JHEP Reports最新文献

{"title":"Validation of NIAAAm-CRP criteria to predict alcohol-associated steatohepatitis on liver histology","authors":"Rudolf E. Stauber ,&nbsp;Pierre-Emmanuel Rautou ,&nbsp;Horia Stefanescu ,&nbsp;Adelina Horhat ,&nbsp;Maja Thiele ,&nbsp;Carolin Lackner","doi":"10.1016/j.jhepr.2024.101055","DOIUrl":"10.1016/j.jhepr.2024.101055","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><p>In clinical practice, the diagnosis of alcohol-associated hepatitis (AH) is mostly based on non-invasive criteria, which were defined at a consensus conference by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). These criteria were recently modified by adding C-reactive protein (CRP) and termed NIAAAm-CRP criteria, which showed superior diagnostic accuracy for presence of alcohol-associated steatohepatitis (ASH) on liver histology. The aim of our study was to validate the diagnostic accuracy of both original NIAAA criteria and NIAAAm-CRP criteria for presence of ASH on liver histology in an independent cohort.</p></div><div><h3>Methods</h3><p>Data from a large multinational cohort of 445 patients with alcohol-associated liver disease (ALD) that served to establish a novel grading and staging system of alcohol-associated liver disease were analyzed retrospectively. Diagnosis of ASH was based on presence of hepatocyte ballooning plus lobular neutrophil infiltration and established in virtual consensus meetings of multiple expert liver pathologists.</p></div><div><h3>Results</h3><p>Complete data including CRP values were available in 346 patients. Overall diagnostic accuracy for prediction of ASH was 73% for NIAAA criteria and 77% for NIAAAm-CRP criteria. In a subgroup with suspected severe AH (MELD &gt;20, n = 123), overall diagnostic accuracy for prediction of ASH was 69% for NIAAA criteria and 74% for NIAAAm-CRP criteria.</p></div><div><h3>Conclusion</h3><p>Our findings confirm recent data on suboptimal diagnostic accuracy of original NIAAA criteria and validate slightly better but still suboptimal performance of NIAAAm-CRP criteria for presence of ASH.</p></div><div><h3>Impact and Implications</h3><p>Alcohol-associated steatohepatitis (ASH) is diagnosed on liver histology but liver biopsy is not always feasible. Non-invasive diagnosis based on clinical findings has been proposed using the National Institute on Alcohol Abuse and Alcoholism (NIAAA) criteria and recently improved using NIAAAm-CRP criteria. Our findings validate slightly better but still suboptimal performance of NIAAAm-CRP criteria for the presence of histological ASH. Clinical trials of novel drugs should focus on histologically proven ASH.</p></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":null,"pages":null},"PeriodicalIF":8.3,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589555924000569/pdfft?md5=7cc2a363eb19bd0e9379846b875de3b4&pid=1-s2.0-S2589555924000569-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140275852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soluble urokinase plasminogen activator receptor levels predict survival in patients with portal hypertension undergoing TIPS","authors":"Sven H. Loosen ,&nbsp;Fabian Benz ,&nbsp;Raphael Mohr ,&nbsp;Philipp A. Reuken ,&nbsp;Theresa H. Wirtz ,&nbsp;Lioba Junker ,&nbsp;Christian Jansen ,&nbsp;Carsten Meyer ,&nbsp;Michael Praktiknjo ,&nbsp;Alexander Wree ,&nbsp;Johanna Reißing ,&nbsp;Münevver Demir ,&nbsp;Wenyi Gu ,&nbsp;Mihael Vucur ,&nbsp;Robert Schierwagen ,&nbsp;Andreas Stallmach ,&nbsp;Anselm Kunstein ,&nbsp;Johannes Bode ,&nbsp;Christian Trautwein ,&nbsp;Frank Tacke ,&nbsp;Christoph Roderburg","doi":"10.1016/j.jhepr.2024.101054","DOIUrl":"10.1016/j.jhepr.2024.101054","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><p>Transjugular intrahepatic portosystemic shunt (TIPS) is the most effective therapy for complications of portal hypertension. However, clinical outcomes following TIPS placement vary widely between patients and identifying ideal candidates remains a challenge. Soluble urokinase plasminogen activator receptor (suPAR) is a circulating marker of immune activation that has previously been associated with liver inflammation, but its prognostic value in patients receiving TIPS is unknown. In the present study, we evaluated the potential clinical relevance of suPAR levels in patients undergoing TIPS insertion.</p></div><div><h3>Methods</h3><p>suPAR concentrations were measured by ELISA in hepatic vein (HV) and portal vein (PV) blood samples from 99 patients (training cohort) as well as peripheral venous blood samples from an additional 150 patients (validation cohort) undergoing TIPS placement. The association between suPAR levels and patient outcomes was assessed using Kaplan-Meier methods and Cox-regression analyses.</p></div><div><h3>Results</h3><p>suPAR concentrations were significantly higher in HV samples compared to PV samples and correlated with PV concentration, the presence of ascites, renal injury, and consequently with the Child-Pugh and MELD scores. Patients with lower suPAR levels had significantly better short- and long-term survival after TIPS insertion, which remained robust after adjustment for confounders in multivariate Cox-regression analyses. Sensitivity analysis showed an improvement in risk prediction in patients stratified by Child-Pugh or MELD scores. In an independent validation cohort, higher levels of suPAR predicted poor transplant-free survival after TIPS, particularly in patients with Child-Pugh A/B cirrhosis.</p></div><div><h3>Conclusion</h3><p>suPAR is largely derived from the injured liver and its levels are predictive of outcome in patients undergoing TIPS. suPAR, as a surrogate of hepatic inflammation, may be used to stratify care in patients following TIPS insertion.</p></div><div><h3>Impact and implications</h3><p>Transjugular intrahepatic portosystemic shunt (TIPS) is the most effective therapy for complications of portal hypertension. However, clinical outcomes following TIPS placement vary widely between patients and identification of the ideal candidates remains challenging. We show that soluble urokinase plasminogen activator receptor (suPAR), a circulating marker of immune activation that can easily be measured in routine clinical practice, is a novel marker to identify patients who will benefit from TIPS and those who will not.</p></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":null,"pages":null},"PeriodicalIF":8.3,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589555924000557/pdfft?md5=89e3d4ed48a048279553ab9ce9f68dce&pid=1-s2.0-S2589555924000557-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Expert management of congenital portosystemic shunts and their complications” [JHEP Reports 6 (2024)]","authors":"Valérie Anne McLin ,&nbsp;Stéphanie Franchi-Abella ,&nbsp;Timothée Brütsch ,&nbsp;Atessa Bahadori ,&nbsp;Valeria Casotti ,&nbsp;Jean de Ville de Goyet ,&nbsp;Grégoire Dumery ,&nbsp;Emmanuel Gonzales ,&nbsp;Florent Guérin ,&nbsp;Sebastien Hascoet ,&nbsp;Nigel Heaton ,&nbsp;Béatrice Kuhlmann ,&nbsp;Frédéric Lador ,&nbsp;Virginie Lambert ,&nbsp;Paolo Marra ,&nbsp;Dr Aurélie Plessier ,&nbsp;Alberto Quaglia ,&nbsp;Anne-Laure Rougemont ,&nbsp;Laurent Savale ,&nbsp;Moinak Sen Sarma ,&nbsp;Barbara Elisabeth Wildhaber","doi":"10.1016/j.jhepr.2024.101024","DOIUrl":"https://doi.org/10.1016/j.jhepr.2024.101024","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":null,"pages":null},"PeriodicalIF":8.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589555924000259/pdfft?md5=961262b63ca507c4fd8c09a6c7cb441a&pid=1-s2.0-S2589555924000259-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright and information","authors":"","doi":"10.1016/S2589-5559(24)00049-1","DOIUrl":"https://doi.org/10.1016/S2589-5559(24)00049-1","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":null,"pages":null},"PeriodicalIF":8.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589555924000491/pdfft?md5=e4970b212d7ec370a3e6dacf81b9cb2a&pid=1-s2.0-S2589555924000491-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board page","authors":"","doi":"10.1016/S2589-5559(24)00046-6","DOIUrl":"https://doi.org/10.1016/S2589-5559(24)00046-6","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":null,"pages":null},"PeriodicalIF":8.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589555924000466/pdfft?md5=a07cc30680bf87b4d91652b807615ba8&pid=1-s2.0-S2589555924000466-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Trends in decompensated cirrhosis and hepatocellular carcinoma among people with a hepatitis B notification in New South Wales” [JHEP Reports 4 (2022)]","authors":"Syed Hassan Bin Usman Shah ,&nbsp;Maryam Alavi ,&nbsp;Behzad Hajarizadeh ,&nbsp;Gail V. Matthews ,&nbsp;Marianne Martinello ,&nbsp;Mark Danta ,&nbsp;Janaki Amin ,&nbsp;Matthew G. Law ,&nbsp;Jacob George ,&nbsp;Heather Valerio ,&nbsp;Gregory J. Dore","doi":"10.1016/j.jhepr.2024.101022","DOIUrl":"10.1016/j.jhepr.2024.101022","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":null,"pages":null},"PeriodicalIF":8.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589555924000235/pdfft?md5=6980a7fdbc86fac24ae82d64ecd8ebb3&pid=1-s2.0-S2589555924000235-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139818548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive role of hepatic venous pressure gradient in bleeding events among patients with cirrhosis undergoing orthotopic liver transplantation","authors":"Mikhael Giabicani ,&nbsp;Pauline Joly ,&nbsp;Stéphanie Sigaut ,&nbsp;Clara Timsit ,&nbsp;Pauline Devauchelle ,&nbsp;Fédérica Dondero ,&nbsp;François Durand ,&nbsp;Pierre Antoine Froissant ,&nbsp;Myriam Lamamri ,&nbsp;Audrey Payancé ,&nbsp;Aymeric Restoux ,&nbsp;Olivier Roux ,&nbsp;Tristan Thibault-Sogorb ,&nbsp;Shantha Ram Valainathan ,&nbsp;Mickaël Lesurtel ,&nbsp;Pierre-Emmanuel Rautou ,&nbsp;Emmanuel Weiss","doi":"10.1016/j.jhepr.2024.101051","DOIUrl":"10.1016/j.jhepr.2024.101051","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><p>Major bleeding events during orthotopic liver transplantation (OLT) are associated with poor outcomes. The proportion of this risk related to portal hypertension is unclear. Hepatic venous pressure gradient (HVPG) is the gold standard for estimating portal hypertension. The aim of this study was to analyze the ability of HVPG to predict intraoperative major bleeding events during OLT in patients with cirrhosis.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed a prospective database including all patients with cirrhosis who underwent OLT between 2010 and 2020 and had liver and right heart catheterizations as part of their pre-transplant assessment. The primary endpoint was the occurrence of an intraoperative major bleeding event.</p></div><div><h3>Results</h3><p>The 468 included patients had a median HVPG of 17 mmHg [interquartile range, 13-22] and a median MELD on the day of OLT of 16 [11-24]. Intraoperative red blood cell transfusion was required in 72% of the patients (median 2 units transfused), with a median blood loss of 1,000 ml [575-1,500]. Major intraoperative bleeding occurred in 156 patients (33%) and was associated with HVPG, preoperative hemoglobin level, severity of cirrhosis at the time of OLT (MELD score, ascites, encephalopathy), hemostasis impairment (thrombocytopenia, lower fibrinogen levels), and complications of cirrhosis (sepsis, acute-on-chronic liver failure). By multivariable regression analysis with backward elimination, HVPG, preoperative hemoglobin level, MELD score, and tranexamic acid infusion were associated with the primary endpoint. Three categories of patients were identified according to HVPG: low-risk (HVPG &lt;16 mmHg), high-risk (HVGP ≥16 mmHg), and very high-risk (HVPG ≥20 mmHg).</p></div><div><h3>Conclusions</h3><p>HVPG predicted major bleeding events in patients with cirrhosis undergoing OLT. Including HVPG as part of pre-transplant assessment might enable better anticipation of the intraoperative course.</p></div><div><h3>Impact and implications</h3><p>Major bleeding events during orthotopic liver transplantation (OLT) are associated with poor outcomes but the proportion of this risk related to portal hypertension is unclear. Our work shows that hepatic venous pressure gradient (HVPG), the gold standard for estimating portal hypertension, is a strong predictor of major bleeding events and blood loss volume in patients with cirrhosis undergoing OLT. Three groups of patients can be identified according to their risk of major bleeding events: low-risk patients with HVPG &lt;16 mmHg, high-risk patients with HVPG ≥16 mmHg, and very high-risk patients with HVPG ≥20 mmHg. HVPG could be systematically included in the pre-transplant assessment to anticipate intraoperative course and tailor patient management.</p></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":null,"pages":null},"PeriodicalIF":8.3,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589555924000521/pdfft?md5=f8e70d7bfcc17e1b76098bcbe70de7c2&pid=1-s2.0-S2589555924000521-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate postpartum cessation of tenofovir did not increase risk of virological or clinical relapse in highly viremic pregnant mothers with chronic hepatitis B infection","authors":"Yu Chen ,&nbsp;Lung-Yi Mak ,&nbsp;Mary H.Y. Tang ,&nbsp;Jingyi Yang ,&nbsp;Chun Bong Chow ,&nbsp;Ai-Ming Tan ,&nbsp;Tao Lyu ,&nbsp;Juan Wu ,&nbsp;Qingjuan Huang ,&nbsp;Hai-Bo Huang ,&nbsp;Ka-Shing Cheung ,&nbsp;Man-Fung Yuen ,&nbsp;Wai-Kay Seto","doi":"10.1016/j.jhepr.2024.101050","DOIUrl":"10.1016/j.jhepr.2024.101050","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><p>Peripartum prophylaxis (PP) with tenofovir disoproxil fumarate (TDF) is the standard of care to prevent mother-to-child transmission of chronic hepatitis B (CHB) infection in mothers who are highly viremic. We investigated the maternal and infant outcomes in a large Chinese cohort of TDF-treated CHB pregnant participants.</p></div><div><h3>Methods</h3><p>In this prospective study, treatment-naive mothers with CHB and highly viremic (HBV DNA ≥200,000 IU/ml) but without cirrhosis were treated with TDF at 24–28 weeks of pregnancy. In accordance with Chinese CHB guidelines, TDF was stopped at delivery or ≥4 weeks postpartum. Serum HBV DNA and alanine aminotransferase were monitored every 6–8 weeks to determine virological relapse (VR). Infants received standard neonatal immunization, and HBV serology was checked at 7–12 months of age.</p></div><div><h3>Results</h3><p>Among 330 participants recruited (median age 30, 82.7% HBeAg+, median HBV DNA 7.82 log IU/ml), TDF was stopped at delivery in 66.4% and at ≥4 weeks in 33.6%. VR was observed in 98.3%, among which 11.6% were retreated with TDF. Timing of TDF cessation did not alter the risk of VR (99.0 <em>vs</em>. 96.9%), clinical relapse (19.5 <em>vs</em>. 14.3%), or retreatment (12.6 <em>vs</em>. 10.1%) (all <em>p</em> &gt; 0.05). A similar proportion of patients developed alanine aminotransferase flare five times (1.1 <em>vs</em>. 2.1%; <em>p</em> = 0.464) and 10 times (0.5 <em>vs</em>. 0%; <em>p</em> = 0.669) above the upper limit of normal (ULN) in the early withdrawal and late withdrawal groups, respectively. No infants developed HBsAg-positivity.</p></div><div><h3>Conclusions</h3><p>PP-TDF and neonatal immunization were highly effective in preventing mother-to-child transmission of HBV in mothers who are highly viremic. Timing of cessation of PP-TDF did not affect the risk of VR or retreatment.</p></div><div><h3>Impact and Implications</h3><p>In pregnant mothers with chronic hepatitis B infection who are started on peripartum tenofovir to prevent mother-to-child-transmission (MTCT), the optimal timing for antiviral withdrawal during the postpartum period remains unknown. This prospective study demonstrates that stopping tenofovir immediately at delivery, compared with longer treatment duration of tenofovir, did not lead to an increased risk of virological relapse, retreatment, or transmission of the virus to the baby. Shortening the duration of peripartum antiviral prophylaxis from 12 weeks to immediately after delivery can be considered. The immediate withdrawal of peripartum tenofovir, combined with standard neonatal immunization schemes, is 100% effective in preventing MTCT among pregnant mothers with CHB who are highly viremic, with a high rate of vaccine response in infants.</p></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":null,"pages":null},"PeriodicalIF":8.3,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258955592400051X/pdfft?md5=7c823a326115936fcf170ca16dbfa557&pid=1-s2.0-S258955592400051X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140470198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse pregnancy outcomes as a risk factor for new-onset metabolic dysfunction-associated steatotic liver disease in postpartum women: A nationwide study","authors":"Young Mi Jung ,&nbsp;Seung Mi Lee ,&nbsp;Wonyoung Wi ,&nbsp;Min-Jeong Oh ,&nbsp;Joong Shin Park ,&nbsp;Geum Joon Cho ,&nbsp;Won Kim","doi":"10.1016/j.jhepr.2024.101033","DOIUrl":"https://doi.org/10.1016/j.jhepr.2024.101033","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><p>Adverse pregnancy outcomes (APOs) can worsen cardiometabolic risk factors in women, raising their likelihood of developing cardiometabolic diseases at a young age after their initial pregnancy. Nevertheless, there are limited data on the risk of newly developing metabolic dysfunction-associated steatotic liver disease (MASLD) in women who have had APOs. This study aimed to evaluate the risk of new-onset MASLD after experiencing APOs.</p></div><div><h3>Methods</h3><p>Singleton pregnant women who underwent national health screenings 1 year before pregnancy and 1 year after delivery were included in this study. APOs were defined as the presence of at least one of the followings: hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), preterm birth, low birth weight, and placental abruption. The primary outcome was new-onset MASLD based on the presence of APOs.</p></div><div><h3>Results</h3><p>Among 80,037 study participants, 9,320 (11.6%) experienced APOs during pregnancy. Women who experienced APOs had an increased risk of developing new-onset MASLD after delivery even after adjustments for various covariates (adjusted odds ratio [OR] 1.58, 95% CI 1.45–1.72). In particular, women who experienced either HDP or GDM showed a significantly increased risk of developing new-onset MASLD (adjusted OR 2.20, 95% CI 1.81–2.67, for HDP and adjusted OR 1.83, 95% CI 1.65–2.03, for GDM). Moreover, there was a tendency toward an increased risk of new-onset MASLD according to the number of APOs (<em>p</em> &lt;0.001 for trend of odds).</p></div><div><h3>Conclusions</h3><p>APOs were associated with the risk of new-onset MASLD after delivery. Specifically, only HDP or GDM were identified as risk factors for new-onset MASLD.</p></div><div><h3>Impact and implications</h3><p>This nationwide cohort study confirms that postpartum women with a history of adverse pregnancy outcomes (APOs) are at an increased risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD). These findings may bring us one step closer to understanding the exact mechanisms underlying such an important association between prior APOs and cardiovascular disease (CVD) risk among postpartum women. This bidirectional association between APOs and MASLD highlights the importance of considering pregnancy history in assessing CVD risk in women. It suggests a need for closer monitoring and lifestyle interventions for women with a history of APOs to reduce the risk of MASLD and subsequent CVD complications.</p></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":null,"pages":null},"PeriodicalIF":8.3,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258955592400034X/pdfft?md5=34f9f1f8228a5c3dd628e5a52d8739fe&pid=1-s2.0-S258955592400034X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140163567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiome dynamics and Enterobacterales infection in liver transplant recipients: A prospective observational study","authors":"Federica D’Amico ,&nbsp;Matteo Rinaldi ,&nbsp;Renato Pascale ,&nbsp;Marco Fabbrini ,&nbsp;Maria Cristina Morelli ,&nbsp;Antonio Siniscalchi ,&nbsp;Cristiana Laici ,&nbsp;Simona Coladonato ,&nbsp;Matteo Ravaioli ,&nbsp;Matteo Cescon ,&nbsp;Simone Ambretti ,&nbsp;Pierluigi Viale ,&nbsp;Patrizia Brigidi ,&nbsp;Silvia Turroni ,&nbsp;Maddalena Giannella","doi":"10.1016/j.jhepr.2024.101039","DOIUrl":"10.1016/j.jhepr.2024.101039","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><p>The aim of this study was to investigate gut microbiome (GM) dynamics in relation to carbapenem-resistant Enterobacterales (CRE) colonization, CRE infection, and non-CRE infection development within 2 months after liver transplant (LT).</p></div><div><h3>Methods</h3><p>A single-center, prospective study was performed in patients undergoing LT from November 2018 to January 2020. The GM was profiled through 16S rRNA amplicon sequencing of a rectal swab taken on the day of transplantation, and fecal samples were collected weekly until 1 month after LT. A subset of samples was subjected to shotgun metagenomics, including resistome dynamics. The primary endpoint was to explore changes in the GM in the following groups: (1) CRE carriers developing CRE infection (CRE_I); (2) CRE carriers not developing infection (CRE_UI); (3) non-CRE carriers developing microbial infection (INF); and (4) non-CRE carriers not developing infection (NEG).</p></div><div><h3>Results</h3><p>Overall, 97 patients were enrolled, and 91 provided fecal samples. Of these, five, nine, 22, and 55 patients were classified as CRE_I, CRE_UI, INF, and NEG, respectively. CRE_I patients showed an immediate and sustained post-LT decrease in alpha diversity, with depletion of the GM structure and gradual over-representation of <em>Klebsiella</em> and <em>Enterococcus</em>. The proportions of <em>Klebsiella</em> were significantly higher in CRE_I patients than in NEG patients even before LT, serving as an early marker of subsequent CRE infection. CRE_UI patients had a more stable and diverse GM, whose compositional dynamics tended to overlap with those of NEG patients.</p></div><div><h3>Conclusions</h3><p>GM profiling before LT could improve patient stratification and risk prediction and guide early GM-based intervention strategies to reduce infectious complications and improve overall prognosis.</p></div><div><h3>Impact and implications</h3><p>Little is known about the temporal dynamics of gut microbiome (GM) in liver transplant recipients associated with carbapenem-resistant Enterobacterales (CRE) colonization and infection. The GM structure and functionality of patients colonized with CRE and developing infection appeared to be distinct compared with CRE carriers without infection or patients with other microbial infection or no infection and CRE colonization. Higher proportions of antimicrobial-resistant pathogens and poor representation of bacteria and metabolic pathways capable of promoting overall host health were observed in CRE carriers who developed infection, even before liver transplant. Therefore, pretransplant GM profiling could improve patient stratification and risk prediction and guide early GM-based intervention strategies to reduce infectious complications and improve overall prognosis.</p></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":null,"pages":null},"PeriodicalIF":8.3,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589555924000405/pdfft?md5=3b165275703f2183e963fb5c2db0507e&pid=1-s2.0-S2589555924000405-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139828955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}