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Topic Review
Pathological Conditions with Excessive Hepatic Glycogen Accumulation
The liver is a major store of glycogen and is essential in maintaining systemic glucose homeostasis. In healthy individuals, glycogen synthesis and breakdown in the liver are tightly regulated. Abnormal glycogen metabolism results in prominent pathological changes in the liver, often manifesting as hepatic glycogenosis or glycogen inclusions. This can occur in genetic glycogen storage disease or acquired conditions with insulin dysregulation such as diabetes mellitus and non-alcoholic fatty liver disease or medication effects. Excessive glycogen accumulation within hepatocytes occurs in diseases caused or accompanied by the dysregulation of carbohydrate metabolism, as well as in conditions not primarily driven by altered carbohydrate metabolism. In these pathological conditions, the excess glycogen is distinctly visible on H&E; the hepatocytes usually exhibit cytoplasmic pallor and rarefaction or may show cytoplasmic-glycogen-filled inclusion bodies. Some hepatocytes may also demonstrate glycogen-filled nuclear vacuoles without a delimiting membrane (“glycogenated nuclei”); these are frequently seen in patients with diabetes and obesity, although they can also be seen in other liver conditions such as Wilson’s disease.
  • 1.4K
  • 06 Apr 2023
Topic Review
Hepatitis B Virus Nucleocapsid
Hepatitis B virus (HBV) is a small enveloped DNA virus which replicates its tiny 3.2 kb genome by reverse transcription inside an icosahedral nucleocapsid, formed by a single ~180 amino acid capsid, or core, protein (Cp). HBV causes chronic hepatitis B (CHB), a severe liver disease responsible for nearly a million deaths each year. Dynamic changes in Cp chemical modification and capsid conformation are crucial in the viral life-cycle and represent a promising new antiviral target.
  • 1.4K
  • 07 Mar 2022
Topic Review
Extrahepatic Manifestations in Hepatitis C Virus Infection
Hepatitis C is a liver infection caused by the hepatitis C virus and is a major health problem that contributes to the global burden of chronic disease. Chronic infection can lead to liver cancer and death from end-organ damage. Despite the introduction of novel anti-viral therapy, the disease burden is still high. 
  • 1.4K
  • 30 Dec 2022
Topic Review
Nutritional Approach to Chronic Constipation1
Chronic constipation (CC) is one of the most common gastroenterological diagnoses in clinical practice. Treatment includes several steps, depending on the severity of symptoms. Lifestyle modifications and increased intake of fiber and water are suggested by most health professionals. Unfortunately, the recommendations in this regard are the most varied, often conflicting with each other and not always based on solid scientific arguments. 
  • 1.3K
  • 25 Oct 2021
Topic Review
Neural Signaling in the Pancreatic Cancer Microenvironment
Pancreatic cancer is one of the most lethal malignant diseases. Various cells in the tumor microenvironment interact with tumor cells and orchestrate to support tumor progression. Several kinds of nerves are found in the tumor microenvironment, and each plays an essential role in tumor biology. Studies have shown that sympathetic, parasympathetic, and sensory neurons are found in the pancreatic cancer microenvironment. Neural signaling not only targets neural cells, but tumor cells and immune cells via neural receptors expressed on these cells, through which tumor growth, inflammation, and anti-tumor immunity are affected. Thus, these broad-range effects of neural signaling in the pancreatic cancer microenvironment may represent novel therapeutic targets. The modulation of neural signaling may be a therapeutic strategy targeting the whole tumor microenvironment.
  • 1.3K
  • 15 Sep 2022
Topic Review
Liver Injury and Macrophage Issue
The liver is an essential immunological organ due to its gatekeeper position to bypassing antigens from the intestinal blood flow and microbial products from the intestinal commensals. The tissue-resident liver macrophages, termed Kupffer cells, represent key phagocytes that closely interact with local parenchymal, interstitial and other immunological cells in the liver to maintain homeostasis and tolerance against harmless antigens. Upon liver injury, the pool of hepatic macrophages expands dramatically by infiltrating bone marrow-/monocyte-derived macrophages. The interplay of the injured microenvironment and altered macrophage pool skews the subsequent course of liver injuries. It may range from complete recovery to chronic inflammation, fibrosis, cirrhosis and eventually hepatocellular cancer.
  • 1.3K
  • 29 Jul 2021
Topic Review
Intestinal Permeability and Liver Cirrhosis
An alteration of gut microbiota and their products, particularly endotoxins may play a major role in the pathogenesis of liver diseases. Gut dysbiosis caused by a high-fat diet and alcohol consumption induces increased intestinal permeability, the so-called “leaky gut.” Clinical studies have found that plasma endotoxin levels are elevated in patients with chronic liver diseases. The decreased diversity of gut microbiota in cirrhotic patients before liver transplantation is also related to a higher incidence of posttransplant infections and cognitive impairment. The exposure to endotoxins activates macrophages via toll-like receptor 4 (TLR4), leading to a greater production of proinflammatory cytokines and chemokines including tumor necrosis factor–alpha, interleukin (IL)–6, and IL-8, which play key roles in the progression of liver diseases. TLR4 is also a major receptor activated by the binding of endotoxins in hepatic stellate cells, which play a crucial role in liver fibrogenesis that could develop into hepatocarcinogenesis, suggesting the importance of the interaction between endotoxemia and TLR4 signaling as a target for preventing liver disease progression.
  • 1.3K
  • 13 Jul 2021
Topic Review
Liv.52 in Alcoholic Liver Disease
Alcoholic liver disease (ALD) has been a growing concern in developed and developing nations. Oxidative stress and lipid peroxidation are the most common cause of the development and progression of ALD. Due to paucity in the number and efficacy of hepatoprotective drugs currently available, and with the easy availability of natural therapy and herbal medicines, ALD is managed using a combination of pharmaceutical interventions and herbal medications.
  • 1.3K
  • 23 Nov 2022
Topic Review
Hepatic Lipotoxicity in Acute Fatty Liver of Pregnancy
Acute fatty liver of pregnancy (AFLP), a catastrophic illness for both the mother and the unborn offspring, develops in the last trimester of pregnancy with significant maternal and perinatal mortality. AFLP is also recognized as an obstetric and medical emergency. Maternal AFLP is highly associated with a fetal homozygous mutation (1528G>C) in the gene that encodes for mitochondrial long-chain hydroxy acyl-CoA dehydrogenase (LCHAD). The mutation in LCHAD results in the accumulation of 3-hydroxy fatty acids, such as 3-hydroxy myristic acid, 3-hydroxy palmitic acid and 3-hydroxy dicarboxylic acid in the placenta, which are then shunted to the maternal circulation leading to the development of acute liver injury observed in patients with AFLP. 
  • 1.3K
  • 17 Mar 2022
Topic Review
Nutritional Therapies on the Intestinal Microbiome
Inflammatory bowel disease (IBD) is a chronic, autoimmune disorder of the gastrointestinal tract with numerous genetic and environmental risk factors. Patients with Crohn’s disease (CD) or ulcerative colitis (UC) often demonstrate marked disruptions of their gut microbiome. The intestinal microbiota is strongly influenced by diet. The association between the increasing incidence of IBD worldwide and increased consumption of a westernized diet suggests host nutrition may influence the progression or treatment of IBD via the microbiome. Several nutritional therapies have been studied for the treatment of CD and UC. While their mechanisms of action are only partially understood, existing studies do suggest that diet-driven changes in microbial composition and function underlie the diverse mechanisms of nutritional therapy. Despite existing therapies for IBD focusing heavily on immune suppression, nutrition is an important treatment option due to its superior safety profile, potentially low cost, and benefits for growth and development. These benefits are increasingly important to patients. In this entry, we will describe the clinical efficacy of the different nutritional therapies that have been described for the treatment of CD and UC. 
  • 1.3K
  • 05 Jan 2022
Topic Review
Probiotic-Produced Metabolites
Probiotic bacteria (PB) are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Lactobacilli and Bifidobacteria are the most common probiotics, but the yeast Saccharomyces boulardii and Bacillus species are also widely known.
  • 1.3K
  • 30 Nov 2021
Topic Review
Vitamin D, microbiome, and IBD
Inflammatory bowel disease (IBD) is a chronic inflammation of the gastrointestinal tract (GIT), including Crohn’s disease (CD) and ulcerative colitis (UC), which differ in the location and lesion extensions. Both diseases are associated with microbiota dysbiosis, with a reduced population of butyrate-producing species, abnormal inflammatory response, and micronutrient deficiency (e.g., vitamin D hypovitaminosis). Vitamin D (VitD) is involved in immune cell differentiation, gut microbiota modulation, gene transcription, and barrier integrity. Vitamin D receptor (VDR) regulates the biological actions of the active VitD (1α,25-dihydroxyvitamin D3), and is involved in the genetic, environmental, immune, and microbial aspects of IBD. VitD deficiency is correlated with disease activity and its administration targeting a concentration of 30 ng/mL may have the potential to reduce disease activity. Moreover, VDR regulates functions of T cells and Paneth cells and modulates release of antimicrobial peptides in gut microbiota-host interactions. Meanwhile, beneficial microbial metabolites, e.g., butyrate, upregulate the VDR signaling.
  • 1.3K
  • 31 Jan 2021
Topic Review
Biliary Atresia Animal Models
Biliary atresia (BA) is a progressive fibro-obliterative process with a variable degree of inflammation involving the hepatobiliary system. Its consequences are incalculable for the patients, the affected families, relatives, and the healthcare system. Scientific communities have identified a rate of about 1 case per 10,000–20,000 live births, but the percentage may be higher, considering the late diagnoses. The etiology is heterogeneous. BA, which is considered in half of the causes leading to orthotopic liver transplantation, occurs in primates and non-primates. To consolidate any model, (1) more transport and cell membrane studies are needed to identify the exact mechanism of noxa-related hepatotoxicity; (2) an online platform may be key to share data from pilot projects and new techniques; and (3) the introduction of differentially expressed genes may be useful in investigating the liver metabolism to target the most intricate bilio-toxic effects of pharmaceutical drugs and toxins. 
  • 1.3K
  • 19 Jul 2022
Topic Review
Bile Acid Malabsorption
Bile acid malabsorption (BAM), known also as bile acid diarrhea, is a cause of several gut-related problems, the main one being chronic diarrhea. It has also been called bile acid-induced diarrhea, cholerheic or choleretic enteropathy, bile salt diarrhea or bile salt malabsorption. It can result from malabsorption secondary to gastrointestinal disease, or be a primary disorder, associated with excessive bile acid production. Treatment with bile acid sequestrants is often effective.
  • 1.3K
  • 09 Oct 2022
Topic Review
Bile Acid Diarrhoea
Bile acid diarrhoea (BAD) is a widespread gastrointestinal disease that presents as chronic watery diarrhoea as well as bloating and abdominal pain. This condition is often misdiagnosed as irritable bowel syndrome and is estimated to affect 1% of the United Kingdom population alone. BAD is associated with excessive bile acid synthesis secondary to a gastrointestinal or idiopathic disorder (also known as primary BAD). Current treatment includes diet changes and bile acid sequestrant medication.
  • 1.3K
  • 19 May 2021
Topic Review
Gut Microbiome and Liver Diseases
The important role of human gut microbiota in liver diseases has long been recognized as dysbiosis and the translocation of certain microbes from the gut to liver. With the development of high-throughput DNA sequencing, the complexity and integrity of the gut microbiome in the whole spectrum of liver diseases is emerging. Specific patterns of gut microbiota have been identified in liver diseases with different causes, including alcoholic, non-alcoholic, and virus induced liver diseases, or even at different stages, ranging from steatohepatitis, fibrosis, cirrhosis, to hepatocellular carcinoma. At the same time, the mechanism of how microbiota contributes to liver diseases goes beyond the traditional function of the gut–liver axis which could lead to liver injury and inflammation.
  • 1.3K
  • 11 May 2021
Topic Review
Endoscope Capsules
There are multiple benefits offered by capsule endoscopy (CE). First, the patients do not need sedation to undergo a CE analysis. The CE can analyze the entire GI tract from the esophagus, passing through the stomach, until the small intestine, which could not be properly analyzed through conventional endoscopy. The capsule has the size of a conventional vitamin capsule, and it can be easily swallowed, moving naturally through the GI tract until excretion. This fact indicates a painless procedure compared with the discomfort suffered by the long endoscopy sessions.
  • 1.3K
  • 28 Nov 2023
Topic Review
Endoscopy Lifetime Systems Architecture
Systems engineering captures the desires and needs of the customer to conceptualize a system from the overall goal down to the small details prior to any physical development. While many systems projects tend to be large and complicated (i.e., cloud-based infrastructure, long-term space travel shuttles, missile defense systems), systems engineering can also be applied to smaller, complex systems. The system of interest is the endoscope, a standard biomedical screening device used in laparoscopic surgery, screening of upper and lower gastrointestinal tracts, and inspection of the upper airway.
  • 1.3K
  • 25 Oct 2022
Topic Review
Non-Steroid Anti-Inflammatory Drugs/Acetylsalicylic Acid-Associated Gastropathy
Drugs are widely used to treat different diseases in modern medicine, but they are often associated with adverse events. Those located in the gastrointestinal tract are common and often mild, but they can be serious or life-threatening and determine the continuation of treatment. The stomach is often affected not only by drugs taken orally but also by those administered parenterally. The first description of the endoscopic picture of the damage to the gastric mucosa associated with the use of aspirin was published by A. Douthwait and J. Lintoff in 1938.
  • 1.3K
  • 18 Jul 2023
Topic Review
Protocols of Investigation of Neonatal Cholestasis
Neonatal cholestasis (NC) starts during the first three months of life and comprises extrahepatic and intrahepatic groups of diseases, some of which have high morbimortality rates if not timely identified and treated. Prolonged jaundice, clay-colored or acholic stools, and choluria in an infant indicate the urgent need to investigate the presence of NC, and thenceforth the differential diagnosis of extra- and intrahepatic causes of NC. The differential diagnosis of NC is a laborious process demanding the accurate exclusion of a wide range of diseases, through the skillful use and interpretation of several diagnostic tests. A wise integration of clinical-laboratory, histopathological, molecular, and genetic evaluations is imperative, employing extensive knowledge about each evaluated disease as well as the pitfalls of each diagnostic test. 
  • 1.3K
  • 02 Nov 2022
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