Gastroenterology Research最新文献

{"title":"Risk Factors for Mortality in Patients With Strangulating Intestinal Obstruction Who Present With Septic Disseminated Intravascular Coagulation Prior to the Initiation of Treatment.","authors":"En Amada, Yoshihiro Watanabe","doi":"10.14740/gr2119","DOIUrl":"https://doi.org/10.14740/gr2119","url":null,"abstract":"<p><strong>Background: </strong>Strangulating ileus is a life-threatening surgical emergency characterized by intestinal ischemia and necrosis due to impaired blood flow and is frequently complicated by septic disseminated intravascular coagulation (DIC). Despite surgical and intensive care management, prognosis remains extremely poor. Early identification of prognostic factors associated with mortality is therefore crucial. This study aimed to identify early predictors of poor prognosis in patients with strangulating ileus complicated by septic DIC.</p><p><strong>Methods: </strong>We retrospectively analyzed 67 patients diagnosed with strangulating ileus at a single institution between 2020 and 2024, who subsequently developed septic DIC according to the Japanese Society for Emergency Medicine criteria and were treated with recombinant thrombomodulin (rTM). Patients with preoperative intestinal perforation, malignant tumors, or those receiving maintenance dialysis were excluded. Systemic inflammatory response syndrome (SIRS) score, Quick Sequential Organ Failure Assessment (qSOFA) score, Sequential Organ Failure Assessment (SOFA) score, DIC score, and white blood cell (WBC) count were evaluated preoperatively (Pre) and on the day after rTM administration (Day 1). Patients were divided into a survival group (S group) and a mortality group (M group), and variables were compared between groups. Univariate and multivariate logistic regression analyses were performed to identify independent prognostic factors.</p><p><strong>Results: </strong>Among the 67 patients, 38 survived and 29 died. On Day 1, SIRS scores, qSOFA scores, SOFA scores, and DIC scores were all significantly higher in the mortality group than in the survival group (P < 0.05). Mortality was also significantly higher in patients with a Day 1 WBC count < 8,000/µL and those with a Day 1 DIC score > 4. Multivariate logistic regression analysis identified a Day 1 WBC count < 8,000/µL (odds ratio (OR), 19.8; 95% confidence interval (CI), 3.64-72.6; P = 0.012) and a Day 1 DIC score > 4 (OR, 1.75; 95% CI, 1.27-9.34; P = 0.04) as independent predictors of mortality.</p><p><strong>Conclusions: </strong>In patients with strangulating ileus complicated by septic DIC, early leukopenia and persistently high DIC scores after rTM administration are independent poor prognostic factors. Early recognition of these indicators may allow prompt escalation of intensive care and contribute to improved outcomes in this highly lethal condition.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"19 1","pages":"28-34"},"PeriodicalIF":1.7,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Impact of <i>Clostridioides difficile</i> Infection on Thirty-Day Readmissions and Outcomes Following Coronary Artery Bypass Grafting: A Seven-Year National Analysis.","authors":"Abhin Sapkota, Ninda Sherpa, Maria Grba, Fernando Sigala, Ernesto Luna, Gedion Yilma Amdetsion, Hemant R Mutneja, Vikram Kotwal","doi":"10.14740/gr2099","DOIUrl":"https://doi.org/10.14740/gr2099","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> infection (CDI) is a common hospital-acquired infection, particularly seen among patients who undergo coronary artery bypass grafting (CABG). This study aimed to assess the trends and impact of CDI on 30-day readmissions and outcomes in CABG patients.</p><p><strong>Methods: </strong>This retrospective analysis used the Nationwide Readmissions Database from 2016 to 2022. Patients undergoing CABG were identified using International Classification of Diseases, 10th Revision (ICD-10) procedure codes. Patients with CDI were identified using ICD-10 diagnosis codes. Multiple logistic regression was performed to adjust for confounding factors. Trend analysis was done.</p><p><strong>Results: </strong>A total of 1,279,605 adult patients undergoing CABG were included, of whom 5,567 (0.44%) had concurrent CDI. Patients with CDI were older (mean age 68.6 vs. 66.3 years, P < 0.001) and had higher medical comorbidity (Charlson Comorbidity Index ≥ 3: 68.4% vs. 45.35%, P < 0.001). They also had significantly higher rates of 30-day readmissions (12.63% vs. 7.35%, adjusted odds ratio (aOR), 1.42), in-hospital mortality (11.64% vs. 2.58%, aOR, 2.72), and complications including cardiac arrest (7.56% vs. 2.04%, aOR, 2.55), cardiogenic shock (26.89% vs. 9.50%, aOR, 2.33), sepsis/septic shock (26.05% vs. 2.51%, aOR, 8.28), all with P < 0.001. Over the study period, there was a decline in CABG admissions. CDI incidence among CABG patients also declined with a parallel decline in 30-day readmissions.</p><p><strong>Conclusions: </strong>Patients who underwent CABG with concurrent CDI experienced greater readmission rates, mortality, periprocedural adverse events, and resource utilization. Further studies need to be done for possible interventions to reduce these outcomes.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"19 1","pages":"18-27"},"PeriodicalIF":1.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Therapeutic Response Predicts Outcome in Chronic Constipation: A Multicenter Prospective Observational Study.","authors":"Tadayuki Oshima, Seiji Futagami, Yoshimasa Tanaka, Mariko Hojo, Kimio Isshi, Kazuki Kakimoto, Yujiro Uchiyama, Hiroshi Iida, Atsushi Oshio, Koji Nakada","doi":"10.14740/gr2071","DOIUrl":"https://doi.org/10.14740/gr2071","url":null,"abstract":"<p><strong>Background: </strong>Chronic constipation, common in clinical practice, requires treatment to enhance quality of life and possibly extend life expectancy. However, predictors of treatment efficacy remain largely unexplored. This study aimed to identify factors predicting treatment success in patients with chronic constipation.</p><p><strong>Methods: </strong>A multicenter, prospective observational study evaluated patients with moderate to severe chronic constipation using the Chronic Constipation-Therapeutic Efficacy and Satisfaction Test (CC-TEST) questionnaire. Symptoms were assessed before treatment and at 2 and 4 weeks post-treatment. Multivariate analyses identified predictive factors based on three treatment efficacy assessment criteria: patient's impression, numeric rating scale (NRS) for symptom intensity, and spontaneous bowel movement (SBM) frequency status.</p><p><strong>Results: </strong>Constipation medications were administered to 97 patients, with significant symptom improvements observed at 2 and 4 weeks (CC-TEST). The greatest effects were seen in hard stools, difficulty in defecation, and infrequent bowel movements. In the multiple regression analysis, baseline clinical characteristics and symptom profiles were not significant predictors of treatment response. Incorporating 2-week treatment responsiveness revealed that non-responsiveness at 2 weeks (β = 0.487), and a lower stool symptom subscale score (β = -0.344), were associated with poorer patient's impression. For the NRS, non-responsiveness at 2 weeks (β = 0.279) was a significant predictor. For SBM, non-responsiveness at 2 weeks (β = -0.274) predicted outcomes. Including 2-week non-responsiveness improved the predictive accuracy for 4-week efficacy.</p><p><strong>Conclusions: </strong>The therapeutic response at 2 weeks is the most significant predictor of subsequent treatment response at 4 weeks in patients with chronic constipation.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"19 1","pages":"43-53"},"PeriodicalIF":1.7,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acyl-CoA Synthetase Long-Chain Family Member 4 in Liver Injury: Multidimensional Regulation and Therapeutic Potential.","authors":"Ming Xing Liang, Mao Yi Wang, Yu Zhi Su, Ying Zhou, Yu Xin Xie, Wei Li, Ying Hua Chen, Yi Huai He","doi":"10.14740/gr2098","DOIUrl":"https://doi.org/10.14740/gr2098","url":null,"abstract":"<p><p>Acyl-CoA synthetase long-chain family member 4 (ACSL4) is a key enzyme that catalyzes the conjugation of long-chain fatty acids with coenzyme A to form acyl-CoA, showing particularly high specificity for polyunsaturated fatty acids. In recent years, ACSL4 has gained increasing attention for its central role in various liver diseases, including metabolic dysfunction-associated steatotic liver disease, liver fibrosis, hepatocellular carcinoma, and ferroptosis. This article systematically elaborates on the expression profiles and localization of ACSL4 in different liver cell types, as well as its multidimensional regulatory mechanisms in liver injury and the pathogenesis of related diseases. In addition, it explores the potential therapeutic prospects of targeting ACSL4.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"19 1","pages":"1-17"},"PeriodicalIF":1.7,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy of Early and Late Vedolizumab or Infliximab Interventions in Moderate Ulcerative Colitis: A Multicenter, Retrospective Cohort Study.","authors":"Rui Ping Meng, Jian Zhang, Hao Qi Wei, Xi Ping Liao, En Liu, Hui Lin, Bao Bao Huang, Lin Lyu, Yan Ling Wei, Jian Yun Zhou, Xia Xie","doi":"10.14740/gr2092","DOIUrl":"https://doi.org/10.14740/gr2092","url":null,"abstract":"<p><strong>Background: </strong>Late biologic intervention has been partly displaced during the last decade by early biologic therapy. However, there is a scarcity of direct evidence to inform clinical decision-making with greater confidence. The study aimed to compare the efficacy and safety of the early biologic approach with those of the late biologic approach in patients with moderate ulcerative colitis (UC).</p><p><strong>Methods: </strong>Moderate UC patients treated with biologics between January 2021 and February 2024 from three Chinese centers were retrospectively included. The outcomes included steroid-free clinical remission rates, clinical remission rates, and mucosal healing rates at week 14 and week 52.</p><p><strong>Results: </strong>A total of 124 moderate UC cases were included. No marked differences in the steroid-free clinical remission rates and clinical remission rates were observed between the two groups at week 14 or at week 52 (P > 0.050). The early biologic therapy group exhibited a numerically higher mucosal healing rate at week 14 (23.3% vs. 12.5%, P = 0.115) and week 52 (15/27 (55.6%) vs. 13/37 (35.1%), P = 0.104) compared to the late biologic therapy group, yet there was no significant difference between two groups.</p><p><strong>Conclusion: </strong>No significant differences in steroid-free clinical remission, clinical remission, and mucosal healing were observed between early and late biologic intervention group.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"19 1","pages":"35-42"},"PeriodicalIF":1.7,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Prevalence of Irritable Bowel Syndrome: An Updated Systematic Review and Meta-Analysis.","authors":"Jhosmer Ballena-Caicedo, Lupita Ana Maria Valladolid-Sandoval, Fiorella E Zuzunaga-Montoya, Victor Juan Vera-Ponce","doi":"10.14740/gr2095","DOIUrl":"10.14740/gr2095","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain and alterations in bowel habits. Previous studies show variability in its prevalence according to region and diagnostic criteria used. The objective was to conduct a systematic review and meta-analysis of the global prevalence of IBS, considering studies that used Rome III and IV criteria.</p><p><strong>Methods: </strong>A systematic search was conducted in Scopus, Embase, PubMed, Web of Science, and Scielo through March 2024. Observational studies reporting IBS prevalence using Rome III or IV criteria were included. Studies in specific populations, conference abstracts, and gray literature were excluded. Methodological quality was assessed using Munn's tool for prevalence studies. Meta-analyses were performed using random-effects models with Freeman-Tukey double arcsine transformation, subgroup analyses by probabilistic sampling, meta-regressions by year, and publication bias assessment through funnel plots.</p><p><strong>Results: </strong>Forty-three studies (26 Rome III, 17 Rome IV) with 188,885 participants were included. The global prevalence was 13.21% (95% confidence interval (CI): 10.70-15.94%) with Rome III and 17.14% (95% CI: 12.00-22.99%) with Rome IV. When considering only studies with probabilistic sampling, prevalences adjusted to 11.19% and 13.28%, respectively. Higher prevalence was found in women (Rome III: 15.69% vs. 11.10% in men; Rome IV: 20.17% vs. 11.45%). Meta-regression showed a trend toward increased prevalence in recent years.</p><p><strong>Conclusion: </strong>Rome IV showed a higher prevalence than Rome III, possibly due to a more precise definition of abdominal pain. The heterogeneity found suggests the need to standardize methodologies and conduct more studies with probabilistic sampling, especially in underrepresented regions.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"18 6","pages":"308-321"},"PeriodicalIF":1.7,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>HFE</i>-C282Y/C282Y Hemochromatosis Patients Have Lower Serum Transferrin and Strong Negative Correlations Between Iron, Ferritin, and Transferrin Saturation Versus Transferrin Compared With <i>HFE</i>-wt/wt Wild-Type Subjects.","authors":"Nils Thorm Milman","doi":"10.14740/gr2100","DOIUrl":"10.14740/gr2100","url":null,"abstract":"<p><strong>Background: </strong><i>HFE</i>-C282Y/C282Y hemochromatosis patients have lower serum transferrin levels than normal individuals, but the reason for this discrepancy has drawn little scientific attention and remains unclarified. The objective of this study was to examine transferrin levels and their correlations with other biochemical iron status markers in Danish patients with the C282Y/C282Y variant and compare with corresponding correlations in a population of healthy Danes with the <i>HFE</i>-wt/wt genotype.</p><p><strong>Methods: </strong>The study comprised 21 patients (11 men) who completed a questionnaire about age, number of years with hemochromatosis, and at least 10 consecutive blood sample results, including ferritin, iron, transferrin and transferrin saturation (TSAT). The control group consisted of 958 persons (441 men).</p><p><strong>Results: </strong>The findings were comparable in both genders: 1) All but one patient had significantly lower transferrin levels than controls; 2) Serum iron and ferritin showed negative correlations with transferrin; 3) TSAT displayed strong negative correlations with transferrin; 4) Positive correlations were present between iron and ferritin, iron and TSAT, and ferritin and TSAT.</p><p><strong>Conclusions: </strong>Hemochromatosis patients had lower transferrin levels than controls, contributing to a higher TSAT; the explanation for this remains unsolved. Patients displayed negative correlations between iron and ferritin vs. transferrin, as well as negative correlations between TSAT and transferrin, suggesting that high TSAT levels may accelerate the degradation of transferrin. In <i>HFE</i>-patients, transferrin metabolism is not clarified, and the potential influence of the C282Y/C282Y variant is unknown. Contrary to \"normal\" metabolism, which is primarily regulated by iron levels, many patients maintain low transferrin and high TSAT even after iron depletion. It would be valuable to explore whether this decrease in transferrin reflects reduced hepatic synthesis or increased degradation. There is a need for further investigation of this important dilemma in <i>HFE</i>-hemochromatosis.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"18 6","pages":"276-285"},"PeriodicalIF":1.7,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Chronic Pancreatitis Etiology on Clinical Outcomes: A Population-Based Propensity-Matched Analysis.","authors":"Khaled Elfert, Mohammed Abusuliman, Mohamed Eldesouki, Omar T Ahmed, Hazem Abosheaishaa, Azizullah Beran, Mouhand Mohamed, Mahmoud Nassar, Shailendra Singh, Sherif Elhanafi","doi":"10.14740/gr2050","DOIUrl":"10.14740/gr2050","url":null,"abstract":"<p><strong>Background: </strong>Chronic pancreatitis (CP) is a complex disease with various underlying etiologies, including alcohol consumption, smoking, autoimmune disorders, genetic predispositions, and other less common causes. Despite extensive research, the impact of these different etiologies on disease progression, complication rates, and long-term outcomes remains insufficiently understood. In particular, the distinction between alcohol-related chronic pancreatitis (ARCP) and non-alcohol-related chronic pancreatitis (NARCP) is not well established in terms of prognosis and therapeutic needs.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study utilizing the TriNetX US Collaborative Network to compare baseline characteristics and clinical outcomes of ARCP versus NARCP. Propensity score matching (PSM) was applied to balance baseline characteristics between both cohorts. Primary outcome was mortality, while secondary outcomes included exocrine pancreatic insufficiency (EPI), pseudocyst formation, development of diabetes and pancreatic cancer, and need for endoscopic retrograde cholangiopancreatography (ERCP) and celiac plexus injection.</p><p><strong>Results: </strong>A total of 203,432 patients with CP were identified, including 11,696 ARCP and 200,560 with NARCP. After PSM (11,678 per group), ARCP was associated with significantly lower rates of mortality (13.0% vs. 16.2%; risk ratio (RR) 0.80), diabetes (22.9% vs. 35.8%; RR 0.64), exocrine pancreatic insufficiency (2.0% vs. 6.1%; RR 0.32), pancreatic cancer (1.1% vs. 8.4%; RR 0.14), and pseudocyst formation (7.1% vs. 9.7%; RR 0.73) compared to NARCP (all P < 0.001). ARCP patients also had lower rates of celiac plexus injection (0.1% vs. 0.8%; RR 0.12) and ERCP (2.3% vs. 10.2%; RR 0.23) (both P < 0.001).</p><p><strong>Conclusion: </strong>In this large, retrospective cohort study, patients with ARCP demonstrated lower rates of mortality, complications, and need for interventions compared to those with NARCP. These findings highlight potential differences in disease progression and clinical management between ARCP and NARCP. Further studies are needed to elucidate underlying mechanisms contributing to these disparities and to refine patient-specific treatment approaches.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"18 6","pages":"269-275"},"PeriodicalIF":1.7,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Regulatory Mechanism of Gastric Motility by Acetylcholine.","authors":"Jun Young Lee, Hyo-Yung Yun, Dae Hoon Kim, Seung Myoung Son, Woong Choi, Hun Sik Kim, Ki Bae Kim, Seung Heun Kang, Hahn Jin Jung, Dong Wook Lee, Wen-Xie Xu, Kyung-Kuk Hwang, Sang Jin Lee, Young Chul Kim, Jang-Whan Bae","doi":"10.14740/gr2063","DOIUrl":"10.14740/gr2063","url":null,"abstract":"<p><strong>Background: </strong>Acetylcholine (ACh), a crucial neurotransmitter for gastric contractions, induces triphasic contraction in stomach. However, the precise mechanism of ACh-induced phasic contractions (AiPCs) remains unclear. Recent data suggest the chloride channel (Cl^- channel) may be the principal channel for AiPC in the stomach. Previous studies demonstrated that the opening of the ATP-sensitive potassium (K_ATP) channel inhibits AiPC. However, it has not been studied whether inhibition of energy metabolism can regulate AiPC in gastric smooth muscles via this channel. This study investigated whether AiPC in gastric smooth muscle are mediated by chloride channels and modulated by K_ATP channels under conditions of energy metabolism inhibition.</p><p><strong>Methods: </strong>Isolated gastric smooth muscle strips from mice and humans were used to record isometric contraction. The subunits of Cl^- and K_ATP channels were evaluated by Western blot.</p><p><strong>Results: </strong>Niflumic acid and 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS), known to block the Cl^- channel, inhibited AiPC in gastric smooth muscles of mice. Sodium cyanide (NaCN) and dextro-mannitol, which inhibit energy metabolism, reduced AiPC in gastric smooth muscles of mice. NaCN also lowered AiPC in gastric smooth muscles of humans and vasomotion in human arterial smooth muscles. By Western blot, subunits of the K_ATP and Cl^- channels were identified in gastric smooth muscles of mice and arterial smooth muscles of humans.</p><p><strong>Conclusions: </strong>This is the first study to demonstrate that suppression of energy metabolism reduces AiPC through activation of K_ATP channels in both murine and human gastric smooth muscle, linking metabolic state to excitatory neurotransmission. Vasomotions in arterial smooth muscles of humans are also decreased by inhibition of energy metabolism.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"18 6","pages":"286-298"},"PeriodicalIF":1.7,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Tofacitinib for Acute Severe Ulcerative Colitis: A Systematic Review and Meta-Analysis.","authors":"Gregory Brennan, Gilmara Coelho Meine, Lucas Monteiro Delgado, Paula Santo","doi":"10.14740/gr2086","DOIUrl":"10.14740/gr2086","url":null,"abstract":"<p><strong>Background: </strong>Acute severe ulcerative colitis (ASUC) is associated with a high risk of colectomy. About 30% of patients do not respond to steroids, requiring rescue therapy. This study aims to evaluate the efficacy and safety of tofacitinib in ASUC.</p><p><strong>Methods: </strong>MEDLINE, Embase, and Cochrane Library were systematically searched. We used random-effects model to calculate pooled proportions with 95% confidence intervals (CIs). For outcomes with ≥ 2 comparative studies, we conducted pairwise meta-analyses and calculated pooled odds ratios (ORs) with 95% CIs.</p><p><strong>Results: </strong>We included six studies. Tofacitinib had a 90-day colectomy rate of 15.1% (95% CI: 8.5-25.3%). The clinical response rate at weeks 12 - 14 was 45.4% (95% CI: 32.6-58.9%), and at week 52 was 30.0% (95% CI: 17.4-46.5%). The clinical remission rate at weeks 12 - 14 was 38.1% (95% CI: 28.7-48.5%), and at week 52 was 27.1% (95% CI: 15.2-43.5%). Steroid-free clinical remission rate was 28.6% (95% CI: 22.2-36.1%) at weeks 12 - 14 and 33.1% (95% CI: 25.6-41.6%) at week 52. The most common adverse events were <i>Clostridioides difficile</i> infection, nausea, cardiovascular events, arthralgia or myalgia, herpes zoster infection, venous thromboembolism, and pneumonia. There was no significant difference in 90-day colectomy rate between tofacitinib and control (OR: 0.52; 95% CI: 0.25 - 1.08; P = 0.08).</p><p><strong>Conclusion: </strong>Tofacitinib demonstrated high clinical response and remission rates, and low adverse events rate. Additionally, there was a trend toward a lower 90-day colectomy rate compared to controls.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"18 6","pages":"299-307"},"PeriodicalIF":1.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}