Diagnosis and Management of Gastrointestinal Inflammation

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 8354

Special Issue Editor

Department of Faculty Therapy, Omsk State Medical University, Omsk, Russia
Interests: diagnosis and therapy of gastrointestinal diseases; H. pylori infection; gastroesophageal reflux disease; gastritis; inflammatory bowel disease; irritable bowel syndrome

Special Issue Information

Dear Colleagues,

I am pleased to invite you to participate in a Special Issue dedicated to the diagnosis and management of gastrointestinal inflammation. The process of inflammation of the digestive tract with its clinical, laboratory, endoscopic, histopathological assessment, complemented by all kinds of molecular biology and genetic methods, plays a key role both in early diagnosis, monitoring, and prognosis and as a target for personalized therapy. It is this link reflux-esophagitis progression to Barrett’s esophagus and associated adenocarcinoma, as well as the risk of gastritis progression to gastric cancer. The increased risk of colorectal cancer among patients with inflammatory bowel disease is a fundamental topic in the discussion around the general biological phenomenon “from inflammation to cancer” and may open new opportunities in the prevention of malignant neoplasms. Inflammation with reduced resistance of the mucosal barrier in COVID-19 infection is associated with the formation of systemic inflammation with the realization of an interaction along the intestine–liver–lung axis, as well as with the possible involvement of inflammation of the digestive tract, including autoimmune genesis.  Finally, a number of systemic diseases target digestive organs, making multidisciplinary consideration of various aspects of gastrointestinal inflammation necessary.

Prof. Dr. Maria A. Livzan
Guest Editor

Manuscript Submission Information

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Keywords

  • gastrointestinal diseases
  • inflammation
  • digestive system diseases
  • diagnostic techniques and procedures
  • microbiome
  • esophagitis
  • gastritis
  • inflammatory bowel disease

Published Papers (6 papers)

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Research

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15 pages, 2573 KiB  
Article
The Translational Impact of Plant-Derived Xeno-miRNA miR-168 in Gastrointestinal Cancers and Preneoplastic Conditions
by Jastin Link, Cosima Thon, Vytenis Petkevicius, Ruta Steponaitiene, Peter Malfertheiner, Juozas Kupcinskas and Alexander Link
Diagnostics 2023, 13(16), 2701; https://doi.org/10.3390/diagnostics13162701 - 18 Aug 2023
Cited by 2 | Viewed by 931
Abstract
Introduction: Diet is one of the most important factors contributing to the multistep process of carcinogenesis. The clinical relevance of exogenous food-derived xeno-microRNAs (miRNAs) in human diseases is poorly understood. In this study, we aimed to evaluate the potential clinical relevance of the [...] Read more.
Introduction: Diet is one of the most important factors contributing to the multistep process of carcinogenesis. The clinical relevance of exogenous food-derived xeno-microRNAs (miRNAs) in human diseases is poorly understood. In this study, we aimed to evaluate the potential clinical relevance of the xeno-miRNA miR-168 in the gastric mucosa along the preneoplastic conditions and gastric carcinogenesis. Methods: For a systematic analysis, we included stomach tissues from patients with different pathologies, including normal mucosa (N), chronic non-atrophic (CNAG) and atrophic gastritis (CAG) and intestinal metaplasia (IM) (n = 72), matched non-tumorous (NT) and tumorous (T) gastric cancer (GC) tissues (n = 81), matched colorectal cancer (CRC) tissues (n = 40), and colon mucosa and faeces from controls and IBD patients. Results: miR-168 was reproducibly detectable in all samples studied, with the highest levels in the proximal upper GI and in non-tumorous compared to tumorous tissues in both GC and CRC. There was no difference related to H. pylori positivity or inflammation grade, while higher miR-168 levels were observed in patients with moderate or severe AG/IM or OLGIM3/4. Survival analysis showed only a small, non-significant trend towards worse overall survival for patients with the highest to lowest miR-168 levels, while no differences were related to Lauren‘s classification. Conclusions: Food-derived xeno miRNAs are reproducibly detectable in the gastric and colonic mucosa. Although the clinically relevant function remains to be elucidated, higher levels of miR-168 in patients with moderate and severe IM merit further investigation. Full article
(This article belongs to the Special Issue Diagnosis and Management of Gastrointestinal Inflammation)
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15 pages, 1743 KiB  
Article
Contrast-Enhanced Computed Tomography and Laboratory Parameters as Non-Invasive Diagnostic Markers of Pancreatic Fibrosis
by Igor E. Khatkov, Dmitry S. Bordin, Konstantin A. Lesko, Elena A. Dubtsova, Nikolay S. Karnaukhov, Maria A. Kiriukova, Nadezhda V. Makarenko, Alexey S. Dorofeev, Irina V. Savina, Diana A. Salimgereeva, Elena I. Shurygina and Ludmila V. Vinokurova
Diagnostics 2023, 13(14), 2435; https://doi.org/10.3390/diagnostics13142435 - 21 Jul 2023
Viewed by 655
Abstract
Pancreatic fibrosis (PF) is a part of the pathogenesis in most pancreatic disorders and plays a crucial role in chronic pancreatitis development. The aim of our study was to investigate a relationship between PF grade and signs in resected pancreatic specimens, and the [...] Read more.
Pancreatic fibrosis (PF) is a part of the pathogenesis in most pancreatic disorders and plays a crucial role in chronic pancreatitis development. The aim of our study was to investigate a relationship between PF grade and signs in resected pancreatic specimens, and the results of both multidetector computed tomography (MDCT) post-processing parameters and fibronectin (FN), hyaluronic acid (HA), matrix metalloproteinase (MMP)-1, and MMP-9 serum levels. The examination results of 74 patients were analyzed. The unenhanced pancreas density (UPD) value and contrast enhancement ratio (CER) showed statistically significant differences in groups with peri- and intralobular fibrosis grades, an integrative index of fibrosis, inflammation in pancreatic tissue, and pancreatic duct epithelium metaplasia, while the normalized contrast enhancement ratio in the venous phase (NCER VP) significantly differed with the perilobular fibrosis grade, integrative fibrosis index, and inflammation (p < 0.05). The blood FN level showed a weak positive correlation with the intralobular fibrosis grade (rho = 0.32, p = 0.008). The blood level of HA positively correlated with the presence of prominent and enlarged peripheral nerves (rho = 0.28, p = 0.02) and negatively correlated with the unenhanced pancreas density value (rho = −0.42, p = 0.0001). MMP-1 and MMP-9 values’ intergroup analysis and correlation did not show any statistical significance. The UPD value, NCER VP, and CER, as well as blood levels of FN and HA, could be used in non-invasive PF diagnosis. Full article
(This article belongs to the Special Issue Diagnosis and Management of Gastrointestinal Inflammation)
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Review

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14 pages, 1110 KiB  
Review
Non-Invasive and Minimally Invasive Biomarkers for the Management of Eosinophilic Esophagitis beyond Peak Eosinophil Counts: Filling the Gap in Clinical Practice
by Pierfrancesco Visaggi, Irene Solinas, Federica Baiano Svizzero, Andrea Bottari, Brigida Barberio, Greta Lorenzon, Matteo Ghisa, Daria Maniero, Elisa Marabotto, Massimo Bellini, Nicola de Bortoli and Edoardo V. Savarino
Diagnostics 2023, 13(17), 2806; https://doi.org/10.3390/diagnostics13172806 - 30 Aug 2023
Cited by 4 | Viewed by 1383
Abstract
Eosinophilic esophagitis (EoE) is a chronic esophageal disease that needs lifelong management and follow-up. The diagnosis requires an upper endoscopy with at least one esophageal biopsy demonstrating >15 eosinophils/high-power field, and often occurs with a diagnostic delay of up to ten years, partly [...] Read more.
Eosinophilic esophagitis (EoE) is a chronic esophageal disease that needs lifelong management and follow-up. The diagnosis requires an upper endoscopy with at least one esophageal biopsy demonstrating >15 eosinophils/high-power field, and often occurs with a diagnostic delay of up to ten years, partly due to the absence of valid non-invasive screening tools. In addition, serial upper endoscopies with esophageal biopsies are mandatory to assess the efficacy of any ongoing treatment in patients with EoE. These procedures are invasive, costly, and, when performed without sedation, are often poorly tolerated by patients. Therefore, there is the clinical need to identify reliable non-invasive or minimally invasive biomarkers that could be used to assess disease activity in clinical practice as a surrogate of peak eosinophil counts on esophageal biopsies. This review summarizes evidence on investigational non-invasive or minimally invasive biomarkers for the diagnosis and follow-up of EoE to report on the state of the art in the field and support future research. We discussed eosinophil-derived mediators including eosinophil cationic protein (ECP), eosinophil-derived neurotoxin (EDN, also known as eosinophil protein X), eosinophil peroxidase (EPO), and major basic protein (MBP) as well as other promising non-eosinophil-derived biomarkers. Although several studies have shown the utility of most biomarkers collected from the serum, esophageal luminal secretions, and feces of EoE patients, numerous limitations currently hamper the integration of such biomarkers in clinical practice. Future studies should aim at validating the utility of non-invasive and minimally invasive biomarkers using rigorous protocols and updated consensus criteria for EoE. Full article
(This article belongs to the Special Issue Diagnosis and Management of Gastrointestinal Inflammation)
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15 pages, 6614 KiB  
Review
Histopathological Evaluation of Gastric Mucosal Atrophy for Predicting Gastric Cancer Risk: Problems and Solutions
by Maria A. Livzan, Sergei I. Mozgovoi, Olga V. Gaus, Anna G. Shimanskaya and Alexei V. Kononov
Diagnostics 2023, 13(15), 2478; https://doi.org/10.3390/diagnostics13152478 - 26 Jul 2023
Viewed by 1496
Abstract
Patients suffering from chronic gastritis and developing gastric mucosa atrophy are at increased risk of the development of gastric cancer. The diagnosis of chronic atrophic gastritis (CAG) is a complex procedure involving a detailed history taking, a thorough physical examination and the use [...] Read more.
Patients suffering from chronic gastritis and developing gastric mucosa atrophy are at increased risk of the development of gastric cancer. The diagnosis of chronic atrophic gastritis (CAG) is a complex procedure involving a detailed history taking, a thorough physical examination and the use of laboratory and instrumental diagnostic methods among which the endoscopy of the upper digestive tract is the cornerstone because it allows the assessment of the topography of gastritis and identification of erosions and areas of intestinal metaplasia with the use of NBI endoscopy. However, the diagnosis of CAG requires morphological examination of the gastric mucosa. So, in addition to assessing macroscopic changes in the gastric mucosa, it is necessary to take biopsy specimens in accordance with the protocols for their morphological and immunohistochemical examination. In the absence of specific diagnostic stigmas of CAG, close cooperation between a clinician, endoscopist and pathologist is necessary. The article presents systematized data on the histopathological assessment of the gastric mucosa atrophy to predict the risk of gastric cancer. Full article
(This article belongs to the Special Issue Diagnosis and Management of Gastrointestinal Inflammation)
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16 pages, 597 KiB  
Review
Diagnosis and Treatment of Helicobacter pylori Infection in Real Practice—New Role of Primary Care Services in Antibiotic Resistance Era
by Enrique Alfaro, Carlos Sostres and Angel Lanas
Diagnostics 2023, 13(11), 1918; https://doi.org/10.3390/diagnostics13111918 - 30 May 2023
Cited by 1 | Viewed by 2675
Abstract
Helicobacter pylori (H. pylori) is a key agent in several upper gastrointestinal diseases. Treatment of H. pylori infection is the main strategy for resolving the associated gastroduodenal damage in infected patients and for the prevention of gastric cancer development. Infection management [...] Read more.
Helicobacter pylori (H. pylori) is a key agent in several upper gastrointestinal diseases. Treatment of H. pylori infection is the main strategy for resolving the associated gastroduodenal damage in infected patients and for the prevention of gastric cancer development. Infection management is becoming complex due to the increase in antibiotic resistance, which already represents a global healthcare problem. Resistance to clarithromycin, levofloxacin or metronidazole have forced the adaptation of eradication regimens in this new reality to reach the eradication rate target recommended in most international guidelines (>90%). In this challenging scenario, molecular methods are revolutionizing the diagnosis of antibiotic-resistant infections and the detection of antibiotic resistance and opening a path towards personalized treatments, although their use is not yet widespread. Moreover, the infection management by physicians is still not adequate, which contributes to aggravating the problem. Both gastroenterologists and mainly primary care physicians (PCPs), who currently routinely manage this infection, perform suboptimal management of the diagnosis and treatment of H. pylori infection by not following the current consensus recommendations. In order to improve H. pylori infection management and to increase PCPs’ compliance with guidelines, some strategies have been evaluated with satisfactory results, but it is still necessary to design and evaluate new different approaches. Full article
(This article belongs to the Special Issue Diagnosis and Management of Gastrointestinal Inflammation)
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Other

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14 pages, 2235 KiB  
Protocol
Comparative Analysis of the Efficacy of Different Regimens of 12 Months Rifaximin-Alfa Therapy in Patients with Liver Cirrhosis and Minimal Hepatic Encephalopathy
by Igor G. Bakulin, Kristina N. Ivanova, Elena Y. Eremina and Natalya V. Marchenko
Diagnostics 2023, 13(20), 3239; https://doi.org/10.3390/diagnostics13203239 - 17 Oct 2023
Cited by 1 | Viewed by 662
Abstract
It is a matter of current interest which rifaximin-α regimens in patients with liver cirrhosis and minimal hepatic encephalopathy are the most efficient. Study objective: to evaluate the effect of various rifaximin-α regimens for 12 months on clinical and laboratory parameters and quality [...] Read more.
It is a matter of current interest which rifaximin-α regimens in patients with liver cirrhosis and minimal hepatic encephalopathy are the most efficient. Study objective: to evaluate the effect of various rifaximin-α regimens for 12 months on clinical and laboratory parameters and quality of life in patients with liver cirrhosis and minimal hepatic encephalopathy. Methods. It was a multicenter, prospective, open-label, observational study that included 288 patients with liver cirrhosis and minimal hepatic encephalopathy of both sexes over the age of 18 years, who were prescribed a 12-month course of treatment with rifaximin-α in accordance with the product label. Statistical analysis was performed in the population of patients who completed all visits according to the protocol (n = 258). Retrospectively, the patients were divided into two subgroups: subgroup 1 (continuous course)—patients who received the study drug for a year and the number of days of administration was 360 days (n = 41); subgroup 2 (cyclic course)—patients who received the study drug during the year for less than 360 days (n = 217). At each of the 4 visits, the quality of life was assessed using the CLDQ questionnaire, the time to perform the number connection test, the severity of symptoms associated with hepatic encephalopathy, and laboratory parameters. Results. During the 12-month observation period, an increase in the total score on the CLDQ quality of life questionnaire in patients with chronic liver diseases was revealed, which indicates an improvement in the quality of life of patients receiving rifaximin-α therapy. When patients were divided into subgroups depending on the duration of therapy, some benefits of continuous rifaximin-α therapy were noted in the more pronounced dynamics of decrease in the time to perform the number connection test, and in decreased severity of the following symptoms associated with hepatic encephalopathy: impaired concentration and memory, cognitive impairment, and decreased performance. Laboratory findings showed positive dynamics in both subgroups. Conclusion. A continuous rifaximin-α regimen in patients with liver cirrhosis and minimal hepatic encephalopathy for 12 months was superior to cyclic use with a more pronounced effect on the quality of life of patients and on the symptoms associated with hepatic encephalopathy. Full article
(This article belongs to the Special Issue Diagnosis and Management of Gastrointestinal Inflammation)
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