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{"title":"Leucine-rich alpha-2 glycoprotein in combination with C-reactive protein for predicting endoscopic activity in Crohn's disease: a single-centre, cross-sectional study.","authors":"Yoshiaki Takada, Hiroki Kiyohara, Yohei Mikami, Masataka Taguri, Ryoya Sakakibara, Yasuhiro Aoki, Kosaku Nanki, Takaaki Kawaguchi, Yusuke Yoshimatsu, Shinya Sugimoto, Tomohisa Sujino, Kaoru Takabayashi, Naoki Hosoe, Haruhiko Ogata, Motohiko Kato, Yasushi Iwao, Nobuhiro Nakamoto, Takanori Kanai","doi":"10.1080/07853890.2025.2453083","DOIUrl":"10.1080/07853890.2025.2453083","url":null,"abstract":"<p><strong>Background and objective: </strong>Leucine-rich alpha-2 glycoprotein (LRG) is a novel biomarker for Crohn's disease (CD). The utility of combination use of LRG and C-reactive protein (CRP) has not been reported. This study aimed to investigate the diagnostic performance of LRG in combination with CRP to predict endoscopic activity.</p><p><strong>Methods: </strong>A single-centre, retrospective, cross-sectional study was conducted. Patients with CD who had serum LRG concentrations measured at least once between June 2020 and May 2021 were enrolled. Clinical activity was evaluated with the Harvey-Bradshaw Index (HBI). Spearman's rank correlation coefficient (<i>r_s</i>) was used to analyse the correlations between the HBI, LRG concentrations and CRP concentrations. In patients undergoing ileocolonoscopy or balloon-assisted enteroscopy within 60 days before or after LRG measurement, endoscopic activity was evaluated with the simple endoscopic score for Crohn's disease (SES-CD). The diagnostic performance of LRG and CRP for endoscopic activity was evaluated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Four hundred and eighty-nine measurements in 343 patients were analysed. Although a strong correlation was found between LRG and CRP concentrations (<i>r_s</i> = 0.75), the HBI did not well correlate with LRG or CRP concentrations. Endoscopic activity was analysed in 56 patients. In diagnosing endoscopically moderate to severe activity (SES-CD > 6), the area under the ROC curve of LRG was greater than that of CRP (0.74 vs. 0.63; <i>p</i> = .037). The optimal cut-off value estimated by Youden's index was 15.5 µg/mL for LRG, and 0.13 mg/dL for CRP. LRG and CRP concentrations were considered positive when they were above these cut-off values, and the sensitivity and specificity for an SES-CD > 6 were 58.3% and 93.8%, respectively. Dual positivity of LRG and CRP showed the highest specificity.</p><p><strong>Conclusions: </strong>Combination use of dual positive LRG and CRP is useful for diagnosing endoscopically moderate to severe disease.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2453083"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017338","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":"Analysis of clinical characteristics of hemorrhagic fever with renal syndrome with acute pancreatitis: a retrospective study.","authors":"Lihua Huang, Min Xiao, Xiaoling Huang, Jun Wu, Jiao Luo, Fuxing Li, Wei Gu","doi":"10.1080/07853890.2025.2453081","DOIUrl":"10.1080/07853890.2025.2453081","url":null,"abstract":"<p><strong>Objective: </strong>This research aimed to analyze the impact of hemorrhagic fever with renal syndrome (HFRS) with acute pancreatitis (AP) on the severity and prognosis of patients, screen the risk factors of HFRS with AP, and establish a nomogram model.</p><p><strong>Methods: </strong>Data were collected from HFRS patients at the First Affiliated Hospital of Dali University and Dali Prefecture People's Hospital (2013-2023). Patients were divided into HFRS with AP (<i>n</i> = 34) and HFRS without AP groups (<i>n</i> = 356). Propensity Score Matching (PSM) and logistic regression analyzed the impact of AP on HFRS severity and short-term prognosis. LASSO-Logistic regression was used to screen risk factors and develop a nomogram model.</p><p><strong>Results: </strong>After PSM, HFRS patients with AP had higher rates of Continuous Renal Replacement Therapy (CRRT) and/or mechanical ventilation use, , ICU admission, and 30-day mortalitycompared with those without AP (<i>p</i> < 0.05). Further analysis revealed that smoking (OR: 3.702), ferritin (OR: 1.002), white blood cell (OR), fibrinogen (OR: 0.463), and platelet (OR: 0.987) were risk factors for HFRS with AP (<i>p</i> < 0.05). A nomogram model was constructed based on these factors, to predict the risk of HFRS with AP, with an Area Under the Curve (AUC) of 0.90 (95% CI: 0.84-0.95). Additionally, the model calibration curve fit well according to the Hosmer-Lemeshow test (χ²=8.51, <i>p</i> = 0.39).</p><p><strong>Conclusion: </strong>Patients with HFRS with AP exhibit higher disease severity and poorer prognosis. Smoking, elevated ferritin and white blood cell levels, decreased fibrinogen and platelet levels are more susceptible to developing AP.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2453081"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018264","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 effect of physical cues on platelet storage lesion.","authors":"Lihan Cheng, Lu Wang, Shichun Wang, Qi Liu, Ronghua Diao, Chunyan Yao","doi":"10.1080/16078454.2025.2450573","DOIUrl":"https://doi.org/10.1080/16078454.2025.2450573","url":null,"abstract":"<p><strong>Background: </strong>Platelet concentrates play an important role in clinical treatment such as platelet function disorders and thrombocytopenia. In the process of preparation and storage of platelets, centrifugation, leukofiltration, and agitation will cause morphological changes and impaired function of platelets, which is associated with the increase of platelet transfusion refractoriness, and named as platelet storage lesion (PSL).</p><p><strong>Method: </strong>This paper proposes three major operations (centrifugation, agitation, and leukofiltration) that platelets experience during the preparation and storage process, to explore the effect of physical cues on PSL. The analysis of morphology, metabolism index, and levels of activation markers are used to monitor the quality of stored platelets and definite the role of physical cues in PSL.</p><p><strong>Result: </strong>In this study, centrifugation, leukofiltration and agitation lead to different degrees of platelet activation, with the extension of storage time. At one hour after separation, PSL can be found through structural change, metabolic parameters, and activation markers of platelets. Agitation maintains more cell numbers, better cell morphology, and lower metabolism rate in platelets, and keeps the low activation state of platelets throughout the storage period. The hard centrifugation group showed the highest level of CD62P expression throughout the storage.</p><p><strong>Conclusion: </strong>our results indicate that agitation can mitigate PSL by supplying sufficient O₂ during preservation, shear stress may cause PSL immediately after the physical cues were applied; however, hydrostatic pressure induced by filtration is negligible for its effects on PSL. Meanwhile, when the physical cues are big enough, the activation of platelets is irreversible, such as spin at 2000 <i>g</i>. The granule secretion of platelets is a kind of irreversible activation; however, the membrane reorganization of platelets is a kind of reversible activation.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"30 1","pages":"2450573"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the effect of nitrate and L-arginine intake on aerobic, anaerobic performance, balance, agility, and recovery in elite taekwondo athletes.","authors":"Zafer Kavcı, Murat Ozan, Yusuf Buzdağlı, Adem Savaş, Halil Uçar","doi":"10.1080/15502783.2024.2445609","DOIUrl":"10.1080/15502783.2024.2445609","url":null,"abstract":"<p><strong>Background: </strong>Taekwondo is a complex martial art that requires speed, balance, agility, and endurance. This study aims to examine the effects of nitrate and L-arginine supplementation on acute aerobic and anaerobic performance, balance, agility, and recovery in elite taekwondo athletes.</p><p><strong>Method: </strong>This study was conducted as a double-blind, randomized, crossover study with the participation of 15 experienced taekwondo athletes aged 19.06 ± 0.96 years and 8.93 ± 1.27 years of training experience. Participants visited the laboratory a total of nine times, including a practice session and anthropometric measurements. These visits consisted of eight experimental sessions conducted at 72-hour intervals. The experimental sessions were conducted with nitrate, L-arginine, and a combination of both supplements (NIT*L-ARG) and placebo. Nitrate supplementation was provided by homogenizing fresh spinach (837.40 mg/kg), while L-ARG was given as a single dose of 6 g in powder form three hours before exercise.</p><p><strong>Results: </strong>NIT*L-ARG supplementation significantly improved the anaerobic performance of athletes in Wingate peak power and peak power (w/kg) compared to placebo and in mean power compared to NIT, L-ARG, and PLA. In addition, NIT*L-ARG supplementation significantly improved blood lactate levels and agility performance immediately after Wingate and Shuttle run tests.</p><p><strong>Conclusion: </strong>The combined intake of NIT*L-ARG was found to be effective in improving aerobic, anaerobic, and agility performances as well as fatigue levels of athletes. It was determined that taking NIT and L-ARG supplements alone contributed to the improvement of improving athletes' performance in Wingate mean power values and subsequent fatigue level compared to PLA.</p>","PeriodicalId":17400,"journal":{"name":"Journal of the International Society of Sports Nutrition","volume":"22 1","pages":"2445609"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is lean mass quantity or quality the determinant of maximal fat oxidation capacity? The potential mediating role of cardiorespiratory fitness.","authors":"Edgardo Opazo-Díaz, Juan Corral-Pérez, Alejandro Pérez-Bey, Alberto Marín-Galindo, Adrián Montes-de-Oca-García, María Rebollo-Ramos, Daniel Velázquez-Díaz, Cristina Casals, Jesús-Gustavo Ponce-González","doi":"10.1080/15502783.2025.2455011","DOIUrl":"10.1080/15502783.2025.2455011","url":null,"abstract":"<p><strong>Background: </strong>Impaired fat oxidation is linked to cardiometabolic risk. Maximal fat oxidation rate (MFO) reflects metabolic flexibility and is influenced by lean mass, muscle strength, muscle quality - defined as the ratio of strength to mass - and cardiorespiratory fitness. The relationship between these factors and fat oxidation is not fully understood. The aim is to analyze the associations of lean-mass, muscle strength and quality with fat oxidation parameters in young adults, considering the mediating role of VO₂max.</p><p><strong>Methods: </strong>A cross-sectional observational study. Eighty-one adults (50 males, 31 females; age 22.8 ± 4.4, BMI 25.70 ± 5.75, lean-mass 54.19 ± 8.78, fat-mass 18.66 ± 11.32) Body composition assessment by bioimpedance determine fat and lean-mass. Indirect calorimetry at rest and exercise was used for the calculation of fat oxidation. An incremental exercise protocol in a cycle ergometer with two consecutive phases was performed. The first to determine MFO consisted of 3 min steps of 15W increments with a cadence of 60rpm. The test was stopped when RQ ≥ 1. After 5 min rest, a phase to detect VO₂max began with steps of 15W/min until exhaustion. Muscular strength was assessed by handgrip dynamometry and the standing longitudinal jump test. A strength cluster was calculated with handgrip and long jump adjusted by sex and age. Data were analyzed using multiple linear regression and mediation analyses.</p><p><strong>Results: </strong>Total lean-mass and leg lean-mass were not associated with MFO. Long jump, relativized by lean-mass and by leg lean-mass have a standardized indirect effect on MFO of 0.50, CI: 0.32-0.70, on MFO/lean-mass 0.43, CI:0.27-0.60 and MFO/leg lean-mass 0.44, CI: 0.30-0.06, which VO₂max mediated, VO₂max/lean-mass and VO₂max/leg lean-mass, respectively (all <i>p</i> < 0.01). The handgrip/arm lean-mass had an indirect effect of 0.25 (CI: 0.12-0.38) on MFO/leg lean-mass, with VO₂max/leg lean-mass as the mediator (<i>p</i> < 0.01). The Cluster/lean-mass and Cluster/Extremities lean-mass have a standardized indirect effect on MFO/lean-mass (0.34, CI: 0.20-0.48) and MFO/leg lean-mass (0.44, CI: 0.28-0.60), mediated by VO2max/lean-mass and VO2max/leg lean-mass (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>Muscular strength and quality have an indirect effect on MFO mediated by VO₂max. These findings suggest the importance of muscle quality on MFO.</p>","PeriodicalId":17400,"journal":{"name":"Journal of the International Society of Sports Nutrition","volume":"22 1","pages":"2455011"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biparatopic binding of ISB 1442 to CD38 in trans enables increased cell antibody density and increased avidity.","authors":"Jeremy Loyau, Thierry Monney, Marco Montefiori, Fedir Bokhovchuk, Jeremy Streuli, Matthew Blackburn, Arnaud Goepfert, Lydia N Caro, Samitabh Chakraborti, Stefania De Angelis, Camille Grandclément, Stanislas Blein, M Lamine Mbow, Ankita Srivastava, Mario Perro, Stefano Sammicheli, Eugene A Zhukovsky, Michael Dyson, Cyrille Dreyfus","doi":"10.1080/19420862.2025.2457471","DOIUrl":"10.1080/19420862.2025.2457471","url":null,"abstract":"<p><p>ISB 1442 is a bispecific biparatopic antibody in clinical development to treat hematological malignancies. It consists of two adjacent anti-CD38 arms targeting non-overlapping epitopes that preferentially drive binding to tumor cells and a low-affinity anti-CD47 arm to enable avidity-induced blocking of proximal CD47 receptors. We previously reported the pharmacology of ISB 1442, designed to reestablish synthetic immunity in CD38+ hematological malignancies. Here, we describe the discovery, optimization and characterization of the ISB 1442 antigen binding fragment (Fab) arms, their assembly to 2 + 1 format, and present the high-resolution co-crystal structures of the two anti-CD38 Fabs, in complex with CD38. This, with biophysical and functional assays, elucidated the underlying mechanism of action of ISB 1442. In solution phase, ISB 1442 forms a 2:2 complex with CD38 as determined by size-exclusion chromatography with multi-angle light scattering and electron microscopy. The predicted antibody-antigen stoichiometries at different CD38 surface densities were experimentally validated by surface plasmon resonance and cell binding assays. The specific design and structural features of ISB 1442 enable: 1) enhanced trans binding to adjacent CD38 molecules to increase Fc density at the cancer cell surface; 2) prevention of avid cis binding to monomeric CD38 to minimize blockade by soluble shed CD38; and 3) greater binding avidity, with a slower off-rate at high CD38 density, for increased specificity. The superior CD38 targeting of ISB 1442, at both high and low receptor densities, by its biparatopic design, will enhance proximal CD47 blockade and thus counteract a major tumor escape mechanism in multiple myeloma patients.</p>","PeriodicalId":18206,"journal":{"name":"mAbs","volume":"17 1","pages":"2457471"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Fusobacterium nucleatum</i> upregulates the immune inhibitory receptor <i>PD-L1</i> in colorectal cancer cells via the activation of ALPK1.","authors":"Coco Duizer, Moniek Salomons, Merel van Gogh, Sanne Gräve, Freke A Schaafsma, Maaike J Stok, Merel Sijbranda, Raghuvandhanan Kumarasamy Sivasamy, Rob J L Willems, Marcel R de Zoete","doi":"10.1080/19490976.2025.2458203","DOIUrl":"10.1080/19490976.2025.2458203","url":null,"abstract":"<p><p><i>Fusobacterium nucleatum</i> is a Gram-negative oncobacterium that is associated with colorectal cancer. The molecular mechanisms utilized by <i>F. nucleatum</i> to promote colorectal tumor development have largely focused on adhesin-mediated binding to the tumor tissue and on the pro-inflammatory capacity of <i>F. nucleatum</i>. However, the exact manner in which <i>F. nucleatum</i> promotes inflammation in the tumor microenvironment and subsequent tumor promotion remains underexplored. Here, we show that both living <i>F. nucleatum</i> and sterile <i>F. nucleatum-</i>conditioned medium promote CXCL8 release from the intestinal adenocarcinoma HT-29 cell line. We determined that the observed pro-inflammatory effect was ALPK1-dependent in both HEK293 and HT-29 cells and that the released <i>F. nucleatum</i> molecule had characteristics that match those of the pro-inflammatory ALPK1 ligand ADP-heptose or related heptose phosphates. In addition, we determined that not only <i>F. nucleatum</i> promoted an ALPK1-dependent pro-inflammatory environment but also other <i>Fusobacterium</i> species such as <i>F. varium</i>, <i>F. necrophorum</i> and <i>F. gonidiaformans</i> generated similar effects, indicating that ADP-heptose or related heptose phosphate secretion is a conserved feature of the <i>Fusobacterium</i> genus. By performing transcriptional analysis of ADP-heptose stimulated HT-29 cells, we found several inflammatory and cancer-related pathways to be differentially regulated, including DNA mismatch repair genes and the immune inhibitory receptor <i>PD-L1</i>. Finally, we show that stimulation of HT-29 cells with <i>F. nucleatum</i> resulted in an ALPK1-dependent upregulation of <i>PD-L1</i>. These results aid in our understanding of the mechanisms by which <i>F. nucleatum</i> can affect tumor development and therapy and pave the way for future therapeutic approaches.</p>","PeriodicalId":12909,"journal":{"name":"Gut Microbes","volume":"17 1","pages":"2458203"},"PeriodicalIF":12.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in genetic engineering for enhanced Polyhydroxyalkanoates (PHA) production: a comprehensive review of metabolic pathway manipulation and gene deletion strategies.","authors":"Raghavendra Paduvari, Divyashree Mysore Somashekara","doi":"10.1080/21655979.2025.2458363","DOIUrl":"10.1080/21655979.2025.2458363","url":null,"abstract":"<p><p>Polyhydroxyalkanoates (PHA) are bioplastics produced by few bacteria as intracellular lipid inclusions under excess carbon source and nutrient-deprived conditions. These polymers are biodegradable and resemble petroleum-based plastics. The rising environmental concerns have increased the demand for PHA, but the low yield in wild-type bacterial strains limits large-scale production. An improvement in the PHA production can be achieved by genetically engineering the wild-type bacterial strains by removing competitive pathways that divert the metabolites away from PHA biosynthesis, cloning strong promotors to overexpress the genes involved in PHA biosynthesis and constructing non-native metabolic pathways that feed the metabolites for PHA production. The desired monomers in the PHA polymers were obtained by elimination of genes involved in PHA biosynthetic pathway. The chain length degradation specific-gene deletion of β-oxidation pathway resulted in the accumulation of PHA monomers having high carbon chain length. A controlled accumulation of monomers in the PHA polymer was achieved by constructing novel pathways in the bacteria and deleting native genes of competitive pathways from the genome of non-PHA producers. The present review attempts to showcase the novel genetic modification approaches conducted so far to enhance the PHA production with a special focus on metabolic pathway gene deletion in various bacteria.</p>","PeriodicalId":8919,"journal":{"name":"Bioengineered","volume":"16 1","pages":"2458363"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Gut in Critical Illness.","authors":"Jayshil J Patel, Mark Barash","doi":"10.1007/s11894-024-00954-4","DOIUrl":"10.1007/s11894-024-00954-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this narrative review is to describe the mechanisms for gut dysfunction during critical illness, outline hypotheses of gut-derived inflammation, and identify nutrition and non-nutritional therapies that have direct and indirect effects on preserving both epithelial barrier function and gut microbiota during critical illness.</p><p><strong>Recent findings: </strong>Clinical and animal model studies have demonstrated that critical illness pathophysiology and interventions breach epithelial barrier function and convert a normally commensal gut microbiome into a pathobiome. As a result, the gut has been postulated to be the \"motor\" of critical illness and numerous hypotheses have been put forward to explain how it contributes to systemic inflammation and drives multiple organ failure. Strategies to ameliorate gut dysfunction have focused on maintaining gut barrier function and promoting gut microbiota commensalism. The trajectory of critical illness may be closely related to gut epithelial barrier function, the gut microbiome and interventions that may contribute towards a deleterious pathobiome with immune dysregulation.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946271","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":"Rectal Prolapse in the Pediatric Population.","authors":"James K Moon, John D Stratigis, Aaron M Lipskar","doi":"10.1007/s11894-024-00953-5","DOIUrl":"10.1007/s11894-024-00953-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Rectal prolapse in the pediatric population presents a clinical challenge with wide variability in etiology, presentation, work-up and management. In this article, we reviewed the evidence supporting various medical and surgical treatment options as well as the recent trends amongst pediatric surgeons.</p><p><strong>Recent findings: </strong>Medical therapy is highly effective in most patients, with bowel management programs being particularly successful. Nonetheless, medically refractory disease, often seen in older children and in children with behavioral/psychiatric disorders, can be challenging. Sclerotherapy with ethanol or 5% phenol can be effective local treatments. 15% hypertonic saline, 50% dextrose, and Deflux are additional safe alternatives. Perianal procedures and perineal procedures are less invasive surgical options, but transabdominal rectopexy appears to be the favored treatment for disease refractory to local treatment. Transabdominal rectopexy with sigmoidectomy, the recommended operation in the adult population for patients with prolapse and constipation, appears only to be preferred in the pediatric population for postoperative recurrences.</p><p><strong>Recent findings: </strong>While outcomes of medical treatment for pediatric rectal prolapse are excellent, sclerotherapy and transabdominal rectopexy are effective options for refractory disease preferred by most pediatric surgeons.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695051","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}