Diagnosis and Classification of Fistula from Inflammatory Bowel Disease and Inflammatory Bowel Disease-Related Surgery

Householder, Sarah; Picoraro, Joseph A.

doi:10.1016/j.giec.2022.04.003

Cited by 3 publications

(1 citation statement)

References 91 publications

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“…Due to long-term chronic inflammation of the intestine, abnormal connections, known as fistulas, may form between the intestine and the skin or adjacent organs, including the bladder and vagina. Based on the location of fistulas and the relationship between fistulas and neighboring organs, fistulas can be divided into two primary types: internal fistulas that open to neighboring organs, such as enteric-intestinal fistulas, enteric-bladder fistulas, and ileocolonic fistulas; and external fistulas that open on the body surface, such as enteric-skin fistulas and perianal fistulas [ 8 , 9 ]. Fistula is one of the major intestinal complications of Crohn’s disease (CD), occurring in 35% to 53% of CD patients during their natural course [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Causal Link between Inflammatory Bowel Disease and Fistula: Evidence from Mendelian Randomization Study

Tan

Zhu

Liu

et al. 2023

JCM

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Background: Previous observational studies have found that fistulas are common in Crohn’s disease (CD) and less common in ulcerative colitis (UC). However, some patients have a fistula before diagnosis. Based on retrospective analysis, it was not possible to determine whether there was a bi-directional causal relationship between inflammatory bowel disease (IBD) and fistulas. Methods: Data were extracted from the open GWAS database; 25,042 cases and 34,915 controls were included for IBD, and 6926 cases and 30,228 controls were included for fistula. Two-sample Mendelian randomization and multivariable Mendelian randomization were used in combination to determine the causal relationship between IBD and fistula. Results: Forward MR showed that IBD increased the risk of colonic or urogenital fistula (FISTULA) (OR: 1.09, 95% CI: 1.05 to 1.13, p = 1.22 × 10−6), mainly associated with fissure and fistula of the anal and rectal regions (FISSANAL) (OR:1.10, 95% CI:1.06 to 1.14, p = 6.12 × 10−8), but not with fistulas involving the female genital tract (FEMGENFISTUL) (OR:0.97, 95% CI: 0.85 to 1.11, p = 0.669). Furthermore, both UC and CD increased the risk of FISTULA. However, after adjusting by MVMR, only CD increased the risk of FISTULA (OR: 1.06, 95% CI: 1.02 to 1.11, p = 0.004), and UC did not increase the risk of FISTULA (OR: 1.01, 95% CI: 0.95 to 1.06, p = 0.838). Reverse MR showed that fistulas did not increase the risk of IBD. Conclusion: Our study confirms it is CD, rather than UC, that casually leads to an increased risk of fistula, but fistulas do not increase the risk of IBD.

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Section: Introductionmentioning

confidence: 99%

Causal Link between Inflammatory Bowel Disease and Fistula: Evidence from Mendelian Randomization Study

Tan

Zhu

Liu

et al. 2023

JCM

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The landscape of new therapeutic opportunities for IBD

Hurtado-Lorenzo,

Swantek

2024

Advances in Pharmacology

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ApaI Polymorphism in the Vitamin D Receptor Gene Decreases the Risk of Perianal Fistulas in Crohn’s Disease

Gisbert-Ferrándiz,

Llau,

Ortiz-Masia

et al. 2024

Nutrients

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Background: Vitamin D, through the activation of its receptor (VDR), plays an immunomodulatory role in the gastrointestinal tract. Single-nucleotide polymorphisms (SNPs) in the VDR gene have been associated with Crohn’s disease (CD) risk, and patients carrying the TaqI polymorphism in this gene run a higher risk of developing a penetrating behavior. Aims: We analyzed the association of BsmI, ApaI, TaqI, and FokI SNPs in the VDR gene with the clinical characteristics of CD. Methods: Four polymorphisms identified in the VDR gene (BsmI, FokI, ApaI, and TaqI) were genotyped in blood samples from CD patients (n = 115) by using PCR-RFLP. The disease’s location and behavior and the presence of perianal fistulas were collected from each patient. Intestinal fibroblasts from ileal resections of CD patients (n = 10) were genotyped, and the expression of fibrotic and inflammatory markers was analyzed by RT-PCR. Results: The data reveal no association between any of the polymorphisms and CD risk. A strong linkage disequilibrium was detected between TaqI and both ApaI and BsmI, which in turn were strongly associated. Homozygosis or heterozygosis for the a allele of the ApaI SNP or b allele of the BsmI SNP was significantly associated with a lower risk of a penetrating behavior, while the aa genotype was associated with a lower risk of perianal fistulas. Fibroblasts carrying the aa genotype expressed lower levels of fibrotic and inflammatory markers. Conclusion: The aa genotype of the ApaI SNP in the VDR gene is associated with a lower risk of perianal fistulas in CD and a reduced expression of fibrotic and inflammatory markers in intestinal fibroblasts.

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Diagnosis and Classification of Fistula from Inflammatory Bowel Disease and Inflammatory Bowel Disease-Related Surgery

Cited by 3 publications

References 91 publications

Causal Link between Inflammatory Bowel Disease and Fistula: Evidence from Mendelian Randomization Study

Causal Link between Inflammatory Bowel Disease and Fistula: Evidence from Mendelian Randomization Study

The landscape of new therapeutic opportunities for IBD

ApaI Polymorphism in the Vitamin D Receptor Gene Decreases the Risk of Perianal Fistulas in Crohn’s Disease

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