Scandinavian Journal of Gastroenterology最新文献

{"title":"Increased mucosal and T-cell expression of 4-1BB and PD-1 are modulated by anti-TNFα treatment in Crohn's disease.","authors":"Morten Aagaard Nielsen, Mia Bendix, Christian Lodberg Hvas, Bent Deleuran, Line S Reinert, Jørgen Agnholt, Anders Dige","doi":"10.1080/00365521.2025.2505622","DOIUrl":"10.1080/00365521.2025.2505622","url":null,"abstract":"<p><strong>Objective: </strong>Pro-inflammatory T-cell responses dominate in Crohn's disease (CD). This may result from a dysbalanced expression of co-stimulatory and inhibitory T-cell receptors. The present study investigated if a dysbalanced co-stimulatory and inhibitory T-cell receptor expression are present in CD and can be rebalanced by anti-TNFα treatment.</p><p><strong>Methods: </strong>Mucosal biopsies from 27 patients with active CD receiving anti-TNF treatment were examined for the mRNA levels of the co-stimulatory 4-1BB and inhibitory PD-1 T-cell receptor. Levels of mRNA were compared between inflamed and noninflamed tissue, and before and after treatment. Peripheral T cells from 12 healthy controls (HC) and 11 active CD patients were evaluated for their expression of 4-1BB and PD-1 by flow cytometry.</p><p><strong>Results: </strong>The 4-1BB mRNA levels in inflamed mucosa were upregulated (> 2-fold) compared with uninflamed mucosa (<i>p</i> < 0.05). Anti-TNFα treatment reduced the 4-1BB and PD-1 mRNA levels in the inflamed gut tissue (<i>p</i> < 0.05). In <i>in vitro</i> activated T cells, the percentage of both 4-1BB and PD-1 positive CD4+ and CD8+ T cells increased more than 1.5 fold compared with HC (<i>p</i> < 0.05). The 4-1BB/PD-1 ratio on activated peripheral T cells was significantly reduced in CD after anti-TNF therapy (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>A dysbalanced mucosal proinflammatory co-stimulatory T cell receptor expression was present in active CD and modified by anti-TNFα treatment. However, anti-TNFα treatment did not normalize the expression of 4-1BB or PD-1 on peripheral T cells although a modest increased immunoregulatory capacity could be demonstrated.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"698-706"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting severe inflammatory bowel disease: a risk matrix model based on the IBSEN III inception cohort.","authors":"Vibeke Strande, Milada Hagen, Charlotte Lund, Øyvind Asak, May-Bente Bengtson, Raziye Boyar, Trond Espen Detlie, Svein Oskar Frigstad, Magne Henriksen, Kristina I Aass Holten, Øistein Hovde, Gert Huppertz-Hauss, Ole Høie, Ingunn Johansen, Asle W Medhus, Bjørn Christian Olsen, Randi Opheim, Gøri Perminow, Petr Ricanek, Roald Torp, Jørgen Valeur, Simen Vatn, Tone Bergene Aabrekk, Bjørn Moum, Marte Lie Høivik, Vendel A Kristensen","doi":"10.1080/00365521.2025.2512591","DOIUrl":"10.1080/00365521.2025.2512591","url":null,"abstract":"<p><strong>Background and aims: </strong>Identifying patients at risk of developing severe inflammatory bowel disease (IBD) can aid treatment decisions. However, predicting disease course remains challenging. We aimed to identify predictive factors associated with severe disease course in the first year after IBD diagnosis.</p><p><strong>Methods: </strong>Newly diagnosed adult (≥18 years) patients with IBD were recruited from a population-based inception cohort (IBSEN III study). Preselected baseline factors were tested for associations with severe disease course, defined as IBD-related hospitalisation, surgery, treatment with ≥2 steroid courses, >2 biologics and/or new event of complication (stricture, fistula, abscess only applicable Crohn's disease (CD)). From a best fitted multivariable logistic regression model stratified by diagnosis and age (18-40/>40 years), probability of severe disease for given combinations of predictive factors was summarised in prediction matrices.</p><p><strong>Results: </strong>At one-year follow-up, 90/559 (16%) patients with ulcerative colitis (UC) and 74/312 (24%) with CD had severe disease. Treatment with systemic steroids, vitamin D deficiency, Simple Clinical Colitis Activity Index >2, and hypoalbuminemia at diagnosis were all significantly associated with severe disease in UC patients. CD patients with stricturing or penetrating disease behaviour, systemic steroids and hypoalbuminemia at diagnosis were associated with severe disease course. The least favourable combination of these factors increased the probability of severe disease from 3% (95%CI[0-5%]) to 72% (95%CI[66-79%]) for UC and from 8% (95%CI[3-13%]) to 88% (95%CI[84-93%]) for CD.</p><p><strong>Conclusions: </strong>Our study identified predictive factors associated with severe disease the first year after diagnosis. The probability of severe disease summarised in matrices enables easy risk stratification.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"716-727"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical importance of American Society of Anesthesiologists physical status on postoperative severe complications and long-term survival after gastrectomy for gastric cancer.","authors":"Kazuaki Matsui, Yoshiki Kawaguchi, Takahiro Iwai, Yukiko Torizaki, Yoko Adachi, Hirofumi Shimoda, Takehiro Shimada, Yasuhito Sekimoto, Hidejiro Urakami, Shiko Seki","doi":"10.1080/00365521.2025.2506534","DOIUrl":"10.1080/00365521.2025.2506534","url":null,"abstract":"<p><strong>Background: </strong>With the increase in gastric cancer among the elderly, gastrectomy is becoming more common even in patients with various comorbidities and poor general conditions. This study aimed to clarify the significance of the American Society of Anesthesiologists physical status (ASA-PS), as an indicator of a patient's general condition, on postoperative complications and long-term survival.</p><p><strong>Methods: </strong>We retrospectively analyzed 529 patients who underwent gastrectomy for gastric cancer. The clinical influence of ASA-PS on the severe postoperative complications and the survival outcomes were investigated.</p><p><strong>Results: </strong>Our participants were classified into three groups: ASA-PS 1, 2 and 3 (<i>n</i> = 117, 334 and 78). Multivariate analysis identified age ≥ 75 and ASA-PS 3 as independent risk factors for Clavien-Dindo ≥ 3 complications (<i>p</i> = 0.012 and < 0.001). Kaplan-Meier analyses demonstrated that 5-year overall survival (OS) and recurrence-free survival significantly worsened sequentially from ASA-PS 1 to 3 (<i>p</i> < 0.001 and < 0.001). Multivariate analysis identified age ≥ 75 and ASA-PS 3, minimally invasive surgery, and pStage ≥ III as independently associated factors for 5-year OS. The negative impact of ASA-PS 3 on OS and cancer-specific survival (CSS) became more prominent in the patients with pStage I gastric cancer (<i>p</i> < 0.001 and 0.081 in pStage I and ≥ II [OS] and <i>p</i> = 0.001 and 0.470 in pStage I and ≥ II [CSS]).</p><p><strong>Conclusions: </strong>Our findings indicated the negative impact of poor ASA-PS on the postoperative outcomes. The influence on the oncological outcomes was particularly prominent in pStage I gastric cancer.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"643-651"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External multicenter validation of the FAMISH score for predicting metachronous gastric lesions after endoscopic submucosal dissection.","authors":"Mónica Garrido, Tatiana Cruz Almeida, Ricardo Kuttner-Magalhães, Ricardo Marcos-Pinto, Sara Archer, Rolando Pinho, Maria Manuela Estevinho, João Santos-Antunes, Rui Morais, Pedro Barreiro, Inês Simão, Michael Bourke, Hunter Wang, Pedro Amaro, Elisa Gravito-Soares, Roman Kuvaev, Sergey Kashin, Miguel Areia, Maria Inês Viegas, Arjun D Koch, Manon C W Spaander, Nanda Provoost, Guido Manfredi, Gianluca Esposito, Giuseppe Losurdo, Arnaud Lemmers, Gloria Fernández-Esparrach, Enrique Rodriguez Santiago, Mário Dinis-Ribeiro, Diogo Libânio","doi":"10.1080/00365521.2025.2522464","DOIUrl":"https://doi.org/10.1080/00365521.2025.2522464","url":null,"abstract":"<p><strong>Background and objectives: </strong>Surveillance after gastric endoscopic submucosal dissection (ESD) is crucial due to the high risk of metachronous gastric lesions (MGL), although this risk may differ between patients. We sought to validate the FAMISH score - a prediction score to estimate MGL risk after gastric ESD - within a multicentric framework.</p><p><strong>Materials and methods: </strong>Performance measures of the FAMISH score were assessed in a retrospective analysis of a multicenter cohort, which included consecutive adult patients undergoing ESD for a primary gastric superficial lesion at 15 international centers, with a minimum endoscopic follow-up of at least 3 years.</p><p><strong>Results: </strong>A total of 855 individuals were included, with 20% of them considered low-risk according to the FAMISH score. After a mean follow-up time of 5 years (SD ± 2 years), 168 patients (19.6%) developed MGL. At 3 years of follow-up, the score achieved 90.4% sensitivity and 93.9% NPV. At 5 years follow-up, the score achieved 89.1% sensitivity and 85.3% NPV. The FAMISH risk score achieved a fair diagnostic accuracy with an AUC of 0.618 at 3 years (<i>p</i> < 0.001) and 0.597 (<i>p</i> = 0.006) at 5 years of follow-up. The progression to MGL at 5 years of follow-up was significantly lower for the low-risk group (9.6% vs. 18.2%, <i>p</i> = 0.029).</p><p><strong>Conclusions: </strong>The FAMISH score achieved an acceptable diagnostic accuracy in a multicentric validation cohort from Western countries. This score is a useful tool to identify patients with low risk for MGL allowing to safely extend surveillance intervals and reduce the burden of care.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking iron therapy in IBD: integrating the microbiota perspective.","authors":"Wojciech Marlicz, Karolina Skonieczna-Żydecka, Igor Łoniewski, Anastasios Koulaouzidis","doi":"10.1080/00365521.2025.2525909","DOIUrl":"https://doi.org/10.1080/00365521.2025.2525909","url":null,"abstract":"<p><p>Iron deficiency and anemia are common in patients with inflammatory bowel disease (IBD), requiring effective and well-tolerated iron replacement strategies. While oral iron is widely used, growing evidence suggests it can disrupt the gut microbiota by reducing beneficial commensal bacteria and promoting pro-inflammatory shifts in the intestinal environment. These changes may exacerbate mucosal inflammation and contribute to gastrointestinal side effects, often resulting in poor adherence. Intravenous iron, by bypassing the gastrointestinal tract, appears to have a less disruptive effect on the microbiota and may more reliably restore iron stores, particularly in patients with active disease or intolerance to oral formulations. Current expert recommendations support intravenous iron as the first-line option in such cases, though oral iron remains a practical choice for selected patients with mild anemia and inactive disease. Emerging research also raises concerns about the safety of oral iron in vulnerable populations, as it may promote dysbiosis and expansion of potentially pathogenic bacteria. In response, adjunctive strategies are being explored to support the microbiota and improve the tolerability and efficacy of oral iron. Incorporating microbiota-related considerations into treatment decisions may enhance outcomes and reduce side effects. Future clinical guidelines should reflect the evolving understanding of the gut microbiome's role in iron metabolism and inflammation, promoting more personalized, microbiota-conscious approaches to iron therapy in IBD.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-3"},"PeriodicalIF":1.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of mucin phenotypes, macroscopic type, and location with invasion depth in early nonampullary duodenal carcinomas.","authors":"Keiichi Hashiguchi, Hiroko Inomata, Hirokazu Kurohama, Junya Shiota, Taro Akashi, Maiko Tabuchi, Moto Kitayama, Kayoko Matsushima, Yuko Akazawa, Naoyuki Yamaguchi, Ken Ohnita, Kengo Kanetaka, Shinji Okano, Hisamitsu Miyaaki","doi":"10.1080/00365521.2025.2522466","DOIUrl":"https://doi.org/10.1080/00365521.2025.2522466","url":null,"abstract":"<p><strong>Objective: </strong>To investigate retrospectively the clinicopathological features of nonampullary duodenal intramucosal carcinoma (M-Ca) and submucosal carcinoma (SM-Ca).</p><p><strong>Materials and methods: </strong>Seventy-three patients (67 with M-Ca and seven with SM-Ca) were included. The assessed clinical variables included patient age, sex, treatment procedure, lesion location, color, and macroscopic type. Pathological outcomes included invasion depth, predominant histological type, lymphovascular invasion, and mucin phenotype.</p><p><strong>Results: </strong>SM-Ca lesions were predominantly located in the duodenal bulb (28.6%) or the oral side of the major papilla in the second portion (57.1%), while M-Ca lesions were primarily located in the second portion (97.0%) (<i>p</i> = 0.029). The superficially elevated type was predominant in the M-Ca group (43.3%), while the protruded type was predominant in the SM-Ca group (42.9%) (<i>p</i> = 0.034). A submucosal tumor-like appearance was more prevalent in the SM-Ca group (28.6%) than in the M-Ca group (1.5%) (<i>p</i> = 0.022). Well-differentiated adenocarcinomas were predominant in both groups (M-Ca, 97%; SM-Ca, 71.4%), with moderately differentiated and papillary adenocarcinomas being more prevalent in the SM-Ca group (14.3% each) (<i>p</i> = 0.042). The gastric mucin phenotype was significantly more prevalent in the SM-Ca group (71.4%) than in the M-Ca group (2.6%) (<i>p</i> < 0.0001). The median depth of submucosal invasion was 1,200 µm in the SM-Ca group. No lymph node metastasis or recurrence was observed.</p><p><strong>Conclusions: </strong>Nonampullary duodenal submucosal carcinomas are characterized by their location on the oral side of the major papilla, protruded macroscopic type, and gastric mucin phenotype. These findings offer insights into distinguishing M-Ca from SM-Ca.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HCC-surveillance is associated with improved HCC-related mortality in patients with cirrhosis - a case-control study.","authors":"Hannes Hegmar, Bonnie Bengtsson, Sofia Ullman, Ian A Rowe, Per Stål, Hannes Hagström","doi":"10.1080/00365521.2025.2517208","DOIUrl":"https://doi.org/10.1080/00365521.2025.2517208","url":null,"abstract":"<p><strong>Background and aims: </strong>Surveillance for hepatocellular carcinoma (HCC) with ultrasound screening is recommended by guidelines. However, there are conflicting data whether HCC-surveillance reduces HCC-related mortality in patients with cirrhosis. The aim of this study was to validate previous findings that found no association between HCC-surveillance and decreased HCC-related mortality.</p><p><strong>Methods: </strong>This was a case-control study in patients with cirrhosis from Stockholm County, Sweden. Cases died from HCC between 2004 and 2020. Controls did not die from HCC, and were matched to cases based on age, sex, etiology of cirrhosis, year of cirrhosis diagnosis, hospital site, MELD, and Child-Pugh scores. An adjusted logistic regression model was used to compare exposure to screening ultrasounds 2 years prior to HCC diagnosis between cases and controls. An odds ratio below one would suggest an association between HCC surveillance and decreased HCC-related mortality.</p><p><strong>Results: </strong>A total of 1272 patients with cirrhosis and HCC died during follow-up, and 516 of these were excluded as potential cases due to a diagnosis of HCC near the cirrhosis diagnosis. From the potential cases 72 cases and 72 controls were matched. The adjusted odds ratio was 0.33 (95% Confidence Interval [CI] = 0.14-0.78).</p><p><strong>Conclusions: </strong>HCC surveillance was associated with decreased HCC-related mortality, indicating that HCC surveillance should continue as recommended in guidelines. However, many patients who died from HCC were diagnosed with HCC close to the cirrhosis diagnosis, suggesting that identifying patients with cirrhosis earlier is highly important for improving HCC-related mortality.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-omic analysis identifies cholesterol metabolism related protein ARV1 as a novel biomarker for Colon adenocarcinoma patients with adenomatous polyposis.","authors":"Yu-Cheng Zhu, Jun Zhang, Kun Liu, Ya-Bin Cheng, Wei Jiang","doi":"10.1080/00365521.2025.2518461","DOIUrl":"10.1080/00365521.2025.2518461","url":null,"abstract":"<p><strong>Objectives: </strong>Familial adenomatous polyposis (FAP) is typically characterized by numerous adenomatous polyps that will inevitably progress to adenocarcinomas. To enhance the clinical management of colon adenocarcinoma (COAD), a deeper understanding of the molecular mechanisms driving malignant transformation in pre-cancerous adenomatous polyposis, as well as the identification of predictive biomarkers, is essential.</p><p><strong>Methods: </strong>In the present study, clinical samples were collected from rare patients with COAD and FAP, and metabolomic and proteomic analyses were performed to elucidate the mechanisms of canceration in FAP patients.</p><p><strong>Results: </strong>The multi-omics analysis showed that cholesterol metabolism is highly activated in COAD tissue and identified 64 genes that are highly expressed in COAD and significantly correlated with prognosis. Improved <i>in situ</i> sequencing (IISS) identified <i>ARV1</i> (ACAT related enzyme 2 required for viability 1) as a critical regulator of cholesterol metabolism. Finally, bioinformatics analysis using the HPA database showed that <i>ARV1</i> expression is negatively correlated with COAD TNM stage; thus, indicating that <i>ARV1</i> might play a role as a tumor suppressor in colon cancer.</p><p><strong>Conclusions: </strong>Overall, cholesterol metabolism was found to be involved in colon adenocarcinoma tumorigenesis and <i>ARV1</i> was identified as a key factor in the early stage of FAP transformation.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity of the Comirnaty Omicron XBB.1.5 booster COVID-19 mRNA vaccine in patients with cirrhosis.","authors":"Samer Al-Dury, Sigrun Einarsdottir, Ellen Fridriksson, Linn Dahlsten Andius, Hao Wang, Sinan Sharba, Amin Mountagui, Johan Waern, Johan Ringlander, Jesper Waldenström, Anna Martner, Kristoffer Hellstrand, Martin Lagging","doi":"10.1080/00365521.2025.2518466","DOIUrl":"https://doi.org/10.1080/00365521.2025.2518466","url":null,"abstract":"<p><p><b>Objective:</b> : To evaluate the durability of immune responses following prior COVID-19 vaccinations and assess the immunogenicity of a fifth mRNA-based COVID-19 booster dose in patients with liver cirrhosis.</p><p><p><b>Materials and Methods</b>: In this longitudinal cohort study, 33 patients with liver cirrhosis received a fifth booster dose of the Comirnaty Omicron XBB.1.5® (Pfizer-BioNTech) mRNA vaccine. Peripheral blood samples were collected prior to and four weeks after vaccination. Humoral immunity was assessed by measuring serum antibodies against the receptor-binding domain of spike (anti-RBD-S1) and nucleocapsid proteins. Cellular immunity was evaluated by quantifying ex vivo Spike 1 (S1)-specific T-cell responses, specifically IL-2 release.</p><p><p><b>Results</b>: The fifth mRNA vaccine dose led to a significant increase in anti-RBD-S1 antibody levels and S1-induced IL-2 release, indicating enhanced humoral and cellular immune responses. The optimal interval for booster administration to maintain elevated antibody titers was identified as 10-12 months. Additionally, a history of prior COVID-19 infection significantly influenced post-booster antibody responses.</p><p><p><b>Conclusions</b>: A fifth mRNA-based COVID-19 booster dose significantly augments both humoral and cellular immunity in patients with liver cirrhosis. These findings support the use of a single annual booster dose to maintain adequate immune protection in this vulnerable population.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipofuscinosis as a novel discriminating feature for drug-induced liver injury from autoimmune hepatitis.","authors":"Sabine Weber, Franziska Erhardt, Jens Neumann, Julian Allgeier, Didem Saka, Nirali Donga, Izabel Mircheva, Rochell Balakumar, Christian M Lange, Alexander L Gerbes","doi":"10.1080/00365521.2025.2517207","DOIUrl":"https://doi.org/10.1080/00365521.2025.2517207","url":null,"abstract":"<p><strong>Background and objective: </strong>Differentiating drug-induced liver injury (DILI) and autoimmune hepatitis (AIH) is a diagnostic challenge. Liver biopsy is recommended in unclear cases, however, clear distinguishing patterns are unknown. We therefore aimed to further identify histopathological features that can discriminate DILI from AIH.</p><p><strong>Methods: </strong>The clinical and histological data of well-characterised 136 DILI and 43 AIH patients from our prospective cohort on patients with acute liver injury and potential drug-related cause were analysed. Logistic binary regression was performed to identify models that could differentiate both two entities.</p><p><strong>Results: </strong>Histopathological findings showed high overlaps between DILI and AIH, and overall concordance between histological and clinical diagnosis was low (48.9%). While interface hepatitis, plasma cell infiltration, and portal-intralobular infiltration were favouring AIH, relevant proportions of DILI patients also presented with those features (44.1%, 46.3% and 29.2%, respectively). Interestingly, on multivariate analysis, lipofuscinosis was the only independent predictor of DILI diagnosis, showing a strong association with DILI diagnosis (odds ratio [OR] 10.8; positive predictive value [PPV] 96.2%). Moreover, logistic regression analysis showed that a model combining different histopathological features (lack of interface hepatitis, fibrosis and eosinophils together with presence of cholestasis, steatosis and lipofuscinosis) could differentiate DILI from AIH with an accuracy of 76.5% and a strikingly high sensitivity of 94.9%.</p><p><strong>Conclusions: </strong>DILI and AIH showed similar histological patterns, however lipofuscinosis was identified as a novel distinctive feature for DILI with an extraordinarily high PPV. Moreover, a model combining a variety of histological features could differentiate both entities with high sensitivity.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}