bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0409 Clinical and serological characteristic of Crohn’s Disease patients with gastrointestinal strictures
Authors: Dudek P , Borkowska A , Małecka-Wojciesko E , Talar-Wojnarowska R 
Published: January 2025

Abstract

Background
Processes of inflammation and fibrogenesis in Crohn’s Disease (CD) contribute to development of strictures and subsequent complications, constituting a significant medical issue. The primary objective of the study was to identify clinical parameters associated with the occurrence of gastrointestinal stenosis, as well as to determine the clinical utility of promising biomarkers of fibrosis in a cohort of patients with CD.

Methods
A single-center cohort study was performed on 78 adults diagnosed with different phenotypes of CD. The study cohort included 36 subjects (46.2%) with gastrointestinal strictures identified by endoscopic or radiological methods, while the control group comprised 42 individuals (53.8%) without stenosis. The assessment of clinical factors, like gender, age of disease onset, disease duration, comorbidities, disease location, extra-intestinal symptoms was undertaken to explore potential associations with the presence of gastrointestinal strictures. Serum levels of candidate biomarkers of fibrosis, including granulocyte-macrophage colony stimulating factor antibodies (GM-CSF Ab), hepatocyte growth factor activator (HGFA), fibronectin isoform ED-A and cartilage oligomeric matrix protein (COMP) were measured using ELISA test.

Results
The overall cohort consisted of 47.44% females (n=37) and 52.56% males (n=41). The median age of disease onset was similar between the stenosis group (25.00 years, IQR: 19.00–37.00) and the non-stenosis group (26.00 years, IQR: 21.00–33.00). A proportion of 44.44% of the stenosis group required surgical or endoscopic treatment due to strictures. The most common sites of stenosis comprised the large intestine (52.78%) and the ileocecal valve region (50%), ranking ileocecal valve involvement as a significant predictor for stricture formation, with OR=3.65 (95% CI: 1.11–13.43, p=0.039). Fibronectin ED-A, with a cut-off of ≤14.52 ng/mL, was significantly associated with strictures occurrence, with OR=0.96 (95% CI: 0.92–1.00, p=0.036). Some trends in GM-CSF Ab levels were observed in patients with ileocecal involvement (median 1.75 ng/mL) compared to those without (median 1.37 ng/mL), nearing statistical significance (p=0.061).

Conclusion
The performed study provided some significant data about stricturing course of CD, with ileocecal valve involvement as a marker of stricture formation among CD patients. Evaluated serum biomarkers, especially fibronectin isoform ED-A, seem to be a promising diagnostic tool, however obtained data are inconsistent and demand further trials.
P0412 Predicting outcomes of disease in patients with Primary Sclerosing Cholangitis and Inflammatory Bowel Disease: a retrospective multicentric study
Authors: Oliveira R , Viegas M I , Abrantes D , Vaz Conde P , Saraiva M , Espinheira M D C , Trindade E , Carvalho I , Perdigoto D , Tavares de Sousa H , Roseira J 
Published: January 2025

Abstract

Background
The impact of coexistent IBD and PSC on disease progression and prognosis is unclear. This study evaluates outcomes in patients with both conditions, using the novel PSC Risk Estimate Tool (PREsTO) for PSC prognosis.

Methods
A retrospective multicentric study identified IBD-PSC patients through a national survey. PREsTO was calculated to predict PSC-related liver decompensation, and IBD progression was tracked via composite outcome measures.

Results
Among 77 identified patients from six nationwide participating centres, 59 were included, predominantly with ulcerative colitis (77%) and pancolitis (89%). Median ages at diagnosis were 22.3 for IBD and 29.8 for PSC, with follow-ups of 12.0 and 6.9 years, respectively.
PREsTO predicted a median 5-year risk of liver decompensation of 5.3% according to baseline characteristics. However, within this period only 1 patient experienced variceal bleeding; no other liver decompensation events were reported. Notably, over full follow-up, there were 20 additional events: jaundice (7), variceal bleeding (1), cholangitis (5), pruritus (7). One patient (1.7%) ultimately required liver transplant.
For IBD, during follow-up, 10 patients (17%) were hospitalised for IBD-related reasons (1 bowel subocclusion, 9 flare-ups). Twelve patients (21%) required at least one course of corticosteroids, and 34% started advanced medical therapy, of whom 57% needed either dose optimisation or modification. Three patients underwent surgery due to refractory disease activity (1 colectomy, 2 proctocolectomies). Importantly, 39% of patients showed subclinical disease activity at the last follow-up, indicated by faecal calprotectin above 250µg/g.

Conclusion
PREsTO may overestimate liver decompensation risk in our IBD-PSC population, which may be due to a young population. However, the impact of PSC extends beyond portal hypertension complications. Nonetheless, the high prevalence of IBD subclinical inflammation in this group raises concerns about potential disease progression and increased cancer risk.
P0416 Efficacy and safety of oral sulphate tablet for bowel preparation in patients with moderate to severe ulcerative colitis: a multicenter cohort study
Authors: Song J H , Shin J , Kong S M , Cha B , Hong J T , Kwon K S 
Published: January 2025

Abstract

Background
Proper bowel preparation is essential factor for accurate, high-level colonoscopy. Poor bowel preparation has been reported in up to 30% of patients due to intolerance to high doses of preparation agent. Orafang [Pharmbiop Korea] is a novel sulphate tablet launched in Korea and is being used safely and effectively. According to a previous study, this oral sulphate tablet(OST) has shown effective bowel cleansing results and safety in patients with inactive IBD. However, data on efficacy and safety in patient with active UC are insufficient. We evaluated the efficacy and safety of OSTs in patients with moderate to severe UC.

Methods
Between January 2022 and July 2024, patients with UC who underwent bowel preparation with OST spilt-dose regimen were enrolled at the Inha university hospital, Samsung Changwon Hospital, and Konkuk University Medical Center. A total 63 patients were retrospectively reviewed. Patients were allocated by disease activity to inactive UC (n=39, 61.9%) or active UC (n=24, 38.1%). We reviewed clinical characteristics, bowel cleansing success rate defined as Boston bowel preparation scale (BBPS) ≥ 8 and safety as assessed by laboratory abnormalities and UC associated complications.

Results
Both the active and inactive inflammation groups showed high cleansing success rates as measured by the BBPS (87.5% vs. 89.7%, p=0.784), with no statistical difference. No clinically significant laboratory abnormalities were found in either group, except for elevations of uric acid above the upper limit observed in two inactive group patients. No endoscopy related complication or UC related hospitalizations occurred in either group.

Conclusion
OST was a low-volume agent for colonoscopy that demonstrated a safe and success bowel cleansing rate regardless of UC activity. Our study results suggest that the OST split-dose regimen is effective and safe even in patients with active UC.

References
Kim, Kyeong Ok, et al. "Efficacy, safety and tolerability of oral sulphate tablet for bowel preparation in patients with inflammatory bowel disease: A multicentre randomized controlled study." Journal of Crohn’s and Colitis 16.11 (2022): 1706-1713.
Manes, Gianpiero, et al. "Appropriateness and diagnostic yield of colonoscopy in the management of patients with ulcerative colitis: a prospective study in an open access endoscopy service." Inflammatory bowel diseases 14.8 (2008): 1133-1138.
Yang, Hyo-Joon, et al. "Novel sulfate tablet PBK-1701TC versus oral sulfate solution for colon cleansing: A randomized phase 3 trial." Journal of Gastroenterology and Hepatology 35.1 (2020): 29-36.
Calderwood, Audrey H., et al. "Boston Bowel Preparation Scale scores provide a standardized definition of adequate for describing bowel cleanliness." Gastrointestinal endoscopy 80.2 (2014): 269-276.
P0417 Impact of Cytomegalovirus infection on patients with Inflammatory Bowel Disease in the Southern Area of Gran Canaria: a case-control study
Authors: Peñate Bolaños PhD M , Tosco-Nuñez T , Hernández Expósito N , Rodríguez Castellot J , Ciordia Nalda I , Alemán Gonzalez H , Quevedo Ruano R , Monescillo Francia A 
Published: January 2025

Abstract

Background
Inflammatory Bowel Disease (IBD) is a chronic condition affecting the digestive tract. During refractory flare-ups, cytomegalovirus (CMV) infection should be ruled out. Objectives: To analyse the characteristics, risk factors, and subsequent outcomes of IBD associated with CMV infection.

Methods
A retrospective case-control study included 50 cases and 50 randomly selected controls with IBD flare-ups between January 2018 and December 2023. CMV infection was diagnosed using PCR on colonic mucosa samples. Epidemiological, clinical, and complication data were analysed.

Results
No differences were observed regarding sex or type of IBD. Significant differences (p&lt;0.05) were found between cases and controls: age during the episode 51 vs 41 years; age at IBD diagnosis 47 vs 36 years; clinical presentation with bloody diarrhea 90% (45) vs 32% (16)); prior immunosuppressive therapy 30% (15) vs 16% (8); clinician-driven biopsy indication 70% (35) vs 60% (30); and hospital-based diagnosis 52% (26) vs 12% (6). The onset of IBD during the episode was less frequent in cases, 16% (8) vs 30% (15), and complete colonoscopy was performed less often, 24% (12) vs 72% (36). Multivariate analysis identified independent risk factors, including treatment with intravenous methylprednisolone, moderate-severe clinical presentation, and corticosteroid-refractory disease.

Conclusion
In our patients, CMV infection during IBD flare-ups was associated with (1) treatment with intravenous methylprednisolone, moderate-severe clinical severity, and corticosteroid refractory; (2) when the indication for a biopsy is based on clinical criteria; and (3) it does not lead to future therapeutic escalations, although it does higher rates of colectomy.

References
1.Dutta S, Ray U. Cytomegalovirus (CMV) as a cause of exacerbation of ulcerative colitis (UC). An approach to diagnosis and management. Indian Journal of Medical Microbiology. noviembre de 2023;46:100469.
2.Kwon J, Fluxá D, Farraye FA, Kröner PT. Cytomegalovirus-related colitis in patients with inflammatory bowel disease. International Journal of Colorectal Disease. 1 de marzo de 2022;37(3):685-91.
3.Mourad FH, Hashash JG, Kariyawasam VC, Leong RW. Ulcerative Colitis and Cytomegalovirus Infection: From A to Z. Journal of Crohn’s and Colitis. 7 de septiembre de 2020;14(8):1162-71.
4.Hazır-Konya H, Avkan-Oğuz V, Akpınar H, Sağol Ö, Sayıner A. Investigation of Cytomegalovirus in Intestinal Tissue in a Country With High CMV Seroprevalence. Turk J Gastroenterol. 1 de febrero de 2021;32(2):123-32.
P0419 Impact of psychopathology and gut-microbiota on disease progression in Ulcerative Colitis: a five-year follow-up study
Authors: D’Onofrio A M , Chiera E , Gomez-Nguyen A , Di Vincenzo F , Spagnolo G , Ferrarese D , Cammarota G , Camardese G , Scaldaferri F 
Published: January 2025

Abstract

Background
Psychological distress and gut dysbiosis are key factors in patients with IBD. This study aimed to assess whether specific psychopathological and gut microbiota features could predict adverse outcomes in patients with UC.

Methods
In this prospective longitudinal cohort study, we enrolled 35 adult patients with UC. At baseline, patients completed a psychometric evaluation and provided a stool sample for gut microbiota analysis. For the purposes of this study, only trait-focused scales (MMPI-2, TAS-20, CD-RISC, STAI-Y2) were considered, while state-focused assessments were excluded. Five years later we reconstructed each patient’s clinical history, focusing on adverse outcomes including failure of biological therapy, UC-related hospitalizations, and UC-related surgeries.

Results
Patients with failure of biological therapy exhibited increased levels of Proteobacteria (p = 0.006), Fusobacteria (p = 0.042), Enterobacteriaceae (p = 0.025), and Trabulsiella (p = 0.011), while Firmicutes were found to be less abundant (p = 0.036). UC-related hospitalized patients presented lower levels of Rikenellaceae (p = 0.011), Ruminococcaceae (p = 0.004), Faecalibacterium (p = 0.004), Lachnospira (p = 0.005), Methanobrevibacter (p = 0.036) and Phascolarctobacterium (p = 0.011), compared to non-hospitalized patients. Considering the psychometric scales, UC-related hospitalized patients had higher scores on the Sc clinical scale (p = 0.032) and higher scores on the OBS (p = 0.044) and HEA (p = 0.026) content scales. Acidaminococcus (p = 0.023) and Bilophila (p = 0.045) were significantly more abundant in patients that underwent UC-related surgery compared to patients who do not. A PCA analysis, specifically conducted on the phyla, revealed differences only between patients who experienced at least one biological failure and those without therapy failure (PERMANOVA: F = 24.2, p = 0.049, explained variance = 48.89%). Other PCA analyses did not show significant differences between the various groups. At the binary logistic regression, Fusobacteria was negatively correlated with the failure of three or more biologics (OR = 0.000; B = -10,584.860, p = 0.028). Hy and Pd were positively correlated with the failure of three or more biologics (OR = 2.167; B = 0.773, p = 0.044) and 2.639 (B = 0.971, p = 0.024). Conversely, Pa and Pt were negatively correlated with multifailure, associated with odds ratios of OR = 0.622, B = -0.476, p = 0.041 and OR = 0.152, B = -1.886, p = 0.021 respectively.

Conclusion
Psychopathological features related to obsessiveness, health concerns, and somatization, along with specific microbiota characteristics (a lower abundance of SCFA-producing bacteria), may act as predictive factors for UC-related adverse outcomes.
P0426 Lumeneye digital proctoscopy is safe, and streamlines management of immune checkpoint inhibitor-induced colitis
Authors: Ibraheim H , Alexander J L , Balcorta M , Dolina G , Harrison Z , Young K , Powell N 
Published: January 2025

Abstract

Background
Immune checkpoint inhibitors (CPI) have transformed cancer outcomes, but trigger CPI-colitis in up to 46%, frequently incurring morbidity and CPI discontinuation. Diagnosis is via endoscopy, with &gt;90% involving distal colonic inflammation. Timely diagnosis and treatment improve outcomes and reduce corticosteroid (cs) duration. The rising prevalence of CPI-colitis strains endoscopy services, risking delays in care. The Lumeneye, a cost-effective GI digital proctoscopy tool with biopsy capability, could streamline patient management pathways.

Methods
A prospective observational feasibility study was conducted at the Royal Marsden Hospital, UK. Patients with suspected CPI- colitis underwent Lumeneye proctoscopy with rectal biopsy sampling in an outpatient setting. Digital images were captured, and clinical data retrieved from electronic medical records. Patient comfort was evaluated using the Modified Gloucester Comfort Scale (MGCS) and, when applicable, compared to standard lower GI endoscopy performed within the previous 6 months. Clinical findings from Lumeneye and standard endoscopy were evaluated for concordance in patients who underwent both within 3 weeks.

Results
Forty Lumeneye procedures were performed on 37 patients (17 males and 20 females, median age 66 years). Cancers included melanoma (n=17), renal (n=4), lung (n=5), and “other” (n=11). CPI therapies included dual anti-CTLA-4/PD-1/L1 (n=14), and anti-PD-1/L1 monotherapy (n=23).
The mean time from referral to examination was shorter for Lumeneye (5 days, IQR 3-7) compared to lower GI endoscopy (21 days, IQR 14-26; p&lt;0.001). The mean procedure time or Lumeneye was 6 (IQR 4-8) minutes. Lumeneye was associated with a lower MGCS score compared to lower GI endoscopy (2 -minimal discomfort vs 3-mild discomfort, p&lt;0.001).
Endoscopic findings revealed normal mucosa in 19 patients; the remainder showed varying degrees of oedema, erythema, and erosions (Figure 1). In 5 cases, views were suboptimal. Concordance between Lumeneye and standard endoscopy was observed in 10/13 patients (83%), with histological agreement in 11/13 (85%).
In 11 cases, normal mucosal findings informed the rationale for rapid cs taper and administration of topical cs (Clipper). In 3 cases, Lumeneye expedited the diagnosis of severe CPI-colitis, leading to timely anti-TNFa escalation. In one case, suspected melanoma deposits in the rectum prompted investigation of metastatic disease.

Conclusion
Examination of patients with CPI-colitis in the physician’s office using Lumeneye was safe, well tolerated and reduced the burden on endoscopy services. Lumeneye streamlined the patient pathway by facilitating early, accurate diagnosis and allowing timely escalation or de-escalation of immunosuppressive therapy.
P0427 Nutritional factors associated with the presence of non-alcoholic fatty liver disease (NAFLD) in patients with inflammatory bowel disease (IBD)
Authors: Castelhano N S , Oliveira E C S D , Lopes M A , Beraldo R F , Baima J P , Herrerias G S P , Quaglio A E V , Di Stasi L C , Barbosa W F , Silva G F , Sassaki L Y 
Published: January 2025

Abstract

Background
Non-alcoholic fatty liver disease (NAFLD) is increasingly prevalent in patients with inflammatory bowel disease (IBD), not only due to the presence of chronic inflammation, but also due to the presence of dysbiosis and risk factors for metabolic disease. Due to the complications of NAFLD, evaluation of at-risk patients is recommended. Therefore, the objective of the study is to evaluate the nutritional status and body composition in IBD patients, comparing groups with and without NAFLD, and identifying the factors associated with NAFLD.

Methods
A cross-sectional study was conducted, assessing clinical data, metabolic syndrome presence, nutritional status, and biochemical markers. Patients were categorized into IBD+NAFLD and IBD-only groups based on hepatic ultrasound findings. Statistical analysis included descriptive statistics and logistic regression.

Results
In total, 129 IBD patients were included, 67 (51.94%) UC and 62 (48.06%) CD, 89 (68.99%) female, 31 (24.03%) with high blood pressure, 18 (13.95%) with dyslipidemia, and 16 (12.40%) with diabetes. Biological therapy was indicated in 65 (50.39%) patients. Clinical activity was observed in 60 (46.51%) of the patients. Presence of NAFLD was observed in 57 (44.19%) patients, being mild (43.86%), moderate (43.86%) or severe (12.28%). Factors associated with the presence of NAFLD were BMI (p&lt;0.0001), overweight or obesity (p&lt;0.0001), waist circumference (p&lt;0.0001), arm circumference (p=0.0002), arm muscle area (p= 0.0136), waist-hip ratio (p=0.0215), calf circumference (p=0.0003), triceps skinfold (p=0.0086), fat mass (p=0.0001), visceral fat (p&lt;0.0001), and hang- grip (p=0.0071). Regarding biochemical tests, patients with NAFLD presented alterations in creatinine (p=0.0343), AST (p=0.0018), ALT (p&lt;0.0001), gammaGT (p&lt;0.0001), ferritin (p=0.0107), glycemia (p=0.0017), glycated hemoglobin (p=0.0064), triglycerides (p&lt;0.0001), basal insulin (p=0.0012). The presence of NAFLD was not associated with IBD activity (p=0.59) or with the use of medications (p&gt;0,05).

Conclusion
The prevalence of NAFLD was high in the IBD population. Risk factors for NAFLD are related to metabolic syndrome. Patients should be investigated for the presence of NAFLD with the aim of controlling risk factors to avoid progression to complications such as liver cirrhosis.
P0448 Unravelling genetic versus environmental factors determining disease course in Inflammatory Bowel Disease: a population-based cohort study in first- and second-generation immigrants
Authors: D’hooghe A T , Poulsen G J , Sørensen C N , Tandon P , Andersen N N , Vermeire S , Verstockt B , Jess T 
Published: January 2025

Abstract

Background
Inflammatory bowel diseases (IBD) incidence in immigrants approximates that of the host country in progressive generations.1 We investigate how immigrant generation affects IBD outcomes.

Methods
In this population-based cohort study, IBD-related hospitalizations, major and minor surgery, targeted therapies, and perianal disease were compared between first- and second-generation immigrants (stratified into Western/non-Western) and native Danes. Their sex, age at diagnosis and time of diagnosis were used to estimate adjusted hazard ratios (aHRs) using Cox proportional hazard regression.

Results
First-generation immigrants had lower risk of major surgery (aHRWestern 0.89; 95% confidence interval [CI] 0.75–1.05, aHRnon-Western 0.79; 95% CI 0.67–0.92) and targeted therapy (aHRWestern 0.87; 95% CI 0.76–0.99, aHRnon-Western 0.83; 95% CI 0.74–0.93) than native Danes, whereas second-generation immigrants resembled native Danes. However, second-generation immigrants had higher risk of hospitalization than native Danes (aHRWestern 1.28; 95% CI 1.05–1.55, aHRnon-Western 1.40; 95% CI 1.28–1.54), whereas in first-generation immigrants this was only observed in non-Western ulcerative colitis (UC) patients (aHR 1.19; 95% CI 1.08–1.32). Across both generations, non-Western immigrants had higher risk of minor surgery (Crohn’s disease [CD]: aHRfirst-generation 1.39; 95% CI 1.10–1.75, aHRsecond-generation 1.53; 95% CI 1.18–1.97), mainly due to increased incidence of perianal disease (CD: aHRfirst-generation 1.55; 95% CI 1.25–1.92; aHRsecond-generation 1.58; 95% CI 1.25–2.01).

Conclusion
Disease outcomes change across immigrant generations, pointing to environmental factors possibly impacting disease course, which needs further investigation. In contrast, non-Western immigrants have more perianal disease in both generations, suggesting a possible role of genetics for this debilitating phenotype.

References
1.Agrawal M, Corn G, Shrestha S, et al. Inflammatory bowel diseases among first-generation and second-generation immigrants in Denmark: a population-based cohort study. Gut. 2021;70(6):1037-43. doi: 10.1136/gutjnl-2020-321798.