Turkish Journal of Gastroenterology最新文献

{"title":"Immune Checkpoint Inhibitor-Related Gastrointestinal Toxicity: Pathogenesis, Diagnosis, and Management.","authors":"Rasim Eren Cankurtaran, Hulusi Can Karpuzcu, Oyku Tayfur Yurekli","doi":"10.5152/tjg.2026.26304","DOIUrl":"https://doi.org/10.5152/tjg.2026.26304","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape across multiple malignancies. However, their expanding use has been accompanied by an increasing spectrum of immune-related adverse events (irAEs), particularly those affecting the gastrointestinal (GI) tract. GI toxicities may involve both the upper and lower GI tract and range from mild, nonspecific symptoms to severe inflammatory complications requiring treatment interruption, hospitalization, or selective immunosuppressive therapy. This review summarizes the current evidence regarding the pathogenesis, clinical presentation, endoscopic and histopathologic findings, and management of GI irAEs associated with ICIs. Upper GI involvement, including esophagitis, gastritis, and duodenitis, is relatively uncommon and typically presents with nonspecific symptoms and heterogeneous endoscopic findings, which may occur despite a macroscopically normal-appearing mucosa. Lower GI toxicity, particularly diarrhea and colitis, is more common and clinically significant, especially in patients receiving anti-CTLA-4-based and combination regimens. Endoscopic evaluation with mucosal biopsy remains central to diagnosis because clinical severity does not always correlate with endoscopic or histopathologic activity. Histopathologic patterns are heterogeneous and may overlap with those of other inflammatory or infectious GI disorders, making clinicopathologic correlation essential. Current management is largely guided by expert consensus and includes supportive care, corticosteroids, and biologic rescue therapy with agents such as infliximab or vedolizumab for steroid-refractory disease. Early recognition, appropriate grading, exclusion of alternative etiologies, and multidisciplinary collaboration among oncologists and gastroenterologists are critical to optimize outcomes while preserving the benefits of cancer immunotherapy.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765593","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}

{"title":"Plasma Proteomic Profiling Identifies Biomarkers and Therapeutic Targets for Predicting Osteoporosis Risk in Patients with Inflammatory Bowel Disease.","authors":"Min Yue, Xiaohua Ye, Zhenhe Jin, Kexin Ye, Chengwei Xu, Tianyu Zhou, Zhe Shen","doi":"10.5152/tjg.2026.26320","DOIUrl":"https://doi.org/10.5152/tjg.2026.26320","url":null,"abstract":"<p><strong>Background/aims: </strong>Inflammatory bowel disease (IBD) is a systemic disorder that affects not only the gastrointestinal tract but also extraintestinal organs and is associated with a significantly increased risk of osteoporosis. This study aims to investigate the association between plasma proteomic profiles and the subsequent risk of osteoporosis in patients with IBD.</p><p><strong>Materials and methods: </strong>Using data from 52 953 participants in the UK Biobank Pharma Proteomics Project, overlapping plasma proteins associated with both IBD and osteoporosis using Cox regression analysis were identified. Among these proteins, those with high predictive importance for IBD-osteoporosis multimorbidity were selected using machine learning and multistate modeling. Single-cell- type expression analysis was conducted to evaluate the cell type-specific enrichment of the candidate predictive protein-coding genes in the intestine.</p><p><strong>Results: </strong>Over a median follow-up of 13.6 years, 339 proteins were significantly associated with IBD and 183 with osteoporosis, with 104 proteins overlapping between the 2 conditions. Machine learning and multistate modeling narrowed these down to 8 candidate predictive proteins (PLAUR, TNFRSF10A, SPINK1, HLA_E, CHGA, SPP1, TNFRSF10B, and IGFBP2) for IBD-osteoporosis multimorbidity. Exploratory single-cell expression analysis of 5 available candidate genes characterized their intestinal expression patterns, providing supportive biological insights.</p><p><strong>Conclusion: </strong>The study delineates the proteomic signatures associated with IBD-osteoporosis multimorbidity, identifies specific proteins associated with both conditions, highlights key molecular players linking the diseases, and identifies both established and potentially novel candidate biomarkers.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766027","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}

{"title":"Zeaxanthin Suppresses Azoxymethane/Dextran Sodium Sulfate-Induced Colorectal Cancer in Mice by Inhibiting Inflammation and Proliferation.","authors":"Mengxiang Yang, Yuejun Han, Ting Jin, Jianping Wang","doi":"10.5152/tjg.2026.25661","DOIUrl":"https://doi.org/10.5152/tjg.2026.25661","url":null,"abstract":"<p><strong>Background/aims: </strong>The treatment of colorectal cancer (CRC) remains a challenge in clinical research. Zeaxanthin (ZEA) has demonstrated substantial anti-inflammatory and anticancer effects. However, its preventive effects and underlying mechanisms in CRC remain elusive. Therefore, this study investigated the preventive effects and 10 molecular mechanisms of ZEA in CRC.</p><p><strong>Materials and methods: </strong>The effects of ZEA on tumor formation, inflammatory responses, and cell proliferation were investigated in an azoxymethane (AOM)/dextran sodium sulfate (DSS)-induced mouse model of CRC. Furthermore, the anti-inflammatory and antiproliferative mechanisms of ZEA were evaluated in vitro using lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages and CRC cell lines (HCT116 and SW620).</p><p><strong>Results: </strong>Treatment with 50 mg/kg ZEA significantly inhibited AOM/DSS-induced CRC progression. Furthermore, treatment with ZEA reduced tumor formation in the colonic lining, increased body weight, enhanced colorectal length, improved overall survival rate, and attenuated pathological changes in mice. Moreover, ZEA significantly reduced proinflammatory cytokines (tumor necrosis factor-α and interleukin-1β) and Ki-67 expression levels. Mechanistically, ZEA mitigated inflammation in LPS-stimulated RAW264.7 macrophages by suppressing the nucleotide-binding oligomerization domain-containing protein 1 (NOD1)/receptor-interacting protein 2 kinase (RIP2)/ nuclear factor-κB (NF-κB) signaling pathway. In addition, it suppressed proliferation of HCT116 and SW620 cells by inhibiting the signaling pathway of PI3K/AKT/MYC.</p><p><strong>Conclusion: </strong>ZEA exerted significant anti-CRC effects, including anti-inflammatory and antiproliferative actions through multitarget mechanisms, such as modulation of the NOD1/RIP2/NF-κB and PI3K/AKT/MYC signaling pathways. These findings suggest that ZEA is a promising natural chemopreventive agent for the prevention and treatment of CRC.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671367","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}

{"title":"Current Approaches to Sedation and Anesthesia in Endoscopy Units: Integrating Pharmacology, Monitoring, and Patient Safety.","authors":"Fatih Sahin, Ali Fuat Erdem, Benedikt Preckel","doi":"10.5152/tjg.2026.26388","DOIUrl":"https://doi.org/10.5152/tjg.2026.26388","url":null,"abstract":"<p><p>Sedation and anesthesia practices in gastrointestinal endoscopy units play a critical role in enhancing patient comfort, improving procedural tolerance, and ensuring procedural success. However, increasing procedural complexity and the growing burden of patient comorbidities have heightened the importance of patient safety, particularly with respect to the cardiorespiratory risks associated with deep sedation. This review provides a comprehensive overview of current sedation and anesthesia practices in endoscopy units, with a focus on patient selection, risk stratification, pharmacological agents, monitoring standards, and complication management. Emphasis is placed on patient-centered and individualized sedation strategies that account for patient age, comorbidities, American Society of Anesthesiologists physical status classification, and procedural characteristics. Propofol remains the cornerstone of endoscopic sedation because of its rapid onset and favorable recovery profile. Nevertheless, newer agents such as remimazolam, ciprofol, and esketamine have emerged as promising alternatives either as primary sedative agents or as adjuvant drugs, offering improved pharmacokinetic predictability, greater hemodynamic stability, and potentially enhanced cardiorespiratory safety. Adjunctive agents, including opioids and ketamine, may further optimize analgesia and sedation quality when used appropriately. Standard monitoring modalities, including pulse oximetry, noninvasive blood pressure, and electrocardiography, are essential, whereas capnography offers significant advantages for the early detection of respiratory compromise. Effective complication management relies on early recognition, timely intervention, and adherence to structured safety protocols. Validated recovery and discharge scoring systems further contribute to safe postprocedural care. In conclusion, safe and effective sedation in gastrointestinal endoscopy units requires a multidisciplinary, protocoldriven approach that integrates individualized pharmacological strategies, appropriate monitoring, and experienced clinical teams.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671383","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}

{"title":"Ineffective Esophageal Motility with and Without Abnormal Acid Exposure: Clinical, Endoscopic, and Manometric Features.","authors":"Harun Erdal, Yusuf Coşkun, Deniz Armağan Deniz, Burak Birsoy, Yusuf Üstün","doi":"10.5152/tjg.2026.25627","DOIUrl":"https://doi.org/10.5152/tjg.2026.25627","url":null,"abstract":"<p><strong>Background/aims: </strong>Ineffective esophageal motility (IEM) is the most common esophageal motility disorder. Reflux is common in patients with IEM. The relationship between IEM and gastroesophageal reflux disease is not fully understood. The current study evaluated the associations between clinical, endoscopic, and manometric characteristics and acid exposure in patients with IEM.</p><p><strong>Materials and methods: </strong>The authors prospectively enrolled patients diagnosed with IEM who underwent high-resolution manometry according to the Chicago classification, version 4.0. Patients were classified into pathological and physiological reflux groups based on multichannel intraluminal impedance-pH ( MII-pH) monitoring results. Clinical, endoscopic, manometric, and MII-pH parameters were compared between the 2 groups.</p><p><strong>Results: </strong>Of the 69 patients, 49 (71%) had pathological reflux and 20 (29%) had physiological reflux. The most frequent symptoms were heartburn, regurgitation, and dysphagia. No significant differences were observed between the 2 groups in demographic, clinical, or endoscopic characteristics. Among the manometric metrics, mean lower esophageal sphincter pressure and esophagogastric junction (EGJ) morphology differed significantly between the 2 groups (P = .017 and P = .046, respectively). All MII‑pH metrics, except weak acid reflux episodes and nonacid reflux episodes, differed significantly between the groups (P <.05).</p><p><strong>Conclusion: </strong>Acid exposure did not affect symptoms in patients with IEM. In addition to impaired esophageal body contractility, impaired esophageal clearance and EGJ barrier dysfunction may contribute to acid exposure.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671359","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}

{"title":"The Potential of Microbiota-Modulating Dietary Strategies in Gallstone Prevention: Evidence from 2 Large Population- Based Cohorts.","authors":"Hongyan He, Luohong Li, Xiaoli Yang","doi":"10.5152/tjg.2026.26355","DOIUrl":"10.5152/tjg.2026.26355","url":null,"abstract":"<p><strong>Background/aims: </strong>Gut-microbiota dysbiosis has been implicated in gallstone formation through alterations in bile acid and cholesterol metabolism, but whether adherence to a microbiota-supportive diet is associated with gallstone disease at the population level remains unclear. The current study examined the cross-sectional association between the Dietary Index for Gut Microbiota (DI-GM) and the prevalence of gallstone disease.</p><p><strong>Materials and methods: </strong>The current study analyzed National Health and Nutrition Examination Survey (NHANES) 2017-2020 (n = 7198 adults aged ≥20 years) and the UK Biobank (n = 126 478) cross-sectionally. DI-GM was calculated using 14 food components in NHANES and 13 food components in the UK Biobank. Gallstone disease was ascertained by self-report in NHANES and by self-report supplemented with inpatient ICD-10 K80 codes in the UK Biobank. The authors used logistic regression (survey-weighted for NHANES and unweighted for the UK Biobank) and restricted cubic splines. A demographic and behavioral adjusted model estimated the total effect and a cardiometabolic adjusted model was used as a conservative sensitivity analysis.</p><p><strong>Results: </strong>Higher DI-GM scores were associated with lower odds of prevalent gallstones in both cohorts. In the total-effect model, each 1-point increment in the DI-GM score was associated with 13% lower odds of gallstone disease in NHANES (odds ratio (OR) = 0.87, 95% confidence interval (CI): 0.83-0.92) and 7% lower odds in the UK Biobank (OR = 0.93, 0.91-0.95). These associations were attenuated but remained significant after cardiometabolic adjustment (NHANES 0.92, 0.87-0.98; UK Biobank 0.95, 0.93-0.97; both P ≤ .007). Compared with the lowest DI-GM category, the highest category was associated with lower odds of gallstone disease in both NHANES (OR, 0.73; 95% CI, 0.60-0.89) and the UK Biobank (OR, 0.80; 95% CI, 0.74-0.87). Restricted cubic spline analyses supported a linear association, and the subgroup and sensitivity analyses yielded consistent results.</p><p><strong>Conclusion: </strong>In 2 demographically distinct populations, greater adherence to a gut microbiota-supportive diet was independently associated with lower odds of prevalent gallstone disease. These cross-sectional findings require prospective confirmation before causal or preventive inferences are drawn. Cite this article as: He H, Li L, Yang X. The potential of microbiota-modulating dietary strategies in gallstone prevention: Evidence from 2 large population-based cohorts. Turk J Gastroenterol. 2026;37(8):880-894.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"880-894"},"PeriodicalIF":2.3,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594413","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":"miR-143-5p as a Prognostic Biomarker in Colorectal Cancer: Inhibition of Tumor Progression Through Targeting MYCBP.","authors":"Chen Mu, Han Zhang","doi":"10.5152/tjg.2026.26198","DOIUrl":"10.5152/tjg.2026.26198","url":null,"abstract":"<p><strong>Background/aims: </strong>miR-143-5p functions as a tumor-suppressive microRNA across various cancer types. The current study investigated the expression, prognostic value, and role of miR-143-5p in colorectal cancer (CRC).</p><p><strong>Materials and methods: </strong>The expression of miR-143-5p was measured by quantitative reverse transcription polymerase chain reaction. Associations between miR-143-5p expression and clinicopathological characteristics of patients with CRC were statistically analyzed. A series of in vitro cell-based assays were performed to investigate the underlying regulatory mechanisms.</p><p><strong>Results: </strong>miR-143-5p was downregulated in CRC and may serve as a promising independent prognostic biomarker. Reduced miR- 143-5p expression was associated with adverse clinicopathological characteristics and decreased 5-year overall survival. MYCBP was identified as a direct target of miR-143-5p. Overexpression of miR-143-5p suppressed the malignant behaviors of CRC cells, which were partially restored by enforced MYCBP expression.</p><p><strong>Conclusion: </strong>miR-143-5p is downregulated in CRC and may function as a potential independent prognostic biomarker. Moreover, miR- 143-5p may play a tumor-suppressive role in CRC by specifically targeting MYCBP.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594319","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":"Common Causes of Drug-Induced Liver Injury in 2025.","authors":"Einar S Björnsson","doi":"10.5152/tjg.2026.26361","DOIUrl":"10.5152/tjg.2026.26361","url":null,"abstract":"<p><p>Drug-induced liver injury (DILI) is an important clinical condition and should be considered in the differential diagnosis of patients with elevated liver enzymes and normal hepatobiliary imaging. In previous studies of DILI, antibiotics were the most commonly implicated class of drugs. A newly recognized phenotype of cefazolin has been described in several studies. After an ultra-short duration of cefazolin, with 1 or 2 doses, a prominent cholestatic or mixed reaction develops 2-3 weeks later. This phenotype was originally described in the United States and has recently been reproduced in a study from Iceland. In a recent and important report from Türkiye, hepatocellular jaundice associated with the antibiotic ornidazole was described; 8% of affected patients required liver transplantation. In recent years, several new agents have been associated with other idiosyncratic DILI associated with prescription drugs, suggesting that the clinical landscape of DILI may be evolving. Liver injury resulting from the biological effects of drugs that modulate the immune system appears to be increasing. In a recent study from Barcelona, anticancer drugs, mainly checkpoint inhibitors, were the most frequent causes of DILI, followed by antibiotics, analgesics, and recreational drugs. Furthermore, several newly recognized hepatotoxic herbal and dietary supplements (HDSs) have been reported. These are Polygonum multiflorum, ashwagandha, green tea extract, turmeric, Tinospora cordifolia, Garcinia cambogia, and kratom. Most patients recover after discontinuation of the HDS, but acute liver failure (ALF), death from ALF, or liver transplantation has been reported in some cases.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594259","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":"Serum GPC3 and AKR1B10 as Diagnostic Biomarkers for Hepatitis E Virus-Associated Acute Liver Failure.","authors":"Guozhong Zhang, Xin Liu, Ying Wang, Kang Lu, Yang Wang","doi":"10.5152/tjg.2026.26017","DOIUrl":"https://doi.org/10.5152/tjg.2026.26017","url":null,"abstract":"<p><strong>Background/aims: </strong>Hepatitis E virus (HEV)-associated acute liver failure (ALF) lacks reliable biomarkers for risk stratification at hospital admission. This study evaluated the diagnostic utility of serum glypican-3 (GPC3) and aldo-keto reductase family 1 member B10 (AKR1B10).</p><p><strong>Materials and methods: </strong>Between May 2023 and May 2025, 231 adults with acute HEV infection were classified as HEV-ALF (n = 43) or HEV without ALF (n = 188). Serum GPC3 and AKR1B10 concentrations were measured using enzyme linked immunosorbent assay. Associations were evaluated using Pearson correlation coefficient r; diagnostic performance was assessed by receiver operating characteristic curves, and independent predictors of ALF were identified using multivariable logistic regression.</p><p><strong>Results: </strong>Patients with HEV-ALF had lower albumin, triglyceride, and cholesterol levels and higher total bilirubin, prothrombin time, and international normalized ratio values than patients without ALF (all P < .05). GPC3 and AKR1B10 concentrations were markedly elevated in the HEV-ALF group (both P < .001) and were strongly correlated (r = 0.610, P < .001). The combination of GPC3 and AKR1B10 demonstrated superior diagnostic performance for identifying ALF, with an area under the curve (AUC) of 0.931, outperforming either GPC3 alone (AUC, 0.832) or AKR1B10 alone (AUC, 0.792). In multivariable logistic regression analysis, elevated GPC3 (odds ratio [OR], 2.138; 95% CI, 1.213-3.771) and AKR1B10 (OR, 2.304; 95% CI, 1.215-4.368) remained independent risk factors for ALF.</p><p><strong>Conclusion: </strong>Serum GPC3 and AKR1B10 were independent predictors of HEV-ALF and may facilitate risk stratification at hospital admission.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594295","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}

{"title":"Impact of Helicobacter pylori Infection Status on SEPTIN9 and SDC2 Methylation Levels and Their Association with Clinical Outcomes in Elderly Patients with Gastric Mucosal Intestinal Metaplasia.","authors":"Zhuwen Yu, Haoxiang Ni, Xiaojuan Chen, Kunting Xiao","doi":"10.5152/tjg.2026.26162","DOIUrl":"https://doi.org/10.5152/tjg.2026.26162","url":null,"abstract":"<p><strong>Background/aims: </strong>The impact of dynamic Helicobacter pylori (Hp) infection status on DNA methylation and progression risk in elderly patients with gastric intestinal metaplasia (IM) remains unclear. This study evaluated the associations of Hp infection status with SEPTIN9 and SDC2 methylation levels and whether baseline methylation markers were associated with subsequent clinical outcomes.</p><p><strong>Materials and methods: </strong>This single-center retrospective cohort study enrolled 200 older adults with IM. Hp infection status was dynamically defined over follow-up as persistent infection, successful eradication, or sustained negative infection. Baseline SEPTIN9 and SDC2 methylation levels were quantified in formalin-fixed, paraffin-embedded tissue samples using quantitative methylation-specific polymerase chain reaction (qMSP). Kaplan-Meier analysis and Cox proportional hazards regression were used to evaluate progression risk. Predictive performance was assessed using Harrell's C-index and time-dependent receiver operating characteristic analysis. Because methylation was measured only at baseline, the analyses were designed to evaluate baseline methylation markers rather than dynamic methylation changes over time.</p><p><strong>Results: </strong>During a median follow-up of 3.86 years, 38 patients (19.0%) experienced disease progression. Persistent Hp infection was associated with higher SEPTIN9 and SDC2 methylation levels (P < .01). Combined double-positive methylation status was associated with an increased risk of IM progression (adjusted hazard ratio [HR] = 3.12, 95% CI: 1.53 6.38, P = .002), with the strongest association observed among patients with persistent Hp infection. Incorporation of the combined methylation indicator improved model discrimination (C-index 0.75 vs. 0.68) and the 5-year area under the curve (0.77 vs. 0.69).</p><p><strong>Conclusion: </strong>Baseline SEPTIN9 and SDC2 methylation levels differed according to the Hp infection status, with the highest levels observed among patients with persistent Hp infection. Baseline combined methylation status was associated with an increased risk of IM progression and may provide incremental value for risk stratification. These findings should be interpreted as baseline associations.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594280","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}