Publications by authors named "Benedikt S Hofer"
Background: Portal hypertension (PH) resulting from static and dynamic intrahepatic changes drives liver-related complications even after removing the underlying aetiological factor.
Objective: We investigated the impact of inflammation on the dynamic component of PH during disease regression in animal models of toxin-induced cirrhosis and patients with alcohol-related cirrhosis.
Methods: In mice, cirrhosis was induced via toxin application for 12 weeks followed by toxin-withdrawal allowing for one or 2 weeks of regression.
Article Synopsis
- The LiverRisk score is a proposed blood test aimed at estimating liver stiffness and identifying patients at risk for compensated advanced chronic liver disease (cACLD) and liver-related events without prior known liver issues.
- In a study involving nearly 7,500 patients, the score's diagnostic performance was evaluated against established methods like FIB-4 and APRI, revealing that while it moderately correlates with liver stiffness measurements, it tends to underestimate them.
- Although the LiverRisk score demonstrated decent accuracy for predicting cACLD and hepatic decompensation, its limitations include a low negative predictive value, indicating it might not effectively rule out disease in some patients.
Article Synopsis
- Cirrhosis creates a proinflammatory environment, and the study aims to analyze specific inflammation patterns across various causes of compensated cirrhosis in both animal models and human patients.
- In rat models, inflammation differed based on the cirrhosis cause, with choline-deficient high-fat diet rats showing the highest proinflammatory gene expression, while in humans, different liver diseases exhibited varying levels of inflammatory markers.
- Despite common upregulation of proinflammatory pathways in all types of liver disease, the impact on fibrosis and portal hypertension varied based on the specific etiology of the disease.
Background And Aims: We aimed to characterise insulin-like growth factor-1 (IGF-1) signalling in patients with advanced chronic liver disease (ACLD).
Methods: Consecutive patients undergoing hepatic venous pressure gradient [HVPG] measurement were prospectively included. Clinical stages were defined as follows: probable ACLD (pACLD): liver stiffness ≥10 kPa and HVPG ≤5 mmHg, S0: mild PH (HVPG 6-9 mmHg), S1: clinically significant PH (CSPH), S2: CSPH with varices, S3: past variceal bleeding, S4: past/current non-bleeding hepatic decompensation and S5: further decompensation.
Article Synopsis
- The study investigates the role of histamine in advanced chronic liver disease (ACLD) and its potential as a prognostic marker.
- It includes 251 patients with ACLD, finding that higher plasma histamine levels correlate with circulatory dysfunction, but levels do not significantly vary across different stages of liver disease.
- Elevated histamine levels are independently associated with an increased risk of acute-on-chronic liver failure (ACLF) or liver-related death over a median follow-up of 29.2 months.
Article Synopsis
- - The study investigated zinc and selenium deficiency in 309 patients with advanced chronic liver disease (ACLD) and found that 73% were deficient in zinc and 63% in selenium, indicating a high prevalence of these deficiencies in this population.
- - It was observed that patients with decompensated ACLD had significantly lower levels of both trace elements compared to those with compensated ACLD, and there were strong correlations between zinc/selenium levels and disease severity indicators like MELD and HVPG.
- - Low levels of zinc and selenium were independently associated with worsening liver-related events, including hepatic decompensation and liver-related death, suggesting that future research should explore the benefits of zinc/selenium supplementation for these patients.
Background & Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of advanced chronic liver disease (ACLD). Portal hypertension drives hepatic decompensation and is best diagnosed by hepatic venous pressure gradient (HVPG) measurement. Here, we investigate the prognostic value of HVPG in MASLD-related compensated ACLD (MASLD-cACLD).
View Article and Find Full Text PDFBackground: Obesity impacts the diagnostic accuracy of shear wave elastography (SWE). A deep abdominal ultrasound transducer (DAX) capable of point (pSWE) and two-dimensional (2D)-SWE has recently been introduced to address this issue.
Methods: We performed a prospective study in a cohort of mostly patients with obesity undergoing liver biopsy with a high prevalence of metabolic dysfunction-associate steatotic liver disease (MASLD).
Background And Aims: The prognostic performance of von Willebrand factor (VWF) may vary across clinical stages of advanced chronic liver disease (ACLD). Therefore, we investigated the evolution of VWF and other biomarkers throughout the full ACLD spectrum and evaluated their stage-specific prognostic utility.
Methods: We retrospectively included Viennese ACLD patients with available information on hepatic venous pressure gradient (HVPG), C-reactive protein (CRP)/VWF levels and outcomes.
Background & Aims: Non-invasive tests (NITs) for clinically significant portal hypertension (CSPH) require validation in patients with hepatitis D virus (HDV)-related compensated advanced chronic liver disease (cACLD). Therefore, we aimed to validate existing NIT algorithms for CSPH in this context.
Methods: Patients with HDV-cACLD (LSM ≥10 kPa or histological METAVIR F3/F4 fibrosis) who underwent paired HVPG and NIT assessment at Medical University of Vienna or Hannover Medical School between 2013 and 2023 were retrospectively included.
Persistent liver injury triggers a fibrogenic program that causes pathologic remodeling of the hepatic microenvironment (i.e., liver fibrosis) and portal hypertension.
View Article and Find Full Text PDFBackground And Aims: Compensated advanced chronic liver disease (cACLD) identifies patients at risk for clinically significant portal hypertension (CSPH), and thus, for liver-related complications. The limited availability of liver stiffness measurements (LSM) impedes the identification of patients at risk for cACLD/CSPH outside of specialized clinics. We aimed to develop a blood-based algorithm to identify cACLD by fibrosis-4 (FIB-4) and CSPH by von Willebrand factor/platelet count ratio (VITRO).
View Article and Find Full Text PDFArticle Synopsis
- The researchers studied how liver stiffness measurement (LSM) can help predict serious health problems and death in people with alcohol-related liver disease (ALD).
- They checked the liver stiffness of patients from Denmark and Austria over about two years to see changes and their effects on health.
- The results showed that changes in liver stiffness were really good at predicting who might get worse health and who might die, helping doctors know who needs more care.
Background: Aetiological therapy improves liver function and may enable hepatic recompensation in decompensated cirrhosis.
Aims: We explored the potential for recompensation in patients with decompensated primary biliary cholangitis (PBC) - considering a biochemical response to ursodeoxycholic acid (UDCA) according to Paris-II criteria as a surrogate for successful aetiological treatment.
Methods: Patients with PBC were retrospectively included at the time of first decompensation.
Background And Aims: Experimental studies linked dysfunctional Farnesoid X receptor (FXR)-fibroblast growth factor 19 (FGF19) signaling to liver disease. This study investigated key intersections of the FXR-FGF19 pathway along the gut-liver axis and their link to disease severity in patients with cirrhosis.
Methods: Patients with cirrhosis undergoing hepatic venous pressure gradient measurement (cohort-I n = 107, including n = 53 with concomitant liver biopsy; n = 5 healthy controls) or colonoscopy with ileum biopsy (cohort-II n = 37; n = 6 controls) were included.
Background & Aims: Non-invasive tests to assess the probability of clinically significant portal hypertension (CSPH) - including the ANTICIPATE±NASH models based on liver stiffness measurement and platelet count±BMI, and the von Willebrand factor antigen to platelet count ratio (VITRO) - have fundamentally changed the management of compensated advanced chronic liver disease (cACLD). However, their prognostic utility has not been compared head-to-head to the gold standard for prognostication in cACLD, i.e.
View Article and Find Full Text PDFBackground And Aims: Patients with cirrhosis show alterations in primary hemostasis, yet prognostic implications of changes in platelet activation remain controversial, and assay validity is often limited by thrombocytopenia. We aimed to study the prognostic role of platelet activation in cirrhosis, focusing on bleeding/thromboembolic events, decompensation, and mortality.
Approach And Results: We prospectively included 107 patients with cirrhosis undergoing a same-day hepatic venous pressure gradient (HVPG) and platelet activation measurement.