bluuebunny/crossref_metadata_2025_split huggingface dataset:
P177 Beta-CGRP in inflammatory bowel disease: a protective neuropeptide of the gut
Authors: Pascual M , Gárate G , Serrano M S , González-Quintanilla V , García M J , Castro Senosiain B , Crespo J , Pascual J , Rivero Tirado M 
Published: January 2024

Abstract

Background
Experimental models indicate that beta calcitonin gene-related peptide (beta CGRP), libertated by enteric neurons, has a potential role on gastrointestinal mucosa homeostasis, but its real role is not well profiled. We measured beta-CGRP circulating levels in a cohort of subjects with a recent diagnosis of inflammatory bowel disease (IBD), to assess the potential role of this neuropeptide in its pathogenesis.

Methods
Morning serum beta-CGRP levels were measured by ELISA (CUSABIO, China) in 96 consecutive patients recently diagnosed of IBD patients (&lt; 1 year) and compared with those belonging to 50 matched healthy controls (HC) and 50 chronic migraine (CM) patients matched by age and sex. We only allowed treatment with either steroids or mesalazine, and registered cardiovascular comorbidities, autoimmune concomitant diseases or extraintestinal manifestations. Statistical analysis was made using SPSS®.

Results
Beta CGRP concentrations were lower in IBD patients (3.1±1.9 pg/mL; 2.9 [2.4-3.4] pg/mL) when comparted to HC (4.7±2.6; 4.9 [4.0-5.8] pg/mL; p&lt;0.001) and CM patients (4.6±2.6; 4.7 [3.3-6.2] pg/mL; p&lt;0.001). Respecting IBD subtypes, beta-CGRP levels were lower in ulcerative colitis patients (3.0±1.9pg/mL; 2.5 [2.1-3.4] pg/mL) as well as Crohn’s disease patients (3.3±2.0 pg/mL; 3.2 [2.4-3.9] pg/mL) to those of HC (p&lt;0.01 and p&lt;0.05, respectively) and CM (p&lt;0.01 and p&lt;0.05, respectively). Beta-CGRP levels in CM did not differ to those with HC (p=0.92).
There were no significant differences when patients were classified by presence/absence of cardiovascular risk factors (yes: 3.1±1.7 pg/mL; no: 3.2±2.1 pg/mL; p=0.93); autoimmune comorbidities (yes: 3.4±1.4 pg/mL; no: 3.1±2.0 pg/mL; p=0.24); mesalazine treatment (yes: 3.1±1.9 pg/mL; no: 3.2±1.9 pg/mL; p=0.91); or steroid treatment (yes: 3.0±1.9 pg/mL; 3.2±1.9 pg/mL; p=0.52). Main characteristics and main results are exposed in table 1 and figure 1.

Conclusion
The reduction in serum beta-CGRP concentrations y patients with recent diagnosis of IBD, compared to two control groups, strongly supports a role for this neuropeptide in the pathophysiology of the disease since its early stages. This decrease was found in both IBD subtypes. Our data indicate a protective role of beta-CGRP in the homeostasis of the gastrointestinal tract.
This study has been co-funded by Instituto de Salud Carlos III (ISCIII) through the project PI20/01358 and by Fondos Europeos de Desarrollo Regional (FEDER), "Una manera de hacer Europa".
P194 Health-related quality of life and fatigue in newly-diagnosed inflammatory bowel diseases: findings from a prospective population-based inception cohort, IBD Prognosis Study
Authors: Attauabi M , Roager Madsen G , Bendtsen F , Seidelin J , Burisch J 
Published: January 2024

Abstract

Background
Patients with inflammatory bowel diseases (IBD) often experience impaired quality of life (QoL) and fatigue. In the current study, we aimed to investigate QoL and fatigue at the time of IBD diagnosis and determine their association with the disease presentation.

Methods
Incident adult patients (≥18 years old) with newly diagnosed ulcerative colitis (UC) or Crohn’s disease (CD) according to the Copenhagen IBD Criteria were included in the IBD Prognosis Study, a prospective, population-based, inception cohort representing approximately 20% of the Danish population (1.1 million). QoL was assessed using EQ-5D-5L and Short inflammatory Bowel Disease Questionnaires (SIBDQ), while fatigue was assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale. A severe disease presentation was defined by the need for glucocorticoids, immunomodulators, biologics, or surgery within three months of disease. Multivariable logistical regression analyses were conducted by adjusting for gender, age, and disease phenotype.

Results
Out of the original cohort, 203 (65.9%) and 116 (57.7%) patients with incident UC and CD, respectively, responded to the questionnaires without differences between responders and non-responders.
The mean EQ-5D-5L index values were significantly lower in patients with UC (0.82, SD 0.17) and CD (0.79, SD 0.23), compared to the Danish background population (both p&lt;0.001). The difference between UC and CD was also statistically significant (p&lt;0.001). Further, more than every third of patients reported severely reduced SIBDQ (UC 29.6%, CD 43.1%, p=0.04).
Severe fatigue was experienced frequently at the diagnosis (UC 26.1%, CD 30.2%, p=0.43), and was more common compared to the control group (means: UC 37.2 (SD 12.0), CD 35.3 (SD 11.5), control group: p&lt;0.001).
Female gender and extensive UC were independently associated with severely impaired SIBDQ and fatigue in patients with UC, while EIMs were associated with both outcomes in UC and CD (Table 1). Finally, severely reduced SIBDQ and severe fatigue were independently associated with a severe disease presentation, as well as IBD-related hospitalization specifically, in both UC and CD (Figure 1).

Conclusion
In this prospective population-based inception cohort of newly diagnosed IBD, we found a high proportion of patients with severely impaired generic QoL, SIBDQ, and fatigue compared to healthy controls. This study emphasizes the importance of addressing these negative symptoms in patients with IBD and their prognostic impact on the disease presentation.
Ref:
1. Jensen MB et al., Scand J Public Health. 2023. doi: 10.1177/14034948211058060.
2. Montan I et al., Value Health. 2018. doi: 10.1016/j.jval.2018.03.013.
P201 Deep learning and minimally invasive inflammatory activity assessment: development and score correlation of a pan endoscopy convolutional network
Authors: Cardoso P , Mascarenhas M , Afonso J , Ribeiro T , Mendes F , Martins M , Andrade P , Cardoso H , Mascarenhas Saraiva M , Ferreira J , Lopes S , Macedo G 
Published: January 2024

Abstract

Background
Capsule endoscopy (CE) is a valuable tool for assessing inflammation in patients with Crohn's disease (CD). The current standard for evaluating inflammation are validated scores like (and clinical laboratory values) like Lewis score (LS), Capsule Endoscopy Crohn's Disease Activity Index (CECDAl) and ELIAKIM. Recent advances in artificial intelligence (Al) have made it possible to automatically select the most relevant frames in capsule endoscopy. In this study, our objective was to develop an automated scoring system using CE images to objectively grade inflammation.

Methods
Pan-enteric CE videos (PillCam Crohn's) performed in CD patients between 09/2020 and 01/2023 were retrospectively reviewed and LS, CECDAl and ELIAKIM scores calculated. We developed a convolutional neural network based automated score consisting in the percentage of positive frames selected by the algorithm (for small bowel and colon separately). We correlated clinical data and the validated scores with the artificial intelligence generated score (AIS).

Results
A total of 61 patients were included. The median LS was 225 [0-6006], CECDAI was 6 [0-33], ELIAKIM was 4 [0-38] and SB_AIS was 0.5659 [0-29.45]. We found a strong correlation between SB_AIS and LS, CECDAl and ELIAKIM scores (Pearson's r= 0.751, r= 0.707, r= 0.655, p =0.001). We found a strong correlation between LS and ELIAKIM (r= 0.768, p = 0.001) and very strong correlation between CECDAl and LS (r= 0.854, p = 0.001) and CECDAl and ELIAKIM scores (r= 0.827, p = 0.001).

Conclusion
Our study showed that the Al-generated score had a strong correlation with validated scores indicating that it could serve as an objective and efficient method for evaluating inflammation in CD patients. As a preliminary study, our findings provide a promising basis for future refining a CE score that can accurately correlate with prognostic factors and aid in the management and treatment of CD patients.
P203 Surveying outcomes of service user experience on the effects of emotional well-being and schooling in paediatric IBD (PIBD) patients in a tertiary PIBD centre
Authors: Lashley C , Buckingham R , Huggett B , Sawney T , Chadokufa S , Kiparissi F , Elzein A 
Published: January 2024

Abstract

Background
We conducted a prospective survey with our PIBD patients and parents seeking outcomes in accordance with our ICN- Improve Care Now participation goals to ‘Improve and optimize the care of children and teens with IBD in underserved and underrepresented populations by addressing healthcare disparities’.

Methods
We sent out a survey to our PIBD patients focusing on their overall satisfaction with the service we deliver in relation to their emotional wellbeing and schooling. We prospectively sent this to our patient cohort of 280 PIBD patients, collecting both quantitative and qualitative data.

Results
76/280 patients and parents (27%) responded, of whom 60/76 (79%) completed the entire survey. Of those responders 45 (75%) were mothers speaking on the behalf of their children aged 5-12 years (n=20 patients). 4 (7%) patients completed the survey themselves, of whom 3 (75%) were aged between 12-18 years. 39 (65%) parents and patients were overall satisfied that the IBD team spoke about getting the right help and support for the child at school. Although 39 (65%) of the patients strongly agreed that we provided information and materials on IBD and support, 21 (35%) of the patients felt that we did not provide the necessary information and education to schools to support them whilst at school.30 (50%) of the overall responders to the survey did not feel that the team had discussed with them the effect IBD has on their feelings and emotions.

Conclusion
Our survey has highlighted the need to provide more education at diagnosis and throughout patient care. This can be achieved by providing physical education packs for schools to be given to every child at diagnosis along with our already established welcome pack. We currently ask patients and families if they would like us to contact their school with information about IBD. This is something we can potentially change, by giving all patients a letter for school at diagnosis for them to give to schools. Caring for the patient’s emotional wellbeing is essential as part of delivering a holistic approach in the care we provide. Although we do offer referral to psychology at diagnosis, this should be followed up regularly and should be included as a standard when patients seen in clinics.
P204 Utility of Rotational Thrombo-Elastometry as an Objective Measure of Hypercoagulability in Patients with Ulcerative Colitis-A Prospective Case Control Study
Authors: Bharadwaj K P , Simon E G , Dave R G , Geevar T , Nair S C , Joseph A J , Dutta A K , Jaleel R , John A , Thomas A , Viswanath A 
Published: January 2024

Abstract

Background
Inflammatory bowel disease (IBD) has an increased risk of venous thromboembolism (VTE) with factors like hospitalization and surgery increasing this risk. Although few recent guidelines recommend anticoagulation thromboprophylaxis for hospitalised IBD patients, there is wide variation in reported practices for VTE prophylaxis. This study was aimed to evaluate Rotational Thrombo-Elastometry (ROTEM) for assessing blood coagulation status in ulcerative colitis (UC) and to evaluate the relationship between ROTEM, disease severity and response to treatment.

Methods
This was a prospective age- and sex-matched study with 60 patients each in UC and irritable bowel syndrome (IBS) groups, latter being controls. Clinical details, blood investigations including ROTEM and D-dimer were collected and analysed after taking informed consent. Hypercoagulable state was defined using Kaufmann’s classification. ROTEM parameters [clotting time (CT), clot formation time (CFT), alpha angle (AA), maximum clot firmness (MCF), maximum lysis (ML)] and D-dimer levels were compared between the two groups.

Results
Of the 60 UC patients (age: 38.6±11.64 years, 44 males); 15(25%) were in remission, 18(30%), 17(28.3%) and 10(16.7%) had mild, moderate, and severe disease respectively. The UC group had significantly more hypercoagulable ROTEM than the control group (66.7% vs. 36.7%, p=0.001). Hypercoagulable ROTEM was found in 9(60%), 8(44.4%), 14(82.3%) and 9(90%) of those in remission, with mild, moderate and severe UC respectively.
Compared to controls; CT [292.36±70.45 vs 337.56±77.89, p=0.001], CFT [103.15±30.31 vs 128.61±40.18, p=0.0001], AA [69.88±5.19 vs 65.36±6.4, p=0.00004], MCF [65.75±5.64 vs 63.25±4.43, p=0.008] and D-dimer levels [329(63-2358) vs 145.5(54-1304), p=0.00001) were significantly abnormal in UC group. Among UC patients with mild, moderate and severe disease; only CFT, AA and D-dimer were significantly different between the groups. There was no significant difference in ROTEM values and D-dimer level in patients with severe UC after one week of treatment.
On univariate analysis; partial Mayo score [OR: 1.49, 95% CI: 1.04-2.12, p=0.028], serum albumin [OR: 0.32, 95% CI: 0.10-0.98, p=0.04], hemoglobin [OR: 0.59, 95% CI: 0.40-0.86, p=0.007], and platelets [OR: 1, 95% CI: 1.01-1.02, p=0.035], were predictors of hypercoagulable state in active UC. On multivariate analysis; only haemoglobin [OR: 0.61, 95% CI: 0.38-0.98, p=0.04] was found to be significant independent predictor.

Conclusion
UC patients had hypercoagulable ROTEM regardless of activity of inflammatory process. The degree of hypercoagulability increased with disease activity. Low haemoglobin was found to predictive of hypercoagulable state in active UC patients.
P206 Metabolomic predictors of response to vedolizumab in Inflammatory Bowel Disease
Authors: Reider S , Watschinger C , Koch R , Tilg H , Moschen A 
Published: January 2024

Abstract

Background
Therapeutic options for patients with IBD have increased substantially over the last decades. Nevertheless, there is still an unmet need for optimization and more targeted allocation of therapies. Treatment with the anti-integrin-a4b7-antibody vedolizumab (VDZ) achieves clinical remission at week 6 in about 50 % of patients with CD and UC . Clinical decision support tools have been developed to help identify patients with a higher likelihood of responding to VDZ. Furthermore, exploratory studies reported associations of response to VDZ with differences in baseline multi-omics measurements. However, personalized selection of biologic therapies in IBD is not yet feasible in clinical practice.

Methods
IBD patients scheduled for therapy with VDZ (n=70, both biologic-naive and -experienced) were recruited and biosamples were obtained before initiating therapy. Response was assessed at week 20 using a multimodal definition incorporating clinical (Harvey-Bradshaw Index &lt; 5 or partial Mayo Score &lt; 2; no need for steroids after week 12) and biochemical criteria (faecal calprotectin &lt; 250 µg/g). Metabolic assessment of baseline plasma samples was performed using a mass-spectrometry-based commercially available technique (Biocrates MxP Quant 500). Differences in absolute concentrations of 630 metabolites were measured and compared between patients responding and not responding to therapy using multivariate statistical approaches accounting for IBD subtype and patient sex.

Results
Significant differences between responders and non-responders to VDZ in the baseline concentrations of three metabolites were detected. These included acylcarnitine (HMDB00062) and a ceramide species (HMDB0004950) which were lower in patients who would respond to VDZ. Conversely, N-methylglycine (HMDB00271) was elevated in responders to VDZ. Additionally, dimensionality reduction using partial least-squares discriminant analysis (PLS-DA) revealed associations between the baseline abundance of certain primary and secondary bile acids and response to VDZ.

Conclusion
In this cohort of IBD patients undergoing therapy with VDZ, baseline host metabolomic variation was associated with response to therapy. Differences in metabolomic profiles are linked to established pathophysiologic processes in the intestine and IBD and represent intriguing possibilities for application in the context of a predictive biomarker signature for response to VDZ.
P207 It’s time to include capsule endoscopy to assess mucosal activity as part of the ‘treat-to-target’ strategy in Crohn’s disease: a real-life experience from a reference center in Argentina
Authors: Gómez E J , Gonzalez R A , Navar S M , Marturano M V , Conde Serra B , Smolarczuk A D , Mercado J D C , Baron P E , Pedreira S C 
Published: January 2024

Abstract

Background
The evaluation of the small bowel (SB) in known Crohn’s disease (kCD) has a significant impact on prognosis with potential therapeutic implications. The treat-to-target strategy is widely accepted, emphasizing that endoscopic healing is associated with improved long-term outcomes. Although capsule endoscopy (CE) shows promise in monitoring the small bowel in kCD, there is limited evidence supporting routine use. The aim of this study was to investigate clinical utility of CE to assess activity and extension of kCD and to evaluate whether the results of CE modify the therapeutic decisions.

Methods
We conducted a single center retrospective cohort study. Adult patients submitted to CE for kCD from Nov-2012 to Nov-2023 were included. Data on demography, previous research, medications for IBD and follow-up were analyzed. Univariate analysis was carried out to identify CE features associated with changes in therapeutic management. A p value &lt;0.05 was considered statistically significant.

Results
A total of 572 CE protocols were performed, of which 76 were in kCD adult patients. The mean age was 36 years (range 16–76), 59% were males and median disease duration was 5.4 years. The CE reached the cecum in 97% and retention was observed in only two patients (2.6%) without necessity of surgical removal. Thirty two of 76 CE protocols (42%) had findings consistent with mucosal activity of CD. The lesions identified by CE included ulcers 30 (39%), erythema and villous edema 21 (28%), stenosis 2 (3%) and were distributed mainly in the distal part of the SB (3rd tertile) in 27 (35%), but in 15 (20%) the proximal SB (1st and 2nd tertile) was also affected. The mean Lewis Score (LS) was 576 (135-5392). Normal or clinically insignificant inflammatory changes (LS &lt;135) ruled out SB mucosal activity in 44 (58%) patients. The results of the CE modified therapeutic decisions in 29 (38%) patients as follows: 17 were started new biological therapy and 7 were optimized. CEs consistent with mucosal inflammatory activity (LS ≥135) were more frequently associated with changes in therapeutic management (OR: 11, 95% CI 4-35, p: 0.04). When both magnetic resonance enterography (MRE) and CE were utilized to assess SB mucosal activity, diagnostic yields of MRE and CE were 45% and 42% respectively. But of the 8 patients with proximal SB affected in CE, only 1 showed inflammatory activity in the MRE.

Conclusion
In our cohort, CE in patients with kCD added valuable clinical information and had a great impact on therapeutic decisions. These results suggest that CE could be incorporated into the treat-to-target strategy for patients with CD. However, randomized controlled trials are required to confirm this recommendation.
P215 Mir-135b, an Early Biomarker of Sporadic and IBD-Related Colorectal Carcinogenetic Progression
Authors: Barberio B , Borga C , Giada M , Zingone F , Fassan M , Savarino E 
Published: January 2024

Abstract

Background
Although the rates of IBD-related-CRC are decreasing over time, CRC is still a leading cause of mortality and reason for colectomy in patients with IBD. Among the different cancer biomarkers, microRNAs (miRs) have emerged as noninvasive tools for diagnosis, monitoring, and prognosis in tissues and biofluids of patients with IBD. Therefore, we aimed to investigate the role of miRs in the development and natural course of IBD-related CRC, in order to identify potential early biomarkers for IBD-related CRC screening and progression.

Methods
The cases were retrospectively collected from the archives of the Surgical Pathology and Cytopathology Unit at the University of Padua. We analysed 9 miRs in colonic tissue specimens of IBD patients with adenoma or dysplasia, with IBD related-CRC, other than 2 control groups of patients with sporadic CRC and of healthy subjects (HC). In addition, we included tissue samples from a colonoscopy that patients with IBD with adenoma or dysplasia underwent some years before the development of mucosal lesions (from 2 to 5 years before), therefore without evidence of adenoma or dysplasia. Results were analyzed with ThermoFisher Connected™ Software and a p-value &lt; 0.05 was considered significant.

Results
Compared to HC, all nine analysed miRs were significantly up-regulated in patients with sCRC, with IBD-related CRC and in IBD patients with adenoma. While, only 3 miRs (miR-135b, mir-21, miR-224) were significantly upregulated in IBD patients with dysplasia (and in their own controls) compared to HC (p&lt;0.0001). Notably, no differences in miRs expression levels were found in patients with IBD-related CRC compared to those found in patients with sCRC. Among all miRs analyzed, only miR-135b and miR-21 resulted significantly up-regulated in patients with IBD. Considering the levels of miR-135b in the tissue samples of IBD patients, we observed an evident increasing trend going from tissue specimens without lesions to those with adenoma or dysplasia and then to those with neoplastic lesions. miR-21 was significantly upregulated in patients with IBD-related CRC compared to both IBD patients with adenoma and their own control samples from a previous negative colonoscopy (p=0.003 and p=0.006, respectively). Likewise, a significant difference in miR-21 levels was observed between patients with IBD-related CRC and those with dysplasia (p=0.02).

Conclusion
miR-21 and miR-135b are involved in the carcinogenesis process of patients with IBD. They could be potential candidate biomarkers for diagnostic purpose, prognostic and predictive stratification of patients.