Digestive Diseases and Sciences最新文献

{"title":"Understanding the Impact of Prior Anti-TNF Exposure on Colectomy Risk in Acute Severe Ulcerative Colitis.","authors":"Arno R Bourgonje, Maia Kayal","doi":"10.1007/s10620-025-08930-2","DOIUrl":"https://doi.org/10.1007/s10620-025-08930-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mirikizumab in the Treatment of Ulcerative Colitis: Initial Real-World Data in a Population from a Large Tertiary Center.","authors":"Joëlle St-Pierre, David Choi, Evan Fear, Natalie K Choi, Alex J Mathew, Russell D Cohen, Sushila R Dalal, Joel Pekow, Noa Krugliak Cleveland, David T Rubin","doi":"10.1007/s10620-025-08950-y","DOIUrl":"https://doi.org/10.1007/s10620-025-08950-y","url":null,"abstract":"<p><strong>Background: </strong>Mirikizumab, an anti-p19IL-23 monoclonal antibody, has shown efficacy and safety in treating moderately to severely active ulcerative colitis (UC) in clinical trials. We assessed the effectiveness and safety of mirikizumab for the treatment of UC in a real-world setting.</p><p><strong>Methods: </strong>We conducted a prospective observational study of adult patients with UC who were started on mirikizumab for active disease between January 1, 2024, and April 30, 2024. Clinical, biochemical, sonographic, and endoscopic data were collected. The primary outcome was clinical response and remission at 12 weeks, and secondary outcomes included corticosteroid-free remission (CSFR) and biochemical marker improvement at week 12. Adverse events were recorded.</p><p><strong>Results: </strong>Twenty-two patients were initiated on mirikizumab during the study period, with 20 included in the analysis. The majority were female (65%) and had a median duration of disease of 12 years (IQR 8.0-18.5]. The majority of patients had previously been exposed to three or more advanced therapies (70% of patients) prior to mirikizumab start. Clinical remission (SCCAI < 3) increased from 30% at baseline to 83% at week 12. CSFR increased from 15% at baseline to 78% at week 12. Median SCCAI scores significantly decreased from 3.5 at baseline to 0.5 at week 12 (p < 0.001), driven primarily by an improvement in general well-being and a decrease in urgency. Adverse effects were mild to moderate, with one serious event of streptococcal pharyngitis.</p><p><strong>Conclusion: </strong>Mirikizumab demonstrated significant clinical effectiveness in achieving clinical remission, response, and CSFR in patients with UC.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Homocysteine Promotes Intestinal Inflammation in Colitis Mice Through the PGE2/STAT3 Signaling Pathway.","authors":"Akang Shao, Qiu Zhao, Min Chen","doi":"10.1007/s10620-025-08903-5","DOIUrl":"https://doi.org/10.1007/s10620-025-08903-5","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Prior Anti-TNF Exposure and Colectomy in Acute Severe Ulcerative Colitis.","authors":"Cong Dai, Xin-Yi Su","doi":"10.1007/s10620-025-08891-6","DOIUrl":"https://doi.org/10.1007/s10620-025-08891-6","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonic Diaphragmatic Disease: The Concerning Dark Depths of NSAIDs.","authors":"Yang Tang, Dongge Gong, Yan Chen, Siqi Tao, Ludovico Docimo, Augusto Lauro, Xiujun Liao, Federico Maria Mongardini","doi":"10.1007/s10620-025-08939-7","DOIUrl":"https://doi.org/10.1007/s10620-025-08939-7","url":null,"abstract":"<p><p>Non-steroidal anti-inflammatory drugs (NSAIDs), widely used for their therapeutic benefits, are associated with significant gastrointestinal complications, including the rare occurrence of colonic diaphragm disease (CDD). Characterized by diaphragm-like fibrotic strictures that narrow the intestinal lumen, CDD often leads to symptoms such as chronic anemia, bowel obstruction, and gastrointestinal bleeding. This report discusses a case of NSAID-induced CDD in a 58-year-old male with a history of prolonged NSAID use for osteoarthritis. The patient's clinical course was marked by progressive fatigue, melena, and intestinal obstruction, necessitating multiple hospitalizations and interventions. Our findings underscore the frequent association of CDD with prolonged NSAID use, particularly enteric-coated formulations, and the predominance of lesions in the right colon. Furthermore, we conducted a comprehensive review of the literature, summarizing 53 reported cases of NSAID-induced colonic diaphragm disease. This review highlights the common clinical manifestations, diagnostic challenges, and therapeutic strategies for this rare condition. Despite medical management and endoscopic interventions, the patient required subtotal colectomy due to recurrent strictures and complications. This case underscores the diagnostic challenges posed by CDD, particularly its overlap with inflammatory bowel disease. Surgical exploration and histological evaluation were essential for diagnosing CDD and guiding appropriate management. This case highlights the importance of recognizing NSAID-induced enteropathy in the differential diagnosis of patients with unexplained gastrointestinal symptoms, emphasizing the need for a thorough drug history and tailored therapeutic strategies. Advanced surgical techniques and novel treatments continue to improve the management of gastrointestinal complications, bettering patient outcomes, and quality of life.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hot TIPS: Pre-emptive TIPS Is Effective and Should Be Used More Frequently.","authors":"Anna Baiges, Joan Carles García-Pagán","doi":"10.1007/s10620-025-08923-1","DOIUrl":"https://doi.org/10.1007/s10620-025-08923-1","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NFAT2 Induces Tumor Cell Proliferation and Metastasis by Acting as a Transcriptional Co-activator of the TGF-β1/SMAD Signaling Pathway and Inducing the Epithelial-Mesenchymal Transition in Liver Cancer.","authors":"Yuqi Liu, Wenhui Mo, Weijie Sun, Jianqing Chen, Jiaojiao Chen, Yueyue Li, Dengyu Han, Weiqi Dai, Ruling Zhang","doi":"10.1007/s10620-025-08890-7","DOIUrl":"https://doi.org/10.1007/s10620-025-08890-7","url":null,"abstract":"<p><strong>Background: </strong>The role of NFAT2 in liver cancer is conflicting, with evidence suggesting both oncogenic and tumor-suppressive effects. A clear understanding of its expression, function, regulation, and mechanism of action in liver cancer remains critical.</p><p><strong>Objectives: </strong>To examine the expression levels, biological functions, regulatory mechanisms, and downstream pathways of NFAT2 in liver cancer and its metastasis.</p><p><strong>Methods: </strong>The expression of NFAT2 was analyzed in liver cancer patients and correlated with clinical outcomes. Functional assays, including proliferation, migration, invasion, and xenograft models, were employed to assess the effects of NFAT2 upregulation and downregulation. Molecular analyses were conducted to identify key pathways and protein interactions underpinning NFAT2's effects. The therapeutic potential of NFAT2 inhibition in combination with sorafenib was also evaluated.</p><p><strong>Results: </strong>NFAT2 overexpression was associated with poor prognosis and shorter disease-free survival in liver cancer patients. Upregulation of NFAT2 promoted hepatoma cell proliferation, migration, and invasion, while its downregulation impaired these pro-oncogenic effects. Mechanistically, NFAT2 enhanced the epithelial-to-mesenchymal transition (EMT) by increasing mesenchymal marker expression (N-cadherin, vimentin, MMP9) and decreasing invasion inhibitors (E-cadherin, ZO-1). It physically interacted with SMAD3 and p300, thereby activating the TGF-β1/SMAD pathway to drive tumor progression. NFAT2 knockdown or inhibition re-sensitized tumor cells to sorafenib, indicating its promising therapeutic potential.</p><p><strong>Conclusion: </strong>NFAT2 acts as a transcriptional co-activator of the TGF-β1/SMAD signaling pathway, promoting liver cancer progression and metastasis. Its inhibition could serve as a novel therapeutic strategy for the treatment of advanced liver cancer, particularly in combination with sorafenib.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal Microbiota Transplantation (FMT) and Clinical Outcomes Among Inflammatory Bowel Disease (IBD) Patients: An Umbrella Review.","authors":"Sheza Malik, Syed Arsalan Ahmed Naqvi, Abul Hasan Shadali, Hajra Khan, Michael Christof, Chengu Niu, David A Schwartz, Douglas G Adler","doi":"10.1007/s10620-025-08946-8","DOIUrl":"https://doi.org/10.1007/s10620-025-08946-8","url":null,"abstract":"<p><strong>Background and aims: </strong>Recent systematic reviews and meta-analyses (SRMAs) have shown inconsistent effectiveness of FMT among patients with IBD. This study aimed to appraise the evidence for clinically relevant outcomes with FMT in patients with IBD using published SRMAs.</p><p><strong>Methods: </strong>We searched major databases from inception through Nov 2023 to identify SRMAs assessing the effectiveness of FMT in patients with IBD. Primary outcomes included clinical remission, clinical response, endoscopic remission/response, a composite endpoint, and adverse effects. We included SRMAs investigating FMT's effect in patients with IBD using RCTs and observational studies data. Methodological quality and evidence certainty were assessed using AMSTAR 2 and GRADE.</p><p><strong>Results: </strong>Out of 106 citations, 16 SRMAs were included with varying study sizes (2 to 60 primary studies) and participants (112 to 1169 per SRMA). Five SRMAs assessed FMT in IBD, while 11 focused on Ulcerative Colitis (UC). Seven SRMAs included RCTs only, and nine included both RCTs and observational studies. Methodological quality was critically low in 9 SRMAs (56%) and low in 7 studies (44%). FMT showed clinical remission benefit in all 16 SRMAs, with varying certainty: 3 high, 4 moderate, 4 low, and 5 very low. Endoscopic remission/response was reported in 5 meta-analyses on UC, with 1 high, 3 moderate, and 1 very low certainty. Combined clinical remission and endoscopic response were reported in 3 SRMAs on UC, with 1 low and 2 moderate certainty. Adverse events were reported in 6 SRMAs, with 1 high, 3 moderate, 1 low, and 1 very low certainty.</p><p><strong>Conclusion: </strong>Current evidence shows potential benefits of FMT in IBD, particularly UC, supported by significant associations in 16 meta-analyses. However, poor methodological quality and variability in evidence certainty call for high-quality RCTs to strengthen the evidence.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transjugular Intrahepatic Portosystemic Shunt for Preventing Rebleeding of Esophageal Varices in Patients with Portal Cavernous Transformation.","authors":"Jin-Wei Chen, Peng-Fei Chen, Jing Li, Xu-Hua Duan, Jian-Zhuang Ren, Wen-Guang Zhang","doi":"10.1007/s10620-025-08955-7","DOIUrl":"https://doi.org/10.1007/s10620-025-08955-7","url":null,"abstract":"<p><strong>Purpose: </strong>Recurrent esophageal variceal bleeding and/or refractory ascites in patients with cavernous transformation of the portal vein (CTPV) is associated with a high fatality rate. Transjugular intrahepatic portosystemic shunt (TIPS) provides a treatment option for preventing esophageal variceal rebleeding and/or refractory ascites. This retrospective study evaluated the safety and efficacy of TIPS for the patients involved.</p><p><strong>Methods: </strong>The records of 41 consecutive patients with CTPV who underwent TIPS at our institution from January 2015 to May 2019 were reviewed. Among the 41 patients, 36 patients had variceal rebleeding only, and 5 patients exhibited both variceal rebleeding and refractory ascites. Ten of these patients underwent TIPS via a transjugular pathway alone; a combined transjugular/transhepatic pathway and a combined transjugular/transsplenic pathway were adopted for 21 and 3 patients, respectively; and the remaining 7 patients failed TIPS.</p><p><strong>Results: </strong>TIPS succeeded in 34 of 41 (82.9%) patients. Four of 34 patients with CTPV were successfully cured with a thick collateral caval stent shunt operation. After TIPS, the mean portosystemic pressure gradient declined from 24.60 ± 6.15 mmHg to 15.89 ± 4.08 mmHg (P < 0.01). The occurrence rate of variceal rebleeding in the TIPS success group was lower than that in the TIPS failure group (11.8% vs 42.9%, P < 0.05). The occurrence rate of recurrent ascites in the TIPS failure group was greater than that in the TIPS success group (75% vs 15.8%, P < 0.05). TIPS patency was 76.5% (26 of 34 patients). During the follow-up time (median 12.64 months), the rate of hepatic encephalopathy was 5.9%, and the survival rate was 85.3%.</p><p><strong>Conclusions: </strong>TIPS is an effective and safe alternative therapy for preventing esophageal variceal rebleeding and/or refractory ascites in patients who exhibit CTPV, and these findings may be beneficial to clinical research.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selenomethionine Alleviates Alcohol-Induced Liver Injury by Inhibiting Ferroptosis.","authors":"Feng Chen, Zhenhua Zhou, Jinxian Fu, Chang Gao","doi":"10.1007/s10620-025-08960-w","DOIUrl":"https://doi.org/10.1007/s10620-025-08960-w","url":null,"abstract":"<p><strong>Background and aim: </strong>Selenomethionine (Se-Met) has been reported to reduce oxidative stress (OS) and hepatic injury; however, its role in alcoholic liver disease (ALD), particularly with ferroptosis, remains poorly understood.</p><p><strong>Methods: </strong>Oxidative stress was induced using ethanol, and ferroptosis was inhibited with ferrostatin-1 (fer-1) in L-02 and LX2 cell lines, respectively. The effects of Se-Met on alcohol-induced hepatocyte damage were evaluated in vitro by examining cell viability, lipid peroxidation, and the level of key ferroptosis-associated markers. In vivo, the interaction between Se-Met and ferroptosis was examined via an ALD mouse model through analyses of liver histology, lipid peroxidation, liver function, and ferroptosis-related indices.</p><p><strong>Results: </strong>In vitro and in vivo experiments indicated that both Se-Met and fer-1 have a significant protective role against alcohol-induced hepatocyte death and liver injury. Treatment with Se-Met or fer-1 can promote hepatocyte proliferation, ameliorate the typical symptoms of lipid peroxidation (e.g., glutathione depletion, superoxide dismutase enzyme activity, intracellular reactive oxygen species (ROS) level, malonaldehyde (MDA) content), and altered the expression of ferroptosis-related factors. Moreover, the findings indicated that the administration of Se-Met or fer-1 significantly ameliorated the pathological alterations and improved liver function indices associated with alcohol-induced liver damage in mice. These effects may collectively suppress the deleterious impact of ethanol on hepatic tissue.</p><p><strong>Conclusion: </strong>This study concluded that the ferroptosis pathway regulated alcohol-induced hepatocyte injury. The administration of selenomethionine protects ALD by partially inhibiting the ferroptosis pathway, providing a novel therapeutic approach for ALD.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}