Gastroenterology articles within Nature Reviews Gastroenterology & Hepatology

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  • Comment |

    Transgender and gender-diverse patients in the United States can have difficulty finding providers who are knowledgeable about their unique health-care needs. In many states, legislation limits the ability of physicians to provide gender-affirming and supportive care. Further awareness, advocacy and research is needed to help mitigate the discrimination and stigma endured by the transgender community.

    • Sarah Singh
    • , Nikki Duong
    •  & Lauren D. Feld

  • Review Article |

    Pouchitis is a common condition that can occur after intestinal surgery. In this Review, Shen discusses our current understanding of the multifactorial pathophysiology, diagnosis and management of pouchitis, primarily in patients with underlying ulcerative colitis.

    • Bo Shen

  • Perspective |

    This Perspective discusses single-cell and single-nuclei RNA sequencing in metabolic dysfunction-associated steatotic liver disease and explains how our understanding of the pathology of the disease will accelerate following the advances in spatial transcriptomics.

    • Kylie P. Matchett
    • , Jasmin Paris
    •  & Neil C. Henderson

  • Perspective |

    Artificial intelligence (AI) is advancing rapidly and is already starting to transform cancer research and care. Here, the authors outline how AI could be incorporated into liver cancer management, highlighting areas with academic, commercial and clinical potential, as well as ongoing progress and pitfalls.

    • Julien Calderaro
    • , Laura Žigutytė
    •  & Jakob Nikolas Kather

  • Comment |

    The lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA+) community navigates a complex social landscape marked by strides in acceptance alongside enduring discrimination. Allies — individuals outside of the LGBTQIA+ spectrum who support and advocate for this community — are paramount, with allyship playing a critical part in influencing the health and well-being of LGBTQIA+ individuals.

    • Daniel J. Huynh
    • , Sonali Paul
    •  & Nikki Duong

  • Perspective |

    Bile acids have important roles in human metabolism and immune regulation. In this Perspective, Dorrestein and colleagues discuss the technologies and data science-related approaches that are improving our understanding of the diversity of bile acids and their multifaceted roles.

    • Ipsita Mohanty
    • , Celeste Allaband
    •  & Pieter C. Dorrestein

  • Comment |

    Cultural safety seeks to remediate health inequities through empowering marginalized and minoritized patient populations, minimizing implicit bias and incorporating social determinants of health into practice. Here, we propose a cultural safety framework to guide communication with patients from sexual and gender minorities.

    • Newsha Nikzad
    • , Nikki Duong
    •  & Sonali Paul

  • Comment |

    Fatty liver disease is one of the most common liver diseases in the Middle East and North Africa region, and globally. Unfortunately, there is a lack of awareness regarding this condition. The nomenclature changes for NAFLD (to MAFLD or MASLD) have gained considerable attention in the hepatology community. Here, we present our point of view on this ongoing change and debate.

    • Yasser Fouad
    • , Salma Barakat
    •  & Hasmik Ghazinyan

  • Review Article |

    Ageing and senescence are major risk factors for liver disease development. This Review provides a comprehensive overview of hepatic senescence, its role in liver disease progression and hepatocellular carcinoma, and discusses potential therapeutic strategies.

    • David Sanfeliu-Redondo
    • , Albert Gibert-Ramos
    •  & Jordi Gracia-Sancho

  • Review Article |

    This Review discusses the role of the gut microbiome in the conversion of primary to secondary bile acids and critically evaluates biochemical pathways that are less well understood. Insights into how secondary bile acid derivatives influence host immune function are also described.

    • Jason M. Ridlon
    •  & H. Rex Gaskins

  • News & Views |

    A new study by Díaz and colleagues links strong alcohol policy with improved health and societal outcomes. The evidence for what works to reduce the enormous burden from alcohol is clear. The question is why are governments still not acting?

    • William Gilmore
    •  & Ian Gilmore

  • Review Article |

    Coeliac disease is an autoinflammatory disease, with the only available treatment being a lifelong gluten-free diet. Alternative therapeutic approaches are needed. This Review explores the concept of tolerance-inducing therapies for coeliac disease, highlighting the underlying mechanisms, progress, challenges and future directions.

    • Ludvig M. Sollid

  • Editorial |

    The Editors of Nature Reviews Gastroenterology & Hepatology travel regularly to conferences to meet with the research community and keep up to date on the latest research and key trends in the field. Come and say hello!

  • Review Article |

    Obesity and metabolic syndrome are two complex and multifactorial conditions. This Review provides a comprehensive overview of dietary fibres, discussing physiochemical properties, microbiota interactions and therapeutic interventions for body weight and insulin resistance regulation.

    • Edward C. Deehan
    • , Valentin Mocanu
    •  & Karen L. Madsen

  • Review Article |

    Hepatic metabolic functions are altered in metabolic diseases. This Review provides a comprehensive overview of glucose metabolism in steatotic liver disease (SLD) and obesity, describes new techniques for hepatic glucose flux assessment and discusses how SLD treatments affect glucose metabolism.

    • Egeria Scoditti
    • , Silvia Sabatini
    •  & Amalia Gastaldelli

  • Clinical Outlook |

    A substantial percentage of patients with inflammatory bowel disease (IBD) exhibit biologic treatment failure or loss of response over time. This article explores the effectiveness and safety of monoclonal antibodies targeting the IL-23 pathway in treating IBD; continued research is needed to address lingering questions regarding long-term safety and efficacy.

    • Silvio Danese
    •  & Laurent Peyrin-Biroulet

  • Year in Review |

    In 2023, there were significant advancements in trials of interventions to reduce mortality and morbidity from alcohol-related liver disease, spanning the entire spectrum of disease: primary prevention to reduce overall alcohol-related harm, secondary prevention to attenuate fibrosis progression and tertiary prevention using antibiotics for severe alcohol-associated hepatitis.

    • Maja Thiele
    •  & Christophe Moreno

  • Review Article |

    Gut microbiota has a vital role in mechanisms involved in overweight and obesity, including host metabolism and energy expenditure. This Review describes the physiology of white and brown adipose tissue and provides timely insights into the gut microbiota–adipose tissue axis.

    • Patrice D. Cani
    •  & Matthias Van Hul

  • Year in Review |

    Important studies published in 2023 outlined new agents and strategies for the management of inflammatory bowel disease. Therapeutic ambitions for the management of inflammatory bowel disease were raised by the success of combinations of biologic agents in ulcerative colitis and early surgical resection in Crohn’s disease.

    • Paulo Gustavo Kotze
    •  & Severine Vermeire

  • Year in Review |

    New light is being shed on the interactions between the gut microbiome, cancer cell signalling and the host immune response. With this knowledge, microbiota-based approaches for improving cancer prevention, prognostication and therapy have started to materialize and will contribute to reducing the global cancer burden.

    • William K. K. Wu
    •  & Jun Yu

  • Year in Review |

    In 2023, we witnessed advances in allocation policies and marginal donors, including living donors. Key improvements included the uncapped Model for End-stage Liver Disease 3.0 score, unveiled machine perfusion trials to standard deceased donors and lessons from the aborted living donor liver transplantations.

    • Nam-Joon Yi

  • Year in Review |

    Enteric nervous system function is essential for survival. Studies published in 2023 have provided important novel insights into the mechanisms that regulate its development and maintenance, and demonstrate how it can be restored when these mechanisms fail.

    • Werend Boesmans

  • Review Article |

    Inflammatory bowel disease (IBD) is an immune-mediated inflammatory disease (IMID). Here, the authors review evidence on the preclinical phase of IBD, outlining and describing the proposed at-risk, initiation and expansion phases. Overlap with other IMIDs is discussed alongside the possible future directions for research into preclinical IBD.

    • Jonas J. Rudbaek
    • , Manasi Agrawal
    •  & Tine Jess

  • News & Views |

    Metabolic dysfunction-associated steatotic liver disease (MASLD) has a strong heritable component, and genome-wide association cohort studies are highlighting the major genetic determinants of this condition. A meta-analysis of these databases has now enabled expansion of the list of the inherited variants that modulate the risk of MASLD. The identification of new MASLD risk loci is improving comprehension of disease pathogenesis and individual risk stratification, and also enabling the identification of novel therapeutic targets and disease subtypes that might ultimately lead to a precision medicine approach.

    • Luca V. C. Valenti
    •  & Vittoria Moretti

  • News & Views |

    Innovative approaches to increase testing are needed to achieve the 2030 hepatitis B and hepatitis C elimination targets. Zhang et al., partnering with local community organizations, successfully used a pay-it-forward approach to increase hepatitis B and hepatitis C testing among men who have sex with men in China.

    • Margaret E. Hellard
    •  & Alisa Pedrana

  • Perspective |

    This Perspective explores the relationship between screening endoscopy and colorectal cancer incidence, examining available evidence and offering insights into the discrepancies between real-world and trial evidence alongside potential pitfalls with interpreting the data.

    • Hermann Brenner
    • , Thomas Heisser
    •  & Michael Hoffmeister

  • Perspective |

    Histological assessment of nonalcoholic fatty liver disease (NAFLD) is essential for clinical practice as it outlines diagnosis and lays the foundation of medical care. This Perspective summarizes the advancements in digital histology and discusses current and future applications in NAFLD.

    • Arun J. Sanyal
    • , Prakash Jha
    •  & David E. Kleiner

  • Editorial |

    Liver fibrosis is a substantial risk factor for liver cancer development. In this issue, we focus on molecular and cellular mechanisms of hepatic fibrogenesis and discuss therapeutic implications.

  • Review Article |

    Increasing evidence shows a role of cellular stress responses in nonalcoholic steatohepatitis (NASH) and liver fibrosis pathogenesis. This Review provides a comprehensive overview of the molecular mechanisms involved in cellular stress in fibrogenesis and their role in NASH progression.

    • Sachin Sharma
    • , Dounia Le Guillou
    •  & Jennifer Y. Chen

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