1.Role of naringenin in the prevention and treatment of autoimmune hepatitis and its molecular mechanism
Changwen LIN ; Qiuyi REN ; Mengjie ZHENG ; Huan YAN ; Jia LI ; Jiaxin FENG ; Haiying LIN ; Faming SHU ; Xiaoling ZHOU ; Dewen MAO ; Fuli LONG
Journal of Clinical Hepatology 2026;42(6):1419-1425
Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease mediated by T lymphocytes, and it can progress to liver cirrhosis or even liver failure without timely intervention. As a natural flavonoid compound, naringenin (NAR) shows a potential value in the prevention and treatment of AIH through multiple mechanisms such as remodeling immune homeostasis, targeted inhibition of inflammatory pathways, antioxidation, regulating hepatocyte metabolism and apoptosis, improving mitochondrial function, and regulating intestinal flora. However, the clinical translation and application of NAR is limited by issues such as low bioavailability and insufficient efficiency of liver-targeted delivery. This article systematically reviews the mechanism of action of NAR in the prevention and treatment of AIH, explores the potential signaling pathways involved in this process, and analyzes existing challenges in its translation and application and future research directions, so as to provide a reference for further research on NAR and its application in the prevention and treatment of AIH.
2.Progress on the application of metabolomics in the prevention and treatment of liver failure using traditional Chinese medicine
Mengling HU ; Jiongfen LI ; Yangling ZENG ; Riyun ZHANG ; Dewen MAO
Journal of Clinical Hepatology 2025;41(6):1207-1212
With the concurrent development of traditional Chinese medicine (TCM) and metabolomics in the diagnosis and treatment of liver failure, techniques such as nuclear magnetic resonance, mass spectrometry, chromatography, metabolic flux analysis, and bioinformatics enable the qualitative or quantitative analysis of endogenous small molecule metabolites in animal models of liver failure and patients with liver failure. These methods help identify specific biomarkers for early diagnosis and clinical intervention. This article reviews recent advancements in metabolomics for the early diagnosis of liver failure, biomarker discovery, identification of TCM syndromes, and the application of TCM in treating liver failure, aiming to provide a basis for TCM-based diagnosis and treatment of liver failure.
3.Construction and practice of the theory of “turbid toxin pathogenesis” and related prevention and treatment strategies for hepatic encephalopathy in traditional Chinese medicine/Zhuang medicine
Zhipeng WU ; Yuqin ZHANG ; Chun YAO ; Minggang WANG ; Na WANG ; Mengru PENG ; Ningfang MO ; Yaqing ZHENG ; Rongzhen ZHANG ; Dewen MAO
Journal of Clinical Hepatology 2025;41(2):370-374
Hepatic encephalopathy is a difficult and critical disease with rapid progression and limited treatment methods in the field of liver disease, and it is urgently needed to make breakthroughs in its pathogenesis. Selection of appropriate prevention and treatment strategies is of great importance in delaying disease progression and reducing the incidence and mortality rates. This article reviews the theory of “turbid toxin pathogenesis” and related prevention and treatment strategies for hepatic encephalopathy in traditional Chinese medicine/Zhuang medicine, proposes a new theory of “turbid toxin pathogenesis”, analyzes the scientific connotations of “turbid”, “toxin”, and the theory of “turbid toxin pathogenesis”, and constructs the “four-step” prevention and treatment strategies for hepatic encephalopathy, thereby establishing the new clinical prevention and treatment regimen for hepatic encephalopathy represented by “four prescriptions and two techniques” and clarifying the effect mechanism and biological basis of core prescriptions and techniques in the prevention and treatment of hepatic encephalopathy, in order to provide a reference for the prevention and treatment of hepatic encephalopathy.
4.Association between bile acid/short-chain fatty acid metabolic disorders and hepatic encephalopathy based on the traditional Chinese medicine theory of Yin and Yang
Luyi YAN ; Weiyu CHEN ; Han WANG ; Wenqian FENG ; Yang DU ; Xueru TIAN ; Yang HONG ; Dewen MAO ; Lei FU ; Chun YAO
Journal of Clinical Hepatology 2025;41(7):1443-1449
Hepatic encephalopathy is a neuropsychiatric syndrome secondary to severe liver disease.Recent studies have shown that the development of hepatic encephalopathy is closely associated with bile acid/short-chain fatty acid metabolic disorder.As the core theory of traditional Chinese medicine,the theory of Yin and Yang provides a unique perspective for analyzing the association between bile acids/short-chain fatty acids and hepatic encephalopathy.Bile acids function like Yang,governing the free flow of Qi and assisting in metabolic processes,while short-chain fatty acids belong to Yin,maintaining internal stability and conservation,preserving the intestinal barrier,and combating inflammation and toxins.Bile acids and short-chain fatty acids constrain each other and are interdependent to regulate the dynamic equilibrium of the gut-liver-brain axis.On this basis,by regulating the metabolic imbalance of bile acids and short-chain fatty acids,it is expected to restore the dynamic balance of Yin and Yang in patients with hepatic encephalopathy under the synergistic intervention of traditional Chinese medicine and Western medicine.
5.Immunomodulatory effect of short-chain fatty acids in hepatic encephalopathy and its potential diagnostic value
Weiyu CHEN ; Dewen MAO ; Han WANG ; Yang DU ; Wenqian FENG ; Lei FU ; Chun YAO
Journal of Clinical Hepatology 2025;42(5):954-962
Hepatic encephalopathy(HE)is a common complication of severe liver disease in the end stage,and it is urgently needed to improve the rate of effective treatment and clarify the pathogenesis of HE.The liver is a crucial hub for immune regulation,and disruption of immune homeostasis is a key factor in the pathological mechanisms of HE.As the main metabolites of intestinal flora,short-chain fatty acids(SCFAs)play a vital role in the biological processes of both innate and adaptive immunity and can regulate the proliferation and differentiation of immune cells maintain the homeostasis of intestinal microenvironment and the integrity of barrier function.Studies have shown that SCFAs participate in bidirectional and dynamic interactions with the liver-gut-brain axis through immunomodulatory pathways,thereby playing an important role in the diagnosis,treatment,and prognostic evaluation of HE.Starting from the immunoregulatory effect of SCFAs,this article summarizes and analyzes the crosstalk relationship between SCFAs and the liver-gut-brain axis and the significance of SCFAs in the diagnosis and treatment of HE,in order to provide new ideas for optimizing clinical prevention and treatment strategies.
6.The role of 3-hydroxy-3-methylglutaryl-coenzyme A reductase in liver diseases
Yangling ZENG ; Yunyong WANG ; Haimei GUAN ; Tianwen WANG ; Baohua XIE ; Guobao LI ; Riyun ZHANG ; Tingshuai WANG ; Dewen MAO
Journal of Clinical Hepatology 2025;42(5):983-990
Cholesterol is an essential molecule for the biosynthesis of cell membranes and cell proliferation and differentiation,and the liver plays a central role in cholesterol metabolism and is responsible for the synthesis,uptake,secretion,and transport of cholesterol.The initial stages of cholesterol synthesis in the liver are particularly important,and abnormalities in such stages are closely associated with the progression of various liver diseases.Studies have shown that as a key rate-limiting enzyme in cholesterol biosynthesis,3-hydroxy-3-methylglutaryl-coenzyme A reductase(HMGCR)has well-defined regulatory properties and has been confirmed as an important target for the regulation of various liver diseases.This article reviews the process of cholesterol metabolism,the degradation and regulatory mechanisms of HMGCR,and the application of inhibitors,as well as the role of HMGCR in liver diseases,in order to provide new insights for scientific research and the clinical prevention and treatment of liver diseases.
7.Mechanism of action of the nuclear factor-kappa B signaling pathway in liver diseases and its potential as a therapeutic target
Wenqian FENG ; Yang DU ; Dewen MAO ; Weiyu CHEN ; Lei FU ; Luyi YAN ; Chun YAO ; Yanmei LAN
Journal of Clinical Hepatology 2025;41(9):1949-1955
Nuclear factor-kappa B (NF-κB) is an important intracellular transcription factor widely involved in the processes such as immune response, inflammatory response, cell proliferation, and apoptosis. The abnormal activation of the NF-κB signaling pathway plays a pivotal role in various liver diseases including chronic hepatitis, liver fibrosis, liver cirrhosis, and hepatocellular carcinoma. Extensive studies have shown that inhibiting NF-κB activity may effectively reduce inflammation and fibrosis and improve metabolic disorders. Several natural compounds, such as matrine and salvianolic acid B, have shown the potential in suppressing NF-κB activity, thereby exerting anti-inflammatory, anti-fibrotic, and anti-tumor effects. This article systematically reviews the critical role of the NF-κB signaling pathway in liver diseases and its potential as a therapeutic target, in order to highlight its potential as a therapeutic target for liver diseases and provide new directions for the treatment of liver diseases.
8.Role of neutrophil extracellular traps in hepatocellular carcinoma
Xueru TIAN ; Weiyu CHEN ; Luyi YAN ; Yang HONG ; Han WANG ; Shouqin LIU ; Lei QING ; Guojuan MA ; Dewen MAO ; Chun YAO
Journal of Clinical Hepatology 2025;41(11):2410-2417
Hepatocellular carcinoma (HCC) is a malignant tumor with high incidence and mortality rates worldwide. Recent studies have shown that neutrophil extracellular traps (NETs) play an important role in the development, progression, and immune escape of HCC. NETs are released by neutrophils and mainly consist of DNA, histones, and antimicrobial molecules, and in addition to immune defense, they are also involved in the initiation, metastasis, and thrombosis of HCC. This article elaborates on the formation and regulatory mechanisms of NETs, explores their potential mechanisms in the initiation, metastasis, immune escape, and thrombosis of HCC, and discusses the prospect of NETs as a target for the diagnosis and treatment of HCC, in order to provide new ideas for the precise treatment of HCC in the future and promote the early diagnosis and effective treatment of HCC.
9.Mechanism of action of the Notch signaling pathway in mediating immune inflammatory response in liver injury
Faming SHU ; Ying HUANG ; Kan ZHANG ; Fajuan HE ; Fuli LONG ; Dewen MAO
Journal of Clinical Hepatology 2025;41(11):2424-2428
Immune inflammatory response runs through the whole pathological process of liver injury, but its specific regulatory mechanism remains unclear. Recent studies have shown that the Notch signaling pathway plays an important role in liver injury by regulating macrophage polarization, activating neutrophil recruitment, and modulating the differentiation of regulatory immune cells. This article systematically reviews the molecular mechanisms of the Notch signaling pathway in mediating immune inflammatory response in liver injury, in order to provide new perspectives for clarifying the molecular mechanism of immune inflammatory damage in liver diseases, as well as a new reference for future research directions.
10.Immunomodulatory effect of short-chain fatty acids in hepatic encephalopathy and its potential diagnostic value
Weiyu CHEN ; Dewen MAO ; Han WANG ; Yang DU ; Wenqian FENG ; Lei FU ; Chun YAO
Journal of Clinical Hepatology 2025;41(5):954-962
Hepatic encephalopathy (HE) is a common complication of severe liver disease in the end stage, and it is urgently needed to improve the rate of effective treatment and clarify the pathogenesis of HE. The liver is a crucial hub for immune regulation, and disruption of immune homeostasis is a key factor in the pathological mechanisms of HE. As the main metabolites of intestinal flora, short-chain fatty acids (SCFAs) play a vital role in the biological processes of both innate and adaptive immunity and can regulate the proliferation and differentiation of immune cells maintain the homeostasis of intestinal microenvironment and the integrity of barrier function. Studies have shown that SCFAs participate in bidirectional and dynamic interactions with the liver-gut-brain axis through immunomodulatory pathways, thereby playing an important role in the diagnosis, treatment, and prognostic evaluation of HE. Starting from the immunoregulatory effect of SCFAs, this article summarizes and analyzes the crosstalk relationship between SCFAs and the liver-gut-brain axis and the significance of SCFAs in the diagnosis and treatment of HE, in order to provide new ideas for optimizing clinical prevention and treatment strategies.

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