Review Articles in 2012

Nutrigenomics utilizes high-throughput genomics technologies to reveal changes in gene and protein expression that are modulated by the patient's nutrition. In this Review, Lynnette Ferguson describes how these methods have been successfully applied to animal models of Crohn's disease, and suggests that the time is right to move them to human studies.

Neurogastroenterology encompasses control of digestion through the enteric nervous system, the central nervous system and integrative centers in sympathetic ganglia. In this Review, John Furness provides a broad overview of the rapidly developing field of neurogastroenterology, with a focus on the roles of the enteric nervous system in the control of the musculature of the gastrointestinal tract and transmucosal fluid movement.

Intraductal papillary mucinous neoplasms of the pancreas (IPMNs) are being increasingly diagnosed, and are the most frequent cystic neoplasms of the pancreas. In this Review, Werner and colleagues describe the key features of IPMNs (including epidemiology and pathology) and focus on the currently available surgical options for the different types of IPMNs.

The gastrointestinal microbiota has come to the fore in the search for the causes of IBD. Microbial diversity studies have continually demonstrated an expansion of the Proteobacteria phylum in patients with IBD. In this Review, the authors comprehensively describe the various associations of Proteobacteria and IBD. They postulate that Proteobacteria with adherent and invasive properties might exploit host defenses, drive proinflammatory change, alter the intestinal microbiota in favor of dysbiosis and ultimately lead to the development of IBD.

Microscopic colitis—characterized by watery diarrhea, normal findings on endoscopy and characteristic findings on microscopy—is being increasingly diagnosed. An accurate pathological diagnosis of this disease is important to differentiate microscopic colitis from disease mimics. In this Review, Chetty and Govender provide an overview of the key features of microscopic colitis, describing the different subtypes, etiopathogenesis, pathology and treatment.

PPIs are one of the most commonly prescribed drugs worldwide. However, it has been suggested that PPIs are associated with an increased risk of pneumonia, bone fractures and enteric infections, and that they interact with clopidogrel. In this Review, Paul Moayyedi and Grigorios Leontiadis detail how the evidence supporting these associations is limited, but suggest that PPIs are only given to patients for whom these drugs have been proven beneficial.

The frequency of endoscopic complications is likely to rise owing to the increased number of indications for therapeutic procedures and also to the increased complexity of endoscopic techniques. Blero and Devière review the most common complications of diagnostic and therapeutic upper gastrointestinal endoscopy, small bowel endoscopy, endoscopic retrograde cholangiopancreatography and colonoscopy. Different modalities of medical, endoscopic and surgical management are also considered.

Although pancreatic neuroendocrine tumors (PanNETs) have long been considered benign tumors, they in fact have considerable malignant potential. This Review outlines the clinicopathological features of PanNETs and the latest advances in our knowledge of the biology of these tumors. The authors also outline how mutational analysis will affect personalized therapy and discuss the approved new targeted agents tailored specifically towards PanNETs.

Genetic variations can affect drug absorption, efflux, metabolism and the ability of drugs to interact with their target proteins. In this Review, Michael Camilleri provides an overview of pharmacogenetics in for the management of non-malignant gastrointestinal diseases on the basis of data from clinical trials. The potential of pharmacogenetics in targeting therapy to the individual patient is also discussed.

Managing the pain of chronic pancreatitis is an important unmet medical need; its treatment has been largely empirical, with variable outcomes. The pathogenesis of pain in chronic pancreatitis is poorly understood but current theories have shifted towards a neurobiological rather than a purely mechanical basis. Pankaj Jay Pasricha discusses some of the specific molecules that might be involved and that might provide potential therapeutic targets.

Cholangiocarcinoma is the second most common tumor of the liver worldwide. Endoscopy could have a useful role in the work-up of patients with hilar cholangiocarcinoma who are unsuitable for surgery. In this Review, the authors present an overview of the diagnostic and therapeutic role of endoscopic procedures in the management of hilar cholangiocarcinoma.

Nonalcoholic fatty liver disease (NAFLD) can affect both adults and children. As the incidence of obesity continues to increase in children and adolescents, so too does the occurrence of NAFLD in these pediatric patients. Here, Alisi and colleagues provide an overview of pediatric NAFLD, describing the epidemiology, pathogenesis, diagnosis and treatment of these young patients.

Nonvariceal upper gastrointestinal bleeding (UGIB) is a major cause of morbidity and mortality worldwide, and despite improvements in the management of patients with this condition, there have only been moderate improvements in mortality rates. This Review discusses the diagnosis of UGIB and describes the optimal management of patients with this condition, in accordance with the current consensus recommendations and contemporary literature. The authors examine endoscopy, management of bleeding and pharmacological therapy for patients with UGIB.