ACMSD inhibition corrects fibrosis, inflammation, and DNA damage in MASLD/MASH

Chronic Inflammation and Immune Dysregulation in Metabolic-Dysfunction-Associated Steatotic Liver Disease Progression: From Steatosis to Hepatocellular Carcinoma

Background/Objectives: Metabolic-dysfunction-associated steatotic liver disease (MASLD) progresses from hepatic steatosis to hepatocellular carcinoma (HCC) as a result of systemic immunometabolic dysfunction. This review summarizes the key roles of the innate and adaptive immune mechanisms driving hepatic injury, fibrogenesis, and carcinogenesis in MASLD. Methods: A comprehensive literature review was performed using PubMed to identify relevant published studies. Eligible articles included original research and clinical studies addressing immunological and metabolic mechanisms in MASLD, as well as emerging therapeutic strategies. Results: We highlight the roles of cytokine networks, the gut-liver axis, and immune cell reprogramming. Emerging therapeutic strategies, including cytokine inhibitors, anti-fibrotic agents, metabolic modulators, and nutraceuticals, offer several indications for attenuating MASLD progression and reducing the prevalence of extrahepatic manifestations. Conclusions: Given the heterogeneity of MASLD, personalized combination-based approaches targeting both inflammation and metabolic stress are essential for effective disease management and the prevention of systemic complications.

Comprehensive study of the murine MASH models' applicability by comparing human liver transcriptomes

AIMS

Multiple murine models, including high-fat diet (HFD), methionine-choline-deficient diet (MCD), choline-deficient, L-amino acid-defined high-fat diet (CDA-HFD), Western diet (WD), carbon tetrachloride (CCl₄) injection, and Gubra-Amylin diet (GAN), are widely used for mechanistic studies and therapeutic evaluation in MASH research. However, due to species-specific differences in metabolism, lifespan, and dietary composition, no single model could fully recapitulate the onset and progression of human MASH. Therefore, a detailed transcriptomic reference is urgently needed to better guide model selection and experimental design.

METHODS

We established three murine MASH models: HFD, MCD and CDA-HFD. Physiological and pathological features were systematically evaluated and compared across models. Bulk and single-cell RNA sequencing were performed, and the resulting data were integrated with transcriptomic profiles from CCl₄-induced models and human MASH datasets, with a focus on metabolism, inflammation, fibrosis, and cellular signaling pathways.

KEY FINDINGS

The CDA-HFD and CCl₄ models closely resembled human MASH in inflammation and fibrosis but disrupted key metabolic pathways. Conversely, the HFD model mirrored metabolic abnormalities but lacked severe inflammation and fibrosis. Immunoinfiltration and single-cell analyses revealed that macrophages dominate the inflammatory process, with activation of PPAR signaling, extracellular matrix remodeling, and phagocytosis.

SIGNIFICANCE

To balance metabolic and pathological fidelity without relying on genetic or toxin means, a combination of the CDA-HFD model with either HFD or WD is recommended as a robust and practical strategy for MASH research.

Decoding Liver Fibrosis: How Omics Technologies and Innovative Modeling Can Guide Precision Medicine

The burden of chronic liver disease (CLD) is dramatically increasing. It is estimated that 20-30% of the population worldwide is affected by CLD. Hepatic fibrosis is a symptom common to all CLDs. Although it affects liver functional activities, it is a reversible stage if diagnosed at an early stage, but no resolutive therapy to contrast liver fibrosis is currently available. Therefore, efforts are needed to study the molecular insights of the disease. Emerging cutting-edge fields in cellular and molecular biology are introducing innovative strategies. Spatial and single-cell resolution approaches are paving the way for a more detailed understanding of the mechanisms underlying liver fibrosis. Cellular models have been generated to recapitulate the in-a-dish pathophysiology of liver fibrosis, yielding remarkable results that not only uncover the underlying molecular mechanisms but also serve as patient-specific avatars for precision medicine. Induced pluripotent stem cells (iPSC) and organoids are incredible tools to reshape the modeling of liver diseases, describe their architecture, and study the residents of hepatic tissue and their heterogeneous population. The present work aims to give an overview of innovative omics technologies revolutionizing liver fibrosis research and the current tools to model this disease.

Pharmacotherapy of Liver Fibrosis and Hepatitis: Recent Advances

Liver fibrosis is a progressive scarring process primarily caused by chronic inflammation and injury, often closely associated with viral hepatitis, alcoholic liver disease, metabolic dysfunction-associated steatotic liver disease (MASLD), drug-induced liver injury, and autoimmune liver disease (AILD). Currently, there are very few clinical antifibrotic drugs available, and effective targeted therapy is lacking. Recently, emerging antifibrotic drugs and immunomodulators have shown promising results in animal studies, and some have entered clinical research phases. This review aims to systematically review the molecular mechanisms underlying liver fibrosis, focusing on advancements in drug treatments for hepatic fibrosis. Furthermore, since liver fibrosis is a progression or endpoint of many diseases, it is crucial to address the etiological treatment and secondary prevention for liver fibrosis. We will also review the pharmacological treatments available for common hepatitis leading to liver fibrosis.

Ex Vivo Tools and Models in MASLD Research

Metabolic dysfunction-associated fatty liver disease (MASLD) presents a growing global health challenge with limited therapeutic choices. This review delves into the array of ex vivo tools and models utilized in MASLD research, encompassing liver-on-a-chip (LoC) systems, organoid-derived tissue-like structures, and human precision-cut liver slice (PCLS) systems. Given the urgent need to comprehend MASLD pathophysiology and identify novel therapeutic targets, this paper aims to shed light on the pivotal role of advanced ex vivo models in enhancing disease understanding and facilitating the development of potential therapies. Despite challenges posed by the elusive disease mechanism, these innovative methodologies offer promise in reducing the utilization of in vivo models for MASLD research while accelerating drug discovery and biomarker identification, thereby addressing critical unmet clinical needs.