Pub Date : 2024-07-15Epub Date: 2024-03-21DOI: 10.5009/gnl230348
Min-Jeong Kim, Han-Na Kim, Jonathan P Jacobs, Hyo-Joon Yang
Background/aims: While DNA methylation and gastric microbiome are each associated with gastric cancer (GC), their combined role in predicting GC remains unclear. This study investigated the potential of a combined DNA methylation and gastric microbiome signature to predict Helicobacter pylori-negative GC.
Methods: In this case-control study, we conducted quantitative methylation-specific polymerase chain reaction to measure the methylation levels of DKK3, SFRP1, EMX1, NKX6-1, MIR124-3, and TWIST1 in the gastric mucosa from 75 H. pylori-negative patients, including chronic gastritis (CG), intestinal metaplasia (IM), and GC. A combined analysis of DNA methylation and gastric microbiome, using 16S rRNA gene sequencing, was performed in 30 of 75 patients.
Results: The methylation levels of DKK3, SFRP1, EMX1, MIR124-3, and TWIST1 were significantly higher in patients with GC than in controls (all q<0.05). MIR124-3 and TWIST1 methylation levels were higher in patients with IM than those with CG and also in those with GC than in those with IM (all q<0.05). A higher methylation level of TWIST1 was an independent predictor for H. pylori-negative GC after adjusting for age, sex, and atrophy (odds ratio [OR], 15.15; 95% confidence interval [CI], 1.58 to 145.46; p=0.018). The combination of TWIST1 methylation and GC microbiome index (a microbiome marker) was significantly associated with H. pylori-negative GC after adjusting for age, sex, and atrophy (OR, 50.00; 95% CI, 1.69 to 1,476; p=0.024).
Conclusions: The combination of TWIST1 methylation and GC microbiome index may offer potential as a biomarker for predicting H. pylori-negative GC.
{"title":"Combined DNA Methylation and Gastric Microbiome Marker Predicts <i>Helicobacter pylori</i>-Negative Gastric Cancer.","authors":"Min-Jeong Kim, Han-Na Kim, Jonathan P Jacobs, Hyo-Joon Yang","doi":"10.5009/gnl230348","DOIUrl":"10.5009/gnl230348","url":null,"abstract":"<p><strong>Background/aims: </strong>While DNA methylation and gastric microbiome are each associated with gastric cancer (GC), their combined role in predicting GC remains unclear. This study investigated the potential of a combined DNA methylation and gastric microbiome signature to predict <i>Helicobacter pylori</i>-negative GC.</p><p><strong>Methods: </strong>In this case-control study, we conducted quantitative methylation-specific polymerase chain reaction to measure the methylation levels of <i>DKK3</i>, <i>SFRP1</i>, <i>EMX1</i>, <i>NKX6-1</i>, <i>MIR124-3</i>, and <i>TWIST1</i> in the gastric mucosa from 75 <i>H. pylori</i>-negative patients, including chronic gastritis (CG), intestinal metaplasia (IM), and GC. A combined analysis of DNA methylation and gastric microbiome, using 16S rRNA gene sequencing, was performed in 30 of 75 patients.</p><p><strong>Results: </strong>The methylation levels of <i>DKK3</i>, <i>SFRP1</i>, <i>EMX1</i>, <i>MIR124-3</i>, and <i>TWIST1</i> were significantly higher in patients with GC than in controls (all q<0.05). MIR124-3 and TWIST1 methylation levels were higher in patients with IM than those with CG and also in those with GC than in those with IM (all q<0.05). A higher methylation level of <i>TWIST1</i> was an independent predictor for <i>H. pylori</i>-negative GC after adjusting for age, sex, and atrophy (odds ratio [OR], 15.15; 95% confidence interval [CI], 1.58 to 145.46; p=0.018). The combination of TWIST1 methylation and GC microbiome index (a microbiome marker) was significantly associated with <i>H. pylori</i>-negative GC after adjusting for age, sex, and atrophy (OR, 50.00; 95% CI, 1.69 to 1,476; p=0.024).</p><p><strong>Conclusions: </strong>The combination of TWIST1 methylation and GC microbiome index may offer potential as a biomarker for predicting <i>H. pylori</i>-negative GC.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"611-620"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15Epub Date: 2024-03-27DOI: 10.5009/gnl240023
Anna S F Lok
Current treatment of chronic hepatitis B virus (HBV) infection, pegylated interferon-α (pegIFN-α) and nucleos(t)ide analogue (NA), can suppress HBV replication, reverse liver inflammation and fibrosis, and decrease risks of cirrhosis and hepatocellular carcinoma, but hepatitis B surface antigen (HBsAg) loss is rare. Functional HBV cure is defined as undetectable HBsAg and unquantifiable serum HBV DNA for at least 24 weeks after a finite course of therapy. This requires suppression of HBV replication and viral protein production as well as restoration of immune response to HBV. Direct-acting antivirals targeting virus entry, capsid assembly, viral protein production and secretion are in clinical trials. In parallel, immune modulatory therapies to stimulate HBV-specific immune response and to remove immune blockade are being tested. Clinical trials of direct-acting antivirals alone or immune modulatory therapies alone have not been successful in achieving HBV cure. Recent combinations of direct-acting antivirals and immune modulatory therapies have shown promising results particularly with combinations that included pegIFN-α. These results need to be confirmed in larger studies with longer follow-up, and further work is needed to develop simpler regimens with fewer drugs that can be administered orally and safely. While there is a strong desire to develop finite therapies that can achieve HBV cure, safety is paramount and new therapies must provide incremental value compared to standard of care, which is predominantly long-term NA therapy.
{"title":"Toward a Functional Cure for Hepatitis B.","authors":"Anna S F Lok","doi":"10.5009/gnl240023","DOIUrl":"10.5009/gnl240023","url":null,"abstract":"<p><p>Current treatment of chronic hepatitis B virus (HBV) infection, pegylated interferon-α (pegIFN-α) and nucleos(t)ide analogue (NA), can suppress HBV replication, reverse liver inflammation and fibrosis, and decrease risks of cirrhosis and hepatocellular carcinoma, but hepatitis B surface antigen (HBsAg) loss is rare. Functional HBV cure is defined as undetectable HBsAg and unquantifiable serum HBV DNA for at least 24 weeks after a finite course of therapy. This requires suppression of HBV replication and viral protein production as well as restoration of immune response to HBV. Direct-acting antivirals targeting virus entry, capsid assembly, viral protein production and secretion are in clinical trials. In parallel, immune modulatory therapies to stimulate HBV-specific immune response and to remove immune blockade are being tested. Clinical trials of direct-acting antivirals alone or immune modulatory therapies alone have not been successful in achieving HBV cure. Recent combinations of direct-acting antivirals and immune modulatory therapies have shown promising results particularly with combinations that included pegIFN-α. These results need to be confirmed in larger studies with longer follow-up, and further work is needed to develop simpler regimens with fewer drugs that can be administered orally and safely. While there is a strong desire to develop finite therapies that can achieve HBV cure, safety is paramount and new therapies must provide incremental value compared to standard of care, which is predominantly long-term NA therapy.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"593-601"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15Epub Date: 2024-05-08DOI: 10.5009/gnl230451
Junghwan Lee, Dongwook Oh, Dong-Wan Seo, Tae Jun Song, Do Hyun Park, Sung Koo Lee, Seung-Mo Hong
Background/aims: : Endoscopic papillectomy (EP) is increasingly used as an alternative to surgery for managing benign ampullary neoplasms. However, post-EP resection margins are often positive or indeterminate, and there is no consensus on the management of ampullary adenomas with positive or indeterminate margins after EP. This study was designed to compare the long-term outcomes between resected margin-negative (RMN) and resected margin-positive/indeterminate (RMPI) groups and to identify factors associated with clinical outcomes.
Methods: : This retrospective analysis included patients with ampullary adenoma without evidence of adenocarcinoma who underwent EP between 2004 and 2016. The RMN and RMPI groups were compared for recurrence rates and recurrence-free duration during a mean follow-up duration of 71.7±39.8 months. Factors related to clinical outcomes were identified using multivariate analysis.
Results: : Of the 129 patients who underwent EP, 82 were in the RMN group and 47 were in the RMPI group. The RMPI group exhibited a higher recurrence rate compared to the RMN group (14.6% vs 34.0%, p=0.019). However, the recurrence-free duration was not significantly different between the groups (34.7±32.6 months vs 36.2±27.4 months, p=0.900). Endoscopic treatment successfully managed recurrence in both groups (75% vs 75%). Submucosal injection was a significant risk factor for residual lesions (hazard ratio, 4.11; p=0.009) and recurrence (hazard ratio, 2.57; p=0.021).
Conclusions: : Although ampullary adenomas with positive or indeterminate margins after EP showed a higher rate of recurrence at long-term follow-up, endoscopic treatment was effective with favorable long-term outcomes. Submucosal injection prior to resection was associated with increased risk of recurrence and residual lesions.
背景/目的: :内镜乳头切除术(EP)越来越多地被用来替代手术治疗良性膀胱肿瘤。然而,内镜乳头切除术后的切除边缘往往是阳性或不确定的,而且对于内镜乳头切除术后切除边缘阳性或不确定的膀胱腺瘤的处理还没有达成共识。本研究旨在比较切除边缘阴性组(RMN)和切除边缘阳性/不确定组(RMPI)的长期疗效,并确定与临床疗效相关的因素:这项回顾性分析纳入了2004年至2016年间接受EP手术的无腺癌证据的胰腺腺瘤患者。在平均71.7±39.8个月的随访期间,比较了RMN组和RMPI组的复发率和无复发持续时间。通过多变量分析确定了与临床结果相关的因素:在接受 EP 治疗的 129 例患者中,82 例为 RMN 组,47 例为 RMPI 组。与 RMN 组相比,RMPI 组的复发率更高(14.6% 对 34.0%,P=0.019)。不过,两组的无复发持续时间无明显差异(34.7±32.6 个月 vs 36.2±27.4个月,P=0.900)。两组患者的内镜治疗都成功控制了复发(75% vs 75%)。粘膜下注射是残留病灶(危险比,4.11;P=0.009)和复发(危险比,2.57;P=0.021)的重要风险因素:尽管EP术后边缘阳性或不确定的膀胱腺瘤在长期随访中复发率较高,但内镜治疗效果显著,长期疗效良好。切除前粘膜下注射与复发和残留病灶风险增加有关。
{"title":"Long-term Outcomes of Ampullary Adenoma According to Resected Margin Status after Endoscopic Papillectomy.","authors":"Junghwan Lee, Dongwook Oh, Dong-Wan Seo, Tae Jun Song, Do Hyun Park, Sung Koo Lee, Seung-Mo Hong","doi":"10.5009/gnl230451","DOIUrl":"10.5009/gnl230451","url":null,"abstract":"<p><strong>Background/aims: </strong>: Endoscopic papillectomy (EP) is increasingly used as an alternative to surgery for managing benign ampullary neoplasms. However, post-EP resection margins are often positive or indeterminate, and there is no consensus on the management of ampullary adenomas with positive or indeterminate margins after EP. This study was designed to compare the long-term outcomes between resected margin-negative (RMN) and resected margin-positive/indeterminate (RMPI) groups and to identify factors associated with clinical outcomes.</p><p><strong>Methods: </strong>: This retrospective analysis included patients with ampullary adenoma without evidence of adenocarcinoma who underwent EP between 2004 and 2016. The RMN and RMPI groups were compared for recurrence rates and recurrence-free duration during a mean follow-up duration of 71.7±39.8 months. Factors related to clinical outcomes were identified using multivariate analysis.</p><p><strong>Results: </strong>: Of the 129 patients who underwent EP, 82 were in the RMN group and 47 were in the RMPI group. The RMPI group exhibited a higher recurrence rate compared to the RMN group (14.6% vs 34.0%, p=0.019). However, the recurrence-free duration was not significantly different between the groups (34.7±32.6 months vs 36.2±27.4 months, p=0.900). Endoscopic treatment successfully managed recurrence in both groups (75% vs 75%). Submucosal injection was a significant risk factor for residual lesions (hazard ratio, 4.11; p=0.009) and recurrence (hazard ratio, 2.57; p=0.021).</p><p><strong>Conclusions: </strong>: Although ampullary adenomas with positive or indeterminate margins after EP showed a higher rate of recurrence at long-term follow-up, endoscopic treatment was effective with favorable long-term outcomes. Submucosal injection prior to resection was associated with increased risk of recurrence and residual lesions.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"747-755"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15Epub Date: 2024-06-28DOI: 10.5009/gnl240241
Won Jae Yoon
Background/aims: The public fear of pancreatic diseases including pancreatic cancer (PC) appears to be growing. The aims of this study were to evaluate the causes of fear of pancreatic diseases and assess clinical outcomes of such individuals.
Methods: This was a retrospective study of 249 individuals who visited the Pancreatobiliary Diseases Center at Ewha Womans University Seoul Hospital due to the fear of pancreatic diseases between January 2019 and August 2021. Those referred from other departments or external medical facilities were excluded. Collected data included demographic details, comorbidities, causes of fear of pancreatic diseases, and the presence of pancreatic lesions in imaging studies.
Results: The median age was 55 years (range, 22 to 82 years). One hundred eleven subjects (44.6%) were male. The causes of fear of pancreatic diseases were abdominal pain (n=144, 57.8%), back pain (n=114, 45.8%), body weight change (n=35, 14.1%), family history of pancreatic diseases (n=32, 12.9%), and others (n=39, 15.7%). Within the group with family history of pancreatic diseases, 25 subjects had a first-degree relative with PC. Of the 200 subjects who underwent imaging, there was no evidence of pancreatic diseases in 182 (91.0%). Pancreatic lesions identified were cystic lesions (n=15, 7.5%), non-specific calcification (n=1, 0.5%), lipoma (n=1, 0.5%), and solid tumor (n=1, 0.5%), later diagnosed as unresectable PC.
Conclusions: Abdominal pain and back pain were the major causes of fear of pancreatic diseases. The prevalence of PC among those who underwent imaging was 0.5%. Such characteristics should be considered when consulting individuals with fear of pancreatic diseases.
{"title":"Public Fear of Pancreatic Diseases: Causes and Clinical Outcomes at a Single Korean Center.","authors":"Won Jae Yoon","doi":"10.5009/gnl240241","DOIUrl":"10.5009/gnl240241","url":null,"abstract":"<p><strong>Background/aims: </strong>The public fear of pancreatic diseases including pancreatic cancer (PC) appears to be growing. The aims of this study were to evaluate the causes of fear of pancreatic diseases and assess clinical outcomes of such individuals.</p><p><strong>Methods: </strong>This was a retrospective study of 249 individuals who visited the Pancreatobiliary Diseases Center at Ewha Womans University Seoul Hospital due to the fear of pancreatic diseases between January 2019 and August 2021. Those referred from other departments or external medical facilities were excluded. Collected data included demographic details, comorbidities, causes of fear of pancreatic diseases, and the presence of pancreatic lesions in imaging studies.</p><p><strong>Results: </strong>The median age was 55 years (range, 22 to 82 years). One hundred eleven subjects (44.6%) were male. The causes of fear of pancreatic diseases were abdominal pain (n=144, 57.8%), back pain (n=114, 45.8%), body weight change (n=35, 14.1%), family history of pancreatic diseases (n=32, 12.9%), and others (n=39, 15.7%). Within the group with family history of pancreatic diseases, 25 subjects had a first-degree relative with PC. Of the 200 subjects who underwent imaging, there was no evidence of pancreatic diseases in 182 (91.0%). Pancreatic lesions identified were cystic lesions (n=15, 7.5%), non-specific calcification (n=1, 0.5%), lipoma (n=1, 0.5%), and solid tumor (n=1, 0.5%), later diagnosed as unresectable PC.</p><p><strong>Conclusions: </strong>Abdominal pain and back pain were the major causes of fear of pancreatic diseases. The prevalence of PC among those who underwent imaging was 0.5%. Such characteristics should be considered when consulting individuals with fear of pancreatic diseases.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"756-760"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical Parameters Work Well as Predictive Factors for Atezolizumab and Bevacizumab Treatment in Hepatocellular Carcinoma.","authors":"Ji Yeon Lee, Pil Soo Sung","doi":"10.5009/gnl240274","DOIUrl":"10.5009/gnl240274","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"18 4","pages":"558-559"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15Epub Date: 2023-11-30DOI: 10.5009/gnl230130
Sang Hoon Kim, Yura Choi, Jihong Oh, Eui Yeon Lim, Jung Eun Lee, Eun-Ji Song, Young-Do Nam, Hojun Kim
Background/aims: : Functional dyspepsia (FD) has long been regarded as a syndrome because its pathophysiology is multifactorial. However, recent reports have provided evidence that changes in the duodenal ecosystem may be the key. This study aimed to identify several gastrointestinal factors and biomarkers associated with FD, specifically changes in the duodenal ecosystem that may be key to understanding its pathophysiology.
Methods: : In this case-control study, 28 participants (12 with FD and 16 healthy control individuals) were assessed for dietary nutrients, gastrointestinal symptom severity, immunological status of the duodenal mucosa, and microbiome composition from oral, duodenal, and fecal samples. Integrated data were analyzed using immunohistochemistry, real-time polymerase chain reaction, 16S rRNA sequencing, and network analysis.
Results: : Duodenal mucosal inflammation and impaired expression of tight junction proteins were confirmed in patients with FD. The relative abundance of duodenal Streptococcus (p=0.014) and reductions in stool Butyricicoccus (p=0.047) were confirmed. These changes in the gut microbiota were both correlated with symptom severity. Changes in dietary micronutrients, such as higher intake of valine, were associated with improved intestinal barrier function and microbiota.
Conclusions: : This study emphasizes the relationships among dietary nutrition, oral and gut microbiota, symptoms of FD, impaired function of the duodenal barrier, and inflammation. Assessing low-grade inflammation or increased permeability in the duodenal mucosa, along with changes in the abundance of stool Butyricicoccus, is anticipated to serve as effective biomarkers for enhancing the objectivity of FD diagnosis and monitoring.
{"title":"Associations among the Duodenal Ecosystem, Gut Microbiota, and Nutrient Intake in Functional Dyspepsia.","authors":"Sang Hoon Kim, Yura Choi, Jihong Oh, Eui Yeon Lim, Jung Eun Lee, Eun-Ji Song, Young-Do Nam, Hojun Kim","doi":"10.5009/gnl230130","DOIUrl":"10.5009/gnl230130","url":null,"abstract":"<p><strong>Background/aims: </strong>: Functional dyspepsia (FD) has long been regarded as a syndrome because its pathophysiology is multifactorial. However, recent reports have provided evidence that changes in the duodenal ecosystem may be the key. This study aimed to identify several gastrointestinal factors and biomarkers associated with FD, specifically changes in the duodenal ecosystem that may be key to understanding its pathophysiology.</p><p><strong>Methods: </strong>: In this case-control study, 28 participants (12 with FD and 16 healthy control individuals) were assessed for dietary nutrients, gastrointestinal symptom severity, immunological status of the duodenal mucosa, and microbiome composition from oral, duodenal, and fecal samples. Integrated data were analyzed using immunohistochemistry, real-time polymerase chain reaction, 16S rRNA sequencing, and network analysis.</p><p><strong>Results: </strong>: Duodenal mucosal inflammation and impaired expression of tight junction proteins were confirmed in patients with FD. The relative abundance of duodenal <i>Streptococcus</i> (p=0.014) and reductions in stool <i>Butyricicoccus</i> (p=0.047) were confirmed. These changes in the gut microbiota were both correlated with symptom severity. Changes in dietary micronutrients, such as higher intake of valine, were associated with improved intestinal barrier function and microbiota.</p><p><strong>Conclusions: </strong>: This study emphasizes the relationships among dietary nutrition, oral and gut microbiota, symptoms of FD, impaired function of the duodenal barrier, and inflammation. Assessing low-grade inflammation or increased permeability in the duodenal mucosa, along with changes in the abundance of stool <i>Butyricicoccus</i>, is anticipated to serve as effective biomarkers for enhancing the objectivity of FD diagnosis and monitoring.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"621-631"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15Epub Date: 2023-11-30DOI: 10.5009/gnl230385
Chin-Hee Song, Nayoung Kim, Ryoung Hee Nam, Soo In Choi, Jae Young Jang, Eun Hye Kim, Jina Choi, Yonghoon Choi, Hyuk Yoon, Sun Min Lee, Yeong-Jae Seok
Background/aims: : The gut microbiome has emerged as a key player that mechanistically links various risk factors to colorectal cancer (CRC) etiology. However, the role of the gut microbiome in CRC pathogenesis remains unclear. This study aimed to characterize the gut microbiota in healthy controls (HCs) and patients with colorectal adenoma (AD) and CRC in subgroups based on sex and age.
Methods: : Study participants who visited the hospital for surveillance of CRC or gastrointestinal symptoms were prospectively enrolled, and the gut microbiome was analyzed based on fecal samples.
Results: : In terms of HC-AD-CRC sequence, commensal bacteria, including lactate-producing (Streptococcus salivarius) and butyrate-producing (Faecalibacterium prausnitzii, Anaerostipes hadrus, and Eubacterium hallii) bacteria, were more abundant in the HC group than in the AD and CRC groups. In the sex comparison, the female HC group had more lactate-producing bacteria (Bifidobacterium adolescentis, Bifidobacterium catenulatum, and Lactobacillus ruminis) than the male HC group. In age comparison, younger subjects had more butyrate-producing bacteria (Agathobaculum butyriciproducens and Blautia faecis) than the older subjects in the HC group. Interestingly, lactate-producing bacteria (B. catenulatum) were more abundant in females than males among younger HC group subjects. However, these sex- and age-dependent differences were not observed in the AD and CRC groups.
Conclusions: : The gut microbiome, specifically lactate- and butyrate-producing bacteria, which were found to be abundant in the HC group, may play a role in preventing the progression of CRC. In particular, lactate-producing bacteria, which were found to be less abundant in healthy male controls may contribute to the higher incidence of CRC in males.
{"title":"The Possible Preventative Role of Lactate- and Butyrate-Producing Bacteria in Colorectal Carcinogenesis.","authors":"Chin-Hee Song, Nayoung Kim, Ryoung Hee Nam, Soo In Choi, Jae Young Jang, Eun Hye Kim, Jina Choi, Yonghoon Choi, Hyuk Yoon, Sun Min Lee, Yeong-Jae Seok","doi":"10.5009/gnl230385","DOIUrl":"10.5009/gnl230385","url":null,"abstract":"<p><strong>Background/aims: </strong>: The gut microbiome has emerged as a key player that mechanistically links various risk factors to colorectal cancer (CRC) etiology. However, the role of the gut microbiome in CRC pathogenesis remains unclear. This study aimed to characterize the gut microbiota in healthy controls (HCs) and patients with colorectal adenoma (AD) and CRC in subgroups based on sex and age.</p><p><strong>Methods: </strong>: Study participants who visited the hospital for surveillance of CRC or gastrointestinal symptoms were prospectively enrolled, and the gut microbiome was analyzed based on fecal samples.</p><p><strong>Results: </strong>: In terms of HC-AD-CRC sequence, commensal bacteria, including lactate-producing (<i>Streptococcus salivarius</i>) and butyrate-producing (<i>Faecalibacterium prausnitzii, Anaerostipes hadrus, and Eubacterium hallii</i>) bacteria, were more abundant in the HC group than in the AD and CRC groups. In the sex comparison, the female HC group had more lactate-producing bacteria (<i>Bifidobacterium adolescentis, Bifidobacterium catenulatum,</i> and <i>Lactobacillus ruminis</i>) than the male HC group. In age comparison, younger subjects had more butyrate-producing bacteria (<i>Agathobaculum butyriciproducens</i> and <i>Blautia faecis</i>) than the older subjects in the HC group. Interestingly, lactate-producing bacteria (<i>B. catenulatum</i>) were more abundant in females than males among younger HC group subjects. However, these sex- and age-dependent differences were not observed in the AD and CRC groups.</p><p><strong>Conclusions: </strong>: The gut microbiome, specifically lactate- and butyrate-producing bacteria, which were found to be abundant in the HC group, may play a role in preventing the progression of CRC. In particular, lactate-producing bacteria, which were found to be less abundant in healthy male controls may contribute to the higher incidence of CRC in males.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"654-666"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Impact of Body Composition on the Prognosis of Nonalcoholic Fatty Liver Disease.","authors":"Do Seon Song","doi":"10.5009/gnl240200","DOIUrl":"10.5009/gnl240200","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"18 4","pages":"562-563"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15Epub Date: 2023-12-26DOI: 10.5009/gnl230303
Jae Hyup Jung, Seung Hyun Won, Kwangrok Jung, Jun Suh Lee, Jong-Chan Lee, Jin Won Kim, Yoo-Seok Yoon, Jin-Hyeok Hwang, Ho-Seong Han, Jaihwan Kim
Background/aims: : Recently, patients with pancreatic cancer (PC) who underwent resection have exhibited improved survival outcomes, but comprehensive analysis is limited. We analyzed the trends of contributing factors.
Methods: : Data of patients with resected PC were retrospectively collected from the Korean Health Insurance Review and Assessment Service (HIRA) database and separately at our institution. Cox regression analysis was conducted with the data from our institution a survival prediction score was calculated using the β coefficients.
Results: : Comparison between the periods 2013-2015 (n=3,255) and 2016-2018 (n=3,698) revealed a difference in the median overall survival (25.9 months vs not reached, p<0.001) when analyzed with the HIRA database which was similar to our single-center data (2013-2015 [n=119] vs 2016-2018 [n=148], 20.9 months vs 32.2 months, p=0.003). Multivariable analyses revealed six factors significantly associated with better OS, and the scores were as follows: age >70 years, 1; elevated carbohydrate antigen 19-9 at diagnosis, 1; R1 resection, 1; stage N1 and N2, 1 and 3, respectively; no adjuvant treatment, 2; FOLFIRINOX or gemcitabine plus nab-paclitaxel after recurrence, 4; and other chemotherapy or supportive care only after recurrence, 5. The rate of R0 resection (69.7% vs 80.4%), use of adjuvant treatment (63.0% vs 74.3%), and utilization of FOLFIRINOX or gemcitabine plus nab-paclitaxel (25.2% vs 47.3%) as palliative chemotherapeutic regimen, all increased between the two time periods, resulting in decreased total survival prediction score (mean: 7.32 vs 6.18, p=0.004).
Conclusions: : Strict selection of surgical candidates, more use of adjuvant treatment, and adoption of the latest combination regimens for palliative chemotherapy after recurrence were identified as factors of recent improvement.
背景/目的: :最近,接受切除术的胰腺癌(PC)患者的生存率有所提高,但综合分析却很有限。我们分析了促成因素的趋势:我们从韩国健康保险审查和评估服务(HIRA)数据库中回顾性收集了切除胰腺癌患者的数据,并在本机构分别进行了分析。利用本院的数据进行了 Cox 回归分析,并使用 β 系数计算了生存预测得分:2013-2015年(n=3255)和2016-2018年(n=3698)期间的比较显示,中位总生存期存在差异(25.9个月 vs 未达到,p70岁,1人;诊断时碳水化合物抗原19-9升高,1人;R1切除,1人;N1和N2期,分别为1人和3人;未进行辅助治疗,2人;复发后进行FOLFIRINOX或吉西他滨加nab-紫杉醇,4人;复发后仅进行其他化疗或支持治疗,5人。R0切除率(69.7% vs 80.4%)、辅助治疗使用率(63.0% vs 74.3%)、FOLFIRINOX或吉西他滨加纳布紫杉醇(25.2% vs 47.3%)作为姑息化疗方案的使用率在两个时间段之间均有所上升,导致总生存预测评分下降(平均:7.32 vs 6.18,P=0.004):结论:严格选择手术对象、更多使用辅助治疗以及复发后采用最新的联合方案进行姑息化疗被认为是近期病情好转的因素。
{"title":"Analysis of Recent Improvement of Survival Outcomes in Patients with Pancreatic Cancer Who Underwent Upfront Surgery.","authors":"Jae Hyup Jung, Seung Hyun Won, Kwangrok Jung, Jun Suh Lee, Jong-Chan Lee, Jin Won Kim, Yoo-Seok Yoon, Jin-Hyeok Hwang, Ho-Seong Han, Jaihwan Kim","doi":"10.5009/gnl230303","DOIUrl":"10.5009/gnl230303","url":null,"abstract":"<p><strong>Background/aims: </strong>: Recently, patients with pancreatic cancer (PC) who underwent resection have exhibited improved survival outcomes, but comprehensive analysis is limited. We analyzed the trends of contributing factors.</p><p><strong>Methods: </strong>: Data of patients with resected PC were retrospectively collected from the Korean Health Insurance Review and Assessment Service (HIRA) database and separately at our institution. Cox regression analysis was conducted with the data from our institution a survival prediction score was calculated using the β coefficients.</p><p><strong>Results: </strong>: Comparison between the periods 2013-2015 (n=3,255) and 2016-2018 (n=3,698) revealed a difference in the median overall survival (25.9 months vs not reached, p<0.001) when analyzed with the HIRA database which was similar to our single-center data (2013-2015 [n=119] vs 2016-2018 [n=148], 20.9 months vs 32.2 months, p=0.003). Multivariable analyses revealed six factors significantly associated with better OS, and the scores were as follows: age >70 years, 1; elevated carbohydrate antigen 19-9 at diagnosis, 1; R1 resection, 1; stage N1 and N2, 1 and 3, respectively; no adjuvant treatment, 2; FOLFIRINOX or gemcitabine plus nab-paclitaxel after recurrence, 4; and other chemotherapy or supportive care only after recurrence, 5. The rate of R0 resection (69.7% vs 80.4%), use of adjuvant treatment (63.0% vs 74.3%), and utilization of FOLFIRINOX or gemcitabine plus nab-paclitaxel (25.2% vs 47.3%) as palliative chemotherapeutic regimen, all increased between the two time periods, resulting in decreased total survival prediction score (mean: 7.32 vs 6.18, p=0.004).</p><p><strong>Conclusions: </strong>: Strict selection of surgical candidates, more use of adjuvant treatment, and adoption of the latest combination regimens for palliative chemotherapy after recurrence were identified as factors of recent improvement.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"737-746"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139037602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15Epub Date: 2024-06-05DOI: 10.5009/gnl230291
June Hwa Bae, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang
Background/aims: Studies on elective switching to the subcutaneous (SC) formulation of infliximab revealed comparable efficacy and safety and higher infliximab level than those exhibited by intravenous (IV) infliximab. However, no studies have reported on the effectiveness of SC switching in ulcerative colitis (UC) patients who experienced IV infliximab failure during maintenance treatment.
Methods: This retrospective study included UC patients who had been switched to SC infliximab because of IV infliximab failure, between January 2021 and January 2023. Group A was defined as having clinically and biochemically active UC (secondary loss of response), and group B consisted of patients with stable symptoms but biochemically active UC.
Results: Twenty-three patients met the inclusion criteria: 15 in group A and eight in group B. The serum infliximab levels significantly increased after SC switching in both groups. The electively switched group also exhibited increased infliximab levels after SC switching. Patients in group A showed improved partial Mayo score with a significant decrease in fecal calprotectin and C-reactive protein after switching. In group B, the fecal calprotectin level significantly decreased without clinical relapse after switching. A high proportion of patients (≥80%) in both groups achieved clinical and/or biochemical responses at the last follow-up. During the follow-up period, only two patients in group A discontinued SC infliximab, and only one complained of severe injection site reaction.
Conclusions: In UC patients who experience IV infliximab failure during maintenance treatment, switching to SC infliximab may be a promising option because of better efficacy and safety.
背景/目的:关于选择性改用英夫利西单抗皮下制剂的研究显示,与静脉注射英夫利西单抗相比,皮下制剂具有相似的疗效和安全性,且英夫利西单抗水平更高。然而,对于在维持治疗过程中静脉注射英夫利西单抗失败的溃疡性结肠炎(UC)患者,还没有关于皮下注射英夫利西单抗的有效性的研究报告:这项回顾性研究纳入了 2021 年 1 月至 2023 年 1 月期间因静脉注射英夫利西单抗失败而改用静脉注射英夫利西单抗的 UC 患者。A组定义为临床和生化活动性UC(继发性应答丧失),B组包括症状稳定但生化活动性UC患者:23名患者符合纳入标准:两组患者的血清英夫利西单抗水平在转换 SC 后均显著升高。选择性换药组在换药后也显示出英夫利西单抗水平的升高。A 组患者的部分梅奥评分有所改善,大便钙蛋白和 C 反应蛋白在换药后明显下降。在 B 组中,换药后粪便钙蛋白水平明显下降,但临床症状没有复发。在最后一次随访中,两组中都有很高比例的患者(≥80%)出现了临床和/或生化反应。在随访期间,A组只有两名患者停用了SC英夫利西单抗,只有一名患者抱怨出现了严重的注射部位反应:结论:对于在维持治疗期间静脉注射英夫利西单抗失败的 UC 患者,转用沙龙英夫利西单抗可能是一个很有前景的选择,因为它具有更好的疗效和安全性。
{"title":"Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure.","authors":"June Hwa Bae, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang","doi":"10.5009/gnl230291","DOIUrl":"10.5009/gnl230291","url":null,"abstract":"<p><strong>Background/aims: </strong>Studies on elective switching to the subcutaneous (SC) formulation of infliximab revealed comparable efficacy and safety and higher infliximab level than those exhibited by intravenous (IV) infliximab. However, no studies have reported on the effectiveness of SC switching in ulcerative colitis (UC) patients who experienced IV infliximab failure during maintenance treatment.</p><p><strong>Methods: </strong>This retrospective study included UC patients who had been switched to SC infliximab because of IV infliximab failure, between January 2021 and January 2023. Group A was defined as having clinically and biochemically active UC (secondary loss of response), and group B consisted of patients with stable symptoms but biochemically active UC.</p><p><strong>Results: </strong>Twenty-three patients met the inclusion criteria: 15 in group A and eight in group B. The serum infliximab levels significantly increased after SC switching in both groups. The electively switched group also exhibited increased infliximab levels after SC switching. Patients in group A showed improved partial Mayo score with a significant decrease in fecal calprotectin and C-reactive protein after switching. In group B, the fecal calprotectin level significantly decreased without clinical relapse after switching. A high proportion of patients (≥80%) in both groups achieved clinical and/or biochemical responses at the last follow-up. During the follow-up period, only two patients in group A discontinued SC infliximab, and only one complained of severe injection site reaction.</p><p><strong>Conclusions: </strong>In UC patients who experience IV infliximab failure during maintenance treatment, switching to SC infliximab may be a promising option because of better efficacy and safety.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"667-676"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141246753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}