Pub Date : 2025-02-01DOI: 10.1016/j.clinre.2024.102520
Haodong Qiao , Huaibin Guo , Ze Liang , Lin Kang , Wanxing Zhang
Introduction
Hepatocellular carcinosarcoma (HCS) is a rare and aggressive liver tumor with limited clinical evidence due to its infrequency. This case series aimed to enrich the existing knowledge on the diagnosis and clinical management of HCS.
Methods
Four patients with HCS were evaluated, focusing on their symptoms, diagnoses, treatments, and outcomes. The imaging characteristics and tumorigenesis of HCS were also investigated, highlighting the role of p53 mutations.
Results
This case series found that timely surgery and localized chemotherapy are crucial in managing HCS. Despite the promising results of targeted therapy, its limitations were observed in some patients. The onset and progression of HCS were found to be significantly correlated with the presence of p53 mutations.
Conclusions
This case series underscores the need for further research to improve the diagnosis and treatment of HCS and emphasizes the importance of timely surgery and localized chemotherapy in mitigating tumor side effects and potentially prolonging survival.
{"title":"Primary hepatocellular carcinosarcoma: A case series and literature review","authors":"Haodong Qiao , Huaibin Guo , Ze Liang , Lin Kang , Wanxing Zhang","doi":"10.1016/j.clinre.2024.102520","DOIUrl":"10.1016/j.clinre.2024.102520","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatocellular carcinosarcoma (HCS) is a rare and aggressive liver tumor with limited clinical evidence due to its infrequency. This case series aimed to enrich the existing knowledge on the diagnosis and clinical management of HCS.</div></div><div><h3>Methods</h3><div>Four patients with HCS were evaluated, focusing on their symptoms, diagnoses, treatments, and outcomes. The imaging characteristics and tumorigenesis of HCS were also investigated, highlighting the role of p53 mutations.</div></div><div><h3>Results</h3><div>This case series found that timely surgery and localized chemotherapy are crucial in managing HCS. Despite the promising results of targeted therapy, its limitations were observed in some patients. The onset and progression of HCS were found to be significantly correlated with the presence of p53 mutations.</div></div><div><h3>Conclusions</h3><div>This case series underscores the need for further research to improve the diagnosis and treatment of HCS and emphasizes the importance of timely surgery and localized chemotherapy in mitigating tumor side effects and potentially prolonging survival.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102520"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clinre.2025.102532
Cindy SERDJEBI , Juliette FOUCHER , Adrien BESSON , Joel GAY , Adèle DELAMARRE , Claude COHEN-BACRIE
Purpose
Hepatoscope® is an ultraportable ultrasound system with 50 Hz two-dimensional transient elastography (2DTE) for liver stiffness measurement (LSM). It provides a quality index (QI) for individual stiffness values that is based on imaging features. This study evaluated the 2DTE intra- and inter-user repeatability in patients with chronic liver diseases (CLD) for novice and expert operators across various QI conditions. We compared the performances with other imaging and non-imaging elastography techniques.
Methods
This investigation was a prospective cross-sectional single-center study. One hundred CLD patients underwent LSMs with vibration-controlled transient elastography (VCTE™), two-dimensional shear wave elastography (2DSWE) and 2DTE. Expert and novice operators each performed two consecutive exams with 2DTE, blinded to any output. Intra-class correlation coefficient for intra-, and inter-user repeatability were calculated as well as applicability for various QI conditions, and Spearman's correlations against VCTE and 2DSWE were assessed.
Results
Computing LSM as the median of 10 stiffness values with a QI>85 % yielded the best compromise between reliability and applicability. In this setting, expert and inter-operator repeatability showed significant improvement over the condition with no QI threshold (ICC = 0.81 and 0.79, respectively) and 95 % applicability. Novice repeatability was excellent with a more restrictive QI (ICC = 0.80). LSM with 2DTE demonstrated strong and moderate correlation with VCTE and 2DSWE (r = 0.63 and 0.55, respectively).
Conclusion
Hepatoscope 2DTE provides a promising and reliable alternative for non-invasive liver stiffness assessment in patients with CLD. The application of the image-based QI enhances LSM reliability and consistency across novice and expert operators.
{"title":"Hepatoscope 2DTE's image-based quality index enhances applicability and repeatability of liver stiffness measurement","authors":"Cindy SERDJEBI , Juliette FOUCHER , Adrien BESSON , Joel GAY , Adèle DELAMARRE , Claude COHEN-BACRIE","doi":"10.1016/j.clinre.2025.102532","DOIUrl":"10.1016/j.clinre.2025.102532","url":null,"abstract":"<div><h3>Purpose</h3><div>Hepatoscope® is an ultraportable ultrasound system with 50 Hz two-dimensional transient elastography (2DTE) for liver stiffness measurement (LSM). It provides a quality index (QI) for individual stiffness values that is based on imaging features. This study evaluated the 2DTE intra- and inter-user repeatability in patients with chronic liver diseases (CLD) for novice and expert operators across various QI conditions. We compared the performances with other imaging and non-imaging elastography techniques.</div></div><div><h3>Methods</h3><div>This investigation was a prospective cross-sectional single-center study. One hundred CLD patients underwent LSMs with vibration-controlled transient elastography (VCTE™), two-dimensional shear wave elastography (2DSWE) and 2DTE. Expert and novice operators each performed two consecutive exams with 2DTE, blinded to any output. Intra-class correlation coefficient for intra-, and inter-user repeatability were calculated as well as applicability for various QI conditions, and Spearman's correlations against VCTE and 2DSWE were assessed.</div></div><div><h3>Results</h3><div>Computing LSM as the median of 10 stiffness values with a QI>85 % yielded the best compromise between reliability and applicability. In this setting, expert and inter-operator repeatability showed significant improvement over the condition with no QI threshold (ICC = 0.81 and 0.79, respectively) and 95 % applicability. Novice repeatability was excellent with a more restrictive QI (ICC = 0.80). LSM with 2DTE demonstrated strong and moderate correlation with VCTE and 2DSWE (<em>r</em> = 0.63 and 0.55, respectively).</div></div><div><h3>Conclusion</h3><div>Hepatoscope 2DTE provides a promising and reliable alternative for non-invasive liver stiffness assessment in patients with CLD. The application of the image-based QI enhances LSM reliability and consistency across novice and expert operators.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102532"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clinre.2025.102527
Ruizhi Shi , Xu Hui , Ting Tong , Junfeng Li , Liting Zhang , Kehu Yang
Background
Acute liver failure (ALF) poses a significant threat to patient health with high mortality rates. While Non-Bioartificial Artificial Liver Support system (NBALSS) has been utilized as a transitional intervention to liver transplant, its efficacy remains uncertain, It is also used as a last-line treatment for patients who are not candidates for liver transplantation.
Objective
The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of NBALSS in treating acute liver failure (ALF). The primary outcome was overall survival (OS), while the secondary outcome focused on inflammatory factor levels.
Methods
We conducted a comprehensive search across various databases, including PubMed, EMbase, The Cochrane Library, Web of Science, CBM, Wanfang Database, VIP database, and CNKI database. The search spanned from the inception of the databases to July 2023. Two independent reviewers screened literature, extracted data, assessed bias risk in the selected studies and used GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) to rate the certainty of evidence. Random and fixed effects meta-analyses were used to determine the average effect of the interventions on ALF. The sensitivity analysis was conducted using the leave-one-out test. Additionally, subgroup analyses were carried out based on a singular NBALSS treatment or combined treatment of two NBALSS and follow-up duration.
Results
Twelve RCTs involving 824 patients were identified. The use of NBALSS was associated with a significantly improved overall survival (OS) [RR = 1.42, 95 %CI (1.26, 1.61), low certainty] and notable reductions in total bilirubin (TBIL) [MD = -57.60, 95 %CI (-79.60, -35.59), moderate certainty], alanine aminotransferase (ALT) [MD = -48.28, 95 %CI (-76.57, -19.98), low certainty], tumor necrosis factor (TNF-α) [MD = -1.49, 95 %CI (-2.24, -0.73), very low certainty], and interleukin 6 (IL-6) [MD = -178.72, 95 %CI (-277.37, -80.06), very low certainty]. However, the effects of NBALSS on interleukin-2 (IL-2) [MD = 1.33, 95 %CI (-0.33, 3.00), very low certainty], interleukin-8 (IL-8) [MD = -44.75, 95 %CI (-163.04, 73.55), very low certainty], and Sequential Organ Failure Score (SOFA) [MD = -4.06, 95 %CI (-8.92, 0.80), very low certainty] remained uncertain.
Conclusions
Moderate to very low certainty of evidence indicates that NBALSS may improve OS and biochemical indexes, cytokines in patients with ALF. However, the certainty of evidence is limited by risk of bias, incositency and imprecision. High-quality and larger trials are needed to better determine the effect of NBALSS on patient-important outcomes.
{"title":"Non-bioartificial artificial liver support system in acute liver failure: A comprehensive systematic review and meta-analysis of randomized controlled trials","authors":"Ruizhi Shi , Xu Hui , Ting Tong , Junfeng Li , Liting Zhang , Kehu Yang","doi":"10.1016/j.clinre.2025.102527","DOIUrl":"10.1016/j.clinre.2025.102527","url":null,"abstract":"<div><h3>Background</h3><div>Acute liver failure (ALF) poses a significant threat to patient health with high mortality rates. While Non-Bioartificial Artificial Liver Support system (NBALSS) has been utilized as a transitional intervention to liver transplant, its efficacy remains uncertain, It is also used as a last-line treatment for patients who are not candidates for liver transplantation.</div></div><div><h3>Objective</h3><div>The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of NBALSS in treating acute liver failure (ALF). The primary outcome was overall survival (OS), while the secondary outcome focused on inflammatory factor levels.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search across various databases, including PubMed, EMbase, The Cochrane Library, Web of Science, CBM, Wanfang Database, VIP database, and CNKI database. The search spanned from the inception of the databases to July 2023. Two independent reviewers screened literature, extracted data, assessed bias risk in the selected studies and used GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) to rate the certainty of evidence. Random and fixed effects meta-analyses were used to determine the average effect of the interventions on ALF. The sensitivity analysis was conducted using the leave-one-out test. Additionally, subgroup analyses were carried out based on a singular NBALSS treatment or combined treatment of two NBALSS and follow-up duration.</div></div><div><h3>Results</h3><div>Twelve RCTs involving 824 patients were identified. The use of NBALSS was associated with a significantly improved overall survival (OS) [RR = 1.42, 95 %CI (1.26, 1.61), low certainty] and notable reductions in total bilirubin (TBIL) [MD = -57.60, 95 %CI (-79.60, -35.59), moderate certainty], alanine aminotransferase (ALT) [MD = -48.28, 95 %CI (-76.57, -19.98), low certainty], tumor necrosis factor (TNF-α) [MD = -1.49, 95 %CI (-2.24, -0.73), very low certainty], and interleukin 6 (IL-6) [MD = -178.72, 95 %CI (-277.37, -80.06), very low certainty]. However, the effects of NBALSS on interleukin-2 (IL-2) [MD = 1.33, 95 %CI (-0.33, 3.00), very low certainty], interleukin-8 (IL-8) [MD = -44.75, 95 %CI (-163.04, 73.55), very low certainty], and Sequential Organ Failure Score (SOFA) [MD = -4.06, 95 %CI (-8.92, 0.80), very low certainty] remained uncertain.</div></div><div><h3>Conclusions</h3><div>Moderate to very low certainty of evidence indicates that NBALSS may improve OS and biochemical indexes, cytokines in patients with ALF. However, the certainty of evidence is limited by risk of bias, incositency and imprecision. High-quality and larger trials are needed to better determine the effect of NBALSS on patient-important outcomes.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102527"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A case of Vonoprazan-induced collagenous colitis associated with eosinophilic gastroenteritis","authors":"Rion Masaoka , Yasumi Katayama , Koji Toyoda , Yumi Kusano , Ikuhiro Kobori , Masaya Tamano","doi":"10.1016/j.clinre.2025.102535","DOIUrl":"10.1016/j.clinre.2025.102535","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102535"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clinre.2025.102526
Pierre-Antoine Soret , Jérémie Gautheron
{"title":"Catching the STING: Unlocking senescence and PD-L1 in PBC","authors":"Pierre-Antoine Soret , Jérémie Gautheron","doi":"10.1016/j.clinre.2025.102526","DOIUrl":"10.1016/j.clinre.2025.102526","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102526"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mixed neuroendocrine non-neuroendocrine neoplasm combining neuroendocrine tumor with hepatocellular carcinoma in the context of multiple endocrine neoplasia type 1","authors":"Madeleine Mulsant , Jean-François Mosnier , Eric Frampas , Tamara Matysiak-Budnik , Bastien Jamet , Yann Touchefeu","doi":"10.1016/j.clinre.2025.102533","DOIUrl":"10.1016/j.clinre.2025.102533","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102533"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clinre.2025.102544
Xi Li , Jing Zhang , Sheza Malik , Aakriti Jain , Mingyuan Wang , Chengu Niu
Background
Autoimmune hepatitis (AIH) is a chronic inflammatory disease primarily affecting the liver, with a higher prevalence among women of reproductive age. The latest nationwide statistics regarding its impact on maternal and fetal outcomes during pregnancy are lacking.
Aims
To analyze the real impact of AIH on maternal and fetal outcomes in hospitalized delivery patients, and provide theoretical guidance for comprehensive clinical management.
Methods
A retrospective analysis was conducted using data from the 2016–2020 National Inpatient Sample database in the United States. Multivariate logistic regression analysis was used to assess the influence of AIH on maternal and fetal outcomes during pregnancy.
Results
A total of 17,825,445 hospitalized delivery patients were included, among which 1,185 had AIH. After adjusting for potential confounding factors, compared to hospitalized delivery patients without AIH, the AIH group exhibited significantly higher rates of adverse maternal and fetal outcomes, including hypertension complications of pregnancy (AOR 1.68, 95 % CI 1.09–2.58), preterm birth (AOR 2.89, 95 % CI 1.91–4.38), fetal growth restriction (AOR 2.21, 95 % CI 1.34–3.64), and fetal death (AOR 4.13, 95 % CI 1.33–12.83). AIH showed no association with cesarean section or large fetus. In the group of delivery in patients with AIH, patients who develop hypertensive disorders have a higher probability of concomitant diabetes mellitus (OR 6.85, 95 % CI 2.19–21.45), hypertension (OR 4.64, 95 % CI 1.68–12.82), and obesity (OR 3.06, 95 % CI 1.26–7.42). Additionally, AIH patients incurred higher total costs and longer hospital stays during the delivery hospitalization.
Conclusion
Patients with AIH face an increased risk of hypertensive disorders of pregnancy, preterm birth, fetal growth restriction, and fetal death during delivery. It is crucial to enhance awareness of these potential occurrence risks.
{"title":"Maternal and fetal outcomes of autoimmune hepatitis in pregnancy: A United States hospitalized patient study","authors":"Xi Li , Jing Zhang , Sheza Malik , Aakriti Jain , Mingyuan Wang , Chengu Niu","doi":"10.1016/j.clinre.2025.102544","DOIUrl":"10.1016/j.clinre.2025.102544","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune hepatitis (AIH) is a chronic inflammatory disease primarily affecting the liver, with a higher prevalence among women of reproductive age. The latest nationwide statistics regarding its impact on maternal and fetal outcomes during pregnancy are lacking.</div></div><div><h3>Aims</h3><div>To analyze the real impact of AIH on maternal and fetal outcomes in hospitalized delivery patients, and provide theoretical guidance for comprehensive clinical management.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using data from the 2016–2020 National Inpatient Sample database in the United States. Multivariate logistic regression analysis was used to assess the influence of AIH on maternal and fetal outcomes during pregnancy.</div></div><div><h3>Results</h3><div>A total of 17,825,445 hospitalized delivery patients were included, among which 1,185 had AIH. After adjusting for potential confounding factors, compared to hospitalized delivery patients without AIH, the AIH group exhibited significantly higher rates of adverse maternal and fetal outcomes, including hypertension complications of pregnancy (AOR 1.68, 95 % CI 1.09–2.58), preterm birth (AOR 2.89, 95 % CI 1.91–4.38), fetal growth restriction (AOR 2.21, 95 % CI 1.34–3.64), and fetal death (AOR 4.13, 95 % CI 1.33–12.83). AIH showed no association with cesarean section or large fetus. In the group of delivery in patients with AIH, patients who develop hypertensive disorders have a higher probability of concomitant diabetes mellitus (OR 6.85, 95 % CI 2.19–21.45), hypertension (OR 4.64, 95 % CI 1.68–12.82), and obesity (OR 3.06, 95 % CI 1.26–7.42). Additionally, AIH patients incurred higher total costs and longer hospital stays during the delivery hospitalization.</div></div><div><h3>Conclusion</h3><div>Patients with AIH face an increased risk of hypertensive disorders of pregnancy, preterm birth, fetal growth restriction, and fetal death during delivery. It is crucial to enhance awareness of these potential occurrence risks.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102544"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clinre.2025.102528
Faouzi SALIBA
{"title":"Acute liver failure: Beyond the guidelines, the challenge of liver support therapies","authors":"Faouzi SALIBA","doi":"10.1016/j.clinre.2025.102528","DOIUrl":"10.1016/j.clinre.2025.102528","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102528"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clinre.2025.102530
Jai Kumar , Misha Hasan , Sana Mohsin , Mojtaba Hussain Alzaher , Tripti Nagar , Adeena Jamil , Ali Ahmed , Vamsi Krishna Lavu , Sarwan Kumar
Background and aims
Several randomized clinical trials have been conducted assessing the potential efficacy of Farnesoid X receptor (FXR) agonists in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). A comprehensive review and analysis were needed to evaluate the findings of these trials. Hence, this systematic review and meta-analysis aim to study the association between FXR agonists and hepatic outcomes in patients with MASLD.
Methods
Systematic review and meta-analysis evaluating the efficacy of FXR agonists in 1,227 patients assigned to the FXR intervention group compared to 650 patients in the placebo group. Changes in liver enzymes and hepatic steatosis assessed by MRI-PDFF were evaluated.
Results
FXR agonist use was associated with a significant reduction in levels of AST, (WMD= -4.51, 95% CI=[-8.39,-0.63], P=0.02); ALT (WMD= -13.02, 95% CI=[-17.85,-8.19], P<0.00001); GGT (WMD= -32.20, 95% CI=[-38.63,-25.98], P<0.00001); MRI-PDFF, (SMD= -1.14, 95% CI=[-1.92,-0.35], P=0.005). FXR agonists did not significantly affect ALP levels, (WMD= 25.04, 95% CI=[19.22,30.87], P<0.00001]
Conclusion
Results show promising evidence supporting the efficacy of FXR agonists in reducing hepatic steatosis and biomarkers of hepatic injury such as ALT, AST, and GGT.
{"title":"Assessing the efficacy of farnesoid X receptor agonists in the management of metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis","authors":"Jai Kumar , Misha Hasan , Sana Mohsin , Mojtaba Hussain Alzaher , Tripti Nagar , Adeena Jamil , Ali Ahmed , Vamsi Krishna Lavu , Sarwan Kumar","doi":"10.1016/j.clinre.2025.102530","DOIUrl":"10.1016/j.clinre.2025.102530","url":null,"abstract":"<div><h3>Background and aims</h3><div>Several randomized clinical trials have been conducted assessing the potential efficacy of Farnesoid X receptor (FXR) agonists in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). A comprehensive review and analysis were needed to evaluate the findings of these trials. Hence, this systematic review and meta-analysis aim to study the association between FXR agonists and hepatic outcomes in patients with MASLD.</div></div><div><h3>Methods</h3><div>Systematic review and meta-analysis evaluating the efficacy of FXR agonists in 1,227 patients assigned to the FXR intervention group compared to 650 patients in the placebo group. Changes in liver enzymes and hepatic steatosis assessed by MRI-PDFF were evaluated.</div></div><div><h3>Results</h3><div>FXR agonist use was associated with a significant reduction in levels of AST, (WMD= -4.51, 95% CI=[-8.39,-0.63], P=0.02); ALT (WMD= -13.02, 95% CI=[-17.85,-8.19], P<0.00001); GGT (WMD= -32.20, 95% CI=[-38.63,-25.98], P<0.00001); MRI-PDFF, (SMD= -1.14, 95% CI=[-1.92,-0.35], P=0.005). FXR agonists did not significantly affect ALP levels, (WMD= 25.04, 95% CI=[19.22,30.87], P<0.00001]</div></div><div><h3>Conclusion</h3><div>Results show promising evidence supporting the efficacy of FXR agonists in reducing hepatic steatosis and biomarkers of hepatic injury such as ALT, AST, and GGT.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102530"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clinre.2025.102545
Yijia He , Miaomin Ye , Yin Xia, Ziyi Zhong, Weiping Wang, Qian Li
Background
Prior research has highlighted associations between inflammatory cytokines and non-alcoholic fatty liver disease (NAFLD), but causal relationships remain unclear. Employing the Mendelian randomization (MR) approach, this investigation aims to explore the connection between 41 inflammatory cytokines and NAFLD-related diseases.
Methods
Our research implemented bidirectional study focusing on 41 cytokines in 8,293 Finns, predicting genetic associations with NAFLD, nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. We primarily utilized the inverse variance weighted (IVW) method to evaluate the bidirectional relationships. Additionally, a sensitivity analysis was carried out to ensure the reliability of our findings.
Results
An elevated risk for NAFLD was correlated with both IL-2 (OR = 1.226, 95 % CI = 1.018–1.477, p = 0.031) and TNF-β (OR = 1.151, 95 % CI = 1.011–1.310, p = 0.033). IL-16 is associated with decreased NAFLD risk (OR = 0.820, 95 % CI = 0.719–0.934, p = 0.033). β-NGF (OR = 2.495, 95 % CI = 1.019–6.108, p = 0.045) and SCGFβ (OR = 1.541, 95 % CI = 1.052–2.256, p = 0.026) are linked to higher NASH risk. No significant associations were found for fibrosis and cirrhosis. Furthermore, the causal relationship between genetic predisposition to NAFLD-related diseases and various inflammatory cytokines was established.
Conclusions
Our MR analysis identifies specific cytokines as genetic predictors for NAFLD and NASH. IL-2 and TNF-β increase NAFLD risk, IL-16 appears protective, and β-NGF and SCGFβ are associated with greater NASH risk. These insights are crucial for understanding the etiology and treatment of NAFLD-related diseases.
{"title":"The role of cytokines as predictors for NAFLD-related diseases: A bidirectional Mendelian randomization study","authors":"Yijia He , Miaomin Ye , Yin Xia, Ziyi Zhong, Weiping Wang, Qian Li","doi":"10.1016/j.clinre.2025.102545","DOIUrl":"10.1016/j.clinre.2025.102545","url":null,"abstract":"<div><h3>Background</h3><div>Prior research has highlighted associations between inflammatory cytokines and non-alcoholic fatty liver disease (NAFLD), but causal relationships remain unclear. Employing the Mendelian randomization (MR) approach, this investigation aims to explore the connection between 41 inflammatory cytokines and NAFLD-related diseases.</div></div><div><h3>Methods</h3><div>Our research implemented bidirectional study focusing on 41 cytokines in 8,293 Finns, predicting genetic associations with NAFLD, nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. We primarily utilized the inverse variance weighted (IVW) method to evaluate the bidirectional relationships. Additionally, a sensitivity analysis was carried out to ensure the reliability of our findings.</div></div><div><h3>Results</h3><div>An elevated risk for NAFLD was correlated with both IL-2 (OR = 1.226, 95 % CI = 1.018–1.477, <em>p</em> = 0.031) and TNF-β (OR = 1.151, 95 % CI = 1.011–1.310, <em>p</em> = 0.033). IL-16 is associated with decreased NAFLD risk (OR = 0.820, 95 % CI = 0.719–0.934, <em>p</em> = 0.033). β-NGF (OR = 2.495, 95 % CI = 1.019–6.108, <em>p</em> = 0.045) and SCGFβ (OR = 1.541, 95 % CI = 1.052–2.256, <em>p</em> = 0.026) are linked to higher NASH risk. No significant associations were found for fibrosis and cirrhosis. Furthermore, the causal relationship between genetic predisposition to NAFLD-related diseases and various inflammatory cytokines was established.</div></div><div><h3>Conclusions</h3><div>Our MR analysis identifies specific cytokines as genetic predictors for NAFLD and NASH. IL-2 and TNF-β increase NAFLD risk, IL-16 appears protective, and β-NGF and SCGFβ are associated with greater NASH risk. These insights are crucial for understanding the etiology and treatment of NAFLD-related diseases.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102545"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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