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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.
The suppression of excessive immune responses by infusion of regulatory T cells would require a product of high purity, adequate ex vivo expansion and functional stability. A description of the process to obtain an autologous cell product fulfilling these characteristics paves the way to develop clinical trials in humans.
A new position statement from Europe endorses expert-based recommendations to consider bariatric surgery as a treatment for severe NAFLD in severely obese adolescents. This article discusses the problem of severe paediatric obesity, its relationship with NAFLD, and the knowledge and needs regarding bariatric surgery in adolescents.
A genetic predisposition to IBD is widely accepted; however IBD heritability is dependent on more than the simple additive risk of genetic variants. In a new study using zebrafish, convincing evidence is presented that alterations in the epigenetic regulation of TNF might contribute to the 'missing heritability' of IBD.
The benefits of statins go beyond decreasing cholesterol levels; in liver disease, statins reduce the risk of progressive liver fibrosis and provide protection during infections and ischaemia–reperfusion injury. New evidence shows that statins improve response to interferon-based anti-HCV therapy, decrease progression to cirrhosis and likelihood of developing hepatocellular carcinoma.
Oesophageal dysphagia is considered to be an 'alarm symptom' related to diseases such as oesophageal carcinoma and more commonly, functional disorders. Frank Zerbib and Taher Omari discuss the different aetiologies and clinical presentation of oesophageal dysphagia. In addition, they outline the use of endoscopy, biopsy and high resolution manometry for diagnosis.
Patients with oesophageal dysphagia caused by oesophageal motility disorders can be categorized according to the Chicago Classification.This Review provides an overview of the literature concerning treatment options for patients with dysphagia associated with achalasia, hypercontractile disorders and hypocontractility disorders of the oesophagus.
Biliary atresia is a severe cholangiopathy with a poorly defined pathogenesis and treatment strategy that leads to end-stage cirrhosis in most children. The authors of this Review bring together the most up-to-date understanding of the pathogenesis of biliary atresia, how environmental and genetic factors create various clinical phenotypes and provide insights into future clinical trial design.
Neural pathways regulate key functions of the gastrointestinal tract, including motility and inflammation. Here, the authors discuss how neural reflex pathways regulate intestinal inflammation, providing insights into the basic underlying mechanisms and the therapeutic potential of interventions that manipulate this system.
Treatment for inflammatory disorders has progressed remarkably since the introduction of highly effective biologic agents. Lessons can be learned from how other clinical specialties use immunomodulatory agents. In this article, Her and Kavanaugh introduce a rheumatology perspective to the management of inflammatory disorders to provide insights that might inform clinical practice in gastroenterology.