Hepatocellular carcinoma surveillance after hepatitis C virus eradication: Is liver stiffness measurement more useful than laboratory fibrosis markers?
We read with great interest the article by M. Pons and colleagues in which they estimated the incidence of liver-related events and predictive ability of non-invasive markers of liver fibrosis after successful antiviral therapy for HCV infection.1 In this prospective 2 center study from Spain, including patients with HCV-related compensated advanced chronic liver disease (liver stiffness (LS) ≥10 kPa), hepatocellular carcinoma (HCC) developed in 4.4% (25/572) of cases within 2.8 years of the end of treatment (EOT). (Source: Journal of Hepatology)
Source: Journal of Hepatology - June 1, 2020 Category: Gastroenterology Authors: Ekaterina Nabatchikova, Dzhamal Abdurakhmanov, Teona Rozina, Elena Nikulkina, Elena Tanaschuk, Sergey Moiseev Tags: Letter to the Editor Source Type: research

Reply to: “Hepatocellular carcinoma surveillance after hepatitis C virus eradication: Is liver stiffness measurement more useful than laboratory fibrosis markers?” and “External validation of noninvasive predictors of hepatocellular carcinoma in patients with HCV advanced chronic liver disease after ora l antivirals”
We thank Nabatchikova et  al.1 and Shiba et al.2 for their interest and comments on our work.3 First, we would like to explain that the main reason for predicting an event (hepatocellular carcinoma [HCC] in this case) is to guide future action (for example HCC screening). In our study, our initial aim was to identify a su bpopulation of patients with compensated advanced chronic liver disease (cACLD), in whom HCV had been cured, who could avoid HCC surveillance; unfortunately, we failed. All HCV-cured patients with cACLD need continued HCC screening. (Source: Journal of Hepatology)
Source: Journal of Hepatology - June 1, 2020 Category: Gastroenterology Authors: Joan Genesc à Tags: Letter to the Editor Source Type: research

Effective medical treatments for PSC needed ASAP - is AESOP the answer?
Currently available pharmacological strategies for primary sclerosing cholangitis (PSC) have limited efficacy and novel therapies are eagerly awaited.1 Aesop's Fables provide a valuable resource of inspiring lessons for life across all ages. As such, ‘The Tortoise and the Hare’ reminds us of the importance of endurance, a quality which may become essential when combating complex and devastating diseases such as PSC. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 29, 2020 Category: Gastroenterology Authors: Michael Trauner Tags: Editorial Source Type: research

Single cell RNA sequencing analysis did not predict hepatocyte infection by SARS-CoV-2
It is with great interest that we read the research article by Wang et al. In their manuscript, the presence of SARS-CoV-2 viral particles in hepatocytes is shown with additional arguments for viral replication and cytopathy in infected hepatocytes which provides a partial explanation for the high prevalence of abnormal liver laboratory tests in COVID-19 patients1. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 27, 2020 Category: Gastroenterology Authors: Vincent De Smet, Stefaan Verhulst, Leo A. van Grunsven Tags: Letter to the Editor Source Type: research

Liver tests abnormalities in COVID-19: trick or treat?
We read with interest the recent study by Cai et al [1], which describes the role of liver function tests (LFTs) in a population of hospitalized patients with COVID-19. The authors ’ finding of a 41% prevalence of patients at admission with at least one elevated LFT appears to be higher than those previously reported in other cohorts of patients from Asia (25-30%) [2,3]. Similarly, when analyzing a consecutive cohort of 292 RT-PCR-confirmed Covid-19 patients admitted to our center until 30 March 2020, we also noticed that the prevalence of elevated LFTs was lower in our cohort. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 26, 2020 Category: Gastroenterology Authors: Edoardo Vespa, Nicola Pugliese, Daniele Piovani, Antonio Capogreco, Silvio Danese, Alessio Aghemo, Humanitas Covid-19 Task Force Tags: Letter to the Editor Source Type: research

Reply to: “Definition of SPSS: we need to speak the same language”
We appreciate the interest of Nicoar ă-Farcău et al. in our recent multicenter study published in Journal of Hepatology.1 (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 26, 2020 Category: Gastroenterology Authors: Michael Praktiknjo, Jordi Torner, Macarena Sim ón-Talero, Wenyi Gu, Antoni Perez-Poch, Cristina de la Torre, Inés del Val, Francisco Alpiste, Joan Genescà, Jonel Trebicka Tags: Letter to the Editor Source Type: research

MARC1 variant rs2642438 increases hepatic phosphatidylcholines and decreases severity of non-alcoholic fatty liver disease in humans
We read with great interest the review by Tr épo and Valenti on recent developments in genetics of NAFLD,1 which highlighted the need for further confirmation of the association between the rs2642438 (p.A165T) variant in the mitochondrial amidoxime reducing component 1 (MARC1) gene and liver disease risk. This missense variant was recently sh own to associate with protection from all-cause cirrhosis.2 MARC1 encodes for a molybdenum-containing enzyme in the outer mitochondrial membrane, which has reductive activity for N-hydroxylated compounds, e.g. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 26, 2020 Category: Gastroenterology Authors: Panu K. Luukkonen, Anne Juuti, Henna Sammalkorpi, Anne K. Penttil ä, Matej Orešič, Tuulia Hyötyläinen, Johanna Arola, Marju Orho-Melander, Hannele Yki-Järvinen Tags: Letter to the Editor Source Type: research

Efficacy of NS5A inhibitors against unusual and potentially difficult-to-treat HCV subtypes commonly found in sub Saharan Africa and South East Asia
In this study, we manufactured HCV replicons which express the NS5A protein from the unusual HCV subtypes 1l, 3b, 3g, 4r, 6u, 6v. We then tested the effect of the NS5A inhibitors daclatasvir, elbasvir, ledipasvir, pibrentasvir and velpa tasvir on blocking replication on these replicons. We show that these replicons are resistance at some level to all NS5A inhibitors other than pibrentasvir. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 26, 2020 Category: Gastroenterology Authors: Dung Nguyen, David Smith, Alun Vaughan-Jackson, Andrea Magri, Eleanor Barnes, Peter Simmonds, STOP-HCV Consortium Source Type: research

Reply to: “Can sorafenib use influence outcome when comparing stereotactic body radiation therapy with radiofrequency ablation in patients with hepatocellular carcinoma?”
We highly appreciate the letter from A. Kumar, “Can sorafenib use influence outcome when comparing stereotactic body radiation therapy with radiofrequency ablation in patients with hepatocellular carcinoma?”1 on our recent article comparing stereotactic body radiation therapy (SBRT) with radiofrequency ablation (RFA) in Asian patients with h epatocellular carcinoma.2 We also thank him for his valuable comments regarding the role of adjuvant sorafenib following locoregional treatments. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 25, 2020 Category: Gastroenterology Authors: Nalee Kim, Jinsil Seong Tags: Letter to the Editor Source Type: research

Peptide SMIM30 promotes HCC development by inducing SRC/YES1 membrane anchoring and MAPK pathway activation
Very little is known about how peptides activate signaling pathways that play a crucial role in diseases such as cancer. Specifically, we reported one conserved peptide encoded by LINC00998, SMIM30. This peptide promoted the tumorigenesis of HCC by modulating cell proliferation and migration. Of note, it bound the non-receptor tyrosine kinases, SRC/YES1, to drive their membrane anchoring and phosphorylation, activating the downstream MAPK signaling pathway. Our work not only unravels a new mechanism of HCC tumorigenesis promoted by peptides, but also demonstrates how the peptide works in activating the signaling pathway. (...
Source: Journal of Hepatology - May 24, 2020 Category: Gastroenterology Authors: Yanan Pang, Zhiyong Liu, Huan Han, Beilei Wang, Wei Li, Chuanbin Mao, Shanrong Liu Source Type: research

SARS-CoV-2 related liver impairment – perception may not be the reality
To the Editor (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 23, 2020 Category: Gastroenterology Authors: Cyriac Abby Philips, Rizwan Ahamed, Philip Augustine Tags: Letter to the Editor Source Type: research

An international multicentre study of protocols for liver transplantation during a pandemic: A case for quadripartite equipoise
We describe a four-dimensional model of Quadripartite Equipoise that models these ethical tensions and can guide the regulation of transplant activity in response to the increasing burden on healthcare systems. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 22, 2020 Category: Gastroenterology Authors: Claire Alexandra Chew, Shridhar Ganpathi Iyer, Alfred Wei Chieh Kow, Krishnakumar Madhavan, Andrea Sze Teng Wong, Karim J. Halazun, Narendra Battula, Irene Scalera, Roberta Angelico, Sharid Farid, Bettina M. Buchholz, Fernando Rotellar, Albert Chi-Yan Cha Source Type: research

A Local Response to COVID-19 for Advanced Liver Disease: Current Model of Care, Challenges and Opportunities
We read with great interest the work by Tapper and Asrani in the recent issue of the Journal of Hepatology, entitled, “The COVID Pandemic Will Have a Long-Lasting Impact on the Quality of Cirrhosis Care”.1 While we share the authors’ concerns about care disruptions and the long term negative consequences for cirrhosis care, we posit that the future of cirrhosis care need not be painted in such stark colors. I n fact, the pandemic has created an unprecedented natural experiment teaching us valuable lessons about patient care that can be both long-lasting and life-saving. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 21, 2020 Category: Gastroenterology Authors: Marina Serper, Abraham Shaked, Kim M. Olthoff, Maarouf Hoteit, Brenda Appolo, K. Rajender Reddy Tags: Letter to the Editor Source Type: research

Definition of SPSS: we need to speak the same language
This study, as well as their previous prominent work,2 shed light on the role of SPSS in the prognosis of cirrhosis, a role which should not be neglected. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 21, 2020 Category: Gastroenterology Authors: Oana Nicoar ă-Farcău, Xiaoze Wang, Xuefeng Luo Tags: Letter to the Editor Source Type: research

High Mortality Rates for SARS-CoV-2 Infection in Patients with Pre-existing Chronic Liver Disease and Cirrhosis: Preliminary Results from an International Registry
To the Editor: Chronic liver disease (CLD) and cirrhosis are common conditions1 associated with immune dysregulation2 leading to concerns that these patients are at increased risk for complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and resulting coronavirus disease 2019 (COVID-19).3 However, the effects of COVID-19 among patients with pre-existing liver disease are currently undefined. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 21, 2020 Category: Gastroenterology Authors: Andrew M. Moon, Gwilym J. Webb, Costica Aloman, Matthew J. Armstrong, Tamsin Cargill, Renumathy Dhanasekaran, Joan Genesc à, Upkar S. Gill, Theodore W. James, Patricia D. Jones, Aileen Marshall, George Mells, Ponni V. Perumalswami, Xiaolong Qi, Feng Su, Tags: Letter to the Editor Source Type: research

Non-selective beta-blockers impair global circulatory homeostasis and renal function in cirrhotic patients with refractory ascites
Using a load-independent echocardiographic index of systolic cardiac function, we have identified the mechanisms whereby non-selective beta-blockers could impair survival in refractory ascites. We show that peripheral vasodilation and sympathetic activation lead to increased left ventricle systolic function in cirrhosis with ascites, as an adaptive mechanism to maintain renal perfusion. When ascites becomes refractory, this compensatory cardiac response to vasodilation is critically dependent on sympathetic hyperactivation and is hardly able to maintain renal perfusion. In this setting, -blockade blunt the sympathetic over...
Source: Journal of Hepatology - May 20, 2020 Category: Gastroenterology Authors: Luis T éllez, Luis Ibáñez-Samaniego, Candelas Pérez del Villar, Raquel Yotti, Javier Martínez, Laura Carrión, Enrique Rodríguez de Santiago, Maite Rivera, Ana González-Mansilla, Óscar Pastor, Javier Bermejo, Rafael Bañares, Agustín Albillos, Co Source Type: research

Landmark survival analysis and impact of anatomic origin in prospective clinical trials of biliary tract cancer
Patients with gallbladder cancer have worse overall survival compared to those with other anatomic biliary tract cancer primary sites of origin and should be considered as a stratification factor in clinical trials. Landmark survival rates allow for adjusted prognosis prediction for patients with advanced biliary tract cancer who survive for some time. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 20, 2020 Category: Gastroenterology Authors: Mair éad Geraldine McNamara, Andre Lopes, Harpreet Wasan, David Malka, David Goldstein, Jenny Shannon, Takuji Okusaka, Jennifer J. Knox, Anna Dorothea Wagner, Thierry André, David Cunningham, Markus Moehler, Lars Henrik Jensen, Dieter Koeberle, Tanios B Source Type: research

Lack of genetic evidence that fatty liver disease predisposes to COVID-19
Financial support: This work was supported by project grants from Amgen and Sanofi-Aventis, the Swedish Research Council [Vetenskapsr ådet (VR), 2016-01527], the Swedish state under the Agreement between the Swedish government and the county councils (the ALF-agreement) [SU 2018-04276], the Novonordisk Foundation Grant for Excellence in Endocrinology [Excellence Project, 9321-430], the Swedish Diabetes Foundation [DIA 2017-205], the Swedish Heart Lung Foundation [20120533], the Wallenberg Academy Fellows from the Knut and Alice Wallenberg Foundation [KAW 2017.0203] (SR). (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 20, 2020 Category: Gastroenterology Authors: Luca Valenti, Oveis Jamialahmadi, Stefano Romeo Tags: Letter to the Editor Source Type: research

Editorial Board
(Source: Journal of Hepatology)
Source: Journal of Hepatology - May 16, 2020 Category: Gastroenterology Source Type: research

Discover the EASL Campus: your open-access eLearning Hub
(Source: Journal of Hepatology)
Source: Journal of Hepatology - May 16, 2020 Category: Gastroenterology Source Type: research

Join the EASL Community
(Source: Journal of Hepatology)
Source: Journal of Hepatology - May 16, 2020 Category: Gastroenterology Source Type: research

Download the EASL app
(Source: Journal of Hepatology)
Source: Journal of Hepatology - May 16, 2020 Category: Gastroenterology Source Type: research

Contents
(Source: Journal of Hepatology)
Source: Journal of Hepatology - May 16, 2020 Category: Gastroenterology Source Type: research

JHEP at a glance (June 2020)
(Source: Journal of Hepatology)
Source: Journal of Hepatology - May 16, 2020 Category: Gastroenterology Source Type: research

From the Editor's Desk …
Transarterial radioembolization (TARE) with Y90 microspheres is used worldwide to treat patients with hepatocellular carcinoma (HCC). In contrast with repeated chemoembolization, Y90-RE is usually designed as a single treatment that nevertheless demands a pre-treatment work-up. Such work-up includes injecting Tc-99m macroaggregated albumin (MAA) to estimate lung shunt fraction and lung dose. To find out if MAA scans could be eliminated from routine practice in early HCC, Gabr et al. reviewed the lung shunt fraction from 448 patients with early stage HCC (UNOS T1/T2 or Milan criteria) treated by TARE. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 16, 2020 Category: Gastroenterology Authors: Patrizia Burra, Frank Tacke, Vlad Ratziu, Stefan Zeuzem, Bruno Sangro, Paolo Angeli Tags: From the Editor's Desk Source Type: research

Streamlining TARE or personalizing SIRT? Different philosophies to treat different HCCs with Yttrium-90 …
The use of Yttrium-90 microspheres in liver malignancies is known by two names: selective internal radiation therapy (SIRT) and transarterial radioembolization (TARE). Interestingly, the two names reflect two representations of the therapy, and might be a reason why the role of SIRT in the field of hepatocellular carcinoma (HCC) treatment is still not clear in the mind of many clinicians. While some guidelines (i.e. EASL's) do not recommend its use, others (i.e. ESMO's) do recognize some space in the therapeutic armamentarium. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 16, 2020 Category: Gastroenterology Authors: Julien Edeline, Etienne Garin Tags: Editorial Source Type: research

Two-dimensional-cultures of primary human hepatocytes allow efficient HBV infection: Old tricks still work!
HBV is an enveloped DNA virus that can only replicate in highly differentiated human hepatocytes. It persists in the nucleus of infected cells as an episomal, covalently-closed-circular DNA (cccDNA). Approved therapies with nucleos(t)ide analogs efficiently suppress viremia, but they neither target HBV cccDNA nor are they curative. Therefore, there is a high need for in  vitro studies to identify and test new antiviral strategies, particularly those aimed at silencing or degrading cccDNA. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 15, 2020 Category: Gastroenterology Authors: Julie Lucifora, Maud Michelet, Michel Rivoire, Ulrike Protzer, David Durantel, Fabien Zoulim Tags: Letter to the Editor Source Type: research

Stereotactic body radiation therapy vs. radiofrequency ablation  in HCC: comparing noncomparable data
I read with great interest the article by Kim et  al. recently published in the Journal of Hepatology.1 The authors aimed to compare the effectiveness of stereotactic-body radiation therapy (SBRT) and radiofrequency ablation (RFA) in a retrospective cohort of 2,064 patients. Propensity score matching analysis was performed to minimize the effects of potential confounders and selection biases. In brief, the authors showed that SBRT was associated with a lower cumulative local recurrence rate (CLRR) than RFA (p (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 15, 2020 Category: Gastroenterology Authors: Boris Guiu Tags: Letter to the Editor Source Type: research

Hepatocellular carcinoma risk stratification in HBV cirrhosis: Time to turn the page?
We read with great interest the recent article by Yip et  al., which describes the external validation of PAGE-B related scores for hepatocellular carcinoma (HCC) risk stratification in a very large cohort of patients with chronic hepatitis B treated with nucleo(s)tide analogues (NAs).1 Since it has become clear that NA therapy may reduce but not elimina te the risk of HCC, particularly in patients with cirrhosis, current guidelines recommend continued HCC surveillance despite successful antiviral therapy. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 15, 2020 Category: Gastroenterology Authors: Milan J. Sonneveld, Willem Pieter Brouwer, Robert A. de Man Tags: Letter to the Editor Source Type: research

Reply to: “Accurate diagnosis of NAFLD-related hepatic fibrosis with non-invasive methods: A comment for moving forward”
We thank Dr Li for his valuable comments in line with 2 important topics in the field of non-invasive liver tests: the process of developing non-invasive strategies and the context of their use. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 15, 2020 Category: Gastroenterology Authors: Jeremie Riou, Clemence M. Canivet, Jerome Boursier Tags: Letter to the Editor Source Type: research

Reply to: “Hepatocellular carcinoma risk stratification in HBV cirrhosis: Time to turn the page”
We appreciate the interest of Sonneveld and colleagues in our work to validate PAGE-B-related risk scores to predict the development of hepatocellular carcinoma (HCC).1 Mixing cirrhotic and non-cirrhotic patients to derive an HCC risk score may mask the real risk of HCC in cirrhotic patients. As a result, the negative predictive value for HCC might be over-estimated in cirrhotic patients. Obviously, the use of platelet counts and serum albumin in PAGE-B-related scores are not sensitive enough to identify patients with early liver cirrhosis. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 15, 2020 Category: Gastroenterology Authors: Henry Lik-Yuen Chan, Vincent Wai-Sun Wong, Terry Cheuk-Fung Yip, Grace Lai-Hung Wong Tags: Letter to the Editor Source Type: research

FGF15 improves outcomes after brain dead donor liver transplantation with steatotic and non-steatotic grafts in rats
After brain death, potential liver donors have reduced intestinal FXR, which is associated with reduced intestinal, circulatory and hepatic levels of FGF15. A similar reduction in the cell-surface receptor complex Fgfr4/Klb is observed, whereas CYP7A1 is overexpressed; together, these result in dangerous accumulation of bile acid. Brain-dead donors can also present hepatic damage and regeneration failure, as well as reduced YAP activity. Here, we demonstrate that when such donors receive appropriate doses of FGF15, CYP7A1 levels and hence hepatic bile acid toxicity are reduced; while activation of the Hippo-YAP signaling p...
Source: Journal of Hepatology - May 14, 2020 Category: Gastroenterology Authors: Jos é Gulfo, Floriana Rotondo, Cindy G. Ávalos de León, María Eugenia Cornide-Petronio, Carla Fuster, Jordi Gracia-Sancho, Mónica B. Jiménez-Castro, Carmen Peralta Source Type: research

Accurate diagnosis of NAFLD-related hepatic fibrosis with non-invasive methods: A comment for moving forward
I congratulate Boursier et  al. for their recent study on the non-invasive diagnosis of non-alcoholic fatty liver disease (NAFLD).1 I would like to raise 2 methodological objections. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 14, 2020 Category: Gastroenterology Authors: Weizheng Li Tags: Letter to the Editor Source Type: research

NAFLD referral patterns in a large US academic center
We read with interest the manuscript by Srivastava et  al.1 We are excited to hear of a novel pathway to capture patients with non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis or cirrhosis using sequential non-invasive scoring systems. With the development of agents to potentially reverse NAFLD fibrosis, there is a significant need to i mprove screening of at-risk populations and develop mechanisms for early effective linkage-to-care. Srivastava et al. shed light on the scale of the problem when it comes to screening in the UK, but data from the US remain limited. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 12, 2020 Category: Gastroenterology Authors: Marcia Leung, Cindy Piao, Souvik Sarkar Tags: Letter to the Editor Source Type: research

Introducing the Expert Opinion series
The Journal of Hepatology welcomes thought-provoking opinions proffered by accomplished leaders in the field, eloquently expressed in an academic spirit, in an attempt to promote debate or to change the perspective on unsettled clinical or experimental research topics. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 12, 2020 Category: Gastroenterology Authors: Paolo Angeli, Vlad Ratziu Tags: Editorial Source Type: research

Glycolytic activation of monocytes regulates the accumulation and function of neutrophils in human hepatocellular carcinoma
Neutrophils constitute a major component in human HCC. Although less characterized, they are emerging as important players in the pathophysiology of the disease. The current study provides evidence that monocytes were educated by tumor microenvironments to up-regulate their levels of glycolysis, which led to the production of large amounts of CXCL2 and CXCL8 via PFKFB3-NF- κB axis. CXCL2 and CXCL8 effectively recruited peripheral neutrophils and sustained the survival of these otherwise short-lived cells. The accumulated neutrophils were then induced by both monocytes-derived TNF-α and tumor-derived soluble fac...
Source: Journal of Hepatology - May 12, 2020 Category: Gastroenterology Authors: Zhi-Peng Peng, Ze-Zhou Jiang, Hao-Fan Guo, Meng-Meng Zhou, Yu-Fan Huang, Wan-Ru Ning, Jin-Hua Huang, Limin Zheng, Yan Wu Source Type: research

Reply to: ‘NAFLD or comorbidities, that is the question’
We thank Ponziani et al. for their interest in our manuscript and for their thoughtful comments.1 They raised the concern that the 37.6% prevalence of NAFLD in our cohorts was rather high compared to the 26.9% reported in Northeastern China and wondered the possibility that we have over diagnosis NAFLD. If there is over diagnosis of NAFLD, the prevalence should be similar in the stable and progressive groups, as opposed to the marked difference, 25.8% vs 87.2 % respectively, observed in our study. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 12, 2020 Category: Gastroenterology Authors: Dong Ji, Dawei Zhang, George Lau Tags: Letter to the Editor Source Type: research

Health status of patients with Autoimmune Liver Disease during SARS-CoV-2 outbreak in northern Italy
During the pandemic caused by the novel Coronavirus SARS-CoV-2 disease (COVID-19) questions arise on risk of patients with autoimmune conditions under immunosuppressive drugs (IS). There is a mounting evidence that severe COVID-19 is characterized by an imbalanced multi-system immune-inflammatory response to the pathogen by the host, and acknowledged risk factors for poorer outcome are older age and preexisting non-respiratory chronic pro-inflammatory conditions such as obesity, hypertension, diabetes and cardiovascular disease (1). (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 12, 2020 Category: Gastroenterology Authors: Angelo Di Giorgio, Emanuele Nicastro, Camilla Speziani, Massimo De Giorgio, Luisa Pasulo, Bianca Magro, Stefano Fagiuoli, Lorenzo D' Antiga Tags: Letter to the Editor Source Type: research

Can sorafenib use influence outcome when comparing stereotactic body radiation therapy with radiofrequency ablation in patients with hepatocellular carcinoma?
I read with interest the study by Kim et  al.,1 comparing stereotactic body radiation therapy (SBRT) to radiofrequency ablation (RFA) in Asian patients with hepatocellular carcinoma (HCC). In this retrospective multicenter study, the cohort included 2,064 patients: 1,568 and 496 in the RFA and SBRT groups, respectively. More than half of the patients (56.5%) had developed recurrent tumors, mainly after transarterial chemoembolization (TACE, 44.8%). To adjust for unbalanced clinical factors, propensity score matching was performed, which resulted in 313 in each group. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 11, 2020 Category: Gastroenterology Authors: Ashish Kumar Tags: Letter to the Editor Source Type: research

Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers
This study aimed to establish benchmark values in laparoscopic left lateral sectionectomy (LLLS) and in laparoscopic right hepatectomy (LRH) from data of identified expert centers based on a composite indicator of healthcare quality. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 11, 2020 Category: Gastroenterology Authors: Christian Hobeika, David Fuks, Fran çois Cauchy, Claire Goumard, Brice Gayet, Alexis Laurent, Olivier Soubrane, Ephrem Salamé, Daniel Cherqui, Jean-Marc Regimbeau, Jean-Yves Mabrut, Olivier Scatton, Eric Vibert, AFC-LLR-2018 study group Source Type: research

Hepatic fibrosis: A convergent response to liver injury that is reversible
Deposition of extracellular matrix accompanies wound repair and regeneration following liver injury; however, repeated injury from chronic viral hepatitis (HBV, HCV etc.), Western diet, alcohol, environmental toxins, and/or immune diseases may provoke a progressive fibrotic response characterized by excess collagen accumulation. Hepatic fibrosis progressively restricts normal liver regeneration, thus increasing the risk of liver failure. Hepatic fibrosis also generates a permissive micro-environment for the development of liver cancer through mechanisms that are not fully elucidated. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 10, 2020 Category: Gastroenterology Authors: Shuang Wang, Scott L. Friedman Tags: Hepatology Snapshot Source Type: research

Associations between reproductive factors and biliary tract cancers in women from the Biliary Tract Cancers Pooling Project
Our findings show that risk of gallbladder cancer (GBC) is increased among women who have given birth (especially women with 5 or more children). In women from Asian countries, later age at menarche increases the risk of GBC, intrahepatic bile duct cancer (IHBDC), extrahepatic bile duct cancer. We did not see this same association in women from Western countries. Age at menopause was not associated with the risk of any BTC. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 10, 2020 Category: Gastroenterology Authors: Sarah S. Jackson, Hans-Olov Adami, Gabriella Andreotti, Laura E. Beane-Freeman, Amy Berrington de Gonz ález, Julie E. Buring, Gary E. Fraser, Neal D. Freedman, Susan M. Gapstur, Gretchen Gierach, Graham G. Giles, Francine Grodstein, Patricia Hartge, Mazd Source Type: research

SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19
We reported the clinical characteristics and liver pathological manifestations of COVID-19 patients with elevated liver enzymes. Our findings suggested SARS-CoV-2 infection in liver is a crucial cause of hepatic impairment in COVID-19 patients (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 10, 2020 Category: Gastroenterology Authors: Yijin Wang, Shuhong Liu, Hongyang Liu, Wei Li, Fang Lin, Lina Jiang, Xi Li, Pengfei Xu, Lixin Zhang, Lihua Zhao, Yun Cao, Jiarui Kang, Jianfa Yang, Ling Li, Xiaoyan Liu, Yan Li, Ruifang Nie, Jinsong Mu, Fengmin Lu, Shousong Zhao, Jiangyang Lu, Jingmin Zha Source Type: research

Reply to: ‘Younger patients with MAFLD are at increased risk of severe COVID-19 illness: A multicenter preliminary analysis’
We read with interest the letter by YJ Zhou et al. stressing the finding that, in their own series, MAFLD is associated with increased risk of severe COVID-19 illness in younger but not older patients.1 As pointed out by the authors, a notable limitation of the study was the smaller sample size of the older cohort of patients, which might influence the validity of the results. Actually, if both aged groups were combined together and analyzed as a whole, MALFD subjects had a high likelihood of severe disease when compared with non-MAFLD subjects (26.9% vs 14.5% p =0.004). (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 10, 2020 Category: Gastroenterology Authors: Dong Ji, Enqiang Qin, George Lau Tags: Letter to the Editor Source Type: research

ER stress-induced upregulation of NNMT contributes to alcohol-related fatty liver development
In this study, we have identified ER stress-induced upregulation of liver nicotinamide methyltransferase (NNMT), the enzyme catalyzing nicotinamide degradation using s-adenosylmethionine as a methyl donor, to be a pathological regulator in alcoholic fatty liver development. NNMT inhibition protects against fatty liver development resulted from chronic alcohol consumption, which is associated with suppressed de novo lipogenic activity and enhanced AMPK activation. Thus, our data suggest that NNMT may be a potential therapeutic target for the treatment of alcoholic liver disease. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 7, 2020 Category: Gastroenterology Authors: Qing Song, Yingli Chen, Jun Wang, Liuyi Hao, Chuyi Huang, Alexandra Griffiths, Zhaoli Sun, Zhangxiang Zhou, Zhenyuan Song Source Type: research

Hepatic stellate cell autophagy inhibits extracellular vesicle release to attenuate liver fibrosis
In chronic liver injury, platelet-derived growth factor (PDGF)-stimulated hepatic stellate cells (HSCs) release fibrogenic extracellular vesicles (EVs). EVs include multivesicular body (MVB)-derived exosomes and Rho-associated kinase (ROCK)-dependent plasma membrane budding-derived microvesicles. Autophagy plays substantial roles in maintaining liver homeostasis and its deregulation has been associated with liver disease. However, the effect of autophagy in regulating fibrogenic EVs and amplifying pro-fibrotic signals among HSCs remains unknown. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 7, 2020 Category: Gastroenterology Authors: Jinhang Gao, Bo Wei, Thiago M. de Assuncao, Zhikui Liu, Xiao Hu, Samar Ibrahim, Shawna A. Cooper, Sheng Cao, Vijay H. Shah, Enis Kostallari Source Type: research

Equal opportunity offer for all hepatocytes
It is widely accepted that homeostasis of the hepatocyte mass is maintained by division of mature hepatocytes with little or no contribution by cells with stem/progenitor phenotypes. However, in recent years several groups found evidence that normal tissue regeneration originates from subsets of mature hepatocytes with distinct stem-like features and distinct locations in the liver. Three papers1 –3 in a recent issue of Cell Stem Cell now challenge the concept of “specialized” regenerative hepatocytes and indicate randomly positioned hepatocytes as the cellular source of liver regeneration, using various ...
Source: Journal of Hepatology - May 6, 2020 Category: Gastroenterology Authors: Zhen Dai, Michael Ott, Amar Deep Sharma Tags: Editorial Source Type: research

Stereotactic body radiotherapy for hepatocellular carcinoma – still searching for a role
Radiofrequency ablation (RFA) is currently recommended for patients with early stage hepatocellular carcinoma (HCC) who are not candidates for transplantation or resection.1 Although there are no randomised trials, comparative studies demonstrate that RFA for tumours less than 2 cm is associated with similar outcomes to surgery, and for tumours less than 3 cm, 3-year overall and recurrence-free survival is around 76% and 46%, respectively.2,3 Beyond 3 cm, RFA achieves necrosis in only 30 –40%.4,5 Consequently, the EASL guidelines recommend RFA for single tumours of 2–3 cm as an alternative to surgical resection...
Source: Journal of Hepatology - May 6, 2020 Category: Gastroenterology Authors: Tim Meyer Tags: Editorial Source Type: research

Reply to “Clinical characteristics of COVID-19 patients with abnormal liver tests”
We thank Chen P. and Zhou B. for their interest in our manuscript and for their thoughtful comments. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 6, 2020 Category: Gastroenterology Authors: Qingxian Cai, Jun Chen Tags: Letter to the Editor Source Type: research

Changing epidemiology and outcomes of acute kidney injury in hospitalized patients with cirrhosis – a US population-based study
Sudden damage to the kidneys is becoming more common in people who are hospitalized and have cirrhosis. Despite advances in cirrhosis care, those with damage to the kidneys remain at higher risk of dying. (Source: Journal of Hepatology)
Source: Journal of Hepatology - May 6, 2020 Category: Gastroenterology Authors: Archita P. Desai, Shannon M. Knapp, Eric S. Orman, Marwan S. Ghabril, Lauren D. Nephew, Melissa Anderson, Pere Gin ès, Naga P. Chalasani, Kavish R. Patidar Source Type: research