Current Opinion in Gastroenterology最新文献

Assessing patient-reported outcomes in primary sclerosing cholangitis: an update. 评估原发性硬化性胆管炎患者报告的预后：最新进展。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-14 DOI: 10.1097/MOG.0000000000001075

Donna M Evon, Bryce B Reeve

{"title":"Assessing patient-reported outcomes in primary sclerosing cholangitis: an update.","authors":"Donna M Evon, Bryce B Reeve","doi":"10.1097/MOG.0000000000001075","DOIUrl":"https://doi.org/10.1097/MOG.0000000000001075","url":null,"abstract":"Purpose of review: Patient-reported outcome (PRO) measures validated in primary sclerosing cholangitis (PSC) are needed for clinical trials. This review describes the recent US Food & Drug Administration (FDA) Patient-Focused Drug Development (PFDD) guidelines, existing PRO measures used in PSC studies, and the design of PSC-specific symptom measures adherent with the guidelines.Recent findings: FDA released updated guidance reflecting best practices for the design and evaluation of clinical outcome assessments (including PROs) and the design of trial endpoints. Two recent systematic reviews (2018, 2020) identified multiple PRO measures used in PSC studies, with two additional measures published since. Of these, four were developed in samples inclusive of PSC patients and six have been psychometrically evaluated in PSC. Published evidence to sufficiently support alignment with the recent guidance is sparse. We review the design of three symptom measures for PSC to illustrate alignment with FDA guidance, including qualitative and quantitative studies to provide evidence for their validity for use in adult PSC trials.Summary: Investigators planning to use PRO measures as study endpoints for PSC need to be adherent with the recent FDA guidelines and build the evidence base to support the measure as fit-for-purpose as an endpoint for clinical trials.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current approach to diagnosis and management of low-phospholipid associated cholelithiasis syndrome. 目前低磷脂相关性胆石症综合征的诊断和治疗方法。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-07 DOI: 10.1097/MOG.0000000000001077

Pierre-Antoine Soret, Olivier Chazouillères, Christophe Corpechot

{"title":"Current approach to diagnosis and management of low-phospholipid associated cholelithiasis syndrome.","authors":"Pierre-Antoine Soret, Olivier Chazouillères, Christophe Corpechot","doi":"10.1097/MOG.0000000000001077","DOIUrl":"https://doi.org/10.1097/MOG.0000000000001077","url":null,"abstract":"Purpose of review: Low phospholipid-associated cholelithiasis (LPAC) syndrome is a rare genetic form of intrahepatic cholesterol lithiasis, affecting mainly young adults. This review describes the recent advances in genetic and clinical characterization, diagnosis and management of LPAC syndrome.Recent findings: Recent publications report data from several retrospective cohorts. These cohorts describe the main clinical features, the most frequent radiological lesions, complications, the results of biliary endoscopic procedures and the prognosis associated with LPAC syndrome.Summary: LPAC syndrome has been linked to a partial defect in the ATP binding cassette subfamily B member 4 (ABCB4) gene encoding the canalicular phospholipid transporter multidrug resistance protein 3, but this mechanism would explain only half the cases, or even fewer. This syndrome is characterized by the appearance of cholelithiasis at an abnormally early age (before 40) and by the persistence of biliary symptoms after cholecystectomy. The diagnosis is usually confirmed by an ultrasound scan of the liver, which reveals the presence of intrahepatic microlithiasis, as evidenced by comet-tail images or microspots along the intrahepatic bile ducts. Ursodeoxycholic acid, at a daily dose of 5-15 mg/kg, is the reference treatment. If not performed prior to diagnosis, cholecystectomy should be avoided wherever possible. In complicated or refractory forms, endoscopic biliary intervention may be necessary.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of deep response to ursodeoxycholic acid in primary biliary cholangitis - should it be the new clinical standard? 熊去氧胆酸深度反应对原发性胆管炎的影响——是否应作为新的临床标准？

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-06 DOI: 10.1097/MOG.0000000000001076

Adrielly Martins, Cynthia Levy

{"title":"The impact of deep response to ursodeoxycholic acid in primary biliary cholangitis - should it be the new clinical standard?","authors":"Adrielly Martins, Cynthia Levy","doi":"10.1097/MOG.0000000000001076","DOIUrl":"https://doi.org/10.1097/MOG.0000000000001076","url":null,"abstract":"Purpose of review: This review explores the emerging concept of \"deep response\" in primary biliary cholangitis (PBC), defined by the normalization of biochemical markers, particularly alkaline phosphatase and bilirubin. It examines its potential as a new standard for disease management and its implications for long-term patient outcomes, health policies, and clinical decision-making.Recent findings: Recent studies suggest that achieving a deep response significantly improves long-term outcomes in some patients with PBC. In particular, a significant complication-free survival gain was observed among patients who at baseline were at high risk for disease progression. However, limitations in data and the variability in patient populations pose challenges for universal adoption of this standard.Summary: Deep biochemical response represents a promising new standard for optimizing PBC management, offering measurable goals for clinicians and potentially improved long-term outcomes for patients. However, further research is necessary to better define the appropriate biochemical thresholds, understand the risks of overprescribing, and identify patient subgroups that are most likely to benefit from this strategy. A balanced, patient-centered approach incorporating deep response into comprehensive management could improve care for high-risk PBC patients.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of low birth weight and preterm delivery on the development of childhood celiac disease: a systematic review and meta-analysis on observational studies. 低出生体重和早产对儿童乳糜泻发展的影响：观察性研究的系统回顾和荟萃分析

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-03 DOI: 10.1097/MOG.0000000000001074

Mansour Bahardoust, Ali Delpisheh, Shabnam Rashidi, Meisam Haghmoradi, Babak Goodarzy, Reza Mahdian Jouybari

{"title":"Effect of low birth weight and preterm delivery on the development of childhood celiac disease: a systematic review and meta-analysis on observational studies.","authors":"Mansour Bahardoust, Ali Delpisheh, Shabnam Rashidi, Meisam Haghmoradi, Babak Goodarzy, Reza Mahdian Jouybari","doi":"10.1097/MOG.0000000000001074","DOIUrl":"https://doi.org/10.1097/MOG.0000000000001074","url":null,"abstract":"Purpose of review: Whether low birth weight (LBW) and preterm delivery (PD) are associated with the risk of developing celiac disease (CD) in children remains unclear. This systematic review and meta-analysis aimed to evaluate the association between LBW and PD with CD development in children.Recent findings: We searched PubMed, Embase, Scopus, Web of Science, and Google Scholar databases based on the Mesh terms to find observational studies that investigated the association of LBW and PD with CD development in children up to July 18, 2024. This systematic review was based on the PRISMA 2020 checklist. Heterogeneity between studies was assessed with Cochran's Q and I2 tests. Meta-regression was used to control heterogeneity. Publication bias was evaluated using Egger's test. Finally, ten studies involving 3 434 290 participants were included. Based on 10 studies, the pooled prevalence of LBW was 6.4 per 1000 children with CD. A pooled estimate of ten studies did not show a significant relationship between LBW and the risk of developing CD in children [odds ratio (OR): 0.96, 95% confidence interval (CI): 0.76, 1.16, I2: 67.9%, P: 0.001). Also, the pooled estimate of six studies did not show a significant relationship between PD and the risk of developing CD in children (OR: 0.98, 95% CI: 0.81, 1.16, I2: 67.5%, P: 0.001).Summary: We found no evidence of an association between LBW and PD with the risk of developing CD in children.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hepatic metabolism and ketone production in metabolic dysfunction-associated steatotic liver disease. 代谢功能障碍相关脂肪变性肝病的肝脏代谢和酮生成

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-03 DOI: 10.1097/MOG.0000000000001079

Eric P Plaisance

引用次数: 0

The use of artificial intelligence in colonoscopic evaluations. 人工智能在结肠镜评估中的应用。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-01 Epub Date: 2024-10-25 DOI: 10.1097/MOG.0000000000001063

Kareem Khalaf, Tommy Rizkala, Alessandro Repici

{"title":"The use of artificial intelligence in colonoscopic evaluations.","authors":"Kareem Khalaf, Tommy Rizkala, Alessandro Repici","doi":"10.1097/MOG.0000000000001063","DOIUrl":"10.1097/MOG.0000000000001063","url":null,"abstract":"Purpose of review: This review aims to highlight the transformative impact of artificial intelligence in the field of gastrointestinal endoscopy, particularly in the detection and characterization of colorectal polyps.Recent findings: Over the past decade, artificial intelligence has significantly advanced the medical industry, including gastrointestinal endoscopy. Computer aided diagnosis - detection (CADe) systems have shown notable success in increasing ADR. Recent meta-analyses of RCTs have demonstrated that patients undergoing colonoscopy with CADe assistance had a higher ADR compared with conventional methods. Similarly, computer aided diagnosis - characterization (CADx) systems have proven effective in distinguishing between adenomatous and nonadenomatous polyps, enhancing diagnostic confidence and supporting cost-saving measures like the resect-and-discard strategy. Despite the high performance of these systems, the variability in real-world adoption highlights the importance of integrating artificial intelligence as an assistive tool rather than a replacement for human expertise.Summary: Artificial intelligence integration in colonoscopy, through CADe and CADx systems, marks a significant advancement in gastroenterology. These systems enhance lesion detection and characterization, leading to improved diagnostic accuracy, training outcomes, and clinical workflow efficiency. While artificial intelligence offers substantial benefits, the optimal approach involves using artificial intelligence to augment the expertise of endoscopists, ensuring that clinical decisions remain under human oversight.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"3-8"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-01 Epub Date: 2024-12-05 DOI: 10.1097/MOG.0000000000001067

引用次数: 0

Updates on therapeutic endoscopic ultrasound. 治疗性内窥镜超声的最新进展。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-01 Epub Date: 2024-11-15 DOI: 10.1097/MOG.0000000000001072

George Wahba, Jeffrey H Lee

{"title":"Updates on therapeutic endoscopic ultrasound.","authors":"George Wahba, Jeffrey H Lee","doi":"10.1097/MOG.0000000000001072","DOIUrl":"10.1097/MOG.0000000000001072","url":null,"abstract":"Purpose of review: Multiple endoscopic ultrasound (EUS) guided therapeutic interventions have been developed for the management of benign and malignant pancreaticobiliary and gastrointestinal luminal pathology. Recent high-quality evidence is increasingly validating these interventions and positioning them within evidence-based therapeutic algorithms.Recent findings: Here we review therapeutic EUS-guided interventions including pancreatic fluid collection drainage, gastroenterostomy, biliary drainage, pancreatic duct drainage and gallbladder drainage. The most up-to-date high-quality evidence supporting these interventions is presented including comparative data with other conventional treatment options. Newer emerging interventions such as tumor ablation are also reviewed. Current controversies and future avenues for research are discussed. The key role of EUS-guided interventions in managing pancreaticobiliary pathology in patients with a surgically altered anatomy is highlighted.Summary: Multiple EUS therapeutic interventions have evolved from experimental or rescue options to now well established first- and second-line interventions over other endoscopic, percutaneous and surgical alternatives with the support of high-quality data. Further research is needed to better optimize patient selection and guide long term postintervention follow-up.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"16-28"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial. 社论。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-01 Epub Date: 2024-12-05 DOI: 10.1097/MOG.0000000000001069

Russell D Cohen

引用次数: 0

Tight junction regulation, intestinal permeability, and mucosal immunity in gastrointestinal health and disease. 胃肠道健康和疾病中的紧密连接调节、肠道渗透性和粘膜免疫。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-01 Epub Date: 2024-11-04 DOI: 10.1097/MOG.0000000000001066

Kushal Saha, Yin Zhou, Jerrold R Turner

{"title":"Tight junction regulation, intestinal permeability, and mucosal immunity in gastrointestinal health and disease.","authors":"Kushal Saha, Yin Zhou, Jerrold R Turner","doi":"10.1097/MOG.0000000000001066","DOIUrl":"10.1097/MOG.0000000000001066","url":null,"abstract":"Purpose of review: The contributions of intestinal barrier loss, that is, increased permeability, to multiple disorders, including inflammatory bowel disease (IBD), have been a topic of speculation for many years, and the literature is replete with conclusions based on correlation and speculation. The goal of this article is to critically review recent advances in mechanistic understanding of barrier regulation and the evidence for and against contributions of intestinal barrier loss to disease pathogenesis.Recent findings: It is now recognized that intestinal permeability reflects the combined effects of two distinct routes across tight junctions, which form selectively permeable seals between adjacent epithelial cells, and mucosal damage that leads to nonselective barrier loss. These are referred to as pore and leak pathways across the tight junction and an unrestricted pathway at sites of damage. Despite advances in phenotypic and mechanistic characterization of three distinct permeability pathways, development of experimental agents that specifically target these pathways, and remarkable efficacy in preclinical models, pathway-targeted therapies have not been tested in human subjects.Summary: After decades of speculation, therapeutic interventions that target the intestinal barrier are nearly within reach. More widespread use of available tools and development of new tools that discriminate between pore, leak, and unrestricted pathway permeabilities and underlying regulatory mechanisms will be essential to understanding the local and systemic consequences of intestinal barrier loss.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"46-53"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669730","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}

引用次数: 0