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Background: Histological mucosal healing has become a paramount target goal to achieve in the treatment of inflammatory bowel diseases. However, there is still a lack of agreement on the best way to reach this goal, since numerous histological scores are available worldwide., Aims: We investigated whether claudin-2, a member of claudin family involved in the regulation of intestinal tight junctions, might be useful to assess the presence of active disease in patients with inflammatory bowel diseases., Methods: Biopsies from 123 patients with ulcerative colitis, Crohn's disease, infectious colitides and irritable bowel syndrome patients where tested with immunohistochemistry for claudin-2., Results: Claudin-2 appeared to be a very sensitive marker of disease activity in inflammatory bowel diseases, but was negative in the other kinds of patients. In addition, immunohistochemistry for claudin-2 showed good reproducibility by different pathologists., Conclusions: Should these findings be confirmed in more numerous cohorts of patients, and especially in those with minimal or focal residual disease activity, this simple assessment could be useful in the routine daily practice to facilitate the task of pathologists and clinicians in the diagnosis and management of patients with inflammatory bowel diseases., Competing Interests: Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Cardiovascular manifestations of inflammatory bowel disease (IBD) are considered rare. The aim of the present study was to assess cardiac structure and function by means of traditional Doppler echocardiography and tissue Doppler imaging in order to better appreciate myocardial subclinical alterations and their future implications for these kind of patients., Methods: Twenty-seven patients affected by Crohn's disease (CD) and 43 suffering from ulcerative colitis (UC) were enrolled. They were selected without cardiovascular diseases nor risk factors. They were compared with 24 healthy subjects matched for sex and age. Everyone underwent transthoracic echocardiography., Results: IBD patients had larger left atrial anterior-posterior dimension (34±7 vs. 31±2 mm; P=0.001) and volume (46±7 vs. 41±6; P=0.002), reduced left ventricular (LV) ejection fraction (59±6 vs. 63±5%; P=0.006) and higher pulmonary artery systolic pressure (26±6 vs. 22±2 mmHg; P<0.001) than healthy volunteers. Moreover, LV diastolic function was slightly altered in patients in respect of controls. Atrioventricular valve regurgitation was prevalent in IBD. Finally, we found that 18 (25.7%) patients had mitral valve prolapse, 35 (50.0%) mitral valve leaflets thickening and 3 (4.3%) pericardial effusion. We did not find differences in echocardiographic parameters between CD and UC., Conclusions: Our study suggests that subclinical cardiac involvement is frequent among IBD patients. The underlying mechanisms require further evaluation, but might be due to a systemic increase in cytokines and profibrotic factors.

Background: Extraintestinal manifestations significantly affect the quality of life of patients with Crohn's disease. The aim of the present study is to define the risk factors for extraintestinal manifestations and the relative influence of intestinal surgery., Patients and Methods: In a cohort of 223 patients with Crohn's disease we analyzed the association between demographic/clinico-pathological factors and extraintestinal manifestations. In addition, we evaluated their association with the timing of appearance of the extraintestinal manifestations with respect to the intestinal surgery., Results: Fifty-seven patients (25.6%) developed 91 extraintestinal manifestations. Demographic and clinico-pathological variables significantly associated with extraintestinal manifestations were: female gender (OR 2.84, 95% CI: 1.37-5.90) and colonic involvement (OR 2.68, 95% CI: 1.06-6.76). In patients not undergoing surgery and in patients with extraintestinal manifestations present only before surgery, the latency period between the onset of Crohn'S disease and extraintestinal manifestations were 3.7 +/-8.2 and 2.1 +/- 6.3 years, respectively. In patients developed extraintestinal manifestations only after surgery, the latency between surgery and extraintestinal manifestations was 12.0 +/-10.0 years. In 5 patients with early onset of extraintestinal manifestations, these did not regress or recur after surgery., Conclusion: Female gender and colonic involvement are confirmed as risk factors for the development of extraintestinal manifestations in Crohn's disease. Surgical treatment of the intestinal disease represents a therapeutic option for patients with extraintestinal manifestations, as it seems to prevent or delay these manifestations in most cases.