Expert Review of Gastroenterology & Hepatology最新文献_第5页

The TL1A inhibitors in IBD: what's in the pot? TL1A抑制剂在IBD中的作用是什么？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-01-08 DOI: 10.1080/17474124.2025.2450795

F Lusetti, C Bezzio, A De Bernardi, M Dota, G Manes, S Saibeni

{"title":"The TL1A inhibitors in IBD: what's in the pot?","authors":"F Lusetti, C Bezzio, A De Bernardi, M Dota, G Manes, S Saibeni","doi":"10.1080/17474124.2025.2450795","DOIUrl":"10.1080/17474124.2025.2450795","url":null,"abstract":"Introduction: Inflammatory bowel diseases (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), present ongoing challenges despite advances in pathophysiological understanding and therapeutic options. Current therapies often fail to achieve sustained remission, necessitating exploration of novel treatment targets.Areas covered: This review explores the role of Tumor Necrosis Factor-like cytokine 1A (TL1A) and its receptor DR3 in IBD pathogenesis, detailing their involvement in mucosal homeostasis and immune modulation. Recent studies on TL1A inhibitors highlight their potential in mitigating inflammation and fibrosis in IBD.Expert opinion: TL1A inhibition emerges as a promising therapeutic strategy, supported by encouraging outcomes in clinical trials for moderate to severe IBD. Future research may elucidate TL1A's broader impact on immunity, epithelial integrity and fibrosis, offering new avenues for therapeutic intervention and biomarker discovery. Ongoing phase 3 trials are pivotal in assessing TL1A inhibitors as effective and safe treatments for IBD. Additionally, exploration of TL1A's role in fibrosis-associated complications and its potential as a biomarker for treatment response holds promise for personalized medicine approaches. Consideration of TL1A inhibition in concurrent immune-mediated inflammatory diseases suggests broader therapeutic implications beyond gastrointestinal manifestations of IBD.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"15-25"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnosing eosinophilic esophagitis in pediatric patients.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-02-03 DOI: 10.1080/17474124.2025.2462221

Ellie J M Furuta, Dan Atkins, Glenn T Furuta

{"title":"Diagnosing eosinophilic esophagitis in pediatric patients.","authors":"Ellie J M Furuta, Dan Atkins, Glenn T Furuta","doi":"10.1080/17474124.2025.2462221","DOIUrl":"10.1080/17474124.2025.2462221","url":null,"abstract":"Introduction: Eosinophilic esophagitis (EoE) is an increasingly common disease that can present in children with the symptoms of feeding dysfunction, abdominal pain, vomiting, reflux-like symptoms, dysphagia, or food impaction. Diagnostically, children must have symptoms, dense esophageal eosinophilia, and other potential causes of these findings ruled out. Diagnostic recognition is critical to avoid food impactions and potential esophageal stricture development.Areas covered: In this review, a PubMed search using the search terms eosinophilic esophagitis, pediatric, and diagnosis were used to cover the last 10 years (2013-2023) of literature.Expert opinion: Early detection of EoE in children depends on increased recognition of diagnostic clues by many specialties. As increasing efforts to publicize the importance of EoE in children continues, our understanding of the molecular underpinnings of EoE is making rapid advances. Increasing growth of this knowledge base will provide more personalized diagnostic approaches, targeted interventions, and innovative treatments.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"145-153"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

AKI in ACLF: navigating the complex therapeutic puzzle. ACLF的AKI：导航复杂的治疗难题。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-01-23 DOI: 10.1080/17474124.2025.2456121

Rakhi Maiwall, Fagun Sharma

{"title":"AKI in ACLF: navigating the complex therapeutic puzzle.","authors":"Rakhi Maiwall, Fagun Sharma","doi":"10.1080/17474124.2025.2456121","DOIUrl":"10.1080/17474124.2025.2456121","url":null,"abstract":"Introduction: Acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF) is driven by the severity of systemic inflammation, acute portal hypertension driving circulatory dysfunction, hyperbilirubinemia, and toxicity of bile acids. The spectrum is mostly structural, associated with reduced response to vasoconstrictors. The progression is rapid, and need of renal replacement therapy and extracorporeal therapies may be required for the management. The development of renal failure is usually considered when defining the syndrome of ACLF.Areas covered: In the current review we discuss the pathophysiological basis, natural course, and response to the current therapeutic modalities and challenges in assessing and managing AKI in patients with ACLF. We conducted a comprehensive search of electronic databases such as PubMed, Web of Science, and Scopus using keywords like lactate, NGAL, and PHTN, as well as CRRT, PLEX, ACLF, and AKI phases for our review. Peer-reviewed English papers that addressed our issue were considered.Expert opinion: The difficulties and specific management strategies for AKI in ACLF patients are discussed emphasizing the importance of customized protocols, risk assessment guided by biomarkers, and investigation of extracorporeal therapies that target bile acids.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"165-180"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gut microbiota: the pathogenetic bridge between inflammatory bowel disease and metabolic-associated steatotic liver disease.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-02-07 DOI: 10.1080/17474124.2025.2464037

Giuseppe Guido Maria Scarlata, Ludovico Abenavoli

引用次数: 0

Antireflux surgery - choosing the right candidate. 抗反流手术-选择合适的人选。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-01-05 DOI: 10.1080/17474124.2024.2449455

André J Smout, Marlies P Schijven, Albert J Bredenoord

{"title":"Antireflux surgery - choosing the right candidate.","authors":"André J Smout, Marlies P Schijven, Albert J Bredenoord","doi":"10.1080/17474124.2024.2449455","DOIUrl":"10.1080/17474124.2024.2449455","url":null,"abstract":"Introduction: Surgical gastric fundoplication is an effective treatment option for gastroesophageal reflux disease. In contrast to acid suppression, fundoplication nearly abolishes all types of reflux, acid and nonacid. However, in some cases, lasting side effects of the procedure may overshadow its positive effects. It has remained difficult to determine which patients are the most suitable candidates for fundoplication.Areas covered: This review aims to evaluate the available data on preoperative factors that are associated with the outcome of fundoplication and to determine which combination of patient characteristics and preoperative test results provides optimal selection. In addition, we assess the need for tailoring the procedure on the basis of the preoperative quality of esophageal peristalsis.Expert opinion: Surgical treatment of gastroesophageal reflux disease is underutilized as it may provide an excellent option for a subset of GERD patients. It is not sensible to restrict surgical treatment to patients who do not respond to acid suppression. However, meticulous patient selection is key. Most importantly, surgical treatment should not be considered in patients in whom there is no convincing evidence that the symptoms are caused by reflux. Impaired esophageal peristalsis should not be regarded as a contraindication against fundoplication.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"27-38"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Antireflux surgeries and hiatal repair: keys to success.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-02-12 DOI: 10.1080/17474124.2025.2464039

Abigail Claire Watson, David Ian Watson

{"title":"Antireflux surgeries and hiatal repair: keys to success.","authors":"Abigail Claire Watson, David Ian Watson","doi":"10.1080/17474124.2025.2464039","DOIUrl":"10.1080/17474124.2025.2464039","url":null,"abstract":"Introduction: Gastroesophageal reflux is common, and when medical therapy is ineffective, alternative treatments should be considered. Nissen fundoplication controls reflux but can be followed by side effects such as dysphagia and flatulence. To improve outcomes, modifications have been advocated.Areas covered: Modifications to Nissen fundoplication and newer procedures for gastroesophageal reflux aim to improve overall outcome. Randomized controlled trials (RCTs) and long-term outcomes from large cohorts are prioritized to consider the optimal procedure for reflux and hiatus hernia.Expert opinion: Fundoplication is an effective treatment for gastroesophageal reflux, with success rates of >80% reported at 18-20-year follow-up. RCTs confirm that Nissen fundoplication delivers better reflux control than medication. However, some patients are troubled by side effects. Anterior and posterior partial fundoplication variants have been proposed as procedures that offer equally good reflux control, but fewer side effects, and RCTs have confirmed this with follow-up to 20 years. Which partial fundoplication is better is debated. Alternative laparoscopic or endoscopic approaches require expensive implants or equipment and deliver less reliable reflux control than partial fundoplication. Currently, level I evidence confirms that laparoscopic partial fundoplication delivers the optimal outcome in fit patients with reflux that is not well controlled by medication.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"181-195"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring immunological perturbations between hepatocellular carcinoma risk, inflammation and obesity. 探讨肝细胞癌风险、炎症和肥胖之间的免疫扰动。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2024-12-21 DOI: 10.1080/17474124.2024.2444557

Elsa Vitale, Alessandro Rizzo, Oronzo Brunetti, Giovanni Brandi

引用次数: 0

UK medical cannabis registry: an updated analysis of clinical outcomes of cannabis-based medicinal products for inflammatory bowel disease. 英国医用大麻登记处：对以大麻为基础的药物治疗炎症性肠病临床结果的最新分析。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2025-01-09 DOI: 10.1080/17474124.2024.2443574

Aashray Gupta, Simon Erridge, Vivian Graf, Monica Kelada, Lara Bapir, Naveen Jesuraj, John Warner-Levy, Evonne Clarke, Katy McLachlan, Ross Coomber, James J Rucker, Michael W Platt, Mikael H Sodergren

{"title":"UK medical cannabis registry: an updated analysis of clinical outcomes of cannabis-based medicinal products for inflammatory bowel disease.","authors":"Aashray Gupta, Simon Erridge, Vivian Graf, Monica Kelada, Lara Bapir, Naveen Jesuraj, John Warner-Levy, Evonne Clarke, Katy McLachlan, Ross Coomber, James J Rucker, Michael W Platt, Mikael H Sodergren","doi":"10.1080/17474124.2024.2443574","DOIUrl":"10.1080/17474124.2024.2443574","url":null,"abstract":"Background: Treatments for inflammatory bowel disease (IBD) remain limited, and cannabis-based medicinal products (CBMPs) provide promise in addressing inflammation and pain. However, long-term data on CBMP efficacy in IBD are scarce. This study examines health-related quality of life (HRQoL) changes in IBD patients treated with CBMPs.Research design and methods: Patients with IBD were identified from the UK Medical Cannabis Registry. Primary outcomes were changes in the short IBD questionnaire (SIBDQ), EQ-5D-5L, single-item sleep quality scale (SQS), and generalized anxiety disorder-7 (GAD-7), from baseline to 18-months after CBMP treatment started. Secondary outcomes were adverse event prevalence.Results: Analysis of 116 patients with IBD included 94 males (81.03%) with a mean age of 39.52 ± 9.12 years. There were improvements in the SIBDQ, GAD-7, SQS, and EQ-5D-5L Index (p < 0.001). At 18-months, 30 (25.86%) patients achieved a minimal clinically important difference (MCID) in the SIBDQ. Patients with severe baseline anxiety and above-median THC doses were more likely to achieve this MCID (p < 0.050). Twenty (17.24%) patients reported 155 (133.62%) adverse events.Conclusions: CBMP treatment was associated with improvement in IBD-specific outcomes in patients and general HRQoL over 18-months. However, causation cannot be inferred. Hence, randomized controlled trials are still required.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"829-838"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Revisiting septic shock in cirrhosis: a call for personalized management. 肝硬化脓毒性休克的再诊：个体化治疗的呼吁。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2025-01-02 DOI: 10.1080/17474124.2024.2443813

Vishnu Girish, Rakhi Maiwall

{"title":"Revisiting septic shock in cirrhosis: a call for personalized management.","authors":"Vishnu Girish, Rakhi Maiwall","doi":"10.1080/17474124.2024.2443813","DOIUrl":"10.1080/17474124.2024.2443813","url":null,"abstract":"Introduction: Patients with cirrhosis are known to be prone to infections. Infections can trigger organ failures and decompensations in cirrhosis. Septic shock can increase mortality by fourfold and cause hemodynamic imbalances, adding to the already hyperdynamic circulation. Management of septic shock in cirrhosis can be tricky due to this complex interplay of altered hemodynamics, immune function, and coagulation.Areas covered: In this review, we explore the pathophysiological basis, screening, monitoring and management of septic shock in cirrhosis. We also explore novel biomarkers, the growing challenge of multidrug-resistant pathogens and novel and adjunctive therapies. Finally, we propose an algorithm for the management of septic shock in cirrhosis. We conducted a comprehensive search of electronic databases such as PubMed, Web of Science, and Cochrane Library using the keywords and MeSH terms like 'septic shock,' 'cirrhosis,' 'liver disease,' 'sepsis' among others. The search was restricted to peer-reviewed articles in English.Expert opinion: The difficulties in managing septic shock in cirrhosis are discussed, emphasizing personalized approaches over protocol-driven care. Fluid and vasopressor management, antibiotic timing and selection, the role of adjunctive therapies, the importance of lactate clearance, gut failure, and the need for further research in this population are highlighted.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"795-813"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extraintestinal complications of celiac disease: treatment considerations. 乳糜泻的肠外并发症：治疗考虑。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2024-12-25 DOI: 10.1080/17474124.2024.2443053

Pilar Lazzano, Elia Fracas, Nicoletta Nandi, Lucia Scaramella, Luca Elli

{"title":"Extraintestinal complications of celiac disease: treatment considerations.","authors":"Pilar Lazzano, Elia Fracas, Nicoletta Nandi, Lucia Scaramella, Luca Elli","doi":"10.1080/17474124.2024.2443053","DOIUrl":"10.1080/17474124.2024.2443053","url":null,"abstract":"Introduction: Celiac disease (CD) is an autoimmune enteropathy characterized by atrophy of the intestinal mucosa triggered by the ingestion of gluten in individuals with a genetic predisposition. CD manifests with heterogeneous array of symptoms, including a wide range of intestinal and extraintestinal symptoms and manifestations (EIMs). The mechanisms involved in the pathogenesis of EIMs in CD are not only related to intestinal mucosal damage and associated malabsorption but also to systemic inflammation. To date, the only effective treatment for CD is a lifelong gluten-free diet (GFD). Proper adherence to the GFD leads in most cases to a gradual resolution of intestinal atrophy and results in an improvement of the clinical manifestations associated with intestinal damage.Areas covered: This review, based on a Pubmed literature search, describes the extraintestinal complications associated with CD, emphasizing strategies for therapeutic management and responsiveness to the GFD.Expert opinion: CD is associated with different EIMs which can affect different organs. The main clinical interest is if these complications respond to the GFD, which occur at variable rate and not for all disorders associated with CD. Therefore, often complementary additional therapies are needed to achieve optimal symptoms resolution.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"761-777"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0