Clinical and Molecular Hepatology最新文献

Bariatric Surgery Reduced Long-Term Mortality in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease and Cirrhosis. 减肥手术降低了代谢功能障碍相关性脂肪肝和肝硬化患者的长期死亡率。

IF 14 1区医学

Clinical and Molecular Hepatology Pub Date : 2024-11-14 DOI: 10.3350/cmh.2024.0564

Nicholas A Rouillard, Scott D Barnett, Xinrong Zhang, Leslie Kam, Richie Manikat, Ramsey Cheung, Mindie H Nguyen

{"title":"Bariatric Surgery Reduced Long-Term Mortality in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease and Cirrhosis.","authors":"Nicholas A Rouillard, Scott D Barnett, Xinrong Zhang, Leslie Kam, Richie Manikat, Ramsey Cheung, Mindie H Nguyen","doi":"10.3350/cmh.2024.0564","DOIUrl":"https://doi.org/10.3350/cmh.2024.0564","url":null,"abstract":"Objective: With the obesity pandemic, metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease and a leading cause of end-stage liver disease and liver-related deaths in the U.S.A. Therefore, we aimed to compare the long-term outcomes of patients with MASLD and cirrhosis with and without bariatric surgery.Design: Patients were retrospectively identified from the California Department of Healthcare Access and Information database, 2005 to 2019, for a population-based cohort study. Propensity score matching (PSM) was used to balance background risks between patients with cirrhosis who underwent bariatric surgery and those who did not. Overall, liver-related, and non-liver-related mortality were analyzed.Results: Of 91,708 eligible patients with MASLD and cirrhosis, PSM yielded 2,107 patients who underwent bariatric surgery and 8,428 non-bariatric controls. Compared to matched controls, patients who underwent bariatric surgery had lower 5-year overall (24.9% vs. 37.1%; P < 0.0001), liver-related (3.3% vs. 14%; P < 0.0001), and non-liver-related mortality (22.3% vs. 26.9%; P = 0.046). In multivariable analysis, bariatric surgery was associated with decreased overall mortality (adjusted hazard ratio [aHR] = 0.63; P < 0.0001), liver-related (aHR = 0.24; P < 0.0001), and non-liver-related (aHR = 0.81; P = 0.0026) mortality. However, only laparoscopic surgeries were associated with lower overall mortality (aHR = 0.39; P < 0.0001) whereas open surgeries were associated with higher overall mortality (aHR = 1.24; P = 0.022).Conclusion: Patients with MASLD and cirrhosis who underwent bariatric surgery, specifically laparoscopic approaches, had significantly lower mortality risk than non-surgical counterparts.","PeriodicalId":10275,"journal":{"name":"Clinical and Molecular Hepatology","volume":" ","pages":""},"PeriodicalIF":14.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prospect of emerging treatments for HBV functional cure. HBV 功能性治愈新疗法的前景。

IF 14 1区医学

Clinical and Molecular Hepatology Pub Date : 2024-11-14 DOI: 10.3350/cmh.2024.0855

Rex Wan-Hin Hui, Lung-Yi Mak, James Fung, Wai-Kay Seto, Man-Fung Yuen

{"title":"Prospect of emerging treatments for HBV functional cure.","authors":"Rex Wan-Hin Hui, Lung-Yi Mak, James Fung, Wai-Kay Seto, Man-Fung Yuen","doi":"10.3350/cmh.2024.0855","DOIUrl":"https://doi.org/10.3350/cmh.2024.0855","url":null,"abstract":"Functional cure, defined as sustained hepatitis B surface antigen (HBsAg) seroclearance with unquantifiable hepatitis B virus (HBV) DNA at 24 weeks off treatment, is a favorable treatment endpoint in chronic hepatitis B (CHB). Nonetheless, functional cure is rarely attained with the current treatment modalities of nucleos(t)ide analogues (NUCs) and pegylated interferon alpha (Peg-IFNα). Multiple novel virus-targeting agents and immunomodulators are under development for HBV with functional cure as the treatment goal. Among virus-targeting agents, antisense oligonucleotides (ASOs) and small-interfering RNA (siRNAs) are the most advanced in the developmental pipeline, and can induce potent and sustainable HBsAg suppression. The other virus-targeting agents have varying effects on HBsAg and HBV DNA, depending on the drug mechanism. In contrast, immunomodulators have modest effects on HBsAg and have limited roles in monotherapy. Multiple combination regimens incorporating RNA interference agents with immunomodulators have been studied through many ongoing clinical trials. These combination strategies demonstrate synergistic effects in inducing functional cure, and will likely be the future direction of development. Despite the promising results, research is warranted to optimize treatment protocols and to establish criteria for NUC withdrawal after novel therapies. Functional cure is now an attainable target in CHB, and the emerging novel therapeutics will revolutionize CHB management.","PeriodicalId":10275,"journal":{"name":"Clinical and Molecular Hepatology","volume":" ","pages":""},"PeriodicalIF":14.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correspondence to editorials on "Safety and efficacy of HK-660S in patients with primary sclerosing cholangitis: A randomized double-blind phase 2a trial". 关于 "HK-660S 对原发性硬化性胆管炎患者的安全性和有效性：随机双盲2a期试验 "的社论。

IF 14 1区医学

Clinical and Molecular Hepatology Pub Date : 2024-11-11 DOI: 10.3350/cmh.2024.0989

Woo Hyun Paik, Do Hyun Park

引用次数: 0

Universal self-testing as a cost-effective weapon to eliminate hepatitis C virus in the Republic of Korea. 在大韩民国，普及自我检测是消除丙型肝炎病毒的一种具有成本效益的武器。

IF 14 1区医学

Clinical and Molecular Hepatology Pub Date : 2024-11-11 DOI: 10.3350/cmh.2024.0992

Eun Sun Jang

引用次数: 0

Correspondence to editorial on "Development and validation of a stromal-immune signature to predict prognosis in intrahepatic cholangiocarcinoma". 为 "用于预测肝内胆管癌预后的基质免疫特征的开发与验证 "的社论撰写通讯。

IF 14 1区医学

Clinical and Molecular Hepatology Pub Date : 2024-11-11 DOI: 10.3350/cmh.2024.0998

Yu-Hang Ye, Shao-Lai Zhou

引用次数: 0

Hepatitis E as a trigger for Acute-on-Chronic Liver Failure. 戊型肝炎是急性慢性肝衰竭的诱发因素。

IF 14 1区医学

Clinical and Molecular Hepatology Pub Date : 2024-11-11 DOI: 10.3350/cmh.2024.0758

Maria Buti, Juan Carlos Ruiz-Cobo, Rafael Esteban, Mar Riveiro-Barciela

引用次数: 0

Reply to "Insights on Risk Score Development: Considerations for Early-Stage Hepatocellular Carcinoma Models". 对 "关于风险评分开发的见解：早期肝细胞癌模型的考虑因素"。

IF 14 1区医学

Clinical and Molecular Hepatology Pub Date : 2024-11-11 DOI: 10.3350/cmh.2024.0999

Chun-Ting Ho, Elise Chia-Hui Tan, Chien-Wei Su

引用次数: 0

Hard-to-treat autoimmune hepatitis and primary biliary cholangitis: The dawn of a new era of pharmacological treatment. 难以治疗的自身免疫性肝炎和原发性胆汁性胆管炎：药物治疗新时代的曙光。

IF 14 1区医学

Clinical and Molecular Hepatology Pub Date : 2024-11-11 DOI: 10.3350/cmh.2024.0821

Atsumasa Komori, Yuki Kugiyama

{"title":"Hard-to-treat autoimmune hepatitis and primary biliary cholangitis: The dawn of a new era of pharmacological treatment.","authors":"Atsumasa Komori, Yuki Kugiyama","doi":"10.3350/cmh.2024.0821","DOIUrl":"https://doi.org/10.3350/cmh.2024.0821","url":null,"abstract":"Patients with hard-to-treat autoimmune hepatitis (AIH) or primary biliary cholangitis (PBC) are defined a posteriori as those who do not show a sufficient response or are intolerant to pharmacological treatments, thus not achieving biochemical surrogate endpoints that are associated with long-term liver-related-event-free survival. The absence of a recently harmonized definition of 'complete biochemical response within 6 months (CBR≤6M)', which is defined as the normalization of serum transaminase and IgG levels below the upper limit of normal (ULN) at ≤6 months after treatment initiation is regarded as hard-to-treat AIH. The implementation of CBR≤6M, in turn, has been facilitating clinical trials, e.g., between azathioprine and mycophenolate mofetil, to reconsider appropriate first-line steroid sparing agents, leading to a reduction in the number of hard-to-treat AIH cases. Regarding PBC, one of the disseminated definitions of hard-to-treat patients is the absence of POISE criteria, which are evaluated at 12 months with serum alkaline phosphatase and bilirubin levels, after the introduction of ursodeoxycholic acid. Hard-to-treat PBC not meeting the POISE criteria has very recently been the target population for the U.S. FDA-approved second-line drugs, elafibranor and seladelpar. In future pharmacological treatment of AIH and PBC, the primary objective for AIH is likely to focus on lowering the number of hard-to-treat patients with personalized steroid sparing treatment regimens. A challenging goal in PBC treatment is the further optimization of treatment surrogate endpoints, even to the stricter ALP normalization, with which an indication of second- or later-line drugs might be expanded, but could ultimately lengthen patients' long-term survival.","PeriodicalId":10275,"journal":{"name":"Clinical and Molecular Hepatology","volume":" ","pages":""},"PeriodicalIF":14.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the Editor Clinical and Molecular Hepatology Correspondence on the Editorial regarding "The use of transient elastography for predicting hepatocellular carcinoma in chronic hepatitis B patients". 致编辑的信临床与分子肝病学》杂志就 "使用瞬态弹性成像技术预测慢性乙型肝炎患者的肝细胞癌 "发表的社论进行通信。

IF 14 1区医学

Clinical and Molecular Hepatology Pub Date : 2024-11-11 DOI: 10.3350/cmh.2024.0994

Mirko Zoncapè, Emmanuel A Tsochatzis

引用次数: 0

Stem cell exosomes: new hope and future potential for relieving liver fibrosis. 干细胞外泌体：缓解肝纤维化的新希望和未来潜力。

IF 14 1区医学

Clinical and Molecular Hepatology Pub Date : 2024-11-07 DOI: 10.3350/cmh.2024.0854

Lihua Li, Yongjie Liu, Kunpeng Wang, Jinggang Mo, Zhiyong Weng, Hao Jiang, Chong Jin

{"title":"Stem cell exosomes: new hope and future potential for relieving liver fibrosis.","authors":"Lihua Li, Yongjie Liu, Kunpeng Wang, Jinggang Mo, Zhiyong Weng, Hao Jiang, Chong Jin","doi":"10.3350/cmh.2024.0854","DOIUrl":"https://doi.org/10.3350/cmh.2024.0854","url":null,"abstract":"Liver fibrosis is a chronic liver injury resulting from factors like viral hepatitis, autoimmune hepatitis, non-alcoholic steatohepatitis, fatty liver disease, and cholestatic liver disease. Liver transplantation is currently the gold standard for treating severe liver diseases. However, it is limited by a shortage of donor organs and the necessity for lifelong immunosuppressive therapy. Mesenchymal stem cells (MSCs) can differentiate into various liver cells and enhance liver function when transplanted into patients due to their differentiation and proliferation capabilities. Therefore, it can be used as an alternative therapy for treating liver diseases, especially for liver cirrhosis, liver failure, and liver transplant complications. However, due to the potential tumorigenic effects of MSCs, researchers are exploring a new approach to treating liver fibrosis using extracellular vesicles (exosomes) secreted by stem cells. Many studies show that exosomes released by stem cells can promote liver injury repair through various pathways, contributing to the treatment of liver fibrosis. In this review, we focus on the molecular mechanisms by which stem cell exosomes affect liver fibrosis through different pathways and their potential therapeutic targets. Additionally, we discuss the advantages of exosome therapy over stem cell therapy and the possible future directions of exosome research, including the prospects for clinical applications and the challenges to be overcome.","PeriodicalId":10275,"journal":{"name":"Clinical and Molecular Hepatology","volume":" ","pages":""},"PeriodicalIF":14.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0