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Related Concept Videos

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
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Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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C-Reactive Protein in Immune Checkpoint Inhibitor-Associated Colitis: A Scoping Review of Evidence and Knowledge

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C-reactive protein (CRP) shows limited evidence for diagnosing immune-mediated diarrhea and colitis (IMDC) in cancer patients. While potentially supportive, CRP lacks validated thresholds and cannot replace current diagnostic methods for IMDC.

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Area of Science:

  • Oncology
  • Gastroenterology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are crucial cancer therapies but can cause immune-mediated diarrhea and colitis (IMDC).
  • Accurate IMDC diagnosis and severity assessment are vital but often require invasive procedures.
  • C-reactive protein (CRP) is a potential biomarker for inflammation, but its role in IMDC is unclear.

Purpose of the Study:

  • To conduct a scoping review mapping evidence on C-reactive protein (CRP) and immune-mediated diarrhea and colitis (IMDC).
  • To identify knowledge gaps regarding CRP's utility in diagnosing and assessing IMDC severity.

Main Methods:

  • A comprehensive literature search was performed across PubMed, Embase, and Web of Science (January 2010-April 2025).
  • Included studies focused on adult patients receiving ICIs with gastrointestinal immune-related adverse events and reported CRP levels.
  • Data extraction covered study design, patient characteristics, CRP measurement, and association with IMDC diagnosis, severity, or outcomes.

Main Results:

  • Five observational studies with 583 patients were included.
  • Only one study analyzed CRP in confirmed IMDC, showing a correlation with severity but no validated diagnostic thresholds.
  • No studies provided sufficient data on CRP's diagnostic accuracy (sensitivity, specificity, predictive values) for IMDC.

Conclusions:

  • Evidence linking CRP to IMDC is limited and heterogeneous, with no validated diagnostic performance data.
  • CRP may serve as a supportive marker for further investigation but does not replace established IMDC diagnostic pathways.
  • Future research should focus on prospective studies integrating CRP with organ-specific biomarkers for IMDC triage and severity assessment.