Reviews & Analysis

Increasing levels of antibiotic resistance in Helicobacter pylori are a serious threat to human health globally. This Review discusses H. pylori infection and antibiotic resistance, and provides insights into the underlying mechanisms and clinical implications (including detection and management).

This Review explores how the gut microbiota acts as a driver and regulator of host circadian rhythms and metabolism, highlighting its unique role in transducing dietary cues. Key determinants of microbial oscillations and insights into microbial control of chronometabolism are discussed.

Pancreatic cancer is a leading cause of cancer death worldwide. This Review outlines the current knowledge of established pancreatic cancer risk factors, including lifestyle and inherited risk factors.

Chemokines have an important role in liver diseases such as alcohol-associated liver disease, nonalcoholic fatty liver disease, cirrhosis and hepatocellular carcinoma. This Review describes the regulation of chemokines in the liver, their roles in liver diseases and the potential therapeutic targets.

This Review describes the evidence of an association and causal link between nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM), discusses their pathophysiological mechanisms and summarizes the pharmacological treatments that might benefit or adversely affect the risk of T2DM or NAFLD progression.

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.

Postbiotics are emerging substances prepared from inactivated microorganisms, in contrast to probiotics, which must be administered alive. This Consensus Statement outlines a definition for the term ‘postbiotics’ as determined by an expert panel convened by the International Scientific Association for Probiotics and Prebiotics.

Studies of liver regeneration after injury have provided knowledge of the role of external signals and internal metabolic and regenerative pathways. However, less is understood about homeostatic maintenance of normal liver size in the absence of external injury. Three important new studies explore liver regeneration and homeostasis using novel lineage tagging of hepatic cells and single-cell RNA transcriptomics.

The efficacy of faecal microbiota transplantation for the treatment of a range of diseases varies. In this Perspective, Sokol and colleagues discuss the relevance of various recipient factors that influence faecal microbiota transplantation success such as inflammation, immunity and genetics.

Immunotherapeutic interventions might be effective tools for the treatment of hepatocellular carcinoma. This Review provides up-to-date information on the clinical use of currently available immunotherapies in hepatocellular carcinoma, the mechanisms of response and resistance, and the therapeutic strategies under development.

Aryl hydrocarbon receptor (AHR) signalling has important roles in the intestine. In this Review, Stockinger, Shah and Wincent discuss AHR regulation, its role in various intestinal cell types and in intestinal inflammation and tumorigenesis.

Pancreatic ductal adenocarcinoma (PDAC) has a unique tumour microenvironment. Notably, PDAC can reprogramme metabolism in response to this microenvironment. This Review discusses metabolism in pancreatic cancer, including insights into mechanisms and processes as well as the potential therapeutic applications.

Enteric glia regulate homeostasis in the enteric nervous system and influence gastrointestinal function. This Review provides an update on enteric glial biology and the underlying mechanisms by which enteric glia regulate gastrointestinal function and disease, with a focus on neuronal and immune interactions.

Evidence suggests that ileal Crohn’s disease is distinct from colonic Crohn’s disease on a multitude of layers. This Review provides a structured overview of this evidence and its implications for clinical decision-making.

Intense research is ongoing to dissect the reciprocal interactions between microbiota and drugs. New work finds that a drug to dampen host inflammation can also have off-target effects on the microbiota at transcriptional, metabolic and compositional levels, with resultant expanded benefits to the host.

This Review provides mechanistic and clinical insights into COVID-19 in the context of liver disease, discussing the potential underlying biology and clinical features of SARS-CoV-2 infection in patients with pre-existing liver conditions. The management of these patients is also discussed, including SARS-CoV-2 vaccination strategies.

The prevalence of nonalcoholic fatty liver disease (NAFLD) has increased rapidly and is associated with obesity in epidemiology and pathogenesis. A new study reports that hepatic and extrahepatic complications can develop in lean individuals with NAFLD, highlighting the importance of metabolic phenotypes in NAFLD assessment instead of BMI-based approaches.

Necrotizing enterocolitis (NEC) is an acute intestinal emergency in preterm infants, which is often later complicated by cognitive delay and neurodevelopmental disability. A new study performed in mice suggests that CD4⁺ T cells can travel from the NEC-inflamed gut to the brain and cause IFNγ-mediated brain injury.

Oesophageal cancer is a global health problem with two main histological subtypes, oesophageal adenocarcinoma and oesophageal squamous cell carcinoma. This Review establishes the current epidemiology of oesophageal cancer, with a particular focus on the increasing incidence of oesophageal adenocarcinoma and its precursor, Barrett oesophagus.

Although COVID-19 is a respiratory disease and its causative agent, SARS-CoV-2, principally infects the respiratory tract, extrapulmonary manifestations are observed. This Perspective explores the gastrointestinal symptoms associated with COVID-19 and the putative underlying mechanisms, discussing experimental evidence on SARS-COV-2 gastrointestinal infection and the potential for faecal–oral transmission.