Publications by authors named "Masatoshi Ishigami"
Objectives: To identify the diagnostic criteria for metabolic dysfunction-associated steatotic liver disease (MASLD) related to liver fibrosis and to characterize patients with cryptogenic steatotic liver disease (SLD) (non-MASLD) among those previously diagnosed with nonalcoholic fatty liver disease (NAFLD).
Methods: This multicenter retrospective study included 511 patients diagnosed with NAFLD via liver biopsy, and the prevalence of MASLD was assessed based on the diagnostic criteria. Patients were divided into those who met the MASLD criteria and those who did not, and the characteristics of advanced fibrosis and associated cardiometabolic factors were evaluated.
Article Synopsis
- The study aimed to evaluate the effectiveness and tolerability of direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) across different genotypes (GTs) in a global, real-world context, focusing particularly on GT3 and GT6.
- Researchers analyzed data from 15,849 chronic hepatitis C patients across Asia, North America, and Europe over a seven-year period, noting demographic factors such as age, sex, and prior treatment history.
- Results showed a high sustained virological response (SVR12) rate of 96.9% overall, with variances by genotype, highlighting that independent factors like advanced age, cirrhosis, and previous treatment failures affected treatment outcomes, while being
Article Synopsis
- Oral antiviral therapy for chronic hepatitis B (CHB) is effective and well-tolerated, but real-world data on how well patients are evaluated and treated is limited, prompting this study.
- In a cross-sectional analysis of 12,566 adult patients from 25 centers across 9 countries, it was found that 73.3% received adequate evaluation, with only 32.6% of those deemed treatment-eligible actually starting antiviral therapy.
- Factors influencing evaluation and treatment included gender, with females more likely to be evaluated but less likely to start treatment, and geographical differences, particularly among Asian patients from Western regions showing lower rates of evaluation and treatment.
The combination of atezolizumab and bevacizumab has become the first-line treatment for patients with unresectable hepatocellular carcinoma (HCC). However, no studies have reported on specific intestinal microbiota associated with the efficacy of atezolizumab and bevacizumab. In this study, we analyzed fecal samples collected before treatment to investigate the relationship between the intestinal microbiome and the efficacy of atezolizumab and bevacizumab.
View Article and Find Full Text PDFBackground And Aim: The benefits of entecavir (ETV) versus tenofovir disoproxil fumarate (TDF) in reducing the development of chronic hepatitis B (CHB)-related hepatocellular carcinoma remain controversial. Whether mortality rates differ between patients with CHB treated with ETV and those treated with TDF is unclear.
Methods: A total of 2542 patients with CHB treated with either ETV or TDF were recruited from a multinational cohort.
A 59-year-old Japanese woman presented with hyperferritinemia. We decided against iron removal treatment because there were no symptoms or signs of iron-induced organ damage. A follow-up study revealed a gradual increase in transferrin saturation.
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- The study investigates the effects of antiviral treatment on long-term outcomes in patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) related hepatocellular carcinoma (HCC) after they undergo surgical resection.
- It included 1,906 participants across 12 international sites, revealing that only 47% received antiviral therapy during a mean follow-up of 5 years, with variable rates of treatment success between HBV (57%) and HCV (35%).
- Results showed that antiviral therapy initiated close to diagnosis is significantly linked to better survival rates, highlighting a gap in treatment utilization despite its benefits.
Article Synopsis
- Racial and ethnic disparities exist in hepatitis C virus (HCV) treatment and survival rates for related liver cancer, with Black patients facing the worst outcomes.
- In a study of 6,069 patients, treatment rates for direct-acting antiviral agents (DAA) were significantly lower for Black individuals (18.7%) compared to other racial groups, impacting their survival rates.
- The study concluded that although DAA treatment rates were low overall, achieving sustained virologic response (SVR) eliminated racial disparities, highlighting the need for better early diagnosis and access to HCV treatment for all patients.
Article Synopsis
- * Patients undergoing endoscopic resection for stomach tumors were randomly assigned to take either 1-kestose or a placebo while on a potassium-competitive acid blocker for 8 weeks.
- * Results showed significant dysbiosis in the placebo group, while the 1-kestose group maintained microbiome diversity, suggesting that 1-kestose may help prevent dysbiosis linked to potassium-competitive acid blockers.
Background: Antitumor necrosis factor (TNF)-α antibodies have improved the outcome of inflammatory bowel disease (IBD); but half of patients remain unresponsive to treatment. Interleukin-18 (IL-18) gene polymorphism is associated with resistance to anti-TNF-α antibodies, but therapies targeting IL-18 have not been clinically applied. Only the mature protein is biologically active, and we aimed to investigate whether specific inhibition of mature IL-18 using a monoclonal antibody (mAb) against a neoepitope of caspase-cleaved mature IL-18 could be an innovative treatment for IBD.
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- * The study involved 31 patients treated with UST, with clinical remission rates improving from 9.7% at 2 weeks to 64.5% at 48 weeks; however, 38.7% of patients discontinued treatment, primarily due to primary failure.
- * High baseline C-reactive protein (CRP) levels were identified as a significant risk factor for discontinuation of UST, highlighting the need for clinicians to consider CRP when making treatment decisions for UC patients.
Article Synopsis
- - Elevated serum gamma-glutamyl transferase (GGT) levels are linked to higher mortality rates in chronic hepatitis B (CHB) patients receiving nucleotide/nucleoside analog treatments, showing significant increases in GGT measurements before and six months after treatment.
- - A study analyzing 2,843 CHB patients found that factors such as cirrhosis, age, and pretreatment GGT levels are strong predictors of both all-cause and liver-related mortality, with cirrhosis having the highest hazard ratio.
- - The link between pretreatment GGT levels and mortality remains consistent regardless of alcohol use history, and there is a noticeable dose-dependent association with different percentiles of GGT indicating increased mortality risk
Article Synopsis
- The study investigates the risk of needing treatment for varices (enlarged veins) in children with biliary atresia (BA), a serious liver condition that can occur in newborns or infants.
- Using advanced imaging techniques, researchers assessed liver and spleen stiffness in 53 BA patients to determine the likelihood of requiring endoscopic treatments for varices.
- A new combined diagnostic method involving liver stiffness, spleen stiffness, and a lab test drastically lowered the chance of missing varices needing treatment to just 5%, improving patient care and monitoring.
Background & Aims: It is unclear if there may be sex differences in response to nucleos(t)ide analogs including virologic response (VR), biochemical response (BR), complete response (CR), and hepatocellular carcinoma (HCC) incidence among hepatitis B patients. We compared nucleos(t)ide analog treatment outcomes by sex.
Methods: We performed a retrospective cohort study of 3388 treatment-naïve adult hepatitis B patients (1250 female, 2138 male) from the Real-World Evidence from the Global Alliance for the Study of Hepatitis B Virus consortium who initiated therapy with either entecavir or tenofovir from 22 sites (Argentina, Korea, Japan, Taiwan, and the United States).
Background: Elevated bile acid levels have been associated with liver tumors in fatty liver. Ileal bile acid transporter inhibitors may inhibit bile acid absorption in the distal ileum and increase bile acid levels in the colon, potentially decreasing the serum and hepatic bile acid levels. This study aimed to investigate the impact of these factors on liver tumor.
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- Obscure gastrointestinal bleeding can occur when the source of bleeding is unknown, even after procedures like balloon-assisted endoscopy; Dieulafoy's lesion in the small bowel is often suspected as the cause.
- A retrospective study analyzed 38 patients diagnosed with Dieulafoy's lesion through double-balloon endoscopy, focusing on their clinical characteristics and whether bleeding could be predicted before the procedure.
- The median age of patients was 72, with a high comorbidity rate; most lesions were found in the upper jejunum and lower ileum, with a 21% rebleeding rate after endoscopic treatment, and multiple episodes of hematochezia linked to the likelihood of receiving multiple diagnoses.
Background And Aims: Both fibrosis status and body weight are important for assessing prognosis in nonalcoholic fatty liver disease (NAFLD). The aim of this study was to identify population clusters for specific clinical outcomes based on fibrosis-4 (FIB-4) index and body mass index (BMI) using an unsupervised machine learning method.
Methods: We conducted a multicenter study of 1335 biopsy-proven NAFLD patients from Japan.
Importance: The diagnostic performance of the fibrosis-4 index (FIB-4) and nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS) for advanced fibrosis in lean patients with NAFLD is limited.
Objective: To evaluate the diagnostic performance of the FIB-4 and NFS in lean individuals with NAFLD.
Design, Setting, And Participants: This diagnostic study included adults with biopsy-proven NAFLD from 6 referral centers in Asia from 1995 to 2019.
Clinical course and prognosis of patients with hepatocellular carcinoma and haemophilia.
Eur J Gastroenterol Hepatol
October 2023
Introduction: Although patients with haemophilia are known to develop hepatocellular carcinoma (HCC) at a lower age than patients without, there are few reports on the clinical course and prognosis of HCC.
Aim: We aimed to investigate the clinical course and prognosis of patients with HCC and haemophilia.
Methods: Twenty-two patients with haemophilia, who were initially diagnosed with HCC between 2003 and 2021, were included.
Background: Proteinuria is a common adverse event in systemic therapy for hepatocellular carcinoma (HCC). However, whether the presence of pretreatment proteinuria affects the clinical course is still unclear.
Method: From 2011 to 2022, 321 patients with unresectable HCC who were treated with systemic therapy as first-line treatment were enrolled in this study.
Introduction: Current guidelines discourage the use of direct-acting antiviral (DAA) containing protease-inhibitor (PI) in advanced HCV cirrhosis. We aimed to compare the real-world tolerability of PI vs. non-PI DAA regimens in this population.
View Article and Find Full Text PDFBackground And Aims: HCC risk in chronic hepatitis B (CHB) is higher in the indeterminate phase compared with the inactive phase. However, it is unclear if antiviral therapy reduces HCC risk in this population. We aimed to evaluate the association between antiviral therapy and HCC risk in the indeterminate phase.
View Article and Find Full Text PDFImmune-related sclerosing cholangitis (irSC) is relatively rare and its clinical characteristics are not well known. In this study, we aimed to summarize the clinical features of irSC. Clinical data were collected retrospectively from 1,393 patients with advanced malignancy treated with immune-checkpoint inhibitors (ICIs) between August 2014 and October 2021.
View Article and Find Full Text PDFVanishing bile duct syndrome (VBDS) is a rare but potentially serious cholestatic liver disease caused by various etiologies, including drugs. We herein report a complicated case of VBDS with acute tubular necrosis (ATN) that improved significantly with steroid treatment. An Asian man in his 30s was admitted with the acute onset of severe jaundice and a decline in the renal function.
View Article and Find Full Text PDFLipid droplets (LDs) have been observed in the nuclei of hepatocytes; however, their significance in liver disease remains unresolved. Our purpose was to explore the pathophysiological features of intranuclear LDs in liver diseases. We included 80 patients who underwent liver biopsies; the specimens were dissected and fixed for electron microscopy analysis.
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