Gastro hep advances最新文献

{"title":"Prevalence, Genetic Risks, and Cardiovascular Outcomes of Metabolic and Alcohol-Associated Liver Disease in a Longitudinal Multiethnic US Cohort","authors":"Jie Yao , Xiuqing Guo , Jingyi Tan , Callie Zaborenko , Jerome I. Rotter , Naga P. Chalasani","doi":"10.1016/j.gastha.2026.100960","DOIUrl":"10.1016/j.gastha.2026.100960","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 7","pages":"Article 100960"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147993931","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":"Endoscopic Ultrasound–Directed Transgastric Fine-Needle Aspiration in Diagnosis of Pancreatic Head Mass","authors":"Luke Durbin,&nbsp;Reem Al Shabeeb,&nbsp;William Abel,&nbsp;Abbinaya Elangovan,&nbsp;Patrick Okolo,&nbsp;Paul Yeaton,&nbsp;Varun Kesar,&nbsp;Vivek Kesar","doi":"10.1016/j.gastha.2025.100864","DOIUrl":"10.1016/j.gastha.2025.100864","url":null,"abstract":"<div><div>Renal cell carcinoma is an aggressive malignancy, with distant metastases often diagnosed many years following radical nephrectomy. We describe a case of pancreatic metastasis in a patient with prior renal cell carcinoma and history of Roux-en-Y gastric bypass, diagnosed using endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP) procedure. Our case demonstrates the utility of endoscopic ultrasound–directed transgastric ERCP to both diagnose and manage treatment of malignancy in patients with altered anatomy, as a minimally invasive alternative to ERCP.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 3","pages":"Article 100864"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038872","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":"Outcome-Specific Cardiovascular and Hypertensive Risk Profiles in Metabolic Dysfunction-Associated Steatotic Liver Disease: Insights From a Competing Risk Cohort Analysis","authors":"Masashi Hirooka ,&nbsp;Teruki Miyake ,&nbsp;Ryo Yano ,&nbsp;Yoshiko Nakamura ,&nbsp;Yuki Okazaki ,&nbsp;Toyoki Shimamoto ,&nbsp;Atsushi Yukimoto ,&nbsp;Yasunori Yamamoto ,&nbsp;Takao Watanabe ,&nbsp;Osamu Yoshida ,&nbsp;Kana Hirooka ,&nbsp;Yoshio Tokumoto ,&nbsp;Masanori Abe ,&nbsp;Takeru Iwata ,&nbsp;Yoichi Hiasa","doi":"10.1016/j.gastha.2025.100806","DOIUrl":"10.1016/j.gastha.2025.100806","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Metabolic dysfunction–associated steatotic liver disease (MASLD) is a cardiovascular risk factor affecting one in four adults globally. However, it remains unclear whether MASLD uniformly elevates risk across cardiometabolic outcomes. We investigated the outcome-specific associations of MASLD, incident cardiovascular disease (CVD), and hypertension (HTN) in a large Asian cohort.</div></div><div><h3>Methods</h3><div>We analyzed 24,384 adults (median age 51.4 years; 51.2% women) enrolled in a retrospective Japanese health-screening program (2007–2022). MASLD was diagnosed based on the criteria of ultrasonography-confirmed hepatic steatosis and metabolic dysfunction. Primary outcomes were major adverse cardiovascular events and new-onset arterial HTN. We applied time-dependent Cox regression, multistate modeling, and Fine-Gray competing risk analysis over 127,419 person-years (median follow-up: 5.2 years).</div></div><div><h3>Results</h3><div>Baseline MASLD prevalence was 23.8%. MASLD significantly increased the risk of CVD (adjusted hazard ratio: 1.83; 95% confidence interval: 1.63–2.07; <em>P</em> &lt; .001), with a dose-dependent effect and stronger associations in younger adults. In contrast, MASLD was not associated with incident arterial HTN (hazard ratio: 1.02; 95% confidence interval: 0.95–1.09; <em>P</em> = .634). Competing risk analysis confirmed this divergence (interaction <em>P</em> &lt; .001). MASLD accounted for 17.0% of all CVD events (population-attributable risk). Multistate models showed that MASLD preferentially progressed to CVD rather than HTN.</div></div><div><h3>Conclusion</h3><div>MASLD substantially increased cardiovascular risk but showed minimal association with HTN. These findings challenge the assumption of a uniform cardiometabolic risk in MASLD and underscore the need for outcome-specific risk stratification and targeted CVD prevention in patients with MASLD.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 1","pages":"Article 100806"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364348","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":"Limited but Growing Use of Medications for Alcohol Use Disorder by Gastroenterologists: A Medicare Analysis, 2016-2024","authors":"Haiden A. Huskamp ,&nbsp;Po-Hung Chen ,&nbsp;Alene Kennedy-Hendricks ,&nbsp;Constance M. Horgan ,&nbsp;Dominic Hodgkin ,&nbsp;Alisa B. Busch","doi":"10.1016/j.gastha.2026.100934","DOIUrl":"10.1016/j.gastha.2026.100934","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 5","pages":"Article 100934"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147658293","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":"Summarization of Narrative Clinical Data of Inflammatory Bowel Disease With Foundational Large Language Models","authors":"Soonwook Hong MD ,&nbsp;Alexandra C. Greb ,&nbsp;Prince Shah-Riar ,&nbsp;Henry M. Zheng ,&nbsp;Berkeley N. Limketkai","doi":"10.1016/j.gastha.2026.100967","DOIUrl":"10.1016/j.gastha.2026.100967","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 7","pages":"Article 100967"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152301","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":"Mortality and Infectious Adverse Events in Neutropenic Patients Undergoing Gastrointestinal Endoscopic Procedures: A Systematic Review and Meta-Analysis","authors":"Janak Bahirwani ,&nbsp;Rishika Chugh ,&nbsp;Ashley N. Tran ,&nbsp;Amy Ogurick ,&nbsp;Alyssa A. Grimshaw ,&nbsp;Maria Ciarleglio ,&nbsp;Yanhong Deng ,&nbsp;Badr Al-Bawardy ,&nbsp;Kenneth W. Hung ,&nbsp;Loren Laine","doi":"10.1016/j.gastha.2026.100994","DOIUrl":"10.1016/j.gastha.2026.100994","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The safety of gastrointestinal endoscopy in neutropenic patients remains unestablished. Gastrointestinal and infectious disease society guidelines indicate that infectious adverse events are increased after endoscopy in neutropenic patients. We performed a systematic review and meta-analysis to assess the safety of endoscopy in neutropenic patients.</div></div><div><h3>Methods</h3><div>Cochrane Library, Embase, Google Scholar, MEDLINE, PubMed, Scopus, and Web of Science were searched through September 2025 for studies in neutropenic patients (absolute neutrophil count &lt;1000 cells/μL) undergoing endoscopy with outcome data on infections, mortality, or fever. Conference abstracts from January 2017 to September 2025 were also searched. Two reviewers independently identified studies meeting inclusion criteria, performed data extraction, and assessed risk of bias. Coprimary outcomes were 30-day infection-related mortality and infectious adverse events within 7 days of endoscopy. Secondary outcomes were new bacteremia and new fever within 7 days of endoscopy. Random-effects meta-analyses were performed.</div></div><div><h3>Results</h3><div>Six cohort studies met eligibility criteria (N = 1241 patients). Pooled incidence was 0.0% (95% confidence interval [CI] 0.00%–0.03%; I² = 0.0%) for infection-related mortality and 7.3% (95% CI 0.00%–25.57%; I² = 98.6%) for infectious adverse events, which consisted of bacteremia (2.4% [95% CI 0.03%–6.99%; I² = 87.3%]) and new fever (4.8% [95% CI 0.00%–9.74%; I² = 99%]). Preprocedural antibiotic use did not reduce infectious adverse events or bacteremia as compared to no antibiotic use: odds ratio = 2.97, 95% CI 0.47–18.67.</div></div><div><h3>Conclusion</h3><div>Infection-related mortality within 30 days was 0% and infectious adverse events within 7 days occurred in 7.3% of neutropenic patients undergoing endoscopy. These findings suggest endoscopy maybe safely performed in appropriately selected neutropenic patients.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 8","pages":"Article 100994"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148234437","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":"Risk of Clostridioides difficile Infection After Helicobacter pylori Treatment in a Large Population in the United States","authors":"Lawrence J. Leung ,&nbsp;Sophie A. Merchant ,&nbsp;Jessica M. Badalov ,&nbsp;Douglas A. Corley ,&nbsp;Dan Li","doi":"10.1016/j.gastha.2025.100832","DOIUrl":"10.1016/j.gastha.2025.100832","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Adverse outcomes associated with the treatment of <em>Helicobacter pylori</em> remain poorly understood. We investigated whether <em>H pylori</em> treatment was associated with an increased risk of <em>Clostridioides difficile</em> infection (CDI).</div></div><div><h3>Methods</h3><div>This retrospective cohort study included all adult members who tested positive for <em>H pylori</em> between January 1, 2000, and December 31, 2020, at Kaiser Permanente Northern California. We measured the incidence of CDI after <em>H pylori</em> treatment and evaluated the predictors of CDI using multivariable logistic regression.</div></div><div><h3>Results</h3><div>Of 139,226 individuals who tested positive for <em>H pylori</em>, the incidence of CDI was 5.9/10,000 within 3 months (<em>P</em> = .02) and 7.0/10,000 (<em>P</em> = .003) within 6 months after <em>H pylori</em> treatment, compared with 2.7/10,000 among untreated individuals. The adjusted odds ratio (aOR) (95% confidence interval) for CDI within 3 months after <em>H pylori</em> treatment was 2.00 (1.02–3.90) overall, 3.15 (1.14–8.70) for concomitant therapy, and 6.34 (2.75–14.59) for bismuth quadruple therapy. Inflammatory bowel disease (IBD) (aOR, 7.89 [2.38–26.21]) and history of CDI (aOR, 8.27 [1.92–35.62]) had the strongest association with CDI, while Asians/Pacific Islanders (aOR, 0.22 [0.09–0.55] and non-English language preference (aOR, 0.30 [0.12–0.72]) were associated with a lower risk.</div></div><div><h3>Conclusion</h3><div>In a large, diverse, community-based population, treatment of <em>H pylori</em> was associated with an increased risk of CDI, although the overall incidence was very low. History of IBD and prior CDI were the strongest predictors of CDI. These findings support the safety of <em>H pylori</em> treatment, although caution should be exercised when treating <em>H pylori</em> among individuals with IBD or a prior history of CDI.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100832"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571966","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":"Cysteine Restriction Induces Ferroptosis Depending on the S-adenosylmethionine and Polyamine Biosynthetic Pathways in Hepatic Cancer Cells","authors":"Keisuke Tada ,&nbsp;Kazuki Mitsuyama ,&nbsp;Hironari Nishizawa ,&nbsp;Hiroki Shima ,&nbsp;Akihiko Muto ,&nbsp;Motoshi Wada ,&nbsp;Daisuke Saigusa ,&nbsp;Kazuhiko Igarashi","doi":"10.1016/j.gastha.2025.100817","DOIUrl":"10.1016/j.gastha.2025.100817","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Liver diseases such as hepatocellular carcinoma are known to be affected by nutrition and metabolic activities, but the mechanisms behind them remain unclear. We aimed to reveal the relationship between the concentration of sulfur-containing amino acids and hepatocellular response, and further investigated the mechanism focusing on methionine adenosyltransferase, which plays the central role in methionine metabolism by synthesizing <em>S</em>-adenosylmethionine (SAM).</div></div><div><h3>Methods</h3><div>Mouse hepatoma Hepa1 cells were cultured in media with reduced amounts of cysteine, methionine, or both. Cell death was monitored using propidium iodide and annexin V staining followed by flow cytometry. Metabolites were measured by mass spectrometry. Inhibitors of ferroptosis (Fer-1), necroptosis (GSK872), SAM synthesis (cycloleucine), or polyamine synthesis (sardomozide and difluoromethylornithine) were used.</div></div><div><h3>Results</h3><div>Cysteine restriction induced marked cell death, whereas simultaneous restriction of cysteine and methionine fully suppressed the cell death. Cysteine restriction-induced cell death was suppressed with Fer-1 and GSK872, suggesting the involvement of ferroptosis in this process. Cysteine restriction decreased reduced glutathione, which was rescued by simultaneous restriction of cysteine and methionine. Cysteine restriction-induced cell death was also suppressed by knockdown of MAT2A or its inhibitor cycloleucine. Furthermore, inhibitors of several enzymes in the polyamine biosynthetic pathway also suppressed the cell death. In contrast, primary culture of mouse hepatocytes did not show cell death upon cysteine restriction.</div></div><div><h3>Conclusion</h3><div>These results suggest that cysteine-glutathione and SAM-polyamine metabolic pathways are critical modulators of ferroptosis of hepatic cancer cells. Since normal liver cells were more resistant to ferroptosis than cancer cells, cysteine restriction may be exploited in treating hepatic cancer by inducing ferroptosis specifically in cancer cells without affecting normal cells in the liver.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100817"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618664","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":"Submit to Pearls From the Pros","authors":"David A. Katzka,&nbsp;Vinod K. Rustgi,&nbsp;Shanthi Srinivasan","doi":"10.1016/j.gastha.2025.100813","DOIUrl":"10.1016/j.gastha.2025.100813","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 1","pages":"Article 100813"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363785","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":"Efficacy of Upadacitinib Retreatment or Dose Escalation After Loss of Response in Ulcerative Colitis: Data From the Open-Label Extension of the U-ACTIVATE Study","authors":"Remo Panaccione ,&nbsp;Jean-Frédéric Colombel ,&nbsp;Marla Dubinsky ,&nbsp;Christopher Ma ,&nbsp;Michelle Kujawski ,&nbsp;Erica Cheng ,&nbsp;Elena Dubcenco ,&nbsp;Sina Ogholikhan ,&nbsp;Elena Marced Barrachina ,&nbsp;Tadakazu Hisamatsu","doi":"10.1016/j.gastha.2026.100969","DOIUrl":"10.1016/j.gastha.2026.100969","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Upadacitinib (UPA) is a Janus kinase inhibitor approved for moderately to severely active ulcerative colitis (UC). Patients may discontinue and then restart UPA treatment or require dose adjustment; however, the impact on overall efficacy of treatment interruption or dose escalation is not fully characterized. This analysis of the U-ACTIVATE (<span><span>NCT03006068</span><svg><path></path></svg></span>) open-label extension (OLE) study evaluated the efficacy of UPA retreatment after UPA withdrawal or dose escalation during UPA maintenance following a loss of response in patients with UC.</div></div><div><h3>Methods</h3><div>Patients who responded to 8 weeks of UPA 45 mg induction therapy were rerandomized to placebo, UPA 15 mg (UPA15), or 30 mg (UPA30) in the 52-week U-ACHIEVE (<span><span>NCT02819635</span><svg><path></path></svg></span>) maintenance study. Patients who subsequently lost response on placebo during maintenance could enter the U-ACTIVATE OLE and were retreated with UPA at a 15 mg dose (UPA retreatment group); patients who lost response on maintenance UPA15 continued UPA15 during the OLE. Patients who lost response on UPA15 during the OLE and met prespecified criteria were escalated to UPA30. Clinical and endoscopic remissions were assessed through week 144. Safety was not assessed in this analysis but has been reported previously.</div></div><div><h3>Results</h3><div>The UPA retreatment group enrolled 110 patients; 57 remained on UPA15 (UPA15OLE→UPA15) and 47 were escalated to UPA30 (UPA15OLE→UPA30) by week 144. A total of 39 patients lost response on maintenance UPA15 and entered the OLE on UPA30 (UPA15Maint→UPA30). At week 144, the following proportion of patients achieved clinical remission per adapted Mayo score and endoscopic remission, respectively: UPA15OLE→UPA15: 76.3% and 33.3%, UPA15OLE→UPA30: 61.1% and 56.4%, and UPA15Maint→UPA30: 43.5% and 40.7%.</div></div><div><h3>Conclusion</h3><div>In patients with UC, clinical and endoscopic efficacy could be recaptured following UPA retreatment or dose escalation in the U-ACTIVATE OLE.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 7","pages":"Article 100969"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148180122","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}