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Topic - From NAFLD to MAFLD: the Dawn of a New Era?

A special issue of Hepatoma Research

ISSN 2454-2520 (Online), ISSN 2394-5079 (Print)

Submission deadline: 15 Apr 2021

Guest Editor(s)

  • Dr. Amedeo Lonardo, MD
    Operating Unit of Metabolic Syndrome, Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Modena, Italy.


Special Issue Introduction

Nonalcoholic fatty liver disease (NAFLD) is becoming a major cause of hepatocellular carcinoma (HCC). However, incomplete knowledge of the pathomechanisms of hepatic carcinogenesis and a lack of tools to stratify the risk of HCC hamper the implementation of effective screening programs and commonly result in a late diagnosis of HCC among those with NAFLD.

Similar to non-A, non-B Hepatitis virus, later renamed Hepatitis C virus, nonalcoholic fatty liver disease (NAFLD) initially received a "negative" definition. The "nonalcoholic" attribute was originally designed to emphasize the histological similarities with the full spectrum of alcoholic liver disease at variance with which, though, NAFLD is typically observed in the nonalcoholic. Forty years of intensive studies have failed to identify any effective drug treatment and the more rapidly progressive form of NAFLD, i.e. nonalcoholic steatohepatitis (NASH), other than the difficult-to-maintain lifestyle changes, essentially remains an orphan disease.

NAFLD is strongly and bi-directionally linked with metabolic derangements, namely insulin resistance and its correlates such as visceral obesity, dysglicemia/type 2 diabetes, and atherogenic dyslipidemia. So strong is such a nexus that, recently, NAFLD has received the long-awaited novel "positive" denomination metabolic associated fatty liver disease (MAFLD). The advantages of defining a disease based on what it is, rather than what it is not, are indubitable. However, prudence should be exercised owing to the risks of prematurely abandoning the old and immediately adopting the novel MAFLD definition. Preliminary evidence suggests that "MAFLD" is more practical than "NAFLD" for capturing those with a high risk of liver disease progression. Nevertheless, additional studies are awaited to either confirm or disprove this notion, with special regard to the risk of HCC.

Clinicians, drug industries, health authorities, nurses, patients and researchers are now faced with novel challenges regarding evaluation and validation of this novel nomenclature. Is this functional? Is it feasible in research and clinical practice? Will it help to identify a more homogeneous subset of NAFLD patients amenable to the benefit of more effective treatment approaches than the disappointing ones we have tested so far? Shall we avoid that NAFLD and MAFLD are used interchangeably? Shall we have to re-write all that we know regarding NAFLD? Does MAFLD specifically add to the risk of HCC?

Against this intriguing backdrop, Hepatoma Research is willing to contribute to this extensive clinical and academic debate by publishing a special issue entitled “From NAFLD to MAFLD: the Dawn of a New Era?”. This special issue specifically focuses on the NAFLD-MAFLD comparative analysis and accurate scrutiny of the pros and cons of the novel nomenclature.

We cordially invite all those who work in this field to submit their articles (Original Articles, Reviews, Commentaries, Editorials) for publication in Hepatoma Research. Special emphasis will be given to the risk of developing HCC in MAFLD, systemic and hepatic molecular mechanisms involved in hepatic carcinogenesis, as well as biomarkers of early HCC and other clinical and translational topics.

1. Primary and secondary NAFLD/MAFLD: similarities and differences
2. Sex differences in NAFLD/MAFLD
3. Personalized diagnosis and management
4. Genetics of NAFLD/MAFLD
5. Natural course of disease
6. NAFLD/MAFLD, hepatic and extra-hepatic cancer
7. NAFLD/MAFLD and cardio-nephro-metabolic risk: fact of fiction?
8. Histology versus non-invasive assessment: when and for whom?
9. Biomarkers
10. Role of conventional ultrasonography and novel imaging techniques in the initial and follow-up assessment


1. Sanja Stojsavljevic-Shapeski  Department of Gastroenterology and Hepatology, Sisters of Charity University Hospital Center, Zagreb, Croatia.
2. Azriyanti binti Anuar Zaini  Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
3. Rosa Lombardi  Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, Policlinico Hospital, University of Milan, Milan, Italy.
4. Ioanna Panagiota Kalafati  Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Athens, Greece.
5. Mazen Noureddin  Division of Digestive and Liver Diseases, Comprehensive Transplant Program, Cedars-Sinai Medical Center, Los Angeles, California, USA.
6. Matthew J. Armstrong  Liver Transplant Unit, Queen Elizabeth University Hospitals Birmingham, Birmingham, UK.
7. Jonathan P Jacobs  The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
8. Chandra S Bhati  Departments of Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, USA.
9. Benash Altaf  Department of Physiology, Aziz Fatimah Medical and Dental College, Faisalabad, Pakistan.
10. Alessandro Mantovani  Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
11. Zhang Lili  Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
12. Giovanni Targher  Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
The list is arranged in no particular order and being updated.

Submission Deadline

15 Apr 2021

Submission Information

Articles of special issue are free of charge for article processing.
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Submission Deadline: 15 Apr 2021
Contacts: Delphine Wong, Assistant Editor,

Published Articles

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