Review Articles in 2017

Approximately half of patients diagnosed with oesophageal cancer have metastatic or unresectable disease. Here, the authors discuss the multidisciplinary interventions available to manage dysphagia, improve quality of life and prolong survival in these individuals.

Optogenetic and chemogenetic approaches hold great promise in neurogastroenterological research. In this Review, the authors discuss the advantages and limitations of available tools and cover optimal approaches for targeting specific cell types in the gut.

Cellular senescence is induced in response to various stresses and can either prevent or fuel disease and tumorigenesis. Here, the authors provide an overview of senescence aimed at gastroenterologists and hepatologists and detail how modulation of senescence might be used for therapeutic purposes.

Hepatitis E virus (HEV) is a public health concern in both developing and developed countries. Here, the authors describe advances in understanding HEV biology, clinical infection and the challenges still to be overcome in HEV research, particularly with respect to cell culture and animal models.

Chronic opioid use is increasing worldwide and has negative effects in the gastrointestinal and central nervous systems. This Review summarizes the evidence and consequences of opioid misuse in gastroenterology, as well as alternative pharmacological and nonpharmacological strategies for pain management in patients with gastrointestinal disorders.

A wide variety of environmental triggers have been associated with IBD pathogenesis, including the gut microbiota, diet, pollution and early-life factors. This Review discusses the latest evidence and progress towards better understanding the environmental factors associated with IBD.

Bile acids link the gut microbiota to both hepatic and intestinal metabolism, and this tripartite relationship has been implicated in gastrointestinal disease. In this Review, the authors outline the mechanistic links between bile acid–microbiota crosstalk and gastrointestinal inflammation and carcinogenesis, with a specific emphasis on the major bile-acid-sensing receptors.

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.

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.

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.

Direct-acting antiviral agents (DAAs) are highly effective treatments for HCV, but are not always accessible to people who inject drugs (PWID). Here, Grebely and colleagues outline the epidemiology of HCV in PWID, discuss current data on DAA outcomes in this population and highlight steps required to broaden access to HCV therapy with the eventual goal of HCV elimination.

Endocrine (such as diabetes) and exocrine (such as pancreatitis) disorders of the pancreas have a substantial burden worldwide. This Review explores the potential of regenerative medicine and cell-based approaches to restore both endocrine and exocrine pancreatic function, describing insights into cell replacement, implantation and reprogramming.

Perianal fistulizing Crohn's disease has a major negative effect on a patient's quality of life and is a predictor of poor long-term outcome. Here, the authors provide an up-to-date overview on the pathogenesis and diagnosis of fistulizing Crohn's disease, as well as therapeutic strategies.

Clinicians face a rapidly evolving set of challenges and opportunities for generating insights into the health of patients from microbiome analysis. Here, the authors summarize the major decision points confronting new entrants to the field or for those designing new projects in microbiome research.

Changes in the composition and metabolic function of the gut microbiota have been linked to IBD, but a direct causal association has yet to be established in humans. This Review discusses the evidence supporting dysbiosis in the gut microbiota in Crohn's disease and ulcerative colitis, exploring evidence from animal models and the translation to human disease.

Owing to its unique composition and influence on numerous biological processes, the extracellular matrix (ECM) is an ideal therapeutic substrate for tissue repair. In this Review, the authors provide an overview of ECM bioscaffolds derived from gastrointestinal tissues, and discuss advances in regenerative medicine using these scaffolds for the reconstruction of functional gastrointestinal tissues.

Combating the obesity epidemic necessitates a range of effective therapies. In this Review, Dixon and Lee explore the medical devices developed to bridge the gap between conservative lifestyle and pharmacotherapy interventions and disruptive surgical approaches, focusing on mechanisms of action, efficacy and safety.

Increasing evidence suggests that the gut microbiota are important modulators of chronic liver disease progression and the development of hepatocellular carcinoma. In this Review, Yu and Schwabe discuss the mechanisms by which the gut microbiota promote hepatocarcinogenesis, and explore therapeutic interventions with clinical potential.