Volume 14 Issue 1, January 2017

Patients with ulcerative colitis in clinical remission are increasingly undergoing colonoscopies to determine endoscopic remission. However, the histological evaluation of biopsy samples provides additional criteria to predict which patients are most likely to undergo relapse, so what is the ideal therapeutic end point for patients with ulcerative colitis?

Pancreatic ductal adenocarcinoma (PDAC) is thought to develop through the stepwise accumulation of cancer gene mutations. A new study suggests that 16% of PDACs exhibit genetic rearrangements that simultaneously altered two or more cancer driver genes. These findings challenge the current models of PDAC development, but arguably remain compatible with a stepwise tumour progression.

The intestinal epithelium acts as a barrier requiring a contiguous layer of cells and junctions that seal the paracellular space. This Review discusses the mechanisms of intestinal barrier loss and the role of epithelial barrier function in the pathogenesis of intestinal and systemic diseases.

Biologic agents have revolutionized the management of IBD and biosimilars (copy versions of the originator agents) are emerging as an alternative. This Review outlines the concept of biosimilars and their adoption in gastroenterology, their current use and future challenges.

The association between NAFLD and diabetes mellitus has garnered increasing attention in the past few years. In this Review, Tilg and colleagues explore in detail the molecular mechanisms linking NAFLD and diabetes mellitus, and discuss clinical aspects arising from the interaction of both diseases.

Gastrointestinal surgery induces physiological stress and can include major reconstruction of the gastrointestinal tract, which can have profound effects on resident gut microbiota. Here, Guyton and Alverdy describe how the gut microbiota influence recovery after gastrointestinal surgery, including complications such as infection and anastomotic leak.

The liver regulates immune defence during sepsis, but is also a target for sepsis-related injury. Liver dysfunction can affect the prognosis of sepsis, particularly in patients with cirrhosis. In this Review, the importance of the liver in sepsis, the factors contributing to sepsis in patients with liver cirrhosis and new therapeutic strategies are discussed.