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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. 
  • 603
  • 23 Mar 2022
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.
  • 602
  • 27 Apr 2021
Topic Review
Gut Virome in Childhood Diseases
Mammals are colonized by numerous microbes, collectively referred to as the microbiota. The microbiota forms a stable symbiotic relationship with the host and is indispensable for health maintenance. Although the eubacteria are the best characterized component of the human gut microbiota, it also includes commensal populations of viruses, fungi, multicellular parasites and archaea. Evidence highlights that the virome, consisting in DNA and RNA eukaryotic viruses, bacterial viruses (i.e., bacteriophages) and archaeal viruses, exerts a fundamental role in the host wellbeing. Indeed, alterations of the adult virome have been linked to increased disease susceptibility, suggesting that maintaining or restoring a structurally and functionally correct composition of the virome might represent in the near future a promising approach to prevent or cure different human diseases. Although the knowledge of childhood virome is currently very limited, modifications of the virome composition have been associated with several diseases during the pediatric age, such as inflammatory bowel disease, type 1 diabetes, malnutrition, diarrhea and celiac disease. 
  • 599
  • 14 May 2021
Topic Review
Hepatic Encephalopathy
Hepatic encephalopathy (HE) is a major complication of cirrhosis, which is associated with gut microbial composition and functional alterations.
  • 601
  • 12 Oct 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. 
  • 600
  • 17 Nov 2021
Topic Review
Sarcopenic Obesity
Sarcopenia was first termed in 1989 by Rosenberg et al. as a muscle loss in the aging population [19]. Although several definitions coexist, sarcopenia’s well-adopted description is an age-related process characterized by progressive loss of skeletal muscle mass and function.
  • 599
  • 18 Mar 2021
Topic Review
Cirrhotic Cardiomyopathy
Cirrhotic cardiomyopathy (CCM), cardiac dysfunction in end-stage liver disease in the absence of prior heart disease, is an important clinical entity that contributes significantly to morbidity and mortality. The original definition for CCM, established in 2005 at the World Congress of Gastroenterology (WCG), was based upon known echocardiographic parameters to identify subclinical cardiac dysfunction in the absence of overt structural abnormalities. Subsequent advances in cardiovascular imaging and in particular myocardial deformation imaging have rendered the WCG criteria outdated. A number of investigations have explored other factors relevant to CCM, including serum markers, electrocardiography, and magnetic resonance imaging. CCM characteristics include a hyperdynamic circulatory state, impaired contractility, altered diastolic relaxation, and electrophysiological abnormalities, particularly QT interval prolongation. It is now known that cardiac dysfunction worsens with the progression of cirrhosis. Treatment for CCM has traditionally been limited to supportive efforts, but new pharmacological studies appear promising. Left ventricular diastolic dysfunction in CCM can be improved by targeted heart rate reduction. Ivabradine combined with carvedilol improves left ventricular diastolic dysfunction through targeted heart rate reduction, and this regimen can improve survival in patients with cirrhosis. Orthotopic liver transplantation also appears to improve CCM. 
  • 599
  • 12 Oct 2021
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.
  • 598
  • 12 Jul 2022
Topic Review
Tumor Microenvironment in Hepatocellular Carcinoma
The interaction of the cellular environment surrounding the tumor plays a relevant role in hepatocellular carcinoma (HCC) pathogenesis. The tumor microenvironment is directly implicated in the modulation of liver fibrosis, the process of hepatocarcinogenesis, the epithelial-mesenchymal transition (EMT), invasion, and metastasis. Besides liver cancer cells, several cell types participate in the tumor progression in the liver. 
  • 597
  • 25 Feb 2022
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.
  • 596
  • 21 Apr 2021
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