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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.
  • 1.1K
  • 30 Mar 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.
  • 1.1K
  • 17 Mar 2023
Topic Review
Insights into Acute Pancreatitis Associated COVID-19
Pancreatic injury can manifest from an asymptomatic elevation of amylase and lipase to severe acute pancreatitis (AP).
  • 1.1K
  • 07 Jan 2022
Topic Review
Non-Steroid Anti-Inflammatory Drugs/Acetylsalicylic Acid-Associated Gastropathy
Drugs are widely used to treat different diseases in modern medicine, but they are often associated with adverse events. Those located in the gastrointestinal tract are common and often mild, but they can be serious or life-threatening and determine the continuation of treatment. The stomach is often affected not only by drugs taken orally but also by those administered parenterally. The first description of the endoscopic picture of the damage to the gastric mucosa associated with the use of aspirin was published by A. Douthwait and J. Lintoff in 1938.
  • 1.1K
  • 18 Jul 2023
Topic Review
Overview of Nonalcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease (NAFLD) is defined by the presence of >5% of hepatic steatosis demonstrated, either radiographically or histologically, in the absence of significant alcohol consumption. NAFLD is the most common liver disease worldwide, with a continuously growing prevalence. The pathophysiology of the disease is complex and includes several mechanisms, with metabolic syndrome and insulin resistance playing a major role. It is crucial to diagnose NAFLD before it advances to nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis, presented by its complications which include ascites, portal hypertension, bleeding varices and encephalopathy. Another important complication of NAFLD and cirrhosis is hepatocellular carcinoma (HCC), a cancer with increasing incidence and poor prognosis. Even with the growing prevalence of NAFLD, diagnosis via liver biopsies is unrealistic, considering the costs and complications. Noninvasive tests, including serum biomarkers and elastography, are cost-effective and convenient, thereby replacing liver biopsies in diagnosing and excluding liver fibrosis
  • 1.1K
  • 23 Nov 2022
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. 
  • 1.1K
  • 08 Mar 2023
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.
  • 1.1K
  • 16 Jun 2021
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%.
  • 1.1K
  • 25 Jul 2022
Topic Review
Herbal Approaches to Pediatric Functional Abdominal Pain
Chronic abdominal pain is one of the most common problems seen by both pediatricians and pediatric gastroenterologists. Abdominal-pain-related functional gastrointestinal disorders (AP-FGIDs) are diagnosed in children with chronic and recurrent abdominal pain meeting clinical criteria set forth in the Rome IV criteria. AP-FGIDs affect approximately 20% of children worldwide and include functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain (FAP), and abdominal migraine. IBS accounts for 45% of pediatric AP-FGIDs. The pathophysiology of functional abdominal pain involves an interplay of factors including early life events, genetics, psychosocial influences, and physiologic factors of visceral sensitivity, motility disturbance, altered mucosal immune function, and altered central nervous system processing. Researchers discuss popular herbal treatments typically used in the field of complementary medicine to treat pediatric AP-FGIDs: peppermint oil, fennel, licorice, and STW5.
  • 1.1K
  • 14 Sep 2022
Topic Review
EUS and EUS-FNA
Endoscopic ultrasonography (EUS) has greater spatial resolution than other diagnostic imaging modalities. In addition, if gallbladder lesions are found and gallbladder cancer is suspected, EUS is an indispensable modality, enabling detailed tests for invasion depth evaluation using the Doppler mode and ultrasound agents. Furthermore, for gallbladder lesions, EUS fine-needle aspiration (EUS-FNA) can be used to differentiate benign and malignant forms of conditions, such as xanthogranulomatous cholecystitis, and collect evidence before chemotherapy.
  • 1.1K
  • 29 Mar 2022
Topic Review
Gastrointestinal-Bleeding between NOACs and VKAs
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.
  • 1.1K
  • 15 Jan 2021
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.
  • 1.1K
  • 11 Oct 2023
Topic Review
Artificial Intelligence in Digestive Healthcare
With modern society well entrenched in the digital area, the use of Artificial Intelligence (AI) to extract useful information from big data has become more commonplace in our daily lives than we perhaps realize. A number of medical specialties such as Gastroenterology rely heavily on medical images to establish disease diagnosis and patient prognosis, as well as to monitor disease progression. Moreover, some such imaging techniques have been adapted so that they can potentially deliver therapeutic interventions. The digitalization of medical imaging has paved the way for important advances in this field, including the design of AI solutions to aid image acquisition and analysis.
  • 1.1K
  • 08 May 2023
Topic Review
Spontaneous Bacterial Peritonitis in Decompensated Liver Cirrhosis
Spontaneous bacterial peritonitis (SBP) is defined as a bacterial infection of the ascitic fluid without a surgically treatable intra-abdominal infection source. SBP is a common, severe complication in cirrhosis patients with ascites, and if left untreated, in-hospital mortality may exceed 90%. However, the incidence of SBP has been lowered to approx. 20% through early diagnosis and antibiotic therapy. There are three types of SBP. Bacterial translocation from the gastrointestinal tract is the most common source of SBP. Distinguishing SBP from secondary bacterial peritonitis is essential because the conditions require different therapeutic strategies. The standard treatment for SBP is prompt broad-spectrum antibiotic administration and should be tailored according to community-acquired SBP, healthcare-associated or nosocomial SBP infections, and local resistance profile. Albumin supplementation, especially in patients with renal impairment, is also beneficial. Selective intestinal decontamination is associated with a reduced risk of bacterial infection and mortality in the high-risk group.
  • 1.1K
  • 01 Dec 2022
Topic Review
Physiological Significance of Esophageal TRPV4 Channel
Transient receptor potential vanilloid 4 (TRPV4) is a non-selective cation channel that is broadly expressed in different human tissues, including the digestive system, where it acts as a molecular sensor and a transducer that regulates a variety of functional activities.
  • 1.1K
  • 27 Apr 2022
Topic Review
Nutrition/Exercise in Upper Gastrointestinal Cancers
Malnutrition and muscle wasting are associated with impaired physical functioning and quality of life in oncology patients. Patients diagnosed with upper gastrointestinal (GI) cancers are considered at high risk of malnutrition and impaired function. Due to continuous improvement in upper GI cancer survival rates, there has been an increased focus on multimodal interventions aimed at minimizing the adverse effects of cancer treatments and enhancing survivors’ quality of life. 
  • 1.1K
  • 28 Sep 2021
Topic Review
Virtual Chromoendoscopy in Capsule Endoscopy
Video capsule endoscopy (VCE) is a minimally invasive endoscopic modality, which was initially introduced for the investigation of the small intestine, but currently a range of capsules are available that can facilitate the inspection of the entire GI tract.
  • 1.1K
  • 17 Aug 2022
Topic Review
Combined Biological Therapy for Refractory Inflammatory Bowel Disease
Current medical treatment for inflammatory bowel disease (IBD) does not achieve 100% response rates, and a subset of refractory and severely ill patients have persistent active disease after being treated with all possible drug alternatives. Ustekinumab plus vedolizumab and vedolizumab plus anti-TNF were the most used biological therapies (CoT) for Crohn’s disease. For ulcerative colitis, the most used CoTs were vedolizumab plus anti-TNF and vedolizumab plus tofacitinib. 
  • 1.1K
  • 23 Mar 2022
Topic Review
OCT Applications in GI Tract
Optical coherence tomography (OCT) is uniquely poised for advanced imaging in the gastrointestinal (GI) tract as it allows real-time, subsurface and wide-field evaluation at near-microscopic resolution, which may improve the current limitations or even obviate the need of superficial random biopsies in the surveillance of early neoplasias in the near future. OCT’s greatest impact so far in the GI tract has been in the study of the tubular esophagus owing to its accessibility, less bends and folds and allowance of balloon employment with optimal contact to aid circumferential imaging. Moreover, given the alarming rise in the incidence of Barrett's esophagus and its progression to adenocarcinoma in the U.S., OCT has helped identify pathological features that may guide future therapy and follow-up strategy. This review will explore the current uses of OCT in the gastrointestinal tract and future directions, particularly with non-endoscopic office-based capsule OCT and the use of artificial intelligence to aid in diagnoses.
  • 1.1K
  • 06 Nov 2020
Topic Review
Role of HIF-1 and NRF2 in Pancreatic Cancer
Hypoxia inducible factor-1 and KEAP1-NRF2, stress response mechanisms for hypoxia and oxidative stress, respectively, contribute to the aggressive behaviors of pancreatic cancer. These key molecules for stress response mechanisms are activated, both in pancreatic cancer cells and in pancreatic stellate cells. Both factors are involved in the mutual activation of cancer cells and stellate cells, by inducing cancer-promoting signals and their mediators. Therapeutic interventions targeting these pathways are promising approaches for novel therapies.
  • 1.1K
  • 19 Apr 2022
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