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Introduction

The etiology and pathogenesis of inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC) are complex and the mechanisms that lead to the development of these diseases remain unclear. Extracellular vesicles (EVs) are small particles covered with a cell membrane, originating from the emitting cell, excreted into the extracellular medium, and subsequently captured by receptor cells. EVs have a role in multiple diseases and they could also have a function in IBD pathogenesis. Therefore, the analysis of EVs isolated from the serum of newly diagnosed IBD patients (before starting any treatment) may represent an appropriate experimental approach to elucidate their role in IBD pathogenesis.

Aims & Methods

We aimed to evaluate EVs’ composition and potential effects in the pathogenesis of IBD. To assay this, EVs were isolated by size exclusion chromatography from the 500 µl of serum from 100 patients with IBD (50 patients with CD and 50 patients with UC) recently diagnosed and 50 healthy controls (HC). Then, the protein loaded in the EVs was characterized by proteomics and their size and concentration in serum by Nanoparticle tracking analysis (NTA). The biological function of EVs and alterations in signaling pathways related to IBD were determined using Ingenuity Pathways Analysis (IPA) to analyze the OMICs results.

Results

A total of 1,100 proteins have been identified, of which 105 proteins were differentially expressed by patients with CD versus HC, 111 proteins by patients with UC versus HC, and 32 proteins by patients with UC versus CD. IPA analysis revealed that proteins carried in EVs are involved in the dysregulation of immune pathways such as the acute phase response, LXR/RXR activation pathway, and the complement pathway. These pathways were regulated differentially in IBD patients compared with HC, but also when the CU group was compared with the CD group being upregulated nuclear receptors signaling and cytotoxicity pathways.

Conclusion

EVs carry proteins that can be involved in the dysregulation of the immune system in IBD; this effect would be different in UC and CD since their EVs show a differential profile. Consequently, EVs may play role in IBD pathogenesis and source of strong biomarkers candidates for diagnosis in UC and CD. Further studies on their specific function during IBD are warranted.

PROTEOMIC CHARACTERIZATION OF SERUM EXTRACELLULAR VESICLES FROM NEWLY DIAGNOSED PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Irene Soleto 1, Montse Baldan Martin 1, Cristina Ramírez 1, Macarena Orejudo del Río 1, Sara García 1, Jorge Mercado 1, Mikel Azkargorta 2, Ibon Iloro 2, Lorena Ortega Moreno 3, Laila Aldars-García 1, SABINO RIESTRA MENENDEZ 4, Montserrat Rivero 5, Ana Gutiérrez-Casbas 6, Iago Rodríguez-Lago 7, Luis Fernández-Salazar 8, Daniel Sebastian Ceballos Santos 9, JOSE MANUEL BENITEZ CANTERO 10, Mariam Aguas 11, Iria Bastón-Rey 12, Fernando Bermejo 13, María José Casanova 1, Rufo Lorente Poyatos 14, Yolanda Ber Nieto 15, Daniel Ginard 16, Maria Esteve Comas 17, Felix Elortza 2, Javier Gisbert 1, Noa Martin-Cofreces 18, María Chaparro 1

1 Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain

2 Proteomics Platform, CIC bioGUNE, BRTA (Basque Research & Technology Alliance), CIBERehd, Derio, Spain

3 Área de Farmacología y Nutrición y Bromatología, Universidad Rey Juan Carlos, Madrid, Spain

4 Hospital Universitario Central de Asturias, Madrid, Spain

5 Marqués de Valdecilla Universitary Hospital, Valdecilla, Spain

6 Hospital General Universitario Alicante, Alicante, Spain

7 Hospital Universitario de Galdakao, Bilbao, Spain

8 Hospital Clínico Universitario de Valladolid, Valladolid, Spain

9 Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain

10 Hospital Universitario Reina Sofia, Cordoba, Spain

11 La Fe Universitary and Politecnic Hospital, Valencia, Spain

12 University Hospital of Santiago de Compostela, La Coruña, Spain

13 Hospital Fuenlabrada, Fuenlabrada, Spain

14 Hospital General Ciudad Real, Ciudad real, Spain

15 Hospital San Jorge, Huesca, Spain

16 Hospital Universitari Son Espases, Palma de Mallorca, Spain

17 Hospital Universitari Mutua Terrassa, Barcelona, Spain

18 Immunology Unit from Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria Princesa, Universidad Autonoma de Madrid (UAM), Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain

Conference

UEG Week Copenhagen 2023

Topics

IBD

Submission format

Abstract

Session

PP 05 IBD (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

UEG Podcast Episode

New

UEG Podcast

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Malignancy in IBD with Hannah Gordon

Hannah Gordon, Pradeep Mundre

Topics

Digestive Oncology IBD

Published

2026

UEG Mistakes In Articles

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Crohn’s disease (CD) is a chronic inflammatory bowel condition that can present with a wide range of intestinal and extra-intestinal manifestations. This condition can develop at any age and have a significant impact and impairment on quality of life for individuals including on relationships, educational attainment and work productivity. In particular, the time around and after diagnosis often involves the most upheaval for patients, and equally the biggest opportunity for effective intervention. Several recent advances have had a major impact on optimal management of patients with newly diagnosed CD. Here, we discuss the mistakes that are commonly made when managing patients presenting with a new diagnosis of CD. We summarise the evidence base and offer helpful and pragmatic tips for practising clinicians.

Mistakes in newly diagnosed Crohn's disease and how to avoid them

Joana Roseira, Nurulamin Noor

Topics

IBD

Citation

Roseira J and Noor N. Mistakes in newly diagnosed crohn's disease and how to avoid them. UEG Education 2025; 25: 18-23.

Published

2025

UEG Standards and Guidelines

Consensus

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Abstract

Background

The incidence and prevalence of inflammatory bowel disease [IBD] have increased significantly in low- and middle-income countries [LMICs] in recent decades. Managing IBD in these settings presents substantial challenges. This consensus aims to describe the epidemiology of IBD in LMICs and to highlight the key challenges in its diagnosis and treatment.

Method

The consensus-defining strategy followed the previous European Crohn’s and Colitis Organisation [ECCO] consensus guidelines [available at www.ecco-ibd.eu]. The authors reviewed the available evidence and formulated statements accordingly. Provisional ECCO statements and supporting text were drafted based on a comprehensive literature review and further refined through two voting rounds, which included external reviewers and national representatives from ECCO’s 36 member countries. The final ECCO statements, representing a consensus of at least 80% agreement among participants, were approved during an online meeting. Consensus statements should be interpreted in context with their accompanying commentary rather than in isolation and should not be used solely to guide patient management. The supporting text was finalized under the guidance of each working group leader [VP, HY, TK, AH] and subsequently integrated by the consensus leader [AE].

Results

Data on IBD epidemiology in LMICs remain limited. Public and healthcare professional awareness and timely access to early diagnostic modalities, advanced medical and surgical therapies, and specialist multidisciplinary care are key gaps in IBD care in LMICs. The complexity and chronic nature of IBD, along with the necessity for a multidisciplinary approach, pose significant challenges to adopting a holistic management strategy in LMICs.

Conclusion

There is a critical need for further studies to assess the specific needs of LMICs. Such research will help guide resource allocation and improve IBD management in these settings.

ECCO Consensus on management of Inflammatory Bowel Disease in low-and middle-income countries

Alaa El-Hussuna

Publisher

European Crohn’s and Colitis Organisation

Guideline

Consensus

Topics

IBD

Citation

Journal of Crohn's and Colitis; 2025

Published

2025

UEG Podcast Episode

UEG Podcast

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Best of UEG Week - DDM Summit with Francisco Real

Francisco X. Real, Julia Mayerle

Topics

Digestive Oncology

Published

2025

UEG Mistakes In Articles

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Familial Mediterranean fever (FMF), also called periodic disease, Armenian disease, etc., is a prototypical autoinflammatory disorder where the underlying mechanism is the dysfunction of innate immunity, resulting in unprovoked episodes of inflammation.¹ Although considered rare worldwide, it is prevalent in people of Mediterranean origin; however, one can expect to encounter patients in all parts of the modern world. FMF is a monogenic disease with autosomal recessive inheritance.² Unlike other monogenic disorders, the diagnosis remains largely clinical, and it is important to understand the limitations of genetic testing. Another distinguishing feature is the well-established effectiveness of lifelong monotherapy with colchicine in preventing attacks and complications.³

Mistakes in Familial Mediterranean Fever and how to avoid them

Manik Gemilyan, Gagik Hakobyan

Topics

Primary Care

Published

2025

UEG Standards and Guidelines

Clinical Practice Guideline

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Abstract

The current consensus guideline offers a comprehensive and practical guidance on the diagnostic and monitoring of patients with inflammatory bowel disease (IBD). It provides recommendations on requirements for initial diagnosis, detection of complications, the use of monitoring tools in patients with IBD and diagnostics in specific situations, such as pregnancy, postoperatively and for cancer surveillance. The guideline is a joint project of the European Crohn’s and Colitis Organization (ECCO), the European Society of Gastrointestinal and Abdominal Radiology, the European Society of Pathology, and the International Bowel Ultrasonography Group under the leadership of ECCO.

ECCO-ESGAR-ESP-IBUS Guideline on Diagnostics and Monitoring of Patients with Inflammatory Bowel Disease: Part 1: initial diagnosis, monitoring of known inflammatory bowel disease, detection of complications

Torsten Kucharzik

Publisher

European Crohn’s and Colitis Organisation

Guideline

Clinical Practice Guideline

Topics

IBD

Citation

Journal of Crohn's and Colitis, Volume 19, Issue 7

Published

2025

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