International Hepatology

Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers, characterized by high mortality rates and limited treatment options. Immunotherapy, particularly immune checkpoint blockade (ICB), has shown remarkable efficacy in treating cancers like melanoma and non-small cell lung cancer. However, many PDAC patients exhibit poor responses to ICB, mainly due to the tumor’s low immunogenicity and its immunosuppressive tumor microenvironment (TME). Inhibiting epigenetic regulators, such as SETDB1, KDM5B, and PHF8, has been shown to induce retrotransposon-mediated immune responses, thereby enhancing sensitivity to immunotherapy. While this approach shows promise in cancer treatment, its role in PDAC remains unclear. A recent study published in Gut identifies the key role of MED12 in modulating TME through the epigenetic silencing of retrotransposons, thus reshaping the immune TME in PDAC.

Portal hypertension is a severe complication of chronic liver disease, directly associated with clinical outcomes such as ascites and variceal bleeding. Transjugular intrahepatic portosystemic shunt (TIPS) is an effective treatment that significantly reduces portal pressure. Portal pressure gradient (PPG) is commonly used to assess portal pressure in patients undergoing TIPS. Recently, a study conducted by Dr. Guohong Han's team from Xi'an International Medical Center Hospital that published in the Journal of Hepatology, explored the optimal timing of measurement and hemodynamic target of PPG in cirrhotic patients with variceal bleeding undergoing covered stent TIPS. Dr. Yong Lv from Xijing Hospital is the first author of this article, and Dr. Guohong Han is the corresponding author.