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Topic Review
GLP-1RA-Associated Side Effects and Potential Concerns
Amidst the obesity and type II diabetes mellitus (T2DM) epidemics, glucagon-like peptide-1 receptor agonists (GLP-1RAs) stand out as a promising therapeutic ally, achieving notable success in glycemic control and weight management. While GLP-1RAs’ positive clinical outcomes are commendable, they introduce significant gastrointestinal (GI) challenges, emphasizing the pivotal role of gastroenterologists in understanding and managing these implications. Physicians should be vigilant of potential complications if endoscopy is indicated and considered.
  • 322
  • 05 Mar 2024
Topic Review
MAFLD and Chronic Viral Hepatitis
Metabolic dysfunction-associated fatty liver disease (MAFLD) has now affected nearly one-third of the global population and has become the number one cause of chronic liver disease in the world because of the obesity pandemic. Chronic hepatitis resulting from hepatitis B virus (HBV) and hepatitis C virus (HCV) remain significant challenges to liver health even in the 21st century. The co-existence of MAFLD and chronic viral hepatitis can markedly alter the disease course of individual diseases and can complicate the management of each of these disorders. A thorough understanding of the pathobiological interactions between MAFLD and these two chronic viral infections is crucial for appropriately managing these patients.
  • 321
  • 30 Jan 2024
Topic Review
Antioxidant and Anti-Inflammatory Phytochemicals for Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) mainly comprises Crohn’s disease (CD) and ulcerative colitis (UC) and is a group of chronic relapsing disorders characterized by inflammation of the gastrointestinal tract with variable phenotypic expression. Multiple factors have been implicated in the etiology of IBD, including environmental, genetic, microbiological and immunological interactions. However, the exact reasons remain unclear, although substantial progress in elucidating the complexity of IBD manifestation has been made in the past decades. There is clinical overlap of symptoms of CD and UC, including bloody or watery diarrhea, recurrent abdominal pain, tenesmus as well as non-specific systemic symptoms such as fatigue, fever and weight loss. CD can affect various parts of the intestine, i.e., both small and large intestine, while UC is known to affect only the colon. IBD usually follows a lifelong pattern of remissions and flare-ups that impacts the quality of life of patients. The inflammation of the gastrointestinal tract during flare-ups is mediated by neutrophils that release cytokines, enzymes and reactive oxygen species (ROS) leading to damage and even ulceration of the mucosa.
  • 319
  • 19 Mar 2024
Topic Review
Molecular Mechanisms of Antiviral Protease Inhibitor-induced Liver Injury
Antiviral protease inhibitors (PIs) are peptidomimetic molecules that block the active catalytic center of viral proteases and, thereby, prevent the cleavage of viral polyprotein precursors into maturation. They continue to be a key class of antiviral drugs that can be used either as boosters for other classes of antivirals or as major components of current regimens in therapies for the treatment of infections with human immunodeficiency virus (HIV) and/or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, sustained/lifelong treatment with the drugs or drugs combined with other substance(s) often leads to severe hepatic side effects such as lipid abnormalities, insulin resistance, and steatohepatitis. Molecular mechanisms underlying the PI-induced liver injury and potential therapeutic/pharmaceutical solutions are systemically reviewed here. 
  • 317
  • 15 May 2023
Topic Review
The Molecular Mechanisms of Lipopolysaccharides Tolerance
Lipopolysaccharides (LPSs) are complex molecules found in the outer membrane of Gram-negative bacteria, which are composed of three main regions: lipid A, core oligosaccharide, and O antigen.
  • 315
  • 09 Nov 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. 
  • 314
  • 12 May 2023
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.
  • 314
  • 31 Jul 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. 
  • 314
  • 15 Nov 2023
Topic Review
Essential Factors Involved in Inflammatory Bowel Disease
Inflammatory bowel diseases (IBD) are without cure and troublesome to manage because of the considerable diversity between patients and the lack of reliable biomarkers. Diet, gut microbiota, genetics and other patient factors are essential for disease occurrence and progression. The gut epithelial barrier separates the luminal contents from the underlying tissue layers and immune cells. It controls the interactions between the patient’s immune system, the gut microbiota and environmental factors such as food components and is implicated in IBD.
  • 313
  • 18 Jul 2023
Topic Review
Immunotherapy in MS-Stable Colorectal Cancer
Immunotherapy is an innovative treatment that is highly effective against certain cancers, such as skin and lung cancer. However, for colorectal cancer, one of the most prevalent cancers, it does not benefit most patients. Recent research suggests that by treating liver metastases first, immunotherapy might become effective for those with colorectal cancer.
  • 313
  • 22 Nov 2023
Topic Review
Dysbiosis in Gut Microbiotas
Dysbiosis refers to a disruption of the symbiotic relationship between the microbiota and the host, and it can contribute to various chronic diseases both within and outside the gut. These diseases include obesity, inflammatory bowel disease, diabetes mellitus, metabolic syndrome, atherosclerosis, chronic liver disease, neurological disorders, and cancer. Several factors can influence the composition of the microbiota and increase the risk of dysbiosis. These factors include diet, environmental factors, stress, aging, genetic factors, and broad-spectrum antibiotic use. 
  • 312
  • 05 Mar 2024
Topic Review
Advancements in Understanding NAFLD
Non-alcoholic fatty liver disease (NAFLD), recently renamed by an international consensus panel as metabolic-associated fatty liver disease (MAFLD), affects up to 1 billion patients worldwide. This change in nomenclature is in keeping with more recent understanding of this disease and its inherent link to metabolic syndrome.
  • 310
  • 14 Nov 2023
Topic Review
Circulating Biomarkers Involved in Chronic Pancreatitis
Chronic pancreatitis (CP) is the end-stage of continuous inflammation and fibrosis in the pancreas evolving from acute- to recurrent acute-, early, and, finally, end-stage CP. Currently, prevention is the only way to reduce disease burden. In this setting, early detection is of great importance. Due to the anatomy and risks associated with direct sampling from pancreatic tissue, most of the information on the human pancreas arises from circulating biomarkers thought to be involved in pancreatic pathophysiology or injury. 
  • 309
  • 27 Feb 2024
Topic Review
Visceral Hypersensitivity Association with  Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a severe problem in the health service. It is estimated that it accounts for 3% of all medical consultations. Moreover, this diagnosis is made in the case of about 40% of all outpatient gastroenterological referrals. The visceral stimuli from the digestive tract are transmitted via afferent nerves through the spinal cord to the brain, where they are felt as pain. The overreaction observed in the brain of irritable bowel syndrome (IBS) patients may be due to increased peripheral sensitivity to stimuli from the gastrointestinal tract.
  • 308
  • 11 Oct 2023
Topic Review
Potential Therapeutic Strategies of Metabolic-Associated Fatty Liver Disease
Metabolic-associated Fatty Liver Disease is one of the outstanding challenges in gastroenterology. The increasing incidence of the disease is undoubtedly connected with the ongoing obesity pandemic. The lack of specific symptoms in the early phases and the grave complications of the disease require an active approach to prompt diagnosis and treatment. Therapeutic lifestyle changes should be introduced in a great majority of patients; but, in many cases, the adherence is not satisfactory. There is a great need for an effective pharmacological therapy for Metabolic-Associated Fatty Liver Disease, especially before the onset of steatohepatitis.
  • 308
  • 12 Nov 2023
Topic Review
Branched-Chain Amino Acids in Liver Disease
Advanced chronic liver disease (ACLD) represents a complex and multifactorial clinical entity characterized by liver dysfunction and associated complications.
  • 307
  • 07 Dec 2023
Topic Review
Methods of Measuring Pancreatic Cystic Lesion Size
The incidence of pancreatic cystic lesions (PCLs) has been rising due to improvements in imaging. Of these, intraductal papillary mucinous neoplasms (IPMNs) are the most common and are thought to contribute to almost 20% of pancreatic adenocarcinomas. All major society guidelines for the management of IPMNs use size defined by maximum diameter as the primary determinant of whether surveillance or surgical resection is recommended. However, there is no consensus on how these measurements should be obtained or whether a single imaging modality is superior. Furthermore, the largest diameter may fail to capture the complexity of PCLs, as most are not perfectly spherical.
  • 306
  • 14 Sep 2023
Topic Review
Gut Microbiota and NAFLD Development
NAFLD, the most common liver disorder in the Western world, is characterized by intrahepatic lipid accumulation; is highly prevalent in the aging population; and is closely associated with obesity, insulin resistance, hypertension, and dyslipidemia.
  • 305
  • 23 Sep 2022
Topic Review
Management of Pediatric Feeding Disorder
Pediatric feeding disorder (PFD) is defined as impaired oral intake that is not age appropriate and is associated with at least one dysfunctional domain: medical; nutritional; feeding skills; and psychosocial  Feeding difficulties take time to resolve and are best managed in progressive phases. A series of short-term goals are typically developed that can lead to complex interdisciplinary coordination of care. Using a stepwise treatment approach to PFD is important because, even though feeding problems are relatively common—occurring in up to 45% of children in the general population—the condition is severe enough to warrant intensive intervention in about 10%. A stepwise approach ensures that feeding problems are not overlooked or treated inappropriately.
  • 305
  • 03 Mar 2023
Topic Review
Elevated Serum Alpha-Fetoprotein Levels in Pregnant Women
The most common association related to alpha-fetoprotein (AFP) is fetal neural tube defect (NTD), and indeed, this is where the international career of this protein began. In times when ultrasonography was not yet technically advanced, the detection of high levels of AFP in maternal serum (MS-AFP) and amniotic fluid was the basis for suspecting neural tube defects. In cases where there was no confirmation of NTD, other causes were sought. It has been established that high titers of MS-AFP could originate in other defects or diseases, such as (1) increased proteinuria in severe fetal kidney diseases; (2) pathological overproduction in liver diseases; (3) penetration through the membranes of gastrointestinal organs exposed to amniotic fluid; (4) passage through the walls of skin vessels; and as a side effect of (5) hepatic hematopoiesis and increased transfer through the edematous placenta in fetal anemia. 
  • 301
  • 24 Jan 2024
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