Lancet Gastroenterology & Hepatology最新文献

{"title":"Metabolic syndrome myopathy: defining an emerging clinical entity in patients with MASLD.","authors":"Melinda Wang, Jennifer C Lai","doi":"10.1016/S2468-1253(26)00088-9","DOIUrl":"10.1016/S2468-1253(26)00088-9","url":null,"abstract":"","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":" ","pages":"647-649"},"PeriodicalIF":39.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All in her head: dismantling medical misogyny in disorders of gut-brain interaction.","authors":"Tiffany H Taft, Tina Aswani-Omprakash, Johannah Ruddy","doi":"10.1016/S2468-1253(26)00095-6","DOIUrl":"10.1016/S2468-1253(26)00095-6","url":null,"abstract":"","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":" ","pages":"650-652"},"PeriodicalIF":39.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drugging the undruggable in pancreatic cancer.","authors":" The Lancet Gastroenterology Hepatology","doi":"10.1016/s2468-1253(26)00195-0","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00195-0","url":null,"abstract":"","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"230 1","pages":"645"},"PeriodicalIF":35.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148408203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons from a ransomware crisis and its effect on adult liver transplant services.","authors":"Abdul Rahman Hakeem,Karen Mercer,Bu Hayee,Oliver Long,Abid Suddle,Wayel Jassem,Parthi Srinivasan,Krishna Menon,Anneliese Rigby,Miriam Cortes-Cerisuelo,Varuna Aluvihare","doi":"10.1016/s2468-1253(26)00183-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00183-4","url":null,"abstract":"","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"12 1","pages":"655-657"},"PeriodicalIF":35.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148408200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing benefit and burden: rethinking post-polypectomy colonoscopy surveillance strategies.","authors":"Joep E G IJspeert, Michael Bretthauer, Rodrigo Jover, Evelien Dekker","doi":"10.1016/S2468-1253(26)00128-7","DOIUrl":"10.1016/S2468-1253(26)00128-7","url":null,"abstract":"<p><p>Post-polypectomy colonoscopy surveillance is widely implemented to reduce colorectal cancer incidence and mortality, yet increasing evidence raises concerns about whether current strategies are optimally balanced in terms of benefit, burden, and resource use. At least some individuals currently classified as being high risk for post-polypectomy colorectal cancer might actually have a low absolute risk, suggesting that surveillance might be overused in this group of patients. At the same time, colonoscopy surveillance imposes considerable burden at the patient, health-care system, and societal levels, including procedural risks, costs, and pressure on endoscopy capacity. This Viewpoint critically examines the limitations underlying current post-colonoscopy surveillance strategies, including reliance on historical data with inadequate collection of quality indicators, insufficient focus on the absolute risk of colorectal cancer, and potential misclassification of patients' risk. We argue that these limitations might have led to suboptimal allocation of surveillance intensity. We advocate for a shift towards a more comprehensive risk-stratified framework, in which surveillance decisions are guided by absolute colorectal cancer risk thresholds and could incorporate less invasive triage approaches for lower-risk individuals. Overall, we propose rethinking post-polypectomy surveillance to better align clinical practice with contemporary evidence with the goal of improving patient outcomes while minimising unnecessary interventions and health-care burden.</p>","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":" ","pages":"720-726"},"PeriodicalIF":39.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148285011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The spectrum of steatotic liver disease in the USA - Authors' reply.","authors":"James M Paik,Zobair M Younossi","doi":"10.1016/s2468-1253(26)00185-8","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00185-8","url":null,"abstract":"","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"9 1","pages":"655"},"PeriodicalIF":35.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148408199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver stiffness dynamics in European populations (LiverScreen): a longitudinal, multicentre, prospective, population-based cohort study.","authors":"Jesse Pustjens, Katrine Tholstrup Bech, Guillem Pera, Laurens A van Kleef, Helle Lindholm Schnefeld, Robert J de Knegt, Sarwa Darwish Murad, Harry L A Janssen, Peter Andersen, Johanne Kragh Hansen, Llorenç Caballeria, Carla Chacon, Ingrid Arteaga, Pere Toran, Anita Arslanow, Anna Soria, Marta Cervera, Aleksander Krag, Isabel Graupera, Pere Ginès, Willem Pieter Brouwer, Maja Thiele","doi":"10.1016/S2468-1253(26)00091-9","DOIUrl":"10.1016/S2468-1253(26)00091-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Liver stiffness measurement (LSM) is a recommended screening tool for liver fibrosis. We aimed to examine long-term LSM dynamics within three European populations and identify risk factors for clinically significant changes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This longitudinal, multicentre, prospective, population-based cohort study included three cohorts: Barcelona (recruited from primary care settings in Barcelona, Spain), Odense (recruited from a population at risk of alcohol-related liver disease in Odense, Denmark), and Rotterdam (including individuals recruited from the general population as part of the Rotterdam Study in Rotterdam, Netherlands). Participants aged 18 years or older were recruited using random sampling strategies. At baseline and follow-up, we collected participant medical history and medication use, anthropometric measurements, and fasting blood samples, and trained research nurses obtained LSM by vibration-controlled transient elastography. Participants were invited for follow-up after a minimum of 1 year. The two primary outcomes were clinically significant LSM changes, defined as: an LSM increase from a baseline value of less than 8·0 kPa to a follow-up value of 8·0 kPa or more, combined with a 30% or more change (ie, clinically significant LSM increase); or an LSM decrease from a baseline value of 8·0 kPa or more to a follow-up of less than 8·0 kPa, combined with a 30% or more change (ie, clinically significant LSM decrease).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between Feb 2, 2010, and Oct 1, 2021, 8077 participants underwent baseline measurement, of whom 7884 had a reliable LSM. Date of last follow-up was Sept 4, 2024. Of 7884 participants at baseline, 1418 participants were ineligible for follow-up due to death, relocation, or inability to visit the research centre, leaving 6466 participants eligible for long-term follow-up. A total of 1286 declined follow-up, resulting in 5180 participants attending follow-up visits, corresponding to an 80·1% participation rate among those eligible. LSM was not performed in 588 participants due to logistical constraints, and 56 measurements were unreliable. The final longitudinal cohort comprised 4536 participants, with a median follow-up of 4·3 years (IQR 4·1-8·4). At baseline, median age was 62 years (IQR 56-68; range 19-92); 2345 (51·7%) participants were female and 2191 (48·3%) were male. 251 (5·5%) had a LSM of 8·0 kPa or more at baseline, of whom 110 (43·8%) had a clinically significant LSM decrease during follow-up. Among the 4285 (94·5%) participants with a baseline LSM of less than 8·0 kPa, 112 (2·6%) had a clinically significant increase during follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;Our findings suggest that repeated LSM screening in community-dwelling European populations is feasible. During long-term follow-up, there was a low incidence of clinically significant LSM increase, suggesting that screening should be targeted towards individ","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":" ","pages":"689-699"},"PeriodicalIF":39.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COLOR III: widespread TaTME dissemination demands a LAPCO-equivalent framework.","authors":"Shazad Q Ashraf,Andrew D Beggs","doi":"10.1016/s2468-1253(26)00112-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00112-3","url":null,"abstract":"","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"8 1","pages":"653"},"PeriodicalIF":35.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148408198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HLA-DRB1*01:03 in patients with inflammatory bowel disease: a genotype-phenotype association study.","authors":"Qian Zhang, Eathar Shakweh, Mohmmed Tauseef Sharip, Benjamin Zare, Christopher Roberts, Nicola J Wyatt, Jennifer Clough, Claire Bewshea, Omar El Garwany, Robert Lees, Saima Mukhtar, Hameed Rehman, Hollie Thistle, Robert Mulligan, Melanie Taylor, Parizade Raymode, Benjamin Hamilton, Nurulamin M Noor, Francesco Morda, Madeleine Taylor, Mina Gyanwali, Ogwa Tobi, Stefanos Kateroglou, Sean Von Hagt, Shaji Sebastian, Ailsa Hart, Laura Keylock, Laetitia Pele, Charlie W Lees, Tim Raine, Christopher A Lamb, Carl A Anderson, Tariq Ahmad, Holm Uhlig, Miles Parkes, Laura Fachal, Nicholas A Kennedy, James C Lee","doi":"10.1016/S2468-1253(26)00113-5","DOIUrl":"10.1016/S2468-1253(26)00113-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The association between HLA-DRB1*01:03 and severe ulcerative colitis has long been recognised. However, the recent discovery of an association with neutralising auto-antibodies against IL-10 raises new questions about whether this haplotype contributes to other subphenotypes of inflammatory bowel disease (IBD). We sought to systematically reappraise the contribution of HLA-DRB1*01:03 across the full spectrum of IBD subphenotypes, including multiple disease-related adverse outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this genotype-phenotype association study, we used data from patients with IBD of inferred European ancestry from more than 100 UK hospitals who were recruited into the National Institute for Health and Care Research IBD BioResource or the UK IBD Genetics Consortium cohorts between 2005 and 2025. Associations between HLA-DRB1*01:03 and IBD phenotypes were examined using logistic or linear regression, and adjusted for sex, smoking, diagnosis, follow-up, genetic principal components, six co-inherited HLA alleles, and other significant associations. Time-to-event analyses were performed using Cox regression models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;43 762 patients with IBD (21 839 with Crohn's disease and 21 923 with ulcerative colitis or IBD unclassified) were included in our analysis. HLA-DRB1*01:03 carriage was observed in 2009 (4·6%) patients with IBD and associated with multiple severe outcomes in the adjusted models, including colonic resection in patients with Crohn's disease (odds ratio 1·35 [95% CI 1·07-1·69]), colectomy in patients with ulcerative colitis or IBD unclassified (1·99 [1·63-2·43]), perianal disease in both patients with Crohn's disease (1·65 [1·42-1·92]) and patients with ulcerative colitis or IBD unclassified (1·70 [1·27-2·28]), and advanced therapy use in patients with Crohn's disease (1·33 [1·12-1·58]) and patients with ulcerative colitis or IBD unclassified (2·17 [1·86-2·52]). HLA-DRB1*01:03 was associated with younger-onset ulcerative colitis or IBD unclassified and older-onset Crohn's disease. HLA-DRB1*01:03 also associated with earlier development of perianal Crohn's disease (hazard ratio 1·61 [95% CI 1·24-2·07]), earlier need for colonic surgery in patients with Crohn's disease (1·43 [1·13-1·82]), and earlier colectomy in patients with ulcerative colitis or IBD unclassified (1·69 [1·33-2·14]). HLA-DRB1*01:03 carriers initiated advanced therapy earlier (HR 1·37 [95% CI 1·18-1·59] in patients with Crohn's disease and 1·82 [1·53-2·16] in patients with ulcerative colitis or IBD unclassified) and had a higher risk of advanced therapy failure across IBD phenotypes (HR 1·23 [95% CI 1·02-1·50]).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;HLA-DRB1*01:03 emerges as a genetic determinant of severe disease in both patients with Crohn's disease and patients with ulcerative colitis. Although further validation is needed, assessing HLA-DRB1*01:03 carriage might help identify patients who could b","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":" ","pages":"660-671"},"PeriodicalIF":39.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The glucagon and GLP-1 receptor dual agonist DD01 for metabolic dysfunction-associated steatotic liver disease and steatohepatitis (DD01-DN-02): 12-week results from a randomised, double-blind, multicentre, placebo-controlled, phase 2 trial","authors":"Prof Mazen Noureddin MD, Prof Winston Dunn MD, Rashmee Patil MD, Dimple Desai MD, Rohit Puskoor MD, Jaehee Shin MS, Dennis To PhD, Adam C Bell PhD, Daniel R Lee MS, Yen-Huei Lin PhD, Seulki Lee PhD","doi":"10.1016/s2468-1253(26)00130-5","DOIUrl":"https://doi.org/10.1016/s2468-1253(26)00130-5","url":null,"abstract":"Metabolic dysfunction-associated steatohepatitis (MASH) is a major public health problem arising in the context of metabolic syndrome and obesity. DD01 is a liver-targeted GLP-1 receptor and glucagon dual agonist being investigated for the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD) and MASH. The DD01-DN-02 trial aimed to evaluate the efficacy and safety of DD01 in adults with MASLD or MASH; this initial analysis reports prespecified 12-week outcomes to assess early hepatic effects.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"51 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}