Gastro hep advances最新文献

{"title":"Caloric Restriction Is Associated With Enhanced Clinical Outcomes in Hospitalized Patients With Ulcerative Colitis","authors":"Tomoyuki Nagai,&nbsp;Yoriaki Komeda,&nbsp;Saki Yoshida,&nbsp;Kohei Handa,&nbsp;Sho Masaki,&nbsp;Masashi Kono,&nbsp;Hajime Honjo,&nbsp;Shigenaga Matsui,&nbsp;Naoko Tsuji,&nbsp;Hiroshi Kashida,&nbsp;Masatoshi Kudo","doi":"10.1016/j.gastha.2025.100842","DOIUrl":"10.1016/j.gastha.2025.100842","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Ulcerative colitis (UC) is a chronic inflammatory bowel disease with a relapsing-remitting course that often requires hospitalization during flares. While prolonged fasting has traditionally led to high-calorie intravenous nutrition, excessive caloric intake may induce hyperglycemia, increase infection risk, and inhibit autophagy. This study aimed to evaluate the impact of a short-term, calorie-restricted regimen (≤400 kcal/day), designed to promote autophagy, on clinical outcomes in hospitalized patients with UC.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 38 patients admitted for UC exacerbation between January 2022 and December 2024. Patients were categorized into a calorie-restricted group (≤400 kcal/day) or a standard nutrition group (&gt;400 kcal/day) based on their total caloric intake. The calorie-restricted group received only intravenous fluids and noncaloric beverages. The primary endpoint was clinical remission at day 14, while secondary endpoints included the length of hospital stay and incidence of adverse events.</div></div><div><h3>Results</h3><div>The clinical remission at day 14 following treatment initiation was significantly higher in the calorie-restricted group (86% [12/14]) compared to the standard nutrition group (42% [10/24]) (<em>P</em> &lt; .05). The mean duration of hospitalization was also significantly shorter in the calorie-restricted group (11.0 ± 3.3 days) compared to the standard nutrition group (22.1 ± 8.9 days) (<em>P</em> &lt; .01). The calorie-restricted group experienced mild, transient adverse events but no serious complications. In contrast, the standard nutrition group experienced serious adverse events such as catheter-related infections and myocarditis.</div></div><div><h3>Conclusion</h3><div>Caloric restriction during hospitalization for UC exacerbation may be associated with increased clinical remission and a shorter hospital stay. That nutritional strategy offers a potentially novel and cost-effective approach distinct from conventional bowel rest. Further prospective, multicenter studies are warranted to validate these findings.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100842"},"PeriodicalIF":0.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B Surface Antigen Loss and Improved Clinical Outcomes in Asians with Chronic Hepatitis B Virus Infection","authors":"Wallis Lau ,&nbsp;Myriam Drysdale ,&nbsp;Eleonora Morais ,&nbsp;Luis Antunes ,&nbsp;Loey Mak ,&nbsp;Christopher Lee ,&nbsp;Catarina Camarinha ,&nbsp;Xiaohui Sun ,&nbsp;Adrienne Y.L. Chan ,&nbsp;May Lam ,&nbsp;Vera Gielen ,&nbsp;Dickens Theodore ,&nbsp;Ian C.K. Wong ,&nbsp;Iain A. Gillespie","doi":"10.1016/j.gastha.2025.100844","DOIUrl":"10.1016/j.gastha.2025.100844","url":null,"abstract":"<div><h3>Background and aims</h3><div>Chronic hepatitis B virus (HBV) infection accounts for substantial disease burden and mortality due to liver complications. Hepatitis B surface antigen (HBsAg) loss is a key component of functional cure when assessing treatment efficacy. However, the impact of HBsAg loss on clinical outcomes deserves further exploration.</div></div><div><h3>Methods</h3><div>This population-based cohort study used electronic health record data from a territory-wide database in Hong Kong to identify patients with chronic HBV infection (2005–2019). The association between HBsAg loss and outcomes was assessed: compensated cirrhosis, decompensated liver disease (DLD), hepatocellular carcinoma (HCC), and all-cause mortality (ACM). A marginal structural model using inverse probability weighting was used to estimate hazard ratios (HRs; 95% confidence interval [CI]) adjusted for time-fixed and time-varying confounders. Health-care resource utilization before and after loss was evaluated.</div></div><div><h3>Results</h3><div>The study population comprised 71,077 patients accruing 348,379 person-years; 1639 (2.3%) experienced HBsAg loss, which occurred with a mean (standard deviation) of 74.63 (37.5) months after chronic HBV index date. HBsAg loss was associated with a reduced risk of DLD (74%; HR 0.26 [95% CI 0.08–0.83]), HCC (66%; 0.34 [0.19–0.61]), and ACM (26%; 0.74 [0.57–0.97]). The HR for compensated cirrhosis was 0.57 (0.30–1.14). Each additional month of HBsAg loss was associated with decreased risk of HCC and ACM. Of those experiencing HBsAg loss, cumulative probability of persistence at 24 and 60 months was 99% and 97%, respectively. Hospital admission, inpatient days, and drug prescribing were higher before HBsAg loss versus 6, 12, and 24 months post-HBsAg loss.</div></div><div><h3>Conclusion</h3><div>In this large population-based study with extended follow-up in Hong Kong, HBsAg loss was associated with reduced risk of DLD, HCC, and ACM.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100844"},"PeriodicalIF":0.0,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Eosinophilic Esophagitis Among Ethnic Groups in a Private Vs a Safety Net-Hospital in Southern California","authors":"Ibrahim Abboud ,&nbsp;Susie Lee ,&nbsp;Jordan Stellern ,&nbsp;Andrew Cruz ,&nbsp;Nicholas Placone ,&nbsp;Jennifer Dodge ,&nbsp;Collin Mayemura ,&nbsp;Anisa Shaker ,&nbsp;Edy Soffer","doi":"10.1016/j.gastha.2025.100840","DOIUrl":"10.1016/j.gastha.2025.100840","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Eosinophilic esophagitis (EoE) is rapidly increasing in incidence and prevalence. It is more prevalent among Whites as compared to Hispanics. The reasons for this disparity remain unclear. We aimed to compare EoE Prevalence between a private facility and a safety-net hospital, the latter treating a larger proportion of foreign-born Spanish-speaking patients, and to examine differences in prevalence among Hispanics across both facilities.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cross-sectional study of adult patients who underwent upper endoscopy for dysphagia, food impaction, or EoE at 2 medical centers. The primary outcome was a diagnosis of EoE, based on clinical, endoscopic, and pathologic criteria. Logistic regression was employed to calculate adjusted odds ratios (ORs) for EoE.</div></div><div><h3>Results</h3><div>Of 1005 patients, a higher proportion of Hispanic (73.3% versus 19.7%) and Spanish-speaking patients (64.8% versus 7.6%) received care at the safety-net hospital. Overall, 70 (7.0%) patients were diagnosed with EoE, with a higher prevalence at the private versus safety-net hospital (10.5% versus 1.9%; <em>P</em> &lt; .001). In a multivariable analysis, odds of EoE remained lower for Hispanic vs White patients (OR = 0.20, 95% CI (0.1–0.5), <em>P</em> &lt; .01), after adjustment for hospital setting and primary language. Within the Hispanic subgroup, neither the hospital setting (OR = 1.90, 95% CI (0.3–13.9), <em>P</em> = .53) nor primary spoken language (OR = 0.56, 95% CI (0.1–4.1), <em>P</em> = .56) showed a significant association with EoE.</div></div><div><h3>Conclusion</h3><div>The prevalence of EoE was significantly higher among Whites than Hispanics. Among Hispanics, the prevalence of EoE was not influenced by hospital setting or primary language. These results suggest that intrinsic factors, including possible genetic influences, may contribute to the disparity in EoE prevalence between the 2 groups.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100840"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Circulating MiR-4651 as Novel Biomarker for Metabolic Dysfunction–Associated Steatotic Liver Disease","authors":"Mélanie Kirchmeyer ,&nbsp;Anthoula Gaigneaux ,&nbsp;Florence A. Servais ,&nbsp;Anita Arslanow ,&nbsp;Claudia Rubie ,&nbsp;Markus Casper ,&nbsp;Matthias Glanemann ,&nbsp;María L. Martínez-Chantar ,&nbsp;Marcin Krawczyk ,&nbsp;Frank Lammert ,&nbsp;Iris Behrmann","doi":"10.1016/j.gastha.2025.100839","DOIUrl":"10.1016/j.gastha.2025.100839","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Metabolic dysfunction–associated steatotic liver disease (MASLD) affects &gt;30% of adults and is becoming one of the leading causes of hepatocellular carcinoma (HCC). Reliable biomarkers are needed for the early diagnosis of HCC and detection of chronic liver diseases, like MASLD. Here we assessed the biomarker potential of circulating microRNAs in a cohort of patients genotyped for the risk allele of <em>patatin-like phospholipase domain-containing protein 3</em> (<em>PNPLA3</em>), associated with increased susceptibility to chronic liver diseases.</div></div><div><h3>Methods</h3><div>The cohort comprised 70 MASLD patients (40 with simple steatosis, 9 with metabolic dysfunction–associated steatohepatitis (MASH), 21 with cirrhosis), 47 HCC patients (32 with cirrhosis), and 14 healthy controls. Serum levels of miR-122-5p, miR-146a-5p, miR-146b-5p, miR-21-5p, miR-335-5p, miR-433-3p, miR-4530, miR-4651, miR-526a2, and miR-873-5p were quantified using custom qPCR plates. Their suitability for prediction of MASLD (steatosis/MASH/cirrhosis) or HCC was assessed by receiver operating characteristic curve analyses.</div></div><div><h3>Results</h3><div>MiR-4651 and miR-21-5p were significantly reduced in sera from patients with MASLD, particularly in those with simple steatosis. Both microRNAs effectively distinguished MASLD patients with simple steatosis from healthy controls (area under the curve: 0.95 and 0.89, respectively). Moreover, miR-4651 emerged as the best predictor for differentiating “complicated” MASLD (i.e., MASH or cirrhosis) from simple steatosis; the predictive values could be increased by including additional parameters into the models (Fibroscan, thrombocytes, cytokines, or other miRNAs). miR-335-5p showed strong ability to differentiate HCC from healthy individuals (area under the curve: 0.86). The <em>PNPLA3</em> p.I148M genotype was not associated with altered levels of microRNAs.</div></div><div><h3>Conclusion</h3><div>Serum microRNAs, in particular miR-4651, may serve as additional biomarkers in patients with steatotic liver disease.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100839"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endohepatology: Evolving Indications, Challenges, Unmet Needs and Opportunities","authors":"Akash Roy ,&nbsp;Mithun Sharma ,&nbsp;Anand V. Kulkarni ,&nbsp;Sundeep Lakhtakia ,&nbsp;Aniruddha Pratap Singh ,&nbsp;Rakesh Kalapala ,&nbsp;Gregory G. Ginsberg ,&nbsp;D.Nageshwar Reddy ,&nbsp;K. Rajender Reddy","doi":"10.1016/j.gastha.2025.100838","DOIUrl":"10.1016/j.gastha.2025.100838","url":null,"abstract":"<div><div>Endohepatology provides a unison of 2 rapidly developing fields of hepatology and advanced endoscopy. Conventionally, endoscopy in liver disease was restricted primarily to the management of varices. However, multiple new domains have emerged in advanced endoscopy, driven mainly by endoscopic ultrasound (EUS), and as such find several applications in clinical hepatology. Robust data have emerged regarding EUS liver biopsy and the management of gastric varices, and are becoming the first line of care at experienced centers. EUS-guided portal pressure gradient and direct measurements appear to be an exciting frontier for portal pressure assessment. EUS shear wave elastography holds promise but needs standardization and comparison to well-established noninvasive surrogates. Endobariatrics opens up new avenues in optimizing comprehensive obesity management. Interesting crossroads emerge in liver transplantation, where endohepatology may provide a unique single setting investigation and therapeutic solution. Several other potential uses are emerging but need to be replicated across settings. While the advancements usher in excitement, several gaps in knowledge and pragmatic concerns remain with the application of endohepatology, which need to be balanced against patient safety and in optimizing outcomes.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100838"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Esophageal Disease Modeling: Microfluidic Platforms for Adult Tissue–Resident Stem Cell Culture and Differentiation","authors":"Sara Hosseini-Farahabadi ,&nbsp;Omar Abuhussein ,&nbsp;Corina Stewart ,&nbsp;Guang Gao ,&nbsp;Tenanye Haglund ,&nbsp;David Schaeffer ,&nbsp;Fergal Donnellan ,&nbsp;Frank McKeon ,&nbsp;Wa Xian ,&nbsp;Dermot Kelleher ,&nbsp;Shane Duggan","doi":"10.1016/j.gastha.2025.100837","DOIUrl":"10.1016/j.gastha.2025.100837","url":null,"abstract":"<div><h3>Background and aims</h3><div>Classical organoid models of Barrett’s esophagus (BE) lack accessible luminal surfaces, tissue depth and tractable stem cell and immune cell components. Herein, we aimed to seed adult tissue-resident stem cells (ASC) with advanced organ-on-a-chip (OOAC) microfluidics to provide a platform upon which to study the immunobiology of BE and associated high grade dysplasia (HGD).</div></div><div><h3>Methods</h3><div>ASCs from BE and HGD and gastroesophageal junction (GEJ) were obtained using methods analogous to ground-state stem cell culture and conditional reprogramming. ASC differentiation was achieved on Transwells and flexible OOAC with tissues examined by immunohistochemistry and single-cell RNA sequencing gene expression analysis. Monocytic cell line THP1 was utilized in transmigration experiments.</div></div><div><h3>Results</h3><div>Monolayered ASCs exhibited colony formation, self-renewal and air–liquid interface-mediated differentiation resulting in 3D furrow formation, mucus production and cell types reflective of tissue of origin-foveolar, goblet, enterocyte-like. Levels of intestinal marker Trefoil Factor 3 were abundant in BE tissue, significantly lower in HGD and absent in GEJ. The gastric marker Gastrokine1 was only expressed in HGD- and GEJ-differentiated ASCs. Comparatively, tissues derived from OOAC displayed significantly enhanced villus-like structure, height, and prolonged survival (&lt;19 days) when compared to Transwell-differentiated equivalents. Single-cell RNAseq analysis detected populations representative of stem cells, transit amplifying stem cells, early and late enterocytes, goblet and enteroendocrine cells and CXCL8 positive immunomodulatory cells in both systems. However, significantly higher levels of proliferating cells, terminal enterocyte-like, Goblet cells, and enteroendocrine-like cells were observed in BE-OOAC systems. THP1 cells were tracked under flow conditions in BE-OOAC and their transmigration through the endothelial layer was evident only in the presence of organoid tissue above.</div></div><div><h3>Conclusion</h3><div>These findings showed that OOACs offer more physiologically relevant environments, promote deeper cellular differentiation, and increased cellular tractability when seeded as ASCs rather than classical organoid aggregates.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100837"},"PeriodicalIF":0.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Mediterranean Fever Gene Mutations on Clinical Characteristics in Patients With Inflammatory Bowel Disease","authors":"Tomoya Nakamura ,&nbsp;Kohei Wagatsuma ,&nbsp;Yuki Hayashi ,&nbsp;Hiromu Morikubo ,&nbsp;Daisuke Saito ,&nbsp;Masashi Idogawa ,&nbsp;Masanori Nojima ,&nbsp;Jun Miyoshi ,&nbsp;Minoru Matsuura ,&nbsp;Tadakazu Hisamatsu ,&nbsp;Hiroshi Nakase","doi":"10.1016/j.gastha.2025.100836","DOIUrl":"10.1016/j.gastha.2025.100836","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The Mediterranean fever (<em>MEFV</em>) gene, which encodes a pyrin protein, is the causative gene of familial Mediterranean fever. Patients with inflammatory bowel disease (IBD) have a significantly higher frequency of <em>MEFV</em> mutations than healthy controls; however, the pathological significance of this difference remains unknown. This study investigated the relationship between <em>MEFV</em> mutations and the clinical characteristics of IBD and refractoriness in patients with a confirmed diagnosis of ulcerative colitis (UC) or Crohn's disease (CD).</div></div><div><h3>Methods</h3><div>This retrospective cohort included 260 patients with UC and 131 patients with CD who visited Sapporo Medical University Hospital or Kyorin University Hospital from April 2021 to March 2023. Demographic and clinical data were collected, and blood samples were examined for <em>MEFV</em> mutations using next generation sequencing.</div></div><div><h3>Results</h3><div>Mutations of the <em>MEFV</em> gene were found in 60.8% of UC and 56.5% of CD patients. Two or more overlapping mutations were identified in 26.2% patients with UC and 19.8% patients with CD. In patients with IBD, mutations in exons 2 and 3 were associated with extraintestinal manifestations (EIMs), and the coexistence of exon 2 and 3 mutations further strengthened this association. G250R (<em>P</em> = .0096, odds ratio 3.49 [1.36–8.98]) and G304R (<em>P</em> = .039, odds ratio 2.62 [1.05–6.54]) in exon 2, and P373Q (<em>P</em> = .0016, odds ratio 7.86 [2.19–28.26]) in exons 3, were significantly associated with EIMs; when stratifying patients with IBD, this trend was observed in patients with UC, but not in those with CD.</div></div><div><h3>Conclusion</h3><div>The <em>MEFV</em> mutation rate was higher in Japanese patients with UC and CD than in healthy controls. <em>MEFV</em> mutations could influence EIMs in patients with IBD.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100836"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 1 Autoimmune Pancreatitis in a Teenager With Ulcerative Colitis: A Case Report","authors":"Jerry H. Rose ,&nbsp;Michael J. Sikorski ,&nbsp;Patrick W. Ruane ,&nbsp;Dania Hudhud ,&nbsp;Abdulhameed M. Al-Sabban","doi":"10.1016/j.gastha.2025.100834","DOIUrl":"10.1016/j.gastha.2025.100834","url":null,"abstract":"<div><div>Type 2 autoimmune pancreatitis (AIP) is a recognized complication of ulcerative colitis (UC), whereas type 1 AIP—an immunoglobulin G4-related sclerosing pancreatitis—is uncommon in this patient population and typically presents in older males. We present a case of recurrent pancreatitis in an 18-year-old male with UC. Investigations revealed elevated immunoglobulin G4 levels and images demonstrating diffuse pancreatic strictures and parenchymal enlargement, consistent with type 1 AIP. The patient showed a favorable response to glucocorticoid therapy. This case highlights a potential new association between AIP and UC and emphasizes early recognition and treatment.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100834"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight Change is Associated With Metabolic Liver Health in a General Population Extending Beyond Weight Loss Targets of International Guidelines","authors":"Laurens A. van Kleef ,&nbsp;Mesut Savas ,&nbsp;Maurice Michel ,&nbsp;Cyrielle Caussy ,&nbsp;Jesse Pustjens ,&nbsp;Adriaan G. Holleboom ,&nbsp;Elisabeth F.C. van Rossum ,&nbsp;Harry L.A. Janssen ,&nbsp;Jörn M. Schattenberg ,&nbsp;Willem P. Brouwer","doi":"10.1016/j.gastha.2025.100831","DOIUrl":"10.1016/j.gastha.2025.100831","url":null,"abstract":"<div><h3>Background and aims</h3><div>Weight loss of ≥3%–10% is recommended in metabolic dysfunction–associated steatotic liver disease (MASLD) management, according to current guidelines. We investigated the associations between weight change and impaired metabolic liver health and focused on associations beyond these recommendations.</div></div><div><h3>Methods</h3><div>Adults from the National Health and Nutrition Examination Survey 2017–2020, with data on 1-year weight history, controlled attenuation parameter and/or liver stiffness measurement (LSM) were selected. Exclusion criteria were age ≥80 years, body mass index &lt;18.5 kg/m², excessive alcohol and viral hepatitis. Impaired metabolic liver health included MASLD (controlled attenuation parameter ≥275 dB/m with ≥1 cardiometabolic riskfactor), at-risk metabolic dysfunction–associated steatohepatitis (MASH) (FibroScan aspartate aminotransferase score ≥0.35) and LSM ≥8 kPa. Multivariate logistic regression models were adjusted for demographics and prior weight.</div></div><div><h3>Results</h3><div>We included 6802 individuals (aged 48 years [33–62], 48.9% male). MASLD was present in 42.2%, at-risk MASH in 6.5% and LSM ≥8 kPa in 9.1%. Over 1 year, 29% gained and 28% lost ≥3% weight. Compared to stable weight, weight gain ≥3% was associated with increased MASLD prevalence (adjusted odds ratio (aOR):1.78; 95% confidence interval (CI): 1.48–1.95), at-risk MASH (aOR: 1.78; 95% CI: 1.39–2.29) and LSM ≥8 kPa (aOR:1.48; 95%CI:1.19–1.84); whilst weight loss ≥ 3% was associated with reduced MASLD prevalence (aOR: 0.54; 95% CI: 0.47–0.62), at-risk MASH (aOR: 0.72; 95% CI: 0.55–0.94) and LSM ≥8 kPa (aOR: 0.62; 95% CI: 0.49–0.78). Results were consistent when weight loss was further categorized or when assessed as continuous variable without evidence for nonlinearity.</div></div><div><h3>Conclusion</h3><div>The prevalence of impaired metabolic liver health decreased with weight loss. Greater reported weight loss was associated with lower observed risks. Hence, we should recommend losing weight beyond the currently recommended targets to further reduce the risk of advanced liver disease.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100831"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Fibulin-5 as a Novel Marker for Advanced Fibrosis in Chronic Hepatitis C","authors":"Yutaka Yasui ,&nbsp;Misako Sato-Matsubara ,&nbsp;Masaru Enomoto ,&nbsp;Tsutomu Matsubara ,&nbsp;Mana Kosugi ,&nbsp;Kirara Inoue ,&nbsp;Truong Huu Hoang ,&nbsp;Hideto Yuasa ,&nbsp;Hideki Fujii ,&nbsp;Atsuko Daikoku ,&nbsp;Yoshihiro Ikura ,&nbsp;Etsushi Kawamura ,&nbsp;Sawako Uchida-Kobayashi ,&nbsp;Akihiro Tamori ,&nbsp;Norifumi Kawada","doi":"10.1016/j.gastha.2025.100827","DOIUrl":"10.1016/j.gastha.2025.100827","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Despite remarkable advances in the treatment of viral hepatitis, liver fibrosis sometimes persists after viral eradication. The accumulation of elastic fiber is associated with unfavorable clinical outcomes. We aimed to clarify the utility of plasma fibulin-5 (FBLN5), a component of elastic fibers, in assessing liver fibrosis in patients with chronic hepatitis.</div></div><div><h3>Methods</h3><div>We reviewed 90 patients with chronic hepatitis C who underwent liver biopsy. Using immunohistochemistry and in situ hybridization, we investigated the localization of FBLN5 and its correlation with α-smooth muscle actin (αSMA). We then analyzed mRNA and protein expression in human hepatic stellate cells (HHSteCs) and primary mouse stellate cells. Lastly, we evaluated the utility of plasma FBLN5 for predicting liver fibrosis in patients with hepatitis C.</div></div><div><h3>Results</h3><div>Immunohistochemical analysis revealed a correlation between the quantity of FBLN5 and αSMA (<em>r</em> = 0.65) as well as FBLN5 and fibrosis stage (<em>r</em> = 0.30). FBLN5 was localized to areas enriched for αSMA-positive cells. In situ hybridization confirmed the colocalization of FBLN5 mRNA with αSMA and desmin-positive cells. Single nuclear RNA-sequencing analysis revealed that FBLN5 expression is predominantly expressed in the hepatic stellate cell/fibroblast cluster in other etiology, and the expression level was higher in cirrhotic livers. FBLN5 was overexpressed in cultured HHSteCs in response to 2.0 μg/mL transforming growth factor-β1 (<em>P</em> &lt; .001), with increased FBLN5 concentration in the medium of transforming growth factor-β1-treated activated HHSteC. FBLN5 upregulation was also confirmed in primary-cultured mouse stellate cells. Finally, plasma FBLN5 levels increased with fibrosis progression in patients with chronic hepatitis C (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>FBLN5 may represent the activation of hepatic stellate cells, and plasma FBLN5 levels have the potential to predict advanced fibrosis, especially in fibrosis related to elastic fibers.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100827"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}