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.

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.

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.

Live microorganisms can be manipulated and engineered for colorectal cancer detection and treatment through methods such as faecal microbiota transplantation, native bacteria engineering and synthetic circuit engineering. Although promising, substantial effort is required to translate these approaches for clinical use.

Steatotic liver disease has emerged as an important risk factor for cardiovascular disease, type 2 diabetes mellitus and chronic kidney disease. Successful treatment of steatotic liver disease might also be effective in preventing these cardiometabolic diseases.

Strong multidisciplinary support and political commitment have helped Spain become one of the countries most likely to eliminate hepatitis C. In this Comment, we set out six key elements of the Spanish elimination effort that can serve as a model elsewhere and the remaining barriers to overcome.

Inflammatory bowel disease (IBD) clinical trials face a recruitment crisis. This is attributable to multiple individual trials competing for the same pool of participants, growing sample size demands and the increased availability of licensed alternative options for many potential participants. We need phase II trials that are more efficient both in design and in outcomes measured in order to deliver earlier and more precise answers, rather than simply offering a crude preview of what a subsequent phase III trial might look like.

In this Comment, we provide a strategic framework for what could and should be measured, across four domains, to optimize standards of care for multidisciplinary models of care in nonalcoholic fatty liver disease.

In gastroenterology, ChatGPT and large language models (LLMs) can assist clinicians in various tasks but also have several shortcomings. Although LLMs have great potential to assist clinicians in health care, they should be used as a tool to support, rather than replace, human expertise.

Barrett oesophagus is not detected before its progression to oesophageal adenocarcinoma in over one-half of patients, and improvements in screening for Barrett oesophagus in primary care could substantially reduce mortality associated with this cancer. Advances in screening technology will help, but collaboration of gastroenterologists with primary care providers is essential.

Little Brain Big Brain is a biannual meeting organized and attended by young investigators. Since its inception in 1989, this meeting has brought together promising junior researchers in neurogastroenterology. The XVIIth meeting featured the latest basic, clinical and industry research in the field in a special post-pandemic edition.

Gastrointestinal research in Latin America is hampered by a lack of financial support and by biases, affecting research advancement in the region and career development of Latin American scientists. Engagement of the next generation of leaders and established scientists is, therefore, essential to avoid perpetuation of the existing inequalities.

A new report from the World Health Organization has evaluated the risks of dietary exposure to nanoplastic and microplastic particles (NMPs) to human health. Although challenges in the detection of NMPs in food and beverages remain, it is clear that humans are being exposed. Presently, no convincing evidence of adverse health effects are found, but major knowledge gaps remain.

The European Medicines Agency safety committee has revisited the label and recommended the use of Janus kinase inhibitors in patients with certain risk factors only if no suitable treatment alternatives are available. Although regulatory decisions are key to place therapeutic options based on safety, broad restrictions might lead to unintended consequences without an individualized benefit–risk evaluation.

Hepatitis B virus (HBV) core protein-targeting compounds are in or entering clinical development without a standardized nomenclature. We propose a naming convention for these core-targeting antiviral products to provide clarity and accelerate HBV drug development.

Practical recommendations on achieving equitability in biomedical research can advance essential efforts to balance research representation. In this Comment, we highlight how to generate interoperable and robust datasets, engage in thoughtful partnerships with researchers across geographies and cultures, and embrace innovative opportunities to push microbiome research beyond the gut and beyond bacteria.

The recent increase in unexplained acute hepatitis in children in 2022 has focused attention on acute paediatric liver disease. We discuss emerging evidence and leading causal hypotheses in context with potential long-term effects of the COVID-19 pandemic for young children.

Only 12 high-income countries are on track to meet the World Health Organization’s goal of eliminating hepatitis C as a public health threat by 2030, and micro-elimination opportunities in high-risk populations in settings such as hospitals are often overlooked. We propose ten steps to eliminate hepatitis C in hospitals.

Hepatitis C virus (HCV) infection is common among people who are incarcerated in low- and middle-income countries. Prison policy changes towards HCV testing and treatment are pivotal for social justice and can be a crucial step for achieving HCV global elimination targets.

Biological sex bias in clinical trials is a common issue in various medical fields, including gastroenterology and hepatology. Without sex parity and increased attention to sex-specific analyses, the translation of trial results into real-world clinical practice remains suboptimal with unpredictable consequences for patient care.