Topic Review
Fibroblast Subsets in Colorectal cancer
CAFs are defined as fibroblasts surrounding malignant tumor cells and are the most abundant cell type in the tumor microenvironment of colorectal cancer (CRC). CAFs consist of various functionally heterogeneous subsets which can promote or restrain cancer progression. Although most previous research has focused on the biology of epithelial cells, accumulating evidence shows that certain CAF subsets can also importantly contribute to tumor initiation and progression, thereby possibly providing avenues for improvement of clinical care for CRC patients. However, attention needs to be paid to comprehensive characterization and reporting of the subsets being investigated in CAF studies to enable more precise identification and targeting of “unfavorable” CAFs in advanced CRC.
  • 583
  • 28 Jan 2021
Topic Review
Acute Pancreatitis
The incidence of acute and chronic pancreatitis is increasing in the United States. Rates of acute pancreatitis (AP) are similar in both sexes, but chronic pancreatitis (CP) is more common in males. When stratified by etiology, women have higher rates of gallstone AP, while men have higher rates of alcohol- and tobacco-related AP and CP, hypercalcemic AP, hypertriglyceridemic AP, malignancy-related AP, and type 1 autoimmune pancreatitis (AIP). 
  • 685
  • 27 Jan 2021
Topic Review
Genetic Abnormalities in Pancreatitis
Hereditary pancreatitis (HP) has been defined as either two or more individuals within a family exhibiting pancreatitis for two or more generations, or pancreatitis linked to mutation of the PRSS1 gene. In 2000, a mutation in the serine protease inhibitor gene (Kazal type 1: SPINK1) was reported to be related to sporadic pancreatitis of unknown etiology.
  • 560
  • 26 Jan 2021
Topic Review
Pancreatic Fluid Collection
Pancreatic fluid collection (PFC) is one of the local complications that occurs after acute pancreatitis. Recently, the gold standard for management of pancreatic fluid collection has changed from aggressive debridement to a more conservative approach. Endoscopic drainage and necrosectomy are now accepted treatment approaches for patients with symptomatic walled-off pancreatic necrosis (WON). The current recommendations advocate step-up approaches for the treatment of symptomatic WON. Previous recommendations stipulated that endoscopic intervention should be delayed until more than four weeks after the onset. Recent data on early drainage have been increasing and this option might be considered in well-encapsulated cases, but the percutaneous route is preferred if the drainage is performed within two weeks after onset or in nonencapsulated cases.
  • 644
  • 20 Jan 2021
Topic Review
Pig in Pediatric Drug Discovery
Drug therapy in pediatric patients is challenging in view of the maturation of organ systems and processes that affect pharmacokinetics and pharmacodynamics. Especially for the youngest age groups and for pediatric-only indications, neonatal and juvenile animal models can be useful to assess drug safety and to better understand the mechanisms of diseases or conditions. In this respect, the use of neonatal and juvenile pigs in the field of pediatric drug discovery and development is promising, although still limited at this point. This study summarizes the comparative postnatal development of pigs and humans and discusses the advantages of the juvenile pig in view of developmental pharmacology, pediatric diseases, drug discovery and drug safety testing. Furthermore, limitations and unexplored aspects of this large animal model are covered. At this point in time, the potential of the neonatal and juvenile pig as nonclinical safety models for pediatric drug development is underexplored.
  • 566
  • 19 Jan 2021
Topic Review
Secretory IgA
Secretory IgA (SIgA) is the dominant antibody class in mucosal secretions, it is also present in saliva and breast milk. The majority of plasma cells producing SIgA are located within mucosal membranes lining the intestines, airway and reproductive tracts, as well as mammary gland. SIgA protects against the adhesion of pathogens and their penetration into the mucosal barriers. Moreover, SIgA regulates microbiota composition at mucosa sites and provides local homeostasis.
  • 4.1K
  • 17 Jan 2021
Topic Review
Gastrointestinal-Bleeding between NOACs and VKAs
Non-vitamin K antagonist oral anticoagulants (NOACs) are more commonly used to prevent atrial fibrillation (AF) patients from thromboembolic events than vitamin K antagonists (VKAs). However, the gastrointestinal bleeding (GIB) risk in the Asian AF patients associated with NOACs in comparison with VKAs remained unaddressed.
  • 608
  • 15 Jan 2021
Topic Review
Oral Manifestations of IBD
Inflammatory bowel disease (IBD) comprises chronic heterogeneous disorders of unknown etiology, resulting from multifactorial environmental precipitants in genetically susceptible individuals. IBD are distinguished in two main phenotypes, Crohn’s disease (CD) and ulcerative colitis (UC), characterized by inflammation of the intestinal mucosa. While UC affects the rectum and a variable extent of the colon, CD can involve any location of the gastrointestinal (GI) tract, from the oral cavity to the anus. Furthermore, up to 36% of patients with IBD may have extra-intestinal manifestations (EIM) which can affect almost any organ of the body (eyes, joints, liver, pancreas, skin, blood, and mouth).
  • 681
  • 12 Jan 2021
Topic Review
IBS and IBD
Irritable bowel syndrome (IBS) is a functional heterogenous disease with a multifactorial pathogenesis. It is characterized by abdominal pain, discomfort, and alteration in gut motility. The occurrence of similar symptoms was observed in patients in clinical remission of inflammatory bowel diseases (IBD) that is Crohn’s disease (CD) and ulcerative colitis (UC), which pathogenesis is also not fully understood. IBS and IBD seem to be quite separate entities, but still, they do share some similarities. First, their symptoms overlap to some extent: They both may include abdominal pain, bloating, diarrhea, and watery stools, which can make it difficult to distinguish between these disorders. However, pain in IBS results from tension in the intestinal wall and can be relieved by defecation, while in IBD, it is more constant, and it may result from inflammatory cytokines impacting on afferent nerve firing. Moreover, in the case of IBD, there are so-called “alarm symptoms”, such as fever, weight and appetite loss, bloody stool, vomiting, or anemia, which are absent in IBS. Second, despite the fact that extracolonic symptoms may appear in the course of both diseases, in IBS, they are more general and include, for example, nausea or dyspepsia, while they seem to be more serious and disabling in IBD—they may affect joints, eyes, skin or liver. Furthermore, the epidemiology is slightly different—IBS may occur at any age and is seen more often in women, while IBD appear mainly in young adults between 15 and 30 years old and remain gender-neutral—as mentioned earlier. Phenotypic differences are also clear—in IBS, visibly normal mucosa is observed. On the contrary, in IBD, inflammation, ulcerations, fibrosis, and structuring can be seen during colonoscopy with the naked eye. The pathogenesis of IBS and IBD is not completely understood; however, it is believed to be multifactorial. In both cases, it may include not only environmental and psychological factors (such as stress, depression, negative life events) but also genetic factors, enduring submucosal inflammation, and other changes involving the gut–brain axis and alteration in gut microbiota.
  • 612
  • 12 Jan 2021
Topic Review
Her-2 in Gastrointestinal Tumours
Gastrointestinal (GI) tumors account for a quarter of all the cancer burden and a third of the global cancer-related mortality. Among them, some cancers retain a dismal prognosis; therefore, newer and innovative therapies are urgently needed in priority disease areas of high-unmet medical need. In this context, HER2 could be a relevant prognostic and predictive biomarker acting as a target for specific drugs. However, if the role of HER2 has been object of investigation for several years in gastric cancer, it is not well established in other GI malignancies. The aim of this narrative review was to portray the current landscape of the potential role of HER2 as a predictive biomarker for GI tumors beyond gastric cancer. In colon cancer, the benefit from anti-HER2 therapies is less clear than in gastric neoplasms for the lack of controlled studies. Pancreatic, biliary tract adenocarcinomas and hepatocarcinoma may derive a less clear clinical benefit by using anti-HER2 agents in HER2 positive tumors. Overall, the results are promising and seem to suggest that the integration of multiple modalities of therapies can optimize the cancer care. However, further prospective trials are needed to validate the use of personalized targeted therapies in this field.
  • 546
  • 11 Jan 2021
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