Articles in 2018

Metabolic surgery is the best treatment for long-term weight loss maintenance and comorbidity control. In this Review, the authors discuss how gut physiology adapts to these procedures and the consequent effects on food intake, weight loss, liver disease and cancer.

New findings show that a gut microbiome signature derived from metagenomic and phenomic data can accurately predict nonalcoholic fatty liver disease (NAFLD) in obese women. The data highlight a role for phenylacetic acid, a microbial product of aromatic amino acid metabolism, in the cross-talk between the gut microbiome and the host hepatic phenotype.

Intervention studies have helped characterize the potential mechanisms linking obesity and risk of gastrointestinal cancers in humans. Here, the authors explore the findings of these trials and detail how the key pathways involved, including inflammation, adipokines and metabolic dysfunction, might modulate carcinogenesis in gastrointestinal tissues.

Liver diseases exert a substantial disease burden across the Asia–Pacific region. In this Review, the authors explore the epidemiological trends in the most common liver diseases in the region, including HBV infection, HCV infection and nonalcoholic fatty liver disease, and discuss implications for preventive measures.

In this Review, the authors summarize how various interactions at the gastrointestinal epithelium regulate gut physiology. They also discuss how neuroimmunophysiology has advanced the understanding of gastrointestinal pathophysiology with the potential to reveal novel therapies for disorders such as IBS and IBD.

Biomedical ‘big data’ has opened opportunities for data repurposing to reveal new insights into complex diseases. Public data on IBD have been repurposed for novel diagnostics and therapeutics, and these datasets continue to grow. Here, we discuss the practicalities and implications of open data informatics for IBD.

More than 250 million people worldwide are chronically infected with the hepatitis B virus (HBV). In this Comment, members of the International Coalition to Eliminate HBV appraise the current policy environment and the need for appropriate cure research and preparedness to complement the WHO global elimination strategy, the HBV vaccine and the well-tolerated but poorly accessed therapy.

Pancreatic cancer is a disease with high tumour heterogeneity and dismal prognosis. There are few therapeutic options and many promising drugs have failed in patients, which makes better models to predict drug efficacy a key research priority. Now, a new study shows that patient-derived organoids can be used for molecular and therapeutic profiling and might be useful to predict clinical responses.

Current approaches to manage decompensated cirrhosis are based on targeted strategies aimed at preventing or treating specific complications of the disease. Here, Bernardi and Caraceni discuss the shift in focus from individual treatments targeting individual complications to disease-modifying agents able to slow the progression of decompensation.

A new report in Science by Ma and colleagues uncovers the interplay of microbiota-controlled bile acid metabolism and immune responses in the context of primary and metastatic liver tumours in mice. Their findings shed light on the gut–liver axis in hepatic malignancies.

IBD is associated with disruptions to resident microbial populations and inflammatory immune responses; however, little is known about how bacteria influence pathogenic immunity. New research identifies microbially produced ascorbate as a potential drug target to ameliorate disease by inhibiting inflammatory T cell function through altered cellular metabolism.

New findings show that disease-specific T cells that target gluten in patients with coeliac disease persist for decades. The data highlight a central role for a highly select and stable population of T cells in disease persistence and support the feasibility of diagnostics and therapies targeting these cells.

Intraepithelial T cells (IETs) are a unique collection of T cells located at the epithelial barrier. This Review highlights the role of these cells in gut homeostasis and disease, including coeliac disease and IBD. Targeting of IETs in therapeutic interventions is also discussed.

Excess adiposity is a risk factor for many cancers of the gastrointestinal system. In this Review, the authors examine the epidemiological evidence of associations between obesity and gastrointestinal cancer risk and explore the potential mechanisms underlying these relationships.