Publications by authors named "Uojima Haruki"
Regular monitoring of patients with a history of hepatitis C virus (HCV) infection is critical for the detection and management of hepatocellular carcinoma (HCC). Mac-2 binding protein glycosylation isomer (M2BPGi) has been used to monitor fibrosis progression and predict HCC. However, HCC prediction based on M2BPGi has not been optimized.
View Article and Find Full Text PDFA woman in the 70s with a decreased appetite and weight loss (4 kg) in the last 3 months was referred to our hospital. An enhanced CT scan of the abdomen showed a hepatocellular carcinoma (HCC) of 83 mm in diameter of the liver with metastasis to the para-aortic lymph nodes, the left adrenal gland, and the right lower lung lobe (cStage IVb). She was started on atezolizumab + bevacizumab (Atezo-Bev) therapy.
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- The study analyzed 107 patients undergoing balloon-occluded retrograde transvenous obliteration (BRTO) due to uncontrollable hepatic encephalopathy (HE) and assessed the impact of esophageal varices (EVs) on outcomes.
- Patients were divided into two groups based on the presence of EVs, and results showed that those with EVs had significantly shorter event-free survival and overall survival compared to those without EVs.
- The findings suggest that having EVs may indicate a higher risk of complications and mortality following the BRTO procedure in HE patients.
Article Synopsis
- - The study investigates how the expression of Mac-2 binding protein (M2BP) in the liver relates to fat accumulation and changes in the liver environment in patients with metabolic dysfunction associated steatotic liver disease (MASLD).
- - Liver samples from 46 MASLD patients were analyzed for M2BP expression using immunohistochemical staining, revealing a higher M2BP staining grade in sinusoidal cells compared to hepatocytes, and a correlation between hepatocyte staining and liver inflammation.
- - Results indicate that fat accumulation triggers M2BP expression linked to liver inflammation in hepatocytes and fibrosis in sinusoidal cells, suggesting a complex role of M2BP in MASLD pathology.
The standard treatment duration for acute cholangitis (AC) involves a 4-7-day antimicrobial treatment post-biliary drainage; however, recent studies have suggested that a ≤ 2-3 days is sufficient. However, clinical practice frequently depends on body temperature as a criterion for discontinuing antimicrobial treatment. Therefore, in this study, we assessed whether patients with AC can achieve successful outcomes with a ≤ 7-day antimicrobial treatment, even with a fever, assuming the infection source is effectively controlled.
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- 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
- A study investigated the impact of the rs16906115 polymorphism in the interleukin-7 gene on immune-related adverse events (irAEs) and treatment response to immune checkpoint inhibitors within a Japanese population.
- Conducting a comparison between participants with severe irAEs and those with none, as well as hepatocellular carcinoma patients categorized by treatment response, researchers found no significant association between the polymorphism and irAEs, but identified a link to poorer treatment outcomes in responders.
- The findings suggest that while the rs16906115 minor allele does not predict irAEs, its homozygosity may indicate a reduced likelihood of effective treatment results in this Japanese cohort.
Background: Pimitespib (TAS-116), a first-in-class, oral, selective heat-shock protein 90 inhibitor, is approved as fourth-line treatment for gastrointestinal stromal tumors in Japan. This phase 1 study evaluated the cardiac safety of pimitespib.
Methods: In this open-label, nonrandomized, multicenter study, Japanese patients (aged ≥20 years) with refractory, advanced solid tumors received placebo on day -1, then pimitespib 160 mg daily on days 1-5 of the cardiac safety evaluation period.
Article Synopsis
- The study aimed to find important biomarkers for predicting how patients with unresectable hepatocellular carcinoma (u-HCC) respond to a combination treatment of atezolizumab and bevacizumab (ATZ + BV).
- Researchers evaluated circulating tumor DNA (ctDNA) and levels of various immune-related cytokines in blood samples from 158 u-HCC patients to identify potential indicators of treatment outcomes.
- Key findings showed that while ctDNA mutations weren't correlated with treatment response, high levels of CXCL9 and low levels of LAG-3 were significant predictors of better progression-free survival and overall survival in patients undergoing ATZ + BV therapy.
Article Synopsis
- A 67-year-old Japanese woman with liver cirrhosis from primary biliary cholangitis was admitted to the hospital after losing consciousness.
- She was diagnosed with hepatic encephalopathy (HE) through imaging and symptoms assessment.
- Molecular tests showed a link between urease-positive S. salivarius found in her saliva and stool, suggesting it may contribute to increased ammonia production and subsequent HE in cirrhosis patients.
Aim: This study aims to evaluate the efficacy and safety of lenvatinib radiofrequency ablation (RFA) sequential therapy for certain hepatocellular carcinoma (HCC) patients.
Methods: One hundred and nineteen patients with unresectable HCC in the intermediate stage with Child-Pugh A were retrospectively recruited in a multicenter setting. Those in the lenvatinib RFA sequential therapy group received lenvatinib initially, followed by RFA and the retreatment with lenvatinib.
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.
Article Synopsis
- Short-term antimicrobial treatment for acute cholangitis can be effective, even for patients with positive blood cultures, according to a study that analyzed treatment outcomes.
- The study assessed 389 cases and found a high clinical cure rate of 92.6% in patients treated with a three-day or shorter course of antibiotics.
- Results suggest that patients on short-course therapy had similar or better outcomes in terms of recurrence rates and hospital stays compared to those receiving longer treatment.
Introduction: In this multicenter clinical study, we aimed to investigate the efficacy and safety of the transhepatic arterial administration of granulocyte-colony stimulating factor (G-CSF)-mobilized autologous peripheral blood (PB)-CD34 cells compared with standard therapy in patients with decompensated cirrhosis type C.
Methods: Patients were randomly assigned (2:1) to the CD34 cell transplant (CD34 cell) or standard-of-care (SOC) group and followed up for 52 weeks. The primary endpoints were the non-progression rate of Child-Pugh (CP) scores at 24 weeks post-enrollment and the safety of the protocol treatment.
Article Synopsis
- The study investigates how esophageal varices change in patients with cirrhosis after achieving sustained virological response (SVR) using direct-acting antivirals (DAAs).
- 243 patients were examined before and after DAA treatment, revealing that 14.8% experienced worsened varices post-SVR and 11.9% showed improvement.
- The ALBI score at SVR12 was identified as a significant predictor for both worsening varices and the development of new varices, with specific cut-off values highlighting the risk.
- Despite achieving SVR, patients with high ALBI scores remain at risk for negative changes in their esophageal varices.
Aim: An association between hepatitis B core-related antigen (HBcrAg) kinetics and hepatocarcinogenesis during nucleoside (t)id analog (NA) treatment has recently been reported. HBcrAg kinetics and factors associated with HBcrAg response during tenofovir alafenamide (TAF) administration remain unclear. In this multicenter retrospective study, we aimed to clarify the efficacy and safety of TAF in treatment-naïve patients with chronic hepatitis B, focusing on the reduction in HBcrAg levels.
View Article and Find Full Text PDFBackground: The relationship between liver fibrosis and inflammation and Mac-2-binding protein glycosylation isomer (M2BPGi) in patients with chronic liver disease (CLD) other than hepatitis C remains uncertain, owing to the limitations of qualitative methods. Here, we evaluated the influence of liver fibrosis and inflammation on quantitative M2BPGi (M2BPGi-Qt) in CLD, considering each etiology.
Methods: We recruited 1373 patients with CLD.
Background And Aim: The appropriate duration of antimicrobial therapy for acute cholangitis (AC) arising from multiple hilar biliary obstructions as opposed to simple obstruction in the extrahepatic bile duct has not been established. This study assessed the efficacy of the duration of antimicrobial treatments in the Tokyo Guidelines 2018 for AC based on the cause and site of obstruction.
Methods: This single-center retrospective study involved patients with AC who underwent successful biliary drainage and completed a 7-day or shorter antimicrobial treatment.
Background 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.
Objectives: We aimed to develop and validate a simple scoring system to predict in-hospital mortality after endoscopic variceal ligation (EVL) for esophageal variceal bleeding.
Methods: Data from a 13-year study involving 46 Japanese institutions were split into development (initial 7 years) and validation (last 6 years) cohorts. The study subjects were patients hospitalized for esophageal variceal bleeding and treated with EVL.
Background: Although the combination of atezolizumab and bevacizumab (ATZ + BEV) is a standard treatment for advanced hepatocellular carcinoma (HCC), strategies for addressing treatment failure and prognostic factors of post-progression survival (PPS) remain unestablished.
Methods: We conducted a multicentre retrospective study to evaluate PPS following ATZ + BEV treatment in patients with advanced HCC. We classified the patients into three groups: BCLC stage B and BCLC stage C without or with new extrahepatic lesions (BCLCp-C1 and BCLCp-C2, respectively) at the time of progression.
Although the number of resistant bacteria tends to increase with prolonged antimicrobial therapy, no studies have examined the relationship between the duration of antimicrobial therapy and increase in the number of resistant bacteria in acute cholangitis. We hypothesized that the short-term administration of antimicrobial agents in acute cholangitis would suppress bacterial resistance. This was a single-center, retrospective, observational study of patients with acute cholangitis admitted between January 2018 and June 2020 who met the following criteria: successful biliary drainage, positive blood or bile cultures, bacteria identified from cultures sensitive to antimicrobials, and subsequent cholangitis recurrence by January 2022.
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- * M2BPGi, secreted by cancer-associated fibroblasts, enhances the growth and invasion of PC cells, independent of galectin-3 suppression.
- * Reducing M2BPGi levels in mice with PC led to smaller tumors and increased effectiveness of the chemotherapy drug gemcitabine, suggesting it could be a new treatment approach for PC.
Background: Esophageal variceal bleeding is a severe complication associated with liver cirrhosis and typically necessitates endoscopic hemostasis. The current standard treatment is endoscopic variceal ligation (EVL), and Western guidelines recommend antibiotic prophylaxis following hemostasis. However, given the improvements in prognosis for variceal bleeding due to advancements in the management of bleeding and treatments of liver cirrhosis and the global concerns regarding the emergence of multidrug-resistant bacteria, there is a need to reassess the use of routine antibiotic prophylaxis after hemostasis.
View Article and Find Full Text PDFBackground And Aim: While several predictive models for the development of hepatocellular carcinoma (HCC) have been proposed, including those for patients with chronic hepatitis C virus (HCV) infection who have achieved sustained virologic response (SVR), the best model may differ between regions. We compared the ability of six reported models to stratify the risk of post-SVR HCC in Japan, where rigorous surveillance and early detection of HCC is common.
Methods: A total of 6048 patients with no history of HCC who achieved SVR by oral direct-acting antiviral drugs were enrolled in this nationwide study.