Pub Date : 2023-10-25DOI: 10.1186/s43066-023-00296-2
Danil I. Peregud, Valeria Yu. Baronets, Anna S. Lobacheva, Alexandr S. Ivanov, Irina V. Garmash, Olga S. Arisheva, Zhanna D. Kobalava, Sergey V. Pirozhkov, Natalia N. Terebilina
Abstract Background and aim Brain-derived neurotrophic factor (BDNF) functions not only in the brain but also in peripheral tissues such as the liver. Genetic factors determine the development of alcohol dependence and somatic consequences of chronic intoxication, especially liver cirrhosis. The BDNF gene polymorphisms are associated with alcohol dependence; however, their relationship with the development of alcohol-related liver cirrhosis (ALC) has not yet been established. This study evaluated the association between single-nucleotide polymorphisms (SNPs) within the BDNF gene and liver cirrhosis in heavy drinkers. Methods BDNF-related SNPs rs925946, rs6265, rs10835210, rs7103411, and rs75945125 were determined using real-time PCR in heavy drinkers with and without liver cirrhosis. Single SNPs and defined haplotypes within the BDNF gene were tested for association with ALC. Results According to both codominant and recessive genetic models, carriers of the rs925946 TT genotype have an elevated risk of liver cirrhosis development with odds ratios (confidence intervals) 6.287 (1.286–30.738) and 6.321 (1.317–30.348), respectively. BDNF SNPs rs6265, rs10835210, rs7103411, and rs75945125 do not associate with risk of ALC. One block of haplotypes consisting of rs10835210 and rs7103411 demonstrated linkage disequilibrium ( D ′ = 1 and r 2 = 0.228). The revealed haplotypes do not associate with the development of liver cirrhosis in alcohol heavy drinkers. Conclusion Thus, the BDNF rs925946 SNP is associated with the risk of ALC in heavy drinkers. Future investigations of the BDNF gene-related genetic markers of ALC will help to objectively assess the risk and severity of liver damage and correct the corresponding therapy.
{"title":"Relationship between BDNF gene polymorphisms and alcohol-related liver cirrhosis","authors":"Danil I. Peregud, Valeria Yu. Baronets, Anna S. Lobacheva, Alexandr S. Ivanov, Irina V. Garmash, Olga S. Arisheva, Zhanna D. Kobalava, Sergey V. Pirozhkov, Natalia N. Terebilina","doi":"10.1186/s43066-023-00296-2","DOIUrl":"https://doi.org/10.1186/s43066-023-00296-2","url":null,"abstract":"Abstract Background and aim Brain-derived neurotrophic factor (BDNF) functions not only in the brain but also in peripheral tissues such as the liver. Genetic factors determine the development of alcohol dependence and somatic consequences of chronic intoxication, especially liver cirrhosis. The BDNF gene polymorphisms are associated with alcohol dependence; however, their relationship with the development of alcohol-related liver cirrhosis (ALC) has not yet been established. This study evaluated the association between single-nucleotide polymorphisms (SNPs) within the BDNF gene and liver cirrhosis in heavy drinkers. Methods BDNF-related SNPs rs925946, rs6265, rs10835210, rs7103411, and rs75945125 were determined using real-time PCR in heavy drinkers with and without liver cirrhosis. Single SNPs and defined haplotypes within the BDNF gene were tested for association with ALC. Results According to both codominant and recessive genetic models, carriers of the rs925946 TT genotype have an elevated risk of liver cirrhosis development with odds ratios (confidence intervals) 6.287 (1.286–30.738) and 6.321 (1.317–30.348), respectively. BDNF SNPs rs6265, rs10835210, rs7103411, and rs75945125 do not associate with risk of ALC. One block of haplotypes consisting of rs10835210 and rs7103411 demonstrated linkage disequilibrium ( D ′ = 1 and r 2 = 0.228). The revealed haplotypes do not associate with the development of liver cirrhosis in alcohol heavy drinkers. Conclusion Thus, the BDNF rs925946 SNP is associated with the risk of ALC in heavy drinkers. Future investigations of the BDNF gene-related genetic markers of ALC will help to objectively assess the risk and severity of liver damage and correct the corresponding therapy.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135217073","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}
Abstract Background and aims Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease in type-2 diabetics. The quality of life among those patients was not explored well. Hence, the present study aimed to correlate the determinants with the quality of life (QoL) among the study subjects. Methods A hospital-based case–control study was conducted at Bhargavi Gastro and Surgical Hospital, Warangal, Telangana, with 358 subjects, from 1 November 2019 to 31 October 2021 (24 months). A 358 of cohort type-2 diabetes mellitus (T2DM) subjects were recruited with 1:1 of NAFLD and without NAFLD. QoL was determined with the SF-36 questionnaire, which comprises eight domains. Statistical analysis included t test, chi-square, and Spearman correlation performed with SPSSV.25 software. Results Out of 358 subjects, 200 (55.8%) were males and 158 (44.1%) were females. Glycemic parameters (FBS and HbA1c), lipid profile, liver transaminases (SGPT and SGOT), and serum uric acid levels were significantly high in NAFLD subjects ( p < 0.05). The SF-36 score, four domains (physical, energy, mental health, and pain) are significantly reduced in NAFLD subjects p < 0.05). A significant correlation between blood urea and impaired physical, emotional mental, and general health was observed in NAFLD subjects. In the NAFLD subjects, elevated FBS levels lead to impairment of physical and emotional status. Social functioning, general health, and pain were impaired with BMI and TG levels in NAFLD subjects. The mean, SD of SF-36 scores showed no significant difference in contrast to HbA1c among both groups ( p > 0.05). Conclusion The decreased QoL was observed in subjects of T2DM with NAFLD. The QoL is significantly influenced by elevated FBS, SGPT, SGOT, and TG levels. Hence, clinicians need to be vigilant and implement strategies to improve the quality of life in type 2 diabetics with NAFLD.
{"title":"Health-related quality of life and its determinants among South Indian type 2 diabetes patients with and without non-alcoholic fatty liver disease","authors":"Usha Sree Puneem, Vanitha Rani Nagasubramanian, Vasudeva Murthy Sindgi, Subburaya Mudaliyar Rajendran Ramakrishnan, Ranakishor Pelluri","doi":"10.1186/s43066-023-00288-2","DOIUrl":"https://doi.org/10.1186/s43066-023-00288-2","url":null,"abstract":"Abstract Background and aims Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease in type-2 diabetics. The quality of life among those patients was not explored well. Hence, the present study aimed to correlate the determinants with the quality of life (QoL) among the study subjects. Methods A hospital-based case–control study was conducted at Bhargavi Gastro and Surgical Hospital, Warangal, Telangana, with 358 subjects, from 1 November 2019 to 31 October 2021 (24 months). A 358 of cohort type-2 diabetes mellitus (T2DM) subjects were recruited with 1:1 of NAFLD and without NAFLD. QoL was determined with the SF-36 questionnaire, which comprises eight domains. Statistical analysis included t test, chi-square, and Spearman correlation performed with SPSSV.25 software. Results Out of 358 subjects, 200 (55.8%) were males and 158 (44.1%) were females. Glycemic parameters (FBS and HbA1c), lipid profile, liver transaminases (SGPT and SGOT), and serum uric acid levels were significantly high in NAFLD subjects ( p < 0.05). The SF-36 score, four domains (physical, energy, mental health, and pain) are significantly reduced in NAFLD subjects p < 0.05). A significant correlation between blood urea and impaired physical, emotional mental, and general health was observed in NAFLD subjects. In the NAFLD subjects, elevated FBS levels lead to impairment of physical and emotional status. Social functioning, general health, and pain were impaired with BMI and TG levels in NAFLD subjects. The mean, SD of SF-36 scores showed no significant difference in contrast to HbA1c among both groups ( p > 0.05). Conclusion The decreased QoL was observed in subjects of T2DM with NAFLD. The QoL is significantly influenced by elevated FBS, SGPT, SGOT, and TG levels. Hence, clinicians need to be vigilant and implement strategies to improve the quality of life in type 2 diabetics with NAFLD.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136013553","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 : 2023-10-12DOI: 10.1186/s43066-023-00268-6
Ayman F. El-Shayeb, Akram A. Degheidy, Sawsan El-Mallah, John Farid, Amany N. Abbasy
Abstract Background Decompensated liver cirrhosis (DLC) is now known as a chronic inflammatory process, evidenced by elevated levels of circulatory pro-inflammatory cytokines and chemokines which in turn lead to the development of more hepatic decompensation and multi-organ failure. Resistin has a pro-inflammatory effect through the production of several cytokines (e.g., IL-1, IL-6, IL-12, and TNF-α) and cell adhesion molecules. Interleukin-6 (IL-6) is a proinflammatory cytokine playing a crucial role in acute phase responses and in regulating immune reactions through activation and differentiation of T and B lymphocytes. The current study aimed to evaluate the value of serum resistin and IL-6 as biomarkers of DLC and their role as prognostic markers of complications in these patients. Results This study was conducted on 90 patients divided into three groups: group I—30 patients with compensated cirrhosis (CLC); group II—40 patients with DLC; and group III consisted of 20 healthy controls. Serum resistin and IL-6 levels were statistically significantly higher in patients with DLC compared to patients with CLC at baseline. A cut-off value of > 302 pg/ml for serum resistin was found to discriminate between CLC and DLC with a specificity of 73.33% and sensitivity of 92.50% and a cut-off level of > 31 pg/mL for IL-6 differentiated between the two groups with a sensitivity of 85.0% and specificity of 76.67%. Patients with DLC were followed up for 3 months, 10 patients (25%) passed away, and 19 patients out of the remaining 30 (63.3%) patients developed complications including acute kidney injury, spontaneous bacterial peritonitis, variceal hemorrhage, encephalopathy, and hepatocellular carcinoma. Serum resistin and IL-6 were found to be significantly higher at baseline in those patients who developed complications or mortality after the follow-up period. In addition, there were positive correlations between IL-6 and resistin and MELD-NA and CRP. Conclusion Serum resistin and IL-6 could be used as sensitive diagnostic and prognostic biomarkers of decompensated cirrhotic patients.
{"title":"Validity of serum resistin level and Il-6 as prognostic biomarkers of decompensated liver cirrhosis in chronic hepatitis C virus patients","authors":"Ayman F. El-Shayeb, Akram A. Degheidy, Sawsan El-Mallah, John Farid, Amany N. Abbasy","doi":"10.1186/s43066-023-00268-6","DOIUrl":"https://doi.org/10.1186/s43066-023-00268-6","url":null,"abstract":"Abstract Background Decompensated liver cirrhosis (DLC) is now known as a chronic inflammatory process, evidenced by elevated levels of circulatory pro-inflammatory cytokines and chemokines which in turn lead to the development of more hepatic decompensation and multi-organ failure. Resistin has a pro-inflammatory effect through the production of several cytokines (e.g., IL-1, IL-6, IL-12, and TNF-α) and cell adhesion molecules. Interleukin-6 (IL-6) is a proinflammatory cytokine playing a crucial role in acute phase responses and in regulating immune reactions through activation and differentiation of T and B lymphocytes. The current study aimed to evaluate the value of serum resistin and IL-6 as biomarkers of DLC and their role as prognostic markers of complications in these patients. Results This study was conducted on 90 patients divided into three groups: group I—30 patients with compensated cirrhosis (CLC); group II—40 patients with DLC; and group III consisted of 20 healthy controls. Serum resistin and IL-6 levels were statistically significantly higher in patients with DLC compared to patients with CLC at baseline. A cut-off value of > 302 pg/ml for serum resistin was found to discriminate between CLC and DLC with a specificity of 73.33% and sensitivity of 92.50% and a cut-off level of > 31 pg/mL for IL-6 differentiated between the two groups with a sensitivity of 85.0% and specificity of 76.67%. Patients with DLC were followed up for 3 months, 10 patients (25%) passed away, and 19 patients out of the remaining 30 (63.3%) patients developed complications including acute kidney injury, spontaneous bacterial peritonitis, variceal hemorrhage, encephalopathy, and hepatocellular carcinoma. Serum resistin and IL-6 were found to be significantly higher at baseline in those patients who developed complications or mortality after the follow-up period. In addition, there were positive correlations between IL-6 and resistin and MELD-NA and CRP. Conclusion Serum resistin and IL-6 could be used as sensitive diagnostic and prognostic biomarkers of decompensated cirrhotic patients.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969238","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 : 2023-10-11DOI: 10.1186/s43066-023-00292-6
Maddalena Zippi, Antonella Toma, Wandong Hong, Sirio Fiorino, Alfonso Grottesi
Abstract Background Gastrointestinal bleeding from cholecystoduodenal fistula is rare. It is usually managed surgically, although a conservative approach is reported in isolated cases. Case presentation A 71-year-old male patient was admitted to the emergency department (ED) presenting melena associated with severe anemia, requiring a blood transfusion. An urgent upper endoscopy showed the intestinal orifice of a cholecystoduodenal fistula. This finding was confirmed by radiological examination and laparoscopy. Cholecystectomy and simultaneous excision of the fistula were successfully performed. As a result, a diagnosis of Mirizzi syndrome type Va was also made. Conclusion A cholecystoduodenal fistula orifice leading to gastrointestinal bleeding is difficult to diagnose without an endoscopic examination of the upper digestive tract. Following this first diagnostic step, a comprehensive patient examination should be conducted, specifically if a history of gallbladder lithiasis has been reported.
{"title":"A rare gastrointestinal bleeding due to a cholecystoduodenal fistula: a case report","authors":"Maddalena Zippi, Antonella Toma, Wandong Hong, Sirio Fiorino, Alfonso Grottesi","doi":"10.1186/s43066-023-00292-6","DOIUrl":"https://doi.org/10.1186/s43066-023-00292-6","url":null,"abstract":"Abstract Background Gastrointestinal bleeding from cholecystoduodenal fistula is rare. It is usually managed surgically, although a conservative approach is reported in isolated cases. Case presentation A 71-year-old male patient was admitted to the emergency department (ED) presenting melena associated with severe anemia, requiring a blood transfusion. An urgent upper endoscopy showed the intestinal orifice of a cholecystoduodenal fistula. This finding was confirmed by radiological examination and laparoscopy. Cholecystectomy and simultaneous excision of the fistula were successfully performed. As a result, a diagnosis of Mirizzi syndrome type Va was also made. Conclusion A cholecystoduodenal fistula orifice leading to gastrointestinal bleeding is difficult to diagnose without an endoscopic examination of the upper digestive tract. Following this first diagnostic step, a comprehensive patient examination should be conducted, specifically if a history of gallbladder lithiasis has been reported.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136211334","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 : 2023-10-05DOI: 10.1186/s43066-023-00285-5
Mona Mahmoud Hassouna, Mohammed Sayed Moustafa, Mona Hamdy, Eman Abdelsameea, Mohamed Abbasy, Mary Naguib
Abstract Patients with chronic liver disease (CLD) as chronic hepatitis C (CHC) are at high risk of diabetes type 2 (T2D). Genetic factors are suggested to modulate diabetes development in cirrhotic patients. TCF7L2 gene has been reported to be associated with type 2 diabetes, but the association of TCF7L2 with cirrhotic patients with diabetes is unclear. We aimed to study the TCF7L2 gene polymorphisms (rs 290487) in cirrhotic patients with diabetes. Method The study was assessed on 25 cirrhotic patients with type 2 diabetes who were compared to 25 cirrhotic HCV patients (nondiabetic), 25 diabetic type 2 patients, and 25 age- and gender-matched healthy control groups. After the collection of relevant clinical data and basic laboratory tests, single-nucleotide polymorphism (SNP) in the TCF7L2 gene (rs290487) was performed by a real-time PCR technique. Results Cirrhotic patients with diabetes presented significantly poorer liver function, higher incidence of cirrhotic complications, and higher glucose levels compared with cirrhotic nondiabetic patients. The TCF7L2 rs290487 TT variant showed significantly increased diabetes risk in cirrhotic patients compared with CC and CT genotypes. Conclusions TCF7L2 rs290487 polymorphism could be associated with increased diabetic risk in cirrhotic patients.
{"title":"Study of transcription factor 7-like 2 (TCF7L2) gene polymorphism in cirrhotic patients with diabetes","authors":"Mona Mahmoud Hassouna, Mohammed Sayed Moustafa, Mona Hamdy, Eman Abdelsameea, Mohamed Abbasy, Mary Naguib","doi":"10.1186/s43066-023-00285-5","DOIUrl":"https://doi.org/10.1186/s43066-023-00285-5","url":null,"abstract":"Abstract Patients with chronic liver disease (CLD) as chronic hepatitis C (CHC) are at high risk of diabetes type 2 (T2D). Genetic factors are suggested to modulate diabetes development in cirrhotic patients. TCF7L2 gene has been reported to be associated with type 2 diabetes, but the association of TCF7L2 with cirrhotic patients with diabetes is unclear. We aimed to study the TCF7L2 gene polymorphisms (rs 290487) in cirrhotic patients with diabetes. Method The study was assessed on 25 cirrhotic patients with type 2 diabetes who were compared to 25 cirrhotic HCV patients (nondiabetic), 25 diabetic type 2 patients, and 25 age- and gender-matched healthy control groups. After the collection of relevant clinical data and basic laboratory tests, single-nucleotide polymorphism (SNP) in the TCF7L2 gene (rs290487) was performed by a real-time PCR technique. Results Cirrhotic patients with diabetes presented significantly poorer liver function, higher incidence of cirrhotic complications, and higher glucose levels compared with cirrhotic nondiabetic patients. The TCF7L2 rs290487 TT variant showed significantly increased diabetes risk in cirrhotic patients compared with CC and CT genotypes. Conclusions TCF7L2 rs290487 polymorphism could be associated with increased diabetic risk in cirrhotic patients.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134976329","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 : 2023-10-05DOI: 10.1186/s43066-023-00289-1
Aylin Altan Kus, Selim Keceoglu, Ali Ozer
Abstract Background Contrast-enhanced magnetic resonance imaging (MRI) plays a crucial role in the diagnosis of hepatocellular carcinoma (HCC). This study aims to assess the performance of MRI features for evaluating hepatocellular carcinoma (HCC) aggressiveness in living liver transplantation in patients. Material and methods This retrospective study included patients who underwent liver transplantation in our hospital between 2015 and 2020. Abdominal contrast-enhanced MRIs of these patients were reviewed, and clinical, radiological, and histopathological findings of HCCs were recorded. The prognostic features of HCCs as determined by MRI were compared with Edmondson-Steiner (E-S) grades. Liver parenchyma fibrosis based on an apparent diffusion coefficient (ADC) map was correlated with histological subclassification of cirrhosis using the Laennec staging system. Results The study subjects included 37 men and 8 women with a mean age of 59.56 ± 7.81 (range: 25–72). The mean tumour size was 37.33 ± 22.27 mm (range: 10–118 mm), and nine tumours (23.1%) involved portal vein tumour thrombosis. There was a significant correlation between tumour grade and size ( p = 0.007) and intratumoral fat ( p = 0.014) even though no significant correlations between grade and mean ADC value, capsule appearance, presence of satellite lesions, smooth margin, imaging of the tumour feeding artery, and corona enhancement of HCC ( p > 0.05) were found. There was a statistically significant correlation between mild (stage 4A) and moderate (stage 4B) fibrosis of non-tumorous liver parenchyma and ADC value ( p < 0.001). Conclusion Our study found that ADC values can be used to distinguish mild cirrhotic livers from moderate cirrhotic livers. Diffusion MRI might be used to diagnose the degree of liver fibrosis without histopathological analysis. According to our results, only intralesional fat and tumour size correlated with tumour grade, and as such, these parameters could be used as prognostic MRI biomarkers for HCC.
{"title":"MRI features for predicting the pathological grade of HCC in patients undergoing liver transplantation","authors":"Aylin Altan Kus, Selim Keceoglu, Ali Ozer","doi":"10.1186/s43066-023-00289-1","DOIUrl":"https://doi.org/10.1186/s43066-023-00289-1","url":null,"abstract":"Abstract Background Contrast-enhanced magnetic resonance imaging (MRI) plays a crucial role in the diagnosis of hepatocellular carcinoma (HCC). This study aims to assess the performance of MRI features for evaluating hepatocellular carcinoma (HCC) aggressiveness in living liver transplantation in patients. Material and methods This retrospective study included patients who underwent liver transplantation in our hospital between 2015 and 2020. Abdominal contrast-enhanced MRIs of these patients were reviewed, and clinical, radiological, and histopathological findings of HCCs were recorded. The prognostic features of HCCs as determined by MRI were compared with Edmondson-Steiner (E-S) grades. Liver parenchyma fibrosis based on an apparent diffusion coefficient (ADC) map was correlated with histological subclassification of cirrhosis using the Laennec staging system. Results The study subjects included 37 men and 8 women with a mean age of 59.56 ± 7.81 (range: 25–72). The mean tumour size was 37.33 ± 22.27 mm (range: 10–118 mm), and nine tumours (23.1%) involved portal vein tumour thrombosis. There was a significant correlation between tumour grade and size ( p = 0.007) and intratumoral fat ( p = 0.014) even though no significant correlations between grade and mean ADC value, capsule appearance, presence of satellite lesions, smooth margin, imaging of the tumour feeding artery, and corona enhancement of HCC ( p > 0.05) were found. There was a statistically significant correlation between mild (stage 4A) and moderate (stage 4B) fibrosis of non-tumorous liver parenchyma and ADC value ( p < 0.001). Conclusion Our study found that ADC values can be used to distinguish mild cirrhotic livers from moderate cirrhotic livers. Diffusion MRI might be used to diagnose the degree of liver fibrosis without histopathological analysis. According to our results, only intralesional fat and tumour size correlated with tumour grade, and as such, these parameters could be used as prognostic MRI biomarkers for HCC.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135482057","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 : 2023-10-05DOI: 10.1186/s43066-023-00291-7
David Audu, Vinood B. Patel, Olufunmilayo A. Idowu, Fakilahyel M. Mshelbwala, Adewumi B. Idowu
Abstract Background In malaria-endemic countries, repeated intake of artemisinin-based combination therapies (ACTs) is rampant and driven by drug resistance, improper usage, and easy accessibility. Stress effects and potential liver toxicity due to the frequent therapeutic use of ACTs have not been extensively studied. Here, we investigated the effects of repeated treatment with standard doses of the commonly used ACTs artemether/lumefantrine (A/L) and artesunate-amodiaquine (A/A) on oxidative stress and liver function markers in male mice (BALB/c). Methods Forty Five mice were divided into three groups: control, A/L, and A/A. The drugs were administered three days in a row per week, and the regimen was repeated every two weeks for a total of six cycles. The levels of oxidative stress and liver function markers were measured in both plasma and liver tissue after initial (baseline) and repeated exposures for the second, third, and sixth cycles. Results Exposure to A/L or A/A caused a significant ( p < 0.001) increase in plasma malondialdehyde (MDA) levels after the first and repeated exposure periods. However, Hepatic MDA levels increased significantly ( p < 0.01) only after the sixth exposure to A/A. Following either single or repeated exposure to A/L or A/A, plasma and liver glutathione peroxidase (GPx) and catalase (CAT) activities, plasma aspartate and alanine transaminase, alkaline phosphatase activity, and bilirubin levels increased, whereas total plasma protein levels decreased significantly ( p < 0.001). Varying degrees of hepatocyte degeneration and blood vessel congestion were observed in liver tissues after a single or repeated treatment period. Conclusion Irrespective of single or repeated exposure to therapeutic doses of A/L or A/A, plasma oxidative stress and liver damage were observed. However, long-term repeated A/A exposure can led to hepatic stress. Compensatory processes involving GPx and CAT activities may help reduce the observed stress.
{"title":"Baseline and recurrent exposure to the standard dose of artemisinin-based combination therapies (ACTs) induces oxidative stress and liver damage in mice (BALB/c)","authors":"David Audu, Vinood B. Patel, Olufunmilayo A. Idowu, Fakilahyel M. Mshelbwala, Adewumi B. Idowu","doi":"10.1186/s43066-023-00291-7","DOIUrl":"https://doi.org/10.1186/s43066-023-00291-7","url":null,"abstract":"Abstract Background In malaria-endemic countries, repeated intake of artemisinin-based combination therapies (ACTs) is rampant and driven by drug resistance, improper usage, and easy accessibility. Stress effects and potential liver toxicity due to the frequent therapeutic use of ACTs have not been extensively studied. Here, we investigated the effects of repeated treatment with standard doses of the commonly used ACTs artemether/lumefantrine (A/L) and artesunate-amodiaquine (A/A) on oxidative stress and liver function markers in male mice (BALB/c). Methods Forty Five mice were divided into three groups: control, A/L, and A/A. The drugs were administered three days in a row per week, and the regimen was repeated every two weeks for a total of six cycles. The levels of oxidative stress and liver function markers were measured in both plasma and liver tissue after initial (baseline) and repeated exposures for the second, third, and sixth cycles. Results Exposure to A/L or A/A caused a significant ( p < 0.001) increase in plasma malondialdehyde (MDA) levels after the first and repeated exposure periods. However, Hepatic MDA levels increased significantly ( p < 0.01) only after the sixth exposure to A/A. Following either single or repeated exposure to A/L or A/A, plasma and liver glutathione peroxidase (GPx) and catalase (CAT) activities, plasma aspartate and alanine transaminase, alkaline phosphatase activity, and bilirubin levels increased, whereas total plasma protein levels decreased significantly ( p < 0.001). Varying degrees of hepatocyte degeneration and blood vessel congestion were observed in liver tissues after a single or repeated treatment period. Conclusion Irrespective of single or repeated exposure to therapeutic doses of A/L or A/A, plasma oxidative stress and liver damage were observed. However, long-term repeated A/A exposure can led to hepatic stress. Compensatory processes involving GPx and CAT activities may help reduce the observed stress.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135482169","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}
Abstract Hepatitis B virus (HBV) and hepatitis C virus (HCV) are amongst the most common causative agents of viral hepatitis with its severe complications, including liver cirrhosis, decompensation, and hepatocellular carcinoma (HCC). Elimination of viral hepatitis, a significant challenge, has become an adopted global goal with certainly designed targets set by the World Health Assembly to be met by 2030. While many countries, including Egypt, have started executive plans for viral hepatitis elimination and achieved remarkable progress, the emergence of the COVID-19 pandemic has markedly affected all the machinery of the healthcare systems and specifically laid countries off their track in their viral hepatitis elimination process. The pandemic disrupted most healthcare services, and health staff and hospital resources were recruited mainly for managing the crisis, which significantly negatively impacted the management of other less severe diseases, including viral hepatitis. Social distancing and restrictive measures applied by most countries to contain the pandemic have affected medical services offered to patients with hepatitis. All supply chains of medications and vaccinations concerned with treating and preventing viral hepatitis have been markedly compromised. Many efforts and strategies are required to combat the severe and deleterious implications of the pandemic on the management of viral hepatitis worldwide in an attempt to get the situation under control and resume the pathway towards viral hepatitis elimination.
{"title":"The implications of the COVID-19 pandemic on hepatitis B and C elimination programs in Egypt: current situation and future perspective","authors":"Aisha Elsharkawy, Reham Samir, Mohamed Abdallah, Mohamed Hassany, Mohamed El-Kassas","doi":"10.1186/s43066-023-00290-8","DOIUrl":"https://doi.org/10.1186/s43066-023-00290-8","url":null,"abstract":"Abstract Hepatitis B virus (HBV) and hepatitis C virus (HCV) are amongst the most common causative agents of viral hepatitis with its severe complications, including liver cirrhosis, decompensation, and hepatocellular carcinoma (HCC). Elimination of viral hepatitis, a significant challenge, has become an adopted global goal with certainly designed targets set by the World Health Assembly to be met by 2030. While many countries, including Egypt, have started executive plans for viral hepatitis elimination and achieved remarkable progress, the emergence of the COVID-19 pandemic has markedly affected all the machinery of the healthcare systems and specifically laid countries off their track in their viral hepatitis elimination process. The pandemic disrupted most healthcare services, and health staff and hospital resources were recruited mainly for managing the crisis, which significantly negatively impacted the management of other less severe diseases, including viral hepatitis. Social distancing and restrictive measures applied by most countries to contain the pandemic have affected medical services offered to patients with hepatitis. All supply chains of medications and vaccinations concerned with treating and preventing viral hepatitis have been markedly compromised. Many efforts and strategies are required to combat the severe and deleterious implications of the pandemic on the management of viral hepatitis worldwide in an attempt to get the situation under control and resume the pathway towards viral hepatitis elimination.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135592322","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 : 2023-10-04DOI: 10.1186/s43066-023-00287-3
Pooja Dudeja, Taishee Pal, Aman Sharma
Abstract Background Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disorders that will be started from more than or equal to 5% of fats deposited into the liver hepatocyte cells and progressively leads to steatosis, further increment in fat deposition, and signature of inflammatory markers which cause the non-alcoholic steatohepatitis (NASH) condition. Due to a lack of diagnosis and effective treatment, NASH is converted into liver cirrhosis or hepatocarcinoma, which indicates the irreversible stage of the disease and finally recommends liver transplantation for patient survival. However, nowadays, several clinical biomarkers are identified, and most of the new biomarkers are in the developmental stage, but still the diagnosis of each stage of fatty liver is unaccomplished. So, in this review article, we try to present all current mechanistic perspectives to find the non-invasive biomarkers which could be the best approach in the future to diagnose fatty liver disease in each stage. Main text NAFLD is a growing phase disease if properly not taken care of by the patient. There are certain factors that can make fast progress in the disease stage like NAFLD to advance liver fibrosis or hepatocarcinoma. We describe to the best extent how different types of disease stages in the case of the fatty liver could be diagnosed using non-invasive biomarkers. A certain type of mechanistic pathophysiology approach is used to differentiate each stage of fatty liver disease like serum biomarkers (inflammatory cytokines), lipoproteins, micro-RNAs, gut microbiome-associated biomarkers, lipid droplet-associated perilipins, apolipoprotein E, the role of dihydroceramide, and gene expression studies. Conclusions Recent advancements in diagnostic biomarkers research focused on non-invasive methods, but the diagnosis of different stages of fatty liver disease is still inconclusive. We tried to cover all the potential non-invasive biomarkers in our manuscript. This review helps the researchers to develop possible diagnostic biomarkers for each stage of liver disease.
{"title":"The novel approach for non-invasive diagnostic biomarkers from an early stage of NAFLD to advanced fibrosis","authors":"Pooja Dudeja, Taishee Pal, Aman Sharma","doi":"10.1186/s43066-023-00287-3","DOIUrl":"https://doi.org/10.1186/s43066-023-00287-3","url":null,"abstract":"Abstract Background Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disorders that will be started from more than or equal to 5% of fats deposited into the liver hepatocyte cells and progressively leads to steatosis, further increment in fat deposition, and signature of inflammatory markers which cause the non-alcoholic steatohepatitis (NASH) condition. Due to a lack of diagnosis and effective treatment, NASH is converted into liver cirrhosis or hepatocarcinoma, which indicates the irreversible stage of the disease and finally recommends liver transplantation for patient survival. However, nowadays, several clinical biomarkers are identified, and most of the new biomarkers are in the developmental stage, but still the diagnosis of each stage of fatty liver is unaccomplished. So, in this review article, we try to present all current mechanistic perspectives to find the non-invasive biomarkers which could be the best approach in the future to diagnose fatty liver disease in each stage. Main text NAFLD is a growing phase disease if properly not taken care of by the patient. There are certain factors that can make fast progress in the disease stage like NAFLD to advance liver fibrosis or hepatocarcinoma. We describe to the best extent how different types of disease stages in the case of the fatty liver could be diagnosed using non-invasive biomarkers. A certain type of mechanistic pathophysiology approach is used to differentiate each stage of fatty liver disease like serum biomarkers (inflammatory cytokines), lipoproteins, micro-RNAs, gut microbiome-associated biomarkers, lipid droplet-associated perilipins, apolipoprotein E, the role of dihydroceramide, and gene expression studies. Conclusions Recent advancements in diagnostic biomarkers research focused on non-invasive methods, but the diagnosis of different stages of fatty liver disease is still inconclusive. We tried to cover all the potential non-invasive biomarkers in our manuscript. This review helps the researchers to develop possible diagnostic biomarkers for each stage of liver disease.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135592061","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 : 2023-10-02DOI: 10.1186/s43066-023-00284-6
Waleed Attia Hassan, Sherif I. Kamel, Ibrahim Abdel Naby Mahmoud, Nahed Makhlouf, Mahmoud Moubark, Sahar M. Hassany
Abstract Background Regression of fibrosis and improvement of portal hemodynamics after achievement of sustained viral response (SVR) in patients with chronic hepatitis C (HCV) is a subject of debate in different studies. Some studies reported improvement in the degree of fibrosis, while others did not find significant changes. Objective We aimed to evaluate changes in liver fibrosis, portal hemodynamics and clinical outcomes in patients with chronic HCV-related liver cirrhosis after the achievement of SVR with direct-acting antiviral drugs (DAAs). Patients and methods In our prospective longitudinal study, a total of 100 patients with chronic HCV infection-related liver cirrhosis were recruited, received DAAs, and completed the follow-up period. Clinical evaluation for assessment of liver disease severity using MELD and Child–Pugh class and scores were done. A noninvasive assessment of liver fibrosis using serum biomarkers (APRI index & FIB4 score) and share wave elastography (SWE) was done. Portal hemodynamic evaluation using Doppler ultrasound was done. All were done at baseline and 3 and 12 months after the end of therapy. Results A significant reduction in the degree of fibrosis was observed. Share wave elastography (SWE) readings showed 19.79% and 30.45% reduction 3 and 12 months after the end of therapy respectively ( P < 0.001). Regarding the FIB4 score, the percentage of score reduction was 19.8% and 26.46% 3 and 12 months after the end of therapy, respectively ( P < 0.01). APRI scores showed 22.6% and 41.09% reduction 3 and 12 months after the end of therapy respectively ( P < 0.001). Significant improvement in Child–Pugh scores 3 and 12 months after the end of treatment was observed. Doppler ultrasound showed a significant increase in portal vein flow velocity, a significant decrease in time average mean velocity, and cross-section area 12 months after the end of treatment. Conclusion There was a considerable degree of reduction of liver fibrosis, improvement of portal hemodynamics, and Child–Pugh score in cirrhotic HCV patients who achieved SVR after DAAs. Trial registration ClinicalTrials.gov, ID: NCT03241823 . Registered on 08 May 2017.
{"title":"Assessment of hepatic fibrosis, portal hemodynamic changes, and disease severity in patients with HCV-related liver cirrhosis after sustained virologic response to direct-acting antiviral drugs (DAAs)","authors":"Waleed Attia Hassan, Sherif I. Kamel, Ibrahim Abdel Naby Mahmoud, Nahed Makhlouf, Mahmoud Moubark, Sahar M. Hassany","doi":"10.1186/s43066-023-00284-6","DOIUrl":"https://doi.org/10.1186/s43066-023-00284-6","url":null,"abstract":"Abstract Background Regression of fibrosis and improvement of portal hemodynamics after achievement of sustained viral response (SVR) in patients with chronic hepatitis C (HCV) is a subject of debate in different studies. Some studies reported improvement in the degree of fibrosis, while others did not find significant changes. Objective We aimed to evaluate changes in liver fibrosis, portal hemodynamics and clinical outcomes in patients with chronic HCV-related liver cirrhosis after the achievement of SVR with direct-acting antiviral drugs (DAAs). Patients and methods In our prospective longitudinal study, a total of 100 patients with chronic HCV infection-related liver cirrhosis were recruited, received DAAs, and completed the follow-up period. Clinical evaluation for assessment of liver disease severity using MELD and Child–Pugh class and scores were done. A noninvasive assessment of liver fibrosis using serum biomarkers (APRI index & FIB4 score) and share wave elastography (SWE) was done. Portal hemodynamic evaluation using Doppler ultrasound was done. All were done at baseline and 3 and 12 months after the end of therapy. Results A significant reduction in the degree of fibrosis was observed. Share wave elastography (SWE) readings showed 19.79% and 30.45% reduction 3 and 12 months after the end of therapy respectively ( P < 0.001). Regarding the FIB4 score, the percentage of score reduction was 19.8% and 26.46% 3 and 12 months after the end of therapy, respectively ( P < 0.01). APRI scores showed 22.6% and 41.09% reduction 3 and 12 months after the end of therapy respectively ( P < 0.001). Significant improvement in Child–Pugh scores 3 and 12 months after the end of treatment was observed. Doppler ultrasound showed a significant increase in portal vein flow velocity, a significant decrease in time average mean velocity, and cross-section area 12 months after the end of treatment. Conclusion There was a considerable degree of reduction of liver fibrosis, improvement of portal hemodynamics, and Child–Pugh score in cirrhotic HCV patients who achieved SVR after DAAs. Trial registration ClinicalTrials.gov, ID: NCT03241823 . Registered on 08 May 2017.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135895784","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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