New global map of Crohnʼs disease: Genetic, environmental, and socioeconomic correlations

Economou, Michael; Pappas, Georgios

doi:10.1002/ibd.20352

Cited by 161 publications

(114 citation statements)

References 132 publications

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“…Crohn's disease is an immunologically mediated inflammatory bowel disease with a reported incidence of 4.0-7.0, 7.1, and 1.34 per 100,000 persons in Europe, the U.S., and Korea, respectively [1,2]. The etiology of Crohn's disease remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Autologous adipose tissue-derived stem cells treatment demonstrated favorable and sustainable therapeutic effect for Crohn's fistula

Lee¹,

Park²,

Cho³

et al. 2013

Stem Cells

251

203

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Fistula is a representative devastating complication in Crohn's patients due to refractory to conventional therapy and high recurrence. In our phase I clinical trial, adipose tissue-derived stem cells (ASCs) demonstrated their safety and therapeutic potential for healing fistulae associated with Crohn's disease. This study was carried out to evaluate the efficacy and safety of ASCs in patients with Crohn's fistulae. In this phase II study, forty-three patients were treated with ASCs. The amount of ASCs was proportioned to fistula size and fistula tract was filled with ASCs in combination with fibrin glue after intralesional injection of ASCs. Patients without complete closure of fistula at 8 weeks received a second injection of ASCs containing 1.5 times more cells than the first injection. Fistula healing at week 8 after final dose injection and its sustainability for 1-year were evaluated. Healing was defined as a complete closure of external opening without any sign of drainage and inflammation. A modified per-protocol analysis showed that complete fistula healing was observed in 27/33 patients (82%) by 8 weeks after ASC injection. Of 27 patients with fistula healing, 26 patients completed additional observation study for 1-year and 23 patients (88%) sustained complete closure. There were no adverse events related to ASC administration. ASC treatment for patients with Crohn's fistulae was well tolerated, with a favorable therapeutic outcome. Furthermore, complete closure was well sustained. These results strongly suggest that autologous ASC could be a novel treatment option for the Crohn's fistula with high-risk of recurrence. STEM

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Section: Introductionmentioning

confidence: 99%

Autologous adipose tissue-derived stem cells treatment demonstrated favorable and sustainable therapeutic effect for Crohn's fistula

Lee¹,

Park²,

Cho³

et al. 2013

Stem Cells

251

203

View full text Add to dashboard Cite

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“…IBD, once considered a disease of industrialized countries, is now reported globally. The highest incidences (8-66/100 000 population) of Crohn's are found in Wales, New Zealand, Canada, Scotland, France, the Netherlands and Scandinavia [17] . Other industrial countries such as in the United Kingdom, the United States and in Europe have intermediate rates ranging from 4-7/100 000 [17,18] .…”

Section: Incidencementioning

confidence: 99%

“…The highest incidences (8-66/100 000 population) of Crohn's are found in Wales, New Zealand, Canada, Scotland, France, the Netherlands and Scandinavia [17] . Other industrial countries such as in the United Kingdom, the United States and in Europe have intermediate rates ranging from 4-7/100 000 [17,18] . Historically, IBD was infrequently reported in developing countries, but currently low incidence rates are reported (0.2-3/100 000) in such countries like Brazil, China, Korea, Greece, Japan, Malta and Slovakia [19] .…”

Section: Incidencementioning

confidence: 99%

State-of-the-art of irritable bowel syndrome and inflammatory bowel disease research in 2008

McFarland¹

2008

WJG

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Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two of the leading causes of chronic intestinal conditions in the world. This issue of World Journal of Gastroenterology (WJG ) presents a series of papers from world experts who discuss the current knowledge and opinions on these important conditions. Although great strides have been made in the diagnosis, treatment and pathology of IBS and IBD; much has yet to be explained. The etiologies and risk factors of these multifactorial conditions remain elusive. Specific diagnostic biomarkers need to be developed and safer treatments developed. The burden of IBS and IBD on the healthcare system is felt with repeated medical care visits and high costs. IBS and IBD patients can account for 30%-50% of office visits at gastroenterology services/clinics. Over one million people have IBD in the United States, with 30 000 new cases being diagnosed every year. One-quarter million people in the UK are afflicted with IBD. The cost of medical care in the United States for IBD is estimated to be $1.8 billion/year. IRRITABLE BOWEL SYNDROME (IBS)Incidence of IBS IBS is a global problem and is more common in women than men. In developed countries, the prevalence of IBS ranges from 3%-25% of adults [1][2][3][4] and in the United States, IBS affects 15 million adults [5] . In the United Kingdom, IBS affects 10%-15% of the adult population [6] . The cost of direct and indirect medical care for IBS reached over $200 billion dollars in the United States [5,7] . Diagnosis of IBSAs there are no biologic markers for IBS, the diagnosis is usually based on symptoms and exclusion of other known causes of intestinal distress [6] . Unlike IBD, IBS does not cause severe inflammation, ulcers or other structural damage that aids the diagnosis of IBD. IBS is a functional disorder characterized by abdominal bloating, flatulence, abdominal pain and bowel dysfunction. The varying nature of symptoms and lack of structural abnormalities presents a diagnostic challenge. There are three main types of disease phenotypes: diarrhea-predominant (IBS-D), constipation-predominant (IBD-C) or alternating diarrhea-constipation (IBS-A). The diarrhea-predominant type is more common (48%) in males, whereas constipation-predominant (39%) or alternating types (48%) are more common in women [1] . Several tools (for example, Rome Ⅲ, Manning criteria) have been developed to standardize the diagnosis of IBS. Most of the historic research has been focused on the pathophysiology of diarrhea, but constipation has not been as well described. The review by McCrea and colleagues in this issue summarizes our current knowledge about the physiology and pathology of constipation [8] . The prevalence of constipation ranges from 15%-25% in the general population and is more common in women than men and in ages over 70 years old [9] . The typical definition of constipation (less than three stools/week) may not be a sensitive measure for this condition, as individuals vary widely in their own bowel habits. ...

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“…1 CD has a relapsing-remitting course and treatment depends on controlling disease symptoms and maintaining remission. However, a majority of CD patients require surgery within the first 10 years of diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 A range of factors have been associated with an increased risk of complicated (stricturing and penetrating) CD behaviour including the specific NOD2 genotypes [4][5][6] having had perianal disease [8][9][10][11] and cigarette smoking. 1,6,8,[12][13][14] Complicated disease is strongly associated with a requirement for surgery 15 ; therefore, knowledge of such genetic, environmental and clinical predictors may guide clinicians in developing a personalised approach for individual patients. 2,3,16 The ability to predict those who will have a more indolent disease course is also important given the range of adverse drug reactions and the cost of anti-TNF drugs.…”

Section: Introductionmentioning

confidence: 99%

An Envirogenomic Signature Is Associated with Risk of IBD-Related Surgery in a Population-Based Crohn’s Disease Cohort

Nasir

Griffiths

Nasir

et al. 2013

Journal of Gastrointestinal Surgery

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Background and Aims Crohn's disease (CD) is an inflammatory bowel disease (IBD) caused by a combination of genetic, clinical, and environmental factors. Identification of CD patients at high risk of requiring surgery may assist clinicians to decide on a top-down or step-up treatment approach. Methods We conducted a retrospective case-control analysis of a population-based cohort of 503 CD patients. A regressionbased data reduction approach was used to systematically analyse 63 genomic, clinical and environmental factors for association with IBD-related surgery as the primary outcome variable. Results A multi-factor model was identified that yielded the highest predictive accuracy for need for surgery. The factors included in the model were the NOD2 genotype (OR=1.607, P=2.3×10 −5 ), having ever had perianal disease (OR=2.847, P=4×10 −6 ), being post-diagnosis smokers (OR=6.312, P=7.4×10 −3 ), being an ex-smoker at diagnosis (OR=2.405, P=1.1×10 −3 ) and age (OR=1.012, P=4.4×10 −3 ). Diagnostic testing for this multi-factor model produced an area under the curve of 0.681 (P=1×10 −4 ) and an odds ratio of 3.169, (95 % CI P=1×10 −4 ) which was higher than any factor considered independently.Conclusions The results of this study require validation in other populations but represent a step forward in the development of more accurate prognostic tests for clinicians to prescribe the most optimal treatment approach for complicated CD patients.

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New global map of Crohnʼs disease: Genetic, environmental, and socioeconomic correlations

Cited by 161 publications

References 132 publications

Autologous adipose tissue-derived stem cells treatment demonstrated favorable and sustainable therapeutic effect for Crohn's fistula

Autologous adipose tissue-derived stem cells treatment demonstrated favorable and sustainable therapeutic effect for Crohn's fistula

State-of-the-art of irritable bowel syndrome and inflammatory bowel disease research in 2008

An Envirogenomic Signature Is Associated with Risk of IBD-Related Surgery in a Population-Based Crohn’s Disease Cohort

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