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Crohn Disease: HELP
Articles from Rome, IT
Based on 273 articles published since 2008

These are the 273 published articles about Crohn Disease that originated from Rome, IT during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11
1 Guideline Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. 2015

Pennazio, Marco / Spada, Cristiano / Eliakim, Rami / Keuchel, Martin / May, Andrea / Mulder, Chris J / Rondonotti, Emanuele / Adler, Samuel N / Albert, Joerg / Baltes, Peter / Barbaro, Federico / Cellier, Christophe / Charton, Jean Pierre / Delvaux, Michel / Despott, Edward J / Domagk, Dirk / Klein, Amir / McAlindon, Mark / Rosa, Bruno / Rowse, Georgina / Sanders, David S / Saurin, Jean Christophe / Sidhu, Reena / Dumonceau, Jean-Marc / Hassan, Cesare / Gralnek, Ian M. ·Division of Gastroenterology, San Giovanni Battista University Teaching Hospital, Turin, Italy. · Digestive Endoscopy Unit, Catholic University, Rome, Italy. · Department of Gastroenterology, Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University Tel-Hashomer, Israel. · Klinik für Innere Medizin, Bethesda Krankenhaus Bergedorf, Hamburg, Germany. · Department of Medicine II, Sana Klinikum, Offenbach, Germany. · Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands. · Gastroenterology Unit, Ospedale Valduce, Como, Italy. · Division of Gastroenterology, Shaare Zedek Medical Center, Jerusalem, Israel. · Department of Medicine I, Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany. · Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Service d'Hépato-gastro-entérologie, Paris, France. · Medizinische Klinik, Evangelisches Krankenhaus, Düsseldorf, Germany. · Department of Hepato-Gastroenterology, Nouvel Hôpital Civil, University Hospital of Strasbourg, Strasbourg, France. · Royal Free Unit for Endoscopy and Centre for Gastroenterology, The Royal Free Hospital and University College London, London, UK. · Department of Medicine B, University of Münster, Münster, Germany. · Institute of Gastroenterology and Liver Diseases, Ha'emek Medical Center Afula, Israel, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology Haifa, Israel. · Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. · Gastroenterology Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal. · Clinical Psychology Unit, Department of Psychology, University of Sheffield. · Centre Hospitalier Lyon Sud, Pierre Bénite, Lyon, France. · Gedyt Endoscopy Center, Buenos Aires, Argentina. ·Endoscopy · Pubmed #25826168.

ABSTRACT: This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). The Guideline was also reviewed and endorsed by the British Society of Gastroenterology (BSG). It addresses the roles of small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders. Main recommendations 1 ESGE recommends small-bowel video capsule endoscopy as the first-line investigation in patients with obscure gastrointestinal bleeding (strong recommendation, moderate quality evidence). 2 In patients with overt obscure gastrointestinal bleeding, ESGE recommends performing small-bowel capsule endoscopy as soon as possible after the bleeding episode, optimally within 14 days, in order to maximize the diagnostic yield (strong recommendation, moderate quality evidence). 3 ESGE does not recommend the routine performance of second-look endoscopy prior to small-bowel capsule endoscopy; however whether to perform second-look endoscopy before capsule endoscopy in patients with obscure gastrointestinal bleeding or iron-deficiency anaemia should be decided on a case-by-case basis (strong recommendation, low quality evidence). 4 In patients with positive findings at small-bowel capsule endoscopy, ESGE recommends device-assisted enteroscopy to confirm and possibly treat lesions identified by capsule endoscopy (strong recommendation, high quality evidence). 5 ESGE recommends ileocolonoscopy as the first endoscopic examination for investigating patients with suspected Crohn's disease (strong recommendation, high quality evidence). In patients with suspected Crohn's disease and negative ileocolonoscopy findings, ESGE recommends small-bowel capsule endoscopy as the initial diagnostic modality for investigating the small bowel, in the absence of obstructive symptoms or known stenosis (strong recommendation, moderate quality evidence).ESGE does not recommend routine small-bowel imaging or the use of the PillCam patency capsule prior to capsule endoscopy in these patients (strong recommendation, low quality evidence). In the presence of obstructive symptoms or known stenosis, ESGE recommends that dedicated small bowel cross-sectional imaging modalities such as magnetic resonance enterography/enteroclysis or computed tomography enterography/enteroclysis should be used first (strong recommendation, low quality evidence). 6 In patients with established Crohn's disease, based on ileocolonoscopy findings, ESGE recommends dedicated cross-sectional imaging for small-bowel evaluation since this has the potential to assess extent and location of any Crohn's disease lesions, to identify strictures, and to assess for extraluminal disease (strong recommendation, low quality evidence). In patients with unremarkable or nondiagnostic findings from such cross-sectional imaging of the small bowel, ESGE recommends small-bowel capsule endoscopy as a subsequent investigation, if deemed to influence patient management (strong recommendation, low quality evidence). When capsule endoscopy is indicated, ESGE recommends use of the PillCam patency capsule to confirm functional patency of the small bowel (strong recommendation, low quality evidence). 7 ESGE strongly recommends against the use of small-bowel capsule endoscopy for suspected coeliac disease but suggests that capsule endoscopy could be used in patients unwilling or unable to undergo conventional endoscopy (strong recommendation, low quality evidence).

2 Guideline ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. 2014

Levine, Arie / Koletzko, Sibylle / Turner, Dan / Escher, Johanna C / Cucchiara, Salvatore / de Ridder, Lissy / Kolho, Kaija-Leena / Veres, Gabor / Russell, Richard K / Paerregaard, Anders / Buderus, Stephan / Greer, Mary-Louise C / Dias, Jorge A / Veereman-Wauters, Gigi / Lionetti, Paolo / Sladek, Malgorzata / Martin de Carpi, Javier / Staiano, Annamaria / Ruemmele, Frank M / Wilson, David C / Anonymous3320775. ·*Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel †Dr von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel §Pediatric Gastroenterology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands ||Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy ¶Children's Hospital, University of Helsinki, Helsinki, Finland #Semmelweis University, Budapest, Hungary **Department of Paediatric Gastroenterology and Nutrition, Yorkhill Children's Hospital, Glasgow, UK ††Department of Paediatrics, Hvidovre University Hospital, Copenhagen, Denmark ‡‡St.-Marien-Hospital, Department of Pediatrics, Bonn, Germany §§Department of Diagnostic Imaging, The Hospital for Sick Children ||||Department of Medical Imaging, University of Toronto, Toronto Canada ¶¶Hospital S. João, Porto, Portugal ##Pediatric Gastroenterology and Nutrition, UZ Brussels, Brussels, Belgium ***Departement Neurofarba, University of Florence, Meyer Children Hospital, Florence, Italy †††Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College, Cracow, Poland ‡‡‡Department of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital Sant Joan de Déu, Barcelona, Spain §§§Department of Translational Medical Sciences, Section of Pediatrics, University of Naples "Federico II," Naples, Italy ||||||Université Sorbonne Paris Cité, Université Paris Descartes, INSERM U989, AP-HP, Hôpital Necker Enfants Malades, Service de Gastroentérologie Pédiatrique, Paris, France ¶¶¶Child Life and Health, University of Edinburgh, Edinburgh, UK. ·J Pediatr Gastroenterol Nutr · Pubmed #24231644.

ABSTRACT: BACKGROUND: The diagnosis of pediatric-onset inflammatory bowel disease (PIBD) can be challenging in choosing the most informative diagnostic tests and correctly classifying PIBD into its different subtypes. Recent advances in our understanding of the natural history and phenotype of PIBD, increasing availability of serological and fecal biomarkers, and the emergence of novel endoscopic and imaging technologies taken together have made the previous Porto criteria for the diagnosis of PIBD obsolete. METHODS: We aimed to revise the original Porto criteria using an evidence-based approach and consensus process to yield specific practice recommendations for the diagnosis of PIBD. These revised criteria are based on the Paris classification of PIBD and the original Porto criteria while incorporating novel data, such as for serum and fecal biomarkers. A consensus of at least 80% of participants was achieved for all recommendations and the summary algorithm. RESULTS: The revised criteria depart from existing criteria by defining 2 categories of ulcerative colitis (UC, typical and atypical); atypical phenotypes of UC should be treated as UC. A novel approach based on multiple criteria for diagnosing IBD-unclassified (IBD-U) is proposed. Specifically, these revised criteria recommend upper gastrointestinal endoscopy and ileocolonscopy for all suspected patients with PIBD, with small bowel imaging (unless typical UC after endoscopy and histology) by magnetic resonance enterography or wireless capsule endoscopy. CONCLUSIONS: These revised Porto criteria for the diagnosis of PIBD have been developed to meet present challenges and developments in PIBD and provide up-to-date guidelines for the definition and diagnosis of the IBD spectrum.

3 Editorial Lesson from epidemiology of paediatric Crohn's disease. 2019

Cucchiara, Salvatore / Isoldi, Sara / Nobili, Valerio. ·Women's and Children's Department, Sapienza University of Rome, Italy. Electronic address: salvatore.cucchiara@uniroma1.t. · Women's and Children's Department, Sapienza University of Rome, Italy. ·Dig Liver Dis · Pubmed #30712953.

ABSTRACT: -- No abstract --

4 Editorial Histologic features in pediatric ileitis: Is it possible to tip the balance towards Crohn's disease? 2018

Oliva, Salvatore / Bassotti, Gabrio / Villanacci, Vincenzo. ·Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Rome, Italy. · Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia School of Medicine, Perugia, Italy. · Pathology Section, Department of Molecular and Translational Medicine, Brescia, Italy. Electronic address: villanacci@spedalicivili.brescia.it. ·Dig Liver Dis · Pubmed #29397324.

ABSTRACT: -- No abstract --

5 Editorial Beyond remission and mucosal healing in Crohn's disease. Exploring the deep with cross sectional imaging. 2017

Maconi, Giovanni / Armuzzi, Alessandro. ·Gastroenterology Unit, Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Milan, Italy. Electronic address: giovanni.maconi@unimi.it. · IBD Unit, Presidio Columbus, Fondazione Policlinico Gemelli Università Cattolica, Rome, Italy. Electronic address: alearmuzzi@yahoo.com. ·Dig Liver Dis · Pubmed #28449813.

ABSTRACT: -- No abstract --

6 Editorial Predicting the Durability of Biological Therapy in Pediatric Crohn's Disease: Do the Immunomodulators Matter? 2015

Aloi, Marina / Cucchiara, Salvatore. ·Department of Pediatrics and Childhood Neuropsychiatry, Sapienza University of Rome, Italy; Pediatric Gastroenterology, Hepatology and Digestive Endoscopy Unit, University Hospital Umberto I, Rome, Italy. ·Clin Gastroenterol Hepatol · Pubmed #26091738.

ABSTRACT: -- No abstract --

7 Editorial Crohn's disease, the mycobacterium paratuberculosis and the genetic bond: An unexpected trio. 2015

Perricone, Carlo / Borgiani, Paola. ·Rheumatology, Department of Medicine, Sapienza University of Rome, Rome, Italy. Electronic address: carlo.perricone@gmail.com. · Department of Biomedicine and Prevention, Section of Genetic, School of Medicine, University of Rome "Tor Vergata", Rome, Italy. ·Clin Res Hepatol Gastroenterol · Pubmed #25771330.

ABSTRACT: -- No abstract --

8 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.

9 Editorial Editorial: long-term safety and efficacy of certolizumab pegol for Crohn's disease. 2014

Cesarini, M / Danese, S. ·Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Rome, Italy. cesarini.monica@yahoo.it. ·Aliment Pharmacol Ther · Pubmed #25303376.

ABSTRACT: -- No abstract --

10 Editorial Mucosal healing as a treatment for IBD? 2014

Papi, Claudio / Aratari, Annalisa. ·Gastroenterology and Hepatology Unit, San Filippo Neri Hospital, Rome, Italy. ·Expert Rev Gastroenterol Hepatol · Pubmed #24654957.

ABSTRACT: In the last years mucosal healing has emerged as an important therapeutic goal for patients with inflammatory bowel disease. Growing evidence suggests that mucosal healing can improve patient outcomes and, potentially, can alter the natural course of the disease by inducing sustained clinical remission and reducing hospitalizations and surgery. However several questions remain to be answered. A validated definition of mucosal healing is still lacking and the effect size of different drugs is difficult to assess because of different definitions, different study design, and different timing of endoscopic evaluation. The evidence that mucosal healing has a high positive predictive value for long-term good clinical outcome is still limited and, therefore, mucosal healing remains a weak surrogate end point of disease course. Future studies are needed to develop a standardized definition of mucosal healing and to prospectively assess the impact of mucosal healing on long-term clinical outcomes.

11 Editorial Regulatory T-cell therapy for Crohn's disease: in vivo veritas. 2012

Danese, Silvio / Fiorino, Gionata / Rutella, Sergio. ·IBD Center, Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy. Electronic address: sdanese@hotmail.com. · IBD Center, Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy. · Pediatric Hematology/Oncology and Transfusion Medicine, IRCCS Bambino Gesù Children's Hospital, Rome, Italy. ·Gastroenterology · Pubmed #23000230.

ABSTRACT: -- No abstract --

12 Review Advances in understanding the role of cytokines in inflammatory bowel disease. 2018

Bevivino, Gerolamo / Monteleone, Giovanni. ·a Department of Systems Medicine , University of Rome Tor Vergata , Italy. ·Expert Rev Gastroenterol Hepatol · Pubmed #30024302.

ABSTRACT: INTRODUCTION: Cytokines represent the key pathophysiologic elements that govern the initiation, progression, and, in some circumstances, the resolution of the inflammation occurring in inflammatory bowel disease (IBD). Areas covered: In this review, we will focus on the main effector and anti-inflammatory cytokines produced in IBD and discuss the results of recent trials in which cytokine-based therapy has been used for treating IBD patients. Expert commentary: The possibility to sample mucosal biopsies from IBD patients and analyze which molecular pathways are prominent during the active phases of the disease and the easy access to various models of experimental colitis has largely advanced our understanding about the role of cytokines in IBD. These progresses have facilitated the development of several therapeutic compounds, which either target inflammatory cytokines or enhance the regulatory function of immunosuppressive cytokines. While some of such drugs are effective in the induction and maintenance of remission of the disease, other compounds are not useful for attenuating the ongoing mucosal inflammation, thus establishing a hierarchical scale of the relevance of cytokines in IBD. Further work is needed to identify biomarkers, which could help personalize cytokine-targeted therapy and minimize potential side effects.

13 Review Vedolizumab for inflammatory bowel disease: From randomized controlled trials to real-life evidence. 2018

Scribano, Maria Lia. ·IBD Unit, Azienda Ospedaliera San Camillo-Forlanini, Rome 00152, Italy. marialiascribano@virgilio.it. ·World J Gastroenterol · Pubmed #29930467.

ABSTRACT: The biologic antitumor necrosis factor alpha (anti-TNFα) agents have revolutionised the treatment of inflammatory bowel disease (IBD). However, some patients experience primary nonresponse, loss of response, or intolerance. Therefore, introducing a newer class of therapy with a mechanism of action that acts on different inflammatory pathways involved in IBD pathogenesis is appealing. Vedolizumab is a fully humanised monoclonal antibody that selectively targets α4β7 integrin. Based on the results of the pivotal clinical GEMINI trials, vedolizumab was approved for the treatment of adult patients with moderately to severely active ulcerative colitis (UC) and Crohn's disease (CD) refractory or intolerant to either conventional therapy or TNFα inhibitors. This review describes the efficacy, safety, and tolerability of vedolizumab reported in both randomized, controlled, clinical trials and from real-world experience in patients with UC and CD in order to identify its place in treatment algorithms for IBD.

14 Review The intriguing role of Rifaximin in gut barrier chronic inflammation and in the treatment of Crohn's disease. 2018

Lopetuso, Loris R / Napoli, Marco / Rizzatti, Gianenrico / Gasbarrini, Antonio. ·a Department of Internal Medicine and Gastroenterology , Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore , Roma , Italy. ·Expert Opin Investig Drugs · Pubmed #29865875.

ABSTRACT: INTRODUCTION: The gastrointestinal tract acts as a functional unit organized as a semipermeable multilayer system, in which commensal gut microbiota represents the anatomical barrier. Recently, several studies have highlighted the involvement of gut microbiota in inflammatory bowel diseases (IBD) pathogenesis, in sustaining gut barrier chronic inflammation, and in conditioning disease course and therapeutical response. This evidence provides a rationale for treating patients with gut microbiota modifiers. Among these, Rifaximin represents a non-traditional antibiotic able to act as a 'eubiotic' on intestinal barrier. AREAS COVERED: The purpose of this narrative review is to explore the impact of Rifaximin on gut barrier and gut microbiota in IBD, in particular in Crohn's disease (CD), and to analyze its potential therapeutic applications. EXPERT OPINION: The possibility of a beneficial activity of Rifaximin in chronic intestinal inflammation and CD has been debated and evaluated with different studies having obtained promising but still preliminary data. Larger trials are therefore needed. This gut-specific antibiotic could represent an alternative to systemic antibiotics thanks to its favorable safety profile and promising efficacy data. Rifaximin could exert, when appropriate, a synergic effect with immunomodulators in IBD, acting on both the microbial and the immunological sides of gut barrier impairment.

15 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.

16 Review [Towards new therapeutic paradigms beyond symptom control in the management of inflammatory bowel diseases.] 2018

Festa, Stefano / Zerboni, Giulia / Aratari, Annalisa / Ballanti, Riccardo / Papi, Claudio. ·UOC Gastroenterologia, UOS Malattie Infiammatorie Croniche dell'Intestino, Ospedale San Filippo Neri, Roma. ·Recenti Prog Med · Pubmed #29451523.

ABSTRACT: Inflammatory bowel diseases, Crohn's disease and ulcerative colitis are chronic relapsing conditions that may result in progressive bowel damage, high risk of complications, surgery and permanent disability. The conventional therapeutic approach for inflammatory bowel diseases is based mainly on symptom control. Unfortunately, a symptom-based therapeutic approach has little impact on major long-term disease outcomes. In other chronic disabling conditions such as diabetes, hypertension and rheumatoid arthritis, the development of new therapeutic approaches has led to better outcomes. In this context a "treat to target" strategy has been developed. This strategy is based on identification of high-risk patients, regular assessment of disease activity by means of objective measures, adjustment of treatment to reach the pre-defined target. A treat to target approach has recently been proposed for inflammatory bowel disease with the aim at modifying the natural history of the disease. In this review, the evidence and the limitations of the treat to target paradigm in inflammatory bowel disease are analyzed and discussed.

17 Review Hybrid imaging in Crohn's disease: from SPECT/CT to PET/MR and new image interpretation criteria. 2018

Catalano, Onofrio / Maccioni, Francesca / Lauri, Chiara / Auletta, Sveva / Dierckx, Rudi / Signore, Alberto. ·Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center, Groningen, The Netherlands. · Department of Radiological Sciences, Oncology and Pathology, Umberto I Hospital, Sapienza University Rome, Rome, Italy. · Unit of Nuclear Medicine, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy. · Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center, Groningen, The Netherlands - sveva.auletta@hotmail.it. ·Q J Nucl Med Mol Imaging · Pubmed #29191001.

ABSTRACT: Crohn's disease is a chronic relapsing disease characterized by mucosal inflammation, lymphocytes infiltration and fibrotic strictures. Usually, the assessment of location, extension, inflammatory activity and severity of intestinal lesions is complex and invasive with endoscopic methods or histological and biochemical investigations. Thus, the diagnosis remains a challenge for the management of patients. Nuclear medicine techniques, in particular hybrid and molecular imaging, might offer a valid option for the evaluation and determination of the prognosis of the disease. Indeed, imaging methods provide a non-invasive, reproducible and quantitative analysis. An overview of the currently available multimodality imaging techniques in Crohn's disease are reviewed, with particular regard to positron-emission tomography/magnetic resonance and the choice of the best evaluation Score, explaining advantages and disadvantages of each one, with particular regard to their potential role for the assessment of disease activity and extent of inflammation in order to improve the diagnosis. We propose new interpretation criteria for PET/MR images.

18 Review Review article: the gut microbiome in inflammatory bowel disease-avenues for microbial management. 2018

McIlroy, J / Ianiro, G / Mukhopadhya, I / Hansen, R / Hold, G L. ·School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK. · Internal Medicine, Gastroenterology and Liver Unit, Gastroenterology Area, Fondazione Policlinico Universitario Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy. · Royal Hospital for Children, Glasgow, UK. ·Aliment Pharmacol Ther · Pubmed #29034981.

ABSTRACT: BACKGROUND: The concept of an altered collective gut microbiota rather than identification of a single culprit is possibly the most significant development in inflammatory bowel disease research. We have entered the "omics" era, which now allows us to undertake large-scale/high-throughput microbiota analysis which may well define how we approach diagnosis and treatment of inflammatory bowel disease (IBD) in the future, with a strong steer towards personalised therapeutics. AIM: To assess current epidemiological, experimental and clinical evidence of the current status of knowledge relating to the gut microbiome, and its role in IBD, with emphasis on reviewing the evidence relating to microbial therapeutics and future microbiome modulating therapeutics. METHODS: A Medline search including items 'intestinal microbiota/microbiome', 'inflammatory bowel disease', 'ulcerative colitis', 'Crohn's disease', 'faecal microbial transplantation', 'dietary manipulation' was performed. RESULTS: Disease remission and relapse are associated with microbial changes in both mucosal and luminal samples. In particular, a loss of species richness in Crohn's disease has been widely observed. Existing therapeutic approaches broadly fall into 3 categories, namely: accession, reduction or indirect modulation of the microbiome. In terms of microbial therapeutics, faecal microbial transplantation appears to hold the most promise; however, differences in study design/methodology mean it is currently challenging to elegantly translate results into clinical practice. CONCLUSIONS: Existing approaches to modulate the gut microbiome are relatively unrefined. Looking forward, the future of microbiome-modulating therapeutics looks bright with several novel strategies/technologies on the horizon. Taken collectively, it is clear that ignoring the microbiome in IBD is not an option.

19 Review European Crohn's and Colitis Organisation Topical Review on Treatment Withdrawal ['Exit Strategies'] in Inflammatory Bowel Disease. 2018

Doherty, Glen / Katsanos, Konstantinos H / Burisch, Johan / Allez, Matthieu / Papamichael, Konstantinos / Stallmach, Andreas / Mao, Ren / Berset, Ingrid Prytz / Gisbert, Javier P / Sebastian, Shaji / Kierkus, Jaroslaw / Lopetuso, Loris / Szymanska, Edyta / Louis, Edouard. ·Centre for Colorectal Disease, St Vincent's University Hospital & University College Dublin, Dublin, Ireland. · Department of Gastroenterology and Hepatology, University and Medical School of Ioannina, Ioannina, Greece. · Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark. · Department of Gastroenterology and Hepatology, Hôpital Saint-Louis, APHP, INSERM UMRS 1160, Université Denis Diderot, Paris, France. · Center for Inflammatory Bowel Diseases, Harvard Medical School, Boston, MA, USA. · Department of Internal Medicine IV [Gastroenterology, Hepatology and Infectious Disease], University Hospital Jena, Jena, Germany. · Department of Gastroenterology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. · Gastroenterology Department, Alesund Hospital, Helse More Romsdal Hospital Trust, Alesund, Norway. · Department of Gastroenterology, Hospital Universitario de la Princesa, Instituto de Investigaciun Sanitaria Princesa (IIS-IP) and Centro de Investigaciun Biomédica en Red de Enfermedades Heprticas y Digestivas (CIBEREHD), Madrid, Spain. · IBD Unit, Department of Gastroenterology, Hull & East Yorkshire Hospitals NHS Trust, Hull, UK. · Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, Children's Memorial Health Institute, Warsaw, Poland. · Department of Gastroenterology and Internal Medicine, Catholic University of Rome-A. Gemelli Hospital, Rome, Italy. · Department of Pediatrics, Nutrition, and Metabolic Disorders, Children's Memorial Health Institute, Warsaw, Poland. · Department of Gastroenterology, CHU Liège, Sart Tilman, Liège, Belgium. ·J Crohns Colitis · Pubmed #28981623.

ABSTRACT: Clinically effective therapies now exist for remission maintenance in both ulcerative colitis [UC] and Crohn's Disease [CD]. For each major class of IBD medications [5-aminosalicyclates, immunomodulators, and biologic agents], used alone or in combination, there is a risk of relapse following reduction or cessation of treatment. A consensus expert panel convened by the European Crohn's and Colitis Organisation [ECCO] reviewed the published literature and agreed a series of consensus practice points. The objective of the expert consensus is to provide evidence-based guidance for clinical practice so that physicians can make informed decisions in partnership with their patients. The likelihood of relapse with stopping each class of IBD medication is reviewed. Factors associated with an altered risk of relapse with withdrawal are evaluated, and strategies to monitor and allow early identification of relapse are considered. In general, patients in clinical, biochemical, and endoscopic remission are more likely to remain well when treatments are stopped. Reintroduction of the same treatment is usually, but not always, successful. The decision to stop a treatment needs to be individualized, and shared decision making with the patient should take place.

20 Review Pharmacogenetics of inflammatory bowel disease: a focus on Crohn's disease. 2017

Rufini, Sara / Ciccacci, Cinzia / Novelli, Giuseppe / Borgiani, Paola. ·Department of Biomedicine & Prevention, Genetics Unit, University of Rome "Tor Vergata", Rome, Italy. ·Pharmacogenomics · Pubmed #28686143.

ABSTRACT: Crohn's disease is an inflammatory bowel disease showing a high heterogeneity in phenotype and a strong genetic component. The treatment is complex, due to different severity of clinical parameters and to the fact that therapies only permit to control symptoms and to induce remission for short periods. Moreover, all categories of drugs present a great interindividual variability both in terms of efficacy and side effects appearance. For this reason, the identification of specific genomic biomarkers involved in drugs response will be of great clinical utility in order to foresee drug's efficacy and to prevent adverse reactions, permitting a more personalized therapeutic approach. In this review, we focus the attention on the pharmacogenetic studies regarding drugs commonly utilized in Crohn's disease treatment.

21 Review Diagnostic yield of capsule endoscopy versus magnetic resonance enterography and small bowel contrast ultrasound in the evaluation of small bowel Crohn's disease: Systematic review and meta-analysis. 2017

Kopylov, Uri / Yung, Diana E / Engel, Tal / Vijayan, Sanju / Har-Noy, Ofir / Katz, Lior / Oliva, Salvatore / Avni, Tomer / Battat, Robert / Eliakim, Rami / Ben-Horin, Shomron / Koulaouzidis, Anastasios. ·Gastroenterology Department, Sheba Medical Center, Ramat-Gan, and Sackler School of Medicine, Tel-Aviv University, Israel. Electronic address: ukopylov@gmail.com. · Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, United Kingdom. · Gastroenterology Department, Sheba Medical Center, Ramat-Gan, and Sackler School of Medicine, Tel-Aviv University, Israel. · Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy. · Department of Medicine E, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, and Sackler School of Medicine, Tel-Aviv University, Israel. · McGill University Health Center, McGill University, Montreal, QC, Canada. ·Dig Liver Dis · Pubmed #28512034.

ABSTRACT: BACKGROUND AND AIMS: Capsule endoscopy (CE), magnetic resonance enterography (MRE) and small bowel (SB) intestinal contrast ultrasound (SICUS) are the modalities of choice for SB evaluation. This study aimed to compare the diagnostic yield (DY) of CE to MRE and SICUS in detection and monitoring of SB CD through meta-analysis of the available literature. METHODS: We performed a systematic literature search for trials comparing the accuracy of CE, MRE and SICUS for detection of active SB inflammation in patients with suspected and/or established CD. Only prospective studies comparing CE with another additional diagnostic modality were included in the final analysis. Pooled odds ratios (ORs) for the DY of the three modalities were calculated. RESULTS: A total of 112 studies were retrieved; following selection, 13 studies were eligible for analysis. The DY of CE for detection of active SB CD was similar to that of MRE (10 studies, 400 patients, OR 1.17; 95% CI 0.83-1.67) and SICUS (5 studies, 142 patients, OR 0.88; 95% CI 0.51-1.53). The outcomes were similar for the subgroups of suspected versus established CD and adult versus pediatric patients. CE was superior to MRE for proximal SB CD (7 studies, 251 patients, OR 2.79; 95% CI 1.2-6.48); the difference vs SICUS was not significant. CONCLUSION: CE, MRE and SICUS have similar DY for detection of SB CD in both suspected and established CD. CE is superior to MRE for detection of proximal SB disease, however the risk of capsule retention should be considered.

22 Review Inflammatory Bowel Disease-Unclassified in Children: Diagnosis and Pharmacological Management. 2017

D'Arcangelo, Giulia / Aloi, Marina. ·Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. · Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. marina.aloi@uniroma1.it. ·Paediatr Drugs · Pubmed #28150131.

ABSTRACT: Inflammatory bowel diseases are chronic disorders of the gastrointestinal tract that include Crohn's disease (CD), ulcerative colitis (UC) and inflammatory bowel disease-unclassified (IBDU). The latter defines a subgroup of patients with clinical and endoscopic evidence of chronic colitis, without specific features of either CD or UC. These patients will possibly be re-classified as having UC or CD during the follow-up, although a significant percentage of them will keep the diagnosis of IBDU. IBDU is the rarest subtype of IBD, both in children and in adults, although it is twice as common among the pediatric population, especially in the younger ages. The diagnosis can only be made after a comprehensive diagnostic work-up, combining clinical history, physical and laboratory examination, upper and lower gastrointestinal endoscopy, with histology and imaging of the small bowel. The therapeutic strategy is borrowed from that of UC and CD, although recent data suggest that IBDU has a lower therapeutic burden with a generally mild disease course and a good response to mesalamine. Since there are only few published data on pediatric IBDU, and no guidelines on its management are available, this review aims at summarizing the most recent evidence for the diagnostic work-up with a specific focus on medical and surgical options in the treatment of IBDU.

23 Review IL-23 Blockade for Crohn s disease: next generation of anti-cytokine therapy. 2017

Furfaro, Federica / Gilardi, Daniela / Allocca, Mariangela / Cicerone, Clelia / Correale, Carmen / Fiorino, Gionata / Danese, Silvio. ·a IBD Center, Department of Gastroenterology , Humanitas Research Hospital , Rozzano , Milan , Italy. · b Department of Internal Medicine and Medical Specialties , Sapienza University , Rome , Italy. · c Department of Biomedical Sciences , Humanitas University , Rozzano , Milan , Italy. ·Expert Rev Clin Immunol · Pubmed #28067059.

ABSTRACT: INTRODUCTION: Adaptive immunity in intestinal inflammation may play a key role in the pathogenesis of Crohn's disease. In particular, interleukin (IL)-23 may be a key mediator in chronic intestinal inflammation by inducing the differentiation of naïve CD4 + T cells into Th17, with the production of several pro-inflammatory cytokines. Furthermore, IL-23 induces interferon-γ (IFN- γ) production from activated T cells, a critical cytokine in innate and adaptive immunity against infections. Areas covered: We aim to review the available data from literature regarding the role of IL-23, with a more specific focus on the recent progresses in the therapeutic modulation of this cytokine. Expert commentary: Increased knowledge regarding the role of IL-23 has allowed for the development of effective therapeutic progresses by blocking the IL-23 mediated pathways. Primary or secondary loss of response to anti-TNF therapies in Crohn's disease patients during the first year is widely described in literature: the development of new drugs, with alternative mechanisms of action, is thus a key point to consider for the optimal management of these subjects. Drugs blocking the IL-12/23 pathway showed a good efficacy and safety profile in immune-mediated diseases Further studies are necessary regarding the role of the single blockade of IL-23.

24 Review Bowel Ultrasonography in the Management of Crohn's Disease. A Review with Recommendations of an International Panel of Experts. 2016

Calabrese, Emma / Maaser, Christian / Zorzi, Francesca / Kannengiesser, Klaus / Hanauer, Stephen B / Bruining, David H / Iacucci, Marietta / Maconi, Giovanni / Novak, Kerri L / Panaccione, Remo / Strobel, Deike / Wilson, Stephanie R / Watanabe, Mamoru / Pallone, Francesco / Ghosh, Subrata. ·*Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; †Ambulanzzentrum Gastroenterologie am Klinikum Lüneburg, Lüneburg, Germany; ‡Klinik für Allgemeine Innere Medizin und Gastroenterologie, Lüneburg, Germany; §Digestive Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ‖Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota; ¶Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada; **Department of Clinical Sciences, L. Sacco University Hospital, Milan, Italy; ††University Hospital Erlangen, Erlangen, Germany; and ‡‡Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University Hospital, Tokyo, Japan. ·Inflamm Bowel Dis · Pubmed #26958988.

ABSTRACT: BACKGROUND: Bowel ultrasonography (US) is considered a useful technique for assessing mural inflammation and complications in Crohn's disease (CD). The aim of this review is to appraise the evidence on the accuracy of bowel US for CD. In addition, we aim to provide recommendations for its optimal use. METHODS: Publications were identified by literature search from 1992 to 2014 and selected based on predefined criteria: 15 or more patients; bowel US for diagnosing CD, complications, postoperative recurrence, activity; adequate reference standards; prospective study design; data reported to allow calculation of sensitivity, specificity, agreement, or correlation values; articles published in English. RESULTS: The search yielded 655 articles, of which 63 were found to be eligible and retrieved as full-text articles for analysis. Bowel US showed 79.7% sensitivity and 96.7% specificity for the diagnosis of suspected CD, and 89% sensitivity and 94.3% specificity for initial assessment in established patients with CD. Bowel US identified ileal CD with 92.7% sensitivity, 88.2% specificity, and colon CD with 81.8% sensitivity, 95.3% specificity, with lower accuracy for detecting proximal lesions. The oral contrast agent improves the sensitivity and specificity in determining CD lesions and in assessing sites and extent. CONCLUSIONS: Bowel US is a tool for evaluation of CD lesions in terms of complications, postoperative recurrence, and monitoring response to medical therapy; it reliably detects postoperative recurrence and complications, as well as offers the possibility of monitoring disease progression.

25 Review Advances in Exploring the Role of Micrornas in Inflammatory Bowel Disease. 2016

Ciccacci, Cinzia / Politi, Cristina / Novelli, Giuseppe / Borgiani, Paola. ·Department of Biomedicine and Prevention, Section of Genetics, School of Medicine, University of Rome "Tor Vergata", Rome, Italy. ·Microrna · Pubmed #26750140.

ABSTRACT: Inflammatory bowel diseases, including Crohn's Disease and Ulcerative Colitis, result from a dysregulated inflammatory response to environmental factors in genetically predisposed individuals. The list of genetic factors involved in the development of these diseases has considerably increased in last years. However, recently, new promising insights on inflammatory bowel diseases have been produced by studies on microRNAs. MicroRNAs are small non coding RNA molecules, that play a pivotal role in gene expression and regulation. They are involved in many biological processes, such as cellular proliferation and differentiation, signal transduction and, more recently, they have been recognized as also having a role in the innate and adaptative response. In this review we give an overview on the role of microRNAs in the pathogenesis of inflammatory bowel diseases.