Reviews & Analysis

A new study shows that a real-world care pathway for patients with NAFLD in primary care can increase the detection of patients with clinically significant liver disease and decrease referrals for patients who could be managed in the community.

A new study provides evidence that platelets exert potent inflammatory effects and play a central part in the progression from simple steatosis to nonalcoholic steatohepatitis. The results from this and other studies raise important questions regarding the role of platelets in the development of hepatocellular carcinoma in individuals with fatty liver disease.

A new study provides mechanistic insight into the carcinogenic potential of human colonic mucosal microbial biofilms, confirming that both microbiota composition and organization along with the host inflammatory response are contributing factors to creating the ‘perfect storm’ in terms of colorectal carcinogenesis.

In a new study, the risk of new mental illness postpartum was significantly increased in women with IBD, and specifically in those with Crohn’s disease. Disturbingly, the risk of a substance disorder was also elevated in these women. The findings highlight that disease management during pregnancy is challenging and requires a multidisciplinary approach.

A new study shows that a sustainable faecal microbiota transplantation (FMT) treatment protocol, including anaerobic sample preparation, induces remission of active ulcerative colitis. The promising results are another piece in the puzzle, but it is not yet possible to draw conclusions and implement the procedure in clinical practice.

A new study provides evidence that colonization of germ-free mice with faecal bacteria from healthy infants can protect against signs of cow’s milk allergy in mice. The results from this and other studies raise the intriguing question of whether the gut microbiota can be manipulated for food allergy prevention and therapy.

Two recent papers show that probiotics colonize the gut in permissive volunteers only and delay the reconstitution of the microbiome after antibiotics treatment. In the absence of any clinical readouts, it is still difficult to extrapolate these observations in terms of short-term or long-term health consequences for patients.

A new study of a fibroblast growth factor 19 analogue in patients with primary sclerosing cholangitis (PSC) provides provocative results. The data challenge alkaline phosphatase levels as the appropriate surrogate end point in PSC trials and highlight alternatives, urging efforts to identify better clinical end points for this disease.

Over the past decade, many studies have revealed the importance of the gut microbiome in disease development and treatment, including in cancer. Because both host genetics and the gut microbiome can influence host phenotype and treatment outcome, there is an urgent need to develop precision medicine and personalize dietary supplementation based on an individual’s microbiome.

Innovative solutions are needed to overcome the global disparity in patients awaiting kidney transplantation versus donor organs available. A new study reports a promising new strategy of transplanting kidneys from HCV-infected donors into HCV-uninfected recipients and treating their HCV with direct-acting antivirals post-transplant — recipients achieved HCV cure with excellent one-year kidney allograft function.

New findings show that a gut microbiome signature derived from metagenomic and phenomic data can accurately predict nonalcoholic fatty liver disease (NAFLD) in obese women. The data highlight a role for phenylacetic acid, a microbial product of aromatic amino acid metabolism, in the cross-talk between the gut microbiome and the host hepatic phenotype.

Pancreatic cancer is a disease with high tumour heterogeneity and dismal prognosis. There are few therapeutic options and many promising drugs have failed in patients, which makes better models to predict drug efficacy a key research priority. Now, a new study shows that patient-derived organoids can be used for molecular and therapeutic profiling and might be useful to predict clinical responses.

A new report in Science by Ma and colleagues uncovers the interplay of microbiota-controlled bile acid metabolism and immune responses in the context of primary and metastatic liver tumours in mice. Their findings shed light on the gut–liver axis in hepatic malignancies.

IBD is associated with disruptions to resident microbial populations and inflammatory immune responses; however, little is known about how bacteria influence pathogenic immunity. New research identifies microbially produced ascorbate as a potential drug target to ameliorate disease by inhibiting inflammatory T cell function through altered cellular metabolism.

New findings show that disease-specific T cells that target gluten in patients with coeliac disease persist for decades. The data highlight a central role for a highly select and stable population of T cells in disease persistence and support the feasibility of diagnostics and therapies targeting these cells.

Serrated polyps contribute substantially to the development of colorectal cancer. Unfortunately, our knowledge of the molecular events that drive these lesions is limited. Now, a new study describes an organoid-based mouse model that might accelerate our understanding of the serrated neoplasia pathway.

Recurrence of hepatocellular carcinoma after resection or ablation with curative intent is common and not prevented by direct-acting antiviral agent (DAA) therapy for hepatitis C. Owing to multiple methodological inconsistencies, available studies fail to answer whether DAA therapy anticipated risk of severe tumour recurrence: a prospective randomized study might serve the purpose.

In a new study, Maier et al. reveal that non-antibiotic drugs intended to target human cells have off-target effects on the growth of human gut bacteria at clinically relevant concentrations. These results emphasize the need for a new field of metagenomic toxicology aimed at a more comprehensive understanding of the toxicity of compounds for humans and their associated microbial communities.

Colorectal cancer screening can save lives but there is a need for targeted, personalized screening. A new study examines an individual risk assessment based on family history, lifestyle, environmental and genetic factors, but faecal haemoglobin levels and their change over time can also help to further identify patients at high risk.

The efficacy of Helicobacter pylori eradication therapy for the prevention of preneoplastic lesions in gastric cancer remains controversial. A new placebo-controlled trial and a large-scale observational study tackle this problem and show the positive effects of eradication therapy.