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e160
Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
P.07.7
CROHN’S DISEASE IS A REAL TIME SENSITIVE EVOLUTIVE
PATHOLOGY BASED ON LÉMANN INDEX? PRELIMINARY DATA
FROM A TERTIARY PEDIATRIC IBD CENTER
Bodini G.*
1
, Arrigo S.
2
, Bizzocchi A.
2
, Giannini E.
1
, Savarino V.
1
,
Savarino E.
3
, Barabino A.
2
1
IRCCS San Martino, Genoa, Italy,
2
Ospedale Gaslini, Genoa, Italy,
3
3Gastroenterology Unit, Department of Surgery, Oncology and
Gastroenterology, Padua, Italy
Background and aim:
Crohn’s disease (CD) is a chronic and
progressive condition that, due to disease complication, leads
to surgical resection in the majority of cases. Recently, a panel of
expert developed the Lémann Index (LI), a new tool aimed to assess
the progressive bowel damage due to disease course. The LI takes
into account disease extension and the presence of stenotic and
penetrating lesions, providing a quantitative score of disease which
seems to increase over time in adult patients. Data on pediatric
population in this regard are lacking. The aim of our investigation
was to measure the LI in a pediatric cohort at diagnosis and the
trend of LI during the time.
Material and methods:
We retrospectively selected 48 consecutive
pediatric patients who were firstly diagnosed in our hospital by
abdominal Magnetic Resonance Imaging, Colonoscopy and upper
GI endoscopy and in case of perianal disease, a pelvic MRI. Patients
were included in case of age between 6 to 17 years. We evaluated LI
and deltaLI from the diagnosis to the last pediatric outpatient visit
or to the transition to adult outpatient.
Results:
We included in our investigation a total of 48 CD pediatric
patients (21 male, median age of 18 years, range 11-34, median age of
diagnosis 13 years, range 7-17) who were followed-up for a median
of 42 months (range 3-117). Among them, 35 (72.9%) patients had
a stable LI during the follow up, whereas 13 (23.1%) increased their
LI during the time. There was no statistical significant difference
between median LI at beginning and end of follow-up (1.8, range
0.3-10 vs 1.8, range 0.3-7.6. P=0.51). Moreover, analyzing data from
patients who utilized anti-TNF therapies, we found out no significant
difference among LI at beginning and end of follow-up (3, range 03-
10 vs 2.3, range 0.8-7.6. P=0.86).
Conclusions:
In contrast to adult population, our data suggest
that LI in pediatric population is not a useful tool to assess disease
progression. Moreover, independently from therapy used, we
observed that LI remain stable in the majority of our pediatric CD
patients during a long-term follow up.
P.07.8
IL-33/ST2 AXIS MODULATES EPITHELIAL REPAIR AND GUT
MUCOSAL WOUND HEALING IN DSS-COLITIC MICE
Lopetuso L.R.*
1
, De Salvo C.
2
, Wang X.M.
2
, Abbott D.W.
2
,
Scaldaferri F.
1
, Gasbarrini A.
1
, Pizarro T.T.
2
1
Internal Medicine, Gastroenterology Division, Catholic University
of Sacred Heart, Rome, Italy,
2
Pathology Department, Case Western
Reserve University School of Medicine, Cleveland, United States
Background and aim:
Increasing evidence confirms that IL-33 and
ST2 are important factors in the pathogenesis of IBD. The aim was
to characterize the precise role of the IL-33/ST2 axis following acute
epithelial injury and mucosal repair in DSS-induced colitic mice.
Material and methods:
3% DSS was administered for 5d to C57/
BL6 wild-type (WT), IL-33 KO and ST2 KO mice. DSS was then
replaced with drinking water for 2 wks (recovery period). Another
group of WT mice received DSS for 5d and IL-33 (33ug/kg, i.p.) or
vehicle (VEH) every other day during the recovery period. Mice were
sacrificed either after DSS challenge or after 1 or 2 wks of recovery.
Body weight, occult blood test, and stool consistency were measured
daily to calculate DAI, and endoscopic and histological evaluation
of colons were performed. IHC, qPCR and Western blots were done
on full-thickness colons for IL-33 and ST2 localization, mRNA
expression, and evaluation of protein isoforms, respectively.
Results:
DSS administered to WT mice resulted in increased body
weight loss and DAI. More severe colitis was observed following
DSS+1wk recovery vs. after 5d of DSS, which decreased after
DSS+2wks recovery. IL-33 mRNA transcripts were elevated after DSS,
and even more so following DSS+recovery vs. CT, but similar to CT
after DSS+2wks recovery. ST2 mRNA expression was also increased
after DSS+recovery vs. CT, while no difference was found between 5d
of DSS challenge and CT and after DSS+2wks recovery. Full-length,
bioactive IL33, ST2L and sST2 were expressed in all experimental
groups; the cleaved, less active form of IL33 was increased in only
DSS exposed mice vs. CT. IHC showed intense IL-33 and ST2 staining
within the inflamed and ulcerated mucosa of DSS-treated mice. ST2
staining was more evident during the recovery phase following DSS,
notably localized to subepithelial myofibroblasts in close proximity
to areas of re-epithelialization. Both IL-33 and ST2 KO mice showed
increased colonic inflammation after 2 wks recovery compared to
after 5d DSS and vs also WT. IL-33 treatment of WT mice resulted
in increased body weight, reduced DAI, and decreased colonic
inflammation after 2 wks recovery vs. VEH.
Conclusions:
Our results suggest that activation of the IL-33/ST2
axis promotes epithelial repair and mucosal healing following acute
epithelial injury during DSS-induced colitis.
P.07.9
EFFECTIVENESS OF PSYCHOLOGICAL SUPPORT ON QUALITY OF
LIFE IN IBD PATIENTS
Tongiorgi A.*
1
, Beretta E.
1
, Ceccarelli L.
2
, Bertani L.
3
, Caudai C.
4
,
Laino G.
3
, Mumolo M.G.
1
, Marchi S.
3
, Costa F.
1
1
Az. Ospedaliero-Universitaria Pisana - UO Gastroenterologia Univ.,
Pisa, Italy,
2
ASL1 Massa Carrara - SSD Endoscopia Digestiva, Carrara,
Italy,
3
University of Pisa, Pisa, Italy,
4
Istituto di Scienza e Tecnologia
della Formazione del CNR, Pisa, Italy
Background and aim:
Inflammatory bowel diseases (IBD), with their
typical chronic relapsing course, often induce both a constant basal
stress, and periods of acute stress in the case of an exacerbation, a
therapeutic change or surgery.
This study aims to assess whether a psychological treatment can help
patients in facing the disease better, reducing anxiety, improving the
management of emotions, stress and quality of life.
We proposed to the patients a group of psychological support,
designed to promote a better management of the disease and the
emotional states associated.
Material and methods:
We enrolled 43 consecutive patients with
Ulcerative Colitis and Crohn’s Disease, with a mild / moderate
activity according to the Mayo score or Simple Index respectively.
They participated in the psychological support groups: each group
was made up of 5-6 persons, and consisted in a meeting a week
for a 6 week period. Twenty-six IBD patients with similar disease
characteristics, not participating in the groups, were enrolled as
control group.
All the 69 patients underwent a psychological assessment at the
first visit and after 6 weeks (duration time of the psychological
treatment), with self-administered tests (CES-D; STAI-Y, TAS-20;
BRIEF COPE; BRIEF-IPQ; IBDQ), validated for Italians samples and
customarily used. We made a comparison of the average values of
the parameters at week 0 and at week 6 both in the treated group
than in the control group.
Statistical analysis was performed by using the Anderson-Darling
test, Bartlett test, the Fisher Exact Test for nominal variables, the