Review Articles in 2019

Primary biliary cholangitis (PBC) is a chronic, inflammatory and cholestatic liver disease with a variable rate of progression towards biliary cirrhosis. Here, the authors discuss the current understanding of PBC pathogenesis and highlight implications for new therapies.

This Review discusses the molecular heterogeneity of hepatocellular carcinoma, the intrinsic and extrinsic factors that stimulate tumour evolution and how this information can be leveraged to improve the clinical management of patients with this disease.

IBD treatment has an expanding repertoire of drugs targeting different aspects of the immune response. This Review focuses on unravelling the complexity of mucosal immune responses in IBD pathogenesis and how analytical assays might be harnessed to effectively stratify and individualise IBD therapy.

Functional constipation is common in children and adults worldwide. Here, the authors provide an overview of the differing management strategies for childhood and adult functional constipation, including insights into epidemiology, pathophysiology, diagnosis and therapy.

Primary liver cancers are frequently accompanied by rearrangements of metabolic pathways. This Review discusses the role of metabolic liver disruptions and the implications of these processes, emphasizing their clinical relevance and value in early diagnosis and prognosis and as putative therapeutic targets.

This Review discusses the genetics of nonalcoholic fatty liver disease (NAFLD), including evidence of shared genetic modifiers and possible pleiotropic effects between NAFLD and other liver diseases or metabolic disorders. The translational implications and future challenges are also discussed.

Innate immune responses are currently seen as a key element driving hepatic inflammation in nonalcoholic steatohepatitis. However, this Review discusses the increasing evidence pointing to the role of adaptive immunity as an additional factor promoting liver inflammation and driving disease progression.

Colorectal cancer (CRC) is one of the most common cancers worldwide. This Review describes the role of microorganisms in colorectal carcinogenesis, and the potential clinical translation of the gut microbiota as a biomarker for CRC diagnosis and prognosis, and as an approach for disease prevention and to improve therapy.

Multiple therapeutic approaches are being developed to achieve sustained, off-treatment suppression of HBV. In this Review, the authors examine T cell and B cell responses to HBV and the potential for immunotherapies to restore or release endogenous adaptive immunity by direct or indirect approaches.

Pancreatic cystic neoplasms are a heterogeneous group of pancreatic cysts with different biological behaviours and variable risk of progression to malignancy. This Review summarizes the latest developments in the diagnosis and management of pancreatic cysts, including the quality of available evidence.

There is an emerging understanding of the roles of intestinal gases, generated via chemical interactions or the microbial metabolism of dietary substrates, in gut homeostasis and pathophysiology. In this Review, the authors discuss these emerging data, highlighting links with dietary intake and new gas profiling methods.

Chronic HBV infection is a serious problem; few patients achieve the ultimate goal of hepatitis B surface antigen loss. This Review integrates findings from research in HBV infection kinetics and discusses how they can aid understanding and management of HBV infection.

Colorectal cancer is one of the most common cancers worldwide. This Review provides a comprehensive summary of colorectal cancer epidemiology, with emphasis on modifiable lifestyle and nutritional factors, chemoprevention and screening.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide. This Review summarizes the epidemiology, risk factors (including viral hepatitis and NAFLD), molecular profiles and treatment of HCC, providing insights into how the global burden of HCC can be reduced.

The design of clinical trials for hepatocellular carcinoma is complicated by a number of obstacles. In this Review, the authors discuss the advances in systemic therapy for hepatocellular carcinoma and critically discuss trial designs in the context of past successes and failures.

Macrophages are the gatekeepers of intestinal immune homeostasis. This Review discusses the molecular and cellular mechanisms involved in the differentiation and function of intestinal macrophages in homeostasis and inflammation, and their role in resolving the inflammatory process.

The gut microbiota has been implicated in a range of diseases. This Review describes current understanding of probiotics and prebiotics as a means to manage the microbiota to improve host health, including mechanisms of actions and potential for clinical use.

Nonalcoholic fatty liver disease (NAFLD) has become the most common form of chronic liver disease in children and adolescents. In this Review, the authors summarize current knowledge and new advances related to the epidemiology, pathogenesis and management of paediatric NAFLD.

Telomerase is a key enzyme for cell survival that prevents telomere shortening. In this Review, the roles of telomeres and telomerase in cirrhosis and liver carcinogenesis are discussed, in addition to their potential in clinical practice as biomarkers and therapeutic targets.

New knowledge has been steadily acquired in genetic and congenital cholangiopathies. Here, the authors discuss Alagille syndrome, polycystic liver diseases, fibropolycystic liver diseases and cystic fibrosis-related liver disease and the insights that these conditions provide into the mechanisms of acquired cholangiopathies.