Nayan S. Patel

Risk of Postoperative Complications Among Inflammatory Bowel Disease Patients Treated Preoperatively With Vedolizumab

Objectives:Vedolizumab is increasingly used to treat patients with ulcerative colitis (UC) and Crohn’s disease (CD), however, its safety during the perioperative period remains unclear. We compared the 30-day postoperative complications among patients treated preoperatively with vedolizumab, anti-tumor necrosis factor (TNF)-α agents or non-biological therapy.Methods:The retrospective study cohort was comprised of patients receiving vedolizumab, anti-TNF-α agents or non-biological therapy within 4 weeks of surgery. The rates of 30-day postoperative complications were compared between groups using univariate and multivariate analysis. Propensity score-matched analysis was performed to compare the outcome between groups.Results:Among 443 patients (64 vedolizumab, 129 anti-TNF-α agents, and 250 non-biological therapy), a total of 144 patients experienced postoperative complications (32%). In multivariate analysis, age >65 (odds ratio (OR) 3.56, 95% confidence interval (CI) 1.30–9.76) and low-albumin (OR 2.26, 95% CI 1.28–4.00) were associated with increased risk of 30-day postoperative complications. For infectious complications, steroid use (OR 3.67, 95% CI 1.57–8.57, P=0.003) and low hemoglobin (OR 3.03, 95% CI 1.32–6.96, P=0.009) were associated with increased risk in multivariate analysis. Propensity score matched analysis demonstrated that the risks of postoperative complications were not different among patients preoperatively receiving vedolizumab, anti-TNF-α agents or non-biological therapy (UC, P=0.40; CD, P=0.35).Conclusions:In the present study, preoperative vedolizumab exposure did not affect the risk of 30-day postoperative complications in UC and CD. Further, larger studies are required to confirm our findings.

Pro‐inflammatory chemokine C‐C motif ligand 16 (CCL‐16) dysregulation in irritable bowel syndrome (IBS): a pilot study

Background  Irritable bowel syndrome (IBS) is a serious health problem that affects an estimated 10–15% of people worldwide and has economic consequences in the United States of over

Stress and Gene Expression of Individuals With Chronic Abdominal Pain

30 billion annually. In the US, IBS affects all races and both sexes, with more females than males (2 : 1) reporting symptoms consistent with IBS. Although the etiology of this functional gastrointestinal disorder is unknown, literature suggests that a subclinical inflammatory component has a role in the etiologic mechanisms underlying IBS. The aim of this study was to evaluate the gene expression of inflammatory biomarkers in patients with and without IBS and among different IBS phenotypes.

Weight Phenotype Diagnostic Test Method: Body Mass Index or Body Fat Percent for Gene Expression

Background: Research examining the role of stress in gastrointestinal (GI) symptoms such as chronic abdominal pain (CAP) is controversial. The purpose of this study was to examine the expression of genes involved in metabolic stress and toxicity in men and women with high and low levels of perceived stress with and without CAP. Methods: Data and samples were collected and the expression of genes involved in metabolic stress and toxicity was analyzed in 26 individuals who had consented to participate in a natural history protocol. Subjects completed the 10-item Perceived Stress scale (PSS). Fasting participants’ peripheral whole blood was collected for proteomic and genomic studies. Polymerase chain reaction (PCR) array was used to analyze the expression of 84 key genes involved in human stress and toxicity plus 5 housekeeping genes. Plasma interleukin-1 alpha (IL-1α) protein was quantified via enzyme-linked immunosorbent assay (ELISA). Results: Interleukin-1 alpha gene (IL1A) was upregulated in females with high stress versus females with low stress by 2.58-fold (95% CI [0.88, 4.28]). IL1A was upregulated in participants with high stress and CAP versus those with low stress and CAP by 3.47-fold (95% CI [1.14, 5.80]). Conclusions: An upregulation of the gene coding the pro-inflammatory cytokine IL-1α suggests that the mechanism behind stress-related changes in GI symptoms is pro-inflammatory in nature. The results of this study contribute to the knowledge of the mechanism behind stress-related CAP symptoms and gender differences associated with these disorders.

Tu1445 Correlation of Circulating Mirnas and Interleukin-10 Levels in Patients With and Without Chronic Abdominal Pain

Obesity continues increasing at epidemic levels worldwide, as does the number of genetic studies that focus on obesity. Body mass index (BMI) is often used to characterize weight phenotypes and obesity status due to its simplicity. Refined measurements of body composition may be needed to understand variations in gene expression. This study explores gene expression when individuals are characterized as overweight based on BMI versus body fat percent. Individuals were recruited to a natural history protocol at the National Institutes of Health. Twelve Caucasian participants with the highest and lowest BMI were included. Whole-body air displacement plethysmography was performed to calculate body fat percent, and BMI was calculated. Fasting whole blood was collected and RNA extracted. Quantitative real time PCR array was used to determine expression of 96 obesity related genes. The PCR array from participants with high BMI compared to low BMI showed dysregulation of four genes: peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PPARGC1A), pro-opiomelanocortin (POMC), growth hormone secretagogue receptor (GHSR), and leptin (LEP), whereas participants with high body fat compared to low body fat showed dysregulation of one gene: PPARGC1A. This research showed differential gene expression and clinical indices depending on method of weight classification.

Pro-inflammatory chemokine C-C motif ligand 16 (CCL-16) dysregulation in irritable bowel syndrome (IBS): a pilot study: Inflammatory biomarkers in IBS

medically diagnosed IBS. The registry includes data collected on motion sickness symptoms and prior experience of nausea and vomiting immediately post-general anaesthetic. Results 3074 (94% female, age 56(17-85) years) cases were evaluable for IBS (96.9% with motion sickness data and 75.3% with post-general anaesthetic nausea data). The prevalence of IBS was 8% for limited Rome III IBS, 22.3% for extended Rome III IBS and 12.6% for medically diagnosed IBS. Motion sickness was associated with limited IBS, odds ratio 1.5(95%CI 1.122.01) (p=0.006) and medically diagnosed IBS, 1.4(95%CI 1.06-1.74) (p=0.015). Similarly nausea immediately post-general anaesthetic was associated with both (1.4(95%CI 1.031.84) (p=0.03) and 1.7(95%CI 1.34-2.17) (p=<0.005) respectively). However with extended criteria IBS the association with motion sickness was lost 1.2(95%CI 0.95-1.43) (p=NS) but maintained for post-general anaesthetic nausea 1.5(95%CI 1.22-1.80) (p=<0.005). Conclusions Post-general anaesthetic nausea is clearly associated with IBS. Motion sickness is associated with limited criteria Rome III and medically diagnosed IBS but not extended criteria IBS, a more heterogeneous phenotype with likely greater environmental influences. We suggest that these associations may indicate the common influence of altered central processing of stimuli in the generation of IBS, motion sickness and post-general anaesthetic nausea.

Pro-inflammatory chemokine C-C motif ligand 16 (CCL-16) dysregulation in irritable bowel syndrome (IBS)

Background  Irritable bowel syndrome (IBS) is a serious health problem that affects an estimated 10–15% of people worldwide and has economic consequences in the United States of over

Diagnostic Yield of Colorectal Cancer Screening in Abdominal Solid Organ Transplant Candidates and Implications for Post-Transplant Surveillance

30 billion annually. In the US, IBS affects all races and both sexes, with more females than males (2 : 1) reporting symptoms consistent with IBS. Although the etiology of this functional gastrointestinal disorder is unknown, literature suggests that a subclinical inflammatory component has a role in the etiologic mechanisms underlying IBS. The aim of this study was to evaluate the gene expression of inflammatory biomarkers in patients with and without IBS and among different IBS phenotypes.

Risk of Postoperative Complications Among Inflammatory Bowel Disease Patients Treated Preoperatively with Anti-integrin and Anti-Tumor Necrosis Factor Agents

Background  Irritable bowel syndrome (IBS) is a serious health problem that affects an estimated 10–15% of people worldwide and has economic consequences in the United States of over

Genetic Expression of Inflammatory Markers in Patients With Fatty Liver

30 billion annually. In the US, IBS affects all races and both sexes, with more females than males (2 : 1) reporting symptoms consistent with IBS. Although the etiology of this functional gastrointestinal disorder is unknown, literature suggests that a subclinical inflammatory component has a role in the etiologic mechanisms underlying IBS. The aim of this study was to evaluate the gene expression of inflammatory biomarkers in patients with and without IBS and among different IBS phenotypes.