Alimentary Pharmacology & Therapeutics最新文献

{"title":"Steatotic Liver Disease Prevalence in China: A Population-Based Study and Meta-Analysis of 17.4 Million Individuals.","authors":"Zhenqiu Liu, Jiayi Huang, Luojia Dai, Huangbo Yuan, Yanfeng Jiang, Chen Suo, Li Jin, Tiejun Zhang, Xingdong Chen","doi":"10.1111/apt.70051","DOIUrl":"https://doi.org/10.1111/apt.70051","url":null,"abstract":"<p><strong>Background: </strong>Steatotic liver disease (SLD), including metabolic dysfunction-associated SLD (MASLD), has emerged as a leading cause of chronic liver disease in China.</p><p><strong>Aims: </strong>We aimed to provide a comprehensive and updated description of SLD prevalence in China.</p><p><strong>Methods: </strong>We described the prevalence, subgroup distribution, and clinical characteristics of SLD in the Taizhou Study of Liver Diseases (T-SOLID). Additionally, we searched for studies reporting SLD prevalence in five databases. Eligible data were analysed using a generalised linear mixed model. Linear regression was applied to estimate the annual average percentage change (AAPC).</p><p><strong>Results: </strong>Of the 28,623 participants in T-SOLID, 30.8% were diagnosed with SLD, among which 83.8% were classified as MASLD. Prevalence of SLD increased from 22.1% in 2018 to 36.7% in 2021. The meta-analysis included 792 publications and 17,404,296 subjects. Nationwide, the pooled SLD prevalence rose from 23.8% (95% CI 21.9%-25.9%) during 2001-2010 to 27.9% (26.0%-29.8%) during 2016-2023 in the general population (AAPC = 2.56, p < 0.0001), equating to approximately 402.0 million cases. An increase in SLD prevalence was observed in subpopulations by region, sex, and age, and in high-risk groups. Northeast China had the highest prevalence (35.0%). Males had a higher prevalence rate than females (35.0% vs. 20.6%). SLD prevalence increased with age, ranging from 8.1% in children and adolescents to 31.8% in the elderly. Meta-regression identified calendar period, age, sex, geographical area, and residence area as significant determinants of SLD prevalence.</p><p><strong>Conclusion: </strong>The ubiquitously rising prevalence of SLD in Chinese populations underscores the urgent need for targeted public health interventions.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Characteristics and Survival Outcomes of Patients With Cirrhosis According to Underlying Liver Aetiology.","authors":"Yu Shi, Nicholas Chien, Ashley Fong, Vy H Nguyen, Surya Teja Gudapati, Angela Chau, Sally Tran, Linda Henry, Ramsey Cheung, Changqing Zhao, Minjuan Jin, Mindie H Nguyen","doi":"10.1111/apt.70059","DOIUrl":"https://doi.org/10.1111/apt.70059","url":null,"abstract":"<p><strong>Background and aims: </strong>Updated data on the survival of patients with cirrhosis are limited, especially for subgroups by specific liver disease aetiology. To inform practice, future modelling studies, and public health planning, our study aimed to provide updated and granular data on survival outcomes of patients with cirrhosis stratified by liver disease aetiology. We also assessed their changes over time.</p><p><strong>Methods: </strong>We analysed 8726 consecutive adult patients with cirrhosis who presented at Stanford university medical center during 1/2005-1/2022.</p><p><strong>Results: </strong>8726 Patients had the following etiologies: hepatitis C virus (HCV) (28.1%), hepatitis B virus (HBV) (4.8%), alcohol-associated (ALD, 33.3%), metabolic-associated steatotic liver disease (MASLD) (9.5%), autoimmune (9.6%), cryptogenic (8.2%) and other etiologies (6.5%). Patients with cryptogenic cirrhosis had the lowest overall 5-, 10-, and 15-year cumulative survival (57.5%, 34.3% and 21.4%), as well as for liver and nonliver-related death, followed by ALD, MASLD, HCV, and autoimmune, while HBV patients had the best survival (86.0%, 70.1% and 65.1%), respectively. On multivariable Cox regression, cryptogenic cirrhosis (vs. HBV) was associated with the highest risk of all-cause death (aHR: 2.24, 95% CI 1.67-3.00), followed by MASLD and ALD (all p < 0.001). Post-2010 time was associated with a 33% lower risk of all-cause death (p = 0.0011); While in the post-2010 period, MASLD (vs. HBV) was associated with the highest risk of all-cause death (aHR: 1.92, 95% CI 1.32-2.80, p < 0.001) followed by cryptogenic and ALD.</p><p><strong>Conclusions: </strong>Survival outcomes in patients with cirrhosis varied by aetiology and have changed over time, which should be taken into account for future practice guidelines and modelling studies.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Health Disorders in a Coeliac Disease Population After Diagnosis-A Nationwide Cohort Analysis.","authors":"Rama Nanah, Claire Jansson-Knodell, Arjun Chatterjee, Robana Nanah, M Housam Nanah, Jehad Almasri, Andrew Ford, Osama Hamid, Ahmed Telbany, Alberto Rubio-Tapia","doi":"10.1111/apt.70053","DOIUrl":"https://doi.org/10.1111/apt.70053","url":null,"abstract":"<p><strong>Background: </strong>There is a female predominance of diagnosed coeliac disease with sex-related differences in clinical presentation. Delayed menarche, infertility and pregnancy complications have been linked to poor nutritional status and autoimmune mechanisms, but women's health data in coeliac disease are scant and contradictory.</p><p><strong>Aim: </strong>To describe rates of women's health disorders in US patients with coeliac disease.</p><p><strong>Methods: </strong>We used TriNetX, a database of 80 healthcare organisations, for a retrospective observational analysis. Coeliac disease was identified using ICD-10 code (K90.0) and positive coeliac serology. Women aged 10-60 years with coeliac disease were compared to ambulatory women without a diagnosis of coeliac disease or positive coeliac serology. We divided women into age groups matched by propensity score.</p><p><strong>Results: </strong>We identified > 25,000,000 outpatient women without coeliac disease, and 9368 with coeliac disease. Patients with coeliac disease were younger (mean 25 vs. 28.5 years) and had lower mean BMI (24.6 vs. 26.1). Women with coeliac disease had higher odds of later women's health conditions including absent/rare menstruation (4.6% vs. 2.0%; OR 2.34), infertility (1.4% vs. 0.9%; OR 1.69), polycystic ovarian syndrome (3.3% vs. 1.0%; OR 3.2), menopausal disorders (4.3% vs. 1.56%; OR 285) and primary ovarian failure (0.96% vs. 0.16%; OR 6.25).</p><p><strong>Conclusions: </strong>Women with coeliac disease have higher frequencies of subsequent women's health disorders related to ovarian function, menstruation, fertility and menopause. Clinicians should be aware of these associations to detect women's health disorders during longitudinal coeliac care and promptly refer for a multidisciplinary approach with obstetrics and gynaecology.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicentre Study of 10,369 Symptomatic Patients Comparing the Diagnostic Accuracy of Colon Capsule Endoscopy, Colonoscopy and CT Colonography.","authors":"James Turvill, Monica Haritakis, Scott Pygall, Emily Bryant, Harriet Cox, Greg Forshaw, Crispin Musicha, Victoria Allgar, Robert Logan, Mark McAlindon","doi":"10.1111/apt.70046","DOIUrl":"https://doi.org/10.1111/apt.70046","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, NHS England introduced colon capsule endoscopy (CCE) at scale to support the recovery of endoscopy. Symptomatic patients referred with suspected colorectal cancer (CRC) and a faecal immunochemical test (FIT) ≤ 100 μg Hb/g faeces were offered CCE.</p><p><strong>Aims: </strong>To evaluate the safety, diagnostic accuracy and utility of CCE in this setting.</p><p><strong>Methods: </strong>Consenting patients, referred on a suspected CRC pathway with FIT ≤ 100 μg Hb/g faeces, were offered CCE, colonoscopy or CT colonography. Each cohort was to be age-, sex-, symptom- and FIT-matched. We performed a paired comparison of findings in those who required colorectal endoscopy after CCE and recorded clinical outcomes.</p><p><strong>Results: </strong>We recruited 4878 patients for CCE, 5025 for colonoscopy and 466 for CT colonography patients. CCE was safely tolerated by 98.4% of patients. CCE identified a matched mass lesion in all patients with CRC when the examination was complete and adequately prepared. More polyps ≥ 10 mm and 6-9 mm were detected by CCE than by colonoscopy or CT colonography. Per-patient sensitivities for polyps ≥ 10 mm and 6-9 mm were 97% in those with a paired, complete and adequately prepared CCE than colonoscopy. Completion (74%) and bowel preparation adequacy rates (74%) were poorer than those of colonoscopy and CTC (both 88%). However, CCE usefully performed a filter function in 86% of patients.</p><p><strong>Conclusions: </strong>CCE is safe and accurate for the diagnosis of colorectal disease. In the suspected CRC pathway, its 'filter function' complements existing colorectal diagnostic services by creating additional capacity.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Surveillance Colonoscopy for Detection of Neoplasia in Inflammatory Bowel Disease—Is Dye-Based Chromoendoscopy Always the Final Answer?","authors":"Andrea Cassinotti, Lorenzo Canova","doi":"10.1111/apt.70027","DOIUrl":"https://doi.org/10.1111/apt.70027","url":null,"abstract":"&lt;p&gt;Surveillance colonoscopy has been recommended in patients with inflammatory bowel disease (IBD) for over 20 years to manage their risk of colorectal neoplasia. However, many aspects of a high-quality examination are still debated [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;\u0000&lt;p&gt;Advances in endoscopic technology and evolving clinical paradigms, including updated nomenclature for serrated lesions and more accurate diagnostic criteria for lesion characterisation, have challenged our technical approach to endoscopic surveillance in IBD [&lt;span&gt;2&lt;/span&gt;]. Consequently, purely statistical comparisons between different surveillance strategies may be methodologically weak when they involve technologies and protocols that are too heterogeneous due to the numerous variables influencing their application.&lt;/p&gt;\u0000&lt;p&gt;Shehab et al. presented a network meta-analysis (NMA) including 22 randomised controlled trials and three prospective cohort studies covering nine different technologies used for neoplasia detection in IBD [&lt;span&gt;3&lt;/span&gt;]. They concluded that dye-based chromoendoscopy (DCE), especially with high-definition (HD), HD-white light endoscopy with segmental reinspection (HD-WLE-SR) and chromoendoscopy-guided endomicroscopy (CEM) outperformed other methods, including virtual chromoendoscopy (VCE), which includes Narrow Band Imaging (NBI), Fuji Intelligent Colour Enhancement (FICE) and i-SCAN, with similar results between HD-WLE-SR and DCE.&lt;/p&gt;\u0000&lt;p&gt;The finding in favour of HD-WLE with SR is interesting because it would provide an alternative to DCE that would simplify surveillance. However, this result stems from the inclusion of just one study [&lt;span&gt;4&lt;/span&gt;]. Equally interesting is the good performance of CEM, although supported by older proof-of-concept studies that used endoscope-based confocal laser endomicroscopy (eCLE) currently no longer commercially available [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;\u0000&lt;p&gt;What is the clinical message? Does DCE remain the only appropriate, yet unloved, surveillance tool? Should we ultimately abandon the hope of using VCE, a tool both easy to activate and widely available in many endoscopy units, despite evidence from some head-to-head studies demonstrating its non-inferiority to DCE? Notably, NBI appeared inferior to DCE based on studies limited by the use of non-magnified instruments and by diagnostic criteria that later proved to be inaccurate (i.e. Kudo's) in IBD. Conversely, FICE was not inferior to DCE, noting that the only included study stressed the need to use specific diagnostic criteria to better enhance the accuracy of this technology [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;\u0000&lt;p&gt;Could the recurrent supremacy of DCE in many NMAs be attributed to operational factors that a purely statistical approach fails to capture? In this regard, Toruner et al. analysed technical and clinical aspects influencing the quality of surveillance colonoscopy: among all, the “time factor” dominated (i.e. the attention devoted), not only in chronometric terms [&lt;span&gt;6&lt;/span&gt;]. That same “ti","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"27 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Surveillance Colonoscopy for Detection of Neoplasia in Inflammatory Bowel Disease—Is Dye-Based Chromoendoscopy Always the Final Answer? Authors' Reply","authors":"Mohammad Shehab, Ahmed Al-Hindawi, Talat Bessissow","doi":"10.1111/apt.70057","DOIUrl":"https://doi.org/10.1111/apt.70057","url":null,"abstract":"&lt;p&gt;We appreciate the thoughtful editorial by Drs. Cassinotti and Canova [&lt;span&gt;1&lt;/span&gt;], which raised pertinent questions about the landscape of endoscopic surveillance in inflammatory bowel disease (IBD).&lt;/p&gt;\u0000&lt;p&gt;Our network meta-analysis reviewed published data on IBD dysplasia detection technologies [&lt;span&gt;2&lt;/span&gt;]. We acknowledge that significant heterogeneity exists. Our paper highlighted variability in protocols, nomenclature and patient populations, amongst others; this is the best that can be done with the available data. It reflected the inherent challenges in standardising large-scale surveillance studies in an evolving field. Notwithstanding the aforementioned limitations, the data deemed dye-based chromoendoscopy (DCE) superior.&lt;/p&gt;\u0000&lt;p&gt;While attractive for its ease of use, available data on virtual chromoendoscopy (VCE), particularly magnified narrow-band imaging, are limited. Until further evidence clarifies VCE's performance relative to DCE, we view it as a reasonable alternative in the absence of DCE expertise. Regarding confocal endomicroscopy, we agree that its utility is limited by a lack of commercialisation.&lt;/p&gt;\u0000&lt;p&gt;DCE's advantage is in revealing subtle, previously unmasked mucosal abnormalities [&lt;span&gt;3, 4&lt;/span&gt;]. The editorial raises an interesting point regarding the ‘time factor’ or ‘devoted attention’ potentially contributing to DCE's effectiveness. The study by Toruner et al. investigated white light endoscopy (WLE) and suggested that longer procedural times may improve colonic representativeness through more evenly spaced random biopsies [&lt;span&gt;5&lt;/span&gt;]. However, this pertains to flat dysplasia, an endoscopically invisible subtype detected primarily by random biopsies rather than active mucosal inspection. Thus, the increased time probably reflects stricter protocol adherence rather than a deliberate search for abnormalities.&lt;/p&gt;\u0000&lt;p&gt;Indeed, initial results of high-definition WLE with segmental re-inspection (HDWLE-SR) are drawn from one promising study [&lt;span&gt;6&lt;/span&gt;]. If proven to be a successful alternative to DCE, it could simplify workflows and encourage wider adoption, considering endoscopists' familiarity with HD-WLE. Segmental re-inspection may exemplify the ‘attention’ that enhances detection. HDWLE-SR's success may also stem from being conducted primarily at expert centres with highly experienced IBD endoscopists, increasing the likelihood of identifying missed regions upon re-inspection. Nonetheless, replication and validation are necessary before reaching strong conclusions.&lt;/p&gt;\u0000&lt;p&gt;Given WLE's limitations in detecting flat lesions, current guidelines recommend random four quadrant and targeted biopsies [&lt;span&gt;7&lt;/span&gt;]. Yet, DCE and VCE comparators often employ targeted-only approaches. Perhaps the real clinical utility of DCE or VCE lies in reducing the biopsy burden for patients, endoscopists and pathologists while maintaining diagnostic performance. The value of non-targeted biopsies has been questione","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"3 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Association of Antibiotic Exposure With Microscopic Colitis—Authors' Reply","authors":"Máté Szilcz, Jonas W. Wastesson, David Bergman, Kristina Johnell, Jonas F. Ludvigsson","doi":"10.1111/apt.70056","DOIUrl":"https://doi.org/10.1111/apt.70056","url":null,"abstract":"&lt;p&gt;We thank Drs. Tome and Pardi for their editorial on our study examining the association between antibiotic exposure and microscopic colitis (MC) [&lt;span&gt;1&lt;/span&gt;]. We appreciate their careful literature review and insightful discussion regarding potential confounding factors that may influence the observed relationship between drug exposures and MC.&lt;/p&gt;\u0000&lt;p&gt;As the editorial highlighted, studies investigating medications associated with MC have consistently encountered challenges in disentangling causation from confounding. We aimed to address this through a self-controlled design [&lt;span&gt;2&lt;/span&gt;], in which cases acted as their own controls, thereby mitigating important confounders, such as genetic predisposition, that are difficult to account for in traditional cohort studies [&lt;span&gt;3&lt;/span&gt;]. In studies where external controls are necessary, matching by clinical characteristics and healthcare engagement patterns can further reduce confounding, thereby strengthening causal inference. However, we acknowledge that detection bias remains a consideration. Patients experiencing gastrointestinal symptoms on certain medications (e.g., antibiotics) may be more likely to undergo endoscopic evaluation, thereby increasing MC detection.&lt;/p&gt;\u0000&lt;p&gt;Medication exposures often occur in combination, particularly in older adults. These combinations (e.g., antibiotics combined with non-steroidal anti-inflammatory drugs or proton pump inhibitors) may amplify gastrointestinal side effects. The interplay of multiple drugs further complicates the challenge of establishing a direct causal link between any single medication and MC. Future research should investigate the impact of polypharmacy on MC incidence and severity, ideally through prospective, longitudinal studies with a rigorous selection of control groups.&lt;/p&gt;\u0000&lt;p&gt;Looking ahead, comprehensive studies are needed to understand how various drugs alter the intestinal environment, contributing to MC development. One potential option is investigating the gut microbiome's role and how antibiotic-induced dysbiosis may prime the colonic mucosa for an aberrant immune response. Incorporating stool metagenomics, mucosal immunologic markers, and detailed pharmacokinetic/pharmacodynamic data into prospective studies could provide crucial insights into the pathophysiology of MC. Such investigations may pave the way for precision medicine approaches, enabling targeted interventions based on microbiome profiles, immune pathways, or genetic predispositions to prevent or mitigate MC in high-risk individuals [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;\u0000&lt;p&gt;Large-scale data analyses using real-world evidence and electronic health record-based pharmacoepidemiologic studies could help to identify at-risk subgroups effectively. This might include older adults with multiple comorbidities, individuals with specific genetic or immune backgrounds, or patients requiring complex drug regimens. By leveraging big data analytics, future research could move beyond broad a","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"14 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Lipidomics in MASLD and MetALD—Authors' Reply","authors":"Kai Markus Schneider, Carolin V. Schneider","doi":"10.1111/apt.70058","DOIUrl":"https://doi.org/10.1111/apt.70058","url":null,"abstract":"&lt;p&gt;We appreciate the insightful editorial [&lt;span&gt;1&lt;/span&gt;] highlighting the significance of our lipidomic findings for detecting higher alcohol consumption in steatotic liver disease (SLD) [&lt;span&gt;2&lt;/span&gt;]. When looking at SLD on a population level, one key challenge is that MetALD remains so rare that it is likely underreported [&lt;span&gt;3&lt;/span&gt;]. This raises concerns about misclassification, particularly in cohorts relying on self-reported alcohol intake [&lt;span&gt;4&lt;/span&gt;]. Biomarkers such as carbohydrate-deficient transferrin (CDT) in serum or ethylglucuronid (ETG) may serve as objective measures of alcohol intake and could be particularly useful in individuals with advanced SLD [&lt;span&gt;5&lt;/span&gt;], where accurate assessment of alcohol exposure is crucial for prognosis and management. While previous studies have demonstrated the utility of CDT in detecting chronic alcohol consumption, its role in distinguishing moderate drinkers from those with excessive intake in the setting of SLD remains uncertain [&lt;span&gt;6&lt;/span&gt;].&lt;/p&gt;\u0000&lt;p&gt;HDL might be a starting point to differentiate MASLD from MetALD but, while lipidomics has provided key discriminatory markers, the next logical step is integrating proteomics to refine the distinction between these subtypes further. Beyond biochemical markers, the interaction between alcohol intake in SLD and emerging pharmacological interventions remains an area of critical importance. With the advent of novel therapies for MASLD/MASH, including Resmetirom [&lt;span&gt;7&lt;/span&gt;], GLP-1 receptor agonists [&lt;span&gt;8&lt;/span&gt;] and agents targeting relevant metabolic pathways, for example, FGF21 [&lt;span&gt;9&lt;/span&gt;], their potential interaction with alcohol metabolism warrants further scrutiny. Additionally, the interplay between lifestyle factors, genetic risk variants and alcohol consumption remains poorly understood. Given that alcohol intake is highly variable across populations, differs over time and is influenced by socioeconomic, cultural and behavioural factors, future studies should aim to integrate multiomic data, including lipidomics, proteomics and metabolomics, to dissect these complex interactions.&lt;/p&gt;\u0000&lt;p&gt;Moving forward, a comprehensive approach combining lipidomics, proteomics and metabolomics will be essential to uncover non-linear relationships that may remain hidden when analysing a single omics layer. We propose developing a multi-omics-based score to differentiate MASLD and MetALD more effectively, ultimately aiding in personalised risk assessment and therapeutic decisions.&lt;/p&gt;\u0000&lt;p&gt;Lastly, lipidomic differences between MASLD and MetALD further validate the new nomenclature's attempt to differentiate subgroups within SLD [&lt;span&gt;10&lt;/span&gt;]. The distinct lipid profiles observed in MetALD—particularly the elevation of HDL-centric lipidomic markers and ketone body metabolites—suggest that these two entities are biologically distinct rather than merely reflecting a continuum of alcohol exposure. This supports the concept that the cl","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"4 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Early Ileal Resection in Crohn's Disease Is Not Associated With Severe Long-Term Outcomes: The ERIC Study: Authors' Reply","authors":"Nathan Grellier, Julien Kirchgesner, Philippe Seksik","doi":"10.1111/apt.70052","DOIUrl":"https://doi.org/10.1111/apt.70052","url":null,"abstract":"&lt;p&gt;We thank Drs. Kelm and Flemming for their insightful letter [&lt;span&gt;1&lt;/span&gt;] regarding our article [&lt;span&gt;2&lt;/span&gt;]. We appreciate their remarks and would like to address their questions.&lt;/p&gt;\u0000&lt;p&gt;First, we would like to clarify a crucial point regarding our findings in relation to the primary outcome. Contrary to what Drs. Kelm and Flemming suggested, we found no statistically significant difference between the early resection group (&lt; 6 months) and the other groups (6 months–2 years and 2–5 years) for the risk of a second ileocecal resection. However, patients who underwent early ileocecal resection required fewer post-operative treatments and demonstrated less morphological recurrence, supporting early resection as an effective treatment to maintain remission.&lt;/p&gt;\u0000&lt;p&gt;Second, accumulating evidence supports early ileocecal resection as a valuable approach for maintaining long-term remission in Crohn's disease isolated to the terminal ileum [&lt;span&gt;3&lt;/span&gt;]. The challenge lies in identifying a safe approach that minimises recurrence risk while potentially reducing the need for subsequent immunosuppressive therapies. However, the key issue remains the stratification of recurrence risk and the selection of optimal surgical candidates.&lt;/p&gt;\u0000&lt;p&gt;The two centres involved in our study conduct weekly multidisciplinary IBD board meetings. Decisions regarding surgery for patients with IBD were always preceded by these discussions. Addressing the question regarding decision-making criteria for surgery versus advanced therapy is challenging in a retrospective setting. However, considering surgical indications, 95% of patients in the early resection group had complicated disease, compared to 82% in the late resection group. This suggests that patients who had early resection underwent surgery primarily out of necessity due to abscess or obstruction. These surgeries took place before the LIRIC trial, which later established laparoscopic ileocecal resection as a viable option for uncomplicated localised ileal Crohn's disease. In addition, the use of advanced therapies for complicated diseases was less standardised in the study period than it is today [&lt;span&gt;4, 5&lt;/span&gt;].&lt;/p&gt;\u0000&lt;p&gt;As pointed out, we did not report perioperative morbidity or the potential impact of surgery on quality of life and post-operative digestive symptoms. These limitations are due to the retrospective nature of our study. Data in the immediate post-operative period were not collected comprehensively, and quality of life was not assessed systematically, particularly for patients who underwent surgery in the early 2000s. We acknowledge that surgery should only be considered when it is safe and associated with minimal adverse outcomes [&lt;span&gt;6&lt;/span&gt;]. The main challenge for future studies will be to identify predictors of optimal quality of life after ileocecal resection, and the timing of surgery may be an important factor to consider. It remains to be addressed which patients will benefi","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"35 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis: Inverse Association Between Helicobacter pylori Infection and Eosinophilic Oesophagitis","authors":"Irene Spinelli, Serena Porcari, Chiara Esposito, William Fusco, Francesca Romana Ponziani, Cristiano Caruso, Edoardo Vincenzo Savarino, Antonio Gasbarrini, Giovanni Cammarota, Marcello Maida, Antonio Facciorusso, Gianluca Ianiro","doi":"10.1111/apt.70042","DOIUrl":"https://doi.org/10.1111/apt.70042","url":null,"abstract":"Exposure to <i>Helicobacter pylori</i> (<i>H. pylori</i>) has been associated with a decreased risk of eosinophilic oesophagitis (EoE).","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"25 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}