Arab Journal of Gastroenterology

Endoscopic full-thickness resection for a duodenal gastrointestinal stromal tumour Publication date: Available online 6 December 2019 Source: Arab Journal of Gastroenterology Author(s): Xiang-lei Yuan, Xiao-wei Liu, Bing Hu

Drug-induced pancreatitis: An update Publication date: Available online 2 December 2019 Source: Arab Journal of Gastroenterology Author(s): Jie Zheng, Qiu-Jin Yang, Fu-Tao Dang, Jing Yang Abstract Drug-induced pancreatitis is a disease that is receiving increasing attention. This article reviews the advances in the incidence, risk factors, pathogenesis, diagnosis, treatment and prevention of drug-induced pancreatitis by reviewing the literature on drug-induced pancreatitis, especially in the literature of the latest 10 years. The incidence of drug-induced pancreatitis is relatively low, however, there is an increasing trend with the widespread use of drugs, and the incidence seems to be related to regional distribution. There is currently lack of data on the epidemiology of drug-induced pancreatitis in China. In recent years, research on the pathogenesis of drug-induced pancreatitis has made some progress, but further research is needed. Drug-induced pancreatitis is a diagnosis of exclusion. With the deepening of understanding and research, a new diagnostic process has been proposed. Pharmacogenomics is expected to help prevent and perform an individual treatment of drug-induced pancreatitis.

Treatments of nonalcoholic fatty liver disease in adults who have no other illness: A Review article Publication date: Available online 2 December 2019 Source: Arab Journal of Gastroenterology Author(s): Sepideh Ahadi, Afshin Gharekhani, Afshin Shiva Abstract Nonalcoholic fatty liver disease (NAFLD) is one of the most common liver diseases. In the absence of treatment, NAFLD can damage the liver tissue and even have extra-hepatic complications. No therapeutic regimen has ever been approved for the treatment of this disease. A variety of clinical trials have been conducted in the field of NAFLD. Reviewing these trials is necessary to provide the most effective treatments. In this article, we aimed to review randomized controlled trials that evaluate the effects of pharmacological agents on NAFLD adults without other illness.

Circulating microRNAs (miR-21, miR-223, miR-885-5p) along the clinical spectrum of HCV-related chronic liver disease in Egyptian patients Publication date: Available online 2 December 2019 Source: Arab Journal of Gastroenterology Author(s): Mona Zaky Nasser, Naglaa Ali Zayed, Ahmed Mahmoud Mohamed, Dina Attia, Gamal Esmat, Ahmed Khairy Abstract Background and study aims MicroRNAs (miRNAs), small single stranded RNAs, function in the post-transcriptional regulation of gene expression and incorporated in pathogenesis of HCV related chronic liver disease. This study was designed to evaluate the significance of serum miR-21, miR-223, and miR-885-5p as biomarkers in various clinicopathological stages of HCV related chronic liver disease. Patients and methods Serum miR-21, miR-223, and miR-885-5p were quantified by quantitative RT PCR in 60 patients with HCV-related liver disease (presumably genotype 4), in addition to 25 healthy controls. HCV patients were classified into: chronic non-cirrhotic HCV (n = 15), HCV related liver cirrhosis (n = 15), and hepatocellular carcinoma (HCC) (n = 30). Results: Serum levels of miR-885-5p in cirrhotic patients ± HCC (n = 45) were significantly higher than the non-cirrhotic patients (n = 15); p = 0.007 and healthy control; p = 0.001. However, no such significance was detected between HCC and non-HCC HCV patients; p = 0.12. Serum miRNA-885-5p was able to discriminate cirrhosis ± HCC from healthy controls using ROC analysis; AUC 0.85, 87% sensitivity and 80% specificity. On the other hand, HCC patients had significantly higher serum miR-2 1evels than non-HCC patients (non-cirrhotic and cirrhotic groups, n = 30); p = 0.048 and the control group; p = 0.002. ROC could differentiate HCC from control group; AUC 0.89, 80% sensitivity, 80% specificity. Both serum bilirubin and albumin showed significant weak correlation with miRNA-885-5p (r = 0.42, p = 0.001) and (r = −0.27, p = 0.04), respectively but no such correlation was observed with serum miRNA-21. In contrast, miRNA-223 showed no significant difference across the studied groups. Conclusion Along the spectrum of HCV-related chronic liver disease, miR-885-5p could be a potential marker for advanced liver damage while miR-21 could be a helpful diagnostic marker for HCC.

Endoscopic ultrasound-guided fine-needle aspiration of sigmoid colon cancer undiagnosed with endoscopic biopsy Publication date: Available online 20 November 2019 Source: Arab Journal of Gastroenterology Author(s): Shogo Nakano, Kosuke Minaga, Yukitaka Yamashita

Effect of low dose albumin administration in spontaneous bacterial peritonitis on renal function and survival Publication date: Available online 20 November 2019 Source: Arab Journal of Gastroenterology Author(s): Elloumi Hela, Sabbah Mériam, Bibani Norsaf, Trad Dorra, Elleuch Nour, Gargouri Dalila, Ouakaa Asma, Kharrat Jamel Abstract Background and Study Aims Current guidelines favour albumin administration during spontaneous bacterial peritonitis (SBP). However, its use is limited in clinical practice and low doses are preferred. The aim of our study was to determine the effect of low dose albumin perfusion during SBP on mortality and prevention of hepatorenal syndrome (HRS) in cirrhotic patients. Patients and methods A retrospective study including consecutive patients with SBP hospitalized from 2002 to 2015 was performed. All patients were treated by intravenous empiric antibiotics associated with albumin infusion (30 g/day the first and third day) irrespective of patient's weight. The diagnosis of HRS was assessed according to the International Ascites Club criteria. The survival, the frequency of HRS and any disturbance in renal function were recorded. Results Fourty nine patients (sex ratio = 0.81, mean age 60.6 years [23–89]) were included. Main cause of cirrhosis was hepatitis B and C in 42.9% of cases. 63.3% were of Child Pugh C score%. The first line intravenous antibiotic treatment was based on cefotaxime in 87.8% of cases, followed by ofloxacin in 6.1% of cases. The outcome was favourable in 85.7% of cases. HRS was observed in 9 patients (18.3%) within 18 months [1–55]. Otherwise, 10 patients (20.4%) experienced an increase in creatinine level despite of albumin perfusion. The immediate mortality was 4%, and the six months survival was of 81.8%. Conclusion Despite even a low dose administration of albumin during SBP, renal dysfunction and HRS occurred less than described in literature. These results associated with cost considerations could suggest to use such an intervention during SBP or to select high risk patients who must receive albumin perfusion during SBP.

Up-regulation of TIMP-3 and RECK decrease the invasion and metastasis ability of colon cancer Publication date: September 2019 Source: Arab Journal of Gastroenterology, Volume 20, Issue 3 Author(s): Jinmiao Wang, Yunshou Lin, Tao Jiang, Chao Gao, Duowei Wang, Xiaodong Wang, Ying Wei, Tong Liu, Liwei Zhu, Pengzhi Wang, Feng Qi Abstract Background and study aims Although the function of microRNA21 (miR-21) in the invasion and metastasis of colon cancer has been extensively studied, the mechanisms of invasion and migration related pathways between and its targets are still not elucidated. This study explored the mechanisms of the pathway between miR-21 and the target genes in vitro and in vivo. Materials and methods We transfected pmiRZip21 or Leti3 into colon cancer cells. The levels of miR-21 expression, mRNA transcription and protein of target genes were analysed by TaqMan microRNA assays, RT-PCR and western blot, respectively. Scratch migration and trans-well assays were used to evaluate metastasis and invasion. To build a subcutaneous tumour animal model, detect the level of miR-21 and the target genes and then identify the mechanisms in vivo. Results MiR-21 expression levels in colon cancer cells transfected with pmiRZip21 in vivo or in vitro were decreased (P < 0.05). The mRNA and protein levels of TIMP-3 and RECK were up-regulated after inhibiting miR-21 in vitro and in vivo (P < 0.05), but those of BMPR-II and PCDH17 were not. In pmiRZip21-transfected colon cancer cells, invasion and migration were significantly decreased both in vitro and vivo (P < 0.05). Conclusions Up-regulation of TIMP-3 and RECK, by inhibiting miR-21 expression can decrease tumour invasion and metastasis ability in vitro and in vivo, and has potential as a possible target site in anti-tumour therapy. More effects in vivo have to be investigated in further research.

Vitamin D, linoleic acid, arachidonic acid and COX-2 in colorectal cancer patients in relation to disease stage, tumour localisation and disease progression Publication date: September 2019 Source: Arab Journal of Gastroenterology, Volume 20, Issue 3 Author(s): Berska Joanna, Bugajska Jolanta, Grabowska Agnieszka, Hodorowicz-Zaniewska Diana, Sztefko Krystyna Abstract Background and study aims Evidence shows that vitamin D and cyclooxygenase type 2 (COX-2) might play role in aetiology/progression of cancer. It is suggested that antitumour effect of vitamin D depends on vitamin D-receptor (VDR) expression. Aim of the study was to determine vitamin D and polyunsaturated fatty acids in colorectal cancer patients. Patients and methods A total of 39 patients with colorectal cancer (mean ± SD age: 65.5 ± 6.8 years) and 25 controls (mean ± SD age: 51.0 ± 6.9 years) were studied. 25-hydroxycholecalciferol-25(OH)D3 in serum was quantitatively determined by high-performance liquid chromatography (HPLC). Levels of linoleic acid (LA) and arachidonic acid (AA) of serum phospholipids were measured by gas-chromatography (GC). Expression of VDR and COX-2 in normal colonic mucosa and tumour tissue was measured by real time polymerase chain reaction (RT-PCR). Results The mean value of 25(OH)D3 was significantly lower in the colorectal cancer patients with early stages of the disease and in patients with tumour confined to the rectum compared to control group (p < 0.02, p < 0.03, respectively). The higher concentration of AA (patients with early stages of the disease) and lower concentration of LA (patients with the advanced stages of the disease) was noticed compared to the control group. For the patients with the early stages of the disease the higher mean fold change of mRNA VDR and the lower mean fold change of mRNA COX-2 was noticed (p < 0.03, p < 0.02, respectively). Conclusion The assessment of vitamin D status in patients with colorectal cancer should include measurement of mRNA VDR expression in tumour tissue.

Editorial Board Publication date: September 2019 Source: Arab Journal of Gastroenterology, Volume 20, Issue 3 Author(s):

Egyptian recommendations for management of Helicobacter pylori infection: 2018 report Publication date: September 2019 Source: Arab Journal of Gastroenterology, Volume 20, Issue 3 Author(s): Mohamed Alboraie, Walied Elhossary, Osama Aboelfotoh Aly, Bahaa Abbas, Lobna Abdelsalam, Doaa Ghaith, Zakarya Shady, Yasmine Gaber, Eman Adel, David Peura, David Armstrong, Gamal Esmat, Ahmed Gomaa, Ahmed El Ray, Ahmed Altonbary, Ahmad Soliman, Ahmed Zeid, Amgad Elzahaby, Assem Elfert, Hany Shehab