Journal of Gastroenterology最新文献

{"title":"Current status and trends in ERCP and post-ERCP pancreatitis in Japan: a nationwide observational study.","authors":"Tomoo Manaka, Tetsuya Takikawa, Kunio Tarasawa, Kazuhiro Kikuta, Ryotaro Matsumoto, Yu Tanaka, Takanori Sano, Shin Hamada, Shin Miura, Kiyoshi Kume, Kenji Fujimori, Kiyohide Fushimi, Atsushi Masamune","doi":"10.1007/s00535-025-02254-8","DOIUrl":"10.1007/s00535-025-02254-8","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is indispensable for the management of biliary and pancreatic diseases but carries a high risk of post-ERCP pancreatitis (PEP). This study aimed to clarify the current status and temporal trends of ERCP and PEP in Japan, including preventive measures.</p><p><strong>Methods: </strong>We conducted a retrospective, population-based cohort study using the Diagnosis Procedure Combination database from April 1, 2016, to March 31, 2023. Trend analyses were performed for ERCP, PEP, nonsteroidal anti-inflammatory drugs (NSAIDs), and protease inhibitors. Additionally, factors associated with PEP and severe PEP were evaluated.</p><p><strong>Results: </strong>Among the 1,073,513 ERCP cases, PEP and severe PEP incidences were 85,212 (7.9%) and 4841 cases (0.5%), respectively. The mortality rate was 0.5% for severe PEP and 0.2% for non-severe cases. The number of ERCP procedures and the proportion of therapeutic ERCP increased over time. The incidence of PEP declined from 9.1% in the fiscal year 2016-2017 to 6.4% in the fiscal year 2022, while the incidence of severe PEP decreased from 0.5 to 0.33% over the same period. The usage rate of rectal NSAIDs increased from 16.4 to 27.6%, whereas that of protease inhibitors decreased from 70.5 to 53.5%. The administration of rectal NSAIDs at doses of 20-25 mg and 50 mg was associated with a reduced risk of severe PEP.</p><p><strong>Conclusions: </strong>The number of ERCP procedures and the proportion of therapeutic ERCP have increased, whereas the incidences of PEP and severe PEP have decreased. Rectal NSAIDs may prevent the progression of PEP to severe disease.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"1036-1046"},"PeriodicalIF":6.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction of neuropilin-1 and hepatocyte growth factor/C-Met pathway in liver fibrosis progression in hepatocyte-specific NRP-1 knockout mice.","authors":"Han Ding, Huanran Lv, Minghao Sui, Xinyu Wang, Yanning Sun, Miaomiao Tian, Shujun Ma, Yuchan Xue, Miao Zhang, Xin Wang, Jianni Qi, Le Wang, Qiang Zhu","doi":"10.1007/s00535-025-02262-8","DOIUrl":"10.1007/s00535-025-02262-8","url":null,"abstract":"<p><strong>Background: </strong>Hepatocyte growth factor (HGF)/c-Met signaling critically influences liver fibrosis, but its interaction with neuropilin-1 (NRP-1) in hepatocytes remains unclear. We investigated the role of hepatocyte-specific NRP-1 deletion in liver fibrosis progression and its relationship with the HGF/c-Met pathway.</p><p><strong>Methods: </strong>Hepatocyte-specific NRP-1 knockout mice were generated using the Cre-lox system, and liver fibrosis was induced by carbon tetrachloride injections or a methionine- and choline-deficient diet. Fibrosis severity, hepatocyte injury, and cytokine secretion were evaluated via histology, biochemical assays, and molecular analyses in isolated hepatocytes. In vitro experiments were conducted in primary hepatocytes and Huh7 cells using lentiviral overexpression and knockdown of NRP-1. Chromatin immunoprecipitation and dual-luciferase reporter assays were performed to analyze transcription factor binding to the NRP-1 promoter.</p><p><strong>Results: </strong>Hepatocyte NRP-1 expression increased significantly during liver fibrosis and was positively correlated with HGF/c-Met expression and fibrosis severity. In vivo, NRP-1 inhibition reduced extracellular matrix accumulation and abnormal angiogenesis in Alb-Cre NRP-1^f/f mice. In vitro, NRP-1 blockade inhibited c-Met activation and reduced transforming growth factor-beta and vascular endothelial growth factor secretion in hepatocytes. NRP-1 functioned as a co-receptor for HGF/c-Met, with HGF upregulating NRP-1 expression at transcript and protein levels. NRP-1 promoted fibrosis through the Met/extracellular signal-regulated kinase pathway. Furthermore, HGF increased retinoic acid receptor alpha expression, promoting NRP-1 transcription.</p><p><strong>Conclusions: </strong>HGF-induced upregulation of hepatocyte NRP-1, mediated by RARA binding to its promoter, drives liver fibrosis through c-Met pathway activation, highlighting NRP-1 as a potential therapeutic target for liver fibrosis.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"1000-1013"},"PeriodicalIF":6.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating tumor-infiltrating lymphocytes as predictors of lymph node metastasis in deep submucosal invasive esophageal squamous cell carcinoma: a retrospective cross-sectional study.","authors":"Hirona Konishi, Yuji Urabe, Yoshiki Hatsushika, Satoshi Masuda, Takeo Nakamura, Kazuki Ishibashi, Junichi Mizuno, Takeshi Takasago, Hidenori Tanaka, Akiyoshi Tsuboi, Ken Yamashita, Yuichi Hiyama, Yoshihiro Kishida, Hidehiko Takigawa, Akira Ishikawa, Toshio Kuwai, Yoichi Hamai, Yuji Murakami, Shiro Oka","doi":"10.1007/s00535-025-02286-0","DOIUrl":"https://doi.org/10.1007/s00535-025-02286-0","url":null,"abstract":"<p><strong>Background: </strong>Various subtypes of tumor-infiltrating lymphocytes (TILs) are associated with prognosis in various cancer types. In esophageal squamous cell carcinoma (ESCC), TILs have been associated with prognosis in advanced stages of the disease. However, their significance in superficial esophageal squamous cell carcinoma (SESCC) remains unknown. In this study, we investigated the role of TILs in SESCC.</p><p><strong>Methods: </strong>First, we included 212 SESCC lesions with a diameter of 10-20 mm (65 pT1a-EP, 74 pT1a-LPM,40 pT1a-MM, and 33 pT1b-SM lesions) that were resected at our hospital from November 2007 to December 2019. We then examined changes in TILs related to tumor invasion. We evaluated the phenotype and number of TILs using triple immunofluorescence staining for CD4, CD8, and FoxP3. In addition, we selected 97 consecutive pT1b-SM lesions treated during the same period. These specimens were used to examine the association between TILs and lymph node metastasis (LNM) in pT1b-SM cases.</p><p><strong>Results: </strong>The number of CD4 + , CD8 + , and FoxP3 + TILs infiltrating the tumor increased significantly with increasing invasion depth. In pT1b-SM lesions, CD4 + , CD8 + , and FoxP3 + TIL counts were significantly higher in the invasive front (IF) than in the tumor center (CT). Moreover, in patients undergoing surgical resection or endoscopic submucosal dissection (regardless of additional chemoradiotherapy), the number and ratio of FoxP3 + TILs in IF were significantly higher in patients with LNM than in those without, suggesting their potential utility as predictive biomarkers.</p><p><strong>Conclusions: </strong>The number and ratio of FoxP3 + TILs in the IF may be an indicator of LNM risk in SESCC.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The PNPLA3 I148M variant is associated with immune cell infiltration and advanced fibrosis in MASLD: a prospective genotype-phenotype study.","authors":"Jaejun Lee, Jung Hoon Cha, Hee Sun Cho, Keungmo Yang, Hyun Yang, Heechul Nam, Mi Young Byun, Seok Keun Cho, Jinsung Park, Hyuk Wan Ko, Seong Wook Yang, Pil Soo Sung, Si Hyun Bae","doi":"10.1007/s00535-025-02285-1","DOIUrl":"https://doi.org/10.1007/s00535-025-02285-1","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence reveals that immune cells significantly contribute to metabolic dysfunction-associated steatotic liver disease (MASLD) progression. The patatin-like phospholipase domain-containing protein 3 (PNPLA3) I148M variant has been linked to hepatic inflammation and fibrosis; however, its role in immune cell infiltration and activation within the liver remains unclear.</p><p><strong>Methods: </strong>Seventy patients with MASLD were prospectively enrolled. Genomic DNA was extracted from buccal swabs or liver biopsy samples, followed by single nucleotide polymorphism genotyping to determine the rs738409 SNP genotype at codon 148 of PNPLA3. Immunohistochemistry was conducted using CD3 and CD68 antibodies to quantify T cell and macrophage infiltration, respectively. Total RNA extracted from biopsy specimens was used for quantitative reverse transcription polymerase chain reaction to assess the expression of specific markers associated with immune cell activation.</p><p><strong>Results: </strong>Among the 70 patients with MASLD, 34 had the GG genotype, whereas 21 and 15 had the GC and CC genotypes, respectively. The GG genotype group showed a higher proportion of advanced fibrosis (F3 or F4) than the GC + CC group (P = 0.051). GG genotype carriers exhibited significantly higher CD3⁺ and CD68⁺ cell counts in the periportal region than the GC/CC carriers (P < 0.05). The transcriptomic analysis revealed elevated expression of markers associated with chronic antigen stimulation and immune cell activation (CD8A, GZMB, CCL2, and TIMP1) in GG carriers compared with those of GC and CC (P < 0.05). Furthermore, correlations among various markers, including inflammatory, steatosis-associated, and fibrosis-associated markers, exhibited consistent positive correlations.</p><p><strong>Conclusions: </strong>Our findings revealed that the PNPLA3 I148M variant and increased immune cell infiltration and activation were significantly correlated within the MASLD liver. Further studies are needed to elucidate the mechanistic links between this genetic variant and liver inflammation.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of sarcopenia and changes in skeletal muscle mass on prognosis of patients with pancreatic ductal adenocarcinoma receiving chemotherapy with first-line gemcitabine and nab-paclitaxel: a prospective study.","authors":"Tomoya Emori, Masahiro Itonaga, Reiko Ashida, Tomokazu Ishihara, Akiya Nakahata, Yuki Kawaji, Takashi Tamura, Yasunobu Yamashita, Kazuhiro Fukatsu, Masayuki Kitano","doi":"10.1007/s00535-025-02283-3","DOIUrl":"https://doi.org/10.1007/s00535-025-02283-3","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is an important prognostic factor for cancer patients. Here, we prospectively examined the effects of sarcopenia on progression-free survival (PFS) and overall survival (OS) of patients with pancreatic ductal adenocarcinoma (PDAC) treated with first-line gemcitabine and nab-paclitaxel (GnP).</p><p><strong>Methods: </strong>This single-center prospective study enrolled patients with unresectable PDAC treated with first-line GnP between May 2020 and January 2024. The skeletal muscle index (SMI) was used as an index of sarcopenia. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 diagnostic algorithm. PFS and OS of patients with/without sarcopenia were compared. The univariate and multivariate analyses were performed to identify variables significantly associated with prognosis. Changes in skeletal muscle mass (SMM) were also compared with patient prognosis.</p><p><strong>Results: </strong>Of the 66 patients who received first-line GnP, 21 had sarcopenia. The median PFS of those with or without sarcopenia was 3.7 and 6.9 months, respectively (p = 0.045); the median OS was 8.4 and 15.1 months, respectively (p = 0.006). Multivariate analysis identified sarcopenia as an independent prognostic factor for PFS and OS (p = 0.009, p = 0.005, respectively). The rates of major grade 3 or 4 adverse events were significantly higher in the sarcopenia group (p = 0.008). In the sarcopenia group, an early increase in SMM was an independent good prognostic factor (p = 0.041).</p><p><strong>Conclusions: </strong>Sarcopenia is an independent indicator of poor prognosis in patients with PDAC treated with first-line GnP. Increasing SMM in patients with sarcopenia may prolong PFS.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing age at diagnosis raises malignancy risk and aminosalicylate intolerance influences therapeutic strategies in ulcerative colitis: a multicenter I‑BRITE cohort study.","authors":"Shintaro Akiyama, Yuka Ito, Mamiko Shiroyama, Satoshi Suzuki, Masanori Ochi, Toshiro Kamoshida, Hiroshi Kashimura, Junichi Iwamoto, Rie Saito, Tsuyoshi Kaneko, Kazuto Ikezawa, Yoshinori Hiroshima, Junji Hattori, Takashi Mamiya, Satoshi Fukuda, Kazuho Ikeda, Hiroyuki Ariga, Junya Kashimura, Masaaki Nishi, Masaomi Nagase, Kiichiro Tsuchiya","doi":"10.1007/s00535-025-02279-z","DOIUrl":"https://doi.org/10.1007/s00535-025-02279-z","url":null,"abstract":"<p><strong>Background: </strong>The management and characteristics of ulcerative colitis (UC) have evolved over time. We aimed to clarify how changing clinical profiles and treatment options affect patient outcomes.</p><p><strong>Methods: </strong>This retrospective multicenter study of 13 hospitals divided diagnostic era into six periods: Era 1 (before June 30, 1998) and five subsequent 5-year intervals, with Era 6 (July 1, 2018-June 30, 2023) representing the most recent period. We compared therapeutic trends and outcomes across diagnostic eras, including the risk of first systemic steroid, advanced therapy (ADT) use, colectomy, UC-associated neoplasia (UCAN), and extracolonic malignancies.</p><p><strong>Results: </strong>We included 1,867 UC patients. The proportion of elderly onset cases was significantly higher in Eras 5-6 (13%) compared to Eras 1-4 (0%-8.1%). Aminosalicylate intolerance was significantly more frequent in Era 6 (10%) and was significantly associated with earlier systemic steroid and ADT use, though not with colectomy or UCAN. While prescribing patterns of conventional therapies remained unchanged, the preferred first-line ADT shifted from infliximab to vedolizumab in recent diagnostic years. The cumulative risk of colectomy and UCAN did not significantly differ between eras. However, the cumulative risk of extracolonic malignancy was significantly higher in recent diagnostic years and significantly associated with older age at diagnosis.</p><p><strong>Conclusions: </strong>In the recent diagnostic era, the increase in elderly onset UC has been accompanied by a higher malignancy risk, favoring vedolizumab as first-line ADT, especially in elderly patients. Increased aminosalicylate intolerance has led to earlier initiation of systemic steroids and ADTs, which may contribute to improved outcomes.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New potential biomarkers of ulcerative colitis and disease course - integrated metagenomic and metabolomic analysis among Polish patients.","authors":"Oliwia Zakerska-Banaszak, Karolina Ladziak, Dariusz Kruszka, Kacper Maciejewski, Lukasz Wolko, Iwona Krela-Kazmierczak, Agnieszka Zawada, Marie Vibeke Vestergaard, Agnieszka Dobrowolska, Marzena Skrzypczak-Zielinska","doi":"10.1007/s00535-025-02280-6","DOIUrl":"10.1007/s00535-025-02280-6","url":null,"abstract":"<p><strong>Background & aim: </strong>The course of ulcerative colitis (UC) involves successive periods of remission and exacerbation but is difficult to predict. Gut dysbiosis in UC has already been intensively investigated. However, are periods of exacerbation and remission associated with specific disturbances in the composition of the intestinal microbiota and its metabolome? Our goal was to answer this question and to identify bacteria and metabolites necessary to maintain the remission.</p><p><strong>Methods: </strong>We enrolled 65 individuals, including 20 UC patients in remission, 15 in exacerbation, and 30 healthy controls. Metagenomic profiling of the gut microbial composition was performed based on 16S rRNA V1-V9 sequencing. Stool and serum metabolic profiles were studied by chromatography combined with mass spectrometry.</p><p><strong>Results: </strong>We revealed significant differences in the gut bacterial and metabolic composition between patients in active UC and those in remission, as well as in healthy controls. As associated with UC remission we have identified following bacteria: Akkermansia, Agathobacter, Anaerostipes, Enterorhabdus, Coprostanoligenes, Colinsella, Ruminococcus, Subdoligranulum, Lachnoclostridium, Coriobacteriales, Erysipelotrichaceae, and Family XII, and compounds - 1-hexadecanol, phytanic acid, squalene, adipic acid, cis-gondoic acid, nicotinic acid, tocopherol gamma, ergosterol and lithocholic acid. Whereas, in the serum lithocholic acid, indole and xanthine were found as potential candidates for biomarkers of UC remission.</p><p><strong>Conclusion: </strong>We have demonstrated that specific bacteria, metabolites, and their correlations could be crucial in the remission of UC among Polish patients. Our results provide valuable insights and a significant source for developing new hypotheses on host-microbiome interactions in diagnosis and course of UC.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-cell transcriptomics reveals hypoxia-driven iCAF_PLAU is associated with stemness and immunosuppression in anorectal malignant melanoma.","authors":"Hao Zhang, Lin Gan, Xiaofei Duan, Baojing Tuo, Hao Zhang, Senbo Liu, Yugui Lian, Enjie Liu, Zhenqiang Sun","doi":"10.1007/s00535-025-02273-5","DOIUrl":"https://doi.org/10.1007/s00535-025-02273-5","url":null,"abstract":"<p><strong>Background: </strong>Anorectal malignant melanoma (ARMM) is a refractory malignancy that not only responds poorly to radiotherapy but also to immunotherapy. Tumor microenvironment (TME) components play an essential role in tumor progression and therapeutic response. However, TME characteristics of ARMM are not well understood.</p><p><strong>Methods: </strong>We conducted a single-cell RNA sequencing on tumor and blood tissue from three ARMM patients, and combined with cutaneous melanoma datasets from the Gene Expression Omnibus database for a comprehensive joint analysis.</p><p><strong>Results: </strong>Our findings revealed that cancer cells have four major patterns of chromosomal mutations. ARMM cancer cells exhibited marked intratumoral heterogeneity, and elevated angiogenesis, hypoxia, stemness, and epithelial-mesenchymal transition characteristics. We also identified the cancer stem cell subpopulation c5_Mel_CD55_VEPH1 in ARMM. Notably, we observed that CD8 + T cells in ARMM were poorly infiltrated and predominantly in a terminal exhausted state. Moreover, we identified a unique population of PLAU + fibroblast cells (iCAF_PLAU) in ARMM that likely have differentiated from myofibroblasts under hypoxic conditions. The iCAF_PLAU population enhances the stemness and aggressiveness of cancer cells through the ligand-receptor pairs WNT5A_FZD3_LRP6 and NRG1_ERBB3. In addition, iCAF_PLAU secretes CCL2, which binds to CCR1 on SPP1 + macrophages (TAM_SPP1) cells, leading to the activation of NFKBIA in TAM_SPP1 and subsequent upregulation of IL6, which may be linked to the exhaustion process of CD8 + T cells. Immunofluorescence staining confirmed the co-localization of iCAF_PLAU with TAM_SPP1 and TAM_SPP1 with CD8 + T cells.</p><p><strong>Conclusion: </strong> Our data suggest a potential role of iCAF_PLAU in mediating cell-cell interactions within the TME of ARMM, highlighting potential therapeutic targets for this aggressive malignancy.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert consensus on diagnostic guidelines for pediatric inflammatory bowel disease in Japan.","authors":"Takahiro Kudo, Katsuhiro Arai, Itaru Iwama, Shin-Ichiro Hagiwara, Takashi Ishige, Koji Yokoyama, Fumihiko Kakuta, Keisuke Jimbo, Hiroki Kondou, Yugo Takaki, Shingo Kurasawa, Hiroki Fujikawa, Yuhki Koike, Fumihito Hirai, Shinya Ashizuka, Kenji Watanabe, Toshiaki Shimizu, Tadakazu Hisamatsu","doi":"10.1007/s00535-025-02271-7","DOIUrl":"https://doi.org/10.1007/s00535-025-02271-7","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) can occur at any age. In pediatric patients, the disease may present with a broader range of symptoms and more severe course than in adults, due to ongoing growth and development. Therefore, pediatric IBD often exhibits an atypical clinical course and laboratory findings. It is essential to recognize differences in disease presentation, differential diagnoses, and evaluation strategies specific to children. The revised Porto criteria, proposed by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) in 2014, are widely used globally, including in Japan, for the diagnosis of pediatric IBD.</p><p><strong>Purpose: </strong>Despite the widespread use of these criteria, no formal diagnostic guidelines for pediatric IBD have been developed in Japan. We aimed to support future guideline development by summarizing important diagnostic considerations and clinical practices for pediatric IBD in Japan.</p><p><strong>Methods: </strong>This review was developed based on relevant international diagnostic guidelines and the expert opinions of Japanese pediatric gastroenterologists. It outlines key clinical and laboratory evaluations, as well as current treatment and follow-up approaches.</p><p><strong>Results: </strong>We summarized recommended diagnostic tests and clinical points that require special attention in children with suspected IBD. The article reflects both global standards and domestic clinical experience.</p><p><strong>Conclusion: </strong>Although this article does not provide formal diagnostic criteria or assess evidence levels, it offers accurate and practical information to guide physicians and patients in the diagnosis and management of pediatric IBD in Japan.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low HDL cholesterol levels in women and hypertriglyceridemia in men: predictors of MASLD onset in individuals without steatosis.","authors":"Tsubasa Tsutsumi, Takumi Kawaguchi, Hideki Fujii, Yoshihiro Kamada, Yuichiro Suzuki, Koji Sawada, Miwa Tatsuta, Tatsuji Maeshiro, Hiroshi Tobita, Takemi Akahane, Chitomi Hasebe, Miwa Kawanaka, Takaomi Kessoku, Yuichiro Eguchi, Hayashi Syokita, Atsushi Nakajima, Tomoari Kamada, Hitoshi Yoshiji, Hiroshi Sakugawa, Asahiro Morishita, Tsutomu Masaki, Takumi Ohmura, Toshio Watanabe, Yoshioki Yoda, Nobuyuki Enomoto, Masafumi Ono, Kanako Fuyama, Kazufumi Okada, Naoki Nishimoto, Yoichi M Ito, Hirokazu Takahashi, Michael R Charlton, Mary E Rinella, Yoshio Sumida","doi":"10.1007/s00535-025-02242-y","DOIUrl":"10.1007/s00535-025-02242-y","url":null,"abstract":"<p><strong>Background: </strong>Individuals with metabolic-associated steatotic liver disease (MASLD) have a worse prognosis compared to patients without steatosis, and its prevalence is increasing. However, detailed risk factors based on obesity and sex remain unclear. We aimed to investigate the impact of cardiometabolic risk factors (CMRFs) on the risk of MASLD in individuals without pre-existing SLD.</p><p><strong>Methods: </strong>SLD was diagnosed by ultrasonography. Non-SLD individuals were followed 65,657 person-years. Incidence rates of MASLD were assessed by Kaplan-Meier analysis. Furthermore, independent factors associated with the development of MASLD were identified using Cox regression analysis, stratified by four groups: obese men, non-obese men, obese women, and non-obese women.</p><p><strong>Results: </strong>The overall incidence rate of MASLD was 39.3/1,000 person-years. The cumulative incidence was highest in obese men, followed by obese women, non-obese men, and non-obese women. Two or more CMRFs increased the risk of MASLD in all groups. Low HDL cholesterol level was the strongest independent risk factor in both obese and non-obese women and hypertriglyceridemia for both obese and non-obese men. The impact of these CMRFs was stronger in non-obese individuals. (HR [95% CI]: women non-obese 1.9 [1.5-2.4], obese 1.4 [1.1-1.8]; men non-obese 2.3 [1.9-2.9], obese 1.5 [1.2-2.0]).</p><p><strong>Conclusions: </strong>Multiple CMRFs are important to MASLD development, regardless of sex and obesity. In this Japanese cohort, low HDL cholesterol in women and hypertriglyceridemia in men were the most significant risk factors, especially among the non-obese group. These findings suggest that sex-specific CMRFs may play a role in the development of MASLD.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"891-904"},"PeriodicalIF":6.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}