Frontiers in gastroenterology (Lausanne, Switzerland)最新文献

{"title":"Endoscopy in surgery.","authors":"María Rita Rodríguez-Luna, Silvana Perretta","doi":"10.3389/fgstr.2023.1186945","DOIUrl":"https://doi.org/10.3389/fgstr.2023.1186945","url":null,"abstract":"<p><p>The expanding role of flexible endoscopy (FE) has helped to establish better diagnostic strategies and fewer invasive therapies within the lumen of the gastrointestinal (GI) tract. Endoscopic skills represent critical tools for surgeons since they markedly impact perioperative outcomes. Although it is widely recognized that endoscopy plays a key role in digestive surgery, endoscopic curricula and syllabi may vary depending on geographical regions, which have their own standardized guidelines such as the United States and countries with numerous disparities such as Western Europe. Such heterogeneous practices represent a call for action, particularly as surgical societies aim to expand cutting-edge endoscopy within surgery. This article outlines the crucial role of intraoperative endoscopy in commonly performed digestive surgeries and stresses the need to develop standardized endoscopic training curricula in surgery, particularly in Europe.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"2 ","pages":"1186945"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446094","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 safety and efficacy of endoscopic ultrasound-guided portal pressure gradient measurement with concomitant endoscopic ultrasound-guided liver biopsy: a systematic review.","authors":"Alexander Malik, Muhammad Nadeem Yousaf, Ghassan M Hammoud","doi":"10.3389/fgstr.2023.1209539","DOIUrl":"https://doi.org/10.3389/fgstr.2023.1209539","url":null,"abstract":"<p><strong>Introduction: </strong>Portal hypertension (PH) is a complication of advanced liver disease. Traditionally, PH has been quantified using hepatic venous pressure gradient (HVPG) through an indirect transjugular approach requiring ionizing radiation exposure. Endoscopic ultrasound-guided porto-systemic pressure gradient (EUS-PPG) measurement is an emerging alternative, minimally invasive technique that provides direct portal pressure measurement. The aim of this systematic review is to evaluate the safety and efficacy of EUS-PPG measurement and concomitant EUS-guided liver biopsy (EUS-LB) in patients with chronic liver disease.</p><p><strong>Methods: </strong>The preferred reporting items for systematic reviews and meta-analyses method was used. A PubMed, Medline, Web of Science, Google Scholar, and CINAHL search for terms \"endoscopic ultrasound,\" \"EUS,\" and \"portal pressure gradient\" was used to identify qualifying studies. Eligible studies included those which were published before 2022, reporting outcomes of EUS-PPG measurement, simultaneous EUS-LB if applicable, and adverse events rate. Risk of bias was assessed by Egger's test. Results were synthesized using I² to test heterogeneity.</p><p><strong>Results: </strong>Four published studies including 147 patients met inclusion criteria, with mean age 59.6 years, 59% male. Indications for EUS-PPG measurement were history of chronic liver disease or suspected cirrhosis, viral hepatitis, alcohol associated liver disease, hepatic sinusoidal obstruction or Budd Chiari syndrome. The pooled technical success rate of EUS-PPG measurements was 98.61% with 95% confidence interval of 95.20% - 99.82%. A 25-gauge needle was used in 92% (135/147) of patients. EUS-PPG measurement was performed through a transgastric approach in all 147 (100%) patients using a compact manometer with pressure transducer and non-compressible tubing. The mean PPG was 10.07 (range 6.44 - 13.70) mmHg. Ninety-five patients underwent simultaneous EUS-LB using 19G needle with wet suction technique. Technical success rate of EUS-LB was 100% and specimen was adequate in 99% (94/95) patients to establish histological diagnosis. There were no major life-threatening complications of the EUS-PPG procedure. Predominant adverse events were abdominal pain 6.1% (9/147) and sore throat 5.4% (8/147).</p><p><strong>Conclusion: </strong>EUS-PPG measurement is safe and useful in providing an assessment of portal pressure in patients with chronic liver disease. Future studies are needed to evaluate whether there is consistent correlation between EUS-PPG measurements and histologic fibrosis stage by liver biopsy.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"2 ","pages":"1209539"},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446068","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":"Advances in colon capsule endoscopy: a review of current applications and challenges.","authors":"E Gibbons, O B Kelly, B Hall","doi":"10.3389/fgstr.2023.1316334","DOIUrl":"https://doi.org/10.3389/fgstr.2023.1316334","url":null,"abstract":"<p><p>Colon capsule endoscopy (CCE) has been demonstrated to be comparable to traditional colonoscopy and better than CT colonography (CTC) for the detection of colonic pathology. It has been shown to have a high incremental yield after incomplete colonoscopy. It is a safe test with good patient acceptability. Challenges currently include great variability in completion rates and high rates of re-investigation. In this review, we will discuss the evidence to date regarding CCE in symptomatic and surveillance populations, and in those post incomplete colonoscopy. We will discuss current challenges faced by CCE and areas for further research.</p>","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"2 ","pages":"1316334"},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446071","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":"Editorial: Exploring the interplay between clinical and non-clinical outcomes for children and adults with inflammatory bowel disease.","authors":"Angharad Vernon-Roberts, Tiffany Taft, Taryn Lores, Jospeh Meredith, Christian P Selinger","doi":"10.3389/fgstr.2023.1311951","DOIUrl":"https://doi.org/10.3389/fgstr.2023.1311951","url":null,"abstract":"","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"2 ","pages":"1311951"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446092","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":"Current status and clinical applications of tissue engineering of the gastrointestinal tract: a systematized narrative review","authors":"Yilin Liu, Lynn Chong, Matthew Read","doi":"10.3389/fgstr.2023.1277094","DOIUrl":"https://doi.org/10.3389/fgstr.2023.1277094","url":null,"abstract":"Background Since the advent of regenerative medicine, tissue engineering of the gastrointestinal tract (GIT) has been extensively studied in laboratory animals and humans. Various biologic scaffolds and cell sources have been trialed to repair or reconstruct different GIT defects. Achievements in this field have led to novel approaches in curing GIT diseases and circumventing the morbidity-related complications associated with current therapy. Objective This review aims to describe recent advances in GIT tissue engineering, with an emphasis on technologies with potential for clinical use. Methods A literature search was conducted in Ovid MEDLINE ® ALL for relevant studies (2000–September 2023) using the keywords “tissue-engineering”, “scaffolds”, “organoids”, “cell-therapy”, “esophagus”, “stomach”, “small intestine”, “colon”, “rectum”, and “anus”. Articles were included if they were in vivo animal studies or clinical studies written in English that investigated tissue engineering for treating GIT defects. Results A total of 836 articles were identified in the initial search. Following duplicate removal, abstract, and full-text screening, 48 articles were included in the final review. Many studies on esophageal defects thus far have described the success of covering partial-thickness defects with autologous cell sheets and closing full-thickness defects with decellularized scaffolds in both animals and humans. A limited number of reports have also demonstrated the de novo organogenesis of the esophagus to repair short-segment circumferential esophageal defects with autologous pluripotent cells and scaffolds. In the stomach, multiple animal studies have reported on the feasibility of gastric epithelium regeneration using multipotent cells and/or scaffolds to correct partial- and full-thickness defects. One study observed the regeneration of whole-layer stomach defects using the organoids-on-polymer approach. Similarly, in the intestine, pluripotent cells and scaffolds were shown to effectively repair both partial- and full-thickness defects. Animal experiments have produced tissue-engineered small intestines (TESI) with the organoids-on-polymer approach. Furthermore, in the rectum and anus, mesenchymal stem cell therapies with or without bioscaffolds have shown promise for treating full-thickness defects, as demonstrated in multiple human trials. Conclusion Tissue-engineering approaches for repairing various types of GI defects in the esophagus, stomach, intestines, rectum, and anus have been extensively explored in animal models, with promising outcomes. Moreover, successful human trials have demonstrated the feasibility of reconstructing esophageal, rectal, and anal defects using these innovative approaches. Technologies such as mesenchymal stem cells, decellularization, organoids, and cell sheets are the most promising and closer to clinical translation. Collaboration between gastrointestinal surgery and regenerative medicine is expected to brin","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"8 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135479719","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":"Fecal microbiota transplantation—could stool donors’ and receptors’ diet be the key to future success?","authors":"Rita Silva, Liliana Dinis, Arnau Peris, Luís Novais, Conceição Calhau, Diogo Pestana, Cláudia Marques","doi":"10.3389/fgstr.2023.1270899","DOIUrl":"https://doi.org/10.3389/fgstr.2023.1270899","url":null,"abstract":"Fecal microbiota transplantation (FMT) is indicated in many countries for patients with multiple recurrences of Clostridioides difficile infection (CDI) for whom appropriate antibiotic treatments have failed. Donor selection is a demanding and rigorous process in view of the implementation of FMT programs worldwide. One of the most noteworthy factors that has been shown to affect FMT outcomes is the microbial diversity of the stool donor. A detailed assessment of the donor’s microbiota is crucial, as the microbiota is complex, dynamic, and resilient, and a healthy microbiota has several dimensions in addition to the absence of pathogens. Diet is one of the most important factors that modulates the composition and function of the gut microbiome (GM) and has a critical role in orchestrating the host–microbiota crosstalk throughout life. The diversity of the human GM seems to be related to variations in dietary patterns. Currently, the dietary patterns of stool donors and receptors are not taken into consideration in any way for FMT. In this study, we reflect on the importance of including this type of assessment in the stool donor screening process and knowing the impact of diet on the GM, as well as the importance of monitoring receptors’ diet to ensure the engraftment of the transplanted microbiota.","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"12 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135270666","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":"Editorial: Benefiting from microbes: challenges in getting the 'pros' and avoiding the 'cons'.","authors":"Santanu Chattopadhyay, Gopal Murugaiyan, Neerja Hajela, Balakrishnan Siddartha Ramakrishna","doi":"10.3389/fgstr.2023.1293448","DOIUrl":"https://doi.org/10.3389/fgstr.2023.1293448","url":null,"abstract":"","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"2 ","pages":"1293448"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446103","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":"X-ray phase-contrast 3D virtual histology characterises complex tissue architecture in colorectal cancer","authors":"Angelika Svetlove, Titus Griebel, Jonas Albers, Lorenzo D’Amico, Philipp Nolte, Giuliana Tromba, Hanibal Bohnenberger, Frauke Alves, Christian Dullin","doi":"10.3389/fgstr.2023.1283052","DOIUrl":"https://doi.org/10.3389/fgstr.2023.1283052","url":null,"abstract":"Precise morphological analysis of tumour tissue samples is crucial for accurate diagnosis and staging of colorectal cancer (CRC), but remains limited by the 2D nature of conventional histology. Our aim is to offer a 3D representation of tissue samples by means of X-ray-based imaging to facilitate the evaluation of clinically relevant features in cancer tissue, a process that is currently subject to various restrictions. In this study, we show that propagation-based synchrotron radiation-based free propagation phase-contrast microcomputed tomography (SRµCT) is suitable for the generation of 3D tumour volumes with 2-µm voxel size using standard formalin-fixed, paraffin-embedded tissue from CRC patients and provides sufficient contrast for virtual histology. We demonstrate that, using an existing registration pipeline, a 2D histologic haematoxylin–eosin slice can be placed in the context of the 3D µCT volume. The precisely registered histologic section can then be used as a “seed point” for the segmentation and depiction of major histologic features. This approach allows for a more comprehensive understanding of the organisation of the tumour in space with respect to other structures such as vessels, fat, and lymph nodes, and has the potential to improve patients’ prognostic outcomes.","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"40 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135316480","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":"Adalimumab biosimilar ABP 501 is equally effective and safe in long-term management of inflammatory bowel diseases patients when used as first biologic treatment or as replace of the ADA originator for a non-medical reason","authors":"Giammarco Mocci, Arianna Cingolani, Giorgia Orrù, Carla Felice, Francesca Maria Onidi, Gianmarco Lombardi, Davide Checchin, Raffaele Colucci, Laurino Grossi, Antonio Ferronato, Chiara Rocchi, Marta Ascolani, Paolo Usai Satta, Lucia Fanini, Stefano Pilati, Antonio Tursi","doi":"10.3389/fgstr.2023.1218228","DOIUrl":"https://doi.org/10.3389/fgstr.2023.1218228","url":null,"abstract":"Objective Biosimilars represent a new opportunity for inflammatory bowel disease (IBD) treatment and economic sustainability of therapies. This study aimed to evaluate the efficacy and long-term safety of the adalimumab biosimilar ABP 501 in biologic-naïve vs. biologic-switched IBD patients. Methods A retrospective observational study was conducted using a database of patients with IBD treated with ABP 501, biologic-naïve or switched from the original, at eight IBD centers. We included adult patients with at least one year of follow-up. The primary objective of this study was to assess the efficacy (persistence) and safety (adverse event rate) of ABP 501 therapy. Results A total of 118 patients with IBD were included in the analysis: 84 patients with Crohn’s disease (CD) (39 women, 45 men, mean age 40.4 ± 14.3 years; 33% biologic-naïve) and 34 patients with ulcerative Colitis (UC) (16 women, 18 men, mean age 38.9 ± 14.9 years; 61.8% biologic-naïve). Regarding the primary endpoint, no difference was observed in the efficacy between biologic-naïve patients and patients with Adalimumab (ADA) originator replacement for non-medical reasons in terms of long-term persistence. However, ABP 501 showed a higher percentage of sustained clinical remission at 2 years in patients with CD (64 patients, 77%) than in those with UC (15 patients, 45.5%; p=0.00091). Nine patients (six with CD and three with UC) experienced adverse events that led to drug discontinuation in three. Conclusions APB 501 showed a good safety and efficacy profile in maintaining clinical response at 2 years in patients with IBD, both as a treatment-naïve and as a replacement for ADA originator for non-medical reasons.","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135366219","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":"A blood-based transcriptomic signature stratifies severe Crohn’s disease and defines potentially targetable therapeutic pathways","authors":"Rivkah Gonsky, Evan Adams, Alka A. Potdar, Gregory Botwin, Eva Biener-Ramanujan, Dermot P. B. McGovern, Jonathan G. Braun, Phillip Fleshner, Stephan R. Targan","doi":"10.3389/fgstr.2023.1251133","DOIUrl":"https://doi.org/10.3389/fgstr.2023.1251133","url":null,"abstract":"Introduction Despite advances in medical therapy, many patients with Crohn’s disease (CD) ultimately require surgery for disease management. Identifying the underlying molecular pathways for subgroup stratification is critical to the improvement of prognostics and therapeutics and to biomarker discovery. Methods We purified CD3 + T cells from the paired blood and mucosa samples of 100 CD and 17 non-inflammatory bowel disease (IBD) subjects requiring surgery. Longitudinal samples ( n = 49) were collected 4–13 months postoperatively. Results Transcriptional profiling at the time of surgery revealed two CD patient subgroups: the CD-PBT subgroup, which was clustered tightly with non-IBD subjects, and the CD-PBmu(cosal) subgroup, which shifted from peripheral toward a mucosal-like expression profile. The CD-PBmu subgroup was characterized by differential gene expression, elevated genetic transcriptional risk score (TRS), and a distinct T-cell subset composition associated with perianal-penetrating/stricturing disease, post-surgical recurrence, and immunoreactivity to multiple microbial antigens. CD-PBmu subtyping was validated in a CD cohort in whom anti-TNF therapy had been unsuccessful. The CD-PBmu subgroup, in contrast to the CD-PBT subgroup, was distinguished by decreased pro-inflammatory cytokine/chemokine and adhesion molecule expression postoperatively. For clinical translation, we identified a CD-PBmu 42-gene classifier associated with a TRS signature, clinical severity markers, and underlying protein kinase signaling pathways to identify therapeutic targets. Discussion The CD-PBmu signature holds potential for future investigation to improve accuracy in identifying a subset of patients with severe CD who may benefit from early initiation of therapeutics to defined molecular pathways.","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135884902","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}