AFP is not more effective than seton removal alone to achieve FAP-CD closure.

The dominant MAB do not differ between noninflamed and inflamed ileal mucosa in Crohn's disease. This argues against a localized dysbiosis to explain the patchy distribution of mucosal lesions.

The serologic panel for inflammatory bowel disease (IBD) is rapidly expanding. Antineutrophil cytoplasmic antibodies (ANCA) and anti-Saccharomyces cerevisiae mannan antibodies (ASCA) have remained the most widely studied markers, but immune reactivity against a new group of bacterial antigens such as I2, OmpC (outer membrane porin C), and flagellin, has been described in Crohn's disease. Several clinical avenues have been explored, such as the usefulness of serologic markers as screening tools for IBD and in accelerating a diagnosis in patients with indeterminate colitis. Another area of interest is disease stratification. Emerging data suggest there is a diversity of qualitative and quantitative responses to environmental antigens that differs among groups of IBD patients and may be associated with different clinical behaviors. As a result, it may be possible to tailor therapy on the basis of serologic responses. Prospective studies are needed before translating this concept into clinical practice. Clustering of IBD patients into more homogeneous subgroups based on antibody responses may help to unravel the pathophysiology of subsets of IBD.

Background A better patient’s knowledge on their Inflammatory Bowel Disease (IBD) could improve its outcome and quality of life. The aim of this study was to assess if an education program improves IBD patients’ skills as regards to their disease. Methods The GETAID group conducted a prospective multicenter randomized controlled study. IBD patients were included at diagnosis, or after a significant event in the disease course. Patients were randomized between “educated” or control groups for 6 months. Education was performed by trained healthcare professionals. A psycho-pedagogic score (ECIPE) was evaluated by a “blinded” physician at baseline and after 6 and 12 months (M6 and M12). The primary endpoint was the increase of ECIPE score at M6 of more than 20%. Results 263 patients were included in 19 centers (Male:40%; Median age:30.8; CD:73%). 133 patients were randomized in the educated group, and 130 in the control group. The median relative increase of the ECIPE score at M6 was higher in the educated group as compared to the control group (16.7%(0-42.1%) vs 7%(0-18.8%) respectively p=0.0008). The primary endpoint was met in 46% vs 24% of the patients in the educated and control groups respectively (p=0.0003). A total of 92 patients met the primary endpoint. In multivariate analysis, predictors of an increase of at least 20% of the ECIPE score were randomization in the educated group (OR=2.59) and no previous surgery (OR=1.92). Conclusion These findings support the set-up of education programs in centers involved in the management of IBD patients.