Volume 02 · Issue 01 · 2022

Each year, viral hepatitis and its complications affect millions of patients and cause one-and-a-half million deaths. To deal with this immense public health burden, international organizations have, as part of their sustainable development goals, set up the plan "Elimination of Hepatitis by 2030," which has been ratified by most countries. The plan’s aims include the prevention of different hepatitis viruses and the treatment of existing patients. However, a mid-term analysis revealed that lest novel maneuvers are adopted, some of the plan’s objectives may not be attained. While new infections seem to be contained by vaccines and other public health measures, the persistent reservoir of chronic hepatitis viruses -hepatitis B virus (HBV) and hepatitis C virus (HCV) - may not be properly addressed. Although antiviral therapy against chronic HCV infection is promising, chronic-HBV-infected persons may not be properly handled. There are about 296 million chronic hepatitis B (CHB) patients in the world, and only 10% of them are aware of their infection. Thus, the undetected CHB patients should be found, and a proper approach should be devised to address this issue, especially in developing countries that harbor the main bulk of CHB patients. In addition, there is no finite therapy for CHB patients, and the safety and efficacy of the existing drugs are also questionable. This indicates the need for novel drugs for CHB patients. In light of this, this study aimed to offer measures that could discover the millions of undetected patients and address the need for developing innovative drugs for CHB patients and thus substantiate the "Elimination of Hepatitis by 2030" plan.

The pandemic of coronavirus disease 2019 has threatened humans for more than one and a half years. In particular, viral mutation like delta strain has led to third- or fourth-wave transmission among the countries in Asia, Europe, and North America. Although large-scale vaccination has been carried out in many countries, the incidence of reinfection and vaccine-past breakthrough infection is becoming an emerging challenge to humans worldwide. The related mechanisms underlying the reinfection and breakthrough infection remain unknown. In this review, we summarized the challenge and related reasons for severe acute respiratory syndrome coronavirus 2 reinfection and breakthrough infection. Simultaneously, we addressed some critical contents of the study in future.

Exosomes (exos) widely distributed in a variety of biological fluids, including blood, urine, saliva, sputum, breast milk, cerebrospinal fluid, and ascites, contain specific bioactive contents which are involved in physiological and pathological processes, such as signal molecular transfer, substance metabolism, gene regulation, and immune regulation. Macrophages are important innate immune cells which usually act as the first line of defense against infection, and can switch between different functional phenotypes in response to the changes around the microenvironment. Evidence suggests that macrophage-derived exos exert a crucial effect on infection, inflammation, regeneration, tumors, fibrosis, and other lesions in multiple human diseases. However, the role and mechanism of macrophage-derived exos in liver diseases remain to be explored. This review summarizes the current researches on the role and possible mechanism of macrophage-derived exos in liver diseases, with the purpose of providing new potential targets and directions for diagnostic biomarker and clinical treatment of liver diseases.

Liver failure is characterized by the rapid deterioration of liver function, often accompanied by ascites, coagulation dysfunction, hepatic encephalopathy, and other critical complications. Owing to the complex multifaceted pathogenesis and consequential clinical manifestations of the disease, liver failure displays poor prognosis and warrants comprehensive clinical treatment and management. Liver transplantation remains the only well-established treatment for liver failure. However, several factors including transplantation cost and low organ donation rates limit the rate of liver transplantation. The development of a suitable therapy for liver failure is a significant challenge and remains a cause of concern for the medical world. Granulocyte colony-stimulating factor (G-CSF), a member of the cytokine family of hematopoietic growth factors, is involved in the migration of hematopoietic stem cells into the damaged liver, and effectuates their dedifferentiation into hepatocytes. Liver regeneration involves a complex crosstalk of multiple cell types, including hepatocytes, endothelial cells, and inflammatory cells. Neutrophils and monocytes/macrophages that present different types of innate immune cells were found to play a crucial role in the progression of inflammation and restoration of the liver tissue. G-CSF, known as the most common used cytokine, may also affect these immune cells by combining G-CSF receptors on their surface. The immunomodulatory activity of G-CSF should be studied and described in order to ascertain its therapeutic effect on liver failure.

Since the coronavirus disease 2019 (COVID-19) began to spread, it remains pandemic worldwide. The European Medicines Agency’s human medicines committee and Food and Drug Administration have only granted a conditional marketing authorization for remdesivir to treat COVID-19. It is essential to apply other valuable treatments. Convalescent plasma (CP), donated by persons who have recovered from COVID-19, is the cellular component of blood that contains specific antibodies. Therefore, to determine the feasibility of CP for COVID-19, the effectiveness and controversy are discussed in depth here. It is suggested that CP plays a certain role in the treatment of COVID-19. As a treatment, it may have its own indications and contraindications, which need to be further discussed. Meanwhile, it is critical to establish a standard procedure for treatment from CP collection, preservation, transport, to transfusion, and conduct some large sample randomized controlled trials to confirm the transfusion dosage, appropriate time, frequency, and actively prevent adverse outcomes that may occur.

The novel coronavirus (SARS-CoV-2) infection has become a heavy burden on global health. Although the coronavirus disease 2019 (COVID-19) may adversely affect multiple organs and systems of infected patients, to the best of our knowledge, there is little investigation of the SARS-CoV-2’s impact on bone marrow. Our clinical and cytological findings in this case of severe COVID-19 infection provide novel insights into the pathogenesis of SARS-CoV-2 infection in the hematopoietic system. We recommend that physicians consider SARS-CoV-2 infection’s effect on bone marrow in patients who are slow to recover and suggest that a better understanding of the bone marrow morphology in COVID-19-infected patients is needed.