We read with interest the study by Pan et al. on tenofovir alafenamide (TAF) therapy throughout pregnancy in mothers with chronic hepatitis B (CHB) [1]. This well-designed study, employing propensity score matching and subgroup analyses, provides reassuring evidence on TAF safety across all trimesters, demonstrating effective reduction of maternal hepatitis B virus (HBV) DNA levels and prevention of

We are grateful to Dr. Vyas [1] for his thoughtful comments and insights in response to our recent publication [2]. We fully agree with his perspective that treatment decisions in this context must be individualised and guided by ALT, HBeAg status, HBV DNA levels, and fibrosis scores. As pregnancy progresses, physiological changes impose an increasing burden on the maternal liver, often exacerbating

We appreciate the commentary provided by Drs. Hoang and Ko on our study and appreciate the summary they have provided [1, 2]. We want to highlight and discuss several important considerations in our study. We acknowledge Drs. Hoang and Ko's comment that our FOCUS-HBV cohort was a highly selected cohort and potentially not generalisable to an unlinked immigrant chronic hepatitis B population in the

It is well-known that the burden of chronic hepatitis B (CHB) in Western countries is disproportionally shouldered by their immigrant populations [1, 2]. In the United States, it is estimated that 60%–90% of CHB seroprevalence is attributed to its foreign-born (FB) population [3]. Despite this high disease prevalence, data characterising this growing population have been limited to retrospective cohorts

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I appreciate the opportunity to comment on the review article by Bonner et al. [1]. The article rightly highlights the duodenum as the site where enzymatic interaction with gluten will be most beneficial. The caricain-based supplement was the first technology proposing the small intestine as the site of enzyme activity through extensive in vitro studies and clinical trials. The product formulation

We thank Prof. Macrae for his supportive letter [1] regarding our review. As emphasised in our article [2], dietary supplements claiming to digest gluten, or gluten immunogenic peptides, are not approved as treatments for coeliac disease. Indeed, there is no pharmaceutical that has regulatory approval as a treatment for coeliac disease. Furthermore, the draft guidance from the FDA highlights that treatment

Metabolic dysfunction–associated steatotic liver disease (MASLD) has become a major global health concern, affecting approximately 25%–30% of adults worldwide [1]. Although recent reclassification efforts have clarified its diagnostic criteria [2], identifying patients at the highest risk of disease progression using simple, non-invasive methods remains a major unmet need [3, 4]. In a proof-of-concept

We would like to express our appreciation for the thoughtful and constructive editorial commentary by Zipprich and Ripoll [1] on our recent work [2]. We fully agree with the emphasised importance of recent advances in the personalization of treatment with TIPS (transjugular intrahepatic portosystemic shunt). Indeed, the field of TIPS has seen significant advances, particularly with the introduction

The effects of chronic inflammation in patients with inflammatory bowel diseases (IBD) extend beyond the gastrointestinal tract, impacting outcomes as diverse as cognitive function [1] and cardiovascular health [2-4]. Patients with IBD are at a higher risk for arterial and venous cardiovascular disease. In addition to the effect of traditional cardiovascular risk factors, the elevated cardiovascular

We commend Dr Ananthakrishnan [1] for highlighting the clinical implications of our findings of an increased risk of major adverse cardiovascular events after coronary intervention in patients with inflammatory bowel disease (IBD) [2]. In patients with IBD, chronic inflammation is widely recognised as the key driver in the pathogenesis of cardiovascular disease (CVD) and recurrent cardiovascular events

We thank Dr Cristofori et al. [1] for their thoughtful and detailed feedback on our meta-analysis [2]. We appreciate their emphasis on the importance of adhering to established diagnostic criteria when distinguishing eosinophilic oesophagitis (EoE) from oesophageal eosinophilia. We acknowledge that combining these entities may introduce bias, particularly given the clinical and histological differences

We read with interest the meta-analysis by Spinelli et al. which reported a 46% lower risk of eosinophilic oesophagitis (EoE) and oesophageal eosinophilia in individuals infected with Helicobacter pylori [1]. While we commend the authors for their contributions, the decision to group EoE and oesophageal eosinophilia may have introduced bias, as these entities have dissimilar diagnostic criteria. According

The placement of transjugular intrahepatic portosystemic shunts (TIPS) has long served as an intervention for patients with decompensated cirrhosis and portal hypertension-related complications, mainly ascites and variceal bleeding. While the introduction of ePTFE covered stent has effectively reduced the risk of thrombosis, achieving the optimal portal pressure gradient (PPG) remains a nuanced balancing

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Editors. We enthusiastically read the brilliant research by Villanueva et al. which, by systematically reviewing randomised clinical trials (RCTs) comparing non-selective beta-blocker (NSBB) versus variceal band ligation (VBL) for primary acute variceal bleeding (AVB) prevention in cirrhotic patients presenting high-risk varices, revealed NSBBs significantly improved survival versus VBL, with no additional

The Phase 2b trial of MK-3655 (NCT04583423) provides critical insights into fibroblast growth factor 21 (FGF21) pathway modulation, yet raises fundamental questions about therapeutic targeting strategies [1]. While the reported 26.1% placebo-adjusted liver fat reduction at 300 mg (p < 0.05) aligns with early-phase FGF21 analogs [2], it falls substantially below the ≥ 40% reductions seen with efruxifermin

We read with interest the study by Ye et al. [1]. The authors demonstrated that targeted next-generation sequencing (tNGS) has high sensitivity (83%) and 100% specificity for detecting Mycobacterium tuberculosis from fresh ulcer base biopsy samples, offering an alternative to conventional methods like acid-fast bacillus staining, TB-PCR, and histopathological examination. Given the diagnostic challenges

We appreciate the opportunity to respond to the comments submitted by Mao et al. [1] relating to our article [2]. They provided thoughtful commentary about the strengths and weaknesses of our study, and we agree with several concerns and recommendations that they shared. For example, they highlighted the potential limitations of relying upon ICD-10 codes to assess the abdominal pain status of each

We appreciate the systematic evaluation of the effects of antispasmodics in patients with IBD by Dr. Khunsriraksakul and colleagues [1]. This addressed an important gap in our understanding of the effectiveness of antispasmodics in patients with IBD and has raised critical concerns for clinical practice. However, some aspects could be further refined to enhance clinical relevance. First, the definition

We appreciate the interest and comments of Dr. Green and colleagues on our article about antroduodenal motility in patients with hypermobility spectrum disorders/hypermobile Ehlers–Danlos syndrome (HSD/hEDS) [1, 2]. They commented on the high frequency of food intolerance in the HSD/hEDS population resulting in a high prevalence of enteral and parenteral feeding, and the possible role of enteric dysmotility

We commend Sweerts et al. for their largest-to-date investigation using antroduodenal manometry (ADM) in 50 patients with hypermobility spectrum disorders (HSD) and hypermobile Ehler-Danlos Syndrome (hEDS) compared to 189 non-HSD/hEDS patients [1]. ADM, a labour-intensive and technically challenging procedure, comes the closest to the gold standard of histopathological evaluation of full-thickness

We thank Drs. Ainsworth and Frimor for their thoughtful editorial comments on our manuscript [1, 2]. The authors introduced two papers that slightly preceded our report and provided initial insights into the real-world use of mirikizumab. Our study had a broader, more heterogeneous population enabling more detailed analyses as well as subgroup analyses comparing clinical outcomes by prior biologic

The therapeutic landscape of ulcerative colitis (UC) is rapidly evolving, driven by biologic and small-molecule agents specifically targeting the inflammatory pathways. Among these, mirikizumab, an anti-IL-23p19 monoclonal antibody, recently gained approval based on pivotal randomised controlled trials (RCTs) demonstrating efficacy in both induction and maintenance phases of therapy [1]. While RCTs

Editors, We currently work in a clinical environment where expert IBD organisations and clinicians recommend that patients with Crohn's disease avoid emulsifiers. Unfortunately, these recommendations are based upon preclinical data that have not been translated to human real-world food intake. We have questioned the wisdom of providing non-evidence-based recommendations that demonise food components

The impact of ultra-processed foods (UPFs) on inflammatory bowel disease (IBD) pathogenesis is increasingly recognised [1-3]. Clinical and preclinical studies link UPFs, including dietary emulsifiers, to dysbiosis, mucous layer disruption and immune activation [1, 2]. Since the increasing consumption of processed foods has been linked to increased incidence and prevalence of chronic disease, including

The CHRONO-NAFLD trial by Tsitsou et al. [1] provides valuable insights into combining Mediterranean diet (MD) and time-restricted feeding (TRF) for metabolic dysfunction-associated steatotic liver disease (MASLD). While the study demonstrates comparable weight loss across groups and superior glycemic benefits with early TRF, three critical questions warrant further discussion to contextualise these

We sincerely thank Drs. Zhu and Zhou [1] for their thoughtful comments on our recent randomised study examining the effects of a 12-week Mediterranean-type time-restricted feeding (TRF) protocol in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) [2]. Our study is distinguished by the use of a hypocaloric Mediterranean diet as the control group, which has emerged as the

We read with keen interest the recent article by Ye et al. [1] entitled “Crohn's Disease with Latent Tuberculosis Infection or Intestinal Tuberculosis (ITB): Rapid Discrimination by Targeted Next—Generation Sequencing”. We feel that this work represents important progress in discriminating ITB and CD. Not only do the authors demonstrate targeted next generation sequencing (tNGS) on intestinal tissue

We commend Tan et al. [1] for raising concerns about the impact of Fibrosis-4 (FIB-4) Index based screening on metabolic dysfunction-associated steatotic liver disease (MASLD)-related hepatocellular carcinoma (HCC). In their retrospective study, 13% of HCC patients had a low FIB-4 score, which if used prospectively in primary care, would classify them as ‘low risk MASH’ according to American Association

We thank Guan et al. for their interest in and critical comments on our work regarding the risk of incident type 2 diabetes (T2D) and prediabetes among individuals who achieve hepatitis C virus (HCV) cure with direct-acting antivirals (DAAs) [1, 2]. First, our study assessed liver stiffness measurement (LSM) at the time point of sustained virologic response at off-therapy week 12 (SVR12). While the

We carefully read Chang's article [1] on the relationship between sustained virological response (SVR) after HCV treatment and subsequent risk of type 2 diabetes (T2D) and prediabetes. This study determined the incidence of T2D and prediabetes in a sustained virologic response state and suggested that factors such as liver stiffness and body mass index could be important predictors of the management

We thank Mr. Anand and Mr. Tozer for their interest in our study [1, 2] and for their ongoing contributions to the field of perianal fistulising Crohn's disease (PFCD) through the TOpClass consortium. Several important considerations were raised in their editorial that require further explanation. We agree that a limitation of our retrospective study was our inability to assess for abscess recurrence

Seton placement has been a cornerstone in the management of perianal Crohn's disease (pCD) fistulae since the time of Hippocrates, when lint was wrapped around horsehair to maintain drainage and reduce the risk of abscess [1]. Few interventions can be older but still in use today, with recent work on the classification and management of pCD still advocating their use [2-4] (Table 1). McCurdy et al