Microscopic Colitis and Risk of Inflammatory Bowel Disease in a Nationwide Cohort Study

Khalili, Hamed; Burke, Kristin E.; Roelstraete, Björn; Sachs, Michael; Olén, Ola; Ludvigsson, Jonas F.

doi:10.1053/j.gastro.2019.12.028

Cited by 50 publications

(51 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, a chronic active colitis pattern of injury does not necessarily indicate an IBD‐like course for patients with ICI colitis. A recent study has shown an increased risk for developing IBD in patients with microscopic colitis, 28 suggesting shared pathogenetic mechanisms that may explain the variety of morphological manifestations observed in ICI colitis.…”

Section: Discussionmentioning

confidence: 99%

Medication‐specific variations in morphological patterns of injury in immune check‐point inhibitor‐associated colitis

et al. 2020

View full text Add to dashboard Cite

Aims A varied spectrum of histopathological changes has been associated with immune checkpoint inhibitor (ICI) colitis. This study was performed to evaluate the prevalence of different histopathological patterns of injury in patients with ICI colitis and their association with specific immune check‐point inhibitors. Methods and results Biopsies from patients with clinically and histologically confirmed ICI colitis were reviewed blindly to determine the predominant pattern of injury and to quantitate discrete histological parameters using the Geboes score. Paneth cell metaplasia, intraepithelial lymphocytes, abnormal subepithelial collagen and degree of crypt epithelial apoptosis was also recorded. A total of 86 patients with ICI colitis (ipilimumab, n = 14; ipilimumab + nivolumab, n = 29; nivolumab, n = 20 and pembrolizumab, n = 23) were included. The patterns of injury identified included diffuse active colitis (n = 22), chronic active colitis (n = 22), lymphocytic colitis (LC, n = 16), collagenous colitis (CC, n = 14), graft‐versus‐host disease‐like colitis (n = 7) and mixed colitis (n = 5). Patients on ipilimumab were more likely to have a diffuse active colitis pattern without features of chronicity (P < 0.01) and less likely to have LC (P < 0.05) compared to other ICIs. LC and CC were more common in patients on nivolumab and pembrolizumab relative to other groups (P < 0.05). Chronic active colitis was most frequent in nivolumab patients (P < 0.05), and these patients had received more ICI doses and had been on ICI treatment longer compared to other treatment groups. Conclusions ICI colitis should be considered in the differential diagnosis of all the common inflammatory patterns of colitis and shows medication specific differences in patterns of injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Medication‐specific variations in morphological patterns of injury in immune check‐point inhibitor‐associated colitis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The proportion of male in these individuals was 40.0%, which was significantly high in patients with I group (26.7%) compared to H group (Supplementary Table S4). Recent studies observed no evidence for associations between gastrointestinal inflammation and gender (Khalili et al, 2020). The median value of alanine aminotransferase and total bile acid was 18 U/L and 3.35 µmol/L, respectively.…”

Section: Study Populationsmentioning

confidence: 84%

Rewiring of Microbiota Networks in Erosive Inflammation of the Stomach and Small Bowel

Chen

Fan

Zhang

et al. 2020

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

The development of non-invasive, inexpensive, and effective early diagnosis tests for gastric and small-bowel lesions is an urgent requirement. The introduction of magnetically guided capsule endoscopy (MGCE) has aided examination of the small bowel for diagnoses. However, the distribution of the fecal microbiome in abnormal erosions of the stomach and small bowel remains unclear. Herein, alternations in the fecal microbiome in three groups [normal, small-bowel inflammation, and chronic gastritis (CG)] were analyzed by metagenomics and our well-developed method [individual-specific edge-network analysis (iENA)]. In addition to the dominant microbiota identified by the conventional differential analysis, iENA could recognize novel network biomarkers of microbiome communities, such as the genus Bacteroide in CG and small-bowel inflammation. Combined with differential network analysis, the network-hub microbiota within rewired microbiota networks revealed high-ranked iENA microbiota markers, which were disease specific and had particular pathogenic functions. Our findings illuminate the components of the fecal microbiome and the importance of specific bacteria in CG and small-bowel erosions, and could be employed to develop preventive and non-invasive therapeutic strategies.

show abstract

“…34 We categorized educational level into compulsory school (≤9 years of education), upper secondary school (10-12 years), college or university (≥13 years), and a "missing" category for those missing education information. Three baseline comorbidities were also adjusted for: IBD due to its association with MC and PD risk 14,35 ; celiac disease as a risk factor for IBD and MC 13,36 ; and chronic obstructive pulmonary disease (COPD) as a proxy for long-term smoking, which is associated with both MC and PD risks. 2,13 The diagnoses of IBD and COPD were identified from the NPR using the Swedish ICD codes provided in Table S1.…”

Section: Adjustment For Confoundingmentioning

confidence: 99%

“…12,13 Recently, patients with MC were found to have substantially increased risk of classic inflammatory bowel disease (IBD) than individuals without MC, consistent with an earlier report on genetic overlap between the two diseases. 14,15 Interestingly, IBD has been associated with higher risk of PD, particularly when IBD developed in later adulthood (≥60 years). 16 Moreover, several physiological perturbations implicated in PD pathogenesis, such as autoimmune dysfunction, 17 intestinal dysbiosis, 18 and disruption of epithelial permeability, 19 are also demonstrated in MC, implying a possible connection between MC and PD.…”

mentioning

confidence: 99%

Association Between Microscopic Colitis and Parkinson's Disease in a Swedish Population

et al. 2021

Self Cite

View full text Add to dashboard Cite

A BS TRACT: Background: Gastrointestinal inflammation has been linked with Parkinson's disease (PD). Microscopic colitis (MC) is an intestinal inflammatory disease with unknown relationship with PD.Objective: This study aimed to examine the association of MC with PD risk. Methods: In this nationwide matched cohort study in Sweden, PD incidence was compared between 12,609 patients with histologically confirmed MC and a matched population cohort of 58,879 MC-free individuals and a sibling cohort comprising all unaffected siblings of the MC patients (N MC /N Sibling = 6281/12,351). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models. Results: During a mean follow-up of $7 years, we identified 449 incident PD diagnoses among the MC patients and the population cohort. Overall, MC was associated with an adjusted HR of 1.76 for PD, but the association attenuated substantially during follow-up. In the time-varying effects model, PD hazard was 3.45-fold (95% CI: 2.42, 4.93) higher during the first 2 years after biopsy and 1.80-fold (95% CI: 1.23, 2.64) higher during the following 3 years among MC versus MC-free individuals but was not different beyond 5 years after biopsy (HR: 1.03; 95% CI: 0.68, 1.54). This temporal pattern of MC-PD associations persisted when comparing MC patients to their siblings. In a post hoc case-control analysis, we also detected a strong association between MC and preexisting PD (odds ratio: 3.46; 95% CI: 2.91, 4.12). Conclusions: Our findings suggest that MC may not be a risk factor for PD; instead, it may co-occur with PD as a comorbidity or develop after a diagnosis of PD.

show abstract

Microscopic Colitis and Risk of Inflammatory Bowel Disease in a Nationwide Cohort Study

Cited by 50 publications

References 43 publications

Medication‐specific variations in morphological patterns of injury in immune check‐point inhibitor‐associated colitis

Medication‐specific variations in morphological patterns of injury in immune check‐point inhibitor‐associated colitis

Rewiring of Microbiota Networks in Erosive Inflammation of the Stomach and Small Bowel

Association Between Microscopic Colitis and Parkinson's Disease in a Swedish Population

Contact Info

Product

Resources

About