Pub Date : 2024-05-28DOI: 10.1038/s41575-024-00934-z
Adrià Cañellas-Socias, Elena Sancho, Eduard Batlle
Despite extensive research and improvements in understanding colorectal cancer (CRC), its metastatic form continues to pose a substantial challenge, primarily owing to limited therapeutic options and a poor prognosis. This Review addresses the emerging focus on metastatic CRC (mCRC), which has historically been under-studied compared with primary CRC despite its lethality. We delve into two crucial aspects: the molecular and cellular determinants facilitating CRC metastasis and the principles guiding the evolution of metastatic disease. Initially, we examine the genetic alterations integral to CRC metastasis, connecting them to clinically marked characteristics of advanced CRC. Subsequently, we scrutinize the role of cellular heterogeneity and plasticity in metastatic spread and therapy resistance. Finally, we explore how the tumour microenvironment influences metastatic disease, emphasizing the effect of stromal gene programmes and the immune context. The ongoing research in these fields holds immense importance, as its future implications are projected to revolutionize the treatment of patients with mCRC, hopefully offering a promising outlook for their survival. Metastatic colorectal cancer (mCRC) has a poor prognosis, and therapeutic options are limited. This Review provides a comprehensive overview of the genetic and molecular underpinnings of mCRC, discussing the therapeutic potential arising from this knowledge.
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Pub Date : 2024-05-23DOI: 10.1038/s41575-024-00945-w
Katrina Ray
{"title":"Positive phase III trials for ileal bile acid transporter inhibitors","authors":"Katrina Ray","doi":"10.1038/s41575-024-00945-w","DOIUrl":"10.1038/s41575-024-00945-w","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":45.9,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-22DOI: 10.1038/s41575-024-00946-9
Katrina Ray
{"title":"Sex and ethnic disparities persist in hepatitis B management","authors":"Katrina Ray","doi":"10.1038/s41575-024-00946-9","DOIUrl":"10.1038/s41575-024-00946-9","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":45.9,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-21DOI: 10.1038/s41575-024-00947-8
Katrina Ray
{"title":"Microbiota and colorectal cancer — controlling for confounders challenges associations","authors":"Katrina Ray","doi":"10.1038/s41575-024-00947-8","DOIUrl":"10.1038/s41575-024-00947-8","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":45.9,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141073816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-19DOI: 10.1038/s41575-024-00932-1
Daniel R. Dickstein, Collin R. Edwards, Catherine R. Rowan, Bella Avanessian, Barbara M. Chubak, Christopher W. Wheldon, Priya K. Simoes, Michael H. Buckstein, Laurie A. Keefer, Joshua D. Safer, Keith Sigel, Karyn A. Goodman, B. R. Simon Rosser, Stephen E. Goldstone, Serre-Yu Wong, Deborah C. Marshall
The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI — encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable. Receptive anal intercourse (RAI) is an important consideration in gastrointestinal disorders and cancers. This Review discusses the anorectum as a sexual organ, providing an overview of pleasurable and problematic RAI and how gastrointestinal disease itself and associated treatments (such as surgery) can affect RAI. Strategies to manage problematic RAI to improve sexual health are also described.
体验愉悦性活动的能力对人类健康非常重要。接受性肛交（RAI）是一种常见的愉悦性活动，尽管经常被人鄙视。人们对结肠、直肠和肛门疾病及其治疗对肛交的影响知之甚少。由于症状和治疗相关毒性反应的不可预测性，患有胃肠道疾病的患者很难进行 RAI。患者可能会出现括约肌张力过高、胃肠道症状特有的焦虑、结构性疾病导致的骨盆血流改变、癌症导向疗法导致的感觉减退或造口术导致的身体形象问题。这些都可能导致 RAI 问题--包括无性交痛（RAI 疼痛）、性唤起功能障碍、性高潮功能障碍和性欲减退。针对患有胃肠道疾病和/或与治疗相关的功能障碍的患者的 RAI 问题，治疗策略包括骨盆底肌肉强化和拉伸、心理干预和恢复装置。为医护人员提供一个讨论愉悦性 RAI 和诊断有问题 RAI 的框架，有助于改善患者的治疗效果。将 RAI 正常化、肯定 RAI 带来的快感并承认胃肠道系统与性快感、性功能和性健康有关，将有助于将性健康的科学范式转变为更加公正和公平的范式。
{"title":"Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus","authors":"Daniel R. Dickstein, Collin R. Edwards, Catherine R. Rowan, Bella Avanessian, Barbara M. Chubak, Christopher W. Wheldon, Priya K. Simoes, Michael H. Buckstein, Laurie A. Keefer, Joshua D. Safer, Keith Sigel, Karyn A. Goodman, B. R. Simon Rosser, Stephen E. Goldstone, Serre-Yu Wong, Deborah C. Marshall","doi":"10.1038/s41575-024-00932-1","DOIUrl":"10.1038/s41575-024-00932-1","url":null,"abstract":"The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI — encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable. Receptive anal intercourse (RAI) is an important consideration in gastrointestinal disorders and cancers. This Review discusses the anorectum as a sexual organ, providing an overview of pleasurable and problematic RAI and how gastrointestinal disease itself and associated treatments (such as surgery) can affect RAI. Strategies to manage problematic RAI to improve sexual health are also described.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41575-024-00932-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-15DOI: 10.1038/s41575-024-00942-z
Jordan Hindson
{"title":"Telemedicine for hepatitis C virus treatment in opioid treatment programmes","authors":"Jordan Hindson","doi":"10.1038/s41575-024-00942-z","DOIUrl":"10.1038/s41575-024-00942-z","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140940062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-14DOI: 10.1038/s41575-024-00941-0
Jordan Hindson
{"title":"Multi-omic links between gut microbiome and cardiovascular disease","authors":"Jordan Hindson","doi":"10.1038/s41575-024-00941-0","DOIUrl":"10.1038/s41575-024-00941-0","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":null,"pages":null},"PeriodicalIF":65.1,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140919744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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