Effect of Hypertension on Long-term Adverse Clinical Outcomes and Liver Fibrosis Progression in MASLD.

Background & Aims: Hypertension is common in metabolic dysfunction-associated steatotic liver disease (MASLD), but its impact on long-term clinical outcomes and disease progression remains unclear. This study investigated the association of hypertension and risk of adverse clinical outcomes and progression of liver stiffness/fibrosis in MASLD.

Methods: Three multicenter prospective cohorts were analyzed: the UK BioBank (UKBB) cohort to assess the risk of adverse clinical outcomes, the VCTE-Prognosis cohort to assess liver stiffness/fibrosis progression, and the Paired Liver Biopsy cohort to assess histologic liver fibrosis progression.

[Acute pancreatitis: Progress through Restraint?].

Acute pancreatitis (AP) is a potentially life-threatening disease, often progressing in 2 phases: initial sterile inflammation, followed by later infected necrosis. Advances in care have shifted management toward a minimally invasive, step-up approach. AP is diagnosed based on typical abdominal pain, elevated lipase, or characteristic imaging - amylase is no longer essential.

Efficacy and safety of ervogastat alone and in combination with clesacostat in patients with biopsy-confirmed metabolic dysfunction-associated steatohepatitis and F2-F3 fibrosis (MIRNA): results from a phase 2, randomised, double-blind, double-dummy study.

Background: Ervogastat, a diacylglycerol acyltransferase 2 (DGAT2) inhibitor, and clesacostat, an acetyl-coenzyme A carboxylase (ACC) inhibitor, have shown promise in reducing hepatic steatosis. Increased circulating triglycerides, a mechanistic consequence of ACC inhibitors, has been shown to be downregulated by DGAT2 inhibitor co-administration. We assessed the efficacy and safety of ervogastat alone and ervogastat plus clesacostat in adults with biopsy-confirmed metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis stage 2 or 3.

Machine learning based CAGIB score predicts in-hospital mortality of cirrhotic patients with acute gastrointestinal bleeding.

Acute gastrointestinal bleeding (AGIB) is a potentially lethal complication in cirrhosis. In this prospective international multi-center study, the performance of CAGIB score for predicting the risk of in-hospital death in 2467 cirrhotic patients with AGIB was validated. Machine learning (ML) models were established based on CAGIB components, and their area under curves (AUCs) were calculated and compared.

Emerging Trends in Patients Hospitalised With Cirrhosis-Aetiologies, Complications and Outcomes Compared to Other Chronic Health Conditions.

Background: The aetiologies, complications and overall burden of cirrhosis have undergone changes in recent years.

Aims: This study aimed to assess the emerging trends in cirrhosis and its complications whilst also comparing them to other major chronic health conditions.

Methods: This retrospective study covering 2011-2022 was conducted at the Charité University Hospital Berlin and University Hospital Leipzig (validation cohort), Germany.

Antifibrotic therapies for metabolic dysfunction-associated steatotic liver disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects more than a quarter of the adult population worldwide. MASLD can progress to metabolic dysfunction-associated steatohepatitis (MASH), which is associated with increased risk of progression to liver fibrosis, cirrhosis and hepatocellular carcinoma, as well as cardiovascular complications. The pathogenesis of MASLD is complex and initiated by altered metabolic signalling circuits between the adipose tissue, muscle, gut and liver.

Systemic immune response induced by radiofrequency ablation versus microwave ablation at varying powers in murine models of hepatocellular carcinoma.

Background: Thermal ablation for orthotopic tumors can activate the immune system, eliciting tumor-specific immune responses. With the recognition of the immune system's role in cancer outcomes and the demand for effective immunotherapies, there is a clinical need to optimize ablation techniques to enhance anti-tumor immunity. This study evaluates the effects of microwave ablation (MWA) and radiofrequency ablation (RFA) at varying powers and durations on systemic T cell profiles and cytokine levels.

A call for doubling the diagnostic rate of at-risk metabolic dysfunction-associated steatohepatitis.

Metabolic dysfunction-associated steatohepatitis (MASH) is an increasingly important contributor to morbidity and mortality. Little emphasis has been placed on its timely diagnosis and interventions to prevent adverse disease outcomes. The principal determinant of MASH outcomes is the liver fibrosis stage.

Metabolic Dysfunction-Associated Steatohepatitis Diagnosis and Management in Germany: Insights From an Expert Consensus Panel.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease. Metabolic dysfunction-associated steatohepatitis (MASH), a progressive form of MASLD, can lead to fibrosis and cirrhosis. The incidence and burden of MASH in Germany are expected to double by 2030, while diagnostic and management challenges persist.

Correction: Protein carbamylation in atherosclerotic plaques correlates with uremia and disease progression, localizing predominantly to foam cells.

[This corrects the article DOI: 10.3389/fimmu.2025.

Late Onset of Pseudoachalasia in Anti-Hu-Associated Syndrome.

Pseudoachalasia is a rare manifestation of anti-Hu-associated syndrome. We present the case of a 61-year-old female patient presenting primarily with progressive pain and sensory disturbance of all limbs. Neurological symptoms progressed after the primary treatment response and onconeural anti-Hu-antibodies were tested positive, which is often a surrogate to paraneoplastic syndrome.

Concordance between single-slice abdominal computed tomography-based and bioelectrical impedance-based analysis of body composition in a prospective study.

Objectives: Body composition analysis (BCA) is a recognized indicator of patient frailty. Apart from the established bioelectrical impedance analysis (BIA), computed tomography (CT)-derived BCA is being increasingly explored. The aim of this prospective study was to directly compare BCA obtained from BIA and CT.

Liver biopsy and acute hepatology in intensive care unit patients.

Introduction: Besides hepatic impairment in critical illness and sepsis, patients with specific liver diseases such as acute liver failure (ALF), alcohol-associated hepatitis (AAH), liver cirrhosis with acute decompensation or acute-on-chronic liver failure (ACLF) regularly requires management in intensive care. Uncertainties exist, if and when liver biopsy is needed for diagnosis and treatment at the intensive care unit (ICU).

Areas Covered: We review the role of liver biopsy in the diagnostic workup of liver dysfunction and organ failure at the ICU.

Key takeaways from the updated multidisciplinary European MASLD guidelines.

The new European clinical practice guidelines from three scientific societies (European Association for the Study of the Liver, European Association for the Study of Diabetes and European Association for the Study of Obesity) on the management of metabolic dysfunction-associated steatotic liver disease (MASLD) provide detailed recommendations on diagnosis, risk stratification, monitoring strategies, treatment and prevention. Lifestyle interventions (eg, weight reduction, Mediterranean diet, exercise, alcohol abstinence) and the treatment of cardiometabolic risk factors continue to be the mainstay of treatment and prevention of the disease. Incretin mimetics that are approved to treat obesity and/or type 2 diabetes such as semaglutide and tirzepatide have benefits for ameliorating metabolic dysfunction-associated steatohepatitis (MASH).

Protein carbamylation in atherosclerotic plaques correlates with uremia and disease progression, localizing predominantly to foam cells.

Introduction: Carbamylation is a non-enzymatic post-translational protein modification common in patients with uremia that causes pro-atherogenic alterations in plasma proteins. It is abundantly present in late-stage atherosclerotic plaques; however, the pathogenic relevance and functional consequences of this accumulation are not known.

Methods: Human atherosclerotic plaque tissue samples were stratified by plaques' stage and kidney function.

Immunopathogenic mechanisms and immunoregulatory therapies in MASLD.

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), is the most prevalent chronic liver disease worldwide, with an estimated global prevalence of approximately 30%; however, effective pharmacotherapies are still limited due to its complex pathogenesis and etiology. Therefore, a more thorough understanding of disease pathogenesis is urgently needed. An increasing number of studies suggest that MASLD and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), are driven by chronic overnutrition, multiple genetic susceptibility factors, and pathogenic consequences, including hepatocyte damage and liver inflammation.

Prospects of Mendelian Randomization in Hepatology: A Comprehensive Literature Review with Practice Guidance Mendelian randomization and hepatology.

Mendelian randomization (MR), a powerful statistical tool for causal inference, has been widely applied in various fields of medical research, even extending to economics and psychology. In hepatology, MR has been utilized to identify risk factors and potential therapeutic targets for liver diseases, including metabolic dysfunction-associated steatotic liver disease, cholestatic and autoimmune liver diseases or hepatobiliary cancer. MR can provide evidence of causation via associations between genetic variants, modifiable exposures and liver disease occurrence or outcomes, using large existing datasets.

Bariatric surgery for metabolic dysfunction-associated steatotic liver disease (MASLD): Current knowledge of mechanisms.

Metabolic dysfunction-associated steatotic liver diseases (MASLDs) encompass a spectrum of liver disorders primarily defined by hepatic steatosis and cardiometabolic risk factors. MASLD affects over 30% of the global adult population, representing a substantial risk for public health. MASLD can progress from simple steatosis to steatohepatitis (termed MASH), marked by inflammation and fibrosis, potentially leading to cirrhosis and liver cancer.

[Diagnostic and therapeutic management of MASLD].

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed fatty liver, is closely associated with insulin resistance, obesity and cardiometabolic risk factors. It is the most common cause of liver cirrhosis and hepatocellular carcinoma and is associated with a significantly increased risk of cardiovascular events. With a global prevalence of 25-35%, it represents a growing socioeconomic burden.

Small intestinal neuroendocrine tumors lack early genomic drivers, acquire DNA repair defects and harbor hallmarks of low REST expression.

The tumorigenesis of small intestinal neuroendocrine tumors (siNETs) is not understood and comprehensive genomic and transcriptomic data sets are limited. Therefore, we performed whole genome and transcriptome analysis of 39 well differentiated siNET samples. Our genomic data revealed a lack of recurrent driver mutations and demonstrated that multifocal siNETs from individual patients can arise genetically independently.

Correlation between ultrasound-based hepatic steatosis grade and thyroid hormone levels.

Background: Thyroid hormones impact on metabolic homeostasis, and low thyroid hormone levels, both systemically and hepatically, have been linked to hepatic steatosis. However, prior studies in this area often lacked quantification of steatosis. Ultrasound attenuation analysis (USAT) is a novel imaging technique for hepatic steatosis detection based on the attenuation coefficient.

Reviewing the function of macrophages in liver disease.

Introduction: The liver is a central metabolic organ, but is also hosting a unique immune microenvironment to sustain homeostasis and proper defense measures against injury threats in healthy individuals. Liver macrophages, mostly represented by the tissue-resident Kupffer cells and bone marrow- or monocyte-derived macrophages, are intricately involved in various aspects of liver homeostasis and disease, including tissue injury, inflammation, fibrogenesis and repair mechanisms.

Areas Covered: We review recent findings on defining the liver macrophage landscape and their functions in liver diseases with the aim of highlighting potential targets for therapeutic interventions.