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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.
  • 876
  • 10 Nov 2022
Topic Review
Physiopathology of Crohn’s Disease
Crohn’s disease (CD) is a severe chronic inflammatory disease of the gastrointestinal tract (GIT) with relapsing–remitting behavior. It is also called regional ileitis due to its frequent involvement of the ileum, which can occur anywhere in the GIT, being typically transmural.
  • 876
  • 15 Feb 2023
Topic Review
JAK-STAT Pathway in Immune Checkpoint Inhibitor-Induced Colitis Patients
Immunotherapy has emerged as a pivotal component in the treatment of various malignancies, encompassing lung, skin, gastrointestinal, and head and neck cancers. The foundation of this therapeutic approach lies in immune checkpoint inhibitors (ICI). While ICIs have demonstrated remarkable efficacy in impeding the neoplastic progression of these tumours, their use may give rise to substantial toxicity, notably in the gastrointestinal domain, where ICI colitis constitutes a significant aspect. The optimal positioning of Janus kinase (JAK)–signal transducer and activator of transcription (STAT) pathway inhibitors in the therapeutic management of ICI colitis remains unclear. Numerous reports have highlighted notable improvements in ICI colitis through the application of pan-JAK-STAT inhibitors, with tofacitinib, in particular, reporting evident clinical remission of colitis. 
  • 876
  • 08 Feb 2024
Topic Review
Liver Transplantation versus Liver Resection
For patients with early-stage hepatocellular carcinoma, it is important to know whether liver transplantation offers a survival benefit over liver resection. Patients receiving transplantation often have different characteristics in terms of their cancer stage and liver function compared to those being resected. This makes a comparison of the two treatment modalities challenging. This article presents a critical appraisal of the currently available literature. We not only provide a summary of the main results of individual articles but also describe their strengths and weaknesses, the relationships among them, and their trends. As a result, we suggest the regression discontinuity design for future studies that uses thresholds of a treatment guideline to help ensure that the groups are more comparable. 
  • 873
  • 29 Mar 2022
Topic Review
Pathogenesis of Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is a very complex world health problem. Approximately 905,677 new cases and 830,180 HCC-related deaths were reported in 2020. The estimation of more than 1 million deaths caused by HCC by 2030 has been predicted. The pathogenesis of hepatocellular carcinoma (HCC) is a multifactorial process that has not yet been fully investigated.
  • 872
  • 08 May 2023
Topic Review
Surgical Techniques for Rectal Prolapse
Complete rectal prolapse or rectal procidentia is a debilitating disease that presents with fecal incontinence, constipation, and rectal discharge. Definitive surgical techniques described for this disease include perineal procedures such as mucosectomy and rectosigmoidectomy, and abdominal procedures such as rectopexy with or without mesh and concomitant resection. The debate over these techniques regarding the lowest recurrence and morbidity rates, and the best functional outcomes for constipation or incontinence, has been going on for decades. The heterogeneity of available studies does not allow us to draw firm conclusions. 
  • 870
  • 02 Aug 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.
  • 869
  • 21 Apr 2021
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.
  • 868
  • 26 Oct 2021
Topic Review
Current Helicobacter Pylori Diagnostics
Helicobacter pylori (H. pylori) is one of the most common human pathogens and a leading etiological factor for various gastroduodenal diseases, including chronic gastritis, peptic ulcers, gastric adenocarcinoma, and MALT lymphoma. According to the latest systematic review with meta-analysis, 44.3% (95% CI: 40.9–47.7) of the global population are infected with this microorganism. Timely diagnosis and subsequent eradication of H. pylori in adults allows one to resolve inflammatory changes in the gastric mucosa and prevent the development of precancerous conditions (atrophic gastritis and intestinal metaplasia).
  • 862
  • 26 Aug 2021
Topic Review
Inflammation and Infections in Anal Cancer
The anal canal is a short (3–4 cm) segment located distal to the rectum, commencing at the anorectal ring and extending to the anal verge. The World Health Organization classifies anal canal cancers as epithelial, mesenchymal and secondary tumors. Anal squamous cell cancer (SCC) occurs most frequently, accounting for approximately 80% to 85% of all anal canal cancers.
  • 862
  • 13 May 2022
Topic Review
Emerging Therapies for Advanced Cholangiocarcinoma
Cholangiocarcinoma (CCA) is a rare malignant tumor that develops from the epithelium of the bile ducts or peribiliary glands (PBGs). Although CCA is considered a rare tumor in Western countries, it represents 3% of all gastrointestinal malignant tumors worldwide and the second most common primary liver cancer
  • 861
  • 05 Nov 2021
Topic Review
Microbiota in Healthy Individuals
Although the microbiome is dynamic, changing in relation with human age and health status, there is an equilibrium between different types of species maintaining eubiosis and sustaining an absence of pathology. “All diseases begin in the gut” is an ancient quote that still maintains its truth: alteration of the composition and function of the healthy microbial structure leads to dysbiosis, resulting in various gastrointestinal (GI) disorders, systemic metabolic diseases, and neurological impairments.
  • 860
  • 14 Dec 2022
Topic Review
Cholestatic Pruritus in Children
Pruritus in the setting of cholestatic liver disease is difficult to treat and occurs in patients ranging in age from infancy to adulthood. Likely multifactorial in etiology, this symptom often involves multimodal therapy targeting several pathways and mechanisms proposed in the underlying etiology of cholestatic pruritus. Conventional therapies for the treatment of cholestatic pruritus in children include ursodeoxycholic acid, cholestyramine, hydroxyzine, and rifampin. Therapies used in the adult population with limited data in pediatric patients include opioid antagonists and selective serotonin reuptake inhibitors. Ileal bile acid transport inhibitors have been shown to alleviate pruritus in many children with Alagille syndrome and progressive familial intrahepatic cholestasis and it is an additional therapy available for consideration for these patients. Ultimately, surgical management and liver transplantation are considered in select refractory cases.
  • 860
  • 14 Jun 2023
Topic Review
Screening for NAFLD in the Outpatient Pharmacy
Non-alcoholic fatty liver disease (NAFLD) stands as an increasingly pressing global health challenge, underscoring the need for timely identification to facilitate effective treatment and prevent the progression of chronic liver disorders. Given the projected scarcity of specialized healthcare professionals, particularly hepatologists and gastroenterologists, the role of pharmacists emerges as pivotal in NAFLD management. 
  • 857
  • 28 Sep 2023
Topic Review
Enteric Glia and Its Modulation by Endocannabinoid System
The enteric nervous system (ENS) is a part of the autonomic nervous system that intrinsically innervates the gastrointestinal (GI) tract. Whereas enteric neurons have been deeply studied, the enteric glial cells (EGCs) have received less attention. However, these are immune-competent cells that contribute to the maintenance of the GI tract homeostasis through supporting epithelial integrity, providing neuroprotection, and influencing the GI motor function and sensation. The endogenous cannabinoid system (ECS) includes endogenous classical cannabinoids (anandamide, 2-arachidonoylglycerol), cannabinoid-like ligands (oleoylethanolamide (OEA) and palmitoylethanolamide (PEA)), enzymes involved in their metabolism (FAAH, MAGL, COX-2) and classical (CB1 and CB2) and non-classical (TRPV1, GPR55, PPAR) receptors. The ECS participates in many processes crucial for the proper functioning of the GI tract, in which the EGCs are involved.
  • 854
  • 01 Nov 2022
Topic Review
Intestinal Microbiota and miRNA in IBD
Inflammatory bowel disease (IBD) includes Crohn’s disease (CD) and ulcerative colitis (UC) and comprises a chronic gastrointestinal tract disorder characterized by hyperactive and dysregulated immune responses to environmental factors, including gut microbiota and dietary components.
  • 851
  • 20 Apr 2023
Topic Review
The Role of aHSCs in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is a global healthcare challenge, which affects more than 815,000 new cases every year. Activated hepatic stellate cells (aHSCs) remain the principal cells that drive HCC onset and growth. aHSCs suppress the anti-tumor immune response through interaction with different immune cells. They also increase the deposition of the extracellular matrix proteins, challenging the reversion of fibrosis and increasing HCC growth and metastasis.
  • 840
  • 27 Dec 2022
Topic Review
Natural Coumarin Derivatives Used for Intestinal Anti-Inflammatory Drugs
Coumarin derivatives modulating the Nrf2 signaling pathway and displaying simultaneous intestinal anti-inflammatory activities, effects potentially useful in the management of intestinal inflammatory processes. Coumarin derivatives modulating the Nrf2 signaling pathway and displaying intestinal anti-inflammatory activity include simple coumarins, linear and angular furanocoumarins from plant origin, and coumarin derivatives produced by the fermentative process performed by gut microbiota on the plant-derived products commonly used in human feeding.
  • 840
  • 25 Apr 2023
Topic Review
Acute Liver Injury and COVID-19
COVID-19 patients with severe illness are likely to present with atypical liver biochemistry tests. A number of systematic and meta-analysis studies have examined pooled odds ratios of hepatocellular and hepatobiliary enzymes to differentiate between severe and non-severe COVID-19 illness. In a meta-analysis of 8 studies involving 7467 COVID-19 patients by Xin et al. individuals had pooled odds ratio of 3.21, 2.35 and 1.87 for elevated AST, ALT and total bilirubin levels respectively in severe illness.
  • 839
  • 23 Nov 2021
Topic Review
High-Quality Colonoscopy Components 1, 2 & 3
Colorectal cancer (CRC) continues to be the third leading cause of cancer-related deaths in the US. Colonoscopy remains the best preventative tool against the development of CRC. As a result, high-quality colonoscopy is becoming increasingly important.
  • 837
  • 09 Jun 2022
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