State-of-the-Art in Inflammatory Bowel Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 9056

Special Issue Editors


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Guest Editor
1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
2. IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
Interests: evidence based medicine; systematic reviews; meta-analysis; network meta-analysis; research methodology
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
2. IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
Interests: epidemiology; biostatistics; evidence based medicine; systematic reviews; meta-analysis; umbrella review; research methodology; GRADE.
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Inflammatory bowel disease is a group of chronic diseases which has seen an incredible surge of new treatment options in recent years. Several new treatments are being under scrutiny or are already under evaluation for marketing approval. Despite the availability of new therapeutic options should be welcomed, clinicians have to face unprecedented challenges in gauging which treatment is the most suitable for each patient. We still lack adequate and updated data to compare the efficacy and safety profile of most of the therapeutic options available, including in particular head-to-head RCTs, but also real-world comparative studies, new and updated meta-analyses, network meta-analyses and new or updated prognostic scores to help personalized medicine. In this special issue entitled “State-of-Art in Inflammatory Bowel Diseases”, we would like to welcome any original study or systematic/narrative review/evidence synthesis related to the above-mentioned issues.

Dr. Stefanos Bonovas
Dr. Daniele Piovani
Guest Editors

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Keywords

  • Inflammatory bowel diseases
  • Crohn’s disease
  • Ulcerative colitis
  • Systematic reviews
  • Meta-analysis
  • Network meta-analysis
  • Umbrella reviews
  • Models
  • Statistical
  • Prognosis

Published Papers (3 papers)

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Review

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12 pages, 847 KiB  
Review
Journey through Crohn’s Disease Complication: From Fistula Formation to Future Therapies
by Federica Rubbino, Luana Greco, Alessio di Cristofaro, Federica Gaiani, Stefania Vetrano, Luigi Laghi, Stefanos Bonovas and Daniele Piovani
J. Clin. Med. 2021, 10(23), 5548; https://doi.org/10.3390/jcm10235548 - 26 Nov 2021
Cited by 5 | Viewed by 3591
Abstract
Crohn’s Disease (CD) is a chronic inflammatory disorder in which up to 50% of patients develop fistula within 20 years after the initial diagnosis, and half of these patients suffer perianal fistulizing disease. The etiopathogenesis of CD-related perianal fistula is still unclear, and [...] Read more.
Crohn’s Disease (CD) is a chronic inflammatory disorder in which up to 50% of patients develop fistula within 20 years after the initial diagnosis, and half of these patients suffer perianal fistulizing disease. The etiopathogenesis of CD-related perianal fistula is still unclear, and its phenotypical and molecular characteristics are even more indefinite. A better understanding would be crucial to develop targeted and more effective therapeutic strategies. At present, the most accredited theory for the formation of CD-related fistula identifies the epithelial-to-mesenchymal transition (EMT) as the driving force. It has been well recognized that CD carries an increased risk of malignancy, particularly mucinous adenocarcinoma is often associated with long-standing fistula in CD patients. Despite the availability of multiple treatment options, perianal fistulizing CD represents a therapeutic challenge and is associated with an important impact on patients’ quality of life. To date, the most effective management is multidisciplinary with the cooperation of gastroenterologists, surgeons, radiologists, and nutritionists and the best recommended treatment is a combination of medical and surgical approaches. Full article
(This article belongs to the Special Issue State-of-the-Art in Inflammatory Bowel Disease)
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12 pages, 448 KiB  
Review
Ultrasound Elastography in the Assessment of the Intestinal Changes in Inflammatory Bowel Disease—Systematic Review
by Dominika Ślósarz, Elżbieta Poniewierka, Katarzyna Neubauer and Radosław Kempiński
J. Clin. Med. 2021, 10(18), 4044; https://doi.org/10.3390/jcm10184044 - 7 Sep 2021
Cited by 17 | Viewed by 2421
Abstract
Inflammatory bowel disease (IBD) is a chronic condition affecting primarily the gastrointestinal tract and characterized by growing incidence worldwide. Complex diagnostic process of IBD as well as evaluation of disease activity and intestinal complications that are crucial for the therapeutic decisions, require repetitive, [...] Read more.
Inflammatory bowel disease (IBD) is a chronic condition affecting primarily the gastrointestinal tract and characterized by growing incidence worldwide. Complex diagnostic process of IBD as well as evaluation of disease activity and intestinal complications that are crucial for the therapeutic decisions, require repetitive, invasive, expensive, time-consuming and poorly tolerated tests. In contrast to endoscopy and computed tomography, ultrasound elastography (UE) is non-invasive, non-radiating and non-contrasting dependent tool which might be utilized in IBD patients for the assessment of the intestinal changes. Therefore, we performed the systematic review to evaluate the possible application of the ultrasound elastography for assessment of the intestinal changes in IBD. After the search of three databases: PubMed, World of Knowledge and Scopus, we identified 12 papers which were included in the final analysis. The majority of the studies were focused on the evaluation of the symptomatic ileal/ileocolonic strictures in Crohn’s disease patients that required surgical resection. Only one study concerned ulcerative colitis. The authors evaluated different UE techniques: strain elastography (SE), acoustic radiation force impulse (ARFI) and shear wave elastography (SWE). Results were expressed with semi-quantitative color mapping and strain measurement. Histological scores of inflammation and fibrosis in Crohn’s disease were used as a reference test in the majority of studies. Ultrasound elastography seems to be a promising novel imaging technique supporting evaluation of the intestinal strictures in Crohn’s disease patients in respect to fibrosis detection as well as differentiation between fibrosis and inflammation. However, further research is needed to establish the position of ultrasound elastography in IBD management. Full article
(This article belongs to the Special Issue State-of-the-Art in Inflammatory Bowel Disease)
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Other

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16 pages, 1316 KiB  
Systematic Review
Procedures in Fecal Microbiota Transplantation for Treating Irritable Bowel Syndrome: Systematic Review and Meta-Analysis
by Tânia Rodrigues, Sofia Rodrigues Fialho, João Ricardo Araújo, Rita Rocha and André Moreira-Rosário
J. Clin. Med. 2023, 12(5), 1725; https://doi.org/10.3390/jcm12051725 - 21 Feb 2023
Cited by 7 | Viewed by 1956
Abstract
Background: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disease with no effective treatment. Altered microbiota composition seems implicated in disease etiology and therefore fecal microbial transplantation (FMT) has emerged as a possible treatment therapy. To clarify the clinical parameters impacting FMT efficacy, [...] Read more.
Background: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disease with no effective treatment. Altered microbiota composition seems implicated in disease etiology and therefore fecal microbial transplantation (FMT) has emerged as a possible treatment therapy. To clarify the clinical parameters impacting FMT efficacy, we conducted a systematic review with subgroup analysis. Methods: A literature search was performed identifying randomized controlled trials (RCTs) comparing FMT with placebo in IBS adult patients (8-week follow-up) with a reported improvement in global IBS symptoms. Results: Seven RCTs (489 participants) met the eligibility requirements. Although FMT seems not to be effective in global improvement of IBS symptoms, subgroup analysis shows that FMT through gastroscopy or nasojejunal tube are effective IBS treatments (RR 3.03; 95% CI 1.94–4.73; I2 = 10%, p < 0.00001). When considering non-oral ingestion routes, IBS patients with constipation symptoms are more likely to benefit from FMT administration (p = 0.003 for the difference between IBS subtypes regarding constipation). Fresh fecal transplant and bowel preparation seem also to have impact on FMT efficacy (p = 0.03 and p = 0.01, respectively). Conclusion: Our meta-analysis revealed a set of critical steps that could affect the efficacy of FMT as clinical procedure to treat IBS, nevertheless more RCTs are needed. Full article
(This article belongs to the Special Issue State-of-the-Art in Inflammatory Bowel Disease)
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