Intestinal Research最新文献

{"title":"Liquid biopsy for colorectal cancer screening: chances and challenges.","authors":"Hyoung Il Choi, Jae Myung Cha","doi":"10.5217/ir.2026.00080","DOIUrl":"https://doi.org/10.5217/ir.2026.00080","url":null,"abstract":"<p><p>Liquid biopsy refers to the analysis of tumor-derived components in blood to enable minimally invasive cancer detection and characterization. Circulating tumor cells, circulating tumor DNA, and tumor-derived extracellular vesicles have demonstrated diagnostic and prognostic potential in colorectal cancer (CRC). As liquid biopsy allows for real-time, repeatable assessment of the tumor burden and may capture molecular heterogeneity across primary and metastatic sites, it has emerged as a promising tool for CRC screening. Early studies have suggested the feasibility of CRC detection; however, its sensitivity for the detection of advanced adenomas remains limited. To date, no adequately powered randomized trial has demonstrated that liquid biopsy-based screening reduces the rate of CRC-specific mortality. Evidence has been derived largely from case-control or single-round prospective studies, and validation results have been inconsistent. Assay heterogeneity, lack of standardization, uncertain downstream clinical pathways, and limited real-world cost-effectiveness data further constrain its implementation. Modeling studies have indicated that reduced specificity and increased test positivity could substantially increase colonoscopy demand, which challenges the capacity of health systems. Although liquid biopsy offers practical advantages, including high acceptability and potential integration into routine care, current evidence does not support the replacement of established modalities, such as fecal immunochemical testing or colonoscopy, in organized CRC screening programs. Further rigorous prospective validation and health system-level evaluations are required before liquid biopsy can be successfully applied in CRC screening.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390868","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":"Post-treatment simplified MaRIA score predicts clinical outcome in Crohn's disease patients.","authors":"Ami Kawamoto, Kento Takenaka, Junichi Tsuchiya, Momo Wakui, Kazuo Ohtsuka, Ryuichi Okamoto","doi":"10.5217/ir.2026.00077","DOIUrl":"https://doi.org/10.5217/ir.2026.00077","url":null,"abstract":"","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390866","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":"Real-world effectiveness and safety of upadacitinib in Korean patients with inflammatory bowel disease: a single-center retrospective study.","authors":"Ji Eun Kim, Yeong Chan Lee, Minjee Kim, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim, Sung Noh Hong","doi":"10.5217/ir.2025.00235","DOIUrl":"10.5217/ir.2025.00235","url":null,"abstract":"<p><strong>Background/aims: </strong>Upadacitinib, a selective Janus kinase 1 inhibitor, has demonstrated efficacy in clinical trials for inflammatory bowel disease (IBD); however, real-world data from Asian populations remain limited.</p><p><strong>Methods: </strong>We conducted a singlecenter retrospective study to evaluate the real-world effectiveness and safety of upadacitinib in Korean patients with ulcerative colitis (UC) or Crohn's disease (CD). Adult patients who initiated upadacitinib between July 2021 and November 2024 were included. Symptom-based clinical activity was assessed using patient-reported outcomes at baseline and 6 months. Adverse events and surgical interventions were also documented.</p><p><strong>Results: </strong>Forty patients (28 CD, 12 UC) were analyzed. At 6 months, symptom-based clinical remission was achieved in 82.4% of CD and 81.8% of UC patients, with clinical response rates of 88.2% and 90.9%, respectively. No clinical or treatment-related factors were significantly associated with remission in univariate analyses. Adverse events occurred in 57.5% of patients, all grade 1, and no treatment discontinuations were required. Six patients with CD required surgery during treatment.</p><p><strong>Conclusions: </strong>Upadacitinib was effective and well tolerated over 6 months in Korean patients with moderate-to-severe IBD, including those with biologic-experienced patients. These findings support its use in routine clinical practice, while highlighting the need for prospective studies to confirm its long-term safety and efficacy in Asian populations.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"563-570"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The JAK attack: transforming the management of ulcerative colitis in India.","authors":"Arshdeep Singh, Arshia Bhardwaj, Vandana Midha, Ajit Sood","doi":"10.5217/ir.2025.00153","DOIUrl":"10.5217/ir.2025.00153","url":null,"abstract":"<p><p>Inflammatory bowel disease is increasingly recognized as a significant clinical entity in India, reflecting the country's ongoing epidemiological transition. With a rising incidence and an expanding disease spectrum, the limitations of conventional therapeutic agents, such as corticosteroids and thiopurines, have become increasingly evident. This review examines the transformative role of Janus kinase inhibitors, particularly tofacitinib, in redefining therapeutic goals and bridging the gap between medical innovation and real-world implementation in resource-limited settings. Tofacitinib represents a pivotal advancement in the therapeutic landscape of ulcerative colitis (UC) in India, offering the advantages of oral administration, rapid onset of action, predictable pharmacokinetics, and cost-effective generic formulations-thereby overcoming several longstanding barriers to the adoption of advanced therapies. Accumulating real-world evidence from India supports its clinical utility across various phenotypes of UC, including corticosteroid-dependent or refractory disease, acute severe UC, ulcerative proctitis, elderly-onset UC, and in achieving deeper remission endpoints such as histologic healing. Furthermore, its incorporation into routine clinical practice has contributed to a measurable reduction in corticosteroid reliance, thereby aligning treatment strategies with international standards of care. By combining efficacy, safety, accessibility, and ease of use, tofacitinib has catalyzed a paradigm shift in the management of UC in the Indian context.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"392-403"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness, safety, and pharmacokinetics of the infliximab biosimilar CT-P13 after non-medical switch from the infliximab originator in patients with inflammatory bowel disease.","authors":"Ryohei Nomaru, Teruyuki Takeda, Atsushi Takahashi, Hiroyuki Mikumo, Shigeyoshi Yasukawa, Akihiro Koga, Takao Kanemitsu, Yoichiro Ono, Noritaka Takatsu, Masaki Miyaoka, Takashi Hisabe, Hisatomi Arima, So Imakiire, Eri Yamauchi, Shinya Ashizuka, Fumihito Hirai","doi":"10.5217/ir.2025.00118","DOIUrl":"10.5217/ir.2025.00118","url":null,"abstract":"<p><strong>Background/aims: </strong>The introduction of anti-tumor necrosis factor-α antibodies transformed the landscape of inflammatory bowel disease (IBD) treatment. Because biologics are associated with increased medical costs, the use of biosimilars (BS) is recommended. However, high-quality evidence on the efficacy of BS in Japan remains limited. Therefore, this study aimed to evaluate the efficacy and safety of BS in patients with IBD.</p><p><strong>Methods: </strong>Patients with IBD who underwent a non-medical switch (NMS) from infliximab originator (IFX-O) to IFX-BS at Fukuoka University Chikushi Hospital were prospectively evaluated. The observation period was up to 56 weeks after the NMS, and the rate of continuation, clinical remission at 56 weeks, safety, and changes in trough concentration were analyzed. Moreover, a questionnaire survey regarding BS and NMS was conducted.</p><p><strong>Results: </strong>A total of 167 patients were included in this study. The continuation rate for IFX-BS therapy after NMS was high (95.6%). The remission maintenance rate at 56 weeks was 85.7% for patients with Crohn's disease and 77.8% for patients with ulcerative colitis. Adverse events were observed in 22.8% of patients. However, only 2 severe adverse events were recorded. The ratios of trough concentrations at 8, 24, and 56 weeks to that at week 0 were 115.6%, 101.2%, and 123.5%, respectively, indicating statistical non-inferiority. In a questionnaire survey, only 6.2% of the patients were aware of BS, however, more than half of them agreed with the NMS recommendation.</p><p><strong>Conclusions: </strong>The efficacy and safety of IFX-BS after NMS are high. In addition, its trough concentration is serologically non-inferior to baseline values.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"552-562"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous thromboembolism prophylaxis in pregnant women with inflammatory bowel disease: evidence gaps and future directions from the KASID Guidelines Task Force Team.","authors":"Jiyoung Yoon, Eun Mi Song, Dong Hyun Kim, Young Joo Yang, Seung Yong Shin, Ji Eun Kim, June Hwa Bae, Seung Min Hong, Sang-Bum Kang, Eun Soo Kim, Seong-Eun Kim, Seong-Jung Kim, Jun Lee, Soo-Young Na, Soo Jung Park, Sang Hyoung Park, Myung Ha Kim, Won Moon, Sung-Ae Jung","doi":"10.5217/ir.2026.00128","DOIUrl":"10.5217/ir.2026.00128","url":null,"abstract":"<p><p>Venous thromboembolism (VTE) is a serious and potentially life-threatening complication in patients with inflammatory bowel disease (IBD), with the risk further increased during pregnancy and the postpartum period. Pregnancy induces a physiological hypercoagulable state, which, when combined with the chronic inflammatory and prothrombotic milieu of IBD, may result in synergistic thrombotic risk. Population-based cohort studies and meta-analyses consistently demonstrate an elevated risk of VTE during pregnancy and the postpartum period among women with IBD compared with those without, with risk being further amplified by active disease, hospitalization, or cesarean delivery. Current gastroenterology and obstetric guidelines recommend selective, risk-stratified thromboprophylaxis rather than routine anticoagulation for all pregnant women with IBD, emphasizing individualized assessment based on disease activity and additional obstetric risk factors. However, the majority of available evidence and current guideline recommendations are based predominantly on data from Western populations. Although the relative risk of VTE appears broadly comparable across ethnicities, Asian populations demonstrate substantially lower absolute incidence rates and distinct obstetric practice patterns, raising concerns regarding the direct applicability of Western guidelines. This narrative review summarizes the current evidence on the risk of VTE associated with pregnancy and the postpartum period in women with IBD and systematically examines existing thromboprophylaxis recommendations and safety considerations. Consequently, it identifies key clinical variables and analytical perspectives relevant to Asian populations that should be addressed in future research and aims to facilitate the development of population-specific, risk-based thromboprophylaxis strategies that balance the benefits and risks of anticoagulation.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":"24 3","pages":"404-416"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventive and therapeutic effects of co-administration of Bacteroides thetaiotaomicron and infliximab on dextran sodium sulfate-induced colitis in mice.","authors":"Sara Ahmadi Badi, Hamid Reza Moradi, Ahmad Berimipour, Shima Shojaie, Arian Kariman, Hananeh Tavakoli Aval, Seyed Amirhesam Seyedi, Mehdi Davari, Mohammad Hassan Sohouli, Shohreh Khatami, Seyed Davar Siadat, Pejman Rohani","doi":"10.5217/ir.2025.00061","DOIUrl":"10.5217/ir.2025.00061","url":null,"abstract":"<p><strong>Background/aims: </strong>The gut microbiota plays a crucial role in the pathogenesis and treatment of inflammatory bowel diseases (IBD). This study aimed to investigate the effects of active, heat-inactivated, and cell-free supernatant (CFS) forms of Bacteroides thetaiotaomicron, alone or in combination with infliximab, in dextran sodium sulfate (DSS)-induced colitis in mice. Colitis was induced by oral administration of DSS for seven days. B. thetaiotaomicron in its various forms was orally administered at a dose of 1 × 108 CFU prior to and during colitis induction. Infliximab was intraperitoneally injected from days 3 to 5 of DSS exposure. Colitis severity, gene expression, tumor necrosis factor alpha levels, and gut microbiota were assessed by disease activity index, reverse transcription-quantitative polymerase chain reaction (RT-qPCR), enzyme-linked immunosorbent assay (ELISA), and qPCR, respectively.</p><p><strong>Results: </strong>Active B. thetaiotaomicron and its CFS form significantly alleviated colitis symptoms compared to the heat-inactivated form. Furthermore, co-administration of active B. thetaiotaomicron and infliximab significantly modulated the colonic mRNA expression of Ocln, Tff3, Muc2 (upregulated), and Ace2 (downregulated). This combination also exhibited synergistic improvement in colitis severity in treated mice.</p><p><strong>Conclusions: </strong>These findings underscore the therapeutic potential of B. thetaiotaomicron in IBD, either alone or in combination with infliximab, and support further development of microbiota-based strategies for IBD prevention and treatment.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"475-491"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-tumor necrosis factor-α therapy and paradoxical autoimmunity in inflammatory bowel disease: a need for risk-aware monitoring.","authors":"Ji Eun Kim","doi":"10.5217/ir.2026.00169","DOIUrl":"10.5217/ir.2026.00169","url":null,"abstract":"","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":"24 3","pages":"387-388"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upadacitinib in Asian inflammatory bowel disease practice: encouraging real-world efficacy.","authors":"Eun Soo Kim","doi":"10.5217/ir.2026.00200","DOIUrl":"10.5217/ir.2026.00200","url":null,"abstract":"","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":"24 3","pages":"389-391"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal surrogate markers strongly correlate with endoscopic findings in pediatric onset inflammatory bowel disease: a retrospective study in Japan.","authors":"Ryoko Yoshimura, Takahiro Kudo, Masanori Toda, Kosuke Kashiwagi, Masumi Nagata, Kaori Aoki, Natsuki Ito, Kazuhide Tokita, Nobuyasu Arai, Reiko Kyodo, Masamichi Sato, Eri Miyata, Keisuke Jimbo, Yoshikazu Ohtsuka, Toshiaki Shimizu, Hiromichi Shoji","doi":"10.5217/ir.2025.00103","DOIUrl":"10.5217/ir.2025.00103","url":null,"abstract":"<p><strong>Background/aims: </strong>Endoscopy serves as the gold standard for assessing disease activity in inflammatory bowel disease (IBD). Noninvasive biomarkers have been under exploration as potential alternatives. This study aims to examine the diagnostic effectiveness of fecal immunochemical tests, along with levels of fecal calprotectin (FC) and fecal lactoferrin (FL), in stool samples from patients with early-onset IBD.</p><p><strong>Methods: </strong>Children with childhood-onset IBD who visited the Department of Pediatrics and Adolescent Medicine at Juntendo University Hospital between August 2019 and July 2023 were included. FC levels, FL levels, and fecal immunochemical test results were measured using a colloidal gold agglutination assay. Fecal biomarker results and endoscopic findings were reviewed retrospectively.</p><p><strong>Results: </strong>Sixty-five patients had ulcerative colitis (UC), 20 had Crohn's disease (CD), and 3 had unclassified IBD. The participants, aged 3-27 years (median, 18.0 years), included 56 males and 32 females. Stool samples (n = 1,105) were analyzed, from 803 with UC, 251 with CD, and 51 with IBD. Endoscopic evaluations were conducted in 45 UC patients and 18 CD patients. A significant correlation was found between the FC and FL. These biomarkers were significantly correlated with the endoscopic activity index in both UC and CD patients.</p><p><strong>Conclusions: </strong>FC is valuable for diagnosing endoscopic inflammation and predicting recurrence. A significant correlation was observed between FC and FL. In patients with UC and CD, both markers strongly correlated with endoscopic activity. Thus, FC and FL can serve as a reliable alternative to endoscopic evaluation in pediatric patients with childhood-onset IBD.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"492-503"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}