Neurogastroenterology and Motility最新文献

{"title":"Gastric and sacral electrical stimulation for motility disorders-A clinical perspective.","authors":"Charlotte Desprez, Anne-Marie Leroi, Guillaume Gourcerol","doi":"10.1111/nmo.14884","DOIUrl":"10.1111/nmo.14884","url":null,"abstract":"<p><strong>Background: </strong>Electrical stimulation of the gut has been investigated in recent decades with a view to treating various gastro-intestinal motility disorders including, among others, gastric electrical stimulation to relieve nausea and vomiting associated with gastroparesis and sacral neuromodulation to treat fecal incontinence and/or constipation. Although their symptomatic efficacy has been ascertained by randomized controlled trials, their mechanisms of action are not fully understood.</p><p><strong>Purpose: </strong>This review summarizes the past year's literature on the mechanisms of action of gut electrical stimulation therapies, including their impact on the gut-brain axis.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14884"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy-Induced Neuropathy Affecting the Gastrointestinal Tract.","authors":"Gema Vera, Kulmira Nurgali, Raquel Abalo","doi":"10.1111/nmo.14976","DOIUrl":"10.1111/nmo.14976","url":null,"abstract":"<p><strong>Background: </strong>Cancer is a major global cause of morbidity and mortality. Survivorship is increasing, bringing new challenges. Cancer treatment, including chemotherapeutic drugs, immunotherapy, and radiotherapy, can have severe and impactful gastrointestinal side effects occurring shortly after treatment (acute toxicity) or persisting for years after treatment ends (late/chronic toxicity).</p><p><strong>Purpose: </strong>The aim of this article is to review the neurotoxic effects of chemotherapy on the enteric nervous system (ENS) and the gut extrinsic innervation. These effects could contribute to the development of long-term gastrointestinal dysfunctions. Research, primarily conducted in animal models, indicates that antitumoral drugs can lead to chemotherapy-induced enteric neuropathy (CIEN). Studies, mainly performed in the myenteric plexus, show that CIEN is characterized by a reduced density of nerve cells and fibers, as well as an imbalanced representation of neuronal subpopulations or their markers, with enteric glial cells also affected. These alterations underlie changes in neuronal activity and gastrointestinal motor function. Although research on the submucosal plexus remains limited, evidence suggests that CIEN affects the entire ENS. Furthermore, scarce studies show that CIEN also occurs in humans. Moreover, emerging experimental data on chemotherapy-induced alterations in visceral sensitivity suggest that the extrinsic innervation of the gut is also affected, but this has received little attention thus far. Nevertheless, this could contribute to the development of chemotherapy-induced brain-gut axis (BGA) disorders in the long term. Cancer chemotherapy (and probably also immunotherapy and radiotherapy) seems to cause neuropathic effects on the intrinsic and extrinsic innervation of the gastrointestinal tract, with an important impact on gastrointestinal and BGA functions. This is a relatively neglected area deserving further investigation.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14976"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative ileus-Immune mechanisms and potential therapeutic interventions.","authors":"Zheng Wang, Nathalie Stakenborg, Guy Boeckxstaens","doi":"10.1111/nmo.14951","DOIUrl":"10.1111/nmo.14951","url":null,"abstract":"<p><strong>Background: </strong>Postoperative ileus (POI) is a condition marked by a temporary suppression of gastrointestinal motility following abdominal surgery. The mechanism of POI encompasses various factors and is characterized by two phases: the early neurogenic phase involving both adrenergic and non-adrenergic neural pathways; the later immune-mediated phase is characterized by a sterile inflammatory response that lasts several days. Activation of muscularis macrophages triggers a sterile inflammatory process that results in dysfunction of the enteric nervous system (ENS) and a reversible inhibition of gastrointestinal motility.</p><p><strong>Purpose: </strong>In this minireview, recent insights in the pathophysiological mechanisms underlying POI and potential new therapeutic strategies are described.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14951"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504790","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":"Use of Human In Vitro Gut Specimens for Translational Neurogastroenterology and Motility in the 21st Century.","authors":"Dmitrii Pavlov, Fievos L Christofi","doi":"10.1111/nmo.15022","DOIUrl":"10.1111/nmo.15022","url":null,"abstract":"<p><p>There is a huge gap in our understanding of the human ENS and translating data from mice to humans that is important when developing targeted therapeutics. The ENS or \"human little brain in the gut\" is easily accessible for study in GI surgical or biopsy samples. This mini review is focused on the use of human gut specimens in translating laboratory data on ENS and enteric neuropathies in neurogastroenterology and motility from mice to humans. Availability of viable human gut samples, in combination with technological advances in innovative recording techniques and new in vitro models provide powerful ways to study neural activity and secretomotor function or monitor motility in health and disease with exquisite sophistication and precision. Electrophysiological recordings, optical recordings with voltage-sensitive dyes, or Ca²⁺ imaging (in adult or fetal gut) is used to study neural activity in human ENS in health and disease. 'First in man patch clamp recordings' is possible in isolated networks of human myenteric ganglia, opening the door for patch-seq. The human ENS at single cell resolution (snRNA-seq) revealed cell-diversity, similarities and differences between human and mouse in vitro. Visceral afferent recordings are used for mechanosensation and pain signaling in humans. Stem cell therapies may hold future promise for patients with enteric neuropathies. A greater focus on the human ENS and enteric neuropathies (i.e. IBS, FD, postoperative ileus, CIPO, chronic constipation, Hirschsprung Disease, infection, gastroparesis, Parkinson's disease, IBD, visceral pain) is one important step for consideration in developing potential therapeutics before proceeding to more expensive and complex clinical trials in patients to treat GI Disorders and Diseases.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e15022"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special Issue \"Enteric Neuropathy From Basic to Clinical Practice\".","authors":"Fedias L Christofi, Raquel Abalo, Kirsteen N Browning","doi":"10.1111/nmo.70095","DOIUrl":"10.1111/nmo.70095","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70095"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226058","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":"Mechanisms of enteric neuropathy in diverse contexts of gastrointestinal dysfunction.","authors":"Julia R Jamka, Brian D Gulbransen","doi":"10.1111/nmo.14870","DOIUrl":"10.1111/nmo.14870","url":null,"abstract":"<p><p>The enteric nervous system (ENS) commands moment-to-moment gut functions through integrative neurocircuitry housed in the gut wall. The functional continuity of ENS networks is disrupted in enteric neuropathies and contributes to major disturbances in normal gut activities including abnormal gut motility, secretions, pain, immune dysregulation, and disrupted signaling along the gut-brain axis. The conditions under which enteric neuropathy occurs are diverse and the mechanistic underpinnings are incompletely understood. The purpose of this brief review is to summarize the current understanding of the cell types involved, the conditions in which neuropathy occurs, and the mechanisms implicated in enteric neuropathy such as oxidative stress, toll like receptor signaling, purines, and pre-programmed cell death.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e14870"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Symptomatic Response to Prokinetic Treatment Using Gastric Alimetry.","authors":"Chris Varghese, Sibylle Van Hove, Gabriel Schamberg, Billy Wu, Nooriyah Poonawala, Mikaela Law, Nicky Dachs, Gen Johnston, India Fitt, Daphne Foong, Henry P Parkman, Thomas Abell, Vincent Ho, Stefan Calder, Armen A Gharibans, Christopher N Andrews, Gregory O'Grady","doi":"10.1111/nmo.70132","DOIUrl":"10.1111/nmo.70132","url":null,"abstract":"<p><strong>Background: </strong>Chronic neurogastroduodenal disorders are challenging to manage, with therapy often initiated on a trial and error basis. Prokinetics play a significant role in management, but responses are variable and have been associated with adverse events, impacting widespread use. We investigated whether body surface gastric mapping (BSGM) biomarkers (using Gastric Alimetry) could inform patient selection for prokinetic therapy.</p><p><strong>Methods: </strong>Patients with chronic gastroduodenal symptoms taking oral prokinetic agents, regardless of gastric emptying status, were prospectively recruited and underwent BSGM (30 m baseline, 482 kcal standardized meal, 4 h postprandial recording) while off-prokinetic agents. Patients were followed up with daily symptom diaries. A subset was compared to matched patients not taking prokinetic agents. Prokinetic responders were defined based on symptom improvement greater than a minimum clinically important difference methodology.</p><p><strong>Key results: </strong>Forty-two patients (88% female; median age 36; median BMI 26) taking prokinetics were analyzed. Prokinetic prescribing, compared to matched patients, was independent of BSGM metrics (p > 0.15). In patients on existing prokinetics (withheld for BSGM), lower amplitudes predicted reduced symptom burden, whereas low rhythm stability predicted a worse symptom burden (p < 0.05). In prokinetic-naive patients (i.e., started on a prokinetic during the study), a lower postprandial amplitude predicted responders (mean 37.5 ± 10.6 uV in responders [n = 5] vs. mean 54.8 ± 6.6 uV among nonresponders [n = 3], p = 0.047).</p><p><strong>Conclusions: </strong>Gastric Alimetry biomarkers may help in the prediction of prokinetic response in patients with chronic gastroduodenal symptoms. Lower postprandial amplitudes, indicating a reduced meal response, appear to predict benefit, while impaired rhythm stability predicted poorer therapeutic response.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70132"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743322","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":"Distinct Subgroups in Gastroparesis Defined by Simultaneous Body Surface Gastric Mapping and Gastric Emptying Breath Testing.","authors":"Chris Varghese, I-Hsuan Huang, Gabriel Schamberg, Stefan Calder, Christopher N Andrews, Greg O'Grady, Jan Tack, Armen A Gharibans","doi":"10.1111/nmo.70124","DOIUrl":"https://doi.org/10.1111/nmo.70124","url":null,"abstract":"<p><strong>Background: </strong>Gastroparesis is a heterogeneous disorder with several contributing pathophysiologies. In this study, we used simultaneous body surface gastric mapping (BSGM) and gastric emptying breath testing (GEBT) to subgroup patients with gastroparesis based on dynamic spectral meal response profiles and emptying rate.</p><p><strong>Methods: </strong>Patients with chronic gastroduodenal symptoms and negative gastroscopy underwent simultaneous BSGM and GEBT with 30 min fasting and 4 h postprandial recording. In addition to standard metrics, the BSGM 'meal response ratio' (MRR) compared amplitude in the first 2 h postprandially to the subsequent 2 h (lagged meal response ≤ 1).</p><p><strong>Results: </strong>One hundred and forty-three patients underwent simultaneous BSGM and GEBT (79% female, median age 31 years, median BMI 23 kg/m²), of whom 36 of 143 (25.2%) had delayed gastric emptying. Those with a lagged meal response had longer T_1/2 (median 95.0 [IQR 59-373] vs. median 78.0 [IQR 31-288], p = 0.009) and higher rates of delayed emptying (42.9% vs. 16.7% p = 0.03). BSGM phenotypes identified in patients with delayed emptying were lagged meal response (25%), low gastric amplitude/rhythm stability (30.6%), elevated gastric frequencies (11.1%), and normal BSGM spectral analysis (33.3%). T_1/2 weakly correlated with worse total symptom burden score (r = 0.18, p = 0.03).</p><p><strong>Conclusion: </strong>Combined BSGM and gastric emptying testing defines subgroups of gastroparesis based on several BSGM abnormalities, including a novel group with delayed postprandial onset of gastric motor activity in association with delayed emptying.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70124"},"PeriodicalIF":2.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732420","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":"Lactose Breath Test and Genotyping Showed Higher Concordance Than the Urine Gaxilose Test for the Diagnosis of Lactose Malabsorption in Adults.","authors":"V Martín-Dominguez, M C López-Vega, T Álvarez-Malé, I Pérez-Lucendo, R Ferreiros-Martínez, I Granero-Cremades, A Ezquerra-Durán, M I Berlanga-Gómez, J Fernández-Pacheco, V Mancheño-Del Real, C Santander, E J Laserna-Mendieta","doi":"10.1111/nmo.70130","DOIUrl":"https://doi.org/10.1111/nmo.70130","url":null,"abstract":"<p><strong>Background: </strong>Lactose malabsorption (LM) is a common condition that occurs when undigested lactose reaches the colon, often causing symptoms such as diarrhea, flatulence, and abdominal pain. Diagnosis can be obtained by performing several tests, each with advantages and disadvantages. This study aims to compare three of the five available methods-the genetic, the urine gaxilose, and the lactose breath tests (LBT) - to evaluate their concordance and assess patient preferences.</p><p><strong>Methods: </strong>This is an observational and prospective study from two Spanish hospitals, including 73 adult patients with digestive symptoms and LM suspicion. Alongside the three evaluated methods, the lactose intolerance quick test was performed on duodenal samples in a subgroup of patients. Interpretation of LM was determined based on test concordance. Patient questionnaires were completed once all the tests had been performed.</p><p><strong>Results: </strong>There were 71% of female patients, the mean age was 37.6 years, and 52% showed LM. The patients with LM more commonly displayed nausea or vomiting (p = 0.039), avoidance of dairy products (p = 0.023), and use of analgesic and/or anti-inflammatory drugs (p = 0.016). Higher concordance among tests was found in patients without LM (83%), compared to 53% in patients with LM, due to false negatives (32%) for the gaxilose test. All tests showed over 90% sensitivity, with LBT displaying the highest (97%). Genetic testing showed the highest specificity (95%) and the gaxilose test the lowest (68%). Among the three tests, 72% of patients preferred the genetic test.</p><p><strong>Conclusions: </strong>The LBT and genetic tests showed higher concordance than gaxilose for detecting LM.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70130"},"PeriodicalIF":2.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732421","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":"Efficacy and Safety of the Enterosorbent Silicolgel in Irritable Bowel Syndrome, IBS-D and IBS-M: A Randomized, Double-Blind, Placebo-Controlled, Multi-Center Trial.","authors":"O Kuzminska, B Vitkovska, Yurii Kuvaiskov, Chris G Hatton","doi":"10.1111/nmo.70118","DOIUrl":"https://doi.org/10.1111/nmo.70118","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is a common gastrointestinal disorder significantly reducing quality of life. Silicolgel, a colloidal silicic acid enterosorbent, acts locally in the gut. This double-blind, placebo-controlled trial investigated its safety and efficacy in IBS-D and IBS-M, subtypes affecting over 60% of IBS sufferers.</p><p><strong>Methods: </strong>After 2 weeks of screening, patients were randomized into 4 weeks of treatment, followed by a no-medication phase to assess return of symptoms. Patients recorded bowel habits, abdominal pain, QoL, and global symptoms using weekly questionnaires and daily diaries. Primary outcome was a ≥ 50 point reduction in IBS Severity Scoring System (IBS SSS).</p><p><strong>Results: </strong>From 139 adults with ROME IV IBS-D or IBS-M, 120 were randomized and all completed screening and treatment phases (silicolgel n = 60, placebo n = 60). After 4 weeks' treatment: 91.67% (ITT) achieved the primary outcome in the silicolgel group versus 20.00% for placebo (relative risk (RR) = 4.58, 95% CI 2.74-7.65, p < 0.001). Mean IBS SSS for silicolgel reduced to 92.75 [62.68], -162.87 versus 257.58 [74.94] +3.17 for the placebo group (U = 210.5, r = 0.76, p < 0.001). Silicolgel also improved bowel habit, abdominal pain, distension, flatulence, and QoL. IBS-D and IBS-M patients showed the same improvements. Adverse events were similar in both groups, with no serious events attributable to silicolgel or placebo. Onset of action was rapid; after 2 weeks, 85.0% on silicolgel achieved the primary outcome versus 11.7% on placebo (significant difference).</p><p><strong>Conclusion: </strong>Silicolgel is safe and effective in IBS-D and IBS-M, providing an alternative to the limited treatments currently available.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70118"},"PeriodicalIF":3.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715154","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}