{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T18:09:27Z","timestamp":1791137367315,"version":"4.1.0"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T00:00:00Z","timestamp":1636675200000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Nonalcoholic steatohepatitis (NASH) is a leading cause of chronic liver disease worldwide with limited treatment options. Duodenal mucosal resurfacing (DMR) has been associated with improvement in glycaemic parameters and liver function tests (LFTs) in type 2 diabetes. This study aimed to assess the effect of DMR in patients with NASH.<\/jats:p><jats:p>\n          Patients and methods\u2002This was a single-center, open-label pilot study. Patients with definite, biopsy-proven NASH (nonalcoholic fatty liver disease activity score [NAS] \u2265\u200a4) underwent a single DMR procedure followed by a 2-week postprocedural diet, without lifestyle intervention. The primary outcome was either resolution of NASH with no worsening of fibrosis or improvement in fibrosis (\u2265\u200a1 stage) with no worsening of NASH at 12 months. Secondary outcomes were changes in key histological parameters of NASH, surrogate markers of fibrosis, LFTs, and metabolic factors at 12 months.<\/jats:p><jats:p>\n          Results\u2002From 2017 to 2019, 14 patients underwent successful DMR, of whom 11 were included in the analysis. After 12 months, no resolution of NASH was observed, while three patients (27\u200a%) had marginal improvement in fibrosis with no worsening of NASH. Serious adverse events related to the procedure were reported in two patients out of 14 (14\u200a%). Neither weight loss nor improvement in NAS score, or in the other secondary outcomes, were observed at 12 months.<\/jats:p><jats:p>\n          Conclusions\u2002In this small and heterogenous study population, we found that DMR, in the absence of lifestyle intervention, did not induce NASH resolution and marginally improved liver fibrosis at 12 months. <\/jats:p>","DOI":"10.1055\/a-1550-7668","type":"journal-article","created":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T23:51:01Z","timestamp":1636761061000},"page":"E1792-E1800","source":"Crossref","is-referenced-by-count":24,"title":["Endoscopic duodenal mucosal resurfacing for nonalcoholic steatohepatitis (NASH): a pilot study"],"prefix":"10.1055","volume":"09","author":[{"given":"Alia","family":"Hadefi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"},{"name":"Laboratory of Experimental Gastroenterology, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurine","family":"Verset","sequence":"additional","affiliation":[{"name":"Department of Pathology, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles (ULB), Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Pezzullo","sequence":"additional","affiliation":[{"name":"Department of Radiology. CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Rosewick","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Gastroenterology, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Degr\u00e9","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"},{"name":"Laboratory of Experimental Gastroenterology, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Gustot","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"},{"name":"Laboratory of Experimental Gastroenterology, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"},{"name":"Laboratory of Experimental Gastroenterology, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Devi\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"},{"name":"Laboratory of Experimental Gastroenterology, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Tr\u00e9po","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"},{"name":"Laboratory of Experimental Gastroenterology, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,11,12]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.jhep.2019.06.021","article-title":"The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis","volume":"71","author":"Z M Younossi","year":"2019","journal-title":"J Hepatol"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-020-00381-6","article-title":"Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention","author":"D Q Huang","year":"2020","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1016\/j.cgh.2017.05.029","article-title":"Long-term outcomes of nonalcoholic fatty liver disease: from nonalcoholic steatohepatitis to nonalcoholic steatofibrosis","volume":"15","author":"Z M Younossi","year":"2017","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jhep.2020.03.039","article-title":"A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement","volume":"73","author":"M Eslam","year":"2020","journal-title":"J Hepatol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.2337\/dci18-0033","article-title":"Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","volume":"41","author":"M J Davies","year":"2018","journal-title":"Diabetes Care"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1053\/j.gastro.2015.04.005","article-title":"Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis","volume":"149","author":"E Vilar-Gomez","year":"2015","journal-title":"Gastroenterology"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1001\/jamainternmed.2019.2248","article-title":"Association of weight loss interventions with changes in biomarkers of nonalcoholic fatty liver disease: a systematic review and meta-analysis","volume":"179","author":"D A Koutoukidis","year":"2019","journal-title":"JAMA Intern Med"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.jhep.2017.05.016","article-title":"Treatment of NAFLD with diet, physical activity and exercise","volume":"67","author":"M Romero-G\u00f3mez","year":"2017","journal-title":"J Hepatol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1053\/j.gastro.2020.06.006","article-title":"Bariatric surgery provides long-term resolution of nonalcoholic steatohepatitis and regression of fibrosis","volume":"159","author":"G Lassailly","year":"2020","journal-title":"Gastroenterology"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.2337\/dc16-0383","article-title":"Endoscopic duodenal mucosal resurfacing for the treatment of type 2 diabetes: 6-month interim analysis from the first-in-human proof-of-concept study","volume":"39","author":"H Rajagopalan","year":"2016","journal-title":"Diabetes Care"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1016\/j.jhep.2019.07.026","article-title":"Endoscopic bariatric and metabolic therapies for non-alcoholic fatty liver disease","volume":"71","author":"BK Abu Dayyeh","year":"2019","journal-title":"J Hepatol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1136\/gutjnl-2019-318349","article-title":"Endoscopic duodenal mucosal resurfacing for the treatment of type 2 diabetes mellitus: One year results from the first international, open-label, prospective, multicentre study","volume":"69","author":"A CG Van Baar","year":"2020","journal-title":"Gut"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.jhepr.2019.10.006","article-title":"Endoscopic duodenal mucosal resurfacing improves glycaemic and hepatic indices in type 2 diabetes: 6-month multicentre results","volume":"1","author":"A CG van Baar","year":"2019","journal-title":"JHEP Reports"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.gie.2019.03.024","article-title":"Duodenal mucosal resurfacing: proof-of-concept, procedural development, and initial implementation in the clinical setting","volume":"90","author":"R J Haidry","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/j.jhep.2015.11.004","article-title":"EASL\u2013EASD\u2013EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease","volume":"64","author":"European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO)","year":"2016","journal-title":"J Hepatol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1053\/j.gastro.2018.12.036","article-title":"Noninvasive Assessment of liver disease in patients with nonalcoholic fatty liver disease","volume":"156","author":"L Castera","year":"2019","journal-title":"Gastroenterology"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jhep.2016.04.021","article-title":"Sitagliptin vs. placebo for non-alcoholic fatty liver disease: A randomized controlled trial.","volume":"65","author":"J Cui","year":"2016","journal-title":"J Hepatol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.2337\/diacare.22.9.1462","article-title":"Insulin sensitivity indices obtained from oral glucose tolerance testing: Comparison with the euglycemic insulin clamp","volume":"22","author":"M Matsuda","year":"1999","journal-title":"Diabetes Care"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-323608","article-title":"Safety and efficacy of hydrothermal duodenal mucosal resurfacing in patients with type 2 diabetes: the randomised, double-blind, sham-controlled, multicentre REVITA-2 feasibility trial","author":"G Mingrone","year":"2021","journal-title":"Gut"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.gie.2020.12.021","article-title":"Duodenal mucosal resurfacing combined with glucagon-like peptide-1 receptor agonism to discontinue insulin in type 2 diabetes: a feasibility study","volume":"94","author":"A CG van Baar","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1053\/j.gastro.2019.11.312","article-title":"MAFLD: A consensus-driven proposed nomenclature for metabolic associated fatty liver disease","volume":"158","author":"M Eslam","year":"2020","journal-title":"Gastroenterology"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"N Chalasani","year":"2018","journal-title":"Hepatology"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1056\/NEJMoa1212914","article-title":"Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes","volume":"369","author":"A HEAD Research Group Look","year":"2013","journal-title":"N Engl J Med"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.jhep.2020.04.030","article-title":"Standardisation of diet and exercise in clinical trials of NAFLD-NASH: Recommendations from the Liver Forum","volume":"73","author":"O Glass","year":"2020","journal-title":"J Hepatol"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.cgh.2018.06.011","article-title":"Rates of and factors associated with placebo response in trials of pharmacotherapies for nonalcoholic steatohepatitis: systematic review and meta-analysis","volume":"17","author":"M AT Han","year":"2019","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.2337\/dc16-0383","article-title":"Endoscopic duodenal mucosal resurfacing for the treatment of type 2 diabetes: 6-month interim analysis from the first-in-human proof-of-concept study","volume":"39","author":"H Rajagopalan","year":"2016","journal-title":"Diabetes Care"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1550-7668.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T23:55:28Z","timestamp":1636761328000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1550-7668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":26,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,10,25]]},"published-print":{"date-parts":[[2021,11]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1550-7668","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}