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Infectious diseases affecting the small bowel – what not to miss
Purpose of review This review summarizes infectious diseases involving the small bowel (SB) with a focus on recent literature related to diagnosis and pathophysiology. Recent findings Typical symptom for SB infections is diarrhea, mostly self-limiting. Pathogens include bacteria, viruses, fungi, protozoan parasites, and helminths. Host–pathogen interaction is of special interest in infections with potentially severe or prolonged course. Research uses increasingly enterocyte cell culture systems. SARS-CoV2 can also infect enterocytes via angiotensin converting enzyme 2 (ACE2) receptor and causes gastrointestina...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research

Peutz-Jeghers syndrome
Purpose of review Peutz-Jeghers syndrome is a rare, autosomal dominant, hereditary polyposis syndrome defined by gastrointestinal hamartomas and mucocutaneous pigmentations, caused by a germline mutation in the serine/ threonine kinase 11 or liver kinase B1 (STK11/LKB1) genes. Hamartomatous polyps located throughout the gastrointestinal tract can be complicated by bleeding and small bowel intussusception, potentially leading to the need for emergency surgery. Individuals suffering from Peutz-Jeghers syndrome have an increased lifetime risk of various forms of cancer (gastrointestinal, pancreatic, lung, breast, uterine,...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research

Systemic manifestations – do not forget the small bowel
Purpose of review Systemic diseases can afflict the small bowel (SB) but be challenging to diagnose. In this review, we aim to provide a broad overview of these conditions and to summarise their management. Recent findings Small bowel capsule endoscopy (SBCE) is an important modality to investigate pathology in the SB. SB imaging can be complementary to SBCE for mural and extramural involvement and detection of multiorgan involvement or lymphadenopathy. Device assisted enteroscopy provides a therapeutic arm, to SBCE enabling histology and therapeutics to be carried out. Summary SB endoscopy is essential i...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research

Editorial: Traversing through the small bowel and what not to miss
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research

Synthetic human livers for modeling metabolic diseases
Purpose of review In this review, we will explore recent advances in human induced pluripotent stem cell (iPSC)-based modeling of metabolic liver disease and biofabrication of synthetic human liver tissue while also discussing the emerging concept of synthetic biology to generate more physiologically relevant liver disease models. Recent finding iPSC-based platforms have facilitated the study of underlying cellular mechanisms and potential therapeutic strategies for a number of metabolic liver diseases. Concurrently, rapid progress in biofabrication and gene editing technologies have led to the generation of hum...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Mesenchymal stem cell therapy for liver disease: current status and future perspectives
Purpose of review Liver transplantation is the gold standard for the treatment of end-stage liver disease. However, a shortage of donor organs, high cost, and surgical complications limit the use of this treatment. Cellular therapies using hepatocytes, hematopoietic stem cells, bone marrow mononuclear cells, and mesenchymal stem cells (MSCs) are being investigated as alternative treatments to liver transplantation. The purpose of this review is to describe studies using MSC transplantation for liver diseases based on the reported literature and to discuss prospective research designed to improve the efficacy of MSC the...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

The role of bariatric surgery in the management of nonalcoholic steatohepatitis
Purpose of review Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in the United States and increasing globally. The progressive form of NAFLD, nonalcoholic steatohepatitis (NASH), can lead to cirrhosis and complications of end-stage liver disease. No FDA-approved therapy for NAFLD/NASH exists. Treatment of NAFLD/NASH includes effective and sustained life-style modification and weight loss. This review reports on the recent findings of bariatric surgery in the management of NASH. Recent findings NAFLD, at all stages, is common in those who meet indication for bariatric surge...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Statins for treatment of chronic liver disease
Purpose of review Statins are a class of lipid lower medications used primarily in patients with high-risk cardiovascular disease. Since their development, statins have been considered to be harmful in patients with liver disease, and many of the prescribing information labels consider them to be contraindicated in patients with active liver disease. However, recent studies have shown the contrary, warranting further investigation and discussion. This review aims to describe the latest literature on the mechanism, safety profile and potential benefits of statins use on the natural history of chronic liver disease (CLD)...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Novel treatment options for acute hepatic porphyrias
Purpose of review Acute hepatic porphyrias (AHP) are a group of rare diseases that are characterized by episodic acute neurovisceral pain episodes caused by abnormal accumulation of the neurotoxic porphyrin precursor delta-aminolevulinic acid (ALA). Patient with frequent recurrent acute attacks have been difficult to treat and these patients sometimes require liver transplantation. Recent developments in small interfering RNA (siRNA)-based therapy led to the development of an effective prophylactic treatment for patients with frequent recurrent attacks. This review will describe treatment options for AHP and highlight ...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Advances in cirrhotic cardiomyopathy
Purpose of review Cirrhotic cardiomyopathy (CCM) is a well-recognized entity. When patients with CCM encounter challenges such as liver transplantation, overt cardiac dysfunction manifests, leading to morbidity and mortality. Although revised diagnostic criteria for CCM have recently been proposed, these still need to be validated. Recent findings Previous reviews have summarized the mechanisms of CCM, such as abnormalities of the β-adrenergic pathway, cardiac plasma membrane biophysical and biochemical properties, and electrophysiological changes. Cardiomyocyte apoptosis, inflammation, and oxidative stress als...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Novel treatments for alcoholic hepatitis
Purpose of review The current article aims to review the latest literature on updates in therapeutics for alcohol-associated liver disease (ALD), integration of treatment of alcohol use disorder (AUD) into the management of ALD, and the role of liver transplantation for alcoholic hepatitis. Recent findings ALD has recently become the most common indication for liver transplantation due to the increasing prevalence of AUD and the paucity of therapeutic options. There is broad consensus on the importance of early identification of AUD and the incorporation of its treatment in the management of ALD. New targets for...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Acute-on-chronic liver failure: update on pathogenesis, therapeutic targets, predictive models, and liver transplantation
Purpose of review Acute-on-chronic liver failure (ACLF) is a clinical syndrome in patients with chronic liver disease that is associated with multiple organ failures and a high short-term mortality. Systemic inflammation is suggested to play a key role in its pathogenesis, although the precise causative mechanism is unknown. The purpose of this review is to present and discuss new findings related to: mechanisms underlying ACLF, therapeutic targets, risk prediction models for developing ACLF, and liver transplantation for ACLF. Recent findings Recent studies of ACLF pathophysiology classified the immunosuppressi...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Updated strategies in the management of acute variceal haemorrhage
This article reviews the most recent studies regarding the management of acute esophageal variceal haemorrhage. Recent findings New randomized control trials and meta-analyses confirmed the role of early transjugular intrahepatic portosystemic shunt (TIPS) in the management of acute variceal haemorrhage in Child-Pugh C (10–13) and B patients with active bleeding. A recent randomized controlled trial focused on the duration of vasoactive therapy showed no difference between 2 and 5 days of octreotide. A randomized trial showed decreased use of blood products for the correction of coagulopathy using a thromboelastog...
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Editorial: Advances in hepatology – 2021
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - April 9, 2021 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research