Dr. Falk Video report
Who get’s EoE? – Part II: Genetic & geographical risk factors
The most important facts summarized:
– Is there anything known about the interactions between genetic and environmental risk factors?
o A gene and environment interaction is very likely
o A number of gene variants are associated with EoE, e.g. variations in the Calpain-14-or TGF-β gene
– Do you have an explanation for the existence of geographical EoE-hotspots?
o The presence in western countries like the US seems to be associated with air pollution and large commercial farming enterprises
o It is assumed that environmental factors harm the esophageal barrier and thereby expose the esophagus to allergenic triggers
o The peak prevalence of EoE around the age of 35 to 50 could be associated with the increase in mass farming practices and changes in the food supply 30 to 50 years ago
Dr. Falk Video-Report – interview with Prof. Evan Dellon, Chapel Hill (USA), which took place during ueg week 2019 in Barcelona (Spain) within the scope of the Satellite Symposium „EoE – Recent Developments in Diagnosis & Treatment“. In part II of the interview „Who get’s EoE?“ Prof. Dellon describes genetic and geographical risk factors for the development of the disease.
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Latest research in brief:
Bowel
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Pan L et al, Am J Gastroenterol. 2020;115(5):766–73
Digestive symptoms in COVID-19 patients: Results of a cross-sectional cohort study from China suggest that gastrointestinal symptoms, in particular lack of appetite and diarrhea, occur in up to half of the patients with COVID-19 and may be present even in the absence of respiratory symptoms.
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El-Salhy M et al, Gut. 2020;69(5):859–67
Fecal microbiota transplantation (FMT) for patients with irritable bowel syndrome (IBS): Results of a randomized trial reveal that FMT may be an effective treatment for IBS patients. Utilizing a well-defined donor with normal intestinal diversity and a favorable microbial signature appears to be essential for successful FMT. Moreover, response to therapy increases with FMT dose.
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Panaccione R et al, Gut. 2020;69(4):658–64
Cost effectivity of tight control for Crohn’s disease: A tight control strategy used in the CALM trial, which is based on clinical parameters as well as biomarkers of inflammation, is cost-effective as compared to conventional therapy. The economic value of tight control therapy increased when costs related to work productivity are incorporated.
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Liver Biliary Tracts
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Taylor RS et al, Gastroenterology. 2020;158(6):1611–25.e12
Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH): Improvement of fibrosis stage is a common end point in clinical trials. A current systematic review and meta-analysis demonstrates that the fibrosis stage is associated with risk of mortality and liver-related morbidity in patients with NAFLD and NASH and thus confirms the validity of this surrogate marker as end point in clinical trials.
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Gouya L et al, Hepatology. 2020;71(5):1546–58
NAcute hepatic porphyria: A current prospective register study demonstrates that this group of rare genetic disorders is associated with a high disease burden (inpatient treatment e.g. with hemin) and diminished quality of life (chronic symptoms impairing day-to-day functioning). These results highlight the need for novel therapies.
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Levitsky J et al, Hepatology. 2020;71(5):1775–86
Renal outcomes after liver transplantation: A model based on clinical parameters and the protein markers β2 microglobulin and CD40 can predict future renal deterioration early after liver transplantation. This model may thus help in the early selection of recipients for proactive renal sparing strategies.
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Oesophagus Stomach Duodenum
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Khan MA et al, Am J Gastroenterol. 2020;115(5):671–8
Proton-pump inhibitor (PPI) therapy and risk of dementia: A meta-analysis of observational studies did not find an association between PPI therapy and increased risk of dementia including Alzheimer dementia.
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Lau JYW et al, N Engl J Med. 2020;382(14):1299–308/em>
Timing of endoscopy for upper gastrointestinal bleeding: In patients with high risk for future bleeding and death, endoscopy performed within 6 hours after gastroenterological consultation did not result in reduced mortality or recurrent bleeding rates as compared to endoscopy performed within 6–24 hours.
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Suzuki S et al, Gut. 2020;69(6):1019–26
Helicobacter pylori treatment using the potent acid inhibitor vonoprazan: First-line dual therapy with vonoprazan and low-dose amoxicillin for 7 days provided acceptable eradication rates in Japanese patients similar to vonoprazan-based triple therapy in regions with high clarithromycin resistance.
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Pancreas
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Pishvaian MJ et al, Lancet Oncol. 2020;21(4):508–18
Molecular profiling and targeted therapies in patients with pancreatic cancer: Real-world data from the US suggest that molecular tumor profiling and subsequent targeted therapies can have a substantial effect on patient survival.
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Current Falk literature:
Crohn’s Disease and Ulcerative Colitis in Children and Adolescents
Author: M. Claasen
in collaboration with: S. Buderus, J. de Laffolie, A. Enninger, M. Melter,
C. Posovszky, B. Rodeck
(132 pages)
S4e