Hepatology最新文献

{"title":"Developing palliative care interventions in liver disease using formative and summative qualitative evaluation.","authors":"Marie Bakitas,Nicholas Hoppmann,Macy Stockdill,Shena Gazaway,Margaret Armstrong,Sarah Khalidi,Ivan Herbey,Stephanie Ford,Tamara Nix Parker,Jennifer Frank,Victor Navarro,Manisha Verma","doi":"10.1097/hep.0000000000001242","DOIUrl":"https://doi.org/10.1097/hep.0000000000001242","url":null,"abstract":"Evaluation of the effectiveness of nascent care delivery interventions to integrate palliative care into end-stage-liver disease (ESLD) is limited. Intervention development and evaluation is a systematic, complex, and time-consuming process. Qualitative research approaches, known as formative and summative evaluations, are recommended during intervention development to explore intervention mechanisms, to determine the need for refinement, and to provide a deeper understanding of intervention efficacy, effectiveness, and implementation barriers and facilitators. Although qualitative formative and summative evaluations are resource-intensive, they provide critical information about intervention feasibility, patient and clinician acceptability, and patient-centeredness. This review summarizes how qualitative formative and summative evaluation methods can inform the design, adaptation, and evaluation of interventions to integrate palliative care into ESLD. We describe the completed qualitative summative evaluation study, embedded within PAL-LIVER, an in progress 19-site cluster randomized trial of hepatologist- vs palliative specialist-led palliative care for patients with ESLD and their caregivers. We include patient, family, and clinician demographic data emphasizing how the sample is representative of the parent RCT and describe how the embedded qualitative study explored patient, family, and clinicians' perspectives on the intervention. Specifically, we sought to understand how the intervention was enacted (fidelity) and to provide a roadmap for future palliative care practice integration in ESLD. In conclusion, formative and summative evaluations play a vital role in improving interventions so that valuable and scarce palliative care resources are applied equitably and effectively and so that patients and their caregivers experience the best possible care and quality of life as they live with ESLD.","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"7 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849563","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":"Cirrhosis and age are key determinants of HCC risk in individuals with primary sclerosing cholangitis: A multicenter longitudinal cohort study","authors":"Magnus Holmer, Michael Ingre, Martti Färkkilä, Cyriel Ponsioen, Bregje Mol, Christoph Schramm, Trine Folseraas, Kristine Wiencke, Nora Cazzagon, Elisa Catanzaro, Antonio Molinaro, Emma Nilsson, Johan Vessby, Stergios Kechagias, Nils Nyhlin, Mårten Werner, Annika Bergquist","doi":"10.1097/hep.0000000000001351","DOIUrl":"https://doi.org/10.1097/hep.0000000000001351","url":null,"abstract":"Background &amp; Aims The risk of hepatocellular carcinoma (HCC) in primary sclerosing cholangitis (PSC) is unclear. Studies indicate a low risk for HCC questioning the rationale for current HCC surveillance guidelines. This study explores the risk of HCC in a longitudinal multicenter cohort with over 3.000 PSC-subjects. Approach &amp; results Subjects with well characterized PSC (n=3.071) were followed at 12 university hospitals within the International PSC registry (IPSCR) collaboration for a total of 38,387 person-years. Incident HCC was registered. Subjects were followed from PSC-diagnosis until death, liver transplantation, diagnosis of hepatobiliary malignancy, or February 2024. <jats:italic toggle=\"yes\">Poisson</jats:italic> regression was used to calculate incidence rate ratios for HCC for the total population and for subgroups of different ages and cirrhosis status. Thirty-nine subjects developed HCC after a mean time of 16.4 years (SD ±10.7) from PSC diagnosis. In 26 (66.7%) of HCC cases, cirrhosis was diagnosed before HCC. The mean age at HCC diagnosis was 55.6 years (±SD13.1 years) and 28 (71.8%) were male. HCC was associated with cirrhosis (IRR 10.8;95%CI=5.7-20.5) and age (IRR 1.05;95%CI=1.03-1.08). At the age 50, the incidence rate was 0.81 and 0.47 for cirrhotic men and women respectively. For non-cirrhotic subjects, the risk was low for both men and women and all age groups. Conclusion Hepatocellular carcinoma is relatively rare in patients with primary sclerosing cholangitis who do not have cirrhosis, especially in those under the age of 50. Our findings indicate that HCC monitoring for patients with PSC can be tailored, based on their age and cirrhosis status.","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"74 1 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841365","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":"Multiomics approaches for identifying the PANoptosis signature and prognostic model via a multimachine-learning computational framework for intrahepatic cholangiocarcinoma","authors":"Yanxi Yu, Yan You, Yuxin Duan, Meiqing Kang, Baoyong Zhou, Jian Yang, Kunli Yin, Wentao Ye, Ranning Xu, Hao Wang, Ziqi Zhang, Zuotian Huang, Yanyao Liu, Zhongjun Wu, Rui Tao, Rui Liao","doi":"10.1097/hep.0000000000001352","DOIUrl":"https://doi.org/10.1097/hep.0000000000001352","url":null,"abstract":"Background &amp; Aims: The aims of the present study were to characterize the PANoptosis signature in intrahepatic cholangiocarcinoma (ICC) patients, construct a novel model to guide clinical diagnosis and treatment, and further explore the associated molecular mechanisms of drug resistance. Approach &amp; Results: In total, 85 PANoptosis-related genes that possess both PANoptosis and multiomics features were respectively screened from transcriptomic data from the OEP001105 public cohort and from transcriptomic and proteomic sequencing data from The First Affiliated Hospital of Chongqing Medical University. A novel framework integrating Cox regression analysis and five machine learning algorithms was developed to identify the five hub genes (POSTN, SFN, MYOF, HOGA1, and PECR), The subsequently constructed PANoptosis risk score (PANRS) demonstrate outstanding performance in predicting prognosis and clinical translation across multicenter cohorts with multiomics profiling. Bulk and single-cell transcriptome profiling were used to investigate the tumor microenvironment (TME), emphasizing the crucial role of macrophages in the TME of ICCs. Moreover, a positive spatial correlation of CAFs-derived POSTN expression with TAMs infiltration and PD-L1/PD-L2 expression in ICC patients was observed, suggesting that overexpression of POSTN may lead to resistance to ICB therapy in ICC patients. Conclusion: The present study identified a precise prognostic and treatment strategy for ICC patients prone to PANoptosis, investigated the molecular mechanisms of PANoptosis in ICC cells, and highlighted the potential clinical relevance of the PANRS in predicting prognosis and therapy response. These findings will help guide clinical treatment strategies for ICC.","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"26 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837076","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":"Unraveling the genetic susceptibility to HBV-related liver cancer: The role of virus-host immune interactions","authors":"Pierre Tonnerre, Yujin Hoshida, Thomas F. Baumert","doi":"10.1097/hep.0000000000001355","DOIUrl":"https://doi.org/10.1097/hep.0000000000001355","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"7 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837075","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":"Accurate identification and risk-stratification of HBeAg-negative indeterminate phase of chronic hepatitis B: not all shades of grey are the same","authors":"Tai-Chung Tseng, Anna Suk-Fong Lok","doi":"10.1097/hep.0000000000001353","DOIUrl":"https://doi.org/10.1097/hep.0000000000001353","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"74 4 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837073","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: Primary sclerosing cholangitis and autoimmune hepatitis - distinct or common autoimmune penetrance?","authors":"Aiva Lundberg Båve,Erik von Seth,Michael Ingre,Caroline Nordenvall,Annika Bergquist","doi":"10.1097/hep.0000000000001326","DOIUrl":"https://doi.org/10.1097/hep.0000000000001326","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"60 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822632","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":"Targeting the ER stress sensor IRE1 protects the liver from fibrosis through the downregulation of the proteostasis factor P4HB/PDIA1.","authors":"Younis Hazari, Lama Habbouche, Valeria A Garcia Lopez, Hery Urra, Javier Diaz, Giovanni Tamburini, Mateus Milani, Sylvere Durand, Fanny Aprahamian, Reese Baxter, Menghao Huang, X Charlie Dong, Luis Gonzalez-Rojas, Juan Francisco Silva, Ignacio Tapia-Dufey, Helena Vihinen, Vlad Ratziu, Fabienne Foufelle, Jan G Hengstler, Eija Jokitalo, Jessica L Maiers, Lars Plate, Guido Kroemer, Beatrice Bailly-Maitre, Claudio Hetz","doi":"10.1097/HEP.0000000000001335","DOIUrl":"https://doi.org/10.1097/HEP.0000000000001335","url":null,"abstract":"<p><p>Collagen is the main cargo of the secretory pathway, contributing to hepatic fibrogenesis due to extensive accumulation of extracellular matrix. An excess of collagen deposition is a characteristic feature of several chronic liver diseases. Collagen overproduction imposes pressure on the secretory pathway, altering endoplasmic reticulum (ER) proteostasis. Here we investigated the possible contribution of the unfolded protein response UPR, the main adaptive pathway that monitors and adjusts protein production capacity at the ER, to collagen biogenesis and liver disease. Genetic ablation of the ER stress sensor IRE1 in the liver using conditional knockout mice reduced liver damage and collagen deposition in models of fibrosis, steatosis, and acute hepatotoxicity. Proteomic profiling identified the prolyl 4-hydroxylase (P4HB, also known as PDIA1) as a major IRE1-regulated gene, a critical factor involved in collagen maturation. Cell culture studies demonstrated that IRE1 deficiency results in collagen retention at the ER, reducing its secretion, and this phenotype is rescued by P4HB/PDIA1 overexpression. Analyses of human MASH samples revealed a positive correlation between IRE1 signaling and P4HB/PDIA1 expression as well as the severity of the disease. Altogether, our results establish a role of the IRE1/P4HB axis in the regulation of collagen production and support its implication in the pathogenesis of liver fibrosis.</p>","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":""},"PeriodicalIF":12.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810137","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: Post-TIPS hemodynamic target adherence fails to improve outcomes in cirrhotic patients.","authors":"Davide Roccarina, Dario Saltini, Marco Senzolo, Silvia Nardelli, Stefania Gioia, Lara Biribin, Fabio Marra, Filippo Schepis, Francesco Vizzutti","doi":"10.1097/HEP.0000000000001350","DOIUrl":"10.1097/HEP.0000000000001350","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":""},"PeriodicalIF":12.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810135","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: Considerations on the use of LPCN 1148 in cirrhotic patients with sarcopenia.","authors":"Benjamin J Bruno, Joshua C Weavil, Jonathan Ogle, Nachiappan Chidambaram, Anthony DelConte, Mahesh V Patel, Elizabeth J Carey, Arun J Sanyal, Jennifer C Lai","doi":"10.1097/HEP.0000000000001348","DOIUrl":"https://doi.org/10.1097/HEP.0000000000001348","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":""},"PeriodicalIF":12.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810132","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":"Letter to the Editor: Considerations on the use of LPCN 1148 in cirrhotic patients with sarcopenia.","authors":"Xinxing Tantai, Lu Li, Shejiao Dai","doi":"10.1097/HEP.0000000000001347","DOIUrl":"10.1097/HEP.0000000000001347","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":""},"PeriodicalIF":12.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810129","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}