UEG's content platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

Re-live UEG Week 2026 on Gutflix Gut Guide online What's new on Gutflix

Trending on Gutflix

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

THE ECONOMIC IMPACT OF USTEKINUMAB IN THE TREATMENT OF INFLAMMATORY BOWEL DISEASE: A TARGETED LITERATURE REVIEW

Kunal Shastri 1, Kerise Clarke 2, Margaret Ainslie-Garcia 2, Nicole Ferko 2

Affiliations

1 Fresenius Kabi SwissBioSim Gmbh, Eysins, Switzerland

2 EVERSANA, Burlington, Canada

Summary

AI Generated

A targeted literature review of 12 economic studies found that ustekinumab, despite clinical efficacy in inflammatory bowel disease, is among the highest-cost biologics with low cost-effectiveness probabilities across multiple payer perspectives.

The review analyzed 12 economic studies from various payer perspectives (US, Japanese, Canadian, Swedish, Polish, French, and German) evaluating ustekinumab in Crohn's disease and ulcerative colitis populations
Only two studies (Polish and Swedish perspectives in anti-TNF-failure Crohn's disease patients) found ustekinumab cost-effective; most studies showed it was dominated by other biologics including vedolizumab and infliximab based on incremental cost-effectiveness ratios
Ustekinumab had the highest cost per responder or remitter compared to other therapies in Japanese and US analyses, and German and Canadian studies found zero probability of cost-effectiveness at current willingness-to-pay thresholds
No studies evaluated ustekinumab biosimilars, which the authors suggest could improve cost-effectiveness and expand patient access as the economic burden of inflammatory bowel disease increases globally

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Ustekinumab, an interleukin (IL) 12/23 inhibitor is a biologic used to treat inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC). Clinical and real-world evidence has demonstrated its ability to provide a clinically meaningful response and remission among patients; however, the economic impact of its use may not be favourable from the payer perspective. The objective of this targeted literature review was to understand the economic impact of ustekinumab reference product in the treatment of patients with IBD.

Aims & Methods

A literature search was conducted in MEDLINE for economic publications that evaluate the economic impact of ustekinumab or include ustekinumab within their analyses. Search terms included “budget impact model”, “budget impact analysis”, “cost-utility”, “cost-effect”, “ulcerative colitis”, “Crohn’s disease” and “ustekinumab” from database inception until Feb 8^th, 2024. Only studies published in English were eligible for inclusion.

Results

A total of 30 hits were screened for inclusion, yielding 12 relevant studies that discussed economic implications of ustekinumab. Five articles were conducted from the US payer perspective, two from the Japanese payer perspective, and one each from the Canadian, Swedish, Polish, French, and German perspectives. The economic models included budget impact models (n = 2), cost-effectiveness models (n = 8), and cost per responder/remitter analyses (n = 2). Five studies used a CD patient population, six studies focused on UC, and one study included a mixed population of CD and UC. In CD studies, two found ustekinumab was cost-effective: these studies were conducted from the perspective of Polish and Swedish payers in CD patients who failed anti-TNF therapy. Both studies used a Markov based model to assess cost-effectiveness of treatments. In the remaining CD studies, ustekinumab was associated with the highest cost per responder/remitter (Japanese payer perspective) and was dominated by other treatments in cost-effectiveness analyses (US payer perspective). The studies conducted in the UC patient population also found that, although clinically effective, ustekinumab was dominated (based on the incremental cost effectiveness ratio [ICER]) by other biologics included in the analyses (eg, vedolizumab and infliximab). Similar to the CD patient population, the cost per responder/remitter was highest for ustekinumab compared to five other therapies including tofacitinib and golimumab (US payer perspective). However, in two UC studies, ustekinumab was observed to be more effective than the most cost-effective treatment option (from the Japanese and US payer perspectives), highlighting that its price negatively affected its ICER. Moreover, cost-effectiveness analyses conducted by the German and Canadian perspectives, demonstrated that ustekinumab was not a cost-effective therapy at the current willingness to pay threshold (0% probability). Note, that no studies tested the possible cost-effectiveness of an ustekinumab biosimilar which would positively influence the cost associated with ustekinumab treatment.

Conclusion

This literature review demonstrated that, despite its high efficacy, ustekinumab is among the highest costing biologics available for the treatment of IBD with low probabilities of cost-effectiveness across several studies. As the economic burden for IBD is increasing globally, cost-saving therapeutic options such as biosimilars may help to provide savings that can be redistributed in a healthcare system or provide funds to expand patient access.

Disclosure

Kunal Shastri is an employee of Fresenius Kabi a manufacturer of biosimilars. Kerise Clarke, Margaret Ainslie-Garcia, Nicole Ferko are employees of EVERSANA a company who receives consulting fees from Fresenius Kabi.

Conference

UEG Week Vienna 2024

Submission format

Abstract

Session

Other (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

More Like This:

HIGH ADHERENCE TO THE MEDITERRANEAN DIET DELAYS SURGERY AND REPROGRAMS INTESTINAL CELLULAR STATES IN CROHN’S DISEASE

Stefania Vetrano

Treating obesity: From mechanism to personalization

Amalia Gastaldelli

Con: Neoadjuvant therapy

Hana Algül

Pro: Upfront surgery

Sanjay Pandanaboyana

DIET QUALITY AND DIVERSITY IN CHILDHOOD AND ADOLESCENCE AND LATER RISK OF INFLAMMATORY BOWEL DISEASE: A TRI-NATIONAL BIRTH COHORT STUDY

Karl Mårild

CONSUMPTION OF ULTRA-PROCESSED FOOD PROMOTE INFLAMMATORY POTENTIAL OF FECAL MICROBIOME THROUGH ALTERING THE BALANCE OF TH17 AND RORYT TREG

Williams Turpin

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

HIGH ADHERENCE TO THE MEDITERRANEAN DIET DELAYS SURGERY AND REPROGRAMS INTESTINAL CELLULAR STATES IN CROHN’S DISEASE

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

HIGH ADHERENCE TO THE MEDITERRANEAN DIET DELAYS SURGERY AND REPROGRAMS INTESTINAL CELLULAR STATES IN CROHN’S DISEASE

Alejandra Angela Carriles Linares 1,2, Michele Salerno 1,2, Stefano De Zanet 1,2, Faris Hrvat 1, Laura Loy 2, Roberto Gabbiadini 2, Patrizia Gnagnarella 3, Giuseppe Privitera 1,2, Arianna Dal Buono 2, Cristina Bezzio 1,2, Daniele Piovani 1,2, Stefanos Bonovas 1,2, Gisella Figlioli 1,2, Giulia Rizzo 2, Giada Mori 2, Gianluca Tognon 4, Samuel Elias Pineda Chavez 2,1, Massimo Claudio Fantini 5,6, Sara Onali 5,6, Michele Carvello 1,2, Antonino Spinelli 1,2, Alessandro Armuzzi 1,2, Stefania Vetrano 2,1

Affiliations

1 Humanitas University, Pieve Emanuele, Milan, Italy

2 IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

3 IEO European Institute of Oncology IRCCS, Milan, Italy

4 University of Skövde, Skövde, Sweden

5 Azienda Ospedaliero-Universitaria di Cagliari, Monserrato, Cagliari, Italy

6 University of Cagliari, Monserrato, Cagliari, Italy

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Introduction

Fibrostenotic Crohn’s disease (CD) leads to intestinal obstruction and surgery, yet determinants of fibrogenesis remain poorly defined. While dietary patterns influence inflammation, their role in fibrotic progression remains unclear. We investigated whether Mediterranean diet adherence influences disease progression.

Aims & Methods

We conducted a retrospective cohort study including 1,092 patients with Crohn’s disease from two tertiary referral centers (mean age at diagnosis 33.6 years, SD 15.3; 54% male), with B1 disease in 67%, B2 in 27%, and B3 in 6%. Mediterranean diet adherence was quantified using a validated food frequency questionnaire and a 0–9-point score.
The primary outcome was intestinal surgery for fibrostenotic CD, and the secondary outcome was de novo intestinal stenosis. Time-to-event analyses were performed using Kaplan–Meier estimates and multivariable Cox regression, with time zero defined as first clinical assessment. Patients were censored at last clinical follow-up for surgery and at last colonoscopy for stenosis, reflecting routine clinical practice with variable follow-up intervals.
Mechanistic studies were performed in SAMP1/YitFc mice fed a Mediterranean or control diet for 12 weeks. Disease severity, fibrosis, and ileal remodeling were assessed. Spatial transcriptomics was performed in murine tissue, while bulk RNA sequencing was conducted on fibroblasts from 10 CD patients stratified by diet adherence.

Results

Over a median follow-up of 2.54 years (3,772 person-years), 313 patients (28.7%) underwent surgery, corresponding to an incidence rate of 8.3 per 100 person-years. The 5-year cumulative incidence of surgery decreased progressively across Mediterranean diet adherence levels (39.2% low, 31.8% moderate, 25.0% high; p < 0.001).
For de novo stenosis, the 5-year cumulative incidence was 49.6% (95% CI 45.6–53.2%), with a graded reduction across adherence levels (56.4%, 51.2%, 35.8%). Multivariable models confirmed an independent protective association between higher Mediterranean diet adherence and both outcomes.
In mice, the Mediterranean diet attenuated intestinal inflammation and collagen deposition compared with the control diet (p < 0.001).
Spatial transcriptomics revealed diet-dependent remodeling of the intestinal microenvironment, characterized by expansion of goblet cells and RGS5+ structural myofibroblasts, with reduced SPP1+ pro-fibrotic and CD74+ inflammatory fibroblasts. In contrast, the control diet promoted inflammatory and metabolically dysregulated stromal states. Similarly, in human samples, high Mediterranean diet adherence was associated with enrichment of RGS5+ structural myofibroblasts in the intestinal mucosa.

Conclusion

Higher adherence to the Mediterranean diet is associated with reduced risk of intestinal surgery and de novo stenosis in CD. Integrated human and experimental data suggest that the Mediterranean diet may modulate fibrostenotic progression by directly reshaping epithelial and stromal cellular states, beyond anti-inflammatory effects, providing a potential strategy to influence intestinal tissue remodeling.

Event

UEG Week Barcelona 2026

Topics

Paediatrics Small Intestine & Nutrition IBD Gut Microbiota

Submission format

Abstract

Session

Beyond prescriptions: Improving IBD outcomes with non-pharmaceutical approaches

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

HIGH ADHERENCE TO THE MEDITERRANEAN DIET DELAYS SURGERY AND REPROGRAMS INTESTINAL CELLULAR STATES IN CROHN’S DISEASE

Stefania Vetrano

Treating obesity: From mechanism to personalization

Amalia Gastaldelli

Con: Neoadjuvant therapy

Hana Algül

Pro: Upfront surgery

Sanjay Pandanaboyana

DIET QUALITY AND DIVERSITY IN CHILDHOOD AND ADOLESCENCE AND LATER RISK OF INFLAMMATORY BOWEL DISEASE: A TRI-NATIONAL BIRTH COHORT STUDY

Karl Mårild

CONSUMPTION OF ULTRA-PROCESSED FOOD PROMOTE INFLAMMATORY POTENTIAL OF FECAL MICROBIOME THROUGH ALTERING THE BALANCE OF TH17 AND RORYT TREG

Williams Turpin

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Treating obesity: From mechanism to personalization

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Treating obesity: From mechanism to personalization

Amalia Gastaldelli 1

Affiliations

1 Institute of Clinical Physiology, Pisa, Italy

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Barcelona 2026

Topics

Hepatobiliary Small Intestine & Nutrition Mechanisms & Personalised Medicine

Session

Therapy update: Anti-obesity

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

HIGH ADHERENCE TO THE MEDITERRANEAN DIET DELAYS SURGERY AND REPROGRAMS INTESTINAL CELLULAR STATES IN CROHN’S DISEASE

Stefania Vetrano

Treating obesity: From mechanism to personalization

Amalia Gastaldelli

Con: Neoadjuvant therapy

Hana Algül

Pro: Upfront surgery

Sanjay Pandanaboyana

DIET QUALITY AND DIVERSITY IN CHILDHOOD AND ADOLESCENCE AND LATER RISK OF INFLAMMATORY BOWEL DISEASE: A TRI-NATIONAL BIRTH COHORT STUDY

Karl Mårild

CONSUMPTION OF ULTRA-PROCESSED FOOD PROMOTE INFLAMMATORY POTENTIAL OF FECAL MICROBIOME THROUGH ALTERING THE BALANCE OF TH17 AND RORYT TREG

Williams Turpin

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Con: Neoadjuvant therapy

Hana Algül 1

Affiliations

1 Technical University of Munich, Munich, Germany

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Barcelona 2026

Topics

Digestive Oncology Surgery Pancreas Mechanisms & Personalised Medicine

Session

Future treatment for resectable pancreatic cancer: Cut, treat or personalise?

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

HIGH ADHERENCE TO THE MEDITERRANEAN DIET DELAYS SURGERY AND REPROGRAMS INTESTINAL CELLULAR STATES IN CROHN’S DISEASE

Stefania Vetrano

Treating obesity: From mechanism to personalization

Amalia Gastaldelli

Con: Neoadjuvant therapy

Hana Algül

Pro: Upfront surgery

Sanjay Pandanaboyana

DIET QUALITY AND DIVERSITY IN CHILDHOOD AND ADOLESCENCE AND LATER RISK OF INFLAMMATORY BOWEL DISEASE: A TRI-NATIONAL BIRTH COHORT STUDY

Karl Mårild

CONSUMPTION OF ULTRA-PROCESSED FOOD PROMOTE INFLAMMATORY POTENTIAL OF FECAL MICROBIOME THROUGH ALTERING THE BALANCE OF TH17 AND RORYT TREG

Williams Turpin

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Pro: Upfront surgery

Sanjay Pandanaboyana 1

Affiliations

1 Freeman hospital, Newcastle upon tyne, United Kingdom

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Barcelona 2026

Topics

Digestive Oncology Surgery Pancreas Mechanisms & Personalised Medicine

Session

Future treatment for resectable pancreatic cancer: Cut, treat or personalise?

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

HIGH ADHERENCE TO THE MEDITERRANEAN DIET DELAYS SURGERY AND REPROGRAMS INTESTINAL CELLULAR STATES IN CROHN’S DISEASE

Stefania Vetrano

Treating obesity: From mechanism to personalization

Amalia Gastaldelli

Con: Neoadjuvant therapy

Hana Algül

Pro: Upfront surgery

Sanjay Pandanaboyana

DIET QUALITY AND DIVERSITY IN CHILDHOOD AND ADOLESCENCE AND LATER RISK OF INFLAMMATORY BOWEL DISEASE: A TRI-NATIONAL BIRTH COHORT STUDY

Karl Mårild

CONSUMPTION OF ULTRA-PROCESSED FOOD PROMOTE INFLAMMATORY POTENTIAL OF FECAL MICROBIOME THROUGH ALTERING THE BALANCE OF TH17 AND RORYT TREG

Williams Turpin

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

DIET QUALITY AND DIVERSITY IN CHILDHOOD AND ADOLESCENCE AND LATER RISK OF INFLAMMATORY BOWEL DISEASE: A TRI-NATIONAL BIRTH COHORT STUDY

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

DIET QUALITY AND DIVERSITY IN CHILDHOOD AND ADOLESCENCE AND LATER RISK OF INFLAMMATORY BOWEL DISEASE: A TRI-NATIONAL BIRTH COHORT STUDY

Annie Guo 1, Ida Sigvardsson 1, Sabine Jansson 2,3, Henrik Imberg 4,5, Anne Lise Brantsæter 6, Anne Vibeke Wewer 7,2,3, Johnny Ludvigsson 8,9, Ketil Størdal 10,11, Mikkel Malham 3,2, Karl Mårild 12,1

Affiliations

1 University of Gothenburg, Gothenburg, Sweden

2 Hvidovre Hospital, Hvidovre, Denmark

3 Copenhagen University Hospital, Hvidovre, Denmark

4 Statistiska Konsultgruppen Sweden AB, Gothenburg, Sweden

5 University of Gothenburg, Gothenburgsw, Sweden

6 Norwegian Institute of Public Health, Oslo, Norway

7 Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark

8 Crown Princess Victoria Children’s Hospital, Linköping, Sweden

9 Linköping University, Linköping, Sweden

10 Oslo University Hospital, Oslo, Norway

11 University of Oslo, Oslo, Norway

12 Queen Silvia Children’s Hospital, Gothenburg, Sweden

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Introduction

Diet influences the gut microbiome composition and immune system development across the lifespan.^{1, 2} While a high diet quality in the first year of life has been associated with a reduced risk of later IBD,³ the impact of diet in school age and adolescence on IBD risk remains largely unexplored.

Aims & Methods

The aim was to investigate the associations between diet quality and diversity in childhood and adolescence and later risk of inflammatory bowel disease (IBD). We followed individuals born in 1996–2009 from three population-based birth cohorts (The Norwegian Mother, Father and Child Cohort Study, the Danish National Birth Cohort, and All Babies in Southeast Sweden). The primary outcome was IBD, and the time of event was defined as the first of at least two diagnostic codes for IBD in linked national patient registers by 2022. Dietary exposures were measured using repeated questionnaires: diet quality at ages 7–8 and 11–14 years was measured using a modified Healthy Eating Index, and diet diversity at age 11–14 years was assessed using a Diet Diversity Score. Each dietary exposure was modeled into low, medium, and high based on tertiles. Cohort-specific adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for developing IBD, Crohn’s disease (CD), and ulcerative colitis (UC) were estimated using Cox proportional hazards regression adjusted for sex, IBD heredity, and socioeconomic status, pooled across cohorts using a random-effects model. Joint modeling was conducted to account for the repeated diet quality measurements and their association with time to IBD development.

Results

We followed 137,179 individuals for 1,894,582 person-years. During this time, 811 developed IBD. The pooled aHR for IBD comparing high vs low diet quality was 0.83 (95% CI 0.62–1.10) at ages 7–8, and 0.69 (0.51–0.93) at ages 11–14 (Table 1). Similar associations were observed for CD (ages 7–8: aHR=0.74 [0.45–1.21]; ages 11–14: aHR=0.66 [0.44–0.99]), but not for UC (ages 7–8, aHR=0.98 [0.73–1.31]; ages 11–14, aHR=0.71 [0.48–1.07]). For high vs low diet diversity at ages 11–14, the pooled aHRs were 0.76 (0.58–1.00) for overall IBD, 0.79 (0.49–1.26) for CD, and 0.74 (0.49–1.11) for UC. Joint modelling also showed that a higher overall longitudinal diet quality exposure was associated with a reduced risk of IBD (0.87 [0.78–0.97] and CD (0.87 [0.78–0.94], with largely similar estimates in the adjusted model.

	Inflammatory bowel disease		Crohn's disease
Exposure	HR (95% CI)	aHR (95% CI)	HR (95% CI)	aHR (95% CI)
Diet quality 7-8 years
Low	Reference	Reference	Reference	Reference
Medium	0.80 (0.67–0.95)	0.79 (0.66–0.94)	0.78 (0.60–1.01)	0.76 (0.58–0.99)
High	0.83 (0.64–1.08)	0.83 (0.62–1.10)	0.76 (0.47–1.22)	0.74 (0.45–1.21)
Diet quality 11-14 years
Low	Reference	Reference	Reference	Reference
Medium	0.83 (0.66–1.04)	0.83 (0.66–1.04)	0.84 (0.61–1.16)	0.83 (0.60–1.16)
High	0.69 (0.51–0.92)	0.69 (0.51–0.93)	0.66 (0.44–0.99)	0.66 (0.44–0.99)

Multiple imputation was applied to handle missing data. CI, confidence interval; HR, hazard ratio.

Conclusion

In this tri-national birth cohort study, higher diet quality in childhood and adolescence, particularly at 11–14 years of age, was associated with a lower risk of CD.

References

1. Lynch SV, Pedersen O. The Human Intestinal Microbiome in Health and Disease. N Engl J Med 2016;375:2369-2379.
2. Dong TS, Gupta A. Influence of Early Life, Diet, and the Environment on the Microbiome. Clinical Gastroenterology and Hepatology 2019;17:231-242.
3. Guo A, Ludvigsson J, Brantsæter AL, et al. Early-life diet and risk of inflammatory bowel disease: a pooled study in two Scandinavian birth cohorts. Gut 2024;73:590-600.

Event

UEG Week Barcelona 2026

Topics

Paediatrics Small Intestine & Nutrition IBD Gut Microbiota

Submission format

Abstract

Session

Beyond prescriptions: Improving IBD outcomes with non-pharmaceutical approaches

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

HIGH ADHERENCE TO THE MEDITERRANEAN DIET DELAYS SURGERY AND REPROGRAMS INTESTINAL CELLULAR STATES IN CROHN’S DISEASE

Stefania Vetrano

Treating obesity: From mechanism to personalization

Amalia Gastaldelli

Con: Neoadjuvant therapy

Hana Algül

Pro: Upfront surgery

Sanjay Pandanaboyana

DIET QUALITY AND DIVERSITY IN CHILDHOOD AND ADOLESCENCE AND LATER RISK OF INFLAMMATORY BOWEL DISEASE: A TRI-NATIONAL BIRTH COHORT STUDY

Karl Mårild

CONSUMPTION OF ULTRA-PROCESSED FOOD PROMOTE INFLAMMATORY POTENTIAL OF FECAL MICROBIOME THROUGH ALTERING THE BALANCE OF TH17 AND RORYT TREG

Williams Turpin

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

CONSUMPTION OF ULTRA-PROCESSED FOOD PROMOTE INFLAMMATORY POTENTIAL OF FECAL MICROBIOME THROUGH ALTERING THE BALANCE OF TH17 AND RORYT TREG

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

CONSUMPTION OF ULTRA-PROCESSED FOOD PROMOTE INFLAMMATORY POTENTIAL OF FECAL MICROBIOME THROUGH ALTERING THE BALANCE OF TH17 AND RORYT TREG

Jeongseok Kim 1, Cong Phi Dang 2, Cathy McShane 1, Alyssa Waslyk 1, Qilong Li 1, Benoît Chassaing 3, Sun-Ho Lee 1,2, Ken Croitoru 1,2, Williams Turpin 1,2

Affiliations

1 Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada

2 Temerty Faculty of Medicine, University of Toronto, Toronto, Canada

3 Institut Pasteur, Université Paris Cité, INSERM U1306, Paris, France

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Introduction

Crohn’s disease (CD) is a chronic disorder of unknown etiology. Diet, particularly the consumption of ultra-processed foods (UPFs), has been implicated in CD development. Despite this, there is limited research examining how UPFs influence the mucosal immune response. Our study aims to (i) determine whether long-term UPF consumption alters the inflammatory potential of the gut microbiome and (ii) assess whether transfer of the microbiome from individuals consuming high amounts of UPFs affects intestinal T-cell populations in germ-free mice (GFMs).

Aims & Methods

Serum and stool samples collected prior to the onset of CD were obtained from the GEM project, a cohort of prospectively followed healthy first-degree relatives of CD patients. The microbiome was characterized by 16S rRNA sequencing of stool DNA, and serum protein profiles were measured using the Olink Proximity Extension Assay. For mouse experiments, human feces from high- or low-UPF consumers, defined as individuals with more than 40% of daily caloric intake derived from NOVA4 food items according to the NOVA classification, were transplanted into wild-type germ-free recipient mice fed either a standard chow diet or a Western diet. After four weeks of microbial colonization, lamina propria T-cell populations in the intestine, including RORγt⁺ Treg (CD4⁺RORγt⁺FoxP3⁺) and Th17 (CD4⁺RORγt⁺FoxP3⁻) cells, were analyzed using flow cytometry.

Results

Our study included 2,336 participants, including 1,977 from Canada and 359 from the United States. The mean proportion of total energy consumption from UPFs was 36.6 ±12.7%. Participants with higher UPF consumption showed significant difference in 36 serum proteins (q<0.007) compared with those with lower UPF consumers. Notably, immune-related proteins, including IL2RA, TNFRS9, TNFRSF11A, and CD4, were enriched in individuals with high UPF consumption. Microbiome analysis revealed that several taxa, predominantly from the Lachnospiraceae and Ruminococcaceae families, were associated with UPF consumption. In addition, the presence of Marvinbryantia was associated with an increased risk of CD among individuals with high UPF consumption. Mice receiving feces from high-UPF consumers exhibited reduced proportion of protective RORyt⁺ Treg cells in both the ileum and colon (p<0.001). Moreover, mice fed a Western diet (high in fat and simple sugars) and colonized with feces from high-UPF consumer showed a significantly higher proportion of Th17 cells in the colon than mice receiving feces from low-UPF consumers (p=0.023).

Conclusion

Our findings suggest that UPF consumption alters the inflammatory potential of the gut microbiome. Using gnotobiotic mice, we further demonstrated that UPF-associated microbial communities may induce an imbalance between RORγt⁺ regulatory T cells and Th17 cells. Together, these results suggest that the gut microbiome associated with high UPF consumption may contribute to CD onset through immune dysregulation and support the notion that dietary modulation of the microbiome could represent a potential strategy for CD prevention.

Disclosure

On half of the CCC-GEM Project Research Consortium
Funding agencies: CCC, CIHR, and Helmsley Charitable trust

Event

UEG Week Barcelona 2026

Topics

IBD Mechanisms & Personalised Medicine Immunology Gut Microbiota Small Intestine & Nutrition

Submission format

Abstract

Session

On bugs and food: New lessons in microbiomics and dietomics in IBD

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

HIGH ADHERENCE TO THE MEDITERRANEAN DIET DELAYS SURGERY AND REPROGRAMS INTESTINAL CELLULAR STATES IN CROHN’S DISEASE

Stefania Vetrano

Treating obesity: From mechanism to personalization

Amalia Gastaldelli

Con: Neoadjuvant therapy

Hana Algül

Pro: Upfront surgery

Sanjay Pandanaboyana

DIET QUALITY AND DIVERSITY IN CHILDHOOD AND ADOLESCENCE AND LATER RISK OF INFLAMMATORY BOWEL DISEASE: A TRI-NATIONAL BIRTH COHORT STUDY

Karl Mårild

CONSUMPTION OF ULTRA-PROCESSED FOOD PROMOTE INFLAMMATORY POTENTIAL OF FECAL MICROBIOME THROUGH ALTERING THE BALANCE OF TH17 AND RORYT TREG

Williams Turpin