Impact of microplastics and nanoplastics on liver health:Current understanding and future research directions

With continuous population and economic growth in the 21st century,plastic pollution is a major global issue.However,the health concern of microplastics/nanoplastics(MPs/NPs)decomposed from plastic wastes has drawn public attention only in the recent decade.This article summarizes recent works dedicated to understanding the impact of MPs/NPs on the liver-the largest digestive organ,which is one of the primary routes that MPs/NPs enter human bodies.The interrelated mechanisms including oxidative stress,hepatocyte energy re-distribution,cell death and autophagy,as well as immune responses and inflammation,were also featured.In addition,the disturbance of microbiome and gut-liver axis,and the association with clinical diseases such as metabolic dysfunction-associated fatty liver disease,steatohepatitis,liver fibrosis,and cirrhosis were briefly discussed.Finally,we discussed potential directions in regard to this trending topic,highlighted current challenges in research,and proposed possible solutions.

Transcriptome analysis creates a new era of precision medicine for managing recurrent hepatocellular carcinoma

The high incidence of hepatocellular carcinoma(HCC)recurrence negatively impacts outcomes of patients treated with curative intent despite advances in surgical techniques and other locoregional liver-targeting therapies.Over the past few decades,the emergence of transcriptome analysis tools,including real-time quantitative reverse transcription PCR,microarrays,and RNA sequencing,has not only largely contributed to our knowledge about the pathogenesis of recurrent HCC but also led to the development of outcome prediction models based on differentially expressed gene signatures.In recent years,the single-cell RNA sequencing technique has revolutionized our ability to study the complicated crosstalk between cancer cells and the immune environment,which may benefit further investigations on the role of different immune cells in HCC recurrence and the identification of potential therapeutic targets.In the present article,we summarized the major findings yielded with these transcriptome methods within the framework of a causal model consisting of three domains:primary cancer cells;carcinogenic stimuli;and tumor microenvironment.We provided a comprehensive review of the insights that transcriptome analyses have provided into diagnostics,surveillance,and treatment of HCC recurrence.

Hepatocellular carcinoma in patients with renal dysfunction: Pathophysiology, prognosis, and treatment challenges

The population of patients with hepatocellular carcinoma(HCC)overlaps to a high degree with those for chronic kidney disease(CKD)and end-stage renal disease(ESRD).The degrees of renal dysfunction vary,from the various stages of CKD to dialysis-dependent ESRD,which often affects the prognosis and treatment choice of patients with HCC.In addition,renal dysfunction makes treatment more difficult and may negatively affect treatment outcomes.This study summarized the possible causes of the high comorbidity of HCC and renal dysfunction.The possible mechanisms of CKD causing HCC involve uremia itself,long-term dialysis status,immunosuppressive agents for postrenal transplant status,and miscellaneous factors such as hormone alterations and dysbiosis.The possible mechanisms of HCC affecting renal function include direct tumor invasion and hepatorenal syndrome.Finally,we categorized the risk factors that could lead to both HCC and CKD into four categories:Environmental toxins,viral hepatitis,metabolic syndrome,and vasoactive factors.Both CKD and ESRD have been reported to negatively affect HCC prognosis,but more research is warranted to confirm this.Furthermore,ESRD status itself ought not to prevent patients receiving aggressive treatments.This study then adopted the well-known Barcelona Clinic Liver Cancer guidelines as a framework to discuss the indicators for each stage of HCC treatment,treatment-related adverse renal effects,and concerns that are specific to patients with pre-existing renal dysfunction when undergoing aggressive treatments against CKD and ESRD.Such aggressive treatments include liver resection,simultaneous liver kidney transplantation,radiofrequency ablation,and transarterial chemoembolization.Finally,focusing on patients unable to receive active treatment,this study compiled information on the latest systemic pharmacological therapies,including targeted and immunotherapeutic drugs.Based on available clinical studies and Food and Drug Administration labels,this study details the drug indications,side effects,and dose adjustments for patients with renal dysfunction.It also provides a comprehensive review of information on HCC patients with renal dysfunction from disease onset to treatment.