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Life
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Gastrointestinal Health: Clinical Research and Therapeutic Innovations—2nd Edition
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Gastrointestinal Health: Clinical Research and Therapeutic Innovations—2nd Edition

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 18 September 2026 | Viewed by 3176

Special Issue Editors

Prof. Dr. Ludovico Abenavoli

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Guest Editor
Department of Health Sciences, University “Magna Græcia”, Campus Germaneto, I-88100 Catanzaro, Italy
Interests: nonalcoholic fatty liver disease; alcoholic liver disease; gut microbiota; Mediterranean diet; nutrition; COVID-19; probiotic
Special Issues, Collections and Topics in MDPI journals
Dr. Giuseppe Guido Maria Scarlata

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Guest Editor
Department of Health Sciences, University of Catanzaro “Magna Graecia”, Catanzaro, Italy
Interests: gut-liver axis; gut microbiota; fatty liver disease; viral hepatitis; COVID-19, antimicrobial resistance
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We would like to warmly invite you to contribute to the second edition of the Special Issue “Gastrointestinal Health: Clinical Research and Therapeutic Innovations”.

This Special Issue will comprise a collection of original studies and reviews that explore the dynamic landscape of gastroenterology. This project will highlight pivotal advancements in diagnostic methodologies, therapeutic strategies, and clinical practices designed to enhance gastrointestinal health. Contributions will report on novel treatments for common gastrointestinal disorders, including irritable bowel syndrome, inflammatory bowel disease, and gastroesophageal reflux disease. At the same time, conditions affecting the liver, such as fatty liver disease, liver cirrhosis, and hepatocellular carcinoma, will also be addressed. Key focus areas include the gut microbiota's role in health and disease and investigations into the therapeutic potential of probiotics, prebiotics, and dietary interventions. This Special Issue will also address challenges and opportunities in translating basic research findings into clinical practice, fostering a holistic understanding of gastrointestinal health. Multidisciplinary perspectives will be emphasized, integrating insights from gastroenterologists, hepatologist, nutritionists, microbiologists, and clinical researchers. This collaborative approach will allow us to bridge the gap between laboratory research and bedside application, promoting evidence-based innovations that can be readily adopted in clinical settings. Overall, this Special Issue will serve as an invaluable resource for clinicians, researchers, and healthcare professionals dedicated to advancing the field of gastroenterology. By highlighting the latest clinical research and therapeutic innovations, it will enhance patient care, improve health outcomes, and pave the way for future discoveries in gastrointestinal health.

Prof. Dr. Ludovico Abenavoli
Dr. Giuseppe Guido Maria Scarlata
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gut microbiota
  • inflammatory bowel diseases
  • irritable bowel syndrome
  • gastroesophageal reflux disease
  • fatty liver disease
  • liver cirrhosis
  • probiotics
  • mediterranean diet
  • epidemiology
  • diagnosis
  • treatment
  • artificial intelligence

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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25 pages, 3169 KB  
Article
Muscle Function Impairment in Crohn’s Disease Patients: Risk Factors and Clinical Implications—Single-Tertiary-Center Experience
by Jelena Spiric Milovancevic, Aleksandar Toplicanin, Sasa Vuksanovic, Srdjan Djuranovic, Aleksandra Pavlovic Markovic, Sanja Mazic, Marina Djelic Blagojevic and Aleksandra Sokic-Milutinovic
Life 2026, 16(5), 790; https://doi.org/10.3390/life16050790 - 8 May 2026
Viewed by 230
Abstract
Sarcopenia in inflammatory bowel disease can significantly influence disease course. Since current assessment focuses mainly on muscle quantity, we aimed to evaluate muscle function in Crohn’s disease (CD) patients and identify those at increased risk of muscle function impairment. This cross-sectional study included [...] Read more.
Sarcopenia in inflammatory bowel disease can significantly influence disease course. Since current assessment focuses mainly on muscle quantity, we aimed to evaluate muscle function in Crohn’s disease (CD) patients and identify those at increased risk of muscle function impairment. This cross-sectional study included 84 patients with CD (76.2% male, mean age 35 ± 11 years) receiving infliximab. Body composition was assessed by bioelectrical impedance analysis, muscle strength by handgrip strength (HGS), and physical performance by gait speed. Half of the cohort demonstrated reduced muscle strength relative to age- and sex-adjusted norms, while none met criteria for confirmed sarcopenia. One third of the patients had low physical performance and only one patient screened positive for sarcopenia. In multivariable linear regression, sex was the strongest independent predictor of HGS (p < 0.001), followed by ileocolonic disease localization, which was independently associated with lower HGS compared to ileal (p = 0.045) and colonic (p = 0.046). Hemoglobin remained an independent predictor of HGS after multivariable adjustment (p = 0.021). Low muscle strength is common in patients with CD treated with infliximab, even in the absence of low muscle mass. Ileocolonic disease localization and lower hemoglobin levels are predictors of low muscle strength, highlighting the importance of early and comprehensive muscle function assessment in this population. Full article
(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations—2nd Edition)
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13 pages, 448 KB  
Article
Impact of Disease Severity and Age on Outcomes After Laparoscopic Versus Open Appendectomy: A Single-Center Retrospective Cohort Study
by Nicolae-Dragoș Mărgăritescu, Stelian-Stefaniță Mogoantă, Tiberiu Stefăniță Țenea Cojan, Laurențiu Augustus Barbu and Liviu Vasile
Life 2026, 16(5), 706; https://doi.org/10.3390/life16050706 - 22 Apr 2026
Viewed by 351
Abstract
Background: Acute appendicitis is one of the most common surgical emergencies worldwide. This study aimed to evaluate the impact of disease severity and age on outcomes after laparoscopic versus open appendectomy and to identify predictors of prolonged hospitalization. Methods: A single-center retrospective cohort [...] Read more.
Background: Acute appendicitis is one of the most common surgical emergencies worldwide. This study aimed to evaluate the impact of disease severity and age on outcomes after laparoscopic versus open appendectomy and to identify predictors of prolonged hospitalization. Methods: A single-center retrospective cohort study was conducted at a tertiary emergency hospital, including 311 adult patients who underwent appendectomy between January 2020 and December 2024. The primary outcome was length of hospital stay (LOS), with prolonged hospitalization defined as LOS > 7 days. Results: The study included 311 patients (mean age 43.3 ± 18.0 years; 58.5% male), of whom 38.6% had complicated appendicitis. Complicated appendicitis was associated with older age and longer hospitalization. The laparoscopic approach was associated with a significantly shorter LOS compared with the open approach (4.43 ± 2.62 vs. 5.68 ± 3.11 days, p < 0.001). Increasing age independently predicted complicated appendicitis and prolonged hospitalization, while laparoscopy remained independently associated with reduced LOS after adjustment for measured confounders. No significant interaction was observed between surgical approach and disease severity. Conclusions: Disease severity and age are the main determinants of postoperative outcomes in acute appendicitis. Laparoscopic appendectomy was independently associated with shorter hospital stay after adjustment, although this association may be attenuated in more severe disease. Full article
(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations—2nd Edition)
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14 pages, 304 KB  
Article
Limited Predictive Value of NLR, PLR and SII in Thrombosed Hemorrhoids: A Real-World Analysis
by Liviu Vasile, Stelian-Stefaniță Mogoantă, Tiberiu-Ștefăniță Țenea-Cojan, Nicolae-Dragoș Mărgăritescu and Laurențiu Augustus Barbu
Life 2026, 16(4), 568; https://doi.org/10.3390/life16040568 - 31 Mar 2026
Viewed by 444
Abstract
Background: Systemic inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) have been increasingly investigated as inexpensive biomarkers in various inflammatory and thrombotic conditions. However, their clinical utility in thrombosed hemorrhoids remains poorly defined. This [...] Read more.
Background: Systemic inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) have been increasingly investigated as inexpensive biomarkers in various inflammatory and thrombotic conditions. However, their clinical utility in thrombosed hemorrhoids remains poorly defined. This study aimed to evaluate the diagnostic and predictive performance of NLR, PLR and SII in a real-world cohort of patients with hemorrhoidal disease. Methods: We conducted a retrospective observational study including 120 consecutive adult patients admitted with hemorrhoidal disease between January 2020 and December 2024. Systemic inflammatory indices were calculated from admission blood tests. Comparative analyses, receiver operating characteristic (ROC) curves, tertile trend assessment, and univariate and multivariable logistic regression models were used to evaluate the association between inflammatory indices and thrombosed hemorrhoids. Results: Thrombosed hemorrhoids were identified in 55.8% of patients. Median values of NLR, PLR and SII did not differ significantly between thrombosed and non-thrombosed cases (all p > 0.05). ROC analysis demonstrated poor discriminatory performance (AUC: 0.52 for NLR, 0.55 for PLR, and 0.51 for SII). In multivariable analysis adjusted for age, sex and bleeding status, none of the inflammatory indices were independently associated with thrombosed hemorrhoids (all p > 0.05). No significant trends were observed across NLR tertiles. Conclusions: In this real-world cohort, systemic inflammatory indices showed limited diagnostic and predictive value for thrombosed hemorrhoids. These findings suggest that routine inflammatory ratios provide minimal incremental benefit beyond standard clinical assessment in this predominantly localized benign anorectal condition. Further prospective multicenter studies exploring dynamic and tissue-level biomarkers are warranted. Full article
(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations—2nd Edition)

Review

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23 pages, 2019 KB  
Review
Gut Microbiota Biomarkers in Patients with Hepatocellular Carcinoma in the Era of Immune Checkpoint Inhibitors
by Maria Cerreto, Marta Maestri, Maria Pallozzi, Lucia Cerrito, Leonardo Stella, Gianluca Ianiro, Antonio Gasbarrini and Francesca Romana Ponziani
Life 2026, 16(4), 641; https://doi.org/10.3390/life16040641 - 10 Apr 2026
Viewed by 542
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionized the therapeutic landscape for hepatocellular carcinoma (HCC); however, a considerable proportion of patients do not achieve durable clinical benefits. This highlights the need for reliable predictive biomarkers, which are currently lacking. The accumulated evidence supports a relevant [...] Read more.
Immune checkpoint inhibitors (ICIs) have revolutionized the therapeutic landscape for hepatocellular carcinoma (HCC); however, a considerable proportion of patients do not achieve durable clinical benefits. This highlights the need for reliable predictive biomarkers, which are currently lacking. The accumulated evidence supports a relevant role of the gut–liver axis in modulating immunotherapy outcomes, and several studies have identified distinct microbial features associated with either responders or non-responders. Responders to immunotherapy frequently present with higher microbial diversity and enrichment of beneficial taxa, whereas the expansion of pro-inflammatory and pathogenic bacteria has been associated with primary resistance and increased treatment-related toxicity in non-responders. However, the available findings remain heterogeneous across cohorts, likely owing to differences in geography, diet, liver disease etiology, treatment regimens, and microbiome analytical methods. Machine-learning models integrating metagenomic and metabolomic data have shown encouraging results in defining microbial signatures associated with treatment outcomes, although variability among cohorts currently limits their clinical applicability and generalizability. Beyond microbial taxonomic composition, microbiota-derived metabolites—such as short-chain fatty acids, bile acids, inosine, and tryptophan catabolites—appear to play a crucial role in shaping the tumor microenvironment and host immune responses, thus representing additional candidate biomarkers, also due to the relative ease of their measurement. Finally, microbiota-targeted interventions are emerging as potential strategies to enhance immunotherapy efficacy. Overall, the gut microbiome and its metabolic activity represent promising tools, albeit still under investigation, for patient stratification and personalized management in HCC treated with ICIs. Therefore, this review aims to summarize and critically discuss the current evidence on gut microbiota-derived biomarkers of response and resistance to ICIs in HCC, with particular focus on microbial composition, microbiota-related metabolites, and emerging microbiome-based therapeutic strategies. This narrative review provides an updated overview of the role of gut microbiota as both a biomarker and a therapeutic target in patients with hepatocellular carcinoma (HCC) receiving immune checkpoint inhibitor (ICI) therapy. Full article
(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations—2nd Edition)
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33 pages, 1446 KB  
Review
Bioengineering Interventions to Enhance the Capacity of the Gut Microbiota in Controlling Food Allergies
by Manish Kumar, Shivani Nalla, Jatindra N. Tripathy and Akhilesh Kumar Shakya
Life 2026, 16(3), 433; https://doi.org/10.3390/life16030433 - 7 Mar 2026
Viewed by 1195
Abstract
Food allergies arise when environmental factors, lifestyle choices, and genetic predispositions affect the integrity of the gut epithelial barrier. Under healthy conditions, gut microbiota supports intestinal tight junction integrity and promotes immune tolerance to dietary allergens. Disruption of this microbiota increases susceptibility to [...] Read more.
Food allergies arise when environmental factors, lifestyle choices, and genetic predispositions affect the integrity of the gut epithelial barrier. Under healthy conditions, gut microbiota supports intestinal tight junction integrity and promotes immune tolerance to dietary allergens. Disruption of this microbiota increases susceptibility to epithelial barrier leakage, thereby enabling food allergens to penetrate the bloodstream from the gut and leading to allergic sensitization. Restoring gut homeostasis through allergen-specific immunotherapy (AIT), executed via oral termed as oral immunotherapy (OIT), skin as subcutaneous immunotherapy (SCIT), or under the tongue in the form of sublingual immunotherapy (SLIT), remains a promising yet complex and multifaceted approach. In parallel, probiotics offer a simpler alternative to reinforce epithelial barrier function, restore cellular homeostasis, mitigate allergy symptoms, and represent the probiotics-based OIT. Recently, several bioengineering strategies have been developed toward enriching gut microbiota, such as using additives such as carbohydrates, polyphenols, and probiotics. While generic probiotics have shown efficacy, their undefined dosages and administration protocols pose challenges for clinical standardization in the form of OIT. Emerging developments include recombinant probiotics engineered to express the specific allergen in a controlled manner inside the gut. However, safety concerns regarding their clinical application remain under active discussion. This review highlights various bioengineering strategies to enhance the probiotic capacity, address safety considerations, and explore future prospects for managing food allergies. Full article
(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations—2nd Edition)
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