المؤلفون: Alireza Norouzi, Aabbas Ali Keshtkar, Sima Besharat, Ahmad Sohrabi, Taghi Amiriani, Gholamreza Roshandel, Sabine Kienesberger, Hesamaddin Shirzad-Aski

المصدر: Journal of Clinical Gastroenterology. 55:380-392

مصطلحات موضوعية: Funnel plot, medicine.medical_specialty, Helicobacter Infections, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Odds Ratio, Humans, Medicine, Colonization, Helicobacter pylori, biology, business.industry, Gastroenterology, Odds ratio, Publication bias, Colitis, Inflammatory Bowel Diseases, biology.organism_classification, digestive system diseases, Confidence interval, Study heterogeneity, 030220 oncology & carcinogenesis, Meta-analysis, 030211 gastroenterology & hepatology, business

الوصف: Background Various observational studies have examined a potential relationship between Helicobacter pylori colonization and inflammatory bowel diseases (IBDs); however, results are inconclusive. This systematic review evaluates articles reporting an association between human H. pylori colonization and IBD. Methods A systematic search of studies was conducted to evaluate a possible relationship between H. pylori colonization and IBD. Seven databases and different types of gray literature were searched. After screening for relevant articles, selection and data extraction were done. After that, the data were analyzed, and pooled odds ratios (ORs) were calculated, using meta-analysis. Heterogeneity, sensitivity, and subgroups analyses were conducted. Funnel plots followed by Begg and Egger tests were done to assess the publication bias. Results Among 58 studies, including 13,549 patients with IBD and 506,554 controls, the prevalence of H. pylori colonization was 22.74% and 36.30%, respectively. A significant negative association was observed between H. pylori colonization and IBD (pooled OR: 0.45, 95% confidence interval 0.39-0.53, P≤0.001). The random-effect model showed significant statistical heterogeneity in the included studies (I=79%). No publication bias was observed. Among subgroups, ORs were notably different when the data were stratified by the age difference between patient and control group, and by study regions and/or continent. Finally, the meta-regression analysis showed significant results, in terms of the age difference and region variables. Conclusions In this meta-analysis, all statistical data support the theory that H. pylori has a protective role in IBD. However, more primary studies using proper methodology are needed to confirm this association.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8c3b5a7a5b88c76f70a7ffb3b41539e9
https://doi.org/10.1097/mcg.0000000000001415

المؤلفون: Vivian Huang, Kristel Leung, Arif Yusuf, Parul Tandon

المصدر: Journal of Clinical Gastroenterology. 53:574-581

مصطلحات موضوعية: Adult, medicine.medical_specialty, Population, Serum albumin, Prenatal diagnosis, Gastroenterology, Inflammatory bowel disease, Feces, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Prenatal Diagnosis, Internal medicine, medicine, Humans, education, education.field_of_study, biology, business.industry, Inflammatory Bowel Diseases, medicine.disease, Ulcerative colitis, digestive system diseases, Pregnancy Complications, 030220 oncology & carcinogenesis, biology.protein, Gestation, Female, 030211 gastroenterology & hepatology, Calprotectin, business

الوصف: Active inflammatory bowel disease (IBD) may increase the risk of adverse outcomes during pregnancy. Our aim was to systematically review the role of noninvasive fecal tests, such as fecal calprotectin (FCP) and lactoferrin (FL), and laboratory tests including C-reactive protein (CRP), hemoglobin, and albumin in the assessment of IBD during pregnancy. A systematic search of electronic databases was performed through October 2018 for studies assessing the utility of fecal and laboratory tests in predicting IBD activity in pregnant patients. Active disease was defined based on routinely used clinical criteria such as the Harvey-Bradshaw Index or Mayo score for ulcerative colitis. Noninvasive test levels were stratified by the presence of active disease and by gestational period (preconception, first trimester, second trimester, and third trimester). Thirteen studies were included. Both FCP and FL levels were significantly higher in pregnant patients with IBD compared with those without IBD. FCP levels were also significantly higher in patients with active disease compared with those with the inactive disease during all gestational periods. Furthermore, 3 studies demonstrated no consistent correlation with serum CRP and active IBD during pregnancy. Similarly, serum albumin and hemoglobin levels did not correlate with disease activity in pregnant patients with IBD. Given the lack of high-quality evidence, only FCP appears to correlate with IBD activity in all gestational periods of pregnancy. The utility of the other noninvasive tests such as serum CRP, hemoglobin, and albumin remains to be determined in this population.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5fa9c52fd5164a4f8114c3460cc3868f
https://doi.org/10.1097/mcg.0000000000001244

المؤلفون: Sherry Yueh Hsia Chiu, Jean Ching Yuan Fann, Ming-Shiang Wu, Tony Hsiu Hsi Chen, Tsung-Hsien Chiang, Cheng Ying Liu, Ming Wei Lin, Amy Ming Fang Yen, Chu-Kuang Chou, Sam Li Sheng Chen, Chia-Tung Shun, Yi-Chia Lee, Han-Mo Chiu, Jaw-Town Lin

المصدر: Journal of Clinical Gastroenterology. 53:e186-e193

مصطلحات موضوعية: Adult, Male, Oncology, medicine.medical_specialty, Taiwan, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pepsin, Predictive Value of Tests, Stomach Neoplasms, Pepsinogen A, Internal medicine, Biomarkers, Tumor, medicine, Humans, Cancer death, Aged, Aged, 80 and over, Community based, biology, business.industry, Gastroenterology, Middle Aged, Helicobacter pylori, biology.organism_classification, digestive system diseases, 030220 oncology & carcinogenesis, Predictive value of tests, biology.protein, Female, 030211 gastroenterology & hepatology, Serum pepsinogen, business, Cohort study

الوصف: The purpose of this article is to validate the long-term association between initial serum pepsinogen (PG) measurements and subsequent gastric cancer-specific deaths from a long-term longitudinal cohort.Endoscopic surveillance can be effective and efficient in reducing gastric cancer mortality if a biomarker such as serum PG is available to identify high-risk individuals and if the biomarker also is specific to gastric cancer risk.Between 1995 and 1998, a gastric cancer-screening program was conducted in a high-risk population: The first stage involved PG testing, and the second stage involved upper endoscopy. The outcome was gastric cancer death, which was monitored until December 31, 2010; results were expressed as the hazard ratio (HR) and corresponding 95% confidence interval (CI) using the Cox proportional hazards regression model. Other causes of death were used as comparators.Among participants (n=3514) aged ≥30 years, 1682 (47.9%) were screened to determine serum PG levels. After 16 years of follow-up, 14 deaths from gastric cancer were documented. Multivariate analyses adjusted for age, sex, and Helicobacter pylori serological positivity showed that PG-I30 μg/L and PG-I30 μg/L or PG-I/II ratio3 were significantly associated with the risk of gastric cancer death (HR, 3.27; 95% CI, 1.11-9.61 and HR, 3.45; 95% CI, 1.18-10.12, respectively). In contrast, there were no significant associations between PG and other causes of death, including neoplastic and non-neoplastic diseases.This long-term cohort study shows the usefulness of PG measurement as a biomarker that is specific to the risk of gastric cancer death.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8b2821ada288d174ac1409ea9f7671ba
https://doi.org/10.1097/mcg.0000000000000992

المؤلفون: Fernanda Cristofori, Michele Barone, Marco Gobbetti, Lorenzo Polimeno, Stefania Castellaneta, Antonio Francavilla, Maria De Angelis, Ruggiero Francavilla, Maria Piccolo, Francesco Semeraro, Flavia Indrio

المصدر: Journal of Clinical Gastroenterology. 53:e117-e125

مصطلحات موضوعية: medicine.medical_specialty, Gut flora, Placebo, Gastroenterology, law.invention, 03 medical and health sciences, Probiotic, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Multicenter trial, Medicine, Prospective cohort study, Irritable bowel syndrome, biology, business.industry, nutritional and metabolic diseases, medicine.disease, biology.organism_classification, digestive system diseases, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Gluten free, business

الوصف: Goals:The goals of this study were to evaluate the efficacy and safety of a probiotic mixture in patients with celiac disease (CD) with irritable bowel syndrome (IBS)-type symptoms despite a strict gluten-free diet (GFD).Background:About 30% of patients with CD adherent to a GFD suffer from IBS-type

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::bfe433e8668739555d8897ef8f1109a8
https://doi.org/10.1097/mcg.0000000000001023

المؤلفون: Kongliang Sun, Lifang Fan, Mary Wong, Yuntian Hong, Xuemo Sean Fan, Hanlin L. Wang, Xiaoyu Xie, Congqing Jiang

المصدر: Journal of clinical gastroenterology. 55(3)

مصطلحات موضوعية: medicine.medical_specialty, Cell Count, Disease, Inflammatory bowel disease, Gastroenterology, Pathogenesis, Irritable Bowel Syndrome, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Mast Cells, Intestinal Mucosa, Irritable bowel syndrome, biology, business.industry, CD117, medicine.disease, Mast cell, Ulcerative colitis, digestive system diseases, Diarrhea, medicine.anatomical_structure, 030220 oncology & carcinogenesis, biology.protein, 030211 gastroenterology & hepatology, Colitis, Ulcerative, medicine.symptom, business

الوصف: Goal We aimed to study the density of intramucosal mast cells in histologically normal colonic mucosa biopsied from patients with a clinical diagnosis of irritable bowel syndrome (IBS). Background Mast cell activation has been thought to implicate in the pathogenesis of inflammatory bowel disease (IBD). Whether it serves a role in the pathogenesis of IBS remains controversial. Study A total of 127 colonoscopic mucosal biopsies were immunohistochemically stained, including 51 IBS, 66 IBD, and 10 normal control samples. Intact mast cells were quantified in 3 high power fields (HPF) in areas showing the highest density. Results CD117 was sensitive in detecting mast cells in colonic mucosa. The mast cell counts in all biopsies ranged from 2 to 60 per HPF (mean=17.5±7.2). The density of intramucosal mast cells were similar among IBS, IBD and normal control groups (P=0.6733). IBD in remission versus IBS (17.1±8.0 vs. 18.1±7.0; P=0.4804), Crohn disease versus ulcerative colitis (17.1±10.4 vs. 17.2±5.2; P=0.9463), IBS with diarrhea versus without diarrhea (19.5±6.3 vs. 16.8±6.9; P=0.1404). Forty biopsies (31.5%) showing ≥20 mast cells per HPF appeared to equally distribute among various disease groups (P=0.7283). Conclusions There is no significant difference in the number of intramucosal mast cells between IBS and IBD that show normal colonic biopsies. In IBS patients, the number of intramucosal mast cell does not correlate with symptoms. The mast cell count (≥20/HPF) is not a reliable criterion for the diagnosis of IBS or for the distinction between patients with IBS and those with IBD in remission.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ffcfd14dcf5a6b4fbe7c683cb9ebb39d
https://pubmed.ncbi.nlm.nih.gov/32649443

المؤلفون: Kenneth E.L. McColl

المصدر: Journal of Clinical Gastroenterology. 52:1-5

مصطلحات موضوعية: 0301 basic medicine, medicine.medical_specialty, Population, Lumen (anatomy), Disease, Gastroenterology, Helicobacter Infections, Gastric Acid, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Helicobacter, education, education.field_of_study, Helicobacter pylori, biology, business.industry, Stomach, digestive, oral, and skin physiology, Reflux, Cardia, Postprandial Period, biology.organism_classification, digestive system diseases, 030104 developmental biology, medicine.anatomical_structure, Gastroesophageal Reflux, Gastric acid, 030211 gastroenterology & hepatology, business

الوصف: In 2001, it was observed that the cardia region of the lumen of the stomach remained highly acidic after a meal and escaped the buffering effect of the food. This phenomenon was termed the acid pocket and is thought to explain why reflux symptoms occur after meals despite the buffering effect of food. This review describes the discovery of the acid pocket and our progress in understanding the intragastric physiology producing it, its exaggeration in hiatus hernia and role in reflux disease. The recent discovery that the acid pocket is attenuated in the Helicobacter pylori-infected population and the significance of this to the negative association between H. pylori and reflux disease and its complications is also addressed. Finally, the role of the acid pocket in providing protection from potentially pathogenic ingested microorganisms is discussed.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::534017993177ef3df616adff41c28dbe
https://doi.org/10.1097/mcg.0000000000000939

المؤلفون: Marina Russo, Annamaria Staiano, Elena Scarpato

المصدر: Journal of Clinical Gastroenterology. 52:S7-S9

مصطلحات موضوعية: 0301 basic medicine, medicine.medical_specialty, Disease, Gut flora, digestive system, Inflammatory bowel disease, law.invention, Immune tolerance, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, medicine, Colitis, Pediatric gastroenterology, biology, business.industry, Gastroenterology, biology.organism_classification, medicine.disease, digestive system diseases, Lactobacillus reuteri, 030104 developmental biology, Immunology, 030211 gastroenterology & hepatology, business

الوصف: Etiology of inflammatory bowel disease (IBD) is not yet completely understood, but it is hypothesized that a disruption of the immune tolerance to gut microbiota, due to several potential factors like an abnormal gut microbiota composition and activity, may lead to IBD occurrence. Manipulation of the intestinal microbiota is an attractive target for the management of IBD, and probiotics could be useful to influence the disease's course. However, the existing literature on the usefulness of probiotics in IBD is relatively limited. At present, there is no evidence of efficacy for any bacterial strain in the induction or maintenance of remission in pediatric Crohn's disease, while there is limited evidence for the use of VSL#3 and Lactobacillus reuteri ATCC 55730, in addition to standard therapy, for the induction of remission in pediatric ulcerative colitis. Moreover, current data assessing the therapeutic efficacy of probiotics in IBD do not fulfill evidence-based standards, with long-term maintenance studies and larger prospective randomized controlled trials still lacking.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::2d27d4885b8b78dd092d17ac6d31f08c
https://doi.org/10.1097/mcg.0000000000001095

المؤلفون: Matthew Regueiro, David G. Binion, Jana G. Hashash, Douglas J. Hartman, Pamela L. Beatty, Olivera J. Finn, Kristen Critelli, Miguel Regueiro, Hani Tamim

المصدر: J Clin Gastroenterol

مصطلحات موضوعية: medicine.medical_specialty, Colon, Ileum, Inflammation, Disease, Gastroenterology, digestive system, Article, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Recurrence, Internal medicine, Medicine, Humans, skin and connective tissue diseases, neoplasms, MUC1, Retrospective Studies, Crohn's disease, biology, business.industry, Mucin, Mucin-1, Mucins, Colonoscopy, medicine.disease, biological factors, digestive system diseases, medicine.anatomical_structure, 030220 oncology & carcinogenesis, biology.protein, Biomarker (medicine), 030211 gastroenterology & hepatology, Tumor Necrosis Factor Inhibitors, Antibody, medicine.symptom, business

الوصف: BACKGROUND MUC1-glycoprotein is expressed at low levels and in fully glycosylated form on epithelial cells. Inflammation causes MUC1 overexpression and hypoglycosylation. We hypothesized that overexpression of hypoglycosylated MUC1 would be found in postoperative Crohn's disease (CD) recurrence and could be considered an additional biomarker of recurrence severity. METHODS We examined archived neo-terminal ileum biopsies from patients with prior ileocecal resection who had postoperative endoscopic assessment of CD recurrence and given a Rutgeerts ileal recurrence score. Consecutive tissue sections were stained using 2 different anti-MUC1 antibodies, HMPV that recognizes all forms of MUC1 and 4H5 that recognizes only inflammation-associated hypoglycosylated MUC1. RESULTS A total of 71 postoperative CD patients were evaluated. There was significant increase in MUC1 expression of both glycosylated/normal (P

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f5e6ab2b0ae7b27f4bb2fa7cd7a8c647
https://pubmed.ncbi.nlm.nih.gov/32195770

المؤلفون: Monther Bajbouj, Knut Brockow, Roland M. Schmid, Christoph Schlag, Simon Nennstiel, Simon Weidlich, Julia Slotta-Huspenina, Moritz Jesinghaus

المصدر: Journal of clinical gastroenterology. 54(1)

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Biopsy, Immunoglobulin E, Gastroenterology, Diagnosis, Differential, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Esophagus, Internal medicine, parasitic diseases, medicine, Humans, Prospective Studies, Eosinophilic esophagitis, Prospective cohort study, Budesonide, Aged, Clinical Trials as Topic, medicine.diagnostic_test, biology, business.industry, fungi, Reflux, Eosinophilic Esophagitis, Middle Aged, medicine.disease, digestive system diseases, 030220 oncology & carcinogenesis, Immunoglobulin G, GERD, biology.protein, Gastroesophageal Reflux, 030211 gastroenterology & hepatology, Female, Antibody, Differential diagnosis, business

الوصف: For eosinophilic esophagitis (EoE) recently an association with immunoglobulin (Ig)G4 rather than IgE has been reported. Gastroesophageal reflux disease (GERD) is the most important differential diagnosis of EoE. We compared esophageal IgG4 plasma cell infiltration and serum IgG4 levels of EoE patients (before and after budesonide therapy) with GERD patients.Prospectively collected serum samples of 17 EoE patients before and after 8 weeks of therapy with budesonide (1 mg BID) were analyzed for total and antigen-specific IgG4 and IgE levels. Also, immunohistochemical analysis of total and IgG4-positive plasma cells was performed on esophageal biopsies of these patients. In total, 14 GERD patients without histologic proof of eosinophilic infiltration were taken as a control group.Total IgG4 serum levels in EoE patients were significantly higher than in GERD patients (121.0 vs. 71.2 mg/dL; P=0.038) and decreased under budesonide therapy (121.0 vs. 104.2 mg/dL; P=0.019). IgE levels did not differ significantly between all groups. In EoE patients also a high number of esophageal IgG4-positive plasma cells was detected and significantly reduced under therapy (29.1 vs. 0.1 IgG4-positive cells; P0.001). In GERD patients no relevant esophageal plasma cell infiltration could be seen.In EoE patients elevated systemic IgG4 serum levels compared with GERD patients can be seen and decrease under topical steroid therapy. Also, local IgG4 plasma cells expression is high in EoE, but not in GERD patients and normalize under therapy. These findings are further proof for a possible association of EoE with IgG4.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::57753265f9177501bf92f52bc5792d4e
https://pubmed.ncbi.nlm.nih.gov/30614939

المؤلفون: Adam Lee Goldstein, Naomi Fliss-Isakov, Nathan Gluck, Guy Rosner, Shira Zelber-Sagi, Hagit Tulchinsky, Revital Kariv

المصدر: Journal of clinical gastroenterology. 53(2)

مصطلحات موضوعية: Adenoma, Adult, Male, medicine.medical_specialty, Adolescent, Adenomatous polyposis coli, medicine.medical_treatment, Adenomatous Polyposis Coli Protein, Colonic Pouches, medicine.disease_cause, Gastroenterology, Familial adenomatous polyposis, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, medicine, Prevalence, Missense mutation, Humans, Indel, Genetic Association Studies, Retrospective Studies, Mutation, biology, Proctocolectomy, business.industry, Proctocolectomy, Restorative, medicine.disease, digestive system diseases, Adenomatous Polyposis Coli, 030220 oncology & carcinogenesis, Colonic Neoplasms, biology.protein, 030211 gastroenterology & hepatology, Female, Pouch, business

الوصف: Background Patients with familial adenomatous polyposis (FAP) may carry various adenomatous polyposis coli (APC) mutations. However, genotype-phenotype correlation for APC mutations is still debated and is yet to be evaluated with regard to pouch polyp formation. Objective To evaluate the association between APC mutation type and exon location and the outcome of pouch adenoma. Design setting and patients Forty-five FAP patients with defined pathogenic APC mutations, who underwent total proctocolectomy and ileal pouch anal anastomosis were classified by mutation type and location. Analysis was conducted for clinical and endoscopic parameters. Results Twenty patients had either indel/deletion mutations and 25 had nonsense/missense mutations. The indel/deletion group was associated with higher prevalence of preoperative hundreds of colonic adenomas (66.7% vs. 30%; P=0.030), lower rates of stapled versus sewn anastomosis (46.7% vs. 76%; P=0.060), of single stage surgery (13.3% vs. 44%; P=0.045) and with higher pouch adenoma formation rate (50% vs. 8%; P=0.002). Twenty-seven were carriers of exons 1 to 14 mutations and 18 were carriers of exon 15 mutations. Carriers of exon 15 mutations had higher prevalence of preoperative hundreds of colonic adenomas (55.6% vs. 22.2%; P=0.003) and a higher tendency for pouch and cuff adenoma formation rate. Adjusted odds ratio for pouch adenoma formation was 8.32 (1.42-48.80; P=0.019) for the indel/deletion group versus nonsense/missense, but no significant independent association was noted with mutation location. The mean number of pouch and cuff adenoma formation (per endoscopy) was higher among carriers of exon 15 mutations, but no significant independent association was noted the with mutation type. Conclusions Type and location of APC mutation are associated with colonic polyp burden, surgical outcome and likelihood of developing pouch adenomas. These findings may contribute to surgical and endoscopic surveillance decisions for FAP patients.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0f580e5f2c03e88a553c844bb8a86f0a
https://pubmed.ncbi.nlm.nih.gov/29099467