Pub Date : 2025-06-19DOI: 10.1038/s41575-025-01093-5
Burcin Ekser, Luis A. Fernandez
Liver xenotransplantation and genetically engineered pig livers have potential to save human lives. Liver xenotransplants can either act as a bridge to allotransplantation or support the recovery and regeneration of a whole or reduced native liver in acute liver failure and in major hepatectomies through ex vivo perfusion or auxiliary liver xenotransplantation.
{"title":"Promise and pitfalls of liver xenotransplantation","authors":"Burcin Ekser, Luis A. Fernandez","doi":"10.1038/s41575-025-01093-5","DOIUrl":"10.1038/s41575-025-01093-5","url":null,"abstract":"Liver xenotransplantation and genetically engineered pig livers have potential to save human lives. Liver xenotransplants can either act as a bridge to allotransplantation or support the recovery and regeneration of a whole or reduced native liver in acute liver failure and in major hepatectomies through ex vivo perfusion or auxiliary liver xenotransplantation.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"22 8","pages":"527-528"},"PeriodicalIF":51.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319681","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 : 2025-06-18DOI: 10.1038/s41575-025-01086-4
Mark Rochman, Kendall Kellerman, Michael P. Jankowski, Marc E. Rothenberg
The oesophagus has traditionally been viewed as a simple conduit for food transport. In performing this delivery function, it confronts a continuous influx of foreign antigens, including food particles with variable microbial content, and encounters many biophysical stimuli triggered by food textures and temperature. To meet these challenges, the oesophagus comprises a robust barrier featuring a thick, multilayered epithelium coated by mucins and mechanically held together by strong adhesion complexes, including desmosomal junctions. Sentinel immune cells, including a notable presence of CD8+ resident memory T cells, mast cells and dendritic cells, are abundant alongside IL-1 family cytokines released and activated under tight homeostatic regulation through a balance of proteases and antiproteases. Pattern recognition receptors, such as Toll-like receptors on epithelial cells, identify foreign antigens and can trigger cytokine release. Disruptions, whether acquired or genetically inherited, in these innate immune functions contribute to disease onset. Here, we present evidence that the oesophagus is an immune organ with extensive sensing properties designed to tolerate and mount defences against antigenic and biophysical challenges. This Perspective article provides a detailed overview of the oesophagus as an immune organ, highlighting its innate immune components and sensing mechanisms that maintain homeostasis and barrier integrity while responding to antigenic and biophysical challenges.
{"title":"The oesophagus as an immune organ","authors":"Mark Rochman, Kendall Kellerman, Michael P. Jankowski, Marc E. Rothenberg","doi":"10.1038/s41575-025-01086-4","DOIUrl":"10.1038/s41575-025-01086-4","url":null,"abstract":"The oesophagus has traditionally been viewed as a simple conduit for food transport. In performing this delivery function, it confronts a continuous influx of foreign antigens, including food particles with variable microbial content, and encounters many biophysical stimuli triggered by food textures and temperature. To meet these challenges, the oesophagus comprises a robust barrier featuring a thick, multilayered epithelium coated by mucins and mechanically held together by strong adhesion complexes, including desmosomal junctions. Sentinel immune cells, including a notable presence of CD8+ resident memory T cells, mast cells and dendritic cells, are abundant alongside IL-1 family cytokines released and activated under tight homeostatic regulation through a balance of proteases and antiproteases. Pattern recognition receptors, such as Toll-like receptors on epithelial cells, identify foreign antigens and can trigger cytokine release. Disruptions, whether acquired or genetically inherited, in these innate immune functions contribute to disease onset. Here, we present evidence that the oesophagus is an immune organ with extensive sensing properties designed to tolerate and mount defences against antigenic and biophysical challenges. This Perspective article provides a detailed overview of the oesophagus as an immune organ, highlighting its innate immune components and sensing mechanisms that maintain homeostasis and barrier integrity while responding to antigenic and biophysical challenges.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"22 9","pages":"657-667"},"PeriodicalIF":51.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319631","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 : 2025-06-16DOI: 10.1038/s41575-025-01085-5
Otto B. van Leeuwen, David Nasralla, Carlo D. L. Ceresa, Philipp Dutkowski, Peter J. Friend, Gabriel C. Oniscu, Robert J. Porte, Vincent E. de Meijer, on behalf of the COPE 2 Consortium
Liver transplantation is challenged by organ scarcity and ageing donors. Machine perfusion is a promising technique to enhance organ preservation and assessment, improving liver utilization and patient outcomes. Here, we discuss current practices in machine perfusion using the IDEAL framework and outline the steps needed to advance this technology clinically.
{"title":"The IDEAL framework for machine perfusion in liver transplantation","authors":"Otto B. van Leeuwen, David Nasralla, Carlo D. L. Ceresa, Philipp Dutkowski, Peter J. Friend, Gabriel C. Oniscu, Robert J. Porte, Vincent E. de Meijer, on behalf of the COPE 2 Consortium","doi":"10.1038/s41575-025-01085-5","DOIUrl":"10.1038/s41575-025-01085-5","url":null,"abstract":"Liver transplantation is challenged by organ scarcity and ageing donors. Machine perfusion is a promising technique to enhance organ preservation and assessment, improving liver utilization and patient outcomes. Here, we discuss current practices in machine perfusion using the IDEAL framework and outline the steps needed to advance this technology clinically.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"22 10","pages":"669-671"},"PeriodicalIF":51.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296046","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 : 2025-06-04DOI: 10.1038/s41575-025-01084-6
Richard Parker, Juan P. Arab, Jeffrey V. Lazarus, Ramon Bataller, Ashwani K. Singal
Alcohol-related liver disease (ALD) is a major cause of morbidity and premature mortality around the world, with a substantial cost to individuals and to health-care systems. The incidence of ALD is closely associated with alcohol intake, and it is a preventable disease. There is clear evidence that public health measures to reduce alcohol consumption are effective, which in turn can have a positive effect on ALD. Effective policy includes controlling the price of alcohol, limiting or banning alcohol advertising and restricting the availability of alcohol. The strength of public health policy depends on the political willingness to develop robust strategies. However, effective lobbying of policy-makers by the alcohol industry and lack of political will are barriers to the implementation of these measures, resulting in suboptimal national alcohol control policies. Clinicians are well-placed to campaign for effective public health policy regarding alcohol to reduce the prevalence of ALD for the benefit of patients, their families and wider society. In this Perspective, we summarize the evidence for public health policies that affect alcohol consumption and the prevalence of ALD. There is clear evidence that public health measures to reduce alcohol consumption are effective, which can have a positive effect on alcohol-related liver disease. In this Perspective, Parker and colleagues discuss public health policies that affect alcohol consumption and alcohol-related liver disease.
{"title":"Public health policies to prevent alcohol-related liver disease","authors":"Richard Parker, Juan P. Arab, Jeffrey V. Lazarus, Ramon Bataller, Ashwani K. Singal","doi":"10.1038/s41575-025-01084-6","DOIUrl":"10.1038/s41575-025-01084-6","url":null,"abstract":"Alcohol-related liver disease (ALD) is a major cause of morbidity and premature mortality around the world, with a substantial cost to individuals and to health-care systems. The incidence of ALD is closely associated with alcohol intake, and it is a preventable disease. There is clear evidence that public health measures to reduce alcohol consumption are effective, which in turn can have a positive effect on ALD. Effective policy includes controlling the price of alcohol, limiting or banning alcohol advertising and restricting the availability of alcohol. The strength of public health policy depends on the political willingness to develop robust strategies. However, effective lobbying of policy-makers by the alcohol industry and lack of political will are barriers to the implementation of these measures, resulting in suboptimal national alcohol control policies. Clinicians are well-placed to campaign for effective public health policy regarding alcohol to reduce the prevalence of ALD for the benefit of patients, their families and wider society. In this Perspective, we summarize the evidence for public health policies that affect alcohol consumption and the prevalence of ALD. There is clear evidence that public health measures to reduce alcohol consumption are effective, which can have a positive effect on alcohol-related liver disease. In this Perspective, Parker and colleagues discuss public health policies that affect alcohol consumption and alcohol-related liver disease.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"22 8","pages":"587-594"},"PeriodicalIF":51.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211012","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 : 2025-06-04DOI: 10.1038/s41575-025-01077-5
Yolanda Sanz, John F. Cryan, Mélanie Deschasaux-Tanguy, Eran Elinav, Rebekka Lambrecht, Patrick Veiga
The gut microbiome has an undeniable role in mediating the health effects of the diet, given its ability to co-digest nutrients and influence nutrient signalling to multiple organ systems. As a suboptimal diet is a major risk factor for and contributor to disease, understanding the multidirectional interactions between the food we eat, the gut microbiome and the different body organ systems is crucial from a public health perspective. Indeed, this research area is leading to the refinement of nutritional concepts and strategies to optimize health through diet. In this Review, we provide an update on how dietary patterns and food intake shape gut microbiome features, the mode of action of diet–microorganism interactions on the immune, nervous and cardiometabolic systems and how this knowledge could explain the heterogeneity of dietary responses, and support food-based dietary guidelines and medical and precision nutrition. Finally, we discuss the knowledge gaps and research efforts needed to progress towards the integration of microbiome science with more precise dietary advice to leverage the role of nutrition in human health. In this Review, Sanz and colleagues discuss how diet shapes the gut microbiome, the role of diet–microbiome interactions on the immune, nervous and cardiometabolic systems, and implications for dietary guidelines and precision nutrition.
{"title":"The gut microbiome connects nutrition and human health","authors":"Yolanda Sanz, John F. Cryan, Mélanie Deschasaux-Tanguy, Eran Elinav, Rebekka Lambrecht, Patrick Veiga","doi":"10.1038/s41575-025-01077-5","DOIUrl":"10.1038/s41575-025-01077-5","url":null,"abstract":"The gut microbiome has an undeniable role in mediating the health effects of the diet, given its ability to co-digest nutrients and influence nutrient signalling to multiple organ systems. As a suboptimal diet is a major risk factor for and contributor to disease, understanding the multidirectional interactions between the food we eat, the gut microbiome and the different body organ systems is crucial from a public health perspective. Indeed, this research area is leading to the refinement of nutritional concepts and strategies to optimize health through diet. In this Review, we provide an update on how dietary patterns and food intake shape gut microbiome features, the mode of action of diet–microorganism interactions on the immune, nervous and cardiometabolic systems and how this knowledge could explain the heterogeneity of dietary responses, and support food-based dietary guidelines and medical and precision nutrition. Finally, we discuss the knowledge gaps and research efforts needed to progress towards the integration of microbiome science with more precise dietary advice to leverage the role of nutrition in human health. In this Review, Sanz and colleagues discuss how diet shapes the gut microbiome, the role of diet–microbiome interactions on the immune, nervous and cardiometabolic systems, and implications for dietary guidelines and precision nutrition.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"22 8","pages":"534-555"},"PeriodicalIF":51.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211011","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 : 2025-06-02DOI: 10.1038/s41575-025-01078-4
Inflammatory bowel disease remains a global health challenge, despite advances in treatment and understanding of disease biology. In this issue, we focus on the most pressing priorities in inflammatory bowel disease research and care.
{"title":"Prioritizing inflammatory bowel disease","authors":"","doi":"10.1038/s41575-025-01078-4","DOIUrl":"10.1038/s41575-025-01078-4","url":null,"abstract":"Inflammatory bowel disease remains a global health challenge, despite advances in treatment and understanding of disease biology. In this issue, we focus on the most pressing priorities in inflammatory bowel disease research and care.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"22 6","pages":"361-361"},"PeriodicalIF":51.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41575-025-01078-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192853","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 : 2025-05-23DOI: 10.1038/s41575-025-01076-6
Rashid Lui (, ), Renu Dhanasekaran, Yu Bin Tan (, ), Claudia Wing-Kwan Wu, Jan Bornschein, Daniel Q. Huang (, ), Arndt Vogel, Shilpa Grover
Onco-gastroenterology is defined as a collaborative subspecialty of Gastroenterology that is dedicated to the unique needs of individuals with or at risk of cancer, with a focus on maintaining and managing their digestive and liver health throughout their clinical course.
{"title":"Redefining cancer care: the case for an onco-gastroenterology subspecialty","authors":"Rashid Lui \u0000 (, ), Renu Dhanasekaran, Yu Bin Tan \u0000 (, ), Claudia Wing-Kwan Wu, Jan Bornschein, Daniel Q. Huang \u0000 (, ), Arndt Vogel, Shilpa Grover","doi":"10.1038/s41575-025-01076-6","DOIUrl":"10.1038/s41575-025-01076-6","url":null,"abstract":"Onco-gastroenterology is defined as a collaborative subspecialty of Gastroenterology that is dedicated to the unique needs of individuals with or at risk of cancer, with a focus on maintaining and managing their digestive and liver health throughout their clinical course.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"22 7","pages":"459-461"},"PeriodicalIF":51.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122676","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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