bluuebunny/crossref_metadata_2025_split huggingface dataset:
P588 T cell response to SARS-CoV-2 mRNA vaccines by an interferon-gamma release immunoassay in patients with Inflammatory Bowel disease receiving anti-TNF and thiopurine treatment
Authors: Mayorga Ayala L F , Herrera-deGuise C , Esperalba J , Martinez-Gomez X , Céspedes Martinez E , Robles Alonso V , Jimenez A , Perez Martinez Z , Oller E , Ibarz A , Fernandez-Naval C , Martinez-Gallo M , Lopez Messeguer M , Casellas F , Borruel N 
Published: January 2022

Abstract

Background
Treatment with anti-TNF agents and thiopurines has been associated with an impaired immune response to some vaccines. SARS-CoV-2 vaccination is very effective in healthy individuals, but studies in inflammatory bowel disease (IBD) populations are scarce, especially regarding T cell response. We aimed to evaluate the T cell and antibody response in a cohort of IBD patients on anti-TNF and thiopurine treatment who received two doses of the SARS-CoV2 mRNA vaccine.

Methods
An observational, prospective study was carried out at our IBD clinic. We included Crohn’s disease (CD) and Ulcerative colitis (UC) patients receiving anti-TNF as monotherapy or anti-TNF + thiopurine (combo) or thiopurines only for at least six months at inclusion. Blood samples were drawn for interferon-gamma release assay (IGRA) and antibody determination six (+/- 2) weeks after the second vaccine dose. The specific T cell response to SARS-CoV-2 was determined by IGRA using Qiagen® QuantiFERON® SARS-CoV-2 RUO tubes with a patented Spike protein combination. Interferon-gamma was measured by CLIA using the LIAISON® QuantiFERON-®TB Gold Plus assay. As there is no validated cut-off point, we used those obtained in a cohort of 20 healthy health professionals published by our group (doi.org/10.1016/j.medcli.2021.09.013). Antibodies to the Spike (S) SARS-CoV-2 protein were analyzed by CLIA. Adverse events (AEs) and clinical activity were recorded.

Results
We recruited 148 IBD patients, 57 treated with anti-TNF monotherapy, 53 with combo, and 38 with thiopurine only. Seventy percent had CD, and 60% were male. Using the cut-off value of the cohort mentioned above, the T-cell response was positive in 92% of anti-TNF monotherapy, 83% in combo, and 87% of the thiopurine group (p=ns). The anti-S antibodies were positive in 100% of our cohort. There were no changes in disease activity rates after the second vaccination, nor were severe AEs detected.

Conclusion
SARS-CoV-2 mRNA vaccination was very effective in IBD patients receiving anti-TNF (combo or monotherapy) or thiopurine treatment as measured by both T cell and antibody response. IGRA-specific tests may constitute a valuable tool in assessing cellular immunity in immunocompromised patients.
P623 The effectiveness and tolerability of Crohn’s disease exclusion diet in adult Crohn’s disease patients: a retrospective study
Authors: Mahajna H , Abu-Salah R , Tzur M , Kedar N , Ben-Horin S , Kopylov U , Engel T 
Published: January 2022

Abstract

Background
Crohn’s disease exclusive enteral nutrition (EEN), a dietary therapy which consists exclusively of liquid formula, was shown to be effective in the induction of remission in the pediatric population but limited by poor tolerability to avoiding oral food. Crohn’s disease exclusion diet (CDED) is based on excluding certain food components that are thought to negatively affect the gut immunity, the gut barrier, and the microbiome. In children and young adults, CDED combined with partial enteral nutrition (PEN) were highly effective in inducing clinical response and remission. Despite the promising data regarding the tolerability and effectiveness of CDED in prospective trials, real world data, especially those conducted on adult patients’ population, still lacks.

Methods
This is a retrospective study of adult CD patients treated with CDED at a tertiary medical center (Sheba medical center, Israel). All included patients had active CD (Harvey Bradshaw index &gt;4). The study endpoint was a composite outcome of clinical response (HBI decline of at least 3 points) or remission (HBI decline to below 5 points) at 6 week and at 12–18 weeks.

Results
Overall, 40 patients who met the inclusion criteria were treated by CDED between year 2020 and 2021. 67.5% were females; mean age 29.5±13.3; mean disease duration 3.4±4.7 years; mean CRP 20.1±26.1mg/dl; mean calprotectin 599.4±510.5 mcg/g at study onset;
At CDED initiation, 17 (42.5%) were bio-naive; 14 (35%) were under maintenance therapy with a biologic; for 15 (37.5%) patients, CDED was the first treatment for CD; eleven (27.5%) patients started CDED concomitantly with another treatment (7 with corticosteroids and 4 with biologics). Most (85%) of patients combined the CDED with partial enteral nutrition.
Forty patients and 20 patients underwent a follow-up assessment at week 6 and 12–18, respectively. The mean HBI at the beginning of the study was 8.0±3.9 and declined to 4.5±3.0 and 3.7±2.9 at weeks 6 and 12–18, respectively. Twenty-six (65%) patients and 16 (40%) patients achieved the study composite endpoint by week 6 and 12–18, respectively. Four (10%) patients required corticosteroid treatment during the CDED treatment. Patients who achieved the study endpoint at week 6 had shorter durations of the disease (2.3±3.8 vs 5.6±5.4 years, P=0.03) compared to patients who didn’t. No other significant differences were noted in disease characteristics and disease activity parameters between responders and non-responders.

Conclusion
In a real-world setting, treatment with CDED (either exclusive or combined with an additional treatment) appears to be effective in treating adult CD patients but adherence to the diet remains a challenge. Further and longer-term real-world studies are warranted.
P656 The impact of periodontitis on IBD disease activity
Authors: Madsen G R , Bertl K , Stavropoulos A , Burisch J 
Published: January 2022

Abstract

Background
Inflammatory bowel disease (IBD) and periodontitis are chronic, progressive, inflammatory diseases with similarities in their respective pathogenesis, which involve a complex interplay between a dysbiotic microbiota and a dysregulated immune-inflammatory response. Periodontitis has been associated with an adverse impact on other inflammatory diseases and the general health. Whether presence of periodontitis is associated with IBD disease activity is uncertain.

Methods
A questionnaire-based survey was conducted in Denmark. A total of 1,093 patients with IBD, i.e., 527 patients with Crohn’s disease (CD) and 566 patients with Ulcerative colitis (UC), answered the questionnaire. The survey included questions on social demographics, oral health, as well as IBD-related characteristics. Oral health was assessed by the number of teeth, the state of teeth and gums, and the Periodontal Screening Score (PESS) which is a validated instrument to screen for severe periodontitis. Disease activity in patients with UC and CD was assessed by the Simple Clinical Colitis Index (SCCAI) and the Harvey & Bradshaw’s Activity Index (HBI), respectively. Disease related disability was assessed by the Inflammatory bowel disease disability index (IBD-DI). Univariate and multivariate statistical analyses were performed to assess each variable.

Results
Patients with CD reported significantly fewer remaining teeth (p=0.004) and poorer state of teeth and gums (p=0.001) in comparison to patients with UC. Irrespective of IBD disease subtype, patients with a reduced number of teeth scored significantly higher on the IBD disability index (p=0.001) and reported an increased disease activity in the last 12 months (p=0.001). Patients with self-reported severe periodontitis scored significantly higher on the IBD disability index (p=0.041) and reported an increased disease activity in the last 12 months (p=0.001). For patients with UC, self-reported severe periodontitis was associated with a higher SCCAI score (p=0.031). Likewise, patients with CD who had a reduced number of teeth scored significantly higher on the HBI (p=0.017).

Conclusion
Periodontitis was significantly associated with increased IBD disease activity as well as increased IBD disease related disability. CD patients had significantly poorer oral health compared with UC patients. Our results highlight a need for an increased focus on oral health in patients with IBD.
P688 Sex difference in inflammatory bowel disease patients regarding depression: a nationwide population based study in Korea
Authors: Moon J M , Han K , Shin S Y , Choi C H , Kim J S 
Published: January 2022

Abstract

Background
Inflammatory bowel disease (IBD) patients are often exposed to the risks of developing psychological symptoms such as anxiety or depression. We aimed to investigate sex difference regarding incidence of depression among Korean IBD patients.

Methods
A cohort involving a total of 133,216 subjects were established using Korean HIRA (health insurance review & assessment service) database from January 2009 to December 2017. Newly diagnosed IBD patients were 47,416, according to the International Classification of Diseases, 10th revision (ICD-10). From the newly diagnosed IBD population, we defined incidence of depression using the ICD-10 code.

Results
Among the IBD population, 27,172 (57.3%) were male and they were slightly younger than female (39.09 and 39.81, p&lt;001). During the follow-up period, a total of 5,355 were newly diagnosed as depression. The incidence of depression were more evident in the female both in ulcerative colitis (incidence ratio, IR, per 1000 of 23.55 and 32.81, to male and female, respectively) and crohn’s disease (IR per 1000 of 16.24 and 30.76, respectively) This trend was consistent even with variables adjusted to age, diabetes, hypertension and medication use (biologics, steroids, 5-ASA, immunomodulators and antibiotics) Female IBD patients were at an increased risk of developing depression compared to male with a hazard ratio of 1.40 (1.33–1.48, p&lt;0.001). Further subgroup analyses were performed according to age, co-morbidities and biologics use, revealing similar results.

Conclusion
Risk of depression was elevated in Korean female IBD patients compared to males. Gastroenterologists managing IBD patients on clinics should be well aware of gender-specific issues regarding depression.
P689 Multicenter, cross-sectional, observational study on Epstein–Barr viral infection status and thiopurine use by age group in patients with inflammatory bowel disease in Japan
Authors: Miura M , Shimizu H , Saito D , Miyoshi J , Matsuura M , Kudo T , Hirayama D , Yoshida M , Arai K , Iwama I , Nakase H , Shimizu T , Hisamatsu T 
Published: January 2022

Abstract

Background
The Epstein–Barr virus (EBV) infection status in patients with inflammatory bowel disease (IBD), particularly those using thiopurines, may be associated with the risk of lymphoproliferative disorder and hemophagocytic lymphohistiocytosis. This was the first multicenter survey of EBV infection in Japanese patients with IBD (UMIN000033004). Factors related to the EBV infection status were also investigated.

Methods
This cross-sectional observational study of the EBV infection status in pediatric and adult patients with IBD was conducted at five tertiary institutions in Japan. Serum EBV anti-viral capsid antigen (VCA) IgG, and EBV anti-VCA IgM were measured in 495 patients with IBD□(UC:313 patients, CD:174 patients, IBD-U:8 patients). Patient characteristics (sex, age at diagnosis, age at onset, duration of illness, and disease location), treatments, and blood examination results were obtained from the medical records at each institution. Prior EBV infection was defined as anti-VCA IgM negativity and anti-VCA IgG positivity.

Results
mong the 495 patients, 56.2% (278/495) were male, and the median age at diagnosis of IBD was 18 years. The median age at the time of the anti-VCA IgG examination was 25 years(range: 0–92 years). Of the 495 patients, 9 were anti-VCA IgM-positive and 354 were anti-VCA IgG-positive (seroprevalence: 72.8%). The proportion of patients with prior EBV infection was 0% for those aged &lt;5 years, &lt;60% for those aged &lt;30 years, and &gt;90% for those aged &gt;30 years. The patients’ current thiopurine use was 37.8% (187/486) for all anti-VCA IgM negative patients and 42.3% (85/201) for anti-VCA IgM negative patients aged &lt;20 years. The proportion of EBV-uninfected patients using thiopurines was 28.4% (52/183) for all patients and 51.8% (44/85) for aged &lt;20 years. Age was significantly associated with anti-VCA IgG seropositivity (p &lt; 0.01, odds ratio: 0.902, 95% confidence interval: 0.880–0.925). No cases of lymphoproliferative disorder, hemophagocytic lymphohistiocytosis, or chronic active EBV infection were reported.

Conclusion
Approximately 30% of Japanese patients with IBD were EBV-uninfected, including those using thiopurines. Age was a significant factor for anti-VCA IgG seropositivity.
P690 Rates of IBD in New Zealand Māori population at Lakes District Health Board: low but increasing
Authors: Qiu M , Patel R N , Gearry R B 
Published: January 2022

Abstract

Background
Inflammatory bowel disease (IBD) is a chronic, inflammatory disease that is increasingly prevalent in New Zealand (NZ). Previous regional studies describe significantly lower rates of IBD in Māori (the indigenous people of NZ) compared to non-Māori. We aimed to describe IBD incidence and prevalence at Lakes District Health Board (DHB), with a focus on the Māori population.

Methods
All patients with IBD at Lakes DHB are managed using an IBD database. The database was reviewed and demographic, clinical, IBD phenotype, treatment and surgical data were extracted. Rates of IBD and other characteristics were compared between Māori and non-Māori.

Results
197 IBD patients were identified, consisting of 100 (51%) with Crohn’s disease, 77 (39%) with ulcerative colitis, and 20 with IBD-unspecified. The median age was 48±17 and 100 (50.8%) were males. 15 (7.6%) patients were Māori and 182 (92.4%) European/other (Figure 1), leading to IBD ethnic-specific prevalences of 34.9 and 256.8/100,000, respectively. Rates of current/ex-smoking were similar in Māori and non-Māori (~30%), so was biologic use (40%). Despite statistically insignificant, Māori were more likely to be hospitalised over the last ten years (mean admissions 1.8 vs 1.1). In the last 20 years, there has been a steady increase in IBD incidence among non-Maori population. In Māori population, although the rates were consistently lower, more were diagnosed over the last 5 years, demonstrating an increasing incidence (Figure 2).
Figure 1. Lakes DHB demographics and IBD status

Figure 2. Comparison of IBD incidence in Māori and non-Māori at Lakes DHB

Conclusion
Our findings are concordant with previous studies showing gradually increased rates of IBD in NZ and low rates in Māori. However, rates in the last five years are increasing in Māori population which may reflect a true increase in incidence due to changes in environmental risk factor exposure or increased rates of presentation and diagnosis in Māori over the last five years.
P705 The effects of commonly consumed dietary fibres on the gut microbiome and its fibre fermentative capacity in adults with inflammatory bowel disease in remission
Authors: Gerasimidis K , Nichols B , McGowan M , Svolos V , Papadopoulou R , Kokkorou M , Rebull M , Bello Gonzalez T , Hansen R , Russell R K , Gaya D R 
Published: January 2022

Abstract

Background
It has been suggested that the gut microbiome of patients with inflammatory bowel disease (IBD) is unable to ferment dietary fibre. This project explored the in vitro effect of fibre fermentation on production of short chain fatty acids (SCFA) and on microbiome composition.

Methods
Faecal samples were collected from 40 adults (&gt;16 y) with IBD (n=20 with Crohn’s disease and n=20 with Ulcerative colitis) in clinical remission and 20 healthy controls (HC). In vitro batch culture fermentations were carried out using as substrates maize starch, apple pectin, raftilose, wheat bran, α cellulose and a mixture of these 5 fibres. SCFA concentration (umol/g) was quantified with gas chromatography and microbiome was profiled with 16S rRNA sequencing.

Results
Fibre fermentation did not correct the baseline microbial dysbiosis or lower diversity seen in either CD or UC. For all fibres, up to 51% of baseline ASVs or genera changed in abundance in HC. In patients with IBD, fermentation of fibre substrates had no effect on species or genera abundance. Production of SCFA varied among the different fibre substrates but this was not different between the two IBD groups and compared to HC after either 5 or 24 hour fermentation.

Conclusion
Despite extensive microbial dysbiosis, patients with IBD have a similar capacity to ferment fibre and release SCFA as HC. Fibre supplementation alone may be unlikely to restore to a healthy status the compositional shifts characteristic of the IBD microbiome.
N03 Medication adherence in relation to Health-related Quality of Life in patients with Inflammatory Bowel Disease – A cross-sectional study
Authors: Johansson E , Lovén Wickman U 
Published: January 2022

Abstract

Background
Inflammatory Bowel Diseases are chronic diseases often with complex treatment. The treatment is lifelong and complex and may include several different pharmaceutical groups and sometimes surgery. Not rarely is treatment resistance developed and the treatment may come with different degrees of side effects. Earlier research has shown insufficient to medication adherence and a lower degree of health-related quality of life in patients with inflammatory bowel disease.
The aim is to describe the relationship between medication adherence and health-related quality of life in a Swedish population diagnosed with inflammatory bowel disease. Additional research questions are if any risk factors of low medication adherence can be identified from the collected variables.

Methods
This cross-sectional study included N=206 patients from three different regions in Sweden. The questionnaires MMAS-8 and Short Health Scale were used combined with a questionnaire regarding patient characteristics. The data and patient characteristics were described and analyzed using descriptive statistics.
Ethical approval has been received from the Regional Ethical Review Board, Linköping, Sweden (no.: 2015/369-31).

Results
The majority of patients had Ulcerative Colitis (62.6%) There were no significant differences between the different groups of Inflammatory Bowel Disease regarding patient characteristics apart from having gone through surgical procedures, which were more common in patients with Crohn’s disease. A small correlation was shown between medication adherence and the health-related quality of life dimension social function (rho = -0.146; p &lt;0.05). Medication adherence showed no significant correlations to the remaining health-related quality of life dimensions: disease related worry, symptom burden and sense of general well-being. Possible risk factors identified for low medication adherence were age between 30 and 50, working at high occupational level, and higher educational level.

Conclusion
The complexity of measuring medication adherence has been established, making it difficult to make any certain conclusions regarding the hypothesis in this report. This study showed no clear association between medication adherence and health-related quality of life in patients with inflammatory bowel disease. However, it visualized the need of optimizing the instruments used to measure medication adherence in individuals with a non-conventional treatment plan
The Law’s Business: Peculiar Profits in Edward Jones’sThe Known World
Authors: Yukins Elizabeth 
Published: January 2022

AbstractThis essay examines Edward Jones’s radical historiography in The Known World (2003), specifically how he represents law as a mercurial, illogical, and generative force in the workings of American slavery. Centrally, Jones highlights the viability and profitability of the American nineteenth-century legal system’s absurdities. The essay extends current scholarship to reckon with a central tension in Jones’s novel: his linking of the quotidian with the bizarre. Jones’s understated realism is, paradoxically, rife with freakish phenomenon, from two-headed chickens to cannibalistic lawmen, and his juxtaposition of the commonplace and the freakish compels readers to recognize the absurd and potent powers of American slave law. Beginning with Jones’s anachronistic reference to a historian and a local story of two-headed chickens, the essay shows how conjoined entities and other anomalous phenomenon in Jones’s novel enable three key historiographic interventions. First, the symbol of conjoined entities connects with the dual and dysfunctional status of slaves before the law—namely, a slave’s legal identity as coexistent person and property. Second, “two-headedness” serves as means to interrogate the mental acrobatics necessitated by antebellum law. Specifically, Jones creates an intensely ambivalent officer of the law—a sheriff of two minds, I argue—to explore the psychological exertions needed to administer a nonsensical legal paradigm. Finally, and most importantly, Jones’s metaphors of conjoined entities illuminate the interconnected, interdependent workings of law and economics in fictional Manchester County, Virginia. Two-headed chickens link with a far more profitable conjoining in American history—namely, what Jones calls “the law’s business” in slavery.
Biochemical characterization and analysis of gene expression of an α-mannosidase secreted by Paracoccidioides brasiliensis
Authors: Corrêa Priscila C , Fernandes Fabrício F , Costa Marcelo V , Landgraf Taise N , Panunto-Castelo Ademilson 
Published: January 2022

Abstract

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by fungi of the Paracoccidioides genus, being endemic in Latin America and with the highest number of cases in Brazil. Paracoccidioides spp. release a wide range of molecules, such as enzymes, which may be important for PCM establishment. Here, we identified the 85- and 90-kDa proteins from the supernatants of P. brasiliensis cultures as being an α-mannosidase. Because the expected mass of this α-mannosidase is 124.2-kDa, we suggest that the proteins were cleavage products. Indeed, we found an α-mannosidase activity in the culture supernatants among the excreted/secreted antigens (ESAg). Moreover, we determined that the enzyme activity was optimal in buffer at pH 5.6, at the temperature of 45ºC, and with a concentration of 3 mM of the substrate p-NP-α-D-Man. Remarkably, we showed that the gene expression of this α-mannosidase was higher in yeasts than hyphae in three P. brasiliensis isolates with different virulence degrees that were grown in Ham's F12 synthetic medium for 15 days. But in complex media YPD and Fava Netto, the significantly higher gene expression in yeasts than in hyphae was seen only for the virulent isolate Pb18, but not for intermediate virulence Pb339 and low virulence Pb265 isolates. These results about the high expression of the α-mannosidase gene in the pathogenic yeast form of P. brasiliensis open perspectives for studying this α-mannosidase concerning the virulence of P. brasiliensis isolates.

Lay summary
Paracoccidioides brasiliensis causes deep mycosis, paracoccidioidomycosis. We determined for the first time the biochemical properties of an α-mannosidase released by this fungus. We suggest that the enzyme gene expression in the fungus is associated with fungal morphology, stress, and virulence.