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2022 was a proficuous year in both the nonalcoholic fatty liver disease (NAFLD) and obesity fields. Pharmacological treatment for obesity and NAFLD is moving forward, with the possibility of replacing bariatric surgery, artificial intelligence might help us access the histological effects of new drugs, and there were advances in personalized hepatocellular carcinoma screening in patients with NAFLD.
Key studies published in 2022 further established the importance of alterations in the gut microenvironment and interactions with the enteric and central nervous systems in symptom generation in irritable bowel syndrome and suggested novel and clinically accessible therapeutic approaches for this large group of patients.
In 2022, we witnessed advances in the field of alcohol-related liver disease. Key developments included the discovery of novel proteomics-based biomarkers and potential therapeutic targets that regulate the recognition of molecules derived from gut microbiota to modulate liver injury. Additionally, there have been significant advances in refining selection for liver transplantation in severe alcohol-associated hepatitis.
Various pathways enable communication between the gut and brain, and this communication influences physiology and behaviour. Studies published in 2022 demonstrate how our understanding of several of these pathways is advancing rapidly.
The year 2022 was notable for substantial research progress related to pancreatic ductal adenocarcinoma (PDAC). The first single-cell and spatial transcriptomic atlases of PDAC were reported, a mechanism for how Schwann cells promote perineural invasion was explored, and, finally, the role of exercise in abrogating immunosuppression was shown.
The gut microbiome field is shifting from association to modulation. Microbiota-based treatments come in many shapes and sizes, ranging from dietary intervention to live bacterial products. Recent methodological advances are instrumental to developing innovative new treatment strategies in microbiome-linked pathologies.
Key studies published in 2022 highlight the emergence of several novel drugs for inflammatory bowel disease. Head-to-head trials and network meta-analyses have also been conducted to identify the sequencing of these treatments, but we still have a long way to go to achieve personalized medicine.
The use of antibiotics affects the gut microbiota. Fenneman and colleagues discuss the role of antibiotics in the epidemiology and pathogenesis of several inflammatory conditions that involve the digestive tract: types 1 and 2 diabetes, eosinophilic oesophagitis, coeliac disease and inflammatory bowel disease.
Eosinophilic oesophagitis (EoE) is a chronic inflammatory disease of the oesophagus with distinct clinicopathological features and a relationship to other atopic diseases. This Review provides an updated overview of the pathogenesis and clinical management of EoE and discusses treatment options.
Secretory antibodies regulate intestinal bacteria, but their specificity and dependence on T cells have been matters of debate. This Perspective argues that bacteria-reactive antibodies are highly specific and that their production is under the control of T cells.
