Letter to the Editor: Immune-transcriptomic profiles in peripheral blood mononuclear cells highlight early dysregulation in adolescent non-alcoholic fatty liver disease

Abstract

We read with interest the recent study by Zeber-Lubecka et al, published in the World Journal of Hepatology, investigating transcriptome profiles of peripheral blood mononuclear cells (PBMCs) in male adolescents with non-alcoholic fatty liver disease (NAFLD). To maintain consistency with the original publication, we retain the term “NAFLD” throughout this commentary, while recognizing the recent shift toward the MASLD nomenclature. The authors stimulated PBMCs ex vivo with autologous fecal extracts to explore immune-microbiota interactions. Their results revealed distinct transcriptomic and cytokine patterns, including elevated pro-inflammatory mediators indicative of early immune dysregulation. These findings underscore the impact of host-specific gut microbiota on systemic immunity and suggest that PBMC-based immune signatures could serve as minimally invasive biomarkers. This work provides valuable insights into gut-immune crosstalk in pediatric NAFLD and offers a foundation for future research on early diagnosis and therapeutic strategies.

Keywords: Adolescent non-alcoholic fatty liver disease; Peripheral blood mononuclear cells; Immune dysregulation; Gut-liver axis; Transcriptomic profiling

Core Tip: This letter highlights early immune disturbances in adolescents with non-alcoholic fatty liver disease (NAFLD) revealed through transcriptomic and cytokine analysis of peripheral blood mononuclear cells (PBMCs). By exposing PBMCs to autologous fecal extracts, the study recreated gut-liver interactions in vitro, demonstrating how host-specific microbiota shape systemic immune responses. These results suggest that PBMC-derived immune signatures could serve as minimally invasive biomarkers and inform the development of personalized diagnostic and therapeutic strategies in pediatric NAFLD.