The pathogenesis of inflammatory bowel diseases (IBD) is critically influenced by the intestinal barrier integrity disruption, characterized by widened intercellular junctions, microerosions, and increased permeability, which impacts disease course, relapse risk, and regeneration. Gut microbiota, dietary habits, and the gut–brain axis modulate barrier function and extraintestinal manifestations. Novel biomarkers and technologies (confocal laser endomicroscopy, 3D imaging, and artificial intelligence) enable in vivo cellular-level assessment, paving the way for precision medicine and targeted biological interventions. Further studies are required to elucidate causal mechanisms and validate new therapeutic strategies.

Introduction: Neuroendocrine tumors of the pancreas account for 2–5% of all pancreatic neoplasms. Histopathologically, they can be well-differentiated or poorly differentiated, and are graded into three categories based on mitotic index and Ki-67 proliferation rate. These grades significantly influence the prognosis and future therapeutic decisions. Endoscopic ultrasound (EUS) with fine-needle aspiration biopsy has long been pivotal in the diagnosis of pancreatic neuroendocrine tumors. More recently, EUS-guided radiofrequency ablation (EUS-RFA) has emerged as a new therapeutic modality in this patient population.
Methods: This study presents data from patients undergoing EUS-guided radiofrequency ablation at the National Institute of Oncology in the year of 2024. We discuss the indications of the procedure and highlight criteria for patient selection. All ablations were performed using a 19-gauge, 10 mm cooled tip RFA needle applying 50 W of energy for 15 seconds per ablation through 1–3 needle passes, utilizing a Taewoong Viva Combo RF generator.
Results: During the study period, a total of 17 patients were diagnosed with pan-NET in our unit, of whom 5 were deemed suitable for EUS-RFA treatment. Key selection criteria included tumor location and size (mean diameter: 14.25 mm; range 9–17 mm), biological behavior (G1), absence of contraindications, and patient-specific factors (mean age: 63.5 years; range 55–74 years). No early complications were observed post-procedure. One patient presented with abdominal pain 120 hours after ablation, which resolved rapidly with intravenous antibiotics and was attributed to needle tract irritation. Oncological follow-up imaging (abdominal CT; 3, 6, and 12 months post-ablation) showed complete or partial (>50%) tumor regression in three patients.
Conclusions: Preliminary experience suggests that EUS-RFA is a safe and effective therapeutic option for pan-NETs. It can be applied with curative intent in well-differentiated tumors smaller than 20 mm, and palliatively in patients with high surgical risk, offering a minimally invasive treatment alternative with a low complication rate.

Background: Perianal fistulas of Crohn’s disease (CD) create a significant burden on patient lives. However, the efficacy and safety of adipose-derived mesenchymal stem cell treatment are contradicting, and real-world evidence is lacking. We aimed to examine the usability of darvadstrocel therapy in mana­ging perianal CD.
Methods: In this retrospective multicenter study, CD patients with perianal fistulas were enrolled and followed. The primary outcome was perianal clinical remission (all treated fistulas have closed) at weeks 26 and 52, while the secondary outcomes were clinical response rates (≥1 fistulas have closed), perianal activity (PDAI), patient satisfaction, and adverse events. The data was recorded at the baseline and weeks 12, 26, and 52. Prediction of primary outcomes was performed by logistic regression.
Results: Overall, based on the data of 223 patients (male/female ratio: 0.48), perianal clinical remission was achieved in 78.2% and 62.3% until week 26 and 52, whereas baseline PDAI score (OR: 0.75), number of fistulas (OR: 0.28), and the number of weeks after preparation for surgery (OR: 0.98) were associated with treatment failure. The clinical response rates were 84.8% and 79.8% at week 26 and 52. Moreover, the improvement of subjective perianal symptoms was achieved in 77.8% and 78.4% of the patients, respectively. Adverse events occurred in 13.5% of the patients, with perianal abscesses and proctalgia reported the most.
Conclusion: Effectiveness data are higher than the clinical trials. The safety profile is reassuring, and patients’ satisfaction is high. Appropriate patient selection, fistula preparation, and expertise may help to achieve treatment success.