Digestive diseases (Basel, Switzerland)最新文献

{"title":"Dissecting 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":"10.1159/000547536","url":null,"abstract":"<p><strong>Background: </strong>Chronic infection with the Hepatitis B virus (HBV) is a major contributor to advanced liver diseases. The HBV replication process and the in vivo models available to study this virus are complex. HBV entry into hepatocytes involves a multifaceted interplay of viral particles, host cell receptors, and endocytic pathways. Key host receptors, including sodium taurocholate co-transporting polypeptide (NTCP), epidermal growth factor receptor (EGFR), and asialoglycoprotein receptor (ASGPR), facilitate viral internalization via clathrin-mediated endocytosis.</p><p><strong>Summary: </strong>Following entry, the HBV genome undergoes a series of intracellular processes including capsid disassembly, engagement with transport factors, and chromatinization, leading to the formation of covalently closed circular DNA (cccDNA) within the host nucleus. Several animal models have been developed to study these mechanisms, offering insights into HBV biology and pathogenesis.</p><p><strong>Key messages: </strong>(i) HBV replication is a highly regulated, multi-step process dependent on host-virus interactions. (ii) Host receptors like NTCP, EGFR, and ASGPR are critical for HBV internalization into hepatocytes. (iii) Understanding HBV replication and cccDNA formation is essential for developing targeted treatments. (iv) Diverse animal models are indispensable for advancing HBV research and therapeutic development.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"678-696"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","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}

{"title":"Comparable Long-Term Liver Transplant Outcomes in Primary Sclerosing Cholangitis 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":"10.1159/000547227","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of liver transplants (LT) in the USA. Despite its overlap with other indications, its intersection with primary sclerosing cholangitis (PSC) remains unexplored.</p><p><strong>Methods: </strong>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, body mass index (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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>PSC/MASLD had a higher transplant probability and lower waitlist survival than PSC. Posttransplant 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.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"569-581"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577572","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}

{"title":"Long-Term Outcome of Repeat Resection versus Radiofrequency Ablation for Intrahepatic Recurrence after Curative Resection of Hepatocellular Carcinoma Initially within Barcelona Clinic Liver Cancer Staging System 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":"10.1159/000546743","url":null,"abstract":"<p><strong>Introduction: </strong>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 Barcelona clinic liver cancer staging system (BCLC) stage 0-A primary HCC who developed no more than three recurrent tumors, each ≤3 cm in size, after curative resection.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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. The median overall survival (OS) after retreatment 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 (RFS) after retreatment 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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"555-568"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","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}

{"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":"<p><p><p>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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. </p>.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"477-487"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","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}

{"title":"Delayed Diagnosis of Hepatitis C Infection: Results of a Nationwide US Study.","authors":"Charles R Levesley, Xinrong Zhang, Richie Manikat, Ramsey Cheung, Mindie H Nguyen","doi":"10.1159/000548379","DOIUrl":"10.1159/000548379","url":null,"abstract":"<p><strong>Introduction: </strong>Universal screening of hepatitis C virus (HCV) was encouraged for individuals born 1945-65 in the USA in 2012. In 2014, efficacious treatments, namely, direct-acting antivirals (DAAs), were introduced. To examine their impact on the HCV care cascade, the proportion of and factors associated with delayed HCV diagnosis in the USA were examined in a national real-world cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed 69,989 adults with an HCV-related liver complication using the Merative™ Marketscan® Medicare Database (1/2007-12/2021). We defined delayed HCV diagnosis as a HCV diagnosis 2 years prior to or any time after the development of a liver complication, including cirrhosis, liver transplant, or hepatocellular carcinoma.</p><p><strong>Results: </strong>The cohort mean age was 55.8 years, 65.9% were male, and the vast majority (60,628 or 86.6%) had delayed HCV diagnosis with 47.7% occurring within 6 months of the complication. The proportion of delayed HCV diagnosis decreased from 89.1% before 2015 to 75.1% from 2015 to 2021. On multivariable analysis, complication diagnosis dates after 2015 and higher Charlson Comorbidity Index were associated with decreased odds of delayed HCV diagnosis, while male sex, mental health, and alcohol use were linked with increased odds of delayed HCV diagnosis.</p><p><strong>Conclusion: </strong>Delayed HCV diagnosis occurred in almost 9 in 10 patients with chronic hepatitis C and liver complications overall and in 3 out of 4 even after DAA availability during the 2015-2021 time period. Further efforts are needed to improve HCV screening and linkage to care.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"667-677"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042960","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}

{"title":"High Ultra-Processed Food Consumption Is Associated with Clinical Exacerbation in Patients with Crohn's Disease in Remission: A Prospective Cohort Study.","authors":"Chen Sarbagili-Shabat, Shira Zelber-Sagi, Naomi Fliss Isakov, Ayal Hirsch, Yulia Ron, Laura Sol Grinshpan, Nathaniel Aviv Cohen, Haim Leibovitzh, Tamar Thurm, Nitsan Maharshak","doi":"10.1159/000546486","DOIUrl":"10.1159/000546486","url":null,"abstract":"<p><strong>Introduction: </strong>Diet can impact the clinical course of Crohn's disease (CD). However, the importance of food processing level is uncertain. We aimed to evaluate whether ultra-processed foods (UPFs) are associated with an increased risk of relapse among patients with CD in clinical remission.</p><p><strong>Methods: </strong>In this prospective cohort study, adult patients with CD in clinical remission were followed for 1 year or until clinical relapse, as assessed by the Harvey Bradshaw index. Dietary intake was assessed using a food frequency questionnaire and a dedicated validated processed food questionnaire to evaluate UPF consumption. Multivariable Cox proportional hazard models were used to estimate the adjusted hazard ratio of disease relapse according to high or low UPF consumption.</p><p><strong>Results: </strong>A total of 111 patients with CD (mean age 37.9 ± 14.0 years) in clinical remission were followed. Over a median period of 12 months [interquartile range, 8-12], 24 patients (21.6%) experienced clinical relapse. Fecal calprotectin levels were increased at the relapse visit compared to baseline (193.0 μg/g [114.0-807.0] and 79.0 μg/g [17.0-274.5], respectively, p = 0.002). A higher intake of UPFs was associated with an increased risk of CD relapse (HR = 3.86; 95% CI 1.30-11.47). Ultra-processed breads and pastries, as well as oils and spreads, were the UPF subgroups with the strongest positive associations (HR = 3.27; 95% CI 1.26-8.45 and HR = 2.76; 95% CI 1.02-7.45, respectively).</p><p><strong>Conclusion: </strong>UPF consumption is associated with an increased risk of relapse in patients with CD in remission. This study, along with future research, can contribute to establishing nutritional guidelines aimed at reducing UPF consumption in this population.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"466-475"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112386","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}

{"title":"The Impact of <i>Helicobacter pylori</i> Eradication on Long-Term Body Weight Changes, Ghrelin, and Leptin Levels.","authors":"Katja Tepeš, Mojca Lunder, Urša Pečar Fonović, Gorazd Avguštin, Rok Orel, David Štubljar, Bojan Tepeš","doi":"10.1159/000547912","DOIUrl":"10.1159/000547912","url":null,"abstract":"<p><strong>Introduction: </strong>The association between chronic Helicobacter pylori infection and hormone levels affecting food intake and obesity remains controversial. Thus, our aim was to investigate the long-term effect of H. pylori eradication on changes in ghrelin and leptin levels in a cohort of patients with a largely non-atrophic gastritis.</p><p><strong>Methods: </strong>A total of 72 patients meeting the inclusion and exclusion criteria were enrolled between July 2020 and November 2022. Participants were randomly assigned to two treatment groups (group 1: 14-day regimen with esomeprazole, amoxicillin, and clarithromycin; group 2: 14-day regimen with esomeprazole, amoxicillin, metronidazole, and colloidal bismuth subcitrate). We evaluated changes in insulin resistance (HOMA-IR score), body mass index, and serum levels of ghrelin and leptin (ELISA test). Measurements were conducted at baseline, 2 months, and 1 year following successful H. pylori eradication.</p><p><strong>Results: </strong>Of the 72 patients included, 13.9% (10/72) did not complete the study protocol. Both treatment groups were similar at enrollment and showed no statistically significant differences. A statistically significant decrease in ghrelin serum levels was observed in both treatment groups (p < 0.001), but not in leptin serum levels (p = 0.309).</p><p><strong>Conclusions: </strong>Successful eradication of chronic H. pylori gastritis lowered ghrelin serum levels. Additionally, no changes in patient weight were observed. Serum leptin levels showed no significant changes. These results confirm that there is no hormonal influence on increased body weight after H. pylori eradication.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"619-629"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877969","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}

{"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":"10.1159/000547007","url":null,"abstract":"<p><strong>Introduction: </strong>Serum leucine-rich alpha-2 glycoprotein (LRG) levels are measured to monitor ulcerative colitis; 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.</p><p><strong>Methods: </strong>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-tumor necrosis factor (TNF)-α agents.</p><p><strong>Results: </strong>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).</p><p><strong>Discussion/conclusion: </strong>LRG levels are influenced by medications, even in patients with mucosal healing. These effects should be considered when using LRG to monitor UC.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"506-514"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487681","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}

{"title":"Peri-Complication Diagnosis of Nonalcoholic Fatty Liver Disease: A US Population-Based Retrospective Analysis.","authors":"Richie Manikat, Sally Tran, Leslie Yeeman Kam, Deepti Dronamraju, Ramsey Cheung, Mindie H Nguyen","doi":"10.1159/000547392","DOIUrl":"10.1159/000547392","url":null,"abstract":"<p><strong>Introduction: </strong>Screening guidelines for nonalcoholic fatty liver disease, now called metabolic dysfunction-associated steatotic liver disease (MASLD), remain controversial, though early diagnosis can faciliate intervention and prevention.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (odds ratio [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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"582-592"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639493","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}

{"title":"Adult Food Protein-Induced Enterocolitis Syndrome: A Review of Emerging Evidence and Clinical Considerations.","authors":"Mehwish Ahmed, Pavadee Poowuttikul, William D Chey, Benjamin R Hart","doi":"10.1159/000547494","DOIUrl":"10.1159/000547494","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Summary: </strong>There is a paucity of literature on FPIES in the gastroenterology literature. This review aimed to bring awareness to this entity as a possible etiology of gastrointestinal symptoms. Symptoms include abdominal pain, diarrhea, repetitive vomiting, and nausea, which occur 1 to 4 h 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 is the gold standard for diagnosis.</p><p><strong>Key messages: </strong>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.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"534-540"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736619","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}