Elżbieta Szczygieł-Pilut, Michał Błaż, Elżbieta Pociask, Elżbieta Paszek, Anetta Undas
{"title":"Elevated factor VIIa-antithrombin complexes are associated with stroke or cardiovascular death in patients with atrial fibrillation.","authors":"Elżbieta Szczygieł-Pilut, Michał Błaż, Elżbieta Pociask, Elżbieta Paszek, Anetta Undas","doi":"10.1111/eci.70091","DOIUrl":"https://doi.org/10.1111/eci.70091","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is associated with a prothrombotic state. We investigated whether factor VIIa-antithrombin (FVIIa-AT) complexes, a marker of tissue factor (TF) exposure, are associated with thromboembolic events in AF.</p><p><strong>Methods: </strong>In 224 nonvalvular AF patients (66% men, median age 69 years, median CHA<sub>2</sub>DS<sub>2</sub>VASc score 4), 71% on direct oral anticoagulants, we measured FVIIa-AT complexes, along with endogenous thrombin potential (ETP), von Willebrand factor (VWF) and 8-isoprostane, reflecting oxidative stress. During a median follow-up of 53 [interquartile range, IQR 47-57] months, we recorded a composite endpoint: ischemic stroke, systemic thromboembolism or cardiovascular (CV) death.</p><p><strong>Results: </strong>FVIIa-AT complexes (median 145 [IQR 125-170] pM) were higher in patients with permanent AF (p < .001), vascular disease (p = .02), previous stroke (p < .001) and smoking (p = .006) as compared with patients without these comorbidities. FVIIa-AT correlated with NT-proBNP (r = .15, p = .022) and ETP (r = .25, p < .001). During follow-up, the composite endpoint was recorded in 30 patients (13.4%, 3.0% per year) including 20 with ischemic stroke (8.9%, 2.0% per year, respectively). Patients with the composite endpoint had 29.2% higher baseline FVIIa-AT complexes compared with the remainder. Patients with FVIIa-AT complexes in the top quartile (>170 pM) had an increased risk of the composite endpoint (HR 12.0, 95% CI 5.2-28.0, p < .0001). FVIIa-AT complexes, along with VWF, remained independently associated with the composite endpoint.</p><p><strong>Conclusions: </strong>This study is the first to show that high plasma FVIIa-AT complexes are independently associated with thromboembolic events or CV death in AF, suggesting the need for more potent anticoagulation to suppress the residual TF-mediated coagulation.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70091"},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324889","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}
Gea Ciccarelli, Gianfranco Di Giuseppe, Giulia Gliozzo, Laura Soldovieri, Giuseppe Quero, Enrico Celestino Nista, Michela Brunetti, Francesca Cinti, Sara Sofia De Lucia, Bolette Hartmann, Andrea Mari, Antonio Gasbarrini, Sergio Alfieri, Alfredo Pontecorvi, Jens Juul Holst, Andrea Giaccari, Teresa Mezza
{"title":"Incretin system and glucagon secretion in patients with chronic pancreatitis.","authors":"Gea Ciccarelli, Gianfranco Di Giuseppe, Giulia Gliozzo, Laura Soldovieri, Giuseppe Quero, Enrico Celestino Nista, Michela Brunetti, Francesca Cinti, Sara Sofia De Lucia, Bolette Hartmann, Andrea Mari, Antonio Gasbarrini, Sergio Alfieri, Alfredo Pontecorvi, Jens Juul Holst, Andrea Giaccari, Teresa Mezza","doi":"10.1111/eci.70093","DOIUrl":"https://doi.org/10.1111/eci.70093","url":null,"abstract":"<p><strong>Background: </strong>Diabetes of the exocrine pancreas (DEP) is an underdiagnosed form of diabetes, prevalently caused by acute and chronic pancreatitis (CP). The contribution of incretin system dysfunction and the role of glucagon levels in the pathogenesis of DEP remain unclear. The aim of our study is to assess the secretion of glucagon like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP) and glucagon, along with the incretin effect, in individuals with and without CP. By comparing these parameters within the same glucose tolerance class, we seek to elucidate specific hormonal alterations that characterize DEP.</p><p><strong>Methods: </strong>To pursue this aim, we conducted a cross-sectional study on 32 patients with chronic pancreatitis (wCP) and 60 patients without chronic pancreatitis (w/oCP), who were administered an oral glucose tolerance test, a hyperglycemic clamp and a mixed meal test with measurement of glucose, insulin, C-peptide, GLP-1, GIP and glucagon.</p><p><strong>Results: </strong>The comparison between individuals wCP and w/oCP showed worse beta-cell function and lower incretin effect for the former, but incretin and glucagon levels were similar. Diabetes prevalence was higher in the group wCP than in the group w/oCP (56% vs. 33%). Thus, to evaluate the differences determined by CP, we found it necessary to stratify individuals according to glucose tolerance class. After stratification, we found that both groups had similar beta-cell function, incretin effect and incretin and glucagon secretion.</p><p><strong>Conclusions: </strong>Therefore, incretin and glucagon levels and the incretin effect varied according to glucose tolerance, not the presence or absence of CP. Similar defects in incretin secretion and effects are responsible for diabetes development in individuals wCP and w/oCP.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70093"},"PeriodicalIF":4.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324890","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}
Eugenia Carvalho, Reid D Landes, Matthew Cotter, Leanna M Delhey, Elisabet Børsheim, Shannon Rose
{"title":"Enhanced mitochondrial respiration in peripheral blood mononuclear cells (PBMCs) from young children with overweight/obesity and insulin resistance.","authors":"Eugenia Carvalho, Reid D Landes, Matthew Cotter, Leanna M Delhey, Elisabet Børsheim, Shannon Rose","doi":"10.1111/eci.70090","DOIUrl":"https://doi.org/10.1111/eci.70090","url":null,"abstract":"<p><strong>Background: </strong>Studies implicating dysfunctional mitochondrial respiration in metabolic tissues in the development of insulin resistance in obesity have only included adults. Peripheral blood mononuclear cells (PBMCs) and platelets have been found to reflect systemic mitochondrial fitness and bioenergetic health. We sought to identify bioenergetic differences in PBMCs and platelets from children with obesity and insulin resistance and determine associations with whole-body metabolism and/or biomarkers of metabolic health and inflammation.</p><p><strong>Methods: </strong>We stratified prepubertal children (ages 5-10 years) into three groups: normal weight insulin sensitive (N-IS; n = 20), overweight/obese insulin sensitive (O-IS; n = 28) and overweight/obese insulin resistant (O-IR; n = 17). We measured oxygen consumption rate and proton efflux rate in PBMCs and platelets. We estimated whole-body resting metabolic rate by bioimpedance and dietary fatty acid oxidation by oral deuterated palmitate and quantifying recovery of D<sub>2</sub>O in urine. We used ANOVA for comparisons among groups and Spearman correlations for associations between circulating cell bioenergetics and whole-body metabolism and biomarkers.</p><p><strong>Results: </strong>O-IS and O-IR PBMCs exhibited increased maximal mitochondrial respiration and spare respiratory capacity compared to N-IS. Bioenergetics shifted towards glycolysis in O-IS PBMCs as compared to both N-IS and O-IR PBMCs. In platelets, glycolysis and ATP production rates were decreased in O-IR compared to O-IS children. PBMC respiration positively correlated with BMIz, HOMA-IR and fasting glucose and insulin, but negatively correlated with inflammatory cytokines. Dietary fatty acid oxidation was higher in O-IS compared to N-IS children and positively correlated with PBMC spare respiratory capacity. Resting metabolic rate correlated positively with several parameters of PBMC mitochondrial respiration.</p><p><strong>Conclusions: </strong>PBMCs from young children with overweight/obesity exhibit adaptations to the metabolic stressors associated with insulin resistance, and PBMC metabolism correlates well with whole-body metabolism.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70090"},"PeriodicalIF":4.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316188","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}
Sabrina Pagano, Emmanuel Somm, François R Jornayvaz, Nicolas Vuilleumier
{"title":"Autoimmunity in MASLD: Focus on autoantibodies, anti-apolipoprotein A1 IgG and G protein-coupled receptors.","authors":"Sabrina Pagano, Emmanuel Somm, François R Jornayvaz, Nicolas Vuilleumier","doi":"10.1111/eci.70092","DOIUrl":"https://doi.org/10.1111/eci.70092","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), represents a significant public health concern, as it is closely linked to rising obesity rates and metabolic syndrome, affecting approximately 30% of the global population. In addition, MASLD, along with its more severe form, metabolic dysfunction-associated steatohepatitis (MASH), increases the risk of cardio-metabolic diseases and hepatocellular carcinoma. In recent years, multiple G-protein-coupled receptors (GPCRs) have been identified as potential therapeutic targets for these disorders. Additionally, autoimmunity is believed to potentially play a role in the development of mechanisms contributing to the pathogenesis of MASLD/MASH. This narrative review examines the diverse autoantibodies associated with the disease, with a particular emphasis on antibodies targeting apolipoprotein A-1 (AAA-1) and their relationship with anti-GPCRs antibodies.</p><p><strong>Results: </strong>Several autoantibodies have been identified in up to 30% of individuals with MASLD/MASH, both with and without concomitant autoimmune diseases. Among the anti-GPCR autoantibodies identified in MASLD to date are those targeting the angiotensin II type 1 receptor and the endothelin-1 type A receptor. While the contribution of this class of autoantibodies to MASLD/NASH remains unclear, AAA-1 appears to be pathogenic, acting as pro-steatotic and pro-inflammatory mediators. Additionally, current data suggest shared functional responses between anti-GPCR antibodies and AAA1 in cell-based assays used to detect anti-GPCR presence.</p><p><strong>Conclusion: </strong>A better understanding of the role of humoral autoimmunity and the interactions among its various components in the metabolic dysfunction underlying MASLD/MASH has the potential to open new perspectives for early detection and therapeutic interventions.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70092"},"PeriodicalIF":4.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301343","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}
Rubén Fuentes Artiles, Caroline E Gebhard, Catherine Gebhard
{"title":"Integrating gender medicine into modern healthcare: Progress and barriers.","authors":"Rubén Fuentes Artiles, Caroline E Gebhard, Catherine Gebhard","doi":"10.1111/eci.70089","DOIUrl":"https://doi.org/10.1111/eci.70089","url":null,"abstract":"<p><strong>Background: </strong>Sex and gender are fundamental determinants of health, influencing disease risk, diagnosis, treatment, and outcomes across medical disciplines. While sex refers to biological characteristics, gender encompasses sociocultural dimensions, including behaviours and identities.</p><p><strong>Results: </strong>The field of gender medicine has evolved significantly from its roots in the women's health movement of the 1960s and 1970s, which initially sought to address reproductive rights and the systematic exclusion of women from clinical research. Over time, the focus has expanded to recognize sex- and gender-based differences in all populations, including men and gender-diverse individuals. Despite progress, persistent challenges remain. Many clinical guidelines inadequately incorporate sex and gender considerations, and women continue to be underrepresented in clinical trials, resulting in suboptimal efficacy and a higher incidence of adverse effects in women. Recent initiatives, including government-funded research programs, specialized gender medicine professorships and regulatory measures promoting equitable clinical trial participation, represent positive steps forward. However, a systematic, interdisciplinary approach is required to fully integrate gender-sensitive medicine into research, education and clinical practice. This narrative review explores the historical development of gender medicine, current advancements and remaining challenges. We highlight the need for improved research methodologies, policy changes and targeted interventions to ensure equitable healthcare. A structured action plan emphasizing regulatory support, education, industry involvement and public awareness is essential to accelerate the field's integration.</p><p><strong>Conclusion: </strong>Recognising and addressing sex- and gender-sensitive health differences will lead to more personalised and effective medical care, ultimately improving health outcomes for all individuals.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70089"},"PeriodicalIF":4.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274539","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}
Graziella D'Arrigo, Mercedes Gori, Carmela Marino, Patrizia Pizzini, Graziella Caridi, Francesco Marino, Giovanna Parlongo, Annalisa Pitino, Giovanni S F Bruno, Giovanni Tripepi, Francesca Mallamaci, Carmine Zoccali
{"title":"A cross-lagged analysis of the relationship between quality of life and kidney function in CKD patients.","authors":"Graziella D'Arrigo, Mercedes Gori, Carmela Marino, Patrizia Pizzini, Graziella Caridi, Francesco Marino, Giovanna Parlongo, Annalisa Pitino, Giovanni S F Bruno, Giovanni Tripepi, Francesca Mallamaci, Carmine Zoccali","doi":"10.1111/eci.70087","DOIUrl":"https://doi.org/10.1111/eci.70087","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) significantly impacts patient well-being, with declining glomerular filtration rate (eGFR) often leading to worsening quality of life (QoL). However, the directionality of the eGFR-QoL relationship remains unclear due to limitations of prior cross-sectional and longitudinal studies.</p><p><strong>Methods: </strong>This study applied cross-lagged analysis to investigate the reciprocal relationship between eGFR and QoL (measured using SF-36 Physical and Mental Component Scores [PCS and MCS]) over 36 months in 422 CKD patients recruited from nephrology units in Southern Italy. Generalized Method of Moments (GMM) models tested two hypotheses: (1) PCS as a determinant of MCS, or vice versa; and (2) eGFR as a determinant of MCS/PCS, or vice versa.</p><p><strong>Results: </strong>Cross-lagged analysis confirmed that lower eGFR significantly predicted declines in both PCS and MCS in subsequent visits (p < .05). At the same time, the reverse relationship (QoL affecting eGFR) was not statistically significant. Multivariable models, adjusting for potential confounders including demographic factors, comorbidities, and socioeconomic status, confirmed these findings.</p><p><strong>Conclusion: </strong>Kidney function decline leads to worsening QoL, whereas deterioration in QoL does not impact eGFR decline. These findings support prioritising interventions that slow the progression of CKD as a means to preserve quality of life. This study highlights the utility of cross-lagged analysis in nephrology research and underscores the importance of early chronic kidney disease (CKD) management to maintain patient well-being.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70087"},"PeriodicalIF":4.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247139","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}
Wee Siong Teo, Manlin Zhao, Tommaso Bucci, Steven Ho Man Lam, Hongyu Liu, Yang Chen, Giuseppe Boriani, Hung-Fat Tse, Tze-Fan Chao, Gregory Y H Lip
{"title":"Clinical associations and prognosis in Asian and European patients with symptom-controlled atrial fibrillation: Insights from two prospective registries in Europe and Asia.","authors":"Wee Siong Teo, Manlin Zhao, Tommaso Bucci, Steven Ho Man Lam, Hongyu Liu, Yang Chen, Giuseppe Boriani, Hung-Fat Tse, Tze-Fan Chao, Gregory Y H Lip","doi":"10.1111/eci.70086","DOIUrl":"https://doi.org/10.1111/eci.70086","url":null,"abstract":"<p><strong>Background: </strong>Clinical associations and prognosis of patients with symptom-controlled AF (scAF) remain poorly understood.</p><p><strong>Methods: </strong>We analysed data from the Asian-Pacific Heart Rhythm Society and EURObservational Research Programme registries. Based on the European Heart Rhythm Association (EHRA) score, patients were classified as scAF (EHRA I or II) or symptomatic AF (EHRA III or IV). Clinical characteristics were examined by logistic regression, and prognosis was assessed by Cox models. The primary outcome was composed of all-cause death and major cardiovascular events. Interaction analyses were performed to investigate ethnic differences.</p><p><strong>Results: </strong>Among 13,577 AF patients (mean age 69.0 ± 11.6 years; 38.7% female), 11,470 (84.5%) had scAF. Asians were more likely to be scAF, characterised by younger age and lower cardiovascular burden compared to Europeans. Diabetes mellitus was significantly associated with scAF only in Asians (adjusted odd ratio [aOR] 1.43, 95% confidence interval [CI] 1.03-2.04, p<sub>interaction</sub> = 0.021). The associations with hypertension (aOR 1.29, 95% CI 0.98-1.70, p<sub>interaction</sub> = 0.004) and prior ischemic stroke (aOR 1.75, 95% CI 0.96-3.58, p<sub>interaction</sub> = 0.045) were more evident in Asians. Patients with scAF showed a notable association with increased likelihood of using vitamin K antagonists (aOR 1.19, 95% CI 1.07-1.33), which was more prominent in Asians. In both Asians and Europeans, scAF was associated with reduced rhythm control management. Compared to non-scAF, European patients with scAF had a reduced risk of the composite outcome, but the association was non-significant in Asians (p<sub>interaction</sub> = 0.594).</p><p><strong>Conclusion: </strong>Asians and Europeans with scAF demonstrate clinically relevant differences in terms of overall prevalence, related risk factors, and clinical management.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70086"},"PeriodicalIF":4.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247140","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}
Amir Askarinejad, Deirdre A Lane, Parham Sadeghipour, Majid Haghjoo, Gregory Y H Lip
{"title":"Stroke prevention in atrial fibrillation: A narrative review of current evidence and emerging strategies.","authors":"Amir Askarinejad, Deirdre A Lane, Parham Sadeghipour, Majid Haghjoo, Gregory Y H Lip","doi":"10.1111/eci.70082","DOIUrl":"https://doi.org/10.1111/eci.70082","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with a significantly increased risk of mortality and morbidity from stroke, thromboembolism and dementia. Recent advances in stroke prevention strategies necessitate an updated approach to management.</p><p><strong>Results: </strong>Published evidence shows that the Atrial Fibrillation Better Care (ABC) pathway significantly improves stroke prevention outcomes in AF patients, reducing mortality, stroke incidence and bleeding events. Characterisation of AF using the 4S-AF framework helped guide personalised treatment selection and was associated with improved clinical outcomes. For patients unsuitable for anticoagulation, left atrial appendage occlusion has been identified as a viable alternative. Digital health technologies demonstrate increasing utility in early AF detection to enable timely stroke prevention interventions. There is evidence for the dynamic nature of stroke (and bleeding) risk, as well as arrhythmia burden and AF progression over time, in addition to changes in ABC pathway adherence.</p><p><strong>Conclusions: </strong>Effective stroke prevention in AF requires a comprehensive holistic approach incorporating appropriate risk stratification, guideline-adherent anticoagulation and management of underlying cardiovascular conditions and other comorbidities. The ABC pathway, supported by characterisation using the 4S-AF framework, provides a structured approach to optimise outcomes. Regular reassessment of risk, along with careful selection of anticoagulation strategies, remains crucial. Integration of digital health technologies and structured care pathways shows promise in improving patient outcomes.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70082"},"PeriodicalIF":4.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247146","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}
José Ignacio Martínez-Montoro, Raquel Sancho-Marín, Luis Ocaña-Wilhelmi, Isabel Arranz-Salas, Nerea Ruiz-Campos, María José García-López, Francisco J Tinahones, Carolina Gutiérrez-Repiso
{"title":"Gastric microbiota-specific signatures in adults with obesity and Helicobacter pylori-negative gastritis.","authors":"José Ignacio Martínez-Montoro, Raquel Sancho-Marín, Luis Ocaña-Wilhelmi, Isabel Arranz-Salas, Nerea Ruiz-Campos, María José García-López, Francisco J Tinahones, Carolina Gutiérrez-Repiso","doi":"10.1111/eci.70085","DOIUrl":"https://doi.org/10.1111/eci.70085","url":null,"abstract":"<p><strong>Background: </strong>The role of the gastric microbiome in the pathophysiology of gastritis beyond Helicobacter pylori (HP) infection is poorly understood and has remained unexplored in patients with obesity. The aim of this study was to analyse gastric mucosa-associated microbiota in patients with obesity and nonatrophic chronic gastritis in the absence of HP infection or history of HP eradication.</p><p><strong>Methods: </strong>This was a case-control study conducted at Virgen de la Victoria University Hospital in Malaga, performed in patients with severe obesity (body mass index ≥40 kg/m<sup>2</sup>) undergoing sleeve gastrectomy, without HP infection and no history of HP eradication. Gastric biopsy specimens were collected at surgery and were analysed by 16S rRNA sequencing. Participants were divided into two groups according to the histological evaluation: nonatrophic chronic gastritis and nongastritis. An exploratory prospective analysis to determine the influence of gastritis on short-term outcomes after surgery was also performed.</p><p><strong>Results: </strong>Sixty-seven participants (38 in the gastritis and 29 in the nongastritis group) were included. A lower alpha diversity (evenness and Shannon diversity indexes) and beta diversity (weighted Unifrac distance) were shown in the gastritis group. Higher relative abundances in the families Micrococcaceae, Streptococcaceae and Leuconostocaceae and the genera Streptococcus, Weissella and Cryptobacterium were observed in the gastritis group, compared with the nongastritis group. An enrichment in pathways involved in toluene degradation, heterolactic fermentation and secondary metabolites biosynthesis, such as ergothioneine and terpenoids, was found in the gastritis group. Also, higher total cholesterol levels 1 year after the surgery were observed in the gastritis group compared with the nongastritis group, although no within-group differences from baseline to 1 year were detected in this parameter.</p><p><strong>Conclusion: </strong>Our results suggest a relationship between the gastric microbiome and nonatrophic chronic gastritis in obesity, beyond HP infection.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70085"},"PeriodicalIF":4.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247141","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":"Prostate cancer screening: Clinical trial rather than evidence-based medical practice.","authors":"Takeshi Takahashi","doi":"10.1111/eci.70088","DOIUrl":"https://doi.org/10.1111/eci.70088","url":null,"abstract":"","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70088"},"PeriodicalIF":4.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224833","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}