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?

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.

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?

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.

Microbiota profiling using stool samples is limited in its ability to represent intestinal microbial dynamics. CRISPR-engineered bacteria can be used to acquire cellular RNAs and create a gene expression ‘memory’ during gastrointestinal transit, with the potential to capture microbial transcriptomic changes in the gastrointestinal tract without invasive sampling.

Owing to its simplicity, dextran sulfate sodium (DSS)-induced colitis is one of the most widely used mouse models of colitis. However, the severity of inflammation varies from one experiment to another. In a new study, Forster and colleagues have provided new insights into the DSS model by revealing specific microbial taxa that underlie disease variability.

New data demonstrate racial and ethnic disparities in access to prescription medications in persons with chronic liver disease in the USA. Here, we discuss potential health equity solutions that address structural and social determinants of health to mitigate liver health inequities in access to liver disease pharmacotherapies.

The liver microenvironment has a dynamic complexity that has not yet been adequately described. A new omics study sheds light on the hepatic parenchymal and immune cell heterogeneity by focusing on the spatial distribution of myeloid cells and macrophages in homeostasis and nonalcoholic fatty liver disease.

A subset of colorectal cancers arises from sessile serrated lesions. Tumorigenesis via the serrated neoplasia pathway is largely unexplored. Now, a new study suggests that this pathway is initiated by gastric metaplasia induced by damage and repair, which is triggered by disadvantageous composition of microbiota in the proximal colon.

Although nonalcoholic fatty liver disease is the most prevalent liver disease worldwide, there is a paucity of good-quality data on its natural history and most studies to date have reported on retrospective data. Robust data are required to inform regulatory end points, trial design and models of care.

Secretory immunoglobulin A (SIgA) regulates the composition and function of the gut microbiota and modulates its interaction with the host, but how this regulation is achieved is poorly understood. Now, Rollenske and colleagues profile the consequences of SIgA binding to the gut microbiota. They suggest that parallel generic and unique epitope-specific effects of SIgA regulate the intestinal microbiota.

Dietary fibre supports gut health and microbial ecology. Thus, characterizing the effects of inadequate fibre and intake of specific fibre formulations on the gut microbiome provides necessary information to move us towards diet–microbiome target treatments to support health.

Gene editing to correct inherited liver disorders has promise for future therapeutic intervention, but lack of effective and safe delivery of the gene-editing machinery to hepatocytes complicates its clinical application. Two studies now report efficient delivery to the liver of non-human primates, providing proof of concept for novel treatment of inherited hypercholesterolaemia.

Colorectal cancer screening has a large potential to reduce incidence and mortality, and screening programmes have been implemented in many countries and regions. Emerging epidemiological trends and evidence on the effectiveness and cost-effectiveness of various screening options call for regular updates of screening recommendations.

Delineation of fibroblast heterogeneity has the potential to identify select mesenchymal populations involved in health and disease. A recent study integrated single-cell transcriptomic data to generate a fibroblast atlas of steady-state and perturbed tissues in mice and humans, showing baseline and context-specific fibroblast phenotypes between species and pathologies, including IBD.

Cholangiopathies account for a remarkable proportion of liver transplantation cases, reinforcing the need for novel therapeutic approaches. Organoids hold great promise as novel cell-based therapies, although their applicability has not been addressed in humans. Now, a new study has reported the therapeutic effectiveness of cholangiocyte organoids to repair the injured human biliary epithelium.