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대한간학회> Clinical and Molecular Hepatology(대한간학회지)

Clinical and Molecular Hepatology(대한간학회지) update

Clinical and Molecular Hepatology (CMH)

  • : 대한간학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCI,SCOPUS
  • : 연속간행물
  • : 계간
  • : 2287-2728
  • : 2287-285x
  • : 대한간학회지()→Korean Journal of Hepatology(2004~)→대한간학회지(2012~)

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수록범위 : 1권1호(1995)~27권1호(2021) |수록논문 수 : 4,700
Clinical and Molecular Hepatology(대한간학회지)
27권1호(2021년 01월) 수록논문
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KCI등재 SCI SCOPUS

1Current understanding of primary biliary cholangitis

저자 : Atsushi Tanaka

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 1호 발행 연도 : 2021 페이지 : pp. 1-21 (21 pages)

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Primary biliary cholangitis (PBC) causes chronic and persistent cholestasis in the liver, eventually resulting in cirrhosis and hepatic failure without appropriate treatment. PBC mainly develops in middle-aged women, but it is also common in young women and men. PBC is considered a model of autoimmune disease because of the presence of disease-specific autoantibodies, that is, antimitochondrial antibodies (AMAs), intense infiltration of mononuclear cells into the bile ducts, and a high prevalence of autoimmune diseases such as comorbidities. Histologically, PBC is characterized by degeneration and necrosis of intrahepatic biliary epithelial cells surrounded by a dense infiltration of mononuclear cells, coined as chronic non-suppurative destructive cholangitis, which leads to destructive changes and the disappearance of small- or medium-sized bile ducts. Since 1990, early diagnosis with the detection of AMAs and introduction of ursodeoxycholic acid as first-line treatment has greatly altered the clinical course of PBC, and liver transplantation-free survival of patients with PBC is now comparable to that of the general population. (Clin Mol Hepatol 2021;27:1-21)

KCI등재 SCI SCOPUS

2The role of the gut microbiome and diet in the pathogenesis of non-alcoholic fatty liver disease

저자 : Erica Jennison , Christopher D. Byrne

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 1호 발행 연도 : 2021 페이지 : pp. 22-43 (22 pages)

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Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease, with a prevalence that is increasing in parallel with the global rise in obesity and type 2 diabetes mellitus. The pathogenesis of NAFLD is complex and multifactorial, involving environmental, genetic and metabolic factors. The role of the diet and the gut microbiome is gaining interest as a significant factor in NAFLD pathogenesis. Dietary factors induce alterations in the composition of the gut microbiome (dysbiosis), commonly reflected by a reduction of the beneficial species and an increase in pathogenic microbiota. Due to the close relationship between the gut and liver, altering the gut microbiome can affect liver functions; promoting hepatic steatosis and inflammation. This review summarises the current evidence supporting an association between NAFLD and the gut microbiome and dietary factors. The review also explores potential underlying mechanisms underpinning these associations and whether manipulation of the gut microbiome is a potential therapeutic strategy to prevent or treat NAFLD. (Clin Mol Hepatol 2021;27:22-43)

KCI등재 SCI SCOPUS

3Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective

저자 : Gwyneth Soon , Aileen Wee

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 1호 발행 연도 : 2021 페이지 : pp. 44-57 (14 pages)

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Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a major cause of liver fibrosis and cirrhosis. Accurate assessment of liver fibrosis is important for predicting disease outcomes and assessing therapeutic response in clinical practice and clinical trials. Although noninvasive tests such as transient elastography and magnetic resonance elastography are preferred where possible, histological assessment of liver fibrosis via semiquantitative scoring systems remains the current gold standard. Collagen proportionate area provides more granularity by measuring the percentage of fibrosis on a continuous scale, but is limited by the absence of architectural input. Although not yet used in routine clinical practice, advances in second harmonic generation/two-photon excitation fluorescence (SHG/TPEF) microscopy imaging show great promise in characterising architectural features of fibrosis at the individual collagen fiber level. Quantification and calculation of different detailed variables of collagen fibers can be used to establish algorithm-based quantitative fibrosis scores (e.g., qFibrosis, q-FPs), which have been validated against fibrosis stage in NAFLD. Artificial intelligence is being explored to further refine and develop quantitative fibrosis scoring methods. SHG-microscopy shows promise as the new gold standard for the quantitative measurement of liver fibrosis. This has reaffirmed the pivotal role of the liver biopsy in fibrosis assessment in NAFLD, at least for the near-future. The ability of SHG-derived algorithms to intuitively detect subtle nuances in liver fibrosis changes over a continuous scale should be employed to redress the efficacy endpoint for fibrosis in NASH clinical trials; this approach may improve the outcomes of the trials evaluating therapeutic response to antifibrotic drugs. (Clin Mol Hepatol 2021;27:44-57)

KCI등재 SCI SCOPUS

4Recent updates on the management of autoimmune hepatitis

저자 : Atsumasa Komori

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 1호 발행 연도 : 2021 페이지 : pp. 58-69 (12 pages)

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Autoimmune hepatitis (AIH) is an immunoinflammatory chronic liver disease with dynamic and rather heterogeneous disease manifestations. A trend of increasing prevalence of AIH has been observed worldwide, along with a relative increase in the percentage of male patients. AIH is characterized and diagnosed based on serum biochemistry and liver histology: elevated aminotransferases and serum immunoglobulin G (IgG), the presence of serum anti-nuclear antibody or anti-smooth muscle antibody, and interface lympho-plasmacytic hepatitis. Clinical manifestations differ among disease subtypes with distinct time-frames, i.e., AIH with a chronic insidious onset, and acute-onset AIH (the diagnosis of which is often challenging due to the lack of typical serum findings). The absence of disease-specific biomarkers or histological findings may expand the disease phenotype into drug-induced AIH-like liver injury. Corticosteroids and azathioprine are recommended first-line treatments for AIH. The complete normalization of aminotransferases and serum IgG is an essential treatment response to ensure long-term overall survival. An incomplete response or intolerance to these drugs is considered an indication for second-line treatment, especially with mycophenolate mofetil. Lifelong maintenance treatment is required for the majority of patients, but the few who achieve prolonged and stringent biochemical remission with lower alanine aminotransferase and IgG within the normal range may be able to discontinue the medications. In the future, the quality of life of AIH patients should be managed by personalized medicine, including the appropriate selection and dosing of first-line therapy and perhaps alternating with potential therapeutics, and the prediction of the success of treatment withdrawal. (Clin Mol Hepatol 2021;27:58-69)

KCI등재 SCI SCOPUS

5The development of mesenchymal stem cell therapy in the present, and the perspective of cell-free therapy in the future

저자 : Yusuke Watanabe , Atsunori Tsuchiya , Shuji Terai

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 1호 발행 연도 : 2021 페이지 : pp. 70-80 (11 pages)

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Cirrhosis is a chronic condition that can lead to liver failure. Currently, the viable option for decreasing mortality is liver transplantation. However, transplant surgery is highly invasive. Therefore, cell-based therapy has been developed as an alternative. Based on promising findings from preclinical research, some new trials have been registered. One of them was autologous bone marrow cell infusion therapy and found that ameliorating liver fibrosis activated liver regeneration. Now, majority of trials focus on low-immunogenicity mesenchymal stem cells (MSCs) appropriate for allogeneic administration. However, despite about 20 years of research, only a limited number of cell-based therapies have entered routine practice. Furthermore, potential shortcomings of cell-based therapy include a limit on the number of cells, which may be administered, as well as their failure to infiltrate target organs. On the other hand, these research show that MSCs act as “conducting cells” and regulate host cells including macrophages via extracellular vesicles (EVs) or exosome signals, leading to ameliorate liver fibrosis and promote regeneration. Therefore, the concept of cell-free therapy, which makes use of cell-derived EVs or exosomes, is attracting attention. Cell-free therapies may be safely administered in large doses and are able to infiltrate target organs. However, development of cell-free therapy exhibits its own set of challenges and such therapy may not be completely curative in the context of liver disease. This review describes the history of cell-based therapy research and recent advances in cell-free therapy, as well as discussing the need for more effective therapies. (Clin Mol Hepatol 2021;27:70-80)

KCI등재 SCI SCOPUS

6Drug-drug interactions with direct-acting antivirals ― less is more

저자 : Grace Lai-hung Wong

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 1호 발행 연도 : 2021 페이지 : pp. 81-82 (2 pages)

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KCI등재 SCI SCOPUS

7Probiotics for treatment of nonalcoholic fatty liver disease: It is worth a try

저자 : Tian-yi Ren , Xiao-yan Li , Jian-gao Fan

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 1호 발행 연도 : 2021 페이지 : pp. 83-86 (4 pages)

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8Metabolic disease as a risk of hepatocellular carcinoma

저자 : Naoshi Nishida

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 1호 발행 연도 : 2021 페이지 : pp. 87-90 (4 pages)

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10Alcohol-related cirrhosis: The most challenging etiology of cirrhosis is more burdensome than ever

저자 : Marta Tonon , Salvatore Piano

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 1호 발행 연도 : 2021 페이지 : pp. 94-96 (3 pages)

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See Article on Page 175
REFERENCES

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