Review Articles in 2013

Factors associated with ageing, such as comorbidities, polypharmacy and diminished physical reserve, can affect the natural history of IBD. This Review highlights how these age-associated variables can affect older patients with IBD and also illustrates the multiple gaps in our current knowledge of IBD in the elderly.

Helicobacter pyloriinfection has been associated with multiple diseases, including cardiovascular disease and hepatobiliary diseases, localized outside of the stomach, especially those characterized by a persistent and low-grade systemic inflammation. Here, the authors describe the most important studies published so far about a possible role ofH. pyloriin non-gastrointestinal diseases.

IBD is a chronic disorder with disease onset ranging from early childhood to beyond the sixth decade of life. This Review provides an overview of the differences in epidemiology, clinical characteristics, and natural history of paediatric, adult, and elderly-onset IBD. In addition, potential differences in host–gene–microbial interactions according to age are highlighted.

We are moving towards an era of disease categorization beyond Crohn's disease and ulcerative colitis to a more robust definition of a spectrum of IBD subtypes. This Review outlines some of the genetic, clinical, biochemical, serological, and microbiome data that could be used for risk stratification and treatment selection in clinically meaningful subgroups of patients.

Here, Nathalie Rommel, Jan Tack and colleagues provide an overview of the extensive literature concerning globus and discuss the quality of the evidence to date. They also put forward a potential theoretical model to support management and future research in globus.

This Review presents the emerging surgical therapies available to treat patients with faecal incontinence. These techniques include neuromodulation, neosphincter creation (muscle or artificial) and injection therapy. The need for further research and development—not only in terms of the devices and procedures, but also to identify which patients are likely to benefit most from such interventions—is also highlighted.

Patients chronically infected with HBV are at risk of HBV reactivation if immunosuppressive therapies are initiated. In this Review, Hwang and Lok describe the clinical manifestations, incidence and risk factors associated with HBV reactivation during immunosuppression. Practical insights into the management of patients with HBV who require immunosuppressive therapy are also provided.

Cardiac dysfunction has been reported in patients with cirrhosis—nearly half of whom have been shown to have abnormalities in cardiac function—and improved understanding of these changes has led to the definition of so-called cirrhotic cardiomyopathy. Here, the authors describe the underlying pathophysiology, clinical features, diagnosis and treatment of cirrhotic cardiomyopathy.

Minimal access surgery (MAS) is widely used for colon cancer, but its use for rectal cancer remains limited owing to issues with technical feasibility and oncologic outcomes. In this Review, the current evidence in support of laparoscopic and robotic total mesorectal excision for rectal cancer resection is presented. Other MAS approaches, including transanal endoscopic microsurgery and natural orifice transluminal endoscopic surgery, are also discussed.

In this Review—intended as an introduction to the topic of hepatic autophagy for clinical scientists—the authors describe the different types of hepatic autophagy, their role in maintaining homeostasis in a healthy liver and the contribution of autophagic malfunction to liver disease.

This Review describes advances in artificial and bioartificial liver support systems and current developments. The evolving field of hepatocyte transplantation as a less invasive alternative to whole-organ transplantation is also reviewed, and a detailed overview of cutting-edge hepatic tissue engineering is included. Challenges and opportunities of the different approaches are analysed with respect to clinical relevance, as well as basic science concerns.

Optimal management of NASH is required because the condition can progress to cirrhosis and end-stage liver failure. Once first-line therapy with diet and lifestyle changes has failed, pharmacological intervention is indicated. This Review discusses the available evidence from clinical trials on pharmacological agents for NASH.

Paediatric GERD is difficult to manage. Here, Yvan Vandenplas discusses the issues surrounding accurate diagnosis of gastro-oesophageal reflux and GERD. He also presents current therapeutic options for these conditions, including nonpharmacological, pharmacological and surgical approaches.

Understanding HCV transmission routes is essential for designing and implementing control strategies to reduce the prevalence of HCV infection and the burden of hepatitis C. Here, the main routes of HCV transmission in industrialized and resource-constrained countries are presented, along with a global agenda on how the burden of HCV could be reduced.

The incidence of NAFLD, which increases the risk of liver cancer, is increasing to epidemic proportions. This Review outlines the correlations between liver cancer and NAFLD-related cirrhosis, and the role of the metabolic syndrome in the development of liver cancer. Advances in understanding the progression of NAFLD to hepatocellular carcinoma from preclinical models will also be discussed.

The sensing mechanism of the gut and the effector systems with which they communicate interact intimately on an anatomical and functional level. Here, John Furness and colleagues discuss how recent discoveries are enabling us to develop a comprehensive understanding of the integrated responses of the gut to the sensory information it receives.

NAFLD is a complex disease. Considerable variability exists in the severity and risk of morbidity and mortality among individuals with NAFLD, which could be influenced by genetic and environmental factors. Here, the authors discuss the latest knowledge on the genetics of NAFLD and how this genetic variation might determine disease phenotype and progression.

Accurate diagnosis and staging of NAFLD is of utmost prognostic importance. The gold standard for diagnosis is histological examination, but growing interest exists in novel noninvasive methods to evaluate NAFLD. This Review describes the advantages and limitations of noninvasive methods for the diagnosis and quantification of steatosis, diagnosis of NASH and staging of hepatic fibrosis in NAFLD.

The advent of potent, pan-genotypic all-oral direct-acting antiviral (DAA) regimens necessitates a critical examination of the immediate application of PEG-IFN, ribavirin and DAA regimens in patients with chronic hepatitis C. This comprehensive Review outlines some of the conundrums facing physicians and summarizes current and pending treatment options for patients with hepatitis C.

Bile acids have a crucial role in the digestion of dietary lipids and as signalling molecules in a number of metabolic pathways. Bile acid receptors have become attractive therapeutic targets for liver disease and metabolic disorders. Here, the authors provide an overview of bile acid signalling in humans and highlight the therapeutic potential of compounds that target these pathways.