Review
Immunology
Siyu Wu, Haiqiang Wang
Summary: IgG4-related digestive diseases are a group of chronic inflammatory disorders that are often misdiagnosed as malignancies. A comprehensive understanding of these diseases remains challenging, and current diagnosis relies on integrated diagnostic criteria and specific organ involvement criteria. Further research is needed to elucidate the underlying mechanisms and explore potential treatments.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Multidisciplinary Sciences
Su Jin Choi, Soo Min Ahn, Ji Seon Oh, Seokchan Hong, Chang-Keun Lee, Bin Yoo, Yong-Gil Kim
Summary: This study investigated the predictors of relapse in IgG4-related disease, focusing on serum IgG4 levels during initial treatment. 57 patients with IgG4-RD were retrospectively recruited and followed up for at least 6 months after immunosuppressive therapy. The normalization of serum IgG4 levels at six months was found to independently predict relapse-free outcomes.
Article
Medicine, Research & Experimental
Yunpeng Li, Lifeng Wang
Summary: We report a case of IgG4-related autoimmune hepatitis in an elderly male patient with unexplained hepatic insufficiency. After excluding other diseases and observing elevated levels of IgG4 and abnormal liver disease antibody spectrum, the patient was diagnosed with IgG4-AIH. Treatment with prednisone and ursodeoxycholic acid improved the patient's liver function significantly and resulted in discharge from the hospital.
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
(2023)
Review
Gastroenterology & Hepatology
Atsushi Tanaka, Kenji Notohara
Summary: IgG4-related disease is a chronic inflammatory disease that may affect multiple organs of the body, characterized by elevated serum IgG4 levels and massive infiltration of IgG4(+) plasma cells in damaged tissues. The phenotypes of IgG4-RD in the liver, such as IgG4-AIH and IgG4-hepatopathy, along with their clinical characteristics, remain to be established due to the lack of consensus.
HEPATOLOGY RESEARCH
(2021)
Article
Gastroenterology & Hepatology
Kensuke Kubota, Terumi Kamisawa, Takahiro Nakazawa, Atsushi Tanaka, Itaru Naitoh, Yusuke Kurita, Hajime Takikawa, Michiaki Unno, Shigeyuki Kawa, Atsushi Masamune, Seiji Nakamura, Kazuichi Okazaki
Summary: This study reviewed the data of 924 patients with IgG4-SC from a nationwide survey in Japan and found that 15% of these patients developed cancer. The risk of cancer development was significantly influenced by relapse, and most cancers occurred within 8 years after the diagnosis of IgG4-SC, with the highest risks in pancreatic and biliary cancers. Maintenance steroid treatment had a positive impact on the prognosis of these patients.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Hasan Ali, Taqi Rizvi, Mumtaz Niazi, Mark Galan, Nikolaos Pyrsopoulos
Summary: This case study presents a potential link between syphilitic hepatitis and autoimmune hepatitis, suggesting that treatment for syphilis may trigger an autoimmune response. Autoimmune hepatitis is a chronic liver disease that is believed to result from a combination of genetic and environmental factors.
JOURNAL OF CLINICAL AND TRANSLATIONAL HEPATOLOGY
(2022)
Article
Multidisciplinary Sciences
Ichiro Mizushima, Masahiro Konishi, Hajime Sanada, Kazuyuki Suzuki, Akari Takeji, Takeshi Zoshima, Satoshi Hara, Kiyoaki Ito, Hiroshi Fujii, Kazunori Yamada, Mitsuhiro Kawano
Summary: Untreated patients with IgG4-RD often have fewer affected organs and lower IgG4-RD responder index. Serum IgG4 levels may be a useful predictor of unfavorable outcomes in untreated patients.
SCIENTIFIC REPORTS
(2021)
Article
Gastroenterology & Hepatology
Masayuki Ueno, Hiroyuki Takabatake, Takahisa Kayahara, Youichi Morimoto, Kenji Notohara, Motowo Mizuno
Summary: This study investigated the long-term outcomes of drug-induced autoimmune-like hepatitis (DI-ALH) caused by pulse steroid therapy. The study found that among the patients who developed acute liver injury within 3 months after the therapy, 5 were diagnosed with DI-ALH. Not tapering off prednisolone after the therapy was a significant risk factor for the subsequent development of DI-ALH. Prednisolone was effective for treating DI-ALH and could be safely withdrawn once remission was achieved.
HEPATOLOGY RESEARCH
(2023)
Article
Surgery
Brian H. Horwich, Tom Z. Liang, Jennifer L. Dodge, Shefali Chopra, Jeffrey A. Kahn, Takeshi Saito
Summary: Autoimmune hepatitis (AIH), post-transplant recurrent AIH (rAIH), and plasma cell-rich rejection (PCR) are clinical diagnoses with the shared histopathologic hallmark of plasma cell hepatitis (PCH). This study evaluated IgG4-PC infiltration in these diagnoses and found that IgG4-Positivity is associated with clinical characteristics. The authors suggest incorporating IgG4-Positivity into the classification and treatment strategies for PCH.
TRANSPLANT INTERNATIONAL
(2022)
Review
Immunology
Jiachen Liu, Wei Yin, Lisa S. Westerberg, Pamela Lee, Quan Gong, Yan Chen, Lingli Dong, Chaohong Liu
Summary: IgG(4)-RD is a newly discovered autoimmune disease characterized by elevated serum IgG(4) concentrations and multi-organ fibrosis. The pathogenesis of this disease involves abnormal adaptive immune cells and cytokines, including different types of T and B cells, and cytokines secreted by these cells, leading to fibrosis in multiple organs.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Gastroenterology & Hepatology
Aparna Goel, Paul Kwo
Summary: The goal of autoimmune hepatitis treatment is achieving clinical and biochemical remission. Standard care involves induction treatment with corticosteroids and gradual tapering of steroids. Alternatives to standard therapy can be considered for patients with intolerance or inadequate response. Treatment withdrawal is achievable in less than 20% of patients after 2 years of sustained remission, and liver transplantation should be considered for patients with progressive disease or complications.
CLINICS IN LIVER DISEASE
(2024)
Article
Gastroenterology & Hepatology
Victoria Gordon, Ratul Adhikary, Victoria Appleby, Debasish Das, James Day, Toby Delahooke, Selena Dixon, David Elphick, Claire Hardie, Michael A. Heneghan, Barbara Hoeroldt, Patricia Hooper, John Hutchinson, Rebecca Jones, Faisal Khan, Guruprasad P. Aithal, Jane Metcalf, Alick Nkhoma, Stavroula Pelitari, Martin Prince, Annell Prosser, Vinay Sathyanarayana, Sushma Saksena, Deven Vani, Andrew Yeoman, George Abouda, Andrew Nelson, Dermot Gleeson
Summary: This study analyzed the treatment and outcomes of 1267 patients with autoimmune hepatitis (AIH) in 28 UK hospitals. It found that patients who were untreated with steroids, received higher prednisolone doses, and did not receive a steroid-sparing agent (SSA) had higher death/transplant rates.
LIVER INTERNATIONAL
(2022)
Article
Medicine, General & Internal
You-Wen Tan, Jia-Min Wang, Li Chen
Summary: In this case report, a 68-year-old woman was diagnosed with IgG4-related autoimmune hepatitis (AIH) combined with giant-cell hepatitis (GCH). Treatment with methylprednisolone led to significant improvement in symptoms, liver function, and immunological indicators.
WORLD JOURNAL OF CLINICAL CASES
(2021)
Review
Immunology
Maria Maslinska, Joanna Dmowska-Chalaba, Michal Jakubaszek
Summary: The role of IgG4 in IgG4-RD and other autoimmune diseases has attracted attention. IgG4, as a unique subclass of immunoglobulins, is generally considered non-inflammatory and tolerance inducing, but in IgG4-RD, it may play a pathogenic role in fibrogenesis and inflammation.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Immunology
Verena Endmayr, Cansu Tunc, Lara Ergin, Anna de Rosa, Rosa Weng, Lukas Wagner, Thin-Yau Yu, Andreas Fichtenbaum, Thomas Perkmann, Helmuth Haslacher, Nicolas Kozakowski, Carmen Schwaigerl, Gerda Rickert, Simon Hametnerl, Livia Almeida Dutra, Christian Lechnerl, Desiree de Simoni, Kai-Nicolas Poppert, Georg Johannes Mueller, Susanne Pirkerl, Walter Pirker, Aleksandra Angelovski, Matus Valach, Michelangelo Maestri, Melania Guida, Roberta Ricciardi, Florian Frommlet, Daniela Sieghart, Miklos Pinter, Romana Hoftbergerl, Inga Koneczny
Summary: The study found that anti-neuronal IgG4-AID and IgG4-RLD are likely distinct disease entities with different clinical and immunopathological features.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Gastroenterology & Hepatology
Masatoshi Kudo, Richard S. Finn, Shukui Qin, Kwang-Hyub Han, Kenji Ikeda, Ann-Lii Cheng, Arndt Vogel, Francesco Tovoli, Kazuomi Ueshima, Hiroshi Aikata, Carlos Lopez Lopez, Marc Pracht, Zhiqiang Meng, Bruno Daniele, Joong-Won Park, Daniel Palmer, Toshiyuki Tamai, Kenichi Saito, Corina E. Dutcus, Riccardo Lencioni
Summary: The study aimed to validate objective response as an independent predictor of overall survival (OS) in individuals with unresectable hepatocellular carcinoma (HCC) receiving systemic anti-angiogenic therapy. The results showed that objective response assessed by investigator-assessed mRECIST could predict the survival of patients. Further studies are needed to confirm this finding.
JOURNAL OF HEPATOLOGY
(2023)
Article
Oncology
Philippe Merle, Masatoshi Kudo, Stanimira Krotneva, Kirhan Ozgurdal, Yun Su, Irina Proskorovsky
Summary: This study compared the efficacy and safety of regorafenib and cabozantinib in the second-line treatment of advanced hepatocellular carcinoma. The results showed that regorafenib had a favorable overall survival, lower rates of dose reduction and treatment discontinuation due to adverse events, and lower rates of severe diarrhea and fatigue compared to cabozantinib.
Article
Radiology, Nuclear Medicine & Medical Imaging
Naoshi Nishida, Masatoshi Kudo
Summary: With the development of advanced methods for diagnosis and treatment, the complexity of medical data has increased, leading to the potential for misinterpretation and serious consequences. Artificial intelligence (AI) can help avoid human errors and has shown promising results in diagnosing and managing liver diseases. This paper summarizes recent advances in AI for liver disease and introduces the use of AI in diagnosing liver tumors using B-mode ultrasonography.
Article
Oncology
Andrea Casadei-Gardini, Margherita Rimini, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, Lorenza Rimassa, Jose Presa, Gianluca Masi, Changhoon Yoo, Sara Lonardi, Francesco Tovoli, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Tiziana Pressiani, Margarida Montes, Caterina Vivaldi, Caterina Solda, Fabio Piscaglia, Atsushi Hiraoka, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Massimo Iavarone, Giovanni Di Costanzo, Fabio Marra, Mario Scartozzi, Emiliano Tamburini, Giuseppe Cabibbo, Francesco Giuseppe Foschi, Marianna Silletta, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Valentina Burgio, Mara Persano, Angelo Della Corte, Francesca Ratti, Francesco De Cobelli, Luca Aldrighetti, Stefano Cascinu, Alessandro Cucchetti
Summary: This retrospective multi-center study compared the clinical efficacy and safety of lenvatinib and atezolizumab plus bevacizumab as a first-line treatment for unresectable HCC. The results showed that atezolizumab plus bevacizumab did not have a significant survival advantage over lenvatinib overall. However, lenvatinib had a higher overall survival rate in patients with non-alcoholic steatohepatitis/non-alcoholic fatty liver disease, while atezolizumab plus bevacizumab had a higher overall survival rate in patients with viral hepatitis. After adjusting for population, atezolizumab plus bevacizumab provided better safety profile for most adverse events.
EUROPEAN JOURNAL OF CANCER
(2023)
Article
Gastroenterology & Hepatology
Naoya Kato, Masatoshi Kudo, Kaoru Tsuchiya, Atsushi Hagihara, Kazushi Numata, Hiroshi Aikata, Yoshitaka Inaba, Shunsuke Kondo, Kenta Motomura, Naohiro Okano, Masafumi Ikeda, Manabu Morimoto, Shingo Kuroda, Akiko Kimura
Summary: Cabozantinib demonstrated efficacy and manageable safety profile in Japanese patients with advanced HCC. The median PFS was 7.4 months in the prior-sorafenib cohort and 3.6 months in the sorafenib-naive cohort. Disease control rate was 85.0% and 64.3% in the prior-sorafenib and sorafenib-naive cohorts, respectively. The most common adverse events were palmar-plantar erythrodysesthesia syndrome, diarrhea, hypertension, and decreased appetite. No new safety concerns were identified.
HEPATOLOGY RESEARCH
(2023)
Editorial Material
Oncology
Masatoshi Kudo
Review
Oncology
Yasunori Minami, Naoshi Nishida, Masatoshi Kudo
Summary: This article discusses the imaging characteristics and differential diagnosis of hepatocellular carcinoma and other hypervascular liver lesions. Artificial intelligence in medical imaging analysis shows promise as a decision support tool, but further validation is needed.
Review
Oncology
Arndt Vogel, Robin Katie Kelley, Philip Johnson, Philippe Merle, Thomas Yau, Masatoshi Kudo, Tim Meyer, Lorenza Rimassa
Summary: A systematic literature review reveals the importance of liver function assessments in predicting disease prognosis and response to systemic anticancer therapy in patients with advanced hepatocellular carcinoma. The study supports liver function as a prognostic marker and highlights the value of stratifying patients based on baseline liver function in clinical trials for aHCC.
Article
Oncology
Masatoshi Kudo, Richard S. S. Finn, Peter R. R. Galle, Andrew X. X. Zhu, Michel Ducreux, Ann-Lii Cheng, Masafumi Ikeda, Kaoru Tsuchiya, Ken-ichi Aoki, Jing Jia, Riccardo Lencioni
Summary: The study demonstrates the efficacy and safety of atezolizumab + bevacizumab treatment in patients with baseline BCLC Stage B hepatocellular carcinoma, consistent with the overall study population.
Review
Medicine, General & Internal
Yasuo Otsuka, Ken Kamata, Masatoshi Kudo
Summary: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a useful method for diagnosing pancreatic masses. The diagnostic performance of EUS-FNA can be improved by using contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS), which helps avoid fibrosis in the pancreatic mass. However, the effectiveness of CH-EUS-FNA is still a matter of debate, as only one out of eight studies showed improved sensitivity.
Article
Medicine, General & Internal
Takushi Manabe, Chikara Ogawa, Kei Takuma, Mai Nakahara, Kyoko Oura, Tomoko Tadokoro, Koji Fujita, Joji Tani, Mitsushige Shibatoge, Asahiro Morishita, Masatoshi Kudo, Tsutomu Masaki
Summary: This study validated the assessment of sarcopenia using psoas muscle volume as a measure and found that sarcopenia was associated with shorter survival in patients with liver disease. The psoas muscle volume index (PMVI) may be useful in evaluating sarcopenia, including cases where sarcopenia cannot be diagnosed using the commonly used psoas muscle index (PMI).
Article
Medicine, General & Internal
Yasuo Otsuka, Yoriaki Komeda, Masayuki Takeda, Takayuki Takahama, Masashi Kono, Mamoru Takenaka, Satoru Hagiwara, Naoshi Nishida, Hiroshi Kashida, Masatoshi Kudo
Summary: A 76-year-old woman presented with lower abdominal pain and nausea. Imaging showed a soft tissue mass extending to the liver surface, diagnosed as epithelioid mesothelioma. After chemotherapy, the patient achieved long-term survival of more than 5 years.
CASE REPORTS IN MEDICINE
(2023)
Article
Biochemistry & Molecular Biology
Tomohiro Watanabe, Kosuke Minaga, Hajime Honjo, Masatoshi Kudo
Summary: The liver showed hypo-responsiveness to antigens and high doses of orally-administered ovalbumin (OVA) generated unique CD4+ T cells and tolerogenic dendritic cells that can suppress Th1 responses. OVA administration at high doses inhibited hepatitis development in mice with OVA-specific CD4+ T cells, and this was associated with downregulation of Th1 responses. The results suggest that high-dose oral antigen administration can suppress Th1-mediated hepatitis in an antigen-non-specific manner.
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS
(2023)
Article
Gastroenterology & Hepatology
Hiroko Iijima, Masatoshi Kudo, Shoji Kubo, Masayuki Kurosaki, Michiie Sakamoto, Shuichiro Shiina, Ryosuke Tateishi, Nakashima Osamu, Takumi Fukumoto, Yutaka Matsuyama, Takamichi Murakami, Arata Takahashi, Hiroaki Miyata, Norihiro Kokudo
Summary: Data from a nationwide follow-up survey of primary liver cancer in Japan, which compiled information from 20,889 newly registered patients and 42,274 previously registered follow-up patients, showed that patients with hepatocellular carcinoma (HCC) in the 23rd survey were older at the time of clinical diagnosis, had more female patients, had more non-B non-C HCC patients, had smaller tumor diameter, and were more frequently treated with hepatectomy compared to the previous survey. The data obtained from this survey are expected to contribute to advancing clinical research and treatment of primary liver cancer worldwide.
HEPATOLOGY RESEARCH
(2023)
Article
Oncology
Masatoshi Kudo