bluuebunny/crossref_metadata_2025_split huggingface dataset:
P232 Depression and fatigue in active IBD from a microbiome perspective - a bayesian approach to faecal metagenomics
Authors: Thomann A , Wuestenberg T , Wirbel J , Zeller G , Thomann P , Knoedler L L , Ebert M , Reindl W 
Published: January 2022

Abstract

Background
Extraintestinal symptoms are common in inflammatory bowel diseases (IBD) and include depression and fatigue. These are highly prevalent especially in active disease, potentially due to inflammation-mediated changes in the microbiota-gut-brain-axis.
The aim of this study was to investigate associations between structural and functional microbiota characteristics and severity of fatigue and depressive symptoms in patients with active IBD

Methods
We included clinical data of 62 prospectively enrolled patients with IBD in an active disease state. All patients were scheduled for a change in the therapeutic regime, and completed questionnaires and collected stool samples before induction of the new therapy. Based on taxonomical and functional metagenomic annotations of faecal gut microbiota, we investigated associations between bacterial genera/functional (KEGG-)modules and symptom severity of self-reported fatigue and depression by means of a bayesian triple association approach

Results
Triple associations with moderate to strong evidence were found for 3 genera (Odoribacter, Anaerotruncus and Alistipes) and 3 functional modules (pectin-, glycosaminoglycan- and central carbohydrate metabolism) with regard to depression (left), and for 4 genera (Intestinimonas, Anaerotruncus, Eubacterium and Clostridiales g.i.s) and 2 functional modules implicating amino acid and central carbohydrate metabolism with regard to fatigue (right).

Conclusion
This study provides first evidence of a triple association between microbiota composition, function and extraintestinal symptoms in active IBD. Depression and fatigue were associated with lower abundances of short chain fatty acid-producers and distinct pathways implicating glycan-, carbohydrate and amino acid metabolism. Our results suggest that microbiota-directed therapeutic approaches may reduce fatigue and depression in IBD and should be investigated in future research
P242 Latent Tuberculosis: frequency of occurrence and effect on clinical, laboratory, endoscopic and morphological activity of the course Inflammatory Bowel Diseases
Authors: Babayeva-Sadigova G , Makhmudov U , Asadova G , Quliyev F , Samadova T , Mirzazade O , Hasanova A 
Published: January 2022

Abstract

Background
Early diagnosis of tuberculosis remains challenging due to the nonspecific clinical manifestations that can mimic other gastrointestinal diseases and range from acute to chronic abdominal disease. In recent decades, latent tuberculosis (LTI) has been of particular interest. Patients with inflammatory bowel disease (IBD) are at risk of contracting tuberculosis.

Aim
to identify the incidence of LTI in patients with IBD and its effect on the clinical, laboratory, endoscopic and morphological activity of IBD.

Methods
The study included 350 patients with IBD, who were monitored and a group of patients (188 people (UC = 80, CD = 101, MC = 7) who did not respond / or poorly respond to basic IBD therapy were identified. In this group, the determination of the quantiferon test was carried out. To achieve this goal, two main hypotheses were considered: assessment of IBD-associated and systemic vascular lesions (h/s CRP, platelet count, homocysteine, vit D, urine albumin, fecal calprotectin and lactoferrin; α-TNF, IL-1,IL-2,IL-4,IL-6,IL-8,IL-10,IL-18; endoscopic examination with pathomorphological assessment), assessment of changes in the thickness of the vascular intima and blood flow velocity (based on the doppler determination of the pulse wave velocity (PWV) and the thickness of the intima media (CIMT) on the common carotid, vertebral and subclavian arteries).

Results
The number of positive responses to the quantiferon test was found in 37 patients (19.7%) / 10.6%) out of 188 patients (53.7%); positive skin tests (Mantoux reaction) ≥5 mm in 78 (22.3%) patients; altered peritoneal lymph nodes in 28 (8%), pulmonary and pleural TB in 9 (2.57%) patients. There were no patients with intestinal TB / “+” TB PCR in the gastrointestinal tract tissue. The prevalence of positive cases according to the quantiferon test was: in the general group of patients - 10.6%. Laboratory indicators for both IBD and systemic vascular lesions were higher in the group of patients with latent tuberculosis (Table 1, Table 2). Damage to the vascular bed (based on doppler determination of pulse wave velocity (PWV) and intimal thickness (CIMT) on the common carotid, vertebral and subclavian arteries) was more pronounced in the group of patients with latent tuberculosis (CIMT (mm) 0.68 ± 0, 1 / 0.67 ± 0.2; PWV (sm / s) 93.3 ± 2.2 / 97.2 ± 1.4).

Conclusion
Conclusion. Comparing the results of the data before and after the treatment of latent TB in patients with IBD, certain dependences of the influence of infection on the course of IBD (h/s CRP, platelet levels, homocysteine, fecal calprotetin and lactoferrin, IL-8 and a decreased vit. D; changes, associated with damage to the vascular bed), endoscopic and morphological activity.
P248 Lifestyle changes after Inflamatory Bowel Disease diagnosis
Authors: Belén Galipienso O , Cameo J , Bernabeu P , Mira C , García M D M , Pomares C , Muñoz D , Canales N , Gutierrez A , Zapater P , van-der Hofstadt C , Jover R , Ruiz M T , Sempere L 
Published: January 2022

Abstract

Background
Some lifestyle factors seem to modify the course and clinical outcomes in patients with Inflammatory Bowel Disease (IBD). A higher level of exercise has been associated with lower risk of relapse among patients in remission whereas obesity increases the risk of treatment failure. Moreover, sleep disturbances and stress have been associated with a higher risk of flare up. The relationship between various lifestyle factors and IBD seems to be bi-directional. In clinical practice, we observe lifestyle changes in patients with IBD unknowing exactly their incidence. The aim of this study is to assess lifestyle changes after IBD diagnosis.

Methods
Prospective and multicenter observational study in patients with new diagnosis of IBD. Semi-structured interviews were conducted evaluating lifestyle changes (diet, physical activity, rest, relaxation techniques, and leisure activities) in the first 6 months after IBD diagnosis.

Results
154 patients were included 79 (51.3%) Crohn’s disease (CD), 75 (48.7%) Ulcerative Colitis (UC). 68 (44.2%) women, 86 (55.8%) men. Mean age 42.5 years (±16.1). BMI 24.9 ± 5. 67 (43.5%) were never-smokers, 26 (16.9%) smokers, 61 (39.6%) ex-smokers. Lifestyle changes consisted in dietary modifications in 94 (61%) patients, increased physical activity in 43 (27.9%) patients, increased time for resting in 32 (20.8%) patients, the use of relaxation techniques in 11 (7.1%) patients and increased leisure activities in 27 (17.5%) patients. There were no differences in lifestyle changes between CD patients and UC patients except for the diet, which was more often modified by CD patients than UC patients [58 (73.4%) vs. 36 (48%) p=0.001, OR 95% 2.9 (1.5–5.8)]. Regarding differences between both sexes, men more frequently increased exercise than women [30 (34.9%) vs. 13 (19.1%) p=0.03 OR 95% 2.2 (1.07-4-7)]. There were no differences in rest, relaxation, leisure activities and dietary changes between men and women. Age was not associated with changes in lifestyle, except for leisure activities, which were more often increased in patients under 40 years of age than patients over 40 years of age [17 (23.9%) vs 10 (12%) p=0.053, OR 95% 2.2 (0.97–5.4)].

Conclusion
Lifestyle changes in IBD patients appear soon, and diet is the most frequently modified habit.
P252 Low adherence is associated with worse disease course in Ulcerative Colitis: a retrospective study from a single referral center
Authors: Viola A , Demarzo M G , Abbruzzese A , Chiappetta M F , Costantino G , Alibrandi A , Fries W 
Published: January 2022

Abstract

Background
New therapeutic approaches for ulcerative colitis (UC) are becoming available but still there is no robust evidence for predictors of poor outcome. We aimed to evaluate factors associated with a more aggressive UC course.

Methods
Data of all UC outpatients followed for at least 3 years after diagnosis were retrospectively collected. Demographic, anamnestic data, disease characteristics and treatment were collected. Disease patterns were defined according to the IBSEN study (Henriksen M. et al1). Disease worsening at 3 years was defined as the presence of disease extension at endoscopy, proctocolectomy and or early use of biologics. Risk factors for chronically active disease were assessed. Moreover, the following outcomes were explored according to disease extent at diagnosis (E1-E2 vs E3): corticosteroid free remission, hospitalization, early use of immunomodulators and biologics, colorectal cancer, adherence, mucosal healing at 3 years. Survival analysis was carried out to estimate the probability of receive a biological treatment within 3 and 5 years from diagnosis according to disease extent (E1 vs E2 vs E3) and disease patterns.

Results
A total of 345 UC patients were included and followed for a mean period of 94 months. Patients with extensive colitis had a higher rate of colectomy (p &lt; 0.001), hospitalizations (p=0.004) and of chronically active disease 3 years after diagnosis (p &lt; 0.001) and were more likely to receive early biologics and IMM (p= 0.04 and p=0.01 respectively) (Figure 1). The only factor associated with chronic active disease was non-adherence (p &lt; 0.03; OR 0.49, 95% CI: 0.26–0.95) (Table 1). No differences were found for the probability to receive biologics within 3 and 5 years from diagnosis according to Montreal extension at diagnosis and disease pattern.

Conclusion
Patients diagnosed with pancolitis were more likely to underwent colectomy or to have a chronically active disease with a higher rate of hospitalization, early use of IMM or biologics. The only predictor for chronically active UC was the lack of adherence to therapy within the first 3 years after diagnosis.

Reference
1. Henriksen M, et al; IBSEN Study Group. Ulcerative colitis and clinical course: results of a 5-year population-based follow-up study (the IBSEN study). Inflamm Bowel Dis. 2006;12:543–50.
The study was supported by a grant from Ferring S.p.A.
P253 Are we doing enough to prevent colectomy in Inflammatory Bowel Disease (IBD) patients? A 5-year review of colectomy rates in Shropshire and Mid-Wales UK (2015–2019)
Authors: Javed A , Butterworth J , Townson G 
Published: January 2022

Abstract

Background
Colectomy for IBD significantly impacts the psycho-social aspects & quality of life.

Methods
Electronic records were retrospectively analysed for colectomy rates & parameters of interest.

Results
68 patients (Men 37:Women31), median age 30 years had colectomies. Annual colectomy rates remained constant;7 (2015), 20 (2016), 11 (2017) & (2018) each and 19 (2019). 28% had colectomy within 1 year of diagnosis and only 63% received a biologic agent. Over half, (54%)had emergency surgeries & 37% experienced infections, re-laparotomy and ileus (20% each).

Conclusion
There is an opportunity to risk-stratify patients at diagnosis based on the risk factors (men, younger age, severe/extensive disease) to a top-down therapy & treat to target strategy to reduce colectomy rates.
P256 The practical use of an eHealth platform for inflammatory bowel disease patients: the validation of the IBD Tool web-based tele-monitoring system
Authors: Giuffrida E , Mangia M , Figini V , Carli E , Colombo A , Mendolaro M , Lavagna A , Lia C , Bonina M , Martínez De Carnero F , Morello E , Cosimato M , Rocca R , Pagna G , Daperno M 
Published: January 2022

Abstract

Background
Tele-monitoring and eHealth tools are useful to monitor disease burden and activity in inflammatory bowel disease (IBD). We developed a web-based tele-monitoring platform (IBD Tool), in order to monitor granularly disease activity and impact on patients’ lives. Aim of this abstract is to report preliminary data on IBD Tool effectiveness.

Methods
Consecutive IBD patients were offered the access to the tele-monitoring platform (IBD Tool) as a part of an ongoing investigator-initiated observational study, overall 677 patients were enrolled between February and November 2021. Validated questionnaires administered on the platform captured disease activity [Harvey Bradshaw Index (HBI), Simple Clinical Colitis Activity Index (SCCAI), Monitor IBD At Home Questionnaire for Crohn’s disease (CD) or for ulcerative colitis (UC): MIAH-CD or MIAH-UC] and disease burden and quality of life. Patients were randomized 1:1 to standard of care (only activity questionnaires required every 3-months) and telemedicine (activity questionnaires required monthly, remaining questionnaires every 3-months).

Results
Out of 678 patients enrolled, 585 (87%) are active on the platform and filled overall 14,297 questionnaires during an average follow-up of 9.8 months, the mean number of questionnaires filled/patient was 24.9. Characteristics of the patient enrolled in the study are presented in Table 1.
Table 1. Characteristics of patients enrolled on the IBD Tool tele-monitoring platform and questionnaires filled

Among the 320 cases with 2 or more observations in the IBD Tool platform, it was possible to analyse disease activity variation (summarized as constant, amelioration, or worsening) according to SCCAI or HBI changes ±2 points, results are detailed in Table 2.
Table 2. Charateristics of patients constant, ameliorating or worsening in time.

Conclusion
Patients’ persistence in the tele-monitoring system is adequate; the systems offer granular and precise multidimensional evaluation of IBD patients.
P266 Elderly-onset Inflammatory Bowel Disease: a retrospective single-center study with current follow-up
Authors: Dias E , Nunes A C R , Garrido I , Andrade P , Lopes S , Macedo G 
Published: January 2022

Abstract

Background
Elderly-onset inflammatory bowel disease (IBD) will be seen more frequently with the ageing of the population and the increasing incidence of IBD. However, to date there are few studies focusing in the medical management of IBD in this patient population. The aim of our study was to describe the main clinical features of elderly-onset IBD.

Methods
Patients diagnosed with IBD after the age of 65 years (elderly-onset IBD) until December 2020 with current follow-up in a specialized IBD consultation in a tertiary hospital center (by June 2021) were included in this retrospective study. The hospital electronic medical records were searched in order to retrieve demographic and clinical data of the patients.

Results
A total of 61 patients were included, with mean age of 72.0 years (range 65–86); 34 (55.7%) were male. All patients were alive and with current follow-up. Mean follow-up duration was 84 months (interquartile range 35–97). The most common type was ulcerative colitis in 36 (59%) patients, whereas Crohn’s disease was diagnosed in 25 (41%). Among patients with ulcerative colitis, 14 (38.9%) had pancolitis, 11 (30.6%) left-sided colitis and 11 (30.6%) proctitis. Crohn’s disease was most often ileal in 48% of patients, followed by colonic in 44% and only 8% of patients presented ileocolonic disease. Non-stenosing non-penetrating behavior was present in 19 (76%) patients, followed by stenosing behavior in 6 (24%), with no case of penetrating phenotype; associated perianal disease was detected in 5 (20%) patients. Salicylates were used as single maintenance therapy in 44 (72.1%) of all patients with IBD; 11 (18%) patients required immunosuppressant therapy with biological agents including infliximab (n=5), vedolizumab (n=5) or ustekinumab (n=1) whereas 4 (6.6%) patients required no specific treatment. Surgery was necessary in only 3 (4.9%) patients: 2 performed total colectomy for refractory ulcerative colitis, whereas the other required right ileocolectomy for stenosing Crohn’s disease. At the time of diagnosis, anemia was present in 23 (37.7%) patients. In 21 (34.4%), levels of C-reactive protein were significantly elevated (&gt;10 mg/L) and hypoalbuminemia was present in 12 (19.7%). Vitamin D levels were measured in 44 patients, among these 41 (93.2%) presented abnormally low levels.

Conclusion
Patients with elderly-onset IBD appear to have a mild disease course, with low use of biological agents and surgery. Ileocolonic involvement and penetrating phenotype in Crohn’s disease appear to be rare. Nevertheless, other comorbidities are often present and IBD may contribute to a higher prevalence of laboratory abnormalities including anemia and vitamin D deficiency.
P272 Psychological burden in newly diagnosed IBD patients: Differences between Crohn’s Disease and Ulcerative Colitis in early IBD
Authors: Bernabeu P , Cameo J I , Gutiérrez A , García G , García M F , Aguas M , Belen O , Zapater P , Cabezos P , Andreu A , Jover R , van-der Hofstadt C , Ruiz M T , Sempere L 
Published: January 2022

Abstract

Background
Psychological factors such as stress, anxiety and depression are frequently related to IBD. However, there are few studies of these factors in patients with a new diagnosis of IBD. The aim of the present study is to test the psychological burden in patients with a recent diagnosis of IBD and to check if there are differences between Crohn’s disease (CD) and Ulcerative Colitis (UC).

Methods
Prospective, multi-center, observational study in patients with a new diagnosis of IBD (&lt;6 months). The patients were recruited from 4 different Spanish hospitals. Patients were evaluated using the Holmes and Rae social readjustment rating (SRRS), the hospital anxiety and depression scale (HAD), Scale of Stress Perceived by the Disease (EAE) and quality of life questionnaire for patients with inflammatory bowel disease (IBDQ).

Results
We included 156 patients, 69 (44.2%) women and 87 men (55.8%); 80 (51.3%) CD and 76 (48.7%) UC, mean age 42.3 (SD 16.21) years. The sample was homogeneous between groups in relation to socio-demographic variables. In the total sample a 60.9% of the patient associated the onset of the disease with a stressful life event. Patients with CD showed a greater psychological impact on measures of anxiety, CD 48.8% - UC 25%, OR 2.8, (95% CI 1.4–5.6), depression CD 25% - UC 9.2%, OR 3.2 (95%CI 1.2–8.3) and stressful life events CD 86.3% - UC 67.1%, OR 3 (95%CI 1.3–6.8). In terms of general quality of life, 82.9% of UC patients showed high scores compared to 57.5% of CD patients, OR 0.27 (95%CI 0.13–0.58). In the IBDQ domains, CD patients had lower scores than UC patients, except in the digestive domain, where scores were similar. In the scale of perceived stress due to the disease, both groups showed elevated values (CD 86.3% - UC 80.3%).

Conclusion
Patients with a recent diagnosis of CD are more emotionally affected and have a poorer quality of life at the beginning of the diagnosis when compared to patients with UC. Both have high scores in perceived stress due to the disease. They perceive the disease at diagnosis as a highly stressful life event, so this should be considered to promote interventions (perhaps disease-specific) aimed at alleviating that stress and preventing it from interfering with the course of the disease.
P285 Longitudinal single cell transcription profiling of peripheral blood disentangles shared and biologic-specific patterns of early remission in active IBD patients
Authors: Bernardes J P , Mishra N , Schulte-Schrepping J , Herresthal S , Tran F , Aden K , Beyer M , Schultze J , Rosenstiel P 
Published: January 2022

Abstract

Background
IBD patients suffer from an uncertain disease course with only 10–20% of patients sustainably benefiting from complete and long-term remission, despite several modern biologic therapies being available. Large multi-omics datasets aimed to elucidate the relationship between changes in disease pathophysiology upon introduction of targeted therapy have delineated overal molecular pathways affected by biologic treatment (e.g. anti-TNF treatment). However, cell-specific molecular studies with the ability to detect cellular features associated with biologic treatment remain scarce, in particular, studies that focused on the mechanisms of action different biologic treatments and potential predictors of early therapy response.

Methods
We collected longitudinal single-cell RNA-seq data from 21 IBD patients treated with anti-TNF and anti-IL12/23 biologic treatments. The analysis included single-cell transcription profiles of PBMCs (&gt;500,000 cells) collected before and two and six weeks after the first round of treatments. Cell-types of interest were identified by selecting changes in immune cell proportions and molecular patterns detected throughout the course of treatment. Specifically, we were interested in identifying molecular pathways that distinguish patients undergoing remission at 14 weeks of treatment (Partial Mayo score &lt;2 or HBI &lt;5).

Results
Upon anti-TNF therapy, most patients displayed an increase in the number of B cells, with patients with a favourable disease outcome most likely to display an increase in the proportion of memory and transitional B cells. Remarkably, for Crohn’s disease patients, transitional B cell proportion increased throughout the course of anti-TNF treatment, while it decreased for patients undergoing anti-IL12/23 treatment. Molecular signatures related to leukocyte and lymphocyte proliferation were shared at early time points of therapy response, but interestingly, the decrease was not sustained for patients not undergoing remission. Similar patterns could be identified for NF-κB and Toll-like receptor signaling pathways in memory B cells. Moreover, we identified a molecular cluster comprised of Fc receptor-like (FCRL) family members that might infer response to anti-TNF treatment even before the treatment has started, implying hyperactivity of B cells in inflammation as a determinant factor of therapy response.

Conclusion
Here, we identified cell-type specific molecular changes in the B cell compartment that are specific to the biologic treatment. Underlining the importance of comparative clinical studies in boosting the rates of patients with a high chance for long-term benefit, by stringent optimization of therapy and personalized treatment.