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Journal of Clinical and Translational Hepatology 2023年第6期11卷 1377-1386页

作者： Quentin Binet Audrey Loumaye Michel P Hermans nicolas lanthier Service d’Hépato-Gastroentérologie Cliniques universitaires Saint-LucUCLouvainBrusselsBelgium Service d’Endocrinologie et Nutrition Cliniques universitaires Saint-LucUCLouvainBrusselsBelgium

Background and Aims:Most data on liver assessment in type 2 diabetes mellitus(T2DM)patients are from retrospective cohorts with selection *** aimed at appraising the feasibility,results,and benefits of an outpatient systematic noninvasive screening for metabolic dysfunction-associated fatty liver disease(MAFLD)severity and determinants in T2DM ***:We conducted a 50-week crosssectional study enrolling adult T2DM outpatients from a diabetes *** algorithm based on guidelines was applied using simple bioclinical scores and,if applicable,ultrasound and/or ***:Two hundred and thirteen patients were *** age and body mass index were 62 years and 31 kg/m^(2) and 29% of patients had abnormal transaminase *** acceptance rate of additional liver examinations was 92%.The prevalence of MAFLD,advanced fibrosis and cirrhosis was 87%,11%,and 4%,*** than half of the cases of advanced fibrosis had not been suspected and were detected by this *** was associated with poor glycemic control,elevated transaminases,low HDL-C and the absence of peripheral arterial *** fibrosis was linked to high waist circumference and excessive alcohol consumption,which should be interpreted with caution owing to the small number of patients reporting excessive ***:Simple bioclinical tools allowed routine triage of T2DM patients for MAFLD severity,with high adherence of high-risk patients to subsequent noninvasive exams.

关键词： Noninvasive tests MAFLD Outpatient Steatosis Fibrosis

Improving the prognosis before and after liver transplantation:Is muscle a game changer?

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World Journal of Gastroenterology 2022年第40期28卷 5807-5817页

作者： Alexis Goffaux Alicia Delorme Géraldine Dahlqvist nicolas lanthier Laboratory of Hepato-Gastroenterology Institut de Recherche Expérimentale et CliniqueUniversitécatholique de LouvainBrussels 1200Belgium Service d’Hépato-Gastroentérologie Cliniques universitaires Saint-LucUniversitécatholique de LouvainBrussels 1200Belgium

Liver transplantation(LT)is currently the only curative treatment option for selected patients with end stage liver disease or hepatocellular *** waiting list-mortality,post-transplant morbidity and mortality and refining the selection of the patients remain our current central *** this field,different concepts dealing with nutrition and the muscle such as sarcopenia,malnutrition,frailty or myosteatosis have emerged as possible game *** more than a decade,many prospective studies have demonstrated that sarcopenia and frailty are major predictive factors of mortality in the waiting list but also after *** is also a well-known risk factor for morbidity and *** composition is a newer concept giving insight on muscle quality which has also been shown to be linked to poorer *** of these terms has a precise definition as well as pathophysiological *** bidirectional liver-muscle axis makes sense in this *** the best,easy to use in clinical practice tools to assess muscle quality,quantity,and function in this specific population and developing quality prospective studies to identify interventional strategies that could improve these parameters as well as evaluate the effect on mortality are among the important challenges of today.

关键词： Muscle Liver Transplantation Sarcopenia Myosteatosis Frailty

Collagen proportionate area correlates to hepatic venous pressure gradient in non-abstinent cirrhotic patients with alcoholic liver disease

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World Journal of Hepatology 2018年第1期10卷 73-81页

作者： Sophie Restellini nicolas Goossens Sophie Clément nicolas lanthier Francesco Negro Laura Rubbia-Brandt Laurent Spahr Department of Medical Specialties Division of Gastroenterology and Hepatology Geneva University Hospitals and University of Geneva Department of Genetic and Laboratory Medicine Division of Clinical Pathology Geneva University Hospitals and University of Geneva Laboratory of Gastroenterology and Hepatology Institut de Recherche Expérimentale et Clinique Université catholique de Louvain

AIM To explore the relationship between collagen proportionate area(CPA) and portal hypertension-related clinical manifestations in alcoholic liver disease(ALD).METHODS Retrospective study with chart review of patients with ALD adressed to our center between January 2012 and December 2013 for a transjugular liver biopsy(TJLB) and hepatic hemodynamic study. Patients were included if they met the following criteria:(1) Medical indication for a liver biopsy in the setting of ALD;(2) recent(< 15 d) clinical, radiological, endoscopic and biological data available; and(3) estimated follow-up of at least 6 mo. Liver tissue from cirrhotic subjects obtained from transjugular liver biopsies was stained with Picro Sirius red and computer-assisted digital image analysis to determine fibrosis density using CPA was performed. RESULTS We included 61 patients with alcoholic ALD, subdivided in 41 active alcohol drinkers and 20 durably abstinent patients. Nine healthy liver donors served as controls. Mean CPA in patients with ALD was 7.1%, with no difference between active drinkers and abstinent patients(P = 0.17). Using a fibrosis density cutoff of 5%, we observed a positive correlation between high fibrosis density and the hepatic venous pressure gradient(HVPG) only in active drinkers(P = 0.02). At 12-mo of follow-up, in the group of active alcohol drinkers, patients reaching a composite outcome showed a higher HVPG value as compared to those who did not(18.5 mm Hg vs 14.5 mm Hg P < 0.04) whereas CPA values were similar(6.9% vs 11%, P = 0.23).CONCLUSION In active alcoholic ALD, CPA correlates to portal pressure but only HVPG predicts clinical events, pointing to the role of alcohol as a modulator of portal hypertension.

关键词： Fibrosis Hepatic venous pressure gradient Cirrhosis Chronic advanced liver disease Collagen proportionate area

Targeting Kupffer cells in non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: Why and how?

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World Journal of Hepatology 2015年第19期7卷 2184-2188页

作者： nicolas lanthier Service d’Hépato-gastroentérologie Cliniques Universitaires Saint-Luc Université catholique de Louvain Laboratory of Hepatogastroenterology Institut de Recherche Expérimentale et Clinique Université catholique de Louvain

Mechanisms for non-alcoholic steatohepatitis(NASH)development are under investigation in an era of increased prevalence of obesity and metabolic syndrome. Previous findings have pointed to the role of adipose tissue, adipose tissue macrophages and their secretory products in the development of a chronic inflammatory status inducing insulin resistance and a higher risk of liver steatosis called non-alcoholic fatty liver disease. The activation of resident macrophages [Kupffer cells(KC)] and the recruitment of blood derived monocytes/macrophages into the diseased liver have now been identified as key elements for disease initiation and progression. Those cells could be activated through gut flora modifications and an altered gut barrier function but also through the internalization of toxic lipid compounds in adjacent hepatocytes or in KC themselves. Due to the role of activated KC in insulin resistance, fibrosis development and inflammation amplification, they became a target in clinical trials. A shift towards an anti-inflammatory KC phenotype through peroxisome proliferator activator-receptorδ agonists, an inhibition of macrophage recruitment through anti-C-C chemokine receptor 2 action and a specific blocking of internalization of toxic lipoxidation or glycation compounds into KC by galectin-3 receptor inhibitors are now under investigation in human NASH.

关键词： Steatosis Non-alcoholic steatohepatitis Insulin No