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ZNF143-mediated upregulation of MEX3C promotes hepatocellular carcinoma progression ZNF143 介导的 MEX3C 上调会促进肝细胞癌的进展。
IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-31 DOI: 10.1016/j.clinre.2024.102492
Lili Zhang , Nan Dang , Jiongyi Wang , Wenying Zhang , Xiaohua Hu , Bin Jiang , Dan Zhao , Feng Liu , Haihua Yuan

Background

Microvascular invasion is strongly associated with aggressive tumor behavior and recurrence in hepatocellular carcinoma (HCC) patients. Zinc finger protein 143(ZNF143) is a transcription factor involved in a wide variety of physiological and developmental processes. This study primarily focuses on the exact biological role and mechanism of ZNF143 in HCC migration and invasion.

Methods

The expression and prognosis of ZNF143 in HCC patients were analyzed. The levels of ZNF143, mex-3 RNA binding family member C (MEX3C) were quantified by western blot and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Cell migration ability was detected by wound- healing assay. Matrigel transwell assay was conducted to evaluate the invasion of HCC cells. The differential expression genes of ZNF143 overexpression and knockdown were screened by mRNA profiling analysis. Dual luciferase assay was performed to determine the promoter activity of MEX3C. The enrichment of ZNF143 at MEX3C promoter was determined by chromatin immunoprecipitation (ChIP).

Results

ZNF143 is overexpressed in HCC tissues and that its overexpression is correlated with poorer prognosis, especially in HCC patients with higher tumor grades and microvascular invasion. Gain- and loss-of function experiments showed that ZNF143 promotes migration and invasion in HCC cells. mRNA profiling showed that ZNF143 significantly upregulates MEX3C. ZNF143 was positively correlated with MEX3C expression in HCC tissue. ZNF143 activates MEX3C transcription by directly binding to its promoter. MEX3C knockdown inhibited migration and invasion induced by ZNF143 overexpression in HCC cells.

Conclusion

ZNF143 promotes HCC cell migration and invasion by binding to MEX3C promoter and activating its expression.
背景:微血管侵犯与肝细胞癌(HCC)患者的侵袭性肿瘤行为和复发密切相关。锌指蛋白 143(ZNF143)是一种转录因子,参与多种生理和发育过程。本研究主要关注 ZNF143 在 HCC 迁移和侵袭中的确切生物学作用和机制:方法:分析 ZNF143 在 HCC 患者中的表达和预后。方法:分析了 ZNF143 在 HCC 患者中的表达和预后,并通过 Western 印迹和反转录定量聚合酶链反应(RT-qPCR)对 ZNF143、mex-3 RNA 结合家族成员 C(MEX3C)的水平进行了定量。通过伤口愈合试验检测细胞迁移能力。Matrigel transwell 试验用于评估 HCC 细胞的侵袭能力。通过 mRNA 图谱分析筛选 ZNF143 过表达和敲除的差异表达基因。通过双荧光素酶检测来确定MEX3C的启动子活性。染色质免疫沉淀(ChIP)测定了ZNF143在MEX3C启动子上的富集:结果:ZNF143在HCC组织中过表达,其过表达与较差的预后相关,尤其是在肿瘤分级较高和微血管侵犯较多的HCC患者中。mRNA分析表明,ZNF143能显著上调MEX3C。ZNF143与HCC组织中MEX3C的表达呈正相关。ZNF143通过直接结合到MEX3C的启动子来激活MEX3C的转录。MEX3C敲除抑制了ZNF143过表达诱导的HCC细胞迁移和侵袭:结论:ZNF143通过与MEX3C启动子结合并激活其表达,促进了HCC细胞的迁移和侵袭。
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引用次数: 0
Predictive value of hepatic venous pressure gradient in cirrhotic portal vein thrombosis development 肝静脉压力梯度对肝硬化门静脉血栓形成的预测价值
IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-30 DOI: 10.1016/j.clinre.2024.102484
Huan Zhong , Sizhu Lu , Min Xu, Na Liu, Wei Ye, Yongfeng Yang

Background & Aims

There are lots of risk factors reported for cirrhotic portal vein thrombosis (PVT) development, however, the relationship between hepatic venous pressure gradient (HVPG) and PVT development remains unclear.

Methods

The clinical outcomes of cirrhotic patients who had no PVT and underwent HVPG measurement at baseline between March 2018 and March 2022 were analyzed retrospectively. Screening for non-tumoral PVT development was implemented by contrast-enhanced computed tomography and/or magnetic resonance imaging every 6-12 months.

Results

Eighty-two cirrhotic patients were evaluated over a follow-up period. Of these, 12 patients (14.6%) experienced the development of PVT. The occurrence of non-tumoral PVT at one, two, and three years were 6.6%, 11.7%, and 22.2% respectively. HVPG (p=0.038;HR 1.07;95%CI 1.00-1.14) and alcohol liver disease (ALD) (p=0.019;HR 4.20;95%CI 1.27-13.89) were independently associated with a high PVT risk. The cutoff value of HVPG was 17.52 mmHg. The cumulative incidence of PVT differed significantly among groups stratified by HVPG thresholds of 16mmHg (P=0.011). The sensitivity and specificity of HVPG≥16mmHg in predicting PVT development were 100.0% and 35.7%.

Conclusions

In patients with liver cirrhosis, the value of HVPG was the independent predictive factor of PVT development. Screening for PVT was recommended during follow-up in patients with HVPG≥16 mmHg.
背景与目的:肝硬化门静脉血栓形成(PVT)的风险因素很多,但肝静脉压力梯度(HVPG)与PVT形成之间的关系仍不清楚:回顾性分析了2018年3月至2022年3月期间无PVT且基线时接受HVPG测量的肝硬化患者的临床结果。每 6-12 个月通过对比增强计算机断层扫描和/或磁共振成像筛查非肿瘤性 PVT 的发展:82名肝硬化患者接受了随访评估。结果:在随访期间,对 82 名肝硬化患者进行了评估,其中 12 名患者(14.6%)出现了 PVT。一年、两年和三年后,非肿瘤性 PVT 的发生率分别为 6.6%、11.7% 和 22.2%。HVPG(p=0.038;HR 1.07;95%CI 1.00-1.14)和酒精性肝病(ALD)(p=0.019;HR 4.20;95%CI 1.27-13.89)与高 PVT 风险独立相关。HVPG 的临界值为 17.52 mmHg。按 HVPG 临界值 16mmHg 分层的各组间 PVT 累计发生率差异显著(P=0.011)。HVPG≥16mmHg预测PVT发生的敏感性和特异性分别为100.0%和35.7%:结论:在肝硬化患者中,HVPG 值是预测 PVT 发生的独立因素。结论:在肝硬化患者中,HVPG 值是预测 PVT 发生的独立因素,建议在随访期间对 HVPG≥16 mmHg 的患者进行 PVT 筛查。
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引用次数: 0
Real-world effectiveness and safety of CT-P13, an infliximab biosimilar, for inflammatory bowel diseases: A prospective national observational cohort study (ReFLECT study) 英夫利昔单抗生物类似物 CT-P13 治疗炎症性肠病的实际有效性和安全性:一项前瞻性全国观察队列研究(ReFLECT 研究)。
IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-22 DOI: 10.1016/j.clinre.2024.102483
David Laharie , Yoram Bouhnik , Lucine Vuitton , Amélie Biron , Gaelle Pierron , Yves Brault , Maryse Assing , Amira Bouzidi , Aurélien Amiot , Stephane Nancey

Background

ReFLECT was a French, prospective, multicenter, observational cohort study evaluating the effectiveness and safety of the infliximab (IFX) biosimilar CT-P13 in a real-world setting. Here, we describe the results for adults with inflammatory bowel disease (IBD).

Methods

Eligible patients with IBD were recruited and received intravenous CT-P13 induction and/or maintenance therapy; patients were either naive to IFX (IFX-naive) or previously treated with IFX originator or another IFX biosimilar (IFX-switched). The primary objective was CT-P13 persistence, which was measured as a time-dependent variable during a two-year follow-up period with four prespecified visits. Safety was assessed.

Results

The adult IBD population comprised 530 patients with Crohn's disease (CD), including 327 categorized as IFX-naive, 188 as IFX-switched, 11 as other (i.e., previously received IFX but received another treatment before switching to CT-P13), and 4 with missing data; and 221 patients with ulcerative colitis (UC), including 152 categorized as IFX-naive, 59 as IFX-switched, 8 as other, and 2 with missing data. After two years of follow-up, the rates of CT-P13 persistence were 71.7 % (95 % CI: 66.7, 77.0) and 63.7 % (55.3, 73.3) in patients with CD and UC, respectively. CT-P13 persistence was greater for IFX-switched patients than for IFX-naive patients (CD: 83.7 % [95 % CI: 78.0, 89.9] vs 65.7 % [58.6, 73.7]; UC: 91.2 % [81.7, 100.0] vs 53.4 % [43.0, 66.2]). The main reason for CT-P13 discontinuation was loss of response (CD/UC) in both IFX-naive (14.7 %/21.7 %) and IFX-switched (7.4 %/5.1 %) groups. Among patients (CD and UC, respectively), 51.3 % and 45.2 % reported ≥1 adverse event (AE), and 13.2 % and 12.7 % reported serious AEs, respectively.

Conclusion

After two years of follow-up, the effectiveness of intravenous CT-P13 was maintained in >80 % of IFX-switched patients. CT-P13 induced effective therapeutic maintenance in IFX-naive patients. CT-P13 had an acceptable safety profile.

Trial registration

ClinicalTrials.gov identifier: NCT02925338
研究背景ReFLECT 是一项法国前瞻性多中心观察性队列研究,评估了英夫利昔单抗 (IFX) 生物仿制药 CT-P13 在真实世界中的有效性和安全性。在此,我们将介绍针对成人炎症性肠病(IBD)患者的研究结果:我们招募了符合条件的 IBD 患者,他们接受了 CT-P13 的静脉诱导和/或维持治疗;患者要么对 IFX 不敏感(IFX-naive),要么曾接受过 IFX 原研药或另一种 IFX 生物仿制药的治疗(IFX-switched)。主要目标是CT-P13的持续性,在为期两年的随访期间,以时间变量的形式测量CT-P13的持续性。此外还评估了安全性:成年 IBD 患者包括 530 名克罗恩病 (CD) 患者,其中 327 名为 IFX-naive,188 名为 IFX-switched,11 名为其他(即之前接受过 IFX 但在转用 CT-P13 之前接受过其他治疗),4 名数据缺失;溃疡性结肠炎 (UC) 患者 221 名,其中 152 名为 IFX-naive,59 名为 IFX-switched,8 名为其他,2 名数据缺失。随访两年后,CD 和 UC 患者的 CT-P13 持续率分别为 71.7% (95% CI: 66.7, 77.0) 和 63.7% (55.3, 73.3)。IFX转换患者的CT-P13持续率高于IFX免疫患者(CD:83.7% [95% CI:78.0, 89.9] vs 65.7% [58.6, 73.7];UC:91.2% [81.7, 89.9] vs 65.7% [58.6, 73.7]):91.2%[81.7,100.0] vs 53.4% [43.0,66.2])。IFX-naive组(14.7%/21.7%)和IFX-switched组(7.4%/5.1%)停用CT-P13的主要原因是反应消失(CD/UC)。在患者(CD组和UC组)中,分别有51.3%和45.2%的患者报告了≥1次不良事件(AE),分别有13.2%和12.7%的患者报告了严重不良事件:经过两年的随访,超过80%的IFX转换患者维持了静脉注射CT-P13的疗效。CT-P13能有效维持IFX-naive患者的疗效。CT-P13的安全性可接受:试验注册:ClinicalTrials.gov identifier:NCT02925338。
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引用次数: 0
The clinical prognostic risk stratification system for HIV infected hepatocellular carcinoma 艾滋病病毒感染肝细胞癌临床预后风险分层系统。
IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-19 DOI: 10.1016/j.clinre.2024.102479
Yifan Chen , Han Zhao , Yao Wang , Bo Liu , Zhimin Chen , Yu Tao , Yang Xun , Hua Yang , Rongqiu Liu , Lizhi Feng , Xinhua Liu , Hengjing Li , Sibo Wang , Baolin Liao , Dong Zhao , Haolan He , Hua You

Background

Patients with human immunodeficiency virus (HIV) are more susceptible to liver cancer because of their compromised immune system. There is no specific prognostic model for HIV-infected hepatocellular carcinoma (HCC) patients.

Methods

Clinical data of 85 patients with HIV-infected HCC was divided into a 7:3 ratio for training and internal validation sets, while the data of 23 patients with HIV-infected HCC was served as the external validation set. Data of 275 HIV-negative HCC patients was considered as external HIV-negative validation set. Variables associated with overall survival (OS) in the training set were used to develop the HIV-infected HCC prognosis (HIHP) model. The model was tested in the internal and external validation sets. The predictive accuracy of the model was assessed with conventional HIV-negative HCC prognostic scoring systems.

Results

In the training set, variables independently associated with OS in multivariable analysis were organ involvement and tumor number. The HIHP model demonstrated a significant association with OS in the training set, with a median OS of 13 months for low risk, 7 months for medium risk, and 3 months for high risk (p < 0.001). The HIHP model showed a significant association with OS, and exhibited greater discriminative abilities compared to conventional HIV-negative HCC prognostic models both in the internal and external validation sets. In the external HIV-negative validation set, the HIHP model did not show better discrimination than conventional HIV-negative HCC scores.

Conclusion

The new model presented in the work provided a more accurate prognostic prediction of OS in HIV-infected HCC patients. However, the model is not applicable to patients with HIV-negative HCC.
背景:人类免疫缺陷病毒(HIV)感染者由于免疫系统受损,更容易罹患肝癌。目前还没有针对艾滋病毒感染的肝细胞癌(HCC)患者的特定预后模型:85例HIV感染的HCC患者的临床数据按7:3的比例分为训练集和内部验证集,23例HIV感染的HCC患者的数据作为外部验证集。275例HIV阴性HCC患者的数据被视为外部HIV阴性验证集。训练集中与总生存期(OS)相关的变量被用于开发艾滋病毒感染的 HCC 预后(HIHP)模型。该模型在内部和外部验证集中进行了测试。该模型的预测准确性与传统的 HIV 阴性 HCC 预后评分系统进行了评估:结果:在训练集中,多变量分析中与OS独立相关的变量是器官受累和肿瘤数目。在训练集中,HIHP模型与OS有显著相关性,低危患者的中位OS为13个月,中危患者为7个月,高危患者为3个月(P < 0.001)。在内部和外部验证集中,HIHP模型与OS有显著相关性,与传统的HIV阴性HCC预后模型相比,HIHP模型具有更强的判别能力。在外部 HIV 阴性验证集中,HIHP 模型并未显示出比传统 HIV 阴性 HCC 评分更好的判别能力:结论:该研究提出的新模型能更准确地预测HIV感染的HCC患者的OS预后。然而,该模型不适用于HIV阴性HCC患者。
{"title":"The clinical prognostic risk stratification system for HIV infected hepatocellular carcinoma","authors":"Yifan Chen ,&nbsp;Han Zhao ,&nbsp;Yao Wang ,&nbsp;Bo Liu ,&nbsp;Zhimin Chen ,&nbsp;Yu Tao ,&nbsp;Yang Xun ,&nbsp;Hua Yang ,&nbsp;Rongqiu Liu ,&nbsp;Lizhi Feng ,&nbsp;Xinhua Liu ,&nbsp;Hengjing Li ,&nbsp;Sibo Wang ,&nbsp;Baolin Liao ,&nbsp;Dong Zhao ,&nbsp;Haolan He ,&nbsp;Hua You","doi":"10.1016/j.clinre.2024.102479","DOIUrl":"10.1016/j.clinre.2024.102479","url":null,"abstract":"<div><h3>Background</h3><div>Patients with human immunodeficiency virus (HIV) are more susceptible to liver cancer because of their compromised immune system. There is no specific prognostic model for HIV-infected hepatocellular carcinoma (HCC) patients.</div></div><div><h3>Methods</h3><div>Clinical data of 85 patients with HIV-infected HCC was divided into a 7:3 ratio for training and internal validation sets, while the data of 23 patients with HIV-infected HCC was served as the external validation set. Data of 275 HIV-negative HCC patients was considered as external HIV-negative validation set. Variables associated with overall survival (OS) in the training set were used to develop the HIV-infected HCC prognosis (HIHP) model. The model was tested in the internal and external validation sets. The predictive accuracy of the model was assessed with conventional HIV-negative HCC prognostic scoring systems.</div></div><div><h3>Results</h3><div>In the training set, variables independently associated with OS in multivariable analysis were organ involvement and tumor number. The HIHP model demonstrated a significant association with OS in the training set, with a median OS of 13 months for low risk, 7 months for medium risk, and 3 months for high risk (<em>p</em> &lt; 0.001). The HIHP model showed a significant association with OS, and exhibited greater discriminative abilities compared to conventional HIV-negative HCC prognostic models both in the internal and external validation sets. In the external HIV-negative validation set, the HIHP model did not show better discrimination than conventional HIV-negative HCC scores.</div></div><div><h3>Conclusion</h3><div>The new model presented in the work provided a more accurate prognostic prediction of OS in HIV-infected HCC patients. However, the model is not applicable to patients with HIV-negative HCC.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 10","pages":"Article 102479"},"PeriodicalIF":2.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459649","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}
引用次数: 0
Ascites and psychiatric symptoms associated with syphilis 与梅毒有关的腹水和精神症状。
IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-19 DOI: 10.1016/j.clinre.2024.102480
Huayu Zhang , Huajie Liu , Qinglin Tang , Mingqing Zhang
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引用次数: 0
Efficacy of gastric per-oral endoscopic myotomy remains similar after failure of interventional techniques in refractory gastroparesis 在难治性胃瘫的介入治疗失败后,胃经口内镜肌切开术的疗效仍然相似。
IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-18 DOI: 10.1016/j.clinre.2024.102481
Marion Chartier , Henri Duboc , David Moszkowicz , Marie Dior , Maude Le Gall , Benoit Coffin , Heithem Soliman

Background and aims

Gastric per-oral endoscopic myotomy (G-POEM) is a new therapeutic option for the treatment of refractory gastroparesis. However, the outcome of G-POEM after the failure of gastric electrical stimulation (GES) or other pylorus-targeting therapies has been poorly reported.

Methods

Data were collected from patients referred for G-POEM for refractory gastroparesis. The efficacy in patients with previous interventional techniques was compared to patients naïve to instrumental technique. The primary endpoint was the 6-month clinical success rate, defined as at least a 1-point decrease in the Gastroparesis Cardinal Symptom Index (GCSI).

Results

Among 48 patients referred for G-POEM, 32 patients had previous instrumental treatments (66%): 15 (31%) had GES, and 17 (35%) had pyloric endoscopic dilation or toxin injection. The technical success rate was 100%. At 6 months, clinical success was achieved in 25/48 patients (52%) and the GCSI decreased from 3.38 (2.94–3.95) to 2.25 (1.11–3.36) (p < 0.001). The 6-month success rate was similar in patients with or without previous instrumental treatment (50.0% vs 56.3%; p = 0.41). The complication rate was also similar in the two groups (6.3% vs 12.5%; p = 0.59), with only one severe adverse event. The only predictive factor for success at 6 months was a higher body mass index (OR = 1.14 [1.01–1.32]; p = 0.05).

Conclusion

G-POEM is safe and remains effective after GES or previous pyloric treatment failure, with 50% efficacy at 6 months. The therapeutic strategy in refractory gastroparesis remains to be defined.
背景和目的:胃经口内镜肌切开术(G-POEM)是治疗难治性胃瘫的一种新疗法。然而,胃电刺激(GES)或其他幽门靶向疗法失败后,G-POEM 的疗效却鲜有报道:方法:从因难治性胃瘫而转诊接受 G-POEM 治疗的患者中收集数据。方法:从因难治性胃瘫而转诊接受 G-POEM 治疗的患者中收集数据,并将曾接受过介入治疗的患者的疗效与未接受过器械治疗的患者的疗效进行比较。主要终点是6个月的临床成功率,即胃瘫卡迪纳尔症状指数(GCSI)至少下降1分:在 48 名转诊的 G-POEM 患者中,32 名患者(66%)曾接受过器械治疗:其中 15 人(31%)接受过 GES 治疗,17 人(35%)接受过幽门内窥镜扩张术或毒素注射。技术成功率为 100%。6 个月后,25/48 患者(52%)取得了临床成功,GCSI 从 3.38(2.94-3.95)降至 2.25(1.11-3.36)(P < 0.001)。既往接受过或未接受过器械治疗的患者的 6 个月成功率相似(50.0% vs 56.3%;P = 0.41)。两组患者的并发症发生率也相似(6.3% vs 12.5%;p = 0.59),只有一起严重不良事件。6个月时成功的唯一预测因素是体重指数较高(OR = 1.14 [1.01-1.32]; p = 0.05):结论:G-POEM 是安全的,在 GES 或之前的幽门治疗失败后仍然有效,6 个月时有效率为 50%。难治性胃瘫的治疗策略仍有待确定。
{"title":"Efficacy of gastric per-oral endoscopic myotomy remains similar after failure of interventional techniques in refractory gastroparesis","authors":"Marion Chartier ,&nbsp;Henri Duboc ,&nbsp;David Moszkowicz ,&nbsp;Marie Dior ,&nbsp;Maude Le Gall ,&nbsp;Benoit Coffin ,&nbsp;Heithem Soliman","doi":"10.1016/j.clinre.2024.102481","DOIUrl":"10.1016/j.clinre.2024.102481","url":null,"abstract":"<div><h3>Background and aims</h3><div>Gastric per-oral endoscopic myotomy (G-POEM) is a new therapeutic option for the treatment of refractory gastroparesis. However, the outcome of G-POEM after the failure of gastric electrical stimulation (GES) or other pylorus-targeting therapies has been poorly reported.</div></div><div><h3>Methods</h3><div>Data were collected from patients referred for G-POEM for refractory gastroparesis. The efficacy in patients with previous interventional techniques was compared to patients naïve to instrumental technique. The primary endpoint was the 6-month clinical success rate, defined as at least a 1-point decrease in the Gastroparesis Cardinal Symptom Index (GCSI).</div></div><div><h3>Results</h3><div>Among 48 patients referred for G-POEM, 32 patients had previous instrumental treatments (66%): 15 (31%) had GES, and 17 (35%) had pyloric endoscopic dilation or toxin injection. The technical success rate was 100%. At 6 months, clinical success was achieved in 25/48 patients (52%) and the GCSI decreased from 3.38 (2.94–3.95) to 2.25 (1.11–3.36) (p &lt; 0.001). The 6-month success rate was similar in patients with or without previous instrumental treatment (50.0% vs 56.3%; p = 0.41). The complication rate was also similar in the two groups (6.3% vs 12.5%; p = 0.59), with only one severe adverse event. The only predictive factor for success at 6 months was a higher body mass index (OR = 1.14 [1.01–1.32]; p = 0.05).</div></div><div><h3>Conclusion</h3><div>G-POEM is safe and remains effective after GES or previous pyloric treatment failure, with 50% efficacy at 6 months. The therapeutic strategy in refractory gastroparesis remains to be defined.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102481"},"PeriodicalIF":2.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The prevalence of small intestine bacterial overgrowth in irritable bowel syndrome is much higher with lactulose than glucose breath test: Results of a retrospective monocentric study 乳果糖呼气试验中肠易激综合征小肠细菌过度生长的发生率远高于葡萄糖呼气试验:一项回顾性单中心研究的结果。
IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-18 DOI: 10.1016/j.clinre.2024.102482
François Mion , Fabien Subtil , Christelle Machon , Sabine Roman , Anne Mialon

Background

Glucose (GBT) and lactulose (LBT) breath tests have been recommended for the diagnosis of small intestinal bacterial overgrowth (SIBO). LBT may yield a higher prevalence of SIBO diagnosis, because of its limited small bowel absorption, and therefore colonic fermentation. The aim of this retrospective study was to confirm this hypothesis, in irritable bowel syndrome patients (IBS).

Methods

Among a cohort of 995 patients who underwent GBT or LBT, 287 with typical IBS according to Rome IV criteria, without past digestive surgery or significant medical comorbidities, were included.

Results

155 IBS patients underwent GBT, and 132 LBT (71% women, mean age 45±15, mean BMI: 22.6±4.3 kg/m2). There were no difference between both groups in terms of demographics, IBS type and severity of symptoms. The prevalence of SIBO according to LBT was 47%, versus 4.5% only with GBT (p<0.001). The prevalence of methane values ≥ 10 ppm were similar in both groups (34%).

Conclusion

LBT is very frequently positive in IBS patients, as compared to GBT. The 2 tests are thus not interchangeable for the diagnosis of SIBO. Furthermore, the positivity of both tests was not correlated with symptoms, which may indicate a poor clinical interest of these tests in IBS.
背景:葡萄糖(GBT)和乳糖(LBT)呼气试验被推荐用于诊断小肠细菌过度生长(SIBO)。由于乳糖的小肠吸收有限,因此结肠发酵可能会导致 SIBO 诊断的发生率更高。这项回顾性研究的目的是在肠易激综合征(IBS)患者中证实这一假设:在接受 GBT 或 LBT 的 995 名患者中,有 287 名根据罗马 IV 标准患有典型的肠易激综合征,既往未接受过消化系统手术,也没有严重的并发症:155名IBS患者接受了GBT,132名患者接受了LBT(71%为女性,平均年龄(45±15)岁,平均体重指数(BMI):22.6±4.3 kg/m2)。两组患者在人口统计学、肠易激综合征类型和症状严重程度方面没有差异。根据 LBT,SIBO 的患病率为 47%,而 GBT 仅为 4.5%(p 结论:LBT 在肠易激综合征患者中的阳性率非常高:与 GBT 相比,LBT 在肠易激综合征患者中的阳性率很高。因此,这两种检验在诊断 SIBO 时不能互换。此外,这两种检验的阳性率与症状无关,这可能表明这些检验对肠易激综合征的临床意义不大。
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引用次数: 0
Therapeutic effects of fecal microbial transplantation on alcoholic liver injury in rat models 粪便微生物移植对大鼠酒精性肝损伤模型的治疗效果
IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-11 DOI: 10.1016/j.clinre.2024.102478
Yue Zhang , Pengfei Li , Bo Chen , Ruipeng Zheng

Objective

Disruption of gut microbiota is closely related to the progression of alcoholic liver disease (ALD). This study aimed to explore the therapeutic effect of fecal microbiota transplantation (FMT) in ALD rats using a combination of microbiological and metabolomic techniques.

Methods

Three liver injury rat models were constructed using alcohol, CCL4, and alcohol combined with CCL4, and administered an FMT treatment comprising the fecal microbiota of healthy rats via the gastric route for 12 consecutive weeks. We measured the therapeutic effect of FMT treatment on liver inflammation, intestinal mucosal barrier, and bacterial translocation in ALD rats using 16S rRNA and UPLC-Q/TOF-MS technology to detect the effects of FMT on the intestinal microbiota and metabolic patterns of ALD rats.

Results

FMT treatment effectively improved liver function, prolonged survival time, improved the intestinal mucosal barrier, reduced bacterial translocation, alleviated liver inflammation, and delayed the progression of liver fibrosis in three types of liver injury models. The microbiome and metabolomic results showed that FMT can effectively improve gut microbiota disorder in ALD rats and improve metabolic patterns by regulating metabolic pathways such as the arachidonic acid and retinol pathways.

Conclusion

FMT treatment could reverse alcohol induced liver injury by improving gut microbiota and metabolic patterns in ALD rats, and oral FMT could be an effective therapeutic approach for ALD.
目的肠道微生物群的破坏与酒精性肝病(ALD)的进展密切相关。本研究旨在结合微生物学和代谢组学技术,探讨粪便微生物群移植(FMT)对 ALD 大鼠的治疗效果。结果FMT治疗有效改善了三种肝损伤模型的肝功能,延长了存活时间,改善了肠粘膜屏障,减少了细菌转运,缓解了肝脏炎症,延缓了肝纤维化的进展。微生物组和代谢组学结果显示,FMT能有效改善ALD大鼠肠道微生物群紊乱,并通过调节花生四烯酸和视黄醇等代谢途径改善代谢模式。
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引用次数: 0
Real-life effectiveness of allogeneic expanded adipose-derived mesenchymal stem cell therapy for perianal fistulizing refractory Crohn's disease 异体扩增脂肪间充质干细胞治疗肛周瘘难治性克罗恩病的实际疗效:异体间充质干细胞治疗肛周瘘CD。
IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-28 DOI: 10.1016/j.clinre.2024.102473
Maria Alonso-Gomez , Anne Laure Charlois , Eddy Cotte , Claire Gay , Pauline Danion , Emilie Malezieux , Romain Altwegg , Gilles Boschetti , Stéphane Nancey

Background

Real life data about the long-term efficacy of darvadstrocel for treating perianal fistulas in Crohn's disease (CD) remain scarce. Aim: To report the effectiveness and safety of darvadstrocel therapy to close perianal fistula in a real-life cohort of CD patients.

Methods

All patients with CD suffering complex draining perianal fistulas who consecutively underwent administration of a single local injection of darvadstrocel at two centres were followed up and evaluated. The primary endpoint was clinical remission (closure of all external openings with no discharge at pressure) at week 24. Combined remission (defined as clinically plus MRI-assessed fistula closure) were also assessed at week 24 and 52.

Results

A total of 36 CD patients (19 Male, mean age 38.5 years) were included with a median follow up of 16 months. Clinical remission was achieved in 17 out of 36 patients (47.2 %) and combined remission in 15 out of 36 patients (41.6 %) at week 24. At week 52, clinical and combined remission was achieved in 17 out of 36 patients (47.2 %) and in 15 out of 33 evaluable patients (45.4 %), respectively.

Conclusion

In this real-world setting, a successful response to darvadstrocel therapy based on clinical remission was reported in around half of the patients and combined remission including radiological assessment in more than 4 out of 10 patients.
背景:有关达伐司他韦治疗克罗恩病(CD)肛周瘘管的长期疗效的真实数据仍然很少。目的:报告达伐司他韦治疗克罗恩病患者肛周瘘管的有效性和安全性:方法:在两个中心对所有患有复杂引流性肛周瘘的 CD 患者进行随访和评估,这些患者连续接受了达伐司他赛单次局部注射。主要终点是第24周时的临床缓解(所有外部开口闭合,按压无分泌物)。在第24周和第52周还对综合缓解(定义为临床和核磁共振评估的瘘管闭合)进行了评估:共纳入 36 名 CD 患者(19 名男性,平均年龄 38.5 岁),中位随访时间为 16 个月。在第 24 周,36 名患者中有 17 人(47.2%)获得临床缓解,36 名患者中有 15 人(41.6%)获得综合缓解。第 52 周时,36 名患者中有 17 人(47.2%)实现了临床缓解,33 名可评估患者中有 15 人(45.4%)实现了综合缓解:结论:在这一真实世界环境中,约半数患者对达伐司曲塞疗法的临床缓解做出了成功的反应,10 例患者中有 4 例以上获得了包括放射学评估在内的综合缓解。
{"title":"Real-life effectiveness of allogeneic expanded adipose-derived mesenchymal stem cell therapy for perianal fistulizing refractory Crohn's disease","authors":"Maria Alonso-Gomez ,&nbsp;Anne Laure Charlois ,&nbsp;Eddy Cotte ,&nbsp;Claire Gay ,&nbsp;Pauline Danion ,&nbsp;Emilie Malezieux ,&nbsp;Romain Altwegg ,&nbsp;Gilles Boschetti ,&nbsp;Stéphane Nancey","doi":"10.1016/j.clinre.2024.102473","DOIUrl":"10.1016/j.clinre.2024.102473","url":null,"abstract":"<div><h3>Background</h3><div>Real life data about the long-term efficacy of darvadstrocel for treating perianal fistulas in Crohn's disease (CD) remain scarce. Aim: To report the effectiveness and safety of darvadstrocel therapy to close perianal fistula in a real-life cohort of CD patients.</div></div><div><h3>Methods</h3><div>All patients with CD suffering complex draining perianal fistulas who consecutively underwent administration of a single local injection of darvadstrocel at two centres were followed up and evaluated. The primary endpoint was clinical remission (closure of all external openings with no discharge at pressure) at week 24. Combined remission (defined as clinically plus MRI-assessed fistula closure) were also assessed at week 24 and 52.</div></div><div><h3>Results</h3><div>A total of 36 CD patients (19 Male, mean age 38.5 years) were included with a median follow up of 16 months. Clinical remission was achieved in 17 out of 36 patients (47.2 %) and combined remission in 15 out of 36 patients (41.6 %) at week 24. At week 52, clinical and combined remission was achieved in 17 out of 36 patients (47.2 %) and in 15 out of 33 evaluable patients (45.4 %), respectively.</div></div><div><h3>Conclusion</h3><div>In this real-world setting, a successful response to darvadstrocel therapy based on clinical remission was reported in around half of the patients and combined remission including radiological assessment in more than 4 out of 10 patients.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102473"},"PeriodicalIF":2.6,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342887","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}
引用次数: 0
Optimization of endoscopic treatment strategies for R0 resection of rectal neuroendocrine tumors smaller than 10 mm 小于 10 毫米的直肠神经内分泌肿瘤 R0 切除术的内窥镜治疗策略优化。
IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-26 DOI: 10.1016/j.clinre.2024.102469
Jieti Wang , Xiaolan Zhang , Ke Chen , Yun Liang , Yuan Liu , Ziting Jiang , Yiping He , Jie Chen , Jianqiang Liu

Background

The optimal histologically complete (R0) resection methods of endoscopy for rectal neuroendocrine tumor (NET) ≤ 10 mm remains controversial. We aimed to assess the optimal endoscopic treatments for NETs.

Methods

The retrospective enrolled patients (n = 208) with rectal NETs were divided into 3 subsets according to pathological tumor size: 2 - 3 mm, 4 - 5 mm, and 6 - 10 mm NETs. Factors associated with R0 resection according to different endoscopic treatments (accidental diagnostic biopsy by cold forceps, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD)) and tumor size were investigated. All patients underwent follow-up and no local recurrence or metastasis were identified.

Results

A total of 208 patients were enrolled. In patients with 2 - 3 mm NETs, the R0 resection rate was 100.0 % for biopsy, EMR, and ESD. The R0 resection rate for biopsy of 4 - 5 mm and 6 - 10 mm NETs was 34.3 % and 0.0 % respectively, which was inferior to the EMR/ESD rate (4 - 5mm: p < 0.001; 6 - 10 mm: p < 0.001: respectively). For patients with ≤ 10 mm NETs, EMR and ESD had a comparable en bloc (p = 0.082) and R0 resection rates (p = 0.651).

Conclusion

Accidental diagnostic biopsy by cold forceps could be considered as the possible treatment for 2 - 3 mm rectal NETs. And for patients with ≤ 10 mm rectal NETs, both EMR and ESD might be sufficient.
背景:对于直肠神经内分泌肿瘤(NET)≤10 mm的最佳组织学完全(R0)切除方法仍存在争议。我们旨在评估NET的最佳内镜治疗方法:回顾性入组的直肠NET患者(n = 208)根据病理肿瘤大小分为3个亚组:2 - 3 mm、4 - 5 mm和6 - 10 mm的NET。研究人员根据不同的内镜治疗方法(冷钳意外诊断性活检、内镜下粘膜切除术(EMR)和内镜下粘膜下剥离术(ESD))和肿瘤大小调查了R0切除率的相关因素。所有患者均接受了随访,未发现局部复发或转移:结果:共有 208 名患者入选。在2-3毫米的NET患者中,活检、EMR和ESD的R0切除率均为100.0%。4-5毫米和6-10毫米NET活检的R0切除率分别为34.3%和0.0%,低于EMR/ESD的R0切除率(4-5毫米:P<0.001;6-10毫米:P<0.001)。对于≤10毫米的NET患者,EMR和ESD的全切率(p = 0.082)和R0切除率(p = 0.651)相当:结论:对于2-3毫米的直肠NET,可以考虑使用冷钳进行诊断性活检。对于≤10毫米的直肠NET患者,EMR和ESD可能都足够了。
{"title":"Optimization of endoscopic treatment strategies for R0 resection of rectal neuroendocrine tumors smaller than 10 mm","authors":"Jieti Wang ,&nbsp;Xiaolan Zhang ,&nbsp;Ke Chen ,&nbsp;Yun Liang ,&nbsp;Yuan Liu ,&nbsp;Ziting Jiang ,&nbsp;Yiping He ,&nbsp;Jie Chen ,&nbsp;Jianqiang Liu","doi":"10.1016/j.clinre.2024.102469","DOIUrl":"10.1016/j.clinre.2024.102469","url":null,"abstract":"<div><h3>Background</h3><div>The optimal histologically complete (R0) resection methods of endoscopy for rectal neuroendocrine tumor (NET) ≤ 10 mm remains controversial. We aimed to assess the optimal endoscopic treatments for NETs.</div></div><div><h3>Methods</h3><div>The retrospective enrolled patients (<em>n</em> = 208) with rectal NETs were divided into 3 subsets according to pathological tumor size: 2 - 3 mm, 4 - 5 mm, and 6 - 10 mm NETs. Factors associated with R0 resection according to different endoscopic treatments (accidental diagnostic biopsy by cold forceps, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD)) and tumor size were investigated. All patients underwent follow-up and no local recurrence or metastasis were identified.</div></div><div><h3>Results</h3><div>A total of 208 patients were enrolled. In patients with 2 - 3 mm NETs, the R0 resection rate was 100.0 % for biopsy, EMR, and ESD. The R0 resection rate for biopsy of 4 - 5 mm and 6 - 10 mm NETs was 34.3 % and 0.0 % respectively, which was inferior to the EMR/ESD rate (4 - 5mm: <em>p</em> &lt; 0.001; 6 - 10 mm: <em>p</em> &lt; 0.001: respectively). For patients with ≤ 10 mm NETs, EMR and ESD had a comparable en bloc (<em>p</em> = 0.082) and R0 resection rates (<em>p</em> = 0.651).</div></div><div><h3>Conclusion</h3><div>Accidental diagnostic biopsy by cold forceps could be considered as the possible treatment for 2 - 3 mm rectal NETs. And for patients with ≤ 10 mm rectal NETs, both EMR and ESD might be sufficient.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102469"},"PeriodicalIF":2.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342885","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}
引用次数: 0
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Clinics and research in hepatology and gastroenterology
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