Review Articles, News & Views, Perspectives, Hypotheses, Analyses and Review in 2013

Current therapies for chronic HBV infection are focused on adults. However, the timing of primary infection of HBV often occurs during infancy or childhood, particularly in endemic areas. Children have the potential for a long lifespan and should be treated properly and early before complications develop.

With millions of humans infected yearly with HCV, leading to cirrhosis and cancer, a vaccine is urgently needed. Cultured virus particles constitute the antigen in most antiviral vaccines. A study in mice demonstrated induction of neutralizing antibodies by immunization with cell-culture-derived HCV, providing new possibilities for vaccine development.

With expanding waistlines, the prevalence of NAFLD has burgeoned to become the leading cause of chronic liver disease in the USA. A subset of patients with NAFLD meet criteria for NASH with its inherent risk of progression to cirrhosis. Verma et al. addressed the utility of alanine aminotransferase levels for predicting NASH or advanced fibrosis to decide who would benefit from the definitive test of liver biopsy.

Golimumab, a human anti-TNF antibody, is effective in patients with ulcerative colitis, according to new findings from an international phase III double-blind trial. The addition of this drug makes a ménage à trois of available drugs—comprising infliximab, adalimumab and golimumab—for the treatment of ulcerative colitis.

IBD often affects patients during their peak reproductive years. In this Review, the authors summarize the latest information concerning the safety of medications used to treat IBD during pregnancy and lactation, as well as their effect on fertility.

Endomicroscopy and endocytoscopy not only enable prediction of histology, but actual visualization of microscopic tissue details in real time. The authors of this Review discuss these microscopic imaging devices, outlining potential indications for their use and future directions for this technology.

Pancreatic cancer remains a lethal malignancy with poor prognosis. Here, the authors summarize emerging data on the role of mucins in the development and progression of pancreatic cancer and its microenvironment and discuss the diagnostic and therapeutic contributions of mucins for patients with pancreatic cancer.

This Review summarizes advances in molecular imaging approaches and provides an overview of molecular beacons and targets, as well as endoscopic devices for imaging. Studies on detection and characterization of lesions are put in perspective along with current challenges for this innovative approach.

Genetic testing in relatives of individuals with Lynch syndrome is of utmost importance for targeted screening and prevention. A recent systematic review suggests that the uptake of testing in at-risk relatives is inadequate and therefore the cost-effectiveness of Lynch syndrome testing is questionable. The results of this study are discussed here.

The evolution in surgical technique has somewhat bridged the chasm between need and availability of liver grafts for young children. This study, using data on >2,600 liver transplantations in children <2 years of age from the United Network of Organ Sharing, shows that partial grafts from deceased donors can provide outcomes on par with whole livers.

The main therapeutic strategies for GERD are antireflux surgery and pharmacological intervention. The vast majority of patients with GERD receive or prefer medical over surgical therapy. A recent study compared minimal access surgery with medical management and provided 5-year follow up data.

Extraintestinal symptoms are common in patients with IBD, and can affect nearly every organ of the body. The most common manifestations include arthropathies, mucocutaneous and ophthalmological manifestations as well as manifestations of the hepatobiliary system. The authors provide a comprehensive overview of different extraintestinal manifestations and complications, including their management, in patients with IBD.

Bariatric surgery is an effective treatment for obesity, providing long-term maintenance of weight loss. Here, the authors discuss the various mechanisms by which the different types of bariatric surgery (including Roux-en-Y gastric bypass, vertical sleeve gastrectomy and adjusted gastric banding) exert their effects on body weight. Evidence from animal and human studies will be discussed.

Anti-TNF agents are effective drugs available for IBD treatment. However, antibody formation against these drugs hampers clinical effectiveness and increases risk of drug reactions. Knowledge on antibody kinetics and antibody testing is of critical importance to make well-informed decisions about starting, continuing, discontinuing and restarting of anti-TNF agents.

Hepatic encephalopathy is a severe neuropsychiatric complication of both acute and chronic liver failure. Here, the authors present new evidence that systemic and central proinflammatory mechanisms acting alone or in concert with other toxins have a role in the pathogenesis of hepatic encephalopathy. Novel diagnostic and therapeutic opportunities are also discussed.

The development of direct-acting antiviral therapies is a major advance in HCV treatment and numerous agents are in various stages of clinical development. With this rapidly changing landscape in HCV therapy, the potential of drug–drug interactions is an important aspect of management. Here, the pharmacokinetic interactions of current and investigational agents for hepatitis C are discussed.

Globally, 130–170 million people have HCV infection; however, distribution patterns are highly variable. This Review outlines the latest information on the epidemiology and natural history of HCV infection. The disease burden and mortality of HCV-related diseases, and the potential effect of HCV treatment on disease burden, are also outlined.

Pancreaticojejunostomy and pancreaticogastrostomy are both used for reconstruction after pancreaticoduodenectomy; which method is best is still debated. A nationwide multicentre randomized clinical trial that compared these two types of reconstruction has demonstrated that pancreaticogastrostomy is associated with a substantially lower rate of clinically relevant postoperative pancreatic fistula than pancreaticojejunostomy.

Serotonin (5-HT) has been recognized for decades as an important signalling molecule in the gut, but it is still revealing its secrets. Mawe and Hoffman outline the conventional and nonconventional actions of 5-HT, and describe potential therapeutic strategies targeting this molecule and its receptors.

Autoimmune gastritis is a chronic progressive inflammatory condition that results in the replacement of the parietal cell mass by atrophic and metaplastic mucosa. This Review summarizes the epidemiology, pathogenesis and pathological aspects of autoimmune atrophic gastritis. The authors also provide practical advice for the diagnosis and management of patients with this disease.