European Journal of Gastroenterology & Hepatology最新文献

{"title":"Differential association of platelet indices in NAFLD/NASH: a Mendelian randomized study.","authors":"Hao Huang, Yang Bai, Yang Zhao, Xiaowei Sun","doi":"10.1097/MEG.0000000000003029","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003029","url":null,"abstract":"<p><strong>Objective: </strong>Platelets play important roles in thrombosis, immunity, and inflammation. Recent studies have shown a relationship between platelet indices and nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH). However, the nature and direction of this causal relationship remain controversial. This study used two-sample Mendelian randomization (MR) to elucidate the potential causal relationships.</p><p><strong>Methods: </strong>Genetic associations of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) were obtained from the summary statistics of a genome-wide association study from the UK Biobank, those of NAFLD/NASH were sourced from the FinnGen database, and two different genome-wide association meta-analyses. Inverse variance weighting was conducted, with weighted median, Mendelian randomisation-Egger, and Mendelian randomisation Pleiotropy Residual Sum and Outlier methods used as sensitivity analyses. Estimates from the inverse variance weighting method were meta-analyzed. Reverse MR Analysis was conducted using NAFLD data.</p><p><strong>Results: </strong>Increased genetically predicted PDW levels were consistently associated with increased NAFLD risk from all three sources (OR = 1.08, 95% CI = 1.01-1.15; P = 0.020). Genetically predicted NAFLD was associated with increased MPV (OR = 1.008, 95% CI: 1.005-1.032; P = 0.008). Increased levels of genetically predicted PDW were associated with an increased risk of NASH (OR = 1.603, 95% CI: 1.154-2.228; P = 0.005). Decreased levels of genetically predicted PLT and PCT were associated with an increased risk of NASH (OR = 0.679, 95% CI: 0.487-0.947, P = 0.023; OR = 0.587, 95% CI: 0.408-0.843; P = 0.004).</p><p><strong>Conclusion: </strong>Our results suggest that fluctuations in platelet indices are important in predicting the onset and progression of NAFLD/NASH.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590782","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":"Cost-utility and clinical impact of endoscopic screening for esophageal and gastric neoplasia in patients with head and neck neoplasms.","authors":"Rui Morais, João Afonso, Nuno Sousa, Bernardo Sousa-Pinto, Diogo Libânio, Bárbara Marinho, Maria Luísa Sacramento, Mariana Simplício, Isabel Faria-Ramos, Luís Azevedo, Margarida Marques, Helena Silveira, Irene Gullo, Fátima Carneiro, João Santos-Antunes, Guilherme Macedo","doi":"10.1097/MEG.0000000000002988","DOIUrl":"10.1097/MEG.0000000000002988","url":null,"abstract":"<p><strong>Objective: </strong>Patients with head and neck neoplasms (HNN) are at an increased risk of esophageal neoplasia (EN) and gastric neoplasia (GN). We aimed to assess the clinical impact and cost-utility of endoscopic screening in this population in the Western setting.</p><p><strong>Methods: </strong>In this single-center study HNN patients eligible for curative treatment underwent screening esophagogastroduodenoscopy. We assessed the frequency, clinical, and pathological outcomes of EN and GN. The cost-effectiveness of an annual endoscopic screening for EN was evaluated from a societal perspective, using a Markov model and probabilistic sensitivity analysis. In addition, we performed a sensitivity analysis using data on the prevalence of detected EN lesions in the four largest previous Western studies on this topic.</p><p><strong>Results: </strong>Forty-six HNN patients met the inclusion criteria and underwent endoscopic screening. Six EN were detected in five patients (10.9%, 95% confidence interval: 1.9-19.9%). Additionally, five GN were detected in five patients. Most patients had early-stage EN or GN (90%) and were treated with endoscopic resection (80%). Endoscopic screening strategy had an incremental cost-effectiveness ratio of 39 357.8 €/quality-adjusted life years gained, being cost-effective at a willingness-to-pay threshold of two times the Portuguese gross domestic product per capita. In the sensitivity analysis, it remained cost-effective when considering the prevalence of EN reported in Germany, France, and Brazil.</p><p><strong>Conclusion: </strong>An endoscopic screening program identified EN or GN in a fifth of HNN patients, most presenting at an early stage. The program implementation appears to be cost-effective in Portugal. These results may be applicable to other medium-to-high-income Western countries.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"815-825"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of multidisciplinary discussion on pancreatic neuroendocrine tumours, experience of a tertiary centre.","authors":"Francesca Lodato, Alessia Gazzola, Marco Signoretti, Laura Mastrangelo, Luca Gaetani, Stefano Landi, Silvana Bernadetta Puglisi, Elio Jovine, Vincenzo Cennamo","doi":"10.1097/MEG.0000000000002997","DOIUrl":"10.1097/MEG.0000000000002997","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic neuroendocrine tumours (pNETs) are rapidly increasing. Their management implies considerable resources. Multidisciplinary discussion of tumours has become a cornerstone in clinical oncology but no studies demonstrate a clear clinical benefit. The aim of the present study is to evaluate whether the systematic discussion of patients with pNET in multidisciplinary meeting (MM) has changed their management.</p><p><strong>Methods: </strong>This retrospective single-centre study was held from 2004 to 2023. Since 2018 all patients were discussed in MM; thus, they were divided into two groups (board and no board) to evaluate clinical and surgical outcomes and whether multidisciplinary discussion improved adherence to guidelines.</p><p><strong>Results: </strong>A total of 128 patients were enrolled (55 board group and 73 no board). Groups were comparable for gender (36.4% female vs. 45.2%), mean age (60.3 vs. 61.7 years), mean American Society of Anesthesiologists score (2.66 vs. 2.71), Charlson Comorbidity Index (CCI) (CCI < 6, 80 vs. 79.45%), rate of functioning tumours (7.3 vs. 16.4%, P  = 0.2), and pre/postoperative grading. Endoscopic ultrasound (EUS) was used more in board vs. no board (EUS: 90.9 vs. 71.2%, P  = 0.005, EUS with fine-needle aspiration 89.1 vs. 65.8%, P  = 0.002). More patients underwent surgery in no board (78.1 vs. 61.8%, P  = 0.045). Postoperative complications were comparable as well as mortality (9.1 vs. 9.6%) and adherence to guidelines (board vs no board adherents: 90.3 vs. 87.6%, P  = 0.9).</p><p><strong>Conclusion: </strong>Systematic multidisciplinary discussion does not result in significant clinical impact in terms of surgical complications, recurrences, and reinterventions. A selective approach in multidisciplinary discussion would be worth considering.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"826-832"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973650","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":"Racial disparities in posttransplant outcomes among recipients undergoing simultaneous liver-kidney transplantation.","authors":"David Uihwan Lee, Mohammed Rifat Shaik, Kimberly Schuster, Sindhura Kolachana, Aneesh Bahadur, Ki Jung Lee, Harrison Chou, Gregory Hongyuan Fan, Daniel Jung, Raffi Karagozian","doi":"10.1097/MEG.0000000000002962","DOIUrl":"10.1097/MEG.0000000000002962","url":null,"abstract":"<p><strong>Background: </strong>Patients with end-stage cirrhosis may experience renal dysfunction, necessitating a simultaneous kidney-liver transplant (SKLT). Guidelines have been put forth by the United Network for Organ Sharing (UNOS) to streamline the SKLT allocation process and ensure equitable access to transplantation. However, there is a scarcity of literature on racial and ethnic disparities in post-SKLT outcomes.</p><p><strong>Methods: </strong>The UNOS Standard Transplant Analysis and Research Database was queried from 2005 to 2019 to study SKLT patients. Patients were stratified by race: White (reference group) recipients ( n  = 3513), Black recipients ( n  = 859), Hispanic recipients ( n  = 964), Asian recipients ( n  = 206), and other recipients ( n  = 85). Primary endpoints included all-cause mortality and graft failure while secondary endpoints were specific causes of death.</p><p><strong>Results: </strong>Hispanic recipients had a lower risk of all-cause mortality (aHR: 0.79, 95% CI: 0.68-0.93, P  = 0.003), while Black recipients had a significantly increased risk of graft failure compared to Whites (aHR: 1.63, 95% CI: 1.16-2.30, P  = 0.005). Evaluation of specific causes of recipient death revealed a higher risk of death due to gastrointestinal hemorrhage among Blacks (aHR: 4.16, 95% CI: 1.04-16.68, P  = 0.04).</p><p><strong>Conclusion: </strong>Our study findings show Black patients experience higher rates of graft failure compared to White counterparts. The reasons for these disparities are not fully understood but likely a combination of biological and social factors. Further investigation is warranted to ascertain the specific factors influencing these outcomes.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"844-863"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controlling nutritional status score predicts posthepatectomy liver failure: an online interpretable machine learning prediction model.","authors":"Jun Yuan, Rui Qing Zhang, Qiang Guo, Aji Tuerganaili, Ying Mei Shao","doi":"10.1097/MEG.0000000000002965","DOIUrl":"10.1097/MEG.0000000000002965","url":null,"abstract":"<p><strong>Background and aims: </strong>Posthepatectomy liver failure (PHLF) remains a severe complication after hepatectomy for hepatocellular carcinoma (HCC) and accurate preoperative evaluation and predictive measures are urgently needed. We investigated the impact of the controlling nutritional status (CONUT) score on PHLF and utilized machine learning (ML) algorithms to identify high-risk individuals of PHLF.</p><p><strong>Method: </strong>A total of 464 patients with HCC undergoing hepatectomy were randomized 7 : 2: 1 into the training group ( n  = 324), test group ( n  = 94), and validation group ( n  = 46). In the training group, variables were screened by univariate logistic regression combined with least absolute shrinkage and selection operator regression. Models were then developed using nine ML algorithms and the optimal model was interpreted via SHapley Additive exPlanations and deployed online.</p><p><strong>Results: </strong>PHLF was present in 29 of 324 (8.9%) patients. The light gradient boosting machine (LightGBM) model based on the CONUT score exhibited excellent performance, with an area under the curve (AUC) of 0.927 [95% confidence interval (CI): 0.886-0.967], an area under the precision-recall curve (AUPRC) of 0.644 (95% CI: 0.469-0.785), and a Brier score of 0.055 in the training group. And an AUC of 0.703 (95% CI: 0.528-0.879), an AUPRC of 0.420 (95% CI: 0.096-0.703), and a Brier score of 0.091 in the test group. In the validation group, AUC, AUPRC, and Brier score were 0.808 (95% CI: 0.637-0.980), 0.516 (95% CI: 0.086-0.841), and 0.096, respectively. The model was made available online for clinical application (LightGBM for PHLF).</p><p><strong>Conclusion: </strong>The CONUT score significantly influences PHLF. The LightGBM model demonstrates the prominent predictive capacity of PHLF.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"875-884"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980400","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":"Effect of high-intensity interval training on clinical parameters in patients with metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis of randomized controlled trials.","authors":"Jie Fu, Chunlan Liu, Luping Yang, Binbin Zhang, Run Zhou, Chaohua Deng, Huiqin Zhang, Jianing Kong, Jie Li, Junping Shi","doi":"10.1097/MEG.0000000000002964","DOIUrl":"10.1097/MEG.0000000000002964","url":null,"abstract":"<p><p>High-intensity interval training (HIIT) has potential health benefits in the treatment of many chronic diseases. However, the efficacy of HIIT in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear. This systematic review and meta-analysis aimed to assess the impact of HIIT on intrahepatic lipids (IHLs) , liver enzymes, and metabolic profiles in individuals with MASLD. All randomized-controlled trials (RCT) that evaluated and compared the effects of HIIT on clinical parameters in patients with MASLD were searched using the PubMed, EMBASE, WOS, and Cochrane databases. Data analysis and integration were performed using RevMan 5.3 (Cochrane Collaboration, Copenhagen, Denmark) and Stata version 18 software (StataCorp LLC, College Station, Texas, USA), and outcomes were assessed using the standardized mean difference (SMD). Our results showed that compared with other types of exercise or no exercise, HIIT could reduce the levels of IHL [SMD: -0.56%, 95% confidence interval (CI): -0.99 to -0.13, P  = 0.01], BMI (SMD: -0.31, 95% CI: -0.62 to -0.01, P  = 0.04), alanine aminotransferase (ALT) (SMD: -0.61, 95% CI: -0.95 to -0.26, P  = 0.0006), and aspartate aminotransaminase (AST) (SMD: -0.43, 95% CI: -0.81 to -0.05, P  = 0.03) in patients with MASLD. In addition, subgroup analyses showed that HIIT had a positive impact on clinical indicators in patients with MASLD with an intervention duration of less than equal to 8 weeks. This study supports the idea that HIIT can significantly reduce IHL, BMI, ALT, and AST levels, and further studies are needed to assess the long-term adherence and treatment effects of HIIT.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"789-798"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paper Alert.","authors":"","doi":"10.1097/MEG.0000000000003011","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003011","url":null,"abstract":"<p><p>A selection of interesting papers that were published in the month before our press date in major journals likely to report important results in gastroenterology and hepatology. Peter Hayes and John Plevris The Royal Infirmary, Edinburgh EH3 9YW, UK.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"37 7","pages":"887-890"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224826","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 of free triiodothyronine and total triiodothyronine with nonalcoholic fatty liver disease: from National Health and Nutrition Examination Survey and Mendelian randomization study.","authors":"Wei Hao, Lanlan Chen, Ting Li, Guoyue Lv","doi":"10.1097/MEG.0000000000002963","DOIUrl":"10.1097/MEG.0000000000002963","url":null,"abstract":"<p><strong>Background: </strong>Nonalcoholic fatty liver disease (NAFLD) is associated with multiple factors, yet the relationship between NAFLD and thyroid-related biomarkers remains unclear. This study aims to elucidate this potential linkage.</p><p><strong>Methods: </strong>Utilizing data from the US National Health and Nutrition Examination Survey (NHANES), we explored the possible associations between thyroid-related biomarkers and NAFLD through multivariable logistic regression, subgroup analysis, and interaction tests. A bidirectional Mendelian randomization (MR) approach complemented by various sensitivity analyses was then employed to ascertain these relationships' causality.</p><p><strong>Results: </strong>Our NHANES analysis indicated significant associations between elevated levels of free triiodothyronine (FT3) [odds ratio (OR): 2.59, 95% confidence interval (CI): 1.50-4.49] and total triiodothyronine (TT3) (OR: 2.01, 95% CI: 1.27-3.18) with the prevalence of NAFLD. MR findings reinforced the causal relationship, demonstrating that NAFLD may elevate FT3 ( β : 0.05, 95% CI: 0.01-0.09) and TT3 ( β : 0.08, 95% CI: 0.02-0.14) levels. Additionally, thyroid-stimulating hormone (TSH) was confirmed as an independent risk factor for NAFLD (OR: 1.10, 95% CI: 1.04-1.18), with specific MR sensitivity analyses supporting the robustness of these results.</p><p><strong>Conclusion: </strong>This study indicates potential elevations in FT3, TT3, and thyroglobulin levels associated with NAFLD, while also identifying TSH as a risk factor for NAFLD. These findings underscore the importance of routine thyroid function monitoring both in the general population and particularly in individuals with NAFLD.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"864-874"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989966","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":"Prognostic factors for mortality in patients with acute-on-chronic liver failure.","authors":"Huijie Jiang, Zhihao Zhao, Shiyu Cui, Xianggen Kong, Xuemei Jiang","doi":"10.1097/MEG.0000000000002958","DOIUrl":"10.1097/MEG.0000000000002958","url":null,"abstract":"<p><strong>Objective: </strong>The aim is to explore significant prognostic factors for 90-day mortality in patients with acute-on-chronic liver failure (ACLF) and assist clinicians in the early identification of critically ill ACLF patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 288 ACLF patients, who were classified into survivors ( n  = 187) and nonsurvivors ( n  = 101) based on 90-day outcomes. Multivariate stepwise logistic regression analyses were employed to identify significant prognostic factors and construct a novel prognostic model, the AHUCTPI. The model's performance was assessed and the internal validation was performed. Additionally, the influence of dynamic changes in laboratory markers on 90-day mortality was examined.</p><p><strong>Results: </strong>Independent risk factors for 90-day mortality included age ≥45 years, presence of hepatic encephalopathy (HE), and upper gastrointestinal bleeding (UGB) during hospitalization, imaging-confirmed cirrhosis at admission, elevated baseline total bilirubin (TBIL), reduced baseline platelet-to-neutrophil ratio (PNR), and elevated baseline international normalized ratio (INR) ( P  < 0.05 for all). The AHUCTPI model's formula is as follows: Logit ( p ) = -10.019 + 1.808 × age (1 if ≥45 years, 0 if <45 years) + 1.048 × HE (1 if present, 0 if absent) + 1.721 × UGB (1 if present, 0 if absent) + 1.362 × cirrhosis (1 if present, 0 if absent) + 0.008 × TBIL (μmol/L) - 0.039 × PNR + 1.963 × INR. The AUHCTPI model demonstrated superior predictive accuracy compared with the MELD (Model for End-Stage Liver Disease) score, with the area under the receiver operating characteristic curve values of 0.914 and 0.739, respectively, and calibration curves closely approximating the ideal curve.</p><p><strong>Conclusion: </strong>ACLF is a complex, dynamic syndrome. Age, HE, and UGB during hospitalization, imaging-diagnosed cirrhosis at admission, baseline TBIL, PNR, and INR were significant predictors for 90-day mortality in ACLF patients, and the AHUCTPI model provides excellent calibration and discrimination. Dynamic monitoring of laboratory trends enhances prognostic accuracy and supports timely clinical decision-making.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"833-843"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FoxP3-positive T regulatory cells and its effector mechanisms in Crohn's disease: an immunohistochemical and image morphometric analysis on endoscopic mucosal biopsies.","authors":"Susama Patra, Shalini Chaudhary, Subash Chandra Samal, Pavithra Ayyanar, Somanath Padhi, Hemanta Kumar Nayak, Amit Kumar Satapathy, Saurav Nayak, Ajit Sahu, Tapaskanti Parida, Mohammed Shahin","doi":"10.1097/MEG.0000000000002971","DOIUrl":"10.1097/MEG.0000000000002971","url":null,"abstract":"<p><strong>Objective: </strong>Crohn's disease (CD) is an immune inflammatory disorder of the gastrointestinal tract arising from a complex interplay of genetic, environmental, microbiome, and immune factors. Regulatory T cells (Tregs), characterized by FoxP3 expression, are crucial for maintaining immune homeostasis through PD-1/PD-L1 interaction, interleukin (IL)-10 release, and granzyme (GrB) production. This study aimed to elucidate the role of FoxP3 positive (+) Tregs in CD.</p><p><strong>Methods: </strong>Segmental colonoscopic biopsies from 46 treatment-naive CD cases (34 adults and 12 children) categorized into noninflamed [ n  = 32; Nancy histologic index (NHI) 0, 1] and inflamed ( n  = 100; NHI 2-4) mucosae using NHI. CD4, FoxP3, PD-1, IL-10, and GrB immunoexpression were analyzed by eyeballing and image morphometry. Findings were correlated with activity, granulomas, and skip lesions; and compared with site-matched non-inflammatory bowel disease (IBD) controls ( n  = 30).</p><p><strong>Results: </strong>FoxP3+ Tregs, IL-10, PD-1, and GrB expressions were significantly higher in NHI 3-4 mucosae than in NHI 0-1 and controls ( P  < 0.05). No significant differences were observed between adults and children, whereas those with granulomas had increased expression ( P  = 0.045). The FoxP3 : CD4 ratio positively correlated with IL-10 (Spearman, r  = 0.307, P  = 0.002), GrB ( r  = 0.302, P  = 0.002), but not with PD-1 ( r  = 0.98, P  = 0.33).</p><p><strong>Conclusions: </strong>Our findings point to the possibility of a qualitative defect in FoxP3+ Tregs in CD. The functional arms of Tregs in CD need to be elucidated further in larger prospective cohorts to validate our observations and pave the way for future immunotherapy.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"799-809"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975800","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}