Nature Reviews Gastroenterology &Hepatology最新文献

{"title":"Lessons from incretin-based therapy in MASH and obesity","authors":"Herbert Tilg, Giovanni Targher","doi":"10.1038/s41575-025-01096-2","DOIUrl":"https://doi.org/10.1038/s41575-025-01096-2","url":null,"abstract":"Glucagon-like peptide 1 receptor agonists are effective pharmacotherapies for the treatment of obesity and related disorders. In metabolic dysfunction-associated steatohepatitis with moderate to advanced fibrosis, semaglutide improved liver histology over 72 weeks. In another new study, tirzepatide was superior to semaglutide in reducing body weight in individuals with obesity.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"57 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500725","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":"Pregnancy and liver health: delivering new collaborations to advance the MASLD and MASH field","authors":"Luiza Borges Manna, Caroline Ovadia","doi":"10.1038/s41575-025-01094-4","DOIUrl":"https://doi.org/10.1038/s41575-025-01094-4","url":null,"abstract":"<p>We read with great interest the article by Allen et al. (Envisioning how to advance the MASH field. <i>Nat. Rev. Gastroenterol. Hepatol</i>. <b>21</b>, 726–738 (2024))¹, and particularly welcomed the acknowledgement of the intrauterine environment’s contribution to metabolic dysfunction-associated steatotic liver disease (MASLD; formerly known as nonalcoholic fatty liver disease) development in the offspring. The concept of the Developmental Origins of Health and Disease, pioneered by David Barker in 1986 (ref. ²), highlights pregnancy as a valuable period to influence public health by addressing the intergenerational effect of non-communicable diseases, and it is highly fitting that MASLD is now recognized in this paradigm. But perhaps it is time to shine a brighter spotlight on pregnancy as a tool to advance the MASLD public health agenda.</p><p>In addition to offering insights into future offspring disease, pregnancy events can be used to predict long-term maternal outcomes. The International Federation of Gynecology and Obstetrics has emphasized the value of using pregnancy as a screening tool for a range of conditions³, highlighting the immediate postpartum period as an important window for early preventive interventions⁴. The antenatal period, often the first regular point of contact with healthcare professionals, also offers a unique triad of opportunity composed of engagement, motivation and receptivity to healthcare advice. Although this concept has mostly been applied to subsequent cardiovascular disease and type 2 diabetes⁵, evidence suggests that it is equally relevant to the field of MASLD. For instance, literature demonstrates that women affected by gestational diabetes are 50% more likely to develop MASLD within 16 months to 25 years of pregnancy than those without⁶. Although a causal relationship has not been confirmed, it is important to consider whether the metabolic challenges of pregnancy and associated dyslipidaemia, exacerbated by certain gestational disorders, could trigger or accelerate the pathway towards MASLD and metabolic dysfunction-associated steatohepatitis (MASH; formerly known as nonalcoholic steatohepatitis).</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"46 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500726","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 to ‘Pregnancy and liver health: delivering new collaborations to advance the MASLD and MASH field’","authors":"Alina M. Allen, Jeffrey V. Lazarus","doi":"10.1038/s41575-025-01095-3","DOIUrl":"https://doi.org/10.1038/s41575-025-01095-3","url":null,"abstract":"<p>We thank Borges Manna and Ovadia for their comments on our recent Perspective (Envisioning how to advance the MASH field. <i>Nat. Rev. Gastroenterol. Hepatol</i>. <b>21</b>, 726–738 (2024))¹ and for highlighting the importance of including pregnancy as a lens through which to further the MASLD public health agenda (Pregnancy and liver health: delivering new collaborations to advance the MASLD and MASH field. <i>Nat. Rev. Gastroenterol. Hepatol</i>. https://doi.org/10.1038/s41575-025-01094-4 (2025))².</p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD; formerly known as nonalcoholic fatty liver disease)³ is now the leading cause of end-stage liver disease requiring liver transplantation in women⁴. Owing to its slow progression, early identification — potentially decades before complications arise — presents a critical opportunity for timely intervention to prevent cirrhosis, adverse outcomes and mortality. Though rare, cirrhosis in pregnancy worsens fetal outcomes⁵. Antenatal and postpartum periods present ideal windows for early detection.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"80 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500724","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":"Promise and pitfalls of liver xenotransplantation","authors":"Burcin Ekser, Luis A. Fernandez","doi":"10.1038/s41575-025-01093-5","DOIUrl":"https://doi.org/10.1038/s41575-025-01093-5","url":null,"abstract":"Liver xenotransplantation and genetically engineered pig livers have potential to save human lives. Liver xenotransplants can either act as a bridge to allotransplantation or support the recovery and regeneration of a whole or reduced native liver in acute liver failure and in major hepatectomies through ex&nbsp;vivo perfusion or auxiliary liver xenotransplantation.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"100 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319681","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 oesophagus as an immune organ","authors":"Mark Rochman, Kendall Kellerman, Michael P. Jankowski, Marc E. Rothenberg","doi":"10.1038/s41575-025-01086-4","DOIUrl":"https://doi.org/10.1038/s41575-025-01086-4","url":null,"abstract":"<p>The oesophagus has traditionally been viewed as a simple conduit for food transport. In performing this delivery function, it confronts a continuous influx of foreign antigens, including food particles with variable microbial content, and encounters many biophysical stimuli triggered by food textures and temperature. To meet these challenges, the oesophagus comprises a robust barrier featuring a thick, multilayered epithelium coated by mucins and mechanically held together by strong adhesion complexes, including desmosomal junctions. Sentinel immune cells, including a notable presence of CD8⁺ resident memory T cells, mast cells and dendritic cells, are abundant alongside IL-1 family cytokines released and activated under tight homeostatic regulation through a balance of proteases and antiproteases. Pattern recognition receptors, such as Toll-like receptors on epithelial cells, identify foreign antigens and can trigger cytokine release. Disruptions, whether acquired or genetically inherited, in these innate immune functions contribute to disease onset. Here, we present evidence that the oesophagus is an immune organ with extensive sensing properties designed to tolerate and mount defences against antigenic and biophysical challenges.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"147 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319631","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 IDEAL framework for machine perfusion in liver transplantation","authors":"Otto B. van Leeuwen, David Nasralla, Carlo D. L. Ceresa, Philipp Dutkowski, Peter J. Friend, Gabriel C. Oniscu, Robert J. Porte, Vincent E. de Meijer","doi":"10.1038/s41575-025-01085-5","DOIUrl":"https://doi.org/10.1038/s41575-025-01085-5","url":null,"abstract":"Liver transplantation is challenged by organ scarcity and ageing donors. Machine perfusion is a promising technique to enhance organ preservation and assessment, improving liver utilization and patient outcomes. Here, we discuss current practices in machine perfusion using the IDEAL framework and outline the steps needed to advance this technology clinically.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"70 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296046","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":"Post-antibiotics microbiome restoration driven by diet","authors":"Jordan Hindson","doi":"10.1038/s41575-025-01090-8","DOIUrl":"https://doi.org/10.1038/s41575-025-01090-8","url":null,"abstract":"<p>Gut microbiome dysbiosis is associated with a wide range of diseases, but factors influencing restoration of the microbiome are less well-studied.</p><p>In a study published in <i>Nature</i>, researchers tracked the recovery of the gut microbiome after antibiotic treatment in mice receiving either a regular chow diet or a high-fat, low-fibre ‘Western’ diet. The mice on the regular chow diet (high in fibre) exhibited improved recovery of the gut microbiome compared with those on the Western-style diet. Metabolic modelling observations suggested that microbiome recovery is shaped by availability of dietary resources, such as simple versus complex carbohydrates.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"4 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260402","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":"Head-to-head trial of HCV treatment regimens","authors":"Jordan Hindson","doi":"10.1038/s41575-025-01091-7","DOIUrl":"https://doi.org/10.1038/s41575-025-01091-7","url":null,"abstract":"<p>A head-to-head trial published in <i>The Lancet</i> has compared two antiviral combination regimens for treatment of chronic hepatitis C virus (HCV) infection. The randomized controlled non-inferiority trial (ISRCTN, 61522291), conducted in two public hospitals in Vietnam, randomized adults (<i>n</i> = 624) with chronic HCV infection to receive 400 mg sofosbuvir and either 60 mg daclatasvir or 100 mg velpatasvir.</p><p>The primary outcome of sustained virological response occurred in 294 (97%) participants in the group receiving sofosbuvir and daclatasvir and 292 (95%) participants in the group receiving sofosbuvir and velpatasvir (risk difference 2.2%; 90% credible interval –0.2–4.8; within 5% non-inferiority margin). Therefore, sofosbuvir and daclatasvir was non-inferior to sofosbuvir and velpatasvir. Participants were also randomized to several different novel treatment strategies, which could help expand access to treatment.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"102 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260403","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":"EASL Congress 2025","authors":"Eleni Kotsiliti","doi":"10.1038/s41575-025-01088-2","DOIUrl":"https://doi.org/10.1038/s41575-025-01088-2","url":null,"abstract":"<p>In May 2025, <i>Nature Reviews Gastroenterology &amp; Hepatology</i> attended in person the European Association for the Study of the Liver (EASL) Congress 2025 in Amsterdam, The Netherlands. This was the fourth year the international liver conference was in person and virtual, with the session recordings available to delegates for 3 months.</p><p>According to the organizers, 7,742 people from 119 countries attended the meeting, of whom 7,129 were onsite and 613 online. There were 1,886 accepted abstracts, 1,764 posters and 364 invited faculty.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"62 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228981","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":"Public health policies to prevent alcohol-related liver disease","authors":"Richard Parker, Juan P. Arab, Jeffrey V. Lazarus, Ramon Bataller, Ashwani K. Singal","doi":"10.1038/s41575-025-01084-6","DOIUrl":"https://doi.org/10.1038/s41575-025-01084-6","url":null,"abstract":"<p>Alcohol-related liver disease (ALD) is a major cause of morbidity and premature mortality around the world, with a substantial cost to individuals and to health-care systems. The incidence of ALD is closely associated with alcohol intake, and it is a preventable disease. There is clear evidence that public health measures to reduce alcohol consumption are effective, which in turn can have a positive effect on ALD. Effective policy includes controlling the price of alcohol, limiting or banning alcohol advertising and restricting the availability of alcohol. The strength of public health policy depends on the political willingness to develop robust strategies. However, effective lobbying of policy-makers by the alcohol industry and lack of political will are barriers to the implementation of these measures, resulting in suboptimal national alcohol control policies. Clinicians are well-placed to campaign for effective public health policy regarding alcohol to reduce the prevalence of ALD for the benefit of patients, their families and wider society. In this Perspective, we summarize the evidence for public health policies that affect alcohol consumption and the prevalence of ALD.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"70 1","pages":""},"PeriodicalIF":65.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211012","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}