The development of IBD is known to involve early immunological alterations, but our understanding of the changes in antibody epitope repertoires moving from the prediagnostic phase towards disease onset remains incomplete.

IgG4 antibodies exhibit unique structural and functional properties, which distinguish them from other IgG subclasses. Among clinicians, IgG4 has been primarily associated with IgG4-related diseases (IgG4-RDs), such as autoimmune pancreatitis, where its role has been a focus of intense discussion. However, growing evidence reveals that IgG4 is involved in a broader spectrum of immune-regulatory processes, extending beyond IgG4-RDs and positioning it as a key modulator of immune tolerance. In this context, several specific features allow IgG4 to play dual roles, serving as a protective factor in immune regulatory settings, such as allergic responses and antibody therapies that require tolerance induction towards target cells, while its role in IgG4-RDs remains uncertain, potentially contributing to disease or mitigating tissue damage. This review examines the pathophysiological roles of IgG4 in the regulation of immune responses, highlighting its involvement in both homoeostasis and disease. Furthermore, it explores the therapeutic potential of harnessing IgG4's unique features, not only for IgG4-associated diseases, but also for other indications, where promoting beneficial IgG4 responses could offer therapeutic advantages.

Both lifestyle factors and genetic predisposition contribute to the development of diverticulitis.

Coeliac disease is characterised by immune-mediated damage to the small intestine in response to dietary gluten in genetically predisposed individuals. Increased intestinal permeability is a central component to its pathophysiology. This review explores the evidence for increased permeability in coeliac disease and the underlying mechanisms, including the roles of zonulin, inflammatory cytokines, microbial alterations and immune responses to gliadin peptides. We also review comprehensively the therapies targeting barrier integrity and normalising intestinal permeability, including particular diets and supplements, and experimental and improved medications including larazotide acetate and IMU-856. Finally, we highlight the need for reliable biomarkers for evaluating increased permeability in coeliac disease and advocate for further research on therapies which normalise barrier function, particularly as a strategy to maintain remission.

Chronic inflammation and elevated reactive oxygen species are key contributors to hepatocellular carcinoma (HCC) progression.

Endoscopic intermuscular dissection (EID) is a promising new technique for managing rectal deep submucosal invasive cancer (D-SMIC), but long-term outcome data are currently lacking.

Liver metastasis is a major cause of mortality in patients with colorectal cancer (CRC). Understanding how CRC cells influence the formation of hepatic premetastatic niches (PMNs) is crucial for developing targeted therapies.

Despite inadequate supply and potential contamination risk, human plasma has remained the only source for human serum albumin (pHSA) intravenous administration since the 1940s.

In response to recent advancements in inflammatory bowel disease (IBD) management, the British Society of Gastroenterology (BSG) Clinical Services and Standards Committee (CSSC) has commissioned the BSG IBD section to update its guidelines, last revised in 2019. These updated guidelines aim to complement the IBD standards and promote the use of the national primary care diagnostic pathway for lower gastrointestinal symptoms to enhance diagnostic accuracy and timeliness. Formulated through a systematic and transparent process, this document reflects a consensus of best practices based on current evidence. The guideline, while developed primarily for the UK, is structured to support IBD management internationally. It is endorsed by the BSG executive board and CSSC without external commercial funding, with involvement primarily supported through professional roles in public institutions and the National Health Service (NHS). Methodological revisions since the prior guidelines have enhanced rigor in technical review and development, with methodology details published independently following peer review. In developing the recommendations, 89 clinical experts and stakeholders participated in an online survey, identifying primary outcomes, such as clinical and endoscopic remission, as well as adverse event metrics, all stratified by clinically relevant effect sizes. These guidelines are intended to support clinical decision-making but are not prescriptive, recognizing that individual clinical scenarios may warrant tailored approaches. Further research may inform future revisions as new evidence emerges.

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects over 30% of the general population and is the fastest growing cause of hepatocellular carcinoma (HCC). Current guidelines recommend HCC surveillance in patients with cirrhosis when annual HCC incidence exceeds 1% without specifying the role of non-invasive tests in patient selection.

Chronic hepatitis B (CHB) is a major global health concern primarily due to hepatocellular carcinoma (HCC) development.

Diagnosing the presence of metastasis of pancreatic cancer is pivotal for patient management and treatment, with contrast-enhanced CT scans (CECT) as the cornerstone of diagnostic evaluation. However, this diagnostic modality requires a multifaceted approach.