bluuebunny/crossref_metadata_2025_split huggingface dataset:
P184 Identification of the PAI-1, as a potential non-invasive, fecal biomarker in the Inflammatory Bowel Diseases
Authors: Jójárt B , Molnár T , Diána K , Szabó V , Varga Á , Resál T , Bacsúr P , Szántó K , Földesi I , Molnár T , Maléth J , Farkas K ,   HAS-USz Momentum Epithelial Cell Signaling and Secretion Research Group
Published: January 2023

Abstract

Background
Inflammatory bowel diseases (IBD) are defined by unregulated immune response leading to intestinal inflammation. Monitoring of the intestinal inflammation are mostly invasive, time-consuming and expensive. Therefore, a simple, rapid and non-invasive test, with ability to differentiate IBD from other gastrointestinal conditions and to monitor disease activity and therapeutic response, will have important clinical implications. Our previous cytokine profiling identified that plasminogen activator inhibitor 1 (PAI-1) is expressed in IBD patients with active disease, but not in control. Therefore, our aim was to assess the utility of PAI-1 in monitoring disease activity and therapeutic response of IBD patients in different biological samples.

Methods
Biopsy, serum and fecal samples were collected from more than 150 active IBD patients and controls without IBD. Inclusion criteria included change of therapy or initiation of new treatment for IBD patients. Immunofluorescence (IF) staining was used to observe the presence and localisation of cytokines. Total protein and mRNA were isolated from biopsies and fecal samples. Protein levels were measured by ELISA and gene expression by qRT-PCR.

Results
The IF staining of the biopsy samples revealed a significantly higher percentage of PAI-1 positive cells in the inflamed mucosa compared to the control. The relative mRNA expression of PAI-1 was significant higher in non-responders and untreated, inflamed IBD patients compared to controls and responders. On the other hand, we were not able to detect significant changes between responders and non-responders in gene expression of TNF-α, IL-1β and IL-6. Serum, mucosal and fecal PAI-1 protein levels were significantly higher in IBD patients compared to controls. Whereas no significant difference was observed between Crohn’s disease and ulcerative colitis patients. The PAI-1 level was significant increased in endoscopically and clinically active disease compared to inactive patients and controls. In responders, PAI-1 concentration significantly decreased after initiation of therapy compared to non-responders. Significantly upregulated fecal PAI-1 level was found in active IBD compared to patients with inactive IBD, tumor, adenoma, diverticulosis and control. In addition, the stability analysis of fecal PAI-1 showed that the protein was detectable up to one week at room temperature and 4ºC.

Conclusion
Our findings suggest that serum, mucosal and fecal PAI-1 expression correlates with disease activity in IBD patients, suggesting that it could be utilized to monitor disease activity and possibly therapy response as a non-invasive biomarker in IBD.
P204 Preoperative optimization of patients with inflammatory bowel disease: a multicentre study of EIGA Group
Authors: Molina Arriero G , Mauriz Barreiro M V , Echarri Piudo A , Fraga Iriso R , González Furelos T , López de Ullibarri I , Vázquez Rey M T , Calviño Suárez C , Carmona Campos A , Tejido Sandoval C , García Morales N ,   Inflammatory Bowel Disease Group of Galicia [EIGA]
Published: January 2023

Abstract

Background
A significant percentage of patients with inflammatory bowel disease (IBD) will require surgical treatment at some point in their disease. Preoperative optimization (PO) intends to ensure that the patient arrives in optimal condition to surgery and to minimize the risk of complications. The aim of this study was to assess whether optimization criteria were met in patients with IBD undergoing elective surgery and to describe the percentage of post-surgical complications based on exposure to any of these risk factors.

Methods
IBD patients undergoing intra-abdominal surgery between 1st January 2013 and 30st September of 2021 were retrospectively selected. Data collection included clinical characteristic of IBD, nutritional biochemical parameters and surgical aspects. In addition, risk factors associated with a worse prognosis were collected. Among them, anemia, risk of malnutrition (using the Malnutrition Universal Screening Tool, MUST), smoking, presence of intra-abdominal sepsis and treatment received for IBD in the 30 days prior to surgery, especially the use of corticosteroids. Postsurgical complications were defined as those occurring within 30 days after surgery.

Results
A total of 212 surgeries performed in 5 centres from northwest of Spain were included: 87% in Crohn’s disease, 11% in ulcerative colitis and 2% in unclassified-IBD patients. Patients' clinical and demographic characteristics are summarized in Table 1. Postoperative complications were reported in 20.1% (n=62) of the patients, including suture dehiscence, infection, obstruction, bleeding and thrombosis. The most frequent complication was surgical site infection (10.8% of all the cases). Up to 35.6% of the patients were at risk of malnutrition at the time of surgery (MUST&gt;=1), only half of these patients received some type of nutritional therapy. 20% of patients received at least 20 mg daily of prednisone or equivalent four weeks prior to surgery. Risk factors of post-surgical complications are presented in Table 2. Corticosteroid therapy (&gt; 20 mg daily prednisone or equivalent) (OR 3.52 [95% CI: 1.05–12.6] (p=0.042) and the absence of nutritional support (OR 2.34 [95% CI:1.17-4.65] (p=0.016) were associated with postoperative complications. Multivariate and univariate analysis for postoperative complications are shown in Table 3 and Table 4.

Conclusion
The absence of a PO model increases the risk of postoperative complications. Inadequate preoperative nutritional care and corticosteroid therapy are risk factors for complications in our study. Protocols of PO in IBD patients are recommended.
P223 The usefulness of tissue calprotectin in pediatric Crohn’s disease – a pilot study.
Authors: Szymanska E , Szymanska S , Karkucinka-Wieckowska A , Aldona W , Kierkus J , Dadalski M ,   Biomarkers inflammatory bowel disesae elafin
Published: January 2023

Abstract

Background
Fecal calprotectin (FCP) is a highly sensitive biomarker of intestinal inflammation widely used in diagnostics and monitoring of inflammatory bowel disease (IBD). However, it cannot be used to localize the disease activity and its levels may be false negative or false positive in some cases. The aim of this study was to evaluate tissue calprotectin (TCP) in pediatric patients with Crohn’s disease (CD) and correlate it with FCP and clinical activity of the disease.

Methods
Fifty-seven pediatric patients with CD at the median age of 10.5 (1-17) years (yrs) were examined for fecal and tissue calaprotectin. Values were correlated to disease activity and histopathological changes of the patients’ endoscopic biopsies. Disease activity was assessed using Pediatric Crohn’s Disease Activity Index (PCDAI), fecal calprotectin (FCP) was measured with ELISA test and the immunohistochemical (IHC) staining for calprotectin antigen was performed on bioptic samples from 6 bowel segments and the number of TCP cells was counted per high power field (HPF). Non-parametric statistical tests were used for data analysis.

Results
Patients’ median PCDAI score was 10 (0-63.5), while median FCP was 535 (30-600) ug/g. The only observed correlation was between FCP level and disease activity. There was no associated neither between FCP and TCP, nor TCP and PCDAI.

Conclusion
Tissue calprotectin unlike FCP does not seem to be a good predictor of disease activity in Polish pediatric patients with CD.
P248 The diagnostic accuracy of Intestinal ultrasound for assessing disease activity in the proximal ileum and jejunum in children with Crohn’s disease: Preliminary results of a prospective study
Authors: Vos H , van Wassenaer E , van Schuppen J , van Rijn R , D'Haens G , Benninga M , Koot B ,   RAINBOW group
Published: January 2023

Abstract

Background
Crohn’s disease (CD) is an inflammatory bowel disease (IBD) involving mainly the small intestine and the colon. Current imaging modalities such as magnetic resonance enterography (MRE) to assess disease activity in the small bowel are expensive and are often poorly tolerated by children. Intestinal ultrasound (IUS) is a non-invasive and well tolerated monitoring tool for assessing disease activity in colon and terminal ileum. In children the diagnostic accuracy of IUS for proximal bowel has not been systematically studied. In this study we assess the diagnostic accuracy of IUS compared to MRE for the proximal ileum and jejunum in the paediatric population. Furthermore we aim to establish which IUS features are the best predictors for IBD activity in the proximal ileum and jejunum.

Methods
Paediatric CD patients were prospectively enrolled and underwent MRE and IUS within 7 days. MRE-images were scored using the segmental grading system by Tielbeek et al. The ultrasonographer was blinded for the MRE results and the paediatric radiologist who assessed the MRE images was blinded for IUS results.

Results
Forty-two paediatric CD patients underwent IUS paired with MRE until now. Eighty-four bowel segments were available for analyses. In total 24 bowel segments had mild (n=12) to moderate severe (n=12) disease activity based on MRE. The AUROC of BWT for moderate severe disease was 0.78 (95% CI 0.61-0.95). A cut-off value of BWT &gt;2.5 mm showed had a specificity of 90%. A cut-off value of BWT &lt;1.7 mm showed had a sensitivity of 91%. Of the affected segments 12 had increased Doppler signal and 13 showed mesenteric fat proliferation. No regression analysis was performed since the number of inflamed segments was too low.

Conclusion
IUS is an promising tool to non-invasively assess disease activity in the proximal ileum and jejunum. Our preliminary results suggest that a cut-off for BWT &lt; 2,5mm IUS can be used to demonstrate disease activity. A lager sample size to perform regression analysis and to assess other IUS features for disease activity is currently being collected.
P291 Long term outcomes of children with ulcerative colitis after acute severe colitis: a multicenter study from the GETAID pédiatrique group
Authors: Pigneur B , Cochet M , Delphine L , Coopman S , Raphael E , Thierry L , Claire D , Stéphanie W , Rémi D L , Georges D , Valérie B , Anne B , Christine M , Jerome V , Frank R , Julie L ,   GETAID pédiatrique
Published: January 2023

Abstract

Background
Acute Severe Colitis (ASC) is a frequent and severe complication of ulcerative colitis (UC) that can occur at any time during the disease. Its prognosis can be severe with a high risk of colectomy. The use of immunosuppressants and more recently biotherapies seem to reduce the risk of colectomy. We wished to study the long-term evolution of paediatric-onset UC patients after ASC.

Methods
This retrospective study was conducted in 12 centres of the GETAID paediatric in France. Data on patients with UC aged &lt; 18 years admitted with ASC (defined as paediatric ulcerative colitis activity index [PUCAI] score ≥ 65) between January 2010 and January 2021 were collected at discharge and at 1, 3 and 5 years after admission. The primary outcome of our study was colectomy-free rates at one year. A univariate analysis comparing the profile at diagnosis and at ASC of patients who underwent colectomy, and others was performed to look for prognostic factors associated with the risk of surgery.

Results
Of the 102 patients admitted with ASC, 95 [93%] were treated with corticosteroids. Forty-six [48%] patients were escalated to second-line therapy, mainly to infliximab. Nine patients [8.8%] underwent colectomy before discharge. Long-term follow-up showed colectomy-free rates were 83%, 76% and 72% at 1, 3 and 5 years after initial ASC admission, respectively. In a multivariate analysis, active disease, and use of methotrexate were significantly associated with a higher risk of colectomy. A short delay between diagnosis and ASC, rapid steroid use for ASC and second line therapy with azathioprine and Infliximab were significantly associated with a lower risk of colectomy.

Conclusion
The rate of colostomy remains high after an episode of acute colitis despite the earlier use of biotherapies. But long-term outcome of paediatric-onset UC patients is good with sustained clinical and biological remission.
P332 External validation of intestinal ultrasound scores to detect endoscopic activity in children and adults with Crohn's disease: A prospective cohort study
Authors: Aronskyy I , Spencer E , Kellar A , Pittman N , Dubinsky M , Dolinger M 
Published: January 2023

Abstract

Background
Intestinal ultrasound (IUS) scores were developed for adults and children with Crohn’s disease (CD) but have not been externally validated with endoscopy. This study aimed to externally validate all CD IUS scores with endoscopy.

Methods
Prospective cross-sectional study of children and adults with CD who underwent IUS and colonoscopy within 60 days. The International Bowel Ultrasound Segment Activity Score (IBUS-SAS), Simple Ultrasound Score for Crohn’s disease (SUS-CD), Simple Ultrasound Activity Score for Crohn’s disease (SUAS-CD), and Simple Pediatric Activity Ultrasound Score (SPAUSS) were compared to the Simple Endoscopic Score for Crohn’s disease (SES-CD). Primary outcomes were the area under the receiver operating curve (AUROC) for each IUS score for moderate (SES-CD ≥ 5) and any (SES-CD ≥ 3) CD activity. Secondary outcome was the correlation of IUS scores and SES-CD.

Results
82 CD patients (53 (65%) children, 29 (35%) adults, 41 (50%) female; 50 (61%) ileocolonic disease location) underwent IUS of 150 (74 (49%) terminal ileum) bowel segments with IUS scores and SES-CD. In both children and adults, all scores performed with high accuracy to detect SES-CD ≥ 5 and moderate accuracy to detect SES-CD ≥ 3. To detect SES-CD ≥ 5 in children, a SUAS-CD ≥ 4.5 had the highest AUROC [95% CI] =0.91 [0.85-0.97] (sensitivity=90%, specificity=81%), followed by an IBUS-SAS ≥ 37.8 (AUROC=0.89 [0.83-0.96]), SPAUSS ≥ 4 (AUROC=0.89 [0.81-0.96]), and SUS-CD ≥ 2 (AUROC=0.88 [0.80-0.95]). To detect SES-CD ≥ 5 in adults, an IBUS-SAS ≥ 34.2 had the highest AUROC=0.85 [0.71-98] (sensitivity=70%, specificity=87%) followed by a SAUS-CD ≥ 5.45 (AUROC =0.84 [0.71-0.98]), SUS-CD ≥ 1 (AUROC=0.81 [0.65-0.97]), and SPAUSS ≥ 5 (AUROC=0.78 [0.65-0.97]). To detect SES-CD ≥ 3, SPAUSS ≥ 4 (AUROC=0.78 [0.69-0.87], sensitivity=56%, specificity=92%) and SUS-CD ≥ 3 (AUROC =0.78 [0.68-0.86], sensitivity=56%, specificity=89%) had the highest accuracy in children followed by a SAUS-CD ≥ 4.5 (AUROC=0.74 [0.63-0.86]) and IBUS-SAS ≥ 34 (AUROC=0.73 [0.62-0.84]). In adults, SAUS-CD ≥ 2.68 and IBUS-SAS ≥ 11.2 (AUROC = 0.68 [0.50-0.85], sensitivity=63%, specificity=72%) had the highest accuracy to detect SES-CD ≥ 3 followed by a SUS-CD ≥ 2.5 (AUROC = 0.65 [0.50-0.81]), and SPAUSS ≥ 6 (AUROC = 0.61 [0.45-0.77]). IUS scores moderately correlated with SES-CD in children and adults, of which the IBUS-SAS had the highest (r=0.66 in children vs. r=0.57 in adults).

Conclusion
CD IUS scores are accurate for the detection of endoscopic activity in children and adults. IUS scores may be more accurate in children and correlate better with endoscopy but more studies are needed. This data supports the use of IUS as an accurate monitoring tool, reflective of endoscopic activity.
P340 Issues on implementing treat-to-target approach in Asia Pacific, Middle East and Africa: Reality, gaps, and way forward -APMA IBD Coalition
Authors: Akyüz F , An Y K , Aniwan S , Bui H H , Chan W P , Choi C H , Chopdat N , Connor S , Desai D , Flanagan E , Kobayashi T , Leong R W , Leow A , Leung W K , Limsrivilai J , Peddi K , Pribadi R R , Ran Z , Wei S C , Wu K , Ye B D ,   APMA IBD Group
Published: January 2023

Abstract

Background
To understand the real-world issues and difficulties in implementing treat-to-target (T2T) approach in managing inflammatory bowel disease (IBD) patients in the Asia Pacific, Middle East and Africa (APMA) region.

Methods
A structured survey of 10 questions was sent to 19 IBD specialists from 14 economies/countries in the APMA region between June and August 2022, followed by three hybrid roundtable discussions to identify, elaborate and validate the gaps and challenges in T2T adoption in their healthcare setting. The survey used a series of questions exploring experts’ current practice and preference of treatment endpoints, diagnostic and monitoring tools, and major desirable improvement if resources are not constrained.

Results

The two major gaps expressed by of IBD specialists in the APMA region are to early diagnose and treat IBD patients (61.1%), and the lack of trained IBD nurses (50%) (Figure 1.The major gaps in the diagnosis and monitoring of IBD in routine clinical practice in APMA). While T2T approach is widely accepted among IBD specialists across the APMA region, blood tests (such as CRP, ESR) and faecal calprotectin (FC) test are two commonly used modalities by 77.8% and 72,2% IBD specialists, respectively However, the availability and cost of FC test is the second leading challenge (55.6%) faced by these specialists, with patient compliance being the most challenging (66.7%)(Figure 2.The biggest challenges in monitoring IBD patients in APMA). As to the most desired IBD monitoring tool, 88.9% considered the application of validated and reproducible intestinal ultrasound (Figure 3.Most desired IBD monitoring tool in APMA if resources are not a problem). The availability of trained IBD nurse (39%) and increasing awareness and training of general practitioner (33%) are the two most important factors that IBD specialists considered to improve care of IBD patients in the region (Figure 4.Major improvements required in diagnosis to improve IBD patient care in APMA).

Conclusion
Considerable gaps in implementing T2T approach to managing IBD patients in the APMA region are identified via this survey by IBD specialists. Lack of training of general practitioners, IBD nurses and availability of affordable FC are common issues identified in this region, which would deserve implementation of new educational initiatives and resources reallocation.
P365 Psoriasis in Inflammatory Bowel Disease: Comparison of Extraintestinal Manifestations and Effect of Anti-TNF Therapies
Authors: Kilic D T , Yuksel I 
Published: January 2023

Abstract

Background
Psoriatic lesions may develop in inflammatory bowel disease (IBD) patients as an extraintestinal manifestation or an adverse effect of anti-TNF therapy. The aim of this study was to compare the clinical characteristics of IBD patients with psoriasis between extraintestinal manifestations and the effect of anti-TNF therapies.

Methods
In this cross-sectional study, data was identified between March 2019, and October 2022. Demographic and clinical data of patients with IBD were recorded at baseline and during follow-up. All patients were questioned for psoriasis, and the "onset of psoriasis" was recorded as before or after anti-TNF therapies.

Results
In our tertiary center, a total of 1125 IBD patients were identified through the database (543 with CD, 549 with UC, and 33 with IBD unclassified (IBDU)) and a 336 (29.9%) had an exposure to adalimumab, 322 (28.6%) to infliximab, and 27 (2.4%) to certolizumab. In our cohort, a total of 37 (3.3%) patients, suffered from psoriasis, in which 18 (48.6%) patients on anti-TNF therapy (7 adalimumab, 10 infliximab and 1 certolizumab) developed a drug-induced psoriasis, while 19 (51.4%) patients had psoriasis as an extraintestinal manifestation before the anti-TNF therapies. In patients with all psoriasis, 24 (%64.9) were female and 28 (75.7%) had CD. CD was statistically significantly more common in patients with psoriasis induced by anti-TNF therapy (17 (94.4%) vs. 11 (57.9%), p=0.019).
Anti-TNF therapy induced psoriasis had statistically significantly longer disease duration than psoriasis as an extraintestinal manifestation group (11.5 vs 6 median years, respectively p=0.005), while other baseline characteristics such as age, sex, smoking status, family history of IBD, disease location, behavior, perianal disease, and other extraintestinal involvements were similar. At baseline, serum hemoglobin (13 vs. 12 mg/dL; p=0.069), albumin (4.2 vs.4.3 g/dL; p=0.505), partial MAYO score (6 vs 7 median score; p=0.247) and CDAI (360 vs. 320 median score; p=0.339) were all comparable between the two groups, respectively. Whereas baseline CRP level in extraintestinal manifestation group was significantly higher than anti-TNF therapy induced group (66 vs. 2.8 mg/L; p=0.003).

Conclusion
In this study, we found that up to 3.3% of all IBD patients had psoriasis; half of these cases were anti-TNF therapy induced psoriasis, and the rates of psoriasis in CD patients and female patients were greater than those in UC and male patients. Anti-TNF therapy induced psoriasis had a statistically significantly longer disease duration and lower baseline CRP in comparison to psoriasis as an extraintestinal manifestation.
P372 Endoscopic ultrasonography in the differential diagnosis of Ulcerative colitis and Crohn's disease.
Authors: Belousova E ,   Author(s): Budzinskay A.2 Belousova E.1 Lomakina E.1 Levitskaya A.1 Institute(s): 1Moscow Regional Research and Clinical Institute (MONIKI) Department of Gastroenterology Moscow Russian Federation 2 Moscow Regional Research and Clinical Institute (MONIKI) Department of Endoscopy Moscow Russian Federation Budzinskay A. MD PhD Senior Researcher Belousova E. MD PhD Professor Lomakina E. MD Researcher Levitskaya A. phD candidate
Published: January 2023

Abstract

Background
Background & Aim: Differential diagnosis between Crohn's disease (CD) and ulcerative colitis (UC) could be a challenge, since the endoscopic and clinical characteristics of both may resemble. Furthermore, radiological methods do not provide complete information.To assess the possibilities of endoscopic ultrasonography (EUS, endosonography) for the differential diagnosis between ulcerative colitis (UC) and Crohn's disease (CD) in doubtful or controversial cases.

Methods
Methods: We examined 50 IBD patients during the active phase: CD-28 patients (M: W=16:12,average age 27.3 ± 0.7 years), UC-22 patients (M: W=8:14, average age 32 .6 ±1.7 years). The control group included 15 patients without UC or CD. All patients underwent EUS colonoscopy for measurement of wall thickness, assessment vascularization degree and compression elastography was perform.

Results
Results.It was found that wallthickness in CD was 5.66 ± 0.36 mm, was 1.5 times more than in UC (3.96 mm ± 0.13 mm) and 2 times more than in controls(2, 62 ± 0.11mm). Frequency of all intestinallayers in CD was noted in 68% vs 9% in UC (p &lt; 0.02). On the contrary, in UC, wall thickening due to the mucosa and submucosa was significantly more common than in CD (82% and 7.2%, respectively, p &lt; 0.05). Vascularizationdegree of colon wall in UC in most cases was reduced, while in CD, on the contrary, it was increased. According to elastometry, type 1 staining according to Ueno E., corresponding to the soft-elastic structure of colon wall, was detected in UC in 78% of cases, in CD in 54%. Type 2 according to Ueno E. was verified in 22% in UC, in 45% in CD, which indicates the presence of fibrosis foci in colon wall, mainly in CD patients.

Conclusion
Conclusion. The obtained EUS data can be as criteria for differential diagnosis between UC and CD in compound cases and clarify the presence and degree of fibrosis, for example, if strictures in CD.