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Bile acid transport inhibitors in paediatric hepatology: more than just an itch 胆汁酸转运抑制剂在儿科肝病中的应用：不仅仅是瘙痒
IF 65.1 1区 医学
Nature Reviews Gastroenterology &Hepatology Pub Date : 2024-10-24 DOI: 10.1038/s41575-024-01008-w
Tamir Diamond, Binita M. Kamath
{"title":"Bile acid transport inhibitors in paediatric hepatology: more than just an itch","authors":"Tamir Diamond, Binita M. Kamath","doi":"10.1038/s41575-024-01008-w","DOIUrl":"https://doi.org/10.1038/s41575-024-01008-w","url":null,"abstract":"Apical sodium-dependent bile acid transporter inhibitors have revolutionized care for children with genetic cholestasis. This Clinical Outlook discusses how this new class of drugs came into clinical practice and how they might benefit transplant-free survival for a multitude of indications.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488867","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
Host–pathobiont interactions in Crohn’s disease 克罗恩病中宿主与病原体之间的相互作用
IF 65.1 1区 医学
Nature Reviews Gastroenterology &Hepatology Pub Date : 2024-10-24 DOI: 10.1038/s41575-024-00997-y
Roberta Caruso, Bernard C. Lo, Grace Y. Chen, Gabriel Núñez
{"title":"Host–pathobiont interactions in Crohn’s disease","authors":"Roberta Caruso, Bernard C. Lo, Grace Y. Chen, Gabriel Núñez","doi":"10.1038/s41575-024-00997-y","DOIUrl":"https://doi.org/10.1038/s41575-024-00997-y","url":null,"abstract":"<p>The mammalian intestine is colonized by trillions of microorganisms that are collectively referred to as the gut microbiota. The majority of symbionts have co-evolved with their host in a mutualistic relationship that benefits both. Under certain conditions, such as in Crohn’s disease, a subtype of inflammatory bowel disease, some symbionts bloom to cause disease in genetically susceptible hosts. Although the identity and function of disease-causing microorganisms or pathobionts in Crohn’s disease remain largely unknown, mounting evidence from animal models suggests that pathobionts triggering Crohn’s disease-like colitis inhabit certain niches and penetrate the intestinal tissue to trigger inflammation. In this Review, we discuss the distinct niches occupied by intestinal symbionts and the evidence that pathobionts triggering Crohn’s disease live in the mucus layer or near the intestinal epithelium. We also discuss how Crohn’s disease-associated mutations in the host disrupt intestinal homeostasis by promoting the penetration and accumulation of pathobionts in the intestinal tissue. Finally, we discuss the potential role of microbiome-based interventions in precision therapeutic strategies for the treatment of Crohn’s disease.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488860","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
UEG Week 2024 UEG 2024 周
IF 65.1 1区 医学
Nature Reviews Gastroenterology &Hepatology Pub Date : 2024-10-24 DOI: 10.1038/s41575-024-01013-z
Katrina Ray
{"title":"UEG Week 2024","authors":"Katrina Ray","doi":"10.1038/s41575-024-01013-z","DOIUrl":"https://doi.org/10.1038/s41575-024-01013-z","url":null,"abstract":"<p>From 12–15 October, United European Gastroenterology (UEG) Week was held in person in Vienna, Austria, and online simultaneously. According to the organizers, there were 11,377 total registrants from 114 countries or territories, of whom 11% were registered for the virtual congress, with 4,701 individuals registered for the Postgraduate Teaching Programme, of whom 19% were registered for virtual attendance.</p><p>Alongside the usual variety of sessions on basic, translational and clinical science across the fields of gastroenterology and hepatology, there was an expansion in the scope of the topics covered, and indeed how they were delivered (so-called silent sessions with attendees listening on headphones). Sessions on metabolism and nutrition were noticeably prominent, highlighting the current interest in food as medicine and the new obesity management medications. A whole session was dedicated to the role of nutrition in the pathogenesis and treatment of lower gastrointestinal disease and a late-breaker abstract presented positive data for the ‘Tasty&amp;Healthy’ flexible diet in children and young adults with mild–moderate Crohn’s disease. Attendees were also guided through the underlying mechanisms for GLP1 agonists and the ever-expanding list of dual and triple agonists for the management of obesity, as well as given practical advice on the therapeutic management of obesity, which included lifestyle interventions and surgery.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488812","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
Delving the depths of ‘terra incognita’ in the human intestine — the small intestinal microbiota 探索人类肠道 "未知领域 "的深处--小肠微生物群
IF 65.1 1区 医学
Nature Reviews Gastroenterology &Hepatology Pub Date : 2024-10-23 DOI: 10.1038/s41575-024-01000-4
Bahtiyar Yilmaz, Andrew J. Macpherson
{"title":"Delving the depths of ‘terra incognita’ in the human intestine — the small intestinal microbiota","authors":"Bahtiyar Yilmaz, Andrew J. Macpherson","doi":"10.1038/s41575-024-01000-4","DOIUrl":"https://doi.org/10.1038/s41575-024-01000-4","url":null,"abstract":"<p>The small intestinal microbiota has a crucial role in gastrointestinal health, affecting digestion, immune function, bile acid homeostasis and nutrient metabolism. The challenges of accessibility at this site mean that our knowledge of the small intestinal microbiota is less developed than of the colonic or faecal microbiota. Here, we summarize the features and fluctuations of the microbiota along the small intestinal tract, focusing on humans, and discuss physicochemical factors and assessment methods, including the technical challenges of investigating the low microbial biomass of the proximal small bowel. We highlight the essential protective mechanisms of the small intestine, including motility, the paracellular barrier and mucus, and secretory immunity, to show their roles in limiting excessive exposure of host tissues to microbial metabolites. We address current knowledge gaps, particularly the variability among individuals, the effects of dysbiosis of the small intestinal microbiota on health and how different taxa in small intestinal microbiota could compensate for each other functionally.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487841","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
Actions of thyroid hormones and thyromimetics on the liver 甲状腺激素和拟甲状腺激素对肝脏的作用
IF 65.1 1区 医学
Nature Reviews Gastroenterology &Hepatology Pub Date : 2024-10-17 DOI: 10.1038/s41575-024-00991-4
Rohit A. Sinha, Eveline Bruinstroop, Paul M. Yen
{"title":"Actions of thyroid hormones and thyromimetics on the liver","authors":"Rohit A. Sinha, Eveline Bruinstroop, Paul M. Yen","doi":"10.1038/s41575-024-00991-4","DOIUrl":"https://doi.org/10.1038/s41575-024-00991-4","url":null,"abstract":"<p>Thyroid hormones (triiodothyronine and thyroxine) are pivotal for metabolic balance in the liver and entire body. Dysregulation of the hypothalamus–pituitary–thyroid axis can contribute to hepatic metabolic disturbances, affecting lipid metabolism, glucose regulation and protein synthesis. In addition, reductions in circulating and intrahepatic thyroid hormone concentrations increase the risk of metabolic dysfunction-associated steatotic liver disease by inducing lipotoxicity, inflammation and fibrosis. Amelioration of hepatic metabolic disease by thyroid hormones in preclinical and clinical studies has spurred the development of thyromimetics that target THRB (the predominant thyroid hormone receptor isoform in the liver) and/or the liver itself to provide more selective activation of hepatic thyroid hormone-regulated metabolic pathways while reducing thyrotoxic side effects in tissues that predominantly express THRA such as the heart and bone. Resmetirom, a liver and THRB-selective thyromimetic, recently became the first FDA-approved drug for metabolic dysfunction-associated steatohepatitis (MASH). Thus, a better understanding of the metabolic actions of thyroid hormones and thyromimetics in the liver is timely and clinically relevant. Here, we describe the roles of thyroid hormones in normal liver function and pathogenesis of MASH, as well as some potential clinical issues that might arise when treating patients with MASH with thyroid hormone supplementation or thyromimetics.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142448256","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
Author Correction: Classifying compounds as prebiotics — scientific perspectives and recommendations 作者更正：将化合物归类为益生元--科学视角和建议
IF 65.1 1区 医学
Nature Reviews Gastroenterology &Hepatology Pub Date : 2024-10-16 DOI: 10.1038/s41575-024-01012-0
Robert Hutkins, Jens Walter, Glenn R. Gibson, Cassandre Bedu-Ferrari, Karen Scott, Daniel J. Tancredi, Anisha Wijeyesekera, Mary Ellen Sanders
{"title":"Author Correction: Classifying compounds as prebiotics — scientific perspectives and recommendations","authors":"Robert Hutkins, Jens Walter, Glenn R. Gibson, Cassandre Bedu-Ferrari, Karen Scott, Daniel J. Tancredi, Anisha Wijeyesekera, Mary Ellen Sanders","doi":"10.1038/s41575-024-01012-0","DOIUrl":"https://doi.org/10.1038/s41575-024-01012-0","url":null,"abstract":"<p>Correction to: <i>Nature Reviews Gastroenterology &amp; Hepatology</i> https://doi.org/10.1038/s41575-024-00981-6, published online 2 October 2024.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439734","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
Liraglutide treatment in children with obesity 利拉鲁肽治疗儿童肥胖症
IF 65.1 1区 医学
Nature Reviews Gastroenterology &Hepatology Pub Date : 2024-10-15 DOI: 10.1038/s41575-024-01010-2
Eleni Kotsiliti
{"title":"Liraglutide treatment in children with obesity","authors":"Eleni Kotsiliti","doi":"10.1038/s41575-024-01010-2","DOIUrl":"https://doi.org/10.1038/s41575-024-01010-2","url":null,"abstract":"<p>A phase IIIa trial tested the safety and efficacy of liraglutide, a glucagon-like peptide 1 receptor agonist, in 82 children (6 to &lt;12 years) with obesity. The children were randomly assigned (2:1) to receive a daily dose of 3 mg liraglutide (or the maximum tolerated dose) or placebo and follow lifestyle interventions.</p><p>The treatment lasted 56 weeks with a 26-week follow-up. In week 56, the primary endpoint was reached, which was the percentage change in body mass index (BMI) from baseline: in the liraglutide group, mean BMI percentage change was –5.8% versus 1.6% in the placebo group (95% CI –11.6 to –3.2, <i>P</i> &lt; 0.001). The secondary endpoint was a BMI reduction of at least 5% and was observed in 46% of the children who received liraglutide and 9% of the children in the placebo group (adjusted odds ratio 6.3, 95% CI 1.4–28.8, <i>P</i> = 0.02).</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435977","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
Liver transplantation plus chemotherapy improved survival in patients with colorectal liver metastasis 肝移植加化疗可提高结直肠肝转移患者的生存率
IF 65.1 1区 医学
Nature Reviews Gastroenterology &Hepatology Pub Date : 2024-10-15 DOI: 10.1038/s41575-024-01011-1
Eleni Kotsiliti
{"title":"Liver transplantation plus chemotherapy improved survival in patients with colorectal liver metastasis","authors":"Eleni Kotsiliti","doi":"10.1038/s41575-024-01011-1","DOIUrl":"https://doi.org/10.1038/s41575-024-01011-1","url":null,"abstract":"<p>A multicentre, open-label, prospective, randomized controlled trial (TransMet) assessed liver transplantation plus chemotherapy in 94 patients (intention-to-treat population) with permanently unresectable colorectal liver metastases from resected <i>BRAF</i>-non-mutated colorectal cancer and with no extrahepatic disease. The trial took place in 20 tertiary centres in Europe between 2016 and 2021.</p><p>Patients were randomly assigned (1:1) to the liver transplantation group plus chemotherapy (group A) or chemotherapy alone (group B). Overall, 74 patients were included in the per-protocol analysis. In the intention-to-treat population, 5-year overall survival was 56.6% for group A and 12.6% for group B (HR 0.37; 95% CI 0.21–0.65; <i>P</i> = 0.0003), whereas in the per-protocol analysis population, it was 73.3% and 9.3%, respectively (HR 0.36; 95% CI 0.07–0.33; <i>P</i> = 0.0001).</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435978","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
An expert panel Consensus Statement on ALD without experts by experience 无专家经验的 ALD 专家小组共识声明
IF 65.1 1区 医学
Nature Reviews Gastroenterology &Hepatology Pub Date : 2024-10-14 DOI: 10.1038/s41575-024-00994-1
Tamar Avades, Victoria Allgar, Tom Thompson, Ashwin Dhanda
{"title":"An expert panel Consensus Statement on ALD without experts by experience","authors":"Tamar Avades, Victoria Allgar, Tom Thompson, Ashwin Dhanda","doi":"10.1038/s41575-024-00994-1","DOIUrl":"https://doi.org/10.1038/s41575-024-00994-1","url":null,"abstract":"<p>We fully support the consensus statement on designing clinical trials to address alcohol use in people with alcohol-associated liver disease (ALD), which aims to standardize and improve the design of ALD trials (Lee, B. P. et al. Designing clinical trials to address alcohol use and alcohol-associated liver disease: an expert panel Consensus Statement. <i>Nat. Rev. Gastroenterol. Hepatol</i>. <b>21</b>, 626–645 (2024))<sup>1</sup>. The authors highlight the global burden of ALD and the paucity of clinical trials of interventions to reduce or eliminate alcohol use in people with alcohol use disorder (AUD) — a set of recommendations for this field is crucial.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142431182","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 ‘An expert panel Consensus Statement on ALD without experts by experience’ 对 "没有专家经验的 ALD 专家小组共识声明 "的答复
IF 65.1 1区 医学
Nature Reviews Gastroenterology &Hepatology Pub Date : 2024-10-14 DOI: 10.1038/s41575-024-00995-0
Katie Witkiewitz, Jessica L. Mellinger, Brian P. Lee, Srinivasan Dasarathy, Laura E. Nagy, Mack C. Mitchell
{"title":"Reply to ‘An expert panel Consensus Statement on ALD without experts by experience’","authors":"Katie Witkiewitz, Jessica L. Mellinger, Brian P. Lee, Srinivasan Dasarathy, Laura E. Nagy, Mack C. Mitchell","doi":"10.1038/s41575-024-00995-0","DOIUrl":"https://doi.org/10.1038/s41575-024-00995-0","url":null,"abstract":"<p>We thank Avades and colleagues for the opportunity to expand on our expert panel consensus statement (Lee, B. P. et al. Designing clinical trials to address alcohol use and alcohol-associated liver disease: an expert panel Consensus Statement. <i>Nat. Rev. Gastroenterol. Hepatol</i>. <b>21</b>, 626–645 (2024))<sup>1</sup> to highlight the important role of persons with lived experience of alcohol use disorder (AUD) and/or alcohol-associated liver disease (ALD), their caregivers and their advocates in clinical trials (Avades, T. et al. An expert panel Consensus Statement on ALD without experts by experience. <i>Nat. Rev. Gastroenterol. Hepatol</i>. https://doi.org/10.1038/s41575-024-00994-1 (2024))<sup>2</sup>. Including these voices is critical to guide the design of clinical trials, recruitment and retention efforts, and, most importantly, the implementation of findings for the individuals most affected by these diseases.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142431131","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
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