Pub Date : 2025-11-01Epub Date: 2025-10-10DOI: 10.1016/j.clinre.2025.102705
{"title":"Retraction notice for several articles","authors":"","doi":"10.1016/j.clinre.2025.102705","DOIUrl":"10.1016/j.clinre.2025.102705","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102705"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145263690","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}
Pub Date : 2025-11-01Epub Date: 2025-09-29DOI: 10.1016/j.clinre.2025.102702
Haoxiang Zhu , Jiesen Yu , Jieren Luo , Zihao Cai , Lujin Li , Qingshan Zheng
Background and Aim
Drug development for non-alcoholic fatty liver disease (NAFLD) is frequently hampered by the poor translation of preclinical findings into clinical efficacy. To address this critical challenge, we developed a quantitative cross-species model designed to predict human clinical outcomes from efficacy data in mouse models.
Methods
We performed a model-based meta-analysis (MBMA) of 18 NAFLD drugs, integrating data from published clinical trials with corresponding preclinical mouse studies identified through a systematic search of the Embase and PubMed databases. Using the change in alanine aminotransferase (ΔALT) as the primary biomarker, we constructed an exponential model to define the relationship between ALT reduction in mice and the placebo-corrected response in humans (ΔΔALT). The model's predictive performance was then externally validated using an independent dataset from a study of Linggui Zhugan Tang (LGZGT).
Results
The analysis yielded a robust exponential model, which revealed that a reduction in mouse ΔALT of at least 53.3 U/L is required for a drug to show superiority over placebo in human trials. A more substantial decrease of 128.3 U/L in mice predicted a clinical efficacy exceeding that of Resmetirom, the first FDA-approved therapy for this condition. The model's predictive power was successfully confirmed through external validation with the LGZGT data.
Conclusions
This study developed a cross-species efficacy model from NAFLD clinical and mouse data, revealing an exponential relationship between human and mouse ALT levels. This provides quantitative thresholds for preclinical screening to improve drug development success rates.
{"title":"Development of a cross-species model to predict clinical outcomes based on efficacy in mouse models of non-alcoholic fatty liver disease","authors":"Haoxiang Zhu , Jiesen Yu , Jieren Luo , Zihao Cai , Lujin Li , Qingshan Zheng","doi":"10.1016/j.clinre.2025.102702","DOIUrl":"10.1016/j.clinre.2025.102702","url":null,"abstract":"<div><h3>Background and Aim</h3><div>Drug development for non-alcoholic fatty liver disease (NAFLD) is frequently hampered by the poor translation of preclinical findings into clinical efficacy. To address this critical challenge, we developed a quantitative cross-species model designed to predict human clinical outcomes from efficacy data in mouse models.</div></div><div><h3>Methods</h3><div>We performed a model-based meta-analysis (MBMA) of 18 NAFLD drugs, integrating data from published clinical trials with corresponding preclinical mouse studies identified through a systematic search of the Embase and PubMed databases. Using the change in alanine aminotransferase (ΔALT) as the primary biomarker, we constructed an exponential model to define the relationship between ALT reduction in mice and the placebo-corrected response in humans (ΔΔALT). The model's predictive performance was then externally validated using an independent dataset from a study of Linggui Zhugan Tang (LGZGT).</div></div><div><h3>Results</h3><div>The analysis yielded a robust exponential model, which revealed that a reduction in mouse ΔALT of at least 53.3 U/L is required for a drug to show superiority over placebo in human trials. A more substantial decrease of 128.3 U/L in mice predicted a clinical efficacy exceeding that of Resmetirom, the first FDA-approved therapy for this condition. The model's predictive power was successfully confirmed through external validation with the LGZGT data.</div></div><div><h3>Conclusions</h3><div>This study developed a cross-species efficacy model from NAFLD clinical and mouse data, revealing an exponential relationship between human and mouse ALT levels. This provides quantitative thresholds for preclinical screening to improve drug development success rates.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102702"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205788","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}
Pub Date : 2025-11-01Epub Date: 2025-10-13DOI: 10.1016/j.clinre.2025.102714
Saqlain Haider
{"title":"Geography, not genetics: Reframing esophageal cancer mortality in rural populations","authors":"Saqlain Haider","doi":"10.1016/j.clinre.2025.102714","DOIUrl":"10.1016/j.clinre.2025.102714","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102714"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298880","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}
Pub Date : 2025-11-01Epub Date: 2025-10-13DOI: 10.1016/j.clinre.2025.102712
Jérôme Dumortier , Georges-Philippe Pageaux , Audrey Coilly , Claire Francoz , Filomena Conti , Guillaume Lassailly , Sébastien Dharancy , Pauline Houssel-Debry , José Ursic-Bedoya , Hélène Donnadieu , Groupe de recherche français en greffe de foie (GReF2)
{"title":"Screening for alcohol consumption in liver transplant recipients: results of a nationwide French survey","authors":"Jérôme Dumortier , Georges-Philippe Pageaux , Audrey Coilly , Claire Francoz , Filomena Conti , Guillaume Lassailly , Sébastien Dharancy , Pauline Houssel-Debry , José Ursic-Bedoya , Hélène Donnadieu , Groupe de recherche français en greffe de foie (GReF2)","doi":"10.1016/j.clinre.2025.102712","DOIUrl":"10.1016/j.clinre.2025.102712","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102712"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298891","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}
Pub Date : 2025-11-01Epub Date: 2025-10-10DOI: 10.1016/j.clinre.2025.102713
Vladimir L Cousin, Marine Lys, Ramy Charbel, Jordi Miatello, Pierre Tissières
None.
没有。
{"title":"Loss of Windkessel notch on transcranial doppler, a glancing sign of cerebral hemodynamic alteration","authors":"Vladimir L Cousin, Marine Lys, Ramy Charbel, Jordi Miatello, Pierre Tissières","doi":"10.1016/j.clinre.2025.102713","DOIUrl":"10.1016/j.clinre.2025.102713","url":null,"abstract":"<div><div>None.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102713"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279069","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}
Pub Date : 2025-11-01Epub Date: 2025-09-22DOI: 10.1016/j.clinre.2025.102691
Mohamed Elnaggar , Ibrahim Hassan , Ahmed Bahnasy , Hatem Eltaly , Houman Rezaizadeh
<div><h3>Background</h3><div>Esophageal carcinoma is the seventh most common cancer worldwide and poses a significant public health concern due to its poor overall survival rates. Although treatment advances, including multimodal approaches and enhanced surgical techniques, have emerged, their effect on national mortality trends remains unclear. Understanding the temporal changes in esophageal cancer mortality and potential disparities across demographic and geographic subgroups is crucial for guiding targeted interventions and resource allocation.</div></div><div><h3>Methods</h3><div>We obtained mortality data for esophageal cancer from the CDC WONDER database covering the years 1999 to 2020, using the ICD-10 code (C15) for malignant neoplasm of the esophagus. Annual mortality rates were age-adjusted to the 2000 U.S. standard population and expressed per 10,000 and 100,000 persons. Analyses were stratified by sex (male, female), race/ethnicity (Non-Hispanic Black or African American, Non-Hispanic White, Hispanic), U.S. Census region (Northeast, Midwest, South, West), and urbanization status (rural versus urban). Joinpoint regression identified periods with distinct trends and estimated annual percent changes (APC); the average annual percent change (AAPC) summarized the overall trend.</div></div><div><h3>Results</h3><div>From 1999 to 2020, there were 374,000 recorded deaths from esophageal cancer across a population of over 8 billion. The overall AAMR declined from 4.36 (95 % CI: 4.28–4.44) in 1999 to 3.69 (3.63–3.75) in 2020 (AAPC:0.8 %). Sex disparities were observed, as males had significantly higher mortality (6.43 per 100,000) compared to females (1.38 per 100,000) in 2020, though both showed declining trends (AAPC:0.84 % and -1.12 %, respectively). By race/ethnicity, Black or African American individuals experienced the most pronounced decline, from 6.61 to 2.73 (AAPC:3.82 %), with particularly steep declines after 2018 (APC:1.58 %). Hispanic populations showed moderate decreases from 2.54 to 1.99 (AAPC:1.32 %), while White populations showed minimal change from 4.3 to 4.28 (AAPC:0.05 %).</div><div>Regionally, the West experienced the greatest decline from 4.17 to 3.36 (AAPC:1.08 %), followed by the Northeast which fell from 4.61 to 3.57 (AAPC:1.07 %), the South from 4.23 to 3.56 (AAPC:0.89 %), and the Midwest displaying the smallest decrease from 4.46 to 4.37 (AAPC:0.31 %). Urban areas demonstrated a consistent decline (AAPC:1.09 %), while rural areas showed a modest increase from 4.16 to 4.52 (AAPC: 0.48 %).</div></div><div><h3>Conclusions</h3><div>Mortality due to esophageal cancer in the U.S. has declined modestly from 1999 to 2020, showing substantial variation across demographic and geographic subgroups. Black or African American populations experienced a significant decline in mortality rates compared to other racial groups, while rural areas exhibited concerning increases in mortality rates. Persistent disparities by sex, race/ethn
{"title":"Trends in esophageal cancer mortality in the United States (1999–2024): Disparities by sex, race/ethnicity, region, and urbanization","authors":"Mohamed Elnaggar , Ibrahim Hassan , Ahmed Bahnasy , Hatem Eltaly , Houman Rezaizadeh","doi":"10.1016/j.clinre.2025.102691","DOIUrl":"10.1016/j.clinre.2025.102691","url":null,"abstract":"<div><h3>Background</h3><div>Esophageal carcinoma is the seventh most common cancer worldwide and poses a significant public health concern due to its poor overall survival rates. Although treatment advances, including multimodal approaches and enhanced surgical techniques, have emerged, their effect on national mortality trends remains unclear. Understanding the temporal changes in esophageal cancer mortality and potential disparities across demographic and geographic subgroups is crucial for guiding targeted interventions and resource allocation.</div></div><div><h3>Methods</h3><div>We obtained mortality data for esophageal cancer from the CDC WONDER database covering the years 1999 to 2020, using the ICD-10 code (C15) for malignant neoplasm of the esophagus. Annual mortality rates were age-adjusted to the 2000 U.S. standard population and expressed per 10,000 and 100,000 persons. Analyses were stratified by sex (male, female), race/ethnicity (Non-Hispanic Black or African American, Non-Hispanic White, Hispanic), U.S. Census region (Northeast, Midwest, South, West), and urbanization status (rural versus urban). Joinpoint regression identified periods with distinct trends and estimated annual percent changes (APC); the average annual percent change (AAPC) summarized the overall trend.</div></div><div><h3>Results</h3><div>From 1999 to 2020, there were 374,000 recorded deaths from esophageal cancer across a population of over 8 billion. The overall AAMR declined from 4.36 (95 % CI: 4.28–4.44) in 1999 to 3.69 (3.63–3.75) in 2020 (AAPC:0.8 %). Sex disparities were observed, as males had significantly higher mortality (6.43 per 100,000) compared to females (1.38 per 100,000) in 2020, though both showed declining trends (AAPC:0.84 % and -1.12 %, respectively). By race/ethnicity, Black or African American individuals experienced the most pronounced decline, from 6.61 to 2.73 (AAPC:3.82 %), with particularly steep declines after 2018 (APC:1.58 %). Hispanic populations showed moderate decreases from 2.54 to 1.99 (AAPC:1.32 %), while White populations showed minimal change from 4.3 to 4.28 (AAPC:0.05 %).</div><div>Regionally, the West experienced the greatest decline from 4.17 to 3.36 (AAPC:1.08 %), followed by the Northeast which fell from 4.61 to 3.57 (AAPC:1.07 %), the South from 4.23 to 3.56 (AAPC:0.89 %), and the Midwest displaying the smallest decrease from 4.46 to 4.37 (AAPC:0.31 %). Urban areas demonstrated a consistent decline (AAPC:1.09 %), while rural areas showed a modest increase from 4.16 to 4.52 (AAPC: 0.48 %).</div></div><div><h3>Conclusions</h3><div>Mortality due to esophageal cancer in the U.S. has declined modestly from 1999 to 2020, showing substantial variation across demographic and geographic subgroups. Black or African American populations experienced a significant decline in mortality rates compared to other racial groups, while rural areas exhibited concerning increases in mortality rates. Persistent disparities by sex, race/ethn","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102691"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136717","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}
Pub Date : 2025-11-01Epub Date: 2025-10-09DOI: 10.1016/j.clinre.2025.102708
Ting Tong , Xu Hui , Ruizhi Shi , Junfeng Li , Li Xu , Liting Zhang , Kehu Yang
Background and Aim
The efficacy and safety of budesonide combined with azathioprine (AZA) compared to predniso(lo)ne combined with AZA in the treatment of autoimmune hepatitis (AIH) remain uncertain. This study aimed to compare the efficacy and safety of two combination regimens.
Methods
A comprehensive literature search was performed in various databases from database inception to July 2023. The primary outcome was complete biochemical remission rate of AIH. A fixed-effects model was employed when heterogeneity was low, with risk ratios (RR) and 95 % confidence intervals (CIs) reported.
Results
Six studies involving 929 patients were included in the analysis. Among these studies, four were randomized controlled trials (RCTs), while two were cohort studies. The results of the meta-analysis revealed inconsistent findings regarding the complete biochemical remission (CBR) rate between budesonide combined with AZA and predniso(lo)ne combined with AZA in both RCTs and cohort studies. (RCT: RR=1.45, 95 % CI: 1.24 to 1.68; cohort study: RR=0.86, 95 % CI: 0.57 to 1.28). The meta-analysis revealed that the combination of budesonide and AZA was associated with a reduced occurrence of adverse events (AEs) (RCT: RR=0.49, 95 % CI: 0.35 to 0.69; cohort study: RR=0.61, 95 % CI: 0.43 to 0.88) and steroid-related AEs (RCT: RR=0.51, 95 % CI: 0.35 to 0.74; cohort study: RR=0.64, 95 % CI: 0.44 to 0.95).
Conclusion
The combination of budesonide and AZA may offer potential advantages in terms of efficacy and safety for populations with less severe liver damage or lower ALT/AST levels, although the certainty of evidence is currently low to very low.
{"title":"The efficacy and safety of budesonide combined with azathioprine versus predniso(lo)ne combined with azathioprine for autoimmune hepatitis: A systematic review and meta-analysis","authors":"Ting Tong , Xu Hui , Ruizhi Shi , Junfeng Li , Li Xu , Liting Zhang , Kehu Yang","doi":"10.1016/j.clinre.2025.102708","DOIUrl":"10.1016/j.clinre.2025.102708","url":null,"abstract":"<div><h3>Background and Aim</h3><div>The efficacy and safety of budesonide combined with azathioprine (AZA) compared to predniso(lo)ne combined with AZA in the treatment of autoimmune hepatitis (AIH) remain uncertain. This study aimed to compare the efficacy and safety of two combination regimens.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed in various databases from database inception to July 2023. The primary outcome was complete biochemical remission rate of AIH. A fixed-effects model was employed when heterogeneity was low, with risk ratios (RR) and 95 % confidence intervals (CIs) reported.</div></div><div><h3>Results</h3><div>Six studies involving 929 patients were included in the analysis. Among these studies, four were randomized controlled trials (RCTs), while two were cohort studies. The results of the meta-analysis revealed inconsistent findings regarding the complete biochemical remission (CBR) rate between budesonide combined with AZA and predniso(lo)ne combined with AZA in both RCTs and cohort studies. (RCT: RR=1.45, 95 % CI: 1.24 to 1.68; cohort study: RR=0.86, 95 % CI: 0.57 to 1.28). The meta-analysis revealed that the combination of budesonide and AZA was associated with a reduced occurrence of adverse events (AEs) (RCT: RR=0.49, 95 % CI: 0.35 to 0.69; cohort study: RR=0.61, 95 % CI: 0.43 to 0.88) and steroid-related AEs (RCT: RR=0.51, 95 % CI: 0.35 to 0.74; cohort study: RR=0.64, 95 % CI: 0.44 to 0.95).</div></div><div><h3>Conclusion</h3><div>The combination of budesonide and AZA may offer potential advantages in terms of efficacy and safety for populations with less severe liver damage or lower ALT/AST levels, although the certainty of evidence is currently low to very low.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102708"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257573","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}
Pub Date : 2025-11-01Epub Date: 2025-09-09DOI: 10.1016/j.clinre.2025.102685
Syed Muhammad Mehdi Zaidi , Qunoot Irfan , Rahmah Javed , Zulekha Khalid , Hamna Khan , Muhammad Hasan Ashraf , Mustafa Hassan Alvi , Faiq Wahid , Sana Zehra , Zainab Abbas
Introduction
Metabolic dysfunction-associated Steatotic Liver Disease (MASLD) is prevalent amongst children and adolescents. Despite higher incidence, effective treatment options for this population are controversial. This Meta-analysis aims to evaluate the effects of all non-invasive treatment modalities available for MASLD.
Methods
This study includes PubMed, Cochrane Library, and Embase searches (January 2010 to July 2025) for Randomised Controlled Trials (RCTs), evaluating different treatment modalities of MASLD in pediatrics and adolescent population. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Primary outcomes were Aspartate Aminotransferase (AST), Triglycerides (TGs) and Low-Density Lipoproteins (LDL). Secondary outcomes were Alanine Aminotransferase (ALT), Gamma-Glutamyl Transferase (GGT), High-Density Lipoprotein (HDL) and adverse effects. Data were analyzed using Revman 5.3. Continuous values were pooled using the standard mean difference (SMD). Sensitivity analysis was performed to reduce heterogeneity. This study was registered with PROSPERO, CRD42024596682.
Results
We included 31 RCTs, having 1722 participants. Multiple treatment modalities were identified and categorized into dietary intervention, supplementation, drug intervention and exercise. We further categorized dietary intervention into low-sugar diet, low-fat diet and mediterranean diet and compared against different controls. The low-sugar diet showed significant improvement in TG levels against placebo/usual diet [-2.44,95 %CI:3.61,-1.27] and in AST levels against low-fat diet [-1.02, 95 %CI –1.88, -0.16]. LDL levels showed significant change when probiotics were administered against placebo [-0.33, 95 % CI:0.65,0.00].
Conclusion
Supplements and Dietary intervention have shown improvement in liver enzymes and lipid profile. However, more research is required to evaluate the dosage and adverse effects associated with these interventions.
{"title":"Treatment modalities for metabolic dysfunction-associated steatotic liver disease (MASLD) in children and adolescent: A systematic review and meta-analysis of randomized controlled trials","authors":"Syed Muhammad Mehdi Zaidi , Qunoot Irfan , Rahmah Javed , Zulekha Khalid , Hamna Khan , Muhammad Hasan Ashraf , Mustafa Hassan Alvi , Faiq Wahid , Sana Zehra , Zainab Abbas","doi":"10.1016/j.clinre.2025.102685","DOIUrl":"10.1016/j.clinre.2025.102685","url":null,"abstract":"<div><h3>Introduction</h3><div>Metabolic dysfunction-associated Steatotic Liver Disease (MASLD) is prevalent amongst children and adolescents. Despite higher incidence, effective treatment options for this population are controversial. This Meta-analysis aims to evaluate the effects of all non-invasive treatment modalities available for MASLD.</div></div><div><h3>Methods</h3><div>This study includes PubMed, Cochrane Library, and Embase searches (January 2010 to July 2025) for Randomised Controlled Trials (RCTs), evaluating different treatment modalities of MASLD in pediatrics and adolescent population. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Primary outcomes were Aspartate Aminotransferase (AST), Triglycerides (TGs) and Low-Density Lipoproteins (LDL). Secondary outcomes were Alanine Aminotransferase (ALT), Gamma-Glutamyl Transferase (GGT), High-Density Lipoprotein (HDL) and adverse effects. Data were analyzed using Revman 5.3. Continuous values were pooled using the standard mean difference (SMD). Sensitivity analysis was performed to reduce heterogeneity. This study was registered with PROSPERO, CRD42024596682.</div></div><div><h3>Results</h3><div>We included 31 RCTs, having 1722 participants. Multiple treatment modalities were identified and categorized into dietary intervention, supplementation, drug intervention and exercise. We further categorized dietary intervention into low-sugar diet, low-fat diet and mediterranean diet and compared against different controls. The low-sugar diet showed significant improvement in TG levels against placebo/usual diet [-2.44,95 %CI:3.61,-1.27] and in AST levels against low-fat diet [-1.02, 95 %CI –1.88, -0.16]. LDL levels showed significant change when probiotics were administered against placebo [-0.33, 95 % CI:0.65,0.00].</div></div><div><h3>Conclusion</h3><div>Supplements and Dietary intervention have shown improvement in liver enzymes and lipid profile. However, more research is required to evaluate the dosage and adverse effects associated with these interventions.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102685"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039230","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}
Pub Date : 2025-11-01Epub Date: 2025-09-28DOI: 10.1016/j.clinre.2025.102700
Clara Yzet , Camille Robert , Franck Brazier , Erica Meudjo , Capucine Moreau , Denis Chatelain , Mathurin Fumery
Background
The STRIDE II guidelines recognize endoscopic healing (EH) as one of the main therapeutic goals in ulcerative colitis (UC). Nevertheless, histological healing (HH) could reduce the risk of long-term complications in UC. The aim of this study was to assess the risk of relapse in UC depending on the degree of remission achieved.
Methods
We conducted a prospective study including all consecutive UC patients in clinical remission and EH (MES 0 or 1) between January 2021 and January 2024. The primary endpoint was UC relapse, defined as the need for treatment intensification and/or corticosteroids initiation and/or UC-related hospitalization and/or colectomy. Patients were followed up every 6 months for two years. HH was defined as a Nancy index ≤ 1 (blinded double reading).
Results
A total of 75 patients were included. The median disease duration was 12 years (IQR [7.5–19.0]) and 66 (82 %) patients had a left side colitis (E2) or pancolitis (E3). Patients were treated for a median of 3 years (IQR [1.2 - 6.9]) prior to colonoscopy, 49 (65 %) patients had MES 0. Fifty-nine (79 %) patients of the cohort had HH. After a median follow-up of 21.0 months (IQR [12.0 - 26.5]), relapse was observed in 13 patients (17 %) after a median delay of 11 months (IQR [6.0 - 18.0]). There was no difference in the risk of relapse between patients with MES 1 and MES (13.6 % vs. 30.7 % respectively p = 0.275). The risk of relapse in patient with MES 1 was significantly higher among patient with absence of HH (39.7 % versus 20.1 % respectively p = 0.04). Similarly, in patients with MES 0, the risk of relapse was significantly higher among patients without HH (70.0 % versus 27.4 % respectively, p = 0.023). No UC-related hospitalizations or colectomy were reported during follow-up. In multivariate analysis, absence of HH was the only factor associated with disease relapse (HR 4.55 [1.69; 12.22], p = 0.0118).
Conclusion
In this prospective cohort, histological healing was the only associated with improved long-term outcome in UC patients whatever the degree of endoscopic mucosal healing.
背景:STRIDE II指南承认内镜下愈合(EH)是溃疡性结肠炎(UC)的主要治疗目标之一。然而,组织学愈合(HH)可以降低UC长期并发症的风险。本研究的目的是评估UC复发的风险,这取决于缓解的程度。方法:我们进行了一项前瞻性研究,包括2021年1月至2024年1月期间所有临床缓解和EH (MES 0或1)的连续UC患者。主要终点是UC复发,定义为需要加强治疗和/或开始使用皮质类固醇和/或UC相关住院和/或结肠切除术。每6个月随访一次,随访2年。HH定义为Nancy指数≤1(盲法双读)。结果:共纳入75例患者。中位病程为12年(IQR[7.5-19.0]), 66例(82%)患者出现左侧结肠炎(E2)或全结肠炎(E3)。患者在结肠镜检查前平均治疗3年(IQR[1.2 - 6.9]), 49例(65%)患者MES为0。队列中59例(79%)患者患有HH。在中位随访21.0个月(IQR[12.0 - 26.5])后,13例患者(17%)在中位延迟11个月(IQR[6.0 - 18.0])后复发。MES 1和MES患者的复发风险无差异(分别为13.6% vs. 30.7% p = 0.275)。MES 1患者的复发风险明显高于无HH患者(分别为39.7%对20.1% p = 0.04)。同样,在MES 0患者中,无HH患者的复发风险明显更高(分别为70.0%和27.4%,p = 0.023)。随访期间无uc相关住院或结肠切除术报告。在多因素分析中,HH缺失是唯一与疾病复发相关的因素(HR 4.55 [1.69; 12.22], p = 0.0118)。结论:在这个前瞻性队列中,无论内镜下粘膜愈合程度如何,组织学愈合是唯一与UC患者长期预后改善相关的方法。
{"title":"Impact of histological healing on ulcerative colitis disease course among patients with endoscopic healing: results of a prospective study","authors":"Clara Yzet , Camille Robert , Franck Brazier , Erica Meudjo , Capucine Moreau , Denis Chatelain , Mathurin Fumery","doi":"10.1016/j.clinre.2025.102700","DOIUrl":"10.1016/j.clinre.2025.102700","url":null,"abstract":"<div><h3>Background</h3><div>The STRIDE II guidelines recognize endoscopic healing (EH) as one of the main therapeutic goals in ulcerative colitis (UC). Nevertheless, histological healing (HH) could reduce the risk of long-term complications in UC. The aim of this study was to assess the risk of relapse in UC depending on the degree of remission achieved.</div></div><div><h3>Methods</h3><div>We conducted a prospective study including all consecutive UC patients in clinical remission and EH (MES 0 or 1) between January 2021 and January 2024. The primary endpoint was UC relapse, defined as the need for treatment intensification and/or corticosteroids initiation and/or UC-related hospitalization and/or colectomy. Patients were followed up every 6 months for two years. HH was defined as a Nancy index ≤ 1 (blinded double reading).</div></div><div><h3>Results</h3><div>A total of 75 patients were included. The median disease duration was 12 years (IQR [7.5–19.0]) and 66 (82 %) patients had a left side colitis (E2) or pancolitis (E3). Patients were treated for a median of 3 years (IQR [1.2 - 6.9]) prior to colonoscopy, 49 (65 %) patients had MES 0. Fifty-nine (79 %) patients of the cohort had HH. After a median follow-up of 21.0 months (IQR [12.0 - 26.5]), relapse was observed in 13 patients (17 %) after a median delay of 11 months (IQR [6.0 - 18.0]). There was no difference in the risk of relapse between patients with MES 1 and MES (13.6 % vs. 30.7 % respectively <em>p</em> = 0.275). The risk of relapse in patient with MES 1 was significantly higher among patient with absence of HH (39.7 % versus 20.1 % respectively <em>p</em> = 0.04). Similarly, in patients with MES 0, the risk of relapse was significantly higher among patients without HH (70.0 % versus 27.4 % respectively, <em>p</em> = 0.023). No UC-related hospitalizations or colectomy were reported during follow-up. In multivariate analysis, absence of HH was the only factor associated with disease relapse (HR 4.55 [1.69; 12.22], <em>p</em> = 0.0118).</div></div><div><h3>Conclusion</h3><div>In this prospective cohort, histological healing was the only associated with improved long-term outcome in UC patients whatever the degree of endoscopic mucosal healing.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102700"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197861","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}
Gut dysbiosis emerged as a potential metabolic dysfunction-associated steatotic liver disease (MASLD) trigger due to leaky gut and LPS leakage (endotoxemia). MASLD attracts attention from the scientific community due to the non-existence of a specific treatment, the intimate connection to obesity, and its multiple triggers. In this context, physical exercise is a relevant non-pharmacological strategy. However, different intensities and periodicities can produce divergent results, and their impact on the gut-liver axis remains unraveled. Therefore, this comprehensive review outlines the contribution of exercise (MICT or HIIT) to modulating the gut-liver axis in experimental obesity models, with a focus on the intestinal barrier and hepatic mitochondrial and endoplasmic reticulum (ER) homeostasis. The effects of both exercise protocols are likely related to restoring tight junctions and improving gut permeability. Ceased endotoxemia alleviates MASLD by targeting the endoplasmic reticulum (ER) and mitochondria, countering disturbances caused by glucolipotoxicity and inflammation, like ER stress and mitochondrial dyshomeostasis. Although HIIT is superior to MICT in enhancing gut structure and microbiota diversity and possibly mitigating MASLD due to reduced adiposity and improved insulin sensitivity, regular exercise should be encouraged to counter the obesity pandemic by modulating the gut-liver axis.
{"title":"Gut-liver axis: An emerging target for exercise in obesity management","authors":"Laura Alexia Ramos-da-Silva , Henrique Souza-Tavares , Gabriela Rodrigues Medeiros , Nathan Soares Dantas-Miranda , Gabrielle Lima-de-Figueiredo , Daiana Araujo Santana-Oliveira , Flavia Maria Silva-Veiga , Fabiane Ferreira Martins , Vanessa Souza-Mello","doi":"10.1016/j.clinre.2025.102687","DOIUrl":"10.1016/j.clinre.2025.102687","url":null,"abstract":"<div><div>Gut dysbiosis emerged as a potential metabolic dysfunction-associated steatotic liver disease (MASLD) trigger due to leaky gut and LPS leakage (endotoxemia). MASLD attracts attention from the scientific community due to the non-existence of a specific treatment, the intimate connection to obesity, and its multiple triggers. In this context, physical exercise is a relevant non-pharmacological strategy. However, different intensities and periodicities can produce divergent results, and their impact on the gut-liver axis remains unraveled. Therefore, this comprehensive review outlines the contribution of exercise (MICT or HIIT) to modulating the gut-liver axis in experimental obesity models, with a focus on the intestinal barrier and hepatic mitochondrial and endoplasmic reticulum (ER) homeostasis. The effects of both exercise protocols are likely related to restoring tight junctions and improving gut permeability. Ceased endotoxemia alleviates MASLD by targeting the endoplasmic reticulum (ER) and mitochondria, countering disturbances caused by glucolipotoxicity and inflammation, like ER stress and mitochondrial dyshomeostasis. Although HIIT is superior to MICT in enhancing gut structure and microbiota diversity and possibly mitigating MASLD due to reduced adiposity and improved insulin sensitivity, regular exercise should be encouraged to counter the obesity pandemic by modulating the gut-liver axis.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102687"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084630","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}