研究者詳細 - 寺井　崇二

論文 - 寺井　崇二

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Guidance for Liver Rehabilitation in Chronic Liver Disease. 国際誌

Shuji Terai, Hiroteru Kamimura, Yoichi Hiasa, Norio Akuta, Toru Ishikawa, Yuichiro Eguchi, Hironao Okubo, Takumi Kawaguchi, Miwa Kawanaka, Tatsuo Kanda, Masaaki Korenaga, Ryotaro Sakamori, Masahito Shimizu, Yoshio Sumida, Ryosuke Tateishi, Atsushi Tanaka, Naoki Tanaka, Yasuo Tanaka, Yuki Tahata, Masato Nakai, Tadashi Namisaki, Takashi Nishimura, Atsushi Hiraoka, Takeshi Matsui, Nami Mori, Akio Moriya, Tetsuo Takehara

Hepatology research : the official journal of the Japan Society of Hepatology 56 ( 3 ) 279 - 291 2026年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

In April 2023, the Japan Society of Hepatology published its official guidelines on liver rehabilitation for chronic liver disease. In this article, we summarize the current evidence on the role of liver rehabilitation in slowing the progression of chronic liver disease, particularly metabolic dysfunction-associated steatotic liver disease (MASLD), liver cirrhosis, and hepatocellular carcinoma (HCC). Specifically, we outline the following: (1) the definition of liver rehabilitation and its target population; (2) exercise therapy in liver rehabilitation according to disease state; (3) considerations for patients with complications; (4) nutritional therapy in liver rehabilitation; and (5) potential economic benefits. Liver rehabilitation represents a novel therapeutic approach for patients with chronic liver disease, and this guidance aims to promote high-quality clinical research and strengthen the evidence base for its application.

DOI： 10.1111/hepr.70132

Mesenchymal stromal cell administration promotes macrophage-mediated bile duct regeneration. 国際誌

Takanori Igarashi, Naruhiro Kimura, Hiroyuki Abe, Tomoaki Yoshida, Yusuke Watanabe, Hiroteru Kamimura, Akira Sakamaki, Takeshi Yokoo, Kenya Kamimura, Atsunori Tsuchiya, Shuji Terai

Regenerative therapy 31 101065 - 101065 2026年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Mesenchymal stromal cell (MSC) therapy is used in cirrhosis models of chronic hepatocellular damage and represents a novel therapeutic approach for liver regeneration. However, no studies have examined MSC therapy for bile duct injury and its effects on bile duct regeneration. This study aimed to elucidate the mechanism underlying bile duct regeneration by establishing a regeneration model and administering MSCs. METHODS: A model of bile duct regeneration was developed by feeding mice a 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC)-containing diet to induce bile duct injury, followed by a normal diet to promote bile duct regeneration. MSCs were administered concurrently with the normal diet, and the livers were analyzed after 2 days. An experimental system was also developed in which clodronate liposomes were administered alongside MSCs to eliminate the influence of macrophages. RESULTS: MSC administration significantly increased the rate of body weight gain and the liver-to-body weight ratio on day 2 after the change to a normal diet. Immunostaining revealed an increase in the number of CK19+ cholangiocytes. The numbers of Hnf4α+ and Sox9+ cells were significantly elevated in the MSC-treated group. Flow cytometric analysis of liver lymphocytes showed a significant increase in the number of Ly6C- macrophages in the MSC-treated group. Furthermore, analysis of liver lymphocyte populations and cap analysis of gene expression revealed alterations in the immune response and macrophage-related genes, whereas macrophage removal during MSC treatment abolished the bile duct regenerative effects observed with MSC treatment. CONCLUSIONS: Macrophages play a crucial role in bile duct regeneration, and MSC administration has regenerative effects. This approach has potential as a novel treatment modality for bile duct injuries.

DOI： 10.1016/j.reth.2026.101065

Azathioprine Inhibits Hepatitis A Virus Replication In Vitro

Tatsuo Kanda, Reina Sasaki-Tanaka, Hiroyuki Abe, Takeshi Yokoo, Akira Sakamaki, Kazunao Hayashi, Hiroteru Kamimura, Kenya Kamimura, Ryota Masuzaki, Hirofumi Kogure, Hiroaki Okamoto, Shuji Terai

Pathogens 2026年2月

STRIDE sustained an overall survival benefit with safety profiles in unresectable hepatocellular carcinoma at 5-year follow-up

Tatsuo Kanda, Reina Sasaki-Tanaka, Hiroteru Kamimura, Kazunao Hayashi, Kenya Kamimura, Shuji Terai

Hepatobiliary Surgery and Nutrition 15 ( 1 ) 17 - 17 2026年2月

Liver Volumetry Enhances Prediction of Acute Pancreatitis in Acute Liver Failure: A Nationwide Registry Study. 国際誌

Keisuke Kakisaka, Nobuaki Nakayama, Tokio Sasaki, Kotaro Kumagai, Hidekatsu Kuroda, Ryuzo Abe, Taro Takami, Kazuaki Chayama, Masahito Shimizu, Takuya Genda, Shuji Terai, Kazuaki Inoue, Atsushi Tanaka, Takayuki Matsumoto, Satoshi Mochida

Hepatology research : the official journal of the Japan Society of Hepatology 56 ( 2 ) 233 - 245 2026年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIM: Acute pancreatitis is a recognized complication of acute liver failure (ALF), but its incidence and predictive factors remain poorly defined. Current risk stratification relies primarily on conventional laboratory markers with limited discriminatory ability for pancreatic complications. This study aimed to determine the incidence and prognostic impact of acute pancreatitis in ALF patients and evaluate whether liver volumetry improves prediction beyond conventional markers. METHODS: This cross-sectional retrospective study utilized data from a nationwide survey-based registry conducted by the Intractable Hepato-Biliary Disease Study Group of Japan (2011-2021). We analyzed 142 ALF patients with available liver volumetry data and 90-day outcome information. Patients with pre-existing acute pancreatitis were excluded. Predictive models were developed comparing conventional markers (MELD score) versus an enhanced model incorporating computed tomography liver volume to standard liver volume ratio (CTLV/SLV). Model performance was evaluated using ROC analysis, net reclassification index, and clinical validation. RESULTS: Acute pancreatitis developed in 19 patients (13.4%), typically within the first 8 weeks (84.3% of cases). Logistic regression identified acute pancreatitis as an independent risk factor for poor prognosis (β = 0.2556, p = 0.031). The CTLV/SLV ratio was significantly lower in patients developing pancreatitis (0.80 vs. 1.07, p < 0.001). The enhanced model (MELD + CTLV/SLV) achieved superior discrimination (AUC 0.810) compared to MELD alone (AUC 0.704), with 81% relative risk reduction in the low-risk category. CONCLUSION: Incorporating liver volumetry significantly improves acute pancreatitis prediction in ALF patients, enabling more precise risk stratification and potentially optimizing clinical management strategies.

DOI： 10.1111/hepr.70054

Artificial Intelligence Model for Automated Identification of Bowel Preparation for Colonoscopy (AI-PREPOO): A Multicenter Study. 国際誌

Kosuke Kojima, Kazuya Takahashi, Hiroki Maruyama, Nao Nakajima, Hiroki Sato, Ken-Ichi Mizuno, Shuji Terai

Journal of gastroenterology and hepatology 2026年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Adequate bowel preparation is crucial for high-quality colonoscopy; however, assessing preparation adequacy can be burdensome for both healthcare providers and patients. In this study, we aimed to develop artificial intelligence (AI) models for the automated identification of bowel PREParation for cOlonoscOpy (AI-PREPOO). METHODS: On the day of colonoscopy, participants were instructed to use smartphones to photograph their stool in the toilet after each bowel movement following initiation of polyethylene glycol solution and upload the images to a secure web server. All images were labeled as "ready" or "not ready" for colonoscopy based on clarity and the absence of solid content. Using these labeled images, four image-recognition models based on different deep learning architectures (AI-PREPOO 1-4) were developed using transfer learning to classify stool status as "ready" or "not ready." RESULTS: A total of 282 stool images were collected from 37 patients, with 141 images labeled as "ready" and 141 as "not ready." These images were divided into training (224 images) and test (58 images) sets, and the training set was augmented to 2240 images. All models trained on the augmented dataset achieved high performance, with area under the curve (AUC) values exceeding 0.90. AI-PREPOO 1, based on MobileNetV3-Small, demonstrated the most balanced sensitivity-specificity profile (AUC, 0.95; sensitivity, 0.93; specificity, 0.86). CONCLUSIONS: We developed AI-based models capable of accurately assessing bowel preparation adequacy. AI-PREPOO 1 showed a well-balanced diagnostic performance, suggesting its potential to facilitate bowel preparation assessment and reduce the burden on healthcare providers and patients.

DOI： 10.1111/jgh.70235

Small Bowel Gastrointestinal Stromal Tumors: A 15-Year Cohort Study Focusing on Jejuno-Ileal Site-Specific Outcomes and Prognostic Factors

Yuichi Kojima, Kentaro Tominaga, Yuzo Kawata, Chizuru Kaneko, Shuhei Kondo, Yoshifumi Shimada, Junji Yokoyama, Toshifumi Wakai, Shuji Terai

Cancers 2026年1月

Regulatory T cell stability determines the efficiency of bile duct regeneration during cholangitis. 国際誌

Naruhiro Kimura, Man Chun Wong, Ben Higgins, Gareth Hardisty, Pei-Chi Huang, Matamoana Muller, Maxym Besh, Daniel A Patten, Timothy Kendall, Prakash Ramachandran, Adriano G Rossi, Graham Anderson, Shishir Shetty, David Withers, Atsunori Tsuchiya, Shuji Terai, Wei-Yu Lu

Cell reports 44 ( 11 ) 116557 - 116557 2025年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

Cholangiopathies such as primary sclerosing cholangitis (PSC) cause damage to the bile ducts with no effective cure. Reduction and impairment in the function of regulatory T cells (Tregs) occur in PSC. We investigate whether Tregs regulate bile duct regeneration and the dynamics of Treg turnover during bile duct injury. We use the transgenic Foxp3GFPDTR model to mimic reduced Treg infiltration in PSC and show that Tregs mediate cholangiocyte response to biliary injury. Fate mapping of Tregs reveals that intrahepatic Tregs acquire a pro-inflammatory phenotype, even after interleukin-2 (IL-2)-mediated Treg expansion. Ox40L expression correlates with fibrosis in PSC patients. Enhancing Treg numbers through IL-2 complex administration and blocking Ox40 signaling simultaneously suppresses the inflammatory phenotype of Tregs and reduces bile duct damage and fibrosis. We demonstrate that bile duct regeneration can be enhanced by combining Treg-based therapy and targeting co-stimulatory molecules, such as Ox40L.

DOI： 10.1016/j.celrep.2025.116557

Is higher body mass index correlated with worse clinical outcomes in acute liver failure?

Tatsuo Kanda, Reina Sasaki-Tanaka, Hiroteru Kamimura, Shuji Terai

World Journal of Clinical Cases 13 ( 32 ) 2025年11月

掲載種別：研究論文（学術雑誌）出版者・発行元：Baishideng Publishing Group Inc.

Krishnan et al ’s article is a comprehensive and vigorous retrospective cohort study regarding the association between obesity and clinical outcomes in acute liver failure (ALF). Among patients with ALF in the United States, mean body mass index (BMI) was significantly greater in those who underwent liver transplantation or who died than among survivors, although acetaminophen induced ALF was the most common etiology. A high BMI was associated with renal failure and high grades of hepatic encephalopathy. The prevalence of obesity and its related fatty liver diseases, such as metabolic dysfunction-associated fatty liver disease/ metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis, has increased worldwide. Obesity is related to increased serum cytokines and immune abnormalities. These findings may explain why ALF in patients with high BMI is associated with worse clinical outcomes. Further studies are needed to determine the associations among BMI, ALF and acute-on-chronic liver failure.

DOI： 10.12998/wjcc.v13.i32.113514

A rare case of ulcerative colitis relapse in a diverted colon after rectal cancer surgery: efficacy of carotegrast methyl.

Takanori Igarashi, Kentaro Tominaga, Yuichi Kojima, Mai Nakamura, Takafumi Tonouchi, Nobutaka Takeda, Tomoaki Yoshida, Yuzo Kawata, Akira Sakamaki, Shuji Terai

Clinical journal of gastroenterology 2025年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

This case presents a rare instance of ulcerative colitis (UC) relapse in the functionally isolated left colon following surgery for rectal cancer associated with UC. A 62-year-old man, suspected of having cancer based on positron emission tomography (PET)-computed tomography (CT) findings and elevated carcinoembryonic antigen levels, underwent robot-assisted low anterior resection and temporary transverse colostomy. Postoperatively, leakage and infection made it difficult to administer conventional local treatments or corticosteroids; however, remission was achieved with the oral α4-integrin inhibitor, carotegrast methyl, allowing for stoma closure. To our knowledge, this report is the first to describe the use of carotegrast methyl for recurrent UC in a diverted colon. This case demonstrates that carotegrast methyl may serve as an effective steroid-sparing option for UC relapse in complex postoperative anatomical contexts. It also highlights the potential utility of PET-CT as an adjunctive diagnostic tool for UC-associated cancer.

DOI： 10.1007/s12328-025-02243-7

An exploratory machine learning study on paediatric abdominal pain phenotyping and prediction

Kazuya Takahashi, Michalina Lubiatowska, Huma Shehwana, James K. Ruffle, John A. Williams, Animesh Acharjee, Shuji Terai, Georgios V. Gkoutos, Humayoon Satti, Qasim Aziz

PLOS One 20 ( 11 ) e0336215 - e0336215 2025年11月

掲載種別：研究論文（学術雑誌）出版者・発行元：Public Library of Science (PLoS)

Background

The exact mechanisms underlying paediatric abdominal pain (AP) remain unclear due to patient heterogeneity. This preliminary study aimed to identify AP phenotypes and develop predictive models to explore associated factors, with the goal of guiding future research.

Methods

In 13,790 children from a large birth cohort, data on paediatric and maternal demographics and comorbidities were extracted from general practitioner records. Machine learning (ML) clustering was used to identify distinct AP phenotypes, and an ML-based predictive model was developed using demographics and clinical features.

Results

1,274 children experienced AP (9.2%) (average age: 8.4 ± 1.1 years, male/female: 615/659), who clustered into three distinct phenotypes: Phenotype 1 with an allergic predisposition (n = 137), Phenotype 2 with maternal comorbidities (n = 676), and Phenotype 3 with minimal other comorbidities (n = 340). As the number of allergic diseases or maternal comorbidities increased, so did the frequency of AP, with 17.6% of children with ≥ 3 allergic diseases and 25.6% of children with ≥ 3 maternal comorbidities. The predictive model demonstrated moderate performance in predicting paediatric AP (AUC 0.67), showing that a child’s ethnicity, paediatric allergic diseases, and maternal comorbidities were key predictive factors. When stratified by ML-predicted probability, observed AP rates were 18.9% in the < 40% group, 44.8% in the 40–50% group, 60.6% in the 50–60% group, and 100.0% in the > 60% group.

Conclusions

This study identified distinct AP phenotypes and key risk factors using ML. Furthermore, the predictive ML model enabled risk stratification for paediatric AP. These analyses provide valuable insights to guide future investigations into the mechanisms of AP and may facilitate research aimed at identifying targeted interventions to improve patient outcomes.

DOI： 10.1371/journal.pone.0336215

Tongue shear wave elastography for bulbar dysfunction in amyotrophic lateral sclerosis

Kaori Yanagawa, Makiko Ike, Azusa Aoyama, Takeshi Yokoo, Shuji Terai, Takafumi Hayashi, Osamu Onodera

Clinical Neurophysiology 2025年11月

Efficacy of budesonide and vedolizumab for IBD-U associated with Muckle-Wells syndrome.

Yuzo Kawata, Kentaro Tominaga, Daisuke Kobayashi, Annenkov Alexey, Kosuke Kojima, Osamu Shibata, Yuichi Kojima, Kazuya Takahashi, Hiroteru Kamimura, Shuji Terai

Clinical journal of gastroenterology 2025年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Cryopyrin-associated periodic syndrome (CAPS) is a rare, autosomal dominant inflammatory disorder linked to interleukin (IL)-1β dysregulation. Muckle-Wells syndrome (MWS) is a clinical subtype of CAPS that is often managed with canakinumab, an anti-IL-1β monoclonal antibody. Canakinumab has been approved for all phenotypes of CAPS, with no age restrictions, since 2011. Despite its efficacy in controlling systemic inflammation, its gastrointestinal side effects remain unclear. This report presents the case of a 28 year-old man who developed abdominal pain and diarrhea during treatment with canakinumab for MWS. Colonoscopy revealed findings suggestive of inflammatory bowel disease, and a diagnosis of IBD-unclassified (IBD-U) was made after exclusion of other conditions. Treatment with oral budesonide and vedolizumab led to marked clinical and endoscopic improvements, maintaining remission after budesonide discontinuation. Although the usefulness of systemic prednisolone and anti-TNFα antibody preparations for treating IBD-U in patients with MWS has been previously reported, to the best of our knowledge, this is the first report to highlight the therapeutic effects of budesonide and vedolizumab. Therefore, IBD-U should be considered in the differential diagnosis of patients with CAPS who develop gastrointestinal symptoms. Considering their favorable side-effect profiles, budesonide and vedolizumab may serve as promising treatment alternatives in the future.

DOI： 10.1007/s12328-025-02234-8

Hydrogen-Positive Small Intestinal Bacterial Overgrowth (SIBO) in Japanese Patients With Chronic Intestinal Pseudo-Obstruction (CIPO): A Cross-Sectional Study. 国際誌

Takanori Igarashi, Kentaro Tominaga, Kunihiko Yokoyama, Takuya Wakabayashi, Yuichi Kojima, Yuzo Kawata, Naruhiro Kimura, Kazuya Takahashi, Akira Sakamaki, Shuji Terai

Cureus 17 ( 10 ) e94054 2025年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Evidence for small intestinal bacterial overgrowth (SIBO) in chronic intestinal pseudo‑obstruction (CIPO) remains limited in Asian populations and by gas phenotype. This study aimed to determine the prevalence and gas phenotype distribution (hydrogen-positive SIBO vs. intestinal methanogen overgrowth) in Japanese patients with CIPO using glucose breath testing and to describe associated clinical features. METHODS: This single‑center cross‑sectional study was conducted at Niigata University, Niigata, Japan (April 2019-March 2022), and included 10 CIPO outpatients and 10 healthy controls. Participants fasted for 12 hours and avoided high-fiber foods for 24 hours before testing. Glucose breath testing (50 g, institutional SOP) measured hydrogen (H₂) and methane (CH₄); positivity followed North American Consensus criteria (ΔH₂ ≥20 ppm by 90 min; CH₄ ≥10 ppm). The primary outcome was hydrogen‑positive SIBO (H₂‑SIBO); intestinal methanogen overgrowth (IMO) was analyzed separately. Exact tests accounted for the small sample size. RESULTS: H₂‑SIBO was more frequent in CIPO than in controls (5/10 vs. 0/10; Fisher two‑sided p = 0.0325; continuity‑corrected OR = 21). Overall SIBO (H₂ or CH₄) was 5/10 vs. 1/10 (p = 0.141, two‑sided). No CIPO patient met IMO criteria; one control was methane‑positive. Among CIPO patients, H₂‑SIBO was associated with lower BMI and a higher frequency of diarrhea. CONCLUSIONS: In this small Japanese cohort, CIPO was associated with H₂‑SIBO, whereas IMO was uncommon. These findings should be interpreted with caution due to limited statistical power and potential under-detection of distal overgrowth with glucose substrate. These findings may inform on diagnostic strategies and nutritional management in severe motility disorders.

DOI： 10.7759/cureus.94054

Image analysis of cardiac hepatopathy secondary to heart failure: Machine learning vs gastroenterologists and radiologists. 国際誌

Suguru Miida, Hiroteru Kamimura, Shinya Fujiki, Taichi Kobayashi, Saori Endo, Hiroki Maruyama, Tomoaki Yoshida, Yusuke Watanabe, Naruhiro Kimura, Hiroyuki Abe, Akira Sakamaki, Takeshi Yokoo, Masanori Tsukada, Fujito Numano, Takeshi Kashimura, Takayuki Inomata, Yuma Fuzawa, Tetsuhiro Hirata, Yosuke Horii, Hiroyuki Ishikawa, Hirofumi Nonaka, Kenya Kamimura, Shuji Terai

World journal of gastroenterology 31 ( 34 ) 108807 - 108807 2025年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Congestive hepatopathy, also known as nutmeg liver, is liver damage secondary to chronic heart failure (HF). Its morphological characteristics in terms of medical imaging are not defined and remain unclear. AIM: To leverage machine learning to capture imaging features of congestive hepatopathy using incidentally acquired computed tomography (CT) scans. METHODS: We retrospectively analyzed 179 chronic HF patients who underwent echocardiography and CT within one year. Right HF severity was classified into three grades. Liver CT images at the paraumbilical vein level were used to develop a ResNet-based machine learning model to predict tricuspid regurgitation (TR) severity. Model accuracy was compared with that of six gastroenterology and four radiology experts. RESULTS: In the included patients, 120 were male (mean age: 73.1 ± 14.4 years). The accuracy of the results predicting TR severity from a single CT image for the machine learning model was significantly higher than the average accuracy of the experts. The model was found to be exceptionally reliable for predicting severe TR. CONCLUSION: Deep learning models, particularly those using ResNet architectures, can help identify morphological changes associated with TR severity, aiding in early liver dysfunction detection in patients with HF, thereby improving outcomes.

DOI： 10.3748/wjg.v31.i34.108807

Zinc Acetate Inhibits Hepatitis A Virus Replication: Possible Treatment for Patients with Type A Acute-on-Chronic Liver Failure

Tatsuo Kanda, Reina Sasaki-Tanaka, Hiroyuki Abe, Takeshi Yokoo, Akira Sakamaki, Kazunao Hayashi, Hiroteru Kamimura, Atsunori Tsuchiya, Ryota Masuzaki, Hirofumi Kogure, Hiroaki Okamoto, Shuji Terai

Pathogens 2025年9月

Pretreatment serum angiopoietin-2 predicts prognosis and liver functional reserve after successful HCV eradication with sofosbuvir and velpatasvir in patients with HCV-related decompensated cirrhosis.

Naoki Kawagishi, Goki Suda, Yuki Tahata, Hayato Hikita, Takahiro Kodama, Satoshi Mochida, Nobuyuki Enomoto, Seiichi Mawatari, Hidekatsu Kuroda, Daiki Miki, Masayuki Kurosaki, Yoichi Hiasa, Norifumi Kawada, Taro Yamashita, Hiroshi Yatsuhashi, Hitoshi Yoshiji, Naoya Kato, Taro Takami, Hisamitsu Miyaaki, Kentaro Matsuura, Yasuhiro Asahina, Yoshito Itoh, Ryosuke Tateishi, Yasunari Nakamoto, Eiji Kakazu, Shuji Terai, Masahito Shimizu, Yoshiyuki Ueno, Norio Akuta, Masatsugu Ohara, Naoya Sakamoto, Tetsuo Takehara

Journal of gastroenterology 60 ( 9 ) 1145 - 1156 2025年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Direct-acting-antivirals (DAAs) achieve high sustained-virologic response (SVR) rates, even in patients with hepatitis C virus (HCV)-related decompensated liver cirrhosis (LC). However, predictors of post-treatment liver function improvement and survival remain unclear. This study evaluated pretreatment angiopoietin-2 (Ang2) levels as a predictor of prognosis and liver functional reserve after DAA treatment. METHODS: This multicenter retrospective study included 123 patients with HCV-related decompensated LC treated with sofosbuvir/velpatasvir. Serum Ang2 levels were quantified, and liver function was assessed using the Child-Pugh grading at baseline and 12 weeks after the end of treatment (SVR12). Factors associated with prognosis and post-SVR liver functional reserve (Child-Pugh grade C) were investigated. RESULTS: Multivariate Cox regression analysis revealed that, in addition to age and creatinine levels at SVR12, baseline Ang2 levels (hazard ratio [HR] = 1.151 per 1000 pg/mL, P = 0.033) and Child-Pugh grade C at SVR12 (HR = 11.765, P < 0.001), but not baseline Child-Pugh grade C, were significantly associated with the overall survival. Multivariate analysis revealed that baseline Ang2 levels and baseline Child-Pugh grade C were significantly and independently associated with Child-Pugh grade C at SVR12. The combination of elevated baseline Ang2 levels (≥ 8684 pg/mL; 1 point) and baseline Child-Pugh grade C (1 point) effectively stratified patients with a high likelihood of having Child-Pugh Grade C at SVR12. The incidence rates were as follows: 0 points, 2.1% (2/96); 1 point, 37.5% (9/24); and 2 points, 100% (2/2) (P < 0.001). CONCLUSIONS: Pretreatment Ang2 levels predict survival and liver functional reserve after SVR in HCV-related decompensated LC.

DOI： 10.1007/s00535-025-02275-3

Restoration of the gut-microbiota-liver axis after hepatitis C virus eradication. 国際誌

Takako Inoue, Jiro Nakayama, Hiroshi Mori, Masaru Tanaka, Daisuke Nakagawa, Masaya Ohnishi, Yui Funatsu, Kei Moriya, Hideto Kawaratani, Hisayoshi Watanabe, Goki Suda, Yasuteru Kondo, Tatsuya Ide, Satoru Kakizaki, Satoshi Miuma, Atsushi Suetsugu, Kazuhito Kawata, Takao Watanabe, Etsuko Iio, Rie Momoda, Yutaka Suzuki, Akira Sakamaki, Tsunamasa Watanabe, Takehisa Watanabe, Katsuya Nagaoka, Yoichi Hiasa, Shuji Terai, Hitoshi Yoshiji, Atsushi Toyoda, Ken Kurokawa, Yasuhito Tanaka

JHEP reports : innovation in hepatology 7 ( 9 ) 101494 - 101494 2025年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND & AIMS: We previously reported altered intestinal environmental features during HCV infection. Here, we aimed to characterize the gut-microbiota-liver axis in patients with chronic hepatitis C after a sustained virological response (SVR). METHODS: A total of 174 patients with HCV infection were enrolled in a cross-sectional study: 95 with chronic hepatitis (CH-HCV group) and 79 with cirrhosis or hepatocellular carcinoma (LC/HCC-HCV group). In addition, 75 post-SVR patients were included (CH-SVR group, n = 29; LC/HCC-SVR group, n = 46), along with 23 healthy individuals. A longitudinal study was subsequently conducted on 49 patients (CH, n = 29; LC/HCC, n = 20) with SVR at 24 and 48 weeks after the end of treatment. RNA sequencing was performed on 65 patients with HCV infection, 28 post-SVR patients, and 12 healthy controls. RESULTS: In the cross-sectional analysis, HCV eradication was associated with partial restoration of the dysbiotic gut microbiota, including reduced streptococcal overgrowth and an increase in the potentially beneficial genus Blautia, approaching levels seen in healthy individuals. Additionally, the aberrant fecal bile acid profile showed rebalancing, accompanied by restored expression of genes involved in the classical pathway of cholic and chenodeoxycholic acid biosynthesis. In the longitudinal study, improvements in liver fibrosis and function - evidenced by decreased Fibrosis-4 index and alanine aminotransferase levels - were significantly correlated with increased abundance of Blautia (p <0.0001 and p = 0.0344, respectively), suggesting a beneficial role in liver recovery. CONCLUSION: The gut-microbiota-liver axis is partially restored following HCV eradication, with recovery from liver damage associated with the resurgence of commensal Lachnospiraceae species. IMPACT AND IMPLICATIONS: This study offers significant insights into the gut-microbiota-liver axis in patients with chronic hepatitis C following a sustained virological response. The findings demonstrate that HCV eradication promotes partial restoration of the dysbiotic gut microbiota, particularly an increase in the beneficial genus Blautia, as well as a rebalancing of the fecal bile acid profile. These changes are closely associated with significant improvements in liver fibrosis and function, highlighting a potential role of the gut microbiota in liver recovery and regeneration.

DOI： 10.1016/j.jhepr.2025.101494

Myelodysplastic Syndrome With Trisomy 8 and Behçet Disease-Like Intestinal and Upper Gastrointestinal Involvement. 国際誌

Yuzo Kawata, Kentaro Tominaga, Yusuke Kaneko, Saori Takashima, Yusuke Tani, Yuichi Kojima, Kazuya Takahashi, Shuji Terai

Clinical case reports 13 ( 9 ) e70575 2025年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

We found an extremely rare case of upper gastrointestinal involvement in trisomy 8-positive myelodysplastic syndrome. This is the first reported case of trisomy 8-positive myelodysplastic syndrome with both upper and lower gastrointestinal involvement, which was successfully treated with bone marrow transplantation.

DOI： 10.1002/ccr3.70575

Carbon-Ion Radiotherapy for Hepatocellular Carcinoma: Current Status and Future Prospects: A Narrative Review

Reina Sasaki-Tanaka, Hiroyuki Abe, Tomoaki Yoshida, Yusuke Watanabe, Naruhiro Kimura, Takeshi Yokoo, Akira Sakamaki, Hiroteru Kamimura, Kenya Kamimura, Tatsuo Kanda, Shuji Terai

Journal of Clinical Medicine 14 ( 17 ) 6107 - 6107 2025年8月

掲載種別：研究論文（学術雑誌）出版者・発行元：MDPI AG

Because hepatocellular carcinoma (HCC) is a radiosensitive cancer, radiation therapy has been used for the treatment of HCC; however, external beam therapies are currently not described in most of the guidelines for the treatment of HCC. External beam therapies include photon beam therapies and particle beam therapies, which are composed of X-rays or gamma rays and beams of carbon ions or protons, respectively. The focus of this narrative review is carbon-ion radiotherapy (C-ion RT). C-ion RT is well tolerated by elderly patients with HCC and/or sarcopenic patients. In general, a single HCC greater than 30 mm is a good indication for C-ion RT in patients with Child Grade A/B or ALBI Grade 1/2. The local control rates and overall survival rates at 5 years after C-ion RT for HCCs larger than 30 mm are excellent, with fewer adverse events, such as radiation-induced liver damage. Advanced HCC with portal vein tumor thrombus is also an indication for C-ion RT in certain selected patients. C-ion RT is a promising therapeutic option for patients with HCC.

DOI： 10.3390/jcm14176107

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