Upper Gastrointestinal Tract Involvement in Crohn’s Disease: Frequency, Risk Factors, and Disease Course

Greuter, Thomas; Piller, Alberto; Fournier, Nicolas; Safroneeva, Ekaterina; Straumann, Alex; Godat, Sébastien; Nydegger, Andreas; Scharl, Michael; Rogler, Gerhard; Vavricka, Stephan R.; Schoepfer, Alain

doi:10.1093/ecco-jcc/jjy121

Cited by 51 publications

(54 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Present study showed that the median age of the patients with UGI involvement was significantly lower compared to those without UGI involvement. This is in accordance with a previous study by Thomas and colleagues who demonstrated a higher rate of younger patients (≤16 years) suffering from UGI tract involvement compared to those without (9.4% versus 17.8%, P = 0.005) (Greuter et al, 2018). Another study by Lopez-Siles et al observed that CD patients below 16 years of age had a striking reduction in the population of Akkermansia sp.…”

Section: Discussionsupporting

confidence: 92%

Development of a Novel Metagenomic Biomarker for Prediction of Upper Gastrointestinal Tract Involvement in Patients With Crohn’s Disease

et al. 2020

View full text Add to dashboard Cite

The human gut microbiota is an important component in the pathogenesis of Crohn's disease (CD), promoting host-microbe imbalances and disturbing intestinal and immune homeostasis. We aimed to assess the potential clinical usefulness of the colonic tissue microbiome for obtaining biomarkers for upper gastrointestinal (UGI) tract involvement in CD. We analyzed colonic tissue samples from 26 CD patients (13 with and 13 without UGI involvement at diagnosis) from the Inflammatory Bowel Disease Multi-Omics Database. QIIME1, DiTaxa, linear discriminant analysis effect size (LEfSe), and PICRUSt2 methods were used to examine microbial dysbiosis. Linear support vector machine (SVM) and random forest classifier (RF) algorithms were used to identify the UGI tract involvement-associated biomarkers. There were no statistically significant differences in community richness, phylogenetic diversity, and phylogenetic distance between the two groups of CD patients. DiTaxa analysis predicted significant association of the species Ruminococcus torques with UGI involvement, which was confirmed by the LEfSe analysis (P = 0.025). For the feature ranking method in both linear SVM and RF models, the species R. torques and age at diagnosis contributed to the combined models. The L-methionine biosynthesis III (P = 0.038) and palmitate biosynthesis II (P = 0.050) were under-represented in CD with UGI involvement. These findings suggest that R. torques might serve as a novel potential biomarker for UGI involvement in CD and its correlations, in addition to a range of bacterial species. The mechanisms of interaction between hosts and R. torques should be further investigated.

show abstract

Section: Discussionsupporting

confidence: 92%

Development of a Novel Metagenomic Biomarker for Prediction of Upper Gastrointestinal Tract Involvement in Patients With Crohn’s Disease

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Recently, some sex differences in patients with CD were revealed. Thus, an association between male sex and upper gastrointestinal tract involvement has been identified in patients with CD of the Swiss IBD Cohort Study Group[19]. Perhaps in the future, a greater focus should be placed on potential gender-related differences in IBD treatment.…”

Section: Discussionmentioning

confidence: 99%

Ustekinumab: “Real-world” outcomes and potential predictors of nonresponse in treatment-refractory Crohn’s disease

Hoffmann¹,

Krisam²,

Wehling³

et al. 2019

WJG

View full text Add to dashboard Cite

BACKGROUND Ustekinumab was approved in Europe for the treatment of adults with moderate to severe Crohn's disease (CD) in 2016, and there is an urgent need for data on its everyday use. AIM To obtain data on the daily use of ustekinumab. METHODS This is a retrospective monocentric study. Patients with moderate to severe CD who began ustekinumab therapy at the inflammatory bowel diseases outpatient clinic of the Heidelberg University Hospital between December 2016 and March 2018 were selected based on electronic patient files. The primary study endpoint was combined steroid-free clinical remission or steroid-free clinical response at 24 ± 6 wk of ustekinumab therapy. Secondary study endpoints were: achievement of mucosal healing, sonographic and magnetic resonance imaging response, biochemical response, the need for intestinal surgery within 24 ± 6 wk after treatment initiation, the occurrence of adverse events, treatment discontinuation due to nonresponse or adverse events, improvement of extraintestinal manifestations, clinical response at 48 ± 6 wk of therapy, and association of response with nucleotid oligodimerisation domain 2 mutations. RESULTS Fifty-seven patients with CD (5.3% anti-tumour necrosis factor α naïve, 63.2% having undergone at least one intestinal surgery) were included in the study. Twenty patients (35.1%) achieved steroid-free clinical remission, 6 (10.5%) steroid-free clinical response and 31 (54.4%) were non-responders. Treatment discontinuation due to adverse events occurred in two patients (3.5%). Male sex, the presence of extraintestinal manifestations and the use of steroids at baseline were predictors of nonresponse to ustekinumab therapy. CONCLUSION In a “real-world” treatment-refractory cohort of patients with CD, ustekinumab appeared efficacious and safe.

show abstract

“…Our Swiss group recently described an association between sex and upper gastrointestinal tract involvement (L4 according to Montreal classification) [43]. Male sex and young age were identified as the main risk factors for the involvement of the upper gastrointestinal tract in CD patients [43]. In another study, male sex has been significantly associated with ileal disease in CD (28 vs. 20% in females) [17].…”

Section: Disease Activity and Phenotypementioning

confidence: 99%

“…IBD phenotype and location also show gender-specific differences. Our Swiss group recently described an association between sex and upper gastrointestinal tract involvement (L4 according to Montreal classification) [43]. Male sex and young age were identified as the main risk factors for the involvement of the upper gastrointestinal tract in CD patients [43].…”

Section: Disease Activity and Phenotypementioning

confidence: 99%

Gender Differences in Inflammatory Bowel Disease

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

Upper Gastrointestinal Tract Involvement in Crohn’s Disease: Frequency, Risk Factors, and Disease Course

Abstract: Prevalence of upper GI tract involvement has been increasing over the past decades. Male sex and young age at diagnosis were identified as the main predictive factors for such involvement at CD diagnosis. Involvement of upper GI tract did not result in a worse outcome.

Cited by 51 publications

References 28 publications

Development of a Novel Metagenomic Biomarker for Prediction of Upper Gastrointestinal Tract Involvement in Patients With Crohn’s Disease

Development of a Novel Metagenomic Biomarker for Prediction of Upper Gastrointestinal Tract Involvement in Patients With Crohn’s Disease

Ustekinumab: “Real-world” outcomes and potential predictors of nonresponse in treatment-refractory Crohn’s disease

Gender Differences in Inflammatory Bowel Disease

Contact Info

Product

Resources

About