Gut journal study explores the emerging field of liver vasomics

Liver disease causes more than 2 million deaths annually, accounting for approximately 4% of global mortality. The hepatic vascular system plays a crucial role in distributing blood, nutrients, and metabolic waste within the liver, thereby regulating metabolism, detoxification, and synthesis. Studies show that the progression of liver disease is strongly associated with alterations in the hepatic vascular system, such as portal hypertension (PH) in cirrhosis, which results from sinusoidal dysfunction, splanchnic vasodilation, and the formation of portosystemic collaterals. Current treatment approaches, such as vasodilators and endoscopic interventions, primarily address symptoms rather than targeting the underlying vascular pathology, often leading to side effects. Therefore, researchers advocate for innovative therapies aimed at reversing intrahepatic vascular changes.

A study published in the latest issue of Gut, led by Professor Xiaolong Qi from Zhongda Hospital, Southeast University, China, provides an in-depth definition of Vasomics and categorizes existing hepatic vascular phenotypes into five major types: anatomical, biomechanical, biochemical, pathophysiological, and composite. Liver vasomics, as a novel research discipline, utilizes multimodal imaging techniques, vascular function assessments, and computational pathology to provide new insights into the pathophysiology of liver diseases and potential therapeutic targets. The classification of these phenotypes helps to systematically analyze the complex interactions between the hepatic vasculature and liver diseases. For example, anatomical phenotypes can be obtained using multimodality imaging techniques such as CT, MRI, ultrasound, and histological analysis of the liver, while biomechanical phenotypes involve the assessment of blood flow and vascular elasticity. Biochemical phenotypes focus on the analysis of serum markers and tissue proteins that reflect endothelial dysfunction and inflammation. Pathophysiological phenotypes describe the abnormal structural and functional changes in the hepatic vasculature, such as sinusoidal capillarization and microvascular invasion. Composite phenotypes integrate multiple vascular features to provide a comprehensive assessment of liver diseases.

With advancements in imaging and AI-driven algorithms, researchers can now extract high-throughput vascular features, allowing for the development of mathematical models that can predict disease progression and improve treatment strategies. For instance, a vascular geometry model has been successfully applied to diagnose clinically significant portal hypertension (CSPH) in cirrhotic patients, demonstrating higher accuracy than traditional methods. Moreover, vasomics plays a key role in evaluating treatment response. The effectiveness of anti-angiogenic therapies in liver cancer is closely related to hepatic microvascular structure, and vasomics can help identify patient populations that are most likely to benefit from such treatments.

Despite the great potential of vasomics, its clinical translation still faces numerous challenges. This study highlights key areas for future development, including optimizing the vasomics toolkit by developing standardized methods to improve vascular feature extraction and analysis accuracy; establishing a vasomics bank to create a global data repository that supports large-scale research and clinical applications; and developing standardized vasomics protocols to ensure consistency in data collection and analysis, thereby promoting international collaboration.

“Vasomics represents a revolutionary step forward in liver disease research and clinical care,” says Professor Xiaolong Qi. “By integrating artificial intelligence with advanced imaging and computational modeling, we can achieve a more precise understanding of hepatic vascular changes, ultimately leading to better patient care and improved clinical outcomes.”

With this groundbreaking research, hepatic vasomics is now at the forefront of precision medicine, offering new hope for millions of liver disease patients worldwide.