International Hepatology Communications最新文献

Background: interferon-α is able to induce a sustained inhibition of hepatitis B virus replication in about 30–40% of patients with chronic hepatitis B. There is evidence that non-steroidal antiinflammatory drugs can enhance the synthesis of antiviral proteins induced by interferon-α, Aim: to evaluate the efficacy and tolerability of combined therapy with interferon-α plus indomethacin in HBeAg and HBV-DNA positive patients affected by chronic active hepatitis non-responders to a previous interferon-α treatment. Methods: after six months of retreatment with interferon-α (6 MU thrice weekly) six patients were enrolled, without stopping the therapy, to receive interferon-α (with the same schedule) plus indomethacin (25 mg orally twice daily) for an additional six month course. Results: at the end of treatment and after six months of follow-up alanine transaminase normalization was seen in three (50%) and four (66.7%) patients, HBV-DNA loss in one (17%) and three (50%), $\text{HBeAg}\text{HBeAb}$ serum conversion in one (17%) and two (33%), respectively. The combined therapy was well tolerated and no indomethacin side-effects were observed. The treatment was stopped in one patient after 4 months because of a remarkable increase of alanine transaminase levels, and in another after five months because of hyperthyroidism occurrence. Conclusions: the results of this study, even if obtained in a small number of patients, are encouraging and suggest a randomized controlled trial to be confirmed.

The effects of bile duct ligation for 3 days on biliary excretion of organic anions and cations were studied in the rat. Biliary excretion of organic anions, sulfobromophthalein, leukotriene C₄ and pravastatin, was markedly impaired. Biliary excretion of organic cations, vinblastine and erythromycin was also markedly impaired. These findings indicate that, in the bile duct-ligated rats, various excretory pathways from the liver are damaged, at least partly due to the impairment of canalicular carriers.

We investigated the response of portal venous blood flow in rats to different exercise intensities by long term implantation of an electromagnetic flowprobe around the portal vein. The coefficients of variation for five determinations of portal venous flow for 5 consecutive days before exercise were 9.7 ± 2.0%. The portal venous flow and oxygen consumption (V̇O₂) were simultaneously measured during and after treadmill exercise of five intensities (5–25 m/min). Portal venous flow remained unchanged at the moderate exercise levels of 5, 10 and 15 m/min at a 15% grade for 20 min. The portal flow demonstrated a significant decrease at the 20 m/min with a 60 ml/kg/min of V̇O₂, but the decreased portal venous flow returned to the pre-exercise level during the recovery period. At the highest intensity of exercise, 25 m/min, the decreased portal venous flow remained unchanged throughout the recovery period. We concluded that the continuous measurement of portal venous flow during exercise offers a clear advantage over other methods, and that there was an evoking point during the high intensity exercise though portal venous flow was unaltered at a moderate intensity of exercise.

The purpose of this study is to investigate the ability of neural network to discriminate the two subtypes, mild and severe form, of chronic active hepatitis, on the basis of the patterns of the five blood biochemical parameters. Serum levels of cholinesterase, albumin, alkaline phosphatase, type IV collagen and hyaluronate were used as variables. The neural network trained with the data from 31 patients: 11 of mild form and 20 of severe form of chronic active hepatitis. The ability of the network to predict the diagnosis of the patients who were additionally recruited was tested with a separate group (cross-validation group) of 9 patients with chronic active hepatitis. A neural network with 5 input neurons, 10 hidden neurons and 2 output neurons correctly classified all 31 patients. This network correctly predicted the diagnoses for 78% of the cross-validation group. These results suggested that neural network are useful for the differentiation of two forms of chronic active hepatitis by a less invasive blood biochemical analysis.

Kupffer cells are important in the development of liver injury by producing cytokines and radicals. It is known that all-trans retinoic acid (ATRA) participates in the proliferation and differentiation of cells, and exhibits immunomodulatory and anti-inflammatory properties. We evaluated the in vitro effects of three retinoids, ATRA, retinal and retinol, on the production of tumor necrosis factor-α (TNF-α) and nitric oxide (NO) by the LPS-stimulated rat Kupffer cells. ATRA was the most potent in suppressing the production of TNF-α and NO. The suppressive effect of ATRA on Kupffer cells was concentration-dependent. Results suggest that ATRA may act as an immunomodulator in liver diseases by suppressing the production of TNF-α and NO by Kupffer cells.

From two hundred sixty five patients with liver disease and elevated serum transaminases who were admitted or referred to Atmajaya academic hospital in Jakarta, 37 patients were found to be anti-HBc positive as a sole marker of HBV infection. Nineteen out of these 37 patients were also anti-HCV positive, HCV-RNA was detected in 16 patients. From 1656 individuals with normal serum transaminases who underwent serological examination and consisted of 489 subjects from population based study in Kalianyar (an urban area in Jakarta), 258 students of Atmajaya Medical School, 541 women and 162 children from maternity-child clinic and 206 patients admitted to hospital without evidence of liver disease, anti-HBc as a sole marker for HBV infection was found in 213. However, HCV-RNA was detected only in 2 subjects. We conclude that concomitant findings of anti-HBc as a sole marker for HBV infection and elevated ALT are associated with a relative high prevalence of HCV infection. In a group of individuals without evidence of liver disease, HCV infection was uncommon, even when anti-HBc is present as a sole marker of HBV infection.