
Schematic illustration of mechanisms of metabolic syndrome with special reference to Toll-like receptor 4 (TLR4) and proinflammatory cytokine signaling. High-fat diet impairs gut barrier to induce bacterial translocation resulting in dysbiosis. At the same time, dysbiosis reduces gut barrier integrity via the metabolites produced by gut bacteria. Additionally, this change activates the immune system to induce lipopolysaccharide (LPS). LPS activates systemic TLR4 to produce proinflammatory cytokines, resulting in low-grade inflammation, which causes insulin resistance. LPS triggers facilitatation to recruit macrophages into adipose tissue, and activates macrophages and adipocytes via TLR4 to induce local inflammation in adipose tissues. Under this condition, macrophages increase lipolysis through the release of proinflammatory cytokines to produce free fatty acids (FFAs). FFAs are delivered and accumulated in distant organs such as the liver and skeletal muscle, which can induce inflammation via TLR4, leading to insulin resistance. Among these FFAs, saturated FAs act as a ligand for TLR4 in both macrophages and adipocytes to increase the secretion of proinflammatory cytokines, which also contribute to insulin resistance. Additionally, insulin resistance at adipose tissue increases lipolysis, leading to increased release of FFAs. At the same time, oxidized low-density lipoprotein (LDL) is produced by oxidative stress induced by metabolic endotoxemia, and also activates TLR4 to produce proinflammatory cytokines, which is associated with insulin resistance. Thus, insulin resistance and inflammation cause a vicious cycle to induce each other via TLR4.
Forest plot of the associations between gastroesophageal reflux disease and psychosocial disorders.
Representative case of different endoscopic preparation grades for patients with achalasia.
Differences in alpha and beta diversity in esophageal microbiome (A) alpha diversity (Shannon index) and (B) beta diversity (Bray-Curtis index) The alpha diversity presented as Shannon index. Each dot represents an individual sample. Pink bars represent pre-peroral endoscopic myotomy (POEM), fluid; green bars represent post-POEM, fluid; blue bars represent pre-POEM, tissue; and purple bars represent post-POEM, tissue. Data are presented as box-and-whisker plots, with whiskers representing the lowest and highest values within 1.5*interquartile range (IQR). Black diamonds indicates the mean of Shannon index. *
Prevalence of non-celiac gluten sensitivity (NCGS) in Korea via the survey: do you think eating food containing flour/wheat affects the occurrence of gastrointestinal symptoms? IBS, irritable bowel syndrome; VAS, visual analog scale.
Evolution of the neurogenic bowel dysfunction (NBD) score before and after transanal irrigation in 4 specific initial NBD categories. “Very minor group” is defined by NBD score ranged from 0 to 6, “Minor group” is defined by score ranging from 7 to 9, “Moderate group” is defined by score ranging from 10 to 13, “Severe group” is defined by NBD score ranging from 14 to 27. Red boxes correspond to the analyzed groups.
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Top 10 cited articles
Top 10 cited articles
No. | Cited items | Category | Citations |
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Review | 284 |
2 | What Is New in Rome IV Max J Schmulson, and Douglas A Drossman. Journal of Neurogastroenterology and Motility. 2017 May; 23(2): 151-163. |
Review | 280 |
3 | Pharmacokinetics and Pharmacodynamics of the Proton Pump Inhibitors Jai Moo Shin, and Nayoung Kim. Journal of Neurogastroenterology and Motility. 2013 Jan; 19(1): 25-35. |
Review | 189 |
4 | Biopsychosocial Model of Irritable Bowel Syndrome Yukari Tanaka, Motoyori Kanazawa, Shin Fukudo and Douglas A Drossman. J Neurogastroenterol Motil. 2011 Apr; 17(2): 131-139. |
Review | 168 |
5 | Effect of Probiotics on Central Nervous System Functions in Animals and Humans: A Systematic Review Huiying Wang, In-Seon Lee, Christoph Braun, and Paul Enck. Journal of Neurogastroenterology and Motility. 2016 Oct; 22(4): 589-605. |
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Review | 146 |
7 | Epidemiology of Gastroesophageal Reflux Disease in Asia: A Systematic Review Hye-Kyung Jung. J Neurogastroenterol Motil. 2011 Jan; 17(1): 14-27. |
Review | 145 |
8 | How to Interpret Hydrogen Breath Tests Uday C Ghoshal. J Neurogastroenterol Motil. 2011 Jul; 17(3): 312-317. |
How to Interpret a Functional or Motility Test | 138 |
8 | Achalasia Cardia Subtyping by High-Resolution Manometry Predicts the Therapeutic Outcome of Pneumatic Balloon Dilatation Nitesh Pratap, Rakesh Kalapala, Santosh Darisetty, Nitin Joshi, Mohan Ramchandani, Rupa Banerjee, Sandeep Lakhtakia, Rajesh Gupta, Manu Tandan, G V Rao and D Nageshwar Reddy. J Neurogastroenterol Motil. 2011 Jan; 17(1): 48-53. |
Original Article | 138 |
10 | Methanogens, Methane and Gastrointestinal Motility Konstantinos Triantafyllou, Christopher Chang and Mark Pimentel. J Neurogastroenterol Motil. 2014 Jan; 20(1): 31-40. |
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