World J Hepatol [JOURNAL]
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200 papers
Peripheral basophil activation: A hidden player in the immunopathogenesis of primary biliary cholangitis.
Han HQ, Bao JM, Deng W … +4 more , Guo WF, Li YF, Zheng WQ, Liu HF
World J Hepatol · 2025 Aug · PMID 40901594 · Full text
BACKGROUND: T helper 17 (Th17) cell infiltration and interleukin (IL)-17 secretion in intrahepatic small bile ducts is a critical driver of immune-mediated injury in primary biliary cholangitis (PBC). IL-6 is an essentia...
BACKGROUND: T helper 17 (Th17) cell infiltration and interleukin (IL)-17 secretion in intrahepatic small bile ducts is a critical driver of immune-mediated injury in primary biliary cholangitis (PBC). IL-6 is an essential upstream activator of Th17 cells. Basophil-derived IL-6 promotes the differentiation of CD4+ T cells and Th1 cells into Th17 cells, thereby regulating their immunological functions. AIM: To investigate the activation status and cytokine expression of basophils in PBC, elucidating potential mechanisms through which basophils contribute to its pathogenesis. METHODS: This single-center retrospective case-control study conducted at Guangdong Medical University Affiliated Hospital (China) between September 2019 and August 2024 enrolled 65 consecutive treatment-naïve patients with PBC (PBC group), 65 age- and sex-matched patients with chronic hepatitis B (CHB group), and 65 healthy controls (Normal group). Fourteen participants per group (subgroup) were randomly selected for flow cytometry analysis of basophil proportion, activation markers (CD203c and CD62 L mean fluorescence intensity), IL-6-positive basophils (IL-6+ basophils as a percentage of total basophils), and IL-17-positive T lymphocytes (CD3+CD4+IL-17+ cells) proportion among T cells. Data were analyzed using Kruskal-Wallis and tests as appropriate. RESULTS: Routine blood tests revealed significantly higher basophil counts and proportions in the PBC group compared to the CHB and Normal groups ( < 0.001 for both comparisons), with no significant differences between the CHB and Normal groups ( = 0.201). Flow cytometry revealed a higher basophil proportion in the PBC subgroup compared to the CHB ( = 0.011) and Normal subgroups ( < 0.001). The mean fluorescence intensity of CD203c on basophil surfaces was elevated in the PBC subgroup compared to the CHB ( = 0.032) and Normal subgroups ( = 0.039). The proportion of IL-6+ basophils was significantly higher in the PBC subgroup than in the CHB ( < 0.01) and Normal subgroups ( < 0.001). Similarly, the Th17 cell proportion was markedly elevated in the PBC compared to the CHB ( < 0.001) and Normal subgroups ( < 0.001). CONCLUSION: Patients with PBC have increased peripheral basophil counts with enhanced activation. Activated basophils have increased IL-6 expression, which may indirectly induce Th17 cell proliferation and contribute to PBC pathogenesis.
Role of artificial intelligence-based ocular biomarkers in hepatobiliary diseases: A scoping review.
Parmar UPS, Morya AK, Gupta PC … +2 more , Arora A, Verma N
World J Hepatol · 2025 Aug · PMID 40901593 · Full text
Artificial intelligence (AI) has become an indispensable tool in modern health care, offering transformative potential across clinical workflows and diagnostic innovations. This review explores the sation of AI technolog...
Artificial intelligence (AI) has become an indispensable tool in modern health care, offering transformative potential across clinical workflows and diagnostic innovations. This review explores the sation of AI technologies in synthesizing and analyzing multimodal data to enhance efficiency and accuracy in health care delivery. Specifically, deep learning models have demonstrated remarkable capabilities in identifying seven categories of hepatobiliary disorders using ocular imaging datasets, including slit-lamp, retinal fundus, and optical coherence tomography images. Leveraging ResNet-101 neural networks, researchers have developed screening models and independent diagnostic tools, showcasing how AI can redefine diagnostic practices and improve accessibility, particularly in resource-limited settings. By examining advancements in AI-driven health care solutions, this article sheds light on both the challenges and opportunities that lie ahead in integrating such technologies into routine clinical practice.
Iron metabolism and sepsis-associated liver injury: Methodological considerations and clinical perspectives.
Koker G
World J Hepatol · 2025 Aug · PMID 40901592 · Full text
This letter offered commentary on the recently published article by Wang that investigated the relationship between iron metabolism disorders and sepsis-associated liver injury (SALI). The original study identified seru...
This letter offered commentary on the recently published article by Wang that investigated the relationship between iron metabolism disorders and sepsis-associated liver injury (SALI). The original study identified serum iron and total iron-binding capacity as potential predictive markers of SALI, contributing important insights to critical care hepatology. In this correspondence several methodological considerations that may influence the interpretation and generalizability of the findings were discussed. These include the limitations of a single-center design, the lack of serial biomarker measurements, the omission of hepcidin (a central iron regulatory hormone) as a measured variable, and the exclusive reliance on biochemical criteria for diagnosing liver injury. The potential value of incorporating imaging modalities and additional iron-related markers such as ferritin and transferrin saturation were also highlighted. The aim was to reinforce the importance of a comprehensive approach to iron metabolism in sepsis and to suggest future directions for clinical research that may enhance the diagnostic and prognostic utility of iron-related biomarkers in SALI.
Ectopic adrenal gland in the liver leading to a misdiagnosis of hepatocellular carcinoma: A case report.
Qin MQ, Zhao YP, Xie JP
World J Hepatol · 2025 Aug · PMID 40901591 · Full text
BACKGROUND: Adrenal ectopia is a rare condition in which adrenal tissue is found in an abnormal location, often posing diagnostic challenges. Although generally considered benign, it can present as hepatic or other organ...
BACKGROUND: Adrenal ectopia is a rare condition in which adrenal tissue is found in an abnormal location, often posing diagnostic challenges. Although generally considered benign, it can present as hepatic or other organ lesions, mimicking malignant tumors. In the liver, ectopic adrenal tissue can closely resemble hepatocellular carcinoma or metastatic disease, potentially leading to unnecessary aggressive treatments such as surgery or chemotherapy. Consequently, a high index of suspicion is essential to avoid misdiagnosis and ensure appropriate management. CASE SUMMARY: In this case report, we present a 53-year-old male with ectopic adrenal tissue in the liver, mimicking a potential hepatic malignancy. Based on computed tomography and magnetic resonance imaging findings, which suggested a malignant liver lesion and a left adrenal adenoma, the patient underwent laparoscopic partial hepatectomy under general anesthesia. Intraoperatively, no signs of liver cirrhosis were observed. An intraoperative ultrasound identified a 1.2 cm hypoechoic nodule in segment 7 of the liver. Dissection of the right adrenal gland revealed that the nodule had infiltrated the hepatic parenchyma, confirming the presence of ectopic adrenal tissue. Frozen section pathology revealed proliferating adrenal tissue. The patient recovered smoothly and was discharged 10 days postoperatively. CONCLUSION: This case report underscores the importance of considering adrenal ectopia in the differential diagnosis of liver lesions, especially when imaging findings suggest malignancy.
Duodenal mucosal ablation by irreversible electroporation: Modulating the gut-liver axis in metabolic steatotic liver disease.
Ramírez-Mejía MM, Méndez-Sánchez N
World J Hepatol · 2025 Aug · PMID 40901590 · Full text
Targeting the gut-liver axis has emerged as a promising strategy in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD), a condition that currently represents the most common cause of chroni...
Targeting the gut-liver axis has emerged as a promising strategy in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD), a condition that currently represents the most common cause of chronic liver disease worldwide. Within this axis, the duodenum serves not only as a site of nutrient absorption but also as a metabolic sensor capable of influencing systemic and hepatic homeostasis. We have read with great interest the recent study by Yu , investigating the effects of duodenal mucosal ablation (DMA) by irreversible electroporation in a rat model of MASLD. The authors reported remarkable reductions in hepatic lipid content, improvements in serum lipid profiles, and both structural and functional changes in the intestinal mucosa, including alterations in enteroendocrine signaling. These results corroborate the pivotal role of the gut-liver axis in the pathogenesis of MASLD and highlight the potential of minimally invasive approaches targeting the proximal intestine. In this letter, we discuss the broader implications of these findings, emphasizing the translational relevance of intestinal modulation strategies in the comprehensive treatment of MASLD.
Risk factors and predictive modeling of early postoperative liver function abnormalities.
Zhong L, Wang HY, Li XN … +5 more , Ling Q, Hao N, Li XY, Zhao GF, Liao M
World J Hepatol · 2025 Aug · PMID 40901589 · Full text
BACKGROUND: Research has shown that several factors can influence postoperative abnormal liver function; however, most studies on this issue have focused specifically on hepatic and cardiac surgeries, leaving limited res...
BACKGROUND: Research has shown that several factors can influence postoperative abnormal liver function; however, most studies on this issue have focused specifically on hepatic and cardiac surgeries, leaving limited research on contributing factors in other types of surgeries. AIM: To identify the risk factors for early postoperative abnormal liver function in multiple surgery types and construct a risk prediction model. METHODS: This retrospective cohort study involved 3720 surgical patients from 5 surgical departments at Guangdong Provincial Hospital of Traditional Chinese Medicine. Patients were divided into abnormal ( = 108) and normal ( = 3612) groups based on liver function post-surgery. Univariate analysis and LASSO regression screened variables, followed by logistic regression to identify risk factors. A prediction model was constructed based on the variables selected logistic regression. The goodness-of-fit of the model was evaluated using the Hosmer-Lemeshow test, while discriminatory ability was measured by the area under the receiver operating characteristic curve. Calibration curves were plotted to visualize the consistency between predicted probabilities and observed outcomes. RESULTS: The key factors contributing to abnormal liver function after surgery include elevated aspartate aminotransferase and alanine aminotransferase levels and reduced platelet counts pre-surgery, as well as the sevoflurane use during the procedure, among others. CONCLUSION: The above factors collectively represent notable risk factors for postoperative liver function injury, and the prediction model developed based on these factors demonstrates strong predictive efficacy.
Copper and hepatic lipid dysregulation: Mechanisms and implications.
Gao DJ, Zeng T, Chong YT … +1 more , Li XH
World J Hepatol · 2025 Aug · PMID 40901588 · Full text
Metabolic dysfunction-associated steatotic liver disease (MASLD) and Wilson's disease (WD) are common clinical conditions characterized by hepatic steatosis. Copper has been associated with the progression of hepatic ste...
Metabolic dysfunction-associated steatotic liver disease (MASLD) and Wilson's disease (WD) are common clinical conditions characterized by hepatic steatosis. Copper has been associated with the progression of hepatic steatosis, but its precise mechanism remains unclear. Emerging research on hepatic copper homeostasis-including its role in liver aging, cuproptosis induction, and lipid metabolism dysregulation-highlighted its significance in liver pathophysiology. Multiple mechanisms have been implicated in copper-induced hepatic lipid metabolism abnormalities, including oxidative stress, mitochondrial dysfunction, endoplasmic reticulum stress, impaired glucose metabolism, AMPK activation, hepatic nuclear receptor modulation, and cuproptosis. Both copper excess and deficiency could trigger hepatic steatosis these pathways. This review systematically summarized intracellular copper metabolism regulation, elucidated potential mechanisms of copper-induced hepatic lipid dysregulation, and analyzed copper-lipid metabolism interactions in MASLD and WD. These findings provide insights into the mechanisms by which copper contributes to hepatic steatosis and offer a theoretical basis for targeting copper homeostasis as a therapeutic strategy in the treatment of liver diseases.
Chronic hepatitis C and the risk for atherosclerotic and cardiomyopathic heart disease.
Elkhattib I, Raafat KW, Elsayed B … +1 more , Elnaggar M
World J Hepatol · 2025 Aug · PMID 40901587 · Full text
Hepatitis C virus (HCV) infection has been increasingly associated with cardiovascular complications, particularly atherosclerosis and cardiomyopathy, in addition to its primary hepatic effects. Studies indicate a higher...
Hepatitis C virus (HCV) infection has been increasingly associated with cardiovascular complications, particularly atherosclerosis and cardiomyopathy, in addition to its primary hepatic effects. Studies indicate a higher prevalence of carotid atherosclerosis in patients with chronic hepatitis C infection, with viral load and steatosis emerging as independent risk factors. HCV-related atherosclerosis appears to develop through complex processes involving endothelial dysfunction, inflammation, oxidative stress, and immune dysregulation. Key cytokines, including tumor necrosis factor-alpha and interleukin-6, increase inflammatory responses, while oxidative stress markers, such as malondialdehyde, are associated with an increased risk of atherogenesis. In addition, HCV infection has been linked to cardiomyopathy. Direct viral effects, including HCV replication within cardiomyocytes and cytotoxicity induced by viral proteins, lead to myocardial injury and functional decline. Indirectly, HCV triggers immune-mediated damage, with heightened pro-inflammatory cytokines exacerbating cardiomyocyte apoptosis and fibrosis. Furthermore, HCV infection promotes a procoagulant imbalance, as evidenced by elevated factor VIII levels and thrombin potential, contributing to the increased cardiovascular risk. While substantial evidence indicates a relationship between HCV and cardiovascular disease, further research is needed to establish causality and guide therapeutic interventions.
Imaging insights into pediatric liver masses: A comprehensive minireview for hepatology practice.
Shahid M, Hilal K, Khan M … +4 more , Ejaz ZH, Altaf S, Islam S, Khandwala K
World J Hepatol · 2025 Aug · PMID 40901586 · Full text
Pediatric liver masses encompass a diverse spectrum of benign and malignant lesions, with distinct patterns based on patient age. Optimal imaging is critical for timely diagnosis, management, and prognosis. This pictoria...
Pediatric liver masses encompass a diverse spectrum of benign and malignant lesions, with distinct patterns based on patient age. Optimal imaging is critical for timely diagnosis, management, and prognosis. This pictorial minireview categorizes pediatric liver masses by age group to guide hepatology and radiology practice, with an emphasis on imaging characteristics. In children from birth to six years of age, the most common liver masses include hepatoblastoma, the most common primary hepatic malignancy in this age group; infantile hemangioma, a benign vascular tumor with a characteristic appearance on imaging; and mesenchymal hamartoma, a rare developmental lesion. For children older than six years, liver masses are distinct, with hepatocellular carcinoma being the predominant malignant lesion. Benign masses such as focal nodular hyperplasia and hepatocellular adenoma also emerge in this age range, often linked to hormonal influences or metabolic disorders. The masses observed across all pediatric age groups include hepatic cysts, choledochal cysts, hydatid cysts, pyogenic and amebic abscesses, tuberculosis, lymphoma, and metastases, each presenting with unique imaging features essential for differential diagnosis. This minireview provides a comprehensive, age-based overview of pediatric liver masses, focusing on clinical presentation and key imaging findings to support accurate diagnosis and optimize management strategies in clinical hepatology, particularly in low resource settings.
Assessment of liver stiffness measurement-related markers in predicting liver-related events in viral cirrhosis with clinically significant portal hypertension.
Li YQ, Li YQ, Li JZ … +4 more , Zhu BB, Lu Y, Feng Y, Wang XB
World J Hepatol · 2025 Aug · PMID 40901585 · Full text
BACKGROUND: Clinically significant portal hypertension (CSPH) is a crucial prognostic determinant for liver-related events (LREs) in patients with compensated viral cirrhosis. Liver stiffness measurement (LSM)-related ma...
BACKGROUND: Clinically significant portal hypertension (CSPH) is a crucial prognostic determinant for liver-related events (LREs) in patients with compensated viral cirrhosis. Liver stiffness measurement (LSM)-related markers may help to predict the risk of LREs. AIM: To evaluate the value of LSM and its composite biomarkers [LSM-platelet ratio (LPR), LSM-albumin ratio (LAR)] in predicting LREs. METHODS: This study retrospectively enrolled compensated viral cirrhosis patients with CSPH. The Cox regression model was employed to examine the prediction of LSM, LPR, and LAR for LREs. The model performance was assessed through receiver operating characteristic, decision curve, and time-dependent area under the curve analysis. The Kaplan-Meier curve was used to evaluate the cumulative incidence of LREs, and further stratified analysis of different LREs was performed. RESULTS: A total of 598 patients were included, and 319 patients (53.3%) developed LREs during follow-up. Multivariate proportional hazards modeling demonstrated that LSM, LPR, and LAR were independent predictors of LREs. LPR had better performance in predicting LREs than LAR and LSM (area under the curve = 0.780, 0.727, 0.683, respectively, all < 0.05). The cumulative incidence of LREs in the high-risk group were significantly higher than that in the low-risk group ( < 0.001). Among the different LREs, LPR was superior to LSM and LAR in predicting liver decompensation, while the difference in predicting hepatocellular carcinoma and liver-related death was relatively small. CONCLUSION: LPR is superior to LSM and LAR in predicting LREs in compensated viral cirrhosis patients with CSPH, especially in predicting liver decompensation.
Risk factors for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in cirrhotic patients: A comprehensive minireview.
Zhang JQ, Cheng DL, Zhou CZ … +1 more , Xu XJ
World J Hepatol · 2025 Aug · PMID 40901584 · Full text
Transjugular intrahepatic portosystemic shunt (TIPS) is widely used to treat portal hypertension and its complications patients with cirrhosis. However, managing post-TIPS hepatic encephalopathy (HE) remains a major clin...
Transjugular intrahepatic portosystemic shunt (TIPS) is widely used to treat portal hypertension and its complications patients with cirrhosis. However, managing post-TIPS hepatic encephalopathy (HE) remains a major clinical challenge. HE is characterized by a high incidence and a complex pathogenesis, influenced by various factors. Therefore, careful patient assessment and selection for TIPS is essential. While previous studies have identified several factors contributing to the occurrence of post-TIPS HE, there is a gap in the comprehensive integration of surgical procedural parameters and metabolic mechanisms within a multidimensional analysis. This minireview aims to optimize treatment protocols and refine management strategies by conducting a comprehensive analysis of risk factors, ultimately aiming to reduce the incidence of post-TIPS HE.
Vitamin A toxicity and hepatic pathology: A comprehensive review.
Pestalardo ML, Bevilacqua CS, Amante MF
World J Hepatol · 2025 Aug · PMID 40901583 · Full text
Vitamin A is essential for vision, immunity, and cellular function, but excessive intake, known as hypervitaminosis A, leads to liver toxicity. Toxicity can be acute (from high single doses) or chronic (from prolonged ov...
Vitamin A is essential for vision, immunity, and cellular function, but excessive intake, known as hypervitaminosis A, leads to liver toxicity. Toxicity can be acute (from high single doses) or chronic (from prolonged overconsumption), causing symptoms like nausea, bone pain, and liver damage. The normal values of vitamin A in adults, measured as serum retinol, can range from 0.3 mg/L to 1.2 mg/L. The liver, which stores vitamin A in hepatic stellate cells, becomes overwhelmed, leading to retinoid accumulation, oxidative stress, and inflammation. Pathologically, vitamin A toxicity progresses from hepatic steatosis (fatty liver) to fibrosis and cirrhosis. Histological changes include hepatocellular ballooning, stellate cell activation, and perisinusoidal fibrosis. Molecular mechanisms involve oxidative stress from reactive oxygen species, apoptosis, and dysregulated pathways (tumor growth factor-beta, nuclear factor-kappa B), which drive fibrogenesis. Chronic toxicity also disrupts lipid metabolism, worsening liver injury. Clinically, management includes limiting vitamin A intake and exploring antioxidants (., N-acetylcysteine) or anti-fibrotic therapies. Research gaps include the need for better biomarkers, personalized risk assessment, and refined dietary guidelines. Future studies should focus on therapeutic interventions and experimental models to improve outcomes. In conclusion, while vitamin A is vital, its toxicity poses serious hepatic risks. Understanding its mechanisms and developing targeted treatments are crucial for preventing liver damage and ensuring safe consumption.
Optimal guiding methods for transjugular intrahepatic portosystemic shunt creation: Characteristics of intravascular ultrasound other techniques.
Miao L, Ren JL, Zhao H … +1 more , Li X
World J Hepatol · 2025 Aug · PMID 40901582 · Full text
A recent study in examined the use of intravascular ultrasound (IVUS) for transjugular intrahepatic portosystemic shunt (TIPS) creation. The study concluded that IVUS significantly reduces procedure time, radiation expo...
A recent study in examined the use of intravascular ultrasound (IVUS) for transjugular intrahepatic portosystemic shunt (TIPS) creation. The study concluded that IVUS significantly reduces procedure time, radiation exposure, and the number of needle passes compared to conventional fluoroscopic guidance. IVUS offers real-time visualization of the portal vein, but challenges remain in terms of equipment costs and the operator learning curve. TIPS creation techniques vary widely in clinical practice, where methods, such as conventional fluoroscopy, three-dimensional image fusion, electromagnetic navigation, and IVUS, are commonly employed. In this editorial, we provide a comparative analysis of these methods based on clinical experience and the literature. By evaluating the strengths and limitations of each technique, we aim to inform clinical decision-making and enhance procedural outcomes. Future developments in TIPS creation are likely to focus on hybrid techniques that combine the strengths of IVUS, electromagnetic navigation, and real-time image fusion, potentially leading to more precise, cost-effective, and accessible methods.
Rare complete replacement-type left hepatic artery originating from the left gastric artery: A case report.
Gao XX, Xu XX, Chen P … +7 more , He TX, Du CZ, Zhou Q, Zhou GF, Guo XW, Peng JR, Li HT
World J Hepatol · 2025 Aug · PMID 40901581 · Full text
BACKGROUND: A complete replacement left hepatic artery (LHA) solely originating from the left gastric artery (LGA), with no supply from the hepatic artery proper, is exceptionally rare. This variant places entire left lo...
BACKGROUND: A complete replacement left hepatic artery (LHA) solely originating from the left gastric artery (LGA), with no supply from the hepatic artery proper, is exceptionally rare. This variant places entire left lobe perfusion on the LGA. Literature review confirms no prior reports of such an isolated LHA replacement pattern in surgical/radiological publications. Unrecognized, this anatomy carries significant intraoperative injury risk during hepatobiliary/ upper gastrointestinal surgery. CASE SUMMARY: A 62-year-old man underwent laparoscopic radical gastrectomy with D2 Lymphadenectomy for gastric cancer. During dissection of the hepatogastric ligament, an unexpected vascular anatomy was encountered: The LHA originated exclusively from the LGA, with no conventional branch from the hepatic artery proper. Recognizing this variant artery was essential for left liver perfusion, the LGA was ligated proximally near its celiac origin while meticulously preserving blood flow through the anomalous LHA. The gastrectomy and reconstruction were completed without complication. Postoperative recovery was smooth, with serial liver function tests remaining normal, confirming preserved hepatic arterial supply. CONCLUSION: Preoperative mapping detected a critical aberrant left hepatic artery; its preservation prevented liver ischemia, ensured safety.
Hepatic osteodystrophy: An underrecognized metabolic bone disease.
Pramanik S, Palui R, Ray S
World J Hepatol · 2025 Aug · PMID 40901580 · Full text
Hepatic osteodystrophy (HO) is a common and frequently untreated complication, manifested as osteoporosis or osteopenia, encountered in the evolution of chronic liver diseases (CLD). In addition to patients with chronic...
Hepatic osteodystrophy (HO) is a common and frequently untreated complication, manifested as osteoporosis or osteopenia, encountered in the evolution of chronic liver diseases (CLD). In addition to patients with chronic cholestasis and cirrhosis, patients with CLD from other etiologies may be affected. Several studies have reported an increased prevalence of osteoporosis/osteopenia in patients with CLD. The pathogenesis varies according to etiology and is multifactorial, involving genetic factors, vitamin deficiencies, proinflammatory cytokines, hypogonadism, hyperbilirubinemia, antiviral therapy, corticosteroids, and lifestyle factors. The approach to management should include individualized assessment for fracture risk factors and bone mineral density. Prevention of osteoporosis in CLD relies on the mitigation of risk factors, treatment of underlying hypogonadism, and encouraging a healthy diet and weight-bearing exercise. Treatment trials specific to HO are small, and the primary medical intervention for the treatment of osteoporosis in CLD remains bisphosphonates although the benefit in fracture reduction has not consistently been shown. Further research is necessary to better define the management and specific treatment of HO for the prevention of fragility fractures and to improve the quality of life. This article provides an updated review of HO covering all these aspects.
Liver immunology: Biological role and clinical significance.
Kotlyarov SN
World J Hepatol · 2025 Jul · PMID 40747238 · Full text
Liver diseases are of growing interest to clinicians and researchers due to their high prevalence, difficulty in early diagnosis, and limited treatment options. The liver is an important organ at the intersection of many...
Liver diseases are of growing interest to clinicians and researchers due to their high prevalence, difficulty in early diagnosis, and limited treatment options. The liver is an important organ at the intersection of many metabolic and immune pathways. To this end, it contains a large number of immune cells of both the innate and adaptive immune system that perform multiple functions, detecting and destroying pathogens that enter the body through the intestine, as well as recognizing endogenous antigens. Immune cells in the liver have a complex regulation that can be impaired in various diseases such as metabolic dysfunction-associated steatotic liver disease (MASLD), liver cancer, and biliary diseases. A growing body of evidence reinforces the realization that not only impaired metabolism but also many immune mechanisms underlie MASLD. The liver has complex bilateral immune and metabolic links with the gut microbiota, and disruptions of these links underlie the development and progression of both gastrointestinal and other organ diseases. In this regard, acting on immune mechanisms is a promising therapeutic target for liver diseases.
Analysis of gastric electrical rhythm in patients with metabolic dysfunction-associated steatotic liver disease and type 2 diabetes mellitus.
Wang XX, Yan C, Wang SJ … +6 more , Zhu H, Cao CC, Wu L, Wang S, Hu J, Zhang HH
World J Hepatol · 2025 Jul · PMID 40747237 · Full text
BACKGROUND: Diabetic gastrointestinal autonomic neuropathy (DGAN) often affects the patients' quality of life. Thus, research on influencing factors of DGAN may promote DGAN prevention and decrease the incidence rate. Th...
BACKGROUND: Diabetic gastrointestinal autonomic neuropathy (DGAN) often affects the patients' quality of life. Thus, research on influencing factors of DGAN may promote DGAN prevention and decrease the incidence rate. This study used electrogastrogram (EGG) to assess the relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and DGAN. AIM: To analyze the changes of EGG in patients with MASLD and type 2 diabetes mellitus (T2DM), and to elucidate whether ultrasound-diagnosed MASLD is an independent risk factor for diabetic gastric motility disorders (DGMD). METHODS: A total of 272 patients with T2DM hospitalized at the Second Affiliated Hospital of Soochow University from December 2020 to December 2021 and the Affiliated Suqian Hospital of Xuzhou Medical University from November 2023 to June 2024 were included in the cross-sectional study. General information, clinical data, and medical history of all study subjects, including name, age, gender, body mass index, and duration of diabetes were collected. Laboratory tests included biochemical parameters, glycosylated hemoglobin (HbA1c), fasting C-peptide, 2h postprandial C-peptide and 25-hydroxyvitamin D [25(OH)D]. EGG, fundus examination and carotid artery ultrasonography were performed and results were recorded. According to the results of EGG, the subjects were divided into the DGMD group and non-DGMD group. RESULTS: The duration of diabetes, fasting blood glucose (FBG), HbA1c, 25(OH)D and the prevalence of MASLD were significantly higher in the DGMD group ( < 0.05). Multiple logistic regression analysis showed that the duration, FBG, 25(OH)D and the presence of MASLD were independent influencing factors. CONCLUSION: MASLD is strongly associated with an increased incidence of DGMD. Timely treatment of MASLD is effective to prevent diabetic gastroparesis.
Liver regeneration after partial hepatectomy: Triggers and mechanisms.
Korchilava B, Khachidze T, Megrelishvili N … +5 more , Svanadze L, Kakabadze M, Tsomaia K, Jintcharadze M, Kordzaia D
World J Hepatol · 2025 Jul · PMID 40747236 · Full text
Liver regeneration (LR) following partial hepatectomy (PH) is a unique and complex physiological response that restores hepatic mass and function through tightly orchestrated cellular and molecular events. Traditionally...
Liver regeneration (LR) following partial hepatectomy (PH) is a unique and complex physiological response that restores hepatic mass and function through tightly orchestrated cellular and molecular events. Traditionally viewed as a proliferation-driven process, LR is now understood to involve both hepatocyte hyperplasia and hypertrophy, triggered primarily by hemodynamic alterations such as increased portal pressure and shear stress. These promote LR through endothelial-hepatocyte communication activation of Piezo1 - a mechanosensitive ion channel highly expressed in vascular endothelial cells. This channel is considered one of the potential upstream activators of molecular cascades including the interleukin (IL)-6/signal transducer and activator of transcription 3, tumour necrosis factor-alpha/nuclear factor-kappa B, Wnt/β-catenin, Hippo/ YAP, transforming growth factor-beta, and Notch pathways, which contribute variably to the proliferation, differentiation, or suppression of hepatic cells. Novel insights into the IL-22 and IL-33 signaling axes, bile acid and glutamine metabolism, and the role of intestinal microbiota are also presented as promising emerging targets. This review synthesizes current insights into the interplay between mechanical cues, key signaling pathways, and metabolic reprogramming that govern early regenerative responses. We explore the mechanisms dictating the balance between hyperplasia and hypertrophy, noting that hypertrophy predominates after minor resections, while proliferation is dominant in larger resections. Polyploidization emerges as a significant adaptive mechanism, contributing to hepatocyte survival and tissue remodeling. The importance of ductular reactions, microvascular adjustments, and extracellular matrix dynamics in lobular architecture remodeling is also highlighted. The study explores the occurrence of ductular reactions in both minor and major resections, particularly within the granulation tissue near dissection areas. The paper also examines structural remodeling in regenerated liver tissue, demonstrating ongoing transformations in hepatocyte morphology and sinusoidal architecture even months after PH, and emphasizing that the termination of liver mass regrowth does not equate to the cessation of LR.
Liver and systemic hemodynamics in cirrhotic children.
Tambucci R, Stephenne X, Channaoui A … +1 more , de Magnée C
World J Hepatol · 2025 Jul · PMID 40747235 · Full text
Portal hypertension and cirrhosis are associated with severe hemodynamic changes in hepatic and systemic circulation in the adult population. During cirrhosis progression, circulation becomes hyperdynamic, with cardiac,...
Portal hypertension and cirrhosis are associated with severe hemodynamic changes in hepatic and systemic circulation in the adult population. During cirrhosis progression, circulation becomes hyperdynamic, with cardiac, pulmonary and renal consequences. Cirrhotic adults also present with cirrhotic cardiomyopathy, with systolic and diastolic dysfunction and electrophysiological abnormalities. This article provides an update on normal liver hemodynamics, a brief reminder of the liver and systemic hemodynamics in cirrhotic adults, and a description of liver and systemic hemodynamics in cirrhotic children. This review attempts to clarify whether liver and systemic hemodynamics are altered in cirrhotic children like they are in adults. The characterization of these hemodynamic disturbances could contribute to a better understanding of hepatic and systemic physiopathology in pediatric cirrhosis.
Splenectomy and risk of hepatocellular carcinoma.
Li DQ, Lin ZY, Wang JG … +3 more , Wu RQ, Zhang Y, Du ZQ
World J Hepatol · 2025 Jul · PMID 40747234 · Full text
Hypersplenism is a common complication of cirrhosis that is associated with significant impairment to patients' life quality. Splenectomy is often employed in clinical settings as a treatment for hypersplenism. While spl...
Hypersplenism is a common complication of cirrhosis that is associated with significant impairment to patients' life quality. Splenectomy is often employed in clinical settings as a treatment for hypersplenism. While splenectomy is carried out for the purposes of alleviating hypersplenism-related adverse outcomes like thrombocytopenia or anaemia, studies have suggested alterations in the immune status, hemodynamics, and intestinal microbiota of patients following splenectomy, which may potentially influence the onset and progression of hepatocellular carcinoma (HCC). Additionally, patients have been found to face new health risks post-splenectomy, including infections and thrombosis, which could adversely impact their overall health and potentially increase the risk of HCC. Despite these findings, there is currently no consensus on whether splenectomy affects the risk of postoperative HCC in cirrhotic patients. This review synthesizes the pertinent literature on the incidence of HCC following splenectomy, with an emphasis on current evidence related to its physiology, pathophysiology, and epidemiology. Concepts such as immune status, hemodynamics changes, and intestinal microbiota in post-splenectomy patients are explored, in hopes that it can inform more individualized treatment approaches for patients.
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