Arab Journal Of Gastroenterology[JOURNAL]
Sun
200 papers
Clinical efficacy of Jiawei Yinchenhao decoction combined with ursodeoxycholic acid and probiotics in the management of nonalcoholic fatty liver disease.
Chen D, Li X, Fu J … +3 more , Ma Y, Jiang H, Li Q
Arab J Gastroenterol · 2026 May · PMID 41833459 · Publisher ↗
OBJECTIVE: The study focused on evaluating the clinical effectiveness of Jiawei Yinchenhao decoction (JWYCH) combined with ursodeoxycholic acid (UDCA) and probiotics in the treatment of nonalcoholic fatty liver disease (...
OBJECTIVE: The study focused on evaluating the clinical effectiveness of Jiawei Yinchenhao decoction (JWYCH) combined with ursodeoxycholic acid (UDCA) and probiotics in the treatment of nonalcoholic fatty liver disease (NAFLD). METHODS: Patients with NAFLD were divided into an observation group (JWYCH + UDCA + probiotics) and a control group (UDCA + probiotics). Clinical efficacy, liver function, blood lipids, oxidative stress indicators, inflammatory cytokines, gut microbiota composition, and adverse events were assessed before and after 4 weeks of treatment. RESULTS: The observation group demonstrated a significantly higher clinical effective rate (90.00 %) compared to the control group (71.67 %) (P < 0.05). Both groups showed improved gut flora (increased Bifidobacterium and Lactobacillus, decreased Escherichia coli and Enterococcus), reduced liver enzymes (ALT, AST), bilirubin (TBil), and lipid levels (TC, LDL-C), and attenuated oxidative stress (lower MDA, higher GSH-Px and SOD) and inflammatory markers (TGF-β, TNF-α, IL-8); the observation group exhibited greater improvements across all indicators than the control group (P < 0.05). Adverse reactions were minimal and comparable between groups. CONCLUSION: JWYCH combined with UDCA and probiotics provides superior therapeutic benefits for NAFLD by improving liver function, modulating intestinal microbiota, reducing inflammation and oxidative stress, and enhancing lipid metabolism, with good safety. This integrated approach holds promise for broader clinical application.
The effect of HBE1 on resistance to gemcitabine in pancreatic cancer cells.
Cheng J, Jiang H, Yu X … +5 more , Huang P, Lu Y, Tan S, Liu X, Qin S
Arab J Gastroenterol · 2026 May · PMID 41833458 · Publisher ↗
BACKGROUND: Chemotherapy resistance remains a major challenge in pancreatic cancer treatment, with gemcitabine-based therapy being a primary approach. However, the mechanisms underlying gemcitabine resistance in pancreat...
BACKGROUND: Chemotherapy resistance remains a major challenge in pancreatic cancer treatment, with gemcitabine-based therapy being a primary approach. However, the mechanisms underlying gemcitabine resistance in pancreatic cancer cells are not yet fully understood. This study aimed to investigate the role ofHBE1in conferring resistance to gemcitabine and explore its effects on reactive oxygen species (ROS) production, mitochondrial apoptosis, and endoplasmic reticulum (ER) stress. MATERIALS AND METHODS: A gemcitabine-resistant pancreatic cancer cell line was systematically developed through gradual, six-month exposure to increasing concentrations of gemcitabine. The role ofHBE1was examined by assessing its impact on ROS levels, mitochondrial-mediated apoptosis, and ER stress pathways, includingIRE1α phosphorylationandGRP78 expression. RESULTS: Overexpression ofHBE1was found to suppress ROS generation and inhibit mitochondrial-dependent apoptosis. Additionally, it attenuated ER stress by reducingIRE1α phosphorylationwhile upregulatingGRP78. CONCLUSION: These findings demonstrate a strong correlation between elevatedHBE1expression and gemcitabine resistance in pancreatic cancer cells, suggesting its potential as a therapeutic target to overcome chemoresistance.
Capsule endoscopic features in a severe case of eosinophilic enteritis: A case report.
Pham PQ, Nghiem TD, Duong NX … +4 more , Nguyen TH, Tran YH, Vu HT, Nguyen TD
Arab J Gastroenterol · 2026 May · PMID 41833457 · Publisher ↗
BACKGROUND: Eosinophilic enteritis (EoN) is a rare digestive disorder characterised by eosinophilic infiltration of the small intestine. Diagnosis relies on the recognition of characteristic endoscopic findings and the i...
BACKGROUND: Eosinophilic enteritis (EoN) is a rare digestive disorder characterised by eosinophilic infiltration of the small intestine. Diagnosis relies on the recognition of characteristic endoscopic findings and the identification of eosinophilia in gastrointestinal tissues. Capsule endoscopy is particularly useful for detecting lesions in the small intestine, a region that is difficult to assess. However, the endoscopic features of EoN are poorly understood. CASE PRESENTATION: A 20-year-old Asian man presented with a one-month history of right lower quadrant abdominal pain accompanied by nausea, vomiting, and diarrhea occurring 1-2 times per day. Laboratory tests revealed peripheral blood eosinophilia (665/μL; normal range, 20-400) and elevated C-reactive protein level (28.8 mg/L; normal range, <10 mg/L). Abdominal computed tomography revealed uneven thickening of the ileum and the ileocaecal region. Capsule endoscopy (MC 2000; Intromedic, South Korea) revealed multiple areas of erythema, villous atrophy, erosion, ulceration, and oedema throughout the small intestine. Histopathological examination of a biopsy sample confirmed mucosal infiltration of more than 50 eosinophils per high-power field, leading to the diagnosis of EoN. The patient was administered intravenous methylprednisolone at 40 mg/day, which resulted in significant symptom relief within two weeks. The dose was gradually tapered to 15 mg/day. Follow-up capsule endoscopy performed two months later showed complete resolution of the mucosal lesions in the small intestine. CONCLUSION: This case highlights the key capsule endoscopy findings in EoN, including multiple areas of erythema, villous atrophy, erosion, ulceration, and oedema throughout the small intestine, which may serve as a diagnostic guide for cases in which small bowel biopsy is not feasible.
FGF19/FGFR4/KLB signaling participate in the ferroptosis regulation of hepatocellular carcinoma.
Xia J, Qiu M, Ma H … +1 more , Ren H
Arab J Gastroenterol · 2026 Feb · PMID 41654439 · Publisher ↗
Hepatocellular carcinoma (HCC) is the main histopathological type of liver cancer and the fourth major cause of cancer-related mortality globally, yet the treatment options are very limited. Ferroptosis is a unique iron-...
Hepatocellular carcinoma (HCC) is the main histopathological type of liver cancer and the fourth major cause of cancer-related mortality globally, yet the treatment options are very limited. Ferroptosis is a unique iron-dependent form of oxidative cell death process that plays essential regulatory roles in the occurrence and development of HCC. However, the underlying mechanism in ferroptosis regulation in HCC remains inadequately understood. Aberrant activation of fibroblast growth factor 19-fibroblast growth factor receptor 4-βKlotho (FGF19-FGFR4-KLB) signaling is considered carcinogenic driving pathway in patients with HCC. Recently, increasing evidence has shown that FGFR4 inhibition could trigger ferroptosis process in many tumors. However, as an important ligand of FGFR4, the role of FGF19 in the regulation of ferroptosis remains unclear. In this research, results of western blotting and reactive oxygen species (ROS) assay demonstrated that knock down of KLB enhance the expression of TFRC, a driver gene of ferroptosis, thus blocking the ferroptosis inhibitory effect of FGF19. Based on these available evidence and data, we hypothesize that FGF19 signaling inhibit the ferroptotic cell death in HCC cells through FGFR4-KLB co-receptors, while suppression of FGFR4-KLB could block FGF19 signaling, thus trigger ferroptosis process.
Selection of the best artificial intelligence techniques for analysis of gastrointestinal endoscopic images.
You G, Yang Y, Shen Y
Arab J Gastroenterol · 2026 Feb · PMID 41620373 · Publisher ↗
BACKGROUND AND STUDY AIM: Comprehensive identification and prioritization of artificial intelligence methods developed for the analysis of gastrointestinal endoscopic images can help in selecting the most appropriate tec...
BACKGROUND AND STUDY AIM: Comprehensive identification and prioritization of artificial intelligence methods developed for the analysis of gastrointestinal endoscopic images can help in selecting the most appropriate techniques. This study aimed to introduce the best artificial intelligence techniques developed for analyzing gastrointestinal endoscopic images using fuzzy AHP-TOPSIS methods. PATIENTS AND METHODS: To identify the artificial intelligence techniques developed, a systematic search was conducted across five reputable databases. Subsequently, the Delphi method was employed to establish appropriate criteria for selecting the best artificial intelligence techniques. To estimate the relative weights of these criteria, the fuzzy analytical hierarchy process (FAHP) was utilized. Finally, to prioritize the identified artificial intelligence techniques, the technique for order preference by similarity to the ideal solution (TOPSIS) method was applied. RESULTS: 70 artificial intelligence techniques were identified. Seven selection criteria were introduced: validity, accuracy, comprehensiveness, processing time, cost, simplicity, and executive capability. The top methods selected were the computer-aided detection (CAD) system (0.8203), the human color appearance model (CIECAM) (0.8122), the combined method (PD-CNN-PCC-EELM) (0.8109), the combined method (DNN-CAD) (0.7928), and the ResNet18 deep learning model (0.7921), respectively. CONCLUSIONS: These findings represent a comprehensive approach to the developed techniques, which can be utilized to design methods with improved performance in the future.
Efficacy of Shugan Hewei Decoction in treating chronic atrophic gastritis and its influence on gastric mucosal pathology.
Gong J, Ding W, Xu G
Arab J Gastroenterol · 2026 May · PMID 41611595 · Publisher ↗
BACKGROUND AND STUDY AIMS: To investigate the efficacy of Shugan Hewei Decoction in the treatment of chronic atrophic gastritis (CAG) and its effect on gastric mucosal pathology. PATIENTS AND METHODS: A total of 72 patie...
BACKGROUND AND STUDY AIMS: To investigate the efficacy of Shugan Hewei Decoction in the treatment of chronic atrophic gastritis (CAG) and its effect on gastric mucosal pathology. PATIENTS AND METHODS: A total of 72 patients with CAG admitted from October 2022 to December 2023 were enrolled and divided into two groups using a random number table method. The control group (36 cases) was treated with oral Weifuchun, while the study group (36 cases) received oral Shugan Hewei Decoction. The two groups were compared in terms of total treatment effectiveness rate, incidence of adverse reactions, scores of primary and secondary symptoms (before and after treatment), gastric function indices (pepsinogenⅠ [PGⅠ], pepsinogenⅠ/pepsinogenⅡ [PGⅠ/PGⅡ], and gastrin-17 [G-17]), and scores of gastric mucosal pathological indices (intestinal metaplasia, glandular atrophy, and dysplasia). RESULTS: The total treatment effectiveness rate in the study group was significantly higher than that in the control group, while the total incidence of adverse reactions was significantly lower (both P < 0.05). Before treatment, there were no significant differences between the two groups in scores of primary and secondary symptoms, gastric function indices, or scores of gastric mucosal pathological indices (all P > 0.05). After treatment, the study group showed significantly lower scores of primary and secondary symptoms and gastric mucosal pathological indices, as well as significantly higher gastric function indices compared with the control group (all P < 0.05). CONCLUSION: Shugan Hewei Decoction exhibits favorable efficacy and high safety in the treatment of CAG. It can significantly improve the gastric mucosal pathological state, thus holding relatively high application value in CAG patients.
The role of allopurinol in metabolic dysfunction-associated steatotic liver disease: A randomized clinical trial.
Khani E, Khoshbaten M, Jafarabadi MA … +3 more , Rezaei H, Rahmani M, Shaseb E
Arab J Gastroenterol · 2026 Feb · PMID 41605703 · Publisher ↗
BACKGROUND AND STUDY AIMS: Despite being the leading cause of liver-related mortality, the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD) remains challenging. This study aimed to assess the...
BACKGROUND AND STUDY AIMS: Despite being the leading cause of liver-related mortality, the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD) remains challenging. This study aimed to assess the effects of allopurinol on hepatic enzymes and ultrasonographic grading of MASLD patients, given the important role of uric acid in MASLD pathogenesis. PATIENTS AND METHODS: This randomized clinical trial enrolled 104 patients with MASLD to receive either 100 mg allopurinol daily in addition to the hypocaloric diet (n = 51) or the hypocaloric diet alone (n = 53) for 6 months. Ultrasonographic grading and serum levels of hepatic enzymes, including aspartate transaminase (AST) and alanine transaminase (ALT), were compared at 6 months compared with baseline. Between-group changes were investigated by the chi-squared test and an analysis of covariance (ANCOVA) adjusted for age, sex, BMI, and baseline values. The correlation between serum uric acid levels and liver enzymes was also assessed using the Pearson correlation coefficient (r). RESULTS: Ultrasonographic grading of the allopurinol-treated group, but not the control group, significantly improved from baseline (P = 0.001 and P = 0.096). However, there were no significant differences between the two groups. Within the allopurinol-treated group, ALT and AST levels significantly decreased in the sixth month from baseline (P = 0.004 and P = 0.022, respectively), while no significant changes were observed in the control group (P = 0.571 and P = 0.526, respectively) or between the two groups.Unlike the control group, serum uric acid correlated with ALT and AST levels in patients treated with allopurinol at the sixth month. CONCLUSION: Allopurinol administration in MASLD patients improved ultrasonographic grading and liver enzymes from baseline. However, the comparison with the control group did not support the beneficial effects.
Accuracy of non-invasive indices for diagnosing hepatic steatosis compared to controlled attenuated parameter (CAP) in a Lebanese cohort.
Daniel F, Malak D, Jaafar R … +6 more , Ibrahim MA, Kouzi ZE, Chaitou AR, Mrad R, Kanso M, Khalife M
Arab J Gastroenterol · 2026 Feb · PMID 41592970 · Publisher ↗
BACKGROUND AND STUDY AIMS: Non-invasive liver indices are valuable tools for identifying patients with Metabolic dysfunction-associated steatotic liver disease, given their simplicity and relatively low cost. This study...
BACKGROUND AND STUDY AIMS: Non-invasive liver indices are valuable tools for identifying patients with Metabolic dysfunction-associated steatotic liver disease, given their simplicity and relatively low cost. This study examined the accuracy of several published indices, the hepatic steatosis index (HSI), Framingham steatosis index (FSI), and Dallas steatosis index (DSI), in predicting steatosis compared to the Transient elastography controlled attenuation parameter (CAP). PATIENTS AND METHODS: This is a retrospective cross-sectional study on 720 patients who underwent a FibroScan at the American University of Beirut Medical Center, between 2015 and 2020. The following indices, HSI, FSI, and DSI were calculated. The sensitivity, specificity, and C-statistics of each index were determined and compared to CAP. RESULTS: Out of 557patients who met inclusion criteria, 67 % were found to have hepatic steatosis with an average CAP 289.5 (±70.9). The mean age was 50 (±15.6), and 70 % were male. Those patients were found to have higher BMI and higher prevalence of diabetes and HTN as well as dyslipidemia than the control group with no steatosis. The FSI outperformed the other two indices with fair accuracy in detecting hepatic steatosis based on the C-statistics. HSI and DSI, on the other hand, showed poor discriminatory ability. At the cut-off, where specificity was 90 %, the FSI had the highest sensitivity, 49.6 %, compared to the DSI, 28.6 %, and HSI, 21.8 %. CONCLUSION: Our study demonstrated the non-invasive index FSI's accuracy in diagnosing steatosis compared to the transient elastography-CAP and highlighted its superiority to other indices, the HSI and DSI.
Long-Term outcomes of children diagnosed with indeterminate colitis.
Cetinoglu S, Aksoy B, Demir I … +5 more , Kahveci S, Karabag SO, Guler S, Cagan Appak Y, Baran M
Arab J Gastroenterol · 2026 Feb · PMID 41592969 · Publisher ↗
BACKGROUND AND STUDY AIMS: A third subtype of inflammatory bowel disease (IBD) is indeterminate colitis (IC). The clinical course of IC has not been well defined in children. The aim of this study was to evaluate the out...
BACKGROUND AND STUDY AIMS: A third subtype of inflammatory bowel disease (IBD) is indeterminate colitis (IC). The clinical course of IC has not been well defined in children. The aim of this study was to evaluate the outcomes of children with IC during the follow-up period. PATIENTS AND METHODS: All data were retrospectively reviewed in children diagnosed with IC in our center between 2010 and 2022. Patients' demographics, family history, laboratory findings at diagnosis, serologic immune markers, and clinical findings were noted. RESULTS: Among 185 children diagnosed with IBD between 2010 and 2022, 29 (15.7 %) were classified as having IC. Sixteen patients (55.1 %) were male. A concomitant autoimmune disease was present in seven patients (25 %). Five of the seven patients with additional autoimmune diseases were female. Among the patients with IC, 14 (48 %) had pancolonic involvement in colonoscopy at the time of diagnosis. During follow-up, extraintestinal features of IBD manifested in four (13.7 %) patients, three (10.3 %) patients with arthritis, and one patient (3.4 %) with arthritis and psoriasis. Six patients (20.6 %) harbored pathogenic variants in IBD-related genes, including NOD2 (n = 2), IL10RA (n = 1), and Mediterranean fever (MEFV) (n = 3). Two patients were reclassified as having ulcerative colitis (UC) and Crohn's disease (CD) during follow-up. CONCLUSION: The detection of significant genetic mutations in one-fifth of the patients highlights the need for genetic evaluation, particularly in those with additional autoimmune conditions. Close monitoring of patients in this regard is crucial to ensure the success of treatment and to address any potential complications arising from immune-related issues. More comprehensive studies are essential in this context to understand the course of the disease and improve patient care.
Eradication of Helicobacter pylori in Jordan, Middle East is it different? A quasi experimental study.
Massad M, Odeh M, Bani-Hani A … +15 more , Jebreen S, Alanasweh M, Dweik S, Shraim L, Saleh ZA, Hizzani Y, Alsbeehat L, Jaber M, Khalaf L, Qutifan L, Sallam Z, Saleh L, Shehada S, Serhan HA, Irshaidat S
Arab J Gastroenterol · 2026 Feb · PMID 41592968 · Publisher ↗
BACKGROUND AND STUDY AIMS: Helicobacter pylori is a major cause of peptic ulcer disease and is strongly associated with gastric cancer. Rising resistance to Clarithromycin-based regimens has led to evaluation of alternat...
BACKGROUND AND STUDY AIMS: Helicobacter pylori is a major cause of peptic ulcer disease and is strongly associated with gastric cancer. Rising resistance to Clarithromycin-based regimens has led to evaluation of alternative therapies, including Levofloxacin-based combinations. This study aimed to compare the efficacy of Clarithromycin- versus Levofloxacin-containing triple therapy in a Jordanian population, and to assess the impact of diagnostic methods and metronidazole use on treatment outcomes. PATIENTS AND METHODS: In this prospective, non-randomized controlled trial, 364 adults with confirmed H. pylori infection were recruited from two governmental hospitals in Jordan. Patients received either Clarithromycin- or Levofloxacin-based triple therapy, with or without metronidazole. Diagnosis and treatment response were assessed using gastric biopsy, rapid urease test, or stool antigen test. Follow-up testing occurred four weeks post-treatment. Chi-square tests and Cramer's V were used for statistical analysis. RESULTS: The overall eradication rate was 65.1 %. Clarithromycin-based therapy showed a higher eradication rate (70.8 %) than Levofloxacin-based therapy (60.2 %), though the difference was not statistically significant (P = 0.64). Among patients diagnosed via stool antigen testing, Clarithromycin therapy was significantly more effective (66.3 % vs. 40.4 %, P = 0.003). Neither metronidazole addition nor type of proton pump inhibitor influenced eradication outcomes. CONCLUSION: Clarithromycin-based therapy may be more effective than Levofloxacin-based regimens, particularly when stool antigen testing is used for diagnosis. These findings emphasize the importance of selecting treatment based on local resistance patterns and diagnostic approaches. Further studies are needed to confirm these results and optimize H. pylori treatment strategies.
Role of 3D printing in prevention of COVID 19 transmission during high-risk medical procedures: patient worn personal protective equipment.
Sherif M, Khairy A, Abdelaziz M … +1 more , Gaber Y
Arab J Gastroenterol · 2026 Feb · PMID 41592967 · Publisher ↗
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Assessment of diverse proton pump inhibitor combined with bismuth quadruple regimens and risk factors for Helicobacter pylori eradication in China: A retrospective single-center study.
Zhao X, Fan C, Yang M … +3 more , Liu Y, Zhang Y, Cheng J
Arab J Gastroenterol · 2026 Feb · PMID 41592966 · Publisher ↗
BACKGROUND AND STUDY AIMS: Falling eradication rates of Helicobacter pylori (H. Pylori) have prompted changes in the first-line bismuth-containing quadruple therapy. This study aimed to assess the effectiveness of differ...
BACKGROUND AND STUDY AIMS: Falling eradication rates of Helicobacter pylori (H. Pylori) have prompted changes in the first-line bismuth-containing quadruple therapy. This study aimed to assess the effectiveness of different proton-pump inhibitor (PPI) based quadruple regimens for H. pylori eradication. PATIENTS AND METHODS: Electronic records were examined to acquire information on H. pylori-positive patients treated with a 14-day bismuth-containing quadruple regimen (PPIs, amoxicillin, clarithromycin, and bismuth). Patient demographics and eradication regimen data were also analyzed. Four groups were formed based on the different PPIs: ilaprazole, esomeprazole, omeprazole, and rabeprazole groups. Eradication rates were calculated, and the effectiveness of the treatment regimens was compared. RESULTS: A total of 2637 patients were included, comprising 1469 males and 1168 females. Of these, 22.4 % (n = 590) were treated with an ilaprazole-based quadruple regimen, 33.8 % (n = 892) with an esomeprazole-based regimen, 16.6 % (n = 439) with an omeprazole-based regimen, and 27.2 % (n = 716) with a rabeprazole-based regimen. Eradication rates were significantly higher in the esomeprazole-based regimen than in the ilaprazole-, omeprazole-, and rabeprazole-based regimens (75.2 % vs. 65.8 % vs. 65.4 % vs. 70.9 %, P = 0.001). CONCLUSIONS: The eradication rates across various PPI-based quadruple regimens were comparable; however, the regimen comprising amoxicillin and clarithromycin demonstrated low efficacy and is not advised in settings with high clarithromycin resistance. Among the effective therapeutic regimens, the esomeprazole-based regimen exhibited a slightly higher eradication rate.
Therapeutic potential of curcumin against pancreatitis.
Khoshakhlagh M, Majeed A, Karav S … +2 more , Kesharwani P, Sahebkar A
Arab J Gastroenterol · 2026 Feb · PMID 41592965 · Publisher ↗
Pancreatitis is a serious inflammatory disorder marked by a disruption between protective enzymes and stress signals released through various processes. The key features of both acute and chronic pancreatitis include oxi...
Pancreatitis is a serious inflammatory disorder marked by a disruption between protective enzymes and stress signals released through various processes. The key features of both acute and chronic pancreatitis include oxidative stress and damage to acinar cells, which are indicative of these inflammatory conditions. The advancement of acute pancreatitis (AP) to chronic pancreatitis (CP) occurs due to the development of fibrosis and atrophy due to chronic inflammation and autodigestion. Various factors contribute to the pathological characteristics of these diseases. The severity of pancreatitis is influenced by the levels of activated inflammatory mediators such as interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), nuclear factor kappa B (NF-κB), chemokines, and cytokines. Additionally, the activation of the mitogen-activated protein kinase (MAPK) pathway and the opening of the mitochondrial membrane transition pore in the pancreas have been linked to the onset of pancreatitis. Increasing experimental evidence suggests that certain phytochemical compounds found in natural plants may have a positive impact on AP. Curcumin, the bioactive phytochemical from turmeric, exhibits potent anti-inflammatory and anti-oxidative properties. In the current review, we focus on curcumin's antioxidant and anti-inflammatory properties, which can contribute to the prevention and treatment of pancreatitis.
Non-alcoholic fatty liver disease in patients with Crohn's disease: differences in active and inactive stages.
Lin M, Diao N, Guo H … +5 more , Li F, Yang Q, Huang Z, Gao X, Chao K
Arab J Gastroenterol · 2026 Feb · PMID 41365758 · Publisher ↗
BACKGROUND AND STUDY AIMS: Crohn's disease (CD) activity is a risk factor for non-alcoholic fatty liver disease (NAFLD); however, few studies have focused on NAFLD with different CD activities. This study aimed to analyz...
BACKGROUND AND STUDY AIMS: Crohn's disease (CD) activity is a risk factor for non-alcoholic fatty liver disease (NAFLD); however, few studies have focused on NAFLD with different CD activities. This study aimed to analyze the prevalence, risk factors, and prognosis of NAFLD in patients with active and inactive CD. PATIENTS AND METHODS: Consecutive patients diagnosed with CD between January 2014 and December 2017 were retrospectively enrolled in a tertiary center of China. The clinical characteristics and prognosis of NAFLD in patients with active and inactive CD were analyzed. RESULTS: A total of 844 patients with CD were enrolled. The prevalence of NAFLD was 20.38 % (172/844), and it was mainly lean NAFLD (80.23 %). The prevalence of NAFLD and lean NAFLD was higher in active CD than in inactive CD (23.1 % vs. 15.9 %, P = 0.012, 19.5 % vs. 11.3 %, P = 0.039, respectively). In patients with CD, higher body mass index (BMI), higher C-reactive protein, and lower albumin were risk factors. Risk factors for NAFLD was low ALB in active CD. In inactive CD, the risk factors for NAFLD were higher BMI and ongoing use of azathioprine/6-Mercaptopurine. In a follow-up period of 45.46 ± 18.67 months, NAFLD was alleviated in 74.73 % (68/91) and 64.10 % (25/39) patients with active and inactive CD, respectively, after CD-related treatment. CONCLUSIONS: Approximately one-fifth of patients with CD developed NAFLD, mainly lean NAFLD. NAFLD in active and inactive CD exhibits different characteristics and risk factors, suggesting that the underlying mechanisms of NAFLD in different CD activities may differ. Most of CD patients with NAFLD were alleviated after CD-related treatment.
A solid pseudopapillary neoplasm overlooked for a decade: Long-term stability and development of distal pancreatic atrophy.
Öztürk T, Tanyeri A, Çildağ MB
Arab J Gastroenterol · 2026 May · PMID 41365757 · Publisher ↗
Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor with low malignant potential, most commonly observed in young women. These tumors are frequently asymptomatic and are often detected incidentally during ima...
Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor with low malignant potential, most commonly observed in young women. These tumors are frequently asymptomatic and are often detected incidentally during imaging performed for unrelated reasons. We present a unique case of a 27-year-old female with a pancreatic SPN that remained undiagnosed for ten years due to its isodense appearance on initial computed tomography imaging. The lesion remained stable in size and configuration over a decade and was eventually identified incidentally. Notably, progressive atrophy developed in the distal pancreas, likely secondary to ductal obstruction by the mass. This case highlights the diagnostic challenges of atypical SPNs, emphasizes the importance of careful image interpretation, and provides rare insight into the tumor's natural history in the absence of treatment.
Evaluation of peripheral blood neutrophil extracellular traps as fibrotic markers in patients with chronic hepatitis B.
Xue J, Dong P, Pida M … +4 more , Ma K, Zhao H, Chen J, Wu X
Arab J Gastroenterol · 2026 Feb · PMID 41360691 · Publisher ↗
BACKGROUND AND STUDY AIMS: Neutrophil extracellular trapping networks (NETs) are meshwork structures released by activated neutrophils and are composed of various components such as DNA, histones and granulins. The aim o...
BACKGROUND AND STUDY AIMS: Neutrophil extracellular trapping networks (NETs) are meshwork structures released by activated neutrophils and are composed of various components such as DNA, histones and granulins. The aim of this study was to evaluate the diagnostic value of NETs-related indicators (citH3, cfDNA, and MPO-DNA) as noninvasive fibrosis markers in patients with untreated chronic hepatitis B. PATIENTS AND METHODS: A total of 186 patients with chronic hepatitis B and 56 healthy controls were included in this study. The Ishak scoring system was used to determine the fibrosis stage. NETs-related markers were measured by enzyme-linked immunosorbent assay (ELISA), and the relationship between NETs marker levels and inflammation and fibrosis was analyzed. The diagnostic value of NETs indicators was evaluated by the area under the receiver operating characteristic curve, sensitivity, and specificity. RESULTS: The levels of NETs markers were associated with the activity of liver inflammation. The levels of citH3, cfDNA, and MPO-DNA in the patient group were significantly higher than those in the control group. Additionally, there were differences in the levels of these markers among different fibrosis stages of chronic HBV infection (P < 0.001), with an increase in NETs markers corresponding to higher fibrosis stages. Receiver operating characteristic (ROC) curve analysis showed that the levels of citH3, cfDNA, and MPO-DNA distinguished the patient group from the control group, and the difference was statistically significant (P < 0.001). CONCLUSION: Our results suggest that NETs markers can be used as indicators for the assessment of liver fibrosis in patients with chronic HBV infection.
Ulcerative colitis complicated by granulomatosis with polyangiitis treated with tacrolimus.
Miyaguchi K, Ishimoto K, Matsumoto H … +4 more , Shiomi R, Hamada M, Tsuzuki Y, Imaeda H
Arab J Gastroenterol · 2026 Feb · PMID 41242941 · Publisher ↗
A 64-year-old woman presented with abdominal pain, upper gastrointestinal bleeding, and purpura on her face and extremities. She had previously been treated with mesalazine for ulcerative colitis. Tests revealed anaemia,...
A 64-year-old woman presented with abdominal pain, upper gastrointestinal bleeding, and purpura on her face and extremities. She had previously been treated with mesalazine for ulcerative colitis. Tests revealed anaemia, elevated inflammatory markers (erythrocyte sedimentation rate, 82 mm/h; C-reactive protein concentration, 13.05 mg/dL), and a high proteinase 3-specific antineutrophil cytoplasmic antibody level (94.8 U/mL). Computed tomography showed oedematous thickening of the intestinal wall from the ascending colon to the sigmoid colon. Colonoscopy revealed inflammation of the leukocytoclastic vasculitis, consistent with granulomatosis with polyangiitis mucosa, and the sigmoid colon had various ulcers with mucosal inflammation. Skin biopsy revealed leukocytoclastic vasculitis, indicative of granulomatosis with polyangiitis. Prednisolone (40 mg/day) and tacrolimus (4 mg) resolved the symptoms. To our knowledge, this is the first report of successful tacrolimus therapy for ulcerative colitis complicated by granulomatosis with polyangiitis.
Impact of periampullary duodenal diverticula on the occurrence and characteristics of pancreaticobiliary diseases: a comparative analysis.
Gong Z, Liu F, Xu Y … +2 more , Hu D, Qian M
Arab J Gastroenterol · 2026 Feb · PMID 41224608 · Publisher ↗
BACKGROUND AND STUDY AIMS: Periampullary diverticula (PAD), often detected incidentally during imaging or endoscopy, has been linked to pancreaticobiliary diseases. Previous studies focusing on ERCP patients may overesti...
BACKGROUND AND STUDY AIMS: Periampullary diverticula (PAD), often detected incidentally during imaging or endoscopy, has been linked to pancreaticobiliary diseases. Previous studies focusing on ERCP patients may overestimate PAD prevalence and its association with these diseases. This study aimed to explore the relationship between PAD characteristics, including size and type, and the occurrence of pancreaticobiliary diseases. PATIENTS AND METHODS: Patients who underwent gastroscopy at the Second Affiliated Hospital of Soochow University from January 2018 to December 2022 and were found to have PAD (PAD group) were selected. A control group of patients without PAD was matched by gender and age in a 1:3 ratio. The characteristics of PAD and its correlation with pancreaticobiliary diseases were analyzed. RESULTS: The detection rate of PAD was 0.73 %. A total of 389 patients in the PAD group and 1,167 in the control group were included. The incidence of pancreaticobiliary diseases was significantly higher in the PAD group compared to the control group (51.2 % vs. 32.6 %, P < 0.001). Elderly PAD patients (>60 years) had larger diverticula and a higher incidence of pancreaticobiliary diseases than non-elderly PAD patients (≤60 years). Among different types of PAD, Type I PAD patients had the highest incidence of gallbladder stones and acute pancreatitis. No statistically significant correlation was found between PAD size and pancreaticobiliary diseases, and the incidence of bile duct stones was lower in the giant diverticulum group. CONCLUSION: The presence of PAD is significantly associated with pancreaticobiliary diseases, particularly in elderly PAD patients and those with Type I PAD, where there is a strong correlation with biliary diseases and acute pancreatitis.
Depletion of FOXO4 promotes the development of nonalcoholic fatty liver disease by aggravating high-fat diet-induced liver injury by increasing SPP1 expression.
Huang L, Qian G, Zhang A … +7 more , Xu L, Wang S, Gao Y, Li W, Wang D, Hou M, Lv H
Arab J Gastroenterol · 2026 Feb · PMID 41224607 · Publisher ↗
BACKGROUND AND STUDY AIMS: Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver condition worldwide. Although forkhead box O4 (FOXO4) is implicated in liver diseases, its role in NAFLD remains unclear. M...
BACKGROUND AND STUDY AIMS: Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver condition worldwide. Although forkhead box O4 (FOXO4) is implicated in liver diseases, its role in NAFLD remains unclear. MATERIAL AND METHODS: FOXO4 knockout mice were generated using CRISPR/Cas9 and fed a normal or high-fat diet (NFD/HFD). Human hepatic stellate cell line (LX-2) cells were transfected in vitro with a FOXO4 siRNA plasmid. RESULTS: Twelve weeks of HFD feeding downregulated FOXO4 expression and reduced its colocalization with hepatocyte nuclear factor 4α (HNF4α). HFD-fed mice exhibited increased liver-to-body weight ratios; marked lipid/glycogen accumulation; and elevated serum alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglyceride, and nonesterified fatty acid levels. These pathological manifestations were further exacerbated upon genetic ablation of FOXO4. Specifically, FOXO4 knockout aggravated HFD-induced upregulation of α-smooth muscle actin protein; increased the expression of profibrotic genes (including collagen type I alpha 1 chain, transforming growth factor-β1, and tissue inhibitor of metalloproteinases 1) and inflammatory mediators (such as interleukin-1β, IL-6, and tumour necrosis factor-α); and increased hepatocyte apoptosis. Mechanistically, FOXO4 suppressed secreted phosphoprotein 1 (SPP1) expression in LX-2 cells via direct binding to the SPP1 promoter and transcriptional suppression of its activity. CONCLUSION: FOXO4 downregulation exacerbates HFD-induced NAFLD progression via SPP1-dependent steatosis, inflammation, and fibrosis, thereby suggesting its potential as a therapeutic target.
Effects of rebamipide quadruple therapy with gastrointestinal endoscopy adjuvant therapy on gastrointestinal hormones in patients with gastric ulcer bleeding.
Jing J, Yu J, Ji B … +3 more , Guo J, Li C, Cheng Z
Arab J Gastroenterol · 2025 Nov · PMID 41219078 · Publisher ↗
BACKGROUND AND STUDY AIMS: The study aimed to investigate the effect of rebamipide quadruple therapy combined with gastrointestinal endoscopy on gastrointestinal hormones in patients with gastric ulcer bleeding. PATIENTS...
BACKGROUND AND STUDY AIMS: The study aimed to investigate the effect of rebamipide quadruple therapy combined with gastrointestinal endoscopy on gastrointestinal hormones in patients with gastric ulcer bleeding. PATIENTS AND METHODS: A total of 120 patients with gastric ulcer bleeding were enrolled and randomly assigned into a control group and an observation group, with 60 cases in each group. The control group received rebamipide quadruple therapy, while the observation group received gastrointestinal endoscopy combined with rebamipide therapy. The two groups were compared on general data, therapeutic efficacy, clinical parameters (blood transfusions, hemostasis time, melena relief time, ulcer healing time, and hospitalization duration), coagulation parameters (D-dimer, prothrombin time, activated partial thromboplastin time, fibrinogen), serum levels of gastrin (GAS), motilin (MTL), somatostatin (SS), as well as adverse reactions and re-bleeding rates. RESULTS: The observation group showed a significantly higher clinical efficacy (95.00 %) compared to the control group (80.00 %) (P < 0.05). The observation group had lower blood transfusion volume (401.25 ± 23.57 mL vs. 487.54 ± 30.23 mL), shorter hemostasis time (45.33 ± 9.90 h vs. 51.25 ± 11.62 h), quicker melena remission time (3.37 ± 1.30 d vs. 4.32 ± 1.43 d), faster ulcer healing time (13.73 ± 2.46 d vs. 16.12 ± 3.59 d), and shorter hospitalization time (16.53 ± 2.10 d vs. 19.78 ± 2.47 d) (all P < 0.05). Post-treatment,MTL and GAS levels decreased and SS levels increased in both groups, with the observation group showing significant improvements (P < 0.05). Fib levels also rose in the observation group (3.76 ± 0.31 s vs. 2.64 ± 0.53 s) (P < 0.05). Additionally, D-D, PT, and APTT levels decreased in the observation group and were significantly lower than in the control group (P < 0.05). The observation group had a lower incidence of adverse reactions (8.33 %) and re-bleeding rate (3.33 %) compared to the control group (25.00 % and 16.67 %) (P < 0.05). CONCLUSION: Rebamipide therapy combined with gastrointestinal endoscopy is an effective treatment for gastric ulcer bleeding and demonstrates a high level of safety.
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