Inflammatory Bowel Disease (IBD) is a chronic, relapsing inflammatory disorder of the gastrointestinal tract. Though the pathogenesis of IBD remains unclear, diet is increasingly recognized as a pivotal factor influencing its onset and progression. Fatty acids, essential components of dietary lipids, play diverse roles in IBD, ranging from anti-inflammatory and immune-regulatory functions to gut-microbiota modulation and barrier maintenance. Short-chain fatty acids (SCFAs), products of indigestible dietary fiber fermentation by gut microbiota, have strong anti-inflammatory properties and are seen as key protective factors against IBD. Among long-chain fatty acids, saturated fatty acids, trans fatty acids, and ω-6 polyunsaturated fatty acids exhibit pro-inflammatory effects, while oleic acid and ω-3 polyunsaturated fatty acids display anti-inflammatory actions. Lipid mediators derived from polyunsaturated fatty acids serve as bioactive molecules, influencing immune cell functions and offering both pro-inflammatory and anti-inflammatory benefits. Recent research has also highlighted the potential of medium- and very long-chain fatty acids in modulating inflammation, mucosal barriers, and gut microbiota in IBD. Given these insights, dietary intervention and supplementation with short-chain fatty acids are emerging as potential therapeutic strategies for IBD. This review elucidates the impact of various fatty acids and lipid mediators on IBD and delves into potential therapeutic avenues stemming from these compounds.

Background: Although the beneficial properties of vitamin D in anti-inflammation and immunity-modulation are promising in the management of inflammatory bowel disease (IBD), data were limited for the critical IBD prognosis. The association between serum vitamin D levels and the risk of bowel resection in individuals with IBD remains largely unknown. Materials and Methods: The authors performed a longitudinal cohort study among 5474 individuals with IBD in the UK Biobank. Serum 25-hydroxyvitamin D [25(OH)D] was measured using direct competitive chemiluminescent immunoassay. Bowel resection events were ascertained via national inpatient data. Multivariable-adjusted Cox proportional hazard regression was used to examine the association between serum 25(OH)D and bowel resection risk, presented with hazard ratios (HRs) and 95% CIs. Restricted cubic spline (RCS) was used to evaluate dose-response associations. Results: During a mean follow-up of 13.1 years, the authors documented 513 incident bowel resection cases. Compared to participants with vitamin D deficiency, nondeficient participants showed a significantly reduced bowel resection risk in IBD (HR 0.72, 95% CI: 0.59–0.87, P=0.001), Crohn’s disease (CD, HR 0.74, 95% CI: 0.56–0.98, P=0.038), and ulcerative colitis (UC, HR 0.73, 95% CI: 0.57–0.95, P=0.020). When comparing extreme quintiles of 25(OH)D level, participants with IBD showed a 34% reduced risk of bowel resection (95% CI: 11–51%, P=0.007) and participants with UC showed a 46% reduced risk (95% CI: 19–64%, P=0.003), while this association was not significant in CD (HR 0.93, 95% CI: 0.59–1.45, P=0.740). Linear dose-response associations were observed using the RCS curve (all P-nonlinearity>0.05). Conclusion: Increased serum level of 25(OH)D is independently associated with reduced bowel resection risk in IBD. This association was significant in UC but may not be stable in CD. Vitamin D deficiency is a risk factor for bowel resection in individuals with IBD, and may be an effective metric in predicting and risk-screening surgical events.

Background: Endoscopic ultrasound (EUS) is crucial for diagnosing and managing mediastinal diseases but lacks effective quality control. This study developed and evaluated an artificial intelligence (AI) system to assist in anatomical landmark identification and scanning guidance, aiming to improve quality control of mediastinal EUS examinations in clinical practice. Methods: The AI system for mediastinal EUS was trained on 11 230 annotated images from 120 patients, validated internally (1972 images) and externally (824 images from three institutions). A single-center randomized controlled trial was designed to evaluate the effect of quality control, which enrolled patients requiring mediastinal EUS, randomized 1:1 to AI-assisted or control groups. Four endoscopists performed EUS, with the AI group receiving real-time AI feedback. The primary outcome was standard station completeness; secondary outcomes included structure completeness, procedure time, and adverse events. Blinded analysis ensured objectivity. Results: Between 16 September 2023, and 28 February 2025, a total of 148 patients were randomly assigned and analyzed, with 72 patients in the AI-assisted group and 76 in the control group. The overall station completeness was significantly higher in the AI-assisted group than in the control group (1.00 [IQR, 1.00–1.00] vs. 0.80 [IQR, 0.60–0.80]; P < 0.001), with the AI-assisted group also demonstrating significantly higher anatomical structure completeness (1.00 [IQR, 1.00–1.00] vs. 0.85 [IQR, 0.62–0.92]; P < 0.001). However, no significant differences were found for station 2 (subcarinal area) or average procedural time, and no adverse events were reported. Conclusions: The AI system significantly improved the scan completeness and shows promise in enhancing EUS quality control.