Evidence map›Paper›PMID 29644517›Full record

Observational studyDigestive diseases and sciences2018

Systemic Inflammatory Responses in Ulcerative Colitis Patients and Clostridium difficile Infection.

Julajak Limsrivilai, Krishna Rao, Ryan W Stidham, Shail M Govani, Akbar K Waljee, Andrew Reinink, Laura Johnson, Emily Briggs, Peter D R Higgins

Open access · greenAbstract readComparative StudyObservational Study
In one paragraph

Observational study in Digestive diseases and sciences, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Julajak LimsrivilaiDivision of Gastroenterology, Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Krishna RaoDivision of Gastroenterology, Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Ryan W StidhamDivision of Gastroenterology, Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Shail M GovaniDivision of Gastroenterology, Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Akbar K WaljeeDivision of Gastroenterology, Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Andrew ReininkGastroenterology, Veterans Affairs Medical Center, Minneapolis, MN, USA.
Laura JohnsonDivision of Gastroenterology, Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Emily BriggsDivision of Gastroenterology, Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Peter D R HigginsDivision of Gastroenterology, Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA. phiggins@med.umich.edu.
Michigan Medicine · USVA Center for Clinical Management Research · USSiriraj Hospital · THVeterans Health Administration · US

Funding

Michigan Institute for Clinical and Health Research (MICHR)UL1TR002240 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LUMENG, JULIE C, MASHOUR, GEORGE ALEXANDER · 2017 to 2022
$54.9M
Michigan Institute for Clinical and Health Research (MCHR)UL1TR000433 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MASHOUR, GEORGE ALEXANDER · 2012 to 2016
$49.9M
Research Education CoreP30AG024824 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Neil Alexander · 2004 to 2026
$29.2M
Nonlinear Ultrasound: an Imaging Biomarker of Intestinal Fibrosis in Crohn's DiseaseR01DK109032 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DILLMAN, JONATHAN RUSSELL, HIGGINS, PETER D.R. · 2016 to 2019
$2.4M
Application of Machine Learning Algorithms to Thiopurine Monitoring in IBDR01GM097117 · NIGMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HIGGINS, PETER D.R. · 2012 to 2016
$1.9M
Improving Prediction of Medical Responsiveness and Clinical Outcomes in Crohn's DiseaseK23DK101687 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI STIDHAM, RYAN WILLIAM · 2015 to 2019
$945k
In vivo photoacoustic biopsy for intestinal strictures in Crohn's diseaseR21AI122098 · NIAID · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HIGGINS, PETER D.R., XU, GUAN · 2016 to 2017
$397k
NCATS NIH HHS UL1 TR000433NCATS NIH HHS UL1 TR002240NIAID NIH HHS R21 AI122098NIA NIH HHS P30 AG024824NIDDK NIH HHS K23 DK101687NIDDK NIH HHS R01 DK109032NIGMS NIH HHS R01 GM097117
6 · The paper itself

Abstract

BACKGROUND/

aimsFinding differences in systemic inflammatory response in ulcerative colitis (UC), UC with Clostridium difficile infection (CDI), and CDI could lead to a better ability to differentiate between UC with symptomatic CDI and UC with C. difficile colonization, and could identify specific inflammatory pathways for UC or CDI, which could be therapeutic targets.

methodsWe prospectively collected sera from symptomatic UC patients whose stools were tested for toxigenic C. difficile, and from CDI patients who did not have UC (CDI-noUC). The UC patients with positive tests (UC-CDI) were further categorized into responders to CDI treatment (UC-CDI-R) and non-responders (UC-CDI-NR). We compared serum inflammatory mediators among groups using unadjusted and adjusted multivariable statistics.

resultsWe included 117 UC [27 UC-CDI, 90 UC without CDI (UC-noCDI)] and 16 CDI-noUC patients. Principal component analysis (PCA) did not reveal significant differences either between UC-CDI and UC-noCDI groups, or between UC-CDI-R and UC-CDI-NR groups. In contrast, the PCA showed significant separation between the UC and CDI-noUC groups (P = 0.002). In these two groups, hepatocyte growth factor (HGF) and chemokine (C-C motif) ligand 2 (CCL2) levels were significantly lower and IL-23 levels were higher in UC patients in multivariable analyses. The model to distinguish UC from CDI including IL-23, HGF, CCL2, age, gender, and HGB had an AuROC of 0.93.

conclusionInflammatory profiles could not distinguish UC-CDI from UC-noCDI, and UC-CDI-R from UC-CDI-NR. However, the UC and CDI-noUC groups were significantly different. Future work should examine whether therapeutic agents inhibiting IL-23 or stimulating HGF can treat UC.

Indexed as

AdultAgedAge FactorsAnti-Bacterial AgentsArea Under CurveBiomarkersChemokine CCL2Clostridioides difficileClostridium InfectionsColitis, UlcerativeDiagnosis, DifferentialFemaleHepatocyte Growth FactorHumansImmunosuppressive AgentsInflammation MediatorsAnti-Bacterial AgentsBiomarkersCCL2 protein, humanChemokine CCL2Hepatocyte Growth FactorHGF protein, humanImmunosuppressive AgentsInflammation MediatorsInterleukin-23ChemokineClostridium difficileCytokineGrowth factorInflammatory biomarkerUlcerative colitis

Identifiers

PMID29644517
PMCPMC6015554
OpenAlexW2796706744

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.