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Topic Review
Vitamin D Signaling in Gastro-Rheumatology
Vitamin D has been recently pointed out, and abnormalities of the vitamin D axis have been described in both in vitro and in vivo models of inflammatory bowel diseases (IBD) and arthritis.
  • 706
  • 29 Apr 2021
Topic Review
Epigenetic Mechanisms in the Regulating of PPARγ Function
Contrary to genetic changes in heritability, epigenetics is the study of heritable modifications in gene activity that do not involve direct alteration of the underlying DNA sequences. Epigenetics determines the architecture of chromatin in cell nucleus, and therefore affects specific genomic sequences accessible to cellular regulatory machineries. The epigenome is susceptible to dysregulation throughout life but is highly vulnerable to environmental factors during fetal life since this is a period of rapid DNA synthesis. 
  • 704
  • 06 May 2023
Topic Review
Artificial Intelligence in Endoscopic Ultrasound
Endoscopic Ultrasound (EUS) is widely used for the diagnosis of bilio-pancreatic and gastrointestinal (GI) tract diseases, for the evaluation of subepithelial lesions, and for sampling of lymph nodes and solid masses located next to the GI tract. The role of Artificial Intelligence in healthcare in growing.
  • 704
  • 16 Jun 2023
Topic Review
Effects of GLP-1 Receptor Agonists on NAFLD
Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease, affecting up to 70% of patients with diabetes. There are no specific drugs available for its treatment. Beyond their anti-hyperglycemic effect and the surprising role of cardio- and nephroprotection, GLP-1 receptor agonists (GLP-1 RAs) have shown a significant impact on body weight and clinical, biochemical and histological markers of fatty liver and fibrosis in patients with NAFLD. Therefore, GLP-1 RAs could be a weapon for the treatment of both diabetes mellitus and NAFLD. 
  • 699
  • 12 May 2023
Topic Review
Obesity in Type 2 Diabetes Mellitus
Obesity or excessive weight gain is identified as the most important and significant risk factor in the development and progression of type 2 diabetes mellitus (DM) in all age groups. It has reached pandemic dimensions, making the treatment of obesity crucial in the prevention and management of type 2 DM worldwide. 
  • 698
  • 08 Feb 2024
Topic Review
Immune Classification of Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is a common and aggressive cancer with a high mortality rate. The incidence of HCC is increasing worldwide, and the lack of effective screening programs often results in delayed diagnosis, making it a challenging disease to manage. Immunotherapy has emerged as a promising treatment option for different kinds of cancers, with the potential to stimulate the immune system to target cancer cells. However, the current immunotherapeutic approaches for HCC have shown limited efficacy. Since HCC arises within a complex tumour microenvironment (TME) characterized by the presence of various immune and stromal cell types, the understanding of this interaction is crucial for the identification of effective therapy.
  • 698
  • 31 Jul 2023
Topic Review
Nonalcoholic Fatty Liver Disease Management
Nonalcoholic fatty liver disease (NAFLD) is a rising epidemic worldwide, involving more than a quarter of the world's population. A sedentary lifestyle and consuming a Western diet have led to substantial challenges in managing NAFLD patients. With no curative pharmaceutical therapies, lifestyle modifications, including dietary changes and exercise, that ultimately lead to weight loss remain the only effective therapy for NAFLD. 
  • 693
  • 09 Dec 2021
Topic Review
The Quality of Upper Gastrointestinal Endoscopy
Upper gastrointestinal endoscopy, or EGD, is essential for diagnosing and managing ailments of the upper gastrointestinal tract. The quality of EGD is crucial and carries significant consequences for patient outcomes, the employment of healthcare resources, and the future course of gastroenterology as a medical specialty.
  • 691
  • 28 Dec 2023
Topic Review
Gastrointestinal Endoscopy of Neuroendocrine Neoplasms
Neuroendocrine neoplasms (NENs), also called neuroendocrine tumors (NETs), are relatively uncommon, heterogenous tumors primarily originating in the gastrointestinal tract. With the improvement in technology and increasing use of cross-sectional imaging and endoscopy, they are being discovered with increasing frequency. Advanced gastrointestinal endoscopic technique scan play a crucial role in the diagnosis and management of this rare condition.
  • 691
  • 12 Sep 2023
Topic Review
Opioid-Induced Gut Microbial Dysbiosis
Acute (and thus persistent) pain typically begins with nociceptors; the terminal ends of sensory neurons which are found within the peripheral nervous system (PNS) and are often managed with opioids. Opioid-induced dysbiosis (OID) is a specific condition describing the consequences of opioid use on the bacterial composition of the gut. Opioids have been shown to affect the epithelial barrier in the gut and modulate inflammatory pathways, possibly mediating opioid tolerance or opioid-induced hyperalgesia; in combination, these allow the invasion and proliferation of non-native bacterial colonies. Gut microbial dysbiosis is a change in the gut microbiota’s functional or structural configuration that disrupts gut homeostasis and is linked to several diseases. The changes in the balance and composition of gut microbiota are referred to as opioid-induced dysbiosis (OID), and they are linked to a variety of disease states and the development of antinociceptive tolerance.
  • 689
  • 09 Aug 2022
Topic Review
Diagnosis of Mirizzi Syndrome
Mirizzi syndrome is a complication of gallstone disease caused by an impacted gallstone in the infundibulum of the gallbladder or within the cystic duct, causing chronic inflammation and extrinsic compression of the common hepatic duct or common bile duct. Eventually, mucosal ulceration occurs and progresses to cholecystobiliary fistulation. Numerous systems exist to classify Mirizzi syndrome, with the Csendes classification widely adopted. It describes five types of Mirizzi syndrome according to the presence of a cholecystobiliary fistula and its corresponding severity, and whether a cholecystoenteric fistula is present. 
  • 685
  • 15 Jan 2024
Topic Review
Diet and Nutritional Interventions in Early Life
The infant gut microbiome plays a key role in the healthy development of the human organism and appears to be influenced by dietary practices through multiple pathways. First, maternal diet during pregnancy and infant nutrition significantly influence the infant gut microbiota. Moreover, breastfeeding fosters the proliferation of beneficial bacteria, while formula feeding increases microbial diversity. The timing of introducing solid foods also influences gut microbiota composition. In preterm infants the gut microbiota development is influenced by multiple factors, including the time since birth and the intake of breast milk, and interventions such as probiotics and prebiotics supplementation show promising results in reducing morbidity and mortality in this population.
  • 685
  • 27 Feb 2024
Topic Review
Lipidomics in Non-Alcoholic Fatty Liver Disease
The prevalence of non-alcoholic fatty liver disease (NAFLD) and associated complications, such as hepatocellular carcinoma (HCC), is growing worldwide, due to the epidemics of metabolic risk factors, such as obesity and type II diabetes. Among other factors, an aberrant lipid metabolism represents a crucial step in the pathogenesis of NAFLD and the development of HCC in this population.
  • 685
  • 26 Apr 2023
Topic Review
Promising Highly Targeted Therapies for Cholangiocarcinom
To overcome the poor prognosis of cholangiocarcinoma (CCA), highly targeted therapies, such as antibody-drug conjugates (ADCs), photodynamic therapy (PDT) with/without systemic chemotherapy, and experimental photoimmunotherapy (PIT), have been developed. Three preclinical trials have investigated the use of ADCs targeting specific antigens, namely HER2, MUC1, and glypican-1 (GPC1), for CCA. Trastuzumab emtansine demonstrated higher antiproliferative activity in CCA cells expressing higher levels of HER2. PDT is effective in areas where appropriate photosensitizers and light coexist. Its mechanism involves photosensitizer excitation and subsequent reactive oxygen species production in cancer cells upon irradiation. Hematoporphyrin derivatives, temoporfin, phthalocyanine-4, talaporfin, and chlorine e6 derivatives have mainly been used clinically and preclinically in bile duct cancer. PIT is the most novel anti-cancer therapy developed in 2011 that selectively kills targeted cancer cells using a unique photosensitizer called “IR700” conjugated with an antibody specific for cancer cells. PIT is currently in the early stages of development for identifying appropriate CCA cell targets and irradiation devices. Future human and artificial intelligence collaboration has potential for overcoming challenges related to identifying universal CCA cell targets. This could pave the way for highly targeted therapies for CCA, such as ADC, PDT, and PIT.
  • 684
  • 25 Jul 2023
Topic Review
Metabolic-Dysfunction-Associated Steatotic Liver Disease
Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a chronic liver disease that affects more than a quarter of the global population and whose prevalence is increasing worldwide due to the pandemic of obesity. Obesity, impaired glucose metabolism, high blood pressure and atherogenic dyslipidemia are risk factors for MASLD.
  • 683
  • 01 Nov 2023
Topic Review
Direct Endoscopic Necrosectomy
Walled-off pancreatic necrosis (WOPN) is one of the local complications of acute pancreatitis (AP). Several interventional techniques have been developed over the last few years. The purpose of this entry is to explore such methodologies, with specific focus on endoscopic drainage and direct endoscopic necrosectomy (DEN), through evaluation of their indications and timing for intervention. Findings indicated how, after the introduction of lumen-apposing metal stents (LAMS), DEN is becoming the favorite technique to treat WOPN, especially when large solid debris or infection are present. Additionally, DEN is associated with a lower adverse events rate and hospital stay, and with improved clinical outcome.
  • 682
  • 19 Apr 2022
Topic Review
Microbiota and Non-Alcoholic Steatohepatitis
Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of chronic liver illness associated with obesity and metabolic disorders, such as hypertension, dyslipidemia, or type 2 diabetes mellitus. A more severe type of NAFLD, non-alcoholic steatohepatitis (NASH), is considered an ongoing global health threat and dramatically increases the risks of cirrhosis, liver failure, and hepatocellular carcinoma. Non-alcoholic fatty liver disease (NAFLD), which is characterized by an increase in fat accumulation in the form of micro and macro vacuoles of lipids into hepatocytes (named steatosis), is the most common liver disorder worldwide. Steatosis is classified as mild (5–33%), moderate (34–66%), or severe (more than 66%) depending on the fat number in vacuoles within the cytoplasm of hepatocytes. Additionally, other histopathological features should be taken into account in the presence of steatosis including inflammation, fibrosis, and ballooning degeneration.
  • 681
  • 06 Apr 2021
Topic Review
Artificial Endoscopy
Artificial intelligence (AI) is defined as any machine that has cognitive functions mimicking humans for problem solving or learning. AI has already been tested in several fields of endoscopy, such as in the detection of Barrett’s esophagus or the evaluation of adenoma detection rate during colonoscopy.
  • 680
  • 23 Feb 2022
Topic Review
Role of Exosomes in Immunotherapy of Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is one of the most lethal malignancies, having a significantly poor prognosis and no sufficiently efficient treatments. Immunotherapy, especially immune checkpoint inhibitors (ICIs), has provided new therapeutic approaches for HCC patients. Nevertheless, most patients with HCC do not benefit from immunotherapy. Exosomes are biologically active lipid bilayer nano-sized vesicles ranging in size from 30 to 150 nm and can be secreted by almost any cell.
  • 678
  • 01 Sep 2022
Topic Review
Juvenile Autoimmune Hepatitis
Juvenile autoimmune hepatitis (JAIH) is severe immune-mediated necro-inflammatory disease of the liver with spontaneous progression to cirrhosis and liver failure if left untreated. The diagnosis is based on the combination of clinical, laboratory and histological findings. Prothrombin ratio is a useful prognostic factor to identify patients who will most likely require a liver transplant by adolescence or early adulthood. JAIH treatment consists of immune suppression and should be started promptly at diagnosis to halt inflammatory liver damage and ultimately prevent fibrosis and progression to end-stage liver disease. The risk of relapse is high especially in the setting of poor treatment compliance.
  • 676
  • 06 Sep 2023
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