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Challenges and Innovations in PSC Clinical Trials: Evaluating HK-660S and the Path Forward. PSC 临床试验的挑战与创新:评估 HK-660S 和前进之路。
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-04 DOI: 10.3350/cmh.2024.0942
Nilanga Nishad
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引用次数: 0
ALCOHOL-ASSOCIATED LIVER DISEASE: NATURAL HISTORY, MANAGEMENT AND NOVEL TARGETED THERAPIES. 酒精相关肝病:自然史、管理和新型靶向疗法。
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-31 DOI: 10.3350/cmh.2024.0709
Edilmar Alvarado-Tapias, Elisa Pose, Jordi Gratacós, Ana Clemente-Sánchez, Hugo Hugo López-Pelayo, Ramón Bataller

Alcohol consumption is a leading cause of preventable morbidity and mortality worldwide and the primary cause of advanced liver disease. Alcohol use disorder (AUD) is a chronic, frequently relapsing condition characterized by persistent alcohol consumption despite its negative consequences. Alcohol-associated liver disease (ALD) encompasses a series of stages, from fatty liver (steatosis) to inflammation (steatohepatitis), fibrosis, and, ultimately, liver cirrhosis and its complications. The development of ALD is complex, involving both genetic and environmental factors, yet the exact mechanisms at play remain unclear. Alcohol-associated hepatitis (AH), a severe form of ALD, presents with sudden jaundice and liver failure. Currently, there are no approved targeted therapies able to interfere in the pathogenesis of ALD to stop the progression of the disease, making alcohol abstinence the most effective way to improve prognosis across all stages of ALD. For patients with advanced ALD who do not respond to medical therapy, liver transplantation is the only option that can improve prognosis. Recently, AH has become an early indication for liver transplantation in non-responders to medical treatment, showing promising results in carefully selected patients. This review provides an update on the epidemiology, natural history, pathogenesis, and current treatments for ALD. A deeper insight into novel targeted therapies investigated for AH focusing on new pathophysiologically-based agents is also discussed, including anti-inflammatory and antioxidative stress drugs, gut-liver axis modulators, and hepatocyte regenerative molecules.

饮酒是全球可预防的发病率和死亡率的主要原因,也是晚期肝病的主要病因。酒精使用障碍(AUD)是一种慢性、经常复发的疾病,其特点是尽管会产生不良后果,但仍持续饮酒。酒精相关性肝病(ALD)包括一系列阶段,从脂肪肝(脂肪变性)到炎症(脂肪性肝炎)、纤维化,最终发展为肝硬化及其并发症。ALD 的发展过程十分复杂,涉及遗传和环境因素,但其确切的作用机制仍不清楚。酒精相关性肝炎(AH)是 ALD 的一种严重形式,表现为突发性黄疸和肝功能衰竭。目前,还没有获批的靶向疗法能够干预 ALD 的发病机制以阻止疾病进展,因此戒酒成为改善 ALD 各个阶段预后的最有效方法。对于药物治疗无效的晚期ALD患者来说,肝移植是改善预后的唯一选择。最近,AH已成为药物治疗无反应患者进行肝移植的早期适应症,在精心挑选的患者中显示出良好的效果。本综述介绍了ALD的流行病学、自然史、发病机制和当前治疗方法的最新进展。此外,文章还深入探讨了针对急性肝病研究的新型靶向疗法,重点关注基于病理生理学的新药物,包括抗炎和抗氧化应激药物、肠肝轴调节剂和肝细胞再生分子。
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引用次数: 0
Stroma-tology: Predicting Recurrence in Cholangiocarcinoma. 基质学:预测胆管癌复发
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-29 DOI: 10.3350/cmh.2024.0932
Sergi Marco, Chiara Braconi
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引用次数: 0
Correspondence on editorial regarding "Understanding the impact on digestive disease in the post-COVID-19 condition". 关于 "了解后 COVID-19 条件对消化系统疾病的影响 "社论的通信。
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-29 DOI: 10.3350/cmh.2024.0935
Kwanjoo Lee, Jaeyu Park, Jinseok Lee, Hayeon Lee, Yeonjung Ha, Dong Keon Yon
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引用次数: 0
Prevalence of steatotic liver disease and associated fibrosis in the general population: an epidemiological survey. 普通人群中脂肪肝和相关纤维化的发病率:一项流行病学调查。
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-29 DOI: 10.3350/cmh.2024.0921
Lin Guan, Xinhe Zhang, Shanghao Liu, Xiaolong Qi, Yiling Li
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引用次数: 0
Momentum Towards Simplifying and Expanding Treatment for Chronic Hepatitis B: The Body of Evidence Continues to Grow. 简化和扩大慢性乙型肝炎治疗的势头:证据不断增加。
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-29 DOI: 10.3350/cmh.2024.0929
Robert J Wong
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引用次数: 0
Long-term Outcomes and Risk Modifiers of MASLD Between Lean and Non-Lean Populations. 精益人群与非精益人群之间 MASLD 的长期结果和风险调节因素。
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-23 DOI: 10.3350/cmh.2024.0631
Pojsakorn Danpanichkul, Kanokphong Suparan, Vitchapong Prasitsumrit, Aijaz Ahmed, Karn Wijarnpreecha, Donghee Kim

One-third of adults across the globe exhibit metabolic dysfunction-associated steatotic liver disease (MASLD) - formerly known as nonalcoholic fatty liver disease (NAFLD). To date, MASLD is the fastest-growing etiology of chronic liver disease and hepatocellular carcinoma (HCC). Besides the population with obesity, MASLD can also be found in lean populations, accounting for 13% of the global population, especially Asians. Notably, individuals with lean MASLD face equal or higher overall mortality rates compared to their non-lean counterparts. Risk modifiers encompass advanced age, hepatic fibrosis, and type 2 diabetes mellitus (T2DM). Moreover, the population with lean MASLD is associated with an increased risk of HCC, while their non-lean counterparts are more prone to cardiovascular outcomes and T2DM. Existing evidence indicates a similar risk of liver-related events and extrahepatic cancer between the two groups. However, MASLD-related genetic variants, such as PNPLA3 and TM6SF2, did not significantly affect mortality between the two populations. Still, underreporting alcohol consumption and regional representation limits the study's comprehensiveness. Longitudinal studies and mechanistic explorations are needed to understand differences in lean versus non-lean MASLD populations. This review highlights the need for awareness and tailored interventions in managing MASLD, considering lean individuals' unique risks.

全球有三分之一的成年人患有代谢功能障碍相关性脂肪性肝病(MASLD)--以前称为非酒精性脂肪肝(NAFLD)。迄今为止,MASLD 是慢性肝病和肝细胞癌(HCC)中增长最快的病因。除肥胖人群外,MASLD 也可见于瘦削人群,占全球总人口的 13%,尤其是亚洲人。值得注意的是,与非肥胖人群相比,肥胖型 MASLD 患者的总死亡率相同或更高。风险因素包括高龄、肝纤维化和 2 型糖尿病(T2DM)。此外,瘦型 MASLD 患者罹患 HCC 的风险增加,而非瘦型 MASLD 患者则更容易出现心血管疾病和 T2DM。现有证据表明,这两类人群发生肝脏相关事件和肝外癌症的风险相似。然而,与 MASLD 相关的基因变异,如 PNPLA3 和 TM6SF2,对两类人群的死亡率并无显著影响。不过,酒精消耗量报告不足和地区代表性限制了该研究的全面性。需要进行纵向研究和机理探索,以了解瘦型与非瘦型 MASLD 人群的差异。本综述强调,在管理 MASLD 时,考虑到瘦弱人群的独特风险,需要提高认识并采取有针对性的干预措施。
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引用次数: 0
Urgent Need for Education on Hepatocellular Carcinoma Surveillance Among High-Risk Population in China. 中国亟需在高危人群中开展肝细胞癌监测教育。
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-23 DOI: 10.3350/cmh.2024.0813
Lei Cai, Chao Li, Li-Yang Sun, Yong-Kang Diao, Ming-Da Wang, Tian Yang
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引用次数: 0
Bioactive metabolites: a clue to the link between MASLD and CKD? 生物活性代谢物:MASLD 与慢性肾脏病之间联系的线索?
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-21 DOI: 10.3350/cmh.2024.0782
Wen-Ying Chen, Jia-Hui Zhang, Li-Li Chen, Christopher D Byrne, Giovanni Targher, Liang Luo, Yan Ni, Ming-Hua Zheng, Dan-Qin Sun

Metabolites produced as intermediaries or end-products of microbial metabolism provide crucial signals for health and diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD). These metabolites include products of the bacterial metabolism of dietary substrates, modification of host molecules [such as bile acids (BAs), trimethylamine-N-oxide, and short-chain fatty acids], or products directly derived from bacteria. Recent studies have provided new insights into the association between MASLD and the risk of developing chronic kidney disease (CKD). Furthermore, alterations in microbiota composition and metabolite profiles, notably altered BAs, have been described in studies investigating the association between MASLD and the risk of CKD. This narrative review discusses alterations of specific classes of metabolites, BAs, fructose, vitamin D, and microbiota composition that may be implicated in the link between MASLD and CKD.

作为微生物代谢的中间产物或最终产物产生的代谢物为健康和疾病(如代谢功能障碍相关性脂肪性肝病(MASLD))提供了重要信号。这些代谢物包括细菌代谢食物底物的产物、宿主分子的修饰物[如胆汁酸(BA)、三甲胺-N-氧化物和短链脂肪酸],或直接来自细菌的产物。最近的研究对 MASLD 与慢性肾病(CKD)发病风险之间的关系提供了新的见解。此外,在调查 MASLD 与患慢性肾脏病风险之间关系的研究中,也描述了微生物群组成和代谢物谱的改变,尤其是 BAs 的改变。这篇叙述性综述讨论了可能与 MASLD 和 CKD 之间的联系有关的特定代谢物、BAs、果糖、维生素 D 和微生物群组成的改变。
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引用次数: 0
Correspondence on Editorial regarding "Genetically modified, redirected T cells target hepatitis B surface antigen-positive hepatocytes and hepatocellular carcinoma lesions in a clinical setting". 关于 "临床环境中针对乙型肝炎表面抗原阳性肝细胞和肝细胞癌病变的转基因重定向 T 细胞 "社论的通信。
IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-21 DOI: 10.3350/cmh.2024.0781
Shunda Du, Karin Wisskirchen, Ke Zhang, Ulrike Protzer
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引用次数: 0
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Clinical and Molecular Hepatology
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