Reviews & Analysis

This Review describes how the latest advances in so-called –omics technologies have helped to provide novel insights into the development and biology of oesophageal adenocarcinoma and its precursor lesion Barrett oesophagus. The authors discuss how these molecular profiles could improve patient management in the future, including early diagnosis and monitoring of response to therapy.

Here, the authors summarize new insights into the pathogenesis of NAFLD and NASH, in particular the mechanisms responsible for liver injury and fibrosis. They highlight how a complex interplay between the environment (especially diet), host genetics and the gut microflora is crucial for the development and progression of NAFLD.

The development of obesity and NAFLD is known to be determined by host genetics, diet and lack of exercise. In addition, the gut microbiota has been shown to influence the development of both of these conditions. In this Review, current understanding of the relationship between the intestinal microbiota, obesity and NAFLD is discussed, with an emphasis on causal relationships, latest advances and therapeutic opportunities.

Paediatric IBD often presents with a more severe phenotype and course than adult-onset disease. Here, the current knowledge concerning treatment options for children with IBD are reported. The effectiveness and safety of new therapeutic advances, including biologic agents, in these paediatric patients are also discussed.

In light of the high mortality rate associated with hepatocellular carcinoma (HCC), chemopreventive strategies to prevent or delay the development of this disease are attractive. This Review outlines advances in the field of HCC chemoprevention, in particular focusing on the potential of antiviral therapy against HBV and HCV, the cancer-modifying effects of statins, antidiabetic medications and aspirin, as well as dietary strategies.

Currently, a gluten-free diet is the only approved therapy for coeliac disease. Advances in the understanding of the disease pathogenesis have enabled researchers to develop new treatment strategies. This Review outlines the search for novel future treatment modes and discusses the potential pitfalls of the new research avenues.

IBD often affects patients during their peak reproductive years. In this Review, the authors summarize the latest information concerning the safety of medications used to treat IBD during pregnancy and lactation, as well as their effect on fertility.

Endomicroscopy and endocytoscopy not only enable prediction of histology, but actual visualization of microscopic tissue details in real time. The authors of this Review discuss these microscopic imaging devices, outlining potential indications for their use and future directions for this technology.

Pancreatic cancer remains a lethal malignancy with poor prognosis. Here, the authors summarize emerging data on the role of mucins in the development and progression of pancreatic cancer and its microenvironment and discuss the diagnostic and therapeutic contributions of mucins for patients with pancreatic cancer.

This Review summarizes advances in molecular imaging approaches and provides an overview of molecular beacons and targets, as well as endoscopic devices for imaging. Studies on detection and characterization of lesions are put in perspective along with current challenges for this innovative approach.

Extraintestinal symptoms are common in patients with IBD, and can affect nearly every organ of the body. The most common manifestations include arthropathies, mucocutaneous and ophthalmological manifestations as well as manifestations of the hepatobiliary system. The authors provide a comprehensive overview of different extraintestinal manifestations and complications, including their management, in patients with IBD.

Bariatric surgery is an effective treatment for obesity, providing long-term maintenance of weight loss. Here, the authors discuss the various mechanisms by which the different types of bariatric surgery (including Roux-en-Y gastric bypass, vertical sleeve gastrectomy and adjusted gastric banding) exert their effects on body weight. Evidence from animal and human studies will be discussed.

Hepatic encephalopathy is a severe neuropsychiatric complication of both acute and chronic liver failure. Here, the authors present new evidence that systemic and central proinflammatory mechanisms acting alone or in concert with other toxins have a role in the pathogenesis of hepatic encephalopathy. Novel diagnostic and therapeutic opportunities are also discussed.

The development of direct-acting antiviral therapies is a major advance in HCV treatment and numerous agents are in various stages of clinical development. With this rapidly changing landscape in HCV therapy, the potential of drug–drug interactions is an important aspect of management. Here, the pharmacokinetic interactions of current and investigational agents for hepatitis C are discussed.

Globally, 130–170 million people have HCV infection; however, distribution patterns are highly variable. This Review outlines the latest information on the epidemiology and natural history of HCV infection. The disease burden and mortality of HCV-related diseases, and the potential effect of HCV treatment on disease burden, are also outlined.

Serotonin (5-HT) has been recognized for decades as an important signalling molecule in the gut, but it is still revealing its secrets. Mawe and Hoffman outline the conventional and nonconventional actions of 5-HT, and describe potential therapeutic strategies targeting this molecule and its receptors.

Autoimmune gastritis is a chronic progressive inflammatory condition that results in the replacement of the parietal cell mass by atrophic and metaplastic mucosa. This Review summarizes the epidemiology, pathogenesis and pathological aspects of autoimmune atrophic gastritis. The authors also provide practical advice for the diagnosis and management of patients with this disease.

Haemorrhoid disease is the most frequent proctologic complaint. The management of haemorrhoids has evolved rapidly during the past few decades. Here, the authors describe the current treatment options for the effective management of patients with grade I–IV haemorrhoids, presenting both conservative and surgical approaches.

Excessive consumption of alcohol can have serious physical, psychological and social implications. Alcohol dependence is a complex genetic disease, with variants in many different genes affecting a person's risk of becoming dependent on alcohol. Here, the authors discuss the genetic factors underlying this disorder.

This Review summarizes current knowledge on the role of different microRNAs (miRNAs) in liver diseases. The functions of the most relevant miRNAs that have specific roles in liver damage, hepatocyte functions, viral hepatitis, alcoholic and nonalcoholic liver disease, liver fibrosis and hepatocellular carcinoma are highlighted. The emerging utility of miRNAs as potential biomarkers in liver diseases is also discussed.