More than shots in the dark: improving patient stratification to move closer to personalised therapies in intrahepatic cholangiocarcinoma
Cholangiocarcinomas, the second most frequent hepatic tumour after hepatocellular carcinoma, make up around 2% of all gastrointestinal malignancies. It is believed that these tumours have been occurring more frequently recently, at least in Western countries, and that this is mostly due to an increase in intrahepatic cholangiocarcinoma (iCCA).1 The combination of cisplatin and gemcitabine was established as the first-line therapy for patients with advanced cholangiocarcinoma for several years based on the findings of the ABC-02 trial. Recently, the phase III TOPAZ-1 and KEYNOTE-966 studies found a survival benefit with dur...
Source: Gut - February 23, 2024 Category: Gastroenterology Authors: Arechederra, M., Casadei Gardini, A., Raggi, C. Tags: Gut Commentary Source Type: research
Correction: British Society of Gastroenterology guidelines on sedation in gastrointestinal endoscopy
Sidhu R, Turnbull D, Haboubi H, et al. British Society of Gastroenterology guidelines on sedation in gastrointestinal endoscopy. Gut 2024;73:219-45. doi: 10.1136/gutjnl-2023-330396
During the peer review process, the following statement was altered. We would like to issue a correction to Statement 10 in relation to monitoring requirements during endoscopy.
This should read:
Procedure Room Requirements
We recommend all patients undergoing gastrointestinal endoscopy (sedated or unsedated) have continuous monitoring of pulse, blood pressure, oxygen saturations and respiration rates as. We recommend supplemental oxygen where a...
Source: Gut - February 23, 2024 Category: Gastroenterology Tags: Gut Correction Source Type: research
Is the significant risk of perioperative complications associated with radical surgery following non-curative endoscopic submucosal dissection for early colorectal cancer still acceptable?
We read the interesting study by Spadaccini et al, which compared the oncological outcomes between patients who received either a clinical follow-up or radical surgery following a non-curative endoscopic submucosal dissection (ESD), finding no difference in terms of tumour recurrence after a follow-up of 30 months.1 The current guidelines indicate radical surgery following non-curative ESD.2 However, the risk factors for residual disease after ESD have been investigated only in retrospective surgical series, and colorectal surgery is associated with a significant chance of complications or stoma formation, especially in pa...
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Rottoli, M., Gori, A., Pellino, G., Flacco, M. E., Spinelli, A., Poggioli, G., COVID-CRC Study Group, Rottoli, Gori, Romano, Belvedere, Lanci, Parlanti, Vago, Pezzuto, Canavese, Dajti, Cardelli, Catalioto, Russo, Violante, Morezzi, Maurino, Filippone, Ber Tags: Gut PostScript Source Type: research
In silico method to maximise the biological potential of understudied metabolomic biomarkers: a study in pre-eclampsia
This study pointed to a long-standing issue in metabolomic studies. The lack of robust strategies for biomarker discovery would leave readers with the impression that ‘the biomarker is out-of-nowhere but works’, especially in those scarcely studied biomarkers. Herein, we provided a strategy that infers the potential of understudied biomarkers for further investigation. A previous study has shown that gut bacterial dysbiosis can cause pre-eclampsia (PE) symptoms through the gut–placenta axis.3 However, the role and potential therapeutic effect of gut metabolites as key mediators between bacteria and host r...
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Zheng, H., Mai, F., Zhang, S., Lan, Z., Wang, Z., Lan, S., Zhang, R., Liang, D., Chen, G., Chen, X., Feng, Y. Tags: Gut PostScript Source Type: research
Conclusion that autoimmune gastritis does not predispose to gastric cancer is unproven
I read with great interest the paper by Rugge et al1 with the commentary by Goldenring2 challenging an old, established fact that autoimmune gastritis (AIG) (pernicious anaemia) predisposes to gastric adenocarcinoma.3 The idea behind the study by authors from three different countries was that AIG induces gastric adenocarcinoma only in those having had an initial, but transient Helicobacter pylori infection not detectable at the time of cancer diagnosis. They studied patients with presumed AIG (gastritis restricted to the oxyntic mucosa and negative for H. pylori) by endoscopy with biopsies two times with a mean of 7.5 yea...
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Waldum, H. L. Tags: Open access, Gut PostScript Source Type: research
Considerations for peripheral blood transport and storage during large-scale multicentre metabolome research
We read with interest the multiomic studies by Kong et al and Chen et al examining gut microbiome–metabolome interactions and potential diagnostic and classification biomarkers in colorectal cancer.1 2 Large-scale, multicentre, multisample, longitudinal studies are imperative to understand complex relationships between the metabolome and digestive diseases. Analysis of matched blood and stool can advance biomarker development and aid mechanistic exploration, providing samples are collected and stored appropriately. Buffered kits are commercially available for stable transfer of stool samples to storage.3 However, sta...
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Alexander, J. L., Wyatt, N. J., Camuzeaux, S., Chekmeneva, E., Jimenez, B., Sands, C. J., Fuller, H., Takis, P., Ahmad, T., Doyle, J. A., Hart, A., Irving, P. M., Kennedy, N. A., Lees, C. W., Lindsay, J. O., McIntyre, R. E., Parkes, M., Prescott, N. J., R Tags: Open access, Gut PostScript Source Type: research
Inflammation-associated gut microbiome in postacute sequelae of SARS-CoV-2 points towards new therapeutic targets
We read with interest the recent report by Liu et al1 describing faecal microbiome differences with postacute sequelae of SARS-CoV-2 (PASC), commonly referred to as ‘Long-COVID’. We have previously reported elevated levels of SARS-CoV-2-specific T cells with PASC compared with resolved COVID-19 (RC; no lingering symptoms at the time of sample collection) that correlated with increased levels of the inflammatory marker IL-6, suggesting that elevated inflammation in PASC may be related to immune response to residual virus.2 Although several studies have reported gut microbiome differences during acute COVID-19,3 ...
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Carneiro, V. L., Littlefield, K. M., Watson, R., Palmer, B. E., Lozupone, C. Tags: Open access, Gut PostScript Source Type: research
Effect of rapid colonic transit on stool microbiome and short-chain fatty acids in diarrhoea-predominant irritable bowel syndrome
In a recent article in GUT,1 we showed that, among 194 patients with diarrhoea-predominant irritable bowel syndrome (IBS-D), 43 had altered bile acid (BA) metabolism (ABAM) (serum 7αC4>52 ng/mL). Patients with ABAM, had faster colonic transit (CT), lower α diversity and a different microbial compositional profile based on β diversity compared with IBS-D without ABAM. There were no significant differences in the stool short-chain fatty acid (SCFA) concentrations between the two groups.1 There is evidence that transit impacts gut microbiome composition and diversity.2 We wish to extend the previous analys...
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: BouSaba, J., Zheng, T., Dilmaghani, S., Johnson, S., Chen, J., Camilleri, M. Tags: Gut PostScript Source Type: research
Cut-off value of clarithromycin resistance in the treatment of Helicobacter pylori infection: how low is low?
We read the Maastricht VI/Florence consensus report for the management of Helicobacter pylori (H. pylori) infection by Malfertheiner et al1 published in the Gut with great interest. The experts addressed that the goal of any antimicrobial therapy is to cure reliably H. pylori infection in the majority (eg, ≥90%) of patients. The goal of cure rate ≥90% meets the expectation of patients in the real-world expectation survey of Asia-Pacific patients for H. pylori eradication therapy,2 which showed 91% of accepted minimal eradication rate expected by H. pylori-infected patients. In the consensus report, clarithromycin tri...
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Hsu, P.-I., Chuah, S.-K., Yamaoka, Y., Wu, D.-C. Tags: Gut PostScript Source Type: research
GI highlights from the literature
Basic scienceLooking into the future of microbiome analysis for diagnosis of diarrhoeal illness Wu Q, Badu S, So S, et al. The pan-microbiome profiling system Taxa4Meta identifies clinical dysbiotic features and classifies diarrheal disease. J Clin Invest 2023: e170859. doi: 10.1172/JCI170859 Microbiome profiling is emerging as a disease-specific biomarker. Available bioinformatics pipelines are subjected to technical and demographic bias. Wu et al created a new pipeline (Taxa4Meta) and tested its performance. Equal, short or long, length 16S amplicon sequencing (ie, currently used) leads to inaccurate taxonomic compositio...
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Smith, P. J. Tags: Gut JournalScan Source Type: research
Updates to the modern diagnosis of GERD: Lyon consensus 2.0
The Lyon Consensus provides conclusive criteria for and against the diagnosis of gastro-oesophageal reflux disease (GERD), and adjunctive metrics that consolidate or refute GERD diagnosis when primary criteria are borderline or inconclusive. An international core and working group was assembled to evaluate research since publication of the original Lyon Consensus, and to vote on statements collaboratively developed to update criteria. The Lyon Consensus 2.0 provides a modern definition of actionable GERD, where evidence from oesophageal testing supports revising, escalating or personalising GERD management for the symptoma...
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Gyawali, C. P., Yadlapati, R., Fass, R., Katzka, D., Pandolfino, J., Savarino, E., Sifrim, D., Spechler, S., Zerbib, F., Fox, M. R., Bhatia, S., de Bortoli, N., Cho, Y. K., Cisternas, D., Chen, C.-L., Cock, C., Hani, A., Remes Troche, J. M., Xiao, Y., Vae Tags: GUT Recent advances in clinical practice, Open access, Gut Source Type: research
Gut virome in inflammatory bowel disease and beyond
Conclusions
The field of gut virome is progressively expanding, thanks to the advancements of sequencing technologies and bioinformatic pipelines. These have contributed to a better understanding of how virome dysbiosis is linked to intestinal disease pathogenesis and how the modulation of virome composition may help the clinical intervention to ameliorate gut disease management. (Source: Gut)
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Tun, H. M., Peng, Y., Massimino, L., Sin, Z. Y., Parigi, T. L., Facoetti, A., Rahman, S., Danese, S., Ungaro, F. Tags: GUT Recent advances in basic science, Open access, Gut Source Type: research
Novel function of MOTS-c in mitochondrial remodelling contributes to its antiviral role during HBV infection
Conclusion
MOTS-c has the potential to serve as a biomarker for the progression of HBV infection while also enhancing antiviral efficacy. These findings present a promising innovative approach for effectively treating patients with CHB. Furthermore, our research uncovers a novel role for MOTS-c in regulating MYH9-actin-mediated mitochondrial dynamics and contributing to mitochondrial biogenesis. (Source: Gut)
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Lin, C., Luo, L., Xun, Z., Zhu, C., Huang, Y., Ye, Y., Zhang, J., Chen, T., Wu, S., Zhan, F., Yang, B., Liu, C., Ran, N., Ou, Q. Tags: Gut Hepatology Source Type: research
HLA-DPA1*02:01~B1*01:01 is a risk haplotype for primary sclerosing cholangitis mediating activation of NKp44+ NK cells
Conclusion
Our studies identify a novel PSC risk haplotype HLA-DP A1*02:01~DPB1*01:01 and provide clinical and functional data implicating NKp44+NK cells that recognise HLA-DPA1*02:01-DPB1*01:01 expressed on cholangiocytes in PSC pathogenesis. (Source: Gut)
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: Zecher, B. F., Ellinghaus, D., Schloer, S., Niehrs, A., Padoan, B., Baumdick, M. E., Yuki, Y., Martin, M. P., Glow, D., Schröder-Schwarz, J., Niersch, J., Brias, S., Müller, L. M., Habermann, R., Kretschmer, P., Früh, T., Dä Tags: Open access, Gut Hepatology Source Type: research
Enhanced antitumour immunity following neoadjuvant chemoradiotherapy mediates a favourable prognosis in women with resected pancreatic cancer
Conclusion
PDAC tumours of women are more sensitive to gemcitabine-based nCRT, resulting in longer OS after resection compared with men. This may be due to enhanced immunity impeding the infiltration of protumoral M2 macrophages into the TME. Our findings highlight the importance of considering sex disparities and mitigating immunosuppressive macrophage polarisation for personalised PDAC treatment. (Source: Gut)
Source: Gut - January 5, 2024 Category: Gastroenterology Authors: van Eijck, C. W. F., Mustafa, D. A. M., Vadgama, D., de Miranda, N. F. C. C., Groot Koerkamp, B., van Tienhoven, G., van der Burg, S. H., Malats, N., van Eijck, C. H. J., Dutch Pancreatic Cancer Group (DPCG) Tags: Open access, Gut Pancreas Source Type: research
