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Biomedicines
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Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and...
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Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (28 February 2025) | Viewed by 13227

Special Issue Editors

Dr. Beata Jabłońska

E-Mail Website
Guest Editor
Department of Digestive Tract Surgery, Medical University of Silesia, Katowice, Poland
Interests: gastrointestinal surgery; oncological surgery; vascular surgery; gastroenterology; angiology; oncology; nutritional status; nutrition
Special Issues, Collections and Topics in MDPI journals
Dr. Sławomir Mrowiec

E-Mail Website
Guest Editor
Department of Digestive Tract Surgery, Medical University of Silesia, Katowice, Poland
Interests: pancreaticoduodenectomy; vascular resection; distal and total pancreatectomy; middle segment pancreatectomy; pancreaticojejunostomy; POPF; drainage operations in chronic pancreatitis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Gastrointestinal diseases involve various benign and malignant pathologies of a digestive tract as well as liver, biliary tract and pancreas. Their diagnostics and treatment is usually very challenging and requires an engagement of the multidisciplinary team including gastroenterologists, radiologists, oncologists and surgeons.The laboratory, imaging and endoscopic, non-invasive and invasive investigations are used in diagnostics of gastrointestinal diseases. Also, the management has got a wide spectrum: from observation and conservative treatment to invasive radiological, endoscopic and surgical procedures.Recently, both diagnostics and treatment of gastrointestinal diseases have been improved, including i.a. molecular laboratory tests, gastrointestinal endoscopy with artificial intelligence, targeted and immunological oncological therapy, as well as robotic surgery.

This Special Issue on “Gastrointestinal Disease: New Diagnostic and Therapeutic Approaches” will focus on new aspects regarding laboratory diagnostics as well as pharmacological, immunological, and targeted treatment of these diseases.  We invite original research and review papers related to all novel aspects of diagnostics and treatment of gastrointestinal diseases.

Dr. Beata Jabłońska
Dr. Sławomir Mrowiec
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • inflammatory bowel disease
  • gastrointestinal tumor
  • gastrointestinal cancer
  • acute pancreatitis
  • chronic pancreatitis
  • pancreatic cyst
  • biliary cyst

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Published Papers (9 papers)

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Editorial

Jump to: Research, Review, Other

4 pages, 208 KiB  
Editorial
Gastrointestinal Disease: New Diagnostic and Therapeutic Approaches
by Beata Jabłońska and Sławomir Mrowiec
Biomedicines 2023, 11(5), 1420; https://doi.org/10.3390/biomedicines11051420 - 11 May 2023
Cited by 6 | Viewed by 3258
Abstract
Gastrointestinal diseases (GIDs) involve various benign and malignant pathologies of the digestive tract, as well as the liver, biliary tract, and pancreas [...] Full article
(This article belongs to the Special Issue Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy)

Research

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13 pages, 1534 KiB  
Article
The Effects of the Biological Agents Infliximab, Vedolizumab, and Ustekinumab on Intestinal Anastomosis: An Experimental Study in Rats
by Alexandra Menni, Georgios Tzikos, Patroklos Goulas, George Chatziantoniou, Angeliki Vouchara, Athanasios S. Apostolidis, Aristeidis Ioannidis, Georgios Germanidis, Lyssimachos G. Papazoglou, Olga Giouleme and Stylianos Apostolidis
Biomedicines 2025, 13(5), 1079; https://doi.org/10.3390/biomedicines13051079 - 29 Apr 2025
Abstract
Background/Objectives: The potential side effects of the use of biological agents in the perioperative period are still under investigation. This animal prospective study aimed to evaluate the overall impact of biological factor administration after intestinal surgery. Methods: This study included 80 [...] Read more.
Background/Objectives: The potential side effects of the use of biological agents in the perioperative period are still under investigation. This animal prospective study aimed to evaluate the overall impact of biological factor administration after intestinal surgery. Methods: This study included 80 female Wistar rats sorted into four groups: three groups received one of the biological factors, infliximab, vedolizumab, or ustekinumab; the control group received placebo therapy. After enterotomy and intestinal anastomosis, the bursting pressure (BP) of the anastomosis was compared among the groups on postoperative days (PODs) 3 and 7. Results: On POD3, the control group presented with a significantly higher mean BP (154.6 ± 39.7 mmHg) compared to the infliximab (66.8 ± 10.4 mmHg), vedolizumab (105.4 ± 37.6 mmHg), and ustekinumab (98.8 ± 47.9 mmHg) groups. A post hoc analysis among the three biological agent groups revealed differences only when comparing infliximab and vedolizumab rats with the controls on POD3 (p < 0.001) and with the ustekinumab rats on POD7, having a greater mean BP (282.5 ± 80.1 mmHg, p = 0.031). No differences were observed regarding the event of broken anastomosis among the four groups. Conclusions: This experimental study’s findings highlight the varying detrimental effects of different biological agents on the strength of intestinal anastomosis, with ustekinumab demonstrating superior performance. Full article
(This article belongs to the Special Issue Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy)
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16 pages, 3095 KiB  
Article
Long-Term Outcomes of Patients with Poor Prognostic Factors Following Transanal Endoscopic Microsurgery (TEMS) for Early Rectal Cancer
by Muneeb Ul Haq, Khaled Noureldin, David Mark Pritchard, Arthur Sun Myint, Carrie A. Duckworth, Ngu Wah Than, David M. Hughes, Shakil Ahmed and Muhammad Ahsan Javed
Biomedicines 2025, 13(2), 521; https://doi.org/10.3390/biomedicines13020521 - 19 Feb 2025
Viewed by 503
Abstract
Background: Transanal endoscopic microsurgery (TEMS) is an organ-preserving approach for treatment of early rectal cancer (ERC). However, adverse histopathological features identified post-TEMS often necessitate adjuvant therapy. This study aims to compare the long-term oncological outcomes of patients who underwent TEMS and were offered [...] Read more.
Background: Transanal endoscopic microsurgery (TEMS) is an organ-preserving approach for treatment of early rectal cancer (ERC). However, adverse histopathological features identified post-TEMS often necessitate adjuvant therapy. This study aims to compare the long-term oncological outcomes of patients who underwent TEMS and were offered adjuvant treatments with total mesorectal excision (TME), chemoradiotherapy (CRT), radiotherapy (RT), active surveillance, or dose escalation with contact X-ray brachytherapy (CXB). Methods: This study included patients treated with TEMS for ERC between September 2012 and December 2022, with follow-up until December 2023. Patients with adverse histopathological features (extra-mural venous invasion, lympho-vascular invasion, R1 margins, tumour budding) were assigned to adjuvant treatments. Inverse probability of treatment weighting (IPTW) was applied to mitigate selection bias. Results: Of the 117 patients, 24 underwent TME, 17 received CRT, 25 received RT, 14 underwent active surveillance, and 37 patients received CXB boost along with CRT. The median follow-up was 60 months (IQR 52–73). During this time, 29 patients developed recurrence, and 15 died. The 5-year overall survival (OS) was 78.6%, and disease-free survival (DFS) was 70.9%. Compared to CXB, the mortality risk for CRT (HR = 0.81; 95% CI: 0.20–3.28; p = 0.77) and TME (HR = 3.68; 95% CI: 0.46–29.79; p = 0.22) was not significantly different. However, TME was associated with a significantly higher recurrence risk compared to CXB (HR = 7.57; 95% CI: 1.23–46.84; p = 0.029). Conclusions: An organ-preserving strategy with CRT or CRT combined with a CXB boost may offer comparable long-term outcomes and reduced recurrence risks for patients undergoing TEMS for ERC with poor prognostic features. Further research with larger cohorts is needed to validate these results. Full article
(This article belongs to the Special Issue Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy)
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14 pages, 824 KiB  
Article
Metabolic Dysfunction-Associated Steatotic Liver Disease: The Associations between Inflammatory Markers, TLR4, and Cytokines IL-17A/F, and Their Connections to the Degree of Steatosis and the Risk of Fibrosis
by Sorina-Cezara Coste, Olga Hilda Orășan, Angela Cozma, Vasile Negrean, Adela-Viviana Sitar-Tăut, Gabriela Adriana Filip, Adriana Corina Hangan, Roxana Liana Lucaciu, Mihaela Iancu and Lucia Maria Procopciuc
Biomedicines 2024, 12(9), 2144; https://doi.org/10.3390/biomedicines12092144 - 21 Sep 2024
Cited by 3 | Viewed by 1782
Abstract
Background: The pathogenesis of MASLD (metabolic dysfunction-associated steatotic liver disease) is driven by environmental, genetic, metabolic, immune, and inflammatory factors. IL-17 and TLR4 determine hepatic steatosis, inflammation, and finally fibrosis. Objectives: To explore the associations between the plasma levels of inflammatory [...] Read more.
Background: The pathogenesis of MASLD (metabolic dysfunction-associated steatotic liver disease) is driven by environmental, genetic, metabolic, immune, and inflammatory factors. IL-17 and TLR4 determine hepatic steatosis, inflammation, and finally fibrosis. Objectives: To explore the associations between the plasma levels of inflammatory markers, TLR4, and the cytokines IL17A/F, as well as their connections with the degree of hepatic steatosis and the risk of hepatic fibrosis (defined by the FIB-4 score) in MASLD patients. Methods: The study cohort included 80 patients diagnosed with MASLD. The IL-17A/F and TLR4 serum concentrations were determined using the ELISA method. Results: We found a significant difference in the CAR levels (C-reactive protein to albumin ratio) when comparing MASLD patients with severe steatosis to those with mild/moderate steatosis (Student’s t test, t (71) = 2.32, p = 0.023). The PIV (pan-immune inflammatory value) was positively correlated with the SII (systemic immune inflammation index), (r = 0.86, p < 0.0001) and the CAR (r = 0.41, p = 0.033) in MASLD patients with severe steatosis. In contrast, increased values of the LMR (lymphocyte to monocyte ratio) were significantly associated, with decreased levels of the SII (ρ = −0.38, p = 0.045). We also found a positive correlation between the CAR and the SII (r = 0.41, p = 0.028). In patients with mild/moderate steatosis, a significant positive correlation was observed between the SII and IL17A (r = 0.36, p = 0.010), the PIV and the CAR (r = 0.29, p = 0.011), the PIV and the SII (r = 0.87, p < 0.0001) and the PIV and IL17A (r = 0.3, p = 0.036). A negative correlation was observed between the LMR and the SII (r = −0.55, p < 0.0001) and the CAR and IL17F (r = −0.37, p = 0.011). Regarding the inflammatory markers, the PIV (336.4 vs. 228.63, p = 0.0107), and the SII (438.47 vs. 585.39, p = 0.0238) had significantly lower levels in patients with an intermediate–high risk of hepatic fibrosis as compared with the patients with a low risk of hepatic fibrosis. The PNI (prognostic nutritional index) (47.16 vs. 42.41, p = 0.0392) had significantly different levels in patients with the likelihood of hepatic fibrosis than those with a low risk of hepatic fibrosis. Conclusions: Regarding the inflammatory markers, the PIV and the SII hold promise as biomarkers for discriminating between MASLD patients with an intermediate–high risk and those with a low risk of hepatic fibrosis. Our findings underscore the role of IL-17A and its potential relationship with inflammatory markers in MASLD pathogenesis and the progression to hepatic fibrosis. Full article
(This article belongs to the Special Issue Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy)
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11 pages, 610 KiB  
Article
Exploring Vitamin D Deficiency and IGF Axis Dynamics in Colorectal Adenomas
by George Ciulei, Olga Hilda Orășan, Angela Cozma, Vasile Negrean, Teodora Gabriela Alexescu, Simina Țărmure, Florin Eugen Casoinic, Roxana Liana Lucaciu, Adriana Corina Hangan and Lucia Maria Procopciuc
Biomedicines 2024, 12(8), 1922; https://doi.org/10.3390/biomedicines12081922 - 22 Aug 2024
Viewed by 1120
Abstract
(1) Colorectal cancer is a major cause of cancer-related death, with colorectal adenomas (CRAs) serving as precursors. Identifying risk factors such as vitamin D deficiency and the insulin-like growth factor (IGF) axis is crucial for prevention. (2) This case–control study included 85 participants [...] Read more.
(1) Colorectal cancer is a major cause of cancer-related death, with colorectal adenomas (CRAs) serving as precursors. Identifying risk factors such as vitamin D deficiency and the insulin-like growth factor (IGF) axis is crucial for prevention. (2) This case–control study included 85 participants (53 CRA patients and 32 controls) who underwent colonoscopy. We measured serum vitamin D3 (cholecalciferol), calcidiol (vitamin D metabolite), calcitriol (active vitamin D metabolite), insulin-like growth factor-1 (IGF-1), and insulin-like growth factor binding protein-3 (IGFBP-3) to explore their associations with CRA risk. (3) Results: We found that lower cholecalciferol levels were a significant risk factor for CRA (OR = 4.63, p = 0.004). Although no significant differences in calcidiol and calcitriol levels were observed between CRA patients and controls, calcidiol deficiency was common in the study population. IGF-1 levels inversely correlated with age, calcitriol, and IGFBP-3 in CRA patients. (4) This study highlights the potential of lower cholecalciferol levels to detect patients at risk of CRA when calcidiol values cannot, suggesting the importance of evaluating different vitamin D metabolites in cancer prevention research. Our findings underscore the need to further investigate the interactions between calcitriol, the active form of vitamin D, and the IGF axis in colorectal cancer development. Full article
(This article belongs to the Special Issue Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy)
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12 pages, 810 KiB  
Article
Diagnostic Performance of Serum Leucine-Rich Alpha-2-Glycoprotein 1 in Pediatric Acute Appendicitis: A Prospective Validation Study
by Javier Arredondo Montero, Raquel Ros Briones, Amaya Fernández-Celis, Natalia López-Andrés and Nerea Martín-Calvo
Biomedicines 2024, 12(8), 1821; https://doi.org/10.3390/biomedicines12081821 - 11 Aug 2024
Cited by 2 | Viewed by 1290
Abstract
Introduction: Leucine-rich alpha-2-glycoprotein 1(LRG-1) is a human protein that has shown potential usefulness as a biomarker for diagnosing pediatric acute appendicitis (PAA). This study aims to validate the diagnostic performance of serum LRG-1 in PAA. Material and Methods: This work is a subgroup [...] Read more.
Introduction: Leucine-rich alpha-2-glycoprotein 1(LRG-1) is a human protein that has shown potential usefulness as a biomarker for diagnosing pediatric acute appendicitis (PAA). This study aims to validate the diagnostic performance of serum LRG-1 in PAA. Material and Methods: This work is a subgroup analysis from BIDIAP (BIomarkers for DIagnosing Appendicitis in Pediatrics), a prospective single-center observational cohort, to validate serum LRG-1 as a diagnostic tool in PAA. This analysis included 200 patients, divided into three groups: (1) healthy patients undergoing major outpatient surgery (n = 56), (2) patients with non-surgical abdominal pain (n = 52), and (3) patients with a confirmed diagnosis of PAA (n = 92). Patients in group 3 were divided into complicated and uncomplicated PAA. In all patients, a serum sample was obtained during recruitment, and LRG-1 concentration was determined by Enzyme-Linked ImmunoSorbent Assay (ELISA). Comparative statistical analyses were performed using the Mann–Whitney U, Kruskal–Wallis, and Fisher’s exact tests. The area under the receiver operating characteristic curves (AUC) was calculated for all pertinent analyses. Results: Serum LRG-1 values, expressed as median (interquartile range) were 23,145 (18,246–27,453) ng/mL in group 1, 27,655 (21,151–38,795) ng/mL in group 2 and 40,409 (32,631–53,655) ng/mL in group 3 (p < 0.0001). Concerning the type of appendicitis, the serum LRG-1 values obtained were 38,686 (31,804–48,816) ng/mL in the uncomplicated PAA group and 51,857 (34,013–64,202) ng/mL in the complicated PAA group (p = 0.02). The area under the curve (AUC) obtained (group 2 vs. 3) was 0.75 (95% CI 0.67–0.84). For the discrimination between complicated and uncomplicated PAA, the AUC obtained was 0.66 (95% CI 0.52–0.79). Conclusions: This work establishes normative health ranges for serum LRG-1 values in the pediatric population and shows that serum LRG-1 could be a potentially helpful tool for diagnosing PAA in the future. Future prospective multicenter studies, with the parallel evaluation of urinary and salivary LRG-1, are necessary to assess the implementability of this molecule in actual clinical practice. Full article
(This article belongs to the Special Issue Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy)
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14 pages, 530 KiB  
Article
Expression of Selected miRNAs in Undifferentiated Carcinoma with Osteoclast-like Giant Cells (UCOGC) of the Pancreas: Comparison with Poorly Differentiated Pancreatic Ductal Adenocarcinoma
by Alexey Popov, Jan Hrudka, Arpád Szabó, Martin Oliverius, Zdeněk Šubrt, Jana Vránová, Vanda Ciprová, Jana Moravcová and Václav Mandys
Biomedicines 2024, 12(5), 962; https://doi.org/10.3390/biomedicines12050962 - 26 Apr 2024
Cited by 1 | Viewed by 1437
Abstract
Undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) of the pancreas represents a rare subtype of pancreatic ductal adenocarcinoma (PDAC). Despite a distinct morphology and specific clinical behavior, UCOGCs exhibit unexpected similarities in regard to DNA mutational profiles with conventional PDAC. Treating pancreatic ductal [...] Read more.
Undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) of the pancreas represents a rare subtype of pancreatic ductal adenocarcinoma (PDAC). Despite a distinct morphology and specific clinical behavior, UCOGCs exhibit unexpected similarities in regard to DNA mutational profiles with conventional PDAC. Treating pancreatic ductal adenocarcinoma is particularly challenging, with limited prospects for cure. As with many other malignant neoplasms, the exploration of microRNAs (miRNAs, miRs) in regulating the biological characteristics of pancreatic cancer is undergoing extensive investigation to enhance tumor diagnostics and unveil the therapeutic possibilities. Herein, we evaluated the expression of miR-21, -96, -148a, -155, -196a, -210, and -217 in UCOGCs and poorly differentiated (grade 3, G3) PDACs. The expression of miR-21, miR-155, and miR-210 in both UCOGCs and G3 PDACs was significantly upregulated compared to the levels in normal tissue, while the levels of miR-148a and miR-217 were downregulated. We did not find any significant differences between cancerous and normal tissues for the expression of miR-96 and miR-196a in G3 PDACs, whereas miR-196a was slightly, but significantly, downregulated in UCOGCs. On the other hand, we have not observed significant differences in the expression of the majority of miRNAs between UCOGC and G3 PDAC, with the exception of miR-155. UCOGC samples demonstrated lower mean levels of miR-155 in comparison with those in G3 PDACs. Full article
(This article belongs to the Special Issue Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy)
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Review

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22 pages, 1132 KiB  
Review
Diagnostic and Therapeutic Advances of RNAs in Precision Medicine of Gastrointestinal Tumors
by Runhan Liu, Jiaxin Zhou, Xiaochen Chen, Jie Zhang, Qunzhi Chen, Xiaoming Liu and Kunhou Yao
Biomedicines 2025, 13(1), 47; https://doi.org/10.3390/biomedicines13010047 - 28 Dec 2024
Viewed by 1286
Abstract
Gastrointestinal tumors present a significant challenge for precision medicine due to their complexity, necessitating the development of more specific diagnostic tools and therapeutic agents. Recent advances have positioned coding and non-coding RNAs as emerging biomarkers for these malignancies, detectable by liquid biopsies, and [...] Read more.
Gastrointestinal tumors present a significant challenge for precision medicine due to their complexity, necessitating the development of more specific diagnostic tools and therapeutic agents. Recent advances have positioned coding and non-coding RNAs as emerging biomarkers for these malignancies, detectable by liquid biopsies, and as innovative therapeutic agents. Many RNA-based therapeutics, such as small interfering RNA (siRNA) and antisense oligonucleotides (ASO), have entered clinical trials or are available on the market. This review provides a narrative examination of the diagnostic and therapeutic potential of RNA in gastrointestinal cancers, with an emphasis on its application in precision medicine. This review discusses the current challenges, such as drug resistance and tumor metastasis, and highlights how RNA molecules can be leveraged for targeted detection and treatment. Additionally, this review categorizes specific diagnostic biomarkers and RNA therapeutic targets based on tissue type, offering a comprehensive analysis of their role in advancing precision medicine for gastrointestinal tumors. Full article
(This article belongs to the Special Issue Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy)
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Other

17 pages, 2832 KiB  
Systematic Review
Digestive Amyloidosis Trends: Clinical, Pathological, and Imaging Characteristics
by Sandica Bucurica, Andreea-Simona Nancoff, Miruna Valeria Moraru, Ana Bucurica, Calin Socol, Daniel-Vasile Balaban, Mihaela Raluca Mititelu, Ionela Maniu, Florentina Ionita-Radu and Mariana Jinga
Biomedicines 2024, 12(11), 2630; https://doi.org/10.3390/biomedicines12112630 - 17 Nov 2024
Cited by 1 | Viewed by 1634
Abstract
Amyloidosis is a group of diseases characterized by the extracellular deposition of abnormally folded, insoluble proteins that lead to organ dysfunction. While it commonly affects the cardiovascular system, gastrointestinal (GI) tract involvement is undetermined. Recent research has focused on understanding the pathophysiology, diagnostic [...] Read more.
Amyloidosis is a group of diseases characterized by the extracellular deposition of abnormally folded, insoluble proteins that lead to organ dysfunction. While it commonly affects the cardiovascular system, gastrointestinal (GI) tract involvement is undetermined. Recent research has focused on understanding the pathophysiology, diagnostic challenges, and therapeutic approaches to GI amyloidosis, particularly in systemic amyloid light-chain (AL) and amyloid A (AA) forms. GI manifestations can include motility disorders, bleeding, and, in severe cases, bowel obstruction. This review highlights the importance of the early recognition of digestive symptoms and associated imagistic findings in GI amyloidosis by analyzing the research that included clinical, pathological, and endoscopic approaches to amyloidosis. A systematic search of the PubMed and Scopus databases identified 19 relevant studies. Our findings showed that amyloid deposits commonly affect the entire GI tract, with AL amyloidosis being the most predominant form. Endoscopic evaluations and biopsy remain key diagnostic tools, with Congo Red staining and mass spectrometry being used to confirm amyloid type. Although progress has been made in diagnosis, the absence of targeted therapies and the indistinct nature of GI symptoms continue to be challenging. Full article
(This article belongs to the Special Issue Pancreatic, Liver, Biliary Tract and Intestinal Diseases: Pathogenesis, Diagnostics and Therapy)
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