Volume 14 Issue 7, July 2017

International guidelines recognize surgery as a standard treatment option for type 2 diabetes mellitus, including in mildly obese individuals who fail to respond to conventional therapies. A new report from the STAMPEDE trial now provides further evidence and emphasizes the need for health care regulators to introduce appropriate reimbursement policies for metabolic surgery.

A new study identifies heterozygous loss-of-function mutations in three additional genes (ALG8, SEC61B and PKHD1) as causative for the development and progression of isolated polycystic liver diseases. Mutations in these genes, together with previously described mutations in other genes (PRKCSH, SEC63, LRP5 and GANAB), might now explain ∼50% of PLD cases.

A new study shows that the prebiotic inulin improves vascular function in an animal model of cardiovascular disease. A key mechanism for how dietary gut microbiota modulation regulates host physiology through the activities of host–microbiota co-metabolic signalling via bile acids and glucagon-like peptide 1 is also explained.

There have been no major improvements in the prevention or treatment of necrotizing enterocolitis (NEC) over the past several decades, and therefore a 'magic bullet' is urgently needed. However, new data demonstrate that disialyllacto-N-tetraose levels in breast milk can predict the risk of NEC, and these findings might provide a strategy for successful intervention.

Activation of hepatic stellate cells (HSCs) in liver injury is the primary driver of hepatic fibrosis. In this Review, Tsuchida and Friedman detail the varied intracellular and extracellular signalling pathways leading to HSC activation, as well as the role of HSCs in liver fibrosis resolution and as therapeutic targets.

Serotonin is a key intercellular signalling molecule with well-known functions in the gastrointestinal tract, particularly for motility. This Review explores the non-conventional roles of gut-derived serotonin in the gut and other peripheral tissues, including during gastrointestinal inflammation, haematopoiesis, metabolic homeostasis and bone remodelling.

Imaging and endoscopy remains key to the diagnosis of gastrointestinal malignancies, especially for early disease detection. Here, the authors describe multimodal imaging techniques and how they can be applied along the gastrointestinal tract, in particular for the identification of pre-malignant lesions in the oesophagus, stomach and colon.

Acute gastroenteritis precipitates post-infectious IBS in 10–30% of patients. In this Perspectives, Ghoshal and Gwee discuss evidence of overlap between post-infectious IBS, tropical sprue (which can also develop after acute gastroenteritis) and small intestinal bowel overgrowth, and argue that greater understanding of the links between these conditions will improve understanding of IBS pathogenesis.