Clinics and research in hepatology and gastroenterology最新文献

{"title":"Catching the STING: Unlocking senescence and PD-L1 in PBC","authors":"Pierre-Antoine Soret , Jérémie Gautheron","doi":"10.1016/j.clinre.2025.102526","DOIUrl":"10.1016/j.clinre.2025.102526","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102526"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964058","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":"Mixed neuroendocrine non-neuroendocrine neoplasm combining neuroendocrine tumor with hepatocellular carcinoma in the context of multiple endocrine neoplasia type 1","authors":"Madeleine Mulsant , Jean-François Mosnier , Eric Frampas , Tamara Matysiak-Budnik , Bastien Jamet , Yann Touchefeu","doi":"10.1016/j.clinre.2025.102533","DOIUrl":"10.1016/j.clinre.2025.102533","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102533"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001026","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":"Maternal and fetal outcomes of autoimmune hepatitis in pregnancy: A United States hospitalized patient study","authors":"Xi Li ,&nbsp;Jing Zhang ,&nbsp;Sheza Malik ,&nbsp;Aakriti Jain ,&nbsp;Mingyuan Wang ,&nbsp;Chengu Niu","doi":"10.1016/j.clinre.2025.102544","DOIUrl":"10.1016/j.clinre.2025.102544","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune hepatitis (AIH) is a chronic inflammatory disease primarily affecting the liver, with a higher prevalence among women of reproductive age. The latest nationwide statistics regarding its impact on maternal and fetal outcomes during pregnancy are lacking.</div></div><div><h3>Aims</h3><div>To analyze the real impact of AIH on maternal and fetal outcomes in hospitalized delivery patients, and provide theoretical guidance for comprehensive clinical management.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using data from the 2016–2020 National Inpatient Sample database in the United States. Multivariate logistic regression analysis was used to assess the influence of AIH on maternal and fetal outcomes during pregnancy.</div></div><div><h3>Results</h3><div>A total of 17,825,445 hospitalized delivery patients were included, among which 1,185 had AIH. After adjusting for potential confounding factors, compared to hospitalized delivery patients without AIH, the AIH group exhibited significantly higher rates of adverse maternal and fetal outcomes, including hypertension complications of pregnancy (AOR 1.68, 95 % CI 1.09–2.58), preterm birth (AOR 2.89, 95 % CI 1.91–4.38), fetal growth restriction (AOR 2.21, 95 % CI 1.34–3.64), and fetal death (AOR 4.13, 95 % CI 1.33–12.83). AIH showed no association with cesarean section or large fetus. In the group of delivery in patients with AIH, patients who develop hypertensive disorders have a higher probability of concomitant diabetes mellitus (OR 6.85, 95 % CI 2.19–21.45), hypertension (OR 4.64, 95 % CI 1.68–12.82), and obesity (OR 3.06, 95 % CI 1.26–7.42). Additionally, AIH patients incurred higher total costs and longer hospital stays during the delivery hospitalization.</div></div><div><h3>Conclusion</h3><div>Patients with AIH face an increased risk of hypertensive disorders of pregnancy, preterm birth, fetal growth restriction, and fetal death during delivery. It is crucial to enhance awareness of these potential occurrence risks.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102544"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078738","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":"Acute liver failure: Beyond the guidelines, the challenge of liver support therapies","authors":"Faouzi SALIBA","doi":"10.1016/j.clinre.2025.102528","DOIUrl":"10.1016/j.clinre.2025.102528","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102528"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945811","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":"Assessing the efficacy of farnesoid X receptor agonists in the management of metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis","authors":"Jai Kumar ,&nbsp;Misha Hasan ,&nbsp;Sana Mohsin ,&nbsp;Mojtaba Hussain Alzaher ,&nbsp;Tripti Nagar ,&nbsp;Adeena Jamil ,&nbsp;Ali Ahmed ,&nbsp;Vamsi Krishna Lavu ,&nbsp;Sarwan Kumar","doi":"10.1016/j.clinre.2025.102530","DOIUrl":"10.1016/j.clinre.2025.102530","url":null,"abstract":"<div><h3>Background and aims</h3><div>Several randomized clinical trials have been conducted assessing the potential efficacy of Farnesoid X receptor (FXR) agonists in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). A comprehensive review and analysis were needed to evaluate the findings of these trials. Hence, this systematic review and meta-analysis aim to study the association between FXR agonists and hepatic outcomes in patients with MASLD.</div></div><div><h3>Methods</h3><div>Systematic review and meta-analysis evaluating the efficacy of FXR agonists in 1,227 patients assigned to the FXR intervention group compared to 650 patients in the placebo group. Changes in liver enzymes and hepatic steatosis assessed by MRI-PDFF were evaluated.</div></div><div><h3>Results</h3><div>FXR agonist use was associated with a significant reduction in levels of AST, (WMD= -4.51, 95% CI=[-8.39,-0.63], P=0.02); ALT (WMD= -13.02, 95% CI=[-17.85,-8.19], P&lt;0.00001); GGT (WMD= -32.20, 95% CI=[-38.63,-25.98], P&lt;0.00001); MRI-PDFF, (SMD= -1.14, 95% CI=[-1.92,-0.35], P=0.005). FXR agonists did not significantly affect ALP levels, (WMD= 25.04, 95% CI=[19.22,30.87], P&lt;0.00001]</div></div><div><h3>Conclusion</h3><div>Results show promising evidence supporting the efficacy of FXR agonists in reducing hepatic steatosis and biomarkers of hepatic injury such as ALT, AST, and GGT.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102530"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977811","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 cytokines as predictors for NAFLD-related diseases: A bidirectional Mendelian randomization study","authors":"Yijia He ,&nbsp;Miaomin Ye ,&nbsp;Yin Xia,&nbsp;Ziyi Zhong,&nbsp;Weiping Wang,&nbsp;Qian Li","doi":"10.1016/j.clinre.2025.102545","DOIUrl":"10.1016/j.clinre.2025.102545","url":null,"abstract":"<div><h3>Background</h3><div>Prior research has highlighted associations between inflammatory cytokines and non-alcoholic fatty liver disease (NAFLD), but causal relationships remain unclear. Employing the Mendelian randomization (MR) approach, this investigation aims to explore the connection between 41 inflammatory cytokines and NAFLD-related diseases.</div></div><div><h3>Methods</h3><div>Our research implemented bidirectional study focusing on 41 cytokines in 8,293 Finns, predicting genetic associations with NAFLD, nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. We primarily utilized the inverse variance weighted (IVW) method to evaluate the bidirectional relationships. Additionally, a sensitivity analysis was carried out to ensure the reliability of our findings.</div></div><div><h3>Results</h3><div>An elevated risk for NAFLD was correlated with both IL-2 (OR = 1.226, 95 % CI = 1.018–1.477, <em>p</em> = 0.031) and TNF-β (OR = 1.151, 95 % CI = 1.011–1.310, <em>p</em> = 0.033). IL-16 is associated with decreased NAFLD risk (OR = 0.820, 95 % CI = 0.719–0.934, <em>p</em> = 0.033). β-NGF (OR = 2.495, 95 % CI = 1.019–6.108, <em>p</em> = 0.045) and SCGFβ (OR = 1.541, 95 % CI = 1.052–2.256, <em>p</em> = 0.026) are linked to higher NASH risk. No significant associations were found for fibrosis and cirrhosis. Furthermore, the causal relationship between genetic predisposition to NAFLD-related diseases and various inflammatory cytokines was established.</div></div><div><h3>Conclusions</h3><div>Our MR analysis identifies specific cytokines as genetic predictors for NAFLD and NASH. IL-2 and TNF-β increase NAFLD risk, IL-16 appears protective, and β-NGF and SCGFβ are associated with greater NASH risk. These insights are crucial for understanding the etiology and treatment of NAFLD-related diseases.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102545"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122092","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":"Access to care and the Hispanic paradox among Hispanic patients with hepatocellular carcinoma","authors":"Patrick L. Quinn ,&nbsp;Fode Tounkara ,&nbsp;Marcel Grau Rodríguez ,&nbsp;Kunika Chahal ,&nbsp;Shah Saiyed ,&nbsp;Goutam Gutta ,&nbsp;Connor Hannon ,&nbsp;Angela Sarna ,&nbsp;Alex Kim ,&nbsp;Jordan M. Cloyd ,&nbsp;Yamilé Molina ,&nbsp;Jan Kitajewski ,&nbsp;Aslam Ejaz","doi":"10.1016/j.clinre.2024.102519","DOIUrl":"10.1016/j.clinre.2024.102519","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite the disproportionate impact of hepatocellular carcinoma (HCC) on Hispanic patients, reported outcomes are limited, particularly among subpopulations. Our study aimed to evaluate outcomes in access to care and survival among racial and ethnic Hispanic subpopulations.</div></div><div><h3>Methods</h3><div>The National Cancer Database was utilized to identify patients diagnosed with HCC between 2004 and 2020. The independent variables of interest were racial/ethnic groups, with the Hispanic population disaggregated by race and Hispanic heritage. The primary outcomes were the presentation of early versus late-stage HCC, undergoing a curative-intent procedure, time to treatment, and overall survival. Logistic regression was performed with adjustments made for demographic, clinical, and socioeconomic variables.</div></div><div><h3>Results</h3><div>Among 211,988 patients with HCC identified, 12.3 % (<em>n</em> = 26,085) were classified as Hispanic. In comparison with NHW patients, South/Central American patients had the lowest odds of early-stage presentation (OR=0.91; <em>p</em> = 0.1), Cuban patients had the lowest odds of undergoing a curative-intent procedure (OR=0.72; <em>p</em> = 0.04), and Mexican patients had the highest odds of delayed treatment (OR=1.45; <em>p</em> &lt; 0.001). Hispanics had a longer median survival at 19 months than NHW patients (15 months, <em>p</em> &lt; 0.001), with Hispanic Black (HR 0.59, <em>p</em> &lt; 0.001) and Dominican (HR 0.56, <em>p</em> &lt; 0.001) patients having the lowest mortality risk among Hispanic subpopulations.</div></div><div><h3>Discussion</h3><div>Despite decreased resection rates and increased likelihood of delayed treatment, Hispanics had improved survival across its subpopulations in comparison to NHW patients, further highlighting the Hispanic paradox.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102519"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892325","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":"Efficacy and safety of dapagliflozin compared to pioglitazone in diabetic and non-diabetic patients with non-alcoholic steatohepatitis: A randomized clinical trial","authors":"Mona S. Abdel Monem ,&nbsp;Abdulmoneim Adel ,&nbsp;Maggie M. Abbassi ,&nbsp;Doaa H. Abdelaziz ,&nbsp;Mohamed Hassany ,&nbsp;Maissa El Raziky ,&nbsp;Nirmeen A. Sabry","doi":"10.1016/j.clinre.2025.102543","DOIUrl":"10.1016/j.clinre.2025.102543","url":null,"abstract":"<div><h3>Background</h3><div>Non-alcoholic steatohepatitis (NASH) is a serious end-stage spectrum of non-alcoholic fatty liver disease (NAFLD) with associated high risk of hepatic and extrahepatic complications. Several studies showed the significant beneficial effect of dapagliflozin on body composition, hepatic and metabolic parameters on NAFLD/NASH patients. The study aimed to investigate the efficacy and safety of dapagliflozin in both diabetic and non-diabetic biopsy-proven NASH patients; compared to pioglitazone.</div></div><div><h3>Methods</h3><div>This was a four-group, prospective, randomized, parallel, open label study in which 100 biopsy-proven NASH patients were selected, stratified to diabetics and non-diabetics and randomized with 1:1 allocation to either 30 mg pioglitazone or 10 mg dapagliflozin, once daily for 24 weeks. Histological evaluation, anthropometric measures, hepatic, metabolic biochemical markers, fibrosis non-invasive markers, quality of life (QOL) and medications adverse events were examined.</div></div><div><h3>Results</h3><div>Dapagliflozin showed a comparable histological effect to pioglitazone in both diabetic and non-diabetic patients (P&gt;0.05). As assessed by transient elastography, it also showed a comparable effect on liver fibrosis grade improvement from baseline in diabetics (P=0.287) versus a significant superiority in non-diabetics (P=0.018). Dapagliflozin showed a significant superiority in all anthropometric measures (P&lt;0.001) and QOL (P&lt;0.05) among both diabetics and non-diabetics. There was a significant interaction between interventions and diabetes status on change from baseline of hepatic and metabolic panel collectively (P=0.023) in favor to dapagliflozin among diabetics.</div></div><div><h3>Conclusion</h3><div>Compared to pioglitazone, dapagliflozin had a comparable effect histologically, superior effect biochemically among diabetics and superior effect on liver fibrosis, steatosis and insulin resistance among non-diabetics.</div></div><div><h3>Trial Registration</h3><div>The study was registered on clinicaltrials.gov, identifier number NCT05254626.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102543"},"PeriodicalIF":2.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064138","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":"Lower gastrointestinal bleeding from colonic varices of unknown origin","authors":"Jitendra Jonnagaddala ,&nbsp;Sabah Ahmed ,&nbsp;Jamil Mahmoud El Chayeb","doi":"10.1016/j.clinre.2025.102536","DOIUrl":"10.1016/j.clinre.2025.102536","url":null,"abstract":"<div><div>Gastrointestinal bleeding; Colonic varices; Lower gastrointestinal bleeding</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102536"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045726","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":"Patient-reported outcomes in mothers with chronic hepatitis B infection: A cross-sectional analysis","authors":"Shi OuYang ,&nbsp;Yueying Deng ,&nbsp;Yawen Geng ,&nbsp;Xiaoli Yuan ,&nbsp;Tingting Peng ,&nbsp;Junchao Qiu ,&nbsp;Zhirong Xiao ,&nbsp;Shengguang Yan ,&nbsp;Haitao Deng ,&nbsp;Xiaotong Peng ,&nbsp;Calvin Q. Pan","doi":"10.1016/j.clinre.2025.102537","DOIUrl":"10.1016/j.clinre.2025.102537","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>The health-related quality of life (HRQoL) during pregnancy has not been well-lidated in mothers with chronic hepatitis B (CHB). We aim to compare patient-reported outcomes (PROs) in CHB mothers with those of healthy mothers during pregnancy.</div></div><div><h3>Methods</h3><div>Between 4/16/2023 and 7/31/2023, we invited consecutive CHB and healthy mothers to complete the self-administered 36-item Short Form Survey (SF-36) and the Chronic Liver Disease Questionnaire (CLDQ) for PRO assessment. Pairwise comparisons of PRO scores between groups were performed using chi-square tests. Covariates for worse PROs were further analyzed by the multiple linear regression model to identify the independent predictors</div></div><div><h3>Results</h3><div>Among 257 participants (CHB: healthy control was 100:157), the mean (SD) age was 29.6 (3.4), and the majority completed the PRO assessment at the gestational weeks of 16–24. When compared to healthy mothers, CHB mothers had a significant impairment of PROs in the CLDQ domain of worry (6.97±0.16 vs 5.83±0.99, <em>p</em>&lt;0.05) and the SF-36 domain of social functioning (95.33±10.00 vs 91.67±16.37, <em>p</em>&lt;0.05). The subgroup analyses in CHB mothers showed HBV DNA &gt;200,000 IU/mL associated with significantly worse PROs. The multivariate analyses identified CHB infection, severe nausea or vomiting, poor living conditions, and spousal negative attitude as independent predictors of HRQoL impairment.</div></div><div><h3>Conclusion</h3><div>This study suggests that CHB infection during pregnancy negatively impacted HRQoL, particularly in worry and social functioning domains. CHB infection was an independent predictor for PRO impairments. Further integration of monitoring and intervention on HRQoL impairment should be considered when managing CHB mothers during pregnancy.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102537"},"PeriodicalIF":2.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051824","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}