scholarly journals Su1794 – Proposed Modification of Paris Classification to Include Histological Findings Improves Definition of Pan-Enteric Involvement in Pediatric Crohn’s Disease

2019 ◽  
Vol 156 (6) ◽  
pp. S-614
Author(s):  
Jessica Connors ◽  
Sana Basseri ◽  
Mohsin Rashid ◽  
Anthony Otley ◽  
Johan E. van Limbergen
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Histological Findings ◽  
Paris Classification ◽  
Proposed Modification ◽  
Definition Of

scholarly journals L’ALTRA PARTE DI NOI – IL MICROBIOMA UMANO

2013 ◽  
Author(s):  
Paolo Landini
Keyword(s):  
Crohn’S Disease ◽  
Immune System ◽  
Crohn's Disease ◽  
Beneficial Effect ◽  
Human Microbiota ◽  
Pathological Conditions ◽  
Beneficial Microorganisms ◽  
Potential Impact ◽  
Definition Of

The importance of microorganisms associated with man, the so-called “human microbiota” has become increasingly clear from recent scientific studies. Although it has been known for many years that some microorganisms might have a beneficial effect on processes such as digestion or on the immune system, the specific mechanisms of these phenomena have never been thoroughly studied. However, in recent years the prevalence of either beneficial microorganisms or harmful bacteria, even though not strictly pathogenic, has been associated with pathological conditions such as obesity, Crohn’s disease, atherosclerosis, and other diseases in which a bacterial component had never been implicated. In this report, I describe the main concepts related to the definition of microbiome and the potential impact of studying the mechanisms of man-microbiome interaction on the treatment of several illnesses.

scholarly journals Crohn’s Disease Patients in Remission Display an Enhanced Intestinal IgM+ B Cell Count in Concert with a Strong Activation of the Intestinal Complement System

Cells ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 78 ◽  
Author(s):  
Sophie Preisker ◽  
Ann-Kathrin Brethack ◽  
Arne Bokemeyer ◽  
Dominik Bettenworth ◽  
Christian Sina ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Complement System ◽  
Expression Patterns ◽  
Critical Role ◽  
Mucosal Immune Response ◽  
Immunoglobulin M ◽  
Complement Components ◽  
Activation Pathways ◽  
Definition Of

Inflammatory bowel disease (IBD) is an umbrella term that comprises Crohn’s disease (CD) and ulcerative colitis (UC). Both entities are characterized by a disturbed mucosal immune response and an imbalance of intestinal microbiota composition. The complement system (C) plays a critical role in the detection, and clearance of bacteria and dysregulation of single complement components has been linked to IBD. Here, we asked if the C contributes to distinct subtypes of inflammation observed in CD and UC. We performed systematical expression analyses of the intestinal C in IBD patients and controls. Immunohistochemistry or immunoblot experiments were performed to verify qPCR data. Activity of the three activation pathways of C was studied in sera samples. In CD patients a strong upregulation of the C was observed enabling the definition of unique expression patterns being associated either with remission or active disease. These data were reflected by an enhanced C activation in sera and fecal samples. An excessive mucosal presence of immunoglobulin M (IgM) and CR2/CD21 positive B cells in concert with decreased fecal IgA level was identified in CD patients in remission. These findings point to an exacerbated induction of the intestinal C that may potentially be involved in the etiology of CD.

scholarly journals P049 Lewis score: a useful tool for the diagnosis but not for the definition of prognosis in suspected Crohn's disease

2017 ◽  
Vol 11 (suppl_1) ◽  
pp. S102-S103
Author(s):  
M. Silva ◽  
H. Cardoso ◽  
A. Peixoto ◽  
M. Marques ◽  
E. Rodrigues-Pinto ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Definition Of

scholarly journals P191 Non-specific terminal ileitis: prevalence, clinical course and association with later diagnosis of Crohn’s disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S259-S259
Author(s):  
E Koureta ◽  
M Tampaki ◽  
T Voulgaris ◽  
E Laoudi ◽  
P Karatzas ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Course ◽  
Disease Diagnosis ◽  
Study Patient ◽  
Histological Findings ◽  
Terminal Ileitis ◽  
Endoscopic Findings ◽  
Initial Symptoms

Abstract Background The existing literature does not provide adequate guidance on the diagnosis and management of patients with non-specific terminal ileitis, while the data regarding the percentage of patients that finally develop Crohn’s disease are scarce. Methods The aim of this study was to evaluate the prevalence and natural course of non-specific terminal ileitis in patients who underwent colonoscopy in our department during the last decade. All patients with endoscopic findings of terminal ileitis and non-specific histological findings between 2008 and 2018 were included in the study. Patient characteristics, initial symptoms, biopsy findings, and the patients’ clinical and endoscopic course were recorded. Patients with a history of Crohn’s disease or histological findings related to specific diseases were excluded. Results Out of 5.353 colonoscopies in total, 92 patients (mean age: 50 years, men: 56.5%, asymptomatic: 72.5%) with non-specific terminal ileitis were identified (prevalence: 1.7%). Among 92 patients, 56 (61%) had available follow-up information for at least 6 months after initial endoscopy. In these patients, the reasons for performing endoscopy were chronic diarrhea (21/56, 37.5%), screening (16/56, 28.6%), abdominal pain (12/56, 21.4%), iron deficiency (5/56, 9%) and visible blood in stool (2/56, 3.5%). Endoscopic findings included erosions/ulcerations (62.5%), mucosal edema (23.2%), mucosal erythema (10.7%) and ileal valve stenosis (3.6%). Among 56 patients, 16 (28.6%) received medical treatment that included aminosalicylates (25%), budesonide (62.5%) and antibiotics (12.5%). Recession of symptoms was recorded in 20 out of 40 symptomatic patients (50%). Interestingly, symptomatic relief was more frequent in patients who did not receive any treatment (75%) comparing to those who received medications (26.3%), (p=0.02). In total, 23/56 (41%) patients underwent 2nd endoscopy with persisting endoscopic findings in 15/23 (65.2%). Eleven out of 56 (19.6%) patients were eventually diagnosed with Crohn’s disease. The probability of Crohn’s disease diagnosis was significantly higher in symptomatic patients (27.5%) comparing to asymptomatic (0%) (p=0.019). The majority of patients with Crohn’s disease (9/11, 81.8%) remained symptomatic after initial endoscopy (p= 0.002), while 90% of them had persisting endoscopic findings in follow-up endoscopy (p=0.019). Conclusion Non-specific terminal ileitis has a generally benign clinical course regardless of the administered treatment. However, patients with persisting symptoms and endoscopic findings should be followed closely to monitor later development of Crohn’s disease.

scholarly journals Possible association between Mycobacterium paratuberculosis infection and Crohn's disease in human

2018 ◽  
Vol 48 (2) ◽  
pp. 57
Author(s):  
Z. DIMARELI-MALLI (Ζ. ΔΗΜΑΡΕΛΛΗ-ΜΑΛΛΗ) ◽  
C. SARRIS (Κ. ΣΑΡΡΗΣ)
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Causative Agent ◽  
Clinical Course ◽  
Johne's Disease ◽  
Unknown Aetiology ◽  
Mycobacterium Paratuberculosis ◽  
Histological Findings ◽  
Pathogenic Role ◽  
Dna Hybridisation

Crohn's disease is a granulomatous ileocolitis of humans, of unknown aetiology, which generally manifests itself during the prime of life. The chronic, progressive clinical course and histological findings are consistent wiht a mycobacterial aetiology. Evidence supporting a pathogenic role for a mycobacterium has become available only in the last decade with the isolation of this microorganism from Crohn's disease tissue. M. paratuberculosis, which is the causative agent of Johne's disease in animals, has been identified in patients with Crohn's disease by PCR and DNA hybridisation techniques. It has been shown that isolates of M. paratuberculosis from Crohn's disease are indentical with pathogenic strains in ruminants.

scholarly journals Capsule Endoscopy Complements Magnetic Resonance Enterography and Endoscopy in Evaluating Small Bowel Crohn’s Disease

2019 ◽  
Author(s):  
David O Prichard ◽  
Zachary Hamilton ◽  
Thomas Savage ◽  
Matthew Smyth ◽  
Carlie Penner ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Magnetic Resonance ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Magnetic Resonance Enterography ◽  
Newly Diagnosed ◽  
Paris Classification ◽  
Active Inflammation ◽  
Wireless Capsule

Abstract Aims Wireless capsule endoscopy (WCE) and magnetic resonance enterography (MRE) are increasingly utilized to evaluate the small bowel (SB) in Crohn’s disease (CD). The primary aims were to compare the ability of WCE and MRE to detect SB inflammation in children with newly diagnosed CD, and in the terminal ileum (TI) to compare them to ileo-colonoscopy. Secondary aims were to compare diagnostic accuracy of WCE and MRE and changes in Paris classification after each study. Methods Patients (10 to 17 years of age) requiring ileo-colonoscopy for suspected CD were invited to participate. Only patients with endoscopic/histologic evidence of CD underwent MRE and WCE. SB inflammation and extent were documented and comparative analyses performed. Results Of 38 initially recruited subjects, 20 completed the study. WCE and MRE were similarly sensitive in identifying active TI inflammation (16 [80%] versus 12 [60%]) and any SB inflammation (17 [85%] versus 16 [80%]). However, WCE detected more extensive SB disease than MRE with active inflammation throughout the SB in 15 [75%] versus 1 [5%] patient (P < 0.001). Moreover, WCE was more likely to detect proximal SB disease (jejunum and ileum) compared to MRE (85% versus 50%, P = 0.04). Overall, the Paris classification changed in 65% and 85% of patients following MRE and WCE, respectively. Conclusions WCE is as sensitive as MRE for identifying active TI inflammation, but appears more sensitive in identifying more proximal SB inflammation. In the absence of concern regarding stricturing or extra-luminal disease WCE can be considered for the evaluation of suspected SB CD.

scholarly journals Targeting mucosal healing in Crohn’s disease: what the clinician needs to know

2019 ◽  
Vol 12 ◽  
pp. 175628481985686 ◽  
Author(s):  
Entcho Klenske ◽  
Christian Bojarski ◽  
Maximilian Waldner ◽  
Timo Rath ◽  
Markus F. Neurath ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Clinical Practice ◽  
Crohn's Disease ◽  
Clinical Management ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Mucosal Healing ◽  
Ongoing Debate ◽  
Definition Of

In recent years, mucosal healing has emerged as a key therapeutic goal in the clinical management of patients with Crohn’s disease, as it has been associated with improved long-term clinical outcomes. With the vast improvements in endoscopic imaging techniques and the increase in available treatment options, which reportedly are able to induce mucosal healing, the practising physician is left to wonder: how is endoscopic mucosal healing exactly defined in Crohn’s disease, and how can it effectively be achieved and monitored in daily clinical practice? Within this review, we will give an overview of the ongoing debate about the definition of mucosal healing and the modalities to monitor inflammation, and finally present available therapies with the capacity to induce mucosal healing.

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