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Impact of Donor Age on Liver Transplant Outcomes in Patients with Acute-on-Chronic Liver Failure: A Cohort Study. 急性慢性肝功能衰竭患者肝移植结果的供体年龄影响:队列研究
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-06-21 DOI: 10.5009/gnl230143
Jie Zhou, Danni Ye, Shenli Ren, Jiawei Ding, Tao Zhang, Siyao Zhang, Zheng Chen, Fangshen Xu, Yu Zhang, Huilin Zheng, Zhenhua Hu

Background/aims: Liver transplantation is the most effective treatment for the sickest patients with acute-on-chronic liver failure (ACLF). However, the influence of donor age on liver transplantation, especially in ACLF patients, is still unclear.

Methods: In this study, we used the data of the Scientific Registry of Transplant Recipients. We included patients with ACLF who received liver transplantation from January 1, 2007, to December 31, 2017, and the total number was 13,857. We allocated the ACLF recipients by age into group I (donor age ≤17 years, n=647); group II (donor age 18-59 years, n=11,423); and group III (donor age ≥60 years, n=1,787). Overall survival (OS), graft survival, and mortality were compared among the three age groups and the four ACLF grades. Cox regression was also analyzed.

Results: The 1-, 3-, and 5-year OS rates were 89.6%, 85.5%, and 82.0% in group I; 89.4%, 83.4%, and 78.2% in group II; and 86.8%, 78.4%, and 71.4% in group III, respectively (p<0.001). When we analyzed the different effects of donor age on OS with different ACLF grades, in groups II and III, we observed statistical differences. Finally, the cubic spline curve told us that the relative death rate changed linearly with increasing donor age.

Conclusions: Donor age is related to OS and graft survival of ACLF patients after transplantation, and poorer results were associated with elderly donors. In addition, different donor ages have different effects on recipients with different ACLF grades.

背景/目的:肝移植是急性慢性肝功能衰竭(ACLF)重症患者最有效的治疗方法。然而,供体年龄对肝移植的影响,尤其是对 ACLF 患者的影响仍不清楚:在这项研究中,我们使用了移植受者科学登记处的数据。我们纳入了从 2007 年 1 月 1 日至 2017 年 12 月 31 日接受肝移植的 ACLF 患者,总人数为 13857 人。我们将ACLF受者按年龄分为I组(供体年龄≤17岁,n=647)、II组(供体年龄18-59岁,n=11423)和III组(供体年龄≥60岁,n=1787)。比较了三个年龄组和四个 ACLF 等级的总存活率(OS)、移植物存活率和死亡率。同时还进行了Cox回归分析:结果:I组的1年、3年和5年OS率分别为89.6%、85.5%和82.0%;II组分别为89.4%、83.4%和78.2%;III组分别为86.8%、78.4%和71.4%(P结论:供体年龄与 ACLF 患者移植后的操作系统和移植物存活率有关,老年供体的结果较差。此外,不同的供体年龄对不同分级的 ACLF 受体有不同的影响。
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引用次数: 0
Clinical Outcomes of Secondary Duodenal Self-Expandable Metallic Stenting for Duodenal Stent Dysfunction in Patients with Malignant Duodenal Obstruction: A Retrospective Multicenter Study. 恶性十二指肠梗阻患者二次十二指肠自扩张金属支架治疗十二指肠支架功能障碍的临床疗效:一项回顾性多中心研究。
IF 3.4 3区 医学 Q1 Medicine Pub Date : 2024-05-22 DOI: 10.5009/gnl240014
Hoonsub So, Hyun Don Joo, Tae Jun Song, Sung Woo Ko, Ho Seung Lee, Sung Hyun Cho, Dongwook Oh, Sung Yong Han, Dong Uk Kim, Dong-Wan Seo

Background/aims: Malignant duodenal obstruction has become more common with the development of palliative therapies.The outcomes of endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) are comparable to those of surgical gastrojejunostomy or duodenal stenting. However, EUS-GJ is technically challenging. Duodenal self-expandable metallic stent (SEMS) placement is popular; however, obstructions are common. Duodenal SEMS obstruction can be managed with the insertion of a second SEMS in a stent-in-stent manner. Therefore, we aimed to analyze the clinical outcomes of secondary duodenal SEMS placement in patients with malignant duodenal obstruction.

Methods: We retrospectively analyzed the data of patients who underwent secondary duodenal stent insertion for duodenal stent dysfunction between January 2016 and December 2021. The primary outcome was stent patency. The secondary outcomes were clinical success, factors associated with dysfunction, patient survival, and adverse events.

Results: A total of 109 patients were included. The mean age was 64.4±11.2 years, and 63 patients (57.8%) were male. Ninety-two patients (84.4%) had pancreaticobiliary cancer. Clinical success was achieved in 94 cases (86.2%). Twenty-three patients experienced stent dysfunction with 231 days of median stent patency (95% confidence interval [CI], 169 to not available). After a multivariable Cox hazard analysis of stent patency, the Eastern Cooperative Oncology Group performance status (hazard ratio [HR], 2.13; 95% CI, 1.20 to 3.81; p=0.010) and the first stent patency ≥6 months (HR, 0.33; 95% CI, 0.11 to 0.95; p=0.050) remained significant associated factors. Adverse events occurred in five patients (4.6%).

Conclusions: Secondary duodenal stent insertion is a viable option for first duodenal stent obstruction. Further comparative studies involving surgery or EUS-GJ for obstructed duodenal stents are warranted.

背景/目的:内镜超声引导下胃空肠吻合术(EUS-GJ)的疗效与外科胃空肠吻合术或十二指肠支架术相当。然而,EUS-GJ 在技术上具有挑战性。十二指肠自膨式金属支架(SEMS)置入术很受欢迎,但阻塞也很常见。十二指肠 SEMS 梗阻可通过以支架中支架的方式插入第二个 SEMS 来处理。因此,我们旨在分析恶性十二指肠梗阻患者二次十二指肠SEMS置入术的临床效果:我们回顾性分析了2016年1月至2021年12月期间因十二指肠支架功能障碍而接受二次十二指肠支架植入术的患者数据。主要结果是支架通畅。次要结果为临床成功率、功能障碍相关因素、患者存活率和不良事件:结果:共纳入 109 例患者。平均年龄为(64.4±11.2)岁,63 名患者(57.8%)为男性。92例患者(84.4%)患有胰胆管癌。94例(86.2%)获得了临床成功。23名患者出现支架功能障碍,中位支架通畅时间为231天(95%置信区间[CI],169天至不详)。在对支架通畅率进行多变量 Cox 危险分析后,东部合作肿瘤学组表现状态(危险比 [HR],2.13;95% CI,1.20 至 3.81;P=0.010)和首次支架通畅时间≥6 个月(HR,0.33;95% CI,0.11 至 0.95;P=0.050)仍是重要的相关因素。5名患者(4.6%)发生了不良事件:结论:二次十二指肠支架植入是首次十二指肠支架阻塞的可行方案。结论:二次十二指肠支架植入术是治疗首次十二指肠支架阻塞的可行方案,有必要对手术或 EUS-GJ 治疗十二指肠支架阻塞进行进一步的比较研究。
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引用次数: 0
Single-Cell RNA Sequencing Shows T-Cell Exhaustion Landscape in the Peripheral Blood of Patients with Hepatitis B Virus-Associated Acute-on-Chronic Liver Failure. 单细胞 RNA 测序显示乙型肝炎病毒相关急性慢性肝衰竭患者外周血中的 T 细胞衰竭景观
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-15 Epub Date: 2023-06-15 DOI: 10.5009/gnl220449
Jia Yao, Yaqiu Ji, Tian Liu, Jinjia Bai, Han Wang, Ruoyu Yao, Juan Wang, Xiaoshuang Zhou

Background/aims: The occurrence and development of hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) is closely related to the immune pathway. We explored the heterogeneity of peripheral blood T cell subsets and the characteristics of exhausted T lymphocytes, in an attempt to identify potential therapeutic target molecules for immune dysfunction in ACLF patients.

Methods: A total of 83,577 T cells from HBV-ACLF patients and healthy controls were screened for heterogeneity by single-cell RNA sequencing. In addition, exhausted T-lymphocyte subsets were screened to analyze their gene expression profiles, and their developmental trajectories were investigated. Subsequently, the expression of exhausted T cells and their capacity in secreting cytokines (interleukin 2, interferon γ, and tumor necrosis factor α) were validated by flow cytometry.

Results: A total of eight stable clusters were identified, among which CD4+ TIGIT+ subset and CD8+ LAG-3+ subset, with high expression of exhaust genes, were significantly higher in the HBV-ACLF patients than in normal controls. As shown by pseudotime analysis, T cells experienced a transition from naïve T cells to effector T cells and then exhausted T cells. Flow cytometry confirmed that the CD4+TIGIT+ subset and CD8+LAG-3+ subset in the peripheral blood of the ACLF patients were significantly higher than those in the healthy controls. Moreover, in vitro cultured CD8+LAG-3+ T cells were significantly fewer capable of secreting cytokines than CD8+LAG-3- subset.

Conclusions: Peripheral blood T cells are heterogeneous in HBV-ACLF. The exhausted T cells markedly increase during the pathogenesis of ACLF, suggesting that T-cell exhaustion is involved in the immune dysfunction of HBV-ACLF patients.

背景/目的:乙型肝炎病毒相关急性慢性肝衰竭(HBV-ACLF)的发生和发展与免疫途径密切相关。我们探讨了外周血 T 细胞亚群的异质性和衰竭 T 淋巴细胞的特征,试图找出 ACLF 患者免疫功能障碍的潜在治疗靶分子:通过单细胞 RNA 测序筛选了来自 HBV-ACLF 患者和健康对照组的 83,577 个 T 细胞的异质性。此外,还筛选了衰竭的 T 淋巴细胞亚群,分析其基因表达谱,并研究其发育轨迹。随后,通过流式细胞术验证了衰竭 T 细胞的表达及其分泌细胞因子(白细胞介素 2、干扰素 γ 和肿瘤坏死因子 α)的能力:结果:HBV-ACLF 患者共发现了 8 个稳定集群,其中 CD4+ TIGIT+ 亚群和 CD8+ LAG-3+ 亚群的排气基因表达量明显高于正常对照组。伪时间分析表明,T细胞经历了从幼稚T细胞到效应T细胞再到衰竭T细胞的转变。流式细胞术证实,ACLF 患者外周血中的 CD4+TIGIT+ 亚群和 CD8+LAG-3+ 亚群明显高于健康对照组。此外,体外培养的 CD8+LAG-3+ T 细胞分泌细胞因子的能力明显低于 CD8+LAG-3- 亚群:结论:在 HBV-ACLF 中,外周血 T 细胞具有异质性。结论:HBV-ACLF 患者的外周血 T 细胞具有异质性,在 ACLF 的发病过程中,衰竭的 T 细胞明显增加,这表明 T 细胞衰竭与 HBV-ACLF 患者的免疫功能障碍有关。
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引用次数: 0
The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis. 关联彩色成像与白光成像在幽门螺杆菌感染内镜诊断中的诊断性能比较:系统综述和荟萃分析。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-15 Epub Date: 2023-10-06 DOI: 10.5009/gnl230244
Jae Gon Lee, In Kyung Yoo, Abdullah Ozgur Yeniova, Sang Pyo Lee

Background/aims: Recognizing Helicobacter pylori infection during endoscopy is important because it can lead to the performance of confirmatory testing. Linked color imaging (LCI) is an image enhancement technique that can improve the detection of gastrointestinal lesions. The purpose of this study was to compare LCI to conventional white light imaging (WLI) in the endoscopic diagnosis of H. pylori infection.

Methods: We conducted a comprehensive literature search using PubMed, Embase, and the Cochrane Library. All studies evaluating the diagnostic performance of LCI or WLI in the endoscopic diagnosis of H. pylori were eligible. Studies on magnifying endoscopy, chromoendoscopy, and artificial intelligence were excluded.

Results: Thirty-four studies were included in this meta-analysis, of which 32 reported the performance of WLI and eight reported the performance of LCI in diagnosing H. pylori infection. The pooled sensitivity and specificity of WLI in the diagnosis of H. pylori infection were 0.528 (95% confidence interval [CI], 0.517 to 0.540) and 0.821 (95% CI, 0.811 to 0.830), respectively. The pooled sensitivity and specificity of LCI in the diagnosis of H. pylori were 0.816 (95% CI, 0.790 to 0.841) and 0.868 (95% CI, 0.850 to 0.884), respectively. The pooled diagnostic odds ratios of WLI and LCI were 15.447 (95% CI, 8.225 to 29.013) and 31.838 (95% CI, 15.576 to 65.078), respectively. The areas under the summary receiver operating characteristic curves of WLI and LCI were 0.870 and 0.911, respectively.

Conclusions: LCI showed higher sensitivity in the endoscopic diagnosis of H. pylori infection than standard WLI.

背景/目的:在内窥镜检查中识别幽门螺杆菌感染很重要,因为它可以导致验证性测试的执行。关联彩色成像(LCI)是一种可以提高胃肠道病变检测的图像增强技术。本研究的目的是比较LCI和传统白光成像(WLI)在幽门螺杆菌感染的内镜诊断中的作用。方法:我们使用PubMed、Embase和Cochrane图书馆进行了全面的文献检索。所有评估LCI或WLI在幽门螺杆菌内镜诊断中的诊断性能的研究都符合条件。排除了放大内窥镜、彩色内窥镜和人工智能的研究。结果:本荟萃分析包括34项研究,其中32项报告了WLI的表现,8项报告了LCI在诊断幽门螺杆菌感染方面的表现。WLI在诊断幽门螺杆菌感染中的综合敏感性和特异性分别为0.528(95%置信区间[CI],0.517至0.540)和0.821(95%可信区间,0.811至0.830)。LCI在幽门螺杆菌诊断中的综合敏感性和特异性分别为0.816(95%CI,0.790-0.841)和0.868(95%CI,0.850-0.884)。WLI和LCI的合并诊断优势比分别为15.447(95%置信区间,8.225至29.013)和31.838(95%可信区间,15.576至65.078)。WLI和LCI的总结接收机工作特性曲线下的面积分别为0.870和0.911。结论:LCI对幽门螺杆菌感染的内镜诊断灵敏度高于标准WLI。
{"title":"The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of <i>Helicobacter pylori</i> Infection: A Systematic Review and Meta-Analysis.","authors":"Jae Gon Lee, In Kyung Yoo, Abdullah Ozgur Yeniova, Sang Pyo Lee","doi":"10.5009/gnl230244","DOIUrl":"10.5009/gnl230244","url":null,"abstract":"<p><strong>Background/aims: </strong>Recognizing <i>Helicobacter pylori</i> infection during endoscopy is important because it can lead to the performance of confirmatory testing. Linked color imaging (LCI) is an image enhancement technique that can improve the detection of gastrointestinal lesions. The purpose of this study was to compare LCI to conventional white light imaging (WLI) in the endoscopic diagnosis of <i>H. pylori</i> infection.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search using PubMed, Embase, and the Cochrane Library. All studies evaluating the diagnostic performance of LCI or WLI in the endoscopic diagnosis of <i>H. pylori</i> were eligible. Studies on magnifying endoscopy, chromoendoscopy, and artificial intelligence were excluded.</p><p><strong>Results: </strong>Thirty-four studies were included in this meta-analysis, of which 32 reported the performance of WLI and eight reported the performance of LCI in diagnosing <i>H. pylori</i> infection. The pooled sensitivity and specificity of WLI in the diagnosis of <i>H. pylori</i> infection were 0.528 (95% confidence interval [CI], 0.517 to 0.540) and 0.821 (95% CI, 0.811 to 0.830), respectively. The pooled sensitivity and specificity of LCI in the diagnosis of <i>H. pylori</i> were 0.816 (95% CI, 0.790 to 0.841) and 0.868 (95% CI, 0.850 to 0.884), respectively. The pooled diagnostic odds ratios of WLI and LCI were 15.447 (95% CI, 8.225 to 29.013) and 31.838 (95% CI, 15.576 to 65.078), respectively. The areas under the summary receiver operating characteristic curves of WLI and LCI were 0.870 and 0.911, respectively.</p><p><strong>Conclusions: </strong>LCI showed higher sensitivity in the endoscopic diagnosis of <i>H. pylori</i> infection than standard WLI.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11096912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111279","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}
引用次数: 0
Progress and Clinical Applications of Crohn's Disease Exclusion Diet in Crohn's Disease. 克罗恩病排异饮食在克罗恩病中的应用进展。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-15 Epub Date: 2023-10-16 DOI: 10.5009/gnl230093
Duo Xu, Ziheng Peng, Yong Li, Qian Hou, Yu Peng, Xiaowei Liu

Crohn's disease is a chronic intestinal inflammatory disorder of unknown etiology. Although the pharmacotherapies for Crohn's disease are constantly updating, nutritional support and adjuvant therapies have recently gained more attention. Due to advancements in clinical nutrition, various clinical nutritional therapies are used to treat Crohn's disease. Doctors treating inflammatory bowel disease can now offer several diets with more flexibility than ever. The Crohn's disease exclusion diet is a widely used diet for patients with active Crohn's disease. The Crohn's disease exclusion diet requires both exclusion and inclusion. Periodic exclusion of harmful foods and inclusion of wholesome foods gradually improves a patient's nutritional status. This article reviews the Crohn's disease exclusion diet, including its structure, mechanisms, research findings, and clinical applications.

克罗恩病是一种病因不明的慢性肠道炎症性疾病。尽管克罗恩病的药物治疗方法不断更新,但营养支持和辅助治疗最近受到了更多的关注。由于临床营养学的进步,各种临床营养疗法被用于治疗克罗恩病。治疗炎症性肠病的医生现在可以提供比以往任何时候都更灵活的几种饮食。克罗恩病排除饮食是一种广泛用于活动性克罗恩病患者的饮食。克罗恩病排除饮食需要排除和包容。定期排除有害食物和摄入有益健康的食物会逐渐改善患者的营养状况。本文综述了克罗恩病排除饮食的结构、机制、研究结果和临床应用。
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引用次数: 0
Helicobacter pylori Infection Status and Gastric Tumor Incidence According to the Year of Birth. 按出生年份分类的幽门螺杆菌感染状况与胃肿瘤发病率。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-15 Epub Date: 2023-11-29 DOI: 10.5009/gnl230211
Jong Hwa Na, Sun-Young Lee, Jeong Hwan Kim, In-Kyung Sung, Hyung Seok Park

Background/aims: : The prevalence of Helicobacter pylori-naive status is increasing. Nonetheless, biennial gastroscopy is recommended for all Koreans aged 40 to 75 years. This study aimed to determine whether gastric cancer screening guidelines could be changed according to H. pylori infection status and year of birth.

Methods: : Koreans who underwent serum assays and gastroscopy for gastric cancer screening between 2010 and 2016 were included if screening tests were followed up for ≥3 times. H. pylori infection was confirmed when invasive tests or 13C-urea breath tests were positive. In the case of negative test findings, eradication history, serologically detected atrophy, and intestinal metaplasia/atrophy were checked for past infection. If all were absent, H. pylori-naive status was confirmed.

Results: : Two-thousand and two (256 H. pylori-naive, 743 past-infected, and 1,003 infected) Koreans underwent screening tests for 95.5±28.4 months. The mean year of birth in the naive group (1969±7) differed from those of the past-infected (1957±10, p<0.001) and infected (1958±10, p<0.001) groups. H. pylori-naive status was correlated with recent year of birth (r=0.368, p<0.001). No gastric tumors were observed among the naive participants (p=0.007), whereas 23 adenomas, 18 adenocarcinomas, and two neuroendocrine tumors were detected in 1.9% (14/743) of past-infected and 2.5% (25/1,003) of infected participants, including four infected participants with metachronous tumors.

Conclusions: : The prevalence of H. pylori-naive status is increasing in young Koreans, and gastric tumors are rare in this population. Hence, biennial gastroscopy could be waived after the confirmation of naive status.

背景/目的:幽门螺杆菌幼稚状态的患病率正在上升。尽管如此,对于40 ~ 75岁的韩国人来说,还是建议每两年做一次胃镜检查。本研究旨在确定胃癌筛查指南是否可以根据幽门螺杆菌感染状况和出生年份进行改变。方法:纳入2010年至2016年期间接受血清检测和胃镜检查进行胃癌筛查的韩国人,如果筛查试验随访≥3次。当有创性检查或13c -尿素呼气试验呈阳性时,确认幽门螺杆菌感染。在试验结果阴性的情况下,检查根除史、血清学检测到的萎缩和肠化生/萎缩是否有感染史。如果全部缺失,则确认幽门螺杆菌幼稚状态。结果:2000名韩国人(256名幽门螺杆菌感染者,743名既往感染者,1003名感染者)接受了筛查试验,时间为95.5±28.4个月。初发组的平均出生年份(1969±7)与既往感染组的平均出生年份(1957±10)不同,幽门螺杆菌初发状态与近期出生年份相关(r=0.368, p)。结论:韩国年轻人幽门螺杆菌初发状态的患病率呈上升趋势,该人群胃肿瘤较少见。因此,在确认幼稚状态后,可以放弃两年一次的胃镜检查。
{"title":"<i>Helicobacter pylori</i> Infection Status and Gastric Tumor Incidence According to the Year of Birth.","authors":"Jong Hwa Na, Sun-Young Lee, Jeong Hwan Kim, In-Kyung Sung, Hyung Seok Park","doi":"10.5009/gnl230211","DOIUrl":"10.5009/gnl230211","url":null,"abstract":"<p><strong>Background/aims: </strong>: The prevalence of <i>Helicobacter pylori</i>-naive status is increasing. Nonetheless, biennial gastroscopy is recommended for all Koreans aged 40 to 75 years. This study aimed to determine whether gastric cancer screening guidelines could be changed according to <i>H. pylori</i> infection status and year of birth.</p><p><strong>Methods: </strong>: Koreans who underwent serum assays and gastroscopy for gastric cancer screening between 2010 and 2016 were included if screening tests were followed up for ≥3 times. <i>H. pylori</i> infection was confirmed when invasive tests or <sup>13</sup>C-urea breath tests were positive. In the case of negative test findings, eradication history, serologically detected atrophy, and intestinal metaplasia/atrophy were checked for past infection. If all were absent, <i>H. pylori</i>-naive status was confirmed.</p><p><strong>Results: </strong>: Two-thousand and two (256 <i>H. pylori</i>-naive, 743 past-infected, and 1,003 infected) Koreans underwent screening tests for 95.5±28.4 months. The mean year of birth in the naive group (1969±7) differed from those of the past-infected (1957±10, p<0.001) and infected (1958±10, p<0.001) groups. <i>H. pylori</i>-naive status was correlated with recent year of birth (r=0.368, p<0.001). No gastric tumors were observed among the naive participants (p=0.007), whereas 23 adenomas, 18 adenocarcinomas, and two neuroendocrine tumors were detected in 1.9% (14/743) of past-infected and 2.5% (25/1,003) of infected participants, including four infected participants with metachronous tumors.</p><p><strong>Conclusions: </strong>: The prevalence of <i>H. pylori</i>-naive status is increasing in young Koreans, and gastric tumors are rare in this population. Hence, biennial gastroscopy could be waived after the confirmation of naive status.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11096908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138451366","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}
引用次数: 0
Research Progress of Central and Peripheral Corticotropin-Releasing Hormone in Irritable Bowel Syndrome with Comorbid Dysthymic Disorders. 肠易激综合征并发癔症的中枢和外周促肾上腺皮质激素释放激素的研究进展。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-15 Epub Date: 2023-08-08 DOI: 10.5009/gnl220346
Yi Feng Liang, Xiao Qi Chen, Meng Ting Zhang, He Yong Tang, Guo Ming Shen

Irritable bowel syndrome (IBS) is considered a stress disorder characterized by psychological and gastrointestinal dysfunction. IBS patients not only suffer from intestinal symptoms such as abdominal pain, diarrhea, or constipation but also, experience dysthymic disorders such as anxiety and depression. Studies have found that corticotropin-releasing hormone plays a key role in IBS with comorbid dysthymic disorders. Next, we will summarize the effects of corticotropin-releasing hormone from the central nervous system and periphery on IBS with comorbid dysthymic disorders and relevant treatments based on published literatures in recent years.

肠易激综合征(IBS)被认为是一种以心理和肠胃功能紊乱为特征的应激障碍。肠易激综合征患者不仅会出现腹痛、腹泻或便秘等肠道症状,还会出现焦虑和抑郁等癔症。研究发现,促肾上腺皮质激素释放激素在肠易激综合征合并癔症中起着关键作用。接下来,我们将根据近年来发表的文献,总结来自中枢神经系统和外周的促肾上腺皮质激素释放激素对合并癔症的肠易激综合征的影响及相关治疗方法。
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引用次数: 0
Environmental and Microbial Factors in Inflammatory Bowel Disease Model Establishment: A Review Partly through Mendelian Randomization. 炎症性肠病模型建立中的环境和微生物因素:部分通过孟德尔随机化的综述。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-15 Epub Date: 2023-10-10 DOI: 10.5009/gnl230179
Zesheng Lin, Wenjing Luo, Kaijun Zhang, Shixue Dai

Inflammatory bowel disease (IBD) is a complex condition resulting from environmental, microbial, immunologic, and genetic factors. With the advancement of Mendelian randomization research in IBD, we have gained new insights into the relationship between these factors and IBD. Many animal models of IBD have been developed using different methods, but few studies have attempted to model IBD by combining environmental factors and microbial factors. In this review, we examine how environmental factors and microbial factors affect the development and progression of IBD, and how they interact with each other and with the intestinal microbiota. We also summarize the current methods for creating animal models of IBD and compare their advantages and disadvantages. Based on the latest findings from Mendelian randomization studies on the role of environmental factors in IBD, we discuss which environmental and microbial factors could be used to construct a more realistic and reliable IBD experimental model. We propose that animal models of IBD should consider both environmental and microbial factors to better mimic human IBD pathogenesis and to reveal the underlying mechanisms of IBD at the immune and genetic levels. We highlight the importance of environmental and microbial factors in IBD pathogenesis and offer new perspectives and suggestions for improving experimental animal modeling. Our goal is to create a model that closely resembles the clinical picture of IBD.

炎症性肠病(IBD)是一种由环境、微生物、免疫和遗传因素引起的复杂疾病。随着孟德尔随机化研究IBD的进展,我们对这些因素与IBD之间的关系有了新的认识。已经使用不同的方法开发了许多IBD动物模型,但很少有研究试图通过结合环境因素和微生物因素来建立IBD模型。在这篇综述中,我们研究了环境因素和微生物因素如何影响IBD的发展和进展,以及它们如何相互作用和与肠道微生物群相互作用。我们还总结了目前建立IBD动物模型的方法,并比较了它们的优缺点。基于孟德尔随机化研究中关于环境因素在IBD中作用的最新发现,我们讨论了哪些环境和微生物因素可以用来构建更现实、更可靠的IBD实验模型。我们建议IBD的动物模型应考虑环境和微生物因素,以更好地模拟人类IBD的发病机制,并在免疫和遗传水平上揭示IBD的潜在机制。我们强调了环境和微生物因素在IBD发病机制中的重要性,并为改进实验动物模型提供了新的视角和建议。我们的目标是创建一个与IBD临床情况非常相似的模型。
{"title":"Environmental and Microbial Factors in Inflammatory Bowel Disease Model Establishment: A Review Partly through Mendelian Randomization.","authors":"Zesheng Lin, Wenjing Luo, Kaijun Zhang, Shixue Dai","doi":"10.5009/gnl230179","DOIUrl":"10.5009/gnl230179","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a complex condition resulting from environmental, microbial, immunologic, and genetic factors. With the advancement of Mendelian randomization research in IBD, we have gained new insights into the relationship between these factors and IBD. Many animal models of IBD have been developed using different methods, but few studies have attempted to model IBD by combining environmental factors and microbial factors. In this review, we examine how environmental factors and microbial factors affect the development and progression of IBD, and how they interact with each other and with the intestinal microbiota. We also summarize the current methods for creating animal models of IBD and compare their advantages and disadvantages. Based on the latest findings from Mendelian randomization studies on the role of environmental factors in IBD, we discuss which environmental and microbial factors could be used to construct a more realistic and reliable IBD experimental model. We propose that animal models of IBD should consider both environmental and microbial factors to better mimic human IBD pathogenesis and to reveal the underlying mechanisms of IBD at the immune and genetic levels. We highlight the importance of environmental and microbial factors in IBD pathogenesis and offer new perspectives and suggestions for improving experimental animal modeling. Our goal is to create a model that closely resembles the clinical picture of IBD.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11096900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41182458","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}
引用次数: 0
Activin and Hepatocyte Growth Factor Promotes Colorectal Cancer Stemness and Metastasis through FOXM1/SOX2/CXCR4 Signaling. 活化素和肝细胞生长因子通过 FOXM1/SOX2/CXCR4 信号促进结直肠癌干性和转移
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-15 Epub Date: 2023-07-17 DOI: 10.5009/gnl220531
Hong Peng, Ting Ye, Lei Deng, Xiaofang Yang, Qingling Li, Jin Tong, Jinjun Guo

Background/aims: Cancer stem cells (CSCs) are believed to drive tumor development and metastasis. Activin and hepatocyte growth factor (HGF) are important cytokines with the ability to induce cancer stemness. However, the effect of activin and HGF combination treatment on CSCs is still unclear.

Methods: In this study, we sequentially treated colorectal cancer cells with activin and HGF and examined CSC marker expression, self-renewal, tumorigenesis, and metastasis. The roles of forkhead box M1 (FOXM1) and sex-determining region Y-box 2 (SOX2), two stemness-related transcription factors, in activin/HGF-induced aggressive phenotype were explored.

Results: Activin and HGF treatment increased the expression of CSC markers and enhanced sphere formation in colorectal cancer cells. The tumorigenic and metastatic capacities of colorectal cancer cells were enhanced upon activin and HGF treatment. Activin and HGF treatment preferentially promoted stemness and metastasis of CD133+ subpopulations sorted from colorectal cancer cells. FOXM1 was upregulated by activin and HGF treatment, and the knockdown of FOXM1 blocked activin/HGF-induced stemness, tumorigenesis, and metastasis of colorectal cancer cells. Similarly, SOX2 was silencing impaired sphere formation of activin/HGF-treated colorectal cancers. Overexpression of SOX2 rescued the stem cell-like phenotype in FOXM1-depleted colorectal cancer cells with activin and HGF treatment. Additionally, the inhibition of FOXM1 via thiostrepton suppressed activin/HGF-induced stemness, tumorigenesis and metastasis.

Conclusions: Sequential treatment with activin and HGF promotes colorectal cancer stemness and metastasis through activation of the FOXM1/SOX2 signaling. FOXM1 could be a potential target for the treatment of colorectal cancer metastasis.

背景/目的:癌症干细胞(CSCs)被认为是肿瘤发生和转移的驱动力。激活素和肝细胞生长因子(HGF)是重要的细胞因子,具有诱导癌症干细胞的能力。然而,活化素和肝细胞生长因子联合治疗对癌症干细胞的影响尚不清楚:本研究中,我们用激活素和HGF连续处理结直肠癌细胞,并检测了CSC标记物的表达、自我更新、肿瘤发生和转移。研究还探讨了叉头盒 M1(FOXM1)和性别决定区 Y-盒 2(SOX2)这两种与干细胞相关的转录因子在活化素/HGF诱导的侵袭性表型中的作用:结果:激活素和 HGF 处理增加了 CSC 标志物的表达,并增强了结直肠癌细胞球的形成。激活素和 HGF 处理后,结直肠癌细胞的致瘤和转移能力增强。激活素和 HGF 处理可优先促进从结直肠癌细胞中分拣出的 CD133+ 亚群的干性和转移。FOXM1在活化素和HGF处理后上调,敲除FOXM1可阻断活化素/HGF诱导的结直肠癌细胞的干性、肿瘤发生和转移。同样,沉默 SOX2 也会阻碍活化素/HGF 处理的结直肠癌球体的形成。过表达 SOX2 可挽救经活化素和 HGF 处理的 FOXM1 贫化结直肠癌细胞的干细胞样表型。此外,通过硫司替尼抑制FOXM1可抑制活化素/HGF诱导的干细胞、肿瘤发生和转移:结论:通过激活FOXM1/SOX2信号传导,活化素和HGF的连续处理可促进结直肠癌的干性和转移。FOXM1可能是治疗结直肠癌转移的潜在靶点。
{"title":"Activin and Hepatocyte Growth Factor Promotes Colorectal Cancer Stemness and Metastasis through FOXM1/SOX2/CXCR4 Signaling.","authors":"Hong Peng, Ting Ye, Lei Deng, Xiaofang Yang, Qingling Li, Jin Tong, Jinjun Guo","doi":"10.5009/gnl220531","DOIUrl":"10.5009/gnl220531","url":null,"abstract":"<p><strong>Background/aims: </strong>Cancer stem cells (CSCs) are believed to drive tumor development and metastasis. Activin and hepatocyte growth factor (HGF) are important cytokines with the ability to induce cancer stemness. However, the effect of activin and HGF combination treatment on CSCs is still unclear.</p><p><strong>Methods: </strong>In this study, we sequentially treated colorectal cancer cells with activin and HGF and examined CSC marker expression, self-renewal, tumorigenesis, and metastasis. The roles of forkhead box M1 (FOXM1) and sex-determining region Y-box 2 (SOX2), two stemness-related transcription factors, in activin/HGF-induced aggressive phenotype were explored.</p><p><strong>Results: </strong>Activin and HGF treatment increased the expression of CSC markers and enhanced sphere formation in colorectal cancer cells. The tumorigenic and metastatic capacities of colorectal cancer cells were enhanced upon activin and HGF treatment. Activin and HGF treatment preferentially promoted stemness and metastasis of CD133+ subpopulations sorted from colorectal cancer cells. FOXM1 was upregulated by activin and HGF treatment, and the knockdown of FOXM1 blocked activin/HGF-induced stemness, tumorigenesis, and metastasis of colorectal cancer cells. Similarly, SOX2 was silencing impaired sphere formation of activin/HGF-treated colorectal cancers. Overexpression of SOX2 rescued the stem cell-like phenotype in FOXM1-depleted colorectal cancer cells with activin and HGF treatment. Additionally, the inhibition of FOXM1 via thiostrepton suppressed activin/HGF-induced stemness, tumorigenesis and metastasis.</p><p><strong>Conclusions: </strong>Sequential treatment with activin and HGF promotes colorectal cancer stemness and metastasis through activation of the FOXM1/SOX2 signaling. FOXM1 could be a potential target for the treatment of colorectal cancer metastasis.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11096902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10139343","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}
引用次数: 0
GATA4 Forms a Positive Feedback Loop with CDX2 to Transactivate MUC2 in Bile Acids-Induced Gastric Intestinal Metaplasia. GATA4与CDX2形成正反馈环路,在胆汁酸诱导的胃肠道变性中反式激活MUC2
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-15 Epub Date: 2023-03-02 DOI: 10.5009/gnl220394
Xiaofang Yang, Ting Ye, Li Rong, Hong Peng, Jin Tong, Xiao Xiao, Xiaoqiang Wan, Jinjun Guo

Background/aims: Gastric intestinal metaplasia (GIM), a common precancerous lesion of gastric cancer, can be caused by bile acid reflux. GATA binding protein 4 (GATA4) is an intestinal transcription factor involved in the progression of gastric cancer. However, the expression and regulation of GATA4 in GIM has not been clarified.

Methods: The expression of GATA4 in bile acid-induced cell models and human specimens was examined. The transcriptional regulation of GATA4 was investigated by chromatin immunoprecipitation and luciferase reporter gene analysis. An animal model of duodenogastric reflux was used to confirm the regulation of GATA4 and its target genes by bile acids.

Results: GATA4 expression was elevated in bile acid-induced GIM and human specimens. GATA4 bound to the promoter of mucin 2 (MUC2) and stimulate its transcription. GATA4 and MUC2 expression was positively correlated in GIM tissues. Nuclear transcription factor-κB activation was required for the upregulation of GATA4 and MUC2 in bile acid-induced GIM cell models. GATA4 and caudal-related homeobox 2 (CDX2) reciprocally transactivated each other to drive the transcription of MUC2. In chenodeoxycholic acid-treated mice, MUC2, CDX2, GATA4, p50, and p65 expression levels were increased in the gastric mucosa.

Conclusions: GATA4 is upregulated and can form a positive feedback loop with CDX2 to transactivate MUC2 in GIM. NF-κB signaling is involved in the upregulation of GATA4 by chenodeoxycholic acid.

背景/目的:胃肠化生(GIM)是胃癌的一种常见癌前病变,可由胆汁酸反流引起。GATA 结合蛋白 4(GATA4)是一种肠转录因子,参与胃癌的进展。然而,GATA4 在 GIM 中的表达和调控尚未明确:方法:研究了胆汁酸诱导的细胞模型和人体标本中 GATA4 的表达。通过染色质免疫沉淀和荧光素酶报告基因分析研究了 GATA4 的转录调控。利用十二指肠胃反流动物模型证实胆汁酸对 GATA4 及其靶基因的调控作用:结果:胆汁酸诱导的 GIM 和人体标本中 GATA4 表达升高。GATA4 与粘蛋白 2(MUC2)的启动子结合并刺激其转录。GATA4 和 MUC2 的表达在 GIM 组织中呈正相关。在胆汁酸诱导的 GIM 细胞模型中,GATA4 和 MUC2 的上调需要核转录因子-κB 激活。GATA4和尾部相关同源染色体2(CDX2)相互转录,以驱动MUC2的转录。在经去氧胆酸处理的小鼠胃粘膜中,MUC2、CDX2、GATA4、p50和p65的表达水平均升高:结论:在 GIM 中,GATA4 上调,并能与 CDX2 形成正反馈环,转激活 MUC2。NF-κB信号转导参与了去氧胆酸对GATA4的上调。
{"title":"GATA4 Forms a Positive Feedback Loop with CDX2 to Transactivate MUC2 in Bile Acids-Induced Gastric Intestinal Metaplasia.","authors":"Xiaofang Yang, Ting Ye, Li Rong, Hong Peng, Jin Tong, Xiao Xiao, Xiaoqiang Wan, Jinjun Guo","doi":"10.5009/gnl220394","DOIUrl":"10.5009/gnl220394","url":null,"abstract":"<p><strong>Background/aims: </strong>Gastric intestinal metaplasia (GIM), a common precancerous lesion of gastric cancer, can be caused by bile acid reflux. GATA binding protein 4 (GATA4) is an intestinal transcription factor involved in the progression of gastric cancer. However, the expression and regulation of GATA4 in GIM has not been clarified.</p><p><strong>Methods: </strong>The expression of GATA4 in bile acid-induced cell models and human specimens was examined. The transcriptional regulation of GATA4 was investigated by chromatin immunoprecipitation and luciferase reporter gene analysis. An animal model of duodenogastric reflux was used to confirm the regulation of GATA4 and its target genes by bile acids.</p><p><strong>Results: </strong>GATA4 expression was elevated in bile acid-induced GIM and human specimens. GATA4 bound to the promoter of mucin 2 (MUC2) and stimulate its transcription. GATA4 and MUC2 expression was positively correlated in GIM tissues. Nuclear transcription factor-κB activation was required for the upregulation of GATA4 and MUC2 in bile acid-induced GIM cell models. GATA4 and caudal-related homeobox 2 (CDX2) reciprocally transactivated each other to drive the transcription of MUC2. In chenodeoxycholic acid-treated mice, MUC2, CDX2, GATA4, p50, and p65 expression levels were increased in the gastric mucosa.</p><p><strong>Conclusions: </strong>GATA4 is upregulated and can form a positive feedback loop with CDX2 to transactivate MUC2 in GIM. NF-κB signaling is involved in the upregulation of GATA4 by chenodeoxycholic acid.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11096910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9363607","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}
引用次数: 0
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Gut and Liver
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