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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
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
ICI-Based Combination Therapy for HCC
Advanced, unresectable hepatocellular carcinoma has a dismal outcome. Multiple immune checkpoint inhibitors (ICIs) targeting the programmed-cell death 1 pathway (PD-1/L1) have been approved for the treatment of advanced HCC. However, outcomes remain undesirable and unpredictable on a patient-to-patient basis. The combination of anti-PD-1/L1 with alternative agents, chiefly cytotoxic T-lymphocyte antigen-4 (CTLA-4) ICIs or agents targeting other oncogenic pathways such as the vascular endothelial growth factor (VEGF) pathway and the c-MET pathway, has, in addition to the benefit of directly targeting alterative oncogenic pathways, in vitro evidence of synergism through altering the genomic and function signatures of T cells and expression of immune checkpoints. Several trials have been completed or are underway evaluating such combinations. Finally, studies utilizing transcriptomics and organoids are underway to establish biomarkers to predict ICI response. 
  • 1.2K
  • 06 May 2021
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
Polyphenols in Tea
A diet high in polyphenols is associated with a diversified gut microbiome. Tea is the second most consumed beverage in the world, after water. The health benefits of tea might be attributed to the presence of polyphenol compounds such as flavonoids (e.g., catechins and epicatechins), theaflavins, and tannins. 
  • 1.2K
  • 18 May 2021
Topic Review
Gut Microbiota and Gut–Liver Axis in Liver Disease
The gut microbiota composition is important for nutrient metabolism, mucosal barrier function, immunomodulation, and defense against pathogens. Alterations in the gut microbiome can disturb the gut ecosystem. These changes may lead to the loss of beneficial bacteria or an increase in potentially pathogenic bacteria. Furthermore, these have been shown to contribute to the pathophysiology of gastrointestinal and extra-intestinal diseases. Pathologies of the liver, such as non-alcoholic liver disease, alcoholic liver disease, cirrhosis, hepatocellular carcinoma, autoimmune hepatitis, viral hepatitis, and primary sclerosing cholangitis have all been linked to changes in the gut microbiome composition.
  • 1.2K
  • 08 Jun 2022
Topic Review
The Gut Microbiome and Female Health
Given that females may be more likely to be affected by some ailments such as osteoarthritis, heart disease, cancer, and anxiety, it is imperative to study the effect of the gut microbiome and its role in female health. It is evident that the presence/ratio of microbial species is altered in polycystic ovarian syndrome, cancer, pregnancy, and menopause. Thus, potential probiotics should be developed and the administration of certain bacterial species should be considered, as novel independent or adjunct therapies for various female-related pathologies.
  • 1.2K
  • 30 Nov 2022
Topic Review
Visceral Hypersensitivity Association with  Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a severe problem in the health service. It is estimated that it accounts for 3% of all medical consultations. Moreover, this diagnosis is made in the case of about 40% of all outpatient gastroenterological referrals. The visceral stimuli from the digestive tract are transmitted via afferent nerves through the spinal cord to the brain, where they are felt as pain. The overreaction observed in the brain of irritable bowel syndrome (IBS) patients may be due to increased peripheral sensitivity to stimuli from the gastrointestinal tract.
  • 1.2K
  • 11 Oct 2023
Topic Review
Fibroblast Subsets in Colorectal cancer
CAFs are defined as fibroblasts surrounding malignant tumor cells and are the most abundant cell type in the tumor microenvironment of colorectal cancer (CRC). CAFs consist of various functionally heterogeneous subsets which can promote or restrain cancer progression. Although most previous research has focused on the biology of epithelial cells, accumulating evidence shows that certain CAF subsets can also importantly contribute to tumor initiation and progression, thereby possibly providing avenues for improvement of clinical care for CRC patients. However, attention needs to be paid to comprehensive characterization and reporting of the subsets being investigated in CAF studies to enable more precise identification and targeting of “unfavorable” CAFs in advanced CRC.
  • 1.2K
  • 28 Jan 2021
Topic Review
OCA on Different Physiological Processes through FXR Activation
Obeticholic acid (OCA) or 6-alpha-ethyl-chenodeoxycholic acid is a semisynthetic modified bile acid derivative that acts on the farnesoid X receptor (FXR) as an agonist with a higher potency than bile acid. The FXR is a nuclear receptor highly expressed in the liver and small intestine and regulates bile acid, cholesterol, glucose metabolism, inflammation, and apoptosis. 
  • 1.2K
  • 08 Mar 2023
Topic Review
Celiac Disease in Children during COVID Pandemic
Celiac disease is a chronic inflammatory disease that primarily affects the small intestine following the ingestion of gluten and the related prolamins found in wheat, rye, oats, and barley. It has a prevalence in the general population worldwide of approximately 1%.
  • 1.2K
  • 25 Jul 2022
Topic Review
Gut Microbial Modulation
Gut microbial composition codevelops with the host from birth and is influenced by several factors, including drug use, radiation, psychological stress, dietary changes and physical stress. Importantly, gut microbial dysbiosis has been clearly associated with several diseases, including cancer, rheumatoid arthritis and Clostridium difficile-associated diarrhoea, and is known to affect human health and performance.
  • 1.2K
  • 12 Oct 2022
Topic Review
AhR, NLRP3 Inflammasome and IBD
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gut that includes ulcerative colitis (UC) and Crohn’s disease (CD). with colitis-associated colorectal cancer (CAC) being a progressive intestinal inflammation due to inflammatory bowel disease (IBD). While this is an exemplification of the negatives of inflammation, it is just as crucial to have some degree of the inflammatory process to maintain a healthy immune system. A pivotal component in the maintenance of such intestinal homeostasis is the innate immunity component, inflammasomes. Inflammasomes are large, cytosolic protein complexes formed following stimulation of microbial and stress signals that lead to the expression of pro-inflammatory cytokines. The NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome has been extensively studied in part due to its strong association with colitis and CAC. The aryl hydrocarbon receptor (AhR) has recently been acknowledged for its connection to the immune system aside from its role as an environmental sensor. AhR has been described to play a role in the inhibition of the NLRP3 inflammasome activation pathway. The NLRP3 inflammasome is one of the most extensively studied NLRs due to its clinical relevance in a wide range of human diseases. This 115 kDa cytosolic protein complex consists of a triadic constitution; the NACHT scaffold which serves as a central oligomerization domain with an ATPase activity, the N-terminal PYCARD adaptor which recruits the apoptosis-associated speck-like protein (ASC) and the C-terminal leucine-rich repeat (LRR) which are thought to be involved in detecting stimuli.
  • 1.2K
  • 30 Mar 2021
Topic Review
Metformin Protects Livers against NASH-related-HCC
Nonalcoholic fatty liver disease (NAFLD) is strongly linked to the global epidemic of obesity and type 2 diabetes mellitus (T2DM). Notably, NAFLD can progress from the mildest form of simple steatosis to nonalcoholic steatohepatitis (NASH) that increases the risk for hepatocellular carcinoma (HCC), which is a malignancy with a dismal prognosis and rising incidence in the United States and other developed counties, possibly due to the epidemic of NAFLD. Metformin, the first-line drug for T2DM, has been suggested to reduce risks for several types of cancers including HCC and protect against NASH-related HCC, as revealed by epidemical studies on humans and preclinical studies on animal models.
  • 1.2K
  • 12 Oct 2021
Topic Review
New-Onset Liver Injuries Due to COVID-19
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted the world and caused the 2019 coronavirus disease (COVID-19) pandemic. The clinical manifestations of the virus can vary from patient to patient, depending on their respective immune system and comorbidities. SARS-CoV-2 can affect patients through two mechanisms: directly by targeting specific receptors or by systemic mechanisms.
  • 1.2K
  • 17 Mar 2023
Topic Review
IBS and IBD
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.
  • 1.2K
  • 12 Jan 2021
Topic Review
Fecal Microbiota Transplantation
Among all the methods available to achieve this purpose, fecal microbiota transplantation (FMT) is one of the most promising, being able to directly reshape the recipient’s gut microbial communities.
  • 1.2K
  • 16 Jun 2021
Topic Review
COVID-19 and Autoimmune Liver Diseases
SARS-CoV-2 infection can trigger autoimmune responses, either by a systemic hyperstimulation of the immune system or molecular mimicry (or both). COVID-19 can activate a hyperstimulation of the immune system or, through the exposure to foreign peptides homologous to human peptides (molecular mimicry), contribute to the development of autoantibodies and autoimmune liver diseases.
  • 1.2K
  • 01 Jun 2022
Topic Review
Cholestatic Diseases
Cholestatic diseases are based on bile dysfunction due to defects affecting bile synthesis or secretion. These processes involve a wide range of enzymes and membrane transporters involved in hepatobiliary circulation. According to its origin, cholestasis can be classified into two main groups: acquired cholestasis and genetic cholestasis.
  • 1.2K
  • 10 Jun 2022
Topic Review
DAO Activity in the Monitoring of Diverse Diseases
The serum level of diamine oxidase (DAO) reflects the integrity and maturation of the small intestinal mucosa. This measure is important in diagnosing various diseases, including chronic urticaria tachyphylaxis, multiple organ dysfunction syndrome, preterm abortion, and migraine.
  • 1.2K
  • 01 Feb 2023
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