Alimentary Pharmacology & Therapeutics最新文献

{"title":"Afamin and Apolipoprotein F Associated With Liver Steatosis From People Living With HIV: A Discovery Study","authors":"Mario Frías, Eduardo Chicano-Gálvez, Antonio Rivero-Juárez, Ana Gordon, Diana Corona-Mata, José María Moyano, Ángela Peralbo-Molina, Ángela Camacho, Ignacio Pérez-Valero, María del Mar Malagón, Antonio Rivero","doi":"10.1111/apt.70119","DOIUrl":"https://doi.org/10.1111/apt.70119","url":null,"abstract":"Liver steatosis (LS) is a condition that is characterised by hepatic fat accumulation unrelated to significant alcohol consumption. This study explored the serum proteomic profile associated with LS in people living with HIV (PLWH).","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"72 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737073","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: Enhancing the Diagnostic Performance of the Oral Cholate Challenge Test: Implications for Avoidance of Potentially Unnecessary Endoscopy","authors":"Tarek Hassanein, Andrew P. Keaveny, Parvez Mantry, Mitchell Shiffman, Michael Leise, Kamran Qureshi, Alastair D. Smith, Michael P. McRae, Joanne C. Imperial, Gregory T. Everson","doi":"10.1111/apt.70116","DOIUrl":"https://doi.org/10.1111/apt.70116","url":null,"abstract":"<p>In our previous publications in Alimentary Pharmacology & Therapeutics [<span>1, 2</span>], we highlighted the diagnostic performance of the disease severity index (DSI) derived from the oral cholate challenge test [<span>3-5</span>] (HepQuant DuO) to rule out large oesophageal varices (LEV) and other significant lesions of portal hypertension. In these publications, two criteria were evaluated: (1) using DSI ≤ 18.3 alone and (2) using DSI ≤ 24 or < 25 with platelet count > 135,000 μL<sup>−1</sup>. The sensitivity cut-off for rule-out of LEV was based on Baveno VII criteria for miss rate < 5% (sensitivity > 95%) [<span>6</span>]. The diagnostic performance for DSI ≤ 18.3 was previously reported [<span>1, 2</span>], but the diagnostic performance of DSI with platelet count was not. Table 1 shows the combination of DSI ≤ 18.3 or DSI ≤ 24 with PLT > 135,000 μL<sup>−1</sup> for the HepQuant DuO test. The HepQuant DuO test had miss rates < 5% (sensitivity > 95%), negative predictive values (NPV) > 99% and negative likelihood ratios (NLR) ≤ 0.08. Specificity was 63.8% for LEV and 58.3% for all significant lesions of portal hypertension.</p>\u0000<div>\u0000<header><span>TABLE 1. </span>Diagnostic performance (95% CI) of the combination of DSI ≤ 18.3 with DSI ≤ 24 and platelet count > 135,000 μL<sup>−1</sup> from the oral cholate challenge test (HepQuant DuO) to rule out of large oesophageal varices (LEV) and all portal hypertensive lesions (defined as oesophageal varices needing treatment, LEV, large gastric varices or severe portal hypertensive gastropathy).</header>\u0000<div tabindex=\"0\">\u0000<table>\u0000<thead>\u0000<tr>\u0000<td></td>\u0000<th>Large oesophageal varices</th>\u0000<th>All portal hypertensive lesions</th>\u0000</tr>\u0000</thead>\u0000<tbody>\u0000<tr>\u0000<td>Sensitivity (%)</td>\u0000<td>95.9 (86.0, 99.5)</td>\u0000<td>97.2 (85.5, 99.9)</td>\u0000</tr>\u0000<tr>\u0000<td>Specificity (%)</td>\u0000<td>63.8 (58.9, 68.5)</td>\u0000<td>58.3 (51.1, 65.2)</td>\u0000</tr>\u0000<tr>\u0000<td>Positive likelihood ratio</td>\u0000<td>2.65 (2.30, 3.05)</td>\u0000<td>2.33 (1.96, 2.77)</td>\u0000</tr>\u0000<tr>\u0000<td>Negative likelihood ratio</td>\u0000<td>0.06 (0.02, 0.25)</td>\u0000<td>0.05 (0.01, 0.33)</td>\u0000</tr>\u0000<tr>\u0000<td>Prevalence (%)</td>\u0000<td>10.8 (8.1, 14.1)</td>\u0000<td>15.3 (11.0, 20.6)</td>\u0000</tr>\u0000<tr>\u0000<td>Positive predictive value (%)</td>\u0000<td>24.4 (21.8, 27.1)</td>\u0000<td>29.7 (26.2, 33.4)</td>\u0000</tr>\u0000<tr>\u0000<td>Negative predictive value (%)</td>\u0000<td>99.2 (97.1, 99.8)</td>\u0000<td>99.1 (94.4, 99.9)</td>\u0000</tr>\u0000<tr>\u0000<td>Miss rate (%)</td>\u0000<td>4.1</td>\u0000<td>2.8</td>\u0000</tr>\u0000<tr>\u0000<td>EGDs avoided (%)</td>\u0000<td>57.3</td>\u0000<td>49.8</td>\u0000</tr>\u0000</tbody>\u0000</table>\u0000</div>\u0000<div></div>\u0000</div>\u0000<p>From this analysis, we conclude that the combined criteria of DSI ≤ 18.3 with DSI ≤ 24 plus platelet count > 135,000 μL<sup>−1</sup> may be sufficient to rule out LEV and aid the decision to avoid endoscopy (EGD) (Table 1). When used in combination, the diagnostic performance for LEV is maintained with a low miss rate (4.1%) but a much higher likelihood to avoid endoscopy (57.3%). The","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"52 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734412","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: Balancing Cost and Consequence of Colon Capsule Endoscopy in Colorectal Cancer Pathways—Finding the Sweet Spot","authors":"Ian Io Lei, Ramesh P. Arasaradnam, Anastasios Koulaouzidis","doi":"10.1111/apt.70104","DOIUrl":"https://doi.org/10.1111/apt.70104","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"13 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723373","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":"Featured Cover","authors":"Kai Markus Schneider,&nbsp;Feng Cao,&nbsp;Helen Ye Rim Huang,&nbsp;Lanlan Chen,&nbsp;Yazhou Chen,&nbsp;Rongpeng Gong,&nbsp;Anastasia Raptis,&nbsp;Kate Townsend Creasy,&nbsp;Jan Clusmann,&nbsp;Felix van Haag,&nbsp;Paul-Henry Koop,&nbsp;Adrien Guillot,&nbsp;Tom Luedde,&nbsp;Rohit Loomba,&nbsp;Sven Francque,&nbsp;Carolin Victoria Schneider","doi":"10.1111/apt.70110","DOIUrl":"https://doi.org/10.1111/apt.70110","url":null,"abstract":"<p>The cover image is based on the article <i>The Lipidomic Profile Discriminates Between MASLD and MetALD</i> by Kai Markus Schneider et al., https://doi.org/10.1111/apt.70012 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"61 8","pages":"i"},"PeriodicalIF":6.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Balancing Cost and Consequence of Colon Capsule Endoscopy in Colorectal Cancer Pathways—Finding the Sweet Spot. Authors' Reply","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.70105","DOIUrl":"https://doi.org/10.1111/apt.70105","url":null,"abstract":"<p>The authors of the large English colon capsule endoscopy (CCE) diagnostic accuracy study are grateful to Dr. Lei et al. for their informed and thoughtful observations [<span>1, 2</span>]. We think that there are two important and related observations of our own to make in response.</p>\u0000<p>First, on an ‘intention to investigate’ basis, rather than in complete and adequately prepared CCE, more polyps were detected by CCE than colonoscopy. This meant that an informed management plan could be made for many patients even when CCE was incomplete or inadequately prepared. Second, as you infer, CCE was introduced to mitigate the impact of the Covid-19 pandemic on colorectal cancer diagnosis. That is, its purpose was primarily to inform risk rather than prevent onward investigation, as one might plan for in the future.</p>\u0000<p>We very much agree that multiple, mitigatable factors, not yet fully defined, may contribute to the onward investigation rate and so inform how best CCE should complement a future colorectal diagnostics pathway. Beyond patient selection, touched on above, all of the factors outlined are absolutely pertinent. Our own view about polyp overdiagnosis is uncertain. Double counting seems unlikely since polyp detection was recorded on both a per patient and per polyp basis. The high false positivity of polyps ≥ 10 mm in those who had matched investigations, both of which were complete and adequately prepared, suggests that the reference standard may need to be revisited.</p>\u0000<p>We believe other factors are also important, such as shared decision making, patient choice, and the purpose of CCE in a clinical setting. We very much agree that such should help generate a ‘balanced approach’ for future recommendations. Our study importantly allows us to move beyond the safety and accuracy across a broad clinical setting and into that exciting new space where we can optimise.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"57 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723644","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: Chrononutrition and MASLD—Its About Time (Restricted Feeding)!","authors":"Hannah Mohr, Jonathan G. Stine","doi":"10.1111/apt.70078","DOIUrl":"https://doi.org/10.1111/apt.70078","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"9 43 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713050","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: Chrononutrition and MASLD—It is About Time (Restricted Feeding)! Authors' Reply","authors":"Sofia Tsitsou, Magdalini Adamantou, Triada Bali, Aristi Saridaki, Kalliopi‐Anna Poulia, Dimitrios S. Karagiannakis, Emilia Papakonstantinou, Evangelos Cholongitas","doi":"10.1111/apt.70107","DOIUrl":"https://doi.org/10.1111/apt.70107","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"11 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713053","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":"Clinical Trial: Effect of Abdominal Vibration Combined With Walking Exercise Programme on Bowel Preparation in Older Patients With Constipation","authors":"Yuan-Yuan Zhang, Ramoo Vimala, Ping Lei Chui, Ida Normiha Hilmi","doi":"10.1111/apt.70103","DOIUrl":"https://doi.org/10.1111/apt.70103","url":null,"abstract":"Older patients with constipation are at an increased risk of inadequate bowel preparation.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"57 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143703388","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: Disappearing Microbe, Emerging Disease? Nuancing the Protective Effects of Helicobacter pylori Against Eosinophilic Oesophagitis. Authors' Reply","authors":"Irene Spinelli, Gianluca Ianiro","doi":"10.1111/apt.70099","DOIUrl":"https://doi.org/10.1111/apt.70099","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"4 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702857","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: Disappearing Microbe, Emerging Disease? Nuancing the Protective Effects of Helicobacter pylori Against Eosinophilic Oesophagitis","authors":"Enzo Emanuele, Piercarlo Minoretti","doi":"10.1111/apt.70075","DOIUrl":"https://doi.org/10.1111/apt.70075","url":null,"abstract":"&lt;p&gt;We commend Spinelli et al. [&lt;span&gt;1&lt;/span&gt;] for their comprehensive meta-analysis of 19 studies encompassing 1.7 million subjects, which substantially advances our understanding of &lt;i&gt;Helicobacter pylori&lt;/i&gt; (Hp) infection's potential protective role against eosinophilic oesophagitis (EoE). Their findings demonstrate a notable 46% reduction in the odds of EoE development among Hp-exposed individuals. Notwithstanding the meticulous synthesis of existing data, several methodological refinements and research directions warrant consideration to further elucidate this intriguing epidemiological relationship.&lt;/p&gt;\u0000&lt;p&gt;First, stratification by Hp virulence factors and strain specificity could illuminate mechanistic insights. While the meta-analysis aggregated all Hp infections, growing evidence suggests strain-specific immunomodulatory effects—particularly cagA+ strains, which elicit more robust Th1 responses [&lt;span&gt;2&lt;/span&gt;]. Subgroup analyses comparing cagA+ versus cagA− infections might reveal differential protection against EoE, as observed in other Th2-mediated conditions such as asthma [&lt;span&gt;3&lt;/span&gt;]. Second, geographic heterogeneity warrants deeper exploration. Although Spinelli et al. [&lt;span&gt;1&lt;/span&gt;] found comparable odds reductions in Eastern (odds ratio: 0.53) and Western (odds ratio: 0.52) cohorts, Hp infection prevalence diverged remarkably (43% vs. 14%, respectively). This paradox suggests region-specific confounders, such as genetic factors or endemic helminth infections synergising with Hp's immunoregulatory effects [&lt;span&gt;4&lt;/span&gt;]. Regression models accounting for regional socioeconomic indices, sanitation standards and antibiotic stewardship could disentangle these interactions further. Third, temporality in the Hp–EoE relationship remains unresolved. The stronger inverse association in post-2019 studies (56% vs. 37% reduction) [&lt;span&gt;1&lt;/span&gt;] is in accordance with EoE's rising incidence but raises questions about birth cohort effects [&lt;span&gt;5&lt;/span&gt;]. Case–control studies nested within longitudinal birth cohorts could clarify whether early-life Hp acquisition may confer greater protection than adult exposure, as hypothesised for allergic diseases. Additionally, Mendelian randomisation studies using genetic variants as proxies for Hp susceptibility might better establish causality whilst minimising confounding [&lt;span&gt;6&lt;/span&gt;]. Fourthly, the meta-analysis did not elaborate on mucosal cytokine profiles, transcriptomic alterations, or microbiome signatures associated with EoE and their potential modification by Hp infection. We further contend that non-invasive biomarkers of EoE, including autoantibodies and inflammatory mediators [&lt;span&gt;7&lt;/span&gt;], warrant comprehensive investigation in relation to Hp. pylori status. Finally, within existing clinical trials involving EoE patients [&lt;span&gt;8-10&lt;/span&gt;], it would be valuable to analyse the prevalence of Hp infection and to examine how it might influence therapeutic outcomes.&lt;/p&gt;\u0000&lt;p&gt;In c","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"35 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143703544","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}