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Sugiura K, Kawasaki H, Egami T, Kaneko M, Ishida N, Tamura S, Tani S, Yamade M, Hamaya Y, Osawa S, Takeuchi H, Baba S, Sugimoto K, Iwaizumi M. Iron deposition in gastric black spots: Clinicopathological insights and NanoSuit-correlative light and electron microscopy analysis. DEN OPEN 2025; 5:e398. [PMID: 38895560 PMCID: PMC11182783 DOI: 10.1002/deo2.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 05/23/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024]
Abstract
Objectives Black spots (BSs) are lentiginous findings observed in the gastric body and fundus during upper gastrointestinal endoscopy and are predominantly seen in patients undergoing Helicobacter pylori eradication treatment. However, the detailed patient background and exact composition are poorly understood. This study aims to clarify the clinicopathological features of BSs, examine patient demographics, and use the NanoSuit-correlative light and electron microscopy (CLEM) method combined with scanning electron microscopy-energy dispersive X-ray spectroscopy for elemental analysis. Methods Patients who underwent upper gastrointestinal endoscopy between 2017 and 2022 were included. Data on age, medications, blood tests, and H. pylori infection status were retrospectively gathered from medical records. Univariate analysis was conducted to examine BS presence, with results then used in a multivariate model to identify associated risk factors. Additionally, pathological specimens from patients with BSs were analyzed for elemental composition using the NanoSuit-CLEM method combined with scanning electronmicroscopy-energy dispersive X-ray spectroscopy. Results An analysis of 6778 cases identified risk factors for BSs, including older age and using proton pump inhibitors, statins, corticosteroids, and antithrombotic drugs. Endoscopically, BSs correlated with higher gastric atrophy and lower active H. pylori infection. Iron deposition at BS sites was specifically identified using NanoSuit-CLEM. Conclusions BSs on gastrointestinal endoscopy may indicate an absence of active H. pylori inflammation. The discovery of iron deposition within BSs using the NanoSuit-CLEM method has offered new insights into the possible causative factors and advances our understanding of the etiology of BSs, bringing us closer to unraveling the underlying mechanisms of their formation.
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Affiliation(s)
- Kiichi Sugiura
- First Department of MedicineHamamatsu University School of MedicineShizuokaJapan
| | - Hideya Kawasaki
- Institute for NanoSuit ResearchPreeminent Medical Photonics Education and Research CenterHamamatsu University School of MedicineShizuokaJapan
| | - Takatoshi Egami
- First Department of MedicineHamamatsu University School of MedicineShizuokaJapan
| | - Masanao Kaneko
- First Department of MedicineHamamatsu University School of MedicineShizuokaJapan
| | - Natsuki Ishida
- First Department of MedicineHamamatsu University School of MedicineShizuokaJapan
| | - Satoshi Tamura
- First Department of MedicineHamamatsu University School of MedicineShizuokaJapan
| | - Shinya Tani
- First Department of MedicineHamamatsu University School of MedicineShizuokaJapan
| | - Mihoko Yamade
- First Department of MedicineHamamatsu University School of MedicineShizuokaJapan
| | - Yasushi Hamaya
- First Department of MedicineHamamatsu University School of MedicineShizuokaJapan
| | - Satoshi Osawa
- Department of Endoscopic and Photodynamic MedicineHamamatsu University School of MedicineShizuokaJapan
| | - Hiroya Takeuchi
- Department of SurgeryHamamatsu University School of MedicineShizuokaJapan
| | - Satoshi Baba
- Department of Diagnostic PathologyHamamatsu University School of MedicineShizuokaJapan
| | - Ken Sugimoto
- First Department of MedicineHamamatsu University School of MedicineShizuokaJapan
| | - Moriya Iwaizumi
- Department of Laboratory MedicineHamamatsu University School of MedicineShizuokaJapan
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2
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Uehara S, Sasaki F, Sahara H, Tanaka A, Hinokuchi M, Maeda H, Arima S, Hashimoto S, Kanmura S, Ido A. Establishment of a swine model of delayed bleeding after endoscopic procedure. DEN OPEN 2025; 5:e411. [PMID: 39050142 PMCID: PMC11266432 DOI: 10.1002/deo2.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/01/2024] [Accepted: 07/06/2024] [Indexed: 07/27/2024]
Abstract
Objectives Although delayed bleeding after endoscopic procedures has become a problem, currently, there are no appropriate animal models to validate methods for preventing it. This study aimed to establish an animal model of delayed bleeding after endoscopic procedures of the gastrointestinal tract. Methods Activated coagulation time (ACT) was measured using blood samples drawn from a catheter inserted into the external jugular vein of swine (n = 7; age, 6 months; mean weight, 13.8 kg) under general anesthesia using the cut-down method. An upper gastrointestinal endoscope was inserted orally, and 12 mucosal defects were created in the stomach by endoscopic mucosal resection using a ligating device. Hemostasis was confirmed at this time point. The heparin group (n = 4) received 50 units/kg of unfractionated heparin via a catheter; after confirming that the ACT was ≥200 s 10 min later, continuous heparin administration (50 units/kg/h) was started. After 24 h, an endoscope was inserted under general anesthesia to evaluate the blood volume in the stomach and the degree of blood adherence at the site of the mucosal defect. Results Delayed bleeding was observed in three swine (75%) in the heparin-treated group, who had a maximum ACT of >220 s before the start of continuous heparin administration. In the non-treated group (n = 3), no prolonged ACT or delayed bleeding was observed at 24 h. Conclusion An animal model of delayed bleeding after an endoscopic procedure in the gastrointestinal tract was established using a single dose of heparin and continuous heparin administration after confirming an ACT of 220 s.
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Affiliation(s)
- Shohei Uehara
- Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Fumisato Sasaki
- Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Hisashi Sahara
- Division of Experimental Large Animal ResearchLife Science and Laboratory Animal Research UnitCenter for Advanced Science Research and PromotionKagoshima UniversityKagoshimaJapan
| | - Akihito Tanaka
- Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Makoto Hinokuchi
- Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Hidehito Maeda
- Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Shiho Arima
- Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Shinichi Hashimoto
- Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Shuji Kanmura
- Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Akio Ido
- Digestive and Lifestyle DiseasesKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
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3
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Tomooka F, Kitagawa K, Mitoro A, Fujinaga Y, Nishimura N, Namisaki T, Akahane T, Kaji K, Asada S, Sato S, Hanatani JI, Mori H, Motokawa Y, Iwata T, Kachi H, Osaki Y, Yoshiji H. Unilateral drainage and chemotherapy prolong the patency of a plastic stent placed above the sphincter of Oddi in patients with malignant hilar biliary obstruction. DEN OPEN 2025; 5:e404. [PMID: 39011511 PMCID: PMC11248713 DOI: 10.1002/deo2.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/17/2024]
Abstract
Objectives To evaluate the results of inside stent therapy for unresectable malignant hilar biliary obstruction and identify factors related to stent patency duration. Methods Of 44 patients who underwent initial inside-stent placement above the sphincter of Oddi from April 2017 to December 2022, 42 with the resolution of jaundice (clinical success rate, 95.5%) were retrospectively analyzed. Univariate and multivariate logistic regression analysis identified factors associated with stent patency duration. Results Univariate analysis revealed significant differences in the drainage method (406 days for unilateral drainage vs. 305 days for bilateral drainage of the right and left liver lobes, p = 0.022) with or without chemotherapy (406 days with vs. 154 days without, p = 0.038). Multivariate analysis (Cox proportional hazards analysis) revealed similar results, with unilateral drainage (p = 0.031) and chemotherapy (p = 0.048) identified as independent factors associated with prolonged stent patency. Early adverse events were observed in two patients (4.8%; one cholangitis, one pancreatitis). Conclusions Inside-stent therapy was safely performed in patients with malignant hilar biliary obstruction. Simple unilateral drainage and chemotherapy may prolong stent patency.
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Affiliation(s)
- Fumimasa Tomooka
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Koh Kitagawa
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Akira Mitoro
- Division of Endoscopy Nara Medical University Nara Japan
| | | | | | - Tadashi Namisaki
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Takemi Akahane
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Kosuke Kaji
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Shohei Asada
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Shinya Sato
- Department of Gastroenterology Nara Medical University Nara Japan
| | | | - Hitoshi Mori
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Yuki Motokawa
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Tomihiro Iwata
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Hiroki Kachi
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Yui Osaki
- Department of Gastroenterology Nara Medical University Nara Japan
| | - Hitoshi Yoshiji
- Department of Gastroenterology Nara Medical University Nara Japan
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Shinozaki S, Osawa H, Miura Y, Nomoto H, Sakamoto H, Hayashi Y, Yano T, Despott EJ, Yamamoto H. Endoscopic findings and outcomes of gastric mucosal changes relating to potassium-competitive acid blocker and proton pump inhibitor therapy. DEN OPEN 2025; 5:e400. [PMID: 38919514 PMCID: PMC11196240 DOI: 10.1002/deo2.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/27/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024]
Abstract
Gastric mucosal changes associated with long-term potassium-competitive acid blocker and proton pump inhibitor (PPI) therapy may raise concern. In contrast to that for PPIs, the evidence concerning the safety of long-term potassium-competitive acid blocker use is scant. Vonoprazan (VPZ) is a representative potassium-competitive acid blocker released in Japan in 2015. In order to shed some comparative light regarding the outcomes of gastric mucosal lesions associated with a long-term acid blockade, we have reviewed six representative gastric mucosal lesions: fundic gland polyps, gastric hyperplastic polyps, multiple white and flat elevated lesions, cobblestone-like gastric mucosal changes, gastric black spots, and stardust gastric mucosal changes. For these mucosal lesions, we have evaluated the association with the type of acid blockade, patient gender, Helicobacter pylori infection status, the degree of gastric atrophy, and serum gastrin levels. There is no concrete evidence to support a significant relationship between VPZ/PPI use and the development of neuroendocrine tumors. Current data also shows that the risk of gastric mucosal changes is similar for long-term VPZ and PPI use. Serum hypergastrinemia is not correlated with the development of some gastric mucosal lesions. Therefore, serum gastrin level is unhelpful for risk estimation and for decision-making relating to the cessation of these drugs in routine clinical practice. Given the confounding potential neoplastic risk relating to H. pylori infection, this should be eradicated before VPZ/PPI therapy is commenced. The evidence to date does not support the cessation of clinically appropriate VPZ/PPI therapy solely because of the presence of these associated gastric mucosal lesions.
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Affiliation(s)
- Satoshi Shinozaki
- Shinozaki Medical ClinicTochigiJapan
- Department of MedicineDivision of GastroenterologyJichi Medical UniversityTochigiJapan
| | - Hiroyuki Osawa
- Department of MedicineDivision of GastroenterologyJichi Medical UniversityTochigiJapan
| | - Yoshimasa Miura
- Department of MedicineDivision of GastroenterologyJichi Medical UniversityTochigiJapan
- Department of MedicineDivision of Gastroenterology and HepatologyNihon University School of MedicineTokyoJapan
| | - Hiroaki Nomoto
- Department of MedicineDivision of GastroenterologyJichi Medical UniversityTochigiJapan
| | - Hirotsugu Sakamoto
- Department of MedicineDivision of GastroenterologyJichi Medical UniversityTochigiJapan
| | - Yoshikazu Hayashi
- Department of MedicineDivision of GastroenterologyJichi Medical UniversityTochigiJapan
| | - Tomonori Yano
- Department of MedicineDivision of GastroenterologyJichi Medical UniversityTochigiJapan
| | - Edward J. Despott
- Royal Free Unit for EndoscopyThe Royal Free Hospital and UCL Institute for Liver and Digestive HealthLondonUK
| | - Hironori Yamamoto
- Department of MedicineDivision of GastroenterologyJichi Medical UniversityTochigiJapan
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5
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Ishihara Y, Ichita C, Jinushi R, Sasaki A. Clinical assessment of computed tomography for detecting ingested blister packs: A single-center retrospective study. DEN OPEN 2025; 5:e406. [PMID: 39011510 PMCID: PMC11248714 DOI: 10.1002/deo2.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/24/2024] [Accepted: 06/30/2024] [Indexed: 07/17/2024]
Abstract
Objectives Blister pack (BP) ingestion poses serious risks, such as gastrointestinal perforation, and accurate localization by computed tomography (CT) is a common practice. However, while it has been reported in vitro that CT visibility varies with the material type of BPs, there have been no reports on this variability in clinical settings. In this study, we investigated the CT detection rates of different BPs in clinical settings. Methods This single-center retrospective study from 2010 to 2022 included patients who underwent endoscopic foreign body removal for BP ingestion. The patients were categorized into two groups for BP components, the polypropylene (PP) and the polyvinyl chloride (PVC)/polyvinylidene chloride (PVDC) groups. The primary outcome was the comparison of CT detection rates between the groups. We also evaluated whether the BPs contained tablets and analyzed their locations. Results This study included 61 patients (15 in the PP group and 46 in the PVC/PVDC group). Detection rates were 97.8% for the PVC/PVDC group compared to 53.3% for the PP group, a significant difference (p < 0.01). No cases of BPs composed solely of PP were detected by CT. Blister packs were most commonly found in the upper thoracic esophagus. Conclusions Even in a clinical setting, the detection rates of PVC and PVDC were higher than that of PP alone. Identifying PP without tablets has proven challenging in clinical. Considering the risk of perforation, these findings suggest that esophagogastroduodenoscopy may be necessary, even if CT detection is negative.
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Affiliation(s)
- Yo Ishihara
- Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan
- Department of Palliative Medicine International University of Health and Welfare Narita Hospital Chiba Japan
| | - Chikamasa Ichita
- Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan
- Department of Health Data Science Yokohama City University Kanagawa Japan
| | - Ryuhei Jinushi
- Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan
- Department of Gastroenterology Saitama Medical University International Medical Center Saitama Japan
| | - Akiko Sasaki
- Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan
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6
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Kudo T, Nishimoto S, Horiuchi I, Kurasawa S, Ukai S, Horiuchi A. Comparison of propofol-based sedation and midazolam sedation in pediatric bidirectional endoscopy conducted by pediatric gastroenterologists. DEN OPEN 2025; 5:e391. [PMID: 38881579 PMCID: PMC11178518 DOI: 10.1002/deo2.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/06/2024] [Accepted: 05/12/2024] [Indexed: 06/18/2024]
Abstract
Objectives The effectiveness and safety of propofol-based sedation and midazolam sedation in pediatric bidirectional endoscopy were compared. Methods We retrospectively analyzed the cases of pediatric patients (≤15 years old) who had undergone bidirectional endoscopy, esophagogastroduodenoscopy, and colonoscopy by pediatric gastroenterologists. Demographic data, indications, sedatives/dosages, clinical outcomes, endoscopic findings, adverse events, and total patient time requirements (total time in which patients stay in our hospital) were compared in the two sedation groups. Results Ninety-one children (51 boys, 40 girls, mean age 13 years, range 9-15) treated at our hospital were enrolled. Propofol alone or in combination with midazolam and/or pentazocine was administered to 51 patients (propofol-based sedation group). Midazolam alone or in combination with pentazocine was administered to the other 40 patients (midazolam sedation group). In the propofol group, the following mean doses were used: propofol, 96 mg (range 40-145 mg); midazolam, 4.9 mg (range 3-5 mg); and pentazocine, 7.5 mg. In the midazolam group, the mean doses of midazolam and pentazocine were 6.2 mg (range 4-10 mg) and 15 mg, respectively. All procedures were successfully completed by pediatric gastroenterologists. The total procedure times and endoscopic findings were similar in the two groups, but the median patient time requirement in the propofol group was significantly shorter versus the midazolam group (7.3 h vs. 8.4 h, p < 0.001). No adverse events occurred in either group. Conclusions Propofol-based sedation in pediatric bidirectional endoscopy was safely and effectively performed by pediatric gastroenterologists, and its patient time requirement was shorter than that for midazolam sedation.
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Affiliation(s)
- Takahiro Kudo
- Digestive Disease Center Showa Inan General Hospital Nagano Japan
- Department of Pediatrics Juntendo University Faculty of Medicine Tokyo Japan
| | - Satomi Nishimoto
- Digestive Disease Center Showa Inan General Hospital Nagano Japan
- Department of Pediatrics Osaka Medical and Pharmaceutical University Osaka Japan
| | - Ichitaro Horiuchi
- Digestive Disease Center Showa Inan General Hospital Nagano Japan
- Department of Gastroenterology Shinshu University Hospital Nagano Japan
| | - Shingo Kurasawa
- Digestive Disease Center Showa Inan General Hospital Nagano Japan
| | - Satoshi Ukai
- Digestive Disease Center Showa Inan General Hospital Nagano Japan
| | - Akira Horiuchi
- Digestive Disease Center Showa Inan General Hospital Nagano Japan
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Minakata N, Ikematsu H, Kiyomi F, Inoue S, Akutagawa T, Watanabe T, Yano T, Shimoda R. Usefulness of virtual scale endoscope for early gastrointestinal lesions. DEN OPEN 2025; 5:e386. [PMID: 38903962 PMCID: PMC11187934 DOI: 10.1002/deo2.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/22/2024] [Accepted: 04/29/2024] [Indexed: 06/22/2024]
Abstract
Objectives For early gastrointestinal lesions, size is an important factor in the selection of treatment. Virtual scale endoscope (VSE) is a newly developed endoscope that can measure size more accurately than visual measurement. This study aimed to investigate whether VSE measurement is accurate for early gastrointestinal lesions of various sizes and morphologies. Methods This study prospectively enrolled patients with early gastrointestinal lesions ≤20 mm in size visually. Lesion sizes were measured in the gastrointestinal tract visually, on endoscopic resection specimens with VSE, and finally on endoscopic resection specimens using a ruler. The primary endpoint was the normalized difference (ND) of VSE measurement. The secondary endpoints were the ND of visual measurement and the variation between NDs of VSE and visual measurements. ND was calculated as (100 × [measured size - true size] / true size) (%). True size was defined as size measured using a ruler. Results This study included 60 lesions from April 2022 to December 2022, with 20 each in the esophagus, stomach, and colon. The lesion size was 14.0 ± 6.3 mm (mean ± standard deviation). Morphologies were protruded, slightly elevated, and flat or slightly depressed type in 8, 24, and 28 lesions, respectively. The primary endpoint was 0.3 ± 8.8%. In the secondary endpoints, the ND of visual measurement was -1.7 ± 29.3%, and the variability was significantly smaller in the ND of VSE measurement than in that of visual measurement (p < 0.001, F-test). Conclusions VSE measurement is accurate for early gastrointestinal lesions of various sizes and morphologies.
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Affiliation(s)
- Nobuhisa Minakata
- Department of Gastroenterology and EndoscopyNational Cancer Center Hospital EastChibaJapan
| | - Hiroaki Ikematsu
- Department of Gastroenterology and EndoscopyNational Cancer Center Hospital EastChibaJapan
| | - Fumiaki Kiyomi
- Department of Statistics and Data CenterClinical Research Support Center KyushuFukuokaJapan
| | - Suma Inoue
- Department of Internal MedicineDivision of GastroenterologySaga UniversitySagaJapan
| | - Takashi Akutagawa
- Department of Endoscopic Diagnostics and TherapeuticsSaga University HospitalSagaJapan
| | - Takashi Watanabe
- Department of Gastroenterology and EndoscopyNational Cancer Center Hospital EastChibaJapan
| | - Tomonori Yano
- Department of Gastroenterology and EndoscopyNational Cancer Center Hospital EastChibaJapan
| | - Ryo Shimoda
- Department of Endoscopic Diagnostics and TherapeuticsSaga University HospitalSagaJapan
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Tomishima K, Isayama H, Suzuki A, Ishii S, Takahashi S, Fujisawa T. Technical review of endoscopic ultrasound-guided drainage/anastomosis and trans-endosonographically created route procedures for the treatment of pancreatic diseases. DEN OPEN 2025; 5:e393. [PMID: 38854708 PMCID: PMC11157673 DOI: 10.1002/deo2.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 05/17/2024] [Indexed: 06/11/2024]
Abstract
Endoscopic ultrasound (EUS)-guided pancreatic duct drainage includes two procedures: EUS-guided drainage/anastomosis (EUS-D/A) and trans-papillary drainage with EUS-assisted pancreatic rendezvous. EUS-guided pancreatogastrostomy is the most common EUS-D/A procedure and is recommended as a salvage procedure in cases in which endoscopic retrograde cholangiopancreatography fails or is difficult. However, initial EUS-D/A is performed in patients with surgically altered anatomy at our institution. It is one of the most difficult interventional EUS procedures and has a high incidence of adverse events. The technical difficulties differ according to etiology, and the incidence of adverse events varies between initial EUS-D/A and subsequent trans-endosonographically/EUS-guided created route procedures. Hence, it is important to meticulously prepare a procedure based on the patient's condition and the available devices. The technical difficulties in EUS-D/A include: (1) determination of the puncture point, (2) selection of a puncture needle and guidewire, (3) guidewire manipulation, and (4) dilation of the puncture route and stenting. Proper technical procedures are important to increase the success rate and reduce the incidence and severity of adverse events. The complexity of EUS-D/A is also contingent on the severity of pancreatic fibrosis and stricture. In post-pancreatectomy cases, determination of the puncture site is important for success because of the remnant pancreas. Trans-endosonographically/EUS-guided created route procedures following initial EUS-D/A are also important for achieving the treatment goal. This article focuses on effective strategies for initial EUS-D/A, based on the etiology and condition of the pancreas. We mainly discuss EUS-D/A, including its indications, techniques, and success-enhancing strategies.
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Affiliation(s)
- Ko Tomishima
- Department of GastroenterologyGraduate School of MedicineJuntendo UniversityTokyoJapan
| | - Hiroyuki Isayama
- Department of GastroenterologyGraduate School of MedicineJuntendo UniversityTokyoJapan
| | - Akinori Suzuki
- Department of GastroenterologyGraduate School of MedicineJuntendo UniversityTokyoJapan
| | - Shigeto Ishii
- Department of GastroenterologyGraduate School of MedicineJuntendo UniversityTokyoJapan
| | - Sho Takahashi
- Department of GastroenterologyGraduate School of MedicineJuntendo UniversityTokyoJapan
| | - Toshio Fujisawa
- Department of GastroenterologyGraduate School of MedicineJuntendo UniversityTokyoJapan
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9
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Ohno E, Kuzuya T, Kawabe N, Nakaoka K, Tanaka H, Nakano T, Funasaka K, Miyahara R, Hashimoto S, Hirooka Y. Current status of endoscopic ultrasound in the diagnosis of intraductal papillary mucinous neoplasms. DEN OPEN 2025; 5:e413. [PMID: 39040523 PMCID: PMC11260769 DOI: 10.1002/deo2.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/02/2024] [Accepted: 07/06/2024] [Indexed: 07/24/2024]
Abstract
The new Kyoto guidelines for the management of intraductal papillary mucinous neoplasm (IPMN) provide evidence-based recommendations for the diagnosis and treatment of IPMN. Endoscopic ultrasonography (EUS) is a diagnostic modality with a high spatial resolution that allows detailed observation and obtaining cyst fluid or tissue samples via EUS-guided fine needle aspiration (EUS-FNA). Currently, EUS is an indispensable examination method for the diagnosis of pancreatic diseases. On the other hand, there have been concerns that EUS imaging tends to be highly operator-dependent, and may lack objectivity. Previous guidelines have assigned EUS as an option for patients with worrisome features. However, recent reports indicate that the sensitivity of EUS for the diagnosis of mural nodules (MNs) is more than 90%, comparable or superior to that of contrast-enhanced computed tomography or magnetic resonance cholangiopancreatography. The specific advantages of EUS in the diagnosis of IPMN are: (1) high spatial resolution imaging for the diagnosis of MNs, (2) contrast-enhanced EUS for differentiation of intra-cystic MNs from mucous clots, and (3) pathological diagnosis using EUS-FNA and differential diagnosis of a pancreatic cystic tumor by cystic fluid analysis. In order to utilize EUS in the diagnosis of IPMN, endoscopists are required to have the skills to provide sufficiently objective imaging findings.
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Affiliation(s)
- Eizaburo Ohno
- Department of Gastroenterology and HepatologyFujita Health University School of MedicineAichiJapan
| | - Teiji Kuzuya
- Department of Gastroenterology and HepatologyFujita Health University School of MedicineAichiJapan
| | - Naoto Kawabe
- Department of Gastroenterology and HepatologyFujita Health University School of MedicineAichiJapan
| | - Kazunori Nakaoka
- Department of Gastroenterology and HepatologyFujita Health University School of MedicineAichiJapan
| | - Hiroyuki Tanaka
- Department of Gastroenterology and HepatologyFujita Health University School of MedicineAichiJapan
| | - Takuji Nakano
- Department of Gastroenterology and HepatologyFujita Health University School of MedicineAichiJapan
| | - Kohei Funasaka
- Department of Gastroenterology and HepatologyFujita Health University School of MedicineAichiJapan
| | - Ryoji Miyahara
- Department of Gastroenterology and HepatologyFujita Health University School of MedicineAichiJapan
| | - Senju Hashimoto
- Department of Gastroenterology and HepatologyFujita Health University Bantane HospitalAichiJapan
| | - Yoshiki Hirooka
- Department of Gastroenterology and HepatologyFujita Health University School of MedicineAichiJapan
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10
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Qatomah A, Aihara H. Colorectal endoscopic submucosal dissection in the USA: The current state and future perspectives. DEN OPEN 2025; 5:e394. [PMID: 38915785 PMCID: PMC11194299 DOI: 10.1002/deo2.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/16/2024] [Accepted: 05/27/2024] [Indexed: 06/26/2024]
Abstract
Endoscopic submucosal dissection (ESD) is a transformative advancement in the endoscopic management of superficial gastrointestinal lesions. Initially conceived for the treatment of early gastric cancer, ESD has demonstrated proficiency in achieving en-bloc resection of superficial gastrointestinal lesions. ESD has experienced widespread acceptance in Japan and East Asia; however, its adoption in the USA remains delayed. This initial hesitancy could be attributed to procedural complexity and training demands; nonetheless, recently, ESD has been gaining popularity in the USA. This is due to the advancements in endoscopic technology, tailored training programs, and cumulative evidence regarding the efficacy and safety of ESDs. This review aimed to deliberate the historical progress, current implementation, and prospective trajectory of ESDs in the USA. With ongoing clinical research, technological integration, and educational efforts, ESD is likely to become the gold standard for managing large gastrointesitinal lesions. This progress marks an imperative step toward less invasive, more precise, and patient-centric approaches regarding advanced therapeutic endoscopy in the USA.
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Affiliation(s)
- Abdulrahman Qatomah
- Division of Gastroenterology and HepatologyMcGill University Health CenterMontrealCanada
- Division of Gastroenterology and HepatologyKing Faisal Specialist Hospital and Research CenterJeddahSaudi Arabia
| | - Hiroyuki Aihara
- Division of Gastroenterology, Hepatology and EndoscopyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
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11
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Sakiris A, Fraz EN, Rajandran A, Smith J, Allen B, Pillai S, Ramaswamy PK, John S. Rare presentations of small bowel endometriosis. DEN OPEN 2025; 5:e395. [PMID: 38868705 PMCID: PMC11166675 DOI: 10.1002/deo2.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/07/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024]
Abstract
Despite endometriosis being a relatively common chronic gynecological condition in women of childbearing age, small bowel endometriosis is rare. Presentations can vary from completely asymptomatic to reported symptoms of abdominal pain, bloating, and diarrhea. The following two cases depict very atypical manifestations of ileal endometriosis that presented as obscure intermittent gastrointestinal bleeding and bowel obstruction requiring surgical intervention. The first case describes a previously healthy 40-year-old woman with severe symptomatic iron deficiency anemia and intermittent melena. A small bowel enteroscopy diagnosed multiple ulcerated strictures in the distal small bowel as the likely culprit. Despite nonsteroidal anti-inflammatory drug-induced enteropathy being initially considered as the likely etiology, histopathological examination of the resected distal ileal segment revealed evidence of endometriosis. The second case describes a 66-year-old with a presumptive diagnosis of Crohn's disease who reported a 10-year history of intermittent perimenstrual abdominal pain, diarrhea, and nausea with vomiting. Following two subsequent episodes of acute bowel obstruction and surgical resection of the patient's stricturing terminal ileal disease, histopathological examination demonstrated active chronic inflammation with endometriosis. Small bowel endometriosis should be considered as an unusual differential diagnosis in women who may present with obscure gastrointestinal bleeding from the small bowel or recurrent bowel obstruction.
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Affiliation(s)
- Anthony Sakiris
- Department of GastroenterologyGold Coast University HospitalGold CoastAustralia
| | - Ezaam Naik Fraz
- Department of GastroenterologyGold Coast University HospitalGold CoastAustralia
| | - Arvinf Rajandran
- Department of GastroenterologyGold Coast University HospitalGold CoastAustralia
| | | | | | | | | | - Sneha John
- Department of GastroenterologyGold Coast University HospitalGold CoastAustralia
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12
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Jiao D, Xu L, Gu Z, Yan H, Shen D, Gu X. Pathogenesis, diagnosis, and treatment of epilepsy: electromagnetic stimulation-mediated neuromodulation therapy and new technologies. Neural Regen Res 2025; 20:917-935. [PMID: 38989927 DOI: 10.4103/nrr.nrr-d-23-01444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/18/2024] [Indexed: 07/12/2024] Open
Abstract
Epilepsy is a severe, relapsing, and multifactorial neurological disorder. Studies regarding the accurate diagnosis, prognosis, and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy. The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression, protein expression, ion channel activity, energy metabolites, and gut microbiota composition. Satisfactory results are lacking for conventional treatments for epilepsy. Surgical resection of lesions, drug therapy, and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy. Non-pharmacological treatments, such as a ketogenic diet, gene therapy for nerve regeneration, and neural regulation, are currently areas of research focus. This review provides a comprehensive overview of the pathogenesis, diagnostic methods, and treatments of epilepsy. It also elaborates on the theoretical basis, treatment modes, and effects of invasive nerve stimulation in neurotherapy, including percutaneous vagus nerve stimulation, deep brain electrical stimulation, repetitive nerve electrical stimulation, in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation. Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures. Additionally, many new technologies for the diagnosis and treatment of epilepsy are being explored. However, current research is mainly focused on analyzing patients' clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level, which has led to a lack of consensus regarding the mechanisms related to the disease.
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Affiliation(s)
- Dian Jiao
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Lai Xu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Zhen Gu
- Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Hua Yan
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Dingding Shen
- Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Xiaosong Gu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
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13
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Yamazaki H, Minato Y, Madhu D, Iida T, Banjyoya S, Kimura T, Furuta K, Nagae S, Itou Y, Takeuchi N, Takayanagi S, Kimoto Y, Kano Y, Sakuno T, Ono K, Ohata K. Extraction of terminal ileal lipomas to cecum can facilitate endoscopic resection: A case series with video. DEN OPEN 2025; 5:e375. [PMID: 38694538 PMCID: PMC11058687 DOI: 10.1002/deo2.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 05/04/2024]
Abstract
Large ileal lipomas over 2 cm can cause symptoms, that may require a resection. Due to the narrow lumen and thin walls of the ileum, endoscopic treatments can have a high risk of adverse events and require technical expertise, thus surgical resection is currently the mainstay of treatment. To overcome the technical challenges, we developed a novel method to endoscopically resect terminal ileal lipomas. The technique involves extracting the lesion into the cecum, which creates sufficient space to maneuver, and a better field of view. The lipoma is resected with endoscopic mucosal resection or endoscopic submucosal dissection. The appearance of the lipoma protruding out of the ileocecal valve resembles that of a tongue sticking out of the mouth, thus we named this the "tongue out technique". To assess the technical feasibility of this method, we retrospectively analyzed seven cases of terminal ileal lipoma that were endoscopically resected using the "tongue out technique" at NTT Medical Center Tokyo between January 2017 and October 2023. Technical success was 100% and en bloc resection was achieved in all cases. The median size was 31 (14-55) mm. Three cases were resected with endoscopic mucosal resection while endoscopic submucosal dissection was performed on the other four cases. There was one case of delayed post-endoscopic mucosal resection bleeding, which was caused by clip dislodgement. There were no perforations. No recurrence of the lipoma or associated symptoms have been observed. This new technique can allow more ileal lipomas to be treated with minimally invasive and organ-preserving endoscopic procedures.
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Affiliation(s)
- Hiroshi Yamazaki
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Yohei Minato
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Deepak Madhu
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Toshifumi Iida
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Susumu Banjyoya
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Tomoya Kimura
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Koichi Furuta
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Shinya Nagae
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Yohei Itou
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Nao Takeuchi
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Shunya Takayanagi
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Yoshiaki Kimoto
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Yuki Kano
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Takashi Sakuno
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Kohei Ono
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
| | - Ken Ohata
- Department of Gastrointestinal EndoscopyNTT Medical Center TokyoTokyoJapan
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14
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Ma Y, Chen S, Dai G. Exploring prognostic factors for survival in patients with advanced pancreatic cancer undergoing PD-1 inhibitor immunotherapy. Hum Vaccin Immunother 2024; 20:2376429. [PMID: 39041377 PMCID: PMC11268236 DOI: 10.1080/21645515.2024.2376429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 07/02/2024] [Indexed: 07/24/2024] Open
Abstract
Immunotherapy, led by programmed cell death protein-1 (PD-1) inhibitors, has emerged as a prominent antitumor therapy, yet prognostic challenges persist in pancreatic cancer (PC). This retrospective, single-center study evaluated prognostic factors in advanced PC patients treated with PD-1 inhibitors at the PLA General Hospital's Oncology Department from 2015-2022. With ethics approval by the Ethics Committee of the General Hospital of the People's Liberation Army (S2021-228-03), we analyzed 126 patients using Kaplan-Meier and Cox models. p < .05 was considered a statistically significant difference. Median overall survival (mOS) and progression-free survival (mPFS) were 12.1 and 4.6 months, respectively. Significant mOS predictors were surgery history (44.2 months vs. 10 months, *p = .022), absence of liver metastases (44.2 months vs. 6.4 months, *p = .034), and baseline CA19-9 ≤ 216.15 U/ml (18.5 months vs. 9.2 months, *p = .049). For mPFS, histologic differentiation (5.5 months vs. 3.2 months, *p = .022) and first-line PD-1 inhibitor use (5.1 months vs. 1.5 months, ***p = .001) were key. Subgroup analyses highlighted early progression in low histologic differentiation and earlier death without surgery. History of surgery, absence of liver metastases, baseline CA19-9 level, and histologic intermediate/high differentiation may predict PD-1 inhibitor efficacy in advanced PC, pending validation in prospective trials.
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Affiliation(s)
- Yue Ma
- Department of Medical Oncology, Medical School of Chinese PLA, Beijing, China
- Department of Medical Oncology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Shiyun Chen
- Department of Medical Oncology, Medical School of Chinese PLA, Beijing, China
- Department of Medical Oncology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Guanghai Dai
- Department of Medical Oncology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
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15
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Yang Y, Shen J, Deng P, Chen P. Mechanism investigation of Forsythoside A against esophageal squamous cell carcinoma in vitro and in vivo. Cancer Biol Ther 2024; 25:2380023. [PMID: 39046082 DOI: 10.1080/15384047.2024.2380023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 06/21/2024] [Accepted: 07/10/2024] [Indexed: 07/25/2024] Open
Abstract
CONTEXT Forsythoside A (FSA) was extracted from Forsythia suspensa, a traditional Chinese medicine, which has been demonstrated to exert anti-inflammatory, antibacterial, and other pharmacological effects. However, the anticancer effect of FSA in esophageal squamous cell carcinoma (ESCC) has not been documented. OBJECTIVE The present study aimed to elucidate the mechanism of FSA against ESCC. MATERIALS AND METHODS Network pharmacology and molecular docking were employed to predict the mechanism. FSA was utilized to treat ESCC cell lines KYSE450 and KYSE30, followed by CCK-8 assay, cell cloning formation assay, flow cytometry, Western blot, RNA-seq analysis, and subsequent in vivo experiments. RESULTS Network pharmacology and molecular docking predicted that the therapeutic effect of FSA in ESCC is mediated through proteins such as BCL2 and BAX, influencing KEGG pathways associated with apoptosis. In vitro experiments showed that FSA inhibited cell proliferation and plate clone formation, promoted cell apoptosis and impacted the cell cycle distribution of G2/M phase by regulating BCL2, BAX, and p21. Further RNA-seq in KYSE450 cells showed that FSA regulated the expression of 223 genes, specifically affecting the biological process of epidermal development. In vivo experiments showed that gastric administration of FSA resulted in notable reductions in both tumor volume and weight by regulating BCL2, BAX, and p21. 16S rRNA sequencing showed that FSA led to significant changes of beta diversity. Abundance of 11 specific bacterial taxa were considerably changed following administration of FSA. CONCLUSIONS This study presents a novel candidate drug against ESCC and establishes a foundation for future clinical application.
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Affiliation(s)
- Yingying Yang
- School of Life Sciences, Zhengzhou Normal University, Zhengzhou, People's Republic of China
| | - Junru Shen
- School of Life Sciences, Zhengzhou Normal University, Zhengzhou, People's Republic of China
| | - Peiyuan Deng
- School of Life Sciences, Zhengzhou Normal University, Zhengzhou, People's Republic of China
| | - Ping Chen
- Academy of Medical Sciences, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, People's Republic of China
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16
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Yang S, Pi J, Ma W, Gu W, Zhang H, Xu A, Liu Y, Shi T, Yang F, Chen L. Prognostic value of the fibrinogen-to-albumin ratio (FAR) in patients with chronic heart failure across the different ejection fraction spectrum. Libyan J Med 2024; 19:2309757. [PMID: 38290043 PMCID: PMC10829812 DOI: 10.1080/19932820.2024.2309757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
The ratio of fibrinogen to albumin (FAR) is considered a new inflammatory biomarker and a predictor of cardiovascular disease risk. However, its prognostic value for patients with chronic heart failure (CHF) with different ejection fractions (EFs) remains unclear. A total of 916 hospitalized patients with CHF from January 2017 to October 2021 in the First Affiliated Hospital of Kunming Medical University were included in the study. Death occurred in 417 (45.5%) patients out of 916 patients during a median follow-up time of 750 days. Among these patients, 381 patients suffered from HFrEF (LVEF <40%) and 535 patients suffered from HFpEF or HFmrEF (HFpEF plus HFmrEF, LVEF ≥ 40%). Patients were categorized into high-level FAR (FAR-H) and low-level FAR (FAR-L) groups based on the optimal cut-off value of FAR (9.06) obtained from receiver operating characteristic (ROC) curve analysis. Upon analysing the Kaplan - Meier plots, the incidence of death was significantly higher in all patients with FAR-H and patients in both HF subgroups (p < 0.001). The multivariate Cox proportional hazard analyses indicated that the FAR was an independent predictor of all-cause mortality, regardless of heart failure subtype. (HR 1.115, 95% CI 1.089-1.142, p < 0.001; HFpEF plus HFmrEF, HR 1.109, 95% CI 1.074-1.146, p < 0.0001; HFrEF, HR 1.138, 95% CI 1.094-1.183, p < 0.0001) The optimal cut-off value of FAR in predicting all-cause mortality was 9.06 with an area under the curve value of 0.720 (95% CI: 0.687-0.753, p < 0.001), a sensitivity of 68.8% and a specificity of 65.6%. After adjusting for the traditional indicators (LVEF, Lg BNP, etc.), the new model with the FAR had better prediction ability in patients with CHF. Elevated FAR is an independent predictor of death in CHF and is not related to the HF subtype.
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Affiliation(s)
- Sirui Yang
- Department of Cardiology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Jiangyuan Pi
- Graduate School of Kunming Medical University, Kunming, China
| | - Wenfang Ma
- Department of Cardiology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Wenyi Gu
- Department of Cardiology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Hongxing Zhang
- Department of Cardiology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Anyu Xu
- Department of Cardiology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Yanqing Liu
- Department of Cardiology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Tao Shi
- Department of Cardiology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Fazhi Yang
- Department of Cardiology, Kunming Medical University First Affiliated Hospital, Kunming, China
| | - Lixing Chen
- Department of Cardiology, Kunming Medical University First Affiliated Hospital, Kunming, China
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17
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Franco D’Souza R, Mathew M, Mishra V, Surapaneni KM. Twelve tips for addressing ethical concerns in the implementation of artificial intelligence in medical education. MEDICAL EDUCATION ONLINE 2024; 29:2330250. [PMID: 38566608 PMCID: PMC10993743 DOI: 10.1080/10872981.2024.2330250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
Artificial Intelligence (AI) holds immense potential for revolutionizing medical education and healthcare. Despite its proven benefits, the full integration of AI faces hurdles, with ethical concerns standing out as a key obstacle. Thus, educators should be equipped to address the ethical issues that arise and ensure the seamless integration and sustainability of AI-based interventions. This article presents twelve essential tips for addressing the major ethical concerns in the use of AI in medical education. These include emphasizing transparency, addressing bias, validating content, prioritizing data protection, obtaining informed consent, fostering collaboration, training educators, empowering students, regularly monitoring, establishing accountability, adhering to standard guidelines, and forming an ethics committee to address the issues that arise in the implementation of AI. By adhering to these tips, medical educators and other stakeholders can foster a responsible and ethical integration of AI in medical education, ensuring its long-term success and positive impact.
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Affiliation(s)
- Russell Franco D’Souza
- Department of Education, UNESCO Chair in Bioethics, Melbourne, Australia
- Department of Organisational Psychological Medicine, International Institute of Organisational Psychological Medicine, Melbourne, Australia
| | - Mary Mathew
- Department of Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Vedprakash Mishra
- School of Hogher Education and Research, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, India
| | - Krishna Mohan Surapaneni
- Department of Biochemistry, Panimalar Medical College Hospital & Research Institute, Chennai, India
- Department of Medical Education, Panimalar Medical College Hospital & Research Institute, Chennai, India
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18
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Wu J, Xia X, Gong L, Huang S, Zheng H, Qiao G, Tang Y. Neoadjuvant chemoimmunotherapy for small cell carcinoma of the esophagus: Clinical efficacy and biomarker exploration. Hum Vaccin Immunother 2024; 20:2370085. [PMID: 38967227 PMCID: PMC11229733 DOI: 10.1080/21645515.2024.2370085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/15/2024] [Indexed: 07/06/2024] Open
Abstract
Small cell carcinoma of the esophagus (SCCE) is a rare and highly malignant type of esophageal cancer with no standard treatment, facing challenges of resistance to conventional therapies. This study presents the cases of one extensive-stage and two limited-stage SCCE patients treated with chemoimmunotherapy. The two limited-stage patients underwent surgery post-treatment and experienced notable and enduring positive responses. This represents the first documented application of neoadjuvant chemoimmunotherapy in limited-stage SCCE patients. Additionally, comprehensive immunohistochemical analysis and whole exome sequencing were performed on the case patients. The findings revealed that infiltration of CD8+ T cells and PD-L1 expression in the SCCE tumor were key factors for favorable responses in SCCE patients receiving chemoimmunotherapy.
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Affiliation(s)
- Junhan Wu
- Shantou University Medical College, Shantou, China
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Xin Xia
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Longlong Gong
- Genecast Biotechnology Co. Ltd, Wuxi City, Jiangsu, China
| | - Shujie Huang
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Hongbo Zheng
- Genecast Biotechnology Co. Ltd, Wuxi City, Jiangsu, China
| | - Guibin Qiao
- Shantou University Medical College, Shantou, China
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yong Tang
- Department of Thoracic Surgery, Shenzhen Nanshan People's Hospital, Shenzhen, China
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19
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Baccouche C, Ayari M, Abdelaali I, Dhaoui A, Jomni T, Douggui MH. Endoscope disinfectant-induced colonic pseudolipomatosis: case series of a rare condition. Future Sci OA 2024; 10:FSO985. [PMID: 38869427 PMCID: PMC11172253 DOI: 10.2144/fsoa-2023-0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/28/2024] [Indexed: 06/14/2024] Open
Abstract
Aim: Colonic mucosal pseudolipomatosis is a rare and benign endoscopic finding with distinct macroscopic and histological characteristics. Case series: We observed a form of unprecedented colitis in eight patients in a 3-month period. Operators have found, during colonoscopy, flat or slightly raised whitish-yellow plaques, in the colonic mucosa of all patients. Histological examination concluded to pseudolipomatosis. After investigation, the disinfectant machine was found to have technical malfunctioning of the rinse cycle of the endoscope during this period. No other cases were observed after the machine was fixed. Conclusion: Pseudolipomatosis is more an endoscopically induced lesion than a true pathological condition. A careful check of the disinfection process should be carried out when such lesions are detected.
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Affiliation(s)
- Charfeddine Baccouche
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Myriam Ayari
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Imen Abdelaali
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Amen Dhaoui
- Pathology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Taieb Jomni
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Mohamed Hedi Douggui
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
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20
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Hu G, Che P, Deng L, Liu L, Liao J, Liu Q. MiR-378a-5p exerts a radiosensitizing effect on CRC through LRP8/β-catenin axis. Cancer Biol Ther 2024; 25:2308165. [PMID: 38389136 PMCID: PMC10896128 DOI: 10.1080/15384047.2024.2308165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/17/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND MiRNAs are closely related to tumor radiosensitivity. MiR-378a-5p level is down-regulated in colorectal cancer (CRC). Therefore, this study intends to explore the role of miR-378a-5p in CRC, especially radiosensitivity. METHODS The expression of miR-378a-5p was analyzed in CRC samples. CRC cell lines were treated with different doses of X-rays. Bioinformatics analysis, dual-luciferase reporter assay and RT-qPCR were used to detect the expressions and binding relationship of miR-378a-5p and low-density lipoprotein receptor-related protein 8 (LRP8). MiR-378a-5p inhibitor or/and siLRP8 were transfected into CRC cells with or without irradiation. Subsequently, clonogenic assay, flow cytometry and in vivo experiments including tumorigenesis assay, immunohistochemistry, RT-qPCR and Western blot were performed to clarify the role of miR-378a-5p/LRP8 axis in the radiosensitivity of CRC. RESULTS The down-regulated expression of miR-378a-5p in CRC is related to histological differentiation and tumor-node-metastasis (TNM) stage. After irradiation, the survival fraction of CRC cells was decreased, while the apoptotic rate and the level of miR-378a-5p were increased. Restrained miR-378a-5p repressed apoptosis and apoptosis-related protein expressions, yet promoted the proliferation and the radioresistance of cells by regulating β-catenin in CRC cells. LRP8 was highly expressed in CRC, and targeted by miR-378a-5p. SiLRP8 improved radiosensitivity and reversed the effect of miR-378a-5p down-regulation on CRC cells. Overexpressed miR-378a-5p and irradiation enhanced the level of miR-378a-5p, yet suppressed the expressions of Ki67 and LRP8 as well as tumorigenesis. CONCLUSION MiR-378a-5p may exert a radiosensitizing effect on CRC through the LRP8/β-catenin axis, which may be a new therapeutic target for CRC radioresistance.
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Affiliation(s)
- Guolin Hu
- Department of Oncology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
| | - Pengbiao Che
- Department of Ultrasound, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
| | - Ling Deng
- Department of Oncology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
| | - Lei Liu
- Department of Oncology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
| | - Jia Liao
- Department of Oncology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
| | - Qi Liu
- Department of Oncology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
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21
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Ye C, Liu X, Liu Z, Pan C, Zhang X, Zhao Z, Sun H. Fusobacterium nucleatum in tumors: from tumorigenesis to tumor metastasis and tumor resistance. Cancer Biol Ther 2024; 25:2306676. [PMID: 38289287 PMCID: PMC10829845 DOI: 10.1080/15384047.2024.2306676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/13/2024] [Indexed: 02/01/2024] Open
Abstract
Fusobacterium nucleatum, an anaerobic Gram-negative bacterium primarily residing in the oral cavity, has garnered significant attention for its emerging role in cancer progression and prognosis. While extensive research has revealed mechanistic links between Fusobacterium nucleatum and colorectal cancer, a comprehensive review spanning its presence and metastatic implications in cancers beyond colorectal origin is conspicuously absent. This paper broadens our perspective from colorectal cancer to various malignancies associated with Fusobacterium nucleatum, including oral, pancreatic, esophageal, breast, and gastric cancers. Our central focus is to unravel the mechanisms governing Fusobacterium nucleatum colonization, initiation, and promotion of metastasis across diverse cancer types. Additionally, we explore Fusobacterium nucleatum's adverse impacts on cancer therapies, particularly within the domains of immunotherapy and chemotherapy. Furthermore, this paper underscores the clinical research significance of Fusobacterium nucleatum as a potential tumor biomarker and therapeutic target, offering a novel outlook on its applicability in cancer detection and prognostic assessment.
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Affiliation(s)
- Chun Ye
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Xiao Liu
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Zilun Liu
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Chuxuan Pan
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Xiaowei Zhang
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Zhanyi Zhao
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Haitao Sun
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Laboratory Medicine, Central People’s Hospital of Ji’an, Shanghai East Hospital of Ji’an, Ji’an, China
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Luo A, Liu H, Huang C, Wei S. Exosome-transmitted circular RNA circ-LMO7 facilitates the progression of osteosarcoma by regulating miR-21-5p/ARHGAP24 axis. Cancer Biol Ther 2024; 25:2343450. [PMID: 38742566 PMCID: PMC11095575 DOI: 10.1080/15384047.2024.2343450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
The potential function and mechanism of circRNAs in regulating malignant performances of Osteosarcoma (OS) cells have not been well investigated. The expression level of CircLMO7, miR-21-5p and ARHGAP24 were detected by RT-qPCR. The relationship between miR-21-5p and circ-LMO7, as well as between miR-21-5p and ARHGAP24, was predicted and examined through bioinformatics analysis and luciferase reporter gene experiments. Moreover, OS cell growth, invasion, migration, and apoptosis were detected using the cell counting kit-8 (CCK-8), transwell and flow cytometry assays, respectively. ARHGAP24 protein level was measured using western blotting. In present study, we choose to investigate the role and mechanism of circ-LOM7 on OS cell proliferation, migration and invasion. circ-LOM7 was found to be down-regulated in OS tissues and cell lines. Enforced expression of circ-LOM7 suppressed the growth, invasion, and migration of OS cells. In contrast, decreasing circ-LMO7 expression had opposite effects. Furthermore, miR-21-5p was predicted to be sponged by circ-LMO7, and had an opposite role of circ-LMO7 in OS. Moreover, ARHGAP24 served as miR-21-5p's downstream target. Mechanistically, circ-LMO7 was packed in exosomes and acted as a cancer-suppresser on OS by sponging miR-21-5p and upregulating the expression of ARHGAP24. The exosomal circ-LMO7 expression was significantly decreased in OS cell exosomes, and co-culture experiments showed that exosomal circ-LMO7 suppressed the proliferation ability of OS cells. Circ-LMO7 exerts as a tumor suppressor in OS, and the circ-LMO7/miR-21-5P/ARHGAP24 axis is involved in OS progression.
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Affiliation(s)
- Anyu Luo
- Department of Orthopedics, Hanyang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Hanlin Liu
- Department of Orthopedics, Hanyang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Chen Huang
- Department of Orthopedics, Hanyang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Sheng Wei
- Department of Orthopedics, Hanyang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
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Wang S, Wu R, Chen Q, Liu T, Li L. Exosomes derived from TNF-α-treated bone marrow mesenchymal stem cells ameliorate myocardial infarction injury in mice. Organogenesis 2024; 20:2356341. [PMID: 38766777 PMCID: PMC11110693 DOI: 10.1080/15476278.2024.2356341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/13/2024] [Indexed: 05/22/2024] Open
Abstract
Exosomes derived from bone marrow mesenchymal stem cells (BMSCs) exhibit considerable therapeutic potential for myocardial regeneration. In our investigation, we delved into their impact on various aspects of myocardial infarction (MI), including cardiac function, tissue damage, inflammation, and macrophage polarization in a murine model. We meticulously isolated the exosomes from TNF-α-treated BMSCs and evaluated their therapeutic efficacy in a mouse MI model induced by coronary artery ligation surgery. Our comprehensive analysis, incorporating ultrasound, serum assessment, Western blot, and qRT-PCR, revealed that exosomes from TNF-α-treated BMSCs demonstrated significant therapeutic potential in reducing MI-induced injury. Treatment with these exosomes resulted in improved cardiac function, reduced infarct area, and increased left ventricular wall thickness in MI mice. On a mechanistic level, exosome treatment fostered M2 macrophage polarization while concurrently suppressing M1 polarization. Hence, exosomes derived from TNF-α-treated BMSCs emerge as a promising therapeutic strategy for alleviating MI injury in a mouse model.
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Affiliation(s)
- Shuo Wang
- Department of Cardiovascular Medicine, Hebei Medical University of Shijiazhuang People’s Hospital, Shijiazhuang, Hebei, China
| | - Rubin Wu
- Department of Cardiovascular Medicine, Hebei Medical University of Shijiazhuang People’s Hospital, Shijiazhuang, Hebei, China
| | - Qincong Chen
- Department of Cardiovascular Medicine, Hebei Medical University of Shijiazhuang People’s Hospital, Shijiazhuang, Hebei, China
| | - Tao Liu
- Department of Cardiovascular Medicine, Hebei Medical University Second Hospital, Shijiazhuang, Hebei, China
| | - Liu Li
- Department of Cardiovascular Medicine, Hebei Medical University First Hospital, Shijiazhuang, Hebei, China
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24
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Grieve LM, Rani A, ZeRuth GT. Downregulation of Glis3 in INS1 cells exposed to chronically elevated glucose contributes to glucotoxicity-associated β cell dysfunction. Islets 2024; 16:2344622. [PMID: 38652652 PMCID: PMC11042057 DOI: 10.1080/19382014.2024.2344622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
Chronically elevated levels of glucose are deleterious to pancreatic β cells and contribute to β cell dysfunction, which is characterized by decreased insulin production and a loss of β cell identity. The Krüppel-like transcription factor, Glis3 has previously been shown to positively regulate insulin transcription and mutations within the Glis3 locus have been associated with the development of several pathologies including type 2 diabetes mellitus. In this report, we show that Glis3 is significantly downregulated at the transcriptional level in INS1 832/13 cells within hours of being subjected to high glucose concentrations and that diminished expression of Glis3 is at least partly attributable to increased oxidative stress. CRISPR/Cas9-mediated knockdown of Glis3 indicated that the transcription factor was required to maintain normal levels of both insulin and MafA expression and reduced Glis3 expression was concomitant with an upregulation of β cell disallowed genes. We provide evidence that Glis3 acts similarly to a pioneer factor at the insulin promoter where it permissively remodels the chromatin to allow access to a transcriptional regulatory complex including Pdx1 and MafA. Finally, evidence is presented that Glis3 can positively regulate MafA transcription through its pancreas-specific promoter and that MafA reciprocally regulates Glis3 expression. Collectively, these results suggest that decreased Glis3 expression in β cells exposed to chronic hyperglycemia may contribute significantly to reduced insulin transcription and a loss of β cell identity.
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Affiliation(s)
- LilyAnne M. Grieve
- Department of Biological Sciences, Murray State University, Murray, KY, USA
| | - Abhya Rani
- Department of Biological Sciences, Murray State University, Murray, KY, USA
| | - Gary T. ZeRuth
- Department of Biological Sciences, Murray State University, Murray, KY, USA
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25
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Fathi M, Taher HJ, Al-Rubiae SJ, Yaghoobpoor S, Bahrami A, Eshraghi R, Sadri H, Asadi Anar M, Gholamrezanezhad A. Role of molecular imaging in prognosis, diagnosis, and treatment of gastrointestinal cancers: An update on new therapeutic methods. World J Methodol 2024; 14:93461. [DOI: 10.5662/wjm.v14.i4.93461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/31/2024] [Accepted: 07/15/2024] [Indexed: 07/26/2024] Open
Abstract
One of the leading causes of cancer-related death is gastrointestinal cancer, which has a significant morbidity and mortality rate. Although preoperative risk assessment is essential for directing patient care, its biological behavior cannot be accurately predicted by conventional imaging investigations. Potential pathophysiological information in anatomical imaging that cannot be visually identified can now be converted into high-dimensional quantitative image features thanks to the developing discipline of molecular imaging. In order to enable molecular tissue profile in vivo, molecular imaging has most recently been utilized to phenotype the expression of single receptors and targets of biological therapy. It is expected that molecular imaging will become increasingly important in the near future, driven by the expanding range of biological therapies for cancer. With this live molecular fingerprinting, molecular imaging can be utilized to drive expression-tailored customized therapy. The technical aspects of molecular imaging are first briefly discussed in this review, followed by an examination of the most recent research on the diagnosis, prognosis, and potential future clinical methods of molecular imaging for GI tract malignancies.
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Affiliation(s)
- Mobina Fathi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran
| | | | | | - Shirin Yaghoobpoor
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran
| | - Ashkan Bahrami
- Faculty of Medicine, Kashan University of Medical Sciences, Kashan 1617768911, Iran
| | - Reza Eshraghi
- Faculty of Medicine, Kashan University of Medical Sciences, Kashan 1617768911, Iran
| | - Hossein Sadri
- Faculty of Medicine, Kashan University of Medical Sciences, Kashan 1617768911, Iran
| | - Mahsa Asadi Anar
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
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Shen M, Shi Y, Ge Z, Qian J. Effects of Mesalamine Combined with Live Combined Bifidobacterium, Lactobacillus and Enterococcus Capsules on Intestinal Mucosa Barrier Function and Intestinal Microbiota in Mildly Active Crohn's Disease Patients. J INVEST SURG 2024; 37:2297565. [PMID: 38159563 DOI: 10.1080/08941939.2023.2297565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
Objective: This study is aimed at investigating the impact of mesalamine combined with Live combined Bifidobacterium, Lactobacillus and Enterococcus capsules on intestinal mucosa barrier function and intestinal microbiota in mildly active Crohn's disease patients.Methods: Ninety-six Crohn's disease patients in mild activity period were randomized into the control group (treated with mesalamine) and the observation group (treated with mesalamine combined with Live combined Bifidobacterium, Lactobacillus and Enterococcus capsules) (n = 48). After 4 wk of treatment, the patients were evaluated for their clinical efficacy. Intestinal microbiota counts, serum inflammatory factors, T lymphocyte subsets, and mucosal barrier function indicators in both groups were assessed.Results: After 4 wk of treatment, the total clinical effective rate of the observation group was higher than that of the control group. The number of Lactobacillus acidophilus (L. acidophilus) and Bifidobacterium Longum (B. longum) in the intestinal tract, serum IL-10 levels, and peripheral blood CD4+ and CD4+/CD8+ levels were higher, and the number of Bacteroides vulgatus (B. vulgatus), the levels of TNF-α, IL-6, CRP, CD8+, ET, D-lactate, DAO, and urine L/M ratio were lower in the observation group in comparison to those in the control group (all p < 0.05).Conclusion: Mesalamine combined with Live combined Bifidobacterium, Lactobacillus and Enterococcus capsules are more effective in treating mildly active Crohn's disease.
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Affiliation(s)
- Meiqin Shen
- Department of Gastroenterology, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Yingqi Shi
- Department of Gastroenterology, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Zhenming Ge
- Department of Gastroenterology, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Junbo Qian
- Department of Gastroenterology, Nantong First People's Hospital, Nantong, Jiangsu, China
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27
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Cairns CA, Xiao L, Wang JY. Posttranscriptional Regulation of Intestinal Mucosal Growth and Adaptation by Noncoding RNAs in Critical Surgical Disorders. J INVEST SURG 2024; 37:2308809. [PMID: 38323630 PMCID: PMC11027105 DOI: 10.1080/08941939.2024.2308809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 01/12/2024] [Indexed: 02/08/2024]
Abstract
The human intestinal epithelium has an impressive ability to respond to insults and its homeostasis is maintained by well-regulated mechanisms under various pathophysiological conditions. Nonetheless, acute injury and inhibited regeneration of the intestinal epithelium occur commonly in critically ill surgical patients, leading to the translocation of luminal toxic substances and bacteria to the bloodstream. Effective therapies for the preservation of intestinal epithelial integrity and for the prevention of mucosal hemorrhage and gut barrier dysfunction are limited, primarily because of a poor understanding of the mechanisms underlying mucosal disruption. Noncoding RNAs (ncRNAs), which include microRNAs (miRNAs), long ncRNAs (lncRNAs), circular RNAs (circRNAs), and small vault RNAs (vtRNAs), modulate a wide array of biological functions and have been identified as orchestrators of intestinal epithelial homeostasis. Here, we feature the roles of many important ncRNAs in controlling intestinal mucosal growth, barrier function, and repair after injury-particularly in the context of postoperative recovery from bowel surgery. We review recent literature surrounding the relationships between lncRNAs, microRNAs, and RNA-binding proteins and how their interactions impact cell survival, proliferation, migration, and cell-to-cell interactions in the intestinal epithelium. With advancing knowledge of ncRNA biology and growing recognition of the importance of ncRNAs in maintaining the intestinal epithelial integrity, ncRNAs provide novel therapeutic targets for treatments to preserve the gut epithelium in individuals suffering from critical surgical disorders.
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Affiliation(s)
- Cassandra A. Cairns
- Cell Biology Group, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland 21201
| | - Lan Xiao
- Cell Biology Group, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland 21201
| | - Jian-Ying Wang
- Cell Biology Group, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland 21201
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland 21201
- Baltimore Veterans Affairs Medical Center, Baltimore, Maryland 21201
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28
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Benjamin S, Assounga A. Transferrin levels are associated with malnutrition markers in hemodialysis patients in KwaZulu-Natal, South Africa. Ren Fail 2024; 46:2337292. [PMID: 38616181 PMCID: PMC11017997 DOI: 10.1080/0886022x.2024.2337292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 03/27/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION Malnutrition is a global phenomenon and may be contributing to the increasing size of the hemodialysis (HD) population in South Africa and is affecting morbidity and clinical outcomes. Our study assessed whether transferrin could be a possible marker for malnutrition in the HD population. METHODS Clinical parameters (including skinfold thickness and mid-upper arm circumference [MUAC]) and laboratory markers (including transferrin and hemoglobin) were measured during a six-month period in a sample of 59 HD patients. RESULTS Linear regression analysis showed that MUAC (p = 0.027) as well as skinfold thickness (p = 0.021) had a significant association with transferrin levels within the HD participants. There was no significant association between transferrin levels or MUAC with hemoglobin levels (p = 0.075). Furthermore, the study found that decreased transferrin levels (< 2.15 g/dL to 3.80 g/dL) were closely related to malnutrition in the malnutrition distribution groups within the study, with 97.7% of HD participants being classified in one of the malnutrition groups. CONCLUSION Thus, transferrin levels are a valuable marker for malnutrition within the HD patient population and can be included along with clinical assessment parameters such as MUAC and skinfold thickness as primary indicators for malnutrition.
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Affiliation(s)
- Sherilene Benjamin
- Department of Biomedical and Clinical Technology, Durban University of Technology, Durban, South Africa
| | - Alain Assounga
- Department of Nephrology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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29
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Antonio J, Evans C, Ferrando AA, Stout JR, Antonio B, Cinteo H, Harty P, Arent SM, Candow DG, Forbes SC, Kerksick CM, Pereira F, Gonzalez D, Kreider RB. Common questions and misconceptions about protein supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2024; 21:2341903. [PMID: 38626029 PMCID: PMC11022925 DOI: 10.1080/15502783.2024.2341903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 04/07/2024] [Indexed: 04/18/2024] Open
Abstract
Protein supplementation often refers to increasing the intake of this particular macronutrient through dietary supplements in the form of powders, ready-to-drink shakes, and bars. The primary purpose of protein supplementation is to augment dietary protein intake, aiding individuals in meeting their protein requirements, especially when it may be challenging to do so through regular food (i.e. chicken, beef, fish, pork, etc.) sources alone. A large body of evidence shows that protein has an important role in exercising and sedentary individuals. A PubMed search of "protein and exercise performance" reveals thousands of publications. Despite the considerable volume of evidence, it is somewhat surprising that several persistent questions and misconceptions about protein exist. The following are addressed: 1) Is protein harmful to your kidneys? 2) Does consuming "excess" protein increase fat mass? 3) Can dietary protein have a harmful effect on bone health? 4) Can vegans and vegetarians consume enough protein to support training adaptations? 5) Is cheese or peanut butter a good protein source? 6) Does consuming meat (i.e., animal protein) cause unfavorable health outcomes? 7) Do you need protein if you are not physically active? 8) Do you need to consume protein ≤ 1 hour following resistance training sessions to create an anabolic environment in skeletal muscle? 9) Do endurance athletes need additional protein? 10) Does one need protein supplements to meet the daily requirements of exercise-trained individuals? 11) Is there a limit to how much protein one can consume in a single meal? To address these questions, we have conducted a thorough scientific assessment of the literature concerning protein supplementation.
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Affiliation(s)
- Jose Antonio
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Cassandra Evans
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Arny A. Ferrando
- University of Arkansas for Medical Sciences, Department of Geriatrics, Little Rock, AR, USA
| | - Jeffrey R. Stout
- University of Central Florida, School of Kinesiology and Rehabilitation Science, Orlando, FL, USA
| | - Brandi Antonio
- University of Central Florida, School of Kinesiology and Rehabilitation Science, Orlando, FL, USA
| | - Harry Cinteo
- Lindenwood University, Exercise and Performance Nutrition Laboratory, St. Charles, MO, USA
| | - Patrick Harty
- Lindenwood University, Exercise and Performance Nutrition Laboratory, St. Charles, MO, USA
| | - Shawn M. Arent
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, Columbia, SC, USA
| | - Darren G. Candow
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, Canada
| | - Scott C. Forbes
- Brandon University, Department of Physical Education, Faculty of Education, Brandon, MB, Canada
| | - Chad M. Kerksick
- Lindenwood University, Exercise and Performance Nutrition Laboratory, St. Charles, MO, USA
| | - Flavia Pereira
- Keiser University, Exercise and Sport Science, West Palm Beach Flagship Campus, West Palm Beach, FL, USA
| | - Drew Gonzalez
- Texas A&M University, Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, College Station, TX, USA
| | - Richard B. Kreider
- Texas A&M University, Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, College Station, TX, USA
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30
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Okuno N, Hara K, Haba S, Kuwahara T, Urata M, Kondo T, Yamamoto Y. Endoscopic ultrasound-guided vascular intervention for pancreaticojejunal variceal bleeding. Endoscopy 2024; 56:E329-E330. [PMID: 38594005 PMCID: PMC11003815 DOI: 10.1055/a-2291-9619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Affiliation(s)
- Nozomi Okuno
- Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kazuo Hara
- Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shin Haba
- Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | | | - Minako Urata
- Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takashi Kondo
- Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
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Elshibani FA, Alamami AD, Mohammed HA, Rasheed RA, El Sabban RM, Yehia MA, Abdel Mageed SS, Majrashi TA, Elkaeed EB, El Hassab MA, Eldehna WM, El-Ashrey MK. A multidisciplinary approach to the antioxidant and hepatoprotective activities of Arbutus pavarii Pampan fruit; in vitro and in Vivo biological evaluations, and in silico investigations. J Enzyme Inhib Med Chem 2024; 39:2293639. [PMID: 38153110 PMCID: PMC10763860 DOI: 10.1080/14756366.2023.2293639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023] Open
Abstract
The Libyan Strawberry, Arbutus pavarii Pampan (ARB), is an endemic Jebel Akhdar plant used for traditional medicine. This study presents the antioxidant and hepatoprotective properties of ARB fruit-extract. ARB phytochemical analysis indicated the presence of 354.54 GAE and 36.2 RE of the phenolics and flavonoids. LC-MS analysis identified 35 compounds belonging to phenolic acids, procyanidins, and flavonoid glycosides. Gallic acid, procyanidin dimer B3, β-type procyanidin trimer C, and quercetin-3-O-glucoside were the major constituents of the plant extract. ARB administration to paracetamol (PAR)-intoxicated rats reduced serum ALT, AST, bilirubin, hepatic tissue MDA and proinflammatory markers; TNF-α and IL-6 with an increase in tissue GSH level and SOD activity. Histological and immunohistochemical studies revealed that ARB restored the liver histology and significantly reduced the tissue expression of caspase 3, IL-1B, and NF-KB in PAR-induced liver damage. Docking analysis disclosed good binding affinities of some compounds with XO, COX-1, 5-LOX, and PI3K.
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Affiliation(s)
- Fatma A. Elshibani
- Department of Pharmacognosy, Faculty of Pharmacy, University of Benghazi, Benghazi, Libya
| | - Abdullah D. Alamami
- Department of Basic Medical Science, Faculty of Pharmacy, University of Benghazi, Benghazi, Libya
| | - Hamdoon A. Mohammed
- Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, Qassim University, Qassim, Saudi Arabia
- Department of Pharmacognosy and Medicinal Plants, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Rabab Ahmed Rasheed
- Department of Medical Histology and Cell Biology, Faculty of Medicine, King Salman International University (KSIU), South Sinai, Egypt
| | - Radwa M. El Sabban
- Department of Anatomy, Faculty of Medicine, October 6 University, Giza, Egypt
| | - Mohamed A. Yehia
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, October 6 University, Giza, Egypt
| | - Sherif S. Abdel Mageed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo, Egypt
| | - Taghreed A. Majrashi
- Department of Pharmacognosy, College of Pharmacy, King Khalid University, Asir, Saudi Arabia
| | - Eslam B. Elkaeed
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Riyadh, Saudi Arabia
| | - Mahmoud A. El Hassab
- Department of Medicinal Chemistry, Faculty of Pharmacy, King Salman International University (KSIU), South Sinai, Egypt
| | - Wagdy M. Eldehna
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Mohamed K. El-Ashrey
- Department of Medicinal Chemistry, Faculty of Pharmacy, King Salman International University (KSIU), South Sinai, Egypt
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Zeng W, Zheng L, Li Y, Yang J, Mao T, Zhang J, Liu Y, Ning J, Zhang T, Huang H, Chen X, Lu F. Engineered extracellular vesicles for delivering functional Cas9/gRNA to eliminate hepatitis B virus cccDNA and integration. Emerg Microbes Infect 2024; 13:2284286. [PMID: 37982370 PMCID: PMC10763861 DOI: 10.1080/22221751.2023.2284286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
The persistence of HBV covalently closed circular DNA (cccDNA) and HBV integration into the host genome in infected hepatocytes pose significant challenges to the cure of chronic HBV infection. Although CRISPR/Cas9-mediated genome editing shows promise for targeted clearance of viral genomes, a safe and efficient delivery method is currently lacking. Here, we developed a novel approach by combining light-induced heterodimerization and protein acylation to enhance the loading efficiency of Cas9 protein into extracellular vesicles (EVs). Moreover, vesicular stomatitis virus-glycoprotein (VSV-G) was incorporated onto the EVs membrane, significantly facilitating the endosomal escape of Cas9 protein and increasing its gene editing activity in recipient cells. Our results demonstrated that engineered EVs containing Cas9/gRNA and VSV-G can effectively reduce viral antigens and cccDNA levels in the HBV-replicating and infected cell models. Notably, we also confirmed the antiviral activity and high safety of the engineered EVs in the HBV-replicating mouse model generated by hydrodynamic injection and the HBV transgenic mouse model. In conclusion, engineered EVs could successfully mediate functional CRISPR/Cas9 delivery both in vitro and in vivo, leading to the clearance of episomal cccDNA and integrated viral DNA fragments, and providing a novel therapeutic approach for curing chronic HBV infection.
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Affiliation(s)
- Wanjia Zeng
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Liwei Zheng
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Yukun Li
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Jing Yang
- School of Medicine, Shihezi University, Shihezi, People’s Republic of China
| | - Tianhao Mao
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Jing Zhang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Yanna Liu
- Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Jing Ning
- Department of Gastroenterology, Beijing Key Laboratory for Helicobacter Pylori Infection and Upper Gastrointestinal Diseases, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Ting Zhang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Hongxin Huang
- Department of Pathogen Biology and Biosecurity, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Xiangmei Chen
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Fengmin Lu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People’s Republic of China
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Xu H, Du Z, Li Z, Liu X, Li X, Zhang X, Ma J. MUC1-EGFR crosstalk with IL-6 by activating NF-κB and MAPK pathways to regulate the stemness and paclitaxel-resistance of lung adenocarcinoma. Ann Med 2024; 56:2313671. [PMID: 38325364 PMCID: PMC10851807 DOI: 10.1080/07853890.2024.2313671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The chemotherapy resistance often leads to chemotherapy failure. This study aims to explore the molecular mechanism by which MUC1 regulates paclitaxel resistance in lung adenocarcinoma (LUAD), providing scientific basis for future target selection. METHODS The bioinformatics method was used to analyse the mRNA and protein expression characteristics of MUC1 in LUAD. RT-qPCR and ELISA were used to detect the mRNA and protein expression, flow cytometry was used to detect CD133+ cells, and cell viability was detected by CCK-8 assay. The mRNA-seq was performed to analyse the changes in expression profile, GO and KEGG analysis were used to explore the potential biological functions. RESULTS MUC1 is highly expressed in LUAD patients and is associated with a higher tumour infiltration. In paclitaxel resistance LUAD cells (A549/TAX cells), the expression of MUC1, EGFR/p-EGFR and IL-6 were higher than that of A549 cells, the proportion of CD133+ cells was significantly increased, and the expression of cancer stem cell (CSCs) transcription factors (NANOG, OCT4 and SOX2) were significantly up-regulated. After knocking down MUC1 in A549/Tax cells, the activity of A549/Tax cells was significantly decreased. Correspondingly, the expression of EGFR, IL-6, OCT4, NANOG, and SOX2 were significantly down-regulated. The mRNA-seq showed that knocking down MUC1 affected the gene expression, DEGs mainly enriched in NF-κB and MAPK signalling pathway. CONCLUSION MUC1 was highly expressed in A549/TAX cells, and MUC1-EGFR crosstalk with IL-6 may be due to the activation of NF-κB and MAPK pathways, which promote the enrichment of CSCs and lead to paclitaxel resistance.
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Affiliation(s)
- Hongyu Xu
- Department of Oncology, 363 Hospital, Chengdu, Sichuan, P.R. China
| | - Zedong Du
- Department of Oncology, Chengdu Second People’s Hospital, Chengdu, Sichuan, P.R. China
| | - Zhihui Li
- Department of Oncology, The General Hospital of Western Theater Command of PLA, Chengdu, Sichuan, P.R. China
| | - Xianguo Liu
- Department of Oncology, 363 Hospital, Chengdu, Sichuan, P.R. China
| | - Xueting Li
- Department of Oncology, 363 Hospital, Chengdu, Sichuan, P.R. China
| | - Xuan Zhang
- Science and Education Department, 363 Hospital, Chengdu, Sichuan, P.R. China
| | - Jiayu Ma
- Department of Oncology, 363 Hospital, Chengdu, Sichuan, P.R. China
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Cassidy-Matthews C, Pearce M, Hussaini T, Spittal P, Caron N, Daley C, Alfred R, Yoshida EM. "My feelings and my thoughts are my lived experience, not the numbers they show me on a piece of paper": Indigenous experiences of liver transplantation in British Columbia, Canada. Int J Circumpolar Health 2024; 83:2359747. [PMID: 38805610 PMCID: PMC11136460 DOI: 10.1080/22423982.2024.2359747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/21/2024] [Indexed: 05/30/2024] Open
Abstract
Indigenous Peoples in Canada face healthcare inequities impacting access to solid organ transplantation. The experiences of Indigenous patients during the liver transplant process, and how transplant professionals perceive challenges faced by Indigenous Peoples, has not been studied. Thirteen semi-structured qualitative interviews were conducted via telehealth with Indigenous liver transplant patients (n = 7) and transplant care providers (n = 6) across British Columbia, Canada between April 2021-May 2022. Themes were identified to inform clinical approaches and transplant care planning and validated by Indigenous health experts. Among patient participants: transplants occurred between 1992-2020; all were women; and the mean age at the time of interview was 60 years. Among transplant care provider participants: roles included nursing, social work, and surgery; 83% were women; and the median number of years in transplant care was ten. Three broad themes were identified: Indigenous strengths and resources, systemic and structural barriers, and inconsistent care and cultural safety across health professions impact Indigenous patient care during liver transplantation. This study contributes insights into systemic barriers and Indigenous resilience in the liver transplant journey. Dismantling structural barriers to early linkage to care is needed, and training for transplant clinicians on Indigenous histories, cultural protocols, and cultural safety is strongly recommended.
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Affiliation(s)
- Chenoa Cassidy-Matthews
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- The Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Margo Pearce
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- The Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Trana Hussaini
- The Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Patricia Spittal
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- The Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Nadine Caron
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- The Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- The Department of Surgery, The University of British Columbia, Vancouver, BC, Canada
| | - Cole Daley
- The Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- The Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Ruth Alfred
- The Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Eric M. Yoshida
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- The Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- The Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
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Lu Y, Gao L, Zhang W, Zeng Y, Hu J, Song K. Caffeic acid phenethyl ester restores mitochondrial homeostasis against peritoneal fibrosis induced by peritoneal dialysis through the AMPK/SIRT1 pathway. Ren Fail 2024; 46:2350235. [PMID: 38721924 PMCID: PMC11086008 DOI: 10.1080/0886022x.2024.2350235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/27/2024] [Indexed: 05/12/2024] Open
Abstract
Increasing evidence suggests that peritoneal fibrosis induced by peritoneal dialysis (PD) is linked to oxidative stress. However, there are currently no effective interventions for peritoneal fibrosis. In the present study, we explored whether adding caffeic acid phenethyl ester (CAPE) to peritoneal dialysis fluid (PDF) improved peritoneal fibrosis caused by PD and explored the molecular mechanism. We established a peritoneal fibrosis model in Sprague-Dawley rats through intraperitoneal injection of PDF and lipopolysaccharide (LPS). Rats in the PD group showed increased peritoneal thickness, submesothelial collagen deposition, and the expression of TGFβ1 and α-SMA. Adding CAPE to PDF significantly inhibited PD-induced submesothelial thickening, reduced TGFβ1 and α-SMA expression, alleviated peritoneal fibrosis, and improved the peritoneal ultrafiltration function. In vitro, peritoneal mesothelial cells (PMCs) treated with PDF showed inhibition of the AMPK/SIRT1 pathway, mitochondrial membrane potential depolarization, overproduction of mitochondrial reactive oxygen species (ROS), decreased ATP synthesis, and induction of mesothelial-mesenchymal transition (MMT). CAPE activated the AMPK/SIRT1 pathway, thereby inhibiting mitochondrial membrane potential depolarization, reducing mitochondrial ROS generation, and maintaining ATP synthesis. However, the beneficial effects of CAPE were counteracted by an AMPK inhibitor and siSIRT1. Our results suggest that CAPE maintains mitochondrial homeostasis by upregulating the AMPK/SIRT1 pathway, which alleviates oxidative stress and MMT, thereby mitigating the damage to the peritoneal structure and function caused by PD. These findings suggest that adding CAPE to PDF may prevent and treat peritoneal fibrosis.
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Affiliation(s)
- Ying Lu
- Department of Nephrology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Luyan Gao
- Department of Nephrology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Wenwen Zhang
- Department of Nephrology, Zibo City Hospital Combined of Traditional Chinese and Western Medicine, Zibo, China
| | - Ying Zeng
- Department of Nephrology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Ji Hu
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Kai Song
- Department of Nephrology, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Ebigbo A, Vlasenko D, Scheppach MW, Nagl S, Anthuber M, Messmann H. Nonexposed endoscopic wall inversion surgery with sentinel node mapping for a high risk gastric lesion. Endoscopy 2024; 56:E527. [PMID: 38889895 PMCID: PMC11188763 DOI: 10.1055/a-2342-0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Affiliation(s)
- Alanna Ebigbo
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | - Dmytro Vlasenko
- Department of Abdominal and Visceral Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Markus W. Scheppach
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | - Sandra Nagl
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | - Matthias Anthuber
- Department of Abdominal and Visceral Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Helmut Messmann
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
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Ji X, Wu Q, Cao X, Liu S, Zhang J, Chen S, Shan J, Zhang Y, Li B, Zhao H. Helicobacter pylori East Asian type CagA hijacks more SHIP2 by its EPIYA-D motif to potentiate the oncogenicity. Virulence 2024; 15:2375549. [PMID: 38982595 PMCID: PMC11238919 DOI: 10.1080/21505594.2024.2375549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Abstract
CagA is a significant oncogenic factor injected into host cells by Helicobacter pylori, which is divided into two subtypes: East Asian type (CagAE), characterized by the EPIYA-D motif, and western type (CagAW), harboring the EPIYA-C motif. CagAE has been reported to have higher carcinogenicity than CagAW, although the underlying reason is not fully understood. SHIP2 is an intracellular phosphatase that can be recruited by CagA to perturb the homeostasis of intracellular signaling pathways. In this study, we found that SHIP2 contributes to the higher oncogenicity of CagAE. Co-Immunoprecipitation and Pull-down assays showed that CagAE bind more SHIP2 than CagAW. Immunofluorescence staining showed that a higher amount of SHIP2 recruited by CagAE to the plasma membrane catalyzes the conversion of PI(3,4,5)P3 into PI(3,4)P2. This alteration causes higher activation of Akt signaling, which results in enhanced IL-8 secretion, migration, and invasion of the infected cells. SPR analysis showed that this stronger interaction between CagAE and SHIP2 stems from the higher affinity between the EPIYA-D motif of CagAE and the SH2 domain of SHIP2. Structural analysis revealed the crucial role of the Phe residue at the Y + 5 position in EPIYA-D. After mutating Phe of CagAE into Asp (the corresponding residue in the EPIYA-C motif) or Ala, the activation of downstream Akt signaling was reduced and the malignant transformation of infected cells was alleviated. These findings revealed that CagAE hijacks SHIP2 through its EPIYA-D motif to enhance its carcinogenicity, which provides a better understanding of the higher oncogenic risk of H. pylori CagAE.
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Affiliation(s)
- Xiaofei Ji
- School of Basic Medical Sciences, Binzhou Medical University, Yantai, Shandong, China
| | - Qianwen Wu
- The Second School of Clinical Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Xinying Cao
- School of Basic Medical Sciences, Binzhou Medical University, Yantai, Shandong, China
| | - Shuzhen Liu
- School of Basic Medical Sciences, Binzhou Medical University, Yantai, Shandong, China
| | - Jianhui Zhang
- School of Basic Medical Sciences, Binzhou Medical University, Yantai, Shandong, China
| | - Si Chen
- School of Basic Medical Sciences, Binzhou Medical University, Yantai, Shandong, China
| | - Jiangfan Shan
- School of Basic Medical Sciences, Binzhou Medical University, Yantai, Shandong, China
| | - Ying Zhang
- The Second School of Clinical Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Boqing Li
- School of Basic Medical Sciences, Binzhou Medical University, Yantai, Shandong, China
| | - Huilin Zhao
- School of Basic Medical Sciences, Binzhou Medical University, Yantai, Shandong, China
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38
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Paida K, Gupta S. Ultrasound-guided removal of embedded fishbone. Endoscopy 2024; 56:E398-E399. [PMID: 38759960 PMCID: PMC11101265 DOI: 10.1055/a-2307-5672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Affiliation(s)
- Keerti Paida
- Gastroenterology, Concord Repatriation General Hospital, Sydney, Australia
- Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Saurabh Gupta
- Gastroenterology, Sydney Adventist Hospital, Sidney, Australia
- School of Medicine and Psychology, Australian National University, Canberra, Australia
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Li C, Li S, Wang T, Xu Y, Xu Z, Huang F, Chen C. Application of through-the-scope twin clip for defect closure after gastric gastrointestinal stromal tumor transoral super minimally invasive surgery resection. Endoscopy 2024; 56:E603-E604. [PMID: 38977030 DOI: 10.1055/a-2346-5017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Affiliation(s)
- Chenyang Li
- Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Shuling Li
- Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Tao Wang
- Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Yan Xu
- Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Zhongrui Xu
- Department of Gastroenterology, The Fourth Medical Center of PLA General Hospital, Beijing, China
| | - Fuxiu Huang
- Department of Gastroenterology, The Fourth Medical Center of PLA General Hospital, Beijing, China
| | - Chao Chen
- Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing, China
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Jia S, Si R, Liu G, Zhong Q. Diosgenin protects against cationic bovine serum albumin-induced membranous glomerulonephritis by attenuating oxidative stress and renal inflammation via the NF-κB pathway. PHARMACEUTICAL BIOLOGY 2024; 62:285-295. [PMID: 38516898 PMCID: PMC10962310 DOI: 10.1080/13880209.2024.2330602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
CONTEXT Membranous glomerulonephritis (MGN) is a leading cause of nephrotic syndrome in adults. Diosgenin (DG) has been reported to exert antioxidative and anti-inflammatory effects. OBJECTIVE To investigate the renoprotective activity of DG in a cationic bovine serum albumin-induced rat model of MGN. MATERIALS AND METHODS Fourty male Sprague-Dawley rats were randomized into four groups. The MGN model was established and treated with a DG dose (10 mg/kg) and a positive control (TPCA1, 10 mg/kg), while normal control and MGN groups received distilled water by gavage for four consecutive weeks. At the end of the experiment, 24 h urinary protein, biochemical indices, oxidation and antioxidant levels, inflammatory parameters, histopathological examination, immunohistochemistry and immunoblotting were evaluated. RESULTS DG significantly ameliorated kidney dysfunction by decreasing urinary protein (0.56-fold), serum creatinine (SCr) (0.78-fold), BUN (0.71-fold), TC (0.66-fold) and TG (0.73-fold) levels, and increasing ALB (1.44-fold). DG also reduced MDA (0.82-fold) and NO (0.83-fold) levels while increasing the activity of SOD (1.56-fold), CAT (1.25-fold), glutathione peroxidase (GPx) (1.55-fold) and GSH (1.81-fold). Furthermore, DG reduced Keap1 (0.76-fold) expression, Nrf2 nuclear translocation (0.79-fold), and induced NQO1 (1.25-fold) and HO-1 (1.46-fold) expression. Additionally, DG decreased IL-2 (0.55-fold), TNF-α (0.80-fold) and IL-6 (0.75-fold) levels, and reduced protein expression of NF-κB p65 (0.80-fold), IKKβ (0.93-fold), p-IKKβ (0.89-fold), ICAM-1 (0.88-fold), VCAM-1 (0.91-fold), MCP-1 (0.88-fold) and E-selectin (0.87-fold), and also inhibited the nuclear translocation of NF-κB p65 (0.64-fold). DISCUSSION AND CONCLUSIONS The results suggest a potential therapeutic benefit of DG against MGN due to the inhibition of the NF-κB pathway, supporting the need for further clinical trials.
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Affiliation(s)
- Shiyan Jia
- Department of Anesthesiology, Anesthesia and Trauma Research Unit, Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Cangzhou, China
- College of Basic Medical Sciences, Shanxi University of Chinese Medicine, Jinzhong, China
- Department of Nephrology, Shanxi Province Hospital of Traditional Chinese Medicine, Taiyuan, China
| | - Ruihua Si
- College of Basic Medical Sciences, Shanxi University of Chinese Medicine, Jinzhong, China
- Department of Nephrology, Shanxi Province Hospital of Traditional Chinese Medicine, Taiyuan, China
| | - Guangzhen Liu
- Department of Nephrology, Shanxi Province Hospital of Traditional Chinese Medicine, Taiyuan, China
| | - Qiming Zhong
- Department of Nephrology, Shanxi Province Hospital of Traditional Chinese Medicine, Taiyuan, China
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Yang C, Han J, Liu H, He Y, Zhang Z, Liu X, Waqas F, Zhang L, Duan H, He J, Dong L. Storage of plasma-derived exosomes: evaluation of anticoagulant use and preserving temperatures. Platelets 2024; 35:2337255. [PMID: 38630028 DOI: 10.1080/09537104.2024.2337255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 03/25/2024] [Indexed: 04/19/2024]
Abstract
Exosomes carry large cargo of proteins, lipids, and nucleic acids, serving as versatile biomarkers for disease diagnosis and vehicles for drug delivery. However, up to date, no well recognized standard procedures for exosome storage were available for clinical application. This study aimed to determine the optimal storage conditions and the anticoagulants for plasma-derived exosome isolation. Fresh whole blood samples were collected from healthy participants and preserved in four different anticoagulants including sodium citrate (SC1/4), sodium citrate (SC1/9), lithium heparin (LH), or Ethylenediamine tetraacetic acid (EDTA), respectively. Exosomes were extracted from the plasma by differential ultracentrifugation and stored at three different temperatures, 4°C, -20°C or - 80°C for a duration ranging from one week to six months. All plasma samples for storage conditions comparison were pretreated with LH anticoagulant. Exosome features including morphological characteristics, pariticles size diameter, and surface protein profiles (TSG101, CD63, CD81, CD9, CALNEXIN) were assessed by transmission electron microscopy, Nanoparticle Tracking Analysis, and Western Blotting, respectively. Exosomes preserved in LH and SC1/4 group tended to remain intact microstructure with highly abundant protein biomarkers. Exosomes stored at 4°C for short time were prone to be more stable compared to thos at -80°C. Exosomes stored in plasma were superior in terms of ultrastructure, size diameter and surface protein expression to those stored in PBS. In conclusion, plasma-dervied exosome characteristics strictly depend on the anticoagulants and storage temperature and duration.
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Affiliation(s)
- Caiting Yang
- Shanxi Provincial Key Laboratory for Medical Molecular Cell Biology, Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education and Institute of Biomedical Sciences, Shanxi University, Taiyuan, China
| | - Jie Han
- Center for Biomechanics and Bioengineering, Key Laboratory of Microgravity (National Microgravity Laboratory), and Beijing Key Laboratory of Engineered Construction and Mechanobiology, Institute of Mechanics, Chinese Academy of Sciences, Beijing, China
- School of Engineering Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Hai Liu
- Shanxi Provincial Key Laboratory for Medical Molecular Cell Biology, Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education and Institute of Biomedical Sciences, Shanxi University, Taiyuan, China
| | - Yuyu He
- Shanxi Provincial Key Laboratory for Medical Molecular Cell Biology, Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education and Institute of Biomedical Sciences, Shanxi University, Taiyuan, China
| | - Zhenhua Zhang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiaochun Liu
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Farooq Waqas
- Shanxi Provincial Key Laboratory for Medical Molecular Cell Biology, Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education and Institute of Biomedical Sciences, Shanxi University, Taiyuan, China
| | - Lizhong Zhang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Huiping Duan
- Tuberculosis Department, The Fourth People's Hospital of Taiyuan, Taiyuan, China
| | - Jing He
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Li Dong
- Shanxi Provincial Key Laboratory for Medical Molecular Cell Biology, Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education and Institute of Biomedical Sciences, Shanxi University, Taiyuan, China
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Héroin L, Christmann PY, Habersetzer F, Mayer P. Black esophagus: complete esophageal necrosis with lower esophageal perforation. Endoscopy 2024; 56:E53-E54. [PMID: 38262452 PMCID: PMC10805582 DOI: 10.1055/a-2226-0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Affiliation(s)
- Lucile Héroin
- Department of Hepatology and Gastroenterology, Pôle Hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
- Digestive Endoscopy, IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France
| | - Pierre-Yves Christmann
- Department of Hepatology and Gastroenterology, Pôle Hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
- Digestive Endoscopy, IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France
| | - François Habersetzer
- Department of Hepatology and Gastroenterology, Pôle Hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
- Digestive Endoscopy, IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France
- Inserm U1110, Institute for Viral and Liver Diseases, LabEx HepSYS, University of Strasbourg, Faculty of Medicine, Strasbourg, France
| | - Pierre Mayer
- Department of Hepatology and Gastroenterology, Pôle Hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg (HUS), Strasbourg, France
- Digestive Endoscopy, IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France
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Sahoo K, Sundararajan V. Methods in DNA methylation array dataset analysis: A review. Comput Struct Biotechnol J 2024; 23:2304-2325. [PMID: 38845821 PMCID: PMC11153885 DOI: 10.1016/j.csbj.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/25/2024] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
Understanding the intricate relationships between gene expression levels and epigenetic modifications in a genome is crucial to comprehending the pathogenic mechanisms of many diseases. With the advancement of DNA Methylome Profiling techniques, the emphasis on identifying Differentially Methylated Regions (DMRs/DMGs) has become crucial for biomarker discovery, offering new insights into the etiology of illnesses. This review surveys the current state of computational tools/algorithms for the analysis of microarray-based DNA methylation profiling datasets, focusing on key concepts underlying the diagnostic/prognostic CpG site extraction. It addresses methodological frameworks, algorithms, and pipelines employed by various authors, serving as a roadmap to address challenges and understand changing trends in the methodologies for analyzing array-based DNA methylation profiling datasets derived from diseased genomes. Additionally, it highlights the importance of integrating gene expression and methylation datasets for accurate biomarker identification, explores prognostic prediction models, and discusses molecular subtyping for disease classification. The review also emphasizes the contributions of machine learning, neural networks, and data mining to enhance diagnostic workflow development, thereby improving accuracy, precision, and robustness.
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Affiliation(s)
| | - Vino Sundararajan
- Correspondence to: Department of Bio Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore 632 014, Tamil Nadu, India.
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Rosón PJ, Fernandez Cano F, Romero MA, Paris A. Gastric peroral endoscopic myotomy mucosotomy closure using a novel hand suturing device. Endoscopy 2024; 56:E518-E519. [PMID: 38906173 PMCID: PMC11192589 DOI: 10.1055/a-2334-2750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Affiliation(s)
- Pedro J. Rosón
- Digestive System and Endoscopy Unit, Hospital Vithas Xanit, Benalmadena, Spain
| | | | - Mari A. Romero
- Digestive System and Endoscopy Unit, Hospital Vithas Xanit, Benalmadena, Spain
| | - Alicia Paris
- Digestive System and Endoscopy Unit, Hospital Vithas Xanit, Benalmadena, Spain
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45
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Huang H, Li J, Chen T, Lu M, Zhuoma G, Chen L, Gan Y, Ye H. The correlation between blood lipids and intrahepatic cholestasis syndrome during pregnancy. J OBSTET GYNAECOL 2024; 44:2369929. [PMID: 38963226 DOI: 10.1080/01443615.2024.2369929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 06/13/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND To analyse changes in lipid levels during the development of intrahepatic cholestasis of pregnancy (ICP) and identify new biomarkers for predicting ICP. METHODS A retrospective case-control study was conducted to analyse 473 pregnant women who underwent regular prenatal examinations and delivered at the Women and Children's Hospital, School of Medicine, Xiamen University, between June 2020 and June 2023, including 269 normal pregnancy controls and 204 pregnant women with cholestasis. RESULTS Patients with ICP with gestational diabetes mellitus (GDM) have lower high-density lipoprotein (HDL) levels than in those without GDM. Total bile acid (TBA) levels were significantly higher in pregnant women with GDM than those without. The apolipoprotein A (APOA) level was lower in patients with ICP and hypothyroidism than those without hypothyroidism. TBA levels were significantly higher in pregnant women with hypothyroidism than those without. Triglyceride (TG) levels were significantly higher in patients with preeclampsia (PE) than those without. HDL and APOA levels were lower in women with ICP complicated by preterm delivery than those with normal delivery. The AUC (area under the curve) of the differential diagnosis of cholestasis of pregnancy for the APOA/APOB (apolipoprotein B) ratio was 0.727, with a sensitivity of 85.9% and specificity of 47.5%. CONCLUSIONS The results suggested that dyslipidaemia is associated with an increased risk of ICP and its complications. The timely detection of blood lipid and bile acid levels can assist in the diagnosis of ICP and effectively prevent ICP and other complications.
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Affiliation(s)
- Huibin Huang
- Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen City, China
| | - Juan Li
- Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen City, China
| | - Tianhua Chen
- Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen City, China
| | - Meidan Lu
- Department of obstetrics, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen City, China
| | - Gunsang Zhuoma
- School of Public Health, Xiamen University, Xiamen City, China
| | - Lijin Chen
- Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen City, China
| | - Yuebin Gan
- Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen City, China
| | - Huiming Ye
- Department of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen City, China
- Department of Laboratory Medicine, School of Public Health, Xiamen University, Xiamen City, China
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Tomishima K, Suzuki A, Ito K, Ishii S, Fujisawa T, Fukumura Y, Isayama H. Remarkable tumor shrinkage in hilar biliary cholangiocarcinoma confirmed by peroral cholangioscopy following neoadjuvant chemotherapy. Endoscopy 2024; 56:E85-E86. [PMID: 38290706 PMCID: PMC10827524 DOI: 10.1055/a-2234-4355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- Ko Tomishima
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Akinori Suzuki
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Koichi Ito
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Shigeto Ishii
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Toshio Fujisawa
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yuki Fukumura
- Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroyuki Isayama
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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47
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Bu C, Wang Z, Lv X, Zhao Y. A dual-gene panel of two fragments of methylated IRF4 and one of ZEB2 in plasma cell-free DNA for gastric cancer detection. Epigenetics 2024; 19:2374988. [PMID: 39003776 PMCID: PMC11249030 DOI: 10.1080/15592294.2024.2374988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024] Open
Abstract
Early detection is crucial for increasing the survival rate of gastric cancer (GC). We aimed to identify a methylated cell-free DNA (cfDNA) marker panel for detecting GC. The differentially methylated CpGs (DMCs) were selected from datasets of The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. The selected DMCs were validated and further selected in tissue samples (40 gastric cancer and 36 healthy white blood cell samples) and in a quarter sample volume of plasma samples (37 gastric cancer, 12 benign gastric disease, and 43 healthy individuals). The marker combination selected was then evaluated in a normal sample volume of plasma samples (35 gastric cancer, 39 control diseases, and 40 healthy individuals) using real-time methylation-specific PCR (MSP). The analysis of the results compared methods based on 2-ΔΔCt values and Ct values. In the results, 30 DMCs were selected through bioinformatics methods, and then 5 were selected for biological validation. The marker combination of two fragments of IRF4 (IRF4-1 and IRF4-2) and one of ZEB2 was selected due to its good performance. The Ct-based method was selected for its good results and practical advantages. The assay, IRF4-1 and IRF4-2 in one fluorescence channel and ZEB2 in another, obtained 74.3% sensitivity for the GC group at any stage, at 92.4% specificity. In conclusion, the panel of IRF4 and ZEB2 in plasma cfDNA demonstrates good diagnostic performance and application potential in clinical settings.
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Affiliation(s)
- Chunxiao Bu
- Department of Magnetic Resonance Imaging,The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhilong Wang
- Henan Academy of Medical Sciences, Zhengzhou, Henan, China
| | - Xianping Lv
- Department of Transfusion, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yanteng Zhao
- Department of Transfusion, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Rossier LN, Décosterd NP, Matter CB, Staudenmann DA, Moser A, Egger B, Seibold FW. SARS-CoV-2 vaccination in inflammatory bowel disease patients is not associated with flares: a retrospective single-centre Swiss study. Ann Med 2024; 56:2295979. [PMID: 38289017 PMCID: PMC10829820 DOI: 10.1080/07853890.2023.2295979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/12/2023] [Indexed: 02/01/2024] Open
Abstract
INTRODUCTION Vaccination hesitancy is an important barrier to vaccination among IBD patients. The development of adverse events is the main concern reported. The purpose of this monocentric study was to assess SARS-CoV-2 vaccination safety in IBD patients by evaluating the postvaccination flare risk and incidence of overall adverse events. METHODS Surveys were handed out on three consecutive months to each patient presenting at the Crohn-Colitis Centre, where they documented their vaccination status and any side effects experienced after vaccination.Dates of flares occurring in 2021 were recorded from their electronic medical records. Baseline and IBD characteristics and flare incidence were compared between the vaccinated and unvaccinated patients, and among the vaccinated population before and after their vaccination doses. The characteristics of patients who developed side effects and of those who did not were compared. RESULTS We enrolled 396 IBD patients, of whom 91% were vaccinated. The proportion of patients who experienced flares was statistically not different between the vaccinated and the unvaccinated population (1.8 vs 2.6 flares per 100 person-months (p = 0.28)). Among vaccinated patients, there was no difference across the prevaccination, 1 month post any vaccination, and more than 1 month after any vaccination periods, and between the Spikevax and Cominarty subgroups. Overall, 46% of patients reported vaccination side effects, mostly mild flu-like symptoms. CONCLUSION SARS-CoV-2 vaccination with mRNA vaccines seems safe, with mostly mild side effects. The IBD flare risk is not increased in the month following any vaccination.
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Affiliation(s)
- Laura N. Rossier
- Intesto, Gastroenterology and Crohn-Colitis Center, Fribourg and Berne, Switzerland
- Faculty of Medicine, University of Fribourg, Switzerland
| | - Natalie P. Décosterd
- Intesto, Gastroenterology and Crohn-Colitis Center, Fribourg and Berne, Switzerland
| | - Christoph B. Matter
- Intesto, Gastroenterology and Crohn-Colitis Center, Fribourg and Berne, Switzerland
| | - Dominic A. Staudenmann
- Intesto, Gastroenterology and Crohn-Colitis Center, Fribourg and Berne, Switzerland
- Faculty of Medicine, University of Fribourg, Switzerland
| | | | - Bernhard Egger
- Faculty of Medicine, University of Fribourg, Switzerland
- Department of Surgery, Cantonal Hospital Fribourg
| | - Frank W. Seibold
- Intesto, Gastroenterology and Crohn-Colitis Center, Fribourg and Berne, Switzerland
- Faculty of Medicine, University of Fribourg, Switzerland
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Shiomi D, Sumi K, Kawasaki Y, Nomura N, Ushio J, Ito T, Inoue H. Endoscopic hand suturing of a covered self-expandable metal stent to prevent migration in malignant gastric outlet obstruction. Endoscopy 2024; 56:E422-E423. [PMID: 38759971 PMCID: PMC11101266 DOI: 10.1055/a-2313-3869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Affiliation(s)
- Daijiro Shiomi
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Kazuya Sumi
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Yuki Kawasaki
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Norihiro Nomura
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Jun Ushio
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Takayoshi Ito
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Haruhiro Inoue
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
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50
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Shi L, Wei S, Yan Q, Xie JX, Wu J, Wang L. A migrating fishbone. Endoscopy 2024; 56:E116-E117. [PMID: 38325413 PMCID: PMC10849842 DOI: 10.1055/a-2233-2968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Affiliation(s)
- Lei Shi
- Department of Gastroenterology, Shenzhen People’s Hospital (Second Clinical Medical College, Jinan University), Shenzhen, China
- Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - SaiLing Wei
- Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qiong Yan
- Department of Gastroenterology, Shenzhen People’s Hospital (Second Clinical Medical College, Jinan University), Shenzhen, China
- Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jia Xun Xie
- Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - JinYu Wu
- Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lisheng Wang
- Department of Gastroenterology, Shenzhen People’s Hospital (Second Clinical Medical College, Jinan University), Shenzhen, China
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