Alimentary Pharmacology & Therapeutics最新文献

{"title":"Accelerated Biological Aging in Cholestatic Liver Disease: Telomere Attrition and Association With Disease Severity","authors":"Saqr G. Alsakarneh, Brian D. Juran, Jenna Fernandez, Mrinal Patnaik, Gregory J. Gores, Nicholas F. LaRusso, Konstantinos N. Lazaridis","doi":"10.1111/apt.71013","DOIUrl":"https://doi.org/10.1111/apt.71013","url":null,"abstract":"Background Primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC) are rare, chronic cholestatic liver diseases with heterogeneous progression and limited biomarkers of disease biology. Epigenetic age acceleration has been demonstrated in PSC and PBC, suggesting accelerated biological aging. DNA methylation–derived telomere length (DNAmTL) reflects replicative aging and cellular turnover, but its role in PSC and PBC remains unclear. We aimed to evaluate DNAmTL in PSC and PBC and its association with disease severity. Methods We analysed and compared DNAmTL and age‐adjusted DNAmTL among patients with PSC ( <jats:italic>n</jats:italic> = 474) versus PSC controls ( <jats:italic>n</jats:italic> = 484) and patients with PBC ( <jats:italic>n</jats:italic> = 291) versus PBC controls ( <jats:italic>n</jats:italic> = 291). Associations with clinical outcomes were assessed using nonparametric tests and multivariable logistic regression models. Correlations with primary sclerosing cholangitis Risk Estimate Tool (PREsTO) score and epigenetic age acceleration (AgeAccelGrim) were evaluated using linear regression. Results Patients with PSC demonstrated significantly shorter age‐adjusted DNAmTL compared with controls (median −0.036 vs. 0.016, <jats:italic>p</jats:italic> &lt; 0.001). Patients with PBC also exhibited reduced DNAmTL relative to controls (median 6.814 vs. 6.885, <jats:italic>p</jats:italic> &lt; 0.001). Within PSC, shorter DNAmTL was associated with cirrhosis (OR 0.21, 95% CI 0.06–0.69, <jats:italic>p</jats:italic> = 0.013) and advanced disease (OR 0.20, 95% CI 0.06–0.67, <jats:italic>p</jats:italic> = 0.009). Shorter DNAmTL was also observed in hepatic decompensation and hepatobiliary malignancy, including cholangiocarcinoma. DNAmTL inversely correlated with PReSTO score ( <jats:italic>p</jats:italic> &lt; 0.001). DNAmTL was strongly inversely correlated with AgeAccelGrim in both PSC and PBC ( <jats:italic>p</jats:italic> &lt; 0.001). Conclusion Cholestatic liver diseases are associated with shortened DNAmTL, which independently correlates with disease severity in PSC. Together with epigenetic age acceleration, these findings support a model of accelerated biological aging in PSC and PBC characterized by converging signatures of accelerated biological aging that may contribute to progressive biliary injury and fibrosis.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"5 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070940","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":"Revisiting Ferritin‐ IgG Score to Predict Complete Biochemical Response in Autoimmune Hepatitis","authors":"Álvaro Díaz‐González, Bastian Engel, Manuel Hernández‐Guerra, Indhira Pérez‐Medrano, Beatriz Mateos, Rosa M. Morillas, Elena Gómez, Judith Gómez, Diana Horta, Isabel Conde, María Del Barrio, Ignasi Olivas, Ismael El Hajra, Mar Riveiro‐Barciela, Ana Barreira‐Díaz, Carmen López, Carmen Álvarez‐Navascúes, Manuel Rodríguez Perálvarez, Elmar Jaeckel, Richard Taubert, María‐Carlota Londoño","doi":"10.1111/apt.71014","DOIUrl":"https://doi.org/10.1111/apt.71014","url":null,"abstract":"Background Predictive tools in autoimmune hepatitis (AIH) are scarce. A study proposed low ferritin and high IgG as prognostic markers for complete biochemical response (CBR). Aims We aimed to externally validate the prognostic role of ferritin‐IgG score and its individual components in an independent multicentre AIH cohort. Methods This multicentre study included 487 patients from the Hannover cohort ( <jats:italic>n</jats:italic> = 166) and the Spanish ColHai registry ( <jats:italic>n</jats:italic> = 321). Patients with ferritin &lt; 2.09×ULN received 1 point and those with IgG &gt; 1.89×ULN received 1 point, yielding a score of 0–2. Because baseline characteristics differed between cohorts, the score was additionally evaluated after inverse probability of treatment weighting (IPTW) propensity score. Results At baseline, Hannover patients were younger ( <jats:italic>p</jats:italic> = 0.005) and had higher transaminases, bilirubin ( <jats:italic>p</jats:italic> &lt; 0.001), ferritin ( <jats:italic>p</jats:italic> = 0.006) and IgG ( <jats:italic>p</jats:italic> = 0.006). Overall, 79.7% achieved CBR; CBR rates were higher in ColHai at 6 (50.2% vs. 34.6%, <jats:italic>p</jats:italic> = 0.001) and 12 months (67.6% vs. 51.9%, <jats:italic>p</jats:italic> = 0.001). The score was associated with response in the Hannover cohort but showed no predictive capacity in ColHai (C‐statistic 0.51 [95% CI 0.45–0.56] at 6 months; 0.51 [0.45–0.57] at 12 months; 0.54 [0.47–0.61] at any time during the follow‐up). After IPTW, the score was not associated with CBR in the ColHai cohort (HR 0.86, 95% CI 0.67–1.10), whereas IgG retained its predictive value, with baseline levels &lt; 1.89×ULN associated with a higher probability of achieving CBR. Conclusions The ferritin‐IgG score failed external validation in an independent multicentre cohort. Ferritin showed no prognostic value, whereas the predefined IgG threshold retained its ability to predict treatment response.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"15 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070941","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":"Review Article: Cancer Surveillance for Early Detection of Liver Cancer in Patients with HBV Infection","authors":"Andrew J. Park, Bai L. Pan, Xingfei Pan, James Park, Jiahong Dong, Calvin Q. Pan","doi":"10.1111/apt.71008","DOIUrl":"https://doi.org/10.1111/apt.71008","url":null,"abstract":"Background and Aims Chronic hepatitis B virus (HBV) infection remains a major cause of hepatocellular carcinoma (HCC). Although antiviral therapy reduces cirrhosis and liver failure, HCC may still develop in patients with HBV, including in non‐cirrhotic livers. This review aimed to evaluate current HCC surveillance strategies in HBV infection, focusing on risk stratification and advances in early detection. Methods English‐language literature published in PubMed and the Cochrane Database was comprehensively reviewed. This narrative review assessed the effectiveness of HCC surveillance strategies in HBV‐infected patients, with emphasis on recent advances in early‐stage HCC detection. Results This review summarizes viral, host and environmental factors associated with HCC susceptibility and evaluates current surveillance using ultrasound with or without alpha‐fetoprotein (AFP). Surveillance eligibility should follow guideline‐defined risk criteria: patients with an estimated annual HCC risk below 0.2% generally do not require routine surveillance and should undergo periodic risk reassessment, whereas patients meeting surveillance criteria should undergo ultrasound with or without AFP every 6 months. Risk‐prediction scores can refine assessment but should be distinguished from early‐detection tests. GALAD, HES 2.0, multi‐target blood tests, and abbreviated magnetic resonance imaging are promising early‐detection approaches, but much of the supporting evidence derives from mixed‐aetiology or non‐HBV cohorts and prospective HBV‐specific validation remains limited. Conclusion A risk‐adapted approach should separate estimation of future HCC risk from surveillance and early‐detection testing. Guideline‐eligible patients should undergo surveillance every 6 months, while emerging biomarker, imaging and artificial‐intelligence approaches remain adjunctive or investigational pending further HBV‐specific validation.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"16 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070970","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: Temporal Alignment of Proton Pump Inhibitor Exposure and Gastric Neuroendocrine Neoplasm Risk in Autoimmune Gastritis. Authors' Reply.","authors":"Sara Massironi, Marco Vincenzo Lenti, Edith Lahner, Antonio Di Sabatino, Silvio Danese","doi":"10.1111/apt.71018","DOIUrl":"10.1111/apt.71018","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068829","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":"Persistence, Safety and Pharmacokinetics of Vedolizumab After Switching to the Subcutaneous Route in a Prospective French National Cohort Study.","authors":"Marianne Hupé, Nicolas Mathieu, Aurélien Amiot, Philippe Seksik, Maeva Charkaoui, Cyrielle Gilletta-de-Saint-Joseph, Arnaud Bourreille, Mélanie Serrero, Yoram Bouhnik, Maria Nachury, Xavier Roblin, Stéphane Nancey, Vered Abitbol, Jean-Marc Gornet, Céline Montuclard, Xavier Hébuterne, Thierry Paupard, Cléa Rouillon, Mehdi Kaassis, Pierre Andrau, Morgane Amil, Magalie Baudrant, Laurent Peyrin-Biroulet, Stéphane Paul, Eric Vicaut, David Laharie","doi":"10.1111/apt.70986","DOIUrl":"https://doi.org/10.1111/apt.70986","url":null,"abstract":"<p><strong>Background and aim: </strong>We conducted a prospective study to evaluate the persistence, efficacy, pharmacokinetics, and safety of subcutaneous VDZ (SC-VDZ) after switching from the intravenous (IV) route.</p><p><strong>Methods: </strong>All patients with ulcerative colitis (UC) or Crohn's disease (CD) in clinical remission who switched from IV-VDZ to SC-VDZ between 2022 and 2024 were included in this multicentric prospective French national cohort study. Primary endpoint was SC-VDZ persistence at Week 52. Patients who had a disease-related surgery, repeated or prolonged (> 14 days) steroid courses, and those who were lost to follow-up were considered non-persistent.</p><p><strong>Results: </strong>Among the 337 patients analysed, 246 (73%) had UC and 91 (27%) CD; 214 (64%) were on a standard IV-VDZ regimen. At Week 52, SC-VDZ persistence was 84% [95% confidence interval: 80-88], with no significant difference between diseases (p = 0.36). During the study period, 32 patients (10%) had a dose increase of SC-VDZ (either to 216 mg weekly or to 108 mg 2-weekly), including 17 (53%) who had been on a standard IV-VDZ regimen, and five (16%) eventually stopped VDZ due to persistent loss-of-response despite dose increase. Twelve out of 16 patients were successfully switched back to IV-VDZ. Vedolizumab drug levels were similar between persistent and non-persistent patients throughout the study period. A total of 183 patients (54%) reported at least one AE, most frequently injection-site reactions (20%) and infections (17%), leading to SC-VDZ discontinuation in 25 patients (7%).</p><p><strong>Conclusion: </strong>In this multicentric cohort, the persistence at 1 year from switch to SC-VDZ in IBD patients was 84%.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068818","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: Timing Matters-Interpreting Colonic Gas Reduction With Gel-Forming Fibres.","authors":"Peng-Fei Wang","doi":"10.1111/apt.71023","DOIUrl":"https://doi.org/10.1111/apt.71023","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068824","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: Beyond the Matrix—Upadacitinib in Real‐World Refractory Crohn's Disease","authors":"Iria Bastón‐Rey, Iago Rodríguez‐Lago, Manuel Barreiro‐de Acosta","doi":"10.1111/apt.71019","DOIUrl":"https://doi.org/10.1111/apt.71019","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"99 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043490","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: What Does MAPI‐Informed ALD Classification Capture?","authors":"Zichen Yu","doi":"10.1111/apt.71011","DOIUrl":"https://doi.org/10.1111/apt.71011","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"5 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149033059","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: Proton Pump Inhibitor Prescribing in Autoimmune Gastritis—From Real‐World Exposure to Indication‐Driven Reassessment","authors":"Francesco Calabrese, Vincenzo Savarino, Edoardo V. Savarino, Edoardo G. Giannini, Elisa Marabotto","doi":"10.1111/apt.71016","DOIUrl":"https://doi.org/10.1111/apt.71016","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"65 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149033058","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: MetALD ‐ ALD Prediction Index—A Scalable Biomarker for Alcohol Phenotyping Beyond PEth . Authors' Reply","authors":"Yuge Li, Qian Zhang, Haorui Liu, Zhenyu Huo, Shanshan Wu","doi":"10.1111/apt.71010","DOIUrl":"https://doi.org/10.1111/apt.71010","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"11 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149033061","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}