Nature Reviews Gastroenterology &Hepatology最新文献

{"title":"Digestive Disease Week 2025","authors":"Katrina Ray","doi":"10.1038/s41575-025-01083-7","DOIUrl":"https://doi.org/10.1038/s41575-025-01083-7","url":null,"abstract":"<p>From 3–6 May 2025, <i>Nature Reviews Gastroenterology &amp; Hepatology</i> attended Digestive Disease Week in San Diego, USA. According to the organizers, more than 13,400 people were registered for the conference (in-person and online).</p><p>As usual, a wide array of sessions was available across basic, translational and clinical science in gastroenterology and hepatology with tantalizing insights into unpublished data from ongoing studies and interim trial results. For basic and translational sciences, cutting-edge talks covered a range of topics, including the small intestinal microbiome, advances in organoid technology and cellular plasticity in metaplasia. Clinical sessions addressed the evolving management of obesity, changes in the global incidence of inflammatory bowel disease, and interventions to reduce disparities and improve care for Native American populations and other minorities. Abstracts featured at the meeting included, among others, an interim analysis from the STENOVA trial, a phase IIa trial of a small molecule inhibitor (AGMB-129, an oral ALK5 inhibitor) for fibrostenotic Crohn’s disease and early insights into the safety, tolerability and pharmacodynamic effects of tolerizing nanoparticles (TPM502) for the treatment of coeliac disease.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"121 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945763","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}

{"title":"Early Crohn’s disease: can we change the disease course?","authors":"Geert D’Haens, Melek Simsek","doi":"10.1038/s41575-025-01072-w","DOIUrl":"https://doi.org/10.1038/s41575-025-01072-w","url":null,"abstract":"Current treatments for Crohn’s disease prioritize early intervention with biological therapies, with several landmark trials demonstrating that starting biologic agents within the first years of diagnosis leads to superior patient outcomes. Although challenges remain, early use of biological treatments is increasingly supported in managing moderate to severe Crohn’s disease.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"4 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945761","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}

{"title":"Deep Visual Proteomics elucidates α1-antitrypsin deficiency","authors":"Jordan Hindson","doi":"10.1038/s41575-025-01079-3","DOIUrl":"https://doi.org/10.1038/s41575-025-01079-3","url":null,"abstract":"<p>In a new study published in <i>Nature</i>, researchers have investigated the progression of the genetic liver disease α1-antitrypsin deficiency (AATD) in human tissue. Spatial proteomics by mass spectrometry and machine learning, via a technique termed Deep Visual Proteomics, was able to analyse the progressive proteotoxicity of AATD, a condition that causes misfolding of α1-antitrypsin in hepatocytes.</p><p>A set of formalin-fixed, paraffin-embedded biopsy samples and resections from patients with AATD across various fibrosis stages was used to map the proteome of hepatocytes undergoing AATD-induced proteotoxicity. Among other mechanistic observations, the researchers determined that α1-antitrypsin accumulation is mostly cell-intrinsic. They also identified a late-stage phenotype characterized by globular protein aggregates that precedes cell death.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"25 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939951","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}

{"title":"Inflammatory bowel disease: classifying global regions by epidemiological stage","authors":"Jordan Hindson","doi":"10.1038/s41575-025-01080-w","DOIUrl":"https://doi.org/10.1038/s41575-025-01080-w","url":null,"abstract":"<p>It has previously been proposed that the epidemiology of inflammatory bowel disease (IBD) in a region evolves predictably across four distinct epidemiological stages determined by changes in incidence and prevalence. The four stages are emergence, acceleration in incidence, compounding prevalence and prevalence equilibrium.</p><p>Now, a new study published in <i>Nature</i> has applied this framework to real-world data. Data (1920–2024) from 522 population-based studies including 82 global regions were used to develop a machine-learning model that defined the epidemiological stages of regions across the globe (stages 1–3). In addition, the researchers modelled a future transition to stage 4 (which has not yet been observed in any region) in several stage 3 regions.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"81 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939950","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}

{"title":"Gut-to-brain vagal afferents transmit reward signals","authors":"Kenny L. Chan","doi":"10.1038/s41575-025-01070-y","DOIUrl":"https://doi.org/10.1038/s41575-025-01070-y","url":null,"abstract":"<p>Although the gut–brain axis has long been thought to guide mood and behaviour, it had not been thoroughly investigated at a neurocircuit level until 2018, when a key paper by Han and colleagues delineated a gut-to-brain circuit stimulating reward behaviour. By mapping and manipulating the peripheral nervous system, the investigators found that sensory neurons in the nodose ganglion of the vagus nerve transmit signals from the gut to trigger midbrain dopamine release from the substantia nigra. Accordingly, stimulating these sensory neurons is rewarding and sufficient to condition taste or place preferences.</p><p>Although now pivotal in neurogastroenterology, this work was initially met with conceptual and technical obstacles. For example, the vagus nerve was typically associated with negative valence, acting as a brake to cease feeding and promote satiety. However, using trans-synaptic viral tracing, this study demonstrated that gut-innervating vagal afferent nerves directly ascend to and activate reward-processing brain regions. This finding represented a dogmatic shift, illustrating that nutrient-based reward signals could be conveyed from the gastrointestinal tract through vagal circuitry and not solely through neuroendocrine signalling, as previously believed.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"26 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143933465","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}

{"title":"Congenital diarrhoea and enteropathy genetics","authors":"Eleni Kotsiliti","doi":"10.1038/s41575-025-01074-8","DOIUrl":"https://doi.org/10.1038/s41575-025-01074-8","url":null,"abstract":"<p>Congenital diarrhoea and enteropathy (CODE) disorders are rare and primarily affect the intestinal epithelium in infancy, leading to substantial morbidity and mortality. In a new multicentre study published in <i>The New England Journal of Medicine</i>, investigators in Canada and the USA characterized the genetic profile of CODE disorders via next-generation sequencing and identified known and novel pathogenic variants.</p><p>The researchers analysed the exomes or genomes of 139 infants (including 10 sibling pairs) with a clinical diagnosis of congenital diarrhoea. Next-generation sequencing data revealed variants in 24 known monogenic CODE genes, such as <i>EPCAM</i> and <i>SLC9A3</i>, including a novel variant in <i>NEUROG3</i>. Three CODE candidate genes, <i>GRWD1</i>, <i>MYO1A</i> and <i>MON1A</i>, were then functionally characterized in cell-based assays and zebrafish models. The researchers further classified those three genes through proximity-dependent biotin identification, showing that variants dysregulated intestinal pathways and protein function, such as goblet cell dysfunction, microvilli mislocalization and endosomal sorting.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"34 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893252","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}

{"title":"Maintaining remission in ulcerative colitis","authors":"Eleni Kotsiliti","doi":"10.1038/s41575-025-01073-9","DOIUrl":"https://doi.org/10.1038/s41575-025-01073-9","url":null,"abstract":"<p>A new clinical study published in <i>The Lancet Gastroenterology &amp; Hepatology</i> assessed the effectiveness of laparoscopic appendicectomy in maintaining remission in ulcerative colitis.</p><p>From 2012 to 2022, 1,386 patients with ulcerative colitis in remission were initially screened in a pragmatic, open-label, randomized controlled superiority trial (ACCURE) in 22 centres across the Netherlands, Ireland and the UK. Of those, 197 patients were randomly assigned (1:1) to undergo appendicectomy plus continued maintenance medical therapy or to continue maintenance therapy alone (control group). The patients were included in the intention-to-treat analyses, and the primary outcome was the proportion of patients with a disease relapse within 1 year.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"26 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893253","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}

{"title":"Developing microbiome research in Africa: the essential role of clinician scientists","authors":"Mashiko Setshedi, Gianluca Ianiro","doi":"10.1038/s41575-025-01069-5","DOIUrl":"https://doi.org/10.1038/s41575-025-01069-5","url":null,"abstract":"<p>We read with interest the Comment by Kouidhi and Oduaran, in which they advocate the standardization of microbiome data collection across Africa (Kouidhi, S. &amp; Oduaran, O. H. Strengthening the foundation of African microbiome research: strategies for standardized data collection. <i>Nat. Rev. Gastroenterol. Hepatol</i>. <b>21</b>, 742–743 (2024))¹. They highlight the tremendous opportunities of African microbiome research, while also acknowledging the potential obstacles to its implementation, which include the absence of standardized frameworks for metadata collection. To overcome these obstacles, they propose several recommendations, including the development of standardized templates, the launch of training programmes to educate researchers, the implementation of centralized databases that exploit state-of-the-art computational tools and machine learning, regular monitoring and feedback-based improvement of processes, and proactive engagement of local communities.</p><p>The present era is particularly fruitful for microbiome research, as after decades of research we have started to observe the clinical implementation of such efforts. For example, faecal microbiota transplantation is an established treatment option for recurrent <i>Clostridioides difficile</i> infection and is currently being investigated for chronic non-communicable diseases². In addition, live biotherapeutic products have been approved by the FDA and are currently marketed in the USA². An increasing number of studies are also exploring the diagnostic potential of the microbiome in different clinical areas, such as in colorectal cancer³, inflammatory bowel disease⁴ and cancer immunotherapy⁵. Moreover, global recommendations to standardize microbiome diagnostics have been released⁶. Taken together, these translational efforts, along with a decrease in sequencing costs and free availability of most computational software⁷, are expected to promote the development of African microbiome research and boost its clinical application. This last step has considerable potential for healthcare improvement in Africa, where the epidemiology of cancer and non-communicable diseases is progressively worsening^8,9.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"43 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889660","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}

{"title":"Common misconceptions and controversies in the management of irritable bowel syndrome","authors":"Christopher J. Black, Carolina Olano, Eamonn M. M. Quigley, Alexander C. Ford","doi":"10.1038/s41575-025-01065-9","DOIUrl":"https://doi.org/10.1038/s41575-025-01065-9","url":null,"abstract":"<p>Despite an increase in our understanding of the pathophysiology of irritable bowel syndrome (IBS), in the context of abnormal gut–brain axis communication, and advances in both pharmacological and non-pharmacological treatment of the disorder, there remain areas in which there are misconceptions and controversies in the clinical management of IBS. This Perspective aims to highlight some of the most common misconceptions and controversies in IBS management, including those that the scientific literature has resolved, but for which further education of clinicians dealing with patients with IBS might be required to implement the findings from medical research. Areas of remaining contention are also discussed, as are suggestions as to how these issues could be addressed, both by advances in clinical practice and by further research.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"16 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876002","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}

{"title":"Shaping the future of inflammatory bowel disease: a global research agenda for better management and public health response","authors":"Virginia Solitano, Charles N. Bernstein, Iris Dotan, Axel Dignass, Rhondell Domilici, Marla C. Dubinsky, Richard B. Gearry, Ailsa Hart, Gilaad G. Kaplan, Christopher Ma, Fernando Magro, Joyce Wing Yan Mak, Siew C. Ng, Remo Panaccione, Sreecanth Raja, David T. Rubin, Corey A. Siegel, Vipul Jairath, Laurent Peyrin-Biroulet, Silvio Danese","doi":"10.1038/s41575-025-01063-x","DOIUrl":"https://doi.org/10.1038/s41575-025-01063-x","url":null,"abstract":"<p>Inflammatory bowel disease (IBD) is a growing global health challenge affecting more than 7 million people worldwide. With increasing prevalence across all age groups, including children and adolescents, IBD places substantial strain on health-care systems and society, resulting in high direct medical costs, lost productivity and reduced quality of life. Despite therapeutic advances, suboptimal disease control and delays in timely diagnosis and adequate treatment persist. Regional disparities in health-care access contribute to these challenges, especially in low-income countries. Addressing these inequities is crucial for improving global IBD outcomes. Using a Delphi methodology, experts from clinical care, research, public health and advocacy (including patient representation) identified priorities across six domains (37 statements in total): epidemiology, care models, treatment strategies, education and awareness, patient and community engagement, and leadership to promote health equity. These priorities emphasize quantifying the burden of IBD, addressing health-care disparities, validating care models, exploring novel treatments, advancing education, engaging patients and advocating for health equity policies. The comprehensive approach seeks to optimize care models, promote patient engagement and ensure equitable access to health care. The identified priorities serve as a guide for both clinical and non-clinical researchers, and funders dedicated to IBD-related initiatives, fostering international collaboration to improve IBD management and reduce its impact globally.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"26 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857901","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}