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Genetic variants in the 6p21.3 region influence hepatitis B virus clearance and chronic hepatitis B risk in the Han Chinese population 6p21.3 区域的基因变异影响汉族人群的乙型肝炎病毒清除率和慢性乙型肝炎风险
Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.livres.2024.02.001
Jiancheng Huang , Mingkuan Su , Fanhui Kong , Hongbin Chen , Shuiqing Wu , Jianfeng Guo , Haiying Wu

Background and aim

A genome-wide association study has indicated the association of numerous genes in the 6p21.3 region with chronic hepatitis B virus (HBV) infection. In this study, we screened 12 representative single-nucleotide polymorphisms (SNPs) from the 6p21.3 region and investigated their association with the risk of chronic hepatitis B (CHB) to better understand the molecular etiology underlying CHB risk in the Han Chinese population.

Methods

Between March 2021 and November 2022, we included 183 patients with CHB (case group) and 196 with natural HBV clearance (control group). Allele typing of the selected SNPs was performed using snapshot technology. The correlation between the 12 chosen SNPs and the risk of chronic HBV infection was examined using binary logistic regression analysis. Interacting genes of the variants were identified, and expression quantitative trait loci (eQTL) were analyzed using the 3DSNP database.

Results

We validated 12 previously reported CHB susceptibility sites, including rs1419881 of transcription factor 19 (TCF19), rs3130542 and rs2853953 of human leukocyte antigen (HLA)-C, rs652888 of euchromatic histone-lysine-methyltransferase 2 (EHMT2), rs2856718, rs9276370, rs7756516, and rs7453920 of HLA-DQ, rs378352 of HLA-DOA, and rs3077, rs9277535, and rs9366816 of HLA-DP. Logistic regression analyses revealed that polymorphisms such as rs9276370, rs7756516, rs7453920, rs3077, rs9277535, and rs9366816 were positively correlated with natural HBV clearance in the dominant model. Conversely, rs3130542 and rs378352 were identified as risk factors for CHB. Haplotype analysis revealed that rs9276370, rs7756516, and rs7453920 in HLA-DQ were TTG and GCA haplotypes. Although the TTG haplotype was positively correlated with a higher risk of CHB, the GCA haplotype significantly influenced the natural clearance of HBV. Bioinformatics analysis demonstrated that rs378352, rs3077, and rs9366816 were located within enhancer states; rs3077 and rs9366816 overlapped with nine transcription factor-binding sites, whereas rs378352 altered five sequence motifs. Furthermore, eQTL analysis demonstrated the functional tendencies of eight statistically significant SNPs (rs3130542, rs9276370, rs7756516, rs7453920, rs378352, rs3077, rs9277535, and rs9366816).

Conclusions

Genetic variations within the 6p21.3 region were associated with chronic HBV infection in the Han Chinese population in southern China. Furthermore, the GCA haplotype including rs9276370, rs7756516, and rs7453920 of HLA-DQ contributed significantly to natural HBV clearance, implying that multiple SNPs exert a cumulative allelic effect on HBV infection.

背景和目的一项全基因组关联研究表明,6p21.3区的许多基因与慢性乙型肝炎病毒(HBV)感染有关。在本研究中,我们筛选了 6p21.3 区域中 12 个具有代表性的单核苷酸多态性(SNPs),并调查了它们与慢性乙型肝炎(CHB)风险的相关性,以更好地了解中国汉族人群中 CHB 风险的分子病因。方法在 2021 年 3 月至 2022 年 11 月期间,我们纳入了 183 例 CHB 患者(病例组)和 196 例 HBV 自然清除患者(对照组)。采用快照技术对所选 SNPs 进行等位基因分型。采用二元逻辑回归分析法研究了所选的 12 个 SNP 与慢性 HBV 感染风险之间的相关性。确定了变异的相互作用基因,并使用 3DSNP 数据库分析了表达定量性状位点(eQTL)。结果 我们验证了之前报道的 12 个 CHB 易感位点,包括转录因子 19(TCF19)的 rs1419881、人类白细胞抗原(HLA)-C 的 rs3130542 和 rs2853953、euchromatic组蛋白-赖氨酸-甲基转移酶2(EHMT2)的rs652888,HLA-DQ的rs2856718、rs9276370、rs7756516和rs7453920,HLA-DOA的rs378352,以及HLA-DP的rs3077、rs9277535和rs9366816。逻辑回归分析显示,在显性模型中,rs9276370、rs7756516、rs7453920、rs3077、rs9277535 和 rs9366816 等多态性与 HBV 自然清除率呈正相关。相反,rs3130542 和 rs378352 被确定为 CHB 的风险因素。单倍型分析表明,HLA-DQ 中的 rs9276370、rs7756516 和 rs7453920 是 TTG 和 GCA 单倍型。虽然TTG单倍型与较高的CHB风险呈正相关,但GCA单倍型对HBV的自然清除有显著影响。生物信息学分析表明,rs378352、rs3077 和 rs9366816 位于增强子状态;rs3077 和 rs9366816 与 9 个转录因子结合位点重叠,而 rs378352 则改变了 5 个序列基序。此外,eQTL 分析表明了 8 个具有统计学意义的 SNPs(rs3130542、rs9276370、rs7756516、rs7453920、rs378352、rs3077、rs9277535 和 rs9366816)的功能倾向。此外,包括 HLA-DQ 的 rs9276370、rs7756516 和 rs7453920 在内的 GCA 单倍型对自然清除 HBV 有显著作用,这意味着多个 SNP 对 HBV 感染有累积等位基因效应。
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引用次数: 0
Role of the portal system in liver regeneration: From molecular mechanisms to clinical management 门静脉系统在肝脏再生中的作用:从分子机制到临床管理
Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.livres.2024.01.002
Hanzhi Xu , Xun Qiu , Zhoucheng Wang , Kai Wang , Yawen Tan , Fengqiang Gao , Marcos Vinicius Perini , Xiao Xu

The liver has a strong regenerative capacity that ensures patient recovery after hepatectomy and liver transplantation. The portal system plays a crucial role in the dual blood supply to the liver, making it a significant factor in hepatic function. Several surgical strategies, such as portal vein ligation, associating liver partition and portal vein ligation for staged hepatectomy, and dual vein embolization, have highlighted the portal system's importance in liver regeneration. Following hepatectomy or liver transplantation, the hemodynamic properties of the portal system change dramatically, triggering regeneration via shear stress and the induction of hypoxia. However, excessive portal hyperperfusion can harm the liver and negatively affect patient outcomes. Furthermore, as the importance of the gut–liver axis has gradually been revealed, the effect of metabolites and cytokines from gut microbes carried by portal blood on liver regeneration has been acknowledged. From these perspectives, this review outlines the molecular mechanisms of the portal system's role in liver regeneration and summarizes therapeutic strategies based on the portal system intervention to promote liver regeneration.

肝脏具有很强的再生能力,可确保肝切除术和肝移植术后患者的康复。门静脉系统在肝脏的双重血液供应中起着至关重要的作用,是影响肝功能的重要因素。门静脉结扎术、分期肝切除术中的肝分割和门静脉结扎术以及双静脉栓塞术等多种手术策略都强调了门静脉系统在肝脏再生中的重要性。肝切除术或肝移植后,门静脉系统的血流动力学特性会发生显著变化,通过剪切应力和缺氧诱导引发再生。然而,过度的门静脉高灌注会损害肝脏,并对患者的预后产生负面影响。此外,随着肠肝轴的重要性逐渐被揭示,门静脉血液携带的肠道微生物代谢物和细胞因子对肝脏再生的影响也得到了认可。从这些角度出发,本综述概述了门静脉系统在肝脏再生中发挥作用的分子机制,并总结了基于门静脉系统干预以促进肝脏再生的治疗策略。
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引用次数: 0
Viral hepatitis E: Clinical manifestations, treatment, and prevention 戊型病毒性肝炎:临床表现、治疗和预防
Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.livres.2024.01.001
Qiumin Luo , Jia Chen , Yeqiong Zhang , Wenxiong Xu , Ying Liu , Chan Xie , Liang Peng

Hepatitis E is a globally distributed infection that varies in seroprevalence between developed and developing regions. In the less developed regions of Asia and Africa, a high seropositivity rate has been reported for hepatitis E virus (HEV) antibodies. Although acute hepatitis E is often self-limited and has a favorable prognosis, some populations experience severe manifestations, which may progress to liver failure. Moreover, some immunocompromised patients are at risk of developing chronic HEV infection and cirrhosis. Proactive screening, reducing misdiagnosis, improving patient management, timely antiviral therapy for severe and chronic cases, and vaccination of high-risk groups are important measures to reduce the morbidity of hepatitis E. This review focused on the clinical presentation, management, and prevention of hepatitis E.

戊型肝炎是一种全球分布的传染病,其血清流行率在发达地区和发展中地区之间存在差异。在亚洲和非洲的欠发达地区,戊型肝炎病毒(HEV)抗体的血清阳性率很高。虽然急性戊型肝炎通常是自限性的,预后良好,但有些人群表现严重,可能发展为肝功能衰竭。此外,一些免疫力低下的患者有发展为慢性戊型肝炎病毒感染和肝硬化的风险。积极筛查、减少误诊、改善患者管理、对重症和慢性病例及时进行抗病毒治疗以及为高危人群接种疫苗是降低戊型肝炎发病率的重要措施。
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引用次数: 0
Targeting nuclear receptors for NASH/MASH: From bench to bedside 靶向核受体治疗 NASH/MASH:从实验室到临床
Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.livres.2024.03.002
Rohit A. Sinha

The onset of metabolic dysfunction-associated steatohepatitis (MASH) or non-alcoholic steatohepatitis (NASH) represents a tipping point leading to liver injury and subsequent hepatic complications in the natural progression of what is now termed metabolic dysfunction-associated steatotic liver diseases (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD). With no pharmacological treatment currently available for MASH/NASH, the race is on to develop drugs targeting multiple facets of hepatic metabolism, inflammation, and pro-fibrotic events, which are major drivers of MASH. Nuclear receptors (NRs) regulate genomic transcription upon binding to lipophilic ligands and govern multiple aspects of liver metabolism and inflammation. Ligands of NRs may include hormones, lipids, bile acids, and synthetic ligands, which upon binding to NRs regulate the transcriptional activities of target genes. NR ligands are presently the most promising drug candidates expected to receive approval from the United States Food and Drug Administration as a pharmacological treatment for MASH. This review aims to cover the current understanding of NRs, including nuclear hormone receptors, non-steroid hormone receptors, circadian NRs, and orphan NRs, which are currently undergoing clinical trials for MASH treatment, along with NRs that have shown promising results in preclinical studies.

代谢功能障碍相关性脂肪性肝炎(MASH)或非酒精性脂肪性肝炎(NASH)的发病是导致肝损伤和随后肝并发症的临界点,这种疾病现在被称为代谢功能障碍相关性脂肪性肝病(MASLD),以前称为非酒精性脂肪肝(NAFLD)。由于目前还没有针对 MASH/NASH 的药物治疗方法,因此人们正在竞相开发针对肝脏代谢、炎症和促纤维化事件等多个方面的药物,而这些正是 MASH 的主要驱动因素。核受体(NRs)与亲脂配体结合后可调节基因组转录,并控制肝脏代谢和炎症的多个方面。核受体的配体包括激素、脂类、胆汁酸和合成配体,这些配体与核受体结合后可调节靶基因的转录活动。目前,NR 配体是最有希望获得美国食品和药物管理局批准作为 MASH 药物治疗的候选药物。本综述旨在介绍目前对 NRs(包括核激素受体、非类固醇激素受体、昼夜节律 NRs 和孤儿 NRs)的认识,这些 NRs 目前正在用于 MASH 治疗的临床试验中,同时还包括在临床前研究中显示出良好效果的 NRs。
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引用次数: 0
Physical activity and exercise in liver cancer 肝癌患者的体育活动和锻炼
Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.livres.2024.03.001
Haiyan Chen , Huimin Zhou , Bo Wu , Hanxiao Lu , Jie Zhang , Yan Zhang , Yuanlong Gu , Guangwen Zhou , Jie Xiang , Jun Yang

Sarcopenia and physical deconditioning are common complications in patients with liver cancer, which are frequently caused by insufficient physical activity and poor nutritional status, resulting in physical frailty and a significant impact on the patient’s physical fitness. Notably, sarcopenia, frailty, and poor cardiopulmonary endurance have all been linked to higher mortality rates among patients with liver cancer. Exercise intervention significantly improves various health parameters in liver cancer patients, including metabolic syndrome, muscle wasting, cardiorespiratory endurance, health-related quality of life, and reduction in hepatic venous pressure gradient. However, the link between physical exercise and liver cancer is commonly overlooked. In this article, we will examine the impact of exercise on liver cancer and present the most recent evidence on the best types of exercise for various stages of liver cancer. This article also summarizes and discusses the molecular mechanisms that control metabolism and systemic immune function in tumors. In brief, physical exercise should be considered an important intervention in the prevention and treatment of liver cancer and its complications.

肌肉疏松症和身体机能减退是肝癌患者常见的并发症,通常是由于体力活动不足和营养状况不良造成的,从而导致患者身体虚弱,对患者的体能产生重大影响。值得注意的是,肌肉疏松症、虚弱和心肺耐力差都与肝癌患者较高的死亡率有关。运动干预能明显改善肝癌患者的各种健康指标,包括代谢综合征、肌肉萎缩、心肺耐力、与健康相关的生活质量以及肝静脉压力梯度的降低。然而,体育锻炼与肝癌之间的联系通常被忽视。在本文中,我们将探讨运动对肝癌的影响,并介绍针对肝癌不同阶段的最佳运动类型的最新证据。本文还总结并讨论了控制肿瘤代谢和全身免疫功能的分子机制。简而言之,体育锻炼应被视为预防和治疗肝癌及其并发症的重要干预措施。
{"title":"Physical activity and exercise in liver cancer","authors":"Haiyan Chen ,&nbsp;Huimin Zhou ,&nbsp;Bo Wu ,&nbsp;Hanxiao Lu ,&nbsp;Jie Zhang ,&nbsp;Yan Zhang ,&nbsp;Yuanlong Gu ,&nbsp;Guangwen Zhou ,&nbsp;Jie Xiang ,&nbsp;Jun Yang","doi":"10.1016/j.livres.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.livres.2024.03.001","url":null,"abstract":"<div><p>Sarcopenia and physical deconditioning are common complications in patients with liver cancer, which are frequently caused by insufficient physical activity and poor nutritional status, resulting in physical frailty and a significant impact on the patient’s physical fitness. Notably, sarcopenia, frailty, and poor cardiopulmonary endurance have all been linked to higher mortality rates among patients with liver cancer. Exercise intervention significantly improves various health parameters in liver cancer patients, including metabolic syndrome, muscle wasting, cardiorespiratory endurance, health-related quality of life, and reduction in hepatic venous pressure gradient. However, the link between physical exercise and liver cancer is commonly overlooked. In this article, we will examine the impact of exercise on liver cancer and present the most recent evidence on the best types of exercise for various stages of liver cancer. This article also summarizes and discusses the molecular mechanisms that control metabolism and systemic immune function in tumors. In brief, physical exercise should be considered an important intervention in the prevention and treatment of liver cancer and its complications.</p></div>","PeriodicalId":36741,"journal":{"name":"Liver Research","volume":"8 1","pages":"Pages 22-33"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542568424000059/pdfft?md5=78998b626ea43c8886f4937301389c06&pid=1-s2.0-S2542568424000059-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140296802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Protective effects of cyclosporine and its analog NIM-811 in a murine model of hepatic ischemia-reperfusion injury 环孢素及其类似物 NIM-811 在小鼠肝缺血再灌注损伤模型中的保护作用☆。
Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.livres.2024.02.002
Joshua Hefler , Rena Pawlick , Braulio A. Marfil-Garza , Aducio Thiesen , Nerea Cuesta-Gomez , Sanaz Hatami , Darren H. Freed , Constantine Karvellas , David L. Bigam , A.M. James Shapiro

Background and aim

The liver is susceptible to ischemia-reperfusion injury (IRI) during hepatic surgery, when the vessels are compressed to control bleeding, or liver transplantation, when there is an obligate period of ischemia. The hallmark of IRI comprises mitochondrial dysfunction, which generates reactive oxygen species, and cell death through necrosis or apoptosis. Cyclosporine (CsA), which is a well-known immunosuppressive agent that inhibits calcineurin, has the additional effect of inhibiting the mitochondrial permeability transition pore (mPTP), thereby, preventing mitochondrial swelling and injury. NIM-811, which is the nonimmunosuppressive analog of CsA, has a similar effect on the mPTP. In this study, we tested the effect of both agents on mitigating warm hepatic IRI in a murine model.

Materials and methods

Before ischemic insult, the mice were administered with intraperitoneal normal saline (control); CsA at 2.5, 10, or 25 mg/kg; or NIM-811 at 10 mg/kg. Thereafter, the mice were subjected to partial warm hepatic ischemia by selective pedicle clamping for 60 min, followed by 6 h of recovery after reperfusion. Serum alanine transaminase (ALT) was measured, and the liver tissue was examined histologically for the presence of apoptosis and the levels of inflammatory cytokines.

Results

Compared with the control mice, the mice treated with 10 and 25 mg/kg of CsA and NIM-811 had significantly lower ALT levels (P < 0.001, 0.007, and 0.031, respectively). Moreover, the liver tissue showed reduced histological injury scores after treatment with CsA at 2.5, 10, and 25 mg/kg and NIM-811 (P = 0.041, <0.001, 0.003, and 0.043, respectively) and significant decrease in apoptosis after treatment with CsA at all doses (P = 0.012, 0.007, and <0.001, respectively). Levels of the pro-inflammatory cytokines, particularly interleukin (IL)-1β, IL-2, IL-4, IL-10, and keratinocyte chemoattractant/human growth-regulated oncogene significantly decreased in the mice treated with the highest dose of CsA (25 mg/kg) than those in the control mice.

Conclusions

Premedication with CsA or NIM-811 mitigated hepatic IRI in mice, as evidenced by the decreased ALT and reduced injury on histology. These results have potential implications on mitigating IRI during liver transplantation and resection.

背景和目的肝脏在肝脏手术中容易受到缺血再灌注损伤(IRI)的影响,因为在手术中会压迫血管以控制出血,或者在肝脏移植手术中会出现强制性缺血期。IRI 的特征包括线粒体功能障碍(产生活性氧)和细胞坏死或凋亡。环孢素(CsA)是一种著名的免疫抑制剂,可抑制钙调磷酸酶,还具有抑制线粒体通透性转换孔(mPTP)的作用,从而防止线粒体肿胀和损伤。NIM-811 是 CsA 的非免疫抑制类似物,对 mPTP 也有类似作用。在本研究中,我们测试了这两种药物在小鼠模型中减轻温性肝脏 IRI 的效果。材料和方法在缺血损伤前,给小鼠腹腔注射正常生理盐水(对照组)、2.5、10 或 25 mg/kg 的 CsA 或 10 mg/kg 的 NIM-811。之后,通过选择性椎动脉夹闭使小鼠接受部分温性肝缺血 60 分钟,再灌注后恢复 6 小时。结果与对照组小鼠相比,接受 10 和 25 毫克/千克 CsA 和 NIM-811 治疗的小鼠的 ALT 水平显著降低(P 分别为 0.001、0.007 和 0.031)。此外,使用 2.5、10 和 25 毫克/千克的 CsA 和 NIM-811 治疗后,肝组织显示组织学损伤评分降低(P = 0.041、<0.001、0.003 和 0.043),使用所有剂量的 CsA 治疗后,肝细胞凋亡显著减少(P = 0.012、0.007 和 <0.001)。接受最高剂量 CsA(25 毫克/千克)治疗的小鼠体内促炎细胞因子,尤其是白细胞介素 (IL)-1β、IL-2、IL-4、IL-10 和角质形成细胞趋化因子/人生长调节癌基因的水平比对照组小鼠显著降低。这些结果对减轻肝移植和肝切除过程中的肝脏IRI具有潜在的意义。
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引用次数: 0
Should they wait? Two children under 3 years old infected by HCV 1b successfully treated by ledipasvir/sofosbuvir: A report of two cases 他们应该等待吗?雷地帕韦/索非布韦成功治疗2例3岁以下感染HCV 1b的儿童:2例报告
Q2 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.livres.2023.11.001
Mingna Li , Kuerbannisa Wulayin , Shutao Lin , Chao Wu , Lubiao Chen
Although direct-acting antivirals (DAAs) have notably increased the sustained virological response (SVR) rates in hepatitis C virus (HCV)-infected adolescent patients, the efficacy and safety for young children under 3 years old remain unclear. Currently, no guidelines recommend DAA therapy for this situation worldwide. Furthermore, the China National Medical Products Administration has not approved any DAA for treating children below 12 years old. Here, we described the characteristics of two children approximately 2 years old, who were infected by HCV genotype 1b and had significant clinical symptoms. Both received 12 weeks of ledipasvir/sofosbuvir (Case 1: 45.00 mg/200 mg per day, weight 17 kg; Case 2: 33.75 mg/150 mg per day, weight 12 kg). They achieved SVR at 12 weeks after treatment completion without obvious treatment-related adverse effects. Therefore, the safety and benefits of ledipasvir/sofosbuvir treatment in children under 3 years old seem to be confirmed. Our findings require further evaluation.
尽管直接作用抗病毒药物(DAAs)显著提高了丙型肝炎病毒(HCV)感染青少年患者的持续病毒学反应(SVR)率,但其对3岁以下幼儿的疗效和安全性仍不清楚。目前,尚无指南推荐DAA治疗这种情况。此外,中国国家药品监督管理局尚未批准任何用于治疗12岁以下儿童的DAA。在这里,我们描述了两名大约2岁的儿童的特征,他们感染了HCV基因型1b并有明显的临床症状。两例患者均接受12周的雷地帕韦/索非布韦治疗(病例1:45.00 mg/200 mg/天,体重17 kg;病例2:33.75 mg/150 mg/天,体重12 kg)。他们在治疗完成后12周达到SVR,没有明显的治疗相关不良反应。因此,ledipasvir/sofosbuvir治疗3岁以下儿童的安全性和益处似乎得到了证实。我们的发现需要进一步评估。
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引用次数: 0
Hepatocellular carcinoma recurrence: Predictors and management 肝细胞癌复发:肝细胞癌复发:预测因素和处理方法
Q2 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.livres.2023.11.004
Walaa Abdelhamed , Mohamed El-Kassas
Hepatocellular carcinoma (HCC), the sixth most common cancer globally, is associated with high mortality rates and more than 830,000 annual deaths. Despite advances in the available management options including surgical resection and local ablative therapies, recurrence rates after the initial treatment exceed 50%, even among patients who have undergone curative-intent therapy. Moreover, postsurgical HCC recurrence occurs in about 70% of cases five years postoperatively. The management of recurrent HCC remains undefined. This review discusses different predictors for HCC recurrence after each treatment modality and different approaches available to stratify these patients. More specific guidelines for managing HCC recurrence and strict surveillance protocols for such recurrence after initial HCC management are needed.
肝细胞癌(HCC)是全球第六大常见癌症,死亡率高,每年死亡人数超过83万人。尽管现有的治疗选择包括手术切除和局部消融治疗取得了进展,但初始治疗后的复发率超过50%,即使在接受了治疗意图治疗的患者中也是如此。此外,术后5年HCC复发的病例约占70%。复发性HCC的治疗仍不明确。本综述讨论了不同治疗方式后HCC复发的不同预测因素,以及对这些患者进行分层的不同方法。需要更具体的HCC复发管理指南和严格的HCC初始治疗后复发监测方案。
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引用次数: 0
The contributions of bacteria metabolites to the development of hepatic encephalopathy 细菌代谢产物在肝性脑病发展中的作用
Q2 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.livres.2022.11.005
Miranda Claire Gilbert, Tahereh Setayesh, Yu-Jui Yvonne Wan
Over 20% of mortality during acute liver failure is associated with the development of hepatic encephalopathy (HE). Thus, HE is a complication of acute liver failure with a broad spectrum of neuropsychiatric abnormalities ranging from subclinical alterations to coma. HE is caused by the diversion of portal blood into systemic circulation through portosystemic collateral vessels. Thus, the brain is exposed to intestinal-derived toxic substances. Moreover, the strategies to prevent advancement and improve the prognosis of such a liver-brain disease rely on intestinal microbial modulation. This is supported by the findings that antibiotics such as rifaximin and laxative lactulose can alleviate hepatic cirrhosis and/or prevent HE. Together, the significance of the gut-liver-brain axis in human health warrants attention. This review paper focuses on the roles of bacteria metabolites, mainly ammonia and bile acids (BAs) as well as BA receptors in HE. The literature search conducted for this review included searches for phrases such as BA receptors, BAs, ammonia, farnesoid X receptor (FXR), G protein-coupled bile acid receptor 1 (GPBAR1 or TGR5), sphingosine-1-phosphate receptor 2 (S1PR2), and cirrhosis in conjunction with the phrase hepatic encephalopathy and portosystemic encephalopathy. PubMed, as well as Google Scholar, was the search engines used to find relevant publications.
急性肝衰竭期间超过 20% 的死亡率与肝性脑病(HE)的发生有关。因此,肝性脑病是急性肝衰竭的一种并发症,可引起从亚临床改变到昏迷等多种神经精神异常。HE 是由于门静脉血液通过门静脉侧支血管转入全身循环所致。因此,大脑会接触到肠源性有毒物质。此外,防止这种肝脑疾病恶化和改善预后的策略依赖于肠道微生物调节。利福昔明等抗生素和通便剂乳果糖能缓解肝硬化和/或预防肝脑病的研究结果也支持这一观点。总之,肠道-肝脏-大脑轴在人类健康中的重要性值得关注。本综述论文重点研究细菌代谢产物(主要是氨、胆汁酸和胆汁酸受体)在肝硬化中的作用。本综述的文献检索包括对 BA 受体、BAs、氨、类雌激素 X 受体 (FXR)、G 蛋白偶联胆汁酸受体 1 (GPBAR1 或 TGR5)、鞘氨醇-1-磷酸受体 2 (S1PR2)、肝硬化等词组以及肝性脑病和门静脉脑病等词组的检索。PubMed 和 Google Scholar 是用于查找相关出版物的搜索引擎。
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引用次数: 0
Dietary pattern and hepatic lipid metabolism 饮食模式与肝脏脂质代谢
Q2 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.livres.2023.11.006
Peng Zou, Lin Wang
The liver is the leading site for lipid metabolism, involving not only fatty acid beta-oxidation but also de novo synthesis of endogenous triglycerides and ketogenesis. The liver maintains systemic lipid homeostasis by regulating lipid synthesis, catabolism, and transportation. Dysregulation of hepatic lipid metabolism precipitates disorders, such as non-alcoholic fatty liver disease (NAFLD), affecting the whole body. Thus, comprehending and studying hepatic lipid metabolism is crucial for preventing and treating metabolic liver diseases. Traditionally, researchers have investigated the impact of a single nutrient on hepatic lipid metabolism. However, real-life dietary patterns encompass diverse nutrients rather than single components. In recent years, there have been increased studies and notable progress regarding the effects of distinct dietary patterns on hepatic lipid metabolism. This review summarizes the influence of diverse dietary patterns on hepatic lipid metabolism, elucidating underlying molecular mechanisms and appraising the therapeutic potential of dietary patterns in managing hepatic steatosis.
肝脏是脂质代谢的主要部位,不仅涉及脂肪酸β -氧化,还涉及内源性甘油三酯的重新合成和生酮。肝脏通过调节脂质合成、分解代谢和运输来维持全身脂质稳态。肝脏脂质代谢失调导致疾病,如影响全身的非酒精性脂肪性肝病(NAFLD)。因此,了解和研究肝脏脂质代谢对代谢性肝病的防治至关重要。传统上,研究人员研究了单一营养素对肝脏脂质代谢的影响。然而,现实生活中的饮食模式包含多种营养成分,而不是单一成分。近年来,关于不同饮食模式对肝脏脂质代谢影响的研究越来越多,并取得了显著进展。本文综述了不同饮食模式对肝脏脂质代谢的影响,阐明了潜在的分子机制,并评价了饮食模式在治疗肝脂肪变性中的治疗潜力。
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Liver Research
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