World Journal of Gastroenterology最新文献

{"title":"Chaihu-Shugan-San ameliorates chronic atrophic gastritis by inhibiting nuclear factor-kappa B-mediated inflammation and apoptosis.","authors":"Jin Song, Dan-Yan Li, Xiao-Li Zhang, Sha-Sha He, Ning Wang, Hui-Cun Zhang, Yun-Jing Bai, Bo Li, Sheng-Sheng Zhang","doi":"10.3748/wjg.v32.i10.115957","DOIUrl":"10.3748/wjg.v32.i10.115957","url":null,"abstract":"<p><strong>Background: </strong>Chaihu-Shugan-San (CSS), a classic traditional Chinese medicine formula, has demonstrated significant efficacy in treating various gastrointestinal disorders.</p><p><strong>Aim: </strong>To explore the therapeutic efficacy of CSS in alleviating chronic atrophic gastritis (CAG), and elucidate the underlying mechanisms of action.</p><p><strong>Methods: </strong>High performance liquid chromatography-mass spectrometry was used to identify the main active components of CSS. The therapeutic effects of CSS at doses of 925 mg/kg/day and 1850 mg/kg/day on N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced CAG were evaluated. Network pharmacology and molecular docking were used to predict the potential targets of CSS in CAG. The impact of CSS on the gut microbiota of rats was investigated by 16S rRNA sequencing.</p><p><strong>Results: </strong>The main active components of CSS were lipids and lipid-like molecules, phenylpropanoids and polyketides. <i>In vivo</i> experiments showed that CSS significantly ameliorated MNNG-induced CAG by inhibiting inflammation and apoptosis. The core target of CSS to alleviate CAG were tumor necrosis factor, interleukin (IL)-1β, IL-6, <i>BAX</i>, <i>BCL2</i>, caspase-3/caspase-9, and <i>NFKBIA</i>. Gene Ontology analysis of these core targets revealed their predominant association with the nuclear factor-kappa B (NF-κB) signaling complex and <i>BAX</i> apoptotic complex. Molecular docking demonstrated that six compounds in CSS, including baicalin, licoisoflavone B, licochalcone B, glabrone, glycyrrhiza flavonol A, and marmin exhibited strong binding affinities with <i>NFKBIA</i>. 16S rRNA sequencing indicated that CSS promoted beneficial changes in the colonic microbial community.</p><p><strong>Conclusion: </strong>CSS alleviated CAG by inhibiting NF-κB-mediated inflammation and apoptosis, providing insights into its mechanism of action in protection against CAG.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"115957"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms and therapeutic potential of traditional Chinese medicine for inflammatory bowel disease.","authors":"Si-Hui Zeng, Xiao-Yan Jiang, De-Rong Lin, Wei-Jian Zhang, Yu-Qi Wu, Lin Xu, Shao-Ju Guo","doi":"10.3748/wjg.v32.i10.115821","DOIUrl":"10.3748/wjg.v32.i10.115821","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory disorder of the intestine with a rising global incidence that significantly impairs patients' quality of life. Although modern medical therapies can provide short-term symptom relief, they are often limited by dependence on medication and considerable adverse effects. Traditional Chinese medicine (TCM) has demonstrated longstanding clinical efficacy and preclinical advantages in IBD management, yet systematic summaries and in-depth mechanistic insights remain insufficient. This minireview explores recent advances in the mechanistic research of TCM for IBD to inform alternative therapeutic strategies. A systematic literature search was conducted using databases including PubMed, Science Citation Index Expanded, and China National Knowledge Infrastructure to synthesize current evidence, focusing on literature published between 2023 and 2025. Findings reveal that TCM exerts therapeutic effects through holistic, multicomponent, multi-target, and multi-pathway regulation. Key mechanisms involve modulation of inflammatory signaling pathways, immune homeostasis, gut microbiota composition, intestinal barrier integrity, autophagy, metabolic functions, gene expression, and synergistic multi-target therapy. Despite existing research limitations, the evolution from empirical herbal use toward modern scientific understanding promises to accelerate the modernization and global integration of TCM. This minireview provides foundational insights for future research and clinical practice, with the potential to benefit IBD patients worldwide.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"115821"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous transhepatic cholangioscopy-assisted procedures for the management of postoperative benign bilioenteric anastomotic strictures with or without biliary stones.","authors":"Xu Ren, Chen Wang, Yong-Ping Qu, Xiu-Fen Tang, Tian Xia, Yi-Xia Lu, Xiao-Mei Sun","doi":"10.3748/wjg.v32.i10.116152","DOIUrl":"10.3748/wjg.v32.i10.116152","url":null,"abstract":"<p><strong>Background: </strong>Postoperative benign bilioenteric anastomotic stricture (BBAS) is a serious complication of biliary surgeries.</p><p><strong>Aim: </strong>To determine the efficacy and safety of percutaneous transhepatic cholangioscopy (PTCS)-assisted procedures, including stricture dilation and recanalization for BBAS and biliary stone therapy for concomitant stones.</p><p><strong>Methods: </strong>Patients with BBAS who received PTCS-assisted procedures were included. Primary outcomes were anastomotic patency (including initial anastomotic patency after stricture dilation and cumulative anastomotic patency after PTCS catheter removal) and treatment success (<i>i.e.</i>, negative clinical clamping trial and removable indwelling PTCS catheter). Secondary outcomes were technical success for the three PTCS-assisted procedures, duration of the indwelling PTCS catheter, and adverse events.</p><p><strong>Results: </strong>Forty patients were included; 32 underwent PTCS-assisted stricture dilation/recanalization and 36 underwent biliary stone therapy. The initial patency rates were 58.1% and 41.9% at 1 and 2 years, respectively, and the cumulative patency rates were 74.3%, 59.7, 49.8%, and 34.8% at 1, 3, 5, and 7 years, respectively. The treatment success rate was 90.6% (29/32) for PTCS-assisted stricture procedures. The technical success rates were 100% (31/31), 87.5% (7/8), and 94.5% (34/36) for PTCS-assisted stricture dilation, recanalization, and biliary stone therapy, respectively. The median duration of the indwelling PTCS catheter in the 29 patients with treatment success was 6 (range: 2-109) months. Only one patient experienced acute bleeding, which was manageable.</p><p><strong>Conclusion: </strong>PTCS-assisted procedures are efficacious and safe for the management of BBAS and concomitant biliary stones. Placement of an indwelling PTCS catheter across the anastomosis after stricture dilation improves the anastomotic patency.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"116152"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing an esophago-pleural fistula disease model in rabbits with a magnetic compression technique.","authors":"Qing He, Xiang-Yu Chen, Qin Xiang, Chang-Hao Huang, Zhi-Wei Wu","doi":"10.3748/wjg.v32.i9.114302","DOIUrl":"https://doi.org/10.3748/wjg.v32.i9.114302","url":null,"abstract":"<p><strong>Background: </strong>Esophageal pleural fistula (EPF) primarily arises as a complication of esophageal surgery, malignant tumors, or trauma. The high mortality rate associated with EPF underscores the critical need for early diagnosis and aggressive treatment, which often involves a multidisciplinary approach including thoracic drainage, broad-spectrum antibiotics, nutritional support, and often surgical or endoscopic intervention. Despite its clinical severity, a corresponding animal disease model for mechanistic and therapeutic research remains unavailable.</p><p><strong>Aim: </strong>To establish a stable and reproducible EPF animal model using magnetic compression technology (MCT).</p><p><strong>Methods: </strong>EPF modeling surgery was successfully performed on 20 New Zealand white rabbits (weight: 2-3 kg) with our self-developed MCT device. Postoperatively, radiographic confirmation of magnet positioning was conducted within 24 hours. Fistula tract tissue samples were subjected to hematoxylin-eosin and Masson's trichrome histochemical staining. Pathological specimens were intentionally withheld from a subset of rabbits (<i>n</i> = 8) to assess long-term stability; these animals were monitored for a prolonged period until postoperative day (POD) 30 before euthanasia, allowing for observation of chronic changes.</p><p><strong>Results: </strong>The rabbit model of EPF was successfully established. The average surgical time was 26.6 ± 4 minutes. Magnets were spontaneously excreted at 7.0 ± 0.7 days postoperatively (<i>n</i> = 18/20). Pleural abscesses developed in 14 rabbits (70%). All rabbits (<i>n</i> = 8) reached the 30-day endpoint without intervention. Data analysis revealed no significant correlation between the abscess size, surgery time, anesthesia time, magnet discharge time, and weight changes within POD 9. Gross pathology confirmed the formation of EPFs and pleural abscesses. Spontaneous healing tendencies were observed in a subset of fistulas (<i>n</i> = 6). Histological analysis revealed esophageal epithelial migration advancing toward the fistula lumen, whereas pleural abscess cavities contained extensive necrotic debris characterized by neutrophilic infiltration and fibrin deposition, collectively validating the model's success.</p><p><strong>Conclusion: </strong>The magnetic compression-derived rabbit EPF model exhibits high establishment success and prolonged viability, enabling robust pathophysiological research.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 9","pages":"114302"},"PeriodicalIF":5.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a 3,5-diethoxycarbonyl-1,4-dihydrocollidine diet-induced mouse model in a comparative experimental study of portal hypertension.","authors":"Jin-Bo Zhao, Zheng-Hao Wu, Jia-Yun Lin, Gu-Qing Luo, Chi-Hao Zhang, Guang-Bo Wu, Qiang Fan, Xiao-Liang Qi, Hai-Zhong Huo, Ji-Wei Yu, Hong-Jie Li, Lei Zheng, Meng Luo","doi":"10.3748/wjg.v32.i9.114207","DOIUrl":"https://doi.org/10.3748/wjg.v32.i9.114207","url":null,"abstract":"<p><strong>Background: </strong>Portal hypertension (PHT) is a life-threatening complication of chronic liver disease, necessitating reliable animal models that mimic its clinical heterogeneity. Classical mouse models like bile duct ligation (BDL) exhibit a low 4-week survival (35%), while carbon tetrachloride (CCl₄) models have delayed pathogenesis, requiring ≥ 8 weeks for PHT development, limiting their efficiency.</p><p><strong>Aim: </strong>To evaluate the 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC) diet-induced mouse model as a biliary PHT model, comparing it to BDL and CCl₄ models.</p><p><strong>Methods: </strong>Mice were assigned to DDC diet, BDL, or CCl₄ groups. Assessments included portal pressure, histological examination of biliary fibrosis and hepatic stellate cell (HSC) activation (desmin expression), scanning electron microscopy for sinusoidal fenestrae and capillarization, endothelial nitric oxide synthase (eNOS) regulation (phosphorylated-eNOS/total eNOS ratio and total eNOS level), ductular reaction, inflammatory infiltration, and portosystemic shunting. Survival rates and operational feasibility (feed-based administration) were evaluated.</p><p><strong>Results: </strong>At 4 weeks, DDC induced portal pressure comparable to BDL and CCl₄. The DDC model showed moderate biliary fibrosis (similar to BDL but less than CCl₄) and greater HSC activation than the other two models. Sinusoidal fenestrae reduction and capillarization in DDC matched BDL and CCl₄ models. DDC had decreased phosphorylated-eNOS/total eNOS ratio, while BDL and CCl₄ models exhibited reduced total eNOS. DDC demonstrated robust ductular response, inflammation, and shunting, a hallmark of PHT. Survival was 100% (<i>vs</i> 35% BDL, 58.3%-66.6% CCl₄), with simpler feed-based induction.</p><p><strong>Conclusion: </strong>The DDC model offers strong biliary PHT relevance, high survival, and efficiency, making it a superior alternative to BDL and CCl₄ models for biliary PHT research.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 9","pages":"114207"},"PeriodicalIF":5.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lianhe Xiaozhi ointment ameliorates metabolic dysfunction-associated steatotic liver disease <i>via</i> peroxisome proliferator-activated receptor alpha pathway activation.","authors":"Li-Juan Nie, Gao-Xiang Wang, Xin-Yi Yang, Jing Sun, Yu-Tian Cao, Yan Lou, Yi-Fan Lu, Jiang-Yi Yu, Xi-Qiao Zhou","doi":"10.3748/wjg.v32.i9.114544","DOIUrl":"https://doi.org/10.3748/wjg.v32.i9.114544","url":null,"abstract":"<p><strong>Background: </strong>Lianhe Xiaozhi ointment (LXO), an innovative formulation derived from the classic Huanglian Wendan decoction, has been granted a national invention patent. With increasing years of clinical expertise within the Jiangsu Province Hospital of Chinese Medicine in China, LXO has become increasingly recognized as a potent remedy for metabolic disorders, particularly metabolic dysfunction-associated steatotic liver disease (MASLD). To date, specific bioactive components and underlying mechanisms remain unclear.</p><p><strong>Aim: </strong>To determine the bioactive components of LXO and clarify its mechanisms of action relevant to management of MASLD.</p><p><strong>Methods: </strong>We used ultra-high performance liquid chromatography with quadrupole time-of-flight mass spectrometry and network pharmacology approaches to systematically determine the key bioactive components of LXO and elucidate biological pathways modulated in the treatment of MASLD. Critical signaling pathways were also elucidated <i>via</i> hepatic transcriptomic analysis, and an exhaustive and rigorous exploration of the therapeutic efficacy and underlying mechanisms of LXO in MASLD was conducted <i>via</i> a combination of <i>in vivo</i> and <i>in vitro</i> high-fat model experiments.</p><p><strong>Results: </strong>Network pharmacology analysis revealed six pivotal bioactive components within LXO that collectively serve as the cornerstone for their efficacy against MASLD. LXO exerts multiple therapeutic effects, including weight gain retardation, amelioration of glucose and lipid metabolism disturbances, liver injury mitigation, hepatic inflammation alleviation, and correction of gut microbiota disorders. Multiple platform analyses, including hepatic transcriptomics, quantitative real-time polymerase chain reaction, and western blotting, confirmed that LXO induces peroxisome proliferator-activated receptor alpha (PPARα) transcriptional activation in the liver. <i>In vitro</i> studies confirmed that a PPARα antagonist markedly diminishes the lipid-lowering capacity of LXO.</p><p><strong>Conclusion: </strong>Collectively, our findings suggest that LXO exerts therapeutic effects on high-fat diet-induced MASLD at least in part <i>via</i> PPARα pathway activation.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 9","pages":"114544"},"PeriodicalIF":5.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous treatment of concomitant achalasia coexisting with epiphrenic diverticulum: The practice of submucosal tunneling technique.","authors":"Xin-Wei Hao, Ya-Wei Bi, Zi-Meng Wang, Xiao-Tong Niu, Jing-Yuan Xiang, Song Su, Long-Song Li, En-Qiang Linghu, Ning-Li Chai","doi":"10.3748/wjg.v32.i9.114758","DOIUrl":"https://doi.org/10.3748/wjg.v32.i9.114758","url":null,"abstract":"<p><strong>Background: </strong>Esophageal epiphrenic diverticulum (ED) often occurs in patients with esophageal motility disorders, and its incidence rate is approximately 3%-7% in achalasia (AC). A distinct septum has been observed in some patients with AC coexisting with ED during gastroscopy. Digestive endoscopic tunnel technique has emerged as a promising therapeutic approach for these patients.</p><p><strong>Aim: </strong>To evaluate the therapeutic effectiveness of specific treatment methods for ED with septum (ED + S) or ED without septum (ED - S) in AC patients.</p><p><strong>Methods: </strong>This retrospective cohort study included 31 patients with AC and esophageal diverticula (21 patients with septum and 10 patients without septum) between January 2016 and January 2025. In ED + S group, submucosal tunneling myotomy combined with diverticular septotomy was performed, while patients in the ED - S group underwent submucosal myotomy alone. The Eckardt scores before and after surgery were compared to evaluate symptom relief and clinical success. The Gastroesophageal Reflux Disease Questionnaire (GERD-Q) score and gastroscopy findings were used to evaluate postoperative gastroesophageal reflux.</p><p><strong>Results: </strong>The corresponding operation steps were completed in both groups, with a technical success rate of 100%. We successfully followed up with 18 and 10 patients in the ED + S and ED - S group, with a median follow-up period of 2.5 years and 3.0 years, respectively. The postoperative Eckardt scores [median (interquartile range)] were significantly lower in both groups compared with preoperative scores [ED + S group: 6.0 (4.0-8.0) <i>vs</i> 0 (0-2.0), <i>P</i> < 0.05; ED - S group: 6.0 (3.75-8.25) <i>vs</i> 1.0 (0-3.0), <i>P</i> < 0.05]. The clinical success rates (Eckardt score ≤ 3) were 88.9% and 90.0%, respectively. The GERD-Q score was used to evaluate postoperative gastroesophageal reflux, and 3 patients (3/18, 16.7%) in ED + S group and 2 patients (2/10, 20%) in ED - S group experienced symptomatic reflux (GERD-Q score ≥ 8).</p><p><strong>Conclusion: </strong>In AC patients with ED + S, submucosal tunneling myotomy with diverticular septotomy can achieve good therapeutic effects. When there is no obvious septum, submucosal tunneling myotomy is an effective method.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 9","pages":"114758"},"PeriodicalIF":5.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Succinylation: A novel regulatory axis in cholelithiasis-insights from lysine acetyltransferase 2A/adenosine monophosphate-activated protein kinase signaling.","authors":"He-Rui Wei, Fan Xiao","doi":"10.3748/wjg.v32.i9.114416","DOIUrl":"10.3748/wjg.v32.i9.114416","url":null,"abstract":"<p><p>Cholelithiasis represents a common clinical condition within the digestive tract and continues to pose a substantial global health challenge, largely due to its high rate of recurrence and a scarcity of effective non-surgical interventions. Although protein succinylation has been widely characterized as a post-translational modification, its implications in cholelithiasis pathogenesis had remained poorly defined. A groundbreaking study by Wang <i>et al</i> demonstrates that lysine acetyltransferase 2A-mediated succinylation of adenosine monophosphate-activated protein kinase suppresses cholelithiasis. This work not only provides novel mechanistic insights into cholelithiasis but also establishes succinylation as a promising therapeutic target, thereby addressing a critical knowledge gap in the field.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 9","pages":"114416"},"PeriodicalIF":5.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparable remission and health care use in real-world inflammatory bowel disease patients initiating originator biologics <i>vs</i> biosimilars.","authors":"Cristiano S Moura, Albert Etingin, Luck Lukusa, Harminder Singh, Neeraj Narula, Laura E Targownik, Yvette Leung, Petros Zezos, Beata Polewiczowska-Nowak, Waqqas Afif, Sasha Bernatsky","doi":"10.3748/wjg.v32.i9.114580","DOIUrl":"https://doi.org/10.3748/wjg.v32.i9.114580","url":null,"abstract":"<p><strong>Background: </strong>Biologic therapies, including anti-tumor necrosis factor agents, have significantly improved the management of inflammatory bowel disease (IBD). However, their high cost can limit patient access. Biosimilars are a more affordable option than originator biologics and offer potential for improved accessibility, though real-world evidence comparing their effectiveness remains limited.</p><p><strong>Aim: </strong>To describe real-world, comparative outcomes of IBD patients taking biologics and biosimilars, focusing on remission and healthcare use.</p><p><strong>Methods: </strong>We used data from a multicenter registry-based cohort, which includes participants from six Canadian IBD clinical centers. Adults with ulcerative colitis or Crohn's disease who initiated biosimilar, or originator formulations of infliximab or adalimumab were included. The primary outcome was clinical remission; secondary outcomes included hospitalizations and emergency department (ED) visits. Kaplan-Meier survival analyses and multivariable Cox regression models were used to assess time to these outcomes, adjusting for disease activity, treatment history, and demographic characteristics.</p><p><strong>Results: </strong>A total of 258 individuals were analyzed (192 biosimilar initiators and 66 originator users). The median time to remission was similar between biosimilars (12.2 months) and originators (12.8 months). We did not detect difference in the likelihood of achieving remission when comparing biosimilar and originator treatments (adjusted hazard ratio: 1.49; 95% confidence interval: 0.96-2.32). Hospitalization and ED visit rates were also comparable. Corticosteroid use and prior hospitalizations were associated with increased hospitalization risk.</p><p><strong>Conclusion: </strong>This study suggests biosimilars and originators have similar remission, ED visits, and hospitalization in IBD. This reinforces confidence in their equivalence, improving access while supporting healthcare system sustainability.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 9","pages":"114580"},"PeriodicalIF":5.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative serum carcinoembryonic antigen: Powerful marker for prognostic prediction and adjuvant chemotherapy decision-making in patients with stage II and III colorectal cancer.","authors":"Fen-Qi Du, Jia-Lu Liu, Liu-Dan Mai, Xin-Hao Han, Wen-Jie Song, Da Yang, Qiu-Ju Zhang, Rui Zhang, Yan-Long Liu, Jin-Xue Tong","doi":"10.3748/wjg.v32.i9.114200","DOIUrl":"https://doi.org/10.3748/wjg.v32.i9.114200","url":null,"abstract":"<p><strong>Background: </strong>Assessment of the prognosis, follow-up monitoring, and adjuvant treatment decision-making for patients with stage II and III colorectal cancer (CRC) are controversial, as CRC harbors tremendous heterogeneity. Carcinoembryonic antigen (CEA) is an important tumor marker; however, the use of this marker in the management of CRC has not garnered adequate attention.</p><p><strong>Aim: </strong>To determine the significance of perioperative CEA levels in prognostic stratification and treatment decision making to provide personalized diagnosis and treatment for patients with stage II and III CRC.</p><p><strong>Methods: </strong>Patients in the training and validation cohorts were diagnosed with primary stage II or III CRC. Preoperative CEA (pre-CEA) and postoperative CEA (post-CEA) were collectively defined as perioperative CEA. Kaplan-Meier (K-M) survival analyses were used to describe patient survival. Cox stepwise regression analysis based on Akaike information criterion was used to determine the prognostic value of clinicopathological characteristics. Nomograms were developed to predict the probability of overall survival (OS) and disease-free survival (DFS). Annual hazard curves and pie charts were used to demonstrate the features of recurrence or metastasis. Differences were considered statistically significant at <i>P</i> < 0.05.</p><p><strong>Results: </strong>A total of 2496 and 1293 patients were included in the training and validation cohorts, respectively. K-M analysis indicated that patients with elevated perioperative CEA had poorer OS and DFS, with post-CEA being an independent prognostic factor for OS and DFS. Nomograms based on factors associated with prognosis were constructed, which showed good predictive ability for 3-, 5-, and 7-year OS and DFS. Patients with elevated perioperative CEA were more likely to have recurrence or metastasis, and the period of the second year after surgery was the peak time of recurrence or metastasis. OS and DFS were significantly worse in patients without adjuvant chemotherapy when they had elevated perioperative CEA. Adjuvant chemotherapy could significantly improve the OS of patients with elevated perioperative CEA. Patients with elevated post-CEA who received XELOX could achieve better OS and DFS.</p><p><strong>Conclusion: </strong>Perioperative CEA demonstrate sufficient sensitivity in the prognosis prediction and follow-up of patients with stage II and III CRC. Furthermore, perioperative CEA, especially post-CEA, show promise in guiding adjuvant chemotherapy, suggesting potential for further study.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 9","pages":"114200"},"PeriodicalIF":5.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}