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Nature Publishing Group

Publications in this journal

• Coeliac disease: Lack of consensus regarding definitions of coeliac disease.

  Authors: Markku Mäki

  Nature reviews. Gastroenterology & hepatology.

• Pancreatic cancer: USP9X can be used to predict pancreatic cancer outcomes.

  Authors: Claire Greenhill

  Nature reviews. Gastroenterology & hepatology.

• Contributions of the microbial hydrogen economy to colonic homeostasis.

  Authors: Franck Carbonero, Ann C Benefiel, H Rex Gaskins

  Nature reviews. Gastroenterology & hepatology.

  Colonic gases are among the most tangible features of digestion, yet physicians are typically unable to offer long-term relief from clinical complaints of excessive gas. Studies characterizingColonic gases are among the most tangible features of digestion, yet physicians are typically unable to offer long-term relief from clinical complaints of excessive gas. Studies characterizing colonic gases have linked changes in volume or composition with bowel disorders and shown hydrogen gas (H(2)), methane, hydrogen sulphide, and carbon dioxide to be by-products of the interplay between H(2)-producing fermentative bacteria and H(2) consumers (reductive acetogens, methanogenic archaea and sulphate-reducing bacteria [SRB]). Clinically, H(2) and methane measured in breath can indicate lactose and glucose intolerance, small intestinal bacterial overgrowth and IBS. Methane levels are increased in patients with constipation or IBS. Hydrogen sulphide is a by-product of H(2) metabolism by SRB, which are ubiquitous in the colonic mucosa. Although higher hydrogen sulphide and SRB levels have been detected in patients with IBD, and to a lesser extent in colorectal cancer, this colonic gas might have beneficial effects. Moreover, H(2) has been shown to have antioxidant properties and, in the healthy colon, physiological H(2) concentrations might protect the mucosa from oxidative insults, whereas an impaired H(2) economy might facilitate inflammation or carcinogenesis. Therefore, standardized breath gas measurements combined with ever-improving molecular methodologies could provide novel strategies to prevent, diagnose or manage numerous colonic disorders.

• Colonoscopy: Reducing faecal incontinence following colonoscopy.

  Authors: Felix W Leung

  Nature reviews. Gastroenterology & hepatology.

• IBD: Optimizing vaccination strategies against HBV in patients with IBD.

  Authors: Isobel Franks

  Nature reviews. Gastroenterology & hepatology.

• Increased risk of cardiovascular disease and chronic kidney disease in NAFLD.

  Authors: Enzo Bonora, Giovanni Targher

  Nature reviews. Gastroenterology & hepatology.

  NAFLD is very common in the general population and its prevalence is increasing worldwide in parallel with the increasing incidences of obesity and metabolic diseases, mainly type 2 diabetes. In someNAFLD is very common in the general population and its prevalence is increasing worldwide in parallel with the increasing incidences of obesity and metabolic diseases, mainly type 2 diabetes. In some cases, however, the diagnosis of NAFLD remains uncertain because other causes of liver disease are not easy to exclude in patients who are diagnosed with NAFLD after a biochemical or ultrasonographic analysis. Several studies have documented a strong association between NAFLD and traditional and nontraditional risk factors for cardiovascular disease (CVD) and chronic kidney disease (CKD). Accordingly, patients with NAFLD have an increased prevalence and incidence of both CVD and CKD. It is reasonable to believe that NAFLD, CVD and CKD share common risk factors (such as visceral obesity, insulin resistance, dysglycaemia, dyslipidaemia and hypertension) and therefore that NAFLD might simply be a marker rather than a causal risk factor of CVD and CKD. In this context, the identification of NAFLD might be an additional clinical feature to improve the stratification of patients for their risk of CVD and CKD. Growing evidence suggests that in patients with NAFLD, especially if NASH is present, several molecules released from the steatotic and inflamed liver might have pathogenic roles in the development of atherosclerosis and kidney damage. If these findings are confirmed by further studies, NAFLD could become a target for the prevention and treatment of CVD and CKD. NAFLD, whatever its role (marker or causal risk factor), is therefore a clinical condition that deserves greater attention from gastroenterologists, endocrinologists, cardiologists and nephrologists, as well as internists and general practitioners.

• Endoscopy: CT enterography improves detection if Crohn's disease skips the distal ileum.

  Authors: Andy McLarnon

  Nature reviews. Gastroenterology & hepatology.

• Liver: Dietary cholesterol and fat synergistically fuel the development of NASH in experimental models.

  Authors: Katrina Ray

  Nature reviews. Gastroenterology & hepatology.

• New vision in video capsule endoscopy: current status and future directions.

  Authors: Laurel R Fisher, William L Hasler

  Nature reviews. Gastroenterology & hepatology.

  Now, more than 10 years after the approval of video capsule endoscopy (VCE), the technology has become an essential component in the management of several clinical conditions. Currently, two capsulesNow, more than 10 years after the approval of video capsule endoscopy (VCE), the technology has become an essential component in the management of several clinical conditions. Currently, two capsules are approved in the USA for visualizing the small bowel mucosa, one capsule is authorized for oesophageal assessment and several others are in use or under evaluation worldwide. New investigations have focused on optical improvements, advances in intestinal cleansing and risk reduction strategies to optimize VCE methodologies in clinical care. Established indications diagnosed using VCE include unexplained gastrointestinal bleeding, small bowel Crohn's disease (in adults and children >10 years old), localization of small bowel tumours and a broad range of miscellaneous abnormalities. Investigations are ongoing to determine the utility of VCE in colon cancer screening, assessment of oesophageal disorders and diagnosis of coeliac disease. Active research is in progress into ways to improve the efficacy of VCE recording interpretation, prolong imaging time and further enhance optics and imaging methods. To expand the potential utility of VCE, novel devices that can manoeuvre within or insufflate the gut lumen, tag or biopsy suspect lesions, or target drug delivery to specific sites are in development. To facilitate these advances, consortia have been organized to promote innovative VCE technologies.

• Liver: Potential of autotaxin as a diagnostic marker and therapeutic target for itch of cholestasis.

  Authors: Natalie J Wood

  Nature reviews. Gastroenterology & hepatology.

• Vitamin B(12) transport from food to the body's cells-a sophisticated, multistep pathway.

  Authors: Marianne J Nielsen, Mie R Rasmussen, Christian B F Andersen, Ebba Nexø, Søren K Moestrup

  Nature reviews. Gastroenterology & hepatology.

  Vitamin B(12) (B(12); also known as cobalamin) is a cofactor in many metabolic processes; deficiency of this vitamin is associated with megaloblastic anaemia and various neurological disorders. InVitamin B(12) (B(12); also known as cobalamin) is a cofactor in many metabolic processes; deficiency of this vitamin is associated with megaloblastic anaemia and various neurological disorders. In contrast to many prokaryotes, humans and other mammals are unable to synthesize B(12). Instead, a sophisticated pathway for specific uptake and transport of this molecule has evolved. Failure in the gastrointestinal part of this pathway is the most common cause of nondietary-induced B(12) deficiency disease. However, although less frequent, defects in cellular processing and further downstream steps in the transport pathway are also known culprits of functional B(12) deficiency. Biochemical and genetic approaches have identified novel proteins in the B(12) transport pathway-now known to involve more than 15 gene products-delineating a coherent pathway for B(12) trafficking from food to the body's cells. Some of these gene products are specifically dedicated to B(12) transport, whereas others embrace additional roles, which explains the heterogeneity in the clinical picture of the many genetic disorders causing B(12) deficiency. This Review describes basic and clinical features of this multistep pathway with emphasis on gastrointestinal transport of B(12) and its importance in clinical medicine.

• IBS: Disease mechanisms in IBS.

  Authors: Isobel Franks

  Nature reviews. Gastroenterology & hepatology.

• IBD: Poor outcomes after Clostridium difficile infection in IBD.

  Authors: Sahil Khanna, Darrell S Pardi

  Nature reviews. Gastroenterology & hepatology.

• IBD: Mucosal healing-EXTENDing our knowledge in Crohn's disease.

  Authors: Silvio Danese, Laurent Peyrin-Biroulet

  Nature reviews. Gastroenterology & hepatology.

• Liver transplantation: Left lobe living donor liver transplantation could improve donor outcomes.

  Authors: Claire Greenhill

  Nature reviews. Gastroenterology & hepatology.

• MicroRNAs in pancreatic cancer metabolism.

  Authors: Pankaj K Singh, Randall E Brand, Kamiya Mehla

  Nature reviews. Gastroenterology & hepatology.

  Advances in understanding the biology of tumour progression and metastasis have clearly highlighted the importance of aberrant tumour metabolism, which supports not only the energy requirements butAdvances in understanding the biology of tumour progression and metastasis have clearly highlighted the importance of aberrant tumour metabolism, which supports not only the energy requirements but also the enormous biosynthetic needs of tumour cells. Such metabolic alterations modulate glucose, amino acid and fatty-acid-dependent metabolite biosynthesis and energy production. Although much progress has been made in understanding the somatic mutations and expression genomics behind these alterations, the regulation of these processes by microRNAs (miRNAs) is only just beginning to be appreciated. This Review focuses on the miRNAs that are potential regulators of the expression of genes whose protein products either directly regulate metabolic machinery or serve as master regulators, indirectly modulating the expression of metabolic enzymes. We focus particularly on miRNAs in pancreatic cancer.

• Transplantation: Sharing of donated livers is not equal.

  Authors: Richard B Freeman

  Nature reviews. Gastroenterology & hepatology.

• Acute and chronic pouchitis-pathogenesis, diagnosis and treatment.

  Authors: Bo Shen

  Nature reviews. Gastroenterology & hepatology.

  Restorative proctocolectomy with ileal pouch-anal anastomosis has become the procedure of choice for the majority of patients with ulcerative colitis who require surgical treatment. Pouchitis, theRestorative proctocolectomy with ileal pouch-anal anastomosis has become the procedure of choice for the majority of patients with ulcerative colitis who require surgical treatment. Pouchitis, the most common long-term complication of the procedure, involves a spectrum of disease processes with heterogeneous risk factors, clinical features, disease courses and prognoses. In addition, clinical symptoms of pouchitis are not specific and often overlap with those of other inflammatory and functional pouch disorders, such as Crohn's disease of the pouch and irritable pouch syndrome. Pouchoscopy and biopsy, along with laboratory and radiographic evaluations, are often required for accurate diagnosis in patients with symptoms indicative of pouchitis. Dysbiosis has been implicated as a triggering factor for pouchitis, and concurrent infection with pathogens, such as Clostridium difficile, might contribute to disease relapse and exacerbation. Antibiotic therapy is the main treatment modality. However, the management of antibiotic-dependent and antibiotic-refractory pouchitis remains challenging. Secondary causes of pouchitis, such as ischaemia, NSAID use, the presence of concurrent primary sclerosing cholangitis and other systemic immune-mediated disorders, should be evaluated and properly managed.

• Virus-drug interactions-molecular insight into immunosuppression and HCV.

  Authors: Qiuwei Pan, Hugo W Tilanus, Herold J Metselaar, Harry L A Janssen, Luc J W van der Laan

  Nature reviews. Gastroenterology & hepatology.

  Liver transplantation is an effective treatment for end-stage liver disease that is attributable to chronic HCV infection. However, long-term outcomes are compromised by universal virologicalLiver transplantation is an effective treatment for end-stage liver disease that is attributable to chronic HCV infection. However, long-term outcomes are compromised by universal virological recurrence in the graft. Reinfection that occurs after transplantation has increased resistance to current interferon-based antiviral therapy and often leads to accelerated development of cirrhosis. Important risk factors for severe HCV recurrence are linked to immunosuppression. Owing to the lack of good randomized, controlled trials, the optimal choice of immunosuppressants is still debated. By contrast, much progress has been made in the understanding of HCV biology and the antiviral action of interferons. These new insights have greatly expanded our knowledge of the molecular interplay between HCV and immunosuppressive drugs. In this article, we explore the effect of different immunosuppressants on the complex cellular events involved in HCV infection and interferon signalling. Potential implications for clinical practice and future drug development are discussed.

• Imaging: Differentiation of colorectal lesions.

  Authors: Andy McLarnon

  Nature reviews. Gastroenterology & hepatology.

• Obesity: Weight loss after Roux-en-Y gastric bypass is associated with SNPs in ghrelin receptor gene.

  Authors: Claire Greenhill

  Nature reviews. Gastroenterology & hepatology.

• Genetics: Genetic susceptibility has a role in the development of diverticular disease.

  Authors: Isobel Franks

  Nature reviews. Gastroenterology & hepatology.

• Microbiota: Tolerating gluten-a role for gut microbiota in celiac disease?

  Authors: Katrina Ray

  Nature reviews. Gastroenterology & hepatology.

• Celiac disease: Obesity in celiac disease.

  Authors: Rajiv Sonti, Peter H R Green

  Nature reviews. Gastroenterology & hepatology.

• IBS: New insights into pathogenesis of diarrhea-predominant IBS.

  Authors: Isobel Franks

  Nature reviews. Gastroenterology & hepatology.

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