Annals of hepatology最新文献_第4页

Pruritus in primary biliary cholangitis: insights from the German PBC registry across secondary and tertiary care 原发性胆道胆管炎的瘙痒：来自德国PBC登记的见解，跨越二级和三级护理。

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2026-01-01 Epub Date: 2025-10-11 DOI: 10.1016/j.aohep.2025.102140

Toni Herta , Annegret Franke , Tobias Müller , Kerstin Stein , Heike Bantel , Rainer Günther , Gerald Denk , Philipp A. Reuken , Jörn M. Schattenberg , Uwe Naumann , Tobias Böttler , Andreas Weber , Stefan Zeuzem , Matthias Hinz , Robin Greinert , Christoph Berg , Thaddäus Till Wissniowski , Karl-Georg Simon , Jonel Trebicka , Rüdiger Behrens , Andreas E. Kremer

Introduction and Objectives

Pruritus is a frequent and burdensome symptom in patients with primary biliary cholangitis (PBC), significantly affecting quality of life. Despite its clinical relevance, data on the prevalence and management, particularly across different levels of healthcare, remain limited. We aimed to assess prevalence, severity, and treatment of pruritus in PBC patients across secondary and tertiary care.

Patients and Methods

Within the German PBC registry, the intensity and management of pruritus were assessed cross-sectionally by treating physicians using a standardized 4-point verbal rating scale (absent, mild, moderate, severe), as well as by analyzing prescribed antipruritic medications.

Results

Pruritus was reported in 23 % (n = 120/515) of patients and classified as mild, moderate, or severe in 59 (49 %), 41 (34 %), and 20 (17 %) cases, respectively. The prevalence of pruritus was 27 % (n = 96/360) for tertiary versus 16 % (n = 24/155) for secondary care (p = 0.006). Moderate or severe pruritus was observed in 13.3 % (n = 48/360) of patients at tertiary centers compared to 8.4 % (n = 13/155) at secondary centers (p = 0.137). Antipruritic therapies were used in only 22.5 % (n = 27/120) patients with pruritus, with bezafibrate being the most frequently prescribed medication (63 %, n = 17/27). Patients with pruritus were more likely to receive antipruritic therapies in tertiary than secondary care: 26 % (n = 25/96) vs. 8 % (n = 2/24) (p = 0.098).

Conclusions

Pruritus in patients with PBC is common and under-treated in the real-world scenario. Assessment and management vary by healthcare level, highlighting the need for standardized care and greater awareness of treatment options across all settings.

简介和目的：瘙痒是原发性胆道胆管炎（PBC）患者常见且令人难以忍受的症状，严重影响生活质量。尽管它具有临床意义，但关于患病率和管理的数据，特别是在不同级别的医疗保健中，仍然有限。我们的目的是评估PBC患者在二级和三级护理中瘙痒的患病率、严重程度和治疗。患者和方法：在德国PBC登记中，治疗医生使用标准化的4点口头评定量表（无、轻度、中度、重度）对瘙痒的强度和管理进行横断面评估，并通过分析处方抗瘙痒药物进行评估。结果：23% （n=120/515）的患者出现瘙痒，分别有59例（49%）、41例（34%）和20例（17%）患者出现轻度、中度和重度瘙痒。三级护理的瘙痒率为27% (n=96/360)，二级护理的瘙痒率为16% (n=24/155) （p=0.006）。三级中心13.3% （n=48/360）的患者出现中度或重度瘙痒，而二级中心为8.4% (n=13/155) （p=0.137）。只有22.5% （n=27/120）的瘙痒患者使用止痒疗法，贝扎布特是最常用的处方药（63%,n=17/27）。瘙痒患者在三级护理中接受止痒治疗的可能性高于二级护理：26% （n=25/96）对8% (n=2/24) （p=0.098）。结论：PBC患者的瘙痒在现实世界中很常见，但治疗不足。评估和管理因医疗保健水平而异，强调需要标准化护理和提高对所有环境中治疗方案的认识。

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引用次数: 0

Outcomes and risk of relapse after living donor and deceased donor liver transplantation for alcohol-associated liver disease 酒精相关性肝病活体供体和死亡供体肝移植术后复发的结果和风险

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2026-01-01 Epub Date: 2025-12-24 DOI: 10.1016/j.aohep.2025.102177

Chloe Huen Wai Choy , Hills King Hei Suen , Tiffany Cho Lam Wong , Miu Yee Chan , Kin Pan Au , Jeff Wing Chiu Dai , James Yan Yue Fung , Tan To Cheung , Albert Chi Yan Chan

Introduction and Objectives

The six-month abstinence rule for alcohol-associated liver disease (ALD) patients may exclude candidates from life-saving transplantation without reliably predicting relapse. We compared outcomes of deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT) in ALD patients, with modified abstinence criteria.

Patients and Methods

ALD patients evaluated for transplantation from 2008–2020 were analyzed. 6-month abstinence was required for DDLT but not for LDLT patients with favorable psychological assessments. Survival analyses were conducted from evaluation i.e., intention-to-treat (ITT) and transplantation. Patients with living donors were categorized as intended for LDLT (ITT-LDLT) and those without as intended for DDLT (ITT-DDLT). Patients who were ineligible for transplantation served as the control group.

Results

Of the 216 ALD patients evaluated, 79 (36.6%) were accepted for transplantation. Five-year ITT survival was superior in the ITT-LDLT group (83.3%) compared to ITT-DDLT (62.6%, P = 0.04) and controls (30.7%, P < 0.001). Among transplant recipients (DDLT n = 34, LDLT n = 20), five-year graft survival was comparable between DDLT and LDLT (79.8% vs 76.5%, P = 0.84) despite only 40% of LDLT patients achieving six-month abstinence. Alcohol relapse rates were comparable between DDLT and LDLT (32.4% vs. 30.0%, P > 0.99). Alcohol dependence (HR=7.32, P < 0.001) and medical non-compliance (HR=4.19, P = 0.007) predicted relapse.

Conclusions

Liver transplantation provided significant survival benefit for carefully selected ALD patients. With comprehensive psychological assessment, patients without psychiatric disorders or compliance issues can achieve excellent outcomes after transplantation.

前言和目的：酒精相关性肝病（ALD）患者的6个月戒酒规则可能会在没有可靠预测复发的情况下将候选患者排除在挽救生命的移植之外。我们比较了ALD患者的死亡供肝移植（DDLT）和活体供肝移植（LDLT）的结果，并修改了禁欲标准。患者和方法：对2008-2020年接受移植评估的ALD患者进行分析。DDLT患者需要禁欲6个月，而心理评价良好的LDLT患者则不需要。生存分析从评估，即意向治疗（ITT）和移植进行。活体供体患者分为LDLT （ITT-LDLT）和DDLT （ITT-DDLT）两组。不适合移植的患者作为对照组。结果：216例ALD患者中，79例（36.6%）接受移植。ITT- ldlt组的5年ITT生存率（83.3%）优于ITT- ddlt组（62.6%，P=0.04）和对照组（30.7%,P0.99）。结论：肝移植为精心挑选的ALD患者提供了显著的生存益处。通过全面的心理评估，没有精神障碍或依从性问题的患者可以在移植后获得良好的预后。

{"title":"Outcomes and risk of relapse after living donor and deceased donor liver transplantation for alcohol-associated liver disease","authors":"Chloe Huen Wai Choy , Hills King Hei Suen , Tiffany Cho Lam Wong , Miu Yee Chan , Kin Pan Au , Jeff Wing Chiu Dai , James Yan Yue Fung , Tan To Cheung , Albert Chi Yan Chan","doi":"10.1016/j.aohep.2025.102177","DOIUrl":"10.1016/j.aohep.2025.102177","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The six-month abstinence rule for alcohol-associated liver disease (ALD) patients may exclude candidates from life-saving transplantation without reliably predicting relapse. We compared outcomes of deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT) in ALD patients, with modified abstinence criteria.</div></div><div><h3>Patients and Methods</h3><div>ALD patients evaluated for transplantation from 2008–2020 were analyzed. 6-month abstinence was required for DDLT but not for LDLT patients with favorable psychological assessments. Survival analyses were conducted from evaluation i.e., intention-to-treat (ITT) and transplantation. Patients with living donors were categorized as intended for LDLT (ITT-LDLT) and those without as intended for DDLT (ITT-DDLT). Patients who were ineligible for transplantation served as the control group.</div></div><div><h3>Results</h3><div>Of the 216 ALD patients evaluated, 79 (36.6%) were accepted for transplantation. Five-year ITT survival was superior in the ITT-LDLT group (83.3%) compared to ITT-DDLT (62.6%, <em>P</em> = 0.04) and controls (30.7%, <em>P</em> < 0.001). Among transplant recipients (DDLT <em>n</em> = 34, LDLT <em>n</em> = 20), five-year graft survival was comparable between DDLT and LDLT (79.8% vs 76.5%, <em>P</em> = 0.84) despite only 40% of LDLT patients achieving six-month abstinence. Alcohol relapse rates were comparable between DDLT and LDLT (32.4% vs. 30.0%, <em>P</em> > 0.99). Alcohol dependence (HR=7.32, <em>P</em> < 0.001) and medical non-compliance (HR=4.19, <em>P</em> = 0.007) predicted relapse.</div></div><div><h3>Conclusions</h3><div>Liver transplantation provided significant survival benefit for carefully selected ALD patients. With comprehensive psychological assessment, patients without psychiatric disorders or compliance issues can achieve excellent outcomes after transplantation.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"31 1","pages":"Article 102177"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843263","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}

引用次数: 0

Comment on “Comparisons of global incidence and risk factor profiles of hepatocellular carcinoma and intrahepatic cholangiocarcinoma” 对“肝细胞癌和肝内胆管癌全球发病率和危险因素的比较”发表评论。

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2026-01-01 Epub Date: 2026-01-14 DOI: 10.1016/j.aohep.2026.102182

Zhiwei Wang, Lujie Xiang, Lingli Ye, Qingjing Ru

引用次数: 0

Comment on “Pancreatic involvement and its prognostic impact in acute-on-chronic liver failure” 对“急性和慢性肝衰竭中胰腺受累及其预后影响”的评论。

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2026-01-01 Epub Date: 2026-01-23 DOI: 10.1016/j.aohep.2026.102191

Yujing Yang, Hailian Zhou

引用次数: 0

Impact of neohepatic albumin-bilirubin scores on renal outcomes following living donor liver transplantation: a propensity score analysis 新肝白蛋白-胆红素评分对活体肝移植后肾脏预后的影响：倾向评分分析。

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2026-01-01 Epub Date: 2025-09-08 DOI: 10.1016/j.aohep.2025.102111

Hye-Won Jeong , Hye-Mee Kwon , Sung-Hoon Kim , Seong-Mi Yang , In-Gu Jun , Jun-Gol Song , Gyu-Sam Hwang

Introduction and Objectives

Acute kidney injury (AKI) after liver transplantation (LT) impacts patient and graft outcomes. The Albumin-Bilirubin (ALBI) score, an objective and sensitive liver function index, may help predict post-LT outcomes. This study evaluated the association between neohepatic ALBI scores and renal outcomes in living donor LT (LDLT) recipients.

Patients and Methods

We examined 2171 adult LDLT recipients between 2012 and 2019. Outcomes included severe post-LT AKI, renal replacement therapy (RRT), chronic kidney disease (CKD) at 1 year, early allograft dysfunction (EAD), and overall graft failure. Multivariate logistic regression, Cox proportional hazards regression, and propensity score matched (PSM) analyses were performed to evaluate the association between neohepatic ALBI and post-LT outcomes.

Results

Severe AKI, RRT, CKD, EAD, and overall graft failure occurred in 21.6%, 2.2%, 41.9%, 5.9%, and 15.8% of patients, respectively. Higher neohepatic ALBI scores (≥-1.615) were significantly associated with severe AKI (OR: 2.34, 95% CI: 1.79–3.04, P<0.001, multivariate analysis; OR: 2.18, 95% CI: 1.62–2.95, P<0.001, PSM analysis), RRT (OR: 3.80, 95% CI: 1.53–11.31, P=0.008, multivariate analysis; OR: 7.17, 95% CI: 1.61–31.89, P=0.010, PSM analysis), CKD (OR: 1.22, 95% CI: 1.00–1.47, P=0.044, multivariate analysis; OR: 1.43, 95% CI: 1.11–1.85, P=0.006, PSM analysis), and overall graft failure (HR: 1.30, 95% CI: 1.01–1.68, P=0.041, multivariate analysis; HR: 1.55, 95% CI: 1.08–2.23, P=0.018, PSM analysis).

Conclusions

Neohepatic ALBI scores are significantly associated with post-LT severe AKI, RRT, CKD, and graft failure, underscoring their prognostic value in LDLT recipients.

简介和目的：肝移植（LT）后急性肾损伤（AKI）影响患者和移植物的预后。白蛋白-胆红素（ALBI）评分是一种客观且敏感的肝功能指数，可能有助于预测肝移植后的预后。本研究评估了活体肝移植（LDLT）受者新肝ALBI评分与肾脏预后之间的关系。患者和方法：我们在2012年至2019年期间检查了2171名成年LDLT受体。结果包括严重的lt后AKI、肾脏替代治疗（RRT）、1年后慢性肾病（CKD）、早期同种异体移植物功能障碍（EAD）和整体移植物衰竭。采用多变量logistic回归、Cox比例风险回归和倾向评分匹配（PSM）分析来评估新肝性ALBI与肝移植后预后之间的关系。结果：严重AKI、RRT、CKD、EAD和整体移植物衰竭发生率分别为21.6%、2.2%、41.9%、5.9%和15.8%。较高的新肝ALBI评分（≥-1.615）与严重AKI显著相关（OR: 2.34, 95% CI: 1.79-3.04）。结论：新肝ALBI评分与lt后严重AKI、RRT、CKD和移植物衰竭显著相关，强调了其在LDLT受体中的预后价值。

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引用次数: 0

Simultaneous physical and nutritional intervention reduces frailty in patients with cirrhosis listed for liver transplantation: a randomized controlled trial 同时进行身体和营养干预可减少肝硬化肝移植患者的虚弱：一项随机对照试验。

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2026-01-01 Epub Date: 2025-09-11 DOI: 10.1016/j.aohep.2025.102114

Carlos Benítez , Diego Reyes , Catalina Grandy , Isidora Thomas , Nicolás Lavados , Nicole Kim , Anny Gálvez , Silvana Valdés , Soledad Contreras , Roberto Candia

Introduction and Objectives

Frailty is associated with an increased morbidity and mortality among patients with cirrhosis. However, no specific treatment strategy has been formally recommended for these patients. This study aims to evaluate the effectiveness of a strategy based on exercise and nutritional intervention improving frailty in cirrhotic patients listed for transplantation.

Patients and Methods

Patients with increased Liver Frailty Index (LFI) (≥3.2) were randomized to a control group (standard exercise and nutritional counseling) or intervention group (guided by physical therapist and dietitian) for 12 weeks, LFI was measured, and patients were classified as frail or prefrail. The change in LFI was assessed at the end of study.

Results

Sixty-six patients were included (34 to the control group and 32 to the intervention group), age 59.3 ± 8.8, male 51.5 %, main etiologies: MASLD (40.9 %), ALD (15.2 %), MetALD (6.1 %), PBC (6.1 %), autoimmune hepatitis (4.5 %), MELD Na 17.2 ± 5, Child Pugh A/B/C 13.6 %/57.6 %/28.8 %, Na 137±3 mEq/L, creatinine 0.8 ± 0.3 mg/dL, bilirubin 3.3 ± 3 mg/dL, INR 1.5 ± 0.4, albumin 3.3 ± 0.5 g/dL, LFI 4.23 ± 0.5, frail/prefrail (%) 34.8/65.2. There was a significant improvement in LFI at the end of the study in the intervention group (ΔLFI 0.4 vs ΔLFI 0.14, p = 0.02). Notably, we found a significant reduction in the proportion of frail patients in the intervention group vs control group (28.1 % vs 8.8 %, p = 0.02) at the end of the study.

Conclusions

This randomized controlled trial conducted in patients listed for liver transplantation demonstrates that a dual intervention can effectively reduce frailty in this population.

简介和目的：虚弱与肝硬化患者发病率和死亡率增加有关。然而，对于这些患者，还没有正式推荐具体的治疗策略。本研究旨在评估基于运动和营养干预的策略在肝硬化移植患者中改善虚弱的有效性。患者和方法：肝脆弱指数（LFI）升高（≥3.2）的患者随机分为对照组（标准运动和营养咨询）或干预组（由物理治疗师和营养师指导），为期12周，测量LFI，并将患者分为虚弱或虚弱前期。在研究结束时评估LFI的变化。结果：纳入66例患者（对照组34例，干预组32例），年龄59.3±8.8岁，男性51.5%，主要病因：MASLD（40.9%）、ALD（15.2%）、MetALD（6.1%）、PBC（6.1%）、自身免疫性肝炎（4.5%）、MELD Na 17.2±5、Child Pugh A/B/C 13.6%/57.6%/28.8%、Na 137±3mEq/L、肌酐0.8±0.3 mg/dL、胆红素3.3±3 mg/dL、INR 1.5±0.4、白蛋白3.3±0.5 g/dL、LFI 4.23±0.5、体弱/体弱（%）34.8/65.2。干预组在研究结束时LFI有显著改善（ΔLFI 0.4 vs ΔLFI 0.14, p=0.02）。值得注意的是，在研究结束时，我们发现干预组中虚弱患者的比例明显低于对照组（28.1% vs 8.8%, p=0.02）。结论：这项在肝移植患者中进行的随机对照试验表明，双重干预可以有效地减少这一人群的脆弱性。

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引用次数: 0

Effects of artificial liver support systems on nosocomial infections and mortality in non-transplanted liver failure patients 人工肝支持系统对非移植性肝衰竭患者院内感染和死亡率的影响。

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2026-01-01 Epub Date: 2025-09-09 DOI: 10.1016/j.aohep.2025.102113

Yuan Li , Xiaoting Wang , Junkai Fan, Jiale Xie, Huimin Liu, Chunrong Ping, Zhijie Feng, Yan Wang

Introduction and Objectives

Artificial liver support systems (ALSS) offer a technical solution for patients with liver failure (LF), serving as a bridge to recovery or transplantation. However, the number of LF patients eligible for transplants is limited. This study investigates the incidence of nosocomial infections and survival outcomes in LF patients treated with ALSS who do not undergo liver transplantation.

Patients and Methods

A retrospective cohort study was conducted on LF patients receiving standard medical care (SMC) with ALSS versus those treated only with SMC. General and laboratory data were collected from all LF patients. A logistic regression model was used to assess the risk of nosocomial infections associated with ALSS use, while a Cox proportional hazards model was used to evaluate mortality risk in LF patients undergoing ALSS treatment. Survival times for both groups were calculated using Kaplan–Meier analysis.

Results

A total of 306 LF patients were analyzed, comprising 200 males (65.4%) and 106 females (34.6%), with an average age of 49.9 years (95% CI = 48.2-51.6). Multivariate logistic regression analysis showed that ALSS was not linked to the risk of nosocomial infections (odds ratio =1.189, 95%CI=0.442-3.202, p=0.732). However, hazard ratio (HR) results indicated that ALSS is a protective factor for survival in LF patients (HR=0.533, 95%CI=0.374-0.760, p=0.001), supported by Kaplan–Meier curve analysis demonstrating prolonged survival time in the ALSS group among LF patients.

Conclusions

ALSS is not an independent risk factor for nosocomial infections and could effectively prolong the lifespan of LF patients without liver transplantation. Further intervention studies are needed to validate these findings.

简介和目的：人工肝支持系统（ALSS）为肝功能衰竭（LF）患者提供了一种技术解决方案，可作为恢复或移植的桥梁。然而，适合移植的LF患者数量有限。本研究调查了不接受肝移植的接受ALSS治疗的LF患者的医院感染发生率和生存结局。患者和方法：对接受标准医疗护理（SMC）联合ALSS治疗的LF患者与仅接受SMC治疗的LF患者进行了回顾性队列研究。收集所有LF患者的一般和实验室数据。采用logistic回归模型评估与ALSS使用相关的医院感染风险，采用Cox比例风险模型评估接受ALSS治疗的LF患者的死亡风险。采用Kaplan-Meier分析计算两组患者的生存时间。结果：共分析LF患者306例，其中男性200例（65.4%），女性106例（34.6%），平均年龄49.9岁（95% CI = 48.2-51.6）。多因素logistic回归分析显示，ALSS与院内感染风险无关（优势比=1.189,95%CI=0.442 ~ 3.202, p=0.732）。然而，风险比（HR）结果显示，ALSS是LF患者生存的保护因素（HR=0.533, 95%CI=0.374-0.760, p=0.001）， Kaplan-Meier曲线分析支持ALSS组在LF患者中延长生存时间。结论：ALSS不是院内感染的独立危险因素，可有效延长非肝移植的LF患者的生存期。需要进一步的干预研究来验证这些发现。

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引用次数: 0

Drug-induced liver injury: a real-world pharmacovigilance study using the FDA Adverse Event Reporting System database (2004–2024) 药物性肝损伤：使用FDA不良事件报告系统数据库2004-2024的真实世界药物警戒研究

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2026-01-01 Epub Date: 2025-11-15 DOI: 10.1016/j.aohep.2025.102156

Dongxuan Li , Duan Wang , Guili Huang , Qinglong Liu , Yalan Wang , Rui Zhang , Songqing Liu , Qian Du

Introduction and Objectives

Timely identification and discontinuation of culprit-drug is the cornerstone in managing drug-induced liver injury (DILI), and this study aims to thoroughly investigate the potential hepatotoxic drugs by using the FDA Adverse Event Reporting System (FAERS) database.

Materials and Methods

DILI-related reports in the FAERS database between 2004 and 2024 were used to compile a reported culprit-drug list, and the single drug and drug class with the highest reporting frequency were counted accordingly. The disproportionality analysis was used to assess the DILI risk of each reported culprit-drug.

Results

236,918 DILI-related reports were submitted to the FAERS database between 2004 and 2024, in which 1459 drugs were reported as culprit-drug. Paracetamol is the most frequently reported single drug, while antineoplastic agents are the most frequently reported drug class. 806 of 1459 drugs showed positive signals in disproportionality analysis, among which vorasidenib is the drug with the highest signal strength, followed by floxuridine, pyrazinamide, delandistrogene moxeparvovec, and isoniazid. In the distribution analysis of positive signal drugs, antineoplastic agents have the largest number of positive drugs and occupy a dominant position among high-risk level drugs.

Conclusions

Our study summarized a reported culprit-drug list of DILI by comprehensively reviewing the liver injury-related reports in the FAERS database, and highlighted the prominent position of antineoplastic agents in reporting frequency, risk signal strength ranking, number of positive signal drugs, and high-risk drug distribution, suggesting that we may need to pay more attention to the liver injury risk of antineoplastic agents in clinical practice.

前言和目的：及时识别和停药是治疗药物性肝损伤（DILI）的基础，本研究旨在通过FDA不良事件报告系统（FAERS）数据库全面调查潜在的肝毒性药物。材料与方法：采用FAERS数据库中2004 - 2024年dili相关报告编制报告的元凶-药物清单，并对报告频次最高的单一药物和药物类别进行统计。歧化分析用于评估每种报告的罪魁祸首药物的DILI风险。结果：2004 - 2024年FAERS数据库共收到与dili相关的报告236918份，其中1459种药物被报告为罪魁祸首药物。扑热息痛是最常报道的单一药物，而抗肿瘤药物是最常报道的药物类别。1459种药物中有806种在歧化分析中显示阳性信号，其中沃拉西尼是信号强度最高的药物，其次是氟尿定、吡嗪酰胺、德兰异构体莫舍帕韦克和异烟肼。在阳性信号药物分布分析中，抗肿瘤药物阳性药物数量最多，在高危水平药物中占主导地位。结论：我们的研究通过对FAERS数据库中肝损伤相关报告的综合梳理，总结出了DILI报告的罪魁药物清单，并强调了抗肿瘤药物在报告频次、风险信号强度排序、阳性信号药物数量、高危药物分布等方面的突出地位，提示我们在临床实践中可能需要更加重视抗肿瘤药物的肝损伤风险。

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引用次数: 0

Antibiotic consumption, genetic risk and incidence of metabolic dysfunction-associated steatotic liver disease: a prospective cohort study 抗生素消费、遗传风险和代谢功能障碍相关脂肪变性肝病的发病率：一项前瞻性队列研究

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2026-01-01 Epub Date: 2025-10-10 DOI: 10.1016/j.aohep.2025.102136

Ziming Zheng , Yumei Huang , Jijuan Zhang , Jinchi Xie , An Pan , Yunfei Liao , Yu Zhang

Introduction and Objectives

The association between antibiotic consumption and the risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD) remains ambiguous. This study aimed to investigate this relationship within a large prospective cohort from the UK Biobank.

Patients and Methods

We conducted a prospective cohort study of 143,279 adults aged 40 to 70 years, among whom 1477 were diagnosed with MASLD for the first time. Multivariate Cox proportional hazards regression models were employed to assess the data. The genetic risk score (GRS) for MASLD was derived from five single-nucleotide variants, and mediation analysis was performed to evaluate the role of metabolic syndrome (MetS).

Results

Our findings demonstrated that individuals with antibiotic exposure during childhood or adolescence exhibited a significantly higher risk of developing MASLD compared to those without antibiotic exposure (P < 0.001, HR 1.39; 95 % CI 1.21–1.59). No significant interaction was observed between antibiotic consumption and genetic predisposition for MASLD. Mediation analysis revealed that MetS and central obesity accounted for 21.98 % and 13.55 % of the association between early-life antibiotic exposure and MASLD, respectively (P < 0.001), particularly in women (P for interaction = 0.031).

Conclusions

Long-term antibiotic exposure in early life was significantly associated with a higher risk of developing MASLD, and this association persisted after adjustment for genetic predisposition factors.

前言和目的：抗生素消费与发生代谢功能障碍相关脂肪变性肝病（MASLD）的风险之间的关系仍然不明确。这项研究的目的是在英国生物银行的一个大型前瞻性队列中调查这种关系。患者和方法：我们对143,279名年龄在40至70岁之间的成年人进行了一项前瞻性队列研究，其中1,477名首次诊断为MASLD。采用多变量Cox比例风险回归模型对数据进行评估。MASLD的遗传风险评分（GRS）来自5个单核苷酸变异，并进行中介分析以评估代谢综合征（MetS）的作用。结果：我们的研究结果表明，在儿童或青少年时期接触抗生素的个体与没有接触抗生素的个体相比，患MASLD的风险明显更高（P < 0.001, HR 1.39; 95% CI 1.21-1.59）。抗生素的使用和MASLD的遗传易感性之间没有明显的相互作用。中介分析显示，met和中心性肥胖分别占早期抗生素暴露与MASLD之间关联的21.98%和13.55% (P < 0.001)，特别是在女性中（相互作用P = 0.031）。结论：早期长期抗生素暴露与发生MASLD的高风险显着相关，并且在调整遗传易感性因素后这种关联仍然存在。

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引用次数: 0

Toward standardization and translation of stem cell therapy in liver failure 肝衰竭干细胞治疗的规范化和转化。

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology

Pub Date : 2026-01-01 Epub Date: 2025-11-26 DOI: 10.1016/j.aohep.2025.102164

Parth Aphale , Himanshu Shekhar , Shashank Dokania

引用次数: 0