Journal of Gastroenterology and Hepatology最新文献

{"title":"The Comparison Between Low- and High-Concentration Injection Solution Ability for Colorectal Endoscopic Submucosal Dissection.","authors":"Naohisa Yoshida, Ryohei Hirose, Yoshikazu Inagaki, Takaaki Murakami, Yutaka Inada, Daisuke Hasegawa, Yuri Tomita, Reo Kobayashi, Osamu Dohi, Ken Inoue, Yoshito Itoh, Naoyuki Yamaguchi","doi":"10.1111/jgh.16943","DOIUrl":"https://doi.org/10.1111/jgh.16943","url":null,"abstract":"<p><strong>Background and aim: </strong>Injection solution is important for achieving submucosal elevation in endoscopic submucosal dissection (ESD) and various viscous solutions categorized as low-concentration injection solution (LCS) or high-concentration injection solution (HCS) are used. We analyzed the difference between LCS and HCS in colorectal ESD.</p><p><strong>Methods: </strong>This was a prospective, randomized controlled trial at six Japanese institutions. Patients with early neoplastic lesions of ≥ 20 mm were enrolled from March 2022 to September 2023. Sodium alginate (Liftal K, Kaigen Pharma Co., Osaka, Japan) was used as the injection solution, and the concentration of HCS and LCS was set at 0.6% and 0.3%, respectively. Participants were randomized to HCS or LCS groups and the primary endpoint was the noninferiority about ESD procedure time of LCS compared to HCS.</p><p><strong>Results: </strong>The LCS and HCS groups consisted of 79 and 82 cases, respectively. The ESD procedure time (min, mean ± standard deviation) was significantly noninferior between the LCS and HCS groups (p < 0.001) and was significantly shorter in the LCS group than in the HCS group (61.9 ± 39.2 vs. 76.9 ± 67.5, p = 0.044). There were no significant differences in en bloc resection (98.7% vs. 100.0%, p = 0.985), perioperative perforation (2.5% vs. 2.4%, p = 0.639), and delayed bleeding (1.3% vs. 1.2%, p = 0.493). In the subgroup analysis, the ESD procedure times were significant for lesions of ≥ 40 mm (74.3 ± 30.4 vs. 125.3 ± 107.2, p = 0.031) and experts (51.5 ± 29.2 vs. 69.4 ± 58.9, p = 0.046). Additionally, injection volumes (mL) were not significant (38.0 ± 20.2 vs. 33.0 ± 27.0, p = 0.098) in the two groups.</p><p><strong>Conclusion: </strong>LCS was noninferior to HCS in terms of procedure time and significantly reduced it.</p><p><strong>Trial registration: </strong>University Hospital Medical Information Network Clinical Trials Registry number: UMIN000048661.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676871","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":"Optimizing Model Construction and Ideal Cutoff Mechanisms in Targeted Screening for Autoimmune Gastritis.","authors":"Pedro Robson Costa Passos, Valbert Oliveira Costa Filho","doi":"10.1111/jgh.16940","DOIUrl":"https://doi.org/10.1111/jgh.16940","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657515","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":"PPARγ/β/δ Agonists Can Ameliorate Dextran Sodium Sulfate-Induced Colitis and Modulate Gut Microbiota.","authors":"Jian-Hong Li, Jing Xu, Jin-Xia Hu, Hao-Ming Xu, Xue Guo, Yan Zhang, Jing-Kui Xu, Chen Huang, Yu-Qiang Nie, You-Lian Zhou","doi":"10.1111/jgh.16929","DOIUrl":"https://doi.org/10.1111/jgh.16929","url":null,"abstract":"<p><strong>Background and aim: </strong>Peroxisome proliferator-activated receptors (PPARs), as nuclear receptors, modulate both lipid metabolism and inflammatory/immune processes. This study examines the impact of modulating the activities of the PPAR subtypes PPARβ/ð and PPARγ on the gut microbiota in inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>Mice with dextran sulfate sodium (DSS)-induced acute colitis were treated with the PPARγ agonist pioglitazone, PPARβ/δ agonist GW0742, or their respective antagonists (GW9662, GSK3787). Weight loss, diarrhea severity, hematochezia, and disease activity index were assessed daily. Upon study completion, colon length, histopathology, and mRNA levels of the intestinal barrier and inflammatory markers were measured. Occludin and E-cadherin levels were assessed via immunofluorescence analysis, and cecal samples underwent 16S rRNA sequencing for gut microbiota analysis.</p><p><strong>Results: </strong>Our findings revealed that the agonists pioglitazone and GW0742 effectively suppressed DSS-induced colitis, improved clinical symptoms, reversed colon shortening, and mitigated histological damage. Conversely, their antagonists, GW9662 and GSK3787, failed to alleviate inflammation and sometimes exacerbated disease indicators. Both agonists modulated DSS-induced dysbiosis by reducing the abundance of proinflammatory cytokine-associated microbiota, including Bacteroides, Enterococcus, and Escherichia-Shigella, while enhancing both α-diversity and β-diversity of the gut microbiome, to restore equilibrium.</p><p><strong>Conclusion: </strong>Our findings reveal that activation of PPARγ and PPARβ/δ can balance the gut microbiota in mice and ameliorate experimental colitis in mice. Thus, PPARγ and PPARβ/δ have protective effects against IBD and could serve as novel therapeutic targets for its treatment.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657518","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":"NLRP3 and Gut-Liver Axis: New Possibility for the Treatment of Alcohol-Associated Liver Disease.","authors":"Lu Dong, Haotian Zhang, Yanyu Kang, Fei Wang, Ting Bai, Yong Yang","doi":"10.1111/jgh.16935","DOIUrl":"https://doi.org/10.1111/jgh.16935","url":null,"abstract":"<p><p>Alcohol-associated liver disease (ALD) is one of the most prevalent chronic diseases worldwide, with persistently high morbidity and mortality rates. Previous studies have identified NLRP3 inflammasome as a class of receptors of intracellular intrinsic immunity. These receptors can be activated by both intrinsic and extracellular danger signals, leading to the release of downstream pro-inflammatory factors, including interleukin IL-1β and IL-18. These vesicles are critical for maintaining host defense. Concurrently, researchers have identified a close relationship between the microbiome, gut-liver axis, and NLRP3 inflammasome with ALD. Consequently, the present study focus on the structure and activation of the NLRP3 inflammasome, the gut-liver axis, and intestinal microecological regulation, as well as the relationship between bile acid metabolism and the gut-liver axis. The objective of this study is to provide a foundation of knowledge and references for the development of targeted therapeutic interventions of ALD that are informed by the dynamic interplay between the NLRP3 inflammasome and the gut-liver axis.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649246","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":"Colonic Diverticulosis and Uncomplicated Diverticulitis Are Associated With a Lower Not Higher Risk of Mortality When Confounding Factors Are Held Constant.","authors":"Raquel A Cameron, Michael P Jones, Guy D Eslick, Nicholas J Talley","doi":"10.1111/jgh.16928","DOIUrl":"https://doi.org/10.1111/jgh.16928","url":null,"abstract":"<p><strong>Background and aim: </strong>The association between colonic diverticulosis, diverticulitis, and mortality is controversial. This study evaluated the association between diverticular disease and mortality over a prolonged period in a GP cohort.</p><p><strong>Methods: </strong>GP records were sourced from the United Kingdom medical database (THIN). Diverticulosis and diverticulitis were identified via Read codes. The overall patient cohort (n = 1 274 260) included patients with colonic diverticula (n = 39 521 [3.1%], mean age 54) and no diverticula (control group) (n = 1 234 739 [96.9%], mean age 38). Poisson regression estimated relative rates, and durational time at risk and survival probability were calculated.</p><p><strong>Results: </strong>Colonic diverticula are associated with an increased mortality risk when compared with nondiverticular patients (OR = 1.89, 95% CI 1.84-1.94; p < 0.001). However, controlling for age, sex, and potential confounding variables yielded a decreased mortality risk overall for colonic diverticula patients (HR = 0.66, 95% 0.64-0.6; p < 0.001). When the diverticulitis cohort is separated into uncomplicated and complicated, increased mortality is observed in both uncomplicated diverticulitis (HR = 0.64, 95% CI 0.61-0.66; p < 0.001) and complicated diverticulitis (HR = 1.14, 95% CI 1.02-1.28; p = 0.024), but on controlling for confounding, there is a decreased risk of mortality for uncomplicated diverticulitis (HR = 0.65, 95% CI 0.63-0.66; p < 0.001) but almost two times increased mortality risk for complicated diverticulitis (HR = 1.18, 95% CI 1.05-1.32; p = 0.006).</p><p><strong>Conclusions: </strong>In this large UK GP sample, controlling for age, sex, and comorbidities, patients with uncomplicated diverticula are associated with a lower mortality risk. However, complicated diverticulitis still carries two times the risk of mortality than those with no or uncomplicated colonic diverticula.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649191","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":"Enhancing Prognostic Accuracy in Colorectal Cancer Patients With Second Primary Malignancies: A Critical Perspective.","authors":"Muhammad Nouman Javed, Umna Ahmed, Noor Ul Eman","doi":"10.1111/jgh.16942","DOIUrl":"https://doi.org/10.1111/jgh.16942","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634078","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":"Advancing Competency Assessments in Gastrointestinal Endoscopy Training.","authors":"Amir Farah, Amir Mari","doi":"10.1111/jgh.16937","DOIUrl":"10.1111/jgh.16937","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634068","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":"Balancing Benefits and Risks: The Role of Tranexamic Acid in Upper Gastrointestinal Bleeding.","authors":"Jinyu Wu, Yun Liao","doi":"10.1111/jgh.16941","DOIUrl":"https://doi.org/10.1111/jgh.16941","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634071","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 'Cirrhosis in primary practice: many patients remain potentially undiagnosed and are not receiving liver cancer surveillance'.","authors":"","doi":"10.1111/jgh.16918","DOIUrl":"https://doi.org/10.1111/jgh.16918","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624889","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":"Systemic Therapy for Advanced Gastrointestinal Stromal Tumors in 2025: Current Standard of Care and Emerging Therapeutic Strategies.","authors":"Joshua Tian Ming Hoe, Evelyn Yi Ting Wong, Timothy Kwang Yong Tay, Valerie Shiwen Yang","doi":"10.1111/jgh.16932","DOIUrl":"https://doi.org/10.1111/jgh.16932","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624892","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}