Hepatology InternationalPub Date : 2024-10-01Epub Date: 2024-07-16DOI: 10.1007/s12072-024-10692-4
Maria Eva Argenziano, Mi Na Kim, Michele Montori, Alessandro Di Bucchianico, Daniele Balducci, Sang Hoon Ahn, Gianluca Svegliati Baroni
{"title":"Epidemiology, pathophysiology and clinical aspects of Hepatocellular Carcinoma in MAFLD patients.","authors":"Maria Eva Argenziano, Mi Na Kim, Michele Montori, Alessandro Di Bucchianico, Daniele Balducci, Sang Hoon Ahn, Gianluca Svegliati Baroni","doi":"10.1007/s12072-024-10692-4","DOIUrl":"10.1007/s12072-024-10692-4","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is undergoing a transformative shift, with metabolic-associated fatty liver disease (MAFLD) emerging as a dominant etiology. Diagnostic criteria for MAFLD involve hepatic steatosis and metabolic dysregulation. Globally, MAFLD prevalence stands at 38.77%, significantly linked to the escalating rates of obesity. Epidemiological data indicate a dynamic shift in the major etiologies of hepatocellular carcinoma (HCC), transitioning from viral to metabolic liver diseases. Besides the degree of liver fibrosis, several modifiable lifestyle risk factors, such as type 2 diabetes, obesity, alcohol use, smoking, and HBV, HCV infection contribute to the pathogenesis of HCC. Moreover gut microbiota and genetic variants may contribute to HCC development.The pathophysiological link between MAFLD and HCC involves metabolic dysregulation, impairing glucose and lipid metabolism, inflammation and oxidative stress. Silent presentation poses challenges in early MAFLD-HCC diagnosis. Imaging, biopsy, and AI-assisted techniques aid diagnosis, while HCC surveillance in non-cirrhotic MAFLD patients remains debated.ITA.LI.CA. group proposes a survival-based algorithm for treatment based on Barcelona clinic liver cancer (BCLC) algorithm. Liver resection, transplantation, ablation, and locoregional therapies are applied based on the disease stage. Systemic treatments is promising, with initial immunotherapy results indicating a less favorable response in MAFLD-related HCC.Adopting lifestyle interventions and chemopreventive measures with medications, including aspirin, metformin, and statins, constitute promising approaches for the primary prevention of HCC.Prognosis is influenced by multiple factors, with MAFLD-HCC associated with prolonged survival. Emerging diagnostic biomarkers and epigenomic markers, show promising results for early HCC detection in the MAFLD population.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"922-940"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatology InternationalPub Date : 2024-10-01Epub Date: 2024-08-08DOI: 10.1007/s12072-024-10699-x
Chun-Jen Liu, Wai Kay Seto, Ming-Lung Yu
{"title":"Dual-etiology MAFLD: the interactions between viral hepatitis B, viral hepatitis C, alcohol, and MAFLD.","authors":"Chun-Jen Liu, Wai Kay Seto, Ming-Lung Yu","doi":"10.1007/s12072-024-10699-x","DOIUrl":"10.1007/s12072-024-10699-x","url":null,"abstract":"<p><p>Metabolic dysfunction-associated fatty liver disease (MAFLD) and viral hepatitis due to chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection are common liver diseases worldwide. Excessive alcohol consumption and alcoholic liver disease (ALD) are also emerging health problems. Therefore, in clinical practice, we may encounter subjects with dual etiology of liver diseases such as coexisting MAFLD/HBV, MAFLD/HCV, and MAFLD/ALD. In this review, we summarize the epidemiology, clinical features, and mutual interactions of MAFLD with coexisting HBV, HCV, or ALD. The impact of MAFLD on the progression of liver diseases and treatment outcomes in patients with chronic viral hepatitis and the clinical questions to be addressed regarding dual MAFLD and ALD are also discussed.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"897-908"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatology InternationalPub Date : 2024-10-01Epub Date: 2024-07-05DOI: 10.1007/s12072-024-10704-3
Yasser Fouad, Mohamed Alboraie, Gamal Shiha
{"title":"Epidemiology and diagnosis of metabolic dysfunction-associated fatty liver disease.","authors":"Yasser Fouad, Mohamed Alboraie, Gamal Shiha","doi":"10.1007/s12072-024-10704-3","DOIUrl":"10.1007/s12072-024-10704-3","url":null,"abstract":"<p><p>The most common chronic liver illness worldwide is metabolic dysfunction linked to fatty liver disease (MAFLD), which is poorly understood by doctors and patients. Many people with this disease develop steatohepatitis, cirrhosis and its consequences, as well as extrahepatic manifestations; these conditions are particularly common if they are linked to diabetes mellitus or obesity. A breakthrough with numerous benefits is the switch from NAFLD to MAFLD in terms of terminology and methodology. The diagnosis of MAFLD is based on affirmative criteria; unlike NAFLD, it is no longer based on exclusion. The diagnosis of MAFLD and the evaluation of steatosis and fibrosis is achieved using liver biopsy and non-invasive laboratory or radiographic techniques. We briefly address the most recent developments in MAFLD epidemiology and diagnosis.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"827-833"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatology InternationalPub Date : 2024-10-01Epub Date: 2024-07-17DOI: 10.1007/s12072-024-10710-5
Jihye Lim, Sung-Eun Kim, Ae Jeong Jo, Jung Hee Kim, Seul Ki Han, Tae Hyung Kim, Hyung Joon Yim, Young Kul Jung, Do Seon Song, Eileen L Yoon, Hee Yeon Kim, Seong Hee Kang, Young Chang, Jeong-Ju Yoo, Sung Won Lee, Jung Gil Park, Ji Won Park, Soung Won Jeong, Young Joo Jin, Hyoung Su Kim, Ki Tae Suk, Moon Young Kim, Sang Gyune Kim, Won Kim, Jae Young Jang, Jin Mo Yang, Dong Joon Kim
{"title":"Effect of diabetes on mortality and liver transplantation in alcoholic liver cirrhotic patients with acute decompensation.","authors":"Jihye Lim, Sung-Eun Kim, Ae Jeong Jo, Jung Hee Kim, Seul Ki Han, Tae Hyung Kim, Hyung Joon Yim, Young Kul Jung, Do Seon Song, Eileen L Yoon, Hee Yeon Kim, Seong Hee Kang, Young Chang, Jeong-Ju Yoo, Sung Won Lee, Jung Gil Park, Ji Won Park, Soung Won Jeong, Young Joo Jin, Hyoung Su Kim, Ki Tae Suk, Moon Young Kim, Sang Gyune Kim, Won Kim, Jae Young Jang, Jin Mo Yang, Dong Joon Kim","doi":"10.1007/s12072-024-10710-5","DOIUrl":"10.1007/s12072-024-10710-5","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have investigated the influence of diabetes on alcoholic liver cirrhosis patients, leaving its impact unclear. Thus, we conducted a study to reveal the association of diabetes and clinical outcomes of such patients.</p><p><strong>Materials and methods: </strong>We prospectively collected data from multicenter pertaining to 965 patients diagnosed with alcoholic liver cirrhosis, all of whom were admitted due to acute decompensation between 2015 and 2019. Risk of major precipitating factors and incidences of death or liver transplantation in patients with and without diabetes was comparatively assessed. Propensity score (PS) matching was performed at a 1:2 ratio for accurate comparisons.</p><p><strong>Results: </strong>The mean age was 53.4 years, and 81.0% of the patients were male. Diabetes was prevalent in 23.6% of the cohort and was positively correlated with hepatic encephalopathy and upper gastrointestinal bleeding, although not statistically significant. During a median follow-up of 903.5 person-years (PYs), 64 patients with and 171 without diabetes died or underwent liver transplantation, with annual incidence of 33.6/100 PYs and 24.0/100 PYs, respectively. In the PS-matched cohort, the incidence of death or liver transplantation was 36.8/100 PYs and 18.6/100 PYs in the diabetes and matched control group, respectively. After adjusting for various factors, coexisting diabetes significantly heightened the risk of death or liver transplantation in the short and long term, in addition to prolonged prothrombin time, low serum albumin, elevated total bilirubin and creatinine, and decreased serum sodium levels.</p><p><strong>Conclusions: </strong>Diabetes increases the risk of death or liver transplantation in patients with alcoholic liver cirrhosis.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1579-1588"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatology InternationalPub Date : 2024-10-01Epub Date: 2024-08-11DOI: 10.1007/s12072-024-10714-1
Atsushi Tanaka, Kenichi Harada
{"title":"Acute presentation of autoimmune hepatitis -from acute hepatitis to ALF and ACLF.","authors":"Atsushi Tanaka, Kenichi Harada","doi":"10.1007/s12072-024-10714-1","DOIUrl":"10.1007/s12072-024-10714-1","url":null,"abstract":"<p><p>Acute presentation of autoimmune hepatitis (AIH) occurs in 22-43% of all AIH cases, and is not a rare condition. Rather than constituting a single disease entity, it represents a clinical spectrum characterized by considerable variability in severity and the presence of preexisting chronic AIH. This spectrum ranges from acute AIH and acute severe AIH to AIH presenting as acute liver failure (ALF) or as acute-on-chronic liver failure (ACLF), contingent upon factors such as coagulopathy, hepatic encephalopathy, and underlying liver disease. Diagnosing acute presentation of AIH can be particularly challenging due to the frequent absence of classical serologic signatures such as autoantibodies and elevated IgG levels. Histopathological examination remains essential for diagnosis, typically necessitating percutaneous or transjugular liver biopsy. Corticosteroids (CS) are recommended for the management of acute AIH and acute severe AIH with coagulopathy. However, the therapeutic response to CS should be meticulously monitored. If a poor response is anticipated, liver transplantation (LT) should be promptly considered. For AIH presenting as ALF with encephalopathy or ACLF with advanced underlying liver disease, LT is generally advised. Nonetheless, there is potential for a trial of CS therapy in cases of ALF with low MELD scores or ACLF without encephalopathy. This review provides an overview of the latest findings concerning the definition, diagnosis, and management of acute presentation of AIH.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1385-1395"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The relationship between CXCR6+CD8+T cells and clinicopathological parameters in patients with primary biliary cholangitis.","authors":"Huilian Shi, Xiangtao Xu, Shuangshuang Wang, Qinlei Chen, Fan Zhang, Haiyan Guo, Weiting Lu, Fei Qiao","doi":"10.1007/s12072-024-10715-0","DOIUrl":"10.1007/s12072-024-10715-0","url":null,"abstract":"<p><strong>Background: </strong>CXCR6+CD8+T cells have been implicated in the pathogenesis of various liver and autoimmune diseases. However, their involvement in primary biliary cholangitis (PBC) has not been elucidated.</p><p><strong>Methods: </strong>We used immunohistochemistry and flow cytometry to quantify CXCR6+CD8+T cells in hepatic tissue and peripheral blood samples obtained from CXCR6+CD8+T cells obtained from PBC patients. Then, we performed comprehensive statistical analyses to access the correlation between the abundance of these cells and clinical as well as pathological data across different stages of PBC.</p><p><strong>Results: </strong>Our research revealed that CXCR6+ cell frequencies in CD3+CD8+T cells from PBC patients significantly exceeded that of healthy controls (HCs) (2.24 vs. 0.61%, p < 0.01). A similar pattern emerged for hepatic CXCR6+CD8+T cell counts, which were notably higher in the PBC cohort compared to HCs. Our cohort consisted of 118 PBC patients, categorized into 62 early-stage (E-PBC) and 56 late-stage (L-PBC) cases. Notably, significant disparities existed between these groups in terms of liver enzyme and lipid profile levels (p < 0.05), with no notable differences observed in gender, age, blood counts, cholesterol levels, or autoantibodies (p > 0.05). Intriguingly, the quantity of hepatic CXCR6+CD8+T cells per high power field (HPF) was significantly elevated in both E-PBC and L-PBC patients as opposed to normal liver samples, indicating a substantial increase in these cells across all stages of PBC (p = 0.000). Spearman's rank correlation analysis showed a positive correlation between CXCR6+CD8+T cell counts and serum levels of Alkaline Phosphatase (AKP) and Gamma-Glutamyl Transferase (GGT), ANA, IgG and IgM, while revealing a negligible correlation with Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST). Subsequent findings indicated significant variances in CXCR6+ cell numbers not only among different PBC stages but also across various degrees of inflammation and fibrosis (p ≤ 0.007). In a follow-up study post-Ursodeoxycholic Acid (UDCA) treatment, stark differences were identified in biochemical and immunohistochemical profiles between responder (31 patients) and non-responder (33 patients) groups (p < 0.05). A Wilcoxon rank-sum test further demonstrated a significant difference in the level of hepatic CXCR6+CD8+T cells between these two response groups (p = 0.002).</p><p><strong>Conclusion: </strong>CXCR6+CD8+T cells play a vital role in the pathogenesis of PBC, exhibiting correlations with the extent of inflammation, staging of liver fibrosis, and response to pharmacological interventions in PBC patients.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1555-1565"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatology InternationalPub Date : 2024-10-01Epub Date: 2024-07-08DOI: 10.1007/s12072-024-10682-6
Zhen-Xin Zeng, Jia-Yi Wu, Shao-Wu Zhuang, Mao-Lin Yan
{"title":"Reply to: \"Is the TAE score a promising prognostic predictor for unresectable hepatocellular carcinoma treated with TACE plus lenvatinib with PD‑1 inhibitors? Further validation should be performed\".","authors":"Zhen-Xin Zeng, Jia-Yi Wu, Shao-Wu Zhuang, Mao-Lin Yan","doi":"10.1007/s12072-024-10682-6","DOIUrl":"10.1007/s12072-024-10682-6","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1589-1590"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatology InternationalPub Date : 2024-10-01Epub Date: 2024-06-16DOI: 10.1007/s12072-024-10691-5
Sunitha Vimalesvaran, Pietro Vajro, Anil Dhawan
{"title":"Pediatric metabolic (dysfunction)-associated fatty liver disease: current insights and future perspectives.","authors":"Sunitha Vimalesvaran, Pietro Vajro, Anil Dhawan","doi":"10.1007/s12072-024-10691-5","DOIUrl":"10.1007/s12072-024-10691-5","url":null,"abstract":"<p><p>The historical use of the term non-alcoholic fatty liver disease (NAFLD) in obese/overweight children has been controversial as to the appropriateness of this terminology in children, and lately, in adults too. Newer game-changer terminology, metabolic (dysfunction)-associated fatty liver disease (MAFLD), for this condition signifies a positive step forward that addresses the limitations of the previous definition for both adults and children. The prevalence of MAFLD has surged in tandem with the global rise in obesity rates, establishing itself as a predominant cause of chronic liver disease in both adult and pediatric populations. The adoption of the recently proposed nomenclature reflects a more encompassing comprehension of the disease and its etiology compared to its predecessor, NAFLD. Notably, the revised terminology facilitates the recognition of MAFLD as an autonomous condition while acknowledging the potential coexistence of other systemic fatty liver disorders. Particularly in children, this includes various paediatric-onset genetic and inherited metabolic disorders, necessitating thorough exclusion, especially in cases where weight loss interventions yield no improvement or in the absence of obesity. MAFLD presents as a multifaceted disorder; evidence suggests its origins lie in a complex interplay of nutritional, genetic, hormonal, and environmental factors. Despite advancements, current non-invasive diagnostic biomarkers exhibit limitations in accuracy, often necessitating imaging and histological evaluations for definitive diagnosis. While dietary and lifestyle modifications stand as cornerstone measures for MAFLD prevention and management, ongoing evaluation of therapeutic agents continues. This article provides an overview of the latest developments and emerging therapies in the realm of paediatric MAFLD.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"873-883"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}