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Retraction notice for several articles 几篇文章的撤稿通知
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-10-10 DOI: 10.1016/j.clinre.2025.102705
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引用次数: 0
Development of a cross-species model to predict clinical outcomes based on efficacy in mouse models of non-alcoholic fatty liver disease 基于非酒精性脂肪性肝病小鼠模型疗效的跨物种模型预测临床结果的建立
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-09-29 DOI: 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.
背景和目的:非酒精性脂肪性肝病(NAFLD)的药物开发经常受到临床前研究结果转化为临床疗效的不良影响。为了解决这一关键挑战,我们开发了一个定量的跨物种模型,旨在根据小鼠模型的疗效数据预测人类临床结果。方法:我们对18种NAFLD药物进行了基于模型的荟萃分析(MBMA),整合了已发表的临床试验数据和通过系统搜索Embase和PubMed数据库确定的相应临床前小鼠研究数据。利用丙氨酸转氨酶(ΔALT)的变化作为主要生物标志物,我们构建了一个指数模型来定义小鼠ALT减少与人类安慰剂纠正反应之间的关系(ΔΔALT)。然后,使用来自灵桂竹干汤(LGZGT)研究的独立数据集对模型的预测性能进行了外部验证。结果:该分析产生了一个强大的指数模型,该模型显示,在人体试验中,一种药物至少需要减少53.3 U/L的小鼠ΔALT才能显示出优于安慰剂的优势。在小鼠中更大幅度的减少128.3 U/L预示着临床疗效超过瑞斯替龙,瑞斯替龙是fda批准的第一个治疗这种疾病的药物。通过对LGZGT数据的外部验证,成功地验证了模型的预测能力。结论:本研究根据NAFLD临床和小鼠数据建立了一个跨物种疗效模型,揭示了人和小鼠ALT水平之间的指数关系。这为临床前筛选提供了定量阈值,以提高药物开发成功率。
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引用次数: 0
Geography, not genetics: Reframing esophageal cancer mortality in rural populations 地理,而非遗传学:重塑农村人口食管癌死亡率。
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-10-13 DOI: 10.1016/j.clinre.2025.102714
Saqlain Haider
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引用次数: 0
Screening for alcohol consumption in liver transplant recipients: results of a nationwide French survey 肝移植受者饮酒筛查:法国一项全国性调查结果
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-10-13 DOI: 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)
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引用次数: 0
Loss of Windkessel notch on transcranial doppler, a glancing sign of cerebral hemodynamic alteration 经颅多普勒显示Windkessel缺口缺失,这是脑血流动力学改变的初步迹象。
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-10-10 DOI: 10.1016/j.clinre.2025.102713
Vladimir L Cousin, Marine Lys, Ramy Charbel, Jordi Miatello, Pierre Tissières
None.
没有。
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引用次数: 0
Trends in esophageal cancer mortality in the United States (1999–2024): Disparities by sex, race/ethnicity, region, and urbanization 美国食管癌死亡率趋势(1999-2024):性别、种族/民族、地区和城市化差异
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-09-22 DOI: 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
背景:食管癌是全球第七大常见癌症,由于其较低的总生存率,引起了重大的公共卫生问题。尽管出现了治疗进展,包括多模式方法和改进的手术技术,但它们对国家死亡率趋势的影响仍不清楚。了解食管癌死亡率的时间变化以及不同人口和地理亚群之间的潜在差异对于指导有针对性的干预和资源分配至关重要。方法:采用食道恶性肿瘤的ICD-10编码(C15),从CDC WONDER数据库中获取1999年至2020年食管癌死亡率数据。年死亡率根据2000年美国标准人口进行年龄调整,并以每1万人和每10万人表示。分析按性别(男性、女性)、种族/民族(非西班牙裔黑人或非裔美国人、非西班牙裔白人、西班牙裔)、美国人口普查地区(东北部、中西部、南部、西部)和城市化状况(农村与城市)进行分层。结合点回归确定了具有明显趋势的时期和估计的年百分比变化(APC);平均年变化百分比(AAPC)概括了总体趋势。结果:从1999年到2020年,在超过80亿的人口中,有374,000人死于食道癌。总体AAMR从1999年的4.36 (95% CI: 4.28-4.44)下降到2020年的3.69 (3.63-3.75)(AAPC: -0.8%)。性别差异也被观察到,2020年男性的死亡率(6.43 / 10万)明显高于女性(1.38 / 10万),尽管两者都呈现下降趋势(AAPC分别为-0.84%和-1.12%)。按种族/民族划分,黑人或非洲裔美国人的下降最为明显,从6.61降至2.73 (AAPC: -3.82%), 2018年之后的下降尤为急剧(APC: -1.58%)。西班牙裔从2.54下降到1.99 (AAPC: -1.32%),白人从4.3下降到4.28 (AAPC: -0.05%)。从地区来看,西部从4.17下降到3.36 (AAPC: -1.08%),降幅最大,其次是东北从4.61下降到3.57 (AAPC: -1.07%),南部从4.23下降到3.56 (AAPC: -0.89%),中西部从4.46下降到4.37 (AAPC: -0.31%),降幅最小。城市地区表现出持续的下降(AAPC: -1.09%),而农村地区则从4.16小幅上升到4.52 (AAPC: 0.48%)。结论:从1999年到2020年,美国食管癌死亡率略有下降,在人口统计学和地理亚组中显示出实质性的变化。与其他种族群体相比,黑人或非洲裔美国人的死亡率大幅下降,而农村地区的死亡率则出现了相应的上升。性别、种族/民族和城市化方面的持续差异强调需要有针对性的预防战略、早期发现举措和增加获得专门护理的机会,特别是在死亡率趋势与全国模式不同的农村地区。
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引用次数: 0
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 布地奈德联合硫唑嘌呤与普瑞尼索联合硫唑嘌呤治疗自身免疫性肝炎的疗效和安全性:系统评价和荟萃分析
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-10-09 DOI: 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.
背景与目的:布地奈德联合硫唑嘌呤(AZA)治疗自身免疫性肝炎(AIH)的疗效和安全性尚不确定。本研究旨在比较两种联合用药方案的疗效和安全性。方法:从数据库建立到2023年7月,在各数据库中进行全面的文献检索。主要观察指标为AIH生化完全缓解率。当异质性较低时,采用固定效应模型,报告95%置信区间(ci)的风险比(RR)。结果:6项研究共纳入929例患者。其中4项为随机对照试验(rct), 2项为队列研究。荟萃分析的结果显示,在随机对照试验和队列研究中,布地奈德联合AZA和泼尼索联合AZA的完全生化缓解率(CBR)不一致。(RCT: RR=1.45, 95% CI: 1.24 ~ 1.68;队列研究:RR=0.86, 95% CI: 0.57 ~ 1.28)。荟萃分析显示,布地奈德联合AZA可降低不良事件(ae) (RCT: RR=0.49, 95% CI: 0.35 ~ 0.69;队列研究:RR=0.61, 95% CI: 0.43 ~ 0.88)和类固醇相关ae (RCT: RR=0.51, 95% CI: 0.35 ~ 0.74;队列研究:RR=0.64, 95% CI: 0.44 ~ 0.95)的发生率。结论:布地奈德联合AZA对于肝损害程度较轻或ALT/AST水平较低的人群在疗效和安全性方面可能具有潜在优势,尽管证据的确定性目前较低至非常低。
{"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 ,&nbsp;Xu Hui ,&nbsp;Ruizhi Shi ,&nbsp;Junfeng Li ,&nbsp;Li Xu ,&nbsp;Liting Zhang ,&nbsp;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}
引用次数: 0
Treatment modalities for metabolic dysfunction-associated steatotic liver disease (MASLD) in children and adolescent: A systematic review and meta-analysis of randomized controlled trials 儿童和青少年代谢功能障碍相关脂肪变性肝病(MASLD)的治疗方式:随机对照试验的系统回顾和荟萃分析
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-09-09 DOI: 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.
简介:代谢功能障碍相关的脂肪变性肝病(MASLD)在儿童和青少年中普遍存在。尽管发病率较高,但该人群的有效治疗方案仍存在争议。本荟萃分析旨在评估所有可用于MASLD的非侵入性治疗方式的效果。方法:本研究包括PubMed、Cochrane Library和Embase检索(2010年1月至2025年7月)的随机对照试验(RCTs),评估儿科和青少年MASLD的不同治疗方式。使用Cochrane Risk of bias 2工具评估偏倚风险。主要指标为天冬氨酸转氨酶(AST)、甘油三酯(tg)和低密度脂蛋白(LDL)。次要指标为谷氨酰基转移酶(ALT)、谷氨酰基转移酶(GGT)、高密度脂蛋白(HDL)及不良反应。数据分析采用Revman 5.3软件。使用标准平均差(SMD)汇总连续值。进行敏感性分析以减少异质性。本研究注册号为PROSPERO, CRD42024596682。结果:我们纳入31项随机对照试验,共1722名受试者。确定了多种治疗方式,并将其分为饮食干预、补充、药物干预和运动。我们进一步将饮食干预分为低糖饮食、低脂饮食和地中海饮食,并与不同的对照组进行比较。低糖饮食与安慰剂/常规饮食相比,TG水平有显著改善[-2.44,95%CI: -3.61,-1.27], AST水平与低脂饮食相比有显著改善[-1.02,95%CI: -1.88, -0.16]。与安慰剂相比,给予益生菌组LDL水平有显著变化[-0.33,95% CI: -0.65,0.00]。结论:补充剂和饮食干预可改善肝酶和血脂。然而,需要更多的研究来评估与这些干预措施相关的剂量和不良反应。
{"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 ,&nbsp;Qunoot Irfan ,&nbsp;Rahmah Javed ,&nbsp;Zulekha Khalid ,&nbsp;Hamna Khan ,&nbsp;Muhammad Hasan Ashraf ,&nbsp;Mustafa Hassan Alvi ,&nbsp;Faiq Wahid ,&nbsp;Sana Zehra ,&nbsp;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}
引用次数: 0
Impact of histological healing on ulcerative colitis disease course among patients with endoscopic healing: results of a prospective study 内镜下愈合患者组织学愈合对溃疡性结肠炎病程的影响:一项前瞻性研究的结果
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-09-28 DOI: 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。
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引用次数: 0
Gut-liver axis: An emerging target for exercise in obesity management 肠肝轴:肥胖管理运动的新目标。
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-09-16 DOI: 10.1016/j.clinre.2025.102687
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
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.
肠道生态失调是一种潜在的代谢功能障碍相关的脂肪变性肝病(MASLD)触发器,由于肠道渗漏和LPS泄漏(内毒素血症)。由于不存在特定的治疗方法,与肥胖的密切联系以及其多重触发因素,MASLD引起了科学界的关注。在这种情况下,体育锻炼是一种相关的非药物策略。然而,不同的强度和周期可以产生不同的结果,它们对肠肝轴的影响仍然不清楚。因此,本综述概述了运动(MICT或HIIT)对实验性肥胖模型中肠-肝轴调节的贡献,重点关注肠屏障和肝脏线粒体和内质网(ER)稳态。两种运动方案的效果可能与恢复紧密连接和改善肠道通透性有关。停止内毒素血症通过靶向内质网(ER)和线粒体来缓解MASLD,对抗糖脂毒性和炎症引起的紊乱,如内质网应激和线粒体失衡。尽管HIIT在增强肠道结构和微生物群多样性方面优于MICT,并可能因减少肥胖和改善胰岛素敏感性而减轻MASLD,但应鼓励定期运动,通过调节肠-肝轴来对抗肥胖流行。
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引用次数: 0
期刊
Clinics and research in hepatology and gastroenterology
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