Inflammatory Pathologies

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 2665

Special Issue Editor


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Guest Editor
1. Department of Gastroenterology, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TH, UK
2. Department of Gastroenterology, Mazumdar Shaw Medical Centre, Narayana Health, Bangalore, India
Interests: Inflammatory bowel disease; ulcerative colitis; Crohn’s disease; biologics in IBD; small molecules in IBD

Special Issue Information

Dear Colleagues,

Inflammatory pathologies, which generally refer to chronic inflammatory conditions, represent a significant problem in healthcare today. According to the World Health Organization, chronic inflammatory diseases are among the greatest threats to human health. These conditions not only cause significant morbidity to patients, but also exert a huge burden on healthcare systems worldwide. The projected number of patients suffering from these conditions is likely to increase in the coming decades. It is imperative that we have an enhanced understanding of the underlying reasons for this surge in inflammatory pathologies.

There have been significant advances made in recent decades regarding the management of these conditions, such as novel biomarkers, immunotherapies, and newer diagnostic tools. Further research into preventive measures, early diagnostic techniques and management are necessary to tackle the expected surge in the coming years.

We look forward to receiving your contributions.

Dr. Uday Nagesh Shivaji
Guest Editor

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Keywords

  • systemic chronic inflammation
  • biomarkers of inflammation
  • imaging in inflammatory pathology

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Published Papers (3 papers)

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Research

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9 pages, 434 KiB  
Article
Long-Term Follow Up of Patients Treated for Inflammatory Bowel Disease and Cytomegalovirus Colitis
by Gurtej Singh, Clarissa Rentsch, William Beattie, Britt Christensen, Finlay Macrae and Jonathan P. Segal
Diagnostics 2024, 14(18), 2030; https://doi.org/10.3390/diagnostics14182030 - 13 Sep 2024
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Abstract
Background: Pathological reactivation of latent Cytomegalovirus (CMV) is triggered by inflammation and immunosuppression; both present in the pathogenesis and treatment of Inflammatory Bowel Disease (IBD). Whether CMV reactivation is associated with escalating medical therapy, further hospital admissions, or worse clinical outcomes remains controversial. [...] Read more.
Background: Pathological reactivation of latent Cytomegalovirus (CMV) is triggered by inflammation and immunosuppression; both present in the pathogenesis and treatment of Inflammatory Bowel Disease (IBD). Whether CMV reactivation is associated with escalating medical therapy, further hospital admissions, or worse clinical outcomes remains controversial. This study aimed to follow up IBD patients with an index episode of CMV colitis and analyse the clinical outcomes. Methods: A retrospective study of patients with IBD treated for CMV colitis was completed. The outcome results were collected at 6-month and 12-month time points after the first episode of CMV colitis. A total of 13 patients with Ulcerative Colitis and 1 with Crohn’s Disease were included. Results: CMV colitis recurrence occurred in 29% of patients at 12 months. A total of 43% of patients had changed their biologic dose at 6 months and 29% had escalated their biologic dose at 12 months. At 12 months, 36% of patients had been re-hospitalised, including three colectomies. Disease remission was only achieved by 29% of patients at 12 months. Conclusions: IBD patients with CMV colitis have substantial rates of re-hospitalisation, failed medical therapy, and colectomy. These risks may be greater at <6 months from an index episode of CMV colitis. Full article
(This article belongs to the Special Issue Inflammatory Pathologies)
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Review

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15 pages, 1014 KiB  
Review
Controversies in Venous Thromboembolism Risk Assessment in Inflammatory Bowel Disease: A Narrative Review
by Nikhil Sharma, Pavit Tewatia, Philip R. Harvey and Aditi Kumar
Diagnostics 2024, 14(19), 2112; https://doi.org/10.3390/diagnostics14192112 - 24 Sep 2024
Viewed by 606
Abstract
Inflammatory bowel disease (IBD) is a chronic inflammatory condition affecting the gastrointestinal tract with increasing rates of incidence and prevalence across the world. Complex inflammatory and prothrombotic pathophysiology in IBD makes venous thromboembolism (VTE) a common complication with significant morbidity and mortality. This [...] Read more.
Inflammatory bowel disease (IBD) is a chronic inflammatory condition affecting the gastrointestinal tract with increasing rates of incidence and prevalence across the world. Complex inflammatory and prothrombotic pathophysiology in IBD makes venous thromboembolism (VTE) a common complication with significant morbidity and mortality. This risk is increased in pregnancy. As we continue to understand the pathogenesis of IBD, this article highlights the continued risk of VTE following discharge, for which there is currently no clear guidance, yet the risk of VTE remains high. Furthermore, we discuss this increased VTE risk in the context of pregnant IBD patients and the relevant current guidelines. Alongside this, medications that are used to manage IBD carry their own thrombotic risk, which clinicians should be aware of. Assessing VTE risks in IBD populations using newer medications should be a focus of future research. Full article
(This article belongs to the Special Issue Inflammatory Pathologies)
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Other

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25 pages, 2070 KiB  
Systematic Review
The Diagnostic Accuracy of Colon Capsule Endoscopy in Inflammatory Bowel Disease—A Systematic Review and Meta-Analysis
by Ian Io Lei, Camilla Thorndal, Muhammad Shoaib Manzoor, Nicholas Parsons, Charlie Noble, Cristiana Huhulea, Anastasios Koulaouzidis and Ramesh P. Arasaradnam
Diagnostics 2024, 14(18), 2056; https://doi.org/10.3390/diagnostics14182056 - 16 Sep 2024
Viewed by 806
Abstract
Colon capsule endoscopy (CCE) has regained popularity for lower gastrointestinal investigations since the COVID-19 pandemic. While there have been systematic reviews and meta-analyses on colonic polyp detection using CCE, there is a lack of comprehensive evidence concerning colonic inflammation. Therefore, this systematic review [...] Read more.
Colon capsule endoscopy (CCE) has regained popularity for lower gastrointestinal investigations since the COVID-19 pandemic. While there have been systematic reviews and meta-analyses on colonic polyp detection using CCE, there is a lack of comprehensive evidence concerning colonic inflammation. Therefore, this systematic review and meta-analysis aimed to assess the diagnostic accuracy of CCE for colonic inflammation, predominantly ulcerative colitis (UC) and Crohn’s disease (CD). Methods: We systematically searched electronic databases (EMBASE, MEDLINE, PubMed Central, and Cochrane Library) for studies comparing the diagnostic accuracy between CCE and optical endoscopy as the standard reference. A bivariate random effect model was used for the meta-analysis. Results: From 3797 publications, 23 studies involving 1353 patients were included. Nine studies focused on UC, and ten focused on CD. For UC, CCE showed a pooled sensitivity of 92% (95% CI, 88–95%), a specificity of 71% (95% CI, 35–92%), and an AUC of 0.93 (95% CI, 0.89–0.97). For CD, the pooled sensitivity was 92% (95% CI, 89–95%), and the specificity was 88% (95% CI, 84–92%), with an AUC of 0.87 (95% CI, 0.76–0.98). Overall, for inflammatory bowel disease, the pooled sensitivity, specificity, and AUC were 90% (95% CI, 85–93%), 76% (95% CI, 56–90%), and 0.92 (95% CI, 0.94–0.97), respectively. Conclusions: Despite the challenges around standardised disease scoring and the lack of histological confirmation, CCE performs well in diagnosing inflammatory bowel disease. It demonstrates high sensitivity in both UC and Crohn’s terminal ileitis and colitis and high specificity in Crohn’s disease. Further studies are needed to evaluate the diagnostic accuracy of other colonic inflammatory conditions. Full article
(This article belongs to the Special Issue Inflammatory Pathologies)
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