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Topic Review
Leaky Gut and Autoimmunity
Damage to the tissue and the ruining of functions characterize autoimmune syndromes. This review centers around leaky gut syndromes and how they stimulate autoimmune pathogenesis. Lymphoid tissue commonly associated with the gut, together with the neuroendocrine network, collaborates with the intestinal epithelial wall, with its paracellular tight junctions, to maintain the balance, tolerance, and resistance to foreign/neo-antigens. The physiological regulator of paracellular tight junctions plays a vital role in transferring macromolecules across the intestinal barrier and thereby maintains immune response equilibrium. A new paradigm has explained the intricacies of disease development and proposed that the processes can be prevented if the interaction between the genetic factor and environmental causes is barred by re-instituting the intestinal wall function. The latest clinical evidence and animal models reinforce this current thought and offer the basis for innovative methodologies to thwart and treat autoimmune syndromes.
  • 1.1K
  • 05 Jan 2021
Topic Review
Leaky Gut and Fatty Liver
Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and the leading cause of chronic liver disease in pediatric and adult populations living in industrialized countries. NAFLD encompasses steatosis and nonalcoholic steatohepatitis (NASH), and it is characterized by perivenular and lobular inflammation. Progression to fibrosis and cirrhosis are the primary complications of NAFLD. Based on a recent meta-analysis, one in four people in Europe, the United States, and Asia have NAFLD.
  • 634
  • 09 Aug 2021
Topic Review
Leaky Gut Syndrome
Leaky gut syndrome- is a medical condition characterized by increased intestinal permeability which may cause chronic inflammation and contributes to pathogenesis of wide range of diseases. According to the hypothesis of leaky gut syndrome, increased intestinal permeability enables antigens to cross intestinal barrier and absorb into the bloodstream consequently trigger the immune system and cause systemic reactions. Although LGS is very popular in alternative medicine circles, there is still little evidence to support hypothesis that it is a direct cause of any widespread problems.  
  • 1.2K
  • 25 Nov 2020
Topic Review
Lenvatinib for Hepatocellular Carcinoma
Lenvatinib, which is an oral multikinase inhibitor, showed non-inferiority to the sorafenib in terms of overall survival (OS) and a higher objective response rate (ORR) and better progression-free survival (PFS) in patients with hepatocellular carcinoma (HCC). A good liver function and Barcelona Clinic Liver Cancer (BCLC) intermediate stage were key factors in achieving therapeutic efficacy. The management of adverse events plays an important role in continuing lenvatinib treatment. While sequential therapies contributed to prolonging overall survival, effective molecular targeted agents for administration after lenvatinib have not been established. Repeated transcatheter arterial chemoembolization (TACE) was associated with a decline in the liver function and poor therapeutic response in BCLC intermediate patients. Recently, the Asia-Pacific Primary Liver Cancer Expert (APPLE) Consensus Statement proposed the criteria for TACE unsuitability. Upfront systemic therapy may be better for BCLC intermediate stage HCC patients with a high tumor burden, while selective TACE will be recommended to obtain a curative response in patients with a low tumor burden. This entry introduce the therapeutic response, management of adverse events, post-progression treatment after lenvatinib and treatment strategy for BCLC intermediate stage HCC.
  • 443
  • 12 Oct 2021
Topic Review
Lenvatinib in Hepatocellular Carcinoma Treatment
Hepatocellular carcinoma (HCC) is a major public health issue and, as the most common primary liver tumour, its incidence reaches one million new cases per year worldwide. Sorafenib has been the standard treatment of care since 2007, based on improved overall survival (OS) in randomised controlled trials compared to placebo. However, the management of advanced HCC has been modified since 2017 with the development of new and effective systemic treatments that improve both OS and progression free survival (PFS). Lenvatinib has been approved by the United States Food and Drug Administration and the European Medicines Agency after demonstration of the non-inferiority to sorafenib as first-line treatment for patients with advanced or unresectable HCC who have not received prior systemic therapy, based on the results of the phase III REFLECT study. Two other TKIs, regorafenib and cabozantinib, were also approved in second line after sorafenib.
  • 433
  • 29 Dec 2021
Topic Review
Lifestyle and Hepatocellular Carcinoma
Liver cancer remains a global health challenge, and while infection by hepatitis B virus and hepatitis C virus are the main risk factors for hepatocellular carcinoma (HCC) development, non-alcoholic steatohepatitis is associated with metabolic syndrome or diabetes mellitus is becoming a more frequent risk factor.
  • 492
  • 07 Jan 2022
Topic Review
Link of Microbiome–Gut–Brain Axis and Brain Disorders
Neuropsychiatric diseases cover a wide spectrum of diseases affecting the brain, behaviour, and mood, affecting people of any age. Disruptions in microbial compositions have been implicated in diseases such as asthma, diabetes, inflammatory bowel disease, obesity, and autism. The microbiota–gut–brain axis (MGBA) is a bidirectional communication pathway between the gut bacteria and the central nervous system (CNS). It is an extension of the gut–brain axis, in which the enteric nervous system (ENS), CNS, and the GI-tract work together to affect physiological aspects of the gut: motility, secretion, and acid and mucus production. The bacteria may influence the brain via the production of neurotransmitters and bacterial metabolites via stimulation of the vagal nerve, the immune system, or the hypothalamic–pituitary–adrenal axis (HPA-axis). On the other hand, the brain’s effects on the gut in terms of secretion, peristalsis, and sensory are mainly transferred via the vagus nerve.
  • 581
  • 05 Sep 2022
Topic Review
Lipid Metabolism in Metabolic-Associated Steatotic Liver Disease
Metabolic-associated steatotic liver disease (MASLD) is a cluster of pathological conditions primarily developed due to the accumulation of ectopic fat in the hepatocytes. During the severe form of the disease, i.e., metabolic-associated steatohepatitis (MASH), accumulated lipids promote lipotoxicity, resulting in cellular inflammation, oxidative stress, and hepatocellular ballooning. If left untreated, the advanced form of the disease progresses to fibrosis of the tissue, resulting in irreversible hepatic cirrhosis or the development of hepatocellular carcinoma. Although numerous mechanisms have been identified as significant contributors to the development and advancement of MASLD, altered lipid metabolism continues to stand out as a major factor contributing to the disease.
  • 230
  • 29 Dec 2023
Topic Review
Lipidomics in Non-Alcoholic Fatty Liver Disease
The prevalence of non-alcoholic fatty liver disease (NAFLD) and associated complications, such as hepatocellular carcinoma (HCC), is growing worldwide, due to the epidemics of metabolic risk factors, such as obesity and type II diabetes. Among other factors, an aberrant lipid metabolism represents a crucial step in the pathogenesis of NAFLD and the development of HCC in this population.
  • 298
  • 26 Apr 2023
Topic Review
Lipopolysaccharide in Inflammatory Bowel Diseases
Lipopolysaccharides (LPSs) are bacterial surface glycolipids, produced by Gram-negative bacteria. LPS is known to determine acute inflammatory reactions, particularly in the context of sepsis. However, LPS can also trigger chronic inflammation. In this case, the source of LPS is not an external infection, but rather an increase in endogenous production, which is usually sustained by gut microbiota (GM), and LPS contained in food. The first site in which LPS can exert its inflammatory action is the gut: both GM and gut-associated lymphoid tissue (GALT) are influenced by LPS and shift towards an inflammatory pattern. The changes in GM and GALT induced by LPS are quite similar to the ones seen in IBD: GM loses diversity, while GALT T regulatory (Tregs) lymphocytes are reduced in number, with an increase in Th17 and Th1 lymphocytes. Additionally, the innate immune system is triggered, through the activation of toll-like receptor (TLR)-4, while the epithelium is directly damaged, further triggering inflammation.
  • 1.9K
  • 25 Jun 2021
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