Ahmed El-Sayed, C. Oztumer, Camellia Richards, O. Salim, Mathuri Sivakumar, Laith Alrubaiy
Background: Ulcerative colitis (UC) is a relapsing–remitting inflammatory condition that has an increasing incidence across the world, including in the Middle East. Biological monoclonal antibody drugs (biologics) have been shown to be advantageous in treating UC. We undertook a review of the currently available biological and small-molecule therapies, with a particular emphasis on those currently licensed in the United Arab Emirates (UAE). Methods: We conducted a literature search for studies on biological therapies using the PubMed, MEDLINE, and Embase databases using a list of keywords that were generated following referral to existing treatment guidelines for UC. Papers looking at biological and small-molecule treatments for UC in adult populations were included. Pediatric, pregnancy, and cost-effectiveness studies were excluded. Results and Discussion: There are currently three classes of biologics (anti-tumor necrosis factors (anti-TNFs), anti-integrins, and anti-interleukins) and one class of small-molecule therapy (Janus kinase (JAK) inhibitor) licensed for UC treatment in the UAE. Within the anti-TNF class, three medications have been approved: infliximab, adalimumab, and golimumab. For JAK inhibitors, there are two: tofacitinib and upadacitinib. There is only one licensed medication in the remaining classes: vedolizumab (anti-integrin) and ustekinumab (anti-interleukin). The length of studies varied from 6–8 weeks for induction studies and 52 weeks for maintenance studies. The studies demonstrated increased efficacy in these medications compared to placebos when clinical response, clinical remission, and other secondary measures such as mucosal healing were assessed following the induction and maintenance phases. Biosimilars of infliximab and adalimumab are also available for treating UC, and their safety and efficacy were compared to their biologic originators. Conclusions: The introduction of biologics has been proven to be beneficial for the treatment of UC. This review summarizes the efficacy and safety of each biological class in the treatment of the disease; however, biological drug registries and further studies are required to offer more insight into the comparative efficacy and safety of these agents.
{"title":"Biologics in Focus: A Comprehensive Review of the Current Biological Therapies for Ulcerative Colitis in the United Arab Emirates (UAE)","authors":"Ahmed El-Sayed, C. Oztumer, Camellia Richards, O. Salim, Mathuri Sivakumar, Laith Alrubaiy","doi":"10.3390/gidisord6010018","DOIUrl":"https://doi.org/10.3390/gidisord6010018","url":null,"abstract":"Background: Ulcerative colitis (UC) is a relapsing–remitting inflammatory condition that has an increasing incidence across the world, including in the Middle East. Biological monoclonal antibody drugs (biologics) have been shown to be advantageous in treating UC. We undertook a review of the currently available biological and small-molecule therapies, with a particular emphasis on those currently licensed in the United Arab Emirates (UAE). Methods: We conducted a literature search for studies on biological therapies using the PubMed, MEDLINE, and Embase databases using a list of keywords that were generated following referral to existing treatment guidelines for UC. Papers looking at biological and small-molecule treatments for UC in adult populations were included. Pediatric, pregnancy, and cost-effectiveness studies were excluded. Results and Discussion: There are currently three classes of biologics (anti-tumor necrosis factors (anti-TNFs), anti-integrins, and anti-interleukins) and one class of small-molecule therapy (Janus kinase (JAK) inhibitor) licensed for UC treatment in the UAE. Within the anti-TNF class, three medications have been approved: infliximab, adalimumab, and golimumab. For JAK inhibitors, there are two: tofacitinib and upadacitinib. There is only one licensed medication in the remaining classes: vedolizumab (anti-integrin) and ustekinumab (anti-interleukin). The length of studies varied from 6–8 weeks for induction studies and 52 weeks for maintenance studies. The studies demonstrated increased efficacy in these medications compared to placebos when clinical response, clinical remission, and other secondary measures such as mucosal healing were assessed following the induction and maintenance phases. Biosimilars of infliximab and adalimumab are also available for treating UC, and their safety and efficacy were compared to their biologic originators. Conclusions: The introduction of biologics has been proven to be beneficial for the treatment of UC. This review summarizes the efficacy and safety of each biological class in the treatment of the disease; however, biological drug registries and further studies are required to offer more insight into the comparative efficacy and safety of these agents.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140088769","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}
Martin Tobi, Monina Pascua, Rebecca Rodriguez, Yu-Xiao Yang, John Lieb, Douglas Weinstein, David E. Kaplan
Venous collateral shunting of blood from the splanchnic to systemic venous systems due to portal hypertension increases the pressure in the ventral lingual venous bed. We hypothesized that the appearance of sublingual varices evaluated by pre-endoscopy/bedside visual inspection of ventrum of tongue (VIVOT) might predict the presence of esophageal varices (EVs). Methods: To test this hypothesis, we prospectively enrolled patients with cirrhosis (CP) referred for EV screening for assessment of lingual vasculature after informed consent. Non-cirrhosis control patients were also enrolled. Methods: VIVOT was scored based on the presence of vessels > 2 mm and/or serpiginous veins. VIVOT scores were then correlated with endoscopic findings. Results: A total of 59 patients with cirrhosis (Group 1) were enrolled, as were 62 patients without cirrhosis (Group 2). Group 1 consisted of 100% male patients with mean age 59.5 ± 5.4 years; 39.0% were African American (AA). Group 2 consisted of 86% male patients, 59.0 ± 13 years and 53% AA. Among Group 1 patients, varices were present in 29% (16 esophageal and 3 gastric). There were no demographic differences among Group 1 patients with or without varices. Positive VIVOT scores were associated with EVs on endoscopy in 11 of 16 patients (sensitivity 68.75%). Positive VIVOT findings were present in 8 of 40 patients without EVs (specificity 80%). False-positive VIVOT scores were present in 6 of 62 non-cirrhotic controls. Overall, the positive predictive value among patients with cirrhosis was 59% with a negative predictive value of 84%. Conclusions: VIVOT has modest values in predicting EVs and should not be used alone to stratify patients for endoscopic evaluation when elastography and laboratory tests are available; however, its use in resource-limited settings to identify high-risk patients may be considered.
{"title":"Prospective Visual Inspection of the Ventrum of Tongue (VIVOT) Vasculature Predicts the Presence of Esophageal Varices","authors":"Martin Tobi, Monina Pascua, Rebecca Rodriguez, Yu-Xiao Yang, John Lieb, Douglas Weinstein, David E. Kaplan","doi":"10.3390/gidisord6010017","DOIUrl":"https://doi.org/10.3390/gidisord6010017","url":null,"abstract":"Venous collateral shunting of blood from the splanchnic to systemic venous systems due to portal hypertension increases the pressure in the ventral lingual venous bed. We hypothesized that the appearance of sublingual varices evaluated by pre-endoscopy/bedside visual inspection of ventrum of tongue (VIVOT) might predict the presence of esophageal varices (EVs). Methods: To test this hypothesis, we prospectively enrolled patients with cirrhosis (CP) referred for EV screening for assessment of lingual vasculature after informed consent. Non-cirrhosis control patients were also enrolled. Methods: VIVOT was scored based on the presence of vessels > 2 mm and/or serpiginous veins. VIVOT scores were then correlated with endoscopic findings. Results: A total of 59 patients with cirrhosis (Group 1) were enrolled, as were 62 patients without cirrhosis (Group 2). Group 1 consisted of 100% male patients with mean age 59.5 ± 5.4 years; 39.0% were African American (AA). Group 2 consisted of 86% male patients, 59.0 ± 13 years and 53% AA. Among Group 1 patients, varices were present in 29% (16 esophageal and 3 gastric). There were no demographic differences among Group 1 patients with or without varices. Positive VIVOT scores were associated with EVs on endoscopy in 11 of 16 patients (sensitivity 68.75%). Positive VIVOT findings were present in 8 of 40 patients without EVs (specificity 80%). False-positive VIVOT scores were present in 6 of 62 non-cirrhotic controls. Overall, the positive predictive value among patients with cirrhosis was 59% with a negative predictive value of 84%. Conclusions: VIVOT has modest values in predicting EVs and should not be used alone to stratify patients for endoscopic evaluation when elastography and laboratory tests are available; however, its use in resource-limited settings to identify high-risk patients may be considered.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140431084","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}
A. Caturano, Massimiliano Cavallo, Davide Nilo, Gaetano Vaudo, Vincenzo Russo, R. Galiero, Luca Rinaldi, Raffaele Marfella, Marcellino Monda, Giovanni Luca, F. C. Sasso
Diabetic gastroparesis (DGP) delays gastric emptying in diabetes patients, notably impacting those with type 1 and long-standing type 2 diabetes. Symptoms include early satiety, fullness, appetite loss, bloating, abdominal pain, and vomiting, arising from slow stomach-to-intestine food movement. DGP’s unpredictable nature complicates diagnosis and blood glucose management, leading to severe complications like dehydration, malnutrition, and bezoar formation. Understanding DGP’s mechanisms is crucial for effective management. Vagal dysfunction, disturbances in the interstitial cells of Cajal, reduced neural nitric oxide synthase, and increased oxidative stress contribute to the complex pathophysiology. Accurate diagnosis demands a comprehensive approach, utilizing tools like gastric scintigraphy and the Gastric Emptying Breath Test. Considering the complex relationship between DGP and glycemia, managing blood glucose levels becomes paramount. Nutritional interventions, tailored to each patient, address malnutrition risks, emphasizing smaller, more frequent meals and liquid consistency. DGP’s complex nature necessitates collaborative efforts for enhanced diagnostic strategies, improved pathophysiological understanding, and compassionate management approaches. This comprehensive approach offers hope for a future where individuals with DGP can experience improved well-being and quality of life.
{"title":"Diabetic Gastroparesis: Navigating Pathophysiology and Nutritional Interventions","authors":"A. Caturano, Massimiliano Cavallo, Davide Nilo, Gaetano Vaudo, Vincenzo Russo, R. Galiero, Luca Rinaldi, Raffaele Marfella, Marcellino Monda, Giovanni Luca, F. C. Sasso","doi":"10.3390/gidisord6010016","DOIUrl":"https://doi.org/10.3390/gidisord6010016","url":null,"abstract":"Diabetic gastroparesis (DGP) delays gastric emptying in diabetes patients, notably impacting those with type 1 and long-standing type 2 diabetes. Symptoms include early satiety, fullness, appetite loss, bloating, abdominal pain, and vomiting, arising from slow stomach-to-intestine food movement. DGP’s unpredictable nature complicates diagnosis and blood glucose management, leading to severe complications like dehydration, malnutrition, and bezoar formation. Understanding DGP’s mechanisms is crucial for effective management. Vagal dysfunction, disturbances in the interstitial cells of Cajal, reduced neural nitric oxide synthase, and increased oxidative stress contribute to the complex pathophysiology. Accurate diagnosis demands a comprehensive approach, utilizing tools like gastric scintigraphy and the Gastric Emptying Breath Test. Considering the complex relationship between DGP and glycemia, managing blood glucose levels becomes paramount. Nutritional interventions, tailored to each patient, address malnutrition risks, emphasizing smaller, more frequent meals and liquid consistency. DGP’s complex nature necessitates collaborative efforts for enhanced diagnostic strategies, improved pathophysiological understanding, and compassionate management approaches. This comprehensive approach offers hope for a future where individuals with DGP can experience improved well-being and quality of life.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441980","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}
Marisa Francesca Motta, Giuseppe Pulitano, Antonino Bagnulo, G. Buriani, Umberto Di Maio, F. Amone, Vincenzo Nobile, R. Malivindi
TAMIXAM® is a novel technology that combines hyaluronic acid and tamarind seed extract in its formulation. It is designed to protect the esophageal mucosa by creating a barrier through its filmogenic properties. The aim of this study is to evaluate the safety and efficacy of this technology through mucoadhesion tests, a cell viability assay, TEER measurements, and morphological analysis on reconstructed esophageal mucosa exposed to 10% hydrochloric acid before and after treatment. The mucoadhesion test highlighted the synergistic bioadhesive effect of the technology’s components. Cell viability assays revealed the substantial mucoprotective and barrier effects of the technology, preserving tissue viability when applied before exposure to acid insult. A morphological analysis illustrated TAMIXAM®’s efficacy in countering acid-induced damage, reducing erosion, necrosis, and tissue degeneration compared to the positive control, both pre- and post-acid insult. An evaluation of epithelial integrity through TEER measurements indicated a minimal reduction in tissues treated with the invention before acid exposure, demonstrating its ability to maintain epithelial integrity in the presence of an acid insult. However, this effect was less pronounced in tissues treated with the technology after the acid insult, implying a potential partial recovery of epithelial integrity. Furthermore, comprehensive in vitro and in vivo studies supported the safety profile of the invention. In conclusion, TAMIXAM® emerged as a compelling solution, providing enhanced mechanical action to maintain epithelial balance and shield the esophageal mucosa from acid-induced damage.
{"title":"An Evaluation of the Efficacy and Safety of TAMIXAM®, Based on Hyaluronic Acid and Tamarind Seed Extract, for Esophageal Mucosal Protection from Acid Insult","authors":"Marisa Francesca Motta, Giuseppe Pulitano, Antonino Bagnulo, G. Buriani, Umberto Di Maio, F. Amone, Vincenzo Nobile, R. Malivindi","doi":"10.3390/gidisord6010015","DOIUrl":"https://doi.org/10.3390/gidisord6010015","url":null,"abstract":"TAMIXAM® is a novel technology that combines hyaluronic acid and tamarind seed extract in its formulation. It is designed to protect the esophageal mucosa by creating a barrier through its filmogenic properties. The aim of this study is to evaluate the safety and efficacy of this technology through mucoadhesion tests, a cell viability assay, TEER measurements, and morphological analysis on reconstructed esophageal mucosa exposed to 10% hydrochloric acid before and after treatment. The mucoadhesion test highlighted the synergistic bioadhesive effect of the technology’s components. Cell viability assays revealed the substantial mucoprotective and barrier effects of the technology, preserving tissue viability when applied before exposure to acid insult. A morphological analysis illustrated TAMIXAM®’s efficacy in countering acid-induced damage, reducing erosion, necrosis, and tissue degeneration compared to the positive control, both pre- and post-acid insult. An evaluation of epithelial integrity through TEER measurements indicated a minimal reduction in tissues treated with the invention before acid exposure, demonstrating its ability to maintain epithelial integrity in the presence of an acid insult. However, this effect was less pronounced in tissues treated with the technology after the acid insult, implying a potential partial recovery of epithelial integrity. Furthermore, comprehensive in vitro and in vivo studies supported the safety profile of the invention. In conclusion, TAMIXAM® emerged as a compelling solution, providing enhanced mechanical action to maintain epithelial balance and shield the esophageal mucosa from acid-induced damage.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140452802","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}
In this study, an exploratory model was tested to investigate the mediating role of gastrointestinal-specific anxiety and perceived disability in the relation between disease activity and the outcomes of quality of life and depression in patients with inflammatory bowel disease (IBD). In a cross-sectional design, data from an online survey of patients with IBD (over the age of 16) recruited through a UK-based IBD charity were used to test a model of serial mediation. Measures targeted disease activity (self-reported), gastrointestinal-specific anxiety (Visceral Sensitivity Index), perceived disability (Perceived Disability Scale), IBD-specific quality of life (UK Inflammatory Bowel Disease Questionnaire), and depression (Depression subscale of the Depression, Anxiety, and Stress Scale). The theoretical model was investigated using model 6 of the PROCESS macro for SPSS. Bootstrapped 95% confidence intervals were constructed for each estimate A total of 320 participants provided valid responses to the survey. Gastrointestinal-specific anxiety and perceived disability were found to serially mediate the relationship between disease activity and quality of life (95%CI = −0.80 to −0.19) and disease activity and depression (95%CI = 0.13 to 0.59). Findings suggested that the effect of multiple psychosocial variables in the experience of people living with IBD and its respective outcomes should be taken into account when planning treatment. The theoretical and clinical implications of these findings are discussed.
{"title":"Investigating the Role of Gastrointestinal-Specific Anxiety and Perceived Disability in the Adjustment to Inflammatory Bowel Disease","authors":"Angela Seaman, Nuno Ferreira","doi":"10.3390/gidisord6010014","DOIUrl":"https://doi.org/10.3390/gidisord6010014","url":null,"abstract":"In this study, an exploratory model was tested to investigate the mediating role of gastrointestinal-specific anxiety and perceived disability in the relation between disease activity and the outcomes of quality of life and depression in patients with inflammatory bowel disease (IBD). In a cross-sectional design, data from an online survey of patients with IBD (over the age of 16) recruited through a UK-based IBD charity were used to test a model of serial mediation. Measures targeted disease activity (self-reported), gastrointestinal-specific anxiety (Visceral Sensitivity Index), perceived disability (Perceived Disability Scale), IBD-specific quality of life (UK Inflammatory Bowel Disease Questionnaire), and depression (Depression subscale of the Depression, Anxiety, and Stress Scale). The theoretical model was investigated using model 6 of the PROCESS macro for SPSS. Bootstrapped 95% confidence intervals were constructed for each estimate A total of 320 participants provided valid responses to the survey. Gastrointestinal-specific anxiety and perceived disability were found to serially mediate the relationship between disease activity and quality of life (95%CI = −0.80 to −0.19) and disease activity and depression (95%CI = 0.13 to 0.59). Findings suggested that the effect of multiple psychosocial variables in the experience of people living with IBD and its respective outcomes should be taken into account when planning treatment. The theoretical and clinical implications of these findings are discussed.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140453273","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}
B. Norton, A. Papaefthymiou, Andrea Telese, Ritwika Mallik, Alberto Murino, Gavin Johnson, Charles Murray, Janine Makaronidis, Rehan Haidry
Type 2 diabetes (T2D) is one of the most significant and fast-growing health challenges of the 21st century. Despite the variety of available glucose-lowering agents, many patients do not attain or maintain adequate glycaemic control. Bariatric surgery demonstrates a profound anti-diabetic effect, which is almost immediate and weight-loss independent. The significant improvement in diabetes after bariatric surgery together with the endoscopic accessibility of the duodenum has led to the development of new metabolic endoscopic procedures that capitalise on the importance of the proximal small bowel in glycaemic control. Clinical trials have shown a clear efficacy signal, and now, several devices are undergoing evaluation as primary T2D treatments. Establishing where these procedures fit into the treatment algorithms for T2D and how they can be combined with modern pharmacotherapies is needed in a rapidly changing landscape. Ultimately, through metabolic endoscopy, gastroenterologists are on the cusp of providing safe and effective treatments for the multidisciplinary management of T2D.
{"title":"Metabolic Endoscopy: Should Gastroenterologists Be Treating Type 2 Diabetes?","authors":"B. Norton, A. Papaefthymiou, Andrea Telese, Ritwika Mallik, Alberto Murino, Gavin Johnson, Charles Murray, Janine Makaronidis, Rehan Haidry","doi":"10.3390/gidisord6010013","DOIUrl":"https://doi.org/10.3390/gidisord6010013","url":null,"abstract":"Type 2 diabetes (T2D) is one of the most significant and fast-growing health challenges of the 21st century. Despite the variety of available glucose-lowering agents, many patients do not attain or maintain adequate glycaemic control. Bariatric surgery demonstrates a profound anti-diabetic effect, which is almost immediate and weight-loss independent. The significant improvement in diabetes after bariatric surgery together with the endoscopic accessibility of the duodenum has led to the development of new metabolic endoscopic procedures that capitalise on the importance of the proximal small bowel in glycaemic control. Clinical trials have shown a clear efficacy signal, and now, several devices are undergoing evaluation as primary T2D treatments. Establishing where these procedures fit into the treatment algorithms for T2D and how they can be combined with modern pharmacotherapies is needed in a rapidly changing landscape. Ultimately, through metabolic endoscopy, gastroenterologists are on the cusp of providing safe and effective treatments for the multidisciplinary management of T2D.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139835020","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}
B. Norton, A. Papaefthymiou, Andrea Telese, Ritwika Mallik, Alberto Murino, Gavin Johnson, Charles Murray, Janine Makaronidis, Rehan Haidry
Type 2 diabetes (T2D) is one of the most significant and fast-growing health challenges of the 21st century. Despite the variety of available glucose-lowering agents, many patients do not attain or maintain adequate glycaemic control. Bariatric surgery demonstrates a profound anti-diabetic effect, which is almost immediate and weight-loss independent. The significant improvement in diabetes after bariatric surgery together with the endoscopic accessibility of the duodenum has led to the development of new metabolic endoscopic procedures that capitalise on the importance of the proximal small bowel in glycaemic control. Clinical trials have shown a clear efficacy signal, and now, several devices are undergoing evaluation as primary T2D treatments. Establishing where these procedures fit into the treatment algorithms for T2D and how they can be combined with modern pharmacotherapies is needed in a rapidly changing landscape. Ultimately, through metabolic endoscopy, gastroenterologists are on the cusp of providing safe and effective treatments for the multidisciplinary management of T2D.
{"title":"Metabolic Endoscopy: Should Gastroenterologists Be Treating Type 2 Diabetes?","authors":"B. Norton, A. Papaefthymiou, Andrea Telese, Ritwika Mallik, Alberto Murino, Gavin Johnson, Charles Murray, Janine Makaronidis, Rehan Haidry","doi":"10.3390/gidisord6010013","DOIUrl":"https://doi.org/10.3390/gidisord6010013","url":null,"abstract":"Type 2 diabetes (T2D) is one of the most significant and fast-growing health challenges of the 21st century. Despite the variety of available glucose-lowering agents, many patients do not attain or maintain adequate glycaemic control. Bariatric surgery demonstrates a profound anti-diabetic effect, which is almost immediate and weight-loss independent. The significant improvement in diabetes after bariatric surgery together with the endoscopic accessibility of the duodenum has led to the development of new metabolic endoscopic procedures that capitalise on the importance of the proximal small bowel in glycaemic control. Clinical trials have shown a clear efficacy signal, and now, several devices are undergoing evaluation as primary T2D treatments. Establishing where these procedures fit into the treatment algorithms for T2D and how they can be combined with modern pharmacotherapies is needed in a rapidly changing landscape. Ultimately, through metabolic endoscopy, gastroenterologists are on the cusp of providing safe and effective treatments for the multidisciplinary management of T2D.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139775290","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}
Rocío Cáceres-Matos, Aurora Castro-Méndez, Marina Domínguez, Daniel Pabón-Carrasco, Manuel Pabón-Carrasco
Colorectal cancer (CRC) is a disease characterised by the development of malignant tumours in the colon or rectum; it is considered the most common cancer in women, and up to 50% of cases can be prevented with a healthy lifestyle. Nutritional habits are related to its appearance, and the current trend of an increased consumption of ultra-processed foods (UPFs) has led to a surge in the incidence of CRC in recent years. This systematic review aims to evaluate, based on scientific evidence, the role of UPF in the incidence of CRC. The PubMed, Scopus, CINAHL, and Web of Science databases were reviewed, and a total of 24 scientific articles were selected according to the inclusion and exclusion criteria of this review (studies from the past 5 years and observational studies in English). The conclusions of this study point to an association between UPF-based diets and the appearance of CRC, which is promoted by the harmful effects of the consumption of high levels of sugar, fat, red meat, and additives. These dietary habits, coupled with a sedentary lifestyle and obesity, further increase the incidence of CRC.
{"title":"The Influence of Ultra-Processed Food on Colorectal Cancer: A Systematic Review","authors":"Rocío Cáceres-Matos, Aurora Castro-Méndez, Marina Domínguez, Daniel Pabón-Carrasco, Manuel Pabón-Carrasco","doi":"10.3390/gidisord6010012","DOIUrl":"https://doi.org/10.3390/gidisord6010012","url":null,"abstract":"Colorectal cancer (CRC) is a disease characterised by the development of malignant tumours in the colon or rectum; it is considered the most common cancer in women, and up to 50% of cases can be prevented with a healthy lifestyle. Nutritional habits are related to its appearance, and the current trend of an increased consumption of ultra-processed foods (UPFs) has led to a surge in the incidence of CRC in recent years. This systematic review aims to evaluate, based on scientific evidence, the role of UPF in the incidence of CRC. The PubMed, Scopus, CINAHL, and Web of Science databases were reviewed, and a total of 24 scientific articles were selected according to the inclusion and exclusion criteria of this review (studies from the past 5 years and observational studies in English). The conclusions of this study point to an association between UPF-based diets and the appearance of CRC, which is promoted by the harmful effects of the consumption of high levels of sugar, fat, red meat, and additives. These dietary habits, coupled with a sedentary lifestyle and obesity, further increase the incidence of CRC.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139853376","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}
Rocío Cáceres-Matos, Aurora Castro-Méndez, Marina Domínguez, Daniel Pabón-Carrasco, Manuel Pabón-Carrasco
Colorectal cancer (CRC) is a disease characterised by the development of malignant tumours in the colon or rectum; it is considered the most common cancer in women, and up to 50% of cases can be prevented with a healthy lifestyle. Nutritional habits are related to its appearance, and the current trend of an increased consumption of ultra-processed foods (UPFs) has led to a surge in the incidence of CRC in recent years. This systematic review aims to evaluate, based on scientific evidence, the role of UPF in the incidence of CRC. The PubMed, Scopus, CINAHL, and Web of Science databases were reviewed, and a total of 24 scientific articles were selected according to the inclusion and exclusion criteria of this review (studies from the past 5 years and observational studies in English). The conclusions of this study point to an association between UPF-based diets and the appearance of CRC, which is promoted by the harmful effects of the consumption of high levels of sugar, fat, red meat, and additives. These dietary habits, coupled with a sedentary lifestyle and obesity, further increase the incidence of CRC.
{"title":"The Influence of Ultra-Processed Food on Colorectal Cancer: A Systematic Review","authors":"Rocío Cáceres-Matos, Aurora Castro-Méndez, Marina Domínguez, Daniel Pabón-Carrasco, Manuel Pabón-Carrasco","doi":"10.3390/gidisord6010012","DOIUrl":"https://doi.org/10.3390/gidisord6010012","url":null,"abstract":"Colorectal cancer (CRC) is a disease characterised by the development of malignant tumours in the colon or rectum; it is considered the most common cancer in women, and up to 50% of cases can be prevented with a healthy lifestyle. Nutritional habits are related to its appearance, and the current trend of an increased consumption of ultra-processed foods (UPFs) has led to a surge in the incidence of CRC in recent years. This systematic review aims to evaluate, based on scientific evidence, the role of UPF in the incidence of CRC. The PubMed, Scopus, CINAHL, and Web of Science databases were reviewed, and a total of 24 scientific articles were selected according to the inclusion and exclusion criteria of this review (studies from the past 5 years and observational studies in English). The conclusions of this study point to an association between UPF-based diets and the appearance of CRC, which is promoted by the harmful effects of the consumption of high levels of sugar, fat, red meat, and additives. These dietary habits, coupled with a sedentary lifestyle and obesity, further increase the incidence of CRC.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139793311","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}
Nikola Panic, Marco Marino, Goran Hauser, Silvia Jacobsen, F. Curcio, Francesco Meroi, A. Cifù, E. Castagnaviz, C. Pistis, Giovanni Terrosu, M. Bulajic, S. F. Vadalà di Prampero, Dino Tarabar, Irena Krznarić-Zrnić, Gordana Kovacevic, Ivan Ranković, Martina Fabris
The serological support for early diagnosis and differential diagnosis of inflammatory bowel diseases (IBDs) is actually very limited. In this study, we evaluated the performance of a promising multiparametric method including either well-established and newly developed biomarkers. We conducted a multicenter cross-sectional study at the Gastroenterology Units of Udine (Italy), Rijeka (Croatia) and Belgrade (Serbia). Sera was collected from IBD patients, and autoantibody profiles were determined using a mosaic cell and tissue-based indirect immunofluorescence (IIF) method simultaneously investigating anti-saccharomyces cerevisiae antibodies (ASCAs), anti-atypical perinuclear neutrophilic antibodies (P-ANCAs), anti-pancreatic antigens antibodies (PABs) and anti-goblet cells antibodies (GAB). The study finally enrolled 156 patients with IBD: 100 affected by Crohn’s disease (CD) and 56 by ulcerative colitis (UC). Twenty age-sex matched blood donors (BDs) were included as controls. PAB (anti-CUZD1 and/or anti-GP2 antibodies) were present in 24 CD patients versus none of the UC patients or BDs (24% sensitivity, 100% specificity). As regards CD patients, combined positivity of PAB and ASCA (sensitivity 84%, specificity 71.4%) performed better than ASCA alone. Colon involvement (87.5% vs. 60.5%; p = 0.014), deep mucosal lesions (58.3% vs. 25.0%; p = 0.002) and need for biologic therapies (79.2% vs. 46.1%; p = 0.005) were significantly more prevalent in PAB-positive than in PAB-negative CD patients. Multivariate analysis identified PAB positivity (OR = 3.67; 95%CI = 1.29–10.46) and anti-CUZD1 in particular (OR = 3.54; 95%CI = 1.08–11.63) as significant risk factors for deep mucosal lesion development in CD. A multiparametric diagnostic approach appears very useful to better characterize IBD patients. PABs, whether isolated or combined with other autoantibodies, may support differential diagnosis but above all facilitate the selection of CD patients at risk for more severe disease.
实际上，用于炎症性肠病（IBD）早期诊断和鉴别诊断的血清学支持非常有限。在这项研究中，我们评估了一种很有前景的多参数方法的性能，该方法包括成熟的和新开发的生物标记物。我们在乌迪内（意大利）、里耶卡（克罗地亚）和贝尔格莱德（塞尔维亚）的消化科进行了一项多中心横断面研究。我们收集了 IBD 患者的血清，并使用镶嵌细胞和组织间接免疫荧光（IIF）方法测定了自身抗体谱，同时调查了抗酵母菌抗体（ASCAs）、抗典型核周中性粒细胞抗体（P-ANCAs）、抗胰腺抗原抗体（PABs）和抗小叶细胞抗体（GAB）。研究最终招募了 156 名 IBD 患者：其中 100 人患有克罗恩病（CD），56 人患有溃疡性结肠炎（UC）。20名年龄性别匹配的献血者（BD）作为对照。24 名 CD 患者体内存在 PAB（抗 CUZD1 和/或抗 GP2 抗体），而 UC 患者或 BDs 中则没有（敏感性为 24%，特异性为 100%）。就 CD 患者而言，PAB 和 ASCA 联合阳性（敏感性 84%，特异性 71.4%）优于单用 ASCA。结肠受累（87.5% vs. 60.5%；p = 0.014）、深部粘膜病变（58.3% vs. 25.0%；p = 0.002）和需要生物疗法（79.2% vs. 46.1%；p = 0.005）在 PAB 阳性的 CD 患者中的发生率明显高于 PAB 阴性的患者。多变量分析发现，PAB 阳性（OR = 3.67；95%CI = 1.29-10.46），尤其是抗 CUZD1（OR = 3.54；95%CI = 1.08-11.63）是 CD 患者发生深部粘膜病变的重要危险因素。多参数诊断方法似乎非常有助于更好地描述 IBD 患者的特征。PABs，无论是单独存在还是与其他自身抗体合并存在，都有助于鉴别诊断，但最重要的是，它有助于选择有可能患上更严重疾病的 CD 患者。
{"title":"A Multiparametric Method Improves the Serological Characterization of Inflammatory Bowel Diseases: Preliminary Results from a Multicenter Eastern Europe Study","authors":"Nikola Panic, Marco Marino, Goran Hauser, Silvia Jacobsen, F. Curcio, Francesco Meroi, A. Cifù, E. Castagnaviz, C. Pistis, Giovanni Terrosu, M. Bulajic, S. F. Vadalà di Prampero, Dino Tarabar, Irena Krznarić-Zrnić, Gordana Kovacevic, Ivan Ranković, Martina Fabris","doi":"10.3390/gidisord6010011","DOIUrl":"https://doi.org/10.3390/gidisord6010011","url":null,"abstract":"The serological support for early diagnosis and differential diagnosis of inflammatory bowel diseases (IBDs) is actually very limited. In this study, we evaluated the performance of a promising multiparametric method including either well-established and newly developed biomarkers. We conducted a multicenter cross-sectional study at the Gastroenterology Units of Udine (Italy), Rijeka (Croatia) and Belgrade (Serbia). Sera was collected from IBD patients, and autoantibody profiles were determined using a mosaic cell and tissue-based indirect immunofluorescence (IIF) method simultaneously investigating anti-saccharomyces cerevisiae antibodies (ASCAs), anti-atypical perinuclear neutrophilic antibodies (P-ANCAs), anti-pancreatic antigens antibodies (PABs) and anti-goblet cells antibodies (GAB). The study finally enrolled 156 patients with IBD: 100 affected by Crohn’s disease (CD) and 56 by ulcerative colitis (UC). Twenty age-sex matched blood donors (BDs) were included as controls. PAB (anti-CUZD1 and/or anti-GP2 antibodies) were present in 24 CD patients versus none of the UC patients or BDs (24% sensitivity, 100% specificity). As regards CD patients, combined positivity of PAB and ASCA (sensitivity 84%, specificity 71.4%) performed better than ASCA alone. Colon involvement (87.5% vs. 60.5%; p = 0.014), deep mucosal lesions (58.3% vs. 25.0%; p = 0.002) and need for biologic therapies (79.2% vs. 46.1%; p = 0.005) were significantly more prevalent in PAB-positive than in PAB-negative CD patients. Multivariate analysis identified PAB positivity (OR = 3.67; 95%CI = 1.29–10.46) and anti-CUZD1 in particular (OR = 3.54; 95%CI = 1.08–11.63) as significant risk factors for deep mucosal lesion development in CD. A multiparametric diagnostic approach appears very useful to better characterize IBD patients. PABs, whether isolated or combined with other autoantibodies, may support differential diagnosis but above all facilitate the selection of CD patients at risk for more severe disease.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140488425","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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