• Special Issue Topic

    Exploring Chronic Liver Disease

    Submission Deadline: December 31, 2021

    Guest Editor

    Dr. Amedeo Lonardo E-Mail

    Director of Simple Operating Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy

    Research Keywords: NAFLD; NASH; cirrhosis; HCC

    About the Special Issue

    Chronic liver disease (CLD) defines an etiologically diverse group of disorders spanning from viral hepatitis to non-communicable diseases due to alcoholic, metabolic (i.e. nonalcoholic fatty liver disease, NAFLD), genetic, auto-immune and other causes. From a clinico-pathological perspective, the spectrum is also heterogeneous and includes such phenotypically variable entities as steatosis, steatohepatitis, chronic hepatitis, liver cirrhosis and cancer.

    The burden of CLD varies across different countries and over time. A recent study conducted in Texas, USA, found that, compared to prevalent chronic conditions, such as either congestive heart failure or chronic obstructive pulmonary disease, patients with CLD had increased rates of hospitalization, longer hospital stays, and more readmissions. It was noted that, despite these adverse outcomes, CLD individuals also had less access to post-acute care (1).

    Since 1990, the Global Burden of Disease (GBD) consortium has employed more than 3,600 researchers in approximately 150 countries, to register data regarding health loss from more than 350 diseases in 195 countries (2). A recent analysis of the GBD database has demonstrated that the global burden of liver cancer and cirrhosis has steadily increased from 2012 to 2017: although viral hepatitis remains the most common cause of liver deaths, NAFLD is the most rapidly growing contributor to liver mortality and morbidity (3).

    CLD poses a menace not only to health systems in the western world, but also in China. Data from the 2016 GBD Study evaluating the burden of CLD in 33 Chinese provinces found that cirrhosis and other CLD impose a huge health burden in China, with Hepatitis B virus remaining the leading cause of disease (4).

    For clinicians and health care providers CLD represents a formidable challenge owing to the need for inter- and multi-disciplinary competences. Typically, CLD patients, further to accurate medical history, physical examination (a routine extension of which will modernly also include first-line ultrasonography in many areas of the world) will often need extensive laboratory evaluation; elastometry; accurate imaging studies with “heavy” techniques such as CT scanning and MR imaging; histological characterization whenever indicated; assessment of portal hemodynamics through either invasive or non-invasive techniques; and digestive endoscopy. Many medical specializations are typically involved: not only hepatologists (of various cultural areas such as internal medicine, gastroenterology and infectious diseases) but also diabetologists, lipidologists; molecular virologists; clinical pharmacologists; oncologists; geneticists and others.

    Given the complexity of this vivid and rapidly evolving scenario, novel disease management models are greatly needed to handle the anticipated increase in hospitalizations for CLD (2). Therefore, the Editor has chosen to dedicate a single-topic issue of Exploration of Medicine to CLD, entitled “Exploring Chronic Liver Disease”. This special issue is addressed to an audience of, and open to contributions from, a large variety of writers, mainly but not limited to clinicians; radiologists; virologists; geneticists; pharmacologists; researchers in the drug industry; basic scientists; nurses; biotechnicians; patients; health authorities; and medical students, all of whom are encouraged to propose their studies. The following categories will be considered for publication: Original Article and Review (Meta-Analysis, Systematic Review); Case Report, Commentary, and Perspective articles.


    1. Asrani SK, Kouznetsova M, Ogola G, Taylor T, Masica A, Pope B, et al. Increasing health care burden of chronic liver disease compared with other chronic diseases, 2004-2013. Gastroenterology. 2018;155:719-29.e4.

    2. About GBD. Available from: http://www.healthdata.org/gbd/about. [Last accessed on 19 Aug 2020].

    3. Paik JM, Golabi P, Younossi Y, Mishra A, Younossi ZM. Changes in the global burden of chronic liver diseases from 2012 to 2017: the growing impact of nonalcoholic fatty liver disease. Hepatology. 2020;[Epub ahead of print].

    4. Li M, Wang ZQ, Zhang L, Zheng H, Liu DW, Zhou MG. Burden of cirrhosis and other chronic liver diseases caused by specific etiologies in China, 1990-2016: findings from the global burden of disease study 2016. Biomed Environ Sci. 2020;33:1-10.

    Keywords: biomarkers; cardiometabolic risk; clinical chemistry; endoscopy; genetics; geriatrics gut-liver-axis; imaging techniques; infectious diseases; liver failure; lifestyle changes; liver histology; liver transplantation; medicinal chemistry; metabolic disorders; pediatrics; personalized medicine; portal hypertension; ultrasonography; viral hepatitis

    Published Articles

    Open Access
    Original Article
    Pyogenic liver abscess: contrast-enhanced ultrasound allows morpho-evolutive classification and guides personalized management
    Aim: The aim of this study is to propose a contrast-enhanced ultrasound (CEUS)-based morphologic classification of pyogenic liver abscess (PLA) reflecting different evolutive stages and to assess th [...] Read more.
    Giampiero Francica
    Published: June 28, 2022 Explor Med. 2022;3:289–299
    DOI: https://doi.org/10.37349/emed.2022.00093
    Times Cited: 0
    Open Access
    Case Report
    Complex liver injury induced by combined Aloe Vera and vitamin A oral supplements, as assessed by histology and the updated RUCAM
    A case of combined acute and chronic liver injury related to consumption of multi-ingredient nutritional oral supplements containing Aloe Vera gel and vitamin A among other vitamins, minerals and di [...] Read more.
    Katerina Delladetsima ... Stratigoula Sakellariou
    Published: April 24, 2022 Explor Med. 2022;3:181–187
    DOI: https://doi.org/10.37349/emed.2022.00084
    Times Cited: 0
    Open Access
    Elimination of hepatitis C virus infection in Europe: targeting the obstacles
    Dante Romagnoli
    Published: February 24, 2022 Explor Med. 2022;3:71–76
    DOI: https://doi.org/10.37349/emed.2022.00075
    Open Access
    Functions of two distinct Kupffer cells in the liver
    Tissue-resident macrophages play critically important roles in host homeostasis and pathogenesis of diseases, with the functions of phagocytosis, metabolism, and immune modulation. Recently, two research studies accomplished by a  [...] Read more.
    Chunye Zhang ... Ming Yang
    Published: December 31, 2021 Explor Med. 2021;2:511–515
    DOI: https://doi.org/10.37349/emed.2021.00067
    Open Access
    Molecular targets regulating endoplasmic reticulum-mitochondria crosstalk for NAFLD treatment
    Non-alcoholic fatty liver disease (NAFLD) as the most common chronic liver disease poses a significant impact on public healthcare and economic risk worldwide. As a multifactorial disease, NAFLD is usually associated with many com [...] Read more.
    Chunye Zhang, Ming Yang
    Published: December 31, 2021 Explor Med. 2021;2:494–510
    DOI: https://doi.org/10.37349/emed.2021.00066
    Times Cited: 0
    Open Access
    Separating the apples from the oranges: from NAFLD heterogeneity to personalized medicine
    Recently, Arrese and Colleagues have published a review article entitled, “Insights into Nonalcoholic Fatty-Liver Disease (NAFLD) Heterogeneity” (Semin Liver Dis. 2021;41:421–34. doi: 10.1055/s-0041-1730927). This milestone  [...] Read more.
    Amedeo Lonardo
    Published: October 31, 2021 Explor Med. 2021;2:435–442
    DOI: https://doi.org/10.37349/emed.2021.00061
    Open Access
    Exploring evidence-based innovative therapy for the treatment of chronic HBV infection: experimental and clinical
    With the advent of various vaccines and antimicrobial agents during the 20th century, the control and containment of infectious diseases appeared to be a matter of time. However, studies unveiled the diverse natures of microbes, t [...] Read more.
    Sheikh Mohammad Fazle Akbar ... Yoichi Hiasa
    Published: October 31, 2021 Explor Med. 2021;2:392–409
    DOI: https://doi.org/10.37349/emed.2021.00058
    Times Cited: 0
    Open Access
    Breastfeeding duration and reduced risk of NAFLD in midlife of parous women
    Alessandro Mantovani ... Andrea Dalbeni
    Published: October 31, 2021 Explor Med. 2021;2:378–381
    DOI: https://doi.org/10.37349/emed.2021.00056
    Open Access
    Original Article
    High prevalence of false positive SARS-CoV2 serology in a cohort of patients with liver autoimmune diseases
    Aim: Monitoring the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) immunization in patients with autoimmune diseases is of particular concern to understand their response to the infection and to the v [...] Read more.
    Maria Giulia Cornacchia ... Gaetano Serviddio
    Published: August 31, 2021 Explor Med. 2021;2:372–377
    DOI: https://doi.org/10.37349/emed.2021.00055
    Open Access
    An engineered mayhem: YAP/TAZ mechanosignaling and hepatocarcinogenesis in NAFLD
    Gyorgy Baffy
    Published: August 31, 2021 Explor Med. 2021;2:305–310
    DOI: https://doi.org/10.37349/emed.2021.00048
    Times Cited: 0
    Open Access
    Case Report
    Hepatic manifestations of drug reaction with eosinophilia and systemic symptoms syndrome
    Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening drug reaction, which can affect multiple organs. Patients with DRESS syndrome and hepatic manifestations may present alterati [...] Read more.
    Maria Gabriela Delgado ... Jean François Dufour
    Published: April 30, 2021 Explor Med. 2021;2:122–134
    DOI: https://doi.org/10.37349/emed.2021.00037
    Times Cited: 0