Gut最新文献

{"title":"Risk of metachronous advanced neoplasia in patients with serrated lesions depending on follow-up schedule.","authors":"Juliette Labelle, Roupen Djinbachian, Heiko Pohl, Douglas K Rex, Edgard Medawar, Benoit Panzini, Mickael Bouin, Edmond-Jean Bernard, Daniel von Renteln","doi":"10.1136/gutjnl-2024-333681","DOIUrl":"10.1136/gutjnl-2024-333681","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":"1548-1550"},"PeriodicalIF":25.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440423","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":"Screening and eradication of Helicobacter pylori for gastric cancer prevention: Taipei Global Consensus II","authors":"Jyh-Ming Liou, Peter Malfertheiner, Tzu-Chan Hong, Hsiu-Chi Cheng, Kentaro Sugano, Shailja Shah, Bor-Shyang Sheu, Mei-Jyh Chen, Tsung-Hsien Chiang, Yi-Chu Chen, Yoshio Yamaoka, Sunny H Wong, Chieh-Chang Chen, Yeong Yeh Lee, Duc Trong Quach, Deng-chyang Wu, Ping-I Hsu, Chun-Ying Wu, Jeng-Yih Wu, Jiing-Chyuan Luo, Wei-Lun Chang, Hong Lu, Hidekazu Suzuki, Hwoon-Yong Jung, Varocha Mahachai, Ratha-korn Vilaichone, Francis Mégraud, Jaw-Town Lin, Khay-Guan Yeoh, Wai Keung Leung, Emad M El-Omar, Yi-Chia Lee, Ming-Shiang Wu","doi":"10.1136/gutjnl-2025-336027","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-336027","url":null,"abstract":"Objective To convene a global consensus on Helicobacter pylori ( H pylori ) screening and eradication strategies for gastric cancer prevention, identify key knowledge gaps and outline future research directions. Methods 32 experts from 12 countries developed and refined consensus statements on H pylori management, using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to assess evidence and the Delphi method to achieve ≥80% agreement. Results Consensus was achieved on 28 statements. Eradication of H pylori , the primary cause of gastric cancer, reduces the risk of gastric cancer across all age groups, with the greatest risk reduction before the onset of premalignant conditions. H pylori eradication also promotes ulcer healing, prevents ulcer recurrence and reduces the risk of NSAID/aspirin related ulcers. H pylori transmission primarily occurs within families, making family based approaches promising for reducing spread and improving treatment outcomes. H pylori screening should prioritise high risk populations. 13C-urea breath test or monoclonal stool antigen tests are preferred. Validated serological testing is a feasible alternative in low prevalence settings when followed by confirmatory non-serological testing. Integrating H pylori screening into existing health programmes may optimise patient adherence and resource utilisation. Empiric eradication treatment, especially bismuth quadruple therapy, is recommended in regions with high H pylori antibiotic resistance for conventional antibiotics. Potassium competitive acid blocker based regimens are alternatives. Confirmatory testing is strongly recommended to ensure H pylori eradication. Endoscopy is suggested for H pylori infected individuals with a high risk of gastric cancer and/or alarm features. H pylori eradication does not increase the risk of reflux oesophageal adenocarcinoma. Long term disruptions to the microbiota and resistome, as well as the environmental impact of increased antibiotic use, warrant further investigation. The development of an H pylori vaccine remains an unmet need, as does the establishment of a risk stratified approach informed by advanced genetic research. Conclusion H pylori eradication is an effective prevention strategy for gastric cancer that should be offered to all infected adult individuals. Future research should prioritise determining the optimal timing for screening, evaluating long term individual and population outcomes, as well as identifying more precise risk stratification parameters. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"53 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003084","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":"T cells engineered to carry a high-affinity HBV-specific T cell receptor: a potent weapon against advanced HBV-related HCC","authors":"Robert Thimme, Christoph Neumann-Haefelin","doi":"10.1136/gutjnl-2025-336452","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-336452","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third most common cause of cancer-related death worldwide, and the incidence is predicted to further increase substantially within the next 20 years in all regions of the world.1 HCC surveillance in individuals at risk, including patients with liver cirrhosis as well as patients with HBV infection or metabolic dysfunction associated steatohepatitis, aims at early diagnosis of HCC, allowing for curative treatment such as resection or liver transplantation. In addition, locoregional therapies such as radiofrequency ablation, microwave ablation, transarterial chemoembolisation or radiotherapy are valuable treatment options in intermediate cancer stages. A large proportion of patients, however, are diagnosed in an advanced cancer stage, with multiple liver lesions or even extrahepatic metastases. These patients require systemic therapy. During the last few years, checkpoint-inhibitor based immunotherapy has become the first-line therapy for advanced HCC.2 While immunotherapy has prolonged survival in approximately one-third of patients substantially, a large proportion of patients has little benefit from immunotherapy. Unfortunately, adequate predictors of treatment response are still lacking. Possible reasons for inadequate response to immunotherapy may include non-canonical pathways of exhaustion of tumour-specific T cells that cannot be reverted by checkpoint inhibitors, as well as insufficient priming of tumour-specific T cells due to the immunotolerant liver environment or additional immune-evasive strategies of the tumour.3–5 These limitations of checkpoint-inhibitor-based immunotherapy may be circumvented by T cell engineering, redirecting autologous bulk T cells either to express a tumour-specific T cell receptor (TCR) or a chimeric antigen receptor (CAR). Engineered TCR T cells have the limitation that they depend on presentation of (tumour) antigens on specific human leucocyte antigens (HLA). For example, TCR …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"14 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003087","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":"Abdominal pain and muco-bloody stool in a patient who had a transplant: a diagnostic imaging challenge","authors":"Guanqun Xing, Siqi Pan, Chen Yang, Weixun Zhou, Xiaoqing Li","doi":"10.1136/gutjnl-2025-336583","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-336583","url":null,"abstract":"A 36-year-old man presented with abdominal pain lasting 5 months and muco-bloody stools for 1 month. Subsequently, he progressed to incomplete intestinal obstruction (defaecation difficulty and colonic distension). The patient had a history of acute B lymphoblastic leukaemia 3 years ago and underwent allogeneic haematopoietic stem cell transplantation (allo-HSCT). Post-transplant, he developed acute graft-versus-host disease (GVHD) involving the oral cavity and skin, managed with ciclosporin and ruxolitinib until the onset of abdominal pain. Laboratory findings indicated normal white blood cell count, haemoglobin and platelets, but elevated D-dimer (1.34 mg/L FEU) and high-sensitivity C-reactive protein (35.9 mg/L). Colonoscopy revealed sigmoid and rectal mucosal hyperaemia, nodularity and snowflake-like erosions (figure 1A-C). CT imaging demonstrated diffuse sigmoid and rectal wall thickening, mucosal enhancement and collateral vasculature (figure 1D,E). Initial suspicion of ulcerative colitis (UC) led to unsuccessful mesalazine therapy. Figure 1 Endoscopic and CT findings before …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"22 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002997","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":"Does prior endoscopic intramuscular dissection for rectal cancer increase the risk of permanent stoma in patients requiring completion total mesorectal excision?","authors":"Krzysztof Bujko","doi":"10.1136/gutjnl-2025-336644","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-336644","url":null,"abstract":"Van der Schee et al 1 recently reported favourable 3-year oncological outcomes following endoscopic intramuscular dissection (EID). Patients with suspected rectal deep submucosal invasive cT1N0 or cT2N0 cancer were eligible for the study. The authors suggested that EID is a safe alternative to primary total mesorectal excision (TME) in such cases. Notably, of the 177 patients, 53 (30%) underwent completion TME and 16 (9%) received adjuvant chemoradiotherapy due to high-risk histopathological features identified in the EID specimen. Thus, before EID can be widely recommended, its potential adverse impact on subsequent completion TME is worth evaluating. I am concerned that some patients with tumours that were initially eligible …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"58 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995494","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":"Cutting waste in endoscopy: the roles of professional practice and staffing levels.","authors":"Koshiro Fujisawa,Tatsuya Fujikawa","doi":"10.1136/gutjnl-2025-336564","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-336564","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":"37 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960249","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":"Bacteroides intestinalis mediates the sensitivity to irinotecan toxicity via tryptophan catabolites","authors":"Yuanlong Hou, Hao Wu, Zhuangyi Zhang, Jie Wang, Qifan Chen, Chunang Lian, Dandan He, Ziguang Li, Wei Wei, Xin Lin, Daming Sun, Baoshan Cao, Ting Xu, Mingyuan Cai, Guangji Wang, Xueli Zhang, Liping Duan, Haiping Hao, Xiao Zheng","doi":"10.1136/gutjnl-2024-334699","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-334699","url":null,"abstract":"Background Late-onset diarrhoea remains a poorly managed concern for clinical irinotecan therapy. Although bacterial β-glucuronidases (β-GUS) mediated SN-38 production is prevailingly thought to mediate intestinal toxicity, β-GUS inhibitors confer limited benefits in the clinic. Objective This study aimed to explore the role and mechanism of endogenous bacterial metabolites in susceptibility to irinotecan toxicity. Design Gut microbiota profiles and metabolites in patients with colorectal cancer (CRC) with or without diarrhoea were investigated via 16S rRNA sequencing, shotgun metagenomics and metabolomics. The role of microbial metabolites was investigated in mice by metabolic bioengineering and intestinal organoid culture. The mechanism of microbial metabolites on intestinal stem cells was investigated by transcriptional profiling and chemical intervention. Results Gut microbial configuration was differentially remodelled in diarrhoea and non-diarrhoea patients with irinotecan therapy, and the susceptibility was transmissible to recipient mice via transplantation of baseline faecal microbiome. Bacteroides intestinalis ( B. intestinalis ) was notably expanded in the diarrhoea-prone cohorts as well as in irinotecan-treated mice. B. intestinalis colonisation sensitised intestinal epithelia to irinotecan-induced chemical injury, partially via tryptophan metabolite indole-3-acetate (IAA). Both B. intestinalis and bioengineered bacteria that produce IAA exacerbated irinotecan-induced intestinal epithelial injury in mice. Mechanistically, IAA suppressed PI3K-Akt signalling, thereby impairing the renewal of intestinal epithelia under the insult of irinotecan. In clinical patients receiving irinotecan therapy, faecal IAA level was closely associated with the diarrhoea severity. Conclusion Our study uncovers the mechanism of endogenous bacterial metabolite in shaping the individual susceptibility to irinotecan toxicity and suggests IAA as a potential predictive biomarker. Data are available upon reasonable request.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"42 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930218","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: Gene score to quantify systemic inflammation in patients with acutely decompensated cirrhosis","authors":"BMJ Publishing Group Ltd and British Society of Gastroenterology","doi":"10.1136/gutjnl-2024-333876corr1","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-333876corr1","url":null,"abstract":"Trebicka J, Aguilar F, Queiroz Farias A, et al . Gene score to quantify systemic inflammation in patients with acutely decompensated cirrhosis. Gut 2025;74:1293–1307. The correct affiliations …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"11 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144792630","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":"Pathological tau propagation from the brain to the colon via the vagal efferent pathway in Alzheimer’s disease","authors":"Hyunjung Choi, Seok Beom Hong, Hui-Wen Liu, Hyeonggyu Song, June-Hyun Jeong, Kyusik Ahn, SeongJun Kim, Jaehoon Song, Jong Won Han, Dongjoon Lee, Jinchul Ahn, Min-Seon Kim, Seok Chung, Inhee Mook-Jung","doi":"10.1136/gutjnl-2024-334571","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-334571","url":null,"abstract":"Background Alzheimer’s disease (AD) is a neurodegenerative disorder marked by the accumulation of amyloid-β (Aβ) plaques and tau neurofibrillary tangles, leading to cognitive decline. Recent research has highlighted the involvement of the gut–brain axis (GBA) in AD progression, suggesting that the disease may also affect the gut. Objective To investigate the transmission of tau from the brain to the gut via the vagus nerve and its impact on gut function, we aimed to develop a novel in vitro system to simulate the GBA. Design We used an AD animal model to examine the spread of tau from the brain to the colon. We also established an innervated colon-on-a-chip model to replicate the key components of the GBA, including vagal motor neurons, enteric neurons and colon epithelial cells. Results In ADLPAPT mice, we observed tau aggregates in the nerve plexuses of the colon and confirmed that tau spreads from the hippocampus to the dorsal motor nucleus of the vagus and enteric neurons in the colon. This tau transmission was barely observed in ADLPAPT mice with vagotomy, suggesting the possibility of a neural pathway through which tau pathology can propagate from the brain to the colon. The colon-on-a-chip system effectively mimicked this pathway, showing that tau could be transmitted along the vagal motor neuron to enteric neurons and impact colon epithelium stability. Conclusions This study demonstrates that tau pathology can propagate from the brain to the colon via the vagus nerve, providing evidence supporting the brain-to-gut axis in AD. Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable. All relevant data are included in the article or supplementary files.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"25 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144928256","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":"Immunosuppressive contribution of tumour-infiltrating B cells in human intrahepatic cholangiocarcinoma and their role in chemoimmunotherapy outcome","authors":"Giulia Milardi, Barbara Franceschini, Chiara Camisaschi, Simone Puccio, Guido Costa, Cristiana Soldani, Paolo Uva, Davide Cangelosi, Roberta Carriero, Luca Lambroia, Antonella Cammarota, Giulio Lodetti-Zangrandi, Ines Malenica, Marco Erreni, Ilaria Montali, Chiara Raggi, Paolo Kunderfranco, Michela Anna Polidoro, Alessio Aghemo, Rita Balsano, Tiziana Pressiani, Salvatore Piscuoglio, Luca Di Tommaso, Guido Torzilli, Lorenza Rimassa, Enrico Lugli, Barbara Cassani, Ana Lleo","doi":"10.1136/gutjnl-2025-334861","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-334861","url":null,"abstract":"Background Intrahepatic cholangiocarcinoma (iCCA) is a highly aggressive biliary tract cancer with a poor prognosis and a complex tumour microenvironment (TME) that remains poorly understood. Objective This study aimed to investigate the phenotypic and molecular characteristics of B lymphocytes, their interactions with the TME and their prognostic implications. Design B-cell compartments in the tumour, peritumour, and peripheral blood of iCCA patients were analysed using multimodal single-cell technologies. The B-cell interactome with the iCCA TME was explored in silico, and ex vivo assays assessed the impact of interactions with cancer-associated fibroblasts (CAFs) and tumour cells on B-cell biology. B-cell modulation during chemoimmunotherapy in advanced iCCA was also evaluated. Results B cells were enriched in adjacent tumour-free tissues and formed mature tertiary lymphoid structures (TLS), correlating with better prognosis. Conversely, tumour-infiltrating B cells were scarce, immature and displayed reduced effector function with increased immunosuppressive features. Coculture with tumour cells or CAFs impaired B-cell differentiation and function, including downregulation of BAFFR in peripheral B cells. IL-6 and TGF-β emerged as major drivers of B-cell dysfunction; dual blockade restored B-cell activation and differentiation. Elevated frequencies of circulating BAFFR+ B cells and hyperexpanded clonotypes were linked to improved chemoimmunotherapy response. Conclusions iCCA is characterised by a profoundly immunosuppressive TME that impairs B-cell function through soluble factors and cellular interactions. Our findings identify B cells as biomarkers and therapeutic targets, supporting strategies to restore B-cell function and promote mature TLS to enhance immunotherapy responsiveness in iCCA. Data are available in a public, open access repository. Data are available on reasonable request. scRNA-seq data: raw data set is available in the Gene Expression Omnibus (GEO) database (<http://www.ncbi.nlm.nih.gov/geo>) under accession number GSE171899. Raw sc scRNA-seq and WES data were downloaded from the National Genomics Data Center after authorised access (accession number HRA000863). Data from: Song G et al. Single-cell transcriptomic analysis suggests two molecularly distinct subtypes of intrahepatic cholangiocarcinoma. Nat Commun. 2022 Mar 28;13:1642. doi: 10.1038/s41467-022-29164-0- Tables summarising clinical data are included. Scripts used to analyse the flow cytometry single-cell data are available at <https://github.com/luglilab/Cytophenograph>. All other codes are available on reasonable request.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"13 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144924072","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}