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Topic Review
Tissue Biopsy-Based MSI Testing
Colorectal cancer (CRC) is the third most commonly-diagnosed cancer in the world and ranked second for cancer-related mortality in humans. Microsatellite instability (MSI) is an indicator for Lynch syndrome (LS), an inherited cancer predisposition, and a prognostic marker which predicts the response to immunotherapy. A recent trend in immunotherapy has transformed cancer treatment to provide medical alternatives that have not existed before. It is believed that MSI-high (MSI-H) CRC patients would benefit from immunotherapy due to their increased immune infiltration and higher neo-antigenic loads. MSI testing such as immunohistochemistry (IHC) and PCR MSI assay has historically been a tissue-based procedure that involves the testing of adequate tissue with a high concentration of cancer cells, in addition to the requirement for paired normal tissues. The invasive nature and specific prerequisite of such tests might hinder its application when surgery is not an option or when the tissues are insufficient. The application of next-generation sequencing, which is highly sensitive, in combination with liquid biopsy, therefore, presents an interesting possibility worth exploring. This review aimed to discuss the current body of evidence supporting the potential of liquid biopsy as a tool for MSI testing in CRC.
  • 1.3K
  • 16 Nov 2021
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. 
  • 1.3K
  • 24 Mar 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. 
  • 1.3K
  • 17 Feb 2022
Topic Review
Ghrelin
Ghrelin is an endogenous ligand for the ghrelin receptor, previously known as the growth hormone secretagogue receptor. This hormone is mainly produced by endocrine cells present in the gastric mucosa. The ghrelin-producing cells are also present in other organs of the body, mainly in the digestive system, but in much smaller amount. Ghrelin exhibits a broad spectrum of physiological effects, such as stimulation of growth hormone secretion, gastric secretion, gastrointestinal motility, and food intake, as well as regulation of glucose homeostasis and bone formation, and inhibition of inflammatory processes.
  • 1.3K
  • 21 Oct 2021
Topic Review
Pathophysiology of Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) encompasses a group of heterogeneous diseases that entail chronic, relapsing gastrointestinal tract inflammation of inexactly known etiology and pathogenesis. IBD is clinically classified as Crohn’s disease (CD) or ulcerative colitis (UC) based on symptoms, disease location, and histopathological characteristics.
  • 1.3K
  • 28 Jan 2023
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.
  • 1.3K
  • 08 Apr 2022
Topic Review
Food's Effect for Endotoxemia
Endotoxemia and hyperinflammation are important factors for determining the severity of infectious and non-infectious disease. The most important endotoxin is LPS, lipopolysaccharide, which is present at high concentrations in the intestine as part of the intestinal bacterial flora. The LPS from these bacteria can induce a chronic subclinical inflammatory process under certain circumstances.
  • 1.3K
  • 09 Sep 2021
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.
  • 1.3K
  • 06 Nov 2020
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. 
  • 1.2K
  • 21 Mar 2022
Topic Review
Fecal Markers of Inflammation
Inflammatory bowel diseases (IBDs) are chronic inflammatory disorders of the gastrointestinal tract whose etiology is unknown. Pathogenesis of IBD is attributed to the complex interaction of genetic susceptibility, environmental factors (such as smoking, diet, and infections), and the gut microbiota. This results in an uncontrolled immune response leading to mucosal damage. IBDs are characterized by a relapsing and remitting course and require lifelong treatment. Therapy aims to induce remission, maintain remission, and avoid disease progression. Fecal markers are a heterogeneous group of biological substances formed by the inflamed intestinal mucosa or pass through it and enter the intestinal lumen and feces, where they can be measured. The advantage of fecal markers of inflammation over blood markers is that they provide information about the inflammatory process’s location, particularly the location along the gastrointestinal tract. Still, they also are not specific to IBD.
  • 1.2K
  • 05 Feb 2021
Topic Review
Antimicrobial Resistance in Escherichia coli
Public healthcare systems all over the world are faced with a great challenge in this respect. Obviously, there are many bacteria that can cause infections in humans and animals alike, but somehow it seems that the greatest threat nowadays comes from the Enterobacteriaceae members, especially Escherichia coli.
  • 1.2K
  • 08 Feb 2021
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.
  • 1.2K
  • 09 Oct 2021
Topic Review
Inflammatory Bowel Disease-Associated Colorectal Cancer
Colonic inflammatory bowel disease (IBD) encompasses ulcerative colitis (UC) and Crohn’s colitis (CC). Patients with IBD are at increased risk for colitis-associated colorectal cancer (CACRC) compared to the general population. CACRC is preceded by IBD, characterized by highly heterogenous, pharmacologically incurable, pertinacious, worsening, and immune-mediated inflammatory pathologies of the colon and rectum. The molecular and immunological basis of CACRC is highly correlated with the duration and severity of inflammation, which is influenced by the exogenous free hemoglobin alpha chain (HbαC), a byproduct of infiltrating immune cells; extravasated erythrocytes; and macrophage erythrophagocytosis. The exogenous free HbαC prompts oxygen free radical-arbitrated DNA damage (DNAD) through increased cellular reactive oxygen species (ROS), which is exacerbated by decreased tissue antioxidant defenses. Mitigation of the Fenton Reaction via pharmaceutical therapy would attenuate ROS, promote apoptosis and DNAD repair, and subsequently prevent the incidence of CACRC. Three pharmaceutical options that attenuate hemoglobin toxicity include haptoglobin, deferoxamine, and flavonoids (vitamins C/E). Haptoglobin’s clearance rate from plasma is inversely correlated with its size; the smaller the size, the faster the clearance. Thus, the administration of Hp1-1 may prove to be beneficial.
  • 1.2K
  • 13 Jul 2023
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. 
  • 1.2K
  • 05 Nov 2020
Topic Review
Molecular Pathology and Biomarkers of Pancreatic Ductal Adenocarcinoma
Pancreatic ductal adenocarcinoma (PDAC) has an extremely poor prognosis due to the lack of methods or biomarkers for early diagnosis and its resistance to conventional treatment modalities, targeted therapies, and immunotherapies. PDACs are a heterogenous group of malignant epithelial neoplasms with various histomorphological patterns and complex, heterogenous genetic/molecular landscapes. The newly proposed molecular classifications of PDAC based on extensive genomic, transcriptomic, proteomic and epigenetic data have provided significant insights into the molecular heterogeneity and aggressive biology of this deadly disease. Studies characterizing the tumor microenvironment (TME) have shed light on the dynamic interplays between the tumor cells and the immunosuppressive TME of PDAC, which is essential to disease progression, as well as its resistance to chemotherapy, newly developed targeted therapy and immunotherapy. There is a critical need for the development of predictive markers that can be clinically utilized to select effective personalized therapies for PDAC patients.
  • 1.2K
  • 02 Dec 2022
Topic Review
Acacia Catechu Willd. for CRC
The research for innovative treatments against colon adenocarcinomas is still a great challenge. Acacia catechu Willd. heartwood extract (AC) has health-promoting qualities, especially at gastrointestinal level. This study characterized AC for its catechins content and investigates the apoptotic-enhancing effect in human colorectal adenocarcinoma HT-29 cells, along with its ability to spare healthy tissue. Results showed that AC  induced an increase in apoptotic cells and ROS formation, reduction in mitochondria membrane potential as well as increase in caspase-9 and -3 activity. AC did not affect rat ileum and colon rings viability and functionality, suggesting its safe profile toward healthy tissue. The present findings outline the potential of AC for colon cancer treatment.
  • 1.2K
  • 14 Apr 2021
Topic Review
Interferon Regulatory Factors in NAFLD and NASH
Interferon regulatory factors (IRFs), a family of transcription factors that regulate Interferon (IFN) expression, play important roles in both innate and adaptive immune responses. IRF-involved signaling pathways contribute to hepatic inflammation, insulin resistance, and immune cell activation, such as macrophage polarization, playing critical roles in non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) pathogenesis. Treatments such as microRNAs, PPAR modulators, anti-inflammatory agents, and TLR agonists or antagonists that modulate IRF-mediated signaling pathways can ameliorate the progression of NAFLD to NASH. 
  • 1.2K
  • 06 May 2022
Topic Review
Gene Therapy for Cholestasis
Cholestatic diseases can be caused by the dysfunction of transporters involved in hepatobiliary circulation. Although pharmacological treatments constitute the current standard of care for these diseases, none are curative, with liver transplantation being the only long-term solution for severe cholestasis, albeit with many disadvantages. Liver-directed gene therapy has shown promising results in clinical trials for genetic diseases, and it could constitute a potential new therapeutic approach for cholestatic diseases. Gene therapy has emerged as a promising approach to achieve safe, stable, and efficient long-term correction for a wide range of genetic diseases, including monogenic liver disorders, for which liver transplantation remains the only cure, as well as acquired liver diseases.
  • 1.2K
  • 14 Jun 2022
Topic Review
Human Gastrointestinal Microbiota
The human gastrointestinal microbiota (GIM) is a complex and diverse ecosystem that consists of community of fungi, viruses, protists and majorly bacteria. The association of several human illnesses, such as inflammatory bowel disease, allergy, metabolic syndrome and cancers,have been linked directly or indirectly to compromise in the integrity of the GIM, for which some medical interventions have been proposed or attempted. This review highlights and gives update on various technologies, including microfluidics, high-through-put sequencing, metabolomics, metatranscriptomics and culture in GIM research and their applications in gastrointestinal microbiota therapy, with a view to raise interest in the evaluation, validation and eventual use of these technologies in diagnosis and the incorporation of therapies in routine clinical practice.
  • 1.2K
  • 27 Aug 2020
Topic Review
Alcohol Consumption and Pancreatitis
Pancreatitis is a common inflammatory disorder of the pancreas, associated with high mortality and healthcare burdens worldwide. It mainly consists of two forms: acute pancreatitis (AP) and chronic pancreatitis (CP). Alcohol exposure is a known etiological factor for both AP and CP.
  • 1.1K
  • 19 Apr 2022
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