Digestion最新文献

{"title":"Metagenomics Study Suggests the Role of Vitamins and Gut Microbiome in Autism Spectrum Disorder.","authors":"Ez Sadoon Mahdi, Majid Komijani, Anita Alaghmand","doi":"10.1159/000545483","DOIUrl":"10.1159/000545483","url":null,"abstract":"<p><strong>Introduction: </strong>Autism is a neurological disability that often appears after the age of three in children, also known as an autism spectrum disorder (ASD). Several studies have examined the influence of some environmental factors, and many parameters related to the behavior of autistic patients have been measured in order to find ways to reduce ASD. This study investigates the relationship between ASD and serum levels of vitamin D3, B12, folic acid, and the gut microbiome.</p><p><strong>Methods: </strong>The serum levels of vitamin D3, B12, and folic acid in ASD patients were measured by the ELISA method and compared to healthy groups. DNA was extracted from stool samples of ASD patients and the control group, and then the gut microbiome was investigated via a metagenomics approach. Metagenomics sequencing was performed to analyze the 16S rRNA gene sequencing for phylum and sub phylum level microbiome.</p><p><strong>Result: </strong>The result showed no significant change in the VitD3 and folate levels of ASD patients compared to the control group (p = 0.157 and p = 0.0505, respectively). There was a significant difference in the VitB12 level between control healthy individuals and ASD patients, in which the serum VitB12 concentration was significantly lower than the control group (p = 0.0001). Our results regarding gut metagenomics showed that the abundance of the Actinobacteria by the phylum level was significantly higher in the ASD patients compared to the control group (p = 0.0013). The abundance of the Firmicutes by the phylum level was significantly lower in the ASD patients compared to the control group (p = 0.0016). The abundance of Bifidobacteriaceae, and Ruminococcaceae by the family level was significantly higher in the ASD patients compared to the control group (p = 0.0004 and p = 0.0489, respectively). Our results indicated less species richness in the ASD patients compared to the control group.</p><p><strong>Conclusion: </strong>Patients with ASD have lower serum levels of vitamin B12 and different gut microbiome compared to healthy controls. Low vitamin B12 levels and altered gut microbiome are significantly associated with ASD in this study. However, further research is needed to determine whether these factors could serve as predictors of severe outcomes in ASD.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-15"},"PeriodicalIF":3.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997404","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":"Investigation of Recognition Areas by Explainable Artificial Intelligence for Colonoscopy Images of Irritable Bowel Syndrome.","authors":"Hiroshi Mihara, Shun Kuraishi, Haruka Fujinami, Takayuki Ando, Ichiro Yasuda","doi":"10.1159/000546183","DOIUrl":"10.1159/000546183","url":null,"abstract":"<p><strong>Introduction: </strong>Irritable bowel syndrome (IBS) is a condition in which gastroenterological endoscopists cannot detect anomalies using colonoscopy, yet an artificial intelligence (AI) developed for IBS colonoscopy images has been able to distinguish between IBS and healthy individuals with high accuracy. However, it was unclear which areas the AI identified as abnormal. The aim of this study was to elucidate how AI identifies regions typical of IBS by constructing an additional explainable AI (XAI).</p><p><strong>Methods: </strong>Colonoscopy images of healthy individuals, patients with constipation-predominant IBS, and patients with diarrhea-predominant IBS, which are available in a repository (<ext-link ext-link-type=\"doi\" xlink:href=\"https://doi.org/10.5061/dryad.9s4mw6mkp\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">https://doi.org/10.5061/dryad.9s4mw6mkp</ext-link>), were used. After setting up a Python environment on a local PC, the XAI models for the three groups were developed. Images not used in the AI construction were then evaluated using XAI. XAI-generated images were independently assessed by two evaluators, H.M. and S.K., to record and reconcile the characteristic differences among the three groups.</p><p><strong>Results: </strong>Images correctly identified as those of healthy individuals by XAI were evaluated as characteristics over the entire image. By contrast, for IBS, only parts of the images were evaluated as characteristic regions. For diarrhea-predominant IBS, regions characterized by clear vascular boundaries, homogeneity or erythematous tones, or narrow and somewhat dark-appearing sections of the intestinal tract were identified. For constipation-predominant IBS, regions characterized by unclear vascular boundaries, faded tones, or dark sections where the end was not visible were identified.</p><p><strong>Conclusion: </strong>An XAI for IBS was collaboratively developed by endoscopists and clinical engineers, enabling the visualization of regions characteristic of IBS and healthy individuals. The real-time display of XAI is expected to further advance the elucidation of IBS pathophysiology.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and Verification of B4GALNT2 as an Epigenetic Marker in Ulcerative Colitis.","authors":"Yi Zhu, Yuan Zhou, Honggang Jiang, Zhiheng Chen, Bohao Lu, Jiaming Wu","doi":"10.1159/000545944","DOIUrl":"10.1159/000545944","url":null,"abstract":"<p><strong>Introduction: </strong>Ulcerative colitis (UC) represents an inflammatory bowel disease characterized with a multifaceted pathogenesis, which may be attributed to influence by genetic factors. This study aimed to identify and validate novel markers associated with UC, with a specific focus on their regulation through DNA methylation.</p><p><strong>Methods: </strong>Gene expression and DNA methylation profiling of intestinal mucosal tissues from UC and healthy controls was retrieved from the GEO repository. Differentially expressed and methylated genes were examined in UC. Subsequently, overlapped analyses were performed to identify highly expressed and hypomethylated genes, as well as lowly expressed and hypermethylated genes. Functional annotation, transcription factor-mRNA network analysis, and protein-protein interaction (PPI) network analysis were conducted for above genes. Dextran sodium sulfate (DSS)-induced LOVO and Caco-2 cells were established to stimulate UC injury. The expression and methylation of B4GALNT2 was verified by real-time quantitative polymerase chain reaction and methylation-specific PCR. Cell Counting Kit-8, flow cytometry, Western blot, and enzyme-linked immunosorbent assay were used to measure cell survival, apoptosis, and cytokine levels after B4GALNT2 overexpression.</p><p><strong>Results: </strong>Our study screened 1 downregulated and hypermethylated gene (B4GALNT2) and 114 upregulated and hypomethylated genes in UC. They were markedly associated with immune response. Totally, 10 potential transcription factors were predicted. The PPI network revealed their complex interactions. B4GALNT2 was confirmed to be downregulated and hypermethylated in DSS-induced intestinal epithelial cells and in DSS-induced UC mouse model. B4GALNT2 overexpression enhanced cell viability and weakened apoptosis and cytokine production and release of DSS-induced intestinal epithelial cells.</p><p><strong>Conclusion: </strong>Collectively, this study integrally analyzed DNA methylation and gene expression in UC as well as identified and verified B4GALNT2 as a key epigenetic marker.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-19"},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985173","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":"A New Anti-Parietal Cell Antibody Titer Measurement Kit for Diagnosis of Autoimmune Gastritis.","authors":"Masanori Ito, Yasuhiko Maruyama, Shuichi Terao, Kimaru Okubo, Kaori Hidaka, Tomotaka Sakamoto, Ken Haruma","doi":"10.1159/000545454","DOIUrl":"10.1159/000545454","url":null,"abstract":"<p><strong>Introduction: </strong>Recent findings revealed that autoimmune gastritis (AIG) is not rare in Japan. Therefore, the accurate diagnosis of AIG is essential in upper gastrointestinal practice. Diagnostic criteria for AIG were established in 2023; however, the conventional fluorescent antibody (FA) method for anti-parietal cell antibody (APCA) titer measurements has low accuracy and is clinically problematic.</p><p><strong>Methods: </strong>We developed a latex agglutination (LA) method using a new human-derived antigen. Samples subjected to measurements were sera from AIG cases (127 cases, 49 males, average age 65.9 years) and control cases (129 cases, 81 males, average age 66.1 years) provided by the main facility and three affiliated facilities in Japan. APCA in whole serum was measured using the FA and LA methods.</p><p><strong>Results: </strong>The diagnostic ability of AIG using the FA method was as follows: sensitivity of 99.2%, specificity of 41.1%, and an overall agreement rate of 69.9%, with low specificity previously being reported. On the other hand, the new LA method had good diagnostic performance with a sensitivity of 93.7%, a specificity of 95.4%, and an overall agreement rate of 94.5%.</p><p><strong>Conclusion: </strong>We developed a new APCA measurement system that will contribute to the accurate diagnosis of AIG. The use of this measurement system in clinical practice will facilitate the diagnosis and treatment of AIG.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Contributing to the Efficacy of Fecal Microbiota Transplantation for Diarrhea-Dominant Functional Bowel Disorders.","authors":"Tsuyoshi Yamane, Tatsuhiro Masaoka, Chiharu Ishii, Hiroaki Masuoka, Wataru Suda, Shunya Kurokawa, Taishiro Kishimoto, Yohei Mikami, Shinji Fukuda, Takanori Kanai","doi":"10.1159/000545183","DOIUrl":"10.1159/000545183","url":null,"abstract":"<p><strong>Introduction: </strong>In cases of effective fecal microbiota transplantation (FMT) for irritable bowel syndrome (IBS), donor feces have been observed to be enriched in Bifidobacterium spp. Moreover, FMT for functional bowel disease can improve psychiatric symptoms. Although intestinal dysbiosis has received attention as one of the pathophysiologies of IBS, the efficacy of FMT for IBS has not yet been established. In this study, we performed a post hoc analysis of the efficacy of FMT, focusing on metabolites in donor feces.</p><p><strong>Methods: </strong>FMT was performed in 12 patients, 8 with refractory diarrhea-predominant IBS and 4 with functional diarrhea (FDr), who were refractory to medical therapy. The donors were family members within a second degree of kinship and differed for each transplant. Fecal characteristics were evaluated before and 12 weeks after transplantation using the Bristol stool scale (BS). BS scores of 3-5 at 12 weeks after transplantation were considered to indicate responders, while BS scores of 6 and 7 indicated nonresponders. Metagenomic and metabolomic analyses of all 12 donor fecal samples were performed to compare the responder and nonresponder groups.</p><p><strong>Results: </strong>Before transplantation, all patients had BS scores of 6-7, but 12 weeks after transplantation, 6 were considered responders and 6 were nonresponders. Metagenomic analysis showed that effective donor feces contained significantly higher levels of Prevotella than did the ineffective donor feces. Metabolomic analysis showed that effective donor feces contained significantly higher levels of propionate and butyrate and significantly lower lactate levels than did ineffective donor feces.</p><p><strong>Conclusion: </strong>Propionate-, butyrate-, or Prevotella-rich donor feces may contribute to successful FMT in patients with diarrhea-dominant functional gastrointestinal disorders.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971196","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 between Microbiome Dysbiosis and Postoperative Disorders before and after Gastrectomy.","authors":"Tsuyoshi Tanaka, Tadashi Fujii, Hideaki Takahashi, Kento Kuramitsu, Kohei Funasaka, Eizaburo Ohno, Shingo Akimoto, Masaya Nakauchi, Susumu Shibasaki, Ichiro Uyama, Yoshiki Hirooka, Koichi Suda, Takumi Tochio","doi":"10.1159/000545678","DOIUrl":"10.1159/000545678","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrectomy considerably affects the gut microbiome; however, the association between dysbiosis and post-gastrectomy syndrome remains to be explored. This study prospectively explored fecal gut microbiota alterations following gastrectomy, investigating their potential association with weight loss.</p><p><strong>Methods: </strong>The gut microbiome of 21 patients with gastric cancer scheduled for gastrectomy in April-October 2022 was analyzed using 16S rRNA gene next-generation sequencing. Stool and blood samples were collected before and 3 months after gastrectomy. The microbiome profiles were compared to those of 85 healthy controls. Bacterial taxa demonstrating significant changes were determined using the linear discriminant analysis effect size algorithm and further analyzed for their relationship with weight loss in the gastrectomy cohort.</p><p><strong>Results: </strong>Postoperative complications (≥grade 2) were observed in 14.3% of patients. Postoperative weight loss was -10.9%, with the following breakdown: distal (-7.0%), total (-13.5%), and proximal (-14.0%) gastrectomy (p = 0.003). Microbiota analysis demonstrated a significant incline in the abundance of the Streptococcus salivarius group and a decline in Bacteroides uniformis in patients with gastric cancer compared to healthy controls. The S. salivarius group exhibited a further increase, while B. uniformis showed signs of recovery after gastrectomy. Additionally, 5α-reductase gene levels, reported to decrease as several cancers progress, were found to elevate post-surgery. Furthermore, patients experiencing greater weight loss showed a significant reduction in Faecalibacterium prausnitzii levels, while lower serum prealbumin and zinc levels were associated with the abundance of Escherichia coli.</p><p><strong>Conclusion: </strong>Gastrectomy significantly alters the gut microbiome. Supporting microbiome health with prebiotics may help alleviate postoperative issues and improve patients' quality of life.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-13"},"PeriodicalIF":3.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985786","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":"KIF4A Facilitates Oxaliplatin Resistance and Stemness in Colon Cancer by Boosting Glucose Metabolism.","authors":"Cheng Cai, Xia Zhang, Chenyang Ge, Shicheng Zhou, Zhekang Jin, Kangfu Dai, Nannan Dai, Xingxing Yu, Jianping Wang","doi":"10.1159/000544914","DOIUrl":"10.1159/000544914","url":null,"abstract":"<p><strong>Introduction: </strong>Colon cancer (CC) is a malignant tumor commonly found in the intestines with high incidence and mortality rates. Oxaliplatin (OXA) is a platinum-based chemotherapy drug widely used to treat CC. However, frequent drug resistance in patients results in suboptimal treatment outcomes. Though kinesin family member 4A (KIF4A) has been reported to be upregulated in various cancers and linked with poor prognosis in patients, its regulatory mechanism in cellular metabolism remains unclear.</p><p><strong>Methods: </strong>The human CC/OXA-resistant cell line (HCT116-R) was constructed. CCK-8 assay was employed to calculate the half-maximal inhibitory concentration (IC50) of CC cells. The level of cell stemness was assessed by cell sphere formation assay. The enrichment of KIF4A in signaling pathways of CC was analyzed through Gene Set Enrichment Analysis (GSEA). The bioinformatics analysis was applied to reveal the differential expression of KIF4A in CC and its correlation with genes related to stemness or glycolysis. The assessment of lactate in the supernatant was finished by utilizing the lactate detection kit. The oxidative phosphorylation and glycolysis levels in cells were measured by a Seahorse analyzer. The mRNA expression level of KIF4A was detected by quantitative real-time PCR. Furthermore, the Western blot (WB) was employed to determine the protein expression of glycolysis-related enzymes in cells. A mouse OXA-resistant CC xenograft tumor model was established, with changes in tumor volume and final weight recorded. TUNEL was utilized to detect the apoptosis level in tissues and immunohistochemistry to examine the distribution of KIF4A and ki-67 in tissues. The levels of stemness-related proteins in tissues were detected through WB.</p><p><strong>Results: </strong>KIF4A was upregulated in CC, exhibiting a positive association with OXA resistance. High expression of KIF4A promoted cancer cell survival and cancer stemness. In GSEA prediction, KIF4A in CC may be linked with the glycolysis pathway. Correspondingly, the expression of KIF4A in CC was positively correlated with the expression of glycolysis-related proteins. Tests for lactate content and glycolysis/oxidative phosphorylation levels revealed that knocking down KIF4A repressed glycolytic function in the drug-resistant strain but reinforced mitochondrial oxidative phosphorylation. Furthermore, KIF4A overexpression effectively boosted the OXA resistance and stemness of cells, which was reversed by glycolysis inhibitor. The mouse model validated the above results.</p><p><strong>Conclusion: </strong>KIF4A is significantly upregulated in CC to reinforce the glycolysis of cancer cells, thus facilitating cell stemness and resistance to OXA-based therapy.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-13"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729315","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":"Associations between Serum Insulin-Like Growth Factor-Related Molecules and Colorectal Cancer Risk by Tumor Location: A Nested Case-Control Study.","authors":"Yasushi Adachi, Masanori Nojima, Yingsong Lin, Yasushi Sasaki, Hiro-O Yamano, Hiroshi Nakase, Kenji Wakai, Mitsuru Mori, Akiko Tamakoshi","doi":"10.1159/000545457","DOIUrl":"10.1159/000545457","url":null,"abstract":"<p><strong>Introduction: </strong>The activity of the mitogen insulin-like growth factor (IGF) is controlled by IGF-binding protein (IGFBP). Colorectal cancers (CRCs) are heterogeneous, with left- and right-sided CRCs, showing different clinical and molecular characteristics. This case-control study, nested in the Japan Collaborative Cohort study, assessed associations between serum levels of IGF-related molecules and incidences of CRC by location.</p><p><strong>Methods: </strong>A baseline survey obtained serum samples from 39,242 participants. Subjects diagnosed with CRC during follow-up were regarded as cases. Conditional logistic regression modeling was used to calculate odds ratios (ORs) for cancer incidence associated with IGF-related molecules.</p><p><strong>Results: </strong>This analysis included 176 cases and 524 controls. No IGF-related molecules appeared associated with risks of overall or left-sided CRC. Both total IGFBP3 and free IGFBP3 (estimated as IGFBP3 - [IGF1 + IGF2]) were associated with incidence of right-sided CRC (p for trends = 0.027 and 0.003, respectively), with the third tertile of total and free IGFBP3 showing the highest risk (OR = 6.25 and 7.96, respectively). Free IGF, estimated as (IGF1 + IGF2)/IGFBP3, was inversely associated with incidence of right-sided CRC (p for trends = 0.014), with the third tertile showing the lowest risk (OR = 0.18). Among subjects followed for over 3 years, the association of IGF-related molecules with overall CRC was similar. Free IGFBP3 was associated with the incidence of right-sided CRC (p for trends = 0.004). Free IGF was inversely associated with the incidence of right-sided CRC (p for trends = 0.002). However, free IGFs were associated with a risk of left-sided CRC (p for trends = 0.041), with the third tertile showing the highest risk (OR = 3.10).</p><p><strong>Conclusions: </strong>Serum IGF-related molecules are associated with the risk of CRC. These associations might differ by tumor location.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-12"},"PeriodicalIF":3.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709009","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":"Which of Vonoprazan Alone or Intravenous Proton Pump Inhibitor Followed by Vonoprazan Is Optimal for Reducing Delayed Bleeding in Gastric Endoscopic Submucosal Dissection?","authors":"Hiroko Abe, Kunio Tarasawa, Waku Hatta, Naotaro Tanno, Yutaka Hatayama, Yohei Ogata, Masahiro Saito, Xiaoyi Jin, Tomoyuki Koike, Akira Imatani, Shin Hamada, Kenji Fujimori, Kiyohide Fushimi, Atsushi Masamune","doi":"10.1159/000545253","DOIUrl":"10.1159/000545253","url":null,"abstract":"<p><strong>Introduction: </strong>In gastric endoscopic submucosal dissection (ESD), both vonoprazan alone and intravenous proton pump inhibitor (PPI) followed by vonoprazan have lower delayed bleeding risk than PPI alone. This study aimed to clarify an optimal acid-suppressive method in gastric ESD.</p><p><strong>Methods: </strong>This population-based cohort study included patients who underwent gastric ESD on only vonoprazan (vonoprazan alone group) or intravenous PPI followed by vonoprazan (intravenous PPI group) using the Diagnosis Procedure Combination database in Japan between 2014 and 2021. The primary outcome was delayed bleeding. To balance the two comparison groups, propensity score matching (PSM), based on 18 variables, was performed; subsequently, to compare the bleeding outcome, logistic regression analysis was performed.</p><p><strong>Results: </strong>Of 63,952 patients, 24,710 pairs were compared following PSM. The delayed bleeding risk in the vonoprazan alone group was similar to that in the intravenous PPI group (odds ratio [OR], 1.00; 95% confidence interval, 0.93-1.08; delayed bleeding rate, 5.9% vs. 5.9%). The results were consistent in some sensitivity and subgroup analyses; however, the result was modified by the status of antithrombotic agents (p for interaction = 0.029). In additional analyses, in patients with antithrombotic agent, the vonoprazan alone group had a higher delayed bleeding risk than the intravenous PPI group (OR, 1.15).</p><p><strong>Conclusion: </strong>Both vonoprazan alone and intravenous PPI followed by vonoprazan might be acceptable in gastric ESD when antithrombotic agents were not administered, whereas intravenous PPI followed by vonoprazan might be favorable in patients with antithrombotic agents.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Helicobacter pylori Stool Antigen Test with the Bioluminescent Enzyme Immunoassay Affected by Proton Pump Inhibitors?","authors":"Chika Kusano, Koshiro Tsutsumi, Toshiki Horii, Sho Suzuki, Hirofumi Kiyokawa, Tadateru Maehata, Itsuko Hirayama, Shinya Minami, Tetsuya Sumiyoshi, Ryuji Nagahama","doi":"10.1159/000545347","DOIUrl":"10.1159/000545347","url":null,"abstract":"<p><strong>Introduction: </strong>Proton pump inhibitors (PPIs) can lead to false-negative results in Helicobacter pylori stool antigen (HpSA) testing. A new bioluminescent enzyme immunoassay (BLEIA)-based HpSA test was introduced. This study aimed to evaluate the sensitivity of this test in patients on PPIs and compare its sensitivity with that of the enzyme immunoassay (EIA).</p><p><strong>Methods: </strong>We included patients without a history of H. pylori eradication who were diagnosed as H. pylori-positive via culture, microscopy, rapid urease tests, urea breath tests, serum H. pylori antibody tests, or HpSA tests. The sensitivity of HpSA detection was compared among patients based on their PPI intake using both BLEIA and conventional EIA.</p><p><strong>Results: </strong>Enrollment occurred from December 2020 to July 2022 across 10 facilities, with 109 patients enrolled in both the PPI and non-PPI groups. The sensitivity of BLEIA was 65.9% in the PPI group and 87.1% in the non-PPI group, showing a difference of -22.0% (95% CI: -11.0% to -32.9%) (p = 0.0003). For EIA, the sensitivity was 54.1% in the PPI group and 72.4% in the non-PPI group, with a difference of -18.3% (95% CI: -5.5% to -30.4%) (p = 0.0076). Significant differences in sensitivity were observed for both BLEIA and EIA between the PPI and non-PPI groups (p = 0.005 and p < 0.0001, respectively), with BLEIA demonstrating higher sensitivity.</p><p><strong>Conclusion: </strong>This study indicated that the sensitivity of HpSA detection using BLEIA decreased under PPI administration. Additionally, BLEIA may have higher sensitivity than EIA.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}