Nature Reviews Gastroenterology &Hepatology最新文献_第2页

Interaction of inflammation and portal hypertension in cirrhosis progression. 肝硬化进展中炎症和门静脉高压的相互作用。

IF 65.1 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-09-29 DOI: 10.1038/s41575-025-01107-2

Dalila Costa,Jonel Trebicka,Cristina Ripoll,Richard Moreau,Rajiv Jalan,Thomas Reiberger

{"title":"Interaction of inflammation and portal hypertension in cirrhosis progression.","authors":"Dalila Costa,Jonel Trebicka,Cristina Ripoll,Richard Moreau,Rajiv Jalan,Thomas Reiberger","doi":"10.1038/s41575-025-01107-2","DOIUrl":"https://doi.org/10.1038/s41575-025-01107-2","url":null,"abstract":"Decompensated cirrhosis describes an advanced clinical stage with clinical complications, such as ascites, variceal bleeding or hepatic encephalopathy, associated with considerable mortality. Portal hypertension is the main risk factor for developing decompensation in patients with compensated cirrhosis, whereas systemic inflammation is the key driving force for organ failure, that is, for acute-on-chronic liver failure in later stages of cirrhosis. As portal hypertension and systemic inflammation coexist in patients with cirrhosis, an improved understanding of their interaction and dynamic role in distinct stages of cirrhosis is an important step forward towards the development of urgently needed therapeutic interventions. Based on emerging evidence from clinical and translational studies, a novel concept of different predominant pathomechanisms of decompensated cirrhosis is presented, which includes portal hypertension-predominant, systemic inflammmation-predominant and mixed portal hypertension-systemic inflammation phenotypes. A comprehensive set of biomarkers and surrogates of portal hypertension and systemic inflammation might assist clinicians in identifying a predominance of one over the other cirrhosis phenotype. As survival rates of patients with decompensated cirrhosis have remained detrimental without liver transplantation over the past decades, future studies should build on this knowledge to develop effective portal hypertension and systemic inflammation-directed therapies for this underserved population.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"7 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Clinical trial design, biomarkers and end points in metabolic and alcohol-related liver disease. 代谢性和酒精相关性肝病的临床试验设计、生物标志物和终点。

IF 65.1 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-09-26 DOI: 10.1038/s41575-025-01120-5

Luis Antonio Diaz,Maja Thiele,Alexandre Louvet,Brian P Lee,Veeral Ajmera,Federica Tavaglione,Cynthia L Hsu,Daniel Q Huang,Elisa Pose,Ramon Bataller,Craig McClain,Jessica Mellinger,Monica Tincopa,Mack C Mitchell,Vlad Ratziu,Mary E Rinella,Shiv K Sarin,Vijay H Shah,Gyongyi Szabo,Vincent Wai-Sun Wong,Meena B Bansal,Lorenzo Leggio,Patrick S Kamath,Aleksander Krag,Arun J Sanyal,Marco Arrese,Juan Pablo Arab,Quentin M Anstee,Philippe Mathurin,Rohit Loomba

{"title":"Clinical trial design, biomarkers and end points in metabolic and alcohol-related liver disease.","authors":"Luis Antonio Diaz,Maja Thiele,Alexandre Louvet,Brian P Lee,Veeral Ajmera,Federica Tavaglione,Cynthia L Hsu,Daniel Q Huang,Elisa Pose,Ramon Bataller,Craig McClain,Jessica Mellinger,Monica Tincopa,Mack C Mitchell,Vlad Ratziu,Mary E Rinella,Shiv K Sarin,Vijay H Shah,Gyongyi Szabo,Vincent Wai-Sun Wong,Meena B Bansal,Lorenzo Leggio,Patrick S Kamath,Aleksander Krag,Arun J Sanyal,Marco Arrese,Juan Pablo Arab,Quentin M Anstee,Philippe Mathurin,Rohit Loomba","doi":"10.1038/s41575-025-01120-5","DOIUrl":"https://doi.org/10.1038/s41575-025-01120-5","url":null,"abstract":"Metabolic and alcohol-related liver disease (MetALD) is a newly defined entity within the spectrum of steatotic liver disease, characterized by the interplay of cardiometabolic risk factors and alcohol consumption. The evolving epidemiology and complex pathophysiology of MetALD present unique challenges and opportunities for clinical trial design. Inclusion criteria should require simultaneous evidence of metabolic dysfunction (at least two cardiometabolic features) and verified quantifiable alcohol exposure recorded over the preceding 3-6 months. Traditional histological end points are limited by invasiveness, sampling error and interpretative variability. Thus, imaging modalities, serum-based fibrosis biomarkers and quantitative measures of alcohol intake are gaining relevance as non-invasive, reproducible and patient-centric end points aiming to improve trial feasibility. Furthermore, incorporating alcohol biomarkers, stratifying patients by metabolic risk factor burden, and using adaptive designs of trials might enhance the precision and generalizability of MetALD clinical trials. Although uncertainties remain regarding optimal patient selection criteria, event rates and the dynamic interplay between metabolic dysfunction and alcohol intake, ongoing research efforts aim to refine diagnostic criteria, standardize methodologies and validate novel end points. These advances will ultimately accelerate drug development, improve trial efficiency and foster interventions to treat MetALD.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"42 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

NeuroGASTRO 2025.

IF 51 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-09-22 DOI: 10.1038/s41575-025-01128-x

Katrina Ray

引用次数: 0

Diagnosing paediatric coeliac disease. 诊断小儿乳糜泻。

IF 51 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-09-22 DOI: 10.1038/s41575-025-01125-0

Jason C Lin

引用次数: 0

Tissue-resident memory CD8+ T cells: master deciphers of the hepatic environment. 组织驻留记忆CD8+ T细胞：肝脏环境的主要解密者。

IF 65.1 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-09-22 DOI: 10.1038/s41575-025-01118-z

Daniel Brown Romero,George E Finney,Michael Dudek,Laura J Pallett

{"title":"Tissue-resident memory CD8+ T cells: master deciphers of the hepatic environment.","authors":"Daniel Brown Romero,George E Finney,Michael Dudek,Laura J Pallett","doi":"10.1038/s41575-025-01118-z","DOIUrl":"https://doi.org/10.1038/s41575-025-01118-z","url":null,"abstract":"Tissue-resident memory CD8+ T (CD8+ TRM) cells are localized within peripheral tissues, such as the liver, poised to provide effective immunosurveillance, as well as rapid and enhanced effector functions upon stimulation. Here we review how hepatic CD8+ TRM cells decipher a myriad of environmental signals, ranging from cellular and soluble factors to direct interactions with the underlying stroma and structural tissue niche, which dictate their derivation, retention and function. We discuss insights from both mouse and human studies that have contributed to our understanding of how CD8+ TRM cells can, depending on the context, provide targeted antigen-specific antiviral and antitumour immune responses and elicit antigen-independent tissue-damaging responses that contribute to liver pathology. Specifically, we discuss how the CD8+ TRM cell functional response is shaped by multiple factors and how such environmental cues tip the balance between these dual 'Jekyll and Hyde' response modes. Finally, we examine strategies to better identify and characterize hepatic CD8⁺ TRM cells and how the enhanced functionality of CD8+ TRM cells can be harnessed therapeutically in the context of hepatocellular carcinoma.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"53 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Multifaceted effects of the microbiome in pancreatic cancer: from association to modulation. 微生物组在胰腺癌中的多方面影响：从关联到调节。

IF 65.1 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-09-22 DOI: 10.1038/s41575-025-01119-y

Ryan M Thomas

{"title":"Multifaceted effects of the microbiome in pancreatic cancer: from association to modulation.","authors":"Ryan M Thomas","doi":"10.1038/s41575-025-01119-y","DOIUrl":"https://doi.org/10.1038/s41575-025-01119-y","url":null,"abstract":"Investigations into the microbiome in human diseases have exponentially increased over the past several decades, and the microbiome has been associated with nearly every malignancy, with research moving beyond associative studies to investigations into the microbiome as a causative factor in carcinogenesis. Pancreatic ductal adenocarcinoma (PDAC), the most common malignancy of the pancreas, is a major cause of worldwide cancer mortality owing to the lack of screening methods, late stage at diagnosis and poor response to currently available treatments. Microbiome-pancreatic cancer research has advanced, with research demonstrating that elements of the gut microbiome can modulate antitumour immune function, and microbial-derived products have been shown to influence response to chemotherapy. Additionally, microbiome-based 'signatures' have been identified that can act as biomarkers to predict PDAC and improve on currently available serum tumour markers. In this Review, how the microbiome mechanistically influences pancreatic tumours, with a focus on PDAC, and its clinical implications is described using ground-breaking historical and contemporary studies as a framework. The direction for future studies is also discussed.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"24 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Food as medicine in gastrointestinal cancer therapy. 食物作为药物在胃肠道肿瘤治疗中的应用。

IF 65.1 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-09-18 DOI: 10.1038/s41575-025-01117-0

Fiona C Malcomson,Mihir M Shah,Urvi A Shah

引用次数: 0

Defining the mucosal ecosystem: epithelial–mesenchymal interdependence in gastrointestinal health and disease 定义粘膜生态系统：胃肠道健康和疾病中的上皮-间充质相互依赖

IF 65.1 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-09-11 DOI: 10.1038/s41575-025-01113-4

Frances J. England, Manqiang Lin, Michael Sigal, Simon J. Leedham

{"title":"Defining the mucosal ecosystem: epithelial–mesenchymal interdependence in gastrointestinal health and disease","authors":"Frances J. England, Manqiang Lin, Michael Sigal, Simon J. Leedham","doi":"10.1038/s41575-025-01113-4","DOIUrl":"https://doi.org/10.1038/s41575-025-01113-4","url":null,"abstract":"<p>The crypt–villus architecture of the intestinal mucosa is underpinned by dynamic interactions between distinct populations of epithelial, stromal and immune cells. Although the epithelial compartment has attracted substantial attention, there is a growing appreciation for the critical role of mesenchymal cells in shaping epithelial stem cell function and dictating lineage specification. In this Review, we outline how the epithelial and mesenchymal compartments of the developing gut evolve in a mutually dependent manner to establish dynamic reciprocal signalling gradients that maintain adult tissue homeostasis. We discuss how perturbations to this delicate ecosystem result in rapid adaptive cellular responses that act to restore tissue function. Furthermore, we explore how the intricate nature of cell fate interdependence also renders the mucosa susceptible to pathological disruption. Drawing on the latest studies, we highlight the crosstalk networks between the epithelial and stromal compartments that underlie these processes and consider how these insights are informing future research directions and therapeutic strategies. In doing so, we advocate for a shift away from the conventional epithelial-centric paradigm toward a more integrated framework that considers the full spectrum of intercellular interactions maintaining intestinal tissue integrity and shaping disease progression.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"86 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Changes in cholera burden across Africa 非洲霍乱负担的变化

IF 51 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-09-08 DOI: 10.1038/s41575-025-01124-1

Jordan Hindson

引用次数: 0

Vaccine for pancreatic and colorectal cancer: phase I AMPLIFY-201 trial 胰腺癌和结直肠癌疫苗：I期AMPLIFY-201试验

IF 51 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-09-08 DOI: 10.1038/s41575-025-01123-2

Jordan Hindson

引用次数: 0