Νon-alcoholic fatty liver disease (NAFLD) is a common cause of end-stage liver disease in developed countries. Oxidative stress plays a key role during the course of the disease and vitamin E supplementation has shown to be beneficial due to its antioxidative properties. We aim to investigate the effect of vitamin E supplementation on serum aminotransferase levels in patients with NAFLD. Three electronic databases (MEDLINE, CENTRAL, and Embase) were reviewed for randomized trials that tested vitamin E supplementation versus placebo or no intervention in patients with NAFLD, published until April 2023. A total of 794 patients from 12 randomized trials were included in this meta-analysis. Notwithstanding the studies’ heterogeneity and moderate internal validity in certain cases, among studies testing vitamin E supplementation at 400 IU/day and above, the values of alanine aminotransferase (ALT) were reduced compared with placebo or no intervention [ALT Mean Difference (MD) = −6.99 IU/L, 95% CI (−9.63, −4.35), for studies conducted in Asian countries and MD = −9.57 IU/L, 95% CI (−12.20, −6.95) in non-Asian countries]. Regarding aspartate aminotransferase (AST), patients in the experimental group experienced a reduction in serum levels, though smaller in absolute values [AST MD = −4.65 IU/L, 95% CI (−7.44, −1.86) in studies conducted in Asian populations] and of lower precision in non-Asian studies [MD = −5.60 IU/L, 95% CI (−11.48, 0.28)].

Asthma is generally characterized by variable symptoms such as dyspnea and wheezing and variable airflow obstruction. This review focuses on a subset of patients suffering from asthma with persistent airflow limitation that is not fully reversible (asthma with fixed airflow obstruction, FAO). The pathophysiology, the risk factors and the clinical outcomes associated with FAO are presented, as well as the distinct clinical entity of severe asthma and its inflammatory subtypes (T2 and non-T2). The current strategies for the treatment of these endotypes and treatment of the distinct Asthma/COPD overlap (ACO) phenotype are described. Management and medical interventions in FAO and/or ACO patients demand a holistic approach, which is not yet clearly established in guidelines worldwide. Finally, a treatment algorithm that includes FAO/ACO management based on pharmacological and non-pharmacological treatment, guideline-based management for specific co-morbidities, and modification of the risk factors is proposed.

Inflammatory bowel disease (IBD)-associated colorectal cancer (CRC) remains a significant clinical challenge due to its link with chronic inflammation and the inherent limitations of current prevention and surveillance strategies. The cGAS-STING pathway has emerged as a key player in the immune regulation of inflammation-driven carcinogenesis, demonstrating both protective and pathogenic roles. This review examines the contrasting roles of the cGAS-STING signaling pathway in intestinal inflammation and colitis-associated cancer (CAC), emphasizing its promise as a target for cancer prevention strategies. Evidence suggests that modulating this pathway could preserve epithelial integrity, limit chronic inflammation, and bolster anti-tumor immunity. Despite advancements in therapies like mesalazine and surveillance colonoscopy programs, gaps in efficacy remain, particularly for Crohn’s disease and high-risk populations. Future research should focus on integrating cGAS-STING-targeted approaches with existing modalities to provide personalized and less invasive strategies for CAC prevention. By harnessing this pathway’s therapeutic potential, a paradigm shift in managing IBD-associated CRC may be achieved, addressing the challenges of long-term disease surveillance and prevention.

Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder with multifactorial etiology, including genetic components. Despite numerous genetic association studies (GAS), the role of specific gene polymorphisms in GERD susceptibility remains unclear due to inconsistent findings. To systematically review GAS on GERD and conduct a meta-analysis to evaluate the association between specific gene polymorphisms and GERD risk. A systematic review of PubMed, Cochrane, ScienceDirect, Scopus, DisGENET, GWASCatalog, and HuGE Phenopedia databases (2012-2024) was conducted to identify GAS for GERD. Meta-analytical methods were used to synthesize the results. 21 GAS, including 27,783 GERD patients and 83,857 controls, were analyzed, focusing on 132 polymorphisms across 105 genes. Meta-analysis of seven studies revealed a significant association between GNB3 rs5443 C > T and increased GERD-like symptom phenotypes (ORp = 2.24, 95 % CI: 1.56-3.21), suggesting a dominant genetic model. No significant associations were found for TNF, IL1B, or CYP2C19. Heterogeneity and potential bias were observed in some analyses, necessitating cautious interpretation of the findings. The findings support a robust association between GNB3 rs5443 C > T and susceptibility to GERD-like symptom phenotypes, suggesting a potential genetic predisposition. Additional large, well-characterized studies using standardized GERD definitions are needed to validate these results and elucidate the broader genetic landscape of the disease.

Backgrounds: Gastric malignancies are exceptionally rare among children and young adults, and their clinicopathological characteristics and outcomes remain poorly defined. This study aimed to evaluate the demographic, clinical, and survival features of gastric cancer in patients aged ≤24 years using population-based data. Methods: Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database (2004–2016) for individuals ≤ 24 years with primary gastric malignancies. Cox proportional hazards models were used to identify predictors of overall survival (OS). Results: A total of 324 patients were included (mean age: 20 years; 50% female). Adenocarcinoma was the most common histologic subtype (52%), nearly half of which were signet ring cell carcinomas (46%). The majority of patients (59%) were diagnosed at stage IV. Median OS was 18 months, and 5-year OS was 49%. Children and adolescents (≤18 years) had significantly better survival than young adults (median OS: 34 vs. 15 months, p < 0.01). In multivariable analysis, advanced AJCC stage and higher lymph node ratio were independently associated with worse overall survival, while lymphoma histology and radiotherapy were linked to more favourable outcomes. Conclusions: Gastric cancers in patients ≤ 24 years often present at advanced stages and are dominated by aggressive histology. Prognosis is primarily determined by tumour stage, histological subtype, and lymph nodal burden. These population-based risk estimates support risk stratification and prognostic assessment in young patients by highlighting histology- and nodal-burden-driven prognostic strata.