Effect of five dietary emulsifiers on inflammation, permeability, and the gut microbiome: a placebo-controlled randomized trial.

Background And Aims: Dietary emulsifier consumption might promote intestinal inflammation, eventually leading to inflammatory bowel diseases. However human data are scarce and involve a limited number of emulsifiers. We studied the effects of an emulsifier-free diet (EFD) and specific emulsifier supplementation.

Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in Endoscopy, Radiology and Histology in IBD Diagnostics.

In this review, a comprehensive overview of the current state of artificial intelligence (AI) research in Inflammatory Bowel Disease (IBD) diagnostics in the domains of endoscopy, radiology and histology is presented. Moreover, key considerations for development of AI algorithms in medical image analysis are discussed. AI presents a potential breakthrough in real-time, objective and rapid endoscopic assessment, with implications for predicting disease progression.

Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in medical management and precision medicine.

Background And Aims: Artificial intelligence (AI) is increasingly being applied in various fields of medicine, including Inflammatory Bowel Diseases (IBD). This systematic review, conducted as part of the ECCO 9th Scientific Workshop on AI in IBD, explores AI applications in multiomic precision medicine, large language models (LLMs) for textual tasks and utilisation of wearable and remote care technologies.

Methods: A comprehensive systematic analysis of the literature was undertaken, emphasising three topics: multiomic predictive models in IBD; natural language processing (NLP) and LLMs for clinical practice, research and patient communication; and the role of remote monitoring and wearable devices.

Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in IBD: Regulatory and Methodological Considerations.

With the rapid growth of artificial intelligence (AI) applications in the field of inflammatory bowel disease (IBD), an increasing number of regulatory and methodological considerations have become apparent. Currently, there remains much uncertainty and limited experience in the field of IBD regarding some of the regulatory and methodological pitfalls to be considered when developing and deploying AI applications for positive clinical and health system impact. Accordingly, an expert panel was convened by the European Crohn's and Colitis Organisation (ECCO) to review the published literature and provide an overview of key regulatory aspects for the application of AI in IBD.

Results of the Ninth Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial intelligence in IBD surgery: opportunities and limitations.

In this narrative review we present the current status of developments in artificial intelligence in the filed of IBD surgery. We lay down the foundations for how IBD surgery may utilise the potential opportunities in utilizing the rapid advances in AI technology as it used in other surgical disciplines. The main areas of potential utility are in the areas of surgical training, risk prediction in the pre, intra and post operative period in IBD patients undergoing surgery and in IBD surgical research.

PAVFCOS: The development of a core outcome set for pouch anal and vaginal fistula.

Aims: The primary aim was to develop a patient-centred core outcome set (COS) for interventional studies in patients with pouch anal and vaginal fistula (PAVF).

Method: PAVFCOS was developed using the methodology outlined by the Core Outcome Measures in Effectiveness Trials (COMET). Systematic review and qualitative patient interviews produced a long list of candidate outcomes.

ECCO-ESGAR-ESP-IBUS Guideline on Diagnostics and Monitoring of Patients with Inflammatory Bowel Disease: Part 1.

The current consensus guideline offers a comprehensive and practical guidance on the diagnostic and monitoring of patients with inflammatory bowel disease (IBD). It provides recommendations on requirements for initial diagnosis, detection of complications, the use of monitoring tools in patients with IBD and diagnostics in specific situations, such as pregnancy, postoperatively and for cancer surveillance. The guideline is a joint project of the European Crohn's and Colitis Organization (ECCO), the European Society of Gastrointestinal and Abdominal Radiology, the European Society of Pathology, and the International Bowel Ultrasonography Group under the leadership of ECCO.

The EXTENT Study: Results From an International Expert Delphi Consensus to Define Ultrasonographic Parameters for Measuring Bowel Damage in Crohn's Disease.

Background & Aims: A primary aim in managing Crohn's disease (CD) is preventing bowel damage. The Lémann index (LI) quantifies structural bowel damage using magnetic resonance enterography (MRE) or computed tomography enterography (CTE) and, for colonic CD, colonoscopy. Intestinal ultrasonography (IUS) provides a noninvasive imaging alternative, although its role in LI assessment remains unexplored.

Inflammatory Bowel Disease and Risk of More than 1,500 Comorbidities: A Disease-wide Prediagnostic and Postdiagnostic Phenomic Association Study.

Introduction: Inflammatory bowel disease (IBD) is associated with various extraintestinal manifestations. We aimed to identify comorbidities in IBD and the timing of their development to provide potentially useful insight into the associations with IBD.

Methods: We conducted a population and disease-wide phenomic association study in IBD, using >6 million International Classification of Diseases, Tenth Revision coded healthcare contacts from 10 years before and up-to 17 years after IBD diagnosis to investigate associations with 1,583 comorbidities.

Assessment of PredictSURE IBD Assay in a Multinational Cohort of Patients With Inflammatory Bowel Disease.

Background And Aims: PredictSURE IBD is a prognostic blood test that classifies newly diagnosed, treatment-naïve Inflammatory Bowel Disease (IBD) patients into 'IBDhi' (high-risk) or 'IBDlo' (low-risk) groups (risk of future aggressive disease). We evaluated this assay in a multinational cohort and explored the effect of concomitant corticosteroids on its discrimination.

Methods: One hundred thirty-six (71 Ulcerative colitis [UC], 65 Crohn's Disease [CD]) and 41 (15 UC, 26 CD) patients with active IBD were 'unexposed' and 'exposed', respectively, to corticosteroids at baseline blood sampling.

Unraveling Genetic Versus Environmental Factors Determining Disease Course in Inflammatory Bowel Diseases: A Population-Based Cohort Study in First- and Second-Generation Immigrants.

Background: Inflammatory bowel diseases (IBD) incidence in immigrants approximates that of the host country in progressive generations but less is known about their disease outcome. We investigate how the immigrant generation affects IBD outcomes.

Methods: In this population-based cohort study, the risks of first IBD-related hospitalization, first IBD-related surgery, need for advanced therapies, and perianal disease were compared between first- and second-generation immigrants (stratified into Western/non-Western) and native Danes, using Cox proportional hazard regression to estimate adjusted hazard ratios (aHRs), correcting for sex, age at IBD diagnosis, and calendar year of IBD diagnosis.

Positioning Guselkumab in The Treatment Algorithm of Patients with Crohn's Disease.

Guselkumab, a selective interleukin-23 (IL-23) inhibitor, has emerged as a promising biologic therapy for the management of patients with moderate-to-severe Crohn's disease (CD) and has been recently approved for its treatment. Unlike conventional therapies, guselkumab offers a different mechanism of action by selectively inhibiting IL-23, a key cytokine implicated in the pathogenesis of CD. IL-23 drives intestinal inflammation through activation of the Th17 cell pathway and other immune processes, positioning IL-23 inhibition as a critical therapeutic approach.

Differential effects of tofacitinib on macrophage activation contribute to lack of response in ulcerative colitis patients.

Background And Aims: Tofacitinib, a Janus kinase inhibitor, is approved for the treatment of moderate-to-severe ulcerative colitis. Nonetheless, 40-60% of patients will not respond adequately. The mechanisms underlying responses to tofacitinib remain unknown.

ECCO Topical Review on Predictive Models on Inflammatory Bowel Disease Disease Course and Treatment Response.

Background And Aims: Inflammatory bowel disease (IBD) poses a clinical challenge due to its variable progression and treatment response. Despite the development of predictive models, their clinical application remains limited due to validation and methodological inconsistencies. The current topical review examines existing predictive models, assesses their relevance, and discusses the barriers to their clinical implementation.

Expert recommendations to standardize transcriptomic analysis in inflammatory bowel disease clinical trials.

Background And Aims: Substantial methodological and reporting heterogeneity confounds the interpretation and generalizability of transcriptomic data for inflammatory bowel disease (IBD) studies. We aimed to develop recommendations to standardize transcriptomic research in clinical trials.

Methods: A 2-part study was undertaken.

The Development of a Multidisciplinary Care Pathway for Patients with Inflammatory Bowel Disease Before, During and After Pregnancy.

: Recent advancements have significantly enhanced our understanding of the interplay between inflammatory bowel disease (IBD) and reproductive health. While international organizations provide guidelines for best practices, translating them into actionable strategies is crucial. This study aimed to develop a comprehensive care pathway to enhance preconception counselling and support for patients with IBD in the perinatal period, ensuring they receive optimal expert care.

Cooking methods affect advanced glycation end products and lipid profiles: A randomized cross-over study in healthy subjects.

Thermal treatments used in ultra-processed foods (UPFs) lead to advanced glycation end products (AGEs). UPFs and serum AGEs are associated with cardiometabolic disease. We explore differential cooking methods as a mechanistic link between UPFs and detrimental health outcomes through a randomized cross-over cooking method trial in healthy subjects using identical ingredients and a deep profiling analysis.

Drug tissue concentration and STAT3 modulation as determinants of tofacitinib response in ulcerative colitis.

Introduction: Inflammatory bowel disease management has advanced with therapies like Janus kinase inhibitors (JAKi). Despite their promise, JAKi pharmacokinetic-pharmacodynamic (PK-PD) profiles and tissue-level effects remain underexplored. This study investigates tissue and serum tofacitinib levels, their correlation with therapeutic efficacy, and molecular mechanisms underlying treatment response.

Serum extracellular RNAs as a noninvasive approach to differentiate inflammatory bowel disease subtypes: a proof-of-concept study.

Background And Aims: Extracellular RNAs (exRNAs), including in serum, show potential as noninvasive biomarkers. However, their (patho)physiological role is still not fully understood. In this study, we characterized serum exRNAs in patients with inflammatory bowel diseases (IBDs) and evaluated their ability to differentiate ulcerative colitis (UC) from Crohn's disease (CD).

Real-time automated assessment of histological disease activity in patients with ulcerative colitis using single-wavelength endoscopy technology.

Single-wavelength endoscopy (SWE) has shown promising results in assessing histological disease activity in ulcerative colitis. Our objective was to validate the real-time performance of a bedside prototype of SWE computer-aided diagnosis (CAD) as proof of concept.A bedside module for real-time use evaluated histological disease activity when endoscopy was performed in the rectum and sigmoid based on white-light endoscopy and SWE (410 nm monochromatic light).

No Increased Risk of Venous Thromboembolism or Infectious Complications after Janus Kinase Inhibitor Exposure in Patients with Ulcerative Colitis Undergoing Surgery.

Introduction: Total colectomy for ulcerative colitis (UC) is associated with postoperative morbidity, including venous thromboembolic events (VTE). In light of recent concerns about increased major adverse events associated with Janus kinase (JAK) inhibitor exposure, we aimed to evaluate the postoperative VTE risk as well as other complications in UC patients undergoing colectomy.

Methods: This single-center retrospective cohort study included all UC patients who underwent (procto)colectomy between 2013 and March 2022 and documented the 180-day postoperative non-infectious and infectious complications.

Individual-network based predictions of microbial interaction signatures for response to biological therapies in IBD patients.

Inflammatory Bowel Disease (IBD), which includes Ulcerative Colitis (UC) and Crohn's Disease (CD), is marked by dysbiosis of the gut microbiome. Despite therapeutic interventions with biological agents like Vedolizumab, Ustekinumab, and anti-TNF agents, the variability in clinical, histological, and molecular responses remains significant due to inter-individual and inter-population differences. This study introduces a novel approach using Individual Specific Networks (ISNs) derived from faecal microbial measurements of IBD patients across multiple cohorts.

Radiation exposure in patients with inflammatory bowel disease.

Background And Aims: Radiological imaging is crucial for diagnosing and monitoring patients with inflammatory bowel diseases (IBD). With increasing awareness of radiation risks, imaging doses should be "as low as reasonably achievable," with a risk level that one should try to stay underneath 75 mSv. However, real-world data on cumulative exposure are limited.