JGH Open最新文献

Helicobacter pylori infection has been extensively studied in relation to various gastrointestinal disorders, with emerging evidence suggesting a significant association with inflammatory bowel disease (IBD). Epidemiological studies consistently demonstrate an inverse relationship between H. pylori infection and IBD development, particularly Crohn's disease (CD). Meta-analyses reveal a significantly lower prevalence of H. pylori among IBD patients compared to healthy controls, supporting the hypothesis of a potential protective effect. This negative correlation appears particularly strong for virulent strains expressing CagA, suggesting strain-specific immunomodulatory properties. The protective mechanisms may involve H. pylori's ability to modulate host immune responses and maintain gut microbial homeostasis. Experimental models show that H. pylori colonization can induce regulatory T-cell responses and downregulate pro-inflammatory cytokines, potentially creating an immunological balance that protects against IBD development. Conversely, H. pylori eradication has been associated with increased IBD incidence and disease flares, possibly through disruption of established microbial ecosystems and immune regulation. Clinical observations further support this relationship, demonstrating that H. pylori-positive CD patients often experience milder disease courses with fewer complications. However, the interaction remains complex, as H. pylori infection may also exert detrimental effects in certain contexts. The bacterium's influence appears to depend on multiple factors, including infection timing, strain characteristics, and host genetic background. Current evidence highlights the crucial interplay between H. pylori, gut microbiota composition, and mucosal immunity in shaping IBD pathogenesis. Future research should focus on elucidating precise molecular mechanisms and evaluating whether targeted modulation of H. pylori could offer therapeutic potential, while considering potential risks.

The gastrointestinal (GI) tract plays a vital role in regulating metabolic pathways, nutrient absorption, and cellular homeostasis. Abnormalities in the GI tract often arise from unhealthy lifestyles, genetic mutations, and prolonged medication use, leading to disorders such as ulcers, cirrhosis, and malignancies. Conventional treatments including chemotherapy and surgery remain limited by high costs, invasiveness, and incomplete tissue recovery. Recent advances in bioengineering have enabled the development of grafts and drug-delivery systems that repair and regenerate functional GI tissue. This review presents a comprehensive overview of GI disorders, their current therapeutic options, and emerging tissue-engineering strategies that integrate regenerative medicine and traditional therapies to address metabolic and genetic dysfunctions.

Rising antibiotic resistance has challenged empirical regimens for Helicobacter pylori eradication. While concomitant therapy is widely used, its effectiveness is reduced in resistant settings. Tailored therapy, guided by antimicrobial susceptibility testing, may improve outcomes. We performed a meta-analysis of randomized controlled trials (RCTs) comparing tailored versus concomitant therapy as a first-line treatment. We searched PubMed, Google Scholar, Cochrane, and ClinicalTrials.gov through April 2025 for RCTs enrolling treatment-naïve adults with confirmed H. pylori infection. The primary outcome was the eradication rate by intention-to-treat (ITT) and per-protocol (PP) analyses, with adverse events as a secondary outcome. We included eight RCTs with 2524 patients (1332 tailored, 1192 concomitant). Tailored therapy achieved higher eradication rates than concomitant therapy in the ITT analysis (87.4% vs. 83.2%; RR = 1.05; 95% CI: 1.00–1.10; p = 0.05) and the PP analysis (92.6% vs. 89.1%; RR = 1.04; 95% CI: 1.00–1.07; p = 0.03). Furthermore, tailored therapy was associated with a significantly lower incidence of adverse events (35.6% vs. 45.6%; RR = 0.71; 95% CI: 0.58–0.86; p = 0.0007). In conclusion, tailored therapy provides modestly higher H. pylori eradication rates and significantly fewer adverse events compared to empirical concomitant therapy. These findings support using tailored therapy as the preferred first-line option, particularly in regions with high antibiotic resistance and as access to rapid molecular testing expands.