Hepatology Forum最新文献

{"title":"Suspected azathioprine-induced hypersensitivity pneumonitis in a patient with autoimmune hepatitis: A rare case report.","authors":"Yusuf Bunyamin Ketenci, Hakan Demiroz, Mehmet Akca, Ufuk Avcioglu","doi":"10.14744/hf.2026.08929","DOIUrl":"https://doi.org/10.14744/hf.2026.08929","url":null,"abstract":"<p><p>Azathioprine (AZA) is a widely prescribed immunosuppressive agent in the long-term management of autoimmune hepatitis (AIH), valued for its steroid-sparing properties and efficacy in maintaining disease remission. While its common adverse effects - such as myelosuppression, hepatotoxicity, and gastrointestinal intolerance - are well-recognized and routinely monitored, hypersensitivity pneumonitis (HP) remains an exceptionally rare but potentially life-threatening complication. Herein, we describe a 21-year-old female patient with AIH diagnosed at age 18. Who developed possible AZA-induced HP during the 3^rd year of continuous therapy. We discuss the potential immunopathogenic mechanisms, review the limited literature on AZA-related pulmonary toxicity, and emphasize the importance of early recognition to prevent irreversible lung injury and optimize patient outcomes.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 3","pages":"302-305"},"PeriodicalIF":2.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764059","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":"AI redefines fibrosis patterns in steatotic liver disease: Opportunities and challenges.","authors":"Xiao-Dong Zhou, Yusuf Yilmaz, Ming-Hua Zheng","doi":"10.14744/hf.2026.86430","DOIUrl":"10.14744/hf.2026.86430","url":null,"abstract":"","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"88-90"},"PeriodicalIF":2.1,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685909","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":"Artificial intelligence-based multiclass classification of etiologies in patients with elevated liver enzymes: A prospective cohort study.","authors":"Yavuz Ozden, Omer Yuzugulen, Nuh Mehmet Buyukberber","doi":"10.14744/hf.2026.79050","DOIUrl":"https://doi.org/10.14744/hf.2026.79050","url":null,"abstract":"<p><strong>Background and aim: </strong>Elevated liver enzymes are a common reason for hepatology referral, but etiological overlap complicates diagnosis. Most artificial intelligence applications address binary tasks, whereas routine practice requires multiclass discrimination. We developed and internally validated an explainable multiclass model to differentiate five major causes of persistent liver enzyme elevation.</p><p><strong>Materials and methods: </strong>This prospective proof-of-concept cohort included 280 consecutive adults with unexplained persistent aminotransferase elevation. Final diagnoses-metabolic dysfunction-associated steatotic liver disease, viral hepatitis, alcohol-related liver disease, drug-induced liver injury, or autoimmune hepatitis-were independently adjudicated by three hepatologists. Data were split into training (70%) and independent test (30%) sets, and four supervised algorithms were evaluated. To assess incorporation bias, a basic model using routine clinical and biochemical variables was compared with an extended model including serological markers. Interpretability was assessed using SHapley Additive exPlanations.</p><p><strong>Results: </strong>eXtreme gradient boosting achieved the best test-set performance, with an overall accuracy of 0.86 (95% CI 0.78-0.93) and balanced accuracy of 0.87 (95% CI 0.82-0.92). Class-specific AUROC values ranged from 0.92 to 0.95. Serological markers improved discrimination for autoimmune hepatitis (AUROC increase, 0.15; p<0.03) and viral hepatitis (increase, 0.11; p<0.02). Interpretability analysis identified clinically plausible predictors. Misclassifications occurred in 12 cases (14.3%), mainly in overlapping drug-induced liver injury-autoimmune hepatitis presentations.</p><p><strong>Conclusion: </strong>An explainable multiclass model differentiated five major etiologies of persistent liver enzyme elevation. Serological markers added value for autoimmune and viral etiologies. External validation is required before clinical implementation.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 3","pages":"249-255"},"PeriodicalIF":2.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763913","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":"A rare but lethal hepatic infection: Emphysematous hepatitis - Case report and literature review.","authors":"Gokalp Okut, Mehmet Alperen Ugur, Halil Yildiz, Halil Takci, Sait Murat Dogan","doi":"10.14744/hf.2025.05779","DOIUrl":"https://doi.org/10.14744/hf.2025.05779","url":null,"abstract":"<p><p>Emphysematous hepatitis (EH) is a rare and often fatal liver infection characterized by gas within the hepatic parenchyma without abscess formation. Diabetes mellitus and gastrointestinal malignancies are the main predisposing factors. Prompt diagnosis and aggressive treatment are essential due to its fulminant course. A 67-year-old male with uncontrolled type 2 diabetes and a long smoking history presented with abdominal pain, nausea, vomiting, dyspnea, and altered consciousness. Laboratory tests revealed elevated liver enzymes, hyperbilirubinemia, severe hyperglycemia, and increased inflammatory markers. Abdominal CT showed a gas-containing lesion in the left hepatic lobe without fluid collection. Due to rapid clinical deterioration, emergency surgical resection was performed. Despite postoperative intensive care and meropenem therapy, the patient died six hours after surgery. Cultures grew <i>E. coli</i> and <i>Enterobacter hormaechei</i>. Only 19 EH cases have been reported to date. Most patients are elderly and have diabetes. Diagnosis relies on CT imaging, which reveals intrahepatic gas without abscess. Pathogenesis may involve anaerobic bacterial fermentation and microcirculatory impairment in diabetic patients. Despite antibiotics and drainage, mortality remains high. EH should be considered in diabetic patients with sepsis and intrahepatic gas on CT. Early diagnosis and immediate intervention-including antimicrobial therapy and drainage-are critical to improving survival.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 3","pages":"296-301"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763897","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":"Endoscopic ultrasound strain elastography in MASLD: Evaluation against transient elastography and non-invasive markers.","authors":"Ahmed Ezzat Helal, Mohamed ElBasiony, Ahmed Abdel-Razik, Nasser Mousa, Gamal Shiha","doi":"10.14744/hf.2026.10200","DOIUrl":"https://doi.org/10.14744/hf.2026.10200","url":null,"abstract":"<p><strong>Background and aim: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a global health concern. Endoscopic ultrasound (EUS) combines multiple diagnostic modalities, including elastography. This study aimed to evaluate the diagnostic performance of EUS strain elastography parameters in patients with MASLD, compared with vibration-controlled transient elastography (VCTE) and non-invasive markers.</p><p><strong>Materials and methods: </strong>A total of 75 adults with MASLD underwent EUS strain elastography. Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were measured by VCTE. Assessments of non-invasive biomarkers, including the fibrosis index based on six parameters (FIB-6) and fatty liver index (FLI), were conducted.</p><p><strong>Results: </strong>The liver strain histogram (SH) standard deviation (SD) could diagnose steatosis when referenced by CAP, with an area under the receiver operating characteristic curve (AUROC) of 0.707 (p=0.029). Both liver SH SD (AUROC=0.883, p<0.001) and liver SH mode percentage (Mode%) (AUROC=0.836, p<0.001) could diagnose steatosis when referenced by FLI (FLI ≥30). The liver strain ratio (SR) could diagnose advanced fibrosis (rule-in stage ≥F3) when referenced by LSM, yielding an AUROC of 0.677 and p=0.048. Liver SR (AUROC=0.707, p=0.002) and liver SH Mode% (AUROC=0.725, p<0.001) could diagnose significant fibrosis (stage ≥F2) when referenced by FIB-6 (FIB-6 ≥2.003).</p><p><strong>Conclusion: </strong>SH SD shows potential for detecting steatosis, and SR with SH Mode% could be indicative of fibrosis (significant and advanced). However, further biopsy-based studies are needed.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 3","pages":"269-276"},"PeriodicalIF":2.1,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765416","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":"MELD 3.0: Exploring and expanding its utility beyond transplantation.","authors":"Pavan Kumar Reddy Kalluru, Hassan Emad Buhulaigah, Kishan Kumar Allikesam, Deekshitha Kuchi, Abdul Muqtadir, Nirmal Onteddu, Apoorva Cherukuri, Teja Allagadda, Madhusree Kamakkagari, Hossein Rajali","doi":"10.14744/hf.2026.50793","DOIUrl":"https://doi.org/10.14744/hf.2026.50793","url":null,"abstract":"<p><p>The model for end-stage liver disease (MELD) score has evolved into a cornerstone of liver transplantation prioritization. With the recent development of MELD 3.0, which incorporates serum albumin and sex-adjusted variables, its predictive accuracy and applicability have expanded significantly. This review examines the potential clinical applications of MELD 3.0 beyond transplant selection, highlighting its utility as a broader prognostic tool across various hepatic and systemic conditions. Data from multiple domains suggest that MELD 3.0 provides meaningful clinical insight. In orthotopic heart transplantation, MELD 3.0 has demonstrated superior predictive power for short-term mortality and postoperative intensive care unit resource utilization. In acute variceal hemorrhage, it has maintained good discriminatory ability, although calibration challenges limit its use as a standalone tool. Among patients with hepatocellular carcinoma and renal insufficiency, MELD 3.0 has shown moderate predictive value for survival but has been outperformed by albumin-bilirubin-based models. In transjugular intrahepatic portosystemic shunt procedures, MELD 3.0 has effectively stratified pre- and postprocedural risk, enhancing dynamic patient monitoring and decisions regarding transplant timing. For alcohol-associated hepatitis, MELD 3.0 has surpassed older models in predicting mortality and the need for renal replacement therapy, particularly in women and malnourished patients. In oncology, MELD 3.0 has contributed to mortality risk assessment in hepatic visceral crisis when combined with inflammatory markers. However, its performance has been less robust in hepatic hydrothorax, where mortality has occurred at lower MELD scores, and in spontaneous bacterial peritonitis, where it has performed comparably to other MELD variants. Collectively, these findings underscore the growing relevance of MELD 3.0 as a generalizable risk stratification tool across acute and chronic liver-related conditions. Although further prospective validation is warranted, its incorporation into routine hepatology and multidisciplinary care pathways may enhance prognostic precision and inform therapeutic decision-making beyond transplantation.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 3","pages":"241-248"},"PeriodicalIF":2.1,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762296","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":"Shifts in liver biopsy indications and histopathological diagnoses: A report from a tertiary care center in Türkiye.","authors":"Yunus Emre Dalkilic, Yavuz Emre Parlar, Cem Simsek, Zehranur Kiki, Osman Dag, Cenk Sokmensuer, Hatice Yasemin Balaban","doi":"10.14744/hf.2026.96331","DOIUrl":"https://doi.org/10.14744/hf.2026.96331","url":null,"abstract":"<p><strong>Background and aim: </strong>Despite advances in non-invasive methods, liver biopsy remains essential for diagnosis, prognosis, and treatment planning, and this study aimed to evaluate trends in its indications and pathological findings.</p><p><strong>Materials and methods: </strong>A total of 1533 adult liver biopsies at a tertiary referral hospital (2000-2022) were retrospectively reviewed for indications and diagnoses.</p><p><strong>Results: </strong>The annual number of liver biopsies performed remained stable over the last two decades (730 vs. 803; p=0.06). The mean patient age was 43±15 years, with 52% being female. The leading indications were abnormal liver function tests (53.4%), fibrosis/cirrhosis (40.9%), treatment follow-up (2.7%), hepatomegaly (1.6%), and fever of unknown origin (0.9%). Between 2000-2011 and 2012-2022, the indications for liver biopsy changed significantly: biopsies for fibrosis/cirrhosis increased, whereas those for evaluation of treatment response and disease monitoring and for hepatomegaly decreased (p=0.01, p<0.001, and p=0.02, respectively). In the post-COVID-19 period, abnormal liver function tests became the predominant indication (42.2% vs. 69.2%), whereas fibrosis/cirrhosis decreased (54.2% vs. 28%). The most frequent pathological diagnosis was chronic hepatitis B virus (HBV) infection (38.6%), followed by chronic hepatitis C virus (HCV) (11.5%), metabolic dysfunction-associated steatohepatitis (MASH) (8.5%), autoimmune hepatitis (AIH) (7.7%), and primary biliary cholangitis (PBC) (4.2%). Across decades, MASH (6.4% vs. 10.3%; p=0.008), AIH (4% vs. 11.1%), and PBC (1.1% vs. 7%) increased significantly (p<0.001), while chronic HCV declined (17.3% vs. 6.1%; p<0.001). Chronic HBV remained stable (38.2% vs. 38.9%).</p><p><strong>Conclusion: </strong>Over the past 22 years, the annual number of liver biopsies remained stable, with abnormal liver function tests as the leading indication, a decline in fibrosis/cirrhosis evaluation, chronic hepatitis B as the most common diagnosis, and a gradual rise in autoimmune liver diseases and MASH.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 3","pages":"262-268"},"PeriodicalIF":2.1,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760628","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":"Duration of vasoconstrictors after endoscopic variceal ligation in acute variceal bleeding: A systematic review and network meta-analysis.","authors":"Suprabhat Giri, Saurav Panda, Ankita Singh, Jijo Varghese, Sushrut Ingawale, Elliot B Tapper, Don C Rockey, Ashok Choudhury","doi":"10.14744/hf.2025.82371","DOIUrl":"https://doi.org/10.14744/hf.2025.82371","url":null,"abstract":"<p><strong>Background and aim: </strong>Studies on the duration of vasoconstrictors after endoscopic variceal ligation (EVL) for acute variceal bleeding (AVB) have shown varying results. The present network meta-analysis compared the effectiveness of vasoconstrictors after EVL based on the therapy duration.</p><p><strong>Materials and methods: </strong>The electronic databases of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus were searched from inception to March 2024 for randomized studies comparing the duration of vasoconstrictors in AVB after EVL (Group 1: ≤24 hours, Group 2: >24 to ≤72 hours, Group 3: >72 to ≤120 hours). Rebleeding and mortality risk were analyzed using pairwise and network meta-analyses.</p><p><strong>Results: </strong>Eleven studies (n=1,066) met the inclusion criteria. Rebleeding rates varied from 0-38% in Group 1, 2-12% in Group 2, and 0-26% in Group 3. There was no difference in the risk of rebleeding in Group 1 (risk ratio [RR]: 1.36, 95% confidence interval [CI]: 0.48-3.52) or Group 2 (RR: 1.34, 95% CI: 0.42-4.54), compared to Group 3. Similarly, there was no difference either in 5-day mortality risk among the groups (RR: 0.66, 95% CI: 0.09-2.52 and 1.08, 95% CI: 0.15-6.43 for Groups 1 and 2, respectively, vs. Group 3) or 30-day mortality risk (RR: 1.18, 95% CI: 0.51-2.51 and 0.98, 95% CI: 0.36-2.52 for Groups 1 and 2, respectively, vs. Group 3).</p><p><strong>Conclusion: </strong>The current network meta-analysis provides no evidence to support the use of vasoconstrictors following EVL. These data suggest that vasoconstrictors can be stopped early after EVL, facilitating early discharge from the hospital.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 3","pages":"218-226"},"PeriodicalIF":2.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763103","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":"Assessment of GALAD score as a diagnostic and prognostic factor of <i>de novo</i> hepatitis C-related hepatocellular carcinoma post treatment with direct-acting antivirals.","authors":"Ahmed Ramadan, Ashraf Omar Abdelaziz, Mohamed Mahmoud Nabeel, Mirna Atef, Mai Hamed Kamel, Tamer Mahmoud Elbaz, Ammar Hatem, Eman Medhat, Ahmed Hosni Abdelmaksoud, Rania Lithy, Rabab Maher, Sabrin Aa Mohamed, Amgad Hamed Kamel, Hend Ibrahim Shousha","doi":"10.14744/hf.2025.57613","DOIUrl":"10.14744/hf.2025.57613","url":null,"abstract":"<p><strong>Background and aim: </strong>The GALAD score (Gender, Age, AFP, AFP-L3, and Des-gamma- carboxy prothrombin) is a mathematical model that incorporates gender, age, alpha-fetoprotein (AFP), the lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP). It has been developed to assess the presence of hepatocellular carcinoma (HCC) in patients with chronic liver disease. This study aimed to evaluate the efficacy of the GALAD score in predicting HCC and assessing its prognosis in patients with hepatitis C-related HCC who had received prior direct-acting antiviral (DAA) treatment.</p><p><strong>Materials and methods: </strong>This case-control study included patients with hepatitis C virus (HCV)-related liver cirrhosis who had been treated with DAAs, with or without HCC, recruited from the HCC clinic at Kasr Al-Ainy Hospital, Cairo University. Patients were followed until death or the end of the study period. Collected data included clinical and laboratory parameters, levels of DCP, AFP, and AFP-L3, imaging findings, treatment response, and survival outcomes. Logistic regression analysis was used to identify independent predictors of HCC, mortality, and recurrence.</p><p><strong>Results: </strong>Eighty-eight patients with HCV-related HCC following DAA treatment and 88 patients without HCC were recruited, with no significant differences in gender or age between the two groups. Participants with HCC had a higher mean GALAD score than those without HCC (4.32±2.47 vs. 1.32±1.46, p<0.001). The area under the receiver operating characteristic (ROC) curve (AUC) for the GALAD score in diagnosing HCC at a cut-off value of 3.805 was 0.849 (95% confidence interval [CI]: 0.794-0.905, p<0.001), with a sensitivity of 59.3% and a specificity of 97.7%. Multivariate logistic regression identified liver stiffness (odds ratio [OR]=1.140, 95% CI: 1.007-1.291, p=0.038) and the GALAD score (OR=2.378, 95% CI: 1.171-4.831, p=0.017) as independent predictors of HCC. The GALAD score demonstrated low prognostic value for mortality, with an AUC of 0.564 (95% CI: 0.434-0.693). Patients with HCC recurrence had a slightly higher baseline GALAD score than those without recurrence (6.16 vs. 4.18, p=0.032).</p><p><strong>Conclusion: </strong>The GALAD score demonstrated adequate diagnostic performance for predicting HCC following DAA therapy but showed low prognostic value.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"101-107"},"PeriodicalIF":2.1,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685963","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":"Plasma <i>PDGFRβ</i> and <i>PSD4</i> methylation levels for non-invasive staging of liver fibrosis.","authors":"Burge Ulukan, Hong Yang, Hande Uludag, Cheng Zhang, Ali Mutlu, Murat Dayangac, Murat Akyildiz, Buket Yigit, Shaghayegh Soleimani, Hale Kirimlioglu, Burcu Saka, Cigdem Ataizi Celikel, Fatih Eren, Adil Mardinoglu, Yusuf Yilmaz, Mujdat Zeybel","doi":"10.14744/hf.2025.84568","DOIUrl":"10.14744/hf.2025.84568","url":null,"abstract":"<p><strong>Background and aim: </strong>While liver biopsy remains the reference standard for assessing hepatic fibrosis, the major prognostic factor in metabolic dysfunction-associated steatotic liver disease (MASLD), its inherent limitations have driven the search for innovative non-invasive diagnostic tests. In this study, we sought to evaluate the diagnostic accuracy of plasma <i>PDGFRβ</i> and <i>PSD4</i> methylation levels, integrated within machine learning algorithms, for non-invasive staging of hepatic fibrosis in patients with MASLD, and to compare its performance against established non-invasive biomarkers.</p><p><strong>Materials and methods: </strong>Patients with biopsy-proven MASLD and healthy controls were recruited from the three institutions. Quantitative methylation of circulating cell-free DNA was assessed using bisulfite modification and pyrosequencing. The resulting data were used to develop linear discriminant analysis, random forest, and support vector machine algorithms to identify patients at different stages of fibrosis.</p><p><strong>Results: </strong>The study included 234 patients with histologically confirmed MASLD and 43 healthy controls. Each dataset was validated using an independent cohort. Advanced fibrosis was associated with elevated plasma <i>PDGFRβ</i> and <i>PSD4</i> methylation levels in both the discovery and validation cohorts. The integration of plasma DNA methylation markers with clinical parameters demonstrated performance comparable to that of existing noninvasive biomarkers for detecting both significant and advanced fibrosis, achieving area under the curve scores exceeding 0.75 across all models.</p><p><strong>Conclusion: </strong>Supervised machine learning algorithms incorporating plasma <i>PDGFRβ</i> and <i>PSD4</i> DNA methylation levels show promise as a non-invasive approach for assessing hepatic fibrosis in MASLD.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"125-132"},"PeriodicalIF":2.1,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686195","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}