Pub Date : 2023-10-09DOI: 10.31146/1682-8658-ecg-216-8-24-26
L. B. Lazebnik
The international working group “Multi-Society and Multi-Stakeholder Consensus Revision of the NAFLD Nomenclature” proposed to replace the widely used term NAFLD - Non-alcoholic fatty liver disease with SLD - Steatotic Liver Disease - Steatous Liver Disease, using it in the form of an “umbrella” to include in this concept Metabolic and Alcoholic liver disease, its drug lesions and severe systemic diseases of the hepatic parenchyma.
{"title":"Steatotic liver disease - an international interpretation of the concept an “umbrella” for all diseases of the hepatic parenchyma","authors":"L. B. Lazebnik","doi":"10.31146/1682-8658-ecg-216-8-24-26","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-24-26","url":null,"abstract":"The international working group “Multi-Society and Multi-Stakeholder Consensus Revision of the NAFLD Nomenclature” proposed to replace the widely used term NAFLD - Non-alcoholic fatty liver disease with SLD - Steatotic Liver Disease - Steatous Liver Disease, using it in the form of an “umbrella” to include in this concept Metabolic and Alcoholic liver disease, its drug lesions and severe systemic diseases of the hepatic parenchyma.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.31146/1682-8658-ecg-216-8-151-166
E. V. Loshkova, E. I. Kondratyeva, A. I. Khavkin, E. K. Zhekaite, Yu. V. Kotova, Yu. L. Melyanovskaya, M. I. Erokhina, E. A. Yablokova, V. A. Zhelev
The study of cytokine production and its genetic regulation in diseases of various pathogenesis in childhood, which include several mechanisms of inflammation - this is autoimmune against the background of celiac disease, type 1 diabetes and CAI, lymphoproliferative against the background of oncohematological diseases, microbial-inflammatory against the background of chronic pyelonephritis and cystic fibrosis and metabolic against the background of obesity and a decrease in bone mineral density is necessary to expand understanding of pathogenesis, predict variants of the clinical course of diseases (clinical phenotypes) and complications, as well as response to therapy. The literature review is devoted to the analysis and interpretation of data on the effect of vitamin D supply and its genetic regulation on the course of diseases, combined according to the leading pathogenetic mechanism of inflammation into autoimmune, microbial, and lymphoproliferative models.
{"title":"Vitamin D: genetic regulation of inflammation in autoimmune, metabolic and microbial models","authors":"E. V. Loshkova, E. I. Kondratyeva, A. I. Khavkin, E. K. Zhekaite, Yu. V. Kotova, Yu. L. Melyanovskaya, M. I. Erokhina, E. A. Yablokova, V. A. Zhelev","doi":"10.31146/1682-8658-ecg-216-8-151-166","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-151-166","url":null,"abstract":"The study of cytokine production and its genetic regulation in diseases of various pathogenesis in childhood, which include several mechanisms of inflammation - this is autoimmune against the background of celiac disease, type 1 diabetes and CAI, lymphoproliferative against the background of oncohematological diseases, microbial-inflammatory against the background of chronic pyelonephritis and cystic fibrosis and metabolic against the background of obesity and a decrease in bone mineral density is necessary to expand understanding of pathogenesis, predict variants of the clinical course of diseases (clinical phenotypes) and complications, as well as response to therapy. The literature review is devoted to the analysis and interpretation of data on the effect of vitamin D supply and its genetic regulation on the course of diseases, combined according to the leading pathogenetic mechanism of inflammation into autoimmune, microbial, and lymphoproliferative models.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.31146/1682-8658-ecg-216-8-86-92
M. V. Sargsyan, A. O. Melikyan, O. A. Melikyan
In this paper we discuss classical types of acute glomerulonephritis in young adults, when the intake of paracetamol and diclofenac led to a dysfunctional and organic liver injury, at the same time it negatively affected the course of acute glomerulonephritis. To study the characteristics of the development of acute reno-cardial syndrome (ARCS) Goal: Assessment of cause and effect relations of renal, hearts and liver injuries in young adults in acute post-streptococcal glomerulonephritis (APSG). With acute nephritic syndrome (ANS) complicated by acute kidney injury (AKI) and without it, to identify the role of the etiological factor on the course of APSG. Methods and Material: 220 male patients with APSG with ANS aged 18-20 were examined. The patients were divided into 2 groups based on the functional state of kidneys. The first group included 140 patients with APSG without ANS, the second group included 80 patients with AKI. Results: Out 66 patients had subclinical liver injury, which resulted from the effect of antipyretic hepatotoxic drugs taken in the initial stage of the disease. Due to the toxic and immunological liver injury, levels of transaminases increase, and albumin levels decrease. These changes occur along with the development of APSG and are correlated with some laboratory values. Impairment of cardiovascular function was observed in all 220 patients. ECG and Echocardiography studies conducted during the cardiac asthma attacks occurred as a decrease of voltage, broadening of the P wave, lengthening of the PQ interval, broadening of the QRS complex, dilatations of the right and left atrium. The severity of clinical manifestations of AKI and ARCS correlates with the degree of macrohematuria, GFR decrease, complement C3 fraction, monocyte. Conclusion. In APSG liver injury has a toxicoallergic character. Frequency of liver injury depends on specific features of a particular organism, it does not depend on the dose of the taken drug. In case of any type of acute glomerulonephritis it is necessary to assess the functional state of liver and after the treatment of the main disease hepatologist follow-up of patients is recommended. Thus in the development of acute reno-cardial syndrome (ARCS) the degree of manifestation of hypervolemia with hypertension, as a result of active immune inflammation of the glomerular apparatus with the development of AKI, plays the main role in the development of ARCS with APSG.. As a rule ARCS in case of APSG with ANS in young adults has a successful outcome.
{"title":"Hepatorenal and renocardial syndrome in young patients with acute glomerulonephritis","authors":"M. V. Sargsyan, A. O. Melikyan, O. A. Melikyan","doi":"10.31146/1682-8658-ecg-216-8-86-92","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-86-92","url":null,"abstract":"In this paper we discuss classical types of acute glomerulonephritis in young adults, when the intake of paracetamol and diclofenac led to a dysfunctional and organic liver injury, at the same time it negatively affected the course of acute glomerulonephritis. To study the characteristics of the development of acute reno-cardial syndrome (ARCS) Goal: Assessment of cause and effect relations of renal, hearts and liver injuries in young adults in acute post-streptococcal glomerulonephritis (APSG). With acute nephritic syndrome (ANS) complicated by acute kidney injury (AKI) and without it, to identify the role of the etiological factor on the course of APSG. Methods and Material: 220 male patients with APSG with ANS aged 18-20 were examined. The patients were divided into 2 groups based on the functional state of kidneys. The first group included 140 patients with APSG without ANS, the second group included 80 patients with AKI. Results: Out 66 patients had subclinical liver injury, which resulted from the effect of antipyretic hepatotoxic drugs taken in the initial stage of the disease. Due to the toxic and immunological liver injury, levels of transaminases increase, and albumin levels decrease. These changes occur along with the development of APSG and are correlated with some laboratory values. Impairment of cardiovascular function was observed in all 220 patients. ECG and Echocardiography studies conducted during the cardiac asthma attacks occurred as a decrease of voltage, broadening of the P wave, lengthening of the PQ interval, broadening of the QRS complex, dilatations of the right and left atrium. The severity of clinical manifestations of AKI and ARCS correlates with the degree of macrohematuria, GFR decrease, complement C3 fraction, monocyte. Conclusion. In APSG liver injury has a toxicoallergic character. Frequency of liver injury depends on specific features of a particular organism, it does not depend on the dose of the taken drug. In case of any type of acute glomerulonephritis it is necessary to assess the functional state of liver and after the treatment of the main disease hepatologist follow-up of patients is recommended. Thus in the development of acute reno-cardial syndrome (ARCS) the degree of manifestation of hypervolemia with hypertension, as a result of active immune inflammation of the glomerular apparatus with the development of AKI, plays the main role in the development of ARCS with APSG.. As a rule ARCS in case of APSG with ANS in young adults has a successful outcome.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.31146/1682-8658-ecg-216-8-48-56
V. T. Tran, I. Yu. Torshin, O. A. Gromova
Aim. Evaluation of the efficacy and safety of human placenta hydrolyzate (HPH) Laennec in the treatment of non-alcoholic fatty liver disease (NAFLD) in an experimental and clinical study. Material and methods. An experimental study was carried out on NAFLD models reproducible by administering various doses of CCl4 to rats. The clinical study involved patients with NAFLD (n=60, mean age 47±9 years) who were on a standard diet of the military hospital of the Republic of Vietnam. Half of the patients (n=30) received Laennec (2 ml/day IM, 4 weeks), while the other half were in the control group. The collected results were analyzed by standard methods of mathematical statistics. Results. Studies in a preclinical model of NAFLD in rats showed a significant reduction in the progression of liver fibrosis against the background of improved lipid metabolism. No negative effects of HPH on the nervous, cardiovascular and respiratory systems of animals have been established. In a clinical study, the mean levels of liver dysfunction markers (AST, ALT, GGT) of patients with NAFLD at the time of treatment initiation in both groups were significantly higher than the normal range (AST - 111±12 U/l, ALT - 103±8 U/l, GGT - 462±60 IU/l). The use of Laennec led to a significant decrease in the incidence of NAFLD symptoms (fatigue, a feeling of bloating in the abdominal cavity, anorexia) and a decrease in the levels of AST, ALT, GGT after a day of the therapy week. After 2 weeks of HLP therapy, there was a significant decrease in the levels of AST (53±4 U/l, control: 99±14 U/l, P<0.001), ALT (71±6 U/l, control: 92±7 U/l, P<0.001) and GGT (260±21 IU/l, control: 384±74 U/l, P<0.001). After 4 weeks of treatment, the parameters significantly decreased towards the lower limit of the normal interval: AST - 45±4 U/l, ALT - 52±5 U/l, GGT - 191±19 IU/l (all P<0.05 compared with the values at 2nd week) against the background of the absence of positive dynamics in the levels of AST, ALT, GGT in the control group. The use of the drug did not cause statistically significant changes in the parameters of clinical or laboratory hematological examination, urinalysis results, levels of other liver enzymes, as well as vital signs. Multivariate analysis showed that the effects of HPH are practically independent of age, gender, medical history, initial levels of AST, ALT, GGT, and other parameters of the biochemical blood test of patients. Conclusion. HPH Laennec is an effective and safe monotherapy for NAFLD.
{"title":"An open-label, controlled trial of the efficacy and safety of Laennec to improve liver function in patients with non-alcoholic fatty liver disease","authors":"V. T. Tran, I. Yu. Torshin, O. A. Gromova","doi":"10.31146/1682-8658-ecg-216-8-48-56","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-48-56","url":null,"abstract":"Aim. Evaluation of the efficacy and safety of human placenta hydrolyzate (HPH) Laennec in the treatment of non-alcoholic fatty liver disease (NAFLD) in an experimental and clinical study. Material and methods. An experimental study was carried out on NAFLD models reproducible by administering various doses of CCl4 to rats. The clinical study involved patients with NAFLD (n=60, mean age 47±9 years) who were on a standard diet of the military hospital of the Republic of Vietnam. Half of the patients (n=30) received Laennec (2 ml/day IM, 4 weeks), while the other half were in the control group. The collected results were analyzed by standard methods of mathematical statistics. Results. Studies in a preclinical model of NAFLD in rats showed a significant reduction in the progression of liver fibrosis against the background of improved lipid metabolism. No negative effects of HPH on the nervous, cardiovascular and respiratory systems of animals have been established. In a clinical study, the mean levels of liver dysfunction markers (AST, ALT, GGT) of patients with NAFLD at the time of treatment initiation in both groups were significantly higher than the normal range (AST - 111±12 U/l, ALT - 103±8 U/l, GGT - 462±60 IU/l). The use of Laennec led to a significant decrease in the incidence of NAFLD symptoms (fatigue, a feeling of bloating in the abdominal cavity, anorexia) and a decrease in the levels of AST, ALT, GGT after a day of the therapy week. After 2 weeks of HLP therapy, there was a significant decrease in the levels of AST (53±4 U/l, control: 99±14 U/l, P<0.001), ALT (71±6 U/l, control: 92±7 U/l, P<0.001) and GGT (260±21 IU/l, control: 384±74 U/l, P<0.001). After 4 weeks of treatment, the parameters significantly decreased towards the lower limit of the normal interval: AST - 45±4 U/l, ALT - 52±5 U/l, GGT - 191±19 IU/l (all P<0.05 compared with the values at 2nd week) against the background of the absence of positive dynamics in the levels of AST, ALT, GGT in the control group. The use of the drug did not cause statistically significant changes in the parameters of clinical or laboratory hematological examination, urinalysis results, levels of other liver enzymes, as well as vital signs. Multivariate analysis showed that the effects of HPH are practically independent of age, gender, medical history, initial levels of AST, ALT, GGT, and other parameters of the biochemical blood test of patients. Conclusion. HPH Laennec is an effective and safe monotherapy for NAFLD.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.31146/1682-8658-ecg-216-8-134-140
R. A. Nasyrov, Yu. A. Fominykh, E. Yu. Kalinina, O. A. Kizimova, D. P. Kovtun, E. V. Shcherbakova, O. S. Minina, A. P. Zavitaeva
The review article discusses the modern pathogenetic links of biliary gastritis, namely the role of endothelial dysfunction, intestinal metaplasia in inflammation and the influence of Helicobacter pylori infection. The problem of combined damage to the mucous membrane of HP-associated and biliary gastritis remains relevant, since modern foreign studies have not come to a consensus, but most authors state increased carcinogenesis of the stomach with a positive HP status against the background of the course of pathological duodenogastric reflux. The article also presents original materials of histological examination of biliary, HP-associated, autoimmune and hyperplastic gastritis with similar morphological features, thereby demonstrating the difficulties of differential diagnosis.
{"title":"Biliary gastritis. Pathomorphological features and differential diagnosis","authors":"R. A. Nasyrov, Yu. A. Fominykh, E. Yu. Kalinina, O. A. Kizimova, D. P. Kovtun, E. V. Shcherbakova, O. S. Minina, A. P. Zavitaeva","doi":"10.31146/1682-8658-ecg-216-8-134-140","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-134-140","url":null,"abstract":"The review article discusses the modern pathogenetic links of biliary gastritis, namely the role of endothelial dysfunction, intestinal metaplasia in inflammation and the influence of Helicobacter pylori infection. The problem of combined damage to the mucous membrane of HP-associated and biliary gastritis remains relevant, since modern foreign studies have not come to a consensus, but most authors state increased carcinogenesis of the stomach with a positive HP status against the background of the course of pathological duodenogastric reflux. The article also presents original materials of histological examination of biliary, HP-associated, autoimmune and hyperplastic gastritis with similar morphological features, thereby demonstrating the difficulties of differential diagnosis.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135142969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.31146/1682-8658-ecg-216-8-27-36
L. V. Tarasova, Yu. V. Tsyganova
Metabolic syndrome is a series of pathologies united by a similar pathogenesis, the end of which, most often, is cardiovascular accidents, which are leaders among the causes of death in the population around the world. Non-alcoholic fatty liver disease (NAFLD) is the hepatic equivalent of the metabolic syndrome, registered earlier than all other equivalents, on the rights of the liver as a first-line energy depot. At the same time, according to multicenter studies, 95% of people with NAFLD (any stage) are not diagnosed with the disease. Clarification of additional risk factors for NAFLD and the presence of a specific biomarker of non-alcoholic liver steatosis would make it possible to stop the vicious cascade of metabolic processes, which in the future can lead to a significant increase in the life expectancy of the population. The potentially high role of Secreted Frizzled Related Protein-4 (SFRP4) adipokine in the early diagnosis of NAFLD is known. The aim of the study was to optimize the early diagnosis of non-alcoholic fatty liver disease using modern indices and biomarkers. Materials and methods. The work was carried out at the Department of Faculty and Hospital Therapy of the Chuvash State University named after I. N. Ulyanov” in the period from 2016 to 2020. This study included several stages: first of all, a retrospective analysis of 1150 outpatient records of patients from several medical organizations of the Chuvash Republic for the period 2016-2018 was carried out. to form two study groups: experimental and control. At the second stage, as a result of applying the exclusion criteria, 162 people remained in the experiment: 110 from the experimental group, 52 from the control group. The subjects of both groups were compared by gender and age, the age range of the subjects varied from 18 to 80 years old with an average value of 48.3 years. Further, the patients undergo a detailed examination, according to the presented plan: Collection of complaints, medical history, objective examination. Laboratory studies (general and biochemical blood tests, lipidogram, assessment of the level of serum adipokine SFRP4). Instrumental studies (ultrasound of the OBP, TE (SAR), ESP with elastometry). Evaluation of the most informative complex indices for the early diagnosis of NAFLD: MI, IVO indices, HSI, FLD-I. Further, all the necessary statistical processing and analysis of the obtained data were performed (Microsoft Office Excel 2016, StatTech v. 2.8.8 (developer - Stattech LLC, Russia)). Results. Accessible (not requiring the use of additional time and material costs) NAFLD indices with the highest sensitivity rates (99.1% and 98.2%, respectively) were MI and IVO. A noticeable direct correlation was traced between MI (p=0.640), moderate - between the IVO (p=0.398) and the elastographically determined index of non-alcoholic liver steatosis. High sensitivity and specificity of skin manifestations (xanthoma, xanthelasma - 69.6% and 89.7% and seborrheic
{"title":"Early diagnosis of non-alcoholic fatty liver disease: the role of biomarkers and complex indices of non-alcoholic fatty liver steatosis","authors":"L. V. Tarasova, Yu. V. Tsyganova","doi":"10.31146/1682-8658-ecg-216-8-27-36","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-27-36","url":null,"abstract":"Metabolic syndrome is a series of pathologies united by a similar pathogenesis, the end of which, most often, is cardiovascular accidents, which are leaders among the causes of death in the population around the world. Non-alcoholic fatty liver disease (NAFLD) is the hepatic equivalent of the metabolic syndrome, registered earlier than all other equivalents, on the rights of the liver as a first-line energy depot. At the same time, according to multicenter studies, 95% of people with NAFLD (any stage) are not diagnosed with the disease. Clarification of additional risk factors for NAFLD and the presence of a specific biomarker of non-alcoholic liver steatosis would make it possible to stop the vicious cascade of metabolic processes, which in the future can lead to a significant increase in the life expectancy of the population. The potentially high role of Secreted Frizzled Related Protein-4 (SFRP4) adipokine in the early diagnosis of NAFLD is known. The aim of the study was to optimize the early diagnosis of non-alcoholic fatty liver disease using modern indices and biomarkers. Materials and methods. The work was carried out at the Department of Faculty and Hospital Therapy of the Chuvash State University named after I. N. Ulyanov” in the period from 2016 to 2020. This study included several stages: first of all, a retrospective analysis of 1150 outpatient records of patients from several medical organizations of the Chuvash Republic for the period 2016-2018 was carried out. to form two study groups: experimental and control. At the second stage, as a result of applying the exclusion criteria, 162 people remained in the experiment: 110 from the experimental group, 52 from the control group. The subjects of both groups were compared by gender and age, the age range of the subjects varied from 18 to 80 years old with an average value of 48.3 years. Further, the patients undergo a detailed examination, according to the presented plan: Collection of complaints, medical history, objective examination. Laboratory studies (general and biochemical blood tests, lipidogram, assessment of the level of serum adipokine SFRP4). Instrumental studies (ultrasound of the OBP, TE (SAR), ESP with elastometry). Evaluation of the most informative complex indices for the early diagnosis of NAFLD: MI, IVO indices, HSI, FLD-I. Further, all the necessary statistical processing and analysis of the obtained data were performed (Microsoft Office Excel 2016, StatTech v. 2.8.8 (developer - Stattech LLC, Russia)). Results. Accessible (not requiring the use of additional time and material costs) NAFLD indices with the highest sensitivity rates (99.1% and 98.2%, respectively) were MI and IVO. A noticeable direct correlation was traced between MI (p=0.640), moderate - between the IVO (p=0.398) and the elastographically determined index of non-alcoholic liver steatosis. High sensitivity and specificity of skin manifestations (xanthoma, xanthelasma - 69.6% and 89.7% and seborrheic ","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.31146/1682-8658-ecg-216-8-184-190
S. A. Chepurnenko, A. D. Nasytko, G. V. Shavkuta
Introduction. An increase in bilirubin and liver enzyme activity may be one of the side effects of statin therapy, often occurring in patients after AMI and coronary artery stenting, or in high and very high risk individuals on high and moderate intensity statin therapy. The frequency of occurrence of increased transaminases and bilirubin is according to different authors. Therefore, in terms of differential diagnosis, the cardiologist should consider Gilbert’s syndrome as a possible cause of hyperbilirubinemia. Description of the clinical case. The article considers a clinical case of differential diagnosis of non-conjugated hyperbilirubinemia detected in a patient after coronary artery stenting. The level of hemoglobin, erythrocytes, reticulocytes did not differ from normal values and did not change over time. This made it possible to exclude the hemolytic genesis of hyperbilirubinemia. Genetic testing was used to establish the homozygous form of Gilbert’s syndrome. However, the presence of fibrotic changes in the liver, an increase in not only unconjugated, but also conjugated bilirubin, hypertriglyceridemia, dyslipidemia, and stenosing atherosclerosis of the coronary arteries did not allow us to state that the patient had only Gilbert’s syndrome. Discussion. According to recent studies, this disease is characterized by a benign course and reduces the risk of developing cardiovascular diseases due to the antioxidant effect of bilirubin. In addition to Gilbert’s syndrome, the patient was diagnosed with an erased form of non-alcoholic fatty liver disease associated with metabolic syndrome. Conclusion. The disease was caused by insulin resistance, a high-calorie diet, excess consumption of saturated fats, refined carbohydrates, and a sedentary lifestyle. The drugs of choice in this case are statins, ezetemibe, and ursodeoxycholic acid. Their appointment allows not only to reduce cardiovascular risk, but also to slow down the further progression of liver fibrosis.
{"title":"Differential diagnosis of unconjugated hyperbilirubinemiadetected after coronary artery stenting","authors":"S. A. Chepurnenko, A. D. Nasytko, G. V. Shavkuta","doi":"10.31146/1682-8658-ecg-216-8-184-190","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-184-190","url":null,"abstract":"Introduction. An increase in bilirubin and liver enzyme activity may be one of the side effects of statin therapy, often occurring in patients after AMI and coronary artery stenting, or in high and very high risk individuals on high and moderate intensity statin therapy. The frequency of occurrence of increased transaminases and bilirubin is according to different authors. Therefore, in terms of differential diagnosis, the cardiologist should consider Gilbert’s syndrome as a possible cause of hyperbilirubinemia. Description of the clinical case. The article considers a clinical case of differential diagnosis of non-conjugated hyperbilirubinemia detected in a patient after coronary artery stenting. The level of hemoglobin, erythrocytes, reticulocytes did not differ from normal values and did not change over time. This made it possible to exclude the hemolytic genesis of hyperbilirubinemia. Genetic testing was used to establish the homozygous form of Gilbert’s syndrome. However, the presence of fibrotic changes in the liver, an increase in not only unconjugated, but also conjugated bilirubin, hypertriglyceridemia, dyslipidemia, and stenosing atherosclerosis of the coronary arteries did not allow us to state that the patient had only Gilbert’s syndrome. Discussion. According to recent studies, this disease is characterized by a benign course and reduces the risk of developing cardiovascular diseases due to the antioxidant effect of bilirubin. In addition to Gilbert’s syndrome, the patient was diagnosed with an erased form of non-alcoholic fatty liver disease associated with metabolic syndrome. Conclusion. The disease was caused by insulin resistance, a high-calorie diet, excess consumption of saturated fats, refined carbohydrates, and a sedentary lifestyle. The drugs of choice in this case are statins, ezetemibe, and ursodeoxycholic acid. Their appointment allows not only to reduce cardiovascular risk, but also to slow down the further progression of liver fibrosis.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.31146/1682-8658-ecg-216-8-100-102
Yu. P. Uspensky, N. V. Baryshnikova, Yu. A. Fominykh, S. V. Ivanov, A. A. Gnutov, Z. Kh. Gulunov, Ya. V. Sousova, A. A. Krasnov, V. A. Apryatina, S. V. Petlenko
{"title":"The effectiveness of the innovative drug “Regasthym Gastro” (alpha-glutamyl tryptophan) in the complex treatment of chronic atrophic gastritis","authors":"Yu. P. Uspensky, N. V. Baryshnikova, Yu. A. Fominykh, S. V. Ivanov, A. A. Gnutov, Z. Kh. Gulunov, Ya. V. Sousova, A. A. Krasnov, V. A. Apryatina, S. V. Petlenko","doi":"10.31146/1682-8658-ecg-216-8-100-102","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-100-102","url":null,"abstract":"<jats:p />","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.31146/1682-8658-ecg-216-8-141-150
V. A. Prikhodko, S. V. Okovityi
Glycyrrhizinic acid is a triterpenoid plant-derived compound with potent antisteatotic, anticytolitic, anti-inflammatory, antifibrotic, anticholestatic as well as antiapoptotic, antineoplastic and some other effects. Recent studies have demonstrated glycyrrhizinic acid to form supramolecular self-associates and micelles, which makes it a pharmacokinetic, and, hence, a pharmacodynamic enhancer. Thus, the prospects and possibilities of combined use of glycyrrhizinic acid in liver disease and other pathologies arise due to the pharmacological properties of the molecule itself as well as its function as drug carrier and delivery enhancer. The present review is focused on the pharmacodynamic and pharmacokinetic features of glycyrrhizinic acid combinations with essential phospholipids and ursodeoxycholic acid.
{"title":"Pharmacodynamic and pharmacokinetic aspects of combined use of glycyrrhizinic acid","authors":"V. A. Prikhodko, S. V. Okovityi","doi":"10.31146/1682-8658-ecg-216-8-141-150","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-141-150","url":null,"abstract":"Glycyrrhizinic acid is a triterpenoid plant-derived compound with potent antisteatotic, anticytolitic, anti-inflammatory, antifibrotic, anticholestatic as well as antiapoptotic, antineoplastic and some other effects. Recent studies have demonstrated glycyrrhizinic acid to form supramolecular self-associates and micelles, which makes it a pharmacokinetic, and, hence, a pharmacodynamic enhancer. Thus, the prospects and possibilities of combined use of glycyrrhizinic acid in liver disease and other pathologies arise due to the pharmacological properties of the molecule itself as well as its function as drug carrier and delivery enhancer. The present review is focused on the pharmacodynamic and pharmacokinetic features of glycyrrhizinic acid combinations with essential phospholipids and ursodeoxycholic acid.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.31146/1682-8658-ecg-216-8-103-109
T. A. Samgina
He aim of the study was to determine the role of polymorphisms of the GGT1 gene and environmental risk factors in the acute biliary pancreatitis. The material of the study was DNA samples obtained from 84 patients with ABP and 573 healthy individuals. The disease was diagnosed using clinical guidelines (Russian Society of Surgeons). To assess the associations of alleles and genotypes of the gene with the risk of acute pancreatitis, the χ2 test and the odds ratio (OR) with 95% confidence intervals (CI) were used. Statistical analysis was carried out using the Statistica 10.0 program (StatSoft, USA) and the SNPStats program. Results. It was found that the A/A-G/G rs5760489 and A/A rs4820599 GGT1 genotypes have an increased risk of ABP. The H3 A-A-A-A haplotype is associated with a reduced risk of the disease, while the H6 A-G-A-A haplotype, on the contrary, increases the risk of developing the disease. The absence of exposure to alcohol abuse reduces the risk of ABP in carriers of the genotypes A/G-G/G rs5760489, A/G-G/G rs4820599, smoking -A/G-G/G rs4820599 and A/G-G/G rs5760489. The A/G-G/G rs4820599, G/A-A/A rs5751909 and A/G-G/G rs5760489 genotypes have a protective effect with sufficient consumption of fresh vegetables and fruits, the main suppliers of glutathione to the body. The presence of glutathione deficiency leads to the oxidative stress, and phenotypic changes we found: leukocytosis (allele A, rs5760489), peritonitis (allele A, rs5751909). Conclusion. The GGT1 gene can be used to predict the development and clinical course of acute biliary pancreatitis and its complications.
{"title":"The joint contribution of the GGT1 gene and some haploand phenotypes to the development of acute biliary pancreatitis","authors":"T. A. Samgina","doi":"10.31146/1682-8658-ecg-216-8-103-109","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-103-109","url":null,"abstract":"He aim of the study was to determine the role of polymorphisms of the GGT1 gene and environmental risk factors in the acute biliary pancreatitis. The material of the study was DNA samples obtained from 84 patients with ABP and 573 healthy individuals. The disease was diagnosed using clinical guidelines (Russian Society of Surgeons). To assess the associations of alleles and genotypes of the gene with the risk of acute pancreatitis, the χ2 test and the odds ratio (OR) with 95% confidence intervals (CI) were used. Statistical analysis was carried out using the Statistica 10.0 program (StatSoft, USA) and the SNPStats program. Results. It was found that the A/A-G/G rs5760489 and A/A rs4820599 GGT1 genotypes have an increased risk of ABP. The H3 A-A-A-A haplotype is associated with a reduced risk of the disease, while the H6 A-G-A-A haplotype, on the contrary, increases the risk of developing the disease. The absence of exposure to alcohol abuse reduces the risk of ABP in carriers of the genotypes A/G-G/G rs5760489, A/G-G/G rs4820599, smoking -A/G-G/G rs4820599 and A/G-G/G rs5760489. The A/G-G/G rs4820599, G/A-A/A rs5751909 and A/G-G/G rs5760489 genotypes have a protective effect with sufficient consumption of fresh vegetables and fruits, the main suppliers of glutathione to the body. The presence of glutathione deficiency leads to the oxidative stress, and phenotypic changes we found: leukocytosis (allele A, rs5760489), peritonitis (allele A, rs5751909). Conclusion. The GGT1 gene can be used to predict the development and clinical course of acute biliary pancreatitis and its complications.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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