Background Diet may contribute to inflammatory bowel disease (IBD) pathogenesis. In a previous French cohort, we found an association between high protein intake and increased risk of IBD. We aimed to investigate this relationship in the EPIC-IBD (European Prospective Investigation into Cancer and Nutrition – Inflammatory Bowel Diseases) cohort. Methods 413 593 participants from 8 European countries were included. Dietary data were collected at baseline from validated food frequency questionnaires. Mean daily intake of nutrients was assessed using the EPIC nutrient database. To reduce bias in the estimation of relative risks, calibrated dietary data were obtained from the country and sex-specific calibration models for all participants. Associations between proteins (total, animal, and vegetable) or food sources of animal proteins, and IBD risk were estimated by Cox proportional hazard models. Results After a mean follow-up of 16 years, 595 incident cases of IBD were identified, including 177 Crohn’s disease (CD) and 418 ulcerative colitis (UC) cases. No association was observed between total protein intake and IBD risk (adjusted HR for the fourth vs. the first quartile = 1.25; CI 95% = 0.89–1.77, P-trend = 0.33). There was a significant association between the calibrated continuous variable of animal protein intake and IBD risk (adjusted HR per 10 g/day: 1.10; 95% CI = 1.004–1.21) although no association was found for extreme quartiles (HR: 0.99; 95% CI = 0.73–1.34; P-trend = 0.91). There was no association between vegetable protein intake and IBD risk. There was an association between meat consumption and IBD risk (adjusted HR for the fourth vs.. the first quartile = 1.37; CI95% = 1.02–1.82, P-trend = 0.003) and between red meat consumption and IBD risk (adjusted HR for the fourth vs. the first quartile = 1.41; CI95% = 1.03–1.92, P-trend = 0.006). In separate analyses for CD and UC, there was an association between total meat and UC risk, and between red meat and UC risk. No association was found between food sources of animal proteins and CD risk. Conclusion Animal protein intake is associated with IBD risk in the EPIC-IBD cohort. Observed associations between meat consumption and IBD or UC risk, and between red meat consumption and IBD or UC risk deserve further investigation.

Inflammatory bowel disease (IBD), which comprises of Crohn's disease and ulcerative colitis, is an idiopathic relapsing and remitting disease in which the interplay of different environment, microbial, immunological and genetic factors that attribute to the progression of the disease. Numerous studies have been conducted in multiple aspects including clinical, endoscopy and histopathology for the diagnostics and treatment of IBD. However, the molecular mechanism underlying the aetiology and pathogenesis of IBD is still poorly understood. This review tries to critically assess the scientific evidence at the transcriptomic level as it would help in the discovery of RNA molecules in tissues or serum between the healthy and diseased or different IBD subtypes. These molecular signatures could potentially serve as a reliable diagnostic or prognostic biomarker. Researchers have also embarked on the study of transcriptome to be utilized in targeted therapy. We focus on the evaluation and discussion related to the publications reporting the different approaches and techniques used in investigating the transcriptomic changes in IBD with the intention to offer new perspectives to the landscape of the disease.

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Methods A multicenter prospective cross-sectional study was performed from July 2012 to December 2014. We compared patients with and without gastric polyps for the prevalence of colorectal adenomas. The odds ratios (OR) were computed by logistic regression analysis after multivariable adjustments. Results Totally 1546 patients were included, with 770 patients in the gastric polyp group and 776 in the age-and sexmatched control group. Patients with gastric polyps had greater odds of having any colorectal adenoma (adjusted OR=2.36, 95% confidence interval [CI]: 1.81 to 3.09, p<0.001) and advanced colorectal adenomas (adjusted OR=2.74, 95% CI: 1.76 to 4.28, p<0.001) than those without. The positive association between gastric polyps and colorectal adenomas remained significant in both women (OR=2.34, 95% CI: 1.66 to 3.29, p<0.001) and men (OR=1.87, 95% CI: 1.31 to 2.66, p=0.001). Patients over the age of 40 with gastric polyps had a higher prevalence of colorectal adenomas than those without (40-49 year: OR=1.81, 95% CI=1.02-3.21, p=0.04; 50-59 year: OR=1.88, 95% CI=1.26-2.81, p<0.001; 60-74 year: OR=2.62, 95% CI=1.73-3.98, p<0.001).Conclusions The presence of gastric polyps is significantly associated with a higher prevalence of colorectal adenomas, especially advanced colorectal adenomas. Colonoscopy might be considered in patients with gastric polyps, of any gender, and over the age of 40.

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