Hepatology International最新文献

{"title":"Identification of PANoptosis-relevant subgroups and predicting signature to evaluate the prognosis and immune landscape of patients with biliary tract cancer.","authors":"Dongming Liu, Wenshuai Chen, Zhiqiang Han, Yu Wang, Wei Liu, Aomei Ling, Qiang Wu, Huikai Li, Hua Guo","doi":"10.1007/s12072-024-10718-x","DOIUrl":"https://doi.org/10.1007/s12072-024-10718-x","url":null,"abstract":"<p><strong>Background: </strong>This study conducted molecular subtyping of biliary tract cancer patients based on 19 PANoptosis-related gene signatures.</p><p><strong>Methods: </strong>Through consensus clustering, patients were categorized into two subtypes, A and B. By integrating multi-omics data and clinical information from different cohorts, we elucidated the association between different subtypes of biliary tract cancer and patient prognosis, which correlated with the immune infiltration characteristics of patients.</p><p><strong>Results: </strong>LASSO regression analysis was performed on the 19 gene signatures, and we constructed and validated a 9-gene risk score prognostic model that accurately predicts the overall survival rate of different biliary tract cancer patients. Additionally, we developed a predictive nomogram demonstrating the clinical utility and robustness of our model. Further analysis of the risk score-based immune landscape highlighted potential associations with immune cell infiltration, chemotherapy, and immune therapy response.</p><p><strong>Conclusion: </strong>Our study provides valuable insights into personalized treatment strategies for biliary tract cancer, which are crucial for improving patient prognosis and guiding treatment decisions in clinical practice.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912439","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":"A global survey on the use of the international classification of diseases codes for metabolic dysfunction-associated fatty liver disease.","authors":"Huai Zhang, Giovanni Targher, Christopher D Byrne, Seung Up Kim, Vincent Wai-Sun Wong, Luca Valenti, Myer Glickman, Jaime Ponce, Christos S Mantzoros, Javier Crespo, Henning Gronbaek, Wah Yang, Mohammed Eslam, Robert J Wong, Mariana Verdelho Machado, Ming-Lung Yu, Omar M Ghanem, Takeshi Okanoue, Jun-Feng Liu, Yong-Ho Lee, Xiao-Yuan Xu, Qiuwei Pan, Meili Sui, Amedeo Lonardo, Yusuf Yilmaz, Li-Yong Zhu, Christophe Moreno, Luca Miele, Monica Lupsor-Platon, Lei Zhao, Teresa LeAnn LaMasters, Robert G Gish, Huijie Zhang, Marius Nedelcu, Wah Kheong Chan, Ming-Feng Xia, Fernando Bril, Jun-Ping Shi, Christian Datz, Stefano Romeo, Jian Sun, Dan Liu, Silvia Sookoian, Yi-Min Mao, Nahum Méndez-Sánchez, Xiao-Yan Wang, Nikolaos T Pyrsopoulos, Jian-Gao Fan, Yasser Fouad, Dan-Qin Sun, Cosimo Giannini, Jin Chai, Ze-Feng Xia, Dae Won Jun, Guo-Jing Li, Sombat Treeprasertsuk, Ying-Xu Li, Tan To Cheung, Faming Zhang, George Boon-Bee Goh, Masato Furuhashi, Wai-Kay Seto, Hui Huang, Anna Di Sessa, Qing-Hong Li, Evangelos Cholongitas, Le Zhang, Themis Reverbel Silveira, Giada Sebastiani, Leon A Adams, Wei Chen, Xiaolong Qi, Ivan Rankovic, Victor De Ledinghen, Wen-Jie Lv, Masahide Hamaguchi, Radwan Kassir, Dirk Müller-Wieland, Manuel Romero-Gomez, Ying Xu, Yi-Cong Xu, Shi-Yao Chen, Mohammad Kermansaravi, Mohammad Shafi Kuchay, Sander Lefere, Chetan Parmar, Gregory Y H Lip, Chun-Jen Liu, Fredrik Åberg, George Lau, Jacob George, Shiv Kumar Sarin, Jing-Ya Zhou, Ming-Hua Zheng","doi":"10.1007/s12072-024-10702-5","DOIUrl":"10.1007/s12072-024-10702-5","url":null,"abstract":"<p><strong>Background: </strong>With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) and the publication of the metabolic dysfunction-associated fatty liver disease (MAFLD) nomenclature in 2020, it is important to establish consensus for the coding of MAFLD in ICD-11. This will inform subsequent revisions of ICD-11.</p><p><strong>Methods: </strong>Using the Qualtrics XM and WJX platforms, questionnaires were sent online to MAFLD-ICD-11 coding collaborators, authors of papers, and relevant association members.</p><p><strong>Results: </strong>A total of 890 international experts in various fields from 61 countries responded to the survey. We also achieved full coverage of provincial-level administrative regions in China. 77.1% of respondents agreed that MAFLD should be represented in ICD-11 by updating NAFLD, with no significant regional differences (77.3% in Asia and 76.6% in non-Asia, p = 0.819). Over 80% of respondents agreed or somewhat agreed with the need to assign specific codes for progressive stages of MAFLD (i.e. steatohepatitis) (92.2%), MAFLD combined with comorbidities (84.1%), or MAFLD subtypes (i.e., lean, overweight/obese, and diabetic) (86.1%).</p><p><strong>Conclusions: </strong>This global survey by a collaborative panel of clinical, coding, health management and policy experts, indicates agreement that MAFLD should be coded in ICD-11. The data serves as a foundation for corresponding adjustments in the ICD-11 revision.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1178-1201"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327437","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":"Efficacy and safety of robotic versus laparoscopic liver resection for hepatocellular carcinoma: a propensity score-matched retrospective cohort study.","authors":"He Li, Lingzhan Meng, Simiao Yu, Haocheng Zheng, Lingxiang Yu, Hongbo Wang, Hui Ren, Hu Li, Xiaofeng Zhang, Zizheng Wang, Peng Yu, Xiongwei Hu, Muyi Yang, Jin Yan, Yanling Shao, Li Cao, Xia Ding, Zhixian Hong, Zhenyu Zhu","doi":"10.1007/s12072-024-10658-6","DOIUrl":"10.1007/s12072-024-10658-6","url":null,"abstract":"<p><strong>Background: </strong>Evidence concerning long-term outcome of robotic liver resection (RLR) and laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) patients is scarce.</p><p><strong>Methods: </strong>This study enrolled all patients who underwent RLR and LLR for resectable HCC between July 2016 and July 2021. Propensity score matching (PSM) was employed to create a 1:3 match between the RLR and LLR groups. A comprehensive collection and analysis of patient data regarding efficacy and safety have been conducted, along with the evaluation of the learning curve for RLR.</p><p><strong>Results: </strong>Following PSM, a total of 341 patients were included, with 97 in the RLR group and 244 in the LLR group. RLR group demonstrated a significantly longer operative time (median [IQR], 210 [152.0-298.0] min vs. 183.5 [132.3-263.5] min; p = 0.04), with no significant differences in other perioperative and short-term postoperative outcomes. Overall survival (OS) was similar between the two groups (p = 0.43), but RLR group exhibited improved recurrence-free survival (RFS) (median of 65 months vs. 56 months, p = 0.006). The estimated 5-year OS for RLR and LLR were 74.8% (95% CI: 65.4-85.6%) and 80.7% (95% CI: 74.0-88.1%), respectively. The estimated 5-year RFS for RLR and LLR were 58.6% (95% CI: 48.6-70.6%) and 38.3% (95% CI: 26.4-55.9%), respectively. In the multivariate Cox regression analysis, RLR (HR: 0.586, 95% CI (0.393-0.874), p = 0.008) emerged as an independent predictor of reducing recurrence rates and enhanced RFS. The operative learning curve indicates that approximately after the 11th case, the learning curve of RLR stabilized and entered a proficient phase.</p><p><strong>Conclusions: </strong>OS was comparable between RLR and LLR, and while RFS was improved in the RLR group. RLR demonstrates oncological effectiveness and safety for resectable HCC.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1271-1285"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916326","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 hepatic steatosis, steatohepatitis and metabolic dysfunction: distinct roles in hepatocellular carcinoma occurrence in chronic hepatitis B patients.","authors":"Xindan Hu, Ying Wen","doi":"10.1007/s12072-024-10675-5","DOIUrl":"10.1007/s12072-024-10675-5","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1338-1339"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456332","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}

{"title":"NAFLD and MAFLD independently increase the risk of major adverse cardiovascular events (MACE): a 20-year longitudinal follow-up study from regional Australia.","authors":"Karl Vaz, William Kemp, Ammar Majeed, John Lubel, Dianna J Magliano, Kristen M Glenister, Lisa Bourke, David Simmons, Stuart K Roberts","doi":"10.1007/s12072-024-10706-1","DOIUrl":"10.1007/s12072-024-10706-1","url":null,"abstract":"<p><strong>Background and aims: </strong>The association between fatty liver disease (FLD) and cardiovascular disease (CVD) in an Australian context has yet to be defined. The primary aim of this study was to investigate the association between FLD and 3-point major adverse cardiovascular events (MACE).</p><p><strong>Methods: </strong>This was a longitudinal follow-up study of a randomly sampled adult cohort from regional Australia between 2001 and 2003. Baseline covariates included demographic details, anthropometry, health and lifestyle data, and laboratory tests. Non-alcoholic fatty liver disease (NAFLD) and metabolic-(dysfunction) associated fatty liver disease (MAFLD) were diagnosed in participants with fatty liver index (FLI) ≥ 60 and meeting other standard criteria. ICD-10 codes were used to define clinical outcomes linked to hospitalisations. Three-point MACE defined as non-fatal myocardial infarction (MI) and cerebrovascular accident (CVA) and CVD death.</p><p><strong>Results: </strong>In total, 1324 and 1444 participants met inclusion criteria for NAFLD and MAFLD analysis, respectively. Over 23,577 and 25,469 person-years follow-up, NAFLD and MAFLD were independent predictors for 3-point MACE, adjusting for demographic covariates and known cardiometabolic risk factors, whilst considering non-CVD death as a competing event (NAFLD: sub-hazard ratio [sHR] 1.56, 95% confidence interval [CI 1.12-2.19]; MAFLD: sHR 1.51, 95% CI 1.11-2.06). The results held true on several sensitivity analyses.</p><p><strong>Conclusions: </strong>Both forms of FLD increase the risk for CVD independent of traditional cardiometabolic risk factors.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1135-1143"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616273","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}

{"title":"Hepatic artery infusion chemotherapy combined with camrelizumab plus rivoceranib for hepatocellular carcinoma with portal vein tumor thrombosis: a multicenter propensity score-matching analysis.","authors":"Yangyang Li, Jiandong Guo, Wendao Liu, Huajin Pang, Yipei Song, Siyi Wu, Fengtao Zhang, Dong Yan, Junwei Chen, Chao An, Chengzhi Li","doi":"10.1007/s12072-024-10672-8","DOIUrl":"10.1007/s12072-024-10672-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Portal vein tumor thrombosis (PVTT) signifies late-stage hepatocellular carcinoma (HCC) with high-risk progression and poor prognosis. As a standard treatment, sorafenib monotherapy has limited the efficacy in managing HCC with PVTT. Currently, both hepatic arterial infusion chemotherapy (HAIC) and the combination of camrelizumab and rivoceranib have shown favorable survival benefits for advanced HCC, surpassing the standard sorafenib treatment. In this study, we investigate the safety and efficacy of HAIC combined with camrelizumab and rivoceranib in treating HCC patients with PVTT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From January 2020 to December 2021, HCC patients with PVTT, who received either a triple regime of HAIC combined with camrelizumab and rivoceranib or a dual regime of camrelizumab and rivoceranib as their first-line treatment, were reviewed for eligibility at four hospital centers in China. To balance any intergroup differences, propensity score matching (PSM) was applied. The aim of this study is to compare the efficacy of the dual and triple combination treatment regimens based on survival prognosis and tumor response and evaluate the safety based on the occurrence of adverse reactions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;In this study, a total of 411 patients who received either the triple treatment regime (HAIC combined with camrelizumab plus rivoceranib, referred to as the HAICCR group, n = 292) or the dual treatment regime (camrelizumab combined with rivoceranib, referred to as the CR group, n = 119) between January 2020 and December 2021 were included. The results showed that the HAICCR group exhibited significantly better overall survival (mOS: 19.60 months vs. 11.50 months, p &lt; 0.0001) and progression-free survival (mPFS: 10.0 months vs. 5.6 months, p &lt; 0.0001) compared to the CR group in the overall cohort. Moreover, the HAICCR group also had a significantly higher ORR (objective response rate, 55.5% vs. 42.0%, p = 0.013) and DCR (disease control rate, 89.0% vs. 79.0%) compared to the CR group. After PSM, a final matched cohort of 83 pairs was obtained, and the survival benefits were consistent in this cohort as well (mOS: 18.70 months vs. 11.0 months, p &lt; 0.0001; mPFS: 10.0 months vs. 5.6 months, p &lt; 0.0001). However, there was no significant difference in the ORR between the triple and dual combination regimes. Univariate and multivariate analysis showed that CTP (Child-Turcotte-Pugh) stage, ALBI (albumin-bilirubin index) grade, tumor number, and treatment regime were significant risk factors affecting overall survival, while AFP (α-fetoprotein) level, tumor number, metastasis, and treatment regime were significant risk factors affecting progression-free survival. As for safety, hypertension and hand-foot syndrome were the two most common adverse reactions in both groups, with no significant difference in the occurrence of adverse reactions between the two groups (p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusi","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1286-1298"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876305","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}

{"title":"Chinese guidelines on the management of ascites in cirrhosis : Chinese Society of Hepatology, Chinese Medical Association.","authors":"Xiaoyuan Xu, Huiguo Ding, Jidong Jia, Lai Wei, Zhongping Duan, Chengwei Tang, Enqiang Linghu, Yuemin Nan, Ying Han, Jinghang Xu, Hui Zhuang","doi":"10.1007/s12072-024-10697-z","DOIUrl":"10.1007/s12072-024-10697-z","url":null,"abstract":"<p><p>In 2023, Chinese Society of Hepatology of Chinese Medical Association convened a panel of experts to update the Chinese guidelines on the management of ascites and associated complications in cirrhosis which was launched in 2017 and renamed this guidelines as \"Guidelines on the Management of Ascites in Cirrhosis.\" This comprehensive resource offers essential recommendations for the diagnosis and treatment of cirrhotic ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1071-1089"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558666","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":"Age-related differences in drug-induced liver injury: a retrospective single-center study from a large liver disease specialty hospital in China, 2002-2022.","authors":"Simiao Yu, Jiahui Li, Tingting He, Haocheng Zheng, Sici Wang, Yongqiang Sun, Liping Wang, Jing Jing, Ruilin Wang","doi":"10.1007/s12072-024-10679-1","DOIUrl":"10.1007/s12072-024-10679-1","url":null,"abstract":"<p><strong>Background and aims: </strong>Drug-induced liver injury (DILI) is a prevalent adverse reaction in clinical settings. However, there is limited research on age-related differences in DILI. We performed a large-scale retrospective study to delineate the characteristics of DILI across different age groups.</p><p><strong>Methods: </strong>We collected data on a total of 17,946 patients with confirmed DILI hospitalized at the Fifth Medical Center of the People's Liberation Army (PLA) General Hospital in Beijing, China, from January 1, 2002, to December 31, 2022. The patients were stratified based on age into the following groups: children (< 18 years), young adults (18-44 years), middle-aged individuals (45-64 years), and elderly individuals (≥ 65 years). We gathered demographic information, medical histories, laboratory results, disease severity assessments, and mortality statistics for all patients.</p><p><strong>Results: </strong>Overall, the distribution of DILI cases across different age groups was as follows: 6.57% were children, 24.82% were young adults, 49.06% were middle-aged individuals, and 19.54% were elderly individuals. The percentage of females increased with age, rising from 36.47% in the pediatric group to 60.51% in the elderly group. Notably, central nervous system agents (15.44%) and anti-infectious agents (21.80%) were more commonly associated with DILI in children, while cardiovascular agents (10.58%) and herbal dietary supplements or traditional medicines (H/TMs) (26.29%) were more prevalent among elderly people with DILI. Among all age groups, hepatocellular-type DILI was more common in the pediatric group (p < 0.001), whereas cholestatic-type DILI and chronic DILI were more prevalent in the elderly group (p < 0.001). Acute liver failure (ALF) and fatal outcomes were more prevalent in the pediatric and elderly groups, particularly in the pediatric group (2.04%, p = 0.041; 0.85%, p = 0.007, respectively).</p><p><strong>Conclusions: </strong>Children and elderly individuals face a higher risk of adverse outcomes following DILI.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1202-1213"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426660","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}

{"title":"Midodrine plus propranolol versus propranolol alone in preventing first bleed in patients with cirrhosis and severe ascites: a randomized controlled trial.","authors":"Abhijeet Ranjan, Ankur Jindal, Rakhi Maiwall, Chitranshu Vashishtha, Rajan Vijayaraghavan, Vinod Arora, Shiv K Sarin","doi":"10.1007/s12072-024-10687-1","DOIUrl":"10.1007/s12072-024-10687-1","url":null,"abstract":"<p><strong>Background: </strong>Propranolol, a non-selective beta-blocker, commonly used to prevent variceal bleed, but might precipitate circulatory dysfunction in severe ascites. Midodrine, an alpha-1 adrenergic agonist improves renal perfusion and systemic hemodynamics. Addition of midodrine might facilitate higher maximum tolerated dose (MTD) of propranolol, thereby less risk of variceal bleed in cirrhosis patients with severe ascites.</p><p><strong>Methods: </strong>140 patients with cirrhosis and severe/refractory ascites were randomized- propranolol and midodrine (Gr.A,n = 70) or propranolol alone (Gr.B,n = 70). Primary outcome was incidence of bleed at 1 year. Secondary outcomes included ascites control, achievement of target heart rate (THR), HVPG response and adverse effects.</p><p><strong>Results: </strong>Baseline characteristics were comparable between two groups. Cumulative incidence of bleed at 1 year was lower in Gr.A than B (8.5%vs.27.1%,p-0.043). The MTD of propranolol was higher in Gr.A (96.67 ± 36.6 mg vs. 76.52 ± 24.4 mg; p-0.01) and more patients achieved THR (84.2%vs.55.7%,p-0.034). Significantly higher proportion of patients in Gr.A had complete resolution of ascites [17.1%vs.11.4%,p-0.014), diuretic tolerance (80%vs.60%,p-0.047) at higher doses(p-0.02) and lesser need for paracentesis. Patients in Gr.A also had greater reduction in variceal grade (75.7%vs.55.7%;p-0.01), plasma renin activity (54.4% from baseline) (p = 0.02). Mean HVPG reduction was greater in Gr.A than B [4.38 ± 2.81 mmHg(23.5%) vs. 2.61 ± 2.87 mmHg(14.5%),p-0.045]. Complications like post-paracentesis circulatory dysfunction and spontaneous bacterial peritonitis on follow-up were higher in Gr.B than A (22.8%vs.51.4%,p = 0.013 and 10%vs.15.7%, p = 0.03, respectively).</p><p><strong>Conclusion: </strong>Addition of midodrine facilitates effective use of propranolol in higher doses and greater HVPG reduction, thereby preventing first variceal bleed, reduced paracentesis requirements with fewer ascites- related complications in patients with cirrhosis with severe/refractory ascites.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1261-1270"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897877","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":"HBeAg induces neutrophils activation impairing NK cells function in patients with chronic hepatitis B.","authors":"Zhiqian Feng, Junliang Fu, Lili Tang, Chunmei Bao, Honghong Liu, Kai Liu, Tao Yang, Jin-Hong Yuan, Chun-Bao Zhou, Chao Zhang, Ruonan Xu, Fu-Sheng Wang","doi":"10.1007/s12072-024-10689-z","DOIUrl":"10.1007/s12072-024-10689-z","url":null,"abstract":"<p><strong>Background: </strong>The role of neutrophils in hepatitis B virus (HBV) infection has been a subject of debate due to their involvement in antiviral responses and immune regulation. This study aimed to elucidate the neutrophil characteristics in patients with chronic hepatitis B (CHB).</p><p><strong>Methods: </strong>Through flow cytometry and ribonucleic acid-sequencing analysis, the phenotypes and counts of neutrophils were analyzed in patients with CHB. Moreover, the effects of HBeAg on neutrophils and the corresponding pattern recognition receptors were identified. Simultaneously, the cross-talk between neutrophils and natural killer (NK) cells was investigated.</p><p><strong>Results: </strong>Neutrophils were activated in patients with CHB, characterized by higher expression levels of programmed death-ligand 1 (PD-L1), cluster of differentiation 86, and interleukin-8, and lower levels of CXC motif chemokine receptor (CXCR) 1 and CXCR2. Hepatitis B e antigen (HBeAg) partially induces neutrophil activation through the Toll-like receptor 2 (TLR2). A consistent upregulation of the TLR2 and HBeAg expression was observed in patients with CHB. Notably, the genes encoding molecules pivotal for NK-cell function upon NK receptor engagement enriched in neutrophils after HBeAg activation. The HBeAg-activated neutrophils demonstrated the ability to decrease the production of interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α) in NK cells, while the PD-1 and PD-L1 pathways partially mediated the immunosuppression.</p><p><strong>Conclusions: </strong>The immunosuppression of neutrophils induced by HBeAg suggests a novel pathogenic mechanism contributing to immune tolerance in patients with CHB.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1122-1134"},"PeriodicalIF":5.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199543","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}