Research Priorities for Precision Medicine in NAFLD
NAFLD is a multisystem condition and the leading cause of chronic liver disease globally. There are no approved NAFLD-specific dugs. To advance in the prevention and treatment of NAFLD, there is a clear need to better understand the pathophysiology and genetic and environmental risk factors, identify subphenotypes, and develop personalized and precision medicine. In this review, we discuss the main NAFLD research priorities, with a particular focus on socioeconomic factors, interindividual variations, limitations of current NAFLD clinical trials, multidisciplinary models of care, and novel approaches in the management of p...
Source: Clinics in Liver Disease - February 26, 2023 Category: Gastroenterology Authors: Paula Iruzubieta, Ramon Bataller, Mar ía Teresa Arias-Loste, Marco Arrese, José Luis Calleja, Graciela Castro-Narro, Kenneth Cusi, John F. Dillon, María Luz Martínez-Chantar, Miguel Mateo, Antonio Pérez, Mary E. Rinella, Manuel Romero-Gómez, Jörn M Source Type: research
Role of Liver Biopsy in Clinical Trials and Clinical Management of Nonalcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis constitute a spectrum of histologic lesions characterized by varying degrees of hepatocellular injury and fat accumulation with inflammation and scarring. Fibrosis associated with this disease may progress to cirrhosis and its complications. As there are no approved therapies, clinical trials to assess potential forms of drug therapy are conducted to assess drugs for efficacy and safety before submission to regulatory review. Liver biopsies are performed and evaluated to confirm the diagnosis of nonalcoholic steatohepatitis and to assess fibrosis stage for i...
Source: Clinics in Liver Disease - February 26, 2023 Category: Gastroenterology Authors: Zachary D. Goodman Source Type: research
Extrahepatic Outcomes of Nonalcoholic Fatty Liver Disease
Patients with nonalcoholic fatty liver disease (NAFLD) are at high risk of cardiovascular disease, including carotid atherosclerosis, coronary artery disease, heart failure, and arrhythmias. The risk is partially due to shared risk factors, but it may vary according to liver injury. A fatty liver may induce an atherogenic profile, the local necro-inflammatory changes of nonalcoholic steatohepatitis may enhance systemic metabolic inflammation, and fibrogenesis can run parallel in the liver and in the myocardium and precedes heart failure. The detrimental impact of a Western diet combines with polymorphisms in genes associat...
Source: Clinics in Liver Disease - February 26, 2023 Category: Gastroenterology Authors: Angelo Armandi, Elisabetta Bugianesi Source Type: research
Consultations in Liver Disease
CLINICS IN LIVER DISEASE (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 16, 2022 Category: Gastroenterology Authors: Steven L. Flamm Source Type: research
Copyright
Elsevier (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 16, 2022 Category: Gastroenterology Source Type: research
Contributors
NORMAN GITLIN, MD, FRCP (LONDON), FRCPE (EDINBURGH), FAASLD, FACP, FACG (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 16, 2022 Category: Gastroenterology Source Type: research
Contents
Steven L. Flamm (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 16, 2022 Category: Gastroenterology Source Type: research
Forthcoming Issues
Update on Non-Alcoholic Steatohepatitis (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 16, 2022 Category: Gastroenterology Source Type: research
Autoantibodies in Primary Biliary Cholangitis
Primary biliary cholangitis (PBC) is a chronic immune-mediated liver disease characterized by a lymphocytic cholangitis, with subsequent cholestasis, progressive liver fibrosis, and ultimately complications arising from end-stage liver disease. Testing for autoantibodies is important in the diagnosis of PBC, as well as stratifying prognosis. This review focuses on the role of autoantibodies in the diagnosis of PBC, as well as the relationship between autoantibodies with pathophysiology and prognostication, along with a discussion regarding novel and other related disease autoantibodies. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - October 19, 2022 Category: Gastroenterology Authors: Kristel K. Leung, Gideon M. Hirschfield Source Type: research
Evaluation and Management of Pruritus in Primary Biliary Cholangitis
Chronic pruritus is a classic symptom in patients with primary biliary cholangitis. It affects up to two-thirds of patients in the course of the disease. Efficient therapy consists of topical treatment combined with systemic options such as anion exchangers, rifampicin, bezafibrate, μ-opioid receptor antagonists, selective-serotonin receptor uptake inhibitors, and gabapentinoids. Future therapeutic approaches may contain the selective blockade of the enterohepatic cycle by inhibiting the ileal bile acid transporter, the agonism at κ-opioid receptors, and antagonism of the mas -related G protein–coupled receptor X4. As ...
Source: Clinics in Liver Disease - October 19, 2022 Category: Gastroenterology Authors: Miriam M. D üll, Andreas E. Kremer Source Type: research
Noninvasive Evaluation of Fibrosis and Portal Hypertension in Primary Biliary Cholangitis
Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease that, if left untreated or insufficiently treated, inexorably progresses toward cirrhosis and its potentially fatal complications. Alongside with the biochemical response to ursodeoxycholic acid therapy, advanced liver fibrosis and portal hypertension (PH) were shown to be major prognostic determinants in PBC. Therefore, one of the goals of noninvasive PBC evaluation should be to early diagnose compensated advanced disease and/or clinically significant PH. In this article, the main methods of noninvasive assessment of liver fibrosis and PH in PBC, and...
Source: Clinics in Liver Disease - October 19, 2022 Category: Gastroenterology Authors: Christophe Corpechot Source Type: research
Hepatocellular Carcinoma in Primary Biliary Cholangitis
Hepatocellular carcinoma (HCC) is potentially fatal complication affecting patients with primary biliary cholangitis (PBC). The incidence of HCC is 13 per 1000 person-years in patients with PBC cirrhosis, but much lower at 2.7 per 1000 person-years among patients with PBC without cirrhosis. Risk factors for the development of HCC in PBC include the presence of advanced fibrosis or cirrhosis and male sex, with some studies suggesting that treatment with ursodeoxycholic acid (UDCA) and UDCA response may reduce risk. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - October 19, 2022 Category: Gastroenterology Authors: Alexander M. Sy, Raphaella D. Ferreira, Binu V. John Source Type: research
Liver Transplantation for Primary Biliary Cholangitis
Despite a significant increase in the total number of liver transplants (LTs) performed over the last 3 decades, primary biliary cholangitis (PBC) has become an uncommon indication for LT, which likely reflects the benefits of earlier diagnosis and available treatment, such as ursodeoxycholic acid (UDCA). Nonetheless, LT remains the only cure for patients with progressive PBC despite medical therapy with survival rates that are among the highest of all indications for LT. Post-LT PBC patients, however, are at increased risk of rejection and disease recurrence. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - October 19, 2022 Category: Gastroenterology Authors: Eric F. Martin Source Type: research
Primary Biliary Cholangitis
CLINICS IN LIVER DISEASE (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - October 19, 2022 Category: Gastroenterology Authors: BINU V. JOHN Source Type: research
Copyright
Elsevier (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - October 19, 2022 Category: Gastroenterology Source Type: research
