Inflammatory Bowel Diseases: New Diagnostic and Therapeutic Approaches

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Immunology and Immunotherapy".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 1889

Special Issue Editors


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Guest Editor
1. Department of Gastroenterology, Vila Nova de Gaia Espinho Hospital Center, Vila Nova de Gaia, Portugal
2. Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
Interests: inflammatory bowel disease; endoscopy
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Guest Editor
1. Department of Gastroenterology, São João Hospital University Centre, Porto, Portugal
2. Unidade de Farmacologia Clínica, São João Hospital University Centre, Porto, Portugal
3. Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
Interests: gastroenterology

Special Issue Information

Dear Colleagues,

Inflammatory bowel diseases (IBDs), including Crohn's disease and ulcerative colitis, are lifelong gastrointestinal tract disorders whose prevalence is projected to reach 1% by 2030. The unpredictable remitting–relapsing course is a defining characteristic, significantly contributing to the burden of IBD. Remarkable advancements in the understanding of IBDs have been made in recent decades. It is now evident that IBDs arise from a complex interplay of genetic, environmental, and microbial factors, leading to dysregulated immune responses. However, there are still several unresolved aspects that limit timely diagnosis and therapeutic options, impacting patients' prognosis and quality of life. Therefore, it is crucial to encourage research that addresses the existing knowledge gaps. In this Special Issue, we invite original research or review articles focused on various topics related to IBD, including:

  • Mechanisms underlying IBD pathogenesis;
  • Disease monitoring;
  • Biomarkers;
  • Pharmacological innovations (new targets and combination therapy);
  • Endoscopic treatment;
  • Risk stratification and individualized therapy;
  • Management of extraintestinal manifestations;
  • Comorbidities in patients with IBD

Dr. Maria Manuela Estevinho
Dr. Fernando Magro
Guest Editors

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Keywords

  • bowel inflammation
  • crohn’s disease
  • endoscopy
  • inflammatory bowel disease
  • targeted therapy
  • ulcerative colitis

Published Papers (2 papers)

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Research

13 pages, 1621 KiB  
Article
Enhancing Calprotectin’s Predictive Power as a Biomarker of Endoscopic Activity in Ulcerative Colitis: A Machine Learning Use Case
by Mihaela Dranga, Cătălina Mihai, Otilia Gavrilescu, Cristina Cijevschi Prelipcean and Iolanda Valentina Popa
Biomedicines 2024, 12(3), 475; https://doi.org/10.3390/biomedicines12030475 - 20 Feb 2024
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Abstract
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by periods of exacerbation and remission, making disease monitoring and management challenging. Endoscopy, the gold standard for assessing disease activity and severity, involves invasive procedures and is associated with patient discomfort and risks. [...] Read more.
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by periods of exacerbation and remission, making disease monitoring and management challenging. Endoscopy, the gold standard for assessing disease activity and severity, involves invasive procedures and is associated with patient discomfort and risks. Using machine learning (ML) to combine fecal calprotectin with other clinical or biological tests can significantly enhance the non-invasive prediction of endoscopic disease activity (EDA) in UC. Aim: To prove that by fusing fecal calprotectin with other clinical data into an ML model, the performance of the non-invasive prediction of EDA can be significantly improved. Methods: We conducted a prospective, observational, single-center study encompassing 103 patients diagnosed with UC. We employed multilayer perceptron models as the core ML algorithm for predicting EDA. For the constructed models, we utilized the varImp function from the caret library in R to assess the significance of each variable in predicting the outcome. Results: Calprotectin as a sole predictor obtained an accuracy of 70% and an area under the curve (AUC) of 0.68. Combining calprotectin with the list of selected predictors that were fed to the MLP models improved accuracy and the AUC. The accuracy of the algorithm on the test set was 85%. Similarly, the AUC increased to 0.93. This is the first study to propose the use of calprotectin as a predictor in an ML model to estimate UC endoscopic disease activity. Conclusion: The deployment of this ML model can furnish doctors and patients with valuable evaluation of endoscopic disease activity which can be highly beneficial for individuals with UC who need long-term treatment. Full article
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20 pages, 3592 KiB  
Article
Interrelation of Hypoxia-Inducible Factor-1 Alpha (HIF-1 α) and the Ratio between the Mean Corpuscular Volume/Lymphocytes (MCVL) and the Cumulative Inflammatory Index (IIC) in Ulcerative Colitis
by Ioan Sabin Poenariu, Lidia Boldeanu, Bogdan Silviu Ungureanu, Daniel Cosmin Caragea, Oana Mariana Cristea, Vlad Pădureanu, Isabela Siloși, Anca Marinela Ungureanu, Răzvan-Cristian Statie, Alina Elena Ciobanu, Dan Ionuț Gheonea, Eugen Osiac and Mihail Virgil Boldeanu
Biomedicines 2023, 11(12), 3137; https://doi.org/10.3390/biomedicines11123137 - 24 Nov 2023
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Abstract
We intended to investigate the presence and medical application of serum hypoxia-inducible factor-1 alpha (HIF-1α) along with the already known systemic inflammatory markers and the new one’s inflammatory indices, the proportion of mean corpuscular volume and lymphocytes (MCVL) and the cumulative inflammatory index [...] Read more.
We intended to investigate the presence and medical application of serum hypoxia-inducible factor-1 alpha (HIF-1α) along with the already known systemic inflammatory markers and the new one’s inflammatory indices, the proportion of mean corpuscular volume and lymphocytes (MCVL) and the cumulative inflammatory index (IIC), for patients with ulcerative colitis (UC). We sought to establish correlations that may be present between the serum levels of HIF-1α and these inflammatory indices, as well as their relationship with disease activity and the extent of UC, which can provide us with a more precise understanding of the evolution, prognosis, and future well-being of patients. Serum samples were collected from 46 patients diagnosed with UC and 23 controls. For our assessment of the serum levels of HIF-1α, we used the Enzyme-Linked Immunosorbent Assay (ELISA) technique. Thus, for HIF-1α we detected significantly higher values in more severe and more extensive UC. When it came to MCVL and IIC, we observed statistically significant differences between the three groups being compared (Severe, Moderate, and Mild). Our study highlighted that HIF-1α correlated much better with a disease activity score, MCVL, and IIC. With MCVL and IIC, a strong and very strong correlation had formed between them and well-known inflammation indices. By examining the ROC curves of the analyzed parameters, we recognized that TWI (accuracy of 83.70%) provides the best discrimination of patients with early forms of UC, followed by HIF-1α (73.90% accuracy), MCVL (70.90% accuracy), and PLR (70.40%). In our study, we observed that HIF-1α, MCVL, and PLR had the same sensitivity (73.33%) but HIF-1α had a much better specificity (60.87% vs. 58.70%, and 54.35%). Also, in addition to the PLR, HIF-1α and MCVL can be used as independent predictor factors in the discrimination of patients with early forms of UC. Full article
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