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Topic Review
Interventional Treatment of Budd–Chiari Syndrome
Medical treatment is regarded as the primary course of action in patients with Budd–Chiari syndrome (BCS). Its efficacy, however, is limited, and most patients require interventional treatment during follow-up. Short-segment stenosis or the occlusion (the so-called web) of hepatic veins or the inferior vena cava are frequent in Asian countries. An angioplasty with or without stent implantation is the treatment of choice to restore hepatic and splanchnic blood flow. The long-segment thrombotic occlusion of hepatic veins, common in Western countries, is more severe and may require a portocaval shunting procedure to relieve hepatic and splanchnic congestion.
  • 276
  • 24 Jul 2023
Topic Review
Relevance of Fish Oil in Gastrointestinal-Cancer-Associated Cachexia
Fish oil is rich in omega-3 fatty acids, which aid in energy metabolism and utilizing fatty acids high in energy density. It has been shown to reduce levels of pro-inflammatory mediators because fish oil contains high amounts of omega-3 fatty acids, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and other polyunsaturated fatty acids (PUFAs). In a study of GI cancer patients undergoing surgical intervention, adding fish oil to arginine improved post-surgical outcomes and shortened recovery compared to no nutritional support in 305 patients.
  • 276
  • 07 Aug 2023
Topic Review
Juvenile Autoimmune Hepatitis
Juvenile autoimmune hepatitis (JAIH) is severe immune-mediated necro-inflammatory disease of the liver with spontaneous progression to cirrhosis and liver failure if left untreated. The diagnosis is based on the combination of clinical, laboratory and histological findings. Prothrombin ratio is a useful prognostic factor to identify patients who will most likely require a liver transplant by adolescence or early adulthood. JAIH treatment consists of immune suppression and should be started promptly at diagnosis to halt inflammatory liver damage and ultimately prevent fibrosis and progression to end-stage liver disease. The risk of relapse is high especially in the setting of poor treatment compliance.
  • 275
  • 06 Sep 2023
Topic Review
Percutaneous Ablation-Induced Immunomodulation in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide and its incidence is rising. Percutaneous locoregional therapies, such as radiofrequency ablation and microwave ablation, are widely used as curative treatment options for patients with small HCC, but their effectiveness remains restricted because of the associated high rate of recurrence, occurring in about 70% of patients at five years. These thermal ablation techniques have the particularity to induce immunomodulation by destroying tumours, although this is not sufficient to raise an effective antitumour immune response. Ablative therapies combined with immunotherapies could act synergistically to enhance antitumour immunity. 
  • 274
  • 09 Sep 2022
Topic Review
Management of Inflammatory Bowel Disease and Colorectal Cancer
Patients with inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn’s disease, have an increased risk of developing colorectal cancer (CRC). Although advancements in endoscopic imaging techniques, integrated surveillance programs, and improved medical therapies have contributed to a decreased incidence of CRC in patients with IBD, the rate of CRC remains higher in patients with IBD than in individuals without chronic colitis. Patients with IBD-related CRCs exhibit a poorer prognosis than those with sporadic CRCs, owing to their aggressive histological characteristics and lower curative resection rate. 
  • 273
  • 31 Aug 2023
Topic Review
Microbiota in the Natural History of Pancreatic Cancer
Pancreatic cancer is still burdened with a severe prognosis, despite advances in the diagnosis and surgical management of this disease. The microbiota is a true organ, capable of several interactions throughout the digestive system. Microbiota can influence the development of precancerous disease predisposing to pancreatic cancer (PC). At the same time, neoplastic tissue shows specific characteristics in terms of diversity and phenotype, determining the short- and long-term prognosis.
  • 272
  • 20 Feb 2023
Topic Review
TGF-β, Activin and Follistatin in Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is an immune-mediated inflammatory condition predominantly affecting the gastrointestinal (GI) tract. An increasing prevalence of IBD has been observed globally. The pathogenesis of IBD includes a complex interplay between the intestinal microbiome, diet, genetic factors and immune responses. The consequent imbalance of inflammatory mediators ultimately leads to intestinal mucosal damage and defective repair. Growth factors, given their specific roles in maintaining the homeostasis and integrity of the intestinal epithelium, are of particular interest in the setting of IBD. Furthermore, direct targeting of growth factor signalling pathways involved in the regeneration of the damaged epithelium and the regulation of inflammation could be considered as therapeutic options for individuals with IBD. Several members of the transforming growth factor (TGF)-β superfamily, particularly TGF-β, activin and follistatin, are key candidates as they exhibit various roles in inflammatory processes and contribute to maintenance and homeostasis in the GI tract. 
  • 272
  • 05 May 2023
Topic Review
Clostridioides difficile Mouse Model
Clostridioides difficile is an anaerobic, spore-forming bacterium associated with intestinal infection, manifesting a broad spectrum of gastrointestinal symptoms, ranging from mild diarrhea to severe colitis. A primary risk factor for the development of C. difficile infection (CDI) is antibiotic exposure. Elderly and immunocompromised individuals are particularly vulnerable to CDI. A pivotal aspect for comprehending the complexities of this infection relies on the utilization of experimental models that mimic human CDI transmission, pathogenesis, and progression. These models offer invaluable insights into host–pathogen interactions and disease dynamics, and serve as essential tools for testing potential therapeutic approaches.
  • 273
  • 23 Feb 2024
Topic Review
Features of Liver Injury in COVID-19 Clinical Particularities
COVID-19 clinical presentation falls on a wide spectrum, from mild cases complaining of minor symptoms to severe illness with multiorgan dysfunctions and death. Multiple organ injuries have been described in COVID-19, such as pulmonary affliction, acute kidney damage, liver injury, stroke, cardiovascular and digestive tract disorders. 
  • 269
  • 07 Apr 2023
Topic Review
Gut Microbiota in Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a complex multifactorial chronic inflammatory disease, that includes Crohn’s disease (CD) and ulcerative colitis (UC), having progressively increasing global incidence. Disturbed intestinal flora has been highlighted as an important feature of IBD and offers promising strategies for IBD remedies.
  • 267
  • 13 Jul 2023
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