Thank you for the privilege of serving you as the editor of HEPATOLOGY over the past 5 years. Selleck Z IETD FMK I look forward to reading about the new developments in our field under the leadership of Dr. Michael Nathanson and his new editorial team. “
“Vitamin D, like coffee, is a trendy
topic in hepatology. Vitamin D has been reported to have antifibrotic properties. García-Álvarez et al. performed a meta-analysis to investigate whether vitamin D status was associated with fibrosis and response to antiviral treatment in chronic hepatitis C (CHC). The investigators identified 18 studies covering more than 2,500 patients. Low plasma levels of 25-hydroxyvitamin D were associated with more advanced fibrosis.
Given that this advanced fibrosis is associated with decreased response to antiviral treatment, it is not surprising that low vitamin D levels were also associated with poor response. Patients with CHC frequently have low levels of vitamin D. This work falls short of showing that supplementation is beneficial. This is not the famous battle of Lodi, but the battle of low D! (Hepatology 2014;60:1541-1550.) Regulatory T cells (Tregs), which control against excessive immune response, are heterogeneous. Tregs demonstrate plasticity: They can acquire specialized suppressive functions or be subverted into cytokine-producing cells contributing to, rather than suppressing, the inflammatory response. This tuning depends on cues from the microenvironment. Piconese et al. characterized PD-1 inhibiton the hepatic Tregs in different stages of CHC. Noncirrhotic liver contained relatively few Tregs, and these cells produced interferon-gamma. Cirrhotic livers and hepatocellular carcinoma (HCC) contained more Tregs, and these cells expressed OX40 and had a Th1-suppressing phenotype. OX40, also known as CD134, fosters proliferation. OX40 ligand expression correlated with hepatitis C virus (HCV) viremia. It would appear that the profile of hepatic Tregs changes as CHC progresses: These cells seem to contribute
to inflammation selleck chemicals llc at the noncirrhotic stage and favor immune tolerance at the cirrhotic stage. (Hepatology 2014;60:1494-1507.) With the availability of safer, more potent direct antiviral agent combinations, indication to treat CHC will take into account societal aspects, such as risk of secondary transmission. Jacka et al. performed a detailed analysis of factors associated with phylogenetic clustering among people who inject drugs. This retrospective study enrolled 655 participants from the Vancouver Injection Drug Users Study. One third of participants demonstrated phylogenetic clustering. Factors associated with clustering were age, human immunodeficiency virus infection, HCV seroconversion, and syringe borrowing.