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Topic Review
Oxidative Stress-Induced Cellular Senescence in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) represents a worryingly increasing cause of malignancy-related mortality, while Metabolic Associated Fatty Liver Disease (MAFLD) is going to become its most common cause. Understanding the complex underlying pathophysiology of MAFLD-related HCC can provide opportunities for successful targeted therapies. Of particular interest in this sequela of hepatopathology is cellular senescence, a complex process characterised by cellular cycle arrest initiated by a variety of endogenous and exogenous cell stressors. A key biological process in establishing and maintaining senescence is oxidative stress, which is present in multiple cellular compartments of steatotic hepatocytes. Oxidative stress-induced cellular senescence can change hepatocyte function and metabolism, and alter, in a paracrine manner, the hepatic microenvironment, enabling disease progression from simple steatosis to inflammation and fibrosis, as well as HCC. The duration of senescence and the cell types it affects can tilt the scale from a tumour-protective self-restricting phenotype to the creator of an oncogenic hepatic milieu. 
  • 299
  • 03 Jul 2023
Topic Review
Endoscopy on Reducing and Preventing Musculoskeletal Injuries
Gastrointestinal (GI) endoscopy forms an important part of the daily practice of a gastroenterologist. Its use and applicability nowadays shift from diagnostic to therapeutic fields, and it forms a significant part of the workload of the GI practitioner. Ergonomics in GI endoscopy plays an important role in occupational injury prevention. Due to a higher volume of procedures, the problem with musculoskeletal injuries is becoming bigger and everyday more present among fellow gastroenterologists.
  • 299
  • 22 Sep 2023
Topic Review
Management of Hyponatremia in Cirrhosis
Hyponatremia is a strong predictor of mortality and is also associated with an increased probability of hepatorenal syndrome, disturbance of consciousness, infections, and unfavorable post-transplant outcomes. In the management of hyponatremia, it is crucial to distinguish between hypovolemic and hypervolemic hyponatremia. The treatment of hypervolemic hyponatremia should be started only in symptomatic patients. The cessation of the treatment with traditional diuretics and fluid restriction may prevent further decrease in natremia. Pharmacological treatment is directed towards cirrhosis itself, precipitating factor, or hyponatremia directly. Currently, only albumin infusions can be recommended routinely. Other possibilities, such as vaptans, splanchnic vasoconstrictors, niravoline, or osmotic diuretics, are restricted to specific use cases (e.g., imminent liver transplantation) or need more research to determine their efficacy.
  • 299
  • 16 Oct 2023
Topic Review
Pathophysiological Mechanisms of Metabolic-Associated Liver Disease
Metabolic-associated liver disease (MAFLD) affects up to 70% of overweight and more than 90% of morbidly obese people, and its pathogenesis is rather complex and multifactorial. The criteria for MAFLD include the presence of hepatic steatosis in addition to one of the following three criteria: overweight or obesity, presence of type 2 diabetes mellitus (T2DM), or evidence of metabolic dysregulation. If the specific criteria are present, the diagnosis of MAFLD can be made regardless of alcohol consumption and previous liver disease. The pathophysiological mechanisms of MAFLD, including inflammation, lipotoxicity, mitochondrial disfunction, and oxidative stress, as well as the impact of intestinal gut microbiota, are constantly being elucidated. 
  • 298
  • 19 Jan 2024
Topic Review
Photodynamic, Photothermal and Photoimmune Therapy in Hepatocellular Carcinoma
Liver cancer is a malignancy that includes the structure of the liver and intrahepatic bile ducts and is classified as follows: hepatocellular carcinoma, cholangiocarcinoma, hepatic angiosarcoma (hemangiosarcoma), hepatoblastoma, and fibrolamellar carcinoma. Hepatocellular carcinoma (HCC), known also as hepatoma, is the most common type of primary liver neoplasm. HCC is known today as a major malignant disease with high morbidity and mortality, which seriously threatens the health and life span of patients. Conventional cancer therapies comprise surgical procedures, radiation therapy and chemotherapy, which may be efficient but have significant adverse effects. Newer, more prominent cancer-targeted action plans, such as the phototherapy methods including photodynamic therapy (PDT), photothermal therapy (PTT), and photoimmunotherapy (PIT), have sparked excitement and hope as synergistic multimodal cancer therapies, incorporating nanomedicine to overcome the biological barriers and to help treat cancer patients. 
  • 297
  • 15 May 2023
Topic Review
Metformin in Esophageal Cancer
Esophageal cancer (EC), ranking sixth in global cancer mortality, comprises two distinct diseases: esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). EAC is linked to Barrett’s esophagus (BE), influenced by factors like gastroesophageal reflux disease (GERD) and obesity, while ESSC arises from squamous cells, with tobacco and alcohol as notable risks.
  • 296
  • 14 Mar 2024
Topic Review
High-Fat Diet in Inflammatory Bowel Disease
The intestinal immune balance is disrupted by a high-fat diet (HFD) in several ways, such as impairing the intestinal barrier, influencing immune cells, and altering the gut microbiota. In contrast, a rational diet is thought to maintain intestinal immunity by regulating gut microbiota.
  • 295
  • 25 Jun 2023
Topic Review
Multidisciplinary Approach for Acute Colonic Obstruction Endoscopic Management
Acute colonic obstruction is one of the most common manifestations of locally advanced colorectal cancer. Endoscopic stenting has become by far the minimally invasive treatment of choice for malignant colonic obstruction especially in the palliative setting. 
  • 295
  • 23 Feb 2024
Topic Review
Role of Exosomes in Epstein-Barr Virus-Associated Gastric Cancer
Exosomes are considered to be involved in the pathogenesis of various diseases, including cancer, viral infections, and autoimmune diseases. Epstein-Barr virus (EBV)-infected cells have been found to secrete exosomes for intercellular communication. Exosomal pathways play vital roles in the pathogenesis of EBV-related malignancies. 
  • 294
  • 10 Feb 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.
  • 294
  • 12 Sep 2023
Topic Review
Glucocorticoids in Alcoholic Hepatitis
Alcoholic hepatitis is a major health and economic burden worldwide. Glucocorticoids (GCs) are the only first-line drugs recommended to treat severe alcoholic hepatitis (sAH), with limited short-term efficacy and significant side effects.
  • 291
  • 30 Sep 2022
Topic Review
Mycobacterium avium ssp. paratuberculosis and Crohn’s Disease
Mycobacterium avium ssp. paratuberculosis (MAP) is the cause of Johne’s disease (JD), which is a chronic infectious gastrointestinal disease of ruminants and is often fatal. In humans, MAP has been associated with Crohn’s disease (CD) for over a century, without conclusive evidence of pathogenicity. Numerous researchers have contributed to the subject, but there is still a need for evidence of the causation of CD by MAP.
  • 290
  • 07 Mar 2024
Topic Review
Diagnostic Modalities of Endoscopic Ultrasound without Biopsy
Gastric subepithelial lesions (SELs) are intramural lesions that arise underneath the gastric mucosa. SELs can be benign, but can also be malignant or have malignant potential. Their correct identification is of vital importance for a successful management. Due to their location, standard luminal endoscopy cannot determine the exact nature of these lesions. Therefore, endosonography (EUS) alone or EUS with fine needle aspiration (FNA) or fine needle biopsy (FNB) have been established as the next step in the diagnostic algorithm.
  • 289
  • 12 Jul 2023
Topic Review
Nlrp3 Inflammasome in Colitis-Associated Colo-Rectal Cancer
Colitis-associated colo-rectal cancer remains the leading cause of mortality in inflammatory bowel diseases, with inflammation remaining one of the bridging points between the two pathologies. The NLRP3 inflammasome complex plays an important role in innate immunity; however, its misregulation can be responsible for the apparition of various pathologies such as ulcerative colitis.
  • 279
  • 21 Feb 2023
Topic Review
Pancreatic Neuroendocrine Tumors and Management
The growing importance of advanced endoscopy in the diagnosis and treatment of pancreatic neuroendocrine neoplasms (PanNETs) necessitates a comprehensive understanding of various biochemical markers, genetic testing methods, radiological techniques, and treatment approaches that encompass multiple disciplines within and beyond gastrointestinal oncology.
  • 279
  • 16 Aug 2023
Topic Review
Multi-Omics in Inflammatory Bowel Disease
The notion and importance of omes, omics and multi-omics in both health and complex diseases like inflammatory bowel disease (IBD) is introduced, followed by a discussion of the various omics believed to be relevant to IBD pathogenesis, and how multi-omics “big data” can generate new insights translatable into useful clinical tools in IBD such as biomarker identification, prediction of remission and relapse, response to therapy, and precision medicine.
  • 278
  • 12 Oct 2023
Topic Review
Biomarkers in Inflammatory Bowel Disease
The role of biomarkers in the diagnosis of inflammatory bowel disease is not fully characterized. C-reactive protein has a short half-life and elevates quickly after the onset of an inflammatory process; the performance is better in Crohn’s disease than in ulcerative colitis. Erythrocyte sedimentation rate is easy to determine, widely available, and cheap, but the long half-life, the influence of age, anemia, smoking, and drugs limit its usefulness. Fecal markers have good specificity, but suboptimal accuracy. Microbial antibodies and novel immunological markers show promise but need further evidence before entering clinical practice. Proteomic methods could represent the dawn of a new era of stool protein/peptide biomarker panels able to select patients at risk of inflammatory bowel disease.
  • 276
  • 16 Oct 2023
Topic Review
Tyrosine Kinase Inhibitors in BCLC-B Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) represents an entity of poor prognosis, especially in cases of delayed diagnosis. Tyrosine kinase inhibitors (TKIs) have multiple anti-tumor effects and are widely used in several types of cancers. They down-regulate different molecular pathways that take part in carcinogenesis. The primary targets are the tyrosine kinase receptors (RTKs), key proteins that regulate cancer growth and metastasis. Specifically, TKIs block the phosphorylation of tyrosine kinases and the subsequent signaling pathways, slowing down cancer growth. Some of the inhibited networks are the rat sarcoma (RAS)/mitogen-activated protein kinases (MAPKs), phosphoinositide 3-kinase (Pi3K)/protein kinase B (AKT)/mechanistic target of rapamycin (mTOR), phospholipase C (PLC)/Ca2+/calmodulin-dependent protein kinase-protein kinase C (CaMK-PKC), Janus kinase (JAK)/signal transducer and activator of transcription protein family (STAT), epidermal growth factor receptor (EGFR), vascular endothelial growth factor receptor (VEGFR), fibroblast growth factor receptor (FGFR), platelet-derived growth factor receptor (PDGFR), hepatocyte growth factor receptor (HGFR, Met), and RAF kinases. Due to their multiple actions, TKIs were the standard treatment of care in advanced HCC over the last 15 years, but after the induction of IO, they now comprise the second-line option.
  • 276
  • 27 Dec 2023
Topic Review
Viral Liver Disease and Intestinal Gut–Liver Axis
The intestinal microbiota is closely related to liver diseases via the intestinal barrier and bile secretion to the gut. Impairment of the barrier can translocate microbes or their components to the liver where they can contribute to liver damage and fibrosis.
  • 272
  • 26 Jan 2024
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. 
  • 272
  • 08 Feb 2024
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