| 1. |
- Beamish, Andrew J., et al.
(författare)
-
Metabolic and bariatric surgery in adolescents
- 2019
-
Ingår i: Nature Reviews. Gastroenterology & Hepatology. - : NATURE PUBLISHING GROUP. - 1759-5045 .- 1759-5053. ; 16:10, s. 585-587
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- A new study has added valuable outcome data from adolescents 5 years after undergoing Roux-en-Y gastric bypass. By comparing outcomes from adolescents and adults, the study adds to the existing evidence base, highlighting metabolic and bariatric surgery as an increasingly valuable tool in the multidisciplinary management of adolescents with severe obesity.
|
|
| 2. |
- Gustafsson, Jenny K, 1981, et al.
(författare)
-
The role of goblet cells and mucus in intestinal homeostasis
- 2022
-
Ingår i: Nature Reviews Gastroenterology & Hepatology. - : Springer Science and Business Media LLC. - 1759-5045 .- 1759-5053. ; 19, s. 785-803
-
Forskningsöversikt (refereegranskat)abstract
- Mucus, produced by goblet cells, provides the intestinal tract with an additional layer of protection. This Review discusses the role of mucus and goblet cells in intestinal health and disease, and dissects the underlying regulatory mechanisms. The intestinal tract faces numerous challenges that require several layers of defence. The tight epithelium forms a physical barrier that is further protected by a mucus layer, which provides various site-specific protective functions. Mucus is produced by goblet cells, and as a result of single-cell RNA sequencing identifying novel goblet cell subpopulations, our understanding of their various contributions to intestinal homeostasis has improved. Goblet cells not only produce mucus but also are intimately linked to the immune system. Mucus and goblet cell development is tightly regulated during early life and synchronized with microbial colonization. Dysregulation of the developing mucus systems and goblet cells has been associated with infectious and inflammatory conditions and predisposition to chronic disease later in life. Dysfunctional mucus and altered goblet cell profiles are associated with inflammatory conditions in which some mucus system impairments precede inflammation, indicating a role in pathogenesis. In this Review, we present an overview of the current understanding of the role of goblet cells and the mucus layer in maintaining intestinal health during steady-state and how alterations to these systems contribute to inflammatory and infectious disease.
|
|
| 3. |
- Högberg, Lotta, et al.
(författare)
-
Diagnosis criteria in young children
- 2009
-
Ingår i: Nature Reviews Gastroenterology & Hepatology. - : Nature Publishing Group. - 1759-5045 .- 1759-5053. ; 6:8, s. 447-448
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
|
|
| 4. |
- Högberg, Lotta, et al.
(författare)
-
Pediatric celiac disease-is a diagnostic biopsy necessary?
- 2012
-
Ingår i: Nature Reviews Gastroenterology & Hepatology. - : Nature Publishing Group. - 1759-5045 .- 1759-5053. ; 9:3, s. 127-128
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- A small-bowel biopsy is currently required in the diagnosis of celiac disease in children. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition has now presented new guidelines for the diagnosis of celiac disease, which indicate that small-bowel biopsy could be avoided in certain cases.
|
|
| 5. |
- Johansson, Malin E V, 1971, et al.
(författare)
-
The gastrointestinal mucus system in health and disease.
- 2013
-
Ingår i: Nature reviews. Gastroenterology & hepatology. - : Springer Science and Business Media LLC. - 1759-5053 .- 1759-5045. ; 10:6, s. 352-61
-
Forskningsöversikt (refereegranskat)abstract
- Mucins--large, highly glycosylated proteins--are important for the luminal protection of the gastrointestinal tract. Enterocytes have their apical surface covered by transmembrane mucins and goblet cells produce the secreted gel-forming mucins that form mucus. The small intestine has a single unattached mucus layer, which in cystic fibrosis becomes attached, accounting for the intestinal manifestations of this disease. The stomach and colon have two layers of mucus; the inner layer is attached and the outer layer is less dense and unattached. In the colon, the outer mucus layer is the habitat for commensal bacteria. The inner mucus layer is impervious to bacteria and is renewed every hour by surface goblet cells. The crypt goblet cells have the ability to restitute the mucus layer by secretion, for example after an ischaemic challenge. Proteases of certain parasites and some bacteria can cleave mucins and dissolve the mucus as part of their pathogenicity. The inner mucus layer can, however, also become penetrable to bacteria by several other mechanisms, including aberrations in the immune system. When bacteria reach the epithelial surface, the immune system is activated and inflammation is triggered. This mechanism might occur in some types of ulcerative colitis.
|
|
| 6. |
- Keller, J., et al.
(författare)
-
Advances in the diagnosis and classification of gastric and intestinal motility disorders
- 2018
-
Ingår i: Nature Reviews Gastroenterology & Hepatology. - : Springer Science and Business Media LLC. - 1759-5045 .- 1759-5053. ; 15:5, s. 291-308
-
Tidskriftsartikel (refereegranskat)abstract
- Disturbances of gastric, intestinal and colonic motor and sensory functions affect a large proportion of the population worldwide, impair quality of life and cause considerable health-care costs. Assessment of gastrointestinal motility in these patients can serve to establish diagnosis and to guide therapy. Major advances in diagnostic techniques during the past 5-10 years have led to this update about indications for and selection and performance of currently available tests. As symptoms have poor concordance with gastrointestinal motor dysfunction, clinical motility testing is indicated in patients in whom there is no evidence of causative mucosal or structural diseases such as inflammatory or malignant disease. Transit tests using radiopaque markers, scintigraphy, breath tests and wireless motility capsules are noninvasive. Other tests of gastrointestinal contractility or sensation usually require intubation, typically represent second-line investigations limited to patients with severe symptoms and are performed at only specialized centres. This Consensus Statement details recommended tests as well as useful clinical alternatives for investigation of gastric, small bowel and colonic motility. The article provides recommendations on how to classify gastrointestinal motor disorders on the basis of test results and describes how test results guide treatment decisions.
|
|
| 7. |
|
|
| 8. |
- König, Julia, 1983-, et al.
(författare)
-
Faecal microbiota transplantation in IBS : new evidence for success?
- 2020
-
Ingår i: Nature Reviews. Gastroenterology & Hepatology. - : Nature Publishing Group. - 1759-5045 .- 1759-5053. ; 17:4, s. 199-200
-
Tidskriftsartikel (refereegranskat)abstract
- Faecal microbiota transplantation (FMT) aims to restore an altered microbiota and has been suggested as a potential treatment option for irritable bowel syndrome (IBS), among other diseases. A new study suggests that the use of a so-called superdonor is necessary to successfully treat patients with IBS using FMT.
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
- Lazarus, JV, et al.
(författare)
-
Defining comprehensive models of care for NAFLD
- 2021
-
Ingår i: Nature reviews. Gastroenterology & hepatology. - : Springer Science and Business Media LLC. - 1759-5053 .- 1759-5045. ; 18:10, s. 717-729
-
Tidskriftsartikel (refereegranskat)
|
|
| 13. |
- Lohr, JM, et al.
(författare)
-
IgG4-related diseases of the digestive tract
- 2022
-
Ingår i: Nature reviews. Gastroenterology & hepatology. - : Springer Science and Business Media LLC. - 1759-5053 .- 1759-5045. ; 19:23, s. 185-197
-
Tidskriftsartikel (refereegranskat)
|
|
| 14. |
|
|
| 15. |
- Mardinoglu, Adil, 1982, et al.
(författare)
-
Systems biology in hepatology: approaches and applications
- 2018
-
Ingår i: Nature Reviews Gastroenterology & Hepatology. - : Springer Science and Business Media LLC. - 1759-5045 .- 1759-5053. ; 15:6, s. 365-377
-
Tidskriftsartikel (refereegranskat)abstract
- Detailed insights into the biological functions of the liver and an understanding of its crosstalk with other human tissues and the gut microbiota can be used to develop novel strategies for the prevention and treatment of liver-associated diseases, including fatty liver disease, cirrhosis, hepatocellular carcinoma and type 2 diabetes mellitus. Biological network models, including metabolic, transcriptional regulatory, protein-protein interaction, signalling and co-expression networks, can provide a scaffold for studying the biological pathways operating in the liver in connection with disease development in a systematic manner. Here, we review studies in which biological network models were used to integrate multiomics data to advance our understanding of the pathophysiological responses of complex liver diseases. We also discuss how this mechanistic approach can contribute to the discovery of potential biomarkers and novel drug targets, which might lead to the design of targeted and improved treatment strategies. Finally, we present a roadmap for the successful integration of models of the liver and other human tissues with the gut microbiota to simulate whole-body metabolic functions in health and disease.
|
|
| 16. |
|
|
| 17. |
- Masoodi, Mojgan, et al.
(författare)
-
Metabolomics and lipidomics in NAFLD : biomarkers and non-invasive diagnostic tests
- 2021
-
Ingår i: Nature Reviews. Gastroenterology & Hepatology. - : Nature Publishing Group. - 1759-5045 .- 1759-5053. ; 18:12, s. 835-856
-
Forskningsöversikt (refereegranskat)abstract
- Nonalcoholic fatty liver disease (NAFLD) is one of the most common liver diseases worldwide and is often associated with aspects of metabolic syndrome. Despite its prevalence and the importance of early diagnosis, there is a lack of robustly validated biomarkers for diagnosis, prognosis and monitoring of disease progression in response to a given treatment. In this Review, we provide an overview of the contribution of metabolomics and lipidomics in clinical studies to identify biomarkers associated with NAFLD and nonalcoholic steatohepatitis (NASH). In addition, we highlight the key metabolic pathways in NAFLD and NASH that have been identified by metabolomics and lipidomics approaches and could potentially be used as biomarkers for non-invasive diagnostic tests. Overall, the studies demonstrated alterations in amino acid metabolism and several aspects of lipid metabolism including circulating fatty acids, triglycerides, phospholipids and bile acids. Although we report several studies that identified potential biomarkers, few have been validated.
|
|
| 18. |
- Moayyedi, P., et al.
(författare)
-
Evidence-based and mechanistic insights into exclusion diets for IBS
- 2020
-
Ingår i: Nature Reviews Gastroenterology & Hepatology. - : Springer Science and Business Media LLC. - 1759-5045 .- 1759-5053. ; 17, s. 406-413
-
Tidskriftsartikel (refereegranskat)abstract
- Exclusion diets are popular in the management of irritable bowel syndrome (IBS). This Review outlines the mechanisms by which food might lead to symptoms in IBS and discusses different approaches to how exclusion diets can be evaluated in randomized controlled trials. Exclusion diets are becoming increasingly popular in the management of irritable bowel syndrome (IBS). Several mechanisms exist by which food items might cause gastrointestinal symptoms, such as direct osmotic effects of food in the gut lumen, changes to the gut microbiota and immune activation. These effects have been demonstrated in animal models and in human studies, particularly in the case of gluten-free diets and diets low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). Indeed, randomized controlled trials (RCTs) suggest that gluten-free diets and low-FODMAP diets improve IBS symptoms, and guidelines recommend the latter approach for treating symptoms in some patients with IBS. Designing such RCTs is challenging as participants need to eat so an 'inert' placebo is not an option. Blinding is also an issue with these studies; in the future, new exclusion diets should not advertise what the diet consists of until it is proved to reduce symptoms. In this Review, we outline the advantages and disadvantages of each choice of control group and emphasize the importance of collecting mechanistic data (regarding direct effects of food on the gut lumen, changes in gut microbiota and intestinal inflammation) as well as symptom data in RCTs of exclusion diets in IBS.
|
|
| 19. |
|
|
| 20. |
- Simrén, Magnus, 1966, et al.
(författare)
-
New treatments and therapeutic targets for IBS and other functional bowel disorders
- 2018
-
Ingår i: Nature Reviews Gastroenterology & Hepatology. - : Springer Science and Business Media LLC. - 1759-5045 .- 1759-5053. ; 15:10, s. 589-605
-
Tidskriftsartikel (refereegranskat)abstract
- Functional bowel disorders (FBDs) are a spectrum of disorders characterized by combinations of symptoms attributable to the lower gastrointestinal tract. Most current first-line therapies for IBS and other FBDs target the predominant symptom and mainly affect one symptom in the symptom complex. Additional broadly effective treatment alternatives targeting the entire symptom complex are needed. New drugs for FBDs (such as lubiprostone, linaclotide, plecanatide, prucalopride, eluxadoline and rifaximin) target key mechanisms in the pathophysiology of these disorders and improve both the abnormal bowel habit and other key symptoms, such as abdominal pain and bloating. The current development of new treatment alternatives is focusing on different aspects of the complex pathophysiology of IBS and other FBDs: gut microenvironment (via diet and modulation of gut microbiota), enterohepatic circulation of bile acids, gastrointestinal secretion, motility and sensation, gut-brain interactions, gut barrier function and the immune system within the gastrointestinal tract. Studies also suggest that personalized treatment of IBS and other FBDs is possible using various diagnostic markers.
|
|
| 21. |
|
|
| 22. |
- Spencer, Jo, et al.
(författare)
-
Human intestinal B cells in inflammatory diseases.
- 2023
-
Ingår i: Nature reviews. Gastroenterology & hepatology. - : Springer Science and Business Media LLC. - 1759-5053 .- 1759-5045. ; 20:4, s. 254-65
-
Forskningsöversikt (refereegranskat)abstract
- The intestinal lumen contains an abundance of bacteria, viruses and fungi alongside ingested material that shape the chronically active intestinal immune system from early life to maintain the integrity of the gut epithelial barrier. In health, the response is intricately balanced to provide active protection against pathogen invasion whilst tolerating food and avoiding inflammation. B cells are central to achieving this protection. Their activation and maturation generates the body's largest plasma cell population that secretes IgA, and the niches they provide support systemic immune cell specialization. For example, the gut supports the development and maturation of a splenic Bcell subset - the marginal zone B cells. In addition, cells such as the Tfollicular helper cells, which are enriched in many autoinflammatory diseases, are intrinsically associated with the germinal centre microenvironment that is more abundant in the gut than in any other tissue in health. In this Review, we discuss intestinal B cells and their role when a loss of homeostasis results in intestinal and systemic inflammatory diseases.
|
|
| 23. |
|
|
| 24. |
- Tysk, Curt
(författare)
-
Large intestine : Remission of lymphocytic colitis with budesonide
- 2009
-
Ingår i: Nature reviews. Gastroenterology & hepatology. - : Springer Science and Business Media LLC. - 1759-5053 .- 1759-5045. ; 6:9, s. 506-507
-
Tidskriftsartikel (refereegranskat)abstract
- Few randomized, controlled trials have investigated the efficacy of pharmacological treatment for lymphocytic colitis. data from a new randomized, placebo-controlled trial have demonstrated the efficacy of budesonide in inducing remission of this disease; this study is an important contribution to this field.
|
|
| 25. |
|
|
| 26. |
|
|
| 27. |
|
|
| 28. |
- Öhman, Lena, 1967, et al.
(författare)
-
Crosstalk at the mucosal border: importance of the gut microenvironment in IBS.
- 2015
-
Ingår i: Nature reviews. Gastroenterology & hepatology. - : Springer Science and Business Media LLC. - 1759-5053 .- 1759-5045. ; 12, s. 36-49
-
Tidskriftsartikel (refereegranskat)abstract
- The aetiology and pathology of IBS, a functional bowel disorder thought to lack an organic cause, is largely unknown. However, studies suggest that various features, such as altered composition of the gut microbiota, together with increased intestinal permeability, a changed balance in the enteroendocrine system and a dysregulated immune system in the gut, most likely have an important role in IBS. Exactly how these entities act together and give rise to symptoms is still unknown, but an altered gut microbiota composition could lead to dysregulation of the intestinal barrier as well as the enteroendocrine and the immune systems, which (through interactions with the nervous system) might generate symptoms. This Review highlights the crosstalk between the gut microbiota, the enteroendocrine system, the immune system and the role of intestinal permeability in patients with IBS.
|
|
| 29. |
- Öhman, Lena, 1967, et al.
(författare)
-
Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions.
- 2010
-
Ingår i: Nature reviews. Gastroenterology & hepatology. - : Springer Science and Business Media LLC. - 1759-5053 .- 1759-5045. ; 7:3, s. 163-73
-
Forskningsöversikt (refereegranskat)abstract
- IBS is one of the most common functional gastrointestinal disorders worldwide and is thought to be the result of disturbed neural function along the brain-gut axis. The mechanisms behind this disturbance are not clear, but important roles for low-grade inflammation and immunological alterations in the development of symptoms compatible with IBS have become evident. The development of long-standing gastrointestinal symptoms after infectious gastroenteritis and patients with IBD in remission frequently having functional gastrointestinal symptoms support this hypothesis. An increased innate immune activity in the intestinal mucosa and in blood is found in subpopulations of patients with IBS. Mast cells and monocytes seem to be particularly important. In addition, studies have demonstrated that IBS may be associated with an activated adaptive immune response. Increased epithelial barrier permeability and an abnormal gut flora might lead to increased activation of the intestinal immune system. Functional and anatomical evidence for abnormal neuroimmune interactions has been found in patients with IBS. The link between immune alterations and severity of gastrointestinal symptoms and the positive effect of anti-inflammatory treatments in IBS further highlight the relevance of neuroimmune interactions in this condition.
|
|
| 30. |
- Clemens, John, et al.
(författare)
-
New-generation vaccines against cholera
- 2011
-
Ingår i: NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY. - 1759-5045. ; 8:12, s. 701-710
-
Forskningsöversikt (refereegranskat)abstract
- Cholera is a major global health problem, causing approximately 100,000 deaths annually, about half of which occur in sub-Saharan Africa. Although early-generation parenteral cholera vaccines were abandoned as public health tools owing to their limited efficacy, newer-generation oral cholera vaccines have attractive safety and protection profiles. Both killed and live oral vaccines have been licensed, although only killed oral vaccines are currently manufactured and available. These killed oral vaccines not only provide direct protection to vaccinated individuals, but also confer herd immunity. The combination of direct vaccine protection and vaccine herd immunity effects makes these vaccines highly cost-effective and, therefore, attractive for use in developing countries. Administration of these oral vaccines does not require qualified medical personnel, which makes their use practical--even in developing countries. Although new-generation oral cholera vaccines should not be considered in isolation from other preventive approaches, especially improved water quality and sanitation, they represent important tools in the public health armamentarium to control both endemic and epidemic cholera.
|
|
| 31. |
|
|
| 32. |
- Krishnan, U., et al.
(författare)
-
The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia-tracheoesophageal fistula
- 2023
-
Ingår i: Nature Reviews Gastroenterology & Hepatology. - 1759-5045. ; 20, s. 735-755
-
Tidskriftsartikel (refereegranskat)abstract
- Oesophageal atresia-tracheoesophageal fistula (EA-TEF) is a common congenital digestive disease. Patients with EA-TEF face gastrointestinal, surgical, respiratory, otolaryngological, nutritional, psychological and quality of life issues in childhood, adolescence and adulthood. Although consensus guidelines exist for the management of gastrointestinal, nutritional, surgical and respiratory problems in childhood, a systematic approach to the care of these patients in adolescence, during transition to adulthood and in adulthood is currently lacking. The Transition Working Group of the International Network on Oesophageal Atresia (INoEA) was charged with the task of developing uniform evidence-based guidelines for the management of complications through the transition from adolescence into adulthood. Forty-two questions addressing the diagnosis, treatment and prognosis of gastrointestinal, surgical, respiratory, otolaryngological, nutritional, psychological and quality of life complications that patients with EA-TEF face during adolescence and after the transition to adulthood were formulated. A systematic literature search was performed based on which recommendations were made. All recommendations were discussed and finalized during consensus meetings, and the group members voted on each recommendation. Expert opinion was used when no randomized controlled trials were available to support the recommendation. The list of the 42 statements, all based on expert opinion, was voted on and agreed upon. Currently, systematic care for adults and adolescents with oesophageal atresia-tracheoesophageal fistula (EA-TEF) as they transition into adulthood is lacking. A multidisciplinary group of experts structured this Consensus Statement offering guidelines for the care of adolescents and adults with EA-TEF during transition.
|
|
