Current Opinion in Gastroenterology最新文献_第7页

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 : 2025-03-01 Epub Date: 2025-01-03 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":"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":"74-80"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","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

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 : 2025-03-01 Epub Date: 2025-01-02 DOI: 10.1097/MOG.0000000000001079

Eric P Plaisance

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

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

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

Neuro-immune cell interactions in the regulation of intestinal immune homeostasis. 神经-免疫细胞在调节肠道免疫平衡中的相互作用。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-01 Epub Date: 2024-10-17 DOI: 10.1097/MOG.0000000000001065

Xiaoxiao Hou, David Artis

{"title":"Neuro-immune cell interactions in the regulation of intestinal immune homeostasis.","authors":"Xiaoxiao Hou, David Artis","doi":"10.1097/MOG.0000000000001065","DOIUrl":"10.1097/MOG.0000000000001065","url":null,"abstract":"Purpose of review: Bidirectional regulation between neurons and immune cells in the intestine governs essential physiological processes, including digestion, metabolism and motility, while also controlling intestinal inflammation and maintaining tissue homeostasis. This review covers recent advances and future research challenges focused on the regulatory molecules and potential therapeutic targets in neuron-immune interactions within the intestine.Recent findings: Recently identified molecular and cellular pathways have been shown to regulate neuron-immune cell cross talk in the context of maintaining tissue homeostasis, modulating inflammation, and promoting intestinal repair. Additionally, behaviors governed by the central nervous system, including feeding and stress responses, can play key roles in regulating intestinal immunity and inflammation.Summary: This review emphasizes recent progress in understanding the complex interplay between the nervous system and intestinal immune system and outlines future research directions. These advances have the potential to lead to innovative therapies targeting gastrointestinal disorders including inflammatory bowel diseases, allergic responses and cancer.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"38-45"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479818","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

Using nutrition to help recovery from infections. 利用营养帮助从感染中恢复。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-01 Epub Date: 2024-11-20 DOI: 10.1097/MOG.0000000000001068

Ines B Moura, Anthony M Buckley

{"title":"Using nutrition to help recovery from infections.","authors":"Ines B Moura, Anthony M Buckley","doi":"10.1097/MOG.0000000000001068","DOIUrl":"10.1097/MOG.0000000000001068","url":null,"abstract":"Purpose of review: Antibiotics are a cornerstone of modern medicine, but antibiotic consumption can have depleting effects on the gut microbiota, potentially leading to gastrointestinal symptoms and other diseases, namely Clostridioides difficile infection. Because nutrition is a major driver of gut microbiota diversity and function, here we explore the current evidence on the potential of diets in alleviate the deleterious effects of antibiotics consumed during infections.Recent findings: Beneficial nutrients can enhance the symbiotic effect of the gut microbiota with the host, supporting anti-inflammatory responses and maintaining tight junction integrity. Short-chain fatty acids have been shown to positively affect the immune response, reducing the severity of C. difficile infection, whereas high-fibre diets have been shown to promote faster recovery of the gut microbiota after antibiotic therapy.Summary: The role of nutrition during infection is gaining momentum, with key findings exploring the effect of some nutrients in limiting the severity of infections and helping the microbiota recover from antibiotic-induced dysbiosis. Although this field is in its infancy, these findings open the possibility of personalised nutrition as a way of restoring microbiome diversity. But more work is needed to identify the most effective types and combinations of nutrients to achieve this.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"41 1","pages":"54-58"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781764","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

Endoscopic management of colonic perforations. 结肠穿孔的内窥镜治疗。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-01-01 Epub Date: 2024-11-20 DOI: 10.1097/MOG.0000000000001071

Prabin Sharma, Stavros N Stavropoulos

{"title":"Endoscopic management of colonic perforations.","authors":"Prabin Sharma, Stavros N Stavropoulos","doi":"10.1097/MOG.0000000000001071","DOIUrl":"10.1097/MOG.0000000000001071","url":null,"abstract":"Purpose of review: We will review the current management of colonic perforations, with particular emphasis on iatrogenic perforations caused by colonoscopy, the leading etiology. We will focus on recently developed endoscopic techniques and technologies that obviate morbid emergency surgery (the standard management approach in years past).Recent findings: Colonic perforations are rare but potentially fatal complications of both diagnostic and therapeutic colonoscopy resulting in death in approximately 5% of cases with the mortality increasing with delay in diagnosis and treatment. As novel endoscopic techniques and tools have flourished in recent years, our approach to management of these perforations has evolved. With the availability of newer tools such as over the scope clips, enhanced through the scope clips and novel endoscopic suturing devices, colonic perforations can be managed effectively in many or most patients without the morbidity of surgical interventions.Summary: With expanding use of colonoscopy, inadvertent outcomes such as perforations are bound to increase as well. Early diagnosis permits minimally invasive, nonsurgical, endoscopic management in most cases if the expertise and tools are available. Centers with high colonoscopy volumes including therapeutic procedures would be well served to invest in the requisite technologies and expertise.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"29-37"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734374","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