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Metabolic and alcohol-associated liver disease (MetALD): a representation of duality
MetALD is a recently coined term that refers to a systemic entity to describe patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and simultaneous moderate alcohol consumption. The deleterious association of alcohol and metabolic risk factors synergistically increases the development of steatohepatitis, fibrosis, and hepatocellular carcinoma (HCC). Despite its increasing incidence, the pathophysiological mechanisms triggering liver damage in MetALD remain unclear. This review aims to summarize the prevalence, pathophysiology of MetALD, taking into account the latest clinical and translational aspects.
Clostridioides difficile infection induces a pro-inflammatory and pro-steatotic metabolic state in liver
Using a multi-omics approach, this study investigated Clostridioides difficile infection (CDI) as a direct contributor to hepatic dysmetabolism. Fifty-four C57BL/6 mice were divided into Control, Antibiotic control (Abx), and C. difficile-infected (C. diff) groups. The Abx and C. diff groups received antibiotics to induce gut dysbiosis, followed by C. difficile challenge in C. diff group. Mice were euthanized after 48 h to collect samples for multi-omics analyses. Liver metabolomics and transcriptomics pathway analyses revealed significant alterations in lipid metabolism, including dysregulation in glycerolipid, steroid, and energy metabolisms in C. difficile-infected mice. Metabolites and pathways associated with oxidative stress and inflammation were enriched. Gut metagenome-liver metabolome correlation analysis identified specific bacterial species correlating with differentially enriched liver metabolites involved in oxidative stress, amino acid, and uric acid metabolism. CDI triggers metabolic shifts that could facilitate steatosis and inflammation, suggesting that CDI could be a risk factor for metabolic liver diseases.
Role of VEGFA in type 2 diabetes mellitus rats subjected to partial hepatectomy
The crucial role of vascular endothelial growth Factor A (VEGFA) in healthy rat livers undergoing partial hepatectomy under vascular occlusion (PH + I/R) has been demonstrated. This study evaluates whether this observation can be extrapolated to the presence of type 2 diabetes mellitus (T2DM). VEGFA was pharmacologically modulated and its effects during liver surgery were evaluated. Exogenous VEGFA exacerbated necrosis, with no changes in inflammation, apoptosis, or regeneration compared to PH + I/R. Endogenous VEGFA inhibition led to damage and inflammation similar to PH + I/R but promoted regeneration via PI3K/AKT. VEGFA did not affect hepatic VEGFB. VEGFB administration increased necrosis without affecting apoptosis or regeneration. Low hepatic VEGFA and VEGFB in PH + I/R may be influenced by intestine and adipose tissue. Detrimental effects of exogenous VEGFA could be due to exacerbated hepatic necrosis, while endogenous VEGFA inhibition improved regeneration via PI3K/AKT. Therefore, endogenous VEGFA inhibition is a protective strategy promoting liver regeneration in PH + I/R with T2DM.
Crosstalk between gut microbiotas and fatty acid metabolism in colorectal cancer
Colorectal cancer (CRC) is the third most common malignancy globally and the second leading cause of cancer-related mortality. Its development is a multifactorial and multistage process influenced by a dynamic interplay between gut microbiota, environmental factors, and fatty acid metabolism. Dysbiosis of intestinal microbiota and abnormalities in microbiota-associated metabolites have been implicated in colorectal carcinogenesis, highlighting the pivotal role of microbial and metabolic interactions. Fatty acid metabolism serves as a critical nexus linking dietary patterns with gut microbial activity, significantly impacting intestinal health. In CRC patients, reduced levels of short-chain fatty acids (SCFAs) and SCFA-producing bacteria have been consistently observed. Supplementation with SCFA-producing probiotics has demonstrated tumor-suppressive effects, while therapeutic strategies aimed at modulating SCFA levels have shown potential in enhancing the efficacy of radiation therapy and immunotherapy in both preclinical and clinical settings. This review explores the intricate relationship between gut microbiota, fatty acid metabolism, and CRC, offering insights into the underlying mechanisms and their potential translational applications. Understanding this interplay could pave the way for novel diagnostic, therapeutic, and preventive strategies in the management of CRC.
Accelerometer-based sedentary time and physical activity with MASLD and liver cirrhosis in 2684 British adolescents
Evidence on the long-term relationship of sedentary time (ST), light physical activity (LPA) and moderate-to-vigorous PA (MVPA) with liver steatosis, fibrosis, cirrhosis, and changes in liver enzymes in the paediatric population is limited. This study examined the associations of cumulative ST, LPA and MVPA from childhood with longitudinal changes in liver indices and enzymes. From the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, 2684 children aged 11 years who had at least one follow-up time-points accelerometer-measured ST, LPA and MVPA over a period of 13 years, and liver indices and enzymes measures at age 24 years clinic visit were included. Liver steatosis and fibrosis were assessed by transient elastography and staged as fibrosis stage F0-F4 and steatosis grade (S0-S3) at age 24 years. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transferase (GGT) were assayed at ages 17 and 24 years. Longitudinal associations were examined using generalized linear mixed-effect models, while mediation analyses were conducted with structural equation models. Among 2684 children (mean [SD] age, 11.75 [0.24] years; 1537 [57.3%] females]), the prevalence of liver steatosis at age 17 years was 2.6% and 20.5% at age 24 years. The cumulative 1-minute/day increase in ST from ages 11–24 years was associated with higher odds of liver cirrhosis (odds ratio 1.004 [95% CI 1.002–1.005] p < 0.001) and severe liver steatosis (1.001 [1.001–1.002] p = 0.002) at age 24 years. Increased ST from childhood was directly associated with progressively increased ALT, AST and GGT from ages 17 to 24 years. Cumulative 1-min/day LPA was associated with lower odds of liver cirrhosis (0.990 [0.990–0.991] p < 0.001) and severe liver steatosis (0.999 [0.998–0.999] p < 0.001) at age 24 years, as well as decreased liver enzymes. Cumulative 1-min/day MVPA was associated with associated with lower odds of severe liver steatosis (0.996 [0.994–0.998] p < 0.001) but not liver cirrhosis at age 24 years. MVPA effect on lowering liver steatosis was significantly suppressed (64% suppression) by increased fat mass. In conclusion, increasing LPA, sustaining MVPA and decreasing ST from childhood may independently attenuate and reverse the risk of severe liver steatosis and liver cirrhosis by young adulthood.
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