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Cover image supplied by H. Plovier and P. D. Cani, WELBIO (Walloon Excellence in Life sciences and BIOtechnology), Louvain Drug Research Institue, Metabolism and Nutrition research group, Université catholique de Louvain, Belgium. Founded by an ERC Starting Grant 336452-ENIGMO.Immunofluorescence image of enteroendocrine L cells in the epithelium and gut bacteria in the luminal content of the mouse proximal colon. Tissue was stained to show L cells (mouse anti-GLP1) and intermediary filaments of the colonic epithelium (rabbit anti-cytokeratin 8). Nuclei were stained by Hoechst 33342. Gut microbes present in the colonic content can be seen thanks to aspecific staining.
Little progress has been made in the pharmacological management of patients with hepatic encephalopathy, partly because it is difficult to perform clinical trials in this group of patients. A new clinical trial now suggests that polyethylene glycol is more effective than the current standard first-line therapy in these patients.
Evidence is mounting that molecular mechanisms underlie gut dysfunction and symptom generation in IBS. Although it is still an uphill struggle, this mounting evidence is a good starting point for the discovery of one or more IBS biomarkers.
The best time point to determine cure of chronic hepatitis C was explored in a retrospective analysis of five published trials of sofosbuvir–ribavirin with or without PEG-IFN. The authors conclude that SVR12 can be used effectively to determine 'cure' rates in trials and in clinical practice.
Portal vein thrombosis occurs frequently in patients with cirrhosis, but it is unclear whether it is a cause or consequence of decompensation in cirrhosis. The heterogeneity of data on the influence of portal vein thrombosis on the natural history of cirrhosis has been added to in a new study.
Infant nutrition is a key determinant of the early gut microbiota structure. This Review discusses the effect of diet on host–microbial interactions in early life and highlights the key aspects of nutritional programming during the postnatal period that influence the lifelong function of the immune system in health and disease.
Patients with IBD might be at increased risk of cardiovascular disease and stroke. This Review discusses the epidemiology, pathophysiology, risk factors (in particular, the role of IBD activity and IBD-related medications) and management of cardiovascular disease in patients with IBD. The potential effects of cardiovascular medications on IBD are also discussed.
The pathophysiology of IBS is complex with a number of different factors involved. Here, the authors highlight crosstalk between the gut microbiota, enteroendocrine system, immune system (including neuroimmune interactions) and intestinal permeability in the development of IBS. Insights into how these entities might interact are discussed.
The origin of Barrett oesophagus has been debated for many years, but no consensus has been reached. In this Perspectives article, Stuart McDonald and colleagues look at the Barrett lesion itself: at its phenotype, its complexity, its clonal architecture and its stem cell organization. They conclude that current evidence most strongly supports an origin from stem cells in the cardia.