Eosinophilic esophagitis: novel concepts regarding pathogenesis and clinical manifestations.
Authors: Sciumé GD, Visaggi P, Sostilio A, Tarducci L, Pugno C, Frazzoni M, Ricchiuti A, Bellini M, Giannini EG, Marchi S, Savarino V, De Bortoli N Abstract Eosinophilic esophagitis is a chronic disease whose incidence and prevalence are increasing, based on a genetic-driven interaction between environment and immune system. Several gene loci involved in the development of the disease have been identified. A two-step mechanism has been hypothesized: a TSLP-induced allergic sensitization followed by upregulation of CAPNA14-related esophageal-specific pathways. Environment seems to have a larger effect than...
Source: Minerva Gastroenterologica e Dietologica - January 15, 2021 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Hepatic steatosis integrated approach: nutritional guidelines and joined nutraceutical administration.
CONCLUSIONS: Chrysanthellum americanum and Pistacia lentiscus L. extracts were absolutely safe and effective and gave a substantial contribution to the life quality benefit, metabolic balance and gut function in patients with hepatic steatosis. PMID: 33443240 [PubMed - in process] (Source: Minerva Gastroenterologica e Dietologica)
Source: Minerva Gastroenterologica e Dietologica - January 15, 2021 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Liver and spleen elastography as predictor of portal hypertension and esophageal varices.
Authors: Aquino-Matus J, Uribe M, Chavez-Tapia N Abstract Liver stiffness is related to the degree of hepatic fibrosis which ultimately causes portal hypertension and gastroesophageal varices. Variceal bleeding is a worrisome and potentially fatal complication of cirrhosis, primary prophylaxis has demonstrated a reduction in decompensation and mortality. Portal hypertension and esophageal varices needing treatment could be predicted through noninvasive methods, including elastography, that evaluates the mechanical properties of liver or spleen tissue in concordance to the propagation of mechanical waves. T...
Source: Minerva Gastroenterologica e Dietologica - December 19, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Early detection of pancreatic tumors by advanced EUS imaging.
Authors: Dietrich CF, Shi L, Koch J, Löwe A, Dong Y, Cui XW, Worni M, Jenssen C Abstract The early detection of pancreatic ductal adenocarcinoma (PDAC) dramatically improves outcome. All available state-of-the-art imaging methods allow early detection with EUS being the best technique for exclusion of PDAC and detection of very early PDAC. Etiological differentiation of small SPL is important to guide individually tailored patients management including radical surgery in resectable PDAC, medical (neoadjuvant or palliative intended) treatment in patients with non-resectable malignancy, pancreatic parenchym...
Source: Minerva Gastroenterologica e Dietologica - December 19, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Risk stratification in primary sclerosing cholangitis.
Authors: Mulinacci G, Cristoferi L, Palermo A, Lucà M, Gerussi A, Invernizzi P, Carbone M Abstract Primary Sclerosing Cholangitis (PSC) is a chronic liver disorder commonly affecting young patients and associated with uncertain prognosis and elevated risk of end-stage liver disease and hepatobiliary cancer. Rate of progression in PSC is heterogeneous and accurately predicting the disease course is of paramount importance to clinical practice and interventional trial design. So far, efforts have brought to the development of models looking at short-to-middle-term outcome using composite models including cl...
Source: Minerva Gastroenterologica e Dietologica - December 12, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Eosinophilic esophagitis and biologics.
Authors: Ghisa M, Laserra G, Maniero D, Marabotto E, Barberio B, Pelizzaro F, Barbuscio I, Zingone F, Savarino V, Savarino E Abstract EoE incidence and prevalence have sharply increased in the last decade and management of these patients is changing rapidly. Standard regimens as elimination diet, proton pump inhibitors and topical swallowed steroids are not able to achieve remission in all patients. Moreover, loss of efficacy and safety concerns for long-term medical treatments are rising questions. As for other chronic immune-mediated diseases, biologics have been evaluated for treatment of EoE. Several t...
Source: Minerva Gastroenterologica e Dietologica - December 5, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

The role of endoscopy in eosinophilic esophagitis: from diagnosis to therapy.
Authors: Arsiè E, Cantù P, Penagini R Abstract Endoscopy plays an important role in the management of eosinophilic esophagitis (EoE), since it is involved in the diagnosis, follow up and treatment of this condition. In patients presenting with food impaction, dysphagia and other symptoms of suspected EoE, esophago-gastric-duodenoscopy (EGD) with multiple esophageal biopsies should be performed to confirm or rule out the diagnosis of EoE. The EREFS system, a validated instrument for assessment of the endoscopically-identified esophageal features in EoE (edema, rings, exudates, longitudinal furrows and str...
Source: Minerva Gastroenterologica e Dietologica - December 5, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

What does liver elastography measure? Technical aspects and methodology.
Authors: Dietrich CF, Shi L, Wei Q, Dong Y, Cui XW, Löwe A, Worni M, Ferraioli G Abstract Elastography can be thought as an extension of the ancient technique of palpation. After giving a short introduction to the history of elastography, the different technologies that are nowadays available and the physics behind them, the article focuses on the assessment of liver stiffness in patients with diffuse liver disease using shear wave elastography (SWE). Practical advices on how to perform the SWE techniques and on the factors that should be taken into account for a correct interpretation of the results are ...
Source: Minerva Gastroenterologica e Dietologica - December 5, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

IgG4-related autoimmune liver disease.
Authors: Capurso G, Pedica F, Palumbo D, Della Torre E Abstract The term IgG4-related autoimmune liver disease (AILD) refers to hepato-biliary manifestations of IgG4-related disease (IgG4-RD) including IgG4-related sclerosing cholangitis and IgG4-related pseudotumors. The association of some forms of autoimmune hepatitis to IgG4-RD remains controversial. Although autoimmune phenomena have not been clearly observed in IgG4-AILD, perturbation of the adaptive immune system and activation of the humoral response represent established pathophysiological hallmarks and potential therapeutic targets. Clinical mani...
Source: Minerva Gastroenterologica e Dietologica - December 5, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Nutritional approach to eosinophilic esophagitis: which diet and when.
This article updates recent knowledge on dietary therapy for EoE and provides guideline to choose the most suitable alternative for patients with EoE, as well as practical tips to achieve the best results in clinical practice. PMID: 33267566 [PubMed - as supplied by publisher] (Source: Minerva Gastroenterologica e Dietologica)
Source: Minerva Gastroenterologica e Dietologica - December 5, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Eosinophilic esophagitis: definition, epidemiology and quality of life.
Authors: Frazzoni L, Tolone S Abstract Eosinophilic esophagitis (EoE) is a clinicopathological disease defined by symptoms of esophageal dysfunction and ≥15 eosinophils/HPF after excluding other causes of esophageal eosinophilia. Increasing attention has been paid by clinicians and researchers after its first description in 1978. Many consensuses and guidelines have been issued over the years, as gastroenterologists did not reach an agreement on EoE definition, especially regarding the controversial responsiveness to proton pump inhibitor (PPI) therapy. Of note, recent evidence suggests that the incidenc...
Source: Minerva Gastroenterologica e Dietologica - December 5, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Open challenges in the management of autoimmune hepatitis.
Authors: Gerussi A, Halliday N, Carbone M, Invernizzi P, Thorburn D Abstract Autoimmune Hepatitis (AIH) is a rare autoimmune disease of the liver with many open questions as regards its aetiopathogenesis, natural history and clinical management. The classical picture of AIH is chronic hepatitis with fluctuating elevation of serum transaminases and Immunoglobulin G levels, the presence of circulating autoantibodies and typical histological features. However, atypical presentations do occur and are not well captured by current diagnostic scores, with important consequences in terms of missed diagnoses and de...
Source: Minerva Gastroenterologica e Dietologica - December 5, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

The small intestine: barrier, permeability and microbiota. Key messages for clinicians.
Authors: Stalla FM, Astegiano M, Ribaldone DG, Saracco GM, Pellicano R Abstract In recent years, there has been growing interest in the comprehension of the physiology of intestinal permeability and microbiota and how these elements could influence the pathogenesis of diseases. The term intestinal permeability describes all the processes that allow the passage of molecules as water, electrolytes and nutrients through the intestinal barrier by the para-cellular or the trans-cellular transport systems with several implications for self-tolerance and not-self immunity. An increased permeability might induce a...
Source: Minerva Gastroenterologica e Dietologica - December 5, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Bleeding peptic ulcer disease: over or through the scope clipping?
Authors: Sbeit W, Mari A, Pellicano R, Khoury T PMID: 33267570 [PubMed - as supplied by publisher] (Source: Minerva Gastroenterologica e Dietologica)
Source: Minerva Gastroenterologica e Dietologica - December 5, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Liver fibrosis in NAFLD patients: examining the opportunity to find a non-invasive, accurate and low-cost tool.
Authors: Sanna C PMID: 33267571 [PubMed - as supplied by publisher] (Source: Minerva Gastroenterologica e Dietologica)
Source: Minerva Gastroenterologica e Dietologica - December 5, 2020 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research