Hepatology Research最新文献

{"title":"Proximal splenic artery embolization for treatment of refractory ascites, a single-center experience.","authors":"Abdul Rehman Mustafa, Raneem Atta, Russell P Goodman, Vincent Wu, Zubin Irani, Omar Zurkiya, Emily D Bethea, Kei Yamada, Eric P Wehrenberg-Klee","doi":"10.1111/hepr.14116","DOIUrl":"https://doi.org/10.1111/hepr.14116","url":null,"abstract":"<p><strong>Aim: </strong>Refractory ascites from portal hypertension can be managed with regular large-volume paracentesis (LVP) or transjugular intrahepatic portosystemic shunt (TIPS). Large-volume paracentesis is clinically unsatisfactory and many patients are ineligible or relatively contraindicated for TIPS or Denver shunt. Proximal splenic artery embolization (PSAE) using coils or plugs reduces but does not completely stop splenic arterial inflow, differing from distal splenic artery embolization techniques. By reducing splenic arterial inflow, splenic vein outflow is also decreased, lowering portal pressure and thus treating refractory ascites.</p><p><strong>Methods: </strong>In this institutional review board-approved single-center retrospective study, electronic medical records were reviewed to obtain demographics and baseline clinical and laboratory data, paracentesis data before and after PSAE, PSAE procedural details, and follow-up imaging up to 12 months post-PSAE. Mixed-effects models were used for statistical analysis.</p><p><strong>Results: </strong>Ten patients with LVP-dependent ascites meeting inclusion criteria underwent PSAE for refractory ascites from 2017 to 2024. Prior to PSAE, four patients had TIPS, three had liver transplants, and the remaining three were neither TIPS nor transplant candidates. In the month before PSAE, patients averaged 3.8 ± 1.7 paracentesis sessions, draining a total of 20.84 ± 10.39 L of fluid monthly. Post-PSAE, the number of paracentesis sessions decreased to 2.1 ± 2.7, 1.0 ± 1.7, 0.4 ± 1.1, and 0.0 ± 0.0 at 1, 3, 6, and 12 months, respectively (p = 0.03). Corresponding ascitic volume drained decreased to 8.7 ± 10.3, 2.7 ± 6.4, 2.0 ± 5.4, and 0.0 ± 0.0 L (p = 0.01). Over the 12-month follow-up period, 6 of 10 patients became LVP-independent.</p><p><strong>Conclusion: </strong>Proximal splenic artery embolization can improve refractory ascites in certain patients with portal hypertension, thus providing safe and effective treatment as an alternative to TIPS.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345703","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":"A classification model for resectability in hepatocellular carcinoma patients.","authors":"Ikuo Nakamura, Tomoaki Yoh, Takashi Nishimura, Masayuki Okuno, Tomohiro Okamoto, Hideaki Sueoka, Kenjiro Iida, Masaharu Tada, Takamichi Ishii, Satoru Seo, Yasuhiro Fujimoto, Hiroko Iijima, Seiko Hirono, Etsuro Hatano","doi":"10.1111/hepr.14108","DOIUrl":"https://doi.org/10.1111/hepr.14108","url":null,"abstract":"<p><strong>Aim: </strong>Some patients undergoing liver resection for hepatocellular carcinoma (HCC) have poor outcomes. Therefore, we aimed to propose a new resectability classification for patients with HCC.</p><p><strong>Methods: </strong>We classified patients into three categories: resectable (R), borderline resectable (BR), and unresectable (UR). Patients (n = 409) who underwent hepatectomy for HCC were assigned to the non-UR (R and BR classes combined; n = 285) and UR-HCC classes (n = 68; training cohort). Patient characteristics in the BR-HCC and R-HCC groups were compared. The new criteria were tested in a validation cohort (n = 295).</p><p><strong>Results: </strong>Of the 285 patients, 229 and 56 were classified into the R- and BR-HCC classes, respectively, using macrovascular invasion, tumor size, and future liver remnant/modified albumin-bilirubin scores. Patients with BR-HCC demonstrated significantly worse progression-free and overall survival (p < 0.0001 and p < 0.0001, respectively) than patients with R-HCC in the training cohort. Similar results were observed in the validation cohort. Multivariate analysis of the non-UR-HCC group in the training cohort revealed that the tumor number and BR-HCC were independent predictive factors for poor overall survival.</p><p><strong>Conclusions: </strong>This classification can help select patients with BR-HCC for preoperative treatment before considering surgery.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345700","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":"Newly established borderline resectable 1 (BR1) category is one of the favorable candidates for selecting the use of multidisciplinary combination therapy in patients with advanced hepatocellular carcinoma treated with systemic therapy.","authors":"Yusuke Kawamura, Norio Akuta, Junichi Shindoh, Masaru Matsumura, Satoshi Okubo, Licht Tominaga, Shigeki Yamamoto, Yasuka Eriksson, Tetsuya Hosaka, Satoshi Saitoh, Hitomi Sezaki, Fumitaka Suzuki, Yoshiyuki Suzuki, Kenji Ikeda, Yasuji Arase, Masaji Hashimoto, Takuyo Kozuka, Hiromitsu Kumada","doi":"10.1111/hepr.14114","DOIUrl":"https://doi.org/10.1111/hepr.14114","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the newly established oncological criteria of resectability of hepatocellular carcinoma (HCC) for selecting suitable candidates for systemic and combination therapy.</p><p><strong>Methods: </strong>The data of 156 consecutive HCC patients with intrahepatic target nodules who had initially received systemic therapy (lenvatinib and atezolizumab plus bevacizumab) were reviewed. The patients were classified into three groups according to the novel oncological criteria for resectability (R, resectable; BR1, borderline resectable 1; and BR2, borderline resectable 2). The prognostic ability and clinical utility for selecting this population to receive combined use of multiple systemic sequential and locoregional therapy was then evaluated. Combined use of systemic sequential therapy with more than two agents and locoregional treatment was defined as multidisciplinary combination therapy (MCT), while systemic sequential therapy only and repeated locoregional treatment was defined as a single treatment procedure (STP).</p><p><strong>Results: </strong>Patients classified as R and BR1 had significantly better overall survival (OS) compared with BR2 (R vs. BR2, p = 0.012; BR1 vs. BR2, p = 0.004). However, there was no significant difference between R and BR1 (p = 1.000), in spite of significantly worse oncological status in the BR1 patients. Following a R0 resection and MCT, the BR1 patients had significantly better OS compared with those receiving STP or no additional treatment (median OS, not reached vs. 25.2 months and 20.1 vs. 11.3 months, respectively; p = 0.034).</p><p><strong>Conclusions: </strong>In patients with advanced HCC with intrahepatic target nodules the BR1 category is one of the favorable candidates for selecting those to be treated with MCT strategies.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345702","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":"Prediction of hepatocellular carcinoma in patients with Fontan-associated liver disease using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid magnetic resonance imaging.","authors":"Atsushi Yamamoto, Michinobu Nagao, Akihiro Inoue, Risako Nakao, Reiko Sakai, Yu Nishina, Satoru Morita, Akiko Sakai, Tomomi Kogiso, Koichiro Kaneko, Katsutoshi Tokushige, Kei Inai, Shuji Sakai, Junichi Yamaguchi","doi":"10.1111/hepr.14113","DOIUrl":"https://doi.org/10.1111/hepr.14113","url":null,"abstract":"<p><strong>Aim: </strong>The unique feature of Fontan circulation is elevated central venous pressure, which causes Fontan-associated liver disease (FALD). FALD is associated with a high incidence of hepatocellular carcinoma (HCC). Performing biopsies in patients with FALD is difficult as a result of warfarinization; gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI), a noninvasive examination, is useful for characterizing liver disease and detecting HCC. However, few studies have reported the detailed features of Gd-EOB-DTPA MRI, and the association between these findings and prognosis. Thus, this study aimed to investigate the utility of Gd-EOB-DTPA MRI to predict HCC development in patients with FALD.</p><p><strong>Methods: </strong>This study enrolled 44 patients with FALD (mean age 25 years) who underwent Gd-EOB-DTPA MRI. The hepatobiliary phase images were scored semiqualitatively, and the patients were classified into the mild (0-1 point) or severe group (≥2 points). The endpoint was HCC, and event-free survival was analyzed using Kaplan-Meier and log-rank tests.</p><p><strong>Results: </strong>The severe group included 19 patients. During a mean follow-up of 58 months, HCC developed in six patients. Kaplan-Meier analysis revealed that patients in the severe group had a significantly poorer prognosis than those in the mild group (p = 0.0053). The Fibrosis-4 index and liver-to-spleen ratio of patients with HCC were moderate.</p><p><strong>Conclusions: </strong>Gd-EOB-DTPA MRI can be used to classify disease severity and predict the prognosis of patients with FALD.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285966","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":"High serum growth differentiation factor 15 is a risk factor for the occurrence of hepatocellular carcinoma in chronic hepatitis B patients treated with nucleos(t)ide analogs","authors":"Emi Sometani, Hayato Hikita, Kazuhiro Murai, Hidenori Toyoda, Satoshi Tanaka, Tsugiko Oze, Jihyun Sung, Akiyoshi Shimoda, Makoto Fukuoka, Satoshi Shigeno, Keisuke Fukutomi, Kumiko Shirai, Yuki Tahata, Yoshinobu Saito, Akira Nishio, Kunimaro Furuta, Takahiro Kodama, Ryotaro Sakamori, Tomohide Tatsumi, Eiji Mita, Akihiro Umezawa, Yasuhito Tanaka, Tetsuo Takehara","doi":"10.1111/hepr.14111","DOIUrl":"https://doi.org/10.1111/hepr.14111","url":null,"abstract":"AimPatients with chronic hepatitis B (CHB) remain at risk for hepatocellular carcinoma (HCC) even with nucleos(t)ide analog therapy. We evaluated risk factors for HCC development, including serum hepatitis B virus (HBV) RNA, hepatitis B core‐related antigen level, and growth differentiation factor 15 (GDF15) level, a predictor of HCC development in patients with chronic hepatitis C.MethodsWe collected clinical data and stored serum from CHB patients without a history of HCC who were receiving nucleos(t)ide analog treatment for more than 1 year and whose HBV DNA level was less than 3.0 log IU/mL. We measured the serum levels of HBV RNA and GDF15.ResultsAmong 242 CHB patients, 57 had detectable HBV RNA, and GDF15 was quantified in all patients. The median GDF15 level was 0.86 ng/mL. Cox proportional hazards analysis revealed that male sex and higher GDF15, FIB‐4 index, alpha‐fetoprotein and gamma‐glutamyl transpeptidase were independent risk factors for HCC. The presence of HBV RNA above the lower limit of quantification was not a risk factor. When we set cutoff values based on the Youden index, the cumulative incidence of HCC was significantly higher in the male, AFP ≥3.0 ng/mL, gamma‐glutamyl transpeptidase ≥22 U/L, FIB‐4 index ≥1.93, and GDF‐15 ≥1.17 ng/mL groups. In patients with no or more than three of these five risk factors, the 10‐year HCC cumulative incidence rates were 0% and 41.0%, respectively.ConclusionsHigh serum GDF15 is an independent risk factor for the occurrence of HCC in CHB patients treated with nucleos(t)ide analogs.","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265513","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":"Novel protocol for prevention from hepatitis B reactivation following living‐donor liver transplantation","authors":"Takuma Izumi, Takeo Toshima, Shinji Itoh, Shohei Yoshiya, Yuki Bekki, Norifumi Iseda, Yuriko Tsutsui, Katsuya Toshida, Yuki Nakayama, Takuma Ishikawa, Tomoharu Yoshizumi","doi":"10.1111/hepr.14110","DOIUrl":"https://doi.org/10.1111/hepr.14110","url":null,"abstract":"AimReactivation of hepatitis B virus (HBV) after liver transplantation (LT) remains a problem; thus, development of more effective HBV reactivation prophylaxis is desirable. We evaluated the efficacy of a combination of a long‐term nucleotide analog (NA), such as entecavir (ETV) or tenofovir alafenamide (TAF), and short‐term hepatitis B immunoglobulin (HBIG) in preventing HBV reactivation and compared it with conventional HBV prophylaxis.MethodsBetween February 1999 and August 2023, 135 patients underwent living‐donor liver transplantation for liver cirrhosis or acute liver failure caused by HBV infection or received an LT from a hepatitis B core antibody‐positive donor. Recipients who had undergone LT were classified as being in the first or second era (namely until September 2017 and from October 2017), respectively, and outcomes of prophylaxis against HBV reactivation were compared between the two eras.ResultsIn the second era, recipients with HBV‐related disease or who had received hepatitis B core antibody‐positive liver received combination therapy with short‐term HBIG and an NA such as TAF and ETV long‐term. The duration of HBIG treatment was markedly shorter than in the first era in both categories of patients and HBIG could be discontinued in all cases. Surprisingly, we observed HBV reactivation in the first era, but not in the second era, in both groups.ConclusionsWe have established a protocol for prophylaxis against HBV reactivation using a combination of short‐term HBIG and long‐term NA. This protocol was found to be sufficient to prevent HBV reactivation after LT.","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265557","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":"Hepatic Mac2‐BP expression depends on liver fibrosis and inflammation due to fat accumulation in patients with metabolic dysfunction‐associated steatotic liver disease","authors":"Haruki Uojima, Hanako Tsujikawa, Ken Yamazaki, Masaya Sugiyama, Akira Take, Yoshihiko Sakaguchi, Kazuyoshi Gotoh, Takashi Satoh, Hisashi Hidaka, Shunji Hayashi, Chika Kusano, Michiie Sakamoto, Masashi Mizokami","doi":"10.1111/hepr.14109","DOIUrl":"https://doi.org/10.1111/hepr.14109","url":null,"abstract":"AimData on the upregulation of Mac‐2 binding protein (M2BP) expression associated with fat accumulation in the liver are limited. Therefore, we aimed to assess the relationship between hepatic M2BP expression and changes in the liver microenvironment due to fat accumulation in patients with metabolic dysfunction associated steatotic liver disease (MASLD).MethodsLiver specimens obtained from 46 patients with MASLD were subjected to immunohistochemical staining to visualize M2BP expression in the liver. The staining intensity in the hepatocytes and sinusoidal cells was classified as high or low grade. First, the correlation between hepatic M2BP expression and microenvironmental changes caused by fat accumulation was examined. Then, the influence of hepatic M2BP expression on serum M2BP glycosylation isomer levels in patients with MASLD was evaluated.ResultsThe staining grade of M2BP was higher in the sinusoidal cells than in the hepatocytes (<jats:italic>p</jats:italic> = 0.015). The patients with high staining grade in their hepatocytes had more severe lobular inflammation than those with low staining grade (<jats:italic>p</jats:italic> = 0.037). Additionally, the patients with high staining grade in their sinusoidal cells presented more severe fibrosis than those with low staining grade (<jats:italic>p</jats:italic> = 0.018). The staining grade in the hepatocytes correlated positively with serum M2BP glycosylation isomer levels (<jats:italic>p</jats:italic> = 0.023), whereas no correlation was observed between sinusoidal staining grade and serum M2BP glycosylation isomer levels (<jats:italic>p</jats:italic> = 0.393).ConclusionsFat accumulation in patients with MASLD leads to M2BP expression in hepatocytes due to liver inflammation and that in sinusoidal cells due to fibrosis.","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181202","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":"Elevated nuclear expression of ZHX1 correlates with poor prognosis in hepatocellular carcinoma (HCC): Comparison of nuclear and cytoplasmic distribution of the ZHX family in HCC cells.","authors":"Yu-Hong Ma, Shinya Maekawa, Shinichi Takano, Tatsuya Yamaguchi, Takeshi Ishida, Shinya Takaoka, Masaru Muraoka, Yasuyuki Komiyama, Hitomi Takada, Yuichiro Suzuki, Mitsuaki Sato, Jianglin Fan, Nobuyuki Enomoto","doi":"10.1111/hepr.14100","DOIUrl":"https://doi.org/10.1111/hepr.14100","url":null,"abstract":"<p><strong>Aim: </strong>The role of the zinc fingers and homeoboxes family (ZHX1-3), transcriptional repressors, through their subcellular localization in hepatocellular carcinoma (HCC), is not fully understood. The present study aimed to examine the differential nuclear and cytoplasmic expression of ZHXs in HCC tissues.</p><p><strong>Methods: </strong>Immunohistochemistry was utilized to detect the expression of ZHXs in 54 liver tissues from HCC (n = 33), hepatitis C (n = 16), and the normal liver tissue surrounding hepatic metastasis of colorectal cancer (n = 5). Next-generation sequencing and digital polymerase chain reaction identified gene mutations associated with HCC. Kaplan-Meier curves were constructed to evaluate the relationship between ZHX expression and survival. The results were validated using data from The Cancer Genome Atlas. Univariate and multivariate Cox regression analyses were undertaken to identify independent prognostic factors.</p><p><strong>Results: </strong>High nuclear expression of ZHX1 was associated with poor overall survival (OS), while high nuclear expression of ZHX2 correlated with higher recurrence. Conversely, patients with high cytoplasmic expression of ZHX3 had lower recurrence and better OS. Hepatitis B virus-associated HCC was related to high cytoplasmic expression of ZHX1, which was marginally related to telomerase reverse transcriptase (TERT) promoter mutation-negative HCC. In contrast, low nuclear expression of ZHX3 was associated with TERT promoter mutation-positive HCC and HCC patients over 70 years old.</p><p><strong>Conclusions: </strong>These results suggest that the expression and localization of different ZHXs may be related to HCC progression, potentially inferring genetic backgrounds such as TERT promoter mutation. Further studies on the relationship between HCC and ZHXs will enhance our understanding and control of HCC.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106917","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":"Efficacy of steroid therapy for improving native liver survival after pediatric acute liver failure with immune activation.","authors":"Hiroshi Oue, Eitaro Hiejima, Hideaki Okajima, Tatsuya Okamoto, Eri Ogawa, Elena Yukie Uebayashi, Etsuro Hatano, Takenori Suga, Yotaro Hanami, Kazushige Ashina, Shinichi Kai, Tsuyoshi Sogo, Ayano Inui, Takeshi Matsubara, Kaoru Sakai, Motoko Yanagita, Hironori Haga, Sachiko Minamiguchi, Yosuke Yamada, Hiroshi Nihira, Kazushi Izawa, Takahiro Yasumi, Junko Takita","doi":"10.1111/hepr.14107","DOIUrl":"https://doi.org/10.1111/hepr.14107","url":null,"abstract":"<p><strong>Aim: </strong>Recent evidence suggests that acute liver failure (ALF) in some patients may reflect a dysregulated immune response, and that corticosteroids improve survival of the native liver in ALF patients with high serum alanine aminotransferase levels, which are an indication of liver inflammation. However, it is unclear whether steroids are effective for pediatric acute liver failure (PALF). The aim of this retrospective case-control study is to examine whether steroid therapy for PALF accompanied by immune activation improves the survival of native liver and to identify factors that predict responses to steroid treatment.</p><p><strong>Methods: </strong>Of 38 patients with PALF treated at Kyoto University Hospital from February 2006 to August 2022, 19 receiving steroids who met the specific criteria for identifying the pathophysiology of immune activity in the liver (the \"Steroid group\"), and seven steroid-free patients who also met the criteria (\"Nonsteroid group\") were enrolled. Patients in the \"Steroid group\" were categorized as \"responders\" or \"nonresponders\" according to treatment outcome. Clinical and histological data were analyzed.</p><p><strong>Results: </strong>Survival of the native liver in the Steroid group was significantly higher than that in the Nonsteroid group (68% vs. 0%, respectively; p = 0.0052). Nonresponders were significantly younger, with higher Model for End-stage Liver Disease and pediatric end-stage liver disease scores, higher prothrombin time - international normalized ratio, and higher serum ferritin levels than responders. Massive hepatic necrosis was more common in nonresponders.</p><p><strong>Conclusion: </strong>Steroid therapy is effective for PALF patients with liver inflammation; however, liver transplantation should be prioritized for young children with ALF accompanied by severe coagulopathy or massive hepatic necrosis.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017278","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":"Hepatitis B surface antigen glycan isomer as a new potential biomarker in patients with hepatitis B virus infection","authors":"Taiki Okumura,&nbsp;Takeji Umemura","doi":"10.1111/hepr.14106","DOIUrl":"10.1111/hepr.14106","url":null,"abstract":"&lt;p&gt;It is estimated that over 254 million people worldwide are infected with HBV, causing roughly 1.1 million deaths annually&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; as HBV infection progresses to liver cirrhosis and HCC.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; Nucleoside/nucleotide analogs and pegylated interferon are currently available antiviral regimens for managing chronic HBV infection. However, it remains difficult to eradicate the cccDNA of HBV in hepatocyte nuclei. Thus, serological biomarkers such as HBsAg, HBV DNA, and HBcrAg have been established to estimate HBV replication activity, predict therapeutic responses, and assess the risk of HCC development.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Although the currently available quantitative HBsAg assay has been proven to correlate with serum HBV DNA and intrahepatic cccDNA levels,&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; it cannot distinguish HBsAg in terms of HBV virions and noninfectious SVPs. Hepatitis B virus envelope proteins include three distinct types of HBsAg: S-HBsAg, M-HBsAg, and L-HBsAg. The HBV particles in a patient's blood include infectious Dane particles containing viral DNA and SVPs. The SVPs are composed mainly of S-HBsAg and are 1000 times more abundant than Dane particles, which are composed primarily of M-HBsAg protein. To accurately assess disease status, HBV virions must be closely monitored and clearly distinguished from SVPs.&lt;/p&gt;&lt;p&gt;Hepatitis B surface antigens are heavily glycosylated with N-glycans and O-glycans.&lt;span&gt;&lt;sup&gt;7, 8&lt;/sup&gt;&lt;/span&gt; Whole-glycan structural analyses have revealed that the PreS2 domain on M-HBs, but not on L-HBs, contain a highly conserved O-glycosylated site in genotype C.&lt;span&gt;&lt;sup&gt;9, 10&lt;/sup&gt;&lt;/span&gt; A recombinant monoclonal antibody against this HBsAgGi was then generated using an O-glycosylated PreS2 peptide. Unlike conventional HBsAg testing, which recognizes the entirety of viral particles, HBsAgGi specifically identifies infectious HBV particles containing M-HBsAg, that is, Dane particles containing DNA and RNA. Hepatitis B antigen glycan isomer testing is now commercially available and can be measured in patient serum with an enzyme-linked immunosorbent assay kit featuring a monoclonal antibody to O-glycosylated PreS2 on M-HBsAg. Evidence on the clinical utility of HBsAgGi is now growing.&lt;/p&gt;&lt;p&gt;Recent studies have described correlations of HBsAgGi with other HBV-associated markers along with HBsAgGi kinetics. We earlier reported that serum HBsAgGi had stronger correlations with serum HBV DNA than did total HBsAg after excluding patients under NA therapy (&lt;i&gt;r&lt;/i&gt; = 0.4332 vs. 0.3927).&lt;span&gt;&lt;sup&gt;11&lt;/sup&gt;&lt;/span&gt; Murata et al. showed that serum HBsAgGi was significantly associated with HBcrAg at baseline (&lt;i&gt;r&lt;/i&gt; = 0.452, &lt;i&gt;p&lt;/i&gt; = 0.001) and after 48 weeks of NA therapy (&lt;i&gt;r&lt;/i&gt; = 0.388, &lt;i&gt;p&lt;/i&gt; = 0.007).&lt;span&gt;&lt;sup&gt;12&lt;/sup&gt;&lt;/span&gt; Similarly, Kozuka et al. showed that serum HBsAgGi was significantly associated with iTACT-HBcrAg at baseline (&lt;i&gt;r&lt;/i&gt; = 0.56 &lt;i&gt;p&lt;/i&gt; &lt; 0.001) a","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008747","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}