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NAFLD between genes and environment: what drives fibrogenesis?
Angelo Armandi, J?rn M Schattenberg
doi : 10.1136/gutjnl-2020-321964
May 2021-Volume 70-5 (5 August, 2020)
Transcription factors as drivers of distinct pancreatic ductal adenocarcinoma (PDAC) programmes: a role for HNF4A
Giuseppe Riccardo Diaferia, Gioacchino Natoli
doi : 10.1136/gutjnl-2020-322814
May 2021-Volume 70-5 (1 October, 2020)
Towards personalised management for non-variceal upper gastrointestinal bleeding
Joseph J Y Sung, Loren Laine, Ernst J Kuipers, Alan N Barkun
doi : 10.1136/gutjnl-2020-323846
May 2021-Volume 70-5 (1 March, 2021)
Guidelines from national and international professional societies on upper gastrointestinal bleeding highlight the important clinical issues but do not always identify specific management strategies pertaining to individual patients. Optimal treatment should consider the personal needs of an individual patient and the pertinent resources and experience available at the point of care. This article integrates international guidelines and consensus into three stages of management: pre-endoscopic assessment and treatment, endoscopic evaluation and haemostasis and postendoscopic management. We emphasise the need for personalised management strategies based on patient characteristics, nature of bleeding lesions and the clinical setting including available resources.
Multicentre prospective study of COVID-19 transmission following outpatient GI endoscopy in the UK
Bu'Hussain Hayee, The SCOTS project group, James East, Colin J Rees, Ian Penman
doi : 10.1136/gutjnl-2020-322730
May 2021-Volume 70-5 (14 September, 2020)
Original research: Development and validation of a serum microRNA biomarker panel for detecting gastric cancer in a high-risk population
Jimmy Bok Yan So, Ritika Kapoor, Feng Zhu, Calvin Koh, Lihan Zhou, Ruiyang Zou, Yew Chung Tang, Patrick C K Goo, Sun Young Rha, Hyun Cheol Chung, Joanne Yoong, Celestial T Yap, Jaideepraj Rao, Chung-King Chia, Stephen Tsao, Asim Shabbir, Jonathan Lee, Kong-Peng Lam, Mikael Hartman, Wei Peng Yong, Heng-Phon Too, Khay-Guan Yeoh
doi : 10.1136/gutjnl-2020-322065
May 2021-Volume 70-5 (7 October, 2020)
An unmet need exists for a non-invasive biomarker assay to aid gastric cancer diagnosis. We aimed to develop a serum microRNA (miRNA) panel for identifying patients with all stages of gastric cancer from a high-risk population.
Original research: Equivalent performance of single-use and reusable duodenoscopes in a randomised trial
Ji Young Bang, Robert Hawes, Shyam Varadarajulu
doi : 10.1136/gutjnl-2020-321836
May 2021-Volume 70-5 (7 September, 2020)
Single-use duodenoscopes have been recently developed to eliminate risk of infection transmission from contaminated reusable duodenoscopes. We compared performances of single-use and reusable duodenoscopes in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).
Original research: WASh multicentre randomised controlled trial: water-assisted sigmoidoscopy in English NHS bowel scope screening
Matthew D Rutter, Rachel Evans, Zoe Hoare, Christian Von Wagner, Jill Deane, Shiran Esmaily, Tony Larkin, Rhiannon Edwards, Seow Tien Yeo, Llinos Haf Spencer, Emily Holmes, Brian P Saunders, Colin J Rees, Zacharias P Tsiamoulos, Iosif Beintaris
doi : 10.1136/gutjnl-2020-321918
May 2021-Volume 70-5 (7 September, 2020)
The English Bowel Cancer Screening Programme invites 55?year olds for a sigmoidoscopy (Bowel Scope Screening (BSS)), aiming to resect premalignant polyps, thus reducing cancer incidence. A national patient survey indicated higher procedural pain than anticipated, potentially impacting on screening compliance and effectiveness. We aimed to assess whether water-assisted sigmoidoscopy (WAS), as opposed to standard CO2 technique, improved procedural pain and detection of adenomatous polyps.
Original research: Multiomics analysis reveals the presence of a microbiome in the gut of fetal lambs
Yanliang Bi, Yan Tu, Naifeng Zhang, Shiqing Wang, Fan Zhang, Garret Suen, Dafu Shao, Shengli Li, Qiyu Diao
doi : 10.1136/gutjnl-2020-320951
May 2021-Volume 70-5 (15 February, 2021)
Microbial exposure is critical to neonatal and infant development, growth and immunity. However, whether a microbiome is present in the fetal gut prior to birth remains debated. In this study, lambs delivered by aseptic hysterectomy at full term were used as an animal model to investigate the presence of a microbiome in the prenatal gut using a multiomics approach.
Original research: Anti-SARS-CoV-2 antibody responses are attenuated in patients with IBD treated with infliximabEditor's Choice
Nicholas A Kennedy, James R Goodhand, Claire Bewshea, Rachel Nice, Desmond Chee, Simeng Lin, Neil Chanchlani, Jeffrey Butterworth, Rachel Cooney, Nicholas M Croft, Ailsa L Hart, Peter M Irving, Klaartje B Kok, Christopher A Lamb, Jimmy K Limdi, Jonathan Macdonald, Dermot PB McGovern, Shameer J Mehta, Charles D Murray, Kamal V Patel, Richard CG Pollok, Timothy Raine, Richard K Russell, Christian P Selinger, Philip J Smith, Jack Bowden, Timothy J McDonald, Charlie W Lees, Shaji Sebastian, Nicholas Powell, Tariq Ahmad
doi : 10.1136/gutjnl-2021-324388
May 2021-Volume 70-5 (22 March, 2021)
Antitumour necrosis factor (anti-TNF) drugs impair protective immunity following pneumococcal, influenza and viral hepatitis vaccination and increase the risk of serious respiratory infections. We sought to determine whether infliximab-treated patients with IBD have attenuated serological responses to SARS-CoV-2 infections.
Original research: Accuracy of a no-biopsy approach for the diagnosis of coeliac disease across different adult cohorts
Hugo A Penny, Suneil A Raju, Michelle S Lau, Lauren JS Marks, Elisabeth MR Baggus, Julio C Bai, Gabrio Bassotti, Hetty J Bontkes, Antonio Carroccio, Mihai Danciu, Mohammad H Derakhshan, Arzu Ensari, Azita Ganji, Peter H R Green, Matt W Johnson, Sauid Ishaq, Benjamin Lebwohl, Adam Levene, Roxana Maxim, Hamid Mohaghegh Shalmani, Mohammad Rostami-Nejad, David Rowlands, Irene A Spiridon, Amitabh Srivastava, Umberto Volta, Vincenzo Villanacci, Graeme Wild, Simon S Cross, Kamran Rostami, David S Sanders
doi : 10.1136/gutjnl-2020-320913
May 2021-Volume 70-5 (2 November, 2020)
We aimed to determine the predictive capacity and diagnostic yield of a 10-fold increase in serum IgA antitissue transglutaminase (tTG) antibody levels for detecting small intestinal injury diagnostic of coeliac disease (CD) in adult patients.
Original research: Development and validation of a model to predict survival in colorectal cancer using a gradient-boosted machine
Jean-Emmanuel Bibault, Daniel T Chang, Lei Xing
doi : 10.1136/gutjnl-2020-321799
May 2021-Volume 70-5 (4 September, 2020)
The success of treatment planning relies critically on our ability to predict the potential benefit of a therapy. In colorectal cancer (CRC), several nomograms are available to predict different outcomes based on the use of tumour specific features. Our objective is to provide an accurate and explainable prediction of the risk to die within 10 years after CRC diagnosis, by incorporating the tumour features and the patient medical and demographic information.
Original research: CDK1/2/5 inhibition overcomes IFNG-mediated adaptive immune resistance in pancreatic cancer
Jin Huang, Pan Chen, Ke Liu, Jiao Liu, Borong Zhou, Runliu Wu, Qiu Peng, Ze-Xian Liu, Changfeng Li, Guido Kroemer, Michael Lotze, Herbert Zeh, Rui Kang, Daolin Tang
doi : 10.1136/gutjnl-2019-320441
May 2021-Volume 70-5 (14 August, 2020)
Adaptive immune resistance mediated by the cytokine interferon gamma (IFNG) still constitutes a major problem in cancer immunotherapy. We develop strategies for overcoming IFNG-mediated adaptive immune resistance in pancreatic ductal adenocarcinoma cancer (PDAC).
Original research: Reciprocal regulation of pancreatic ductal adenocarcinoma growth and molecular subtype by HNF4? and SIX1/4
Soledad A Camolotto, Veronika K Belova, Luke Torre-Healy, Jeffery M Vahrenkamp, Kristofer C Berrett, Hannah Conway, Jill Shea, Chris Stubben, Richard Moffitt, Jason Gertz, Eric L Snyder
doi : 10.1136/gutjnl-2020-321316
May 2021-Volume 70-5 (21 August, 2020)
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with a 5-year survival of less than 5%. Transcriptomic analysis has identified two clinically relevant molecular subtypes of PDAC: classical and basal-like. The classical subtype is characterised by a more favourable prognosis and better response to chemotherapy than the basal-like subtype. The classical subtype also expresses higher levels of lineage specifiers that regulate endodermal differentiation, including the nuclear receptor hepatocyte nuclear factor 4 ? (HNF4?). The objective of this study is to evaluate the role of HNF4?, SIX4 and SIX1 in regulating the growth and molecular subtype of PDAC.
Original research: Western-type diet influences mortality from necrotising pancreatitis and demonstrates a central role for butyrate
Fons F van den Berg, Demi van Dalen, Sanjiv K Hyoju, Hjalmar C van Santvoort, Marc G Besselink, Willem Joost Wiersinga, Olga Zaborina, Marja A Boermeester, John Alverdy
doi : 10.1136/gutjnl-2019-320430
May 2021-Volume 70-5 (1 September, 2020)
The gut microbiota are the main source of infections in necrotising pancreatitis. We investigated the effect of disruption of the intestinal microbiota by a Western-type diet on mortality and bacterial dissemination in necrotising pancreatitis and its reversal by butyrate supplementation.
Original research: Multiregion whole-exome sequencing of intraductal papillary mucinous neoplasms reveals frequent somatic KLF4 mutations predominantly in low-grade regions
Kohei Fujikura, Waki Hosoda, Matth?us Felsenstein, Qianqian Song, Johannes G Reiter, Lily Zheng, Violeta Beleva Guthrie, Natalia Rincon, Marco Dal Molin, Jonathan Dudley, Joshua D Cohen, Pei Wang, Catherine G Fischer, Alicia M Braxton, Michaël Noë, Martine Jongepier, Carlos Fern?ndez-del Castillo, Mari Mino-Kenudson, C Max Schmidt, Michele T Yip-Schneider, Rita T Lawlor, Roberto Salvia, Nicholas J Roberts, Elizabeth D Thompson, Rachel Karchin, Anne Marie Lennon, Yuchen Jiao, Laura D Wood
doi : 10.1136/gutjnl-2020-321217
May 2021-Volume 70-5 (7 October, 2020)
Intraductal papillary mucinous neoplasms (IPMNs) are non-invasive precursor lesions that can progress to invasive pancreatic cancer and are classified as low-grade or high-grade based on the morphology of the neoplastic epithelium. We aimed to compare genetic alterations in low-grade and high-grade regions of the same IPMN in order to identify molecular alterations underlying neoplastic progression.
Original research: Loss of hepatic Mboat7 leads to liver fibrosis
Veera Raghavan Thangapandi, Oskar Knittelfelder, Mario Brosch, Eleonora Patsenker, Olga Vvedenskaya, Stephan Buch, Sebastian Hinz, Alexander Hendricks, Marina Nati, Alexander Herrmann, Devavrat Ravindra Rekhade, Thomas Berg, Madlen Matz-Soja, Klaus Huse, Edda Klipp, Josch K Pauling, Judith AH Wodke, Jacobo Miranda Ackerman, Malte von Bonin, Elmar Aigner, Christian Datz, Witigo von Sch?nfels, Sophie Nehring, Sebastian Zeissig, Christoph R?cken, Andreas Dahl, Triantafyllos Chavakis, Felix Stickel, Andrej Shevchenko, Clemens Schafmayer, Jochen Hampe, Pallavi Subramanian
doi : 10.1136/gutjnl-2020-320853
May 2021-Volume 70-5 (26 June, 2020)
The rs641738C>T variant located near the membrane-bound O-acyltransferase domain containing 7 (MBOAT7) locus is associated with fibrosis in liver diseases, including non-alcoholic fatty liver disease (NAFLD), alcohol-related liver disease, hepatitis B and C. We aim to understand the mechanism by which the rs641738C>T variant contributes to pathogenesis of NAFLD.
Original research: Exploring prognostic indicators in the pathological images of hepatocellular carcinoma based on deep learning
Jie-Yi Shi, Xiaodong Wang, Guang-Yu Ding, Zhou Dong, Jing Han, Zehui Guan, Li-Jie Ma, Yuxuan Zheng, Lei Zhang, Guan-Zhen Yu, Xiao-Ying Wang, Zhen-Bin Ding, Ai-Wu Ke, Haoqing Yang, Liming Wang, Lirong Ai, Ya Cao, Jian Zhou, Jia Fan, Xiyang Liu, Qiang Gao
doi : 10.1136/gutjnl-2020-320930
May 2021-Volume 70-5 (30 September, 2020)
Tumour pathology contains rich information, including tissue structure and cell morphology, that reflects disease progression and patient survival. However, phenotypic information is subtle and complex, making the discovery of prognostic indicators from pathological images challenging.
Original research: Non-alcoholic fatty liver disease and risk of incident diabetes mellitus: an updated meta-analysis of 501 022 adult individuals
Alessandro Mantovani, Graziana Petracca, Giorgia Beatrice, Herbert Tilg, Christopher D Byrne, Giovanni Targher
doi : 10.1136/gutjnl-2020-322572
May 2021-Volume 70-5 (16 September, 2020)
Follow-up studies have shown that non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of incident diabetes, but currently, it is uncertain whether this risk changes with increasing severity of NAFLD. We performed a meta-analysis of relevant studies to quantify the magnitude of the association between NAFLD and risk of incident diabetes.
Targeting G protein-coupled receptors for the treatment of chronic pain in the digestive system
Lena Gottesman-Katz, Rocco Latorre, Stephen Vanner, Brian L Schmidt, Nigel W Bunnett
doi : 10.1136/gutjnl-2020-321193
May 2021-Volume 70-5 (3 December, 2020)
Chronic pain is a hallmark of functional disorders, inflammatory diseases and cancer of the digestive system. The mechanisms that initiate and sustain chronic pain are incompletely understood, and available therapies are inadequate. This review highlights recent advances in the structure and function of pronociceptive and antinociceptive G protein-coupled receptors (GPCRs) that provide insights into the mechanisms and treatment of chronic pain.
Targeting the gut-liver-immune axis to treat cirrhosis
Thomas Henry Tranah, Lindsey A Edwards, Bernd Schnabl, Debbie Lindsay Shawcross
doi : 10.1136/gutjnl-2020-320786
May 2021-Volume 70-5 (15 October, 2020)
Cirrhotic portal hypertension is characterised by development of the decompensating events of ascites, encephalopathy, portal hypertensive bleeding and hepatorenal syndrome, which arise in a setting of cirrhosis-associated immune dysfunction (CAID) and define morbidity and prognosis. CAID describes the dichotomous observations that systemic immune cells are primed and display an inflammatory phenotype, while failing to mount robust responses to pathogen challenge. Bacterial infections including spontaneous bacterial peritonitis are common complications of advanced chronic liver disease and can precipitate variceal haemorrhage, hepatorenal syndrome and acute-on-chronic liver failure; they frequently arise from gut-derived organisms and are closely linked with dysbiosis of the commensal intestinal microbiota in advanced chronic liver disease.
GI highlights from the literature
Philip J Smith
doi : 10.1136/gutjnl-2021-324798
May 2021-Volume 70-5 (7 April, 2021)
PostScript: Survival in Crohn’s disease-associated small bowel adenocarcinoma
Paolo Giuffrida, Alessandro Vanoli, Antonio Di Sabatino
doi : 10.1136/gutjnl-2020-322364
May 2021-Volume 70-5 (24 July, 2020)
PostScript: Reply: Survival in Crohn’s disease-associated small bowel adenocarcinoma
Jordan E Axelrad, Ola Olén, Michael C Sachs, Rune Erichsen, Lars Pedersen, Jonas Halfvarson, Johan Askling, Anders Ekbom, Henrik Toft S?rensen, Jonas F Ludvigsson
doi : 10.1136/gutjnl-2020-322450
May 2021-Volume 70-5 (1 September, 2020)
PostScript: Three-dimensional bioprinted hepatorganoids in liver failure
Savneet Kaur, Dinesh Mani Tripathi, Sourabh Ghosh
doi : 10.1136/gutjnl-2020-322317
May 2021-Volume 70-5 (21 July, 2020)
PostScript: Endoscopic ultrasound (EUS)-guided fine needle biopsy (FNB) formalin fixed paraffin-embedded (FFPE) pancreatic tissue samples are a potential resource for microbiota analysis
Andrea C Masi, Yaa E A Oppong, Beate Haugk, Christopher A Lamb, Linda Sharp, James M Shaw, Christopher J Stewart, Kofi W Oppong
doi : 10.1136/gutjnl-2020-322457
May 2021-Volume 70-5 (18 August, 2020)
PostScript: Characterisation of ?? T cells infiltrating colorectal cancer
Elena Lo Presti, Anna Maria Corsale, Marta Di Simone, Francesco Dieli, Serena Meraviglia
doi : 10.1136/gutjnl-2020-322101
May 2021-Volume 70-5 (31 July, 2020)
PostScript: Choosing the best approach for laterally spreading lesions at the anorectal junction
Jo?o Santos-Antunes, Margarida Marques, F?tima Carneiro, Guilherme Macedo
doi : 10.1136/gutjnl-2020-322392
May 2021-Volume 70-5 (31 July, 2020)
Aggressive case of early onset gastric cancer; identifying the knowledge gap
Jennifer M Kolb, Stephen Leong, Lindsey M Westbrook, Swati G Patel
doi : 10.1136/gutjnl-2019-320453
May 2021-Volume 70-5 (11 March, 2020)
Correction: YAP1 mediates gastric adenocarcinoma peritoneal metastases that are attenuated by YAP1 inhibition
doi : 10.1136/gutjnl-2019-319748corr1
May 2021-Volume 70-5 (7 April, 2021)
