Clinical Gastroenterology and Hepatology最新文献

{"title":"Efficacy of Dupilumab on Facilitated Food Reintroduction in Eosinophilic Esophagitis.","authors":"Nicole Wolfset, Amanda B Muir, Alain J Benitez, Danielle Williams, Ignacio De La Torre, Melanie A Ruffner, David A Hill, Christine Cazeau, James T Angello, Amr Radwan, Sandy Durrani, Sabina deMarchi, Jonathan M Spergel","doi":"10.1016/j.cgh.2025.08.025","DOIUrl":"10.1016/j.cgh.2025.08.025","url":null,"abstract":"<p><strong>Background & aims: </strong>Eosinophilic esophagitis (EoE) is a chronic, type 2 inflammatory disease of the esophagus commonly triggered by food allergens. Eliminating dietary EoE trigger foods can effectively treat EoE in some cases, but maintaining adherence can be challenging and can reduce quality of life. We aimed to assess the efficacy of dupilumab on reintroducing these foods based on clinical outcomes in patients with EoE.</p><p><strong>Methods: </strong>We conducted an open-label pilot study in which patients aged 6 to 25 years with EoE induced by milk, egg, soy, or wheat were treated with weight- and age-tiered dupilumab for 3 months, followed by standardized reintroduction of trigger foods at months 3, 6, and 9, while continuing on dupilumab treatment. Symptoms, histology, endoscopy, and esophageal diameter were compared prior to and following every phase of food reintroduction to month 12. All patients had previously failed trigger food reintroduction on their current EoE medication.</p><p><strong>Results: </strong>Twenty-one patients were enrolled. All patients who completed the study were able to reintroduce at least one serving size of trigger foods by month 12, and 8 patients were able to add foods every 3 months. There was no worsening of any clinical outcome, including symptoms, histology, and esophageal diameter. There were no serious treatment-related adverse events.</p><p><strong>Conclusion: </strong>Patients with EoE treated with dupilumab were able to safely reintroduce EoE trigger foods into their diet without exacerbation of histologic, endoscopic, or symptomatic measures of EoE severity. Some patients were able to reintroduce food at an earlier timepoint than others.</p><p><strong>Clinicaltrials: </strong>gov, Number: NCT05247866.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212078","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":"Even Lower Alcohol Intake Might Be Harmful For East Asian Males With MASLD Spectrum.","authors":"Byungyoon Yun, Juyeon Oh, Heejoo Park, Jian Lee, Beom Kyung Kim, Jin-Ha Yoon","doi":"10.1016/j.cgh.2025.09.030","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.09.030","url":null,"abstract":"<p><strong>Background: </strong>Current alcohol guidelines for metabolic dysfunction-associated steatotic liver disease (MASLD) developed in Europe/North America may be unsuitable for East Asians, who often possess ALDH2 genetic variants that increase sensitivity to alcohol. We determined ethnicity-specific alcohol thresholds using liver-related events (LRE) risk in East Asian men with MASLD.</p><p><strong>Methods: </strong>This South Korean nationwide cohort study included 1,087,803 men (age ≥40 years) with MASLD identified from the 2011-2012 national health examinations. Alcohol intake was categorized as none, <70g, 70∼140g, 140∼210g, and ≥210g/week. The primary outcome was LREs, defined as newly diagnosed hepatocellular carcinoma, liver cirrhosis (with or without decompensation), or liver-related mortality. Cox-proportional hazards models were used to assess the risk of LREs. Subgroup and restricted cubic spline analyses were further performed.</p><p><strong>Results: </strong>During a median follow-up of 11 years, 26,742 participants (2.5%) developed LREs. Compared to no alcohol, increased LRE risk was observed with alcohol intake of 140-210 g/week (adjusted hazard ratio [aHR] 1.10; 95% confidence interval [CI] 1.05-1.14), with a further increase at ≥210 g/week (aHR 1.30; 95% CI 1.25-1.34). In vulnerable subgroups (diabetes, body mass index<25 kg/m2, abnormal alanine aminotransferase levels), LRE risk significantly increased with even lower threshold (70∼140 g/week). Spline analysis confirmed a nonlinear, generally J-shaped, dose-response relationship between alcohol consumption and LRE risk. Similar trends were observed with alcohol intake averages from the 2009-2010 and 2011-2012 examinations.</p><p><strong>Conclusion: </strong>East Asian men with MASLD had increased LRE risk at thresholds substantially.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211718","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":"Resolution of metabolic dysfunction improves liver health among Chinese children: evidence from two prospective cohorts.","authors":"Lili Yang, Menglong Li, Min Zhao, Yifei Hu, Bo Xi","doi":"10.1016/j.cgh.2025.09.029","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.09.029","url":null,"abstract":"<p><strong>Background & aims: </strong>New metabolic dysfunction-associated steatotic liver disease (MASLD) definition emphasizes the crucial role of metabolic dysfunction in MASLD pathogenesis. This study aimed to examine whether the resolution of metabolic dysfunction can mitigate the risk of hepatic steatosis in Chinese children.</p><p><strong>Methods: </strong>Data were obtained from two prospective cohort studies in China, including 2,158 children aged 6-11 years at baseline, with a four-year follow-up. Based on metabolic status (normal vs. abnormal) at baseline and follow-up, children were categorized into four distinct groups. Hepatic steatosis was assessed by abdominal ultrasonography and/or serum alanine aminotransferase measurements.</p><p><strong>Results: </strong>At follow-up, 10.4% (n=225) of children developed hepatic steatosis. Baseline metabolic dysfunction significantly increased the risk of incident hepatic steatosis (odds ratio [OR]: 3.31, 95% confidence interval [CI]: 2.42-4.52). Compared with children who kept metabolically healthy at both baseline and follow-up, those with persistent metabolic dysfunction (OR: 6.01, 95%CI: 3.96-9.12) and those who developed metabolic dysfunction at follow-up (OR: 1.99, 95%CI: 1.19-3.33) had significantly increased risks of hepatic steatosis. Notably, children whose metabolic dysfunction resolved to normal status at follow-up presented no increased risk (OR: 0.64, 95%CI: 0.26-1.57).</p><p><strong>Conclusions: </strong>Metabolic dysfunction is a strong predictor of incident hepatic steatosis in children, and resolution of this dysfunction attenuates the attendant risk. These findings highlight the importance of primary and secondary interventions targeting metabolic risk factors to improve liver health in children.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211730","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":"Syphilitic Proctitis Mimicking Ulcerative Colitis.","authors":"Hiroki Uekado, Daisuke Watanabe, Yuzo Kodama","doi":"10.1016/j.cgh.2025.09.024","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.09.024","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205622","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":"Author's Reply to: \"Letter to the editor: The global rising tide of advanced fibrosis / cirrhosis\".","authors":"Mohammad Zamani, Rohit Loomba","doi":"10.1016/j.cgh.2025.08.041","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.08.041","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205662","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":"Associations Between Sexual Orientation and Disorders of Gut-Brain Interaction in Sexual Minority Populations.","authors":"Anthony Kerbage, Yueqi Wu, Qijun Yang, Madison Simons, Samita Garg, Scott Gabbard, Colin Wu, Sarah Ballou, Trisha Pasricha, Chethan Ramprasad, Prashant Singh, Anthony Lembo","doi":"10.1016/j.cgh.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.09.022","url":null,"abstract":"<p><strong>Background & aims: </strong>Sexual and gender minority (SGM) individuals (e.g., those identifying as Lesbian, Gay, Bisexual, Transgender, Queer or Other [LGBTQ+]) are disproportionately affected by psychological distress and trauma, all recognized risk factors for disorders of gut-brain interaction (DGBIs). This suggests a potentially higher burden of DGBIs in SGM populations. However, the relationship between SGM status and DGBIs has not been well characterized in large-scale clinical datasets.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional analysis using All of Us database to identify the relationship between sexual orientation and presence of bowel DGBIs. Eligible participants were adults (≥18 years) who completed a sexual orientation survey and had gastrointestinal diagnostic data available. Participants self-identified as straight, gay or lesbian, or bisexual. Outcomes included irritable bowel syndrome (IBS), functional diarrhea, and chronic constipation, identified using ICD-10 codes. Chi-square tests and multivariable logistic regression models were used to assess associations between sexual orientation and DGBIs, stratified by gender and adjusted for demographic, socioeconomic, and psychological factors. Interaction analyses were conducted to assess whether the association between sexual orientation and DGBIs differs between men and women. Missing data were imputed using multiple imputation by chained equations (MICE) to address missing covariate data under a Missing at Random (MAR) assumption, and sensitivity analyses with pooled results were compared with complete-case analyses to support robustness.</p><p><strong>Results: </strong>Among 386,242 eligible participants, 3.58% (n=13,843) identified as gay or lesbian, and 4.09% (n=15,788) as bisexual. Gay or bisexual men had significantly higher odds of being diagnosed with IBS (aOR 1.55, 95%CI 1.36-1.76), functional diarrhea (aOR 1.82, 95%CI 1.36-2.38), chronic constipation (aOR 1.33, 95%CI 1.08-1.63), and a composite DGBI outcome of any of these diagnoses (aOR 1.49, 95%CI 1.33-1.66) compared to straight men. Among women, there were no statistically significant associations between sexual orientation and any of the DGBI diagnoses or the composite outcome. Interaction analyses demonstrated that these associations were significantly stronger among men, particularly for any DGBI, functional diarrhea, and IBS.</p><p><strong>Conclusions: </strong>Sexual orientation was independently associated with DGBI diagnoses among men, with no significant associations observed among women. These findings underscore the importance of considering gender-specific patterns when evaluating gastrointestinal health in sexual minority populations and highlight the need for tailored, inclusive approaches to DGBI care and research.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205711","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":"Menopause May Partially Explain Age-related Increased Risk of MASLD Fibrosis: A Causal Mediation Analysis.","authors":"Itunu O Sokale, Yan Liu, Hashem B El-Serag, Fasiha Kanwal, Aaron P Thrift, Maya Balakrishnan","doi":"10.1016/j.cgh.2025.08.040","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.08.040","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191329","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":"A decade of decreasing reimbursement strains gastroenterology practices and threatens their independence.","authors":"Jonathan A Busam, Eric D Shah","doi":"10.1016/j.cgh.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.09.026","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191364","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":"REPLY LETTER TO DR. CAMILLERI REGARDING \"THE ASSESSMENT OF GASTROINTESTINAL TRANSIT BY THE ATMO CAPSULE\".","authors":"Braden Kuo, William D Chey","doi":"10.1016/j.cgh.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.09.023","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184717","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":"Reply to Letter to the Editor.","authors":"Han Hee Lee, Siddharth Singh","doi":"10.1016/j.cgh.2025.09.021","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.09.021","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181743","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}