News & Views

A new case report of successful treatment of refractory ulcerative colitis with CD19-directed chimeric antigen receptor T cell therapy sheds light on the role of B lineage cells in disease pathogenesis and the possibility of an ‘immune reset’. This approach could reshape therapeutic strategies, although its long-term efficacy, safety and positioning remain open questions.

In a new study by Liu and colleagues, researchers demonstrated a novel neuroepithelial circuit in colonic neuropod cells through which a molecular pattern from resident microorganisms was relayed to the brain — a ‘neurobiotic sense’ by which the host adjusted its feeding behaviour by monitoring a gut microbial pattern.

Glucagon-like peptide 1 receptor agonists are effective pharmacotherapies for the treatment of obesity and related disorders. In metabolic dysfunction-associated steatohepatitis with moderate to advanced fibrosis, semaglutide improved liver histology over 72 weeks. In another new study, tirzepatide was superior to semaglutide in reducing body weight in individuals with obesity.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a heterogeneous disease regarding its pathophysiology and clinical outcomes. Two novel studies suggest that different clusters of people with MASLD exist, explaining part of this heterogeneity. These findings and future research applying data dimensionality reduction approaches might be beneficial for implementing precision medicine in MASLD.

A study in Nature Medicine developed a new clinical test based on a gut metagenome-derived multispecies biomarker panel for the diagnosis of inflammatory bowel disease, which outperformed faecal calprotectin. Shortly after, a study in Cell identified a health-relevant network-based core microbiome that could substantially advance precision microbiome medicine.

The advent of next-generation RAS inhibitors brings renewed optimism to the care of patients with pancreatic cancer after decades of failure for novel therapeutics. A recent study highlights the potent antitumour activity of the multi-selective RAS(ON) inhibitor RMC-7977 across a spectrum of preclinical pancreatic cancer models.

An expert panel has proposed 28 recommendations for the design and conduct of clinical trials for alcohol use disorders and alcohol-associated liver disease. This field has a scarcity of clinical trials, despite alcohol abuse and alcohol-related liver disease being one of the greatest causes of morbidity and mortality worldwide.

A new study by Díaz and colleagues links strong alcohol policy with improved health and societal outcomes. The evidence for what works to reduce the enormous burden from alcohol is clear. The question is why are governments still not acting?

Metabolic dysfunction-associated steatotic liver disease (MASLD) has a strong heritable component, and genome-wide association cohort studies are highlighting the major genetic determinants of this condition. A meta-analysis of these databases has now enabled expansion of the list of the inherited variants that modulate the risk of MASLD. The identification of new MASLD risk loci is improving comprehension of disease pathogenesis and individual risk stratification, and also enabling the identification of novel therapeutic targets and disease subtypes that might ultimately lead to a precision medicine approach.

Innovative approaches to increase testing are needed to achieve the 2030 hepatitis B and hepatitis C elimination targets. Zhang et al., partnering with local community organizations, successfully used a pay-it-forward approach to increase hepatitis B and hepatitis C testing among men who have sex with men in China.

Recent clinical trials have demonstrated efficacy and safety of etrasimod, a new sphingosine-1-phosphate receptor modulator, in the treatment of patients with moderately-to-severely active ulcerative colitis. Etrasimod is a promising new oral treatment option for ulcerative colitis, although long-term efficacy and safety data should be accumulated.

A new study has found that a strain of the gut bacterium Lactiplantibacillus plantarum activates a NOD2–type I interferon–insulin-like growth factor 1 pathway in young mice to partially protect against the deleterious growth effects of a diet deficient in protein and fat. Could live biotherapeutic products or their derivatives unlock the full potential of nutritional interventions against childhood stunting?

A prospective study suggests that the risk of liver fibrosis with methotrexate treatment has been overestimated. The findings suggest the need to reconsider the intensive strategies and the screening tools that are recommended for monitoring liver fibrosis in patients receiving methotrexate.

In a study published in Nature, new data have highlighted the bacterial strain-level sharing rates of mother–offspring pairs, twins, families, cohabiting individuals and individuals within a population, as well as those between different populations, providing a comprehensive view of the transmission landscape of the intestinal and oral microbiome in humans. These findings highlight the need to reassess diseases currently considered to be non-communicable and underscore the importance of considering social structure and transmissibility in the design of microbial studies.

New data suggest that moderate fluid resuscitation is safer in acute pancreatitis than the standard aggressive fluid resuscitation. The findings suggest that an approach that includes safety and goal-directed checkpoints could enable treatment to be individualized and highlight the importance of clinical evidence in challenging dogma and improving evidence-based medicine.

Microbiota profiling using stool samples is limited in its ability to represent intestinal microbial dynamics. CRISPR-engineered bacteria can be used to acquire cellular RNAs and create a gene expression ‘memory’ during gastrointestinal transit, with the potential to capture microbial transcriptomic changes in the gastrointestinal tract without invasive sampling.

Owing to its simplicity, dextran sulfate sodium (DSS)-induced colitis is one of the most widely used mouse models of colitis. However, the severity of inflammation varies from one experiment to another. In a new study, Forster and colleagues have provided new insights into the DSS model by revealing specific microbial taxa that underlie disease variability.

New data demonstrate racial and ethnic disparities in access to prescription medications in persons with chronic liver disease in the USA. Here, we discuss potential health equity solutions that address structural and social determinants of health to mitigate liver health inequities in access to liver disease pharmacotherapies.

The liver microenvironment has a dynamic complexity that has not yet been adequately described. A new omics study sheds light on the hepatic parenchymal and immune cell heterogeneity by focusing on the spatial distribution of myeloid cells and macrophages in homeostasis and nonalcoholic fatty liver disease.

A subset of colorectal cancers arises from sessile serrated lesions. Tumorigenesis via the serrated neoplasia pathway is largely unexplored. Now, a new study suggests that this pathway is initiated by gastric metaplasia induced by damage and repair, which is triggered by disadvantageous composition of microbiota in the proximal colon.