Gut最新文献

{"title":"Haematemesis in an elderly patient.","authors":"Patricia Mester, Laura Drösch, Stephan Schmid, Florian Weber, Arne Kandulski, Martina Müller, Vlad Pavel","doi":"10.1136/gutjnl-2024-333198","DOIUrl":"10.1136/gutjnl-2024-333198","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":" ","pages":"1363-1513"},"PeriodicalIF":25.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-scale profile study on hepatitis B surface antigen levels in chronic hepatitis B: implications for drug development targeting functional cure","authors":"Rex Wan-Hin Hui, Trevor Kwan-Hung Wu, Karen Cheuk-Ying Ho, Ryan Hin-Man Leung, Matthew Shing-Hin Chung, Danny Ka-Ho Wong, James Fung, Wai-Kay Seto, Lung Yi Mak, Man-Fung Yuen","doi":"10.1136/gutjnl-2025-335219","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335219","url":null,"abstract":"Background Quantitative hepatitis B surface antigen (qHBsAg) is an important biomarker in chronic hepatitis B (CHB). Objective Establish qHBsAg profiles to guide novel drug development. Design Baseline qHBsAg profiles, longitudinal qHBsAg trajectories and predictors of HBsAg seroclearance were determined in a large CHB cohort. Results This study included 4287 patients with qHBsAg measurements between 2009 and 2020 (62.5% male; mean age 48.0; 45.2% on nucleos(t)ide analogues (NUC)) with median baseline qHBsAg of 630.8 (117.1–1875.5) IU/mL. 3437 (80.2%), 2516 (58.7%) and 997 (23.3%) patients had baseline qHBsAg <3000 IU/mL, <1000 IU/mL and <100 IU/mL, respectively (69.2%, 46.9% and 22.9% in treatment-naïve; 93.4%, 73.0% and 23.6% in NUC-treated patients correspondingly). Among patients with recent qHBsAg measurements in 2018 (n=1593), 98.9%, 71.1% and 26.9% of patients had baseline qHBsAg <3000 IU/mL, <1000 IU/mL and <100 IU/mL, respectively (99.3%, 67.1% and 34.2% in treatment-naïve; 98.7%, 73.1% and 23.0% in NUC-treated patients correspondingly). Age (OR 1.019–1.049), hepatitis B e antigen positivity (OR 0.264–0.349) and HBV DNA (OR 0.675–0.832) were independent determinants of qHBsAg <100 or 1000 IU/mL, respectively (all p<0.05). Among patients with serial qHBsAg measurements, the median qHBsAg reduction was 0.10 (0.02–0.27) log IU/mL/year. After median follow-up for 6.3 (5.7–14.3) years, 526 patients (12.3%) achieved HBsAg seroclearance. Baseline alanine aminotransferase/qHBsAg ratio ≥0.27 independently predicted HBsAg seroclearance (HR 4.904, p<0.001). Conclusion In an endemic population, >40% of patients with CHB have qHBsAg >1000 IU/mL. These patients are unlikely to achieve spontaneous HBsAg seroclearance, but also have suboptimal responses to novel antivirals. Our data has important implications for novel antiviral development. Data are available upon reasonable request.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"733 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786812","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":"CNNM4: a ferroptotic vulnerability in cholangiocarcinoma","authors":"Erica Villa","doi":"10.1136/gutjnl-2025-335061","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335061","url":null,"abstract":"Cholangiocarcinoma (CCA) represents one of the most aggressive malignancies affecting the biliary tree, with limited treatment options and high mortality rates. Despite recent advances in molecular oncology, the prognosis for CCA remains poor, highlighting the urgent need for novel therapeutic strategies. In this context, the study published by Mercado-Gomez et al ,1 provides significant insights into the role of CNNM4, a magnesium transporter, as a regulator of ferroptosis in CCA. By demonstrating how CNNM4 influences magnesium homoeostasis, oxidative stress and cancer metabolism, this study lays the groundwork for exploring targeted therapies aimed at modulating ferroptosis as an anticancer approach (figure 1). Figure 1 Targeting CNNM4 to induce ferroptosis and reduce tumour aggressiveness in cholangiocarcinoma (CCA). This schematic illustrates how CNNM4 inhibition via siRNA reshapes CCA biology, shifting tumour cells from a proliferative and resistant state to one that is more vulnerable to cell death. On the left, CCA cells exhibit high CNNM4 expression, actively transporting magnesium (Mg²+) out of the cell, a process that supports tumour survival, metabolic adaptation and therapy resistance. On siRNA-mediated CNNM4 silencing (centre), this balance is disrupted, leading to intracellular iron (Fe) accumulation and triggering ferroptosis, an iron-dependent form of programmed cell death that CCA cells normally evade. On the right, CNNM4 inhibition results in a profound shift in tumour behaviour—reducing drug resistance, altering metabolic pathways, decreasing cancer stem cell properties and ultimately suppressing metastasis. On the bottom, the mechanisms that link magnesium accumulation and induction of ferroptosis are indicated. These findings highlight CNNM4 as a promising therapeutic target, where its inhibition not only promotes ferroptosis but also weakens CCA’s most aggressive traits, opening new avenues for treatment (Created with BioRender). ROS, reactive oxygen species. Magnesium is …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"26 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786813","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":"Spatial single-cell omics: new insights into liver diseases","authors":"Yuan Suo, Robert Thimme, Bertram Bengsch","doi":"10.1136/gutjnl-2024-332105","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-332105","url":null,"abstract":"The liver is a highly multifunctional organ that can perform many metabolic and immunological functions due to a highly complex spatially organised microarchitecture that is disturbed in many liver diseases. Recent methodological advances in spatial omics technologies enable the comprehensive study of the intrahepatic proteome, transcriptome and metabolome at near single-cell and subcellular resolution. The spatial resolution adds an additional dimension to our understanding of the liver, with the potential to revolutionise our insights into the cellular and molecular mechanisms underlying liver physiology and their dysregulation in liver disease. The identification of spatial niches and interactions is empowered by advanced bioinformatics approaches facilitating spatial cellular and network-level analysis and providing novel opportunities for clinical translation. A recent example in immuno-oncology is the use of spatial architecture-based immune classifications, which can improve patient stratification. In this review, we provide an overview of the current methodology and novel spatial insights into metabolic, infectious, immune-mediated, toxic and malign liver diseases and discuss perspectives for clinical translation.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"54 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786635","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":"Role of CNNM4 in the progression of cholangiocarcinoma: implications for ferroptosis and therapeutic potential","authors":"Maria Mercado-Gómez, Naroa Goikoetxea-Usandizaga, Alvaro Eguileor Giné, Miguel A Merlos Rodrigo, Marta Bento Afonso, Mikel Azkargorta, Leidy Estefanía Zapata-Pavas, Claudia M Rejano-Gordillo, Marta R Romero, Isabel Mendizabal, Pedro M Rodrigues, Hanghang Wu, Rubén Rodríguez-Agudo, Marina Serrano-Maciá, Paula Olaizola, Jon Ander Barrenechea-Barrenechea, Irene González Recio, Maite G Fernandez-Barrena, Diletta Overi, Eugenio Gaudio, Ute Schaeper, Saioa Garcia-Longarte, Mariana Yáñez-Bartolomé, Patricia Peña-SanFelix, Clàudia Gil-Pitarch, Ainhoa Lapitz, Hana Michalkova, Zbynek Heger, Carolina Conter, Rocio I R Macias, Arkaitz Carracedo, Jesús Bañales, Victor Moreno, Angela Lamarca, Rajat Singh, Teresa Cardoso Delgado, Luis Alfonso Martínez-Cruz, Felix Elortza, Matias A Avila, César Martín, Tian V. Tian, Teresa Macarulla, Daniela Buccella, Francisco Javier Cubero, Diego F Calvisi, Guido Carpino, Jose J G Marin, Cecília M P Rodrigues, Maria Luz Martinez-Chantar","doi":"10.1136/gutjnl-2024-333255","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-333255","url":null,"abstract":"Background and objective Cholangiocarcinoma (CCA) is a heterogeneous neoplasm of the biliary epithelium that easily infiltrates, metastasises and recurs. Magnesium disbalance is a hallmark of CCA, with the magnesium transporter cyclin M4 (CNNM4) being a key driver of various hepatic diseases. This study aims to unravel the role of CNNM4 in the initiation and progression of CCA. Design CNNM4 protein and gene expression were assessed in vitro, in vivo and in patients with CCA. Silencing of CNNM4 was effectively achieved by using small interfering RNA (siRNA) or short hairpin RNA in CCA cell lines and GalNAc-conjugated siRNA in a transposon-based CCA mice model. The impact of CNNM4 on tumour cell proliferation, migration and invasion to the lungs was evaluated using the chicken chorioallantoic membrane model. Proteomic analysis was employed to elucidate the underlying molecular mechanisms. Results CNNM4 was upregulated in CCA samples from humans, mice and cell lines. Functional studies demonstrated that CNNM4 deficiency attenuates cell growth, chemoresistance, migration, invasion, cancer stem cell properties and Warburg effect in vitro and in vivo. Proteomic analysis identified nuclear protein 1 as an upstream regulator of CNNM4-induced ferroptosis in CCA, ultimately leading to cell death. The iron chelator deferiprone could reverse the decreased proliferation induced by CNNM4 silencing, while inhibition of the heme oxygenase-1 by zinc protoporphyrin IX affected only the growth of cells with no targeted CNNM4 inhibition, highlighting the specificity of ferroptosis in CNNM4-associated effects. Conclusion This study reveals that increased CNNM4 expression drives CCA progression and malignancy and that its inhibition may be an effective therapeutic strategy to limit proliferation and metastasis in patients with CCA. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"10 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786811","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: 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":"Implementing discard strategies for diminutive polyps using autonomous CADx in clinical practice","authors":"Mahsa Taghiakbari, Douglas K Rex, Heiko Pohl, Cesare Hassan, Roupen Djinbachian, Felix Huang, Daniel von Renteln","doi":"10.1136/gutjnl-2025-335441","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335441","url":null,"abstract":"The strategy of discarding diminutive colonic polyps (≤5 mm) has been discussed for many years. However, despite their exceedingly low risk of malignancy, implementation has remained limited, with minimal impact on clinical practice. More recently, computer-assisted optical diagnosis (CADx) has been introduced to support and potentially enable broader adoption of this approach. We prospectively assessed patient acceptance and examiner-based quality control in 95 out of 102 patients (93.1%) who consented to this approach, involving a total of 149 polyps. Of these, 143 polyps were reviewed by three examiners blinded to CADx diagnoses and the results were compared with CADx diagnoses. Resect-and-discard accuracy was 83.5% excluding sessile serrated lesions (SSLs), while treating SSLs as neoplastic or hyperplastic yielded 75.9% and 84.3%, respectively. Excluding SSLs, the diagnose-and-leave negative predictive value was 92.3%. Surveillance interval recommendations based on CADx and expert review, aligned with current guidelines, achieved 100% concordance, ensuring appropriate follow-up. The rationale behind replacing histopathology for diminutive polyps using optical polyp diagnosis is rooted in the extremely low risk of advanced pathology in diminutive polyps, supporting the safe practice of discarding or leaving polyps in situ when accurately optically diagnosed. Adopting this approach would significantly reduce pathology-associated costs and offer immediate patient management decisions. This prospective clinical pilot study included patients aged 45–80 years undergoing elective colonoscopy at the Montreal University Hospital Center from August 2025 to November 2024. Patients were invited to a study replacing histopathological evaluations of diminutive polyps with autonomous computer-assisted optical (CADx) diagnosis. Exclusion criteria were inflammatory bowel disease, active colitis, familial polyposis syndromes, coagulopathy or severe medical comorbidities. Patients received detailed written and verbal explanations regarding autonomous use of CADx technology, and optical diagnosis polyp management strategies ( resect-and-discard and diagnose-and-leave ). All participants gave written informed consent. Patients declining participation completed a voluntary survey regarding their reasons. Of …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"13 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763281","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":"Reconsidering statins in MASLD: beyond cardiovascular protection to multisystem benefit.","authors":"Xiao-Dong Zhou,Vincent Wai-Sun Wong,Ming-Hua Zheng","doi":"10.1136/gutjnl-2025-336430","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-336430","url":null,"abstract":"","PeriodicalId":12825,"journal":{"name":"Gut","volume":"23 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756196","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":"Targeting Aurora kinase B regulates cholesterol metabolism and enhances chemoimmunotherapy in cholangiocarcinoma.","authors":"Furong Liu,Wei Chen,Ze Zhang,Weifeng Zeng,Haofan Hu,Shangwu Ning,Zhibin Liao,Yachong Liu,Hongwei Zhang,Qinggang Fu,Bixiang Zhang,Xiaoping Chen,Wanguang Zhang,Zhanguo Zhang","doi":"10.1136/gutjnl-2025-335291","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335291","url":null,"abstract":"BACKGROUNDCholangiocarcinoma (CCA) is a highly lethal malignant tumour with increasing incidence. Current therapies exhibit limited benefits, which urgently demand the identification of novel therapeutic targets.OBJECTIVEWe aimed to identify potential therapeutic targets for CCA and broaden current therapies.DESIGNPotential therapeutic targets for CCA were identified by sgRNA library screening and validated in preclinical models. Multi-omics sequencing and various experimental approaches were performed to validate the mechanism by which Aurora kinase B (AURKB) regulates CCA progression and the immune microenvironment, supported by clinical samples from public data sets and Tongji Hospital cohorts. The translational therapy was comprehensively validated in CCA organoid, patient-derived xenograft and preclinical murine models.RESULTSAURKB was identified as a highly expressed and targetable kinase in CCA. Knockout of AURKB significantly inhibited CCA progression, reduced CD8+ T cell exhaustion and enhanced antitumour response. Mechanistically, AURKB promoted the generation of histone H3 lysine 9 tri-methylation (H3K9me3)/serine 10 phosphorylation, leading to a decrease in the enrichment of H3K9me3 at the neutral cholesterol ester hydrolase 1 (NCEH1) promoter, thereby increasing NCEH1 expression and cholesterol levels in tumours. High AURKB expression in clinical samples predicted poorer outcomes in patients with CCA undergoing neoadjuvant chemoimmunotherapy and was associated with cholesterol accumulation within tumours. AURKB inhibitor or simvastatin can suppress CCA progression and significantly enhance sensitivity to chemoimmunotherapy.CONCLUSIONSAURKB regulates cholesterol levels and immune microenvironment in tumours, highlighting that targeting AURKB or adopting cholesterol-reducing strategy holds promise for CCA treatment, especially in conjunction with first-line chemoimmunotherapy.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"14 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756095","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":"Real-world impact of implementing lumen-apposing metal stents for pancreatic fluid collections: a nationwide Japanese study","authors":"Tsuyoshi Hamada, Nobuaki Michihata, Tomotaka Saito, Yuya Kimura, Takuji Iwashita, Hiroki Matsui, Hideyuki Shiomi, Mamoru Takenaka, Keisuke Iwata, Akinori Maruta, Atsuhiro Masuda, Saburo Matsubara, Kiyohide Fushimi, Ichiro Yasuda, Hiroyuki Isayama, Hideo Yasunaga, Yousuke Nakai","doi":"10.1136/gutjnl-2025-335067","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335067","url":null,"abstract":"Background Lumen-apposing metal stents (LAMSs) are increasingly used for the endoscopic management of pancreatic fluid collections (PFCs), including walled-off necrosis (WON) and pancreatic pseudocysts (PCs). Objective To evaluate the nationwide impact of implementing an LAMS (approved in Japan in 2018) on clinical outcomes in real-world settings. Design Using a nationwide inpatient database, we identified 5885 patients who underwent endoscopic ultrasound (EUS)-guided treatment for PFCs at 550 hospitals between 2010 and 2023. We examined the association between treatment period (pre-LAMS vs post-LAMS implementation) and clinical outcomes. Multivariable logistic and linear regression analyses were performed to estimate ORs and coefficients, respectively. Findings were validated using a multi-institutional clinical cohort (n=618) from specialty hospitals with more detailed clinical parameters with data collection during the same period. Results In the pre-LAMS period, 3787 cases were treated exclusively with plastic stents. After 2018, LAMS use stabilised at around 50% among 2098 cases treated between 2019 and 2023. Compared with the pre-LAMS period, patients treated during the post-LAMS period had a higher risk of bleeding with LAMS (adjusted OR, 1.81; 95% CI: 1.55 to 2.13), but not with plastic stents (adjusted OR, 0.96; 95% CI: 0.74 to 1.26). Rates of rescue surgery, in-hospital mortality and length of stay did not differ significantly (p>0.12). The post-LAMS period was associated with increased total costs (adjusted coefficient, US$2813; 95% CI: 1503 to 4122). In analyses stratified by PFC types (WON vs PC), the association of the post-LAMS period with bleeding risk appeared to be stronger for PCs than WON (pinteraction=0.015) and WON patients had a shorter length of stay and lower total costs in the post-LAMS period (pinteraction<0.001). In the validation cohort, the elevated bleeding risk with LAMS was confirmed (adjusted OR, 1.59; 95% CI: 0.86 to 2.95, vs pre-LAMS period), though not statistically significant. Conclusions The implementation of LAMS was not associated with improved key clinical outcomes but was linked to a higher risk of bleeding and increased healthcare costs. These findings do not support the routine use of LAMS for EUS-guided treatment of all PFCs in standard clinical practice but may restrict it to WON cases with clear indications. The datasets derived from the DPC database and analysed during the current study are not publicly available due to contracts with the hospitals providing data to the DPC database. The de-identified data from the WONDERFUL cohort and analytical methods used in the current study will be available from the corresponding author upon reasonable request.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"31 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747297","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}