Pub Date : 2024-09-16DOI: 10.1101/2024.09.16.24313738
Cynthia Akagbosu O Akagbosu, Kathryn E McCauley, Sivaranjani Namasivayam, Hector N Romero-Soto, Wade OBrien, Mickayla Bacorn, Eric Bohrnsen, Benjamin Schwarz, Shreni Mistry, Andres S Burns, P. Juliana Perez-Chaparro, Qing Chen, Phoebe LaPoint, Anal Patel, Lauren E Krausfeldt, Poorani Subramanian, Brian A Sellers, Foo Cheung, Richard Apps, Iyadh Douagi, Shira Levy, Evan P Nadler, Suchitra K Hourigan
Background: Bariatric surgery is highly effective in achieving weight loss in children and adolescents with severe obesity, however the underlying mechanisms are incompletely understood, and gut microbiome changes are unknown. Objectives: 1) To comprehensively examine gut microbiome and metabolome changes after laparoscopic vertical sleeve gastrectomy (VSG) in adolescents and 2) to assess whether the microbiome/metabolome changes observed with VSG influence phenotype using germ-free murine models. Design: 1) A longitudinal observational study in adolescents undergoing VSG with serial stool samples undergoing shotgun metagenomic microbiome sequencing and metabolomics (polar metabolites, bile acids and short chain fatty acids) and 2) a human-to-mouse fecal transplant study. Results: We show adolescents exhibit significant gut microbiome and metabolome shifts several months after VSG, with increased alpha diversity and notably with enrichment of oral-associated taxa. To assess causality of the microbiome/metabolome changes in phenotype, pre-VSG and post-VSG stool was transplanted into germ-free mice. Post-VSG stool was not associated with any beneficial outcomes such as adiposity reduction compared pre-VSG stool. However, post-VSG stool exhibited an inflammatory phenotype with increased intestinal Th17 and decreased regulatory T cells. Concomitantly, we found elevated fecal calprotectin and an enrichment of proinflammatory pathways in a subset of adolescents post-VSG. Conclusion: We show that in some adolescents, microbiome changes post-VSG may have inflammatory potential, which may be of importance considering the increased incidence of inflammatory bowel disease post-VSG.
{"title":"Gut microbiome shifts in adolescents after sleeve gastrectomy with increased oral-associated taxa and pro-inflammatory potential","authors":"Cynthia Akagbosu O Akagbosu, Kathryn E McCauley, Sivaranjani Namasivayam, Hector N Romero-Soto, Wade OBrien, Mickayla Bacorn, Eric Bohrnsen, Benjamin Schwarz, Shreni Mistry, Andres S Burns, P. Juliana Perez-Chaparro, Qing Chen, Phoebe LaPoint, Anal Patel, Lauren E Krausfeldt, Poorani Subramanian, Brian A Sellers, Foo Cheung, Richard Apps, Iyadh Douagi, Shira Levy, Evan P Nadler, Suchitra K Hourigan","doi":"10.1101/2024.09.16.24313738","DOIUrl":"https://doi.org/10.1101/2024.09.16.24313738","url":null,"abstract":"Background: Bariatric surgery is highly effective in achieving weight loss in children and adolescents with severe obesity, however the underlying mechanisms are incompletely understood, and gut microbiome changes are unknown. Objectives: 1) To comprehensively examine gut microbiome and metabolome changes after laparoscopic vertical sleeve gastrectomy (VSG) in adolescents and 2) to assess whether the microbiome/metabolome changes observed with VSG influence phenotype using germ-free murine models. Design: 1) A longitudinal observational study in adolescents undergoing VSG with serial stool samples undergoing shotgun metagenomic microbiome sequencing and metabolomics (polar metabolites, bile acids and short chain fatty acids) and 2) a human-to-mouse fecal transplant study.\u0000Results: We show adolescents exhibit significant gut microbiome and metabolome shifts several months after VSG, with increased alpha diversity and notably with enrichment of oral-associated taxa. To assess causality of the microbiome/metabolome changes in phenotype, pre-VSG and post-VSG stool was transplanted into germ-free mice. Post-VSG stool was not associated with any beneficial outcomes such as adiposity reduction compared pre-VSG stool. However, post-VSG stool exhibited an inflammatory phenotype with increased intestinal Th17 and decreased regulatory T cells. Concomitantly, we found elevated fecal calprotectin and an enrichment of proinflammatory pathways in a subset of adolescents post-VSG. Conclusion: We show that in some adolescents, microbiome changes post-VSG may have inflammatory potential, which may be of importance considering the increased incidence of inflammatory bowel disease post-VSG.","PeriodicalId":501258,"journal":{"name":"medRxiv - Gastroenterology","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-09DOI: 10.1101/2024.09.08.24313266
Jonathan Golob, Krishna Rao, Jeffrey A Berinstein, Prashant Singh, William Chey, Chung Owyang, Nobuhiko Kamada, Peter D.R. Higgins, Vincent Young, Shrinivas Bishu, Allen Lee
Introduction: Even in the absence of inflammation, persistent symptoms in patients with Crohn's disease (CD) are prevalent and worsen quality of life. We previously demonstrated enrichment in sulfidogenic microbes in quiescent CD patients with (qCD+S) vs. without persistent GI symptoms (qCD-S). Thus, we hypothesized that sulfur metabolic pathways would be enriched in stool while differentially abundant microbes would be associated with important sulfur-metabolic pathways in qCD+S. Methods: We performed a multi-center observational study nested within SPARC IBD. Quiescent inflammation was defined by fecal calprotectin level < 150 mcg/g. Persistent symptoms were defined by CD-PRO2. Active CD (aCD) and non-IBD diarrhea-predominant irritable bowel syndrome (IBS-D) were included as controls. Results: Thirty-nine patients with qCD+S, 274 qCD-S, 21 aCD, and 40 IBS-D underwent paired shotgun metagenomic sequencing and untargeted metabolomic profiling. The fecal metabolome in qCD+S was significantly different relative to qCD-S and IBS-D but not aCD. Patients with qCD+S were enriched in sulfur-containing amino acid pathways, including cysteine and methionine, as well as serine, glycine, and threonine. Glutathione and nicotinate/nicotinamide pathways were also enriched in qCD+S relative to qCD-S, suggestive of mitochondrial dysfunction, a downstream target of H2S signaling. Multi-omic integration demonstrated that enriched microbes in qCD+S were associated with important sulfur-metabolic pathways. Bacterial sulfur-metabolic genes, including CTH, isfD, sarD, and asrC, were dysregulated in qCD+S. Finally, sulfur metabolites with and without sulfidogenic microbes showed good accuracy in predicting presence of qCD+S. Discussion: Microbial-derived sulfur pathways and downstream mitochondrial function are perturbed in qCD+S, which implicate H2S signaling in the pathogenesis of this condition. Future studies will determine whether targeting H2S pathways results in improved quality of life in qCD+S.
{"title":"Why Symptoms Linger in Quiescent Crohn's Disease: Investigating the Impact of Sulfidogenic Microbes and Sulfur Metabolic Pathways","authors":"Jonathan Golob, Krishna Rao, Jeffrey A Berinstein, Prashant Singh, William Chey, Chung Owyang, Nobuhiko Kamada, Peter D.R. Higgins, Vincent Young, Shrinivas Bishu, Allen Lee","doi":"10.1101/2024.09.08.24313266","DOIUrl":"https://doi.org/10.1101/2024.09.08.24313266","url":null,"abstract":"Introduction: Even in the absence of inflammation, persistent symptoms in patients with Crohn's disease (CD) are prevalent and worsen quality of life. We previously demonstrated enrichment in sulfidogenic microbes in quiescent CD patients with (qCD+S) vs. without persistent GI symptoms (qCD-S). Thus, we hypothesized that sulfur metabolic pathways would be enriched in stool while differentially abundant microbes would be associated with important sulfur-metabolic pathways in qCD+S. Methods: We performed a multi-center observational study nested within SPARC IBD. Quiescent inflammation was defined by fecal calprotectin level < 150 mcg/g. Persistent symptoms were defined by CD-PRO2. Active CD (aCD) and non-IBD diarrhea-predominant irritable bowel syndrome (IBS-D) were included as controls. Results: Thirty-nine patients with qCD+S, 274 qCD-S, 21 aCD, and 40 IBS-D underwent paired shotgun metagenomic sequencing and untargeted metabolomic profiling. The fecal metabolome in qCD+S was significantly different relative to qCD-S and IBS-D but not aCD. Patients with qCD+S were enriched in sulfur-containing amino acid pathways, including cysteine and methionine, as well as serine, glycine, and threonine. Glutathione and nicotinate/nicotinamide pathways were also enriched in qCD+S relative to qCD-S, suggestive of mitochondrial dysfunction, a downstream target of H<sub>2</sub>S signaling. Multi-omic integration demonstrated that enriched microbes in qCD+S were associated with important sulfur-metabolic pathways. Bacterial sulfur-metabolic genes, including <em>CTH, isfD, sarD</em>, and <em>asrC</em>, were dysregulated in qCD+S. Finally, sulfur metabolites with and without sulfidogenic microbes showed good accuracy in predicting presence of qCD+S. Discussion: Microbial-derived sulfur pathways and downstream mitochondrial function are perturbed in qCD+S, which implicate H<sub>2</sub>S signaling in the pathogenesis of this condition. Future studies will determine whether targeting H<sub>2</sub>S pathways results in improved quality of life in qCD+S.","PeriodicalId":501258,"journal":{"name":"medRxiv - Gastroenterology","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neoadjuvant chemotherapy with cisplatin + 5-fluorouracil followed by radical surgery is the standard treatment for stage II and III esophageal cancers. Although, a more potent regimen comprising cisplatin + 5-fluorouracil with docetaxel, has shown superiority in overall survival compared to the cisplatin + 5-fluorouracil regimen, it involves worsening of Grade 3 or higher adverse events due to docetaxel. Based on these reports, this study aimed to construct a prognostic system for cisplatin + 5-fluorouracil regimens, particularly for locally advanced cancers, to guide selection of neoadjuvant chemotherapy. Biopsy specimens from 82 patients who underwent a cisplatin + 5-fluorouracil regimen plus radical surgery at Saitama Medical University International Medical Center between May 2012 and June 2020 were analyzed. Variants in 56 autophagy- and esophageal cancer-related genes were identified using targeted enrichment sequencing. Overall, 13 single nucleotide variants, including eight non-synonymous group single nucleotide variants predicting recurrence were identified using Fisher's exact test with recurrence as a two-group event, which showed a significant difference (p < 0.05). Additionally, machine learning was used to predict recurrence using 21 features, including eight patient backgrounds. The results showed that the Naive Bayes was highly reliable with an accuracy of 0.88 and Area Under the Curve of 0.9. Thus, we constructed a machine learning model to predict recurrence in patients with esophageal cancer treated with a cisplatin + 5-fluorouracil regimen. We believe that our results will provide useful guidance for the selection of neoadjuvant adjuvant chemotherapy, including the avoidance of docetaxel.
{"title":"Development of a machine-learning model for therapeutic efficacy prediction of preoperative treatment for esophageal cancer using single nucleotide variants of autophagy-related genes","authors":"Yutak Miyawaki, Masataka Hirasaki, Yasuo Kamakura, Tomonori Kawasaki, Yasutaka Baba, Tetsuya Sato, Satoshi Yamasaki, Hisayo Fukushima, Kousuke Uranishi, Yoshinori Makino, Hiroshi Sato, Tetsuya Hamaguchi","doi":"10.1101/2024.09.07.24313244","DOIUrl":"https://doi.org/10.1101/2024.09.07.24313244","url":null,"abstract":"Neoadjuvant chemotherapy with cisplatin + 5-fluorouracil followed by radical surgery is the standard treatment for stage II and III esophageal cancers. Although, a more potent regimen comprising cisplatin + 5-fluorouracil with docetaxel, has shown superiority in overall survival compared to the cisplatin + 5-fluorouracil regimen, it involves worsening of Grade 3 or higher adverse events due to docetaxel. Based on these reports, this study aimed to construct a prognostic system for cisplatin + 5-fluorouracil regimens, particularly for locally advanced cancers, to guide selection of neoadjuvant chemotherapy. Biopsy specimens from 82 patients who underwent a cisplatin + 5-fluorouracil regimen plus radical surgery at Saitama Medical University International Medical Center between May 2012 and June 2020 were analyzed. Variants in 56 autophagy- and esophageal cancer-related genes were identified using targeted enrichment sequencing. Overall, 13 single nucleotide variants, including eight non-synonymous group single nucleotide variants predicting recurrence were identified using Fisher's exact test with recurrence as a two-group event, which showed a significant difference (p < 0.05). Additionally, machine learning was used to predict recurrence using 21 features, including eight patient backgrounds. The results showed that the Naive Bayes was highly reliable with an accuracy of 0.88 and Area Under the Curve of 0.9. Thus, we constructed a machine learning model to predict recurrence in patients with esophageal cancer treated with a cisplatin + 5-fluorouracil regimen. We believe that our results will provide useful guidance for the selection of neoadjuvant adjuvant chemotherapy, including the avoidance of docetaxel.","PeriodicalId":501258,"journal":{"name":"medRxiv - Gastroenterology","volume":"145 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1101/2024.09.05.24313139
Perseus V. Patel, Conner Davis, Amariel Ralbovsky, Daniel Tinoco, Christopher Y.K. Williams, Shadera Slatter, Behzad Naderalvojoud, Michael J. Rosen, Tina Hernandez-Boussard, Vivek Rudrapatna
Background and Aims Patient-reported outcomes (PROs) are vital in assessing disease activity and treatment outcomes in inflammatory bowel disease (IBD). However, manual extraction of these PROs from the free-text of clinical notes is burdensome. We aimed to improve data curation from free-text information in the electronic health record, making it more available for research and quality improvement. This study aimed to compare traditional natural language processing (tNLP) and large language models (LLMs) in extracting three IBD PROs (abdominal pain, diarrhea, fecal blood) from clinical notes across two institutions.
{"title":"Large language models outperform traditional natural language processing methods in extracting patient-reported outcomes in IBD","authors":"Perseus V. Patel, Conner Davis, Amariel Ralbovsky, Daniel Tinoco, Christopher Y.K. Williams, Shadera Slatter, Behzad Naderalvojoud, Michael J. Rosen, Tina Hernandez-Boussard, Vivek Rudrapatna","doi":"10.1101/2024.09.05.24313139","DOIUrl":"https://doi.org/10.1101/2024.09.05.24313139","url":null,"abstract":"<strong>Background and Aims</strong> Patient-reported outcomes (PROs) are vital in assessing disease activity and treatment outcomes in inflammatory bowel disease (IBD). However, manual extraction of these PROs from the free-text of clinical notes is burdensome. We aimed to improve data curation from free-text information in the electronic health record, making it more available for research and quality improvement. This study aimed to compare traditional natural language processing (tNLP) and large language models (LLMs) in extracting three IBD PROs (abdominal pain, diarrhea, fecal blood) from clinical notes across two institutions.","PeriodicalId":501258,"journal":{"name":"medRxiv - Gastroenterology","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1101/2024.09.06.24313193
Anne-Marie C Overstreet, McKenzie Burge, Annette Bellar, Megan McMullen, Douglas Czarnecki, Emily Huang, Vai Pathak, Chelsea Finney, Raveena Vij, Srinivasan Dasarathy, Jaividhya Dasarathy, David Streem, Nicole Welch, Daniel Rotroff, Adam M Schmitt, Laura E Nagy, Jeannette S Messer
Background and aims Alcohol-associated hepatitis (AH) is the most life-threatening form of alcohol-associated liver disease (ALD). AH is characterized by severe inflammation attributed to increased levels of ethanol, microbes or microbial components, and damage-associated molecular pattern (DAMP) molecules in the liver. HSPB1 (Heat Shock Protein Family B (Small) Member 1; also known as Hsp25/27) is a DAMP that is rapidly increased in and released from cells experiencing stress, including hepatocytes. The goal of this study was to define the role of HSPB1 in AH pathophysiology.
{"title":"Evidence that extracellular HSPB1 contributes to inflammation in alcohol-associated hepatitis","authors":"Anne-Marie C Overstreet, McKenzie Burge, Annette Bellar, Megan McMullen, Douglas Czarnecki, Emily Huang, Vai Pathak, Chelsea Finney, Raveena Vij, Srinivasan Dasarathy, Jaividhya Dasarathy, David Streem, Nicole Welch, Daniel Rotroff, Adam M Schmitt, Laura E Nagy, Jeannette S Messer","doi":"10.1101/2024.09.06.24313193","DOIUrl":"https://doi.org/10.1101/2024.09.06.24313193","url":null,"abstract":"<strong>Background and aims</strong> Alcohol-associated hepatitis (AH) is the most life-threatening form of alcohol-associated liver disease (ALD). AH is characterized by severe inflammation attributed to increased levels of ethanol, microbes or microbial components, and damage-associated molecular pattern (DAMP) molecules in the liver. HSPB1 (Heat Shock Protein Family B (Small) Member 1; also known as Hsp25/27) is a DAMP that is rapidly increased in and released from cells experiencing stress, including hepatocytes. The goal of this study was to define the role of HSPB1 in AH pathophysiology.","PeriodicalId":501258,"journal":{"name":"medRxiv - Gastroenterology","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helicobacter pylori (H. pylori), a type of nematode, is a common cause of chronic stomach infection around the world. In 2014, the World Health Organization (WHO) reported that H. pylori infection is a leading cause of gastric cancer (80%) worldwide and has specific carcinogenic factors. H. pylori infection is presumed to be the cause of gastric cancer in more than 98% of gastric cancer patients in East Asia, including Japan. However, only some types of gastric cancers are associated with H. pylori infection. Previous clinical studies have revealed that the bacterium secretes the cytotoxin-associated gene A (CagA) antigen, which inhibits the nuclear translocation of breast cancer susceptibility gene 1 (BRCA1) or BRCA2, a factor that repairs damaged DNA. Accordingly, an association has been pointed out between hereditary breast and ovarian cancers (HBOC) and the development of gastric cancer; however, there is a lack of clarity about the detailed mechanisms underlying the development of gastric cancer by H. pylori infection. Using the information base on hereditary cancers built up through cancer genomic medicine, our group highlighted the higher incidence of gastric cancer in HBOC families, with a preponderance for gastric cancer in male patients from HBOC families. We also verified the safety and efficacy of using poly ADP-ribose polymerase (PARP) inhibitors in patients with hereditary gastric cancer. The present study offers substantial evidence for guiding the establishment of early treatment for patients with advanced/metastatic gastric cancer in whom BRCA1/2 mutations have been detected.
{"title":"Efficacy and Tolerability of Olaparib Plus Paclitaxel in Patients with hereditary gastric cancer linked to a family history of hereditary breast and ovarian cancer (HBOC)","authors":"Takuma Hayashi, Kenji Sano, Mako Okada, Manabu Muto, Ikuo Konishi","doi":"10.1101/2024.09.03.24313047","DOIUrl":"https://doi.org/10.1101/2024.09.03.24313047","url":null,"abstract":"Helicobacter pylori (H. pylori), a type of nematode, is a common cause of chronic stomach infection around the world. In 2014, the World Health Organization (WHO) reported that H. pylori infection is a leading cause of gastric cancer (80%) worldwide and has specific carcinogenic factors. H. pylori infection is presumed to be the cause of gastric cancer in more than 98% of gastric cancer patients in East Asia, including Japan. However, only some types of gastric cancers are associated with H. pylori infection. Previous clinical studies have revealed that the bacterium secretes the cytotoxin-associated gene A (CagA) antigen, which inhibits the nuclear translocation of breast cancer susceptibility gene 1 (BRCA1) or BRCA2, a factor that repairs damaged DNA. Accordingly, an association has been pointed out between hereditary breast and ovarian cancers (HBOC) and the development of gastric cancer; however, there is a lack of clarity about the detailed mechanisms underlying the development of gastric cancer by H. pylori infection. Using the information base on hereditary cancers built up through cancer genomic medicine, our group highlighted the higher incidence of gastric cancer in HBOC families, with a preponderance for gastric cancer in male patients from HBOC families. We also verified the safety and efficacy of using poly ADP-ribose polymerase (PARP) inhibitors in patients with hereditary gastric cancer. The present study offers substantial evidence for guiding the establishment of early treatment for patients with advanced/metastatic gastric cancer in whom BRCA1/2 mutations have been detected.","PeriodicalId":501258,"journal":{"name":"medRxiv - Gastroenterology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Percutaneous transhepatic gallbladder drainage (PTGBD) is an alternative to percutaneous transhepatic biliary drainage (PTBD) for cases of obstructive jaundice in which the bile duct obstruction is below the confluence of the cystic ducts. The present study aimed to evaluate the usefulness of PTGBD and PTBD in patients with obstructive jaundice. This study enrolled patients who had undergone percutaneous biliary drainage for acute cholangitis and obstructive jaundice at two institutions between January 2017 and March 2024. Fifty-five patients were included in this analysis. However, patients with intrahepatic or hilar bile duct stenosis, post choledocholithiasis, complex cholecystitis, total bilirubin levels < 2.0 mg/dL, and uncorrectable bleeding tendency and those who had undergone the procedure and later discontinued without puncture were excluded. The technical success rates, clinical success rates, and complication rates of the procedure were evaluated. The technical success rates were 96.3% (26/27) in the PTGBD group and 82.1% (13/28) in the PTBD group. The clinical success rates were 85.2% (23/27) in the PTGBD group and 67.9% (19/28) in the PTBD group. The complication rates were 11.1% (3/27) in the PTGBD group and 17.9% (5/28) in the PTBD group. Hence, the two groups did not significantly differ in any of the endpoints. The outcomes of PTGBD were comparable to those of PTBD in patients with obstructive jaundice. Hence, PTGBD is a reasonable treatment option for cases of obstructive jaundice in which PTBD is not feasible.
{"title":"Outcomes of percutaneous transhepatic gallbladder drainage versus percutaneous transhepatic biliary drainage for obstructive jaundice","authors":"Tetsushi Azami, Yuichi Takano, Naoki Tamai, Jun Noda, Masataka Yamawaki, Fumitaka Niiya, Naotaka Maruoka, Fumiya Nishimoto, Akira Ishihara, Masatsugu Nagahama","doi":"10.1101/2024.09.03.24313028","DOIUrl":"https://doi.org/10.1101/2024.09.03.24313028","url":null,"abstract":"Percutaneous transhepatic gallbladder drainage (PTGBD) is an alternative to percutaneous transhepatic biliary drainage (PTBD) for cases of obstructive jaundice in which the bile duct obstruction is below the confluence of the cystic ducts. The present study aimed to evaluate the usefulness of PTGBD and PTBD in patients with obstructive jaundice. This study enrolled patients who had undergone percutaneous biliary drainage for acute cholangitis and obstructive jaundice at two institutions between January 2017 and March 2024. Fifty-five patients were included in this analysis. However, patients with intrahepatic or hilar bile duct stenosis, post choledocholithiasis, complex cholecystitis, total bilirubin levels < 2.0 mg/dL, and uncorrectable bleeding tendency and those who had undergone the procedure and later discontinued without puncture were excluded. The technical success rates, clinical success rates, and complication rates of the procedure were evaluated. The technical success rates were 96.3% (26/27) in the PTGBD group and 82.1% (13/28) in the PTBD group. The clinical success rates were 85.2% (23/27) in the PTGBD group and 67.9% (19/28) in the PTBD group. The complication rates were 11.1% (3/27) in the PTGBD group and 17.9% (5/28) in the PTBD group. Hence, the two groups did not significantly differ in any of the endpoints. The outcomes of PTGBD were comparable to those of PTBD in patients with obstructive jaundice. Hence, PTGBD is a reasonable treatment option for cases of obstructive jaundice in which PTBD is not feasible.","PeriodicalId":501258,"journal":{"name":"medRxiv - Gastroenterology","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1101/2024.08.30.24312853
Maria T. Abreu, Maria A. Quintero, Luis Garces, Hajar Hazime, Rose Killian, Katerina M. Faust, Payton Mendygral, Judith Pignac-Kobinger, Cristiana Mangarelli, Ana M. Santander, Irina Fernández, Norma Solis, Mailenys Ortega, Oriana M. Damas, Siobhan Proksell, David H. Kerman, Amar R. Deshpande, Jennifer Seminerio, Jana A.L. Hashash, Philip Harvey, Ingrid Barrera, Tracy Crane
Background Crohn’s disease (CD) is characterized by intestinal inflammation. Diet is a risk factor for inflammatory bowel diseases such as CD and represents a promising adjunctive treatment, yet there are few well-controlled dietary intervention studies in CD patients. Fiber may have beneficial effects; however, most CD patients are told to avoid high-fiber foods. We conducted a longitudinal patient-preference study to examine the effect of a catered low-fat, high- fiber diet (the Mi-IBD diet) on CD symptoms, inflammation, and the microbiome.
背景克罗恩病（CD）以肠道炎症为特征。饮食是 CD 等炎症性肠病的一个危险因素，也是一种很有前景的辅助治疗方法，但目前针对 CD 患者的饮食干预研究很少。纤维可能有益处，但大多数 CD 患者被告知要避免食用高纤维食物。我们进行了一项纵向患者偏好研究，以考察低脂高纤维饮食（Mi-IBD 饮食）对 CD 症状、炎症和微生物组的影响。
{"title":"A high-fiber, low-fat diet improves the symptoms and metabolic profile of patients with Crohn’s disease","authors":"Maria T. Abreu, Maria A. Quintero, Luis Garces, Hajar Hazime, Rose Killian, Katerina M. Faust, Payton Mendygral, Judith Pignac-Kobinger, Cristiana Mangarelli, Ana M. Santander, Irina Fernández, Norma Solis, Mailenys Ortega, Oriana M. Damas, Siobhan Proksell, David H. Kerman, Amar R. Deshpande, Jennifer Seminerio, Jana A.L. Hashash, Philip Harvey, Ingrid Barrera, Tracy Crane","doi":"10.1101/2024.08.30.24312853","DOIUrl":"https://doi.org/10.1101/2024.08.30.24312853","url":null,"abstract":"<strong>Background</strong> Crohn’s disease (CD) is characterized by intestinal inflammation. Diet is a risk factor for inflammatory bowel diseases such as CD and represents a promising adjunctive treatment, yet there are few well-controlled dietary intervention studies in CD patients. Fiber may have beneficial effects; however, most CD patients are told to avoid high-fiber foods. We conducted a longitudinal patient-preference study to examine the effect of a catered low-fat, high- fiber diet (the <em>Mi</em>-IBD diet) on CD symptoms, inflammation, and the microbiome.","PeriodicalId":501258,"journal":{"name":"medRxiv - Gastroenterology","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1101/2024.08.30.24312837
Alfie Thain, Petra Visser, Kathryn Hart, Ebba Nexo, Andrew McCaddon, Luciana Hannibal, Bruce HR Wolffenbuttel, Ralph Green, Nicola Ward, Catherine Heidi Seage, Julian Owen, Katrina Burchell, Marie-Joe Dib, Kourosh R Ahmadi
Objective Pernicious anaemia (PA) is characterised by vitamin B12 deficiency due to autoimmune-mediated loss of gastric parietal cells and intrinsic factor. The Pernicious Anaemia Society (PAS) identified 10 research priorities for PA through a James-Lind Alliance Priority Setting Partnership (JLA-PSP). This study aimed to survey PAS members to identify and characterise a cohort of patients to form a PA research repository.
目的 恶性贫血（PA）的特点是由于自身免疫介导的胃顶细胞和内在因子的丧失而导致维生素 B12 缺乏。恶性贫血协会（PAS）通过詹姆斯-林德联盟（JLA-PSP）的优先事项设定伙伴关系确定了有关 PA 的 10 项优先研究事项。这项研究旨在对 PAS 成员进行调查，以确定一组患者并描述其特征，从而形成 PA 研究资料库。
{"title":"Patient-Reported Characteristics of Pernicious Anaemia: A first step to initiate James Lind Alliance Priority Setting Partnership Driven Research","authors":"Alfie Thain, Petra Visser, Kathryn Hart, Ebba Nexo, Andrew McCaddon, Luciana Hannibal, Bruce HR Wolffenbuttel, Ralph Green, Nicola Ward, Catherine Heidi Seage, Julian Owen, Katrina Burchell, Marie-Joe Dib, Kourosh R Ahmadi","doi":"10.1101/2024.08.30.24312837","DOIUrl":"https://doi.org/10.1101/2024.08.30.24312837","url":null,"abstract":"<strong>Objective</strong> Pernicious anaemia (PA) is characterised by vitamin B12 deficiency due to autoimmune-mediated loss of gastric parietal cells and intrinsic factor. The Pernicious Anaemia Society (PAS) identified 10 research priorities for PA through a James-Lind Alliance Priority Setting Partnership (JLA-PSP). This study aimed to survey PAS members to identify and characterise a cohort of patients to form a PA research repository.","PeriodicalId":501258,"journal":{"name":"medRxiv - Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Sarcopenia is a prognostic factor in patients with hepatocellular carcinoma (HCC). However, the mechanism underlying sarcopenia development in these patients remains unclear. The chemokine interferon-gamma-induced protein 10/C-X-C motif chemokine ligand 10 (IP-10) has been found to be associated with muscle regeneration or destruction. Thus, we aimed to clarify the role of serum IP-10 levels in predicting sarcopenia development in patients with HCC. Methods This retrospective study enrolled 120 patients with primary HCC whose serum IP-10 levels were measured both at baseline and 1 year after the confirmed diagnosis of HCC. Patients who had sarcopenia at baseline computed tomography imaging were assigned to the Sarco-base group, whereas those in whom sarcopenia was found for the first time during the 3-year follow-up were assigned to the Sarco-develop group. Those who never met the criteria during the follow-up period were assigned to the Non-Sarco group. Results The baseline IP-10 levels were significantly lower in the Sarco-base group compared to the rest (88 vs. 110 pg/ml, p = 0.016). Conversely IP-10 levels and IP-10 ratio at 1 year after the confirmed diagnosis of HCC were lower in the Non-Sarco group compared to the rest (25 vs. 62 pg/ml, p < 0.001, 0.91 vs. 1.1, p = 0.044). Further comparisons between the three groups show that the baseline IP-10 levels were higher in the Sarco-develop group than in the Sarco-base (p < 0.001) and Non-Sarco (p = 0.0017) groups. Conclusions Patients with sarcopenia at baseline more frequently presented with low IP-10 levels than those without. Contrarily, the group without sarcopenia at baseline and with high baseline IP-10 levels and IP-10 ratios at 1 year were more likely to develop sarcopenia within 3 years. Monitoring of IP-10 levels may enable the identification of groups prone to develop sarcopenia in patients with HCC.
{"title":"Serum interferon-gamma-induced protein 10 levels can help predict sarcopenia development in patients with primary hepatocellular carcinoma: A retrospective cohort study","authors":"Hitomi Takada, Leona Osawa, Yasuyuki Komiyama, Masaru Muraoka, Yuichiro Suzuki, Mitsuaki Sato, Shoji Kobayashi, Takashi Yoshida, Shinichi Takano, Shinya Maekawa, Nobuyuki Enomoto","doi":"10.1101/2024.08.21.24312385","DOIUrl":"https://doi.org/10.1101/2024.08.21.24312385","url":null,"abstract":"Background Sarcopenia is a prognostic factor in patients with hepatocellular carcinoma (HCC). However, the mechanism underlying sarcopenia development in these patients remains unclear. The chemokine interferon-gamma-induced protein 10/C-X-C motif chemokine ligand 10 (IP-10) has been found to be associated with muscle regeneration or destruction. Thus, we aimed to clarify the role of serum IP-10 levels in predicting sarcopenia development in patients with HCC. Methods This retrospective study enrolled 120 patients with primary HCC whose serum IP-10 levels were measured both at baseline and 1 year after the confirmed diagnosis of HCC. Patients who had sarcopenia at baseline computed tomography imaging were assigned to the Sarco-base group, whereas those in whom sarcopenia was found for the first time during the 3-year follow-up were assigned to the Sarco-develop group. Those who never met the criteria during the follow-up period were assigned to the Non-Sarco group. Results The baseline IP-10 levels were significantly lower in the Sarco-base group compared to the rest (88 vs. 110 pg/ml, p = 0.016). Conversely IP-10 levels and IP-10 ratio at 1 year after the confirmed diagnosis of HCC were lower in the Non-Sarco group compared to the rest (25 vs. 62 pg/ml, p < 0.001, 0.91 vs. 1.1, p = 0.044). Further comparisons between the three groups show that the baseline IP-10 levels were higher in the Sarco-develop group than in the Sarco-base (p < 0.001) and Non-Sarco (p = 0.0017) groups. Conclusions Patients with sarcopenia at baseline more frequently presented with low IP-10 levels than those without. Contrarily, the group without sarcopenia at baseline and with high baseline IP-10 levels and IP-10 ratios at 1 year were more likely to develop sarcopenia within 3 years. Monitoring of IP-10 levels may enable the identification of groups prone to develop sarcopenia in patients with HCC.","PeriodicalId":501258,"journal":{"name":"medRxiv - Gastroenterology","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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