KoBioLabs

Oct 5, 2023

nature reviews gastroenterology & hepatology Abstract Recompensation has gained increasing attention in the field of cirrhosis, particularly in chronic liver disease with a definite aetiology. The current global prevalence of obesity and nonalcoholic fatty liver disease (NAFLD) is increasing, but there is currently a lack of a clear definition for recompensation in NAFLD-related cirrhosis. Here, we provide an up-to-date perspective on the natural history of NAFLD, emphasizing the reversible nature of the disease, summarizing possible mechanisms underlying recompensation in NAFLD, discussing challenges that need to be addressed and outlining future research directions in the field. Recompensation is a promising goal in patients with NAFLD-related cirrhosis, and further studies are needed to explore its underlying mechanisms and uncover its clinical features. Access options Get Nature+, our best-value online-access subscription $29.99 / 30 days $209.00 per year Prices vary by article type from$1.95 Additional access options: Fig. 2: Possible main mechanisms of recompensation in nonalcoholic fatty liver disease-related cirrhosis. References Younossi, Z. M. et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology 77, 1335–1347 (2023). This study proposes a thoughtful renaming and redefinition of NAFLD through a rigorous Delphi process involving extensive international expert consensus, aiming to establish a nomenclature that is informative, systematic and non-stigmatizing. Kim, T. H. et al. Determinants of re-compensation in patients with hepatitis B virus-related decompensated cirrhosis starting antiviral therapy. Aliment. Pharmacol. Ther. 55, 83–96 (2022). This article describes a combined scoring system including six clinical parameters, α-fetoprotein and the timing of antiviral therapy to accurately predict early recompensation in patients with HBV infection-related decompensated cirrhosis. Wang, Q. et al. Validation of Baveno VII criteria for recompensation in entecavir-treated patients with hepatitis B-related decompensated cirrhosis. J. Hepatol. 77, 1564–1572 (2022). In this study, over 50% of patients with decompensated cirrhosis secondary to HBV infection showed recompensation after antiviral treatment, and the study proposes laboratory criteria that could be utilized to define recompensation. Rinella, M. E., Tacke, F., Sanyal, A. J. & Anstee, Q. M. Report on the AASLD/EASL joint workshop on clinical trial endpoints in NAFLD. J. Hepatol. 71, 823–833 (2019). This report summarizes important findings from ongoing and completed trials, defines the scientific evidence supporting distinct end points and provides guidance for future trial design. Sanyal, A. J. et al. Cirrhosis regression is associated with improved clinical outcomes in patients with nonalcoholic steatohepatitis. Hepatology 75, 1235–1246 (2022). In this study in patients with compensated cirrhosis due to NASH, regression of fibrosis was associated with a reduction in liver-related complications, and the findings support the utility of histological fibrosis regression and noninvasive tests as clinical trial end points in NASH cirrhosis. Author information Gong Feng Gong Feng Luca Valenti Precision Medicine, Biological Resource Center and Department of Transfusion Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy Luca Valenti Medical Data Analytics Center, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China Vincent Wai-Sun Wong State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China Vincent Wai-Sun Wong Yasser Mahrous Fouad Yusuf Yilmaz Won Kim Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea Won Kim Giada Sebastiani Zobair M. Younossi Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic Barcelona,-IDIBAPS, University of Barcelona, Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Barcelona, Spain Virginia Hernandez-Gea Ming-Hua Zheng Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China Ming-Hua Zheng Luca Valenti Vincent Wai-Sun Wong Yasser Mahrous Fouad Yusuf Yilmaz Won Kim Giada Sebastiani Zobair M. Younossi Virginia Hernandez-Gea Ming-Hua Zheng Contributions G.F. researched data for the article. All authors contributed substantially to discussion of the content. M.-H.Z. and G.F. wrote the article. All authors reviewed and/or edited the manuscript before submission. Corresponding author Competing interests L.V. reports consulting fees from Gilead Sciences, Pfizer, AstraZeneca, Novo Nordisk, Intercept pharmaceuticals, Diatech Pharmacogenetics, IONIS and Viatris; honoraria from MSD, Gilead Sciences, AlfaSigma, AbbVie and Resalis; and grants from Gilead Sciences. V.W.-S.W. reports grants from Gilead Sciences; consulting fees from AbbVie, Boehringer Ingelheim, Echosens, Gilead Sciences, Intercept, Inventiva, Novo Nordisk, Pfizer and TARGET PharmaSolutions; and honoraria for lectures from Abbott, AbbVie, Gilead Sciences and Novo Nordisk; and is Chairman of Subspecialty Board of Gastroenterology and Hepatology, Hong Kong College of Physicians, and Co-founder of Illuminatio Medical Technology. Y.Y. is a consultant to Zydus, Cymabay and Novo Nordisk. W.K. reports grants from GSK, Gilead Sciences, Novartis, Pfizer, Roche, Springbank, Ildong, Galmed, Dicerna, Enyo, Hanmi, Novo Nordisk and KOBIOLABS; reports consulting fees from Boehringer Ingelheim, Novo Nordisk, Standigm, Daewoong, TSD Life Sciences, Ildong, Olix Pharma, HK Inoen and KOBIOLABS; honoraria for lectures from Ildong, Samil and Novo Nordisk; owns stocks in KOBIOLABS and Lepidyne; and is the founder of Remedygen. G.S. reports honoraria from Merck, Gilead Sciences, Abbvie, Intercept, Novo Nordisk and Pfizer; and unrestricted research funding from Theratechnologies. Z.M.Y. is a consultant to BMS, Gilead Sciences, AbbVie, Intercept and GSK. V.H.-G. reports honoraria for lectures from GORE and Cook Medical. M.-H.Z. and Y.M.F. declare no competing interests. Peer review Peer review information Nature Reviews Gastroenterology & Hepatology thanks Takumi Kawaguchi, and the other, anonymous, reviewer for their contribution to the peer review of this work. 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