Clinics and research in hepatology and gastroenterology最新文献

{"title":"Glucocorticoids accelerate the reduction of disease severity and biochemical parameters in drug-induced liver injury: Assess the causal relationship using the updated RUCAM scale","authors":"Punan Wang , Guanya Guo , Shuangshuang Jiang , Dawei Ding, Jiaqi Yang, Yi Lu, Ying Han, Xinmin Zhou","doi":"10.1016/j.clinre.2025.102635","DOIUrl":"10.1016/j.clinre.2025.102635","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy and clinical application of glucocorticoids (GCs) in patients with drug-induced liver injury (DILI) remain controversial.</div></div><div><h3>Aims</h3><div>To determine the efficacy and suitable population of GCs in patients with DILI.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective study. Patients with moderate-to-severe DILI who met the diagnostic criteria from January 1, 2009 to December 31, 2024 were enrolled. Patients in the GC group and the non-GC group were matched 1:1 by propensity score-matched (PSM), and the reduction of disease severity and biochemical parameters were compared between the two groups. According to the level of TB, the patients with DILI were divided into three groups, and the efficacy of GCs in each subgroup was compared.</div></div><div><h3>Results</h3><div>Patients with DILI in our study were evaluated by the updated RUCAM causality assessment scale. All patients had RUCAM scores≥6 and causal relationship graded as \" probable\" or \" highly probable\". The use of GC treatment differs according to the severity of patients, especially the baseline level of TB ( % in patients with TB <5 ULN, % in patients with 5ULN≤TB≤10ULN, and % in TB≥10ULN). After PSM analysis, 163 patients were included in each group. After PSM, the time of severity reduction was faster in the GC group than the non-GC group (<em>P</em> = 0.022). The adjusted cumulative rate of severity reduction was 62 % in the GC group and 43.6 % in the non-GC group. The cumulative rates of reaching 50 % reduction in AST, ALP, TB level was higher in the GC group than in the non-GC group (<em>P</em> < 0.001, <em>P</em> = 0.0086 and <em>P</em> = 0.003). Patients were divided into three subgroups according to baseline TB level. We found the cumulative rates of who achieved severity reduction and 50 % reduction in liver biochemical parameters at discharge was higher in the GC group than in the non-GC group in patients with 5ULN≤ TB level ≤10ULN but not in patients with TB <5ULN and TB>10ULN. Multivariate analysis showed that sex, age, treatment group and severity were significantly associated with disease severity reduction of patients with DILI. After PSM, there were 56 patients with drug-induced autoimmune hepatitis (DI-AIH) and 270 patients with DILI with no autoimmune features cases in our cohort. The cumulative rate of severity reduction at discharge in the GC group was higher than that in the non-GC group in patients with DI-AIH (<em>P</em> = 0.049). Although the incidence of side effects in the GC group was higher than that in the non-GC group, the adverse reactions were basically relieved with the withdrawal of GCs.</div></div><div><h3>Conclusions</h3><div>GCs accelerated the reduction of disease severity and liver biochemical parameters, especially in patients with 5ULN≤baseline TB level≤10ULN. Sex, age, treatment group and severity were significantly associated with disease severit","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102635"},"PeriodicalIF":2.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257415","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":"Circulating tumor DNA in peripheral blood may predict the efficacy of immune-targeted therapy in patients with hepatocellular carcinoma","authors":"Su-Su Zheng ,&nbsp;Dai Zhang ,&nbsp;Jing-Fang Wu ,&nbsp;Hong Chen ,&nbsp;Zhen-Zhen Zhang ,&nbsp;Guo-Bin Chen ,&nbsp;Xiao-Ying Xie ,&nbsp;Bo-Heng Zhang","doi":"10.1016/j.clinre.2025.102632","DOIUrl":"10.1016/j.clinre.2025.102632","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Hepatocellular carcinoma (HCC) is a highly prevalent and fatal malignancy globally. Accurate prognosis prediction is crucial for developing personalized therapeutic strategies.</div></div><div><h3>Methods</h3><div>This study involved 28 HCC patients who received immune-targeted therapy at the Xiamen Branch of Zhongshan Hospital of Fudan University from April 2020 to June 2022. Next-generation sequencing (NGS) of circulating tumor DNA (ctDNA) was conducted at baseline and after two treatment cycles. The primary objective was to investigate the relationship between changes in variation allele frequency (VAF) during therapy and clinical outcomes.</div></div><div><h3>Results</h3><div>A total of 134 single nucleotide variants, 1 insertion-deletion mutation, and 5 copy number variations were detected across the cohort. A decrease in mean VAF (VAF_mean) after two cycles of immune-targeted therapy was associated with longer progression-free survival. The sensitivity and specificity of VAF_mean reduction in predicting partial response(PR) and complete response(CR) were 1.0 and 0.8125, respectively, which were higher than those of serum alpha-fetoprotein (AFP) levels (0.9167 and 0.4667). No significant correlation was observed between baseline mutation status and the efficacy of immune-targeted therapy.</div></div><div><h3>Conclusions</h3><div>This study highlights that advanced ctDNA analysis can detect somatic mutations in a substantial proportion of patients with advanced HCC. Monitoring ctDNA dynamics during immune-targeted therapy enables real-time assessment of disease status and provides a basis for optimizing treatment strategies.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102632"},"PeriodicalIF":2.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246734","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":"Trends in food protein-induced allergic proctocolitis (FPIAP): Mechanisms and treatment targeting gut microbiome","authors":"Yan Liu ,&nbsp;Zhenmei Li ,&nbsp;Lina Shen ,&nbsp;Kejun Shuai ,&nbsp;Chao Zhang ,&nbsp;Zhifeng Ning","doi":"10.1016/j.clinre.2025.102634","DOIUrl":"10.1016/j.clinre.2025.102634","url":null,"abstract":"<div><h3>Background</h3><div>Food protein-induced allergic proctocolitis (FPIAP) is a non-IgE-mediated food allergy characterized by subacute or chronic inflammatory processes in the gut. Unlike IgE-mediated food allergies that may cause multi-organ syndromes, non-IgE-mediated food allergies mainly affect the gastrointestinal tract. The incidence of FPIAP is rising globally, becoming a significant health concern.</div></div><div><h3>Objectives</h3><div>This article aims to systematically review the epidemiological characteristics, pathogenesis, cell death programs involved in FPIAP, and its relationship with the gut microbiota. It also explores therapeutic developments targeting the intestinal microbiota.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive literature search across multiple databases, including PubMed, Web of Science, and Scopus, up to December 2024. Studies were selected based on predefined inclusion and exclusion criteria. Data extraction and quality assessment were performed by two independent reviewers.</div></div><div><h3>Results</h3><div>The review identified key epidemiological trends, highlighting the increasing incidence of FPIAP. The pathogenesis section elucidates the mechanisms underlying non-IgE-mediated allergies, emphasizing the role of the gut microbiome in mediating dietary factors and immune responses. Specific cell death programs, such as apoptosis and pyroptosis, were found to be involved in the progression of FPIAP. Therapeutic strategies targeting the gut microbiota show promise in managing FPIAP, with probiotics and prebiotics emerging as potential interventions.</div></div><div><h3>Conclusions</h3><div>This review provides valuable insights into the mechanisms of FPIAP and highlights the potential of microbiota-targeted therapies. Future research should focus on large-scale clinical trials to validate the efficacy of these interventions and further explore the complex interplay between diet, gut microbiota, and immune responses in FPIAP.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102634"},"PeriodicalIF":2.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246736","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 triple association of sickle cell disease, primary sclerosing cholangitis and inflammatory bowel disease (SCD-PSC-IBD): iceberg in sight","authors":"Philippe Marteau,&nbsp;Yvon Calmus","doi":"10.1016/j.clinre.2025.102633","DOIUrl":"10.1016/j.clinre.2025.102633","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102633"},"PeriodicalIF":2.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246735","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":"“Evaluation of long-term changes in liver function and structure in patients exposed to SARS-CoV-2 infection: A prospective study”: Authors’ reply","authors":"Erkin Saeed Saifi","doi":"10.1016/j.clinre.2025.102629","DOIUrl":"10.1016/j.clinre.2025.102629","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102629"},"PeriodicalIF":2.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186726","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":"Correspondence on “Evaluation of long-term changes in liver function and structure in patients exposed to SARS-CoV-2 infection: a prospective study”","authors":"Hinpetch Daungsupawong ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.clinre.2025.102628","DOIUrl":"10.1016/j.clinre.2025.102628","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102628"},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173093","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":"Utility of the fibrosis-3 index for predicting liver fibrosis 5 years after achieving sustained virological response in patients with chronic hepatitis C","authors":"Kazuya Kariyama ,&nbsp;Hidenori Toyoda ,&nbsp;Takashi Kumada ,&nbsp;Satoshi Yasuda ,&nbsp;Yoshihiko Tachi ,&nbsp;Takanori Hirai ,&nbsp;Shohei Shiota ,&nbsp;Akiko Wakuta ,&nbsp;Kazuhiro Nouso","doi":"10.1016/j.clinre.2025.102625","DOIUrl":"10.1016/j.clinre.2025.102625","url":null,"abstract":"<div><h3>Aim</h3><div>Non-invasive tests for liver fibrosis frequently use serum aminotransferases; however, their accuracy may be influenced by hepatitis virus eradication. This study evaluated the effectiveness of the age-independent FIB-3 index in patients with chronic hepatitis C who achieved sustained virological response (SVR).</div></div><div><h3>Methods</h3><div>A total of 115 patients who achieved SVR following interferon therapy were analyzed. Liver fibrosis was assessed by biopsy before treatment and 5 years after achieving SVR. The diagnostic accuracies of the FIB-3 and FIB-4 indices were compared using Receiver Operating Characteristic (ROC) curve analysis and representative cutoff values (FIB-3:3.5, FIB-4:2.67), with a specific focus on age-stratified performance.</div></div><div><h3>Results</h3><div>Age-stratified analysis revealed distinct patterns in fibrosis index performance before and after SVR. Among patients aged ≥ 65 years, both indices demonstrated poor accuracy pre-SVR (FIB-3:0.35, FIB-4:0.29) but markedly improved post-SVR, with FIB-3 demonstrating significantly superior performance (accuracy: 0.82 vs 0.64). This improvement was primarily due to better specificity (FIB-3:0.85 vs FIB-4,0.60) while maintaining high sensitivity (0.62 vs 0.87). In patients aged &lt; 65 years, both indices exhibited modest improvement post-SVR, with no significant differences observed.</div></div><div><h3>Conclusions</h3><div>At established cutoff values, the FIB-3 index demonstrated significantly higher diagnostic performance than the FIB-4 index, particularly in patients aged ≥ 65 years who achieved SVR. These findings suggest that the FIB-3 index is a reliable tool for long-term monitoring of liver fibrosis after hepatitis C eradication.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102625"},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181190","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":"Chronic kidney disease in isolated core antibody positive hepatitis B patients: Risk analysis from NHANES 2017–2020 study","authors":"Ke Mi ,&nbsp;Tingdan Ye ,&nbsp;Calvin Q. Pan","doi":"10.1016/j.clinre.2025.102627","DOIUrl":"10.1016/j.clinre.2025.102627","url":null,"abstract":"<div><h3>Background</h3><div>The association between isolated hepatitis B core antibody (HBcAb) positivity and chronic kidney disease (CKD) remains debated. While some studies suggest HBV infection increases CKD risk, others report inconclusive findings. This study evaluated the association between isolated HBcAb positivityand CKD in the U.S. population.</div></div><div><h3>Methods</h3><div>Data from adult participants in the NHANES 2017–2020 pre-pandemic cycle were analyzed based on prespecified eligibility criteria. Participants were categorized into isolated HBcAb positive and non-infected groups. Weighted means and percentages described participant characteristics, while logistic regression models evaluated the association between isolated HBcAb positive and CKD. Multivariate logistic regression identified CKD risk factors among isolated HBcAb positive individuals.</div></div><div><h3>Results</h3><div>Among 7,582 participants (7072 non- infected and 510 isolated HBcAb positive), CKD prevalence was higher in isolated HBcAb positive individuals (7.9 %vs. 5.2 %, <em>P</em> = 0.018). Unadjusted analyses showed isolated HBcAb positivity increased CKD risk (OR = 1.25, 95 % CI: 1.04–1.50, <em>P</em> = 0.019). However, adjusted analyses revealed an inverse association (OR = 0.76, 95 % CI: 0.60–0.98, <em>P</em> = 0.034). In isolated HBcAb positive individuals, older age (OR = 1.06, <em>P</em> = 0.017) and serum urea nitrogen (BUN) elevation (OR = 1.20, <em>P</em> = 0.001) were associated with higher CKD risk, while higher education lever reduced the risk (OR = 0.28, <em>P</em> = 0.030).</div></div><div><h3>Conclusion</h3><div>Although CKD prevalence was higher in isolated HBcAb positive patients, There was no positive association between isolated HBcAb positivity and CKD. Older age and elevated BUN levels were significantly associated with higher CKD risk, while elevated education lever reduced the risk. These findings highlight the needs for individualized monitoring and management of at-risk HBV-infected patients when offering antiviral therapy and monitoring after clinical cure of hepatitis B.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102627"},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179513","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":"Analysis of article types of the top-100 cited articles on gastrointestinal endoscopy","authors":"Yanqing Song ,&nbsp;Lei Deng ,&nbsp;Yanhua Peng ,&nbsp;Rui Zhou","doi":"10.1016/j.clinre.2025.102630","DOIUrl":"10.1016/j.clinre.2025.102630","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102630"},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173086","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":"Natalizumab-induced autoimmune liver injury","authors":"Jeanete Sharay Rodriguez-Martinez ,&nbsp;Nancy Haydee Serrano-Perez ,&nbsp;Guillermo Espinosa-Zarazua ,&nbsp;Jacqueline Cordova-Gallardo","doi":"10.1016/j.clinre.2025.102624","DOIUrl":"10.1016/j.clinre.2025.102624","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102624"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141610","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}