Gastroenterology and Hepatology From Bed to Bench最新文献

Aim: We aimed to utilize a large-scale database to better understand its efficacy in this subpopulation group.

Background: Constipation is one of the most common gastrointestinal complaints in the United States whose alleviation often requires multiple interventions and behavioral changes. Fruits are often one of the dietary recommendations for constipated patients, but their efficacy remains mixed.

Methods: We examined the nationwide cross-sectional study in the 2006 - 2010 National Health and Nutrition Examination Survey (NHANES) database. Patients over 20 years old were stratified into fruit-consumption and non-fruit-consumption groups. We excluded patients who had intestinal disease, colon cancer, celiac disease, and were pregnant. We used multivariable logistic regression to determine the association between fruit intake and constipation status as recorded in the database.

Results: A total of 12,192 patients were included in our study. The average age was 50.5, and 49.56% of the population are Caucasians, followed by 26.43% of Hispanics; 9.84% had constipation; and 70.04% had fruit consumption. After adjusting for age, gender, ethnicity, education, marital status, poverty ratio, body mass index, food healthy index, physical activity, supplemental usage, medications, smoking, and alcohol usage, patients who had fruit consumption had a lower odd of constipation (aOR 0.83, 95%CI (0.72, 0.95), p=0.008). Further, patients who had larger fruit intake were likely to be less constipated. Post-propensity score matching revealed similar statistically significant.

Conclusion: Fruit intake, as well larger amount of fruit intake, was associated with lesser odds of constipation. Additional investigations in the fruit subtype, as well as the longitudinal relationship, are required to understand this relationship.

Aim: This study investigates drug repurposing as a viable approach identifying existing pharmacological agents that could be applied to NAFLD management.

Background: Non-alcoholic fatty liver disease (NAFLD) is a prevalent and complex liver condition affecting approximately 25% of the global population, with significant links to metabolic disorders such as obesity and type 2 diabetes. Despite its high burden, no approved therapies currently exist for NAFLD, underscoring the need for effective treatments.

Methods: We utilized two publicly available datasets (GSE126848 and GSE130970) to identify differentially expressed genes (DEGs) and constructed a protein-protein interaction (PPI) network using Cytoscape. Hub and bottleneck (H&B) genes were identified and further analyzed for pathway enrichment using DAVID and KEGG. Drug candidates were identified through the Connectivity Map (CMap) platform, focusing on compounds with counter-gene signatures.

Results: Pathway analysis highlighted critical pathways involved in NAFLD pathogenesis, including the AGE-RAGE and Rap1 signaling pathways. Several promising repurposed drugs, such as WYE-354 and Triciribine, were identified, targeting key mechanisms like lipid metabolism and inflammation.

Conclusion: This study suggests that drug repurposing may accelerate the development of effective NAFLD therapies, although further clinical validation is needed to confirm the therapeutic potential of these findings.

Aim: The aim of this study was to systematically review the global epidemiology of Inflammatory Bowel Disease (IBD).

Background: IBD is a global concern, and its incidence is rising worldwide.

Methods: We searched PubMed, Scopus, and Web of Science from 1 January 2000 to 14 July 2022 using MeSH keywords. All population-based studies that reported the incidence or prevalence of IBD, Crohn's disease (CD), or ulcerative colitis (UC) were included. Random effect models were applied to combine the prevalence and incidence.

Results: Findings from 215 studies were analyzed. The global prevalence rates of IBD, CD, and UC were 229.7 per 100,000 (95% confidence interval: 212.4 to 247.0), 84.2 (78.5 to 89.9), and 120.4 (110.5 to 130.3), and the incidence was 9.7 per 100,000 person-years (9.2 to 10.2), 4.0 (3.8 to 4.2), and 5.0 (4.6 to 5.3), respectively. The highest IBD and CD incidence were seen in Oceania (21.3 [12.9 to 29.7] and 12.2 [8.5 to 15.9], respectively), while the highest incidence of UC was reported in North America (9.8 [6.7 to 12.8]). According to the pooled prevalence, Europe had the highest prevalence rates of IBD and UC (348.4 [315.2 to 381.5] and 198.6 [181.6 to 215.6], respectively), whereas Oceania was the continent with the highest CD prevalence (173.6 [151.8 to 195.4]).

Conclusion: Our findings showed that the incidence and prevalence of IBD in both developed and developing nations are mounting. Special focus should be placed on understanding and managing pediatric CD cases, necessitating targeted research and early interventions.

Aim: We evaluated their diagnostic potential compared to histopathology and standard biochemical tests of liver function.

Background: Liver fibrosis is considered a reversible condition, making early diagnosis essential. Serum levels of matrix metalloproteinase (MMP) -1 and MMP-2 are investigated as parameters for diagnosing fibrosis in chronic liver disease.

Methods: Commercially available ELISA assays were used to study serum levels of MMP-1 and MMP-2 in 50 patients with nonalcoholic fatty liver disease (NAFLD). Fibrosis stages were evaluated using the METAVIR scoring system. Spearman's coefficient analysed correlations of serum levels of MMP-1, MMP-2, and liver biopsy score, and specificity and sensitivity were calculated through receiver operating characteristic (ROC) analysis.

Results: MMP-1 levels in fibrosis stage F1 (14.20±3.10 ng/mL) were not significantly different from stage F2 (9.26±2.21 ng/mL) but were higher (p<0.001) than F3 (7.15±1.56 ng/mL) and F4 (4.53±0.62 ng/mL). MMP-2 levels in F1 (68.57±8.22 ng/mL) were similar to F2 (76.31±9.25 ng/mL) but lower (p<0.001) than F3 (103.34±17.59 ng/mL) and F4 (214.24±46.72 ng/mL). Significant differences were seen between mild fibrosis (F1-2) and severe fibrosis/cirrhosis (F3-4) for MMP-1 (p<0.01) and MMP-2 (p<0.001). Correlation analysis revealed a weak inverse correlation for MMP-1 (r=-0.383, p<0.01) and a weak direct correlation for MMP-2 (r=0.392, p<0.01) with fibrosis stages. MMP-2 levels >86.78 ng/mL had a sensitivity of 73.7% and specificity of 61.3% for fibrosis detection, while MMP-1 levels <4.96 ng/mL had a sensitivity of 52.6% and specificity of 32.3%. Using ROC analysis, MMP-2 had significant diagnostic ability in detecting liver fibrosis stages (area under the curve 0.722, p<0.01).

Conclusion: Serum levels of MMP-2 are able to detect liver fibrosis. Despite the limited sample size, these findings support further investigation and potential integration of MMP-2 testing into routine clinical practice.

Cystic fibrosis (CF)-like disorders, which present with overlapping clinical features of CF but with distinct genetic causes, are often challenging to diagnose. Recent studies have identified AGR2 mutations as a novel cause of an autosomal recessive disorder resembling CF which is known as RIFTD syndrome (recurrent respiratory infection, failure to thrive with or without diarrhea). We reviewed the clinical, genetic, and imaging findings of two sibling patients presenting with a CF-like phenotype. Sweat chloride testing, chest radiography, and genetic sequencing for AGR2 mutations were performed. We assessed treatment responses and clinical outcomes over a one-year period. The purpose of this report is to describe two siblings of AGR2-related disease to broaden the clinical understanding of this condition and highlight the importance of genetic testing for proper diagnosis.

Gastrointestinal (GI) endoscopy is a fundamental tool for diagnosing and managing digestive diseases. Standardized classification systems have enhanced the consistency, accuracy, and clinical decision-making in endoscopic evaluation. This review explores key classification systems, their applications, and challenges in their implementation (1). A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, Embase, Cochrane Library, Google Scholar, Medline, and ClinicalTrials.gov. Relevant classification systems for upper GI endoscopy were categorized based on anatomical regions and adverse event reporting. Artificial intelligence (AI)-assisted tools were used to refine descriptions of classification criteria, and a structured figure was developed to visually represent these classifications. Major classification systems reviewed include the Los Angeles Classification (2) for reflux esophagitis, Prague Classification (3) for Barrett's esophagus, and the Forrest Classification (4) for peptic ulcer disease. The AGREE Classification (5) was highlighted for its role in adverse event reporting. Advances in high-definition imaging and narrow-band imaging (NBI) (6) have refined these classifications, improving diagnostic precision. However, practical challenges remain, including the complexity of these systems and the need for continuous education among endoscopists (7). Endoscopic classification systems play a crucial role in standardizing the assessment of GI diseases, improving diagnostic accuracy, treatment decisions, and communication among clinicians. As these classifications evolve, their continued refinement and integration into clinical practice will enhance their utility, ensuring consistency in endoscopic evaluations and better patient outcomes.

Celiac disease is an enteropathy caused by intolerance to gluten, with genetic and environmental factors playing a key part in its pathogenesis. This review addresses the use of the gluten-free diet as the primary treatment for patients with celiac disease and the use of probiotics as an adjunctive therapy. The gluten-free diet is the sole treatment for preventing symptoms and allowing the inflamed intestinal mucosa to recover. The gluten-free diet, however, also has some very significant challenges like its complexity, the need for ongoing monitoring by dieticians, and the risk of contamination with gluten even in gluten-free labelled foods. At the same time, the growing interest in the use of probiotics as an adjunct therapy in celiac disease management is based on the hypothetical contribution of the gut microbiota to the pathophysiology of the disease. It has been hypothesized that gut dysbiosis could be involved in the development and maintenance of celiac disease symptoms. Probiotics, in particular the genera Lactobacillus and Bifidobacterium, are among the promising adjuvants for the improvement of gut health. These beneficial microorganisms may play an essential important, crucial role in the breakdown or modification of gluten polypeptides and in the reduction of intestinal epithelial cell damage caused by gliadin. While probiotic use is not a replacement for a gluten-free diet, it can have additive benefits by assisting in the preservation of a healthy balance of gut microbiota and lessening some chronic gastrointestinal symptoms.

Aim: To compare the efficacy and safety of supraglottic airway (SGA) vs. infraglottic airway (IGA) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).

Background: To optimize patient outcomes by improving airway control, various airway techniques have been employed for sedation during ERCP. However, there is uncertainty about the noninferiority of SGA devices compared to IGA.

Methods: We performed a systematic review in PubMed, Embase, and Cochrane Library databases, searching for randomized and non-randomized studies comparing SGA vs. IGA in patients undergoing ERCP and reporting at least one of the outcomes of interest. The primary outcomes were procedure time, incidence of hypoxia, and blood staining events. Statistical analyses were performed using R language 4.3.1. Odds ratio (OR) was used for binary outcomes and mean difference (MD) for continuous outcomes with their respective 95% confidence interval (CI). Heterogeneity was assessed using the Cochran Q test and I² statistics.

Results: The study comprised 1 randomized controlled trial (RCT) and 3 observational studies involving 280 patients. Among them, 160 were allocated to the SGA group and 120 to the IGA group. When comparing procedure times, there was no statistically significant difference between SGA and IGA (MD -1.51 minutes; 95% CI -6.10 to 3.09 minutes; p = 0.52; I² = 62%). Regarding blood staining, statistical significance favored IGA over SGA (OR 2.67; 95% CI 1.12 to 6.41, p = 0.027; I² = 0%).

Conclusion: No statistically significant difference in procedure time was observed between SGA and IGA. However, IGA exhibited a favorable outcome regarding reduced blood staining compared to SGA. Further studies comparing similar outcomes are necessary to assess such associations better.

Aim: Thus, this meta-analysis was performed to assess the prognostic value of serum uric acid in patients with gastrointestinal cancers (GI).

Background: There is growing evidence that high serum uric acid may be used as a potential prognostic marker in gastrointestinal malignancies. However, there are inconsistencies in the reported findings.

Methods: Related studies were identified by searching the following databases: PubMed, Web of Science, Cochrane Library, and Scopus, independently up until 30 October 2023. Relevant analyses were carried out to deal with heterogeneity in the data. According to the inclusion criteria, we used English original papers reporting prognostic value of serum/plasma uric acid to determine hazard ratio (HR) and 95% confidence interval (CI) in patients with GI cancers. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to ascertain the association of uric acid levels with gastrointestinal cancer (GI) risk. The inconsistency index (I2) was used to calculate the level of heterogeneity among the selected studies. The quality of each study was evaluated by Newcastle-OTTAWA Scales (NOS).

Results: A total of 9 papers with 95.285 patients were included in this meta-analysis. The findings indicated a significant association between serum uric acid and poor prognosis in patients with gastrointestinal cancers (HR=1.477, 95% CI 1.165-1.873, P= 0.001). Further, in Subgroup analysis we found that patients would have poor survival rate among different cut-offs of uric acid, ≥ 5mg/dl, HR= 1.403, 95% CI=1.150-1.711, P=0.001 vs cut-off <5mg/dl, HR=1.54, 95% CI=1.140-2.063, P=0.005.

Conclusion: Serum uric acid level is significantly linked to survival outcomes in patients with gastrointestinal cancers. Serum uric acid levels may be an effective prognostic marker associated with clinical outcomes in patients with gastrointestinal cancers. Given the small number of studies included in this meta-analysis and high heterogeneity, we suggest that a more comprehensive study is required to achieve more robust results.

Aim: This study reports differential expression of Antisense RNAs (asRNAs) by analyzing transcriptomic profiles in gallbladder cancer (GBC).

Background: asRNAs play crucial roles in developing various tumors. However, the presence and biological mechanism of asRNAs in GBC development are still unknown.

Methods: Differentially expressed asRNAs (DE-asRNAs) were systematically identified from RNA sequencing data from ten GBC patients. Functional enrichment analysis was performed, followed by the identification of mRNAs targeted by asRNAs and the construction of a gene regulatory network of asRNAs targeting mRNAs.

Results: Of the 891 asRNAs identified, 17 DE-asRNAs were statistically significant. Out of 17, 12 asRNAs were upregulated, and five asRNAs were downregulated. Functional enrichment analysis showed their role in methylation and developmental processes. Of the 17 asRNAs, 14 are novel (UNC5B-AS1, SLC2A1-AS1, BBOX1-AS1, SOX21-AS1, ELFN1-AS1, TRPM2-AS, DNAH17-AS1, DCST1-AS1, VPS9D1-AS1, MIR1-1HG-AS1, HAND2-AS1, PGM5P4-AS1, PGM5P3-AS1, and MAGI2-AS). Enrichment analysis of asRNAs with target mRNAs showed enrichment in biological regulation and developmental processes involved in the PI3K, p53, apoptosis, and VEGF signaling pathways.

Conclusion: This study identified 14 asRNAs for the first time and showed that asRNAs targeting mRNAs strongly associated with tumor development in GBC through the PI3KCA and TP53 pathways.