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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.
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.
In this article, the authors discuss the use of total neoadjuvant therapy for locally advanced rectal cancer. They highlight ongoing trials and discuss future treatment options, including the potential use of multi-omics and artificial intelligence to facilitate treatment selection and prediction of response.
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?
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.
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.
Cirrhosis recompensation is gradually gaining traction, but a definition for recompensation in nonalcoholic fatty liver disease (NAFLD)-related cirrhosis is currently lacking. This Perspective provides an overview of the natural history of NAFLD and discusses NAFLD-related cirrhosis recompensation.
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.
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.
Tackling fibrosis in patients with nonalcoholic steatohepatitis (NASH), one of the major causes of liver cirrhosis, is critical in improving patient outcomes. This Perspective discusses potential strategies to develop better antifibrotic therapies in NASH, from the discovery process to future clinical trials.
Recent clinical trials have demonstrated efficacy and safety of etrasimod, a new sphingosine-1-phosphate receptor modulator, in the treatment of patients with moderately-to-severely active ulcerative colitis. Etrasimod is a promising new oral treatment option for ulcerative colitis, although long-term efficacy and safety data should be accumulated.
A new study has found that a strain of the gut bacterium Lactiplantibacillus plantarum activates a NOD2–type I interferon–insulin-like growth factor 1 pathway in young mice to partially protect against the deleterious growth effects of a diet deficient in protein and fat. Could live biotherapeutic products or their derivatives unlock the full potential of nutritional interventions against childhood stunting?
The appendix is thought to have a role in the pathogenesis of ulcerative colitis but the association remains unclear. In this Perspective, the authors consider the biology of the appendix with respect to its immunological function and the microbiome, and how this relates to its possible involvement in ulcerative colitis.
A prospective study suggests that the risk of liver fibrosis with methotrexate treatment has been overestimated. The findings suggest the need to reconsider the intensive strategies and the screening tools that are recommended for monitoring liver fibrosis in patients receiving methotrexate.
In a study published in Nature, new data have highlighted the bacterial strain-level sharing rates of mother–offspring pairs, twins, families, cohabiting individuals and individuals within a population, as well as those between different populations, providing a comprehensive view of the transmission landscape of the intestinal and oral microbiome in humans. These findings highlight the need to reassess diseases currently considered to be non-communicable and underscore the importance of considering social structure and transmissibility in the design of microbial studies.
New data suggest that moderate fluid resuscitation is safer in acute pancreatitis than the standard aggressive fluid resuscitation. The findings suggest that an approach that includes safety and goal-directed checkpoints could enable treatment to be individualized and highlight the importance of clinical evidence in challenging dogma and improving evidence-based medicine.
Health care contributes to the climate change burden, and measures should be taken to mitigate these effects. This Perspective discusses the carbon footprint of surgery in gastroenterology and hepatology and offers an overview of sustainable strategies.
Intestinal gluconeogenesis (IGN) is a conserved mechanism documented in all vertebrates and it has a crucial role in energy homeostasis and metabolic processes. This Perspective provides an overview of IGN and discusses its importance in natural selection.
Advances in artificial intelligence (AI) are changing endoscopy and gastrointestinal surgery, including computer-assisted detection and diagnosis, computer-aided navigation, robot-assisted intervention and automated reporting. This Perspective introduces the role of AI in computer-assisted interventions in gastroenterology with insights on regulatory aspects and the challenges ahead.
