Browsing by Author "Hernández Rocha, Cristian Antonio"

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    After surgically induced remission, ileal and colonic mucosa-associated microbiota predicts Crohn’s disease recurrence
    (2024) Hernández Rocha, Cristian Antonio; Turpin, Williams; Borowski, Krzysztof; Stempak, Joanne M.; Sabic, Ksenija; Gettler, Kyle; Tastad, Christopher; Chasteau, Colleen; Korie, Ujunwa; Hanna, Mary; Khan, Abdul; Mengesha, Emebet; Bitton, Alain; Schwartz, Marc B.; Barrie, Arthur; Datta, Lisa W.; Lazarev, Mark; Brant, Steven R.; Rioux, John D.; McGovern, Dermot P.B.; Duerr, Richard H.; Schumm L., Phil; Cho, Judy H.; Silverberg, Mark S.
    Background and aims. Investigating the tissue-associated microbiota after surgically induced remission may help to understand the mechanisms initiating intestinal inflammation in Crohn’s disease. Methods: Crohn’s disease patients undergoing ileocolic resection were prospectively recruited in six academic centers. Biopsy samples from the neoterminal ileum, colon and rectosigmoid were obtained from colonoscopies performed after surgery. Microbial DNA was extracted for rRNA gene sequencing. Microbial diversity and taxonomic differential relative abundance were analyzed. A random forest model was applied to analyze the performance of clinical and microbial features to predict recurrence. A Rutgeerts score ≥i2 was deemed as endoscopic recurrence. Results: A total of 349 postoperative colonoscopies and 944 biopsy samples from 262 Crohn’s disease patients were analyzed. Ileal inflammation accounted for most of the explained variance of the ileal and colonic mucosa-associated microbiota. Samples obtained from 97 patients who were in surgically induced remission at first postoperative colonoscopy who went on to develop endoscopic recurrence at second colonoscopy showed lower diversity and microbial deviations when compared to patients who remained in endoscopic remission. Depletion of genus Anaerostipes and increase of several genera from class Gammaproteobacteria at the three biopsy sites increase the risk of further recurrence. Gut microbiome was able to predict future recurrence better than clinical features. Conclusion: Ileal and colonic mucosa-associated microbiome deviations precede development of new onset ileal inflammation after surgically induced remission and show good predictive performance for future recurrence. These findings suggest that targeted microbial modulation is a plausible modality to prevent postoperative Crohn’s disease recurrence.
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    Experiencia de educación continua en línea en gastroenterología para médicos no especialistas
    (2019) Isbej Esposito, Lorena Pilar; Uribe Monasterio, Javier Andrés; Carrasco, Olga; Villarroel, Isaac; Pizarro Rojas, Margarita Alicia; Jirón, María Isabel; Sanhueza, Edgar; Álvarez Lobos, Manuel; Hernández Rocha, Cristian Antonio; Rollán, Antonio; Monsalve Valenzuela, Ximena Bernardita; Díaz Piga, Luis Antonio; Cerda, María Alejandra; Kramer, Tomás; Munizaga, Fernando; Riquelme Pérez, Arnoldo
    Background: Continuing education is essential for health professions and online courses can be a good way for professional development. Aim: To describe the experience with online courses for continuing education in hepatology and gastroenterology and to analyze their educational impact. Material and Methods: A three years’ experience in courses on liver diseases and digestive tract is described. Their curricular design, methodology, and the educational impact was analyzed using the four levels of the Kirkpatrick’s model. Results: On average, there were 321 students per course (2015-2017). 94% were Chilean and 6% from abroad (20 countries). In the educational impact analysis, in level 1 “reaction”: 93% said that the course fulfilled their expectations and 92% would recommend it. In level 2 “learning”: 42% approved the courses. Level 3 “behavior” was not evaluated and level 4 “organizational change” highlighted that the traditional face-to-face continuing education model of Chilean Gastroenterology Society (SChG) changed to full distance model in these three courses, with 1284 students from South America, Asia and Europe, in a 3-years-period. Additionally, these programs were included in the Medical Society of Santiago (SMS) continuing education agenda. Conclusions: The alliance between the SMS and the SChG generated on line courses that meet the educational needs of physicians and medical students, with excellent results and student perception.
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    Impact of Amerindian ancestry on clinical outcomes in Crohn’s disease and ulcerative colitis in a Latino population
    (2025) Pérez Jeldres, Tamara De Lourdes; Bustamante, María Leonor; Álvares, Danilo; Álvarez Lobos, Manuel Marcelo; Kalmer, Lajos; Azócar López, Lorena Karina; Segovia Melero, Roberto; Ascui, Gabriel; Aguilar, Nataly; Estela, Ricardo; Hernández Rocha, Cristian Antonio; Candia Balboa, Roberto Andrés; González, Mauricio; Silva, Verónica; De La Vega, Andrés; Arriagada, Elizabeth; Serrano, Carolina A.; Pávez Ovalle, Carolina Denisse; Quinteros Moraga, Carol; Miquel Poblete, Juan Francisco; Alex, Di Genova
    Research in Inflammatory Bowel Disease (IBD) assessing the genetic structure and its association with IBD phenotypes is needed, especially in IBD-underrepresented populations such as the South American IBD population. Aim. We examine the correlation between Amerindian ancestry and IBD phenotypes within a South American cohort and investigate the association between previously identified IBD risk variants and phenotypes. We assessed the ancestral structure (IBD = 291, Controls = 51) to examine the association between Amerindian ancestry (AMR) and IBD variables. Additionally, we analyzed the influence of known IBD genetic risk factors on disease outcomes. We used Chi-square and Fisher’s tests to analyze the relationship between phenotypes and ancestry proportions, calculating odds ratios (OR) and confidence intervals (CI). Logistic regression examined genetic variants associations with IBD outcomes, and classification models for predicting prolonged remission were developed using decision tree and random forest techniques. The median distribution of global ancestry was 58% European, 39% Amerindian, and 3% African. There were no significant differences in IBD risk based on ancestry proportion between cases and controls. In Ulcerative colitis (UC), patients with a high Amerindian Ancestry Proportion (HAAP) were significantly linked to increased chances of resective surgery (OR = 4.27, CI = 1.41–12.94, p = 0.01), pouch formation (OR = 7.47, CI = 1.86–30.1, p = 0.003), and IBD reactivation during COVID-19 infection (OR = 5.16, CI = 1.61–6.53, p = 0.005). Whereas, in the Crohn’s Disease (CD) group, the median Amerindian ancestry proportion was lower in the group with perianal disease (33.5% versus 39.5%, P value = 0.03). CD patients with High Amerindian Ancestry proportion had lower risk for surgery (OR = 0.17, CI = 0.03–0.83, P value = 0.02). Our study highlights the impact of Amerindian ancestry on IBD phenotypes, suggesting a role for genetic and ancestral factors in disease phenotype. Further investigation is needed to unravel the underlying mechanisms driving these associations.