2026-06-01 2026, Volume 10 Issue 2

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  • research-article
    Qin Cai, Yusi Chen, Li Tang

    As the central metabolic organ, the liver coordinates fundamental biological processes through its specialized cellular architecture and regulatory networks, encompassing metabolism, immunity, and regeneration. Kupffer cells (KCs), the liver-resident macrophages, exhibit functional heterogeneity beyond classical polarization paradigms. Currently, multiple classification systems for KCs have been established utilizing distinct surface markers. However, there is no systematic theoretical framework for the classification of KCs. The strategic positioning of KCs within the hepatic Disse space enables intricate intercellular communication networks with neighboring hepatocytes for coordinated physiological regulation. Their functional plasticity critically regulates systemic iron and metabolic homeostasis, with KC-driven metabolic reprogramming directly influencing hepatic pathophysiology. Furtherly, KC activity shows spatiotemporal regulation by circadian rhythms and nutrient signals, reshaping the liver microenvironment to affect function. This review summarizes advances in liver macrophage biology, highlighting the classification challenges of KCs and their roles in hepatic physiology. Additionally, we discuss how circadian rhythms, aging, diet, and exercise dynamically influence KC functionality, which provides a framework to interpret their regulatory logic and dysfunction in disease.

  • research-article
    Walaa Abdelhamed, Mohamed Elbadry, Mohamed El-Kassas

    Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the leading cause of chronic liver disease worldwide, coinciding with the growing burden of obesity and type 2 diabetes mellitus. While liver biopsy remains the gold standard for assessing hepatic steatosis and fibrosis, its invasiveness, sampling variability, and limited feasibility have necessitated the establishment of non-invasive diagnostic alternatives. Among non-invasive alternatives, conventional B-mode ultrasound (US) has retained a central role as the first-line imaging modality owing to its wide availability, low cost, and reasonable sensitivity and specificity, particularly in moderate-to-severe steatosis. However, traditional B-mode US has several limitations, including operator dependence, poor sensitivity in mild steatosis, and reduced accuracy in obese individuals. Semi-quantitative scoring systems and emerging technologies such as attenuation imaging, shear wave elastography, and vibration-controlled transient elastography, have been recently introduced to improve diagnostic accuracy. Additionally, artificial intelligence (AI) is increasingly being integrated into US platforms to enhance image interpretation, standardize assessments, and reduce interobserver variability. This review provides a comprehensive appraisal of the diagnostic performance, strengths, and limitations of conventional B-mode US and its advanced products in the context of MASLD. US-based techniques are also compared with magnetic resonance spectroscopy and histological assessment, highlighting the evolving role of AI in US diagnostics. Given the global rise of MASLD, optimizing and standardizing US-based approaches are essential to improve early detection, risk stratification, and monitoring strategies. With continued technological refinement and integration of AI, US remains a cornerstone of MASLD diagnosis in clinical practice.

  • research-article
    Yunyang Xu, Jiarui Li, Xingyu Luo, Ze Xiang, Zhe Yang, Xuyong Wei, Xiao Xu, Jian Chen

    Liver cancer (LC) remains one of the most prevalent tumors globally. Despite considerable advancements in its clinical treatment in recent years, the global burden of this disease is projected to increase. According to World Health Organization statistics, the number of LC deaths worldwide in 2022 was 760,000, ranking third among all cancers. Therefore, there is an urgent need to delve deeper into the realms of LC diagnosis, prognosis, and treatment. Proteomics, as an emerging technology leveraging mass spectrometry (MS)-based protein identification, liquid chromatography separation, and bioinformatics-driven data integration, enables the systematic characterization of proteome dynamics to address critical challenges in LC research. These challenges include the discovery of diagnostic and prognostic biomarkers as well as therapeutic targets. By scrutinizing the expression of specific proteins in both normal and cancerous tissues through high-throughput protein microarrays, researchers can uncover novel biomarkers. The use of these biomarkers alone or in combination with established ones holds the potential to significantly advance the fields of LC diagnosis, prognosis, and treatment. In general, the application of proteomics has significantly promoted the development of LC research. In this review, we summarized the latest advancements in the application of proteomics in LC, with a particular focus on diagnosis, prognosis, and treatment. We also concluded selected protein markers, aiming to offer guidance for further applications and present additional therapeutic targets for LC.

  • research-article
    Zhen Yang, Weizhao Tong, Kanglong Zhang, Guoxin Hu

    Liver fibrosis is a key pathological process in the progression of chronic liver disease toward cirrhosis and liver failure. The development of liver fibrosis is closely related to a variety of etiologies, including alcoholic hepatitis, metabolic dysfunction-associated steatotic liver disease (MASLD), viral hepatitis, and drug-induced liver injury. Although advances in antiviral therapies for hepatitis B have contributed to a decline in its incidence, other etiologies such as MASLD and alcoholic hepatitis are becoming the main drivers for liver fibrosis. Currently, the management of liver fibrosis primarily focuses on controlling the underlying causes of liver fibrosis, including antiviral therapy and the cessation of alcohol or drug exposure. However, effective therapeutic options for advanced fibrosis remain limited, resulting in severe complications such as hepatic encephalopathy and portal hypertension, which markedly increase patient mortality and socio-economic burden. Therefore, early diagnosis and timely intervention for liver fibrosis are essential to prevent disease progression. With the ongoing advancement of modern molecular biology technologies, our understanding of the pathogenesis and pathophysiology of liver fibrosis continues to deepen. In this review, we summarize the molecular mechanisms, diagnostic approaches, current treatments, and potential therapeutic targets for liver fibrosis.

  • research-article
    Ruizhe Ren, Siying Ren, Yihan Xu, Xiao Liang, Xiyang Wei

    Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most prevalent chronic liver disorder worldwide, characterized by complex molecular regulatory networks driving its pathogenesis. Non-coding RNAs (ncRNAs), including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), serve as critical regulators of gene expression and have been increasingly recognized for their pivotal roles in MASLD development. Rather than functioning in isolation, these ncRNAs form intricate regulatory networks that integrate and amplify disease signals across multiple cellular compartments and pathological stages. This review provides a comprehensive overview of how these ncRNA networks orchestrate MASLD progression, focusing on their roles in metabolic dysregulation, inflammation, and fibrosis. We further evaluate the diagnostic potential of circulating ncRNAs as stable, non-invasive biomarkers for disease stratification and monitoring, and discuss emerging therapeutic strategies targeting ncRNAs, including antisense oligonucleotides, synthetic mimics, and advanced delivery platforms such as lipid nanoparticles and engineered exosomes. Despite significant progress, challenges related to delivery efficiency, tissue specificity, and safety remain barriers to clinical translation. By synthesizing current knowledge of ncRNA networks in MASLD and highlighting opportunities for therapeutic intervention, this review provides a roadmap for translating ncRNAs into clinical applications for this increasingly prevalent metabolic liver disease.

  • research-article
    Su Guan, Xin Li, Yimei Wang, Mei-Juan Tu, Ai-Ming Yu

    Background and aims: Hepatocellular carcinoma (HCC) cells are metabolically reprogrammed for excessive uptake and metabolism of many nutrients. The tumor suppressive microRNA-148a-3p (miR-148a-3p) is downregulated in HCC, whereas its function in regulating HCC cell metabolism remains obscure. Herein we aimed to delineate the role of miR-148a-3p in HCC cell metabolism by using novel bioengineered miR-148a-3p (BioRNALeu/miR-148a-3p) agent producedin vivo.

    Methods: BioRNALeu/miR-148a-3p was designed by using human leucyl transfer RNA fused hsa-pre-miR-34a carrier, overexpressed inEscherichia coli (E. coli), and purified to high homogeneity. After transfection into HCC cells, the released miR-148a-3p levels were assessed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Cell proliferation was determined by CellTiter-Glo assays. Targets were validated by dual-luciferase reporter assays, immunoblotting, and immunofluorescence confocal imaging. Glycolysis capacity was evaluated by Seahorse XF assays, and glucose, lactate, and amino acid levels were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods.

    Results: BioRNALeu/miR-148a-3p was efficiently processed into target miR-148a-3p in HCC cells to effectively inhibit cell proliferation in a dose- and time-dependent manner. Mechanistically, miR-148a-3p suppressed the protein levels of glucose transporter GLUT1/SLC2A1 and L-type amino acid transporter LAT1/SLC7A5 via acting on their 3′-untranslated regions, as well as amino acid transporter ASCT2/SLC1A5. These, in turn, led to a reduction of glucose uptake, lactate production, and glycolytic flux in HCC cells, and alteration of intracellular amino acid metabolome including glutamine, leucine, phenylalanine, tyrosine, and methionine.

    Conclusions: Reintroduction of miR-148a-3p into HCC cells modulates glucose and amino acid metabolism via regulating multiple SLC transporters, thereby suppressing HCC cell viability. These findings highlight the role of miR-148a-3p in HCC cell metabolism and potential of bioengineered miRNA molecules for functional studies and therapeutic development.

  • research-article
    Hang-Fei Liang, Chuo-Ying Mai, Xuan Li, Jia-Ning Tian, Hai-Guo Su, Min Huang, Jian-Hong Fang, Hai-Tao Wang, Xiao Yang, Hui-Chang Bi

    Background and aims: The mechanism of cholestatic liver injury (CLI) is unclear, and effective therapies are lacking. While peroxisome proliferator-activated receptor alpha (PPARα) agonists show potential hepatoprotective effect and pyroptosis is implicated in hepatocellular damage, how PPARα activation mitigates lithocholic acid (LCA)-induced pyroptosis remains unknown.

    Methods: The hepatoprotective effect of PPARα agonists was evaluated in a mouse model of intrahepatic cholestasis induced by LCA. Liver injury was assessed via serum biochemistry, hematoxylin and eosin and TUNEL staining, and electron microscopy. Pyroptosis pathways were analyzed using real-time quantitative polymerase chain reaction, Western blot, and co-immunoprecipitation.

    Results: Combined morphological, histopathological, and biochemical analyses confirmed that PPARα activation protects against CLI. Compared with LCA treatment alone, PPARα activation significantly attenuated the elevation of serum lactate dehydrogenase (LDH), the increased TUNEL-positive cells, and the formation of hepatocyte membrane pores. Mechanistically, PPARα activation suppressed both NOD-like receptor protein 3 (NLRP3) inflammasome-mediated pyroptosis and apoptosis protease-activating factor-1 (APAF-1)/CASPASE-3/GSDME-mediated pyroptosis. Furthermore, PPARα agonist pretreatment inhibited activation of the nuclear factor-kappa B (NF-κB) and forkhead box O1 (FOXO1) signaling pathways.

    Conclusions: PPARα protects against LCA-induced CLI by inhibiting both NLRP3 inflammasome-mediated pyroptosis associated with NF-κB and APAF-1/CASPASE-3/GSDME-mediated pyroptosis associated with the FOXO1 signaling pathway.