bluuebunny/crossref_metadata_2025_split huggingface dataset:
A4 SACCHAROMYCES BOULARDII CNCM I-745 ENHANCES DUODENAL MICROBIOTA-MEDIATED TRYPTOPHAN METABOLISM IMPROVING GLUTEN IMMUNOPATHOLOGY
Authors: Kan K , Constante M , Rahmani S , Caminero A , Roux X , Galipeau H , Verdu E 
Published: February 2025

Abstract

Background
Impaired microbial indole production and decreased activation of the aryl hydrocarbon receptor (AhR) pathway has been reported in active coeliac disease (CeD). However, whether and how this can be targeted by specific microbial therapies is unknown.

Aims
We tested whether Saccharomyces boulardii CNCM I-745 (Sbou) influences indole production and AhR activation through stimulation of microbial enzymatic activity.

Methods
Transgenic NOD/DQ8 mice were immunized with partially digested gliadin and cholera toxin weekly for 3 weeks followed by gluten challenges (10 mg; alternate days/3 weeks). Non-sensitized mice were used as controls. Mice were treated daily with 3 g/kg of Sbou or water during the study. Additional immunized mice treated or not with Sbou, received daily gavage with AhR antagonist CH-223191 (10 mg/kg) or vehicle. Small intestinal pathology was analysed by villus to crypt (V/C) ratios and CD3+ intraepithelial lymphocyte (IEL) counts. Expression levels of the AhR-activated gene Cyp1a1 were determined by RT-qPCR. Small intestinal microbiota of NOD/DQ8 mice and CeD patients were cultured in BHI media supplemented with 10 g/L Gelatin or Casein as additional protein sources with and without 1x106Sbou CFUs. Free tryptophan and AhR activation were assayed using a commercial kit and a transfected reporter cell line, respectively. Resulting microbiota was assessed by 16S rRNA gene sequencing and PICRUSt-predicted functions.

Results
Sbou increased Cyp1a1 levels, mucosal tryptophan and AhR activation in gluten immunized mice. This was paralleled by improved V/C ratios and lower IELs vs no probiotic, which was inhibited by AhR antagonist. In immunized mice treated with Sbou microbiota analysis revealed higher expression of genes involved in protein digestion and lower tryptophan 2,3-dioxygenase, a tryptophan degrader. Mouse duodenal microbiota cultures treated with Sbou had higher proteolytic activity but lower tryptophan 2,3-dioxygenase, paralleled by higher tryptophan vs cultures with no probiotic. In duodenal microbiota cultures from CeD patients Sbou increased tryptophan vs no probiotic.

Conclusions
S. boulardii CNCM I-745 reduced gluten immunopathology in immunized NOD/DQ8 mice through activation of the AhR pathway. In vitro experiments suggest Sbou synergises with the microbiota to increase free tryptophan from protein sources and inhibit tryptophan degradation, leading to higher indole production and AhR activation. The results identify a specific mechanistic pathway by S. boulardii CNCM I-745 in celiac disease and should encourage clinical testing in this population.

Funding Agencies
CIHRBiocodex, France
A9 IMPLEMENTATION STRATEGIES TO OPTIMIZE DIAGNOSTIC ACCURACY OF COMPUTER-ASSISTED OPTICAL POLYP DIAGNOSIS
Authors: Oleksiw M , Djinbachian R , von Renteln D 
Published: February 2025

Abstract

Background
Artificial intelligence (AI) has enabled the development of computer-aided diagnosis (CADx) systems which offer real-time endoscopic pathology prediction of colorectal polyps. However, the clinical benefit of CADx assisted optical diagnosis remains questionable due to lack of diagnostic ability improvement compared to non CADx assisted optical diagnosis.

Aims
This study aimed to assess diagnostic performance of a novel implementation framework in which optical diagnosis replaces pathology only if CADx and endoscopist agree on polyp diagnosis. We aimed to compare this proposed framework to non CADx assisted optical diagnosis.

Methods
We performed a secondary analysis of a prospective cohort undergoing optical polyp diagnosis at our center. Polyps measuring ≤5mm (diminutive) with available non CADx assisted and CADx assisted optical polyp diagnosis documentation were included in our analysis. In CADx assisted cases, first the CADx diagnostic output was documented, followed by the endoscopist’s final diagnosis after having seen the CADx diagnostic information. Only cases where the endoscopist agreed with the CADx output were retained for CADx assisted optical diagnosis. Primary outcome was the diagnostic accuracy for cases in which the endoscopist agreed with the CADx diagnostic output versus non CADx assisted OD, using pathology as a reference standard. Secondary outcomes included surveillance interval agreement, prevalence of high-confidence diagnoses, and rectosigmoid negative predictive value (NPV).

Results
A total of 817 polyps were included in our analysis. Endoscopists agreed with the CADx diagnostic output in 74.3% of cases. Using CADx-assisted optical diagnosis based on CADx and endoscopist diagnostic agreement, 326/439 diminutive polyps could undergo optical polyp diagnosis in the CADx assisted arm and 378/378 in the non CADx assisted OD arm. Using diagnostic agreement between endoscopist and CADx as a framework for CADx assisted optical diagnosis demonstrated superior diagnostic accuracy, 82.8% (95% CI, 78.7-86.9), compared to accuracy of non CADx assisted optical diagnosis, 76.7% (95% CI, 71.3-80.0) (p=0.0256).

Conclusions
Our study demonstrates that using cases with diagnostic agreement between endoscopist and CADx increases diagnostic accuracy for CADx-assisted OD implementation. Using this framework, CADx assisted OD outperforms non CADx assisted optical diagnosis.

Funding Agencies
None
A12 ASPIRIN USE IN PREGNANT PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A SINGLE CENTRE RETROSPECTIVE STUDY
Authors: Jogendran R , Hothi H , Nabavian H , Eisen S , Srikanth V , O’Connor K , Tandon P , Huang V 
Published: February 2025

Abstract

Background
Low-dose aspirin (LDA) prophylaxis is recommended for pregnant patients who are at high risk of developing preeclampsia. Inflammatory bowel disease (IBD) is a risk factor for preeclampsia, however, our understanding of LDA use on disease activity in pregnant patients with IBD remains limited.

Aims
To evaluate the effect of LDA prophylaxis on clinical outcomes and disease activity in pregnant patients with IBD.

Methods
Pregnant patients with IBD followed at Mount Sinai Hospital from January 2017 to December 2022 were identified. We analyzed baseline characteristics and clinical outcomes in patients with and without LDA use. Clinical outcomes included the start date and dose of LDA, obstetric outcomes, and disease activity during pregnancy or 6 months postpartum defined as partial Mayo score ≥ 2 for ulcerative colitis (UC) and Harvey-Bradshaw Index (HBI) ≥ 5 for Crohn’s disease (CD). IBD-related hospitalization, elevated fecal calprotectin ≥ 250 μg/g, or active endoscopic disease were also utilized as markers of disease activity. Bivariate assessments were performed using Chi-Squared tests for categorical predictors. Univariate logistic regression was performed and reported as odds ratios (OR) with 95% confidence intervals (CI).

Results
287 pregnant patients with IBD were included with a median age at conception of 33 years. Forty-three patients (15.0%) were taking LDA during pregnancy, while 244 (85.0%) were not. LDA use was increased in those of older maternal age (34.5 vs. 33 median years, p = 0.047), IBDU (p = 0.016), pre-existing chronic hypertension (7.0% vs. 1.2%, p = 0.016), and prior history of hypertensive disorders during pregnancy (13.9% vs 1.6%, p &lt; 0.001). There was no significant difference with respect to biologic use, disease activity at conception, and parity. Preeclampsia rates were similar between groups (9.3% vs. 6.5%, p = 0.599), although individuals on LDA had higher rates of gestational hypertension (7.0% vs. 0.8%, p = 0.005). There were no differences in IBD flare, elevated fecal calprotectin, and IBD-related hospitalization during pregnancy or postpartum based on LDA use (P &gt; 0.05). In univariable logistic regression, active disease at conception (OR 5.66, 95% CI 1.96-16.3, p = 0.001) was associated with an increased risk of flare while the use of biologics was correlated with a decreased risk of flare (OR 0.384, 95% CI 0.238-0.619, p &lt; 0.001).

Conclusions
Low dose aspirin use for prophylaxis of preeclampsia in pregnant patients with IBD did not increase the risk of disease activity. Further studies are required in this patient population to assess the effects of LDA on maternal and neonatal outcomes.

Funding Agencies
None
A13 MECHANISM OF INTESTINAL ORGANOID TRANSPLANTATION IN ENHANCING EPITHELIAL REGENERATION DURING EXPERIMENTAL NECROTIZING ENTEROCOLITIS
Authors: Li B , Zito A , Xiong Y , Liang H , Zhu H , Pierro A 
Published: February 2025

Abstract
NOT PUBLISHED AT AUTHOR’S REQUEST
Please acknowledge all funding agencies listed below
Funding Agencies: CIHR
A18 EXPLORING TRAINED IMMUNITY IN INTESTINAL EPITHELIAL CELLS DURING TYPE 2 IMMUNE RESPONSES
Authors: Levy Z L , Needs A , Richer M , Oudhoff M 
Published: February 2025

Abstract

Background
Helminth infections are a serious health threat that remain understudied for how frequently they occur globally. Although antihelminth drugs exist today, reinfection and drug resistance emphasize the need to understand how our body handles subsequent helminth infections, especially in the gastrointestinal system. Normally, type 2 immunity facilitates expulsion of worms from the gastrointestinal tract by relying upon a type 2 immune cell–epithelial response circuit via interleukins (IL)-25 and IL-13 signaling to upregulate helminth-sensing tuft and mucus-producing goblet cells. Recent advances in trained immunity, an evolving field in immunology where it is believed that a previous stimulus can cause changes to the epigenome, demonstrate that stimulating epithelial cells can result into better preparedness for subsequent stimuli via epigenetic changes.

Aims
It is unknown currently whether trained immunity takes place in intestinal epithelial stem cells or how trained immunity affects intestinal stem cell differentiation during a type 2 immune response. This project aims to define whether the intestinal epithelium responds differently to a primary challenge compared to a secondary challenge during a type 2 response. In addition, we hope to identify how such memory would be orchestrated.

Methods
We stimulated intestinal organoids with IL-13 to simulate a type 2 response. Organoids exposed to IL-13 display similar properties to that of the epithelium in vivo upon a helminth infection; i.e. tuft and goblet cell hyperplasia. Upon media replacement, organoids return to homeostasis rapidly, upon which we could re-expose them. Thus, organoids were exposed to IL-13 either once or twice and changes were analyzed by flow cytometry, immunofluorescent confocal microscopy, western blot, and bulk RNA sequencing. In the future, we will strengthen this approach by performing in vivo experiments.

Results
We found that a secondary challenge led to an increased goblet cell response when compared to a primary one. We found that both the number of goblet cells (by flow cytometry), but more importantly, levels of goblet-specific antimicrobial protein RELM-β were strongly increased (western blot and confocal imaging). We are currently assessing the tuft cell responses to determine if it is an overall increased response to IL-13, or whether there is a preferential response (towards goblet cells instead of tuft cells).

Conclusions
Our preliminary data as well as our current experiments strongly suggest that epithelium responds differently to a secondary Type 2 immune challenge compared to a primary one. Ultimately, gaining an understanding of the mechanisms that mediate intestinal epithelial-intrinsic memory can help develop new strategies for treatment of gastrointestinal infections to help reduce the burden faced by those who encounter helminth infections around the world.

Funding Agencies
CIHR
A32 ARTIFICIAL INTELLIGENCE USE IN DIAGNOSIS & MONITORING OF INFLAMMATORY BOWEL DISEASE: A SCOPING REVIEW
Authors: Malik G , Chavannes M , Byrne M F , Dolinger M , Sagami S , Novak K 
Published: February 2025

Abstract

Background
Inflammatory bowel diseases (IBD) are a family of immune-mediated conditions, which are increasing in incidence and prevalence worldwide. Assessment of IBD is done through endoscopy, video capsule endoscopy (VCE), histology, and various imaging modalities including ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Considering the increasing complexities in the assessment of IBD, artificial intelligence (AI) is an important adjunct with potential to enhance diagnosis, drug response and prediction of disease course

Aims
We conducted a scoping review to assess AI in diagnosis, monitoring, and prognostication of patients with IBD, to aid in identification of gaps in knowledge to guide future research endeavors.

Methods
The scoping review protocol was adapted from the recommendations laid out by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis - Scoping Review Extension (PRISMA-ScR). Electronic databases used in the literature search included MEDLINE, EMBASE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and Engineering Village. Two reviewers independently screened the abstracts and titles first before performing full text review. A third review resolved any conflict where needed. All study types were included, and data extraction utilized Covidence. Studies were categorized based on the assessment modality, then themes including, diagnosis, grading activity, prognosis, and monitoring.

Results
A total of 140 studies were included in the final scoping review. The largest number of studies involved endoscopy at 72 (51%) citations, followed by VCE, histology, MRI, CT, and US at 30 (21%), 18 (13%), 13 (9%), 6 (4%), and 1 (0.7%) citation(s), respectively. When looking at themes, most endoscopy studies examined disease activity (65%) while diagnosis was the most common theme in VCE, MRI and CT (77%, 69% and 83%, respectively). Histologic studies focused on prognosis (89%) and the single US study evaluated both diagnosis and prognosis concomitantly. Amongst all the investigative modalities examined, monitoring of IBD was the least studied theme. Peak performance of AI models for grading disease activity during endoscopy was 98.7% compared to human clinicians with less variability observed.

Conclusions
With IBD diagnosis and assessment becoming increasingly complex, AI may be a useful adjunctive tool across multiple modalities. Evaluation of use of AI in US is lacking, despite gaining interest in non-invasive assessment of IBD. Further studies are needed incorporating AI use in US while also investigating its role in monitoring IBD disease activity. We hope this scoping review will serve as a future direction for subsequent research in this area.
Funding Agencies:
A38 OVER-THE-SCOPE AND THROUGH-THE-SCOPE SUTURING OUTCOMES FOR ENDOSCOPIC LEAK AND FISTULA MANAGEMENT: A SYSTEMATIC REVIEW
Authors: Flegg D , Thilakanathan C , Kim H , Motomura D , Gan S , Lam E , Trasolini R , Shahidi N 
Published: February 2025

Abstract

Background
Leaks and fistulae are well-recognized sequelae arising from gastrointestinal surgeries, inflammatory bowel disease, malignancy, and traumatic injury; reflecting significant morbidity, mortality and resource utilization. Endoscopic management has gained traction as a minimally invasive alternative to surgery including both over-the-scope suturing (OTSS) and through-the-scope suturing (TTSS).

Aims
We aimed to systematically evaluate available evidence for OTSS and TTSS outcomes for leak and fistula management.

Methods
From inception to July 1st, 2024, MEDLINE, EMBASE and Cochrane Library were searched for relevant citations. Full-text citations were included if they evaluated both technical success (endoscopic closure of leak or fistula) and clinical success (technical success with avoidance of further intervention) for leak or fistulae management with OTSS or TTSS. In this preliminary analysis, outcomes were reported as ranges.

Results
A total of 11 studies including 185 defects were included for analysis. For fistulae, technical success for OTSS and TTSS ranged from 83-100% and 82-100%, respectively. Clinical success for OTSS and TTSS ranged from 0-80% and 55-100% respectively. For leaks, technical success for OTSS and TTSS ranged from 90-100% and 0-57%, respectively. Clinical success for OTSS and TTTS ranged from 25-100% and 29%, respectively.

Conclusions
OTSS and TTSS are new interventions for leak and fistulae management with varying performance outcomes. Further research is required to delineate optimal candidates for OTSS/TTSS closure and treatment algorithms after technical/clinical failure.

Funding Agencies
None
A57 SUBOPTIMAL FIBRE CONSUMPTION AND ALTERED FIBRE METABOLISM IN CELIAC DISEASE THROUGHOUT THE GASTROINTESTINAL TRACT
Authors: Wulczynski M , Constante M , Blom J , Rueda G H , Rossi L , El-Chaar N , Surette M G , Superdock D , Lawrence D , pinto-sanchez M , Armstrong D , Galipeau H , Verdu E 
Published: February 2025

Abstract

Background
Celiac disease (CeD) is a T-cell mediated enteropathy driven by gluten in people with risk genes HLA-DQ2 or DQ8. Many patients experience symptoms such as constipation and/or persistent mucosal inflammation despite adherence to a gluten-free diet (GFD) and are advised to increase dietary fibre. Preliminary results from gluten-immunized NOD-DQ8 mice revealed that supplemented inulin could improve mucosal healing. However, whether fibre is tolerated and metabolized in CeD is unknown.

Aims
To investigate whether (1) fibre consumption in untreated and treated CeD compared to healthy volunteers (HV); (2) characterize microbial carbolytic capacity in the duodenum and feces.

Methods
We conducted an analysis of CeD patients (newly diagnosed and GFD-treated) and HV attending our specialized McMaster adult CeD clinic. To investigate fibre consumption, participants completed a validated food frequency questionnaire (Victoria DQES v2), and the chloroplast trnL-P6 plastid marker was used to analyze the presence and diversity of plant DNA in feces at the time of sample collection (FoodSeq). To characterize fibre metabolism, fecal SCFA were measured using gas chromatography mass-spectrometry, and microbiota composition from duodenal aspirates was investigated by 16S rRNA gene Illumina sequencing of the V3V4 region. In silico predictions of metabolic functions and relative abundances of key enzymes were completed with PICRUSt2.

Results
Most participants consumed fibre below the minimum recommendation (66% &lt; 25g/day, Health Canada), despite diverse dietary plant consumption. Fibre did not correlate with self-reported gastrointestinal symptoms. Fecal SCFAs were lower in new CeD compared to HV, while GFD was partially rescued (CeD: 2799±927 vs HV: 5199±1616 μg/g, p&lt;0.001; GFD: 4058±1283). Duodenal microbiota composition differed between all groups (Aitchinson Distance β-diversity, p&lt;0.05). Abundance of enzymes related to fibre degradation (α-amylase K07405, fructan β-fructosidase K03332) were decreased in both CeD and GFD groups compared to HV (p&lt;0.001), as was the abundance of several members of the Prevotellaceae family that had the greatest predicted contribution to this function (p&lt;0.05).

Conclusions
Newly diagnosed CeD patients have inadequate fibre consumption and lower microbial capacity to metabolize fibre in the lower and upper GI tract. Despite patients on GFD having the lowest fibre intake, microbial carbolytic activity was improved. Taken together with unpublished findings of inulin accelerating mucosal healing in mouse models of gluten sensitivity, the data should encourage clinical studies to define the effects of fibre supplementation on symptom management and mucosal healing in CeD during GFD.

Funding Agencies
CIHRCeliac Canada
A65 HOSPITALIZATION RATES OF INFLAMMATORY BOWEL DISEASE DURING THE COVID-19 PANDEMIC: A POPULATION-BASED STUDY OF THE ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT.
Authors: Wilson L M , King J A , Buie E , Coward S , Shaheen A , Kaplan G G 
Published: February 2025

Abstract

Background
Inflammatory bowel disease (IBD) places a significant burden on healthcare resources, requiring medical and surgical management in hospital. The COVID-19 pandemic further strained healthcare systems, but the impact of the global pandemic on IBD hospitalization rates remain unclear.

Aims
To examine hospitalization rates for IBD prior to the COVID-19 pandemic (2017-2019) and during the pandemic (2020-2022) in Organisation for Economic Co-Operation and Development (OECD) countries.

Methods
A population-based study was conducted using data from the 34 OECD member countries. Country-level data on annual IBD-related hospital discharge counts and rates (per 100,000 persons) were obtained. Mean hospitalization rates were calculated before (2017 to 2019) and during the pandemic (2020 to 2022). Incident rate ratios (IRR) comparing pandemic to pre-pandemic rates were calculated using Poisson regression, with 95% confidence intervals (CI). Countries without complete data during this the study period were excluded.

Results
Overall, 22 countries were included, with 20 showing a statistically significant decrease in hospitalization rates during the pandemic. These decreases in hospitalization rates during the pandemic ranged from Lithuania’s IRR of 0.57 (95%CI: 0.53, 0.62) to Spain’s IRR of 0.94 (95%CI: 0.92, 0.95). Of the remaining two countries, Korea had an increase in hospitalization rates (IRR: 1.02; 95%CI: 1.00, 1.04; p=0.015), while Costa Rica showed no significant difference (IRR:0.93; 95% CI: 0.82, 1.04).

Conclusions
IBD-related hospital discharge rates significantly decreased in most OECD countries during the pandemic. Future studies should explore whether the increased strain on healthcare systems during the pandemic shifted the management of IBD from hospitals to community-based care.
Table 1. IBD hospitalization discharge rates in OECD countries prior to (2017-2019) and during (2020-2022) the COVID-19 pandemic per 100,000 person-years.

Funding Agencies
None