Annals of hepatology最新文献

{"title":"Novel bacterial cluster “Prevotella, Bacteroides and Suterella” associated with mortality in Mexican patients with acute-on-chronic liver failure (ACLF) and clinical utility of systemic hs-CRP and IL-6: A frontier approach involving next-generation sequencing at the intestinal level in a cohort by alcoholic etiology.","authors":"Paula A. Castaño Jiménez , Tonatiuh A. Baltazar-Díaz , Rodrigo Hernández-Basulto , Mayra P. Padilla-Sánchez , Ksenia K. Kravtchenko , Roxana García-Salcido , María T. Tapia-De la paz , Kevin J. Arellano-Arteaga , Luz A. González-Hernández , Miriam R. Bueno-Topete","doi":"10.1016/j.aohep.2025.101867","DOIUrl":"10.1016/j.aohep.2025.101867","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>ACLF is characterized by acute decompensation of cirrhosis, organ failure, and high short-term mortality. Several studies have demonstrated the relevance of intestinal microbiota (IM) in the pathophysiology of cirrhosis. To date, there are no studies in the Mexican population focused on IM in alcohol-associated ACLF and its relationship with mortality and inflammatory markers.</div></div><div><h3>Aim</h3><div>To analyze the composition and diversity of IM in patients with alcohol-associated cirrhosis and ACLF, healthy controls, and its correlation with inflammatory markers.</div></div><div><h3>Materials and Patients</h3><div>Cross-sectional study, which included 22 decompensated patients with ACLF, 16 decompensated patients without ACLF (CD) and 18 healthy individuals (HI), recruited at the Hospitales Civiles de Guadalajara. Fecal IM was characterized by NGS of the 16S-rRNA gene. Systemic levels of high-sensitivity C-reactive protein (hs-CRP) and interleukin 6 (IL-6) were quantified by ELISA, and bioinformatics analysis of IM was performed using the QIIME2 package. Quality filtering, which includes removal of chimeras and non-biological sequences, was performed using the DADA2 algorithm. Resulting ASVs were taxonomically assigned through a self-trained naïve Bayesian classifier, against the SILVA database. Furthermore, α and β diversity analyses, relative abundances, and ANCOM-BC compositional analysis were performed in the QIIME2 package. Predictive values and associations were performed using ROC curves and Spearman correlations, respectively.</div></div><div><h3>Results</h3><div>ACLF and CD patients showed significantly lower α-diversity compared to CS. The comprehensive bacterial taxonomy profile in ACLF was significantly dominated by pathogenic/inflammatory genera such as Escherichia/Shigella, Enterobacter and Prevotella. In contrast, we observed a depletion of Bacteroides compared to CD. Interestingly, the subanalysis of MI in ACLF patients categorized at 7 and 90 days of mortality showed consistency with the enrichment of the Prevotella, Bacteroides and Suterella cluster. The Proteobacteria/Firmicutes ratio as a potential marker of dysbiosis, was significantly elevated in ACLF patients. Serum levels of hs-CRP and IL-6 were potentially increased in ACLF, in comparison to CD and CS. hs-CRP correlated positively with IL-6 and the Proteobacteria/Firmicutes ratio and negatively with α-diversity. IL-6 levels were positively correlated with MELD-Na. Finally, ROC curve analyses showed that hs-CRP allows discrimination of infections in patients with CD with a cut-off point >70.7 mg/L (AUROC: 0.75, with 90% sensitivity and 68.9% specificity). IL-6 allows discrimination of hepatic encephalopathy (HE) in patients with CD and ACLF with a cut-off point >7051.1 pg/mL (AUROC: 0.67, with 81.4% sensitivity and 45.8% specificity).</div></div><div><h3>Conclusions</h3><div>The dysbiotic/proinflammatory profil","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101867"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and demographic characteristics of liver transplant recipients who develop steatosis in the liver allograft.","authors":"Edgar A. Quezada-Cornejo ,&nbsp;María F. Hernández-Torres ,&nbsp;Pedro A. López-Hernández ,&nbsp;Alma L. Kuljacha-Gastelum","doi":"10.1016/j.aohep.2025.101865","DOIUrl":"10.1016/j.aohep.2025.101865","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Liver steatosis (LS) can develop in liver transplant (LT) recipients, with different studies reporting prevalence of 30-60%, our country has a high prevalence of the components of metabolic syndrome. The objective of this study is to describe the characteristics of liver transplant recipients who develop steatosis.</div></div><div><h3>Materials and Patients</h3><div>Retrospective, transversal and descriptive study in which 28 LT recipients with diagnosis of LS after LT were included, data was retrieved from patients clinical file and the following data were considered: age, sex, history of obesity, arterial hypertension, diabetes mellitus (DM), dyslpidemia and metabolic syndrome (MS) prior and after LT. Other data included were etiology of cirrhosis, immunosuppressive treatment and liver biochemistry at the moment of diagnosis.</div></div><div><h3>Results</h3><div>A statistic sample of 28 LT recipients who developed LS after LT was analyzed, 12 were male (42.9%) and 16 female (57.1%) with a medium age of 52 (27-74). The medium of post-LT years at diagnosis was 8 years (1-19). Etiology of cirrhosis was autoimmune in 14 (50%) patients, viral in 6 (21.4%), steatosis in 4 (13.8%) and alcohol in 4 (13.8%), the diagnostic method was imaging in 15 (53.6%) patients and biopsy in 13 (46.4%). The medium body mass index (BMI) was 28.6 (22-39), presence of pre-LT DM in 4 (13.8%) patients and post-LT DM in 15 (53.6%), pre-LT and post-LT obesity was found in 5(10.7%) and 15 (53.6%) patients, respectively, pre-LT and post-LT arterial hypertension in 3 (10.7%) and 11 (39.3%) patients respectively, pre-LT and post-LT dyslipidemia in 0 (0%) and 22 (78.6%) respectively, pre-LT and post-LT MS in 0 (0%) and 15 (53.6%) respectively. 24 (85.7%) patients used prednisone at diagnosis with a medium dose of 11.8 milligrams (5-30). Previous to diagnosis, 24 (85.7%) received tacrolimus and 23 (82.1%) sirolimus. Liver biochemistry showed the following mediums: ALT 85.3 (16-406), 50.5 (14-273), ALP 139.8 (38-519), GGT 237 (11-2296) and TBIL 0.7 (0.2-1.5).</div></div><div><h3>Conclusions</h3><div>This study highlights the frequency with which metabolic comorbidities after LT presented in comparison to the ones presented before LT, especially DM, obesity and dyslipidemia. Concluding, LT recipients should be tightly monitored for these metabolic parameters to prevent LS in a timely manner.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101865"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic reprogramming induced by fructose promotes therapy´s failure in liver cancer cells in vitro and in vivo.","authors":"Lisette Chávez-Rodríguez ,&nbsp;Oscar A. Escobedo Calvario ,&nbsp;Johann Matschke ,&nbsp;Verena Jendrossek ,&nbsp;Felipe Masso ,&nbsp;Araceli Páez Arenas ,&nbsp;María C. Gutiérrez-Ruíz ,&nbsp;Luis E. Gomez-Quiroz","doi":"10.1016/j.aohep.2025.101856","DOIUrl":"10.1016/j.aohep.2025.101856","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Metabolic reprogramming is a hallmark of cancer cells. Fructose metabolism is decreased in liver cancer cells to counteract the oxidative environment induced by fructose. Ketohexokinase (KHK) A is overexpressed, and its switch confers advantages to cancer cells. The <strong>objective</strong> was to investigate the effect of fructose metabolism on the aggressiveness of liver cancer cells.</div></div><div><h3>Materials and Patients</h3><div>KHK isoform expression was measured by qRT-PCR in Huh-7 and HepG2 cells. Metabolic characteristics of liver cancer cells (Huh-7 and HepG2) treated with a fructose (1mM) for 48h in a high glucose DMEM media (11mM) was developed using Mito Fuel Flex assay and Glycolysis Rate Assay using SeaHorse technology. To prove the hypothesis that fructose metabolism enhances aggressiveness, we performed proliferation and enzymatic assays. Chemoresistance assays (<em>in vitro</em> and <em>in vivo</em>) was developed using Huh-7 cells previously treated with Fructose (1mM) for 72h. Then, we applied Fructose (1mM), Cisplatin (CDDP, 22,11µM for in vitro assays or 100µM for in vivo assays) or Fructose (1mM) + CDDP (22,11µM for in vitro or 100µM for in vivo) for 48h.</div></div><div><h3>Results</h3><div><strong><em>Huh-7 cells expressed higher levels of khk-a compared to HepG2 cells. The isoform switch was</em></strong> associated with improved fructose uptake and higher proliferation in Huh-7 cells. We did not detect differences in mitochondrial glucose or fatty acid oxidation capacity, but glutamine oxidation capacity was lower in Huh-7, indicating the overall dependence of this cell line on the glutamine pathway. However, we only detected differences with fructose-treated (Fru-treated) cells with less dependence on fatty acid oxidation in hepatoma cells, suggesting that fructose metabolism has a different effect with respect to the differentiation level of the cells. Next, we evaluated the glycolytic pathway in the aggressive cell line (Huh-7), and the analysis showed that Fru-treated cells contributed less to media acidification, suggesting the activation of alternative pathways by fructose. The pentose phosphate pathway was affected by fructose and inhibition of glutathione reductase abolished the benefits gained. We then assessed survival to CDDP treatment, and found that both, in vitro and in vivo, fructose treatment improved survival and resistance to CDDP therapy.</div></div><div><h3>Conclusions</h3><div>Fructose promotes a metabolic remodeling leading to the sustained proliferation of liver cancer cells. Specifically, fructose metabolism promotes alternative metabolic pathways that contribute to the aggressiveness of HCC cells. In addition, fructose may increase cancer cell survival and the treatment failure.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101856"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the diagnostic accuracy of MAFLD, MASLD and metabolic syndrome in individuals with and without steatosis.","authors":"Mariana M. Ramírez-Mejía ,&nbsp;Stephany M. Castañeda-Castillo ,&nbsp;Mohammed Eslam ,&nbsp;Nahum Méndez-Sánchez","doi":"10.1016/j.aohep.2025.101818","DOIUrl":"10.1016/j.aohep.2025.101818","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The renaming of non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) marks a crucial milestone in the understanding of this complex disease, recognizing the role of metabolic dysfunction beyond the simple exclusion of excessive alcohol consumption. However, despite these advances, the redefined criteria have generated significant debate around their diagnostic accuracy. This debate centers on several key issues, such as the breadth of the criteria, their applicability in different populations, and the risk of overdiagnosis. The aim of this study is to explore the application of the MAFLD, MASLD and metabolic syndrome criteria in the identification and categorization of individuals with and without hepatic steatosis, with the objective of determining the suitability of both criteria for clinical use.</div></div><div><h3>Materials and Patients</h3><div>A retrospective study was conducted with 600 individuals who attended routine check-ups at Medica Sur Clinic and Foundation, Mexico City, Mexico. Data were collected from clinical evaluations, imaging studies and laboratory tests. The diagnosis of hepatic steatosis was made using vibration-controlled transient elastography. The diagnosis of MAFLD, MASLD and metabolic syndrome was made according to the criteria established for each definition.</div></div><div><h3>Results</h3><div>Among individuals with hepatic steatosis, prevalence rates were 89.4% for MASLD, 81.5% for MAFLD (81.5%), and 32.8% for metabolic syndrome. Interestingly, a higher proportion of individuals without hepatic steatosis met MASLD criteria (53.2%) compared with MAFLD (28.1) and MetS (8.2%) criteria. Sensitivity and specificity analysis revealed a balanced performance of MAFLD, whereas MASLD showed higher sensitivity but lower specificity. Sensitivity and specificity analysis revealed a balanced performance of MAFLD, whereas MASLD showed slightly higher sensitivity but much lower specificity. When assessing the metabolic risk profile, individuals with MAFLD and metabolic syndrome were found to be at higher risk than those with MASLD.</div></div><div><h3>Conclusions</h3><div>MAFLD emerges as a balanced diagnostic framework, offering reliable sensitivity and specificity. Although MASLD exhibits higher sensitivity, its lower specificity</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101818"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil/lymphocyte index as a prognostic predictor in patients with primary biliary cholangitis","authors":"Carlos S. Tinitana-Jumbo,&nbsp;Viridiana López-Ladrón-De Guevara,&nbsp;Karina Cazarín-Chávez,&nbsp;Paloma M. Diego-Salazar,&nbsp;Santiago Camacho-Hernández,&nbsp;María F. Higuera-De la Tijera","doi":"10.1016/j.aohep.2025.101819","DOIUrl":"10.1016/j.aohep.2025.101819","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>There is an inadequate response to first line treatment in 40% of patients with primary biliary cholangitis (PBC). The neutrophil/lymphocyte (N/L) index has been associated with poor long-term prognosis. Our objective was to evaluate the relationship of N/L index with prognosis at 1 year of treatment in patients with PBC.</div></div><div><h3>Materials and Patients</h3><div>This is an observational, retrospective, and analytical study of patients diagnosed with PBC, evaluating the prognosis according to the response to treatment measured by the GLOBE scoring system and its relationship with the N/L index at the time of diagnosis. Qualitative data are expressed as percentages and quantitative data as mean±SD. Statistical comparison was performed with the two-tailed unpaired Student´s t-test or chi-square, as appropriate. Alpha=0.005.</div></div><div><h3>Results</h3><div>A total of 128 patients (54.21±10.26 years, 93.8% women) with PBC were included. According to the GLOBE score, 27.3% were classified as “good prognosis” and 72.7% as “poor prognosis”. The N/L index was lower in the good prognosis group (2.29±0.99) compared to the poor prognosis group (3.06±1.48, p=0.005), also the Meld-Na scoring system was higher in the poor prognosis group (11.57±4.96 vs. 7.62±1.33, p=0.005). Mortality in the population was 9.4% all belonging to the poor prognosis group.</div><div><strong><em>Conclusions:</em></strong> The N/L index in patients diagnosed with PBC is related to the prognosis after one year of treatment as measured by the GLOBE score. It is necessary to prospectively assess the findings in order to be able to determine their prognostic utility at the time of diagnosis.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101819"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Alternate day fasting over Metabolic dysfunction-associated steatohepatitis in adult offspring of dams exposed to cafeteria diet during pregnancy and lactation.","authors":"Martín G. García-Juárez,&nbsp;Tania G. Heredia-Torres,&nbsp;Daniel Arellanos-Soto,&nbsp;Blanca E. Álvarez-Salas,&nbsp;Alberto Camacho-Morales,&nbsp;Ana María G. Rivas-Estilla","doi":"10.1016/j.aohep.2025.101803","DOIUrl":"10.1016/j.aohep.2025.101803","url":null,"abstract":"<div><h3>Introductions and Objectives</h3><div>Metabolic dysfunction-associated steatohepatitis (MASH) is a liver disease characterized by lipid accumulation and inflammation that can be exacerbated by cafeteria diets (CAF) exposition during pregnancy and lactation, whereas Alternate day fasting (ADF) improves metabolic parameters. Evaluate the effect of ADF and CAF maternal programming on MASH-associated markers in the offspring.</div></div><div><h3>Materials and Patients</h3><div>To assess the effect of maternal programming, we elaborated a mice model using 8-week C57BL6 females exposed to a CAF (cafeteria) diet (39% carbs, 49% fats, 12% proteins and sodium 231.8 mg) during 3 weeks of mating, 3 weeks of gestation and 3 weeks of lactation. For maternal programming control, we fed females with a Chow or control diet (57% carbs, 13% fats, 30% proteins and sodium 105 mg) during 3 weeks of mating, 3 weeks of gestation and 3 weeks of lactation. After weaning, the offspring were fed a control diet until they were 8 weeks old. They were then divided into four groups (Control n=8, Control + ADF n=8, CAF n=8, CAF+ ADF n=8) and an alternate day Fasting (ADF) protocol was initiated for 5 weeks. At the end of the fasting protocol, plasma samples were taken and beta-hydroxybutyrate (BHB) concentration was measured; in addition, samples of the left lateral lobe of the liver were taken at slaughter to evaluate by qPCR the effect of intermittent fasting on the expression of metabolic function markers involved during MASH: fibrosis (TGFβ, Col1a1), steatosis (PLIN2, ApoB100, Mylcd, PPARPα) and inflammation (Mcp-1).</div></div><div><h3>Results</h3><div>Groups treated with ADF showed an increase in plasma BHB concentration of 400 μmol compared to non-fasted groups. However, no significant difference was found between the control +ADF and CAF + ADF groups, so no effect of maternal programming with CAF diet on BHB production was observed. Additionally, the relative expression of mRNA from fibrosis-associated markers such as Col1a1 showed an 84% decrease in the CAF maternal programming model, 80% in the Control + ADF group and 88% in the CAF + ADF model with respect to control. Levels of mRNA-Plin2, involved in lipid droplet formation, decreased by 57% in the CAF group, 48% in Control +ADF and 79% in CAF+ADF. On the other hand, mRNA-Mcp-1 levels (chemokine) showed a decrease of 14.36% in CAF, 46.42% in Control + ADF and 62.68% in CAF+ ADF with respect to control.</div></div><div><h3>Conclusions</h3><div>The model of alternate-day fasting (ADF) showed an increased plasma BHB, but we did not observe a maternal programming effect on the concentration of betahydroxybutyrate. Interestingly, maternal programming and ADF reduce the expression of MASH-associated markers involved in fibrosis, lipid droplet formation and inflammation in this mouse model.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101803"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large volume paracentesis: Is there a limit?","authors":"Alejandro Tovar-Duran,&nbsp;Carlos A. Campoverde-Espinoza,&nbsp;Fatima Higuera-De la Tijera,&nbsp;Jose L. Pérez-Hernández","doi":"10.1016/j.aohep.2025.101844","DOIUrl":"10.1016/j.aohep.2025.101844","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Ascites is observed in 5-10% of cirrhotic patients. Large volume paracentesis (LVP), where &gt;5 liters are drained, is safe. Albumin is essential to prevent post-paracentesis circulatory dysfunction (PPCD), with the literature indicating that its incidence increases when draining &gt;8 liters in one session, suggesting draining a smaller amount.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;An observational, analytical, and retrospective study was conducted, which included the clinical records of patients over 18 years of age admitted to the Gastroenterology service of the General Hospital of Mexico \"Dr. Eduardo Liceaga\" from January 2020 to March 2024 with a diagnosis of Grade II or III ascites, without criteria for acute kidney injury (AKI) according to the International Ascites Club (ICA) and with baseline creatinine available in the last 3 months before assessment. The amount of ascites that were drained was evaluated, with no limit of liters in a session, and the occurrence of AKI during the following 7 days after paracentesis as a manifestation of PPCD. The definition of AKI was according to the latest definition by KDIGO / ICA. We excluded patients admitted with a diagnosis of AKI or a history of chronic kidney disease (CKD) of any etiology, and those in whom it was not specified whether albumin was administered after paracentesis. Descriptive statistics were performed with measures of central tendency and dispersion. We used X2, Student's T test, and Mann-Whitney U test to compare the variables. A value of &lt;em&gt;P &lt; 0.05&lt;/em&gt; was considered statistically significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We included 60 patients with a diagnosis of cirrhosis, administered for grade II and grade III ascites, 53.3% were men, with an overall mean age of 51.1 ±10.5 years. Regarding the etiology, 45% were due to alcohol, 21.7% to Fatty Liver Disease Associated with Metabolic Dysfunction (MASLD), as well as the etiology of no filiation; with MELD-Na 17.5 ± 5.7 points. Regarding ascites, 26.7% were grade II and 73.3% grade III, and up to 10% with refractory ascites. The average of liters of ascites drained per session was 8.5 ± 3.8 liters, with a minimum drainage of 5 liters and a maximum of 19.4 liters per session. Of the total patients evaluated, 5% (3) developed AKI after paracentesis, with an elevation of creatinine &gt; 0.3 mg/dl in 48 hours. When comparing groups regarding the presence of ACLF, Child-Pugh, or MELD-Na; Regarding the DPPC, 41.66% (0%) drained less than 8 liters vs 58.34% (8.57%) more than 8 liters, all with refractory ascites, with no significant difference in the development of AKI (p=&gt;0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;LVP is safe as long as the albumin dose is adequately replaced at a dose of 6-8 grams per liter of drained ascites in a single session, with caution in patients with refractory ascites, due to the advanced stage of portal hypertension.&lt;/div&gt;","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101844"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in the progression of liver disease in male and female rats induced by TAA: considerations in the development of pharmacological therapies","authors":"Jesús Dorantes-Alvarez,&nbsp;Moisés Martínez-Castillo,&nbsp;Adrián Flores-Sánchez,&nbsp;Ángel García-López,&nbsp;Luz Castro-Hernández,&nbsp;Abigail Hernandez-Barragan,&nbsp;Marisela Hernández-Santillán,&nbsp;Gabriela Gutierrez-Reyes","doi":"10.1016/j.aohep.2025.101830","DOIUrl":"10.1016/j.aohep.2025.101830","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Thioacetamide (TAA) is a hepatotoxic agent that causes fibrosis, cirrhosis, and cancer. Various doses and regimens of TAA have been tested in different murine models to validate hepatoprotective compounds. To date, only two studies have reported differences in TAA susceptibility according to sex in murine models. To compare the progression of liver disease in male and female Wistar rats induced by TAA.</div></div><div><h3>Materials and Patients</h3><div>Male and female Wistar rats (250 g) were grouped into two conditions: treated with thioacetamide (TAA) and saline solution (CT) intraperitoneally. TAA group (n=12, males=6, females=6): dose 200 mg/kg/3 times per week for 6 weeks; CT group (n=12, males=6, females=6): rats treated with saline solution. Water and food were provided <em>ad libitum</em>, and the animals were monitored daily, with weight recorded weekly. At the end of the treatment, euthanasia was performed with pentobarbital, and an exploratory laparotomy and liver recovery were conducted, with photographic records and macroscopic descriptions for each rat. Statistical analysis and mortality curve were performed using a two-way ANOVA and Log-Rank test.</div></div><div><h3>Results</h3><div>TAA administration caused weight loss in female rats during the first 2 weeks of treatment, but they showed recovery and stabilization from the third week onwards, while males showed progressive weight gain. Unexpectedly, the mortality rate in males by the third week was 66.6%, which remained until the sixth week, compared to 0% mortality in females and control animals. Macroscopic analysis of TAA-treated animals showed no alterations in adjacent organs but revealed evident morphological changes in liver tissue in males, such as heterogeneous dark brown coloration, irregular edges, and tissue nodulation. In contrast, female rats showed more discreet morphological changes of damage after 6 weeks of treatment.</div></div><div><h3>Conclusions</h3><div>The TAA model in Wistar rats demonstrated greater susceptibility to damage in male rats than in female rats. These findings should be considered in future studies, such as exploring new pharmacological therapies and/or biomarker development.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101830"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorimetric test for early diagnosis of spontaneous bacterial peritonitis.","authors":"Claudia G. Solis-Hernandez,&nbsp;Marycamen Alegria-Ovando,&nbsp;Kenia M. Bastida-Guadarrama,&nbsp;F. Yael Duran-Vargas,&nbsp;Paola Zuñiga-Escobedo,&nbsp;Monica Garcia-Baca,&nbsp;D. Ernestina Espinoza-Lopez,&nbsp;Rodrigo Toledo-Galvan,&nbsp;Jessica Mejia-Ramirez,&nbsp;Maria F. Higuera de la Tijera,&nbsp;Jose L. Perez-Hernandez","doi":"10.1016/j.aohep.2025.101887","DOIUrl":"10.1016/j.aohep.2025.101887","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The diagnosis of spontaneous bacterial peritonitis (SBP) requires biochemical analysis that can sometimes take time, so having an effective and rapid method could shorten the time to start the antimicrobial and reduce the risk of complications. Objective: To validate the colorimetric test (reagent strips) in the diagnosis of SBP.</div></div><div><h3>Materials and Patients</h3><div>Observational, prolective, and analytical study of the colorimetric test for the diagnosis of PBE. Diagnostic paracentesis was performed in patients with suspected PBE, for the analysis of the fluid by means of the colorimetric scale of the Mission test strip and compared with the cytochemical analysis in the laboratory (polymorphonuclear ≥ 250 cells/mm³). To assess the test strip as a diagnostic test, a cut-off point of strip reading ≥15 leukocytes is used. A 2 × 2 table is used to compare the positives and negatives of PBE by both cytochemical and dipstick methods. S, E, PPV and NPV were calculated.</div></div><div><h3>Results</h3><div>42 patients with ascites and suspected SBP were included. Of these, 24 patients (57.14%) were in Child-Pugh stage C, 17 patients (40.27%) were in Child-Pugh stage B and only 1 patient (2.38%) was in Child-Pugh stage A. The causes of chronic liver disease were alcohol consumption in 17 patients (40.27%), MASLD in 15 patients (35.71%), autoimmune liver disease in 4 patients (9.52%), unaffiliated etiology in 4 patients (9.52%), infection secondary to hepatitis C virus in 2 patients (4.76%). Of the total, 23 patients (54.7%) were female with a mean age of 54 years (SD ± 12.06). Thirteen patients were diagnosed with PBE, 81% of them with grade II ascites. The sensitivity of the dipstick compared to the cytochemical method was 92.3%, its specificity 86.2%, its positive predictive value (PPV) 99.4%, and its negative predictive value (NPV) 98.6%.</div></div><div><h3>Conclusions</h3><div>Colorimetry (test strips) show adequate sensitivity and specificity, making them a low-cost, easy-to-use, but above all quick to interpret tool for early initiation of antimicrobial therapy in patients with ascites and spontaneous bacterial peritonitis. Although the sample is small, it shows an interesting trend that should be confirmed.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101887"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Hepatic Effect of Sub-chronic Chronic Cadmium Exposure.","authors":"Jessica N. Jiménez-Fabián ,&nbsp;Karina Martínez-Flores ,&nbsp;Leticia Bucio-Ortiz ,&nbsp;Roxana U. Miranda-Labra ,&nbsp;Luis E. Gómez-Quiroz ,&nbsp;María C. Gutierrez-Ruíz ,&nbsp;Veronica Souza-Arroyo","doi":"10.1016/j.aohep.2025.101888","DOIUrl":"10.1016/j.aohep.2025.101888","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>MAFLD is an umbrella disease characterized by lipids storage. Epidemiological studies found that cadmium (Cd) exposure is related to the development of MAFLD. We're interested in evaluating the effect of Cd exposure on lipid accumulation in the liver.</div></div><div><h3>Materials and Patients</h3><div>Eight-week-old CD-1 mice were exposed to Cd (10mg/L) for one and three months, sub-chronic and chronic models, respectively; they were fed with a Chow diet, recording the weight of the animals periodically. Euthanasia was performed, and the liver was macroscopically inspected. Liver damage enzymes were assayed in serum. Liver sections were stained with H&amp;E for morphometric analysis, Sirius red for fibrosis, and Red Oil O (ORO) for lipids. By biochemical studies, we determined the triglycerides and cholesterol content in the liver. The protein content of MAPKs was evaluated by western blot.</div></div><div><h3>Results</h3><div>Cd consumption in both models did not affect the weight of the mice. However, it promoted intestinal inflammation during one month of exposure. Liver/body weight ratio was obtained, despite which Cd was not found to promote hepatomegaly at one and three months of exposure. By H&amp;E, we found that sub-chronic exposure to Cd favored hepatocyte proliferation, and chronic exposure triggered death after cell proliferation; despite this, liver damage enzymes did not increase in serum following sub-chronic and chronic exposure. Subsequently, we evaluated fibrosis in chronic treatment without finding that Cd promotes its accumulation of collagen in the liver. Likewise, we analyzed hepatic triglyceride and cholesterol accumulation without finding that Cd causes lipid accumulation after sub-chronic and chronic exposure. Finally, we evaluated the activation of MAPKs in our model. We found that Cd favors the activation of p38 and the repression of JNK in chronic exposure, suggesting a damage-repair mechanism.</div></div><div><h3>Conclusions</h3><div>Sub-chronic and chronic exposure to Cd (10 mg/L) does not affect physiological parameters; however, activation of p38 is observed, suggesting a liver damage/repair mechanism and possible repression of JNK, which could prevent lipid accumulation.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101888"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}