Annals of hepatology最新文献

{"title":"Adverse effects of the use of terlipressin infusion compared to boluses in patients with liver cirrhosis and variceal hemorrhage. TERMEX study.","authors":"Luis R. Antuna-Villaseñor,&nbsp;Germán A. Roman-Lugo,&nbsp;Jose Pérez-Sánchez,&nbsp;Alexis E. Chavarín-Meza,&nbsp;Yvonne Tadeo-Jiménez,&nbsp;Rosalba Moreno-Alcántar,&nbsp;Aleida Bautista-Santos","doi":"10.1016/j.aohep.2025.101833","DOIUrl":"10.1016/j.aohep.2025.101833","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Cirrhosis is a worldwide health problem as it is a leading cause of mortality. The development of complications in cirrhosis is directly related to the presence of portal hypertension. The risk of annual variceal hemorrhage is 5% for small varices and 15% for large varices. Terlipressin represents a useful drug for this group of patients; classically it has been used in bolus but recent studies have shown that its use in infusion may be superior in bleeding control and with fewer adverse effects. The aim of this study is to define whether there are fewer adverse effects with the use of terlipressin infusion compared to bolus.</div></div><div><h3>Materials and Patients</h3><div>We include patients in the care of the gastroenterology department from July to December 2023 who met the inclusion criteria were included: &gt;18 years, diagnosed with liver cirrhosis and variceal hemorrhage, who had received terlipressin infusion or bolus. Statistical analysis: descriptive statistics, frequencies and percentages were calculated with Student's t and Mann-Whitney U according to the distribution of the variables; Student's t was used to show differences between groups and chi-square to determine the risk of adverse events with bolus respect terlipressin infusion. Wilcoxon test was applied to show differences between groups.</div></div><div><h3>Results</h3><div>58 patients were included, all received endoscopic treatment in addition to terlipressin: 16 patients received infusion (27.6%) and 42 (77.4%) received terlipressin in bolus. Female gender predominated with 30 (51.7%), mean age was 55.8 ±10.93 years; the most frequent etiologies of liver cirrhosis were: (MASLD) steatotic liver disease associated with metabolic dysfunction 19 (32.8%), primary biliary cholangitis 12 (20.7%) and MASLD with significant alcohol consume (MetALD) 8 (13.8%). The median MELD was 16 (12-20) points, and the median Child-Pugh Turcotte score was 7 (6-9). Rebleeding occurred in 8 (13.8%) patients and one patient required rescue TIPS (transjugular portosystemic shunt). The percentage of adverse effects was 27.6% (n=16) and therapy was changed to octreotide in 15 (25.9%) patients. The bolus group had 31% (n=13) adverse effects compared to the infusion group where only 3 (18%). The main adverse effect was abdominal pain in 15.5% (n=9). Mortality was 6.9% in our study(n=4).</div></div><div><h3>Conclusions</h3><div>Adverse effects of terlipressin infusion compared to bolus had no significant difference in the group analyzed. However, there is a tendency in favor of infusion since only 3 patients had adverse effects, we consider that by increasing the sample size, there could be difference in favor of the infusion group.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101833"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896146","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":"Evaluation of the effect of HCV Core protein on the epithelial-mesenchymal transition (EMT) process in non-tumorigenic immortalized hepatocytes","authors":"Verónica Alvarado-Martínez,&nbsp;Tania G. Heredia-Torres,&nbsp;Sonia A. Lozano-Sepúlveda,&nbsp;Ana M. Rivas-Estilla","doi":"10.1016/j.aohep.2025.101808","DOIUrl":"10.1016/j.aohep.2025.101808","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The HCV Core protein is involved in metabolic remodeling and, energy reprogramming through enzymatic changes and redistribution of energy resources, promoting epithelial-mesenchymal transition (EMT) and liver disease. This study addressed the metabolic changes involved in EMT by evaluating the expression of Vimentin and E-cadherin in a non-cancerous cell model.</div></div><div><h3>Materials and Patients</h3><div>An expression plasmid for the HCV Core protein genotype 1b (p-Core) was designed. Transient transfection was performed in the THLE-2 cell line, characterized by a morphology similar to non-tumorigenic human hepatocytes and the expression of differentiated hepatocyte markers, making it ideal for metabolic assays due to its ability to express and regulate proteins involved in metabolism more effectively than primary hepatocyte cultures. For the transfection, p-Core concentrations of 0.5 - 2.0 µg were used, and the cells were cultured for 72 hours. Subsequently, total proteins were extracted and quantified using PKR buffer. The expression levels of Core, Vimentin, and E-cadherin proteins were evaluated by Western Blot, using 40 µg of protein. The relative expression of the proteins was calculated in relation to the endogenous expression of GAPDH using ImageJ software, and the analysis was performed in triplicate.</div></div><div><h3>Results</h3><div>The expression of the viral Core protein (21 kDa) was detected in THLE-2 cells transfected with the p-Core plasmid at 72 hours. It was observed that the expression of the E-cadherin protein (120 kDa) decreased by 80% (in cells transfected with 0.5 µg) and by 25% in cells transfected with 2.0 µg of p-Core. Lastly, an increase in the expression levels of the Vimentin protein (57 kDa) was observed in relation to the concentration of p-Core, doubling with 0.5 µg and increasing sixfold with 2.0 µg of p-Core.</div></div><div><h3>Conclusions</h3><div>The expression of the viral Core protein modulates the translational expression levels of E-cadherin and Vimentin in THLE-2 cells, suggesting its possible involvement in cell adhesion, mobility, and metabolism by HCV. However, detailed studies of the implicated metabolic pathways are required to establish the activation pathways involved.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101808"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895998","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":"Portal cholangiopathy secondary to cavernomatous transformation of the portal vein. Case report","authors":"Karla J. Arroyo García,&nbsp;Luis A. Esquivel-Pacheco,&nbsp;Alexis V. Hinostroza-Pezo,&nbsp;Adolfo Gamiño-Morfín,&nbsp;Alejandro D. Mendoza-Rea,&nbsp;Luis R. Alvarez-Martín,&nbsp;Carlos A. Galvan-Castro","doi":"10.1016/j.aohep.2025.101810","DOIUrl":"10.1016/j.aohep.2025.101810","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Portal cholangitis is a set of alterations that appear in the bile duct secondary to portal hypertension (PH). It is extremely rare and its main etiology is cavernomatous transformation of the portal vein (CPVT). The objective is to present the case of a patient with portal cholangiopathy secondary to TCVP.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;A 17-year-old man with no relevant history began with hemorrhoidal bleeding, requiring hemorrhoidectomy. After 3 weeks, he presented abdominal pain and constipation. Abdominal computed tomography revealed free abdominal fluid, splenomegaly, and portal dilation. A diagnostic paracentesis was performed with GASA 3.1 and liver Doppler ultrasound with a 9mm portal vein, collateral veins, thrombosis and portal cavernomatosis. Initial endoscopy showed small esophageal varices. Hepatotropic infections, HIV and thrombophilias were ruled out, concluding prehepatic PH secondary to TCVP and Child-Pugh A chronic liver disease (CLD).&lt;/div&gt;&lt;div&gt;At 3 years of follow-up, jaundice, generalized pruritus, direct hyperbilirubinemia asadded, with CA 19.9, normal IgG, negative ANA and AMA, and cholangio resonance with stenosis of the common bile duct and dilation of the intrahepatic and extrahepatic bile ducts.&lt;/div&gt;&lt;div&gt;In 2023, at 24 years of age, he had advanced decompensated CLD secondary to probable portal cholangiopathy due to TCVP, with persistent ascites, large esophageal varices, encephalopathy and recurrent cholangitis, so it was decided to place percutaneous drainage with biochemical improvement but presenting new episode of severe acute cholangitis associated with septic shock and acute-on-chronic liver failure, with a torpid evolution despite management with meropenem and ceftriaxone.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;TCVP is characterized by the formation of dilated collateral venous pathways in the portal vein, secondary to portal thrombosis, causing PH. A rare complication of both is portal cholangiopathy.&lt;/div&gt;&lt;div&gt;In the clinical case presented, what is notable is the patient's evolution characterized by cholestasis and CLD secondary to cavernomatosis due to portal thrombosis of unknown cause with progression of complications derived from portal hypertension. As part of the approach, hepatic infectious and hepatic autoimmune processes are ruled out and CA 19.9 is requested to assess the risk of cholangiocarcinoma. Subsequently, a magnetic resonance cholangiography was performed which showed a stenosis of the common bile duct.&lt;/div&gt;&lt;div&gt;Therefore, a portal cholangiopathy was considered due to the history of TCVP and the clinical, biochemical and imaging data that supported the diagnosis despite its low frequency. There are various theories about PH and its involvement of the bile duct, but it is considered to be due to compression of the bile duct walls secondary to the cavernoma, dilation of the venous plexuses of the common bile duct and ischemia,","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101810"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896000","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":"Ceftriaxone versus cefotaxime in the treatment of spontaneous bacterial peritonitis","authors":"Carlos A. Campoverde-Espinoza,&nbsp;Daniel Santana-Vargas,&nbsp;Alejandro Tovar-Durán,&nbsp;Brenda Govea-Mendoza,&nbsp;Verónica G. Pérez-Pérez,&nbsp;Fátima Higuera-De la Tijera,&nbsp;José L. Pérez-Hernández","doi":"10.1016/j.aohep.2025.101863","DOIUrl":"10.1016/j.aohep.2025.101863","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Infections in cirrhotic patients occur in one-third of hospitalized patients. Spontaneous infections (spontaneous bacteremia, spontaneous bacterial peritonitis (SBP), and spontaneous empyema) are the most common and their management with third-generation cephalosporins (cefotaxime or ceftriaxone) is recommended. The effect of albumin on in vitro antimicrobial activity is greater for cefotaxime.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;This is a retrospective, observational, and analytical study. We included clinical records of patients admitted to the Gastroenterology service of the Hospital General de México “Dr. Eduardo Liceaga” from March 2021 to February 2024 with a diagnosis of SBP ≥ 250 polymorphonuclears (PMN), comparing two different treatments (cefotaxime 2gr c/12 hours vs ceftrixone 1 or 2gr/day) and follow-up one year after the event. We evaluated the response to treatment with a second paracentesis with 48 hours of antibiotic therapy. We determined the recurrence at 12 months and the relationship with serum albumin levels in treated patients. We excluded patients with secondary bacterial peritonitis, tuberculosis or carcinomatosis, and previous antibiotic use (except rifaximin). Qualitative variables were expressed as frequencies and percentages; numerical variables as means and standard deviation. We used X2, Student's t-test, and Mann-Whitney U to compare the variables. To compare the percentages of deaths per treatment, response rate, and recurrences at one year, we used the Z test for contingency tables. The log-rank test and the Kaplan-Meier survival curve were used to evaluate survival per treatment at 30 days. A value of &lt;em&gt;P&lt;/em&gt; &lt; 0.05 was considered statistically significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Out of 950 hospitalized cirrhotic, 6.42% (61) presented SBP. 63.9% were male and aged 52±11.9 years. Etiology of cirrhosis, 39.3% alcohol, 26.2% unfiliated, 14.8% MASLD, and 8.2% autoimmune hepatitis. Comparing groups, 29 patients with cefotaxime and 32 with ceftriaxone, with no differences concerning Child-Pugh, MELD score (23 vs 31, &lt;em&gt;p&lt;/em&gt;=0.07), acute on chronic liver failure (ACLF) (56.5% vs 43. 5%, &lt;em&gt;p&lt;/em&gt;=0.79), ACFL points (55 vs 53, &lt;em&gt;p&lt;/em&gt;=0.52), leukocytes, PMN and DHL levels in ascites fluid (&lt;em&gt;p&lt;/em&gt;=0.55, &lt;em&gt;p&lt;/em&gt;=0.45 and &lt;em&gt;p&lt;/em&gt;=0.52), and serum albumin (2.32g/dl vs 2.26gr/dl, &lt;em&gt;p&lt;/em&gt;=0.71). An equal response rate was observed at 28/32 (87.5%) for cefotaxime and 26/29(89.7%) for ceftriaxone with no statistical differences between groups. The recurrence rate was similar with 3 cases for each group with no differences between them. The mortality rate was 14/61(23%); 4/32(12.5%) for cefotaxime and 10/29(34.5%) for ceftriaxone with statistical differences between groups. At 30 days total mortality was 9/61(14.8%) with 2/32(6.2%) for cefotaxime and 7/29 (24.13%) for ceftriaxone with no difference between groups Log-Rank(1) = 3.","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101863"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896007","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 role of the prognostic nutritional index as a prognostic factor in patients with hepatocellular carcinoma.","authors":"Vilma Hernandez-Garza,&nbsp;Berenice Lorenzo-Valle,&nbsp;Kenia Michel Bastida-Guadarrama,&nbsp;Santiago Camacho-Hernandez,&nbsp;Fátima Higuera-de-la-Tijera","doi":"10.1016/j.aohep.2025.101864","DOIUrl":"10.1016/j.aohep.2025.101864","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Immune-nutritional status has been demonstrated to be associated with prognosis in patients with various malignancies. The aim of this study is to determine the association of the nutritional prognostic index (PNI) with survival and assess the correlation between PNI and clinic-pathological parameters in HCC patients.</div></div><div><h3>Materials and Patients</h3><div>An observational, retrospective, descriptive and case series study was performed. We included 69 patients from a third-level hospital with a diagnosis of HCC from February 01, 2019 to July 24, 2023 and studied their survival 12 months after diagnosis. We determined the association between PNI status and their clinic-pathological characteristics and evaluated the impact of PNI on the HCC patient survival. The following formula was used to determine PNI: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per µL). Clinic-pathological characteristics related to disease prognosis included age, sex, body mass index (BMI), alpha-fetoprotein (AFP) value, the presence or not of cirrhosis, tumor size, ECOG score, and BCLC grade. Qualitative data are expressed as percentages and quantitative data as mean±SD. Statistical comparison was performed with two-tailed unpaired Student's t-test or chi-square and Fisher's exact test. Statistical significance was defined as P&lt;0.05.</div></div><div><h3>Results</h3><div>Of the 69 patients diagnosed with HCC, most of the studied population was found to involve males at 56.52% while females were reported at 43.48%, with an age range of 26-81 years and a median age of 61.84, 61.84±9.8 (59.53-64.15). Of the total sample, 10.14% were patients with no diagnosis of cirrhosis while 89.86% were patients with some degree of cirrhosis (Child Pugh Stages: A 37.68%, B 43.48%, C 8.70%). The results indicated that low PNI is associated with poor prognosis while high PNI was found to be beneficial for survival with a 95 % CI=35.48±8.41 (32.42-38.54), 95% CI=40.86±5.42 (39.19-42.54) p=0.0019, respectively. It is also associated with more favorable outcomes, such as lower AFP, lower ECOG grade and lower BCLC staging (p=0.0371, p=0.0303, p= 0.002), respectively. However, we found that age, sex, presence or absence of cirrhosis, BMI and tumor size were not statistically significantly associated with the PNI value.</div></div><div><h3>Conclusions</h3><div>PNI is an independent predictive indicator of survival and is significantly associated with serum AFP, ECOG score, and BCLC stage in patients with HCC.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101864"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896008","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":"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 ,&nbsp;Tonatiuh A. Baltazar-Díaz ,&nbsp;Rodrigo Hernández-Basulto ,&nbsp;Mayra P. Padilla-Sánchez ,&nbsp;Ksenia K. Kravtchenko ,&nbsp;Roxana García-Salcido ,&nbsp;María T. Tapia-De la paz ,&nbsp;Kevin J. Arellano-Arteaga ,&nbsp;Luz A. González-Hernández ,&nbsp;Miriam R. Bueno-Topete","doi":"10.1016/j.aohep.2025.101867","DOIUrl":"10.1016/j.aohep.2025.101867","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;div&gt;To analyze the composition and diversity of IM in patients with alcohol-associated cirrhosis and ACLF, healthy controls, and its correlation with inflammatory markers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;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 &gt;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 &gt;7051.1 pg/mL (AUROC: 0.67, with 81.4% sensitivity and 45.8% specificity).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;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}