Inflammasomes have emerged as critical innate sensors of host immune that defense against pathogen infection, metabolism syndrome, cellular stress and cancer metastasis in the liver. The assembly of inflammasome activates caspase-1, which promotes the maturation of interleukin-1β (IL-1β) and interleukin-18 (IL-18), and initiates pyroptotic cell death (pyroptosis). IL-18 exerts pleiotropic effects on hepatic NK cells, priming FasL-mediated cytotoxicity, and interferon-γ (IFN-γ)-dependent responses to prevent the development of liver diseases. However, considerable attention has been attracted to the pathogenic role of inflammasomes in various acute and chronic liver diseases, including viral hepatitis, nanoparticle-induced liver injury, alcoholic and non-alcoholic steatohepatitis. In this review, we summarize the latest advances on the physiological and pathological roles of inflammasomes for further development of inflammasome-based therapeutic strategies for human liver diseases.

Objective: To analyze the changing trends in etiologies of hospitalized patients with liver disease and provide clinical basis for the formulation of medical policy. Methods: Patients who were hospitalized in the Department of Infectious Diseases from 2006 to 2014 were selected as the research subjects. Data of patients with liver diseases were retrospectively analyzed to determine the proportion of main causes of infection, the proportion of different viral infections in viral hepatitis, and the changing trends in proportion of hepatitis B in different age groups. Kruskal-Wallis test was used for statistical analysis. Results: During 9 consecutive years, the overall proportion of inpatients with liver disease decreased continuously, but the number of patients increased. The top five etiologies of liver diseases were viral hepatitis, drug-induced liver disease, autoimmune liver disease, alcoholic and non-alcoholic fatty liver disease. The proportion of viral hepatitis decreased gradually, and the proportion of drug-induced liver disease and autoimmune liver disease increased markedly. Among viral hepatitis patients, hepatitis B, hepatitis C and hepatitis E were in the top three, with hepatitis B stabilized at around 70%, and the proportion of hepatitis C showed an upward trend. The hospitalization time of hepatitis B patients was gradually shortened, the difference was statistically significant (χ (2) = 205.31, P < 0.001), and the hepatitis B patients were mainly distributed in age groups 31-40, 41-50, and 51-60, the total proportion was above 60%. The difference between the different years of the same age group was not evident, but the proportion of hepatitis B patients decreased gradually in the 14-23 -year- old age group, the difference was statistically significant (χ (2) = 19.51, P = 0.01). Conclusion: Liver disease still holds a principal position in the distribution of infectious diseases, and especially the cause of non-infectious liver disease require sufficient attention and concern. The use of hepatitis B vaccine has effectively diminished the infection rate, but the prevention and control of chronic hepatitis B infection is still facing challenges.

Fibromax is a diagnostic tool composed of the combination of 4 non-invasive biomarker panels for the diagnosis of steatosis (SteatoTest), necrosis and inflammation (ActiTest and NashTest-2) and fibrosis (FibroTest). The purpose of this study was to assess the performance of these biomarker panels in patients with type 2 diabetes mellitus (T2DM). All patients underwent routine labs, a 75 g oral glucose tolerance test, a liver proton magnetic resonance spectroscopy (1H-MRS) to measure intrahepatic triglyceride content, and a percutaneous liver biopsy to establish the diagnosis of non-alcoholic steatohepatitis (NASH) and to grade and stage the disease in those patients with non-alcoholic fatty liver disease (NAFLD) by 1H-MRS. For determination of the scores, plasma samples were blindly provided to establish the SteatoTest, ActiTest, NashTest-2 and FibroTest scores. A total of 220 patients with T2DM were included in this study. When the ability of the SteatoTest to identify patients with T2DM with NAFLD by 1H-MRS was assessed, the overall performance expressed as the area under the receiver operating characteristic curve was 0.73 (95% CI 0.65 to 0.81). The performance of the ActiTest and NashTest-2 to diagnose definite NASH among patients with T2DM was 0.70 (95% CI 0.63 to 0.77) and 0.69 (95% CI 0.62 to 0.76), respectively. Regarding the FibroTest score, its performance to identify patients with moderate or advanced fibrosis was 0.67 (95% CI 0.58 to 0.76) and 0.72 (95% CI 0.61 to 0.83), respectively. Non-invasive panels for the diagnosis of steatosis, NASH and/or fibrosis, which were developed and validated in non-diabetic cohorts, underperformed when applied to a large cohort of patients with T2DM. Results from non-diabetic populations should not be extrapolated to patients with T2DM.

Cirrhosis is a form of liver fibrosis resulting from chronic hepatitis and caused by various liver diseases, including viral hepatitis, alcoholic liver damage, nonalcoholic steatohepatitis, and autoimmune liver disease. Cirrhosis leads to various complications, resulting in poor prognoses; therefore, it is important to develop novel antifibrotic therapies to counter liver cirrhosis. Wnt/β-catenin signaling is associated with the development of tissue fibrosis, making it a major therapeutic target for treating liver fibrosis. In this review, we present recent insights into the correlation between Wnt/β-catenin signaling and liver fibrosis and discuss the antifibrotic effects of the cAMP-response element binding protein/β-catenin inhibitor PRI-724.