Digestion最新文献

{"title":"Increased Extracolonic Cancer Incidence and Mortality in Patients with Serrated Polyposis Syndrome with a History of Colorectal Cancer: A Comparative Cohort Study.","authors":"Yasutsugu Shimohara, Hidehiko Takigawa, Yuji Urabe, Yoshihiro Kishida, Akinori Nagao, Yuki Kitadai, Yukiko Sako, Hidenori Tanaka, Ken Yamashita, Yuichi Hiyama, Toshio Kuwai, Shiro Oka","doi":"10.1159/000552448","DOIUrl":"https://doi.org/10.1159/000552448","url":null,"abstract":"<p><strong>Introduction: </strong>Serrated polyposis syndrome (SPS) is a high-risk factor for colorectal cancer (CRC); however, prognostic differences based on patient characteristics are poorly understood. This exploratory study investigated the impact of concomitant or a history of CRC at the time of SPS diagnosis on long-term prognosis.</p><p><strong>Methods: </strong>Of the 70 patients diagnosed with SPS between 2009 and 2023, 55 with 1-year follow-up were included in this single-center retrospective cohort study. Patients with a history of CRC were assigned to the CRC (+) (n=16) group and those without a history of CRC to the CRC (-) group (n=39). We compared the baseline characteristics, surveillance findings, and long-term outcomes, including new extracolonic cancer incidence and overall survival, between the groups.</p><p><strong>Results: </strong>The CRC (+) group had a significantly higher prevalence of personal history of other cancers (38% vs. 10%, p=0.024) and family history of cancer (69% vs. 38%, p=0.048). The incidence of new extracolonic cancers during follow-up after the diagnosis of SPS was significantly higher in the CRC (+) group (25%; 4/16) than in the CRC (-) group (3%; 1/39) (p=0.012). Overall survival was also significantly poorer in the CRC (+) group (two deaths, 13%) than in the CRC (-) group (p=0.044).</p><p><strong>Conclusions: </strong>A history of CRC in patients with SPS is associated with a higher incidence of new extracolonic cancer and poorer overall survival. These findings suggest that management strategies should extend beyond standard colorectal surveillance to comprehensive systemic monitoring. Therefore, the validation of these results in larger prospective cohorts is warranted.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-18"},"PeriodicalIF":3.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834983","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 Constipation on Quality of Life, Work Productivity, and Treatment Practices: Findings from the CONNECT Web-Based Survey.","authors":"Tomohisa Takagi, Tadashi Shin, Shinji Yoneda, Masaaki Higashikawa, Yusuke Shimada, Minami Umeyama, Masato Ueno","doi":"10.1159/000552237","DOIUrl":"https://doi.org/10.1159/000552237","url":null,"abstract":"<p><strong>Introduction: </strong>Constipation is a common gastrointestinal disorder that negatively affects quality of life, work productivity, and long-term prognosis. To examine the associations between constipation severity and Short Form-8 Health Survey (SF-8) and Work Productivity and Activity Impairment Questionnaire (WPAI) scores, as well as treatment status and patient preferences, through a large-scale survey of the general population.</p><p><strong>Methods: </strong>A web-based questionnaire was administered to 2,300 Japanese adults with constipation symptoms using a large survey panel. The survey assessed the Constipation Scoring System (CSS), Bristol Stool Form Scale (BSFS), SF-8, WPAI, treatment status, and preferences for treatment methods.</p><p><strong>Results: </strong>CSS scores showed significant negative correlations with the SF-8 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores and significant positive correlations with WPAI scores (P < 0.05). Both SF-8 and WPAI scores differed significantly across BSFS categories, with normal stool forms associated with better outcomes (P < 0.05). Only 22.0% of participants received prescription medication for constipation. The most common reason for not seeking medical care was \"inconvenience of visiting a medical institution\" (65.6%). Regarding treatment preferences, 80.8% preferred tablet formulations, and once-daily administration at bedtime was the most favored dosing schedule (56.7%), followed by before breakfast (30.0%).</p><p><strong>Conclusion: </strong>Constipation severity and stool form are associated with quality of life and work productivity, underscoring the importance of appropriate treatment strategies. Patient preference should also be considered when selecting therapeutic options.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-24"},"PeriodicalIF":3.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812263","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":"Comparative assessment of diagnostic accuracy and puncture duration of two EUS-FNB needles (22G Franseen vs. 20G antegrade core trap) in patients with solid pancreatic lesions.","authors":"Golo Petzold, Linda S Huhnold, Richard F Knoop, Dirk Raddatz, André Sasse, Thomas R Heiduk, Jovan Todorovic, Felix Bremmer, Philipp Stroebel, Volker Ellenrieder, Albrecht Neesse, Ahmad Amanzada","doi":"10.1159/000551930","DOIUrl":"https://doi.org/10.1159/000551930","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic ultrasound with fine needle biopsy (EUS-FNB) is the clinical standard for histological confirmation of solid pancreatic lesions. Various types of needles are available. Current guidelines cannot provide recommendations on the type of needle to be used. The aim of the study was to compare the diagnostic accuracy and puncture duration of two EUS-FNB needles (22G Franseen vs. 20G antegrade core trap) in solid pancreatic tumors.</p><p><strong>Methods: </strong>Between 09/2023 and 02/2025, patients with solid pancreatic masses and indication for histological confirmation by EUS-FNB underwent two puncture procedures at a tertiary hospital, one with a 22G FNB needle and one with a 20G FNB needle. The diagnostic accuracy and puncture duration of both needles were compared.</p><p><strong>Results: </strong>Fifty patients were prospectively included. The mean diameter of the solid lesion was 29.43 mm (±8.69). The final diagnosis was pancreatic adenocarcinoma in 47 patients, neuroendocrine tumor in two patients, and pseudotumor in one patient. In 86% of cases (43/50), the diagnosis was made with the 22G needle, and in 66% (33/50) with the 20G needle. This difference was statistically significant (p = 0.019). When both needles were used in combination, the diagnostic accuracy was 90% (45/50). The average puncture time with the 22G needle was 166 seconds (±73) and with the 20G needle 212 seconds (±93). The difference was significant (p=0.007).</p><p><strong>Conclusion: </strong>The 22G FNB needle was superior to the 20G needle in terms of both diagnostic accuracy and puncture time. The study contributes to improving the available data for selecting the most suitable EUS needle types.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-13"},"PeriodicalIF":3.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765445","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":"Endoscopic Management of Pancreatobiliary Diseases in Patients with Surgically Altered Anatomy: A Perspective from Single-Balloon Enteroscopy.","authors":"Yuki Tanisaka, Shomei Ryozawa, Masafumi Mizuide, Akashi Fujita, Suguru Ito, Ryuichi Watanabe, Ryosuke Hamamura, Yoshiki Matsuno","doi":"10.1159/000552310","DOIUrl":"https://doi.org/10.1159/000552310","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) has long been established as a standard procedure with a high success rate and an acceptable incidence of adverse events. However, performing ERCP in patients with surgically altered anatomy (SAA) remains technically challenging, not only because of the difficulty in accessing the target site but also in performing subsequent therapeutic interventions. To address these challenges, balloon enteroscopy-assisted ERCP has been introduced into clinical practice and has demonstrated both efficacy and safety. More recently, the short-type single-balloon enteroscope (short SBE), with a working length of 152 cm and a 3.2-mm working channel, has been widely adopted, enhancing procedural efficiency. The short SBE allows the use of a wider range of accessories in various therapeutic interventions, such as stone extraction and self-expandable metallic stent placement.</p><p><strong>Summary: </strong>This review provides a comprehensive overview of SBE-assisted ERCP, with a particular focus on short SBE. It summarizes reported procedural success and adverse event rates from previous studies and discusses factors associated with procedural failure. In addition, it highlights key technical tips, various procedural approaches using short SBE-assisted ERCP, and recent advances in relevant technologies and devices.</p><p><strong>Key messages: </strong>Despite these advancements, multiple technical challenges still need to be overcome to successfully complete the procedure. Proficiency in alternative treatments, such as endoscopic ultrasound-guided biliary drainage (EUS-BD), is also essential. The decision between BE-assisted ERCP and EUS-BD should be individualized according to the type of postoperative reconstruction, the patient's clinical status, and, importantly, the endoscopist's experience level.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-23"},"PeriodicalIF":3.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765525","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":"An Epidemiological Study on the Relationship between Gastric Mucosal Atrophy, Exhaled Hydrogen Concentration, and Gut Microbiota.","authors":"Satoshi Sato, Daisuke Chinda, Keita Mikami, Masakazu Tobinai, Nao Ishidoya, Keisuke Furusawa, Kaede Miyashiro, Kenta Yoshida, Chikara Iino, Kaori Sawada, Tatsuya Mikami, Shigeyuki Nakaji, Koichi Murashita, Hirotake Sakuraba","doi":"10.1159/000552238","DOIUrl":"https://doi.org/10.1159/000552238","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to conduct an epidemiological investigation of the relationship between gastric mucosal atrophy and exhaled hydrogen gas concentration, including gut microbiota, in residents who participated in health checkups.</p><p><strong>Methods: </strong>Based on pepsinogen I < 70 ng/mL and PG I/PG II < 3 as cut off values, the participants were divided into a control (n=903) and atrophy (n=63) groups. The exhaled hydrogen gas concentrations and gut microbiota were compared in 212 participants from the control group and 53 participants from the atrophy group, selected through propensity score matching. Furthermore, participants were categorized as non-infection, persistent infection, or post-eradication groups based on their Helicobacter pylori (H. pylori) infection status.</p><p><strong>Results: </strong>In the atrophy group, 66.0% were persistent Helicobacter pylori carriers, whereas 39.6% of the control group had undergone H. pylori eradication. The atrophy group showed lower exhaled hydrogen concentration than those of the control group. In the gut microbiota of the atrophy group, an increase in Streptococcus, and a decrease in Blautia were observed. Among H. pylori infection statuses, persistent infection group showed reduced exhaled hydrogen gas concentration and increased gut Streptococcus compared to the non-infection group, but no association was observed with the post-eradication group.</p><p><strong>Conclusions: </strong>Most individuals infected with H. pylori showed evidence of gastric mucosal atrophy, accompanied by decreased breath hydrogen concentrations and alterations in the gut microbiota. Eradication of H. pylori may ameliorate gastric mucosal atrophy, which could subsequently normalize the gut microbial composition and lead to increased levels of exhaled hydrogen.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-22"},"PeriodicalIF":3.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765742","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":"IL-22 associates with Venous Thromboembolism in Inflammatory Bowel Disease: A Hypothesis-Generating Study.","authors":"Rahel Cola, Gerhard Rogler, Luc Biedermann, Fritz Murray, Reto Krapf, Juerg H Beer","doi":"10.1159/000552011","DOIUrl":"https://doi.org/10.1159/000552011","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with inflammatory bowel disease (IBD) are at signifincantly increased risk for venous thromboembolism (VTE). We hypothesized that I) the increased risk is associated with elevated levels of typical pro-inflammatory cytokines and II) that elevated concentrations of specific cytokines could possibly predict a thromboembolic event.</p><p><strong>Methods: </strong>We examined 226 well characterized patients of the Swiss IBD cohort study (SIBDCS); we analyzed serum samples from 78 IBD patients with documented VTE (n=78) and compared them 2:1 with age and sex matched controls without VTE of the same cohort (n=148) . An array of 12 typical proinflammatory cytokines (IL2, IL17a, IL12p70, IL8, IL1b, IL4, IL5, IFN-γ, IL6, IL22, TNF-α, IL-10) was quantified. Detailed disease characteristics - such as activity (mild, moderat, quiescent) as well as age at visit, sex and the time interval between thrombosis and blood collection were statistically analyzed.</p><p><strong>Results: </strong>IL2, IL17a, IL12p70, IL8, IL1b, IL4, IL5, IFN-γ, IL6, TNF-α, IL-10 showed no statistical difference between the thrombosis and control group. In contrast IL-22 levels (0.709 vs. 0.542 pg/ml, P<0.05) were significantly higher in the VTE group.</p><p><strong>Conclusions: </strong>IL-22, may associate with an increased risk of VTE in IBD in this hypothesis- generating study, whereas the other inflammatory parameters measured were not associated. This marker appears to be independent of disease activity, as the other cytokines, which are considered markers of disease activity, did not show a significant difference in comparison. Further targeted and serial measurements will have to confirm our findings.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-23"},"PeriodicalIF":3.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765474","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":"Esophageal hyposensitivity: A key link to aspiration pneumonia in patients with achalasia.","authors":"Kazuki Inamura, Masafumi Wada, Eikichi Ihara, Yoshitaka Hata, Hirotaka Tsuru, Hiroki Fukuya, Mitsuru Esaki, Yosuke Minoda, Xiaopeng Bai, Yoshimasa Tanaka, Takatoshi Chinen, Haruei Ogino, Yoshihiro Ogawa","doi":"10.1159/000552159","DOIUrl":"https://doi.org/10.1159/000552159","url":null,"abstract":"<p><strong>Introduction: </strong>Aspiration pneumonia (AP) is a serious complication of achalasia; however, its risk factors and mechanisms remain unclear. We aimed to identify the clinical characteristics associated with AP and explore its underlying pathophysiology.</p><p><strong>Methods: </strong>This retrospective single-center study was included 70 patients diagnosed with achalasia using high-resolution manometry (HRM) between 2016 and 2022. Patients were categorized into non-AP (n = 42) and AP (n = 28) groups based on chest computed tomography findings. Clinical symptoms (Eckardt score), esophagographic findings, and HRM parameters were compared. Propensity score matching (PSM) was performed to adjust for age and disease duration. In a matched sub-cohort, esophageal mucosal biopsies were analyzed using quantitative real-time PCR to compare mechanosensory/chemosensory channels and inflammatory cytokines.</p><p><strong>Results: </strong>Patients with AP were older and tended to have a longer disease duration than those without AP. The Eckardt score was significantly lower in the AP group, despite no differences in HRM-defined or morphological subtypes on contrast esophagography. This difference remained significant after PSM. Expression levels of TRPV1, TRPV4, and PIEZO1 were significantly reduced in the achalasia (comprising both non-AP and AP patients) group compared with controls and were further decreased in the AP group compared with the non-AP group. Cytokine levels did not differ between the non-AP and AP groups.</p><p><strong>Conclusion: </strong>Esophageal hyposensitivity is a key risk factor for AP in achalasia, independent of HRM-defined or morphological subtypes. Downregulation of TRPV1, TRPV4, and PIEZO1 may underlie reduced symptom perception, providing novel insights into the pathophysiology of aspiration in achalasia.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-20"},"PeriodicalIF":3.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765536","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":"Sequential JAK Inhibitor Switching in Ulcerative Colitis Patients Maintaining Remission: A Multicenter Experience.","authors":"Genta Uchida, Tsunaki Sawada, Masanao Nakamura, Takeshi Yamamura, Keiko Maeda, Eri Ishikawa, Kentaro Murate, Tomoyuki Tsuzuki, Hiroki Kawashima","doi":"10.1159/000552136","DOIUrl":"https://doi.org/10.1159/000552136","url":null,"abstract":"<p><strong>Introduction: </strong>Given the safety concerns associated with the long-term use of Janus kinase (JAK) inhibitors, establishing effective \"exit strategies\" is crucial for patients with ulcerative colitis (UC). This study investigated the efficacy and safety of switching from tofacitinib (TOF) or upadacitinib (UPA) to the JAK1-selective filgotinib (FIL) in patients maintaining remission.</p><p><strong>Methods: </strong>We conducted a retrospective, multicenter study involving 13 UC patients who achieved clinical remission with TOF or UPA and subsequently switched to FIL. The primary endpoint was the cumulative non-relapse rate.</p><p><strong>Results: </strong>During a median follow-up of 679 days, symptomatic relapse occurred in 53.8% (7/13) of patients. The one-year cumulative non-relapse rate was 71.4% for the TOF-switch group and 31.3% for the UPA-switch group. However, many relapses were successfully managed through temporary treatment adjustments, including FIL dose escalation or topical therapy. No serious adverse events were recorded.</p><p><strong>Conclusion: </strong>Sequential switching to FIL may represent a practical intermediate maintenance strategy before complete drug withdrawal, balancing disease control with potential safety benefits.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-12"},"PeriodicalIF":3.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765465","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":"Association of Equol Production Status with the Presence of Precancerous Colorectal Lesions in Japan.","authors":"Yoshihiro Kaneta, Taiki Yamaji, Kouji Harada, Tomoko Fujitani, Zhaoqing Lyu, Mariko Harada Sassa, Hiroaki Ikematsu, Kinichi Hotta, Masau Sekiguchi, Yasuo Kakugawa, Nozomu Kobayashi, Takahisa Matsuda, Motoki Iwasaki","doi":"10.1159/000552061","DOIUrl":"https://doi.org/10.1159/000552061","url":null,"abstract":"<p><strong>Introduction: </strong>Epidemiological evidence regarding the association between equol and precancerous colorectal lesions, including adenomas, sessile serrated lesions, and traditional serrated adenomas, remains unclear. Moreover, since equol production status depends on the composition of the gut microbiota and varies widely among individuals, evaluation based on plasma levels is essential. In this study, we evaluated the association between plasma equol levels and precancerous colorectal lesions.</p><p><strong>Methods: </strong>This cross-sectional study included residents aged 40-79 years in Izu Oshima, Japan. Blood samples were collected at study registration prior to colonoscopy under fasting conditions. In 2024, plasma equol levels were analyzed by gas chromatography-mass spectrometry, and individuals above the measurement quantification limit were classified as equol producers. Colonoscopy was performed for screening, and lesions were assessed based on endoscopic and pathological findings. Odds ratios (ORs) and their 95% confidence intervals (CIs) for precancerous lesions were calculated.</p><p><strong>Results: </strong>Of the 993 participants analyzed, 509 had precancerous colorectal lesions, while 484 served as controls. No significant association was observed between equol production status and the presence of precancerous colorectal lesions (OR: 1.04, 95% CI: 0.77-1.40). Although not statistically significant, an inverse trend was suggested in advanced lesions, defined as advanced adenomas or SSLs with dysplasia (OR: 0.63, 95% CI: 0.34-1.18).</p><p><strong>Conclusion: </strong>This study did not provide significant evidence of an association between equol production status and the presence of precancerous colorectal lesions. Future prospective cohort studies and detailed analysis of intestinal microbiota are needed to clarify the effects of equol on colorectal carcinogenesis.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-25"},"PeriodicalIF":3.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728706","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":"Potassium-Competitive Acid Blocker Increases Ileal Permeability and Exacerbates Ileal Inflammation under Stress Conditions in a Mouse Model of Eosinophilic Enteritis.","authors":"Kei Yamamoto, Fumio Tanaka, Yu Nishida, Hirotsugu Maruyama, Masaki Ominami, Yuji Nadatani, Koji Otani, Shusei Fukunaga, Shuhei Hosomi, Yasuhiro Fujiwara","doi":"10.1159/000552062","DOIUrl":"https://doi.org/10.1159/000552062","url":null,"abstract":"<p><strong>Introduction: </strong>Potassium-competitive acid blockers (P-CABs) have been empirically administered to treat non-esophageal eosinophilic gastrointestinal diseases, although their efficacy remains unproven. Our previous findings demonstrated that psychological stress impairs the intestinal barrier and exacerbates eosinophilic enteritis (EoN) in a mouse model. Moreover, we demonstrated that P-CAB increased intestinal permeability under psychological stress. The aim of this study is to clarify the hypothesis that P-CAB exacerbate EoN by increasing intestinal permeability under stressful conditions.</p><p><strong>Methods: </strong>An EoN model was established in BALB/c mice using ovalbumin (OVA) sensitization and challenge. Mice were subjected to water avoidance stress (WAS) or sham stress (SS) and were administered P-CAB or saline as a vehicle. The ileum was collected for the analysis of ileal microscopic inflammation, mRNA and protein expression levels of T helper type 2 (Th2) cytokines, and ex vivo ileal permeability using a Ussing chamber.</p><p><strong>Results: </strong>Compared with the WAS + Vehicle group, WAS + P-CAB significantly exacerbated the incidence of diarrhea, villus/crypt ratio, eosinophil and mast cell counts, mRNA and protein levels of Th2 cytokines, OVA-specific immunoglobulin E protein levels, and ileal permeability. Larazotide acetate, a zonulin inhibitor, significantly improved ileal inflammation and decreased ileal permeability in the WAS + P-CAB-treated EoN mice.</p><p><strong>Conclusions: </strong>P-CAB increased ileal permeability and exacerbated EoN under stressful conditions. Furthermore, a zonulin inhibitor demonstrated therapeutic effects in EoN with P-CAB under stressful conditions.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-18"},"PeriodicalIF":3.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728703","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}