Publications by authors named "Hedin C"

Article Synopsis
  • The study aimed to find protein signatures in blood that could help identify individuals at high risk for inflammatory bowel disease (IBD), specifically Crohn's disease (CD) and ulcerative colitis.
  • Researchers analyzed blood samples from a large population, utilizing machine-learning methods to identify and validate these protein signatures across multiple cohorts.
  • A specific combination of 29 proteins was effective in differentiating preclinical CD cases from controls, achieving a high accuracy, while the prediction for ulcerative colitis was less robust but still significant.
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Objectives: The optimal nutritional management during a severe flare of inflammatory bowel disease is uncertain. The goal of this study was to describe variations in nutritional practices between different countries, professions and types of hospitals, as well as between ulcerative colitis (UC) and Crohn's disease (CD).

Methods: In this cross-sectional study, a novel questionnaire was distributed in the ECCO Congress 2022 and via ECCO country representatives.

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Background: Recent genetic and transcriptomic data highlight the need for improved molecular characterisation of inflammatory bowel disease (IBD). Proteomics may advance the delineation of IBD phenotypes since it accounts for post-transcriptional modifications.

Aim: We aimed to assess the IBD spectrum based on inflammatory serum proteins and identify discriminative patterns of underlying biological subtypes across multiple European cohorts.

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Background And Study Aims: Lynch syndrome (LS) is a hereditary autosomal dominant condition, with an increased lifetime risk of developing malignancies including colorectal cancer (CRC). Current guidelines differ in recommended colonoscopy-surveillance intervals from 1 to 2 years. Although colonoscopy is considered a safe procedure, there are risks of severe adverse events (SAEs), such as perforation and bleeding, as well as adverse events (AEs), such as abdominal discomfort and post-colonoscopy gastrointestinal infections.

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Article Synopsis
  • Faecal biomarkers are significant for assessing inflammatory bowel disease (IBD), with the study focusing on their role in diagnosing and predicting disease progression.
  • The study included 65 Crohn's disease patients, 90 ulcerative colitis patients, symptomatic controls, and healthy controls, analyzing various biomarkers in faecal samples.
  • Key findings showed that calprotectin and myeloperoxidase were the most accurate in distinguishing IBD from other groups, and their levels could predict an aggressive disease course, especially with myeloperoxidase showing the strongest association.
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Improved biomarkers are needed for pediatric inflammatory bowel disease. Here we identify a diagnostic lipidomic signature for pediatric inflammatory bowel disease by analyzing blood samples from a discovery cohort of incident treatment-naïve pediatric patients and validating findings in an independent inception cohort. The lipidomic signature comprising of only lactosyl ceramide (d18:1/16:0) and phosphatidylcholine (18:0p/22:6) improves the diagnostic prediction compared with high-sensitivity C-reactive protein.

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Background And Aims: Standardising health outcome measurements supports delivery of care and enables data-driven learning systems and secondary data use for research. As part of the Health Outcomes Observatory [H2O] initiative, and building on existing knowledge, a core outcome set [COS] for inflammatory bowel diseases [IBD] was defined through an international modified Delphi method.

Methods: Stakeholders rated 90 variables on a 9-point importance scale twice, allowing score modification based on feedback displayed per stakeholder group.

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Cardiovascular and thromboembolic risks are increasing in the population as a whole and therefore also in inflammatory bowel disease (IBD) patients. Obesity is a worldwide challenge also affecting the IBD population, and a causal association with Crohn's disease may exist. IBD itself, particularly when active, is also associated with a significant risk of thromboembolic and cardiovascular events such as myocardial infarction and stroke.

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Background And Aims: Inflammatory bowel disease may cause long-standing inflammation and fibrosis and may increase the risk of adverse events in colonoscopy. We evaluated whether inflammatory bowel disease and other potential risk factors are associated with bleeding or perforation in a nationwide, population-based, Swedish study.

Methods: Data from 969 532 colonoscopies, including 164 012 [17%] on inflammatory bowel disease patients, between 2003 and 2019, were retrieved from the National Patient Registers.

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The integrin CD49a marks highly cytotoxic epidermal-tissue-resident memory (T) cells, but their differentiation from circulating populations remains poorly defined. We demonstrate enrichment of RUNT family transcription-factor-binding motifs in human epidermal CD8CD103CD49a T cells, paralleled by high RUNX2 and RUNX3 protein expression. Sequencing of paired skin and blood samples revealed clonal overlap between epidermal CD8CD103CD49a T cells and circulating memory CD8CD45RACD62L T cells.

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Introduction: Fecal calprotectin (FC) is a noninvasive tool for examining response to biologics in inflammatory bowel disease (IBD), but its performance in relation to other novel fecal markers of various cellular origins is unknown.

Methods: We performed a prospective multicenter cohort study and included patients with active IBD who provided a fecal sample at initiation of biological therapy. Levels of FC, myeloperoxidase (MPO), human neutrophil lipocalin (HNL), and eosinophil-derived neurotoxin (EDN) were analyzed and related to clinical remission status at 3 months.

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Background: The etiopathogenesis of diverticular disease is unknown.

Objective: To compare the fecal and mucosa-associated microbiota between participants with and without diverticulosis and participants who later developed diverticulitis versus those that did not from a population-based study.

Methods: The PopCol study, conducted in Stockholm, Sweden, invited a random sample of 3556 adults to participate, of which 745 underwent colonoscopy.

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Methods to spatially profile the transcriptome are dominated by a trade-off between resolution and throughput. Here we develop a method named Enhanced ELectric Fluorescence in situ Hybridization (EEL FISH) that can rapidly process large tissue samples without compromising spatial resolution. By electrophoretically transferring RNA from a tissue section onto a capture surface, EEL speeds up data acquisition by reducing the amount of imaging needed, while ensuring that RNA molecules move straight down toward the surface, preserving single-cell resolution.

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Background And Aims: Despite the advances in medical therapies, a significant proportion of patients with inflammatory bowel diseases [IBD] require surgical intervention. This Topical Review aims to offer expert consensus practice recommendations for peri-operative care to optimize outcomes of IBD patients who undergo surgery.

Methods: A multidisciplinary panel of IBD healthcare providers systematically reviewed aspects relevant to peri-operative care in IBD.

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Background: Improved mucosal immune profiling in active and quiescent colonic inflammatory bowel disease (IBD) is needed to develop therapeutic options for treating and preventing flares. This study therefore aimed to provide a comprehensive mucosal characterization with emphasis on immunological host response of patients with active ulcerative colitis (UC active), UC during remission (UC remission) and active colonic Crohn's disease (CD active).

Methods: Colonic biopsies from 47 study subjects were collected for gene expression and pathway analyses using the NanoString host-response panel, including 776 genes and 56 immune-related pathways.

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Article Synopsis
  • Ustekinumab shows promising persistence rates in ulcerative colitis treatment, with 86% of patients remaining on the drug at 16 weeks and 67% at long-term follow-up.
  • Clinical remission rates improved from 17% at 16 weeks to 32% by the last follow-up, while biochemical remission rates increased from 14% to 23%.
  • Men were more likely to continue ustekinumab treatment at 16 weeks, indicating potential gender differences in treatment persistence.
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Almost all currently available treatments for inflammatory bowel disease (IBD) act by inhibiting inflammation, often blocking specific inflammatory molecules. However, given the infectious and neoplastic disease burden associated with chronic immunosuppressive therapy, the goal of attaining mucosal healing without immunosuppression is attractive. The absence of treatments that directly promote mucosal healing and regeneration in IBD could be linked to the lack of understanding of the underlying pathways.

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Article Synopsis
  • Innate lymphoid cells (ILCs) are flexible immune cells residing mainly in mucosal tissues, playing a role in maintaining balance and responding to inflammation based on environmental signals.
  • The study found two subsets of ILCs in tonsils, where CD45RA ILCs displayed low activity (quiescence) while CD62L ILCs exhibited similarities to naïve ILCs without fully differentiating traits.
  • Differentiation of CD62L ILCs leads to metabolic changes necessary for their immune functions, particularly in inflamed tissues like those in inflammatory bowel disease, indicating potential therapeutic targets to restore immune balance.
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Article Synopsis
  • * Data was collected from a nationwide cohort in Sweden, tracking Crohn's disease patients who started TNFi treatment from 2006 to 2017, and measuring bowel surgery incidents a year after treatment began.
  • * The results revealed that patients who continued TNFi treatment for 12 months or more had a significantly lower surgery rate compared to those who used it for less than 12 months, indicating the importance of sustained TNFi therapy in managing Crohn's disease
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Article Synopsis
  • This article is the second part of a two-part series on the management of ulcerative colitis (UC) by the European Crohn's and Colitis Organisation (ECCO).
  • While the first article covered medical management, this one focuses on treating acute severe UC (ASUC) and surgical options for patients who don't respond to medical treatment.
  • The article also offers guidance on preoperative preparations, surgical techniques, and addresses various common clinical situations to update ECCO's recommendations for managing UC.
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Background & Aims: Siblings of people with Crohn's disease (CD) share aspects of the disease phenotype (raised faecal calprotectin, altered microbiota), which are markers of risk for their own development of CD. The aim was to determine whether supplementation with prebiotic oligofructose/inulin induces a prebiotic response and impacts the risk phenotype in CD patients and siblings.

Methods: Patients with inactive CD (n = 19, CD activity index <150) and 12 of their unaffected siblings (with calprotectin >50 μg/g) ingested oligofructose/inulin (15 g/day) for three weeks.

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