Gut最新文献

{"title":"Seeing the unseen: AI radiomics unmasking occult pancreatic cancer?","authors":"Patrick Michl, Laura Roth","doi":"10.1136/gutjnl-2026-338712","DOIUrl":"https://doi.org/10.1136/gutjnl-2026-338712","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856163","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":"Metabolic mechanisms of duodeno-ileal diversion: early bile acid and incretin signalling predict glycaemic outcomes.","authors":"Pichamol Jirapinyo, Francisco Schlottmann, Rudolf Buxhoeveden, David Lautz, Marvin Ryou, Christopher C Thompson","doi":"10.1136/gutjnl-2026-338307","DOIUrl":"https://doi.org/10.1136/gutjnl-2026-338307","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836993","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":"Tumour-autonomous IL-6 signalling creates a metabolic vulnerability in intrahepatic cholangiocarcinoma.","authors":"Francisco Javier Cubero, Rocio I R Macias","doi":"10.1136/gutjnl-2026-338744","DOIUrl":"https://doi.org/10.1136/gutjnl-2026-338744","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837024","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":"Maternal influenza infection during pregnancy and subsequent risk of inflammatory bowel diseases in offspring: a nationwide birth cohort study in South Korea.","authors":"Yujin Choi, Hyunjee Kim, Jaeyu Park, Dongjin Yeo, Jiseung Kang, Dong Keon Yon","doi":"10.1136/gutjnl-2026-338084","DOIUrl":"https://doi.org/10.1136/gutjnl-2026-338084","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836956","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":"Digital twins in IBD-bridging data, biology and trial innovation.","authors":"Michael Colwill, Sailish Honap, Anna-Mary Young, Fernando Magro, Vipul Jairath, Silvio Danese, Laurent Peyrin-Biroulet","doi":"10.1136/gutjnl-2026-338447","DOIUrl":"https://doi.org/10.1136/gutjnl-2026-338447","url":null,"abstract":"<p><p>Clinical trials in IBD face difficulties of escalating complexity, high costs and challenges in recruitment. Digital twins are virtual, data-driven replicas of individual patients that model disease trajectories and treatment responses, which offer a potential innovative change in the conduct of clinical trials in IBD. Built from multimodal datasets integrating clinical, molecular, imaging and real-world data, digital twins can generate synthetic control arms, enable adaptive randomisation and predict disease relapse or treatment response. Early studies across oncology, cardiology and endocrinology demonstrate their feasibility and potential to improve statistical power while reducing patient burden. However, the integration of digital twins into clinical trials in IBD will require rigorous validation frameworks, transparent data governance and attention to algorithmic bias and consent. In this review, we explore how digital twins may transform IBD research-from in silico simulation to adaptive, patient-centred trial design-and outline the regulatory, ethical and logistical challenges to be considered in order to successfully integrate them into future trials.</p>","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769765","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":"Unusual case of diarrhoea.","authors":"Lin Han, Lu Hong, Lisha Yi, Yadong Lai, Qunzhang Zeng","doi":"10.1136/gutjnl-2026-339123","DOIUrl":"https://doi.org/10.1136/gutjnl-2026-339123","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769840","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":"Low-enzyme acute pancreatitis-a diagnostic blind spot in current guidelines.","authors":"Gefu Cai,Alex Váradi,Márk Bérchegyi,Eszter Ágnes Szalai,Vivien Vass,Áron Vincze,Ferenc Izbéki,Mária Papp,László Czakó,Péter J Hegyi,Bálint Erőss,Péter Hegyi,Andrea Szentesi, ","doi":"10.1136/gutjnl-2025-337992","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-337992","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":"99 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147754651","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":"Next-generation AI for visually occult pancreatic cancer detection in a low-prevalence setting with longitudinal stability and multi-institutional generalisability.","authors":"Sovanlal Mukherjee,Ajith Antony,Nandakumar G Patnam,Kamaxi H Trivedi,Aashna Karbhari,Khurram Khaliq Bhinder,Armin Zarrintan,Joel G Fletcher,Mark Truty,Matthew P Johnson,Suresh T Chari,Ajit Harishkumar Goenka","doi":"10.1136/gutjnl-2025-337266","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-337266","url":null,"abstract":"BACKGROUNDFailure of conventional imaging to detect pancreatic ductal adenocarcinoma (PDA) at its visually occult pre-diagnostic stage is a primary barrier to improving its otherwise poor rate of survival.OBJECTIVETo develop and validate the Radiomics-based Early Detection MODel (REDMOD), an AI framework to identify subvisual radiomic signatures of pre-diagnostic PDA on standard-of-care CT.DESIGNSREDMOD was trained on a multi-institutional cohort (n=969; 156 pre-diagnostic, 813 control) and tested on an independent set (n=493; 63 pre-diagnostic, 430 control), simulating a low prevalence (~1:6) early detection paradigm. The fully automated framework couples AI-driven segmentation with a heterogeneous ensemble architecture trained on a 40-feature radiomic signature derived from Synthetic Minority Over-sampling Technique (SMOTE)-balanced data. A tunable Youden Index-optimised classification threshold enables performance calibration without retraining. Validation included direct comparison with radiologists, longitudinal test-retest analysis and external specificity validation across two independent cohorts (n=539 and n=80).RESULTSOn an independent test set (n=493), REDMOD identified occult PDA (AUC 0.82; 73.0% sensitivity) at a median 475-day lead time. This represented nearly twofold higher sensitivity than radiologists (38.9%; p<0.001), which grew to nearly threefold (68.0% vs 23.0%) at >24 months lead time. REDMOD showed strong longitudinal stability (90-92% concordance) and generalisable specificity across multi-institutional (81.3%; n=539) and public (87.5%; n=80) datasets. Mechanistic analyses confirmed predictive power derived principally from multi-scale wavelet-filtered textural features (90% of selected signature), which outperformed unfiltered features (AUC 0.82 vs 0.74; p=0.007) in capturing subvisual architectural disruptions.CONCLUSIONSREDMOD is an automated, mechanistically grounded, longitudinally stable, externally validated AI that surpasses radiologists for PDA detection at its visually occult pre-diagnostic stage. These attributes position it for prospective validation in high-risk cohorts, a necessary step towards shifting the paradigm from late-stage symptomatic diagnosis to proactive pre-clinical interception.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"21 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147754579","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":"Metagenomic identification of gut microbiome signatures for accurate diagnosis and prognostic prediction of Epstein-Barr virus-associated nasopharyngeal carcinoma.","authors":"Kaiqi Lan,Defeng Bai,Li Yuan,Hao Luo,Jing Jin,Su-Chen Li,Lin-Fang Wu,Xue-Song Sun,Sai-Lan Liu,Qiu-Yan Chen,Hai-Qiang Mai,Yong-Xin Liu,Lin-Quan Tang","doi":"10.1136/gutjnl-2026-338223","DOIUrl":"https://doi.org/10.1136/gutjnl-2026-338223","url":null,"abstract":"BACKGROUNDNasopharyngeal carcinoma (NPC) is strongly associated with Epstein-Barr virus (EBV) infection. The gut microbiome can influence outcomes of viral infections but the potential links among the gut microbiome, EBV infection and NPC remain unclear.OBJECTIVETo characterise gut microbiome alterations in EBV-associated NPC, evaluate microbiome-based diagnostic performance (alone and in combination with EBV markers), and explore associations between microbial features, EBV DNA burden, prognosis and the tumour microenvironment.DESIGNWe conducted a large-scale shotgun metagenomic study including 516 patients with EBV-associated NPC and 263 healthy controls. Microbiome dysbiosis, functional pathways and associations with plasma EBV DNA were assessed. Species-level markers were used to build a random forest classifier for NPC diagnosis, and performance was evaluated alone and in combination with EBV-specific markers. Survival analyses were performed to identify microbial features associated with NPC-related mortality and relationships with an immune-suppressive tumour microenvironment were explored.RESULTSNPC was characterised by gut microbiome dysbiosis, including depletion of short-chain fatty acid-producing species and reduced butanoate metabolism, which were significantly associated with plasma EBV DNA. A random forest classifier based on species-level markers distinguished NPC from controls with an area under the curve (AUC) of 0.917; performance improved to an AUC of 0.984 when combined with EBV-specific markers. Specific microbial species were associated with NPC-related mortality and prognostic microbial features were linked to an immune-suppressive tumour microenvironment.CONCLUSIONEBV-associated NPC is associated with distinct gut microbiome and functional alterations that correlate with plasma EBV DNA. Microbial markers show strong diagnostic potential, particularly when integrated with EBV-specific markers, and prognostic microbial features may be linked to an immune-suppressive tumour microenvironment, supporting a potential role of the gut microbiome in NPC tumourigenesis.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"36 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147754668","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":"JOSD1 drives hepatocellular carcinoma malignancy by modulating the ubiquitination-lactylation switch on PGAM1.","authors":"Qing Li,Kai Yu,Suiqing Zhou,Chunyao Fang,Liren Zhang,Feiyu Jin,Xiangyu Hou,Feifan Yao,Yuhong Tang,Jiali Xu,Ruizhi Zhang,Hao Peng,Song Tian,Yang Hu,Dianyu Liu,Xiaofeng Tie,Xiaoyu Liu,Shu Chen,Guandou Yuan,Wen-Li Xu,Mingbei Zhong,Lirong Zhang,Jiaxing Zhang,Yufeng Hu,Zhi-Gang She,Jingjing Dai,Xu Cheng,Songqing He,Xuehao Wang","doi":"10.1136/gutjnl-2025-337331","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-337331","url":null,"abstract":"BACKGROUNDMetabolic reprogramming is a hallmark of hepatocellular carcinoma (HCC), enabling rapid tumour growth and immune evasion. Protein post-translational modification (PTM) crosstalk is a critical regulator of cellular processes; however, its contribution to metabolic reprogramming in HCC remains unclear.OBJECTIVETo elucidate the function of the deubiquitinase JOSD1 in modulating PTM crosstalk and its impact on tumour glycolysis, progression and immunotherapy response in HCC.DESIGNWe combined multi-omics analyses with functional and mechanistic studies in cell lines, animal models and patient samples to characterise JOSD1 and its downstream pathways in HCC.RESULTSJOSD1 was identified as a gene associated with glycolysis and correlated with a poor prognosis. Its over-expression promoted malignant phenotypes and enhanced glycolytic flux. Mechanistically, the JOSD1-AARS1 axis cooperatively regulates the ubiquitination-lactylation crosstalk at the K251 residue of PGAM1, thereby stabilising PGAM1, enhancing its enzymatic activity and promoting lactate accumulation. This metabolic shift impaired CD8+ T cell infiltration and function, promoting immune suppression. Therapeutically, liver-targeted inhibition of JOSD1 effectively suppressed tumour progression and synergised with anti-PD-1 therapy, leading to prolonged survival.CONCLUSIONThe JOSD1-AARS1 axis regulates the ubiquitination-lactylation crosstalk on PGAM1, with JOSD1 acting as the critical upstream molecular switch that drives metabolic reprogramming and immune evasion in HCC. Targeting JOSD1 represents a promising therapeutic strategy to modulate tumour metabolism and improve immunotherapy efficacy.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"1 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147754669","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}