Expert Review of Gastroenterology & Hepatology最新文献_第3页

Anti-fibrotic therapy in Crohn's disease: hype or reality-can intestinal fibrosis be targeted effectively? 克罗恩病的抗纤维化治疗：炒作还是现实——肠道纤维化能有效靶向吗？

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-07-01 Epub Date: 2026-06-28 DOI: 10.1080/17474124.2026.2695461

Sailish Honap, Axel Dignass, Vipul Jairath, Silvio Danese, Fernando Magro, Laurent Peyrin-Biroulet

{"title":"Anti-fibrotic therapy in Crohn's disease: hype or reality-can intestinal fibrosis be targeted effectively?","authors":"Sailish Honap, Axel Dignass, Vipul Jairath, Silvio Danese, Fernando Magro, Laurent Peyrin-Biroulet","doi":"10.1080/17474124.2026.2695461","DOIUrl":"10.1080/17474124.2026.2695461","url":null,"abstract":"Introduction: Fibrostenotic Crohn's disease remains a major unmet clinical need, as currently licensed therapies primarily target inflammation and have not been shown to prevent fibrosis progression or reverse established strictures. Renewed interest in intestinal fibrosis, coupled with an expanding therapeutic pipeline, has prompted renewed debate over whether anti-fibrotic therapy in Crohn's disease represents hype or a realistic therapeutic opportunity.Areas covered: This special report summarizes emerging anti-fibrotic strategies in Crohn's disease, including clinical data for ontunisertib and preclinical evidence for anti-TL1A therapies and obefazimod. It also examines lessons from successful anti-fibrotic drug development in pulmonary and hepatic fibrosis, focusing on pathway selection, patient stratification, endpoint development, and trial design.Expert opinion: Early clinical and translational findings suggest that targeting fibrosis in Crohn's disease may be feasible. In the authors' view, the greater challenge lies in developing the tools and trial frameworks needed to demonstrate that therapies can alter the course of fibrostenotic disease.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"627-631"},"PeriodicalIF":3.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338303","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

Microbial ecology and hepatocellular carcinoma: should a subset be viewed as a microbiome-conditioned malignancy? 微生物生态学和肝细胞癌：一个亚群应该被视为微生物组条件下的恶性肿瘤吗？

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-07-01 Epub Date: 2026-06-11 DOI: 10.1080/17474124.2026.2687711

Vishal G Shelat

引用次数: 0

Immunotherapy plus chemotherapy in advanced biliary tract cancers: pros and cons. 免疫疗法加化疗治疗晚期胆道癌：利弊。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-07-01 Epub Date: 2026-07-13 DOI: 10.1080/17474124.2026.2701716

Gagandeep Brar, Juan W Valle

{"title":"Immunotherapy plus chemotherapy in advanced biliary tract cancers: pros and cons.","authors":"Gagandeep Brar, Juan W Valle","doi":"10.1080/17474124.2026.2701716","DOIUrl":"10.1080/17474124.2026.2701716","url":null,"abstract":"Introduction: Biliary tract cancers (BTC) are highly immunosuppressive 'cold' tumors with limited treatment options. In unresectable or advanced-stage disease, the combination of immune checkpoint inhibition with chemotherapy resulted in a modest survival benefit over chemotherapy.Areas covered: In this review, current obstacles and strategies to improve the benefit of immunotherapy are highlighted. This includes challenges in optimizing patient selection, understanding the tumor microenvironment and interactions with the gut microbiome, and improving combination treatment strategies, whether with targeted agents, locoregional therapies, or other evolving immune therapies. For this review, we performed a PubMed database search and summarized all relevant clinical studies utilizing ICIs in biliary tract cancers from 2019 to the present.Expert opinion: Checkpoint inhibition plus chemotherapy is established as a new standard of care for patients with advanced BTC, with a clinically meaningful subset of patients now achieving durable long-term survival that was previously rare in this disease. The next challenge is to broaden that benefit through biomarker-driven patient selection, use of immunotherapy in earlier stages of disease, and through rational combination strategies. Importantly, these approaches should be grounded in a better understanding of tumor biology as well as the host immune microenvironment.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"647-656"},"PeriodicalIF":3.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430361","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

Management of gastric varices: treatment options and opportunities to improve outcomes. 胃静脉曲张的治疗：治疗方案和改善预后的机会。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-07-01 Epub Date: 2026-06-24 DOI: 10.1080/17474124.2026.2687717

Michael B MacIsaac, Alex Wynne, Peter Hayes

{"title":"Management of gastric varices: treatment options and opportunities to improve outcomes.","authors":"Michael B MacIsaac, Alex Wynne, Peter Hayes","doi":"10.1080/17474124.2026.2687717","DOIUrl":"10.1080/17474124.2026.2687717","url":null,"abstract":"Introduction: Gastric varices represent a challenging clinical scenario due to the severity of consequences when bleeding occurs, the cohort of patients in which it occurs, and a paucity of high-quality prospective data to guide treatment decisions. While a range of endoscopic and radiologic management strategies are now available, ambiguity exists about when to utilize each of these therapies.Areas covered: This study comprehensively reviewed current management considerations and the positioning of available treatment modalities for gastric varices. A literature search was performed using PubMed to identify peer-reviewed articles published until December 2025.Expert opinion: While a lack of large, randomized trials limits the ability to provide definitive guidance for the management of gastric varices, individualized patient care and a multidisciplinary approach with close collaboration between hepatologists, interventional endoscopists, and radiologists is vital. Prompt endoscopic assessment remains important and allows initial management with either direct endoscopic injection (cyanoacrylate glue or thrombin) or if available, EUS-guided therapy. Further follow‑up endoscopic or EUS-guided therapies appear to be safe and effective, but definitive management with radiologic procedures such as transjugular intrahepatic portosystemic shunt to address global portal hypertension or retrograde transvenous obliteration procedures is highly successful and should also be considered.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"633-645"},"PeriodicalIF":3.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307865","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

Hepatocellular carcinoma: new therapies on the horizon. 肝细胞癌：即将出现的新疗法。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-07-01 Epub Date: 2026-07-12 DOI: 10.1080/17474124.2026.2702585

Kizuki Yuza, Miho Akabane, Jun Kawashima, Timothy M Pawlik

{"title":"Hepatocellular carcinoma: new therapies on the horizon.","authors":"Kizuki Yuza, Miho Akabane, Jun Kawashima, Timothy M Pawlik","doi":"10.1080/17474124.2026.2702585","DOIUrl":"10.1080/17474124.2026.2702585","url":null,"abstract":"Introduction: Although immune checkpoint inhibitor (ICI)-based combinations have established the frontline standard for advanced hepatocellular carcinoma (HCC), substantial unmet needs persist-limited response rates, primary and acquired resistance, absent validated predictive biomarkers, and uncertainty regarding optimal sequencing. Hepatic decompensation may rival tumor progression as a determinant of survival in selected patients.Areas covered: Informed by a focused PubMed and Embase search prioritizing literature (January 2020-April 2026), this review examines near-horizon HCC therapies across three domains: emerging systemic agents beyond first-generation kinase inhibitors, including biomarker-directed strategies; evolving immunotherapy, including neoadjuvant ICI regimens associated with major pathological responses in 20-42%, transarterial chemoembolization-ICI combinations with positive progression-free survival in EMERALD-1 (15.0 vs 8.2 months) and LEAP-012 (14.6 vs 10.0 months), and conversion strategies; and locoregional innovations including personalized yttrium-90 dosimetry, stereotactic body radiation therapy, and histotripsy, a first-in-class FDA-approved noninvasive mechanical ablation modality. Translational considerations including hepatic reserve are also addressed.Expert opinion: Treatment sequencing represents the central operational challenge. Biomarker-informed selection, including emerging humoral immunity signatures, may refine frontline decision-making, although prospective validation is essential. A 'liver-first' management philosophy that prioritizes hepatic reserve alongside tumor control is likely to become integral to clinical practice and trial design.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"657-672"},"PeriodicalIF":3.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420044","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

Adjuvant therapy in biliary tract tumors: how will immunotherapy fit in the future? 胆道肿瘤的辅助治疗：免疫治疗将如何适应未来？

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-06-01 Epub Date: 2026-06-11 DOI: 10.1080/17474124.2026.2671178

Alejandro González-Sánchez, Diana Rosero, Raquel Fuentes, Eva Ruiz Hispán, Angela Lamarca

引用次数: 0

Contemporary epidemiology of metabolic dysfunction-associated steatotic liver disease. 代谢功能障碍相关脂肪变性肝病的当代流行病学研究。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-06-01 Epub Date: 2026-06-09 DOI: 10.1080/17474124.2026.2684599

Do Han Kim, Donghyun Ko, Aijaz Ahmed, Donghee Kim

{"title":"Contemporary epidemiology of metabolic dysfunction-associated steatotic liver disease.","authors":"Do Han Kim, Donghyun Ko, Aijaz Ahmed, Donghee Kim","doi":"10.1080/17474124.2026.2684599","DOIUrl":"10.1080/17474124.2026.2684599","url":null,"abstract":"Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is recognized as the most prevalent liver disease worldwide. Globally, it has impacted millions of individuals. With the recent change in terminology, MASLD is no longer a diagnosis of exclusion but rather a criterion-based diagnosis anchored around metabolic dysfunction. In addition to progressive liver fibrosis leading to cirrhosis, MASLD has been linked to extrahepatic complications, which include cardiovascular disease, non-liver-associated malignancies, and other adverse metabolic outcomes. Importantly, disease severity and prognosis are heterogeneous and are influenced by genetic susceptibility, environmental exposures, metabolic comorbidities, and behavioral risk factors.Areas covered: This review provides a contemporary overview of the global incidence and prevalence of MASLD. In addition, it also summarizes recent temporal trends to predict future disease burden. Ultimately, this review seeks to clarify the evolving epidemiologic landscape of MASLD and highlight key gaps that must be addressed to inform effective prevention, surveillance, and health system planning.Expert opinion: The rising prevalence of MASLD demands a shift from generic management to precision medicine. Since disease progression varies wildly based on genetics and metabolic profiles, future care must prioritize identifying high-risk phenotypes early. Without targeted interventions, the recognition of MASLD-related complications will be delayed.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"603-616"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149033","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

Proton pump inhibitors in children: indications and safety. 儿童质子泵抑制剂：适应症和安全性。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-06-01 Epub Date: 2026-06-05 DOI: 10.1080/17474124.2026.2683678

Antonio Corsello, Alessia Romano, Claudio Romano

{"title":"Proton pump inhibitors in children: indications and safety.","authors":"Antonio Corsello, Alessia Romano, Claudio Romano","doi":"10.1080/17474124.2026.2683678","DOIUrl":"10.1080/17474124.2026.2683678","url":null,"abstract":"Introduction: Proton pump inhibitors (PPIs) are among the most frequently prescribed medications in pediatric practice. While highly effective in acid-mediated disorders, concerns regarding overuse, inappropriate indications, and potential adverse effects have emerged, particularly in infants and children with nonspecific symptoms.Areas covered: This review summarizes the current evidence on the indications, efficacy, and safety of PPIs in the pediatric population. A literature search was performed in PubMed/MEDLINE and Embase, supplemented by landmark earlier studies and current clinical practice guidelines. We discuss guideline recommendations and examine the role of PPIs across different clinical scenarios including gastroesophageal reflux disease, esophagitis, eosinophilic esophagitis and special populations. Particular attention is given to emerging data on adverse outcomes, including infections, microbiome alterations, and long-term safety concerns. Strategies for appropriate prescribing, deprescribing, and individualized patient management are also addressed.Expert opinion: PPIs remain overprescribed in pediatrics, often for indications lacking clear benefit. Future efforts should prioritize diagnostic precision, short-term therapeutic trials and systematic deprescribing strategies. A shift toward stewardship-based prescribing, combined with improved clinician education and use of objective diagnostic tools, is essential to optimize outcomes and minimize unnecessary exposure.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"589-601"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156019","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

EUS-guided tissue acquisition: past achievements, current challenges and future directions. eus引导组织采集：过去的成就，当前的挑战和未来的方向。

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-06-01 Epub Date: 2026-06-04 DOI: 10.1080/17474124.2026.2683675

Francisco Vara-Luiz, Pedro Costa-Moreira, Cátia Leitão, Inês Costa-Santos, Marta Patita, Paraskevas Gkolfakis, Francisco Baldaque-Silva, Pedro Pinto-Marques

引用次数: 0

Lyon Consensus 2.0: what has changed for GERD diagnosis? 里昂共识2.0：胃食管反流诊断有何变化？

IF 3.3 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-06-01 Epub Date: 2026-06-15 DOI: 10.1080/17474124.2026.2683677

Fahmi Shibli, Raúl Alberto Jiménez-Castillo, Ronnie Fass

{"title":"Lyon Consensus 2.0: what has changed for GERD diagnosis?","authors":"Fahmi Shibli, Raúl Alberto Jiménez-Castillo, Ronnie Fass","doi":"10.1080/17474124.2026.2683677","DOIUrl":"10.1080/17474124.2026.2683677","url":null,"abstract":"Introduction: The Lyon 2.0 consensus was established to further refine the original Lyon Consensus and address gaps in reflux testing and endoscopic diagnosis of GERD. It represents a significant advancement in the diagnostic framework of GERD through modern definition of GERD, endoscopy findings, conclusive evidence of GERD and reflux testing metrics and thresholds.Areas covered: This is an overall review of the different aspects of GERD diagnosis that were updated in the Lyon 2 consensus compared with the original Lyon Consensus. The review also provides an expert opinion of Lyon 2.0 limitations, emphasizing practical implementation challenges, evidentiary gaps, and the need for a more globally adaptable and data-driven approach.Expert opinion: Lyon 2.0 consensus has markedly advanced GERD diagnosis by establishing a modern definition of GERD, identifying conclusive endoscopic findings for GERD, and introducing updated, standardized metrics and thresholds for reflux testing, along with guidance on appropriate testing both off and on therapy. However, there are several limitations to Lyon Consensus that should be recognized and they include, global access to esophageal testing, disparities, dependence on specialized expertise, regional variability in normative thresholds, reliance on PPI-centric definitions, inadequate integration of nonacid pepsin-mediated injury, and inherent consensus methodology biases.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"525-536"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162251","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