Current Opinion in Gastroenterology最新文献_第3页

Roles for specialized secretory epithelial cells in inflammatory bowel disease. 特化分泌上皮细胞在炎症性肠病中的作用。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-05-12 DOI: 10.1097/MOG.0000000000001176

Zhaoyu Huang, Monica E Brown, Ken S Lau

{"title":"Roles for specialized secretory epithelial cells in inflammatory bowel disease.","authors":"Zhaoyu Huang, Monica E Brown, Ken S Lau","doi":"10.1097/MOG.0000000000001176","DOIUrl":"10.1097/MOG.0000000000001176","url":null,"abstract":"Purpose of review: Current inflammatory bowel disease (IBD) therapies mainly target immune pathways, yet many patients fail to achieve durable remission, highlighting the need to understand epithelial-intrinsic drivers of chronic inflammation and barrier defects. Recent single-cell, spatial, and functional studies have redefined secretory epithelial lineages as active regulators of mucosal immunity, microbial containment, and tissue recovery.Recent findings: Goblet cells are increasingly recognized as heterogeneous barrier sentinels whose region-specific alterations in mucus organization, microbial sensing, and stress responses can influence disease location and variability. Tuft cells are chemosensory hubs that connect luminal cues to type-2 and neuroimmune circuits, with evidence linking tuft-cell programs to repair-associated remodeling in inflammatory settings. Paneth cell dysfunction in ileal Crohn's disease frequently reflects disrupted antimicrobial and stress-adaptation programs, while colonic ulcerative colitis can exhibit injury-associated Paneth-like remodeling within the regenerative epithelium.Summary: Secretory epithelial lineages actively regulate mucosal immunity and barrier integrity through region-dependent programs that shift during chronic inflammation. Defining these lineage states and their signaling outputs can improve patient stratification and reveal epithelial-targeted therapeutic strategies that complement immunomodulatory treatment.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"247-254"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13258108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934982","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

The complement system in inflammatory bowel disease: from early observations to emerging frontiers. 炎症性肠病中的补体系统：从早期观察到新兴前沿。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-06-04 DOI: 10.1097/MOG.0000000000001182

Bryan Ramirez Reyes, Devesha Kulkarni

{"title":"The complement system in inflammatory bowel disease: from early observations to emerging frontiers.","authors":"Bryan Ramirez Reyes, Devesha Kulkarni","doi":"10.1097/MOG.0000000000001182","DOIUrl":"10.1097/MOG.0000000000001182","url":null,"abstract":"Purpose of review: The complement system is one of the most evolutionarily conserved arms of innate immunity and has re-emerged as an important regulator of intestinal inflammation in inflammatory bowel disease (IBD). Early observations from the mid-1970 s such as complement deposition in diseased bowel tissue and elevated serum complement levels in patients with ulcerative colitis and Crohn's disease have evolved into a nuanced understanding of how individual complement components can exert both protective and pathogenic effects in IBD. This review highlights recent advances in complement biology and examines how complement shapes intestinal immune responses, particularly in the setting of ongoing inflammation.Recent findings: The complement system consists of more than 60 proteins that act as rapid first responders to infection. Although traditionally considered primarily liver-derived circulating effectors, recent work has demonstrated local synthesis and activation of key complement components at mucosal sites, including the colon. In parallel, genome-wide association studies have identified variants in complement genes associated with severe IBD complications. Collectively, these findings reveal a dichotomous role for complement in IBD, whereby excessive activation promotes inflammation, while impaired function compromises host defense and worsens disease outcomes.Summary: Complement-targeted therapies have been effective in other diseases but have not yet translated to IBD. A deeper understanding of context-dependent protective versus pathogenic complement functions will be essential for developing future therapeutic strategies.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"42 4","pages":"255-262"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158806","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

Dietary protein as a regulator of colitis and colorectal cancer. 膳食蛋白质对结肠炎和结直肠癌的调节作用。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-05-20 DOI: 10.1097/MOG.0000000000001178

Shrey D Thaker, Lasha Gogokhia, David C Montrose

{"title":"Dietary protein as a regulator of colitis and colorectal cancer.","authors":"Shrey D Thaker, Lasha Gogokhia, David C Montrose","doi":"10.1097/MOG.0000000000001178","DOIUrl":"10.1097/MOG.0000000000001178","url":null,"abstract":"Purpose of review: Diet impacts the pathogenesis of gastrointestinal diseases including inflammatory bowel diseases (IBD) and colorectal cancer (CRC). Although dietary protein can influence physiologic health, its impact on these diseases has not been adequately investigated. Consequently, clinical guidelines on optimal protein intake (i.e. amount and source) to help prevent or treat these conditions are limited.Recent findings: Recent preclinical and clinical studies have examined how modifying dietary protein can impact the pathogenesis of intestinal inflammation. For example, work in mice reveals that higher protein intake worsens colitis and that different dietary protein sources can exert differential effects on colitis severity. Microbial populations and their metabolism were shown to play an important role in mediating these effects. Studies in humans have shown that high intake of red meat is associated with increased IBD incidence and decreased time to relapse in patients with ulcerative colitis; however, it is unclear which other protein sources may be more beneficial. Although a direct connection between dietary protein and CRC has not been established, multiple preclinical studies have shown that reducing dietary protein exerts anticancer effects, including improved response to therapy across multiple tumor types. These effects were shown to be predominantly mediated by restricting tumors of exogenous growth-promoting amino acids, resulting in tumor stress, and in certain cases, activation of antitumor immunity.Summary: As a result of multiple studies, we have gained important insights into the role of dietary protein in mediating colonic inflammation and cancer. This work motivates clinical studies to directly test whether modifying source or amount of protein intake in patients with IBD or CRC will be beneficial for reducing disease severity and improving response to therapy.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"239-246"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984204","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

Intestinal ultrasound in inflammatory bowel disease: current evidence and future directions. 肠道超声诊断炎症性肠病：目前的证据和未来的方向。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-05-14 DOI: 10.1097/MOG.0000000000001175

Mohd Rawhi Abu Hamad, Maté Gergely

{"title":"Intestinal ultrasound in inflammatory bowel disease: current evidence and future directions.","authors":"Mohd Rawhi Abu Hamad, Maté Gergely","doi":"10.1097/MOG.0000000000001175","DOIUrl":"10.1097/MOG.0000000000001175","url":null,"abstract":"Purpose of review: Intestinal ultrasound (IUS) as a noninvasive tool for assessment and longitudinal monitoring of inflammatory bowel disease (IBD) is gaining attention. This review examines current evidence supporting the diagnostic performance and utility of IUS in IBD and explores expanding applications, use in special populations, and remaining gaps in knowledge.Recent findings: Evidence supports its diagnostic accuracy in Crohn's disease (CD) and ulcerative colitis (UC). Bowel wall thickness (BWT) and vascularity through color Doppler signal (CDS) are among the most reliable markers of inflammation. IUS demonstrates utility for disease monitoring, assessment of treatment response, and prediction of long-term outcomes. Activity indices have been externally validated, demonstrating reproducibility. Beyond luminal assessment, transmural remission (TR) is emerging as a therapeutic target. Advanced techniques, including contrast-enhanced ultrasound (CEUS) and small-intestine contrast ultrasound (SICUS), may provide additional value in selected clinical scenarios, although their use remains limited to specialized settings.Summary: IUS is an important practical tool in IBD, complementing endoscopy and biomarkers. Although diagnostic performance is well established, future work should focus on IUS-driven treatment strategies, validation of meaningful endpoints, and addressing barriers to implementation.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"214-222"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934985","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

Postendoscopy esophageal adenocarcinoma and neoplasia: current status and future directions. 内镜后食管腺癌和肿瘤：现状和未来发展方向。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-03-24 DOI: 10.1097/MOG.0000000000001172

Rohit Goyal, D Chamil Codipilly, Prasad G Iyer

{"title":"Postendoscopy esophageal adenocarcinoma and neoplasia: current status and future directions.","authors":"Rohit Goyal, D Chamil Codipilly, Prasad G Iyer","doi":"10.1097/MOG.0000000000001172","DOIUrl":"10.1097/MOG.0000000000001172","url":null,"abstract":"Purpose of review: A substantial proportion of esophageal adenocarcinoma (EAC) and high-grade dysplasia (HGD) cases in Barrett's esophagus (BE) are diagnosed after a dysplasia-negative endoscopy before the next recommended surveillance interval. These are classified as postendoscopy esophageal carcinoma (PEEC) or postendoscopy esophageal neoplasia (PEEN) and represent critical failures of BE surveillance. This review summarizes current definitions, epidemiology, potential etiologies, and evolving strategies to reduce PEEC/PEEN and improve the quality of BE surveillance.Recent findings: High-quality endoscopic examination using high-definition white-light endoscopy (HD-WLE) and virtual chromoendoscopy (CE), adherence to the Seattle biopsy protocol, adequate inspection time, and training in the recognition of visible lesions harboring prevalent dysplasia/EAC, are critical in reducing PEEC/PEEN. Initial data on the use of adjunctive tools (wide-area transepithelial sampling) and molecular biomarkers (p53, DNA methylation panels, and Tissue Systems Pathology tests) demonstrate promising results for detecting prevalent dysplasia and for reducing PEEC and PEEN. BE surveillance quality metrics, such as cancer and neoplasia detection rates, have been shown to be inversely associated with PEEN.Summary: PEEC and PEEN reflect critical gaps in the effectiveness of BE surveillance. Improving the quality of endoscopic surveillance is essential, including meticulous mucosal inspection, appropriate use of advanced imaging techniques, and adherence to systematic biopsy protocols, to minimize missed neoplasia.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"42 4","pages":"288-297"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158841","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

Goblet cell-associated antigen passages in health and disease. 健康和疾病中的杯状细胞相关抗原通道。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-06-04 DOI: 10.1097/MOG.0000000000001183

Amy J Cameron, Gaston P Rizzo, Rodney D Newberry

{"title":"Goblet cell-associated antigen passages in health and disease.","authors":"Amy J Cameron, Gaston P Rizzo, Rodney D Newberry","doi":"10.1097/MOG.0000000000001183","DOIUrl":"10.1097/MOG.0000000000001183","url":null,"abstract":"Purpose of review: In the gut, the immune system is exposed to self and dietary antigens and antigens from microbes including potential pathogens. How the immune system distinguishes between this wide array of substances to mount appropriate responses that range from tolerance to immunity is not well understood.Recent findings: Accumulating evidence suggests that intestinal goblet cells may play a central role in the ability of the immune system to mount appropriate responses and to discriminate between innocuous substances and potential pathogens. Intestinal goblet cells can form goblet cell-associated antigen passages (GAPs), which acquire luminal substances and deliver them to the immune system. GAPs are closely regulated to not only control where and when antigen delivery to the immune system occurs but also to shape downstream immune outcomes. More recent studies suggest roles for GAPs in health and for GAP dysregulation as a contributor to disease.Summary: Here, we review emerging studies and concepts on the role of goblet cells and GAPs, highlighting implications of these observations on the pathogenesis of, and potential therapies for, disease.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"42 4","pages":"223-230"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158783","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 alcohol-associated hepatitis treatment landscape. 酒精相关性肝炎治疗前景

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-05-01 Epub Date: 2026-02-13 DOI: 10.1097/MOG.0000000000001158

Hanna Blaney, Amon Asgharpour

{"title":"The alcohol-associated hepatitis treatment landscape.","authors":"Hanna Blaney, Amon Asgharpour","doi":"10.1097/MOG.0000000000001158","DOIUrl":"10.1097/MOG.0000000000001158","url":null,"abstract":"Purpose of review: Alcohol-associated hepatitis is a severe form of alcohol-associated liver disease and is associated with a high mortality. Treatment of alcohol-associated hepatitis has historically been limited, with few therapies demonstrating survival benefit. However, multiple promising new therapies are on the horizon, with this review highlighting recent advances in alcohol-associated hepatitis treatment.Recent findings: Multiple new pharmacological agents targeting different mechanisms are under study for alcohol-associated hepatitis, including larsucosterol, F-652, and INT-787. Manipulation of the gut-brain axis has also been leveraged for alcohol-associated hepatitis, with use of fecal microbiota transplant and other modalities. Early liver transplantation, while not universally available, has offered improved survival with similar outcomes compared to other etiologies of liver disease. Living donor liver transplantation has also been investigated in alcohol-associated hepatitis, with promising results. While steroids still remain the mainstay of therapy, recent studies have offered nuances to their use, including use of a taper to reduce risk of infection without changing efficacy.Summary: Medical management of alcohol-associated hepatitis has remained largely unchanged since the 1970 s. However, promising therapies targeting multiple aspects of pathophysiology are on the horizon, including a planned phase 3 trial for larsucosterol, an active phase 2a study with INT-787 and a planned trial using F-652.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"107-113"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198204","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

Irritable bowel syndrome with diarrhea: time to change practice? 肠易激综合征伴腹泻：该改变做法了吗？

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-05-01 Epub Date: 2026-02-09 DOI: 10.1097/MOG.0000000000001157

Cristina Caranfil, Luisa Bertin, Fabiana Zingone

{"title":"Irritable bowel syndrome with diarrhea: time to change practice?","authors":"Cristina Caranfil, Luisa Bertin, Fabiana Zingone","doi":"10.1097/MOG.0000000000001157","DOIUrl":"10.1097/MOG.0000000000001157","url":null,"abstract":"Purpose of review: Traditional approaches to irritable bowel syndrome with diarrhea (IBS-D) relied on extensive exclusionary testing and empiric symptom management. Recent advances in understanding neuroimmune pathophysiology, refined diagnostic algorithms, emergence of novel biomarkers, and clarification of comparative treatment efficacy through systematic reviews necessitate evaluation of whether accumulated evidence warrants substantive changes to contemporary diagnostic and therapeutic practice in IBS-D management.Recent findings: Diagnostic paradigms have shifted toward symptom-based approaches utilizing judicious testing informed by alarm features, with emerging biomarkers including neutrophil-to-albumin ratio, microRNA-148, and bile acid malabsorption markers showing promise. Therapeutically, tricyclic antidepressants demonstrate robust efficacy as neuromodulators, while selective serotonin reuptake inhibitors show limited benefit. Emerging neuroimmune therapies targeting mast cell activation, including histamine receptor antagonists, represent promising avenues. Low FODMAP and Mediterranean diets demonstrate substantial efficacy, while brain-gut behavioral therapies achieve clinically meaningful improvements in refractory populations through accessible delivery modalities.Summary: Contemporary evidence supports fundamental practice shifts from exclusionary testing toward targeted investigation of treatable mimics and from empiric management toward mechanism-based multimodal interventions integrating neuromodulators, dietary modifications, and behavioral therapies. Optimal outcomes require individualized treatment selection informed by symptom phenotype and comorbidity profiles, ideally delivered through integrated care models combining gastroenterology, dietetic, and behavioral expertise.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"178-188"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144525","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

Small bowel pathology - diet, pill or buzz? 小肠病理——节食、服药还是嗡嗡声？

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-05-01 Epub Date: 2026-03-31 DOI: 10.1097/MOG.0000000000001161

Reena Sidhu

引用次数: 0

Implementation science: a primer for hepatology research. 实施科学：肝病学研究入门。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-05-01 Epub Date: 2026-03-18 DOI: 10.1097/MOG.0000000000001164

Manisha Verma, Hamza Tahir, Richard Kalman

{"title":"Implementation science: a primer for hepatology research.","authors":"Manisha Verma, Hamza Tahir, Richard Kalman","doi":"10.1097/MOG.0000000000001164","DOIUrl":"10.1097/MOG.0000000000001164","url":null,"abstract":"Purpose of review: Despite significant progress in evidence-based therapies and models of care, hepatology continues to face challenges in translating proven interventions into routine clinical practice. Variability in adoption has contributed to ongoing gaps in quality, outcomes, and equity of care across diverse settings. Implementation science offers a systematic approach to understanding and improving how evidence-based interventions are delivered, adapted, and sustained in real-world environments. This review provides an overview of implementation science and discusses its increasing importance for advancing hepatology research and practice.Recent findings: Recent studies in hepatology have applied implementation science frameworks to better understand why effective interventions fail to reach patients and how those barriers can be addressed. Work in areas such as viral hepatitis elimination, cirrhosis management, palliative care integration, hepatocellular cancer surveillance, and alcohol use disorder treatment illustrates the value of focusing on context, stakeholder engagement, and strategy selection. These studies commonly use established frameworks, pragmatic trial designs, and mixed methods to assess outcomes such as adoption, fidelity, and sustainability alongside clinical impact.Summary: Implementation science offers a practical bridge between discovery and routine care in hepatology. Integrating implementation principles into research, quality improvement initiatives, and trainee education can accelerate the translation of evidence into practice, reduce unwarranted variation in care, and promote more equitable delivery of liver-related services.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"136-142"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475879","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