Journal of Hepatology

Check our September issue! This month's cover features the article "Comparison of non-contrast abbreviated MRI and ultrasound as surveillance modalities for HCC" by Dong Hwan Kim, Jeong Hee Yoon et al. (https://bit.ly/3yJhR8Z) Full issue here: https://bit.ly/36khmDF EASL | The Home of Hepatology

Enhancing Early HCC Detection: Alternating MRI and Ultrasound Outperforms Biannual Ultrasound Ultrasound (US) is commonly used for hepatocellular carcinoma (HCC) surveillance but is less effective in detecting early-stage HCC. This study, compared biannual US with annual non-contrast abbreviated magnetic resonance imaging (NC-AMRI) for HCC detection in high-risk patients. Their study found that NC-AMRI had higher sensitivity (71.0%) and diagnostic yield (4.26%) compared to biannual US (45.2% sensitivity, 1.43% yield). Alternating US and NC-AMRI every 6 months achieved the highest sensitivity (83.9%), suggesting this combined approach is optimal for surveillance. Full text here: https://bit.ly/3yJhR8Z EASL | The Home of Hepatology

✴ Hepatology Snapshot ✴ The liver in haematologic oncologic disorders By Guilherme Cançado, Maya Deeb, David Dodington & Gideon Hirschfield EASL | The Home of Hepatology

Transforming Liver Transplants: A UK Scheme to Enhance Transparency, Equity, and Survival The National Liver Offering Scheme (NLOS) was introduced in the UK in 2018 to enhance transparency, equity, and survival in liver transplants by replacing the geographically based system with a transplant benefit score (TBS). This study, demonstrates that, in its first two years, 68% of livers were allocated using TBS, significantly reducing waiting list mortality while preserving post-transplant survival, marking a significant advancement in organ allocation strategies. Find it here: https://bit.ly/3APysZq EASL | The Home of Hepatology

FGF21 agonists: An emerging therapeutic for metabolic dysfunction-associated steatohepatitis and beyond The worldwide epidemics of obesity, hypertriglyceridemia, dyslipidaemia, type 2 diabetes, and metabolic dysfunction-associated steatotic liver disease (MASLD)/metabolic dysfunction-associated steatohepatitis (MASH) represent a major economic burden on healthcare systems. Patients with at-risk MASH, defined as MASH with moderate or significant fibrosis, are at higher risk of comorbidity/mortality, with a significant risk of cardiovascular diseases and/or major adverse liver outcomes. Despite a high unmet medical need, there is only one drug approved for MASH. Several drug candidates have reached the phase III development stage and could lead to several potential conditional drug approvals in the coming years. Within the armamentarium of future treatment options, FGF21 analogues hold an interesting position thanks to their pleiotropic effects in addition to their significant effect on both MASH resolution and fibrosis improvement. In this review, we summarise preclinical and clinical data from FGF21 analogues for MASH and explore additional potential therapeutic indications. Review by Julie Dubourg et al. Find it here: https://bit.ly/3yZOXl5 EASL | The Home of Hepatology

New Insights into the Crucial Role of CFTR in the Gut-Liver Axis Cystic fibrosis-related liver disease (CFLD) significantly affects morbidity and mortality, with limited treatment options due to its unclear pathobiology. This study, examined CFLD using CFTR-knockout (CFTR-KO) mice, which exhibited liver damage, gut dysbiosis and increased permeability. In contrast, gut-corrected CFTR-KO mice showed no such abnormalities. Single-cell RNA sequencing revealed elevated inflammation in CFTR-KO livers. Treating CFTR-KO mice with nonabsorbable antibiotics improved symptoms, and fecal microbiota transfer did not induce liver issues, suggesting that targeting CFTR or modifying the microbiota could offer new treatment strategies. Find it here: https://bit.ly/3AWlqJo EASL | The Home of Hepatology

Angiocrine signaling in sinusoidal homeostasis and liver diseases The hepatic sinusoids are composed of liver sinusoidal endothelial cells (LSECs), which are surrounded by hepatic stellate cells (HSCs) and contain liver-resident macrophages called Kupffer cells, and other patrolling immune cells. All these cells communicate with each other and with hepatocytes to maintain sinusoidal homeostasis and a spectrum of hepatic functions under healthy conditions. Sinusoidal homeostasis is disrupted by metabolites, toxins, viruses, and other pathological factors, leading to liver injury, chronic liver diseases, and cirrhosis. Alterations in hepatic sinusoids are linked to fibrosis progression and portal hypertension. LSECs are crucial regulators of cellular crosstalk within their microenvironment via angiocrine signaling. This review discusses the mechanisms by which angiocrine signaling orchestrates sinusoidal homeostasis, as well as the development of liver diseases. Here, we summarise the crosstalk between LSECs, HSCs, hepatocytes, cholangiocytes, and immune cells in health and disease and comment on potential novel therapeutic methods for treating liver diseases. Full review here: https://bit.ly/4gd5aUz EASL | The Home of Hepatology

Genetics meets diet: unveiling how personalized nutrition may impacts steatotic siver disease Steatotic liver disease (SLD) is affected by genetics and diet. This study, analyzed data from 21,619 UK Biobank participants, examining dietary patterns, genetic variants (PNPLA3-rs738409-G, TM6SF2-rs58542926-T), and a hepatic steatosis polygenic risk score (PRS). They found that a Mediterranean diet and high intake of fruits, vegetables, and legumes were linked to lower liver fat content (LFC), while higher red/processed meat intake and genetic factors were associated with higher LFC. Dietary impacts were more pronounced in those with higher genetic risk, suggesting personalized dietary counseling could be especially beneficial. Find it here: https://bit.ly/4g1bGOa EASL | The Home of Hepatology

WHAT IS YOUR DIAGNOSIS ❓ A 47-year-old overweight woman (BMI 29) was evaluated for elevated transaminases (AST 146 IU/L , ALT 170 IU/L, normal GGT & AP). Current medication nimesulide. Previous DILI (5 years ago) attributed to amoxicillin-clavulanate. ANA 1/160, HbsAg and anti-HCV negative. 👨🔬A liver biopsy was performed. 🤔What is your diagnosis? 1️⃣ Drug-induced liver injury 2️⃣ Alcohol-related liver disease 3️⃣ Autoimmune hepatitis 4️⃣ Metabolic dysfunction-associated steatotic liver disease Full case here👉https://bit.ly/3ANgQ05 EASL | The Home of Hepatology

Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD)❕ ✔ This joint EASL-EASD-EASO guideline provides an update on definitions, prevention, screening, diagnosis and treatment for MASLD. Find the full text here 👉 https://bit.ly/3XeJnFc EASL | The Home of Hepatology