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Is irritable bowel syndrome an infectious disease?
Abstract Irritable bowel syndrome (IBS) is the most common of all gastroenterological diseases. While many mechanisms have been postulated to explain its etiology, no single mechanism entirely explains the heterogeneity of symptoms seen with the various phenotypes of the disease. Recent data from both basic and clinical sciences suggest that underlying infectious disease may provide a unifying hypothesis that better explains the overall symptomatology. The presence of small intestinal bowel overgrowth (SIBO) has been documented in patients with IBS and reductions in SIBO as determined by breath testing correlate wi...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Thompson JR Tags: World J Gastroenterol Source Type: research

Molecular genetics and targeted therapeutics in biliary tract carcinoma.
Abstract The primary malignancies of the biliary tract, cholangiocarcinoma and gallbladder cancer, often present at an advanced stage and are marginally sensitive to radiation and chemotherapy. Accumulating evidence indicates that molecularly targeted agents may provide new hope for improving treatment response in biliary tract carcinoma (BTC). In this article, we provide a critical review of the pathogenesis and genetic abnormalities of biliary tract neoplasms, in addition to discussing the current and emerging targeted therapeutics in BTC. Genetic studies of biliary tumors have identified the growth factors and r...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Marks EI, Yee NS Tags: World J Gastroenterol Source Type: research

Hepatic non-parenchymal cells: Master regulators of alcoholic liver disease?
Abstract Chronic alcohol consumption is one of the most common causes of the progression of alcoholic liver disease (ALD). In the past, alcohol-mediated hepatocyte injury was assumed to be a significantly major cause of ALD. However, a huge number of recent and brilliant studies have demonstrated that hepatic non-parenchymal cells including Kupffer cells, hepatic stellate cells, liver sinusoidal endothelial cells and diverse types of lymphocytes play crucial roles in the pathogenesis of ALD by producing inflammatory mediators such as cytokines, oxidative stress, microRNA, and lipid-originated metabolites (retinoic ...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Seo W, Jeong WI Tags: World J Gastroenterol Source Type: research

Liver pathology of hepatitis C, beyond grading and staging of the disease.
Abstract Liver biopsy evaluation plays a critical role in management of patients with viral hepatitis C. In patients with acute viral hepatitis, a liver biopsy, though uncommonly performed, helps to rule out other non-viral causes of deranged liver function. In chronic viral hepatitis C, it is considered the gold standard in assessment of the degree of necroinflammation and the stage of fibrosis, to help guide treatment and determine prognosis. It also helps rule out any concomitant diseases such as steatohepatitis, hemochromatosis or others. In patients with chronic progressive liver disease with cirrhosis and dom...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Dhingra S, Ward SC, Thung SN Tags: World J Gastroenterol Source Type: research

Chronic hepatitis C virus infection: Serum biomarkers in predicting liver damage.
Abstract Currently, a major clinical challenge in the management of the increasing number of hepatitis C virus (HCV) infected patients is determining the best means for evaluating liver impairment. Prognosis and treatment of chronic hepatitis C (CHC) are partly dependent on the assessment of histological activity, namely cell necrosis and inflammation, and the degree of liver fibrosis. These parameters can be provided by liver biopsy; however, in addition to the risks related to an invasive procedure, liver biopsy has been associated with sampling error mostly due to suboptimal biopsy size. To avoid these pitfalls,...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Valva P, Ríos DA, De Matteo E, Preciado MV Tags: World J Gastroenterol Source Type: research

Vertically acquired hepatitis C virus infection: Correlates of transmission and disease progression.
Abstract The worldwide prevalence of hepatitis C virus (HCV) infection in children is 0.05%-0.4% in developed countries and 2%-5% in resource-limited settings, where inadequately tested blood products or un-sterile medical injections still remain important routes of infection. After the screening of blood donors, mother-to-child transmission (MTCT) of HCV has become the leading cause of pediatric infection, at a rate of 5%. Maternal HIV co-infection is a significant risk factor for MTCT and anti-HIV therapy during pregnancy seemingly can reduce the transmission rate of both viruses. Conversely, a high maternal vira...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Tovo PA, Calitri C, Scolfaro C, Gabiano C, Garazzino S Tags: World J Gastroenterol Source Type: research

Analysis of peripheral blood dendritic cells as a non-invasive tool in the follow-up of patients with chronic hepatitis C.
Abstract Hepatitis C virus (HCV) has a high propensity to establish chronic infections. Failure of HCV-infected individuals to activate effective antiviral immune responses is at least in part related to HCV-induced impairment of dendritic cells (DCs) that play a central role in activating T cell responses. Although the impact of HCV on DC phenotype and function is likely to be more prominent in the liver, major HCV-induced alterations are detectable in peripheral blood DCs (pbDCs) that represent the most accessible source of DCs. These alterations include numerical reduction, impaired production of inflammatory cy...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Crosignani A, Riva A, Della Bella S Tags: World J Gastroenterol Source Type: research

Rheumatic manifestations of hepatitis C virus chronic infection: Indications for a correct diagnosis.
Abstract Hepatitis C virus (HCV) is a hepato- and lymphotropic agent that is able to induce several autoimmune rheumatic disorders: vasculitis, sicca syndrome, arthralgias/arthritis and fibromyalgia. The severity of clinical manifestations is variable and sometimes life-threatening. HCV infection can mimic many primitive rheumatic diseases, therefore, it is mandatory to distinguish HCV-related manifestations from primitive ones because the prognosis and therapeutic strategies can be fairly dissimilar. The new direct-acting antivirals drugs can help to avoid the well-known risks of worsening or new onset of autoimmu...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Palazzi C, D'Amico E, D'Angelo S, Gilio M, Olivieri I Tags: World J Gastroenterol Source Type: research

Alcoholic liver disease and hepatitis C virus infection.
Abstract Alcohol consumption and hepatitis C virus (HCV) infection have a synergic hepatotoxic effect, and the coexistence of these factors increases the risk of advanced liver disease. The main mechanisms of this effect are increased viral replication and altered immune response, although genetic predisposition may also play an important role. Traditionally, HCV prevalence has been considered to be higher (up to 50%) in alcoholic patients than in the general population. However, the presence of advanced alcoholic liver disease (ALD) or intravenous drug use (IDU) may have confounded the results of previous studies,...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Novo-Veleiro I, Alvela-Suárez L, Chamorro AJ, González-Sarmiento R, Laso FJ, Marcos M Tags: World J Gastroenterol Source Type: research

New approaches in the treatment of hepatitis C.
Abstract About 130-170 million people, is estimated to be infected with the hepatitis C virus (HCV). Chronic HCV infection is one of the leading causes of liver-related death and in many countries it is the primary reason for having a liver transplant. The main aim of antiviral treatment is to eradicate the virus. Until a few years ago the only treatment strategy was based on the combination of pegylated interferon and ribavirin (PEG/RBV). However, in genotypes 1 and 4 the rates of viral response did not surpass 50%, reaching up to 80% in the rest. In 2011 approval was given for the first direct acting antiviral ag...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: González-Grande R, Jiménez-Pérez M, González Arjona C, Mostazo Torres J Tags: World J Gastroenterol Source Type: research

Gut epithelial barrier dysfunction in human immunodeficiency virus-hepatitis C virus coinfected patients: Influence on innate and acquired immunity.
Abstract Even in cases where viral replication has been controlled by antiretroviral therapy for long periods of time, human immunodeficiency virus (HIV)-infected patients have several non-acquired immunodeficiency syndrome (AIDS) related co-morbidities, including liver disease, cardiovascular disease and neurocognitive decline, which have a clear impact on survival. It has been considered that persistent innate and acquired immune activation contributes to the pathogenesis of these non-AIDS related diseases. Immune activation has been related with several conditions, remarkably with the bacterial translocation rel...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Márquez M, Fernández Gutiérrez Del Álamo C, Girón-González JA Tags: World J Gastroenterol Source Type: research

Natural killer cells in hepatitis C: Current progress.
Abstract Patients infected with the hepatitis C virus (HCV) are characterized by a high incidence of chronic infection, which results in chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. The functional impairment of HCV-specific T cells is associated with the evolution of an acute infection to chronic hepatitis. While T cells are the important effector cells in adaptive immunity, natural killer (NK) cells are the critical effector cells in innate immunity to virus infections. The findings of recent studies on NK cells in hepatitis C suggest that NK cell responses are indeed important in each phase o...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Yoon JC, Yang CM, Song Y, Lee JM Tags: World J Gastroenterol Source Type: research

Metabolic alterations and hepatitis C: From bench to bedside.
Abstract In addition to causing cirrhosis and hepatocellular carcinoma, hepatitis C virus (HCV) is thought to cause hypolipidemia, hepatic steatosis, insulin resistance, metabolic syndrome, and diabetes. The viral life cycle of HCV depends on cholesterol metabolism in host cells. HCV core protein and nonstructural protein 5A perturb crucial lipid and glucose pathways, such as the sterol regulatory element-binding protein pathway and the protein kinase B/mammalian target of rapamycin/S6 kinase 1 pathway. Although several lines of transgenic mice expressing core or full HCV proteins exhibit hepatic steatosis and/or d...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Chang ML Tags: World J Gastroenterol Source Type: research

Host restriction factors for hepatitis C virus.
Abstract Host-hepatitis C virus (HCV) interactions have both informed fundamental concepts of viral replication and pathogenesis and provided novel insights into host cell biology. These findings are illustrated by the recent discovery of host-encoded factors that restrict HCV infection. In this review, we briefly discuss these restriction factors in different steps of HCV infection. In each case, we discuss how these restriction factors were identified, the mechanisms by which they inhibit HCV infection and their potential contribution to viral pathogenesis. PMID: 26819515 [PubMed - in process] (Source: World...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Zhou LY, Zhang LL Tags: World J Gastroenterol Source Type: research

MicroRNA-mediated interactions between host and hepatitis C virus.
Abstract MicroRNAs (miRNAs) are small noncoding RNAs. More than 2500 mature miRNAs are detected in plants, animals and several types of viruses. Hepatitis C virus (HCV), which is a positive-sense, single-stranded RNA virus, does not encode viral miRNA. However, HCV infection alters the expression of host miRNAs, either in cell culture or in patients with liver disease progression, such as liver fibrosis, cirrhosis, and hepatocellular carcinoma. In turn, host miRNAs regulate HCV life cycle through directly binding to HCV RNAs or indirectly targeting cellular mRNAs. Increasing evidence demonstrates that miRNAs are on...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Li H, Jiang JD, Peng ZG Tags: World J Gastroenterol Source Type: research

Significance of hepatitis virus infection in the oncogenic initiation of hepatocellular carcinoma.
Abstract Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death worldwide. Chronic infection of hepatitis B virus (HBV) and/or hepatitis C virus (HCV) is a major risk factor in the development of the HCC, independently from excessive alcohol abuse and metabolic disease. Since the biology of HBV and HCV is different, their oncogenic effect may go through different mechanisms, direct and/or indirect. Viral hepatitis infection is associated with cellular inflammation, oxidative stress, and DNA damage, that may lead to subsequent hepatic injuries such as chronic hepatitis, fibrosis, cir...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Sukowati CH, El-Khobar KE, Ie SI, Anfuso B, Muljono DH, Tiribelli C Tags: World J Gastroenterol Source Type: research

Nutrition therapy: Integral part of liver transplant care.
Abstract Managing malnutrition before liver transplantation (LTx) while on the waiting list and, excessive weight gain/metabolic disturbances in post-surgery are still a challenge in LTx care. The aim of this review is to support an interdisciplinary nutrition approach of these patients. Cirrhotic patients are frequently malnourished before LTx and this is associated with a poor prognosis. Although the relation between nutritional status versus survival, successful operation and recovery after LTx is well established, prevalence of malnutrition before the operation is still very high. Emerging research has also dem...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Anastácio LR, Davisson Correia MI Tags: World J Gastroenterol Source Type: research

Liver transplantation in acute liver failure: A challenging scenario.
Abstract Acute liver failure is a critical medical condition defined as rapid development of hepatic dysfunction associated with encephalopathy. The prognosis in these patients is highly variable and depends on the etiology, interval between jaundice and encephalopathy, age, and the degree of coagulopathy. Determining the prognosis for this population is vital. Unfortunately, prognostic models with both high sensitivity and specificity for prediction of death have not been developed. Liver transplantation has dramatically improved survival in patients with acute liver failure. Still, 25% to 45% of patients will sur...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Mendizabal M, Silva MO Tags: World J Gastroenterol Source Type: research

Different behaviour of BK-virus infection in liver transplant recipients.
Abstract Polyomavirus BK (BKV) infects up to 90% of the general population. After primary infection, occurring early during childhood, a state of non-replicative infection is established in the reno-urinary tract, without complications for immunocompetent hosts. In immunocompromised individuals, particularly transplanted patients, asymptomatic BKV viremia and/or viruria can be observed. Renal grafts may also be sources of infection as BKV prefers kidneys rather than other solid organs for transplantation such as the liver. The mechanism behind the higher incidence of BKV infection in kidney transplant patients, com...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Umbro I, Tinti F, Muiesan P, Mitterhofer AP Tags: World J Gastroenterol Source Type: research

Hemostasis in liver transplantation: Pathophysiology, monitoring, and treatment.
Abstract Recent findings in the pathophysiology and monitoring of hemostasis in patients with end stage liver disease have major impact on coagulation management during liver transplantation. There is increasing evidence, that the changes in both coagulation factors and platelet count regularly observed in patients with liver cirrhosis cannot be interpreted as a reliable indicator of diffuse bleeding risk. Instead, a differentiated view on hemostasis has led to the concept of a rebalanced coagulation system: While it is important to recognize that procoagulant factors are reduced in liver cirrhosis, it is also evid...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Hartmann M, Szalai C, Saner FH Tags: World J Gastroenterol Source Type: research

Post reperfusion syndrome during liver transplantation: From pathophysiology to therapy and preventive strategies.
Abstract This review aims at evaluating the existing evidence regarding post reperfusion syndrome, providing a description of the pathophysiologic mechanisms involved and possible management and preventive strategies. A PubMed search was conducted using the MeSH database, "Reperfusion" AND "liver transplantation" were the combined MeSH headings; EMBASE and the Cochrane library were also searched using the same terms. 52 relevant studies and one ongoing trial were found. The concept of post reperfusion syndrome has evolved through years to a multisystemic disorder. The implications of the main organ, recipient and p...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Siniscalchi A, Gamberini L, Laici C, Bardi T, Ercolani G, Lorenzini L, Faenza S Tags: World J Gastroenterol Source Type: research

Liver transplantation for viral hepatitis in 2015.
Abstract Liver transplantation (LT) is a life-saving treatment for patients with end-stage liver disease and for patients with liver cell cancer related to liver disease. Acute and chronic liver diseases related to hepatitis viruses are between the main indications for liver transplantation. The risk of viral reinfection after transplantation is the main limiting factor in these indications. Before the availability of antiviral prophylaxis, hepatitis B virus (HBV) recurrence was universal in patients who were HBV DNA-positive before transplantation. The natural history of recurrent HBV was accelerated by immunosupp...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Ferrarese A, Zanetto A, Gambato M, Bortoluzzi I, Nadal E, Germani G, Senzolo M, Burra P, Russo FP Tags: World J Gastroenterol Source Type: research

Modulation of splanchnic circulation: Role in perioperative management of liver transplant patients.
Abstract Splanchnic circulation is the primary mechanism that regulates volumes of circulating blood and systemic blood pressure in patients with cirrhosis accompanied by portal hypertension. Recently, interest has been expressed in modulating splanchnic circulation in patients with liver cirrhosis, because this capability might produce beneficial effects in cirrhotic patients undergoing a liver transplant. Pharmacologic modulation of splanchnic circulation by use of vasoconstrictors might minimize venous congestion, replenish central blood flow, and thus optimize management of blood volume during a liver transplan...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Mukhtar A, Dabbous H Tags: World J Gastroenterol Source Type: research

Current diagnosis and treatment of benign biliary strictures after living donor liver transplantation.
Abstract Despite advances in surgical techniques, benign biliary strictures after living donor liver transplantation (LDLT) remain a significant biliary complication and play an important role in graft and patient survival. Benign biliary strictures after transplantation are classified into anastomotic or non-anastomotic strictures. These two types differ in presentation, outcome, and response to therapy. The leading causes of biliary strictures include impaired blood supply, technical errors during surgery, and biliary anomalies. Because patients usually have non-specific symptoms, a high index of suspicion should...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Chang JH, Lee I, Choi MG, Han SW Tags: World J Gastroenterol Source Type: research

Application of contrast-enhanced ultrasound after liver transplantation: Current status and perspectives.
We describe UCAs, their technical requirements, the recommended clinical indications, image interpretation and the limitations for contrast-enhanced ultrasound applications in liver transplantation. PMID: 26819526 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Ren J, Wu T, Zheng BW, Tan YY, Zheng RQ, Chen GH Tags: World J Gastroenterol Source Type: research

Vascular complications after adult living donor liver transplantation: Evaluation with ultrasonography.
Abstract Living donor liver transplantation (LDLT) has been widely used to treat end-stage liver disease with improvement in surgical technology and the application of new immunosuppressants. Vascular complications after liver transplantation remain a major threat to the survival of recipients. LDLT recipients are more likely to develop vascular complications because of their complex vascular reconstruction and the slender vessels. Early diagnosis and treatment are critical for the survival of graft and recipients. As a non-invasive, cost-effective and non-radioactive method with bedside availability, conventional ...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Ma L, Lu Q, Luo Y Tags: World J Gastroenterol Source Type: research

Impact of obesity treatment on gastroesophageal reflux disease.
This article aims to review the impact of both conservative and aggressive approaches of obesity treatment on GERD. PMID: 26819528 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Khan A, Kim A, Sanossian C, Francois F Tags: World J Gastroenterol Source Type: research

Diagnosing gastrointestinal illnesses using fecal headspace volatile organic compounds.
Abstract Volatile organic compounds (VOCs) emitted from stool are the components of the smell of stool representing the end products of microbial activity and metabolism that can be used to diagnose disease. Despite the abundance of hydrogen, carbon dioxide, and methane that have already been identified in human flatus, the small portion of trace gases making up the VOCs emitted from stool include organic acids, alcohols, esters, heterocyclic compounds, aldehydes, ketones, and alkanes, among others. These are the gases that vary among individuals in sickness and in health, in dietary changes, and in gut microbial a...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Chan DK, Leggett CL, Wang KK Tags: World J Gastroenterol Source Type: research

Hepatitis C in non-hepatic solid organ transplant candidates and recipients: A new horizon.
Abstract Hepatitis C virus (HCV) infection is estimated to affect 130-150 million people globally which corresponds to 2%-3% of the total world population. It remains the leading indication for liver transplant worldwide and has been demonstrated to negatively impact both patient and graft survival following non-hepatic organ transplantation. In the era of interferon-based therapy, although treatment and cure of HCV prior to non-hepatic transplant improved survival, tolerability and low cure rates substantially limited therapy. Interferon (IFN)-based therapy following non-hepatic solid organ transplant, due to the ...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Belga S, Doucette KE Tags: World J Gastroenterol Source Type: research

Mechanisms of intrahepatic triglyceride accumulation.
Abstract Hepatic steatosis defined as lipid accumulation in hepatocytes is very frequently found in adults and obese adolescents in the Western World. Etiologically, obesity and associated insulin resistance or excess alcohol intake are the most frequent causes of hepatic steatosis. However, steatosis also often occurs with chronic hepatitis C virus (HCV) infection and is also found in rare but potentially life-threatening liver diseases of pregnancy. Clinical significance and outcome of hepatic triglyceride accumulation are highly dependent on etiology and histological pattern of steatosis. This review summarizes ...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Ress C, Kaser S Tags: World J Gastroenterol Source Type: research

Diagnosis of follicular lymphoma of the gastrointestinal tract: A better initial diagnostic workup.
Abstract Due to an increasing incidence and more frequent recognition by endoscopists, gastrointestinal follicular lymphoma has been established as a variant of follicular lymphoma. However, due to its rarity, there are no established guidelines on the optimal diagnostic strategy for patients with primary gastrointestinal follicular lymphoma or secondary gastrointestinal involvement of systemic follicular lymphoma. This review offers an overview and pitfalls to avoid during the initial diagnostic workup of this disease entity. Previously reported case reports, case series, and retrospective studies are reviewed and...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Iwamuro M, Kondo E, Takata K, Yoshino T, Okada H Tags: World J Gastroenterol Source Type: research

Hepatitis C virus prevalence and genotype distribution in Pakistan: Comprehensive review of recent data.
Abstract Hepatitis C virus (HCV) is endemic in Pakistan and its burden is expected to increase in coming decades owing mainly to widespread use of unsafe medical procedures. The prevalence of HCV in Pakistan has previously been reviewed. However, the literature search conducted here revealed that at least 86 relevant studies have been produced since the publication of these systematic reviews. A revised updated analysis was therefore needed in order to integrate the fresh data. A systematic review of data published between 2010 and 2015 showed that HCV seroprevalence among the general adult Pakistani population is ...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Umer M, Iqbal M Tags: World J Gastroenterol Source Type: research

Appraisal of needle-based confocal laser endomicroscopy in the diagnosis of pancreatic cysts.
Abstract Nearly 2.5% of cross-sectional imaging studies will report a finding of a cystic pancreatic lesion. Even though most of these are incidental findings, it remains very concerning for both patients and treating clinicians. Differentiating and predicting malignant transformation in pancreatic cystic lesions is clinically challenging. Current evaluation of suspicious cystic lesions includes a combination of radiologic imaging, endoscopic ultrasound (EUS) and cyst fluid analyses. Despite these attempts, precise diagnostic stratification among non-mucinous, mucinous, and malignant cystic lesions is often not pos...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Krishna SG, Lee JH Tags: World J Gastroenterol Source Type: research

Non-invasive assessment of liver fibrosis: Between prediction/prevention of outcomes and cost-effectiveness.
Abstract The assessment of the fibrotic evolution of chronic hepatitis has always been a challenge for the clinical hepatologist. Over the past decade, various non-invasive methods have been proposed to detect the presence of fibrosis, including the elastometric measure of stiffness, panels of clinical and biochemical parameters, and combinations of both methods. The aim of this review is to analyse the most recent data on non-invasive techniques for the evaluation of hepatic fibrosis with particular attention to cost-effectiveness. We searched for relevant studies published in English using the PubMed database fro...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Stasi C, Milani S Tags: World J Gastroenterol Source Type: research

Systematic review of prognostic importance of extramural venous invasion in rectal cancer.
CONCLUSION: Historically, there has been huge variation in the prevalence of EMVI through inconsistent reporting. However the presence of EMVI clearly leads to worse survival outcomes. As detection rates become more consistent, EMVI may be considered as part of risk-stratification in rectal cancer. Standardised histopathological definitions and the use of magnetic resonance imaging to identify EMVI will improve detection rates in the future. PMID: 26819536 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Chand M, Siddiqui MR, Swift I, Brown G Tags: World J Gastroenterol Source Type: research

Treatment of chronic hepatitis B patients with tyrosine-methionine-aspartate-aspartate mutations.
Abstract Lamivudine is an antiviral used for the treatment of chronic hepatitis B. Several studies have reported various mutations that are induced by lamivudine therapy. These mutations in the tyrosine-methionine-aspartate-aspartate (YMDD) motif are necessary and sufficient to confer high-level lamivudine resistance. During treatment with lamivudine, mutations develop in the YMDD motif of the hepatitis B virus (HBV) polymerase gene and lamivudine cannot prevent the replication of the mutant form. The virulence strain of developed mutation in the polymerase gene is lower than the original virus and they are suscept...
Source: World Journal of Gastroenterology : WJG - January 28, 2016 Category: Gastroenterology Authors: Calica Utku A, Karabay O Tags: World J Gastroenterol Source Type: research

Diet and nutritional factors in inflammatory bowel diseases.
Abstract Inflammatory bowel disease (IBD) development is affected by complex interactions between environmental factors, changes in intestinal flora, various predisposing genetic properties and changes in the immune system. Dietary factors seem to play an underestimated role in the etiopathogenesis and course of the disease. However, research about food and IBD is conflicting. An excessive consumption of sugar, animal fat and linoleic acid is considered a risk factor for IBD development, whereas a high fiber diet and citrus fruit consumption may play a protective role. Also, appropriate nutrition in particular peri...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Owczarek D, Rodacki T, Domagała-Rodacka R, Cibor D, Mach T Tags: World J Gastroenterol Source Type: research

Bisphosphonates as potential adjuvants for patients with cancers of the digestive system.
Abstract Best known for their anti-resorptive activity in bone, bisphosphonates (BPs) have generated interest as potential antineoplastic agents given their pleiotropic biological effects which include antiproliferative, antiangiogenic and immune-modulating properties. Clinical studies in multiple malignancies suggest that BPs may be active in the prevention or treatment of cancer. Digestive tract malignancies represent a large and heterogeneous disease group, and the activity of BPs in these cancers has not been extensively studied. Recent data showing that some BPs inhibit human epidermal growth factor receptor (...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Ang C, Doyle E, Branch A Tags: World J Gastroenterol Source Type: research

Inflammatory bowel disease imaging: Current practice and future directions.
Abstract The purpose of this paper is to evaluate the role of imaging in inflammatory bowel disease (IBD), including detection of extraluminal complications and extraintestinal manifestations of IBD, assessment of disease activity and treatment response, and discrimination of inflammatory from fibrotic strictures. IBD is a chronic idiopathic disease affecting the gastrointestinal tract that is comprised of two separate, but related intestinal disorders; Crohn's disease and ulcerative colitis. The paper discusses, in detail the pros and cons of the different IBD imaging modalities that need to be considered in order...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Kilcoyne A, Kaplan JL, Gee MS Tags: World J Gastroenterol Source Type: research

Protective links between vitamin D, inflammatory bowel disease and colon cancer.
Abstract Vitamin D deficiency has been associated with a wide range of diseases and multiple forms of cancer including breast, colon, and prostate cancers. Relatively recent work has demonstrated vitamin D to be critical in immune function and therefore important in inflammatory diseases such as inflammatory bowel disease (IBD). Because vitamin D deficiency or insufficiency is increasingly prevalent around the world, with an estimated 30%-50% of children and adults at risk for vitamin D deficiency worldwide, it could have a significant impact on IBD. Epidemiologic studies suggest that low serum vitamin D levels are...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Meeker S, Seamons A, Maggio-Price L, Paik J Tags: World J Gastroenterol Source Type: research

Application of computational methods in genetic study of inflammatory bowel disease.
Abstract Genetic factors play an important role in the etiology of inflammatory bowel disease (IBD). The launch of genome-wide association study (GWAS) represents a landmark in the genetic study of human complex disease. Concurrently, computational methods have undergone rapid development during the past a few years, which led to the identification of numerous disease susceptibility loci. IBD is one of the successful examples of GWAS and related analyses. A total of 163 genetic loci and multiple signaling pathways have been identified to be associated with IBD. Pleiotropic effects were found for many of these loci;...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Li J, Wei Z, Hakonarson H Tags: World J Gastroenterol Source Type: research

Inflammatory bowel disease associated neoplasia: A surgeon's perspective.
Abstract Inflammatory bowel disease (IBD) is associated with increased risk of colorectal cancer (CRC). The risk is known to increase with longer duration of the disease, family history of CRC, and history of primary sclerosing cholangitis. The diagnosis of the neoplastic changes associated with IBD is difficult owing to the heterogeneous endoscopic appearance and inter-observer variability of the pathological diagnosis. Screening and surveillance guidelines have been established which aim for early detection of neoplasia. Several surgical options are available for the treatment of IBD-associated neoplasia. Patient...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Althumairi AA, Lazarev MG, Gearhart SL Tags: World J Gastroenterol Source Type: research

Disrupted regulatory T cell homeostasis in inflammatory bowel diseases.
Abstract In the gut, where billions of non-self-antigens from the food and the microbiota are present, the immune response must be tightly regulated to ensure both host protection against pathogenic microorganisms and the absence of immune-related pathologies. It has been well documented that regulatory T cells (Tregs) play a pivotal role in this context. Indeed, Tregs are able to prevent excessive inflammation, which can lead to the rupture of intestinal homeostasis observed in inflammatory bowel diseases (IBDs). Both the worldwide incidence and prevalence of such diseases have increased throughout the latter part...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Pedros C, Duguet F, Saoudi A, Chabod M Tags: World J Gastroenterol Source Type: research

Diagnostic imaging advances in murine models of colitis.
Abstract Inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis are chronic-remittent inflammatory disorders of the gastrointestinal tract still evoking challenging clinical diagnostic and therapeutic situations. Murine models of experimental colitis are a vital component of research into human IBD concerning questions of its complex pathogenesis or the evaluation of potential new drugs. To monitor the course of colitis, to the present day, classical parameters like histological tissue alterations or analysis of mucosal cytokine/chemokine expression often require euthanasia of animals. Rec...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Brückner M, Lenz P, Mücke MM, Gohar F, Willeke P, Domagk D, Bettenworth D Tags: World J Gastroenterol Source Type: research

Assessment of stricturing Crohn's disease: Current clinical practice and future avenues.
Abstract Crohn's disease (CD) is a chronic remittent idiopathic disease. Although the early phase of the disease is commonly characterized by inflammation-driven symptoms, such as diarrhea, the frequency of fibrostenotic complications in patients with CD increases over the long-term course of the disease. This review presents the current diagnostic options for assessing CD-associated strictures. In addition to the endoscopic evaluation of CD strictures, this review summarizes the currently available imaging modalities, including ultrasound and cross-sectional imaging techniques. In addition to stricture detection, ...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Bettenworth D, Nowacki TM, Cordes F, Buerke B, Lenze F Tags: World J Gastroenterol Source Type: research

How to predict clinical relapse in inflammatory bowel disease patients.
Abstract Inflammatory bowel diseases have a natural course characterized by alternating periods of remission and relapse. Disease flares occur in a random way and are currently unpredictable for the most part. Predictors of benign or unfavourable clinical course are required to facilitate treatment decisions and to avoid overtreatment. The present article provides a literature review of the current evidence on the main clinical, genetic, endoscopic, histologic, serologic and fecal markers to predict aggressiveness of inflammatory bowel disease and discuss their prognostic role, both in Crohn's disease and ulcerativ...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Liverani E, Scaioli E, Digby RJ, Bellanova M, Belluzzi A Tags: World J Gastroenterol Source Type: research

Protein tyrosine phosphatase non-receptor type 2 and inflammatory bowel disease.
Abstract Genome wide association studies have associated single nucleotide polymorphisms within the gene locus encoding protein tyrosine phosphatase non-receptor type 2 (PTPN2) with the onset of inflammatory bowel disease (IBD) and other inflammatory disorders. Expression of PTPN2 is enhanced in actively inflamed intestinal tissue featuring a marked up-regulation in intestinal epithelial cells. PTPN2 deficient mice suffer from severe intestinal and systemic inflammation and display aberrant innate and adaptive immune responses. In particular, PTPN2 is involved in the regulation of inflammatory signalling cascades, ...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Spalinger MR, McCole DF, Rogler G, Scharl M Tags: World J Gastroenterol Source Type: research

Advances in nutritional therapy in inflammatory bowel diseases: Review.
Abstract Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn's disease are chronic, life-long, and relapsing diseases of the gastrointestinal tract. Currently, there are no complete cure possibilities, but combined pharmacological and nutritional therapy may induce remission of the disease. Malnutrition and specific nutritional deficiencies are frequent among IBD patients, so the majority of them need nutritional treatment, which not only improves the state of nutrition of the patients but has strong anti-inflammatory activity as well. Moreover, some nutrients, from early stages of life are su...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Wędrychowicz A, Zając A, Tomasik P Tags: World J Gastroenterol Source Type: research

Endothelial dysfunction in inflammatory bowel diseases: Pathogenesis, assessment and implications.
Abstract Endothelial dysfunction is considered one of the etiological factors of inflammatory bowel disease (IBD). An inflammatory process leads to functional and structural changes in the vascular endothelium. An increase of leukocyte adhesiveness and leukocyte diapedesis, as well as an increased vascular smooth muscle tone and procoagulant activity is observed. Structural changes of the vascular endothelium comprise as well capillary and venule remodeling and proliferation of endothelial cells. Hypoxia in the inflammatory area stimulates angiogenesis by up-regulation of vascular endothelial growth factor, fibrobl...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Cibor D, Domagala-Rodacka R, Rodacki T, Jurczyszyn A, Mach T, Owczarek D Tags: World J Gastroenterol Source Type: research

Role of antibiotics for treatment of inflammatory bowel disease.
Abstract Inflammatory bowel disease is thought to be caused by an aberrant immune response to gut bacteria in a genetically susceptible host. The gut microbiota plays an important role in the pathogenesis and complications of the two main inflammatory bowel diseases: Crohn's disease (CD) and ulcerative colitis. Alterations in gut microbiota, and specifically reduced intestinal microbial diversity, have been found to be associated with chronic gut inflammation in these disorders. Specific bacterial pathogens, such as virulent Escherichia coli strains, Bacteroides spp, and Mycobacterium avium subspecies paratuberculo...
Source: World Journal of Gastroenterology : WJG - January 21, 2016 Category: Gastroenterology Authors: Nitzan O, Elias M, Peretz A, Saliba W Tags: World J Gastroenterol Source Type: research