Alimentary Pharmacology & Therapeutics最新文献

{"title":"Editorial: Redefining Decompensation in Cirrhosis—More Than an Academic Playground?","authors":"Anja Tiede, Benjamin Maasoumy","doi":"10.1111/apt.70334","DOIUrl":"https://doi.org/10.1111/apt.70334","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"27 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899335","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: Impact of Alcohol Consumption on the Development and Progression of Metabolic Dysfunction–Associated Steatotic Liver Disease","authors":"Yunxuan Lei,&nbsp;Yixuan Zhu,&nbsp;Wenjing Ni,&nbsp;Junping Shi,&nbsp;Wai-Kay Seto,&nbsp;Jie Li","doi":"10.1111/apt.70335","DOIUrl":"10.1111/apt.70335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic dysfunction–associated steatotic liver disease (MASLD) is recognised as a globally prevalent chronic liver disease, primarily driven by metabolic risk factors such as insulin resistance, obesity, dyslipidaemia and impaired glucose metabolism. Traditionally considered distinct from alcohol-related liver disease, MASLD is increasingly being re-evaluated in light of new evidence regarding the role of alcohol consumption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To clarify the multifaceted effects of alcohol intake on the progression of MASLD. We focus on the underlying pathophysiological mechanisms, clinical implications and the challenges associated with risk stratification in affected individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a narrative review of epidemiological and mechanistic studies on the interaction between alcohol intake and metabolic dysfunction in MASLD up to 30 June 2025.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Accumulating evidence indicates that even moderate alcohol consumption can amplify hepatic steatosis through multiple interconnected mechanisms, including oxidative stress, disrupted lipid metabolism and gut microbiota dysbiosis. These changes trigger inflammatory cascades and accelerate the progression from simple steatosis to steatohepatitis, fibrosis and cirrhosis in individuals with underlying metabolic dysfunction. Epidemiological studies have revealed a dose-dependent relationship between alcohol intake and liver disease severity, with synergistic effects particularly evident in patients with obesity or metabolic syndrome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Alcohol amplifies MASLD progression through synergistic mechanisms. Standardised evaluation of alcohol use is critical for risk stratification and the development of personalised treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 7","pages":"680-691"},"PeriodicalIF":6.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899337","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: PSC as an Independent Risk Factor for CRC Without IBD: Can Observed Epidemiological Trends Help Uncover Biological Mechanisms and Guide Surveillance Strategies?","authors":"Natassia Tan, Kristel Leung","doi":"10.1111/apt.70325","DOIUrl":"https://doi.org/10.1111/apt.70325","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"15 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899321","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: Redefining Decompensation in Cirrhosis—More Than an Academic Playground? Authors' Reply","authors":"Lucie Simonis, Lorenz Balcar, Georg Kramer, Thomas Reiberger, Georg Semmler","doi":"10.1111/apt.70344","DOIUrl":"https://doi.org/10.1111/apt.70344","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"50 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899336","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: Redefining Safety in Post-Liver Transplant IBD-Why Therapeutic Effectiveness Is the Ultimate Shield.","authors":"Mohammed Nabil Quraishi, Badr Al-Bawardy","doi":"10.1111/apt.70310","DOIUrl":"https://doi.org/10.1111/apt.70310","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870532","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: Redefining Safety in Post-Liver Transplant IBD-Why Therapeutic Effectiveness Is the Ultimate Shield. Authors' Reply.","authors":"Simone Chin, Danny Con, Patrick Hilley, Crispin Corte, Ken Liu, Adam Testro, Peter De Cruz, Matthew C Choy, Ashish Srinivasan","doi":"10.1111/apt.70341","DOIUrl":"https://doi.org/10.1111/apt.70341","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870533","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: Dual Advanced Therapy in Refractory Ulcerative Colitis-Hope Beyond Monotherapy.","authors":"Ahmed B Bayoumy,Nanne K de Boer","doi":"10.1111/apt.70318","DOIUrl":"https://doi.org/10.1111/apt.70318","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"15 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857690","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: Dual Advanced Therapy in Refractory Ulcerative Colitis-Hope Beyond Monotherapy. Authors' Reply.","authors":"Pardhu Bharath Neelam,Rupa Banerjee","doi":"10.1111/apt.70339","DOIUrl":"https://doi.org/10.1111/apt.70339","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"31 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857693","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: Intestinal Ultrasound for the Assessment of Constipation—Out of the Shadows? Authors' Reply","authors":"Ryan M. Mathias,&nbsp;Thomas M. Goodsall,&nbsp;Claire E. Parker,&nbsp;Alice S. Day,&nbsp;Yoon K. An,&nbsp;Brandon Baraty,&nbsp;Chamara Basnayake,&nbsp;Jakob Begun,&nbsp;Ray K. Boyapati,&nbsp;Rebecca Burgell,&nbsp;Michael T. Dolinger,&nbsp;Giovanni Maconi,&nbsp;Kerri L. Novak,&nbsp;Shintaro Sagami,&nbsp;Rebecca L. Smith,&nbsp;Ashish R. Srinivasan,&nbsp;Stuart A. Taylor,&nbsp;Vipul Jairath,&nbsp;Christopher Ma,&nbsp;Robert V. Bryant","doi":"10.1111/apt.70338","DOIUrl":"10.1111/apt.70338","url":null,"abstract":"&lt;p&gt;We appreciate the insightful comments by Vos and colleagues on our expert position statement on the role of intestinal ultrasound (IUS) in luminal contents assessment [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;IUS is a rapidly evolving area emerging as an alternative modality for the assessment of disorders of gut-brain interaction (DGBI) [&lt;span&gt;2&lt;/span&gt;]. Patients with DGBI are exposed to more ionising radiation than healthy controls; IUS offers safety, cost effectiveness, and accuracy over conventional assessment methods [&lt;span&gt;3&lt;/span&gt;]. Until recently, however, IUS for functional assessment has remained in the realm of paediatrics, with a paucity of adult studies and a lack of description or validation of sonographic parameters [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Our position statement [&lt;span&gt;2&lt;/span&gt;] was intended to serve as initial guidance and a summation of current evidence. A narrative review has further summarised available evidence on luminal contents assessment [&lt;span&gt;5&lt;/span&gt;]. A study performed in a DGBI cohort did not find a correlation between sonographic findings and symptoms, but did suggest that IUS was useful in identifying those patients who would benefit from therapy for constipation rather than treatment of diarrhoea due to identification of faecal loading [&lt;span&gt;6&lt;/span&gt;]. Together, these set the scene for IUS in the assessment of luminal contents in clinical practice. However, they clearly illustrate knowledge gaps and the need for further research.&lt;/p&gt;&lt;p&gt;Small studies have shown that IUS is as accurate as computed tomography [&lt;span&gt;7, 8&lt;/span&gt;]. However, prospective, blinded, and centrally read studies are required to measure the accuracy and validity of IUS in measuring luminal contents, to improve reliability and uptake in both clinical trials and practice [&lt;span&gt;9&lt;/span&gt;]. The Sonographic Examination and Assessment of Ulcerative Colitis Associated Constipation (SEE UCAC trial, ACTRN12622001207707) is the first prospective, blinded, and centrally read study to directly compare the accuracy of luminal contents assessment against CT scan with ultrasound. Interim results of 63 patients suggest close correlation between IUS and CT in assessing luminal contents as well as excellent inter-rater agreement between sonographic parameters [&lt;span&gt;10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The body of evidence supporting the use of IUS in clinical practice has remained in the assessment of inflammation, particularly in adults. It is now with great optimism that we see the increasing interest and growing potential of IUS in the assessment of DGBI and luminal contents emerging from the shadows into the spotlight.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Ryan M. Mathias:&lt;/b&gt; conceptualization; writing – original draft. &lt;b&gt;Thomas M. Goodsall:&lt;/b&gt; writing – review and editing. &lt;b&gt;Claire E. Parker:&lt;/b&gt; writing – review and editing. &lt;b&gt;Alice S. Day:&lt;/b&gt; writing – review and editing. &lt;b&gt;Yoon K. An:&lt;/b&gt; writing – review and editing. &lt;b&gt;Brandon Baraty:&lt;/b&gt; writing – review and editing. &lt;b&gt;Chamara Basnayake:&lt;/b&gt; writing – r","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 8","pages":"855-856"},"PeriodicalIF":6.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850913","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":"Editorial: Intestinal Ultrasound for the Assessment of Constipation—Out of the Shadows?","authors":"J. M. B. W. Vos,&nbsp;M. A. Benninga,&nbsp;K. B. Gecse,&nbsp;F. A. E. De Voogd","doi":"10.1111/apt.70300","DOIUrl":"10.1111/apt.70300","url":null,"abstract":"&lt;p&gt;Constipation is a common disorder of gut-brain interaction (DGBI) affecting both paediatric and adult populations [&lt;span&gt;1, 2&lt;/span&gt;]. Although Rome IV criteria are the gold standard, diagnosing a patient with constipation can be challenging due to the non-specific nature of its symptoms and the overlap with other disorders. Diagnostic tools—such as digital rectal examination or radiologic modalities including abdominal X-ray, CT scan, or MRI—are invasive and come with high costs or significant radiation exposure [&lt;span&gt;3&lt;/span&gt;]. This highlights the unmet need for a non-invasive, objective approach to assess constipation and faecal loading.&lt;/p&gt;&lt;p&gt;Intestinal ultrasound (IUS) is emerging as an ideal point-of-care tool, with a growing body of evidence supporting its use in monitoring inflammatory bowel disease [&lt;span&gt;4&lt;/span&gt;]. More recently, its potential application has expanded to include the evaluation of DGBI, particularly constipation [&lt;span&gt;5, 6&lt;/span&gt;]. However, standardised sonographic criteria for these conditions are lacking, and the diagnostic accuracy of IUS in constipation remains to be fully established.&lt;/p&gt;&lt;p&gt;To address this gap, a RAND/UCLA-modified Delphi consensus panel—comprising international experts in gastroenterology and radiology—integrated current evidence with expert opinion to develop guidance on the use of IUS in the evaluation of constipation [&lt;span&gt;7&lt;/span&gt;]. The panel endorsed 43 statements supporting the use of IUS to assess luminal contents and colonic architecture. Notably, IUS was rated as an appropriate modality for detecting faecal loading across various colonic segments, including the rectum. In paediatric patients, the transverse rectal diameter was identified as a key metric: a diameter &gt; 30 mm was considered predictive of faecal loading. This aligns with prior systematic reviews, although rectal size varies among children and is perhaps age- or sex-dependent [&lt;span&gt;5&lt;/span&gt;]. Future implementation requires standardisation and assessment of reliability and reproducibility for adult and paediatric populations. In addition, a transperineal approach instead of an abdominal approach might increase accuracy, as has been demonstrated for ulcerative proctitis [&lt;span&gt;8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Additional sonographic features, including posterior acoustic shadowing, echogenic foci, and haustral loss, were considered useful in identifying faecal loading beyond the rectum. However, these features are not specific, as intraluminal gas may produce similar artefacts. This overlap introduces interpretation variability, particularly among less experienced operators. Although some studies have demonstrated concordance between IUS findings and CT imaging in detecting constipation-related features [&lt;span&gt;9, 10&lt;/span&gt;], data remain limited. Further validation studies are needed to establish reliability against robust reference standards.&lt;/p&gt;&lt;p&gt;Despite current limitations, the potential of IUS in constipation assessment is substanti","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 8","pages":"853-854"},"PeriodicalIF":6.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851081","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}