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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.
  • 666
  • 26 Apr 2023
Topic Review
Benefits of Adjuvant/Neoadjuvant Chemotherapy for Pancreatic Adenocarcinoma
In addition to established evidence of the efficacy of adjuvant chemotherapy (AC) for pancreatic ductal adenocarcinoma (PDAC), evidence of the effects of neoadjuvant treatments (NATs), including chemotherapy and chemoradiotherapy, has also been accumulating. Recent results from prospective studies and meta-analyses suggest that NATs may be beneficial not only for borderline resectable PDAC, but also for resectable PDAC, by increasing the likelihood of successful R0 resection, decreasing the likelihood of the development of lymph node metastasis, and improving recurrence-free and overall survival. In addition, response to NAT may be informative for predicting the clinical course after preoperative NAT followed by surgery; in this way, the postoperative treatment strategy can be revised based on the effect of NAT and the post-neoadjuvant therapy/surgery histopathological findings.
  • 665
  • 04 Mar 2024
Topic Review
Translational Application of Fluorescent Molecular Probes
Ischemia and reperfusion injury comprise complex mechanisms involving disarrangement of the splanchnic microcirculatory flow and impairment of the mitochondrial respiratory chain due to initial hypoxemia and subsequent oxidative stress during the reperfusion phase. 
  • 664
  • 19 Apr 2022
Topic Review
Nutritional Factors Benefit Postmenopausal Women with NAFLD
Nonalcoholic fatty liver disease (NAFLD) is a prevalent condition among postmenopausal women that can lead to severe liver dysfunction and increased mortality. There is also growing evidence that specific nutritional factors may help to prevent or treat NAFLD. For example, supplementation with vitamins C, D, and E may exert beneficial effects on liver health or related metabolic features, primarily through their antioxidant and anti-inflammatory properties. Coffee consumption is inversely associated with a number of liver-related conditions, including slower progression of fibrosis, lower transaminase levels, and decreased liver-related mortality, and some of these positive effects may be due to caffeine. Caffeine has also been shown to improve features of metabolic syndrome, including hepatic injury in high carbohydrate, high-fat-diet-fed rat; increase energy expenditure; and reduce total body, trunk, and visceral fat or fat mass. 
  • 664
  • 21 Jun 2023
Topic Review
Influence of Gut–Liver Axis on Portal Hypertension
Clinically significant portal hypertension is associated with most complications of advanced chronic liver disease (ACLD), including variceal bleeding, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and hepatic encephalopathy. Gut dysbiosis is a hallmark of ACLD with portal hypertension and consists of the overgrowth of potentially pathogenic bacteria and a decrease in autochthonous bacteria; additionally, congestion makes the intestinal barrier more permeable to bacteria and their products, which contributes to the development of complications through inflammatory mechanisms within the gut–liver axis. The identification of the gut–liver liver-axis-related metabolic and molecular pathways may serve as a target for new therapeutic strategies through the modulation of the intestinal environment.
  • 663
  • 01 Sep 2022
Topic Review
Fecal Microbiota Transplantation in Inflammatory Bowel Disease
Inflammatory bowel diseases represent a complex array of diseases of incompletely known etiology that led to gastrointestinal tract chronic inflammation. In inflammatory bowel disease, a promising method of treatment is represented by fecal microbiota transplantation (FMT). As the use, safety and effectiveness of FMT for recurrent Clostridioides difficile infection (CDI) has increased in recent years, it has also demonstrated real clinical benefits for treating SARS-CoV-2 and CDI co-infection. As a result of immune dysregulation, Crohn's disease and ulcerative colitis cause damage to the digestive tract.
  • 663
  • 10 May 2023
Topic Review
Endoscopy in Inflammatory Bowel Disease
Endoscopy is an essential tool supporting inflammatory bowel disease diagnosis, and ileocolonoscopy is essential to the diagnostic process because it allows for histological sampling. A decent description of endoscopic lesions may lead to a correct final diagnosis up to 89% of the time. Moreover, endoscopy is key to evaluating endoscopic severity, which in both Crohn’s disease and ulcerative colitis is associated with worse disease outcomes (e.g., more frequent advanced therapy requirements or more frequent hospitalizations and surgeries). Endoscopic severity should be reported according to validated endoscopic scores, such as the Mayo endoscopic subscore (MES) or the ulcerative colitis endoscopic index of severity (UCEIS) for ulcerative colitis, the Rutgeerts score for postoperative Crohn’s recurrence, and the Crohn’s disease endoscopic index of severity (CDEIS) or the simplified endoscopic score for Crohn’s disease (SES-CD) for luminal Crohn’s disease activity. 
  • 662
  • 15 Nov 2023
Topic Review
Microbial Translocation Disorders
Gut microbes are immunologically tolerated in the gastrointestinal tract but trigger aggressive immune responses upon translocation across the gut barrier. Although oral tolerance, a physiological process that dampens immune responses to food proteins and commensal microbiota, remains poorly defined, significant progress was made during and after the Human Immunodeficiency Virus epidemic in the 1980s and the discovery of regulatory T cells in 1995. Additional insight was gained after the discoveries of innate lymphoid cells in 2008 and the functional elucidation of mucosal mast cells.
  • 661
  • 28 Apr 2023
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. 
  • 661
  • 15 Jan 2024
Topic Review
MRI-Based Assessment of Rectal Cancer Post-Neoadjuvant Therapy
Rectal cancer presents significant diagnostic and therapeutic challenges, with neoadjuvant therapy playing a pivotal role in improving resectability and patient outcomes. Magnetic resonance imaging (MRI) serves as a critical tool in assessing treatment response.
  • 661
  • 12 Jan 2024
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. 
  • 659
  • 12 May 2023
Topic Review
Image-Guided Locoregional Therapies (LRTs)
Image-guided locoregional therapies (LRTs) are a crucial asset in the treatment of hepatocellular carcinoma (HCC), which has proven to be characterized by an impaired antitumor immune status. LRTs not only directly destroy tumor cells but also have an immunomodulating role, altering the tumor microenvironment with potential systemic effects. 
  • 658
  • 15 Dec 2021
Topic Review
Diet–Microbiota Interplay in Macrophage Plasticity and Intestinal Health
Inflammatory bowel diseases (IBD) are chronic disorders of the gastrointestinal tract with an increasing prevalence worldwide. Macrophages, innate immune cells that exhibit high plasticity, perpetuate inflammatory signalling in IBD through excessive release of inflammatory mediators. In recent years, pioneering research has revealed the importance of the interplay between macrophages and gut microbiota in maintaining intestinal homeostasis. Particular attention is focusing on microbiota-derived metabolites, believed to possess immunomodulatory properties capable of manipulating macrophage plasticity. Microbiota-derived short-chain fatty acids (SCFAs) and indole compounds, along with dietary sourced omega-3 (ω-3) polyunsaturated fatty acids (PUFA), exert anti-inflammatory effects, attributable to interactions with macrophages.
  • 657
  • 27 May 2022
Topic Review
Management of Fibro-Stenosing Crohn’s Disease
Fibro-stenosing Crohn’s disease (CD) is a common disease presentation that leads to impaired quality of life and often requires endoscopic treatments or surgery. Managing the treatment of individuals with fibro-stenosing CD is challenging and requires a multidisciplinary team comprising a gastroenterologist, a colorectal surgeon, and a radiologist to evaluate the appropriate strategy. The optimal therapeutic approach changes according to the features of the stenosis (i.e., location, length, angulation), the presence of any associated complications (i.e., fistula, abscess, dysplasia), and the patient’s preference.
  • 657
  • 10 May 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.
  • 653
  • 09 Aug 2022
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.
  • 649
  • 31 Jul 2023
Topic Review
The Intestinal Microbiota in Chronic Liver Disease
Chronic liver disease (CLD) is a significant global health burden, leading to millions of deaths annually. The gut–liver axis plays a pivotal role in this context, allowing the transport of gut-derived products directly to the liver, as well as biological compounds from the liver to the intestine. The gut microbiota plays a significant role in maintaining the health of the digestive system. A change in gut microbiome composition as seen in dysbiosis is associated with immune dysregulation, altered energy and gut hormone regulation, and increased intestinal permeability, contributing to inflammatory mechanisms and damage to the liver, irrespective of the underlying etiology of CLD.
  • 649
  • 26 Sep 2023
Topic Review
Theragnostic Strategies in Colorectal Cancer
Liquid biopsy has emerged as a minimally invasive tool that is capable of detecting genomic alterations from primary or metastatic tumors, allowing the prognostic stratification of patients, the detection of the minimal residual disease after surgical or systemic treatments, the monitoring of therapeutic response, and the development of resistance, establishing an opportunity for early intervention before imaging detection or worsening of clinical symptoms. On the other hand, preclinical and clinical evidence demonstrated the role of gut microbiota dysbiosis in promoting inflammatory responses and cancer initiation. Altered gut microbiota is associated with resistance to chemo drugs and immune checkpoint inhibitors, whereas the use of microbe-targeted therapies including antibiotics, pre-probiotics, and fecal microbiota transplantation can restore response to anticancer drugs, promote immune response, and therefore support current treatment strategies in colorectal cancer (CRC).
  • 648
  • 10 Mar 2021
Topic Review
Transoral Outlet Reduction for Roux-en-Y Gastric Bypass
Obesity is a chronic relapsing disease of global pandemic proportions. In this context, an increasing number of patients are undergoing bariatric surgery, which is considered the most effective weight loss treatment for long-term improvement in obesity-related comorbidities. One of the most popular bariatric surgeries is the Roux-en-Y gastric bypass (RYGB).
  • 646
  • 15 Jun 2023
Topic Review
Non-Invasive Serological Markers of Hepatic Fibrosis
Liver fibrosis is a significant global health concern, leading to complications such as cirrhosis and hepatocellular carcinoma if not diagnosed and managed effectively. Our study synthesizes recent advancements in the field, including serological test panels and imaging techniques, and discusses the limitations of current methods like liver biopsy. We believe that our findings could significantly contribute to the journal’s focus on liver diseases, offering valuable insights for both clinicians and researchers.
  • 642
  • 23 Dec 2024
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