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Background. Ulcerative Colitis (UC) is a frequent type of Inflammatory Bowel Disease, characterized by periods of remission and exacerbation. Gut dysbiosis may influence pathophysiology and clinical response in UC. The purpose of this study was to evaluate whether gut microbiota is related to the active and remission phases of UC compared to healthy subjects. Results. Cross-sectional study. Fecal samples from 18 patients with UC (clinically characterized as active (n=9), remission (n=9)) and 15 healthy subjects were collected. After fecal DNA extraction, the 16S rRNA gene was amplified and sequenced (Illumina MiSeq platform), operational taxonomic units were analyzed with the QIIME (Quantitative Insights Into Microbial Ecology) software. Alpha and beta diversities were compared between clinical settings, as well as the relation between most frequent genus with UC severity indicators. Gut microbiota composition revealed higher abundance of the phyla Proteobacteria and Fusobacteria in active UC, as compared with remission UC and healthy subjects. Likewise, marked abundance of the genus Bilophila and Fusobacteria were present in active UC, as compared with the other groups, whereas higher abundance of Faecalibacterium characterized both remission UC and healthy subjects. Microbial community’s richness and diversity in active UC were significantly different from the other groups. Relative abundance of Fecalibacterium and Roseburia showed higher correlation with fecal calprotectin, while relative abundance of Bilophila and Fusobacterium showed AUCs (Area under the curve) 0.917 and 0.988 for active vs remission UC, respectively. Conclusion. Gut dysbiosis is related to clinically relevant phases of UC and healthy controls. Particularly, Fecalibacterium, Roseburia, Bilophila, and Fusobacterium were identified as genus highly related with clinical phases of UC.

La colitis ulcerosa (CU) y la enfermedad de Crohn (EC) tienen diferentes opciones de tratamiento, que incluyen aminosalicilatos, corticosteroides, tiopurinas, inhibidores de calcineurina y biológicos como anticitocinas y antiintegrinas. Y recientemente el uso de vedolizumab (VDZ), el cual es un anticuerpo monoclonal humanizado selectivo para el intestino que se une a las integrinas α4β7, bloqueando selectivamente el tráfico de linfocitos en el intestino. El objetivo de este metaanálisis fue estimar la eficacia y seguridad del fármaco VDZ en ensayos clínicos aleatorizados en pacientes adultos no tratados previamente con terapia biológica y corticosteroides con CU y EC. Metodología: Se realizó una revisión sistemática de la literatura y un metaanálisis para evaluar la efectividad y seguridad del VDZ en pacientes con CU y EC. Se realizó una búsqueda en las bases de datos PubMed/Medline sobre pacientes adultos con CU sin previo uso de terapia biológica y corticosteroides bajo tratamiento de VDZ en ensayos clínicos aleatorizados. Resultados: Se seleccionaron cinco estudios que cumplieron los criterios de selección. Y se determinó que en la semana 14 de tratamiento, el 32% de los pacientes con CU estaban en remisión; y a los 12 meses, el 46% estaba en remisión clínica. Las tasas de remisión sin corticosteroides fueron del 26% en la semana 14 y del 42% en el mes 12. En el mes 12, del 33 al 77% de los pacientes con CU presentaron curación de la mucosa. El 9% de los pacientes informaron eventos adversos graves. Conclusiones: El VDZ demostró eficacia en pacientes con CU y EC activa de moderada a grave, logrando la remisión en el mes 12 de tratamiento. Estos hallazgos concuerdan con los datos y el apoyo de los ensayos clínicos aleatorizados muestran el perfil de riesgo-beneficio a largo plazo del VDZ.

Background: Fecal calprotectin (FC) can be a valuable tool to optimize health care for patients with inflammatory bowel disease (IBD). The objective of this observational study was to determine the level of knowledge of the FC test in Mexican patients with IBD. Methods: A self-report questionnaire was distributed via Facebook to patients with IBD. The survey consisted of 15 questions in two categories: the first category assessed knowledge of IBD diagnosis, and the second category assessed knowledge of the FC test. Results: In total, 460 patients with IBD participated, of which 83.9% (386) had ulcerative colitis (UC) and 16.0% (74) had Crohn’s disease (CD). Regarding IBD diagnosis, 41.9% of participants stated that they did not know of a non-invasive test for fecal matter to identify inflammation of the colon. Regarding the FC test, 57.5% (UC) and 58.1% (CD) stated that they did not know about the test. Additionally, 65.8% (UC) and 51.3% (CD) of participants stated that they had never received the FC test and 82.6% (UC) and 77.0% (CD) recognized that the FC test was difficult to access in their medical practice. Furthermore, 66% (UC) and 52.7% (CD) of participants noted that their specialist doctor had never suggested the FC test to them, yet 89.1% (UC) and 87.8% (CD) stated that they would prefer FC analysis for their IBD follow-up assessments. Conclusions: There is little knowledge of the FC biomarker among Mexican patients with IBD. This suggests the need for greater dissemination of its use and scope as a biomarker in IBD.