Digestive diseases (Basel, Switzerland)最新文献

Adult FPIES: A Review of Emerging Evidence and Clinical Considerations. 成人FPIES：新出现的证据和临床考虑的回顾。

IF 2.1

Digestive diseases (Basel, Switzerland) Pub Date : 2025-07-25 DOI: 10.1159/000547494

Mehwish Ahmed, Pavadee Poowuttikul, William D Chey, Benjamin R Hart

{"title":"Adult FPIES: A Review of Emerging Evidence and Clinical Considerations.","authors":"Mehwish Ahmed, Pavadee Poowuttikul, William D Chey, Benjamin R Hart","doi":"10.1159/000547494","DOIUrl":"https://doi.org/10.1159/000547494","url":null,"abstract":"Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated reaction to food well-known in the allergy and immunology literature that presents with delayed gastrointestinal symptoms. It is classically diagnosed in children and infants, however new-onset cases have recently been identified in the adult population.Summary: There is a paucity of literature on FPIES in the gastroenterology literature. This review aims to bring awareness to this entity as a possible etiology of gastrointestinal symptoms. Symptoms include abdominal pain, diarrhea, repetitive vomiting, and nausea, which occur one to four hours after initial ingestion of food. In adult-onset cases, food triggers most often include seafood (fish, crustacean, and mollusk). Egg, wheat, and cow's milk have also been identified as triggers for adult-onset FPIES. Oral food challenge (OFC) is the gold standard for diagnosis.Key messages: This review provides an overview of the current literature on adult-onset FPIES. Adult and pediatric patients notably have different presentations of FPIES and different triggers. Providers should be aware of these distinctions when diagnosing this condition.","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-12"},"PeriodicalIF":2.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clostridioides difficile infection in Patients Undergoing Acid-Suppressive Treatment: A Large Cohort Study with Propensity Score Matching. 抑酸治疗患者的艰难梭菌感染：一项倾向评分匹配的大队列研究。

IF 2.1

Digestive diseases (Basel, Switzerland) Pub Date : 2025-07-25 DOI: 10.1159/000547573

Ilsoo Kim, Joon Sung Kim, Jae Myung Park, Dae Young Cheung, Tae Ho Kim, Woo Chul Chung, Jung-Hwan Oh, Hyun Ho Choi, Seung-Woo Lee

{"title":"Clostridioides difficile infection in Patients Undergoing Acid-Suppressive Treatment: A Large Cohort Study with Propensity Score Matching.","authors":"Ilsoo Kim, Joon Sung Kim, Jae Myung Park, Dae Young Cheung, Tae Ho Kim, Woo Chul Chung, Jung-Hwan Oh, Hyun Ho Choi, Seung-Woo Lee","doi":"10.1159/000547573","DOIUrl":"https://doi.org/10.1159/000547573","url":null,"abstract":"Introduction: Clostridioides difficile infection (CDI) is a significant concern in patients undergoing acid-suppressive therapy. This study aimed to evaluate and compare the risk of CDI in patients being treated with proton pump inhibitors (PPIs), histamine 2 receptor antagonists (H2RAs), or potassium-competitive acid blockers (PCAB; tegoprazan).Methods: This retrospective observational cohort study evaluated 606,460 individuals prescribed PPIs, H2RAs, or tegoprazan for more than seven days, resulting in 22,431 matched individuals after propensity score matching. Primary outcome was CDI incidence within 12 weeks of medication use.Results: Patients receiving PPIs exhibited a significantly higher relative risk (RR) (RR, 1.86; 95% confidence interval [CI]: 1.18-2.91) of developing CDI than those receiving H2RAs. Tegoprazan showed no significant increase in CDI risk (RR, 1.07; 95% CI: 0.64-1.79) compared to H2RAs. The risk of CDI increased with a longer duration of acid suppressant use. No dose-dependent differences in CDI occurrence were observed across PPI doses, and no significant differences were found in the incidence of severe CDI among the groups.Conclusions: Proton pump inhibitors were associated with a higher risk of CDI than H2RAs. These findings highlight the need for careful selection of acid-suppressive therapies, particularly in high-risk populations.","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-19"},"PeriodicalIF":2.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dissection the Hepatitis B Virus Replication Mechanisms and Advances in In Vivo Models: A Comprehensive Review. 乙型肝炎病毒复制机制的解剖和体内模型的进展：综述。

Digestive diseases (Basel, Switzerland) Pub Date : 2025-07-24 DOI: 10.1159/000547536

Ashish Kumar Vyas, S Amitha Banu, Kajal Rahangdale, Ram Kumar Nema, Nirupma Trehanpati

{"title":"Dissection the Hepatitis B Virus Replication Mechanisms and Advances in In Vivo Models: A Comprehensive Review.","authors":"Ashish Kumar Vyas, S Amitha Banu, Kajal Rahangdale, Ram Kumar Nema, Nirupma Trehanpati","doi":"10.1159/000547536","DOIUrl":"https://doi.org/10.1159/000547536","url":null,"abstract":"Chronic infection of the Hepatitis B virus (HBV) is a leading cause of advanced liver diseases. The process of HBV replication and available in-vivo models to study the HBV are very complex. The entry into hepatocytes is a multifaceted interplay involving viral particles, host cell receptors, and endocytic processes. Interaction between the HBV viral particle and specific host receptors such as sodium taurocholate co-transporting polypeptide (NTCP), epidermal growth factor receptor (EGFR), and asialoglycoprotein receptor (ASGPR) triggers internalization through clathrin-dependent endocytosis. Subsequently, the HBV genome is transported into the host cell nucleus through a series of steps including capsid disassembly, engagement of transport factors, chromatinization, ultimately resulting in the formation of covalently closed circular DNA (cccDNA). There are various animal models used to study HBV. A thorough understanding of these mechanisms and models is crucial for unravelling the HBV lifecycle and advancing the development of targeted therapeutic strategies. This review provides an in-depth analysis of HBV replication and highlights recent insights into various animal models used to study HBV.","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-31"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Serum-soluble human leukocyte antigen G serves as a biomarker for early gastric cancer screening among the elderly people. 血清可溶性人白细胞抗原G可作为老年人早期胃癌筛查的生物标志物。

Digestive diseases (Basel, Switzerland) Pub Date : 2025-07-19 DOI: 10.1159/000547447

Shuangzhen Bao, Xinying Wang, Jiangang Zhao

{"title":"Serum-soluble human leukocyte antigen G serves as a biomarker for early gastric cancer screening among the elderly people.","authors":"Shuangzhen Bao, Xinying Wang, Jiangang Zhao","doi":"10.1159/000547447","DOIUrl":"https://doi.org/10.1159/000547447","url":null,"abstract":"Background: Gastric cancer is a major cause of gastrointestinal cancer deaths, and early detection is key to improving survival. Current diagnostic methods have limitations, highlighting the need for new biomarkers. Our study aimed to explore the potential of serum soluble human leukocyte antigen-G (sHLA-G), Pepsinogen I/ Pepsinogen II (PGI/PGII) ratio (PGR), and gastrin-17 (G17) as markers for diagnosing and monitoring gastric cancer progression.Methods: A retrospective study was conducted to analyze serum levels of sHLA-G, PGR, and G17. These levels were compared among various gastric conditions, including chronic non-atrophic gastritis, chronic atrophic gastritis, precancerous lesions, and gastric cancer. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of these biomarkers.Results: This study included 429 elderly patients who underwent gastric examination. Results showed that serum levels of sHLA-G and G17 were significantly higher while PGR levels were significantly lower in the gastric cancer group (all p<0.001). ROC analysis revealed that the combined model of sHLA-G, PGR, and G17 had the best diagnostic performance (AUC = 0.89, sensitivity 86.90%, specificity 76.52%). Additionally, sHLA-G levels were closely associated with cancer progression, tumor size, lymph node metastasis, and Helicobacter pylori infection, suggesting it may serve as a biomarker for gastric cancer progression.Conclusion: Serum sHLA-G can serve as an effective biomarker for gastric cancer screening, revealing a better effective diagnostic performance in combination with PGR and G-17. The combination of these biomarkers enhances diagnostic accuracy and may facilitate early diagnosis and risk stratification of gastric cancer patients.","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-19"},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peri-complication Diagnosis of Nonalcoholic Fatty Liver Disease: A U.S. Population-based Retrospective Analysis. 非酒精性脂肪性肝病的围合并期诊断：一项基于美国人群的回顾性分析

Digestive diseases (Basel, Switzerland) Pub Date : 2025-07-14 DOI: 10.1159/000547392

Richie Manikat, Sally Tran, Leslie Yeeman Kam, Deepti Dronamraju, Ramsey Cheung, Mindie H Nguyen

{"title":"Peri-complication Diagnosis of Nonalcoholic Fatty Liver Disease: A U.S. Population-based Retrospective Analysis.","authors":"Richie Manikat, Sally Tran, Leslie Yeeman Kam, Deepti Dronamraju, Ramsey Cheung, Mindie H Nguyen","doi":"10.1159/000547392","DOIUrl":"https://doi.org/10.1159/000547392","url":null,"abstract":"Background: Screening guidelines for nonalcoholic fatty liver disease (MASLD) remain controversial, though early diagnosis can faciliate intervention and prevention. We aimed to determine the proportion of patients with a delayed diagnosis of MASLD (i.e., diagnosis within 6 months or after a liver complication).Methods: A retrospective analysis of adult patients within the Merative™ Marketscan® Databases (1/2007-12/2021) with a diagnosis of MASLD, a liver complication (defined as HCC, cirrhosis with or without evidence of portal hypertension such as varices, ascites, and hepatic encephalopathy or liver transplant), and ≥12 months of insurance coverage prior to the first liver complication.Results: We analyzed 143,310 patients meeting inclusion criteria. The majority (95,843, 66.8%, p<0.001) had a pericomplication diagnosis of MASLD. Compared to patients without delayed diagnosis, those with a pericomplication diagnosis were older (57.6±14.5 vs. 53.8±12.5), more likely to have used tobacco (18.7% vs. 12.6%) and illicit drugs (2.3% vs. 1.4%), metabolic diseases, and higher mean Charlson Comorbidity Index (CCI, 3.0±3.0 vs 1.9±2.3), all p<0.0001. On multivariable logistic regression adjusted for age, sex, and CCI, a first visit with gastroenterology (OR 0.32, 95% CI 0.31-0.32, p<0.001), or a specialist seeing patients with metabolic disease (cardiology, endocrinology, or nephrology) (OR 0.44, 95% CI 0.43-0.45, p<0.001) more than 12 months prior to a complication was associated with significantly lower odds of delayed diagnosis of MASLD.Conclusions: Diagnosis of MASLD in real-world patients is severely delayed, with 2 in 3 patients diagnosed either after or within 6 months from a liver complication. Patients followed longitudinally by medical providers in gastroenterology and other metabolic specialties had a substantially lower risk of an early complication.","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-21"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparable Long-Term Liver Transplant Outcomes in PSC with and without MASLD: Last Decade Analysis of the UNOS Database. 合并和不合并MASLD的PSC长期肝移植结果比较：UNOS数据库近十年分析

Digestive diseases (Basel, Switzerland) Pub Date : 2025-07-04 DOI: 10.1159/000547227

Leandro Sierra, Natchaya Polpichai, Nazli Begum Ozturk, Lynette M Sequeira, Eleazar Montalvan-Sanchez, Nikki Duong

{"title":"Comparable Long-Term Liver Transplant Outcomes in PSC with and without MASLD: Last Decade Analysis of the UNOS Database.","authors":"Leandro Sierra, Natchaya Polpichai, Nazli Begum Ozturk, Lynette M Sequeira, Eleazar Montalvan-Sanchez, Nikki Duong","doi":"10.1159/000547227","DOIUrl":"https://doi.org/10.1159/000547227","url":null,"abstract":"Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of liver transplants (LT) in the US. Despite its overlap with other indications, its intersection with primary sclerosing cholangitis (PSC) remains unexplored.Methods: We performed a retrospective cohort study using the UNOS/OPTN database (2013-2024) to evaluate outcomes in PSC, MASLD, and PSC/MASLD. Exclusions included prior/multi-organ transplants, BMI <15 kg/m², pediatric recipients, and other liver diseases. A propensity-matched analysis adjusting for age and sex was conducted. Outcomes included LT probability, waitlist survival, and post-LT graft and patient survival, assessed by Kaplan-Meier and Cox proportional hazards models.Results: We included 255 PSC, 255 MASLD, and 85 PSC/MASLD patients, matched 1:3:3. BMI and diabetes rates were highest in PSC/MASLD (31.2 kg/m²; 43.5%) and MASLD (30.9 kg/m²; 54.5%) (p<0.001). Hepatic decompensation, including ascites and encephalopathy, was more common in PSC/MASLD and MASLD than PSC (p<0.001). On the waitlist, PSC/MASLD had the best 1-year survival (93%) but declined sharply to 70% by 4 years (95%), compared to PSC (77%) and MASLD (63%) (p=0.02). PSC/MASLD also had the highest 5-year LT probability (52%), followed by MASLD (46%) (p<0.001). Post-LT, patient and graft survival were similar across groups. In multivariate analysis, diabetes (HR 1.22) and life support (HR 1.39) independently predicted worse post-LT outcomes.Conclusions: PSC/MASLD had a higher transplant probability and lower waitlist survival than PSC. Post-transplant outcomes were similar across groups. Diabetes and life support independently worsened post-LT outcomes, emphasizing the need for diabetes management in MASLD and PSC/MASLD.","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-26"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Zenker Peroral Endoscopic Myotomy Is Safe and Effective for the Management of Pharyngeal Pouch: A Multicentre Retrospective Cohort Study. Zenker经口内窥镜肌切开术（Z-POEM）安全有效地治疗咽袋：一项多中心回顾性队列研究。

IF 2.1

Digestive diseases (Basel, Switzerland) Pub Date : 2025-06-30 DOI: 10.1159/000546645

Benjamin Norton, Katie Siggens, Apostolis Papaefthymiou, Andrea Telese, Margaret Duku, Alberto Murino, Gavin Johnson, Charles Murray, Borzoueh Mohammadi, Muntzer Mughal, Raf Bisschops, Noor Mohammed, Pradeep Bhandari, Martin Birchall, Rehan Haidry

{"title":"Zenker Peroral Endoscopic Myotomy Is Safe and Effective for the Management of Pharyngeal Pouch: A Multicentre Retrospective Cohort Study.","authors":"Benjamin Norton, Katie Siggens, Apostolis Papaefthymiou, Andrea Telese, Margaret Duku, Alberto Murino, Gavin Johnson, Charles Murray, Borzoueh Mohammadi, Muntzer Mughal, Raf Bisschops, Noor Mohammed, Pradeep Bhandari, Martin Birchall, Rehan Haidry","doi":"10.1159/000546645","DOIUrl":"10.1159/000546645","url":null,"abstract":"Introduction: A Zenker diverticulum (ZD) is a sac-like outpouching at the pharyngo-oesophageal junction, which is characterised by dysphagia and regurgitation. Surgery has been the predominant treatment but carries the burden of invasiveness, complications, and recurrence. Zenker peroral endoscopic myotomy (Z-POEM) is an alternative minimally invasive endoscopic treatment for ZD. We report on the safety and efficacy of Z-POEM in the UK.Methods: Consecutive patients undergoing Z-POEM by expert interventional endoscopists at four UK referral centres were retrospectively analysed between 2019 and 2024. Patient demographics, technical and clinical success, and 30-day adverse events were recorded. The primary outcome was clinical success, which was defined as a reduction in Dakkak and Bennett dysphagia score to ≤1 without need for repeat intervention.Results: Among 61 patients undergoing Z-POEM, the median age was 76 (IQR 69-80), 37.7% (n = 23) were female, mean pouch size was 37.3 mm (SD 18.0) in depth, and 37.3% had undergone prior intervention. The overall technical success was 100%, mean procedural time was 49.4 min (SD 19.3), and 10 patients underwent a hybrid procedure due to submucosal fibrosis. Overall, the clinical success was 93.1% over a mean follow-up of 11.2 months. There were five AEs related to the procedure classified as AGREE grade II (8.5%), and the recurrence rate was 11.1% over a median time of 7.5 months (IQR 6.3-10.3).Conclusion: Z-POEM is a safe and effective endoscopic treatment for ZD that is associated with high technical and clinical success. A hybrid procedure may be utilised in the presence of submucosal fibrosis.","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term outcome of repeat resection versus radiofrequency ablation for intrahepatic recurrence after curative resection of hepatocellular carcinoma initially within BCLC 0-A stages: A multicenter study. 一项多中心研究：首次在BCLC 0-A期肝细胞癌根治性切除后肝内复发，重复切除与射频消融的长期预后

Digestive diseases (Basel, Switzerland) Pub Date : 2025-06-24 DOI: 10.1159/000546743

Yueqing Xu, Xiaoyun Zhang, Haiqing Wang, Zonghan Liu, Jiayi Wu, Yu Zhang, Junyi Shen, Wei Peng, Xielin Feng, Lvnan Yan, Maolin Yan, Shuqun Cheng, Tianfu Wen

{"title":"Long-term outcome of repeat resection versus radiofrequency ablation for intrahepatic recurrence after curative resection of hepatocellular carcinoma initially within BCLC 0-A stages: A multicenter study.","authors":"Yueqing Xu, Xiaoyun Zhang, Haiqing Wang, Zonghan Liu, Jiayi Wu, Yu Zhang, Junyi Shen, Wei Peng, Xielin Feng, Lvnan Yan, Maolin Yan, Shuqun Cheng, Tianfu Wen","doi":"10.1159/000546743","DOIUrl":"https://doi.org/10.1159/000546743","url":null,"abstract":"Background: Hepatocellular carcinoma (HCC) is the most common primary liver cancer with an extremely high recurrence rate. Due to the absence of definitive treatment guidelines for recurrent HCC, this study assessed the effectiveness of repeat resection (RR) versus percutaneous radiofrequency ablation (RFA) in patients initially diagnosed with BCLC stage 0-A primary HCC who developed no more than three recurrent tumors, each ≤3 cm in size, after curative resection.Methods: This study retrospectively analyzed patients diagnosed with recurrent HCC between January 1, 2010, and May 30, 2022, across five centers, who underwent either RR or RFA. All patients met the eligibility criteria for both treatments.Results: This study included 464 patients (224 in the RR group and 240 in the RFA group). Both groups were predominantly male (87.1% vs 82.9%) and aged ≤60 years (72.8% vs 69.9%). The groups showed differences in histological differentiation of initial tumors and size of recurrent tumors, but these baseline characteristics were balanced after propensity score matching (PSM).The median overall survival after retreatment (OS) was 100.3 months in the RR group and 67.4 months in the RFA group (HR 0.612, 95% CI [0.414-0.904], P=0.013). The median recurrence-free survival after retreatment(RFS) was 34.6 months in the RR group and 16.2 months in the RFA group (HR 0.574, 95% CI [0.447-0.737], P<0.001). Both RFS and OS were significantly better in the RR group than in the RFA group.Conclusion: In patients with primary HCC classified as BCLC stage 0-A who have undergone curative resection, RR is superior to RFA in terms of both RFS and OS when the recurrent tumors are ≤3 in number and ≤3 cm in size.","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of therapeutic agents on serum leucine-rich alpha-2 glycoprotein for monitoring endoscopically remitted ulcerative colitis. 治疗药物对富亮氨酸α -2糖蛋白监测内镜缓解溃疡性结肠炎的影响。

Digestive diseases (Basel, Switzerland) Pub Date : 2025-06-24 DOI: 10.1159/000547007

Junnosuke Hayasaka, Akira Matsui, Daisuke Kikuchi, Shu Hoteya

{"title":"Impact of therapeutic agents on serum leucine-rich alpha-2 glycoprotein for monitoring endoscopically remitted ulcerative colitis.","authors":"Junnosuke Hayasaka, Akira Matsui, Daisuke Kikuchi, Shu Hoteya","doi":"10.1159/000547007","DOIUrl":"https://doi.org/10.1159/000547007","url":null,"abstract":"Background Serum leucine-rich alpha-2 glycoprotein (LRG) levels are measured to monitor ulcerative colitis (UC); however, the impact of concomitant medications on LRG remains unclear. This exploratory study aimed to determine the effects of various agents on serum LRG levels. Methods We conducted a single-center, retrospective study using medical records at our hospital from October 1, 2020, to June 30, 2023. Patients who underwent lower gastrointestinal endoscopy within 1 year before or after LRG measurement and had confirmed mucosal healing were included. The effects of medication on LRG levels were assessed using multiple regression analysis following multiple imputations. The analyzed agents included 5-aminosalicylic acid (5-ASA), immunomodulators, corticosteroids, calcineurin inhibitors, Janus kinase inhibitors, vedolizumab, interleukin-23 receptor antagonists, and anti-TNF-α agents. Results A total of 214 patients (351 measurements) were included. The median LRG was 11.2 μg/ml. Among patients, 63.2 had a Mayo Endoscopic Subscore of 0, while 36.8% had a score of 1. The frequency of medication use was as follows: 5-ASA (88.9%), immunomodulators (13.1%), corticosteroids (2.6%), calcineurin inhibitors (0.9%), Janus kinase inhibitors (5.7%), vedolizumab (3.4%), interleukin-23 receptor antagonists (1.7%), and anti-TNF-α agents (7.4%). Corticosteroids, calcineurin inhibitors, Janus kinase inhibitors, and anti-TNF-α agents were negatively associated with LRG (β = -3.42, -10.4, -2.34, and -3.01, respectively). Conversely, vedolizumab and interleukin-23 receptor antagonists were positively associated with LRG. (β =1.83 and 4.69, respectively). Conclusions LRG levels are influenced by medications, even in patients with mucosal healing. These effects should be considered when using LRG to monitor UC.","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-22"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of Vonoprazan-Based Triple Therapy with Sitafloxacin and Amoxicillin for Third-Line Helicobacter pylori Eradication: A Multicenter Prospective Analysis on Drug Resistance and gyrA Mutations. 以vonoprazan为基础的西他沙星和阿莫西林三联疗法对三线幽门螺杆菌根除的疗效：耐药性和gyrA突变的多中心前瞻性分析

Digestive diseases (Basel, Switzerland) Pub Date : 2025-06-13 DOI: 10.1159/000546914

Shunpei Wasaki, Hideki Mori, Juntaro Matsuzaki, Hidekazu Suzuki, Kenro Hirata, Hiroyuki Imaeda, Masahiro Yoshioka, Atsushi Nakazawa, Akira Okazawa, Takanori Kanai, Tatsuhiro Masaoka

{"title":"Efficacy of Vonoprazan-Based Triple Therapy with Sitafloxacin and Amoxicillin for Third-Line Helicobacter pylori Eradication: A Multicenter Prospective Analysis on Drug Resistance and gyrA Mutations.","authors":"Shunpei Wasaki, Hideki Mori, Juntaro Matsuzaki, Hidekazu Suzuki, Kenro Hirata, Hiroyuki Imaeda, Masahiro Yoshioka, Atsushi Nakazawa, Akira Okazawa, Takanori Kanai, Tatsuhiro Masaoka","doi":"10.1159/000546914","DOIUrl":"https://doi.org/10.1159/000546914","url":null,"abstract":"Introduction: Vonoprazan (VPZ) is a potent gastric acid secretion inhibitor used to improve the outcomes of Helicobacter pylori eradication treatments. However, the increasing prevalence of antibiotic-resistant H. pylori strains has limited the efficacy of H. pylori eradication therapies. The aim of this study was to evaluate the efficacy and safety of a 7-day triple therapy with VPZ, amoxicillin (AMOX), and sitafloxacin (STFX) as a third-line H. pylori eradication treatment.Methods: Patients in whom second-line eradication therapy failed were enrolled. The minimum inhibitory concentrations of STFX and AMOX, as well as the gyrA mutation status of H. pylori strains, were determined before treatment. The patients received VPZ (20 mg) twice daily, AMOX (500 mg) four times daily, and STFX (100 mg) twice daily for 7 days (vonoprazan-amoxicillin-sitafloxacin [VAS] group). Successful eradication was evaluated using the 13C urea breath test.Results: Of the 114 patients enrolled, 75 were treated with the VAS regimen. The overall eradication rate in the VAS group was 90.7% and 94.4% in the intention-to-treat and per-protocol populations, respectively. The VAS regimen completely eradicated GyrA mutation-negative H. pylori strains. Furthermore, it eradicated all strains containing gyrA mutations at position D91. Adverse events were observed in 38.7% of patients, and treatment was discontinued in one patient because of eruption, diarrhea, and headache.Conclusion: Overall, the 7-day VAS regimen exhibited excellent safety profile and efficacy as a third-line eradication treatment, even against gyrA mutation-positive H. pylori strains.","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-18"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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