Journal of Gastroenterology and Hepatology最新文献

{"title":"Role of the Dietitian in the Inflammatory Bowel Disease Multidisciplinary Team.","authors":"Nicky E McCarthy, Michael Schultz, Catherine L Wall","doi":"10.1111/jgh.70001","DOIUrl":"https://doi.org/10.1111/jgh.70001","url":null,"abstract":"<p><p>In recent years, nutrition and dietetics have evolved from playing a supporting role in inflammatory bowel disease care to becoming an integral part of the treatment approach. Nutrition and dietary treatments address malnutrition, which is known to be highly prevalent in inflammatory bowel disease patients, reduce active inflammation, provide symptom relief, and enhance quality of life. Patients believe that nutrition-based strategies are an important part of their disease management but generally have difficulty accessing specialist nutrition advice. Best practice inflammatory bowel disease management guidelines recommend coordinated multidisciplinary care models, but many multidisciplinary teams do not currently include dietitians. Research has shown that inflammatory bowel disease multidisciplinary teams that do include dietitians have improved patient disease outcomes and cost efficiencies. As the only health professional with extensive training in medical nutrition therapy and dietary counseling, dietitians are the most appropriate health professional to carry out detailed nutritional assessments and advise patients on individualized diet and nutrition treatments for inflammatory bowel disease. The growing emphasis on dietary therapy in inflammatory bowel disease and the complexity of evidence-based dietary recommendations highlight the need for dietitians to be an integral part of the multidisciplinary team caring for inflammatory bowel disease patients.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Model Predicting Artificial Intelligence Use by Gastroenterology Nurses in Clinical Practice: A Cross-Sectional Multicenter Survey.","authors":"Thomas Yuen Tung Lam, Yue Hu, Y Yi, Peter J Schulz, May O Lwin, Kalya M Kee, Wilson W B Goh, Max F K Cheung, H S Lee, Alice S H Fan, Phyllis P Y Lam, S F Lam, L Zhou, Y Chen, F Li, Ying Lau, Jer-Wei Wu, Han-Mo Chiu, H Xu, Joseph J Y Sung","doi":"10.1111/jgh.17042","DOIUrl":"https://doi.org/10.1111/jgh.17042","url":null,"abstract":"<p><strong>Background and aims: </strong>Nurses' participation during colonoscopy has been demonstrated to significantly improve the detection rate of polyps and adenomas. Nonetheless, the adoption of AI in clinical practice still poses challenges. There is limited understanding of the factors influencing gastroenterology nurses' intentions to use AI in clinical practice. We aimed to examine how gastroenterology nurses' intentions to use AI are affected by perceived usefulness, acceptance of this technology, and perceived risk via a moderated mediation model controlling for nurses' characteristics.</p><p><strong>Methods: </strong>A cross-sectional multicenter survey study was conducted among gastroenterology nurses from 54 hospitals in Taiwan, Hong Kong, and mainland China. A total of 337 nurses (mean age 37.40 ± 8.29 years, 81.6% females) completed the survey.</p><p><strong>Results: </strong>After controlling for previous experience with AI, number of working years, and work role, a statistically significant direct effect of perceived usefulness on use intention was found. The indirect effect of perceived usefulness on use intention through AI technology acceptance was the most robust when perceived risk was at the lowest level.</p><p><strong>Conclusions: </strong>Findings suggest that perceived usefulness facilitated the intentional use of AI in clinical practice through acceptance of AI, especially when perceived risk was low.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Malignant Potential of Gastric Adenomas: The Role of Endoscopic Features and Genetic Alterations.","authors":"Takeshi Ishida, Tatsuya Yamaguchi, Takashi Yoshida, Shoji Kobayashi, Toru Kuno, Shinya Takaoka, Yuko Aonuma, Satoshi Kawakami, Masaru Muraoka, Yuichiro Suzuki, Mitsuaki Sato, Shinichi Takano, Shinya Maekawa, Nobuyuki Enomoto","doi":"10.1111/jgh.17043","DOIUrl":"https://doi.org/10.1111/jgh.17043","url":null,"abstract":"<p><strong>Background and aim: </strong>There is no \"gold standard\" treatment for gastric adenomas due to uncertainty about their malignant potential. We wanted to understand better the factors contributing to their transformation into malignant tumors by analyzing their long-term development, including endoscopic observations and genetic abnormalities.</p><p><strong>Methods: </strong>A total of 34 gastric tumor specimens from 17 patients were analyzed. All patients initially received a diagnosis of adenoma through a biopsy. Subsequently, eight patients were confirmed to have adenoma, while nine were diagnosed with carcinoma following an endoscopic mucosal dissection. The tumor lesions were isolated using laser-capture microdissection for DNA extraction. Subsequent targeted sequencing of 50 cancer-related genes was performed. The resultant data were compared with the patient's clinical records, and the endoscopic findings, including tumor color, microsurface pattern, and microvascular pattern, were observed.</p><p><strong>Results: </strong>In ESD specimens, the most frequently detected gene alterations were in APC (53%), KRAS (18%), TP53 (12%), and FBXW (12%). There were no differences in frequency between final diagnoses, although there was a tendency to detect more gene alterations in cases ultimately diagnosed with adenoma (p = 0.05). Conversely, endoscopic findings of reddish/same color rate (p < 0.01) and MSP/MVP irregular rate (p < 0.05) were higher in cases with a final carcinoma diagnosis at ESD.</p><p><strong>Conclusions: </strong>Color and magnifying NBI during endoscopy help predict malignant transformation when patients are followed up for adenomas.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Introducing Artificial Intelligence on Colonoscopy: A Retrospective Study on Potential Benefits and Drawbacks.","authors":"Ayaka Takasu, Hirofumi Kogure, Zhehao Dai, Yuki Yamada, Masako Nakayama, Robert Bechara, Takuji Gotoda, Yoshimasa Miura","doi":"10.1111/jgh.17040","DOIUrl":"https://doi.org/10.1111/jgh.17040","url":null,"abstract":"<p><strong>Background and aim: </strong>Computer-aided detection (CAD) can improve adenoma detection rates (ADRs); however, the impact of its introduction into real-world practice remains unclear. This study investigated the effect of CAD's introduction on colonoscopy in a hospital.</p><p><strong>Methods: </strong>This retrospective study included 1314 patients who underwent colonoscopy between January and December 2023 at a single facility where CAD was introduced in three of four endoscopy rooms. ADR, polyp detection rate (PDR), and sessile serrated lesion detection rate (SSLDR) were first compared between patients who underwent colonoscopy without CAD before introduction to the facility (pre-intervention non-CAD group) and those who underwent colonoscopy with CAD after introduction (CAD group). Subsequently, cases without CAD were analyzed to evaluate endoscopists' performance by comparing the detection rates between the pre-intervention non-CAD group and patients who underwent colonoscopy without CAD after introduction (post-intervention non-CAD group).</p><p><strong>Results: </strong>ADR (49.3% vs. 31.6%, p < 0.001) and PDR (57.9% vs. 39.8%, p < 0.001) were significantly higher in the CAD group than in the pre-intervention non-CAD group; SSLDR (4.4% vs. 2.8%, p = 0.14) was comparable between groups. ADR (31.6% vs. 13.5%, p < 0.001) and PDR (39.8% vs. 18.2%, p < 0.001) were significantly lower in the post-intervention non-CAD group than in the pre-intervention non-CAD group.</p><p><strong>Conclusions: </strong>The introduction of CAD-assisted colonoscopy significantly improved ADR and PDR. However, CAD reliance may lead to lapses in attention toward independent lesion detection by endoscopists. It is essential to consider how CAD should be utilized in clinical practice to maximize its benefits.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guselkumab in East Asians With Moderate-to-Severe Ulcerative Colitis: Subgroup Analysis of the QUASAR Induction and Maintenance Studies.","authors":"Baili Chen, Byong Duk Ye, Qian Cao, Fumihito Hirai, Masayuki Saruta, Minhu Chen, Susan Pelak, Nicole Shipitofsky, Ye Miao, Keira Herr, Bryan Wahking, Jianmin Zhuo, Tadakazu Hisamatsu","doi":"10.1111/jgh.17036","DOIUrl":"https://doi.org/10.1111/jgh.17036","url":null,"abstract":"<p><strong>Background and aim: </strong>The global QUASAR (NCT04033445) clinical program demonstrated the efficacy and safety of guselkumab, a dual-acting interleukin-23 p19 subunit inhibitor, as induction and maintenance therapy in participants with moderate to severely active ulcerative colitis (UC). We report a subgroup analysis in East Asian participants.</p><p><strong>Methods: </strong>The QUASAR program included two randomized, placebo-controlled, 12-week induction studies of guselkumab 200 mg (and 400 mg, Phase 2b) IV every 4 weeks (q4w) in adults with baseline modified Mayo scores of 5-9 and inadequate response/intolerance to conventional and/or advanced UC therapy. Clinical responders to guselkumab induction were re-randomized (1:1:1) at maintenance study baseline to SC guselkumab 200 mg q4w, 100 mg q8w, or placebo. Primary endpoints were clinical response (Phase 2b) or clinical remission (Phase 3) at induction Week 12 (I-12) and clinical remission at maintenance Week 44 (M-44). Subgroup analyses included participants from sites in China, Japan, Korea, and Taiwan region.</p><p><strong>Results: </strong>Data were from 71 (Phase 2b) and 135 (Phase 3) East Asians in the induction studies and 106 in the maintenance study. At Week I-12, 45.5%-58.8% of guselkumab versus 25.5%-29.2% of placebo participants achieved clinical response and 16.0%-23.8% versus 4.2%-5.5%, respectively, achieved clinical remission. At Week M-44, 37.1%-46.3% of guselkumab versus 13.3% of placebo participants achieved clinical remission. The adverse event profile was generally consistent with the global QUASAR population.</p><p><strong>Conclusions: </strong>Results support the efficacy and safety of guselkumab induction and maintenance in East Asians with moderately to severely active UC, consistent with findings from the global QUASAR studies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT04033445; EudraCT, 2018-004002-25.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compositional and Metabolomic Shifts of the Gut Microbiome in Alcohol-Related Liver Disease.","authors":"Cheng-Hao Kuo, Emad El-Omar, Cheng-Yen Kao, Jaw-Town Lin, Chun-Ying Wu","doi":"10.1111/jgh.17038","DOIUrl":"https://doi.org/10.1111/jgh.17038","url":null,"abstract":"<p><p>Alcohol-related liver disease (ALD) is a major global health concern characterized by steatosis and liver inflammation due to chronic alcohol consumption. Emerging evidence suggests that ALD is not solely a liver pathology but also involves dysfunction of the gut-liver axis, where alterations in the gut microbiota play a significant role. Although alcohol-associated dysbiosis has been extensively studied, whether these microbial changes contribute to ALD development or are merely a consequence of alcohol exposure remains unclear. To prove causation, it is essential to decipher which specific taxa and their metabolites drive the maladaptation of host-microbiota interactions upon alcohol exposure. In this review, we summarize the compositional changes in the gut microbiome after alcohol exposure, identifying traits of alcohol-induced dysbiosis and distinguishing them from those associated with liver disease. The effects of alcohol-induced dysbiosis on microbial metabolism and host responses are reviewed, focusing on the key classes of microbiota-derived metabolites, notably free fatty acids, tryptophan and its indole derivatives, and secondary bile acids. We discuss how alterations in these metabolites disrupt intestinal barrier function, immune responses, and metabolic signaling pathways, thereby exacerbating alcohol-induced injury. Advanced omics technologies and microbiome modulation strategies will help further investigation into these mechanisms. Detailed mechanistic insights into host-microbiota interactions could unveil novel therapeutic targets, offering potential strategies to prevent or mitigate ALD by modulating the gut microbiome and its metabolites.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carcinoma of Esophagus.","authors":"Joseph Sung, Dongxin Lin, Rebecca Fitzgerald, Prateek Sharma, Simon Law, David Ilson","doi":"10.1111/jgh.16990","DOIUrl":"https://doi.org/10.1111/jgh.16990","url":null,"abstract":"<p><p>Carcinoma of esophagus is one of the most common cancer worldwide, but its epidemiology is changing. Squamous cell carcinoma is declining in the East, but adenocarcinoma is rising in the West, probably related to the pandemic of obesity and changing lifestyle. Screening of esophageal cancer (both endoscopic and nonendoscopic methods) is recommended in patients suffering from long-term acid reflux symptoms associated with high-risk factors and surveillance in patients with Barrett's esophagus. Endoscopy with virtual chromoendoscopy, endoscopic ultrasound, and CT scan is essential for diagnosis and staging of the disease. Endoscopic therapy can be used to treat early diseases. Surgery remains a mainstay treatment. Multimodality treatment strategies involving combinations of chemotherapy, radiotherapy, and more recently immunotherapy and target therapies are gaining momentum.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Promotion of Wound Healing by Acetate in Murine Colonic Epithelial Cell via c-Jun N-Terminal Kinase Activation\".","authors":"","doi":"10.1111/jgh.17039","DOIUrl":"https://doi.org/10.1111/jgh.17039","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Diagnosis Alkaline Phosphatase and Antimitochondrial Antibody Positivity Vary by Race/Ethnicity Among Patients With Primary Biliary Cholangitis.","authors":"Allyce Caines, Mei Lu, Trueman Wu, Sheri Trudeau, Christina Melkonian, Humberto C Gonzalez, Amandeep K Sahota, Mark A Schmidt, Yihe Daida, Christopher L Bowlus, Stuart C Gordon","doi":"10.1111/jgh.17035","DOIUrl":"https://doi.org/10.1111/jgh.17035","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis of primary biliary cholangitis (PBC) is made using alkaline phosphatase (ALP) and positive antimitochondrial antibody (AMA), but these biomarkers may vary by race. There is also little known about changes in ALP in the years prior to PBC diagnosis.</p><p><strong>Methods: </strong>Using data from the Fibrotic Liver Disease Consortium, we used matched pairs to evaluate racial differences in ALP for up to 5 years prior to diagnosis. We also compared rates of AMA positivity by race.</p><p><strong>Results: </strong>1335 confirmed PBC patients were included: 769 (58%) non-Hispanic white (NHW); 110 (8%) Black; 138 (11%) Asian American Pacific Islander (AAPI); and 318 (24%) Hispanic. 774 patients had AMA test results. Black patients had significantly lower AMA positivity than NHWs. Black patients were less likely to be AMA-positive compared to NHW patients (OR = 0.50, 95% CI 0.29-0.86, p = 0.012). There were no significant differences in rates of AMA positivity between AAPI or  Hispanic versus NHW patients. All patient groups had elevated ALP for 2-5 years prior to diagnosis. ALP differed between Black and NHW patients only at specific times before diagnosis. There were no significant differences in ALP between Hispanic and NHW patients. AAPI patients had significantly lower ALP compared to NHWs.</p><p><strong>Conclusion: </strong>In a diverse sample of PBC patients, we observed significant differences in AMA positivity and pre-diagnosis ALP levels by race. Future studies to better characterize PBC across racial/ethnic groups are warranted.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thermophiles, Thick-Walled Bacteria, and Pseudomonads in High-Altitude Gut Microbiota.","authors":"Fang Yan, Shi-Min Wu, Wen-Qiang Yuan, Yun-Han Yang, Hao Zhu, De-Jun Cui","doi":"10.1111/jgh.17032","DOIUrl":"https://doi.org/10.1111/jgh.17032","url":null,"abstract":"<p><strong>Background and aim: </strong>High-altitude environments are characterized by low oxygen and reduced low pressure, which impose significant physiological challenges on organisms. Among various adaptive systems, the intestinal flora plays a crucial role in maintaining gut health and barrier integrity function under such conditions. This study aimed to elucidate the regulatory mechanisms of intestinal flora in high-altitude environments, focusing on downregulating intracellular Bone Morphogenetic Protein 4 (BMP4) to influence glycolysis metabolism, thereby affecting intercellular communication of the intestinal mucosal barrier and matrix remodeling.</p><p><strong>Methods: </strong>High-altitude mouse intestinal flora composition and function were analyzed using 16S rRNA and metagenomic sequencing. Additionally, single-cell sequencing was employed to examine cell population communication and gene expression differences between normal and high-altitude mouse intestinal tissues.</p><p><strong>Results: </strong>Single-cell sequencing showed significantly reduced interactions between intestinal fibroblasts and epithelial cells in high-altitude mice, accompanied by a marked increase in BMP4 expression. Overexpression of BMP4 was found to activate the glycolysis pathway. Gut microbiota metabolites, including secondary bile acids, lactic acid, and butyrate, exhibited protective effects on hypoxia-induced intestinal mucosal barrier injury, with butyrate showing the most prominent effect. Under hypoxic conditions, butyrate suppressed the BMP4/glycolysis pathway, thereby alleviating hypoxia-induced intestinal mucosal barrier damage.</p><p><strong>Conclusion: </strong>This study uncovered a novel mechanism by which the gut microbiota in high-altitude environments modulate glycolysis metabolism through BMP4 downregulation, thereby affecting intercellular communication and matrix remodeling within the intestinal mucosal barrier.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}