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Gut 2019 Apr 20. Epub 2019 Apr 20.

Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Gut 2019 Apr 19. Epub 2019 Apr 19.

Centre de Recherche Saint-Antoine (CRSA), Sorbonne Université, INSERM, Paris, France.

Objective: Patients with primary sclerosing cholangitis (PSC) were previously shown to display a bacterial gut dysbiosis but fungal microbiota has never been examined in these patients. The aim of this study was to assess the fungal gut microbiota in patients with PSC.

Design: We analysed the faecal microbiota of patients with PSC and concomitant IBD (n=27), patients with PSC and no IBD (n=22), patients with IBD and no PSC (n=33) and healthy subjects (n=30). Read More

Gut 2019 Apr 17. Epub 2019 Apr 17.

Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China.

Gut 2019 Apr 17. Epub 2019 Apr 17.

Gastroenterology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.

Gut 2019 Apr 17. Epub 2019 Apr 17.

Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.

Gut 2019 Apr 17. Epub 2019 Apr 17.

Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.

Objective: Over half of patients with IBS have either diarrhoea (IBS-D) or a mixed stool pattern (IBS-M). The relative efficacy of licenced pharmacological therapies is unclear in the absence of head-to-head trials. We conducted a network meta-analysis to resolve this uncertainty. Read More

Gut 2019 Apr 13. Epub 2019 Apr 13.

Gastroenterology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Background And Aims: Serrated polyposis syndrome (SPS) is associated with an increased risk of colorectal cancer (CRC). International guidelines recommend surveillance intervals of 1-2 years. However, yearly surveillance likely leads to overtreatment for many. Read More

Gut 2019 Apr 12. Epub 2019 Apr 12.

Université Paris-Descartes, Paris-Sorbonne Cité, Paris, France.

Introduction: The optimal trial design for assessing novel therapies in paediatric IBD (PIBD) is a subject of intense ongoing global discussions and debate among the different stakeholders. However, there is a consensus that the current situation in which most medications used in children with IBD are prescribed as off-label without sufficient paediatric data is unacceptable. Shortening the time lag between adult and paediatric approval of drugs is of the upmost importance. Read More

Gut 2019 Apr 12. Epub 2019 Apr 12.

Team Proliferation Stress and Liver Physiopathology, Genome and Cancer, Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, Paris, France.

Objectives: Polyploidy is a fascinating characteristic of liver parenchyma. Hepatocyte polyploidy depends on the DNA content of each nucleus (nuclear ploidy) and the number of nuclei per cell (cellular ploidy). Which role can be assigned to polyploidy during human hepatocellular carcinoma (HCC) development is still an open question. Read More

Gut 2019 Apr 10. Epub 2019 Apr 10.

Section for Nutrition Research, Department of Medicine, Imperial College London, London, UK.

Objective: To investigate the underlying mechanisms behind changes in glucose homeostasis with delivery of propionate to the human colon by comprehensive and coordinated analysis of gut bacterial composition, plasma metabolome and immune responses.

Design: Twelve non-diabetic adults with overweight and obesity received 20 g/day of inulin-propionate ester (IPE), designed to selectively deliver propionate to the colon, a high-fermentable fibre control (inulin) and a low-fermentable fibre control (cellulose) in a randomised, double-blind, placebo-controlled, cross-over design. Outcome measurements of metabolic responses, inflammatory markers and gut bacterial composition were analysed at the end of each 42-day supplementation period. Read More

Gut 2019 Apr 10. Epub 2019 Apr 10.

Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Objective: Despite improvements in imaging, serum CA19-9 and pathological evaluation, differentiating between benign and malignant bile duct strictures remains a diagnostic conundrum. Recent developments in next-generation sequencing (NGS) have opened new opportunities for early detection and management of cancers but, to date, have not been rigorously applied to biliary specimens.

Design: We prospectively evaluated a 28-gene NGS panel (BiliSeq) using endoscopic retrograde cholangiopancreatography-obtained biliary specimens from patients with bile duct strictures. Read More

Gut 2019 Apr 10. Epub 2019 Apr 10.

Department of Psychology, Institue of Psychiatry, Psychology and Neuroscience, King's College, London, UK.

Objective: To evaluate the clinical effectiveness of two modes of cognitive-behavioural therapy (CBT) for IBS compared with treatment as usual (TAU) in refractory IBS.

Design: A three-arm randomised controlled trial assessing telephone-delivered CBT (TCBT), web-based CBT (WCBT) with minimal therapist support, and TAU. Blinding participants and therapists was not possible. Read More

Gut 2019 Apr 9. Epub 2019 Apr 9.

Department of laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Gut 2019 Apr 9. Epub 2019 Apr 9.

AMMICa, CNRS-UMS 3655 and INSERM-US23, Gustave Roussy, Villejuif, France.

Gut 2019 Apr 6. Epub 2019 Apr 6.

Department of Medicine II, University Hospital, LMU Munich, Munich, Germany.

Background And Aims: Besides well-defined genetic alterations, the dedifferentiation of mature acinar cells is an important prerequisite for pancreatic carcinogenesis. Acinar-specific genes controlling cell homeostasis are extensively downregulated during cancer development; however, the underlying mechanisms are poorly understood. Now, we devised a novel in vitro strategy to determine genome-wide dynamics in the epigenetic landscape in pancreatic carcinogenesis. Read More

Gut 2019 Apr 6. Epub 2019 Apr 6.

Department of Gastroenterolgy and Hepatology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium.

Gut 2019 Apr 6. Epub 2019 Apr 6.

Center for Microbiome Analyses and Therapeutics, Department of Experimental Bacteriology, Leiden University Medical Center, Leiden, the Netherlands.

Gut 2019 Apr 6. Epub 2019 Apr 6.

School of Pharmaceutical Sciences, Beijing Advanced Innovation Center for Structural Biology, Tsinghua University, Beijing, China.

Objective: Increased de novo fatty acid (FA) synthesis and cholesterol biosynthesis have been independently described in many tumour types, including hepatocellular carcinoma (HCC).

Design: We investigated the functional contribution of fatty acid synthase (Fasn)-mediated de novo FA synthesis in a murine HCC model induced by loss of Pten and overexpression of c-Met (sgPten/c-Met) using liver-specific knockout mice. Expression arrays and lipidomic analysis were performed to characterise the global gene expression and lipid profiles, respectively, of sgPten/c-Met HCC from wild-type and knockout mice. Read More

Gut 2019 Apr 3. Epub 2019 Apr 3.

Gut 2019 Apr 3. Epub 2019 Apr 3.

Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Patients with Crohn's disease commonly develop ileal and less commonly colonic strictures, containing various degrees of inflammation and fibrosis. While predominantly inflammatory strictures may benefit from a medical anti-inflammatory treatment, predominantly fibrotic strictures currently require endoscopic balloon dilation or surgery. Therefore, differentiation of the main components of a stricturing lesion is key for defining the therapeutic management. Read More

Gut 2019 Mar 29. Epub 2019 Mar 29.

Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China.

Objective: To develop a gastric cancer (GC) risk prediction rule as an initial prescreening tool to identify individuals with a high risk prior to gastroscopy.

Design: This was a nationwide multicentre cross-sectional study. Individuals aged 40-80 years who went to hospitals for a GC screening gastroscopy were recruited. Read More

Gut 2019 Mar 29. Epub 2019 Mar 29.

State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health & School of Life Science, Xiamen University, Xiamen, China.

Objective: This study aimed to develop a novel therapeutic vaccine based on a unique B cell epitope and investigate its therapeutic potential against chronic hepatitis B (CHB) in animal models.

Methods: A series of peptides and carrier proteins were evaluated in HBV-tolerant mice to obtain an optimised therapeutic molecule. The immunogenicity, therapeutic efficacy and mechanism of the candidate were investigated systematically. Read More

Gut 2019 Mar 28. Epub 2019 Mar 28.

Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.

Objective: Eosinophilic oesophagitis (EoO) and IBD are immune-mediated diseases of the gastrointestinal tract with possible overlapping pathogenic mechanisms. Our aim was to define the epidemiology and clinical implications of concurrent EoO and IBD diagnoses.

Design: We conducted a prospective cohort analysis using the Truven MarketScan database (2009-2016) to estimate the incidence and prevalence of EoO in patients with Crohn's disease (CD) or UC and vice versa. Read More

Gut 2019 Mar 28. Epub 2019 Mar 28.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

Objective: The intestinal lumen contains several proteases. Our aim was to determine the role of faecal proteases in mediating barrier dysfunction and symptoms in IBS.

Design: 39 patients with IBS and 25 healthy volunteers completed questionnaires, assessments of in vivo permeability, ex vivo colonic barrier function in Ussing chambers, tight junction (TJ) proteins, ultrastructural morphology and 16 s sequencing of faecal microbiota rRNA. Read More

Gut 2019 Mar 26. Epub 2019 Mar 26.

Department of Medical Biochemistry, University of Gothenburg, Gothenburg, Sweden.

Objective: The colonic inner mucus layer protects us from pathogens and commensal-induced inflammation, and has been shown to be defective in active UC. The aim of this study was to determine the underlying compositional alterations, their molecular background and potential contribution to UC pathogenesis.

Design: In this single-centre case-control study, sigmoid colon biopsies were obtained from patients with UC with ongoing inflammation (n=36) or in remission (n=28), and from 47 patients without colonic disease. Read More

Gut 2019 Mar 25. Epub 2019 Mar 25.

Department of Internal Medicine IV, University Hospital of Heidelberg, Heidelberg, Germany.

Objective: Scheduled endoscopic dilatation of dominant strictures (DS) in primary sclerosing cholangitis (PSC) might improve outcome relative to endoscopic treatment on demand, but evidence is limited. Since randomisation is difficult in clinical practice, we present a large retrospective study comparing scheduled versus on-demand endoscopic retrograde cholangiopancreatography (ERCP) based on patient preferences.

Design: Between 1987 and 2017, all new patients with PSC had been offered scheduled ERCP with dilatation of a DS if diagnosed; the latter was repeated at defined intervals until morphological resolution, independent of clinical symptoms (treatment group). Read More

Gut 2019 Mar 22. Epub 2019 Mar 22.

Department of General Surgery, Huashan Hospital, Cancer Metastasis Institute, Fudan University, Shanghai, China.

Objective: In the tumour microenvironment, critical drivers of immune escape include the oncogenic activity of the tumour cell-intrinsic osteopontin (OPN), the expression of programmed death ligand 1 (PD-L1) and the expansion of tumour-associated macrophages (TAMs). We investigated the feasibility of targeting these pathways as a therapeutic option in hepatocellular carcinoma (HCC) mouse models.

Design: We analysed the number of tumour-infiltrating immune cells and the inflammatory immune profiles in chemically induced liver tumour isolated from wild-type and knockout (KO) mice. Read More

Gut 2019 Feb 2. Epub 2019 Feb 2.

Institute of Pathology, UniversitatsKlinikum Heidelberg, Heidelberg, Germany.

Objective: We aimed at the identification of genetic alterations that may functionally substitute for mutation in ß-catenin-activated hepatocellular adenomas (HCAs) and hepatocellular carcinoma (HCC).

Design: Large cohorts of HCA (n=185) and HCC (n=468) were classified using immunohistochemistry. The mutational status of the gene was determined in ß-catenin-activated HCA (b-HCA) and HCC with at least moderate nuclear CTNNB1 accumulation. Read More

Gut 2019 Mar 20. Epub 2019 Mar 20.

Department of Medicine, University of Calgary, Calgary, Alberta, Canada.

Gut 2019 Mar 19. Epub 2019 Mar 19.

Department Gastroenterology and Gastrointestinal Oncology, University Medical Centre Goettingen, Goettingen, Germany.

Gut 2019 Mar 18. Epub 2019 Mar 18.

Liver Disease Lab, CIC bioGUNE, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Derio, Bizkaia, Spain.

Gut 2019 Mar 16. Epub 2019 Mar 16.

Department of Gastroenterology and Hepatology, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.

Gut 2019 Mar 16. Epub 2019 Mar 16.

Munich Cancer Registry, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University (LMU), Munich, Germany.

Objective: Hepatocellular carcinoma (HCC) is a major cause of death worldwide and its incidence is expected to increase globally. Aim of this study was to assess whether the implementation of screening policies and the improvement of treatment options translated into a real-world survival benefit in HCC patients.

Design: 4078 patients diagnosed with HCC between 1998 and 2016 from the Munich Cancer Registry were analysed. Read More

Gut 2019 Mar 14. Epub 2019 Mar 14.

Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.

Objective: There is a striking association between human cholestatic liver disease (CLD) and inflammatory bowel disease. However, the functional implications for intestinal microbiota and inflammasome-mediated innate immune response in CLD remain elusive. Here we investigated the functional role of gut-liver crosstalk for CLD in the murine Mdr2 knockout model resembling human primary sclerosing cholangitis (PSC). Read More

Gut 2019 Mar 14. Epub 2019 Mar 14.

Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, London, UK.

Objective: The crypt population in the human intestine is dynamic: crypts can divide to produce two new daughter crypts through a process termed crypt fission, but whether this is balanced by a second process to remove crypts, as recently shown in mouse models, is uncertain. We examined whether crypt fusion (the process of two neighbouring crypts fusing into a single daughter crypt) occurs in the human colon.

Design: We used somatic alterations in the gene cytochrome c oxidase (CCO) as lineage tracing markers to assess the clonality of bifurcating colon crypts (n=309 bifurcating crypts from 13 patients). Read More

Gut 2019 Mar 14. Epub 2019 Mar 14.

Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Kansas, USA.

Background: Biopsies are obtained to confirm intestinal metaplasia and rule out prevalent dysplasia and cancer when Barrett's oesophagus (BE) is detected at index upper endoscopy (oesophagogastroduodenoscopy [EGD]).

Aim: The purpose of this systematic review was to obtain summary estimates of the prevalence of high-grade dysplasia (HGD) and oesophageal adenocarcinoma (EAC) associated with BE during index EGD for chronic GERD symptoms, defined as neoplasia detection rate (NDR) which could be used as a quality measure.

Methods: An extensive search was performed within PUBMED, EMBASE and the Cochrane Library databases to identify studies in which patients underwent index endoscopy for the evaluation of the presence of BE. Read More

Gut 2019 Mar 14. Epub 2019 Mar 14.

Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.

Objectives: Intraductal papillary mucinous neoplasms (IPMNs) are pancreatic cysts that can progress to invasive pancreatic cancer. Associations between oncogenesis and oral microbiome alterations have been reported. This study aims to investigate a potential intracystic pancreatic microbiome in a pancreatic cystic neoplasm (PCN) surgery patient cohort. Read More

Gut 2019 Mar 12. Epub 2019 Mar 12.

EFS, Univ Brest, Inserm, UMR 1078, GGB, Brest, France.

Gut 2019 Mar 11. Epub 2019 Mar 11.

Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China.

Objective: Esophagogastroduodenoscopy (EGD) is the pivotal procedure in the diagnosis of upper gastrointestinal lesions. However, there are significant variations in EGD performance among endoscopists, impairing the discovery rate of gastric cancers and precursor lesions. The aim of this study was to construct a real-time quality improving system, WISENSE, to monitor blind spots, time the procedure and automatically generate photodocumentation during EGD and thus raise the quality of everyday endoscopy. Read More

Gut 2019 Mar 9. Epub 2019 Mar 9.

Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, UK.

Objective: Current strategies to guide selection of neoadjuvant therapy in oesophageal adenocarcinoma (OAC) are inadequate. We assessed the ability of a DNA damage immune response (DDIR) assay to predict response following neoadjuvant chemotherapy in OAC.

Design: Transcriptional profiling of 273 formalin-fixed paraffin-embedded prechemotherapy endoscopic OAC biopsies was performed. Read More

Gut 2019 Mar 6. Epub 2019 Mar 6.

Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California, USA.

Objective: The Collaborative Cross (CC) is a mouse population model with diverse and reproducible genetic backgrounds used to identify novel disease models and genes that contribute to human disease. Since spontaneous tumour susceptibility in CC mice remains unexplored, we assessed tumour incidence and spectrum.

Design: We monitored 293 mice from 18 CC strains for tumour development. Read More

Gut 2019 Mar 6. Epub 2019 Mar 6.

Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.

Objective: The pathogenesis of UC relates to gut microbiota dysbiosis. We postulate that alterations in the viral community populating the intestinal mucosa play an important role in UC pathogenesis. This study aims to characterise the mucosal virome and their functions in health and UC. Read More

Gut 2019 Mar 4. Epub 2019 Mar 4.

Université de Strasbourg, Inserm, Institut de Recherche sur les Maladies Virales et Hépatiques UMR_S1110, F-67000 Strasbourg, France.

Objective: Hepatitis D virus (HDV) is a circular RNA virus coinfecting hepatocytes with hepatitis B virus. Chronic hepatitis D results in severe liver disease and an increased risk of liver cancer. Efficient therapeutic approaches against HDV are absent. Read More

Gut 2019 Mar 2. Epub 2019 Mar 2.

State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Background And Aims: Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer-related death worldwide. Neurotransmitter-initiated signalling pathway is profoundly implicated in tumour initiation and progression. Here, we investigated whether dysregulated neurotransmitter receptors play a role during pancreatic tumourigenesis. Read More

Gut 2019 05 2;68(5):769-770. Epub 2019 Mar 2.

Gastroenterology Unit, Addenbrookes Hospital, Cambridge, UK.

Gut 2019 05 2;68(5):952. Epub 2019 Mar 2.

Gut 2019 Feb 11. Epub 2019 Feb 11.

Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.

Objective: Faecal microbiota transplant (FMT) effectively treats recurrent infection (rCDI), but its mechanisms of action remain poorly defined. Certain bile acids affect germination or vegetative growth. We hypothesised that loss of gut microbiota-derived bile salt hydrolases (BSHs) predisposes to CDI by perturbing gut bile metabolism, and that BSH restitution is a key mediator of FMT's efficacy in treating the condition. Read More

Gut 2019 Feb 27. Epub 2019 Feb 27.

Department of Gastroenterology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.

Objective: The effect of colonoscopy on colorectal cancer mortality is limited by several factors, among them a certain miss rate, leading to limited adenoma detection rates (ADRs). We investigated the effect of an automatic polyp detection system based on deep learning on polyp detection rate and ADR.

Design: In an open, non-blinded trial, consecutive patients were prospectively randomised to undergo diagnostic colonoscopy with or without assistance of a real-time automatic polyp detection system providing a simultaneous visual notice and sound alarm on polyp detection. Read More

Gut 2019 Feb 27. Epub 2019 Feb 27.

Gastroenterology and Gastrointestinal Oncology, Georg-August-Universitat Gottingen Universitatsmedizin, Gottingen, Germany.

Gut 2019 Feb 26. Epub 2019 Feb 26.

Flinders Centre for Innovation in Cancer, Flinders University, Bedford Park, South Australia, Australia.