Reviews & Analysis

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  • In 2020, major advances to the understanding of gastrointestinal inflammatory and infectious disease have been made using ‘mini-gut’ organoids. Key findings include the discovery of somatic inflammatory gene mutations in ulcerative colitis epithelium, a unique mutational signature in colorectal cancer caused by genotoxic Escherichia coli, and infection of intestinal organoids by SARS-CoV-2.

    • Vivian S. W. Li
    Year in Review
  • The World Health Organization’s targets for hepatitis C elimination by 2030 are ambitious, but, in 2020, global leadership demonstrated by Egypt, innovative strategies to improve linkage to treatment for marginalized populations and the broadened capacity of direct-acting antiviral therapy have been promising for enhanced global elimination efforts.

    • Gregory J. Dore
    • Sahar Bajis
    Year in Review
  • The common end stage of liver disease is decompensated cirrhosis and the further development towards acute-on-chronic liver failure. In this Review, the authors discuss the possible pathogenic, diagnostic and therapeutic role of the gut microbiota in decompensation of cirrhosis and progression to acute-on-chronic liver failure.

    • Jonel Trebicka
    • Peer Bork
    • Manimozhiyan Arumugam
    Review Article
  • A gluten-free diet is currently the only effective treatment for coeliac disease but an increased understanding of disease pathogenesis has led to the identification of several potential therapeutic targets. This Review provides a broad overview of current and emerging therapies for coeliac disease.

    • Laura Kivelä
    • Alberto Caminero
    • Katri Lindfors
    Review Article
  • Dietary fibre has been shown to be beneficial for gastrointestinal health. This Review discusses the physicochemical and functional characteristics of dietary fibres and provides insight into their role in gastrointestinal health and the management of gastrointestinal disorders.

    • Samantha K. Gill
    • Megan Rossi
    • Kevin Whelan
    Review Article
  • Important studies published in 2020 highlight that coeliac disease is a systemic autoimmune-like disorder with the potential to result in serious long-term health consequences that might also occur outside the gastrointestinal tract. Ultimately, the results of these studies will enable the development of better strategies for the management of coeliac disease.

    • Katri Kaukinen
    Year in Review
  • Chronic liver injury leads to liver inflammation and fibrosis, through which activated myofibroblasts in the liver secrete extracellular matrix proteins that generate the fibrous scar. This Review summarizes studies of the molecular mechanisms underlying liver fibrosis and its reversibility.

    • Tatiana Kisseleva
    • David Brenner
    Review Article
  • This Review describes the pathophysiological roles of peroxisome proliferator-activated receptors (PPARs) in nonalcoholic steatohepatitis and related metabolic diseases, and summarizes the preclinical and clinical data on the use of PPAR agonists to treat nonalcoholic steatohepatitis as part of a systemic metabolic disease.

    • Sven Francque
    • Gyongyi Szabo
    • Frank Tacke
    Review Article
  • The enteric nervous system (ENS) is an important component of gastrointestinal function and a pivotal hub connecting the gut to other organs. A new study now explores the human and mouse ENS at the single-cell level, providing key insights into the transcriptomic landscape of the ENS and its constituent cells.

    • Ana Carina Bon-Frauches
    • Werend Boesmans
    News & Views
  • Population screening and endoscopic surveillance are widely used for colorectal cancer (CRC) prevention and early diagnosis. This Perspective explores the rationale for and approach to risk stratification for CRC prevention and diagnosis, including the limitations, advantages and future challenges for this approach.

    • Mark A. Hull
    • Colin J. Rees
    • Sara Koo
    Perspective
  • The management of viral hepatitis in the setting of pregnancy requires special consideration. This Review examines each hepatitis virus individually to address the effect of pregnancy on the natural history of infection and how the viral infections influence maternal and infant outcomes, including mother-to-child transmission.

    • Norah A. Terrault
    • Miriam T. Levy
    • Gonzague Jourdain
    Review Article
  • The global burden of inflammatory bowel disease (IBD) is evolving. This Perspective summarizes the global epidemiology of IBD and its changing burden of disease, postulating that the disease is evolving into four epidemiological stages: Emergence, Acceleration in Incidence, Compounding Prevalence and Prevalence Equilibrium.

    • Gilaad G. Kaplan
    • Joseph W. Windsor
    Perspective
  • A new study sheds further light on the interplay between environmental stimuli, the gut microbiota and intestinal inflammation. Identification of modifiable environmental triggers and the mechanisms by which they act has implications for the prevention and treatment of inflammatory bowel disease.

    • Charlie W. Lees
    News & Views
  • Inflammatory bowel disease (IBD) has different manifestations and associated risk factors between the sexes. This Review explores the sex-based differences in presentation and management of IBD, as well as insights into sex-based differences in pathogenesis and underlying mechanisms inferred from basic research.

    • Wendy A. Goodman
    • Ian P. Erkkila
    • Theresa T. Pizarro
    Review Article
  • Liver biopsy sample evaluation is an essential part of clinical studies in nonalcoholic steatohepatitis (NASH) and is key in excluding confounding morbidities. Current scoring systems, which are decisive for study inclusion, rely on imprecisely defined histological features, leading to a high observer variability of disease categorization. In this News & Views, measures to overcome these limitations are discussed.

    • Thomas Longerich
    • Peter Schirmacher
    News & Views
  • Therapeutic drug monitoring (TDM) has been suggested as a useful tool for managing patients with inflammatory bowel disease on biologic therapy. This Perspective examines evidence and guidelines related to TDM in inflammatory bowel disease management and also strategies to optimize biologic treatment where TDM is not available.

    • Marjorie Argollo
    • Paulo Gustavo Kotze
    • Geert D’Haens
    Perspective
  • Food addiction is an eating behaviour that reflects alterations in brain–gut–microbiome (BGM) interactions and a shift towards hedonic mechanisms. This Review summarizes the physiology of food addiction in obesity as it relates to BGM interactions and provides insights into treatment targets for food addiction aimed at each level of the BGM axis.

    • Arpana Gupta
    • Vadim Osadchiy
    • Emeran A. Mayer
    Review Article
  • Faecal microbiota transplantation (FMT) has emerged as a successful treatment for recurrent Clostridioides difficile infection. In this Perspective, the authors examine the pharmacology of FMT in treatment of C. difficile infection and consider FMT within a pharmacological framework using the parameters intrinsic to all therapeutics: pharmacy, pharmacokinetics, pharmacodynamics and pharmacotherapeutics.

    • Alexander Khoruts
    • Christopher Staley
    • Michael J. Sadowsky
    Perspective