Nature Reviews Gastroenterology &Hepatology最新文献

{"title":"Phase I trial of faecal microbiome transplantation for food allergy","authors":"Katrina Ray","doi":"10.1038/s41575-026-01254-0","DOIUrl":"10.1038/s41575-026-01254-0","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 10","pages":"740-740"},"PeriodicalIF":57.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795552","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":"Sexual dimorphism in the liver.","authors":"Anisha Jain, Satdarshan P Monga","doi":"10.1038/s41575-026-01244-2","DOIUrl":"https://doi.org/10.1038/s41575-026-01244-2","url":null,"abstract":"<p><p>Sexual dimorphism, which is defined as systematic differences between male and female individuals not limited to characteristics related to reproduction, has been recognized in many organ systems and is emerging as an important component of hepatic function in health and disease. Oestrogen is considered the predominant driver of sexual dimorphism in the liver. Other molecular mechanisms independent of oestrogen including epigenetic regulation and immune function contribute to differences between sexes as do other as yet unknown mechanisms. Clinically, hepatic sexual dimorphisms manifest in many ways. For example, women have a lower incidence of many liver disorders including metabolic-dysfunction-associated steatotic liver disease and liver cancer but are more susceptible to benign neoplasms and autoimmune liver diseases such as primary biliary cholangitis. Better understanding the diverse contributors to hepatic sexual dimorphism, including sociodemographic factors, could deepen our understanding of liver biology and aid in sex-specific clinical management and disease prevention. In this Review, we describe the molecular mechanisms of sexual dimorphisms in liver physiology, including oestrogen signalling, genes encoded on sex chromosomes, epigenetic effects on metabolism and immune function. We also describe hepatic sexual dimorphisms in liver pathophysiology, including in metabolic-dysfunction-associated steatotic liver disease, autoimmune diseases, viral hepatitis and liver cancer.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":" ","pages":""},"PeriodicalIF":57.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795573","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":"Noninvasive testing for fibrosis and cirrhosis in MASLD","authors":"Katrina Ray","doi":"10.1038/s41575-026-01247-z","DOIUrl":"10.1038/s41575-026-01247-z","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 10","pages":"739-739"},"PeriodicalIF":57.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795583","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":"From researcher to CEO: closing the gap between discovery and delivery","authors":"Jelena Mann","doi":"10.1038/s41575-026-01249-x","DOIUrl":"10.1038/s41575-026-01249-x","url":null,"abstract":"A patient advocate asked what decades of fibrosis research meant for the people he represented. I had no answer. That question exposed a gap that the scientific community must now confront: between the knowledge we generate and the means to deliver it to patients.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 10","pages":"737-738"},"PeriodicalIF":57.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795577","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":"Relieving IBD with duvakitug","authors":"Katrina Ray","doi":"10.1038/s41575-026-01251-3","DOIUrl":"10.1038/s41575-026-01251-3","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 10","pages":"739-739"},"PeriodicalIF":57.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795633","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":"Global epidemiology of metabolic and alcohol-associated liver disease: risk factors, natural history and clinical implications.","authors":"Luis Antonio Díaz, Elisa Pose, Mads Israelsen, Rohit Loomba","doi":"10.1038/s41575-026-01240-6","DOIUrl":"https://doi.org/10.1038/s41575-026-01240-6","url":null,"abstract":"<p><p>Metabolic and alcohol-associated liver disease (MetALD) is driven by alcohol consumption and the presence of cardiometabolic risk factors (CMRFs), mainly obesity and diabetes. Since its formal definition in 2023, accumulating evidence suggests that MetALD affects approximately 4.1% of the global adult population, with marked regional heterogeneity. However, under-recognition remains pervasive because alcohol intake is systematically under-reported; objective biomarkers such as phosphatidylethanol increase the diagnosis of MetALD by up to fourfold. Moreover, MetALD confers a substantially higher risk of progression to cirrhosis, hepatocellular carcinoma and major adverse liver outcomes compared with metabolic dysfunction-associated steatotic liver disease. Emerging data indicate that alcohol and CMRFs act synergistically rather than additively, accelerating liver inflammation and fibrosis. Cost-effectiveness analyses support risk-based screening that couples simple blood-based non-invasive tests with imaging and advanced serum biomarkers of liver fibrosis. Key research priorities include refining epidemiological estimates, standardizing biomarker cut-offs, elucidating dynamic interactions between alcohol and CMRFs, validating non-invasive prognostic tools, and evaluating therapies that target both metabolic and alcohol-related injury. Addressing these gaps is essential to mitigate the growing clinical and economic burden of MetALD.</p>","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":" ","pages":""},"PeriodicalIF":57.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795569","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":"Viral pyroptosis linked to lethal hepatic lipid accumulation","authors":"Katrina Ray","doi":"10.1038/s41575-026-01248-y","DOIUrl":"10.1038/s41575-026-01248-y","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 10","pages":"739-739"},"PeriodicalIF":57.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761160","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":"Author Correction: The dynamic spectrum of steatotic liver disease: the global perspective.","authors":"Zobair M Younossi, Shira Zelber-Sagi, Markos Kalligeros, Dana Ivancovsky Wajcman, Linda Henry, Laura Sol Grinshpan, Mads Israelsen, Luis Antonio Diaz, Jiangao Fan, Marco Arrese, Ajay Duseja, C Wendy Spearman, Mohamed El-Kassas, Yusuf Yilmaz, Juan Pablo Arab, Ashwani K Singal, Claudia P Oliveira, Mario G Pessoa, Mary Rinella, Stuart K Roberts, Rohit Kohli, Laurent Castera, Rohit Loomba, Michael Roden, Scott Isaacs, Frank Tacke, Vincent Wai-Sun Wong, James Paik, Maria Stepanova, Saleh A AlQahtani, Aleksander Krag","doi":"10.1038/s41575-026-01245-1","DOIUrl":"https://doi.org/10.1038/s41575-026-01245-1","url":null,"abstract":"","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":" ","pages":""},"PeriodicalIF":57.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758971","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 dynamic spectrum of steatotic liver disease: the global perspective","authors":"Zobair M. Younossi,&nbsp;Shira Zelber-Sagi,&nbsp;Markos Kalligeros,&nbsp;Dana Ivancovsky Wajcman,&nbsp;Linda Henry,&nbsp;Laura Sol Grinshpan,&nbsp;Mads Israelsen,&nbsp;Luis Antonio Diaz,&nbsp;Jiangao Fan,&nbsp;Marco Arrese,&nbsp;Ajay Duseja,&nbsp;C. Wendy Spearman,&nbsp;Mohamed El-Kassas,&nbsp;Yusuf Yilmaz,&nbsp;Juan Pablo Arab,&nbsp;Ashwani K. Singal,&nbsp;Claudia P. Oliveira,&nbsp;Mario G. Pessoa,&nbsp;Mary Rinella,&nbsp;Stuart K. Roberts,&nbsp;Rohit Kohli,&nbsp;Laurent Castera,&nbsp;Rohit Loomba,&nbsp;Michael Roden,&nbsp;Scott Isaacs,&nbsp;Frank Tacke,&nbsp;Vincent Wai-Sun Wong,&nbsp;James Paik,&nbsp;Maria Stepanova,&nbsp;Saleh A. AlQahtani,&nbsp;Aleksander Krag","doi":"10.1038/s41575-026-01235-3","DOIUrl":"10.1038/s41575-026-01235-3","url":null,"abstract":"Steatotic liver disease (SLD) comprises metabolic dysfunction-associated SLD, metabolic and alcohol-related liver disease, and alcohol-related liver disease, conditions that frequently overlap rather than fall into distinct categories. Cardiometabolic risk factors (CMRFs), including obesity, type 2 diabetes, hypertension and dyslipidaemia, are highly prevalent across SLD subtypes, with most patients exhibiting multiple metabolic abnormalities. These risks interact synergistically with alcohol exposure, accelerating fibrosis progression to cirrhosis and liver mortality. Importantly, both alcohol consumption and metabolic risks are dynamic and can fluctuate over time, leading to transitions across the SLD spectrum that static diagnostic thresholds might not adequately capture. Misclassification is common, particularly due to under-reporting of alcohol intake, underscoring the value of objective alcohol biomarkers such as phosphatidylethanol. Accurate risk stratification, therefore, requires an integrated approach combining systematic alcohol screening, structured evaluation of CMRFs and non-invasive fibrosis assessment. Management must be multidisciplinary, combining alcohol reduction strategies, optimization of metabolic control and liver-directed therapies. However, most emerging pharmacotherapies for metabolic dysfunction-associated steatohepatitis exclude individuals with concurrent alcohol use, creating a gap between clinical trial populations and real-world practice. A dynamic, spectrum-based framework incorporating repeated reassessment of alcohol and metabolic risks offers the most pragmatic path for diagnosis, treatment and equitable care delivery in SLD. Steatotic liver disease encompasses a spectrum of conditions driven by metabolic dysfunction and/or alcohol consumption. This Review provides a comprehensive global overview of the disease and critically examines current therapeutic strategies and future perspectives.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 11","pages":"812-829"},"PeriodicalIF":57.5,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689440","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":"Multidisciplinary Delphi consensus statement on minimal standards for clinical metadata and end points in microbiome studies","authors":"Robert Schierwagen,&nbsp;Federica Carraturo,&nbsp;Anandhi Iyappan,&nbsp;Maximilian J. Brol,&nbsp;Celine Druart,&nbsp;Mads Israelsen,&nbsp;Zahra Hassani,&nbsp;Kevin Legent,&nbsp;Yolanda Godoy,&nbsp;Corrado Vecchi,&nbsp;Julie Rodriguez,&nbsp;Ida Falk Villesen,&nbsp;Alexander Jarde,&nbsp;Manimozhiyan Arumugam,&nbsp;Aleksander Krag,&nbsp;Emmanuelle Maguin,&nbsp;Peer Bork,&nbsp;Human Microbiome Action Consortium,&nbsp;Joel Doré,&nbsp;Jonel Trebicka,&nbsp;Alessio Fasano","doi":"10.1038/s41575-026-01229-1","DOIUrl":"10.1038/s41575-026-01229-1","url":null,"abstract":"The lack of harmonization for microbiome-based clinical studies represents a critical issue for microbiome researchers and stakeholders, although microbiome research and clinical studies on the gut microbiome have been intensively conducted for more than a decade. The selection of a minimum metadata set to be analysed and reported during clinical studies with microbiome outcomes, the identification of reference materials, the definition of standardized sampling procedures and data analysis protocols, and the choice of unified clinical end points are still lacking. The two-round Delphi survey, conducted within the framework of the Horizon Europe Human Microbiome Action (HMA) consortium, aimed to standardize metadata collection, sampling procedures, data generation and sharing, and standard operating procedures for aspects of gut microbiome-based clinical studies beyond outcomes. The process involved 72 scientists and experts worldwide in the first round and 61 experts in the second round, with an 85% participation rate from the first to the second round. On the basis of the outcome of the Delphi survey, the HMA consortium provided 15 recommendations that might be taken up by the community at large to promote coherence and harmonization in the way microbiome clinical research is and will be performed. The recommendations mainly focus on the gut microbiome and diseases associated with the gastrointestinal tract and gut–organ axes. In this Consensus Statement, an international panel of experts provides recommendations to harmonize metadata, sampling, analysis and end points in gut microbiome-based clinical research.","PeriodicalId":18793,"journal":{"name":"Nature Reviews Gastroenterology &Hepatology","volume":"23 11","pages":"863-876"},"PeriodicalIF":57.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41575-026-01229-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670055","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}