Autoimmune hepatitis (AIH) is a chronic progressive inflammatory liver disease of immune-mediated origin, which causes long-term liver inflammation and damage. Traditionally, treatment includes azathioprine (AZA) combined with steroids, but recent studies have highlighted mycophenolate mofetil (MMF) as a potential alternative, particularly for patients who do not respond well to AZA.

This study aims to evaluate the association between IDO index and the prognosis of colorectal cancer (CRC). We searched databases such as PubMed, to collect relevant English studies on the association between IDO level and the prognosis of CRC published before October 10, 2024. This meta-analysis included 11 studies involving 2068 patients. The results showed that IDO levels were not significantly correlated with OS in CRC patients (HR0.85, 95%CI 0.54-1.33, P = 0.488), but elevated IDO was associated with reduced disease-free survival (DFS) in CRC patients (HR 0.61, 95%CI 0.38-0.99, P = 0.044).Elevated IDO was significantly associated with the incidence of liver metastasis (HR 4.66, 95%CI 1.72-12.64, P = 0.003) and lymphatic infiltration (HR 2.75, 95%CI 1.52-4.97, P < 0.001) in CRC patients. In conclusion, high expression of IDO is significantly associated with DFS, liver metastasis and lymphatic infiltration in CRC patients, and may serve as a biomarker and therapeutic target for DFS, liver metastasis, and lymphatic metastasis in CRC.

Background Metabolic dysfunction-associated steatotic liver disease (MASLD)-formerly known as non-alcoholic fatty liver disease-is the leading cause of chronic liver disease globally. However, early diagnosis and specific treatment have not yet been achieved. Plasminogen activator inhibitor-1 (PAI-1) is closely related to MASLD and may be an important indicator for its diagnosis and treatment. This updated meta-analysis aimed to comprehensively explore the relationship between circulating PAI-1 levels and MASLD. Methods Article retrieval was carried out in seven provenances (PubMed, Cochrane Library, EMBASE, CNKI, WANFANG, Clinical Trials Database, and Grey Literature Database) using free text words and MeSH terms. The meta-analysis was performed using RevMan 5.3 and Stata 12. Outcomes were presented as standardised mean difference (SMD) with 95% confidence intervals (CI). Results A total of 23 studies were included in the meta-analysis. The levels of circulating PAI-1 in patients with MASLD were significantly higher than those in healthy controls (SMD = 1.44, 95% CI [1.06, 1.83]). Subgroup and meta-regression analyses based on key factors, such as area, age, and BMI, were performed to explore the sources of heterogeneity. In the BMI subgroup analysis, the participants were divided into two groups. While the subgroup results were inconclusive, the meta-regression suggested that the area (i.e. the geographic region of the study population) may be a major contributor to heterogeneity (p < 0.001). Conclusions Patients with MASLD have significantly high circulating PAI-1 levels; however, this correlation may vary in different regions, thereby providing a reference for further research on MASLD.

Several studies have shown a connection between periodontal diseases and conditions such as heart disease, diabetes, and pregnancy. This study aimed to investigate the relationship between inflammatory bowel disease (IBD), including ulcerative colitis (UC), Crohn's disease (CD), and periodontitis.

Global plastic waste production remains a critical environmental issue. Microplastics (MPs), plastic particles less than 5 mm, are now pervasive across ecosystems. Humans are exposed to MPs via ingestion, inhalation, and dermal contact raising concerns about their health impacts. This systematic review investigates the influence of MPs on the human gut microbiome, focusing on changes in microbial composition, diversity, and metabolic pathways based on 12 studies identified through Scopus and PubMed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Findings show that exposure to MPs such as polyethylene (PE), polystyrene (PS), polyethylene terephthalate (PET), polyvinyl chloride (PVC), and polylactic acid (PLA), induces gut dysbiosis, marked by a loss of beneficial genera, and enrichment of pathogenic species. MPs also impair short-chain fatty acid (SCFA) production, alter metabolic functions, and modulate immune pathways, contributing to intestinal diseases, metabolic syndrome, and chronic inflammation. The extent of disruption is influenced by MP-specific properties such as type, size, and concentration. These results suggest that MPs are emerging environmental risk factors with tangible implications for human health. To fully understand the health concerns associated with MPs long-term, human-relevant studies with standardized methodologies are urgently needed to define safe exposure levels and guide policies aimed at reducing MP-related health risks.

Colorectal cancer (CRC) is a leading cause of cancer-related deaths globally, and researchers continue to explore its underlying factors. This systematic review and meta-analysis study aimed to clarify the prevalence and potential association between intestinal parasitic infections (IPIs) and CRC.

Transcatheter arterial chemoembolization (TACE) is a fundamental treatment for unresectable hepatocellular carcinoma despite its tendency to induce postembolization syndrome (PES), which can negatively impact the quality of life and treatment outcomes of patients. This study aimed to evaluate the efficacy of prophylactic dexamethasone in reducing PES following TACE.

Colon cancer (CC) is the third most diagnosed malignancy and second leading cause of cancer mortality globally, with ~ 1.9 million new cases and 903,859 deaths annually (Bray et al. in CA Cancer J Clin 68(6):394-424, 2018). Diet represents a key modifiable risk factor for CC pathogenesis (Herr and Buchler in Cancer Treat Rev 36:377-383, 2010). Cruciferous vegetables (CV)-rich in glucosinolates that hydrolyze into bioactive isothiocyanates (Willett in Cancer Epidem Biomar 10:3-8, 2001; Murillo and Mehta in Nutr Cancer. 41(1-2):17-28, 2001; Higdon et al. in Pharmacol Res 55:224-36, 2007)-exhibit chemopreventive properties through carcinogen detoxification, apoptosis induction, and cell cycle arrest (Zhang et al. in Proc Nutr Soc 65:68-75, 2006). While prior meta-analyses report an inverse association between CV intake and CC risk (Tse and Eslick in Nutr Cancer 66(1):128-39, 2014), the quantitative dose-response relationship remains uncharacterized, limiting translational insights for dietary guidance.

The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) is to summarize the available evidence and offer expert best practice advice on the incorporation of the functional lumen imaging probe (FLIP) into clinical practice, specifically its utility in the evaluation of esophageal symptoms, esophageal motor dysfunction, gastroesophageal reflux disease, and eosinophilic esophagitis.

The aim of this systematic review and meta-analysis was to assess the association between serum neuregulin 4 (Nrg4) levels and non-alcoholic fatty liver disease (NAFLD).

This meta-analysis aims to evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) for hepatocellular carcinoma (HCC) located at specific anatomical sites of the liver compared with non-specific sites.

The long-term impact of acute pancreatitis (AP) on quality of life (QoL) remains inconclusive. This systematic review and meta-analysis aimed to evaluate long-term QoL outcomes in patients after AP.

Endoscopy is a critical tool in the management of acute variceal bleeding (AVB). However, the optimal timing for its implementation remains controversial, with varying recommendations across different clinical guidelines. This study aims to evaluating the impact of endoscopy timing on patient outcomes.

Neuroendocrine carcinoma of the esophagus is a highly aggressive and rare type of cancer, making diagnosis and treatment challenging for clinicians. The current guidelines provide conflicting recommendations, and no standardized treatment protocol is available. We aim to deliver a systematic review of esophageal neuroendocrine carcinoma, including patient characteristics, treatment options, and prognostic factors.

Inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with poorer prognosis of gastric cancer (GC) patients and may guide treatment decisions. This meta-analysis aims to evaluate the impact of NLR and PLR on the prognosis of GC patients undergoing neoadjuvant chemotherapy (NAC).

A defunctioning ileostomy is frequently created to avert the implications of a colo-rectal anastomotic dehiscence in rectal cancer surgery. The timing of closure of the ileostomy remains debatable as it is believed that early closure (EC) may be beneficial to most patients than the standard practice of late closure (LC). This meta-analysis was performed to compare surgical outcomes in patients who underwent EC versus LC.

Hemorrhoids, a common anorectal condition, can be managed through surgical or conservative treatments. The aim of this meta-analysis is to compare the efficacy and safety of surgical and conservative treatments for hemorrhoids.

To evaluate the diagnostic efficacy of magnetic resonance imaging proton density fat fraction (MRI-PDFF) in assessing hepatic steatosis among patients with metabolic dysfunction-associated steatotic liver disease (MASLD) through systematic review and meta-analysis approaches.

Chronic gastrointestinal (GI) diseases, including functional, inflammatory, and neoplastic conditions, are increasing globally, partly due to modern lifestyles. The circadian rhythm, regulated by the central clock in the hypothalamus and synchronized with peripheral clocks in the GI organs, orchestrates GI functions in response to environmental cycles. This clock is influenced by cues such as light, sleep, and eating times. The circadian machinery prepares the host to cope with environmental conditions to adjust cellular and organ function accordingly. Modern behaviors-like night-time light exposure, travel across time zones, shift work, mistimed eating, and social jet lag-disrupt the circadian clock, affecting GI processes such as digestion, absorption, motility, intestinal barrier function, immune function, and the microbiome, promoting not only GI pathology, but also systemic inflammatory and metabolic disorders. This review summarizes the circadian rhythm's role in normal GI function, examines the consequences of circadian disruption in the GI tract, and discusses circadian-based therapeutic interventions. These interventions aim to realign the circadian clock with external cues or optimize medication timing according to biological rhythms. Understanding the role of the circadian clock in GI conditions can provide preventive and therapeutic opportunities to reduce the burden of GI diseases.

Senescence is an irreversible cell cycle arrest-characterized by morphologic alterations, genomic instability, and secretome changes-that profoundly affects the tissue structure and function. Accumulating evidence indicates that senescence plays a relevant role in gastrointestinal pathologies: senescence contributes to salivary gland hypofunction, is instrumental in the development of oral submucous fibrosis, drives age-dependent hepatic steatosis, and regulates the clinical progression of steatotic liver disease. Senescence in the biliary tract develops in response to ischemic injury in biliary complications and is characteristic of biliary conditions such as biliary atresia, primary sclerosing cholangitis, and primary biliary cirrhosis. Senescence also contributes to acute pancreatitis, plays a major role in the dysfunction of pancreatic β-cells, and is a hallmark of a number of gastrointestinal conditions such as inflammatory bowel disease and colorectal cancer. These examples illustrate the widespread effect of cellular senescence in the gastrointestinal tract, not just as a consequence of the disease but also as a driver of pathology and a potential therapeutic target. In this review we describe the mechanisms, hallmarks, and consequences of cellular senescence as well as the therapeutic potential of senescence-targeting interventions. We aim to highlight the importance of understanding the molecular basis of senescence in gastroenterology while connecting the worlds of research and clinical practice.