Turkish Journal of Gastroenterology最新文献

{"title":"Association Between High-Sensitivity C-Reactive Protein Levels and Metabolic Dysfunction-Associated Steatotic Liver Disease and Liver Fibrosis Risk: A Study Based on NHANES Data.","authors":"Chaolong Xu, Kai Wang, Zhiming Peng, Peng Chen, Chengchen Zhang, Xianyi Zeng, Chenghao Tan, Yunchen Huang","doi":"10.5152/tjg.2025.24251","DOIUrl":"10.5152/tjg.2025.24251","url":null,"abstract":"<p><p>Background/Aims: High-sensitivity C-reactive protein (hs-CRP) is a known inflammatory biomarker linked to various metabolic disorders. This study sought to examine the association between hs-CRP levels and the risk of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis (LF). Materials and Methods: Data from 2787 participants of the 2017-2020 National Health and Nutrition Examination Survey were analyzed. The evaluation of liver steatosis and fibrosis was performed using transient elastography. Furthermore, logistic regression models were applied to examine the correlation between 4 categorized levels of hs-CRP and the risks of MASLD and LF. Results: Compared to individuals with hs-CRP ≤3 mg/L, those with hs-CRP levels of 3.01-6 mg/L, 6.01-10 mg/L, and ≥10.01 mg/L exhibited markedly increased risks of MASLD, with odds ratios and 95% CI of 2.229 (1.892-2.625), 2.474 (1.982-3.090), and 3.175 (2.497-4.037), respectively. The receiver operating characteristic and calibration curves of the model validated the significant association of higher hs-CRP levels with increased MASLD and LF risk. Conclusion: Elevated hs-CRP levels are prominently associated with increased risks of MASLD and LF. High-sensitivity C-reactive protein could serve as a potential biomarker for identifying and managing MASLD and related fibrosis risks.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"36 9","pages":"590-599"},"PeriodicalIF":1.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vincamine Mitigates Methotrexate-Induced Liver Fibrosis Model.","authors":"Yonca Yılmaz Ürün, Gürkan Güner, Ejder Saylav Bora, Ayşe Buket Taşkın, Muslih Ürün, Oytun Erbaş","doi":"10.5152/tjg.2025.24716","DOIUrl":"10.5152/tjg.2025.24716","url":null,"abstract":"<p><p>Background/Aims: Liver fibrosis is linked to higher rates of death and disease. This study examined the hepatoprotective properties of vincamine and its potential therapeutic application in treating liver damage caused by methotrexate in rats. Materials and Methods: Thirty male Wistar albino rats, with weights ranging from 150 to 200 g and ages between 10 and 12 weeks, were included in the study. A total of 10 rats were selected to serve as the control group, receiving no medication. A group of 20 rats was given a single intraperitoneal dose of 20 mg/kg methotrexate in order to cause liver damage. Subsequently, the participants were randomly allocated into 2 cohorts and administered either 1 mL/kg/day tap water or 50 mg/kg/day vincamine orally through gavage on a daily basis for a duration of 10 days. Following the completion of the treatment period, the animals were euthanized and their livers were examined histologically. Furthermore, the levels of plasma galectin-3 (gal-3), cytokeratin 18, malondialdehyde (MDA), alanine transaminase (ALT), liver MDA, and transforming growth factor beta (TGF-β) levels were evaluated. Results: Treatment with vincamine resulted in a significant decrease in plasma gal-3, cytokeratin, MDA, and ALT levels and liver MDA and TGF-β levels compared to the methotrexate and saline group. Vincamine treatment effectively protected against liver injury, and histopathological examination of the livers confirmed these results. Conclusion: This study demonstrates that vincamine alleviates methotrexate-induced liver toxicity via exhibiting antioxidant, antiinflammatory, and anti-fibrotic activities and improved liver functionally, biochemically, and histopathologically.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"36 10","pages":"641-648"},"PeriodicalIF":1.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of Endoscopic Ultrasound Strain Elastography for Measuring Liver Stiffness and the Role of Blood Cytokeratin 18 Levels as a Surrogate Marker of Fibrosis.","authors":"Deniz Guney Duman, Yesim Ozen Alahdab, Coskun Ozer Demirtas, Yusuf Yılmaz, Feyza Dilber, Filiz Ture Ozdemir, Caglayan Keklikkiran, Haluk Tarik Kani, Umut Emre Aykut, Osman Cavit Ozdogan","doi":"10.5152/tjg.2025.24070","DOIUrl":"10.5152/tjg.2025.24070","url":null,"abstract":"<p><p>Background/Aims: The role of semi-quantitative strain ratio (SR) using real-time endoscopic ultrasound strain elastography (EUS-E) in chronic liver disease (CLD) and cirrhosis is yet to be determined. Herein, the aim was to assess the usefulness of EUS-E to detect CLD and cirrhosis. Materials and Methods: Patients with cirrhosis and non-cirrhotic CLD were enrolled prospectively. Patients without liver disease and undergoing EUS examinations for non-hepatic indications were taken as control group. Strain ratio was calculated from strains of hepatic vein and liver parenchyma. Fibrosis-4 (FIB-4) and aspartate aminotransferase (AST)-to-Platelet Ratio Index (APRI) scores were recorded, and blood cytokeratin-18 (CK-18) levels were measured to assess hepatic fibrosis. A clinical evaluation was also conducted. Results: One hundred participants (control: 49, CLD: 33, cirrhotic: 18) were included. The SR and liver parenchyma strains in cirrhotics were significantly higher than those in the CLD (P < .001) and control (P < .001) groups. Strain ratio threshold set at 5.67 had a sensitivity of 94.4% and a specificity of 95.9% to differentiate cirrhotics from control patients. An SR threshold of 10.65 had a sensitivity of 94.4% and a specificity of 84.8% in differentiating cirrhotics from CLD patients. The SR showed a strong positive correlation with FIB-4 and APRI scores, but not with CK-18 levels. Conclusions: Strain ratio thresholds of 5.67 and 10.65 obtained by EUS-E are useful to differentiate cirrhotics from non-cirrhotic CLD patients and liver-disease-free subjects, respectively. This pilot study is the first one evaluating the role of EUS-E in liver diseases, and future studies involving patients having CLD of specific etiologies are warranted.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"36 10","pages":"692-699"},"PeriodicalIF":1.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil-Lymphocyte Ratio and LDH/Albumin Ratio as Biomarkers for Severity and Mortality in Acute Pancreatitis.","authors":"Göksel Bengi, İbrahim Çelik, Süleyman Dolu, Soner Önem, Müjde Soytürk, Serkan Rendeci, Ömer Topalak, Hale Akpinar","doi":"10.5152/tjg.2025.24828","DOIUrl":"10.5152/tjg.2025.24828","url":null,"abstract":"<p><strong>Background/aims: </strong>Acute pancreatitis (AP) is a common and potentially severe condition, and early identification of its severity is critical for appropriate clinical management. This study aimed to investigate the role of the Neutrophil-Lymphocyte Ratio (NLR) and Lactate dehydrogenase (LDH)/Albumin Ratio (LAR) in predicting the severity and prognosis of patients with AP and to determine the optimal NLR value.</p><p><strong>Materials and methods: </strong>The demographic, clinical, and laboratory data of patients diagnosed with AP were retrospectively analyzed. Neutrophil-Lymphocyte Ratio was measured at admission (0 hours), and at 24 and 48 hours; C-reactive protein (CRP) values were recorded at 0 and 48 hours; and the LAR was calculated based on LDH and albumin values measured at 48 hours post admission. These values were compared with disease severity, mortality, organ failure, length of hospital stay, and the need for intensive care according to Ranson and bedside index of severity in AP (BISAP) scores.</p><p><strong>Results: </strong>According to the BISAP scoring, 38 patients (16%) were classified as having severe AP, while 200 patients (84%) had mild AP. The best parameter for predicting severe AP was found to be the 24-hour NLR with a sensitivity of 79% and specificity of 67%. The best parameter for predicting mortality and organ failure was the NLR at 48 hours. There was a statistically significant difference between the length of hospital stay and the need for intensive care with the CRP value at 48 hours. Additionally, there was a statistically significant relationship between LAR and mortality, length of hospital stay, organ failure, and the need for intensive care.</p><p><strong>Conclusion: </strong>This study demonstrates that the NLR and the LDH/Albumin Ratio are important and easily accessible markers for determining the severity and prognosis of AP. The NLR at 48 hours is an effective parameter for predicting mortality and organ failure, while the LDH/Albumin Ratio is significant in predicting mortality.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"497-507"},"PeriodicalIF":1.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetics and Expression of the Wnt Signaling Pathway in Ulcerative Colitis.","authors":"Zuhal Altintas, Mehmet Emin Erdal, Engin Altintas","doi":"10.5152/tjg.2025.24619","DOIUrl":"10.5152/tjg.2025.24619","url":null,"abstract":"<p><strong>Background/aims: </strong>Secreted frizzled-related proteins (SFRPs) are antagonists that bind Wnt and inhibit signaling through this pathway. Secreted frizzled-related proteins are silenced by promoter methylation and cause hyperactivation of the Wnt pathway. In this study, the aim was to evaluate the relationship between methylation and expression of genes involved in the Wnt signaling pathway and the risk of cancer development in inflammatory bowel disease.</p><p><strong>Materials and methods: </strong>The patient group consisted of 20 individuals who were diagnosed with left-side ulcerative colitis and underwent surveillance colonoscopy; the control group consisted of 15 individuals without symptoms and endoscopic pathology who were screened for colorectal cancer. Tissue samples were obtained from inflamed and non-inflamed areas of the colon. Methylation and gene expression profiles of the Wnt pathway genes APC1A, APC2, SFRP1, SFRP2, SFRP4, and SFRP5 were analyzed from DNA and RNA obtained from these tissues.</p><p><strong>Results: </strong>A significant correlation was found between the methylation status and expression of the SFRP4 gene in the proximal colon in the patient group compared to controls (P = .018). For the methylation of the APC2 gene, 8 patients were methylated (40%), and 12 were unmethylated (60%), while 1 of the controls was methylated (6.7%) and 14 were unmethylated (93.3%) (P = .018). There was no statistically significant association between methylation, expression, and inflammation status for other genes between patients and controls.</p><p><strong>Conclusion: </strong>In ulcerative colitis, inflammation is thought to be associated with both increased APC2 methylation and decreased expression findings due to decreased SFRP4 methylation in non-inflamed areas. However, more research is needed to establish a link with ulcerative colitis-related neoplasia.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"508-514"},"PeriodicalIF":1.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Pancreatic Enzyme Insufficiency in the Etiology of Functional Dyspepsia Resistant to Standard Treatment.","authors":"Fatih Kemik, Gozde Ceylan, Abdurrahman F Aydin, Bilger Çavuş, Asli Ormeci, Ziya Imanov, Ibrahim V Senkal, Kenan Nuriyev, Zulal Istemihan, Filiz Akyuz, Selman F Besisik, Sabahattin Kaymakoglu, Kadir Demir","doi":"10.5152/tjg.2025.24729","DOIUrl":"10.5152/tjg.2025.24729","url":null,"abstract":"<p><strong>Background/aims: </strong>Functional dyspepsia (FD) is diagnosed in the absence of an identifiable organic cause. Pancreatic enzyme insufficiency (PEI) remains an underrecognized condition in these patients. This study aimed to investigate the prevalence of PEI among FD patients unresponsive to standard therapy and to evaluate its clinical and biochemical characteristics.</p><p><strong>Materials and methods: </strong>A total of 154 patients diagnosed with FD were followed, among which 66 patients who did not respond to at least 4 weeks of standard treatment, including acid-reducing therapies, prokinetics, and antidepressants, were evaluated. Additionally, 34 healthy volunteers were included as a control group. Organic pathologies were excluded in all 66 patients with FD resistant to standard treatment using endoscopy, endoscopic biopsy, and imaging methods. Fecal elastase-1 (FE-1) enzyme levels were measured to determine the prevalence of PEI in both groups.</p><p><strong>Results: </strong>Pancreatic enzyme insufficiency was detected in 5 (7.57%) of the 66 treatment-resistant FD patients, while none of the controls had PEI. The prevalence of PEI was significantly higher in diabetic patients than in non-diabetic patients within the study group (P = .037). Patients with diarrhea, sticky stools, and frequent foul-smelling stools exhibited a higher prevalence of PEI (P = .022, P = .001, and P = .004, respectively). In the study group, PEI patients had lower serum calcium, phosphorus, and magnesium levels than the control group (P = .018, P = .011, and P = .001, respectively).</p><p><strong>Conclusion: </strong>Pancreatic enzyme insufficiency was identified in 7.57% of patients resistant to standard treatment. In patients resistant to standard therapy for at least 4 weeks, the presence of symptoms such as diarrhea, sticky stools, and foul-smelling stools, along with diabetes mellitus and low serum calcium, phosphorus, and magnesium levels, may warrant consideration of PEI as a potential underlying condition.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"467-473"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Inflammatory Markers in Septic Critically Ill Patients with Chronic Liver Disease: A Retrospective Analysis.","authors":"Nazlıhan Boyacı Dündar, Kamil İnci, Gülbin Aygencel, Melda Türkoğlu, Onur Gökçe, Mehmet Cindoruk","doi":"10.5152/tjg.2025.24794","DOIUrl":"10.5152/tjg.2025.24794","url":null,"abstract":"<p><strong>Background/aims: </strong>Septic patients with chronic liver disease (CLD) experience high morbidity and mortality rates, particularly in the intensive care unit (ICU) setting, due to immune dysfunction. Despite their vulnerability, data on prognostic markers remain scarce, particularly when assessed in conjunction with disease severity scores. This study aimed to evaluate the prognostic value of various inflammatory markers, including white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), lactate, and lactate-to-albumin ratio (LAR), in septic critically ill CLD patients.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted on 126 septic CLD patients admitted to ICU. Data on demographics, clinical scores, inflammatory markers, and clinical outcomes were collected. Logistic regression and ROC analyses were used to identify independent predictors of ICU mortality.</p><p><strong>Results: </strong>Intensive care unit mortality was 66%. In addition to higher Acute Physiology and Chronic Health Evaluation II (APACHE II) (39.3 ± 7.2 vs. 21 ± 5.1, P < .001), Sequential Organ Failure Assessment (12.4 ± 3.5 vs. 8.5 ± 3.1, P < .001), CLIF-C ACLF [63 (54-69) vs. 50 (41- 53)] scores, ICU non-survivors had higher WBC (median: 14 400/µL vs. 7300/µL, P < .001), lactate (median: 4.6mmol/L vs. 2.4mmol/L, P < .001), NLR (median: 12.5 vs. 9, P = .015), and LAR (median: 2.15 vs. 0.93, P < .001) compared to survivors. Multivariate analysis identified APACHE II (OR 1.183, 95% CI: 1.003-1.396, P = .046), CLIF-C ACLF (OR 1.104, 95% CI: 1.002-1.216, P = .046), and LAR (OR 2.992, 95% CI: 1.277-7.009, P = .012) as independent predictors of ICU mortality. The LAR was the most significant inflammatory marker (area under the curve: 0.783, cut-off: 1.17), even in the subgroup of patients with low acute decompensation scores based on the CLIF-C ACLF score.</p><p><strong>Conclusion: </strong>The LAR was a valuable prognostic marker for ICU mortality in septic CLD patients, even in the absence of advanced organ failure. This marker potentially outperforms other traditional inflammatory markers and could aid in early risk stratification for critically ill septic CLD patients.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"600-608"},"PeriodicalIF":1.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-line Eradication of Helicobacter pylori Infection with High-Dose Amoxicillin and Vonoprazan: A Systematic Review and Meta-analysis.","authors":"Hongxiu Yu, Zhengwen Zhou, Zhi Liu","doi":"10.5152/tjg.2025.24371","DOIUrl":"10.5152/tjg.2025.24371","url":null,"abstract":"<p><strong>Background/aims: </strong>Due to increasing Helicobacter pylori resistance, the effectiveness of proton pump inhibitor-based regimens has diminished. There is a need to assess the high-dose amoxicillin (≥3 g/day) and vonoprazan dual therapy through meta-analysis to determine if it is more effective than previous protocols.</p><p><strong>Materials and methods: </strong>A computer search of PubMed, Web of Science, Cochrane Library, Embase, and ClinicalTrials.gov was carried out to identify randomized controlled trials of massive dose amoxicillin and vonoprazan double treatment for H. pylori infection, up to June 2023. The primary outcome measures were the eradication rate and adverse event rate.</p><p><strong>Results: </strong>A total of 7 studies encompassing 2601 patients were analyzed. The eradication rate of the high-dose dual group has no statistically significant differences compared to the control group (non-high-dose amoxicillin combined with vonoprazan) in intention-totreat (ITT) [OR=1.12, 95% CI (0.85, 1.48), P = .42] and per-protocol (PP) analysis [OR=1.08, 95% CI (0.74, 1.58), P = .69]. The incidence of adverse events [OR=0.63, 95% CI (0.45, 0.88), P = .007] was significantly reduced in the dual treatment group. Subgroup analysis revealed that the eradication rate in China [OR=1.34, 95% CI (1.01, 1.87), P = .04] was higher for the high-dose dual group compared with the control group in ITT analysis.</p><p><strong>Conclusion: </strong>The eradication rate of high-dose amoxicillin and vonoprazan dual regimen is similar to that of previous regimens, and the adverse event rate is significantly lower.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"410-419"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etrasimod in Treatment of Ulcerative Colitis: A Comprehensive Review.","authors":"Osman Cagin Buldukoglu, Yusuf Erzin, Ayhan Hilmi Cekin, Silvio Danese","doi":"10.5152/tjg.2025.25148","DOIUrl":"10.5152/tjg.2025.25148","url":null,"abstract":"<p><p>Ulcerative colitis (UC) is a chronic, inflammatory disease of the colon. The unpredictable, systemic, and debilitating nature of UC puts disease management and patient monitoring at a pivotal point. Despite substantial development in pharmacotherapies for UC in recent years, a significant proportion of patients either fail to respond to treatment or lose their response over the course of the disease. The backbone of disease management in UC is 5-aminosalicylic acid (5-ASA), but patients unresponsive to 5-ASA or with severe disease require advanced therapies including tumor necrosis factor-alpha inhibitors (TNFi), anti-integrins, anti-interleukins and small molecule therapy, Janus kinase (JAK) inhibitors, and S1PR modulators. This review will briefly overview the current state of medical therapeutic options in UC, with further detailing the molecular and clinical aspects of Etrasimod, a sphingosine-1-phosphate receptor (S1PR) modulator.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"36 6","pages":"336-342"},"PeriodicalIF":1.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Scoring in Biliary Atresia.","authors":"Şükrü Güngör, Fatma İlknur Varol, Ebubekir Altundaş, Emre Gök, Turan Yıldız, Sevgi Demiröz","doi":"10.5152/tjg.2025.24469","DOIUrl":"10.5152/tjg.2025.24469","url":null,"abstract":"<p><p>Background/Aims: The aim of this study was to develop a diagnostic scoring model to predict the need for intraoperative cholangiography in patients with neonatal cholestasis suspected of having biliary atresia (BA) and to aid in the early diagnosis of BA. Materials and Methods: Data from 70 patients with neonatal cholestasis who underwent intraoperative cholangiography with a preliminary diagnosis of BA between 2019 and 2024 were retrospectively reviewed. Data from patients with and without BA were compared. Thescoring was based on 3 parameters: acholic stool observed clinically on inspection, findings suggestive of BA on ultrasound, and elevated gamma-glutamyl transferase (GGT) levels. The best GGT cut-off point for the diagnosis of BA was determined by receiver operating characteristic analysis. The diagnostic success of the scoring model for BA was statistically evaluated. Results: There were no significant differences in age and gender between BA and non-BA groups. Gamma-glutamyl transferase levels were elevated in all patients. Acholic stools were present in 98% of BA patients. Ultrasound findings suggestive of BA were present in 88.5% of patients with BA. The authors found the best GGT cut-off value for the diagnosis of BA to be ≥366 (73% sensitivity, 77.8% specificity). In the scoring model the authors developed, the presence of 2 parameters provided diagnostic success with high sensitivity (98%) and specificity (83.3%). Conclusion: The study provides a reliable and sensitive diagnostic criterion to determine the need for intraoperative cholangiography in infants with neonatal cholestasis. These data should be validated in larger prospective case series.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"1 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}