Reviews & Analysis

Pancreatic development is a dynamic process. This Review discusses the development and cellular plasticity that occurs in the pancreas in health and disease, with insights into early development, endocrine and exocrine lineages and the pancreatic microenvironment.

Cirrhosis, portal hypertension and hepatocellular carcinoma (HCC) are interconnected but are often addressed separately. This Review outlines the key interactions between portal hypertension and HCC in cirrhosis, and explores the management of these conditions across all stages, proposing an integrated, stage-based management framework.

γδ T cells are an important component of local immune surveillance. This Review discusses their role in colorectal cancer and hepatocellular carcinoma development and provides a detailed overview of their therapeutic potential.

This Review outlines the role of gut–brain signalling in eating behaviour and obesity, highlighting gut-derived signals and cues relevant during eating phases. Underlying mechanisms of this gut–brain communication are discussed alongside the key role of the vagus nerve in this process.

Metabolic dysfunction-associated steatotic liver disease (MASLD) involves multifactorial metabolic, inflammatory and oxidative stress-driven pathology. In this Perspective, we highlight the role of cytochrome P450 oxidoreductase (CPR) as a potentially overlooked regulator of pathways shaping MASLD development and progression.

Steatotic liver disease (SLD), including metabolic dysfunction-associated SLD, requires an age-tailored treatment approach across the life course. This Review highlights age-adjusted lifestyle approaches (such as diet and physical activity) for the prevention and management of SLD, with insights and practical guidance across age groups, from infancy to older age.

In this Review, Lenti and colleagues discuss advances in the epidemiology, pathogenesis, clinical management and endoscopic surveillance of autoimmune gastritis. They also outline directions for future research.

Concerns have been raised as to whether microplastics and nanoplastics (MNPs) influence human health. This Perspective examines the emerging evidence on MNP accumulation in the liver and its potential effects on human liver health and disease. Research gaps and priorities are also addressed.

In this Review, Jiang and colleagues describe how gut microbial enzymes regulate host metabolic health and diseases. They also discuss the methodology for studying gut microbial enzymes and their potential clinical applications.

In this Review, Neufert and Neurath discuss the pathophysiological mechanisms of colitis-associated colorectal cancer, focusing on the tumour epithelium, stromal cells, mucosal barrier and mechanisms of tumour development. They also discuss potential implications for personalized therapy.

In this Perspective, Iacucci and colleagues describe the role of artificial intelligence in inflammatory bowel disease care, highlighting emerging applications as well as implications for implementation.

Current drug approvals reshape metabolic dysfunction-associated steatohepatitis (MASH) therapeutic strategies. This Review highlights current and emerging therapeutic targets and discusses a mechanism-based framework for personalized, combination-oriented management in MASH.

‘Gut health’ is a widely used term, but there is much uncertainty and inconsistency related to its use. An international panel has now provided a definition that includes consideration of both gastrointestinal function and symptom burden. While advancing the field, the definition also prompts a number of areas of debate.

Metabolites are important mediators of metabolism at the cellular and organismal levels. This Review explores the concept of metabotherapy, harnessing metabolites to prevent and treat gastrointestinal disorders, providing insights into metabolite classifications and their pathophysiological mechanisms in health and disease and mapping their potential as therapeutic targets.

This Consensus Statement provides a definition of the term ‘gut health’, as well as a discussion of the relevant domains that contribute to gut health and a framework for appropriate use of the term in the context of therapeutic interventions.

Steatotic liver diseases affect millions worldwide through alcohol and metabolic insults. This Review highlights steatotic liver disease genetic architecture, how it informs disease biology, drug discovery and risk stratification through polygenic risk scores and the need for improved clinical applications.

Steatotic liver disease (SLD), which might lead to cirrhosis and hepatocellular carcinoma, is on the rise worldwide. This Expert Recommendation draws on lessons learned to tackle viral hepatitis and proposes a framework for SLD screening and testing policies.

Preclinical models are essential to study disease pathogenesis and test novel treatments. Here, a broad overview of metabolic dysfunction-associated steatotic liver disease and steatohepatitis-associated hepatocarcinoma preclinical models is provided, detailing main features, advances and limitations of in vitro and in vivo models, and how they translate to human disease.

Protein is an essential nutrient in the human diet. This Review explores the fate of dietary protein in the gastrointestinal tract and its influence on colonic health and disease, providing insights into dietary protein metabolism, digestion, absorption, fermentation and the implications for colonic health.

Some of the highlights in the pancreatic cancer field in 2025 include long-term data on personalized neoantigen vaccine approaches in resected pancreatic adenocarcinoma, detailed clinico-genomic analyses of large clinical trial datasets, and therapeutic strategies for early-stage disease.