Hepatology最新文献

{"title":"Exome-wide association analysis identifies novel risk loci for alcohol-associated hepatitis.","authors":"Qiaoping Yuan, Colin Hodgkinson, Xiaochen Liu, Bruce Barton, Nancy Diazgranados, Melanie Schwandt, Timothy Morgan, Ramon Bataller, Suthat Liangpunsakul, Laura E Nagy, David Goldman","doi":"10.1097/HEP.0000000000001027","DOIUrl":"10.1097/HEP.0000000000001027","url":null,"abstract":"<p><strong>Background and aims: </strong>Alcohol-associated hepatitis (AH) is a clinically severe, acute disease that afflicts only a fraction of patients with alcohol use disorder. Genomic studies of alcohol-associated cirrhosis (AC) have identified several genes of large effect, but the genetic and environmental factors that lead to AH and AC, and their degree of genetic overlap, remain largely unknown. This study aims to identify genes and genetic variations that contribute to the development of AH.</p><p><strong>Approach and results: </strong>Exome-sequencing of patients with AH (N=784) and heavy drinking controls (N=951) identified an exome-wide significant association for AH at patalin-like phospholipase domain containing 3, as previously observed for AC in genome-wide association study, although with a much lower effect size. Single nucleotide polymorphisms (SNPs) of large effect size at inducible T cell costimulatory ligand ( ICOSLG ) (Chr 21) and TOX4/RAB2B (Chr 14) were also exome-wide significant. ICOSLG encodes a co-stimulatory signal for T-cell proliferation and cytokine secretion and induces B-cell proliferation and differentiation. TOX high mobility group box family member 4 ( TOX4 ) was previously implicated in diabetes and immune system function. Other genes previously implicated in AC did not strongly contribute to AH, and the only prominently implicated (but not exome-wide significant) gene overlapping with alcohol use disorder was alcohol dehydrogenase 1B ( ADH1B ). Polygenic signals for AH were observed in both common and rare variant analysis and identified genes with roles associated with inflammation.</p><p><strong>Conclusions: </strong>This study has identified 2 new genes of high effect size with a previously unknown contribution to alcohol-associated liver disease and highlights both the overlap in etiology between liver diseases and the unique origins of AH.</p>","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":"1304-1317"},"PeriodicalIF":12.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141764583","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":"Erratum: Protein tyrosine phosphatase receptor S acts as a metastatic suppressor in hepatocellular carcinoma by control of epithermal growth factor receptor-induced epithelial-mesenchymal transition.","authors":"Zhi-Chao Wang, Qiang Gao, Jie-Yi Shi, Wei-Jie Guo, Liu-Xiao Yang, Xin-Yang Liu, Long-Zi Liu, Li-Jie Ma, Meng Duan, Ying-Jun Zhao, Yong-Na Wu, Dong-Mei Gao, Xiao-Ying Wang, Guo-Ming Shi, Zhen-Bin Ding, Ai-Wu Ke, Qi-Qun Tang, Ya Cao, Jian Zhou, Jia Fan","doi":"10.1097/HEP.0000000000001176","DOIUrl":"10.1097/HEP.0000000000001176","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":"E131-E132"},"PeriodicalIF":12.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rapidly evolving landscape of HCC: Selecting the optimal systemic therapy.","authors":"Valentina Zanuso, Lorenza Rimassa, Chiara Braconi","doi":"10.1097/HEP.0000000000000572","DOIUrl":"10.1097/HEP.0000000000000572","url":null,"abstract":"<p><p>Over the past years, there has been a remarkable advance in the systemic treatment options for advanced HCC. The overall survival has gradually increased over time, with larger benefits for patients with sensitive tumors and preserved liver function, the latter being an essential condition for the delivery of sequential lines of treatment and optimization of clinical outcomes. With the approval of new first-line agents and the introduction of immune checkpoint inhibitor-based therapies, the treatment landscape of advanced HCC is becoming wider than ever. Atezolizumab plus bevacizumab and, more recently, durvalumab plus tremelimumab have entered the clinical practice and are the current standard of care for treatment-naïve patients, surpassing sorafenib and lenvatinib monopoly. As no head-to-head comparisons are available among all the first-line treatment options, the recommendation for the most appropriate choice and sequence is patient-driven and integrates efficacy data with clinical comorbidities, background liver disease, and the safety profile of available drugs. In addition, predictive biomarkers for successful patients' stratification are yet to be available and constitute the focus of ongoing research. The treatment algorithm is likely to become even more complex since systemic therapeutic approaches are now being translated into earlier stages of the disease, with an impact on the evolution of the sequential treatment of patients with HCC.</p>","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":"1365-1386"},"PeriodicalIF":12.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10258702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial RUNX3 controls LSEC dysfunction and angiocrine LRG1 signaling to prevent liver fibrosis.","authors":"Uttam Ojha, Somi Kim, Chang Yun Rhee, Jihye You, Yoon Ha Choi, Soo-Hyun Yoon, Soo Young Park, Yu Rim Lee, Jong Kyoung Kim, Suk-Chul Bae, You Mie Lee","doi":"10.1097/HEP.0000000000001018","DOIUrl":"10.1097/HEP.0000000000001018","url":null,"abstract":"<p><strong>Background and aims: </strong>Liver fibrosis represents a global health burden, given the paucity of approved antifibrotic therapies. Liver sinusoidal endothelial cells (LSECs) play a major gatekeeping role in hepatic homeostasis and liver disease pathophysiology. In early tumorigenesis, runt-related transcription factor 3 (RUNX3) functions as a sentinel; however, its function in liver fibrosis in LSECs remains unclear. This study aimed to investigate the role of RUNX3 as an important regulator of the gatekeeping functions of LSECs and explore novel angiocrine regulators of liver fibrosis.</p><p><strong>Approach and results: </strong>Mice with endothelial Runx3 deficiency develop gradual and spontaneous liver fibrosis secondary to LSEC dysfunction, thereby more prone to liver injury. Mechanistic studies in human immortalized LSECs and mouse primary LSECs revealed that IL-6/JAK/STAT3 pathway activation was associated with LSEC dysfunction in the absence of RUNX3. Single-cell RNA sequencing and quantitative RT-PCR revealed that leucine-rich alpha-2-glycoprotein 1 ( LRG1 ) was highly expressed in RUNX3-deficient and dysfunctional LSECs. In in vitro and coculture experiments, RUNX3-depleted LSECs secreted LRG1, which activated HSCs throughTGFBR1-SMAD2/3 signaling in a paracrine manner. Furthermore, circulating LRG1 levels were elevated in mouse models of liver fibrosis and in patients with fatty liver and cirrhosis.</p><p><strong>Conclusions: </strong>RUNX3 deficiency in the endothelium induces LSEC dysfunction, LRG1 secretion, and liver fibrosis progression. Therefore, endothelial RUNX3 is a crucial gatekeeping factor in LSECs, and profibrotic angiocrine LRG1 may be a novel target for combating liver fibrosis.</p>","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":"1228-1243"},"PeriodicalIF":12.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750655","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":"Reply: Development and validation of pFIB scores for exclusion of significant liver fibrosis in pediatric MASLD.","authors":"Sander Lefere, Antonella Mosca, Christian Hudert, Ellen Dupont, Emer Fitzpatrick, Eirini Kyrana, Anil Dhawan, Laura Kalveram, Andrea Pietrobattista, Anja Geerts, Ruth De Bruyne","doi":"10.1097/HEP.0000000000001088","DOIUrl":"10.1097/HEP.0000000000001088","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":"E119-E120"},"PeriodicalIF":12.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel phosphodiesterase inhibitor for the treatment of chronic liver injury and metabolic diseases.","authors":"Dalton W Staller, Sanjali S Panigrahi, Yahani P Jayasinghe, Yuxiang Dong, Sohan Mahto, Virender Kumar, Donald R Ronning, Ram I Mahato","doi":"10.1097/HEP.0000000000000999","DOIUrl":"10.1097/HEP.0000000000000999","url":null,"abstract":"<p><strong>Background and aims: </strong>Chronic liver disease leads to ~2 million deaths annually. Cyclic AMP (cAMP) signaling has long been studied in liver injury, particularly in the regulation of fatty acid (FA) β-oxidation and pro-inflammatory polarization of tissue-resident lymphocytes. Phosphodiesterase 4B inhibition has been explored as a therapeutic modality, but these drugs have had limited success and are known to cause significant adverse effects. The PDE4 inhibitor 2-(4-([2-(5-Chlorothiophen-2-yl)-5-ethyl-6-methylpyrimidin-4-yl]amino)phenyl)acetic acid) (known as A-33) has yet to be explored for the treatment of metabolic diseases.</p><p><strong>Approach and results: </strong>Herein, we evaluated the efficacy of A-33 in the treatment of animal models of alcohol-associated liver disease and steatotic liver disease. We demonstrated that A-33 effectively ameliorated the signs and symptoms of chronic liver disease, resulting in significant decreases in serum alanine aminotransferase and aspartate aminotransferase levels, decreased overall fat and collagen deposition in the liver, decreased intrahepatic triglyceride concentrations, and normalized expression of genes related to β-oxidation of fatty acids, inflammation, and extracellular matrix deposition. We also designed and synthesized a novel analog of A-33, termed MDL3, which inhibited both phosphodiesterase 4B and PDE5A and was more effective in ameliorating pathophysiological signs and symptoms of liver injury and inflammation. In addition, MDL3 re-sensitized obese mice to glucose and significantly inhibited the pathological remodeling of adipose tissue, which was not observed with A-33 administration.</p><p><strong>Conclusions: </strong>In conclusion, we synthesized and demonstrated that MDL3, a novel phosphodiesterase 4B and PDE5A inhibitor, presents a promising avenue of exploration for treating chronic liver disease.</p>","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":"1288-1303"},"PeriodicalIF":12.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475544","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":"Epidemiological and economical burden of cholestatic liver disease","authors":"Bregje Mol, Ellen Werner, Emma L. Culver, Adriaan J. van der Meer, Johannes A. Bogaards, Cyriel Y. Ponsioen","doi":"10.1097/hep.0000000000001341","DOIUrl":"https://doi.org/10.1097/hep.0000000000001341","url":null,"abstract":"The main cholestatic liver diseases comprise primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC), and IgG4-related cholangitis (IgG4-C). Despite being classified as rare diseases these are becoming gradually more important in the field of hepatology since their incidence is slowly rising while viral hepatitis burden is declining. Cholestatic liver diseases now rank among the three most frequent indications for liver transplantation in many Western countries. An accurate understanding of the epidemiology and burden of disease on both the individual and society of cholestatic diseases is of great importance. This review aims at providing a comprehensive overview of the current literature on the epidemiology, health related quality of life, and economical burden of PSC, PBC, and IgG4-C.","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"3 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143757956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Can pFIB scores reliably exclude significant liver fibrosis in pediatric MASLD?","authors":"Sander Lefere, Antonella Mosca, Christian Hudert, Ellen Dupont, Emer Fitzpatrick, Eirini Kyrana, Anil Dhawan, Laura Kalveram, Andrea Pietrobattista, Anja Geerts, Ruth De Bruyne","doi":"10.1097/HEP.0000000000001069","DOIUrl":"10.1097/HEP.0000000000001069","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":"E116-E117"},"PeriodicalIF":12.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury in severe alcohol-associated hepatitis treated with anakinra plus zinc or prednisone.","authors":"Kavish R Patidar, Wanzhu Tu, Thomas G Cotter, Douglas A Simonetto, Amon Asgharpour, Muhammad Y Jan, Qing Tang, Yunpeng Yu, Yang Li, Moyinoluwa Taiwo, Prashanth Thevkar Nagesh, Srinivasan Dasarathy, Patrick S Kamath, Craig J McClain, Naga Chalasani, Gyongyi Szabo, Ramon Bataller, Mack Mitchell, Wajahat Z Mehal, Laura E Nagy, Vijay H Shah, Samer Gawrieh, Arun J Sanyal","doi":"10.1097/HEP.0000000000001019","DOIUrl":"10.1097/HEP.0000000000001019","url":null,"abstract":"<p><strong>Background and aims: </strong>In a recent trial, patients with severe alcohol-associated hepatitis treated with anakinra plus zinc (A+Z) had lower survival and higher acute kidney injury (AKI) rates versus prednisone (PRED). We characterize the clinical factors and potential mechanisms associated with AKI development in that trial.</p><p><strong>Approach and results: </strong>Data from 147 participants in a multicenter randomized clinical trial (74 A+Z, 73 PRED) were analyzed. AKI, AKI phenotypes, and kidney injury biomarkers were compared between participants who did/did not develop AKI in the 2 treatment arms. Multivariable competing risk analyses were performed to identify baseline risk factors for incident AKI, with death treated as a competing event. Risk factors considered were age, sex, mean arterial pressure, white blood cell count, albumin, MELD, ascites, HE, and treatment arm. At baseline, no participants had AKI; 33% (n=49) developed AKI during follow-up. AKI incidence was higher in A+Z than in PRED (45% [n=33] versus 22% [n=16], p =0.001). AKI phenotypes were similar between the 2 treatment arms ( p =0.361), but peak AKI severity was greater in A+Z than PRED (stage 3 n=21 [63.6%] vs. n=8 [50.0%], p =0.035). At baseline, urine-neutrophil-gelatinase-associated lipocalin levels were similar between participants who developed AKI in both treatment arms ( p =0.319). However, day 7 and 14 urine-neutrophil-gelatinase-associated lipocalin levels were significantly elevated in participants treated with A+Z who developed AKI versus participants treated with PRED who developed AKI ( p =0.002 and 0.032, respectively). On multivariable competing risk analysis, only A+Z was independently associated with incident AKI (subdistribution hazard ratio 2.35, p =0.005).</p><p><strong>Conclusions: </strong>AKI occurred more frequently and was more severe in participants treated with A+Z. A+Z-treated participants with AKI had higher urine-neutrophil-gelatinase-associated lipocalin, suggesting that A+Z maybe nephrotoxic in patients with severe alcohol-associated hepatitis.</p>","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":"1256-1268"},"PeriodicalIF":12.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141726529","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":"Getting to HBV Cure – will new biomarkers help?","authors":"Jordan J. Feld, Adam J. Gehring, Fabien Zoulim","doi":"10.1097/hep.0000000000001334","DOIUrl":"https://doi.org/10.1097/hep.0000000000001334","url":null,"abstract":"The natural history and response to therapy in chronic hepatitis B (CHB) infection have been defined by a combination of serological and virological biomarkers along with liver biochemistry and/or histology. A number of novel biomarkers including HBV RNA, hepatitis B core-related antigen (HBcrAg), hepatitis B core antigen (HBcAg) and quantitative hepatitis B surface antigen (qHBsAg) have been developed and evaluated in different clinical settings. Novel immunological biomarkers have also been studied but have been less well characterized. In addition to providing insights into HBV biology, these novel biomarkers may significantly aid in the design, development and assessment of novel antiviral strategies aiming for cure of CHB. Biomarkers can be used to confirm the mechanism of action or target engagement of a novel agent but also may be used for patient selection for trials and clinical use. Ideally, biomarkers can be used to more accurately define stages of CHB, particularly degrees of virological control. In this review, the serological, virological and immunological biomarkers are described with a focus on how they can be used to guide development of HBV cure strategies. New terminology is proposed for clinical endpoints, including Sustained Control to replace the concept of partial cure and Resolved Chronic Infection to replace Functional Cure, reserving the term Cure for clearance or silencing of all cccDNA and integrated HBV DNA.","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"62 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143757953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}