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Publisher: Oxford University Press   (Total: 406 journals)

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Showing 1 - 200 of 406 Journals sorted alphabetically
ACS Symposium Series     Full-text available via subscription   (SJR: 0.189, CiteScore: 0)
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.79, CiteScore: 2)
Adaptation     Hybrid Journal   (Followers: 9, SJR: 0.143, CiteScore: 0)
Advances in Nutrition     Hybrid Journal   (Followers: 53, SJR: 2.196, CiteScore: 5)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.434, CiteScore: 1)
Aesthetic Surgery J. Open Forum     Open Access  
African Affairs     Hybrid Journal   (Followers: 66, SJR: 1.869, CiteScore: 2)
Age and Ageing     Hybrid Journal   (Followers: 90, SJR: 1.989, CiteScore: 4)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 19, SJR: 1.376, CiteScore: 3)
American Entomologist     Full-text available via subscription   (Followers: 8)
American Historical Review     Hybrid Journal   (Followers: 169, SJR: 0.467, CiteScore: 1)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 44, SJR: 2.113, CiteScore: 3)
American J. of Clinical Nutrition     Hybrid Journal   (Followers: 177, SJR: 3.438, CiteScore: 6)
American J. of Epidemiology     Hybrid Journal   (Followers: 197, SJR: 2.713, CiteScore: 3)
American J. of Health-System Pharmacy     Full-text available via subscription   (Followers: 52, SJR: 0.595, CiteScore: 1)
American J. of Hypertension     Hybrid Journal   (Followers: 25, SJR: 1.322, CiteScore: 3)
American J. of Jurisprudence     Hybrid Journal   (Followers: 19, SJR: 0.281, CiteScore: 1)
American J. of Legal History     Full-text available via subscription   (Followers: 9, SJR: 0.116, CiteScore: 0)
American Law and Economics Review     Hybrid Journal   (Followers: 27, SJR: 1.053, CiteScore: 1)
American Literary History     Hybrid Journal   (Followers: 16, SJR: 0.391, CiteScore: 0)
Analysis     Hybrid Journal   (Followers: 22, SJR: 1.038, CiteScore: 1)
Animal Frontiers     Hybrid Journal   (Followers: 1)
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 16, SJR: 1.423, CiteScore: 3)
Annals of Botany     Hybrid Journal   (Followers: 38, SJR: 1.721, CiteScore: 4)
Annals of Oncology     Hybrid Journal   (Followers: 56, SJR: 5.599, CiteScore: 9)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 10, SJR: 0.722, CiteScore: 1)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 34, SJR: 0.728, CiteScore: 2)
Antibody Therapeutics     Open Access  
AoB Plants     Open Access   (Followers: 4, SJR: 1.28, CiteScore: 3)
Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 17, SJR: 0.858, CiteScore: 2)
Applied Linguistics     Hybrid Journal   (Followers: 59, SJR: 2.987, CiteScore: 3)
Applied Mathematics Research eXpress     Hybrid Journal   (Followers: 1, SJR: 1.241, CiteScore: 1)
Arbitration Intl.     Full-text available via subscription   (Followers: 21)
Arbitration Law Reports and Review     Hybrid Journal   (Followers: 14)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 30, SJR: 0.731, CiteScore: 2)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 3)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
Astronomy & Geophysics     Hybrid Journal   (Followers: 44, SJR: 0.146, CiteScore: 0)
Behavioral Ecology     Hybrid Journal   (Followers: 52, SJR: 1.871, CiteScore: 3)
Bioinformatics     Hybrid Journal   (Followers: 337, SJR: 6.14, CiteScore: 8)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 9, SJR: 1.446, CiteScore: 3)
Biometrika     Hybrid Journal   (Followers: 20, SJR: 3.485, CiteScore: 2)
BioScience     Hybrid Journal   (Followers: 29, SJR: 2.754, CiteScore: 4)
Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 1, SJR: 0.146, CiteScore: 0)
Biostatistics     Hybrid Journal   (Followers: 17, SJR: 1.553, CiteScore: 2)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 186, SJR: 2.115, CiteScore: 3)
BJA Education     Hybrid Journal   (Followers: 65)
Brain     Hybrid Journal   (Followers: 68, SJR: 5.858, CiteScore: 7)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 50, SJR: 2.505, CiteScore: 5)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 3, SJR: 2.15, CiteScore: 3)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 36, SJR: 2.161, CiteScore: 2)
British J. of Aesthetics     Hybrid Journal   (Followers: 25, SJR: 0.508, CiteScore: 1)
British J. of Criminology     Hybrid Journal   (Followers: 604, SJR: 1.828, CiteScore: 3)
British J. of Social Work     Hybrid Journal   (Followers: 86, SJR: 1.019, CiteScore: 2)
British Medical Bulletin     Hybrid Journal   (Followers: 6, SJR: 1.355, CiteScore: 3)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 34)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 4, SJR: 1.376, CiteScore: 1)
Cambridge J. of Economics     Hybrid Journal   (Followers: 70, SJR: 0.764, CiteScore: 2)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 12, SJR: 2.438, CiteScore: 4)
Cambridge Quarterly     Hybrid Journal   (Followers: 10, SJR: 0.104, CiteScore: 0)
Capital Markets Law J.     Hybrid Journal   (Followers: 2, SJR: 0.222, CiteScore: 0)
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.135, CiteScore: 5)
Cardiovascular Research     Hybrid Journal   (Followers: 14, SJR: 3.002, CiteScore: 5)
Cerebral Cortex     Hybrid Journal   (Followers: 48, SJR: 3.892, CiteScore: 6)
CESifo Economic Studies     Hybrid Journal   (Followers: 22, SJR: 0.483, CiteScore: 1)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.42, CiteScore: 3)
Children and Schools     Hybrid Journal   (Followers: 6, SJR: 0.246, CiteScore: 0)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 5, SJR: 0.412, CiteScore: 0)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 22, SJR: 0.329, CiteScore: 0)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 10, SJR: 1.392, CiteScore: 2)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 10, SJR: 0.183, CiteScore: 0)
Classical Receptions J.     Hybrid Journal   (Followers: 27, SJR: 0.123, CiteScore: 0)
Clean Energy     Open Access   (Followers: 1)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 69, SJR: 5.051, CiteScore: 5)
Communication Theory     Hybrid Journal   (Followers: 24, SJR: 2.424, CiteScore: 3)
Communication, Culture & Critique     Hybrid Journal   (Followers: 27, SJR: 0.222, CiteScore: 1)
Community Development J.     Hybrid Journal   (Followers: 27, SJR: 0.268, CiteScore: 1)
Computer J.     Hybrid Journal   (Followers: 9, SJR: 0.319, CiteScore: 1)
Conservation Physiology     Open Access   (Followers: 3, SJR: 1.818, CiteScore: 3)
Contemporary Women's Writing     Hybrid Journal   (Followers: 9, SJR: 0.121, CiteScore: 0)
Contributions to Political Economy     Hybrid Journal   (Followers: 6, SJR: 0.906, CiteScore: 1)
Critical Values     Full-text available via subscription  
Current Developments in Nutrition     Open Access   (Followers: 2)
Current Legal Problems     Hybrid Journal   (Followers: 29)
Current Zoology     Full-text available via subscription   (Followers: 3, SJR: 1.164, CiteScore: 2)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 9, SJR: 1.791, CiteScore: 3)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 14, SJR: 0.259, CiteScore: 1)
Diplomatic History     Hybrid Journal   (Followers: 21, SJR: 0.45, CiteScore: 1)
DNA Research     Open Access   (Followers: 5, SJR: 2.866, CiteScore: 6)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 4)
Early Music     Hybrid Journal   (Followers: 17, SJR: 0.139, CiteScore: 0)
Econometrics J.     Hybrid Journal   (Followers: 32, SJR: 2.926, CiteScore: 1)
Economic J.     Hybrid Journal   (Followers: 113, SJR: 5.161, CiteScore: 3)
Economic Policy     Hybrid Journal   (Followers: 46, SJR: 3.584, CiteScore: 3)
ELT J.     Hybrid Journal   (Followers: 24, SJR: 0.942, CiteScore: 1)
English Historical Review     Hybrid Journal   (Followers: 56, SJR: 0.612, CiteScore: 1)
English: J. of the English Association     Hybrid Journal   (Followers: 17, SJR: 0.1, CiteScore: 0)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.818, CiteScore: 2)
Environmental Epigenetics     Open Access   (Followers: 2)
Environmental History     Hybrid Journal   (Followers: 26, SJR: 0.408, CiteScore: 1)
EP-Europace     Hybrid Journal   (Followers: 3, SJR: 2.748, CiteScore: 4)
Epidemiologic Reviews     Hybrid Journal   (Followers: 9, SJR: 4.505, CiteScore: 8)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 19, SJR: 0.113, CiteScore: 0)
European Heart J.     Hybrid Journal   (Followers: 66, SJR: 9.315, CiteScore: 9)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 10, SJR: 3.625, CiteScore: 3)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 2)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. : Case Reports     Open Access  
European Heart J. Supplements     Hybrid Journal   (Followers: 8, SJR: 0.223, CiteScore: 0)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9, SJR: 1.681, CiteScore: 2)
European J. of Intl. Law     Hybrid Journal   (Followers: 201, SJR: 0.694, CiteScore: 1)
European J. of Orthodontics     Hybrid Journal   (Followers: 5, SJR: 1.279, CiteScore: 2)
European J. of Public Health     Hybrid Journal   (Followers: 20, SJR: 1.36, CiteScore: 2)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 10, SJR: 1.172, CiteScore: 2)
European Review of Economic History     Hybrid Journal   (Followers: 30, SJR: 0.702, CiteScore: 1)
European Sociological Review     Hybrid Journal   (Followers: 43, SJR: 2.728, CiteScore: 3)
Evolution, Medicine, and Public Health     Open Access   (Followers: 12)
Family Practice     Hybrid Journal   (Followers: 16, SJR: 1.018, CiteScore: 2)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 16, SJR: 1.492, CiteScore: 4)
Fems Microbiology Letters     Hybrid Journal   (Followers: 28, SJR: 0.79, CiteScore: 2)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 32, SJR: 7.063, CiteScore: 13)
Fems Yeast Research     Hybrid Journal   (Followers: 13, SJR: 1.308, CiteScore: 3)
Food Quality and Safety     Open Access   (Followers: 1)
Foreign Policy Analysis     Hybrid Journal   (Followers: 24, SJR: 1.425, CiteScore: 1)
Forest Science     Hybrid Journal   (Followers: 8, SJR: 0.89, CiteScore: 2)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 1.133, CiteScore: 3)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.104, CiteScore: 0)
French History     Hybrid Journal   (Followers: 33, SJR: 0.118, CiteScore: 0)
French Studies     Hybrid Journal   (Followers: 21, SJR: 0.148, CiteScore: 0)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.152, CiteScore: 0)
Gastroenterology Report     Open Access   (Followers: 2)
Genome Biology and Evolution     Open Access   (Followers: 16, SJR: 2.578, CiteScore: 4)
Geophysical J. Intl.     Hybrid Journal   (Followers: 39, SJR: 1.506, CiteScore: 3)
German History     Hybrid Journal   (Followers: 23, SJR: 0.161, CiteScore: 0)
GigaScience     Open Access   (Followers: 5, SJR: 5.022, CiteScore: 7)
Global Summitry     Hybrid Journal   (Followers: 1)
Glycobiology     Hybrid Journal   (Followers: 13, SJR: 1.493, CiteScore: 3)
Health and Social Work     Hybrid Journal   (Followers: 57, SJR: 0.388, CiteScore: 1)
Health Education Research     Hybrid Journal   (Followers: 16, SJR: 0.854, CiteScore: 2)
Health Policy and Planning     Hybrid Journal   (Followers: 24, SJR: 1.512, CiteScore: 2)
Health Promotion Intl.     Hybrid Journal   (Followers: 22, SJR: 0.812, CiteScore: 2)
History Workshop J.     Hybrid Journal   (Followers: 33, SJR: 1.278, CiteScore: 1)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 28, SJR: 0.105, CiteScore: 0)
Human Communication Research     Hybrid Journal   (Followers: 15, SJR: 2.146, CiteScore: 3)
Human Molecular Genetics     Hybrid Journal   (Followers: 9, SJR: 3.555, CiteScore: 5)
Human Reproduction     Hybrid Journal   (Followers: 72, SJR: 2.643, CiteScore: 5)
Human Reproduction Open     Open Access   (Followers: 1)
Human Reproduction Update     Hybrid Journal   (Followers: 20, SJR: 5.317, CiteScore: 10)
Human Rights Law Review     Hybrid Journal   (Followers: 62, SJR: 0.756, CiteScore: 1)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 58, SJR: 1.591, CiteScore: 3)
ICSID Review : Foreign Investment Law J.     Hybrid Journal   (Followers: 10)
ILAR J.     Hybrid Journal   (Followers: 2, SJR: 1.732, CiteScore: 4)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.679, CiteScore: 1)
IMA J. of Management Mathematics     Hybrid Journal   (SJR: 0.538, CiteScore: 1)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.496, CiteScore: 1)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 1.987, CiteScore: 2)
Industrial and Corporate Change     Hybrid Journal   (Followers: 9, SJR: 1.792, CiteScore: 2)
Industrial Law J.     Hybrid Journal   (Followers: 39, SJR: 0.249, CiteScore: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 47, SJR: 2.511, CiteScore: 4)
Information and Inference     Free  
Innovation in Aging     Open Access  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 9, SJR: 1.319, CiteScore: 2)
Integrative Biology     Full-text available via subscription   (Followers: 6, SJR: 1.36, CiteScore: 3)
Integrative Organismal Biology     Open Access  
Interacting with Computers     Hybrid Journal   (Followers: 11, SJR: 0.292, CiteScore: 1)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7, SJR: 0.762, CiteScore: 1)
Intl. Affairs     Hybrid Journal   (Followers: 66, SJR: 1.505, CiteScore: 3)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 26)
Intl. Health     Hybrid Journal   (Followers: 6, SJR: 0.851, CiteScore: 2)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 2.167, CiteScore: 4)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 36, SJR: 1.348, CiteScore: 2)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 64, SJR: 0.601, CiteScore: 1)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 246, SJR: 3.969, CiteScore: 5)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 5, SJR: 0.202, CiteScore: 1)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 28, SJR: 0.223, CiteScore: 1)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 10, SJR: 0.285, CiteScore: 1)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.403, CiteScore: 1)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.808, CiteScore: 4)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 11, SJR: 1.545, CiteScore: 1)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 38, SJR: 0.389, CiteScore: 1)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 11, SJR: 0.724, CiteScore: 2)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.168, CiteScore: 1)
Intl. Political Sociology     Hybrid Journal   (Followers: 40, SJR: 1.465, CiteScore: 3)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 23, SJR: 0.401, CiteScore: 1)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 9, SJR: 0.983, CiteScore: 1)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 49, SJR: 2.581, CiteScore: 2)
Intl. Studies Review     Hybrid Journal   (Followers: 25, SJR: 1.201, CiteScore: 1)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 2, SJR: 0.15, CiteScore: 0)
ITNOW     Hybrid Journal   (Followers: 1, SJR: 0.103, CiteScore: 0)
J. of African Economies     Hybrid Journal   (Followers: 17, SJR: 0.533, CiteScore: 1)
J. of American History     Hybrid Journal   (Followers: 46, SJR: 0.297, CiteScore: 1)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 14, SJR: 1.065, CiteScore: 2)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 15, SJR: 2.419, CiteScore: 4)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 5, SJR: 0.585, CiteScore: 1)
J. of Biochemistry     Hybrid Journal   (Followers: 41, SJR: 1.226, CiteScore: 2)
J. of Breast Imaging     Full-text available via subscription  
J. of Burn Care & Research     Hybrid Journal   (Followers: 10, SJR: 0.768, CiteScore: 2)

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Similar Journals
Journal Cover
Inflammatory Bowel Diseases
Journal Prestige (SJR): 2.511
Citation Impact (citeScore): 4
Number of Followers: 47  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1078-0998 - ISSN (Online) 1536-4844
Published by Oxford University Press Homepage  [406 journals]
  • Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report
           From the American Gastroenterological Association IBD Parenthood Project
           Working Group
    • Authors: Mahadevan U; Robinson C, Bernasko N, et al.
      Pages: 627 - 641
      Abstract: This article is being published jointly in Inflammatory Bowel Diseases, American Journal of Obstetrics and Gynecology, and Gastroenterology.
      PubDate: Fri, 01 Mar 2019 00:00:00 GMT
      DOI: 10.1093/ibd/izz037
      Issue No: Vol. 25, No. 4 (2019)
       
  • A JAK1 Selective Kinase Inhibitor and Tofacitinib Affect Macrophage
           Activation and Function
    • Authors: De Vries L; Duarte J, De Krijger M, et al.
      Pages: 647 - 660
      Abstract: BackgroundJanus kinases (JAKs) mediate cytokine signaling involved in inflammatory bowel disease. The pan-JAK inhibitor tofacitinib has shown efficacy in the treatment of ulcerative colitis. However, concerns regarding adverse events due to their wide spectrum inhibition fueled efforts to develop selective JAK inhibitors. Given the crucial role of myeloid cells in intestinal immune homeostasis, we evaluated the effect of pan-JAK and selective JAK inhibitors on pro- and anti-inflammatory macrophage polarization and function (M1/M2) and in experimental colitis.MethodsMurine bone marrow–derived macrophages or human monocytes were treated using JAK1 and JAK3 selective inhibitors (JAK1i;JAK3i) and tofacitinib and were evaluated by transcriptional, functional, and metabolic analyses. In vivo, oral administration of JAK1i and tofacitinib (10 or 30 mg/kg) was tested in both acute and acute rescue dextran sodium sulfate (DSS) colitis.ResultsBoth tofacitinib and JAK1i but not JAK3i effectively inhibited STAT1 phosphorylation and interferon gamma–induced transcripts in M1 polarized macrophages. Strikingly, transcriptional profiling suggested a switch from M1 to M2 type macrophages, which was supported by increased protein expression of M2-associated markers. In addition, both inhibitors enhanced oxidative phosphorylation rates. In vivo, JAK1i and tofacitinib did not protect mice from acute DSS-induced colitis but ameliorated recovery from weight loss and disease activity during acute rescue DSS-induced colitis at the highest dose.ConclusionJAK1i and tofacitinib but not JAK3i induce phenotypical and functional characteristics of anti-inflammatory macrophages, suggesting JAK1 as the main effector pathway for tofacitinib in these cells. In vivo, JAK1i and tofacitinib modestly affect acute rescue DSS-induced colitis.
      PubDate: Sat, 19 Jan 2019 00:00:00 GMT
      DOI: 10.1093/ibd/izy364
      Issue No: Vol. 25, No. 4 (2019)
       
  • Small Bowel Inflammation in Crohn’s Disease and Other Conditions
    • Authors: Sorrentino D; Nguyen V.
      Abstract: To the Editor:
      PubDate: Tue, 11 Sep 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy286
      Issue No: Vol. 25, No. 4 (2018)
       
  • The Role of Autologous Fecal Microbiota Transplantation in Diversion
           Colitis: A Case Report
    • Authors: Kalla R; Pitt M, Sharma A.
      Abstract: To the Editor:
      PubDate: Fri, 24 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy270
      Issue No: Vol. 25, No. 4 (2018)
       
  • The Effect of Smoking on the Risk of Pouchitis in Ulcerative Colitis
           Patients With Ileal Pouch-anal Anastomosis
    • Authors: Dai C; Jiang M, Sun M.
      Abstract: To the Editors:
      PubDate: Tue, 14 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy260
      Issue No: Vol. 25, No. 4 (2018)
       
  • Response to the Letter to the Editor from Dai et al, Regarding “Smoking
           and the Risk of Pouchitis in Ulcerative Colitis Patients with Ileal Pouch
           Anal Anastomosis”
    • Authors: Gorrepati V; Stuart A, Deiling S, et al.
      Abstract: To the Editors:
      PubDate: Mon, 13 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy261
      Issue No: Vol. 25, No. 4 (2018)
       
  • Infliximab Has a Number of Well-Described Adverse Effects. Is Myeloid
           Metaplasia One of These in Elderly Long-standing IBD Patients'
    • Authors: Caruso M; Cavalcanti E, Ignazzi A, et al.
      Abstract: To the Editor:
      PubDate: Mon, 13 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy262
      Issue No: Vol. 25, No. 4 (2018)
       
  • Crohn’s Disease–Like Ileitis and the Inhibitory Effect of
           Sucralose on Streptococci
    • Authors: Rodriguez-Palacios A; Cominelli F.
      Abstract: To the Editor:
      PubDate: Mon, 06 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy251
      Issue No: Vol. 25, No. 4 (2018)
       
  • Is Splenda, or Sucralose, Causally Linked to Inflammatory Bowel
           Disease'
    • Authors: Lynch B; Roberts A, Lee Grotz V.
      Abstract: To the Editor:
      PubDate: Mon, 06 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy250
      Issue No: Vol. 25, No. 4 (2018)
       
  • High-grade MiNEN in a Long-standing History of Ulcerative Colitis: An
           Unexpected Evolution
    • Authors: Guadagno E; De Rosa F, Borrelli G, et al.
      Abstract: To the Editor:
      PubDate: Mon, 06 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy257
      Issue No: Vol. 25, No. 4 (2018)
       
  • Clinical Potential of Anti-inflammatory Effects of Faecalibacterium
           prausnitzii and Butyrate in Inflammatory Bowel Disease
    • Authors: Sitkin S; Pokrotnieks J.
      Abstract: To the Editor:
      PubDate: Mon, 06 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy258
      Issue No: Vol. 25, No. 4 (2018)
       
  • A Diagnosis of Inflammatory Bowel Disease and Access to Psychotherapy:
           Rural Patients Who Accept Treatment Report Psychosomatic Benefits
    • Authors: Watt P; Irving M.
      Abstract: To the Editor:
      PubDate: Sat, 21 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy245
      Issue No: Vol. 25, No. 4 (2018)
       
  • Ulcerative Colitis and Atypical Hemolytic-Uremic Syndrome: An Unusual But
           Potentially Life-threatening Complication
    • Authors: Viada Bris J; Velasco Rodríguez-Belvís M, de Lucas Collantes C, et al.
      Abstract: Hemolytic-uremic syndrome (HUS) is defined as the triad of nonimmune hemolytic anemia, thrombocytopenia, and acute renal failure, in which the underlying lesions are mediated by systemic thrombotic microangiopathy (TMA). The atypical HUS (aHUS) can be considered a subtype of HUS that is rare in childhood and has a worse prognosis. Recent findings have established that the TMA in aHUS are consequences of the disregulation of the complement activation, leading to endotelial damage mediated by the complement terminal pathway.1, 2 Likewise, previous research suggests an important role for the deregulation of the alternative complement cascade in the pathogenesis of inflammatory bowel disease (IBD).3, 4 We report the case of a patient with ulcerative colitis (UC) who developed aHUS during a flare-up of her chronic disease. This association is extremely infrequent and had been previously reported in only 1 patient.5
      PubDate: Wed, 20 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy226
      Issue No: Vol. 25, No. 4 (2018)
       
  • Financial Conflicts of Interest in Inflammatory Bowel Disease Guidelines
    • Authors: Grindal A; Khan R, Scaffidi M, et al.
      Pages: 642 - 645
      Abstract: BackgroundIndustry payments can lead to financial conflicts of interest (FCOI) among authors of clinical practice guidelines (CPGs). Guidelines for inflammatory bowel disease (IBD) may be at particularly high risk. We determined the prevalence of FCOI in IBD CPGs produced by various gastroenterology societies.MethodsWe conducted a cross-sectional analysis of FCOI disclosure among CPGs related to the management of IBD. We ascertained the prevalence and types of FCOI for each guideline and determined adherence to National Academy of Medicine (NAM) standards. FCOI disclosures were compared between societies producing CPGs.ResultsWe identified 11 relevant CPGs with 173 total authors. There were 117 (68%) authors who declared a payment. A total of 107 (62%) authors declared FCOI related to a medication recommended in the guideline. There was a significant difference (P < 0.001) between the proportion of authors with FCOI between countries or regions.
      Authors of US CPGs had a significantly lower FCOI prevalence (19%) compared with other societies.
      Authors of UK CPGs had a significantly lower FCOI prevalence (56%) compared with Canadian (84%) and European (94%) CPGs. Three (27%) guidelines adhered to both NAM standards.ConclusionsA substantial portion of authors of IBD CPGs had FCOI. Our study found a significant difference in FCOI prevalence based on CPG sponsor nationality. Most CPGs for IBD did not adhere to NAM standards for FCOI disclosure.
      PubDate: Fri, 05 Oct 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy315
      Issue No: Vol. 25, No. 4 (2018)
       
  • Conflicts of Interest in Clinical Practice Guidelines
    • Authors: Lashner B; Cominelli F.
      Pages: 646 - 646
      Abstract: Clinical practice guidelines (CPGs) are important documents that greatly influence patient care. They are meant to reduce variability among health care providers so patients receive more consistent high-quality care. Considering that CPGs are cited frequently, as editors, we need to be certain that guidelines published in Inflammatory Bowel Diseases are as free of bias as possible. Influence from a pharmaceutical company, whether direct or through unrevealed conflicts of interest needs to be avoided to ensure confidence by physicians and patients in the recommendations of the guidelines.
      PubDate: Fri, 05 Oct 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy317
      Issue No: Vol. 25, No. 4 (2018)
       
  • Interactions Between Autophagy and the Unfolded Protein Response:
           Implications for Inflammatory Bowel Disease
    • Authors: Hooper K; Barlow P, Henderson P, et al.
      Pages: 661 - 671
      Abstract: Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis, is characterized by chronic inflammation of the gastrointestinal tract. The etiology involves a combination of genetic and environmental factors resulting in abnormal immune responses to intestinal microbiota. Genetic studies have strongly linked genes involved in autophagy to CD, and genes involved in the unfolded protein response (UPR) to IBD. The UPR is triggered in response to accumulation of misfolded proteins in the endoplasmic reticulum (ER), and autophagy plays a key role in relieving ER stress and restoring homeostasis. This review summarizes the known interactions between autophagy and the UPR and discusses the impact of these converging pathways on IBD pathogenesis. With a paucity of effective long-term treatments for IBD, targeting of synergistic pathways may provide novel and more effective therapeutic options.
      PubDate: Mon, 24 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy380
      Issue No: Vol. 25, No. 4 (2018)
       
  • Smoking and Risk of Microscopic Colitis: A Systematic Review and
           Meta-analysis
    • Authors: Jaruvongvanich V; Poonsombudlert K, Ungprasert P.
      Pages: 672 - 678
      Abstract: BackgroundThe association between smoking and inflammatory bowel disease has long been recognized, but its role in the development of microscopic colitis is less well defined. This systematic review and meta-analysis was conducted with the aims to identify all available studies on the association between smoking and risk of microscopic colitis and to synthesize their results.MethodsThe MEDLINE and EMBASE databases were searched from inception to May 2018 for cohort studies and case–control studies that compared the risk of microscopic colitis among current/former smokers vs individuals who have never smoked. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were extracted from the included studies and pooled together using a random-effects model, generic inverse variance method of DerSimonian and Laird. Between-study heterogeneity was quantified using the Q statistic and I2. Publication bias was assessed using funnel plots.ResultsSeven studies (2 cohort studies and 5 case–control studies) with 262,312 participants met the eligibility criteria and were included in the meta-analysis. Relative to never-smokers, current smokers had significantly increased odds of microscopic colitis, with a pooled OR of 2.99 (95% CI, 2.15–4.15; I2, 64%). Former smokers also had significantly higher odds of microscopic colitis compared with never-smokers, with a pooled OR of 1.63 (95% CI, 1.37–1.94; I2, 0%). Funnel plots were symmetric and did not provide suggestive evidence of publication bias for both analyses.ConclusionsThe current systematic review and meta-analysis found a significantly higher risk of microscopic colitis among current smokers compared with never-smokers. The risk attenuated among former smokers but remained significantly higher among never-smokers.
      PubDate: Thu, 20 Sep 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy296
      Issue No: Vol. 25, No. 4 (2018)
       
  • Reporting Colonic Biopsies in Patients With Inflammatory Bowel Disease; a
           Practical Approach
    • Authors: Haboubi N.
      Pages: 679 - 684
      Abstract: Crohn’s disease (CD) and ulcerative colitis (UC) are common diseases; for convenience, we lump them together as inflammatory bowel disease (IBD). Colonic biopsies are essential for establishing a diagnosis, monitoring treatment, and/or identifying complications. This article attempts to detail the histological criteria of UC and CD and also informs on a lifelong approach of reporting colonic biopsies from patients with IBD. Often the clinical information on the accompanying request form is not available to the pathologist. In these cases, the author has initiated a reproducible system of pattern-based reporting with a differential diagnosis. This type of report offers a working diagnosis for the clinician before the final diagnosis, which is recommended to be undertaken in a setting of combined clinico-pathological conference (CPC). This system carries objective parameters and standardizes reporting to significantly minimize the interobserver variations among reporting pathologists. If a CPC facility is not available, we offer an alternative evidence-based arrangement. We discourage the use the term “nonspecific colitis” as we have shown that it has no clinical value or agreed-upon and recognized histopathological features. As the paper addresses mucosal biopsies, the entity of indeterminate colitis will not be included in this article as this diagnosis is strictly based on colonic resectate.10.1093/ibd/izy288_video1izy288.video15839278247001
      PubDate: Tue, 25 Sep 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy288
      Issue No: Vol. 25, No. 4 (2018)
       
  • A Systematic Review of Self-Management Interventions for Children and
           Adolescents With Inflammatory Bowel Disease
    • Authors: Tran L; Mulligan K.
      Pages: 685 - 698
      Abstract: BackgroundSelf-management of inflammatory bowel disease is complex. Children and adolescents (CA) with inflammatory bowel disease (IBD) often have difficulty with managing aspects of their condition, resulting in treatment nonadherence and impaired psychosocial function. Self-management interventions are developed to help support patients and their parents/carers to effectively self-manage. The aim of this systematic review was to evaluate the efficacy of self-management interventions in children and adolescents with IBD.MethodsThe review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic literature search of the following databases was conducted to identify controlled trials of interventions aiming to enhance IBD self-management in CA: Medline, Embase, Cochrane, CINAHL, and PsychINFO. Two reviewers screened articles for inclusion.ResultsNine trials (11 articles) met the inclusion criteria. Most were underpowered, with 7 recruiting fewer than 50 participants. The interventions aimed to enhance psychological well-being (n = 5), medication adherence (n = 3), or calcium intake (n = 1). There was considerable heterogeneity in intervention content and outcomes assessment. Some benefits were reported in disease activity, adherence, and psychological well-being, but findings were inconsistent.ConclusionsSelf-management is difficult for CA with IBD; however, this review identified only a small number of interventions to support self-management, most of which were underpowered and only 1 that was conducted outside the United States. Clinical consensus is required on which self-management activities should be recommended to patients and targeted in interventions and which core outcomes should be assessed. Adequately powered trials of interventions are required to identify how best to support self-management in CA with IBD.
      PubDate: Fri, 05 Oct 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy299
      Issue No: Vol. 25, No. 4 (2018)
       
  • Inflammatory Bowel Diseases Were Associated With Risk of Sexual
           Dysfunction in Both Sexes: A Meta-analysis
    • Authors: Zhao S; Wang J, Liu Y, et al.
      Pages: 699 - 707
      Abstract: BackgroundAn association between inflammatory bowel diseases (IBD) and increased susceptibility to sexual dysfunction (SD) was reported in a number of studies.MethodMEDLINE (PubMed), EMBASE, and the Cochrane Library were systematically searched for all relevant studies reporting the sexual function in IBD patients. Relative risk (RR) with a 95% confidence interval (CI) was used to summarize the association between IBD and risk of SD. Subgroup and sensitivity analyses were applied to detect potential bias.ResultsOverall, 351,668 male individuals and 1309 female individuals (the mean age ranged from 33.6 years to 52.4 years) were included from 8 studies (of which 4 studies provided the outcomes of both sexes). Synthesis of results revealed that IBD was significantly associated with an elevated risk of SD in male subjects (7 studies, RR = 1.41, 95% CI, 1.09–1.81, P = 0.008; heterogeneity: I2 = 80.2%, P < 0.001) and female subjects (5 studies, RR = 1.76, 95% CI, 1.28–2.42, P < 0.001; heterogeneity: I2 = 69.6%, P = 0.011). Stratified analysis by the mean age of the individuals indicated that patients with IBD with a relatively young age (male: younger than 50 years; female: younger than 40 years) exhibited a significantly increased odds of SD. Sensitivity analyses showed that no single study dominated the overall combined RR.ConclusionEvidence from this meta-analysis revealed that both male and female patients with IBD have a significantly increased risk of SD, which should remind both gastroenterologists and urologists to be aware of the potential hazardous effect of IBD for developing SD.
      PubDate: Fri, 23 Nov 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy345
      Issue No: Vol. 25, No. 4 (2018)
       
  • A Meta-analysis of Sexual Function in Patients With Inflammatory Bowel
           Disease: Examining a Small Piece of the Puzzle
    • Authors: Friedman S.
      Pages: 708 - 710
      Abstract: Crohn’s disease and ulcerative colitis most commonly occur during the peak reproductive years. Young patients must often cope with debilitating symptoms of diarrhea, abdominal pain, and perianal fistulae and the impact of medical and surgical treatment on sexual function and reproductive outcomes. It is understandably difficult to manage sometimes-severe symptoms, side effects of medications, and the uncertainties of living with a chronic illness while trying to engage in sexual relationships. Patients with inflammatory bowel disease (IBD) report increased depression and anxiety, poor body image, and increased worry and concern when considering sex.1, 2 Two new validated questionnaires that measure sexual function in women and men with IBD, respectively, the IBD – Female Sexual Dysfunction Scale (IBD-FSDS) and the IBD – Male Sexual Dysfunction Scale (IBS-MSDS), demonstrate that sexual dysfunction is associated with depression and increased disease activity in women3 and depression, increased disease activity, and a history of an ileoanal pouch anastomosis (IPAA) in men.4 As these 2 questionnaires were specifically validated for patients with IBD, they did not, by necessity, contain control groups but rather used the “gold standard” Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF) for comparison.
      PubDate: Fri, 23 Nov 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy348
      Issue No: Vol. 25, No. 4 (2018)
       
  • Antibiotics Potentiate Adherent-Invasive E. coli Infection and Expansion
    • Authors: Oberc A; Fiebig-Comyn A, Tsai C, et al.
      Pages: 711 - 721
      Abstract: BackgroundCrohn’s disease (CD) is an inflammatory bowel disease with a complex etiology. Paradoxically, CD is associated with the use of antibiotics and with an increased abundance of an unusual phenotypic group of Escherichia coli known as adherent-invasive E. coli (AIEC). However, the impact of antibiotics on AIEC infection has not been well studied in controlled models of infection.MethodsWe infected mice with AIEC before or after treatment with a variety of different classes of antibiotics. We assessed levels of AIEC in the feces and tissues, AIEC localization by immunofluorescence microscopy, and tissue pathology.ResultsWe found that a wide range of antibiotic classes strongly potentiated initial AIEC infection and expanded AIEC in chronically infected mice. We found that the ability of antibiotics to potentiate AIEC infection did not correlate with a stereotyped shift in the gut bacterial community but was correlated with a decrease in overall diversity and a divergence from the pre-antibiotic state. We found that antibiotic-induced inflammation provided a fitness advantage for AIEC expansion through their use of oxidized metabolites in the postantibiotic period.ConclusionsOur results show that antibiotics can render hosts more susceptible to initial AIEC infection and can worsen infection in previously colonized hosts. AIEC appears to exploit host inflammatory responses that arise in the postantibiotic period, highlighting a previously unknown interaction between CD risk factors.
      PubDate: Thu, 29 Nov 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy361
      Issue No: Vol. 25, No. 4 (2018)
       
  • Difference in Pathomechanism Between Crohn’s Disease and Ulcerative
           Colitis Revealed by Colon Transcriptome
    • Authors: Yang L; Tang S, Baker S, et al.
      Pages: 722 - 731
      Abstract: BackgroundWe aim to identify the differences in colonic mucosal transcriptome between Crohn’s disease (CD) and ulcerative colitis (UC) for a better understanding of the molecular pathology.MethodsDifferentially expressed genes (DEG) in the colonic mucosa of CD and UC were identified with a global gene expression microarray dataset generated from the colon biopsies of CD and UC patients and normal controls. The DEGs were then processed to identify altered pathways and modularized DEGs and pathways. Quantitative real-time polymerase chain reaction (qRT-PCR) analysis with an independent cohort of samples was performed to validate the microarray data.ResultsAt the pathway level, virus infection and autoimmune pathways were upregulated in CD but not in UC when compared with controls. Some of the relevant DEGs (such as TAP1 and TAP2) were elevated in both CD and UC, with CD exhibiting more pronounced elevations. Gene expression levels in viral infection pathways were correlated with those of autoimmune pathways. In contrast, pattern recognition–mediated innate immune pathways (TLR4 and TLR2) were significantly elevated in UC but not in CD. Similar results were observed with an independent cohort by qRT-PCR.ConclusionsOur data support the hypothesis that viral infection induced autoimmunity may represent a pathomechanism for IBD, especially CD. However, pattern recognition–mediated innate immunity targeting microbiome may play a more important role in UC compared with CD. Our findings identified different intervention targets for CD and UC, which may lead to more effective treatments for IBD patients.
      PubDate: Tue, 04 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy359
      Issue No: Vol. 25, No. 4 (2018)
       
  • Tenascin-C Produced by Intestinal Myofibroblasts Promotes
           Colitis-associated Cancer Development Through Angiogenesis
    • Authors: Kawamura T; Yamamoto M, Suzuki K, et al.
      Pages: 732 - 741
      Abstract: ABSTRACTBackgroundColitis-associated cancer (CAC) is one of the prognostic factors in inflammatory bowel disease (IBD), and prevention of CAC is a critical concern for patients with IBD. Component cells of the microenvironment, especially myofibroblasts, are known to affect tumor development, but the role of intestinal myofibroblasts (IMFs) in CAC has not been clarified. Here, we explored the role of IMFs in CAC and sought to identify candidate genes as novel therapeutic targets for the prevention of CAC.MethodsWe used the azoxymethane (AOM)/dextran sodium sulfate (DSS) model for dysplasia and CAC. Flow cytometry and RNA sequencing (RNA-seq) were performed to obtain an unbiased gene expression profile of IMFs. The transcriptome of significantly differentially expressed genes was analyzed by RNA-seq, quantitative reverse transcriptase polymerase chain reaction, and immunohistochemistry.ResultsComparison of normal intestinal fibroblasts and IMFs revealed 1045 genes with significantly differential expression. Among them, we focused on tenascin-C (TNC; q = 0.00232, Log2(Fold Change) = 3.87). Tenascin-C gene expression was markedly increased in the dysplasia model compared with control and CAC model (P < 0.05). Tenascin-C protein was barely expressed in normal and nondysplastic mucosa but strongly expressed in the stroma around dysplastic lesions. Moreover, TNC surrounded and enclosed integrin αvβ3–positive microvessels. Administration of ATN-161, an antagonist of αvβ3-integrin, significantly suppressed tumorigenesis of CAC through inhibition of angiogenesis (P < 0.05).ConclusionsIn the early stages of CAC, TNC produced by IMFs affects tumor development via integrin αvβ3-mediated angiogenesis. Intestinal myofibroblasts might be a novel therapeutic target for preventing CAC.
      PubDate: Tue, 04 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy368
      Issue No: Vol. 25, No. 4 (2018)
       
  • Starch Consumption May Modify Antiglycan Antibodies and Fecal Fungal
           Composition in Patients With Ileo-Anal Pouch
    • Authors: Goren I; Godny L, Reshef L, et al.
      Pages: 742 - 749
      Abstract: BackgroundInflammatory bowel diseases (IBDs) are characterized by serologic responses to glycans. Patients with ulcerative colitis (UC) after proctocolectomy with ileo-anal anastomosis (pouch surgery) may develop inflammation (pouchitis) that resembles Crohn’s disease (CD). We hypothesized that patients’ serologic responses were affected by their consumption of dietary sugars. This study analyzed the correlations between antiglycan antibody expression and dietary sugar consumption in patients with UC pouch and the evolution in antibody levels over time.MethodsPatients were followed prospectively for 2 consecutive visits. The following antiglycan carbohydrate antibodies were detected by enzyme-linked immunosorbent assay: antichitobioside (ACCA), antilaminaribioside (ALCA), antimannobioside (AMCA), and anti–Saccharomyces cerevisiae (ASCA) antibodies. Patients completed a food frequency questionnaire. The fungal community in patients’ fecal samples was analyzed by sequencing the internal transcribed spacer 2 (ITS2) region of nuclear ribosomal DNA.ResultsWe included 75 UC pouch patients aged 45.2 ± 14 years who underwent pouch surgery 9.8 ± 6.7 years previously. Of these patients, 34.7% (n = 26) showed seropositivity for antiglycan antibodies. Starch consumption was significantly higher in patients with positive serologic responses (P = 0.05). Higher starch consumption was associated with higher AMCA and ACCA titers, which increased by 4.08% (0.8%–7.4%; P = 0.014) and 4.8% (0.7%–9.1%; P = 0.007), respectively, for each 10-g increase of dietary starch. The per-patient change in the relative abundance of Candida albicans in fecal samples correlated positively with changes in starch consumption (Spearman’s r = 0.72; P = 0.012).ConclusionsStarch consumption correlated with positive antiglycan serology (ACCA and AMCA), suggesting that increased dietary starch intake may promote a specific immune response in patients with IBD.
      PubDate: Tue, 11 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy370
      Issue No: Vol. 25, No. 4 (2018)
       
  • Second-Look Endoscopy in Hospitalized Severe Ulcerative Colitis: A
           Retrospective Cohort Study
    • Authors: Borren N; Khalili H, Luther J, et al.
      Pages: 750 - 755
      Abstract: BackgroundAcute severe ulcerative colitis (ASUC) is a serious complication of ulcerative colitis (UC). Management of partial responders to steroids or rescue therapy remains challenging. Whether there is a role for re-look sigmoidoscopic evaluation in disease management is unknown.MethodsOur study cohort consisted of patients who underwent 2 sigmoidoscopic procedures during the same index hospitalization for ASUC at our center. Reasons for repeat endoscopic evaluation and endoscopic and histologic severity of inflammation during both procedures were noted. Multivariable regression models were performed to identify predictors of improvement at the second endoscopic assessment and to determine the independent effect of such an improvement on in-hospital colectomy and at 3, 6, and 12 months.ResultsOur study included 49 patients (mean age, 42 years; 52% women). Just under one-third of patients (30%) were noted to have improved endoscopic appearance at the second sigmoidoscopy, at a median of 9 days after initial exam. None of the patients who had improvement on the second endoscopy underwent in-hospital colectomy, compared with 46% of those with worsening or persistent disease (P = 0.002). Similar differences in the improved group persisted at 3 months (P = 0.007) and 6 months (P = 0.027). Histologic severity at the first endoscopy was associated with increased risk of colectomy in-hospital (odds ratio, 3.8; 95% confidence interval, 1.02–14.21) and at 3 and 6 months.ConclusionsAfter a median interval of 9 days, endoscopic improvement was noted in 30% of patients with ASUC undergoing a second sigmoidoscopy, which predicted lower rates of colectomy in-hospital and at 3 and 6 months.
      PubDate: Tue, 11 Sep 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy282
      Issue No: Vol. 25, No. 4 (2018)
       
  • Phenotypic Characterization of Very Early-Onset Inflammatory Bowel Disease
           with Interleukin-10 Signaling Deficiency: Based on a Large Cohort Study
    • Authors: Zheng C; Huang Y, Hu W, et al.
      Pages: 756 - 766
      Abstract: BackgroundInterleukin-10 (IL10)/interleukin-10 receptor (IL10R) deficiency is a rare disease with life-threatening infantile-onset colitis. We sought to accurately phenotype this disorder based on a large cohort of patients with a proven defect of IL10 signaling and to clarify the effects of allogeneic hematopoietic stem cell transplantation (HSCT).MethodsWe analyzed the phenotypes of our 61 patients and reviewed 78 other previously reported cases with identified mutations in the genes encoding IL10 or IL10R. We also compared the clinical features of patients with interleukin-10 receptor B (IL10RB), interleukin-10 receptor A (IL10RA), and IL10 mutations. The therapeutic effects of allogeneic HSCT were evaluated.ResultsWe found that the disease onset time was extremely early: 70.3% within 30 days postnatal and 94.9% within the first 6 months of life. In addition, 94.2% of patients typically presented with perianal lesions. Oral ulcers and skin rash were common extra-intestinal manifestations (33.8% and 51.8%, respectively). There was no statistically significant difference in disease onset time, perianal lesion involvement, or mortality rate among patients with IL10RB, IL10RA, or IL10 deficiency. However, the surgery rate was higher in patients with IL10RB mutations than in those with IL10 or IL10RA mutations (P < 0.05). Compared with those with IL10RA deficiency, a higher percentage (32%, 9 of 28) of patients with IL10RB mutations developed B-cell lymphoma (P < 0.01). Compared with other regions, a higher percentage (98.7%) of IL10RA mutations was detected among patients in East Asia countries (P < 0.01), with hot-spot mutation sites of c.C301T and c.G537A. Allogeneic HSCT is efficacious but has a high mortality rate (17.5%, 7 of 40).ConclusionsOur study expands the current knowledge on the genotype-correlated phenotypes with a defect of IL10 signaling. B-cell lymphoma was more frequent than would be expected in patients with IL10RB mutations. There may be a unique genetic architecture among Eastern Asia compared with other populations. Although allogeneic HSCT represents a causal therapeutic approach for IL10-and IL10R-deficient patients, a word of caution is warranted.
      PubDate: Thu, 13 Sep 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy289
      Issue No: Vol. 25, No. 4 (2018)
       
  • Ustekinumab Is Effective for the Treatment of Crohn’s Disease of the
           Pouch in a Multicenter Cohort
    • Authors: Weaver K; Gregory M, Syal G, et al.
      Pages: 767 - 774
      Abstract: BackgroundCrohn’s disease (CD) of the pouch and chronic pouchitis occur in approximately 10% of patients after ileal pouch–anal anastomosis (IPAA) for refractory ulcerative colitis (UC) or UC-related dysplasia. The efficacy of anti–tumor necrosis factor (anti-TNF) agents and vedolizumab have been reported for the treatment of CD of the pouch and chronic pouchitis, but little is known regarding the use of ustekinumab in these settings. Our primary aim was to evaluate the efficacy of ustekinumab for these conditions.MethodsThis is a retrospective, multicenter cohort study evaluating the efficacy of ustekinumab in patients with CD of the pouch and chronic pouchitis. Clinical response or remission was judged by the treating physician’s assessment at 6 months.ResultsFifty-six patients (47 with CD of the pouch and 9 with chronic pouchitis) were included the study. Of these, 73% had previously been treated with either anti-TNF therapy, vedolizumab, or both after IPAA. Among patients with CD of the pouch and chronic pouchitis, 83% demonstrated clinical response 6 months after induction with ustekinumab. Responders demonstrated significantly less pouch inflammation on endoscopy when compared with nonresponders (29% vs 100%; P = 0.023). Higher mean body mass index at induction (26.3 vs 23.7; P = 0.033) and male sex (83% vs 30%; P = 0.014) were significant predictors of nonresponse to ustekinumab in those with CD of the pouch.ConclusionIn this refractory patient population, ustekinumab appears to be a safe and effective treatment for chronic pouchitis and CD of the pouch in biologic-naïve patients and those with prior anti-TNF or vedolizumab therapy failure.10.1093/ibd/izx005_video1izy302.video15844889626001
      PubDate: Fri, 05 Oct 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy302
      Issue No: Vol. 25, No. 4 (2018)
       
  • Escalation of Immunosuppressive Therapy for Inflammatory Bowel Disease Is
           Not Associated With Adverse Outcomes After Infection With Clostridium
           difficile
    • Authors: Lukin D; Lawlor G, Hudesman D, et al.
      Pages: 775 - 781
      Abstract: BackgroundClostridium difficile infection (CDI) is common in patients with inflammatory bowel disease (IBD), often leading to diagnostic confusion and delays in IBD therapy escalation. This study sought to assess outcomes after CDI in IBD patients exposed to new or escalated immunosuppressive therapy.MethodsThis multicenter retrospective cohort study included IBD patients with documented CDI at 4 academic medical centers. Data were abstracted from clinical databases at each institution. Outcomes at 30 and 90 days were compared between patients undergoing new or intensified immunosuppressive therapy and those without therapy escalation. Continuous variables were compared using t tests, and proportions using chi-square tests. Multivariable logistic regression was used to determine the association of individual variables with severe outcomes (including death, sepsis, and/or colectomy) within 90 days. Secondary outcomes included CDI recurrence, rehospitalization, worsening of IBD, and severe outcomes within 30 days.ResultsA total of 207 adult patients with IBD and CDI were included, of whom 62 underwent escalation to biologic or corticosteroid therapy (median time to escalation, 13 days). Severe outcomes within 90 days occurred in 21 (15.6%) nonescalated and 1 (1.8%) therapy-escalated patients. Serum albumin <2.5 mg/dL, lactate >2.2 mg/dL, intensive care unit admission, hypotension, and comorbid disease were associated with severe outcomes. Likelihood of severe outcomes was decreased in patients undergoing escalation of IBD therapy after CDI (adjusted odds ratio [aOR], 0.12) and increased among patients aged >65 years (aOR, 4.55).ConclusionsTherapy escalation for IBD within 90 days of CDI was not associated with worse clinical outcomes. Initiation of immunosuppression for active IBD may therefore be appropriate in carefully selected patients after treatment of CDI.
      PubDate: Fri, 12 Oct 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy308
      Issue No: Vol. 25, No. 4 (2018)
       
  • Efficacy of Therapeutic Intervention for Patients With an Ulcerative
           Colitis Mayo Endoscopic Score of 1
    • Authors: Fukuda T; Naganuma M, Sugimoto S, et al.
      Pages: 782 - 788
      Abstract: BackgroundMucosal healing (MH) is proposed as a therapeutic target for ulcerative colitis (UC). Recent studies have indicated that the rate of clinical relapse in patients with a Mayo endoscopic score (MES) of 1 is higher than that of patients with an MES of 0. However, no study has yet investigated whether therapeutic intervention prevents clinical relapse in patients with an MES of 1.MethodsPatients with UC with an MES of 1 and partial Mayo score ≤2 were included in this study. All patients were followed from first colonoscopy (CS) until follow-up CS. Differences in the rate of clinical relapse (requiring additional treatment for UC) or endoscopic exacerbation (MES ≥2 and proximal extension) were compared between the therapeutic intervention (immediately after first CS) group and the nontherapeutic intervention group; risk factors for relapse were also assessed.ResultsAmong 1523 patients with UC who underwent CS between 2013 and 2016, 220 patients were included in this study. The rate of clinical relapse (P = 0.005) and endoscopic exacerbation (P = 0.11) in patients with therapeutic intervention was lower than that in patients without therapeutic intervention. Multivariable analysis indicated that absence of therapeutic intervention (P = 0.001 for clinical relapse, P = 0.050 for endoscopic exacerbation) and a higher Ulcerative Colitis Endoscopic Index of Severity vascular pattern score immediately after first CS (P = 0.021 for clinical relapse, P = 0.019 for endoscopic exacerbation) were risk factors for both clinical relapse and endoscopic exacerbation.ConclusionsTherapeutic intervention for patients with UC with an MES of 1 might prevent disease relapse.
      PubDate: Thu, 27 Sep 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy300
      Issue No: Vol. 25, No. 4 (2018)
       
  • Safety of Anti-TNF-Alpha Therapy During Pregnancy on Long-term Outcome of
           Exposed Children: A Controlled, Multicenter Observation
    • Authors: Duricova D; Dvorakova E, Hradsky O, et al.
      Pages: 789 - 796
      Abstract: BackgroundEvidence of the impact of in utero exposure to anti–tumor necrosis factor (TNF)–alpha on long-term childhood development is limited. The aim was to assess the impact of in utero exposure to anti-TNF-alpha due to mothers’ inflammatory bowel disease (IBD) on long-term postnatal development of exposed children.MethodsWe included consecutive children (≥12 months of age) born to mothers with IBD (2007–2016) treated with anti-TNF-alpha during pregnancy in 3 centers in the Czech Republic. A control group was comprised of unexposed children of non-IBD mothers undergoing mandatory check-ups at general pediatricians’ offices. Data on perinatal period, psychomotor development, vaccination, infections, antibiotics, and allergy were collected by treating pediatricians using a predefined questionnaire.ResultsSeventy-two exposed and 69 unexposed children were included (median age, 35 and 50 months, respectively). Exposed children had growth and psychomotor development similar to controls. There was no significant difference in infectious complications within the first year of life (23.9% vs 17.4%; P = 0.36) or during the whole follow-up between exposed infants and controls (P = 0.32). Concomitant immunosuppressants during pregnancy and anti-TNF-alpha levels in cord blood were not associated with elevated infection rate within the first year of life (P > 0.05). Over 95% of exposed children had adequate serologic response to vaccination, except for haemophilus and mumps vaccines. Clinically manifested allergy was similar between the groups (P = 0.98).ConclusionsAnti-TNF-alpha exposure in utero does not seem to have a negative impact on postnatal development of children with regard to infectious complications, allergy, growth, or psychomotor development when compared with unexposed children of non-IBD women.
      PubDate: Thu, 20 Sep 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy294
      Issue No: Vol. 25, No. 4 (2018)
       
  • Preventive Health Care Among Postpartum Women With Inflammatory Bowel
           Disease: Results From the PIANO Registry
    • Authors: Mao E; Sheibani S, Martin C, et al.
      Pages: 797 - 802
      Abstract: BackgroundHealth care maintenance (HCM) is reduced among inflammatory bowel disease (IBD) patients. This study aims to characterize rates of HCM in a closely monitored subpopulation—postpartum women with IBD—and identify predictors of noncompliance.MethodsA national prospective pregnancy registry was utilized to collect completion rates of HCM recommendations (cervical cancer screening; osteoporosis screening; pneumococcal, hepatitis A, hepatitis B, and influenza vaccines). Completion of a recommendation at least once during follow-up was sufficient, except for influenza vaccine, which was assessed yearly. Patients were classified by drug exposures: immunomodulator (Group A), biologic (Group B), combination therapy (Group AB), and unexposed. Confounders assessed were steroid exposure, IBD flare, IBD care site, primary care provider (PCP) access, marital status, income, education level, and race.ResultsThere were 628 postpartum IBD women with at least 1 year of follow-up. HCM rates were as follows: cervical cancer screening (84%), osteoporosis screening (54%), pneumococcal (50%), hepatitis A (61%), hepatitis B (81%), and influenza (72%) vaccines. The unexposed group demonstrated lower pneumococcal vaccination rates than groups A, B, and AB. Group B demonstrated lower cervical cancer screening rates than the unexposed. PCP access and low education predicted hepatitis vaccine noncompliance. Unmarried status and low income predicted cervical cancer screening noncompliance. Low income predicted influenza vaccine noncompliance.ConclusionsPostpartum women have multiple providers, yet they complete HCM at suboptimal rates. Risk factors include biologic exposure, unmarried status, low income, low education, and access to a PCP. Awareness among providers and patients is important and needs to be enhanced.
      PubDate: Tue, 25 Sep 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy293
      Issue No: Vol. 25, No. 4 (2018)
       
  • Fecal Calprotectin Responses Following Induction Therapy With Vedolizumab
           
    • Authors: Reinisch W; Bressler B, Curtis R, et al.
      Pages: 803 - 810
      Abstract: BackgroundIn patients with ulcerative colitis (UC), fecal calprotectin (FC) concentrations correlate with endoscopic inflammation evidence. This study investigated the effect of vedolizumab induction on FC concentrations and whether FC concentrations could be a reliable surrogate measure of disease status.MethodsData from the placebo-controlled, phase 3 trial GEMINI 1 were used to evaluate week-6 relationships between outcomes (including clinical remission, mucosal healing [MH], and endoscopic remission) and both absolute FC concentration values and relative FC concentration changes from baseline (%FC0-6). Sensitivity and specificity were calculated by cross-tabulation; the value of week-6 FC concentration as surrogate biomarker was measured with Youden J statistic computed for various cut points.ResultsGEMINI 1 induction phase enrolled 895 patients. Fecal calprotectin concentration decreases were deeper in patients with clinical remission, MH, and/or endoscopic remission than in patients without. The best week-6 indicator of clinical or endoscopic remission in this data set was absolute FC concentration ≤150 µg/g. The surrogate biomarker values (based on areas under the curve) for the best-performing cut points (FC0-6 reduction >90%, FC ≤150 µg/g) were fair (range, 0.70–0.77, total population). More patients met the ≤150 µg/g cut point with vedolizumab than with placebo. Baseline FC concentrations were not correlated with clinical outcomes.ConclusionsFecal calprotectin concentration reductions were greater with vedolizumab induction than with placebo. Week-6 FC concentrations had only fair surrogate biomarker value for endoscopic status. Our data suggest that, while FC may reflect inflammatory burden, FC concentration after vedolizumab induction may not be a robust biomarker of mucosal inflammation.
      PubDate: Fri, 05 Oct 2018 00:00:00 GMT
      DOI: 10.1093/ibd/izy304
      Issue No: Vol. 25, No. 4 (2018)
       
 
 
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