Frontiers in gastroenterology (Lausanne, Switzerland)最新文献

{"title":"Parental and perinatal risk factors associated with onset of IBD: a systematic literature review and meta-analysis.","authors":"Kristian Paul Mallon, Ciara McBride, Colm Antoine O Morain, Glen A Doherty, Richeal Burns","doi":"10.3389/fgstr.2025.1621215","DOIUrl":"https://doi.org/10.3389/fgstr.2025.1621215","url":null,"abstract":"<p><strong>Introduction: </strong>There is accumulating evidence that certain perinatal and prenatal factors may contribute to the onset of IBD, however evidence on some risk factors is inconsistent. The present study seeks to extend current knowledge on these risk factors and provide a comprehensive overview of which factors are associated with IBD onset and their direction of effect.</p><p><strong>Methods: </strong>A Systematic review and meta-analysis of case-control, cohort studies and randomised controlled trials (RCTs) investigating the association between parental and perinatal factors and onset of IBD was conducted. Studies were included if they reported details on patients with a diagnosis of IBD (including Crohn's Disease [CD] and/or Ulcerative Colitis [UC]), defined and measured according to endoscopic, radiological, and histopathological findings, confirmed by a gastroenterologist or physician. Computerised bibliographic searches of Ovid MEDLINE, Web of Science, and the Cochrane Library were conducted from 01/01/2002 to the 01/01/2022. Where possible, summaries of the effects of perinatal and prenatal variables for each study were provided by calculating risk estimates using the DerSimonian and Laird random effects model. Levels of heterogeneity were evaluated using the I² statistic. Data were analysed using Stata version 17. Study protocol details are published on the International prospective register of systematic reviews (PROSPERO), registration number: CRD42022290798.</p><p><strong>Results: </strong>Fifteen eligible studies were identified, encompassing 9 case-control and 6 cohort studies, with no RCTs identified. A total of 6,507 patients with IBD were described in these studies (1,819 UC; 3,908 CD; 754 IBD; 4 IBD-unclassified patients). Three predictors of IBD risk were identified. Any poor maternal health or disease in mother during pregnancy (Pooled RR 1.78, 95% CI 1.24-2.31), maternal IBD (Pooled RR 4.59, 95% CI 1.68-7.50), and familial history (Pooled RR 2.87, 95% CI 1.80-3.93), were associated with an increased risk of overall IBD.</p><p><strong>Discussion: </strong>This systematic review and meta-analysis suggests parental and perinatal factors may have a role in the onset of IBD. These findings highlight the importance of early-life exposures for later IBD development and indicate a requirement for further research in this area.</p><p><strong>Systematic review registration: </strong>PROSPERO, identifier (CRD42022290798).</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"4 ","pages":"1621215"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446075","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":"Case Report: A novel approach to pseudoportomesenteric hypertension with refractory chylothorax and ascites.","authors":"Ahmet Sakiri, Annalise De Marco, Shreekar Patel, Naser Khan, Thayer Hamoudah, Altaf Dawood, Rajesh Kakarla","doi":"10.3389/fgstr.2025.1499385","DOIUrl":"https://doi.org/10.3389/fgstr.2025.1499385","url":null,"abstract":"<p><p>Pseudoportomesenteric hypertension (PPMH) is a rare form of non-cirrhotic portal hypertension caused by increased pressure in the portal and mesenteric venous systems. Unlike traditional portal hypertension, which arises from liver cirrhosis, PPMH stems from conditions that are extrahepatic in etiology, such as venous thrombosis, external compression by intra-abdominal masses, or congenital anomalies. Treatment is aimed at addressing the underlying cause of obstruction. We report a case of PPMH secondary to a pancreatic neuroendocrine tumor (PNET). A female in her 60s presented with a six-month history of diarrhea, 30-pound weight loss, and dyspnea. Initial evaluation revealed massive right pleural effusion with subtotal lung collapse, cardio-mediastinal shift, and sub-segmental pulmonary emboli. Additionally, she had extensive four-quadrant ascites and a heterogeneous mass at the pancreatic head and uncinate process encasing the superior mesenteric artery (SMA), with mass effect on the superior mesenteric vein (SMV). The patient developed refractory ascites and chylothorax, which were managed with a chest tube and abdominal drain placement. Retroperitoneal lymph node biopsy confirmed a well-differentiated grade 2 primary PNET. Following a multidisciplinary assessment, the patient underwent stent placement in the SMV. Initial trans-hepatic portal venography showed a portal vein pressure of 12 cm H2O and a significantly elevated SMV pressure of 32 cm H2O, indicating severe obstruction at the portal-mesenteric confluence. Extensive mesenteric collateralization and large duodenal and mesenteric varices were noted. Angioplasty and stenting of the SMV were performed, resulting in a 10 cm H2O reduction in the pressure gradient, improved antegrade hepatopetal flow, and resolution of varices. This case highlights the importance of recognizing extrahepatic causes of portal hypertension, particularly in patients with malignant tumors, and the role of palliative endovascular interventions in managing the sequelae of PPMH.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"4 ","pages":"1499385"},"PeriodicalIF":0.0,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446251","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":"Prevalence of celiac disease in a Tunisian cohort.","authors":"Mariam Ghozzi, Marco Kai, Tanja Seifert, Sarra Melayah, Fatma Mechi, Sarra Romdhani, Zeineb Ben Chedly, Ibtissem Ghedira","doi":"10.3389/fgstr.2025.1619533","DOIUrl":"https://doi.org/10.3389/fgstr.2025.1619533","url":null,"abstract":"<p><strong>Background: </strong>Accurate and non-invasive diagnostics of celiac disease are essential for effective patient management. Although small intestine biopsy remains the diagnostic gold standard, serological assays offer a promising alternative. This study evaluated the performance and concordance of immunoblot, indirect immunofluorescence test (IIFT), and enzyme-linked immunosorbent assay (ELISA) in detecting celiac disease-specific autoantibodies in a Tunisian cohort, aiming to assess the potential of combining various assays to reduce reliance on invasive procedures.</p><p><strong>Methods: </strong>Serum samples from 80 celiac disease patients and appropriate controls were analyzed using three serological methods. IIFT was employed to detect IgA autoantibodies against endomysium using primate liver and human umbilical cord substrates. ELISA was used to quantify anti-tissue transglutaminase (tTG) IgA and deamidated gliadin peptide (DGP) autoantibodies. Immunoblots assessed additional autoantibodies (tTG, GAF-3X, and ASCA), along with further evaluation of IgG autoantibodies (intrinsic factor and parietal cell antibodies). Concordance among methods was evaluated.</p><p><strong>Results: </strong>IIFT detected anti-endomysium IgA autoantibodies in 100% (80/80) of celiac patients (in this cohort), with no positivity in controls. ELISA demonstrated that both tTG IgA and DGP autoantibodies were present in all celiac disease patients. All controls (n = 158) were ELISA-negative, indicating 100% specificity in both assays. Immunoblots revealed tTG IgA in 99% (79/80) of patients, while GAF-3X autoantibodies were detected in 94% (IgA) and 85% (IgG) of celiac patients. In addition, ASCA IgA autoantibodies were present in 31% of celiac disease patients, with minimal reactivity observed in controls. A Venn diagram illustrated high concordance among the assays for tTG autoantibody detection, reinforcing the reliability of this autoantibody marker.</p><p><strong>Conclusion: </strong>The robust and consistent detection of celiac disease-specific autoantibodies, particularly tTG IgA and DGP autoantibodies, across multiple serological platforms underscores their diagnostic utility. The high concordance among these markers supports the potential of combined autoantibody testing to serve as a non-invasive alternative to biopsy, thereby enhancing clinical management of celiac disease.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"4 ","pages":"1619533"},"PeriodicalIF":0.0,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446199","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":"Bioinformatic analysis of the potential common pathogenic mechanisms for gastric precancerous lesions and <i>Helicobacter pylori</i>.","authors":"Liufeng Yi, Tiantong Jiang, Siyu Tao, Nachuan Li, Yuan Ding, Meng Li, Shaoli Wang, Zhen Liu","doi":"10.3389/fgstr.2025.1598916","DOIUrl":"https://doi.org/10.3389/fgstr.2025.1598916","url":null,"abstract":"<p><strong>Objective: </strong>Gastric precancerous lesions (GPL) represent a critical stage in the progression from gastritis to gastric cancer (GC). Helicobacter pylori (H. pylori) infection is a significant etiological factor exacerbating the inflammatory-cancerous transformation. The host immune status is a central regulatory mechanism for GPL, while persistent H. pylori infection drives changes in the immune microenvironment (IME). However, the potential pathological link between GPL and H. pylori remains unclear. This study aims to identify common differentially expressed genes (DEGs) between GPL and H. pylori using bioinformatics analysis, thereby elucidating their shared pathogenic mechanisms.</p><p><strong>Methods: </strong>DEGs were extracted from GPL datasets (GSE87666) and H. pylori datasets (GSE60427) sourced from the Gene Expression Omnibus (GEO) database through GEO2R and R software. Protein-protein interaction (PPI) networks were generated using the STRING database and analyzed with Cytoscape software to identify hub genes. The diagnostic value of these hub genes was evaluated through Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) analysis, validated with datasets GSE130823, GSE60662, and GSE5081. Immune infiltration analysis of key genes was conducted using the CIBERSORT algorithm and ssGSEA. Gene mutation analysis was carried out using the cBioPortal database, and small molecule drugs were detected using the Connectivity Map (CMap) database.</p><p><strong>Results: </strong>The analysis revealed 189 DEGs. Functional enrichment analysis highlighted pathways related to immune system regulation, leukocyte migration and chemotaxis, cytokine-cytokine receptor interaction, and chemokine signaling. Seven hub genes were identified: IL6, FCGR3A, CCL3, CXCR4, CXCL9, CCL4, and CCR1. High AUC values for these hub genes indicated their potential for predicting disease occurrence.</p><p><strong>Conclusions: </strong>This research identified seven hub genes closely related to GPL and H. pylori, elucidating potential mechanisms of disease progression, particularly emphasizing the roles of the IME and chemokine activity. These findings may provide insights for identifying disease biomarkers, inhibiting the \"inflammation-cancer\" transformation, and preventing GC. Furthermore, the targets and molecular mechanisms identified in this study require further experimental validation to confirm their therapeutic potential.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"4 ","pages":"1598916"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446189","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":"Faecal immunochemical test to triage patients with possible colorectal cancer symptoms: insights from the New Zealand FIT for symptomatic pilot.","authors":"Kai Sheng Saw, Lu-Ana Ngatai, Cathy Whiteside, Susan Parry, Ian Bissett","doi":"10.3389/fgstr.2025.1622258","DOIUrl":"https://doi.org/10.3389/fgstr.2025.1622258","url":null,"abstract":"<p><strong>Background: </strong>The New Zealand (NZ) FIT for Symptomatic Pilot (FSP) aimed to determine the feasibility of using faecal immunochemical test (FIT) as a triaging tool to assess patients presenting with symptoms suspicious for colorectal cancer (CRC).</p><p><strong>Methods: </strong>This is a double-blinded diagnostic accuracy study conducted in two Health NZ Districts from July 2022 to January 2024. Consecutive adult patients referred with symptoms of suspected CRC, who were triaged for colonoscopy by endoscopists, were invited to perform a quantitative FIT. The diagnostic performance of FIT for CRC was assessed.</p><p><strong>Results: </strong>Valid FIT results were returned by 1,158 (82%) of 1,413 eligible patients; 1,043 were included in the diagnostic accuracy analysis. At low (\"rule-out\") faecal haemoglobin (f-Hb) thresholds, the sensitivity and specificity for CRC were 93.8% (CI 79.2-99.2) and 75.9% (CI 73.1-78.5) for f-Hb ≥4 μg/g and 90.6% (CI 75.0-98.0) and 83.1% (CI 80.6-85.4) for f-Hb ≥10 μg/g. At a higher (\"rule-in\") f-Hb threshold of ≥150 μg/g, the sensitivity and specificity for CRC were 78.1% (CI 60.0-90.7) and 95.9% (CI 94.4-97.0). The prevalence of CRC was 3.1%. At the lower limit of f-Hb detection, 73.7% of symptomatic patients had a negative FIT.</p><p><strong>Conclusion: </strong>FSP demonstrated that FIT identified both a small group of symptomatic patients with a high risk of undiagnosed CRC for urgent investigation and the majority of symptomatic patients with a very low f-Hb who could avoid colonoscopy. Using FIT in this setting should protect patients from unnecessary colonoscopy, diagnose CRC earlier, and optimise colonoscopy utilisation.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"4 ","pages":"1622258"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446069","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":"A case report of adult congenital intestinal malrotation.","authors":"Yu Gao, Xiaobiao Song, Qiang Song","doi":"10.3389/fgstr.2025.1643128","DOIUrl":"https://doi.org/10.3389/fgstr.2025.1643128","url":null,"abstract":"<p><p>Congenital intestinal malrotation is a rare congenital digestive tract anomaly, primarily due to the failure of the intestines to rotate and fix properly within the peritoneal cavity during fetal development. This abnormality can lead to severe complications such as intestinal volvulus, intestinal obstruction, and even intestinal necrosis. Although the condition is more commonly seen in neonates, cases in adults have also been reported, often with delayed diagnosis due to atypical symptoms. In this article, we will discuss the diagnosis and treatment of congenital intestinal malrotation in adults.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"4 ","pages":"1643128"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446174","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":"Improving ¹³C-urea breath test performance metrics for diagnosis of <i>Helicobacter pylori</i> infection.","authors":"Paula Mantero, Germán Rodolfo Flekenstein, Mariana Andrea Janjetic, Julián Andrés Fuda, Horacio Emilio Torti, Gustavo Cernadas, Marcela Beatriz Zubillaga, Cinthia Gabriela Goldman","doi":"10.3389/fgstr.2025.1634183","DOIUrl":"https://doi.org/10.3389/fgstr.2025.1634183","url":null,"abstract":"<p><p>The ¹³C-Urea Breath Test (¹³C-UBT) is a popular, non-invasive method used for the diagnosis of <i>Helicobacter pylori</i> infection. This work evaluates its performance for the initial diagnosis and post-treatment follow-up in dyspeptic adults from Buenos Aires, Argentina. We retrospectively analyzed data from two earlier studies, which evaluated <i>H. pylori</i> infection using ¹³C-UBT and histology of gastric biopsies. Additionally, we assessed the ¹³C-UBT performance against the concordant results of both histology and PCR in a subsample with available data. The ¹³C-UBT was performed using a commercial kit, with isotope-ratio-mass-spectrometry (IRMS) as the measurement technique. Results from 154 volunteers were evaluated to assess the performance of ¹³C-UBT for the initial diagnosis of <i>H. pylori</i> infection, with histological evaluation as the reference method. For a cut-off value set at 3.5‰, sensitivity was 93.0%, specificity was 95.6%, accuracy was 94.2%, positive predictive value (PPV) was 96.4% and negative predictive value (NPV) was 91.5%. The subsample analysis of ¹³C-UBT vs. histology and PCR showed improved results: sensitivity 98.8%, specificity 98.3%, accuracy 98.6%, PPV 98.8% and NPV 98.3%. In contrast, ¹³C-UBT performance for confirming <i>H. pylori</i> eradication was studied in 46 patients, showing a sensitivity of 94.4%, specificity 100.0%, accuracy 97.8%, PPV 100.0% and NPV 96.6%. The analysis of sensitivity, specificity and accuracy as a function of the cut-off revealed that the optimal value could be lowered to 3.0‰ in our laboratory. These results demonstrate that the ¹³C-UBT is a non-invasive, highly accurate method for both the initial and post-treatment diagnosis of <i>H. pylori</i> infection.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"4 ","pages":"1634183"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446120","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 IBD-disk accurately assesses disability and psychological burden at IBD diagnosis and predicts adverse outcomes in both UC and Crohn's disease during the first year of treatment: a prospective observational cohort study.","authors":"Peter Rimmer, Viorelia Stoica, Maryam Ibrahim, Asima Javed, Karl Hazel, Michael Owusu, Daniel Regan-Komito, Rachel Cooney, Asif J Iqbal, Iain Chapple, Philip Harvey, Tariq H Iqbal","doi":"10.3389/fgstr.2025.1642061","DOIUrl":"https://doi.org/10.3389/fgstr.2025.1642061","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is linked with increased prevalence of mental health disorders (MHD), particularly anxiety and depression. How this influences treatment outcomes in the first year after diagnosis is poorly studied. The IBD disk is a patient-reported outcome measure that quantifies disease-associated disability. Our objectives were to determine if the disk can identify those at risk of adverse treatment outcomes during the first year after diagnosis and assess if it could accurately screen for significant mental health symptoms at IBD presentation.</p><p><strong>Materials and methods: </strong>Patients with suspected IBD were seen in a rapid-access clinic. An IBD disk was completed upon first review, pre-diagnosis. A subgroup simultaneously completed the Hospital Anxiety and Depression scale (HADS). Repeat disks were completed after diagnosis, with 12-month outcomes collected prospectively.</p><p><strong>Results: </strong>188 patients completed a baseline IBD disk (97 Crohn's disease [CD], 91 Ulcerative colitis [UC]), 95 completed a simultaneous HADS and 82 completed a repeat disk after diagnosis and treatment. Pre-existing MHD were more frequent in CD. Pre-diagnosis, the IBD Disk 'Emotions' domain correlated with HADS depression (r_s=0.607 p<.001), anxiety (r_s=0.586 p<.001) and reliably identified HADS defined moderate-severe depression (Area under the curve [AUC] 0.873, 95% CI 0.804 - 0.942). An 'Emotions' domain score ≥7 identified all patients meeting this HADS threshold (Sensitivity 100%, specificity 60.5%, Youden's index 0.601). The strength of discrimination fell post diagnosis (AUC 0.712, 95% CI 0.491 - 0.932), with ongoing high 'Emotions' domain scores strongly linked to disease activity in both CD and UC. Elevated baseline disk scores in UC predicted the subsequent need for advanced therapies (p=0.019), persistent active disease at 12 months (p=0.023) and need for inpatient treatment (p<.001). In CD, elevated disk scores predicted need for advanced therapies (p=0.014) and persistent active disease (p=0.015), though an association with the need for surgical resection within 12 months was not statistically significant (p=0.064).</p><p><strong>Conclusions: </strong>The IBD disk reliably screens for symptoms of depression and anxiety and identifies risk of adverse treatment outcomes at IBD presentation. Particularly in UC, higher disk scores at diagnosis could complement existing tools to better identify those who would benefit from early treatment escalation.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"4 ","pages":"1642061"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446177","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":"Alterations in serum and intestinal ACE2 in Inflammatory Bowel Disease and the impact of inflammation.","authors":"Fiona Jones, Ciara Egan, Miriam Tosetto, Moritz Strowitzki, Sarah J Kierans, Catherine Rowan, Margaret Walshe, Elizabeth Ryan, Juliette Sheridan, Garret Cullen, Hugh Mulcahy, Sean Martin, Maura Cotter, Cormac T Taylor, Glen A Doherty","doi":"10.3389/fgstr.2025.1590646","DOIUrl":"https://doi.org/10.3389/fgstr.2025.1590646","url":null,"abstract":"<p><strong>Background/aims: </strong>ACE2 is highly expressed in the gut and with known alterations in expression in IBD patients potentially linked to gut inflammation and fibrosis. In addition, little is known about the role of serum soluble ACE2 (sACE2) or its hypothetical role in SARS-CoV-2 binding. We sought to evaluate tissue and serum ACE2 profiles in IBD and healthy controls and evaluate alterations related to disease activity and medical therapy.</p><p><strong>Methods: </strong>Circulating sACE2 and intestinal tissue ACE2 was evaluated respectively in serum samples and endoscopic biopsies from patients with IBD and healthy controls in addition to murine DSS induced colitis.</p><p><strong>Results: </strong>91 IBD (UC/n=41; CD n=50) and 55 controls were analyzed. Immunohistochemical ACE2 staining in controls was limited to brush border expression with markedly increased colonic ACE2 expression (and reduced ileal ACE2 expression) in IBD. This was not observed in the mouse model which demonstrated positive ileal ACE2 and negative colonic staining in healthy and DSS mice. Colonic ACE2 staining was further increased in Ulcerative Colitis in inflammation (% staining, 20(5-30) vs. 5(0-6.5), p<0.015) and in IBD patients receiving corticosteroids (% staining, 20(20-40) vs 10(0-20), p<0.052). Steroid use was associated with significantly lower sACE2 with a trend towards reduced sACE2 with biologic exposure.</p><p><strong>Conclusion: </strong>We observe significant increases in colonic ACE2 expression in IBD, especially with active colitis. Corticosteroids further modify the observed imbalance between tissue and serum ACE2 levels.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"4 ","pages":"1590646"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446230","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":"Active disease and its associated factors among patients with inflammatory bowel disease in Addis Ababa, Ethiopia: a hospital-based cross-sectional study.","authors":"Zinabu Desalegn, Abate Bane, Guda Merdassa, Amanuel Arota","doi":"10.3389/fgstr.2025.1569933","DOIUrl":"https://doi.org/10.3389/fgstr.2025.1569933","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory bowel disease (IBD) is a chronic inflammatory condition affecting the gastrointestinal tract, primarily classified into Crohn's disease (CD) and ulcerative colitis (UC), with some cases falling into the indeterminate or unclassified category. A significant number of individuals with IBD may present with active disease, which contributes substantially to complications. Therefore, early detection of patients with clinically active disease is essential for timely referral and appropriate management to prevent related complications. This study aimed to assess the prevalence of active disease and its associated factors among patients with IBD.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted at Tikur Anbessa Specialized Hospital and Adera Medical and Surgical Center, Addis Ababa, Ethiopia, in 2024. A total of 252 patients with IBD were selected using a consecutive recruitment technique. Data were collected from medical records and patient interviews using a structured questionnaire. Bivariate logistic regression was performed, followed by multivariable analysis to examine the association between the outcome and predictor variables. Variables with a p-value ≤ 0.25 in the bivariate analysis were included in the multivariable model. A p-value < 0.05 was considered statistically significant.</p><p><strong>Result: </strong>A total of 242 individuals participated in the study, yielding a response rate of 96.03%. More than one-third, 82 (33.88%), of the patients had active disease at the time of inclusion. The majority of IBD patients, 190 (78.51%), were diagnosed with CD. Patients with a monthly income between 500-1000 Ethiopian Birr (ETB) had an approximately 80% lower risk of active disease compared to those with an income of less than 500 ETB (AOR = 0.20; 95% CI: 0.05-0.79). Patients identified as being at high risk for malnutrition based on the Malnutrition Universal Screening Tool (MUST) score had about four times higher risk of active disease compared to those at low risk (AOR = 4.30; 95% CI: 1.69-10.91).</p><p><strong>Conclusion: </strong>One in every three IBD patients had active disease. MUST score and income level were found to be significant predictors of disease activity. Targeted interventions addressing nutritional, clinical, and socioeconomic determinants of IBD outcomes should be implemented.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"4 ","pages":"1569933"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446224","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}