Gastroenterology最新文献

{"title":"Evaluating Research Strategy and Inclusion Criteria of Long-term Proton Pump Inhibitor Use","authors":"Yanqing Niu, Xiaherezhati Aihaiti, Man Li","doi":"10.1053/j.gastro.2024.07.047","DOIUrl":"10.1053/j.gastro.2024.07.047","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"167 7","pages":"Page 1494"},"PeriodicalIF":25.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142283927","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":"The Search for the Ideal Weight Loss Drug: Targeting NTS-GLP1R Neurons for Satiety Without Aversion","authors":"Lin Y. Hung, Kara Gross Margolis","doi":"10.1053/j.gastro.2024.07.031","DOIUrl":"10.1053/j.gastro.2024.07.031","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"167 7","pages":"Page 1493"},"PeriodicalIF":25.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878638","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":"Comparative Efficacy of Advanced Therapies for Management of Moderate-to-Severe Ulcerative Colitis: 2024 American Gastroenterological Association Evidence Synthesis","authors":"Ashwin N. Ananthakrishnan ,&nbsp;M. Hassan Murad ,&nbsp;Frank I. Scott ,&nbsp;Manasi Agrawal ,&nbsp;John P. Haydek ,&nbsp;Berkeley N. Limketkai ,&nbsp;Edward V. Loftus Jr ,&nbsp;Siddharth Singh","doi":"10.1053/j.gastro.2024.07.046","DOIUrl":"10.1053/j.gastro.2024.07.046","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>We performed an updated systematic review and network meta-analysis to inform the 2024 American Gastroenterological Association (AGA) Clinical Guidelines on the management of moderate-to-severe ulcerative colitis (UC).</div></div><div><h3>Methods</h3><div>We searched multiple electronic databases through November 21, 2023, to identify randomized controlled trials in adults with moderate-to-severe UC, comparing different advanced therapies (tumor necrosis factor antagonists, vedolizumab, sphingosine-1-phosphate receptor modulators, interleukin 12/23 or selective interleukin 23 antagonists, and Janus kinase [JAK] inhibitors) against placebo or another active comparator. Our primary outcomes were induction and maintenance of clinical remission, and our secondary outcome was endoscopic improvement. We performed a network meta-analysis using a frequentist approach and applied Grading of Recommendations, Assessment, Development and Evaluation (GRADE) to appraise certainty of evidence.</div></div><div><h3>Results</h3><div>After excluding JAK inhibitors as potential first-line treatment (in accordance with the United States Food and Drug Administration), low-certainty evidence supports clinically important benefit with infliximab, ozanimod, risankizumab, and guselkumab over adalimumab and mirikizumab for achieving remission with induction therapy in biologically naïve patients with moderate-to-severe UC, with risankizumab and ozanimod being ranked the highest for induction of clinical remission. With the inclusion of JAK inhibitors as first-line therapy, upadacitinib was more efficacious compared with all other medications except ozanimod and risankizumab, with low- to moderate-certainty evidence. In patients with prior biologic exposure, upadacitinib, tofacitinib, and ustekinumab were ranked highest for achieving remission.</div></div><div><h3>Conclusions</h3><div>Using Grading of Recommendations, Assessment, Development and Evaluation to appraise quality of evidence, this updated network meta-analysis will be used to inform comparative efficacy and positioning of advanced therapies for the treatment of biologic-naïve and biologic-exposed patients with moderate-to-severe UC.</div></div>","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"167 7","pages":"Pages 1460-1482"},"PeriodicalIF":25.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142449796","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":"An Empirical Dietary Pattern Associated With the Gut Microbial Features in Relation to Colorectal Cancer Risk","authors":"Kai Wang ,&nbsp;Chun-Han Lo ,&nbsp;Raaj S. Mehta ,&nbsp;Long H. Nguyen ,&nbsp;Yiqing Wang ,&nbsp;Wenjie Ma ,&nbsp;Tomotaka Ugai ,&nbsp;Hidetaka Kawamura ,&nbsp;Satoko Ugai ,&nbsp;Yasutoshi Takashima ,&nbsp;Kosuke Mima ,&nbsp;Kota Arima ,&nbsp;Kazuo Okadome ,&nbsp;Marios Giannakis ,&nbsp;Cynthia L. Sears ,&nbsp;Jeffrey A. Meyerhardt ,&nbsp;Kimmie Ng ,&nbsp;Nicola Segata ,&nbsp;Jacques Izard ,&nbsp;Eric B. Rimm ,&nbsp;Mingyang Song","doi":"10.1053/j.gastro.2024.07.040","DOIUrl":"10.1053/j.gastro.2024.07.040","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Epidemiologic evidence for dietary influence on colorectal cancer (CRC) risk through the gut microbiome remains limited.</div></div><div><h3>Methods</h3><div>Leveraging 307 men and 212 women with stool metagenomes and dietary data, we characterized and validated a sex-specific dietary pattern associated with the CRC-related gut microbial signature (CRC Microbial Dietary Score [CMDS]). We evaluated the associations of CMDS with CRC risk according to <em>Fusobacterium nucleatum</em>, <em>pks</em>⁺ <em>Escherichia coli</em>, and enterotoxigenic <em>Bacteroides fragilis</em> status in tumor tissue using Cox proportional hazards regression in the Health Professionals Follow-Up Study (1986–2018), Nurses’ Health Study (1984–2020), and Nurses’ Health Study II (1991–2019).</div></div><div><h3>Results</h3><div>The CMDS was characterized by high industrially processed food and low unprocessed fiber-rich food intakes. In 259,200 participants, we documented 3854 incident CRC cases over 6,467,378 person-years of follow-up. CMDS was associated with a higher risk of CRC (<em>P</em>_trend &lt; .001), with a multivariable hazard ratio (HR_{Q5 vs Q1}) of 1.25 (95% CI, 1.13–1.39). The association remained after adjusting for previously established dietary patterns, for example, the Western and prudent diets. Notably, the association was stronger for tumoral <em>F nucleatum–</em>positive (HR_{Q5 vs Q1}, 2.51; 95% CI, 1.68–3.75; <em>P</em>_trend &lt; .001; <em>P</em>_{heterogeneity} = .03, positivity vs negativity), <em>pks</em>⁺ <em>E coli–</em>positive (HR_{Q5 vs Q1}, 1.68; 95% CI, 0.84<em>–</em>3.38; <em>P</em>_trend = .005; <em>P</em>_{heterogeneity} = .01, positivity vs negativity), and enterotoxigenic <em>Bacteroides fragilis–</em>positive CRC (HR_{Q5 vs Q1}, 2.06; 95% CI, 1.10<em>–</em>3.88; <em>P</em>_trend = .016; <em>P</em>_{heterogeneity} = .06, positivity vs negativity), compared with their negative counterparts.</div></div><div><h3>Conclusions</h3><div>CMDS was associated with increased CRC risk, especially for tumors with detectable <em>F nucleatum</em>, <em>pks</em>⁺ <em>E coli</em>, and enterotoxigenic <em>Bacteroides fragilis</em> in tissue. Our findings support a potential role of the gut microbiome underlying the dietary effects on CRC.</div></div>","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"167 7","pages":"Pages 1371-1383.e4"},"PeriodicalIF":25.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906395","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":"Dietary Pattern Linking to Intestinal Microbial Characteristics and Colorectal Cancer Risk","authors":"Jun Sun","doi":"10.1053/j.gastro.2024.08.012","DOIUrl":"10.1053/j.gastro.2024.08.012","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"167 7","pages":"Pages 1264-1265"},"PeriodicalIF":25.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999758","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":"Bridging the Diagnostic Gap: How Autonomous Artificial Intelligence Can Assist in Endoscopic Diagnosis of Experts","authors":"Hantong Hu","doi":"10.1053/j.gastro.2024.02.037","DOIUrl":"10.1053/j.gastro.2024.02.037","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"167 7","pages":"Pages 1497-1498"},"PeriodicalIF":25.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021403","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":"A Rare Case of Skin and Small Intestine Pigmentation","authors":"Song Xu ,&nbsp;Siqi Tao ,&nbsp;Yan Chen","doi":"10.1053/j.gastro.2024.07.002","DOIUrl":"10.1053/j.gastro.2024.07.002","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"167 7","pages":"Pages 1278-1282"},"PeriodicalIF":25.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590109","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":"Comments on “Metabolic Dysfunction–Associated Fibrosis 5 (MAF-5) Score Predicts Liver Fibrosis Risk and Outcome in the General Population With Metabolic Dysfunction”","authors":"Yuting Guan,&nbsp;Jiaming Yang,&nbsp;Zudong Xu","doi":"10.1053/j.gastro.2024.07.043","DOIUrl":"10.1053/j.gastro.2024.07.043","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"167 7","pages":"Pages 1504-1505"},"PeriodicalIF":25.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153665","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":"Management of Small Bowel Crohn’s Disease Strictures: To Cut, to Stretch, or to Treat Inflammation?","authors":"Cathy Lu ,&nbsp;Brian G. Feagan ,&nbsp;Joel G. Fletcher ,&nbsp;Mark Baker ,&nbsp;Stefan Holubar ,&nbsp;Florian Rieder ,&nbsp;Stenosis Therapy and Anti-Fibrotic Research Consortium","doi":"10.1053/j.gastro.2024.08.030","DOIUrl":"10.1053/j.gastro.2024.08.030","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"167 7","pages":"Pages 1283-1291.e1"},"PeriodicalIF":25.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119409","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":"Crohn’s Patients and Healthy Infants Share Immunodominant B Cell Response to Commensal Flagellin Peptide Epitopes","authors":"Qing Zhao ,&nbsp;Lennard Wayne Duck ,&nbsp;John T. Killian Jr ,&nbsp;Alexander F. Rosenberg ,&nbsp;Peter J. Mannon ,&nbsp;R. Glenn King ,&nbsp;Lee A. Denson ,&nbsp;Subra Kugathasan ,&nbsp;Edward N. Janoff ,&nbsp;Maria C. Jenmalm ,&nbsp;Charles O. Elson","doi":"10.1053/j.gastro.2024.08.015","DOIUrl":"10.1053/j.gastro.2024.08.015","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Inflammatory bowel disease (IBD) is a chronic manifestation of dysregulated immune response to the gut microbiota in genetically predisposed hosts. Nearly half of patients with Crohn’s disease (CD) develop selective serum immunoglobulin (Ig)G response to flagellin proteins expressed by bacteria in the <em>Lachnospiraceae</em> family. This study aimed to identify the binding epitopes of these IgG antibodies and assess their relevance in CD and in homeostasis.</div></div><div><h3>Methods</h3><div>Sera from an adult CD cohort, a treatment-naïve pediatric CD cohort, and 3 independent non-IBD infant cohorts were analyzed using novel techniques including a flagellin peptide microarray and a flagellin peptide cytometric bead array.</div></div><div><h3>Results</h3><div>A dominant B cell peptide epitope in patients with CD was identified, located in the highly conserved “hinge region” between the D0 and D1 domains at the amino-terminus of <em>Lachnospiraceae</em> flagellins. Elevated serum IgG reactivity to the hinge peptide was strongly associated with incidence of CD and the development of disease complications in children with CD up to 5 years in advance. Notably, high levels of serum IgG to the hinge epitope were also found in most infants from 3 different geographic regions (Uganda, Sweden, and the United States) at 1 year of age, which decrements rapidly afterward.</div></div><div><h3>Conclusions</h3><div>These findings identified a distinct subset of patients with CD, united by a shared reactivity to a dominant commensal bacterial flagellin epitope, that may represent failure of a homeostatic response to the gut microbiota beginning in infancy.</div></div>","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"167 7","pages":"Pages 1415-1428"},"PeriodicalIF":25.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035648","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}