Clinics and research in hepatology and gastroenterology最新文献

{"title":"Effects of continuous venous-venous hemofiltration with or without hemoperfusion on patients with hypertriglyceride acute pancreatitis","authors":"Ying Wang ,&nbsp;Gao-fan Dai ,&nbsp;Wen-biao Xiao ,&nbsp;Jing-shi Shi ,&nbsp;Bing-wen Lin ,&nbsp;Jian-dong Lin ,&nbsp;Xiong-jian Xiao","doi":"10.1016/j.clinre.2025.102572","DOIUrl":"10.1016/j.clinre.2025.102572","url":null,"abstract":"<div><h3>Background</h3><div>The role of continuous venous-venous hemofiltration (CVVH) and combined CVVH with hemoperfusion (HP) in patients with acute pancreatitis (AP) is diverse. We hypothesized HP+CVVH, rather than CVVH alone, could have significant benefits in hypertriglyceridemia (HTG)-AP patients.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included 347 patients with hypertriglyceride (HTH) -AP treated from January 2020 to December 2023. We assessed the association of short- and long-term outcomes (including incidence of systemic and local complications, length of ICU and hospital stays, and costs) between the HP+CVVH and CVVH groups. A subgroup analysis was performed to explore the effects of heterogeneity upon the incidence of severe AP (SAP).</div></div><div><h3>Results</h3><div>Among 86 included patients, 40 received HP+CVVH therapy, and 46 received CVVH. Subgroup analysis revealed a lower incidence of severe AP after HP+CVVH therapy in patients with high procalcitonin, C-reactive protein, and interleukin-6 levels (46.4 % vs. 80.0 %, <em>p</em> = 0.019; 33.3 % vs. 72.7 %, <em>p</em> = 0.010; 37.5 % vs. 79.2 %, respectively). A significantly decreased hospital length of stay (LOS) in the HP+CVVH group was observed (10.40 [8.63–12.17] vs. 15.48 [13.02–17.94] days, <em>p</em> = 0.001). Furthermore, HP+CVVH showed a tendency towards lower hospital costs than CVVH ($5128 [4312–5943] vs. $8168 [6416–9920], <em>p</em> = 0.001). No significant differences were observed in the incidence of systemic or local complications, recurrence rates, or quality of life.</div></div><div><h3>Conclusions</h3><div>The use of HP+CVVH yielded superior outcomes in terms of the incidence of SAP compared to that of CVVH, for HTG-AP patients with a high inflammatory burden.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 5","pages":"Article 102572"},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction subtypes and risk of colorectal cancer: A prospective cohort study","authors":"Yuan Li ,&nbsp;Xiang-ming Ma ,&nbsp;Jian-guo Jia,&nbsp;Li-ying Cao","doi":"10.1016/j.clinre.2025.102573","DOIUrl":"10.1016/j.clinre.2025.102573","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate the association between a new definition of metabolic dysfunction-associated steatotic liver disease (MASLD), different metabolic dysfunction subtypes and risk of colorectal cancer(CRC).</div></div><div><h3>Methods</h3><div>A total of 99,979 participants who met the criteria were included from the Kailuan Study. Participants were categorized into three groups based on fatty liver disease and metabolic status: Non-SLD with metabolic normal group(NMN), Non-SLD with metabolic abnormal group(NMA) and MASLD group. Incident of CRC were confirmed by review of medical records. The Cox proportional hazard regression models were used to assess the association MASLD with the risk of CRC by calculating the hazard ratios (HR) and 95 % confidence interval (CI).</div></div><div><h3>Results</h3><div>During a mean 13.54 ± 2.78 years of follow-up, we documented 669 CRC. Multivariate Cox regression analysis showed that compared with the NMN group, MASLD participants demonstrated an increased risk of developing CRC (HR 1.54 95 %CI 1.12–2.13). The greater the number of metabolic dysfunctions, the greater the risks of CRC (<em>P</em> &lt; 0.05). The HR for CRC was 1.93 (95 % CI 1.27–2.92) in MASLD participants with 4–5 items of metabolic dysfunctions. In the subtype analysis, the HR for CRC was 1.97 (95 % CI 1.13–3.45) in lean-MASLD participants and 1.55(95 %CI 1.12–2.15) in diabetes-MASLD participants.</div></div><div><h3>Conclusion</h3><div>MASLD was associated with increased risk of CRC. Moreover, MASLD individuals who complicated by lean or diabetes have an increased risk of developing CRC.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 5","pages":"Article 102573"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the function of kinesin superfamily proteins in gastric cancer: Implications for signal transduction, clinical significance, and potential therapeutic approaches","authors":"Gaurav Sanghvi ,&nbsp;Roopashree R ,&nbsp;Aditya Kashyap ,&nbsp;A. Sabarivani ,&nbsp;Subhashree Ray ,&nbsp;Pushpa Negi Bhakuni","doi":"10.1016/j.clinre.2025.102571","DOIUrl":"10.1016/j.clinre.2025.102571","url":null,"abstract":"<div><div>Gastric cancer (GC), a leading cause of cancer-related mortality, poses a significant global health challenge. Given its complex etiology, understanding the molecular pathways driving GC progression is crucial for developing innovative therapeutic strategies. Among the diverse proteins involved in cellular transport and mitotic regulation, kinesin superfamily proteins (KIFs) have emerged as key players in tumor biology. These motor proteins mediate intracellular transport along microtubules and are essential for processes such as cell division, signaling, and organelle distribution. Evidence indicates that specific KIFs are dysregulated in GC, potentially driving cancer cell proliferation, metastasis, and chemoresistance. Moreover, aberrant KIF expression has been associated with poorer prognoses, highlighting their potential as biomarkers for early diagnosis and therapeutic intervention. This review explores the roles of KIFs in GC and assesses their implications for research and clinical applications. By elucidating the significance of KIFs in GC, this discussion aims to inspire novel insights in cancer biology and advance targeted therapeutic strategies.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 5","pages":"Article 102571"},"PeriodicalIF":2.6,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in autoimmune hepatitis epidemiology, treatment and complication – a 15-year retrospective study","authors":"Mifleh Tatour ,&nbsp;Fadi Abu Baker ,&nbsp;Tarek Saadi ,&nbsp;Ahmad Yahia ,&nbsp;Rawi Hazzan","doi":"10.1016/j.clinre.2025.102570","DOIUrl":"10.1016/j.clinre.2025.102570","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Autoimmune hepatitis (AIH) is a rare, heterogeneous liver disease marked by autoantibodies, hypergammaglobulinemia, and distinct histological features. Predominantly affecting women, its incidence and prevalence show significant regional variability globally. Therefore, our aim is to examine the trends of AIH and to assess its demographics, management, and disease progression using an extensive population-based database.</div></div><div><h3>Materials and Methods</h3><div>This retrospective, population-based study analyzed data from 2.7 million adults in Clalit Health Services, focusing on autoimmune hepatitis (AIH) diagnoses between 2009 and 2023. Data reordered included demographics, clinical details, and treatment regimens. Key outcomes tracked were the development of cirrhosis and its complications.</div></div><div><h3>Results</h3><div>This study included 992 AIH patients with a median age of 51.5 years, 80.4 % female, and a median follow-up of 6.1 years. Obesity was present in 23.2 %, and 10.9 % had thyroid disease. At diagnosis, 22.9 % had cirrhosis, and an additional 137 patients developed cirrhosis during follow-up, leading to a total prevalence of 36.5 %. Among cirrhotic patients, 29.9 % experienced decompensation, 25.3 % developed ascites, 9.3 % had variceal bleeding, and 10.4 % developed hepatic encephalopathy. Hepatocellular carcinoma (HCC) occurred in 5.24 % of cirrhotic patients, with an incidence rate of 6.32 cases per 1000 patient-years. Overall, 11.2 % of cirrhotic patients underwent liver transplantation. The proportion of AIH patients diagnosed with cirrhosis at the time of diagnosis significantly decreased over the study period (<em>p</em> = 0.0028).</div></div><div><h3>Conclusions</h3><div>This study demonstrates a decreasing trend in AIH patients diagnosed with cirrhosis, suggesting earlier detection and improved management, alongside a lower documented incidence of HCC.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 4","pages":"Article 102570"},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serrated lesion detection 2.0: Of blurred vessels and luminal overinflation","authors":"Vincent Zimmer","doi":"10.1016/j.clinre.2025.102564","DOIUrl":"10.1016/j.clinre.2025.102564","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 4","pages":"Article 102564"},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macrophage therapy and liver regeneration: Results and perspectives","authors":"Nicolas Lanthier ,&nbsp;Laurent Spahr","doi":"10.1016/j.clinre.2025.102569","DOIUrl":"10.1016/j.clinre.2025.102569","url":null,"abstract":"<div><div>The recent results of the study evaluating the impact of macrophage transplantation in cirrhosis with the aim of improving liver function open up a number of prospects. Although negative, fewer deaths were observed, as well as a favourable cytokine profile. This is in line with other results obtained in liver disease, notably through signalling and regeneration studies on human liver tissue. For the future, a number of questions need to be answered if we are to make progress in this fascinating field.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 4","pages":"Article 102569"},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of frailty on outcomes and biliary drainage strategies in acute cholangitis: A retrospective cohort analysis","authors":"Ali Jaan ,&nbsp;Amraha Zubair ,&nbsp;Umer Farooq ,&nbsp;Hamna Nadeem ,&nbsp;Ammad Javaid Chaudhary ,&nbsp;Muhammad Shahzil ,&nbsp;Ashish Dhawan ,&nbsp;Hammad Zafar ,&nbsp;Asad ur Rahman ,&nbsp;Tilak Shah","doi":"10.1016/j.clinre.2025.102568","DOIUrl":"10.1016/j.clinre.2025.102568","url":null,"abstract":"<div><h3>Background</h3><div>Acute cholangitis (AC) is a potentially fatal infection of the biliary tract characterized by varying degrees of severity, with endoscopic retrograde cholangiopancreatography (ERCP) serving as the primary drainage modality. Though frailty is linked to poor outcomes in general, its implications for AC patients remain unexplored.</div></div><div><h3>Methods</h3><div>Using the National Inpatient Sample Database 2017–2020, we identified adult AC hospitalizations, which were further stratified based on frailty. A multivariate regression model was used for analysis.</div></div><div><h3>Results</h3><div>We included 32,310 AC patients, out of whom 11,230 (34.76 %) were frail. Frail patients had elevated AC severity as well as in-hospital mortality (adjusted odds ratio [aOR] 6.89; <em>P</em> &lt; 0.01). Additionally, frail patients were found to have significantly higher odds of complications including septic shock (aOR 15.87), acute renal failure (aOR 5.67), acute respiratory failure (aOR 11.11) and need for mechanical ventilation (aOR 13.80). From a procedural viewpoint, frail patients had higher odds of undergoing percutaneous biliary drainage (PBD) but lower odds of undergoing “early” ERCP (ERCP within 24 h of admission). When compared to non-frail counterparts, frail patients were more likely to undergo PBD as opposed to early ERCP (aOR 1.46; <em>P</em> = 0.01).</div></div><div><h3>Conclusion</h3><div>Frailty independently predicts poor AC outcomes and has a notable impact on the choice of biliary drainage procedure. Recognizing frailty instead of age alone as a determinant of AC outcomes can aid clinicians in risk stratification and guide tailored interventions in this population.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 4","pages":"Article 102568"},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the presentation and characteristics OF HCV related hepatocellular carcinoma in the era of direct acting antiviral therapy: A retrospective study","authors":"Randa Salah Abdelmoneim,&nbsp;Fathalla Sedki,&nbsp;Mohamed Fathy Bakosh","doi":"10.1016/j.clinre.2025.102567","DOIUrl":"10.1016/j.clinre.2025.102567","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma (HCC) is the sixth common malignancy worldwide. In Egypt, the main cause of HCC is hepatitis C virus (HCV)-related cirrhosis. After the successful mass treatment program of HCV in 2018 with direct-acting antivirals (DAAs) therapy, a large percentage of patients have been treated and effectively achieved sustained virological response (SVR). Recently, some studies claimed that HCCs that developed after treatment with DAAs have more aggressive behavior. Purpose of the study is to detect the possible change of HCC pattern before and after DAAs era and its effect on overall survival (OS).</div></div><div><h3>Methods</h3><div>428 naïve HCC patients were divided into 2 groups: Group I HCC patients not treated with DAAs and Group II HCC patients treated with DAAs. Then we compared demographic, clinical, radiological, and laboratory characteristics between both groups.</div></div><div><h3>Results</h3><div>Group II had improved liver function tests, including serum bilirubin, albumin, and international normalized ratio, than Group I (<em>p</em> &lt; 0.001, <em>p</em> &lt; 0.001, <em>p</em> &lt; 0.001, respectively). They had a lower level of liver aminotransferases. Group II showed a larger infiltrative pattern of HCC, with a high incidence of portal vein thrombosis (<em>p</em> = 0.003, <em>p</em> &lt; 0.001, <em>p</em> = 0.048, respectively). Group II received more curative or palliative treatment options, while 55 % of Group I received the best supportive care. There was no significant difference in 1-year and 2-years OS between both group, except that group II patients had better 2-year OS in subgroup BCLC stage C.</div></div><div><h3>Conclusion</h3><div>The tumor pattern has changed into a more aggressive phenotype after DAAs. DAAs have succeeded in preserving the liver condition. However, they did not demonstrate any protective effect on the OS of the patients. There is a strong need for strict screening program for early detection of HCC in the early stages, that are eligible for curative options, after HCV treatment of DAAs<strong>.</strong></div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 4","pages":"Article 102567"},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term virological and clinical evaluation of chronic hepatitis B patients under nucleos(t)ide analogues therapy","authors":"Maria Stella Franzè ,&nbsp;Carlo Saitta ,&nbsp;Daniele Lombardo ,&nbsp;Cristina Musolino ,&nbsp;Gaia Caccamo ,&nbsp;Roberto Filomia ,&nbsp;Concetta Pitrone ,&nbsp;Irene Cacciola ,&nbsp;Teresa Pollicino ,&nbsp;Giovanni Raimondo","doi":"10.1016/j.clinre.2025.102566","DOIUrl":"10.1016/j.clinre.2025.102566","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Identifying hepatitis B virus (HBV) patients eligible for safe nucleos(t)ide analogues (NAs) discontinuation remains challenging. Discrepant data on combined HBV DNA and quantitative HBV surface antigen (qHBsAg) assessments are available. This study aimed to identify potential predictors for safe treatment discontinuation by evaluating clinical/virological outcomes in patients on long-term NA therapy.</div></div><div><h3>Patients and methods</h3><div>A retrospective cohort of 139 chronic hepatitis B (CHB) patients - who consecutively started Entecavir or Tenofovir from 2007 to 2011 - was evaluated. The study population was selected based on anti-HBe positivity, absence of prior antiviral treatment, absence of non-HBV-related liver diseases or hepatocellular carcinoma (HCC), and long-term clinical/ultrasonographic/laboratory evaluations post-NA initiation. Serum samples collected before starting NA (T0) and over ten years (T1-T10) were tested for HBV DNA and qHBsAg.</div></div><div><h3>Results</h3><div>Twenty-two/139 (15.8 %) CHB patients (12 chronic hepatitis, 10 cirrhosis) met the inclusion criteria. All patients showed a significant decrease in liver stiffness values in the ten years of follow-up (<em>p</em> = 0.001), and no hepatic decompensation occurred. Three/22 (13.6 %) patients developed HCC. Ten/22 patients (45.5 %; group-A) had fluctuating HBV DNA, while other 10/22 (45.5 %; group-B) showed undetectable HBV DNA for 5–9 years with more significant qHBsAg decline (<em>p</em> = 0.04) than group-A. Two/22 (9.1 %) patients showed a critical qHBsAg decline up to seroconversion together with undetectable HBV DNA.</div></div><div><h3>Conclusions</h3><div>Persistent undetectable HBV DNA levels correlate with qHBsAg reduction and the potential HBsAg seroclearance, suggesting that long-term HBV DNA monitoring in NA-treated CHB patients might help identify candidates for treatment discontinuation.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 4","pages":"Article 102566"},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatomegaly as the first clue to familial mediterranean fever","authors":"Rim Bourguiba ,&nbsp;Romain Guery ,&nbsp;Lea Savey ,&nbsp;Laurence Cuisset ,&nbsp;Sophie Georgin-Lavialle","doi":"10.1016/j.clinre.2025.102565","DOIUrl":"10.1016/j.clinre.2025.102565","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 4","pages":"Article 102565"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}