Clinics and research in hepatology and gastroenterology最新文献

{"title":"Aberrant wound healing complicating device-assisted full thickness resection: Nodular smooth muscle proliferation as a clip artifact","authors":"Vincent Zimmer","doi":"10.1016/j.clinre.2025.102660","DOIUrl":"10.1016/j.clinre.2025.102660","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102660"},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752611","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":"Percutaneous transhepatic bilio-enteric neoanastomosis via the transseptal puncture system in a child with split liver transplant and severe occluded hepatico-jejunostomy","authors":"Guglielmo Paolantonio ,&nbsp;Claudia Benassi ,&nbsp;Gian Luigi Natali","doi":"10.1016/j.clinre.2025.102654","DOIUrl":"10.1016/j.clinre.2025.102654","url":null,"abstract":"<div><div>Pediatric split liver transplantation can be frequently complicated with stenosis of the hepatico-jejunostomy, a high-morbidity outcome that might progress to secondary biliary cirrhosis and require re-transplantation if left untreated. Percutaneous interventional radiology management is typically the safest and most efficient way to prevent surgical revision of the stenotic bilio-enteric anastomosis because the endoscopy is typically not viable in the Roux-en-Y. We report the case of a 6-year-old child with a left lateral segment partial liver transplantation and acute onset of cholestasis due to occlusion of the hepatico-jejuno anastomosis. The biliary stricture was non-crossable with conventional interventional radiological techniques, so the transseptal puncture system was successfully used to resolve the stenosis, creating a new bilio-digestive communication via the percutaneous transhepatic approach. Employment of the transseptal puncture system for percutaneous transhepatic biliary interventional procedures is unusual because this device is commonly used by interventional cardiologists to carry out treatments that necessitate direct access to the left atrium via interatrial septal puncture. Percutaneous transhepatic recanalization of high occlusive biliary stricture is a rare but feasible and valuable procedure alternative to the surgical resolution. Despite the small number of cases reported in literature, it must be regarded as a backup therapy option in the event that the traditional methods are ineffective.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102654"},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713049","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":"The association between metabolic-associated fatty liver diseases and risk of colorectal polyps, neoplasia, and cancer: A systematic review and meta-analysis of over 56 million individuals","authors":"Amir Azimi ,&nbsp;Amir Ghaffari Jolfayi ,&nbsp;Vida Rezayifar ,&nbsp;Fatemeh Ateen ,&nbsp;Hanie Hosseini Fard ,&nbsp;San Khasraw Mohammed Mohammed ,&nbsp;Hale Hosseinizadeh ,&nbsp;Sanam Faizabadi ,&nbsp;Ali Keshavarzian ,&nbsp;Mohammad Ali Mansournia ,&nbsp;Massoud Vosough ,&nbsp;Mohammad Rahmanian","doi":"10.1016/j.clinre.2025.102652","DOIUrl":"10.1016/j.clinre.2025.102652","url":null,"abstract":"<div><h3>Background and aims</h3><div>Non-alcoholic fatty liver disease (NAFLD) and metabolic-associated fatty liver disease (MAFLD) affect over 30 % of the global population. Extrahepatic manifestations, including colorectal malignancies, represent the second leading cause of death in these patients. This study evaluates the association between NAFLD/MAFLD and colorectal polyps, neoplasia, and cancer.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Web of Science, Scopus, and Google Scholar through June 2025. Observational studies reporting odds ratios (ORs) or hazard ratios for colorectal pathologies in NAFLD/MAFLD patients were included. Quality assessment was performed using Joanna Briggs Institute tools. Random-effects meta-analysis calculated pooled effect sizes with subgroup analyses to explore heterogeneity.</div></div><div><h3>Results</h3><div>Forty-eight studies encompassing 56,175,279 participants were analyzed. NAFLD/MAFLD was associated with significantly increased risk of colorectal polyps (OR 1.86, 95 % CI: 1.51–2.30), adenomas (OR 1.81, 95 % CI: 1.62–2.02), CRC (OR 1.37, 95 % CI: 1.30–1.45), overall neoplasia (OR 1.50, 95 % CI: 1.24–1.81), hyperplastic polyps (OR 1.60, 95 % CI: 1.34–1.91), and multiple adenomas (OR 1.49, 95 % CI: 1.16–1.91). Associations were confirmed in both imaging-based and biopsy-proven studies, with adjusted analyses supporting these findings. However, no significant association was found with advanced or large adenomas. Lean patients (BMI &lt;25 kg/m²) showed stronger associations with adenoma risk than those with BMI ≥25 kg/m² (<em>p</em> = 0.027). Sensitivity analyses confirmed the robustness of the results.</div></div><div><h3>Conclusion</h3><div>NAFLD/MAFLD significantly increases colorectal polyp risk, particularly adenomas, hyperplastic polyps, overall neoplasia, and CRC, emphasizing the need for targeted colorectal screening. Future research should focus on prospective studies and mechanistic insights to enhance preventive strategies.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102652"},"PeriodicalIF":2.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706583","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":"The role of tumor microenvironment in lenvatinib resistance of hepatocellular carcinoma","authors":"Yao Jiang ,&nbsp;Yingchen Huang ,&nbsp;Xin Hu ,&nbsp;Guanrong Chen ,&nbsp;Ronggao Chen ,&nbsp;Xiao Xu","doi":"10.1016/j.clinre.2025.102642","DOIUrl":"10.1016/j.clinre.2025.102642","url":null,"abstract":"<div><div>In 2018, lenvatinib was approved as a first-line treatment of advanced hepatocellular carcinoma (HCC). Despite the initial success, its effectiveness in long-term clinical practice is restricted by the emergence of drug resistance. The tumor microenvironment (TME), comprised of various cellular and non-cellular components,collectively drives HCC growth, invasion, and resistance to treatment. Currently, numerous investigations have elucidated that lenvatinib exerts its influence on a multitude of targets within the TME. Moreover, many components of the TME can affect the sensitivity of lenvatinib either directly through interactions or promoting tumor immune evasion. TME plays a crucial role in the development of lenvatinib resistance (LR) in HCC. This review presents an overview on the role of the TME in LR of HCC. Furthermore, it explores therapeutic strategies targeting the TME for overcoming LR. These may improve the efficacy of lenvatinib and the prognosis of advanced HCC patients.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102642"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511651","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":"Hepatic organoids as a platform for liver disease modeling and the development of novel therapies","authors":"E. Luce,&nbsp;A. Messina,&nbsp;J.C. Duclos-Vallée","doi":"10.1016/j.clinre.2025.102647","DOIUrl":"10.1016/j.clinre.2025.102647","url":null,"abstract":"<div><h3>Background and aims</h3><div>Liver diseases pose a major global health burden, and progress in understanding liver pathophysiology and therapeutic development is hampered by the lack of predictive human models. Hepatic organoids (<em>i.e.</em> 3D <em>in vitro</em> structures derived from primary, progenitor, or pluripotent stem cells) offer a physiologically relevant alternative to traditional 2D cultures and animal models. This review provides a comprehensive overview of hepatic organoid systems and their translational potential.</div></div><div><h3>Methods</h3><div>We reviewed recent advances in the generation, culture, and characterization of hepatic organoids. The discussion covers the diversity of cell sources, 3D matrix-based and microfluidic culture platforms, and analytical approaches used to assess organoid structure, function, and heterogeneity. Applications in disease modeling, drug development, and regenerative therapies were also examined.</div></div><div><h3>Results</h3><div>Hepatic organoids recapitulate key liver-specific functions, including albumin secretion, CYP450 activity, and bile canaliculi formation. They have been used to model monogenic and complex liver diseases (e.g., MAFLD, viral hepatitis, cancer) and to predict patient-specific drug responses. Integration into organ-on-chip systems enhances maturation and functional fidelity. Transplantation studies in bile duct ligation and hepatotoxic injury models demonstrated functional engraftment and regeneration. Limitations persist, notably in vascularization, immune integration, and standardization, but emerging solutions such as 3D bioprinting, defined matrices, co-culture strategies, and complementary approaches like bioartificial liver (BAL) systems, are advancing organoids toward clinical applicability.</div></div><div><h3>Conclusion</h3><div>Hepatic organoids are transformative platforms in hepatology, bridging experimental modeling and personalized medicine. Their continued development promises to redefine liver disease research, precision pharmacology, and regenerative therapies.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102647"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556779","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":"The impact of low HER2 expression on clinicopathological features and clinical outcomes in patients with metastatic gastric cancer","authors":"Murad Guliyev ,&nbsp;Shamkhal Safarov ,&nbsp;Murat Günaltılı ,&nbsp;Mehmet Cem Fidan ,&nbsp;Emir Çerme ,&nbsp;Gülin Alkan Şen ,&nbsp;Ahmet Emin Öztürk ,&nbsp;Nuray Kepil ,&nbsp;Özkan Alan ,&nbsp;Nebi Serkan Demirci","doi":"10.1016/j.clinre.2025.102646","DOIUrl":"10.1016/j.clinre.2025.102646","url":null,"abstract":"<div><h3>Background</h3><div>Metastatic gastric cancer (GC) is an extremely fatal malignant disease. Human epidermal growth factor receptor 2 (HER2) is an important therapeutic target in patients with HER2 overexpression or gene amplification. However, the prognostic value of HER2-low expression is still controversial. This study aims to investigate the effect of HER2 expression levels on clinicopathological characteristics and clinical outcomes in patients with metastatic GC.</div></div><div><h3>Methods</h3><div>The study included patients who had diagnosed de novo or recurrent metastatic GC from January 2011 to January 2023. We classified the patients into three categories based on their HER2 expression level: negative, low, and positive.</div></div><div><h3>Results</h3><div>The current study included 191 patients, with 99 (51.8 %) classified as HER2-negative, 42 (22.2 %) as HER2-low, and 50 (26.2 %) as HER2-positive. There were significant differences in the primary origin of gastroesophageal junction (25.3 %, 23.8 %, and 44 %), signet ring cell carcinoma (54.8 %, 44.4 %, and 16 %), mucinous cell carcinoma (40.9 %, 27.8 %, and 12 %), intestinal type histology (17.9 %, 50 %, and 48.9 %), high carcinoembryonic antigen level (34.5 %, 46.2 %, and 56.5 %), &gt;2 metastatic sites (25.3 %, 45.2 %, and 42 %), liver metastasis (33.3 %, 42.9 %, and 66 %), peritoneal metastasis (44.4 %, 28.6 %, and 20 %), and distant lymph node metastasis (53.5 %, 83.3 %, and 58 %) among the HER2-negative, HER2-low, and HER2-positive groups, respectively. The HER2-low group had similar median overall survival (OS) compared to the HER2-negative group (14.8 vs. 14.5 months, p = 0.868), however, significantly shorter median OS than the HER2-positive group (14.8 vs. 18.6 months, p = 0.024).</div></div><div><h3>Conclusions</h3><div>Our findings demonstrated that patients with HER2-low metastatic GC had different clinical and pathological features. The poorer survival rates of the HER2-low group compared to the HER2-positive group might be due to the lack of effective targeted treatments for HER2-low disease. Further research is warranted to develop specific therapeutic strategies for this subgroup.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102646"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567202","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":"Cap pressure characterization and band ligation for a tiny duodenal angioectasia with acute feeding vessel bleeding mimicking a Dieulafoy lesion","authors":"Vincent Zimmer","doi":"10.1016/j.clinre.2025.102643","DOIUrl":"10.1016/j.clinre.2025.102643","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102643"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367971","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":"Specific association and independent predictive value of HBV RNA in the disease progression of hepatitis B with low-level viremia","authors":"Liang Xu ,&nbsp;Bin Yin ,&nbsp;Dandan Chen ,&nbsp;Xia Xiong ,&nbsp;Yongfeng Yang ,&nbsp;Xuping Wu","doi":"10.1016/j.clinre.2025.102648","DOIUrl":"10.1016/j.clinre.2025.102648","url":null,"abstract":"<div><h3>Background and objective(s)</h3><div>HBV RNA serve as a downstream transcriptional product of cccDNA within the liver. This study is the first to investigate the diagnostic significance of serum HBV RNA in HBV low-level viremia (LLV) patients, elucidating the interrelationships among serum HBV RNA, HBV DNA, and HBsAg.</div></div><div><h3>Methods</h3><div>A cohort of 514 HBV LLV patients was collected from The Second Hospital of Nanjing and divided into four groups: asymptomatic HBV carriers (ASC), chronic hepatitis B (CHB), liver cirrhosis (LC), and hepatocellular carcinoma (HCC). All were tested and analyzed for HBV RNA, HBV DNA, HBsAg, HBeAg, and liver function.</div></div><div><h3>Results</h3><div>serum pathological indicators showed statistically significant differences included RNA, DNA, HBsAg, HBeAg-positive, TBIL, DBIL, IBIL, TP, ALB, ALT, AST, ALP, GGT (<em>P</em> &lt; 0.001), and HBeAg-negative (<em>P</em> = 0.019). Both HBV RNA and HBV DNA were positively correlated with HBsAg (<em>r</em> = 0.405, <em>P</em> &lt; 0.001; <em>r</em> = 0.198, <em>P</em> &lt; 0.001). The correlation between HBV RNA and HBsAg was stronger than that between HBV DNA and HBsAg, and this difference became more pronounced after stratifying patients based on disease progression stages. This was also the case in different HBeAg states. We further conducted multivariate logistic regression analysis, and the results showed that RNA had strong statistical significance in the ASC and CHB groups (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Monitoring HBV RNA levels holds certain value in assessing antiviral therapy efficacy and predicting disease progression stages and clinical outcomes in HBV LLV patients.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102648"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636429","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":"Nonalcoholic fatty liver disease and hepatocellular carcinoma","authors":"Kuan-Fu Liao ,&nbsp;Shih-Wei Lai","doi":"10.1016/j.clinre.2025.102651","DOIUrl":"10.1016/j.clinre.2025.102651","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102651"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641975","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":"Interleukin-22 ameliorates alcohol-associated liver fibrosis via Nrf2-ARE signaling: mechanistic insights and clinical correlations","authors":"Xiaojuan Xu ,&nbsp;Heping Zhao ,&nbsp;Jie Zhang ,&nbsp;Hongyou Yan ,&nbsp;Xing Liu ,&nbsp;Junyan Huo ,&nbsp;Lijuan Huo","doi":"10.1016/j.clinre.2025.102617","DOIUrl":"10.1016/j.clinre.2025.102617","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Alcohol-associated liver fibrosis (ALF) is a key, potentially reversible stage leading to alcohol-associated liver cirrhosis, but effective treatments are lacking. This study explored whether interleukin (IL)-22, a hepatocyte survival factor, plays an anti-fibrotic role in ALF by modulating the Nrf2-ARE antioxidant pathway.</div></div><div><h3>Methods</h3><div>IL-22 and Nrf2-ARE inhibitor, ML385, were administered to rat hepatic stellate cells (HSCs) exposed to acetaldehyde. Cell proliferation, cell cycle distribution, and Nrf2-ARE activation were investigated. An ALF mouse model was used to evaluate the effects of IL-22 and ML385 on liver function, fibrosis, and Nrf2-ARE pathway activation. The expression of IL-22 and Nrf2-ARE pathway in ALF/cirrhosis patients was also examined, along with correlations to liver function and liver fibrosis degree.</div></div><div><h3>Results</h3><div>In vitro, IL-22 upregulated the Nrf2-ARE pathway, and inhibited acetaldehyde-induced HSC proliferation and activation. In ALF mice, IL-22 promoted Nrf2-ARE pathway activation, reduced oxidative stress levels and serum transaminases, and ameliorated fibrosis. The ALF patients showed increased expression of IL-22, IL-22R1, and Nrf2-ARE pathway, positively correlating with the Child-Pugh score and fibrosis severity, suggesting a compensatory response.</div></div><div><h3>Conclusions</h3><div>IL-22 alleviates ALF by activating the Nrf2 antioxidant stress pathway, and may offer a promising therapeutic option for ALF/cirrhosis patients.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102617"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191569","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}