Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been accepted as a reliable tool in diagnosing and staging intra-abdominal tumors. In this study, we aimed to investigate the performance of EUS-FNA in the evaluation of liver masses and its impact on patient management and procedure-related complications retrospectively. Data of patients who underwent EUS-FNA biopsies due to liver masses between November 2017 and July 2018 were retrieved retrospectively. Biopsies were performed using 22-G needles. The demographics, EUS-FNA results, sensitivity and specificity of the procedure, negative predictive value, positive predictive value, and specimen sufficiency rates were assessed. A total of 25 patients (10 females) were included in the study. The mean age was 62.73±15.2 years. The mean size of the masses was 34.50±16.04 mm. The technical success rate was 88%. During the EUS-FNA procedure, each patient had only one pass with 94.45% of aspirate sufficiency rate and 86.3% of biopsy sufficiency rate. The diagnostic accuracy rate was 86.3%. There were no complications. For the evaluation of liver masses, EUS-FNA using a 22-G needle with even one pass had high aspiration and biopsy success rates accompanied with high diagnostic accuracy rates.

Background/Aims: Inflammatory bowel diseases (IBDs) are increasingly prevalent and challenging globally. Data regarding IBD frequency and severity between Europe and Asia are needed. The aim was to investigate the trend of IBD in Türkiye during the last 3 decades. Materials and Methods: The study was conducted retrospectively at 14 centers in Türkiye between June 1993 and March 2024. Results: Over 30 years, 4308 patients, of whom 2507 (58.2%) had ulcerative colitis (UC) and 1717 (39.9%) had Crohn’s Disease (CD), were included in the study. The overall median age at the onset of IBD was 34.43 (25.28-45.64) years; the age at onset of IBD was younger in CD compared to UC (32.72 vs. 35.52 years respectively, P < .001). The peak age onset range was 28-32 years in CD, whereas 23-27 years in UC. Overall, 2526 (58.6%) patients were male. The most common location was left-sided colitis in UC patients (45.1%), followed by extensive colitis (31.2%), and proctitis (23.7%), while ileal involvement in CD patients (45.2%), afterward ileocolonic (409%), and colonic (13.5%). Both illnesses are becoming increasingly prevalent. The UC/CD ratio tends to decrease over time. During the study period, 1577 (36.6%) patients received biologic treatment. During the study period, 418 (24.3%) underwent resective surgery for CD and 88 (3.5%) total colectomy for UC; the major abdominal surgery has declined over time. Conclusion: The frequency and characteristic features of IBD in Türkiye appear to be between Europe and Asia. Over time, while the usage of biologic therapy and the rate of CD have increased, the frequency of surgery has decreased. Cite this article as: Durak MB, Cagin YF, Balkan A, et al. Three-decade analysis of inflammatory bowel disease in Türkiye: A multicenter study (1993-2024). Turk J Gastroenterol. 2025;36(12):822-833.

Amaç: Kronik hepatit C tanılı hastalarda doğrudan etkili antiviral ilaç tedavisi sonrasında nekroinflamasyonun bir göstergesi olan alfa fetoprotein değerinde meydana gelen değişimi saptamaktır.Gereç ve Yöntemler: Çalışmamızda Ocak 2015 ile Ocak 2020 tarihleri arasında Cumhuriyet Üniversitesi Tıp Fakültesi Gastroenteroloji Bilim Dalı Polikliniğinde değerlendirilip kronik hepatit C tanısı ile direkt etkili antiviral tedavi başlanan 294 hastanın verileri retrospektif olarak incelenmiştir. Aldıkları direkt etkili antiviral tedavilerine göre; Sofosbuvir/Ledipasvir ± Ribavirin tedavisi alan hastalar 1. grup (n=114), Paritaprevir + Ritonavir/Ombitasvir ± Dasabuvir ± Ribavirin tedavisi alan hastalar 2. grup (n=180) olarak iki ana grupta değerlendirilmiştir.Bulgular: Hastaların tedavi öncesindeki ortalama alfa fetoprotein değeri 8.25±10.82 ng/ml, tedavi bitimindeki ortalama alfa fetoprotein değeri ise 5.14±10.80 ng/ml olarak saptanmış ve bu değişim istatistiksel olarak anlamlı bulunmuştur (p<0.01). Birinci grupta tedavi bitimindeki alfa fetoprotein değerinde tedavi öncesi değere göre anlamlı düşme gözlenirken (p<0.01), 2. grupta hafif düşme gözlenmiş; ancak bu düşüş istatistiksel olarak anlamlı bulunmamıştır (p=0.175).Sonuç: Çalışmamızda kronik hepatit C tanılı hastalarda güncel antiviral tedaviler ile nekroinflamasyonun bir göstergesi olan alfa fetoprotein değerlerinde gerileme olduğu saptanmış ve direkt etkili antiviral ile tedavi sonrası erken dönemde fibroziste anlamlı iyileşme olduğu görülmüştür.

Background/Aims: Proton pump inhibitors have been reported to exert anti-inflammatory and antioxidant effects independent of gastric acid suppression; however, their role in inflammatory bowel disease remains unclear. The current study investigated whether rabeprazole modulates oxidative stress–related and inflammatory pathways in an acetic acid–induced colonic injury (AAIC) and compared these effects with those of prednisolone. Materials and Methods: Forty male Wistar albino rats were randomly assigned to 5 groups (n = 8) using a computer-generated sequence. To ensure unbiased results, the control and AAIC groups received sham gavage of 1 mL of 0.9% NaCl on the same schedule as the treatment groups. Colonic injury was induced by transrectal administration of 3% acetic acid. Rabeprazole (20 mg/kg/day) and/ or prednisolone (2 mg/kg/day) were administered orally for 10 days. Macroscopic and histopathological evaluations were performed. Immunohistochemical expression of 8-hydroxy-2′-deoxyguanosine (8-OHdG), transforming growth factor-β (TGF-β), tumor necrosis factor-α (TNF-α), and nuclear factor-κB (NF-κB) was assessed. Serum malondialdehyde (MDA), glutathione, superoxide dismutase (SOD), and catalase (CAT) levels were measured. Results: Rabeprazole significantly attenuated histopathological damage and inflammatory cell infiltration compared with the AAIC group. Expression of 8-OHdG, TGF-β, TNF-α, and NF-κB was reduced, accompanied by decreased MDA levels and increased SOD and CAT activities. These effects overlapped with those of prednisolone. Combined administration did not provide additional benefit and was associated with reduced protective responses compared with either agent alone. Conclusion: Rabeprazole modulates oxidative stress and inflammatory pathways and alleviates tissue injury in experimental colonic injury; however, its effects are not additive with those of prednisolone. Further studies are warranted to clarify the underlying mechanisms. Cite this article as: .zbek A, Yıldız M, Altınkaya E, Doğan HO, .zkaraca M, Ataseven H. Modulation of oxidative stress and nuclear factor-κB–associated inflammatory signaling by rabeprazole in acetic acid–induced colonic injury. Turk J Gastroenterol. Published online May 20, 2025. doi: 10.5152/tjg.2026.26033.

Background/Objectives: Autoimmune liver diseases (AILDs), including autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis, may include treatment-resistant cases and therefore require new therapeutic strategies. This in silico study evaluated proton pump inhibitors (PPIs) across three pathophysiologically complementary inflammatory targets relevant to hepatic immune injury: TLR4/MD-2, representing upstream innate immune sensing; NLRP3, representing inflammasome-mediated inflammatory amplification; and C5aR1, representing complement-dependent leukocyte recruitment. Methods: The binding profiles of four PPIs (rabeprazole, lansoprazole, omeprazole, and pantoprazole) were analyzed by molecular docking against TLR4/MD-2 (3FXI), NLRP3 (7VTP and 7PZC), and C5aR1 (6C1R and 5O9H). TAK-242, MCC950, and avacopan were included as target-associated reference ligands solely to provide structural and protocol-specific context. Their docking scores were not used as benchmarks of relative binding affinity, inhibitory potency, or pharmacological efficacy. MM-GBSA binding free energy calculations for the best score in all proteins were performed. Molecular docking and molecular dynamics analyses indicated stable interactions for the best docking score. Results: PPIs showed variable but potentially meaningful docking affinities across the evaluated targets. Rabeprazole produced favorable docking scores within the investigated TLR4/MD-2 (−7.85 kcal/mol) and inactive NLRP3 (−9.10 kcal/mol) binding sites under the present docking protocol. The reference ligands TAK-242 and MCC950 were included only to provide structural and protocol-specific context, and their docking scores were not interpreted as measures of relative pharmacological potency. Among the PPIs, lansoprazole showed the most favorable docking score for the C5aR1 allosteric site (−6.93 kcal/mol). Interaction analyses suggested favorable hydrophobic contacts and substantial spatial occupancy within the investigated binding pockets; however, cross-target docking compatibility may partly reflect nonspecific hydrophobic accommodation rather than genuine polypharmacology, and whether these predicted interactions produce target-specific functional effects requires experimental validation. MM-GBSA analysis supported the predicted stability of the rabeprazole–NLRP3 (7PZC) complex (ΔG_bind = −56.97 kcal/mol). Conclusions: These findings prioritize rabeprazole and lansoprazole as PPI scaffolds showing favorable predicted interactions across several inflammation-related target structures within the applied computational framework. These results are hypothesis-generating and do not establish target inhibition, target engagement, or therapeutic efficacy. The results are hypothesis-generating and warrant experimental studies to determine whether these predicted interactions translate into target engagement or modulation of inflammatory signaling in AILDs.