Raghavendra

[Yan Leyfman, MD @YLeyfman]

What happens to the gut when we profoundly eliminate the B-cell compartment?

CAR-T therapy has transformed multiple myeloma, but as BCMA-directed therapies expand, we are beginning to see consequences beyond the tumor.

A new study characterizes CAR-T cell-induced enterocolitis (CAR-TEC) after cilta-cel and provides a striking look at what may be happening within the intestinal mucosa.

Using single-cell transcriptomics, flow cytometry, and tissue imaging of intestinal biopsies, investigators compared patients with CAR-TEC, CAR-T–treated patients without enterocolitis, and healthy volunteers.

They found a remarkably disrupted mucosal ecosystem:

-Profound depletion of mucosal B cells and plasma cells

-Expansion of highly cytotoxic CAR-T cells

-Inflammatory remodeling across myeloid, stromal, and glial compartments

-Telocyte-associated stromal niche dysfunction

And importantly, interferon/JAK-STAT–associated reprogramming was detected across stromal, endothelial, and epithelial compartments.

That observation provided a mechanistic rationale for targeting the pathway.

In two patients, treatment with the selective JAK1 inhibitor upadacitinib was associated with clinical, endoscopic, and histologic improvement.

The bigger story is that CAR-TEC may not simply represent “GI toxicity” from CAR-T.

It may represent a multicellular failure of mucosal homeostasis arising from profound B-cell/plasma-cell depletion, persistent immune activation, and remodeling of the intestinal tissue environment.

As B-cell–targeted therapies expand beyond oncology and into autoimmune disease, understanding what happens to the tissues that depend on these immune populations may become increasingly important.

The next frontier of CAR-T safety may be understanding not only what happens to the tumor—but what happens to the immune ecosystems surrounding it.

https://t.co/8ZBtLHGMrl

#CART #MultipleMyeloma #CellTherapy #Immunotherapy #CARTEC #Gastroenterology #TranslationalMedicine #CancerResearch

[Raghavendra @raghuyar]

Honored to attend the 2nd JGES international conference, presenting our work as two oral presentations, meeting old friends and new ones, spending time with my mentors and Japanese experts. So happy to be back for this scientific event! 🇯🇵
#JGESinternational2026#poem#GItwitter

[Raghavendra @raghuyar]

Case of post subtotal cholecystectomy-bile leak-duodenal narrowing due to chronic DU and ongoing inflammation-no response to CRE dilatation-no IHBD & poor duodenal window for EUS RZV.Only scope that reaches papilla-Upper GI without cap-failed cannulation.#ERCPUGIscope #precut #GI

[Keith Siau @drkeithsiau]

Risk of infection after a needle stick injury from a positive patient:

HIV: 1 in 400
Hep C: 1 in 40
Hep B: 1 in 4

(Assuming recipient has no immunity)

[Raghavendra @raghuyar]

Delighted to get accepted for consecutive years
#ESGEDays2026

[Keith Siau @drkeithsiau]

Do you have an abstract in endoscopy to share and fancy a trip to Milan? Then submit it to the best endoscopy conference in Europe! Whether it’s a case report or a original study, all will be considered - don’t miss out and good luck! @ESGE_news

🗳️: https://t.co/hcZvSobSzF

[J. Sebastián P. A. @JSebastianPA]

Three endoscopic features are associated with a lower likelihood of H. pylori infection:
- the scratch sign
- fundic gland polyps
- presence of RAC

#endoscopy #helicobacter

[ESGE @ESGE_news]

📢 The #ESGEDays2026 abstract submission platform is officially open! 📢
Be a part of Europe's leading endoscopy meeting by submitting your best research - we look forward to showcasing it in fantastic Milan!
All the details here:
➡️ 🔗 https://t.co/aTlmGBQnc1

[Raghavendra @raghuyar]

Hope funding resumes.

[Mushtaq Bilal, PhD @MushtaqBilalPhD]

This is bad news. This is very bad news.

The US government has stopped the funding of PubMed, the most comprehensive database of biomedical literature.

Why would you do this? This database it literally a matter of life and death.

[Mariam Naveed, MD, FACG @MN_GIMD]

Thinking about submitting an abstract? Don’t overlook #ESGEDays !

🌍 Present on an international stage
🤝 Meet colleagues worldwide
📈 Grow your network

Talk to your mentors. Polish your data.

Hit submit.

Opportunities like this shape careers.

[Raghavendra @raghuyar]

Papilla with low risk of pancreatitis during ERCP - separate orifices. But, more commonly seen on routine upper gi endoscopy.

#GITwitter #MedTwitter #ERCP #PostERCPpancreatitis #Papillarymorphology

[Raghavendra @raghuyar]

Hmmm....The new modes keep on increasing in ESU features. Sticking to the modes you are well versed is better. WDYT?

[Raghavendra @raghuyar]

Stop this trend. Ghiblification. Its disrespectful. Miyazaki strongly disapproved AI generated art.Try to pick up a pencil and draw. Respect the pains taken by the real artists.#InsultToLife #RespectTheArt #MiyazakiWisdom #StopStealingTheArt #CelebrateTheMa #Ghiblistudio #Ghibli

[Raghavendra @raghuyar]

Love the thing you do. Love will find you.

[Raghavendra @raghuyar]

POP-L post lithotripsy PD clearance.
Sometimes the best instrument is the basic instrument. Balloons burst, basket wires don't align with stone fragment. Foreign body forceps saves the day.

#EHL #Endoscopy #ERCP

[Raghavendra @raghuyar]

@drshalimar @SGPGI @aiims_newdelhi @elhence_anshu Congratulations

[Raghavendra @raghuyar]

@drkeithsiau Nxt evolution

[Sundeep Lakhtakia @DrLakhtakia]

@docdhir

[vinay dhir @docdhir]

The biggest and best EUS extravaganza in this part of the World.. not to be missed