United European Gastroenterology Journal最新文献

{"title":"Transition From Youth to Adulthood: UEG 2024 Roundtable on Navigating Chronic Digestive and Liver Disease Care.","authors":"Jorge Amil-Dias, Peter Kolja Kvist, Luz Yadira Bravo-Gallego, Daniel Hartmann, Pierluigi Fracasso, Janne Suykens, Hans Tornblom, Maria Buti, Ana Dugic, Joana Torres, Salvatore Leone, Zorana Maravic, Milan Mishkovikj, Tunde Koltai, Anna Carboni, Kremlin Wickramasinghe, Livia Alimena, Patrizia Burra","doi":"10.1002/ueg2.70104","DOIUrl":"https://doi.org/10.1002/ueg2.70104","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993211","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":"IBUS-SAS Is a Highly Accurate Intestinal Ultrasound Score for Predicting Endoscopic Disease Activity in Ulcerative Colitis.","authors":"Sarah Fischer, David Fischmann, Judith Wilde, Marcel Vetter, Laurin Wolf, Carol Geppert, Raja Atreya, Maximilian Waldner, Deike Strobel, Markus F Neurath, Sophie Haberkamp, Sebastian Zundler","doi":"10.1002/ueg2.70053","DOIUrl":"10.1002/ueg2.70053","url":null,"abstract":"<p><strong>Background: </strong>The international bowel ultrasound group-segmental activity score (IBUS-SAS) is a validated tool with high interobserver agreement for accurately detecting disease activity in Crohn's disease (CD). Here, we addressed whether the IBUS-SAS is also suitable to assess disease activity in ulcerative colitis (UC).</p><p><strong>Methods: </strong>The IBUS-SAS and Limberg scores were determined in the sigmoid colon of patients with UC. The results were correlated to established scores of clinical, endoscopic and histologic disease activity (partial [pMS] and endoscopic [eMS] Mayo-Score, ulcerative colitis endoscopic index of severity [UCEIS], histologic Nancy index) and/or biomarkers of inflammation (C-reactive protein [CRP], fecal calprotectin). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) for IBUS-SAS and the Limberg score to predict endoscopic and histologic disease activity were computed by receiver operating characteristics (ROC)-analysis.</p><p><strong>Results: </strong>Fifty-eight patients with UC were enrolled. The median IBUS-SAS was 34.8. It was significantly correlated with pMS, eMS, UCEIS, Nancy index, CRP and fecal calprotectin. On ROC-analysis, a cut-off of 15.9 was reached with 100% sensitivity and 80.0% specificity for the prediction of endoscopic activity, resulting in a PPV of 94.7% and an NPV of 100%. The Limberg score performed only slightly worse (100.0%, 60.0%, 89.9%, 100%, respectively). Comparable results were found regarding the Nancy index for sensitivity (93.9% vs. 93.9%), specificity (57.1% vs. 42.9%), PPV (91.4% vs. 88.9%) and NPV (65.7% vs. 59.0%).</p><p><strong>Conclusions: </strong>This study highlights the potential of IUS for the non-invasive quantification of disease activity in UC and suggests that the IBUS-SAS should be considered as a diagnostic tool in trials and real-world management of UC.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1253-1262"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182613","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":"Global Prevalence of Burnout in Gastroenterology and Endoscopy: A Systematic Review and Meta-Analysis.","authors":"Mohamed G Shiha, Francesca Manza, John Ong, Iago Rodríguez-Lago, Martina Müller, Reena Sidhu","doi":"10.1002/ueg2.70045","DOIUrl":"10.1002/ueg2.70045","url":null,"abstract":"<p><strong>Background: </strong>Burnout is an increasingly recognised phenomenon that negatively affects physicians' well-being, patient safety and the sustainability of healthcare systems. In this systematic review and meta-analysis, we aimed to estimate the global prevalence of burnout in gastroenterology and endoscopy.</p><p><strong>Methods: </strong>We searched Medline, Embase, Scopus and PsycINFO up to November 2024 for studies reporting the prevalence of burnout in gastroenterology and endoscopy. The primary outcome was the prevalence of burnout among gastroenterologists and endoscopists. Secondary outcomes included the prevalence of emotional exhaustion, depersonalisation, low sense of personal accomplishment and gender-related differences in burnout. We used random-effects models to calculate the pooled prevalence and odds ratios (OR) with their 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 22 studies comprising 8124 participants were included. The pooled prevalence of burnout was 45% (95% CI, 37%-54%), with significant variability observed across different geographical regions, assessment tools and definitions of burnout. The pooled prevalence of emotional exhaustion was 31% (95% CI, 22%-40%), depersonalisation was 23% (95% CI, 16%-31%), and low sense of personal accomplishment was 25% (95% CI, 10%-40%). Female gastroenterologists were more likely to experience burnout than males (OR 1.53; 95% CI, 1.16-2.01; p < 0.001).</p><p><strong>Conclusions: </strong>Almost half of gastroenterologists and endoscopists experience burnout, with females being disproportionately affected. These findings highlight the need for urgent action to address burnout and its contributing factors, including gender disparities.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1318-1327"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310500","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":"Multi-Omics Analysis of Ileal Mucosa and Mesentery Before and After Ileocecal Resection in Crohn's Disease.","authors":"Kai Xia, Yiran Jiao, Luoqiu Zhang, Renyuan Gao, Fangtao Wang, Yun Pan, Shuang Cui, Yin Lin, Tianqi Wu, Lin Li, Xiaocai Wu, Yu Ruan, Jing Sun, Lu Yin, Chunqiu Chen, Moubin Lin","doi":"10.1002/ueg2.70069","DOIUrl":"10.1002/ueg2.70069","url":null,"abstract":"<p><p>Crohn's disease (CD), a type of inflammatory bowel disease (IBD), is a chronic disorder involving any part of the gastrointestinal tract. Ileocecal resection may serve as a more effective treatment option for early CD. However, the potential relationship and mechanisms between the ileocecum and remission induction of CD are still elusive. In this study, we conducted 16S rRNA sequencing and liquid chromatography-tandem mass spectrometry (LC-MS/MS) on 68 terminal ileal mucosa and mesentery samples from 34 patients with CD. The results showed an improvement in the microbial health of the ileal mucosa and mesentery in patients with CD after ileocecal resection. In addition, specific spatial alterations in microbiota and metabolites were observed before and after surgery. Furthermore, differentially expressed metabolites in the ileal mucosa and mesentery were subjected to Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. The findings of this study support the therapeutic value of ileocecal resection in CD from a multi-omics perspective and may guide the clinical translation of microbiome-based strategies for precise treatment of CD.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1239-1252"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326991","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":"Systematic Evaluation of Helicobacter pylori Susceptibility to Antibiotics Before First-Line Treatment: A Cohort Study.","authors":"Bernard Denis, Laurianne Plastaras, Izabella Amaritei, Marion Bolliet, Mathilde Clavel, Rémi Darrius, Paul Montet, Sebastian Vuola, Dominique de Briel","doi":"10.1002/ueg2.70090","DOIUrl":"10.1002/ueg2.70090","url":null,"abstract":"<p><strong>Background: </strong>European guidelines recommend that susceptibility tests be routinely performed, even before prescribing first-line treatment of Helicobacter pylori infection. However, empirical treatments are the rule in France, and susceptibility-guided treatments are the exception.</p><p><strong>Objective: </strong>We aimed to report our experience of systematic antibiotic susceptibility testing before first-line treatment.</p><p><strong>Methods: </strong>Prospective registration of all esofagogastroduodenoscopies performed in a community hospital from December 2023 to December 2024. Antral and fundic biopsies were performed, at the discretion of the endoscopist, for histological examination, polymerase chain reaction (PCR) and culture without any freezing.</p><p><strong>Results: </strong>Overall, 3566 adults underwent esofagogastroduodenoscopy, 1785 (50.1%) were tested and H. pylori infection was diagnosed in 308 (17.3%) [95% confidence interval (CI): 15.5%-19.0%] individuals. The sensitivity of PCR for the diagnosis of H. pylori infection was 99.7%, significantly higher than those of histology (94.1%) and culture (95.2%) (p < 0.01). Clarithromycin resistance was observed in 22.6% [95% CI: 17.9%-27.3%] and levofloxacin resistance in 18.6% [95% CI: 14.1%-23.2%] of cases. Among 285 patients treated, susceptibility-guided triple therapy was prescribed in 84.9% of cases (73.3% amoxicillin-clarithromycin, 11.6% amoxicillin-levofloxacin) and quadruple bismuth therapy in 14.4% of cases. The eradication rates were 98.1% [95% CI: 96.0%-100%] for triple therapy amoxicillin-clarithromycin and 100% [95% CI: 100%-100%] for amoxicillin-levofloxacin, significantly higher than 81.3% [95% CI: 67.7%-94.8%] for quadruple bismuth therapy (p < 0.01 and p = 0.03, respectively). Overall, of 218 (70.8%) patients evaluated by the C13 urea breath test, H. pylori was eradicated in 209 (95.9%) [95% CI: 93.2%-98.5%] patients. The PCR-based diagnostic and therapeutic strategy was more cost-effective than the immunohistochemistry-based strategy.</p><p><strong>Conclusion: </strong>A PCR-based susceptibility-guided strategy is easy to implement in routine clinical practice. In more than 7 in 10 patients, PCR enabled the offer of a susceptibility-guided triple therapy that was more effective and less costly than empirical quadruple bismuth therapy. Culture enabled one additional patient in 10 to be offered a susceptibility-guided triple therapy.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1289-1294"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970847","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":"Nurse-Administered Gut-Directed Hypnotherapy for Irritable Bowel Syndrome: A Two-Year Follow-Up Study.","authors":"Jenny Lövdahl, Michaela Blomqvist-Storm, Olafur S Palsson, Gisela Ringström, Hans Törnblom, Magnus Simrén, Inês A Trindade","doi":"10.1002/ueg2.70060","DOIUrl":"10.1002/ueg2.70060","url":null,"abstract":"<p><strong>Background: </strong>Gut-directed hypnotherapy is effective for irritable bowel syndrome (IBS) and a few studies have reported long-lasting therapeutic effects following intervention. No previous studies have evaluated the long-term effects of nurse-administered hypnotherapy.</p><p><strong>Aims: </strong>We aimed to investigate the long-term effects of nurse-administered gut-directed hypnotherapy for IBS and identify factors associated with symptom improvement. Furthermore, we aimed to compare treatment effects between individual and group hypnotherapy.</p><p><strong>Methods: </strong>A 2-year follow-up study including 289 patients with IBS who had completed a 12-week hypnotherapy program (individually or in groups) was conducted. Data were collected at baseline, and at 6-month-, 1-year- and 2-year follow-ups. Irritable bowel syndrome and extracolonic symptom severity (IBS-SSS), gastrointestinal-specific anxiety (VSI), and anxiety and depressive symptoms (HADS) were assessed. Patients reporting a reduction ≥ 50 points (IBS-SSS) were classified as treatment responders.</p><p><strong>Results: </strong>The 2-year follow-up was completed by 207 patients. The proportion of responders at post-treatment was 64.3%, 62.8% at the 6-month follow-up, 64.7% at the 1-year follow-up, and 61.8% at the 2-year follow-up. The severity of IBS symptoms, extracolonic and psychological symptoms were all reduced post-treatment, and this effect lasted over the 2-year follow-up period (p < 0.001). Younger age, individual hypnotherapy, and severe irritable bowel syndrome symptoms at baseline predicted a better response to treatment (R² = 0.16).</p><p><strong>Conclusions: </strong>Nurse-administered gut-directed hypnotherapy is an effective treatment for IBS with long-lasting symptom improvements. Younger age, severe irritable bowel syndrome symptoms, and individual treatment might be important factors associated with effectiveness (ClinicalTrials.gov study protocol IDs: NCT06167018, NCT03432078).</p><p><strong>Trial registration: </strong>ClinicalTrials.gov study protocol IDs: NCT06167018, NCT03432078.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1307-1317"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258957","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":"Pancreatic Exocrine Insufficiency Is Not Uncommon in Celiac Disease: A Systematic Review and Meta-Analysis.","authors":"Miroslav Vujasinovic, Nina Blazevic, Patrick Maisonneuve, Anders Forss, Nikola Panic, Nina Bloch, J Enrique Dominguez Munoz, Jonas F Ludvigsson, J-Matthias Löhr","doi":"10.1002/ueg2.70076","DOIUrl":"10.1002/ueg2.70076","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic exocrine insufficiency (PEI) is seen in primary pancreatic disease but has also been seen in extrapancreatic conditions including celiac disease (CeD). The symptoms of PEI and CeD often overlap, which makes diagnostics challenging. In this systematic review and meta-analysis, we aimed to investigate the prevalence of PEI in CeD.</p><p><strong>Methods: </strong>With the assistance of a professional librarian, we searched five databases: PubMed, Embase, Cochrane, Web of Science Core Collection, and Google Scholar, up until October 21, 2024. The pooled prevalence of PEI in biopsy-confirmed CeD was estimated, and the quality of studies appraised.</p><p><strong>Results: </strong>We identified and screened the titles and abstracts of 1432 publications, of which 60 were reviewed in full text and 12 were included in the analyses. The overall pooled weighted prevalence of PEI in CeD was 13.5% (95% CI 7.2-21.0). The prevalence was similar among children (14.2%; 95% CI 2.0-32.8) and adults (12.8%; 95% CI 7.8-18.7) with CeD. The prevalence in studies that used secretory testing to define PEI was 13.1% (95% CI 6.4-21.3) and in those requiring digestive tests 17.1% (95% CI 5.8-32.1). The weighted prevalence of PEI was significantly higher among untreated CeD patients (18.2%) than patients on a gluten-free diet (6.9%) (p = 0.03), in both adults and children.</p><p><strong>Conclusion: </strong>One in eight individuals with CeD may suffer from PEI. The prevalence was particularly high in untreated CeD. PEI should be considered in patients who do not respond to a gluten-free diet.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1107-1115"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592452","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":"Oral Microcapsule Chromocolonoscopy With Patent Blue V Improves Adenoma Detection Safely and Effectively.","authors":"Berenice Schulte, Georg H Waetzig, Johannes Bethge, Konrad Aden, Claudio C Conrad, Eva-Maria Theismann, Julia K Keppler, Therese Ruhmlieb, Karin Schwarz, Stefan Schreiber, Mark Ellrichmann","doi":"10.1002/ueg2.70067","DOIUrl":"10.1002/ueg2.70067","url":null,"abstract":"<p><strong>Background and objective: </strong>Chromocolonoscopy significantly improves polyp/adenoma detection rates (PDR/ADR). However, its integration into routine clinical practice is hindered by its cumbersome mode of application. The objective was to develop an oral nutritional grade delivery system and to assess its efficacy for colonic release, mucosal staining and PDR/ADR as a proof of concept.</p><p><strong>Methods: </strong>Food-grade shellac microcapsules releasing 87.5 mg of patent blue V (PBM) pH- and time-dependently were used in 35 volunteers receiving diagnostic colonoscopy either due to a positive fecal occult blood test or surveillance in inflammatory bowel disease. Six capsules were administered p.o. during the bowel preparation (Klean-Prep). Mucosal staining was assessed in total and per segment using a five-point grading scale. PDR and ADR were evaluated and compared to a propensity score-matched comparison cohort in a 1:3 ratio.</p><p><strong>Results: </strong>In the PBM cohort, 97.1% (34/35) achieved an optimal to acceptable staining quality (SQ) score of ≥ 8, with a mean total score of 13.4 ± 2.9. PDR was significantly higher in the PBM group at 62.8% compared to 42.9% in the comparison group (CG; p = 0.04). ADR showed no significant differences (p = 0.06). The use of PBM resulted in a significantly increased number of detected polyps and adenomas per colonoscopy compared with CG (polyps: PMB = 1.1 ± 1.1 vs. CG = 0.6 ± 0.8, p = 0.02; adenomas: PBM = 0.8 ± 0.9 vs. CG = 0.3 ± 0.5; p = 0.02).</p><p><strong>Conclusion: </strong>The novel PBM demonstrated uniform mucosal staining when utilized in chromocolonoscopy. Delayed-release patent blue V appears to be a safe and effective alternative to dye-spray techniques and existing oral chromoendoscopy modalities.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1116-1126"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567895","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":"Why High-Quality Guidelines Matter in Gastroenterology-And How UEG Is Leading the Way.","authors":"Brigida Barberio, Jordi Serra, Iago Rodríguez-Lago","doi":"10.1002/ueg2.70079","DOIUrl":"10.1002/ueg2.70079","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1042-1043"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650691","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":"Fecal and Serum Metabolome in Crohn's Disease is Linked With Future Flare.","authors":"Nina Levhar, Rotem Hadar, Tzipi Braun, Raneen Naamneh, Gilat Efroni, Bella Agranovich, Ifat Abramovich, Adi Talan Asher, Orit Picard, Adi Lahat, Doron Yablecovitch, Uri Kopylov, Rami Eliakim, Shomron Ben-Horin, Amnon Amir, Yael Haberman","doi":"10.1002/ueg2.70073","DOIUrl":"10.1002/ueg2.70073","url":null,"abstract":"<p><strong>Background: </strong>Metabolites are key mediators of various physiological functions. However, there is a lack of data linking their levels to future Crohn's Disease (CD) flares.</p><p><strong>Objective: </strong>We aimed to identify systemic and gut metabolic changes that precede flare and generate metabolite-based indexes that predict flare using a test cohort, with validation using an independent cohort.</p><p><strong>Methods: </strong>We analyzed serum and fecal metabolomes in a prospective cohort of patients with quiescent Crohn's Disease monitored until a clinical flare or the end of the study follow-up.</p><p><strong>Results: </strong>We identified specific metabolic changes in pre-flare samples of Crohn's Disease patients and developed prediction models for a subsequent flare using serum and fecal metabolic signatures. Among the fecal metabolites linked to future flares, metabolite classification indicated significantly fewer fatty acids and more carbohydrates in pre-flare samples of patients that eventually flared. Serum metabolites linked with future flares included reduced levels of two Krebs cycle ketogenic derivatives (3-hydroxybutyrate and acetoacetate) and higher urate in pre-flare samples. The predictions based on fecal metabolomics were validated in an independent Crohn's Disease cohort with a similar design. Higher urate levels in the serum metabolomics of the test cohort led us to develop a clinical blood-based index composed of normalized urate-to-creatinine ratio together with CRP [urate/creatinine ratio+log2 (CRP)], which was predictive of flare in the validation cohort 2.</p><p><strong>Conclusions: </strong>Metabolites linked to future flares can provide insight into mechanisms prompting the transition from quiescent to inflammatory Crohn's Disease states and may help identify those at risk for a clinical flare.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1278-1288"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620747","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}