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We read with interest the Rome Consensus paper on faecal microbiota transplantation (FMT) in IBD (a refractory disease with intermittent flare-ups and remissions of intestinal inflammation) by Lopetuso et al .1 It highlights modest efficacies of FMT in treating IBD and adverse event risks caused by bacteria transplantation, according to data from clinical trials.1 Hence, further refinement of FMT is

Background Aberrant Wnt pathway activation is a key driver of colorectal cancer (CRC) and is essential to sustain tumour growth and progression. Although the downstream protein-coding target genes of the Wnt cascade are well known, the long non-coding transcriptome has not yet been fully resolved. Objective In this study, we aim to comprehensively reveal the Wnt-regulated long non-coding transcriptome

Background There is no clinically relevant serological marker for the early detection of oesophageal adenocarcinoma (EAC) and its precursor lesion, Barrett’s oesophagus (BE). Objective To develop and test a blood-based assay for EAC and BE. Design Oesophageal MicroRNAs of BaRRett, Adenocarcinoma and Dysplasia ( EMERALD ) was a large, international, multicentre biomarker cohort study involving 792 patient

BackgroundApproximately half of patients with Crohn's disease require ileocolonic resection. Of these, 50% will subsequently have endoscopic disease recurrence within 1 year. We aimed to evaluate the efficacy and safety of vedolizumab to prevent postoperative recurrence of Crohn's disease. MethodsREPREVIO was a double-blind, randomised, placebo-controlled trial conducted at 13 academic or teaching

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Background & AimsGemcitabine combined with albumin-paclitaxel (AG) is a crucial therapeutic option for pancreatic ductal adenocarcinoma (PDAC). However, the response to chemotherapy is relatively poor, with rapid development of resistance. The aim of this study was to explore the mechanism of resistance to AG and to develop strategies that can sensitize the AG regimen. MethodsWe utilized organoid models

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Background & AimsThis American Gastroenterological Association (AGA) living guideline is intended to support practitioners in the pharmacological management of moderate-to-severe ulcerative colitis (UC). MethodsA multidisciplinary panel of content experts and guideline methodologists used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to prioritize clinical

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Section snippets CME/MOC CreditsThe AGA Institute is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The AGA Institute designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity

We thank Drs. Alexander and Caldera for their stimulating and compelling editorial that excellently contextualised our study evaluating the immunogenicity of original and variant-adapted COVID-19 mRNA vaccines in patients with inflammatory bowel disease (IBD) and healthy controls [1, 2]. To date, the STAR SIGN study has evaluated immunity against wild-type SARS-CoV-2 and the omicron BA.1, BA5, BQ.1

Numerous exposure–outcome relationship studies demonstrate a positive correlation between therapeutic biologic drug concentrations and favourable outcomes in immune-medicated inflammatory disorders including inflammatory bowel disease (IBD) [1, 2]. In the same vein, low drug concentrations are associated with loss of response and immunogenicity [1, 3]. Furthermore, post hoc analyses of randomised controlled

To define the pathophysiology of metabolic dysfunction-associated steatotic liver disease (MASLD) and identify therapeutic options, it is crucial to understand the sources of hepatic fat accumulation. In patients with MASLD, it is estimated that hepatic triglycerides are primarily derived from adipose tissue as free fatty acids (~59%), followed by de novo lipogenesis (~26%) and diet (~15%). However

The human intestinal tract is densely colonized by a microbial community that is subject to intense competition. Bacteria in this complex habitat seek to outcompete their neighbors for nutrients and eliminate competitors with antibacterial toxins. Antagonism can be mediated by diverse effectors including toxic proteins and small molecule inhibitors that are released extracellularly or delivered by

The Western diet is associated with gastrointestinal dysbiosis, an active contributor to the pathophysiology of obesity and its comorbidities. Gastrointestinal dysbiosis is strongly linked to increased adiposity, low-grade inflammation, dyslipidaemia, and insulin resistance in individuals with morbid obesity. Bariatric bypass surgery remains the most effective treatment for achieving significant weight

Protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and risk of long COVID has been associated with the depletion or over-abundance of specific taxa within the gut microbiome. However, the microbial mechanisms mediating these effects are not yet known. We hypothesized that altered microbial production of tryptophan and its downstream derivatives might contribute

DescriptionNonampullary duodenal polyps are found in up to 5% of all upper endoscopies; the vast majority are identified incidentally in asymptomatic patients. Although most are benign, adenomas are estimated to account for 10%–20% of these lesions. Most international guidelines recommend that all duodenal adenomas should be considered for endoscopic resection; this may be associated with a near 15%

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We read with great interest the article by Henniger et al 1 about reducing scope 3 carbon emissions in endoscopy and would like to discuss several points. First, we commend the study’s transparency, as manufacturers provided detailed information about their fabrication and delivery processes. This collaboration exemplifies our shared goal of environmental protection. Furthermore, this is the first

Numerous studies have established that prebiotic ingredients in foods and dietary supplements may play a role in supporting human health. Over the three decades that have passed since prebiotics were first defined as a concept, research has revealed a complex universe of prebiotic-induced changes to the human microbiota. There are strong indications of a direct link between these prebiotic-induced

The Rome criteria, first published in 1994 and currently in their fourth iteration, are widely considered to be the gold standard symptom-based criteria to diagnose disorders of gut-brain interaction (DGBI), formerly known as functional gastrointestinal diseases [1]. To inform the upcoming Rome V criteria, due for publication in 2026, the Rome Foundation analysed the effects of modifying symptoms (e

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DescriptionThe purpose of this American Gastroenterological Association (AGA) Clinical Practice Update is to facilitate understanding and improve the clinical practice of endoscopic enteral access. MethodsThis expert commentary was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance

Intestinal mucins play a crucial role in the mucosal barrier, serving as the body's initial defense against microorganisms. However, how the host regulates the secretion and glycosylation of these mucins in response to bacterial invasion remains unclear. Our study demonstrates that when exposed to Streptococcus gallolyticus (SGG), a gut pathobiont, the host mucosa promptly adjusts the behavior of specialized

The fruits and vegetables we consume as part of our diet are rich in bioactive metabolites that can prevent and ameliorate cardiometabolic diseases, cancers, and neurological conditions. Polyphenols are a major metabolite family that has been intensively investigated in this context. However, for these compounds to exert their optimal bioactivity, they rely on the enzymatic capacity of an individual's

The publisher regrets that this article has been posted prematurely. The article has been temporarily removed and will be reinstated as soon as possible.

Acute-on-chronic liver failure (ACLF) is a severe condition characterised by high short-term mortality, requiring rapid diagnosis, prompt treatment of trigger factors and appropriate prognostic evaluation to guide patients towards the best therapeutic options. Although several scores, such as the model for end-stage liver disease (MELD) and the CLIF-C ACLF score, have been proposed over time to assess

We extend our sincere gratitude to Dr. Francesco Paolo Russo and Alberto Ferrarese for their thorough evaluation and professional insights on our study [1]. We are gratified by their recognition of the potential of the age-adjusted Charlson Comorbidity Index for Hepatitis B Virus-Related Acute-on-Chronic Liver Failure (aCCI-HBV-ACLF) score in enhancing the accuracy of short-term and medium-term prognostic

We read the article published in your esteemed journal titled, “Insulin-like growth factor-1 in cirrhosis is linked to hepatic dysfunction and fibrogenesis and predicts liver-related mortality” by Hartl et al. with great interest. We appreciate the authors for investigating the prognostic role of insulin-like growth factor-1 (IGF-1) in advanced chronic liver disease (ACLD) patients [1]. While the study

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Background Peritoneal metastasis is the most common metastasis pattern of gastric cancer. Patients with gastric cancer peritoneal metastasis (GCPM) have a poor prognosis and respond poorly to conventional treatments. Recently, immune checkpoint blockade (ICB) has demonstrated favourable efficacy in the treatment of GCPM. Stratification of best responders and elucidation of resistance mechanisms of

Many patients with IBD report persisting symptoms, despite resolution of the inflammatory process. Although by definition, a diagnosis of IBS cannot be made, the prevalence of ‘IBS in IBD’ surpasses the rate of IBS in the global population by fivefold. Because IBS-like symptoms are associated with a decreased quality of life and increased healthcare utilisation in IBD, diagnosis and treatment are necessary

Surgical removal is recommended for gastrointestinal stromal tumours (GISTs) larger than 3 cm due to their potential for malignancy but limited wedge resection is not possible in the proximal stomach. Endoscopic removal of larger lesions has been technically limited in complex anatomical regions such as cardia. We report two cases of large proximal (cardia/fundus) GIST tumours (51 and 60 mm) which

Lactic acid bacteria derived extracellular vesicles (LAB-EVs) are nano-sized and carry a variety of biological cargoes. LAB-EVs have proven to be potential mediators of intercellular communication, serving not only the parental bacteria but also the host cell in both physiology and pathology. LAB-EVs are therapeutically beneficial in various diseases through a cell-free strategy. Particularly, EVs

The gut microbiota has been implicated in onset and progression of ulcerative colitis (UC). Here, we assess potential causal involvement of the microbiota and -associated fecal water (FW) metabolome in altering key functional parameters of the colonic epithelium. Fecal samples were collected from N = 51 healthy controls (HC), N = 36 patients with active UC (UC-A), and N = 41 subjects in remission N = 41

Bile acids (BAs) undergo extensive microbial metabolism in the gut and exert hormone-like functions on physiological processes underlying metabolic risk. However, the extent to which gut BA profiles predict cardiometabolic risk and explain individual responses to dietary interventions in humans is still unclear. In the DIRECT-PLUS Trial, we conducted a multi-omics analysis of 284 participants randomized

We thank Dr. Schildkraut et al. for their thoughtful commentary and the acknowledgment of the importance of our study in demonstrating that existing bowel preparation quality assessment instruments, typically used in the general population, are also reliable and valid for patients with Crohn's disease (CD) [1]. The implications of these findings are that instrument selection for use in clinical practice

Adequate bowel preparation is crucial for optimal visualisation and lesion detection and remains a key determinant of colonoscopy quality [1, 2]. Up to one-quarter of colonoscopies are conducted with inadequate bowel preparation, leading to reduced diagnostic yield and detection of nonpolypoid flat lesions, prolonged procedure time and an increased burden of repeat colonoscopies [2, 3]. Several validated

Background Bismuth quadruple therapies (BQTs) including bismuth, a proton pump inhibitor (PPI) and two antibiotics have been shown to be highly effective for treating Helicobacter pylori infection even in areas of high bacterial antibiotic resistance. Objective To describe the time trends of use, effectiveness and safety of BQT in Europe using the European Registry on Helicobacter pylori Management

An extensive network of microbial-host interactions exists in the gut, making the gut microbiome a complex ecosystem to untangle. The microbial composition and the fecal metabolites are important readouts to investigate intricate microbiota-diet-host interplay. However, this ecosystem is dynamic, and it is of interest to understand the degree and timescale of changes occurring in the gut microbiota

INTRODUCTION Fecal microbial transplantation (FMT) has shown promise at inducing remission in ulcerative colitis. This study is the first of its kind to evaluate the efficacy and safety of FMT at inducing remission in Crohn's disease (CD). METHODS This double-blind, placebo-controlled trial was conducted in three Canadian academic centers; randomized patients with mild to moderate CD received FMT or

BACKGROUND Intravenous albumin reduces mortality in SBP. We sought to characterize albumin use for SBP over time and investigate patient and hospital-level factors associated with use. METHODS A retrospective cohort study in the Veterans Health Administration between 2008 and 2021 evaluated trends and patient, practice-, and facility-level factors associated with use among patients with cirrhosis hospitalized