Expert Review of Gastroenterology & Hepatology最新文献_第6页

Novel nutrition strategies in gastric and esophageal cancer. 胃癌和食管癌的新营养策略。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-01-30 DOI: 10.1080/17474124.2025.2457444

Ellen Boyle, Jessie A Elliott

{"title":"Novel nutrition strategies in gastric and esophageal cancer.","authors":"Ellen Boyle, Jessie A Elliott","doi":"10.1080/17474124.2025.2457444","DOIUrl":"10.1080/17474124.2025.2457444","url":null,"abstract":"Introduction: Advances in treatment strategies for gastric and esophageal cancer have led to improved long-term outcomes, however the local and systemic effects of the primary tumor, neoadjuvant therapies and surgery, result in specific nutritional challenges. Comprehensive nutritional evaluation and support represents a core component of multidisciplinary holistic care for this patient population.Areas covered: We provide a detailed overview of nutritional challenges in gastric and esophageal cancer, with a focus on malignant obstruction, preoperative optimization and survivorship. We discuss current management strategies and evidence base, and describe future therapeutic targets.Expert opinion: Data to support the optimal management of malignant dysphagia and obstruction, particularly regarding patient reported outcomes, is currently lacking. The advantages of nutritional optimization in the pre- and immediate postoperative phase are well described, but further research is needed to inform optimal personalised strategies. Emerging data regarding the physiologic regulation of appetite and body weight have provided key insights and informed the development of novel therapeutic targets to improve nutritional status among patients undergoing treatment for oesophageal and gastric cancer.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"89-104"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046042","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

Are bowel purgatives useful in small bowel capsule endoscopy? 肠泻药在小肠胶囊内镜检查中有用吗？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-01-23 DOI: 10.1080/17474124.2025.2458168

Naoki Hosoe

引用次数: 0

Antibiotics in decompensated liver disease - who, when and for how long? 抗生素治疗失代偿性肝病-谁，何时，持续多久？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-02-20 DOI: 10.1080/17474124.2025.2464044

Frederic Haedge, Tony Bruns

{"title":"Antibiotics in decompensated liver disease - who, when and for how long?","authors":"Frederic Haedge, Tony Bruns","doi":"10.1080/17474124.2025.2464044","DOIUrl":"10.1080/17474124.2025.2464044","url":null,"abstract":"Introduction: Bacterial infections are a leading cause of hospitalization and mortality in patients with decompensated cirrhosis. Antibiotic prophylaxis in cirrhotic patients has demonstrated significant short-term reductions in bacterial infections in randomized controlled trials, but at the cost of drug resistance and with uncertain survival benefits.Areas covered: This review examines antibiotic use in cirrhosis, focusing on patients most likely to benefit from antibiotic prophylaxis, management strategies for infections through risk-based antibiotic selection and timely treatment initiation, challenges posed by the emergence of multidrug-resistant organisms, and principles of antimicrobial stewardship.Expert opinion: The efficacy of prophylaxis has decreased over time, and current registry data have questioned its use, emphasizing the need for better risk-based individualized strategies. When bacterial infections occur, the efficacy of antimicrobial therapies depends heavily on local epidemiological patterns and individual patient risk factors, necessitating tailored antibiotic selection based on regional resistance data and specific clinical scenarios. Nosocomial infections, colonization with multidrug-resistant organisms, and prior exposure to systemic antibiotics are key risk factors that should guide empirical therapy selection. Until evidence-based algorithms are available, clinicians should continue to adopt individualized approaches, guided by available evidence, local specificities, and antimicrobial stewardship principles to optimize patient outcomes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"111-130"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374044","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

Revolutionizing liver fibrosis research: the promise of 3D organoid models in understanding and treating chronic liver disease. 革命性的肝纤维化研究：三维类器官模型在理解和治疗慢性肝病方面的前景。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-01-20 DOI: 10.1080/17474124.2025.2455581

Umashanker Navik, Sumeet Kumar Singh, Amit Khurana, Ralf Weiskirchen

{"title":"Revolutionizing liver fibrosis research: the promise of 3D organoid models in understanding and treating chronic liver disease.","authors":"Umashanker Navik, Sumeet Kumar Singh, Amit Khurana, Ralf Weiskirchen","doi":"10.1080/17474124.2025.2455581","DOIUrl":"10.1080/17474124.2025.2455581","url":null,"abstract":"Introduction: Liver fibrosis, marked by excessive extracellular matrix deposition, is a significant consequence of chronic liver injuries from various conditions. It can progress to end-stage liver disease, with liver transplantation often being the only treatment option. Recent advancements in 3D-organoid technology have transformed liver disease research by providing models that mimic the human liver's physiological environment, offering insights into mechanisms of fibrosis and potential therapies.Areas covered: This report highlights cellular and molecular factors leading to liver fibrosis and the limitations of 2D in vitro models in replicating complex liver dynamics. It emphasizes the advantages of 3D-liver organoids as promising tools for advancing research and drug discovery, providing greater accuracy than traditional models. Additionally, it discusses recent advancements in the development and future applications of liver organoids in fibrosis research.Expert opinion: Liver organoids currently lack cellular diversity and essential features such as vascular, neuronal, microbiome, and immune responses, limiting their effectiveness in mature fibrosis models. Addressing these shortcomings through bioengineering advancements and emerging technologies like CRISPR/Cas9 will enhance the utility of liver organoids.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"105-110"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002782","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

Modulating the microbiome in chronic liver diseases - current evidence on the role of fecal microbiota transplantation. 调节慢性肝病中的微生物群——粪便微生物群移植作用的最新证据。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-01-16 DOI: 10.1080/17474124.2025.2450707

Srishti Saha, Bernd Schnabl

{"title":"Modulating the microbiome in chronic liver diseases - current evidence on the role of fecal microbiota transplantation.","authors":"Srishti Saha, Bernd Schnabl","doi":"10.1080/17474124.2025.2450707","DOIUrl":"10.1080/17474124.2025.2450707","url":null,"abstract":"Introduction: The gut microbiota has a complex relationship with the human host and is key to maintaining health. Disruption of the healthy diverse gut microbial milieu plays an important role in the pathogenesis of several diseases including Clostridioides difficile infection (CDI), inflammatory bowel disease, irritable bowel syndrome, alcohol-related liver disease and metabolic-dysfunction associated steatotic liver disease (MASLD). Fecal microbiota transplantation (FMT) is highly effective in treating CDI, though its utility in other diseases is still being explored.Areas covered: In this narrative review, we explore the role of gut microbiota in liver diseases, focusing on key changes in the microbial composition and function. We summarize current evidence on the role of FMT, identifying gaps in current research and outlining future directions for investigation. We comprehensively searched PubMed through 15 October 2024 to identify relevant studies.Expert opinion: While data from available studies shows promise, more research is necessary before we can use FMT for liver diseases. Key areas that require further study are - determining the optimal FMT regimen for each disease, establishing efficacy and safety with larger clinical trials, ensuring safe and equitable access to the FMT product and mechanistic insights into the reasons for success or failure of FMT.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"53-64"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute severe ulcerative colitis: defining the precise moment for colectomy. 急性严重溃疡性结肠炎：确定结肠切除术的精确时机。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-01-03 DOI: 10.1080/17474124.2024.2448451

Paulo Gustavo Kotze, Sailish Honap, Mariane Christina Savio, Rafaela Molteni Moretti Araújo, Abel Botelho Quaresma, Laurent Peyrin-Biroulet

{"title":"Acute severe ulcerative colitis: defining the precise moment for colectomy.","authors":"Paulo Gustavo Kotze, Sailish Honap, Mariane Christina Savio, Rafaela Molteni Moretti Araújo, Abel Botelho Quaresma, Laurent Peyrin-Biroulet","doi":"10.1080/17474124.2024.2448451","DOIUrl":"10.1080/17474124.2024.2448451","url":null,"abstract":"Introduction: Acute severe ulcerative colitis (ASUC) is a critical manifestation of ulcerative colitis (UC), often necessitating colectomy when medical management fails. Despite advancements in therapeutic interventions such as corticosteroids, biologics, and JAK inhibitors, a significant proportion of patients require surgery, with colectomy rates ranging from 10% to 15%.Areas covered: This paper reviews the factors influencing the timing and necessity of colectomy in ASUC management, emphasizing the importance of multidisciplinary decision-making involving gastroenterologists and surgeons.Expert opinion: Key surgical indications include failure of medical therapy, toxic megacolon, perforation, uncontrolled bleeding, and systemic deterioration. Delays in surgery can result in higher morbidity and mortality rates, making timely intervention essential. This review highlights surgical techniques, including total colectomy and end ileostomy, and discusses potential complications, urging a balanced approach to optimize patient outcomes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"5-14"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926971","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

PSC patient with jaundice - should we ERCP? 伴有黄疸的PSC患者-是否应该进行ERCP？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-01-08 DOI: 10.1080/17474124.2025.2450723

Muhammad Umair Tayyub, Deepak Joshi

引用次数: 0

Serological testing for celiac disease in children. 儿童乳糜泻的血清学检测。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-01 Epub Date: 2025-02-04 DOI: 10.1080/17474124.2025.2462245

Marleena Repo, Sara Koskimaa, Saana Paavola, Kalle Kurppa

{"title":"Serological testing for celiac disease in children.","authors":"Marleena Repo, Sara Koskimaa, Saana Paavola, Kalle Kurppa","doi":"10.1080/17474124.2025.2462245","DOIUrl":"10.1080/17474124.2025.2462245","url":null,"abstract":"Introduction: Celiac disease is one of the most common chronic immune-mediated gastrointestinal conditions, characterized by the presence of disease-specific serum antibodies against self-antigen transglutaminase 2. Even though modern serological assays can identify most untreated celiac disease patients and are also increasingly being used to establish a diagnosis, several challenges are associated with the tests, including a lack of standardization, the variable sensitivity and specificity of commercial assays, and inadequate sensitivity for monitoring adherence to a gluten-free diet.Areas covered: This narrative review outlines the current use of serological tests in case-finding and screening, as well as in the follow-up of dietary treatment. Additionally, the possible challenges and pitfalls of serological tests, along with future directions, are addressed.Expert opinion: The excellent accuracy of modern autoantibody tests, especially for greatly elevated levels of transglutaminase 2 antibodies and positive endomysial antibodies, enables using serological testing in establishing a diagnosis. However, better international standardization of the assays is required, the necessity of endomysial antibody testing needs to be further scrutinized, and additional research is needed to improve noninvasive tools for follow-up and to further expand the no-biopsy criteria for celiac disease.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"155-164"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079231","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

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

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