The International Journal of Gastroenterology and Hepatology Diseases - Current Issue

Alcohol consumption trouble is the leading cause of disability and illness in the world. Aside from its negative health consequences, alcohol also has a substantial economic impact on society. This burden manifests itself in the way of health-care costs together with personal expenses for the healing process of morbidities caused by alcohol consumption, diminished earning capacity due to early death. The Government of India (GOI) is concentrating on implementing measures to deal with the alarming and rising cost of non-communicable diseases (NCDs) and disabilities in the nation. After drinking, alcohol increases the release of leptin, called satiety hormone produced in adipose tissues, together with tumour necrosis factor-alpha (TNF-α), which mitigates the hunger in alcoholics. After that, TNF-α triggers secondary inflammatory mediators, such as interleukin-6 (IL-6), interleukin-8 (IL-8) and interleukin-1β (IL-1β), to be over-expressed, which further reduces appetite. Recent research suggests that excessive lipid production, oxidative stress, inflammation along with the intricate connections between the body's immune system, alcohol metabolism and lipid metabolism, are some of the many factors that trigger liver disease caused by alcohol.

There are three medications, namely acamprosate, disulfiram and naltrexone that have been authorised by the Food and Drug Administration (FDA) for the management of drinking disorders. However, these drugs have a number of drawbacks, including symptoms connected to the nervous system. This significant review discusses the scientific mechanisms behind a few particular bioactive constituents of medicinal plants that have been shown to significantly reduce hangover symptoms by detoxifying alcohol metabolites, influencing the metabolic process of alcohol and because of its antioxidants and/or anti-inflammatory capabilities.

Vitamin B12 (cobalamin) is a water-soluble vitamin. It is a crucial vitamin for the health of humans, contributing immensely to numerous biological processes. This study aims to highlight the importance of vitamin B12 in nourishing hair growth and the nervous system and how its malabsorption might trigger various problems in the body. Major absorption of vitamin B12 takes place in the small intestine from several foods like milk, eggs, fish, liver, meat, and yoghurt. Several factors can cause malabsorption of vitamin B12, including atrophy of the gastric mucosa, disease of the terminal ileum in the body, and cigarette smoking. These factors can lead to the demyelination of large nerve fibers in the spinal cord, a variation in the fraction of S-adenosylmethionine to S-adenosylhomocysteine, and an alteration in TNF and epidermal growth factor (EGF) levels, which can cause optic neuropathy and hair loss. Maintaining a proper diet and leading a healthy lifestyle are crucial for maintaining vitamin B12 levels in the body, as the body can store this vitamin for up to 3–6 years. Mainly, the level of vitamin B12 in the healthy human body is 160 to 950 picogrammes per millilitre. In conclusion, the factors leading to malabsorption of vitamin B12 and their consequent deficiencies were examined. The body's numerous crucial functional pathways are influenced by vitamin B12.

Despite enormous advances in the current treatment strategies, liver diseases are associated with high mortality. It is critical to discover novel drug targets for developing effective therapies. Histone deacetylase (HDAC) inhibitors have emerged as a promising therapeutic approach for the treatment of various liver diseases. The use of histone deacetylases and their inhibitors to treat a variety of liver illnesses has been thoroughly reviewed using suitable keywords and key phrases as search terms within scientific databases like Web of Science, Google Scholar, PubMed, and other web sources, and data was collected and sorted from the literature spanning from 1990 to 2023, providing an overview of the role of HDACs in liver diseases together with the evidence of the therapeutic effects of HDAC inhibitors in various liver diseases. HDACs are enzymes that play a crucial role in regulating gene expression by deacetylating histone proteins, which can alter chromatin structure and thereby regulate gene expression. Dysregulation of HDAC activity is associated with liver diseases, including Hepatocellular carcinoma (HCC), non-alcoholic fatty liver disease (NAFLD), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections, etc. as implicated in many studies both in vitro and in vivo. This review summarizes the prevalence of liver diseases and how their impact is significant. We highlight the crucial role of histone deacetylases (HDACs) in liver diseases. In addition, by targeting various mechanisms, HDAC inhibitors have shown promise as novel hepatoprotective agents. These inhibitors can have therapeutic effects in different liver diseases. They can induce cell cycle arrest, promote apoptosis, improve insulin resistance, address hepatic steatosis, and enhance differentiation in hepatocellular carcinoma (HCC) cells. The multifaceted approach of HDAC inhibitors offers potential for innovative treatments in liver diseases.

The discovery of the motilin receptor and advances in techniques warrant a reevaluation of motilin's digestive role. Despite similarities with ghrelin in genomic structure and gastrointestinal effects, motilin and ghrelin receptors are specific and do not cross-react. In rodents, motilin's function is limited due to receptor pseudogenes. While motilin stimulates enteric cholinergic activity rather than directly contracting muscle, its effects differ from the more prolonged impact of agonists like erythromycin and GSK962040. Furthermore, while motilin’s receptor is highly expressed in muscle tissue, motilin primarily acts by promoting enteric cholinergic activity rather than directly inducing muscle contraction. The use of erythromycin, an antibiotic, as a motilin receptor agonist to accelerate gastric emptying in patients has raised safety concerns, particularly regarding the potential for increased antibiotic resistance. Motilide substitutes have not been successful, but new non-motilide small-molecule agonists are in trials for conditions like diabetic gastroparesis. This underscores the importance of balancing artificial models, structural data, and animal studies in pharmacology. In conclusion, the study of motilin and its receptor provides an important example for translational pharmacologists, emphasizing the need to avoid overreliance on artificial systems, structural data, and animal models when developing new therapeutic approaches. The complexities of motilin's actions and the challenges associated with receptor agonism highlight the importance of continued research and innovation in the field of gastrointestinal pharmacology.

Hepatitis C continues to present challenges despite the introduction of directly acting antiviral (DAA) treatments. While DAAs have revolutionized the treatment of hepatitis C by offering high cure rates with fewer side effects, there are still several ongoing challenges. Firstly, identifying and diagnosing individuals with hepatitis C remains a significant barrier. Many people with hepatitis C are unaware of their status, leading to delayed diagnosis and treatment initiation. Additionally, certain populations, such as marginalized communities and people who inject drugs, face barriers to accessing testing and treatment services. Secondly, treatment access and affordability are persistent issues. Although DAAs have been hailed for their efficacy, their high costs limit accessibility for many individuals, particularly in low- and middle-income countries. This highlights the need for continued efforts to improve drug affordability and expand access to treatment globally. Thirdly, addressing co-infections and comorbidities is an ongoing challenge in hepatitis C management. Many individuals with hepatitis C also have coexisting conditions, such as HIV or liver cirrhosis, requiring integrated care approaches to effectively manage these complex health needs. Furthermore, despite the effectiveness of DAAs, reinfection remains a concern, especially among high-risk populations. This emphasizes the importance of comprehensive prevention strategies and ongoing monitoring to prevent recurrent infections. Therefore, while the advent of DAAs has transformed the landscape of hepatitis C treatment, continued efforts are necessary to address the challenges of diagnosis, treatment access, co-infections, and reinfection. A comprehensive approach that integrates testing, treatment, and support services is essential to achieve the goal of hepatitis C elimination.

The long-term health implications of COVID-19 have posed a new challenge in clinical management, especially with the appearance of long COVID syndrome. Most of the attention has been on respiratory and neurological sequelae, but its impact on GI health is underexplored. It has been observed that abnormalities detected during the acute phase of SARS-CoV-2 infection can be used to predict potential post-acute sequelae within the digestive system. These anomalies are accompanied by immune dysregulation, cytokine storms, and damage to hepatocytes, resulting in fatigue, loss of appetite, and nutritional deficiencies persisting for several months and, therefore, significantly worsen recovery and quality of life. This current letter addresses the pertinent interaction between liver dysfunction and GI symptoms in the context of long COVID, highlighting the urgent need for early detection and personalized therapies in predisposed patients. It also examines the influence of vaccination, metabolic health, and early nutrition supplementation on the development and progression of these sequelae. Recent research emphasizes the increasing importance of gut dysbiosis and its link to hepatic impairment in long-term COVID patients. This letter underscores the importance of interdisciplinary collaboration and highlights the urgent need for conducting more research on GI manifestations of long COVID in order to define the mechanisms involved and possible pathways toward therapy.