From Cardiovascular-Kidney-Metabolic Syndrome to Cardiovascular-Renal-Hepatic-Metabolic Syndrome: Proposing an Expanded Framework
Biomolecules,
Год журнала:
2025,
Номер
15(2), С. 213 - 213
Опубликована: Фев. 2, 2025
Cardiometabolic
diseases
represent
an
escalating
global
health
crisis,
slowing
or
even
reversing
earlier
declines
in
cardiovascular
disease
(CVD)
mortality.
Traditionally,
conditions
such
as
obesity,
type
2
diabetes
mellitus
(T2DM),
atherosclerotic
CVD,
heart
failure
(HF),
chronic
kidney
(CKD),
and
metabolic
dysfunction-associated
steatotic
liver
(MASLD)
were
managed
isolation.
However,
emerging
evidence
reveals
that
these
disorders
share
overlapping
pathophysiological
mechanisms
treatment
strategies.
In
2023,
the
American
Heart
Association
proposed
Cardiovascular-Kidney-Metabolic
(CKM)
syndrome,
recognizing
interconnected
roles
of
heart,
kidneys,
system.
Yet,
this
model
omits
liver—a
critical
organ
impacted
by
dysfunction.
MASLD,
which
can
progress
to
steatohepatitis
(MASH),
is
closely
tied
insulin
resistance
contributing
directly
renal
impairment.
Notably,
MASLD
bidirectionally
associated
with
development
progression
CKM
syndrome.
As
a
result,
we
introduce
expanded
framework—the
Cardiovascular-Renal-Hepatic-Metabolic
(CRHM)
syndrome—to
more
comprehensively
capture
broader
inter-organ
dynamics.
We
provide
guidance
for
integrated
diagnostic
approach
aimed
at
halting
advanced
stages
preventing
further
damage.
addition,
highlight
advances
medical
management
target
shared
pathways,
offering
benefits
across
multiple
systems.
Viewing
whole,
rather
than
discrete
entities,
incorporating
into
framework
fosters
holistic
strategy
offers
promising
path
addressing
cardiometabolic
pandemic.
Язык: Английский
The Impact of Liver Failure on the Immune System
Опубликована: Июль 29, 2024
Background:
Liver
failure
profoundly
affects
the
immune
system,
leading
to
dysregulation
of
innate
and
adaptive
responses.
Body:
This
review
explores
intricate
relationship
between
liver
function
homeostasis.
The
role
as
a
central
hub
in
response
initiation
is
elucidated,
emphasizing
its
involvement
hepatic
inflammation
induction
subsequent
systemic
inflammation.
Cytokines,
chemokines,
growth
factors,
lipid
mediators
orchestrate
these
processes,
serving
both
prognostic
biomarkers
potential
therapeutic
targets
failure-associated
dysregulation.
Furthermore,
delves
into
mechanisms
underlying
immunosuppression
failure,
encompassing
alterations
cell
functions
such
neutrophils,
macrophages,
natural
killer
cells
(NK
cells),
well
perturbations
responses
mediated
by
B
T
cells.
Conclusion:
Understanding
immunological
consequences
crucial
for
developing
targeted
interventions
improving
patient
outcomes
disease
management.
Язык: Английский