Can Diet Help Non-Obese Individuals with Non-Alcoholic Fatty Liver Disease (NAFLD)?

Subjects diagnosed with non-alcoholic fatty liver disease (NAFLD) or hepatic steatosis are usually obese or overweight. NAFLD has also been reported in many non-obese healthy subjects as an incidental finding during imaging. Subjects with early-stage NAFLD who are otherwise healthy are often left unmanaged in current clinical practice; it is not clear if an early intervention in those individuals would be of any benefit in preventing NAFLD progression to more serious conditions. Since many of these subjects are non-alcoholic and have a normal body mass index (BMI), an intensive lifestyle change program is not usually recommended. This report presents an otherwise healthy non-alcoholic subject with incidental NAFLD having a normal BMI and a waist circumference below 90 cm who successfully reversed his condition by undertaking a lifestyle intervention. The case report is expected to encourage large cohort studies to substantiate the benefits of dietary interventions in alleviating hepatic steatosis among non-obese individuals

Editorial: maintaining open access to high quality publications at no cost to authors

The inability to access scientific literature freely can be a major obstacle in the advancement of science. Many reputable journals offering optional open access incur a substantial upfront payment to cover their publication costs, and hence many authors cannot afford to publish open access papers in a journal with an established reputation. Publishers charging for article processing claim that the charge is necessary to maintain their reputation and costs for peer review, editing and indexing articles. Thus, some open-access publications have a less rigorous peer-review and editorial process

Editorial Board

Listing of Editorial Board for Volume 1 Issue

Going Natural: Using polymers from nature for gastroresistant applications

Nutraceuticals provide an additional health or medicinal benefit besides their nutritional value and are therefore marketed for the prevention and treatment of certain conditions. Nutraceuticals contain natural ingredients, usually presented in the form of functional foods or as dietary supplements. Many of the ingredients are susceptible to degradation by gastric acid or can provoke nauseatic feelings or induce vomiting on oral administration. Gastroresistant coatings, widely researched and used in pharmaceuticals, employ enteric polymers which are not regarded as natural ingredients or do not possess GRAS (generally regarded as safe) status by the regulatory bodies, thus cannot be used for nutraceutical products. Consequently, most nutraceuticals are not formulated as gastroresistant and can therefore lack efficacy or are well tolerated. This manuscript provides a critical review of natural substances employed in producing gastroresistant products, their shortcomings, and potential industrial applications. It also identifies current gaps in our knowledge to encourage further research in this area

COVID-19 first anniversary review of cases, hospitalization, and mortality in the UK

Introduction: The first confirmed COVID-19 case in UK dates to 11 January 2020, exhibiting its first peak during April 2020. The country has since been hit by another wave in the winter 2020, almost at the first anniversary of the pandemic.Areas covered: An in-depth analysis of the COVID-19 positive cases in the UK throughout the year, hospitalizations, patients in critical care, and COVID-19 associated deaths.Expert opinion: The COVID-19 associated hospital admission accounts to 15% of total COVID-19 positive cases in November 2020. The percentage of total COVID-19 positive patients in the country died from the disease was under 4% in November 2020. Total deaths in England (all-cause) from June to October 2020 were similar to the historic averages. Age was the single most determinator of COVID-19 associated mortality, 50 years or older accounted for 98% of total COVID deaths. Age distribution of COVID-19 associated deaths in 2020 was similar to all-cause mortality age distribution in 2019. There was no significant improvement in the survival rate of COVID-19 patients receiving critical care. This prompts an urgent need to invest in novel antiviral therapeutics to save the most vulnerable in the society

Age-mediated changes in the gastrointestinal tract

Physiological functions of the two extreme ends of the age spectrum, children (<18 y old) and older adults (aged 65 y and over), differ from healthy young adults. This consequently affects the pharmacokinetic profiles of administered drugs, which, in turn, impacts upon clinical practice and drug therapy. The gastrointestinal milieu acts as a distinct and vital organ regulating the dissolution, absorption and metabolism of orally ingested drugs. Age-mediated alteration in the physiology and function of the gut can reshape the pharmacokinetics of certain drugs. However, our understanding of this topic is limited. This article references the gut physiology of healthy adults to capture the available evidence in the literature on the extent and nature of the changes in childhood and older age. The gut, as an organ, is examined with regards to the effect of age on luminal fluid, microbiota, transit and motility, and the intestinal mucosa. Whilst drastic developmental changes were observed in certain aspects of the gastrointestinal environment, the examination reveals significant gaps in our knowledge in the physiology and function of the developing or ageing gut. The revelation of the unknown paves the way towards a better characterization of the human gastrointestinal tract for optimized drug therapy in children and older adults

Does sex matter? The influence of gender on gastrointestinal physiology and drug delivery.

We all respond differently to drugs. Personalised medicine aims to improve efficacy and reduce side effects, and efforts are being made to understand the physiological differences that underlie responses to drugs. Genetics, diet and disease state can be key; however, gender also plays an important role in pharmacokinetics, pharmacodynamics and drug toxicity. Differences in metabolism and clearance of drugs as a consequence of distinct hepatic and renal processes in males and females are now much better understood but little is known about gender differences in the gastrointestinal tract. As the recipient of all orally administered medications, differences at this level can have a major impact on drug delivery and bioavailability; yet these continue to be ignored and insufficiently studied in the context of drug disposition. The aim of this review is to highlight the known gender differences in gut physiology. Clinical case studies are presented, where possible, to illustrate the influence of these differences on drug disposition and gaps in current knowledge are highlighted to encourage further research in this area