Publications by authors named "Arzu Ensari"

Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide, necessitating accurate and robust predictive approaches to assist oncologists with prognosis prediction and therapeutic decision-making in clinical practice. Here, we aimed to identify key genes involved in colorectal cancer pathology and develop a model for prognosis prediction and guide therapeutic decisions in CRC patients. We profiled 49 matched tumour and normal formalin-fixed paraffin-embedded (FFPE) samples using Affymetrix HGU133-X3P arrays and identified 845 differentially expressed genes (FDR ≤ 0.

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In this review, a comprehensive overview of the current state of artificial intelligence (AI) research in Inflammatory Bowel Disease (IBD) diagnostics in the domains of endoscopy, radiology and histology is presented. Moreover, key considerations for development of AI algorithms in medical image analysis are discussed. AI presents a potential breakthrough in real-time, objective and rapid endoscopic assessment, with implications for predicting disease progression.

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Background And Aims: Artificial intelligence (AI) is increasingly being applied in various fields of medicine, including Inflammatory Bowel Diseases (IBD). This systematic review, conducted as part of the ECCO 9th Scientific Workshop on AI in IBD, explores AI applications in multiomic precision medicine, large language models (LLMs) for textual tasks and utilisation of wearable and remote care technologies.

Methods: A comprehensive systematic analysis of the literature was undertaken, emphasising three topics: multiomic predictive models in IBD; natural language processing (NLP) and LLMs for clinical practice, research and patient communication; and the role of remote monitoring and wearable devices.

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With the rapid growth of artificial intelligence (AI) applications in the field of inflammatory bowel disease (IBD), an increasing number of regulatory and methodological considerations have become apparent. Currently, there remains much uncertainty and limited experience in the field of IBD regarding some of the regulatory and methodological pitfalls to be considered when developing and deploying AI applications for positive clinical and health system impact. Accordingly, an expert panel was convened by the European Crohn's and Colitis Organisation (ECCO) to review the published literature and provide an overview of key regulatory aspects for the application of AI in IBD.

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In this narrative review we present the current status of developments in artificial intelligence in the filed of IBD surgery. We lay down the foundations for how IBD surgery may utilise the potential opportunities in utilizing the rapid advances in AI technology as it used in other surgical disciplines. The main areas of potential utility are in the areas of surgical training, risk prediction in the pre, intra and post operative period in IBD patients undergoing surgery and in IBD surgical research.

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Objective: The impact of cytomegalovirus (CMV) on inflammatory bowel disease (IBD) flares remains a matter of debate. This study aimed to evaluate patients with CMV infection who presented with IBD exacerbation in terms of diagnosis and treatment and investigate the importance of CMV DNA levels in colitis development.

Materials And Methods: Patients who were followed up with IBD and examined with clinical suspicion of CMV colitis at a university hospital between January 2016 and December 2021 were retrospectively scanned.

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Article Synopsis
  • Researchers aimed to improve the diagnosis of coeliac disease (CD) with mild mucosal changes by using a new monoclonal antibody to study T cell receptor (TCR)γδ intra-epithelial lymphocytes (IELs).
  • They analyzed 167 cases, including untreated CD and non-coeliac groups, and found that TCRγδ IEL levels were significantly higher in CD patients, correlating with mucosal damage severity.
  • The study proposes a diagnostic algorithm based on γδ IEL counts and ratios, which accurately classified most cases and could enhance histopathological diagnosis for coeliac disease.
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Background: Ultra-short coeliac disease (USCD) is defined as villous atrophy only present in the duodenal bulb (D1) with concurrent positive coeliac serology. We present the first, multicentre, international study of patients with USCD.

Methods: Patients with USCD were identified from 10 tertiary hospitals (6 from Europe, 2 from Asia, 1 from North America and 1 from Australasia) and compared with age-matched and sex-matched patients with conventional coeliac disease.

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Primary enteropathies of infancy comprise of epithelial defects including microvillus inclusion disease, tufting enteropathy, and enteroendocrine cell dysgenesis and autoimmune enteropathies. The diseases in this group cause severe chronic (>2-3 weeks) diarrhoea starting in the first weeks of life and resulting in failure to thrive in the infant. Duodenal biopsies show moderate villous shortening together with crypt hyperplasia which are the main features causing resemblance to coeliac disease.

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Article Synopsis
  • The study looked at how acute graft-versus-host disease (GVHD) affects the gastrointestinal (GI) system in patients who received hematopoietic stem cell transplants, analyzing biopsy results from 164 patients between 2005 and 2019.
  • A total of 479 biopsies were examined, revealing similar levels of GI involvement in both the upper and lower tracts, with the duodenum being the most severely affected area, while the pathology grades generally correlated with clinical assessments.
  • The findings suggest that evaluating the distal colon through rectosigmoidoscopy is effective for diagnosing GI GVHD and that pathology grading provides valuable insights into the severity of the condition.
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Background: Histological changes induced by gluten in the duodenal mucosa of patients with non-coeliac gluten sensitivity (NCGS) are poorly defined. Objectives: To evaluate the structural and inflammatory features of NCGS compared to controls and coeliac disease (CeD) with milder enteropathy (Marsh I-II). Methods: Well-oriented biopsies of 262 control cases with normal gastroscopy and histologic findings, 261 CeD, and 175 NCGS biopsies from 9 contributing countries were examined.

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Diagnosis of non-coeliac gluten sensitivity (NCGS) remains still problematic due to the subjectiveness and lack of a specific biomarker. We aimed to compare NCGS duodenal mucosae with healthy individuals and Marsh type 1 coeliac disease (CD), to determine whether NCGS has characteristic histological features. A total of 44 healthy controls, 42 NCGS, and 44 type 1 CD patients were selected according to clinical, serological, and laboratory data.

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Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in adults. Subepithelial polyclonal immunoglobulin deposits and >70% M-type phospholipase A2 receptor antibody positivity are typical findings in idiopathic MN. A 58-year-old female patient was admitted with clinical presentation of nephrotic syndrome.

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Objective: We aimed to determine the predictive capacity and diagnostic yield of a 10-fold increase in serum IgA antitissue transglutaminase (tTG) antibody levels for detecting small intestinal injury diagnostic of coeliac disease (CD) in adult patients.

Design: The study comprised three adult cohorts. Cohort 1: 740 patients assessed in the specialist CD clinic at a UK centre; cohort 2: 532 patients with low suspicion for CD referred for upper GI endoscopy at a UK centre; cohort 3: 145 patients with raised tTG titres from multiple international sites.

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Article Synopsis
  • This study investigates traditional serrated adenomas (TSAs) found in the stomach and small intestine, focusing on their morphologic features and potential for cancer development.
  • The research analyzed 12 GI polyps displaying TSA characteristics, identifying key features like eosinophilic cells and dysplastic foci using digital imaging and immunohistochemical methods.
  • Findings indicate that gastric TSAs show a higher incidence of neoplastic changes compared to those in the small intestine, and specific markers like CK20 and Ki67 reveal distinct expression patterns in these lesions.
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Coeliac disease (CD) is an autoimmune enteropathy which can present with patchy mucosal lesions. The aim of the present study is to investigate the significance of duodenal bulb biopsy in the diagnostic work-up of CD in both pediatric and adult patients, and to highlight the key points for pathologists. D1 (duodenal bulb) and D2 (distal duodenum) biopsies of 153 newly diagnosed serology-positive CD patients were evaluated for villous/crypt ratio and intraepithelial lymphocyte (IEL) counts on CD3-stained slides and were classified according to Marsh.

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Background: Intestinal lipid malabsorption, resulting from an impaired formation or secretion of chylomicrons and associated with severe hypobetalipoproteinemia (HBL), may be due to biallelic mutations in APOB (homozygous FHBL type-1), MTTP (abetalipoproteinemia), or SAR1B (chylomicron retention disease).

Objective: We investigated four children, each born from consanguineous parents, presenting with steatorrhea, malnutrition, accumulation of lipids in enterocytes, and severe hypocholesterolemia with an apparent recessive transmission.

Methods: We sequenced a panel of genes whose variants may be associated with HBL.

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The diagnosis of celiac disease (CD) no longer rests on a malabsorptive state or severe mucosal lesions. For the present, diagnosis will always require the gold-standard of a biopsy, interpreted through its progressive phases (Marsh classification). Marsh classification articulated the immunopathological spectrum of gluten-induced mucosal changes in association with the recognition of innate (Marsh I infiltration) and T cell-based adaptive (Marsh II, and the surface re-organisation typifying Marsh III lesions) responses.

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Background: Increased angiogenetic activity in inflammatory bowel disease (IBD) has been shown in previous studies. The aim of this study was to evaluate the relationship of serum vascular endothelial growth factor (VEGF) and endostatin levels with clinical features and mucosal expression in patients with ulcerative colitis (UC).

Design And Setting: Cross-sectional analytical study conducted in a tertiary-level public hospital.

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Background: In the present study, we investigated the prognostic and predictive role of neuroendocrine differentiation (NED) and tumor-associated macrophage (TAM) infiltration in tumor tissue from patients with advanced colorectal cancer who had received bevacizumab plus chemotherapy.

Patients And Methods: A total of 123 consecutive patients with advanced colorectal cancer who had received bevacizumab plus irinotecan/oxaliplatin-based combination chemotherapy were included in the present study. In addition to the clinicopathologic parameters, the presence of NED and the level of TAM infiltration were studied as covariates for survival analysis.

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Intraepithelial lymphocytosis (IELosis) with or without villous abnormality is a characteristic feature of gluten sensitivity (GS) including celiac disease (CD) and non-celiac-GS, although various conditions may also be associated with IELosis. In order to distinguish GS from the other causes of IELosis, a threshold for IEL counts is necessary. We aimed to determine a cut-off value for IELs and monitor its value in the spectrum of GS in a large cohort.

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Exploring the villus.

Gastroenterol Hepatol Bed Bench

January 2018

The small intestinal villus and its associated epithelium includes enterocytes as the main cell type and differentiated goblet and argentaffin cells, while the invaginated crypt epithelium is the site of cell division and hence the origin of all epithelial components. Enterocytes form a cohesive monolayer which acts both as a permeability barrier between lumen and the interior, and an important gateway for nutrient digestion, absorption and transport. Differentiation and polarisation of enterocytes depends on cytoskeletal proteins that control cell shape and maintain functionally specialised membrane domains; extracellular matrix (ECM) receptors; channels and transporters regulating ion/solute transfer across the cell.

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