Nature Reviews Gastroenterology &Hepatology最新文献

{"title":"Author Correction: The dynamic spectrum of steatotic liver disease: the global perspective.","authors":"Zobair M Younossi, Shira Zelber-Sagi, Markos Kalligeros, Dana Ivancovsky Wajcman, Linda Henry, Laura Sol Grinshpan, Mads Israelsen, Luis Antonio Diaz, Jiangao Fan, Marco Arrese, Ajay Duseja, C Wendy Spearman, Mohamed El-Kassas, Yusuf Yilmaz, Juan Pablo Arab, Ashwani K Singal, Claudia P Oliveira, Mario G Pessoa, Mary Rinella, Stuart K Roberts, Rohit Kohli, Laurent Castera, Rohit Loomba, Michael Roden, Scott Isaacs, Frank Tacke, Vincent Wai-Sun Wong, James Paik, Maria Stepanova, Saleh A AlQahtani, Aleksander Krag","doi":"10.1038/s41575-026-01245-1","DOIUrl":"10.1038/s41575-026-01245-1","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":" ","pages":""},"PeriodicalIF":57.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758971","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":"The dynamic spectrum of steatotic liver disease: the global perspective","authors":"Zobair M. Younossi, Shira Zelber-Sagi, Markos Kalligeros, Dana Ivancovsky Wajcman, Linda Henry, Laura Sol Grinshpan, Mads Israelsen, Luis Antonio Diaz, Jiangao Fan, Marco Arrese, Ajay Duseja, C. Wendy Spearman, Mohamed El-Kassas, Yusuf Yilmaz, Juan Pablo Arab, Ashwani K. Singal, Claudia P. Oliveira, Mario G. Pessoa, Mary Rinella, Stuart K. Roberts, Rohit Kohli, Laurent Castera, Rohit Loomba, Michael Roden, Scott Isaacs, Frank Tacke, Vincent Wai-Sun Wong, James Paik, Maria Stepanova, Saleh A. AlQahtani, Aleksander Krag","doi":"10.1038/s41575-026-01235-3","DOIUrl":"10.1038/s41575-026-01235-3","url":null,"abstract":"Steatotic liver disease (SLD) comprises metabolic dysfunction-associated SLD, metabolic and alcohol-related liver disease, and alcohol-related liver disease, conditions that frequently overlap rather than fall into distinct categories. Cardiometabolic risk factors (CMRFs), including obesity, type 2 diabetes, hypertension and dyslipidaemia, are highly prevalent across SLD subtypes, with most patients exhibiting multiple metabolic abnormalities. These risks interact synergistically with alcohol exposure, accelerating fibrosis progression to cirrhosis and liver mortality. Importantly, both alcohol consumption and metabolic risks are dynamic and can fluctuate over time, leading to transitions across the SLD spectrum that static diagnostic thresholds might not adequately capture. Misclassification is common, particularly due to under-reporting of alcohol intake, underscoring the value of objective alcohol biomarkers such as phosphatidylethanol. Accurate risk stratification, therefore, requires an integrated approach combining systematic alcohol screening, structured evaluation of CMRFs and non-invasive fibrosis assessment. Management must be multidisciplinary, combining alcohol reduction strategies, optimization of metabolic control and liver-directed therapies. However, most emerging pharmacotherapies for metabolic dysfunction-associated steatohepatitis exclude individuals with concurrent alcohol use, creating a gap between clinical trial populations and real-world practice. A dynamic, spectrum-based framework incorporating repeated reassessment of alcohol and metabolic risks offers the most pragmatic path for diagnosis, treatment and equitable care delivery in SLD. Steatotic liver disease encompasses a spectrum of conditions driven by metabolic dysfunction and/or alcohol consumption. This Review provides a comprehensive global overview of the disease and critically examines current therapeutic strategies and future perspectives.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 11","pages":"812-829"},"PeriodicalIF":57.5,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689440","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":"Multidisciplinary Delphi consensus statement on minimal standards for clinical metadata and end points in microbiome studies","authors":"Robert Schierwagen, Federica Carraturo, Anandhi Iyappan, Maximilian J. Brol, Celine Druart, Mads Israelsen, Zahra Hassani, Kevin Legent, Yolanda Godoy, Corrado Vecchi, Julie Rodriguez, Ida Falk Villesen, Alexander Jarde, Manimozhiyan Arumugam, Aleksander Krag, Emmanuelle Maguin, Peer Bork, Human Microbiome Action Consortium, Joel Doré, Jonel Trebicka, Alessio Fasano","doi":"10.1038/s41575-026-01229-1","DOIUrl":"10.1038/s41575-026-01229-1","url":null,"abstract":"The lack of harmonization for microbiome-based clinical studies represents a critical issue for microbiome researchers and stakeholders, although microbiome research and clinical studies on the gut microbiome have been intensively conducted for more than a decade. The selection of a minimum metadata set to be analysed and reported during clinical studies with microbiome outcomes, the identification of reference materials, the definition of standardized sampling procedures and data analysis protocols, and the choice of unified clinical end points are still lacking. The two-round Delphi survey, conducted within the framework of the Horizon Europe Human Microbiome Action (HMA) consortium, aimed to standardize metadata collection, sampling procedures, data generation and sharing, and standard operating procedures for aspects of gut microbiome-based clinical studies beyond outcomes. The process involved 72 scientists and experts worldwide in the first round and 61 experts in the second round, with an 85% participation rate from the first to the second round. On the basis of the outcome of the Delphi survey, the HMA consortium provided 15 recommendations that might be taken up by the community at large to promote coherence and harmonization in the way microbiome clinical research is and will be performed. The recommendations mainly focus on the gut microbiome and diseases associated with the gastrointestinal tract and gut–organ axes. In this Consensus Statement, an international panel of experts provides recommendations to harmonize metadata, sampling, analysis and end points in gut microbiome-based clinical research.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 11","pages":"863-876"},"PeriodicalIF":57.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41575-026-01229-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms, management and prevention of anorectal sexually transmitted infections","authors":"Phyu Mon Latt, Fabian Y. S. Kong, Christine M. Khosropour, Ming J. Lee, Shivani Pasricha, Kevin Hybiske, Eric P. F. Chow","doi":"10.1038/s41575-026-01232-6","DOIUrl":"10.1038/s41575-026-01232-6","url":null,"abstract":"Anorectal bacterial sexually transmitted infections, predominantly chlamydia, gonorrhoea and syphilis, represent a substantial and evolving global health challenge, with incidence rising despite widespread testing availability. In this Review, we examine the epidemiology and burden of anorectal sexually transmitted infections, explore the pathogenic mechanisms underlying infection and discuss advances in diagnosis, screening and prevention strategies. Anorectal infections are frequently asymptomatic, particularly among men who have sex with men, in which they often exceed the prevalence of urogenital infections. Asymptomatic persistence results from bacterial adaptation to rectal tissues and attenuated local immune responses that fall below symptom thresholds. Molecular diagnostics have transformed detection capabilities, yet substantial challenges persist in distinguishing viable from non-viable microorganisms, expanding point-of-care testing access and balancing screening benefits against antimicrobial stewardship concerns. Treatment approaches continue to evolve in response to emerging resistance patterns, particularly for gonorrhoea. Promising prevention innovations include doxycycline post-exposure prophylaxis, which substantially reduces chlamydia and syphilis incidence and artificial intelligence applications. However, practical implementation in diverse clinical settings remains limited. We highlight important gaps in knowledge and propose research priorities to advance effective control strategies. Anorectal bacterial sexually transmitted infections (STIs) remain a global health challenge. This Review provides an overview of anorectal bacterial STIs focusing on chlamydia, gonorrhoea and syphilis, with insights into global burden, pathophysiology, management and prevention, as well as highlighting knowledge gaps and research priorities.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 11","pages":"830-847"},"PeriodicalIF":57.5,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648919","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":"Desynchronization of intestinal circadian clocks and gastrointestinal dysfunction","authors":"Yuuki Obata \u0000 (, ), Shin Yamazaki \u0000 (, )","doi":"10.1038/s41575-026-01241-5","DOIUrl":"10.1038/s41575-026-01241-5","url":null,"abstract":"Intestinal circadian clocks are emerging as important regulators of gastrointestinal physiology and homeostasis. Recent advances suggest that desynchronization of circadian clocks in distinct intestinal cell types could contribute to gastrointestinal dysfunction, highlighting new opportunities to understand disease mechanisms and identify future research priorities.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 9","pages":"671-672"},"PeriodicalIF":57.5,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620510","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":"Understanding intrapancreatic fat: charting a path forward.","authors":"Erica Park,Peter J Lee","doi":"10.1038/s41575-026-01234-4","DOIUrl":"https://doi.org/10.1038/s41575-026-01234-4","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"349 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522322","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":"Precision adherence support for hepatitis C treatment","authors":"Eleni Kotsiliti","doi":"10.1038/s41575-026-01238-0","DOIUrl":"10.1038/s41575-026-01238-0","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 9","pages":"673-673"},"PeriodicalIF":57.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148459717","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":"Dupilumab shows promise in eosinophilic gastritis","authors":"Eleni Kotsiliti","doi":"10.1038/s41575-026-01239-z","DOIUrl":"10.1038/s41575-026-01239-z","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 9","pages":"673-673"},"PeriodicalIF":57.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148459254","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":"Steatosis fuels replacement liver metastases in colorectal cancer","authors":"Eleni Kotsiliti","doi":"10.1038/s41575-026-01236-2","DOIUrl":"10.1038/s41575-026-01236-2","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 9","pages":"673-673"},"PeriodicalIF":57.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148459256","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":"PIEZO1 senses the mechanics of liver regeneration","authors":"Eleni Kotsiliti","doi":"10.1038/s41575-026-01237-1","DOIUrl":"10.1038/s41575-026-01237-1","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 9","pages":"673-673"},"PeriodicalIF":57.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148459255","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}