Pancreatic endosonographic findings and clinical correlation in Crohn's disease

Abstract

OBJECTIVES: We aimed to evaluate the incidence of pancreatic alterations in Crohn's disease using endoscopic ultrasound (EUS) and to correlate the number of alterations with current clinical data. METHODS: Patients diagnosed with Crohn's disease (n=51) were examined using EUS, and 11 variables were analyzed. A control group consisted of patients with no history of pancreatic disease or Crohn's disease. Patients presenting with three or more alterations underwent magnetic resonance imaging (MRI). Pancreatic function was determined using a fecal elastase assay. RESULTS: Two of the 51 patients (3.9%) presented with four EUS alterations, 3 (5.9%) presented with three, 11 (21.5%) presented with two, and 13 (25.5%) presented with one; in the control group, only 16% presented with one EUS alteration ( p <0.001). Parenchymal abnormalities accounted for 39 of the EUS findings, and ductal abnormalities accounted for 11. Pancreatic lesions were not detected by MRI. Low fecal elastase levels were observed in 4 patients, none of whom presented with significant pancreatic alterations after undergoing EUS. Ileal involvement was predictive of the number of EUS alterations. CONCLUSION: A higher incidence of pancreatic abnormalities was found in patients with Crohn's disease than in individuals in the control group. The majority of these abnormalities are related to parenchymal alterations. In this group of patients, future studies should be conducted to determine whether such morphological abnormalities could evolve to induce exocrine or endocrine pancreatic insufficiency and, if so, identify the risk factors and determine which patients should undergo EUS.

Fusobacterium nucleatum Activates Endoplasmic Reticulum Stress to Promote Crohn’s Disease Development via the Upregulation of CARD3 Expression

“…Crohn's disease (CD) is a chronic and disabling disease that can seriously affect quality of life. The natural history of CD can lead to intestinal damage, such as stenosis, fistula, or bowel resection (Malluta et al, 2019). Goals of therapy include resolution of symptoms and mucosal healing.…”

“…The intact intestinal mucosal barrier can prevent intestinal bacteria, toxins, and antigens from entering immune cells in the lamina propria (Actis et al, 2014). Mucosal healing has been considered the best therapeutic endpoint for CD patients because it is associated with sustained clinical remission followed by a lower incidence of hospitalization and surgery (Malluta et al, 2019). Previous studies have shown that in biofilms, F. nucleatum can penetrate the epithelial/basement membrane barrier and invade the collagen matrix after incubation if the bacterial biofilm is incubated in contact with cells in an organotypic cell culture model (Gursoy et al, 2010).…”

Fusobacterium nucleatum promotes the development of acute liver failure by inhibiting the NAD+ salvage metabolic pathway

“…A complete intestinal mucosal barrier is essential to prevent toxins and antigens from entering the immune cells [ 16 ]. Studies have shown that after the bacterial biofilm of F. nucleatum and cells contact incubation, the bacteria can penetrate the basement membrane barrier and invade the collagen matrix [ 17 ]. In patients with colitis and colorectal cancer, F. nucleatum can invade the mucosa and destroy the mucosal barrier function [ 18 , 19 ].…”

Fusobacterium Nucleatum Promotes the Development of Acute Liver Failure by Inhibiting the NAD+ Salvage Metabolic Pathway

“…A complete intestinal mucosal barrier is essential to prevent toxins and antigens from entering the immune cells [16]. Studies have shown that after the bacterial bio lm of F. nucleatum and cells contact incubation, the bacteria can penetrate the basement membrane barrier and invade the collagen matrix [17]. In patients with colitis and colorectal cancer, F. nucleatum can invade the mucosa and destroy the mucosal barrier function [18,19].…”