Clinical Gastroenterology and Hepatology最新文献

{"title":"Gut Goo: Physiology, Diet, and Therapy of Intestinal Mucus and Biofilms in Gastrointestinal Health and Disease","authors":"John Damianos ,&nbsp;Nada Abdelnaem ,&nbsp;Michael Camilleri","doi":"10.1016/j.cgh.2024.09.007","DOIUrl":"10.1016/j.cgh.2024.09.007","url":null,"abstract":"<div><div>The gastrointestinal tract has remarkable capacity to withstand considerable insults from exposure to abrasive food particles, chemicals, allergens, and pathogenic microbes. Maintaining a robust epithelial barrier sequesters these potentially harmful substances in the lumen, preventing absorption into the systemic circulation. Normal functioning of this barrier is central in diverse physiological processes including digestion, immunity, inflammation, and gut-brain signaling. One crucial component of the barrier is the mucus layer covering the epithelium. There is increased appreciation of the importance of mucus in maintenance of the gut barrier, and how dysregulation of the mucus layer contributes to several common gastrointestinal pathologies. This manuscript reviews the physical and chemical properties of mucus, its maintenance and turnover, and its role in maintaining gut barrier integrity. The dynamic interactions of the mucus layer within the gut ecosystem are illustrated by highlighting how a weakened mucus layer or defective mucus production facilitate pathogenic microbial colonization and mucosal biofilm formation. These may potentially contribute to the pathogenesis of gastrointestinal diseases such as inflammatory bowel diseases or result in secretion and mucosal damage and inflammation in bile acid diarrhea. A final goal is to review how certain dietary factors, especially low-fiber diets and emulsifiers common in Western diets, can harm the mucus layer. This report summarizes evidence from preclinical and human studies that document damage to the mucus layer, and reviews approaches, including diets and probiotics, that promote a healthy mucus layer and break down pathogenic biofilms, thereby potentially preventing and/or treating gastrointestinal diseases that impact mucosal integrity.</div></div>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 205-215"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459521","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":"Patients With Inflammatory Bowel Disease Are at Increased Risk for Complications of Herpes Zoster","authors":"Freddy Caldera ,&nbsp;Siddharth Singh ,&nbsp;Emily E. Zona ,&nbsp;Oscar Ramirez Ramirez ,&nbsp;Jonathan Inselman ,&nbsp;Herbert Heien ,&nbsp;Andrew P. Keaveny ,&nbsp;Mary S. Hayney ,&nbsp;Francis A. Farraye","doi":"10.1016/j.cgh.2024.09.022","DOIUrl":"10.1016/j.cgh.2024.09.022","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Patients with inflammatory bowel disease (IBD) are at an increased risk for vaccine-preventable diseases, such as herpes zoster (HZ). The aim of this study was to determine whether complications of HZ are more frequent in patients with IBD than in non-IBD controls.</div></div><div><h3>Methods</h3><div>This was a retrospective, cohort study using the Optum Research Database. Patients with IBD were matched 1:1 to non-IBD controls based on age, sex, and index year, which was defined as the diagnosis of HZ. We then identified the complications of HZ that occurred up to 90 days after the index date. We compared patients with IBD with non-IBD controls and evaluated the 90-day risk of HZ complications. We used a composite primary outcome for any HZ complication. Secondary outcomes were risk factors for complications.</div></div><div><h3>Results</h3><div>A total of 4756 patients with IBD met the inclusion criteria and were matched to the controls. Patients with IBD were more likely to have complications of HZ than controls (738 [15.52%] vs 595 [12.51%]; <em>P</em> &lt; .0001). Patients with IBD with higher comorbidity scores were more likely to develop complications (1.86 vs 1.18; <em>P</em> &lt; .0001). In the logistic regression analysis of patients with IBD having a higher comorbidity score, above 50 years of age, on anti-tumor necrosis factor (TNF) or corticosteroids were all at increased risk of a complication of HZ.</div></div><div><h3>Conclusion</h3><div>Patients with IBD are more likely to have complications of HZ than controls. Efforts are needed to increase HZ vaccine uptake to reduce the morbidity of HZ.</div></div>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 331-340.e2"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496272","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":"Human Endoscopic Ultrasonography Using Linear Array Scope for Pancreatic Diseases","authors":"Matthew J. DiMagno,&nbsp;Eugene P. DiMagno","doi":"10.1016/j.cgh.2024.05.016","DOIUrl":"10.1016/j.cgh.2024.05.016","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 378-379"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080738","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":"Esophageal Large-Cell Neuroendocrine Carcinoma Mimicking Benign Submucosal Tumor Treated With Endoscopic Submucosal Dissection","authors":"Jiao Li,&nbsp;Zhengkui Zhou,&nbsp;Xiaobin Sun","doi":"10.1016/j.cgh.2024.06.043","DOIUrl":"10.1016/j.cgh.2024.06.043","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages A21-A22"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed Opportunity to Triage Patients With Irritable Bowel Syndrome to Multidisciplinary Therapy","authors":"Bhavana Tetali,&nbsp;William D. Chey,&nbsp;Stacy B. Menees","doi":"10.1016/j.cgh.2024.08.019","DOIUrl":"10.1016/j.cgh.2024.08.019","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 371-373.e1"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104959","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":"Screening for Social Determinants of Health in Underserved Populations to Promote Better Outcomes in ALD and MASLD","authors":"Michael Sun,&nbsp;Aivi A. Rahman,&nbsp;Vincent J.H. Yao","doi":"10.1016/j.cgh.2024.05.027","DOIUrl":"10.1016/j.cgh.2024.05.027","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 379-380"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316864","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":"Development and Validation of a Noninvasive Model for the Detection of High-Risk Varices in Patients With Unresectable Hepatocellular Carcinoma","authors":"Neehar D. Parikh ,&nbsp;Patricia Jones ,&nbsp;Reena Salgia ,&nbsp;Irun Bhan ,&nbsp;Lauren T. Grinspan ,&nbsp;Janice H. Jou ,&nbsp;Kali Zhou ,&nbsp;Prasun Jalal ,&nbsp;Giorgio Roccaro ,&nbsp;Amol S. Rangnekar ,&nbsp;Jihane N. Benhammou ,&nbsp;Anjana Pillai ,&nbsp;Neil Mehta ,&nbsp;Joel Wedd ,&nbsp;Ju Dong Yang ,&nbsp;Amy K. Kim ,&nbsp;Andres Duarte-Rojo ,&nbsp;Omobonike O. Oloruntoba ,&nbsp;Amit Tevar ,&nbsp;Jennifer S. Au ,&nbsp;Amit G. Singal","doi":"10.1016/j.cgh.2024.07.008","DOIUrl":"10.1016/j.cgh.2024.07.008","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Noninvasive variceal risk stratification systems have not been validated in patients with hepatocellular carcinoma (HCC), which presents logistical barriers for patients in the setting of systemic HCC therapy. We aimed to develop and validate a noninvasive algorithm for the prediction of varices in patients with unresectable HCC.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study in 21 centers in the United States including adult patients with unresectable HCC and Child-Pugh A5-B7 cirrhosis diagnosed between 2007 and 2019. We included patients who completed an esophagogastroduodonoscopy (EGD) within 12 months of index imaging but before HCC treatment. We divided the cohort into a 70:30 training set and validation set, with the goal of maximizing negative predictive value (NPV) to avoid EGD in low-risk patients.</div></div><div><h3>Results</h3><div>We included 707 patients (median age, 64.6 years; 80.6% male; 74.0% White). Median time from HCC diagnosis to EGD was 47 (interquartile range, 114) days, with 25.0% of patients having high-risk varices. A model using clinical variables alone achieved an NPV of 86.3% in the validation cohort, whereas a model integrating clinical and imaging variables had an NPV 97.4% in validation. The clinical and imaging model would avoid EGDs in more than half of low-risk patients while misclassifying 7.7% of high-risk patients.</div></div><div><h3>Conclusions</h3><div>A model incorporating clinical and imaging data can accurately predict the absence of high-risk varices in patients with HCC and avoid EGD in many low-risk patients before the initiation of systemic therapy, thus expediting their care and avoiding treatment delays.</div></div>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 281-290.e4"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874341","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":"Diffuse Large B-Cell Duodenal Lymphoma Presenting With Obstruction and Pneumatosis","authors":"Ramzi Hassouneh ,&nbsp;Michael Morton ,&nbsp;Christen K. Dilly","doi":"10.1016/j.cgh.2024.06.045","DOIUrl":"10.1016/j.cgh.2024.06.045","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages A23-A24"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787378","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":"Performance of a Multi-cancer Early Detection Test for Detection of Hepatocellular Carcinoma in Patients With Cirrhosis","authors":"Darine Daher,&nbsp;Purva Gopal,&nbsp;Marie V. Coignet,&nbsp;Vivian Xiao ,&nbsp;Kathryn N. Kurtzman ,&nbsp;Amit G. Singal","doi":"10.1016/j.cgh.2024.07.016","DOIUrl":"10.1016/j.cgh.2024.07.016","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 369-370"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792121","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":"Disparities for Hispanic Adults With Metabolic Dysfunction-associated Steatotic Liver Disease in the United States: A Systematic Review and Meta-analysis","authors":"Kaleb Tesfai ,&nbsp;Jordan Pace ,&nbsp;Nora El-Newihi ,&nbsp;Maria Elena Martinez ,&nbsp;Monica A. Tincopa ,&nbsp;Rohit Loomba","doi":"10.1016/j.cgh.2024.06.038","DOIUrl":"10.1016/j.cgh.2024.06.038","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Prevalence and severity of metabolic dysfunction-associated steatotic liver disease (MASLD) is reported to be higher in Hispanic adults in the United States (U.S.), although rates vary substantially across studies and have increased given the evolving obesity epidemic. This systematic review and meta-analysis quantifies MASLD disease burden and severity in contemporary cohorts to characterize health disparities experienced by adult Hispanic individuals in the U.S.</div></div><div><h3>Methods</h3><div>We searched the MEDLINE, Embase, and Cochrane databases per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies from 2010 to December 2023 were included to capture data representative of current populations given the obesity epidemic. Studies from overlapping cohorts were excluded. Meta-analyses were conducted using random-effects models to estimate pooled prevalence and relative risk (RR) with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>We identified 22 studies, comprising 756,088 subjects, of which 62,072 were Hispanic. The pooled prevalence in U.S. Hispanic adults was 41% (95% CI, 30%–52%) for MASLD, 61% (95% CI, 39%–82%) for metabolic dysfunction-associated steatohepatitis (MASH), 27% (95% CI, 15%–39%) for MASH-associated advanced fibrosis (AF), and 5% (95% CI, 1%–8%) for MASH cirrhosis. Compared with non-Hispanic adults, Hispanic adults had a RR of 1.50 (95% CI, 1.32–1.69) for MASLD, 1.42 (95% CI, 1.04–1.93) for MASH, 1.37 (95% CI, 0.96–1.96) for MASH-associated AF, and 0.93 (95% CI, 0.49–1.77) for MASH cirrhosis.</div></div><div><h3>Conclusion</h3><div>Health disparities for U.S. Hispanic adults continue to worsen with significantly higher relative risk of MASLD and MASH compared with non-Hispanic adults. Public health efforts to optimize screening and care delivery for the adult Hispanic population are urgently needed.</div></div>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"23 2","pages":"Pages 236-249"},"PeriodicalIF":11.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691930","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}