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Topic Review
Lifestyle and Hepatocellular Carcinoma
Liver cancer remains a global health challenge, and while infection by hepatitis B virus and hepatitis C virus are the main risk factors for hepatocellular carcinoma (HCC) development, non-alcoholic steatohepatitis is associated with metabolic syndrome or diabetes mellitus is becoming a more frequent risk factor.
  • 925
  • 07 Jan 2022
Topic Review
Hepatocyte Growth Regulators
Researchers have studied whether growth factors, cytokines, hormones, neurotransmitters, and local hormones (autacoids) promote the proliferation of hepatic parenchymal cells (i.e., hepatocytes) using in vitro primary cultured hepatocytes. The indicators used for this purpose include changes in DNA synthesis activity, nuclear number, cell number, cell cycle, and gene expression. In addition, the intracellular signaling pathways from the plasma membrane receptors to the nucleus have been examined in detail for representative growth-promoting factors that have been found to promote DNA synthesis and cell proliferation of hepatocytes.
  • 924
  • 19 Jan 2023
Topic Review
Therapeutic Quiver of Non-Alcoholic Fatty Liver Disease
The therapeutic quiver of nonalcoholic fatty liver disease (NAFLD) consists of several levels, of which lifestyle, pharmaceutical, and surgical approaches are the main treatments. A multimodal intervention with multiple aspects, such as lifestyle modification, weight loss, specific diets, and medication, is the most appropriate and holistic approach for most people with NAFLD.
  • 924
  • 27 Apr 2023
Topic Review
Intestinal Tryptophan Metabolism in Inflammatory Bowel Disease
Evidence is emerging for the role of intestinal tryptophan metabolism in the development of inflammatory bowel disease (IBD). In order to identify the role of altered intestinal tryptophan metabolism in IBD pathogenesis, a meta-analysis of the transcriptome was performed to identify differentially expressed genes involved in the tryptophan metabolism pathways in intestinal biopsies of IBD as compared to non-IBD controls.
  • 923
  • 18 Jul 2023
Topic Review
Synbiotics in Inflammatory Bowel Diseases
Inflammatory bowel disease (IBD) is a group of chronic relapsing gastrointestinal disorders that are characterized by inflammation of the gastrointestinal tract. The involvement of three distinct recurrent inflammatory features that sustains the chronic inflammation in IBD have been clearly identified that includes, disturbances in the gut microbiota, dysregulated immune response and altered colonic epithelial integrity. Dietary components such as prebiotic dietary fibres (DF) and probiotics due to their potential in modulating immune functions and influencing microbiota are promising strategies in the context of IBD. In this entry, we review the recent evidence from in-vivo studies to support the application of synergistic synbiotic carrying whole-plant complex prebiotic fibre and probiotic in resolving in the inflammatory cycle in IBD.
  • 922
  • 16 Apr 2021
Topic Review
Link of Microbiome–Gut–Brain Axis and Brain Disorders
Neuropsychiatric diseases cover a wide spectrum of diseases affecting the brain, behaviour, and mood, affecting people of any age. Disruptions in microbial compositions have been implicated in diseases such as asthma, diabetes, inflammatory bowel disease, obesity, and autism. The microbiota–gut–brain axis (MGBA) is a bidirectional communication pathway between the gut bacteria and the central nervous system (CNS). It is an extension of the gut–brain axis, in which the enteric nervous system (ENS), CNS, and the GI-tract work together to affect physiological aspects of the gut: motility, secretion, and acid and mucus production. The bacteria may influence the brain via the production of neurotransmitters and bacterial metabolites via stimulation of the vagal nerve, the immune system, or the hypothalamic–pituitary–adrenal axis (HPA-axis). On the other hand, the brain’s effects on the gut in terms of secretion, peristalsis, and sensory are mainly transferred via the vagus nerve.
  • 922
  • 05 Sep 2022
Topic Review
Computer-Aided Polyp Detection
Artificial intelligence (AI) applied to medicine is here to stay. In gastroenterology, AI computer vision applications have been stated as a research priority. The two main AI system categories are computer-aided polyp detection (CADe) and computer-assisted diagnosis (CADx). CADe can detect previously unrecognized lesions and serve as “a second set of eyes” by continuously monitoring mechanisms. Furthermore, these systems may help to reduce in-day variations in ADRs due to operator fatigue.
  • 922
  • 20 Apr 2023
Topic Review
Systemic Therapies for Hepatocellular Carcinoma
Clinical treatment of Hepatocellular carcinoma (HCC) in initial stages includes surgical therapies, resection or tumor ablation, transplantation and transarterial chemoembolization (TACE). In advanced HCC, useful systemic therapies were not available for patients until 2007, when sorafenib was approved.After years without major therapeutic improvements and with increasing incidence, finally advances are arriving for HCC treatment. Sorafenib is no longer the only systemic therapy for patients, and novel combinations are already working in clinical trials. Accumulating data demonstrate that etiology and the HCC microenvironment have a major influence on tumor growth and immune control. The improved knowledge of the specific molecular mechanisms involved is expected to provide evidence-based information critical for clinical management.
  • 921
  • 19 Apr 2022
Topic Review
TLR4 Signaling in Hepatocellular Carcinoma Immunotherapy
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and is a leading cause of cancer-related death worldwide. Immunotherapy has emerged as the mainstay treatment option for unresectable HCC. Toll-like receptor 4 (TLR4) plays a crucial role in the innate immune response by recognizing and responding primarily to bacterial lipopolysaccharides. In addition to its role in the innate immune system, TLR4 has also been implicated in adaptive immunity, including specific anti-tumor immune responses. In particular, the TLR4 signaling pathway seems to be involved in the regulation of several cancer hallmarks, such as the continuous activation of cellular pathways that promote cell division and growth, the inhibition of programmed cell death, the promotion of several invasion and metastatic mechanisms, epithelial-to-mesenchymal transition, angiogenesis, drug resistance, and epigenetic modifications. Emerging evidence further suggests that TLR4 signaling holds promise as a potential immunotherapeutic target in HCC
  • 921
  • 21 Nov 2023
Topic Review
Gastrointestinal Involvement in Extra-Digestive Disease
Calprotectin (CP) is a dimer composed of S100A8 and S100A9, which are calcium and zinc binding proteins. CP is found mainly in neutrophils, where under constitutive conditions, it represents about 45% of the total cytosolic protein. Moreover, calprotectin is constitutively expressed by monocytes, macrophages, dendritic cells oral keratocytes and squamous mucosal epithelium. In inflammation, the expression of calprotectin is increased. CP is released by neutrophils, monocytes, and macrophages during inflammation due to its antimicrobial properties. CP can be detected in serum, urine, cerebrospinal, synovial, and pleural fluids in proportion to the degree of any existing inflammation, but the most useful and widely used form is in stool as a reliable marker of intestinal tissue inflammation. Moreover, CP concentration in feces is approximately six times higher than in plasma.
  • 920
  • 13 Jan 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. 
  • 916
  • 27 Apr 2021
Topic Review
Chitosan-Based Nanomaterials and its Applications
The small intestine provides the major site for the absorption of numerous orally administered drugs. However, before reaching to the systemic circulation to exert beneficial pharmacological activities, the oral drug delivery is hindered by poor absorption/metabolic instability of the drugs in gastrointestinal (GI) tract and the presence of the mucus layer overlying intestinal epithelium. Therefore, a polymeric drug delivery system has emerged as a robust approach to enhance oral drug bioavailability and intestinal drug absorption. Chitosan, a cationic polymer derived from chitin, and its derivatives have received remarkable attention to serve as a promising drug carrier, chiefly owing to their versatile, biocompatible, biodegradable, and non-toxic properties. Several types of chitosan-based drug delivery systems have been developed, including chemical modification, conjugates, capsules, and hybrids. They have been shown to be effective in improving intestinal assimilation of several types of drugs, e.g., antidiabetic, anticancer, antimicrobial, and anti-inflammatory drugs. In this review, the physiological challenges affecting intestinal drug absorption and the effects of chitosan on those parameters impacting on oral bioavailability are summarized. More appreciably, types of chitosan-based nanomaterials enhancing intestinal drug absorption and their mechanisms, as well as potential applications in diabetes, cancers, infections, and inflammation, are highlighted. The future perspective of chitosan applications is also discussed. 
  • 915
  • 13 Jul 2021
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.
  • 915
  • 08 Dec 2022
Topic Review
Extra-Intestinal Manifestations of Celiac Disease
Celiac disease (CD) is a chronic, small-intestinal, immune-mediated enteropathy due to gluten exposition in genetically predisposed individuals. It occurs in about 1% of the population and often remains an underdiagnosed condition. This could be due to the fact that the adult population often lacks the classical signs and symptoms of CD, manifesting only atypical symptoms.
  • 914
  • 26 Jan 2022
Topic Review
Non-Alcoholic Fatty Liver Disease and Cardiovascular Disease
Non-alcoholic fatty liver disease (NAFLD) is a metabolic liver disease, which classically includes a spectrum of progressive pathological conditions, ranging from simple steatosis to non-alcoholic steatohepatitis (NASH) with different grades of fibrosis and cirrhosis. NAFLD is also a “multisystemic” disease, NAFLD is independently associated with serious hepatic complications (e.g., hepatic decompensation, hepatocellular carcinoma [HCC]), but also with an increased risk of developing cardiovascular disease (CVD).
  • 913
  • 17 Feb 2022
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.
  • 913
  • 15 Jul 2022
Topic Review
Occult Infection with Hepatitis C Virus
Occult infection with hepatitis C virus (OCI) is defined as the presence of HCV-RNA in hepatocytes, and/or PBMCs in individuals, who are HCV-RNA negative in serum by conventional diagnostic tests (with LoD 15 IU/mL). Depending on the presence or absence of anti-HCV in serum, two types of OCI are distinguished—seronegative and seropositive. Occult viral persistence by definition escapes clinical diagnostic schemes and can last for many years after spontaneous or treatment-induced sustained virological response (SVR).
  • 910
  • 29 Dec 2021
Topic Review
Diagnosis of Early Gastrointestinal Neoplasia
Meticulous endoscopic characterization of gastrointestinal neoplasias (GN) is crucial to the clinical outcome. Hereby the indication and type of resection (endoscopically, en-bloc or piece-meal, or surgical resection) are determined. By means of established image-enhanced (IEE) and magnification endoscopy (ME) GN can be characterized in terms of malignancy and invasion depth. In this context, the statistical evidence and accuracy of these diagnostic procedures should be elucidated. Here, we present a systematic review of the literature. Results: 21 Studies could be found which met the inclusion criteria. In clinical prospective trials and meta-analyses, the diagnostic accuracy of >90% for characterization of malignant neoplasms could be documented, if ME with IEE was used in squamous cell esophageal cancer, stomach, or colonic GN. Conclusions: Currently, by means of optical diagnosis, today’s gastrointestinal endoscopy is capable of determining the histological subtype, exact lateral spread, and depth of invasion of a lesion. The prerequisites for this are an exact knowledge of the anatomical structures, the endoscopic classifications based on them, and a systematic learning process, which can be supported by training courses. More prospective clinical studies are required, especially in the field of Barrett’s esophagus and duodenal neoplasia.
  • 909
  • 13 Jul 2021
Topic Review
Inflammation in COVID-19
SARS-CoV-2 is an enveloped and positive-sense single stranded RNA (+ssRNA) virus. It belongs to the betacoronavirus family, one of the four groups of the coronoviridae, which also includes two highly pathogenic viruses, Severe Acute Respiratory Syndrome Human Coronavirus (SARS-CoV) and the Middle Eastern Respiratory Syndrome Coronavirus (MERS-Cov).
  • 906
  • 28 Nov 2022
Topic Review
Chronic Inflammatory Bowel Diseases
Susceptibility and disease course of COVID-19 among patients with inflammatory bowel diseases (IBD) are unclear and epidemiological data on the topic are still limited. There is some concern that patients with immuno-mediated diseases such as IBD, which are frequently treated with immunosuppressive therapies, may have an increased risk of SARS-CoV-2 infection with its related serious adverse outcomes, including intensive care unit (ICU) admission and death. Corticosteroids, immunomodulators, and biologic drugs, which are commonly prescribed to these patients, have been associated with higher rates of severe viral and bacterial infections including influenza and pneumonia. It is not known whether these drugs can be so harmful as to justify their interruption during COVID-19 infection or if, on the contrary, patients with IBD can benefit from them. As shown by recent reports, it cannot be excluded that drugs that suppress the immune system can block the characteristic cytokine storm of severe forms of COVID-19 and consequently reduce mortality. Another cause for concern is the up-regulation of angiotensin converting enzyme-2 (ACE2) receptors that has been noticed in these patients, which could facilitate the entry and replication of SARS-CoV-2. The aim of this narrative review is to clarify the susceptibility of SARS-CoV-2 infection in patients with IBD, the clinical characteristics of patients who contract the infection, and the relationship between the severity of COVID-19 and immunosuppressive treatment. 
  • 904
  • 08 Oct 2021
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