Surfing the MASH Tsunami

S4-E42.2 - MASH, MetALD and Alcoholic SLD: A Continuum?


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The EASL SLD Summit aims at updating a global community of liver stakeholders on the most recent advances in SLD research, both pre-clinically and clinically, focusing on MASLD and tackling the issue of MetALD.

In this episode, Jörn Schattenberg, Louise Campbell and Roger Green review the recently concluded meeting with faculty members Sven Francque and Hannes Hagström in two seperate interviews.

This conversation starts with Roger asking Sven for his impression about whether the three diseases - MASH, MetALD, Alcoholic SLD - lie on a single continuum or whether the alcoholic and non-alcoholic causes of disease are separate dimensions. Sven suggests that there are different dimensions that can be seen in elements of hepatic structure and vascularization, but that neither are completely independent. Switching to a different challenge around MetALD and alcohol, Jörn discusses the complexity in patients assessing their own drinking behaviors given that much drinking is a weekend-oriented social event rather than a consistent pattern of daily consumption. In the course of this discussion, both Sven and Jörn note their hope that AI/ML will provide pivotal new insights on these issues. Sven comments that he hopes that research will continue to develop along a path of basic science rather than simple drug testing and development. Roger suggests that the relatively low level of efficacy with late stage development drug suggests that we need to learn far more about the basic science to support development of highly successful drugs and NITs.

With that, listen to the full episode to gain a richer understanding than can be described in this summary. If you have questions or comments around the Summit or any other themes addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at [email protected].

From the official EASL SLD Summit website:

The EASL SLD Summit aims at updating a global community of liver stakeholders on the most recent advances in SLD research, both pre-clinically and clinically, focusing on MASLD and tackling the issue of MetALD. You will gain insights in the most key techniques employed in research, clinical trials and clinical practice, with an understanding of their potential as well as limitations. You will learn about the most recent advances in our understanding of the disease, including the role of sexual dimorphism, circadian clock or vascular mechanisms, and potential new targets as well as modalities of treatment. You will exchange on these topics with both young fellows and established experts in the field in a highly interactive format with a lot of room for discussion. You will get the latest update on where we stand with the efforts of having MASLD, and SLD in general, on the agenda as a public health problem and the roadmap and policies to tackle this problem, in which the people living with SLD, and many stakeholders have been increasingly joining forces. In light of the latter, the Summit will also provide a space to further discuss the nomenclature change and its potential impact on research clinical practice and awareness. A session will be dedicated to discussing in-depth the issue of people who combine alcohol use and metabolic risk factors, designated as MetALD in the latest nomenclature. You will also get the latest data on diagnosis and prognostication in MASH and on how to tackle MASLD as a multisystem disease, informing you not only on what you need to do, but also on the science and evidence behind it.

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