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Advanced Science (Weinheim,... Jun 2021Molecular heterogeneity of hepatobiliary tumor including intertumoral and intratumoral disparity always leads to drug resistance. Here, seven hepatobiliary tumor...
Molecular heterogeneity of hepatobiliary tumor including intertumoral and intratumoral disparity always leads to drug resistance. Here, seven hepatobiliary tumor organoids are generated to explore heterogeneity and evolution via single-cell RNA sequencing. HCC272 with high status of epithelia-mesenchymal transition proves broad-spectrum drug resistance. By examining the expression pattern of cancer stem cells markers (e.g., PROM1, CD44, and EPCAM), it is found that CD44 positive population may render drug resistance in HCC272. UMAP and pseudo-time analysis identify the intratumoral heterogeneity and distinct evolutionary trajectories, of which catenin beta-1 (CTNNB1), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and nuclear paraspeckle assembly transcript 1 (NEAT1) advantage expression clusters are commonly shared across hepatobiliary organoids. CellphoneDB analysis further implies that metabolism advantage organoids with enrichment of hypoxia signal upregulate NEAT1 expression in CD44 subgroup and mediate drug resistance that relies on Jak-STAT pathway. Moreover, metabolism advantage clusters shared in several organoids have similar characteristic genes (GAPDH, NDRG1 (N-Myc downstream regulated 1), ALDOA, and CA9). The combination of GAPDH and NDRG1 is an independent risk factor and predictor for patient survival. This study delineates heterogeneity of hepatobiliary tumor organoids and proposes that the collaboration of intratumoral heterogenic subpopulations renders malignant phenotypes and drug resistance.
Topics: Antigens, Neoplasm; Carbonic Anhydrase IX; Cell Cycle Proteins; Digestive System Diseases; Drug Resistance, Neoplasm; Epithelial-Mesenchymal Transition; Fructose-Bisphosphate Aldolase; Gastrointestinal Neoplasms; Gene Expression Regulation, Neoplastic; Glyceraldehyde-3-Phosphate Dehydrogenase (Phosphorylating); Humans; Hyaluronan Receptors; Intracellular Signaling Peptides and Proteins; Janus Kinases; Neoplastic Stem Cells; Organoids; RNA, Long Noncoding; RNA-Seq; STAT Transcription Factors; Single-Cell Analysis; Transcriptome; beta Catenin
PubMed: 34105295
DOI: 10.1002/advs.202003897 -
Gastroenterology Feb 2022Gastrointestinal diseases account for considerable health care use and expenditures. We estimated the annual burden, costs, and research funding associated with...
BACKGROUND & AIMS
Gastrointestinal diseases account for considerable health care use and expenditures. We estimated the annual burden, costs, and research funding associated with gastrointestinal, liver, and pancreatic diseases in the United States.
METHODS
We generated estimates using data from the National Ambulatory Medical Care Survey; National Hospital Ambulatory Medical Care Survey; Nationwide Emergency Department Sample; National Inpatient Sample; Kids' Inpatient Database; Nationwide Readmissions Database; Surveillance, Epidemiology, and End Results program; National Vital Statistics System; Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research; MarketScan Commercial Claims and Encounters data; MarketScan Medicare Supplemental data; United Network for Organ Sharing registry; Medical Expenditure Panel Survey; and National Institutes of Health (NIH).
RESULTS
Gastrointestinal health care expenditures totaled $119.6 billion in 2018. Annually, there were more than 36.8 million ambulatory visits for gastrointestinal symptoms and 43.4 million ambulatory visits with a primary gastrointestinal diagnosis. Hospitalizations for a principal gastrointestinal diagnosis accounted for more than 3.8 million admissions, with 403,699 readmissions. A total of 22.2 million gastrointestinal endoscopies were performed, and 284,844 new gastrointestinal cancers were diagnosed. Gastrointestinal diseases and cancers caused 255,407 deaths. The NIH supported $3.1 billion (7.5% of the NIH budget) for gastrointestinal research in 2020.
CONCLUSIONS
Gastrointestinal diseases are responsible for millions of health care encounters and hundreds of thousands of deaths that annually costs billions of dollars in the United States. To reduce the high burden of gastrointestinal diseases, focused clinical and public health efforts, supported by additional research funding, are warranted.
Topics: Ambulatory Care; Biomedical Research; Cost of Illness; Digestive System Neoplasms; Endoscopy, Digestive System; Gastrointestinal Diseases; Health Expenditures; Hospitalization; Humans; Liver Diseases; National Institutes of Health (U.S.); Pancreatic Diseases; Patient Readmission; United States
PubMed: 34678215
DOI: 10.1053/j.gastro.2021.10.017 -
Frontiers in Cellular and Infection... 2023Digestive system diseases have evolved into a growing global burden without sufficient therapeutic measures. () is considered as a new potential economical therapy for... (Review)
Review
OBJECTIVES
Digestive system diseases have evolved into a growing global burden without sufficient therapeutic measures. () is considered as a new potential economical therapy for its probiotic effects in the gastrointestinal system. We have provided an overview of the researches supporting various strains' application in treating common digestive system diseases, including infantile colic, diarrhea, constipation, functional abdominal pain, infection, inflammatory bowel disease, diverticulitis, colorectal cancer and liver diseases.
METHODS
The summarized literature in this review was derived from databases including PubMed, Web of Science, and Google Scholar.
RESULTS
The therapeutic effects of in digestive system diseases may depend on various direct and indirect mechanisms, including metabolite production as well as modulation of the intestinal microbiome, preservation of the gut barrier function, and regulation of the host immune system. These actions are largely strain-specific and depend on the activation or inhibition of various certain signal pathways. It is well evidenced that can be effective both as a prophylactic measure and as a preferred therapy for infantile colic, and it can also be recommended as an adjuvant strategy to diarrhea, constipation, infection in therapeutic settings. While preclinical studies have shown the probiotic potential of in the management of functional abdominal pain, inflammatory bowel disease, diverticulitis, colorectal cancer and liver diseases, its application in these disease settings still needs further study.
CONCLUSION
This review focuses on the probiotic effects of on gut homeostasis via certain signaling pathways, and emphasizes the importance of these probiotics as a prospective treatment against several digestive system diseases.
Topics: Humans; Limosilactobacillus reuteri; Colic; Helicobacter Infections; Helicobacter pylori; Digestive System Diseases; Constipation; Abdominal Pain; Diarrhea; Diverticulitis; Inflammatory Bowel Diseases; Colorectal Neoplasms
PubMed: 37662007
DOI: 10.3389/fcimb.2023.1254198 -
Gastrointestinal Endoscopy Feb 2020Achalasia is a primary esophageal motor disorder of unknown etiology characterized by degeneration of the myenteric plexus, which results in impaired relaxation of the...
Achalasia is a primary esophageal motor disorder of unknown etiology characterized by degeneration of the myenteric plexus, which results in impaired relaxation of the esophagogastric junction (EGJ), along with the loss of organized peristalsis in the esophageal body. The criterion standard for diagnosing achalasia is high-resolution esophageal manometry showing incomplete relaxation of the EGJ coupled with the absence of organized peristalsis. Three achalasia subtypes have been defined based on high-resolution manometry findings in the esophageal body. Treatment of patients with achalasia has evolved in recent years with the introduction of peroral endoscopic myotomy. Other treatment options include botulinum toxin injection, pneumatic dilation, and Heller myotomy. This American Society for Gastrointestinal Endoscopy Standards of Practice Guideline provides evidence-based recommendations for the treatment of achalasia, based on an updated assessment of the individual and comparative effectiveness, adverse effects, and cost of the 4 aforementioned achalasia therapies.
Topics: Acetylcholine Release Inhibitors; Botulinum Toxins; Dilatation; Disease Management; Endoscopy, Digestive System; Esophageal Achalasia; Esophageal Sphincter, Lower; Heller Myotomy; Humans; Injections, Intramuscular; Manometry; Myotomy; Societies, Medical; United States
PubMed: 31839408
DOI: 10.1016/j.gie.2019.04.231 -
The Surgical Clinics of North America Dec 2020Endoscopic ultrasound provides high-resolution, real-time imaging of the gastrointestinal tract and surrounding extramural structures. In recent years, endoscopic... (Review)
Review
Endoscopic ultrasound provides high-resolution, real-time imaging of the gastrointestinal tract and surrounding extramural structures. In recent years, endoscopic ultrasound has played an increasing role as an adjunct or alternative method to conventional surgical therapies. The role of endoscopic ultrasound in diagnosis and management of gastrointestinal malignancy, pancreatic diseases, and biliary diseases continues to evolve. Therapeutic endoscopic ultrasound procedures for a variety of pancreatic and biliary indications shows a high technical and clinical success rate, with low rate of adverse events. Endoscopic ultrasound plays a key role in multidisciplinary management of complex surgical and oncology patients and those with pancreaticobiliary disorders.
Topics: Digestive System Diseases; Endosonography; Humans
PubMed: 33128884
DOI: 10.1016/j.suc.2020.07.003 -
The Lancet. Gastroenterology &... Sep 2023
Topics: Humans; Digestive System Diseases; Liver Diseases
PubMed: 37572671
DOI: 10.1016/S2468-1253(23)00244-3 -
Seminars in Diagnostic Pathology Jul 2021Lymphoproliferative processes which occur in the gastrointestinal tract range from benign reactive processes such as follicular hyperplasia (rectal tonsil) to high grade... (Review)
Review
Lymphoproliferative processes which occur in the gastrointestinal tract range from benign reactive processes such as follicular hyperplasia (rectal tonsil) to high grade malignant lymphomas and histiocytic sarcoma. The WHO Classification of Tumors: Digestive System Tumors, 5th Edition was published in 2019 and shows several impactful changes as compared to the 4th Edition published in 2010. WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues 2017 also included detailed changes in hematopoietic neoplasms within the gastrointestinal tract. New entities or renamed hematolymphoid lesions include monomorphic epitheliotropic intestinal T-cell lymphoma, duodenal-type follicular lymphoma, intestinal T-cell lymphoma, NOS and indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. A brief overview of WHO classification of digestive tumors and WHO classification of tumors of hematopoietic and lymphoid tissue is discussed focusing on the changes in the most recent WHO texts. In depth discussions will be presented in other papers in this series.
Topics: Gastrointestinal Diseases; Gastrointestinal Neoplasms; Humans; Lymphoma, B-Cell; Lymphoproliferative Disorders
PubMed: 33714627
DOI: 10.1053/j.semdp.2021.02.004 -
Revista Espanola de Enfermedades... Feb 2021The pandemic caused by SARS-CoV-2 has posed an unprecedented challenge to health systems, leading in many countries to the collapse of health care and a lack of...
The pandemic caused by SARS-CoV-2 has posed an unprecedented challenge to health systems, leading in many countries to the collapse of health care and a lack of preventive measures both for the most vulnerable sections of the population and among healthcare professionals.
Topics: COVID-19; Delivery of Health Care; Digestive System Diseases; Humans
PubMed: 33461301
DOI: 10.17235/reed.2021.7774/2020 -
Journal of Gastroenterology and... May 2020The novel coronavirus disease is currently causing a major pandemic. It is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the... (Review)
Review
The novel coronavirus disease is currently causing a major pandemic. It is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the Betacoronavirus genus that also includes the SARS-CoV and Middle East respiratory syndrome coronavirus. While patients typically present with fever and a respiratory illness, some patients also report gastrointestinal symptoms such as diarrhea, vomiting, and abdominal pain. Studies have identified the SARS-CoV-2 RNA in stool specimens of infected patients, and its viral receptor angiotensin converting enzyme 2 was found to be highly expressed in gastrointestinal epithelial cells. These suggest that SARS-CoV-2 can actively infect and replicate in the gastrointestinal tract. This has important implications to the disease management, transmission, and infection control. In this article, we review the important gastrointestinal aspects of the disease.
Topics: Aerosols; Angiotensin-Converting Enzyme 2; Betacoronavirus; COVID-19; Coronavirus Infections; Digestive System; Digestive System Diseases; Disease Transmission, Infectious; Humans; Infection Control; Pandemics; Peptidyl-Dipeptidase A; Pneumonia, Viral; RNA, Viral; SARS-CoV-2
PubMed: 32215956
DOI: 10.1111/jgh.15047 -
Cells Feb 2022Proper functioning of the digestive system is ensured by coordinated action of the central and peripheral nervous systems (PNS). Peripheral innervation of the digestive... (Review)
Review
Proper functioning of the digestive system is ensured by coordinated action of the central and peripheral nervous systems (PNS). Peripheral innervation of the digestive system can be viewed as intrinsic and extrinsic. The intrinsic portion is mainly composed of the neurons and glia of the enteric nervous system (ENS), while the extrinsic part is formed by sympathetic, parasympathetic, and sensory branches of the PNS. Glial cells are a crucial component of digestive tract innervation, and a great deal of research evidence highlights the important status of ENS glia in health and disease. In this review, we shift the focus a bit and discuss the functions of Schwann cells (SCs), the glial cells of the extrinsic innervation of the digestive system. For more context, we also provide information on the basic findings regarding the function of innervation in disorders of the digestive organs. We find diverse SC roles described particularly in the mouth, the pancreas, and the intestine. We note that most of the scientific evidence concerns the involvement of SCs in cancer progression and pain, but some research identifies stem cell functions and potential for regenerative medicine.
Topics: Digestive System Diseases; Enteric Nervous System; Gastrointestinal Tract; Humans; Neuroglia; Schwann Cells
PubMed: 35269454
DOI: 10.3390/cells11050832