Genetic Risk Profiling and Gene Signature Modeling to Predict Risk of Complications After IPAA

Sehgal, Rishabh; Berg, Arthur; Polinski, Joseph I.; Hegarty, John P.; Lin, Zhenwu; McKenna, Kevin J.; Stewart, David B.; Poritz, Lisa S.; Koltun, Walter A.

doi:10.1097/dcr.0b013e31823e2d18

Cited by 33 publications

(11 citation statements)

References 42 publications

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“…This data differs from other countries where 34% was reported in Scotland [26] and 21.7% in Brazil [27], and differ widely from China (5.3%) [29] and Japan (10%) [30]. To date, there is still no clear explanation for this fact, but it may be influenced by ethnic background, geographic location [35], genetic information [36], diet [37] and some features of the UC, for example, the clinical course [38]. In our study, 20.6% of the patients had active acute pouchitis and 35.3% presented pouchitis in remission due to the adequate response to antibiotic treatment, in contrast with United States where 96% of the patients responded to antibiotic treatment [23].…”

Section: Discussioncontrasting

confidence: 48%

Frequency, Clinical Features and Factors Associated with Pouchitis after Proctocolectomy with Ileo-Pouch-Anal Anastomosis in Patients with Ulcerative Colitis: A Latin-American Country Retrospective-Cohort Study

Yamamoto-Furusho

Aguilar

2015

Dig Surg

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Background: Pouchitis is the most common complication of proctocolectomy with ileo-pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). No previous study in Mexico has evaluated this issue; our aim was to evaluate its frequency, clinical characteristics and factors associated with its presence in Mexican patients with UC and IPAA. Methods: Retrospective-cohort study including 70 patients with histopathological diagnosis of UC and IPAA between 1983 and 2014 from inflammatory bowel disease clinic of a tertiary care center. The statistical analysis used descriptive statistics, chi-square and Fisher's exact test for categorical variables and Student's t test for numeric variables. Univariate analysis was performed to identify the factors associated. Results: Patients presenting with pouchitis accounted for 48.6%. From the 34 cases, 12 (35.3%) had inactive pouchitis; 7 (20.6%) active acute pouchitis; 15 (44.1%) chronic active pouchitis. On average, pouchitis occurred 5.37 years after IPPA. Factors probably associated with its occurrence were the presence of autoimmune concomitant diseases (ACDs; p = 0.06, OR 4.40, 95% CI 0.84-22.9) and extra-intestinal manifestations (EIMs; p = 0.05, OR 2.53, 95% CI 0.96-6.64), which was also probably associated with chronic active pouchitis (p = 0.06, OR 0.31, 95% CI 0.07-1.31). Conclusions: The frequency of pouchitis is high in Mexican UC patients after IPAA. ACDs and EIMs were probably associated with its development.

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Section: Discussioncontrasting

confidence: 48%

Frequency, Clinical Features and Factors Associated with Pouchitis after Proctocolectomy with Ileo-Pouch-Anal Anastomosis in Patients with Ulcerative Colitis: A Latin-American Country Retrospective-Cohort Study

Yamamoto-Furusho

Aguilar

2015

Dig Surg

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“…The ileal pouch anal anastomosis (IPAA) is associated with high failure rates and poor functional outcomes[113], particularly for CD with NOD2 mutation which is associated with severe pouchitis[114,115]. Inflammation in the pouch is significantly higher for CD than for UC[116].…”

Section: Technical Considerations In Surgery For CDmentioning

confidence: 99%

Indications and surgical options for small bowel, large bowel and perianal Crohn's disease

Toh¹,

Stewart²,

Rickard³

et al. 2016

WJG

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Despite advancements in medical therapy of Crohn’s disease (CD), majority of patients with CD will eventually require surgical intervention, with at least a third of patients requiring multiple surgeries. It is important to understand the role and timing of surgery, with the goals of therapy to reduce the need for surgery without increasing the odds of emergency surgery and its associated morbidity, as well as to limit surgical recurrence and avoid intestinal failure. The profile of CD patients requiring surgical intervention has changed over the decades with improvements in medical therapy with immunomodulators and biological agents. The most common indication for surgery is obstruction from stricturing disease, followed by abscesses and fistulae. The risk of gastrointestinal bleeding in CD is high but the likelihood of needing surgery for bleeding is low. Most major gastrointestinal bleeding episodes resolve spontaneously, albeit the risk of re-bleeding is high. The risk of colorectal cancer associated with CD is low. While current surgical guidelines recommend a total proctocolectomy for colorectal cancer associated with CD, subtotal colectomy or segmental colectomy with endoscopic surveillance may be a reasonable option. Approximately 20%-40% of CD patients will need perianal surgery during their lifetime. This review assesses the practice parameters and guidelines in the surgical management of CD, with a focus on the indications for surgery in CD (and when not to operate), and a critical evaluation of the timing and surgical options available to improve outcomes and reduce recurrence rates.

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“…This study was undertaken because previous studies have shown TNFSF15 to be associated with other colonic pathologies, namely IBD. 4 Its association with another inflammatory colonic disease, namely diverticulitis, thus seemed possible. 5,48,49 TL1A expression levels have been found to correlate with the severity of Crohn's inflammation and fibrostenosis in CD.…”

Section: Tnfsf15 and Tl1amentioning

confidence: 99%

“…[3][4][5][6] It plays a role in immunological defense through regulation of T-cell activation, maturation, and differentiation and thus may influence inflammation in diseases of the intestine. It is associated with inflammatory bowel disease (IBD), particularly with a severe phenotype in both ulcerative colitis (UC) and Crohn's disease (CD) as well as pouchitis after restorative proctocolectomy.…”

mentioning

confidence: 99%

The TNFSF15 Gene Single Nucleotide Polymorphism rs7848647 Is Associated With Surgical Diverticulitis

et al. 2014

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Genetic Risk Profiling and Gene Signature Modeling to Predict Risk of Complications After IPAA

Cited by 33 publications

References 42 publications

Frequency, Clinical Features and Factors Associated with Pouchitis after Proctocolectomy with Ileo-Pouch-Anal Anastomosis in Patients with Ulcerative Colitis: A Latin-American Country Retrospective-Cohort Study

Frequency, Clinical Features and Factors Associated with Pouchitis after Proctocolectomy with Ileo-Pouch-Anal Anastomosis in Patients with Ulcerative Colitis: A Latin-American Country Retrospective-Cohort Study

Indications and surgical options for small bowel, large bowel and perianal Crohn's disease

The TNFSF15 Gene Single Nucleotide Polymorphism rs7848647 Is Associated With Surgical Diverticulitis

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