Hypertension and NAFLD risk:Insights from the NHANES 2017-2018 and Mendelian randomization analyses

Background:Hypertension and non-alcoholic fatty liver disease(NAFLD)share several pathophysiologic risk factors,and the exact relationship between the two remains unclear.Our study aims to provide evidence concerning the relationship between hypertension and NAFLD by analyzing data from the National Health and Nutrition Examination Survey(NHANES)2017-2018 and Mendelian randomization(MR)analyses.Methods:Weighted multivariable-adjusted logistic regression was applied to assess the relationship between hypertension and NAFLD risk by using data from the NHANES 2017-2018.Subsequently,a two-sample MR study was performed using the genome-wide association study(GWAS)summary statistics to identify the causal association between hypertension,systolic blood pressure(SBP),diastolic blood pressure(DBP),and NAFLD.The primary inverse variance weighted(IVW)and other supplementary MR approaches were conducted to verify the causal association between hypertension and NAFLD.Sensitivity analyses were adopted to confirm the robustness of the results.Results:A total of 3144 participants were enrolled for our observational study in NHANES.Weighted multivariable-adjusted logistic regression analysis suggested that hypertension was positively related to NAFLD risk(odds ratio[OR]=1.677;95%confidence interval[CI],1.159-2.423).SBP≥130 mmHg and DBP≥80 mmHg were also significantly positively correlated with NAFLD.Moreover,hypertension was independently connected with liver steatosis(β=7.836[95%CI,2.334-13.338]).The results of MR analysis also supported a causal association between hypertension(OR=7.203[95%CI,2.297-22.587])and NAFLD.Similar results were observed for the causal exploration between SBP(OR=1.024[95%CI,1.003-1.046]),DBP(OR=1.047[95%CI,1.005-1.090]),and NAFLD.The sensitive analysis further confirmed the robustness and reliability of these findings(all P>0.05).Conclusion:Hypertension was associated with an increased risk of NAFLD.

Causal Relationship Between Gut Microbiota and Liver Cirrhosis:16S rRNA Sequencing and Mendelian Randomization Analyses

Background and Aims:Accumulating evidence highlights the association between the gut microbiota and liver cirrhosis.However,the role of the gut microbiota in liver cirrhosis remains unclear.Methods:We first assessed the differences in the composition of the bacterial community between CCl4-induced liver cirrhosis and control mice using 16S rRNA sequencing.We then performed a two-sample Mendelian randomization(MR)analysis to reveal the underlying causal relationship between the gut microbiota and liver cirrhosis.Causal relationships were analyzed using primary inverse variance weighting(IVW)and other supplemental MR methods.Furthermore,fecal samples from liver cirrhosis patients and healthy controls were collected to validate the results of the MR analysis.Results:Analysis of 16S rRNA sequencing indicated significant differences in gut microbiota composition between the cirrhosis and control groups.IVW analyses suggested that Alphaproteobacteria,Bacillales,NB1n,Rhodospirillales,Dorea,Lachnospiraceae,and Rhodospirillaceae were positively correlated with the risk of liver cirrhosis,whereas Butyricicoccus,Hungatella,Marvinbryantia,and Lactobacillaceae displayed the opposite effects.However,the weighted median and MR-PRESSO estimates further showed that only Butyricicoccus and Marvinbryantia presented stable negative associations with liver cirrhosis.No significant heterogeneity or horizontal pleiotropy was observed in the sensitivity analysis.Furthermore,the result of 16S rRNA sequencing also showed that healthy controls had a higher relative abundance of Butyricicoccus and Marvinbryantia than liver cirrhosis patients.Conclusions:Our study provides new causal evidence for the link between gut microbiota and liver cirrhosis,which may contribute to the discovery of novel strategies to prevent liver cirrhosis.

Mitochondrial dysfunction: A promising therapeutic target for liver diseases

The liver is an important metabolic and detoxification organ and hence demands a large amount of energy,which is mainly produced by the mitochondria.Liver tissues of pa-tients with alcohol-related or non-alcohol-related liver diseases contain ultrastructural mito-chondrial lesions,mitochondrial DNA damage,disturbed mitochondrial dynamics,and compromised ATP production.Overproduction of mitochondrial reactive oxygen species in-duces oxidative damage to mitochondrial proteins and mitochondrial DNA,decreases mito-chondrial membrane potential,triggers hepatocyte inflammation,and promotes programmed cell death,all of which impair liver function.Mitochondrial DNA may be a poten-tial novel non-invasive biomarker of the risk of progression to liver cirrhosis and hepatocellular carcinoma in patients infected with the hepatitis B virus.We herein present a review of the mechanisms of mitochondrial dysfunction in the development of acute liver injury and chronic liver diseases,such as hepatocellular carcinoma,viral hepatitis,drug-induced liver injury,alcoholic liver disease,and non-alcoholic fatty liver disease.This review also discusses mito-chondrion-centric therapies for treating liver diseases.

Clinical study using mesenchymal stem cells for the treatment of patients with severe COVID-19

The coronavirus disease 2019(COVID-19)caused by SARS-CoV-2 was identified in December 2019.The symptoms include fever,cough,dyspnea,early symptom of sputum,and acute respiratory distress syndrome(ARDS).Mesenchymal stem cell(MSC)therapy is the immediate treatment used for patients with severe cases of COVID-19.Herein,we describe two confirmed cases of COVID-19 in Wuhan to explore the role of MSC in the treatment of COVID-19.MSC transplantation increases the immune indicators(including CD4 and lymphocytes)and decreases the inflammation indicators(interleukin-6 and C-reactive protein).High-flow nasal cannula can be used as an initial support strategy for patients with ARDS.With MSC transplantation,the fracrion of inspired O2(Fi02)of the two patients gradually decreased while the oxygen saturation(Sa02)and partial pressure of oxygen(P02)improved.Additionally,the patients9 chest computed tomography showed that bilateral lung exudate lesions were adsorbed after MSC infusion.Results indicated that MSC transplantation provides clinical data on the treatment of COVID-19 and may serve as an alternative method for treating COVID-19,particularly in patients with ARDS.

IGF2-NR4A2 Signaling Regulates Macrophage Subtypes to Attenuate Liver Cirrhosis

Background and Aims:Liver cirrhosis can lead to liver failure and eventually death.Macrophages are the main contributors to cirrhosis and have a bidirectional role in regulating matrix deposition and degradation.Macrophage-based cell therapy has been developed as an alternative to liver transplantation.However,there is insufficient evidence regarding its safety and efficacy.In this study,we aimed to explore the effect of combining insulin-like growth factor 2(IGF2)with bone marrow-derived macrophages(BMDMs)to treat mice with liver cirrhosis.Methods:We assessed liver inflammation,fibrosis regression,liver function,and liver regeneration in mice with CCl4-induced cirrhosis and treated with BMDM only or IGF2+BMDM.We performed in vitro experiments in which activated hepatic stellate cells(HSCs)were co-cultured with macrophages in the presence or absence of IGF2.The polarity of macrophages and the degree of inhibition of HSCs were examined.The effect of IGF2 on macrophages was also verified by the overexpression of IGF2.Results:Combining IGF2 with BMDM reduced liver inflammation and fibrosis and increased hepatocyte proliferation.Combining IGF2 with BMDM was more effective than using BMDM alone.In vitro experiments demonstrated that IGF2 inhibited HSCs activation by upregulating NR4A2 to promote the anti-inflammatory macrophages phenotype.IGF2 also increased the synthesis of matrix metalloproteinases(MMPs)by macrophages,which may explain why administering IGF2 combined with BMDM was more effective than administering BMDM only.Conclusions:Our study provides a theoretical basis for the future use of BMDM-based cell therapy to treat liver cirrhosis.