Indian Journal of Gastroenterology最新文献

{"title":"Role of serum endotoxin, FGF19, TLR2, TNF-α, IL-12 and IL-10 in NAFLD-associated T2DM pathogenesis: Insights into Th1 bias and protective mechanisms.","authors":"Snigdha Jyoti Das, Barsha Pathak, Sangit Dutta, Sujoy Bose, Purabi Deka Bose","doi":"10.1007/s12664-024-01597-z","DOIUrl":"10.1007/s12664-024-01597-z","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD) in non-obese patients is pathophysiologically distinct, exhibiting common immunological link with type-2 diabetes mellitus (T2DM). This study aims to delineate the role of Toll-like receptor 2 (TLR2)-mediated immuno-modulation along with its association with fibroblast growth factor receptor 4 (FGFR4) and its ligand fibroblast growth factor 19 (FGF19) in the pathogenesis of NAFLD without or with T2DM.</p><p><strong>Methodology: </strong>Blood samples were collected from patients with NAFLD (n = 90), NAFLD with T2DM (n = 90) and healthy cohorts (n = 90) with consent and clinical records. Real-time polymerase chain reaction (PCR), enzyme-linked immunoassay (ELIZA) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to analyze messenger ribonucleic acid (mRNA), protein expression and gene polymorphism.</p><p><strong>Results: </strong>The molecular genetic analysis revealed the prevalence of variant allele(A) in FGFR4 gene in both cases compared to controls. The mRNA expression of FGF19 and TLR2 exhibited significant upregulation in NAFLD without T2DM compared to NAFLD with T2DM. Tumor necrosis factor-α (TNF-α) and interleukin-12 (IL-12) showed upregulation in both disease cohorts compared to control while IL-10 showed significant downregulation in NAFLD with T2DM compared to the other two cohorts. Correlation analysis between FGF19 and TLR2 revealed significant positive association in both NAFLD with and without T2DM. The Th1:Th2 ratio showed significant upregulation in NAFLD with T2DM compared to NAFLD without T2DM.</p><p><strong>Conclusion: </strong>In conclusion, elevated serum endotoxin levels appear to contribute to NAFLD and T2DM development. Upregulated FGF19 seems to be protective against developing T2DM in NAFLD patients. Higher TLR2, TNF-α and IL-12 expression in NAFLD without T2DM suggests a Th1 bias in its pathogenesis, while reduced IL-10 in NAFLD with T2DM implies a more skewed Th1 state in this condition.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"171-180"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of fully circumferential inlet patches (heterotopic gastric mucosa): More complicated than regular inlet patches.","authors":"Daniel L Cohen, Anton Bermont, Haim Shirin","doi":"10.1007/s12664-025-01738-y","DOIUrl":"https://doi.org/10.1007/s12664-025-01738-y","url":null,"abstract":"<p><strong>Background and objectives: </strong>Inlet patches (IP) are usually small islands of ectopic gastric mucosa found in the proximal esophagus, but rare cases of large, fully circumferential IP (FCIP) have been reported. To better understand the clinical course of patients with FCIP, we sought to perform a systematic review of all published cases.</p><p><strong>Methods: </strong>A systematic review of cases of FCIP was performed according to Preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines after thorough searches of PubMed and journal databases for appropriate cases. No restrictions were placed as to article type, country of origin or publication year.</p><p><strong>Results: </strong>Total 30 cases of FCIP from 27 articles were identified. These included patients from 10 different countries published between 1985 and 2024. The mean age was 55.7 with 82.1% men and a mean circumferential IP length of 3.4 cm. A majority of patients were symptomatic with dysphagia and/or a history of food impactions (72.4%). Most cases involved complications from the IP, including a benign stricture/ring/web (20, 66.7%), adenocarcinoma (4, 13.3%) or ulcers/erosions (2, 6.7%). The benign strictures were usually treated by dilation together with anti-secretory medication (10, 50%) or just dilation or medication. The adenocarcinoma cases were treated by surgery (two cases) or endoscopic resection (two cases), while the ulcer cases were treated medically. All cases with follow-up reported a good clinical outcome.</p><p><strong>Conclusions: </strong>Patients with FCIP are frequently symptomatic with dysphagia or food impactions and often have complications, including a stricture/ring or cancer. Despite this, they have good clinical outcomes. Given the risk of malignancy, endoscopic surveillance may be warranted.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Masked hypertension in patients with irritable bowel syndrome.","authors":"Görkem Yıldız, Gürbey Söğüt","doi":"10.1007/s12664-025-01745-z","DOIUrl":"https://doi.org/10.1007/s12664-025-01745-z","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiology of irritable bowel syndrome (IBS) and masked hypertension (mHT) exhibits shared characteristics, including factors such as anxiety and stress. Consequently, the aim of this study was to investigate the frequency of mHT in patients with IBS.</p><p><strong>Method: </strong>Patients diagnosed with IBS in 2020-2023 were re-evaluated using the Rome IV criteria. Patients who did not have sustained HT, as evidenced by repeated in-office blood pressure (BP) measurements and who did not meet the exclusion criteria (chronic renal failure, heart failure, diabetes, cerebrovascular events, pregnancy or puerperium) were included in the study group. A control group was also constituted with the same number of age and gender-matched healthy individuals. The participants were connected to a 24-hour ambulatory BP monitor and the results were analyzed.</p><p><strong>Results: </strong>Total 128 participants, including 64 IBS patients and 64 healthy individuals, were included in our study. The age (36.9 ± 7.3 years; 37.3 ± 7.7 years) and gender (62.5% female; 62.5% female) distributions and the baseline clinical characteristics of the study and control groups were similar. The in-office systolic BP measurements of the IBS patients were significantly higher than those of the control group (124.7 ± 5.4 mmHg compared to 121.8 ± 5.2 mmHg, p = 0.02). The IBS patients also had a higher frequency of mHT (n = 21, 32.8% compared to n = 10, 15.6%, p = 0.02), higher 24-hour daytime systolic BP (127.5 ± 7.6 mmHg compared to 124.8 ± 5.22 mmHg, p = 0.02) and higher nighttime diastolic BP (62.2 ± 7.5 mmHg compared to 59.6 ± 6.1 mmHg, p = 0.03) than the control group. The study group included all four sub-types of IBS: diarrhea-dominant (IBS-D), constipation-dominant (IBS-C), mixed type (IBS-M) and unclassified (IBS-U). It was determined that 57.9% of the IBS-C patients, 27.8% of the IBS-M patients, 23.5% of the IBS-D patients and 10% of the IBS-U patients in the study group had mHT.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first study demonstrating a relationship between IBS and mHT. The frequency of mHT was higher among patients with IBS compared to healthy controls (p = 0.02). Studies on larger patient groups are needed to evaluate the frequency of mHT for the IBS sub-types.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic stricturotomy for inflammatory bowel disease strictures in anatomically challenging locations (deep small bowel, duodenum, anal canal and pouch): A case series with technical review (with videos).","authors":"Partha Pal, Zaheer Nabi, Mohan Ramchandani, Kanapuram Pooja, Rajesh Gupta, Manu Tandan, D Nageshwar Reddy","doi":"10.1007/s12664-025-01754-y","DOIUrl":"https://doi.org/10.1007/s12664-025-01754-y","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abbreviated anorectal biofeedback therapy is beneficial in symptomatic improvement of functional defecatory disorder.","authors":"Stephan Benny, Noble Varghese Mathews, Ajith Thomas, Anoop John, Reuben Thomas Kurien, Sudipta Dhar Chowdhury, Amit Kumar Dutta, Ebby George Simon, A J Joseph, Rajeeb Jaleel","doi":"10.1007/s12664-025-01752-0","DOIUrl":"https://doi.org/10.1007/s12664-025-01752-0","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pancreatitis in elderly versus non-elderly population.","authors":"Rajiv Mehta, Dhvani Adhvaryu, Aarya Desai, Nishtha Nandwani, Mayank Kabrawala, Ritesh Prajapati","doi":"10.1007/s12664-025-01756-w","DOIUrl":"https://doi.org/10.1007/s12664-025-01756-w","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive clinical and microbiological study on the diagnosis and management of cholangitis in patients with biliary atresia undergoing kasai portoenterostomy.","authors":"Merna Adel Aziz, Hala Mohsen Abdullatif, May S Soliman, Sawsan Okasha, Nevian Nabil, Mariam Mahmoud Balah, Hanaa El-Karaksy","doi":"10.1007/s12664-024-01721-z","DOIUrl":"https://doi.org/10.1007/s12664-024-01721-z","url":null,"abstract":"<p><strong>Background and objectives: </strong>Kasai-portoenterostomy (KPE) is the initial attempt to restore the bile flow and salvage the native liver in biliary atresia (BA) patients. Cholangitis is a frequent complication after KPE and adequate treatment impacts the long-term outcome. The aim of our study is to assess the severity of cholangitis episodes in a cohort of BA patients post KPE, identify the causative agents, using several diagnostic methods, as well as to assess the tolerability and efficacy of our antimicrobial protocol.</p><p><strong>Methods: </strong>This analytical retrospective observational study, conducted at Pediatric Hepatology Unit, Cairo University Pediatric Hospital, included infants and children with cholangitis post-KPE enrolled over 30 months. Clinical data collection, basic laboratory investigations inflammatory markers, B-D glucan, blood culture, 16SrDNA, 18SrDNA were performed in all enrolled patients. Cholangitis episodes were treated with intravenous antibiotics according to our antimicrobial protocol that has been implemented in conjunction with the antimicrobial stewardship committee.</p><p><strong>Results: </strong>This study included 30 post-KPE patients, who experienced 47 episodes of cholangitis. Twenty-five episodes of cholangitis were culture positive cholangitis (positive blood culture and/or PCR results and/or liver biopsy). Klebsiella Variicola and Klebsiella pneumoniae were the most prevalent pathogens in 13 and seven cultures, respectively. Meropenem was the most successful antibiotic in the eradication of infection in 11(23.4%) episodes. Culture positive cholangitis showed increased incidence of sepsis and worse outcome in comparison to culture negative cholangitis. The severity of cholangitis was classified into 16 patients (34%) with infection, 28 (60%) sepsis, one (2%) severe sepsis and two (4%) septic shock.</p><p><strong>Conclusion: </strong>Almost half of cholangitis episodes were culture-positive; the commonest pathogen was Klebsiella, showing more severe sepsis and worse outcome.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma exchange to treat liver failure: The field expands.","authors":"Rohan Thomas, Chundamannil E Eapen","doi":"10.1007/s12664-025-01760-0","DOIUrl":"https://doi.org/10.1007/s12664-025-01760-0","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-stratified prevalence of anti-hepatitis A virus antibodies in four metropolitan Indian cities and recent changes in Pune city.","authors":"Sanjay Lalwani, Sonali Palkar, Balasubramanian S, Gurmeet Kaur, Monjori Mitra, Rupeshkumar Deshmukh, Ruta Kulkarni, Vidya Arankalle","doi":"10.1007/s12664-025-01746-y","DOIUrl":"https://doi.org/10.1007/s12664-025-01746-y","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pune, western India, was earlier identified as hyperendemic for hepatitis A. Subsequently, we noted age and socio-economic status-dependent reduction in hepatitis A virus (HAV) prevalence. To assess the situation in different parts of India, this multicentric, hospital-based, cross-sectional study was conducted in four metropolitan cities in the northern/southern/eastern/western regions.</p><p><strong>Methods: </strong>As per age group-anti-HAV-positivity-specific sample size calculations (1-40 years), 496 samples/centre were collected from Pune, Kolkata, Chennai and Ludhiana. All samples were tested for anti-HAV antibodies using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Overall, 44.9% of children up to five years of age were anti-HAV antibody-positive (ELISA), with a steady increase reaching 92.9% by the age of 26-40 years. Importantly, 782/1756 (44.5%) of the total population ≤ 15 years was anti-HAV negative and hence susceptible to HAV. The city-wise analysis documented similar patterns with a few differences. According to the World Health Organization (WHO) classification of HAV endemicity, Pune, Chennai and Ludhiana were classified as cities with intermediate endemicity, whereas Kolkata with lower seroprevalence had low endemicity. Compared to the 2011-2012 survey anti-HAV positivity remained unchanged in the other cities except for the rise in Chennai. Apart from age, other risk factors varied in different cities. A comparison of socio-economic-dependent, age-stratified serosurveys conducted during 1982, 1992, 1998, 2017 and 2022 in Pune documented the shift from high to intermediate endemicity in the population with high socio-economic status in 1998 and lower-middle socio-economic strata in 2017.</p><p><strong>Conclusion: </strong>The lowering of anti-HAV positivity reflects a definite improvement in sanitation and voluntary vaccination, but seems to have slowed down during recent years. Additional, well-defined efforts are necessary.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of DTPA camera-based Gates method versus plasma-clearance methods for assessment of GFR in cirrhosis: A pilot study.","authors":"Smita Divyaveer, Madhuri Kashyap, Kushal Kekan, Madhumita Premkumar, Kanchan Prajapati, Arka De, Anish Bhattacharya, Sarika Sharma Prashar, Komalpreet Kaur, Ashok Kumar Yadav, Jaskiran Kaur, Vaibhav Tiwari, Amol N Patil, Ajay Kumar Duseja, Nipun Verma, Malagouda R Patil, Raja Ramachandran, Vishnuvardhan Bagur, Harbir Singh Kohli","doi":"10.1007/s12664-025-01753-z","DOIUrl":"https://doi.org/10.1007/s12664-025-01753-z","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}