bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1153 Hospital surgical volumes and outcomes in ileocaecal resection for Crohn’s disease in Sweden 2000-2019: A national cohort study
Authors: Soop M , Zuk D , Bryder M , Myrelid P , Thorell A , Ludvigsson J F , Olén O , Nordenvall C 
Published: January 2024

Abstract

Background
Intestinal resection for Crohn’s disease (CD) is often complex and remains associated with significant postoperative morbidity. In several other types of complex surgery, increased case volumes have been associated with better outcomes. In surgery for CD, such an association has not yet been demonstrated.

Methods
In this nationwide cohort study, we used the National Patient Register to identify all CD patients who underwent their first (primary) ileocaecal resection in Sweden 2000-2019 at age 15 years or above. Hospitals were grouped into low, middle, and high-volume centres based on the number of intestinal resections for CD the previous calendar year (1-24, 25-36 and ≥37 resections, respectively). Length of hospital stay, severe postoperative complications and deaths during the first 100 days after the date of index surgical admission were compared between groups, and adjusted for sex, age, duration of disease, preoperative corticosteroid therapy, and year of surgery. Rates of surgical reintervention were used as a measure of severe postoperative morbidity.

Results
In the 20-year study period, 3396 patients underwent primary ileocaecal resection for CD in Sweden; 2371 (69.8%), 527 (15.5%) and 498 (14.7%) in low, middle, and high-volume hospitals, respectively. Median age at surgery was 41, 39 and 34 years, respectively, and the proportion of patients with a diagnostic record of perianal disease was 9, 10 and 16%. Sex, extraintestinal manifestations and preoperative medical therapies and hospital admissions did not differ between hospital types. Laparoscopic surgery was performed in 351 (15%), 126 (24%) and 122 (24%) patients, respectively. Surgical reintervention within 100 days was performed in 117 (4.9%), 19 (3.6%) and 13 (2.6%) patients in the three groups (adjusted odds ratios 0.72 (95% confidence interval 0.43-1.15) for middle-volume and 0.52 (0.28-0.89) for high-volume hospitals, compared to low-volume hospitals, Figure). There were no differences in the length of index admission hospital stay or mortality.

Conclusion
In primary ileocaecal resection for CD, high-volume hospitals had lower odds of early surgical reintervention, compared to low-volume hospitals. This finding may inform considerations of subspecialisation and centralisation in surgery for Crohn’s disease.
P1162 Upadacitinib in Crohn’s Disease Patients: for what type of patients in real world setting ?
Authors: Juillerat P , Martinho-Grueber M , Ruetsch R , Moubayed H , Vullièmoz- M , Michetti. P 
Published: January 2024

Abstract

Background
The oral selective JAK kinase inhibitor, Upadacitinib (UPA; Rinvoq®) has been shown to induce and maintain clinical response and remission in Crohn’s disease (CD), but also in rheumatic and skin diseases. We report here on the largest Swiss experience in "off label" use of this drug.

Methods
A chart review of the Crohn’s and Colitis Center Beaulieu Lausanne and Gastroenterology Center Bulle of CD patients was conducted.

Results
Eighty-nine IBD patients were exposed to UPA treatment. After exclusion of 22 patients (UC and unknown consent status) we analyzed patients’ characteristics of 67 CD patients (72% women) treated between April 2019 and Nov. 2023. All patients had previously failed or were intolerant to, at least, one anti-TNF agent, 75% had been exposed to 4 or more biologics/ small molecules and two-third had received all classes of biologics. Disease location and behavior were mostly ileo-colonic and inflammatory (L3B1) or ileal only and stricturing (L1B2). Half of the patients had co-existing extraintestinal manifestations (mostly spondylarthritis and arthralgias). Advanced combination therapy was used in 27% of cases with anti-TNF agents (n=10), vedolizumab (n=6) and ustekinumab (n=2). UPA was prescribed after a median disease duration of 14 years (range 1-68) for a mean treatment duration of 14 months (mo) (+/- 9.1 SD; range 1-37). Forty-four CD patients (66%) were still on UPA at the time of study completion. A partial or complete response was observed in 51/67 patients (76%) with a mean decrease of CRP of 10.4 mg/l (+/- 17.6 SD) and calprotectin of 610 mcg/g (+/- 1165 SD). Adverse events were mostly viral infections, acnea, hypercholesterolemia, fatigue and headaches.

Conclusion
Upadacitinib is a good treatment option in difficult to treat CD patients with aggressive disease behavior, alone or in combination in case of concomitant rheumatic and gastrointestinal indications.
P1166 Thiopurines and Risk of Cancer in Patients with Inflammatory Bowel Disease -A Danish Nationwide Cohort study 1996-2018
Authors: Wewer M D , Letnar G , Andersen K K , Malham M , Wewer V , Seidelin J B , Bendtsen F , Burisch J 
Published: January 2024

Abstract

Background
Thiopurines are frequently used in patients with inflammatory bowel disease (IBD). The aim of this study was to assess the cancer risk of thiopurine monotherapy and thiopurine in combination with biologics compared to unexposed IBD patients.

Methods
Incident Danish IBD patients from 1996 to 2018 were identified in the national registers. Time at risk started at the date of IBD diagnosis and exposure status was time-dependent. Exposure was defined as registration of thiopurine and/or biologics. A lag period of 6 months was introduced at the first thiopurine registration as it was unlikely to have caused an effect on any immediate cancer case. If no new registration of thiopurines occurred 6 months from the last registration, the patient was assigned to the discontinued group. Non-melanoma skin cancer was analysed separately to avoid masking severe cancer forms and excluded from the overall cancer analyses. Cox regressions were performed to assess the risk of first cancer and risk estimates were presented as hazard ratios (HR) with 95% confidence intervals (CI). Only the incidence bar plot included non-IBD controls, matched on age, sex and municipality. Controls were unexposed to thiopurines.

Results
In total, 43,404 IBD patients were followed for a median of 8.2 years (IQR:3.7-14.2) from diagnosis. During follow-up, 7,736 Crohn’s disease (CD) (50.6%) and 6,632 ulcerative colitis (UC) patients (23.6%) were exposed to thiopurines. Cancer occurred in 1,292 (8.4%) CD and 1,840 (6.5%) UC patients. Both monotherapy and combination therapy were associated with developing any cancer (HR: 1.61 (95%CI:1.42-1.84) and (HR: 3.15 (95%CI:2.10-4.73), respectively) compared to unexposed IBD patients. In the elderly (&gt;65 years), this was particularly apparent (Figure 1). The association between cancer and thiopurines was observed in non-melanoma skin-, melanoma-, urinary tract-, female genital organ-, lymphoid tissue-, colorectal- and digestive organ cancers. In patients who discontinued thiopurines, the HR returned to the level of unexposed HR: 1.01 (95%CI:0.91-1.13). The association with different cancer forms were higher in patients with &gt;4 years and 1-4 years of thiopurine exposure, HR 1.58 (95%CI:1.37-1.82) and HR 1.24 (95%CI:1.07-1.44), compared to unexposed.

Conclusion
Thiopurines were associated with an increased risk of cancer in both mono- and combination therapy, especially in the elderly. This was noticeable in patients with 1-4 and &gt;4 years of exposure, with 24% and 58% increased risk compared to unexposed. Reassuringly, discontinuation of thiopurines returned the risk to baseline and the absolute number of cancers was low. This warrants closer monitoring of all IBD patients, especially the elderly in combination therapy.
P1173 Higher total antioxidant capacity of diet is associated with reduced surgery risk in individuals with Inflammatory Bowel Disease in a prospective cohort study
Authors: Dan L , Wang S , Chen X , Fu T , Chen J , Wang X 
Published: January 2024

Abstract

Background
Oxidative stress exacerbates inflammatory Bowel Disease (IBD), and dietary antioxidants are proposed as a promising manner to counteract this imbalance. However, the role of individual antioxidants in the complex milieu of the human body may exhibit synergistic or interactive effects. The research has yet to comprehensively examine the impact of dietary total antioxidant capacity (TAC) on IBD prognosis. To fill this knowledge gap, this study aimed to investigate the assocaitions between dietary TAC and risk of related surgery among individuals with IBD in a prospectively recruited cohort.

Methods
We included 2439 individuals with IBD at baseline from UK Biobank. All participants have completed a web-based validated 24-h dietary recall up to five rounds in 2009-2012, reporting their consumption of more than 200 foods and beverages. We calculated the TAC of the diet using the oxygen radical absorbance capacity method and were grouped by quintiles. The outcomes of interest were IBD-related surgery (bowel resection, perianal-related surgery, Strictureplasty, and ileoanal pouch formation), ascertained via linkage to national inpatient data. Cox proportional hazard models were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).

Results
During a mean follow-up of 10.4 years, we identified 261 incident surgical cases related to IBD. The mean age of the participants was 56.9 years, and 51% were females. When comparing extreme quintiles of dietary TAC, individuals with higher dietary TAC were associated with a lower risk of related surgery (HR 0.57, 95% CI 0.38-0.86, P=0.007). The inverse associations between dietary TAC and related surgery were consistent among individuals with ulcerative colitis (HR comparing extreme quintiles 0.59, 95% CI 0.36-0.96, P=0.036). For individuals with Crohn’s disease, the associations were not significant when comparing extreme quintiles of dietary TAC (HR 0.51, 95% CI 0.25-1.03, P=0.060), while we observed a significant 9% risk reduction (HR 0.81, 95% CI 0.65-1.00, P=0.048) of related surgery by per 1-SD increment in dietary TAC among individuals with Crohn’s disease.(Table 1)

Conclusion
In this large large-scale population-based cohort study, we observed that higher dietary TAC was associated with reduced risk of related surgery in individuals with IBD. Our findings provide insights that could inform dietary recommendations and potentially improve IBD management strategies.
P1176 The Influence of positive family history on the phenotype and clinical course of inflammatory bowel disease: A Systematic review and meta-Analysis
Authors: Kim Y , Oh D J , Han S J , Park J J 
Published: January 2024

Abstract

Background
The phenotypes and clinical course of familial and sporadic inflammatory bowel disease (IBD) are not yet well-established. We sought to perform a systematic review and meta-analysis to assess the pooled influences of positive family history on disease characteristics and clinical outcomes in IBD.

Methods
We searched MEDLINE, EMBASE, and the COCHRANE library to identify full text articles analyzing disease phenotypes and clinical courses in IBD based on the presence or absence of a family history of IBD. A meta-analysis was performed using a random-effects model to pool estimates and report odds ratios [ORs].

Results
A total of 14 studies were identified as eligible for the meta-analysis. A positive family history (of any degree) of IBD was associated with a lower prevalence of extensive colitis in ulcerative colitis (OR 0.83, 95% confidence interval [CI] 0.72-0.94) but was not associated with most phenotype features including male gender (OR 0.89, 95% CI 0.74-1.07), small intestine involvement (OR 1.11, 95% CI 0.81-1.52), and stricturing or penetrating disease behavior (OR 0.99, 95% CI 0.76-1.29) in Crohn's disease, extraintestinal manifestations (OR 1.26, 95% CI 0.89-1.78), or perianal fistula (OR 1.02, 95% CI 0.84-1.23). Additionally, various clinical outcomes of IBD including IBD-related hospitalization (OR 1.52, 95% CI 0.93-2.47), corticosteroid use (OR 0.91, 95% CI 0.58-1.44), immunomodulator use (OR 1.07, 95% CI 0.98-1.17), biologics use (OR 1.13, 95% CI 0.91-1.42), and intestinal resection surgery (OR 1.01, 95% CI 0.83-1.23) were not associated with family history. In the subgroup analysis of studies analyzing first-degree family history alone, family history was also not associated with small intestine involvement, stricturing or penetrating behavior, perianal fistula, corticosteroid use, immunomodulator use, biologics use, or intestinal resection surgery.

Conclusion
Familial cases with IBD exhibited a lower prevalence of extensive colitis compared to sporadic cases, but the overall disease phenotype and clinical course were similar in both types of IBD.
P1177 Perceptions of patients with Inflammatory Bowel Disease and first degree relatives on prediction and prevention of disease
Authors: Bravo A , Christensen S G , Julsgaard M , Lago I R , Ginard D , Sørensen H G , Fiorino G , Buisson A , Stemmer N , Queiroz N , Ribas A , Izquierdo V P , Siegel C , Croitoiru K , Spencer E A , Peter I , Colombel J F , Agrawal M , Ungaro R , Fidalgo C , Morão B , Torres J 
Published: January 2024

Abstract

Background
Significant advances have been made in understanding the preclinical stages of IBD, and in identifying risk factors and biomarkers to predict IBD onset. With the use of predictive testing to identify patients at risk of developing the disease, it would be possible to intervene and try to mitigate that risk. However, the feasibility of such strategy, would depend on whether individuals at risk of developing IBD would be willing to undergo predictive testing and preventive interventions.

Methods
A Redcap® electronic survey, available in five languages, was disseminated by clinicians and patient’s associations to patients with IBD, first-degree relatives (FDRs) of those with IBD, parents with IBD and healthy children at risk (based on family history), and healthy couples with multiple children including one with IBD. Participants were asked to express their concerns regarding their own or offspring’s risk of developing IBD and acceptable predictive testing and preventive interventions.

Results
817 individuals (75% women, mean age of 41±12 years) living in 28 different countries participated. The majority were parents with IBD of healthy at-risk children (59%). Among individuals with IBD, 50% had Crohn's disease, 55% were on biologic treatment, 25% had undergone surgery, and 62% reported a significant impact on their quality of life. Overall 85% expressed willingness for predictive testing, favoring minimally-invasive methods. Half of participants would agree to cross-sectional imaging and 38% would accept a colonoscopy. The main benefits recognized with predictive testing were the possibility of starting preventive interventions to minimize the risk of developing IBD (74%) and obtaining an earlier diagnosis (63%). Anxiety from a positive result was a concern (57%). A total of 98% would accept preventive interventions. The most accepted were quitting smoking (64%), physical exercise (81%), dietary modification/supplementation (86%/71%) and probiotics (79%); with the optimal duration of the intervention to last up to one year (33%). Participants deemed a risk of minor adverse events up to 10% acceptable, with 33% tolerating a higher risk if disease risk was reduced by 75%. Half agreed that costs should be supported entirely or shared (39%) with the government.

Conclusion
In this international survey of patients with IBD or parents of children at-risk of developing IBD, minimally-invasive predictive testing would be well accepted as well as non-pharmacological and highly effective preventive interventions.
P1202 Genome wide association study result for inflammatory bowel disease: A single institute experience in Taiwan
Authors: Huang P J , Sun T H , Hsu K C , Wang C P , Wu Y H , Chou J W , Cheng K S 
Published: January 2024

Abstract

Background
Inflammatory bowel disease (IBD) have two major subtype disease, including Crohn’s disease(CD) and Ulcerative colitis(UC). These two diseases of IBD in which abnormal reactions of the immune system induced inflammation and ulcers in any part of gastrointestinal tract from oral cavity to rectum, especially in colon and small intestine. Now, IBD still not have an identifiable cause and many articles that discussion about risk loci of IBD was published in recent years. Hence, we try to identify the risky locus related with IBD.

Methods
From January 1992 to December 2023, we retrospectively reviewed the medical records of patients diagnosed as inflammatory bowel disease at our hospital. We also use Phecode Map with ICD9 codes for finding out more pateints. Then, we used the our hospital’s genetic data warehouse to assay these patient’s genome for identifying the specific loci associated with inflammatory bowel disease.

Results
A total of 286 patients with inflammatory bowel disease from January 1992 to December 2023 was in medical record. The number of Crohn's disease and ulcerative colitis were 102 and 184 respectively. However, only 85 patient with CD and 145 patient with UC were in our hospital’s genetic data warehouse. In addition, we seek cooperation with our hospital’s artificial Intelligence Center for using Phecode Map with ICD9 codes for finding out more patients. Finally, 660 case was in genetic data warehouse.The our result of Genome-wide association study (GWAS) for inflammatory bowel disease that identified 15 potential SNPs, such as RTN4, EML6, CLHC1, MYO10, EFEMP1, ADCY2, TPD52 etc.. Two of 15 potential SNPs, NPAS3, DSCAM has been found to be a risky SNPs of IBD in past study and our result of GWAS for IBD. Another 13 SNPs was potential association with IBD in our result, but not well-known risky gene in past research. Only one genetic locus: CRY2 had statistically significant difference and vaule of -log10(p) is more than 6. But, no similar thesis was reported after we review other published papers about loci associated with inflammatory bowel disease. The relationship between CRY2 and inflammatory bowel disease is still pending investigation.

Conclusion
Although, around 200 genomic loci was considered to be associated with inflammatory bowel disease. But, the precise mechanism by which these loci contribute to IBD were still being investigated. However, more genetic loci associated with IBD was identified can lead us to approach the understanding of the underlying biology of the disease.
P1212 Effects of Enterococcus faecalis-derived Gelatinase E on HCT116 colorectal cancer cells
Authors: Henstra C , Fadavizad K , Van Praagh J , Olinga P , Nagelkerke A 
Published: January 2024

Abstract

Background
The leading cause of death in colorectal cancer (CRC) patients is metastasis to crucial organs, such as the lung, brain and liver. The tumour microenvironment (TME) influences metastasis heavily. One important component in the TME of CRC is the microbiota. Microbiota can affect several pathways related to the origin of metastasis and reorganization of the extracellular matrix. One of the possible contributors to early CRC metastasis is Enterococcus faecalis. E. faecalis produces Gelatinase E (GelE), a quorum-sensing protein with collagenolytic properties. The primary goal of our study was to determine the effect of GelE on CRC behaviour, and especially on migration and invasion in HCT-116 human CRC cells. Moreover, we aimed to uncover the underlying pathways by which GelE influences CRC cells.

Methods
Extracellular GelE was purified from E. faecalis strain V583 from the culture medium. HCT-116 cells were cultured and exposed to different concentrations of GelE. We performed a viability assay using CCK-8 to assess potential toxicity of GelE. To test effects of GelE on collagen structure, we measured stiffness of collagen-I. A transwell assay was used to assess the influence of GelE on invasive capacity of cells through a collagen-I matrix. GelE exposed cells were assessed for shape and motility markers using immunofluorescent staining for β-catenin (cell shape) and loss of E-cadherin (cell motility marker). For mechanistic insight of GelE exposure on HCT116, we performed proteomics analysis on the cells.

Results
GelE treatment did not affect relative cell viability of HCT116 cells up to a concentration of 100 μg/ml. Exposure to GelE caused a concentration-dependent increase in HCT-116 cell invasion through collagen-I. The immunostainings showed a downregulation of E-cadherin, indicating an induction of cell motility. Immunostaining for β-catenin showed a statistically significant effect on cell shape, becoming more elongated, an additional indication of cell motility. Proteomics showed possible mechanistic pathways that explain the increased motility including activation of the SMAD pathway, RhoGTPAse activation and activation the urokinase-plasminogen system. Reactome database analysis on the proteomics data also revealed an increase in cell-cycle related pathways.

Conclusion
Our results indicate that E. faecalis-derived GelE drives HCT-116 invasion with an elongated motility. Therefore, drugs inhibiting the activity of GelE could decrease the risk of metastasis in patients with a high E. faecalis V583 abundance in the TME.
P1216 Oral Health status in Inflammatory Bowel Disease patients
Authors: Rodrigues C , Gomes A , Mendes K , Correia M J , Rosa N , Pereira P , Lopes P C , Martins R , Veiga N , Soares C , Ministro P 
Published: January 2024

Abstract

Background
Inflammatory bowel diseases (IBD) affect de gastrointestinal tract primarily as it occurs in oral Crohn´s disease (CD) or as an extraintestinal manifestation (EIM) as aphthous stomatitis either in CD or ulcerative colitis (UC). Moreover, data suggest that IBD patients have a higher prevalence of caries and periodontal disease. The aim of our study was the characterization of oral heath in a cohort of IBD patients compared with a control group without IBD and determine the need of oral health intervention in IBD population.

Methods
This was a collaborative transversal cohort study between an IBD medical appointment in a tertiary hospital and a faculty of dental medicine. Patients from IBD appointment were invited to participate and gave their informed consent. The only exclusion criteria were the incapacity to open the mouth or give a written informed consent. Data was collected regarding demographics, disease characterization, activity, previous IBD related surgeries and current and previous IBD treatments. The control group were heathy controls matched by age and sex. Oral health assessment was achieved by an intraoral clinical examination with the aid of artificial light, oral mirror and WHO periodontal probe. Periodontal diagnosis was achieved through an online periodontal chart (https://www.periodontalchart-online.com), and classified according to periodontal health, periodontitis (stage and grade) and gingivitis. Oral examination provided the Decayed, Missing due to caries, and Filled Teeth Score (DMFT Score) and need for dental treatment and/or prosthetic rehabilitation.

Results
Oral health status of IBD patients confirm the high incidence of PD, with a prevalence of 55.3% and 69.4% for CD and UC patients, respectively. It is important to refer most of the patients diagnosed with PD suffer from the most severe stage of the disease (III and IV), which is not observed for the control group. Poor oral health status is also evident due to the need for dental treatment, since 88.1% of IBD patients need dental treatment and 38.1% need prosthetic rehabilitation (table 1).

Conclusion
IBD affects mainly the digestive system, however there is growing evidence that it also has implications for oral health, namely in periodontitis development, as shown in this study. Thus, good oral hygiene practices, including regular dental check-ups and personalized protocol of periodontal therapy are essential for these patients. Moreover, the collaboration between gastroenterologists and dental professionals is crucial to providing comprehensive care for patients with IBD, addressing both their gastrointestinal and oral health needs.