Despite the similarity of many pathogenetic lesions of the gastrointestinal tract and the oral cavity, there remain unresolved issues related to the etiology and pathogenesis of dental diseases associated with inflammatory bowel diseases.Aim. Analysis and systematization of literature data on the problem of combined diseases of the oral cavity and the gastrointestinal tract.Key findings. Severe recurrent inflammatory bowel disease and the close relationship of all levels of the digestive tube create prerequisites for the development of pathological processes in the oral cavity. Despite the extensive symptoms of oral manifestations of inflammatory bowel disease, aphthous stomatitis is considered more often than other diseases. There are different opinions about the involvement of the oral mucosa in the pathological process in inflammatory bowel disease. Some authors consider the defeat of the mouth in terms of the specific localization of Crohn’s disease, others see in it only extraintestinal manifestations of the disease, along with changes in the skin, joints and eyes. Immunohistochemical studies allow you to answer individual questions of pathogenesis.Conclusion. The presented analysis of publications confirms the morphofunctional unity of various parts of the digestive system, which determines the complex mechanisms of the development of combined diseases.

Anemia is a frequent systemic complication and extra-intestinal manifestation of inflammatory bowel diseases (IBD). Despite significant progress in IBD treatment, late diagnosis and insufficient correction of concomitant anemia remain a problem in routine clinical practice. The review describes the main pathophysiological mechanisms of IBD-associated anemia, such as iron deficiency, chronic inflammation (anemia of chronic disease) and B₉ and B₁₂ deficiencies. The authors highlight the main diagnostic principles of these conditions, present the strategy for their differential diagnosis, describe the state-of-theart approaches to the correction of iron-deficient anemia in IBD, and delineate the role of oral and parenteral medications for replacement therapy. Optimal treatment goals and prevention methods of an iron-deficient condition are given. Special attention is focused on the principles on red cell mass transfusions in acute massive blood loss. The authors describe the main differentiating features of anemia of chronic disease and its treatment in IBD patients with various grades of the inflammation. The paper contains the indications and treatment regimens for B₁₂ and foliate-deficient anemia with consideration of the IBD course. The authors of the article are members of the Working Group of the Russian Society on the study of IBD and believe that the literature analysis performed would allow for its use to issue the Russian clinical guidelines on the management of patients with anemia in ulcerative colitis and Crohn's disease.

Inflammatory bowel diseases (IBD) and acute graft-versus-host disease (GVHD) are associated with persistent intestinal dysfunction preceded by gut bacterial dysbiosis. There are limited data on intestinal bacteriophages in these conditions. The aim of the present work was to detect associations between dominant intestinal bacteria by means of 16S rRNA gene sequencing, and some clinically significant viruses detected with a customized primer panel for NGS-based study. The clinical group included patients with Crohn’s disease (IBD, n = 9), or GVHD (n = 6) subjected to fecal microbiota transplantation (FMT) from healthy donors. The stool specimens were taken initially, and 5 times post-FMT until day 120. Using NGS approach, we have found a higher abundance of Proteobacterota phylum in GVHD, especially, at later terms post-FMT. Moreover, we found an early increase of Klebsiella and E. coli/Shigella abundance in GVHD, along with decreased relative content of Faecalibacterium. Upon evaluation of intestinal phageome, the relative amount of Caudoviricetes class was higher in GVHD. A significant correlation was found between Proteobacteria and Caudoviricetes, thus suggesting their association during the post-FMT period. Moreover, the relative amounts of five Caudoviricetes phage species showed distinct correlations with Klebsiella and Enterococcus ratios at different terms of FMT. In conclusion, parallel use of 16S rRNA gene sequencing and targeted NGS viral panel is a feasible and useful option for tracing specific viral strains in fecal microbiota. The developed array of viral primers may be extended to detect other phages infecting the clinically relevant bacteria.

The literature review presents the current status of the method of high-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation in the treatment of Crohn’s disease.In recent decades, there has been an increase in Crohn’s disease. The frequency of CD the response rate to biopreparations ranges from 20 to 50%, up to 80% of patients need surgical treatment. Due to the insufficient effectiveness of therapy, an active research is underway for new therapeutic opportunities, one of which is the method of HDIT-AHSCT. In the Russian Federation, there are data on the use of mesenchymal stem cells for the treatment of CD, there are no studies on the use of HDIT-AHSCT in IBD. According to the EBMT register in the period from 1994 to 2023. more than 4000 HDIT-AHSCT were performed in patients with autoimmune diseases, the proportion of CD was 6.13% of all protocols. The HDIT-AHSCT procedure consists of the following stages: mobilization of autologous HSCs, apheresis and cryopreservation of HSCs, immunoablative conditioning and infusion of HSCs. Most of the publications on the use of HDIT-AHSCT in CD were not universal in the selection and management of patients. Currently, there is the only one completed RCT on the use of HDIT-AHSCT in CD, the results of which have not received a definite outcome. However, for a cohort of patients with refractory CD, it is necessary to consider the possibility of using this method. The review presents the indications and selection criteria for the HDIT-AHSCT protocol. Further studies of the HDIT-AHSCT in CD will help expand the therapeutic opportunities of treating patients with refractory CD to standard and biological therapy.

The Russian Cross-disciplinary Consensus on the diagnositic and treatment of spondyloarthritis (SpA) in inflammatory bowel diseases (IBD) was prepared on the initiative of the Loginov Moscow Clinical Scientific Center, using the Delphic system. Its purpose was to consolidate the opinions of experts on the most actual issues of diagnosis and treatment of concomitant immuno-inflammatory diseases (SpA and IBD). An interdisciplinary approach is provided by the participation of leading gastroenterologists and rheumatologists. The working group analyzed domestic and foreign publications on the problem of curation of patients with SpA and IBD. There have been 17 statements and 2 treatment algorithms formulated. Statements 1–3 reflect the fundamental principles of management of patients with SpA and IBD. The principles of early diagnosis of SpA and IBD, including the diagnosis of complications of therapy, are described below. Eleven statements are devoted to current methods of treatment, on the basis of which 2 treatment algorithms have been developed. The statements of the Consensus were submitted to the Expert Council for consideration, edits were made, after which an online vote took place. This paper presents current recommendations for the management, diagnosis and treatment of patients with SpA and IBD.

Intestinal bacterial dysbiosis develops in a number of immune-mediated disorders. Fecal microbiota transfer (FMT) is considered a potentially efficient tool for restoration of the patient’s gut microbiota. The aim of our study was to trace the time course of dominant bacterial populations and some Enterobacteria phages in patients with GVHD and Crohn’s disease after FMT procedure. Patients and methods: We observed 12 patients with intestinal graft-versus-host disease (GVHD), and 15 persons with Crohn’s disease after massive anti-infectious treatment. FMT was performed by a standard protocol using oral capsules administered for 2 days. Fecal bacteriome was assessed by 16S rRNA sequencing. Viral sequences were identified by NGS with a customized primer set. Plasma citrulline levels were measured in order to assess enterocyte damage in the patients. Results: Complete clinical response to FMT was observed in 5 of 12 GVHD patients and 10 of 15 Crohn’s disease cases. Before FMT, most anaerobic Bacillota were exhausted in both Crohn’s disease patients and GVHD. Following FMT, Akkermansia ratios tended to decrease within 30 days in Crohn’s disease, along with higher Faecalibacteria, Romboutsia, and Dialister ratios than in GVHD, thus suggesting lesser damage to anaerobic microbiota in Crohn’s disease. Increased contents of facultative anaerobes (Enterococcus and E. coli) was detected in GVHD patients after FMT. Fecal virome changes in Crohn’s disease after FMT included early transient decrease in Caudoviricetes with a rise in Lederbergvirus and Eganvirus ratios at later terms. In GVHD patients, reverse correlations were revealed between E. coli and E. coli-hosted Eganvirus species. Intestinal damage assessed by low plasma citrulline levels was associated with fecal Klebsiella expansion, being more pronounced in GVHD than in Crohn’s disease. Clinical response to FMT in GVHD patients correlated with increased plasma citrulline and lower Eganvirus abundance. Future studies will concern specific relations between fecal bacteriome and virome reconstitution following FMT in gut GVHD and other immune-mediated intestinal disorders.