Clinical and Experimental Gastroenterology最新文献

{"title":"Clinically Adult-Onset Nesidioblastosis with Repeated Severe Hypoglycemia, Successfully Treated by Two Times Pancreatectomies. A Rare Case Report.","authors":"Wataru Izumo, Ryota Higuchi, Masahiro Shiihara, Shuichiro Uemura, Takehisa Yazawa, Noriyoshi Takano, Atsuhiro Ichihara, Toru Furukawa, Yoji Nagashima, Masakazu Yamamoto, Goro Honda","doi":"10.2147/CEG.S520986","DOIUrl":"https://doi.org/10.2147/CEG.S520986","url":null,"abstract":"<p><p>Although nesidioblastosis is the most common cause of hyperinsulinemic hypoglycemia in infants, it is rare in adults. Nesidioblastosis is pathologically characterized by diffuse neoformation of the islets of Langerhans islets from the pancreatic ductal epithelium and is a disease that does not exhibit neoplastic proliferation, unlike insulinoma. Hence, we present a rare case of adult-onset nesidioblastosis that caused repeated severe hypoglycemic symptoms and was cured by pancreatic resection twice, resulting in total pancreatectomy. A 37-year-old woman with the Whipple's triad visited our institution. In the fasting test, the plasma glucose level decreased and immunoreactive insulin levels increased after 12 h. No tumor was identified in the pancreas by imaging. A selective arterial calcium injection test revealed that step-up was detected only in the gastroduodenal artery. The patient underwent pancreatoduodenectomy with a diagnosis of adult-onset nesidioblastosis, with the pancreatic head region as the culprit. Pathological examination revealed neither tumorous islet cells nor an obvious increase in the number of islets. However, there were some isolated single insulin-producing cells in the pancreatic parenchyma, which could cause hyperinsulinemia and hypoglycemia. This patient was diagnosed with adult-onset nesidioblastosis. After the operation, the hypoglycemic symptoms improved, but 1 year later, the same symptoms recurred. The patient underwent remnant pancreatectomy and had no hypoglycemic symptoms for > 5 years after the second surgery.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"163-170"},"PeriodicalIF":2.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Management of Gastroesophageal Reflux Disease: Current Insights.","authors":"Abhinav Vayal-Veettil, C Prakash Gyawali","doi":"10.2147/CEG.S507237","DOIUrl":"https://doi.org/10.2147/CEG.S507237","url":null,"abstract":"<p><p>Gastroesophageal reflux disease (GERD) results from retrograde movement of gastric content into the esophagus and beyond, resulting in symptoms, mucosal injury and long-term complications. Typical symptoms of heartburn and regurgitation are highly suggestive of GERD, but atypical presentations require careful evaluation to rule out alternative diagnoses. Diagnostic modalities, including endoscopy, ambulatory reflux monitoring, and high-resolution manometry, play a pivotal role in confirming GERD and guiding personalized treatment. Management strategies consist of lifestyle modifications, pharmacologic therapy with anti-secretory agents, and adjunctive treatments such as alginates and baclofen. For refractory cases, surgical and endoscopic interventions offer durable symptom relief. Complications of GERD can be esophageal or extraesophageal, and highlight the importance of early diagnosis and effective management. The prognosis for GERD is generally favorable with appropriate treatment, although refractory cases require a tailored approach to address overlapping conditions such as disorders of gut-brain interaction and behavioral disorders. A multidisciplinary, patient-centered approach optimizes outcomes and improves the quality of life for individuals with GERD. This review provides a comprehensive overview of current insights into GERD, focusing on clinical presentation, diagnostic strategies, and therapeutic options.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"149-162"},"PeriodicalIF":2.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Biliary Cholangitis and Seropositive Rheumatoid Arthritis: A Two-Sample Mendelian Randomization Study.","authors":"Zongqi Deng, Wanyang Lei, Xiao Kuang, Xiaoxiao Liu, Wenlin Tai","doi":"10.2147/CEG.S500542","DOIUrl":"10.2147/CEG.S500542","url":null,"abstract":"<p><strong>Background: </strong>Observational studies indicated potential associations between primary biliary cholangitis (PBC) and rheumatoid arthritis (RA). However, the causal relationship between RA and PBC remains unclear and controversial. The aim of this study was to evaluate the causal relationships among seropositive RA (SPRA), seronegative RA (SNRA) and PBC.</p><p><strong>Methods: </strong>This study employed a Mendelian randomization (MR) framework to analyze genome-wide association study (GWAS) data from a European population. The dataset included 802 cases and 16,489 controls for PBC, 18,019 cases and 991,604 controls for SPRA, and 8,515 cases and 1,015,471 controls for SNRA, retrieved on June 11, 2024. Instrumental variables (IVs) were selected based on genome-wide significance (P < 5.0E-08) and independence (R² < 0.001). Palindromic and incompatible SNPs were excluded, and weak instruments (F < 10) were removed. Inverse variance weighting (IVW) was the primary analysis method, complemented by Bayesian weighted MR (BWMR), robustly adjusted profile scores (MR-RAPS), MR-Egger, and weighted median approaches. Sensitivity analyses included Cochran's Q test, MR-Egger regression, MR-PRESSO global test, and leave-one-out analysis to assess the robustness of the results.</p><p><strong>Results: </strong>SPRA increased the risk of genetic susceptibility to PBC (OR=1.28, 95% CI 1.10-1.4, <i>P</i> =0.001). No causal effect of the SNRA on PBC risk was observed.</p><p><strong>Conclusion: </strong>Our findings show that SPRA increases the risk of developing with PBC. This will help inform future screening guidelines for associated PBC in patients with RA.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"139-148"},"PeriodicalIF":2.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Primary Opening of Fistula-in-Ano Always at Dentate Line: Correlation Between MRI and Operative Findings in 379 Patients.","authors":"Pankaj Garg, Gabriele Naldini, Vincent De Parades, Petr Tsarkov, Vipul D Yagnik, Kaushik Bhattacharya, Baljit Kaur, G Mahak","doi":"10.2147/CEG.S515522","DOIUrl":"10.2147/CEG.S515522","url":null,"abstract":"<p><strong>Background: </strong>The primary opening of the cryptoglandular fistula-in-ano is generally assumed to be present at the dentate line as the cryptoglandular glands open there. However, no study has ever systematically studied the location of the primary opening.</p><p><strong>Methods: </strong>All fistula-in-ano patients operated-on over two years were screened and those who were never earlier operated on were included. Magnetic Resonance Imaging (MRI) was done on all patients. The primary fistula opening was localized on the MRI and corroborated with the operative findings. The primary opening was categorized at three levels - at the dentate line, above the dentate line, and below the dentate line.</p><p><strong>Results: </strong>744 anal fistula patients were operated on over two years and 379 patients, who had never been operated on before, were included in the study. 35 patients were excluded (the primary opening could not be localized). In 344 patients (finally analyzed), the primary opening was at the dentate line in 223 patients (64.8%), above the dentate line in 79 (22.9%), and below the dentate line in 42 (12.2%) patients. The primary opening was located above the dentate line in significantly higher numbers in complex fistulas than in simple fistulas (73/102 in complex vs 6/242 in simple fistulas, p<0.00001).</p><p><strong>Conclusion: </strong>Unlike commonly presumed, the primary opening is located at the dentate line in only two-thirds (64.8%) anal fistulas. In 22.9% it was located above the dentate line and in 12.2%, below the dentate line. This is the first study in which the level of primary opening has been systematically analyzed.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"121-137"},"PeriodicalIF":2.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbial Patterns in Newly Diagnosed Inflammatory Bowel Disease Revealed by Presence and Transcriptional Activity - Relationship to Diagnosis and Outcome.","authors":"Simen Svendsen Vatn, Simen Hyll Hansen, Tone Møller Tannæs, Stephan Brackmann, Christine Olbjørn, Daniel Bergemalm, Åsa V Keita, Fernando Gomollon, Trond Espen Detlie, Rahul Kalla, Jack Satsangi, Jørgen Jahnsen, Morten Harald Vatn, Jonas Halfvarson, Johannes Roksund Hov, Petr Ricanek, Aina E F Moen","doi":"10.2147/CEG.S504459","DOIUrl":"10.2147/CEG.S504459","url":null,"abstract":"<p><strong>Background: </strong>As part of the IBD Character initiative, we examined an inception cohort and investigated mucosal microbiota composition and transcriptional activity in relation to clinical outcomes.</p><p><strong>Methods: </strong>A cohort of 237 individuals were included from five countries: Crohn's disease (CD, n = 72), ulcerative colitis (UC, n = 57), symptomatic non-IBD controls (SC, n = 78) and healthy controls (HC, n = 30). Rectal/colonic biopsies were obtained at inclusion, and DNA and RNA were extracted from the same biopsy and examined by sequencing the 16S rRNA V4 region.</p><p><strong>Results: </strong>Beta diversity measurements separated IBD from both HC and SC. IBD and SC exhibited reduced intra-individual diversity compared with HC. When comparing taxonomy at DNA and RNA level, six bacteria were found to differ in abundance and/or transcriptional activity between IBD and symptomatic control, while there were 14 and three between symptomatic control and CD and UC, respectively. A limited number of bacterial taxa were responsible for the largest difference between presence and activity, separating patients and controls. Multiple bacterial taxa were associated with treatment escalation in both UC and CD. Machine-learning models separated IBD from symptomatic controls and treatment escalators from non-escalators (AUC >0.8). However, the differential effects were mainly driven by clinical biomarkers, such as f-calprotectin, s-albumin, and b-hemoglobin.</p><p><strong>Conclusion: </strong>Differences between presence and transcriptional activity were found among multiple taxa when assessing 16S rRNA at DNA and RNA level. Symptomatic controls were more similar to the IBD patients compared to HC. The analyses suggest that the mucosal microbiota carries a moderate diagnostic and predictive potential, outcompeted by f-calprotectin.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"103-119"},"PeriodicalIF":2.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Opinion on the Management, Challenges, and Knowledge Gaps Pertaining to Eosinophilic Esophagitis Among Adults in the Greater Gulf Region.","authors":"Ahmad Jazzar, Ahmed Al-Darmaki, Evan Samuel Dellon, Mohamad Miqdady, Mohammed Attieh Alzahrani, Mohammed S Khan, Mona Al Ahmad, Osama Yousef, Sameer Al Awadhi, Wesam Al Masri, Naglaa M Kamal","doi":"10.2147/CEG.S511469","DOIUrl":"10.2147/CEG.S511469","url":null,"abstract":"<p><p>Eosinophilic esophagitis (EoE) is a type 2 inflammatory esophageal disease that presents in adults as dysphagia and food impaction. EoE is characterized by a predominance of T helper 2 cells among the T cell population. Environmental agents, including food antigens and aeroallergens, trigger EoE. EoE exhibits immunoglobulin E- (IgE-) and non-IgE-mediated allergic responses to these environmental allergens. Local antigen-specific IgE can also trigger mast cell degranulation, thereby worsening EoE. Individuals with atopic dermatitis, asthma, IgE-mediated food allergy, or allergic rhinitis are at a higher risk of developing EoE. EoE treatment aims to achieve clinical improvement, endoscopic mucosal healing, and reduction in or resolution of histological inflammation. However, attaining and maintaining \"deep remission\" with conventional treatments can be challenging, underscoring the need for targeted therapies. This expert opinion focuses on the latest global recommendations for using novel therapies to improve outcomes in patients with EoE. It also highlights current practices in the Greater Gulf region to manage EoE, identify challenges, and address future educational gaps.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"91-102"},"PeriodicalIF":2.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biliary Microbial Community and Metabolic Potential in Patients with Multiple Common Bile Duct Stones.","authors":"Tingting Xia, Shuo Feng, Zigui Zou, Jikai Zhou, Xiaodi Cai, Jianxin Ye, Chenguang Dai","doi":"10.2147/CEG.S512350","DOIUrl":"https://doi.org/10.2147/CEG.S512350","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is widely used in the treatment of choledocholithiasis, while successful extraction of common bile duct stone (CBDS) is commonly hampered by the number of stones. Biliary microbiota has a profound influence on the occurrence of CBDS. In this study, we aimed to investigate the characteristics and metabolic potential of biliary microbiota in patients with multiple CBDS.</p><p><strong>Methods: </strong>Eligible patients were prospectively enrolled in this study at First Affiliated Hospital of Soochow University between December 2022 and October 2023. Bile samples were collected through ERCP. The samples were tested for biliary microbiota and bile acids using 16S rRNA sequencing and ultra-performance liquid chromatography-tandem mass spectrometry, respectively. Metabolic functions were predicted by PICRUSt 2.0 calculation based on MetaCyc database.</p><p><strong>Results: </strong>A total of 31 patients were enrolled, including 17 in multiple stone (MS) group and 14 in single stone (SS) group. Distinct biliary microbial composition was identified in MS group, with a significantly higher abundance of <i>Proteobacteria</i> at phylum level and <i>Enterococcus</i> at genus level, respectively. <i>Klebsiella, Aquabacterium, Morganella</i> and <i>Diaphorobacter</i> were significantly abundant in MS group. Both <i>Morganella</i> and <i>Aeromonas</i> were exclusively found in MS group, along with the absence of <i>Metaprevotella</i>. Chenodeoxycholic acid was significantly enriched in MS group. It was negatively correlated with <i>Enhydrobacter, Massilia</i> and <i>Neglecta</i> that were abundant in SS group. Several metabolic pathways that could increase the risk of CBDS were also enriched in MS group, including L-methionine biosynthesis, aspartate superpathway, glucose and glucose-1-phosphate degradation and superpathway of glycolysis and the Entner-Doudoroff pathway.</p><p><strong>Conclusion: </strong>This study illustrated the microbial structure and metabolic potential of biliary flora in patients with multiple CBDS. The unique biliary microbial community holds the predictive value for clinical conditions. The findings provide new insights about biliary microbiota into the etiology of multiple CBDS.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"67-78"},"PeriodicalIF":2.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolation of Murine Pancreatic Stellate Cells and the Establishment of a New ex-vivo Activation Model.","authors":"Xinye Wang, Miaomiao Li, Xinjuan Liu, Guangyong Sun, Dong Zhang, Lijun Sun, Yue Yin, Weizhen Zhang, Jianyu Hao","doi":"10.2147/CEG.S507384","DOIUrl":"https://doi.org/10.2147/CEG.S507384","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic stellate cells (PSCs) are critical in the development of pancreatic fibrosis. In vitro, cell attachment itself can promote cell activation. Currently, there is a lack of methods for isolating activated PSCs that are unaffected by cell attachment. This study aims to identify effective methods for isolating quiescent and activated murine PSCs (mPSCs) and to evaluate the potential of caerulein in inducing mPSC activation in an ex vivo model.</p><p><strong>Methods: </strong>Pancreatic tissue from mice was digested with collagenase P (1.17 U/mL), Pronase (0.5 mg/mL), and DNase I (0.01 mg/mL). Quiescent and activated mPSCs were isolated using a Nycodenz gradient. Immunostaining for α-smooth muscle actin (α-SMA), Desmin, glial fibrillary acidic protein (GFAP), vimentin, CK19, and CD68 was performed to confirm cell purity. Real-time quantitative PCR (RT-PCR) and RNA sequencing assessed the activation phenotype following caerulein treatment.</p><p><strong>Results: </strong>Quiescent and activated mPSCs were successfully isolated using the Nycodenz gradient, with cells exhibiting typical stellate morphology and positive staining for α-SMA, Desmin and vimentin. Oil Red O staining confirmed lipid droplets in quiescent mPSCs. In the caerulein-treated group, mPSC activation was significantly greater than in the saline-treated control group. RT-PCR revealed progressive upregulation of acta2 (**<i>p</i><0.01, d4 compared to d2, ^## <i>p</i><0.01,d7 compared to d4,**<i>p</i><0.01,d7 compared to d2), col1a (**<i>p</i><0.01, d4 compared to d2,**<i>p</i><0.01,d7 compared to d2), and actg2 (**<i>p</i><0.01, d4 compared to d2, ^## <i>p</i><0.01,d7 compared to d4, **<i>p</i><0.01,d7 compared to d2) mRNA levels at 2, 4, and 7 days post-adhesion. Fibroblast markers were also upregulated, and KEGG and GO enrichment analyses identified key pathways involved in ECM-receptor interactions, cell cycle regulation, PI3K-Akt signaling, and extracellular matrix remodeling.</p><p><strong>Conclusion: </strong>The Nycodenz gradient efficiently isolates quiescent mPSCs, and short-term caerulein treatment effectively activates mPSCs ex vivo, providing a valuable model for studying mPSC activation and related signaling pathways.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"79-89"},"PeriodicalIF":2.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Trends in Inflammatory Bowel Disease-Related Mortality in the US from 1999 to 2022.","authors":"Saif Zurob, Alexandra Brown, Taylor Billion, Muhammad Nouman Aslam, Abubakar Tauseef, Mohsin Mirza, Ali Bin Abdul Jabbar","doi":"10.2147/CEG.S513012","DOIUrl":"https://doi.org/10.2147/CEG.S513012","url":null,"abstract":"<p><strong>Purpose: </strong>Inflammatory bowel disease (IBD) is a grouping of chronic inflammatory diseases of the gastrointestinal tract that affects upwards of 2.4 million Americans. Despite its prevalence, the exact cause remains unknown. This study aims to identify geographical differences in IBD-related mortality.</p><p><strong>Patients and methods: </strong>We utilized Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. IBD-related death and population size data over the span of 1999 to 2022 was extracted. Data was stratified by United States census regions, place of death, and gender. Crude and age-adjusted mortality rates (AAMR) were calculated and trends in mortality were modeled using the Join-point Regression Program, with statistically significant outcomes (p-value ≤ 0.05) denoted via an asterisk (*).</p><p><strong>Results: </strong>During the interval from 1999 to 2022, there were a total of 71,628 deaths due to Inflammatory Bowel Disease (IBD) in the United States. All census regions showed an increase in AAMR over the study period. The Midwest had the highest AAMRs with 1.54 (95% CI 1.42 to 1.65) in 1999 and rising to 1.99 (95% CI 1.87 to 2.11) in 2022 with an AAPC of 1.57 (95% CI 0.75 to 2.14)* and an APC of 9.83 (95% CI 3.43 to 21.10)* from 2018 to 2022. More specifically, Midwestern males displayed the highest AAMR with 1.74 (95% CI 1.54 to 1.94) in 1999 and 2.09 (95% CI 1.9 to 2.27) in 2022, and an APC of 8.50 (95% CI 2.254 to 19.40)* between 2018 and 2022.</p><p><strong>Conclusion: </strong>Persistent regional differences were seen in IBD mortality, with the Midwest having the highest AAMR and Southern states exhibiting the greatest regional increase in AAMR over the past two decades. IBD mortality worsened across all regions during the period of the COVID-19 pandemic.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"55-66"},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A CDKN2B-Associated Immune Prognostic Model for Predicting Immune Cell Infiltration and Prognosis in Esophageal Carcinoma.","authors":"Xiulan Peng, Juping Han, Juan Huang, Longshu Zhou, Xianzhe Chen, Wen Zhou","doi":"10.2147/CEG.S510078","DOIUrl":"https://doi.org/10.2147/CEG.S510078","url":null,"abstract":"<p><strong>Objective: </strong>Studies have indicated that cyclin dependent protein kinase inhibitor 2B (CDKN2B) deletion is one of the most common changes in esophageal cancer (EC) which affects its progression and prognosis. This study explored the association between CDKN2B deletion, immunophenotype, and the prognosis of EC.</p><p><strong>Methods: </strong>We investigated CDKN2B status and RNA expression, identified differentially expressed immune-associated genes between wild-type CDKN2B (CDKN2B^WT) and deleted CDKN2B (CDKN2B^deletion) in Cancer Genome Atlas (TCGA) EC samples. We also a constructed an immune prognostic model (IPM) based on these genes. Thereafter, the effects of IPM on the immune microenvironment of EC were analyzed. Finally, we established a nomogram by integrating the IPM and other clinical factors.</p><p><strong>Results: </strong>CDKN2B deletion leads to downregulation of the immune response in EC. A total of 136 immune-associated genes were identified based on the CDKN2B deletion status, and three genes with remarkable potential as individual targets were selected for model construction. An IPM was developed and validated, it showed good performance in differentiating patients with a low or high risk of poor prognosis, and its predictive ability was independent of traditional clinical features. High-risk patients with EC had increased T follicular helper cells (Tfh) and M0 macrophages, and lower infiltration levels of resting CD4 memory T cells resting, and naive B cells. The nomogram developed for clinical application showed good predictive performance.</p><p><strong>Conclusions: </strong>Our results suggested that CDKN2B deletion was associated with the survival and immune microenvironment in EC. IPM is not only an effective indicator of the immune response and prognosis, but also suggest potential targets for immunotherapy in patients with EC.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"41-54"},"PeriodicalIF":2.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}