Gut最新文献

{"title":"Histology of subepithelial lesions (SELs) in the gastrointestinal tract-resected endoscopic: a database study of 4901 patients.","authors":"Zhipeng Qi, Enpan Xu, Shuchang Xu, Leiming Xu, XiaoBo Li, Liang Zhong, Dongli He, Pinghong Zhou, Zhendong Jin, Yunshi Zhong","doi":"10.1136/gutjnl-2024-333150","DOIUrl":"10.1136/gutjnl-2024-333150","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":"1205-1208"},"PeriodicalIF":23.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364409","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":"Single-cell omics in inflammatory bowel disease: recent insights and future clinical applications.","authors":"Victoria Gudiño, Raquel Bartolomé-Casado, Azucena Salas","doi":"10.1136/gutjnl-2024-334165","DOIUrl":"10.1136/gutjnl-2024-334165","url":null,"abstract":"<p><p>Inflammatory bowel diseases (IBDs), which include ulcerative colitis (UC) and Crohn's disease (CD), are chronic conditions characterised by inflammation of the intestinal tract. Alterations in virtually all intestinal cell types, including immune, epithelial and stromal cells, have been described in these diseases. The study of IBD has historically relied on bulk transcriptomics, but this method averages signals across diverse cell types, limiting insights. Single-cell omic technologies overcome the intrinsic limitations of bulk analysis and reveal the complexity of multicellular tissues at a cell-by-cell resolution. Within healthy and inflamed intestinal tissues, single-cell omics, particularly single-cell RNA sequencing, have contributed to uncovering novel cell types and cell functions linked to disease activity or the development of complications. Collectively, these results help identify therapeutic targets in difficult-to-treat complications such as fibrostenosis, creeping fat accumulation, perianal fistulae or inflammation of the pouch. More recently, single-cell omics have gradually been adopted in studies to understand therapeutic responses, identify mechanisms of drug failure and potentially develop predictors with clinical utility. Although these are early days, such studies lay the groundwork for the implementation in clinical practice of new technologies in diagnostics, monitoring and prediction of disease prognosis. With this review, we aim to provide a comprehensive survey of the studies that have applied single-cell omics to the study of UC or CD, and offer our perspective on the main findings these studies contribute. Finally, we discuss the limitations and potential benefits that the integration of single-cell omics into clinical practice and drug development could offer.</p>","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":"1335-1345"},"PeriodicalIF":23.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189037","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":"Putting the best foot forward: rethinking the paradigms in ASUC.","authors":"Shaji Sebastian, Vineet Ahuja, Ajit Sood","doi":"10.1136/gutjnl-2024-334267","DOIUrl":"10.1136/gutjnl-2024-334267","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":"1201-1202"},"PeriodicalIF":23.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398948","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 disease and ulcerative colitis exhibit prediagnostic antibody signatures with shared and divergent changes towards disease onset","authors":"Arno R Bourgonje, Sergio Andreu-Sánchez, Ranko Gacesa, Gabriel Innocenti, Iris N Kalka, Shelley Klompus, Sigal Leviatan, Yishay Schlesinger, David Krongauz, Adina Weinberger, Bert van der Vegt, Jingyuan Fu, Eran Segal, Alexandra Zhernakova, Thomas Vogl, Rinse K Weersma","doi":"10.1136/gutjnl-2024-334362","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-334362","url":null,"abstract":"Background The development of IBD is known to involve early immunological alterations, but our understanding of the changes in antibody epitope repertoires moving from the prediagnostic phase towards disease onset remains incomplete. Objective In this study, we comprehensively characterised systemic antibody responses in patients with IBD before and after disease onset, aiming to identify prediagnostic disease biomarkers. Design Within Lifelines, a population-based cohort study collecting and storing longitudinal samples from 167 000 individuals over∼15 years, we identified 178 individuals with blood samples taken both before and after IBD-onset. In these prediagnosis and postdiagnosis serum samples (median time span 3.9 years), we profiled antibody epitope repertoires against 344 000 rationally selected microbial, food and immune antigens using phage-display immunoprecipitation sequencing. Results Postdiagnosis, we observe reduced antibody frequencies against herpesviruses, particularly for Epstein-Barr virus and varicella zoster virus, and elevated antibody frequencies against specific enteroviruses, including adenovirus C and enterovirus types B and C. Even before diagnosis, individuals who ultimately developed Crohn’s disease (CD) displayed elevated antibody reactivity against flagellins of both commensal and pathogenic bacteria. This CD-specific profile became even more pronounced postdiagnosis, suggesting the formation of IBD-specific antibody responses years before disease onset. Conclusion This study is the first comprehensive high-resolution analysis of the exact antigenic nature of systemic antibody responses during the transition from prediagnostic to established IBD. The antibody signatures we found may represent a route to developing biomarkers that identify individuals at high risk of developing disease. Data are available upon reasonable request. Raw sequence data will be made available upon request to the corresponding author(s). Due to patient confidentiality, the data sets are available upon reasonable request to Lifelines.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"36 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547216","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":"Correction: pancreatic STAT5 activation promotes KrasG12D-induced and inflammation-induced acinar-to-ductal metaplasia and pancreatic cancer","authors":"BMJ Publishing Group Ltd and British Society of Gastroenterology","doi":"10.1136/gutjnl-2024-332225corr1","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-332225corr1","url":null,"abstract":"Lin Y, Pu S, Wang J et al . Pancreatic STAT5 activation promotes KrasG12D-induced and inflammation-induced acinar-to-ductal metaplasia …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"37 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547226","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":"Lifestyle factors, genetic susceptibility and risk of incident diverticulitis: an integrated analysis of four prospective cohort studies and electronic health records-linked biobank","authors":"Wenjie Ma, Jane Ha, Christopher J Neylan, Heather Munro, Duncan Skerrett, Jonathan M Downie, Magdalena Sevilla-González, Mark Steinwandel, Michael Mumma, Wei Zheng, Lillias H Maguire, Edward L Giovannucci, Lisa L Strate, Andrew T Chan","doi":"10.1136/gutjnl-2025-335364","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335364","url":null,"abstract":"Background Both lifestyle factors and genetic predisposition contribute to the development of diverticulitis. Objective To examine whether lifestyle modification can reduce the genetic risk of diverticulitis. Design We derived an overall healthy lifestyle score for diverticulitis based on smoking, body mass index (BMI), physical activity, fibre and red meat among 179 564 participants in three prospective cohorts-the Nurses’ Health Study (NHS), NHSII and the Health Professionals Follow-Up Study. The association between the healthy lifestyle score and incident diverticulitis was confirmed among 30 750 participants in the Southern Community Cohort Study (SCCS). We assessed genetic risk using a polygenic risk score among 36 077 individuals with genotype data available. We further validated our findings in the Mass General Brigham Biobank (MGBB). Results A healthy lifestyle score was associated with a decreased risk of diverticulitis. Compared with a score of 0, the multivariable-adjusted HR for a score of 5 was 0.50 (95% CI, 0.44 to 0.57; p trend<0.0001). This association was consistent across the SCCS in both non-Hispanic black and white populations. Each unit increase in the healthy lifestyle score was associated with a reduced diverticulitis risk similarly across genetic risk categories, with HRs of 0.89 (95% CI, 0.83 to 0.95) for low, 0.86 (0.81 to 0.92) for mid and 0.87 (0.83 to 0.91) for high genetic risk. In the MGBB cohort, a higher BMI was associated with an increased diverticulitis risk across genetic risk categories. Conclusion Maintaining a healthy lifestyle was associated with a reduced risk of developing diverticulitis, regardless of population differences and genetic susceptibilities. Data are available upon reasonable request. Because of participant confidentiality and privacy concerns, data cannot be shared publicly and requests to data access must be submitted in writing. According to standard controlled access procedures, applications to use NHS/NHSII/HPFS resources will be reviewed by our External Collaborations Committee to verify that the proposed use maintains the protection of the privacy of participants and the confidentiality of the data. Investigators wishing to use NHS/NHSII/HPFS data are asked to submit a brief description of the proposed project (go to <https://www.nurseshealthstudy.org/researchers> (contact email: nhsaccess@channing.harvard.edu) and <https://sites.sph.harvard.edu/hpfs/for-collaborators/> for details). For SCCS cohort data, a Request for Data and Biospecimen Use must be submitted through the SCCS online request system (ORS) at <https://ors.southerncommunitystudy.org/>, or by following the ‘Information for Researchers’ link at the SCCS website (www.southerncommunitystudy.org). Any questions concerning the electronic submission and review process can be emailed to datause@southerncommunitystudy.org. For MGB Biobank data, requests need to be sent to biobank@mgb.org.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"132 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533103","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":"Endoscopic injection of autologous fat tissue for the treatment of chronic gastrointestinal fistulas","authors":"Ivo Boskoski, Valerio Pontecorvi, Anna Amelia Caretto, Dania Nachira, Vincenzo Bove, Massimiliano Papi, Martina De Siena, Maria Valeria Matteo, Loredana Gualtieri, Stefano Margaritora, Stefano Gentileschi, Cristiano Spada","doi":"10.1136/gutjnl-2025-335754","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335754","url":null,"abstract":"Chronic gastrointestinal (GI) fistulas are complex and challenging to treat, often requiring repeated interventions. We present a novel endoscopic approach using mechanically activated autologous adipose tissue-derived mesenchymal cells (atMSCs), with an orbital force to enhance regenerative properties. Five patients with refractory GI fistulas underwent the procedure, achieving complete or almost complete closure in all cases without adverse events (follow-up: 3–12 months). This minimally invasive technique is safe, cost-effective and reproducible. Preliminary results are promising, prompting a prospective clinical trial (NCT06930079) to evaluate efficacy and quality-of-life outcomes at 2 and 6 months postprocedure. Chronic fistulas represent a complex nosologic entity. Treatment is complex, often requiring repeated endoscopic procedures or invasive surgical techniques, resulting in lengthy hospitalisations, onset of complications, disabling sequelae and often unsolved.1–3 In 2018, our centre started a new endoscopic approach, based on the regenerative properties of activated autologous fat tissue, with good results.4–7 The procedure was based on fat harvesting, passage through subsequent filters, and activation by centrifugation, then reinjection into the margins of the fistula’s orifice. This was complex, time-consuming and difficult to standardise. A new, user-friendly, cheap and fast technique was proposed, based on mechanical stimulation with oscillatory movements.8 Procedure: The harvested fat, taken from the medial region of the thighs through a suction microcannula, necessitates the use of a Digital Vortex Mixer (Elea Surgere S.R.L.). After placing the syringes with the lipoaspirate contents in the disposable cup on the Vortex Mixer, an orbital force of 2000 rpm is applied for 8 min (figure 1A). This process activates the atMSCs and separates the lipidic part and the serum (figure 1B). The liquid and the oil are discharged; instead, the remaining fat is emulsified, passing through a 2 mm filter and then loaded in a 19-gauge endoscopic needle for the endoscopic injection in the submucosal layer around the fistula …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"16 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533104","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 dual role of IgG4 in immunity: bridging pathophysiology and therapeutic applications","authors":"Ignazio Piseddu, Julia Mayerle, Ujjwal Mukund Mahajan, Daniel F R Boehmer","doi":"10.1136/gutjnl-2025-335375","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335375","url":null,"abstract":"IgG4 antibodies exhibit unique structural and functional properties, which distinguish them from other IgG subclasses. Among clinicians, IgG4 has been primarily associated with IgG4-related diseases (IgG4-RDs), such as autoimmune pancreatitis, where its role has been a focus of intense discussion. However, growing evidence reveals that IgG4 is involved in a broader spectrum of immune-regulatory processes, extending beyond IgG4-RDs and positioning it as a key modulator of immune tolerance. In this context, several specific features allow IgG4 to play dual roles, serving as a protective factor in immune regulatory settings, such as allergic responses and antibody therapies that require tolerance induction towards target cells, while its role in IgG4-RDs remains uncertain, potentially contributing to disease or mitigating tissue damage. This review examines the pathophysiological roles of IgG4 in the regulation of immune responses, highlighting its involvement in both homoeostasis and disease. Furthermore, it explores the therapeutic potential of harnessing IgG4’s unique features, not only for IgG4-associated diseases, but also for other indications, where promoting beneficial IgG4 responses could offer therapeutic advantages.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"47 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533105","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":"Withdrawal time, CADe and adenoma detection: a prospective study","authors":"Roupen Djinbachian, Mahsa Taghiakbari, Sara-Ivana Calce, Victoire Michal, Erik Deslandres, Mickael Bouin, Jeremy Liu Chen Kiow, Benoit Panzini, Simon Bouchard, Dane Christina Daoud, Daniel von Renteln","doi":"10.1136/gutjnl-2025-335380","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335380","url":null,"abstract":"Randomised controlled trials (RCTs) have shown that computer-aided detection (CADe) can significantly improve adenoma detection rates (ADRs). In contrast, implementation studies did not show ADR improvements when using CADe. To clarify the circumstances under which CADe might show the greatest effects on ADR, we analysed 1165 colonoscopies performed by 15 endoscopists in a prospective study examining CADe’s effects across varying withdrawal and mucosal inspection times. Our results indicate that, on average, CADe increased lesion detection, ADR and advanced adenoma detection rate (AADR) most when corrected withdrawal time (cWT) was under 6 min (ADR 36.1% vs 26.6% with and without CADe, respectively; AADR 9.8% vs 4.4%). However, once CWT exceeded 8 min, the effects of CADe increasing ADR declined markedly (45.4% vs 39.8%). These observations suggest that in an implementation setting, CADe can compensate for shorter inspection intervals and potentially serve as a ‘safety net’ technology. RCTs consistently show that CADe improves ADR in colonoscopy. However, implementation studies have reported no such benefit.1–3 We performed a secondary analysis of a prospective IRB-approved colonoscopy study (CER22.013) that included technology implementation (eg, CADe, CADx), full-length video recording and prospective documentation of all procedural findings (eg, timestamping of anatomical landmarks and polyp detection) of elective colonoscopy procedures for patients aged ≥18 years. A total of 1488 consecutive colonoscopies were performed within this CADe implementation study between December 2020 and July 2024 by 15 endoscopists, with or without using CADe, at the Centre Hospitalier de l'Université de Montréal. Patients undergoing colonoscopies for planned polypectomy procedures or sigmoidoscopies, incomplete or technical failure procedures, and procedures performed by endoscopists with fewer than 10 colonoscopies were excluded (figure 1), yielding a total of 1165 procedures (491 conventional, 674 with CADe). During the procedures, a designated research assistant documented the start and end times of the withdrawal phase and documented …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"19 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520649","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":"Coeliac disease and the intestinal barrier: mechanisms of disruption and strategies for restoration.","authors":"John A Damianos, Adam Bledsoe, Michael Camilleri, Joseph A Murray","doi":"10.1136/gutjnl-2025-335373","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335373","url":null,"abstract":"<p><p>Coeliac disease is characterised by immune-mediated damage to the small intestine in response to dietary gluten in genetically predisposed individuals. Increased intestinal permeability is a central component to its pathophysiology. This review explores the evidence for increased permeability in coeliac disease and the underlying mechanisms, including the roles of zonulin, inflammatory cytokines, microbial alterations and immune responses to gliadin peptides. We also review comprehensively the therapies targeting barrier integrity and normalising intestinal permeability, including particular diets and supplements, and experimental and improved medications including larazotide acetate and IMU-856. Finally, we highlight the need for reliable biomarkers for evaluating increased permeability in coeliac disease and advocate for further research on therapies which normalise barrier function, particularly as a strategy to maintain remission.</p>","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":""},"PeriodicalIF":23.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511800","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}