BackgroundIrritable bowel syndrome (IBS) and gallbladder disease share overlapping symptoms that may contribute to diagnostic uncertainty and unnecessary cholecystectomy. This systematic review and meta-analysis evaluated whether patients with IBS are more likely to undergo cholecystectomy than those without IBS.MethodsA systematic search of PubMed, Embase, Web of Science, and Google Scholar was conducted through June 3, 2026. Observational studies comparing cholecystectomy among adults with and without IBS were included. Random-effects meta-analysis was performed to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analyses, sensitivity analyses, influence diagnostics, meta-regression, publication bias assessment, and risk-of-bias evaluation were conducted.ResultsTen studies met the inclusion criteria for the systematic review, and nine studies comprising 181,848 participants and 6,249 cholecystectomy events were included in the meta-analysis. Patients with IBS had significantly higher odds of undergoing cholecystectomy than controls (OR = 2.57, 95% CI 1.36–4.85; p = 0.009). Between-study heterogeneity was substantial (I2 = 98.1%), but the association remained robust across leave-one-out sensitivity analyses. Subgroup analyses and meta-regression demonstrated that study design, geographic region, IBS diagnostic criteria, study quality, and sample size did not significantly influence the pooled effect estimate. No evidence of publication bias was detected, and the included studies were generally of good methodological quality.ConclusionsPatients with IBS have significantly higher odds of undergoing cholecystectomy than individuals without IBS. These findings support careful evaluation of biliary symptoms in patients with IBS to improve diagnostic accuracy, optimize patient selection for surgery, and reduce unnecessary cholecystectomy.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261412571, identifier CRD420261412571.
ObjectiveTo investigate the pertinence of different potential markers for case identification of WD patients in the French National Health Data System (SNDS).MethodsPatients in the SNDS with hospitalization or long-term disease (LTD) status associated with a diagnostic code for WD (E83.0) between 2009 and 2019 were identified and followed from first documentation until 31st December 2019 (or death). Four patient groups were compared. Group A: patients hospitalized for WD, but with neither LTD status nor specific WD treatment. Group B: patients with LTD status, but without treatment. Group C: patients with treatment, but without LTD status. Group D: patients with both LTD status and WD treatment.Results1,520 patients were included (Group A: N = 702; Group B: N = 153; Group C: N = 194; Group D: N = 471). >75% of untreated patients in Groups A and B were never monitored for copper accumulation. The mean number of blood copper tests over the follow-up period was 0.30 ± 2.47 in Group A, 0.76 ± 2.34 in Group B, 3.99 ± 7.66 in Group C and 5.33 ± 7.90 in Group D. Patients in Group A frequently presented LTD status for conditions unrelated to WD, and higher mortality (hazard ratio: 2.87 [95%CI: 1.87–4.41] compared to Group D), frequently dying of causes unrelated to WD.ConclusionsFor many patients identified only by a hospitalization claim, no specific WD treatments or copper monitoring were ever documented. Substantial doubt exists whether these patients actually had WD. Validation studies are needed to find the optimal diagnostic algorithm to identify WD cases unambiguously, which is a prerequisite for collecting reliable information on WD.
BackgroundChronic atrophic gastritis (CAG) is a precancerous gastric lesion. Although electroacupuncture (EA) can improve CAG-related symptoms and mucosal injury, its molecular responses remain unclear.MethodsMale SPF SD rats were assigned to Control, CAG Model, and EA groups. CAG was induced by a multifactorial protocol. EA was applied at Zusanli (ST36) and Zhongwan (CV12) for 20min/day for 2 weeks. Gastric histopathology was evaluated via hematoxylin-eosin staining. To identify candidate targets of EA for CAG, integrated transcriptomics and data-independent acquisition (DIA) proteomics were employed. Subsequent validation was performed by RT-qPCR.ResultsEA significantly attenuated gastric mucosal atrophy and inflammatory cell infiltration, accompanied by reduced CDK4 and CDK6 mRNA levels (P < 0.05). Transcriptomics identified 1662 DEGs enriched in estrogen signaling pathway and transcriptional misregulation in cancer signaling pathway. DIA-based proteomic identified 298 DEPs enriched in drug metabolism, amino acid metabolism, muscle contraction, muscle regulation, and mitochondrial metabolism. Integrated analysis identified 24 concordant DEGs/DEPs and RT-qPCR confirmed significant downregulation of PDK4 in the EA group (P<0.01).ConclusionEA ameliorated gastric mucosa injury in CAG rats. Downregulation of PDK4 and CDK4/CDK6 mRNA was associated with EA intervention and may contribute to the amelioration of gastric mucosal injury in CAG.
Mucosal vaccination is attracting renewed interest because many clinically relevant pathogens first encounter the host at gastrointestinal or respiratory surfaces, whereas most established vaccines are administered parenterally and are optimized primarily to induce systemic immunity. Engineered probiotics are emerging as living antigen-delivery vectors that may combine mucosal delivery, transient biological persistence, microbial immune signals, and programmable antigen presentation within a single platform. This strategy is particularly relevant to gastrointestinal vaccination, where access to gut-associated lymphoid tissue (GALT) may support local secretory IgA together with systemic responses. SARS-CoV-2 provides an informative experimental bridge because, despite its dominant respiratory manifestations, it can involve intestinal epithelial cells and gastrointestinal mucosal immunity. Using the pAIDA–Escherichia coli Nissle 1917 (EcN) system as a bounded proof of concept, this Perspective defines an integrated translational framework linking GALT-directed immune priming, effective mucosal antigen dose, genetic stability, chassis de-risking, biocontainment, manufacturing, potency, and post-administration clearance. We explicitly distinguish antigen delivery and immunogenicity from functional immunity, protection, and clinical efficacy, and identify the experiments required to advance probiotic-vectored mucosal vaccines toward clinically testable products.
BackgroundSarcopenia is an emerging predictor of adverse outcomes in inflammatory bowel disease (IBD). We assessed its prevalence and prognostic impact in a prospective cohort.MethodsConsecutive adults with IBD were prospectively enrolled (December 2023–August 2024). Sarcopenia was assessed using handgrip strength and bioelectrical impedance analysis (BIA) and patients were classified as non sarcopenic, with probable sarcopenia, or confirmed sarcopenia. Clinical worsening, IBD-related hospitalization, surgery, and infectious complications were prospectively assessed over 12 months.ResultsWe enrolled 113 IBD patients: 32 (28.3%) were non-sarcopenic, 73 (64.6%) had probable sarcopenia, and 8 (7.1%) had confirmed sarcopenia. Confirmed sarcopenia was associated with lower BMI, higher CRP levels, and a higher prevalence of high nutritional risk. During follow-up, clinical worsening occurred in 46.9%, 45.2%, and 87.5% of patients, respectively (p=0.074), while IBD-related hospitalization occurred in 6.2%, 11.0%, and 62.5% (p<0.001). After adjustment for baseline clinical activity, confirmed sarcopenia remained independently associated with IBD-related hospitalization (adjusted OR [aOR] 18.30, 95% CI 3.21–141.14; p<0.001). Confirmed sarcopenia was also independently associated with infectious complications after adjustment for advanced-therapy exposure (aOR 7.40, 95% CI 1.17–54.63; p=0.034). No independent association was observed between sarcopenia and clinical worsening after adjustment for age, baseline clinical activity, BMI, and CRP.ConclusionsIn this prospective cohort of patients with IBD, confirmed sarcopenia was independently associated with an increased risk of IBD-related hospitalization and infectious complications over 12 months. These findings suggest that assessment of muscle strength and mass may provide clinically relevant prognostic information beyond conventional measures of disease activity and nutritional status.
