6765. CRIg+ Macrophages Prevent Gut Microbial DNA-Containing Extracellular Vesicle-Induced Tissue Inflammation and Insulin Resistance.
作者: Zhenlong Luo.;Yudong Ji.;Hong Gao.;Felipe Castellani Gomes Dos Reis.;Gautam Bandyopadhyay.;Zhongmou Jin.;Crystal Ly.;Ya-Ju Chang.;Dinghong Zhang.;Deepak Kumar.;Wei Ying.
来源: Gastroenterology. 2021年160卷3期863-874页
Liver CRIg+ (complement receptor of the immunoglobulin superfamily) macrophages play a critical role in filtering bacteria and their products from circulation. Translocation of microbiota-derived products from an impaired gut barrier contributes to the development of obesity-associated tissue inflammation and insulin resistance. However, the critical role of CRIg+ macrophages in clearing microbiota-derived products from the bloodstream in the context of obesity is largely unknown.
6767. Management of portal hypertension severe complications.
作者: Alberto Zanetto.;Giulio Barbiero.;Michele Battistel.;Salvatore S Sciarrone.;Sarah Shalaby.;Monica Pellone.;Sara Battistella.;Martina Gambato.;Giacomo Germani.;Francesco P Russo.;Patrizia Burra.;Marco Senzolo.
来源: Minerva Gastroenterol (Torino). 2021年67卷1期26-37页
Portal hypertension is a clinical syndrome characterized by an increase in the portal pressure gradient, defined as the gradient between the portal vein at the site downstream of the site of obstruction and the inferior vena cava. The most frequent cause of portal hypertension is cirrhosis. In patients with cirrhosis, portal hypertension is the main driver of cirrhosis progression and development of hepatic decompensation (ascites, variceal hemorrhage and hepatic encephalopathy), which defines the transition from compensated to decompensated stage. In decompensated patients, treatments aim at lowering the risk of death by preventing further decompensation and/or development of acute-on-chronic liver failure. Decompensated patients often pose a complex challenge which typically requires a multidisciplinary approach. The aims of the present review were to discuss the current knowledge regarding interventional treatments for patients with portal hypertension complications as well as to highlight useful information to aid hepatologists in their clinical practice. Specifically, we discussed the indications and contraindications of transjugular intra-hepatic portosystemic shunt and for the treatment of gastro-esophageal variceal hemorrhage in patients with decompensated cirrhosis (first section); we reviewed the use of interventional treatments in patients with hepatic vein obstruction (Budd-Chiari Syndrome) and in those with portal vein thrombosis (second section); and we briefly comment on the most frequent applications of selective splenic embolization in patients with and without underlying cirrhosis (third section).
6768. Severe acute alcoholic hepatitis: can we offer early liver transplantation?
作者: Patrizia Burra.;Debora Bizzaro.;Giovanni Forza.;Alessandra Feltrin.;Biancarosa Volpe.;Andrea Ronzan.;Giuseppe Feltrin.;Giovanni Carretta.;Francesco D'Amico.;Umberto Cillo.;Giacomo Germani.
来源: Minerva Gastroenterol (Torino). 2021年67卷1期23-25页
Alcohol-related liver disease is one of the most prevalent liver diseases worldwide and is the second most common indication for liver transplantation. Most transplant programs require 6 months of abstinence prior to transplantation; commonly referred to as the "six-month rule." According to this rule, the patients admitted for severe acute alcoholic hepatitis are not eligible for liver transplantation in most transplant centers. However, there is increasing evidence that if liver transplantation is performed in selected patients after the first episode of severe decompensation with no response to steroid therapy, it represents an effective treatment. In such selected patients, the post-transplant outcomes are good with survival rates that are significantly higher when compared with patients not responding to medical therapy and not transplanted. A multidisciplinary assessment, involving several stakeholders such as a transplant hepatologist, transplant surgeon, psychologist and psychiatrist is becoming mandatory to properly evaluate the candidate to liver transplantation for alcoholic liver diseases and severe acute alcoholic hepatitis. In the clinical setting of severe acute alcoholic hepatitis, further studies are needed for the identification of accepted selection clinical and psychosocial criteria that can provide the best long-term results. The early liver transplantation option should therefore be explored within strict criteria for this setting.
6769. Evaluating Responses to Gluten Challenge: A Randomized, Double-Blind, 2-Dose Gluten Challenge Trial.
作者: Maureen M Leonard.;Jocelyn A Silvester.;Daniel Leffler.;Alessio Fasano.;Ciarán P Kelly.;Suzanne K Lewis.;Jeffrey D Goldsmith.;Elliot Greenblatt.;William W Kwok.;William J McAuliffe.;Kevin Galinsky.;Jenifer Siegelman.;I-Ting Chow.;John A Wagner.;Anna Sapone.;Glennda Smithson.
来源: Gastroenterology. 2021年160卷3期720-733.e8页
Gluten challenge is used to diagnose celiac disease (CeD) and for clinical research. Sustained gluten exposure reliably induces histologic changes but is burdensome. We investigated the relative abilities of multiple biomarkers to assess disease activity induced by 2 gluten doses, and aimed to identify biomarkers to supplement or replace histology.
6770. The Role of Angiotensin Converting Enzyme 2 in Modulating Gut Microbiota, Intestinal Inflammation, and Coronavirus Infection.
The role of angiotensin converting enzyme 2 has expanded from regulating the renin angiotensin system to regulating intestinal amino acid homeostasis and the gut microbiome. Recently, angiotensin converting enzyme 2 was identified as a primary receptor for severe acute respiratory syndrome coronaviruses 1 and 2 being expressed in multiple tissues including the luminal surface of the gut. In this brief perspective, we examine the role of angiotensin converting enzyme 2 as the receptor for severe acute respiratory syndrome coronavirus 2 and the impact of coronavirus disease 19 infection on the gut microbiome and on the gut epithelium.
6771. Duodenal Adenomas and Cancer in MUTYH-associated Polyposis: An International Cohort Study.
作者: .;Laura E Thomas.;Joanna J Hurley.;Angel Alonso Sanchez.;M Rosario Aznárez.;Ann-Sofie Backman.;Jan Bjork.;Gabriel Capella.;Susan K Clark.;Chrystelle Colas.;Evelien Dekker.;Sunil Dolwani.;Zeinab Ghorbanoghli.;Mark Gonn.;S Gonzalez Romero.;Frederik J Hes.;Hala Jundi.;Sarah Kelland.;Andrew R Latchford.;Helena Leon Brito.;Patrick M Lynch.;Elena Meuser.;Maureen E Mork.;Matthew Mort.;M Navarro Garcia.;Maartje Nielsen.;Yann Parc.;Maria T Ricci.;Jean-Christophe Saurin.;Karin van der Tuin.;Hans Vasen.;Eduardo Vilar.;Olivier Vinet.;Marco Vitellaro.;Sarah-Jane Walton.;Hannah D West.;Julian R Sampson.
来源: Gastroenterology. 2021年160卷3期952-954.e4页 6772. Recurrence After Endoscopic Mucosal Resection: Early and Late Incidence, Treatment Outcomes, and Outcomes in Non-Overt (Histologic-Only) Recurrence.
作者: Ahmed El Rahyel.;Noor Abdullah.;Emma Love.;Krishna C Vemulapalli.;Douglas K Rex.
来源: Gastroenterology. 2021年160卷3期949-951.e2页 6773. Hyperlipasemia and Potential Pancreatic Injury Patterns in COVID-19: A Marker of Severity or Innocent Bystander?
作者: Hemant Goyal.;Sonali Sachdeva.;Abhilash Perisetti.;Rupinder Mann.;Sumant Inamdar.;Benjamin Tharian.
来源: Gastroenterology. 2021年160卷3期946-948.e2页 6774. PD-1 Signaling Promotes Tumor-Infiltrating Myeloid-Derived Suppressor Cells and Gastric Tumorigenesis in Mice.
作者: Woosook Kim.;Timothy H Chu.;Henrik Nienhüser.;Zhengyu Jiang.;Armando Del Portillo.;Helen E Remotti.;Ruth A White.;Yoku Hayakawa.;Hiroyuki Tomita.;James G Fox.;Charles G Drake.;Timothy C Wang.
来源: Gastroenterology. 2021年160卷3期781-796页
Immune checkpoint inhibitors have limited efficacy in many tumors. We investigated mechanisms of tumor resistance to inhibitors of programmed cell death-1 (PDCD1, also called PD-1) in mice with gastric cancer, and the role of its ligand, PD-L1.
6775. Regeneration Defects in Yap and Taz Mutant Mouse Livers Are Caused by Bile Duct Disruption and Cholestasis.
作者: Elisabeth Verboven.;Iván M Moya.;Leticia Sansores-Garcia.;Jun Xie.;Hanne Hillen.;Weronika Kowalczyk.;Gerlanda Vella.;Stefaan Verhulst.;Stéphanie A Castaldo.;Ana Algueró-Nadal.;Lucia Romanelli.;Cristina Mercader-Celma.;Natália A Souza.;Soheil Soheily.;Leen Van Huffel.;Thomas Van Brussel.;Diether Lambrechts.;Tania Roskams.;Frédéric P Lemaigre.;Gabrielle Bergers.;Leo A van Grunsven.;Georg Halder.
来源: Gastroenterology. 2021年160卷3期847-862页
The Hippo pathway and its downstream effectors YAP and TAZ (YAP/TAZ) are heralded as important regulators of organ growth and regeneration. However, different studies provided contradictory conclusions about their role during regeneration of different organs, ranging from promoting proliferation to inhibiting it. Here we resolve the function of YAP/TAZ during regeneration of the liver, where Hippo's role in growth control has been studied most intensely.
6776. Epithelial TLR4 Signaling Activates DUOX2 to Induce Microbiota-Driven Tumorigenesis.
作者: Juan F Burgueño.;Julia Fritsch.;Eddy E González.;Kevin S Landau.;Ana M Santander.;Irina Fernández.;Hajar Hazime.;Julie M Davies.;Rebeca Santaolalla.;Matthew C Phillips.;Sophia Diaz.;Rishu Dheer.;Nivis Brito.;Judith Pignac-Kobinger.;Ester Fernández.;Gregory E Conner.;Maria T Abreu.
来源: Gastroenterology. 2021年160卷3期797-808.e6页
Chronic colonic inflammation leads to dysplasia and cancer in patients with inflammatory bowel disease. We have described the critical role of innate immune signaling via Toll-like receptor 4 (TLR4) in the pathogenesis of dysplasia and cancer. In the current study, we interrogate the intersection of TLR4 signaling, epithelial redox activity, and the microbiota in colitis-associated neoplasia.
6777. Reduction in Inflammatory Bowel Disease Healthcare During the Coronavirus Disease 2019 Pandemic: A Nationwide Retrospective Cohort Study.
作者: Maarten Te Groen.;Monica E W Derks.;Chantal C H J Kuijpers.;Iris D Nagtegaal.;Frank Hoentjen.
来源: Gastroenterology. 2021年160卷3期935-937.e1页 6778. Pancreatic β-Cells Communicate With Vagal Sensory Neurons.
作者: Madina Makhmutova.;Jonathan Weitz.;Alejandro Tamayo.;Elizabeth Pereira.;Maria Boulina.;Joana Almaça.;Rayner Rodriguez-Diaz.;Alejandro Caicedo.
来源: Gastroenterology. 2021年160卷3期875-888.e11页
Destroying visceral sensory nerves impacts pancreatic islet function, glucose metabolism, and diabetes onset, but how islet endocrine cells interact with sensory neurons has not been studied.
6779. Gastroesophageal reflux disease: key messages for clinicians.
作者: Margherita Saracco.;Vincenzo Savarino.;Giorgia Bodini.;Giorgio M Saracco.;Rinaldo Pellicano.
来源: Minerva Gastroenterol (Torino). 2021年67卷4期390-403页
Gastroesophageal reflux disease (GERD) is a chronic common disorder for which patients often refer to specialists. In the last decades, numerous studies helped to clarify the pathophysiology and the natural history of this disease. Currently, in the clinical setting, GERD is defined by the presence of symptoms that, when endoscopic investigation is required, permit to distinguish between cases with or without associated esophageal mucosal injuries. These conditions are called erosive reflux disease and non-erosive reflux disease (NERD), respectively. The latter is the most common manifestation of GERD. Symptoms are defined typical, as heartburn and regurgitation, and atypical (also called extra-esophageal), as coughing and/or wheezing, hoarseness, sore throat, otitis media, and dental manifestations. In this context, it is crucial for clinicians to investigate the presence of features of suspected malignancy, as unexplained weight loss, anemia, dysphagia, persistent vomiting, familiar history of cancer, long history of GERD, and beginning of GERD symptoms after the age of 50 years. The presence of these risk factors should induce to perform an endoscopic examination. Particular attention should be given to functional conditions that can mimic GERD, such as functional heartburn and hypersensitive esophagus as well as, more rarely, eosinophilic esophagitis. The former ones have different pathophysiology and this explains the frequent non-response to proton pump inhibitor drugs. This narrative review provides to clinicians a useful and practical overview of the state-of-the-art on advancements in the knowledge of GERD.
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