Journal: Journal of Crohn's & colitis
Anemia often complicates the course of Inflammatory Bowel Disease (IBD). Hepcidin, a liver-produced peptide hormone, is a key mediator of anemia of chronic disease (ACD). We hypothesized that hepcidin is significantly elevated in anemic CD patients and that hepcidin may cause iron restriction and, therefore, mediate ACD. METHODS: We enrolled 17 patients with CD and ACD recruited from the Cedars-Sinai IBD Center. Routine blood tests included hemoglobin (Hgb), hematocrit, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Anemia was defined as hemoglobin <12g/dL and <13.5g/dL, in men and women, respectively. ACD was diagnosed on the basis of a combination of the following: a) normal or elevated ferritin b) lowered serum iron and total iron binding capacity and c) normal percent iron saturation. Serum and urine hepcidin, as well as IL-6 levels were also measured. Patients with documented iron-deficiency anemia were excluded. RESULTS: There was an excellent correlation between urine (expressed as ng/mg of creatinine) and serum hepcidin levels expressed as ng/ml (r=0.853, p<0.001). We also found a strong positive correlation between serum hepcidin and ferritin levels (r=0.723, p=0.0015). There was a positive correlation between serum hepcidin and IL-6 levels (r=0.546, p=0.023). We found a strong negative correlation between serum hepcidin concentrations and Hgb levels (r=0.528, p=0.029). CONCLUSION: We demonstrate that ACD in CD is characterized by high serum IL-6 and hepcidin levels, which negatively correlate with Hgb levels. Our data support the hypothesis that IL-6-driven hepcidin production mediates ACD in patients with CD.
Vedolizumab is a gut-selective α4β7 integrin antagonist therapy for ulcerative colitis and Crohn’s disease. The GEMINI long-term safety (LTS) trial is an ongoing open-label study investigating the safety of vedolizumab. We present interim exploratory analyses of efficacy in patients with Crohn’s disease.
The GEMINI long-term safety (LTS) study is a continuing phase 3 trial investigating the safety and efficacy of vedolizumab, an α4β7 integrin antagonist for ulcerative colitis (UC) and Crohn’s disease. We provide an interim analysis of efficacy in patients with UC.
Vedolizumab was recently FDA approved for treatment of moderate to severe ulcerative colitis (UC) and Crohn’s disease (CD). No study to date has examined the rate of postoperative infectious complications among patients who received vedolizumab in the perioperative period. We sought to determine the 30-day postoperative infectious complication rate among IBD patients who received vedolizumab within 12 weeks of an abdominal operation as compared to patients who received TNFα inhibitors or no biologic therapy.
The establishment of prognostic models for Crohn’s disease (CD) is highly desirable, as they have the potential to guide physicians in the decision-making process concerning therapeutic choices, improving patients' health and quality of life. Our aim was to derive models for disabling CD disease and reoperation based solely on clinical/demographic data.
A modified Michelassi strictureplasty over the ileocaecal valve or ileocolic anastomosis could be an alternative for ileocaecal resection. This study assessed the outcome of the modified Michelassi strictureplasty in patients with extensive stenotic terminal ileal Crohn’s disease (CD).
Faecal microbiota transplantation (FMT) has been investigated as a potential treatment for inflammatory bowel disease (IBD). We thus performed a systematic review and meta-analysis assessing the effectiveness and safety of FMT in IBD.
Inflammatory bowel diseases (IBD) are chronic disabling gastrointestinal disorders impacting every aspect of the affected individual’s life and account for substantial costs to the health care system and society. New epidemiological data suggest that the incidence and prevalence of the diseases are increasing and medical therapy and disease management have changed significantly in the last decade. An estimated 2.5-3million people in Europe are affected by IBD, with a direct healthcare cost of 4.6-5.6bn Euros/year. Therefore, the aim of this review is to describe the burden of IBD in Europe by discussing the latest epidemiological data, the disease course and risk for surgery and hospitalization, mortality and cancer risks, as well as the economic aspects, patients' disability and work impairment.
Psoriasis and Hidradenitis Suppurativa (HS) co-occur more often with Inflammatory Bowel Disease (IBD) than expected due to shared pathogenic and genetic features. It is known that IBD patients harbour an altered intestinal microbiome characterized by a depletion of Faecalibacterium prausnitzii and increase of Escherichia coli. At present, it is unclear whether a similar intestinal microbiome trend can be identified in IBD-associated skin disorders. We therefore investigated the F. prausnitzii and E. coli abundance in psoriasis and HS, with and without concomitant IBD.
M cells associated with organized lymphoid tissues such as intestinal Peyer’s patches provide surveillance of the intestinal lumen. Inflammation or infection in the colon can induce an M cell population associated with lymphoid infiltrates; paradoxically, induction is dependent on the inflammatory cytokine Tumor Necrosis Factor (TNF)-α. Anti-TNFα blockade is an important therapeutic in Inflammatory Bowel Disease, so understanding the effects of TNFα signaling is important in refining therapeutics.