Clinical and Translational Gastroenterology最新文献

{"title":"THE IMPACT OF MASLD ON AUTOIMMUNE HEPATITIS OUTCOMES: A NATIONWIDE ANALYSIS OF 2880 RECORDS.","authors":"Yassine Kilani, Mohammad Aldiabat, Kym Yves T Sirilan, Ahmad Basil Nasir, Mahmoud Y Madi, Wing-Kin Syn","doi":"10.14309/ctg.0000000000000912","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000912","url":null,"abstract":"<p><strong>Background: </strong>Despite the growing recognition of autoimmune hepatitis (AIH) - Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) overlap, studies today are limited by small sample sizes. This study aimed to investigate the impact of MASLD on the outcomes of patients with AIH using large-scale real world data.</p><p><strong>Methods: </strong>This cohort study used the TriNetX research network to identify U.S. adults (≥18 years) with AIH. Patients were stratified into those with MASLD (AIH-MASLD cohort), and controls (AIH without MASLD). Propensity score matching (1:1) between AIH-MASLD and controls accounted for demographics, comorbidities, and treatments. Outcomes were classified as short-term (within 1 year after diagnosis) or long-term (within 10 years) outcomes.</p><p><strong>Results: </strong>Among 4,798 records with AIH, 1,440 AIH-MASLD patients were propensity matched with 1,440 controls. AIH-MASLD patients demonstrated reduced one-year odds of all-cause mortality (HR = 0.66, 95%CI: 0.44 - 0.98), and immunosuppressive medication use (HR = 0.69, 95%CI: 0.63 - 0.76), along with increased 10-year odds of cirrhosis (HR = 1.22, 95%CI: 1.06 - 1.40) and hepatocellular carcinoma (HR = 2.03, 95%CI: 1.09 - 3.78) compared to controls.</p><p><strong>Conclusions: </strong>In summary, our study using real-world evidence showed a significant association between MASLD and worse clinical outcomes in patients with AIH. Future efforts should be targeted towards facilitating early detection and management of MASLD in AIH patients.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Metabolic Bone Disease in Patients with IgG4-Related Disease With and Without Autoimmune Pancreatitis: A Cross-Sectional Study.","authors":"Guy Katz, Aubree E McMahon, Grace A McMahon, Isha Jha, Marcy B Bolster, Bohang Jiang, Yuqing Zhang, Ana D Fernandes, Zachary S Wallace, Cory A Perugino, John H Stone, Yasmin G Hernandez-Barco","doi":"10.14309/ctg.0000000000000917","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000917","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with IgG4-related disease (IgG4-RD) have risk factors for metabolic bone disease (MBD), yet data are lacking on the prevalence of MBD in IgG4-RD. We assessed screening frequency and prevalence of MBD in patients with IgG4-RD with and without pancreatic involvement.</p><p><strong>Methods: </strong>Using a IgG4-RD registry, we extracted details from medical records related to MBD in patients who actively follow in our system. Living patients with contact information available were invited to complete surveys detailing MBD and associated characteristics.</p><p><strong>Results: </strong>Seventy patients met criteria for medical records review (n=17 with pancreatic involvement). 51% had taken proton pump inhibitors (PPIs), and 30% had investigator-determined MBD. Compared to the US population, the age-standardized prevalence of osteoporosis in the IgG4-RD cohort was higher among both females (28.1% vs. 19.6%, p=0.40) and males (8.3% vs. 4.4%, p=0.48), though this did not achieve statistical significance. Mean T-scores at all sites were numerically lower in patients with pancreatic involvement than those without (all p>0.1).In patient-reported data (n=105), despite 62% of patients reporting ≥3 months of glucocorticoid exposure, only 36% had a DXA performed. Of 15 patients for whom pharmacologic MBD treatment was recommended, 8 (53%) reported adherence to this recommendation.</p><p><strong>Conclusions: </strong>The burden of MBD and its risk factors is high in patients with IgG4-RD, yet screening and treatment is low. While our study was underpowered to detect statistical differences, there may be a greater burden of MBD in patients with pancreatic involvement. Screening and treatment of MBD should be emphasized in these patients.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel CART-Driven Decision Tree Combining NLR and CRP for Early Prognostication of Severe Acute Pancreatitis: A Prospective Vietnamese Cohort Study.","authors":"Tien Manh Huynh, An Tran, Duy Thanh Tran, Yen Hoang Thi Dao, Thong Duy Vo","doi":"10.14309/ctg.0000000000000919","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000919","url":null,"abstract":"<p><strong>Background: </strong>Severe acute pancreatitis (SAP) is a life-threatening condition requiring early risk stratification. While the Bedside Index for Severity in Acute Pancreatitis (BISAP) is widely used, its reliance on complex parameters limits its applicability in resource-constrained settings. This study introduces a decision tree model based on Classification and Regression Tree (CART) analysis, utilizing Neutrophil-to-Lymphocyte Ratio (NLR) and C-reactive Protein (CRP), as a simpler alternative for early SAP prediction.</p><p><strong>Methods: </strong>In a prospective cohort of 340 patients at National Hospital, Vietnam (November 2022-September 2023), NLR, CRP, and BISAP scores were assessed upon admission. CART analysis was used to develop a decision tree, and model performance was compared with BISAP using receiver operating characteristic (ROC) curves, decision curve analysis (DCA).</p><p><strong>Results: </strong>The CART model identified NLR ≥11.4 and CRP ≥173.3 mg/L as optimal thresholds for SAP prediction. The model achieved an area under the curve (AUC) 0.866 in the validation cohort, statistically comparable to BISAP (AUC = 0.900, p = 0.286). The model demonstrated high sensitivity (90.9%), specificity (84.5%), and accuracy (86.25%), confirming its robustness. DCA highlighted similar clinical benefits with BISAP, but the CART-based model offered greater simplicity, making it ideal for resource-limited settings.</p><p><strong>Conclusion: </strong>The CART-derived decision tree using NLR and CRP provides an accessible and reliable tool for early SAP prediction. With performance comparable to BISAP but requiring fewer resources, this model supports rapid, evidence-based decision-making in clinical practice.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real -World Evidence of the Long-Term Clinical Utility of a Vibrating Capsule in the Management of Chronic Idiopathic Constipation.","authors":"Darren M Brenner, Satish Sc Rao, Bryan Curtin, Eamonn Quigley","doi":"10.14309/ctg.0000000000000918","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000918","url":null,"abstract":"<p><strong>Introduction: </strong>Pharmacological therapies for chronic idiopathic constipation (CIC) are useful, but many patients report dissatisfaction from a lack of efficacy and occurrence of adverse events. The vibrating capsule (VC) is an FDA approved non-pharmacologic, treatment for CIC. However, its long-term usefulness in a community setting is unknown. The goal of this study was to assess the long-term efficacy and safety of vibrating capsule treatment in a real-world community setting.</p><p><strong>Methods: </strong>We conducted a post-marketing analysis of CIC patients prescribed VC who completed at least 3 or 6 months of treatment. The clinical utility was assessed via patient reported symptoms in an electronic stool diary. Safety data was also collected.</p><p><strong>Results: </strong>1722 patients were prescribed VC, and 491 and 298 took the VC and kept stool diaries for 3 and 6 months respectively. Approximately 46% of patients were >55 years of age and 85% were women. Compared to baseline, complete spontaneous bowel movement (CSBM) rates increased significantly throughout the 3 and 6 -month periods (average increase of >1 CSBM per week; P< 0.0001). Mean stool consistency (Bristol Stool Form Scale) improved from 2.9 (baseline) to 4.1 during treatment (P<0.0001), mean straining effort (1-4) decreased from 2.9 to 1.6 (P<0.0001), and toileting time also significantly decreased (P<0.0001). Safety analysis revealed that 4.6% of patients reported feeling a sensation of vibration, 1.8% reported abdominal pain and 0.64% reported diarrhea.</p><p><strong>Conclusions: </strong>In a community setting, the VC appears both effective and safe for long term treatment of chronic constipation with diarrhea being notably uncommon.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulatory Role and Biomarker Potential of Gut Microbiota Metabolites in the Progression of Metabolic dysfunction-associated steatotic liver disease (MASLD) to Hepatocellular Carcinoma (HCC).","authors":"Zongyuan Che, Wei Xue, Xuchen Zhao, Congzhong Hu, Yanzhang Tian","doi":"10.14309/ctg.0000000000000914","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000914","url":null,"abstract":"<p><p>Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide. It is now updated as metabolic dysfunction-associated steatotic liver disease (MASLD). The progression of MASLD to hepatocellular carcinoma (HCC) involves complex mechanisms, with the gut microbiota and its metabolites playing a pivotal role in this transformation through the \"gut-liver axis.\" This review systematically summarizes the characteristics of gut microbiota dysbiosis in NAFLD patients and the regulatory mechanisms of its metabolites (e.g., short-chain fatty acids [SCFAs], secondary bile acids, trimethylamine N-oxide [TMAO], and lipopolysaccharides [LPS]) in the progression from MASLD to HCC. SCFAs exert protective effects in the early stages by enhancing the intestinal barrier and modulating immune and metabolic responses. However, metabolic disturbances, such as the \"paradoxical effect\" of butyrate and the lipogenic effect of acetate, may promote the formation of a tumor microenvironment in the later stages. Secondary bile acids (e.g., deoxycholic acid) exacerbate liver fibrosis and carcinogenesis by activating inflammatory pathways (NF-κB, MAPK), inducing oxidative stress, and inhibiting foresaid X receptor (FXR) signaling. TMAO directly drives HCC progression by activating the MAPK/NF-κB pathway, promoting epithelial-mesenchymal transition (EMT), and creating an immunosuppressive microenvironment. LPS accelerates fibrosis and metabolic reprogramming through TLR4-mediated chronic inflammation and hepatic stellate cell activation. This review highlights that the dynamic changes in gut microbiota metabolites are closely associated with MASLD -HCC progression. Specific monitoring of these metabolites may serve as potential biomarkers for early detection. Furthermore, gut-targeted therapies (e.g., fecal microbiota transplantation) have shown translational potential. Future studies are needed to further validate their clinical value and develop precise prevention and treatment strategies.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection performance of colorectal cancer through exhaled breath by electronic nose: a case-control study.","authors":"Qiaoling Wang, Shiyan Tan, Ruyi Zheng, Zhuohong Li, Yuan Chen, Xiaopeng Huang, Yu Fang","doi":"10.14309/ctg.0000000000000916","DOIUrl":"10.14309/ctg.0000000000000916","url":null,"abstract":"<p><strong>Background: </strong>Although colorectal cancer (CRC) screening has been incorporated into organized programs in many countries, a universally accepted noninvasive and efficient screening method remains unavailable.</p><p><strong>Objective: </strong>This study aimed to assess the diagnostic potential of volatile organic compounds (VOCs) in exhaled breath via electronic nose (eNose) for noninvasive CRC detection.</p><p><strong>Methods: </strong>The Cyranose320 sensor device was used to collect and analyze breath samples. Supervised machine learning was applied to evaluate the diagnostic performance of the eNose in CRC detection, using a randomly assigned training and validation set. Two-thirds of the breath samples were used to train models, which were then validated on the remaining patients (external validation). Three machine learning methods were applied for classification: random forest (RF), extreme gradient boosting (XGBoost), and quadratic discriminant analysis (QDA).</p><p><strong>Results: </strong>A total of 105 CRC patients and 101 healthy controls were included. After adjusting for baseline covariates (age, sex, smoking, BMI, comorbidities), machine learning models based on volatile organic compound (VOC) profiles could differentiate CRC patients from healthy controls, achieving areas under the receiver operating characteristic curve (AUC) of at least 0.72 in both the training and validation sets. The final CRC classification models yielded AUCs of 0.93 for RF, 0.88 for XGBoost, and 0.89 for QDA. Furthermore, eNose classified CRC by stage, with an AUC exceeding 0.70 for early and advanced disease.​.</p><p><strong>Conclusions: </strong>Exhaled breath analysis using an eNose may serve as a promising noninvasive method for CRC detection. Further studies with larger populations are needed to confirm its clinical impact.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum STARD4-AS1 As a Novel Marker for Gastric Cancer Diagnosis and Promotes Gastric Cancer Progression.","authors":"Xiuyu Chu, Min Cao, Xinyue Qin, Xian Li, Ming Zheng, Xianjuan Shen, Shaoqing Ju","doi":"10.14309/ctg.0000000000000915","DOIUrl":"10.14309/ctg.0000000000000915","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) is a lethal malignant tumor necessitating high-sensitivity detection to improve diagnostic accuracy and the prognosis of patients. Alterations in long noncoding RNAs can influence cancer progression through various mechanisms. Our study tried to explore the potential of STARD4-AS1 as a GC biomarker and its mechanism of action in GC development.</p><p><strong>Methods: </strong>Pan-cancer analysis using The Cancer Genome Atlas (TCGA) database identified STARD4-AS1. Serum STARD4-AS1 levels in GC patients were measured by quantitative real-time PCR (qRT-PCR), and diagnostic efficiency was assessed using receiver operating characteristic (ROC) curves. Functional inactivation experiments and western blotting evaluated the biological role of STARD4-AS1 in GC cells. Bioinformatics analysis explored its potential role in GC immunotherapy and underlying mechanisms.</p><p><strong>Results: </strong>Pan-cancer analysis revealed lower overall survival in GC patients with higher STARD4-AS1 expression. qRT-PCR confirmed the reproducibility and stability of STARD4-AS1 as a marker. Serum STARD4-AS1 levels in GC patients were significantly higher than those in healthy subjects and gastritis patients. ROC analysis demonstrated that STARD4-AS1 outperformed CEA, CA199, and CA724 in differentiating GC from gastritis, with optimal diagnostic power when combined with these markers. Knockdown of STARD4-AS1 inhibited GC cell proliferation and metastasis and inhibited the epithelial-mesenchymal transition process. Biosignature prediction indicated that higher STARD4-AS1 expression could evaluate prognosis, as well as regulate GC progression through phosphatidylinositol-mediated signaling, and transmembrane receptor protein tyrosine phosphatase signaling pathway.</p><p><strong>Conclusion: </strong>Serum STARD4-AS1 may serve as a diagnostic biomarker and oncogene function for GC for improving diagnosis, monitoring progression, and evaluating prognosis of GC.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Actual and Perceived Risk of Colorectal Neoplasia in First-Degree Relatives of Patients with Colorectal Cancer.","authors":"Julia Hibbert, Korbinian Weigl, Kaja Tikk, Stefanie J Klug, Matthias Schwab, Svitlana Igel, Oliver Müller, Marcus Pichler, Enrico N DeToni, Alexander Philipp, Jutta Nagel, Renate Schmelz, Anna-Magdalena Brosch, Frank Kolligs, Michael Hoffmeister, Hermann Brenner","doi":"10.14309/ctg.0000000000000893","DOIUrl":"10.14309/ctg.0000000000000893","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with a family history (FH) of colorectal cancer (CRC) are at increased risk of CRC. We aimed to assess the objective role and subjective perception of risk factors of colorectal neoplasia within this high-risk group.</p><p><strong>Methods: </strong>Questionnaire and screening colonoscopy results were obtained from individuals aged 40-54 years with a reported FH of CRC in a first-degree relative in a multicenter cross-sectional study in Germany. Descriptive statistics characterized the cohort and distribution of risk factors. Multivariable logistic regression was used to derive adjusted odds ratios (aORs) and corresponding 95% confidence intervals (CIs) to evaluate factors associated with colorectal neoplasia and with subjectively perceived increased CRC-risk.</p><p><strong>Results: </strong>Among 922 participants, 220 (23.9%) were diagnosed with colorectal neoplasia, 63 (6.8%) of these being advanced lesions. Strong associations with advanced neoplasia were observed for obesity (aOR 2.44, 95% CI 1.12-5.22), smoking (aOR 1.47, 95% CI 1.14-1.88 per 10-pack-years) and physical activity <45 minutes per day (aOR 2.51, 95% CI 1.11-5.25). For smoking and physical activity, but not for obesity, similar associations were also seen with any colorectal neoplasia. No associations were seen with number and age at diagnosis of affected family members. By contrast, the latter factors, but none of the behavioral factors were strongly associated with subjectively perceived CRC-risk.</p><p><strong>Discussion: </strong>Within a cohort of individuals aged 40-54 years with a FH of CRC, obesity, smoking, and lack of physical activity represented the most prominent modifiable risk factors for the development of advanced colorectal neoplasia but did not significantly impact risk perception in these high-risk participants.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00893"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Esophageal Motility, Reflux, and Lung Mechanics and Function Are Disease-Specific, Both Between and Within Restrictive and Obstructive Lung Disease.","authors":"Ali Alghubari, Caroline Olson, Jessica Bradley, Ramsah Cheah, Sadia Z Shah, Abdel-Rahman N Naser, Augustine S Lee, Kenneth R DeVault, Lesley A Houghton","doi":"10.14309/ctg.0000000000000874","DOIUrl":"10.14309/ctg.0000000000000874","url":null,"abstract":"<p><strong>Introduction: </strong>Gastroesophageal reflux is common in respiratory disease, but the interplay between gastrointestinal mechanisms that expose individuals to reflux and potentially aspiration, and lung mechanics and function remain incompletely understood. Our aim was to investigate this in patients with chronic obstructive pulmonary disease (COPD) and non-idiopathic pulmonary fibrosis (IPF) interstitial lung disease (non-IPF ILD), and compare with our published findings in IPF.</p><p><strong>Methods: </strong>Fifty-seven patients with COPD (aged: 34-75 years) and 64 with non-IPF ILD (22-75 years) who underwent high-resolution impedance manometry and 24-hour pH impedance together with pulmonary function assessment were compared with 35 IPF patients (51-84 years).</p><p><strong>Results: </strong>COPD patients were less likely to exhibit ineffective esophageal motility (IEM) and/or absent contractility ( P = 0.009; P = 0.028), and tended to exhibit esophagogastric junction outflow obstruction (EGJOO) and/or hypercontractility ( P = 0.09, P = 0.14) than IPF and non-IPF ILD patients. Notably, integrated relaxation pressure correlated with esophageal length index (ELI) ( P = 0.048) and inspiratory LESP ( P = 0.003), with latter 2 correlating with each other ( P < 0.001). EGJOO patients tended to have fewer proximal reflux events and reduced pulmonary function, with the latter inversely correlating with ELI ( P < 0.05). Non-IPF ILD patients were less likely to exhibit EGJOO than COPD patients ( P = 0.27), and less likely to exhibit IEM ( P = 0.07) than IPF patients. However, those with IEM or EGJOO exhibited greater proportions of reflux events reaching the proximal esophagus than those with normal motility ( P < 0.03), which in contrast to IPF, seemed not to associate with worse pulmonary function.</p><p><strong>Discussion: </strong>Associations between esophageal motility, and lung mechanics and function, and consequently reflux, are very disease-specific.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00874"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbial Shift Over 1 Year Among Patients With Newly Diagnosed Crohn's Disease Reflects Clinical Trajectory and Exposure to Biologic Treatment: A Prospective Real-World Inception Cohort.","authors":"Tali Sharar Fischler, Leah Reshef, Lihi Godny, Idan Goren, Jacob E Ollech, Irit Avni-Biron, Hagar Banai Eran, Yifat Snir, Yelena Broitman, Tamar Pfeffer-Gik, Adi Freidenberg, Maor H Pauker, Keren M Rabinowitz, Uri Gophna, Iris Dotan, Henit Yanai","doi":"10.14309/ctg.0000000000000902","DOIUrl":"10.14309/ctg.0000000000000902","url":null,"abstract":"<p><strong>Introduction: </strong>The gut microbiome in Crohn's disease (CD) shows variability and conflicting associations with disease activity. We aimed to assess microbial and clinical trajectories in newly diagnosed CD (ndCD) over 1 year.</p><p><strong>Methods: </strong>This prospective longitudinal inception cohort study followed treatment-naive patients with ndCD for 1 year. The primary outcome was sustained corticosteroid-free clinical remission (CSFR) after 1 year. Paired fecal samples were collected at diagnosis and 1 year later, analyzed using bacterial 16S rRNA gene high-throughput sequencing. Microbial composition changes were compared between baseline and 1-year follow-up and between biologics-treated and conservatively managed patients. Fecal samples from healthy volunteers served as controls.</p><p><strong>Results: </strong>Seventy-three patients participated; 64.4% achieved sustained CSFR after 1 year. During follow-up, 60.3% had moderate-to-severe disease activity and received biologics (95.5% anti-tumor necrosis factor), whereas 39.7% were managed conservatively. Significant microbial improvements, including increased Shannon diversity and decreased microbial dysbiosis index, were observed only in patients achieving sustained CSFR (both P < 0.001). Biologic-treated patients had more disrupted baseline microbiome composition than conservatively managed ones (Shannon, P = 0.04; microbial dysbiosis index, P = 0.03); they showed significant microbial improvement regardless of clinical success, shifting toward a healthier microbiome profile. Changes in clinical outcomes over 1 year correlated with microbial alterations.</p><p><strong>Discussion: </strong>Over 1 year, treatment-naive patients with ndCD showed microbial improvements paralleling clinical outcomes, with shifts toward a healthier state. Biologic therapy enhanced microbial profiles, likely due to greater baseline disruption in these patients. These findings suggest that the microbiome is a marker of inflammation and a modifiable factor in CD management.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00902"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}