United European Gastroenterology Journal最新文献

{"title":"Supplement: 33rd United European Gastroenterology Week 2025.","authors":"","doi":"10.1002/ueg2.70031","DOIUrl":"10.1002/ueg2.70031","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"13 Suppl 8 ","pages":"S5-S6"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune Activation in Primary Sclerosing Cholangitis: A Systematic Review and Comparative Analysis With Inflammatory Bowel Diseases.","authors":"Md Moniruzzaman, Ayesha Shah, Thomas Fairlie, Simon Keely, Grace L Burns, Nicholas Talley, Gerald Holtmann","doi":"10.1002/ueg2.70115","DOIUrl":"https://doi.org/10.1002/ueg2.70115","url":null,"abstract":"<p><strong>Background and objectives: </strong>Primary sclerosing cholangitis (PSC) is a chronic liver disease with aberrant immune dysregulation and bile duct fibrosis. It is often associated with inflammatory bowel disease (IBD), especially ulcerative colitis, raising questions about distinct immune activation in these conditions. Therefore, we aimed to systematically review and compare immune activation patterns in patients with PSC and IBD (without PSC), which may provide deeper insights into PSC pathophysiology.</p><p><strong>Methods: </strong>MEDLINE, Scopus, Cochrane Library, and Embase were searched until July 2024 for relevant studies reporting immune cell profiles, cytokine levels, and gene expression patterns in patients with PSC. Reference articles of patients with IBD were then added to compare the immune profile of patients with PSC (with or without IBD) and patients with IBD-only.</p><p><strong>Results: </strong>Twenty-three articles studying 638 PSC and 557 non-PSC non-IBD subjects were included. PSC patients showed various degrees of immune activation in the systemic circulation, biliary fluid, and liver tissue, most notably regarding integrin β7+ gut-homing T cells, IL-2, and IL-10 compared to their respective controls. Compared with patients with IBD, patients with PSC had reduced Tregs in the systemic circulation. When comparing tissue-based immune markers, PSC-livers had increased Th17 cells, IL-1β, and TNF-α and reduced levels of B cells, IL-2, and IL-10 than the IBD-mucosa.</p><p><strong>Conclusions: </strong>Patients with PSC and patients with IBD without PSC can be differentiated by a distinct immune activation pattern with upregulation of Th17 and downregulation of Treg functions in PSC while other immune parameters do not allow a differentiation of these conditions.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201660","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":"Ligation-Assisted Antireflux Mucosectomy on PPI-Dependent and Cardioesophageal Sphincter Relaxed GERD: 4 Years Results of a Prospective, Multicenter Study (With Video).","authors":"Yuhao Zhu, Bin Liu, Wei Wang, Daishun Chen, Hanxiong Liu, Linfang He, Shuijiao Chen, Guanghui Lian, Xiaomei Zhang, Yu Wu, Xiaowei Liu","doi":"10.1002/ueg2.70120","DOIUrl":"https://doi.org/10.1002/ueg2.70120","url":null,"abstract":"<p><strong>Objectives: </strong>Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal condition and ligation-assisted antireflux mucosectomy (ARMS-L) which is a modified ARMS procedure that combines mucosa ligation and endoscopic mucosectomy was evaluated as an effective and safe endoscopic procedure. Moreover, the long-term efficacy of ARMS-L requires further validation.</p><p><strong>Methods: </strong>This prospective study included 189 patients with proton pump inhibitor (PPI)-dependent and cardioesophageal sphincter-relaxed GERD. Primary endpoint was the treatment efficacy (subjective and objective symptom): the total GERD-HRQL questionnaire score and the rate of PPI discontinuation at the follow-up. Secondary endpoints included improvements in GERD-Q scores, HRM, 24-h pH impedance monitoring, and AFS grade, as objective measures of hiatal disruption.</p><p><strong>Results: </strong>All patients underwent ARMS-L successfully and the average duration of follow-up are 48 months. 70.3% (133/189) of patients achieved a ≥ 50% improvement in the total GERD-HRQL score. HRM parameters improved significantly, with LES resting pressure increasing from 6.3 to 6.6 mmHg and LES residual pressure from 5.9 to 7.2 mmHg. 24-h pH impedance monitoring showed significant improvement, with the DeMeester score decreasing from 27.23 to 8.63. 70.9% of patients stopped PPIs, and 29.1% used PPIs occasionally. The improvement in the DeMeester score was lower in patients with AFS grade 1 (from 24.13 to 9.74) compared with those with grade 2 (from 27.98 to 7.86) and grade 3 (from 28.86 to 8.90).</p><p><strong>Conclusions: </strong>ARMS-L reduced GERD symptoms and improved the quality of life for a long time, particularly in PPI-dependent and cardioesophageal sphincter relaxed GERD patients.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182267","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":"Real-World Molecular Testing in European Early-Onset Colorectal Cancer.","authors":"Penelope V Edwards, Kussai Giuma Ali Eloussta, Andrew Latchford, Omar Faiz, Huw Thomas, Filomena Liccardo, Nikhil Pawa, Robert Hüneburg, Jacob Nattermann, Andrew George, Francesc Balaguer, Marc Martí, Antonino Spinelli, Caterina Foppa, Noel F F C de Miranda, Irene López, Elena Hurtado, Fernando Jiménez, Marta Jiménez-Toscano, Edurne Álvaro, Gonzalo Sanz, Araceli Ballestero, José A Rueda, Cristina Viyuela, Lorena Brandáriz, Rosario Vidal-Tocino, Damián García-Olmo, Carlos Pastor, Rogelio González-Sarmiento, Andreana N Holowatyj, Terri McVeigh, José Perea, Kevin J Monahan","doi":"10.1002/ueg2.70112","DOIUrl":"https://doi.org/10.1002/ueg2.70112","url":null,"abstract":"<p><strong>Purpose: </strong>The global incidence and mortality of early-age onset colorectal cancer (EOCRC, or CRC diagnosed under 50 years) has increased in recent decades. High-risk surveillance and personalised oncological treatment may improve patients' outcomes. This study aims to characterise real-world somatic and germline molecular profiles in European EOCRC patients.</p><p><strong>Patients and methods: </strong>Consecutive patients across the UK, Spain, Germany and Italy from the GEOCODE and SECOC consortia were identified using electronic patient records. Clinicopathological, somatic and germline testing data were collected on EOCRC patients. Tests included mismatch repair (MMR), somatic next generation sequencing (NGS) and germline multi-gene panels.</p><p><strong>Results: </strong>Eight hundred ninety-three EOCRC patients were identified from 23 European centres (45.7% female, median age 42, range 14-49), predominantly in the distal colorectum: 205/893 (22.9%) patients with right-sided tumours, 302/893 (33.8%) left-sided tumours, 288/893 (32.2%) rectal tumours and 97/893 (10.8%) unknown. On somatic analysis, 735/893 (82.3%) of patients had pMMR tumours and 148/893 (16.5%) dMMR. Although 534/893 (59.7%) did not receive NGS somatic testing, somatic variants were detected in 233/359 (64.9%) of those tested. Germline variants were detected in 133/210 (63.3%) patients tested. Lynch syndrome was diagnosed in 93/210 (44.2%), of whom 17/93 (18.2%) presented with pMMR tumours. Systematic recording of family history in these real-world data was variable. In all patients with family history recorded, 153/484 (31.4%) patients reported a relative with CRC.</p><p><strong>Conclusions: </strong>Our results support universal and paired somatic and germline multi-gene panels for all EOCRC patients, regardless of MMR status or family history. Systematic molecular testing approaches are necessary to address disparities in people with EOCRC. Larger unselected cohort studies would support validation of testing prediction models and estimates of clinically relevant variant actionability.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178840","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":"Evaluating Sex Disparity in Pancreatic Ductal Adenocarcinoma Risk in the UK Biobank Cohort.","authors":"Giulia Peduzzi, Roberto Pellungrini, Livia Archibugi, Federico Canzian, Cosmeri Rizzato, Gabriele Capurso, Daniele Campa","doi":"10.1002/ueg2.70102","DOIUrl":"https://doi.org/10.1002/ueg2.70102","url":null,"abstract":"<p><strong>Background: </strong>The incidence of pancreatic ductal adenocarcinoma (PDAC) is lower in females than males (19.0 vs. 20.2 for 100,000 individuals in Europe). This disparity is commonly attributed to differences in exposure to lifestyle risk factors such as smoking and alcohol consumption; however, hormonal activity may also play a role.</p><p><strong>Objective: </strong>This study aimed to comprehensively examine the role of hormone exposure and reproductive factors in males and females in PDAC susceptibility.</p><p><strong>Methods: </strong>We analyzed 816 PDAC cases and 302,645 controls from the UK Biobank prospective cohort. Twenty hormone-related variables and a polygenic risk score (PRS) were examined in females and males using epidemiological methods and machine learning algorithms.</p><p><strong>Results: </strong>Oral contraceptives (OC) use increased PDAC risk (OR = 2.17 (95% CI: 1.70-2.80), p = 8.16 × 10^-10), while each full-term pregnancy decreased it (OR = 0.83 (95% CI: 0.76-0.90), p = 2.60 × 10^-5). In males increased level of sex hormone-binding globulin (SHBG) was associated with a decreased risk (OR = 0.98, 95% CI: 0.97-0.98, p = 7.38 × 10^-10). The machine learning model performed well in both sexes, with AUCs of 0.95 and 0.92, specificity of 0.86 and 0.92 and sensitivity of 0.90 and 0.81 for females and males, respectively. The use of an explainer identified age and the PRS as significant features for both sexes, with additional factors such as age at menopause and OC use for females, and SHBG concentration in blood for males.</p><p><strong>Conclusion: </strong>We observed a consistent protective effect of the factors that decrease-the exposure to menstrual cycle related hormones. Additionally, exogenous hormones increase due to long exposure to OC and HRT increases the risk of the disease. Therefore, our result suggests that it is more important to which hormones an individual is exposed compared to the overall increase or decrease in exposure.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178757","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":"European Society for the Study of Coeliac Disease 2025 Updated Guidelines on the Diagnosis and Management of Coeliac Disease in Adults. Part 1: Diagnostic Approach.","authors":"Abdulbaqi Al-Toma, Fabiana Zingone, Federica Branchi, Annalisa Schiepatti, Georgia Malamut, Cristina Canova, Isabella Rosato, Honoria Ocagli, Nick Trott, Luca Elli, Alina Popp, Carmen Gianfrani, Renata Auricchio, Andra Neefjes-Borst, David S Sanders, Christophe Cellier, Chris J Mulder, Gerd Bouma, Knut E A Lundin, Ludvig M Sollid, Michael Schumann","doi":"10.1002/ueg2.70119","DOIUrl":"https://doi.org/10.1002/ueg2.70119","url":null,"abstract":"<p><strong>Introduction: </strong>Since the publication of the first European Society for the Study of Coeliac Disease (ESsCD) guidelines in 2019, significant advancements have emerged in the diagnosis of coeliac disease (CeD) in adults. These 2025 guidelines incorporate new evidence to refine diagnostic strategies, aiming for improved accuracy of testing, and enhance overall quality of clinical care.</p><p><strong>Methods: </strong>A multidisciplinary panel of experts revised the ESsCD guidelines using the AGREE II instrument (Appraisal of Guidelines for Research and Evaluation II) and the GRADE methodology (The Grading of Recommendations Assessment, Development, and Evaluation). Clinical questions were structured using the PICO format, and statements and recommendations were finalised through a Delphi consensus process. Literature quality was assessed using AMSTAR-2 and QUADAS-2 tools.</p><p><strong>Results: </strong>The updated guidelines are presented in two parts. Part 1 focuses on adult CeD diagnosis, introducing major changes such as a conditional no-biopsy approach for selected adults with high-titre IgA anti-TG2 serology (≥ 10 × ULN). Regarding serology, the use of validated high-performance ELISAs displaying a high diagnostic accuracy is emphasised, while routine use of IgA anti-Endomysium serology is no longer recommended for confirmation. Revised duodenal biopsy protocols now mandate at least four samples from the second part of the duodenum, with bulb biopsies conditionally included. The guidelines provide structured approaches for diagnosing potential CeD, seronegative villous atrophy, and CeD in individuals already on a gluten-free diet. HLA-DQ2/DQ8 typing is recommended for diagnostic clarification in select cases.</p><p><strong>Conclusions: </strong>The updated 2025 ESsCD guidelines provide a comprehensive framework for the diagnosis of CeD in adults. By integrating evolving diagnostic strategies, minimising over-testing, and patient-centred care approaches, they aim to optimise patient outcomes, quality of life and use of diagnostic resources at the same time.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151100","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":"In Memoriam: Prof. Dr. Michael P. Manns (1951-2025).","authors":"Heiner Wedemeyer, Markus Cornberg","doi":"10.1002/ueg2.70110","DOIUrl":"https://doi.org/10.1002/ueg2.70110","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126154","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":"'Call for More Biopsies During Pouchoscopy in Ulcerative Colitis'.","authors":"Vincenzo Villanacci","doi":"10.1002/ueg2.70116","DOIUrl":"https://doi.org/10.1002/ueg2.70116","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114297","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":"Perineural Invasion in Pancreatic Ductal Adenocarcinoma: Recapitulating Its Importance and Defining Future Directions.","authors":"Martin Lovecek, Esra Dirimtekin, Ingrid Garajová, Giulia Gasparini, Stefano Crippa, Elisa Giovannetti, Dana Sochorova, Carmen Mota Reyes, Ihsan Ekin Demir, Pinar Uysal-Onganer","doi":"10.1002/ueg2.70118","DOIUrl":"https://doi.org/10.1002/ueg2.70118","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, mainly due to its aggressive nature, early metastasis, diagnosis at late stages, and limited response to systemic anticancer therapy. Perineural invasion (PNI), defined as the infiltration of neoplastic cells along nerve fibers and within nerve sheaths, is emerging as a critical determinant of PDAC aggressiveness. This position paper by the TRANSPAN PNI Group on Perineural Invasion synthesizes current evidence on the molecular features and clinical implications of PNI in PDAC, compares its prognostic significance in other malignancies, and describes novel biomarker strategies including potential therapeutic interventions.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114294","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":"Addressing Pancreatic Exocrine Insufficiency and the Impact of Pancreatic Enzyme Replacement Therapy Shortages in Europe.","authors":"Afrodita Panaitescu-Damian, Ibrahim Gürcinar, Viorelia Stoica, Salvatore Paiella, Marcus Hollenbach, Ivonne Regel, Dawn Swibold, Gabriele Capurso, Alfredo Carrato, Patrick Michl, Luis Arnes","doi":"10.1002/ueg2.70113","DOIUrl":"https://doi.org/10.1002/ueg2.70113","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092557","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}