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Use of boroscopes in daily routine: Pro-contra debate

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Use of boroscopes in daily routine: Pro-contra debate

Ulrike Beilenhoff 1, Harry Oussoren 2

1 ESGENA Scientific Secretary, Ulm, Germany

2 Amsterdam UMC, Amsterdam, Netherlands

Event

UEG Week Berlin 2025

Topics

Nurses

Session

Hygiene: Update 2025

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

UEG Podcast Episode

New

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Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Topics

Small Intestine & Nutrition

Published

2026

UEG Podcast Episode

UEG Podcast

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Under Pressure with Lina Sopiene

Egle Dieninyte - Misiune

Topics

Primary Care

Published

2025

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ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

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Introduction

Acute pancreatitis (AP) is an acute inflammatory autodigestive disorder triggered by dysfunction of pancreatic exocrine activity and represents the most common gastrointestinal emergency in clinical practice. Global data indicate an annual incidence rate of 33.74 per 100,000 population and a mortality rate of 1.16 per 100,000. Despite ongoing optimization of therapeutic strategies, current clinical management primarily relies on supportive care and surgery. Hypertriglyceridemia (HTG) is the second leading etiological factor for AP, accounting for 10.36% of cases. Compared to other causes, HTG-associated acute pancreatitis (HTG-AP) exhibits higher recurrence rates and more severe complications (e.g., pancreatic necrosis and renal insufficiency). With the rising prevalence of HTG, the disease burden of HTG-AP is increasing, yet its specific pathogenic mechanisms remain unclear.

Aims & Methods

This study integrated whole-genome sequencing (WGS) and next-generation sequencing (NGS) to screen for shared mutations in the exonic regions of 5 HTG-AP family members. Candidate genes were identified based on MutationTaster classification and CADD scores. A mouse model carrying the PDLIM2 gene rs145349678 mutation was constructed using CRISPR/Cas9 technology, and an HTG-AP animal model was established. Pancreatic and hepatic histopathology (HE staining) and serological markers (TG, lipase, amylase, IL-6) were analyzed to evaluate the impact of the mutation on pancreatitis severity and hepatic lipid deposition.

Results

A clinical HTG-AP family was identified, with all 5 members exhibiting hypertriglyceridemia, including 2 cases of recurrent pancreatitis. WGS revealed 278 mutation sites across 10 chromosomes (involving 23 genes) in the family, and NGS validation narrowed these to 7 candidate loci. The PDLIM2 rs145349678 mutation (NM_001368120.1:exon9:c.C1055T:p.A352V), located within the LIM domain (which mediates protein localization and signaling transduction), was selected as the target due to cross-species conservation. Experimental results demonstrated that HTG-AP mice with the PDLIM2 mutation exhibited significantly aggravated pancreatic pathological damage (edema, hemorrhage, and inflammatory cell infiltration; *P* < 0.05), elevated serological markers (TG: 2.3 ± 0.4 vs. 1.5 ± 0.3 mmol/L; lipase: 520 ± 68 vs. 320 ± 45 U/L; IL-6: 48.2 ± 6.1 vs. 28.5 ± 4.3 pg/mL; *P* < 0.01 for all), and a 2.3-fold increase in hepatic lipid deposition (*P* < 0.001) compared to controls.

Conclusion

The PDLIM2 rs145349678 mutation exacerbates inflammatory responses and hepatic lipid accumulation in HTG-AP by modulating lipid metabolism. This finding provides new insights into the pathogenesis of HTG-AP and potential therapeutic targets.

ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

Li Xiaoqin 1, Huize Li 1, Qin Tang 1, Song He 1, Zhihang Zhou 1

1 The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

Event

UEG Week Berlin 2025

Topics

Mechanisms & Personalised Medicine Pancreas

Submission format

Abstract

Session

Cogulation, lipids and bugs: All relevant for pancreatitis

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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IMPROVED ENDOSCOPIC VISIBILITY WITH GEL VERSUS WATER IMMERSION DURING COLORECTAL UNDERWATER EMR: A RANDOMIZED CROSSOVER TRIAL

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Introduction

Underwater endoscopic mucosal resection (UEMR) has been increasingly utilized due to its clinical benefits. However, in patients with poor bowel preparation, UEMR is limited by impaired endoscopic visualization due to luminal turbidity. Viscoclear®, a gel designed to secure endoscopic fields, has been available in Japan since 2020 and has demonstrated a 92.2% effectiveness rate in improving visibility during bleeding or inadequate bowel prep. While its usefulness during UEMR has been anticipated, clinical evidence remains limited. We conducted an image analysis study to evaluate the visibility enhancement effect of gel immersion compared to underwater.

Aims & Methods

This study was a prospective randomized crossover trial to compare the endoscopic visibility of colorectal adenomatous lesions (6-20 mm) between under-water and under-gel observation. Each lesion was observed alternately in both settings using white light imaging (WLI), blue laser imaging (BLI), and linked color imaging (LCI). Color difference (ΔE) between tumor and adjacent non-tumor areas was calculated using the Lab color space in Photoshop (Adobe Systems Inc.) to evaluate lesion margins. Based on preliminary retrospective data from our institution, a sample size of 72 was calculated (power: 0.8, one-sided α: 0.05). (jRCTs062220033)

Results

Between July 2022 and May 2024, 72 lesions were enrolled. Median tumor size was 8 mm (range: 6–18 mm). Histopathology revealed 65 adenomas (90.3%), 2 cancers (2.6%), 3 traditional serrated adenomas (4.1%), and 2 hyperplastic polyps (2.8%). Boston Bowel Preparation Scale Segment Scores (BBPS-SS) were 3 in 50 cases, 2 in 21 cases, and 1 in 1 case.
Median ΔE values in the underwater group were 10.0 (WLI), 15.7 (BLI), and 11.7 (LCI), while those in the under-gel group were 12.4 (WLI), 21.1 (BLI), and 13.1 (LCI). ΔE was significantly higher in the under-gel group than the underwater group under WLI and BLI (p = 0.01 and p < 0.01, respectively).
In subgroup analysis by BBPS-SS, under-gel observation showed significantly higher ΔE in WLI and BLI when BBPS-SS ≤2 (p = 0.03 and p < 0.01, respectively). No significant differences were seen when BBPS-SS was 3.

Conclusion

Under-gel observation improved the visibility of lesion margins under WLI and BLI compared to underwater observation, particularly in patients with suboptimal bowel preparation. Gel immersion endoscopy may therefore be a useful adjunct in difficult visualization conditions during colorectal UEMR.