Hepatology Research最新文献

{"title":"Steroid initiation dose and duration of steroid reduction for immune checkpoint inhibitor-induced liver injury","authors":"Takafumi Yamamoto,&nbsp;Takanori Ito,&nbsp;Takaya Suzuki,&nbsp;Kazuyuki Mizuno,&nbsp;Shinya Yokoyama,&nbsp;Kenta Yamamoto,&nbsp;Norihiro Imai,&nbsp;Yoji Ishizu,&nbsp;Takashi Honda,&nbsp;Hiroki Kawashima","doi":"10.1111/hepr.14200","DOIUrl":"10.1111/hepr.14200","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Treatment for severe immune checkpoint inhibitor (ICI)-induced liver injury (≥ Grade 3) requires prednisolone (PSL) administration and interruption of the underlying malignancy treatment. If the liver injury improves steadily, a lower initial dose of PSL is beneficial. We aimed to investigate the relationship between the initial dose of PSL and the response to PSL or the duration of PSL dose reduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively collected clinical data of patients treated with ICIs at Nagoya University Hospital between September 2014 and December 2023. Patients who received PSL for severe ICI-induced liver injury were divided according to the starting dose into group A (0.8 mg/kg/day) and group B (1.0 mg/kg/day). The time to improvement in liver injury and the reduction of the PSL dose to 10 mg/day were compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 1271 patients were treated with ICIs, of whom 80 experienced severe ICI-induced liver injury. Of the patients, 29 did not receive steroids, and five used PSL doses of &lt;0.5 mg/kg/day. There were no significant differences in the baseline characteristics or laboratory data between the groups. The time to dose reduction to 10 mg/day PSL was significantly shorter in group A than in group B. The time to improvement in liver injury did not differ between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In some patients with severe ICI-induced liver injury, a dose of 0.8 mg/kg/day of PSL is sufficient to achieve a therapeutic effect and shorten the time required to reduce the dose to 10 mg/day.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 7","pages":"977-985"},"PeriodicalIF":3.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exome-based genotype-first reverse phenotyping using structured electronic health record data identifies novel SERPINA1 variants associated with liver markers and demonstrates a dominant effect for specific variants on liver phenotype","authors":"Maël Silva Rodriguez,&nbsp;Margaux Mulot,&nbsp;Céline Chéry,&nbsp;Mouni Bensenane,&nbsp;Rosa-Maria Guéant-Rodriguez,&nbsp;Roland Jaussaud,&nbsp;Aurélie Cobat,&nbsp;François Feillet,&nbsp;Jean-Pierre Bronowicki,&nbsp;Farès Namour,&nbsp;Jean-Louis Guéant,&nbsp;Abderrahim Oussalah","doi":"10.1111/hepr.14203","DOIUrl":"10.1111/hepr.14203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Although several <i>SERPINA1</i> genetic variants have been reported for their pathogenicity to induce liver disorders through phenotype-driven approaches, data regarding genotype-driven approaches of the <i>SERPINA1</i> locus remain unavailable. This study aimed to characterize the clinical and liver biological profiles of patients harboring nonbenign <i>SERPINA1</i> variants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective, exome-based genotype-first reverse phenotyping study using structured electronic health record data from consecutive patients from January 1, 2015, to January 31, 2022. Statistical associations were assessed using frequentist and Bayesian models, with validation in the UK Biobank cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1377 patients analyzed, 15 <i>SERPINA1</i> variants classified as nonbenign were identified in 217 (15.7%) patients. Data were available for 126 patients (median age, 41.5 years; 52.4% male). Liver disease, hyperferritinemia, and pulmonary emphysema were observed in 32.5% (41/126), 23% (29/126), and 5.6% (7/126) of the patients, respectively. The median follow-up duration was 1.3 years and encompassed 1085 biological observations. We confirmed associations with well-documented variants of <i>SERPINA1</i> (p.Glu366Lys, p.Pro393Ser, p.Ala308Ser, p.Glu288Val, and p.Phe76del). We identified three novel genetic associations with liver markers: c.*10G &gt; A, c.1065 + 10C &gt; T, and p.Arg63Cys. The UK Biobank data confirmed significant gene- and variant-level associations, notably for the variants identified in our study, which ranked in the top decile of statistical associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study supports the utility of a genotype-first approach in characterizing hepatic manifestations of nonbenign <i>SERPINA1</i> variants. The findings highlight novel genotype–biomarker associations and suggest a role for <i>SERPINA1</i> genetic testing in patients with unexplained liver abnormalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 7","pages":"1075-1092"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current insights into pathogenesis and anti-inflammatory treatment strategies for severe alcohol-associated hepatitis: focus on neutrophil-targeted therapies","authors":"Ryosuke Kasuga,&nbsp;Po-Sung Chu,&nbsp;Takanori Kanai,&nbsp;Nobuhiro Nakamoto","doi":"10.1111/hepr.14206","DOIUrl":"10.1111/hepr.14206","url":null,"abstract":"<p>Alcohol-associated hepatitis (AH) is the leading cause of liver-related mortality, with severe alcohol-associated hepatitis (SAH) showing a short-term mortality rate of 20%–50% even in developed countries. Corticosteroids are the only evidence-based pharmacologic treatment, but their efficacy is limited to short-term survival, with 30%–40% of patients achieving a complete response. Early liver transplantation (LT) has been explored as a salvage therapy for steroid-refractory SAH, but its feasibility is restricted by ethical concerns and donor shortages, particularly in Japan. In the absence of LT eligibility, patients are often left with the best supportive care, underscoring the urgent need for alternative salvage therapies. Recent studies have explored selective anti-inflammatory strategies targeting proinflammatory cytokines, such as TNFα and IL-1β. However, clinical trials have yet to demonstrate sufficient efficacy to outweigh the increased risk of infection. Granulocyte colony-stimulating factor (G-CSF) therapy has been investigated for its potential to promote liver regeneration, but its efficacy remains inconsistent across populations. Neutrophil-targeted therapies, including granulocyte-monocyte/macrophage apheresis (GMA), have emerged as a novel approach. Our recent pilot study demonstrated improved survival in patients with steroid-refractory SAH treated with GMA, supporting its potential as a safe and effective anti-inflammatory therapy. This review summarizes the latest advances in the treatment of SAH and emphasizes the need for novel salvage therapies to address unmet needs in steroid-refractory cases. Further research is essential to validate these new therapies and to optimize treatment strategies to improve the long-term prognosis of SAH.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 6","pages":"785-794"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathological significance of intranuclear structures in liver biopsy samples","authors":"Norihiro Imai,&nbsp;Yuki Ohsaki,&nbsp;Jinglei Cheng,&nbsp;Hanna Kawecka,&nbsp;Jingjing Zhang,&nbsp;Fumitaka Mizuno,&nbsp;Taku Tanaka,&nbsp;Shinya Yokoyama,&nbsp;Kenta Yamamoto,&nbsp;Takanori Ito,&nbsp;Yoji Ishizu,&nbsp;Takashi Honda,&nbsp;Tetsuya Ishikawa,&nbsp;Michał Woźniak,&nbsp;Hiroaki Wake,&nbsp;Hiroki Kawashima","doi":"10.1111/hepr.14195","DOIUrl":"10.1111/hepr.14195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Glycogenated nuclei (GN) are glycogen deposits within the nuclei and are a frequent pathological finding in metabolic dysfunction-associated steatotic liver disease. This study aimed to investigate the relationship between GN and two morphologically distinct types of intranuclear lipid droplets in liver biopsy specimens and to explore their respective pathological significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 135 liver biopsy specimens. A portion of the liver biopsy specimen was examined using transmission electron microscopy (TEM) to investigate intranuclear lipid droplets in hepatocytes. Nuclear inclusion bodies with clear boundaries and unstained areas on hematoxylin and eosin staining were identified as nuclear glycogen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TEM revealed nucleoplasmic lipid droplets (nLD) in 65% of liver biopsy specimens and invagination of cytoplasmic lipid droplets into the nucleus in 30% of specimens. In contrast, light microscopy detected GN in 82% of specimens. No significant correlations were observed between the frequencies of the two types of intranuclear lipid droplets and nuclear glycogen levels. A significant positive correlation was observed between the frequency of nLD and transaminase levels. Glycogenated nuclei were frequently observed in liver biopsy specimens from patients with MASLD; however, their frequency did not significantly correlate with the degree of hepatic steatosis. Instead, a significant positive correlation was observed between nuclear glycogen and blood HbA1c levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The two types of intranuclear lipid droplets and nuclear glycogen observed in liver biopsy specimens showed no significant correlation in their formation frequencies, suggesting that they possess distinct pathological significance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 7","pages":"1065-1074"},"PeriodicalIF":3.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of muscle volume changes following atezolizumab-bevacizumab therapy in patients with unresectable hepatocellular carcinoma","authors":"Hironori Ochi,&nbsp;Joji Tani,&nbsp;Tetsu Tomonari,&nbsp;Hironori Tanaka,&nbsp;Yusuke Imai,&nbsp;Takaaki Tanaka,&nbsp;Hideko Ohama,&nbsp;Fujimasa Tada,&nbsp;Atsushi Hiraoka,&nbsp;Akira Hirose,&nbsp;Chikara Ogawa,&nbsp;Asahiro Morishita,&nbsp;Akio Moriya,&nbsp;Yoshiko Nakamura,&nbsp;Masashi Hirooka,&nbsp;Akihiro Deguchi,&nbsp;SYMPLE Study Group","doi":"10.1111/hepr.14201","DOIUrl":"10.1111/hepr.14201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to evaluate the prognostic impact of muscle volume changes during atezolizumab-bevacizumab (AB) combination therapy (AB therapy) for unresectable hepatocellular carcinoma (u-HCC). Additionally, we evaluated whether changes in muscle volume relate to prognosis based on treatment response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The present retrospective, multicenter study included 165 patients with u-HCC treated with AB therapy at eight institutions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median albumin–bilirubin score in the entire cohort was −2.42. The objective response rate was 31.5%, and the disease control rate was 80.6%. The median overall survival (OS) was not reached, whereas the median progression-free survival (PFS) was 6.9 months (95% confidence interval [CI]: 5.3–8.5). At the first post-treatment computed tomography scan, patients were categorized into two groups: those with a nondecreased psoas muscle area index (PI) (group A) and those with a decreased PI (group B). The median OS was not reached in either group (<i>p</i> = 0.059). The median PFS was 10.5 months in group A and 5.5 months in group B (<i>p</i> = 0.025). Multivariate analysis using the Cox proportional hazards model identified alpha-fetoprotein ≥400 ng/mL (hazard ratio [HR]: 1.68; 95% CI: 1.11–2.54; <i>p</i> = 0.01) and decreased PI (HR: 1.59; 95% CI: 1.07–2.36; <i>p</i> = 0.02) as factors associated with PFS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nondecreased muscle volume after initiating AB therapy was associated with improved treatment efficacy and prognosis in patients with u-HCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 7","pages":"1046-1053"},"PeriodicalIF":3.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of PBC-10 in Japanese patients with primary biliary cholangitis","authors":"Akihito Takeuchi,&nbsp;Masanori Abe,&nbsp;Sachiko Furukawa,&nbsp;Tadashi Namisaki,&nbsp;Atsushi Takahashi,&nbsp;Kazumichi Abe,&nbsp;Kentaro Kikuchi,&nbsp;Ryo Miura,&nbsp;Naoko Tachizawa,&nbsp;Yoshinari Asaoka,&nbsp;Akinobu Takaki,&nbsp;Yoshiyuki Ueno,&nbsp;Akira Honda,&nbsp;Shuji Terai,&nbsp;Atsumasa Komori,&nbsp;Hiromasa Ohira,&nbsp;Hitoshi Yoshiji,&nbsp;Atsuko Yonezawa,&nbsp;Atsushi Tanaka","doi":"10.1111/hepr.14199","DOIUrl":"10.1111/hepr.14199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease that significantly impairs health-related quality of life (HRQOL). The PBC-10, a short-form HRQOL assessment tool, was developed for rapid screening in clinical settings. This study aimed to verify the reliability and validity of the Japanese version of the PBC-10 in Japanese patients with PBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed HRQOL data from 496 Japanese outpatients with PBC, collected between 2015 and 2016. Reliability was assessed using Cronbach's alpha, item-total score correlations, and ceiling and floor effects. Validity was evaluated by examining correlations between PBC-10 scores and the total and subdomain scores of the Japanese version of the PBC-40, a validated PBC-specific HRQOL questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cronbach's alpha for the PBC-10 was 0.872, demonstrating high internal consistency. Strong item-total score correlations were observed for all items. No ceiling effects were noted, but floor effects were present across all items. The PBC-10 total score showed a very strong positive correlation with the PBC-40 total score (<i>ρ</i> = 0.964, <i>p</i> &lt; 0.001). Strong correlations were also found between most PBC-10 items and the PBC-40 subdomains, supporting validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Japanese version of the PBC-10 is a reliable and valid tool for rapidly assessing HRQOL in Japanese PBC outpatients. It has potential utility for identifying patients who may benefit from emerging treatments targeting symptom relief.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 7","pages":"986-993"},"PeriodicalIF":3.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of antithrombin for treatment of portal vein thrombosis: Nationwide prospective surveillance of 4 years of clinical experience in Japan","authors":"Shoichi Matsutani,&nbsp;Makoto Arakawa,&nbsp;Susumu Nakano","doi":"10.1111/hepr.14197","DOIUrl":"10.1111/hepr.14197","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Antithrombin (AT), a plasma protein with anticoagulant properties, has a long-standing medical history, primarily for treatment of congenital AT deficiency. Accumulated clinical experiences suggest AT is a potential anticoagulant for thrombotic diseases. This study aimed to clarify the effectiveness, safety, and clinical significance of AT in portal vein thrombosis (PVT) treatment in clinical practice in Japan, particularly in liver cirrhosis, where bleeding tendencies are increased.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective, observational post-marketing surveillance study assessed effectiveness and safety of AT in patients with PVT. Data were collected through electronic case report forms at medical institutions across Japan (from February 2018 to January 2021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 680 patients, cirrhosis was the most prevalent underlying disease (79.7%), and the use of concomitant anticoagulants was common (62.8%). In the effectiveness analysis set (<i>N</i> = 477), overall improvement rate after AT administration was 51.2%, reaching 54.1% in patients with class C (severe) cirrhosis. Factors influencing clinical response included AT activity, Child-Pugh score, number of treatment courses, cause of thrombus, and thrombus obstruction. Responders showed a lower cumulative mortality rate versus nonresponders (18.3% vs. 27.6%; <i>p</i> = 0.013); 1-year recurrence rate among responders was 19.3%. In the safety analysis set (<i>N</i> = 680), bleeding events occurred in 5.15% of patients, with 1.32% having major bleeding events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AT showed promise as an anticoagulant for high-risk PVT cases, especially in liver cirrhosis. Further well-designed comparative studies are needed to verify its efficacy in terms of true endpoints, such as long-term prognosis or improvement in cirrhosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 9","pages":"1251-1262"},"PeriodicalIF":3.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoimmune hepatitis following transition from prednisolone to thrombopoietin receptor agonist therapy in immune thrombocytopenic purpura: A clinical precaution","authors":"Kaname Inarimori,&nbsp;Keisuke Kakisaka,&nbsp;Takuya Watanabe,&nbsp;Tokio Sasaki,&nbsp;Yudai Fujiwara,&nbsp;Tamami Abe,&nbsp;Akiko Suzuki,&nbsp;Kei Endo,&nbsp;Yuichi Yoshida,&nbsp;Akio Miyasaka,&nbsp;Hidekatsu Kuroda,&nbsp;Takayuki Matsumoto","doi":"10.1111/hepr.14198","DOIUrl":"10.1111/hepr.14198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autoimmune hepatitis (AIH) occasionally complicates immune thrombocytopenic purpura (ITP). The risk of AIH development after prednisolone (PSL) discontinuation and thrombopoietin receptor agonist (TPO-RA) initiation remains underrecognized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim and Methods</h3>\u0000 \u0000 <p>We report two cases of AIH that developed or exacerbated after switching from PSL to TPO-RAs (avatrombopag and eltrombopag) for ITP treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Case 1 developed AIH 8 months after PSL discontinuation and avatrombopag initiation. Case 2 experienced AIH exacerbation with acute decompensation of liver cirrhosis 2 months after PSL discontinuation while on eltrombopag. Both cases showed no improvement after TPO-RA discontinuation but responded well to PSL reintroduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PSL discontinuation likely unmasks underlying AIH in ITP patients, with TPO-RAs potentially modulating immune responses. Regular liver function monitoring is essential when transitioning ITP patients from PSL to TPO-RAs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 7","pages":"1093-1097"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining advanced lymph node metastasis in intrahepatic cholangiocarcinoma: A multicenter study","authors":"Makoto Kurimoto,&nbsp;Tomoaki Yoh,&nbsp;Shinichi Nakanuma,&nbsp;Hiroaki Sugita,&nbsp;Hideaki Sueoka,&nbsp;Ikuo Nakamura,&nbsp;Seiko Hirono,&nbsp;Takamichi Ishii,&nbsp;Shintaro Yagi,&nbsp;Etsuro Hatano","doi":"10.1111/hepr.14196","DOIUrl":"10.1111/hepr.14196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is no specific boundary for stratifying survival outcomes in patients with node-positive intrahepatic cholangiocarcinoma (ICC). This study aimed to propose advanced nodal status in ICC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from patients with pathologically confirmed node-positive ICC who underwent liver resection (LR) with lymph node dissection (LND) from 2000 to 2020 at three tertiary centers were retrospectively analyzed. The boundaries of regions and the yield that stratified overall survival (OS) were evaluated. The lymph node (LN) regions were defined as follows: hepatoduodenal ligament, common hepatic artery, and peripancreatic area (HCP-area), gastrohepatic area (GH-area), and para-aortic area (A-area).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-four patients with node-positive ICC were enrolled in this study. The median numbers of retrieved LNs and involved LNs (ILNs) were 15 (range: 2–56) and 2 (range: 1–20), respectively. Most patients (96.5%) had ILNs in the HCP-area, whereas only 3 patients (3.5%) had ILNs in other areas without HCP-area involvement. OS of patients with LN metastasis confined to the HCP-area was better than for those beyond this area (median OS: 24.3 vs. 13.3 months, <i>p</i> = 0.047). The best cut-off number of ILNs to stratify OS was 4, and patients with 1–3 ILNs showed better OS than those with ≥ 4 ILNs (25.4 vs. 13.8 months, <i>p</i> = 0.006). Combining distribution and yield showed the best prognostic power compared to using either distribution or yield alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with node-positive ICC, LN metastasis beyond the HCP-area or ≥ 4 ILNs can be proposed as advanced N disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 7","pages":"1038-1045"},"PeriodicalIF":3.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide survey of patients with acute liver failure and late-onset hepatic failure in Japan seen between 2016 and 2021","authors":"Nobuaki Nakayama,&nbsp;Masamitsu Nakao,&nbsp;Yoshihito Uchida,&nbsp;Akio Ido,&nbsp;Yasuhiro Takikawa,&nbsp;Keisuke Kakisaka,&nbsp;Naoya Kato,&nbsp;Kazuaki Chayama,&nbsp;Kazuaki Inoue,&nbsp;Mureo Kasahara,&nbsp;Shuji Terai,&nbsp;Hiromasa Ohira,&nbsp;Isao Sakaida,&nbsp;Taro Takami,&nbsp;Kiyoshi Hasegawa,&nbsp;Masanori Abe,&nbsp;Masahito Shimizu,&nbsp;Hitoshi Yoshiji,&nbsp;Takuya Genda,&nbsp;Ayano Inui,&nbsp;Ryuzo Abe,&nbsp;Hajime Takikawa,&nbsp;Atsushi Tanaka,&nbsp;Satoshi Mochida","doi":"10.1111/hepr.14191","DOIUrl":"10.1111/hepr.14191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>A nationwide survey was conducted to clarify the recent status of patients with acute liver failure (ALF) and late-onset fulminant hepatitis (LOHF) in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two-step surveys were performed annually targeting 782 hospitals, focusing on patients meeting the Japanese diagnostic criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1404 patients seen between 2016 and 2021 were enrolled, including 1373 patients with ALF (824 non-comatose, 320 acute type, and 229 subacute type) and 31 patients with LOHF. Of these, 1117 patients (79.6%) had hepatitis, and 287 patients (20.4%) did not have hepatitis. Compared to patients seen from 2010 to 2015, those from 2016 to 2021 showed a decrease in the proportion of viral cases across all types compared to those up to 2009, whereas the proportion of drug-induced, autoimmune, and indeterminate cases increased. Among the patients, 32 had HBV reactivation due to immunosuppressive and/or antineoplastic therapies (17 HBsAg positive and 15 HBsAg negative). The frequency of complications and various treatment methods did not show significant changes compared to previous surveys. Excluding non-comatose cases, the survival rate with medical treatment for patients with and without hepatitis remained low. Liver transplantation was performed in 144 patients with hepatitis (12.9%) and in 19 patients without hepatitis (6.6%). Multivariate analysis identified disease types, patient age, etiology, liver atrophy, and complications as factors associated with the outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although the clinical features and etiologies of patients with ALF and LOHF have evolved, patient outcomes have not improved in recent years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 6","pages":"932-947"},"PeriodicalIF":3.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}