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Section snippets Understanding Distinctions Between De-intensification, De-escalation, and Cessation of TherapyReduction of therapeutic intensity should be tailored to the specific clinical context and previous therapies. In this context, “de-intensification” serves as an overarching term that encompasses any reduction in therapy intensity, whether or not the patient initially underwent escalation

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We read with great interest the recent publication by Newsome et al. on Phase 3 ESSENCE trial, which assesses the effects of semaglutide 2.4 mg in participants with metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis stages 2 and 3 [1]. This trial represents a pivotal step forward in addressing the unmet need for effective pharmacologic treatments for MASH, a condition with significant

We are interested in a recent article, which is the first to address the potential impact of metabolic dysfunction-associated steatotic liver disease (MASLD) on the treatment response and prognosis of primary biliary cholangitis (PBC) patients and demonstrates that concomitant MASLD worsens the prognosis of PBC patients [1]. We appreciate the innovative work of the authors as the significant prevalence

We thank Li et al. for their interest in our study on the overlap between primary biliary cholangitis (PBC) and metabolic dysfunction-associated steatotic liver disease (MASLD) [1]. Their letter highlights the role of visceral obesity, measured by computed tomography (CT), as a potential contributor to nonresponse to ursodeoxycholic acid (UDCA) in PBC patients [2]. We appreciate their work emphasising

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The gut microbiota is pivotal for maintaining health through beneficial symbiotic interaction with the host supporting the homeostasis of the gastrointestinal tract but also of the majority of extraintestinal organs. Alterations in the gut microbiome have been linked to the pathogenesis of various diseases, including cancer, which remains a leading cause of mortality worldwide. The colonisation or

Background Early detection of colorectal cancer (CRC) is crucial for improving the survival rates of patients. Objective We aimed to develop a novel strategy for early CRC detection using the fragmentomic features of circulating cell-free mitochondrial DNA (ccf-mtDNA). Design Here, a total of 1147 participants, including 478 healthy controls (HCs), 112 patients with advanced adenomas (AAs) and 557

Diet is one of the main factors shaping the human microbiome, yet our understanding of how specific dietary components influence microbial consortia assembly and subsequent stability in response to press disturbances - such as increasing resource availability (feeding rate) - is still incomplete. This study explores the reproducible re-assembly, metabolic interplay, and compositional stability within

Islet cell transplantation (ICT) represents a promising therapeutic approach for addressing diabetes mellitus. However, the islet inflammation during transplantation significantly reduces the surgical outcome rate, which is related to the polarization of macrophages. Chitooligosaccharides (COS) was previously reported which could modulate the immune system, alleviate inflammation, regulate gut microecology

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects around 30% of the global population. Studies suggest that MASLD is associated with compromised brain health and cognitive dysfunction, initiating a growing interest in exploring the liver–brain axis mechanistically within MASLD pathophysiology. With the prevalence of MASLD increasing at an alarming rate, leaving a large proportion

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Osteoporosis is an age-related bone metabolic disease. As an essential endocrine organ, the skeletal system is intricately connected with extraosseous organs. The crosstalk between bones and other organs supports this view. In recent years, the link between the gut microecology and bone metabolism has become an important research topic, both in preclinical studies and in clinical trials. Many studies

Enterohemorrhagic Escherichia coli (EHEC) O157:H7 is an important intestinal pathogen that causes severe foodborne diseases. We previously demonstrated that the genomic island-encoded regulator LmiA activates the locus of enterocyte effacement (LEE) genes to promote EHEC O157:H7 adherence and colonization in the host intestine. However, whether LmiA is involved in the regulation of any other biological

INTRODUCTION Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising therapy for irritable bowel syndrome (IBS). This clinical trial aims to evaluate the influence of taVNS on autonomic functions, rectal sensation, and acetylcholine (Ach) levels and to explore potential mechanisms involving gut microbiota and metabolic profiles. METHODS This study was a single-center, single-blind,

INTRODUCTION Recent advancements in Artificial Intelligence (AI), particularly through the deployment of Large Language Models (LLMs), have profoundly impacted healthcare. This study assesses five LLMs-ChatGPT 3.5, ChatGPT 4, BARD, CLAUDE, and COPILOT-on their response accuracy, clarity, and relevance to queries concerning acute liver failure (ALF). We subsequently compare these results with Chat GPT4

BACKGROUND Despite reports indicating that polyps proximal to the splenic flexure have higher rates of metachronous colorectal adenocarcinoma (CRC), the role of adenoma location on surveillance recommendations remains unclear. This study aimed to analyze the association between index polyp location and post-colonoscopy CRC among participants of the Minnesota Colon Cancer Control Study (MCCCS). METHODS

SUMMARYTwenty‐four‐hour intragastric acidity and 24‐h plasma gastrin concentration were measured on four occasions in six groups of eight healthy male subjects. Each group was studied before dosing, and on days 1, 15 and 29 of dosing with a standard regimen of an H2‐receptor antagonist (cimetidine 800 mg node, nizatidine 300 mg node, famotidine 40 mg node, ranitidine 150 mg node, ranitidine 150 mg

SUMMARYThe acid inhibitory effect of sufotidine, a potent, long‐lasting, competitive H2‐receptor antagonist, was studied in 12 healthy males in a double‐blind, randomized, three‐way cross‐over study of the effect of placebo, sufotidine 600 mg node and sufotidine 600 mg b.d. given over 15 days.On day 1 and 15 of dosing with each regimen, each subject's 24‐h ambulatory intragastric acidity was measured

SUMMARYThe suppression of intragastric acidity with H2‐receptor antagonists may diminish with repeated administration. To assess the degree and dose‐dependance of this tolerance after short‐term dosing, two doses of the H2‐receptor antagonists, ranitidine (300 mg node or q.d.s.) and sufotidine (300 mg or 600 mg b.d.), were given to healthy volunteers for 1 and 2 weeks, respectively. After 1 and 7 days

SUMMARYSimultaneous 24‐h intragastric and plasma gastrin concentrations were measured in 36 healthy subjects, when receiving placebo (day 0) and on days 1 and 8 of dosing with either placebo (n = 8), or high‐dose H2‐blockade with either ranitidine 300 mg q.d.s. (n = 8), ranitidine 1200 mg o.m. (n = 8), or sufotidine 600 mg b.d. (n = 12).Triplicate placebo studies demonstrated good reproducibility for

SUMMARYIn a double‐blind study of Latin square design, twelve healthy male subjects were dosed with combinations of ranitidine 300 mg or placebo (at 08.50 hours) and intravenous pentagastrin (0.6 µg. kg/h) or 0. 9% saline (07.00–18.00 hours). Breakfast and lunch were served at 08.15 and 13.15 hours, respectively; hourly intragastric acidity and plasma gastrin concentration were measured from 08.00‐18

SUMMARYGastric secretory responses to histamine were investigated in anaesthetized dogs following treatment with oral ranitidine at 5 mg/kg twice daily for 358 weeks, and in isolated gastric mucosae from mice receiving sufotidine 240–280 mg. kg/day for 15 months. In neither study were there any significant differences between the acid secretory dose‐response curves to histamine in control and test

Eosinophilic oesophagitis (EoE) is a chronic, immune/antigen-mediated condition characterised by eosinophil-dominated inflammation of the oesophagus, leading to dysphagia and oesophageal dysfunction [1]. Despite advancements in diagnosis and treatment, EoE management remains challenging due to its chronicity and high relapse rates after treatment discontinuation [2]. Recent innovations, including novel

Multiple emerging lines of evidence indicate that the microbiome contributes to aging and cognitive health. However, the roles of distinct microbial components, such as viruses (virome) and their interactions with bacteria (bacteriome), as well as their metabolic pathways (metabolome) in relation to aging and cognitive function, remain poorly understood. Here, we present proof-of-concept results from

The gut mycobiome significantly affects host health and immunity. However, most studies have focused on symbiotic bacteria in the gut microbiome, whereas less attention has been given to symbiotic fungi. Although fungi constitute only 0.01%-0.1% of the gut microbiome, their larger size and unique immunoregulatory functions make them significant. Factors like diet, antimicrobials use, and age can disrupt

Phloroglucinol is a key byproduct of gut microbial metabolism that has been widely used as a treatment for irritable bowel syndrome. Here, we demonstrate that phloroglucinol tempers macrophage responses to pro-inflammatory pathogens and stimuli. In vivo, phloroglucinol administration decreases gut and extraintestinal inflammation in murine models of inflammatory bowel disease and systemic infection

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Objective Ampullary neoplastic lesions can be resected by endoscopic papillectomy (EP) or transduodenal surgical ampullectomy (TSA) while pancreaticoduodenectomy is reserved for more advanced lesions. We present the largest retrospective comparative study analysing EP and TSA. Design Of all patients in the database, lesions with prior interventions, benign histology advanced malignancy (T2 and more)

Background Transmembrane 6 superfamily member 2 (TM6SF2) has a protective role against metabolic dysfunction-associated steatotic liver disease (MASLD). Objective We aim to investigate the mechanistic role and therapeutic potential of hepatic TM6SF2 in MASLD-related hepatocellular carcinoma (HCC). Design Hepatocyte-specific Tm6sf2 knockout ( Tm6sf2 ∆hep) mice were fed with high-fat/high-cholesterol

Background One in three children with Crohn’s disease develop perianal fistula complications (PFCs), among the most disturbing and difficult-to-treat disease-related complications. Retrospective evidence suggests PFCs may be preventable. Objective We aimed to determine if early antitumour necrosis factor-alpha (anti-TNF⍺) therapy prevents PFC development in a well-characterised prospective cohort of

Enteropathogenic Escherichia coli (EPEC) is a bacterium that causes attaching/effacing (A/E) lesions and serious diarrheal disease, a major health issue in developing countries. EPEC pathogenicity results from the effect of virulence factors and dysregulation of host responses. Polyamines, including spermidine, play a major role in intestinal homeostasis. Spermidine is the substrate for deoxyhypusine

The rising incidence of drug-induced liver injury (DILI) parallels contemporary dietary shifts that have transformed the composition of human gut microbiota. The relationship between these phenomena remains unknown. Here, it is unveiled that a high fiber diet (HFiD) provides substantial protection against DILI, whereas a western style diet (WSD) significantly exacerbates DILI. Gut microbiota transplantation

BackgroundInternational guidelines suggest screening for advanced fibrosis due to metabolic dysfunction-associated steatotic liver disease in people with type 2 diabetes, but how to implement these guidelines in clinical care remains unclear. We hypothesise that examination with VCTE could be implemented simultaneously with retina scanning with a high acceptance rate in people with type 2 diabetes

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