Genetic evidence for repurposing of glucagon-like peptide-1 receptor agonists to prevent chronic liver diseases
We read with great interest the study of Wester et al1 that suggested a potential hepatoprotective effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in mitigating the risk of major adverse liver outcomes among patients with type 2 diabetes (T2D). Currently, several studies indicate that GLP-1RAs provide functional protection for chronic liver diseases.2 3 However, uncertainties persist regarding the beneficial effect of GLP-1RAs on chronic liver disease-related outcomes, such as fibrosis progression, primarily due to the limited follow-up time4 and the presence of potential confounding factors (eg, synergistic...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Liu, B., Peng, G., Yin, Y., Shen, C., Yin, X., Cai, Z., Zhang, B. Tags: Gut PostScript Source Type: research
Defining gene-lifestyle interactions in inflammatory bowel disease: progress towards understanding disease pathogenesis
Recently, Lopes et al quantified the effect of modifiable lifestyle factors in inflammatory bowel disease (IBD) prevention using population attributable risk, and reported that 42.9% of Crohn’s disease (CD) cases and 44.4% of ulcerative colitis (UC) cases could have been prevented by lifestyle interventions. This interesting result was based on 6 prospective cohorts including 3 US cohorts with 208 070 participants and 3 large European cohorts that were used for validation.1 Undoubtedly, this well-performed study illustrates the possible merits of lifestyle modification as a prevention strategy for IBD. However, we wo...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Zhao, J., Chen, J., Sun, Y., Yuan, S., Wellens, J., Kalla, R., Theodoratou, E., Li, X., Satsangi, J. Tags: Gut PostScript Source Type: research
Mixed-donor faecal microbiota transplantation was associated with increased butyrate-producing bacteria for obesity
We read with interest the recent article by Haifer et al (Gut, 2022, 2022–3 27 742), which reported that donor gut microbiome stability and species evenness were associated with higher donor species engraftment in patients with UC following faecal microbiota transplantation (FMT). This has brought us one step closer towards the selection of optimal FMT donors. However, the high prevalence of extended-spectrum beta-lactamase organisms and the COVID-19 pandemic have restricted the recruitment of FMT donors.1 An alternative means to increase the stability and species evenness is to pool the stool samples from multiple e...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Xu, Z., Mak, J. W. Y., Lin, Y., Yang, K., Liu, Q., Zhang, F., Lau, L., Tang, W., Ching, J. Y., Tun, H. M., Chan, P., Chan, F. K. L., Ng, S. C. Tags: Gut PostScript Source Type: research
Toning down the role of eosinophils in eosinophilic oesophagitis
Eosinophilic oesophagitis (EoE) is an immune-mediated disease of uncertain aetiology. The diagnosis of EoE relies on the epithelial infiltration of eosinophils (peak eosinophil count of ≥15 per high-power field (HPF)) and on the presence of symptoms. Consequently, a combined clinical–histological endpoint has been devised to assess response to treatments in clinical trials. Recent guidelines drafted by the British Society of Gastroenterology have confirmed the pivotal role of swallowed topical steroid and, for the first time, explicitly considered the use of biological therapy in case of a coexisting severe allerg...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Rossi, C. M., Lenti, M. V., Di Sabatino, A. Tags: Gut PostScript Source Type: research
Vonoprazan-based versus proton pump inhibitor-based therapy in Helicobacter pylori eradication: an updated systematic review and meta-analysis of randomised trials
We read the Maastricht VI/Florence consensus report published in GUT with great interest.1 The report suggested that vonoprazan-based therapy is superior, or not inferior, to conventional proton pump inhibitor (PPI)-based triple therapies for Helicobacter pylori eradication.1 However, the number of randomised controlled trials (RCTs) was small and the majority of previous trials were conducted in Japan.2–5 Recently, several new RCTs from other populations have been reported.6–8 Therefore, we conducted an updated systematic review and meta-analysis of RCTs to compare the efficacy and tolerability of vonoprazan a...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Chen, P.-Y., Tsai, F.-P., Chen, M.-J., Yang, H.-Y., Wu, M.-S., Liou, J.-M. Tags: Gut PostScript Source Type: research
Antibiotic use and inflammatory bowel disease: number needed to harm? Authors reply
We thank Ludvigsson for his interest in our work and for providing additional insights. As noted, our joint works implicate the role of antibiotics in the development of inflammatory bowel disease (IBD), however, there are limitations as well as unique strengths to our study design which should be noted.1 2 Although confounding may exist, our prospective cohort study design limits this possibility. For example, if an individual is not prescribed an antibiotic course for the first 10 years of follow-up, they will initially contribute at-risk time to the ‘no antibiotic exposure’ group. If, however, they are then ...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Faye, A. S., Jess, T. Tags: Gut PostScript Source Type: research
Epidemiology of Helicobacter in Chinese families: a foundation for cost-effective eradication strategies?
Your recent ‘Chinese Consensus Report on Family-based Helicobacter pylori infection Control and management (2021 Edition)’1 and ‘Large-scale, national, family-based epidemiological study on Helicobacter pylori infection in China: the time to change practice for related disease prevention’2 will encourage more doctors in China to consider Helicobacter pylori as a curable aetiology for gastrointestinal symptoms, and as a smart way to prevent gastric cancer in the ageing population. The paper is based on results of a very large new study of H. pylori prevalence in China whereby investigators completed ...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Marshall, B. Tags: Open access, Gut PostScript Source Type: research
Post-COVID-19 irritable bowel syndrome
We read with interest the article by Marasco et al evaluating the prevalence of gastrointestinal (GI) symptoms and post-COVID-19 disorders of gut–brain interaction after hospitalisation for SARS-CoV-2 infection.1 The author found that COVID-19 is associated with a modest increased risk of irritable bowel syndrome (IBS). Postinfectious IBS (PI-IBS) is a common disease in which GI symptoms begin after an episode of infective gastroenteritis. Acute gastroenteritis following infection with bacterial or viral pathogens is an important risk factor for IBS. Our previous study also confirmed that the odds of developing IBS a...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Dai, C., Huang, Y.-H., Jiang, M. Tags: Gut PostScript Source Type: research
GI highlights from the literature
Basic scienceHow ketogenic and vegan diets shape host immunity and gut microbial functions Link V, Subramanian P, Cheung F, et al. Differential peripheral immune signatures elicited by vegan versus ketogenic diets in humans. Nat Med 2024; 302: 560–572. doi: 10.1038/s41591-023-02761-2. Nutritional intervention has therapeutic potential against diseases directly or via the gut microbiota. However, the link between nutrition and the host immunity remains largely unknown. Link et al applied a multiomics approach including flow cytometry, transcriptomic, proteomic, metabolomic and metagenomic analysis to collectively acce...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Smith, P. J. Tags: Gut JournalScan Source Type: research
Fibrosis in IBD: from pathogenesis to therapeutic targets
Background
Intestinal fibrosis resulting in stricture formation and obstruction in Crohn’s disease (CD) and increased wall stiffness leading to symptoms in ulcerative colitis (UC) is among the largest unmet needs in inflammatory bowel disease (IBD). Fibrosis is caused by a multifactorial and complex process involving immune and non-immune cells, their soluble mediators and exposure to luminal contents, such as microbiota and environmental factors. To date, no antifibrotic therapy is available. Some progress has been made in creating consensus definitions and measurements to quantify stricture morphology for clinical ...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Rieder, F., Mukherjee, P. K., Massey, W. J., Wang, Y., Fiocchi, C. Tags: GUT Recent advances in clinical practice, Gut Source Type: research
Coeliac disease: the paradox of diagnosing a food hypersensitivity disorder with autoantibodies
Serum antibodies to the autoantigen transglutaminase 2 (TG2) are increasingly harnessed to diagnose coeliac disease. Diagnostic guidelines for children give recommendation for a no-biopsy-based diagnosis through detection of high amounts of IgA anti-TG2 antibodies in serum with confirmation of positivity in a separate blood sample by characteristic autoantibody-staining of tissue. While measurement of IgA anti-TG2 also is important in the diagnostic workup of adults, the adult guidelines still mandate examination of gut biopsies. This requirement might well change in the future, as might the necessity for confirming autoan...
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: du Pre, M. F., Iversen, R., Sollid, L. M. Tags: GUT Recent advances in basic science, Gut Source Type: research
Glucagon-like peptide-1 receptor agonists and risk of major adverse liver outcomes in patients with chronic liver disease and type 2 diabetes
Conclusion
In patients with chronic liver disease and type 2 diabetes who adhered to therapy over time, GLP1 agonists may result in lower risk of MALO. This suggests that GLP1 agonists are promising agents to reduce risk of chronic liver disease progression in patients with concurrent type 2 diabetes, although this needs to be corroborated in randomised trials. (Source: Gut)
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Wester, A., Shang, Y., Toresson Grip, E., Matthews, A. A., Hagström, H. Tags: Open access, Gut Hepatology Source Type: research
Serum ferritin levels can predict long-term outcomes in patients with metabolic dysfunction-associated steatotic liver disease
Conclusions
This study supports the potential use of serum ferritin values for predicting the long-term prognosis of patients with MASLD. (Source: Gut)
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Armandi, A., Sanavia, T., Younes, R., Caviglia, G. P., Rosso, C., Govaere, O., Liguori, A., Francione, P., Gallego-Duran, R., Ampuero, J., Pennisi, G., Aller, R., Tiniakos, D., Burt, A., David, E., Vecchio, F., Maggioni, M., Cabibi, D., McLeod, D., Pareja Tags: Gut Hepatology Source Type: research
Histone methyltransferase Suv39h1 regulates hepatic stellate cell activation and is targetable in liver fibrosis
Conclusions
Our data demonstrate a previously unrecognised role for Suv39h1 in liver fibrosis and offer proof-of-concept of its targetability in the intervention of cirrhosis. (Source: Gut)
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Kong, M., Zhou, J., Kang, A., Kuai, Y., Xu, H., Li, M., Miao, X., Guo, Y., Fan, Z., Xu, Y., Li, Z. Tags: Gut Hepatology Source Type: research
Spatial transcriptomics reveals a low extent of transcriptionally active hepatitis B virus integration in patients with HBsAg loss
Conclusion
Transcriptionally active HBV integration occurred in chronically HBV-infected patients at different phases, including in patients with HBsAg loss. Antiviral treatment was associated with a decreased number and extent of transcriptionally active viral integrations, implying that early treatment intervention may further reduce the number of viral integration events. (Source: Gut)
Source: Gut - April 5, 2024 Category: Gastroenterology Authors: Yu, X., Gong, Q., Yu, D., Chen, Y., Jing, Y., Zoulim, F., Zhang, X. Tags: Open access, Gut Hepatology Source Type: research
