151
|
Jaan A, Farooq U, Dhawan A, Maqsood MT, Shahnoor S, Maryyum A, Imtiaz Z, Gutman J, Dunnigan K, Mcfarland MS, Mushtaq A. Understanding the role of nutritional status on the outcomes of nonvariceal upper gastrointestinal bleeding: Findings from a retrospective cohort analysis. Clin Nutr 2025; 47:204-211. [PMID: 40037115 DOI: 10.1016/j.clnu.2025.02.021] [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: 07/24/2024] [Revised: 02/18/2025] [Accepted: 02/19/2025] [Indexed: 03/06/2025]
Abstract
BACKGROUND & AIMS Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a common cause of hospitalization worldwide. Malnutrition, on the other hand, varies in prevalence and closely correlates with age and comorbidities. Though malnutrition is linked to poor outcomes generally, its impact on NVUGIB patients remains unexplored. METHODS Using the National Readmission Database (NRD) from 2016 to 2020, we employed the International Classification of Diseases, 10th revision, Clinical Modifications (ICD-10-CM) codes to identify adult patients (aged ≥18 years) admitted with a principal diagnosis of NVUGIB. We further stratified NVUGIB hospitalizations based on the presence and severity of malnutrition. Utilizing a multivariate regression model, we assessed the impact of malnutrition on NVUGIB outcomes. STATA 14.2 was utilized for statistical analysis. RESULTS Out of the 742,592 adult patients admitted with NVUGIB, 76,603 (10.32 %) had malnutrition, categorized as mild to moderate (3.01 %), severe (4.00 %), and malnutrition of unspecified severity (3.29 %). After adjusting for confounding variables, all-cause in-hospital mortality due to NVUGIB was significantly higher in malnourished patients, corresponding to the severity of malnutrition (adjusted odds ratio [aOR] 1.83 & 3.52 in mild-moderate malnutrition and severe malnutrition respectively; P < 0.01). Similarly, malnutrition was associated with progressively higher odds of acute kidney injury (aOR 1.39 & 1.54 for mild-moderate and severe malnutrition, respectively), septic shock (aOR 2.41 & 5.12), hemorrhagic shock (aOR 1.71 & 2.16), and intensive care unit (ICU) admission (aOR 2.00 & 2.97), all increasing with malnutrition severity (P < 0.01). Procedural analysis showed lower odds of diagnostic EGD (aOR 0.95 & 0.92), EGD within 24 h (aOR 0.75 & 0.67), and overall EGD (aOR 0.80 & 0.66) in malnourished patients, but higher odds of rebleeding requiring repeat EGD (aOR 1.12 & 1.19) and radioembolization (aOR 2.04 & 2.75), both rising with malnutrition severity (P < 0.01). Finally, resource utilization estimated by total hospitalization charges, length of stay, discharge to rehabilitation facilities (aOR 1.99 & 2.66), and 30-day readmission rates (aOR 1.29 & 1.38) were also significantly higher among patients with malnutrition (P < 0.01). CONCLUSION Malnutrition exacerbates the outcomes of NVUGIB including higher in-hospital mortality rates, morbidity and resource utilization. Early identification and targeted management of malnutrition in NVUGIB patients are crucial to reducing adverse outcomes and optimizing healthcare resources.
Collapse
Affiliation(s)
- Ali Jaan
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA.
| | - Umer Farooq
- Department of Gastroenterology, Saint Louis University, MO, USA
| | - Ashish Dhawan
- Department of Internal Medicine, Gian Sagar Medical College and Hospital, Punjab, India
| | | | - Syeda Shahnoor
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Adeena Maryyum
- Department of Medicine, Ayub Medical College, Abbottabad, Pakistan
| | - Zeeshan Imtiaz
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Jason Gutman
- Department of Gastroenterology, Rochester General Hospital, Rochester, NY, USA
| | - Karin Dunnigan
- Department of Gastroenterology, Rochester General Hospital, Rochester, NY, USA
| | - Mark S Mcfarland
- Department of Gastroenterology, Rochester General Hospital, Rochester, NY, USA
| | - Asim Mushtaq
- Department of Gastroenterology, Rochester General Hospital, Rochester, NY, USA
| |
Collapse
|
152
|
Rabinowitz LG, Gade A, Feuerstein JD. Medical management of acute severe ulcerative colitis in the hospitalized patient. Expert Rev Gastroenterol Hepatol 2025; 19:467-480. [PMID: 40187895 DOI: 10.1080/17474124.2025.2488884] [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: 11/25/2024] [Accepted: 04/01/2025] [Indexed: 04/07/2025]
Abstract
INTRODUCTION Approximately one in every four patients with ulcerative colitis will develop acute severe ulcerative colitis (ASUC). Historically, this was managed with intravenous steroids and surgery when steroids failed. The use of rescue therapy. AREAS COVERED This review summarizes the latest research in the management of hospitalized patients with ASUC. Covering the historical data and success of rescue therapy with cyclosporine and then with infliximab changed outcomes and reduced the risk of colectomy during the hospitalization and at 1 year. More recently, more biologics and small molecules have been approved and more patients present to the hospital with ASUC already failing anti-tumor necrosis factor antagonists. More recent studies have shown some efficacy of rescue therapy with other classes of biologics (e.g. interleukins and anti-integrins). The more recently approved small molecules (i.e. tofacitinib and Upadacitinib) have shown a rapid onset in therapeutic efficacy in as little as 1 day with sustained response at 1 year in reducing the risk of colectomy following ASUC. EXPERT OPINION In the expert opinion, we discuss the challenges in the treatment of patients with ASUC. We summarize the data of current biologics and new small molecules and their emerging roles in the management of ASUC.
Collapse
Affiliation(s)
- Loren G Rabinowitz
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ajay Gade
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Joseph D Feuerstein
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
153
|
Generalov E, Laryushkin D, Kritskaya K, Kulchenko N, Sinitsyn A, Yakovenko L, Generalova L, Belostotsky N. Immune Basis of Therapeutic Effects of Solanum tuberosum L. Polysaccharide on Chronic Peptic Ulcer Healing. Pharmaceuticals (Basel) 2025; 18:502. [PMID: 40283939 PMCID: PMC12030385 DOI: 10.3390/ph18040502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2025] [Revised: 03/20/2025] [Accepted: 03/28/2025] [Indexed: 04/29/2025] Open
Abstract
Background/Objectives: Polysaccharides are complex molecules with a wide range of biological activities that can be used in various biomedical applications. In this work, the antiulcer effect and influence on the level of pro- and anti-inflammatory cytokines of Solanum tuberosum L. polysaccharide (STP) were studied. Methods: The antiulcer effect of STP was studied in the Okabe chronic peptic ulcer model by evaluating the influence of STP on the ulcer index in Wistar rats, comparing it to omeprazole and ranitidine. Dose-effect analysis was also carried out. The level of pro- and anti-inflammatory cytokines was studied using ELISA kits. Results: After treatment in the polysaccharide groups, ulcer healing is observed in 60-80% of cases, in the omeprazole group in 50%, and in the ranitidine group in 25%. STP intravenous injections lead to the formation of a more differentiated mucous membrane; no coarse scar tissue is formed, which is typical for control and comparison drugs. Glycan causes a significant acceleration of the healing of experimental peptic ulcers in rats. STP appears to modulate pro- and anti-inflammatory cytokines. On the fourth and tenth days, a significant decrease in the levels of pro-inflammatory cytokines IL-1b and IFN-γ was noted in the polysaccharide group compared to the control group, while the level of anti-inflammatory cytokine IL-4 significantly increased. Conclusions: Intravenous administration of STP leads to the restoration of functionality and effective tissue regeneration. The antiulcer activity of STP is based on the regulation of the pro- and anti-inflammatory balance.
Collapse
Affiliation(s)
- Evgenii Generalov
- Faculty of Physics, Lomonosov Moscow State University, 119991 Moscow, Russia;
| | - Denis Laryushkin
- Federal Research Center “Pushchino Scientific Center for Biological Research of the Russian Academy of Sciences”, Institute of Cell Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (D.L.); (K.K.)
| | - Kristina Kritskaya
- Federal Research Center “Pushchino Scientific Center for Biological Research of the Russian Academy of Sciences”, Institute of Cell Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (D.L.); (K.K.)
| | - Nina Kulchenko
- Scientific and Educational Resource Center for Innovative Technologies of Immunophenotyping, Digital Spatial Profiling and Ultrastructural Analysis of the RUDN University, 117198 Moscow, Russia;
- Department of Tumors of the Reproductive and Urinary Organs of Oncourology P.A. Hertsen Moscow Oncology Research Institute—Branch of the National Medical Research Radiological Centre, 125284 Moscow, Russia
| | - Arkady Sinitsyn
- Faculty of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia;
- Federal Research Centre ‘Fundamental of Biotechnology’ of the Russian Academy of Sciences (FRC Biotechnology RAS), 119071 Moscow, Russia
| | - Leonid Yakovenko
- Faculty of Physics, Lomonosov Moscow State University, 119991 Moscow, Russia;
| | | | - Nikolay Belostotsky
- A.S. Loginov Moscow Clinical Research and Practical Center of the Department of Health of Moscow, 111123 Moscow, Russia;
| |
Collapse
|
154
|
Wu M, Liu D, Xiong X, Su Q, Xiang Y, Shen L, An Z, Yang X. Analysis of the molecular mechanisms of ulcerative colitis and atherosclerosis by microarray data. Sci Rep 2025; 15:10715. [PMID: 40155679 PMCID: PMC11953266 DOI: 10.1038/s41598-025-95125-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Accepted: 03/19/2025] [Indexed: 04/01/2025] Open
Abstract
Adults can develop ulcerative colitis (UC), a chronic inflammatory illness of the colon, while atherosclerosis (AA) is a chronic inflammatory disease of the blood vessels caused by a range of risk factors. Prior research has demonstrated that UC increases the risk of AA, although the underlying pathological mechanisms are not entirely understood. The purpose of this work was to discover differentially expressed genes (DEGs) in UC and AA and investigate their molecular processes using a bioinformatics method. The UC (GSE36807) and AA (GSE28829) datasets were obtained from the Gene Expression Omnibus (GEO) database. Following the identification of genes that are differentially expressed in common with UC and AA, functional annotation, the construction of protein-protein interaction (PPI) networks and modules, the identification of hub genes, and co-expression analysis were carried out. A total of 105 (including 92 up-regulated and 13 down-regulated genes) DEGs were selected for correlation analysis in the above two datasets, and after Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional analysis immune responses, cytokines, and chemokines were found to play crucial roles in both diseases. Finally, a total of 16 hub genes were identified by CytoHubba and MCODE plugins in Cytoscape, including Chemokine (C-C motif) ligand 4(CCL4), Toll-like receptor 2 (TLR2), Integrin Beta 2(ITGB2), Chemokine (C-C motif) Receptor 1(CCR1), Toll-Like Receptor 8 (TLR8), Fc Fragment of IgG Receptor IIa (FCGR2A), Neutrophil Cytosolic Factor 2(NCF2), Leukocyte immunoglobulin-like receptor B2(LILRB2), FGR proto-oncogene, Src family tyrosine kinase(FGR), Intercellular Adhesion Molecule 1 (ICAM1), Caspase 1(CASP1), Matrix Metallopeptidase 9(MMP9), Cluster of Differentiation 163(CD163), Complement Component 5a Receptor 1 (C5AR1), Neutrophil Cytosolic Factor 4 (NCF4), Selectin P (SELP). This study discovered a link between UC and AA, as well as shared hub genes and pathways, which may bring new insights into the processes of UC and AA.
Collapse
Affiliation(s)
- Min Wu
- Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, China
| | - Dong Liu
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, China
| | - Xiaoman Xiong
- Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, China
| | - Qiang Su
- Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, China
| | - Yi Xiang
- Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, China
| | - Lang Shen
- Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, China
| | - Zhenxiang An
- The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, 550001, China.
| | - Xiaofang Yang
- Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, China.
| |
Collapse
|
155
|
Di Fulvio M, Rathod YD, Khader S. Diuretics: a review of the pharmacology and effects on glucose homeostasis. Front Pharmacol 2025; 16:1513125. [PMID: 40223924 PMCID: PMC11985539 DOI: 10.3389/fphar.2025.1513125] [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: 10/17/2024] [Accepted: 03/07/2025] [Indexed: 04/15/2025] Open
Abstract
Thiazides, thiazide-like and loop diuretics are commonly prescribed to manage hypertension and heart failure. The main mechanism of action of these diuretics involve inhibition of Na+ reabsorption in the kidneys, leading to increased urine production. While effective, diuretics, particularly hydrochlorothiazide, have been linked to altered glucose metabolism and other metabolic issues. These disruptions in fuel homeostasis are not clearly related to their primary action of fluid management, raising concerns for patients with metabolic syndrome, in which high blood pressure coexists with obesity, insulin resistance, glucose intolerance and dyslipidemia. In this review, we conducted an extensive examination of existing literature on these classes of diuretics, covering publications from the late 1950s to the present. Our objective was to investigate the origins, development and current understanding of the widely recognized association between the use of diuretics in general and their potential negative impact on glucose homeostasis. We focused on the clinical and experimental evidence of the most commonly prescribed diuretics: hydrochlorothiazide, chlorthalidone, bumetanide and furosemide. On one hand, the clinical evidence supports the hypothesis that the metabolic effects on glucose homeostasis are primarily linked to hydrochlorothiazide, with little, if any impact observed in other diuretics. In addition, these metabolic effects do not appear to be related to their diuretic action or intended pharmacological targets, raising concerns about the long-term metabolic impact of specific diuretics, particularly in vulnerable populations, including those with metabolic syndrome. On the other hand, the experimental evidence using animal models suggest variable effects of diuretics in insulin secretion and general glucose metabolism. Although the mechanisms involved are not clearly understood, further research is needed to uncover the molecular mechanisms by which certain diuretics disrupt fuel metabolism and contribute to metabolic disturbances.
Collapse
Affiliation(s)
- Mauricio Di Fulvio
- Department of Pharmacology and Toxicology, School of Medicine, Wright State University, Dayton, OH, United States
| | | | | |
Collapse
|
156
|
Munster LJ, Meriba GR, Schuitema J, van Dieren S, de Groof EJ, Mundt MW, D'Haens GR, Bemelman WA, Buskens CJ, van der Bilt JDW. Early diagnosis of Crohn's disease in patients presenting with a perianal fistula: systematic review and development of a perianal red flags index. Tech Coloproctol 2025; 29:89. [PMID: 40155532 PMCID: PMC11953225 DOI: 10.1007/s10151-024-03106-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Accepted: 12/23/2024] [Indexed: 04/01/2025]
Abstract
BACKGROUND Delay in diagnosing Crohn's disease (CD) in patients presenting with perianal abscess (PAA) and/or fistula (PAF) is common. The aim of this study was to identify red flags suggestive of CD. METHODS A systematic literature review was conducted to identify symptoms associated with CD in patients presenting with PAA/PAF. A questionnaire including those symptoms, supplemented with items from the International Organization for the Study of Inflammatory Bowel Diseases (IO-IBD) red flags index for luminal CD, was administered to all adult patients presenting with a PAF and eventually diagnosed with CD and matched patients (1:3) from the same study period with a cryptoglandular PAF (2012-2023) at a single non-academic teaching hospital. All patients were asked to recall symptoms/signs experienced during their first PAF. RESULTS The systematic review identified 8 articles reporting on 15 clinical characteristics in patients presenting with PAA (n = 2)/PAF (n = 6), supplemented with 13 items from the IO-IBD red flags index (28 items in total). A total of 25 patients with CD and 75 patients with PAF without CD answered the questionnaire. Univariate analysis identified seven items associated with CD (age, family history, > 2 perianal interventions, weight loss, abdominal pain, diarrhoea and fatigue), and four items remained significant in multivariate analysis: age (OR 3.4 [1.0-11.5]), > 2 previous perianal interventions (OR 3.4 [1.0-10.1]), weight loss (OR 14.4 [3.7-55.6]) and abdominal pain (OR 9.8 [1.9-49.8]). Receiver-operating characteristic curve (ROC) analysis showed that a combination of these red flags was associated with good discrimination of CD versus non-CD (AUC 0.83 [0.72-0.94]). CONCLUSIONS The perianal red flags index has a good predictive value for early identification of patients with PAF at risk for underlying CD.
Collapse
Affiliation(s)
- L J Munster
- Department of Surgery, Flevoziekenhuis, Almere, The Netherlands.
- Department of Surgery, Amsterdam UMC (Location VUmc), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - G R Meriba
- Department of Surgery, Flevoziekenhuis, Almere, The Netherlands
- Department of Surgery, Amsterdam UMC (Location VUmc), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - J Schuitema
- Department of Surgery, Flevoziekenhuis, Almere, The Netherlands
- Department of Surgery, Amsterdam UMC (Location VUmc), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - S van Dieren
- Department of Surgery, Amsterdam UMC (Location VUmc), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - E J de Groof
- Department of Surgery, Flevoziekenhuis, Almere, The Netherlands
- Department of Surgery, Amsterdam UMC (Location VUmc), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - M W Mundt
- Department of Gastroenterology and Hepatology, Flevoziekenhuis, Almere, The Netherlands
| | - G R D'Haens
- Department of Gastroenterology and Hepatology, Amsterdam UMC (Location VUmc), Amsterdam, The Netherlands
| | - W A Bemelman
- Department of Surgery, Amsterdam UMC (Location VUmc), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - C J Buskens
- Department of Surgery, Amsterdam UMC (Location VUmc), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - J D W van der Bilt
- Department of Surgery, Flevoziekenhuis, Almere, The Netherlands
- Department of Surgery, Amsterdam UMC (Location VUmc), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| |
Collapse
|
157
|
Farzanegan M, Azizi A, Fard SS, Sadeghi A, Arefi M, Badi HS, Adibi P, Daghaghzadeh H, Zanjani HA. Effectiveness of a bioenergy economy program versus mindfulness-based cognitive therapy on the severity and psychological symptoms of irritable bowel syndrome. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2025; 14:107. [PMID: 40271268 PMCID: PMC12017422 DOI: 10.4103/jehp.jehp_1924_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/20/2024] [Indexed: 04/25/2025]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder causing a great burden on patients' lives due to its physical and psychological symptoms. Mindfulness-based cognitive therapy (MBCT) has previously alleviated IBS symptoms. Bioenergy economy (BEE) is a novel mind-body intervention that has shown moderating effects on many psychological and physical symptoms, particularly in chronic diseases. This research aimed to compare the effectiveness of MBCT and BEE on IBS symptom severity, somatic symptoms, depression, and anxiety. MATERIALS AND METHODS This study was conducted using a quasi-experimental method with a pre-test, post-test, and follow-up design with a control group in Isfahan, Iran. Forty-five patients with IBS were divided into two experimental and one control group (15 subjects in each group). The patients were assessed using the ROME III Diagnostic Criteria for IBS, IBS Severity Index (IBS-SI), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory, and Patient Health Questionnaire (PHQ-15) before and after the intervention. Data were analyzed using analysis of covariance, and SPSS-22 software was used. RESULTS The findings showed that MBCT and BEE both had significant effects on the IBS symptom severity, somatic symptoms, depression, and anxiety (P < 0.01), but there was no significant difference between the mean scores of the two experimental groups in any of the post-test or the follow-up stages (P > 0.05). This concludes that there was no difference between the effectiveness of MBCT and BEE programs (P > 0.05). CONCLUSION Although both interventions had significant results in improving patients' symptoms, the BEE program had a stronger and wider range of effectiveness.
Collapse
Affiliation(s)
- Mahboubeh Farzanegan
- Department of Bioenergy and Psychosomatic Health, Energy Medicine University, California, USA
- Department of Psychosomatic Research, Danesh-e Tandorosti Institute, Isfahan, Iran
| | - Ali Azizi
- Department of Psychosomatic Research, Danesh-e Tandorosti Institute, Isfahan, Iran
| | - Shahla Safavi Fard
- Department of Psychology, Islamic Azad University of Khorasgan, Isfahan, Iran
| | - Ali Sadeghi
- Department of Psychosomatic Research, Danesh-e Tandorosti Institute, Isfahan, Iran
| | - Mozhgan Arefi
- Department of Psychology, Islamic Azad University of Khorasgan, Isfahan, Iran
| | - Hasan Shahoon Badi
- Gastroenterology and Liver Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Payman Adibi
- Gastroenterology and Liver Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Daghaghzadeh
- Gastroenterology and Liver Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | |
Collapse
|
158
|
Tawfik RTM, Abd El-Azeem EM, Elsonbaty SM, Ibrahim EA. Green-synthesized selenium-hydroxytyrosol nanocomposites attenuate hepatocellular carcinoma in rats by modulating oxidative stress, inflammation, and apoptosis. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2025:10.1007/s00210-025-04034-w. [PMID: 40146247 DOI: 10.1007/s00210-025-04034-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/30/2025] [Accepted: 03/06/2025] [Indexed: 03/28/2025]
Abstract
Hepatocellular carcinoma (HCC) poses a significant health risk and greatly affects global rates of illness and death, highlighting an urgent requirement for new treatment strategies. This study examines the therapeutic effects of selenium-hydroxytyrosol nanocomposites (Se-HTNPs) in a rat model with HCC caused by diethylnitrosamine (DEN). Treatment with Se-HTNPs significantly inhibited serum activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin, while increasing serum albumin and total protein levels. Oxidative stress was alleviated, as evidenced by a marked reduction in hepatic malondialdehyde (MDA) levels and an increase in antioxidant markers, such as reduced glutathione (GSH), superoxide dismutase (SOD), and total antioxidant capacity (TAC). Se-HTNPs also significantly decreased hepatic inflammatory markers, such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β), as well as apoptotic markers (p53 and caspase-3) and vascular endothelial growth factor (VEGF). Furthermore, Se-HTNPs suppressed the mRNA expression of c-Jun N-terminal kinase (c-JNK) and nuclear factor kappa B (NF-κB) and improved histopathological alterations brought on by DEN. These findings suggest that Se-HTNPs mitigate DEN-induced HCC in rats through their potent antioxidant, anti-inflammatory, and anti-carcinogenic properties, underscoring their potential as a therapeutic strategy for HCC.
Collapse
Affiliation(s)
- Radwa T M Tawfik
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Eman M Abd El-Azeem
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Sawsan M Elsonbaty
- National Center for Radiation Research and Technology, Atomic Energy Authority, Cairo, Egypt
| | - Ehab A Ibrahim
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt.
| |
Collapse
|
159
|
Kumari S. Mesothelin as a Signal Pathways and Epigenetic Target in Cancer Therapy. Cancers (Basel) 2025; 17:1118. [PMID: 40227616 PMCID: PMC11987799 DOI: 10.3390/cancers17071118] [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: 02/28/2025] [Revised: 03/23/2025] [Accepted: 03/25/2025] [Indexed: 04/15/2025] Open
Abstract
Mesothelin (MSLN), a glycoprotein-based tumor antigen, is elevated in several malignancies and it is related to a poor prognosis, as it enhances tumor aggression, dissemination and chemotherapy resistance. MSLN plays a crucial role in epigenetic and signal pathway regulation and it can be an important biomarker. MSLN targeting is in particular, associated with CA125/MUC16, which offers the potential to improve lung, pancreatic, colon and ovarian cancer detection as well as therapeutic strategies. MSLNtargeted therapies have shown favorable results, such as CAR NK cells, 227Th conjugate and CAR-T cells, which target mesothelin. Significant advancements can be achieved with novel techniques, such as mesothelin-targeting BiTEs and simultaneous CAR-T cells. Immunotherapies targeting mesothelin have the potential to completely transform the way cancer is therapy in patients with limited options. To fully comprehend the mechanisms of MSLN, more investigation is required to explore its role in cancer for improved patient outcomes. The complex control, cellular functions and clinical significance of MSLN in the advancement of cancer are highlighted in this review.
Collapse
Affiliation(s)
- Seema Kumari
- Department of Biotechnology, Dr. B.R Ambedkar University, Srikakulam 532410, Andhra Pradesh, India
| |
Collapse
|
160
|
Morvaridi M, Aryaeian N, Alavinejad P, Seyedian SS, Ghafourian M, Bakhtiari N, Seyedtabib M. Zatariamultiflora hydroalcoholic extract: A triple-blind randomized controlled trial on immune genes, inflammation, and ulcerative colitis symptoms. JOURNAL OF ETHNOPHARMACOLOGY 2025; 344:119527. [PMID: 39987994 DOI: 10.1016/j.jep.2025.119527] [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: 09/10/2024] [Revised: 02/02/2025] [Accepted: 02/19/2025] [Indexed: 02/25/2025]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Zataria multiflora Boiss. (Shirazi thyme) is traditionally used for digestive disorders and inflammatory conditions. Despite its known anti-inflammatory, immunomodulatory, and antioxidant properties, there is limited clinical evidence on its efficacy for ulcerative colitis (UC). AIM OF THE STUDY To evaluate the effectiveness of Zataria multiflora Boiss. (Z. multiflora) extract in alleviating UC symptoms, reducing inflammatory markers, and modulating immune-related gene expression. MATERIALS AND METHODS In a multicenter, randomized, placebo-controlled, triple-blind trial in Iran, 92 participants received Z. multiflora extract (6 mg/kg/day) or a placebo for two months. Inflammatory markers and gene expression were analyzed from blood samples. Disease activity was assessed using the Partial Mayo Score (p-Mayo) and the Gastrointestinal Symptom Rating Scale (GSRS). Data were analyzed with SPSS software. RESULTS The Z. multiflora group showed significant reductions in C-reactive protein (CRP) (p < 0.001), Interleukin-17 (IL-17) (p = 0.001), Interferon-gamma (IFN-γ) (p = 0.002), Nuclear Factor kappa B (NF-κB) (p = 0.002), T-box Transcription Factor T-bet (T-bet) (p = 0.006), and Retinoic Acid-Related Orphan Receptor gamma t (ROR-γt) (p < 0.001). No significant changes were observed in Erythrocyte Sedimentation Rate (ESR) (p = 0.25), GATA Binding Protein 3 (GATA3) (p = 0.09), and Forkhead Box P3 (FOXP3) (p = 0.17). Symptoms such as heartburn, acid reflux, bloating, diarrhea, and fecal urgency improved (p < 0.05). The GSRS score improved (p < 0.001), while the p-Mayo score did not show a significant change (p = 0.24). CONCLUSION Z. multiflora extract significantly alleviated UC symptoms and reduced inflammatory markers, indicating its potential as a complementary treatment for UC. However, the study was limited by its short intervention period and the absence of biopsy analysis to assess local tissue effects. Further longitudinal studies are required to validate these findings and determine long-term efficacy.
Collapse
Affiliation(s)
- Mehrnaz Morvaridi
- Department of Nutrition Sciences, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Naheed Aryaeian
- Department of Nutrition Sciences, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Nutritional Sciences Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Pezhman Alavinejad
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Saeed Seyedian
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehri Ghafourian
- Department of Immunology, Fertility, Infertility and Perinatology Research Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nima Bakhtiari
- Pain Research Center, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Iran
| | - Maryam Seyedtabib
- Department of Biostatistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
161
|
Zhao Y, He L, Sun L, Liu W, Wang H, Zhang J, Gong Y, Wang X. RdxA-independent mechanism of Helicobacter pylori metronidazole metabolism. Front Microbiol 2025; 16:1553734. [PMID: 40207148 PMCID: PMC11979234 DOI: 10.3389/fmicb.2025.1553734] [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: 12/31/2024] [Accepted: 03/13/2025] [Indexed: 04/11/2025] Open
Abstract
Introduction Metronidazole (MNZ) is widely used to treat Helicobacter pylori infection worldwide. However, due to excessive and repeated use, resistance rates have exceeded 90% in some regions. The mechanisms of MNZ resistance have been extensively studied, and RdxA has been identified as the primary enzyme responsible for MNZ activation. Mutations in RdxA, particularly termination mutations, can lead to high-level MNZ resistance. Methods We identified a strain, ICDC15003s, which harbored RdxA termination mutation but remained highly susceptible to MNZ. To explore this phenomenon, we conducted comparative genomic and transcriptomic analyses to define RdxA-independent mechanisms of MNZ metabolism. Results and discussion We found missense mutations in genes such as yfkO, acxB, alr1, glk, and cobB. Additionally, the expression of multiple genes, including TonB-dependent receptor and mod, significantly changed in resistant strains. Notably, the sequences and expression levels of known nitroreductases like FrxA and FdxB remained unchanged after induction of MNZ resistance, suggesting they were not responsible for MNZ sensitivity in ICDC15003s. Instead, transcriptional alterations were observed in genes encoding NADH-quinone oxidoreductase subunit (M, J, H and K), suggesting a potential compensatory mechanism for the loss of RdxA activity. We proposed that NADH-quinone oxidoreductase might serve as an RdxA-independent mechanism for MNZ metabolism and resistance through regulation of its expression levels. This discovery could provide new strategies to address MNZ resistance and aid in developing nitroimidazole antibiotics.
Collapse
Affiliation(s)
- Yakun Zhao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Health Statistics, China Medical University, Shenyang, China
| | - Lihua He
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lu Sun
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wentao Liu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hairui Wang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianzhong Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanan Gong
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaohui Wang
- Department of Gastroenterology, The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
162
|
Qu YT, Ding JY, Pan W, Liu FR, Dong AL. Perspectives in clinical research on Azathioprine for steroid-dependent ulcerative colitis. Front Med (Lausanne) 2025; 12:1551906. [PMID: 40201324 PMCID: PMC11975918 DOI: 10.3389/fmed.2025.1551906] [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: 12/26/2024] [Accepted: 03/11/2025] [Indexed: 04/10/2025] Open
Abstract
This study explores the application of Azathioprine in the treatment of ulcerative colitis (UC) and the challenges associated with its long-term use. While short-term studies demonstrate the efficacy of Azathioprine in steroid-dependent UC, long-term data on its risks, including malignancies, infections, and chronic toxicity, remain insufficient. Furthermore, the impact of Azathioprine on patients' quality of life over extended periods is still unclear. The research highlights the importance of optimizing Azathioprine dosing based on genomic data, particularly through TPMT and NUDT15 genotyping, to minimize adverse effects. However, further research is needed to develop individualized treatment strategies that can improve efficacy and reduce toxicity. The identification of predictive biomarkers, through genomics and proteomics, is likely to play a crucial role in improving treatment precision by identifying patients who are most likely to benefit from Azathioprine therapy. Additionally, combining Azathioprine with biologic therapies (such as anti-TNF agents or integrin inhibitors) and interventions targeting the gut microbiome may enhance the drug's effectiveness while reducing reliance on steroids. Overall, large-scale clinical trials are urgently needed to evaluate the benefits and risks of these emerging therapies, ultimately supporting more personalized treatment approaches for steroid-dependent UC patients.
Collapse
Affiliation(s)
- Yuan-Ting Qu
- Department of Gastroenterology, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China
| | - Jia-Yuan Ding
- Department of Gastroenterology, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China
| | - Wei Pan
- Department of Gastroenterology, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China
| | - Fang-Rui Liu
- Department of Gastroenterology, Mudanjiang First People’s Hospital, Mudanjiang, China
| | - Ai-Lian Dong
- Department of Gastroenterology, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China
| |
Collapse
|
163
|
Yang Y, Deng X, Xiao HX, Ye SM, Wang ZC, Jiang F, Han HX, Wang ZJ, Ma JZ, Lan Y, Ye H, Zhang XZ. Efficacy and safety of Jinghua Weikang capsule combined with amoxicillin-furazolidone triple/quadruple therapies in the rescue treatment of Helicobacter pylori infection. Front Med (Lausanne) 2025; 12:1531620. [PMID: 40201322 PMCID: PMC11975852 DOI: 10.3389/fmed.2025.1531620] [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: 12/03/2024] [Accepted: 03/05/2025] [Indexed: 04/10/2025] Open
Abstract
Aim To evaluate the efficacy and safety of Jinghua Weikang Capsule (JWC) combined with amoxicillin-furazolidone triple/quadruple therapies in the rescue treatment of drug-resistant H. pylori infection. Methods Patients who failed H. pylori eradication therapy at least once were enrolled and randomly assigned into four groups (1:1:1:1), as follows: The control group received 20 mg rabeprazole, 1,000 mg amoxicillin, 220 mg bismuth potassium citrate, and 100 mg furazolidone twice daily (b.i.d.) for 14 days; Group A received 240 mg JWC b.i.d. combined with 20 mg rabeprazole, 1,000 mg amoxicillin, and 100 mg furazolidone b.i.d. for 14 days; Group B received the same regimen as Group A for 14 days, followed by an additional 14 days of 240 mg JWC b.i.d.; and Group C received 240 mg JWC b.i.d. combined with 20 mg rabeprazole, 1,000 mg amoxicillin, 220 mg bismuth potassium citrate, and 100 mg furazolidone b.i.d. for 10 days. The primary outcome was H. pylori eradication at 4 weeks after treatment. Results Four hundred eighty-eight patients were included in this study. The intention-to-treat (ITT) eradication rates in the four groups were 85.2, 73.8, 78.7 and 75.4% (p = 0.136), while the modified intention-to-treat (MITT) eradication rates were 92.0, 84.9, 88.9 and 86.8% (p = 0.398), respectively. And the per-protocol (PP) eradication rates were 92.5, 85.4, 87.9 and 86.7% (p = 0.405), respectively. The eradication rates were comparable among the four groups. No statistically significant differences in eradication rates were observed between each of the three treatment groups and the control group (all p > 0.05). The eradication rate of H. pylori in group B demonstrated non-inferiority compared with the control group (p = 0.0415; 90% CI, -0.0965 to 0.0336). The four groups exhibited similar frequencies of overall adverse events (9.84, 5.74, 6.56%, 2.46%, p = 0.112). Conclusion The eradication rate of the JWC-containing regimen demonstrated no statistically significant difference compared with bismuth-containing quadruple therapy in the rescue treatment of H. pylori infection. The prolonged JWC treatment regimen exhibited non-inferiority in eradication rates. JWC-containing therapies can effectively reduce the incidence of adverse reactions and significantly alleviate certain clinical symptoms. Clinical trial https://clinicaltrials.gov/, identifier ChiCTR1800019326.
Collapse
Affiliation(s)
- Yao Yang
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Xin Deng
- Kunming Traditional Chinese Medicine Hospital, Kunming, China
| | - Hui-Xia Xiao
- Taikang Xianlin Drum Tower Hosipital, Kunming, China
| | - Su-Man Ye
- Beijing University of Chinese Medicine, Beijing, China
| | - Zi-Cheng Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Feng Jiang
- Dongzhimen Hosipital Beijing University of Chinese Medicine, Beijing, China
| | - Hai-Xiao Han
- Oriental Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Zai-Jian Wang
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Ji-Zheng Ma
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China
| | - Yu Lan
- Beijing Jishuitan Hospital, Beijing, China
| | - Hui Ye
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Xue-Zhi Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
- Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| |
Collapse
|
164
|
Coşkun Yaş S, Üçöz Kocaşaban D, Güler S. The role of shock indexes and RDW/albumin ratio in upper gastrointestinal bleeding : Predicting adverse outcomes. Med Klin Intensivmed Notfmed 2025:10.1007/s00063-025-01267-8. [PMID: 40126641 DOI: 10.1007/s00063-025-01267-8] [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: 05/14/2024] [Revised: 01/20/2025] [Accepted: 03/02/2025] [Indexed: 03/26/2025]
Abstract
OBJECTIVE Upper gastrointestinal bleeding (UGIB) is a common condition in emergency departments (ED). The aim of this study is to evaluate the effectiveness of the red blood cell distribution width (RDW) to albumin ratio and three types of shock index (SI) as predictors of adverse outcomes in patients with UGIB in the ED. METHODS The study was designed as a retrospective, single-center study, and patients were screened using electronic medical records. Glasgow Blatchford, RDW/albumin ratio, SI, modified SI (MSI), and age SI were calculated, and adverse outcomes were defined as ICU admission, red blood cell transfusion, in-hospital mortality, and 30-day mortality. The effectiveness of these parameters in predicting adverse outcomes in UGIB patients admitted to the ED was evaluated. RESULTS The study enrolled 174 patients, of whom 17.2% required admission to the ICU, 33.9% received red blood cell transfusions, and 10.3% died within 30 days. Patients with adverse outcomes had significantly higher SI, MSI, age SI, and RDW/albumin ratio values. All four indices were statistically significant predictors of adverse outcomes (area under the curve [AUC] SI: 0.676; AUC MSI: 0.706; AUC age SI: 0.778; AUC RDW/albumin: 0.787). Age SI showed significantly higher prognostic performance in predicting adverse outcomes than SI and MSI. CONCLUSION The present study suggests that SI, MSI, age SI, and RDW/albumin ratio may be useful in predicting adverse outcomes in patients with UGIB. The RDW/albumin ratio was effective in predicting mortality, while age SI showed a higher predictive ability for adverse outcomes compared to SI and MSI.
Collapse
Affiliation(s)
- Secdegül Coşkun Yaş
- Department of Emergency Medicine, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Türkiye.
| | - Dilber Üçöz Kocaşaban
- Department of Emergency Medicine, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Türkiye
| | - Sertaç Güler
- Department of Emergency Medicine, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Türkiye
| |
Collapse
|
165
|
Wang HS, Huang KH, Jiang RS, Lao J, Long JX, Wu MB, Tang JL, Jiang XP, Wang B, Chen ZM, Wang JY. Presenting features and treatment of small intestinal adenomyosis in children: a 10-year retrospective study. Front Pediatr 2025; 13:1555418. [PMID: 40196164 PMCID: PMC11973359 DOI: 10.3389/fped.2025.1555418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2025] [Accepted: 03/07/2025] [Indexed: 04/09/2025] Open
Abstract
Objective This study aims to analyze and summarize the clinical characteristics of small intestinal adenomyosis. Methods A retrospective study was conducted on children with small intestinal adenomyosis at our center from 2014 to 2024. The age of onset, gender, clinical symptoms, auxiliary examination results, treatment plans, and pathological characteristics of the tumors were recorded and analyzed. Results Six cases of small intestinal adenomyosis were analyzed. The male-to-female ratio was 5:1. The median age was 19 months, with two-thirds of the affected children being under 2 years old. Two cases were identified in newborns during the treatment of intestinal malrotation. The remaining patients developed symptoms of intussusception. Preoperative ultrasound identified pathological lead points in two cases. Among the six cases, one case's adenomyoma was located in the jejunum, while the rest was located in the ileum, with tumors ranging from 25 to 140 cm from the ileocecal region. All six patients underwent resection of the tumor segments in the small intestine followed by anastomosis; postoperative prognosis was favorable. Of the six pathological results, glandular-like structures were found in five tumors, with three cases lined with cuboidal or columnar epithelium and one case lined with stratified or squamous epithelium. Conclusions Small intestinal adenomyosis is observed to be more prevalent in male, with onset ages ranging from six days to four years. It frequently coexists with recurrent intussusception, making reduction with air or water enema challenging. Abdominal ultrasound typically shows tumors at the leading edge of the intussusception, with compromised blood flow signals and multiple small cystic or honeycomb-like anechoic structures. Surgery is the primary treatment and generally results in a favorable prognosis.
Collapse
Affiliation(s)
- Huan-sheng Wang
- Department of General Surgery, Shenzhen Children’s Hospital of China Medical University, Shenzhen, Guangdong, China
| | - Ke-hua Huang
- Department of General Surgery, Shenzhen Children’s Hospital of ShanTou University, Shenzhen, Guangdong, China
| | - Ren-sen Jiang
- Department of General Surgery, Shenzhen Children’s Hospital of ShanTou University, Shenzhen, Guangdong, China
| | - Jin Lao
- Department of General Surgery, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
| | - Jie-xing Long
- Department of General Surgery, Shenzhen Children’s Hospital of ShanTou University, Shenzhen, Guangdong, China
| | - Miao-bing Wu
- Department of General Surgery, Shenzhen Children’s Hospital of ShanTou University, Shenzhen, Guangdong, China
| | - Jia-lin Tang
- Department of General Surgery, Shenzhen Children’s Hospital of ShanTou University, Shenzhen, Guangdong, China
| | - Xian-ping Jiang
- Department of Pathology, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
| | - Bin Wang
- Department of General Surgery, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
| | - Zi-min Chen
- Department of General Surgery, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
| | - Jian-yao Wang
- Department of General Surgery, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
| |
Collapse
|
166
|
Eldew H, Soldera J. Evaluation of biological therapies in autoimmune hepatitis: A case-based systematic review. World J Gastrointest Pathophysiol 2025; 16:101481. [PMID: 40123748 PMCID: PMC11923927 DOI: 10.4291/wjgp.v16.i1.101481] [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: 09/15/2024] [Revised: 02/17/2025] [Accepted: 02/25/2025] [Indexed: 03/18/2025] Open
Abstract
BACKGROUND Autoimmune hepatitis (AIH) is typically treated with immunomodulators and steroids. However, some patients are refractory to these treatments, necessitating alternative approaches. Biological therapies have recently been explored for these difficult cases. AIM To assess the efficacy and safety of biologics in AIH, focusing on patients unresponsive to standard treatments and evaluating outcomes such as serological markers and histological remission. METHODS A case-based systematic review was performed following the PRISMA protocol to evaluate the efficacy and safety of biological therapies in AIH. The primary focus was on serological improvement and histological remission. The secondary focus was on assessing therapy safety and additional outcomes. A standardized search command was applied to MEDLINE, EMBASE, and Cochrane Library databases to identify relevant studies. Inclusion criteria encompassed adult AIH patients treated with biologics. Data were analyzed based on demographics, prior treatments, and therapy-related outcomes. A narrative synthesis was employed to address biases and provide a comprehensive overview of the evidence. RESULTS A total of 352 studies were reviewed, with 30 selected for detailed analysis. Key findings revealed that Belimumab led to a favourable response in five out of eight AIH patients across two studies. Rituximab demonstrated high efficacy, with 41 out of 45 patients showing significant improvement across six studies. Basiliximab was assessed in a single study, where the sole patient treated experienced a beneficial outcome. Additionally, a notable number of AIH cases were induced by anti-tumor necrosis factor (TNF) medications, including 16 cases associated with infliximab and four cases with adalimumab. All these cases showed improvement upon withdrawal of the biologic agent. CONCLUSION Belimumab and Rituximab show promise as effective alternatives for managing refractory AIH, demonstrating significant improvements in clinical outcomes and liver function. However, the variability in patient responses to different therapies highlights the need for personalized treatment strategies. The risk of AIH induced by anti-TNF therapies underscores the need for vigilant monitoring and prompt symptom recognition. These findings support the incorporation of biologic agents into AIH treatment protocols, particularly for patients who do not respond to conventional therapies.
Collapse
Affiliation(s)
- Haifa Eldew
- Consultant in Acute Internal Medicine with Specialist Interest in Hepatology, Princess Royal University Hospital, Kings College Hospital Foundation Trust, Orpington Kent BR6 8ND, United Kingdom
| | - Jonathan Soldera
- Acute Medicine and Gastroenterology, University of South Wales, Cardiff CF37 1DL, United Kingdom
| |
Collapse
|
167
|
Peruhova M, Stoyanova D, Miteva DG, Kitanova M, Mirchev MB, Velikova T. Genetic factors that predict response and failure of biologic therapy in inflammatory bowel disease. World J Exp Med 2025; 15:97404. [PMID: 40115750 PMCID: PMC11718585 DOI: 10.5493/wjem.v15.i1.97404] [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: 05/30/2024] [Revised: 10/09/2024] [Accepted: 11/14/2024] [Indexed: 12/26/2024] Open
Abstract
Inflammatory bowel disease (IBD) represents a significant disease burden marked by chronic inflammation and complications that adversely affect patients' quality of life. Effective diagnostic strategies involve clinical assessments, endoscopic evaluations, imaging studies, and biomarker testing, where early diagnosis is essential for effective management and prevention of long-term complications, highlighting the need for continual advancements in diagnostic methods. The intricate interplay between genetic factors and the outcomes of biological therapy is of critical importance. Unraveling the genetic determinants that influence responses and failures to biological therapy holds significant promise for optimizing treatment strategies for patients with IBD on biologics. Through an in-depth examination of current literature, this review article synthesizes critical genetic markers associated with therapeutic efficacy and resistance in IBD. Understanding these genetic actors paves the way for personalized approaches, informing clinicians on predicting, tailoring, and enhancing the effectiveness of biological therapies for improved outcomes in patients with IBD.
Collapse
Affiliation(s)
- Milena Peruhova
- Department of Gastroenterology, University Hospital Heart and Brain, Burgas 1000, Bulgaria
| | - Daniela Stoyanova
- Department of Gastroenterology, Military Medical Academy, Sofia 1606, Bulgaria
| | | | - Meglena Kitanova
- Department of Genetics, Faculty of Biology, Sofia University St. Kliment Ohridski, Sofia 1164, Bulgaria
| | | | - Tsvetelina Velikova
- Department of Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
| |
Collapse
|
168
|
Zhang PP, Tang JN, Xiang BY, Li L, Xie MZ, Qu HY. Unlocking the potential of Radix Astragali and its active ingredients in gastric ulcer therapy. JOURNAL OF ASIAN NATURAL PRODUCTS RESEARCH 2025:1-15. [PMID: 40111320 DOI: 10.1080/10286020.2025.2475475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 02/28/2025] [Accepted: 03/01/2025] [Indexed: 03/22/2025]
Abstract
We studied the protective effects of Radix Astragali (RA) on gastric ulcer (GU). A literature search was conducted using databases from Web of Science, PubMed, Springer, ScienceDirect, Science Direct Chinese National Knowledge Infrastructure (CNKI), and Wanfang. The inclusion criteria for this study were limited to reports on the effects of RA, AS-IV, cycloastragenol, astragalus polysaccharide (APS), and astragalosides (AST) in the treatment of gastric ulcers. Any studies involving gastric lesions that were precancerous or cancerous were eliminated. The search period was from database inception through June 2024. The results suggested RA hold promiseas potential novel therapeutics for the therapy of GU.
Collapse
Affiliation(s)
- Pei-Pei Zhang
- School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha410208, China
- Hunan Engineering Technology Research Center for Medicinal and Functional Food, Hunan University of Chinese Medicine, Changsha410208, China
- Provincial Key Laboratory for TCM Diagnostics of Hunan, Hunan University of Chinese Medicine, Changsha410208, China
| | - Jing-Ni Tang
- Medical School, Hunan University of Traditional Chinese Medicine, Changsha410208, China
| | - Bo-Yu Xiang
- Medical School, Hunan University of Traditional Chinese Medicine, Changsha410208, China
| | - Liang Li
- School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha410208, China
- Hunan Engineering Technology Research Center for Medicinal and Functional Food, Hunan University of Chinese Medicine, Changsha410208, China
- Provincial Key Laboratory for TCM Diagnostics of Hunan, Hunan University of Chinese Medicine, Changsha410208, China
| | - Meng-Zhou Xie
- School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha410208, China
- Hunan Engineering Technology Research Center for Medicinal and Functional Food, Hunan University of Chinese Medicine, Changsha410208, China
- Provincial Key Laboratory for TCM Diagnostics of Hunan, Hunan University of Chinese Medicine, Changsha410208, China
| | - Hao-Yu Qu
- Hunan Engineering Technology Research Center for Medicinal and Functional Food, Hunan University of Chinese Medicine, Changsha410208, China
- School of informatics, Hunan University of Traditional Chinese Medicine, Changsha410208, China
| |
Collapse
|
169
|
Kim KU, Kim J, Jang H, Dan KB, Kim BK, Ji YW, Yi DY, Min H. Protective effects of human breast milk-derived exosomes on inflammatory bowel disease through modulation of immune cells. NPJ Sci Food 2025; 9:34. [PMID: 40113828 PMCID: PMC11926119 DOI: 10.1038/s41538-025-00400-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 02/27/2025] [Indexed: 03/22/2025] Open
Abstract
Human breast milk (HBM)-derived exosomes play a crucial role not only in infant nutrition but also in modulating inflammation, immunity, and epithelial cell protection. This study investigated how HBM-derived exosomes regulate immune cell development and function. The exosomes promoted the differentiation of naïve CD4+ T cells into Treg and Th2 cells while suppressing their differentiation into Th17 and Th1 cells. They also enhanced the proliferation of intestinal epithelial Caco-2 cells and reduced apoptosis in dextran sulfate sodium (DSS)-damaged caco-2 cells. In a DSS-induced colitis mouse model, the exosomes significantly alleviated disease severity, as evidenced by improvements in colon length, disease activity index, and histology grades. Furthermore, the exosomes normalized CD4+ T cell subsets in the spleen, mesenteric lymph nodes, and colon, restoring levels comparable to controls. These findings suggest that HBM-derived exosomes hold promise as a potential therapeutic strategy for inflammatory bowel disease by modulating T-cell responses and protecting intestinal epithelial cells.
Collapse
Affiliation(s)
- Ki-Uk Kim
- College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Jisu Kim
- College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Hyunjun Jang
- College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Kang Bin Dan
- College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Bo Kyeong Kim
- College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Yong Woo Ji
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Department of Ophthalmology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, 16995, Republic of Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, 06973, Republic of Korea
- College of Medicine, Chung-Ang University, Seoul, 06972, Republic of Korea
| | - Hyeyoung Min
- College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea.
| |
Collapse
|
170
|
Zhan C, Peng C, Wei H, Wei K, Ou Y, Zhang Z. Diverse Subsets of γδT Cells and Their Specific Functions Across Liver Diseases. Int J Mol Sci 2025; 26:2778. [PMID: 40141420 PMCID: PMC11943347 DOI: 10.3390/ijms26062778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2025] [Revised: 03/15/2025] [Accepted: 03/17/2025] [Indexed: 03/28/2025] Open
Abstract
γδT cells, a distinct group of T lymphocytes, serve as a link between innate and adaptive immune responses. They are pivotal in the pathogenesis of various liver disorders, such as viral hepatitis, nonalcoholic fatty liver disease (NAFLD), alcoholic liver disease (ALD), liver fibrosis, autoimmune liver diseases, and hepatocellular carcinoma (HCC). Despite their importance, the functional diversity and regulatory mechanisms of γδT cells remain incompletely understood. Recent advances in high-throughput single-cell sequencing and spatial transcriptomics have revealed significant heterogeneity among γδT cell subsets, particularly Vδ1+ and Vδ2+, which exhibit distinct immunological roles. Vδ1+ T cells are mainly tissue-resident and contribute to tumor immunity and chronic inflammation, while Vδ2+ T cells, predominantly found in peripheral blood, play roles in systemic immune surveillance but may undergo dysfunction in chronic liver diseases. Additionally, γδT17 cells exacerbate inflammation in NAFLD and ALD, whereas IFN-γ-secreting γδT cells contribute to antiviral and antifibrotic responses. These discoveries have laid the foundation for the creation of innovative solutions. γδT cell-based immunotherapeutic approaches, such as adoptive cell transfer, immune checkpoint inhibition, and strategies targeting metabolic pathways. Future research should focus on harnessing γδT cells' therapeutic potential through targeted interventions, offering promising prospects for precision immunotherapy in liver diseases.
Collapse
Affiliation(s)
- Chenjie Zhan
- State Key Laboratory of Targeting Oncology, National Center for International Research of Bio-Targeting Theranostics, Guangxi Key Laboratory of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Major New Drugs Innovation and Development, Guangxi Medical University, Nanning 530021, China; (C.Z.); (C.P.)
| | - Chunxiu Peng
- State Key Laboratory of Targeting Oncology, National Center for International Research of Bio-Targeting Theranostics, Guangxi Key Laboratory of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Major New Drugs Innovation and Development, Guangxi Medical University, Nanning 530021, China; (C.Z.); (C.P.)
| | - Huaxiu Wei
- State Key Laboratory of Targeting Oncology, National Center for International Research of Bio-Targeting Theranostics, Guangxi Key Laboratory of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Major New Drugs Innovation and Development, Guangxi Medical University, Nanning 530021, China; (C.Z.); (C.P.)
| | - Ke Wei
- State Key Laboratory of Targeting Oncology, National Center for International Research of Bio-Targeting Theranostics, Guangxi Key Laboratory of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Major New Drugs Innovation and Development, Guangxi Medical University, Nanning 530021, China; (C.Z.); (C.P.)
| | - Yangzhi Ou
- State Key Laboratory of Targeting Oncology, National Center for International Research of Bio-Targeting Theranostics, Guangxi Key Laboratory of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Major New Drugs Innovation and Development, Guangxi Medical University, Nanning 530021, China; (C.Z.); (C.P.)
| | - Zhiyong Zhang
- State Key Laboratory of Targeting Oncology, National Center for International Research of Bio-Targeting Theranostics, Guangxi Key Laboratory of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Major New Drugs Innovation and Development, Guangxi Medical University, Nanning 530021, China; (C.Z.); (C.P.)
- Department of Surgery, Robert-Wood-Johnson Medical School University Hospital, Rutgers University, New Brunswick, NJ 08901-8554, USA
| |
Collapse
|
171
|
Krueger ME, Boles JS, Simon ZD, Alvarez SD, McFarland NR, Okun MS, Zimmermann EM, Forsmark CE, Tansey MG. Comparative analysis of Parkinson's and inflammatory bowel disease gut microbiomes reveals shared butyrate-producing bacteria depletion. NPJ Parkinsons Dis 2025; 11:50. [PMID: 40108151 PMCID: PMC11923181 DOI: 10.1038/s41531-025-00894-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 02/19/2025] [Indexed: 03/22/2025] Open
Abstract
Epidemiological studies reveal that inflammatory bowel disease (IBD) is associated with an increased risk of Parkinson's disease (PD). Gut dysbiosis has been documented in both PD and IBD, however it is currently unknown whether gut dysbiosis underlies the epidemiological association between both diseases. To identify shared and distinct features of the PD and IBD microbiome, we recruited 54 PD, 26 IBD, and 16 healthy control individuals and performed the first joint analysis of gut metagenomes. Larger, publicly available PD and IBD metagenomic datasets were also analyzed to validate and extend our findings. Depletions in short-chain fatty acid (SCFA)-producing bacteria, including Roseburia intestinalis, Faecalibacterium prausnitzii, Anaerostipes hadrus, and Eubacterium rectale, as well depletion in SCFA-synthesis pathways were detected across PD and IBD datasets, suggesting that depletion of these microbes in IBD may influence the risk for PD development.
Collapse
Affiliation(s)
- Maeve E Krueger
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Jake Sondag Boles
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Zachary D Simon
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Stephan D Alvarez
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Nikolaus R McFarland
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
- Department of Medicine, Division of Gastroenterology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Michael S Okun
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
- Department of Medicine, Division of Gastroenterology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Ellen M Zimmermann
- Department of Medicine, Division of Gastroenterology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Christopher E Forsmark
- Department of Medicine, Division of Gastroenterology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Malú Gámez Tansey
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA.
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, USA.
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA.
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA.
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA.
| |
Collapse
|
172
|
Liu YL, Liu J, Wang YT. Risk of progression to high-grade intraepithelial neoplasia and gastric cancer: A multi-center prospective study in Anhui Province, China. World J Gastrointest Oncol 2025; 17:103296. [PMID: 40092961 PMCID: PMC11866224 DOI: 10.4251/wjgo.v17.i3.103296] [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: 11/15/2024] [Revised: 12/18/2024] [Accepted: 01/02/2025] [Indexed: 02/14/2025] Open
Abstract
BACKGROUND Gastric cancer is one of the most common cancers worldwide, especially in East Asia. AIM To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia (LGIN) in the gastric mucosa and provide valuable guidance for improving treatment efficacy. METHODS A total of 357 patients diagnosed with LGIN based on initial pathological examination in Anhui Provincial Hospital or three other medical consortium units between January 2022 and June 2024 were included. Among them, 296 patients were followed up with endoscopic and biopsy pathology. Logistic regression was utilized to analyze the relevant risk factors for LGIN progression in the gastric mucosa. RESULTS The distribution sites of LGIN among the 357 patients were as follows: Gastric antrum (54.6%), gastric cardia (24.1%), gastric angulus (8.7%), gastric body (4.8%), gastric fundus (4.8%), and multiple sites (3.1%). Additionally, of the 357 patients with LGIN, 112 (31.4%) developed ulceration and 59 (16.5%) experienced gastric polyps. Furthermore, 231 of the 357 (64.71%) patients with LGIN tested positive for Helicobacter pylori (H. pylori) infection. The H. pylori infection rates of the patients with LGIN with accompanying atrophy, intestinal metaplasia, and gastric ulcer were 51.95%, 59.31%, and 28.57%, respectively. Multivariate logistic regression analysis showed that age ≥ 60 years [odds ratio (OR) = 3.063, 95% confidence interval (CI): 1.351-6.945, P = 0.007], H. pylori infection (OR = 3.560, 95%CI: 1.158-10.949, P = 0.027), multiple locations (OR = 10.136, 95%CI: 2.045-50.237, P = 0.005), lesion size ≥ 2 cm (OR = 3.921, 95%CI: 1.664-9.237, P = 0.002), and gastric ulcer (OR = 2.730, 95%CI: 1.197-6.223, P = 0.017) were predictive factors for LGIN progression. CONCLUSION LGIN progression is closely related to age, H. pylori positivity, multiple locations, lesion size ≥ 2 cm, and gastric ulcer. Thus, actively identifying these risk factors in patients with LGIN may have certain clinical significance in preventing further tumor progression.
Collapse
Affiliation(s)
- Ying-Ling Liu
- Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
| | - Jie Liu
- Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
| | - Ye-Tao Wang
- Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
| |
Collapse
|
173
|
Qiu J, Hu Y, Li L, Erzurumluoglu AM, Braenne I, Whitehurst C, Schmitz J, Arora J, Bartholdy BA, Gandhi S, Khoueiry P, Mueller S, Noyvert B, Ding Z, Jensen JN, de Jong J. Deep representation learning for clustering longitudinal survival data from electronic health records. Nat Commun 2025; 16:2534. [PMID: 40087274 PMCID: PMC11909183 DOI: 10.1038/s41467-025-56625-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 01/21/2025] [Indexed: 03/17/2025] Open
Abstract
Precision medicine requires accurate identification of clinically relevant patient subgroups. Electronic health records provide major opportunities for leveraging machine learning approaches to uncover novel patient subgroups. However, many existing approaches fail to adequately capture complex interactions between diagnosis trajectories and disease-relevant risk events, leading to subgroups that can still display great heterogeneity in event risk and underlying molecular mechanisms. To address this challenge, we implemented VaDeSC-EHR, a transformer-based variational autoencoder for clustering longitudinal survival data as extracted from electronic health records. We show that VaDeSC-EHR outperforms baseline methods on both synthetic and real-world benchmark datasets with known ground-truth cluster labels. In an application to Crohn's disease, VaDeSC-EHR successfully identifies four distinct subgroups with divergent diagnosis trajectories and risk profiles, revealing clinically and genetically relevant factors in Crohn's disease. Our results show that VaDeSC-EHR can be a powerful tool for discovering novel patient subgroups in the development of precision medicine approaches.
Collapse
Affiliation(s)
- Jiajun Qiu
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Yao Hu
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Li Li
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Abdullah Mesut Erzurumluoglu
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Ingrid Braenne
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Charles Whitehurst
- Immunology & Respiratory Diseases, Boehringer-Ingelheim, Ridgefield, CT, USA
| | - Jochen Schmitz
- Immunology & Respiratory Diseases, Boehringer-Ingelheim, Ridgefield, CT, USA
| | - Jatin Arora
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Boris Alexander Bartholdy
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Shrey Gandhi
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Pierre Khoueiry
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Stefanie Mueller
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Boris Noyvert
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Zhihao Ding
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Jan Nygaard Jensen
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany
| | - Johann de Jong
- Global Computational Biology and Digital Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riβ, Germany.
| |
Collapse
|
174
|
Jin Z, Cao X, Guo Q, Zhang C, Li Q, Wang W, Lv Y, Ma Y, Wang X. TA-V Nanozymes with Acid Resistance Capabilities Effectively Target and Alleviate Ulcerative Colitis Lesions via Oral Delivery. ACS APPLIED MATERIALS & INTERFACES 2025; 17:14912-14923. [PMID: 40013919 DOI: 10.1021/acsami.4c20322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2025]
Abstract
As one of the most common inflammatory bowel diseases (IBDs), ulcerative colitis (UC) has become a rising global health issue that affects people's quality of life. Conventional therapeutic drugs have low bioavailability and may cause serious side effects due to their lack of acidic resistance and lesion-targeting capabilities. The development of novel nanomedicines to overcome these problems is urgently needed. Nanozymes have attracted attention because of their excellent catalytic efficiency in various harsh environments. In this study, tannic acid-vanadium (TA-V) nanozymes with multienzymatic and excellent antioxidant abilities, which exhibit acidic resistance and a negative surface charge, were successfully developed. All these characteristics make it possible that these nanozymes are not easily decomposed by gastric acid and can effectively accumulate in colitis lesions with a positive charge through oral delivery. In vitro and in vivo experiments further demonstrated the excellent prophylactic and therapeutic value of these compounds in the treatment of UC by scavenging reactive oxygen/nitrogen species (ROS/RNS) and mitigating the oxidative stress environment, thus downregulating the levels of the proinflammatory cytokines IL-1β, IL-6, and TNF-α. Furthermore, TA-V also showed excellent biosafety and biocompatibility without causing obvious damage to the main organs. This work provides novel preventative and therapeutic TA-V nanozymes that might have potential clinical applications in UC treatment.
Collapse
Affiliation(s)
- Zhenzhen Jin
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, P. R. China
| | - Xiangjing Cao
- School of Food and Biological Engineering, Hefei University of Technology, Hefei 230009, P. R. China
| | - Qinglong Guo
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, P. R. China
| | - Cong Zhang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, P. R. China
| | - Qingrong Li
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, P. R. China
| | - Wenqi Wang
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, P. R. China
| | - Yong Lv
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, P. R. China
| | - Yan Ma
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, P. R. China
| | - Xianwen Wang
- Anhui Province Key Laboratory of Occupational Health, Anhui No. 2 Provincial People's Hospital, Hefei 230041, P. R. China
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, P. R. China
| |
Collapse
|
175
|
Allay A, Benkirane C, Ben Moumen A, Fauconnier ML, Bouakline H, Nkengurutse J, Serghini Caid H, Elamrani A, Mansouri F. Optimizing ethanol-modified supercritical CO₂ extraction for enhanced bioactive compound recovery in hemp seed oil. Sci Rep 2025; 15:8551. [PMID: 40075119 PMCID: PMC11904181 DOI: 10.1038/s41598-025-91441-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2024] [Accepted: 02/20/2025] [Indexed: 03/14/2025] Open
Abstract
This work aimed to extract hemp seed oil using modified supercritical CO2 with ethanol, while optimizing the overall process through response surface methodology. The effects of extraction temperature (30-60 °C), pressure (10-20 MPa), and time (120-300 min) on oil yield, total phenols (TPC), total tocopherols, oxidative stability index (OSI), total chlorophylls, total carotenoids, quality indices, and color were assessed. For a maximum yield of 28.83 g/100 g of fresh seeds, the oil was extracted at 50 °C and 20 MPa for 244 min. In addition, CO2 modified with different proportions of ethanol (2.5-20%) under the optimized SFE conditions was also tested for enhancing phenolic compound extractability in hemp seed oil. The best proportion was 10% ethanol, which significantly increased the oil yield to 30.13%, TPC to 294.15 GAE mg/kg, total tocopherols to 484.38 mg/kg, and OSI to 28.01 h, without affecting the quality parameters and the fatty acid profile. Furthermore, the phenolic compounds in the extracted oils were analyzed via HPLC-DAD/ESI-MS2. These findings indicated that CO2 modified with ethanol enhanced the extraction of phenolic compounds, 26 of which were identified. Among these, the most abundant compounds were N-trans-caffeoyltyramine, and cannabisins A and B, with concentrations of 50.32, 13.72, and 16.11 mg/kg oil, respectively. The oil obtained by SFE with SC-CO2 + ethanol could be valorized by evaluating its biological activities and its anti-aging, dermato-protective and antimicrobial properties for use in the cosmetics, pharmaceutical and food applications.
Collapse
Affiliation(s)
- Aymane Allay
- Laboratory of Agricultural Production Improvement, Biotechnology, and Environment, Faculty of Sciences, Mohammed I University, B.P. 717, 60000, Oujda, Morocco
| | - Chaymae Benkirane
- Laboratory of Agricultural Production Improvement, Biotechnology, and Environment, Faculty of Sciences, Mohammed I University, B.P. 717, 60000, Oujda, Morocco
| | - Abdessamad Ben Moumen
- Laboratory of Agricultural Production Improvement, Biotechnology, and Environment, Faculty of Sciences, Mohammed I University, B.P. 717, 60000, Oujda, Morocco
| | - Marie-Laure Fauconnier
- Laboratory of Chemistry of Natural Molecules, Gembloux Agro-Bio Tech, University of Liège, Passage des Déportés, 2, 5030, Gembloux, Belgium
| | - Hamza Bouakline
- Laboratory of Applied Chemistry and Environment, Faculty of Sciences, Mohammed I University, B.P. 717, 60000, Oujda, Morocco
| | - Jacques Nkengurutse
- Biology Department, Faculty of Sciences, University of Burundi, P.O. Box 2700, Bujumbura, Burundi.
| | - Hana Serghini Caid
- Laboratory of Agricultural Production Improvement, Biotechnology, and Environment, Faculty of Sciences, Mohammed I University, B.P. 717, 60000, Oujda, Morocco
| | - Ahmed Elamrani
- Laboratory of Agricultural Production Improvement, Biotechnology, and Environment, Faculty of Sciences, Mohammed I University, B.P. 717, 60000, Oujda, Morocco
| | - Farid Mansouri
- Laboratory of Agricultural Production Improvement, Biotechnology, and Environment, Faculty of Sciences, Mohammed I University, B.P. 717, 60000, Oujda, Morocco
- Higher School of Education and Training, Mohammed I University, BP-410, 60000, Oujda, Morocco
| |
Collapse
|
176
|
Tang C, Zhou J, Song Y, Liu S. Etiologies of exocrine pancreatic insufficiency. Gastroenterol Rep (Oxf) 2025; 13:goaf019. [PMID: 40066317 PMCID: PMC11893156 DOI: 10.1093/gastro/goaf019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 09/30/2024] [Accepted: 11/12/2024] [Indexed: 04/11/2025] Open
Abstract
Exocrine pancreatic insufficiency (EPI) is a major cause of maldigestion and malnutrition, resulting from primary pancreatic diseases or other conditions. As the prevalence of EPI continues to rise, accurate identification of its etiology has become critical for the diagnosis and treatment of pancreatic secretory insufficiency. EPI can result from both pancreatic and non-pancreatic disorders. Pancreatic disorders include acute and chronic pancreatitis, pancreatic tumors, cystic fibrosis, procedures that involve pancreatic resection, and other rare causes. Non-pancreatic disorders of EPI include diabetes mellitus, celiac disease, inflammatory bowel disease, gastrointestinal and esophagectomy surgery, as well as advanced patient age. This review aims to provide a comprehensive analysis of the literature on EPI etiology, with a thorough overview to support its consideration as a potential diagnosis.
Collapse
Affiliation(s)
- Chengji Tang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hunan Normal University, Hunan Provincial People’s Hospital, Changsha, Hunan, P. R. China
| | - Jia Zhou
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hunan Normal University, Hunan Provincial People’s Hospital, Changsha, Hunan, P. R. China
- Central Laboratory of Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, P. R. China
| | - Yinghui Song
- Central Laboratory of Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, P. R. China
| | - Sulai Liu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hunan Normal University, Hunan Provincial People’s Hospital, Changsha, Hunan, P. R. China
- Hunan Engineering Research Center of Digital Hepatobiliary Medicine, Changsha, Hunan, P. R. China
- Hunan Key Laboratory for the Prevention and Treatment of Biliary Tract Diseases, Changsha, Hunan, P. R. China
- Research Center for Hepatobiliary and Pancreatic Diseases of Furong Laboratory, Changsha, Hunan, P. R. China
| |
Collapse
|
177
|
Ghosh AN, Walsh CJ, Maiden MJ, Stinear TP, Deane AM. Effect of dietary fibre on the gastrointestinal microbiota during critical illness: A scoping review. World J Crit Care Med 2025; 14:98241. [DOI: 10.5492/wjccm.v14.i1.98241] [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: 06/21/2024] [Revised: 09/27/2024] [Accepted: 10/28/2024] [Indexed: 12/11/2024] Open
Abstract
The systemic effects of gastrointestinal (GI) microbiota in health and during chronic diseases is increasingly recognised. Dietary strategies to modulate the GI microbiota during chronic diseases have demonstrated promise. While changes in dietary intake can rapidly change the GI microbiota, the impact of dietary changes during acute critical illness on the microbiota remain uncertain. Dietary fibre is metabolised by carbohydrate-active enzymes and, in health, can alter GI microbiota. The aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states, specifically during critical illness. Randomised controlled trials and prospective cohort studies that include adults (> 18 years age) and reported changes to GI microbiota as one of the study outcomes using non-culture methods, were identified. Studies show dietary fibres have an impact on faecal microbiota in health and disease. The fibre, inulin, has a marked and specific effect on increasing the abundance of faecal Bifidobacteria. Short chain fatty acids produced by Bifidobacteria have been shown to be beneficial in other patient populations. Very few trials have evaluated the effect of dietary fibre on the GI microbiota during critical illness. More research is necessary to establish optimal fibre type, doses, duration of intervention in critical illness.
Collapse
Affiliation(s)
- Angajendra N Ghosh
- Department of Intensive Care, The Northern Hospital, Epping 3076, Victoria, Australia
| | - Calum J Walsh
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, Melbourne 3052, Victoria, Australia
| | - Matthew J Maiden
- Department of Intensive Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville 3050, Victoria, Australia
| | - Tim P Stinear
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, Melbourne 3052, Victoria, Australia
| | - Adam M Deane
- Department of Intensive Care Medicine, The Royal Melbourne Hospital, Parkville 3050, Victoria, Australia
| |
Collapse
|
178
|
Nagesh VK, Pulipaka SP, Bhuju R, Martinez E, Badam S, Nageswaran GA, Tran HHV, Elias D, Mansour C, Musalli J, Bhattarai S, Shobana LS, Sethi T, Sethi R, Nikum N, Trivedi C, Jarri A, Westman C, Ahmed N, Philip S, Weissman S, Weinberger J, Bangolo AI. Management of gastrointestinal bleed in the intensive care setting, an updated literature review. World J Crit Care Med 2025; 14:101639. [DOI: 10.5492/wjccm.v14.i1.101639] [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: 09/21/2024] [Revised: 11/08/2024] [Accepted: 12/02/2024] [Indexed: 12/11/2024] Open
Abstract
Gastrointestinal (GI) bleeding is a critical and potentially life-threatening condition frequently observed in the intensive care unit (ICU). This literature review consolidates current insights on the epidemiology, etiology, management, and outcomes of GI bleeding in critically ill patients. GI bleeding remains a significant concern, especially among patients with underlying risk factors such as coagulopathy, mechanical ventilation, and renal failure. Managing GI bleeding in the ICU requires a multidisciplinary approach, including resuscitation, endoscopic intervention, pharmacologic therapy, and sometimes surgical procedures. Even with enhanced management strategies, GI bleeding in the ICU is associated with considerable morbidity and mortality, particularly when complicated by multi-organ failure. This review reiterates the need for adequate resuscitation and interventions in managing GI bleeding in critically ill patients, aiming to enhance survival rates and improve the quality of care within the ICU setting.
Collapse
Affiliation(s)
- Vignesh K Nagesh
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Sai Priyanka Pulipaka
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Ruchi Bhuju
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Emelyn Martinez
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Shruthi Badam
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Gomathy Aarthy Nageswaran
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
| | - Hadrian Hoang-Vu Tran
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Daniel Elias
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Charlene Mansour
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Jaber Musalli
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Sanket Bhattarai
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Lokeash Subramani Shobana
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Tannishtha Sethi
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Ritvik Sethi
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Namrata Nikum
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Chinmay Trivedi
- Department of Gastroenterology, Hackensack University Medical Center, Hackensack, NJ 07061, United States
| | - Amer Jarri
- Department of Pulmonology and Critical Care, HCA Florida Bayonet Point Hospital, Hudson, FL 34667, United States
| | - Colin Westman
- Department of Gastroenterology, Hackensack University Medical Center, Hackensack, NJ 07061, United States
| | - Nazir Ahmed
- Department of Gastroenterology, Hackensack University Medical Center, Hackensack, NJ 07061, United States
| | - Shawn Philip
- Department of Gastroenterology, Hackensack University Medical Center, Hackensack, NJ 07061, United States
| | - Simcha Weissman
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Jonathan Weinberger
- Department of Gastroenterology, Hackensack University Medical Center, Hackensack, NJ 07061, United States
| | - Ayrton I Bangolo
- Department of Hematology & Oncology, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ 07601, United States
| |
Collapse
|
179
|
Turjeman S, Rozera T, Elinav E, Ianiro G, Koren O. From big data and experimental models to clinical trials: Iterative strategies in microbiome research. Cell 2025; 188:1178-1197. [PMID: 40054445 DOI: 10.1016/j.cell.2025.01.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Revised: 12/02/2024] [Accepted: 01/27/2025] [Indexed: 05/13/2025]
Abstract
Microbiome research has expanded significantly in the last two decades, yet translating findings into clinical applications remains challenging. This perspective discusses the persistent issue of correlational studies in microbiome research and proposes an iterative method leveraging in silico, in vitro, ex vivo, and in vivo studies toward successful preclinical and clinical trials. The evolution of research methodologies, including the shift from small cohort studies to large-scale, multi-cohort, and even "meta-cohort" analyses, has been facilitated by advancements in sequencing technologies, providing researchers with tools to examine multiple health phenotypes within a single study. The integration of multi-omics approaches-such as metagenomics, metatranscriptomics, metaproteomics, and metabolomics-provides a comprehensive understanding of host-microbe interactions and serves as a robust hypothesis generator for downstream in vitro and in vivo research. These hypotheses must then be rigorously tested, first with proof-of-concept experiments to clarify the causative effects of the microbiota, and then with the goal of deep mechanistic understanding. Only following these two phases can preclinical studies be conducted with the goal of translation into the clinic. We highlight the importance of combining traditional microbiological techniques with big-data approaches, underscoring the necessity of iterative experiments in diverse model systems to enhance the translational potential of microbiome research.
Collapse
Affiliation(s)
- Sondra Turjeman
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
| | - Tommaso Rozera
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Medical and Surgical Sciences, UOC Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Medical and Surgical Sciences, UOC CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy
| | - Eran Elinav
- Department of Systems Immunology, Weizmann Institute of Science, Rehovot, Israel; Microbiome & Cancer Division, DKFZ, Heidelberg, Germany
| | - Gianluca Ianiro
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Medical and Surgical Sciences, UOC Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Medical and Surgical Sciences, UOC CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy
| | - Omry Koren
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel; Kyung Hee University, Seoul, Republic of Korea.
| |
Collapse
|
180
|
Nguyen MT, Lian A, Guilford FT, Venketaraman V. A Literature Review of Glutathione Therapy in Ameliorating Hepatic Dysfunction in Non-Alcoholic Fatty Liver Disease. Biomedicines 2025; 13:644. [PMID: 40149620 PMCID: PMC11940638 DOI: 10.3390/biomedicines13030644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2025] [Revised: 03/01/2025] [Accepted: 03/04/2025] [Indexed: 03/29/2025] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a global cause of liver dysfunction. This spectrum of hepatic disorders can progress to severe conditions, such as non-alcoholic steatohepatitis (NASH) and cirrhosis, due to oxidative stress and sustained cellular injury. With limited pharmacological options, glutathione (GSH), a key antioxidant, has shown promising potential in reducing oxidative stress, maintaining redox balance, and improving liver function. This literature review examines studies from 2014-2024 exploring GSH therapy in NAFLD patients. Eligible studies assessed GSH as the primary intervention for NAFLD in human subjects, reporting outcomes such as liver function or oxidative stress markers. Randomized clinical trials (RCTs) were eligible, while combination therapy studies were included if GSH's effect could be isolated. Exclusions applied to non-NAFLD studies, animal/in vitro models, and non-GSH antioxidant interventions. Analysis of three studies (totaling 109 participants) demonstrated consistent improvements in alanine transaminase (ALT) levels and reductions in oxidative stress markers like 8-hydroxy-2-deoxyguanosine (8-OHdG). However, small sample sizes and inconsistent protocols limit generalizability. Further large-scale RCTs are required to confirm GSH's efficacy, determine optimal dosing, and assess long-term effects. This literature review highlights GSH's potential as a novel NAFLD therapeutic strategy while emphasizing the need for further studies to refine its clinical application.
Collapse
Affiliation(s)
- Michelle Thuy Nguyen
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA; (M.T.N.); (A.L.)
| | - Andrew Lian
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA; (M.T.N.); (A.L.)
| | | | - Vishwanath Venketaraman
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA; (M.T.N.); (A.L.)
| |
Collapse
|
181
|
Costa CJ, Prescott S, Fourie NH, Abey SK, Sherwin LB, Rahim-Williams B, Joseph PV, Posada-Quintero H, Hoffman RK, Henderson WA. Host Transcriptome and Microbial Variation in Relation to Visceral Hyperalgesia. Nutrients 2025; 17:921. [PMID: 40077792 PMCID: PMC11902232 DOI: 10.3390/nu17050921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2025] [Revised: 02/28/2025] [Accepted: 03/04/2025] [Indexed: 03/14/2025] Open
Abstract
BACKGROUND Chronic visceral hypersensitivity is associated with an overstressed pain response to noxious stimuli (hyperalgesia). Microbiota are active modulators of host biology and are implicated in the etiology of visceral hypersensitivity. OBJECTIVES we studied the association between the circulating mRNA transcriptome, the intensity of induced visceral pain (IVP), and variation in the oral microbiome among participants with and without baseline visceral hypersensitivity. METHODS Transcriptomic profiles and microbial abundance were correlated with IVP intensity. Host mRNA and microbes associated with IVP were explored, linking variation in the microbiome to host RNA biology. RESULTS 259 OTUs were found to be associated with IVP through correlation to differential expression of 471 genes in molecular pathways related to inflammation and neural mechanisms, including Rho and PI3K/AKT pathways. The bacterial families Lachnospiraceae, Prevotellaceae, and Veillonellaceae showed the highest degree of association. Oral microbial profiles with reduced diversity were characteristic of participants with visceral hypersensitivity. CONCLUSIONS Our results suggest that the oral microbiome may be involved in systemic immune and inflammatory effects and play a role in nervous system and stem cell pathways. The interactions between visceral hypersensitivity, differentially expressed molecular pathways, and microbiota described here provide a framework for further work exploring the relationship between host and microbiome.
Collapse
Affiliation(s)
- Christopher J. Costa
- Department of Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030, USA;
| | - Stephanie Prescott
- Inova Health Services, L.J. Murphy Children’s Hospital, 3300 Gallows Rd, Falls Church, VA 22042, USA;
| | - Nicolaas H. Fourie
- National Institute of Nursing Research, National Institutes of Health, 31 Center Drive, Bethesda, MD 20892, USA
| | - Sarah K. Abey
- Laboratory of Neuroimaging, National Institute of Alcohol Abuse and Alcoholism, 10 Center Drive, Bethesda, MD 20814, USA
| | - LeeAnne B. Sherwin
- Sinclair School of Nursing, University of Missouri System, 915 Hitt Street, Columbia, MO 65203, USA;
| | - Bridgett Rahim-Williams
- Office of Research and Sponsored Programs, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, USA;
| | - Paule V. Joseph
- National Institute on Alcohol Abuse and Alcoholism, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, USA;
| | - Hugo Posada-Quintero
- Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Storrs, CT 06269, USA;
| | - Rebecca K. Hoffman
- Laboratory of Innovative and Translational Nursing Research, School of Nursing, University of PA, 418 Curie Blvd, Philadelphia, PA 19104, USA;
| | - Wendy A. Henderson
- Department of Biobehavioral Health Sciences, School of Nursing, University of PA, 418 Curie Blvd, Philadelphia, PA 19104, USA
| |
Collapse
|
182
|
Lawate P, Chauhan V, Prasad LR, Pawar A, Puranik AG, Bansal A, Koganti A, Jaiswal A, Puradkar P, Jhaveri K. Real-world-evidence, prospective-observational study to evaluate safety and effectiveness of rabeprazole dual-delayed-release capsules in patients with gastroesophageal reflux disease. World J Gastrointest Pharmacol Ther 2025; 16:103898. [PMID: 40094149 PMCID: PMC11907338 DOI: 10.4292/wjgpt.v16.i1.103898] [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: 12/13/2024] [Revised: 01/24/2025] [Accepted: 02/10/2025] [Indexed: 03/03/2025] Open
Abstract
BACKGROUND Abnormal gastric acid reflux into the esophagus causes symptoms of gastroesophageal reflux disease (GERD) such as heartburn and regurgitation and also leads to mucosal damage. This damage can further lead to complications such as Barrett's esophagus and esophagitis. Conventional proton pump inhibitors (PPIs) often fail to reduce nocturnal acid production, leaving patients with unresolved symptoms that worsen at night and decreased satisfaction. Happi ER, a novel dual delayed-release (DDR) formulation of rabeprazole, aims to address these limitations by providing both immediate and prolonged acid suppression. AIM To evaluate the safety and effectiveness of rabeprazole DDR 20 mg capsule in patients with GERD. METHODS This study involved a multicenter, real-world, prospective, observational design over an eight-week period. A total of 1022 GERD patients were treated with rabeprazole DDR 20 mg capsules (Happi ER), as prescribed by their physicians. We included adult patients with confirmed GERD and persistent heartburn symptoms despite prior PPI use. Outcome measures included heartburn severity, frequency of night-time awakenings, use of rescue medications, and overall patient satisfaction. RESULTS Rabeprazole DDR 20 mg capsules (Happi ER) were shown to be highly effective in treating GERD symptoms. At the end of the study, the mean heartburn score improved significantly from 2.46 ± 0.67 at baseline to 0.16 ± 0.39 (P < 0.0001). The median number of night-time awakenings decreased to 0 (P < 0.0001). More than 93% of patients rated the therapy as "excellent" or "very good", reflecting high satisfaction. No significant adverse effects were reported, and the safety profile was comparable to that of traditional PPIs. CONCLUSION By providing both rapid and sustained acid suppression, Happi ER effectively treats GERD, particularly with respect to night-time symptoms. Its safety and efficacy profile make it a viable option for individuals with mild-to-moderate GERD, significantly improving the quality of life and symptom management.
Collapse
Affiliation(s)
- Parimal Lawate
- Department of Gastroenterology and Liver Disease, Jehangir Hospital, Pune 411001, Mahārāshtra, India
| | - Virender Chauhan
- Department of Gastroenterology, Kainos Superspeciality Hospital, Rohtak 124001, Haryāna, India
| | - Lingampalli Rajendra Prasad
- Department of Gastroenterology, Vrinda Gastro Liver and Endoscopy Clinic, Kurnool 518002, Andhra Pradesh, India
| | - Abhimanrao Pawar
- Department of Gastroenterology, Bharati Vidyapeeth (Deemed To Be) University Medical College and Hospital, Sangli 416410, Mahārāshtra, India
| | - Atul G Puranik
- Department of Surgery, Puranik Hospital, Mumbai 400064, Mahārāshtra, India
| | - Alok Bansal
- Department of Gastroenterology, Gastro Neuro Clinic, Jabalpur 482002, Madhya Pradesh, India
| | - Abhiram Koganti
- Department of Gastroenterology, KIMS Hospitals, Hyderabad 500032, Telangāna, India
| | - Ashok Jaiswal
- Department of Medical Affairs, Zydus Healthcare Limited, Mumbai 400063, Mahārāshtra, India
| | - Pranali Puradkar
- Department of Medical Affairs, Zydus Healthcare Limited, Mumbai 400063, Mahārāshtra, India
| | - Kunal Jhaveri
- Department of Medical Affairs, Zydus Healthcare Limited, Mumbai 400063, Mahārāshtra, India
| |
Collapse
|
183
|
Abdulrasak M, Someili AM, Mohrag M. Cytopenias in Autoimmune Liver Diseases-A Review. J Clin Med 2025; 14:1732. [PMID: 40095848 PMCID: PMC11900928 DOI: 10.3390/jcm14051732] [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: 01/26/2025] [Revised: 02/22/2025] [Accepted: 03/01/2025] [Indexed: 03/19/2025] Open
Abstract
Autoimmune liver diseases (AiLDs), including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC), are immune-mediated conditions associated with significant hepatic and systemic manifestations. Among these, cytopenias-defined as reductions in blood cell counts affecting single or multiple lineages-represent a clinically important, though often under-recognized, complication. Cytopenias in AiLDs arise from diverse mechanisms, including immune-mediated destruction, hypersplenism due to portal hypertension, bone marrow suppression, and nutritional deficiencies. These abnormalities can exacerbate bleeding, infections, or fatigue, complicating the disease course and impacting therapeutic strategies. Immune-mediated cytopenias, such as autoimmune hemolytic anemia (AIHA), immune thrombocytopenic purpura (ITP), and autoimmune neutropenia (AIN), are more frequently associated with AIH, whereas cytopenias in PBC and PSC are largely attributed to hypersplenism. Diagnostic evaluation involves a systematic approach combining clinical history, laboratory testing (e.g., complete blood counts, Coombs tests, and nutritional assessments), imaging studies, and bone marrow evaluation in complex cases. Treatment strategies aim to address the underlying cause of cytopenias, including immunosuppressive therapy for autoimmune mechanisms, beta-blockers or splenectomy for hypersplenism, and supplementation for nutritional deficiencies. Challenges include distinguishing between immune- and hypersplenism-related cytopenias, managing drug-induced cytopenias, and optimizing care in transplant candidates. The recently recognized IgG4-related disease, often mimicking cholestatic AiLDs, adds another layer of complexity, given its association with autoimmune cytopenias and hypersplenism. This review aims to act as a guide for the clinician dealing with patients with AiLDs with respect to the occurrence of cytopenias, with a specific focus on pathophysiology and management of these cytopenias. Furthermore, there need to be enhanced multidisciplinary discussions about those patients between the hematologists and hepatologists, with a maintenance of a high index of suspicion for the rarer causes of cytopenias in AiLDs on the part of the treating physician, and there is a need for further studies to elucidate the mechanisms behind the occurrence of cytopenias in AiLDs.
Collapse
Affiliation(s)
- Mohammed Abdulrasak
- Department of Gastroenterology and Nutrition, Skane University Hospital, 214 28 Malmo, Sweden
- Department of Clinical Sciences, Lund University, 221 00 Malmo, Sweden
| | - Ali M. Someili
- Department of Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (A.M.S.); (M.M.)
| | - Mostafa Mohrag
- Department of Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (A.M.S.); (M.M.)
| |
Collapse
|
184
|
Yang S, Liu H, Liu Y. Advances in intestinal epithelium and gut microbiota interaction. Front Microbiol 2025; 16:1499202. [PMID: 40104591 PMCID: PMC11914147 DOI: 10.3389/fmicb.2025.1499202] [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: 09/20/2024] [Accepted: 02/17/2025] [Indexed: 03/20/2025] Open
Abstract
The intestinal epithelium represents a critical interface between the host and external environment, serving as the second largest surface area in the human body after the lungs. This dynamic barrier is sustained by specialized epithelial cell types and their complex interactions with the gut microbiota. This review comprehensively examines the recent advances in understanding the bidirectional communication between intestinal epithelial cells and the microbiome. We briefly highlight the role of various intestinal epithelial cell types, such as Paneth cells, goblet cells, and enteroendocrine cells, in maintaining intestinal homeostasis and barrier function. Gut microbiota-derived metabolites, particularly short-chain fatty acids and bile acids, influence epithelial cell function and intestinal barrier integrity. Additionally, we highlight emerging evidence of the sophisticated cooperation between different epithelial cell types, with special emphasis on the interaction between tuft cells and Paneth cells in maintaining microbial balance. Understanding these complex interactions has important implications for developing targeted therapeutic strategies for various gastrointestinal disorders, including inflammatory bowel disease, metabolic disorders, and colorectal cancer.
Collapse
Affiliation(s)
- Sen Yang
- Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Pediatrics, The Fifth Peoples Hospital of Chengdu, Chengdu, China
| | - Hanmin Liu
- Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
- The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital, Sichuan University and School of Life Sciences of Fudan University, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yang Liu
- Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology (Sichuan University), Chengdu, China
- The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital, Sichuan University and School of Life Sciences of Fudan University, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
185
|
Sutar P, Pethe A, Kumar P, Tripathi D, Maity D. Hydrogel Innovations in Biosensing: A New Frontier for Pancreatitis Diagnostics. Bioengineering (Basel) 2025; 12:254. [PMID: 40150718 PMCID: PMC11939681 DOI: 10.3390/bioengineering12030254] [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: 12/18/2024] [Revised: 02/24/2025] [Accepted: 02/27/2025] [Indexed: 03/29/2025] Open
Abstract
Pancreatitis is a prominent and severe type of inflammatory disorder that has grabbed a lot of scientific and clinical interest to prevent its onset. It should be detected early to avoid the development of serious complications, which occur due to long-term damage to the pancreas. The accurate measurement of biomarkers that are released from the pancreas during inflammation is essential for the detection and early treatment of patients with severe acute and chronic pancreatitis, but this is sub-optimally performed in clinically relevant practices, mainly due to the complexity of the procedure and the cost of the treatment. Clinically available tests for the early detection of pancreatitis are often time-consuming. The early detection of pancreatitis also relates to disorders of the exocrine pancreas, such as cystic fibrosis in the hereditary form and cystic fibrosis-like syndrome in the acquired form of pancreatitis, which are genetic disorders with symptoms that can be correlated with the overexpression of specific markers such as creatinine in biological fluids like urine. In this review, we studied how to develop a minimally invasive system using hydrogel-based biosensors, which are highly absorbent and biocompatible polymers that can respond to specific stimuli such as enzymes, pH, temperature, or the presence of biomarkers. These biosensors are helpful for real-time health monitoring and medical diagnostics since they translate biological reactions into quantifiable data. This paper also sheds light on the possible use of Ayurvedic formulations along with hydrogels as a treatment strategy. These analytical devices can be used to enhance the early detection of severe pancreatitis in real time.
Collapse
Affiliation(s)
- Prerna Sutar
- School of Health Sciences and Technology, UPES, Bidholi Campus, Dehradun 248007, Uttarakhand, India
| | - Atharv Pethe
- School of Health Sciences and Technology, UPES, Bidholi Campus, Dehradun 248007, Uttarakhand, India
| | - Piyush Kumar
- School of Health Sciences and Technology, UPES, Bidholi Campus, Dehradun 248007, Uttarakhand, India
| | - Divya Tripathi
- School of Health Sciences and Technology, UPES, Bidholi Campus, Dehradun 248007, Uttarakhand, India
| | - Dipak Maity
- Integrated Nanosystems Development Institute, Indiana University Indianapolis, Indianapolis, IN 46202, USA
- Department of Chemistry and Chemical Biology, Indiana University Indianapolis, Indianapolis, IN 46202, USA
| |
Collapse
|
186
|
Chen J, Shen B, Shen H, Zhu L, Yu H, Tong Y, Yu W. The role of gut microbiota in predicting the weight loss following laparoscopic sleeve gastrectomy. Front Microbiol 2025; 16:1560368. [PMID: 40099179 PMCID: PMC11911518 DOI: 10.3389/fmicb.2025.1560368] [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: 01/20/2025] [Accepted: 02/10/2025] [Indexed: 03/19/2025] Open
Abstract
Background Laparoscopic sleeve gastrectomy (LSG) has emerged as a highly effective intervention in the management of obesity. While there has been a recent surge in research exploring the relationship between obesity and gut microbiota, the association between gut microbiota and LSG remains relatively underexplored. This study aimed to investigate the relationship between gut microbiota and both early and later effects of LSG. Methods In this retrospective study, clinical characteristics and preoperative fecal samples were collected from 52 individuals who underwent LSG. Using 16S rRNA gene sequencing, we compared the community composition, alpha diversity, and beta diversity of gut microbiota between patients who experienced efficient weight loss and those who did not. Additionally, comprehensive and correlation analyses were performed to identify potential associations between specific microbial taxa and LSG outcomes. Results The abundances of gut microbiota in patients who experienced efficient weight loss and those who experienced general weight loss were comparable. However, the influence of gut microbiota on the efficacy of weight loss is dynamic. Specifically, the Fusobacteriota phylum significantly contributed to the early curative effects of LSG, while Actinobacteriota had a greater impact on the late curative effects. Additionally, Proteobacteria were found to mediate long-term efficacy through complex mechanisms. Conclusion This study analyzed the preoperative gut microbiota signature to predict the efficacy of LSG, potentially offering valuable insights for clinical applications. Preoperative assessment of gut microbiota profiles could assist patients in their decision-making processes, particularly regarding the potential outcomes of LSG and the long-term impact of the procedure on their health.
Collapse
Affiliation(s)
- Jionghuang Chen
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Liver Regeneration and Metabolism Study Group, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Bo Shen
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Provincial Key Laboratory of Precise Diagnosis and Treatment of Abdominal Infection, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongdan Shen
- Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Linghua Zhu
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hong Yu
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Provincial Key Laboratory of Precise Diagnosis and Treatment of Abdominal Infection, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yifan Tong
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Liver Regeneration and Metabolism Study Group, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Provincial Key Laboratory of Precise Diagnosis and Treatment of Abdominal Infection, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Weihua Yu
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Liver Regeneration and Metabolism Study Group, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
187
|
Saeed U, Myklebust TÅ, Robsahm TE, Aune D, Møller B, Skålhegg BS, Yaqub S, Mala T. Associations between body mass index and gastroesophageal cancer incidence and mortality: novel insights from a nationwide registry-based cohort study. Dis Esophagus 2025; 38:doaf018. [PMID: 40091197 PMCID: PMC11911121 DOI: 10.1093/dote/doaf018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Revised: 01/20/2025] [Accepted: 02/20/2025] [Indexed: 03/19/2025]
Abstract
The association between body mass index (BMI) and cancers of the esophagus and the stomach remains complex and requires further exploration. This study aimed to investigate this association, including early-onset (< 50 years) cancer and cancer related mortality. A nationwide registry-based cohort study was performed by linking data from multiple national registries in Norway. The cohort included 1,723,692 individuals, with 22,473 gastroesophageal cancer cases identified over 55,701,169 person-years of follow-up. In men, a 5 kg/m2 increase in BMI was associated with an increased risk of esophageal (HR 1.34, 95%CI 1.22-1.48) and cardia adenocarcinoma (HR 1.36, 95% CI, 1.22-1.50). This finding extended to individuals with high BMI in early life (16-29 years) for esophageal adenocarcinoma. The highest risk per 5 kg/m2 increase in BMI was observed for early-onset esophageal (HR 2.49, 95%CI 1.23-5.02) and cardia adenocarcinoma (HR 2.26, 95%CI 1.19-4.27). Among women, increased BMI was associated with a higher risk of both esophageal (HR 1.28, 95%CI 1.13-1.44) and gastric adenocarcinoma (HR 1.04, 95%CI 1.01-1.07). Women with elevated BMI in early life also demonstrated increased risk for these cancers. In both sexes, a 5 kg/m2 increase in BMI was inversely associated with squamous cell carcinoma of the esophagus. No association was observed between BMI and risk of cancer-related mortality. This study highlights an elevated risk of gastroesophageal adenocarcinomas with increasing BMI, with notable sex, age, and site-specific variations. The findings also point to a heightened risk of early-onset esophageal and cardia adenocarcinoma in men with high BMI.
Collapse
Affiliation(s)
- Usman Saeed
- Department of Gastrointestinal and Pediatric Surgery, Oslo University Hospital, Oslo, Norway
| | - Tor Åge Myklebust
- Department of Registration, The Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Trude Eid Robsahm
- Department of Research, The Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Dagfinn Aune
- Department of Research, The Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
| | - Bjørn Møller
- Department of Registration, The Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Bjørn Steen Skålhegg
- Division for Molecular Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Sheraz Yaqub
- Department of Gastrointestinal and Pediatric Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tom Mala
- Department of Gastrointestinal and Pediatric Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
188
|
Rinebold E, Huang AL, Hahn SJ. How to Approach the Difficult Perineum in Crohn's Disease. Clin Colon Rectal Surg 2025; 38:148-159. [PMID: 39944307 PMCID: PMC11813606 DOI: 10.1055/s-0044-1786377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2025]
Abstract
Crohn's disease (CD) is a chronic, inflammatory bowel disease with a wide range of presentations, including perianal disease. Presentation is variable, ranging from skin tags to complex fistulas, strictures, and nonhealing wounds. Symptoms of perianal CD can be devastating and may impact quality of life. Optimal management requires coordinated medical and surgical therapy. When possible, conservative treatment of perianal disease should be attempted. However, surgical treatment is often required, and some patients may ultimately require total proctocolectomy with permanent diversion due to the severity of disease. Even with close attention and treatment, disease can be recurrent, and complications of treatment are sometimes worse than the initial presentation. Novel treatments, including use of mesenchymal stem cells and autologous fat grafting, hold some promise, but are not yet widely available. Thorough knowledge of treatment options, careful patient selection, coordination between medical and surgical providers, and setting realistic expectations are important in the successful treatment of difficult perineal CD.
Collapse
Affiliation(s)
- Emily Rinebold
- Division of Colon and Rectal Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, New York
| | - Alex L. Huang
- Division of Colon and Rectal Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, New York
| | - Sue J. Hahn
- Division of Colon and Rectal Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, New York
| |
Collapse
|
189
|
Little EM, Smith SW, Chatham L, Bishop M, Fornes C, Mosby M, Zaldivar L, Molloy Z, Tang G, Schilling MW, Zhang X. Rheological properties of gluten-free chicken nugget batters and sensory characteristics of coated nuggets. J Food Sci 2025; 90:e70124. [PMID: 40111094 DOI: 10.1111/1750-3841.70124] [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: 11/06/2024] [Revised: 02/19/2025] [Accepted: 02/21/2025] [Indexed: 03/22/2025]
Abstract
The prevalence of celiac disease in about 1% of the global population has led to the growing demand for gluten-free alternatives. The quality of gluten-free chicken nugget batters made from rice and chickpea flour and xanthan gum (XG) was assessed and compared with traditional wheat flour. A 3 × 4 factorial design within a randomized complete block framework with three replications was used to examine the rheological properties of batters varying in flour type (wheat, rice, chickpea) and XG concentration (0%, 0.05%, 0.075%, 0.1%). Rheological tests revealed that the addition of 0.075% XG significantly increased the viscosity of CF batters from 51 to 165 mPa·s, restoring structure to a level comparable to gluten-containing WF batters. The addition of 0.075% XG increased the batter pickup for each type of flour. Sensory evaluation consisted of two components: a descriptive analysis with trained panelists examining nuggets at both 0% and 0.075% XG concentrations and a consumer acceptability study (n = 145) focused on nuggets formulated with 0.075% XG. Consumer panel results indicated no differences (p = 0.14) in acceptability between gluten-free and gluten-containing nuggets. Rice flour nuggets achieved the highest overall acceptability (6.2), featuring enhanced fracturability and preferred flavor profiles. While descriptive analysis identified earthy, beany, and nutty notes in chickpea flour nuggets, they were accepted by consumers (6.0). Both rice and chickpea flour proved to be viable substitutes for wheat flour in chicken nugget batters. These findings support the potential of gluten-free alternatives in meeting consumer expectations and dietary needs. PRACTICAL APPLICATION: This research supports the development of gluten-free fried battered chicken nuggets using rice and chickpea flour. By highlighting xanthan gum's role in enhancing batter stability, it offers manufacturers a scalable solution to meet the needs of consumers with gluten intolerance or celiac disease.
Collapse
Affiliation(s)
- Emily Michelle Little
- Department of Biochemistry, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA
| | - Sawyer Wyatt Smith
- Department of Biochemistry, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA
| | - Louis Chatham
- Department of Biochemistry, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA
| | - Macie Bishop
- Department of Biochemistry, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA
| | - Corbin Fornes
- Department of Biochemistry, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA
| | - Morgan Mosby
- Department of Biochemistry, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA
| | - Lizzie Zaldivar
- Department of Biochemistry, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA
| | - Zoe Molloy
- Department of Biochemistry, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA
| | - Guyue Tang
- Department of Biochemistry, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA
| | - M Wes Schilling
- Department of Biochemistry, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA
| | - Xue Zhang
- Department of Animal and Dairy Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| |
Collapse
|
190
|
Entsie P, Amoafo EB, Kang Y, Gustad T, Dorsam GP, Frey MR, Liverani E. Sex-specific activation of platelet purinergic signaling is key in local cytokine release and phagocytosis in the peritoneal cavity in intra-abdominal sepsis. Am J Physiol Cell Physiol 2025; 328:C791-C805. [PMID: 39854048 DOI: 10.1152/ajpcell.00116.2024] [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: 02/20/2024] [Revised: 03/07/2024] [Accepted: 01/17/2025] [Indexed: 01/26/2025]
Abstract
Intra-abdominal sepsis is a life-threatening complex syndrome caused by microbes in the gut microbiota invading the peritoneal cavity. It is one of the major complications of intra-abdominal surgery. To date, only supportive therapies are available. No studies have investigated the progression of intra-abdominal sepsis in the peritoneal cavity. Our group has shown that platelets play an essential role during sepsis, and blocking purinergic signaling in platelets through P2Y1 and P2Y12 antagonism significantly lowered inflammatory levels and improved survival in a murine model of sepsis. Here, we tested whether antagonizing purinergic signaling in platelets in the peritoneal cavity can reduce the local release of cytokines and modulate platelet interaction with the immune system. We used cecal ligation and puncture (CLP) to induce sepsis followed by intraperitoneal administration of MRS2279 (P2Y1 antagonist) or ticagrelor (P2Y12 antagonist) in male and female mice. The peritoneal cavity fluid (PCF) was collected 4 or 24 h post-CLP and analyzed for cell recruitment, platelet markers, cytokines, and platelet immune cell interactions. Platelet markers were increased 24 h after CLP, although the total platelet count in the peritoneal cavity was lower than the blood. Blocking P2Y12 or P2Y1 improved bacterial clearance in the PCF in a sex-dependent manner. The influx of immune cells in the peritoneal cavity was altered by blocking P2Y12 or P2Y1 sex-dependently. Blocking P2Y1 and P2Y12 receptors can enhance the phagocytic activity in the peritoneal cavity in a sex- and time-related manner, and platelets significantly contribute to the development and progression of sepsis in the peritoneal cavity.NEW & NOTEWORTHY Intra-abdominal sepsis is a challenging complication postabdominal surgery caused by perforations of the gastrointestinal tract where microbes invade the peritoneal cavity. This leads to local cytokine release and immune cell dysfunction. Our data identify platelets as key players in mediating inflammation in intra-abdominal sepsis. We have shown that blocking purinergic signaling in the peritoneal cavity reduced cytokine release and cell-cell interactions differently in males and females, hence a sex-specific strategy to improve intra-abdominal sepsis.
Collapse
Affiliation(s)
- Philomena Entsie
- Department of Pharmaceutical Sciences, School of Pharmacy, College of Health and Human Sciences, North Dakota State University, Fargo, North Dakota, United States
| | - Emmanuel Boadi Amoafo
- Department of Pharmaceutical Sciences, School of Pharmacy, College of Health and Human Sciences, North Dakota State University, Fargo, North Dakota, United States
| | - Ying Kang
- Department of Pharmaceutical Sciences, School of Pharmacy, College of Health and Human Sciences, North Dakota State University, Fargo, North Dakota, United States
| | - Thomas Gustad
- Department of Microbiological Sciences, College of Agriculture, Food Systems and Natural Resources, North Dakota State University, Fargo, North Dakota, United States
| | - Glenn P Dorsam
- Department of Microbiological Sciences, College of Agriculture, Food Systems and Natural Resources, North Dakota State University, Fargo, North Dakota, United States
| | - Mark R Frey
- Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Elisabetta Liverani
- Department of Pharmaceutical Sciences, School of Pharmacy, College of Health and Human Sciences, North Dakota State University, Fargo, North Dakota, United States
| |
Collapse
|
191
|
Schonfeld E, Kierans AS, Fox R, Brandman D. Using Incidental Radiologic Findings of Hepatic Steatosis to Improve the Diagnosis of Metabolic Dysfunction-Associated Steatotic Liver Disease. J Am Coll Radiol 2025; 22:358-365. [PMID: 40044315 DOI: 10.1016/j.jacr.2024.12.014] [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: 10/03/2024] [Revised: 12/13/2024] [Accepted: 12/20/2024] [Indexed: 05/13/2025]
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common cause of liver disease worldwide. In patients with MASLD, liver fibrosis stage is the most significant predictor of mortality; therefore, early identification of patients at the greatest risk of advanced fibrosis is essential. Noninvasive tests predict advanced fibrosis and are recommended for use in primary care settings to determine which patients would benefit most from specialty care. The adoption of these tools is not widespread, and several studies have reported underrecognition of cirrhosis in patients with MASLD and diabetes. The finding of hepatic steatosis on imaging performed for evaluation of nonliver conditions may present an avenue for opportunistic screening to identify more patients with MASLD. This article will review recommendations for when hepatic steatosis is found on imaging and noninvasive tests that can be used to help predict fibrosis staging. This is a significant area of research because a new treatment for MASLD has been approved, and other treatments may follow.
Collapse
Affiliation(s)
- Emily Schonfeld
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, New York.
| | | | - Rena Fox
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, California
| | - Danielle Brandman
- Medical Director of Liver Transplant, Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, New York
| |
Collapse
|
192
|
Al-Judaibi B, Alzahrani H, Alahmari A, Almohareb F, Albenmousa A, Al-Hamoudi W, Alghamdi S, Alrajhi I, Alotaibi S, AlMozain N, Saner F, Duvoux C. Emerging need for a hepato-hematology program for patients with sickle cell disease in Saudi Arabia. Saudi J Gastroenterol 2025; 31:53-58. [PMID: 40051245 PMCID: PMC11978243 DOI: 10.4103/sjg.sjg_419_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2024] [Revised: 01/19/2025] [Accepted: 02/10/2025] [Indexed: 03/22/2025] Open
Abstract
ABSTRACT There is an increasing recognition of the need for a specialized hepatohematology program in countries with a high prevalence of sickle cell disease. This program would be tailored specifically for patients with sickle cell disease, addressing the unique challenges they face, including the management of liver and biliary complications, and hematological issues associated with their condition. By integrating hepatology and hematology expertise, we can improve knowledge of liver SCD-related diseases, and patient outcomes, enhance care coordination, and provide comprehensive management strategies for this vulnerable population. While the primary focus of this program is on SCD-related liver disease, there may be opportunities shortly to expand its scope to include patients with various hematological liver diseases.
Collapse
Affiliation(s)
- Bandar Al-Judaibi
- Department of Liver and Health Small Bowel Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hazzaa Alzahrani
- Hematology Department, Adult Transplant Intensive Care Unit, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ali Alahmari
- Hematology Department, Adult Transplant Intensive Care Unit, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Fahad Almohareb
- Hematology Department, Adult Transplant Intensive Care Unit, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ali Albenmousa
- Department of Liver and Health Small Bowel Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Waleed Al-Hamoudi
- Department of Liver and Health Small Bowel Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Saad Alghamdi
- Department of Liver and Health Small Bowel Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ibrahim Alrajhi
- Department of Liver and Health Small Bowel Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Shaykhah Alotaibi
- Hematology Department, Adult Transplant Intensive Care Unit, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Nour AlMozain
- Pathology and Laboratory Medicine, Adult Transplant Intensive Care Unit, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Fuat Saner
- Orgran Transplant Centre of Excellence, Adult Transplant Intensive Care Unit, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Christophe Duvoux
- Department of Hepatology and Medical Liver Transplant Unit, Henri Mondor Hospital-APHP, University Paris Est Creteil, France
| |
Collapse
|
193
|
Kido T, Yanagisawa H, Suka M. Zinc Deficiency Reduces Intestinal Secretory Immunoglobulin A and Induces Inflammatory Responses via the Gut-Liver Axis. Immunology 2025; 174:363-373. [PMID: 39775912 DOI: 10.1111/imm.13896] [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: 06/17/2024] [Revised: 10/07/2024] [Accepted: 12/16/2024] [Indexed: 01/11/2025] Open
Abstract
Nutritional zinc (Zn) deficiency could impair immune function and affect bowel conditions. However, the mechanism by which Zn deficiency affects the immune function of gut-associated lymphoid tissue (GALT) remains unclear. We investigated how Zn deficiency affects the function of GALT and level of secretory IgA (sIgA), a key component of the intestinal immune barrier, its underlying mechanisms, and whether Zn deficiency induces bacterial translocation to the liver. As previous research has indicated that interleukin (IL)-4 administration or Zn supplementation has a beneficial effect on the spleen of Zn-deficient rats, we investigated whether these supplements reverse the GALT immune system. Five-week-old male rats were fed a standard diet, Zn-deficient diet supplemented with saline or IL-4 for 6 weeks, or Zn-deficient diet followed by a standard diet for 4 weeks. Zn deficiency suppressed sIgA secretion in the intestinal tract by affecting GALT function and induced inflammatory responses through bacterial translocation to the liver via the portal vein. Furthermore, IL-4 administration and Zn supplementation in rats with Zn deficiency elicited comparable beneficial effects on GALT function, suggesting that the administration of either IL-4 or Zn could prevent inflammatory response via bacterial translocation to the liver.
Collapse
Affiliation(s)
- Takamasa Kido
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
194
|
Sun M, Liu Y, Ni X, Tan R, Wang Y, Jiang Y, Ke D, Du H, Guo G, Liu K. Intranasal immunization with poly I:C and CpG ODN adjuvants enhances the protective efficacy against Helicobacter pylori infection in mice. Microbes Infect 2025; 27:105433. [PMID: 39461584 DOI: 10.1016/j.micinf.2024.105433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 10/17/2024] [Accepted: 10/19/2024] [Indexed: 10/29/2024]
Abstract
Helicobacter pylori (H. pylori) infection is a serious public health issue, and development of vaccines is a desirable preventive strategy for H. pylori. Toll-like receptor (TLR) ligands have shown potential as vaccine adjuvants that induce immune responses, but polyinosinic-polycytidylic acid (poly I:C), a nucleic acid-based TLR9 ligand, is less well studied in H. pylori vaccine research. Here, we evaluated the effects of poly I:C and CpG oligodeoxynucleotide (CpG ODN), a nucleic acid TLR3 ligand, as adjuvants in combination with the H. pylori recombinant proteins LpoB and UreA to protect against H. pylori infection. For analysis of specific immune responses, the levels of specific antibodies and splenic cytokines were measured in the immunized mice. Compared with CpG ODN, poly I:C could induce mucosal sIgA antibody responses and reduce H. pylori colonization. Additionally, the combination of poly I:C and CpG ODN caused greater immunoprotection and significantly reduced gastritis, exerting synergistic effects. Analysis of splenic cytokines revealed that poly I:C mainly triggered a mixed Th1/Th2/Th17 immune response, whereas the combination of CpG ODN and poly I:C induced a Th1/Th17 immune response. Our findings indicated that increased levels of mucosal sIgA antibodies and a robust splenic Th1/Th17 immune response were associated with reduced H. pylori colonization in vaccinated mice. This study identified a potential TLR ligand adjuvant for developing more effective H. pylori vaccines.
Collapse
Affiliation(s)
- Min Sun
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yu Liu
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiumei Ni
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Runqing Tan
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yi Wang
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yajun Jiang
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Dingxin Ke
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Han Du
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Gang Guo
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China.
| | - Kaiyun Liu
- Biopharmaceutical Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China.
| |
Collapse
|
195
|
Wang M, Zheng C, Zhou F, Ying X, Zhang X, Peng C, Wang L. Iron and Inflammatory Cytokines Synergistically Induce Colonic Epithelial Cell Ferroptosis in Colitis. J Gastroenterol Hepatol 2025; 40:666-676. [PMID: 39586593 DOI: 10.1111/jgh.16826] [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: 01/28/2024] [Revised: 10/05/2024] [Accepted: 11/04/2024] [Indexed: 11/27/2024]
Abstract
Inflammatory bowel disease (IBD) is an inflammatory disease that occurs to the intestinal tract. Many patients with IBD often develop anemia and often receive oral iron supplementation. Many of them develop non-compliance with oral iron therapy, but the mechanisms are not well understood. We interrogated whether colonic epithelial iron overload impacts cell viability and disease severity. We observed increased expression of iron importers and iron accumulation in mature colonocytes in dextran sulfate sodium (DSS)-induced acute colitis and in humans with active colitis. Administration of hepcidin increased epithelial iron overload and aggravated colonic inflammation in DSS-treated mice and IL10-/- mice. Hepcidin-induced iron accumulation increased colonic epithelial death, which was prevented by treatment with Trolox, a vitamin E analog and a scavenger of lipid peroxides. By using cultured Caco-2 cells, we showed that iron and inflammatory cytokines (TNF-α and IL-1β) induced a synergistic increase in the number of necrotic cells. We then showed that the combined treatment by hepcidin and cytokines increased labile iron content and lipid peroxidation in Caco-2 cells. Moreover, liproxstatin-1, a ferroptosis inhibitor, and deferoxamine, an iron chelator, both abolished the hepcidin/cytokines induced death of Caco-2 cells, suggesting ferroptosis. We further elucidated that inflammatory cytokines promote lipid peroxidation and ferroptosis by inducing NOX1-dependent exhaustion of reduced glutathione (GSH). Collectively, our findings demonstrate that the inflammatory context predisposes colonic epithelial cells to iron overload mediated ferroptosis, exacerbating colonic inflammation.
Collapse
Affiliation(s)
- Mo Wang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Chang Zheng
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Fan Zhou
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Xie Ying
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Xiaoqi Zhang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Chunyan Peng
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Lei Wang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| |
Collapse
|
196
|
Jagroo J, Oudit OA, Knowles C, Adidam Venkata S. Confronting Cholelithiasis: A Case Series of Patients With Sickle Cell Disease and Gallstones. Cureus 2025; 17:e80558. [PMID: 40225473 PMCID: PMC11994046 DOI: 10.7759/cureus.80558] [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] [Accepted: 03/14/2025] [Indexed: 04/15/2025] Open
Abstract
Sickle cell disease (SCD) is a prevalent hemoglobinopathy that leads to various complications, including hepatobiliary diseases, which are often underrecognized. Cholelithiasis and choledocholithiasis, resulting from accelerated pigment gallstone formation due to increased hemolysis, are common in SCD patients. This case series aims to raise awareness of the heightened risk of biliary disease in SCD and emphasize the need for early screening and management strategies. We present four cases of adult SCD patients who developed gallstones, each requiring medical intervention for biliary complications. The first case involved a 47-year-old woman with SCD and choledocholithiasis, presenting with right upper quadrant pain and jaundice. She underwent a laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) for stone removal. The second case described a 25-year-old woman with a history of SCD, who had hyperbilirubinemia and dilated common hepatic duct. She successfully underwent ERCP and laparoscopic cholecystectomy after cholelithiasis was confirmed. The third case involved a 34-year-old man with acute abdominal pain and right-sided testicular pain, diagnosed with gallstones and early cholecystitis. Despite plans for surgery, he signed out against medical advice. The fourth case was a 28-year-old woman with recurrent acute chest syndrome, who presented with abdominal pain and was found to have multiple gallstones. She underwent laparoscopic cholecystectomy, but developed acute chest syndrome postoperatively, requiring exchange transfusion. All patients experienced post-surgical recovery, although one patient had complications related to acute chest syndrome. Hepatobiliary manifestations in SCD include cholelithiasis, choledocholithiasis, and other liver-related issues. The formation of pigmented gallstones is a direct result of chronic hemolysis, where increased bilirubin levels contribute to stone formation. The incidence of cholelithiasis in SCD patients is significant, with factors such as hemoglobin levels and bilirubin elevation increasing the likelihood of gallstone formation. Symptomatic gallstones often present with right upper quadrant pain, which can be exacerbated by vaso-occlusive crises. Early intervention, including elective cholecystectomy, can help prevent complications like choledocholithiasis, biliary colic, and cholecystitis. Despite a lack of formal guidelines for routine cholecystectomy in asymptomatic patients, evidence supports early surgical management to prevent further complications and reduce the need for emergent procedures. This case series highlights the importance of early screening and elective cholecystectomy for SCD patients at risk of biliary disease. Early intervention can prevent acute complications, reduce hospitalizations, and improve the quality of life for patients with SCD. Future research and guidelines should focus on establishing protocols for screening and management of gallstone-related hepatobiliary complications in this population.
Collapse
Affiliation(s)
- Javed Jagroo
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Omar A Oudit
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Corey Knowles
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | | |
Collapse
|
197
|
Yang YJ, Jeon SR. Metabolic musculoskeletal disorders in patients with inflammatory bowel disease. Korean J Intern Med 2025; 40:181-195. [PMID: 40102707 PMCID: PMC11938716 DOI: 10.3904/kjim.2024.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Revised: 11/13/2024] [Accepted: 11/14/2024] [Indexed: 03/20/2025] Open
Abstract
Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is a chronic inflammatory disorder that affects not only the gastrointestinal tract but also extraintestinal organs, leading to various extraintestinal manifestations and complications. Among these, musculoskeletal disorders such as osteoporosis, sarcopenia, and axial and peripheral spondyloarthritis are the most commonly observed. These conditions arise from complex mechanisms, including chronic inflammation, malnutrition, gut dysbiosis, and glucocorticoid use, all of which contribute to reduced bone density, muscle loss, and joint inflammation. Osteoporosis and sarcopenia may co-occur as osteosarcopenia, a condition that heightens the risk of fractures, impairs physical performance, and diminishes quality of life, particularly in elderly patients with IBD. Holistic management strategies, including lifestyle modifications, calcium, and vitamin D supplementation, resistance training, and pharmacological interventions, are essential for mitigating the impact of these conditions. Spondyloarthritis, which affects both axial and peripheral joints, further complicates disease management and significantly compromises joint health. Timely diagnosis and appropriate medical interventions, such as administration of nonsteroidal anti-inflammatory drugs and biologics, are critical for preventing chronic joint damage and disability. Moreover, a multidisciplinary approach that addresses both metabolic and inflammatory aspects is essential for optimizing physical function and improving treatment outcomes in patients who have IBD with musculoskeletal involvement.
Collapse
Affiliation(s)
- Young Joo Yang
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon,
Korea
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon,
Korea
| | - Seong Ran Jeon
- Digestive Disease Center, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul,
Korea
| |
Collapse
|
198
|
Zhang Y, Yan Z, Jiao Y, Feng Y, Zhang S, Yang A. Innate Immunity in Helicobacter pylori Infection and Gastric Oncogenesis. Helicobacter 2025; 30:e70015. [PMID: 40097330 PMCID: PMC11913635 DOI: 10.1111/hel.70015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Revised: 01/25/2025] [Accepted: 01/25/2025] [Indexed: 03/19/2025]
Abstract
Helicobacter pylori is an extremely common cause of gastritis that can lead to gastric adenocarcinoma over time. Approximately half of the world's population is infected with H. pylori, making gastric cancer the fourth leading cause of cancer-related deaths worldwide. Innate immunity significantly contributes to systemic and local immune responses, maintains homeostasis, and serves as the vital link to adaptive immunity, and in doing so, mediates H. pylori infection outcomes and consequent cancer risk and development. The gastric innate immune system, composed of gastric epithelial and myeloid cells, is uniquely challenged by its need to interact simultaneously and precisely with commensal microbiota, exogenous pathogens, ingested substances, and endogenous exfoliated cells. Additionally, innate immunity can be detrimental by promoting chronic infection and fibrosis, creating an environment conducive to tumor development. This review summarizes and discusses the complex role of innate immunity in H. pylori infection and subsequent gastric oncogenesis, and in doing so, provides insights into how these pathways can be exploited to improve prevention and treatment.
Collapse
Affiliation(s)
- Yuheng Zhang
- Department of Gastroenterology, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
- Eight‐Year Medical Doctor Program, Peking Union Medical CollegeChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Zhiyu Yan
- Department of Gastroenterology, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
- Department of Medicine, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Yuhao Jiao
- Department of Gastroenterology, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
- Department of Medicine, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Yunlu Feng
- Department of Gastroenterology, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Shengyu Zhang
- Department of Gastroenterology, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Aiming Yang
- Department of Gastroenterology, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| |
Collapse
|
199
|
O'Grady K, Grabrucker AM. Metal Dyshomeostasis as a Driver of Gut Pathology in Autism Spectrum Disorders. J Neurochem 2025; 169:e70041. [PMID: 40108935 PMCID: PMC11923526 DOI: 10.1111/jnc.70041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Revised: 01/31/2025] [Accepted: 02/25/2025] [Indexed: 03/22/2025]
Abstract
Despite being classified as neurodevelopmental disorders, in recent years, there has been a growing interest in the association between autism spectrum disorders (ASDs) and gut pathology. This comprehensive and systematic review explores a potential mechanism underlying gut pathology in ASDs, including alterations in gut microbiota, intestinal permeability, immune dysregulation, and gastrointestinal (GI) symptoms. Specifically, it delves into the role of toxic and essential metals and their interplay, affecting the development and function of the GI tract. The review also discusses the potential implications of this gut pathology in the development and management of ASDs. Studies have shown that heavy metal exposure, whether through environmental sources or dietary intake, can disrupt the delicate balance of trace elements in the gut. This disruption can adversely affect zinc homeostasis, potentially exacerbating gut pathology in individuals with ASDs. The impaired zinc absorption resulting from heavy metal exposure may contribute to the immune dysregulation, oxidative stress, and inflammation observed in the gut of individuals with ASDs. By shedding light on the multifaceted nature of gut pathology, including the impact of metal dyshomeostasis as a non-genetic factor in ASD, this review underscores the significance of the gut-brain axis in the etiology and management of ASDs.
Collapse
Affiliation(s)
- Katelyn O'Grady
- Department of Biological SciencesUniversity of LimerickLimerickIreland
- Bernal InstituteUniversity of LimerickLimerickIreland
- Health Research Institute (HRI)University of LimerickLimerickIreland
| | - Andreas M. Grabrucker
- Department of Biological SciencesUniversity of LimerickLimerickIreland
- Bernal InstituteUniversity of LimerickLimerickIreland
- Health Research Institute (HRI)University of LimerickLimerickIreland
| |
Collapse
|
200
|
Broekaert IJ, Assa A, Borrelli O, Saccomani MD, Homan M, Martin‐de‐Carpi J, Mas E, Miele E, Misak Z, Sila S, Thomson M, Tzivinikos C, Dolinsek J. Approach to anaemia in gastrointestinal disease: A position paper by the ESPGHAN Gastroenterology Committee. J Pediatr Gastroenterol Nutr 2025; 80:510-532. [PMID: 39783775 PMCID: PMC11874238 DOI: 10.1002/jpn3.12454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 10/31/2024] [Accepted: 12/10/2024] [Indexed: 01/12/2025]
Abstract
Anaemia is a frequent consequence of many gastrointestinal (GI) diseases in children and it can even be the initial presenting symptom of underlying chronic GI disease. The definition of anaemia is age and gender-dependent and it can be classified based on pathophysiology, red cell morphology, and clinical presentation. Although nutritional deficiencies, including GI malabsorption of nutrients and GI bleeding, play a major role, other pathophysiologic mechanisms seen in chronic GI diseases, whether inflammatory (e.g., inflammatory bowel disease) or not (e.g., coeliac disease and dysmotility), are causing anaemia. Drugs, such as proton pump inhibitors, mesalamine, methotrexate and sulfasalazine, are also a potential cause of anaemia. Not uncommonly, due to a combination of factors, such as iron deficiency and a chronic inflammatory state, the underlying pathophysiology may be difficult to decipher and a broad diagnostic work-up is required. The goal of treatment is correction of anaemia by supplementation of iron and vitamins. The first therapeutic step is to treat the underlying cause of anaemia including bleeding control, restoration of intestinal integrity and reduction of inflammatory burden. The route of iron and vitamin supplementation is guided by the severity of anaemia.
Collapse
Affiliation(s)
- Ilse Julia Broekaert
- Department of Paediatrics, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
| | - Amit Assa
- The Juliet Keidan Institute of Paediatric Gastroenterology and Nutrition, Shaare Zedek Medical CentreThe Hebrew UniversityJerusalemIsrael
| | - Osvaldo Borrelli
- Division of Neurogastroenterology & Motility, Department of Paediatric GastroenterologyGreat Ormond Street HospitalLondonUK
| | | | - Matjaž Homan
- Department of Gastroenterology, Hepatology and Nutrition, University Children's HospitalFaculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Javier Martin‐de‐Carpi
- Department of Paediatric Gastroenterology, Hepatology and NutritionHospital Sant Joan de DéuBarcelonaSpain
| | - Emmanuel Mas
- Service de Gastroentérologie, Hépatologie, Nutrition et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, and IRSDUniversité de Toulouse, INSERM, INRAE, ENVT, UPSToulouseFrance
| | - Erasmo Miele
- Department of Translational Medical Science, Section of PediatricsUniversity of Naples “Federico II”NaplesItaly
| | - Zrinjka Misak
- Referral Centre for Paediatric Gastroenterology and NutritionChildren's Hospital ZagrebZagrebCroatia
| | - Sara Sila
- Referral Centre for Paediatric Gastroenterology and NutritionChildren's Hospital ZagrebZagrebCroatia
| | - Mike Thomson
- Centre for Paediatric GastroenterologySheffield Children's Hospital NHS Foundation TrustSheffieldUK
| | - Christos Tzivinikos
- Paediatric Gastroenterology Department, Al Jalila Children's Specialty HospitalMohammed Bin Rashid University, Dubai Medical CollegeDubaiUnited Arab Emirates
| | - Jernej Dolinsek
- Department of PaediatricsUniversity Medical Centre MariborMariborSlovenia
| |
Collapse
|