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Topic Review
Cytotoxicity of Thiopurine Drugs in Inflammatory Bowel Disease
As the principal representatives of thiopurines, 6-mercaptopurine (6MP) and its prodrug azathioprine (AZA) are primary immunomodulating agents. They are used for example to manage inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), chronic inflammatory disorders of the gastrointestinal tract. Thiopurines were used to treat CD in the late 1960s and they are currently applied in around 60% of IBD patients.
  • 1.3K
  • 31 Mar 2022
Topic Review
Acute Pancreatitis
The incidence of acute and chronic pancreatitis is increasing in the United States. Rates of acute pancreatitis (AP) are similar in both sexes, but chronic pancreatitis (CP) is more common in males. When stratified by etiology, women have higher rates of gallstone AP, while men have higher rates of alcohol- and tobacco-related AP and CP, hypercalcemic AP, hypertriglyceridemic AP, malignancy-related AP, and type 1 autoimmune pancreatitis (AIP). 
  • 1.3K
  • 27 Jan 2021
Topic Review
Mitochondrial Dysfunction and Acute Fatty Liver of Pregnancy
The liver is one of the richest organs in mitochondria, serving as a hub for key metabolic pathways such as β-oxidation, the tricarboxylic acid (TCA) cycle, ketogenesis, respiratory activity, and adenosine triphosphate (ATP) synthesis, all of which provide metabolic energy for the entire body. Mitochondrial dysfunction has been linked to subcellular organelle dysfunction in liver diseases, particularly fatty liver disease. Acute fatty liver of pregnancy (AFLP) is a life-threatening liver disorder unique to pregnancy, which can result in serious maternal and fetal complications, including death. Pregnant mothers with this disease require early detection, prompt delivery, and supportive maternal care. AFLP was considered a mysterious illness and though its pathogenesis has not been fully elucidated, molecular research over the past two decades has linked AFLP to mitochondrial dysfunction and defects in fetal fatty-acid oxidation (FAO). Due to deficient placental and fetal FAO, harmful 3-hydroxy fatty acid metabolites accumulate in the maternal circulation, causing oxidative stress and microvesicular fatty infiltration of the liver, resulting in AFLP. 
  • 1.3K
  • 11 May 2022
Topic Review
PD-1/PD-L1 Therapy in Non-alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease (NAFLD) is characterized by an enhanced activation of the immune system, which predispose the evolution to nonalcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC). Resident macrophages and leukocytes exert a key role in the pathogenesis of NAFLD. In particular, CD4+ effector T cells are activated during the early stages of liver inflammation and are followed by the increase of natural killer T cells and of CD8+ T cytotoxic lymphocytes which contribute to auto-aggressive tissue damage. To counteract T cells activation, programmed cell death 1 (PD-1) and its ligand PDL-1 are exposed respectively on lymphocytes and liver cells’ surface and can be targeted for therapy by using specific monoclonal antibodies, such as of Nivolumab, Pembrolizumab and Atezolizumab.
  • 1.3K
  • 22 Mar 2022
Topic Review
Clinical, Morphological, and Pathogenetic Characteristics of NAFLD
Nonalcoholic fatty liver disease (NAFLD) is currently one of the most common liver diseases. Unfavorable data on the epidemiology of metabolic syndrome and obesity have increased the attention of clinicians and researchers to the problem of NAFLD. The findings allow us to emphasize the systemic and multifactorial nature of the pathogenesis of liver parenchyma lesion. At the same time, many aspects of its classification, etiology and pathogenesis remain controversial.
  • 1.3K
  • 10 Dec 2021
Topic Review
Oral Manifestations of IBD
Inflammatory bowel disease (IBD) comprises chronic heterogeneous disorders of unknown etiology, resulting from multifactorial environmental precipitants in genetically susceptible individuals. IBD are distinguished in two main phenotypes, Crohn’s disease (CD) and ulcerative colitis (UC), characterized by inflammation of the intestinal mucosa. While UC affects the rectum and a variable extent of the colon, CD can involve any location of the gastrointestinal (GI) tract, from the oral cavity to the anus. Furthermore, up to 36% of patients with IBD may have extra-intestinal manifestations (EIM) which can affect almost any organ of the body (eyes, joints, liver, pancreas, skin, blood, and mouth).
  • 1.2K
  • 12 Jan 2021
Topic Review
The Applications of Colonic Transendoscopic Enteral Tubing
The limitation of traditional delivery methods for fecal microbiota transplantation (FMT) gave birth to colonic transendoscopic enteral tubing (TET) to address the requirement of frequent FMTs. Colonic TET as a novel endoscopic intervention has received increasing attention in practice since 2015 in China. Emerging studies from multiple centers indicate that colonic TET is a promising, safe, and practical delivery method for microbial therapy and administering medication with high patient satisfaction.
  • 1.2K
  • 06 Feb 2023
Topic Review
Enteric Glial Cells
 At first, enteric glial cells were considered to be just a structural support for neurons, but recent findings emphasized more on their functions, and they turned out to be equally as important as neural cells, due to their involvement in all aspects of neural functions for both the central and peripheral nervous system, including the ENS.They have been mostly underestimated, particularly regarding the modulation of their functions by nutraceuticals.
  • 1.2K
  • 09 Nov 2021
Topic Review
Psychogastroenterology
Psychogastroenterology focuses on how psychosocial factors play a role in gut diseases. Psychogastroenterologists are clinicians, such as psychologists, psychiatrists, and social workers, who work in integrative or multidisciplinary care of patients with gastrointestinal disorders. The role of this field has been ranging from suggested prevention, a cure, to a Band-Aid for gut disorders.
  • 1.2K
  • 07 Sep 2020
Topic Review
Endoscopic Ultrasound in Liver Disease
Endoscopic ultrasound is a reliable diagnostic and therapeutic method that has an established role, foremost in pancreatobiliary pathology. 
  • 1.2K
  • 26 Nov 2021
Topic Review
Phytosterols in Nonalcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease (NAFLD) is now recognized as the most common cause of chronic liver disease with an increasing prevalence in both adults and children. Although the symptoms are absent or poorly expressed in most cases, some patients may progress to end-stage liver disease. The pathogenesis of NAFLD is known to be multifactorial. Therapeutic recommendations focus on lifestyle changes in order to reduce the incidence of risk factors and drugs targeting major molecular pathways potentially involved in the development of this disease. Given that a pharmacological treatment, completely safe and effective, is not currently known more research has been done on the effects that some bio-active natural compounds, derived from plants, have in preventing the onset and progression of NAFLD. Numerous studies, in animals and humans, have shown that phytosterols (PSs) play an important role in this pathology. Phytosterols are natural products that are found naturally in plant. More than 250 phytosterols have been identified, but the most common in the diet are stigmasterol, β-sitosterol, and campesterol. Consumption of dietary PSs can reduce serum cholesterol levels. Due to these properties, most studies have focused on their action on lipid metabolism and the evolution of NAFLD. PSs may reduce steatosis, cytotoxicity oxidative stress, inflammation, and apoptosis.
  • 1.2K
  • 17 Jun 2022
Topic Review
Imaging in Portal Vein Thrombosis
The term portal vein thrombosis (PVT) refers to the complete or partial obstruction of blood flow in the portal vein, due to the presence of a thrombus in the vasal lumen. The underlying etiology of PVT remains unclear in up to 50% of children and adults. PVT, either primary or secondary to an underlying chronic liver disease, is the most common cause of prehepatic portal hypertension. On the one hand, primary PVT can be idiopathic, iatrogenic (neonatal umbilical vein catheterization), or related to an altered coagulation status. On the other hand, the progression of most chronic liver diseases leads to fibrosis, which increases sinusoid resistance and determines an abnormal elevation of portal venous pressure. The spontaneous development of a collateral circulation to divert the flow to the systemic circulation is the first observed anomaly, which itself contributes to PVT. 
  • 1.2K
  • 11 Nov 2022
Topic Review
Microbiome-Immune Interactions in Ulcerative Colitis
Inflammatory bowel disease (IBD) is a chronic autoimmune condition affecting the gastrointestinal (GI) tract. IBD includes Crohn’s disease (CD) and ulcerative colitis (UC), with UC characterized by inflammation of colonic mucosa and submucosa starting at the rectum and extending through the colon. The precise etiology of UC is unknown but is thought to involve a combination of environmental and genetic factors. Chief among these is the intestinal microbiome, which has been extensively studied both for its role in disease pathogenesis and possible treatment. In this review, we will discuss the microbial changes that have been described in UC, its interplay with host immune function, and evidence supporting its role as a potential therapeutic. We will also discuss parallels between UC, the microbiome and colitis-associated cancer (CAC).   
  • 1.2K
  • 05 Nov 2021
Topic Review
CD26 Induces Colorectal Cancer Angiogenesis and Metastasis
CD26 has been reported as a marker for colorectal cancer stem cells endowed with tumor-initiating properties and capable of colorectal cancer (CRC) metastasis. This entry demonstrated the functional roles of CD26 in inducing CRC migration, invasion, angiogenesis and metastasis and identified the potential involvement of MMP1 and CAV1 in such process.
  • 1.2K
  • 07 Feb 2022
Topic Review
TNF’s Pathway in CD
Crohn’s disease (CD) is a chronic disorder characterized by full thickness patchy inflammation of the gastrointestinal tract. The pathogenesis is multifactorial and involves defective innate immune responses, microbiome alterations, and dysregulated activation of the acquired component of mucosal immunity. One of the molecular mediators that is involved at different levels in the initiation and progression of intestinal inflammation characteristic of CD is tumor necrosis factor (TNF).
  • 1.2K
  • 15 Oct 2021
Topic Review
Pathophysiological Mechanisms of Anemia in Chronic Liver Disease
Hematological abnormalities are frequently linked to chronic liver disease of any etiology. About 75% of patients with advanced chronic liver disease experience anemia. The causes of anemia are complex and multifactorial, particularly in cirrhotic patients. 
  • 1.2K
  • 23 Aug 2023
Topic Review
Gastric Polyps and Gastric Cancer
Gastric cancer is still an important disease causing many deaths worldwide, although there has been a marked reduction in prevalence during the last few decades. The decline in gastric cancer prevalence is due to a reduction in Helicobacter pylori infection which has occurred for at least 50 years. The most probable mechanism for the carcinogenic effect of H. pylori is hypergastrinemia since H. pylori infected individuals do not have increased risk of gastric cancer before the development of oxyntic atrophy. When atrophy has developed, the carcinogenic process continues independent of H. pylori. Autoimmune gastritis also induces oxyntic atrophy leading to marked hypergastrinemia and development of ECL cell neoplasia as well as adenocarcinoma. Similarly, long-term treatment with efficient inhibitors of acid secretion like the proton pump inhibitors (PPIs) predisposes to ECL cell neoplasia of a different degree of malignancy. Contrasting the colon where most cancers develop from polyps, most polyps in the stomach have a low malignant potential. Nevertheless, gastric polyps may also give rise to cancer and have some risk factors and mechanisms in common with gastric cancer.
  • 1.2K
  • 22 Jun 2021
Topic Review
Dersimelagon in the Treatment of Erythropoietic Protoporphyria
Erythropoietic protoporphyria (EPP) is a genetic disorder stemming from reduced ferrochelatase expression, the final enzyme in the pathway of heme biosynthesis. A closely related condition, X-linked protoporphyria (XLP), bears similar clinical features although it arises from the heightened activity of δ-aminolevulinic acid synthase 2 (ALAS2), the first and normally rate-controlling enzyme in heme biosynthesis in developing red blood cells. Both of these abnormalities result in the buildup of protoporphyrin IX, leading to excruciating light sensitivity and, in a minority of cases, potentially fatal liver complications. Traditionally, managing EPP and XLP involved sun avoidance. However, the emergence of innovative therapies, such as dersimelagon, is reshaping the therapeutic landscape for these conditions.
  • 1.2K
  • 05 Jan 2024
Topic Review
Ultrasound for the Diagnosis of Biliary Atresia
Biliary atresia is an aggressive liver disease of infancy and can cause death without timely surgical intervention. Early diagnosis of biliary atresia is critical to the recovery of bile drainage and long-term transplant-free survival. Ultrasound is recommended as the initial imaging strategy for the diagnosis of biliary atresia. Numerous ultrasound features have been proved helpful for the diagnosis of biliary atresia. In recent years, with the help of new technologies such as elastography ultrasound, contrast-enhanced ultrasound and artificial intelligence, the diagnostic performance of ultrasound has been significantly improved.
  • 1.2K
  • 26 Jan 2022
Topic Review
Paediatric and Adult Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the most common primary liver cancer affecting adults and the second most common primary liver cancer affecting children. 
  • 1.2K
  • 15 Sep 2022
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