463 Endoscopic Ultrasound of the Colon for the Differentiation of Crohn's Disease and Ulcerative Colitis in Comparison to Healthy Controls - A Prospective, Blinded, Comparative Study

Ulcerative colitis and Crohn's disease belong to the same group of Idiopathic Inflammatory Bowel Disease (IBD) with unknown aetiopathogenesis. IBD is a chronic disease with outbursts and recessions. Although symptoms are usually treated with appropriate treatment, they impair the daily activities of the person causing significant morbidity. According to epidemiological studies that have been conducted both internationally and in our area, the number of patients with IBD is constantly increasing, suggesting the existence of an unknown environmental agent that goes into everyday life and causes disease in genetically predisposed individuals. In recent years, research into the aetiopathogenesis of IBD has increased sharply as the problem is continually increasing and therapeutically complicated. Diagnosis and treatment of IBD is very difficult, and despite the various diagnostic tests and available pharmaceutical preparations, some patients are forced to undergo surgical removal of the bowel and other types of disability. For the above reasons, patients are monitored in specialized reference centers by specialized scientists. FThe purpose of this study is to study serological markers, their expression and their utility in the prevention, diagnosis and treatment of patients with IBD. More specifically, some known serological markers with proven specificity / sensitivity were studied in patient with IBD. In the present study, 116 biological samples of serum from patients with Crohn's disease (NK) and 92 biological serum samples from patients with ulcerative colitis (UC) were studied and 99 healthy controls (CTRLS) were also studied. Patients were diagnosed with IBD based on clinical, endoscopic, radiological and pathological criteria and voluntarily participated in this research, which was conducted at the Immunology Research Laboratory of the Medical School of the University of Ioannina in collaboration with the Gastroenterological Clinic of the General Hospital of Ioannina. The samples came from populations in Northwest Greece. The study concerned the existence of ANCA antibodies by the immunofluorescence technique using a kit with ethanol, in particular the separation of pANCA and cANCA antibodies. We also studied the presence of ASCA antibodies using a kit using the ELISA technique. We studied all patients and healthy controls for the presence of ANCA and ASCA antibodies. The results of the study enriched one of the largest databases of patients with IBD, in addition the results of the serological markers were combined with other clinical data from the database by the same patients and healthy controls. This objective was achieved as the Immunology Research Laboratory is one of the largest centers of study and recording of IBD on a pan-Hellenic scale. The study, recording and processing of the data was done using appropriate research statistical methods and modern data analysis of scientific data.

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Diagnostic potential of endoscopic ultrasound for inflammatory bowel diseases and their complications

Medical Council ◽

10.21518/2079-701x-2021-5-176-184 ◽

2021 ◽

pp. 176-184

Author(s):

A. A. Budzinskaya ◽

E. A. Belousova ◽

S. G. Tereshchenko ◽

E. F. Akhmedova

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Gastrointestinal Tract ◽

Crohn's Disease ◽

Endoscopic Ultrasound ◽

Inflammatory Bowel Diseases ◽

Diagnosis And Treatment ◽

The World ◽

Bowel Diseases ◽

Inflammatory Bowel

Inflammatory bowel diseases (IBD), which is a term for two conditions (ulcerative colitis and Crohn’s disease), are chronic inflammatory diseases of the gastrointestinal tract that are the subject of many studies and much discussion around the world. The global prevalence of IBD is 20.4 per 100 thousand for ulcerative colitis and 3.7 per 100 thousand for Crohn’s disease. Every year the number of patients is increasing, which may indicate improvement in diagnosis of IBD, but at the same time demonstrates certain disadvantages and difficulties in the diagnosis and treatment of this group of patients. However, despite the fact that IBD has been exercising the minds of scientists around the world for many decades, many issues of diagnosis and treatment of this pathology appear relevant. Due to the paucisymptomatic condition of patients at early stages and the similarity of its symptoms with other gastroenterological diseases, the diagnosis of IBD involves certain difficulties in many cases. Advanced forms of the disease, as well as complications of IBD, result from late diagnosis. Endoscopic ultrasound (EUS, endo-ultrasound), which includes endoscopic and ultrasound examinations, is a modern imaging technique for the diagnosis of gastrointestinal diseases. The article discusses various international and Russian studies on the use of EUS in various pathologies of the gastrointestinal tract. Despite the absence of EUS in the formal guidelines for IBD, the technique appears promising for diagnosis, differential diagnosis of ulcerative colitis and Crohn’s disease, as well as complications of these diseases, such as primary sclerosing cholangitis, chronic and autoimmune pancreatitis, autoimmune hepatitis, pancreatic cancer, etc.

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Systemic Molecular Mediators of Inflammation Differentiate Between Crohn’s Disease and Ulcerative Colitis, Implicating Threshold Levels of IL-10 and Relative Ratios of Pro-inflammatory Cytokines in Therapy

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz117 ◽

2019 ◽

Vol 14 (1) ◽

pp. 118-129 ◽

Cited By ~ 2

Author(s):

Miranda G Kiernan ◽

J Calvin Coffey ◽

Shaheel M Sahebally ◽

Paul Tibbitts ◽

Emma M Lyons ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Inflammatory Cytokines ◽

Healthy Controls ◽

Mediators Of Inflammation ◽

Faecal Diversion ◽

Inflammatory Bowel ◽

Circulating Fibrocytes ◽

Pro Inflammatory Cytokines

Abstract Background and Aims Faecal diversion is associated with improvements in Crohn’s disease but not ulcerative colitis, indicating that differing mechanisms mediate the diseases. This study aimed to investigate levels of systemic mediators of inflammation, including fibrocytes and cytokines, [1] in patients with Crohn’s disease and ulcerative colitis preoperatively compared with healthy controls and [2] in patients with Crohn’s disease and ulcerative colitis prior to and following faecal diversion. Methods Blood samples were obtained from healthy individuals and patients with Crohn’s disease or ulcerative colitis. Levels of circulating fibrocytes were quantified using flow cytometric analysis and their potential relationship to risk factors of inflammatory bowel disease were determined. Levels of circulating cytokines involved in inflammation and fibrocyte recruitment and differentiation were investigated. Results Circulating fibrocytes were elevated in Crohn’s disease and ulcerative colitis patients when compared with healthy controls. Smoking, or a history of smoking, was associated with increases in circulating fibrocytes in Crohn’s disease, but not ulcerative colitis. Cytokines involved in fibrocyte recruitment were increased in Crohn’s disease patients, whereas patients with ulcerative colitis displayed increased levels of pro-inflammatory cytokines. Faecal diversion in Crohn’s disease patients resulted in decreased circulating fibrocytes, pro-inflammatory cytokines, and TGF-β1, and increased IL-10, whereas the inverse was observed in ulcerative colitis patients. Conclusions The clinical effect of faecal diversion in Crohn’s disease and ulcerative colitis may be explained by differing circulating fibrocyte and cytokine responses. Such differences aid in understanding the disease mechanisms and suggest a new therapeutic strategy for inflammatory bowel disease.

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