Mo1720 Frequency and Chronology of Extraintestinal Manifestations in the Swiss Inflammatory Bowel Disease Cohort

Vavricka, Stephan R.; Gantenbein, Claudine; Spoerri, Muriel; Vavricka, Bettina M. Prinz; Safroneeva, Ekaterina; Navarini, Alexander; Schoepfer, Alain

doi:10.1016/s0016-5085(12)62575-x

“…EIMs are common in IBD, estimated to affect 30%-40% of patients. 111,112 In a Swiss cohort study, symptoms of EIMs before IBD in one-quarter of the patients 113 ; collaboration across specialties, including but not limited to rheumatologists, dermatologists, ophthalmologists, is vital not only to prompt referral of patients with EIM suspicious for IBD to allow for expedient initiation of therapy for both conditions, but also to allow for consideration of both in the selection of therapy, dose, and chronicity of treatment. For example, VDZ, which is gut-selective, is associated with an increased risk of de novo or worsening EIM.…”

Section: Taking Extraintestinal Manifestation Into Considerationmentioning

confidence: 99%

Sa485 OPIOIDS AND LOW BMI BUT NOT BIOLOGICS PREDICT SEVERE INFECTION IN IBD PATIENTS: A 10 YEAR POPULATION BASED COHORT STUDY.

Lyons¹,

Plevris²,

Jenkinson³

et al. 2021

Gastroenterology

0

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Inflammatory bowel diseases (IBDs), including Crohn's disease and ulcerative colitis, are chronic, progressive, immune-mediated diseases of adults and children that have no cure. IBD can cause significant morbidity and lead to complications such as strictures, fistulas, infections, and cancer. In children, IBD can also result in growth impairment and pubertal delays. IBD is highly heterogenous, with severity ranging from mild to severe and symptoms ranging from mild to debilitating. Delay in IBD diagnosis, especially in Crohn's disease, is common and associated with adverse outcomes. Early diagnosis and prompt institution of treatment are the cornerstones for improving outcomes and maximizing health. Early diagnosis requires a low threshold of suspicion and red flags to guide early specialist referral at the primary provider level. Although the armamentarium of IBD medications is growing, many patients will not respond to treatment, and the selection of first-line therapy is critical. Risk stratification of disease severity, based on clinical, demographic, and serologic markers, can help guide selection of first-line therapy. Clinical decision support tools, genomics, and other biomarkers of response to therapy and risk of adverse events are the future of personalized medicine. After starting appropriate therapy, it is important to confirm remission using objective end points (treat to target) with continued control of inflammation with adjustment of therapy using surrogate biomarkers (tight control). Lastly, IBD therapy extends far beyond medications, and other aspects of the overall health and wellbeing of the patient are critical. These include preventive health, nutrition, and psychobehavioral support addressing patients' concerns around complementary therapy and medication adherence, prevention of disability, and ensuring open communication.

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“…PG is a common cutaneous manifestation of inflammatory bowel disease (IBD), more frequently associated with ulcerative colitis than Crohn's disease (1)(2)(3). Approximately 30-40% of patients with PG have underlying IBD and a large proportion of them observe PG onset before their diagnosis of IBD is confirmed (4)(5)(6)(7). Multiple syndromic forms of PG exist, but the most common ulcerative form of PG typically begins as an erythematous nodule that evolves into a chronic purulent ulcer with violaceous undermined borders (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

“…Common sites of PG lesions include the extremities, genitalia, perineal area, and postsurgical stoma sites (8,12). While the course of other cutaneous manifestations associated with IBD, such as erythema nodosum and Sweet's syndrome, often run parallel to that of IBD activity, PG can occur before IBD diagnosis or manifest even after IBD is in remission (4,5,13).…”

Section: Introductionmentioning

confidence: 99%

Inhibition of pyrimidine synthesis in murine skin wounds induces a pyoderma gangrenosum-like neutrophilic dermatosis accompanied by spontaneous gut inflammation

Jatana

¹

,

Ponti

²

,

Johnson

³

et al. 2022

Preprint

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Pyoderma gangrenosum (PG) is a debilitating skin condition often accompanied by inflammatory bowel disease (IBD). Strikingly, ~40% of patients that present with PG have underlying IBD, suggesting shared but unknown pathogenesis mechanisms. Impeding the development of effective treatments for PG is the absence of an animal model that exhibits features of both skin and gut manifestations. This study describes the development of the first experimental drug-induced mouse model of PG with concurrent intestinal inflammation. Topical application of pyrimidine synthesis inhibitors on wounded mouse skin generates skin ulcers enriched in neutrophil extracellular traps (NETs) and pro-inflammatory cellular as well as soluble mediators mimicking human PG. The mice also develop spontaneous intestinal inflammation demonstrated by histologic damage. Further investigations revealed increased circulating immature low-density IL-1β primed granulocytes that undergo enhanced NETosis at inflamed tissue sites supported by increase in circulatory citrullinated histone 3, a marker of aberrant NET formation. Granulocyte depletion dampens the intestinal inflammation in this model, further supporting the notion that granulocytes contribute to the skin-gut crosstalk in PG mice. We anticipate that this novel murine PG model will enable researchers to probe common disease mechanisms and identify more effective targets for treatment for PG patients with IBD.

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266 Nhe3 Is a Drug Target for Treating Diarrhe; A Novel Peptide Stimulates Nhe3 Activity, Prevents Camp, CGMP and Ca2+ Inhibition of Nhe3 and Prevents Cholera Toxin and E. Coli Stable Enterotoxin Fluid Secretion

Zachos¹,

vaughan²,

Sarker³

et al. 2021

Gastroenterology

2

0

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Inflammatory bowel diseases (IBDs), including Crohn's disease and ulcerative colitis, are chronic, progressive, immune-mediated diseases of adults and children that have no cure. IBD can cause significant morbidity and lead to complications such as strictures, fistulas, infections, and cancer. In children, IBD can also result in growth impairment and pubertal delays. IBD is highly heterogenous, with severity ranging from mild to severe and symptoms ranging from mild to debilitating. Delay in IBD diagnosis, especially in Crohn's disease, is common and associated with adverse outcomes. Early diagnosis and prompt institution of treatment are the cornerstones for improving outcomes and maximizing health. Early diagnosis requires a low threshold of suspicion and red flags to guide early specialist referral at the primary provider level. Although the armamentarium of IBD medications is growing, many patients will not respond to treatment, and the selection of first-line therapy is critical. Risk stratification of disease severity, based on clinical, demographic, and serologic markers, can help guide selection of first-line therapy. Clinical decision support tools, genomics, and other biomarkers of response to therapy and risk of adverse events are the future of personalized medicine. After starting appropriate therapy, it is important to confirm remission using objective end points (treat to target) with continued control of inflammation with adjustment of therapy using surrogate biomarkers (tight control). Lastly, IBD therapy extends far beyond medications, and other aspects of the overall health and wellbeing of the patient are critical. These include preventive health, nutrition, and psychobehavioral support addressing patients' concerns around complementary therapy and medication adherence, prevention of disability, and ensuring open communication.

show abstract

Mo1720 Frequency and Chronology of Extraintestinal Manifestations in the Swiss Inflammatory Bowel Disease Cohort

Cited by 7 publications

References 0 publications

Sa485 OPIOIDS AND LOW BMI BUT NOT BIOLOGICS PREDICT SEVERE INFECTION IN IBD PATIENTS: A 10 YEAR POPULATION BASED COHORT STUDY.

Sa485 OPIOIDS AND LOW BMI BUT NOT BIOLOGICS PREDICT SEVERE INFECTION IN IBD PATIENTS: A 10 YEAR POPULATION BASED COHORT STUDY.

Inhibition of pyrimidine synthesis in murine skin wounds induces a pyoderma gangrenosum-like neutrophilic dermatosis accompanied by spontaneous gut inflammation

266 Nhe3 Is a Drug Target for Treating Diarrhe; A Novel Peptide Stimulates Nhe3 Activity, Prevents Camp, CGMP and Ca2+ Inhibition of Nhe3 and Prevents Cholera Toxin and E. Coli Stable Enterotoxin Fluid Secretion

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