Gastro hep advances最新文献

{"title":"Evidence Supporting Utility of the Oral Cholate Challenge Test of Liver Function and Physiology to Aid Clinical Management: A Review of Analytical and Clinical Validation Studies","authors":"Andrew P. Keaveny ,&nbsp;Kamran Qureshi ,&nbsp;Mitchell Shiffman ,&nbsp;Timothy R. Morgan ,&nbsp;K. Rajender Reddy ,&nbsp;Joanne C. Imperial ,&nbsp;Michael P. McRae ,&nbsp;Touraj Shokati ,&nbsp;Gregory T. Everson","doi":"10.1016/j.gastha.2026.100993","DOIUrl":"10.1016/j.gastha.2026.100993","url":null,"abstract":"<div><div>Current standard liver assessments rely on static laboratory values that reflect advanced disease or liver injury rather than overall hepatic health. This limitation highlights the need for dynamic measures of liver function to support accurate risk stratification, therapeutic monitoring, and clinical trial design. Quantitative liver function tests address this gap by providing physiologically based measures of hepatic clearance. Among these, cholate clearance is uniquely suited to assess hepatocellular function and portal-systemic shunting—key determinants of disease severity and prognosis. The oral cholate challenge test (OCCT), HepQuant DuO, is a simple, noninvasive method for quantifying cholate clearance using stable isotope-labeled cholate and liquid chromatography–tandem mass spectrometry analysis. This review highlights the test’s analytical and clinical validation across the spectrum of chronic liver disease. The test’s output parameters, Disease Severity Index, SHUNT%, and hepatic reserve, correlate with portal hypertension, varices, and risk for clinical outcomes. Applications for guiding endoscopic screening, predicting decompensation, and monitoring treatment response are highlighted. Comparative analyses show that the OCCT parameters outperform conventional laboratory tests of liver function and may complement anatomic or physical measurements, such as histology, magnetic resonance imaging, or elastography. Additional data supports its role as a sensitive biomarker and reasonably likely surrogate endpoint for drug trials of chronic liver disease. The OCCT addresses critical gaps in chronic liver disease and drug development and has the potential to transform the assessment of the patient with chronic liver disease.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 8","pages":"Article 100993"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148183580","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":"Comparative Efficacy of Herbal Products for Improving Liver Enzymes and Inflammation in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Systematic Review and Network Meta-Analysis","authors":"Alejandro Chen Liang,&nbsp;Yeison Cruz Castillo,&nbsp;Mariela Denise Fermin Madera,&nbsp;Revathi Thirumushi Sairaj,&nbsp;Jose Medina,&nbsp;Tatiana Alexandra Moreno Díaz,&nbsp;Supritha Chintamaneni,&nbsp;Gabriela Flores Monar,&nbsp;Camila Sanchez Cruz,&nbsp;Rashmi Advani,&nbsp;Sushovan Guha,&nbsp;Ernesto Calderón-Martinez","doi":"10.1016/j.gastha.2026.101045","DOIUrl":"10.1016/j.gastha.2026.101045","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and Aims&lt;/h3&gt;&lt;div&gt;Metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic dysfunction–associated steatohepatitis (MASH) affect adults worldwide and are causes of morbidity. While lifestyle modification remains in first-line therapy, interest has emerged in herbal agents with potential hepatometabolic effects. Evidence synthesis has been limited by heterogeneity in formulations and study quality. We conducted a systematic review and network meta-analysis (NMA) to compare the efficacy of herbal therapies in MASLD/MASH.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and International Prospective Register of Systematic Reviews registration (CRD420251157401), PubMed, Web of Science, EMBASE, and Cochrane were searched through September 2025 for randomized controlled trials evaluating herbal therapies or derivatives in adults with MASLD/MASH. The primary outcomes included alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and liver stiffness. Random-effects NMAs estimated mean differences (MDs) with 95% confidence intervals, with treatment ranking using surface under the cumulative ranking curve (SUCRA). Risk of bias was assessed using RoB 2.0, and certainty of evidence using Confidence in NMA.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Across 131 randomized trials (n = 9191), several herbal interventions significantly improved liver enzymes. In the NMA for alanine aminotransferase, the greatest reductions were seen with artichoke leaf (MD -28.32; &lt;em&gt;P&lt;/em&gt; &lt; .01), cinnamon (MD -25.10; &lt;em&gt;P&lt;/em&gt; = .01), and piperine (MD -25.39; &lt;em&gt;P&lt;/em&gt; = .01), with artichoke leaf achieving the highest SUCRA (0.93). For aspartate aminotransferase, significant reductions were observed for cinnamon (MD -23.50; &lt;em&gt;P&lt;/em&gt; &lt; .01), berberine (MD -19.63; &lt;em&gt;P&lt;/em&gt; &lt; .01), and bergamot + CyC (MD -17.83; &lt;em&gt;P&lt;/em&gt; &lt; .01), with cinnamon being the most effective (SUCRA 0.96). For gamma-glutamyl transpeptidase, significant reductions were observed with cinnamon (MD -12.44; &lt;em&gt;P&lt;/em&gt; = .01), garlic + silymarin (MD -10.92; &lt;em&gt;P&lt;/em&gt; = .01), and berberine (MD -9.74; &lt;em&gt;P&lt;/em&gt; = .01). For liver stiffness, only curcumin (MD -0.76; &lt;em&gt;P&lt;/em&gt; = .03) and pomegranate (MD -0.86; &lt;em&gt;P&lt;/em&gt; = .04) were statistically significant, despite higher SUCRA rankings favoring silymarin (0.81) and hesperidin + flaxseed (0.79). The secondary outcomes showed variable effects on steatosis and fibrosis indices without consistent metabolic significance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This analysis found that several herbal preparations may improve biochemical markers in MASLD and MASH, though results varied and require cautious interpretation given formulation and regulatory inconsistencies. Future work should focus on the most consistently performing agents: cinnamon, curcumin, silymarin, berberine, artichoke leaf, and &lt;em&gt;Nigel","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 9","pages":"Article 101045"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737580","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":"Duodenal Fluid Microbiome Diversity and Pancreatic Cyst Status Among Patients Undergoing Pancreatic Surveillance","authors":"Takuya Oba,&nbsp;Yuto Hozaka,&nbsp;Takeichi Yoshida,&nbsp;Hassan Sinan,&nbsp;Emy Abou Sleimen,&nbsp;Eun Ji Shin,&nbsp;Ellie Afghani,&nbsp;Marcia Irene Canto,&nbsp;Michael Goggins","doi":"10.1016/j.gastha.2026.101027","DOIUrl":"10.1016/j.gastha.2026.101027","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Pancreatic cancer is associated with alterations in the gut microbiome; whether these changes are a cause or consequence of the disease is not known. This study aimed to compare the gut microbiome of patients with precancerous pancreatic cysts to that of patients without cysts.</div></div><div><h3>Methods</h3><div>Case/control analysis of 492 patients undergoing pancreatic surveillance, 267 patients with pancreatic cyst(s) and 225 without. Duodenal fluid bacterial DNA collected during endoscopic ultrasound was amplified and sequenced (16S ribosomal RNA). Measures of alpha and beta diversity were stratified by pancreatic cyst status, adjusting for demographic and clinical factors.</div></div><div><h3>Results</h3><div>Duodenal fluid alpha diversity measures were significantly lower in patients with pancreatic cysts compared to those without, with no significant differences between patients with small vs large pancreatic cysts, or those with worrisome features. Multivariate analysis revealed that measures of alpha diversity (Shannon index, operational taxonomic units, Faith phylogenetic diversity) were independently associated with having a pancreatic cyst: (Shannon index; adjusted odds ratio/95% confidence interval; 0.59/0.45–0.76, <em>P</em> &lt; 01), along with diabetes status (2.35/1.2–4.79, <em>P</em> &lt; .01) and age ≥75 years (2.72/1.43–5.50, <em>P</em> &lt; .002). Duodenal fluid beta diversity differed significantly by covariates, including older age, proton pump inhibitor use, diabetes, current smoking, and regular alcohol use. In patients without these cofactors, duodenal fluid beta diversity did not differ significantly by pancreatic cyst status.</div></div><div><h3>Conclusion</h3><div>Patients undergoing pancreas surveillance who have pancreatic cysts have lower duodenal fluid alpha diversity compared to those without cysts. Further study is needed to determine if gut microbiome profiles predict future cancer risk in patients undergoing pancreas surveillance.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 8","pages":"Article 101027"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363870","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":"Comment on “Sequential FIB-4 Index and M2BPGi Combination Improve Detection of Advanced Fibrosis in MASLD: A MultiCenter Study”","authors":"Anuradha Mokkapati,&nbsp;Rhushvi Thakkar,&nbsp;Anjna Rani,&nbsp;Dinesh Puri","doi":"10.1016/j.gastha.2026.101011","DOIUrl":"10.1016/j.gastha.2026.101011","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 9","pages":"Article 101011"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426947","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":"Rituximab as Salvage Therapy in Difficult-to-Treat Autoimmune Hepatitis: A Prospective Case Series","authors":"Craig Lammert,&nbsp;Nadia Blessing,&nbsp;Maaz Arif,&nbsp;Divya Minnaganti,&nbsp;Regina Weber,&nbsp;Kelsey Green,&nbsp;Raj Vuppalanchi,&nbsp;Naga Chalasani","doi":"10.1016/j.gastha.2026.101095","DOIUrl":"10.1016/j.gastha.2026.101095","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and Aims&lt;/h3&gt;&lt;div&gt;A subset of patients with autoimmune hepatitis (AIH) fail to achieve or sustain a complete biochemical response (CBR) to standard immunosuppression, resulting in a significant unmet clinical need. Rituximab, an anti-CD20 monoclonal antibody, has been investigated in refractory AIH, but prospective data remain limited. We sought to characterize the biochemical response and corticosteroid-sparing effects of rituximab in patients with difficult-to-manage AIH.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;A subset of patients with autoimmune hepatitis (AIH) fail to achieve or sustain a complete biochemical response (CBR) to standard immunosuppression, resulting in a significant unmet clinical need. Rituximab, an anti-CD20 monoclonal antibody, has been investigated in refractory AIH, but prospective data remain limited. We sought to characterize the biochemical response and corticosteroid-sparing effects of rituximab in patients with difficult-to-manage AIH.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We report a prospective case series of adults with difficult-to-manage AIH enrolled in the Genetic Repository of Autoimmune Liver Disease and Contributing Exposures cohort at Indiana University and treated with rituximab (1000 mg intravenously on days 1 and 15). Eligible patients had refractory disease, corticosteroid dependence, or inadequate biochemical control. Response was assessed at 12, 24, and 48 weeks. CBR was defined as normalization of alanine aminotransferase, aspartate aminotransferase, and immunoglobulin G. Analyses of biochemical outcomes were restricted to patients with active baseline disease.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We report a prospective case series of adults with difficult-to-manage AIH enrolled in the Genetic Repository of Autoimmune Liver Disease and Contributing Exposures cohort at Indiana University and treated with rituximab (1000 mg intravenously on days 1 and 15). Eligible patients had refractory disease, corticosteroid dependence, or inadequate biochemical control. Response was assessed at 12, 24, and 48 weeks. CBR was defined as normalization of alanine aminotransferase, aspartate aminotransferase, and immunoglobulin G. Analyses of biochemical outcomes were restricted to patients with active baseline disease.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Seven patients were enrolled; 6 had abnormal baseline biochemical indices. Biochemical improvement at 24 weeks was observed in all 6 patients with active baseline disease (100%), with 1 patient (16.7%) achieving CBR. However, response durability was limited, and biochemical worsening between 24 and 48 weeks occurred in 4 of 6 patients (66.7%). Response patterns included insufficient response with subsequent attenuation (n = 4), sustained CBR (n = 1), and early response followed by relapse (n = 1). Median prednisone-equivalent dose decreased from 30 mg/day at baseline to 12.5 mg/day at 48 weeks (−58.3%). No serious adverse events, infections, or hepatic decompensation occurred.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Seven pati","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 11","pages":"Article 101095"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148947421","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":"Superior Mesenteric Artery Syndrome With Nutcracker Phenomenon in an Ulcerative Colitis Patient: A Case Report and Literature Review","authors":"Abdulla Alabed,&nbsp;Mohamed Wael,&nbsp;Mariam Adnan,&nbsp;Mohamed Alabbasi,&nbsp;Nawara Aljasim,&nbsp;Sara Altamimi,&nbsp;Faisal Abubaker,&nbsp;Omar Sharif","doi":"10.1016/j.gastha.2026.101041","DOIUrl":"10.1016/j.gastha.2026.101041","url":null,"abstract":"<div><div>Superior mesenteric artery syndrome (SMAS) and nutcracker phenomenon or syndrome (if with symptoms) are rare conditions. The former is caused by the compression of the third part of the duodenum between the aorta and the superior mesenteric artery (SMA), leading to duodenal obstruction, while the latter is caused by the compression of the left renal vein between the SMA and the aorta, leading to distal dilation of the vein. Coexistence of both conditions is extremely rare, and up to 2017, only 8 cases were reported. Upon literature review, a few case reports linked either SMAS or the nutcracker phenomenon with Crohn’s disease. To the best of our knowledge, no ulcerative colitis case diagnosed concurrently with SMAS or nutcracker syndrome was found. We report the case of a 20-year-old woman with active ulcerative colitis who presented with a flare-up as well as weight loss, nausea, and vomiting. In addition to her active ulcerative colitis, she was found to have concurrent SMAS and the nutcracker phenomenon upon radiological investigations. SMAS and the nutcracker phenomenon are extremely rare to occur concurrently. Management of such cases can be challenging and ranges from nutritional support to surgical interventions.</div></div><div>Superior mesenteric artery syndrome (SMAS) and nutcracker phenomenon or syndrome (if with symptoms) are rare conditions. The former is caused by the compression of the third part of the duodenum between the aorta and the superior mesenteric artery (SMA), leading to duodenal obstruction, while the latter is caused by the compression of the left renal vein between the SMA and the aorta, leading to distal dilation of the vein. Coexistence of both conditions is extremely rare, and up to 2017, only 8 cases were reported. Upon literature review, a few case reports linked either SMAS or the nutcracker phenomenon with Crohn’s disease. To the best of our knowledge, no ulcerative colitis case diagnosed concurrently with SMAS or nutcracker syndrome was found. We report the case of a 20-year-old woman with active ulcerative colitis who presented with a flare-up as well as weight loss, nausea, and vomiting. In addition to her active ulcerative colitis, she was found to have concurrent SMAS and the nutcracker phenomenon upon radiological investigations. SMAS and the nutcracker phenomenon are extremely rare to occur concurrently. Management of such cases can be challenging and ranges from nutritional support to surgical interventions.</div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 11","pages":"Article 101041"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954479","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":"Chemokine Ligand-3 (CCL3) as a Novel Mediator of Inflammatory Bowel Disease Activity","authors":"Eileen O’Brien,&nbsp;Kyra Fine,&nbsp;Olimpia Sienkiewicz,&nbsp;Yuhong Wei,&nbsp;Christine E. Orr,&nbsp;Daniel J. Mulder","doi":"10.1016/j.gastha.2026.101081","DOIUrl":"10.1016/j.gastha.2026.101081","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Inflammatory bowel disease (IBD) is characterized by dysregulation of the immune system, driven in part by pro-inflammatory macrophage polarization. Chemokine ligand-3 (CCL3) is a chemokine known to mediate inflammation and act to polarize M1 macrophages at the site of inflammation. CCL3 is upregulated in patients with IBD, but its contribution to disease pathophysiology beyond that is unknown. Our hypothesis was that CCL3 expression increases at sites of more intense inflammation in biopsies from patients with IBD and it mediates inflammation through neutrophils and M1 macrophages.</div></div><div><h3>Methods</h3><div>Gastrointestinal mucosal biopsies from patients with IBD in varying states of inflammation were immunostained for CCL3 and co-immunostained for C-C motif chemokine receptor 1 (CCR1) and C-C motif chemokine receptor 5 (CCR5). Imaging mass cytometry was performed to identify CCL3-expressing cell spatial relationships.</div></div><div><h3>Results</h3><div>Immunohistochemistry found that CCL3 was expressed in a variety of cell types in patients with both ulcerative colitis and Crohn’s disease. CCL3 receptors, CCR1 and CCR5, were widely expressed as well, with co-expression of CCL3 occurring in a subset of these cells that was higher than that of CCL3/CCR5. Imaging mass cytometry highlighted a positive correlation between CCL3 and the severity of inflammation of IBD patient biopsies. The majority of CCL3-positive cells were neutrophils and macrophages (in particular, proinflammatory M1 macrophages), but there was also expression on eosinophils and epithelial cells.</div></div><div><h3>Conclusion</h3><div>CCL3 is expressed in many cell types in the gut mucosa in patients with IBD and is positively associated with the severity of local inflammation. CCL3-mediated effects in IBD may occur primarily through the CCR1 signaling pathway, leading to attraction and polarization of macrophages and neutrophils.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 11","pages":"Article 101081"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856366","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":"Regulation and Function of Sox2 and CD44 Expression in the Stomach by Bone Morphogenetic Protein Signaling","authors":"Andrea Todisco,&nbsp;Justin Colacino,&nbsp;Nicholas Lesniak,&nbsp;Lei Peng,&nbsp;Xuan Li,&nbsp;Tsutomu Takeda,&nbsp;Xia Wei,&nbsp;Maria Mao,&nbsp;Veronique Orian-Rousseau,&nbsp;Kathryn A. Eaton","doi":"10.1016/j.gastha.2026.101075","DOIUrl":"10.1016/j.gastha.2026.101075","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and Aims&lt;/h3&gt;&lt;div&gt;The transcription factor Sox2 and the adhesion molecule CD44 are implicated in gastric metaplasia and neoplasia. Lgr5 is a cellular receptor that marks gastric progenitors involved in epithelial homeostasis. We reported that inhibition of bone morphogenetic protein (BMP) signaling in the stomach activates aberrant cells that lead to spasmolytic polypeptide-expressing metaplasia (SPEM), a preneoplastic metaplasia. We investigated the role of BMP-regulated transcriptional programs in gastric metaplasia/SPEM and the localization and function of CD44 and Sox2 in the context of inhibition of BMP signaling.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;The transcription factor Sox2 and the adhesion molecule CD44 are implicated in gastric metaplasia and neoplasia. Lgr5 is a cellular receptor that marks gastric progenitors involved in epithelial homeostasis. We reported that inhibition of bone morphogenetic protein (BMP) signaling in the stomach activates aberrant cells that lead to spasmolytic polypeptide-expressing metaplasia (SPEM), a preneoplastic metaplasia. We investigated the role of BMP-regulated transcriptional programs in gastric metaplasia/SPEM and the localization and function of CD44 and Sox2 in the context of inhibition of BMP signaling.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Deletion of &lt;em&gt;Cd44&lt;/em&gt;, &lt;em&gt;Sox2&lt;/em&gt;, and of &lt;em&gt;BMP Receptor 1a&lt;/em&gt; (&lt;em&gt;Bmpr1a&lt;/em&gt;) in Lgr5 cells was achieved by crossing &lt;em&gt;Lgr5-Cre&lt;/em&gt; mice to mice expressing floxed alleles of &lt;em&gt;Cd44, Sox2&lt;/em&gt;, and &lt;em&gt;Bmpr1a&lt;/em&gt;. The &lt;em&gt;H&lt;/em&gt;&lt;sup&gt;&lt;em&gt;+&lt;/em&gt;&lt;/sup&gt;&lt;em&gt;/K&lt;/em&gt;&lt;sup&gt;&lt;em&gt;+&lt;/em&gt;&lt;/sup&gt;&lt;em&gt;-ATPase β-subunit&lt;/em&gt; promoter was used to express the BMP inhibitor noggin in the corpus. Lineage tracing studies were conducted by crossing &lt;em&gt;Lgr5-Cre&lt;/em&gt; mice to mice expressing &lt;em&gt;Nog&lt;/em&gt; and &lt;em&gt;tdTomato&lt;/em&gt;. Morphology of the mucosa was analyzed by hematoxylin and eosin staining and immunohistochemistry. Single cell RNA sequencing was performed in both control and &lt;em&gt;H&lt;/em&gt;&lt;sup&gt;&lt;em&gt;+&lt;/em&gt;&lt;/sup&gt;&lt;em&gt;/K&lt;/em&gt;&lt;sup&gt;&lt;em&gt;+&lt;/em&gt;&lt;/sup&gt;&lt;em&gt;-Nog&lt;/em&gt; mice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Deletion of &lt;em&gt;Cd44&lt;/em&gt;, &lt;em&gt;Sox2&lt;/em&gt;, and of &lt;em&gt;BMP Receptor 1a&lt;/em&gt; (&lt;em&gt;Bmpr1a&lt;/em&gt;) in Lgr5 cells was achieved by crossing &lt;em&gt;Lgr5-Cre&lt;/em&gt; mice to mice expressing floxed alleles of &lt;em&gt;Cd44, Sox2&lt;/em&gt;, and &lt;em&gt;Bmpr1a&lt;/em&gt;. The &lt;em&gt;H&lt;/em&gt;&lt;sup&gt;&lt;em&gt;+&lt;/em&gt;&lt;/sup&gt;&lt;em&gt;/K&lt;/em&gt;&lt;sup&gt;&lt;em&gt;+&lt;/em&gt;&lt;/sup&gt;&lt;em&gt;-ATPase β-subunit&lt;/em&gt; promoter was used to express the BMP inhibitor noggin in the corpus. Lineage tracing studies were conducted by crossing &lt;em&gt;Lgr5-Cre&lt;/em&gt; mice to mice expressing &lt;em&gt;Nog&lt;/em&gt; and &lt;em&gt;tdTomato&lt;/em&gt;. Morphology of the mucosa was analyzed by hematoxylin and eosin staining and immunohistochemistry. Single cell RNA sequencing was performed in both control and &lt;em&gt;H&lt;/em&gt;&lt;sup&gt;&lt;em&gt;+&lt;/em&gt;&lt;/sup&gt;&lt;em&gt;/K&lt;/em&gt;&lt;sup&gt;&lt;em&gt;+&lt;/em&gt;&lt;/sup&gt;&lt;em&gt;-Nog&lt;/em&gt; mice.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Sox2&lt;sup&gt;+ve&lt;/sup&gt; cells were detected in the antrum but not in the corpus/lesser curvature of wild type mice. Conve","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 12","pages":"Article 101075"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007131","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":"Neighborhood Social Cohesion Associated With Chronic Liver Disease Prevalence and All-Cause Mortality","authors":"Tiange P. Zhang ,&nbsp;Jennifer L. Dodge ,&nbsp;Divya Ayyala-Somayajula ,&nbsp;Norah A. Terrault","doi":"10.1016/j.gastha.2025.100775","DOIUrl":"10.1016/j.gastha.2025.100775","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Neighborhood social cohesion (NSC)—the degree of trust and solidarity within a community—may influence health through multiple pathways including shaping healthy norms, perception of safety, and stress. Whether NSC influences chronic liver disease (CLD) prevalence and associated mortality in the United States is unknown.</div></div><div><h3>Methods</h3><div>Using 172,047 adults from the 2013–2018 National Health Interview Survey with linkage to National Death Index mortality data, NSC was measured using questions on help availability, accountability, trustworthiness, and connectedness among neighbors, with composite scores (4–16) categorized as minimal (4–7), low (8–10), moderate (11–13), and high (14–16). Logistic and Cox regression tested the association between NSC and CLD, and the interaction of NSC and CLD status on all-cause mortality, respectively.</div></div><div><h3>Results</h3><div>Lower NSC was associated with increased odds of CLD: moderate NSC adjusted odds ratio (aOR): 1.10 (confidence interval (CI) 1.03–1.18), low NSC aOR: 1.23 (CI 1.12–1.35), and minimal NSC aOR: 1.36 (CI 1.22–1.52) vs high NSC (trend <em>P</em> &lt; .001). After adjusting for sociodemographic and comorbidity covariates, minimal NSC was associated with a 38% higher mortality risk among adults with CLD (adjusted hazard ratio [aHR]: 1.87, CI 1.40–2.51) vs non-CLD (aHR:1.36, CI 1.21–1.53) (interaction effect aHR: 1.38, CI 1.01–1.89, interaction <em>P</em> = .046). Further adjustment for insurance and employment attenuated the interaction effect (CLD: aHR: 1.59, CI 1.18–2.13; non-CLD: aHR: 1.24, CI 1.10–1.39; interaction effect: aHR: 1.28, CI 0.94–1.76, interaction <em>P</em> = .12).</div></div><div><h3>Conclusion</h3><div>Lower NSC associates with CLD in a dose–response manner. US adults with CLD appear more vulnerable to low NSC and face higher mortality risk than those without CLD. Enhancing social cohesion may offer novel pathways to improve liver health.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 1","pages":"Article 100775"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271177","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":"The Impact, Characteristics, and Demographics of Choledochal Cysts From a Local Population in Texas","authors":"Kalee Moore ,&nbsp;Colby Adamson ,&nbsp;Alexander Grieme ,&nbsp;Suparna Nanua ,&nbsp;Erik Rahimi","doi":"10.1016/j.gastha.2025.100786","DOIUrl":"10.1016/j.gastha.2025.100786","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 1","pages":"Article 100786"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271181","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}