bluuebunny/crossref_metadata_2025_split huggingface dataset:
P087 Communicating Needs and Features of IBD Experiences (CONFIDE) Survey: Impact of Ulcerative Colitis Symptoms on Daily Life
Authors: Dubinsky M C , Schreiber S , Potts Bleakman A , Kayhan C , Ellis H , Hunter Gibble T , Flynn E , Suldecki G , Travis S 
Published: January 2022

Abstract

Background
Bowel urgency is the symptom described by patients as having the most impact on quality of life but is missing from most disease activity indices (Carpio et al., 2016). The Communicating Needs and Features of IBD Experiences (CONFIDE) study aims to increase understanding of patients’ experiences and the impact of IBD on their lives in the United States (US), Europe, and Japan. These data focus on US patients with moderately-to-severely active ulcerative colitis (UC).

Methods
An online, quantitative, cross-sectional survey was conducted with patients with moderately-to-severely active UC in the US in July 2021. Data included patient perspectives on their UC symptoms and the impact on their social life, work/school life, and ability to participate in sports/physical activities. Moderately-to-severely active UC was defined based on treatment, steroid use, and/or hospitalization history. Descriptive statistics (frequencies, percentages) summarise the data.

Results
200 (of 756 total contacted) patients (61.5% male, mean age 40.4, mean disease duration 7.9 years) completed the survey in the US, with 77% (n=153) of patients receiving advanced therapies (biologic or novel oral therapy). Patients declined participation in social events due to bowel urgency (43%), fear of urge incontinence (40%), increased stool frequency (29%), and blood in stool (15%) in the last three months (Fig. 1). Patients declined participation in sports/physical exercise due to bowel urgency (38%), fear of urge incontinence (36%), increased stool frequency (24%), and blood in stool (10%) in the last three months (Fig. 2). Patients declined participation in work/school due to bowel urgency (37%), fear of urge incontinence (42%), increased stool frequency (25%), and blood in stool (16%) in the last three months (Fig. 3). Out of 123 patients who have ever suffered from bowel urgency, in the last three months 42% stopped working for the day sooner than planned and 41% worked fewer hours. Notably, 76% of patients reported wearing a diaper/pad/protection at least once in the last three months due to fear of urge incontinence. Bowel urgency had no impact on work/school for 22% (n=27) of patients who had ever experienced bowel urgency (Fig. 4).

Conclusion
Bowel urgency and fear of urge incontinence are the most reported symptoms leading to patients with UC declining participation in work/school, social events, and sports/physical exercise. Over three quarters of the surveyed patients reported wearing diapers/pads/protection in the past three months due to fear of urge incontinence and only 22% of patients who had ever suffered from bowel urgency reported that it had no impact on work or school.
P096 Store-Operated Calcium Entry Controls Innate and Adaptive Immune Cell Function in Inflammatory Bowel Disease
Authors: Letizia M , Kaufmann U , Wang Y H , Gerbeth L , Sand A , Brunkhorst M , Böttcher C , Schlickeiser S , Fernández-Zapata C , Kunkel D , Siegmund B , Feske S , Weidinger C 
Published: January 2022

Abstract

Background
Inflammatory bowel disease (IBD) represents a major clinical challenge in need of new treatment modalities to improve patient care. Store-operated calcium entry (SOCE) is the predominant calcium influx pathway in T cells, regulating many of their functional properties. However, it is currently unknown whether the pharmacologic inhibition of SOCE is a suitable drug target in IBD. Therefore, we aimed to investigate the effects of SOCE inhibitors (SOCEi) on lymphocytes and epithelial cells isolated from IBD patients.

Methods
Peripheral blood mononuclear cells (PBMC), lamina propria lymphocytes (LPMCs) and epithelial cells were isolated from IBD patients undergoing colon resection. LPMCs or PBMCs were ex-vivo stimulated with Ionomycin/PMA ± SOCEi and subsequently stained with a panel of 37 immunological markers for mass cytometry acquisition. Ca2+ influx measurements were performed in order to assess the metabolic status of immune (PBMCs and LPMCs) and epithelial cells after SOCE blockade. Finally, murine models of colitis were used in order to investigate the effects of SOCE blockade on the induction of intestinal inflammation in-vivo.

Results
Data on B, T, NK, and myeloid cells revealed that treatment with SOCEi caused a dose-dependent inhibition of Ca2+ signaling in human gut-resident lymphocytes and PBMCs. The inhibition of SOCE attenuated the production of pathogenic cytokines including IL-2, IL-4, IL-6, IL-17, TNF-α and IFNγ by colonic T cells and ILCs, reduced the activation of B cells and the production of IL-6 by myeloid cells, without affecting the viability of primary human epithelial cells. Remarkably, mouse models of transfer colitis, in which SOCE signaling components have been blocked, revealed that SOCE is required for the induction of intestinal inflammation in-vivo.

Conclusion
Our data revealed for the first time that the cytokine production and the activation of several immune cell subtypes can be modulated by SOCE blockade in human intestinal inflammation, identifying SOCE as a novel therapeutic target in colitis.
P104 Icariin Attenuates Intestinal Inflammation through Inhibition of the Nuclear Factor-ĸB signaling
Authors: Soh H , Park S , Lee H J , Koh S J , Im J P , Kim J S 
Published: January 2022

Abstract

Background
Icariin is a natural flavonoid glucoside from plants in Epimedium family, known to have anti-oxidative and anti-inflammatory activities. This study investigated the effects of Icariin on nuclear factor-kappa B (NF-ĸB) signaling pathway in intestinal epithelial cells (IEC) and macrophages, and in acute and chronic murine colitis models.

Methods
Human IEC line COLO 205 and murine macrophage cell line RAW 264.7 were pretreated with Icariin and then stimulated with tumor necrosis factor-α (TNF-α) and lipopolysaccharide respectively for in vitro studies. The expression of pro- and anti-inflammatory cytokines were evaluated by real-time RT-PCR (TNF- α, IL-6, IL-8, IL-12, and IL-10), and the effect of Icariin on NF-ĸB signaling pathway was examined by immunoblot analysis to detect IĸBα phosphorylation and degradation. Dextran sulfate sodium (DSS)-induced acute colitis in C57BL/6 wild-type mice and chronic colitis in IL-10-/- mice were treated with or without Icariin for in vivo studies. The severity of colitis was evaluated by daily body weight change, colon length, and colonic tissue histopathology.

Results
Icariin significantly attenuated the production of pro-inflammatory cytokines and degeneration of anti-inflammatory cytokines, and alleviated IĸBα phosphorylation and degradation in both IEC and murine macrophages stimulated by TNF-α and LPS, respectively. Icariin also significantly reduced the severity of colitis in both DSS-induced acute colitis model and chronic colitis in IL-10-/- mice models.

Conclusion
Icariin inhibits NF-ĸB signaling in both IECs and macrophages, and attenuates experimental murine colitis. These results suggest that Icariin may be a potential novel therapeutic agent for inflammatory bowel disease.
P141 Factors Associated with Time to Clinical Remission in Pediatric Luminal Crohn’s disease: a Retrospective Cohort Study
Authors: Sassine S , Fadela Zekhnine S , Qaddouri M , Djani L , Cambron-Asselin C , Savoie-Robichaud M , Lin Y F , Grzywacz K , Groleau V , Dirks M , Drouin É , Halac U , Marchand V , Girard C , Courbette O , Patey N , Dal Soglio D , Deslandres C , Jantchou P 
Published: January 2022

Abstract

Background
The natural evolution of Crohn’s disease is incompletely understood in the pediatric population. Data on factors influencing time-to-remission are very limited in the literature. The aim of this retrospective cohort study was to describe the time to clinical remission in children with Crohn’s disease as well as changes over the past decade and to identify factors associated with time to clinical remission.

Methods
Patients under 18 years old diagnosed between 2009 and 2019 were included. All data were collected from the patients’ medical records and the CHU Sainte-Justine inflammatory bowel disease registry. Survival analyses and linear regression models were used to assess the impact of clinical, laboratory, endoscopic, histological and therapeutic factors on time to clinical remission.

Results
654 patients were included in the study. There was no change in the time to clinical remission over the past decade. Female sex in adolescents (ajusted bêta regression coefficient (aβ)= 31.8 days, p= 0.02), upper digestive tract involvement (aβ= 46.4 days, p= 0.04), perianal disease (aβ= 32.2 days, p= 0.04), presence of active inflammation on biopsies (aβ= 46.7 days, p= 0.01) and oral 5-ASA exposure (aβ=56.6 days, p= 0.002) were all associated with longer time to clinical remission. However, antibiotic exposure (aβ= -29.3 days, p=0.04), increased eosinophils on biopsies (aβ= -29.6 days, p=0.008) and combination of exclusive enteral nutrition and TNF- alpha inhibitors as induction therapy (aβ= -36.8, p=0.04) were associated with shorter time to clinical remission.
Figure 1: Kaplan-Meier curve representing time to clinical remission in patients 13 years old and older by sex.
Figure 2: Kaplan-Meier curve representing the time to clinical remission of patients according to the first induction treatment administered.

Conclusion
Time to clinical remission did not improve during the decade and was associated with baseline clinical and histological data and treatment strategies. Combination of enteral nutrition and TNF-alpha inhibitors was associated with faster clinical remission.
P154 Evaluation of serum protein FingerPrint biomarkers of collagen, citrullinated vimentin and calprotectin in patients with inflammatory bowel disease
Authors: Luo Y , Saini J , Mortensen J , Bay-Jensen A , Karsdal M , Greenawalt D , Harris S 
Published: January 2022

Abstract

Background
Inflammatory bowel disease (IBD) is characterized by chronic inflammation leading to extracellular matrix remodeling, reactive stroma and activated inflammatory cells. In the pursuit of non-invasive biomarkers of disease severity and treatment response for IBD, we evaluated Protein FingerPrint Assay (PFA) of collagen formation and degradation (PRO-C3, C3M, PRO-C4, C4M), neutrophil elastase cleaved calprotectin (CPa9-HNE) and citrullinated vimentin degradation (VICM) in serum collected from 2 clinical trials in Ulcerative Colitis (UC) and Crohns Disease (CD) (NCT01466374 and NCT01294410) and matched healthy volunteers (NHV).

Methods
PFA were generated from serum of 88 UC, 120 CD at baseline and at Day 78 of treatment and 78 NHV. Clinical remission in UC was defined as Mayo score 2 with no individual subscore &gt;1. Clinical response as reduction from baseline in Mayo score 3 and 30%, and decrease from baseline in rectal bleeding subscore 1 or absolute rectal bleeding subscore 1. Clinical remission in CD was defined by an absolute CD Activity Index [CDAI] score &lt; 150 and clinical response as a reduction in CDAI100 points from baseline or an absolute CDAI score &lt; 150. Endoscopic remission was defined as SES-CD of 0. Statistical analysis was performed on all markers between diseased and NHV, pooled responders/remitters vs non-response independent of treatment arm and longitudinally.

Results
At baseline, C3M, C4M and PRO-C4 had significantly higher median levels in UC and CD patients than NHVs. CPa9-HNE and VICM were significantly higher in CD compared to NHV, an increase in these markers was observed but did not meet significance in UC patients (Figure 1). Decrease of VICM from baseline at Day 78 were associated with remission (median -55%, p&lt;0.05) in UC, while VICM decrease from baseline (median -56%, p&lt;0.05) at Day 78 was associated with CD patients achieving endoscopic remission. In CD C3M and C4M was present at lower levels at baseline and during study in patients with clinical remission compared with those without remission. SES-CD scores were positively correlated with C4M, C3M, CPa9-HNE and PRO-C4 at both baseline and Day 78. CD patients achieving endoscopic remission had lower levels of C3M, C4M, PRO-C4 and CPa9-HNE at both baseline and Day 78.

Conclusion
C4M, C3M, PRO-C4, CPa9-HNE and VICM were found at higher levels in serum of IBD patients. VICM demonstrated potential as a biomarker for monitoring disease activity changes. Association of C4M, C3M and PRO-C4 with endoscopic remission in CD patients suggest that these markers may predict disease progress or regression in CD patients. However, further studies are warranted to evaluate these biomarkers in IBD patients.
P164 Assessment of awareness and compliance with the recommendations of primary and secondary prevention of cancer in patients with Inflammatory Bowel Disease
Authors: Tulewicz-Marti E , Łodyga M , Stępień-Wrochna B , Lewandowski K , Rydzewska G 
Published: January 2022

Abstract

Background
Patients with Inflammatory Bowel Disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are at risk of developing malignancies, so prevention and adherence to cancer screening may improve its detection. The aim of this study was to asses the compliance with medical recommendations, especially primary and secondary prevention of cancer.

Methods
This prospective, one-center study was carried out between June and October 2021r. amongst patients from Department of Internal Medicine and Gastroenterology with IBD Division, Central Clinical Hospital of Ministry of Interior Affairs and Administrations, Warsaw, Poland. Patients were asked to complete anonymous questionnaire which included 42 questions concerning lifestyle, cancer risk factors, cancer history, and checkups in patients with IBD.

Results
A total of 190 patients with IBD were included in survey. 117 (61.6%) had CD, 67 (35.3%) UC and 6 (3.2%) unclassified disease. 43.7% were women and more than a half of them had &gt;8 years of the length of the disease. In total 84.2% were taking mesalazine, 48.4% immunosupresive medication and 77.9% biological treatment. Statistically significantly (p=0.034) more patients with CD than those with UC practiced regular physical activity (respectively 65.8% and 48.5%). Patients with UC more often were non-smokers (76.7% vs 92.5% for CD and UC respectively; p=0.007). 39.7% of patients with CD and 27.3% with UC declared alcohol consumption (p=0.128). Only 6% of patients responded not to use sun protection measures when sun-bathing but 24.8% with CD and 34.4% with UC didn’t have regular full-body skin examinations. 78.7% of patients had abdominal ultrasound scan performed in the last year. Out of 52.7% who had colonoscopy recommended, 49.3% of patients declared that the examination was carried out (36.8% of CD and 65.5% of UC; p= 0.038) and another endoscopy was scheduled (18.6% of CD and 48.4% of UC; p&lt;0.001). According to respondents cholangio-MRI was recommended to 14.3% patients with CD and 6.2% with UC (p=0.219). Only 1 patient in both groups did not perform this examination. Most of the examinations were recommended by gastroenterologists. Moreover, in the last 12 months 59.6% of female answerer declared to have ultrasound imagining of the breast and 98.7% gynecological examination performed (65.4% had regular Pap-test screening). 82.3% of respondents knew about HPV vaccination but only 25% were vaccinated.

Conclusion
Our study reveals that many of IBD patients are exposed on risk factors of malignancies. Screening for cancer and regular checkups should be regularly performed. Primary prevention, such as HPV vaccinations, should be reminded to all patients.
P174 Clostridium innocuum Infection in Inpatients with Inflammatory Bowel Disease
Authors: Le P H , Chiu C H , Chiu C T 
Published: January 2022

Abstract

Background
Clostridium innocuum (CI) infection can lead to creeping fat in Crohn’s disease and is associated with intestinal strictures. At present, no clinical study ever has evaluated the role of CI infection in inflammatory bowel disease (IBD).

Methods
In this retrospective cohort study, we enrolled hospitalized IBD patients with culture results for both CI and Clostridioides difficile (CD) in a medical center between October 2019 and April 2021. They were divided into the CI (CI+/CD−), control (CI−/CD−), coinfection (CI+/CD+), and CD (CI−/CD+) groups. We analyzed the risk factors, clinical presentations, and outcomes by comparing the CI and control groups.

Results
We enrolled a total of 90 patients, including 22, 39, 13, and 16 patients in the CI, control, coinfection, and CD groups. The incidence rates of CI (CI+) and CD (CD+) were 39% (35/90) and 32% (29/90), respectively. We analyzed the differences between CI and control groups. We identified the use of steroid (77.3% vs. 46.2%, P = 0.018) and 5-aminosalicylic acid (90.9% vs. 64.1%, P = 0.022) as risk factors of CI infection. Clinical analysis showed that more patients in CI group presented with bloody stool (77.3% vs. 51.3%, P = 0.046). Although CI group had significantly lower overall occurrence of intraabdominal abscess (0% vs. 17.9%, P = 0.042), it showed a lower clinical remission rate (50% vs. 87.5%, P = 0.044) and higher Mayo score at the end of follow-up (10 points vs. 3 points, P = 0.008) in ulcerative colitis.

Conclusion
CI infection may lead to a poorer clinical remission in ulcerative colitis. We should take it into consideration in IBD patents with active inflamamtion or refractory diarrhea with or without CD infection. Precise identification of CI is imperative to guide approproate antimicrobial therapy because of its intrinsic vancomycin resistance nature.
P185 The role of neutrophil-lymphocyte ratio, neutrophil-monocyte ratio, and lymphocyte-monocyte ratio in estimating disease activity in patients with ulcerative colitis
Authors: Sina Dr M , Pemaj X , Akshija I , Prifti S 
Published: January 2022

Abstract

Background
Determining disease activity in ulcerative colitis (UC) patients is important in order to reduce surgery rate and mortality. Colonoscopy has the disadvantage of being invasive, time consuming and expensive. Several laboratory markers have been proposed in order to evaluate UC disease activity.

Methods
The aim is to investigate the utility of neutrophil-lymphocyte ratio (NLR), neutrophil-monocyte ratio (NMR), and lymphocyte-monocyte ratio (LMR) in differentiating active UC from UC in remission. This is a prospective study carried out at a hospital center in Albania, from 2019–2020. Demographic and endoscopic data along with complete blood counts were collected for each UC patient. Based on Mayo score system, patients were classified as active UC (total Mayo score &gt;2 points) and UC in remission (total Mayo score ≤ 2 points). Pearson correlation coefficient was used to analyze associations between parameters. The sensitivity, specificity, and cut-off values were assessed using a receiver operating characteristic curve analysis.

Results
65 UC patients, with a mean age of 45.05 ± 15.5 (16–85) years, of whom 52.3% were females and 47.7% males, were enrolled in this study. 21.4% were in remission and 63.4% were classified as active UC disease. We found a positive correlation between NLR, NMR and disease activity [(r=0.295, p=0.002); (r=0.241, p=0.011) respectively]. NLR and NMR were also significantly higher in active disease group compared to UC in remission (p=0.016 and p=0.03 respectively). ROC analyses revealed that NLR (AUC=0.664, 95% CI, 0.557–0.772) and NMR (AUC=0.644, 95% CI, 0.531–0.756) are satisfactory in differentiating active UC from UC remission patients. A NLR cutoff value of 2.1 had a sensitivity of 60% and specificity of 61% for active UC, while a NMR cutoff value of 12.2 had a sensitivity of 63% and a specificity of 61% for active UC. We didn’t found any correlation between LMR and disease activity

Conclusion
This study shows that NLR and NMR are significantly associated with active UC disease. Given the fact that complete blood count is widely available and inexpensive, NLR and NMR may play a role in differentiating active UC from UC in remission.
P203 The performance of the Rutgeerts’ score, SES-CD, and MM-SES-CD for prediction of post-operative clinical recurrence in Crohn’s disease
Authors: Narula N , Wong E , Dulai P , Marshall J , Jairath V , Reinisch W 
Published: January 2022

Abstract

Background
Prevention of post-operative recurrence in Crohn’s disease (CD) is important to avoid further complications requiring additional surgeries. The Rutgeerts’s score is currently the gold standard assessment in clinical trials of post-operative CD. However, the Simplified Endoscopic Score for CD (SES-CD) has not been validated or used clinically in post-operative CD patients. The Modified Multiplier of the SES-CD (MM-SES-CD) is a novel internally validated tool that was developed to account for differences in items of the SES-CD and has not yet been validated in the setting of post-operative CD. The purpose of this study was to compare the SES-CD and MM-SES-CD scores with the Rutgeerts’ score for predicting clinical recurrence (CR) of post-operative CD.

Methods
This was a post-hoc analysis of data from the phase 3 PREVENT trial (ClinicalTrials.gov identifier: NCT01190839) of 208 participants who received infliximab or placebo. Receiver operating characteristic curve analyses to compare the Rutgeerts’, ileum SES-CD, and ileum MM-SES-CD scores at week 76 with CR at week 104. Multivariate logistic regression models evaluated cut-offs for the odds of achieving week 104 CR, after adjustment for confounders, including treatment allocation, disease duration, prior anti-TNF use, and concomitant immunomodulator use. CR was defined as CDAI score ≥200 and ≥70 point increase from baseline (or development of fistulas, abscesses, or treatment failure) and endoscopic recurrence, defined as Rutgeerts’ score ≥i2.

Results
The Rutgeerts’ score predicted week 104 CR at with fair accuracy [AUC: 0.74 (95% CI: 0.65–0.83)], which was similar to the SES-CD ileum score [AUC: 0.72 (95% CI: 0.64–0.80)] and the MM-SES-CD ileum score [AUC: 0.72 (95% CI: 0.63–0.80)]. Compared to various cut-offs by the other scores, the MM-SES-CD ileum score ≥26 at week 76 had the best ability to predict week 104 CR. Patients with a week 76 MM-SES-CD ileum score ≥26 were 4.17 times (95% CI: 1.90–9.12, p &lt;0.001) more likely to have CR compared to those with a MM-SES-CD ileum score &lt;26.

Conclusion
The ileal SES-CD and ileal MM-SES-CD perform similarly to the Rutgeerts’ score for predicting CR of post-operative CD. The MM-SES-CD threshold of ≥26 best predicted post-operative CR. Clinicians and trialists should consider the use of the MM-SES-CD in the assessment of post-operative CD given its performance and ability to capture colonic disease recurrence.