Comment

Biological sex bias in clinical trials is a common issue in various medical fields, including gastroenterology and hepatology. Without sex parity and increased attention to sex-specific analyses, the translation of trial results into real-world clinical practice remains suboptimal with unpredictable consequences for patient care.

The definition of gastrointestinal involvement in post-acute COVID-19 syndrome, its frequency and its pathophysiology are still not completely understood. Here, we discuss the emerging evidence supporting immunological signatures and the unique nature of the gastrointestinal tract in this syndrome.

The burgeoning field of intratumoural microbiome research has been driven by advances in next-generation sequencing technologies, with compelling evidence on the role of the microbiota in cancer initiation, progression and patient response to treatment. Here, we discuss new concepts of the tumour-associated microbiota and what is needed to advance the translational impact of these findings in gastrointestinal cancers.

Patients with end-stage liver disease and COVID-19 are at a higher risk of hospitalization, ventilation and death than those without chronic liver disease. Whether the aetiology of liver disease also affects the natural history of COVID-19 in cirrhosis is debated. Effective and universal vaccination is paramount to combat SARS-CoV-2 infection.

Although available clinical outcome data are reassuring, the consequences of in utero exposure to inflammatory bowel disease (IBD) pharmacotherapies on the development of the neonatal immune system remain ill-defined. So too does the converse effect on immunological maturation of fetal exposure to maternal inflammatory activity. Both warrant elucidation to appropriately stratify antenatal IBD care.

Declining recruitment rates in inflammatory bowel disease (IBD) trials have resulted in calls to modify the conduct of trials in IBD in order to make them more efficient and patient centred. Here, we propose a number of potential modifications.

Social media is an emerging tool for scholarship and education; however, there is limited guidance on how to incorporate social media scholarship into one’s curriculum vitae. We outline the importance of recognizing gastroenterology-focused social media scholarship and present a standardized method for reporting.

Pancreatic ductal adenocarcinoma (PDAC) reflects the current challenge for immuno-oncology: to develop new drugs for cancers that are resistant to current immunotherapies. Here, we argue for a need to use patients to uncover new strategies that activate anti-tumour immunity.

The application of single-cell RNA sequencing platforms has generated notable insights into the heterogeneity underlying pancreatic ductal adenocarcinoma (PDAC), encompassing both the neoplastic compartment and the tumour microenvironment. In this Comment, we discuss the most pertinent findings gleaned from both mouse models and human PDAC samples, as well as future opportunities.

The Association of Black Gastroenterologists and Hepatologists is a new organization that aims to improve gastrointestinal health outcomes in Black communities, foster networking and scholarship among its members, develop the pipeline of Black gastroenterologists and hepatologists, and promote health equity in the fields of gastroenterology and hepatology.

Traditionally underutilized human excreta have emerged as a rich source of digital biomarkers for disease prevention and early detection. In this Comment, we highlight the breadth of digital biomarkers that can be extracted from human excreta and their potential uses in the context of ‘precision health’.

The popularity of social media amongst medical professionals has led to widespread use for both networking and education. Limited professional guidance exists on the sharing of medical imagery on these platforms. This Comment explores consent and offers reflective advice on the use of medical images on social media.

Intestinal ultrasonography (IUS) is an emerging, noninvasive, highly accessible and low-cost cross-sectional imaging modality for inflammatory bowel disease. This Comment summarizes how IUS in a point-of-care setting enables close patient monitoring.

Data on the efficacy and safety of SARS-CoV-2 vaccines are now available, but evidence for these vaccines in those who are immunocompromised (including patients with inflammatory bowel diseases) are lacking. As vaccination begins, questions on advantages and disadvantages can be partially addressed using the experience from other vaccines or immune-mediated inflammatory disorders.

Progress towards hepatitis B virus (HBV) elimination targets remains slow, despite efforts to support enhanced prevention, diagnosis and treatment. On the basis of insights from interventions against HIV, we argue for the wider use of antiviral therapy for HBV, highlighting the potential public health benefits in preventing liver disease and reducing transmission.

Case reports and retrospective cohort studies have reported an association between acute pancreatitis and COVID-19. As SARS-CoV-2 (the causative agent of COVID-19) receptors are expressed in the pancreas and endothelial damage can occur, this association is plausible. However, this hypothesis has many biases and needs further investigation.

To therapeutically modulate gut microbial ecosystems, a better understanding of gut ecology is key. High-throughput in vitro ecology provides a tool with the necessary power to address these needs and interpersonal treatment response variation.

Structural racism in academia and academic medicine is destructive to science and society. To deny its existence is to fertilize the soil in which it thrives. Uprooting it demands, at the very least, a fundamental transformation in institutional education, policies, practices and resource allocation with sustained anti-racist actions.

The effect of coronavirus disease 2019 (COVID-19) on liver transplantation programmes and recipients is still not completely understood but overall involves the risk of donor-derived transmission, the reliability of diagnostic tests, health-care resource utilization and the effect of immunosuppression. This Comment reviews the effect of COVID-19 on liver transplantation and summarizes recommendations for donor and recipient management.

Data based on next-generation sequencing (NGS) of colorectal cancers (CRC) clearly show that up to 10% of all cases harbour pathogenic variants. Thus, NGS performed for all patients with CRC under the age of 50 could be a cost-effective strategy, leading to a personalized approach to patients and family members.