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Topic Review
First-and Second-Line Therapies for Primary Biliary Cholangitis
Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease characterized by the progressive destruction of the intrahepatic bile ducts. Currently, the first line drug for PBC is ursodeoxycholic acid characterized by anti-apoptotic, anti-inflammatory and protective actions on cholangiocytes. 
  • 1.0K
  • 21 Mar 2022
Topic Review
Therapeutic Targeting of Intestinal Fibrosis in Crohn’s Disease
Intestinal fibrosis is one of the most threatening complications of Crohn’s disease. Endoscopic and surgical approaches are currently the only options available and there is an urgent need for targeted anti-fibrotic therapy. Several molecules investigated in preclinical studies, which are awaiting clinical trials in humans, have proven effective in CD stricturing phenotype and may be available in the near future as additional weapons in preventing or reversing intestinal fibrosis. 
  • 999
  • 24 Mar 2022
Topic Review
Infant Gut Microbiota
Evidence is accumulating which shows that maternal transmission of microbes to the infant gut occurs prenatally, in utero. However, the first big wave of microbial colonization occurs after birth. Gut microbial dysbiosis in infant increase the risk of subsequent asthma through a number of perinatal factors such as diet, delivery mode, antibiotic exposure, maternal asthma during pregnancy and pre-gestational body mass index. Nutrition plays a fundamental role as a potent modifiable factor influencing the human gut microbiota composition, which provides new insights into therapeutic strategies aimed at manipulating the gut microbiota through dietary modification. There is very little evidence to date linking maternal dietary patterns during pregnancy with alterations in the infant gut microbiota. The effect of maternal dietary nutrient intake causes alterations in breast milk microbiota composition. There is however a paucity of human data examining the effects and underlying mechanisms of maternal diet on the infant gut microbiota shaping through the alteration of milk microbiota composition. Further long-term cohort studies are needed where the effect of maternal nutrition during pregnancy and lactation on the infant gut microbiota composition are studied in further detail in context of asthma development and may provide useful insights into potential mechanisms that could potentially reduce the risk of asthma.
  • 993
  • 31 Jul 2020
Topic Review
Inflammatory Bowel Disease
The conventional approach to IBD aims to induce and maintain clinical remission free of corticosteroids, thus minimizing the impact on quality of life.(1) Currently, corticosteroids, sulfasalazine, mesalamine (5-ASA), and immunomodulators are treatment options for patients with IBD. Studies indicate that a substantial proportion of patients do not fully respond to conventional treatment for IBD or that its efficacy wanes over time.(2) Corticosteroid resistance/refractoriness rates range from 8.9% to 25% in individuals with IBD.(3, 4) Identifying safe and effective therapeutic agents for complementary therapy remains an unmet need for these patients. Curcumin also acts by inhibiting the activity of pro-inflammatory proteins such as activated protein-1, peroxisome proliferator-activated receptor gamma, signal translators, and transcription activators, as well as the expression of b-catenin, cyclooxygenase 2, 5-lipoxygenase, and inducible nitric oxide synthase isoform, which play a key role in inflammation.(5) In addition, it acts by blocking the binding between TNF-α and its receptor, preventing the perpetuation of inflammation caused by this cytokine.(6) Curcumin's excellent anti-inflammatory profile makes it a promising therapeutic agent in the treatment of IBD. 
  • 979
  • 05 Nov 2020
Topic Review
Iron Deficiency in Celiac Disease
Iron deficiency anemia (IDA) is the most recognized type of anemia in patients with celiac disease (CD) and may be present in over half of patients at the time of diagnosis. Folate and vitamin B12 malabsorption, nutritional deficiencies, inflammation, blood loss, development of refractory CD, and concomitant Heliobacter pylori infection are other causes of anemia in such patients. The decision to replenish iron stores and the route of administration (oral or intravenous) are controversial due, in part, to questions surrounding the optimal formulation and route of administration.
  • 979
  • 09 Oct 2021
Topic Review
Immune Checkpoint Inhibitor-Related Pancreatitis
The indications for immune checkpoint inhibitors (ICIs) have expanded to include carcinomas of various organs. ICIs include drugs that target programmed cell death-1 (PD-1), programmed cell death ligand 1 (PDL-1), and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4). The indications for these drugs have been expanded to include many types of cancer, as efficacies have been reported for malignant melanoma and lung, kidney, head and neck, stomach, liver, ovarian, and pancreatic cancers .
  • 966
  • 05 May 2022
Topic Review
Growth and Puberty in IBD
Inflammatory bowel diseases are characterized also by retarded growth and delayed puberty. The underlying mechanism of these and other extra-intestinal manifestations are partially known: the main hypotheses are malnutrition and inflammatory response.
  • 960
  • 06 Nov 2020
Topic Review
Endoscopic Ultrasound-Guided Hepaticogastrostomy
Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is widely performed worldwide for various benign and malignant biliary diseases in cases of difficult or unsuccessful endoscopic transpapillary cholangiopancreatography (ERCP). Furthermore, its applicability as primary drainage has also been reported. Although recent advances in EUS systems and equipment have made EUS-HGS easier and safer, the risk of serious adverse events such as bile leak and stent migration still exists. Physicians and assistants need not only sufficient skills and experience in ERCP-related procedures and basic EUS-related procedures such as fine needle aspiration and pancreatic fluid collection drainage, but also knowledge and techniques specific to EUS-HGS.
  • 955
  • 08 Apr 2022
Topic Review
Feeding Problems in Patients with Noonan Syndrome
Noonan syndrome (NS) belongs to the group of Noonan syndrome spectrum disorders (NSSD), which is a group of phenotypically related conditions. Feeding problems are often present not only in infancy but also in childhood, and even beyond that period. More than 50% of infants with NS develop feeding problems, and up to half of these infants will be tube-dependent for some time. Although, in general, there is a major improvement between the age of 1 and 2 years, with only a minority still having feeding problems after the age of 2 years, as long as the feeding problems continue, the impact on the quality of life of both NS infants and their caregivers may be significant. Feeding problems in general improve faster in children with a pathogenic PTPN11 or SOS1 variant. The mechanism of the feeding problems is complex, and may be due to medical causes (gastroesophageal reflux disease and delayed gastric emptying, cardiac disease and infections), feeding-skill dysfunction, nutritional dysfunction with increased energy demand, or primary or secondary psychosocial dysfunction. Many of the underlying mechanisms are still unknown. The treatment of the feeding problems may be a medical challenge, especially when the feeding problems are accompanied by feeding-skill dysfunction and psychosocial dysfunction. 
  • 953
  • 17 Feb 2022
Topic Review
Autoimmune Atrophic Gastritis
Autoimmune atrophic gastritis is an organ-specific immune-mediated condition characterized by atrophy of the oxyntic mucosa. Autoimmune atrophic gastritis (AIG) is characterized by a progressive loss of acid-secreting parietal cells leading to hypo-achlorhydria. Due to this peculiar intra-gastric environment, gastric microbiota composition in individuals with autoimmune atrophic gastritis was first supposed and then recently reported to be different from subjects with a normal acidic healthy stomach. Recent data confirm the prominent role of Helicobacter pylori as the main bacterium responsible for gastric disease and long-term complications. However, other bacteria than Helicobacter pylori, for example, Streptococci, were found in subjects who developed gastric cancer and in subjects at risk of this fearful complication, as well as those with autoimmune gastritis. Gastric microbiota composition is challenging to study due to the acidic gastric environment, the difficulty of obtaining representative samples of the entire gastric microbiota, and the possible contamination by oral or throat microorganisms, which can potentially lead to the distortion of the original gastric microbial composition, but innovative molecular approaches based on the analysis of the hyper-variable region of the 16S rRNA gene have been developed, permitting us to obtain an overall microbial composition view of the RNA gene that is present only in prokaryotic cells. 
  • 952
  • 08 Dec 2020
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