fmre.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
|
13
|
Li X, Tang Z, Liu Y, Zhu X, Liu F. Risk prediction model based on blood biomarkers for predicting moderate to severe endoscopic activity in patients with ulcerative colitis. Front Med (Lausanne) 2023; 10:1101237. [PMID: 36895716 PMCID: PMC9989155 DOI: 10.3389/fmed.2023.1101237] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/30/2023] [Indexed: 02/23/2023] Open
Abstract
Object We explored developing an internal validation model to predict the moderate to severe endoscopic activity of ulcerative colitis (UC) patients based on non-invasive or minimally-invasive parameters. Methods Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and Mayo endoscopic subscore were performed for UC patients who met the criteria from January 2017 to August 2021 through the electronic database of our center. Logistic regression and a least absolute shrinkage and selection operator (Lasso) regression model were performed to screen the risk factors of moderate to severe UC activity. The nomogram was established subsequently. Discrimination of the model was evaluated using the concordance index (c-index), and the calibration plot and 1,000 Bootstrap were used to evaluate the model's performance and conduct internal validation. Results Sixty-five UC patients were included in this study. According to UCEIS criteria,45 patients were moderate to severe endoscopic activity. 26 potential predictors of UC were analyzed by logistic and Lasso regression showed that vitamin D (Vit D), albumin (ALB), prealbumin (PAB), and fibrinogen (Fbg) were the best predictors of moderate to severe endoscopic activity of UC. We used these 4 variables to develop a dynamic nomogram prediction model. The c-index was 0.860, which means good discrimination. The calibration plot and Bootstrap analysis showed that the prediction model accurately distinguished the moderate to severe endoscopic activity in UC patients. The prediction model was verified using a cohort of UC patients with moderate to severe activity defined by the Mayo endoscopic subscore, and it was found that the model still had good discrimination and calibration (c-index = 0.891). Conclusion The model containing Vit D, ALB, PAB, and Fbg was a good tool for evaluating UC activity. The model is simple, accessible, and user-friendly, which has broad application prospects in clinical practice.
Collapse
Affiliation(s)
- Xiaojuan Li
- Department of Gastroenterology, Minhang Hospital, Fudan University, Shanghai, China
| | - Zihui Tang
- Department of Gastroenterology, Shanghai East Hospital, Medicine School of Tongji University, Shanghai, China
| | - Yanbing Liu
- Department of Gastroenterology, Shanghai East Hospital, Medicine School of Tongji University, Shanghai, China
| | - Xinyan Zhu
- Department of Gastroenterology, Shanghai East Hospital, Medicine School of Tongji University, Shanghai, China
| | - Fei Liu
- Department of Gastroenterology, Shanghai East Hospital, Medicine School of Tongji University, Shanghai, China.,Department of Gastroenterology, Ji'an Hospital, Shanghai East Hospital, Ji'an, Jiangxi, China
| |
Collapse
|
14
|
Li X, Yan L, Wang X, Ouyang C, Wang C, Chao J, Zhang J, Lian G. Predictive models for endoscopic disease activity in patients with ulcerative colitis: Practical machine learning-based modeling and interpretation. Front Med (Lausanne) 2022; 9:1043412. [PMID: 36619650 PMCID: PMC9810755 DOI: 10.3389/fmed.2022.1043412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
Background Endoscopic disease activity monitoring is important for the long-term management of patients with ulcerative colitis (UC), there is currently no widely accepted non-invasive method that can effectively predict endoscopic disease activity. We aimed to develop and validate machine learning (ML) models for predicting it, which are desired to reduce the frequency of endoscopic examinations and related costs. Methods The patients with a diagnosis of UC in two hospitals from January 2016 to January 2021 were enrolled in this study. Thirty nine clinical and laboratory variables were collected. All patients were divided into four groups based on MES or UCEIS scores. Logistic regression (LR) and four ML algorithms were applied to construct the prediction models. The performance of models was evaluated in terms of accuracy, sensitivity, precision, F1 score, and area under the receiver-operating characteristic curve (AUC). Then Shapley additive explanations (SHAP) was applied to determine the importance of the selected variables and interpret the ML models. Results A total of 420 patients were entered into the study. Twenty four variables showed statistical differences among the groups. After synthetic minority oversampling technique (SMOTE) oversampling and RFE variables selection, the random forests (RF) model with 23 variables in MES and the extreme gradient boosting (XGBoost) model with 21 variables in USEIS, had the greatest discriminatory ability (AUC = 0.8192 in MES and 0.8006 in UCEIS in the test set). The results obtained from SHAP showed that albumin, rectal bleeding, and CRP/ALB contributed the most to the overall model. In addition, the above three variables had a more balanced contribution to each classification under the MES than the UCEIS according to the SHAP values. Conclusion This proof-of-concept study demonstrated that the ML model could serve as an effective non-invasive approach to predicting endoscopic disease activity for patients with UC. RF and XGBoost, which were first introduced into data-based endoscopic disease activity prediction, are suitable for the present prediction modeling.
Collapse
Affiliation(s)
- Xiaojun Li
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China
| | - Lamei Yan
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China,Department of Gastroenterology, The First Affiliated Hospital of Shaoyang College, Shaoyang, Hunan, China
| | - Xuehong Wang
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China
| | - Chunhui Ouyang
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China
| | - Chunlian Wang
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China
| | - Jun Chao
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China,Hunan Aicortech Intelligent Research Institute Co., Changsha, Hunan, China
| | - Jie Zhang
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Research Center of Digestive Disease, Central South University, Changsha, China,*Correspondence: Jie Zhang,
| | - Guanghui Lian
- Department of Gastroenterology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Guanghui Lian,
| |
Collapse
|
15
|
Kawakami A, Tanaka M, Sakagami K, Choong LM, Kunisaki R, Maeda S, Bjarnason I, Ito H, Hayee B. Daily life difficulties among patients with ulcerative colitis in Japan and the United Kingdom: A comparative study. Medicine (Baltimore) 2022; 101:e30216. [PMID: 36107533 PMCID: PMC9439749 DOI: 10.1097/md.0000000000030268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The difficulty of life scale (DLS) instrument is used to measure specific life problems in patients with ulcerative colitis (UC). Importantly, health care providers should consider the characteristics of the country in which they support patients with UC. This cross-cultural comparison study investigated DLS among patients with UC in Japan and the United Kingdom (UK). Outpatients attending one hospital in London and one in Osaka were included. We collected patient information using the DLS questionnaire, which comprises 18 items in three domains. Mean differences between Japan and the UK were compared for the total score and each domain of the DLS. Variables with P < .05 in univariate analysis were entered into a multiple regression model. We included 142 patients from Japan and 100 patients from the UK in the analysis. Univariate results showed that UK patients had more difficulties than Japanese patients in all three domains. Multivariate results showed that only "decline of vitality or vigor" showed significantly lower difficulty scores in Japanese patients. Having four or more bowel movements per day, visible bleeding, and being a homemaker or unemployed were significantly associated with greater difficulty according to the DLS total score. The level of daily life difficulties assessed using the DLS was greater among patients in the UK than among Japanese patients. This comparative study between patients with UC in Japan and the UK demonstrated certain country-related features for domain 3, "decline of vitality or vigor," of the DLS. The reasons why UK patients felt greater decline in vitality or vigor may be that these patients may have symptoms other than bowel symptoms; also, Japanese patients are more hesitant to express discomfort. The findings of this study might lead to a better understanding of culturally sensitive perceptions of daily life difficulties in UC.
Collapse
Affiliation(s)
- Aki Kawakami
- Department of Gastroenterology, King’s College Hospital, London, United Kingdom
- Department of Critical and Invasive-Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Makoto Tanaka
- Department of Critical and Invasive-Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- *Correspondence: Makoto Tanaka, Department of Critical and Invasive-Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan (e-mail: )
| | | | - Lee Meng Choong
- Department of Gastroenterology, King’s College Hospital, London, United Kingdom
| | - Reiko Kunisaki
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ingvar Bjarnason
- Department of Gastroenterology, King’s College Hospital, London, United Kingdom
| | | | - Bu’Hussain Hayee
- Department of Gastroenterology, King’s College Hospital, London, United Kingdom
| |
Collapse
|
16
|
Elhag DA, Kumar M, Saadaoui M, Akobeng AK, Al-Mudahka F, Elawad M, Al Khodor S. Inflammatory Bowel Disease Treatments and Predictive Biomarkers of Therapeutic Response. Int J Mol Sci 2022; 23:ijms23136966. [PMID: 35805965 PMCID: PMC9266456 DOI: 10.3390/ijms23136966] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 02/08/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic immune-mediated inflammation of the gastrointestinal tract with a highly heterogeneous presentation. It has a relapsing and remitting clinical course that necessitates lifelong monitoring and treatment. Although the availability of a variety of effective therapeutic options including immunomodulators and biologics (such as TNF, CAM inhibitors) has led to a paradigm shift in the treatment outcomes and clinical management of IBD patients, some patients still either fail to respond or lose their responsiveness to therapy over time. Therefore, according to the recent Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE-II) recommendations, continuous disease monitoring from symptomatic relief to endoscopic healing along with short- and long-term therapeutic responses are critical for providing IBD patients with a tailored therapy algorithm. Moreover, considering the high unmet need for novel therapeutic approaches for IBD patients, various new modulators of cytokine signaling events (for example, JAK/TYK inhibitors), inhibitors of cytokines (for example IL-12/IL-23, IL-22, IL-36, and IL-6 inhibitors), anti-adhesion and migration strategies (for example, β7 integrin, sphingosine 1-phosphate receptors, and stem cells), as well as microbial-based therapeutics to decolonize the bed buds (for example, fecal microbiota transplantation and bacterial inhibitors) are currently being evaluated in different phases of controlled clinical trials. This review aims to offer a comprehensive overview of available treatment options and emerging therapeutic approaches for IBD patients. Furthermore, predictive biomarkers for monitoring the therapeutic response to different IBD therapies are also discussed.
Collapse
Affiliation(s)
- Duaa Ahmed Elhag
- Research Department, Sidra Medicine, Doha 26999, Qatar; (D.A.E.); (M.K.); (M.S.)
| | - Manoj Kumar
- Research Department, Sidra Medicine, Doha 26999, Qatar; (D.A.E.); (M.K.); (M.S.)
| | - Marwa Saadaoui
- Research Department, Sidra Medicine, Doha 26999, Qatar; (D.A.E.); (M.K.); (M.S.)
| | - Anthony K. Akobeng
- Division of Gastroenterology, Hepatology and Nutrition, Sidra Medicine, Doha 26999, Qatar; (A.K.A.); (F.A.-M.); (M.E.)
| | - Fatma Al-Mudahka
- Division of Gastroenterology, Hepatology and Nutrition, Sidra Medicine, Doha 26999, Qatar; (A.K.A.); (F.A.-M.); (M.E.)
| | - Mamoun Elawad
- Division of Gastroenterology, Hepatology and Nutrition, Sidra Medicine, Doha 26999, Qatar; (A.K.A.); (F.A.-M.); (M.E.)
| | - Souhaila Al Khodor
- Research Department, Sidra Medicine, Doha 26999, Qatar; (D.A.E.); (M.K.); (M.S.)
- Correspondence:
| |
Collapse
|
17
|
OUP accepted manuscript. J AOAC Int 2022; 105:1153-1161. [DOI: 10.1093/jaoacint/qsac020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/23/2022] [Accepted: 02/07/2022] [Indexed: 11/14/2022]
|
18
|
Houshyar Y, Massimino L, Lamparelli LA, Danese S, Ungaro F. Going Beyond Bacteria: Uncovering the Role of Archaeome and Mycobiome in Inflammatory Bowel Disease. Front Physiol 2021; 12:783295. [PMID: 34938203 PMCID: PMC8685520 DOI: 10.3389/fphys.2021.783295] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
Inflammatory Bowel Disease (IBD) is a multifaceted class of relapsing-remitting chronic inflammatory conditions where microbiota dysbiosis plays a key role during its onset and progression. The human microbiota is a rich community of bacteria, viruses, fungi, protists, and archaea, and is an integral part of the body influencing its overall homeostasis. Emerging evidence highlights dysbiosis of the archaeome and mycobiome to influence the overall intestinal microbiota composition in health and disease, including IBD, although they remain some of the least understood components of the gut microbiota. Nonetheless, their ability to directly impact the other commensals, or the host, reasonably makes them important contributors to either the maintenance of the mucosal tissue physiology or to chronic intestinal inflammation development. Therefore, the full understanding of the archaeome and mycobiome dysbiosis during IBD pathogenesis may pave the way to the discovery of novel mechanisms, finally providing innovative therapeutic targets that can soon implement the currently available treatments for IBD patients.
Collapse
Affiliation(s)
| | - Luca Massimino
- Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Silvio Danese
- Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, Milan, Italy
| | - Federica Ungaro
- Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy
| |
Collapse
|
19
|
Mégier C, Bourbao-Tournois C, Perrotin F, Merle P, Ouaissi M, Diguisto C. Long-term evaluation of the impact of delivery modalities on anal continence in women with Crohn's disease. J Visc Surg 2021; 159:353-361. [PMID: 34799288 DOI: 10.1016/j.jviscsurg.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Crohn's disease (CD) and sphincter injury during childbirth are two risk factors for anal incontinence (AI). The long-term risk of developing AI in women with CD after childbirth has never been studied. GOAL The main objective of the study is to assess the risk of developing severe AI after childbirth in women with CD. METHODS A retrospective study was performed in women with CD who gave birth in a French "Level 3" maternity hospital between 2000 and 2015. The primary endpoint was severe AI as defined by a Wexner score≥9 or a St. Mark's score≥9, at least five years after childbirth. The association between delivery route and occurrence of severe AI was assessed by univariate and multivariate analyses. RESULTS Forty-six women were included, 32 of whom were delivered vaginally and 14 by Caesarean section. Thirty-one percent of the women had severe AI according to the Wexner score, and 41% according to the St. Mark's score. Two factors were associated with severe AI: vaginal delivery and the occurrence of an obstetric perineal injury: (crude OR=8.89, 95% (CI: 1.03-76.57) and crude OR=4.16, 95% (CI: 1.06-16.27) respectively for AI defined by the Wexner score, and crude OR=6.8, 95% (CI: 1.30-35.41) and crude OR=4.3, 95% (CI: 1.23-15.2) for AI defined by the St. Mark's score). After adjusting for confounding factors, only vaginal delivery was associated with severe AI (adjusted OR=22.86, 95% CI: 1.52-931.28 for a Wexner score≥9 and adjusted OR=16. 11 (95% CI: 1.43-533.26) for a St Mark score≥9). CONCLUSION Vaginal birth was associated with the development of severe long-term AI in women with CD.
Collapse
Affiliation(s)
- C Mégier
- Maternity Olympe de Gouges, Regional University Hospital of Tours, 2, Boulevard Tonnellé, 37044 Tours cedex 1, France; François Rabelais University, Tours, France.
| | - C Bourbao-Tournois
- François Rabelais University, Tours, France; Department of Digestive, Oncological, Endocrine, Hepatobiliary and Hepatic Transplantation Surgery. Trousseau Hospital, Regional University Hospital of Tours, Tours, France
| | - F Perrotin
- Maternity Olympe de Gouges, Regional University Hospital of Tours, 2, Boulevard Tonnellé, 37044 Tours cedex 1, France; François Rabelais University, Tours, France
| | - P Merle
- François Rabelais University, Tours, France; Department of Gastroenterology, Trousseau Hospital, Regional University Hospital of Tours, Tours, France
| | - M Ouaissi
- François Rabelais University, Tours, France; Department of Digestive, Oncological, Endocrine, Hepatobiliary and Hepatic Transplantation Surgery. Trousseau Hospital, Regional University Hospital of Tours, Tours, France
| | - C Diguisto
- Maternity Olympe de Gouges, Regional University Hospital of Tours, 2, Boulevard Tonnellé, 37044 Tours cedex 1, France; François Rabelais University, Tours, France
| |
Collapse
|
20
|
Wang L, Zhang J, Sun H, Ji X, Zhang S. Effect of miR-451 on IVF/ICSI-ET outcome in patient with endometriosis and infertility. Am J Transl Res 2021; 13:13051-13058. [PMID: 34956523 PMCID: PMC8661151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/27/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study aimed to explore the effect of miR-451 on IVF/ICSI-ET outcome in endometriosis patients with infertility. METHODS Eighty patients with endometriosis and infertility who came to our hospital for IVF/ICSI-ET from February 2018 to November 2019 were collected as the research participants, and 66 healthy women at the same time were selected as the control group. The miR-451 and MIF expression levels in serum, tissues and cell lines of patients with endometriosis and infertility were quantitatively detected by qRT-PCR. Correlation between miR-451 and endometriosis complicated with infertility was analyzed. The effect of miR-451 on IVF/ICSI-ET outcome in those patients was assessed. RESULTS The miR-451 and MIF expression levels in endometriosis complicated with infertility tissues and cell lines were quantitatively detected by qRT-PCR. Compared with normal people, miR-451 was abnormally low in endometriosis complicated with infertility tissues and cell lines (P<0.001), while MIF was abnormally high (P<0.001), and the miR-451 expression was dramatically down-regulated and the MIF expression was markedly up-regulated in serum of endometriosis patients complicated with infertility. ROC analysis identified that the area under the miR-451 curve (AUC=0.9078) was >0.8, and the AUC (0.8606) of MIF was >0.8. Correlation analysis showed that the expression of miR-451 and MIF was negatively correlated in endometriosis complicated with infertility. According to miR-451 expression in endometriotic lesions, the subjects were divided into the miR-451 high expression group and miR-451 low expression group, with 40 cases in each group. The pregnancy rate after IVF/ICSI-ET in patients with endometriosis and infertility with high expression of miR-451 was higher than that in those with low expression (P>0.05). The incidence of complications during pregnancy after IVF/ICSI-ET in patients with endometriosis and infertility with high expression of miR-451 was lower than that in those with low expression (P>0.05). The pregnancy outcome after IVF/ICSI-ET in the miR-451 high expression group was better than that in the miR-451 low expression group (P<0.05). CONCLUSION miR-451 was down-regulated in endometriosis patients complicated with infertility, and low expression of miR-451 after IVF/ICSI-ET indicated a poor outcome.
Collapse
Affiliation(s)
- Lei Wang
- Department of Reproductive Medicine, Hengshui People's Hospital Hengshui 053000, Hebei Province, China
| | - Jing Zhang
- Department of Reproductive Medicine, Hengshui People's Hospital Hengshui 053000, Hebei Province, China
| | - Hairu Sun
- Department of Reproductive Medicine, Hengshui People's Hospital Hengshui 053000, Hebei Province, China
| | - Xuexia Ji
- Department of Reproductive Medicine, Hengshui People's Hospital Hengshui 053000, Hebei Province, China
| | - Shuzhen Zhang
- Department of Reproductive Medicine, Hengshui People's Hospital Hengshui 053000, Hebei Province, China
| |
Collapse
|
21
|
Langley BO, Guedry SE, Goldenberg JZ, Hanes DA, Beardsley JA, Ryan JJ. Inflammatory Bowel Disease and Neutrophil-Lymphocyte Ratio: A Systematic Scoping Review. J Clin Med 2021; 10:jcm10184219. [PMID: 34575330 PMCID: PMC8466606 DOI: 10.3390/jcm10184219] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/09/2021] [Accepted: 09/14/2021] [Indexed: 12/14/2022] Open
Abstract
Neutrophil–lymphocyte ratio (NLR) is a biomarker of the systemic inflammatory response. The objective of this systematic scoping review was to examine the literature on NLR and inflammatory bowel disease (IBD). PubMed, Embase, Cochrane CENTRAL, CINAHL, ClinicalTrials.gov, Cochrane Specialized Register, DOAJ, PDQT, Biosis Citation Index, Scopus, and Web of Science were systematically searched. A total of 2621 citations yielding 62 primary studies were synthesized under four categories: distinguishing patients with IBD from controls, disease activity differentiation, clinical outcome prediction, and association of NLR with other IBD biomarkers. Thirty-eight studies employed receiver operating characteristic (ROC) curve analysis to generate optimal NLR cutpoints for applications including disease activity differentiation and prediction of response to treatment. Among the most promising findings, NLR may have utility for clinical and endoscopic disease activity differentiation and prediction of loss of response to infliximab (IFX). Overall findings suggest NLR may be a promising IBD biomarker. Assessment of NLR is non-invasive, low cost, and widely accessible given NLR is easily calculated from blood count data routinely and serially monitored in patients with IBD. Further research is justified to elucidate how evaluation of NLR in research and clinical practice would directly impact the quality and cost of care for patients living with IBD.
Collapse
Affiliation(s)
- Blake O. Langley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (B.O.L.); (S.E.G.); (J.Z.G.); (D.A.H.)
| | - Sara E. Guedry
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (B.O.L.); (S.E.G.); (J.Z.G.); (D.A.H.)
| | - Joshua Z. Goldenberg
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (B.O.L.); (S.E.G.); (J.Z.G.); (D.A.H.)
| | - Douglas A. Hanes
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (B.O.L.); (S.E.G.); (J.Z.G.); (D.A.H.)
| | | | - Jennifer Joan Ryan
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (B.O.L.); (S.E.G.); (J.Z.G.); (D.A.H.)
- Correspondence: ; Tel.: +1-503-552-1744
| |
Collapse
|
22
|
Platelet Mass Index and Other Platelet Parameters in the Assessment of Inflammatory Bowel Diseases Activity. CURRENT HEALTH SCIENCES JOURNAL 2021; 47:566-574. [PMID: 35444814 PMCID: PMC8987479 DOI: 10.12865/chsj.47.04.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/18/2021] [Indexed: 11/12/2022]
Abstract
Different qualitative and quantitative changes in platelets are involved in the pathophysiological processes in inflammatory bowel diseases (IBD): ulcerative colitis (UC) and Crohn's disease (CD). The aim of the study was to determine the diagnostic accuracy of Platelet mass Index (PMI) and other platelet parameters in assessment disease activity in patients with UC and CD. A cross-sectional, observational study consisted of 60 IBD patients (30 UC and 30 CD) and 30 healthy subjects (Control group). Patients were grouped according to disease activity into active and inactive (remission). Platelet count (PLC), Plateletcrit (PCT), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) and PMI were determined for all study participants. Receiver operating characteristic (ROC) curve and their corresponding areas under the curve (AUC) were used to determine diagnostic accuracy. Although PLC had the highest AUC (0.756) compared to PCT (AUC: 0.731), PDW (AUC: 0.722) and PMI (AUC: 0.724), they all had fair diagnostic accuracy in distinguishing active and inactive UC patients. Discriminatory accuracy of PLC was excellent (AUC: 0.909), PCT and PMI good to excellent (AUC: 0.809 and AUC: 0.893, respectively) and PDW fair (AUC: 0.789) in classifying CD patients as active and inactive. Platelet parameters are simple, routinely available biomarkers more useful for assessing disease activity for patients with CD than for patients with UC. Our results indicate, for the first time, that PMI may serve as a novel and simple marker in identifying whether IBD patients are in the active or inactive phase of the disease.
Collapse
|