Alcohol‐induced pancreatitis and alcohol‐related liver disease: Two different phenotypes of alcohol‐related harm or related conditions? DOI Open Access
Einar S. Björnsson

Journal of Internal Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 14, 2024

It is well known that overconsumption of alcohol can cause tissue injury in the liver and pancreas, apart from many other organs such as heart, brain, peripheral nervous system. has also been recognized less than 5% individuals who drink excessively will develop episodes acute pancreatitis [1]. The definition heavy drinking beyond scope this editorial, obtaining a reliable history use be challenge. pattern lifetime did not reveal any major differences among patients with disorder (AUD) were hospitalized for rehabilitation (without alcoholic pancreatitis) previously diagnosed alcohol-induced (AIP) [2]. In study, males AIP had significantly lower total amount spirits proportion binge those AUD, suggesting idiosyncratic etiology study Portugal, lifestyle eating habits seemed to impact development [3]. Patients disease (ALD) higher consumption patients, latter group reported more abundant diet past A Swedish prospective population-based revealed vegetable but fruit might prevent non-gallstone-related [4]. Thus, may influence [2-4]. Although knowledge available on risk ALD based threshold values consumption, only minority drinkers [5]. However, incidence both shown increase increased per capita general population [6]. present issue Journal Internal Medicine, Dugic et al. sixfold compared matched controls [7]. 7% experienced prior diagnosis ALD, ninefold controls. cumulative hospitalization ALP was 2.7% controls, seems very low suffer AIP. by al., independent factors developing younger age, male sex, diagnoses obstructive pulmonary included an impressive number long follow-up. This registry good quality health care Sweden socialized medicine system, which means all during period private hospitals have inpatients. it big strength without selection bias. As registry-based studies relying ICD-9 ICD-10 codes, these are always reliable. authors current tried validate their codes 200 pancreatitis, positive predictive value relatively high when accounting missing data (86%). completely clear if accuracy presence or biliary pancreatitis. most common neighbouring countries gallstone-induced [8]. acknowledge, likely some Furthermore, should expected scrutinization medical records, information about managed stop available. Similarly, smoking available, used chronic (COPD) marker smoking. COPD found predictor in-line previous showing increases first 20 years 1969 1989, before detection hepatitis C, suffered C. unclear how affected results. [8], in-hospital mortality observed incident episode comparators, 0.3% versus 0.1%. absolute terms, although statistically significant, results hardly clinically significant. summary, interest probably, despite methodological limitations, published so far relationship between congratulated hard work thorough statistical analysis. there after risk, particularly diagnosis, low. Only 2.8% developed established diagnosis. conceivable prone successful stopping due "antabuse" effect usually painful concluded remarkably few experience vice versa. vast majority never ALD. two phenotypes, AIP, different genetic risks [9, 10]. author declares no conflicts interest. Data sharing applicable article new created analyzed study.

Language: Английский

Recent advances in MASLD genetics: Insights into disease mechanisms and the next frontiers in clinical application DOI Creative Commons
Vincent Chen, Graham F. Brady

Hepatology Communications, Journal Year: 2025, Volume and Issue: 9(1)

Published: Jan. 1, 2025

Metabolic dysfunction–associated steatotic liver disease (MASLD) is the most common chronic in world and a growing cause of liver-related morbidity mortality. Yet, at same time, our understanding pathophysiology genetic underpinnings this increasingly yet heterogeneous has increased dramatically over last 2 decades, with potential to lead meaningful clinical interventions for patients. We have now seen first pharmacologic therapy approved treatment MASLD, multiple other treatments are currently under investigation—including gene-targeted RNA therapies that directly extend from advances MASLD genetics. Here we review recent genetics, some key pathophysiologic insights human genetics provided, ways which may inform practice field near future.

Language: Английский

Citations

1
Alcohol and Hepatocellular Carcinoma DOI
Nghiem B. Ha, Francis Y. Yao

Clinics in Liver Disease, Journal Year: 2024, Volume and Issue: 28(4), P. 633 - 646

Published: July 23, 2024

Language: Английский

Citations

5
Reply: Polygenic risk score in cirrhosis: Does the etiology matter? DOI Creative Commons
Tae‐Hwi Schwantes‐An, Timothy R. Morgan, Devanshi Seth

et al.

Hepatology Communications, Journal Year: 2025, Volume and Issue: 9(2)

Published: Jan. 15, 2025

Language: Английский

Citations

0
Polygenic risk score in cirrhosis: Does the etiology matter? DOI Creative Commons
Marta Alonso‐Peña, M. Arias,

Joaquin Cabezas

et al.

Hepatology Communications, Journal Year: 2025, Volume and Issue: 9(2)

Published: Jan. 15, 2025

Language: Английский

Citations

0
Alcohol-Associated Liver Disease and Risk Stratification for Hepatocellular Carcinoma: A Comprehensive Review DOI Creative Commons

Jaeyoun Choi,

Hyun-seok Kim

Current Hepatology Reports, Journal Year: 2025, Volume and Issue: 24(1)

Published: April 15, 2025

Language: Английский

Citations

0
From detection to intervention, optimizing care for patients with alcohol use disorder and advanced hepatic fibrosis DOI Creative Commons
Paola Zuluaga, Suthat Liangpunsakul

Alcohol Clinical and Experimental Research, Journal Year: 2024, Volume and Issue: 48(12), P. 2253 - 2255

Published: Oct. 27, 2024

Nearly half of the world's population consumes alcohol, with approximately 20% engaging in binge drinking and 5%–10% excessively over long term (Manthey et al., 2019). Alcohol consumption is a leading cause liver disease mortality both United States Europe, contributing to significant public health burden (Karlsen 2022). The risk developing alcohol-associated (ALD) varies widely among individuals, influenced by factors such as genetics (Schwantes-An 2024; Yuan 2024), socioeconomic status (Askgaard 2021), specific patterns (Aberg 2017). Additionally, stigma surrounding heavy complicates accurate tracking alcohol intake, underreporting misdiagnosis (Schomerus Unlike many other diseases, ALD often diagnosed late, typically after serious complications from portal hypertension or advanced fibrosis have developed (Shah progression drinkers heterogeneous; while some individuals develop severe problems rapidly, others may experience slower remain relatively unaffected for years (Israelsen 2024). Noninvasive tests (NITs) play crucial role identifying high-risk patients who require intervention, distinguishing them those at lower Early detection through NITs focuses on two critical scenarios: screening at-risk diagnosing predicting outcomes Liver fibrosis, key predictor failure asymptomatic patients, can be assessed using various methods These include elastography-based tools stiffness measurement (LSM) blood-based markers fibrosis-4 test (FIB-4) While LSM provides valuable insights into stiffness, its availability limited, particularly nonspecialist settings, which restricts use routine early In contrast, biomarkers FIB-4 offer more convenient accessible option screening, allowing easier implementation healthcare settings Patients excessive (EAU) disorder (AUD) represent ALD, primarily due their significantly elevated damage. Prolonged lead development rendering AUD susceptible diseases. Our recent study has highlighted urgency this issue, demonstrating that one five admitted treatment exhibits values indicative (Zuluaga Screening essential, it enables identification initial stages, timely interventions reduce complications. October 2024 issue ACER, Houston al. (2024) examined whether EAU high scores are being appropriately referred hepatology. Analyzing records 1131 large system between 2013 2023, they found only 37% 316 active were hepatology (Houston alcohol-related mental issues trauma less likely receive referrals, hospitalizations higher comorbidity Alarmingly, nearly 63% not care need valuable, but effectiveness depends actions taken following results. Identifying just step; essential providers implement appropriate follow-up address these findings effectively. success initiatives relies coordinated approach emphasizes also importance clinical responses. This includes making prompt referrals specialists, comprehensive management plans, implementing targeted tailored each patient's needs. Without actions, efforts fail translate meaningful improvements patient outcomes. According (2024), despite awareness disease, referral rates services alarmingly low. trend pronounced trauma, frequently miss out evaluations Several contribute concerning issue. First, prioritize immediate needs potential issues, especially emergency inpatient settings. acute focus psychiatric physical crises overshadow assessing underlying (Johnson As result, overlooked, missed opportunities referrals. Second, primary unfamiliar noninvasive score liver-related risks associated knowledge gap result an underestimation severity recognize necessity specialized care. Third, conditions introduce biases (Ahad 2023). Providers might unconsciously view having urgent medical concerns, diminishes emphasis conducting screenings disease. present clear complications, Finally, systemic fragmented models inadequate communication care, health, further exacerbate challenges facilitating (McGinty & Daumit, 2020; Zuchowski 2015). To enhance within multifaceted essential. begins increasing education training emphasizing pathophysiology score. Implementing integrated foster collaboration vital (Winder Such facilitate regular ensuring prioritized standardized protocols assessments during visits streamline individuals. Utilizing electronic flag will process (Khan Engaging about paramount. Empowering advocate well-being greater involvement encourage seek screenings. Establishing robust results specialty improving (Seyed-Nezhad 2021). providers, without unnecessary delays (Sheehan Furthermore, continuous quality improvement framework monitor processes (Hill 2020). By collecting analyzing data rates, patterns, outcomes, identify areas inform ongoing policy adjustments sheds light improved practices fibrosis. low services, research underscores integrating gained interventions, enhanced utilization tools. addressing gaps fostering we improve AUD, better work supported part U01AA026917, UH3AA026903, R01AA030312 NIH/NIAAA; Department Veterans Affairs Merit Award I01CX000361 I01BX006202; Dean's Scholar Indiana University School Medicine (SL); JR20/00016 RD21/0009/0004 Instituto de Salud Carlos III; Centres Recerca Catalunya 2021-SGR-00945. None.

Language: Английский

Citations

1
Development of a Polygenic Risk Score for Metabolic Dysfunction-Associated Steatotic Liver Disease Prediction in UK Biobank DOI Open Access
Tota Giardoglou, Ioanna Gavra, Athina I. Amanatidou

et al.

Genes, Journal Year: 2024, Volume and Issue: 16(1), P. 33 - 33

Published: Dec. 28, 2024

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of liver-related morbidity and mortality. Although invasive biopsy remains golden standard for MASLD diagnosis, Magnetic Resonance Imaging-derived Proton Density Fat Fraction (MRI-PDFF) an accurate, non-invasive method assessment treatment response. This study aimed at developing a Polygenic Risk Score (PRS) to improve MRI-PDFF prediction using UK Biobank data assess individual's genetic liability MASLD. We iteratively sequestered 10% samples as validation set split rest each dataset into base target partitions, containing GWAS summary statistics raw genotype data, respectively. PRSice2 was deployed derive PRS candidates. Based on frequency SNP appearances along candidates, we generated different sets according variable cutoffs. By applying PRSs set, identified optimal which then applied Greek nonalcoholic fatty (NAFLD) study. Data from 3553 participants yielded 49 sets. After calculating every with 75 SNPs selected (incremental R2 = 0.025, p-value 0.00145). Interestingly, 43 were successfully mapped MASLD-related known genes. The could predict traits, like LDL cholesterol diastolic blood pressure in Biobank, also outcome NAFLD Our findings provide strong evidence that powerful model MASLD, while it can be populations ethnicity.

Language: Английский

Citations

1
Alcohol‐induced pancreatitis and alcohol‐related liver disease: Two different phenotypes of alcohol‐related harm or related conditions? DOI Open Access
Einar S. Björnsson

Journal of Internal Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 14, 2024

It is well known that overconsumption of alcohol can cause tissue injury in the liver and pancreas, apart from many other organs such as heart, brain, peripheral nervous system. has also been recognized less than 5% individuals who drink excessively will develop episodes acute pancreatitis [1]. The definition heavy drinking beyond scope this editorial, obtaining a reliable history use be challenge. pattern lifetime did not reveal any major differences among patients with disorder (AUD) were hospitalized for rehabilitation (without alcoholic pancreatitis) previously diagnosed alcohol-induced (AIP) [2]. In study, males AIP had significantly lower total amount spirits proportion binge those AUD, suggesting idiosyncratic etiology study Portugal, lifestyle eating habits seemed to impact development [3]. Patients disease (ALD) higher consumption patients, latter group reported more abundant diet past A Swedish prospective population-based revealed vegetable but fruit might prevent non-gallstone-related [4]. Thus, may influence [2-4]. Although knowledge available on risk ALD based threshold values consumption, only minority drinkers [5]. However, incidence both shown increase increased per capita general population [6]. present issue Journal Internal Medicine, Dugic et al. sixfold compared matched controls [7]. 7% experienced prior diagnosis ALD, ninefold controls. cumulative hospitalization ALP was 2.7% controls, seems very low suffer AIP. by al., independent factors developing younger age, male sex, diagnoses obstructive pulmonary included an impressive number long follow-up. This registry good quality health care Sweden socialized medicine system, which means all during period private hospitals have inpatients. it big strength without selection bias. As registry-based studies relying ICD-9 ICD-10 codes, these are always reliable. authors current tried validate their codes 200 pancreatitis, positive predictive value relatively high when accounting missing data (86%). completely clear if accuracy presence or biliary pancreatitis. most common neighbouring countries gallstone-induced [8]. acknowledge, likely some Furthermore, should expected scrutinization medical records, information about managed stop available. Similarly, smoking available, used chronic (COPD) marker smoking. COPD found predictor in-line previous showing increases first 20 years 1969 1989, before detection hepatitis C, suffered C. unclear how affected results. [8], in-hospital mortality observed incident episode comparators, 0.3% versus 0.1%. absolute terms, although statistically significant, results hardly clinically significant. summary, interest probably, despite methodological limitations, published so far relationship between congratulated hard work thorough statistical analysis. there after risk, particularly diagnosis, low. Only 2.8% developed established diagnosis. conceivable prone successful stopping due "antabuse" effect usually painful concluded remarkably few experience vice versa. vast majority never ALD. two phenotypes, AIP, different genetic risks [9, 10]. author declares no conflicts interest. Data sharing applicable article new created analyzed study.

Language: Английский

Citations

0