United European Gastroenterology Journal最新文献

{"title":"How to Survive and Succeed in the Design and Execution of a Collaborative Randomized Controlled Trial.","authors":"Enrique de-Madaria","doi":"10.1002/ueg2.12726","DOIUrl":"https://doi.org/10.1002/ueg2.12726","url":null,"abstract":"<p><p>This article guides the design and execution of successful collaborative randomized controlled trials (RCTs). Aimed at researchers looking to impact clinical practice, it highlights the advantages of RCTs over observational studies in driving clinical advancements. The article details essential steps in trial development, starting with assembling a core team of a principal investigator, experienced collaborator, methodologist, patient representative, and coordinator. Critical strategies for defining impactful research questions, selecting adequate primary endpoints, and developing a robust protocol are discussed. Additional emphasis is placed on patient-centered outcomes and data integrity, supported by carefully designed electronic case report forms. The article also covers strategies for recruiting collaborators, and managing ethical approvals across multiple centers. Ultimately, it offers insights from the author's experience, encouraging new researchers to overcome challenges in launching their first RCT and reinforcing the role of high-quality, multicentric research in enhancing patient care and clinical outcomes.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999409","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":"Young Adult Patients With Pediatric-Onset Inflammatory Bowel Disease Have a Higher Educational Level and a Higher Employment Rate Than the General Population.","authors":"Hélène Sarter, Delphine Ley, Dominique Turck","doi":"10.1002/ueg2.70033","DOIUrl":"https://doi.org/10.1002/ueg2.70033","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029166","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":"Faecalibacterium Diversity in the Gut Microbiome of Crohn's Disease Patients.","authors":"Paul Mclellan, Sandrine Auger, Marie Therese Goudiaby, Loic Brot, Nicolas Benech, Jean Pierre Grill, Anne Bourrier, Denis Mariat, Camille Mayeur, Muriel Thomas, Véronique Robert, Julien Kirchgesner, Laurent Beaugerie, Harry Sokol, Philippe Langella, Philippe Seksik, Jean Marc Chatel","doi":"10.1002/ueg2.70023","DOIUrl":"https://doi.org/10.1002/ueg2.70023","url":null,"abstract":"<p><p>Faecalibacterium has recently garnered attention for its potential health implications. To better understand its role, we developed and assessed real-time PCR assays for detecting and quantifying various Faecalibacterium species in human stool samples from both healthy individuals and Crohn's disease patients, either in flare or remission. The assays targeted the Microbial Anti-inflammatory Molecule (MAM) genes, which encode MAM proteins. These assays demonstrated 100% species-specificity using strains from six Faecalibacterium species: Faecalibacterium prausnitzii, Faecalibacterium taiwanense, Faecalibacterium duncaniae, Faecalibacterium longum, Faecalibacterium hattori, and Faecalibacterium CNCM4541. They also showed high sensitivity with detection limits of 10^5 bacteria per gram of sample. In healthy individuals, the different Faecalibacterium species varied in abundance. F. taiwanense, F. duncaniae, and F. longum were the most prevalent, around 10^10 bacteria/g of stool. In contrast, F. hattori and CNCM4541 were less abundant, with 10^7 bacteria/g. Despite its low abundance, F. hattori was present in all healthy subjects, while CNCM4541 was detected in only 50% of them. Notably, F. taiwanense, F. duncaniae, and F. longum were found in all healthy individuals. In Crohn's disease patients, both in flare and remission, a decrease in Faecalibacterium species was observed, with no recovery in remission. The most abundant species in Crohn's disease patients were F. prausnitzii and F. duncaniae, around 10^7 bacteria/g, while F. longum, F. hattori, and F. taiwanense were present at lower levels (10^6 bacteria/g), and CNCM4541 was no longer detected. Interestingly, F. prausnitzii showed a smaller decrease in abundance compared with other species. Moreover, F. prausnitzii was significantly more prevalent in patients in remission than in those in flare, suggesting that it may be more resistant to inflammation. These findings highlight the importance of accurately characterizing and quantifying Faecalibacterium species to better understand their role in health and disease.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983470","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":"Differences in the Fecal Metabolome of Autoimmune Pancreatitis Patients.","authors":"Vladyslav Dovhalyuk, Fan Yang, Sara Nikolic, Miroslav Vujasinovic, J-Matthias Löhr, Daniel Globisch","doi":"10.1002/ueg2.70025","DOIUrl":"https://doi.org/10.1002/ueg2.70025","url":null,"abstract":"<p><strong>Background: </strong>Chronic pancreatitis is a risk factor for pancreatic cancer. Autoimmune pancreatitis is a unique form of chronic pancreatitis that is primarily characterized by its immune mediate etiology, clinically resembling pancreatic cancer, yet uniquely responsive to steroid treatment.</p><p><strong>Objective: </strong>Early and accurate diagnosis of autoimmune pancreatitis is vital for effective treatment and patient prognosis, for which new diagnostic tools are urgently required. Gut microbiota dysbiosis has been identified to correlate with the development of pancreatic diseases, which provides new opportunities for the discovery of disease biomarkers.</p><p><strong>Methods: </strong>We utilized a mass spectrometric global metabolomics investigation of patient autoimmune pancreatitis and chronic pancreatitis fecal samples, investigating microbiome, dietary and human metabolism.</p><p><strong>Results: </strong>We discovered a series of newly identified metabolic signatures between both patient groups including enterolactone, 4-guanidinobutanoic acid, and methylthioadenosine sulfoxide. Additionally, the analysis revealed significant differences in several metabolic pathways such as fatty acids, alkaloids, amino acids and peptides.</p><p><strong>Conclusion: </strong>Our observations provide novel insights into important metabolic human pathways and microbiome-derived metabolites to distinguish autoimmune pancreatitis from chronic pancreatitis. These findings reveal systemic metabolic responses and the identified metabolites may be developed into potential biomarkers for future diagnosis to distinguish between autoimmune pancreatitis and chronic pancreatitis.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034035","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":"Pancreatic Enzyme Replacement Therapy Improves Exclusive Enteral Nutrition Related Diarrhea in Crohn's Disease: A Prospective Randomized Trial.","authors":"Jian Kang, Jing Wang, Juan Su, Wei Wang, Yueyue Lu, Zhishun Tang, Liping Zou, Anning Yin, Jiao Li, Haixia Ren, Qian Zhou, Huipeng Wan, Ping An","doi":"10.1002/ueg2.70021","DOIUrl":"https://doi.org/10.1002/ueg2.70021","url":null,"abstract":"<p><strong>Background & aims: </strong>Previous results showed that combined treatment of biologics and exclusive enteral nutrition (EEN) brought moderate-to-severe Crohn's disease patients significant improvements in clinical and endoscopic outcomes. Despite its essential role and favorable safety profile, EEN in the treatment of adult Crohn's disease is frequently underestimated because of lower compliance and several side effects, including EEN-related diarrhea (EEND).</p><p><strong>Methods: </strong>In this prospective, single-center randomized clinical trial, 147 eligible patients with actively moderate-to-severe Crohn's disease treated with biologics and concomitant 16-week EEN were included. Sixty-one patients without EEND were enrolled in the ND group (without EEN-related diarrhea), and other patients with EEND who received pancreatic enzyme replacement therapy (PERT) (43 patients) or not (43 patients) were recruited in PERT and NPERT groups, respectively. The clinical outcomes, biologic outcomes, and endoscopic outcomes were evaluated. Quality of life (QoL) and psychological status were also assessed at baseline and endpoints (week 16).</p><p><strong>Results: </strong>Bowel movements (daily frequency decreased by 5.3 times) and stool consistency (reduced watery and loose stool) were greatly improved in PERT group at week 16. At week 16, patients in the ND and PERT groups achieved similar clinical responses (93% in ND group and 94.7% in PERT group, p = 0.731) and clinical remission (86.0% in ND group and 86.8% in PERT group, p = 0.90) while patients in the NPERT group had significantly lower proportions of these clinical outcomes (67.9% clinical response and 57.1% clinical remission). No significant difference was observed in endoscopic outcomes between each group (p = 0.904). QoL and mental status including anxiety and depression in PERT group had great improvement compared with the NPERT group.</p><p><strong>Conclusions: </strong>Our prospective results provided invaluable evidence that PERT supplementation efficiently improved EEND in Crohn's disease patients with combined treatment of biologics and 16-week EEN, which had a promising effect in active Crohn's disease induction.</p><p><strong>Trial registration: </strong>ChiCTR2200058343.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999611","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":"Disease Clearance in Ulcerative Colitis: A Narrative Review.","authors":"Silvio Danese, Laurent Peyrin-Biroulet, Vipul Jairath, Ferdinando D'Amico, Shashi Adsul, Christian Agboton, Fernando Magro","doi":"10.1002/ueg2.12714","DOIUrl":"https://doi.org/10.1002/ueg2.12714","url":null,"abstract":"<p><p>Ulcerative colitis (UC) is a chronic relapsing disease with significant associated risks such as colectomy, hospitalization, or colorectal cancer. A treat-to-target approach that mitigates disease activity and progression from an early stage is needed. The latest STRIDE II guidelines advocate for clinical and endoscopic remission as the main therapeutic targets in the management of UC; however, histological remission is increasingly being recognized as an important outcome. The concept of disease clearance, a composite outcome comprising clinical, endoscopic, and histological remission, has been proposed as a potential target for patients with UC and has been precisely defined by the International Organization for the Study of Inflammatory Bowel Disease, with the aim of standardizing its use in clinical practice and research. Despite challenges, including variable standardized definitions and uncertainties regarding the timing of reaching different definitions of remission, disease clearance corresponds to comprehensive disease control, and its use as an outcome could help clinicians to better evaluate the actual status of the disease. Furthermore, achieving disease clearance may be related to an improved disease course, positive long-term outcomes, and an improvement in health-related quality of life. Real-world evidence supports the feasibility of achieving disease clearance with various treatment modalities, including vedolizumab, the only gut-selective antilymphocyte trafficking drug. The aim of this narrative review is to explore the concept of disease clearance in patients with disease clearance, mainly focusing on trials evaluating vedolizumab but also other biologics.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041968","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":"Minimal Hepatic Encephalopathy in Cirrhotic Patients: A New Simple and Fast Digital Screening Method.","authors":"Henrike Dobbermann, Raffael Schlüter, Yevgeniy Lyubchenko, Johanna Beder, Sven Danneberg, Katharina Mitzlaff, Iris Engelbart, Jakob Jessberger, Felix Braun, Thomas Becker, Christian Labenz, Monique Janneck, Denys Matthies, Friedhelm Sayk, Jens U Marquardt","doi":"10.1002/ueg2.70004","DOIUrl":"https://doi.org/10.1002/ueg2.70004","url":null,"abstract":"<p><strong>Backround: </strong>Minimal hepatic encephalopathy is a common and prognostically severe complication of cirrhosis with a significant impact on the quality of life. Detailed diagnostic work-up of minimal hepatic encephalopathy is time-consuming and difficult to integrate into daily clinical routine.</p><p><strong>Objective: </strong>We aimed to develop a new, simple, and easy-applicable smartphone-based self-assessment method for screening of minimal hepatic encephalopathy.</p><p><strong>Methods: </strong>92 patients with cirrhosis and 20 healthy controls were recruited to perform 3 different short digital tests on smartphones (Tip test (TT), number connection test (dNCT) and modified Stroop test (ST)). Results were correlated with the Psychometric Hepatic Encephalopathy Score (PHES) as the presumed gold standard for minimal hepatic encephalopathy. The impact of age, gender, education, CHILD and MELD scores was further investigated.</p><p><strong>Results: </strong>All 3 digital tests showed good correlation with PHES (TT r = -0.76, dNCT r = -0.58, and ST r = -0.65; all p < 0.001). Digital tests were performed significantly faster (TT median 41s (IQR 36-51s); dNCT median 21s (IQR 8-16s); ST median 76s (IQR 55-99s) than PHES (median 322s; IQR 261-434s); There were significant differences between age groups and different levels of education (p < 0.05). AUC for TT was 0.835 (95% confidence interval 0.747-0.922, p < 0.001) and highest among all digital tests.</p><p><strong>Conclusion: </strong>All 3 digital tests proved to be suitable for screening of minimal hepatic encephalopathy. TT showed the highest correlation with reference PHES and was not affected by language skills or color blindness, and, thus, might represent a new and fast method for minimal hepatic encephalopathy detection. Intra-individually adjusted smartphone-based thresholds might further eliminate the influence of age, gender, educational level or training, to refine early app-based alerts in case of cognitive deterioration in cirrhotic patients.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997518","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":"Pediatric Autoimmune Pancreatitis: Clinical Findings and Outcomes in Sweden.","authors":"Miroslav Vujasinovic, Fredrik Lindgren, Nikolaos Kartalis, Raffaella Pozzi Mucelli, Dawid Rutkowski, Alexander Waldthaler, Poya Ghorbani, Carlos Fernández Moro, Thomas Casswall, J-Matthias Löhr","doi":"10.1002/ueg2.70022","DOIUrl":"https://doi.org/10.1002/ueg2.70022","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric autoimmune pancreatitis (AIP) is a rare form of pancreatitis in children with poorly understood pathophysiology. It is a recognized risk factor for chronic pancreatitis in approximately 4% of pediatric cases. This study aims to describe the demographics, clinical characteristics, and outcomes of a large Swedish cohort of pediatric AIP patients.</p><p><strong>Patients and methods: </strong>A retrospective analysis of medical records was conducted for patients diagnosed with pediatric AIP between January 2006 and December 2022.</p><p><strong>Results: </strong>Thirty-seven patients were included (20 males, 17 females; mean age 13.5 ± 2.8 years). None had a family history of pancreatic diseases. Most patients (62.2%) presented with acute pancreatitis, followed by weight loss (45.9%), abdominal pain (43.2%), jaundice (21.6%), and fatigue (16.2%). Acute pancreatitis was mild in all cases according to the Atlanta criteria. Multi-organ involvement was observed in 81.1% of patients, and inflammatory bowel disease (IBD) was present in 62.2%. A total of 75.7% of patients received treatment, mainly glucocorticoids, while 24.3% had spontaneous regression. Complete clinical and radiological remission was achieved in 83.8% of treated patients. Pancreatic exocrine insufficiency was present in 43.2% of patients at diagnosis, reducing to 24.3% at the final follow-up. No patients developed diabetes mellitus, except for one who underwent total pancreatectomy due to suspected pancreatic tumor.</p><p><strong>Conclusions: </strong>Pediatric AIP is a rare condition often associated with multi-organ involvement particularly IBD. Most patients respond well to glucocorticoid treatment and achieve remission. Managing IBD may improve the outcomes for both conditions.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Growing Burden of Obesity: Addressing a Global Public Health Challenge.","authors":"Patrizia Burra, Elvira Verduci, Jorge Amil Dias, Maria Buti, Anna Carboni, Coskun Ozer Demirtas, Pierluigi Fracasso, Daniel Hartman, Andrea Laghi, Patrick Michl, Shira Zelber-Sagi","doi":"10.1002/ueg2.70020","DOIUrl":"https://doi.org/10.1002/ueg2.70020","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017376","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":"Disorders of the gut-brain interaction among European people with obesity: Prevalence and burden of compatible symptoms.","authors":"Chloé Melchior, Jóhann P Hreinsson, Jan Tack, Jutta Keller, Qasim Aziz, Olafur S Palsson, Shrikant I Bangdiwala, Ami D Sperber, Magnus Simrén, Jean-Marc Sabaté","doi":"10.1002/ueg2.12700","DOIUrl":"https://doi.org/10.1002/ueg2.12700","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of disorders of the gut-brain interaction (DGBI) among people with obesity in the general population is unknown. Our aim was to assess the prevalence of DGBI among obese subjects in the general population in comparison with normal or overweight subjects, as well as exploring factors associated with DGBI in obesity in Europe.</p><p><strong>Methods: </strong>We included subjects who completed the internet-based survey of the Rome Foundation Global Epidemiology study in 11 European countries. Obesity was defined as a BMI>30 kg/m² and participants were divided into three classes: 1: BMI 30 to <35 kg/m², 2: BMI 35 to <40 kg/m², and 3: BMI 40 kg/m² or higher. The prevalence of symptoms compatible with DGBI was reported and compared between obese and normal or overweight (BMI between 18.5 and <30 kg/m²) participants. Factors potentially associated with DGBI and obesity including demographics, psychological distress (PHQ-4), non-GI somatic symptoms (PHQ-12), quality of life (PROMIS-10), healthcare access, medication and food consumption were assessed.</p><p><strong>Results: </strong>We included 20,117 participants in our analysis. The prevalence of obesity was 17.8% (95% CI 17.3, 18.4), with 12.6%, 3.7% and 1.6% in obesity classes 1, 2 and 3, respectively. The prevalence of any DGBI was 44.2% in the obese group versus 39.6% in the normal or overweight group (OR = 1.20 (1.12, 1.30)), with all DGBI being more prevalent in the obese versus normal or overweight group, with the exception for functional constipation where the opposite pattern was seen. Female sex, higher level of psychological distress and more severe non-GI somatic symptoms were seen in the group with DGBI associated with obesity.</p><p><strong>Conclusions: </strong>Symptoms compatible with DGBI are common among European people with obesity in the general population and are linked with certain demographic and disease-related factors. This should be acknowledged in the management of patients with obesity.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804007","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}