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Pediatric inflammatory bowel disease
Helen M Pappa1, Gaith Semrin, Thomas R Walker
1Center for Inflammatory Bowel Disease, Division of Gastroenterology and Nutrition, Department of Medicine, Children's Hospital Boston, Massachusetts 02115, USA.
Insights
Early-onset inflammatory bowel disease (IBD) is increasing in children. Recent advances in genetics, diagnostics like MRI, and novel therapies offer new hope for managing pediatric IBD and improving outcomes.
Area of Science:
- Pediatric gastroenterology
- Genetics of IBD
- Inflammatory bowel disease research
Background:
- Rising prevalence of early-onset inflammatory bowel disease (IBD) in children and adolescents.
- Significant advancements in adult IBD diagnostics and therapeutics.
- Growing understanding of genetic factors influencing IBD susceptibility.
Purpose of the Study:
- To review recent literature on pediatric inflammatory bowel disease.
- To highlight advances in genetics, diagnostics, and therapy for pediatric IBD.
- To discuss the evolving role of genetics and new treatments in managing pediatric IBD.
Main Methods:
- Review of recent scientific literature on pediatric inflammatory bowel disease.
- Analysis of studies on genetic susceptibility and genotype-phenotype correlations.
- Evaluation of research on noninvasive diagnostic modalities (MRI, fecal lactoferrin).
- Assessment of empirical use and systematic study of novel therapeutic agents in pediatric IBD.
- Review of studies on surgical outcomes in pediatric IBD.
Main Results:
- Strong evidence for genetic susceptibility to IBD, linking genotype to phenotype.
- Exploration of noninvasive diagnostics like MRI and fecal lactoferrin in pediatric IBD.
- Empirical administration and initial systematic studies of new therapeutic agents in children.
- Revised understanding of surgical outcomes in pediatric inflammatory bowel disease.
Conclusions:
- Genetic testing shows evolving potential for predicting susceptibility and guiding therapy in pediatric IBD.
- Inclusion of pediatric patients in clinical trials for new IBD therapies is crucial.
- Future research aims to alter the natural history of early-onset IBD, reduce recurrence, and minimize surgery.
Purpose Of This Review:
The prevalence of early-onset inflammatory bowel disease has been on the rise, with children and adolescents currently accounting for approximately 30% of all patients with this condition. Remarkable new advances in diagnostic modalities and therapy for adults with inflammatory bowel disease, and further information about the role of genetics in determining susceptibility to disease make the review of the recent literature in pediatric inflammatory bowel disease more timely than ever.
Recent Findings:
In the area of genetics, new studies provide strong evidence for genetic susceptibility to disease, and match genotype with phenotypic presentation. A few studies examine the use of noninvasive diagnostic modalities, such as MRI, and biomarkers (fecal lactoferrin) in pediatric inflammatory bowel disease. Remarkable new agents in therapy for adults with inflammatory bowel disease have been empirically administered to children with inflammatory bowel disease. The first attempts to systematically study the effects of these agents in children and adolescents are reviewed here. Furthermore, new studies revise our notion of surgical outcomes in pediatric inflammatory bowel disease.
Summary:
Although premature for clinical practice application, the role of genetic testing in determining disease susceptibility and assisting with prognosis and course of therapy is clearly evolving and needs further study. As new therapeutic agents join the available treatments of inflammatory bowel disease it is imperative to include pediatric patients in clinical trials. The goals of future studies will be to alter the natural history of early-onset inflammatory bowel disease, reduce the frequency of recurrences, and perhaps reduce requirements for surgical intervention.
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