About this Research Topic
First, the general mechanism of inflammation. Inflammation is followed by induction of repair. Is fibrosis just an initial protective mechanism followed by renewal or does it represent permanent replacement of tissue and irreversible structural changes? When does regeneration lead to full restoration and when just to hyperproliferation? What pathways become activated to stop regeneration? Does overactivation lead to cancer?
Second, causes of inflammation in the liver and gut. Why excessive alcohol consumption hits one individual but not another? Why some individuals develop NAFLD and some progressive NASH? Why genetic mutations in only a small fraction of patients might lead to clinical manifestations (e.g. in genetic hemochromatosis)? Such amplifying disease co-factors are important for the liver but also for the gut. For example, what is the role of the intestinal mucus? What is the role of the local immune system vs systemic immunity? What can drugs really achieve? What is the impact of the economic factor in the widespread use of medications? Can therapies really change the course of diseases? How can fibrosis cause functional impairment in the liver, biliary system, pancreas, the upper and lower gastrointestinal tract? Is it inevitable for cancer to develop in chronic, uncontrolled inflammation and how long does it take to develop?
Third, the natural course of inflammation in the liver and gut. The non-invasive, quantitative, clinically useful measurement of inflammatory activity and collagen deposition within the organ are the focus of this section.
Fourth, treatment options. Does inhibition of inflammation require blockage of the disease-causing condition? Are steroids given as symptomatic medications helpful in the long run? Why biologic agents are not used for liver inflammation? Are there anti-fibrotic strategies for the liver and gut at the horizon? Do biologic agents in IBD prevent fibrosis?
Fifth, the role of surgery in inflammation. When to intervene? Is the incidence of surgery truly declining due to new pharmacologic therapies? What are the advantages and what are the pitfalls?
With this Research Topic we want to explore the real, current unmet needs in inflammation and fibrosis of the liver and gut – both in research and clinical practice and focus on fields where progress will be required in the future.
Keywords: NASH, NAFLD, IBD, Liver disease, Therapy
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