Inflammatory bowel diseases (IBD) represent a group of chronic systemic inflammatory conditions with predilection to gastrointestinal tract and include Crohns disease and ulcerative colitis. If the IBD cannot be further specified, a term unclassified IBD is used. Histopathological diagnosis of IBD relies on identifying a chronic inflammatory pattern in proper topographic distribution, showing structural abnormalities of the intestinal mucosa and characteristic cellular composition of the inflammatory infiltrate. The intestinal involvement in Crohns disease is typically segmental, with predilection for terminal ileum and presence of epithelioid granulomas in histology. Ulcerative colitis shows a diffuse pattern of the inflammation and usually affects a rectum, with variable extension towards a terminal ileum. However, there is an expanding knowledge about etiopathogenesis, morphology and clinical presentation of IBD, which led to detailed phenotypic subclassification and defined many atypical variants. As a result, diagnosis of IBD became complex multidisciplinary process. The aim of this work is to present an overview of IBD morphology and to provide a base for histopathological diagnosis of IBD on both bioptic samples and surgical resections.

• Klíčová slova
• Biopsy, Crohn´s disease, Crohn’s disease, Inflammatory bowel disease, Ulcerative colitis, inflammatory bowel disease, morphology, ulcerative colitis,
• MeSH
• Crohnova nemoc * diagnóza   MeSH
• idiopatické střevní záněty * diagnóza   patologie   MeSH
• lidé MeSH
• rektum patologie   MeSH
• střevní sliznice patologie   MeSH
• ulcerózní kolitida * diagnóza   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Prevalence of inflammatory bowel disease (IBD), a chronic inflammatory disorder of the gut, has been on the rise in recent years-not only in the adult population but also especially in pediatric patients. Despite the absence of curative treatments, current therapeutic options are able to achieve long-term remission in a significant proportion of cases. To this end, however, there is a need for biomarkers enabling accurate diagnosis, prognosis, and prediction of response to therapies to facilitate a more individualized approach to pediatric IBD patients. In recent years, evidence has continued to evolve concerning noncoding RNAs (ncRNAs) and their roles as integral factors in key immune-related cellular pathways. Specific deregulation patterns of ncRNAs have been linked to pathogenesis of various diseases, including pediatric IBD. In this article, we provide an overview of current knowledge on ncRNAs, their altered expression profiles in pediatric IBD patients, and how these are emerging as potentially valuable clinical biomarkers as we enter an era of personalized medicine.

• Klíčová slova
• Crohn’s disease, inflammatory bowel disease, microRNA, noncoding RNA, pediatrics, ulcerative colitis,
• MeSH
• biologické markery analýza   MeSH
• Crohnova nemoc genetika   MeSH
• dítě MeSH
• genetické markery genetika   MeSH
• idiopatické střevní záněty genetika   MeSH
• individualizovaná medicína trendy   MeSH
• lidé MeSH
• nekódující RNA analýza   MeSH
• signální transdukce genetika   MeSH
• transkriptom MeSH
• ulcerózní kolitida genetika   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• úvodní články MeSH
• Názvy látek
• biologické markery MeSH
• genetické markery MeSH
• nekódující RNA MeSH

The incidence of inflammatory bowel disease (IBD) in developed countries increases every year. The aetiology is still not completely understood and its clarification is a key prerequisite for effective prophylaxis and therapy. IBD is most-likely caused by a combination of several factors: environmental, genetic, immunological, and disruption of intestinal microbiota composition - dysbiosis. "Westernization" of lifestyle and urbanization seem to be among the most serious environmental factors. The pathogenesis is also influenced by the imbalance between the TH1 and TH2 cellular response and the expression of genes involved in T cell response and immunodeficiency. Last but not least, the worldwide overuse of antimicrobial drugs depletes the microbiome, which has a direct impact on the development of the dysbiosis. The subject of this review is a detailed characterization of the above-mentioned factors involved in the onset and development of IBD. Key words: gut microbiota inflammatory bowel disease immunopathogenesis dysbiosis.

• Klíčová slova
• gut microbiota inflammatory bowel disease immunopathogenesis dysbiosis,
• MeSH
• antiinfekční látky škodlivé účinky   MeSH
• dysbióza patologie   MeSH
• idiopatické střevní záněty imunologie   patologie   MeSH
• lidé MeSH
• rovnováha Th1-Th2 MeSH
• střevní mikroflóra * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antiinfekční látky MeSH

Inflammatory bowel diseases (IBDs), chronic inflammatory disorders affecting the gastrointestinal tract, include Crohn's disease and ulcerative colitis. There are increasing clinical and experimental data showing that obesity, especially visceral adiposity, plays a substantial role in the pathogenesis of IBD. Obesity seems to be an important risk factor also for IBD disease severity and clinical outcomes. Visceral adipose tissue is an active multifunctional metabolic organ involved in lipid storage and immunological and endocrine activity. Bowel inflammation penetrates the surrounding adipose tissue along the mesentery. Mesenteric fat serves as a barrier to inflammation and controls immune responses to the translocation of gut bacteria. At the same time, mesenteric adipose tissue may be the principal source of cytokines and adipokines responsible for inflammatory processes associated with IBD. This review is particularly focusing on the potential role of adipokines in IBD pathogenesis and their possible use as promising therapeutic targets.

• Klíčová slova
• adipokines, inflammatory bowel disease, mesenteric fat, microbiome, visceral obesity,
• MeSH
• abdominální obezita imunologie   metabolismus   MeSH
• adipokiny metabolismus   MeSH
• idiopatické střevní záněty imunologie   metabolismus   MeSH
• lidé MeSH
• nitrobřišní tuk imunologie   metabolismus   MeSH
• tuková tkáň imunologie   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• adipokiny MeSH

Bile acid malabsorption (BAM) is a common but an underestimated and often neglected sign of inflammatory bowel diseases (IBDs), especially those affecting the distal ileum. Clinically relevant BAM is most often present in patients with Crohn's ileitis and particularly in ileal-resected Crohn's disease patients. However, deterioration of bile acid (BA) metabolism occurs also in patients with IBD without ileal disease or in those in clinical remission, and the role of BAM in these patients is not well appreciated by clinicians. In a majority of cases, BAM in IBD is caused by impaired conjugated BA reabsorption, mediated by apical sodium/BA cotransporting polypeptide, localized at the luminal surface of the ileal enterocytes. As a consequence, numerous pathological sequelae may occur, including the malfunction of lipid digestion with clinical steatorrhea, impaired intestinal motility, and/or significant changes in the intestinal microflora environment. In this review, a detailed description of the pathophysiological mechanisms of BAM-related diarrhea is presented. Although BAM is present in a significant number of patients with Crohn's disease, its laboratory assessment is not routinely included in diagnostic workups, partially because of costs, logistical reasons, or the unavailability of the more sophisticated laboratory equipment needed. Simultaneously, novel findings related to the effects of the BA signaling pathways on immune functions (mediated through TGR5, cell membrane G protein-coupled BA receptor 1, nuclear farnesoid X receptor, nuclear pregnane X receptor, or nuclear vitamin D receptor) are discussed along with intestinal metabolism in its relationship to the pathogenesis of IBD.

• MeSH
• idiopatické střevní záněty etiologie   patologie   MeSH
• lidé MeSH
• prognóza MeSH
• průjem komplikace   patologie   MeSH
• steatorea komplikace   patologie   MeSH
• žlučové kyseliny a soli metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• žlučové kyseliny a soli MeSH

Anemia is the most common extraintestinal systemic complication of inflammatory bowel disease. Iron deficiency anemia and anemia of chronic disease are among the most frequent types. Intestinal iron absorption is controlled by the activity of ferroportin. Cells with high expression of ferroportin include enterocytes, and also macrophages and hepatocytes. Iron homeostasis is controlled by the hepcidin-ferroportin axis. Hepcidin is a central regulator of iron metabolism and can also serve as a marker of systemic inflammation. During systemic inflammatory response, the synthesis of hepcidin increases, and hepcidin binds to ferroportin and inhibits its activity. Thus, iron is not absorbed from the bowel into the circulation and also remains sequestered in macrophages. Conversely, hepcidin synthesis is suppressed during conditions requiring increased iron intake for enhanced erythropoiesis, such as iron deficiency anemia or hypoxia. Here, ferroportin is not blocked, and iron is actively absorbed into the bloodstream and also released from the stores. Production of hepcidin is influenced by the status of total body iron stores, systemic inflammatory activity and erythropoietic activity. Oral iron therapy is limited in inflammatory bowel diseases due to ongoing gastrointestinal inflammation. It is less effective and may worsen the underlying disease. Therefore, the choice between oral and parenteral iron therapy must be made with caution. Oral iron would be ineffective at high hepcidin levels due to concurrent ferroportin blockage. Contrarily, low levels of hepcidin indicate that oral iron therapy should be successful. An understanding of hepcidin can help in understanding the body's reaction to iron depletion during the inflammatory process.

• Klíčová slova
• Anemia, Childhood, Hepcidin, Inflammatory bowel disease,
• MeSH
• anemie etiologie   terapie   MeSH
• hepcidiny metabolismus   MeSH
• idiopatické střevní záněty komplikace   MeSH
• lidé MeSH
• proteiny přenášející kationty metabolismus   MeSH
• regulace genové exprese MeSH
• železo aplikace a dávkování   metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• Ferroportin MeSH
• hepcidiny MeSH
• proteiny přenášející kationty MeSH
• železo MeSH

BACKGROUND AND AIMS: Thromboprophylaxis use in paediatric inflammatory bowel disease [IBD] is inconsistent. Current guidelines only support treating children with acute severe colitis with risk factors. We convened an international RAND panel to explore thromboprophylaxis in paediatric IBD inpatients in the context of new evidence. METHODS: We convened a geographically diverse 14-person panel of paediatric gastroenterologists alongside supporting experts. An online survey was sent before an online meeting. Panellists were asked to rate the appropriateness of thromboprophylaxis in hospitalised paediatric IBD patients via 27 scenarios of varying ages, gender, and phenotype, with and without thrombotic risk factors. Anonymised results were presented at the meeting. A second modified survey was distributed to all panellists present at the meeting. Results from the second survey constitute the RAND panel results. The validated RAND disagreement index defined disagreement when ≥ 1. RESULTS: The combined outcome of thromboprophylaxis being considered appropriate until discharge and inappropriate to withhold was seen in 20 of 27 scenarios, including: all patients with new-onset acute severe colitis; all flares of known ulcerative colitis, irrespective of risk factors except in pre-pubescent patients with limited disease and no risk factors; and all Crohn's patients with risk factors. Disagreement was seen in five scenarios regarding Crohn's without risk factors, where outcomes were already uncertain. CONCLUSIONS: RAND panels are an established method to assess expert opinion in areas of limited evidence. This work therefore constitutes neither a guideline nor a consensus; however, the findings suggest a need to re-evaluate the role of thromboprophylaxis in future guidelines.

• Klíčová slova
• Paediatric gastroenterology, inflammatory bowel disease, ulcerative colitis,
• MeSH
• antikoagulancia terapeutické užití   MeSH
• Crohnova nemoc * terapie   MeSH
• idiopatické střevní záněty * farmakoterapie   MeSH
• lidé MeSH
• ulcerózní kolitida * terapie   MeSH
• žilní tromboembolie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antikoagulancia MeSH

Interventional (or therapeutic) inflammatory bowel disease (IBD) endoscopy has an expanding role in the treatment of disease and surgical adverse events. Endoscopic therapy has been explored and used in the management of strictures, fistulas/abscesses, colitis-associated neoplasia, postsurgical acute or chronic leaks, and obstructions. The endoscopic therapeutic modalities include balloon dilation, stricturotomy, stent placement, fistulotomy, fistula injection and clipping, sinusotomy, EMR, and endoscopic submucosal dissection. With a better understanding of the disease course of IBD, improved long-term impact of medical therapy, and advances in endoscopic technology, we can foresee interventional IBD becoming an integrated part of the multidisciplinary approach to patients with complex IBD.

• MeSH
• biologické přípravky terapeutické užití   MeSH
• břišní absces etiologie   chirurgie   MeSH
• endoskopická mukózní resekce MeSH
• gastrointestinální endoskopie * MeSH
• idiopatické střevní záněty komplikace   farmakoterapie   chirurgie   MeSH
• kolorektální nádory etiologie   chirurgie   MeSH
• lidé MeSH
• netěsnost anastomózy chirurgie   MeSH
• stenóza MeSH
• střevní obstrukce etiologie   chirurgie   MeSH
• střevní píštěle etiologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• biologické přípravky MeSH

OBJECTIVE: To bring actual summary of pre and perinatal care of women with Crohn's disease and ulcerative colitis. DESIGN: Review. SETTING: Department of Gynaecology and Obstetrics, General Faculty Hospital and 1st Faculty of Medicine, Prague. METHODS: Review of articles. CONCLUSION: Care of women with inflammatory bowel diseases should be placed in a specialised centre and management of pregnancy should be discussed by a multidisciplinary team included obstetrician, gastroenterologist, surgeon and nutritional specialist. All the possibilities in treatment of these women (except a few of them) are safe during the pregnancy and in the puerperium both for mother and fetus.

• Klíčová slova
• Crohn, IBD, biological therapy, inflammatory bowel disease, pregnancy,
• MeSH
• dospělí MeSH
• idiopatické střevní záněty patofyziologie   MeSH
• komplikace těhotenství patofyziologie   MeSH
• lidé MeSH
• poporodní období MeSH
• těhotenství MeSH
• výsledek těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Inflammatory bowel disease (IBD) is a relapsing and remitting inflammatory disease affecting millions of people worldwide. The active phase of IBD is characterized by excessive formation of reactive oxygen species (ROS) in the intestinal mucosa, which further accelerates the inflammatory process. A feasible strategy for the IBD treatment is thus breaking the oxidation-inflammation vicious circle by scavenging excessive ROS with the use of a suitable antioxidant. Herein, we have developed a novel hydrogel system for oral administration utilizing sterically hindered amine-based redox polymer (SHARP) incorporating covalently bound antioxidant SHA groups. SHARP was prepared via free-radical polymerization by covalent crosslinking of 2-hydroxyethyl methacrylate (HEMA), poly(ethylene oxide) methyl ether methacrylate (PEGMA) and a SHA-based monomer, N-(2,2,6,6-tetramethyl-piperidin-4-yl)-methacrylamide. The SHARP hydrogel was resistant to hydrolysis and swelled considerably (∼90% water content) under the simulated gastrointestinal tract (GIT) conditions, and exhibited concentration-dependent antioxidant properties in vitro against different ROS. Further, the SHARP hydrogel was found to be non-genotoxic, non-cytotoxic, non-irritating, and non-absorbable from the gastrointestinal tract. Most importantly, SHARP hydrogel exhibited a statistically significant, dose-dependent therapeutic effect in the mice model of dextran sodium sulfate (DSS)-induced acute colitis. Altogether, the obtained results suggest that the SHARP hydrogel strategy holds a great promise with respect to IBD treatment.

• Klíčová slova
• Antioxidant, Dextran sodium sulfate-induced colitis, Hydrogel, Inflammatory bowel disease, Reactive oxygen species, Redox polymer, Sterically hindered amine,
• MeSH
• aminy MeSH
• hydrogely MeSH
• idiopatické střevní záněty * farmakoterapie   MeSH
• kolitida * chemicky indukované   farmakoterapie   MeSH
• myši MeSH
• oxidace-redukce MeSH
• polymery MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• aminy MeSH
• hydrogely MeSH
• polymery MeSH