World Journal of Gastroenterology最新文献

{"title":"Correction to \"Metadherin promotes stem cell phenotypes and correlated with immune infiltration in hepatocellular carcinoma\".","authors":"Yi-Ying Wang, Mei-Mei Shen, Jian Gao","doi":"10.3748/wjg.v32.i10.117293","DOIUrl":"https://doi.org/10.3748/wjg.v32.i10.117293","url":null,"abstract":"<p><p>[This corrects the article on p. 901 in vol. 30, PMID: 38516242.].</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"117293"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut bacterial and fungal signatures in relation to human leukocyte antigen-DQ2/DQ8 in children with celiac disease and siblings.","authors":"Dominika Salamon, Agnieszka Krawczyk, Barbara Zapała, Mariusz Duplaga, Kinga Kowalska-Duplaga, Tomasz Gosiewski","doi":"10.3748/wjg.v32.i10.116128","DOIUrl":"10.3748/wjg.v32.i10.116128","url":null,"abstract":"<p><strong>Background: </strong>The presence of human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8 alleles is necessary but not sufficient for the development of celiac disease (CeD). This suggests that additional environmental and biological factors, including bacteria and, above all, the still rarely studied fungal gut microbiota, play key roles in disease onset and progression.</p><p><strong>Aim: </strong>To characterize and compare the intestinal bacteriobiota and mycobiota profiles of children with newly diagnosed CeD and their unaffected siblings, in comparison with a healthy control group.</p><p><strong>Methods: </strong>The study included children and adolescents aged 1 to 18 years. Participants were divided into three groups: (1) 14 patients with newly diagnosed CeD; (2) 16 asymptomatic siblings of CeD patients; and (3) 19 healthy children (control group). Stool samples were collected from all eligible participants. Next-generation sequencing was performed, followed by analysis of the relationship between the gut microbiota and genetic predisposition to CeD, with attention to the HLA DQ2/8 alleles.</p><p><strong>Results: </strong>Regarding alpha diversity, the CeD and sibling groups differed significantly from the control group (bacteria), and the CeD group differed from siblings (fungi). Significant dissimilarities in beta diversity were observed between siblings and both CeD and control groups. In comparisons between CeD group and their siblings, 13 indicator bacterial species were identified, whereas in comparisons between the CeD group and their siblings and controls, 8 indicator fungal species were detected. No significant correlation was found between bacterial species and the presence of the HLA DQ2.5 allele, or between fungal species and HLA DQ2.2. A strong (<i>r</i> = 0.8-0.9) positive relationship was found between <i>Subdoligranulum variabile</i> and several bacterial species. A moderate (<i>r</i> = 0.4-0.7) positive correlation was observed between the fungal species <i>Microidium phyllanthi</i> and <i>Bifidobacterium longum</i>, <i>Clostridium leptum</i> and <i>Romboutsia timonensis.</i></p><p><strong>Conclusion: </strong>While DQ2.5 plays a central role in disease pathogenesis, it appears to have less direct influence on microbial composition. The distinct fungal signatures observed in siblings may serve as early indicators of risk and warrant further investigation.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"116128"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal dysfunction after brain injury: Mechanisms and the role of the brain-gut axis.","authors":"Xia Zhao, Wei Zhang, Ying Zhang, Xing-An Liu","doi":"10.3748/wjg.v32.i10.115731","DOIUrl":"10.3748/wjg.v32.i10.115731","url":null,"abstract":"<p><p>Brain injury (BI) encompasses traumatic BI and stroke, and is a leading cause of mortality and morbidity worldwide. In addition to primary brain damage, BI can cause a series of sequelae, of which gastrointestinal (GI) dysfunction is one of the most important affecting patient outcomes. GI dysfunction, including delayed gastric emptying, increased intestinal permeability, and gut dysbiosis, is common among patients with BI. GI dysfunction not only impairs nutrient absorption and increases the risk for infection, but also enhances secondary BI by aggravating the systemic inflammatory response. The brain-gut axis refers to the bidirectional communication network between the central nervous system and enteric nervous system. This article provides an overview of the mechanisms underlying GI dysfunction after BI and the close relationship with the brain-gut axis. Furthermore, the potential mechanisms underlying brain-gut modulation by probiotics, fecal microbiota transplantation, and vagus nerve stimulation are discussed, which may provide new insights into the treatment of GI dysfunction in patients with BI. An in-depth understanding of the interaction between the brain and GI system is essential to develop more effective therapeutic strategies to alleviate patient suffering and improve survival and quality of life.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"115731"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative study reveals <i>NR1D1</i> mediates <i>Hedyotis diffusa</i>'s antifibrosis <i>via</i> hypoxia inducible factor-1/ammonia axis.","authors":"Si-Wei Xia, Huan Liu, Kai-Yao Yang, Yi-Jie Gao, Meng-Ru Zhang, Jing-Wen Zhou, De-Song Kong, Hong-Yan Wu, Feng Zhang, Li Chen","doi":"10.3748/wjg.v32.i10.115334","DOIUrl":"10.3748/wjg.v32.i10.115334","url":null,"abstract":"<p><strong>Background: </strong>Reversal of hepatic fibrosis (HF) represents a potential cure for chronic liver pathologies; however, clinically approved agents targeting this process remain scarce. Emerging evidence from traditional Chinese medicine (TCM) suggests that <i>Hedyotis diffusa</i> (HD), a botanical agent related to TCM principles of liver pathogenesis, may exert therapeutic effects against fibrotic liver damage. Despite its historical use, the molecular mechanisms underlying its antifibrotic properties and regulatory pathways require systematic elucidation.</p><p><strong>Aim: </strong>To elucidate the efficacy and potential mechanism of HD against HF and to explore potential therapeutic targets.</p><p><strong>Methods: </strong>Liquid chromatograph mass spectrometer revealed six bioactive components of HD injection (HDI) that enter the blood and liver. Network pharmacology using these components predicted related signaling pathways. A HF mouse model was induced by administration of 10% carbon tetrachloride for 8 weeks to validate the efficacy of HDI. Integrated Gene Expression Omnibus (GEO) mining and liver proteomics revealed the antifibrotic mechanism of HD, which was confirmed <i>via</i> target gene interference to elucidate upstream-downstream regulatory relationships.</p><p><strong>Results: </strong>Network pharmacology analysis suggests that HDI may ameliorate HF through the modulation of circadian rhythm, urea metabolism, and hypoxia inducible factor-1 (HIF-1) signaling. GEO data mining and hepatic proteomic profiling in a fibrotic mouse model confirmed the close associations between disease progression and dysregulation of these pathways. HDI intervention significantly restored expression of the circadian regulator <i>NR1D1</i>. Further mechanistic investigations revealed <i>NR1D1</i> as an upstream regulator of HIF-1 signaling, urea cycle function, and ammonia metabolism. <i>In vitro</i> experiments demonstrated that ammonium chloride-induced ammonia accumulation promoted LX2 cell activation, which is potentially associated with mitochondrial dysfunction.</p><p><strong>Conclusion: </strong>HD demonstrates unequivocal efficacy in combating HF, potentially by modulating HIF-1 and the urea cycle through its influence on circadian rhythm genes, with <i>NR1D1</i> as a prominent representative target.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"115334"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating traditional therapies into palliative oncology care: Insights from bottle gourd moxibustion and umbilical therapy.","authors":"Qian-Wen Wan, Xiao-Yu He, Jia-Wang Yan, Yi-Huan Zhao, Fu-Shan Tang","doi":"10.3748/wjg.v32.i10.115549","DOIUrl":"10.3748/wjg.v32.i10.115549","url":null,"abstract":"<p><p>Cancer-related incomplete bowel obstruction presents a significant challenge in oncology, with conventional palliative treatments often proving insufficient in alleviating symptoms and controlling inflammation. In this issue, Wu <i>et al</i> report that bottle gourd moxibustion combined with umbilical therapy (BGM-UT) leads to notable improvement in gastrointestinal recovery, reduced opioid dependency, and lower key inflammatory cytokine levels. These findings suggest that BGM-UT may help interrupt the cycle of pain, opioid side effects, and bowel dysfunction, and could be associated with systemic anti-inflammatory effects. Beyond its clinical implications, this work highlights the possibility that evidence-supported traditional therapies may be integrated into modern oncology care. However, the retrospective, single-center design highlights the need for future prospective, multicenter trials and mechanistic studies. If validated in future studies, BGM-UT may emerge as a promising complementary treatment, offering a potentially less invasive and patient-centered approach that warrants further scientific evaluation.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"115549"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of blood transfusion on outcomes in patients with gastric cancer.","authors":"Prateek Maurya, Anju Gupta, Nishkarsh Gupta","doi":"10.3748/wjg.v32.i10.115683","DOIUrl":"10.3748/wjg.v32.i10.115683","url":null,"abstract":"<p><p>Chen <i>et al</i>'s research provides valuable data supporting the cautious use of transfusions during gastric cancer surgery. However, to interpret causality, it must be acknowledged that recent tend-adjusted studies have consistently shown that the independent effect of transfusions may be smaller than that shown in unadjusted analyses. Future research should employ the following approaches: (1) Extended temporal characterization; (2) Functional immunological assessment; (3) Prospective designs incorporating detailed transfusion data; (4) Machine learning methods; and (5) Mechanistic studies. The relationship between transfusions and cancer treatment outcomes goes far beyond simple immunosuppression or inflammation. It reflects a complex interplay between patient vulnerability, surgical factors, and immune responses, requiring a comprehensive study across multiple biological levels and temporal dimensions.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"115683"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasopressin and fluid retention after liver resection: Comparison with the renin-angiotensin-aldosterone system by surgical extent and liver function.","authors":"Yuto Aoki, Youichi Kawano, Ryo Ga, Kazuhiko Endo, Junji Ueda, Tetsuya Shimizu, Hiroshi Yoshida","doi":"10.3748/wjg.v32.i10.115167","DOIUrl":"10.3748/wjg.v32.i10.115167","url":null,"abstract":"<p><strong>Background: </strong>Early postoperative edema and ascites after liver resection are common; however, the endocrine drivers of water retention are not fully defined. Arginine vasopressin (AVP) promotes antidiuresis <i>via</i> V2-mediated aquaporin trafficking, whereas the renin-angiotensin-aldosterone system primarily modulates sodium handling. Differences in postoperative trajectories and their relationship to early fluid retention have not been clarified in patients undergoing liver resection.</p><p><strong>Aim: </strong>To examine postoperative changes in plasma AVP and plasma aldosterone concentration (PAC) after liver resection, and association with fluid retention.</p><p><strong>Methods: </strong>We conducted a prospective cohort study of adults undergoing elective liver resection at a tertiary center. Blood samples were collected preoperatively, immediately post-resection, and on postoperative days (POD) 1, 2, 3, and 5. The primary objective was characterizing postoperative dynamics of AVP and PAC. Secondary objectives evaluated their temporal alignment with early fluid retention (body weight, urine output during POD 1-3) and compared hormonal profiles between major and minor resections. Analyses used trajectory and time-based comparisons by resection extent.</p><p><strong>Results: </strong>AVP increased sharply immediately after resection and remained above the preoperative baseline through POD 3, showing the most pronounced and sustained elevation after major liver resection. In contrast, PAC showed a transient postoperative increase that returned to near-baseline levels by POD 2. The period of elevated AVP closely matched the time frame during which early postoperative fluid retention was most evident, as indicated by greater short-term weight gain and reduced urine output. These patterns were consistent across sensitivity analyses and showed similar directional trends in subgroup comparisons based on resection extent.</p><p><strong>Conclusion: </strong>AVP remains elevated longer than aldosterone and coincides with early fluid retention, particularly after major resection. Vasopressin-driven antidiuresis may be important in postoperative water retention.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"115167"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution and prognostic value of macrophages in colorectal cancer and adjacent mucosa in patient stages I-III <i>vs</i> IV.","authors":"Wen-Jing Ye, Esraa Ali, Sergii Pavlov, Lenka Červenková, Filip Ambrozkiewicz, Ondřej Vyčítal, Petr Hošek, František Zitrický, Ondřej Daum, Václav Liška, Kari Hemminki, Andriy Trailin","doi":"10.3748/wjg.v32.i10.115130","DOIUrl":"10.3748/wjg.v32.i10.115130","url":null,"abstract":"<p><strong>Background: </strong>Synchronous and metachronous liver metastases (LM) of colorectal cancer (CRC) drastically worsen the patient's survival. The biological and immunological mechanisms underlying these distinct metastatic trajectories remain incompletely understood. Prognostic impact of macrophages in primary CRC (pCRC) is uncertain, with discrepant findings reported for different macrophage subsets and different stage of the disease. Most of prior studies of tumor-infiltrating macrophages in CRC have focused primarily on the tumor core or invasive margin, whereas less attention has been given to the adjacent nontumor mucosa (NM), which may harbor early immunological alterations that precede or accompany metastatic spread.</p><p><strong>Aim: </strong>To evaluate distribution and prognostic value of macrophages in pCRC and NM in patients at stage I-III <i>vs</i> IV.</p><p><strong>Methods: </strong>Paired specimens of pCRC and NM were collected retrospectively from: (1) Stage IV (<i>n</i> = 55) patients with synchronous LM; and (2) Stage I-III (<i>n</i> = 44) patients who developed metachronous LM thereafter. After immunohistochemical staining CD68+ (M0), CD80+ (M1), CD206+ and CD163+ (M2) macrophages were quantified in NM and tumor center (TC) of pCRC. Cell densities in NM and TC and TC/NM ratios were tested as prognostic variables for overall survival since liver surgery. Cox-regression and Kaplan-Meier analyses were applied using the R environment.</p><p><strong>Results: </strong>Densities of macrophages followed the declining pattern from CD163+ through CD206+ and CD68+ to CD80+ in both NM and TC, with significantly smaller densities of all cell types in tumors. Greater densities of CD80+ cells were observed in NM in stage I-III over stage IV patients: 309 (24-1143) cells/mm² <i>vs</i> 208 (3-1084) cells/mm² [median (minimum-maximum), <i>P</i> = 0.04]. High CD163+ cell density in NM in stage IV [hazard ratio = 0.45 (95%CI: 0.22-0.95), <i>P</i> = 0.04] and CD80+ cell density in NM in stage I-III [hazard ratio = 0.24 (95%CI: 0.10-0.57), <i>P</i> = 0.001] were associated with longer overall survival.</p><p><strong>Conclusion: </strong>Contrary to TC of pCRC, we found favorable prognostic implications of macrophages in NM, driven by distinct subsets of macrophages in stage IV (CD163+ M2) and stage I-III CRC (CD80+ M1).</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"115130"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth differentiation factor 11 reprograms M2-like macrophages: Targeting immunometabolism for cancer therapy.","authors":"Saeed Mohammadi, Mahmoud Darweesh, Ahmed Al-Harrasi","doi":"10.3748/wjg.v32.i10.115371","DOIUrl":"10.3748/wjg.v32.i10.115371","url":null,"abstract":"<p><p>This editorial comments on recent research by Escobedo-Calvario <i>et al</i>. Their study revealed that growth differentiation factor 11 (GDF11) functions as a potent, non-cytotoxic immunometabolic modulator within the tumor microenvironment. GDF11 treatment initiates an intense reprogramming in pro-tumoral M2-like macrophages by activating the Smad2/3 pathway and driving a fundamental shift in cellular identity. This reversal is highlighted by the significant downregulation of the M2 marker cluster of differentiation 206 and critical metabolic restructuring, including enhanced mitochondrial function (increased oxygen consumption rate), decreased total cellular cholesterol content, and a necessary increase in reactive oxygen species production. This work uniquely positions GDF11 as a dual-axis therapeutic agent, capable of both direct tumor inhibition and immunometabolic reprogramming of M2-like macrophages, yielding a re-educated secretome that effectively suppresses the pro-proliferative and migratory capacity of hepatocellular carcinoma cells. It suggests GDF11 may be a promising, mechanism-based therapeutic strategy for simultaneously managing the progression of a subset of malignancies and resolving the underlying chronic inflammatory and metabolic disorders associated with M2-like macrophage dysfunction.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"115371"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding liver injury in cystic fibrosis: How to tell drug-induced liver injury from cystic fibrosis liver disease.","authors":"Junseo Lee, Anuroop Yekula, Ava Wexler, William Zhuang, Ashwath Elangovan, Joshua Rosario, Philomena Burger, Gopal Ramaraju, Benyam Addissie, Nicholas Lim, Michael R Narkewicz, Patrick Twohig","doi":"10.3748/wjg.v32.i10.114946","DOIUrl":"10.3748/wjg.v32.i10.114946","url":null,"abstract":"<p><strong>Background: </strong>Cystic fibrosis liver disease (CFLD) is a significant comorbidity in individuals with cystic fibrosis (CF), marked by biliary fibrosis and progressive cholestasis. The advent of CF transmembrane conductance regulator (CFTR) modulators has revolutionized care for lung disease, but their impact on liver-specific disease and outcomes remain unclear. Additionally, the risk of comorbid cholestatic liver injury from medications and progression of CFLD complicates the diagnostic landscape.</p><p><strong>Aim: </strong>To provide a clinical framework for differentiating CFLD and drug induced liver injury (DILI), including from CFTR modulators.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using PubMed, EMBASE, and Cochrane Library databases through March 2025. Studies evaluating pathogenesis, clinical features, diagnostic strategies, and management of CFLD and CFTR modulator-related DILI were included. Data were synthesized to highlight distinguishing clinical and histopathologic features and to guide evidence-based management.</p><p><strong>Results: </strong>CFLD typically presents with insidious progression, portal hypertension, and biliary cirrhosis, whereas CFTR modulator-induced DILI often manifests acutely with jaundice, elevated liver enzymes, and a temporal association with therapy initiation. Key differentiators include biochemical patterns, imaging findings, response to drug withdrawal, and, when necessary, liver histology. Management strategies range from dose modification and supportive care in DILI to ursodeoxycholic acid, nutritional optimization, and portal hypertension management in CFLD.</p><p><strong>Conclusion: </strong>Early recognition and differentiation between DILI and underlying CFLD are essential for optimizing therapy, preserving liver function, and guiding long-term management in patients with CF. As CFTR modulators become the cornerstone of CF management, vigilance for hepatotoxicity is critical. A multidisciplinary approach involving hepatology and CF care teams is recommended.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"32 10","pages":"114946"},"PeriodicalIF":5.4,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}