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2023 was the most memorable year on record for obesity. The American Academy of Pediatrics recognized the complex, multifactorial nature of obesity and the broad range of treatments necessary to care for pediatric patients. The first-ever triple agonist and high-potency oral GLP1 agonist was introduced with unprecedented results.
In 2023, there were significant advancements in trials of interventions to reduce mortality and morbidity from alcohol-related liver disease, spanning the entire spectrum of disease: primary prevention to reduce overall alcohol-related harm, secondary prevention to attenuate fibrosis progression and tertiary prevention using antibiotics for severe alcohol-associated hepatitis.
Fermented foods have gained renewed popularity owing to their health-promoting potential. This Review discusses the mechanisms underlying the benefits of fermented foods in gut health and disease, highlighting how specific fermented food microorganisms, food components and bioactive compounds exert their effects. A future outlook on research is also detailed.
Metastatic colorectal cancer is a heterogeneous disease associated with poor patient outcomes. Although the past decade has seen few first-line treatment advances, key studies published in 2023 established new options for late-line therapy of the disease with and without oncogenic drivers, thus expanding the continuum of care in metastatic colorectal cancer.
Gut microbiota has a vital role in mechanisms involved in overweight and obesity, including host metabolism and energy expenditure. This Review describes the physiology of white and brown adipose tissue and provides timely insights into the gut microbiota–adipose tissue axis.
Important studies published in 2023 outlined new agents and strategies for the management of inflammatory bowel disease. Therapeutic ambitions for the management of inflammatory bowel disease were raised by the success of combinations of biologic agents in ulcerative colitis and early surgical resection in Crohn’s disease.
New light is being shed on the interactions between the gut microbiome, cancer cell signalling and the host immune response. With this knowledge, microbiota-based approaches for improving cancer prevention, prognostication and therapy have started to materialize and will contribute to reducing the global cancer burden.
In this Review, Besselink and colleagues discuss preoperative chemotherapy, radiotherapy and surgical decision-making in patients with borderline resectable pancreatic cancer and locally advanced pancreatic cancer, including disease staging and response evaluation.
In 2023, we witnessed advances in allocation policies and marginal donors, including living donors. Key improvements included the uncapped Model for End-stage Liver Disease 3.0 score, unveiled machine perfusion trials to standard deceased donors and lessons from the aborted living donor liver transplantations.
Enteric nervous system function is essential for survival. Studies published in 2023 have provided important novel insights into the mechanisms that regulate its development and maintenance, and demonstrate how it can be restored when these mechanisms fail.
Inflammatory bowel disease (IBD) is an immune-mediated inflammatory disease (IMID). Here, the authors review evidence on the preclinical phase of IBD, outlining and describing the proposed at-risk, initiation and expansion phases. Overlap with other IMIDs is discussed alongside the possible future directions for research into preclinical IBD.
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.
Cirrhosis recompensation is gradually gaining traction, but a definition for recompensation in nonalcoholic fatty liver disease (NAFLD)-related cirrhosis is currently lacking. This Perspective provides an overview of the natural history of NAFLD and discusses NAFLD-related cirrhosis recompensation.
The incidence of pancreatic ductal adenocarcinoma (PDAC) is rising. In this Review, Hu and O’Reilly summarize the latest advances and clinical trials for the treatment of PDAC, including biomarkers, targeted therapies and immunotherapy as well as novel clinical trial designs. They also discuss emerging therapeutic options for this disease.
This Perspective explores the relationship between screening endoscopy and colorectal cancer incidence, examining available evidence and offering insights into the discrepancies between real-world and trial evidence alongside potential pitfalls with interpreting the data.
Histological assessment of nonalcoholic fatty liver disease (NAFLD) is essential for clinical practice as it outlines diagnosis and lays the foundation of medical care. This Perspective summarizes the advancements in digital histology and discusses current and future applications in NAFLD.
In this Expert Recommendation, Uhlig and colleagues review the therapeutic landscape for monogenic inflammatory bowel disease and propose recommendations for standardized reporting of clinical outcomes.
In this Review, Murphy and Zaki discuss changes in the incidence and mortality of colorectal cancer, including trends by age and birth cohort, and consider the contributions of early-life exposures and emerging risk factors.
