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Updated: Mar 7, 2026
Incorporation of a Survivable Liver Biopsy Procedure in Mice to Assess Non-alcoholic Steatohepatitis NASH Resolution
Published on: April 16, 2019
Endoscopic gastric remodeling and its histologic impact on metabolic dysfunction-associated steatohepatitis: a
Pichamol Jirapinyo1, David J Papke2, Guadalupe Garcia-Tsao3
1Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Background And Aims:
Weight loss through lifestyle modification or glucagon-like peptide-1 receptor agonists (GLP-1RAs) is first-line therapy for metabolic dysfunction-associated steatohepatitis (MASH). However, few subjects achieve sufficient weight loss with lifestyle changes, and long-term medication use limits GLP-1RA adoption. This study evaluated the effect of endoscopic gastric remodeling (EGR), a 1-time, minimally invasive intervention, on MASH histologic features.
Methods:
In this 12-month prospective study, subjects with obesity and biopsy-proven MASH with fibrosis underwent EGR using the U.S. Food and Drug Administration-cleared endoscopic plication device. Baseline and follow-up assessments included EUS-guided liver biopsy and portosystemic pressure gradient measurement.
Results:
Twenty subjects underwent EGR; 13 completed 12-month follow-up. Median weight decreased by 16.5%, with 73% achieving ≥10% total weight loss. MASH resolution occurred in 46%, fibrosis improvement in 54%, and nonalcoholic fatty liver disease Activity Score improved in 85%, with significant reductions in portosystemic pressure gradient. No serious adverse events occurred.
Conclusions:
EGR improves histologic MASH and fibrosis and represents a promising minimally invasive therapy.
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