GI articles
From Wednesday Dec 22 2021 to Saturday Jan 01 2022
This issue includes 290 articles. Please be mindful of the authors and publishers copyright while sharing the content.
Guidelines
| Endoscopy |
Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Strong recommendation, low quality evidence. 8: ESGE suggests that endoscopic ultrasound-directed transgastric ERCP (EDGE) can be offered, in expert centers, to patients with a Roux-en-Y gastric bypass following multidisciplinary decision-making, with the aim of overcoming the invasiveness of laparoscopy-assisted ERCP and the limitations of enteroscopy-assisted ERCP. Weak recommendation, low quality evidence. |
Meta-analysis
meta-analyses and systematic reviews
| Clin Gastroenterol Hepatol |
| Gastroenterology |
There is a substantial delay in the diagnosis of PEUGIC. They are less likely to present with alarm symptoms than detected cancers. PEUGIC are overall less advanced at diagnosis. The majority with PEUGIC have abnormalities reported at the preceding "cancer negative" EGD. The epidemiology of PEUGIC may inform preventive strategy. |
| Gastrointest Endosc |
The role of small-bowel studies in the early evaluation of OGIB is unquestionable, impacting diagnosis, therapeutic and prognosis. Comparative studies are still needed to identify the best timings. |
| Gut |
In a network meta-analysis, upadacitinib 45 mg once daily ranked first for clinical remission in al patients, patients naïve to anti-TNF-α drugs and patients previously exposed. Infliximab 10 mg/kg ranked first for endoscopic improvement. Most drugs were safe and well tolerated. |
| Hepatology |
Risk of HBV reactivation during therapies for HCC: A systematic review. Liver decompensation and death were rarely reported (0%-3%) and only in patients receiving HCC treatment with high HBV reactivation risk. HBsAg-positive patients with HCC are at high or intermediate risk of HBV reactivation depending on the type of HCC therapy. Nucleos(t)ide analogue prophylaxis reduces the risk of HBV reactivation, practically eliminates the risk of hepatitis flare, and should be administered regardless of HCC treatment. |
| Inflamm Bowel Dis |
We highlighted that, overall, colonic CD resembles UC and is distinct from ileal CD, which is in turn closer to pouchitis. We demonstrated that ileal and colonic diseases exhibit specific signatures, independent of their initial clinical classification. This supports molecular, rather than clinical, disease stratification, and may be used to design drugs specifically targeting ileal or colonic diseases. |
The present systematic review indicated that patients with MC may be associated with a lower risk of colorectal adenoma or cancer. The clinical data support the current professional society guideline. A surveillance colonoscopy program is not recommended as standard for patients with MC. |
| J Crohns Colitis |
We provide an illustrative summary of the clinical presentation and treatment effectiveness of this rare, under-recognised condition, and a proposed algorithm for approach and management. Prospective studies with longer follow-up are required to define optimal treatment strategies. |
Evidence on ERAS in IBD is lacking, but this group of patients might benefit from consistent adoption of the pathway. Future studies should define if IBD-specific ERAS pathways and selection criteria are needed. |
| Neurogastroenterol Motil |
Post-operative anorectal manometry in children with Hirschsprung disease: A systematic review. This systematic review demonstrated the lack of high-quality evidence underlying the current understanding of post-operative anorectal motility in children with HD. There was little consistency in reported manometry outcomes between studies. In future work, emphasis must be placed on the application of standardized manometry protocols, cohort reporting, and patient outcome assessments. |
Open access
0articles are open access at time of publication, full text is typically available in PMC (link provided). Moreover, many of the guidelines, editorials and case reports are also open access through the provided publisher link.
Studies
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
The lifetime risk of IBD was about 2.5% for both sexes. In Sweden, the incidence of IBD in al subtypes increased in 1990-2001 but has since declined. One in 40 individuals is expected to be diagnosed with IBD during their lifetime. |
Ustekinumab was effective and well tolerated in this real-world cohort. While ustekinumab proved more effective at 14-weeks, we found no statistically significant differences at 52 weeks compared to vedolizumab. |
In this real-world cohort, ATI as low as 23 ng/mL impacted drug clearance. Our data suggest that dose optimisation for low-level ATI can improve infliximab clearance and prevent loss of response. |
We observed no increase in risk for COVID-19 amongst patients with IBD or risk for de novo IBD after COVID-19 infection. We confirmed prior observations regarding the impact of steroid use on COVID-19 severity in patients with IBD. |
In multivariable analysis, the adjusted hazard ratios (aHR) (95% confidence interval [CI]) for HCC, decompensation, MACE, extrahepatic cancer and mortality were 1.28 (1.2-1.4), 1.34 (1.3-1.4), 0.96 (0.9-1.1), 1.00 (0.9-1.1) and 1.17 (1.1-1.2), respectively, with each 1-kPa increase in liver stiffness. Similarly, the aHR (95% CI) for HCC, decompensation, MACE, extrahepatic cancer and mortality were 4.20 (2.2-8.2), 67.5 (9.2-492), 0.83 (0.4-1.7), 0.90 (0.5-1.7) and 2.90 (1.6-5.4), respectively, in patients with cirrhosis (>4.7 kPa) compared to those with minimal fibrosis (<3 kPa). Increased MRE-associated liver stiffness was associated with increased risk for HCC, decompensation and mortality in a dose-dependent fashion but not with MACE or extrahepatic cancer, implicating a significant role for MRE in liver-related events and mortality; however, further studies are warranted to explore its role in MACE and extrahepatic cancer. |
Review article: current and future treatment approaches for IBS with constipation. A brief discussion of agents in development with novel mechanisms of action is also provided. Quality of life and symptom metrics should be standardized and continue to be represented in future IBS-C trials. The choice of agent should be tailored to probability of improving symptoms, safety, tolerability, and cost. |
The treatment of IBS-D/M ideally involves a multidisciplinary approach of primary care, gastroenterologist and psychologist. Treatment often involves both non-pharmacological and pharmacological therapies. Future therapies may include faecal microbial transplant, Crofelemer and serotonin antagonists, but further studies are needed. |
Review article: current and future treatment approaches for pain in IBS. A plethora of molecular targets and ligands are emerging from pre-clinical studies, together with early clinical evidence for a range of pharmacological, dietary, neurostimulation and novel psychological treatment delivery methods which are reviewed. The history of such emerging approaches, however, merits both caution and optimism in equal measure. Despite good in-roads and emerging options, the management of abdominal pain remains one of the biggest challenges and research priorities for patients with IBS. |
Review article: Diagnosis and investigation of irritable bowel syndrome. Testing for bile acid diarrhoea should be considered for patients with IBS with diarrhoea where available. Hydrogen breath tests for lactose malabsorption or small intestinal bacterial overgrowth have no role in the routine assessment of suspected IBS. Adopting a standardised approach to the diagnosis and investigation of IBS will help to promote high-quality and high-value care for patients overall. |
Review article: epidemiology of IBS and other bowel disorders of gut-brain interaction (DGBI). When the results of multiple studies, conducted over a long period of time, using different diagnostic criteria and different research methodology, and involving different study populations are pooled to determine a single summary prevalence rate it is difficult to interpret the results and to determine their reliability and significance. This pitfall is insufficiently recognised and unfortunate because prevalence rates are important for understanding the burden of disease, for allocating healthcare and research resources, and for incentivising and prioritising new treatments. The aims of the present paper are to highlight our knowledge and understanding of IBS epidemiology within the context of other DGBI, and to present strategies to improve epidemiological research, especially in advance of the new Rome V criteria, to be published in 2026. |
It is of clinical importance to recognise the substantial overlap of IBS symptoms with other gastrointestinal syndromes including gastro-oesophageal reflux disease. This is important to ensure the correct clinical diagnosis of IBS is made and patients are not over investigated. Knowledge of the natural history, stability of subgroups and overlap of IBS with other gastrointestinal conditions should be considered in therapeutic decision making. |
Review article: Physical and psychological comorbidities associated with irritable bowel syndrome. The common extraintestinal comorbidities associated with IBS include anxiety, depression, somatisation, fibromyalgia, chronic fatigue syndrome, chronic pelvic pain, interstitial cystitis, sexual dysfunction and sleep disturbance. The presence of comorbidity in IBS poses a diagnostic and therapeutic challenge with patients frequently undergoing unnecessary investigations and interventions, including surgery. This review discusses the different physical and psychological comorbidities associated with IBS, the shared pathophysiological mechanisms and potential management strategies. |
Effectively communicating the rationale of the brain-gut axis, as well as treatments such as the benefits of neuromodulators or behavioral health treatments can improve patient satisfaction and clinical outcomes. The author concluded that effective patient education can improve the patient-provider relationship and health outcomes. The author also provides info-graphics and a listing of vetted, scientifically backed educational resources for patients to utilize for self management. |
Ustekinumab levels in pregnant women with inflammatory bowel disease and infants exposed in utero. Median time of infant ustekinumab clearance was 9 (range 6-19) weeks (n = 9). Ustekinumab drug levels appear stable in pregnancy, with a delivery infant:maternal ratio similar to that of anti-TNFs. Infant ustekinumab clearance was complete by 20 weeks post-partum, however, infants exposed in utero should avoid live vaccination before 12 months of age until further clearance data are obtained. |
| Am J Gastroenterol |
The left lateral decubitus position is associated with significantly shorter nocturnal esophageal acid exposure time and faster esophageal acid clearance compared with the supine and right lateral decubitus positions (see visual abstract). |
We developed parsimonious models (grade and stage) to predict presence of LPF in esophageal biopsies with inadequate lamina propria and validated our grade model. Our predictive models can be easily used in the clinical setting to include LPF in clinical decisions and determine its effect on treatment outcomes. |
Hepatitis B Virus Infection and Extra-Hepatic Manifestations: A Systemic Disease. Although not completely understood, underlying mechanisms include HBV-induced local and systemic inflammation. Suppression of HBV replication usually improves extrahepatic manifestations. This review will discuss how HBV induces inflammation and the extrahepatic manifestations of HBV infection to guide clinical management. |
Low distal MNBI, proximal MNBI, and PSPW index independently predicted more severe lung function decline over 1 year in patients with IPF. These impedance metrics may have prognostic value and support a role for reflux in IPF pathogenesis. |
Physical activity at each intensity is inversely associated with NAFLD prevalence, with larger effects for higher intensities of physical activity. This association is mediated by better metabolic health, mainly lower insulin resistance and waist circumference. Physical activity should therefore be incorporated into NAFLD disease management and prevention programs. |
Pregnancies With Cirrhosis Are Rising and Associated With Adverse Maternal and Perinatal Outcomes. In this racially diverse, US population-based study, pregnancies with cirrhosis more than doubled over the past decade. Cirrhosis conferred an increased risk of several adverse events, although maternal and perinatal mortality was uncommon. These data underscore the need for reproductive counseling and multidisciplinary pregnancy management in young women with cirrhosis. |
We found that Hispanics born outside the United States were at increased risk of GIM, whereas Hispanics born in the United States were not, independent of Helicobacter pylori infection. Birthplace may be more informative than race/ethnicity when determining GIM risk among US populations. |
These results suggest that the mDF score should no longer be used to assess AH's prognosis. The MELD score has the best performance in predicting short-term mortality. |
This recommendation is based on the increasing disease burden among individuals under age 50, emerging data that the prevalence of advanced colorectal neoplasia in individuals ages 45 to 49 approaches rates in individuals 50 to 59, and modeling studies that demonstrate the benefits of screening outweigh the potential harms and costs. For individuals ages 76 to 85, the decision to start or continue screening should be individualized and based on prior screening history, life expectancy, CRC risk, and personal preference. Screening is not recommended after age 85. |
The interrater reliability of the endoscopic parameters and the Spigelman classification was good and excellent, respectively. The intrarater reliability of the endoscopic parameters and the Spigelman classification was moderate and good, respectively. The results support continued use of the Spigelman classification as the primary end point for future studies and as key endoscopic performance measure. |
| Clin Gastroenterol Hepatol |
Food intolerance is associated with IBS, anxiety, depression, and decreased health-related QOL and frequently leads to food elimination. Adults with lactose and lactose plus food intolerance have higher rates of IBS, increased psychological symptoms, and poorer QOL. |
This study indicates that the benefit of endoscopic clipping following EMR may be specific for >2cm adenomatous polyps located in the proximal colon. Clinicaltrials. gov ID NCT01936948. |
COVID-19 vaccine effectiveness in IBD patients is comparable to that in non-IBD controls and is not influenced by treatment with TNF inhibitors or corticosteroids. The IBD exacerbation rate did not differ between vaccinated and unvaccinated patients. |
Defining the Patchy Landscape of Esophageal Eosinophilia in Children with Eosinophilic Esophagitis. This study supports endoscopic measurement-guided 3-site biopsies for optimal disease assessment of active EoE in children. |
Empirical second-line regimens including 14-day quinolone triple-therapies, 14-day levofloxacin-bismuth quadruple-therapy, 14-day tetracycline-bismuth classical quadruple therapy, and 10-day bismuth quadruple-therapy (as single capsule) provided optimal effectiveness. However, many other second-line treatments evaluated reported low eradication rates; ClincialTrials.gov number, NCT02328131. |
Food insecurity is significantly associated with greater all-cause mortality in adults with NAFLD and advanced fibrosis. Interventions that address food insecurity among adults with liver disease should be prioritized to improve health outcomes in this population. |
Impact of SARS-CoV-2 pandemic on vascular liver diseases. PSVD and SVT patients could be at higher risk of infection by SARS-CoV-2 and at higher risk of severe COVID-19 disease. |
Low accuracy of FIB-4 and NAFLD fibrosis scores for screening for liver fibrosis in the population. Almost one-third (28-29%) of elevated FIB-4/NFS were false positive in both the general population and at-risk cohorts. FIB-4 and NFS are suboptimal for screening purposes due a high risk of overdiagnosis, and non-negligible percentage of false negatives, especially in patients with risk-factors for chronic liver disease. Waist circumference emerged as a potential first step to identify patients at risk for liver fibrosis in the general population. |
CONCLUSION:Mailed outreach significantly increased semi-annual HCC surveillance versus usual care in patients with cirrhosis, with a consistent intervention effect across most examined subgroups. Continued follow-up is ongoing to determine if these increases in surveillance translate into improved downstream outcomes including early HCC detection and curative treatment receipt. NCT02582918 and NCT03756051. |
Maternal AIH was associated with a 5-fold higher odds of preterm birth, and cirrhosis at diagnosis did not add to the impact of AIH on preterm birth. Future studies are needed to understand how to reduce this risk. |
We estimate at least 2 million adults have high-risk NASH in the US. Moreover, the prevalence of high-risk NASH among individuals with T2DM is higher ranging between 8.7% and 22.5%, supporting the case for coordinated case-finding and management. |
The prevalence of moderate/high risk NAFLD is increasing and is associated with increased all-cause, liver-related, and cardiovascular mortality. |
Inactivated whole-virion SARS-CoV-2 vaccines are safe in patients with CLD. Patients with CLD had lower immunological response to SARS-CoV-2 vaccines than healthy population. The immunogenicity is similarly low in non-cirrhotic CLD, compensated cirrhosis and decompensated cirrhosis. |
Concomitant supplementation of fibers during initiation of a low FODMAP diet did not alter symptomatic response in patients with IBS but augmented stool bulk, and normalized low stool water content and slow transit. Resistant starch did not have exert additional symptomatic benefits over sugarcane bagasse alone. |
In the TAF group, the hepatitis B e antigen seroconversion rate was 20.7% at postpartum month 6, infants had normal growth parameters, and no infants were positive for HBsAg at 7 months. The TDF group had comparable safety and effectiveness profiles. CONCLUSIONS:TAF administered throughout or beginning in early pregnancy is generally safe and effective for pregnant women with active CHB and their infants. |
Cross-sectional imaging is highly sensitive, but poorly specific, in detecting endoscopic disease activity and postoperative recurrence. Advanced radiographic disease correlates with endoscopic severity. Patients with radiographic activity in the absence of endoscopic recurrence may be at increased risk for future recurrence, and closer monitoring should be considered. |
Sustained long-term benefit at 30 months and further endoscopic improvements to month 24 were observed in patients with CD receiving upadacitinib. Safety over 30 months was consistent with the known safety profile of upadacitinib. Clinicaltrials.gov ID no NCT02782663. |
| Endoscopy |
Endoscopic screening prevented GC occurrence and death and improved its prognosis in a population-based study. Repeated endoscopy enhanced the effectiveness, for which screening interval needs to be defined in conformity with the severity of gastric lesions. |
We observed 3 complications (2 delayed bleedings, one microperforation) but no case of emergency surgery and no 30-day mortality. The series demonstrates feasibility and excellent safety of ESR using two novel devices for en bloc resection of early gastrointestinal neoplasia. The technique holds the promise of relative technical ease combined with high efficacy. |
Endoscopic transcecal appendectomy: a new endotherapy for appendiceal orifice lesions. There was no tumor recurrence during a median follow-up of 17 months (range 1-28). CONCLUSIONS: ETA is feasible, safe, and effective for complete resection of appendiceal orifice lesions. Larger, multicenter, prospective studies are needed to further assess this technique. |
Recurrence rate was 0 % (95 % confidence interval [CI] 0-0) at follow-up. Post-polypectomy bleeding was experienced by three patients (7.5 %; 95 %CI 0.00-0.15), and no patients developed post-polypectomy syndrome. CONCLUSION:These preliminary results showed 0 % local recurrence rate at 6 months and demonstrated the safety profile of hAPC-EMR. A large, randomized, controlled trial is required to confirm these results. |
Technical and clinical success were high (both 97 %), with recurrence in one patient (3 %) at a median follow-up of 123 days (58-236). Three complications occurred (9 %; one mild, two moderate). CONCLUSIONS: The 15-mm-long cautery-enhanced LAMS was feasible and safe for drainage of PFCs located 10-14 mm from the luminal wall. |
| Gastroenterology |
Associations of body mass index at different ages with early-onset colorectal cancer. Compared to participants with BMI <25 kg/m2, those with BMI ≥30 kg/m2 (obesity) at age 20 and 30 years and approximately 10 years before diagnosis/interview had 2.56 (95% CI 1.20-5.44), 2.06 (1.25-3.40), and 1.88 (1.30-2.73) fold risk of early-onset CRC. The association of BMI with early-onset CRC risk was particularly pronounced among and essentially restricted to the majority of participants with no previous colonoscopy. Obesity at early adulthood is strongly associated with increased risk of early- onset CRC. |
BZW1 is a key molecule in the IRES-dependent translation of HIF1α/c-Myc and plays crucial roles in glycolysis of PDAC. BZW1 might serve as a therapeutic target for patients with pancreatic cancer. |
Deletion of p130Cas suppresses acinar-derived tumorigenesis and progression by repressing PI3K-AKT signaling, even in the presence of a worsening condition like pancreatitis. Our observations finally demonstrated that p130Cas acts downstream of Kras to boost the PI3K activity required for ADM and subsequent tumor initiation. This demonstrates an unexpected driving role of p130Cas downstream of Kras through the PI3K/AKT, thus indicating a rational therapeutic strategy of targeting the PI3K pathway in tumors with high expression of p130Cas. |
Women with DDs and a modest proportion of healthy women had specific patterns of anorectal dysfunction, including inadequate rectal pressurization, anal relaxation, and abdominopelvic-rectoanal coordination. These observations may guide individualized therapy for DD in future. |
Inhibition of p53 sulfoconjugation prevents oxidative hepatotoxicity and acute liver failure. We have uncovered a previously unrecognized and p53-mediated role of PAPSS2 in controlling oxidative response. Inhibition of p53 sulfation may be explored for the clinical management of APAP overdose. |
Further analyses suggested that this was likely mediated partly by higher circulating levels of acetate observed in homozygous carriers (0.056 mmol/L (0.002), P=2.1x10-26), and partly by reduced sucrose uptake, but not lower caloric intake. These findings were verified in Sis-KO mice, which compared to wild-type mice were leaner on a sucrose-containing diet, despite similar caloric intake, had significantly higher plasma acetate levels in response to a sucrose gavage, and had lower plasma glucose level in response to a sucrose-tolerance test. These results suggest that sucrase-isomaltase constitutes a promising drug target for improvement of metabolic health, and that the health benefits are mediated by reduced dietary sucrose uptake and possibly also by higher levels of circulating acetate. |
MNX1-HNF1B axis is indispensable for intraductal papillary mucinous neoplasm lineages. Our organoid analyses identified the MNX1-HNF1B axis to be biologically significant in IPMN lineages. |
FPS predicts long-term fibrosis progression in an etiology-agnostic manner, which can inform anti-fibrotic drug development. |
We identify a novel oncogenic epitranscriptome axis of YTHDF1-m 6 A-ARHGEF2, which regulates CRC tumorigenesis and metastasis. siRNA-delivering LNP drug validated the therapeutic potential of targeting this axis in CRC. |
By 2030, it is projected over $21 billion annually will be spent on GI cancer management. Total spending for GI cancers in the US is substantial and projected to increase. Expenditures are primarily driven by inpatient care for colorectal cancer, although per-capita spending trends differ by GI cancer type. |
| Gastrointest Endosc |
A new concept for colonoscopy including side optics and artificial intelligence. Combining AI with side optics might help detect adenomas that otherwise might have been missed. |
One patient (2.1%) experienced POPFC recurrence, which was managed with percutaneous drainage. EUS-TD for symptomatic POPFCs with a novel LAMS is technically feasible and effective, with an acceptable adverse event rate. Further larger-scale prospective studies are required to confirm the findings of this study. |
After PS matching (2,135 lesions/group), the prevalence of PPB after HSP remained higher than that after CSP (OR, 6.0; 95% CI, 1.34-26.8). For colorectal lesions <10 mm in diameter, the risk of PPB after CSP is significantly lower than that after HSP, after PS matching. CSP for lesions <10 mm could be safely performed compared with HSP. |
With 15 procedures representing the minimum number of cases associated with the lowest risk for postprocedural adverse events, hospital volume is associated with improved outcomes. |
EUS-guided radiofrequency ablation for pancreatic insulinoma: experience in 2 tertiary centers. One elderly patient developed a large retrogastric collection 15 days after treatment, and died 1 month after EUS-RFA. CONCLUSION:Management of pancreatic NETs <2 cm by EUS-RFA seems effective with an acceptable safety profile. Yet, further evidence focusing on long-term survival and recurrence is needed. |
EUS imaging for the diagnosis of nonalcoholic fatty liver disease. For obese patients, EUS had a PPV of 89.7%; NPV was 75%. The finding of course echotexture on EUS had an accuracy of 79% for the diagnosis of grade 3 fibrosis or cirrhosis. EUS is a useful tool for the diagnosis of hepatic steatosis, particularly in obese patients in whom abdominal ultrasound has modest accuracy. |
WATS was twice as likely as FB to find IM in patients without a history of BE who had CLE on endoscopy. In patients with known BE, WATS and FB showed IM and dysplasia with similar frequency. These findings suggest that WATS can be used instead of FB with similar or improved efficacy at detecting IM and dysplasia. |
Polyps ranged in size from 10 to 70 mm, mean 26.5 mm. RRA was found in 18 patients (46%), with increased polyp size correlating with higher recurrence (P 10 mm. Prospective, randomized studies are needed to assess how outcomes compare with traditional cautery-based polypectomy. |
In patients who underwent pancreatoscopy with EHL, mean Izbicki pain score at baseline was 62.3 ± 23.1 (n=25/25) and dropped significantly to 27.5 ± 35.0 (22/25) at 6 months' follow-up (p<0.001). The most common adverse event was acute pancreatitis, al mild and treated conservatively (n=7). CONCLUSION:Pancreatoscopy-guided EHL is a promising treatment for symptomatic CCP patients with obstructive PD stones. |
In video test, Endo-CRC achieved an accuracy of 100.00%. Compared with model W and model I, Endo-CRC performed higher accuracy (91.61% versus 88.27% compared with model I; 91.61% versus 81.32% compared with model W; per image-pair). CONCLUSIONS:The Endo-CRC system has great potential for assisting in CRC invasion depth diagnosis and may be well applied in clinical practice. |
CONCLUSION:Our study was the first to reveal the actual incidence of second gastric cancer after curative ER for differentiated-type gastric cancer. Most lesions could be treated with ER. Continuous endoscopic surveillance after curative ER is important to detect second gastric cancer. |
On multivariate analysis, lesions in the distal esophagus/gastroesophageal junction (OR, 2.1; 95 CI, 1.1-3.9; p=0.02) and prior radiofrequency ablation (OR, 2.5; 95% CI, 1.2-5.5; p=0.02) were predictors of change in histologic diagnosis. CONCLUSION:ESD led to a change of diagnosis in more than half of patients with BE visible neoplasia. Selective ESD can serve as a potential diagnostic/staging tool, particularly in those with suspected invasive disease. |
| Gut |
Objective Using faecal shotgun metagenomic sequencing, we identified the depletion of protects against intestinal tumourigenesis by producing protective metabolites that can promote apoptosis of CRC cells. |
Our large cohort combined with clinical symptom analysis highlights the key regulator of gut microbiota in the pathogenesis of ASD and emphasises the importance of monitoring and targeting the gut microbiome in future clinical applications of ASD. |
The prevalence of MAFLD HCC in Italy is rapidly increasing to cover the majority of patients with HCC. Despite a less favourable cancer stage at diagnosis, patients with MAFLD HCC have a lower risk of HCC-related death, suggesting reduced cancer aggressiveness. |
We then constructed a stroma-targeted nanogel modified with phage display-identified tumour stroma-targeting peptides to co-deliver NO and TRAIL to PDAC and examined the anticancer effect in three-dimensional spheroid cultures in vitro and in orthotopic PDAC models in vivo. RESULTS:The delivery of NO to the PDAC tumour stroma resulted in reprogramming of activated pancreatic stellate cells, alleviation of tumour desmoplasia and downregulation of antiapoptotic BCL-2 protein expression, thereby facilitating tumour penetration by TRAIL and substantially enhancing the antitumour efficacy of TRAIL therapy. CONCLUSION:The co-delivery of TRAIL and NO by a stroma-targeted nanogel that remodels the fibrotic tumour microenvironment and suppresses tumour growth has the potential to be translated into a safe and promising treatment for PDAC. |
ER protein TXNDC5 promotes LF through redox-dependent HSC activation, proliferation and excessive extracellular matrix production. Targeting TXNDC5, therefore, could be a potential novel therapeutic strategy to ameliorate LF. |
| Hepatology |
A New Strategy of Vascular-targeted Therapy for Liver Fibrosis. Liver vascular changes occurred at very early stage of fibrogenesis. Different vessels play different roles in liver fibrosis. The combinational treatment of AAV9-LECT2-shRNA and bevacizumab could significantly improve the therapeutic effects on liver fibrosis. |
After achieving a SVR, a clinical non-response was associated with age and renal involvement; a clinical deterioration/relapse was associated with high pre-treatment rheumatoid factor values and a FCR was inversely associated with age, neuropathy, and high cryocrit levels. CONCLUSIONS:In CV patients, HCV eradication may not correspond to a persistent clinical improvement and clinical response may fluctuate. This implies an attentive approach to post-SVR evaluation through prognostic factors and tailored treatment. |
ACE inhibitors prevent liver-related events in non-alcoholic fatty liver disease. ACEI rather than ARB treatment is associated with a lower risk of liver-related events in NAFLD patients, especially among those with CKD. |
The intersection between autophagy, defective cholangiocyte cilia, and enhanced hepatic cystogenesis contributes to PLD progression and can be considered a novel target for therapeutic interventions. |
Discordance between biopsy-based and MRE-based fibrosis staging is associated with heterogeneity in LSM, as depicted with MRE. |
Microbiota analysis showed no change of the gut microbiome between WT and Bsep KO mice at baseline, but major changes upon LPS challenge in WT mice. Absence of Bsep and cholestasis in general impair LPS clearance by a basolateral uptake block into hepatocytes and consequently less secretion into canaliculi. Impaired LPS removal aggravates hepatic inflammation in cholestasis. |
Selection of antibody-escape HBV variants in human chimeric mice works efficiently. Analysis of such emerging variants helps to identify anchor amino acid residues of the conformational epitope that are difficult to discover by conventional approaches. |
These results were successfully validated both in the internal cohort and external cohort. CONCLUSIONS:Significant liver inflammation is a robust predictor associated with biochemical nonresolution. The established BNR-6 model provides an easy-to-use approach to assess the outcome of chronic DILI. |
Our model, out-performing previous reports at a lower cost by using solely low coverage WGS data, exhibits excellent clinical potential for ultra-sensitive and affordable detecting PLC and its subtypes. |
| Inflamm Bowel Dis |
There is a considerable increase in the number of CT scans performed in IBD patients. Further studies can explore factors influencing the use of CT and MRI of the abdomen in IBD patients. |
This study supports a causal effect between AD and IBD-but not between IBD and AD. There seems to be considerable differences between UC and CD regarding their specific associations with AD. These findings have implications for the management of IBD and AD in clinical practice. |
Prevalence of Mollicutes (Mycoplasma and/or Ureaplasma) was significantly higher in pregnant participants with IBD than in a previously profiled cohort of 172 pregnant women without IBD who delivered at term. CONCLUSIONS:The vaginal microbiome of participants with IBD was stable throughout pregnancy. Prevalence of Mollicutes, which has been associated with preterm delivery, warrants further study in this patient group. |
Superiority of VDZ to ADA is dependent on baseline probability of response, and a VDZ-CDST is capable of identifying UC patients most appropriate for VDZ vs ADA. |
Increases in profibrotic gene expression (Col1a1, FN, TIMP1) along with genes associated with epithelial-mesenchymal transition (vimentin and N-cadherin) were observed in TGFβ -treated epithelial cells. We demonstrate the feasibility of utilizing iPSC-HIO technology to model intestinal fibrotic responses in vitro. This now permits the generation of near unlimited quantities of patient-specific cells that could be used to reveal cell- and environmental-specific mechanisms underpinning intestinal fibrosis. |
Immunological Regulation of Intestinal Fibrosis in Inflammatory Bowel Disease. We critically present evidence from animal models of intestinal fibrosis and analyze inflammation-fibrosis interactions that occur under such experimental scenarios. In addition, we comment on recent findings from large-scale, single-cell profiling of fibrosis-relevant populations in IBD patients. Based on such evidence, we propose future potential targets for antifibrotic therapies to treat patients with IBD. |
The main indication for ICR in CD patients is penetrating disease in HK patients and stricturing disease in NL patients. Although considerable pre- and post-operative management differences were observed between the two geographical areas, the long-term prognosis after ICR is similar. |
Predictors of Sustained Response With Tofacitinib Therapy in Patients With Ulcerative Colitis. Patients with greater clinical improvement after 8 weeks of tofacitinib induction therapy are more likely to maintain response or remission with tofacitinib regardless of dose received during maintenance, highlighting the importance of a robust response to induction therapy. |
Sirtuin 1 upregulation ameliorated TNBS-induced colitis, whereas SIRT1 blockade aggravated TNBS-induced colitis in mice. CONCLUSIONS:CK2 have crucial effects on the development of UC by maintaining reciprocal balance between Th17 and Treg cells. Protein kinase CK2 blockade might be considered as a new therapeutic approach for UC treatment. |
The SEMA-CD applied to retrospective evaluation of colonoscopy reports accurately and reproducibly correlates with SES-CD and SEMA-CD of colonoscopy videos. The SEMA-CD for evaluating colonoscopy reports will enable quantifying mucosal healing in retrospective research. Having objective outcome data will enable higher-quality research to be conducted across multicenter collaboratives and in clinical registries. External validation is needed. |
The risk of IHD is increased in patients with IBD, especially in young female patients with IBD when compared to matched non-IBD subjects. CRP and plasma fibrinogen levels and neutrophil count in the peripheral blood may be potential predictors associated with the occurrence of IHD in patients with IBD. The study's findings have significant implications for the management and prevention of cardiac events in patients with IBD. |
IFX use was observed to increase as 5-ASA and corticosteroid use decreased. Additionally, hospitalization rates decreased following temporal changes in IFX management, yet the surgery and phenotype progression rates remained the same. |
| J Crohns Colitis |
Annual rates of surgeries [AAPC -1.3; p = 0.6] and steroid-dependency [AAPC -1.2; p = 0.3] remained unchanged, while rates of hospitalizations slightly decreased [AAPC -1.2; p < 0.001]. Outcomes were consistently worse in paediatric-onset disease than in adults, despite higher utilization of biologics [28% vs 12%, respectively; p < 0.001]. CONCLUSION:During the biologic era rates of surgeries and steroid-dependency have remained unchanged in patients with UC, while rates of hospitalizations have slightly decreased. |
Gut Epithelial-derived CXCL9 Maintains Gut Homeostasis through Preventing Overgrown E. coli. Gut epithelial cells-derived CXCL9 can kill the expanded E. coli through aceE to remain gut homeostasis. |
Inflammatory Bowel Disease-associated Fatty Liver Disease: the Potential Effect of Biologic Agents. In conclusion, IBD-associated NAFLD possibly follows two different patterns, one manifested during the relapses and one during the remissions of IBD. Some, but not all, biologics may benefit NAFLD in patients with IBD. Further mechanistic and prospective cohort studies are warranted to illuminate the effects of various biologics on NAFLD. |
This review describes the latest research and suggests mechanisms through which miRNA and intestinal microbiota, as joint actors, may participate specifically in IBD pathophysiology. Furthermore, we discuss the diagnostic power and therapeutic potential resulting from their bidirectional communication after faecal transplantation, probiotics intake, anti-miRNAs or miRNA mimics administration. The current literature is summarized in the present work in a comprehensive manner hoping to provide a better understanding of the miRNA-microbiota crosstalk and to facilitate their application in IBD. |
Transitioning patients established on IV vedolizumab to SC appears to be safe and effective, with high patient satisfaction and multiple benefits for the health service. |
| J Hepatol |
This results in a high extracellular concentration and allows icosabutate to avoid the worsening of hepatic oxidative stress seen in response to an unmodified omega-3 fatty acid. The structural changes also markedly improve anti-inflammatory and anti-fibrotic efficacy in a mouse model of non-alcoholic steatohepatitis (NASH). A hepatoprotective effect of icosabutate in patients with elevated circulating lipids at increased risk of NASH is also shown, where rapid reductions in markers of liver injury are observed. |
The frequency of AED liver injury significantly decreased over the last two decades in our experience. AED liver injury has several distinctive features, including preponderance in African American patients and immunoallergic skin reactions with outcomes depending on the type of AED involved. |
Histone acetylation of bile acid transporter genes plays a critical role in cirrhosis. Our data reveal a previously unrecognized function of MCRS1 as a critical histone acetylation regulator, maintaining gene expression and liver homeostasis. MCRS1 loss induces BA transporter acetylation, perturbation of BA flow, and consequently, FXR activation in HSCs. This axis represents a central and universal signaling event in liver cirrhosis, and targeting it would have significant implications for cirrhosis treatment. |
IL-26 inhibits hepatitis C virus replication in hepatocytes. These findings reveal a new role for IL-26 in direct protection against HCV infection, independently of the immune system, and increase our understanding of the antiviral defense mechanisms controlling HCV infection. Future studies should evaluate the possible use of IL-26 for treating other chronic disorders caused by RNA viruses, for which few treatments are currently available, or emerging RNA viruses. |
Long Non-Coding RNA ACTA2-AS1 Promotes Ductular Reaction by Interacting with the p300/ELK1 Complex. Cholangiocyte-selective p300 KO or p300 inhibition attenuate DR/fibrosis in mice. ACTA2-AS1 influences recruitment of p300/ELK1 to specific promoters to drive H3K27ac and epigenetic activation of proliferative/fibrogenic genes. This suggests that cooperation between epigenetic co-activators and lncRNAs facilitates DR/fibrosis in biliary diseases. |
Taken together, our data suggest a critical role for MSR1 in lipid-induced inflammation and a potential therapeutic target for the treatment of NAFLD. |
Within these oncogenic vesicles, we identified a key component that functions as a potent modulator of cancer aggressiveness. By inhibiting this functional component of EVs using a neutralizing antibody, tumor growth was profoundly attenuated in mice. The outcome of the study suggests an effective therapeutic alternative for cancer patients. |
TAZ-induced Cybb contributes to liver tumor formation in non-alcoholic steatohepatitis. TAZ in pre-tumor NASH-hepatocytes, via induction of Cybb and NOX2-mediated DNA damage, contributes to subsequent HCC tumor development. These findings illustrate how NASH provides a unique window into the early molecular events that can lead to tumor formation and suggest that NASH therapies targeting TAZ might also prevent NASH-HCC. |
These updated results confirm atezolizumab plus bevacizumab as the first-line standard of care for advanced hepatocellular carcinoma. CLINICALTRIALS. GOV IDENTIFIER:NCT03434379. |
| Neurogastroenterol Motil |
Application of a RiboTag-based approach to generate and analyze mRNA from enteric neural cells. We present a robust and selective protocol that allows the generation of cell type-specific transcriptional in vivo snapshots of distinct enteric cell populations that will be especially useful for various intestinal disease models involving peripheral neural cells. |
Autoimmune and viral risk factors are associated with achalasia: A case-control study. These findings suggest that achalasia may have autoimmune and viral components contributing to its etiology. Future mechanistic studies could target specific diseases and agents highlighted by this research. |
In this dataset, the 3 oz. WST did not demonstrate adequate sensitivity or specificity to detect aspiration in people with ALS as a stand-alone dysphagia screening tool. |
The scRNA-seq data for these two cell clusters predicted protein interaction networks consistent with immune cell and ICC biology, respectively. The single-cell transcriptome of purified KIT+ CD45- CD11B- human gastric ICC presented here provides new molecular insights and hypotheses into evolving models of GI motility. This knowledge will provide an improved framework to investigate targeted therapies for GI motility disorders. |
The role of vagal innervation on the early development of postoperative ileus in mice. and interferences Afferent nerve signaling to the central nervous system during the development of early POI seems to be mediated mainly via the vagus nerve and to a lesser degree via systemic circulation. During the early hours of POI, the intestinal immune response may be attenuated by vagal modulation, suggesting interactions between the central nervous system and the intestine. |
Reviews/Editorials
Plenty of the editorials have full text available through the publisher website using the provided link
| Aliment Pharmacol Ther |
S1P receptor modulators constitute a novel, promising, safe, and convenient strategy for the treatment of IBD. |
| Clin Gastroenterol Hepatol |
Sugars and Gastrointestinal Health. However, high sugar intake is associated with multiple tissue and organ dysfunctions. Both hyperglycemia and excessive sugar intake disrupt the intestinal barrier, thus increasing gut permeability and causing profound gut microbiota dysbiosis, which results in a disturbance in mucosal immunity that enhances infection susceptibility. This review aims to highlight the roles of different types of dietary carbohydrates and the consequences of their excessive intake for intestinal homeostasis. |
| Gastroenterology |
pylori colonizes gastric glands, directly interacts with stem cells and alters cellular and genomic integrity, as well as the characterization of tissue responses to infection, provide a comprehensive picture of how this bacterium contributes to gastric carcinogenesis. Thirdly, the development of stem cell- and tissue-specific reporter mice have driven our understanding of the signals and mutations that promote different types of GC and now also enable the study of more advanced, metastasized stages. Finally, organoids from human tissue have allowed insights into gastric carcinogenesis by validating mutational and signaling alterations in human primary cells and opening a route to predicting responses to personalized treatment. |
| Gastrointest Endosc |
| Hepatology |
Hepatic Fibrosis 2022: Unmet Needs and a Blueprint for the Future. More urgently, digital pathology methods that leverage machine learning and artificial intelligence must be validated in order to capture more prognostic information from liver biopsies and better quantify the response to therapies. For more refined treatment of NASH, orthogonal approaches that integrate genetic, clinical and pathological datasets may yield treatments for specific sub-phenotypes of the disease. Collectively, these and other advances will strengthen and streamline clinical trials, and better link histologic responses to clinical outcomes. |
Overdiagnosis of hepatocellular carcinoma: Prevented by guidelines? Overdiagnosis can occur for several different reasons including inaccurate diagnostic criteria, detection of premalignant or very early malignant lesions, detection of indolent tumors, and competing risks of mortality. The risk of overdiagnosis is partly mitigated, albeit not eliminated by several guideline recommendations, including definitions for the at-risk population in whom surveillance should be performed, surveillance modalities, surveillance interval, recall procedures, and HCC diagnostic criteria. Continued research is needed to further characterize the burden and trends of overdiagnosis as well as identify strategies to reduce overdiagnosis in the future. |
| J Crohns Colitis |
| J Hepatol |
Letters&Replies
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gut |
| Hepatology |
| J Hepatol |
Others
all remaining publications eg case reports, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
| Inflamm Bowel Dis |
| J Hepatol |