Biologic therapies have revolutionized the treatment of severe allergic diseases, including asthma, atopic dermatitis (AD), chronic spontaneous urticaria (CSU), chronic rhinosinusitis with nasal polyps (CRSwNP), eosinophilic gastrointestinal diseases (EGIDs), and allergic rhinitis (AR). These molecularly targeted agents provide significant benefits for patients unresponsive to conventional treatments by addressing underlying immune mechanisms, particularly type 2 inflammation driven by cytokines such as IL-4, IL-5, and IL-13. Recent advancements include biologics targeting alarmins like thymic stromal lymphopoietin (TSLP) and IL-33, which may address both type 2 and non-type 2 inflammation, broadening their therapeutic scope. Despite their effectiveness, biologics remain expensive, posing socioeconomic challenges, and there are concerns regarding long-term safety and inter-individual variability in responses. Promising innovations such as bispecific antibodies and ultra-long-acting agents are under investigation, alongside digital health tools like remote biomarker monitoring and AI-driven decision support systems, which aim to enhance personalized care. However, disparities in access, particularly for underserved populations, underscore the need for policy reforms and affordable biosimilars. This review synthesizes recent findings and emerging trends, highlighting the evolving role of biologics in transforming allergic disease management and offering insights into future research directions.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and affects nearly 30% of the adult population and 10% of the pediatric population. It is estimated that this number will double by 2030. MASLD is one of the leading causes of hepatocellular carcinoma, cirrhosis, and liver transplantation, as well as a significant risk factor for cardiovascular disease and mortality. Due to the ever-increasing number of patients, the long-term asymptomatic course of the disease, serious complications, and lack of preventive programs, as well as insufficient awareness of the disease among patients and doctors themselves, MASLD is a growing interdisciplinary problem and a real challenge for modern medicine. The main cause of MASLD is an inappropriate lifestyle—inadequate nutrition and insufficient physical activity, which lead to various components of metabolic syndrome. Lifestyle changes—appropriate diet, weight reduction, and systematic physical activity—are also the basis for the prevention and treatment of MASLD. Hence, in recent years, so much importance has been attached to lifestyle medicine, to non-pharmacological treatment as prevention of lifestyle diseases. The narrative review presents possible therapeutic options for non-pharmacological management in the prevention and treatment of MASLD. The best documented and available diets used in MASLD were discussed, focusing on the benefits and drawbacks of the Mediterranean, high-protein, ketogenic, and intermittent fasting diets. In addition, the most recent recommendations regarding physical activity are summarized.

Diabetes and obesity have been recognized as confirmed risk factors for the occurrence of liver fibrosis. Despite the long-standing acknowledgment of “diabesity”, the simultaneous existence of diabetes and obesity, scholarly literature has shown limited attention to this topic. The aim of this pilot study was to assess the prevalence of liver fibrosis among individuals with diabetes (specifically those who are obese) in order to identify the key factors associated with hepatofibrosis and determine the most important associations and differences between patients with and without liver fibrosis. The research included a total of 164 participants (48.17% had comorbid obesity). Liver elastography (Fibroscan) was performed on these individuals in addition to laboratory tests. Liver fibrosis was found in 34.76% of type 2 diabetes patients; male gender almost doubled the risk of hepatofibrosis (RR 1.81) and diabesity nearly tripled this risk (RR 2.81; however, in degree III of obesity, the risk was elevated to 3.65 times higher). Anisocytosis, thrombocytopenia, or elevated liver enzymes raised the incidence of liver fibrosis by 1.78 to 2.47 times. In these individuals, liver stiffness was negatively correlated with MCV, platelet count, and albumin concentration; GGTP activity and HbA1c percentage were positively correlated. The regression analysis results suggest that the concentration of albumin and the activity of GGTP are likely to have a substantial influence on the future management of liver fibrosis in patients with diabesity. The findings of this study can serve as the basis for subsequent investigations and actions focused on identifying potential therapeutic and diagnostic avenues.

Metabolic-associated fatty liver disease (MAFLD) has become a very significant health problem worldwide, characterized by hepatic steatosis and systemic metabolic disturbances. Grasping the complex interaction between the intestine and liver, referred to as the gut-liver axis, is crucial to decipher the pathogenesis of MAFLD and identify potential therapeutic targets. Probiotics, which are live microorganisms offering health benefits, have garnered attention for their potential in treating MAFLD. A literature search in PubMed and Google Scholar using "MAFLD," "NAFLD," "probiotics," and "gut microbiota" yielded 642 studies; 32 clinical trials met the inclusion criteria for the final analysis. This review encapsulates the current knowledge of MAFLD pathophysiology, emphasizing the role of the gut-liver axis, and assesses the clinical evidence supporting probiotic treatments for MAFLD. The mechanisms of action of probiotics are explored, including their ability to modulate gut microbiota composition, enhance epithelial barrier function, and influence the immune response. Various randomized controlled trials have shown that probiotics are effective in enhancing several aspects of MAFLD, such as liver enzymes, lipid profiles, body mass index, insulin sensitivity, or even histological efficacy. However, mixed results have been reported in some clinical trials, highlighting the need for further research to optimize probiotic interventions. Future investigations should focus on standardized protocols, personalized approaches and exploring synergistic combinations with other therapeutic modalities to maximize the potential of probiotics in the treatment of MAFLD.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and affects nearly 30% of the adult population and 10% of the paediatric population. It is estimated that this number will double by 2030. MASLD is one of the leading causes of hepatocellular carcinoma, cirrhosis and liver transplantation, as well as a significant risk factor for cardiovascular disease - heart attack or stroke being the leading cause of death in this group of patients. Due to the ever-increasing number of patients, the long-term asymptomatic course of the disease, serious complications and lack of preventive programmes, as well as insufficient awareness of the disease among patients and doctors themselves, MASLD is a growing interdisciplinary problem and a real challenge for modern medicine. The main cause of MASLD is an inappropriate lifestyle - inadequate nutrition and too little physical activity, which lead to metabolic disorders - overweight and obesity, pre-diabetes and diabetes, hypertension, lipid disorders. Lifestyle changes - appropriate, diet, weight reduction and systematic physical activity - are also the basis for the prevention and treatment of MASLD. Hence, in recent years, so much importance has been attached to lifestyle medicine, to non-pharmacological treatment as prevention of lifestyle diseases. This paper presents methods of non-pharmacological management in the prevention and treatment of MASLD.

Metabolic dysfunction-associated steatotic liver disease -MASLD, is the most common chronic liver disease worldwide, one of the leading causes of cirrhosis, hepatocellular carcinoma and liver transplantation in developed countries, and an important cardiovascular risk factor. It affects about 30% of the adult population and about 10% of the paediatric population. These figures may be underestimated due to the long-standing asymptomatic or sparse course of the disease, the lack of nationwide screening for MASLD in patients with risk factors for its development and the low awareness of both patients and physicians themselves. According to projections, this number could double by 2030 due to the growing obesity epidemic and the associated development of other weight-dependent metabolic complications, such as insulin resistance, pre-diabetic state, type 2 diabetes, lipid disorders and hypertension. The basis for prevention and treatment of MASLD is weight reduction with diet and regular physical activity and modern pharmacotherapy for obesity-related disease, as well as treatment aimed at reducing the cardiometabolic factors - diabetes, hyperlipidaemia and hypertension. Pharmacological treatment of hepatic steatosis, steatohepatitis or liver fibrosis alone is limited, and many drugs are currently in clinical trials. This article presents the current pharmacological options and potential pharmacotherapy pathways for the hepatic complications of MASLD - steatosis, steatohepatitis and incipient liver fibrosis.