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Cited by 18Inflammatory Bowel DiseaseOcular Diseases and Behçet’s SyndromeAutoimmune and Inflammatory Disorders

A scoping review on early inflammatory bowel disease: definitions, pathogenesis, and impact on clinical outcomes

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Estevinho, Maria Manuela, Leão Moreira, Paula, Silva, Isabel, Laranjeira Correia, João, Santiago, Mafalda, Magro, Fernando·2022·Therapeutic Advances in Gastroenterology
DOI 10.1177/17562848221142673PMC PMC9772959
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Abstract

Background: Crohn’s disease (CD) and ulcerative colitis (UC) arise from a dysregulation of the balance between commensal microbiota and mucosal-associated immune system, in patients with genetic and environmental predisposition. Different pathophysiological mechanisms have been reported to influence disease history, with impact on disease phenotype and risk of complications. Objectives: This review aims to summarize the definitions of early CD and UC, analyze the underlying immunological mechanisms, and evaluate the impact of recognizing and treating early inflammatory bowel disease (IBD) on patients’ prognosis (short- and long-term outcomes). Design: To address this issue, we have performed a scoping review. Data sources and methods: Three online databases (MEDLINE, Web of Science, and ScienceDirect) were searched and the results were independently screened by two reviewers. Results: From 683 records identified, 42 manuscripts evaluating early IBD in adult patients were included. The ‘early CD’ concept was first described in 2008. Four years later, an international consensus proposed the definition of diagnosis up to 18 months, in patients without previous or current need for disease-modifying therapies. Several other definitions have been proposed; the ‘2 years since diagnosis’ is the most used, regardless of disease characteristics or medication. The amount of evidence on early UC is lower and more recent. Regarding early disease pathogenesis, most theories emphasize the prominent role of innate immunity, followed by early-Th1 adaptive response. Conclusion: The treatment of early CD seems to be crucial for the management of CD patients, impacting short-, medium-, and long-term outcomes. On the other hand, the early treatment of UC appears to be less advantageous, yet evidence comes from only a few retrospective studies.

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  • Significant knowledge gaps persist on the modulation of IBD patients' microbiome, particularly using probiotics.

    “Even though there is a substantial consensus regarding the microbial underpinnings of IBD, significant knowledge gaps persist, particularly concerning the strategies to modulate microbiome. 2 , 3”

    From Efficacy and safety of probiotics in IBD: An overview of systematic reviews and updated meta-analysis of randomized controlled trials. (2024) · cites this paper as [3]

    The Introduction and Abstract (pages not provided) describe dysregulated interactions between commensal microbiota and the immune system in IBD, supporting the sentence’s microbial-underpinnings premise. The review’s discussion of evidence gaps concerns early treatment, not strategies to modulate the microbiome; searches for microbiome modulation and probiotics found no supporting passage. (LLM, conf=0.83)

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Authors
Estevinho, M. M., Leão Moreira, P., Silva, I., Laranjeira Correia, J., Santiago, M., & Magro, F.
Affiliations
  • Department of Gastroenterology, Vila Nova de Gaia Espinho Hospital Center, Vila Nova de Gaia, Portugal
  • Unidade de Farmacologia Clínica, São João Hospital University Centre, Porto, Portugal
  • Hospital de São João (PT)
  • Centre for Health Technology and Services Research (PT)
  • Universidade do Porto (PT)
Corresponding author
Magro, Fernando
ORCID
Venue
Therapeutic Advances in Gastroenterology
Publisher
SAGE Publications
Published
2022-01
Volume
15
Pages
17562848221142673-17562848221142673
ISSN
  • 1756-283X (ISSN-L)
  • 1756-2848
DOI
10.1177/17562848221142673
PMC
PMC9772959
OpenAlex
W4312211968
Cited by
18
References
1
Citations by year
2026: 3 · 2025: 2 · 2024: 7 · 2023: 6
FWCI
0.58
Type
journal article
Language
en
Open access
Licence
Locations
  • Therapeutic Advances in Gastroenterology (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
  • Health Sciences › Medicine › Epidemiology › Autoimmune and Inflammatory Disorders
Keywords
Crohn's disease, ulcerative colitis, disease definition, pathogenesis, innate immunity, commensal microbiota, mucosal immunity, prognosis, early treatment, disease-modifying therapy

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