World Journal of Hepatology最新文献

{"title":"Hepatic osteodystrophy: An underrecognized metabolic bone disease.","authors":"Subhodip Pramanik, Rajan Palui, Sayantan Ray","doi":"10.4254/wjh.v17.i8.109093","DOIUrl":"10.4254/wjh.v17.i8.109093","url":null,"abstract":"<p><p>Hepatic osteodystrophy (HO) is a common and frequently untreated complication, manifested as osteoporosis or osteopenia, encountered in the evolution of chronic liver diseases (CLD). In addition to patients with chronic cholestasis and cirrhosis, patients with CLD from other etiologies may be affected. Several studies have reported an increased prevalence of osteoporosis/osteopenia in patients with CLD. The pathogenesis varies according to etiology and is multifactorial, involving genetic factors, vitamin deficiencies, proinflammatory cytokines, hypogonadism, hyperbilirubinemia, antiviral therapy, corticosteroids, and lifestyle factors. The approach to management should include individualized assessment for fracture risk factors and bone mineral density. Prevention of osteoporosis in CLD relies on the mitigation of risk factors, treatment of underlying hypogonadism, and encouraging a healthy diet and weight-bearing exercise. Treatment trials specific to HO are small, and the primary medical intervention for the treatment of osteoporosis in CLD remains bisphosphonates although the benefit in fracture reduction has not consistently been shown. Further research is necessary to better define the management and specific treatment of HO for the prevention of fragility fractures and to improve the quality of life. This article provides an updated review of HO covering all these aspects.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 8","pages":"109093"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in cirrhotic patients: A comprehensive minireview.","authors":"Jing-Qiu Zhang, De-Lei Cheng, Chun-Ze Zhou, Xin-Jian Xu","doi":"10.4254/wjh.v17.i8.109678","DOIUrl":"10.4254/wjh.v17.i8.109678","url":null,"abstract":"<p><p>Transjugular intrahepatic portosystemic shunt (TIPS) is widely used to treat portal hypertension and its complications patients with cirrhosis. However, managing post-TIPS hepatic encephalopathy (HE) remains a major clinical challenge. HE is characterized by a high incidence and a complex pathogenesis, influenced by various factors. Therefore, careful patient assessment and selection for TIPS is essential. While previous studies have identified several factors contributing to the occurrence of post-TIPS HE, there is a gap in the comprehensive integration of surgical procedural parameters and metabolic mechanisms within a multidimensional analysis. This minireview aims to optimize treatment protocols and refine management strategies by conducting a comprehensive analysis of risk factors, ultimately aiming to reduce the incidence of post-TIPS HE.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 8","pages":"109678"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the interplay between metabolic dysfunction-associated fatty liver disease and gut dysbiosis: Pathophysiology, clinical implications, and emerging therapies.","authors":"Said A Al-Busafi, Ahmed Alwassief, Ali Madian, Hassan Atalla, Mohamed Alboraie, Ashraf Elbahrawy, Mohammed Eslam","doi":"10.4254/wjh.v17.i8.108730","DOIUrl":"10.4254/wjh.v17.i8.108730","url":null,"abstract":"<p><p>Metabolic dysfunction-associated fatty liver disease (MAFLD) now affects roughly one-quarter of the world's population, reflecting the global spread of obesity and insulin resistance. Reframing non-alcoholic fatty liver disease as MAFLD emphasizes its metabolic roots and spotlights the gut-liver axis, where intestinal dysbiosis acts as a key driver of hepatic injury. Altered microbial communities disrupt epithelial integrity, promote bacterial translocation, and trigger endotoxin-mediated inflammation that accelerates steatosis, lipotoxicity, and fibrogenesis. Concurrent shifts in bile acid signaling and short-chain fatty acid profiles further impair glucose and lipid homeostasis, amplifying cardiometabolic risk. Epidemiological studies reveal pervasive dysbiosis in MAFLD cohorts, linked to diet quality, sedentary behavior, adiposity, and host genetics. Newly developed microbiome-derived biomarkers, advanced elastography, and integrated multi-omics panels hold promise for non-invasive diagnosis and stratification, although external validation remains limited. In early trials, interventions that re-engineer the microbiota including tailored pre-/pro-/synbiotics, rational diet patterns, next-generation fecal microbiota transplantation, and bile-acid-modulating drugs show encouraging histological and metabolic gains. Optimal care will likely couple these tools with weight-centered lifestyle programmes in a precision-medicine framework. Key challenges include inter-ethnic variability in microbiome signatures, the absence of consensus treatment algorithms, and regulatory barriers to live biotherapeutics. Rigorous longitudinal studies are required to translate mechanistic insight into durable clinical benefit and improve patient-centered outcome measures.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 8","pages":"108730"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copper and hepatic lipid dysregulation: Mechanisms and implications.","authors":"Dong-Jing Gao, Tao Zeng, Yu-Tian Chong, Xin-Hua Li","doi":"10.4254/wjh.v17.i8.107803","DOIUrl":"10.4254/wjh.v17.i8.107803","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) and Wilson's disease (WD) are common clinical conditions characterized by hepatic steatosis. Copper has been associated with the progression of hepatic steatosis, but its precise mechanism remains unclear. Emerging research on hepatic copper homeostasis-including its role in liver aging, cuproptosis induction, and lipid metabolism dysregulation-highlighted its significance in liver pathophysiology. Multiple mechanisms have been implicated in copper-induced hepatic lipid metabolism abnormalities, including oxidative stress, mitochondrial dysfunction, endoplasmic reticulum stress, impaired glucose metabolism, AMPK activation, hepatic nuclear receptor modulation, and cuproptosis. Both copper excess and deficiency could trigger hepatic steatosis <i>via</i> these pathways. This review systematically summarized intracellular copper metabolism regulation, elucidated potential mechanisms of copper-induced hepatic lipid dysregulation, and analyzed copper-lipid metabolism interactions in MASLD and WD. These findings provide insights into the mechanisms by which copper contributes to hepatic steatosis and offer a theoretical basis for targeting copper homeostasis as a therapeutic strategy in the treatment of liver diseases.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 8","pages":"107803"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of artificial intelligence-based ocular biomarkers in hepatobiliary diseases: A scoping review.","authors":"Uday Pratap Singh Parmar, Arvind Kumar Morya, Parul C Gupta, Atul Arora, Nipun Verma","doi":"10.4254/wjh.v17.i8.109801","DOIUrl":"10.4254/wjh.v17.i8.109801","url":null,"abstract":"<p><p>Artificial intelligence (AI) has become an indispensable tool in modern health care, offering transformative potential across clinical workflows and diagnostic innovations. This review explores the sation of AI technologies in synthesizing and analyzing multimodal data to enhance efficiency and accuracy in health care delivery. Specifically, deep learning models have demonstrated remarkable capabilities in identifying seven categories of hepatobiliary disorders using ocular imaging datasets, including slit-lamp, retinal fundus, and optical coherence tomography images. Leveraging ResNet-101 neural networks, researchers have developed screening models and independent diagnostic tools, showcasing how AI can redefine diagnostic practices and improve accessibility, particularly in resource-limited settings. By examining advancements in AI-driven health care solutions, this article sheds light on both the challenges and opportunities that lie ahead in integrating such technologies into routine clinical practice.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 8","pages":"109801"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrients as epigenetic modulators in metabolic dysfunction-associated steatotic liver disease.","authors":"Santiago Rodriguez, Maria Luiza Fernandes Dahlem, Carina Rossoni, Norma P Marroni, Claudio A Marroni, Sabrina Alves Fernandes","doi":"10.4254/wjh.v17.i8.108182","DOIUrl":"10.4254/wjh.v17.i8.108182","url":null,"abstract":"<p><p>To improve understanding of the multifaceted nature of metabolic dysfunction-associated steatotic liver disease (MASLD), the American Association for the Study of Liver Diseases, in collaboration with the European Association for the Study of the Liver and the Latin American Association for the Study of the Liver, proposed a broader and more flexible definition, highlighting the role of underlying metabolic dysfunction. MASLD represents the most common chronic liver disease worldwide; however, the impact of the disease goes beyond its epidemiological aspects. Currently, the impact on patients and healthcare systems, due to hepatic and extrahepatic complications, is significant. Recent evidence has demonstrated that epigenetic regulation plays a key role in the development and progression of MASLD. This highly sophisticated regulatory system includes DNA methylation, histone modification, chromatin remodeling, and modulation of non-coding RNA, without causing changes in the primary DNA sequence. Diet, particularly the Westernized diet (characterized by high levels of processed foods, fats, and sugars, but deficient in vitamins and minerals), contributes to the pathogenesis of MASLD through epigenetic modulation at multiple levels. Given the association between diet, epigenetics, and MASLD, this review aims to present some micronutrients and their importance in the prevention and/or treatment of metabolically dysfunction-associated steatotic liver disease.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 8","pages":"108182"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral basophil activation: A hidden player in the immunopathogenesis of primary biliary cholangitis.","authors":"Huan-Qin Han, Jia-Min Bao, Wei Deng, Wei-Fang Guo, Yi-Fan Li, Wei-Qiang Zheng, Hua-Feng Liu","doi":"10.4254/wjh.v17.i8.109685","DOIUrl":"10.4254/wjh.v17.i8.109685","url":null,"abstract":"<p><strong>Background: </strong>T helper 17 (Th17) cell infiltration and interleukin (IL)-17 secretion in intrahepatic small bile ducts is a critical driver of immune-mediated injury in primary biliary cholangitis (PBC). IL-6 is an essential upstream activator of Th17 cells. Basophil-derived IL-6 promotes the differentiation of CD4+ T cells and Th1 cells into Th17 cells, thereby regulating their immunological functions.</p><p><strong>Aim: </strong>To investigate the activation status and cytokine expression of basophils in PBC, elucidating potential mechanisms through which basophils contribute to its pathogenesis.</p><p><strong>Methods: </strong>This single-center retrospective case-control study conducted at Guangdong Medical University Affiliated Hospital (China) between September 2019 and August 2024 enrolled 65 consecutive treatment-naïve patients with PBC (PBC group), 65 age- and sex-matched patients with chronic hepatitis B (CHB group), and 65 healthy controls (Normal group). Fourteen participants per group (subgroup) were randomly selected for flow cytometry analysis of basophil proportion, activation markers (CD203c and CD62 L mean fluorescence intensity), IL-6-positive basophils (IL-6+ basophils as a percentage of total basophils), and IL-17-positive T lymphocytes (CD3+CD4+IL-17+ cells) proportion among T cells. Data were analyzed using Kruskal-Wallis and <i>χ</i> ² tests as appropriate.</p><p><strong>Results: </strong>Routine blood tests revealed significantly higher basophil counts and proportions in the PBC group compared to the CHB and Normal groups (<i>P</i> < 0.001 for both comparisons), with no significant differences between the CHB and Normal groups (<i>P</i> = 0.201). Flow cytometry revealed a higher basophil proportion in the PBC subgroup compared to the CHB (<i>P</i> = 0.011) and Normal subgroups (<i>P</i> < 0.001). The mean fluorescence intensity of CD203c on basophil surfaces was elevated in the PBC subgroup compared to the CHB (<i>P</i> = 0.032) and Normal subgroups (<i>P</i> = 0.039). The proportion of IL-6+ basophils was significantly higher in the PBC subgroup than in the CHB (<i>P</i> < 0.01) and Normal subgroups (<i>P</i> < 0.001). Similarly, the Th17 cell proportion was markedly elevated in the PBC compared to the CHB (<i>P</i> < 0.001) and Normal subgroups (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Patients with PBC have increased peripheral basophil counts with enhanced activation. Activated basophils have increased IL-6 expression, which may indirectly induce Th17 cell proliferation and contribute to PBC pathogenesis.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 8","pages":"109685"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic hepatitis C and the risk for atherosclerotic and cardiomyopathic heart disease.","authors":"Ismail Elkhattib, Kareem Wael Raafat, Basant Elsayed, Mohamed Elnaggar","doi":"10.4254/wjh.v17.i8.108678","DOIUrl":"10.4254/wjh.v17.i8.108678","url":null,"abstract":"<p><p>Hepatitis C virus (HCV) infection has been increasingly associated with cardiovascular complications, particularly atherosclerosis and cardiomyopathy, in addition to its primary hepatic effects. Studies indicate a higher prevalence of carotid atherosclerosis in patients with chronic hepatitis C infection, with viral load and steatosis emerging as independent risk factors. HCV-related atherosclerosis appears to develop through complex processes involving endothelial dysfunction, inflammation, oxidative stress, and immune dysregulation. Key cytokines, including tumor necrosis factor-alpha and interleukin-6, increase inflammatory responses, while oxidative stress markers, such as malondialdehyde, are associated with an increased risk of atherogenesis. In addition, HCV infection has been linked to cardiomyopathy. Direct viral effects, including HCV replication within cardiomyocytes and cytotoxicity induced by viral proteins, lead to myocardial injury and functional decline. Indirectly, HCV triggers immune-mediated damage, with heightened pro-inflammatory cytokines exacerbating cardiomyocyte apoptosis and fibrosis. Furthermore, HCV infection promotes a procoagulant imbalance, as evidenced by elevated factor VIII levels and thrombin potential, contributing to the increased cardiovascular risk. While substantial evidence indicates a relationship between HCV and cardiovascular disease, further research is needed to establish causality and guide therapeutic interventions.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 8","pages":"108678"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myths and facts about the role of diet in metabolic dysfunction-associated steatotic liver disease.","authors":"Sabrina Alves Fernandes","doi":"10.4254/wjh.v17.i8.107909","DOIUrl":"10.4254/wjh.v17.i8.107909","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a leading cause of liver-related morbidity worldwide. Despite broad consensus on the importance of diet in managing the disease, numerous myths and misconceptions persist among patients, healthcare professionals, and the general public. This article aims to critically review the main myths and facts surrounding the role of diet in MASLD, in light of the most current scientific evidence.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 8","pages":"107909"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectopic adrenal gland in the liver leading to a misdiagnosis of hepatocellular carcinoma: A case report.","authors":"Min-Qiu Qin, Yi-Peng Zhao, Ju-Ping Xie","doi":"10.4254/wjh.v17.i8.108443","DOIUrl":"10.4254/wjh.v17.i8.108443","url":null,"abstract":"<p><strong>Background: </strong>Adrenal ectopia is a rare condition in which adrenal tissue is found in an abnormal location, often posing diagnostic challenges. Although generally considered benign, it can present as hepatic or other organ lesions, mimicking malignant tumors. In the liver, ectopic adrenal tissue can closely resemble hepatocellular carcinoma or metastatic disease, potentially leading to unnecessary aggressive treatments such as surgery or chemotherapy. Consequently, a high index of suspicion is essential to avoid misdiagnosis and ensure appropriate management.</p><p><strong>Case summary: </strong>In this case report, we present a 53-year-old male with ectopic adrenal tissue in the liver, mimicking a potential hepatic malignancy. Based on computed tomography and magnetic resonance imaging findings, which suggested a malignant liver lesion and a left adrenal adenoma, the patient underwent laparoscopic partial hepatectomy under general anesthesia. Intraoperatively, no signs of liver cirrhosis were observed. An intraoperative ultrasound identified a 1.2 cm hypoechoic nodule in segment 7 of the liver. Dissection of the right adrenal gland revealed that the nodule had infiltrated the hepatic parenchyma, confirming the presence of ectopic adrenal tissue. Frozen section pathology revealed proliferating adrenal tissue. The patient recovered smoothly and was discharged 10 days postoperatively.</p><p><strong>Conclusion: </strong>This case report underscores the importance of considering adrenal ectopia in the differential diagnosis of liver lesions, especially when imaging findings suggest malignancy.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 8","pages":"108443"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}