S. together with estimates of their numbers to LY294002 supplier calculate how many foreign-born U.S. residents might be expected to have HBV infection. Weinbaum et al.[9] estimated that out of 35,689,467 foreign-born U.S. residents in 2005, 939,416 (or 2.6%) had chronic HBV; Kowdley et al.[10] estimated that out of 38,433,860 foreign-born U.S. residents in 2009, 1,324,693 had chronic HBV in 2009. These calculations critically depend on estimates of HBV infection prevalence in the country of origin, which may be inaccurate, and on the assumption that immigrants to

the U.S. have a similar prevalence of HBV as that of their entire country of origin, which may be untrue. Nonetheless, these staggering estimates of foreign-born U.S. residents with HBV far exceed the number of U.S.-born residents with HBV estimated at 229,000-534,000.[9] Thus, foreign-born persons from endemic and hyperendemic countries now constitute the majority of HBV-infected patients in the U.S. Looking

at incidence rather than prevalence, and using similar methods based on estimates of HBV in the country of origin, Mitchell et al.[11] calculated another thought-provoking statistic: C59 wnt solubility dmso U.S.-acquired new HBV infections had declined to 3,700 in 2006, while the estimated number of foreign-born persons with HBV infection who immigrated to the U.S. (“newly imported infections”) in 2006 was 62,000: nearly 17 times the U.S.-acquired number. These studies suggest that the single PAK5 most important measure to identify HBV-infected persons in the U.S. is to screen foreign-born persons from endemic or hyperendemic countries. Since 2008, the Centers for Disease Control and Prevention (CDC) has recommended HBsAg testing for all persons born in countries or regions with HBsAg prevalence of ≥2% (as well as men who have sex with men, injection-drug users, HIV-positive persons and household, needle-sharing or sex contacts of HBV-positive persons), referral of infected persons to care, and referral of close contacts for testing or vaccination.[5] This was, in fact, an appropriate expansion of a previous CDC recommendation from 2005 to test persons from countries or regions with HBsAg prevalence ≥8%.[12] It is important to note that although

there are many countries with estimated HBsAg prevalence ≥2% (notably most Asian countries except Japan, most African countries, and some Eastern European countries), the majority of foreign-born persons with HBV in the U.S. were born in a small group of countries in East and Southeast Asia: China, Korea, the Philippines, Vietnam, Laos, and Cambodia.[10] These countries have both high numbers of immigrants to the U.S. as well as high prevalence of HBsAg. It is equally important to point out that foreign-born Hispanics, who constitute the majority of foreign-born persons in the U.S., have an overall very low prevalence of HBsAg, well below 2% (except those from a selected small group of countries, e.g., Dominican Republic, Haiti, and Guatemala).

SVR rates are comparatively lower in Tipifarnib mw patients who have majority preponderance of negative predictors. Further strategies focused on addressing these hardest to cure populations are now required. A DEV,1 J MITCHELL,2 K POLKINGHORNE,3 R SKOIEN,4 K STUART,5 W CHENG,6 A LEE,7 M LEVY,8 J LUBEL,9 S NAZARETH,6 S WARNER,1 A WIGG,10 S ROBERTS2 1Department of Gastroenterology, Monash Medical Centre, Melbourne, Australia, 2Department of Gastroenterology, Alfred Hospital, Melbourne,

Australia, 3Department of Epidemiology, Monash Medical Centre, Melbourne, Australia, 4Department of Gastroenterology, Royal Brisbane and Women’s Hospital, Brisbane, Australia, 5Department of Gastroenterology, Princess Alexandra Hospital, Brisbane, Australia, selleck inhibitor 6Department of Gastroenterology, Royal Perth Hospital, Perth, Australia, 7Department of Gastroenterology, Concord Hospital, Sydney, Australia, 8Department of Gastroenterology, Liverpool Hospital, Sydney, Australia, 9Department of Gastroenterology, Eastern Health, Melbourne, Australia, 10Department of Gastroenterology, Flinders Medical Centre, Adelaide, Australia Introduction: In Australia, and many other countries, the standard treatment for HCV genotype 1 is triple therapy with Pegylated

interferon-α-2a/2b, ribavirin (PR) and a first generation direct-acting antiviral (DAA), such as boceprevir (BOC). Uncertainty over the timing of regulatory approval and reimbursement for newer DAAs has led to increasing impetus to treat now to reduce disease progression, especially in advanced liver disease. Current BOC treatment experience data to date is mostly from the northern Bcl-w hemisphere. Thus, we aimed to evaluate

the efficacy and safety of BOC based triple therapy in a large Australian cohort reflective of real-world clinical practice. Methods: A retrospective, observational analysis was conducted in 1026 patients enrolled in an early access program in 65 hepatitis treatment centers. Patients received a PR 4 week lead in followed by either response-guided or fixed-dose duration of BOC for 44 weeks according to standard guidelines. Demographic, clinical and virological data were entered into a central database. Cirrhosis was characterized by a composite of radiological imaging, histology (METAVIR 4) and/or transient elastography (median stiffness >12.5 kPa). Virological response (VR) was defined as undetectable HCV RNA using a sensitive quantitative PCR assay. Results: 407 patients were included in this interim analysis, of whom 308 patients had end of treatment data and 157 had week 12 follow up data. The majority were male (68%) and Caucasian (90%), with mean age of 51 years. Cirrhosis was present in 24% (Child-Pugh A) and 55% had prior PR treatment. HCV genotype 1 distribution was 53% 1a, 16% 1b, 3% 1a/1b, and 28% undifferentiated. IL28B genotype distribution was 20% CC, 35% CT, 7% TT and 38% unknown.

In this line, our results indicating an oncogenic role of the NRF2 pathway in preneoplastic lesions should be considered for their possible translational value. Further investigation is warranted to verify NRF2 activation in human preneoplastic stages as well. If so, targeting this pathway would offer new therapeutic options in stages of progression that could dramatically change the evolution of the disease. We thank G. Diaz for support in statistical analysis, M. Angioni and A. Follenzi for generation and characterization of RH

cells, B. Martinoglio for qRT-PCR, and F. Natale for editing the article. click here Additional Supporting Information may be found in the online version of this article. “
“Background and Aim:  The prevalence of allergic disorders, including asthma, atopic dermatitis, and allergic rhinitis has been increasing, and the prevalence of Helicobacter pylori (H. pylori) infection has been decreasing. Chronic bacterial infection during childhood is reported to protect the development of allergic diseases. The aim of the present study was to identify whether H. pylori infection influences the prevalence of allergic rhinitis, which has become a serious social problem, especially in the developed countries. Methods:  We initially

investigated the association between the prevalence of H. pylori and pollinosis symptoms in 97 healthy volunteers. We had investigated the association between the serum H. pylori–immunoglobulin (Ig) G antibodies and specific IgE antibodies for pollen, mites,

and house dust in 211 consecutive patients. Results:  There were 52.2% (36/69) Ivacaftor chemical structure of H. pylori-negative volunteers with allergic symptoms, which was significantly higher than H. pylori-positive volunteers (14.3%, 4/28, P < 0.05). The risk of pollinosis symptoms by H. pylori infection was 0.148 (95% confidence interval): 0.046–0.475, P < 0.05). The prevalence of H. pylori infection increased according to age, whereas that of specific IgE-positive patients gradually decreased. Among the IgE-positive patients, the prevalence of H. pylori-negative patients was significantly higher than H. pylori-positive patients who were younger in age (P < 0.05). Conclusion: H. pylori infection decreased the pollinosis effects, especially among the younger Interleukin-3 receptor volunteers. However, the prevalence of pollinosis in patients who were 50 years or older were almost same between H. pylori-positive and H. pylori-negative patients; therefore, the recent increase of pollinosis might relate to not only H. pylori infection, but also change in social environment. “
“Histone deacetylases 1 and 2 (HDAC1 and HDAC2) are ubiquitously expressed in tissues, including the liver, and play critical roles in numerous physiopathological processes. Little is known regarding the role of HDAC1 and HDAC2 in liver regeneration.

Sustained off-therapy response (SR) was defined as HBV DNA <2,000 IU/mL combined with normal ALT at 12 months post-therapy. Results: Mean±SD age at baseline was 42±1

1 years and 75% of the patients were males. Mean baseline HBV DNA and HBsAg levels were 5.4±1.4 log10 IU/ml and 3.5±0.6 log10 IU/ml, respectively. Of the 95 patients, 22 (23%) achieved SR and 9 (9.5%) lost HBsAg. HBsAg decline was more profound in responders than in non-responders. HBsAg decline ≧10% from baseline to week 12 was not significantly associated with SR [OR:2.196 (0.740-6.519), p=0.169]. In contrast, HBsAg Torin 1 cost decline >10% from baseline to week 24 was found significantly more frequently in patients with than without SR [81% (17/21) vs 37% (21/57); OR:7.286 (2.162-24.552), p=0.001]. The predictability of the PARC selleck products rule based on HBsAg and HBV DNA levels at 12 weeks was evaluated in a subset of 47 patients with available data [SR: 13/47 (28%)]. Of them, 60% (28/47) did not have any HBsAg decline and 1 7% (8/47) did not have both any HBsAg decline and decline of HBV DNA >2 log 10. Of the latter 8 patients who fulfilled the PARC stopping rule, none achieved SR [Negative Predictive Value (NPV): 1 00%]. Of the 39 patients who did not fulfill the PARC stopping rule, 24 (62%) had HBsAg decline ≧10% at 24 weeks with 12/24 (50%) achieving SR,

while 15 (38%) had HBsAg decline <10% at 24 weeks with only 1/15 (7%) achieved SR (NPV: 93%). Conclusions: In HBeAg-negative, predominantly genotype D, CHB patients treated with peg-interferon-alfa-2a, HBsAg decline >1 0% at 24 weeks is associated with significantly higher probability of SR at 12 months post-therapy. The combination of HBsAg and HBV DNA levels at week 12 with HBsAg decline at week 24 can identify patients with no or a very low chance of SR leading to

early discontinuation of an unsuccessful regimen in almost 50% of patients or more importantly in almost Florfenicol 2/3 of patients without SR. Disclosures: Ioannis Goulis – Consulting: MSD, Gilead Sciences, Novartis, Janssen-Cilag; Grant/Research Support: BMS, Roche; Speaking and Teaching: BMS, MSD, Gilead Sciences, Novartis, Janssen-Cilag, Roche Melanie Deutsch – Consulting: MSD Konstantinos Mimidis – Advisory Committees or Review Panels: ROCHE, MSD, NOVARTIS; Grant/Research Support: GILEAD Sokratis Koulouris – Employment: Roche Hellas George Bakalos – Employment: Roche Hellas SA George V. Papatheodoridis – Advisory Committees or Review Panels: Janssen, Abbott, Boehringer, Novartis, BMS, Gilead, Roche; Consulting: Roche; Grant/Research Support: BMS, Gilead, Roche; Speaking and Teaching: Janssen, Novartis, BMS, Gilead, Roche, MSD The following people have nothing to disclose: Stylianos Karatapanis, Evangelos A. Akriviadis, George N. Dalekos, Maria Raptopoulou-Gigi, Georgios Germani-dis, Christos K.

14, 28, 39 Hu et al.14 demonstrated that appending tyrosine- or dileucine-based motifs of CFTR to a Tac reporter allows for rapid internalization, indicating that the C-terminus of CFTR contains endocytic signals. However, identifying endocytic signals in a full-length polytopic protein is often difficult because creating mutations in the putative Small molecule high throughput screening sequence by alanine scanning or sequential deletion may lead to misprocessing of the full-length protein and hamper its trafficking to the plasma membrane. For example, in full-length multidrug-resistant 1 (MDR1), mutations of analogous leucine or tyrosine residues led to misprocessing and ER retention, precluding the evaluation

of its targeting function.40 find more However, we were able to successfully mutate the tyrosines in the C-terminus of full-length

BSEP and observe the same defect in endocytosis that we had demonstrated in TacCterm. To date, there are no known disease-producing point mutations of human BSEP in the identified endocytic signal region; however, there are premature stop codons that lead to deletion of the tyrosine-based motif.3 Deletion of a major portion of the C-terminus in a human disease-causing Bsep mutant in the rat (R1050X) showed proper targeting to the apical membrane of MDCK cells, indicating that a large portion of the C-terminal nucleotide-binding domain is not necessary for biosynthetic processing and apical targeting.41 However, we and others have identified a number of BSEP mutations that cause a reduction of Bsep on the cell surface through increased rate of internalization in heterologous expression systems.30, 41 This loss of Bsep protein from the canalicular membrane is characteristic of some forms of experimental cholestatic liver injury, as well as human cholestatic liver diseases. Cholestasis induced by estradiol-17β-D-glucuronide, taurolithocholic Benzatropine acid, cyclosporine A, and lipopolycharide all result in redistribution of

Bsep to the subapical cytoplasm.7, 8, 42, 43 Efforts have been made to compensate for the loss of cell surface BSEP with the administration of chemical or pharmacological agents such as MG-132 or sodium phenylbutyrate.30, 41, 44 Although the mechanisms of action are not clearly defined for these agents, one possible explanation for the increase of BSEP cell surface expression is that these compounds limit the extent of ubiquitinylation of BSEP.45 Ubiquitinylation of membrane proteins and endocytic adaptor proteins attenuates signaling of ligand-dependent activation of receptors by targeting these receptors to the endolysosomal pathway for degradation. Hayashi et al.45 showed that attaching short-chain ubiquitin to BSEP shortens the half-life of cell surface BSEP.

Therefore, we believe that the article published by Connolly and coworkers addresses an important aspect of the liver microenvironment regarding the role of DCs in fibrosis progression. Additional studies are warranted to clarify the functional and potentially clinically relevant contribution of DCs for the progression or regression of liver fibrosis. “
“Niemann-Pick disease, types A and B, are lipid storage disorders caused by complete or partial deficiency of a lysosomal enzyme, acid sphingomyelinase. The disorders are inherited in an autosomal recessive pattern and result

in the accumulation of sphingomyelin in various organs including the spleen, liver, lungs, bone marrow and brain. The infantile GSK1120212 nmr variant (type A) usually presents within the first year of life with failure to thrive, hepatomegaly and neurological symptoms, sometimes resulting in liver failure with ascites and jaundice. Most babies die at 2–3 years of age. In Niemann-Pick type B disease, the diagnosis is usually made early in childhood because of failure to thrive and the development learn more of hepatosplenomegaly. Patients then develop progressive neurological symptoms and may have deteriorating pulmonary

function because of foam cell infiltrates. Most patients die in childhood. An important clue to the diagnosis of Niemann-Pick disease, types A and B, is the presence of large foamy macrophages in the bone marrow or liver. In most patients, the diagnosis is confirmed by genetic tests for mutations in the SMPD1 gene or by the demonstration of low acid sphingomyelinase tuclazepam activity in peripheral blood white cells or in cultured fibroblasts. At present, there is no specific treatment for Niemann-Pick disease. The patient illustrated below was 15-month-old female who presented with a 4-month history of hepatosplenomegaly and failure to thrive. She was the product

of a full-term normal pregnancy but her parents were consanguineous and a previous baby had died in the neonatal period. The parents described anorexia and recurrent pneumonia but no vomiting or diarrhea. The baby had a weight and height below the 5th percentile for age. Physical examination revealed marked hepatosplenomegaly but no ascites. Liver enzymes were abnormal with elevation of aspartate aminotransferase (311 u/l), alanine aminotransferase (251 u/l), gamma-glutamyltransferase (77 u/l) and alkaline phosphatase (724 u/l). She had a normal complete blood count, coagulation studies and serum albumin. A computed tomography scan of the chest revealed typical reticulonodular infiltrates in the upper lobes of both lungs (Figure 1). A percutaneous liver biopsy showed lipid-laden foam cells (Figure 2). The diagnosis of Niemann-Pick disease was confirmed by the demonstration of low acid sphingomyelinase activity in peripheral blood white cells.

HEV RNA was undetectable at 4 months. Treatment was discontinued after 6 months and liver enzymes have remained normal to date. The patient denies receiving blood products. She does eat pork, oysters, and mussels. She drinks well water in her rural vacation home. She made several trips to Mexico and experienced an episode of fever

and gastrointestinal disturbance upon returning from a trip in 2002. HEV genotype 3 has been isolated in those click here who consumed pork products, mussels, and game meat.[1, 3, 4] Swine-associated HEV strains have been identified in sewage water[3] and can lead to shellfish contamination. It is tempting to speculate that this patient may have acquired HEV infection Ceritinib in vivo by consuming pork or shellfish. Recent studies in solid organ transplant recipients have shown that acute HEV genotype 3 infection or reactivation in anti-HEV IgG-positive transplant recipients can lead to chronic hepatitis with progression to cirrhosis.[4] Our patient also had HEV genotype 3 infection; the distant history of lupus may have predisposed her to the development of chronic HEV infection. This case highlights the importance of suspecting chronic HEV infection in patients with unexplained chronic hepatitis.

However, the lack of a standardized commercial nucleic acid-based assay in the U.S. to detect HEV RNA in stool or serum limits testing, although two commercially available RT-PCR RNA assays for HEV genotype

3 are reported in Europe.[7] Chronic HEV infections related to genotypes 1 and 2 have not been reported so far. An effective HEV vaccine has been approved in China following a controlled trial in 100,000 volunteers.[8] HEV vaccination would be very useful to prevent chronic HEV in immunosuppressed patients and those with chronic liver disease. “
” On behalf of the 2013 Scientific Program Committee, I welcome Fenbendazole you to Australian Gastroenterology Week and the Federation of Gastrointestinal Societies Meeting 2013 at the Melbourne Convention Centre, 7–9th October. This meeting is the focal point of the Gastroenterological Society of Australia’s (GESA) educational and scientific activities. In 2013, we meet again with our colleagues from the surgical societies ANZGOSA, ANZHPBA, CSSANZ, as well as our nursing colleagues from GENCA. We are delighted to report that there was an impressive number of abstract submissions this year (364), many of superb quality. These abstracts are published in the October supplement of the Journal of Gastroenterology and Hepatology, by discipline categories and within each discipline, in alphabetical order of primary authors. There is an author index on page XYZ to assist with referencing. Thank you again for your scientific contributions and support of GESA and the Federation of Gastrointestinal Societies’ major national meeting for 2013.

37 This finding further supports our hypothesis that miR-17-5p-induced changes in HCC cell metastasis depend on the activation of p38 MAPK and HSP27. Collectively, our study identified a signaling pathway regulated by miR-17-5p using DIGE and confirmed this result by other molecular techniques. To our knowledge, this study is the first to take a nonbiased, broad-based approach to identify

the downstream effects of overexpression of a miR and it provides functional data linking the miR to metastatic characteristics both in vitro and in vivo. high throughput screening assay It also provides data for a mechanism from direct effect to end effect. However, many protein spots remain unidentified. Further elucidation of the total physiological changes and the mechanisms responsible will require improvements in methodology (holistic analysis of all molecules) and miRNA regulation theory. We thank Hong Lei and Xiu-hua Zhang for help with DIGE data analysis. Additional Supporting Information may be found in the online version of this article. “
“Accurate assessment of the coagulated area is imperative to achieve an excellent outcome from percutaneous radiofrequency ablation (PRFA) for the treatment of hepatocellular carcinoma (HCC). We evaluated the efficacy of contrast-enhanced ultrasonography (CEUS) with the contrast-enhancing

agent Sonazoid for precisely assessing the therapeutic Cilomilast mouse effect of PRFA for HCC. We enrolled 87 consecutive patients with solitary

naïve HCC of less than 3 cm in diameter. PRFA treatment was performed with a 17-G cool-tip needle, and CEUS was performed to assess the ablative margin 3 h after the procedure, when the coagulated tumor outline was easiest to discern. The treatment was repeated until an ablative margin greater than 5 mm was confirmed. After CEUS assessment of the therapeutic response, the patients were followed to investigate local tumor recurrence. In 78 patients (89.7%), the outline of the coagulated tumors could be recognized by ultrasonography, and CEUS assessment of the ablative margin was successful. The remaining nine patients were assessed by computed tomography. The 5-year cumulative survival rate after the assessment of the treatment PIK3C2G response with CEUS was 58.4%, and the 4-year cumulative total recurrence rate was 72.3%. The 5-year cumulative local tumor recurrence rate was very low (2.3%). The assessment with CEUS at 3 h after the PRFA procedure was successful in the majority of the patients, and it yielded a very low rate of local recurrence. “
“Unlike many chronic medical conditions, peptic ulcer disease is a potentially curable or avoidable condition because Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) account for the vast majority of cases. The key to successful management rests on choosing appropriate H. pylori diagnostic tests according to specific clinical settings (e.g.

All non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac, and naproxen, now carry a black box label from the US Food and Drug Administration (FDA) because of their association with increased risk of heart attack. NSAIDs do vary in the amount of risk to the heart, with naproxen

the safest. Other NSAIDs vary in their heart risk, mostly seen in those who use them frequently. Using NSAIDs not more than 2 days a week is generally safe in most individuals who have never had a heart attack. Other acute, as-needed medications that may help learn more dial down the migraine pain without causing blood vessel narrowing include metoclopramide, prochloperazine, diphenhydramine, baclofen, acetaminophen, and gabapentin. Trigger point injections and nerve blocks may also be used. Migraine preventive strategies become very important lambrolizumab in individuals with vascular

disease and migraine, as acute treatment options are limited. Topiramate, venlafaxine, and blood pressure medications such as propranolol and candesartan, as well as onabotulinumtoxinA, can be highly effective in decreasing both the intensity and frequency of migraine. In summary, the link of cardiovascular disease and peripheral artery disease with migraine may be present, but it is difficult to separate out from other risk factors often present at the same time such as smoking, diabetes, uncontrolled blood pressure, and other common vascular risks. The presence of coronary artery disease or peripheral vascular disease limits the

use of certain acute and preventive migraine treatments. All medicines that cause artery narrowing should be avoided in the presence of cardiovascular or peripheral vascular disease, but there remain multiple effective treatments to reduce migraine pain and frequency. To find more resources, please visit the American Migraine Foundation (http://kaywa.me/ir2eb) “
“This chapter features an approach to both headache classification and diagnosis. The history of headache classification and the current classification system for headache disorders are first described, Oxaprozin followed by an overview on the approach to the evaluation of a patient with recurrent or daily headache. Then, an outline of a 3 step diagnostic process is presented. First, we emphasize the identification or exclusion of secondary headache disorders by history, physical examination and judicious use of diagnostic tests. Second, 4 groups of primary headache disorders defined based on headache frequency and duration are delineated, and referred to as primary headache syndromes. Finally, the identification of specific disorders within syndromic groups is discussed. “
“A 13-year-old previously healthy female presented at our institution following an acute episode of altered mental status characterized by impairment of speech, urinary incontinence, and emesis.

Histological examination of the resected specimen stained with haematoxylin and eosin confirmed the absence of malignancy and the presence of smooth muscle between layers of duodenal mucosa (Fig. 2C). The muscle layer within the duplication cyst can be clearly MI-503 visualised following immunostaining with antibody to alpha smooth muscle actin (Fig. 2D). The patient has not had another episode of pancreatitis for over six months after the operation. Congenital duodenal duplication cysts are a rare cause of recurrent pancreatitis. Abdominal

pain and distension are typical features but gastrointestinal bleeding can occur due to the presence of ectopic gastric mucosa, allowing subsequent diagnosis during endoscopy. Pancreatitis, secondary to pancreatic ductal outflow obstruction is usually the result of pancreatic duct compression involving the cyst, or stone disease if there is direct communication with the pancreaticobiliary tract. Although endoscopic drainage and snare resection is considered safe, surgical excision is accepted as the treatment of

choice with the intention to alleviate symptoms, prevent pancreatitis and eliminate the risk of malignant transformation, a development reported in only a small number of cases. Contributed by “
“Macrophages display phenotypic plasticity and functional diversity in response to microenvironmental signals and could undergo M1 (classical) or M2 (alternative) activation driven by pro-inflammatory stimuli (interferon-γ/lipopolysaccharide) and anti-inflammatory cytokines (interleukin [IL]-4/IL-13), respectively.[1] Increasing evidence suggests that tumor-associated macrophages (TAM), which acquire an M2-like phenotype and are associated click here with a poor prognosis of cancers.[2, 3] However, the precisely Baricitinib clinical relevance and underlying mechanisms of the interplay of TAM and hepatocellular carcinoma (HCC) are still not fully defined. Recently, we read with great interest the article by Hara et al. describing macrophage colony-stimulating factor (M-CSF/CSF-1) involved in the tumorigenesis

of HCC. They further demonstrated that M-CSF and TAM (M2-subtype macrophages) induced by M-CSF were firmly linked with the high expression of inflammatory cytokines and angiogenesis of liver tumors.[4] Thus, we concluded that the regulation of M-CSF/TAM axis may play a crucial role in the treatment of HCC. Consistent with our analysis, several lines of evidence confirmed that M-CSF exerted remarkable effects during hepatocarcinogenesis by modulating the TAM function. First, Jia et al. elucidated that peritumoral M-CSF receptor (CSF-1R) expression was significantly associated with more intrahepatic metastasis, tumor recurrence and poorer patient survival after hepatectomy.[5] Similarly, Zhu et al. previously indicated that high peritumoral M-CSF and density of macrophages were associated with HCC progression, disease recurrence and poor survival after hepatectomy, and that they would be targets of postoperative adjuvant therapy.