Daily Recap, Sunday, October 3

Welcome to UEG Week Virtual 2021! 

Welcome to UEG Week Virtual 2021 and to the first of three Daily Recaps that will take place throughout the congress. These bite-size recaps will showcase the key scientific sessions from the day, as well as features with UEG Week awardees and other highlights from in and around the congress!

The UEG Week Premiere

The congress programme kicked-off yesterday with the UEG Week Premiere. Hosted in the Virtual Studio by Jonathan McCrea, the session explored the best that is due to come during the congress with Axel Dignass (UEG President), Helena Cortez-Pinto (UEG Vice President) and Herbert Tilg (Chair of the UEG Scientific Committee). The session was opened in exciting fashion, with a brilliant musical display from saxophonist Monika Ciernia.

“It’s been a very challenging year, but again I really believe we have a great programme in store that people will enjoy”, commented Hebert Tilg.

Looking to the future, Axel Dignass said “I am very happy to welcome colleagues and friends to this year’s UEG Week. I am proud to inform you that 8,500 colleagues from 105 countries in all continents from around the world have registered and will follow live from their homes, their hospitals, and their research labs in the coming three days. The scientific programme is packed with informative highlights, new studies, multidisciplinary teaching and many interactive features covering a wide range of topics. We have worked hard to provide you with great science, education and entertainment, but also exciting networking opportunities in the field of digestive health. I invite you to engage, to raise questions, to challenge the faculty, and to interact with the top experts in our field.”

The session welcomed an address from António Guterres, Secretary-General of the United Nations. António Guterres discussed unhealthy food consumption and malnutrition. “I am pleased to greet participants of UEG Week. There is a saying that ‘we are what we eat’. That belief lies behind ‘ingest the best’, the topic and slogan behind this gathering.”

Dr Hans Henri P. Kluge, Regional Director for the WHO Europe, also welcomed guests to the congress, discussing the importance of work in the digestive health arena with a particular focus on digestive oncology and hepatitis. “I wish you a week of innovation and learning”, he said.

The Opening Session

Today’s Opening Session featured further words of welcome from Axel Dignass, Helena Cortez-Pinto and Hebert Tilg, before leading experts presented exciting scientific updates on non-alcoholic fatty liver disease (NAFLD), endoscopic strategies and coeliac disease.

The first presentation of the congress saw Elisabetta Bugianesi discuss the latest developments in NAFLD, including the disease’s heterogeneity, prospective drugs in the pipeline to treat non-alcoholic steatohepatitis (NASH) and recent updates and trials in the field. “Since NAFLD is present in about a quarter of the world’s population, it is a very important talk”, pointed out Helena Cortez-Pinto.

The next lecture, delivered by Jacques Deviere, explored endoscopic strategies targeting metabolic disorders. The rising levels of obesity, diabetes and NAFLD/NASH have all increased the relevance and opportunities in metabolic endoscopy, explained Jacques Deviere, who gave an overview of some of the most important recent trials in the area. “Current endoscopic strategies for metabolic diseases mainly tackle weight-less, and it works for mid-term”, he said. “The direct targeting of insulin resistance through duodenal and jejunal intervention, like bypass and resurfacing, seems promising, but is still investigational.”

The final presentation looked at the pathophysiology and therapy in coeliac disease and was led by Nadine Cerf-Bensussan and Raanan Shamir. The discussion explored the current challenges in coeliac disease, including in the initial diagnosis of the disease, the rising prevalence in a younger population – which is perhaps through increased awareness of the disease – and the lack of adherence to a gluten free diet, which is the only treatment proven to be effective and safe for patients.

Best Abstract Prize: Endoscopic pyloromyotomy effective in refratory gastroparesis 

Gastric per-oral endoscopic myotomy (G-POEM) significantly improves symptoms in patients with severe and refractory gastroparesis, according to the results of a randomised, sham-controlled study conducted in Slovakia and the Czech Republic. The study enrolled 41 adults with a Gastroparesis Cardinal Symptom Index (GCSI) total score >2.3 and scintigraphy-confirmed delayed gastric emptying (GES >60%/2 hours or 10%/4 hours).

Of the 39 randomised patients (20 G-POEM, 19 sham) with successful procedures who completed the 6-month follow-up, 14 in the G-POEM group and three in the sham group had experienced a ≥50% reduction in GCSI from baseline, which was defined as treatment success.

After G-POEM, the mean GCSI score improved significantly from 3.48 ± 0.58 at baseline to 1.18 ± 0.87 at 6 months compared with an improvement from 3.23 ± 0.65 to 2.59 ± 1.05 after the sham procedure. Median gastric retention at 4 hours, which was assessed after 3 months of follow-up, had decreased from 21.9% to 6.7% after G-POEM, but had not changed significantly after the sham procedure: from 26.3% at baseline to 20.5% after the procedure (p=0.376). The difference in gastric emptying improvement between G-POEM and the sham procedure was not significant.

Eleven sham-treated patients subsequently received G-POEM and completed 6 months of follow-up. Of these, nine (82%; 95% CI: 52–95) achieved treatment success at 6 months. All procedures were well tolerated with no severe perioperative or early postoperative adverse events reported. One patient in the G-POEM group developed severe dumping syndrome that required drug treatment.

The results were presented by Rastislav Hustak, who is one of this year’s Best Abstract Awardees.

Best Abstract Prize: Inflammatory plasma protein profiles may help predict response to treatment in Crohn's disease

Profiling inflammatory proteins in the plasma at diagnosis could help predict clinical disease course and response to treatment in patients with Crohn’s disease (CD). Researchers found that inflammatory plasma protein profiles can discriminate three CD patient clusters that show differences in clinical parameters, immune cell type frequency, and response to treatment.

The multinational research team undertook immune profiling of plasma from 95 treatment-naïve pediatric patients with inflammatory bowel disease (IBD) (62 patients with CD, 17 with ulcerative colitis [UC]), 13 with suspected IBD, and three with IBD unclassified [IBD-U]) and 30 healthy controls, evaluating multiple surface and intracellular markers on memory CD4+ T helper (Th) cells and plasma immune proteins. Peripheral blood was obtained at diagnosis and after 10–12 weeks of induction therapy in the IBD patients.

Thirty-six plasma proteins discriminated the IBD patients from the healthy controls. CD and UC patients displayed different plasma protein profiles at diagnosis, with interferon gamma (IFN-μ) significantly associated with CD, while interleukin-17A (IL-17A) was significantly more abundant in UC/IBD-U. Hierarchical clustering of these profiles discriminated two clusters of UC patients at diagnosis, defined by a high or low inflammatory profile, with significantly different disease scores and erythrocyte sedimentation rates.

Three clusters of CD patients were defined at the time of diagnosis: one cluster (CD-1) with high levels of inflammatory proteins, and a higher abundance of proteins associated with neutrophil function and IFN-μ signalling, one cluster (CD-2) with intermediate levels of inflammatory proteins and a marked increase in the percentage of activated (HLA-DR+) memory CD4+ Th cells, and one cluster (CD-3) with lower levels of inflammatory proteins, lower clinical disease activity, lower C-reactive protein (CRP), and higher blood albumin levels (i.e. less severe disease). The three CD clusters responded differently to therapy, with CD-1 patients having more modulated proteins and a greater fold change (correction) after 10–12 weeks of therapy.

The group plans to undertake further analyses to relate these finding to long-term clinical outcomes, with a view to providing greater insight into immune dysregulation in IBD. Maud Heredia presented the findings, with the research receiving a Best Abstract Prize.

Scientific Highlights: Gas-related intestinal symptoms affect nearly all adults on a daily basis, new research finds 

Gas-related symptoms are associated with poorer quality of life, and higher stress, anxiety, and depression, according to a survey being presented today at the congress. Breaking wind is the most frequently reported gas-related issue, affecting eight out of 10 adults in the general population.

Other gas-related reported symptoms included stomach rumbling, which affected 60.5% of respondents, closely followed by belching (58%), and bad breath (48.1%). Trapped wind (47.2%), abdominal distension/swollen tummy (39.6%) and bloating/abdominal pressure (38.5%) also had a noticeable impact, while only 11.1% of respondents reported having no gas symptoms. On average survey participants had been affected by three different gas symptoms within the previous 24-hour period.

The findings from the study, which surveyed nearly 6,000 people across the United States, United Kingdom, and Mexico, were based on a representative sample of people aged 18 to 99 years asked to fill out validated Intestinal Gas Questionnaires (IGQs) via the internet, to measure the presence and severity of 7 gas-related symptoms in the last 24 hours.

Younger people aged 18 to 34 and 35 to 49 had the highest overall burden of gas-related symptoms, with IGQ total scores of 24 and 22.6 respectively, compared to 12.7 in people aged 50 to 64 and 8.6 in the over 65s.

Lead author, Professor Olafur Palsson from the University of North Carolina Department of Medicine, said: “I think the most remarkable and surprising finding in our study is that almost all adults in the general population experience some daily gas-related symptoms. This is important given the data also clearly reveals that these symptoms affect people’s general wellbeing. Having a high amount of these common intestinal symptoms is associated with higher levels of depression, anxiety and stress, as well as impaired general quality of life.”

Lifetime Achievement Awardee 2021: Michael Farthing

Each year UEG awards an outstanding individual for their fundamental contributions to gastroenterology and to UEG as a society. Awardees have helped to improve the lives of people with gastrointestinal diseases and their contributions, leadership and impact have been of importance to the UEG community.

This year’s Lifetime Achievement Awardee is Michael Farthing, who was presented the prize during today’s closing session; ‘The UEG Week Tonight Show’.

Michael has made an outstanding and lasting contribution to gastroenterology, academia and professional societies including UEG. He has had a career-long commitment to international medicine, including in low-income geographical locations. This began with studying in India as a medical student and further developed with an academic interest in gastrointestinal infectious disease. Across the globe he has inspired a generation of researchers to pursue careers in clinical and basic science studies in infectious GI disease including HIV, parasitology, and tropical enteropathy.

Michael has been on the editorial boards of numerous journals and has a legacy from his senior leadership roles in universities across the United Kingdom.

His long-lasting engagement with European societies spans from positions as President of the EAGEN, British Society of Gastroenterology and Vice President of the World Gastroenterology Organisation. Within UEG, as Chair of the Scientific Committee he fostered the development of a science- and education-based congress program that was strictly focused on quality. As Chair of the Future Trends Committee he was the driving force behind the ‘White book of Digestive Health’ and ‘Healthcare in Europe 2040 – Scenarios and implications for digestive and liver diseases’. Under his (vice) presidency from 2012-2015 UEG further professionalised its organisation to be prepared for future challenges and to secure a prosperous next generation.

Michael explained, “It is a very special honour indeed to receive a Lifetime Achievement Award, particularly from an organisation like UEG which many of us have watched develop so successfully over the last 30-40 years and for which I have the deepest of respect.”

Best Abstract Prizes

The very best and most promising science from UEG Week is recognised via the Best Abstract Prizes. Among all the abstracts accepted for presentation at the congress, the three highest scoring abstracts per main abstract topic are chosen, with recognition awarded to the presenting author.

Congratulations to this year’s awardees!

Khellaf Amalou, Algeria

Sergey Bakcharev, Russia

Herbert L. Bonkovsky, United States

Michela Campolo, Italy

Maxime Coriou, Switzerland

Pedro Currais, Portugal

Ottavia De Simoni, Italy

Iris Dotan, Israel

Hadar Edelman-Klapper, Israel

Ciara M Fallon, Ireland

Salma Fourati, France

Alessandro Fugazza, Italy

Paraskevas Gkolfakis, Belgium

Sylke Haal, Netherlands

Nora D Hallensleben, Netherlands

Lukas Hartl, Austria

Maud Heredia, Netherlands

Rastislav Hustak, Czech Republic

Julio Iglesias-Garcia, Spain

Shin Kato, Japan

Sanshiro Kobayashi, Japan

James O Lindsay, United Kingdom

Alfredo J Lucendo, Spain

Giovanni Marasco, Italy

Isabel Martin, United Kingdom

Olga Perez Nyssen, Spain

Melissa Schmidt, United Kingdom

Markus Schneider, Germany

Weixi Shan, China

Christian Shaw, United Kingdom

Kevin Talboom, Netherlands

Fabienne Teysseire, Switzerland

Willemieke G van Braak, Netherlands

Raul Velamazan Sandalinas, Spain

Sean Walsh, United Kingdom

Xiaoyong Wang, China

UEG Week Treasure Hunt!

As you navigate your way through UEG Week Virtual, you will collect points for exploring as many aspects of the virtual congress platform as possible.The 10 top-scoring competitors are visible on our leaderboard below and the delegate with the top score will win a free UEG Week 2022 registration.

The competition is active until Tuesday, October 5, 17:00 CEST, so make sure to collect those points and go for the gold!

Don’t forget to search for our mascot, Doc Anus throughout the platform and click on his icon for extra points!

Sunday Highlights Gallery

That's all for today's recap! Tune in tomorrow for further bitesized highlights from the scientific and wider congress programme.