1.Sequential Changes in Range of Motion and Capsular Fibrosis Following Remobilization in a Rat Adhesive Capsulitis Model Using Cast Immobilization
Du-Han KIM ; Ji-An KIM ; Jong Pil YOON ; Chul-Hyun CHO
Clinics in Orthopedic Surgery 2026;18(1):107-115
Background:
The objective of this study was to investigate sequential changes in range of motion (ROM) and histopathology of the joint capsule after remobilization in a rat adhesive capsulitis (AC) model using cast immobilization.
Methods:
Thirty-five 6-week-old Sprague-Dawley rats were immobilized with casting of the left shoulder. After 4 weeks, the rats were randomly divided into 7 groups (n = 5 per group) according to the duration of remobilization following cast removal: 0 (D0), 1 (W1), 2 (W2), 3 (W3), 4 (W4), 5 (W5), and 6 (W6) weeks. At each time point, 5 rats were euthanized for measurement of the glenohumeral abduction angle and evaluation of capsular thickness in the axillary recess.
Results:
Abduction angle was sequentially increased at each time point after remobilization with cast removal. Significant differences between immobilized and non-immobilized shoulders were observed at D0 (130.4° vs 161.3°), W1 (144.7° vs 160.7°), and W2 (142.3° vs 161.3°). Significant differences in capsular thickness of the axillary recess were observed between immobilized and non-immobilized shoulders at all time periods including D0 (98.0 μm vs. 12.9 μm), W1 (117.7 μm vs. 12.2 μm), W2 (115.7 μm vs.13.1 μm), W3 (54.1 μm vs. 14.9 μm), W4 (54.5 μm vs. 13.4 μm), W5 (23.8 μm vs. 13.5 μm), and W6 (19.8 μm vs. 12.4 μm). Significant differences in capsular fibrosis scores were observed between immobilized and non-immobilized shoulders at W1 (2.2 vs. 0.2) and W2 (2.2 vs. 0.0).
Conclusions
Our study showed that ROM increased sequentially after remobilization in a rat AC model using cast immobilization, and it was normalized at 6 weeks after cast removal. Capsular thickening decreased sequentially, but remained at 6 weeks after cast removal. These findings may provide useful information for further research into verifying potential therapeutic targets using a rat AC model with cast immobilization.
2.The Dual Role and Clinical Potential of Core Fucosylation in Liver Diseases
Zi-Han LEI ; Hui-Min XU ; De-Zhi ZHAO ; Yong-Hong GUO ; Hao-Qi DU
Progress in Biochemistry and Biophysics 2026;53(8):2161-2178
Core fucosylation, catalyzed exclusively by fucosyltransferase 8 (FUT8), is an evolutionarily conserved post-translational modification that has emerged as a central regulatory hub linking liver homeostasis, chronic disease progression, and malignant transformation. Liver diseases, particularly hepatocellular carcinoma, remain a leading global health burden characterized by late diagnosis, limited therapeutic options, and poor overall survival. While aberrant glycosylation is now recognized as a hallmark of cancer and inflammatory disorders, existing research on FUT8-mediated core fucosylation in liver diseases remains fragmented: the dynamic functional switch of FUT8 from a homeostatic regulator to a pathological driver across the full disease continuum has not been systematically delineated, and the integrated mechanisms by which core fucosylation modulates oncogenic signaling, metabolic reprogramming, and immune evasion remain poorly understood. This review synthesizes recent advances to establish a unified framework for understanding the dual role of core fucosylation in liver physiology and pathology, and evaluates its translational potential for precision medicine. At the molecular level, FUT8’s unique catalytic specificity makes core fucosylation an irreplaceable modification, as evidenced by the perinatal lethality and severe organ dysfunction in Fut8 knockout mice. In hepatocellular carcinoma, genomic amplification of guanosine 5'-diphosphate-fucose biosynthetic enzymes provides metabolic support for aberrant core fucosylation. FUT8 expression is tightly regulated by a multi-layered network: transcriptional activation via Wnt/β‑catenin and wild-type p53, epigenetic upregulation by lncRNAs, post-transcriptional repression by miR-122-5p and miR-34a, and virus-specific induction by hepatitis B virus/hepatitis C virus. Physiologically, core fucosylation maintains liver homeostasis through four core mechanisms: it acts as a molecular switch for epidermal growth factor receptor/hepatocyte growth factor receptor signaling to enable liver regeneration; directs polarized secretion of hepatocyte-derived glycoproteins into bile ducts; modulates cholesterol metabolism via the hepatocyte nuclear factor 1α-proprotein convertase subtilisin/kexin type 9-low density lipoprotein receptor axis; and regulates aging through insulin‑like growth factor 1 receptor signaling. Pathologically, core fucosylation exhibits context-dependent dual functions: in liver fibrosis, FUT8 upregulation in hepatic stellate cells forms a negative feedback loop that limits excessive fibrogenesis; in hepatocellular carcinoma, however, aberrant FUT8 overexpression drives cell-autonomous malignancy by constitutively activating epidermal growth factor/hepatocyte growth factor receptor, transforming growth factor‑β/Smad, and Wnt/β‑catenin pathways, while simultaneously establishing a multi-layered immune evasion network by stabilizing programmed cell death ligand 1 and cluster of differentiation 47, and impairing natural killer cell homeostasis via interleukin‑2 receptor β glycosylation. Clinically, stage-specific core fucosylation biomarkers enable non-invasive monitoring of liver disease progression: low molecular mass kringle-Fc fusion protein outperforms conventional markers for early fibrosis detection, while alpha-fetoprotein-L3 and novel glycopeptides (α‑2‑macroglobulin N‑linked glycosylation site 1424, lumican core fucosylated peptide) significantly improve early hepatocellular carcinoma diagnosis, especially in alpha-fetoprotein-negative patients. Next-generation detection technologies (chemoenzymatic labeling, site-specific mass spectrometry) overcome the specificity limitations of traditional lectin assays. Therapeutically, four promising strategies are emerging: small-molecule FUT8 inhibitors, afucosylated antibodies with enhanced antibody‑dependent cellular cytotoxicity, Fuc-modified targeted drug delivery systems, and core fucose-specific lectins for NASH treatment. The core challenge for clinical translation lies in FUT8’s inherent “double-edged sword” effect, as systemic inhibition disrupts its essential physiological functions beyond pathological roles. Long-term systemic FUT8 blockade not only impairs post-injury liver regeneration by abrogating epidermal growth factor/hepatocyte growth factor receptor signaling but also disrupts cholesterol homeostasis via the hepatocyte nuclear factor 1α-proprotein convertase subtilisin/kexin type 9-low density lipoprotein receptor axis, leading to dyslipidemia and altered bile secretion. Critically, it compromises immune surveillance by destabilizing interleukin‑2 receptor β on natural killer cells, reducing their cytotoxic activity against malignant and virally infected cells, and impairs IgG Fc-mediated effector functions, increasing susceptibility to infections. This fundamental trade-off between therapeutic efficacy and systemic toxicity necessitates a paradigm shift from non-specific global inhibition to precision modulation of pathological core fucosylation. By addressing these critical challenges, FUT8-mediated core fucosylation has the potential to transform liver disease management from late-stage intervention to early detection and precision therapy, ultimately improving patient outcomes and reducing the global burden of liver diseases.
3.Risk factors for rebleeding after endoscopic therapy for esophageal and gastric varices in liver cirrhosis patients and construction of a nomogram model
Huijuan SHAO ; Shini HAN ; Aiping ZHANG ; Yuling ZHANG ; Ting LI ; Ya HAN ; Jiucong ZHANG ; Wenshan DOU ; Xiuxia WANG ; Hongwei DU
Journal of Clinical Hepatology 2026;42(8):1845-1856
ObjectiveTo investigate the risk factors for rebleeding after endoscopic therapy for esophageal and gastric varices in liver cirrhosis patients, to construct a clinical predictive model, and to provide a reference for predicting rebleeding in the early stage, reducing the incidence rate of rebleeding, and improving the clinical outcome of patients. MethodsA retrospective analysis was performed for the clinical data of 194 liver cirrhosis patients with gastroesophageal variceal bleeding who received initial endoscopic therapy at Department of Gastroenterology, The Second People’s Hospital of Lanzhou, from January 1, 2021 to May 31, 2025. According to whether rebleeding occurred within 1 year after endoscopic therapy, the patients were divided into rebleeding group and non-rebleeding group. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The patients enrolled were randomly divided into a training set and a validation set at a ratio of 7∶3. In the training set, the Lasso regression analysis was used to obtain optimal predictive variables, and the factors that might affect prognosis were included in the univariate and multivariate Logistic regression analyses to identify independent predictive factors for rebleeding after endoscopic therapy for esophageal and gastric varices in liver cirrhosis patients, which were used to construct a nomogram model. In both the training set and the validation set, the receiver operating characteristic (ROC) curve and the calibration curve were used to assess the discriminatory ability and calibration of the model, and decision curve analysis and the clinical impact curve were used to assess the clinical practicability of the model. ResultsAmong the 194 liver cirrhosis patients with esophageal and gastric varices, 116 (59.79%) experienced rebleeding within 1 year after endoscopic therapy, with 76 patients in the training set and 40 patients in the validation set. In the training set, the Lasso regression analysis and the univariate and multivariate Logistic regression analyses showed that etiology of liver cirrhosis (odds ratio [OR]=3.540, 95% confidence interval [CI]: 1.520 — 7.150, P<0.001), Child-Pugh class (OR=3.560, 95%CI: 1.380 — 9.500, P=0.019), severity of esophageal and gastric varices (OR=8.190, 95%CI: 3.568 — 17.850, P=0.026), and main portal vein diameter (OR=2.954, 95%CI: 1.349 — 15.030, P=0.044) were independent predictive factors for rebleeding of esophageal and gastric varices in liver cirrhosis patients. A nomogram model was constructed based on the above independent predictive factors. The ROC curve analysis showed that this model had an area under the ROC curve of 0.845 (95%CI: 0.778 — 0.912) in the training set and 0.801 (95%CI: 0.798 — 0.868) in the validation set. The model had an index of concordance of 0.832 in the training set and 0.820 in the validation set, suggesting that the model had a good discriminatory ability. The Hosmer-Lemeshow test showed P values of 0.320 and 0.550 in the training set and validation set, respectively, the calibration curve indicated that the predicted probabilities of the nomogram model were in good concordance with the actual observed probabilities, suggesting that the model had good calibration. The decision curve analysis and the clinical impact curve showed that the model had good clinical utility. ConclusionThe nomogram model based on etiology of liver cirrhosis, Child-Pugh class, severity of esophageal and gastric varices, and main portal vein diameter has a certain clinical value in predicting the risk of rebleeding from esophageal and gastric varices in liver cirrhosis.
4.Relationship between emotional state and coping modes social support in patients with multiple myeloma
Journal of Public Health and Preventive Medicine 2025;36(2):152-155
Objective To investigate and analyze the relationship between emotional state and coping modes, social support in patients with multiple myeloma (MM). Methods The medical records of 285 patients with MM who were treated in the hospital from May 2019 to December 2023 were collected retrospectively. The Connor-Davidson Resilience Scale (CD-RISC) was used to investigate the patients’ emotional state. The patients were divided into good emotional state group (CD-RISC score ≥ 60, 173 cases) and poor emotional state group (CD-RISC score < 60, 112 cases) according to the CD-RISC score. General information, Medical Coping Modes Questionnaire (MCMQ) scores and Social Support Rating Scale (SSRS) scores of the two groups were comparatively analyzed. The relationship between emotional state and coping modes, social support in patients with MM was discussed. Results The CD-RISC score in this study was (63.22±3.41). The proportions of facing in MCMQ and high social support in SSRS in the good emotional state group were higher than those in the poor emotional state group (P<0.05). Logistic regression analysis found that coping modes and social support were independent factors affecting the emotional state of patients with MM (P<0.05). Spearman correlation analysis found that emotional state of patients with MM was positively correlated with their coping modes and social support level. Conclusion Emotional state of patients with MM is affected by their coping modes and social support. Transforming their coping mode into facing actively and improving their social support level is beneficial for improving and regulating their emotional state.
5.Role and mechanism of caffeic acid in a mouse model of severe acute pancreatitis
Siyu XU ; Tao LIU ; Lulu LAN ; Yining XUE ; Wei WEI ; Yi HAN ; Sucheng MU ; Haiyan SONG ; Shilin DU
Journal of Clinical Hepatology 2025;41(4):722-730
ObjectiveTo investigate the effect and potential mechanism of caffeic acid (CA) on severe acute pancreatitis (SAP) induced by caerulein combined with lipopolysaccharide (LPS), and to provide a basis for the research on novel drugs for the treatment of SAP. MethodsC57BL/6J mice, aged 6 weeks, were divided into control group, model group, CA group, and octreotide acetate (OA) group, with 6 mice in each group. The mice in the control group were given injection of normal saline, and those in the other groups were given intraperitoneal injection of caerulein combined with LPS to establish a mouse model of SAP. At 1 hour after the first injection of caerulein, the mice in the CA group and the OA group were given intraperitoneal injection of CA or subcutaneous injection of OA at an interval of 8 hours. The general status of the mice was observed after 24 hours of modeling, and serum, pancreas, lung, and colon samples were collected. HE staining was used to observe the histopathological changes of the pancreas and lungs, and the serum levels of α-amylase, lipase, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), alanine aminotransferase, aspartate aminotransferase, and creatinine were measured. RT-PCR was used to measure the expression of proinflammatory factors in the pancreas and lungs; myeloperoxidase (MPO) immunohistochemistry was used to observe the degree of neutrophil infiltration; Western blot was used to measure the activation of nuclear factor-kappa B (NF-κB) and the level of citrullinated histone H3 (CitH3), a marker for the formation of neutrophil extracellular traps (NETs), in the pancreas and lungs, as well as the expression level of ZO-1 in colon tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the Dunnett’s t-test was used for further comparison between two groups. ResultsCompared with the control group, the model group had severe injury in the pancreas and lungs and significant increases in the activity of serum α- amylase and lipase and the levels of the proinflammatory cytokines IL-6, interleukin-1β (IL-1β), and TNF-α in serum and lung tissue (all P<0.05), as well as significant increases in NF-κB activation, neutrophil infiltration, and the formation of NETs in the pancreas and lungs (all P<0.05). Compared with the model group, the CA group had alleviated pathological injury of the pancreas and lungs and significant reductions in the activity of serum α-amylase and the levels of the proinflammatory cytokines IL-6, IL-1β, and TNF-α in serum and lung tissue (all P<0.05), as well as significant reductions in NF-κB activation, neutrophil infiltration, and the formation of NETs in the pancreas and lungs (all P<0.05). ConclusionCA can alleviate SAP induced by caerulein combined with LPS in mice, possibly by inhibiting neutrophil recruitment and the formation of NETs.
6.Satisfactory Clinical Outcomes of Revision Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon-Patellar Bone Allograft
Do Weon LEE ; Sanguk LEE ; Du Hyun RO ; Hyuk-Soo HAN
Clinics in Orthopedic Surgery 2025;17(1):91-99
Background:
Allografts are preferred in certain cases of revision anterior cruciate ligament reconstructions to avoid additional graft harvesting and to fill in enlarged tunnels. The clinical outcomes of quadriceps tendon-patellar bone allograft in revision anterior cruciate ligament reconstruction are not well-known. This study was performed to evaluate the clinical outcomes of revision anterior cruciate ligament reconstructions using quadriceps tendon-patellar bone allografts.
Methods:
Patients who underwent revision anterior cruciate ligament reconstructions with quadriceps tendon-patellar bone allografts with a minimum follow-up of 2 years were retrospectively reviewed. Their mean follow-up length was 33.5 ± 19.5 months.Outcomes including clinical scores (Lysholm, International Knee Documentation Committee [IKDC], Tegner scale, and Knee injury and Osteoarthritis Outcome Score [KOOS]), knee stability (physical examinations and knee arthrometer), return to sports, and any associated complications were assessed. Degrees of graft synovialization were also evaluated using arthroscopy.
Results:
A total of 38 patients were reviewed and their age at the time of surgery and follow-up length were 37.2 ± 12.5 years (range, 17–66 years) and 2.8 ± 1.6 years, respectively. All clinical scores including KOOS, IKDC, Lysholm, and Tegner scale significantly improved at 2 years after surgery and 92.1% of the patients returned to sports. The mean preoperative side-to-side difference in knee arthrometer decreased from 4.5 ± 2.3 mm before surgery to 2.6 ± 1.5 mm after surgery (p < 0.001). Graft synovialization was observed in 13 of 16 patients (81.3%) who underwent second-look arthroscopy. Complication rate was 10.5% (n = 4). All complications were graft re-rupture and occurred at an average of 18 months after revision surgery.
Conclusions
Quadriceps tendon-patellar bone allograft showed satisfactory clinical outcomes in revision anterior cruciate ligament reconstruction and thus could be a good alternative when autograft harvesting is not optimal.
7.Surgical Outcomes of Weight-Bearing Shoulders:Arthroscopic Rotator Cuff Repair and Reverse Shoulder Arthroplasty
Su Cheol KIM ; Hyun Gon KIM ; Young Girl RHEE ; Sung Min RHEE ; Chul-Hyun CHO ; Du-Han KIM ; Hee Dong LEE ; Jae Chul YOO
Clinics in Orthopedic Surgery 2025;17(3):438-452
Background:
This study aimed to report the short- and midterm outcomes of arthroscopic rotator cuff repair (ARCR) and reverse shoulder arthroplasty (RSA) in weight-bearing shoulders.
Methods:
This retrospective multicenter study included 19 cases of ARCR and 10 cases of RSA performed in weight-bearing shoulders from 2009 to 2021. In the ARCR group, postoperative 6-month magnetic resonance imaging confirmed the tendon integrity. In the RSA group, scapular notching, acromial fracture, and implant failure were assessed using plain radiographs, and complications were recorded. In both groups, preoperative and postoperative range of motion and functional scores were documented, along with subjective satisfaction and arm use for weight-bearing on the shoulders. For patients followed up for > 5 years, a midterm analysis was performed.
Results:
The ARCR group included 8 men and 11 women (average age, 58.8 ± 8.0 years). Initially, Patte types 1, 2, and 3 were noted in 9, 8, and 2 patients, respectively, and 4 patients exhibited full-thickness subscapularis tears. Four patients showed supraspinatus retear, and 2 patients showed subscapularis retear. Retear of any rotator cuff was observed in 5 patients (26.3%). Twelve patients were followed up for > 5 years; 11 (91.7%) used their operated arm for weight-bearing and 9 (75.0%) were satisfied. The RSA group included 5 men and 5 women (average age, 74.3 ± 7.9 years). Procedures included RSAs for cuff tear arthropathy (n = 6), osteoarthritis (n = 3), and fracture nonunion (n = 1). No cases of dislocation, prosthesis loosening, or disassociation were observed throughout the follow-up. However, 1 patient required implant removal due to infection, and 4 patients showed stage 1 scapular notching. Five patients were followed up for > 5 years, all of whom expressed satisfaction and used their operated arms for weight-bearing, despite mean forward flexion (107.5° ± 12.6°) and American Shoulder and Elbow Surgeons score (61.5 ± 5.3) being less than reported patient acceptable symptomatic state (110° and 76, respectively).
Conclusions
Both ARCR and RSA showed promising outcomes in terms of weight-bearing on the operated arm and subjective satisfaction at short- and midterm follow-up. Therefore, neither of these surgeries should be considered contraindicated for patients with weight-bearing shoulder conditions.
8.Satisfactory Clinical Outcomes of Revision Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon-Patellar Bone Allograft
Do Weon LEE ; Sanguk LEE ; Du Hyun RO ; Hyuk-Soo HAN
Clinics in Orthopedic Surgery 2025;17(1):91-99
Background:
Allografts are preferred in certain cases of revision anterior cruciate ligament reconstructions to avoid additional graft harvesting and to fill in enlarged tunnels. The clinical outcomes of quadriceps tendon-patellar bone allograft in revision anterior cruciate ligament reconstruction are not well-known. This study was performed to evaluate the clinical outcomes of revision anterior cruciate ligament reconstructions using quadriceps tendon-patellar bone allografts.
Methods:
Patients who underwent revision anterior cruciate ligament reconstructions with quadriceps tendon-patellar bone allografts with a minimum follow-up of 2 years were retrospectively reviewed. Their mean follow-up length was 33.5 ± 19.5 months.Outcomes including clinical scores (Lysholm, International Knee Documentation Committee [IKDC], Tegner scale, and Knee injury and Osteoarthritis Outcome Score [KOOS]), knee stability (physical examinations and knee arthrometer), return to sports, and any associated complications were assessed. Degrees of graft synovialization were also evaluated using arthroscopy.
Results:
A total of 38 patients were reviewed and their age at the time of surgery and follow-up length were 37.2 ± 12.5 years (range, 17–66 years) and 2.8 ± 1.6 years, respectively. All clinical scores including KOOS, IKDC, Lysholm, and Tegner scale significantly improved at 2 years after surgery and 92.1% of the patients returned to sports. The mean preoperative side-to-side difference in knee arthrometer decreased from 4.5 ± 2.3 mm before surgery to 2.6 ± 1.5 mm after surgery (p < 0.001). Graft synovialization was observed in 13 of 16 patients (81.3%) who underwent second-look arthroscopy. Complication rate was 10.5% (n = 4). All complications were graft re-rupture and occurred at an average of 18 months after revision surgery.
Conclusions
Quadriceps tendon-patellar bone allograft showed satisfactory clinical outcomes in revision anterior cruciate ligament reconstruction and thus could be a good alternative when autograft harvesting is not optimal.
9.Surgical Outcomes of Weight-Bearing Shoulders:Arthroscopic Rotator Cuff Repair and Reverse Shoulder Arthroplasty
Su Cheol KIM ; Hyun Gon KIM ; Young Girl RHEE ; Sung Min RHEE ; Chul-Hyun CHO ; Du-Han KIM ; Hee Dong LEE ; Jae Chul YOO
Clinics in Orthopedic Surgery 2025;17(3):438-452
Background:
This study aimed to report the short- and midterm outcomes of arthroscopic rotator cuff repair (ARCR) and reverse shoulder arthroplasty (RSA) in weight-bearing shoulders.
Methods:
This retrospective multicenter study included 19 cases of ARCR and 10 cases of RSA performed in weight-bearing shoulders from 2009 to 2021. In the ARCR group, postoperative 6-month magnetic resonance imaging confirmed the tendon integrity. In the RSA group, scapular notching, acromial fracture, and implant failure were assessed using plain radiographs, and complications were recorded. In both groups, preoperative and postoperative range of motion and functional scores were documented, along with subjective satisfaction and arm use for weight-bearing on the shoulders. For patients followed up for > 5 years, a midterm analysis was performed.
Results:
The ARCR group included 8 men and 11 women (average age, 58.8 ± 8.0 years). Initially, Patte types 1, 2, and 3 were noted in 9, 8, and 2 patients, respectively, and 4 patients exhibited full-thickness subscapularis tears. Four patients showed supraspinatus retear, and 2 patients showed subscapularis retear. Retear of any rotator cuff was observed in 5 patients (26.3%). Twelve patients were followed up for > 5 years; 11 (91.7%) used their operated arm for weight-bearing and 9 (75.0%) were satisfied. The RSA group included 5 men and 5 women (average age, 74.3 ± 7.9 years). Procedures included RSAs for cuff tear arthropathy (n = 6), osteoarthritis (n = 3), and fracture nonunion (n = 1). No cases of dislocation, prosthesis loosening, or disassociation were observed throughout the follow-up. However, 1 patient required implant removal due to infection, and 4 patients showed stage 1 scapular notching. Five patients were followed up for > 5 years, all of whom expressed satisfaction and used their operated arms for weight-bearing, despite mean forward flexion (107.5° ± 12.6°) and American Shoulder and Elbow Surgeons score (61.5 ± 5.3) being less than reported patient acceptable symptomatic state (110° and 76, respectively).
Conclusions
Both ARCR and RSA showed promising outcomes in terms of weight-bearing on the operated arm and subjective satisfaction at short- and midterm follow-up. Therefore, neither of these surgeries should be considered contraindicated for patients with weight-bearing shoulder conditions.
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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