Gut最新文献

{"title":"Correction: Withdrawal of antitumour necrosis factor in inflammatory bowel disease patients in remission: a randomised placebo-controlled clinical trial of GETECCU","authors":"BMJ Publishing Group Ltd and British Society of Gastroenterology","doi":"10.1136/gutjnl-2024-333385corr1","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-333385corr1","url":null,"abstract":"Gisbert JP, Donday MG, Riestra S, et al. Withdrawal of antitumour necrosis factor in inflammatory bowel disease patients in remission: a randomised placebo-controlled …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"18 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568719","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":"Partial cure of chronic hepatitis B: potential implications for HCC surveillance?","authors":"Wai-Kay Seto, Anna Lok","doi":"10.1136/gutjnl-2025-336032","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-336032","url":null,"abstract":"Surveillance of hepatocellular carcinoma (HCC), via 6-monthly ultrasonography with alpha-fetoprotein testing, is currently recommended for patients with chronic liver disease at risk of HCC. Unlike other liver diseases where HCC occurs almost exclusively in patients with cirrhosis, up to 30% of hepatitis B virus (HBV)-associated HCC occurs in patients without cirrhosis.1 Thus, HCC surveillance is additionally recommended for individuals with non-cirrhotic chronic HBV on reaching a certain age, men >40 years and women >50 years in endemic countries, and as early as the third decade of life for individuals from Africa.2 This recommendation is based on a perceived 0.2% per year HCC incidence which was considered cost-effective for HCC surveillance.3 However, a more recent study found an HCC incidence of 0.4% per year to be cost-effective for surveillance at a higher willingness-to-pay level, with a major influence of surveillance adherence.4 HCC surveillance is underused in clinical practice. A meta-analysis found the rate of HCC surveillance among patients with chronic HBV and no cirrhosis to be 32%.1 Low adherence to HCC surveillance has been attributed to multiple patient-related, provider-related and health system-related barriers, including logistical and budgetary difficulties in administering a surveillance programme that can support large numbers of at-risk patients. Since patient adherence is crucial for the success of any surveillance strategy,4 improvement in risk stratification would allow optimisation of surveillance resources. This may be especially true for patients with inactive chronic HBV without cirrhosis, which comprises up to 70% of patients with chronic HBV5 and …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"26 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736736","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":"Performance of the China-CLIF framework in acute-on-chronic liver failure: a multicohort study across all aetiologies","authors":"Jinjin Luo, Meiqian Hu, Tingting Feng, Liyuan Zhang, Yan Huang, Yuxian Huang, Feng Ye, Jiang Li, Ferran Aguilar, Cristina Sánchez-Garrido, Eva Usón-Raposo, Bing Zhu, Qian Zhou, Xi Liang, Jiaqi Li, Peng Li, Jiaojiao Xin, Dongyan Shi, Jianming Zheng, Huafen Zhang, Baoju Wang, Wei Qiang, Heng Yao, Xingping Zhou, Jiaxian Chen, Wen Hu, Bingqi Li, Shiwen Ma, Xiao Wu, Xiao Li, Yuheng Kong, Feiyang Sun, Xi Chen, Tianzhou Wu, Lingling Yang, Suwan Sun, Beibei Guo, Lulu He, Jinjun Chen, Shaojie Xin, Xue Li, Huazhong Chen, Paolo Angeli, Rajiv Jalan, Bingliang Lin, Yu Chen, Shaoli You, Xin Chen, Alberto Queiroz Farias, Jonel Trebicka, Jing Jiang, Richard Moreau, Jun Li, The CANONIC, PREDICT, ACLARA Study Group","doi":"10.1136/gutjnl-2025-335651","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335651","url":null,"abstract":"Background Acute-on-chronic liver failure (ACLF) of various aetiologies is a complex syndrome with high short-term mortality and significant global burden. Objective To explore easily applicable diagnostic criteria and an accurate prognostic score for ACLF. Design Clinical data from 5288 patients (after exclusions from 7388 screened) with acute deterioration of chronic liver disease across various aetiologies were used to evaluate the performance of European Chronic Liver Failure (CLIF) and Chinese Group on the Study of Severe Hepatitis B (COSSH) criteria. Three non-Asian cohorts were performed to validate the results. Results CLIF criteria categorised 844 patients as ACLF (28-day/90-day liver transplantation (LT)-free mortality: 40.7%/57.0%; 321 with non-hepatitis B virus (HBV) aetiology, 523 with HBV aetiology), while COSSH criteria categorised 2038 patients as ACLF (mortality: 27.3%/41.0%; 602 with non-HBV aetiology, 1436 with HBV aetiology). COSSH criteria identified 22.6% (1194/5288) more patients (mortality: 19.1%/31.4%) compared with CLIF criteria, including 14.2% non-HBV patients (mortality: 15.9%/33.3%). COSSH criteria produced a more reasonable epidemiological pyramid-like distribution across severity grades (grades 1–3: 63.4%/27.5%/9.1% vs CLIF’s grades 1–3: 25.8%/56.3%/17.9%). COSSH-ACLF II score showed the highest predictive values for 28-day/90-day LT-free mortality in both cirrhotic and all ACLF patients with various aetiologies, outperforming the CLIF-C ACLF and other scores. The comparable performance of China-CLIFs (renamed from COSSH-ACLFs) was validated in three non-Asian cohorts. Conclusions This study evaluated the broader applicability of the China-CLIF framework across diverse aetiologies and varying severity levels of ACLF. These findings may provide a valuable foundation for harmonising ACLF diagnostic and prognostic system. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"75 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710631","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":"Anticoagulation in colorectal ESD: implications for bleeding risk management.","authors":"Abdulrahman Qatomah,Daryl Ramai,Hiroyuki Aihara","doi":"10.1136/gutjnl-2025-336419","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-336419","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":"110 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701078","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":"Recent advances in clinical practice endohepatology: the endoscopic liver rush.","authors":"Emma Vanderschueren,Michael Praktiknjo,Reiner Wiest,Andres Cardenas,Jonel Trebicka,Wim Laleman","doi":"10.1136/gutjnl-2025-334725","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-334725","url":null,"abstract":"The integration of advanced endoscopy within the practice of hepatology is nowadays heralded in the concept of 'endohepatology' and is dichotomised in applications intervening for disorders of the hepatic parenchyma and vasculature and for biliary tract disease. Current applications under the umbrella of endohepatology focus on advanced diagnostics and vascular, metabolic and hepatobiliary interventions. These involve, among others, endoscopic ultrasound (EUS)-guided liver biopsy, EUS-guided portal pressure gradient measurement, coil and glue embolisation of gastric varices and spontaneous portosystemic shunts, artificial-assisted cholangioscopy.In this review, we aim to focus on different applications within endohepatology which are at the benchtop (or coming close by) and attempt to prognosticate potential future techniques within this rapidly evolving field.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"703 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701326","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":"Pericyte drives the formation of circulating tumour cell-neutrophil clusters to promote colorectal cancer metastasis.","authors":"Sheng Wang,Geni Ye,Xiaoling Xu,Yuning Lin,Xiaobo Li,Zhang Zhang,Ming Qi,Lin Tan,Minjing Cheng,Haishan Zhang,Jinghua Pan,Changwei Lin,Dandan Huang,Rong Deng,Xiaomei Li,Guangsuo Wang,Shenghui Qiu,Xiaodong Chu,Yuhong Chen,Huhu Zeng,Junqiu Zhang,Chenran Wang,Hanlin Shuai,Changzheng Shi,Xia Yuan,Yihai Cao,Minfeng Chen,Maohua Huang,Wencai Ye,Dongmei Zhang","doi":"10.1136/gutjnl-2024-334618","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-334618","url":null,"abstract":"BACKGROUNDCirculating tumour cell (CTC)-neutrophil clusters represent a key driver and a hallmark of tumour metastasis; however, efficient approaches for their elimination are still lacking.OBJECTIVEThis study sought to elucidate the location and mechanisms of CTC-neutrophil cluster formation and develop more effective antimetastasis strategies.DESIGNImmunofluorescence staining of clinical colorectal cancer (CRC) samples was performed to identify the location of CTC-neutrophil clusters. The correlation between the expression of nicotinamide N-methyltransferase (NNMT) in pericytes and patient prognosis, as well as its association with CTC-neutrophil cluster formation, was assessed using clinical specimens and public CRC datasets. The formation process of CTC-neutrophil clusters was visualised using intravital microscope and microfluidic vascular chip models. Bulk RNA sequencing, xenograft and allograft models and pericyte-specific genetic Nnmt deficiency mice were used to investigate the effect of pericyte NNMT on CTC-neutrophil cluster formation and CRC metastasis.RESULTSCTC-neutrophil clusters formed at the vascular-immune interface of CRC primary tumours. Pericytes with high NNMT expression could serve as a poor prognostic biomarker that indicated an increased risk of developing metastasis in CRC. NNMT highly NNMT-expressing pericytes facilitated the formation of CTC-neutrophil clusters by mediating the cellular interaction among CRC cells, neutrophils and endothelial cells through activating the CXCL5/CXCR2 axis. Genetic and pharmacological inhibition of NNMT in pericytes eliminated CTC-neutrophil clusters and suppressed CRC liver metastasis.CONCLUSIONThis study uncovers the previously undefined location and mechanism of CTC-neutrophil cluster formation and underscores the potential of pericyte-driven CTC-neutrophil clusters as a valuable prognostic indicator and therapeutic target for CRC metastasis.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"711 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693265","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":"How accurate is EUS-guided direct portal vein pressure measurement? A comparison with intraoperative measurements.","authors":"Aniruddha Pratap Singh,Zaheer Nabi,Anand Kulkarni,Shujaath Asif,Nitin Jagtap,Sana Fatima Memon,Pradev Inavolu,Priscilla Lopez,Mithun Sharma,Hardik Rughwani,G V Prem,Bala Chandran,Kumar Swamy,Mohan Ramchandani,D Nageshwar Reddy,Sundeep Lakhtakia","doi":"10.1136/gutjnl-2025-335661","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335661","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":"115 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693204","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":"Mitochondrial dysfunction drives basal cell hyperplasia in eosinophilic oesophagitis.","authors":"Masaki Morimoto,Kento Kawasaki,Niamh McNamee,Samuel Flashner,Rieko Shimonosono,Masataka Shimonosono,Norihiro Matsuura,Yasuto Tomita,Wataru Hirose,Ryugo Teranishi,Takefumi Itami,Manti Guha,Pavithra Rajagopalan,Cecilia Martin,Hailey Golden,Diya Dhakal,Benjamin J Wilkins,Andres J Klein-Szanto,Kirk J Wangensteen,Julian A Abrams,Sydney Pomenti,David A Katzka,Jianwen Que,Kelly A Whelan,Amanda B Muir,Hirohito Kita,Benjamin L Wright,Alfred D Doyle,Hiroshi Nakagawa,Uma M Sachdeva","doi":"10.1136/gutjnl-2024-334561","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-334561","url":null,"abstract":"BACKGROUNDEosinophilic oesophagitis (EoE) is a food allergen-induced inflammatory disorder characterised by interleukin (IL)-13-mediated oesophageal inflammation and epithelial basal cell hyperplasia (BCH). The role of mitochondria in EoE pathogenesis remains elusive.DESIGNPrompted by single cell transcriptomics data, we interrogated the role of mitochondria in EoE pathobiology using patient biopsies, EoE-mouse models and oesophageal epithelial cells grown in monolayer and three-dimensional (3D) organoid cultures treated with EoE-relevant cytokines. 3D organoids and EoE-bearing mice were treated with omeprazole-a proton-pump inhibitor used as first-line EoE therapy. We performed CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) interference in mouse organoids to identify the key mitochondrial regulatory genes whose depletion may lead to BCH. We analysed mitochondrial membrane potential, mass and superoxide production by flow cytometry, cellular oxygen consumption by respirometry, mitochondrial structures and perturbation of cellular energy homeostasis by immunoblotting.  RESULTS : Mitochondrial dysfunction appeared to be a hallmark of EoE-related BCH where mitochondrial structural damage was associated with impaired oxidative respiratory capacity, elevation of mitochondrial superoxide and decreased adenosine triphosphate (ATP) production, as corroborated by activation of the adenosine monophosphate (AMP) -activated protein kinase and suppression of mammalian target-of-rapamycin signalling. Depletion of PGC1A, the master regulator of mitochondria biogenesis, recapitulated EoE-related BCH, suggesting that mitochondrial dysfunction drives BCH. Further, omeprazole alleviated mitochondrial damage and dysfunction in EoE-related BCH modelled in mice and patient-derived organoids.  CONCLUSION: Mitochondrial dysfunction is tightly linked to perturbation of redox homeostasis in EoE-related BCH, which is promoted by IL-13 and reversible with omeprazole treatment.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"14 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693263","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":"Statin use association with all-cause mortality and liver-related outcomes: are the benefits true?","authors":"Waseem Amjad,Braden Thomas","doi":"10.1136/gutjnl-2025-336398","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-336398","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":"53 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693264","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":"Insulin-like peptide 5 is released in response to bile acid in the rectum and is associated with diarrhoea severity in patients with bile acid diarrhoea.","authors":"Christopher A Bannon,Julian R F Walters,Tongzhi Wu,Richard G Kay,Austin Punnoose,Robin C Spiller,Jonathan Wilson,Petra Verdino,Peter Barker,Keith Burling,Michael Horowitz,Christopher K Rayner,Alexander C Ford,Frank Reimann,Fiona M Gribble","doi":"10.1136/gutjnl-2025-335393","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335393","url":null,"abstract":"BACKGROUNDInsulin-like peptide 5 (INSL5) is an enteroendocrine hormone expressed in distal colonic 'L cells'. Bile acid receptor agonists are known to stimulate INSL5 secretion in primary cell culture, and administration of an INSL5 analogue in animals promotes colonic motility.OBJECTIVEThis study used a new immunoassay to measure INSL5 in human blood samples, enabling assessment of whether rectal bile acids stimulate INSL5 release in humans and whether INSL5 levels are altered in patients with chronic diarrhoea.DESIGNSerum/plasma samples from previously performed studies were used, including healthy volunteers (n=7) who received a rectal enema of taurocholic acid (TCA); fasting and post prandial samples from healthy volunteers (n=10); patients with bile acid diarrhoea (BAD) (n=19) or irritable bowel syndrome with diarrhoea (IBS-D) (n=8); and patients with IBS-D (n=64) treated with ondansetron or placebo.RESULTSRectal TCA but not a control enema promptly elevated plasma INSL5, with the increase in INSL5 correlating negatively with time to, and positively with desire to, defecate post enema. Healthy volunteers had low INSL5 levels (<100 pg/mL), with no change following a mixed meal. Patients with BAD had elevated INSL5 levels, with average stool consistency being positively correlated with serum INSL5 (p<0.001). In people with IBS-D, INSL5 was elevated (>100 pg/mL) in 42%, and this subgroup showed greater improvements in stool consistency with ondansetron therapy (p<0.05).CONCLUSIONThe study highlights that rectal bile acids stimulate INSL5 secretion in humans, and that INSL5 levels are associated with a colonic pro-motility response and pathophysiology of chronic diarrhoea.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"49 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693266","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}