Gastroenterology and Hepatology From Bed to Bench最新文献

Microvillus inclusion disease (MVD) is a rare autosomal recessive disease that was first discovered in 1978 by Davidson et al., with significant mortality and morbidity within the first year of life. It presents mainly with abdominal symptoms like diarrhoea, abdominal distension, vomiting electrolyte imbalance. Sometimes, depending on the genetic mutation involved, the phenotypic manifestation can vary. Certain genetic mutations are associated with cholestasis, dilated bowel loops, and metabolic acidosis, whereas some present with nystagmus and reduced visual acuity. Electron microscopy of the duodenal biopsy sample is used as a diagnostic tool. Absence or shortening of apical microvilli with microvillus inclusion bodies in mature enterocytes, which are pathognomonic to MVD alongside periodic acid Schiff (PAS)-positive granules or vesicles in the immature enterocytes.

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 investigate the antioxidant properties of betaine against oxytetracycline-induced fatty liver disease.

Background: During the past decades, fatty liver has been considered a public health concern, with prevalence between 10-24% in the world. Betaine has been shown to have some antioxidant properties in our previous studies.

Methods: For this purpose, 32 male Wistar rats, were divided into four groups: control, betaine (Bet., betaine 10 mg/kg daily for 15 days, orally), fatty liver (Fat., induction of fatty liver with oxytetracycline 120 mg/kg during three consecutive days, ip), and fatty liver + betaine group (Fat. + Bet.). On the 19th day, after complete anesthesia, blood samples were taken from the heart, and the liver was sampled for biochemical and histopathology evaluations.

Results: Betaine significantly increased glutathione peroxidase activity (Gpx) in the Bet. and Fat. + Bet. Groups compared to the Fat group (P <0.05). In this regard, glutathione (GSH) content and the total antioxidant capacity (TAC) increased significantly in the betaine-treated rats and Fat. + Bet. group compared to the Fat. Group (P <0.05). Regarding lipid peroxidation, malondialdehyde concentration significantly decreased in Bet. and Fat. + Bet. Groups, when compared to fat. Group (P <0.05). Betaine was able to reduce tissue necrosis and decrease the number of Kupffer cells, restoring the standard color of the cytoplasm of hepatocytes.

Conclusion: The antioxidant properties of betaine are able to prevent fatty liver and oxidative stress in the oxytetracycline-induced fatty liver of rats. The antioxidant properties of betaine appear to prevent fatty liver and oxidative stress in rats with oxytetracycline-induced fatty liver.

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: 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: We assessed whether the Prognostic Nutritional Index (PNI) and the Systemic Inflammation Index (SII) are associated with cirrhosis severity and decompensation.

Background: Cirrhosis severity is routinely staged with MELD and Child-Pugh scores, which only partially capture nutritional and inflammatory status.

Methods: We conducted a cross-sectional study of 202 cirrhotic adults at Shahid Beheshti University hospitals (2018-2022). Demographic, clinical, and lab data were obtained from records. PNI (10 × albumin + 0.005 × lymphocytes) and SII (platelets × neutrophils ÷ lymphocytes) were calculated. Associations with MELD, Child-Pugh, and complications were analyzed (α = 0.05; SPSS).

Results: Higher SII was associated with greater disease severity, including higher MELD (P = 0.040) and higher Child-Pugh class (overall P = 0.010), with SII levels higher in Child-Pugh class C than in class B (P = 0.001). PNI showed an inverse relationship with MELD, consistent with better nutritional status at lower severity. PNI was higher in patients without ascites (P = 0.020). Both indices differed in patients with hepatic encephalopathy versus those without (P = 0.010). Moreover, SII did not differ across variceal grades (P = 0.891), whereas PNI was lower in higher grades (overall P = 0.005).

Conclusion: PNI and SII exhibit significant associations with established severity measures in cirrhosis. These indices may complement MELD and Child-Pugh by integrating nutritional and inflammatory information into routine assessment. Prospective, externally validated studies are warranted to determine predictive utility and clinical impact.

Aim: The aim of this study is to assess the association between LGR5 expression, a cancer stem cell marker, and the location of colorectal cancer (CRC).

Background: The incidence of chemotherapy-resistant CRC is increasing. The location of CRC is important in determining CRC progression. The area itself is associated with the presence of cancer stem cells.

Methods: This cross-sectional study was conducted in Adam Malik Hospital and its sister hospitals. Inclusion criteria were patients who underwent colonoscopy, biopsy, or operation due to CRC, Indonesian, and willing to provide familial medical history regarding CRC and other malignancies up to third-degree relatives. CRC tissue was obtained from each subject as a specimen and underwent immunohistochemistry examination to determine LGR5 expression. Data analysis was performed by SPSS, version 26 (Chicago, 2022).

Results: A total of 118 subjects were involved and divided into proximal (32 subjects), distal (43 subjects), and rectal (43 subjects) CRC. Mean age of subjects was 57.30 (SD 12.99) years with 69 (58.5%) subjects were males. The percentage of high-level LGR5 expression was found in subjects with proximal CRC (72%), followed by distal (44.1%) and rectal (39.5%) CRC. There was a significant association between LGR5 expression and the location of CRC (p=0.014). No relationship was observed between LGR5 expression with gender, age, body mass index, hemoglobin level, leukocyte count, platelet count, and histopathology grade of CRC.

Conclusion: LGR5 expression is associated with CRC. Higher LGR5 expression is observed in proximal CRC.

Aim: This study aimed to evaluate the hepatoprotective and antifibrotic effects of DSF in a rat model of CCl₄-induced liver fibrosis.

Background: Liver fibrosis is a chronic and potentially life-threatening condition characterized by fibroblast proliferation and excessive extracellular matrix deposition. Oxidative stress and inflammation are central mechanisms in its pathogenesis. Disulfiram (DSF), known for its antioxidant and potential antifibrotic properties, may attenuate liver injury.

Methods: Thirty-five male Wistar rats were randomly divided into seven groups (n = 5 per group): Control, Oil, DSF 25 mg/kg, DSF 50 mg/kg, CCl₄, CCl₄ + DSF 25 mg/kg, and CCl₄ + DSF 50 mg/kg. After seven weeks of treatment, liver histopathology, serum liver enzymes (ALT, AST, ALP), and malondialdehyde (MDA) levels were assessed.

Results: CCl₄ administration significantly increased serum ALT and AST levels compared with the Control group (p < 0.001). DSF at 25 mg/kg significantly reduced ALT (p = 0.0265), AST (p = 0.0334), and MDA (p < 0.001) compared with the CCl₄ group. Histopathological analysis revealed improved hepatocyte morphology in the low-dose DSF group (p = 0.0358). However, neither DSF dose produced a significant reduction in collagen deposition or vascular congestion, indicating no clear antifibrotic effect at these doses (>0.9999).

Conclusion: Low-dose DSF demonstrated hepatoprotective effects through improvements in biochemical markers and hepatocyte morphology, but failed to significantly attenuate fibrosis. These findings suggest that lower DSF concentrations (< 25 mg/kg) may offer greater antifibrotic potential and should be further investigated in dose-response studies.

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.