Nutritional therapy has been proven to be a safe and effective treatment for Inflammatory Bowel Disease (IBD), including Crohn’s Disease (CD). Nutritional approaches can help induce and maintain remission, either as a standalone therapy or in combination with other treatments.

New research continues to expand the understanding of which patients would benefit most from dietary therapy, and the best approach to implementing it.

Dear ECCO Friends,

Welcome to this new episode of the Meet the JCC Authors Podcast!

Here, we interview the rising star of intestinal ultrasound (IUS), Michael Dolinger from Mount Sinai Hospital (NY, US), about his recent article in JCC entitled: “Early intestinal ultrasound response to biologic therapy predicts endoscopic remission in children with ileal Crohn's Disease: Results from the Prospective Super Sonic Study”.

We discuss the increasing use of IUS as a tool to predict response to therapies in treat-to-target strategies in both children and adults and how it can identify those patients who will achieve endoscopic remission. In addition, we talk about Michael’s journey and the introduction of IUS in the United States, the learning curves, the future of IUS in IBD, new technologies and much more.

We hope you enjoy it!

Ignacio Catalan-Serra
ECCO News Associate Editor

Robin Dart © ECCO

For this Y-ECCO Interview Corner we met with Shaji Sebastian, who is known to everyone as Seb, on the Friday of the ECCO Congress. Seb has had a long association with ECCO. He is the outgoing Chair of ClinCom and was elected as Treasurer of ECCO at this year’s AGM. He is a consultant in Hull in the North of England, having got there through a somewhat circuitous route, as we will hear...

Vedolizumab, adalimumab, and methotrexate combination therapy in Crohn’s Disease (EXPLORER)

Colombel JF, Ungaro RC, Sands BE, et al.

Clin Gastroenterol Hepatol 2023. doi: 10.1016/j.cgh.2023.09.010. Online ahead of print.

Introduction

The SONIC trial yielded seminal findings showing that the combination of infliximab and azathioprine is more effective than either treatment alone for the maintenance of remission in patients with Crohn’s Disease (CD) [1]. In recent years, despite the availability of an increasing number of biologics and small molecules to treat CD, a ceiling of therapeutic efficacy has been reached [2]. Therefore, there has been a resurgence of interest in whether this therapeutic ceiling “effect” can be overcome with new treatment combinations. In the EXPLORER study, the efficacy and safety of triple combination therapy was assessed using two biologics with different modes of action in association with methotrexate for the treatment of CD.

Higher intra-abdominal visceral adipose tissue mass is associated with lower rates of clinical and endoscopic remission in patients with inflammatory bowel diseases initiating biologic therapy: Results of the Constellation Study

Yarur A, Bruss A, Moosreiner A, et al.

Gastroenterology 2023;165:963–75

Introduction

Despite an expanding therapeutic arsenal, a considerable proportion of patients with Crohn's Disease (CD) and Ulcerative Colitis (UC) fail to achieve or sustain therapeutic responses [1, 2]. Mechanisms contributing to this failure, particularly with respect to biologic therapy, are only partially understood [3]. Uncovering the mechanisms behind loss of response may help to enhance the efficacy of existing treatment options or to develop alternative options for the future.

Some investigations have noted an association between obesity, high intra-abdominal visceral adipose tissue (IA-VAT) mass and unfavourable outcomes in individuals with Inflammatory Bowel Disease (IBD). However, these observations have been constrained by their methodology and have to date focused only on patients having treatment with anti-tumour necrosis factor alpha (anti-TNF-α) agents [4–6], limiting their scope.

The Constellation Study by Yarur and colleagues aimed to investigate the relationship between IA-VAT in patients with IBD and the response to biologic drugs with multiple different mechanisms of action.

Identification of environmental factors that promote intestinal inflammation

Sanmarco LM, Chao CC, Wang YC, et al.

Nature 2022;611:801–9

Introduction

Patients will often ask, “What causes Inflammatory Bowel Disease?” Frustratingly, we remain unable to answer this seemingly simple question, beyond the often-quoted paradigm that unknown environmental factors trigger inflammation in genetically susceptible individuals. Although our understanding of the immune response in IBD has reached phenomenally detailed levels of resolution, the nature and identity of the initial environmental triggers of IBD have continued to remain a mystery. The strong relationship between socioeconomic development and IBD incidence is tantalising evidence of a definable environmental toxin and various substances such as processed food additives have recently been highlighted as potential suspects [1]. However, searching for the causative agent is like looking for a needle in a haystack as the candidate list includes literally every small molecule in existence!

Virginia Solitano © ECCO

Gabriele Dragoni © ECCO

The Y-ECCO Science Workshop celebrated its 10^th edition during the recent ECCO Congress in Stockholm. Held on February 21, 2024, the workshop invited young basic scientists to present and discuss their research with peers and senior opinion leaders. This year’s edition proved a tremendous success, inspiring Y-ECCO Members with a friendly yet intellectually stimulating atmosphere and encouraging them to broaden their knowledge and to prepare for more challenging research steps.

Dear Y-ECCO Friends,

I hope you are all doing well and enjoyed an insightful and interesting ECCO Congress in Stockholm recently. At ECCO 2024, the Y-ECCO Team had to say goodbye to our outgoing Chair, Mark Samaan, who has been exemplary in the role over the past year. On behalf of the entire Y-ECCO Community, thanks Mark! It has been an absolute pleasure working with you, while further expanding the committee under your leadership.

The theme of the 19^th ECCO Congress in Stockholm, “Crossing borders in IBD”, was reflected in the aim of our educational meeting, which extended beyond the histopathological aspects of IBD. The objective was to highlight the collaboration between different specialisations, mirroring the multidisciplinary nature of our daily practice.  This was clearly evident in the various topics covered during our initial session. Additionally, the Congress theme resonated in the diverse composition of our audience. Feedback revealed an equal division between pathologists and specialists from other fields. 

Iva Hojsak, who has recently joined the P-ECCO Committee, is a paediatric gastroenterologist and head of the Paediatric Department and deputy director of the Children's Hospital Zagreb, Croatia. Iva graduated from the Medical School of Zagreb, where she also received her PhD. She was subsequently elected as assistant professor at University of Zagreb Medical School and University of J.J. Strossmayer Medical School.