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Role of astrocytes and microglia in hepatic encephalopathy associated with advanced chronic liver disease:lessons from animal studies

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Neural Regeneration Research 2025年第12期20卷 3461-3475页

作者： Wouter Claeys Anja Geerts Lien Van Hoecke Christophe Van Steenkiste Roosmarijn E.Vandenbroucke department of Internal Medicine and Paediatrics Hepatology Research UnitGhent UniversityGhentBelgium Liver Research Center Ghent Ghent UniversityGhent University HospitalGhentBelgium Barriers in Inflammation VIB-UGent Center for Inflammation ResearchVIBGhentBelgium department of Biomedical Molecular Biology Ghent UniversityGhentBelgium department of gastroenterology and hepatology Ghent University HospitalGhentBelgium department of gastroenterology and hepatology Antwerp UniversityAntwerpBelgium department of gastroenterology and hepatology Maria Middelares HospitalGhentBelgium

Hepatic encephalopathy,defined as neuropsychiatric dysfunction secondary to liver disease,is a frequent decompensating event in *** clinical impact is highlighted by a notable increase in patient mortality rates and a concomitant reduction in overall quality of ***,liver disease,liver function failure,portosystemic shunting,and associated multi-organ dysfunction result in the increase of disease-causing neurotoxins in the circulation,which impairs cerebral *** circulating neurotoxins are ammonia and inflammatory *** the brain,pathophysiology is less well understood,but is thought to be driven by glial cell *** are the only brain resident cells that have ammonia-metabolizing machinery and are therefore putatively most susceptible to ammonia *** on a large body of mostly in vitro evidence,ammonia-induced cellular and molecular disturbances include astrocyte swelling and oxidative ***,the brain resident macrophages,have been linked to the translation of systemic inflammation to the brain *** evidence from animal studies has provided novel insights into old and new downstream effects of astrocyte and microglial dysfunction such as toxin clearance disruption and myeloid cell attraction to the central nervous system ***,state of the art research increasingly implicates neuronal dysfunction and possibly even irreversible neuronal cell ***-type specific investigation in animal models highlights the need for critical revision of the contribution of astrocytes and microglia to well-established and novel cellular and molecular alterations in hepatic *** this review,we therefore give a current and comprehensive overview of causes,features,and consequences of astrocyte and microglial dysfunction in hepatic encephalopathy,including areas of interest for future investigation.

关键词： ammonia astrocytes cirrhosis hepatic encephalopathy microglia neuroinflammation osmotic stress oxidative stress systemic inflammation

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Redefining endoluminal biliary drainage:Challenges and innovations in endosonography-guided techniques

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World Journal of gastroenterology 2025年第1期31卷 146-151页

作者： Marcel Razpotnik department of gastroenterology and hepatology Campus Virchow/Campus MitteCharitéBerlinBerlin 10117Germany

Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary ***,its use in complex biliary obstructions is *** the past decades,therapeutic endosonography(EUS)and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring nonendoscopic or surgical *** show that EUS-guided choledochoduodenostomy is a reliable alternative to endoscopic retrograde cholangiopancreatography in the treatment of distal malignant biliary obstructions and can be considered a primary drainage modality in centers with adequate *** malignant hilar biliary obstructions,draining at least 50%of viable liver tissue often requires combining different *** treatment strategy in these patients should be individualized,depending on the Bismuth classification,patient physical status,and intended systemic *** to the lack of evidence,general recommendations cannot be made for EUS-guided hepaticoduodenostomy or combined procedures with transhepatic bridging *** novel techniques should be limited to selected palliative cases where conventional methods have failed and conducted within clinical trials to generate evidence before broader application.

关键词： Endoscopic biliary drainage Interventional endosonography Lumen-apposing metal stent Malignant hilar biliary obstruction Malignant distal biliary obstruction

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Gastric polyps are not created equal: Know your enemy

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World Journal of gastroenterology 2025年第2期31卷 144-146页

作者： Fady Daniel department of gastroenterology and hepatology American University of Beirut Medical CenterBeirut 11072020Lebanon

Gastric polyps are commonly detected during upper gastrointestinal *** are most often benign and rarely become ***,adequate knowledge,diagnostic modalities,and management strategies should be the endoscopist’s readily available“weapons”to defeat the potentially malignant“enemies”.This article sheds light on the valuable effort by Costa et al to generate a new classification system of gastric polyps as“good”,“bad”,and“ugly”.This comprehensive overview provides clinicians with a simplified decision-making process.

关键词： Gastric polyps Polypoid subepithelial lesions Early gastric cancer Endoscopic ultrasonography Electronic chromoendoscopy

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Patient and physician factors contributing to delays in inflammatory bowel diseases:Enhancing timely diagnosis

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World Journal of gastroenterology 2025年第6期31卷 115-120页

作者： Horia Minea Ana-Maria Singeap Laura Huiban Cristina Maria Muzica Carol Stanciu Anca Trifan department of gastroenterology Faculty of Medicine“Grigore T.Popa”University of Medicine and PharmacyIasi 700115Romania Institute of gastroenterology and hepatology “St.Spiridon”University HospitalIasi 700111Romania

In this article,we comment on the article by Blüthner et *** article provides a comprehensive analysis of the factors contributing to the late detection of Crohn’s disease and ulcerative colitis within a German *** highlights the conse-quences on patient outcomes,particularly disease progression and the increased risk of developing *** study identifies specific predictors asso-ciated with both patient-related and physician-related delays,offering a detailed exploration of the initial ***,the article delves into the distinct patterns observed in the German population,stressing the unique aspects of diagnostic delays that may differ from those reported in other *** detailed examination offers valuable insights into the specific challenges faced within the German healthcare system and underscores the necessity of targeted interventions to facilitate early *** importance of improved screening tools,patient education,and better healthcare infrastructure is emphasized as crucial steps toward improving patient care in inflammatory bowel disease.

关键词： Inflammatory bowel disease Diagnostic delay Disease awareness Healthcare system Screening tools

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Mitochondrial dysfunction in the pathogenesis of acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2025年第1期24卷 76-83页

作者： Xia Chen Rui Zhong Bing Hu department of gastroenterology and hepatology West China HospitalSichuan UniversityChengdu 610041China department of gastroenterology Clinical Medical College and The First Affiliated Hospital of Chengdu Medical CollegeChengdu 610500China

The mechanism of cell damage during acute pancreatitis (AP) has not been fully elucidated, and there is still a lack of specific or effective treatments. Increasing evidence has implicated mitochondrial dysfunction as a key event in the pathophysiology of AP. Mitochondrial dysfunction is closely related to calcium (Ca^(2+)) overload, intracellular adenosine triphosphate depletion, mitochondrial permeability transition pore openings, loss of mitochondrial membrane potential, mitophagy damage and inflammatory responses. Mitochondrial dysfunction is an early triggering event in the initiation and development of AP,and this organelle damage may precede the release of inflammatory cytokines, intracellular trypsin activation and vacuole formation of pancreatic acinar cells. This review provides further insight into the role of mitochondria in both physiological and pathophysiological aspects of AP, aiming to improve our understanding of the underlying mechanism which may lead to the development of therapeutic and preventive strategies for AP.

关键词： Acute pancreatitis Autophagy Calcium Cell death Inflammation Mitochondria Mitophagy

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Multiple endocrine neoplasia type 1:Early diagnosis is very important

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World Journal of gastroenterology 2025年第6期31卷 104-106页

作者： Huan Jiang Bing Hu department of gastroenterology and hepatology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina department of gastroenterology and hepatology Medical Engineering Integration Laboratory of Digestive EndoscopyWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

In this manuscript,we comment on a recent publication by Yuan et *** article provides a detailed scientific diagnostic process for a multiple endocrine neo-plasia type 1 patient,thus offering strong guidance for clini... 详细信息

关键词： Multiple endocrine neoplasia type 1 Primary hyperparathyroidism Gastri-noma Diagnosis Prognosis

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Association between autoimmune gastritis and gastric polyps:Clinical characteristics and risk factors

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 73-87页

作者： Jing-Zheng Jin Xiao Liang Shu-Peng Liu Rui-Lan Wang Qing-Wei Zhang Yu-Feng Shen Xiao-Bo Li Division of gastroenterology and hepatology Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China Division of gastroenterology and hepatology Shanghai Institute of Digestive DiseasesShanghai 200001China Division of gastroenterology and hepatology Renji Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200127China Division of gastroenterology and hepatology Sichuan Armed Police Corps HospitalLeshan 610041Sichuan ProvinceChina Division of gastroenterology and hepatology NHC Key Laboratory of Digestive DiseasesRenji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China department of gastroenterology Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai Institute of Digestive DiseasesShanghai 200127China

BACKGROUnd The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well *** To explore the clinical characteristics and risk factors of AIG with GPs in *** This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July *** collected clinical,biochemical,serological,and demographic data were of each *** regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG *** operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with *** Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,Pnd univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,Pnd enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with *** gastrin-17 levels may also play a role in this *** findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.

关键词： Autoimmune gastritis Gastric polyps Neuroendocrine tumor Risk factors Nomogram

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Gastrointestinal disease in end-stage renal disease

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World Journal of Nephrology 2025年第1期14卷 29-40页

作者： Ayesha Khan Muhammad Mushtaq Giri Movva Aalam Sohal Juliana Yang department of Internal Medicine University of Texas Medical BranchGalvestonTX 77550United States gastroenterology and hepatology Creighton University School of MedicinePhoenixAZ 85012United States Division of gastroenterology and hepatology University of Texas Medical BranchGalvestonTX 77555United States

When kidney function declines to a point where it can no longer maintain life and requires renal replacement therapy(*** transplant or dialysis),it is called end-stage renal disease(ESRD).Patients with ESRD often experience a range of gastrointestinal(GI)symptoms,with prevalence rates reported as high as 77%-79%.These symptoms and pathologies arise from various factors,including electrolyte imbalance,fluid imbalance,toxin buildup,uremia,medications,dietary and lifestyle restrictions,and the effects of *** diseases in patients with renal failure can be further categorized into upper GI,small bowel,and lower GI *** conditions include gastroesophageal reflux disease,nausea and vomiting,dysmotility within the esophagus and stomach,upper GI bleeding,peptic ulcer bleeding,angioectasia,irritable bowel syndrome,mesen-teric ischemia,angiodysplasia,diverticular disease,constipation,pancreatitis,and diseases associated with peritoneal dialysis peritonitis and peritoneal *** review assesses the existing literature on the different GI diseases among individuals with ESRD,shedding light on their pathophysiology and prevalence.

关键词： End-stage renal disease Gastroesophageal reflux disease Nausea Vomiting Esophageal dysmotility Gastric dysmotility Gastrointestinal disease Peritonitis Peri-toneal stenosis Chronic kidney disease

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Lesson learnt from 60 years of liver transplantation:Advancements,challenges,and future directions

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World Journal of Transplantation 2025年第1期15卷 1-23页

作者： Eyad Gadour department of gastroenterology and hepatology King Abdulaziz National Guard HospitalAhsa 36428Saudi Arabia Internal Medicine Zamzam University CollegeKhartoum 11113Sudan

Over the past six decades,liver transplantation(LT)has evolved from an experimental procedure into a standardized and life-saving intervention,reshaping the landscape of organ *** by pioneering breakthroughs,technological advancements,and a deepened understanding of immunology,LT has seen remarkable *** of the most notable breakthroughs in the field include advances in immunosuppression,a revised model for end-stage liver disease,and artificial intelligence(AI)-integrated imaging modalities serving diagnostic and therapeutic roles in LT,paired with ever-evolving technological ***,the refinement of transplantation procedures,resulting in the introduction of alternative transplantation methods,such as living donor LT,split LT,and the use of marginal grafts,has addressed the challenge of organ ***,precision medicine,guiding personalized immunosuppressive strategies,has significantly improved patient and graft survival rates while addressing emergent issues,such as short-term complications and early allograft dysfunction,leading to a more refined strategy and enhanced postoperative *** ahead,ongoing research explores regenerative medicine,diagnostic tools,and AI to optimize organ allocation and posttransplantation *** summary,the past six decades have marked a transformative journey in LT with a commitment to advancing science,medicine,and patient-centered care,offering hope and extending life to individuals worldwide.

关键词： Liver transplantation Model for end-stage liver disease Liver grafts allocation Immunology and organ rejection Types of liver transplantation techniques

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Optimal timing of endoscopic biliary drainage for bile duct leaks:A multicenter,retrospective,clinical study

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World Journal of Gastrointestinal Surgery 2025年第3期17卷 139-149页

作者： De-Xin Chen Kai-Xuan Fang Sheng-Xin Chen Sen-Lin Hou Gui-Hai Wen Hai-Kun Yang Da-Peng Shi Qing-Xin Lu Ya-Qi Zhai Ming-Yang Li department of gastroenterology and hepatology The First Medical CenterChinese PLA General HospitalBeijing 100853China Graduate School Chinese PLA General HospitalBeijing 100853China department of gastroenterology and hepatology The 960th Hospital of PLAJinan 050035Shandong ProvinceChina department of gastroenterology and hepatology The Second Hospital of Hebei Medical UniversityHebei 050035China department of gastroenterology and hepatology Handan Central HospitalHebei 056001China department of gastroenterology and hepatology Shanxi Provincial People’s HospitalShanxi 030012China department of gastroenterology and hepatology First Affiliated Hospital of Army Medical University of PLAChongqing 400042China department of gastroenterology and hepatology Second Affiliated Hospital of Army Medical University of PLAChongqing 400042China department of gastroenterology Chinese PLA General HospitalBeijing 100853China

BACKGROUnd Bile duct leaks(BDLs)are serious postsurgical adverse ***,conservative management with ab-dominal drainage is the initial treatment ***,prolonged abdominal drainage without improvement can lead to biliary stricture and delay the optimal timing of endoscopic retrograde cholangiopancreatography(ERCP).AIM To identify the optimal timing for ERCP and the period during which clinical observation with conservative management is acceptable,balancing ERCP success and the risk of biliary *** We conducted a multicenter retrospective study involving 448 patients with BDLs between November 2002 and November *** patients were divided into four groups based on the timing of ERCP:3 days,7 days,14 days,and 21 *** primary outcome was clinical success,defined as the resolution of BDL and related symptoms within 6 months without additional percutaneous drainage,surgery,or *** secondary outcome was incidence of biliary *** and multivariate logistic regression analyses were performed to identify factors associated with ERCP success and biliary stricture *** In a cohort of 448 consecutive patients diagnosed with BDLs,354 were excluded,leaving 94 patients who underwent *** success was achieved in 84%of cases(79/94),with a median ERCP timing of 20 days(9.5-35.3 days).Biliary strictures were identified in 29(30.9%)*** ERCP within 3 weeks,compared to after 3 weeks,was associated with higher success rates[92.0%(46/50)vs 75.0%(33/44),P=0.032]and a lower incidence of biliary stricture incidence[18.0%(9/50)vs 45.5%(20/44),P=0.005].Subsequent multivariate analysis confirmed the association with higher success rates(odds ratio=4.168,P=0.045)and lower biliary stricture rates(odds ratio=0.256,P=0.007).CONCLUSION Performing ERCP for BDLs within 3 weeks may be associated with a higher success rate and a lower biliary stricture *** patients with BDLs do not respond to conserva

关键词： Endoscopic retrograde cholangiopancreatography Bile duct leaks Endoscopic nasobiliary drainage Endoscopic biliary stent drainage Optimal timing Biliary stricture

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