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Crohn Disease: HELP
Articles by Livia Biancone
Based on 49 articles published since 2010
(Why 49 articles?)
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Between 2010 and 2020, L. Biancone wrote the following 49 articles about Crohn Disease.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Use of corticosteroids and immunosuppressive drugs in inflammatory bowel disease: Clinical practice guidelines of the Italian Group for the Study of Inflammatory Bowel Disease. 2017

Gionchetti, Paolo / Rizzello, Fernando / Annese, Vito / Armuzzi, Alessandro / Biancone, Livia / Castiglione, Fabiana / Comberlato, Michele / Cottone, Mario / Danese, Silvio / Daperno, Marco / D'Incà, Renata / Fries, Walter / Kohn, Anna / Orlando, Ambrogio / Papi, Claudio / Vecchi, Maurizio / Ardizzone, Sandro / Anonymous2840898. ·Department of Medical and Surgical Sciences, IBD Unit, University of Bologna, Bologna, Italy. Electronic address: Paolo.gionchetti@unibo.it. · Department of Medical and Surgical Sciences, IBD Unit, University of Bologna, Bologna, Italy. · AOU Gastroenterology, Careggi University Hospital, Florence, Italy. · IBD Unit Complesso Integrato Columbus-Gemelli Hospital Catholic University Foundation, Rome, Italy. · University "Tor Vergata", Department of Systems Medicine, Rome, Italy. · Gastroenterology Unit, Federico II University, Naples, Italy. · Gastrointestinal Unit, Ospedale Central Hospital, Bolzano, Italy. · Department of Medicine, Pneumology and Nutrition Clinic, V. Cervello Hospital, Ospedali Riuniti Villa Sofia-Cervello University of Palermo, Palermo, Italy. · IBD Center, Humanitas Clinical and Research Centre, Milan, Italy. · Gastroenterology Unit, A.O. Ordine Mauriziano Hospital, Turin, Italy. · Department of Surgical and Gastroenterological Sciences, University of Padua, Padua, Italy. · Clinical Unit for Chronic Bowel Disorders, Department of Internal Medicine, IBD Unit Messina, University of Messina, Messina, Italy. · Department of Gastroenterology, San Camillo-Forlanini Hospital, Rome, Italy. · Gastroenterology Unit, San Filippo Neri Hospital, Rome, Italy. · Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS San Donato Hospital, San Donato Milanese, Italy. · Gastroenterology and Digestive Endoscopy, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy. ·Dig Liver Dis · Pubmed #28254463.

ABSTRACT: The two main forms of intestinal bowel disease, namely ulcerative colitis and Crohn's disease, are not curable but can be controlled by various medical therapies. The Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) has prepared clinical practice guidelines to help physicians prescribe corticosteroids and immunosuppressive drugs for these patients. The guidelines consider therapies that induce remission in patients with active disease as well as treatment regimens that maintain remission. These guidelines complement already existing guidelines from IG-IBD on the use of biological drugs in patients with inflammatory bowel diseases.

2 Guideline The Italian Society of Gastroenterology (SIGE) and the Italian Group for the study of Inflammatory Bowel Disease (IG-IBD) Clinical Practice Guidelines: The use of tumor necrosis factor-alpha antagonist therapy in inflammatory bowel disease. 2011

Orlando, Ambrogio / Armuzzi, Alessandro / Papi, Claudio / Annese, Vito / Ardizzone, Sandro / Biancone, Livia / Bortoli, Aurora / Castiglione, Fabiana / D'Incà, Renata / Gionchetti, Paolo / Kohn, Anna / Poggioli, Gilberto / Rizzello, Fernando / Vecchi, Maurizio / Cottone, Mario / Anonymous3360672 / Anonymous3370672. ·Department of Medicine, Pneumology and Nutrition Clinic, "V. Cervello" Hospital, Ospedali Riuniti "Villa Sofia-Cervello" University of Palermo, Italy. ambrogiorlando@tiscali.it ·Dig Liver Dis · Pubmed #20843756.

ABSTRACT: Biological therapies are an important step in the management of Inflammatory Bowel Diseases. In consideration of high cost and safety issues there is the need to have clear recommendations for their use. Despite the American Gastroenterological Association and the European Crohn's and Colitis Organisation have published exhaustive Inflammatory Bowel Disease guidelines, national guidelines may be necessary as cultural values, economical and legal issues may differ between countries. For these reasons the Italian Society of Gastroenterology and the Italian Group for the study of Inflammatory Bowel Disease have decided to elaborate the Italian guidelines on the use of biologics in Inflammatory Bowel Disease. The following items have been chosen: definitions of active, inactive, steroid dependent and resistant disease; measures of activity; anti-tumor necrosis factor alpha therapy use in active steroid dependent and refractory luminal Crohn's Disease, in fistulising Crohn's Disease, in steroid dependent and resistant active Ulcerative Colitis; risk of cancer; risk of infections during anti-tumor necrosis factor alpha therapy; special situations. These guidelines are based on evidence from relevant medical literature and clinical experience of a national working group.

3 Editorial Treatment of peri-anal fistula in Crohn's disease. 2014

Sica, Giuseppe S / Di Carlo, Sara / Tema, Giorgia / Montagnese, Fabrizio / Del Vecchio Blanco, Giovanna / Fiaschetti, Valeria / Maggi, Giulia / Biancone, Livia. ·Giuseppe S Sica, Sara Di Carlo, Giorgia Tema, Giulia Maggi, Department of Surgery, Tor Vergata University Hospital, Rome 00133, Italy. ·World J Gastroenterol · Pubmed #25309057.

ABSTRACT: Anal fistulas are a common manifestation of Crohn's disease (CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a diagnosis, particularly in CD affecting the colon and rectum. The treatment of peri-anal fistulas is difficult and always multidisciplinary. The European guidelines recommend combined surgical and medical treatment with biologic drugs to achieve best results. Several different surgical techniques are currently employed. However, at the moment, none of these techniques appear superior to the others in terms of healing rate. Surgery is always indicated to treat symptomatic, simple, low intersphincteric fistulas refractory to medical therapy and those causing disabling symptoms. Utmost attention should be paid to correcting the balance between eradication of the fistula and the preservation of fecal continence.

4 Editorial Surgery for inflammatory bowel disease in the era of laparoscopy. 2013

Sica, Giuseppe S / Biancone, Livia. · ·World J Gastroenterol · Pubmed #23674844.

ABSTRACT: During the course of inflammatory bowel disease (IBD), surgery may be needed. Approximately 20% of patients with ulcerative colitis (UC) will require surgery, whereas up to 80% of Crohn's disease (CD) patients will undergo an operation during their lifetime. For UC patients requiring surgery, total proctocolectomy and ileoanal pouch anastomosis (IPAA) is the operation of choice as it provides a permanent cure and good quality of life. Nevertheless a permanent stoma is a good option in selected patients, especially the elderly. Minimally invasive surgery has replaced the conventional open approach in many specialized centres worldwide. Laparoscopic colectomy and restorative IPAA is rapidly becoming the standard of care in the treatment of UC requiring surgery, whilst laparoscopic ileo-cecal resection is already the new gold standard in the treatment of complicated CD of terminal ileum. Short term advantages of laparoscopic surgery includes faster recovery time and reduced requirement for analgesics. It is, however, in the long term that minimally invasive surgery has demonstrated its superiority over the open approach. A better cosmesis, a reduced number of incisional hernias and fewer adhesions are the long term advantages of laparoscopy in IBD surgery. A reduction in abdominal adhesions is of great benefit when a second operation is needed in CD and this influences positively the pregnancy rate in young women undergoing restorative IPAA. In developing the therapeutic plan for IBD patients it should be recognized that the surgical approach to the abdomen has changed and that surgical treatment of complicated IBD can be safely performed with a true minimally invasive approach with great patient satisfaction.

5 Review Ustekinumab in the management of Crohn's disease: Expert opinion. 2018

Armuzzi, Alessandro / Ardizzone, Sandro / Biancone, Livia / Castiglione, Fabiana / Danese, Silvio / Gionchetti, Paolo / Orlando, Ambrogio / Rizzello, Fernando / Scribano, Maria Lia / Vecchi, Maurizio / Daperno, Marco. ·IBD Unit Presidio Columbus, Fondazione Policlinico Gemelli Università Cattolica, Rome, Italy. Electronic address: alessandro.armuzzi@unicatt.it. · UOC Gastroenterologia e Endoscopia Digestiva ASST Fatebenefratelli Sacco - DIBIC "L. Sacco" Università degli Studi, Milan, Italy. · Università degli Studi di Roma "Tor Vergata", Rome, Italy. · Gastroenterologia Università "Federico II" di Napoli, Naples, Italy. · Department of Gastroenterology, Istituto Clinico Humanitas, Rozzano, Milan, Italy. · IBD Unit, DIMEC, University of Bologna, S Orsola-Malpighi Hospital Bologna, Italy. · UOSD MICI AO Osp. Riuniti "Villa Sofia-Cervello", Palermo, Italy. · IBD Unit, San Camillo-Forlanini Hospital, Rome, Italy. · Department of Biomedical Sciences for Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. · Gastroenterology Unit, Mauriziano Hospital, Turin, Italy. ·Dig Liver Dis · Pubmed #29610019.

ABSTRACT: This expert-opinion paper reviews available evidence for the use of ustekinumab, a human interleukin 12/23 monoclonal antibody, in the treatment of Crohn's disease and discusses its potential role in the current treatment scenario for the condition. Ustekinumab appears to be associated with rapid and sustained clinical effect, as reported from the clinical research program, with additional support for potential mucosal healing. These characteristics are paralleled by a favorable safety profile, lack of immunogenicity and the presence of systemic anti-inflammatory activity. Importantly, ustekinumab requires only one single intravenous administration, while subsequent dosing is administered subcutaneously, with potential advantages for home-based therapy. Lastly, the dosage of ustekinumab is flexible. On the basis of the evidence, ustekinumab has a role in patients with primary failure or secondary loss of response to anti-tumor necrosis factor agents, as well as in those who have adverse events on front-line biologics or are reinitiating therapy after a treatment holiday. Current evidence suggests that ustekinumab may be particularly suitable in patients who present extra-intestinal manifestations of the disease or are at risk of infections. Ustekinumab may also be considered in the first-line setting, especially in frail patients, in young subjects or in those who have concomitant immune-mediated diseases.

6 Clinical Trial Mongersen, an oral SMAD7 antisense oligonucleotide, and Crohn's disease. 2015

Monteleone, Giovanni / Neurath, Markus F / Ardizzone, Sandro / Di Sabatino, Antonio / Fantini, Massimo C / Castiglione, Fabiana / Scribano, Maria L / Armuzzi, Alessandro / Caprioli, Flavio / Sturniolo, Giacomo C / Rogai, Francesca / Vecchi, Maurizio / Atreya, Raja / Bossa, Fabrizio / Onali, Sara / Fichera, Maria / Corazza, Gino R / Biancone, Livia / Savarino, Vincenzo / Pica, Roberta / Orlando, Ambrogio / Pallone, Francesco. ·From the Department of Systems Medicine, University of Tor Vergata (G.M., M.C.F., S.O., L.B., F.P.), Gastroenterology Unit-Azienda Ospedaliera San Camillo-Forlanini (M.L.S.), Inflammatory Bowel Disease Unit, Complesso Integrato Columbus, Catholic University (A.A.), and Inflammatory Bowel Disease Unit, Department of Internal Medicine, Division of Gastroenterology, Sandro Pertini Hospital Rome (R.P.), Rome, Department of Surgery, L. Sacco University Hospital (S.A., M.F.), Department of Pathophysiology and Transplantation, University of Milan and Ospedale Policlinico di Milano (F. Caprioli), and Department of Biomedical Sciences for Health, University of Milan, and Gastroenterology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Policlinico San Donato, San Donato Milanese (M.V.), Milan, First Department of Internal Medicine, St. Matteo Hospital Foundation, University of Pavia, Pavia (A.D.S., G.R.C.), Gastroenterologia, Università Federico II di Napoli, Naples (F. Castiglione), Dipartimento di Scienze Chirurgiche Oncologiche e Gastroenterologiche-Unita' Operativa di Gastroenterologia-Universita' degli Studi di Padova, Padua (G.C.S.), Department of Medical and Surgical Specialties, Gastroenterology SOD2, Azienda Ospedaliero Universitaria Careggi, Florence (F.R.), Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo (F.B.), Department of Internal Medicine, Gastroenterology and Hepatology Unit, University of Genoa, Genoa (V.S.), and the Division of Internal Medicine Villa Sofia-Cervello Hospital, University of Palermo, Palermo (A.O.) - all in Italy · and the Department of Medicine, Medical Clinic 1, University of Erlangen-Nürnberg, Erlangen, Germany (M.F.N., R.A.). ·N Engl J Med · Pubmed #25785968.

ABSTRACT: BACKGROUND: Crohn's disease-related inflammation is characterized by reduced activity of the immunosuppressive cytokine transforming growth factor β1 (TGF-β1) due to high levels of SMAD7, an inhibitor of TGF-β1 signaling. Preclinical studies and a phase 1 study have shown that an oral SMAD7 antisense oligonucleotide, mongersen, targets ileal and colonic SMAD7. METHODS: In a double-blind, placebo-controlled, phase 2 trial, we evaluated the efficacy of mongersen for the treatment of persons with active Crohn's disease. Patients were randomly assigned to receive 10, 40, or 160 mg of mongersen or placebo per day for 2 weeks. The primary outcomes were clinical remission at day 15, defined as a Crohn's Disease Activity Index (CDAI) score of less than 150, with maintenance of remission for at least 2 weeks, and the safety of mongersen treatment. A secondary outcome was clinical response (defined as a reduction of 100 points or more in the CDAI score) at day 28. RESULTS: The proportions of patients who reached the primary end point were 55% and 65% for the 40-mg and 160-mg mongersen groups, respectively, as compared with 10% for the placebo group (P<0.001). There was no significant difference in the percentage of participants reaching clinical remission between the 10-mg group (12%) and the placebo group. The rate of clinical response was significantly greater among patients receiving 10 mg (37%), 40 mg (58%), or 160 mg (72%) of mongersen than among those receiving placebo (17%) (P=0.04, P<0.001, and P<0.001, respectively). Most adverse events were related to complications and symptoms of Crohn's disease. CONCLUSIONS: We found that study participants with Crohn's disease who received mongersen had significantly higher rates of remission and clinical response than those who received placebo. (Funded by Giuliani; EudraCT number, 2011-002640-27.).

7 Clinical Trial Early post-operative endoscopic recurrence in Crohn's disease patients: data from an Italian Group for the study of inflammatory bowel disease (IG-IBD) study on a large prospective multicenter cohort. 2014

Orlando, Ambrogio / Mocciaro, Filippo / Renna, Sara / Scimeca, Daniela / Rispo, Antonio / Lia Scribano, Maria / Testa, Anna / Aratari, Annalisa / Bossa, Fabrizio / Tambasco, Rosy / Angelucci, Erika / Onali, Sara / Cappello, Maria / Fries, Walter / D'Incà, Renata / Martinato, Matteo / Castiglione, Fabiana / Papi, Claudio / Annese, Vito / Gionchetti, Paolo / Rizzello, Fernando / Vernia, Piero / Biancone, Livia / Kohn, Anna / Cottone, Mario. ·Internal Medicine, Villa Sofia-Cervello Hospital, Palermo, Italy. Electronic address: ambrogiorlando@gmail.com. · Gastroenterology and Endoscopy Unit, ARNAS Civico Hospital, Palermo, Italy. · Internal Medicine, Villa Sofia-Cervello Hospital, Palermo, Italy. · Department of Gastroenterology, IRCCS, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (FG), Italy. · Department of Gastroenterology, Federico II University, Naples, Italy. · Gastroenterology Unit, San Camillo Forlanini, Rome, Italy. · Department of Gastroenterology, San Filippo Neri Hospital, Rome, Italy. · Department of Internal Medicine, Policlinico Sant'Orsola Malpighi, Bologna, Italy. · Department of Gastroenterology, Sapienza University, Rome, Italy. · Department of Gastroenterology, Tor Vergata University, Rome, Italy. · Department of Gastroenterology, Palermo University, Palermo, Italy. · Department of Gastroenterology, Messina University, Messina, Italy. · Department of Gastroenterology, Padua University, Padua, Italy. · Gastroenterology Unit II, AOU Careggi, Florence, Italy. ·J Crohns Colitis · Pubmed #24630485.

ABSTRACT: INTRODUCTION: The incidence of endoscopic recurrence (ER) in Crohn's disease following curative resection is up to 75% at 1 year. Endoscopy is the most sensitive method to detect the earliest mucosal changes and the severe ER at 1 year seems to predict a clinical relapse. METHODS: The aim of this prospective study was to evaluate the incidence of early ER 6 months after curative resection. Secondary outcome was to evaluate the role of 5-aminosalicylic acid (5-ASA) in the prevention of ER at 6 months. A total of 170 patients were included in the study. They were carried-out from the evaluation of the appearance of ER during a trial performed to assess the role of azathioprine vs. 5-ASA as early treatment of severe ER. All the patients started 5-ASA treatment 2 weeks after surgery. RESULTS: Six months after surgery ER was observed in 105 patients (62%). The endoscopic score was reported as severe in 78.1% of them (82 out of 105). At univariable analysis only ileo-colonic disease influenced the final outcome associating to a lower risk of severe ER (p=0.04; OR 0.52, 95% CI 0.277-0.974). CONCLUSION: In this prospective Italian multicenter IG-IBD study a great proportion of ER occur within 6 months from ileo-colonic resection, with a significant rate of severe ER. Furthermore this study confirms the marginal role of 5-ASA in the prevention of ER. This suggests that post-surgical endoscopic evaluation should be performed at 6 months instead of 1 year to allow an adequate early treatment.

8 Clinical Trial Anti-TNF-alpha treatments and obstructive symptoms in Crohn's disease: a prospective study. 2013

Condino, Giovanna / Calabrese, Emma / Zorzi, Francesca / Onali, Sara / Lolli, Elisabetta / De Biasio, Fabiola / Ascolani, Marta / Pallone, Francesco / Biancone, Livia. ·GI Unit, Department of Systems Medicine, University Tor Vergata, Rome, Italy. ·Dig Liver Dis · Pubmed #23195667.

ABSTRACT: BACKGROUND: The development of symptomatic strictures in Crohn's Disease after anti-Tumour Necrosis Factor-α antibodies is undefined. AIM: To assess, in a prospective longitudinal study, the frequency of sub/obstructions in Crohn's Disease patients after treatment with Infliximab or Adalimumab. Changes of small bowel lesions after these biological therapies were searched by ultrasonography. MATERIALS AND METHODS: From January 2007 to October 2008, 36 Crohn's Disease patients with no previous sub/obstructions were treated with either Infliximab (n=13) or Adalimumab (n=23) for ≥12months (mean follow-up duration after the first treatment 23.2±6.8months). Small Intestine Contrast Ultrasonography was performed before and after treatment in 19/36 patients. Sonographic parameters included: bowel wall thickness, lumen diameter, bowel dilation and lesion extent. RESULTS: Sub/obstructions developed in 3/36 patients treated with Infliximab (n=1) or Adalimumab (n=2), all with fibrostricturing Crohn's Disease. Sonographic parameters did not significantly change after treatment. CONCLUSIONS: Sub/obstructive symptoms may develop in one tenth of Crohn's Disease patients treated with anti-Tumour Necrosis Factor-α antibodies, with no significant sonographic changes of the small bowel lesions.

9 Clinical Trial A phase 1 open-label trial shows that smad7 antisense oligonucleotide (GED0301) does not increase the risk of small bowel strictures in Crohn’s disease. 2012

Zorzi, F / Calabrese, E / Monteleone, I / Fantini, M / Onali, S / Biancone, L / Pallone, F / Monteleone, G. ·Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome, Italy. ·Aliment Pharmacol Ther · Pubmed #22971085.

ABSTRACT: BACKGROUND: In Crohn's disease (CD), knockdown of Smad7, an inhibitor of Transforming Growth Factor (TGF)-β1 activity, with a specific antisense oligonucleotide (GED0301) seems to be safe and tolerable and associates with TGF-β1-mediated suppression of inflammatory pathways. AIM: Since TGF-β1 has pro-fibrogenic effects in many organs, we evaluated whether GED0301 treatment associates with the formation of small bowel strictures. METHODS: Fifteen patients with active, inflammatory CD, receiving oral GED0301 once daily for 7 days, were monitored for the formation of small bowel strictures by Small Intestine Contrast Ultrasonography (SICUS). Serum basic fibroblast growth factor (bFGF) and human chitinase 3-like 1 (also known as YKL-40), two markers of CD-related intestinal strictures, and matrix metalloproteinases (MMP) and tissue inhibitor 1 of MMPs (TIMP1) were analysed at day 0 and day 180 by ELISA. Crohn's disease activity index (CDAI) changes were also monitored. RESULTS: Fourteen patients completed the 6-month study; the remaining underwent intestinal resection for a severe relapse not responsive to medical treatment. No patient developed small bowel stricture and none experienced obstructive symptoms during the study period. GED0301 treatment induced no significant change in the circulating levels of bFGF, YKL-40, MMPs and TIMP1. Seven of 12 patients who reached clinical remission following GED0301 treatment maintained a CDAI < 150 at day 180. CONCLUSION: Short-term treatment of patients with Crohn's disease using GED0301 is not associated with the development of small bowel stricture, thus reinforcing the concept that this drug is safe at least at early time points.

10 Clinical Trial Phase I clinical trial of Smad7 knockdown using antisense oligonucleotide in patients with active Crohn's disease. 2012

Monteleone, Giovanni / Fantini, Massimo C / Onali, Sara / Zorzi, Francesca / Sancesario, Giulia / Bernardini, Sergio / Calabrese, Emma / Viti, Francesca / Monteleone, Ivan / Biancone, Livia / Pallone, Francesco. ·Dipartimento di Medicina Interna, Università Tor Vergata, Rome, Italy. Gi.Monteleone@Med.uniroma2.it ·Mol Ther · Pubmed #22252452.

ABSTRACT: In the gut of patients with Crohn's disease (CD), high Smad7 blocks the immune-suppressive activity of transforming growth factor (TGF)-β1, thereby contributing to amplify inflammatory signals. In vivo in mice, knockdown of Smad7 with a Smad7 antisense oligonucleotide (GED0301) attenuates experimental colitis. Here, we provide results of a phase 1 clinical, open-label, dose-escalation study of GED0301 in patients with active, steroid-dependent/resistant CD, aimed at assessing the safety and tolerability of the drug. Patients were allocated to three treatment groups receiving oral GED0301 once daily for 7 days at doses of 40, 80, or 160 mg. A total of 15 patients were enrolled. No serious adverse event was registered. GED0301 was well tolerated and no patient dropped out during the study. Twenty-five adverse events were documented in 11 patients, the majority of whom were judged to be of mild intensity and unrelated to treatment. GED0301 treatment reduced the percentage of inflammatory cytokine-expressing CCR9-positive T cells in the blood. The study shows for the first time that GED0301 is safe and well tolerated in patients with active CD.

11 Clinical Trial Small bowel capsule endoscopy vs conventional techniques in patients with symptoms highly compatible with Crohn's disease. 2011

Petruzziello, Carmelina / Calabrese, Emma / Onali, Sara / Zuzzi, Sara / Condino, Giovanna / Ascolani, Marta / Zorzi, Francesca / Pallone, Francesco / Biancone, Livia. ·Cattedra di Gastroenterologia, Università degli Studi di Roma "Tor Vergata", Rome, Italy. ·J Crohns Colitis · Pubmed #21453883.

ABSTRACT: BACKGROUND & AIMS: The diagnostic role of Small Bowel Capsule Endoscopy (SBCE) in Crohn's Disease (CD) is under investigation. In a prospective study we investigated the diagnostic role of SBCE in patients with symptoms highly compatible with CD and undefined diagnosis after conventional techniques. METHODS: From September 2005 to May 2009, all patients with clinically suspected CD and not conclusive diagnosis after Ileocolonoscopy (IC), Small Bowel Follow Through (SBFT) and Small Intestine Contrast Ultrasonography (SICUS) were enrolled. Findings compatible with CD included: bowel wall thickness (BWT) >3mm (for SICUS), ulcers, stenosis/strictures, fistulae (for SICUS, SBFT); >5 aphtoid ulcers, deep ulcers and/or strictures (for SBCE). RESULTS: Conventional techniques did not lead to a conclusive diagnosis in 30 patients (19 F, median age 31 years, range 8-57), showing chronic diarrhoea (n=27), abdominal pain (n=23), weight loss (n=5), fever (n=5), Iron Deficiency Anaemia (IDA)(n=5) and/or perianal disease (n=4). Findings compatible but not diagnostic for small bowel CD were detected in 19 (63%) by IC in 12 (40%) by SICUS and in 15 (50%) by SBFT. SBCE showed ileal lesions in 15 (50%) patients, including findings compatible with CD in 12 (40%). SBCE retention requiring surgery was observed in 1 patient. A significant concordance was observed between SBCE and IC k=0.33 C(k)=[0.25;0.42], but not between SBCE and SICUS k=0.13 IC(k)=[0.045;0.22] and between SBCE and SBFT k=0 IC(k)=[-0.089;0.089]. CONCLUSIONS: SBCE may detect lesions compatible with small bowel CD in almost one third of patients with symptoms highly compatible with CD and not conclusive diagnosis by using conventional techniques.

12 Article Impact of surgery on quality of life in Crohn's disease: short- and mid-term follow-up. 2020

D'Ugo, Stefano / Romano, Francesca / Sibio, Simone / Bagaglini, Giulia / Sensi, Bruno / Biancone, Livia / Monteleone, Giovanni / Sica, Giuseppe S. ·Gastrointestinal Surgery Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133, Rome, Italy. dugo.stefano@gmail.com. · Department of Surgery, "Vito Fazzi" Hospital, Piazza F. Muratore, 73100, Lecce, Italy. dugo.stefano@gmail.com. · Gastrointestinal Surgery Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133, Rome, Italy. · Department of Surgery, La Sapienza University, P.le A. Moro, Rome, Italy. · Gastroenterology Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133, Rome, Italy. ·Updates Surg · Pubmed #32185677.

ABSTRACT: Active Crohn's disease has a substantial impact on Quality of Life (QoL). Medical management could be associated to side effects, hospitalization, long treatment period and requires patient's compliance, impacting QoL. Ileocecal resection (ICR) is often required, open or laparoscopic. Aim of the study was to assess Health-Related (HR) QoL changes following ICR, and to identify factors impacting on QoL in the short and mid-term. From a single institution, we created a prospective database of patients undergoing ICR from 01/2009 to 12/2015. HRQoL was analysed with Cleveland Global Quality of Life (CGQL) score, Overall Quality of Happiness (OQH), and asking patients if they would have surgery again. QoL scores were recorded at 30 days, 6, 12 and 36 months postoperatively and compared according to follow-up timing, technique, medical treatment and demographics. Statistical analysis included 187 patients. Mean follow-up was 3.8 ± 2.9 years. Both at 30 days and 6 months postoperatively, CGQL, its items and OQH increased significantly (p < 0.001). Increased values were also recorded at 1 and 3 years; 88% of patients would undergo surgery again. Laparoscopy was associated with improved CGQL scores, while preoperative steroids with worsen data. Young female patients, with penetrating pattern, experienced greater HRQoL improvements. Surgery is associated with improvements of HRQoL and patients' happiness in the short and mid-term. Laparoscopy, steroid-free and young patients showed the best results. ICR should be considered a reasonable alternative to non-operative strategies in selected cases.

13 Article ECCO Guidelines on Therapeutics in Crohn's Disease: Surgical Treatment. 2020

Adamina, Michel / Bonovas, Stefanos / Raine, Tim / Spinelli, Antonino / Warusavitarne, Janindra / Armuzzi, Alessandro / Bachmann, Oliver / Bager, Palle / Biancone, Livia / Bokemeyer, Bernd / Bossuyt, Peter / Burisch, Johan / Collins, Paul / Doherty, Glen / El-Hussuna, Alaa / Ellul, Pierre / Fiorino, Gionata / Frei-Lanter, Cornelia / Furfaro, Federica / Gingert, Christian / Gionchetti, Paolo / Gisbert, Javier P / Gomollon, Fernando / González Lorenzo, Marien / Gordon, Hannah / Hlavaty, Tibor / Juillerat, Pascal / Katsanos, Konstantinos / Kopylov, Uri / Krustins, Eduards / Kucharzik, Torsten / Lytras, Theodore / Maaser, Christian / Magro, Fernando / Marshall, John Kenneth / Myrelid, Pär / Pellino, Gianluca / Rosa, Isadora / Sabino, Joao / Savarino, Edoardo / Stassen, Laurents / Torres, Joana / Uzzan, Mathieu / Vavricka, Stephan / Verstockt, Bram / Zmora, Oded. ·Department of Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland. · University of Basel, Basel, Switzerland. · Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. · IBD Center, Humanitas Clinical and Research Center, Milan, Italy. · Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. · Humanitas Clinical and Research Center, Division of Colon and Rectal Surgery, Humanitas University, Department of Biomedical Sciences, Milan, Italy. · Imperial College London, Department of Surgery and Cancer, St Mark's Hospital, Department of Gastroenterology, London, UK. · IBD Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS - Universita' Cattolica del Sacro Cuore, Rome, Italy. · Department of Internal Medicine I, Siloah St Trudpert Hospital, Pforzheim, Germany. · Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark. · Department of Systems Medicine, University 'Tor Vergata' of Rome, Rome, Italy. · Gastroenterology Practice Minden, Minden, Germany. · Imelda GI Clinical Research Centre, Imelda General Hospital, Bonheiden, Belgium. · Gastrounit, Medical Division, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark. · Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, UK. · Department of Gastroenterology and Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland. · Department of Surgery, Aalborg University Hospital, Aalborg, Denmark. · Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta. · Department of Surgery, Hospital Zollikerberg, Zollikerberg Zürich, Switzerland. · Visceral Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland; Department of Human Medicine, Faculty of Health, University of Witten/Herdecke, Witten, Germany. · IBD Unit, DIMEC, University of Bologna, Bologna, Italy. · Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP], Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD], Madrid, Spain. · IBD UNIT, Hospital Clíico Universitario 'Lozano Blesa', IIS Aragón, CIBEREHD, Zaragoza, Spain. · Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London, UK. · Fifth Department of Internal Medicine, Sub-department of Gastroenterology and Hepatology, University Hospital Bratislava and Faculty of Medicine, Comenius University Bratislava, Slovakia. · Clinic for Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland. · Department of Gastroenterology and Hepatology, University and Medical School of Ioannina, Ioannina, Greece. · Department of Gastroenterology, Tel-HaShomer Sheba Medical Center, Ramat Gan, Israel; and Sackler Medical School, Tel Aviv, Israel. · Department of Gastroenterology, Hepatology and Nutrition, Pauls Stradins Clinical University Hospital, Department of Internal Medicine, Riga Stradiņš University, Riga, Latvia. · Department of Internal Medicine and Gastroenterology, Hospital Lüneburg, Lüneburg, Germany. · National Public Health Organization, Athens, Greece. · Outpatients Department of Gastroenterology, Hospital Lüneburg, Lüneburg, Germany. · Department of Pharmacology and Therapeutics; Institute for Molecular and Cell Biology, University of Porto, Faculty of Medicine, Porto, Portugal. · Department of Medicine [Division of Gastroenterology] and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada. · Department of Surgery, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. · Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy. · Department of Gastroenterology, IPOLFG, Lisbon, Portugal. · Department of Gastroenterology and Hepatology, University Hospitals, KU Leuven, Leuven, Belgium. · Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy. · Department of General Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands. · Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal. · Department of Gastroenterology, IBD unit, Beaujon Hospital, APHP, Clichy, France. · Division of Gastroenterology and Hepatology, University Hospital, Zürich, Switzerland. · Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium, and Department of Chronic Diseases, Metabolism and Ageing, TARGID - IBD, KU Leuven, Leuven, Belgium. · Department of Surgery, Shamir Medical Center [Assaf Harofe], Tel Aviv, Israel. ·J Crohns Colitis · Pubmed #31742338.

ABSTRACT: This article is the second in a series of two publications relating to the European Crohn's and Colitis Organisation [ECCO] evidence-based consensus on the management of Crohn's disease. The first article covers medical management; the present article addresses surgical management, including preoperative aspects and drug management before surgery. It also provides technical advice for a variety of common clinical situations. Both articles together represent the evidence-based recommendations of the ECCO for Crohn's disease and an update of previous guidelines.

14 Article Multiplex gene expression profile in inflamed mucosa of patients with Crohn's disease ileal localization: A pilot study. 2019

Giudici, Francesco / Lombardelli, Letizia / Russo, Edda / Cavalli, Tiziana / Zambonin, Daniela / Logiodice, Federica / Kullolli, Ornela / Giusti, Lamberto / Bargellini, Tatiana / Fazi, Marilena / Biancone, Livia / Scaringi, Stefano / Clemente, Ann Maria / Perissi, Eloisa / Delfino, Giovanni / Torcia, Maria G / Ficari, Ferdinando / Tonelli, Francesco / Piccinni, Marie-Pierre / Malentacchi, Cecilia. ·Marie- Pierre Piccinni, Department of Experimental and Clinical Medicine, University of Firenze, Firenze 50134, Italy. · Marie- Pierre Piccinni, Department of Experimental and Clinical Medicine, University of Firenze, Firenze 50134, Italy. edda.russo@unifi.it. · Dipartimento Chirurgico Ortopedico, Ospedale Carlo Poma di Mantova, Firenze 50134, Italy. · Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Firenze, Firenze 50134, Italy. · Surgical Unit, Department of Surgery and Translational Medicine, University of Firenze, Firenze 50134, Italy. · Department of Internal Medicine, University of Roma Tor Vergata, Roma 00133, Italy. ·World J Clin Cases · Pubmed #31559282.

ABSTRACT: BACKGROUND: Crohn's disease (CD) is a complex disorder resulting from the interaction of genetic, environmental, and microbial factors. The pathogenic process may potentially affect any segment of the gastrointestinal tract, but a selective location in the terminal ileum was reported in 50% of patients. AIM: To characterize clinical sub-phenotypes (colonic and/or ileal) within the same disease, in order to identify new therapeutic targets. METHODS: 14 consecutive patients undergoing surgery for ileal CD were recruited for this study. Peripheral blood samples from each patient were collected and the main polymorphisms of the gene RESULTS: We found a significant increase of Th17 (IL17A and IL17F, IL 23R and CCR6) and Th1 (IFN-γ) gene expression in inflamed mucosa compared to non-inflamed sites of 14 CD patients. CONCLUSION: We observed that the expression of ileal genes related to Th1 and Th17 activity is strongly activated as well as the expression of genes involved in microbiota regulation.

15 Article Real-life effectiveness of ustekinumab in inflammatory bowel disease patients with concomitant psoriasis or psoriatic arthritis: An IG-IBD study. 2019

Pugliese, Daniela / Daperno, Marco / Fiorino, Gionata / Savarino, Edoardo / Mosso, Elena / Biancone, Livia / Testa, Anna / Sarpi, Lucio / Cappello, Maria / Bodini, Giorgia / Caprioli, Flavio / Festa, Stefano / Laino, Gabriella / Maconi, Giovanni / Mazzuoli, Silvia / Mocci, Giammarco / Sartini, Alessandro / D'Amore, Alessandra / Alivernini, Stefano / Gremese, Elisa / Armuzzi, Alessandro. ·IBD Unit, Presidio Columbus, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy. · Gastroenterology Unit, A.O. Ordine Mauriziano, Turin, Italy. · IBD Center, Department of Gastroenterology, Humanitas Research Hospital, Rozzano, Italy. · Gastroenterology Unit, Department Surgery, Oncology and Gastroenterology, University of Padua, Italy. · General and Specialistic Medicine/Gastroenterology, Città della Salute e della Scienza di Torino, Italy. · University of Rome Tor Vergata, Department of Systems Medicine, Gastroenterology, Rome, Italy. · Federico II University, Gastroenterology, Naples, Italy. · Gastroenterologia ed Endoscopia Digestiva Aziendale USL Umbria1, Perugia, Italy. · Gastroenterology and Hepatology Section, DiBiMis, University of Palermo, Palermo, Italy. · Gastrointestinal Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy. · Department of Pathophysiology and Transplantation, University of Milan and Gastroenterology and Endoscopy Unit, IRCCS Cà Granda, IRCCS Policlinico Hospital, Milan, Italy. · IBD Unit, San Filippo Neri Hospital, Rome, Italy. · Department of New Technologies and Translational Research in Medicine and Surgery, University of Pisa, Pisa, Italy. · Luigi Sacco University Hospital, Gastroenterology and IBD Unit, Milan, Italy. · Gastroenterology Unit, San Nicola Pellegrino Hospital, Trani, Italy. · Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy. · Department of Internal Medicine, Gastroenterology Unit, University of Modena and Reggio Emilia, Modena, Italy. · Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Rome, Italy. · Division of Rheumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Rome, Italy. · IBD Unit, Presidio Columbus, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: alearmuzzi@yahoo.com. ·Dig Liver Dis · Pubmed #30992173.

ABSTRACT: BACKGROUND: Few data exist regarding the effectiveness of ustekinumab in inflammatory bowel disease (IBD) patients treated for concomitant psoriasis or psoriatic arthritis. AIMS: to describe the outcomes of IBD patients who received subcutaneous ustekinumab through a dermatological or rheumatological prescription. METHODS: This multicenter, retrospective study included all IBD patients who were started on ustekinumab for concomitant active psoriasis/ psoriatic arthritis, irrespective of IBD activity. The primary endpoint was overall ustekinumab persistence, defined as the maintenance of therapy because of sustained clinical benefit for IBD. RESULTS: Seventy patients (64 Crohn's disease / 6 ulcerative colitis) were enrolled. The median follow-up on ustekinumab therapy was 10.7 months (range, 1.4-67.3). Twelve patients (17.1%) withdrew the treatment after a median of 7.4 months (range, 0.9-23.8). The cumulative probability of maintaining ustekinumab treatment was 97.1% at 6 months and 77.1% at 12 months. Among the 56 patients with baseline active IBD, 34 (60.7%) were in clinical remission at the last follow-up visit. Their cumulative probability of achieving clinical remission was 84.7% and 63.9% at 6 and 12 months, respectively. Two patients stopped ustekinumab for an adverse event. CONCLUSIONS: Subcutaneous ustekinumab had a good effectiveness profile for IBD patients treated for concomitant dermatological or rheumatological conditions.

16 Article The PROSIT Cohort of Infliximab Biosimilar in IBD: A Prolonged Follow-up on the Effectiveness and Safety Across Italy. 2019

Armuzzi, Alessandro / Fiorino, Gionata / Variola, Angela / Manetti, Natalia / Fries, Walter / Orlando, Ambrogio / Maconi, Giovanni / Bossa, Fabrizio / Cappello, Maria / Biancone, Livia / Cantoro, Laura / Costa, Francesco / D'Incà, Renata / Lionetti, Paolo / Principi, Mariabeatrice / Castiglione, Fabiana / Annunziata, Maria L / Di Sabatino, Antonio / Di Girolamo, Maria / Terpin, Maria M / Cortelezzi, Claudio C / Saibeni, Simone / Amato, Arnaldo / Ardizzone, Sandro / Guidi, Luisa / Danese, Silvio / Massella, Arianna / Ventra, Agostino / Rizzuto, Giulia / Massari, Alessandro / Perri, Francesco / Annese, Vito / Anonymous401068. ·IBD Unit, Presidio Columbus, Fondazione Policlinico Gemelli Università Cattolica, Rome, Italy. · Humanitas Research Hospital and University, Gastroenterology and IBD Center, Rozzano, Italy. · Centro Malattie retto-intestinali, Sacro Cuore Don Calabria Hospital, Negrar, Italy. · AOU Careggi, Gastroenterology, Florence, Italy. · University of Messina, Clinical Unit for Chronic Bowel Disorders, Messina, Italy. · Riuniti Villa Sofia-Cervello Hospital, Internal Medicine 2, IBD Unit Palermo, Italy. · Luigi Sacco University Hospital, Gastroenterology and IBD Unit, Milan, Italy. · IRCCS-CSS Hospital, Gastroenterology, San Giovanni Rotondo, Italy. · Gastroenterology and Hepatology Section, DiBiMis, University of Palermo, Palermo, Italy. · University of Rome Tor Vergata, Department of Systems Medicine, Gastroenterology, Roma. · S. Camillo-Forlanini Hospital, Gastroenterology, Rome, Italy. · AOUP, Gastroenterology, Pisa, Italy. · University of Padova, Gastroenterology, Padova, Italy. · Meyer Children's Hospital, Gastroenterology and Nutrition, Florence, Italy. · University of Bari, Gastroenterology, Bari, Italy. · Federico II University, Gastroenterology, Naples, Italy. · IRCCS Policlinico, Gastroenterology, San Donato Milanese-Milano, Italy. · First Department of Medicine, S. Matteo Hospital Foundation, University of Pavia, Pavia, Italy. · University Hospital, Gastroenterology, Modena, Italy. · U.O.C. Gastroenterologia ed Endoscopia Digestiva ASST Ovest Milanese, Legnano, Italy. · SC Gastroenterology ASST Settelaghi Varese, Italy. · ASST Rhodense, Rho Hospital, Gastroenterology Unit, Rho, Italy. · Ospedale Valduce, Gastroenterology, Como, Italy. · Department of Biochemical and Clinical Science "L. Sacco" ASST Fatebenefratelli Sacco-University of Milan, Italy. ·Inflamm Bowel Dis · Pubmed #30137352.

ABSTRACT: BACKGROUND: We report a prospective, nationwide cohort evaluating the safety and effectiveness of CT-P13. METHODS: A structured database was used to record serious adverse events (SAEs), clinical remission/response, inflammatory biomarkers (CRP and calprotectin), and endoscopic findings. RESULTS: Eight hundred ten patients with inflammatory bowel disease (IBD) (452 Crohn's disease [CD]) were enrolled. Four hundred fifty-nine patients were naïve to anti-TNFα (group A), 196 had a previous exposure (group B), and the remaining 155 were switched to CT-P13 (group C). All patients were included in the safety evaluation with a mean follow-up of 345 ± 215 days and a total number of 6501 infusions. One hundred fifty-four SAEs were reported (19%), leading to cessation of the biosimilar in 103 subjects (12.7%). Infusion reactions were 71, leading to cessation of the biosimilar in 53 subjects (6.5%), being significantly more frequent in patients pre-exposed to anti-TNFα (P = 0.017). The efficacy of therapy was calculated in 754 IBD patients, with a mean follow-up of 329 ± 202 days. Forty-eight patients had a primary failure (6.4%), and 188 (25.6%) lost response during follow-up. Six hundred twenty-eight (364 CD) and 360 IBD patients (222 CD) completed the follow-up at 6 and 12 months, respectively. At 12 months, patients without loss of response were 71%, 64%. and 82% in groups A, B, and C, respectively (log rank P = 0.01). Clinical/endoscopic scores and inflammatory biomarkers dropped significantly in CD and UC patients (P = 0.01 and P < 0.0001) compared with baseline. CONCLUSIONS: In this large prospective cohort, no further signals of difference in safety and effectiveness of CT-P13 in IBD has been observed.

17 Article Epstein-Barr virus-positive ileal carcinomas associated with Crohn's disease. 2017

Vanoli, Alessandro / Di Sabatino, Antonio / Martino, Michele / Dallera, Elena / Furlan, Daniela / Mescoli, Claudia / Macciomei, Maria Cristina / Biancone, Livia / Neri, Benedetto / Grillo, Federica / Biletta, Elena / Rugge, Massimo / Sessa, Fausto / Paulli, Marco / Corazza, Gino Roberto / Solcia, Enrico. ·Department of Molecular Medicine, University of Pavia and San Matteo Hospital, Via Forlanini 16, 27100, Pavia, Italy. alessandro.vanoli@unipv.it. · Department of Medicine and Surgery, University of Insubria, Varese, Italy. alessandro.vanoli@unipv.it. · Department of Internal Medicine, University of Pavia and San Matteo Hospital, Pavia, Italy. · Department of Molecular Medicine, University of Pavia and San Matteo Hospital, Via Forlanini 16, 27100, Pavia, Italy. · Department of Medicine and Surgery, University of Insubria, Varese, Italy. · Pathology Unit, Department of Medicine, University of Padua, Padua, Italy. · Pathology Unit, San Camillo-Forlanini Hospital, Rome, Italy. · Department of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy. · Pathology Unit, Department of Surgical and Diagnostic Sciences, University of Genoa, San Martino/IST University Hospital, Genoa, Italy. ·Virchows Arch · Pubmed #28752215.

ABSTRACT: -- No abstract --

18 Article Small bowel carcinomas in celiac or Crohn's disease: distinctive histophenotypic, molecular and histogenetic patterns. 2017

Vanoli, Alessandro / Di Sabatino, Antonio / Martino, Michele / Klersy, Catherine / Grillo, Federica / Mescoli, Claudia / Nesi, Gabriella / Volta, Umberto / Fornino, Daniele / Luinetti, Ombretta / Fociani, Paolo / Villanacci, Vincenzo / D'Armiento, Francesco P / Cannizzaro, Renato / Latella, Giovanni / Ciacci, Carolina / Biancone, Livia / Paulli, Marco / Sessa, Fausto / Rugge, Massimo / Fiocca, Roberto / Corazza, Gino R / Solcia, Enrico. ·Department of Molecular Medicine, University of Pavia, Pavia, Italy. · Pathology Unit, IRCCS San Matteo Hospital, Pavia, Italy. · Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy. · Department of Internal Medicine, IRCCS San Matteo Hospital, University of Pavia, Pavia, Italy. · Biometry and Statistics Service, IRCCS San Matteo Hospital, Pavia, Italy. · Pathology Unit, Department of Surgical and Diagnostic Sciences, San Martino/IST University Hospital, Genova, Italy. · Pathology Unit, Department of Medicine, University of Padua, Padua, Italy. · Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Division of Gastroenterology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. · Unit of Pathology, Luigi Sacco University Hospital, Milan, Italy. · Pathology Section, Spedali Civili Hospital, Brescia, Italy. · Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy. · Department of Gastroenterology, National Cancer Institute, Aviano, Italy. · Gastroenterology Unit, Department of Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy. · Department of Medicine and Surgery, University of Salerno, Salerno, Italy. · Department of Systems Medicine, University of Tor Vergata, Rome, Italy. ·Mod Pathol · Pubmed #28664941.

ABSTRACT: Non-familial small bowel carcinomas are relatively rare and have a poor prognosis. Two small bowel carcinoma subsets may arise in distinct immune-inflammatory diseases (celiac disease and Crohn's disease) and have been recently suggested to differ in prognosis, celiac disease-associated carcinoma cases showing a better outcome, possibly due to their higher DNA microsatellite instability and tumor-infiltrating T lymphocytes. In this study, we investigated the histological structure (glandular vs diffuse/poorly cohesive, mixed or solid), cell phenotype (intestinal vs gastric/pancreatobiliary duct type) and Wnt signaling activation (β-catenin and/or SOX-9 nuclear expression) in a series of 26 celiac disease-associated small bowel carcinoma, 25 Crohn's disease-associated small bowel carcinoma and 25 sporadic small bowel carcinoma cases, searching for new prognostic parameters. In addition, non-tumor mucosa of celiac and Crohn's disease patients was investigated for epithelial precursor changes (hyperplastic, metaplastic or dysplastic) to help clarify carcinoma histogenesis. When compared with non-glandular structure and non-intestinal phenotype, both glandular structure and intestinal phenotype were associated with a more favorable outcome at univariable or stage- and microsatellite instability/tumor-infiltrating lymphocyte-inclusive multivariable analysis. The prognostic power of histological structure was independent of the clinical groups while the non-intestinal phenotype, associated with poor outcome, was dominant among Crohn's disease-associated carcinoma. Both nuclear β-catenin and SOX-9 were preferably expressed among celiac disease-associated carcinomas; however, they were devoid, per se, of prognostic value. We obtained findings supporting an origin of celiac disease-associated carcinoma in SOX-9-positive immature hyperplastic crypts, partly through flat β-catenin-positive dysplasia, and of Crohn's disease-associated carcinoma in a metaplastic (gastric and/or pancreatobiliary-type) mucosa, often through dysplastic polypoid growths of metaplastic phenotype. In conclusion, despite their common origin in a chronically inflamed mucosa, celiac disease-associated and Crohn's disease-associated small bowel carcinomas differ substantially in histological structure, phenotype, microsatellite instability/tumor-infiltrating lymphocyte status, Wnt pathway activation, mucosal precursor lesions and prognosis.

19 Article Training Programs on Endoscopic Scoring Systems for Inflammatory Bowel Disease Lead to a Significant Increase in Interobserver Agreement Among Community Gastroenterologists. 2017

Daperno, Marco / Comberlato, Michele / Bossa, Fabrizio / Armuzzi, Alessandro / Biancone, Livia / Bonanomi, Andrea G / Cassinotti, Andrea / Cosintino, Rocco / Lombardi, Giovanni / Mangiarotti, Roberto / Papa, Alfredo / Pica, Roberta / Grassano, Luca / Pagana, Guido / D'Incà, Renata / Orlando, Ambrogio / Rizzello, Fernando / Anonymous6510904. ·Gastroenterology Unit, AO Ordine Mauriziano, Torino, TO, Italy. · Gastroenterology Unit, Ospedale di Bolzano, Bolzano, Italy. · Gastroenterology Unit, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy. · Gastroenterology Unit, Complesso integrato Columbus, Roma, Italy. · Gastroenterology Unit, Tor Vergata University, Roma, Italy. · Gastroenterology Unit, AOU Careggi, Firenze, Italy. · Gastroenterology Unit, S. Camillo-Forlanini Hospital, Roma, Italy. · Gastroenterology Unit, Cardarelli Hospital, Napoli, Italy. · Gastroenterology Unit, ASL Roma B, Ospedale Pertini, Roma, Italy. · Politecnico di Torino, Torino, Italy. · Istituto Mario Boella, Torino, Italy. · Department of Surgery, Oncology and Gastroenterology, Azienda Ospedaliera di Padova, Padova, Italy. · Internal Medicine Unit, AO Ospedali Riuniti Villa Sofia - Cervello, Palermo, Italy. · Internal Medicine Unit, Policlinic S. Orsola Malpighi and Bologna University, Bologna, Italy. ·J Crohns Colitis · Pubmed #28453758.

ABSTRACT: Background and Aims: Endoscopic outcomes are increasingly used in clinical trials and in routine practice for inflammatory bowel disease [IBD] in order to reach more objective patient evaluations than possible using only clinical features. However, reproducibility of endoscopic scoring systems used to categorize endoscopic activity has been reported to be suboptimal. The aim of this study was to analyse the inter-rated agreement of non-dedicated gastroenterologists on IBD endoscopic scoring systems, and to explore the effects of a dedicated training programme on agreement. Methods: A total of 237 physicians attended training courses on IBD endoscopic scoring systems, and they independently scored a set of IBD endoscopic videos for ulcerative colitis [with Mayo endoscopic subscore], post-operative Crohn's disease [with Rutgeerts score] and luminal Crohn's disease (with the Simple Endoscopic Score for Crohn's Disease [SESCD] and Crohn's Endoscopic Index of Severity [CDEIS]). A second round of scoring was collected after discussion about determinants of discrepancy. Interobserver agreement was measured by means of the Fleiss' kappa [kappa] or intraclass correlation coefficient [ICC] as appropriate. Results: The inter-rater agreement increased from kappa 0.51 (95% confidence interval [95% CI] 0.48-0.55) to 0.76 [95% CI 0.72-0.79] for the Mayo endoscopic subscore, and from 0.45 [95% CI 0.40-0.50] to 0.79 [0.74-0.83] for the Rutgeerts score before and after the training programme, respectively, and both differences were significant [P < 0.0001]. The ICC was 0.77 [95% CI 0.56-0.96] for SESCD and 0.76 [0.54- 0.96] for CDEIS, respectively, with only one measurement. Discussion: The basal inter-rater agreement of inexperienced gastroenterologists focused on IBD management is moderate; however, a dedicated training programme can significantly impact on inter-rater agreement, increasing it to levels expected among expert central reviewers.

20 Article Crohn's Colitis: Development of a multiplex gene expression assay comparing mRNA levels of susceptibility genes. 2017

Russo, Edda / Lombardelli, Letizia / Giudici, Francesco / Cavalli, Tiziana / Ficari, Ferdinando / Fazi, Marilena / Scaringi, Stefano / Biancone, Livia / Logiodice, Federica / Nesi, Mariateresa / Latiano, Anna / Annese, Vito / Torcia, Maria Gabriella / Bechi, Paolo / Tonelli, Francesco / Piccinni, Marie-Pierre / Malentacchi, Cecilia. ·Department of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy. Electronic address: edda.russo@unifi.it. · Department of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy. · Department of Surgery and Translational Medicine (DCMT), Section of Surgery, University of Florence, Florence, Italy. · Department of Surgery and Translational Medicine (DCMT), Section of Surgery, University of Florence, Florence, Italy; Gastroenterology Unit SOD2, AOUC Careggi, Florence, Italy. · Department of Internal Medicine, University of Rome Tor Vergata, Rome, Italy. · Department of Experimental and Clinical Biomedical Sciences (SBSC) "Mario Serio", University of Florence, Florence, Italy. · Division of Gastroenterology, IRCCS "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. · Gastroenterology Unit SOD2, AOUC Careggi, Florence, Italy. ·Clin Res Hepatol Gastroenterol · Pubmed #28365139.

ABSTRACT: Crohn's disease (CD) is a multifactorial immunologically mediated disease. In this study we explored, for the first time, the efficacy of the Multiplex Gene Assay technology for detecting mRNA expression profile of 24 selected CD related genes in endoscopic biopsies and surgical specimens from CD patients with colonic localization of the disease. The polymorphisms of genes most frequently associated with CD were also analysed in DNA samples from the same patients. The analysis of endoscopic samples showed increased expression of 7 genes in inflamed mucosa compared to non-inflamed mucosa and suggests the activation of the autophagy process and of a Th17 adaptive response. The analysis of surgical specimens showed increased expression of 16 genes in inflamed tissue compared to non-inflamed internal controls and revealed the activation of immune-adaptive Th17 response in association with a Th1 response. Furthermore, an increased expression of genes involved in ionic transport and signal transduction was found in inflamed mucosa compared to non-inflamed internal controls. This study confirms the activation of Th17 and Th1 adaptive-immune response also in colonic CD. It should be stressed that these responses have been disclosed in biopsy tissue, while only Th17 differentiation is revealed in endoscopic tissue. Interestingly, the polymorphisms analysis revealed that a homozygous genotype is associated to a more complicated clinical course.

21 Article Small Bowel Carcinomas in Coeliac or Crohn's Disease: Clinico-pathological, Molecular, and Prognostic Features. A Study From the Small Bowel Cancer Italian Consortium. 2017

Vanoli, Alessandro / Di Sabatino, Antonio / Furlan, Daniela / Klersy, Catherine / Grillo, Federica / Fiocca, Roberto / Mescoli, Claudia / Rugge, Massimo / Nesi, Gabriella / Fociani, Paolo / Sampietro, Gianluca / Ardizzone, Sandro / Luinetti, Ombretta / Calabrò, Antonio / Tonelli, Francesco / Volta, Umberto / Santini, Donatella / Caio, Giacomo / Giuffrida, Paolo / Elli, Luca / Ferrero, Stefano / Latella, Giovanni / Ciardi, Antonio / Caronna, Roberto / Solina, Gaspare / Rizzo, Aroldo / Ciacci, Carolina / D'Armiento, Francesco P / Salemme, Marianna / Villanacci, Vincenzo / Cannizzaro, Renato / Canzonieri, Vincenzo / Reggiani Bonetti, Luca / Biancone, Livia / Monteleone, Giovanni / Orlandi, Augusto / Santeusanio, Giuseppe / Macciomei, Maria C / D'Incà, Renata / Perfetti, Vittorio / Sandri, Giancarlo / Silano, Marco / Florena, Ada M / Giannone, Antonino G / Papi, Claudio / Coppola, Luigi / Usai, Paolo / Maccioni, Antonio / Astegiano, Marco / Migliora, Paola / Manca, Rachele / Martino, Michele / Trapani, Davide / Cerutti, Roberta / Alberizzi, Paola / Riboni, Roberta / Sessa, Fausto / Paulli, Marco / Solcia, Enrico / Corazza, Gino R. ·Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy. · Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. · Biometry and Statistics Service, San Matteo Hospital, Pavia, Italy. · Pathology Unit, Department of Surgical and Diagnostic Sciences, San Martino/IST University Hospital, Genova, Italy. · Pathology Unit, Department of Medicine, University of Padua, Padua, Italy. · Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Units of Pathology. · IBD Surgery. · Gastroenterology, Luigi Sacco University Hospital, Milan, Italy. · Departments of Molecular Medicine. · Departments of Experimental and Clinical Biomedical Sciences. · Surgery and Translational Medicine, University of Florence, Florence, Italy. · Divisions of Gastroenterology. · Pathology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. · Center for Prevention and Diagnosis of Coeliac Disease, Fondazione IRCCS Ca' Granda, Milan, Italy. · Division of Pathology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy. · Gastroenterology Unit, Department of Life and Enviromental Sciences, University of L'Aquila, L'Aquila, Italy. · Departments of Radiological, Oncological, Pathological Sciences. · Surgical Sciences, Umberto I Hospital, La Sapienza University, Rome, Italy. · Units of General Surgery. · Pathology, Cervello Hospital, Palermo, Italy. · Department of Medicine and Surgery, University of Salerno, Salerno, Italy. · Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy. · Pathology Section, Spedali Civili Hospital, Brescia, Italy. · Departments of Gastroenterology. · Pathology, National Cancer Institute, Aviano, Italy. · Section of Pathology, Department of Diagnostic Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy. · Departments of Systems Medicine. · Biopathology and Image Diagnostics, University of Tor Vergata, Rome, Italy. · Pathology Unit, San Camillo-Forlanini Hospital, Rome, Italy. · Gastroenterology Section, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy. · Internal Medicine, S.S. Annunziata Hospital, ASST-Pavia, Varzi, Italy. · Clinical Nutrition Unit, Sant'Eugenio Hospital, Rome, Italy. · Unit of Human Nutrition and Health, Istituto Superiore di Sanità, Rome, Italy. · Institute of Pathologic Anatomy, Giaccone University Hospital, University of Palermo, Palermo, Italy. · Units of IBD. · Pathologic Anatomy, San Filippo Neri Hospital, Rome, Italy. · Department of Internal Medicine, University of Cagliari, Cagliari, Italy. · Pathology Unit, SS. Trinità Hospital, Cagliari, Italy. · General and Specialistic Surgery, Città della Salute e della Scienza-Molinette Hospital, Turin, Italy. · Unit of Pathological Anatomy, Sant'Andrea Hospital, Vercelli, Italy. ·J Crohns Colitis · Pubmed #28333239.

ABSTRACT: Background and Aims: An increased risk of small bowel carcinoma [SBC] has been reported in coeliac disease [CD] and Crohn's disease [CrD]. We explored clinico-pathological, molecular, and prognostic features of CD-associated SBC [CD-SBC] and CrD-associated SBC [CrD-SBC] in comparison with sporadic SBC [spo-SBC]. Methods: A total of 76 patients undergoing surgical resection for non-familial SBC [26 CD-SBC, 25 CrD-SBC, 25 spo-SBC] were retrospectively enrolled to investigate patients' survival and histological and molecular features including microsatellite instability [MSI] and KRAS/NRAS, BRAF, PIK3CA, TP53, HER2 gene alterations. Results: CD-SBC showed a significantly better sex-, age-, and stage-adjusted overall and cancer-specific survival than CrD-SBC, whereas no significant difference was found between spo-SBC and either CD-SBC or CrD-SBC. CD-SBC exhibited a significantly higher rate of MSI and median tumour-infiltrating lymphocytes [TIL] than CrD-SBC and spo-SBC. Among the whole SBC series, both MSI─which was the result of MLH1 promoter methylation in all but one cases─and high TIL density were associated with improved survival at univariable and stage-inclusive multivariable analysis. However, only TILs retained prognostic power when clinical subgroups were added to the multivariable model. KRAS mutation and HER2 amplification were detected in 30% and 7% of cases, respectively, without prognostic implications. Conclusions: In comparison with CrD-SBC, CD-SBC patients harbour MSI and high TILs more frequently and show better outcome. This seems mainly due to their higher TIL density, which at multivariable analysis showed an independent prognostic value. MSI/TIL status, KRAS mutations and HER2 amplification might help in stratifying patients for targeted anti-cancer therapy.

22 Article Colonic metaplasia of the neo-terminal ileum in Crohn's Disease. 2017

Biancone, Livia / Albertoni, Laura / Ascolani, Marta / Mescoli, Claudia / Rugge, Massimo. ·Department of Systems Medicine, Unit of Gastroenterology, University of Rome "Tor Vergata", Rome, Italy. Electronic address: biancone@med.uniroma2.it. · Department of Medicine, DIMED, Pathology Unit, University of Padova, Padova, Italy. · Department of Systems Medicine, Unit of Gastroenterology, University of Rome "Tor Vergata", Rome, Italy. ·Dig Liver Dis · Pubmed #28283377.

ABSTRACT: -- No abstract --

23 Article Nutritional status and bioelectrical phase angle assessment in adult Crohn disease patients receiving anti-TNFα therapy. 2017

Emerenziani, Sara / Biancone, Livia / Guarino, Michele Pier Luca / Balestrieri, Paola / Stasi, Elisa / Ribolsi, Mentore / Rescio, Maria Paola / Altomare, Annamaria / Cocca, Silvia / Pallone, Francesco / Cicala, Michele. ·Unit of Digestive Disease of Campus Bio Medico University of Rome, Italy. Electronic address: s.emerenziani@unicampus.it. · Department of Systems Medicine, Università "Tor Vergata" of Rome, Italy. · Unit of Digestive Disease of Campus Bio Medico University of Rome, Italy. ·Dig Liver Dis · Pubmed #28096060.

ABSTRACT: BACKGROUND: Altered body composition is frequently observed in Crohn's disease (CD) patients. AIMS: To investigate the nutritional status, and the effect of different therapeutic regimes in adult CD patients. METHODS: Fat free mass (FFM) and BIA-derived phase angle (PhA) were assessed in 45 CD patients, 22 on conventional therapy (CT) and 23 on maintenance therapy with infliximab (MT). Nutritional status was also assessed in 12 CD patients before and following the induction protocol with infliximab. BIA data of CD patients were compared with those of 20 healthy asymptomatic volunteers. In CD patients C Reactive Protein (CRP) and albuminaemia dosage were obtained. RESULTS: The mean values of PhA and of FFM were significantly lower in CT patients when compared with control group and MT patients. Following infliximab treatment FFM increased, although not significantly, while mean phase angle value significantly increased from 4.6±0.3 to 6.2±0.4 (p<0.05). CRP was significantly lower in MT patients compared to that in CT patients. CONCLUSION: CD patients on conventional therapy showed a lower FFM and a lower mean phase angle score compared to those on infliximab therapy. Following infliximab treatment the mean phase angle score normalized. PhA is a reliable nutritional indicator in IBD patients and could be considered as an additional tool for assessing response to treatment.

24 Article The PROSIT-BIO Cohort: A Prospective Observational Study of Patients with Inflammatory Bowel Disease Treated with Infliximab Biosimilar. 2017

Fiorino, Gionata / Manetti, Natalia / Armuzzi, Alessandro / Orlando, Ambrogio / Variola, Angela / Bonovas, Stefanos / Bossa, Fabrizio / Maconi, Giovanni / DʼIncà, Renata / Lionetti, Paolo / Cantoro, Laura / Fries, Walter / Annunziata, Maria L / Costa, Francesco / Terpin, Maria M / Biancone, Livia / Cortelezzi, Claudio C / Amato, Arnaldo / Ardizzone, Sandro / Danese, Silvio / Guidi, Luisa / Rizzuto, Giulia / Massella, Arianna / Andriulli, Angelo / Massari, Alessandro / Lorenzon, Greta / Ghione, Silvia / Kohn, Anna / Ventra, Agostino / Annese, Vito / Anonymous13420893. ·1IBD Center, Department of Gastroenterology, Humanitas Research Hospital, Humanitas University, Rozzano, Italy; 2Department of Gastroenterology, AOU Careggi, Florence, Italy; 3IBD Unit, Complesso Integrato Columbus-Gemelli Hospital Catholic University Foundation, Rome, Italy; 4Department of Internal Medicine 2, IBD Unit, Riuniti Villa Sofia-Cervello Hospital, Palermo, Italy; 5Unit of Gastroenterology, Centro Malattie Retto-Intestinali, Sacro Cuore Don Calabria Hospital, Negrar, Italy; 6Gastroenterology Unit, IRCCS-CSS Hospital, San Giovanni Rotondo, Italy; 7Gastroenterology and IBD Unit, Luigi Sacco University Hospital, Milan, Italy; 8Unit of Gastroenterology, University of Padova, Padova, Italy; 9Department of Gastroenterology and Nutrition, Meyer Children's Hospital, Florence, Italy; 10Unit of Gastroenterology, S. Camillo-Forlanini Hospital, Rome, Italy; 11Clinical Unit for Chronic Bowel Disorders, University of Messina, Messina, Italy; 12Department of Gastroenterology, IRCCS Policlinico, San Donato Milanese-Milano, Italy; 13Unit of Gastroenterology, AOUP, Pisa, Italy; 14Department of Gastroenterology and Endoscopy, AO Hospital, Legnano, Italy; 15Department of Systems Medicine, Gastroenterology, University of Rome Tor Vergata, Roma, Italy; 16Unit of Gastroenterology, AOU di Circolo Fondazione Macchi, Varese, Italy; 17Department of Gastroenterology, Ospedale Valduce, Como, Italy; and 18Department of Gastroenterology, Fatebenefratelli-Oftalmico Hospital, Milano, Italy. ·Inflamm Bowel Dis · Pubmed #28092307.

ABSTRACT: BACKGROUND: Few data are available on the safety and efficacy of infliximab biosimilar CT-P13 in patients with ulcerative colitis and Crohn's disease. METHODS: A prospective, multicenter, cohort study using a structured database. RESULTS: Consecutive patients (313 Crohn's disease and 234 ulcerative colitis) were enrolled from 31 referral centers; 311 patients were naive to anti-tumor necrosis factor alpha, 139 had a previous exposure to biologics, and the remaining 97 were switched to CT-P13 after a mean of 18 ± 14 infusions of infliximab. The mean follow-up was 4.3 ± 2.8 months, and the total follow-up time was 195 patient-years. After 2061 infusions, 66 serious adverse events were reported (12.1%), 38 (6.9%) of them were infusion-related reactions. The biosimilar had to be stopped in 29 (5.3%) cases for severe infusion reactions (8 naive, 19 previous exposed, and 2 switch), and in further 16 patients (2.9%) for other serious adverse events. Infusion reactions were significantly more frequent in patients pre-exposed to infliximab than to other anti-tumor necrosis factor alpha (incidence rate ratio = 2.82, 95% CI: 1.05-7.9). The efficacy of the biosimilar was evaluated in 434 patients who received treatment for at least 8 weeks, using time-to-event methods for censored observations: 35 patients were primary failures (8.1%). After further 8, 16, and 24 weeks, the efficacy estimations were 95.7%, 86.4%, and 73.7% for naive, 97.2%, 85.2%, and 62.2% for pre-exposed, and 94.5%, 90.8%, and 78.9% for switch, respectively (log-rank P = 0.64). CONCLUSIONS: Although no direct comparison was performed, preliminary data on efficacy and safety of CT-P13 were in line with those of infliximab.

25 Article Polymorphisms in MIR122, MIR196A2, and MIR124A Genes are Associated with Clinical Phenotypes in Inflammatory Bowel Diseases. 2017

Ciccacci, Cinzia / Politi, Cristina / Biancone, Livia / Latini, Andrea / Novelli, Giuseppe / Calabrese, Emma / Borgiani, Paola. ·Department of Biomedicine and Prevention, Genetics Section, University of Rome "Tor Vergata", 00133, Rome, Italy. · Gastroenterology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy. · Department of Biomedicine and Prevention, Genetics Section, University of Rome "Tor Vergata", 00133, Rome, Italy. borgiani@med.uniroma2.it. ·Mol Diagn Ther · Pubmed #27718165.

ABSTRACT: BACKGROUND: Inflammatory bowel diseases (IBDs), including Crohn's disease (CD) and ulcerative colitis (UC), are multifactorial disorders that result from a dysregulated inflammatory response to environmental factors in genetically predisposed individuals. Recently, microRNAs (miRNAs) have been shown to be involved in the development of IBDs. AIMS: We investigated common variants in five miRNA genes in a cohort of Italian IBD patients, to evaluate their possible role in the disease's susceptibility and phenotype manifestations. METHODS: The analysis included 267 CD patients, 207 UC patients, and 298 matched healthy controls. Polymorphisms in the MIR122, MIR499, MIR146A, MIR196A2, and MIR124A genes were evaluated by allelic discrimination assay. RESULTS: We did not find associations between mir polymorphisms and IBD susceptibility. In both diseases, rs17669 and rs11614913 (MIR122 and MIR196A2) seem to contribute to clinical phenotypes: ileal location in CD (odds ratio [OR] = 1.82, p = 0.03; OR = 0.51, p = 0.01), and left-sided extent in UC (OR = 0.43, p = 0.05; OR = 0.28, p = 0.002). In CD, the MIR124A polymorphism (rs531564) contributed to colon location (p = 0.03, OR = 2.74). Finally, the variant allele of rs11614913 was associated with early age at onset in both diseases (p = 0.05 and p = 0.02). CONCLUSIONS: We showed for the first time that polymorphisms in MIR122, MIR196A2, and MIR124A could play a role in clinical phenotype modulation in IBD.

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