Expert Review of Gastroenterology & Hepatology最新文献_第2页

A practical guide to dilating inflammatory bowel disease strictures.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-03-03 DOI: 10.1080/17474124.2025.2471873

Natasha K Klemm, Joseph D Feuerstein

{"title":"A practical guide to dilating inflammatory bowel disease strictures.","authors":"Natasha K Klemm, Joseph D Feuerstein","doi":"10.1080/17474124.2025.2471873","DOIUrl":"10.1080/17474124.2025.2471873","url":null,"abstract":"Introduction: Stricturing Crohn's disease is a common phenotype and treatment aims to improve symptoms, prevent complications, assess for proximal bowel disease activity, and screen for upstream neoplasm. Management is challenging due to diagnostic limitations, stricture composition, and recurrence rate.Areas covered: Categorizing a stricture as inflammatory or fibrotic is necessary to determine appropriate management. Inflammatory strictures are treated with medical therapy, and fibrostenotic strictures require endoscopic or surgical management. While EBD is increasingly utilized, stricture recurrence rates remain high, necessitating repeat endoscopic procedures or surgery. We performed a PubMed (MEDLINE database) search for the latest research on IBD-related stricture management, including detection, diagnosis, and medical and procedural therapies. We highlight the current literature on endoscopic techniques for the treatment of intestinal strictures and future areas of research.Expert opinion: The field of intestinal stricture management is expected to evolve in the coming years and will include enhanced imaging modalities, medication optimization, and increasing use of advanced endoscopic techniques.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"377-387"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482574","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}

引用次数: 0

Cholestatic liver diseases: modern therapeutics.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-03-02 DOI: 10.1080/17474124.2025.2473490

Bridgette B McNally, Elizabeth J Carey

{"title":"Cholestatic liver diseases: modern therapeutics.","authors":"Bridgette B McNally, Elizabeth J Carey","doi":"10.1080/17474124.2025.2473490","DOIUrl":"10.1080/17474124.2025.2473490","url":null,"abstract":"Introduction: Cholestatic liver disease encompasses a broad group of disorders related to impaired normal bile formation, secretion, or excretion. These diseases present with symptoms of fatigue, jaundice, pruritus, and biochemical changes.Areas covered: We focus on updates in the management of autoimmune cholestatic liver disease. The mainstay therapy in PBC is UDCA (ursodeoxycholic acid), but OCA (obeticholic acid) can be considered if suboptimal response or intolerance. Fibrates have shown some promising effects in PBC patients who have not responded to or are intolerant of UDCA and/or OCA; however, they are not FDA approved. Peroxisome Proliferator-Activated Receptor Agonists (PPARs) have emerged as a promising new class of oral agents in PBC. Also, Ileal Bile Acid Transporter (IBAT) inhibitors are being investigated for the treatment of pruritus related to PBC. There are no available treatments for PSC; however, there have been previous investigations into many agents. There are ongoing clinical trials investigating the role of various antibiotics, PPARs, and immunomodulators for the treatment of PSC.Expert opinion: Ongoing investigations into the treatment of both PBC and PSC are essential. We anticipate that alternative management strategies for PBC and PSC will continue to arise in the next 5-10 years.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"365-370"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515047","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}

引用次数: 0

Endoscopic ultrasonography guided gallbladder drainage: "how and when".

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-03-17 DOI: 10.1080/17474124.2025.2478213

Matteo Marasco, Marianna Signoretti, Gianluca Esposito, Stefano Francesco Crinò, Francesco Panzuto, Domenico Galasso

{"title":"Endoscopic ultrasonography guided gallbladder drainage: \"how and when\".","authors":"Matteo Marasco, Marianna Signoretti, Gianluca Esposito, Stefano Francesco Crinò, Francesco Panzuto, Domenico Galasso","doi":"10.1080/17474124.2025.2478213","DOIUrl":"10.1080/17474124.2025.2478213","url":null,"abstract":"Introduction: EUS-guided gallbladder drainage (EUS-GBD) is recognized as an effective minimally invasive alternative technique mainly in managing patients with acute cholecystitis not eligible for cholecystectomy and, more recently, for jaundice relief in inoperable patients with distant malignant biliary obstruction.Areas covered: This review provides an extensive guide to the actual role of EUS-GBD. A comprehensive search was conducted, including articles pertinent to this review's aims. It explored technical aspects and discussed clinical scenarios most suitable for this procedure compared to other traditional drainage methods (percutaneous or endoscopic transpapillary gallbladder drainage). Moreover, the introduction of lumen-apposing metal stents (LAMS) has enhanced EUS-GBD by adding the possibility of direct gallbladder inspection and treatment of stones. The indications for performing EUS-GBD have become wider, and several robust studies described the high technical and clinical success rate with an optimal safety profile.Expert opinion: For optimal EUS-GBD outcomes, a standardized technique and an accurate selection of patients are crucial and should benefit from a multidisciplinary team decision. Still, future efforts are required for more prospective studies to standardize clinical indications, clarify post-procedural management, and acquire new data on long-term follow-up.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"399-412"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623530","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}

引用次数: 0

Arterial stiffness as a complication of metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-02-28 DOI: 10.1080/17474124.2025.2471871

Alexios Giannakodimos, Evangelos Oikonomou, Panteleimon Pantelidis, Panagiotis Theofilis, Niki Katsiki, Athina Goliopoulou, Georgios E Zakynthinos, Emmanouil Korakas, Vasiliki Kalogera, Maciej Banach, Vaia Lampadiari, Eva Kassi, Ignatios Ikonomidis, Gerasimos Siasos

{"title":"Arterial stiffness as a complication of metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis.","authors":"Alexios Giannakodimos, Evangelos Oikonomou, Panteleimon Pantelidis, Panagiotis Theofilis, Niki Katsiki, Athina Goliopoulou, Georgios E Zakynthinos, Emmanouil Korakas, Vasiliki Kalogera, Maciej Banach, Vaia Lampadiari, Eva Kassi, Ignatios Ikonomidis, Gerasimos Siasos","doi":"10.1080/17474124.2025.2471871","DOIUrl":"10.1080/17474124.2025.2471871","url":null,"abstract":"Introduction: The purpose of this systematic review and meta-analysis is to investigate the association of metabolic dysfunction-associated steatotic liver disease (MASLD) with arterial stiffness and enlighten on potential cardiometabolic co-factors.Methods: A literature search in PubMed/Medline, Embase, Scopus, and Web of Science databases was conducted. All the observational studies comparing arterial stiffness indices between adults with Non-alcoholic Fatty Liver Disease (NAFLD), Metabolic Dysfunction Associated-Fatty Liver Disease (MAFLD), or MASLD and apparently healthy individuals with normal liver function were included. Pulse wave velocity (PWV) and augmentation index (AIx) were mainly used as arterial stiffness indices.Results: Fourty one unique studies were included in the systematic review, with 27 deemed eligible for meta-analysis. Patients with MASLD had increased carotid-femoral PWV (14 studies, Mean difference (MD): 0.96 m/s, 95% confidence interval (CI) 0.65-1.27, p < 0.001) compared with healthy individuals. This finding was independent from body mass index, triglycerides, high-density lipoprotein, systolic blood pressure, and fasting plasma glucose. Moreover, patients with MASLD had higher brachial-ankle PWV (13 studies, MD: 78.14 cm/s, 95% CI 60.37-95.90, p < 0.001) and AIx (7 studies, MD: 3.85%, 95% CI 0.87-6.82, p = 0.0195) compared with controls.Conclusions: MASLD is correlated with increased arterial stiffness. This relation is unaffected by common cardiometabolic risk factors.Registration: PROSPERO (ID: CRD42023468258).","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"413-426"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482575","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}

引用次数: 0

Thinking outside the box: unconventional artificial intelligence algorithms in the detection and management of liver cirrhosis.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-03-27 DOI: 10.1080/17474124.2025.2483995

Ahmed Hashim, Bernardo Stefanini, Fabio Piscaglia

引用次数: 0

Gut dysbiosis: cause or consequence of intestinal inflammation in celiac disease?

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-03-26 DOI: 10.1080/17474124.2025.2483406

Stefano Leo, Maureen M Leonard, Francesco Valitutti, Alessio Fasano

{"title":"Gut dysbiosis: cause or consequence of intestinal inflammation in celiac disease?","authors":"Stefano Leo, Maureen M Leonard, Francesco Valitutti, Alessio Fasano","doi":"10.1080/17474124.2025.2483406","DOIUrl":"10.1080/17474124.2025.2483406","url":null,"abstract":"Introduction: Celiac disease (CeD) is an immune-mediated condition that occurs in genetically predisposed individuals ingesting gluten. It is characterized by enteropathy leading to both gastrointestinal and extra-intestinal symptoms. The prevalence of CeD has increased world-wide. Evidence suggests that genetic predisposition and exposure to gluten are necessary but not sufficient for CeD onset, implying that other unknown factors are at play in its pathogenesis.Areas covered: This review summarizes the current knowledge on the contribution of the gut microbiota to CeD pathogenesis, aiming to address the question of whether it is the cause or consequence of the celiac enteropathy. We reviewed the current literature (studies published in PubMed database between 2007 and 2023), linking gut microbiota dysbiosis and CeD, focusing specifically on prospective birth cohorts' studies and discussing how multi-omics and artificial intelligence (AI) could transform the diagnosis of CeD in a personalized medicine approach.Expert opinion: A multi-omic approach will allow for better clarification of the pivotal role of the microbiome in epigenetically triggering CeD pathogenesis. Further, the combination of multi-omics results with AI would pave the way to an improved CeD diagnosis and to the identification of new personalized therapeutic interventions.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-9"},"PeriodicalIF":3.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709179","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}

引用次数: 0

An expert's guide to classical manometric patterns seen in high-resolution colonic manometry.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-27 DOI: 10.1080/17474124.2025.2468301

Phil G Dinning

{"title":"An expert's guide to classical manometric patterns seen in high-resolution colonic manometry.","authors":"Phil G Dinning","doi":"10.1080/17474124.2025.2468301","DOIUrl":"10.1080/17474124.2025.2468301","url":null,"abstract":"Introduction: High-resolution colonic manometry is a research and diagnostic tool used to evaluate colonic motility. Used in health it helps us understand normal colonic motility and the colonic response to physiological stimuli such as meal, as well as chemical (laxatives) and mechanical (distension) stimuli. In pediatric and adult patients with suspected colonic disorders, it can help to understand the abnormal colonic motility associated with the condition.Area covered: High-resolution manometric catheters contain multiple closely spaced sensors that detect intraluminal pressure changes and contractile force, which can be interpreted as contractile activity. This activity forms several distinctive motor patterns that help in understanding normal colonic physiology and provide insights into the potential pathophysiology underlying colonic disorders such as constipation. After a PubMed search of colonic high-resolution manometry studies, this review provides an overview of the characterized motor patterns, when they occur, how they are initiated, their clinical relevance, and their role, if any, in guiding therapeutic interventions.Expert opinion: High-resolution colonic manometry has identified motor patterns that were missed or mislabeled by low-resolution recordings. How best to use this information to guide treatment remains to be determined.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-14"},"PeriodicalIF":3.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425437","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}

引用次数: 0

The role of immunogenicity in optimizing biological therapies for inflammatory bowel disease.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-25 DOI: 10.1080/17474124.2025.2468302

Konika Sharma, Bruno César da Silva, Stephen B Hanauer

{"title":"The role of immunogenicity in optimizing biological therapies for inflammatory bowel disease.","authors":"Konika Sharma, Bruno César da Silva, Stephen B Hanauer","doi":"10.1080/17474124.2025.2468302","DOIUrl":"10.1080/17474124.2025.2468302","url":null,"abstract":"Introduction: Immunogenicity of biologic agents for inflammatory bowel disease (IBD) is a critical issue, especially for tumor necrosis factor (TNF) inhibitors, where anti-drug antibodies (ADAs) significantly impact drug clearance, efficacy, and safety. Studies have demonstrated that non-TNF biologics tend to have lower susceptibility to immunogenicity, potentially offering advantages, especially in long-term management. Understanding these differences is important for optimizing IBD treatment outcomes.Areas covered: This review examines immunogenicity associated with different classes and individual biologic agents used in IBD; including TNF inhibitors and biologics targeting integrins and interleukins. We discuss key factors influencing ADAs formation, including drug structure, route of administration, and patient-specific factors. The literature reviewed includes recent clinical studies and long-term trials focusing on strategies to reduce immunogenicity such as therapeutic drug monitoring (TDM) and advanced combination.Expert opinion: While newer biologics demonstrate lower immunogenicity compared to anti-TNF agents, challenges remain in management to overcome existing ADAs responses while advances in genetic profiling, point-of-care TDM, and combination therapies offer promising pathways to reduce immunogenicity and enhance treatment durability. Continued research and innovation in biologic delivery methods, such as oral and subcutaneous formulations, will be critical in the next decade to further mitigate immunogenic risks and improve patient outcomes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-16"},"PeriodicalIF":3.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440414","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}

引用次数: 0

Endoscopic ultrasound guided liver biopsy and portal pressure gradient: when, why and how? Can it become the standard of care in endo-hepatology?

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-25 DOI: 10.1080/17474124.2025.2469838

Jahnvi Dhar, Amit Yadav, Suvradeep Mitra, Zaheer Nabi, Manik Aggarwal, Pankaj Gupta, Antonio Facciorusso, Stefano Francesco Crinò, Guru Trikudanathan, Jayanta Samanta

{"title":"Endoscopic ultrasound guided liver biopsy and portal pressure gradient: when, why and how? Can it become the standard of care in endo-hepatology?","authors":"Jahnvi Dhar, Amit Yadav, Suvradeep Mitra, Zaheer Nabi, Manik Aggarwal, Pankaj Gupta, Antonio Facciorusso, Stefano Francesco Crinò, Guru Trikudanathan, Jayanta Samanta","doi":"10.1080/17474124.2025.2469838","DOIUrl":"10.1080/17474124.2025.2469838","url":null,"abstract":"Introduction: The armamentarium of 'Endo-hepatology' is proliferating with the advancements in techniques and availability of new devices in the field of endoscopic ultrasound (EUS). This has resulted in the merger of multitude of diagnostic and therapeutic interventions, such as EUS-liver biopsy (LB), EUS-angioembolization of gastric varices, EUS-portal pressure gradient (PPG) measurement, and others into a 'one-stop-shop' for efficient patient management. Lack of standardization of these techniques forms a major hinderance in their widespread adoption.Areas covered: A comprehensive literature search was undertaken across various databases on EUS-LB and EUS-PPG till November 2024 for reviews, observational studies, and randomized trials on EUS-LB and EUS-PPG, describing its indications, technique, and data of safety and efficacy, detailing its role in day-to-day clinical practice.Expert opinion: EUS-LB and EUS-PPG have shown promise in the ever-growing field of endo-hepatology. EUS-LB has exhibited excellent safety profile and comparable tissue yield compared to its percutaneous counterpart. On the other hand, EUS-PPG seems to be a viable alternative although it needs to be standardized further. From a patient and hospital perspective, they might prove to be convenient and cost-effective. Nevertheless, more evidence is warranted before they can be labeled as the new standard of care.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-18"},"PeriodicalIF":3.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467547","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}

引用次数: 0

Progressing advanced therapies for inflammatory bowel disease: Current status including dual biologic therapy and discontinuation of biologics.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-24 DOI: 10.1080/17474124.2025.2469832

Kazuo Yashima, Hiroki Kurumi, Naoyuki Yamaguchi, Hajime Isomoto

{"title":"Progressing advanced therapies for inflammatory bowel disease: Current status including dual biologic therapy and discontinuation of biologics.","authors":"Kazuo Yashima, Hiroki Kurumi, Naoyuki Yamaguchi, Hajime Isomoto","doi":"10.1080/17474124.2025.2469832","DOIUrl":"10.1080/17474124.2025.2469832","url":null,"abstract":"Introduction: Advanced therapies (ADT) that encompass biological agents and small molecules have been approved for the treatment of inflammatory bowel disease (IBD), broadening the spectrum of available treatment options. Nevertheless, a substantial proportion of patients fail to achieve satisfactory responses, necessitating surgical intervention. Treatment objectives have evolved beyond clinical remission, reduction of inflammation, and mucosal healing, shifting focus toward enhancing the quality of life, acknowledging the profound impact of IBD on physical and mental well-being.Area covered: This comprehensive review describes the current landscape of ADT for IBD, including dual biologic therapy (DBT), which involves the combination of two biologics or a single biologic with a small-molecule compound, as well as considerations surrounding the discontinuation of biologics.Expert opinion: ADT is the standard treatment for moderate to severe IBD, while DBT appears promising for specific subsets of patients, including those with refractory disease or extraintestinal manifestations. However, these approaches may increase the risk of adverse effects, including malignancy. To optimize individualized treatment strategies in patients with refractory IBD, further trials are needed to refine ADT's predictive value, establish DBT's safety and indications, define biologic discontinuation criteria, and evaluate emerging biomarkers, artificial intelligence, and bowel ultrasound in patient management.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-20"},"PeriodicalIF":3.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448609","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}

引用次数: 0