Featured
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Consensus Statement |
Designing clinical trials to address alcohol use and alcohol-associated liver disease: an expert panel Consensus Statement
Alcohol-associated liver disease is the main cause of liver-related morbidity and mortality globally. This Consensus Statement makes recommendations for the design, best practice and conduct of clinical trials to evaluate the effects of alcohol use in alcohol-associated liver disease and alcohol use disorder.
- Brian P. Lee
- , Katie Witkiewitz
- & Mack C. Mitchell
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Perspective |
Envisioning how to advance the MASH field
This Perspective discusses the nomenclature change from nonalcoholic fatty liver disease to metabolic dysfunction-associated steatotic liver disease (MASLD) and proposes steps necessary to improve care and end the public health threat posed by MASLD and metabolic dysfunction-associated steatohepatitis.
- Alina M. Allen
- , Zobair M. Younossi
- & Jeffrey V. Lazarus
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Review Article |
Endogenous ethanol production in health and disease
Ethanol is produced in the gut by several different species of fermentative bacteria. This Review discusses the sources and consequences of endogenously produced ethanol, explores its relationship with liver diseases such as metabolic dysfunction-associated steatotic liver disease and covers approaches to target excessive ethanol production in the gut.
- Abraham S. Meijnikman
- , Max Nieuwdorp
- & Bernd Schnabl
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Consensus Statement |
A global consensus on the definitions, diagnosis and management of fibrostenosing small bowel Crohn’s disease in clinical practice
In this Consensus Statement, a global multidisciplinary panel of experts provides recommendations for the definitions, diagnosis and management of patients with fibrostenosing small bowel Crohn’s disease.
- Dominik Bettenworth
- , Mark E. Baker
- & Florian Rieder
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Editorial |
Pride in gastroenterology and hepatology
For Pride Month, we celebrate the LGBTQ+ community and take stock of the challenges they continue to experience. Gastroenterologists and hepatologists can and should advocate, improve inclusion and be effective allies for our LGBTQ+ colleagues and patients.
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Review Article |
Mechanisms of metastatic colorectal cancer
Metastatic colorectal cancer (mCRC) has a poor prognosis, and therapeutic options are limited. This Review provides a comprehensive overview of the genetic and molecular underpinnings of mCRC, discussing the therapeutic potential arising from this knowledge.
- Adrià Cañellas-Socias
- , Elena Sancho
- & Eduard Batlle
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Research Highlight |
Microbiota and colorectal cancer — controlling for confounders challenges associations
- Katrina Ray
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Review Article |
Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus
Receptive anal intercourse (RAI) is an important consideration in gastrointestinal disorders and cancers. This Review discusses the anorectum as a sexual organ, providing an overview of pleasurable and problematic RAI and how gastrointestinal disease itself and associated treatments (such as surgery) can affect RAI. Strategies to manage problematic RAI to improve sexual health are also described.
- Daniel R. Dickstein
- , Collin R. Edwards
- & Deborah C. Marshall
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Research Highlight |
Telemedicine for hepatitis C virus treatment in opioid treatment programmes
- Jordan Hindson
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Review Article |
Mitochondrial function and gastrointestinal diseases
Mitochondria of the intestinal epithelium are vital in intestinal health and disease. This Review provides a comprehensive overview of intestinal epithelial cell mitochondrial dysfunction in inflammatory bowel diseases and colorectal cancer and discusses mitochondrial-targeted therapeutics for these diseases.
- Parsa S. Haque
- , Neeraj Kapur
- & Arianne L. Theiss
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Comment |
Transgender health care in the United States: legal, ethical and practical concerns for gastroenterologists in a changing landscape
Transgender and gender-diverse patients in the United States can have difficulty finding providers who are knowledgeable about their unique health-care needs. In many states, legislation limits the ability of physicians to provide gender-affirming and supportive care. Further awareness, advocacy and research is needed to help mitigate the discrimination and stigma endured by the transgender community.
- Sarah Singh
- , Nikki Duong
- & Lauren D. Feld
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Review Article |
Pouchitis: pathophysiology and management
Pouchitis is a common condition that can occur after intestinal surgery. In this Review, Shen discusses our current understanding of the multifactorial pathophysiology, diagnosis and management of pouchitis, primarily in patients with underlying ulcerative colitis.
- Bo Shen
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Perspective |
Spatial genomics: mapping human steatotic liver disease
This Perspective discusses single-cell and single-nuclei RNA sequencing in metabolic dysfunction-associated steatotic liver disease and explains how our understanding of the pathology of the disease will accelerate following the advances in spatial transcriptomics.
- Kylie P. Matchett
- , Jasmin Paris
- & Neil C. Henderson
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Perspective |
Artificial intelligence in liver cancer — new tools for research and patient management
Artificial intelligence (AI) is advancing rapidly and is already starting to transform cancer research and care. Here, the authors outline how AI could be incorporated into liver cancer management, highlighting areas with academic, commercial and clinical potential, as well as ongoing progress and pitfalls.
- Julien Calderaro
- , Laura Žigutytė
- & Jakob Nikolas Kather
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Comment |
Promoting allyship to support and uplift the LGBTQIA+ community
The lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA+) community navigates a complex social landscape marked by strides in acceptance alongside enduring discrimination. Allies — individuals outside of the LGBTQIA+ spectrum who support and advocate for this community — are paramount, with allyship playing a critical part in influencing the health and well-being of LGBTQIA+ individuals.
- Daniel J. Huynh
- , Sonali Paul
- & Nikki Duong
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Perspective |
The changing metabolic landscape of bile acids – keys to metabolism and immune regulation
Bile acids have important roles in human metabolism and immune regulation. In this Perspective, Dorrestein and colleagues discuss the technologies and data science-related approaches that are improving our understanding of the diversity of bile acids and their multifaceted roles.
- Ipsita Mohanty
- , Celeste Allaband
- & Pieter C. Dorrestein
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Comment |
Improving culturally safe engagement with sexual and gender minority populations
Cultural safety seeks to remediate health inequities through empowering marginalized and minoritized patient populations, minimizing implicit bias and incorporating social determinants of health into practice. Here, we propose a cultural safety framework to guide communication with patients from sexual and gender minorities.
- Newsha Nikzad
- , Nikki Duong
- & Sonali Paul
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Research Highlight |
Biomarker shows no clinical use in guiding treatment for Crohn’s disease
- Eleni Kotsiliti
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Comment |
Towards unifying fatty liver nomenclature: a voice from the Middle East and North Africa
Fatty liver disease is one of the most common liver diseases in the Middle East and North Africa region, and globally. Unfortunately, there is a lack of awareness regarding this condition. The nomenclature changes for NAFLD (to MAFLD or MASLD) have gained considerable attention in the hepatology community. Here, we present our point of view on this ongoing change and debate.
- Yasser Fouad
- , Salma Barakat
- & Hasmik Ghazinyan
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Review Article |
Cell senescence in liver diseases: pathological mechanism and theranostic opportunity
Ageing and senescence are major risk factors for liver disease development. This Review provides a comprehensive overview of hepatic senescence, its role in liver disease progression and hepatocellular carcinoma, and discusses potential therapeutic strategies.
- David Sanfeliu-Redondo
- , Albert Gibert-Ramos
- & Jordi Gracia-Sancho
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Perspective |
Screening for liver fibrosis: lessons from colorectal and lung cancer screening
In this Perspective, Ginès and colleagues discuss liver fibrosis screening programmes using insights from colorectal and lung cancer screening.
- Maja Thiele
- , Patrick S. Kamath
- & Pere Ginès
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Review Article |
Another renaissance for bile acid gastrointestinal microbiology
This Review discusses the role of the gut microbiome in the conversion of primary to secondary bile acids and critically evaluates biochemical pathways that are less well understood. Insights into how secondary bile acid derivatives influence host immune function are also described.
- Jason M. Ridlon
- & H. Rex Gaskins
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News & Views |
Evidence-based alcohol policies are the answer
A new study by Díaz and colleagues links strong alcohol policy with improved health and societal outcomes. The evidence for what works to reduce the enormous burden from alcohol is clear. The question is why are governments still not acting?
- William Gilmore
- & Ian Gilmore
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Review Article |
Tolerance-inducing therapies in coeliac disease — mechanisms, progress and future directions
Coeliac disease is an autoinflammatory disease, with the only available treatment being a lifelong gluten-free diet. Alternative therapeutic approaches are needed. This Review explores the concept of tolerance-inducing therapies for coeliac disease, highlighting the underlying mechanisms, progress, challenges and future directions.
- Ludvig M. Sollid
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Editorial |
Connecting with the community
The Editors of Nature Reviews Gastroenterology & Hepatology travel regularly to conferences to meet with the research community and keep up to date on the latest research and key trends in the field. Come and say hello!
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Review Article |
Effects of dietary fibre on metabolic health and obesity
Obesity and metabolic syndrome are two complex and multifactorial conditions. This Review provides a comprehensive overview of dietary fibres, discussing physiochemical properties, microbiota interactions and therapeutic interventions for body weight and insulin resistance regulation.
- Edward C. Deehan
- , Valentin Mocanu
- & Karen L. Madsen
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Review Article |
Hepatic glucose metabolism in the steatotic liver
Hepatic metabolic functions are altered in metabolic diseases. This Review provides a comprehensive overview of glucose metabolism in steatotic liver disease (SLD) and obesity, describes new techniques for hepatic glucose flux assessment and discusses how SLD treatments affect glucose metabolism.
- Egeria Scoditti
- , Silvia Sabatini
- & Amalia Gastaldelli
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Research Highlight |
Effect of expectation of gluten intake on non-coeliac gluten sensitivity
- Jordan Hindson
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Clinical Outlook |
Are all the IL-23 blockers the same in inflammatory bowel disease?
A substantial percentage of patients with inflammatory bowel disease (IBD) exhibit biologic treatment failure or loss of response over time. This article explores the effectiveness and safety of monoclonal antibodies targeting the IL-23 pathway in treating IBD; continued research is needed to address lingering questions regarding long-term safety and efficacy.
- Silvio Danese
- & Laurent Peyrin-Biroulet
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Review Article |
Autism spectrum disorders and the gastrointestinal tract: insights into mechanisms and clinical relevance
Gastrointestinal issues are common in autism spectrum disorders (ASDs). This Review provides a comprehensive overview of the clinical and mechanistic connections between ASDs and gastrointestinal disorders and how these data might be utilized for future research and novel therapeutic targets.
- Lin Y. Hung
- & Kara Gross Margolis
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Evidence-based Guidelines |
Guidelines for best practices in monitoring established coeliac disease in adult patients
Coeliac disease is a chronic inflammatory disease triggered by gluten consumption in individuals with a genetic susceptibility. These Evidence-Based Guidelines provide recommendations for improving the health care of the patients and discuss future perspectives.
- Luca Elli
- , Daniel Leffler
- & David S. Sanders
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Year in Review |
Novel interventions against alcohol-related liver disease
In 2023, there were significant advancements in trials of interventions to reduce mortality and morbidity from alcohol-related liver disease, spanning the entire spectrum of disease: primary prevention to reduce overall alcohol-related harm, secondary prevention to attenuate fibrosis progression and tertiary prevention using antibiotics for severe alcohol-associated hepatitis.
- Maja Thiele
- & Christophe Moreno
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Review Article |
Gut microbiota in overweight and obesity: crosstalk with adipose tissue
Gut microbiota has a vital role in mechanisms involved in overweight and obesity, including host metabolism and energy expenditure. This Review describes the physiology of white and brown adipose tissue and provides timely insights into the gut microbiota–adipose tissue axis.
- Patrice D. Cani
- & Matthias Van Hul
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Year in Review |
Upgrading therapeutic ambitions and treatment outcomes
Important studies published in 2023 outlined new agents and strategies for the management of inflammatory bowel disease. Therapeutic ambitions for the management of inflammatory bowel disease were raised by the success of combinations of biologic agents in ulcerative colitis and early surgical resection in Crohn’s disease.
- Paulo Gustavo Kotze
- & Severine Vermeire
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Comment |
Role of steatotic liver disease in prediction and prevention of cardiometabolic diseases
Steatotic liver disease has emerged as an important risk factor for cardiovascular disease, type 2 diabetes mellitus and chronic kidney disease. Successful treatment of steatotic liver disease might also be effective in preventing these cardiometabolic diseases.
- Norbert Stefan
- , Amedeo Lonardo
- & Giovanni Targher
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Year in Review |
Microbiota-based biomarkers and therapeutics for cancer management
New light is being shed on the interactions between the gut microbiome, cancer cell signalling and the host immune response. With this knowledge, microbiota-based approaches for improving cancer prevention, prognostication and therapy have started to materialize and will contribute to reducing the global cancer burden.
- William K. K. Wu
- & Jun Yu
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Year in Review |
See the reality again in the field of liver transplantation
In 2023, we witnessed advances in allocation policies and marginal donors, including living donors. Key improvements included the uncapped Model for End-stage Liver Disease 3.0 score, unveiled machine perfusion trials to standard deceased donors and lessons from the aborted living donor liver transplantations.
- Nam-Joon Yi
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Year in Review |
Fresh perspectives on how to build, maintain and repair the ENS
Enteric nervous system function is essential for survival. Studies published in 2023 have provided important novel insights into the mechanisms that regulate its development and maintenance, and demonstrate how it can be restored when these mechanisms fail.
- Werend Boesmans
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Review Article |
Deciphering the different phases of preclinical inflammatory bowel disease
Inflammatory bowel disease (IBD) is an immune-mediated inflammatory disease (IMID). Here, the authors review evidence on the preclinical phase of IBD, outlining and describing the proposed at-risk, initiation and expansion phases. Overlap with other IMIDs is discussed alongside the possible future directions for research into preclinical IBD.
- Jonas J. Rudbaek
- , Manasi Agrawal
- & Tine Jess
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News & Views |
Implications of the evolving knowledge of the genetic architecture of MASLD
Metabolic dysfunction-associated steatotic liver disease (MASLD) has a strong heritable component, and genome-wide association cohort studies are highlighting the major genetic determinants of this condition. A meta-analysis of these databases has now enabled expansion of the list of the inherited variants that modulate the risk of MASLD. The identification of new MASLD risk loci is improving comprehension of disease pathogenesis and individual risk stratification, and also enabling the identification of novel therapeutic targets and disease subtypes that might ultimately lead to a precision medicine approach.
- Luca V. C. Valenti
- & Vittoria Moretti
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News & Views |
Innovation is needed to increase viral hepatitis testing globally
Innovative approaches to increase testing are needed to achieve the 2030 hepatitis B and hepatitis C elimination targets. Zhang et al., partnering with local community organizations, successfully used a pay-it-forward approach to increase hepatitis B and hepatitis C testing among men who have sex with men in China.
- Margaret E. Hellard
- & Alisa Pedrana