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

Occult hepatitis B virus infection. 隐性乙型肝炎病毒感染。

IF 57.5 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2026-09-14 DOI: 10.1038/s41575-026-01257-x

Lung-Yi Mak, Rex Wan-Hin Hui, Teresa Pollicino, Markus Cornberg, Robert Gish, Ira Jacobson, Patrick T Kennedy, Wai-Kay Seto, Giovanni Raimondo, Man-Fung Yuen

{"title":"Occult hepatitis B virus infection.","authors":"Lung-Yi Mak, Rex Wan-Hin Hui, Teresa Pollicino, Markus Cornberg, Robert Gish, Ira Jacobson, Patrick T Kennedy, Wai-Kay Seto, Giovanni Raimondo, Man-Fung Yuen","doi":"10.1038/s41575-026-01257-x","DOIUrl":"https://doi.org/10.1038/s41575-026-01257-x","url":null,"abstract":"Occult hepatitis B virus (HBV) infection (OBI) is defined as the presence of replication-competent HBV DNA in the liver or blood of individuals who are seronegative for hepatitis B surface antigen. The prevalence of OBI varies hugely according to the local endemicity of chronic HBV infection and risk of HBV exposure, ranging from 0.8% in the general population to >10% in those with hepatitis C virus or HIV infection, and to >40% in individuals with isolated positive antibody to hepatitis B core antigen (anti-HBc). Diagnosing OBI remains challenging due to extremely low and fluctuating levels of HBV DNA in individuals over time. Positive serological markers, such as anti-HBc, only arouse clinician suspicion, with no diagnostic confidence, but can be used to identify people with previous exposure to HBV and for subclassification of OBI, which should be combined with serum HBV DNA testing. The consequences of OBI include transmission of HBV during the transfusion of blood products or solid organ transplantation, reactivation of HBV in patients undergoing immunosuppressive therapy, acceleration of disease progression in those with pre-existing chronic liver diseases, and an increased risk of hepatocellular carcinoma development. In this Review, we describe the core knowledge of OBI - epidemiology, diagnosis, mechanisms and virology, and clinical management - that clinicians should be aware of, and elaborate on challenges and future directions associated with OBI.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":" ","pages":""},"PeriodicalIF":57.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970073","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

Heart-liver co-management in MASLD: expert perspectives and recommendations from a multidisciplinary cardiometabolic framework. MASLD的心脏-肝脏联合管理：多学科心脏代谢框架的专家观点和建议。

IF 57.5 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2026-09-09 DOI: 10.1038/s41575-026-01255-z

Xiao-Dong Zhou, Seogsong Jeong, Qin-Fen Chen, Giovanni Targher, Christopher D Byrne, Nicholas W S Chew, Zobair M Younossi, Gregory Y H Lip, Herbert Tilg, Jacob George, Norbert Stefan, Laurence S Sperling, Hung N Luu, Marat Fudim, Rohit Loomba, Ming-Hua Zheng

{"title":"Heart-liver co-management in MASLD: expert perspectives and recommendations from a multidisciplinary cardiometabolic framework.","authors":"Xiao-Dong Zhou, Seogsong Jeong, Qin-Fen Chen, Giovanni Targher, Christopher D Byrne, Nicholas W S Chew, Zobair M Younossi, Gregory Y H Lip, Herbert Tilg, Jacob George, Norbert Stefan, Laurence S Sperling, Hung N Luu, Marat Fudim, Rohit Loomba, Ming-Hua Zheng","doi":"10.1038/s41575-026-01255-z","DOIUrl":"https://doi.org/10.1038/s41575-026-01255-z","url":null,"abstract":"Metabolic dysfunction-associated steatotic liver disease (MASLD) is recognized as a systemic metabolic disorder with marked cardiovascular implications, as cardiovascular disease is a leading cause of death. Despite non-invasive diagnostic tests, such as the fibrosis-4 index and vibration-controlled transient elastography, and the availability of resmetirom and emerging pharmacotherapies with dual liver and cardiovascular benefits (for example, glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors), substantial gaps in coordinated clinical management remain. MASLD is often under-recognized in cardiology, and the cardiovascular risk associated with MASLD is similarly under-appreciated in hepatology practice, resulting in fragmented care and a lack of integrated management pathways. This discrepancy leads to missed opportunities for early intervention and suboptimal outcomes in the progression of both hepatic and cardiovascular diseases. To address these gaps, a more collaborative, multidisciplinary approach is needed, integrating early screening, risk stratification and coordinated management across specialities. In this Expert Recommendation, we outline key considerations for heart-liver co-management in MASLD, propose practical strategies for screening and risk stratification, and discuss pathways to implement coordinated multidisciplinary care in clinical practice within a structured metabolic care framework.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":" ","pages":""},"PeriodicalIF":57.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920494","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

Beyond inflammation: the residual burden as the next target in inflammatory bowel disease. 超越炎症：残余负担作为炎症性肠病的下一个目标。

IF 57.5 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2026-09-09 DOI: 10.1038/s41575-026-01259-9

Brigida Barberio, Shaji Sebastian, Alexander C Ford, Beatriz Gros, Alessandro Armuzzi, Fernando Magro, Vipul Jairath, Edoardo V Savarino

引用次数: 0

Building and regenerating intestines by manipulating intestinal stem cells. 通过操纵肠道干细胞来构建和再生肠道。

IF 57.5 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2026-09-03 DOI: 10.1038/s41575-026-01242-4

Calvin J Kuo, Sarah Blutt, Mark Donowitz, Mary K Estes, Chandan Guha, Ophir D Klein, Linheng Li, Joyce C Niland, António J M Santos, Ramesh A Shivdasani, Jason R Spence, Carol J Swanson, Timothy C Wang, Kelley S Yan, Nicholas C Zachos, Michael A Helmrath

{"title":"Building and regenerating intestines by manipulating intestinal stem cells.","authors":"Calvin J Kuo, Sarah Blutt, Mark Donowitz, Mary K Estes, Chandan Guha, Ophir D Klein, Linheng Li, Joyce C Niland, António J M Santos, Ramesh A Shivdasani, Jason R Spence, Carol J Swanson, Timothy C Wang, Kelley S Yan, Nicholas C Zachos, Michael A Helmrath","doi":"10.1038/s41575-026-01242-4","DOIUrl":"https://doi.org/10.1038/s41575-026-01242-4","url":null,"abstract":"Perturbations of the multifaceted functions of the human intestine can manifest in an extraordinarily diverse range of disease pathologies that span developmental, infectious, inflammatory and neoplastic conditions. Accordingly, there is substantial interest in treating intestinal disorders by harnessing the promise of intestinal stem cells (ISCs). From 2009 to 2024, the National Institute of Diabetes and Digestive and Kidney Diseases sponsored a multi-institution collaborative, the Intestinal Stem Cell Consortium (ISCC), that sought to leverage advances in ISC biology for clinical translation to accelerate in vivo mucosal repair and eventually generate functioning intestinal tissue ex vivo. In this Roadmap, ISCC members summarize the latest advances and current knowledge gaps both from within the ISCC working group and across the field as a whole as relevant to understanding the human ISC niche, stem cell interactions with and in response to pathogens, and cellular and humoral regenerative strategies, towards realizing stem cell-based therapy for intestinal diseases.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":" ","pages":""},"PeriodicalIF":57.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888042","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

Challenges and opportunities in combining radiotherapy and immunotherapy for localized pancreatic cancer. 局部胰腺癌放疗与免疫联合治疗的挑战与机遇。

IF 57.5 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2026-09-02 DOI: 10.1038/s41575-026-01250-4

Gilles Colin, Sylvie Streel, Eric Deutsch, Lorenzo Galluzzi, Pierre Foidart

{"title":"Challenges and opportunities in combining radiotherapy and immunotherapy for localized pancreatic cancer.","authors":"Gilles Colin, Sylvie Streel, Eric Deutsch, Lorenzo Galluzzi, Pierre Foidart","doi":"10.1038/s41575-026-01250-4","DOIUrl":"https://doi.org/10.1038/s41575-026-01250-4","url":null,"abstract":"Even when presenting in the clinic with localized disease, patients with pancreatic ductal adenocarcinoma (PDAC) experience extremely poor survival, owing to local recurrence and/or distant progression driven by micrometastatic lesions despite aggressive systemic chemotherapy. Neither radiation therapy nor immunotherapy have yet been successful at extending the survival of patients with localized PDAC, at least in part owing to a series of (immuno)biological mechanisms of innate and acquired resistance. However, an expanding preclinical and clinical literature from PDAC and other oncological indications identifies novel approaches through which radiation therapy-immunotherapy combinations could improve local and systemic disease control in patients with PDAC. Here, we propose to reposition radiation therapy as an immunological platform rather than a purely cytotoxic treatment modality. To this aim, we critically discuss the rationale, challenges and opportunities for combining radiotherapy with immunotherapy to improve the clinical management of localized pancreatic cancer, focusing on the identification of optimal radiation therapy backbones and innovative immunotherapy approaches that might unlock superior therapeutic interactions between these treatment modalities.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":" ","pages":""},"PeriodicalIF":57.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881175","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

Long non-coding RNAs in colorectal cancer: shaping the tumour microenvironment and advancing precision oncology 结直肠癌中的长链非编码rna：塑造肿瘤微环境和推进精准肿瘤学。

IF 57.5 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2026-09-01 DOI: 10.1038/s41575-026-01243-3

M. Bartolini, F. Battaglin, S. Soni, S. Algaze, K. Ashouri, L. Torres-Gonzalez, P. Mittal, U. Shah, W. Zhang, J. Millstein, A. Puccini, H.-J. Lenz

{"title":"Long non-coding RNAs in colorectal cancer: shaping the tumour microenvironment and advancing precision oncology","authors":"M. Bartolini, F. Battaglin, S. Soni, S. Algaze, K. Ashouri, L. Torres-Gonzalez, P. Mittal, U. Shah, W. Zhang, J. Millstein, A. Puccini, H.-J. Lenz","doi":"10.1038/s41575-026-01243-3","DOIUrl":"10.1038/s41575-026-01243-3","url":null,"abstract":"A new frontier in cancer research is emerging with the exploration of ‘dark DNA’: the non-coding regions of the genome now recognized as essential regulators of cancer biology. Long non-coding RNAs (lncRNAs) have been increasingly acknowledged as key regulators in cancer, having crucial roles in the modulation of intracellular processes as well as in intercellular communication. These roles emphasize the importance of lncRNAs in influencing the tumour microenvironment (TME), a complex and dynamic network that contributes to cancer progression, metastasis and resistance to therapy. In this Review, we explore how lncRNAs regulate the colorectal cancer (CRC) microenvironment, focusing on their mechanisms of action and their effect on critical TME components, including immune cells, cancer-associated fibroblasts and angiogenesis. We explore the dual roles of lncRNAs as oncogenes or tumour suppressors, their involvement in immune modulation, vascular remodelling and extracellular matrix dynamics. Our comprehensive analysis elucidates the molecular pathways, identifies potential biomarkers for patient stratification and proposes new therapeutic strategies to regulate the CRC TME and prevent disease progression and resistance. Ultimately, this Review contributes to a deeper understanding of the intricate lncRNA–TME interplay and underscores their emerging relevance in clinical applications, paving the way for innovations in precision oncology. Long non-coding RNAs (lncRNAs) are emerging as key regulators in cancer progression, including colorectal cancer (CRC). This Review provides a mechanistic overview of the role of lncRNAs in the CRC microenvironment and discusses their potential in precision oncology.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 11","pages":"848-862"},"PeriodicalIF":57.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875309","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

Reply to ‘Closing the policy gap: including children in the global agenda for steatotic liver disease’ 答复“缩小政策差距：将儿童纳入脂肪肝疾病的全球议程”。

IF 57.5 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2026-08-26 DOI: 10.1038/s41575-026-01252-2

Jeffrey V. Lazarus, Bruno Halpern, Peter E. H. Schwarz, Veronica Miller, Ajay Duseja, Harriette G. C. Van Spall

引用次数: 0

Closing the policy gap: including children in the global agenda for steatotic liver disease 缩小政策差距：将儿童纳入脂肪肝疾病全球议程。

IF 57.5 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2026-08-26 DOI: 10.1038/s41575-026-01253-1

Samannay Das, Tamoghna Biswas

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The International Chinese Young Scholars Alliance for the Study of the Liver: facilitating global collaboration 国际华人肝脏研究青年学者联盟：促进全球合作。

IF 57.5 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2026-08-25 DOI: 10.1038/s41575-026-01256-y

Wenhao Li (, ), Zhujun Cao (, ), Yee Hui Yeo (, ), Ying Shang (, ), Kaina Chen (, ), Xiaolong Qi (, )

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The microbial mirror: how a disrupted microbiome forecasts disease and why policy must act 微生物之镜：微生物群紊乱如何预测疾病，以及政策为何必须采取行动。

IF 57.5 1区医学

Nature Reviews Gastroenterology &Hepatology Pub Date : 2026-08-24 DOI: 10.1038/s41575-026-01246-0

Antonio Gasbarrini, Gianluca Ianiro, Giovanni Gasbarrini

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