{"title":"Liver assistive devices in acute liver failure: Current use and future directions","authors":"Victor Dong , Constantine J. Karvellas","doi":"10.1016/j.bpg.2024.101964","DOIUrl":"10.1016/j.bpg.2024.101964","url":null,"abstract":"<div><div>Acute liver failure (ALF) is a rare syndrome where rapid deterioration of liver function occurs after an acute insult in a patient without prior chronic liver disease and leads to jaundice, hepatic encephalopathy (HE), and oftentimes multiorgan failure (MOF). At this time, the only definitive treatment for ALF is LT but some patients, particularly APAP-induced ALF patients, may have ongoing regenerative capacity of the liver and may not require LT with ongoing supportive management. As a result, extracorporeal liver support (ECLS) has been a topic of interest both as a bridge to LT and as a bridge to spontaneous recovery and aims to remove damaging toxins that further aggravate liver failure, stimulate regeneration of the liver, and improve pathophysiologic consequences of liver failure. There are currently two categories of ECLS (artificial and bioartificial). Artificial ECLS does not incorporate active hepatocytes and are based on the principles of filtration and adsorption and includes renal replacement therapy (RRT), plasma adsorption including plasma exchange and Prometheus (Fractionated Plasma Separation and Adsorption), and albumin dialysis including MARS (Molecular Adsorbent Recirculating System) and SPAD (Single Pass Albumin Dialysis). Bioartificial ECLS incorporates active hepatocytes (human or porcine in origin) to improve liver detoxification capacity and to support hepatic synthetic function and includes ELAD (Extracorporeal Liver Assist Device) and HepatAssist.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"73 ","pages":"Article 101964"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Infections in acute liver failure – Assessment, prevention, and management","authors":"Guhan Venkatakrishnan, Binoj S.Pillai Thankamony Amma, Ramachandran N. Menon, Haritha Rajakrishnan, Sudhindran Surendran","doi":"10.1016/j.bpg.2024.101958","DOIUrl":"10.1016/j.bpg.2024.101958","url":null,"abstract":"<div><div>Infections in acute liver failure (ALF) increase the associated morbidity and mortality, and often hamper the possibility of transplantation. Two-thirds of the infections in ALF are bacterial while one-third is fungal. High suspicion for infection is essential whenever there is clinical deterioration. Multi-drug resistant infections are frequently encountered with prolonged ICU stay, invasive lines, ventilation and renal replacement therapy. Since most of the infections in ALF are nosocomial, prevention of infections is crucial by infection control practices in the ICU. Although markers such as CRP, procalcitonin (for bacterial infections), 1,3-beta-D glucan, and galactomannan (fungal infections) aid in the diagnosis, the gold standard is blood culture. Therapy for respiratory infections must be based on BAL or mini-BAL culture. In this article, we discuss the common infections occurring in ALF, methods for early diagnosis and recommended prophylactic, pre-emptive as well as therapeutic options for treating infections in ALF.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"73 ","pages":"Article 101958"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Microbiota in gastrointestinal malignancies","authors":"Ludovica Bricca , Serena Porcari , Edoardo Savarino , Massimo Rugge","doi":"10.1016/j.bpg.2024.101953","DOIUrl":"10.1016/j.bpg.2024.101953","url":null,"abstract":"<div><div>This manuscript provides an overview of the microbiota profile associated with precancerous lesions in the esophagus, stomach, and large bowel.</div><div>The critical review of the available data reveals significant variability in the methods used for microbiota profiling. This variability may affect the reliable identification of specific biological links between histologically profiled neoplastic diseases and the microbiota population.</div><div>Overall, this critical review reveals significant links between microbiota communities and the different lesions within the spectrum of the oncogenetic cascade in various epidemiological contexts and anatomical districts.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"72 ","pages":"Article 101953"},"PeriodicalIF":3.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sandra Garcia-Mateo , Debora Rondinella , Francesca Romana Ponziani , Luca Miele , Antonio Gasbarrini , Giovanni Cammarota , Ángel Lanas , Fernando Gomollón
{"title":"Gut microbiome and metabolic dysfunction-associated steatotic liver disease: Pathogenic role and potential for therapeutics","authors":"Sandra Garcia-Mateo , Debora Rondinella , Francesca Romana Ponziani , Luca Miele , Antonio Gasbarrini , Giovanni Cammarota , Ángel Lanas , Fernando Gomollón","doi":"10.1016/j.bpg.2024.101924","DOIUrl":"10.1016/j.bpg.2024.101924","url":null,"abstract":"<div><div>Gut microbiota plays key functions in the human body, and its alteration is associated with several human disorders. Moreover, its manipulation is being investigated as a potential therapeutic strategy. In this narrative review we will dissect the involvement of the gut microbiota and of the gut–liver axis on metabolic dysfunction-associated steatotic liver disease (MASLD). Additionally, we will review the effects of lifestyle interventions commonly used for MASLD (i.e. Mediterranean diet and physical exercise) on gut microbiome, to understand if their beneficial effect can be microbially mediated. Finally, we will discuss the role and the available evidence of therapeutic microbiome modulators, including prebiotics, probiotics, symbiotics, and fecal microbiota transplantation (FMT), in the management of MASLD.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"72 ","pages":"Article 101924"},"PeriodicalIF":3.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141057863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paweł Józefczuk , Jarosław Biliński , Aleksandra Minkowska , Paweł Łaguna
{"title":"Gut microbiome in children undergoing hematopoietic stem cell transplantation","authors":"Paweł Józefczuk , Jarosław Biliński , Aleksandra Minkowska , Paweł Łaguna","doi":"10.1016/j.bpg.2024.101955","DOIUrl":"10.1016/j.bpg.2024.101955","url":null,"abstract":"<div><div>Hematopoietic stem cell transplantation (HSCT) is used in children as a treatment for various cancers, e.g. acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), or other diseases, e.g. severe congenital immunodeficiency, metabolic disorders, hence the patient population is quite diverse. There is an increasing interest on the role of the microbiome in peri-transplant period. In this review, concepts of HSCT with the focus on the importance of microbiome composition, its changes during treatment and possible microbiota oriented interventions will be discussed. This paper analyzes data in pediatric population, but in view of interesting results and absence of analogous data for pediatric patients, it also looks at studies performed on adult population and pre-clinical trials on animals discussing possible translation to children.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"72 ","pages":"Article 101955"},"PeriodicalIF":3.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giulia Catassi , Elena Lener , Maria Maddalena Grattagliano , Sofya Motuz , Maria Antonietta Zavarella , Stefano Bibbò , Giovanni Cammarota , Antonio Gasbarrini , Gianluca Ianiro , Carlo Catassi
{"title":"The role of microbiome in the development of gluten-related disorders","authors":"Giulia Catassi , Elena Lener , Maria Maddalena Grattagliano , Sofya Motuz , Maria Antonietta Zavarella , Stefano Bibbò , Giovanni Cammarota , Antonio Gasbarrini , Gianluca Ianiro , Carlo Catassi","doi":"10.1016/j.bpg.2024.101951","DOIUrl":"10.1016/j.bpg.2024.101951","url":null,"abstract":"<div><div>Gluten-related disorders (GRD) include celiac disease (CD), non celiac gluten sensitivity (NCGS) and wheat allergy (WA), conditions that are associated with the ingestion of gluten-containing food. Gut microbiota composition and function may be involved in the pathogenesis of GRD. In untreated CD the microbiota is characterized by a reduction in beneficial microbes like <em>Lactobacillus</em> and <em>Bifidobacterium</em> and an increase in pathogenic ones such as <em>Bacteroides</em> and <em>E. coli</em>. Dysbiosis is a hallmark of CD, persists across various disease stages and is only partially corrected by a gluten-free diet. NCGS patients show a different microbial profile, with a notable decrease in microbial richness, and an increase of Ruminococcaceae and decrease of <em>Bacteroidetes</em> and <em>Fusobacteria</em>. The increase of certain bacterial groups such as <em>Clostridium</em> and <em>Anaerobacter</em>, in contrast with the decline of <em>Bacteroides</em> and <em>Clostridium XVIII</em>, marks a distinctive microbial signature associated with allergic responses to food. Mechanisms linking the gut microbiota to the development of GRD include effects on the gut barrier function, microbiota-mediated immune response to gluten, and an impact of microbial metabolites on gluten digestion and tolerance.</div><div>Although the gluten-free diet is the primary therapy of GRDs, treatment with probiotics may contribute to improve the natural history of these disorders, for instance by minimizing the damaging effects of gluten contamination and accelerating the catch-up growth at the beginning of the dietary treatment of CD. Additional high-quality trials are still needed to identify and standardize the use of probiotics/prebiotics in GRDs.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"72 ","pages":"Article 101951"},"PeriodicalIF":3.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Copyright Information","authors":"","doi":"10.1016/S1521-6918(24)00092-1","DOIUrl":"10.1016/S1521-6918(24)00092-1","url":null,"abstract":"","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"72 ","pages":"Article 101967"},"PeriodicalIF":3.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143165756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Microbial dysbiosis in gastric cancer: Association or causation?","authors":"Pallavi Huma Arya, Bhamini Vadhwana, Munir Tarazi","doi":"10.1016/j.bpg.2024.101961","DOIUrl":"10.1016/j.bpg.2024.101961","url":null,"abstract":"","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"72 ","pages":"Article 101961"},"PeriodicalIF":3.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas Ryan , Sophia Ling , Andrew Trinh , Jonathan P. Segal
{"title":"The role of the microbiome in immune checkpoint inhibitor colitis and hepatitis","authors":"Thomas Ryan , Sophia Ling , Andrew Trinh , Jonathan P. Segal","doi":"10.1016/j.bpg.2024.101945","DOIUrl":"10.1016/j.bpg.2024.101945","url":null,"abstract":"<div><div>Immune checkpoint inhibitors have revolutionised management for a variety of different types of malignancies. However, gastrointestinal adverse effects, in particular colitis and hepatitis, are relatively common with up to 30 % of patients being affected. The gut microbiome has emerged as a potential contributor to both the effectiveness of immune checkpoint inhibitors and their side effects. This review will attempt to examine the impact the microbiome has on adverse effects as a result of immune checkpoint inhibitors as well as the potential for manipulation of the microbiome as a form of management for immune mediated colitis.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"72 ","pages":"Article 101945"},"PeriodicalIF":3.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142186346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William Fusco , Ludovica Bricca , Francesco Kaitsas , Maria Francesca Tartaglia , Irene Venturini , Massimo Rugge , Antonio Gasbarrini , Giovanni Cammarota , Gianluca Ianiro
{"title":"Gut microbiota in colorectal cancer: From pathogenesis to clinic","authors":"William Fusco , Ludovica Bricca , Francesco Kaitsas , Maria Francesca Tartaglia , Irene Venturini , Massimo Rugge , Antonio Gasbarrini , Giovanni Cammarota , Gianluca Ianiro","doi":"10.1016/j.bpg.2024.101941","DOIUrl":"10.1016/j.bpg.2024.101941","url":null,"abstract":"<div><div>Colorectal cancer is the third most common type of cancer, with a significant burden on healthcare and social systems. Its incidence is constantly rising, due to the spread of unhealthy lifestyle, i.e. Western diet. Increasing evidence suggests that westernization-driven microbiome alterations may play a critical role in colorectal tumorigenesis. The current screening strategies for this neoplasm, mainly fecal immunochemical tests, are burdened by unsatisfactory accuracy. Novel, non-invasive biomarkers are rising as the new frontier of colorectal cancer screening, and the microbiome-based ones are showing positive and optimistic results. This Review describes our current knowledge on the role of gut microbiota in colorectal cancer, from its pathogenetic action to its clinical potential as diagnostic biomarker.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"72 ","pages":"Article 101941"},"PeriodicalIF":3.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141945574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}