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Gastrointestinal Disease
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Submitted by: Duaa Elhag
Type 1 diabetes (T1D) is an auto-immune disorder characterized by a complex interaction between the host immune system and various environmental factors in genetically susceptible individuals. Genome-wide association studies (GWAS) identified different T1D risk and protection alleles, however, little is known about the environmental factors that can be linked to these alleles. Recent evidence indicated that, among those environmental factors, dysbiosis (imbalance) in the gut microbiota may play a role in the pathogenesis of T1D, affecting the integrity of the gut and leading to systemic inflammation and auto-destruction of the pancreatic β cells.
Submitted by: Young Park
Helminthiasis is an expensive management problem in sheep and goat industry, because the gastrointestinal parasites develop resistance against all anthelmintic chemical products which are discovered and produced by the pharmaceutical industry. The use of natural tannin containing forages such as Sericea Lespedeza is highly promising. Helminthiasis is the invasion of internal parasites into the GI tract of domestic animals, even in humans, causing serious deadly consequences. Sheep and goats are more seriously afflicted than other farm animals. Helminthiasis results in high mortality rate, and poor growth rates, low reproductive performances and low quality products produced from infected animals, which increase high production costs. Anthelmintic drug has been used as the most common control method against gastrointestinal nematodes (GIN) infection. Overuse and misuse of these drugs caused significant GIN resistance against the drugs, especially in sheep and goat production.  
Submitted by: Tsvetelina Velikova
Inflammatory bowel diseases (IBDs) are chronic inflammatory disorders of the gastrointestinal tract whose etiology is unknown. Pathogenesis of IBD is attributed to the complex interaction of genetic susceptibility, environmental factors (such as smoking, diet, and infections), and the gut microbiota. This results in an uncontrolled immune response leading to mucosal damage. IBDs are characterized by a relapsing and remitting course and require lifelong treatment. Therapy aims to induce remission, maintain remission, and avoid disease progression. Fecal markers are a heterogeneous group of biological substances formed by the inflamed intestinal mucosa or pass through it and enter the intestinal lumen and feces, where they can be measured. The advantage of fecal markers of inflammation over blood markers is that they provide information about the inflammatory process’s location, particularly the location along the gastrointestinal tract. Still, they also are not specific to IBD.
Submitted by: Kuang Tsu Yang
Non-vitamin K antagonist oral anticoagulants (NOACs) are more commonly used to prevent atrial fibrillation (AF) patients from thromboembolic events than vitamin K antagonists (VKAs). However, the gastrointestinal bleeding (GIB) risk in the Asian AF patients associated with NOACs in comparison with VKAs remained unaddressed.
Submitted by: Ji Youn Yoo
Dynamic interactions between gut microbiota and a host’s innate and adaptive immune systems play key roles in maintaining intestinal homeostasis and inhibiting inflammation. The gut microbiota metabolizes proteins and complex carbohydrates, synthesize vitamins, and produce an enormous number of metabolic products that can mediate cross-talk between gut epithelial and immune cells. As a defense mechanism, gut epithelial cells produce a mucosal barrier to segregate microbiota from host immune cells and reduce intestinal permeability. An impaired interaction between gut microbiota and the mucosal immune system can lead to an increased abundance of potentially pathogenic gram-negative bacteria and their associated metabolic changes, disrupting the epithelial barrier and increasing susceptibility to infections. Gut dysbiosis, or negative alterations in gut microbial composition, can also dysregulate immune responses, causing inflammation, oxidative stress, and insulin resistance. Over time, chronic dysbiosis and the translocation of bacteria and their metabolic products across the mucosal barrier may increase prevalence of type 2 diabetes, cardiovascular disease, inflammatory bowel disease, autoimmune disease, and a variety of cancers. 
Submitted by: Sonia Sánchez-Campos
Gut microbiota is involved in the maintenance of physiological homeostasis, thus the alteration of its composition and functionality, called dysbiosis, has been associated with many pathologies, and could also be linked with the progressive degenerative process in aging. Specific gut microbiota taxa could be associated to the development of inflammation underlying aging, but also it has been identified some beneficial profiles related to a healthy status in the elderly. Thus, gut microbiota emerges as a therapeutic target with a double impact in the elderly, counteracting both aging itself and associated diseases. 
Submitted by: Angelica Petrillo
Gastrointestinal (GI) tumors account for a quarter of all the cancer burden and a third of the global cancer-related mortality. Among them, some cancers retain a dismal prognosis; therefore, newer and innovative therapies are urgently needed in priority disease areas of high-unmet medical need. In this context, HER2 could be a relevant prognostic and predictive biomarker acting as a target for specific drugs. However, if the role of HER2 has been object of investigation for several years in gastric cancer, it is not well established in other GI malignancies. The aim of this narrative review was to portray the current landscape of the potential role of HER2 as a predictive biomarker for GI tumors beyond gastric cancer. In colon cancer, the benefit from anti-HER2 therapies is less clear than in gastric neoplasms for the lack of controlled studies. Pancreatic, biliary tract adenocarcinomas and hepatocarcinoma may derive a less clear clinical benefit by using anti-HER2 agents in HER2 positive tumors. Overall, the results are promising and seem to suggest that the integration of multiple modalities of therapies can optimize the cancer care. However, further prospective trials are needed to validate the use of personalized targeted therapies in this field.
Submitted by: Marcin Włodarczyk
Irritable bowel syndrome (IBS) is a functional heterogenous disease with a multifactorial pathogenesis. It is characterized by abdominal pain, discomfort, and alteration in gut motility. The occurrence of similar symptoms was observed in patients in clinical remission of inflammatory bowel diseases (IBD) that is Crohn’s disease (CD) and ulcerative colitis (UC), which pathogenesis is also not fully understood. IBS and IBD seem to be quite separate entities, but still, they do share some similarities. First, their symptoms overlap to some extent: They both may include abdominal pain, bloating, diarrhea, and watery stools, which can make it difficult to distinguish between these disorders. However, pain in IBS results from tension in the intestinal wall and can be relieved by defecation, while in IBD, it is more constant, and it may result from inflammatory cytokines impacting on afferent nerve firing. Moreover, in the case of IBD, there are so-called “alarm symptoms”, such as fever, weight and appetite loss, bloody stool, vomiting, or anemia, which are absent in IBS. Second, despite the fact that extracolonic symptoms may appear in the course of both diseases, in IBS, they are more general and include, for example, nausea or dyspepsia, while they seem to be more serious and disabling in IBD—they may affect joints, eyes, skin or liver. Furthermore, the epidemiology is slightly different—IBS may occur at any age and is seen more often in women, while IBD appear mainly in young adults between 15 and 30 years old and remain gender-neutral—as mentioned earlier. Phenotypic differences are also clear—in IBS, visibly normal mucosa is observed. On the contrary, in IBD, inflammation, ulcerations, fibrosis, and structuring can be seen during colonoscopy with the naked eye. The pathogenesis of IBS and IBD is not completely understood; however, it is believed to be multifactorial. In both cases, it may include not only environmental and psychological factors (such as stress, depression, negative life events) but also genetic factors, enduring submucosal inflammation, and other changes involving the gut–brain axis and alteration in gut microbiota.
Submitted by: Yang Zhang
More emerging studies are exploring immunotherapy for solid cancers, including colorectal cancer. Besides, checkpoint blockade immunotherapy and chimeric antigen receptor (CAR) -based immune cell therapy have being examined in clinical trials for colorectal cancer patients. However, immunosuppression that leads to the blockage of normal immunosurveillance often leads to cancer development and relapse.
Submitted by: Sundar Khadka
There are five international hepatitis B virus (HBV) treatment guidelines: AASLD, APASL, EASL, NICE, and WHO. All guidelines recommend treatment based on levels of HBV DNA, alanine aminotransferase (ALT), age, and liver fibrosis. Among five guidelines, only the WHO guideline recommends the aspartate aminotransferase-to-platelet (APRI) to evaluate liver fibrosis as an alternative to elastography.
Melatonin (N-acetyl-5-methoxytryptamine) is an indoleamine with beneficial effects in a broad number of tumors, including the primary liver cancers hepatocarcinoma (HCC) and cholangiocarcinoma (CCA). Among them, melatonin has shown to modulate different cancer-associated processes and enhance drug efficacy against HCC and CCA. Therefore, melatonin has a potential role in improving the current therapeutic landscape in these liver tumors.
Submitted by: Agnieszka Zawada
More research has recently focused on the role of the gut microbiota in the development or course of numerous diseases, including non-communicable diseases. As obesity remains prevalent, the question arises as to what microbial changes are associated with increased obesity prevalence and what kind of prevention and treatment approaches it could provide.
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