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Advances and challenges in diagnosing and managing adult autoimmune enteropathy

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World Journal of Gastroenterology 2025年第2期31卷 128-131页

作者： Grigorios Christodoulidis Sara E Agko Marina N Kouliou Konstantinos E Koumarelas Dimitris Zacharoulis department of general Surgery University Hospital of LarissaLarissa 41110Greece department of intensive care unit Asklepios Paulinen Clinic WiesbadenWiesbaden 65197Germany department of Emergency Medicine General Hospital of LarissaLarissa 41221Greece department of Surgery University Hospital of LarissaLarissa 41334Greece

Autoimmune enteropathy(AIE)is a rare immune mediated disorder primarily affecting children,characterized by chronic diarrhea,malabsorption,vomiting,weight loss and villous *** has also been observed in adults presenting diagnostic and treatment challenges due to its overlap with other gastrointestinal disorders such as celiac *** diagnostic criteria for AIE include small bowel villous atrophy,lack of response to dietary restrictions,presence of anti-enterocyte antibodies,and predisposition to autoimmunity without severe *** criteria emphasize characteristic histological findings and exclusion of other causes of villous *** is associated with various autoimmune disorders and can present with overlapping features with Celiac disease,including villous atrophy but without significant intraepithelial *** primarily involves immunosuppression using corticosteroids,calcineurin inhibitors,and anti-tumor necrosis factor therapy,alongside nutri-tional *** the challenges,understanding AIE’s diverse manifest-ations and improving diagnostic criteria are essential for effective management and improved patient *** research is needed to elucidate the pathogenesis,disease progression and long-term outcomes of AIE.

关键词： Autoimmune enteropathy Diagnosis Prognosis Adult autoimmune enter-opathy and challenges Autoimmune enteropathy and treatment Autoimmune enteropathy and diagnostic criteria Pathophysiology of autoimmune enteropathy

Transient extreme insulin resistance in a critically ill patient:A case report

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World Journal of Clinical Cases 2025年第8期13卷 35-40页

作者： Xiu-Yu Wei Hsiu-Nien Shen department of Internal Medicine Taichung Veterans General HospitalTaichung 407TaiwanChina department of intensive care Medicine Chi Mei Medical CenterTainan 710TaiwanChina

BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin ***,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is *** SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of ***,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose *** Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically *** should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.

关键词： Hyperglycemia Insulin Insulin resistance Sepsis Critical illness Case report

Effect of dietary fibre on the gastrointestinal microbiota during critical illness:A scoping review

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World Journal of Critical care Medicine 2025年第1期14卷 49-59页

作者： Angajendra N Ghosh Calum J Walsh Matthew J Maiden Tim P Stinear Adam M Deane department of intensive care The Northern HospitalEpping 3076VictoriaAustralia department of Microbiology and Immunology The Peter Doherty Institute for Infection and ImmunityMelbourne 3052VictoriaAustralia department of intensive care The Royal Melbourne HospitalThe University of MelbourneParkville 3050VictoriaAustralia department of intensive care Medicine The Royal Melbourne HospitalParkville 3050VictoriaAustralia

The systemic effects of gastrointestinal(GI)microbiota in health and during chronic diseases is increasingly *** strategies to modulate the GI microbiota during chronic diseases have demonstrated *** changes in dietary intake can rapidly change the GI microbiota,the impact of dietary changes during acute critical illness on the microbiota remain *** fibre is metabolised by carbohydrate-active enzymes and,in health,can alter GI *** aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states,specifically during critical *** controlled trials and prospective cohort studies that include adults(>18 years age)and reported changes to GI microbiota as one of the study outcomes using non-culture methods,were *** show dietary fibres have an impact on faecal microbiota in health and *** fibre,inulin,has a marked and specific effect on increasing the abundance of faecal *** chain fatty acids produced by Bifidobacteria have been shown to be beneficial in other patient *** few trials have evaluated the effect of dietary fibre on the GI microbiota during critical *** research is necessary to establish optimal fibre type,doses,duration of intervention in critical illness.

关键词： Gastrointestinal microbiota Dietary fibre Health Critical illness Short chain fatty acids

TRIPLET combined with microwave ablation:A novel treatment for advanced hepatocellular carcinoma

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 10-12页

作者： Fei-Yu Zhao Guo-Wei Si Nian-Song Qian department of Thoracic Oncology Respiratory and Critical Care MedicineThe Eighth Medical Center of People’s Liberation Army General HospitalBeijing 100853China department of Gastroenterology Fourth Medical CentreGeneral Hospital of the People's Liberation ArmyBeijing 100142China Senior department of Thoracic Oncology Respiratory and Critical Care MedicineThe Eighth Medical Center of People’s Liberation Army General HospitalBeijing 100091China

This editorial comments on a study by Zuo et *** focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy,in treating advanced hepatocellular carcinoma(HCC).The potential application of this combination therapy for patients with advanced HCC is evaluated.

关键词： Microwave ablation Hepatic arterial infusion chemotherapy Apatinib Camrelizumab Hepatocellular carcinoma

Sleep as a window to understand and regulate Alzheimer's disease:emerging roles of thalamic reticular nucleus

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Neural Regeneration Research 2025年第6期20卷 1711-1712页

作者： Haoqi Sun Shiqian Shen Robert J.Thomas M.Brandon Westover Can Zhang department of Neurology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Center for Translational Pain Research Department of AnesthesiaCritical Care and Pain MedicineMassachusetis General HospitalHarvard Medical SchoolBostonMAUSA Division of Pulmonary Critical Care and Sleep MedicineDepartment of MedicineBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Genetics and Aging Research unit McCance Center for Brain HealthMass General Institute for Neurodegenerative DiseaseDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA

Introduction:Alzheimer 's disease(AD) is a common neurodegenerative disorder and the primary cause of dementia. Considerable evidence supports the “amyloid hypothesis,” stating that the pathogenesis of AD is primarily caused by the deposition of amyloid-β(Aβ), which drives tau phosphorylation, neuroinflammation, and neurodegeneration in the brain. The amyloid hypothesis is strengthened by the significant and moderate benefit of lecanemab, a humanized antibody through an anti-amyloid mechanism,showing slowed clinical decline(van Dyck et al.,2023). The recent positive results of anti-amyloid trials have brought back focus on the amyloid hypothesis through biochemical, genetic, and pharmacological approaches(Zhang, 2023).

关键词： Alzheimer inflammation hypothesis

RGS4 promotes the progression of gastric cancer through the focal adhesion kinase/phosphatidyl-inositol-3-kinase/protein kinase B pathway and epithelial-mesenchymal transition

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World Journal of Gastroenterology 2025年第2期31卷 113-127页

作者： Peng-Yu Chen Pei-Yao Wang Bang Liu Yang-Pu Jia Zhao-Xiong Zhang Xin Liu Dao-Han Wang Yong-Jia Yan Wei-Hua Fu Feng Zhu department of general Surgery Tianjin Medical University General HospitalTianjin Medical UniversityTianjin 300052China department of general Surgery Jincheng People’s HospitalJincheng 048000Shanxi ProvinceChina

BACKGROUND Regulator of G protein signaling(RGS)proteins participate in tumor formation and metastasis by acting on theα-subunit of heterotrimeric G *** speci-fic effect of RGS,particularly RGS4,on the progression of gastric cancer(GC)is not yet *** To explore the role and underlying mechanisms of action of RGS4 in GC *** The prognostic significance of RGS4 in GC was analyzed using bioinformatics based public databases and verified by immunohistochemistry and quantitative polymerase chain reaction in 90 patients with *** assays were employed to assess the carcinogenic impact of RGS4,and the mechanism of its possible influence was detected by western blot analysis.A nude mouse xenograft model was established to study the effects of RGS4 on GC growth in *** RGS4 was highly expressed in GC tissues compared with matched adjacent normal *** RGS4 expression was correlated with increased tumor-node-metastasis stage,increased tumor grade as well as poorer overall survival in patients with *** experiments demonstrated that RGS4 knockdown suppressed GC cell proliferation,migration and ***,xenograft experiments confirmed that RGS4 silencing significantly inhibited tumor ***,RGS4 knockdown resulted in reduced phosphorylation levels of focal adhesion kinase,phosphatidyl-inositol-3-kinase,and protein kinase B,decreased vimentin and N-cadherin,and elevated *** High RGS4 expression in GC indicates a worse prognosis and RGS4 is a prognostic ***4 influences tumor progression via the focal adhesion kinase/phosphatidyl-inositol-3-kinase/protein kinase B pathway and epithelial-mesenchymal transition.

关键词： Gastric cancer Prognosis Regulator of G protein signaling 4 Focal adhesion kinase Epithelial-mesenchymal transition

Hypoxia-preconditioned bone marrow-derived mesenchymal stem cells protect neurons from cardiac arrest-induced pyroptosis

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Neural Regeneration Research 2025年第4期20卷 1103-1123页

作者： Xiahong Tang Nan Zheng Qingming Lin Yan You Zheng Gong Yangping Zhuang Jiali Wu Yu Wang Hanlin Huang Jun Ke Feng Chen Shengli Clinical Medical College of Fujian Medical University Fujian Medical UniversityFuzhouFujian ProvinceChina department of Emergency Fujian Provincial HospitalFuzhouFujian ProvinceChina Fujian Provincial Key Laboratory of Emergency Medicine FuzhouFujian ProvinceChina The Second department of intensive care unit Fujian Provincial Hospital South BranchFuzhouFujian ProvinceChina

Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological *** preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are *** this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB ***,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by *** results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these *** conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.

关键词： bone marrow–derived mesenchymal stem cells cardiac arrest cardiac resuscitation hypoxic preconditioning liver isoform of phosphofructokinase mitochondria neuroinflammation oxidative stress pyroptosis reactive oxygen species

Controversies around the treatment of peritoneal metastases of colorectal cancer

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 260-264页

作者： Francisco J Morera-Ocon Clara Navarro-Campoy Ticiano Guastella Francisco Landete-Molina department of general Surgery Hospital General de RequenaRequena 46340Spain department of Gynecology and Obstetrics Hospital 9 OctubreValencia 46015Spain department of Pathology Hospital General de RequenaRequena 46340Spain

In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal *** resection for peritoneal metastases from colorectal cancer(CRC)has been gradually accepted in the medical oncology community.A randomized trial(PRODIGE 7)on cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)failed to prove any benefit of oxaliplatin in the overall survival of patients with peritoneal metastases from colorectal ***,isolated systemic chemotherapy for CRC stage IV has demonstrated a reduced response in peritoneal metastases than that obtained in other metastatic sites such as the *** tool is required in those patients to achieve more local control of the *** groups in peritoneal surgery continue to use HIPEC in their procedures,using other agents than oxaliplatin for peritoneal cavity infusion,such as mitomycin *** patients present with complex surgical issues to manage,and consequently a large burden of complications has to be ***,identifying patients who will benefit from CRS with or without HIPEC would be of great interest.

关键词： Colorectal cancer Peritoneal metastasis Hyperthermic intraoperative chemotherapy Treatment strategies Peritoneal Surface Oncology GroupInternational

Therapeutic potential of exercise-hormone irisin in Alzheimer's disease

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Neural Regeneration Research 2025年第6期20卷 1555-1564页

作者： Eunhee Kim Rudolph ETanzi Se Hoon Choi Genetics and Aging Research unit MassGeneral Institute for Neurodegenerative DiseaseDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolCharlestownMAUSA McCance Center for Brain Health Massachusetts General HospitalBostonMAUSA

Irisin is a myokine that is generated by cleavage of the membrane protein fibronectin type Ⅲ domain-containing protein 5(FNDC5) in response to physical exercise. Studies reveal that irisin/FNDC5 has neuroprotective functions against Alzheimer's disease, the most common form of dementia in the elderly, by improving cognitive function and reducing amyloid-β and tau pathologies as well as neuroinflammation in cell culture or animal models of Alzheimer's disease. Although current and ongoing studies on irisin/FNDC5 show promising results, further mechanistic studies are required to clarify its potential as a meaningful therapeutic target for alleviating Alzheimer's disease. We recently found that irisin treatment reduces amyloid-β pathology by increasing the activity/levels of amyloid-β-degrading enzyme neprilysin secreted from astrocytes. Herein, we present an overview of irisin/FNDC5's protective roles and mechanisms against Alzheimer's disease.

关键词： Alzheimer's disease exercise fibronectin typeⅢdomain-containing protein 5(FNDC5) irisin