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Internal transcribed spacer sequencing to explore the intrinsic composition of fungal communities in fungal esophagitis

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World Journal of gastroenterology 2025年第7期31卷 26-38页

作者： Yi-Kang Song Lin Zheng Ai-Xin Liu Jun-Ji Ma department of gastroenterology The Second Hospital of Hebei Medical UniversityHebei Key Laboratory of GastroenterologyHebei Institute of GastroenterologyHebei Clinical Research Center for Digestive DiseasesShijiazhuang050000Hebei ProvinceChina

BACKGROUND Fungal esophagitis(FE)is caused by fungal invasion of the esophageal *** endoscopy,the esophageal mucosa shows edema,congestion,erosion,and ulceration,and bleeds easily when touched,and the surface of the mucosa is covered with small white spots like"bean curd residue".Clinical cases showing typical FE under endoscopic imaging but negative esophageal mucosal brush(referred to as suspected FE)have increased the difficulty and challenge of clinical diagnosis and *** present,the esophageal fungal flora of suspected case has not been thoroughly *** To characterize the fungal flora in FE,suspected FE,and the esophageal normal controls(NCs),and to identify marker species to improve detection of *** This was a case-control study.A total of 19 patients with FE,16 with suspected FE,and 10 NCs were selected by *** esophageal cell brush samples of each group were sequenced by internal transcribed spacer(ITS)1 and analyzed by *** In FE and suspected FE patients,species richness,species diversity and species evenness,as measured by the Chao1 index,Shannon index and Pielou index,were lower than in the NCs,and the comparison between the FE and NCs was the most significant(P<0.05).Compared with the NCs,the relative abundance of Candida in FE and suspected FE patients was significantly increased(P<0.001),while the relative abundance of Yarrowia was significantly decreased(P<0.05).Moreover,Yarrowia abundance in the FE group was significantly lower than in the NCs and suspected FE groups(P<0.001).The area under the curve for Candida in FE and suspected FE patients was 99.5%(P<0.05)and 81.3%(P<0.05),***,compared with FE patients,the relative abundance of Ascomycota and Candida in the esophageal flora of suspected FE patients was decreased,while the relative abundance of Yarrowia,Thermomyces and Pichia was *** ITS showed that composition of the fungal community was similar in the F

关键词： Fungal microbiota Esophagitis Candida Yarrowia Biomarker

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Effect of Modulen vs budesonide on clinical response and mucosal healing in Crohn’s patients

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World Journal of gastroenterology 2025年第5期31卷 84-93页

作者： Baruch Ovadia Eva Niv Sara Stern Katie Elisabeth Mahajna Oren Gal Yael Kopelman department of gastroenterology Hillel Yaffe Medical CenterHadera 38100HaifaIsrael Faculty of Medicine Technion-Israel Institute of TechnologyHadera 38100HaifaIsrael department of gastroenterology Meuhedet Health ServicesHadera 38100HaifaIsrael

BACKGROUND Mucosal healing has become an important goal of Crohn’s disease(CD)***,enriched with transforming growth factor-beta 2,and budeso-nide are commonly accepted treatments for mild-moderate ***,their effects on the small bowel(SB)mucosa remain *** To prospectively assess clinical and mucosal responses to Modulen vs budesonide in adults with CD,using SB capsule *** Thirty patients were divided into two groups:Modulen+home-based diet(21 patients)and budesonide(9 patients)for an eight-week intervention followed by four weeks of ***,laboratory,and endoscopic responses were *** mucosal changes were assessed through SB capsule *** Results indicated significant clinical improvement in the Modulen group with reduced CD activity index(P=0.041)and improved inflammatory bowel disease questionnaire score(P=0.016).Moreover,Modulen was associated with a signifi-cant SB mucosal improvement,evidenced by a decrease in Lewis score(P=0.027).No significant changes were observed in calprotectin or other laboratory ***,budesonide exhibited more modest clinical effects,but it improved calprotectin,hemoglobin,and C-reactive protein levels(P=0.051,P=0.014,and P=0.038,respectively).The capsule endoscopy did not reveal a significant mucosal response in the budesonide *** Both interventions have a role in CD ***,their effects differ and may complement each other:Modulen yields clinical and mucosal improvements,while budesonide primarily leads mainly to laboratory improvements.

关键词： Crohn’s disease Modulen oral polymeric diet Transforming growth factor-beta 2 Budesonide Mucosal healing Clinical response Capsule endoscopy Small bowel capsule

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New perspectives and prospects for the next generation of combination therapy in inflammatory bowel disease

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World Journal of gastroenterology 2025年第5期31卷 124-128页

作者： Wen-Ting Xie Hui Yang Lan Bai Feng-Fei Wu Guangdong Provincial Key Laboratory of gastroenterology Institute of Gastroenterology of Guangdong ProvinceDepartment of GastroenterologyNanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina

This article comments on the letter by Lowell et al,which addresses the next generation of combination therapy for inflammatory bowel disease(IBD).As the understanding of the pathogenesis of IBD continues to improve,treatment strategies are evolving *** letter examines the current status and future directions of combination therapy for IBD,focusing on approaches that combine biologics with immunomodulators and the emerging dual-biologic therapy(DBT).The traditional combination of biologics and immunomodulators has demonstra-ted preliminary efficacy by enhancing the effects of biologics through ***,concerns regarding long-term safety warrant careful *** trials,including DUET-Crohn's disease and DUET-ulcerative colitis,have shown promising potential for the broader adoption of ***,comprehensive data on efficacy and safety,as well as the effective integration of supportive treatments,remain essential to establish new paradigms for the next generation of IBD care.

关键词： Inflammatory bowel disease Biologics Dual-biologic therapy Supportive treatment The next generation of combination therapy

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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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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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WNT/β-catenin-M2 macrophage interplay as a target for therapy against hepatocellular carcinoma:Role of Calculus bovis

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World Journal of gastroenterology 2025年第3期31卷 130-133页

作者： Tryfonas Mpektsis Anastasios Manolakis Andreas Kapsoritakis department of gastroenterology University Hospital of LarisaLarisa 41100Greece

Liver cancer,and in particular hepatocellular carcinoma(HCC)is a disease of rising prevalence and *** date,definitive treatment options include either surgical excision or ablation of the affected *** increasing research on several pathways that could be involved in the progression of HCC,new elements within these pathways emerge as potential targets for novel *** WNT/β-catenin pathway favors the presence of M2 tumor-associated macrophages which in turn promote tumor growth and *** inhibition of this pathway is considered a good candidate for such targeted therapeutic ***,as Huang et al show in their recently published article,Calculus bovis which is used in traditional Chinese medicine can exert an inhibitory effect on theβ-catenin pathway and become a potential candidate for targeted pharmacotherapy against liver cancer.

关键词： Hepatocellular carcinoma Calculus bovis WNT/β-catenin pathway Tumorassociated macrophages

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Keratin 1 modulates intestinal barrier and immune response via kallikrein kinin system in ulcerative colitis

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World Journal of gastroenterology 2025年第6期31卷 62-75页

作者： Xiang-Qian Dong Ying-Hui Zhang Juan Luo Mao-Juan Li Lan-Qing Ma Ya-Ting Qi Ying-Lei Miao department of gastroenterology The First Affiliated Hospital of Kunming Medical UniversityYunnan Province Clinical Research Center for Digestive DiseasesKunming 650032Yunnan ProvinceChina department of gastroenterology Affiliated Hospital of Yunnan UniversityKunming 650021Yunnan ProvinceChina

BACKGROUND External factors in ulcerative colitis(UC)exacerbate colonic epithelial permea-bility and inflammatory *** 1(KRT1)is crucial in regulating these alterations,but its specific role in the progression of UC remains to be fully *** To explore the role and mechanisms of KRT1 in the regulation of colonic epithelial permeability and inflammation in *** A KRT1 antibody concentration gradient test,along with a dextran sulfate sodium(DSS)-induced animal model,was implemented to investigate the role of KRT1 in modulating the activation of the kallikrein kinin system(KKS)and the cleavage of bradykinin(BK)/high molecular weight kininogen(HK)in *** Treatment with KRT1 antibody in Caco-2 cells suppressed cell proliferation,induced apoptosis,reduced HK expression,and increased BK *** further downregulated intestinal barrier proteins,including occludin,zonula occludens-1,and claudin,and negatively impacted the coagulation factor *** changes led to enhanced activation of BK and HK cleavage,thereby intensifying KKS-mediated inflammation in *** the DSS-induced mouse model,administration of KRT1 antibody mitigated colonic injury,increased colon length,alleviated weight loss,and suppressed inflammatory cytokines such as interleukin(IL)-1,IL-6,tumor necrosis factor-α.It also facilitated repair of the intestinal barrier,reducing DSS-induced *** KRT1 inhibits BK expression,suppresses inflammatory cytokines,and enhances markers of intestinal barrier function,thus ameliorating colonic damage and maintaining barrier ***1 is a viable therapeutic target for UC.

关键词： Keratin 1 Ulcerative colitis Kallikrein kinin system Digestive system diseases Bradykinin High molecular weight kininogen Intestinal barrier function Inflammatory cytokines

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Management of chylous ascites after liver cirrhosis: A case report

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World Journal of Hepatology 2025年第1期17卷 150-157页

作者： Zong-Qiang Chen Shu-Jun Zeng Chun Xu department of gastroenterology Guangdong Medical UniversityZhanjiang 524000Guangdong ProvinceChina department of gastroenterology Huizhou Central People’s HospitalHuizhou 516000Guangdong ProvinceChina

BACKGROUND Chylous ascites is an uncommon condition,occurring in less than 1%of ascites *** results from traumatic or obstructive disruption of the lymphatic system,causing the leakage of thoracic or intestinal lymph into the abdominal *** leads to the accumulation of a milky,triglyceride-rich *** adults,malignancy and cirrhosis are the primary causes of chylous ***,chylous ascites accounts for only 0.5%to 1%of all cirrhosis-related ascites *** present,there is a limited understanding of this condition,and effective timely management in clinical practice remains *** SUMMARY This case report presents a patient with hepatic cirrhosis complicated by chylous ascites,who had experienced multiple hospitalizations due to abdominal *** admission,comprehensive examinations and assessments were *** treatment strategy focused on nutritional optimization through a low-sodium,low-fat,and high-protein diet supplemented with medium-chain triglycerides,therapeutic paracentesis,and *** a multidiscip-linary discussion and thorough evaluation of the patient’s condition,surgical indications were *** informing the patient about the benefits and risks,and obtaining consent,a transjugular intrahepatic portosystemic shunt procedure was performed,successfully alleviating the abdominal swelling *** article details the clinical characteristics and treatment approach for this uncommon case,summarizing current management methods for hepatic cirrhosis complicated by chylous *** aim is to provide valuable insights for clinicians encountering similar *** Optimizing nutrition and addressing the underlying cause are essential in the treatment of chylous *** conservative approaches prove ineffective,alternative interventions such as transjugular intrahepatic portosystemic shunt may be considered.

关键词： Chylous ascites Liver cirrhosis Management Transjugular intrahepatic portosystemic shunt Case report

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Effect of cholesterol metabolism on hepatolithiasis

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World Journal of gastroenterology 2025年第1期31卷 157-162页

作者： Lin Zheng Zi-Yu Ye Jun-Ji Ma department of gastroenterology The Second Hospital of Hebei Medical UniversityHebei Key Laboratory of GastroenterologyHebei Institute of GastroenterologyHebei Clinical Research Center for Digestive DiseasesNo.215 Heping West RoadShijiazhuang 050000Hebei ProvinceChina

Surgical intervention is currently the primary treatment for hepatolithiasis;how-ever,some patients still experience residual stones and high recurrence rates after *** metabolism seems to play an important role in hepatoli-thiasis pathogenesis.A high cholesterol diet is one of the significant reasons for the increasing incidence of ***,regular diet and appropriate medical intervention are crucial measures to prevent hepatolithiasis and reduce recurrence rate after *** dietary cholesterol and drugs that increase cholesterol stone solubility are key therapeutic approaches in treating *** article discusses the cholesterol metabolic pathways related to the pathogenesis of hepatolithiasis,as well as food intake and targeted therapeutic drugs.

关键词： Hepatolithiasis Cholesterol metabolism High-fat diet 3-hydroxy-3-methylglutaryl-coenzyme A reductase Interlobular bile duct

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Bile acid therapy for primary biliary cholangitis:Pathogenetic validation

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World Journal of Experimental Medicine 2025年第1期15卷 53-64页

作者： Vasiliy I Reshetnyak Igor V Maev department of Propaedeutics of Internal Diseases and gastroenterology Russian University of MedicineMoscow 127473Russia

Knowledge of the etiological and pathogenetic mechanisms of the development of any disease is essential for its *** the cause of primary biliary cholangitis(PBC),a chronic,slowly progressive cholestatic liver disease,is still unknown,treatment remains *** of the physicochemical properties of various bile acids and the adaptive responses of cholangiocytes and hepatocytes to them has provided an important basis for the development of relatively effective drugs based on hydrophilic bile acids that can potentially slow the progression of the *** in the use of hydrophilic bile acids for the treatment of PBC are also associated with the discovery of pathogenetic mechanisms of the development of cholangiocyte damage and the appearance of the first signs of this *** 35 years,ursodeoxycholic acid(UDCA)has been the unique drug of choice for the treatment of patients with *** recent years,the list of hydrophilic bile acids used to treat cholestatic liver diseases,including PBC,has *** addition to UDCA,the use of obeticholic acid,tauroursodeoxycholic acid and norursodeoxycholic acid as drugs is *** pathogenetic rationale for treatment of PBC with various bile acid drugs is discussed in this *** is made on the mechanisms explaining the beneficial therapeutic effects and potential of each of the bile acid as a drug,based on the understanding of the pathogenesis of the initial stages of PBC.

关键词： Primary biliary cholangitis Treatment of primary biliary cholangitis with bile acids Ursodeoxycholic acid Obeticholic acid Tauroursodeoxycholic acid Norursodeoxycholic acid

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