Gastroenterology and Hepatology From Bed to Bench最新文献

Aim: Based on studies, E. coli strains producing colibactin are selectively enriched in patients with IBD and CRC. This finding raises the possibility that the mentioned compounds may affect this organism and prompted us to conduct this study.

Background: Currently, vitamin D3 is highly recommended in the therapeutic management of inflammatory bowel disease (IBD) and colorectal cancer (CRC). Similar to 5-Aminosalicylic acid (5-ASA) which is a mainstay in treatment of IBD and prevention of CRC related inflammation, the importance of vitamin D3 is also mainly attributed to a series of known protective effects of this compound, particularly regulation of immune response and gut microbiota.

Methods: The antimicrobial effects of vitamin D3 and 5-ASA against E. coli isolated from patients with CRC, IBD, and healthy individuals were assessed by microdilution broth. The expression of virulence-associated genes (clbN, ompC, chuA and yfgL) in isolates treated with these compounds was tested by real-time PCR.

Results: Neither vitamin D3 nor 5-ASAinhibited bacterial growth at the investigated concentrations. The expression of clbN and ompC significantly decreased in vitamin D3-treated isolates (p= 0.01, p= 0.02, respectively). This downregulation was also significant in isolates from the CRC group in comparison with those from IBD patients and healthy individuals.

Conclusion: Vitamin D3's effect on downregulating colibactin, one of the proposed factors in colon carcinogenesis, highlights another unknown aspect of this multifaceted drug. The inability of both studied compounds to inhibit the growth of E. coli may show their benefit in not disturbing the balance of the microbiota.

Aim: This study assessed the prevalence of anti-Hepatitis E Virus (HEV) IgG and IgM antibodies in Solid Organ Transplant (SOT) recipients in Fars Province, southern Iran.

Background: HEV is a common cause of viral hepatitis worldwide. Immunocompromised individuals, particularly SOT recipients, are at risk of chronic HEV infection.

Methods: In this cross-sectional study, 150 serum samples were collected from SOT recipients, including those with liver, kidney, intestinal, or simultaneous pancreas-kidney transplantation. The sera were stored at -20°C and analyzed for anti-HEV IgG and IgM, using a commercial ELISA kit. Data were analyzed, using SPSS.

Results: The mean age of participants was 46.24 ± 15.14 years; with 96 (64%) being male. Anti-HEV IgG antibodies were detected in 53 (35.3%) patients. The prevalence among liver and kidney recipient recipients was 33.3% and 39.2%, respectively (p = 0.63). Anti-HEV IgG seropositivity was significantly associated with older age (p < 0.001) and elevated blood urea nitrogen levels (p = 0.008). No significant associations were observed with other demographic or clinical variables (p > 0.05). All patients tested negative for anti-HEV IgM antibodies.

Conclusion: HEV exposure is relatively common among SOT recipients in southern Iran. The significant association with elevated blood urea nitrogen levels highlights the importance of renal function monitoring in this population.

Aim: This study aimed to ascertain the equivalence in meaning and measurement qualities of two assessment tools, namely the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM) and Quality of Life (PAGI-QOL), in a sample of individuals with upper gastrointestinal disorders in Iran.

Background: There is substantial demand for reliable and accurate research instruments in researchers' native language to evaluate specific concepts of interest.

Methods: The Rome Foundation Guideline was employed as a framework for this investigation. To this end, a rigorous translation process was utilized, involving forward translation by two independent translators, reconciliation, and backward translation. An expert committee evaluated the semantic, idiomatic, experiential, and conceptual aspects of the translations. A panel of gastroenterologists assessed the content and face validity of the translated questionnaires. Cognitive debriefing sessions were conducted involving patients with dyspepsia or gastroesophageal reflux disease. Concurrent validity of the questionnaires was ascertained by comparing them with the 36-item Short Form Health Survey (SF-36).

Results: The findings presented satisfactory translation of the assessment tools, with initial assessments of internal consistency and construct validity demonstrating suitability. In this particular sample, the internal consistency of the PAGI-SYM was excellent (Cronbach's α range: 0.62-0.92), while the PAGI-QOL indicated good internal consistency (Cronbach's α range: 0.68-0.95). Further, there were strong correlations between the total scores of PAGI-SYM and PAGI-QOL, as well as all SF-36 general health subscale (-0.469 and 0.572, p-value<0.001), demonstrating concurrent validity.

Conclusion: Both PAGI-QOL and PAGI-SYM instruments exhibited validity and reliability when applied to assess upper gastrointestinal disorders.

Aim: This systematic review aimed to comprehensively evaluate the existing literature on the epigenetic influence of diet-induced gut microbiome changes in the context of precision nutrition.

Background: Diet influences gut microbiome composition, which regulates epigenetic modifications affecting inflammation, metabolism, and disease susceptibility. Precision nutrition seeks to personalize dietary strategies based on these interactions, yet the role of microbiome-driven epigenetic regulation remains under investigation.

Methods: A systematic review was conducted in 2025 following PRISMA guidelines. Studies exploring the relationship between dietary interventions, gut microbiome composition, and epigenetic changes were identified via PubMed and Google Scholar. Thirty-five studies, including randomized controlled trials, cohort studies, and observational research, met the inclusion criteria. Data on dietary interventions, microbial composition, epigenetic modifications, and health outcomes were synthesized.

Results: Diets rich in fiber and polyphenols enhanced microbial diversity, increased short-chain fatty acid production, and positively influenced epigenetic markers related to metabolic health. In contrast, Western-style and high-fat diets were associated with gut dysbiosis, inflammation, and negative epigenetic changes linked to metabolic disorders. Dietary interventions impacted DNA methylation, histone modifications, and microRNA expression, influencing long-term health.

Conclusion: This review highlights the key role of diet-induced changes in the gut microbiome in modulating epigenetic mechanisms like DNA methylation and histone modifications. These alterations influence metabolic health, disease risk, and precision nutrition strategies. While dietary interventions show promise, challenges such as individual variability and methodological inconsistencies require further research to refine clinical applications of microbiome-driven nutrition.

Aim: Biofeedback has gained widespread recognition for its ability to facilitate and strengthen pelvic floor muscle function, making it a treatment of choice for these patients.

Background: Fecal incontinence is a common issue among children, particularly those with chronic constipation, significantly affecting both the child's and their family's quality of life. Effective therapeutic interventions are essential to mitigate the symptoms and improve overall well-being. Physiotherapy for pediatric fecal incontinence focuses on strengthening, enhancing endurance, and improving coordination of the anal sphincter and pelvic floor muscles.

Methods: This single-blind clinical trial examined the combined efficacy of Tecar therapy and biofeedback compared to biofeedback alone, with standard medical care serving as the control group. The study included 81 children diagnosed with fecal incontinence. Key outcomes evaluated were the severity of incontinence, severity of constipation, and frequency of incontinence episodes per week. These variables were evaluated before and after a six-week treatment period. Statistical analysis included repeated measures ANOVA for within-group comparisons and one-way ANOVA for between-group comparisons.

Results: The results indicated significant improvements across all measured variables in the intervention groups compared to the control group. Notably, the combination of Tecar therapy and biofeedback outperformed biofeedback alone in certain aspects, such as lowering the severity of incontinence.

Conclusion: The findings underscore physiotherapy as a non-invasive and effective first-line intervention for managing fecal incontinence and chronic constipation in pediatric populations. When feasible, the combination of Tecar therapy and biofeedback is recommended to achieve superior outcomes.

Aim: The primary objective was to assess the relationship between the citation number and the quality of the articles, as compared with the level of evidence and the MINORS score. This study's secondary objective was to characterize the 50 most cited articles in the field of oesophagectomy research.

Background: There has been an increased need for an evaluation tool to indicate research quality. Available quality assessment tools include the Level of Evidence, the MINORS score, the Cochrane Risk of Bias 2.0 Tool, the Newcastle Ottawa Scale, CASP Appraisal Checklists, and Legend Evidence Evaluation tools.

Methods: The Web of Science allowed evaluating and comparing articles on oesophagectomy research. The quality of the 50 most cited articles was assessed using the Oxford Centre level of evidence classification and the methodological index for non-randomized studies (MINORS).

Results: Level of evidence II studies were cited more than level IV (P=0.008). There was a significant positive correlation between citation number and MINORS score (P=0.002). The median MINORS score was highest amongst level II studies, followed by levels III, IV, and I. The median MINORS score for level II evidence was significantly higher than for level IV (P=0.001). The study sample size is associated with higher levels of evidence but does not correlate with the citation number. Female authors contributed to 4 out of 50 articles. Recently published articles tended to be cited more frequently. More authors equated to more citations. Prospective studies are more likely to be cited.

Conclusion: Citation analysis can be used as an indicator of quality when assessing articles. It should, however, be used with caution as highly cited work, famous authors, and journals are all more likely to be cited. Citation analysis should be used alongside other well-established tools.

Aim: The aim of this study was to translate and cross-culturally adapt the Constipation Severity Instrument (CSI) and assess its reliability and validity in the Iranian Persian language with chronic functional constipation.

Background: Chronic functional constipation is a common complaint characterized by a range of symptoms. The use of a validated tool adapted to the culture is an important part of the treatment process.

Methods: CSI was translated into Persian language according to Beaton's guidelines. One hundred and twenty-five patients with chronic functional constipation, according to ROME IV criteria, completed the questionnaires. Face validity was assessed in two qualitative and quantitative forms (impact score), internal consistency and test-retest reliability were assessed by Cronbach's alpha coefficient and intraclass correlation coefficient (ICC), respectively. Convergent validity was assessed by correlating the total scores of the CSI and the WCSS. The floor/ ceiling effects of the questionnaire were also assessed.

Results: The impact score of all questions was greater than 1.5. The Cronbach's alpha coefficient for the total score was 0.90 and the ICC was 0.90. The total score of the CSI was significantly correlated with the total score of the WCSS (Spearman's p=0.74). No floor/ceiling effects were found.

Conclusion: The Persian version of the CSI is a reliable and valid tool that can be used for psychometric evaluation. Clinicians can also benefit from this questionnaire when assessing treatment outcomes in Iranian patients.

Aim: The purpose of the study was to assess benefits of oral midodrine in the role of primary prevention of hepatorenal syndrome (HRS) in Child-Turcotte-Pugh Class C (CTP-C) cirrhotics.

Background: The present non-randomized pilot study was designed for primary prevention of HRS as there is absence of an effective and definite treatment for this complication of cirrhosis to date other than liver transplant (LT).

Methods: This study effectively involved 30 patients each enrolled in interventional and control arms suffering from liver cirrhosis CTP-C with normal renal function and having a mean arterial pressure (MAP) < 80 mmHg who were subjected to clinical examination and baseline blood investigations. The mean daily dosage of midodrine used across the study group was 16.75 mg.

Results: At the end of 4 months of study, 11 individuals completed the study without attaining any endpoints from the control group while 23 accomplished it from the interventional arm. Nearly 50 % patients required a midodrine dose of 7.5 mg 8th hourly while the rest attained the targeted MAP with lower doses. By increasing MAP, the rate of HRS development during the study period (i.e. 4 months) was found to be significantly reduced in patients from interventional arm. The number needed to treat (NNT) observed in survival analysis to prevent one death was found to be 7.6.

Conclusion: This study successfully established the role oral midodrine in primary prevention of HRS in cirrhotics at high risk. Midodrine was well tolerated with no significant adverse effects in patients under study.

Aim: This study was conducted to discover the effect of NCAPD3 knockdown on the gene expression profile of gastric cancer.

Background: Gastric cancer, a potentially fatal disease, requires thorough evaluation for targeted interventions. Through the post-analysis of microarray data, it is crucial to further examine the impact of NCAPD3 (Non-SMC condensin II complex subunit D3) inhibition in gastric cancer, emphasizing the need for a more comprehensive analysis of this knockdown.

Methods: The use of Cytoscape and its plug-ins for protein-protein interaction network analysis enables the identification of genes that significantly affect network stability. These hub-bottlenecks are regulated due to the NCAPD3 inhibition and some of them act as compensators in this condition. The hub-bottlenecks pathways identified by ClueGO indicate their relationships in underlying mechanisms of knockdown. These identified central differentially expressed genes could be considered eligible targets for therapeutic interventions. Some of them play compensative roles while others are regulated in NCAPD3 knockdown.

Results: It can be concluded that some of the hub-bottlenecks contribute to compensation mechanisms including NPM1, PTEN, EGFR, HSPA5, and ASNS, while the other ones including HSPA4, DHX9, CAV1, MAP1LC3B, and SRSF1 are among the regulated genes.

Conclusion: In particular, the up-regulation of EGFR and ASNS genes in the knockdown scenario could significantly impact and deteriorate cancer treatment outcomes after comprehensive validation studies.