P550 Diagnosing and treating pediatric Crohn's disease patients: is there a difference between adult and pediatric gastroenterologists’ practices? Results of the BELCRO cohort

Greef, Elisabeth De; Maus, Bärbel; Hoffman, Ilse; Smets, Françoise; Biervliet, S. Van; Scaillon, Michèle; Hauser, Bruno; Paquot, Isabelle; Alliët, Philippe; Arts, W.F.M.; Dewit, Olivier; Peeters, Harald; Baert, F; D’Haens, Geert; Rahier, Jean François; Étienne, Isabelle; Bauraind, O.; Gossum, A. Van; Vermeire, Séverine; Fontaine, Fernand; Muls, Vinciane; Louis, E; Mierop, F Van de; Coche, Jean Charles; Steen, K. Van; Veereman, Gigi

doi:10.1016/s1873-9946(13)60571-1

Cited by 3 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Presentation at diagnosis in both groups was similar (19), with the majority of patients presenting with severe disease. Diagnostic delay was also comparable between both groups (median 3 months (range 1–12 months)) (19). Age certainly differed, because adult physicians tend to see only adolescents, but it did not make a significant difference in the analysis.…”

Section: Discussionmentioning

confidence: 87%

“…None of the studied parameters seemed to explain such difference. Presentation at diagnosis in both groups was similar (19), with the majority of patients presenting with severe disease. Diagnostic delay was also comparable between both groups (median 3 months (range 1-12 months)) (19).…”

Section: Discussionmentioning

confidence: 87%

“…Initial treatment also differed. Adult gastroenterologists tend to use more monotherapy compared with paediatricians, (19) and they use biologicals significantly earlier in the disease course. Nevertheless, our data show that earlier use of biologicals did not result in earlier remission in the BELCRO cohort and treatment schedules did not interfere with disease activity at M36.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Paediatric Crohn Disease

Greef

Hoffman

Smets³

et al. 2016

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Paediatric Crohn Disease

Greef

Hoffman

Smets³

et al. 2016

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

show abstract

“…Genetic variants in NOD2, MHC, and MST1 3p21 were shown to be associated with disease location (colonic CD, ileal CD, and ulcerative colitis [UC]) but not disease behavior (3). However, the genetic contribution to CD pathogenesis has been shown to be disproportionate, ranging from most impactful in very early-onset IBD (26) (VEOIBD) to modest significance in older pediatric and adult IBD patients (27)(28)(29)(30). In rectal tissue from pediatric patients, expression patterns of IL-13, IL23A, and IL17 distinguished colonic CD from UC (31).…”

Section: Discussionmentioning

confidence: 99%

Colonic epithelial miR-31 associates with the development of Crohn’s phenotypes

Keith¹,

Barrow²,

Toyonaga³

et al. 2018

JCI Insight

View full text Add to dashboard Cite

BACKGROUND. Crohn's disease (CD) is highly heterogeneous, due in large part to variability in cellular processes that underlie the natural history of CD, thereby confounding effective therapy. There is a critical need to advance understanding of the cellular mechanisms that drive CD heterogeneity. METHODS. We performed small RNA sequencing of adult colon tissue from CD and NIBD controls. Colonic epithelial cells and immune cells were isolated from colonic tissues, and microRNA-31 (miR-31) expression was measured. miR-31 expression was measured in colonoid cultures generated from controls and patients with CD. We performed small RNA-sequencing of formalinfixed paraffin-embedded colon and ileum biopsies from treatment-naive pediatric patients with CD and controls and collected data on disease features and outcomes. RESULTS. Small RNA-sequencing and microRNA profiling in the colon revealed 2 distinct molecular subtypes, each with different clinical associations. Notably, we found that miR-31 expression was a driver of these 2 subtypes and, further, that miR-31 expression was particularly pronounced in epithelial cells. Colonoids revealed that miR-31 expression differences are preserved in this ex vivo system. In adult patients, low colonic miR-31 expression levels at the time of surgery were associated with worse disease outcome as measured by need for an end ileostomy and recurrence of disease in the neoterminal ileum. In pediatric patients, lower miR-31 expression at the time of diagnosis was associated with future development of fibrostenotic ileal CD requiring surgery CONCLUSIONS. These findings represent an important step forward in designing more effective clinical trials and developing personalized CD therapies.

show abstract

“…Genetic variants in NOD2, MHC, and MST1 3p21 were shown to be associated with disease location (colonic CD, ileal CD and ulcerative colitis (UC)) but not disease behavior (3). But, the genetic contribution to CD pathogenesis has been shown to be disproportionate, ranging from most impactful in very early onset IBD (26) (VEOIBD) to modest significance in older pediatric and adult IBD patients (27)(28)(29)(30). In rectal tissue from pediatric patients, expression patterns of IL-13, IL23A, and IL17 distinguished colonic CD from UC (31).…”

Section: Discussionmentioning

confidence: 99%

Colonic Epithelial miR-31 Associates with the Development of Crohn’s Phenotypes

Keith

Barrow

Kazgan

et al. 2018

Preprint

View full text Add to dashboard Cite

Crohn’s disease (CD) is highly heterogeneous, due in large part to variability in cellular processes that underlie the natural history of CD, thereby confounding effective therapy. There is a critical need to advance understanding of the cellular mechanisms that drive CD heterogeneity. In this study, small RNA-sequencing and microRNA profiling in the colon revealed two distinct molecular subtypes, each with different clinical associations, in both adult and treatment-naïve pediatric CD patients. Notably, we found that microRNA-31 (miR-31) expression by itself can stratify patients into these two subtypes. Through detailed analysis of several colonic mucosa cell types from adult patients, we found that differential levels of miR-31 are particularly pronounced in epithelial cells. We generated patient crypt-derived epithelial colonoids and showed that miR-31 expression differences preserved in this ex-vivo system. In adult patients, low colonic miR-31 expression levels at the time of surgery are associated with post-operative recurrence of ileal disease. In pediatric patients, lower miR-31 expression at the time of diagnosis is associated with the future development of fibrostenotic ileal CD requiring surgery. These findings represent an important step forward in designing more effective clinical trials and developing personalized therapies for CD.

show abstract

P550 Diagnosing and treating pediatric Crohn's disease patients: is there a difference between adult and pediatric gastroenterologists’ practices? Results of the BELCRO cohort

Cited by 3 publications

References 0 publications

Paediatric Crohn Disease

Paediatric Crohn Disease

Colonic epithelial miR-31 associates with the development of Crohn’s phenotypes

Colonic Epithelial miR-31 Associates with the Development of Crohn’s Phenotypes

Contact Info

Product

Resources

About