Dr. Anton Titov, MD.: Professor Friedman, what is the future in liver disease treatment? Fatty liver disease treatment, NASH treatment, and Hepatology in general. You wrote a very thorough review and you are a leading, world-renowned researcher on liver diseases. It's a very exciting time. And it's worth looking at the arc of progress over the course of my career as an example of how far we've come and how far we might still go. You know, when I was a liver Fellow at UCSF in the early 1980s, we basically had no specific treatments for liver disease. Dr. Anton Titov, MD.: What we had were diuretics or water pills, Lasix, and Aldactone. We had corticosteroids if we thought that there was a lot of inflammation in the liver. We had prednisone. We had a syrup called Lactulose, to try to change the risk of altered thinking in patients with very advanced liver disease. And we had no liver transplantation. So fast forward now to 35 to 40 years. We have liver transplantation which is life-saving. We have curative therapies for hepatitis C, which wasn't even known about. The Hepatitis C virus wasn't even discovered in the early 80s. Here we went from discovering the virus to curing it. For Hepatitis B now we have many effective therapies, and newer drugs are trying to clear the virus, which we haven't succeeded in doing for hepatitis B yet. We have treatments for biliary disease. We have a better understanding of genetics. I mean, it's just unrecognizable how far we have come. Dr. Scott Friedman, MD.: But I do believe that the liver has many secrets still to yield. I think among the prospects that not necessarily for NASH, but for liver disease. I'm very excited about prospects of Xenotransplantation. It is having humanized organ donation from mammals, particularly pigs. As you know, there was a very high-profile transplant of a pig heart, a humanized pig heart into a man recently at the University of Maryland, I think in late 2021. As far as I know, the patient is still doing okay. Dr. Scott Friedman, MD.: But it does speak to the idea that the terrible organ shortage that we confront in patients who need donor organs with advanced liver disease may be somewhat addressed by the availability of Xenotransplantation. Now, there are still lots of hurdles to overcome. The biggest risk, of course, is rejection. Dr. Scott Friedman, MD.: But also, the pig genome has endogenous retroviruses that need to be cleared out of their genome using CRISPR or other gene therapy techniques before that organ can be safe to transplant to humans. Dr. Scott Friedman, MD.: But I do think Xenotransplantation could be a major game-changer for the most advanced patients. Dr. Scott Friedman, MD.: But at the same time, I'm confident we're going to have anti-fibrotic liver therapies. We will have more effective anti-inflammatory therapies. We can already reduce liver fat. I actually think that the liver greatest mystery is regeneration. This is not just me. The liver's greatest mystery is the ability of the liver to regenerate. You can literally surgically resect two-thirds of a healthy human liver. You can take the resected specimen with attached blood vessels. And you can put that into a recipient. And the remaining 1/3 of the liver that was left behind in the donor will grow back to full size. Now that only happens if the liver is healthy, Dr. Scott Friedman, MD.: But no other organ can regenerate. And so, I believe that liver regeneration and the ability to suppress fibrosis as the liver regenerates holds an array of secrets that could have a profound impact on both understandings and ultimately treating liver disease and perhaps promoting regeneration. And there are already some pro-regenerative therapies that are in clinical trials. So we're not that far off. And I just think about the idea of the Yin-Yang between blocking fibrosis while regenerating. Dr. Anton Titov, MD.: How the liver knows to do that? It harbors a lot of important clues that we need to dig deep to find.