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  • 1
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2021
    In:  Journal of Crohn's and Colitis Vol. 15, No. Supplement_1 ( 2021-05-27), p. S392-S393
    In: Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 15, No. Supplement_1 ( 2021-05-27), p. S392-S393
    Abstract: Redox imbalance is involved in several aspects of inflammatory bowel disease (IBD). The OxIBDiet (NCT04513015) is a multicentre, 2-phases project involving IBD children and adults with the following aims: 1. To evaluate oxidative status of IBD subjects. 2. To estimate the effects of an antioxidant diet in IBD patients. Preliminary results are shown in this abstract. Methods The total antioxidant capacity, lipid peroxidation and the degree of protein oxidation were measured respectively through the ferric reducing ability of plasma (FRAP, µmol/equivalent FeSO4), serum levels of the thiobarbituric acid reactive substances (TBARs, µmol MDA) and advanced Oxidation Protein Products (AOPP, µmol/g protein). Reactive oxygen species (ROS, Arbitrary Units) and activities (nmol/min/mg of protein) of the main antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPX), glutathione reductase (GR), glutathione S-Transferase (GST) and catalases (CAT) were evaluated in PMNs cells. Oxidative stress markers were correlated with demographic variables and clinical parameters. Results Fifteen adults (mean age: 36.2 ±11.4 years, 47% female, 67% in remission) and thirty five children (mean age: 14.13 ±2.2 years, 60% female, 65% in remission) with IBD have been enrolled so far. FRAP was significantly reduced in IBD children compared to healthy controls (median values: 212.1 vs. 248.3, p=0.0001) and to IBD adults (median value: 281, p & lt;0.001), while no difference was observed between adults with IBD and the control group (p= 0.1). ROS levels did not differ in IBD children compared to adults and controls. The activity of GPX and CAT enzymes was increased in children with IBD in comparison to controls (p:0.02 and 0.001, respectively) while the activity of the other enzymes (GST, GR and SOD) and levels of lipid peroxidation and protein oxidation was not different between the 2 groups. Overall in the IBD group (children plus adults) FRAP was positively correlated with age (r=0.40, p=0.006), male gender (r=0.33, p=0.03) and use of biologics (r=0.47, p=0.001) and inversely correlated to disease activity based on clinical scores (r= -0.38, p=0.009). No correlation was found between FRAP and serum C-reactive protein or calprotectin levels. Conclusion The total antioxidant capacity (FRAP) is significantly impaired in IBD children respect to IBD adults and to healthy controls, thus suggesting an early involvement of oxidative stress in IBD pathogenesis. Moreover, the activity of the main antioxidant enzymes (GPx and CAT) in IBD children is increased, as a possible compensation for redox imbalance. Final results will clarify the involvement of antioxidant cascade in IBD pathogenesis and in therapeutic approach.
    Type of Medium: Online Resource
    ISSN: 1873-9946 , 1876-4479
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 2
    In: Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 16, No. Supplement_1 ( 2022-01-21), p. i496-i496
    Abstract: Oxidative stress takes part in the pathogenesis of inflammatory bowel disease (IBD). The OxIBDiet (NCT04513015) is a multicentre ongoing project designed to evaluate oxidative status of IBD children and adults and to estimate the effects of an antioxidant diet in a subgroup of IBD patients. Methods The total antioxidant capacity, measured through the ferric reducing ability of plasma (FRAP, µmol/equivalent FeSO4) and oxygen radical absorbance capacity (ORAC, plasma trolox equivalents), lipid peroxidation, as serum levels of the thiobarbituric acid reactive substances (TBARs, µmol MDA) and the degree of protein oxidation, as advanced Oxidation Protein Products (AOPP, µmol/g protein), were measured. Activities (nmol/min/mg of protein) of the main antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPX), glutathione reductase (GR), glutathione S-Transferase (GST) and catalases (CAT) were evaluated in PMNs cells and plasma. Oxidative biomarkers were correlated with clinical parameters. Results Twenty-three adults (mean age: 33,7, IQR 20,5 years, 42% male, 63% in remission) and 41 children with IBD (mean age: 12, IQR 4 years, 52% male, 61% in remission) were enrolled and compared respectively to 29 adults and 23 children controls. FRAP was significantly reduced in IBD children compared to adults (202 vs 277 mcmol/eq FeSO4, p & lt;0.0001) and was correlated with age (r=0.5718; p & lt;0.0001). Plasmatic ORAC was significantly higher in IBD children compared to controls and adults with IBD (Figure 1). ORAC in IBD subjects resulted inversely correlated to age (r= -0.4417, p=0.0004) and use of biologics (r= -0.4246, p=0.0006). AOPP were elevated in paediatric IBD versus controls (p=0.0049) and correlated to the diagnosis of Crohn at the multiple regression analysis (r=-0.732; p=0.023). The main antioxidant enzymes plasmatic activities are shown in table 1. Conclusion The antioxidant system and therefore the antioxidant capacity is significantly different in IBD compared to controls and evolve from paediatric to adult age, maybe as an effort to compensate the persistent redox imbalance and inflammation. Involvement of antioxidant cascade in IBD pathogenesis and role in therapeutic approach will be better outlined by the final results.
    Type of Medium: Online Resource
    ISSN: 1873-9946 , 1876-4479
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2389631-0
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  • 3
    In: Digestive and Liver Disease, Elsevier BV, Vol. 50, No. 4 ( 2018-10), p. e398-
    Type of Medium: Online Resource
    ISSN: 1590-8658
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 2061359-3
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  • 4
    In: Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 15, No. Supplement_1 ( 2021-05-27), p. S254-S254
    Abstract: The prevalence and risk of Eating Disorders (ED) in IBD, despite the potential overlap of these two conditions, have been rarely reported. ED diagnosis should be considered in patients with IBD and multidisciplinary approach would be recommended in these complex cases to provide an adequate therapeutic intervention. Screening tools to evaluate eating attitudes and behaviours in patients with IBD could be used in daily practice, as for example the Eating Attitude Test – 26 Methods Children and adolescents (8–18 years) with IBD and age and gender matched healthy controls were prospectively enrolled in 5 italian pediatric IBD units between June 2019 and August 2020. Subjects with an existing diagnosis of ED were excluded. The risk of ED was assessed using a 26 points Likert scale screening tool (CH-EAT-26 and EAT-26 for children & lt; and & gt; 14 years respectively), with a total score of 20 or above indicating a risk for ED. Correlations between clinical and disease’s parameters and the CH-EAT-26/EAT-26 score were calculated Results 110 patients with IBD and 110 age and matched healthy controls were screened with the CH-EAT26/EAT-26 questionnaire. The total EAT26 scores and the prevalence of an at-risk score (score & gt;20) did not differ in IBD subjects compared to controls. IBD patients were more frequently on an exclusion diet with lactose free-diet being the most common regimen. Furthermore, 8.1% of IBD children was on a partial enteral nutrition (PEN). In IBD subjects elevated scores on the Ch-EAT26/EAT-26 were associated with being younger (r=-0,2226, p=0.002), following an exclusion diet (r=0.25, p=0.009) and a partial enteral nutrition (PEN: r=0,2507, p=0.009). Type, duration and activity of disease, gender, weight, height and BMI z-scores were not significantly correlated to the CHEAT26/EAT-26 score. Being on a PEN and following an exclusion diet were the only independents factors influencing the EAT26 score at the multiple regression analysis (p= 0,004; p= 0,034; R2 = 0,25) Conclusion Our results indicate that 5.45% of IBD children have a behavior at risk for developing an ED, a percentage that is not statistically different compared to healthy controls. A particular follow-up should be reserved to patients on restricted diets and on partial enteral nutrition, that can develop maladaptive attitudes toward eating. The development of a disease specific tool or a validation of pre-existing questionnaires would help to identify a robust screening instrument and ultimately to correctly classify the risk of patients. Once the risk is correctly assessed it is mandatory to address the patient to a specific multidisciplinary follow-up.
    Type of Medium: Online Resource
    ISSN: 1873-9946 , 1876-4479
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2389631-0
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  • 5
    In: Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 15, No. Supplement_1 ( 2021-05-27), p. S485-S486
    Abstract: Nutrition is involved in several aspects of pediatric IBD, ranging from disease etiology to induction and maintenance of disease. Presence of nutritional deficiencies can influence clinical outcomes and affect the immune system, growth and sexual maturation in children. Few studies assessed the dietary intake of IBD’s pediatric patients and investigated whether their dietary intakes meet the recommended daily allowances (RDA). Methods Children and adolescents with a diagnosis of IBD ( & gt; 1 year) and healthy controls (age and gender matched) were prospectively enrolled in 5 pediatric Italian IBD units. Daily dietary intake in the previous 6 months was assessed using a Food Frequency Questionnaire (FFQ). Energy intake (EI) and macro and micronutrients intakes were compared to the national RDA (LARN) and EI to the predicted total energy expenditure (TEE) based on the Schofield equation. Adherence to the Mediterranean diet was measured through the KIDMED score. Clinical and auxological data were recorded Results 110 IBD subjects and 110 controls (median age±SD: 14,6 ±2,2 and 13,8±2,8 years, p= 0,45) were enrolled. Weight and height z-scores were significantly lower in IBD compared to controls (p= 0,0005 and p=0,036).Weight, height and BMI z-score did not differ between CD and UC. EI (Kcal/day), the EI/RDA ratio (%) and the EI/TEE ratio (%) were significantly lower in IBD compared to the controls (1893 vs 2068 kcal/day, p= 0,009; 71,5% vs 84,7%, p & lt; 0,0001; 79,8% vs 90,8%, p=0,007). When distributing patients by clinical disease activity, the TEE was lower in patients with active disease compared to patients in remission (1850 vs 1915; p=0,039). A significant correlation was not found between age, gender, type of disease, disease activity, and EI/RDA % and EI/TEE %. Total protein and fat intake were lower in children with IBD compared to controls. Conversely the total carbohydrate intake did not differ between IBD patients and controls (median 289,8 vs 311,7 gr/day, p= 0,077) while the percentage of carbohydrate to EI was higher (CHO % : 61 vs 58; p=0,012). Total charbohydrates intake was significantly lower in patients with active disease compared to patients in remission (265.7 vs 294.3 gr/day; p=0,002). IBD patients reported a lower intake of the main dietary micronutrients compared to controls. A poor adherence to the Mediterranean diet was more frequent in IBD children (37.2% vs 22.7%, p= 0,013). Conclusion The diet of Italian children and adolescents with IBD differs substantially from the general pediatric population and frequently does not meet the RDA. Our data suggest the need of an accurate evaluation of the dietary intake and nutritional status in order to prevent nutritional deficiencies and promote health.
    Type of Medium: Online Resource
    ISSN: 1873-9946 , 1876-4479
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2389631-0
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  • 6
    In: Digestive and Liver Disease, Elsevier BV, Vol. 43 ( 2011-10), p. S400-
    Type of Medium: Online Resource
    ISSN: 1590-8658
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2011
    detail.hit.zdb_id: 2061359-3
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  • 7
    In: Digestive and Liver Disease, Elsevier BV, Vol. 43 ( 2011-10), p. S411-
    Type of Medium: Online Resource
    ISSN: 1590-8658
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2011
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  • 8
    In: Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 16, No. Supplement_1 ( 2022-01-21), p. i112-i113
    Abstract: Very early-onset inflammatory bowel disease (VEOIBD) is diagnosed before the age of 6 years while infantile IBD occurs before the age of 2 years. We aimed to assess disease characteristics and long-term outcomes in these populations. Methods We conducted a retrospective longitudinal cohort study in 21 pediatric centers worldwide. Patients diagnosed with VEOIBD between the years 2008–2018 with at least 2 years of follow-up were included. Results The cohort included 243 patients (52% males), with median follow-up of 5.8 (IQR 3.2–8.4) years. Median age at diagnosis was 3.3 (IQR 1.8–4.5) years, with 69 (28%) diagnosed before the age of 2 years. Disease was classified as Crohn’s disease (CD), ulcerative colitis (UC) and IBD-unclassified (IBDU) in 30%, 59% and 11%, respectively. In patients with UC or IBDU, 75% presented with pancolitis. In patients with CD, 62% presented with isolated colonic disease and 32% with ileo-colonic disease, while 19% had perianal involvement. Genetic testing was performed in 96 (40%) patients [40 (58%) & lt;2 years, 56 (32%) 2–6 years, p=0.001], with monogenic diagnosis identified in 23% (33% and 16%, respectively, p=0.08). The most common findings were mutations in IL10-receptor (5 cases, 23%). Stricturing or penetrating disease was observed in 9 cases (4%). First induction therapies were corticosteroids, 5-aminosalicylic acid (5ASA) and nutritional therapy in 53%, 30% and 11%, respectively. Corticosteroids were more common as first induction in infantile vs. non-infantile IBD (64% vs. 49% respectively, p=0.003). Maintenance therapies included deep immune-suppression (mainly biologics and corticosteroids) in 51%, immunomodulators in 27%, and non-immunosuppressive agents (5-ASA, nutritional therapy and antibiotics) in 22% of patients, with no significant differences between age groups. Compared to patients diagnosed after 2 years of age, patients with infantile IBD presented with higher rates of IBDU, lower levels of hemoglobin and albumin and higher levels of CRP, lower weight (but not height) z-scores, had lower rates of response to first induction therapy and shorter time to hospitalization during follow-up (p & lt;0.05 for all). Colectomy was performed in 11% and diversion surgery in 4% of the cohort, with no significant differences between age groups. No malignancies and nor deaths were observed. At end of follow-up, 85% of patients were in corticosteroid free clinical remission. Conclusion Patients with VEOIBD, including infantile IBD, have fair long-term outcome with low rates of complications and surgical interventions. Nevertheless, patients with infantile IBD demonstrated more severe clinical features at presentation and a lower response to induction therapy.
    Type of Medium: Online Resource
    ISSN: 1873-9946 , 1876-4479
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2389631-0
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  • 9
    In: Inflammatory Bowel Diseases, Oxford University Press (OUP), Vol. 14, No. 9 ( 2008-09), p. 1246-1252
    Type of Medium: Online Resource
    ISSN: 1078-0998
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2008
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  • 10
    Online Resource
    Online Resource
    Elsevier BV ; 2008
    In:  Digestive and Liver Disease Vol. 40, No. 10 ( 2008-10), p. A83-A84
    In: Digestive and Liver Disease, Elsevier BV, Vol. 40, No. 10 ( 2008-10), p. A83-A84
    Type of Medium: Online Resource
    ISSN: 1590-8658
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2008
    detail.hit.zdb_id: 2061359-3
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