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Clinical and Molecular Hepatology最新文献

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Correspondence: Response to Editorial on "GULP1, a Multifaceted Biomarker and Therapeutic Target in HCC".
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-04-04 DOI: 10.3350/cmh.2025.0350
Soon Sun Kim, Hyung Seok Kim, Jae Youn Cheong, Jung Woo Eun
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引用次数: 0
Revisiting unmet needs in clinical research on direct-acting antiviral therapy for HCC patients.
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-04-04 DOI: 10.3350/cmh.2025.0362
Teng-Yu Lee, Pei-Chien Tsai, Shou-Wu Lee, Ming-Lung Yu
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引用次数: 0
Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease.
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-04-04 DOI: 10.3350/cmh.2024.1183
Hye Won Lee, Jae Seung Lee, Mi Na Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim

Background: Recently, the Korean Association for the Study of the Liver (KASL) introduced a noninvasive test (NIT)-based approach that uses the fibrosis-4 (FIB-4) index followed by vibration-controlled transient elastography (VCTE) to identify high-risk patients with metabolic-associated steatotic liver disease (MASLD). In this study, the KASL two-step approach was validated by assessing the risk of liver-related event (LRE) development.

Methods: We retrospectively analyzed 8,131 patients with MASLD who underwent VCTE between 2012 and 2020. The index date was defined as the date of the VCTE measurement. Using the KASL two-step approach (FIB-4 index and subsequent VCTE), patients were stratified into four groups (low-, intermediate-low-, intermediate-high-, and high-risk groups). Outcomes, including LREs such as decompensation (DCC) or hepatocellular carcinoma (HCC) were evaluated.

Results: During the follow-up (median 46.6 months), 86 (1.1%) patients developed LREs (39 [0.5%] with DCC and 47 [0.6%] with HCC). The KASL two-step approach classified 67.6%, 17.7%, 5.7% and 9.0% of patients in the low-, intermediate-low-, intermediate-high-, and high-risk groups, respectively. The cumulative incidences of LREs increased proportionally according to risk stratification (0.07%, 0.10%, 0.29%, and 1.51% at 3 years and 0.35%, 0.26%, 1.94% and 5.46% at 5 years). The overall accuracy in predicting LREs ranged from 67.7-99.8%. The FIB-4 index and subsequent Agile3+, Agile 4, or FibroScan aspartate aminotransferase (FAST) scores showed similar predictive abilities compared to the KASL approach.

Conclusion: The KASL two-step approach is an effective and practical method for risk stratification in patients with MASLD, optimizing patient care through early identification of high-risk individuals.

背景:最近,韩国肝脏研究协会(KASL)推出了一种基于无创检测(NIT)的方法,使用纤维化-4(FIB-4)指数和振动控制瞬态弹性成像(VCTE)来识别代谢相关性脂肪性肝病(MASLD)的高风险患者。在这项研究中,通过评估肝脏相关事件(LRE)发生的风险,对 KASL 两步法进行了验证:我们对2012年至2020年间接受VCTE的8131例MASLD患者进行了回顾性分析。指数日期定义为 VCTE 测量日期。采用KASL两步法(FIB-4指数和随后的VCTE),将患者分为四组(低风险组、中低风险组、中高风险组和高风险组)。对结果进行了评估,包括失代偿(DCC)或肝细胞癌(HCC)等 LRE:随访期间(中位 46.6 个月),86 例(1.1%)患者出现 LRE(39 例 [0.5%] DCC,47 例 [0.6%] HCC)。KASL 两步法将 67.6%、17.7%、5.7% 和 9.0% 的患者分别划分为低危、中低危、中高危和高危组。根据风险分层,LRE 的累积发生率按比例增加(3 年时分别为 0.07%、0.10%、0.29% 和 1.51%,5 年时分别为 0.35%、0.26%、1.94% 和 5.46%)。预测 LRE 的总体准确率为 67.7%-99.8%。与KASL方法相比,FIB-4指数和随后的Agile3+、Agile 4或FibroScan天冬氨酸氨基转移酶(FAST)评分显示出相似的预测能力:KASL两步法是对MASLD患者进行风险分层的一种有效而实用的方法,可通过早期识别高危人群来优化患者护理。
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引用次数: 0
Emerging Therapies and Real-World Application of Metabolic Dysfunction-Associated Steatotic Liver Disease Treatment.
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-04-02 DOI: 10.3350/cmh.2025.0083
Hee Yeon Kim, Mary E Rinella

Metabolic dysfunction-associated steatotic liver disease, formerly referred to as non-alcoholic fatty liver disease, is the most common liver disease in Western countries and has emerged as the leading indication for liver transplantation. Metabolic dysfunction-associated steatohepatitis (MASH), a more advanced stage, carries a high risk of progression to liver fibrosis, cirrhosis, liver failure, and hepatocellular carcinoma. Until recently, lifestyle intervention remained the mainstay of MASH management, with no pharmacological treatments specifically approved. However, advances in understanding its pathophysiological mechanisms have fueled numerous clinical trials, culminating in the FDA's approval of resmetirom as the first treatment for MASH in 2024. Additionally, many investigational drugs are nearing FDA approval or progressing through late-stage clinical trials. This review examines the current therapeutic landscape, highlights strategies for identifying patients suitable for liver-directed therapies in real-world settings, and discusses the challenges that remain.

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引用次数: 0
Lipidomic analysis of alcohol use disorder patients revealed the biomarkers for alcoholic liver disease susceptibility.
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-04-02 DOI: 10.3350/cmh.2025.0227
Dongyao Wang, Hongwei Zhang, Yuxiao Tang
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引用次数: 0
Correspondence to editorial 1 on "Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis".
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-03-31 DOI: 10.3350/cmh.2025.0326
Haiyu Wang, Jinjun Chen
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引用次数: 0
Targeting CD36 to reinvigorate CD8+ T Cells in early-stage hepatocellular carcinoma.
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-03-31 DOI: 10.3350/cmh.2025.0334
Valerie Chew
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引用次数: 0
Correspondence to editorial 3 on "Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis".
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-03-31 DOI: 10.3350/cmh.2025.0328
Haiyu Wang, Jinjun Chen
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引用次数: 0
Correspondence to editorial 2 on "Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis".
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-03-31 DOI: 10.3350/cmh.2025.0327
Haiyu Wang, Jinjun Chen
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引用次数: 0
Tracking the trajectory of kidney dysfunction in cirrhosis: the acute kidney injury - chronic kidney disease spectrum.
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-03-26 DOI: 10.3350/cmh.2024.1060
Vishnu Girish, Rakhi Maiwall

Kidney disease in cirrhosis is now viewed as a continuum encompassing acute kidney injury (AKI), acute kidney disease (AKD), and chronic kidney disease (CKD), rather than three different disorders. Contemporary diagnostic criteria for AKI integrate urine output parameters and acknowledge the intricate relationship and possibility of overlap between functional and structural as well as acute and chronic entities, including hepatorenal syndrome (HRS). AKI demonstrates a propensity for progression to AKD and CKD, particularly in the context of recurrent and severe insults. The diagnostic complexity is further compounded by limitations in serum creatinine (Scr.) measurements, prompting the integration of novel biomarkers and the need to accurately estimate glomerular filtration rate (GFR). The diagnosis, phenotyping, and management of acute kidney injury should be prompt and early, the initial step should always be volume and urine output assessment, a personalized approach is needed and the possibility of co-existing structural or functional kidney disease should be borne in mind. The earlier concept of waiting for 48 hours to diagnose HRS has evolved and early diagnosis and prompt treatment are advised now. Kidney replacement therapy (KRT) and simultaneous liver and kidney transplantation may be required in resistant cases.

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引用次数: 0
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Clinical and Molecular Hepatology
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