Turkish Journal of Gastroenterology最新文献

Background/aims: N-Methyl-N'-nitroso-N-nitrosoguanidine (MNNG) is suspected to increase the risk of developing stomach cancer. Folic acid (FA) is familiar with decreasing inflammation. We expected that FA would protect against MNNG-induced gastric mucosal injury.

Materials and methods: Thirty 12-week-old SPF-grade female Sprague-Dawley (SD) rats were treated with MNNG and given different dosages of FA as an intervention measure. Quantitative polymerase chain reaction (qPCR) was used to analyze the expression of IL-1, IL-6, IL-8, IL-18, TNF-α, NLRP3, ASC, and caspase-1 genes. The enzyme-linked immunosorbent assay (ELISA) was utilized for the identification of inflammatory cytokines. Western blot was accustomed to detecting IL-1β, IL-18, and NLRP3 inflammatory vesicles in gastric tissue. Furthermore, the gastric mucosal tissues underwent histological examination.

Results: Our investigation demonstrated that FA reduced MNNG-induced inflammatory factor increase by decreasing NF-κB signaling (P < .05). Furthermore, FA prevented the MNNG-induced upregulation of NLRP3 inflammasome-related genes and proteins (all P < .01).

Conclusion: Our data imply that MNNG exposure stimulates the NF-κB/NLRP3 pathway, while FA suppresses it, limiting stomach mucosal inflammation.

Background/aims: Pancreatic duct stones (PDS) are one of the leading complications of chronic pancreatitis, causing intractable upper abdominal pain, aggravating the underlying disease, and even increasing the risk of pancreatic cancer. At present, pancreatoscopyguided lithotripsy is considered the second-line endoscopic treatment for pancreatic duct stones. In this systematic review and metaanalysis, we evaluated the efficacy and safety of pancreatoscopy-guided lithotripsy.

Materials and methods: A systematic search was conducted across several medical electronic databases, including PubMed, Web of Science, Medline, and Embase, encompassing publications up to December 2022. Studies reporting complete stone clearance rate, clinical success rate, and adverse event rate were included for analysis. We further aimed to compare the outcomes between electrohydraulic lithotripsy and laser lithotripsy treatment groups.

Results: A total of 17 studies (5 prospective studies and 12 retrospective studies) with 441 patients were included in the meta-analysis. Pooled complete stone clearance rate was 81% (95% CI, 0.74-0.88), pooled clinical success rate was 90% (95% CI, 0.84-0.95), while the pooled adverse event rate was 12% (95% CI, 0.07-0.19).

Conclusion: Pancreatoscopy-guided lithotripsy is a safe and effective treatment for pancreatic duct stones. This is evidenced by high pooled rates of complete stone clearance and clinical success, combined with a relatively low incidence of adverse events.

Background/aims: Colorectal cancer (CRC) is a significant global health concern, and understanding the molecular mechanisms underlying CRC progression and prognosis is crucial. Neutrophil extracellular traps (NETs) have been implicated in various cancers, but their role in CRC and its clinical implications remain to be elucidated.

Materials and methods: Transcriptomic data from TCGA of CRC patients were analyzed to assess NETs enrichment and "NETs formation" pathway scores in NETs_high and NETs_low groups. Univariate Cox regression was used to identify prognosis-associated genes with the Log-Rank test for selection. Patients in the TCGA database were randomly split into training and testing sets to build a prognostic model with LASSO Cox regression. Model diagnostic performance was evaluated using Kaplan-Meier curves and receiver operating characteristic analysis. Single-sample gene set enrichment analysis (ssGSEA) was used to determine the abundance of 23 immune cells. ESTIMATE was used to calculate ImmuneScore and ESTIMATEScore, characterizing immune features of CRC samples.

Results: The NETs_high group in CRC showed significantly better survival than the NETs_low group. A robust prognostic model based on PRKRIP1, SERTAD2, ELFN1, and LINC00672 accurately predicted patient outcomes. NETs_high samples exhibited a more enriched immune environment with higher immune cell infiltration levels, as well as ImmuneScore and ESTIMATEScore. PRKRIP1, SERTAD2, ELFN1, and LINC00672 were significantly correlated with key immune cell types. Additionally, 18 drugs displayed differential sensitivity between NETs_high and NETs_low groups, with Daporinad and Selumetinib as potential therapeutic options.

Conclusion: Our findings may catalyze the development of personalized treatment modalities and bestow invaluable insights into the intricate dynamics governing CRC progression.

Background/aims: This study aimed to evaluate the possible synergistic gastroprotective activity of quercetin and misoprostol in gastric ulcers induced by ethanol in rats.

Materials and methods: Male Wister albino rats were allocated into 6 groups: Negative control, positive control, esomeprazole, quercetin, misoprostol, and a combination of quercetin and misoprostol. All the treatment groups except for the negative control were challenged with a single dose of ethanol (90%) after 14 days of treatment. The animals were euthanized 1 hour after ethanol administration, and the blood samples were collected and used for the measurement of catalase, GSH, LDH, and IL-6. The stomachs were immediately removed and used for the measurement of gastric ulcer index, lesion area, gastric volume, and pH. Finally, gastric tissue was sent for histopathological examination.

Results: The combination of quercetin with misoprostol resulted in a comparable effect to esomeprazole regarding the inhibitory effect on gastric lesions, ulcer index, and free and total acidity. Moreover, this combination significantly decreased the level of LDH with a nonsignificant decrease in the IL-6 level. Esomeprazole and the combination group restored the level of catalase and quercetin alone and in the combination group elevated the level of GSH. Additionally, remarkable protection appeared in the pathological findings, especially in the group treated with quercetin and misoprostol.

Conclusion: This study clearly revealed the gastroprotective effect produced by combining quercetin with misoprostol by decreasing ulcer area and index, restoring antioxidant enzyme levels, and ameliorating inflammation. These findings suggest the use of this combination in a clinical setting.

Background/aims: This study aimed to evaluate the anticarcinogenic potential of Scleromitrion diffusum (Willd.) R. J. Wang (SD) extracts in vitro, along with exploring the underlying compatibility mechanisms.

Materials and methods: Scleromitrion diffusum (Willd.) R. J. Wang extract was prepared and gastric cancer (GC) cells were treated to detect the half maximal inhibitory concentration (IC50)/proliferation and migration/invasion by MTS method and transwell assay. The compatibility mechanisms of SD were analyzed by systems pharmacology strategy, combined with cellular experimental validation.

Results: Scleromitrion diffusum (Willd.) R. J. Wang extract showed inhibitory ability on the proliferation of the GC cell lines dose- and time-dependently. A total of 3 active ingredients are involved in anti-gastric cancer effects of SD, based on the top 50 pathways. The "herb-composition-target-pathway" network showed the multi-target and multi-pathway characteristics of SD. There were 52 related targets shared by SD and GC. The cellular experiments supported that SD significantly reduced ERBB2 and ERBB3 expression levels in GC cells. The overexpression of ERBB2 or ERBB3 partially offset the anti-tumor effects of SD.

Conclusion: Scleromitrion diffusum (Willd.) R. J. Wang inhibited gastric cancer growth and metastasis in vitro, which may be related to the inhibition of the ERBB2/ERBB3/PI3K/AKT pathway.

Background/aims: Mushroom intoxication poses a considerable public health risk due to its potential for severe toxicity and fatality. This study aims to investigate demographic trends, diagnostic locations, and mortality rates of patients with mushroom intoxication.

Materials and methods: This retrospective cohort study utilized data from the National Electronic Database of the Turkish Ministry of Health. The study focused on patients without chronic liver disease or prior liver transplantation presenting with mushroom intoxication between 2018 and 2023. Demographic information, diagnostic locations, and mortality rates were analyzed, considering a six-year period to ensure even seasonal distribution.

Results: Among 30459 individuals admitted with mushroom intoxication, 44.75% were male, with a mean age of 45.84 years. The Black Sea, Marmara, and Central Anatolia regions had the highest number of cases, with specific cities like Tokat, Bolu, Yozgat, and Kastamonu having the highest rates per 100,000 population in 2022. Mushroom intoxication predominantly occurred in May, June, October, and November. Hospitalization occurred in 8.9% of cases, with a 6.6% mortality rate within 90 days and 1.3% progressing to liver transplantation. Notably, mushroom intoxication cases increased by 130% in the first half of 2023, particularly in May and June, correlating with increased rainfall.

Conclusion: Mushroom intoxication is a serious public health issue, with morbidity and mortality influenced by climate factors. The study highlights a significant increase in cases in the first half of 2023, potentially linked to heightened rainfall and climate change.

Background/aims: Hepatocellular carcinoma (HCC) represents a primary liver malignancy with a multifaceted molecular landscape. The interplay between liquid-liquid phase separation (LLPS) and ferroptosis-a regulated form of cell death-has garnered interest in tumorigenesis. However, the precise role of LLPS and ferroptosis-related genes in HCC progression and prognosis remains obscure. Unraveling this connection could pave the way for innovative diagnosis and therapeutic strategies.

Materials and methods: The differentially expressed genes (DEGs) were identified based on 3 GEO datasets, followed by overlapping with LLPS-related and ferroptosis-related genes. Based on central hub genes, a diagnostic model was developed through LASSO regression and validated using KM survival analysis and real-time quantitative polymerase chain reaction (RT-qPCR). Then the effects of NRAS on the development of HCC and ferroptosis were also detected.

Results: We identified 24 DEGs overlapping among HCC-specific, LLPS, and ferroptosis-related genes. A diagnostic model, centered on 5 hub genes, was developed and validated. Lower expression of these genes corresponded with enhanced patient survival rates, and they were distinctly overexpressed in HCC cells. NRAS downregulation significantly inhibited HepG2 cell proliferation and migration (P < .01). Fe2+ content and ROS levels were both significantly increased in the si-NRAS group when compared to those in the si-NC group (P < .01), while opposite results were observed for the protein level of GPX4 and GSH content.

Conclusion: The diagnostic model with 5 hub genes (EZH2, HSPB1, NRAS, RPL8, and SUV39H1) emerges as a potential innovative tool for the diagnosis of HCC. NRAS promotes the carcinogenesis of HCC cells and inhibits ferroptosis.