• Crohn’s disease
• case report
• inflammatory bowel disease
• pulmonary manifestations
• ulcerative colitis

• Bronchial diseases
• Inflammatory bowel diseases
• Multidetector computed tomography
• Pneumonia
• Tracheal diseases

• Crohn’s disease
• bronchiectasis
• causal relationship
• inflammatory bowel disease
• mendelian randomization
• ulcerative colitis

• Humans
• Genome-Wide Association Study
• Mendelian Randomization Analysis
• Reproducibility of Results
• Inflammatory Bowel Diseases/genetics
• Colitis, Ulcerative
• Crohn Disease/epidemiology
• Crohn Disease/genetics
• Bronchiectasis/epidemiology
• Bronchiectasis/genetics

• airway inflammation
• drug-induced lung injury
• inflammatory bowel disease
• lung cancer
• lung involvement
• pneumonia
• respiratory tract infections
• treatment

• alanyl-glutamine (Ala-Gln)
• colitis
• gut microbiota
• pulmonary injury
• signaling pathways

• airway disease
• interstitial pneumonia
• lung disease
• organizing pneumonia
• ulcerative colitis

• Crohn’s disease
• atopic dermatitis
• hidradenitis suppurativa
• immune-mediated inflammatory disease
• inflammatory bowel disease
• multiple sclerosis
• psoriasis
• ulcerative colitis

• Crohn Disease/complications
• Crohn Disease/surgery
• Fibrosis
• Humans
• Pulmonary Fibrosis/complications
• Pulmonary Fibrosis/surgery
• Respiratory Distress Syndrome/etiology

The prevalence of inflammatory bowel disease (IBD) has increased over the past 20 years. Pulmonary involvement in paediatric IBD is rare but may be missed since the spectrum of symptoms is broad and mimics other diseases. The most important differential diagnoses of pulmonary manifestations of IBD are infections and therapy-related side-effects. There is no gold standard to diagnose respiratory manifestations in children with IBD. Diagnostic tests should be chosen according to history and clinical presentation. Treatment of respiratory manifestations of IBD includes inhaled or oral corticosteroids and initiation or step-up of immunomodulatory IBD therapies.

Pulmonary involvement in paediatric IBD is rare but may be underdiagnosed. The spectrum of symptoms is broad and mimics other diseases. The differentiation between IBD-related and drug-induced pulmonary manifestation can be challenging.https://bit.ly/3uZBvpA

Pneumonia and diarrhea are among the leading causes of death worldwide, and epidemiological studies have demonstrated that diarrhea is associated with an increased risk of subsequent pneumonia. Our aim was to determine the impact of intestinal infection on innate immune responses in the lung.

Using a mouse model of intestinal infection by Salmonella enterica serovar Typhimurium (S. Typhimurium [ST]), we investigated associations between gastrointestinal infections and lung innate immune responses to bacterial (Klebsiella pneumoniae) challenge.

We found alterations in frequencies of innate immune cells in the lungs of intestinally infected mice compared with uninfected mice. On subsequent challenge with K. pneumoniae, we found that mice with prior intestinal infection have higher lung bacterial burden and inflammation, increased neutrophil margination, and neutrophil extracellular traps, but lower overall numbers of neutrophils, compared with mice without prior intestinal infection. Total numbers of dendritic cells, innate-like T cells, and natural killer cells were not different between mice with and without prior intestinal infection.

Together, these results suggest that intestinal infection impacts lung innate immune responses, most notably neutrophil characteristics, potentially resulting in increased susceptibility to secondary pneumonia.

• NETs
• diarrhea
• innate immunity
• neutrophils
• pneumonia

• Crohn’s disease
• Pediatric Crohn’s Disease Activity Index
• Pediatric Ulcerative Colitis Activity Index
• St. George’s Respiratory Questionnaire
• extraintestinal manifestation
• inflammatory bowel disease
• ulcerative colitis

We report a unique case of ulcerative colitis-associated bronchiectasis in a pediatric patient 6 years after colectomy. The patient presented with a chronic cough and had a computed tomography demonstrating bronchiectasis. She was treated with sputum expectoration (airway clearance) via chest physiotherapy and pulse-dose steroids with a prolonged oral taper. Her initial response was excellent; however, she experienced a recurrence of symptoms with de-escalation of airway clearance. Pulmonary extraintestinal manifestations of inflammatory bowel disease are most often diagnosed later in life. Both the severity of this patient's presentation and her age are unique to this case.

• Crohn’s disease
• bronchiolitos
• drugs: gastrointestinal system
• drugs: respiratory system
• therapeutic indications

• Bronchiectasis
• Saudi
• cystic fibrosis

Airway diseases are the most commonly described lung manifestations of inflammatory bowel disease (IBD). However, the similarities in disease pathogenesis and the sharing of important environmental risk factors and genetic susceptibility suggest that there is a complex interplay between IBD and airway diseases. Recent evidence of IBD occurrence among patients with airway diseases and the higher than estimated prevalence of subclinical airway injuries among IBD patients support the hypothesis of a two-way association. Future research efforts should be directed toward further exploration of this association, as airway diseases are highly prevalent conditions with a substantial public health impact.

• Inflammatory bowel disease
• Ulcerative colitis
• Asthma
• Chronic obstructive pulmonary disease
• Crohn's disease

• Animals
• Asthma/complications
• Colitis, Ulcerative/complications
• Crohn Disease/complications
• Environment
• Genetic Predisposition to Disease
• Humans
• Inflammation
• Inflammatory Bowel Diseases/complications
• Lung/physiopathology
• Prevalence
• Prognosis
• Pulmonary Disease, Chronic Obstructive/complications
• Respiration Disorders/complications
• Risk Factors

Crohn's disease (CD), known as the disease of gastrointestinal system, is a granulamatous systemic disorder with extraintestinal manifestations including the respiratory system. The resemblance in the embriological origins and the immunities of both organ systems' mucosae, also the circulating immune complexes and the autoantibodies are accepted as contributing factors. The shift of inflammation may become prominent when the colon is removed after colectomy and independent of the bowel disease activity; pulmonary involvement may be exarbecated. In the pediatric population, CD associated pulmonary involvement is very rare, mainly in the form of subclinical alterations and the data are limited mostly to case reports. Therefore, it is possibly overlooked since the diagnosis relies on suspicion. We represent a 5-year-old CD patient with previous bronchiolitis episodes that might have resulted from CD-associated pulmonary involvement; whom later developed severe pneumonia resulting in acute respiratory distress syndrome and bronchiectasia following a colectomy operation.

• Acute respiratory distress syndrome
• Crohn
• colectomy
• infliximab
• pulmonary

• Extraintestinal manifestations
• Inflammatory bowel disease
• Multiple organ systems

AIM: To investigate the protective effect of compound dracorhodin enema on the lung and intestine of mice with distal ulcerative colitis (UC).

METHODS: Sixty male BALB/c mice were randomly divided into four groups (n = 15 each): a normal group, a dextran sulfate sodium (DSS) group, a compound dracorhodin enema group, and a DSS + compound dracorhodin enema group. After inducing UC, the normal group and DSS group were given 1 mL saline, and the other two groups were given compound dracorhodin enema [0.075 g/(kg•d), 1 mL] by gavage. After treatment, disease activity index (DAI) score, colonic histopathology score (HI), lung HI score, and hematoxylin-eosin (HE) staining were used to evaluate the severity of inflammation. Enzyme-linked immunosorbent assay (ELISA), immunohistochemistry, and real-time quantitative PCR (RT-QPCR) assay were used to detect the expression of interleukin (IL)-6 in the lung and colon.

RESULTS: Compared with the normal group and compound dracorhodin enema group, DAI score, colonic HI score, and lung HI score were significantly higher in the other two groups (P < 0.05). Compared with the DSS + compound dracorhodin enema group, colonic and pulmonary tissue inflammation was significantly more severe and pulmonary and colonic expression of IL-6 was significantly higher in the DSS group (P < 0.05).

CONCLUSION: Compound dracorhodin enema can decrease the expression of IL-6 and therefore alleviate UC and UC related lung injury in mice.

• Compound dracorhodin
• Ulcerative colitis
• Inflammatory factor
• Interleukin-6
• Lung

Systemic involvement is well known in patients with inflammatory bowel diseases (IBD), but there are only few data looking to Crohn’s disease (CD) and ulcerative colitis (UC) separately instead of lumping together both entities to IBD. The frequency of bronchial involvement in UC is not yet exactly analysed but reported to be rare. We asked 100 patients with UC for bronchial complaints, and found in 13 patients a bronchial affection. From reports in the literature it is known that sometimes a bronchial involvement in patients with UC can affect the whole bronchial tree including small bronchi. The involvement of bronchial system in UC is obviously more prominent than previously thought and may fulfil the criteria for a separate syndrome. These relations may have consequences for pathogenetic understanding of UC as well as bronchitis and also consequences for treatment regimes.

• Crohn’s disease
• bronchiectasis
• bronchitis
• inflammatory bowel disease
• ulcerative colitis

Extraintestinal manifestations occur commonly in inflammatory bowel diseases (IBD). Pulmonary manifestations (PM) of IBD may be divided in airway disorders, interstitial lung disorders, serositis, pulmonary vasculitis, necrobiotic nodules, drug-induced lung disease, thromboembolic lung disease and enteropulmonary fistulas. Pulmonary involvement may often be asymptomatic and detected solely on the basis of abnormal screening tests. The common embryonic origin of the intestine and the lungs from the primitive foregut, the co-existence of mucosa associated lymphoid tissue in both organs, autoimmunity, smoking and bacterial translocation from the colon to the lungs may all be involved in the pathogenesis of PM in IBD. PM are mainly detected by pulmonary function tests and high-resolution computed tomography. This review will focus on the involvement of the airways in the context of IBD, especially stenoses of the large airways, tracheobronchitis, bronchiectasis, bronchitis, mucoid impaction, bronchial granulomas, bronchiolitis, bronchiolitis obliterans syndrome and the co-existence of IBD with asthma, chronic obstructive pulmonary disease, sarcoidosis and a1-antitrypsin deficiency.

• Inflammatory bowel diseases
• Airways
• Bronchiolitis

Crohn’s disease (CD) is a systemic illness with a constellation of extraintestinal manifestations affecting various organs. Of these extraintestinal manifestations of CD, those involving the lung are relatively rare. However, there is a wide array of lung manifestations, ranging from subclinical alterations, airway diseases and lung parenchymal diseases to pleural diseases and drug-related diseases. The most frequent manifestation is bronchial inflammation and suppuration with or without bronchiectasis. Bronchoalveolar lavage findings show an increased percentage of neutrophils. Drug-related pulmonary abnormalities include disorders which are directly induced by sulfasalazine, mesalamine and methotrexate, and opportunistic lung infections due to immunosuppressive treatment. In most patients, the development of pulmonary disease parallels that of intestinal disease activity. Although infrequent, clinicians dealing with CD must be aware of these, sometimes life-threatening, conditions to avoid further impairment of health status and to alleviate patient symptoms by prompt recognition and treatment. The treatment of CD-related respiratory disorders depends on the specific pattern of involvement, and in most patients, steroids are required in the initial management.

• Crohn’s disease
• Inflammatory bowel disease
• Lung
• Extracolonic involvement

• Anti-Inflammatory Agents/adverse effects
• Crohn Disease/complications
• Crohn Disease/diagnosis
• Crohn Disease/drug therapy
• Gastrointestinal Agents/adverse effects
• Humans
• Lung Diseases/diagnosis
• Lung Diseases/etiology
• Lung Diseases/therapy
• Risk Factors
• Severity of Illness Index
• Treatment Outcome

• Alpha-1-antitrypsin deficiency
• Hypothyroidism
• Inflammatory bowel disease
• Neutrophilic inflammation

Background. To investigate the link and mechanisms between intestine and lung in the ulcerative colitis (UC) rat model. Materials and Methods. We used the UC rat model by immunological sensitization combined with local 2, 4, 6-trinitrobenzene sulfonic acid (TNBS) in 50% ethanol enema, observed dynamically animal general state and body weight, examined the histological and functional changes in the colon, lung, liver, and kidney tissues, and detected microvascular endothelium response towards inflammation characterized with the expression of iNOS, TXB₂, P-selectin, ICAM-1, and vascular endothelial growth factor A (VEGF-A) in the colon and lung tissue. Results. Pulmonary function results suggested ventilator disorder, and pathological findings showed interstitial pneumonia. There were no significant changes in the liver and kidney function and histopathology. The colon and lung tissue iNOS, TXB₂, P-selectin, ICAM-1, and VEGF-A expression of the model rats was significantly higher than the normal rats at both time points. Conclusions. Our study is the first to demonstrate the close association between the large intestine and lung in the immune-TNBS-ethanol-induced UC rat model. Different organs and tissues with the same embryonic origin may share the same pathological specificities in a disease. The present study provided a new way of thinking for pathological changes in clinical complex diseases manifested with multiorgan damage.

Crohn’s disease is a granulomatous systemic disorder of unknown etiology. Obvious pulmonary involvement is exceptional. Tracheal involvement in Crohn’s disease is even more unusual, only a few cases have been reported to date. We herein report a rare case of tracheobronchial nodules and pulmonary infiltrates in both lungs as a complication of Crohn’s disease. A 42-year-old man underwent pancolectomy for multiple broken colon caused by Crohn’s disease. Forty days later pulmonary symptoms and radiologic abnormalities were noted. A search for bacterial (including mycobacteria) and fungal in the repeated sputum proved negative. The treatment consisted of intravenous antimicrobials for one month, but there was no improvement in pyrexia or cough and radiologic abnormalities. Fibreoptic bronchoscopy (FOB) was performed and revealed nodes in the trachea and the right upper lobe opening. Histopathology of tracheobronchial nodules and bronchial mucosa biopsy specimen both showed granulomatous inflammation with proliferation of capillaries and inflammatory cells. Oral steroid and salicylazosulfapyridine were commenced and led to marked improvement in symptoms and an almost complete resolution of his chest radiograph. Repeated FOB showed that nodes in the trachea disappeared and the ones in the right upper lobe opening diminished obviously. Crohn’s disease can be associated with several respiratory manifestations. The form of tracheal and bronchopulmonary involvement in Crohn’s disease is rare and responded well to steroids.

• Crohn’s disease
• Inflammatory bowel disease
• Lung
• Extracolonic involvement

Inflammatory bowel diseases (IBD) include ulcerative colitis (UC) and Crohn's disease (CD) and are due to a dysregulation of the antimicrobial defense normally provided by the intestinal mucosa. This inflammatory process may extend outside the bowel to many organs and also to the respiratory tract. The respiratory involvement in IBD may be completely asymptomatic and detected only at lung function assessment, or it may present as bronchial disease or lung parenchymal alterations. Corticosteroids, both systemic and aerosolized, are the mainstay of the therapeutical approach, while antibiotics must be also administered in the case of infectious and suppurative processes, whose sequels sometimes require surgical intervention. The relatively high incidence of bronchopulmonary complications in IBD suggests the need for a careful investigation of these patients in order to detect a possible respiratory involvement, even when they are asymptomatic.

• Crohn Disease/complications
• Crohn Disease/psychology
• Eye Diseases/etiology
• Humans
• Lung Diseases/etiology
• Mental Disorders/etiology
• Musculoskeletal Diseases/etiology
• Quality of Life
• Skin Diseases/etiology