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Topic Review
Neural Signaling in the Pancreatic Cancer Microenvironment
Pancreatic cancer is one of the most lethal malignant diseases. Various cells in the tumor microenvironment interact with tumor cells and orchestrate to support tumor progression. Several kinds of nerves are found in the tumor microenvironment, and each plays an essential role in tumor biology. Studies have shown that sympathetic, parasympathetic, and sensory neurons are found in the pancreatic cancer microenvironment. Neural signaling not only targets neural cells, but tumor cells and immune cells via neural receptors expressed on these cells, through which tumor growth, inflammation, and anti-tumor immunity are affected. Thus, these broad-range effects of neural signaling in the pancreatic cancer microenvironment may represent novel therapeutic targets. The modulation of neural signaling may be a therapeutic strategy targeting the whole tumor microenvironment.
  • 614
  • 15 Sep 2022
Topic Review
Diabetic Gastroparesis
Diabetic gastroparesis (DGP) is a debilitating gastrointestinal disorder characterized by delayed gastric emptying in individuals with diabetes mellitus, particularly type 1 and long-standing type 2 diabetes. This condition, although not widely known, significantly impacts the quality of life of affected individuals. The symptoms of DGP, including early satiety, excessive fullness after meals, loss of appetite, bloating, abdominal pain, and vomiting, stem from the slowed or stalled movement of food from the stomach to the small intestine.
  • 614
  • 28 Feb 2024
Topic Review
Genetic Abnormalities in Pancreatitis
Hereditary pancreatitis (HP) has been defined as either two or more individuals within a family exhibiting pancreatitis for two or more generations, or pancreatitis linked to mutation of the PRSS1 gene. In 2000, a mutation in the serine protease inhibitor gene (Kazal type 1: SPINK1) was reported to be related to sporadic pancreatitis of unknown etiology.
  • 614
  • 26 Jan 2021
Topic Review
Small Bowel Capsule Endoscopy
Small bowel capsule endoscopy (SBCE) is one of the most useful methods for diagnosing small bowel lesions. When a pill-like capsule endoscope is swallowed, the camera of the capsule endoscope captures the small bowel mucosa. Although it is a noninvasive endoscopy, it has the disadvantage of long reading time. To solve this problem, artificial intelligence (AI) algorithms for SBCE reading are being actively studied. The main goal is to quickly and accurately detect small bowel lesions using an AI algorithm trained on images of lesions. This content briefly summarizes the use of AI algorithms for SBCE reading.
  • 613
  • 07 Jul 2021
Topic Review
Circulating Tumor Cells in Colorectal Cancer
Circulating tumor cells (CTCs)  are intact cells separated from the primary tumor or metastases and released into the peripheral circulation. They were observed and discovered for the first time in 1869 in the blood of a patient with breast cancer. CTCs mainly originate from solid tumors of epithelial origin (breast, prostate, colon, and lung). CTCs are nucleated and express epithelial cell adhesion molecules (EpCAM) and/or cytokeratins (CK) in the cytoplasm without coexpressing the common leukocyte antigen CD45. It is known today that there is significant heterogeneity in cell species and surface markers, which represents a challenge in isolating all clinically relevant subpopulations of CTCs.
  • 611
  • 22 Nov 2022
Topic Review
Inflammatory Bowel Disease and Reproductive Health
Despite the fact that knowledge on obstetrical management of Inflammatory Bowel Diseases (IBDs) has greatly improved over the years, many patients still actively avoid pregnancy for fear of adverse maternal or neonatal outcomes, of adverse effects of pregnancy on the disease activity, of eventual IBD inheritance, or of an increased risk of congenital malformations. Indeed, though data prove that fertility is hardly affected by the disease, a reduced birth rate is nevertheless observed in patients with IBD. Misconceptions on the safety of drugs during gestation and breastfeeding may influence patient choice and negatively affect their serenity during pregnancy or lactation.
  • 609
  • 20 Apr 2022
Topic Review
Chromosomal Instability and Its Role in Therapeutics Response
Variation in chromosome structure is a central source of DNA damage and DNA damage response, together representinga major hallmark of chromosomal instability. Treatment of cancer usually includes surgery, radiotherapy, or chemotherapy. The activity of radiotherapy and most chemotherapy drugs induces DNA damage in proliferating tumor cells. For example, platinum drugs that are effective against cancer cells form DNA adducts. Other drugs, such as anthracyclines induce DNA damage by inhibiting DNA topoisomerases and promoting the production of mitochondrial reactive oxygen species (ROS). In normal cells, DNA damage can be immediately recognized by a DNA damage response (DDR), which activates checkpoints for cell-cycle arrest and DNA repair. In cancer cells, DNA damage per se may be responsible for defective chromosome segregation and chromosomal instability (CIN) or the anomalous binding of DDR proteins to DNA or chromatin proteins. 
  • 609
  • 11 Jan 2023
Topic Review
Surgical Strategies for Recurrent Hepatocellular Carcinoma after Resection
Among primary liver cancers, hepatocellular carcinoma (HCC) is the most common. Surgical resection and liver transplantation both represent potentially curative treatments not only in the case of the first occurrence, but also in those cases of disease recurrence if a proper selection of patients is performed ahead. Incidentally, the type and the time of relapse carry important weight on patient prognosis and overall survival. For these cases, proper management has still not been exactly defined.
  • 608
  • 11 Feb 2023
Topic Review
Advanced Gastroesophageal Cancer
Advanced gastroesophageal cancer (GEC) has a poor prognosis and limited treatment options. Immunotherapy including the anti-programmed death-1 (PD-1) antibodies pembrolizumab and nivolumab have been approved for use in various treatment settings in GEC. 
  • 607
  • 27 Apr 2021
Topic Review
Gut Microbiota and Neuroinflammation in Liver Disease
Liver disease are associated with a wide spectrum of neurological changes, of which the best known is hepatic encephalopathy (HE). Historically, hyperammonemia, was considered the main etiological factor; however, studies demonstrated a key role of neuroinflammation in the development of neurological complications in this setting. Neuroinflammation is characterized by activation of microglial cells and brain secretion of pro-inflammatory cytokines, such as tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6, which alter neurotransmission, leading to cognitive and motor dysfunction. Changes in the gut microbiota resulting from liver disease play a crucial role in the pathogenesis of neuroinflammation. Dysbiosis and altered intestinal permeability, resulting in bacterial translocation and endotoxemia, are responsible for systemic inflammation, which can spread to brain tissue and trigger neuroinflammation. In addition, metabolites derived from the gut microbiota can act on the central nervous system and facilitate the development of neurological complications, exacerbating clinical manifestations. 
  • 606
  • 31 Jul 2023
Topic Review
Microbiota-derived Short-Chain Fatty Acids and Obesity
Microbiota-derived Short-Chain Fatty Acids (SCFAs), primarily acetate, propionate and butyrate, are metabolites produced by gut microbiota via dietary non-digestible carbohydrates (CHO) fermentation. Maternal very low-calorie ketogenic diet (VLCKD) during pregnancy and lactation stimulates the growth of diverse species of SCFA-producing bacteria, which may induce epigenetic changes in infant obese gene expression and modulate adipose tissue inflammation in obesity.
  • 605
  • 29 Oct 2021
Topic Review
Giardia/Cryptosporidium in Neo-Tropical Rodents
Cryptosporidiosis and giardiasis have been identified as emerging diseases in both developed and developing countries. Wildlife has been highlighted to play a major role in the spread of these diseases to humans.
  • 603
  • 21 Apr 2021
Topic Review
Cancer-Associated Fibroblasts in Cholangiocarcinoma
Cholangiocarcinoma (CCA) is an aggressive neoplasia with an increasing incidence and mortality. It is characterized by a strong desmoplastic stroma surrounding cancer cells. Cancer-associated fibroblasts (CAFs) are the main cell type of CCA stroma and they have an important role in modulating cancer microenvironments. CAFs originate from multiple lines of cells and mainly consist of fibroblasts and alpha-smooth muscle actin (α-SMA) positive myofibroblast-like cells. The continuous cross-talking between CCA cells and desmoplastic stroma is permitted by CAF biochemical signals, which modulate a number of pathways. Stromal cell-derived factor-1 expression increases CAF recruitment to the tumor reactive stroma and influences apoptotic pathways. The Bcl-2 family protein enhances susceptibility to CAF apoptosis and PDGFRβ induces fibroblast migration and stimulates tumor lymphangiogenesis. Many factors related to CAFs may influence CCA prognosis.
  • 603
  • 10 Nov 2022
Topic Review
Biliopancreatic Endoscopy in Altered Anatomy
Anatomical post-surgical alterations of the upper gastrointestinal (GI) tract have always been challenging for performing diagnostic and therapeutic endoscopy, especially when biliopancreatic diseases are involved. Esophagectomy, gastrectomy with various reconstructions and pancreaticoduodenectomy are among the most common surgeries causing upper GI tract alterations. Several different techniques developed over the years for biliopancreatic diseases in altered anatomy, in order to perform both endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). They included enteroscopy-assisted ERCP (double and single balloon enteroscopy-ERCP, spiral enteroscopy-ERCP) laparoscopic assisted ERCP, EUS-Directed transgastric ERCP, EUS-directed transgastric intervention, gastric access temporary for endoscopy, and percutaneous assisted trans prosthetic endoscopic therapy.
  • 602
  • 26 Oct 2021
Topic Review
Gastroesophageal Reflux Disease
This entry describes the actual knowledge on diagnosis and management of extra-esophageal manifestations of gastro-esophageal reflux disease. The 2006 Montreal consensus defined GERD as a condition that develops when the reflux of the stomach contents causes troublesome symptoms and/or complications into the esophagus. Tissue damage related to GERD range from esophagitis to Barrett’s esophagus and esophageal adenocarcinoma; troublesome symptoms attributable to reflux can be esophageal (heartburn, regurgitation) or extra-esophageal (EE). GERD can be further classified by the presence of erosions on endoscopic examination (Erosive Reflux Disease [ERD] and Nonerosive Reflux Disease [NERD]).
  • 601
  • 23 Jun 2021
Topic Review
Therapeutic Options of Enterohemorrhagic Escherichia coli Infections
Enterohemorrhagic Escherichia coli (EHEC) are the human pathogenic subset of Shiga toxin (Stx)-producing E. coli (STEC). EHEC are responsible for severe colon infections associated with life-threatening extraintestinal complications such as the hemolytic-uremic syndrome (HUS) and neurological disturbances. Endothelial cells in various human organs are renowned targets of Stx, whereas the role of epithelial cells of colon and kidneys in the infection process has been and is still a matter of debate.
  • 600
  • 15 Jul 2022
Topic Review
Fecal Microbiota Transplantation in the Management of Cancer
In a mutually beneficial connection with its host, the gut microbiota affects the host’s nutrition, immunity, and metabolism. An increasing number of studies have shown links between certain types of disease and gut dysbiosis or specific microorganisms. Fecal microbiota transplantation (FMT) is strongly advised for the treatment of recurrent or resistant Clostridium difficile infection (CDI) due to its outstanding clinical effectiveness against CDI. The therapeutic potential of FMT for other disorders, particularly inflammatory bowel diseases and malignancies, is currently gaining more and more attention. 
  • 599
  • 30 May 2023
Topic Review
Features of Lipid Metabolism Disorders in PBC
Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune liver disease that mostly affects women. A progressive disorder in the processes of bile secretion and enterohepatic bile salts circulation in patients with PBC already in its early stages, leading to an insufficient release of bile acids into the bowel and their entry into the systemic circulation. Insufficient bile acids released into the duodenum contributes to the development of malabsorption, energy malnutrition, and slowly progressive weight loss.
  • 599
  • 08 Dec 2022
Topic Review
Field of Submucosal Endoscopy
Submucosal endoscopy (third-space endoscopy) can be defined as an endoscopic procedure performed in the submucosal space. This procedure is novel and has been utilized for delivery to the submucosal space in a variety of gastrointestinal diseases, such as a tumor, achalasia, gastroparesis, and subepithelial tumors. The main submucosal endoscopy includes peroral endoscopic myotomy, gastric peroral endoscopic myotomy, Zenker peroral endoscopic myotomy, submucosal tunneling for endoscopic resection, and endoscopic submucosal tunnel dissection. Submucosal endoscopy has been used as a viable alternative to surgical techniques because it is minimally invasive in the treatment and diagnosis of gastrointestinal diseases and disorders.
  • 598
  • 16 Jan 2023
Topic Review
Treatments for Acute Intermittent Porphyria
Rare diseases, especially monogenic diseases, which usually affect a single target protein, have attracted growing interest in drug research by encouraging pharmaceutical companies to design and develop therapeutic products to be tested in the clinical arena. Acute intermittent porphyria (AIP) is one of these rare diseases. AIP is characterized by haploinsufficiency in the third enzyme of the heme biosynthesis pathway. Identification of the liver as the target organ and a detailed molecular characterization have enabled the development and approval of several therapies to manage this disease.
  • 597
  • 22 Dec 2022
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