eGastroenterology最新文献

{"title":"Faecal microbiota transplantation for eradicating Helicobacter pylori infection: clinical practice and theoretical postulation.","authors":"Zhi-Ning Ye, Guy D Eslick, Shao-Gang Huang, Xing-Xiang He","doi":"10.1136/egastro-2024-100099","DOIUrl":"10.1136/egastro-2024-100099","url":null,"abstract":"<p><p>The sustained increase in antibiotic resistance leads to a declining trend in the eradication rate of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection with antibiotic-based eradication regimens. Administration of a single probiotic shows limited efficacy in eradicating <i>H. pylori</i> infection. This review indicates that faecal microbiota transplantation (FMT), a novel therapeutic approach, either as a monotherapy or adjunctive therapy, exhibits beneficial effects in terms of the eradication of <i>H. pylori</i> infection and the prevention of adverse events. The role of FMT in <i>H. pylori</i> eradication may be associated directly or indirectly with some therapeutic constituents within the faecal suspension, including bacteria, viruses, antimicrobial peptides and metabolites. In addition, variations in donor selection, faecal suspension preparation and delivery methods are believed to be the main factors determining the effectiveness of FMT for the treatment of <i>H. pylori</i> infection. Future research should refine the operational procedures of FMT to achieve optimal efficacy for <i>H. pylori</i> infection and explore the mechanisms by which FMT acts against <i>H. pylori</i>.</p>","PeriodicalId":72879,"journal":{"name":"eGastroenterology","volume":"2 4","pages":"e100099"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411983","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":"Mechanistic role of long non-coding RNAs in the pathogenesis of metabolic dysfunction-associated steatotic liver disease and fibrosis.","authors":"Henry Wade, Kaichao Pan, Bingrui Zhang, Wenhua Zheng, Qiaozhu Su","doi":"10.1136/egastro-2024-100115","DOIUrl":"10.1136/egastro-2024-100115","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously referred to as non-alcoholic fatty liver disease, encompasses a broad range of hepatic metabolic disorders primarily characterised by the disruption of hepatic lipid metabolism, hepatic lipid accumulation and steatosis. Severe cases of MASLD might progress to metabolic dysfunction-associated steatohepatitis, characterised by hepatic inflammation, hepatocyte ballooning degeneration, activation of hepatic stellate cells (HSCs) and fibrogenesis. It may further progress to hepatocellular carcinoma. In the liver, long non-coding RNAs (lncRNAs) target multiple metabolic pathways in hepatocytes, HSCs, and Kupffer cells at different stages of MASLD and liver fibrosis. In this study, we overview recent findings on the potential role of lncRNAs in the pathogenesis of MASLD and liver fibrosis via modulation of de novo lipid synthesis, fatty acid β-oxidation, lipotoxicity, oxidative stress, metabolic inflammation, mammalian target of rapamycin signalling, apoptosis, ubiquitination and fibrogenesis. We critically assess the literature reports that investigate the complex interplay between lncRNA, microRNA and key mediators in liver injury, in both human participants and animal models of MASLD and liver fibrosis. We also highlight the therapeutic potential of lncRNAs in chronic liver diseases.</p>","PeriodicalId":72879,"journal":{"name":"eGastroenterology","volume":"2 4","pages":"e100115"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054435","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":"Endocrine pathology in young rabbits with cystic fibrosis.","authors":"Xiubin Liang, Xia Hou, Y Eugene Chen, Jian-Ping Jin, Kezhong Zhang, Jie Xu","doi":"10.1136/egastro-2024-100102","DOIUrl":"10.1136/egastro-2024-100102","url":null,"abstract":"<p><strong>Background: </strong>Cystic fibrosis (CF) is an autosomal recessive genetic disorder caused by loss-of-function mutations in the <i>CF</i> transmembrane conductance regulator gene. CF-related pancreatic lesions are known to cause exocrine dysfunctions such as pancreatic insufficiency, and endocrine dysfunctions, including CF related diabetes. In a previous study, we generated CF rabbits using CRISPR/Cas9-mediated gene editing.</p><p><strong>Methods: </strong>CF rabbits were subjected to histological analysis with a focus on CF associated pancreatic lesions. Endocrine function related assays were conducted to evaluate CF related pancreatic endocrine disorders in these animals.</p><p><strong>Results: </strong>We report that CF rabbits develop spontaneous pancreatic lesions at a young age, characterised by pancreatic inflammation and fibrosis, vacuolar degeneration, epithelium mucus-secretory cell metaplasia, and pancreatic duct dilation. The size of the pancreatic islets in the CF rabbits is significantly smaller than that of the wild type animals. Consistent with these pathological findings, young CF rabbits exhibited signs of pancreatic endocrine related disorders such as lower insulin levels and impaired glucose metabolism.</p><p><strong>Conclusions: </strong>Our results suggest that the CF rabbit could serve as a valuable model for translational research on CF related pancreatic endocrine dysfunction.</p>","PeriodicalId":72879,"journal":{"name":"eGastroenterology","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11594368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741591","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":"Early clinical predictors of infected pancreatic necrosis: a multicentre cohort study.","authors":"Kai Song, Wenhua He, Zuoyan Wu, Jie Meng, Wei Tian, Shicheng Zheng, Dong Mu, Ruifeng Wang, Hongda Chen, Yin Zhu, Dong Wu","doi":"10.1136/egastro-2024-100095","DOIUrl":"10.1136/egastro-2024-100095","url":null,"abstract":"<p><strong>Background: </strong>Infected pancreatic necrosis (IPN) exacerbates complications in patients with acute pancreatitis (AP), increasing mortality rates if not treated promptly. We aimed to evaluate the predictive value of clinical characteristics within 24 hours of admission for IPN prediction.</p><p><strong>Methods: </strong>We conducted a retrospective, multicentre cohort study including 3005 patients with AP from eight hospitals in China. Clinical variables collected within 24 hours after admission were analysed using least absolute shrinkage and selection operator regression (10 cross-validations) for variable selection, followed by multivariate logistic regression to develop an IPN prediction model. Internal cross-validation of the development set and validation of the validation set were performed to ensure robustness. Decision curve analysis was used to evaluate its clinical utility.</p><p><strong>Results: </strong>IPN occurred in 176 patients (176/3005, 5.9%). The final model included temperature, respiratory rate, plasma calcium ion concentration, serum urea nitrogen and serum glucose. The area under the receiver operating characteristics curve (AUC) was 0.85 (95% CI 0.81 to 0.89), outperforming widely used severity scoring systems. The model demonstrated robust performance on the internal validation cohort (mean AUC: 0.84) and external validation cohort (AUC: 0.82, 95% CI 0. 77 to 0.87).</p><p><strong>Conclusion: </strong>We developed a simple and robust model for predicting IPN in patients with AP, demonstrating strong predictive performance and clinical utility.</p>","PeriodicalId":72879,"journal":{"name":"eGastroenterology","volume":"2 4","pages":"e100095"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411980","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":"Drug-target Mendelian randomisation applied to metabolic dysfunction-associated steatotic liver disease: opportunities and challenges.","authors":"Shan Luo, Ming-Hua Zheng, Vincent Wai-Sun Wong, Shiu Lun Au Yeung","doi":"10.1136/egastro-2024-100114","DOIUrl":"10.1136/egastro-2024-100114","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most prevalent cause of chronic liver disease worldwide affecting over one-third of the adult population. Despite the recent evolution of new nomenclature and diagnostic criteria for MASLD, progress in drug development for this condition remains limited. This review highlights the potential of drug-target Mendelian randomisation (MR), a study design that leverages human genetics and genomics, for the discovery, repositioning and safety assessment of drug targets in MASLD. We summarised key aspects of designing and appraising a drug-target MR study, discussing its inherent assumptions and considerations for instrument selection. Furthermore, we presented real-world examples from studies in MASLD which focused on opportunities and challenges in identifying novel drug targets, repositing existing drug targets, informing adjunctive treatments and addressing issues in paediatric MASLD.</p>","PeriodicalId":72879,"journal":{"name":"eGastroenterology","volume":"2 4","pages":"e100114"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411979","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":"New dimension in viral hepatitis research.","authors":"Massimiliano Cocca, Barbara Testoni","doi":"10.1136/egastro-2024-100136","DOIUrl":"10.1136/egastro-2024-100136","url":null,"abstract":"<p><p>Chronic hepatitis B is the leading cause of hepatocellular carcinoma and a significant global health issue, affecting over 296 million people worldwide, with 15 million people coinfected with hepatitis delta virus (HDV) suffering accelerated disease progression. Recent advances in single-cell sequencing and spatial transcriptomics offer promising insights to improve the understanding of the liver's immune responses and hepatitis B virus (HBV)-infected cell distribution, with the final goal being the achievement of an HBV 'functional cure'. In this issue of <i>eGastroenterology</i>, Cross <i>et al</i> used the GeoMx nanostring digital spatial profiling (DSP) technology to study gene expression in the liver tissues of three patients (one HBV-monoinfected, one HBV/HDV coinfected and one HBV/human immunodeficiency virus (HIV) coinfected). Unlike other spatial transcriptomics techniques, GeoMx DSP allows targeted selection of specific tissue regions (regions of interest) for analysis, enabling precise gene expression mapping. The study revealed spatially distinct transcriptomic signatures related to immune features and viral burden, identifying a component of underinvestigated immune cells. Despite the small sample size, this proof-of-concept study demonstrates the feasibility of spatial transcriptomics in analysing HBV infections. Future advances, such as integrating viral proteins and nucleic acids, will enhance the understanding of spatial viral replication. Challenges in tissue processing, data analysis and costs remain before spatial transcriptomics can be applied as a diagnostic tool, but ongoing multiomics approaches offer promise for improved diagnosis and therapy.</p>","PeriodicalId":72879,"journal":{"name":"eGastroenterology","volume":"2 3","pages":"e100136"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411975","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":"Evidence-based incorporation of key parameters into MELD score for acute-on-chronic liver failure.","authors":"Xia Yu, Ruoqi Zhou, Wenting Tan, Xiaobo Wang, Xin Zheng, Yan Huang, Jinjun Chen, Beiling Li, Xinxin Liu, Zhiwei Li, Zhongji Meng, Yanhang Gao, Zhiping Qian, Feng Liu, Xiaobo Lu, Jia Shang, Huadong Yan, Yubao Zheng, Weituo Zhang, Shan Yin, Wenyi Gu, Guohong Deng, Xiaomei Xiang, Yi Zhou, Yixin Hou, Qun Zhang, Shue Xiong, Jing Liu, Ruochan Chen, Liyuan Long, Xiuhua Jiang, Sen Luo, Yuanyuan Chen, Chang Jiang, Jinming Zhao, Liujuan Ji, Xue Mei, Jing Li, Tao Li, Rongjiong Zheng, Xinyi Zhou, Qun Cai, Hai Li, Jifang Sheng, Yu Shi","doi":"10.1136/egastro-2024-100101","DOIUrl":"10.1136/egastro-2024-100101","url":null,"abstract":"<p><strong>Background: </strong>The model for end-stage liver disease (MELD) score is widely used for the prognostication in end-stage liver disease but has limited performance in acute-on-chronic liver failure (ACLF). In this study, we identified additional predictive parameters and reformed the MELD score to predict ACLF more accurately.</p><p><strong>Methods: </strong>A meta-analysis was performed on relevant studies to identify the predictive factors of 28-day/90-day outcomes of ACLF, which were validated in two large prospective cohorts. A prognostic score was developed by incorporating predictive parameters into the MELD score. The model was evaluated with a focus on discrimination and calibration.</p><p><strong>Results: </strong>The meta-analysis incorporated 32 cohort studies with a total of 13 939 patients, of which 13 risk factors were identified, and 3 risk factors (age, neutrophil count and hepatic encephalopathy (HE) grade) besides MELD score were validated in 751 patients with ACLF derived from two prospective cohorts. A new model (Chinese Acute-on-Chronic Liver Failure Consortium (CATCH-LIFE)-MELD score) was developed as follows: 0.028×age+0.3×HE grade+0.039×neutrophil count+0.079×MELD score. CATCH-LIFE-MELD score achieved a concordance index of 0.791/0.788 for 28-day/90-day outcomes, which is superior to other traditional scores. Other discrimination indices, including net reclassification improvement, integrated discrimination improvement and probability density function, and calibration including Nagelkerke's R² and Brier scores confirmed its superiority. Moreover, the accuracy of CATCH-LIFE-MELD score remained stable. It was highest in patients with or without hepatitis B virus infection, cirrhosis, liver failure or under the Chinese Group on the Study of Severe Hepatitis B (COSSH) criteria or European Association for the Study of the Liver (EASL) criteria. All results were substantiated by an evaluation using an external cohort.</p><p><strong>Conclusions: </strong>CATCH-LIFE-MELD score, a modified MELD score exhibited improved accuracy in predicting the short-term prognosis of ACLF than other traditional scores.</p>","PeriodicalId":72879,"journal":{"name":"eGastroenterology","volume":"2 3","pages":"e100101"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411974","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":"Lysosomal physiology and pancreatic lysosomal stress in diabetes mellitus.","authors":"Meihua Hao, Sara C Sebag, Qingwen Qian, Ling Yang","doi":"10.1136/egastro-2024-100096","DOIUrl":"10.1136/egastro-2024-100096","url":null,"abstract":"<p><p>Endocrine and exocrine functions of the pancreas control nutritional absorption, utilisation and systemic metabolic homeostasis. Under basal conditions, the lysosome is pivotal in regulating intracellular organelles and metabolite turnover. In response to acute or chronic stress, the lysosome senses metabolic flux and inflammatory challenges, thereby initiating the adaptive programme to re-establish cellular homeostasis. A growing body of evidence has demonstrated the pathophysiological relevance of the lysosomal stress response in metabolic diseases in diverse sets of tissues/organs, such as the liver and the heart. In this review, we discuss the pathological relevance of pancreatic lysosome stress in diabetes mellitus. We begin by summarising lysosomal biology, followed by exploring the immune and metabolic functions of lysosomes and finally discussing the interplay between lysosomal stress and the pathogenesis of pancreatic diseases. Ultimately, our review aims to enhance our understanding of lysosomal stress in disease pathogenesis, which could potentially lead to the discovery of innovative treatment methods for these conditions.</p>","PeriodicalId":72879,"journal":{"name":"eGastroenterology","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607719","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":"Cell-to-cell and organ-to-organ crosstalk in the pathogenesis of alcohol-associated liver disease.","authors":"Hui Gao, Yanchao Jiang, Ge Zeng, Nazmul Huda, Themis Thoudam, Zhihong Yang, Suthat Liangpunsakul, Jing Ma","doi":"10.1136/egastro-2024-100104","DOIUrl":"10.1136/egastro-2024-100104","url":null,"abstract":"<p><p>Alcohol-associated liver disease (ALD) is a growing global health concern and its prevalence and severity are increasing steadily. While bacterial endotoxin translocation into the portal circulation is a well-established key factor, recent evidence highlights the critical role of sterile inflammation, triggered by diverse stimuli, in alcohol-induced liver injury. This review provides a comprehensive analysis of the complex interactions within the hepatic microenvironment in ALD. It examines the contributions of both parenchymal cells, like hepatocytes, and non-parenchymal cells, such as hepatic stellate cells, Kupffer cells, neutrophils, and liver sinusoidal endothelial cells, in driving the progression of the disease. Additionally, we explored the involvement of key mediators, including cytokines, chemokines and inflammasomes, which regulate inflammatory responses and promote liver injury and fibrosis. A particular focus has been placed on extracellular vesicles (EVs) as essential mediators of intercellular communication both within and beyond the liver. These vesicles facilitate the transfer of signalling molecules, such as microRNAs and proteins, which modulate immune responses, fibrogenesis and lipid metabolism, thereby influencing disease progression. Moreover, we underscore the importance of organ-to-organ crosstalk, particularly in the gut-liver axis, where dysbiosis and increased intestinal permeability lead to microbial translocation, exacerbating hepatic inflammation. The adipose-liver axis is also highlighted, particularly the impact of adipokines and free fatty acids from adipose tissue on hepatic steatosis and inflammation in the context of alcohol consumption.</p>","PeriodicalId":72879,"journal":{"name":"eGastroenterology","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904275","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":"New therapeutic target for alcohol-associated hepatitis (AH): AH-associated IL-8⁺ neutrophils.","authors":"Yukun Guan, Dechun Feng, Luca Maccioni, Yang Wang, Bin Gao","doi":"10.1136/egastro-2024-100166","DOIUrl":"10.1136/egastro-2024-100166","url":null,"abstract":"","PeriodicalId":72879,"journal":{"name":"eGastroenterology","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916467","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}