Clinical and Translational Gastroenterology最新文献

{"title":"Effects of Ricinoleic Acid (Castor Oil) on Gut Permeability in Healthy Participants: Provocative Test for Treatments Aimed at Restoring Barrier Function.","authors":"David Yi Yang, Camille Lupianez-Merly, Kara J Jencks, Saam Dilmaghani, Irene Busciglio, Deborah Eckert, Michael Ryks, Roy Dyer, Brady A Vizenor, Yuxi Zhao, Anna Sapone, Michelle G Rooks, Jeremy D Gale, Michael Camilleri","doi":"10.14309/ctg.0000000000000865","DOIUrl":"10.14309/ctg.0000000000000865","url":null,"abstract":"<p><strong>Introduction: </strong>Altered intestinal permeability (IP) is implicated in multiple gastrointestinal and systemic disease conditions; an experimental model of perturbed IP in healthy subjects is needed. Traditional approaches to perturbing IP include use of nonsteroidal anti-inflammatory drugs.</p><p><strong>Methods: </strong>We conducted a single-center, randomized, placebo-controlled pilot study of dose-related effects of castor oil (CO) (and its ingredient ricinoleic acid) at 750, 1,500, or 3,000 mg daily doses on IP. Permeability was assessed using validated 13 C-mannitol and lactulose urine excretion at 0-2, 8-24, and 0-24 hours after oral administration.</p><p><strong>Results: </strong>Permeability analysis across all groups demonstrated significant difference among the groups for 0-2 hours 13 C-mannitol, 0-24 hours 13 C-mannitol, and borderline significant difference for 2-8 hours 13 C-mannitol ( P = 0.060) and 0-24 hours lactulose ( P = 0.056). Direct comparison of 3,000 mg CO vs placebo ( t test) demonstrated higher excretion of 13 C-mannitol and lactulose at 0-2, and 0-24 hours, and lactulose at 2-8 hours.</p><p><strong>Discussion: </strong>CO may perturb small intestinal and colonic permeability in healthy adults.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00865"},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157136","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":"Integrating Etiological Insights With Machine Learning for Precision Diagnosis of Obstructive Jaundice: Findings From a High-Volume Center.","authors":"Ningyuan Wen, Yaoqun Wang, Xianze Xiong, Jianrong Xu, Shaofeng Wang, Yuan Tian, Di Zeng, Xingyu Pu, Bei Li, Jiong Lu, Geng Liu, Nansheng Cheng","doi":"10.14309/ctg.0000000000000849","DOIUrl":"10.14309/ctg.0000000000000849","url":null,"abstract":"<p><strong>Introduction: </strong>Large-scale cohort studies exploring the etiology of obstructive jaundice (OJ) are scarce, with current serum-based diagnostic markers offering suboptimal performance. This study leverages the largest retrospective cohort of patients with OJ to date to investigate its disease spectrum and to develop a novel diagnostic system.</p><p><strong>Methods: </strong>This study involves 2 retrospective observational cohorts. The biliary surgery cohort (BS cohort, n = 349) served for initial data exploration and external validation of machine learning (ML) models. The large general cohort (LG cohort, n = 5,726) enabled an in-depth analysis of etiologies and the determination of relevant diagnostic indicators, in addition to supporting ML model development. Interpretable ML techniques were used to derive insights from the models.</p><p><strong>Results: </strong>The LG cohort highlighted a diverse disease spectrum of OJ, including cholangiocarcinoma (10.39% distal, 10.01% perihilar, and 5.59% intrahepatic), pancreatic adenocarcinoma (19.11%), and common bile duct stones (18.27%) as leading causes. Traditional serum markers such as carbohydrate antigen 19-9 and carcinoembryonic antigen lacked stand-alone diagnostic accuracy. Two ML-based models (collectively termed the ML of OJ based on common laboratory tests model) were developed: a classifier to differentiate benign from malignant causes (AUROC = 0.862) and a multiclass model to further stratify malignant and benign diseases (ACC = 0.777). Interpretable ML tools provided clarity on critical features, offering actionable insights and enhancing transparency in the decision-making process.</p><p><strong>Discussion: </strong>This study elucidates the etiological spectrum of OJ, meanwhile providing a practical and interpretable ML-based diagnostic tool. By leveraging large-scale clinical data, our model provides a rapid and reliable primary assessment for patients with OJ, enabling clinicians to identify potential etiologies and guide further diagnostic workup.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157138","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":"The Enteric Microbiome in Early-Onset Colorectal Cancer: A Comprehensive Review of Its Role as a Biomarker of Disease.","authors":"Jesús M Luévano, Julia Liu, Thaddeus Stappenbeck","doi":"10.14309/ctg.0000000000000864","DOIUrl":"10.14309/ctg.0000000000000864","url":null,"abstract":"<p><p>Early-onset colorectal cancer (EoCRC), a distinct entity from late-onset colorectal cancer (LoCRC), continues to increase in incidence. Known risk factors for LoCRC have been explored to explain this trend, but do not account for it completely. The gastrointestinal microbiome has been associated with LoCRC and additional risk factors of disease; however, it is only now being investigated in the context of EoCRC. A better understanding of the microbiome's function in EoCRC could elucidate its role in the increasing incidence of EoCRC. This article reviews the state of literature related to studies specifically isolating microbiome-related changes in EoCRC compared with LoCRC and age-matched controls. Several studies reviewed in this article highlight the varied results of overall diversity and specific bacteria that are influenced by EoCRC, and the utility of these unique changes to predict for EoCRC. Although the microbiome can be useful in understanding EoCRC, to better predict for disease the microbiome must be studied in more diverse populations and with deeper, more functional characterization in a manner that allows for transference of findings among future studies. These studies indicate that the enteric microbiome holds significant potential as a biomarker for disease but has yet to fully meet an understanding necessary for direct clinical utilization.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157140","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":"Clinical and Endoscopic-Histological Features of Multifocal and Corpus-Restricted Atrophic Gastritis Patients With Non-Cardia Gastric Cancer or Dysplasia: A Multicenter, Cross-Sectional Study.","authors":"Edith Lahner, Bruno Annibale, Emanuele Dilaghi, Cristina Luciano Millado, Marco Vincenzo Lenti, Antonio Di Sabatino, Emanuela Miceli, Sara Massironi, Nicola Zucchini, Renato Cannizzaro, Stefano Realdon, Giuseppe Losurdo, Antonia Valeria Borraccino, Elisa Marabotto, Edoardo Giovanni Giannini, Andrea Pasta, Francesco Calabrese, Luca Mastracci, Roberta Elisa Rossi, Valentina Sciola, Antonella Contaldo, Antonio Pisani, Angela Dalia Ricci, Maria Savino, Gianluigi Giannelli, Mario Milco D'Elios, Chiara Della Bella, Damiano Martino, Fabiana Zingone, Fabio Farinati","doi":"10.14309/ctg.0000000000000862","DOIUrl":"10.14309/ctg.0000000000000862","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Helicobacter pylori (Hp)-related atrophic gastritis (AG) affects corpus and antral mucosa, resulting in multifocal AG (MF-AG); autoimmunity-driven AG is corpus-restricted (CR-AG). AG carries increased gastric dysplasia (GD) and gastric cancer (GC) risk, well established in MF-AG, but debated in CR-AG. This study aimed to assess clinical, endoscopic-histological characteristics of GD-GC in patients with MF-AG and CR-AG.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was the multicenter cross-sectional study across 11 Italian gastroenterology centers on data of non-cardia GD-GC in adult patients with MF-AG or CR-AG based on clinical, endoscopic, and histological charts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eighty-four patients were included with MF-AG and CR-AG in 45 (53.6%) and 39 (46.4%), respectively. Low-grade GD, high-grade GD, and GC were diagnosed in 31 (36.9%), 6 (7.1%), and 47 (56.0%), respectively. GD-GC similarly occurred in patients with MF-AG and CR-AG: high-grade GD in 4 (8.9%) vs 2 (5.1%), low-grade GD in 17 (37.8%) vs 14 (35.9%), and GC in 24 (53.5%) vs 23 (59.0%) ( P &gt; 0.05). Compared with MF-AG, in patients with CR-AG, GD-GC were more commonly polypoid (51.6% vs 27.3%, P = 0.048) and more frequent in the corpus (55.3% vs 28.6%, P = 0.02), but occurred also in the antrum (34.2%) and incisura (10.5%). Surgery was more frequent in CR-AG than in MF-AG (48.6% vs 23.1%, P = 0.02). Corpus atrophy severity and intestinal metaplasia were not different ( P &gt; 0.05), histological Hp positivity was low in both (2.3% vs 2.9%, P = 0.87), but in Hp negatives, active inflammation was present in the antrum in 26.7% and 7.7% ( P = 0.02), and in the corpus in 31.1% and 21.5% ( P = 0.27).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Non-cardia GC and GD may occur in both MF-AG and CR-AG, displaying differences in topography and endoscopic presentation but similarities in nonlesional mucosa, differentiation, and staging. Surveillance should be considered in corpus AG, regardless of extension and supposed etiology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;La gastrite atrofica (AG) Helicobacter pylori (Hp)-relata interessa la mucosa dell'antro e del corpo-fondo dando luogo alla gastrite atrofica multifocale (MF-AG); la gastrite atrofica autoimmune invece è limitata al corpo-fondo risparmiando l'antro (CR-AG). L'AG è ad aumentato rischio per displasia (GD) e cancro gastrico (GC). Questo rischio è ben stabilito nella MF-AG, ma ancor adibattuto nella CR-AG. Questo studio ha come scopo di valutare le caratteristiche cliniche e endoscopico-istologiche di pazienti affetti da GD o GC in MF-AG e CR-AG.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Metodi: &lt;/strong&gt;E' stato condotto uno studio trasversale multicentrico in 11 centri gastroenterologici italiani su dati di pazienti adulti con GD o GC non cardiali in MF-AG o CR-AG basati su schede cliniche e referti endoscopici e istologici.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risultati: &lt;/strong&gt;Sono stati inclusi 84 pazienti, di cui 45 (53.6%) con MF-AG e 39 (46.4%","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126849","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":"Bile Acid Diarrhea Is Associated With an Increased Risk of Type 2 Diabetes and Cardiovascular Disease: A Nationwide Cohort Study.","authors":"Anne-Marie Ellegaard, Matilde Winther-Jensen, Line L Kårhus, Filip K Knop, Martin L Kårhus","doi":"10.14309/ctg.0000000000000863","DOIUrl":"10.14309/ctg.0000000000000863","url":null,"abstract":"<p><strong>Introduction: </strong>Bile acid diarrhea (BAD) is a socially debilitating disease characterized by diarrhea, fecal urgency, and fecal incontinence. It is caused by excessive amounts of bile acids in the colon and is estimated to affect up to 1% of the population. Among other actions, bile acids regulate systemic glucose and lipid metabolism, and BAD has been associated with a dysmetabolic prediabetic-like state. Here, we investigate the association between BAD and type 2 diabetes (T2D) and cardiovascular disease (CVD), respectively.</p><p><strong>Methods: </strong>By using nationwide Danish health registries, individuals with BAD were identified by referral to the diagnostic 75 selenium-homotaurocholic acid test followed by redemption of a prescription of a bile acid sequestrant within 365 days or a BAD diagnosis code (n = 5,954). A reference population of age-matched and sex-matched individuals was included for comparison (n = 59,540).</p><p><strong>Results: </strong>More individuals with BAD than controls developed T2D (8.8% vs 5.2%) and experienced CVD (22.7% vs 18.0%) after index date (i.e., BAD diagnosis or matching, respectively). Sensitivity analyses revealed earlier onset of T2D and CVD in the BAD population compared with matches but no difference between sexes. The cause-specific hazards for T2D and CVD were 1.79 and 1.34, respectively, in the BAD population compared with matches. All-cause mortality-but not CVD-related mortality-was increased among individuals with BAD compared with matches.</p><p><strong>Discussion: </strong>BAD is associated with increased risk and earlier onset of T2D and CVD, respectively, as well as disturbed glucose and lipid metabolism, indicating BAD as a high-risk condition requiring intensified monitoring and relevant preventive interventions.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00863"},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126843","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":"Predictors of 30-Day Unplanned Readmission in Necrotizing Pancreatitis: A 12-Year Experience From a Tertiary Care Center.","authors":"Gaurav Suryawanshi, Megan B Ghai, Nauroze Faizi, Stuart K Amateau, Nabeel Azeem, Shawn Mallery, Martin L Freeman, Guru Trikudanathan","doi":"10.14309/ctg.0000000000000848","DOIUrl":"10.14309/ctg.0000000000000848","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital readmission rate is a key hospital metric and represents a substantial burden to patients and the healthcare system. Necrotizing pancreatitis (NP) patients are at high risk of unplanned readmission. The aim of this study was to determine the incidence and predictors of 30-day unplanned readmission after index hospitalization for NP.</p><p><strong>Methods: </strong>Adult NP patients who were managed at a single tertiary referral center between 2009 and 2022 were identified from a prospective database and categorized into 2 groups based on 30-day unplanned readmission after index hospitalization. Patients with no follow-up who died during index admission or within 30 days of discharge were excluded. Baseline data on admission including demographic, clinical, interventional, imaging, and discharge characteristics were compared. Multivariable analysis was completed to identify independent predictors of 30-day readmission.</p><p><strong>Results: </strong>Among 505 patients with NP (male patients-347 [69%], median age-50 years [inter quartile range 37-63]) 191 (37.8%) had at least 1 unplanned readmission. The most common causes of readmission were abdominal pain (40%) and sepsis (27%). On multivariable analysis, independent predictors for early readmission were necrosis collection size ≥ 6 cm (adjusted odds ratio [aOR] 1.91 [1.11-3.30], P < 0.03), stay at outside hospital ≥ 14 days before transfer to tertiary center (aOR 2.89 [1.27-6.60], P < 0.01), and need for percutaneous feeding tube at the time of discharge (aOR 2.06 [1.01-4.21], P < 0.05).</p><p><strong>Discussion: </strong>Readmission after NP is common and associated with greater mortality at 6 months. Expedited transfer to tertiary center for timely intervention, assiduous follow-up of other high-risk patients (large collections and those who need enteral nutrition) could help avoid readmissions and optimize outcomes.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00848"},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126866","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":"Impact of Treatment Adjustment on the Endoscopic Prognosis of Postoperative Anastomotic Lesions in Patients With Crohn's Disease.","authors":"Linlin Yin, Chenliang Ding, Yi Li, Lei Cao, Hongfei Tu, Yue Zhu, Luxuan Tan, Bin Zhang, Jianfeng Gong","doi":"10.14309/ctg.0000000000000859","DOIUrl":"10.14309/ctg.0000000000000859","url":null,"abstract":"<p><strong>Introduction: </strong>Anastomotic ulcers are common after ileocolonic resection in patients with Crohn's disease (CD). However, the endoscopic prognosis of isolated anastomotic lesions after treatment adjustment remains unclear.</p><p><strong>Methods: </strong>We retrospectively included CD patients with anastomotic lesions who were referred to our center for ileocolonoscopy between 2020 and 2024. We conducted an initial evaluation of the impact of treatment adjustment on the endoscopic prognosis of anastomotic lesions. In addition, we analyzed the association between different adjustment strategies and endoscopic outcome.</p><p><strong>Results: </strong>In total, 199 eligible CD patients with anastomotic lesions were included in our study. Treatment adjustment promoted mucosal healing (multivariable Cox hazard ratio [HR]: 2.376, 1.400-4.032, P = 0.001) and endoscopic improvement (multivariable Cox HR: 2.373, 1.596-3.530, P < 0.001). We also found that the endoscopic ulcer improvement of biologics to biologics switching was superior to that of nontreatment adjustment (Cox HR: 2.055, 1.212-3.482, P = 0.007). Cox regression analyses further confirmed that nonbiologics to biologics switching was associated with better endoscopic mucosal healing (Cox HR: 2.751, 1.494-5.063, P = 0.001) and ulcer improvement (Cox HR: 2.154, 1.322-3.509, P = 0.002). Regarding patients with insufficient trough levels of biologics, biologic optimization significantly improved endoscopic mucosal healing (Cox HR: 2.854, 1.345-6.053, P = 0.006) and endoscopic ulcer improvement (Cox HR: 2.344, 1.288-4.265, P = 0.005).</p><p><strong>Discussion: </strong>Treatment adjustment contributed to the improvement of endoscopic prognosis in anastomotic lesions patients. Different adjustment strategies (biologics to biologics switching, nonbiologics to biologics switching, biologic optimization) similarly resulted in better endoscopic outcome.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00859"},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109735","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":"Letter: Suggestions for Improving Study Design and Incorporating Virological Markers in HBV Functional Cure Research.","authors":"Chaoting Yang, Huaguo Shao, Jinsong Huang","doi":"10.14309/ctg.0000000000000847","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000847","url":null,"abstract":"","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076385","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":"Predictive Value of Tumor Regression Grading on the Prognosis of Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer: A Systematic Review and Meta-Analysis.","authors":"Ruchen Wu, Shuying Lin, Junze Chen, Gang Wang, Lulu Han","doi":"10.14309/ctg.0000000000000860","DOIUrl":"10.14309/ctg.0000000000000860","url":null,"abstract":"<p><strong>Introduction: </strong>Tumor regression grade (TRG) after neoadjuvant chemotherapy is recognized as a significant and favorable prognostic indicator in various cancer types. However, this relationship remains less defined and has not been systematically investigated in locally advanced gastric cancer (LAGC). To address this gap, we conducted a meta-analysis aimed at assessing the prognostic influence of tumor regression after preoperative therapy on disease-free survival (DFS) and overall survival (OS) among patients with LAGC.</p><p><strong>Methods: </strong>A systematic search was conducted across the following databases: PubMed, Web of Science, Embase, Cochrane, WF, CNKI, SinoMed, and VIP. The primary outcomes included DFS and OS, estimated using hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Subsequently, either the fixed-effects model or the random-effects model was used to compute HR and 95% CI based on the results of heterogeneity analysis.</p><p><strong>Results: </strong>A total of 11 studies, comprising 2,733 patients, were included in the final analysis. The results indicated that a lower TRG was associated with prolonged DFS (HR 0.53, 95% CI 0.32-0.88) and prolonged OS (HR 0.59, 95% CI 0.39-0.87) in patients with LAGC who received neoadjuvant chemotherapy. Sensitivity analysis demonstrated that no single study significantly influenced the results for both DFS and OS. Publication bias was identified in the meta-analysis for OS, whereas no publication bias was detected in the meta-analysis for DFS.</p><p><strong>Discussion: </strong>A lower TRG score is associated with improved DFS and OS in patients with LAGC receiving neoadjuvant chemotherapy.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00860"},"PeriodicalIF":3.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976568","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":"Downregulated Expression of Serum Exosome-Derived miR-375-3p Alleviates Interface Hepatitis and Promotes Fibrosis Regression in Patients With Chronic Hepatitis B.","authors":"Ran Xu, Sihao Wang, Quanwei He, Wei Han, Shujuan Gong, Liping Yan, Jiagan Huang, Xiaoyan Zhan, Zhaofang Bai, Jiangtao Liu, Yan Chen, Yongping Yang","doi":"10.14309/ctg.0000000000000850","DOIUrl":"10.14309/ctg.0000000000000850","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic liver inflammation leads to fibrosis, cirrhosis, and hepatocellular carcinoma. Serum alanine aminotransferase is the most widely used indicator of liver inflammatory injury, but it does not accurately reflect the extent of chronic liver inflammation. The role of exosomes in chronic liver inflammation and fibrosis has gained significant interest. The aim of this study was to investigate the association between serum exosome-derived miRNAs and chronic liver inflammation injury in chronic hepatitis B (CHB) patients with significant fibrosis, and to evaluate their potential clinical value.</p><p><strong>Methods: </strong>Using serum samples collected from healthy adults and patients with paired histological CHB and significant fibrosis. Transcriptome analysis was conducted to identify dysregulated exosome-derived miRNAs associated with chronic liver inflammation. These were validated by lipopolysaccharide/D-galactosamine-induced acute liver injury in mice and CCl 4 -induced cirrhosis in rat models, and 80 CHB patients with paired histological after a 72-week treatment.</p><p><strong>Results: </strong>Exosome-derived miR-375-3p was positively associated with interface hepatitis, as determined by transcriptomic screening. Its upregulation was associated with severe interface hepatitis in the mouse and rat models. In the validation cohort, a high proportion of patients in the high-expression group demonstrated severe interface hepatitis (85%, P = 0.022), whereas the low-expression group showed a higher proportion of interface hepatitis improvement (80%, P = 0.002) and regression of fibrosis (70%, P < 0.001).</p><p><strong>Discussion: </strong>The expression level of serum exosome-derived miR-375-3p was positively associated with interface hepatitis and is independently associated with the prognosis of interface hepatitis and fibrosis in patients with CHB and significant fibrosis.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00850"},"PeriodicalIF":3.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956671","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}