Clinical Gastroenterology and Hepatology最新文献

{"title":"Effect, tolerability, and safety of exclusive palatable elemental diet in patients with intestinal microbial overgrowth.","authors":"Ali Rezaie, Bianca W Chang, Juliana de Freitas Germano, Gabriela Leite, Ruchi Mathur, Krystyna Houser, Ava Hosseini, Daniel Brimberry, Mohamad Rashid, Sepideh Mehravar, M J Villanueva-Millan, Maritza Sanchez, Stacy Weitsman, Cristina M Fajardo, Ignacio G Rivera, Joo Lijin, Yin Chan, Gillian M Barlow, Pimentel Mark","doi":"10.1016/j.cgh.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.03.002","url":null,"abstract":"<p><strong>Background & aims: </strong>Elemental diets (EDs) have desirable safety and efficacy profiles in several clinical settings partly due to modulation of gut microbiome. Palatability of EDs remains the main barrier to compliance/adherence, and their effect has not been prospectively explored in microbiome-driven disorders such as small intestinal bacterial overgrowth (SIBO) and intestinal methanogen overgrowth (IMO). We aimed to assess the effect, tolerance, and safety of a novel palatable ED (PED) in subjects with IMO and/or SIBO.</p><p><strong>Methods: </strong>Adult subjects with positive lactulose breath tests (LBT) for SIBO and/or IMO completed one week of screening, 2 weeks of exclusive oral PED, and 2 weeks of follow-up during reintroduction of regular diet. Primary endpoint was changes in stool microbiome after PED and reintroduction of regular diet. Secondary endpoints included tolerability, rate of normalization of LBT, change in stool form based on daily diary and artificial intelligence-analyzed images, symptomatic response, and adverse events.</p><p><strong>Results: </strong>All 30 enrolled subjects tolerated the PED and completed the trial. Several taxonomic differences were detected including decreased relative abundance of Prevotella_9 and Fusobacterium. Abundance of Methanobrevibacter smithii decreased at the end of the trial and correlated with average daily methane levels (p=0.024, r=0.489). Maximum methane levels (41±35 to 12±15 ppm, p<0.001) and hydrogen rise (43±42 to 12±11 ppm, p<0.001) dropped significantly, with 73% normalizing their LBT. Adequate global relief of symptoms was reported in 83% of subjects. No serious or severe adverse events were observed.</p><p><strong>Conclusion: </strong>PED significantly impacts the gut microbiome. Tolerance to EDs improve with enhanced palatability. Larger studies with longer follow-up are needed to assess response durability. (ClinicalTrials.gov ID: NCT05978973).</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Endoscopy Skills Assessment Tools in Programmatic Assessment.","authors":"Elizabeth A Terry, Ahmed Al Qady, Christen K Dilly","doi":"10.1016/j.cgh.2024.12.029","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.029","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Non-malignant Liver and Pancreatic Diseases in the United States Population: Rates and Trends.","authors":"Aynur Unalp-Arida, Constance E Ruhl","doi":"10.1016/j.cgh.2025.01.026","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.01.026","url":null,"abstract":"<p><strong>Background & aims: </strong>Non-malignant liver and pancreatic diseases are common in the United States and lead to significant morbidity, mortality, and health care utilization. We used national survey and claims databases to investigate rates and trends in the liver and pancreatic disease burden over the past decade in the United States.</p><p><strong>Methods: </strong>The Nationwide Emergency Department Sample, National Inpatient Sample, Vital Statistics of the U.S.: Multiple Cause-of-Death Data, Optum Clinformatics® Data Mart, and Centers for Medicare and Medicaid Services Medicare 5% Sample and Medicaid files were used to estimate claims-based prevalence, medical care use, and mortality with an all-listed liver or pancreatic disease diagnosis.</p><p><strong>Results: </strong>In the U.S. population, liver disease contributed to 2.7 million emergency department visits, 2.0 million hospital stays, and 134,000 deaths in 2021. Pancreatitis was a less common but still significant cause of health care use contributing to 733,000 emergency department visits, 552,000 hospital stays, and 9,000 deaths in 2021. For both conditions, male and American Indian / Alaska Native persons had a greater mortality and medical care use burden. During the study period, both medical care use and mortality rates with a liver disease diagnosis rose, concerningly reversing previously declining trends. For pancreatitis, medical care use rates stabilized or declined during recent years and the mortality rate declined through 2019 and then rose through 2021.</p><p><strong>Conclusions: </strong>The burden of non-malignant liver and pancreatic diseases in the United States is substantial. The rise in liver disease mortality rates following the reversal of a previous downward trend is particularly concerning. Hence ongoing surveillance of liver disease and pancreatitis prevalence may better inform research programs.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AGA Clinical Practice Update on Sclerosing Mesenteritis: Commentary.","authors":"Mark T Worthington, Jacqueline L Wolf, Seth D Crockett, Darrell S Pardi","doi":"10.1016/j.cgh.2024.12.025","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.025","url":null,"abstract":"<p><strong>Description: </strong>The purpose of this American Gastroenterological Association Institute Clinical Practice Update is to review the available evidence for diagnosing and treating, as well as examine opportunities for future research in, sclerosing mesenteritis.</p><p><strong>Methods: </strong>This Clinical Practice Update expert commentary was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the Clinical Practice Updates Committee and external peer review through standard procedures of Clinical Gastroenterology and Hepatology. This expert commentary incorporates important and recently published studies in this field, and it reflects the experiences of the authors who are gastroenterologists with expertise in this topic.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blue Notes","authors":"Charles J. Kahi MD, MS, AGAF","doi":"10.1016/j.cgh.2025.01.001","DOIUrl":"10.1016/j.cgh.2025.01.001","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 5","pages":"Pages 683-684"},"PeriodicalIF":11.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of low-dose acetylsalicylic acid on renal function in patients with liver cirrhosis and ascites.","authors":"Henrik Karbannek, Marina Reljic, Andreas Stallmach, Alexander Zipprich, Cristina Ripoll","doi":"10.1016/j.cgh.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.02.005","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elsewhere in the AGA Journals","authors":"","doi":"10.1016/S1542-3565(25)00123-5","DOIUrl":"10.1016/S1542-3565(25)00123-5","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 5","pages":"Pages A19-A20"},"PeriodicalIF":11.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1016/j.cgh.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.01.002","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition of Care in Celiac Disease: A Chance to Advance.","authors":"Laura Kivelä, Claire Jansson-Knodell, Deborah Goldman, Kalle Kurppa, Alberto Rubio-Tapia","doi":"10.1016/j.cgh.2025.01.006","DOIUrl":"10.1016/j.cgh.2025.01.006","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers of histological response in lanifibranor-treated patients with metabolic dysfunction-associated steatohepatitis.","authors":"Jérôme Boursier, Hugo Hervé, Marine Roux, Manal F Abdelmalek, Sven M Francque, Pierre Broqua, Jean-Louis Junien, Jean-Louis Abitbol, Philippe Huot-Marchand, Lucile Dzen, Michael P Cooreman, Sanjaykumar Patel","doi":"10.1016/j.cgh.2024.12.039","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.039","url":null,"abstract":"<p><strong>Background and aims: </strong>Lanifibranor, a pan-peroxisome proliferator-activated receptor agonist, has demonstrated therapeutic efficacy on MASH resolution and fibrosis improvement in the phase 2b NATIVE study. The histological endpoints MASH resolution and fibrosis improvement (E1), MASH resolution without worsening of fibrosis (E2) and fibrosis improvement without worsening of MASH (E3) were investigated with the aim to identify biological signatures of E1, E2, and E3 responders based on serum biomarkers in patients treated with lanifibranor.</p><p><strong>Methods: </strong>NATIVE evaluated lanifibranor 800 and 1200 mg daily versus placebo in patients with non-cirrhotic MASH treated over 24 weeks. Liver biopsy was obtained at baseline and the end of treatment (EOT). Patients receiving lanifibranor were pooled and those with liver biopsies were selected (N=142). A panel of 65 biomarkers were evaluated by assessing baseline and absolute as well as relative changes at EOT.</p><p><strong>Results: </strong>The biomarkers included in E1-score (baseline adiponectin and ferritin; delta of matrix metalloproteinase 9 and transferrin), E2-score (baseline cytokeratin 18 Fragment M65; delta of hyaluronic acid, fructosamine and ALT) and E3-score (baseline cytokeratin 18 Fragment M65 and gamma-GT; delta of AST, insulin, and urea) represented metabolic, apoptotic and fibrosis aspects of the disease. These signatures provided good accuracy for the non-invasive identification of histological response under lanifibranor with AUROC at 0.81±0.08 for E1-score, 0.80±0.08 for E2-score and 0.81±0.08 for E3-score.</p><p><strong>Conclusions: </strong>Results from this analysis show evidence that baseline values and changes in selected serum biomarkers can aid in predicting histological response in MASH under lanifibranor treatment. These findings support utilizing a similar approach in a larger sample size (NATiV3, NCT03008070).</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}