Clinical and Molecular Hepatology最新文献_第3页

Predictive Machine Learning Model in ICU Patients with Acute-on-Chronic Liver Failure and Two or More Organ Failures. 预测机器学习模型在ICU急慢性肝衰竭和两个或两个以上器官衰竭患者中的应用。

IF 16.9 1区医学

Clinical and Molecular Hepatology Pub Date : 2025-09-01 DOI: 10.3350/cmh.2025.0573

Yee Hui Yeo, Mengyi Zhang, Martin S McCoy, Jian Zu, Yingli He, Yi Liu, Juan Li, Taotao Yan, Yuan Wang, Hirsh D Trivedi, Ju Dong Yang, Vinay Sundaram, Xiaodan Sun, Zhujun Cao, Chun-Ying Wu, Jonel Trebicka, Fanpu Ji

{"title":"Predictive Machine Learning Model in ICU Patients with Acute-on-Chronic Liver Failure and Two or More Organ Failures.","authors":"Yee Hui Yeo, Mengyi Zhang, Martin S McCoy, Jian Zu, Yingli He, Yi Liu, Juan Li, Taotao Yan, Yuan Wang, Hirsh D Trivedi, Ju Dong Yang, Vinay Sundaram, Xiaodan Sun, Zhujun Cao, Chun-Ying Wu, Jonel Trebicka, Fanpu Ji","doi":"10.3350/cmh.2025.0573","DOIUrl":"https://doi.org/10.3350/cmh.2025.0573","url":null,"abstract":"Background: Prediction of short-term mortality in patients with acute-on-chronic liver failure (ACLF) admitted in the intensive care unit (ICU) may enhance effective management.Methods: To develop, explain, and validate a predictive machine learning (ML) model for short-term mortality in patients with ACLF with two or more organ failures (OFs). Utilizing a large ICU cohort with detailed clinical information, we identified ACLF patients with two or more OFs according to the EASL-CLIF and NACSELD definitions. ML model was developed for each definition to predict 30-day mortality. The Shapley value was estimated to explain the models. Validation and calibration of these models were performed.Results: Of 5994 patients with cirrhosis admitted to ICU, 1511 met NACSELD criteria, and 1692 met EASL-CLIF grade II or higher criteria. The CatBoost ACLF (CBA) model had the greatest accuracy in the NACSELD cohort (AUC of 0.87), while the Random Forest ACLF (RFA) model performed best in the EASL-CLIF cohort (AUC of 0.83). Both models showed robust calibration. The models were explained by SHAP score analysis, yielding a rank list, and the top twelve predictors were selected. Both simplified models demonstrated similar performance (CBA model: AUC 0.89, RFA model: AUC 0.81) and significantly outperformed contemporary scoring systems, including CLIF-C ACLF and MELD 3.0. The models were validated in both internal and external cohorts. A simple-to-use online tool was created to predict mortality rates.Conclusions: We presented explainable, well-validated, and calibrated predictive models for ACLF patients with two or more OFs, which outperformed existing predictive scores.","PeriodicalId":10275,"journal":{"name":"Clinical and Molecular Hepatology","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945137","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

Sex‑Specific Trends and Demographic vs Epidemiologic Drivers of Alcohol‑Related Cirrhosis in United States, 2021-2040. 美国酒精相关肝硬化的性别特定趋势和人口统计学与 流行病学驱动因素， 2021-2040。

IF 16.9 1区医学

Clinical and Molecular Hepatology Pub Date : 2025-08-25 DOI: 10.3350/cmh.2025.0790

Kui Wang, Yunqing Zeng

引用次数: 0

Correspondence to editorial on "Human cytomegalovirus reactivation in cirrhosis patients with acute decompensation". 与“肝硬化急性代偿失代偿患者巨细胞病毒再激活”社论对应。

IF 16.9 1区医学

Clinical and Molecular Hepatology Pub Date : 2025-08-25 DOI: 10.3350/cmh.2025.0899

Changze Hong, Jinjun Chen

引用次数: 0

Harnessing the Microbiome: Unveiling the Influence of the Gut Microbiota on Hepatobiliary Cancer Therapeutic Strategies. 利用微生物群：揭示肠道微生物群对肝癌治疗策略的影响。

IF 16.9 1区医学

Clinical and Molecular Hepatology Pub Date : 2025-08-25 DOI: 10.3350/cmh.2025.0476

Melody Yusong Li, Xue Qian Wu, Terence Kin Wah Lee

{"title":"Harnessing the Microbiome: Unveiling the Influence of the Gut Microbiota on Hepatobiliary Cancer Therapeutic Strategies.","authors":"Melody Yusong Li, Xue Qian Wu, Terence Kin Wah Lee","doi":"10.3350/cmh.2025.0476","DOIUrl":"https://doi.org/10.3350/cmh.2025.0476","url":null,"abstract":"The gut microbiota significantly influences hepatobiliary cancer therapeutics. Growing evidence indicates that shifts in the gut microbial ecosystem are hallmarks of hepatocellular carcinoma and cholangiocarcinoma, strongly correlating with tumor development, therapeutic resistance, and patient survival. The composition of gut microbiota has emerged as a biomarker associated with treatment outcomes across various modalities, including chemotherapy, radiotherapy, targeted therapy, and immunotherapy. Beneficial bacterial communities enhance antitumor immunity, while pathogenic taxa are linked to reduced therapeutic efficacy. Multi-omics analyses have identified microbial metabolite signatures, such as short-chain fatty acids and bile acids, as potential targets for boosting antitumor responses. This review highlights the transformative potential of leveraging the gut microbiota to enhance precision oncology in hepatobiliary cancer. Future directions should prioritize personalized microbiota modulation approaches, combinatorial therapies targeting gut-liver axis crosstalk, and large-scale validation of microbial biomarkers across diverse populations.","PeriodicalId":10275,"journal":{"name":"Clinical and Molecular Hepatology","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945175","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

Genome-wide SNP-BMI interaction analysis highlights CYP7A1 and GIPR as two novel genetic modifiers of MASLD. 全基因组SNP-BMI互作分析表明CYP7A1和GIPR是MASLD的两个新的遗传修饰因子。

IF 16.9 1区医学

Clinical and Molecular Hepatology Pub Date : 2025-08-25 DOI: 10.3350/cmh.2025.0923

Julia Kozlitina

引用次数: 0

Plasma Lipidomic and Fungal Signatures Predict Early Mortality in Acute Liver Failure. 血浆脂质组学和真菌特征预测急性肝衰竭的早期死亡率。

IF 16.9 1区医学

Clinical and Molecular Hepatology Pub Date : 2025-08-20 DOI: 10.3350/cmh.2025.0813

Yu Ji Kim, Jong-Won Kim

引用次数: 0

Tumor-based biomarkers and circulating tumor DNA for precision medicine in advanced hepatocellular carcinoma. 基于肿瘤的生物标志物和循环肿瘤DNA用于晚期肝癌的精准医疗。

IF 16.9 1区医学

Clinical and Molecular Hepatology Pub Date : 2025-08-20 DOI: 10.3350/cmh.2025.0746

Sabrina Sidali, Claudia Campani, Jihyun An, Ju Hyun Shim, Jean-Charles Nault

{"title":"Tumor-based biomarkers and circulating tumor DNA for precision medicine in advanced hepatocellular carcinoma.","authors":"Sabrina Sidali, Claudia Campani, Jihyun An, Ju Hyun Shim, Jean-Charles Nault","doi":"10.3350/cmh.2025.0746","DOIUrl":"10.3350/cmh.2025.0746","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the most common primary liver cancer and remains a major cause of cancer-related mortality worldwide. Systemic therapies, including targeted therapies and immune checkpoint inhibitors (ICIs), have revolutionized the management of advanced HCC. Although the prognosis of patients with advanced HCC remains poor, significant progress has been made with recent advances in drug development, particularly with the introduction of effective treatments such as atezolizumab plus bevacizumab or durvalumab plus tremelimumab. Indeed, treatment response varies significantly among patients, highlighting the need for robust biomarkers. In addition, the development of molecular driver-targeted therapies remains an active research focus as most genetic alterations observed in HCC are currently undruggable. Meeting these goals will require additional efforts to obtain histological material in clinical trials, in order to enable robust translational research. This review explores the current landscape of biomarkers of response to systemic treatments in HCC, including molecular, immune-based markers as well as circulating tumor DNA and highlights potential paths of improvement.","PeriodicalId":10275,"journal":{"name":"Clinical and Molecular Hepatology","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882252","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

"Surrogates Without Substance?" Questioning the Evidence for Histologic Improvement With HTD1801. “没有实质的代理人？”HTD1801对组织学改善证据的质疑。

IF 16.9 1区医学

Clinical and Molecular Hepatology Pub Date : 2025-08-19 DOI: 10.3350/cmh.2025.0868

Zhihao Lei

引用次数: 0

Letter to the editor on "HTD1801 demonstrates promising potential for histologic improvements in metabolic dysfunction-associated steatohepatitis in both a preclinical and phase 2 study. ". 致编辑的信“HTD1801在临床前和2期研究中显示了代谢功能障碍相关脂肪性肝炎的组织学改善潜力。＂．

IF 16.9 1区医学

Clinical and Molecular Hepatology Pub Date : 2025-08-19 DOI: 10.3350/cmh.2025.0804

Xi-Lin Gao

引用次数: 0

Pediatric metabolic dysfunction-associated steatotic liver disease and the gut microbiome: from research landscape to targeted modulation. 儿童代谢功能障碍相关的脂肪变性肝病和肠道微生物组：从研究前景到靶向调节。

IF 16.9 1区医学

Clinical and Molecular Hepatology Pub Date : 2025-08-19 DOI: 10.3350/cmh.2025.0718

Lu Jiang, Lan-Duoduo Du, Jing Zeng, Hui-Kuan Chu, Zhong Peng, Jian-Gao Fan

{"title":"Pediatric metabolic dysfunction-associated steatotic liver disease and the gut microbiome: from research landscape to targeted modulation.","authors":"Lu Jiang, Lan-Duoduo Du, Jing Zeng, Hui-Kuan Chu, Zhong Peng, Jian-Gao Fan","doi":"10.3350/cmh.2025.0718","DOIUrl":"10.3350/cmh.2025.0718","url":null,"abstract":"Metabolic dysfunction-associated steatotic liver disease (MASLD), formally known as non-alcoholic fatty liver disease, has become the most common form of chronic liver disease in children. The spectrum of pediatric MASLD ranges from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and in rare cases, hepatocellular carcinoma. Its pathogenesis involves a complex interplay among genetic, epigenetic, and environmental factors, along with alterations in the gut microbiota and its associated metabolites. Given the staggering prevalence and the distinct etiopathogenesis of pediatric MASLD, characterization of the gut microbiota and microbial products could facilitate the development of diagnostic tools and inform targeted therapeutic strategies. Current research on the gut microbiome in the context of pediatric MASLD is limited by small sample size, inadequate use of liver biopsy, methodological inconsistencies in sequencing, and confounding effects from metabolic comorbidities. In this review, we summarize clinical studies on alterations in the gut microbiota and microbial products (short-chain fatty acids, bile acids, and ethanol) that impact the pathogenesis of pediatric MASLD. We discuss the therapeutic potential of dietary modification, pharmacological treatments, and probiotics in improving disease progression by summarizing current clinical studies. Enhancing our understanding of the gut-liver axis may aid in the development of effective therapeutic strategies for pediatric MASLD.","PeriodicalId":10275,"journal":{"name":"Clinical and Molecular Hepatology","volume":" ","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871671","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