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Topic Review
MicroRNAs in Ulcerative Colitis
Ulcerative colitis (UC) is a major type of inflammatory bowel disease (IBD), characterized by chronic inflammation of the colon and rectum. Inflammation confined to the mucosa is distributed continuously from the rectum to the proximal colon in UC and causes bloody stools, diarrhea, and abdominal pain.
  • 786
  • 20 Dec 2021
Topic Review
Endoscopic Bariatric and Metabolic Therapies
Obesity is a chronic disease that is becoming increasingly more prevalent and is associated with many health problems, such as metabolic syndrome. The treatment options for obese patients include lifestyle modification, medications, endoscopic bariatric and metabolic therapies (EBMTs), and surgery. In particular, EBMTs have an excellent therapeutic effect and are less invasive than bariatric surgery.
  • 785
  • 10 Aug 2021
Topic Review
The Impact of MicroRNAs during Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a debilitating autoimmune disease characterised by chronic inflammation along the GI tract. Patients diagnosed with IBD are symptomatic for recurrent intestinal inflammation, diarrhoea, abdominal pain, rectal bleeding, weight loss and anaemia. Due to its complexity, a number of factors are attributed to IBD aetiology, including patients’ genetics and makeup of microbiota, food and pharmaceutical consumption, and even limiting antigen exposure due to excessive sanitation. All these aspects further contribute to changes in miRNA expression.
  • 784
  • 24 Apr 2022
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.
  • 782
  • 23 Nov 2021
Topic Review
Oxidative Stress and Nervous Distress in Gastrointestinal Disorders
Oxidative stress is increasingly recognized as a central player in a range of gastrointestinal (GI) disorders, as well as complications stemming from therapeutic interventions. The dysfunction of the ENS is characteristic of a spectrum of disorders, including neurointestinal diseases and conditions such as inflammatory bowel disease (IBD), diabetic gastroparesis, and chemotherapy-induced GI side effects. Neurons in the Enteric nervous system (ENS), while essential for normal gut function, appear particularly vulnerable to oxidative damage. Mechanistically, oxidative stress in enteric neurons can result from intrinsic nitrosative injury, mitochondrial dysfunction, or inflammation-related pathways. Although antioxidant-based therapies have shown limited efficacy, recognizing the multifaceted role of oxidative stress in GI diseases offers a promising avenue for future interventions.
  • 782
  • 01 Nov 2023
Topic Review
Endocrine-Disrupting Chemicals and Nonalcoholic Fatty Liver Disease
Ecological theories suggest that environmental factors significantly influence obesity risk and related syndemic morbidities, including metabolically abnormal obesity associated with nonalcoholic fatty liver disease (MASLD). These factors encompass anthropogenic influences and endocrine-disrupting chemicals (EDCs), synergistically interacting to induce metabolic discrepancies, notably in early life, and disrupt metabolic processes in adulthood. 
  • 782
  • 19 Feb 2024
Topic Review
Nutrition in Pediatric IBD
Inflammatory bowel disease (IBD) refers to a heterogeneous group of disorders encompassing Crohn’s disease (CD), ulcerative colitis (UC) and unclassified inflammatory bowel disease (IBD-U), characterized by a chronic inflammation of the intestinal tract with a relapsing-remitting behavior, and variably presenting with abdominal pain, diarrhea, rectal bleeding and weight loss. Dietary factors and malnutrition play a primary role in the onset and management of pediatric IBD. Moreover, an appropriate diet can decrease the risk of IBD flares, and an age-adequate nutritional status can decrease the risk of complications and surgery in the long-term stage of the disease. Enteral nutrition has a significant impact on mucosal inflammation in CD, and clinical response to oral polymeric diet is associated with down-regulation of mucosal pro-inflammatory cytokines. Nutritional strategies, such as exclusive enteral nutrition or CDED diet, have shown to be more effective than steroids in inducing clinical remission in pediatric patients.
  • 781
  • 13 Apr 2021
Topic Review
Cognitive Dysfunction in NAFLD
Non-alcoholic fatty liver disease (NAFLD) has emerged as the hepatic component of the metabolic syndrome and now seemingly affects one-fourth of the world population. Several features associated with NAFLD have frequently been linked to cognitive dysfunction, i.e. systemic inflammation, impaired urea synthesis, vascular dysfunction, gut dysbiosis, and sleep apnoea. Considering the growing burden of NAFLD, the morbidity from cognitive dysfunction is expected to have huge societal and economic impact. Here, a review of the clinical evidence of cognitive dysfunction in NAFLD is provided.
  • 779
  • 04 Mar 2021
Topic Review
Cytokines and Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) represents a worldwide health matter with a major care burden, high prevalence, and poor prognosis. Its pathogenesis mainly varies depending on the underlying etiological factors, although it develops from liver cirrhosis in the majority of cases. In the premalignant environment, inflammatory cells release a wide range of cytokines, chemokines, growth factors, prostaglandins, and proangiogenic factors, making the liver environment more suitable for hepatocyte tumor progression that starts from acquired genetic mutations. A complex interaction of pro-inflammatory (IL-6, TNF-α) and anti-inflammatory cytokines (TGF-α and -β), pro-angiogenic molecules (including the Angiopoietins, HGF, PECAM-1, HIF-1α, VEGF), different transcription factors (NF-kB, STAT-3), and their signaling pathways are involved in the development of HCC. Since cytokines are expressed and released during the different stages of HCC progression, their measurement, by different available methods, can provide in-depth information on the identification and management of HCC. 
  • 779
  • 13 Jan 2023
Topic Review
TAM Receptors in the Pathophysiology of Liver Disease
TAM receptors (Tyro3, Axl and MerTK) are a family of tyrosine kinase receptors that are expressed in a variety of cell populations, including liver parenchymal and non-parenchymal cells These receptors are vital for immune homeostasis, as they regulate the innate immune response by suppressing inflammation via toll-like receptor inhibition and by promoting tissue resolution through efferocytosis. However, there is increasing evidence indicating that aberrant TAM receptor signaling may play a role in pathophysiological processes in the context of liver disease. This review will explore the roles of TAM receptors and their ligands in liver homeostasis as well as a variety of disease settings, including acute liver injury, steatosis, fibrosis, cirrhosis-associated immune dysfunction and hepatocellular carcinoma. A better understanding of our current knowledge of TAM receptors in liver disease may identify new opportunities for disease monitoring as well as novel therapeutic targets. Nonetheless, this review also aims to highlight areas where further research on TAM receptor biology in liver disease is required.
  • 778
  • 28 Jan 2022
Topic Review
Diagnosis and Prognosis of Nonalcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, occurring in both obese and lean patients. It can lead to life-threatening liver diseases and nonhepatic complications, such as cirrhosis and cardiovascular diseases, that burden public health and the health care system. While liver biopsies are the gold-standard in diagnosing NAFLD, it is highly invasive. Hence, several non-invasive methods are developed to diagnose various stages of disease progression and predict NAFLD-related morbidity and mortality. 
  • 776
  • 18 Jan 2023
Topic Review
Risk Factors for Pancreatic Cancer
Pancreatic cancer is one of the most aggressive malignant neoplastic diseases. The incidence and mortality rates of this disease vary depending on geographical area, which might be explained by the different exposure to risk factors. Currently, the risk factors for pancreatic cancer fall into two broad categories, namely extrinsic and intrinsic factors. Extrinsic factors include alcohol consumption, smoking, a diet rich in saturated fats, and viral infections such as chronic infection with hepatitis B and C viruses. The pathophysiological mechanisms explaining how these hepatotropic viruses contribute to the development of pancreatic cancer are not fully elucidated. The common origin of hepatocytes and pancreatic cells in the multipotent endodermal cells, the common origin of the blood vessels and biliary ducts of the pancreas and the liver, or chronic inflammatory changes may be involved in this interaction.
  • 772
  • 19 Apr 2022
Topic Review
Epidemiology of Eosinophilic Esophagitis
Eosinophilic esophagitis is a Th-2 antigen-mediated disease in which there is an influx of eosinophils to all layers of the esophagus, triggering an inflammatory response. Chronic inflammatory process causes esophageal remodeling, leading to difficulties in swallowing. Food impaction, heartburn, and chest pain are other characteristic (but not pathognomonic) symptoms in adults.
  • 768
  • 13 Apr 2023
Topic Review
Barrett’s Esophagus
Given that endoscopic findings can be used to predict the potential of neoplastic progression in Barrett’s esophagus (BE) cases, the detection rate of dysplastic Barrett’s lesions may become higher even in laborious endoscopic surveillance because a special attention is consequently paid. However, endoscopic findings for effective detection of the risk of neoplastic progression to esophageal adenocarcinoma (EAC) have not been confirmed, though some typical appearances are suggestive. In the present review, endoscopic findings that can be used predict malignant potential to EAC in BE cases are discussed. Conventional results obtained with white light endoscopy, such as length of BE, presence of esophagitis, ulceration, hiatal hernia and nodularity, are used as indicators of a higher risk of neoplastic progression. However, there are controversies in some of those findings. Absence of palisade vessels may be also a new candidate predictor, as that reveals degree of intense inflammation and of cyclooxygenase-2 protein expression with accelerated cellular proliferation. Furthermore, an open type of mucosal pattern and enriched stromal blood vessels, which can be observed by image-enhanced endoscopy including narrow band imaging, have been confirmed as factors useful for prediction of neoplastic progression of BE because they indicate more frequent cyclooxygenase-2 protein expression along with accelerated cellular proliferation. Should the malignant potential of BE be shown predictable by these endoscopic findings, that would simplify methods used for an effective surveillance, because patients requiring careful monitoring would be more easily identified. Development in the near future of a comprehensive scoring system for BE based on clinical factors, biomarkers and endoscopic predictors is required.
  • 767
  • 05 Nov 2020
Topic Review
Role of Chronic Fatigue in Crohn Disease Patients
Crohn’s disease (CD) is a chronic, relapsing disorder belonging to inflammatory bowel diseases (IBD). It is manifested by relapsing transmural inflammation found in any segment of the gastrointestinal tract. Chronic fatigue is a common and underrecognized symptom of CD for which the prevalence is much higher in the population of CD patients compared to the healthy population. It stems from an intricate web of interactions between various risk factors. The implementation of routine screening and a holistic, multidisciplinary approach involving psychological support may be crucial in the management of CD patients with chronic fatigue.
  • 765
  • 10 Aug 2023
Topic Review
Sarcopenia and Osteosarcopenia in CLD
The liver plays a pivotal role in nutrient/energy metabolism and storage, anabolic hormone regulation, ammonia detoxification, and cytokine production. Impaired liver function can cause malnutrition, hyperammonemia, and chronic inflammation, leading to an imbalance between muscle protein synthesis and proteolysis. Patients with chronic liver disease (CLD) have a high prevalence of sarcopenia, characterized by progressive loss of muscle mass and function, affecting health-related quality of life and prognosis. Recent reports have revealed that osteosarcopenia, defined as the concomitant occurrence of sarcopenia and osteoporosis, is also highly prevalent in patients with CLD. Since the differentiation and growth of muscles and bones are closely interrelated through mechanical and biochemical communication, sarcopenia and osteoporosis often progress concurrently and affect each other. Osteosarcopenia further exacerbates unfavorable health outcomes, such as vertebral fracture and frailty. Therefore, a comprehensive assessment of sarcopenia, osteoporosis, and osteosarcopenia, and an understanding of the pathogenic mechanisms involving the liver, bones, and muscles, are important for prevention and treatment.
  • 764
  • 17 Sep 2021
Topic Review
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease (GERD) is a common esophageal disorder characterized by troublesome symptoms associated with increased esophageal acid exposure. The cornerstones of therapy in this regard include treatment with acid-suppressive agents, lifestyle modifications, and dietary therapy, although the latter has not been well defined. As concerns regarding long-term proton pump inhibitor (PPI) use continue to be explored, patients and healthcare providers are becoming increasingly interested in the role of diet in disease management. 
  • 764
  • 22 Aug 2023
Topic Review
Nonalcoholic Fatty Liver Disease and Peripheral Diabetic Polyneuropathy
Peripheral diabetic polyneuropathy (DPN) is a microvascular complication of diabetes mellitus (DM), representing the most clinically relevant manifestation of typical forms of diabetic neuropathy (DN). DPN has been associated with another pathological condition linked to DM and obesity, the nonalcoholic fatty liver disease (NAFLD). NAFLD is a metabolically derangement-based liver disease, defined by the presence of steatosis in more than 5% of hepatocytes, in association with metabolic risk factors (such as obesity, diabetes, and dyslipidemia) and in the absence of excessive alcohol consumption or other chronic liver diseases.
  • 763
  • 21 Oct 2021
Topic Review
Use of Herbal Dietary Supplements in the USA
Herbal and dietary supplement (HDS) use has grown exponentially in the United States. Unfortunately, the incidence of HDS-related liver injury has proportionally increased. Despite the potential for certain HDSs to cause clinically significant liver injury, they are not regulated by the Food and Drug Administration. The efforts have been made to regulate HDSs but are far removed from the scrutiny of prescription medications. Scant literature exists on HDSs and their risks of causing liver injury.
  • 762
  • 19 Aug 2022
Topic Review
HCC Surveillance
Hepatocellular carcinoma (HCC) is probably the epitome of a screening target, with a well-defined high-risk population, accessible screening methods, and multiple curative-intent treatments available for early disease. 
  • 761
  • 21 Jul 2021
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