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Objectives: To assess whether meal or water intake may affect the measurement of the ultrasound (US) attenuation coefficient (AC) imaging, a parameter that is directly related to liver fat content., Methods: The study was performed in two centers (Italy and USA). AC was obtained using the ATI algorithm implemented in the Aplio i-series US systems (Canon Medical Systems, Japan) by one operator at each center. Measurements were performed at baseline and 5, 15, 30, 45 minutes after drinking 500 mL of water (group 1), or 30, 45, 60, 90, 120 minutes after eating a meal of about 600 kcal (group 2). Multilevel generalized estimating equations for repeated measures were used for the statistical analysis to consider the clustered nature of the data., Results: Twenty-six individuals were enrolled: 11 (10 females; age, 43.7 ± 12.5 years) in Italy and 15 (10 females; age, 60.7 ± 6.3 years) in USA. At B-mode US, 10 (38.5%) had liver steatosis. The baseline AC values, in decibel/centimeter/megahertz, were 0.64 (0.12) in group 1 and 0.66 (0.13) in group 2. There was not any significant difference in AC values at every time-point after water or meal intake either in group 1 or group 2. This result did not change including sex, age, and skin-to-liver capsule into the models., Conclusions: The measurement of the AC, which is a biomarker of liver steatosis, does not require a fasting state and drinking water does not affect the result., (© 2024 American Institute of Ultrasound in Medicine.)

Introduction: Epidemiological studies highlight the presence of associations between per- and polyfluoroalkyl substances (PFAS) exposure with liver damage. In 2013, PFAS contamination was discovered in Veneto (Italy), leading to the implementation of a Surveillance Program (SP). Our objective is to investigate the association between PFAS exposure and biomarkers of liver function using single-pollutant and mixture approaches, while exploring the sex-specific differences and the mediating role of obesity in the association., Methods: The study included 42,094 subjects aged ≥20 years participating in the SP. We used generalized additive models to investigate the association between several PFAS and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, adjusting for possible confounders and stratifying by sex. Results were back-transformed to show predicted percentage changes in outcomes per ln-unit increase in PFAS levels; furthermore, we explored the role of BMI in the abovementioned causal pathway, considering it as a potential confounder or mediator PFAS joint effect was investigated using Quantile G-computation., Results: One ln-unit increase in PFHxS concentrations was associated with a 1.49% (95%CI: 0.87, 2.12) and a 0.84% (95% CI: 0.27, 1.40) increase in ALT levels, in males and females respectively; one ln-unit increase in PFOA concentrations was associated with a 1.03% (95%CI: 0.50, 1.55) increase in ALT levels in males, and a 0.52% (95% CI: 0.22, 0.82) and a 0.60% (95% CI: 0.25, 0.96) increase in AST levels in females and males. PFOS showed no association with ALT and AST levels. Quantile G-computation revealed that an interquartile increase in the PFAS mixture was associated with a 3.02% increase (95% CI: 1.65, 4.43) and a 1.65% (95% CI: 0.77, 2.5) increase in ALT levels, in females and males. Mediation analysis suggested that BMI suppressed the association between PFAS and ALT levels, with positive direct effects higher than the total effects., Conclusion: Our findings suggest sex-specific associations between PFAS exposure and liver function biomarkers and underscore the need for additional studies on potential mediators., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The aim of the present study was to evaluate the wild freshwater fish health status using a vast array of biomarkers as predictive factors of pollutant exposure. The European eel (Anguilla anguilla) and brown trout (Salmo trutta fario), resident in rivers with different degrees of pollution in the South of Italy (Picentino River with good environmental quality and Tusciano River with low environmental quality), were examined using biometric parameters, histopathological and immunohistochemical biomarkers to evaluate the health status and a possible correlation with the water quality. Several alterations identified in the liver positively correlated with water and soil pollutants: hemorrhage (p ≤ 0.05), cytoplasmic vacuolization (p ≤ 0.01), hemosiderosis (p ≤ 0.05), irregular arrangement of hepatocytes (p ≤ 0.01), lipid accumulation (p ≤ 0.05), necrosis (p ≤ 0.01), cellular hyperplasia (p ≤ 0.05), leukocyte infiltration (p ≤ 0.01) and melanomacrophages centers (MMC) (p ≤ 0.01). In the spleen, only hemosiderosis correlated with water and soil pollutants (p ≤ 0.05). The inflammatory biomarker tumor necrosis factor α (TNFα) and ciclooxigenase 2 (COX2) responded to the environmental pollution, as well as the oxidative stress biomarkers superoxide dismutase (SOD2) and 8-Hydroxy-2′-deoxyguanosine (8-OHdG). Erythrocytic nuclear abnormalities and erythrocytic cellular abnormalities were found to be significantly higher in the blood of both the European eel (p < 0.0001) and brown trout (p < 0.001) in the Tusciano River compared with the Picentino River. Taken together, these results outline the need to increase the number of suitable biomarkers to assess fish health and reinforce the importance of employing additional biomarkers in biomonitoring programs that can be applied to evaluate water quality and in environmental assessment around the world. [ABSTRACT FROM AUTHOR]

Background: Since November 2020, Italy was the first country to carry out a protocol and use liver from COVID‐19 donors. We aimed to evaluate the medium‐term outcome of patients who underwent liver transplant (LT) with those grafts. Methods: We consecutively enrolled 283 patients who underwent first LT from November 2020 to December 2022 in our Center (follow‐up 468 days). Twenty‐five of 283 (8.8%, study population) received a graft from donors with previous (4%) or active (96%) SARS‐CoV‐2 infection, and 258/283 (91.2%, control group) received a graft from COVID‐19‐negative donors. SARS‐CoV‐2‐RNA was tested on graft tissue of COVID‐19 donors and their recipients underwent weekly evaluation of SARS‐CoV‐2‐RNA in nasal swabs for the first month after LT. Results: One‐year and 2‐year patient survival was 88.5% and 88.5% in study group versus 94.5% and 93.5% in control group, respectively (p =.531). In study population there was no evidence of donor‐recipient virus transmission, but three (12%) patients (vs. 7 [2.7%] of control group, p =.048) developed hepatic artery thrombosis (HAT): they were SARS‐CoV‐2‐RNA negative at LT and 1/3 grafts tested SARS‐CoV‐2‐RNA positive on liver tissue. COVID‐19 donor was independently associated with HAT (odds ratio (OR) = 4.85, 95% confidence interval (CI) 1.10–19.15; p =.037). By comparing study population with control group, acute rejection and biliary complication rates were not significantly different (16% vs. 8.1%, p =.26; 16% vs. 16.3% p =.99, respectively). Conclusions: Our 1‐year results of transplant strategy including liver grafts from COVID‐19 donors were favorable. HAT was the only complication with significantly higher rate in patients transplanted with COVID‐19 donors compared with control group. [ABSTRACT FROM AUTHOR]

Introduction: Lomitapide is a microsomal triglyceride transfer protein inhibitor for patients with homozygous familial hypercholesterolaemia. Due to its mechanism of action, potential hepatic effects of lomitapide are of clinical interest. This study aimed to determine the long‐term hepatic safety of lomitapide. Methods: Data were aggregated from the pivotal phase 3 and extension phase clinical trial with lomitapide (median 5.1 years; serum total bilirubin, transaminases, cytokeratin‐18 [CK‐18] and enhanced liver fibrosis [ELF] score, fat‐soluble vitamins and essential fatty acids), 8‐year data from the Lomitapide Observational Worldwide Evaluation Registry (LOWER) and real‐world evidence from a cohort of patients treated with lomitapide in Italy (hepatic elastography, and FIB‐4 score for hepatic fibrosis). Results: In the phase 3 trial and the LOWER registry, any asymptomatic excursions in liver transaminase levels were not associated with elevations in bilirubin, and no Hy's law cases were detected in up to 8 years follow‐up. There were no clinically relevant increases among hepatic biomarkers CK‐18, CK‐18 fragments or ELF score and fat‐soluble vitamins and essential fatty acids remained above normal levels. In 34 patients treated in Italy with lomita pide for more than 9 years, elevations in hepatic fat were mild‐to‐moderate; hepatic stiffness remained normal, and the mean FIB‐4 score remained below the fibrosis threshold value of 2.67. Conclusions: These data indicate that the hepatic safety of lomitapide remains favourable with no clinically significant elevations in hepatic biomarkers and hepatic stiffness remained normal for more than 9 years follow‐up. Phase 3 trial: NCT00730236; extension phase: NCT00943306; LOWER: NCT02135705. [ABSTRACT FROM AUTHOR]

Retention of foreign bodies (FB) in the liver parenchyma is a rare event in children but it can bring a heavy burden in terms of immediate and long-term complications. Multiple materials can migrate inside the liver. Clinical manifestations may vary, depending on the nature of the foreign body, its route of penetration and timing after the initial event. Moreover, the location of the FB inside the liver parenchyma may pose specific issues related to the possible complications of a challenging surgical extraction. Different clinical settings and the need for highly specialized surgical skills may influence the overall management of these children. Given the rarity of this event, a systematic review of the literature on this topic was conducted and confirmed the pivotal role of surgery in the pediatric population. [ABSTRACT FROM AUTHOR]