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Childhood malnutrition is a global health issue influenced by poorly understood microbial interactions. A new model of co-infection in mice now sheds light on the complex interplay between pathogens, the host and the resident gut microbiota during malnutrition.
Following haematopoietic stem cell transplantation for the treatment of haematopoietic diseases, acute graft-versus-host disease (GVHD) of the gastrointestinal tract is a common complication that presents distinct diagnostic and therapeutic challenges. In this Review, the authors tailor their discussion of the diagnosis, staging and clinical management of gastrointestinal acute GVHD for practising gastroenterologists.
The diagnosis of GERD using functional oesophageal testing has been previously reported, but no updated expert recommendations have been made in over a decade. In this Consensus Statement, the authors describe modern oesophageal physiological tests and their analysis with an emphasis on establishing indications and interpretation parameters for evaluating GERD in clinical practice.
High-resolution manometry (HRM) has transformed our understanding of oesophageal motility disorders, in particular achalasia. In this Consensus Statement, the authors explore the effect HRM has had on the diagnosis and management of achalasia and related syndromes.
The presence of lymph node metastases (LNM) is considered one of the most important features of colorectal cancer (CRC) staging, indicating the need for additional surgery after local excision and adjuvant chemotherapy after surgery. Now, a new study challenges the role of LNM in the progression of CRC.
Non-anatomical resection of colorectal liver metastases is the current preferred approach to maximize sparing of the hepatic parenchyma. A new study raises the question of whether resection in patients with KRAS-mutated colorectal liver metastases should be performed along segmental, anatomical lines to reduce the risk of local liver recurrence.
Patients who are obese and also consume excess alcohol are at increased risk of liver-related disease. In this Review, Parker and colleagues discuss how alcohol and obesity affect adipose tissue function, and describe the importance of the adipose-tissue–liver axis in liver disease pathogenesis and outcomes.
NAFLD is growing in prevalence worldwide, and has emerged as a leading cause of end-stage liver disease in many countries. In this Review, the authors describe the global epidemiology of NAFLD, discuss associated risk factors and outline challenges for screening and management.
Proton-pump inhibitors (PPIs) are widely used for gastric acid suppression in a number of gastric-acid-related diseases, including GERD. However, in recent years, increasing evidence of adverse events has been reported, raising concerns with clinicians and patients. This Review provides an update on the complications and risks of PPI use.
Various mechanisms eliciting symptoms in GERD and its most common phenotypic presentation, nonerosive reflux disease (NERD), have been suspected and investigated. One study now suggests that superficial nerves in the oesophageal epithelium might have a key role in the pathogenesis of NERD and could represent a potential target for topical therapies.
KRAS oncogene mutations are commonly encountered in pancreatic ductal adenocarcinoma, driving tumour initiation, proliferation, progression and metastasis. Human exosomes engineered to deliver small interfering RNA silencing KRASG12D are highly efficient at specifically targeting pancreatic cancer cells to dramatically reduce RAS activation, cancer cell proliferation and metastatic processes.
IBD is associated with markedly reduced intestinal mucosal oxygen levels. In this Review, the authors discuss the role of mucosal hypoxia and hypoxia-induced signalling in IBD and identify potential targets for therapies, focusing on the cell-specific functions of hypoxia-inducible factors, prolyl hydroxylases and nuclear factor-κB.