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Hot Topic Commentary Open Access
Intrahepatic Cholestasis of Pregnancy: A Hot Topic Commentary
Bianca Thakkar, George Y. Wu
Published online September 22, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00381
Review Article Open Access
Exosome-based Therapies for Androgenetic Alopecia: Mechanisms, MicroRNAs, and Clinical Prospects
Pavel Ivanov, Natalia Todosenko, Kristina Yurova, Olga Khaziakhmatova, Larisa Litvinova
Published online October 30, 2025
Gene Expression. doi:10.14218/GE.2025.00058
Abstract
Characteristic signs of alopecia are gradual thinning, disruption of structural features, and the hair development cycle (anagen, catagen, telogen) against the background of miniaturization [...] Read more.

Characteristic signs of alopecia are gradual thinning, disruption of structural features, and the hair development cycle (anagen, catagen, telogen) against the background of miniaturization of hair follicles, which leads to baldness and psychological stress in patients. Despite the rapid development and clinical application of synthetic pharmacological, cellular/acellular, and molecular drugs, no effective therapeutic agent against alopecia has yet been developed. Great hopes are pinned on the improvement of therapeutic strategies with the introduction of exosomes into practical application, which contain a wide array of active substances for the targeted stimulation of hair follicle activity (anagen inducers) through the regulation of intracellular signaling cascades, growth factors, and microRNAs. The review discusses in detail the microRNAs and their intracellular targets that control hair follicle morphogenesis. It also focuses on the prospects of using stem cell exosomes from various sources for the treatment of alopecia, providing a clinical rationale for potential benefits and risks.

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Letter to the Editor Open Access
Licochalcone B: A New Drug for the Prevention and Treatment of Radiation Damage
Jiaqi Wu, Tongtong Lv, Wenxi Liu, Xiaochun Peng
Published online December 18, 2024
Future Integrative Medicine. doi:10.14218/FIM.2024.00045
Original Article Open Access
Hepatosplenic Volumes and Portal Pressure Gradient Identify One-year Further Decompensation Risk Post-transjugular Intrahepatic Portosystemic Shunt
Xinyu Chen, Yicheng Lin, Kefeng Jia, Rong Lv, Jiajun Tian, Fenghui Li, Jun Li, Yiwen Zhang, Ning Wang, Zhongsong Gao, Weili Yin, Fang Wang, Ping Zhu, Chao Yang, Jiayin Wang, Tao Wang, Junqing Yan, Ying Liu, Qing Ye, Huiling Xiang
Published online September 3, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00199
Abstract
Further decompensation in cirrhosis is associated with increased mortality. However, reliable tools to predict further decompensation after transjugular intrahepatic portosystemic [...] Read more.

Further decompensation in cirrhosis is associated with increased mortality. However, reliable tools to predict further decompensation after transjugular intrahepatic portosystemic shunt (TIPS) are currently limited. This study aimed to investigate the incidence and risk factors of further decompensation within one year post-TIPS in patients with cirrhosis and to develop a predictive model for identifying high-risk individuals.

This retrospective cohort study enrolled 152 patients with cirrhosis undergoing TIPS for variceal bleeding and/or refractory ascites (January 2018–January 2024). Patients were stratified according to one-year decompensation outcomes. LASSO regression and multivariable logistic analysis were used to identify predictors, and a nomogram was constructed and internally validated using bootstrapping (1,000 replicates).

Among the 152 patients (median age 57.5 years [IQR 50.0–66.0]; 58.6% male; 58.6% viral/alcohol-associated etiology), 65.8% (100/152) achieved clinical stability at one year post-TIPS, while 34.2% (52/152) developed further decompensation. LASSO regression identified right hepatic lobe volume, spleen volume, and portal pressure gradient (PPG) reduction as key predictors, all independently associated with further decompensation risk in multivariable analysis (OR [95% CI]: 0.683 [0.535–0.873], 1.435 [1.240–1.661], and 0.961 [0.927–0.996], respectively). The nomogram demonstrated superior discrimination compared with PPG reduction alone and benchmark prognostic scores (AUC 0.854 [0.792–0.915] vs. 0.619–0.652; ΔAUC +0.201–+0.235, p < 0.001) with 92.3% sensitivity. High-risk patients (score > 86) had a 10.7-fold higher risk of further decompensation than low-risk patients (60.0% vs. 5.6%; p < 0.0001).

This validated model, combining hepatosplenic volumetry and PPG reduction, accurately stratifies further decompensation risk post-TIPS and may guide targeted surveillance and preventive interventions.

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Original Article Open Access
Arctigenin Prevents Metabolic Dysfunction-associated Steatohepatitis by Inhibiting NLRP3/GSDMD-N Axis in Macrophages
Rui Xue, Lu Jiang, Qian-Ren Zhang, Qing-Jing Wang, Rui-Xu Yang, Tian-Yi Ren, Qin Pan, Jian-Gao Fan
Published online August 25, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00141
Abstract
Metabolic dysfunction-associated steatohepatitis (MASH) represents a critical step in the progression from simple fatty liver disease to more severe conditions such as cirrhosis [...] Read more.

Metabolic dysfunction-associated steatohepatitis (MASH) represents a critical step in the progression from simple fatty liver disease to more severe conditions such as cirrhosis and hepatocellular carcinoma, and it remains difficult to treat. Arctigenin (ATG), a monomer of Fructus Arctii, exhibits anti-inflammatory activity. Therefore, we aimed to examine its potential protective role against MASH and explore the underlying mechanisms.

Male C57BL/6 mice were divided into four groups: control, MASH, low-dose ATG (30 mg/kg/day), and high-dose ATG (120 mg/kg/day). MASH was induced through a choline-deficient, L-amino acid-defined high-fat diet for eight weeks, with concurrent preventive ATG administration. Liver injury, lipid metabolism, inflammation, oxidative stress, and fibrosis were assessed. Network pharmacology was employed to identify the potential protective mechanisms of ATG. Key factors were evaluated in vitro to verify the ATG targets.

ATG administration prevented the progression of MASH in a dose-dependent manner. High-dose ATG significantly reduced hepatic macrophage and neutrophil infiltration, serum enzyme levels, and lipid peroxidation, while enhancing antioxidant enzyme activity. Mechanistic network pharmacology identified modulation of the NLR family pyrin domain containing 3 (NLRP3) inflammasome as the central pathway underlying ATG’s bioactivity. Functional analyses in lipopolysaccharide-stimulated RAW264.7 cells confirmed that ATG inhibited NLRP3 expression, pyroptosis-related protein cleavage (hereinafter referred to as GSDMD-N), and pro-inflammatory chemokine production in a concentration-dependent manner. Notably, ATG disrupted NLRP3/GSDMD-N axis activity in macrophages without causing cellular toxicity.

ATG may inhibit the inflammatory cascade primarily by targeting macrophage NLRP3 inflammasomes, thereby preventing the progression of MASH.

Full article
Opinion Open Access
The Critical Role of Tryptase Testing in the Rapid Diagnosis of Anaphylaxis: A Call for Point-of-care Assays
Uriel S. Bulow, Eric P. Grewal
Published online September 28, 2025
Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2025.00014
Original Article Open Access
RETRACTED: Electroacupuncture-assisted Ribavirin Dosing for Long COVID: A Randomized Controlled Trial
Naylya Djumaeva, Leyla Djumaeva, Gulnara Akhundjanova, Dilbar Urunova
Published online December 23, 2024
Future Integrative Medicine. doi:10.14218/FIM.2024.00043
Abstract
Various devices are used to study the unique electrical properties of acupuncture points (APs), with Voll’s electropuncture diagnostics (EAV) occupying a prominent role. The technical [...] Read more.

Various devices are used to study the unique electrical properties of acupuncture points (APs), with Voll’s electropuncture diagnostics (EAV) occupying a prominent role. The technical design of EAV allows for the testing of drugs to determine their individual selection and dosages. However, the physiological basis of this phenomenon remains unclear. This study investigated the feasibility of evaluating the electrodermal activity of APs to determine the daily dose of ribavirin using electroacupuncture according to the Voll diagnostic system in patients with long COVID.

This blind, randomized, placebo-controlled trial included 101 patients (aged 16 to 50) who met the definition of long COVID and were examined using an EAV testing system that measures the electrodermal activity of APs. Ribavirin was tested at the APs with established decreased electrical impedance readings to determine the daily doses. Fifty-two participants were randomized to the experimental group, and forty-nine to the placebo group. These patients were considered for data analysis.

The results of this study demonstrated the feasibility of using EAV to identify APs with decreased levels of electrodermal activity, followed by medicament testing (MT) of different ribavirin doses to restore the electrodermal activity at these points.

The results indicated that the tested doses of ribavirin in patients with long COVID correlate with electrodermal activity at certain APs along specific meridians. Higher doses of the drug were associated with lower electrodermal activity readings during MT using the EAV diagnostic system. However, further clinical and instrumental studies are needed to evaluate the clinical application of MT in the assessment of long COVID.

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Review Article Open Access
State-of-the-art Multimodal Imaging and Therapeutic Strategies in Radiation-induced Brain Injury: A Comprehensive Review
Xiaojie Wang, Shuang Li, Fangjing Yu, Xiaonan Cui
Published online September 18, 2025
Neurosurgical Subspecialties. doi:10.14218/NSSS.2025.00028
Abstract
Radiotherapy remains one of the essential treatment modalities for brain gliomas, brain metastases, pediatric neuroblastomas, and primary central nervous system lymphomas. With [...] Read more.

Radiotherapy remains one of the essential treatment modalities for brain gliomas, brain metastases, pediatric neuroblastomas, and primary central nervous system lymphomas. With continuous advancements in modern radiotherapy techniques, patients have achieved significantly improved local control rates and prolonged survival. However, the long-term complications associated with radiotherapy have become increasingly evident. Radiation-induced brain injury (RIBI) is a clinical syndrome characterized primarily by neurological dysfunction following focal or whole-brain radiotherapy. It negatively impacts patients’ quality of life and imposes a considerable burden on families and society. With the rapid development of medical imaging and artificial intelligence technologies, multimodal imaging techniques, including structural magnetic resonance imaging, diffusion-weighted imaging, functional magnetic resonance imaging, perfusion imaging, positron emission tomography-computed tomography metabolic imaging, and radiomics, have demonstrated significant potential for early detection, dynamic monitoring, and quantitative evaluation of RIBI. Meanwhile, treatment strategies for RIBI are shifting from traditional symptomatic and supportive care toward multidimensional interventions aimed at protecting the blood-brain barrier, modulating neuroinflammation, and implementing precise targeted therapies. Additionally, emerging studies have explored neuromodulation techniques and gut-brain axis regulation, offering new directions for the prevention and treatment of RIBI. Although conventional imaging methods remain valuable for diagnosing RIBI, they exhibit notable limitations in the early stages of the disease and in differentiating RIBI from tumor recurrence. This review focuses on the current state of technological development, key findings, and existing limitations, with the aim of providing a theoretical foundation and technical support for the early identification and precise intervention of RIBI.

Full article
Original Article Open Access
Serum-derived hsa_circ_101555 as a Diagnostic Biomarker in Non-hepatocellular Carcinoma Chronic Liver Disease: A Phase II Cross-sectional Study
Nourhan Badwei, Amal Tohamy Abdel Moez, Nashwa El-Khazragy, Mohammed Soliman Gado
Published online September 5, 2025
Gene Expression. doi:10.14218/GE.2025.00040
Abstract
Circular RNAs (circRNAs) are non-coding RNAs characterized by a strictly closed-loop covalent structure. They are abundantly detected in various cells due to their conserved nature. [...] Read more.

Circular RNAs (circRNAs) are non-coding RNAs characterized by a strictly closed-loop covalent structure. They are abundantly detected in various cells due to their conserved nature. Studies have reported their potential association with chronic liver disease (CLD), including hepatitis, cirrhosis, and hepatocellular carcinoma (HCC), with possible roles as diagnostic and prognostic markers. This study aimed to analyze the potential use of serum-derived hsa_circ_101555 as a diagnostic tool for CLD without HCC, and to compare it with other known non-invasive parameters for liver disease severity and inflammation. Additionally, it aimed to evaluate its expression among non-HCC CLD patients, CLD with HCC cases reported in our published (phase I) study, and healthy controls.

A cross-sectional study (phase II) was conducted involving 30 clinically, laboratory, and radiologically diagnosed Egyptian non-HCC CLD patients and 30 healthy subjects. The serum expression level of hsa_circ_101555 was measured using real-time polymerase chain reaction. The diagnostic accuracy was assessed through receiver operating characteristic curve analysis, calculating the area under the curve to determine sensitivity and specificity. The study also compared hsa_circ_101555 levels with established non-invasive parameters such as the Child-Turcotte-Pugh and model for end-stage liver disease scores, as well as inflammatory markers like the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio.

hsa_circ_101555 demonstrated high diagnostic accuracy (area under the curve of 0.970) at a cutoff point of 2.088 for differentiating non-HCC CLD patients from healthy controls. Elevated circRNA levels were noted in patients with hepatic encephalopathy and ascites, correlating with advanced liver disease scores (Child-Turcotte-Pugh/model for end-stage liver disease scores). Mean circRNA values were highest in HCC cases, followed by non-HCC CLD patients, and lowest in healthy controls.

Serum-derived hsa_circ_101555 demonstrates high diagnostic accuracy in differentiating non-HCC CLD patients from healthy controls. These findings suggest that hsa_circ_101555 has the potential to serve as a reliable non-invasive biomarker for the early diagnosis of CLD, correlating with disease severity and inflammation markers. Further research with larger sample sizes is warranted to validate its clinical utility and enhance the management of CLD.

Full article
Original Article Open Access
Traditional Chinese Medicine Combined with Peginterferon α-2b in Chronic Hepatitis B: A Real-world Cohort Study
Huiqing Liang, Xiaoting Zheng, Xiaowen Wu, Luyun Zhang, Yaoyu Liu Yanru Zheng, Manying Zhang, Min Hu, Min Jia, Yan Dai, Yizhi Xie, Shaodong Chen
Published online September 18, 2025
Future Integrative Medicine. doi:10.14218/FIM.2025.00020
Abstract
Peginterferon-α treatment exhibits low rates of the serological conversion rate of hepatitis B e antigen (HBeAg) and the negative conversion rate of hepatitis B virus (HBV) DNA, [...] Read more.

Peginterferon-α treatment exhibits low rates of the serological conversion rate of hepatitis B e antigen (HBeAg) and the negative conversion rate of hepatitis B virus (HBV) DNA, with significant myelosuppression leading to treatment discontinuation in some patients. Traditional Chinese medicine (TCM) may ameliorate liver inflammation and modulate immune responses. This study aims to investigate the efficacy of combining TCM with pegylated-interferon (PEG-IFN) α-2b and its impact on myelosuppression adverse effects.

This study included 117 HBeAg-positive chronic hepatitis B (CHB) patients who started initial antiviral therapy at Xiamen Hospital of TCM between June 2018 and January 2023. According to the treatment regimen, patients were divided into the observation group (n = 56, receiving PEG-IFN α-2b combined with Licorice 15 g, Angelica sinensis 20 g, Poria 20 g, Paeonia lactiflora 20 g, Rhizoma Atractylodis Macrocephalae 20 g, Radix Bupleurum Chinense 20 g, Mentha piperita 3 g, Ginger three slices for more than six months) and the control group (n = 61, receiving PEG-IFN α-2b alone). This study retrospectively analyzed etiological indicators, liver biochemical indicators, and blood routine tests before and after treatment.

After 24 and 48 weeks of treatment, the observation group demonstrated significantly superior outcomes to the control group in quantitative reduction of hepatitis B surface antigen, the serological conversion rate of HBeAg, and the reduction in HBV DNA quantification (P < 0.05). By week 48, the HBV DNA negative conversion rate in the observation group (46.67%) was significantly higher than that in the control group (26.67%) (P < 0.05). Regarding safety, the incidence of myelosuppression in the observation group was significantly lower than that in the control group at both 24 and 48 weeks of treatment (P < 0.05)

Real-world findings demonstrate that adjunctive TCM significantly enhances the antiviral efficacy of peginterferon α-2b in HBeAg-positive CHB patients while concurrently mitigating treatment-limiting myelosuppression. This combination strategy may represent a clinically valuable approach to optimizing interferon-based therapy for CHB.

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