Clinical and Experimental Gastroenterology最新文献

{"title":"Panenteric Capsule Endoscopy in Young Patients with Suspected Irritable Bowel Syndrome: A Self-Controlled Feasibility Study.","authors":"Robert Benamouzig, Walaa El Arja, Bakthiar Bejou, Gheorghe Airinei, Nahla Cucherousset, Abdelhakim Tazairt, Mourad Benallaoua, Fabien Wuestenberghs, Jean-Marc Sabaté","doi":"10.2147/CEG.S513612","DOIUrl":"10.2147/CEG.S513612","url":null,"abstract":"<p><strong>Objective: </strong>Although the diagnosis of irritable bowel syndrome (IBS) is based on clinical criteria, a colonoscopy is often performed to rule out alternative digestive disorders. The panenteric PillCam™ Crohn's capsule, which allows non-invasive examination of both the small bowel and the colon, may be an alternative investigation. We aimed to evaluate the feasibility of a strategy based on the panenteric capsule in combination with standard biological tests to exclude gastrointestinal disease in young adult patients with chronic abdominal symptoms suggestive of IBS as an alternative to the classical approach based on colonoscopy.</p><p><strong>Design: </strong>Of 42 consecutive adults aged 18-50 years with symptoms consistent with IBS for more than 6 months, 33 were enrolled, and 27 received both routine biological tests, fecal calprotectin, panenteric capsule, and gastrointestinal endoscopies.</p><p><strong>Results: </strong>All 21 lesions identified by the capsule in 15 patients were unrelated to digestive symptoms, as were the 11 lesions identified by colonoscopy in 7 patients, and all were of little or no clinical interest. In addition, one gastric ulcer and one gastric MALT lymphoma diagnosed only by systematic gastric biopsy were characterized by upper endoscopy. The capsule was preferred by all patients to the classical endoscopic procedures.</p><p><strong>Conclusion: </strong>The diagnosis of IBS was not called into question in any of the patients explored. These preliminary results demonstrate the feasibility of a strategy based on the panenteric capsule in combination with standard biological tests to exclude gastrointestinal disease in young adult patients with chronic abdominal symptoms suggestive of IBS.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"205-213"},"PeriodicalIF":2.3,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039274","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":"<i>Patatin-Like Phospholipase Domain-Containing Protein 3</i> (<i>PNPLA3</i>) rs738409 Variant and Non-Alcoholic Fatty Liver Disease Risk in Vietnamese Working-Age Adults: A Case-Control Study with Metabolic Insights.","authors":"Ha Minh Nguyen, Duong Hoang Huy Le, Thinh Hung Nguyen, Hung Cao Dinh, Tuan Huu Ngoc Nguyen","doi":"10.2147/CEG.S532528","DOIUrl":"10.2147/CEG.S532528","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD) is an increasing public health concern in Vietnam, particularly among working-age adults (18-60 years). The <i>PNPLA3</i> rs738409 variant (C>G) is a well-established risk factor for NAFLD globally; however, its impact on the Vietnamese population remains inadequately studied. This study investigates its association with NAFLD risk and its interaction with metabolic factors.</p><p><strong>Methods: </strong>A case-control study was conducted with 135 NAFLD patients and 270 age- and sex-matched controls, collected from April to August 2023. Hepatic steatosis was evaluated via ultrasound, and NAFLD was diagnosed in cases without excessive alcohol consumption and other liver conditions. Data on demographics, clinical characteristics, and biochemical markers (eg, lipid profiles, liver enzymes) were collected. The rs738409 variant was genotyped using real-time PCR. Statistical methods included Hardy-Weinberg equilibrium testing, allele and genotype frequency comparisons, multivariable logistic regression adjusting for metabolic covariates, and ROC curve analysis to evaluate the predictive accuracy of rs738409.</p><p><strong>Results: </strong>The frequency of the G allele was significantly higher in NAFLD patients (35.93%) compared to controls (28.15%, <i>p</i> = 0.024). Individuals with CG+GG genotypes exhibited an increased risk of NAFLD (OR = 1.433, <i>p</i> = 0.042), with a stronger association in those with low HDL-c (OR = 2.074, <i>p</i> = 0.009). However, multivariable logistic regression analysis indicated that the <i>PNPLA3</i> rs738409 variant was not an independent risk factor for NAFLD in this population, in contrast to obesity and high triglycerides. ROC analysis revealed rs738409 alone had limited predictive power for NAFLD (AUC = 0.5537) but predictive accuracy improved slightly when combined with metabolic factors such as BMI and triglyceride levels (AUC = 0.7840).</p><p><strong>Conclusion: </strong>The <i>PNPLA3</i> rs738409 variant modestly increases NAFLD risk in Vietnamese working-age adults, particularly in those with dyslipidemia. However, metabolic factors, such as obesity and lipid disorders, play a more dominant role. This underscores the importance of lifestyle interventions and metabolic control in NAFLD management.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"191-204"},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991366","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":"Characterization of Bacterial Biofilm Composition in Occluded Plastic Biliary Stents.","authors":"Victor Kalil Flumignan, Marcelo Palma Sircili, Lígia Garcia Germano, Ana Vitoria Dos Santos Souza, Nicole Fernandes Silva, Newton Kiyoshi Fukumasu, Raphaela Marques Anjos, Jose Pinhata Otoch, Everson Luiz Almeida Artifon","doi":"10.2147/CEG.S499088","DOIUrl":"10.2147/CEG.S499088","url":null,"abstract":"<p><strong>Purpose: </strong>Plastic biliary stents are an effective treatment for biliary obstruction. Despite being resolutive and accessible, they are known to have a low patency rate, estimated at 3 to 6 months. This can be attributed to the formation of bacterial biofilm, which leads to the luminal obstruction of the stent. The aim of this study is to identify the bacterial composition of biofilms from obstructed plastic biliary stents removed through ERCP.</p><p><strong>Methods: </strong>Obstructed plastic biliary stents were retrieved from patients undergoing ERCP. The stents were fragmented into three segments of 2.0 cm each: proximal, medial, and distal. Gram staining was performed on each fragment, followed by assessment using optical microscopy. Subsequently, 4 µm cross-sections were made of each fragment, with subsequent analysis by confocal microscopy. The material from the inside of the stents was also placed in culture medium and colony-forming units were counted.</p><p><strong>Results: </strong>Optical microscopy and analysis by confocal microscopy showed a seemingly higher number of bacterial colonies in the distal portion of the stents compared to the proximal and medial regions. A greater presence of bacteria in the distal segments of the stents was confirmed, with growth reaching up to 10¹⁴, while growth in the proximal and medial segments was only observed up to 10⁹ and 10⁸, respectively. Biochemical identification using Gram staining identified both Gram-positive and Gram-negative species: <i>Enterococcus faecium; Aeromonas hydrophila/caviae; Escherichia coli; Enterobacter cloacae; Citrobacter freundii; Klebsiella oxytoca; Proteus vulgaris; Proteus mirabilis; Pantoea sp; Morganella morganii.</i></p><p><strong>Conclusion: </strong>The composition of the biofilm in biliary stents confirmed to be polymicrobial. The distal portion of the stents is likely the most frequent site of obstruction. New strategies, such as the development and improvement of plastic stents, should be considered to slow this growth and enhance permeability.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"179-189"},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945034","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":"Serological Markers of Intestinal Barrier Function and Inflammation as Potential Predictors of Recurrent Primary Sclerosing Cholangitis.","authors":"Mojmir Hlavaty, Jan Brezina, Tetiana Osadcha, Ondrej Fabian, Andrea Vajsova, Pavel Drastich, Monika Cahova, Lukas Bajer","doi":"10.2147/CEG.S508794","DOIUrl":"10.2147/CEG.S508794","url":null,"abstract":"<p><p>The impairment of intestinal barrier function is implicated in primary sclerosing cholangitis, but the clinical evidence is scarce. Therefore, we performed a cross-sectional study to evaluate serological markers of inflammation and intestinal permeability (Reg3a, iFABP, Zonulin, Calprotectin) in patients after liver transplantation (LT) for PSC. The cohort included 26 subjects with PSC recurrence (rPSC), 87 subjects without PSC recurrence (non-rPSC), and a unique control group consisting of post-LT patients (n = 113) transplanted due to alcohol cirrhosis. Generalized Linear Models were calculated to assess the association between serological markers of intestinal barrier function or inflammation (IP_Models) and PSC diagnosis per se (IP_Model_1), non-rPSC (IP_Model_2) or rPSC incidence (IP_Model_3) and compared with models (ST_Models) based on validated PSC markers (ALP, GGT, bilirubin). The increased probability of PSC occurrence (IP_Model_1, p < 0.001, AIC = 182) was associated with higher serum Reg3a concentration, while a negative association was found for iFABP, BMI, and age. The probability of non-recurrence (IP_Model_2, p < 0.001, AIC = 167) was associated with lower Reg3a concentration, older age, and BMI. The performance of IP_Models_1,2 and ST_models_1,2 was comparable. rPSC prediction was less precise by both models (IP_Model_3 p = 0.063, AIC = 92; ST_Model_3 p < 0.001, AIC = 108). rPSC incidence was positively associated with fecal calprotectin and serum zonulin concentrations, while it was independent of Reg3a, iFABP, age or BMI. In conclusion, this pilot study suggests that impaired intestinal permeability is associated with the pathophysiology of rPSC. Our data could serve as a basis for testing in a larger independent validation cohort and, if confirmed, help to explain the mechanisms underlying the pathophysiology of PSC and the recurrence of this disease after transplantation.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"18 ","pages":"171-178"},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697757","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":"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":"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":"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":2.6,"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":2.6,"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}