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Topic Review
Diet in IBD Remission
Identification of the dietary triggers of inflammatory bowel diseases (IBD) and of a dietary regime which can be followed in the long-term by patients, is of paramount importance. Hence, we performed a comprehensive and detailed review of the literature about the role of diet in the maintenance of clinical remission in Crohn’s disease (CD) and Ulcerative colitis (UC), in both adult and paediatric patients. More specifically, we investigated:1) the efficacy of food reintroduction protocols in maintaining clinical remission in patients with CD, following induction of remission with nutritional therapies2.) the efficacy of dietary therapies, including strategies using maintenance enteral nutrition or ordinary food-based diets, on reducing clinical relapse rates in patients with CD and UC3.) the association of dietary components with the risk of developing a clinical relapse in patients with CD and UCFurthermore, we included specific study-related recommendations, which we believe should form the basis of future research studies investigating the role of diet in maintaining clinical remission in IBD.
  • 570
  • 21 Apr 2021
Topic Review
Helicobacter pylori and Respiratory Diseases
Helicobacter pylori (H. pylori) is a Gram-negative bacterium involved in the development of gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue. Unexplained iron deficiency anemia, idiopathic thrombocytopenic purpura and vitamin B12 deficiency have also been related to H. pylori infection, whereas for other extra-gastric diseases, the debate is still open. In this entry, we evaluate and discuss the potential involvement of H. pylori infection in the pathogenesis of several respiratory diseases.
  • 569
  • 28 Sep 2021
Topic Review
Anti-TNFs in Pediatric Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a chronic immune-mediated condition that affects the gastrointestinal tract. The incidence of the disease in children is increasing. However, most clinical trials in this disease have been carried out in adults, and the results have been extrapolated with minimal changes to determine treatment in children. Pediatric IBD (pIBD) is characterized by various factors, including a more severe phenotype than adult diseas. Since IBD is a chronic autoimmune disease, patients diagnosed during childhood live longer with the illness and consequently need treatment for longer. Biological drugs and, more specifically, anti-TNF drugs such as infliximab and adalimumab have proven efficient for treatment of IBD in adults and in children. However, the use of biological drugs differs between children and adults with IBD. For instance, the time between diagnosis and initiation of biological treatment is shorter in children than in adults. In addition, not all the biological drugs approved for adult IBD are approved for children. 
  • 568
  • 17 Nov 2021
Topic Review
Dietary Modulation of Bacteriophages
The role and function of bacteriophages (phages) has been underestimated so far. Natural compounds such as essential oils and tea have been used successfully in naturopathy and folk medicine for hundreds of years. Current research is unveiling the molecular role of their antibacterial, anti-inflammatory, and anticancer properties. The current interdisciplinary review summarizes current knowledge on dietary compounds as to their capacity to modulate the activity of phages, thus potentially contributing to (the modulation of) several gastrointestinal diseases, such as (chronic) inflammation, and even cancer.
  • 567
  • 27 Apr 2021
Topic Review
Targeting Gut in Obesity: Signals from Inner Surface
Obesity is caused by prolonged energy surplus. Current anti-obesity medications are mostly centralized around the energy input part of the energy balance equation by increasing satiety and reducing appetite. Our gastrointestinal tract is a key organ for regulation of food intake and supplies a tremendous number of circulating signals that modulate the activity of appetite-regulating areas of the brain by either direct interaction or through the vagus nerve. Intestinally derived messengers are manifold and include absorbed nutrients, microbial metabolites, gut hormones and other enterokines, collectively comprising a fine-tuned signalling system to the brain. After a meal, nutrients directly interact with appetite-inhibiting areas of the brain and induce satiety. However, overall feeding behaviour also depends on secretion of gut hormones produced by highly specialized and sensitive enteroendocrine cells. Moreover, circulating microbial metabolites and their interactions with enteroendocrine cells further contribute to the regulation of feeding patterns. Current therapies exploiting the appetite-regulating properties of the gut are based on chemically modified versions of the gut hormone, glucagon-like peptide-1 (GLP-1) or on inhibitors of the primary GLP-1 inactivating enzyme, dipeptidyl peptidase-4 (DPP-4). The effectiveness of these approaches shows that that the gut is a promising target for therapeutic interventions to achieve significant weigh loss. 
  • 567
  • 24 Jan 2022
Topic Review
Microbiome in the Pathogenesis of Inflammatory Bowel Disease
The microbiome of patients with inflammatory bowel disease (IBD) is characterized by bacterial dysbiosis (i.e., an imbalance of pathogenic and commensal bacteria). Bacterial diversity has been shown to be reduced during active inflammation in IBD.
  • 566
  • 12 Jul 2022
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.
  • 565
  • 13 Jul 2021
Topic Review
Combined Biological Therapy for Refractory Inflammatory Bowel Disease
Current medical treatment for inflammatory bowel disease (IBD) does not achieve 100% response rates, and a subset of refractory and severely ill patients have persistent active disease after being treated with all possible drug alternatives. Ustekinumab plus vedolizumab and vedolizumab plus anti-TNF were the most used biological therapies (CoT) for Crohn’s disease. For ulcerative colitis, the most used CoTs were vedolizumab plus anti-TNF and vedolizumab plus tofacitinib. 
  • 564
  • 23 Mar 2022
Topic Review
Imaging in Portal Vein Thrombosis
The term portal vein thrombosis (PVT) refers to the complete or partial obstruction of blood flow in the portal vein, due to the presence of a thrombus in the vasal lumen. The underlying etiology of PVT remains unclear in up to 50% of children and adults. PVT, either primary or secondary to an underlying chronic liver disease, is the most common cause of prehepatic portal hypertension. On the one hand, primary PVT can be idiopathic, iatrogenic (neonatal umbilical vein catheterization), or related to an altered coagulation status. On the other hand, the progression of most chronic liver diseases leads to fibrosis, which increases sinusoid resistance and determines an abnormal elevation of portal venous pressure. The spontaneous development of a collateral circulation to divert the flow to the systemic circulation is the first observed anomaly, which itself contributes to PVT. 
  • 560
  • 11 Nov 2022
Topic Review
Pathogenesis of Microscopic Colitis
Microscopic colitis is a type of inflammatory bowel disease and is classified as either collagenous colitis or lymphocytic colitis. The typical presentation is chronic watery diarrhea.
  • 561
  • 01 Aug 2023
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