Remimazolam alleviates hepatic ischemia-reperfusion injury by activating FOXO1/3 signaling : Remimazolam alleviates hepatic ischemia reperfusion injury

BACKGROUND

Hepatic ischemia reperfusion injury (HIRI) frequently gives rise to aggravated liver damage. Currently, there exists a diverse range of anesthetic drugs that possess protective capabilities against ischemia-reperfusion injury (IRI). Nevertheless, the specific functions and underlying mechanisms of remimazolam (RMZL) in HIRI have not been fully elucidated.

METHODS

HIRI models of both hepatocytes and mice were successfully established. To evaluate liver function and injury, ELISA, HE and TUNEL staining were employed. The levels of oxidative stress markers and inflammatory factors were measured using commercial kits. Cell viability and apoptosis were measured by CCK-8 and flow cytometry, respectively. The abundance of genes and proteins was determined utilizing RT-qPCR and western blot.

RESULTS

It was observed that RMZL administration greatly alleviated liver damage and repressed oxidative stress and inflammation in HIRI mouse models. In vitro experiments demonstrated that RMZL strongly protected LO2 cells from H/R-induced cell damage, oxidative stress, and inflammatory responses. Moreover, FOXO1 and FOXO3, which function as classic cell protection and anti-oxidative stress factors, were observed to be downregulated in liver tissue from HIRI mouse models and H/R-challenged LO2 cells. Notably, this downregulation could be reversed by the administration of RMZL. Furthermore, FOXO1 or FOXO3 knockdown abolished the protective effects of RMZL, including promoted cell survival and inhibited oxidative stress and inflammation in LO2 cells upon H/R exposure.

CONCLUSION

These data provided robust support for the notion that RMZL attenuated oxidative stress and inflammation to alleviate HIRI through enhancing FOXO1 and FOXO3 expressions, suggesting that RMZL holds great promise as a potential candidate anesthetic for HIRI treatment.

Shaping the future of inflammatory bowel disease: a global research agenda for better management and public health response

Inflammatory bowel disease (IBD) is a growing global health challenge affecting more than 7 million people worldwide. With increasing prevalence across all age groups, including children and adolescents, IBD places substantial strain on health-care systems and society, resulting in high direct medical costs, lost productivity and reduced quality of life. Despite therapeutic advances, suboptimal disease control and delays in timely diagnosis and adequate treatment persist. Regional disparities in health-care access contribute to these challenges, especially in low-income countries. Addressing these inequities is crucial for improving global IBD outcomes. Using a Delphi methodology, experts from clinical care, research, public health and advocacy (including patient representation) identified priorities across six domains (37 statements in total): epidemiology, care models, treatment strategies, education and awareness, patient and community engagement, and leadership to promote health equity. These priorities emphasize quantifying the burden of IBD, addressing health-care disparities, validating care models, exploring novel treatments, advancing education, engaging patients and advocating for health equity policies. The comprehensive approach seeks to optimize care models, promote patient engagement and ensure equitable access to health care. The identified priorities serve as a guide for both clinical and non-clinical researchers, and funders dedicated to IBD-related initiatives, fostering international collaboration to improve IBD management and reduce its impact globally.

Circulating metabolite signatures indicate differential gut-liver crosstalk in lean and obese MASLD

BACKGROUNDAlterations in circulating metabolites have been described in obese metabolic dysfunction-associated steatotic liver disease (MASLD), but data on lean MASLD are lacking. We investigated serum metabolites, including microbial bile acids and short-chain fatty acids (SCFAs), and their association with lean and obese MASLD.METHODSSerum samples from 204 people of European descent were allocated to groups: lean healthy, lean MASLD, obese healthy, and obese MASLD (n = 47). Liquid chromatography-mass spectrometry-based metabolomics and linear model analysis were performed. MASLD prediction was assessed based on least absolute shrinkage and selection operator regression. Functional effects of altered molecules were verified in organotypic 3D primary human liver cultures.RESULTSLean MASLD was characterized by elevated isobutyrate, methionine sulfoxide, propionate, and phosphatidylcholines. Patients with obese MASLD had increased sarcosine and decreased lysine and asymmetric dimethylarginine. Using metabolites, sex, and BMI, MASLD versus healthy could be predicted with a median AUC of 86.5% and 85.6% in the lean and obese subgroups, respectively. Functional experiments in organotypic 3D primary human liver cultures showed propionate and isobutyrate induced lipid accumulation and altered expression of genes involved in lipid and glucose metabolism.CONCLUSIONLean MASLD is characterized by a distinct metabolite pattern related to amino acid metabolism, lipids, and SCFAs, while metabolic pathways of lipid accumulation are differentially activated by microbial metabolites. We highlight an important role of microbial metabolites in MASLD, with implications for predictive and mechanistic assessment of liver disease across weight categories.FUNDINGRobert Bosch Stiftung, Swedish Research Council (2021-02801, 2023-03015, 2024-03401), ERC Consolidator Grant 3DMASH (101170408), Ruth and Richard Julin Foundation for Gastroenterology (2021-00158), SciLifeLab and Wallenberg National Program for Data-Driven Life Science (WASPDDLS22:006), Novo Nordisk Foundation (NNF23OC0085944, NNF23OC0084420), PMU-FFF (E-18/28/148-FEL).

A viscosity-responsive mitochondria-targeting probe for rapid imaging of fatty liver disease

Fatty liver disease (FLD) is a leading cause of chronic liver disease worldwide, yet current diagnostic methods remain limited by low sensitivity, poor accuracy, and prolonged detection times. Recent studies have linked liver viscosity, particularly mitochondrial viscosity variations, to the progression of FLD, highlighting the need for a rapid and noninvasive viscosity-sensitive imaging tool. Herein, we present a viscosity-responsive fluorescent probe ZLCN, designed for rapid real-time imaging of fatty liver disease. ZLCN integrates an acrylonitrile rotor for viscosity sensing and a pyridine moiety for selective mitochondrial localization, enabling precise detection of viscosity alterations at the subcellular level. The probe exhibits strong fluorescence in high-viscosity environments due to restricted intramolecular rotation. ZLCN exhibits excellent viscosity responsiveness, effectively distinguishing normal and cancerous liver cells based on viscosity differences in vitro. Furthermore, it differentiates AML12 cells with varying viscosity levels, demonstrating its capability to monitor viscosity changes. In fatty liver models, ZLCN could produce intense fluorescence signals in fatty liver tissues and enabled rapid viscosity detection within 30 minutes, demonstrating a significant improvement over conventional imaging technique. These findings establish ZLCN as a promising tool for real-time mitochondrial viscosity monitoring, offering new avenues for early diagnosis and therapeutic assessment of viscosity-related liver diseases.

Genetic variants associated with metabolic dysfunction-associated fatty liver diseases in a Korean population

BACKGROUND

Susceptibility to metabolic dysfunction-associated fatty liver diseases (MAFLD) shows a large inter-ethnic variability. Currently, large-scale genome-wide association studies (GWAS) on MAFLD in a Korean population are limited. This study aimed to investigate genes underlying MAFLD in a Korean population.

METHODS

A total of 13,457 Korean adults (4061 cases and 9396 controls) who underwent abdominal ultrasonography, biochemical testing, and genetic studies at a comprehensive health promotion center from 2019 to 2023 were included. Genome-wide genotyping was conducted using Infinium Asian Screening Array and an iSCAN system (Illumina, San Diego, CA, USA). Gene-based approach was conducted with Multi-Marker Analysis for Genomic Annotation (MAGMA) and Functional Mapping and Annotation (FUMA). Expression quantitative trait loci (eQTLs) mapping was done using GTEx v8 data.

RESULTS

The 22q13.3, 19p13.11, and 2p23.3 loci were associated with MAFLD after adjusting for age, sex, and body mass index (p < 5 × 10-8). Of these, 154 (89%) variants were identified as eQTLs (FDR < 0.05). Gene-based approach showed that PNPLA3, SAMM50, and PARVB were significantly associated with MAFLD (Bonferroni-corrected p < 2.99 × 10-6), followed by PDLIM4, GCKR, APOB, GPAM, HMGA1, C5orf56, and APOC1.

CONCLUSIONS

This is the largest-scale GWAS of MAFLD in a Korean adult population. Genotyping PARVB as well as PNPLA3 might help us identify individuals with the highest risk of MAFLD in Korean adults. These findings would contribute to our understanding of genetic pathogenesis of MAFLD in the Korean population.

A novel TGR5 agonist Sauchinone ameliorates IMQ induced murine psoriasis by regulating macrophage polarization

INTRODUCTION

G-protein-coupled bile acid receptor (TGR5) is a member of G-protein-coupled receptor (GPCR) superfamily that participates in regulating macrophage polarization and resolving inflammatory diseases. Sauchinone is Saururus chinensis derived natural product with anti-inflammatory activity. Still, whether Sauchinone could regulate macrophage polarization and its direct target remain to be explored.

OBJECTIVES

This study aims to demonstrate the direct target of Sauchinone, its influences on macrophage polarization and its pharmacological actions on imiquimod (IMQ) induced mouse psoriasis model.

METHODS

We detected the TGR5 agonistic activity of Sauchinone in mouse/human TGR5/ cAMP response elements (CRE)/HEK293 stable cell lines and verified its direct effect on mouse/human macrophages by Cellular thermal shift assay (CETSA) and by examining downstream CREB phosphorylation. Afterwards, we discovered the activity of Sauchinone on regulating macrophage M1/M2 polarization in Bone marrow-derived macrophages (BMDM) by detecting M1/M2 markers through Enzyme-linked immunosorbent assay (ELISA), Real-time polymerase chain reaction (RT-qPCR), Western blot and Fluorescence-activated cell sorting (FACS). We further utilized macrophages derived from Tgr5-/- mice or introduced TGR5 specific inhibitor, TGR5 si-RNA and PKA inhibitor to determine whether Sauchinone regulated macrophage polarization through TGR5. We then prepared Sauchinone cream formulation to disclose its pharmacological action in IMQ induced mouse psoriasis model and used FACS and immunofluorescence to verify its action on macrophage polarization in psoriatic skin. Moreover, we tested the protective actions of Sauchinone cream in IMQ treated Tgr5-/- mice to verify that Sauchinone alleviated psoriasis in TGR5 dependent manner.

RESULTS

Sauchinone is a novel TGR5 agonist without human/mouse species selectivity. Sauchinone rectified macrophage M1 polarization through activating TGR5. Topical use of Sauchinone cream ameliorated IMQ induced psoriasis and regulated macrophage polarization in psoriatic skins. Sauchinone cream alleviated psoriasis in TGR5 dependent manner.

CONCLUSION

Our work identified Sauchinone as a novel TGR5 agonist that could ameliorate IMQ induced murine psoriasis by regulating macrophage polarization.

Mitochondrial fission regulates midgut muscle assembly and tick feeding capacity

Ticks ingest over 100 times their body weight in blood. As the primary tissue for blood storage and digestion, the tick midgut's regulation in response to this substantial blood volume remains unclear. Here, we show that blood intake triggers stem cell proliferation and mitochondrial fission in the midgut of Haemaphysalis longicornis. While inhibiting stem cell proliferation does not impact feeding behavior, disruption of mitochondrial fission impairs tick feeding capacity. Mitochondrial fission mediated by dynamin 2 (DNM2) regulates ATP generation, which in turn influences the expression of the tropomyosin-anchoring subunit troponin T (TNT). Knockdown of TNT disrupts muscle fiber assembly, hindering midgut enlargement and contraction, thereby preventing blood ingestion. These findings underscore the indispensable role of musculature in facilitating midgut expansion during feeding in ticks.

Multi-omics analyses of the gut microbiota and metabolites in children with metabolic dysfunction-associated steatotic liver disease

The development and severity of metabolic dysfunction-associated steatotic liver disease (MASLD) in children are closely related to alterations of gut microbiota. This study aims to investigate changes in the gut microbiota signature and microbial metabolites in children with MASLD. We collected fecal samples from children and adolescents aged 6-16 years, and the presence of MASLD was diagnosed by ultrasound. We performed 16S ribosomal DNA sequencing and targeted metabolomics in 36 and 25 subjects, consisting of healthy controls, children with obesity, and children with MASLD. The α-diversity was significantly lower in children with obesity and MASLD compared with healthy controls. Linear discriminant analysis of effect size analysis identified Anaerostipes and A. hadrus as the top biomarkers differentiating the obesity group from the MASLD group. In MASLD patients with high alanine aminotransferase values (≥50 U/L for boys and 44 U/L for girls), we observed a decrease in the gut microbiota health index. MASLD patients with high shear wave elastography (E) values (≥6.2 kPa) showed an increased abundance of Ruminococcus torques, which was positively correlated with the levels of deoxycholic acid (DCA) and E values. Importantly, the mediation analysis identified positive associations between R. torques and clinical indicators of MASLD that were mediated by DCA. Overall, our study suggests that gut microbiota and metabolites are significantly altered in children with MASLD, and targeting R. torques may offer potential benefits for disease management.IMPORTANCEThis study investigated alterations in the gut microbiota signature and microbial metabolites in children with metabolic dysfunction-associated steatotic liver disease (MASLD). We found that an increased abundance of Ruminococcus torques was associated with increased levels of deoxycholic acid and the progression of MASLD, suggesting that R. torques may serve as a novel clinical target in pediatric MASLD.

Apilarnil alleviates paracetamol-induced hepatotoxicity by modulating apoptosis and oxidative stress

Paracetamol (PAR) is a drug that is widely used throughout the world and has limited treatment options in case of use-related hepatotoxicity. Apilarnil (AP), a bee product has high levels of antioxidant properties, which result from the rich polyphenols found in its structure. Despite it being shown that AP treatment might have a protective effect on liver damage induced by carbon tetrachloride and lipopolysaccharide, there is no study investigating the possible role of this agent in PAR-induced hepatotoxicity using an experimental in vivo model. Therefore, we aimed to investigate the therapeutic effects of AP on paracetamol-induced hepatotoxicity and its relationship with apoptosis and oxidative stress. Our results indicated that PAR administration caused irregularities in hepatocyte cords, bleeding and dilatation of sinusoids, and inflammatory cell infiltration in the portal area and liver parenchyma. PAR caused an increase in p53 and caspase3 expressions and malondialdehyde (MDA) levels, while it caused a decrease in catalase (CAT) and glutathione peroxidase (GSHpx) levels. AP treatment significantly improved histopathological changes in liver tissues and decreased p53 and caspase3 expressions. Our data suggest that AP alleviates paracetamolinduced hepatotoxicity by regulating p53 and caspase-3 expressions and modulating oxidative stress mechanisms.

An umbrella review of the association between dietary factors and hepatocellular carcinoma risk

Background: Several meta-analyses have summarized the associations between dietary factors and the risk of hepatocellular carcinoma (HCC). However, no research has comprehensively assessed the certainty of this evidence. Methods: PubMed, Embase, and the Cochrane Library were searched from inception to August 2024. The credibility of the evidence was assessed using the pre-specified evidence classification criteria, graded as convincing ("class I"), highly suggestive ("class II"), suggestive ("class III"), weak ("class IV"), or no evidence ("class V"). To evaluate the quality of evidence, the GRADE framework was applied, categorized as "high", "moderate", "low", or "very low" quality. This study was registered at PROSPERO (CRD42023417373). Results: In total, 22 meta-analyses describing 33 non-dose-response and 10 dose-response associations were included. In the non-dose-response associations, convincing evidence (class I) supported an inverse association between coffee intake [risk ratio (RR) 0.50, 95% confidence interval 0.42 to 0.59, GRADE = very low] and risk for HCC. Suggestive evidence (class III) supported the effect of fish (RR 0.81, 0.73 to 0.90; very low), fiber (RR 0.71, 0.61 to 0.84; low), and the Mediterranean diet (RR 0.67, 0.56 to 0.80; very low) in lowering the risk for HCC. Weak evidence (class IV) suggested the protective effects of ginseng, selenium, cruciferous vegetables, whole grains, and vegetables, against HCC, and the negative effect of saturated fat in increasing the risk for HCC. In the dose-response association, convincing evidence (class I) supported that an additional two cups of coffee per day (RR 0.71, 0.60 to 0.77; moderate) lowered HCC risk, and suggestive evidence (class III) indicated that an increase of 10 g day-1 in fiber intake (RR 0.83, 0.76 to 0.91; moderate) lowered HCC risk. Weak evidence (class IV) suggests positive associations between HCC risk and a 1% daily increase in energy from saturated fat and a 100 mg day-1 increase in cholesterol. Conclusions: Dietary factors, especially coffee, fish, fiber, and the Mediterranean diet, are associated with HCC risk. These findings provide a theoretical basis for developing and evaluating dietary interventions to reduce HCC risk.

Liver Fat Accumulation Is Associated With Increased Insulin Secretion Independent of Total, Visceral, and Pancreatic Fat

CONTEXT

Studies in heterogeneous groups of people with respect to sex, body mass index (BMI), and glycemic status (normoglycemia, impaired glucose tolerance, diabetes), indicate no relationship between liver fat accumulation and pancreatic insulin secretion.

OBJECTIVE

This work aimed to better understand the association of liver fat with insulin secretion.

METHODS

A cross-sectional analysis was conducted of 61 men with abdominal obesity who had high liver fat (HLF, ≥ 5.6% by magnetic resonance spectroscopy, n = 28) or low liver fat (LLF, n = 33), but were balanced on BMI, total body fat, visceral adipose tissue (VAT), and pancreatic fat. A frequently sampled 5-hour oral glucose tolerance test with 11 samples, in conjunction with mathematical modeling, was used to compute indices of insulin sensitivity and insulin secretion (oral minimal model).

RESULTS

Compared to individuals with LLF, those with HLF had significantly greater fasting glucose, insulin, C-peptide, and triglycerides; lower high-density lipoprotein cholesterol; but similar glycated hemoglobin A1c. Areas under the 5-hour curve for glucose, insulin, and C-peptide were greater in the HLF group than the LLF group (by ∼10%, ∼38%, and ∼28%, respectively); fasting and total postprandial insulin secretion rates were approximately 37% and approximately 50% greater, respectively (all P < .05); whereas the insulinogenic index was not different. HLF participants had lower whole-body and hepatic insulin sensitivity, disposition index, and total insulin clearance than LLF participants (all P < .05).

CONCLUSION

Accumulation of liver fat is associated with increased insulin secretion independently of total adiposity, abdominal fat distribution, and pancreatic fat. Thereby, hyperinsulinemia in fatty liver disease is partly because of insulin hypersecretion and partly because of impaired insulin clearance.

Anticancer effects of vitamin K combined with transarterial chemoembolization in hepatocellular carcinoma, a randomized controlled trial

BACKGROUND

We have previously reported that vitamin K dosing augments the anticancer effects of sorafenib by suppressing levels of des-γ-carboxy prothrombin, a known tumor growth and angiogenesis factor produced in HCC under sorafenib-induced ischemia. Herein, we aimed to establish whether vitamin K dosing could afford a similar anticancer effect when combined with transarterial chemoembolization (TACE).

METHODS

We performed a randomized controlled trial, assigning patients with unresectable HCC (1:1) to TACE + vitamin K or TACE alone groups. Co-primary endpoints were objective response rate and PFS; the secondary endpoint was safety.

RESULTS

The TACE + vitamin K group (n = 50) exhibited a significantly higher objective response rate than the TACE alone group (n = 51) (96.0% vs. 82.4%, p = 0.028). The PFS was significantly longer in the TACE + vitamin K group than that in the TACE alone group (median time: 262 days [95% confidence interval (CI), 35.8-488.2 days] vs. 146 days [95% CI, 111.6-180.4 days]; p = 0.013, hazard ratio: 0.55 [95% CI, 0.34-0.89]). There were no significant differences in the incidence of adverse events between groups.

CONCLUSIONS

Compared with TACE alone, vitamin K dosing combined with TACE improved anticancer outcomes.

CLINICAL TRIAL NUMBER

UMIN000026404.

ETV4/ALYREF-mediated glycolytic metabolism through PKM2 enhances resistance to ferroptosis and promotes the development of intrahepatic cholangiocarcinoma

BACKGROUND

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatocellular cancer. This study investigated whether ETV4, ALYREF, and PKM2 affect glycolytic metabolism and ferroptosis, thereby potentially influencing ICC.

METHODS

Bioinformatic analysis was used to explore the expression levels and prognosis of ETV4, ALYREF, and PKM2 in ICC and their regulatory relationships were confirmed using in vitro experiments. Glycolytic metabolism and ferroptosis were examined, and chromatin immunoprecipitation and RNA immunoprecipitation experiments were performed to verify whether the ETV4, PKM2, and ALYREF could bind. The effect of ETV4/ALYREF on ICC was further confirmed by in vivo experiments.

RESULTS

ETV4, ALYREF, and PKM2 were highly expressed in ICC. Overexpressed (oe)-ETV4 and oe-PKM2 promoted cell migration and increased glucose (GLU) utilization and lactate and intracellular adenosine triphosphate (ATP) production. Addition of the ferroptosis inducer Erastin to the above groups revealed that sh-ETV4 and sh-ALYREF increased lipid reactive oxygen species (ROS), malondialdehyde (MDA), and Fe2+ levels, and oe-PKM2 reversed these effects in the sh-ETV4 and sh-ALYREF groups. Oe-ETV4 promoted the expression of PKM2, whereas sh-ALYREF inhibited the same. ETV4 could bind to ALYREF and PKM2 promoter, and ALYREF could promote the stability of PKM2 in an m5C-dependent manner. In vivo, ETV4 promotes tumor growth and the expression of proteins related to glycolytic metabolism by regulating ALYREF.

CONCLUSION

ETV4 promotes ICC development and ferroptosis resistance by facilitating glycolytic metabolism, and regulating PKM2 transcription by directly binding to the PKM2 promoter. Additionally, it mediates m5C-dependent PKM2 stabilization by directly binding to ALYREF. This study identified a new potential therapeutic target for ICC.

Peptides targeting RAB11A-FIP2 complex inhibit HPIV3, RSV, and IAV replication as broad-spectrum antivirals

BACKGROUND

The cytoskeletal framework plays a critical role in the early stages of human parainfluenza virus type 3 (HPIV3) replication, including viral mRNA synthesis and translation. However, its contribution to later stages of infection, particularly in the context of RNA biology, is not well understood. This study focuses on the role of the cytoskeleton in viral nucleocapsid (vRNP, a ribonucleoprotein complex essential for RNA virus replication) transport, assembly, and budding, and explores the cooperative role of the small GTPase RAB11A and its effector RAB11 family interacting protein 2 (FIP2) in vRNP trafficking. These processes are crucial for respiratory RNA viruses like respiratory syncytial virus (RSV) and influenza A virus (IAV), highlighting the importance of RNA-protein interactions in viral pathogenesis.

RESULTS

Through the use of cytoskeleton-depolymerizing agents, the study identified actin microfilaments as indispensable for vRNP transport, viral assembly, and viral particle budding. It also revealed the importance of the RAB11A-FIP2 complex in these processes, which are critical for the intracellular trafficking of viral RNA. The development of peptides targeting the RAB11A-FIP2 complex led to the suppression of RAB11A function in infected cells, resulting in vRNP aggregation in the cytoplasm and reduced viral replication. The peptide YT-DRI showed strong broad-spectrum antiviral activity against HPIV3, RSV, and IAV in cellular and animal models and was effective against co-infections in vitro. The antiviral effects of YT-DRI were abolished upon deletion of RAB11A or core components of the RAB11A pathway.

CONCLUSION

This work introduces a promising broad-spectrum antiviral strategy for respiratory tract infections by targeting the RAB11A-FIP2 complex, which regulates the transport and assembly of viral RNA. By disrupting this pathway, YT-DRI effectively inhibits the replication of multiple respiratory RNA viruses, including HPIV3, RSV, and IAV.

Predictive models and clinical manifestations of intrapulmonary vascular dilatation and hepatopulmonary syndrome in patients with cirrhosis: Prospective comparative study

BACKGROUND

Patients with cirrhosis with hepatopulmonary syndrome (HPS) have a poorer prognosis. The disease has a subtle onset, symptoms are easily masked, clinical attention is insufficient, and misdiagnosis rates are high.

AIM

To compare the clinical characteristics of patients with cirrhosis, cirrhosis combined with intrapulmonary vascular dilatation (IPVD), and HPS, and to establish predictive models for IPVD and HPS.

METHODS

Patients with cirrhosis were prospectively screened at a liver-specialized university teaching hospital. Clinical information and blood samples were collected, and biomarker levels in blood samples were measured. Patients with cirrhosis were divided into three groups: Those with pure cirrhosis, those with combined IPVD, and those with HPS based on contrast-enhanced transthoracic echocardiography results and the pulmonary alveolar-arterial oxygen gradient values. Univariate logistic regression and Least Absolute Shrinkage and Selection Operator (LASSO) regression methods were utilized to identify risk factors for IPVD and HPS, and nomograms were constructed to predict IPVD and HPS.

RESULTS

A total of 320 patients were analyzed, with 101 diagnosed with IPVD, of whom 54 were diagnosed with HPS. There were statistically significant differences in clinical parameters among these three groups of patients. Among the tested biomarkers, sphingosine 1 phosphate, angiopoietin-2, and platelet-derived growth factor BB were significantly associated with IPVD and HPS in patients with cirrhosis. Following LASSO logistic regression screening, prediction models for IPVD and HPS were established. The area under the receiver operating characteristic curve for IPVD prediction was 0.792 (95% confidence interval [CI]: 0.737-0.847), and for HPS prediction was 0.891 (95%CI: 0.848-0.934).

CONCLUSION

This study systematically compared the clinical characteristics of patients with cirrhosis, IPVD, and HPS, and constructed predictive models for IPVD and HPS based on clinical parameters and laboratory indicators. These models showed good predictive value for IPVD and HPS in patients with cirrhosis. They can assist clinicians in the early prognosis assessment of patients with cirrhosis, ultimately benefiting the patients.

HEIRES questionnaire: ensuring equality in health research

OBJECTIVE

The inadequate collection, analysis, presentation and dissemination of sex and/or gender disaggregated data leads to persistent gender bias in biomedical research, clinical trials, publications and health information systems which have a negative impact on medical practice. In addition, gender gap persists in many scientific institutions and among researchers, despite various initiatives to promote equality among all professionals involved in research teams. The aim of this study is to create a tool to assess the inclusion of a gender perspective in biomedical research.

METHOD

Relevant scientific publications on gender inclusion and biomedical studies indexed in the Web of Science were analysed, and guidelines and recommendations developed by leading governmental institutions, funding agencies and academic organisations were also reviewed. A panel of experts then used the Delphi method to identify useful variables for designing a questionnaire on gender inclusion in health sciences research.

RESULTS

For the first time, the questionnaire HEIRES assesses the integration of a gender perspective in a transversal way at all stages of biomedical research, from team composition to study development and dissemination. The final result is an immediate and objective score that allows professionals, institutions and policy-makers to identify strengths and potential areas for improvement in the integration of gender perspective in their research and/or within their organisations.

CONCLUSIONS

Identifying gaps in the biomedical research process improves the quality of research centres, teams and studies and bring them closer to a fairer, more inclusive and equitable scenario towards personalised health.

Exposure to microplastics and nanoplastics induces transcriptional and physiological alterations, and immune responses in sea cucumber,Holothuria leucospilota

Microplastics (MPs) and nanoplastics (NPs) are pervasive pollutants widely distributed across aquatic ecosystems. They have gained significant attention due to their potential adverse effects on marine organisms. Many marine species, particularly sea cucumbers, inadvertently ingest these plastic particles due to their non-selective feeding behavior. In this study we carried out a 14-day exposure experiment and investigated the effects of polyethylene MPs and NPs on gene expression, oxidative stress, immune condition and histology of a tropical sea cucumber, Holothuria leucospilota, a most abundant sea cucumbers species in the world. The results showed that MPs and NPs dramatically altered gene expression in discrepant profiles. NPs caused down-regulation of the majority of genes related to metabolic processes. In contrast to the enrichment of GO terms which related to regulation, differentiation and development after being exposed to MPs, metabolome-related GO terms were significantly enriched in NPs exposure. The toxicity mechanism associated with the NPs and MPs exposure involves the activation of the antioxidant defense system and the disruption of immune balance. Furthermore, histological destruction of the respiratory tree in NP and MP groups provided robust evidence for the unstable physiological condition. Our study deepens the comprehension of size-dependent plastic toxicity on marine benthic invertebrates, thereby posing a potential hazard to marine ecosystems.

Bioactive biopolymer films reinforced with cellulose nanocrystals and green-extracted polyphenols from date seeds for veal meat preservation

This study investigated the effectiveness of bioactive films fabricated using chitosan (Cs) reinforced with cellulose nanocrystals (CNC) and polyphenolic components extracted using natural deep eutectic solvents (NADES), both derived from date seeds. The CsCNC films with NADES-extracted date seed polyphenols (DSP) showed significant antimicrobial activity against Staphylococcus aureus, Listeria monocytogenes, Salmonella typhimurium, and Escherichia coli. Total phenolic content (0.01 to 0.20 mg GAE/mL), 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity (0.10 to 3.22 mmol TE/mL), and ferric-ion reducing antioxidant power (0.49 to 3.31 μmol TE/mL) improved significantly. Elongation at break (46.53 % to 90.87 %) and thickness (0.08 mm to 0.17 mm) increased while tensile strength (11.62 MPa to 3.30 MPa) decreased after incorporating DSP. The films improved UV-shielding ability, although DSP affected water barrier properties (2.91 to 7.83 × 10-10 g/m.s.Pa) and increased solubility and swelling rate. The performance of CsCNC bioactive film containing 4 % DSP for preserving veal meat during refrigeration for 8 days was studied. Compared to conventional cling film, the bioactive film retained meat quality by preserving pH, color, and lipid stability while delaying microbial spoilage. This study demonstrates the potential of valorizing both phenolic and cellulosic fractions from date seeds to develop an eco-friendly and bioactive packaging film.

A Mitochondria-Targetable Europium(III) Complex-Based Probe for Time-Gated Luminescence and Lifetime Detection of Hypochlorous Acid In Vitro and In Vivo

We proposed a strategy for developing a mitochondria-targeting lanthanide complex-based probe, Mito-ANMTTTA-Eu3+, designed for hypochlorous acid (HClO) detection using time-gated luminescence intensity and lifetime modes. The probe consists of a terpyridine polyacid-Eu3+ complex as the luminophore, a 4-amino-3-nitrophenyl group for HClO recognition, and a triphenylphosphonium (TPP) group as the mitochondrial-targeting moiety. The probe initially exists in a "dark state," characterized by a relatively short luminescence lifetime. Upon reaction with HClO, the time-gated luminescence (TGL) intensity and the average luminescence lifetime of Mito-ANMTTTA-Eu3+ increased by approximately 20-fold and 15-fold, respectively. These features enable sensitive and accurate detection of HClO by utilizing TGL and luminescence lifetime as complementary detection strategies. Cell imaging studies revealed that the probe was predominantly localized in the mitochondria after coculture with live cells, and it could effectively image both endogenous and exogenous HClO in mitochondria under background-free TGL mode. Furthermore, the probe was effectively implemented for the imaging of HClO in zebrafish and the livers of drug-induced liver injury (DILI) mice, revealing a positive correlation between HClO levels and the degree of DILI. Consequently, this study paves a new way for designing lanthanide complex-based dual-made luminescent probes for biosensing and bioimaging.

Preclinical evaluation of the efficacy and safety of adeno-associated virus 8-tissue-nonspecific alkaline phosphatase-D10 in Alpl-/- and AlplPrx1/Prx1 mouse models for the treatment of early and late-onset hypophosphatasia

We previously documented successful resolution of skeletal and dental disease in the infantile and late-onset murine models of hypophosphatasia (HPP) with a single injection of an adeno-associated serotype 8 vector encoding mineral-targeted TNAP (AAV8-TNAP-D10). Here, we conducted dosing studies in both HPP mouse models. A single escalating dose from 4 × 108 up to 4 × 1010 (vg/b) was intramuscularly injected into 4-day-old Alpl-/- mice (an infantile HPP model) and a single dose from 4 × 106 up to 4 × 109 (vg/b) was administered to 8-wk-old AlplPrx1/Prx1 mice (a late-onset HPP model). Wild-type littermates were used as controls. Serum alkaline phosphatase activity was increased, and PPi levels were decreased in a dose-dependent manner in both the Alpl-/- and AlplPrx1/Prx1 models. Radiographic and μCT analysis of long bones of female and male Alpl-/- mice showed full correction of skeletal phenotype at 4 × 1010 vg/b. We observed full correction of the bone phenotype at 4 × 108 and 4 × 109 in female AlplPrx1/Prx1 mice, but bones remained hypomineralized with the 4 × 106 and 4 × 107 (vg/b) doses after 70 d of treatment. We observed skeletal improvements using the 4 × 109 (vg/b) dose, but the phenotype was not fully corrected in male AlplPrx1/Prx1. Immunohistochemistry using anti-TNAP and anti-D10 antibodies showed high immunolocalization in the femurs of female AlplPrx1/Prx1 mice, while D10 immunolocalization was high in the liver of male AlplPrx1/Prx1 mice at a dose of 4 × 109 (vg/b). This sex-dependent difference was not seen in the infantile HPP model. A serum proteome analysis showed enhanced inflammatory pathways in treated AlplPrx1/Prx1 males compared to treated female mice. We also found a few areas of ectopic calcification in soft organs at the highest tested dose of 4 × 1010 (vg/b) in Alpl-/- or 4 × 109 (vg/b) in the AlplPrx1/Prx1 model. This pre-clinical study will inform the design of clinical trials to develop gene therapy in early-onset and late-onset HPP patients.

Brief early-life motor training induces behavioral changes and alters neuromuscular development in mice

In this study, we aimed to determine the impact of an increase in motor activity during the highly plastic period of development of the motor spinal cord and hindlimb muscles in newborn mice. A swim training regimen, consisting of two sessions per day for two days, was conducted in 1 and 2-day-old (P1, P2) pups. P3-trained pups showed a faster acquisition of a four-limb swimming pattern, accompanied by dysregulated gene expression in the lateral motor column, alterations in the intrinsic membrane properties of motoneurons (MNs) and synaptic plasticity, as well as increased axonal myelination in motor regions of the spinal cord. Network-level changes were also observed, as synaptic events in MNs and spinal noradrenaline and serotonin contents were modified by training. At the muscular level, slight changes in neuromuscular junction morphology and myosin subtype expression in hindlimb muscles were observed in trained animals. Furthermore, the temporal sequence of acquiring the adult-like swimming pattern and postural development in trained pups showed differences persisting until almost the second postnatal week. A very short motor training performed just after birth is thus able to induce functional adaptation in the developing neuromuscular system that could persist several days. This highlights the vulnerability of the neuromuscular apparatus during development and the need to evaluate carefully the impact of any given sensorimotor procedure when considering its application to improve motor development or in rehabilitation strategies.

SDCBP Orchestrated Gastric Cancer Aggression Through Epithelial- Mesenchymal Transition and Macrophages M2 Polarization

Gastric cancer remains a significant global health burden with limited treatment options and high mortality. Syndecan-binding protein (SDCBP), a scaffolding protein involved in tumor differentiation, has attracted attention as a potential therapeutic target in cancers. However, its precise role in gastric cancer progression is not fully understood. In this study, through bioinformatics analysis and gastric cancer samples detection, we discovered that SDCBP was highly expressed in gastric cancer tissues, which was correlated with clinicopathological features such as tumor invasion depth and distant metastasis, and exhibited heterogeneity across histological or molecular subtypes. Elevated SDCBP expression promoted the proliferation, invasion and migration of gastric cancer cells, and modulated epithelial-mesenchymal transition (EMT) via the ERK signaling pathway. Xenograft experiments in mice confirmed that inhibiting SDCBP or ERK signaling could delay cancer progression. We also found that gastric cancer cells with SDCBP knockdown were able to inhibit the M2 polarization of cocultured macrophages, reduce chemotaxis and enhance phagocytosis of macrophages. Therefore, SDCBP plays a crucial role in driving gastric cancer progression. Targeting SDCBP in gastric cancer can partially reverse the malignant phenotype, and SDCBP is expected to be a promising therapeutic target for gastric cancer.

Strain- and sex-dependent variability in hepatic microcirculation and liver function in mice

BACKGROUND

The integrity and functionality of the hepatic microcirculation are essential for maintaining liver health, which is influenced by sex and genetic background. Understanding these variations is crucial for addressing disparities in liver disease outcomes.

AIM

To investigate the sexual dimorphism and genetic heterogeneity of liver microcirculatory function in mice.

METHODS

We assessed hepatic microhemodynamics in BALB/c, C57BL/6J, and KM mouse strains using laser Doppler flowmetry and wavelet analysis. We analyzed the serum levels of alanine transaminase, glutamic acid aminotransferase, total bile acid, total protein, alkaline phosphatase, and glucose. Histological and immunohistochemical staining were employed to quantify microvascular density and the expression levels of cluster of differentiation (CD) 31, and estrogen receptor α, and β. Statistical analyses, including the Mantel test and Pearson correlation, were conducted to determine the relationships among hepatic function, microcirculation, and marcocirculation between different sexes and across genetic backgrounds.

RESULTS

We identified sex-based disparities in hepatic microhemodynamics across all strains, with males exhibiting higher microvascular perfusion and erythrocyte concentration, but lower blood velocity. Strain-specific differences were evident, particularly in the endothelial oscillatory characteristics of the erythrocyte concentration. No sex-dependent differences in estrogen receptor expression were observed, while significant variations in CD31 expression and microvascular density were observed. The correlations highlighted relationships between hepatic microhemodynamics and liver function indicators.

CONCLUSION

Our findings indicate the influence of genetic and sex differences on hepatic microcirculation and liver function, highlighting the necessity of incorporating both genetic background and sex into hepatic physiology studies and potential liver disease management strategies.

Histopathology of Autoimmune Hepatitis: An Update

Autoimmune hepatitis (AIH) is a rare immune-mediated chronic liver disease that is diagnosed based on a combination of biochemical, immunologic, and histologic features and the exclusion of other causes of liver disease. According to the new consensus criteria of the International Autoimmune Hepatitis Pathology Group (IAIHPG), the likely histologic features include a chronic hepatitis pattern of injury with a lymphoplasmacytic portal infiltrate, interface activity, and portal-based fibrosis. More than mild lobular hepatitis with any of the above features can also be diagnosed as likely AIH in the absence of features of another liver disease. Centrilobular injury with prominent hepatocellular necrosis and mononuclear inflammation may represent an acute-onset disease and indicate possible AIH in the absence of concurrent liver disease. Kupffer cell hyaline bodies and portal lymphocyte apoptosis are significantly associated with AIH, whereas emperipolesis and hepatocellular rosette formation are nonspecific features indicative of disease severity. Liver histology is an integral part of the clinical diagnostic scoring system and is required to confirm or support AIH diagnosis. Substitution of the histologic component of the simplified AIH scoring system with the consensus IAIHPG criteria has been proposed to optimize clinical diagnosis. This review explores the significant role of histopathology in AIH by analyzing its main features and current histologic diagnostic criteria, different AIH presentations, differential diagnosis, assessment of concurrent liver disease, and identification of AIH variants with primary cholangiopathy.

High Fibroblast Activation Protein Expression in Hepatocellular Carcinoma: CT Imaging Features and Histological Characteristics

RATIONALE AND OBJECTIVES

To clarify computed tomography (CT) imaging features of high fibroblast activation protein (FAP) expression in hepatocellular carcinoma (HCC) and to investigate their correlation to histological characteristics and prognosis.

METHODS

This retrospective multicenter study evaluated patients with HCC who underwent liver resection between August 2013 and June 2023. Histological staining for FAP was performed, and patients were classified into low and high-FAP expression groups. A predictive model was developed and validated to identify FAP expression levels among CT imaging features. Moreover, CT imaging-related histological characteristics were evaluated. With the predictive model, patients in training cohort were stratified into predicted low and high-FAP expression groups. Overall survival (OS) and recurrence-free survival (RFS) were compared accordingly. Besides, propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analysis were performed, and OS and RFS between the two groups were also compared.

RESULTS

In total, 1197 patients were included (high-FAP HCCs, n=267). Delayed central enhancement (OR: 15.196, 95% CI: 8.996-25.670, P<0.001) and dilated vasculature (OR: 7.455, 95% CI: 4.928-11.277, P<0.001) independently predicted high-FAP expression (AUCs: 0.779, training; 0.766, external validation). Based on these two CT imaging features, intratumoral fibrosis (ITF) and vessel-encapsulating tumor cluster (VETC) pattern were determined. Compared to low-FAP HCCs, high-FAP HCCs were more frequently with high ITF grade (54.7% vs. 22.4%; P<0.001) and VETC pattern (52.1% vs. 22.6%; P<0.001). Patients were divided into predicted low (n=564) and high (n=262) FAP expression groups. The predicted low-FAP group had significantly better or favorable trend toward improved OS and RFS than predicted high-FAP group before (P<0.001, OS and RFS), and after PSM (P=0.009, OS; P=0.005, RFS) and IPTW (P=0.019, OS; P=0.077, RFS).

CONCLUSION

Delayed central enhancement and dilated vasculature are independent factors of high-FAP expression in HCC. Noninvasive identifying FAP expression may offer potential prognostic and therapeutic insights.

Glycosphingolipids as emerging attack points in bladder cancer

Bladder cancer is a prevalent malignancy associated with significant morbidity and mortality worldwide. Emerging research highlights the critical role of glycosphingolipids (GSLs) in bladder cancer progression. In this review, we examine GSL expression profiles in bladder cancer and explore their contributions to key cancer hallmarks, including invasion and metastasis, immune evasion, and resistance to cell death. We further discuss the potential of GSLs as therapeutic targets and non-invasive biomarkers, with an emphasis on recent advances in GSL-targeting strategies. Additionally, we highlight our recent discovery of a novel, patented biomarker for bladder cancer diagnosis, identified using cutting-edge glyco-analytical technologies.

Frequency and risk factors of metabolic associated fatty liver disease among medical students in Egypt

Metabolic (dysfunction) associated fatty liver disease (MAFLD) is a growing global concern. This study assessed the frequency of hepatic steatosis and MAFLD, alongside their associated risk factors, among medical students at Suez University, Egypt. A cross-sectional study was conducted from November 2022 to April 2023 among 84 medical students aged ≥ 18 years. Data on anthropometric parameters, body composition, and lifestyle were collected through self-administered questionnaires, InBody analysis, and FibroScan. MAFLD diagnosis required steatosis (≥ 238 dB/m) with obesity, metabolic dysfunction, or both. Statistical analyses included chi-square tests, ANOVA, and logistic regression. Hepatic steatosis was present in 25% of participants, while MAFLD frequency was 13.1%. Participants with MAFLD exhibited higher body weight (82.34 ± 10.78 kg vs. 65.84 ± 10.61 kg, p < 0.001), BMI (29.05 ± 3.66 vs. 22.90 ± 3.23 kg/m2, p < 0.001), waist circumference (88.73 ± 8.73 cm vs. 78.10 ± 7.96 cm, p < 0.001), BMR (1566.09 ± 27.37 vs. 1429.86 ± 93.44 kcal/day, p < 0.001), and fat mass (32.74 ± 7.25% vs. 23.91 ± 8.60%, p < 0.001). Binary regression analysis revealed increased body weight, BMI, waist circumference, and BMR as significant risk factors for MAFLD. An elevated fat mass percentage with a reduced muscle mass percentage highlighted the sarcopenic obesity role in MAFLD progression. Extreme weight reduction can exacerbate hepatic fat accumulation. Poor sleep quality, a sedentary lifestyle, and an unhealthy diet are also significant predictors. The widespread frequency of steatosis and MAFLD highlights the pressing need to tackle this silent epidemic among young Egyptian adults.

Organoids in Dynamic Culture: Microfluidics and 3D Printing Technologies

With the rapid advancement of biomaterials and tissue engineering technologies, organoid research and its applications have made significant strides. Organoids are increasingly utilized in pharmacology, regenerative medicine, and precision clinical medicine. Current trends in organoid research are moving toward multifunctional composite three-dimensional cultivation and dynamic cultivation strategies. Key technologies driving this evolution, including 3D printing and microfluidics, continue to impact new areas of discovery and clinical relevance. This review provides a systematic overview of these emerging trends, discussing the strengths and limitations of these critical technologies and offering insight and research directions for professionals working in the organoid field.

Associations between non-insulin-based insulin resistance surrogate markers and liver-related outcomes in metabolic dysfunction-associated steatotic liver disease: a nationwide cohort study in South Korea

BACKGROUND

Insulin resistance (IR) is a crucial mechanism in the pathogenesis and clinical progression of metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to examine the relationship between non-insulin-based IR surrogate markers and the incidence of liver-related outcomes in individuals with MASLD in a nationwide Korean cohort.

METHODS

A total of 66,334 individuals with MASLD who underwent a health examination between 1 January 2009 and 31 December 2010 were included in the study and followed until 31 December 2019, with a median follow-up period of 9.4 years. Hepatic steatosis was defined as a fatty liver index ≥ 30. The triglyceride-glucose (TyG) index, triglyceride-to-high-density lipoprotein cholesterol (TG/HDL) ratio, and metabolic score of IR (METS-IR) were employed as non-insulin-based IR surrogate markers. The MASLD groups were divided into four groups based on the non-insulin-based IR surrogate markers quartiles. The primary outcome was liver-related outcomes, as a composite of hepatocellular carcinoma and decompensated liver cirrhosis.

RESULTS

The MASLD group was 64.4% male (average age, 59.0 years). Using the lowest quartile (Q1) of the three non-insulin-based IR surrogate markers as a reference, a decrease in the adjusted hazard ratio for liver-related outcomes was observed from Q2 to Q4: (TyG: Q2 0.90 [95% confidence interval [CI]: 0.79-1.02], Q3 0.80 [95% CI: 0.70-0.91], Q4 0.80 [95% CI: 0.69-0.92]; TG/HDL: Q2 0.85 [95% CI: 0.75-0.97], Q3 0.81 [95% CI: 0.71-0.92], Q4 0.81 [95% CI: 0.71-0.93]; METS-IR: Q2 0.83 [95% CI: 0.73-0.95], Q3 0.80 [95% CI: 0.70-0.91], Q4 0.80 [95% CI: 0.70-0.92]).

CONCLUSIONS

A lower non-insulin-based IR surrogate marker in the MASLD group may be associated with an increased risk of liver-related outcomes. In the course of monitoring MASLD, metabolic alterations must be meticulously observed.

CXCR7 promoted proliferation, migration and invasion in HCC Cells by inactivating Hippo-YAP signaling

BACKGROUND

CXCR7 (ACKR3) has been well-supported as a promoter of growth and metastasis in hepatocellular carcinoma (HCC). Both CXCR7 and Hippo signaling play roles in organ development. We aimed to verify the involvement of Hippo-YAP signaling in CXCR7-regulated HCC proliferation, migration, and invasion.

METHODS

HCCLM3 cells were transfected with si-CXCR7, pcDNA-CXCR7, or related control RNA/empty vector. Cell proliferation was assessed using the Cell Counting Kit-8 (CCK-8), and mRNA and protein levels were measured via quantitative real-time PCR (qPCR) and Western blotting. Colony formation assays were conducted to evaluate proliferation capacity, and Transwell assays were used to assess invasion and migration. Transcriptome data from the TCGA-LIHC dataset were analyzed to investigate the potential effects of CXCR7 in HCC.

RESULTS

si-CXCR7 inhibited cell proliferation in HCCLM3 cells, while pcDNA-CXCR7 promoted it. Migration and invasion were suppressed by si-CXCR7 but enhanced by pcDNA-CXCR7. Patients with higher CXCR7 expression in the TCGA-LIHC dataset had lower overall survival rates and increased gene transcription. The CXCR7-high expressing samples were characterized by the activation of several pathways, including PI3K-AKT signaling, calcium signaling, and the Hippo signaling pathway. si-CXCR7 reduced the relative protein levels of Gαq/11 and GαS while increasing phosphorylated LATS and phosphorylated YAP. Opposite trends in these proteins were observed with pcDNA-CXCR7. Finally, the inhibitory effects of si-CXCR7 on cell proliferation, migration, and invasion were reversed by the YAP inhibitor verteporfin.

CONCLUSION

We suggest that CXCR7 promotes the growth and metastasis of HCC cells, at least in part, by inactivating the Hippo-YAP signaling pathway.

GPX2 inhibition enhances antitumor efficacy of lenvatinib via promoting immunogenic cell death in hepatocellular carcinoma

BACKGROUND

Immunogenic cell death (ICD) is a distinct subtype of regulatory cell death, and represents a potential mechanism to remodel the tumor microenvironment. Lenvatinib is established as the first-line therapy for advanced hepatocellular carcinoma (HCC), but drug resistance limits its efficiency. Our previous research showed that lenvatinib can inhibit GPX2 expression and induce reactive oxygen species (ROS)-related cell apoptosis in HCC. The present study intends to explore whether lenvatinib can induce ICD and clarify its underlying mechanisms in HCC.

METHODS

Flow cytometry was utilized to detect the expression levels of CRT and CD markers, measure intracellular ROS levels, and assess cell apoptosis. Western blot analysis was employed to determine changes in protein levels, while qRT-PCR analysis was used to quantify alterations in mRNA levels. Subcutaneous allograft tumor models were established to investigate the mechanism of lenvatinib against HCC. Immunohistochemical (IF) staining were used to detect the ratio of CD8+GZMB+ cells.

RESULTS

Herein, we found that HCC cells treated with lenvatinib or si-GPX2 showed increased ICD markers, such as CRT exposure, ATP secretion, and HMGB1 release. Notably, we demonstrated that lenvatinib promoted dendritic cells (DCs) maturation and CD8+ T cells activation, thus inducing HCC cell apoptosis when co-cultured with peripheral blood mononuclear cells. Additionally, we further demonstrated that lenvatinib or GPX2 inhibition triggers endoplasmic reticulum stress (ERS) in HCC cells, which is mediated by the accumulation of ROS. Our findings indicate that pre-treatment with the antioxidant N-acetylcysteine suppressed lenvatinib-induced expression of CRT on the cell membrane, ATP secretion and HMGB1 release, and inhibited lenvatinib-induced cell apoptosis. Furthermore, we also found that ERS inhibitor ISRIB could reverse lenvatinib-induced upregulation of ICD biomarkers. Moreover, we further identified that downregulation of GPX2 enhanced the efficacy of lenvatinib via triggering ERS-mediated ICD in HCC.

CONCLUSIONS

This study uncovered that lenvatinib could be a potent ICD inducer, which could trigger ERS via increasing ROS levels in HCC cells, which present valuable insights into the mechanism of lenvatinib-induced ICD in HCC cells. Collectively, our findings highlight the significant therapeutic potential of the combination of targeting GPX2 and treatment with lenvatinib for HCC.

Atezolizumab Plus Bevacizumab in Patients with Unresectable Hepatocellular Carcinoma: Real-World Experience From a US Community Oncology Network

Purpose

Atezolizumab plus bevacizumab (atezo-bev) is a preferred first-line (1L) systemic therapy option for unresectable hepatocellular carcinoma (uHCC). However, evidence of its effectiveness in real-world clinical practice, including in patients with impaired liver function, remains limited.

Patients and Methods

This retrospective observational study included adult patients who initiated 1L atezo-bev for uHCC within The US Oncology Network between 1/1/2019 and 8/31/2022 using structured and unstructured electronic health records data. Overall survival (OS) and real-world progression-free survival (rwPFS) were assessed using Kaplan-Meier methods for the overall cohort and in a subgroup of "trial-like" patients with characteristics that were consistent with those of the IMbrave150 Trial (ECOG performance status 0-1, Child-Pugh class A, albumin-bilirubin grade 1-2).

Results

Overall, 374 patients met eligibility criteria (mean age 68.8 years, 78.9% male, 31% Child-Pugh class B-C among reported, 18% ECOG performance status ≥2 among reported), of whom 132 patients comprised the trial-like subgroup. At a median follow-up of 5.6 months, median (95% CI) OS was 13.2 (9.5, 15.9) months and rwPFS was 6.4 (5.1, 7.7) months. In the trial-like subgroup, median (95% CI) OS was 16.5 (13.2, NR) months and rwPFS was 9.4 (5.7, 12.5) months.

Conclusion

Atezo-bev was used as 1L systemic therapy for HCC in a diverse patient population across US community oncology settings. Real-world effectiveness of atezo-bev among trial-like patients is comparable to that reported in the Phase 3 study. These data can help guide selection of appropriate treatment candidates and maximize the benefits of atezo-bev in routine clinical practice.

Exploring the genetic link between gastroesophageal reflux disease and pancreatic cancer: insights from Mendelian randomization

BACKGROUND

Gastroesophageal reflux disease (GERD) is increasingly recognized for its associations with extragastric diseases, yet its potential role in pancreatic cancer (PC) etiology remains underexplored. This study investigates the genetic causal relationship between GERD and PC using Mendelian randomization (MR), a method designed to reduce confounding factors.

METHODS

A two-sample MR analysis was conducted using genome-wide association studies (GWAS) data. The inverse variance weighted (IVW) method was applied, with additional sensitivity analyses performed to evaluate pleiotropy and heterogeneity.

RESULTS

The IVW analysis demonstrated a significant genetic association between the genetic signature predisposing to GERD and an increased risk of PC (OR: 1.36, 95% CI: 1.04-1.80, P = 0.03). There was no evidence of pleiotropy (P = 0.71) or heterogeneity (P = 0.94).

CONCLUSIONS

Our study provides robust genetic evidence supporting that the genetic predisposition to GERD is associated with an increased risk of PC. These findings emphasize the necessity of integrating GERD into PC risk assessments and encourage further research to elucidate the underlying biological mechanisms. This insight holds potential to inform strategies for early detection, prevention, and personalized management of PC in GERD patients.

Development and Validation of a Risk Prediction Model Based on Inflammatory and Nutritional Composite Indicators for Posthepatectomy Liver Failure Following Radical Resection of Hepatocellular Carcinoma

Purpose

A plethora of studies have demonstrated an association between preoperative inflammatory immunonutritional status and the prognosis of patients with hepatocellular carcinoma. Nonetheless, there is a paucity of research examining the predictive value of inflammatory immunonutritional indicators for postoperative liver failure in this patient population. This study seeks to identify independent predictors of post hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma and to develop a nomogram model.

Patients and Methods

Clinical data were collected from 760 patients diagnosed with hepatocellular carcinoma who underwent surgical treatment at a hospital in China between January 2020 and January 2024. The dataset was randomly divided into a training set (n=570, 75%) and a validation set (n=190, 25%). To identify independent predictors of PHLF in these patients, univariate analysis and least absolute shrinkage and selection operator (LASSO) regression were employed. Subsequently, a multivariate logistic regression model was developed to construct a predictive model. The predictive performance of the nomogram was evaluated using receiver operating characteristic (ROC) curve analysis, calibration curve assessment, and decision curve analysis (DCA).

Results

AAPR, ALBI, GAR, LMR, PNI, INR, APTT, and TT are independent factors associated with PHLF in patients with hepatocellular carcinoma. The C indices for the training and validation datasets were 0.691 (95% CI: 0.634-0.747) and 0.680 (95% CI: 0.556-0.804), respectively. The area under the curve (AUC) and calibration curve analyses demonstrated the nomogram's accuracy in predicting PHLF in this patient population. Furthermore, DCA indicated that the model provides a significant clinical net benefit. A comparison was made of the predictive efficacy of the nomogram prediction model and the associated composite liver function score. ROC curves were plotted for the nomogram prediction model, Child-Pugh score and ALBI score, and AUC values were calculated, which were 0.686 (95% CI 0.635-0.737) for the prediction model, 0.558(95% CI 0.512-0.603) for the Child-Pugh score. The AUC for ALBI score was 0.577 (95% CI 0.530-0.624), indicating that this nomogram prediction model was more effective than other scoring systems in predicting the study population in our center. In this study population, the nomogram model demonstrated an AUC of 0.707 (95% CI 0.620-0.794) for Child-Pugh score grade A and 0.572 (95% CI 0.501-0.643) for Child-Pugh score grade B. For tumors with a diameter of less than 5 cm, the AUC was 0.679 (95% CI 0.608-0.749), and for patients with tumors with a diameter of at least 5 cm, the AUC was 0.715 (95% CI 0.643-0.787).

Conclusion

We have developed an innovative nomogram model designed to predict the incidence of PHLF in patients diagnosed with hepatocellular carcinoma. This nomogram has a good predictive value for PHLF in HCC patients and is important for clinicians to manage patients after hepatectomy.

Interplay of GPC3, Hsa-miR-135b-3p, and FTLP3 in lung cancer metastasis

This study investigates crucial genes involved in lung cancer metastasis and their interactions within a Competitive endogenous RNA (ceRNA) regulatory network using comprehensive transcriptomic data from the TCGA and GEO databases. Differential expression analysis identified ten genes associated with lung cancer metastasis, with Glypican-3 (GPC3) emerging as a key mRNA through survival analysis. A ceRNA network involving GPC3, hsa-miR-135b-3p, and FTLP3 was constructed and validated in both cellular and animal models, elucidating their roles in cell migration, invasion, and tumorigenic potential. The analysis confirmed the significance of key genes like GPC3, with the FTLP3/hsa-miR-135b-3p/GPC3 axis playing a fundamental role in lung cancer progression. Additionally, the study identified correlations between GPC3 expression, immune cell infiltration and immune checkpoints, underscoring its impact on the immune landscape of lung cancer. Overexpression of FTLP3 effectively suppressed the migratory, invasive, and metastatic abilities of lung cancer cells, demonstrating the pivotal role of the FTLP3/hsa-miR-135b-3p/GPC3 ceRNA network in modulating tumor progression and immune responses. These results underscore its potential as a therapeutic target for managing lung cancer metastasis.

High-fat diet alters retinal lipid composition and gene expression networks in mice

BACKGROUND

High-fat diet (HFD) was suggested to be associated with several retinal diseases, including age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy (DR). Nevertheless, our understanding of the mechanisms governing retinal lipid metabolic homeostasis remains limited, with little attention focused on the influence of HFD on different retinal cell types. To address this gap, we established a high-fat model using mice fed with HFD for a duration of 6 months. Then, we conducted a comparative analysis of the retinal lipidome and proteome between normal diet (ND) and HFD-fed mice to explore the impacts of HFD on retinal lipid metabolism and gene expression network. Furthermore, we also investigated the impacts of HFD on retina in single-cell resolution by single-cell transcriptome sequencing.

RESULTS

We found that a long-term HFD significantly altered the lipid composition of the retina, with a dramatically elevated cholesterylesters (CE), phosphatidylcholine (PC), and phosphatidylglycerol (PG) level and a decreased eicosanoid level. Proteomic analysis revealed that the primary bile acid biosynthesis pathway was over-activated in HFD retinas. By using single-cell transcriptome analysis, we identified different regulation of gene expression in MG and rod cells in a high-fat environment, whereas the previously identified activation of the bile acid synthesis pathway was predominantly found in MG cells, and may be regulated by alternative pathways of bile acid synthesis, suggesting the critical roles of MG cells in retinal lipid metabolism.

CONCLUSIONS

Taken together, by multi-omics studies, we unveiled that HFD leading to the development of retinal diseases may be regulated by alternative pathways of bile acid synthesis, and our study will shed light on the treatment of these diseases.

A clinical benchmark of public self-supervised pathology foundation models

The use of self-supervised learning to train pathology foundation models has increased substantially in the past few years. Notably, several models trained on large quantities of clinical data have been made publicly available in recent months. This will significantly enhance scientific research in computational pathology and help bridge the gap between research and clinical deployment. With the increase in availability of public foundation models of different sizes, trained using different algorithms on different datasets, it becomes important to establish a benchmark to compare the performance of such models on a variety of clinically relevant tasks spanning multiple organs and diseases. In this work, we present a collection of pathology datasets comprising clinical slides associated with clinically relevant endpoints including cancer diagnoses and a variety of biomarkers generated during standard hospital operation from three medical centers. We leverage these datasets to systematically assess the performance of public pathology foundation models and provide insights into best practices for training foundation models and selecting appropriate pretrained models. To enable the community to evaluate their models on our clinical datasets, we make available an automated benchmarking pipeline for external use.

Effects of Dietary Rumen-Protected Glucose and Rumen-Protected Taurine Levels on Growth Performance, Serum Biochemical Indicators, and Liver Health in Yaks

Yaks are an important livestock species on the Tibetan Plateau, but traditional grazing practices cause a sharp drop in their weight during winter, leading to grassland degradation due to overgrazing. Although off-site fattening can improve performance and protect ecology, it often leads to a negative energy balance, liver metabolism disorders, and immune impairment due to stress. However, the effects of rumen-protected glucose (RPG) and rumen-protected taurine (RPT) on yak liver health are not yet clear. The purpose of this study was to evaluate the effects of dietary RPG and RPT levels on the growth performance, serum biochemical parameters, liver antioxidant capacity, and immunity of yaks. Twenty-eight healthy yaks weighing 170 ± 10.4 kg were randomly divided into four treatments: LGLT (RPG: 1%-low RPG [LG]; RPT: 5 g/d-low RPT [LT]), LGHT (RPG: 1%-low RPG [LG]; RPT: 20 g/d-high RPT [HT]), HGLT (RPG: 3%-high RPG [HG]; RPT: 5 g/d-low RPT [LT]), and HGHT (RPG: 3%-high RPG [HG]; RPT: 20 g/d-high RPT [HT]). The results showed that compared with the LTHT treatment group, the HGHT group upregulated the serum concentrations of glucose (p = 0.004) and Interleukin-10 (p = 0.03), the relative mRNA expression of small heterodimer partners (p = 0.01), and the sterol 12-alpha-hydroxylase (p < 0.001), while reducing the serum concentration of gamma-glutamyl transferase (p = 0.048). The serum concentration of hepatic protein carbonyl (p = 0.005) and malondialdehyde (p = 0.03) was lower in the LGHT and HGHT treatment groups than in the LGLT and HGLT groups. The relative mRNA expression of Toll-like receptor 4 (p = 0.02), Interleukin-8 (p < 0.01), and Interleukin-1β (p < 0.01) was lower in the LGHT and HGHT groups than in the LGLT and HGLT groups. Tumor necrosis factor expression was lower (p = 0.04) and glucose transporter 2 expression was higher (p < 0.01) in the HGHT group compared to other treatment groups. The expression of glucokinase, glycogen synthase, pyruvate kinase, and farnesoid X receptor was higher in the HGLT treatment group than in other treatments (p < 0.01). In conclusion, dietary supplementation with 3% PRG and 5 g/d PRT can enhance liver antioxidant capacity and immune function, reduce lipid peroxidation, and promote glucose and bile acid metabolism in yaks.

HIF-1α/LTBP2 axis activate HSCs to promote liver fibrosis by interacting with LOXL1 via the ERK pathway

Latent Transforming Growth Factor Beta Binding Protein 2 (LTBP2) is a multi-domain exocrine protein located in the extracellular matrix (ECM) and has been implicated in fibrosis across various organs. However, its role in liver fibrosis remains inadequately understood. This study aims to elucidate the function and mechanism of LTBP2 in hepatic stellate cells (HSCs) activation and liver fibrosis. Our findings indicate that LTBP2 expression is positively correlated with liver fibrosis and is significantly elevated in fibrotic liver tissues from both human and murine models. Importantly, AAV6-mediated knockdown of LTBP2 in HSCs markedly alleviates CCl4-induced liver fibrosis by inhibiting the HSCs activation and reducing collagen deposition in mice. Gain-of-function and loss-of-function experiments confirmed that overexpression or knockdown of LTBP2 can enhance or inhibit the activation of HSCs, proliferation, migration and epithelial-mesenchymal transition (EMT) in LX-2 cells. Mechanistically, chromatin immunoprecipitation (ChIP) assays and dual-luciferase reporter gene assays revealed that Hypoxia-inducible Factor 1α (HIF-1α) promotes LTBP2 expression by directly binding to the LTBP2 promoter region. Furthermore, molecular docking and co-immunoprecipitation (Co-IP) experiments demonstrated an interaction between Lysyl Oxidase Like Protein 1 (LOXL1) and LTBP2. Rescue experiments verified that LTBP2 interacts with LOXL1 via the ERK signaling pathway to promote the activation of HSCs and EMT. Our results provide compelling evidence that the HIF-1α/LTBP2 axis facilitates the activation of HSCs and EMT by interacting with LOXL1 through ERK signaling pathway, suggesting that LTBP2 may serve as a potential therapeutic target for liver fibrosis.

Combined analysis of albumin in situ hybridisation and C reactive protein immunohistochemistry for the diagnosis of intrahepatic cholangiocarcinoma: towards a molecular classification paradigm

AIMS

Intrahepatic cholangiocarcinoma (iCCA) is a diagnosis of exclusion that can pose a challenge to the pathologist despite thorough clinical workup. Although several immunohistochemical markers have been proposed for iCCA, none of them reached clinical practice. We here assessed the combined usage of two promising diagnostic approaches, albumin in situ hybridisation (Alb-ISH) and C reactive protein (CRP) immunohistochemistry, for distinguishing iCCA from other adenocarcinoma primaries.

METHODS

We conducted Alb-ISH and CRP immunohistochemistry in a large European iCCA cohort (n=153) and compared the results with a spectrum of other glandular adenocarcinomas of different origin (n=885). In addition, we correlated expression patterns with clinicopathological information and mutation data.

RESULTS

Alb-ISH was highly specific for iCCA (specificity 98.8%) with almost complete negativity in perihilar CCA and only rare positives among other adenocarcinomas (sensitivity 69.5%). CRP identified the vast majority of iCCA cases (sensitivity 84.1%) at a lower specificity of 86.4%. Strikingly, the combination of CRP and Alb-ISH boosted the diagnostic sensitivity to 88.0% while retaining a considerable specificity of 86.1%. Alb-ISH significantly correlated with CRP expression, specific tumour morphologies and small or large duct iCCA subtypes. Neither Alb-ISH nor CRP was associated with iCCA patient survival. 16 of 17 recurrent mutations in either IDH1, IDH2 and FGFR2 affected Alb-ISH positive cases, while the only KRAS mutation corresponded to an Alb-ISH negative case.

CONCLUSIONS

In conclusion, we propose a sequential diagnostic approach for iCCA, integrating CRP immunohistochemistry and Alb-ISH. This may improve the accuracy of CCA classification and pave the way towards a molecular-guided CCA classification.

Exploring the association between dietary indices and metabolic dysfunction-associated steatotic liver disease: Mediation analysis and evidence from NHANES

BACKGROUND

The association between dietary indices and metabolic dysfunction-associated steatotic liver disease (MASLD) has shown inconsistent results in previous studies. Additionally, the potential mediating variables linking dietary quality to MASLD have not been adequately explored.

METHODS

We analyzed data from 6,369 participants in the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Three dietary indices-Healthy Eating Index (HEI), Energy-adjusted Dietary Inflammatory Index (EDII), and Composite Dietary Antioxidant Index (CDAI)-were evaluated for their associations with MASLD using logistic regression models adjusted for a comprehensive range of covariates. Mediation analysis was performed to evaluate the roles of potential mediators from four domains: insulin resistance (homeostatic model assessment of insulin resistance, HOMA-IR; metabolic score for insulin resistance, METS-IR), systemic inflammation (systemic inflammatory response index, SIRI; systemic immune-inflammation index, SII), obesity or visceral fat distribution (a body shape index, ABSI; body roundness index, BRI), and oxidative stress (Gamma-Glutamyltransferase, GGT; Bilirubin; Uric Acid).

RESULTS

After adjusting for all covariates, only HEI showed a consistent inverse association with MASLD, while EDII and CDAI showed no significant associations. Mediation analysis identified METS-IR, HOMA-IR, BRI, and ABSI as significant mediators in the relationship between HEI and MASLD, with mediation proportion accounting for 47.16%, 48.84%, 52.69%, and 13.84%, respectively.

CONCLUSION

Higher HEI is associated with a reduced risk of MASLD. The findings suggest that insulin resistance and visceral fat distribution partially mediate the relationship between HEI and MASLD, providing insights into potential mechanisms linking diet and liver health.

Bulk RNA-seq conjoined with ScRNA-seq analysis reveals the molecular characteristics of nucleus pulposus cell ferroptosis in rat aging intervertebral discs

OBJECTIVE

Recently, several studies have reported that nucleus pulposus (NP) cell ferroptosis plays a key role in IDD. However, the characteristics and molecular mechanisms of cell subsets involved remain unclear. We aimed to define the key factors driving ferroptosis, and the characteristics of ferroptotic NP cells subsets during IDD.

METHODS

The accumulation of iron ions in NP tissues of rats caudal intervertebral discs (IVDs) was determined by Prussian blue staining. Fluorescent probe Undecanoyl Boron Dipyrromethene (C11-BODIPY) and lipid peroxidation product 4-Hydroxynonenal (4-HNE) staining were performed to assess lipid peroxidation level of NP cells. The differentially expressed genes in NP tissues with aging were overlapped with FerrDB database to screen ferroptosis driving genes associated with aging-related IDD. In addition, single cell sequencing (ScRNA-seq) was used to map the NP cells, and further identify ferroptotic NP cell subsets, as well as their crucial drivers. Finally, cluster analysis was performed to identify the marker genes of ferroptotic NP cells.

RESULTS

Histological staining showed that, compared with 10 months old (10M-old) group, the accumulation of iron ions increased in NP tissues of 20 months old (20M-old) rats, and the level of lipid peroxidation was also enhanced. 15 ferroptosis driving factors related to IDD were selected by cross-enrichment. ScRNA-seq identified 14 subsets in NP tissue cells, among which the number and ratio of 5 subsets was reduced, and the intracellular ferroptosis related signaling pathways were significantly enriched, accompanied by enhanced cell lipid peroxidation. Notably, ranking the up-regulation fold of ferroptosis related genes, we found Atf3 was always present within TOP2 of these five cell subsets, suggests it is the key driving factor in NP cell ferroptosis. Finally, cluster cross-enrichment and fluorescence colocalization analysis revealed that Rps6 +/Cxcl1- was a common molecular feature among the 5 ferroptotic NP cell subsets.

CONCLUSIONS

This study reveals that ATF3 is a key driver of NP cell ferroptosis during IDD, and Rps6 +/Cxcl1- is a common molecular feature of ferroptotic NP cell subsets. These findings provide evidence and theoretical support for subsequent targeted intervention of NP cell ferroptosis, as well as provide directions for preventing and delaying IDD.

Elevated Expression of CHAF1A in Hepatocellular Carcinoma Progression and Immune Modulation

Purpose

This study aimed to explore the role of CHAF1A in hepatocellular carcinoma (HCC) progression, focusing on its expression, co-expression genes, genomic alterations, promoter methylation, clinical relevance, prognostic value, and immune associations.

Methods

CHAF1A mRNA expression was analyzed using UALCAN. Co-expression genes and functions were explored via LinkedOmics. Genomic alterations were assessed using cBioPortal. Promoter methylation and clinical correlations were examined using GEO datasets. Prognostic significance was evaluated via Kaplan-Meier analysis. Immune cell infiltration and checkpoint gene associations were investigated.

Results

CHAF1A was significantly upregulated in HCC and involved in cancer-related pathways. Genomic alterations were prominent in T1-stage tumors, often linked to alcohol-related liver disease. Promoter methylation influenced HCC progression and prognosis. CHAF1A expression correlated with clinical characteristics (gender, stage, grade, etc.) and showed diagnostic potential (AUC = 0.795). High CHAF1A expression predicted poor prognosis across various subgroups and was positively associated with immune cell infiltration and checkpoint genes.

Conclusion

CHAF1A plays a critical role in HCC progression, with elevated expression linked to poor prognosis and immune modulation. These findings highlight its potential as a therapeutic target for HCC.

Human leukocyte antigen-G in hepatocellular carcinoma driven by chronic viral hepatitis or steatotic liver disease

Hepatocellular carcinoma (HCC) is the sixth most common cancer globally and the third leading cause of cancer-related mortality, primarily driven by viral infections (HCV, HBV) and steatotic liver diseases (SLD). Despite advances in treatment, early detection and accurate prognosis remain challenging. The Human leukocyte antigen G (HLA-G) molecule is dysregulated in various conditions, including cancers and viral infections. This study aimed to investigate HLA-G's role in viral-related and SLD-driven HCC. We analyzed a cohort of 116 HCC patients and 140 healthy controls to assess HLA-G genetic variants and soluble levels. Results showed significantly higher levels of soluble HLA-G in HCC patients compared to controls (Pc = 0.003). Moreover, overall survival (OS) was significantly lower in patients with the extended HLA-G*01:01:01/UTR-1 haplotype (Log-rank test, p = 0.002), a trend consistent in both HCV and/or HBV-related HCC (p = 0.025) and SLD-related HCC (p = 0.018). Elevated sHLA-G levels were associated with shorter OS across both subgroups (p = 0.034 (HBV/HCV) and p = 0.010 (SLD), respectively). The findings suggest that elevated levels of soluble HLA-G and specific genetic variants are associated with poor prognosis in HCC patients, highlighting the potential of HLA-G as a prognostic biomarker in both viral-related and steatotic liver disease-related HCC.

Association Between Alpha-1-Acid Glycoprotein and Non-Alcoholic Fatty Liver Disease and Liver Fibrosis in Adult Women

Background: Alpha-1-acid glycoprotein (AGP) is a glycoprotein synthesized mainly by the liver. Nonalcoholic fatty liver disease (NAFLD) and liver fibrosis (LF) are associated with metabolic disorders. The aim of this study was to examine the potential correlation between AGP and both NAFLD and LF. Methods: The data were derived from the 2017-2023 National Health and Nutrition Examination Survey (NHANES). The linear association between AGP and NAFLD and LF was examined by multivariate logistic regression models. Non-linear relationships were described by fitting smoothed curves and threshold effect analysis. Subgroup analysis was also performed to assess potential regulatory factors. Results: The study included 2270 females. AGP was found to be significantly and positively associated with NAFLD [OR = 12.00, 95% CI (6.73, 21.39), p < 0.001] and LF [OR = 2.20, 95% CI (1.07, 4.50), p = 0.042]. Furthermore, the association between AGP and NAFLD was significantly different in the diabetic subgroup (p < 0.05 for interaction). Additionally, we found an inverted U-shaped relationship between AGP and controlled attenuation parameter (CAP), with an inflection point at 1.20 g/L. Conclusions: We found a significant positive correlation between AGP and both NAFLD and LF, and there was an inverted U-shaped relationship between AGP and CAP.

Therapeutic Potential of Raspberry Extract in High-Fat Diet-Induced Liver Injury via Apoptosis and AMPK/PPARα Pathways

This study aimed to explore the efficacy and mechanisms of raspberry (Rubus idaeus L. fruit) aqueous extract (RE) in alleviating high-fat diet (HFD)-induced metabolic-associated fatty liver disease (MAFLD). The MAFLD mouse model was established to examine the effects of RE through liver transcriptome and metabolomics analysis. In this study, RE supplementation significantly alleviated HFD-induced liver injury, hepatosteatosis, inflammation, and insulin resistance. Liver transcriptome analysis demonstrated that RE supplementation favorably regulated signaling pathways involved in fatty acid metabolism and inflammation, including the AMPK signaling pathway, PPAR signaling pathway, apoptosis, etc. Furthermore, the injection of compound C, an antagonist of AMPK, notably reversed the hepatoprotective effects of RE, evidenced by increased lipid profile levels, accelerated fatty acid-related gene disorder, and increased positive tunnel staining area. Furthermore, liver metabolomics analysis demonstrated that RE treatment led to substantial enrichment of the liver tissue metabolite umbelliferone (UMB), which has the potential to ameliorate lipid accumulation and hepatocyte injury through the AMPK signaling pathway. In summary, RE intervention mitigated HFD-induced liver dysfunction in mice, with UMB likely being the primary component responsible for its therapeutic efficacy in the liver. In addition, this study provided new insights, suggesting that RE could be used as a promising therapeutic approach for modulating MAFLD via apoptosis and the AMPK/PPARα signaling pathway.

HIIT versus MICT in MASLD: mechanisms mediated by gut-liver axis crosstalk, mitochondrial dynamics remodeling, and adipokine signaling attenuation

OBJECTIVE

Compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on metabolic dysfunction-associated steatotic liver disease (MASLD), focusing on the mechanisms by which these two exercise modalities influence gut microbiota structure, bile acid metabolism, and intestinal barrier function, as well as their regulatory roles in hepatic lipid synthesis and oxidative dynamics. Explore the synergistic effects of exercise-mediated mitochondrial fusion remodeling and leptin signaling, elucidate the causal relationship between gut-derived factors and hepatic metabolic reprogramming, and reveal the potential multi-scale and cross-organ dominant mechanisms of exercise, providing a theoretical basis for systematically comparing the effects of different exercise modalities.

METHODS

Thirty-two male rats were randomly divided into NFD (n = 8) and HFD (n = 24) groups and fed normal chow and high-fat chow, respectively. After eight weeks, the HFD group was randomly divided into three groups: (1) MICT-8; (2) HIIT-8; and (3) HFD-8. At the end of the experiment, blood, liver, ileum, and skeletal muscle samples were collected for analysis of the rats' baseline conditions, mitochondrial function, hepatic lipid metabolism, bile acid pathway and gut microbiota, and synthesis of analyses.

RESULTS

Both modes of exercise ameliorated metabolic dysregulation and attenuated pathological progression, insulin resistance, and liver fat accumulation in rats with MASLD. Furthermore, both interventions counteracted HFD-induced intestinal barrier dysfunction and restored gut-liver axis homeostasis. HIIT and MICT also upregulated bile acid-related gene expression modulated butyrate-producing bacterial taxa, and adjusted the abundance of butyrate-generating bacteria.

CONCLUSION

Both HIIT and MICT improved lipid metabolism in MASLD rats and the difference between the HIIT and MICT groups was not statistically significant. It is noteworthy that HIIT was more effective in improving mitochondrial function in MASLD than MICT (P < 0.001).

Pioglitazone mitigates acetic acid-induced colitis in rats via epigenetic-modulation and antioxidant mechanisms

Ulcerative colitis (UC) is one of the inflammatory bowel diseases characterized by colonic damage. Epigenetic mechanisms are suggested to play a role in the pathogenesis of UC. Pioglitazone has shown promise for the treatment of UC; however, the role of epigenetic pathways in this effect is unclear. The current study aimed to explore the therapeutic and protective effects of pioglitazone against acetic acid-induced colitis (AA-C) in rats and the role of epigenetic modulation and antioxidant mechanisms in this effect. Forty male albino rats were divided into four groups (n = 10/group): control (normal saline), acetic-acid-induced ulcerative colitis (AA-C) (3 days, 2 ml acetic acid 4%), pioglitazone-treated (AA, followed by 3-week oral pioglitazone 25 mg/kg/day), and pioglitazone-protected groups (3-day oral pioglitazone 25 mg/kg/day before AA, continued with AA, and 3 weeks later). After the experiment, the body weight, colon weight-to-length ratio, and colonic tissue were evaluated. The colonic expression of epigenetic markers (DNA methyltransferase- 1 and methylated E-cadherin), oxidative stress marker (malondialdehyde), antioxidant enzyme (superoxide dismutase), and angiotensin-converting enzyme- 2 (ACE- 2) was evaluated. The pioglitazone-protected and treated groups showed significant inhibition of DNA methyltransferase- 1 and methylated E-cadherin with improvement in colonic tissue macroscopic and microscopic signs of inflammation, improved weight, less oxidative stress, and less ACE- 2 expression. These beneficial actions were more pronounced among the pioglitazone-protected group. Pioglitazone could mitigate AA-C in rats by inhibiting epigenetic DNA methyltransferase- 1 and E-cadherin gene methylation. It also inhibits oxidative stress and prevents the overexpression of ACE- 2.

Metabolic Syndrome and Liver Disease: Re-Appraisal of Screening, Diagnosis, and Treatment Through the Paradigm Shift from NAFLD to MASLD

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), encompasses a spectrum of liver diseases characterized by hepatic steatosis, the presence of at least one cardiometabolic risk factor, and no other apparent cause. Metabolic syndrome (MetS) is a cluster of clinical conditions associated with increased risk of cardiovascular disease, type 2 diabetes, and overall morbidity and mortality. This narrative review summarizes the changes in the management of people with MetS and NAFLD/MASLD from screening to therapeutic strategies that have occurred in the last decades. Specifically, we underline the clinical importance of considering the different impacts of simple steatosis and advanced fibrosis and provide an up-to-date overview on non-invasive diagnostic tests (i.e., imaging and serum biomarkers), which now offer acceptable accuracy and are globally more accessible. Early detection of MetS and MASLD is a top priority as it allows for timely interventions, primarily through lifestyle modification. The liver and cardiovascular benefits of a global and multidimensional approach are not negligible. Therefore, a holistic approach to both conditions, MetS and related chronic liver disease, should be applied to improve overall health and longevity.