Extraintestinal Manifestations in Inflammatory Bowel Disease: From Pathophysiology to Treatment
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Pathophysiology of EIMs
3.1.1. EIMs as Extension of Immune Responses from the Intestine
3.1.2. EIMs as Independent Inflammatory Events
3.1.3. Genetic Basis of EIMs
3.2. Musculoskeletal EIMs
3.3. Skin EIMs
3.4. Ocular EIMs
3.5. Hepatobiliary EIMs
3.6. Other EIMs
3.7. Treatments for EIMs: An Overview
3.7.1. Treatment of Musculoskeletal EIMs
3.7.2. Treatment of Cutaneous EIMs
3.7.3. Treatment of Ocular EIMs
3.7.4. Treatment of Hepatobiliary EIMs
3.7.5. Paradoxical Effects of Advanced Therapies
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Genetic Risk Factors between Inflammatory Bowel Disease and Extraintestinal Manifestations | |
---|---|
Ankylosing spondylitis [15] | IL23R |
Sacroiliitis [13] | NOD2/CARD15 |
Erythema nodosum [16] | PTGER4, ITGAL, SOCS5, CD207, ITGB3, rs6828740 |
Pyoderma gangrenosum [16] | IL8RA, PRDM1, USP15, TIMP3 |
Uveitis [14] | NOD2/CARD15 |
Primary sclerosing cholangitis [1] | SOCS1, JAK2, STAT3, TYK2, UBASSH3A, BCL2L11, FOXO1, IRF1 |
System Involved | Disease | Synchronous with IBD | Treatment That Should Be Considered | Treatment That May Be Considered | Treatment That Cannot Be Recommended |
---|---|---|---|---|---|
Musculoskeletal EIM 13% (12.9–13.7) | Ankylosing spondylitis | no | Anti TNF-α | JAKi | vedolizumab, ustekinumab |
Sacroiliitis | no | Anti TNF-α | JAKi | vedolizumab, ustekinumab | |
Peripheral arthritis type 1 | yes | Anti TNF-α, JAKi, ustekinumab | vedolizumab | - | |
Peripheral arthritis type 2 | no | Anti TNF-α, JAKi, ustekinumab | vedolizumab | - | |
Skin EIM 5% (4.7–5.2) | Erythema nodosum | yes | - | Anti TNF-α | vedolizumab |
Pyoderma gangrenosum | yes or no | systemic steroids | Anti TNF-α, JAKi, ustekinumab | vedolizumab | |
Ocular EIM 2.1% (1.9–2.2) | Uveitis | yes or no | topical steroids, anti TNF-α (100%) | JAKi, ustekinumab | vedolizumab |
Episcleritis | yes | topical lubricants | NSAIDs, corticosteroids | - | |
Scleritis | yes or no | COX-2 inhibitors, topical NSAIDs, systemic corticosteroids | MTX, AZA, mycophenolate mofetil, calcineurin inhibitors, IFX | - | |
Hepatobiliary EIM 0.75% (0.6–0.8) | Primary sclerosing cholangitis | no | - | Ursodeoxycholic acid | - |
Autoimmune hepatitis | yes or no | Systemic steroids, AZA | infliximab | - |
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Faggiani, I.; Fanizza, J.; D’Amico, F.; Allocca, M.; Zilli, A.; Parigi, T.L.; Barchi, A.; Danese, S.; Furfaro, F. Extraintestinal Manifestations in Inflammatory Bowel Disease: From Pathophysiology to Treatment. Biomedicines 2024, 12, 1839. https://doi.org/10.3390/biomedicines12081839
Faggiani I, Fanizza J, D’Amico F, Allocca M, Zilli A, Parigi TL, Barchi A, Danese S, Furfaro F. Extraintestinal Manifestations in Inflammatory Bowel Disease: From Pathophysiology to Treatment. Biomedicines. 2024; 12(8):1839. https://doi.org/10.3390/biomedicines12081839
Chicago/Turabian StyleFaggiani, Ilaria, Jacopo Fanizza, Ferdinando D’Amico, Mariangela Allocca, Alessandra Zilli, Tommaso Lorenzo Parigi, Alberto Barchi, Silvio Danese, and Federica Furfaro. 2024. "Extraintestinal Manifestations in Inflammatory Bowel Disease: From Pathophysiology to Treatment" Biomedicines 12, no. 8: 1839. https://doi.org/10.3390/biomedicines12081839