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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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引用次数: 0
Unveiling the effect of estrogen receptors in alcoholic liver disease: A novel outlook 揭示雌激素受体在酒精性肝病中的作用:一个新的前景
Q2 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.livres.2023.10.002
Sukriti Baweja , Ashmit Mittal , Swati Thangariyal , P. Debishree Subudhi , Shivani Gautam , Rashmi Kaul
Alcoholic liver disease (ALD) has a multifaceted development, progressing from alcoholic steatosis to alcoholic hepatitis and ultimately to alcoholic cirrhosis, irreversible liver damage that can even result in hepatocellular carcinoma. The prevalence of ALD is increasing globally, particularly among middle-aged adults. Gender-based studies have revealed that ALD affects more men; however, disease progression differs between men and women. Despite this, the molecular understanding of alcohol-induced liver injury among genders and its association with changes in sex hormone metabolism, particularly with estrogen and estrogen receptors (ERs) in ALD, remains poor. This review focuses on experimental and human studies describing alcohol and its association with estrogen metabolism and signaling via ERs. Chronic alcohol consumption affects the immune response, and whether estrogen has any contributory effect remains inadequately studied. This review also discusses various therapeutic approaches currently in use and future approaches that can affect the response or progression via estrogen signaling. The role of gender on alcohol consumption and its association with steroid hormones must be elucidated for a better understanding of the pathogenesis of ALD, the development of effective therapeutic approaches, and better disease management in both men and women, as ALD remains a major public health concern.
酒精性肝病(ALD)具有多方面的发展,从酒精性脂肪变性发展到酒精性肝炎,最终发展为酒精性肝硬化,这是一种不可逆的肝损伤,甚至可导致肝细胞癌。ALD的患病率在全球范围内呈上升趋势,尤其是在中年人中。基于性别的研究表明,ALD影响更多的是男性;然而,男性和女性之间的疾病进展是不同的。尽管如此,对性别间酒精性肝损伤及其与性激素代谢变化,特别是ALD中雌激素和雌激素受体(er)变化的关系的分子理解仍然很差。本文综述了酒精及其与雌激素代谢和内质网信号传导的关系的实验和人体研究。长期饮酒影响免疫反应,雌激素是否有任何促进作用仍未充分研究。本综述还讨论了目前使用的各种治疗方法和未来的方法,这些方法可以通过雌激素信号影响反应或进展。性别在酒精消费中的作用及其与类固醇激素的关系必须被阐明,以便更好地了解ALD的发病机制,开发有效的治疗方法,并更好地管理男性和女性的疾病,因为ALD仍然是一个主要的公共卫生问题。
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引用次数: 0
Autophagy modulates physiologic and adaptive response in the liver 自噬调节肝脏的生理和适应反应
Q2 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.livres.2023.12.001
Trinh Van Le , Nhung Hai Truong , Ai Xuan L. Holterman
Autophagy is a physiological process that is ubiquitous and essential to the disposal or recycling of damaged cellular organelles and misfolded proteins to maintain organ homeostasis and survival. Its importance in the regulation of liver function in normal and pathological conditions is increasingly recognized. This review summarizes how autophagy regulates epithelial cell- and non-epithelial cell-specific function in the liver and how it differentially participates in hepatic homeostasis, hepatic injury response to stress-induced liver damage such as cholestasis, sepsis, non-alcoholic and alcohol-associated liver disease, viral hepatitis, hepatic fibrosis, hepatocellular and cholangiocellular carcinoma, and aging. Autophagy-based interventional studies for liver diseases that are currently registered in clinicatrials.gov are summarized. Given the broad and multidirectional autophagy response in the liver, a more refined understanding of the liver cell-specific autophagy activities in a context-dependent manner is necessary.
自噬是一种普遍存在的生理过程,对于处理或回收受损的细胞器和错误折叠的蛋白质以维持器官的稳态和生存至关重要。它在正常和病理条件下调节肝功能的重要性日益被认识到。本文综述了自噬如何调节肝脏上皮细胞和非上皮细胞特异性功能,以及它如何以不同的方式参与肝脏稳态、肝损伤对应激性肝损伤的反应,如胆汁淤滞、败血症、非酒精性和酒精相关肝病、病毒性肝炎、肝纤维化、肝细胞癌和胆管细胞癌以及衰老。总结了目前在clinatrials .gov上注册的基于自噬的肝脏疾病介入研究。鉴于肝脏中广泛且多向的自噬反应,以上下文依赖的方式更精细地了解肝细胞特异性自噬活动是必要的。
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引用次数: 0
Synergistic impacts of rifampicin and doxorubicin against thioacetamide-induced hepatocellular carcinoma in rats 利福平和多柔比星对硫代乙酰胺诱导的大鼠肝细胞癌的协同作用
Q2 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.livres.2023.11.005
Zahraa R. Elshahawy , Entsar A. Saad , Rana R. El-Sadda

Background and aims

Combination therapy is a promising new strategy that has been proposed to increase the efficacy of cancer treatment. We aimed to investigate the anti-cancer activity of rifampicin monotherapy and its combination with doxorubicin against hepatocellular carcinoma (HCC).

Materials and methods

The in vitro half maximal inhibitory concentration (IC50) and selectivity index (SI) of the drugs under investigation against HepG2 and human lung fibroblast (WI38) cell lines were determined. For the in vivo experiment, male Sprague-Dawley albino rats were injected with thioacetamide at 200 mg/kg twice a week for 90 days; HCC development was confirmed histopathologically. Following HCC induction, the rats were treated with intraperitoneal doxorubicin, rifampicin, or their combination for 45 or 90 days. After sacrifice, the livers were examined histopathologically. The levels of aminotransferases, albumin, bilirubin, malondialdehyde, superoxide dismutase (SOD), catalase (CAT), total antioxidant capacity (TAC), and nitric oxide were measured by spectrophotometry. Alpha-fetoprotein, cancer antigen 19-9, tumor necrosis factor-alpha, interleukin-6, Bcl-2-associated X protein, caspase 3, caspase 8, and p53 were estimated using ELISA.

Results

In vitro, the combination of doxorubicin and rifampicin showed the highest SI of 3.43. In vivo, among the measured markers, the levels of TAC, CAT, SOD, and p53 decreased (P < 0.001) and the rest of the measured marker levels increased (P < 0.001) in the HCC-bearing rats; after treatment in all groups, all these changes improved toward normal in a time-dependent manner. The combination of doxorubicin and rifampicin optimized the effects of the two individual drugs and exerted the best antioxidant effects.

Conclusions

In general, compared with rifampicin or doxorubicin alone, combination therapy has favorable outcomes. Based on our results, the combination of rifampicin and doxorubicin might be applicable for HCC chemotherapy.
背景与目的联合治疗是一种很有前途的新策略,可以提高癌症治疗的疗效。本研究旨在探讨利福平单药及联合阿霉素治疗肝细胞癌的抗癌作用。材料与方法测定所研究药物对HepG2和人肺成纤维细胞(WI38)的体外半数最大抑制浓度(IC50)和选择性指数(SI)。在体实验中,雄性Sprague-Dawley白化大鼠按200mg /kg剂量注射硫乙酰胺,每周2次,连续注射90 d;组织病理学证实HCC的发展。肝细胞癌诱导后,大鼠腹腔注射阿霉素、利福平或其联合用药45天或90天。牺牲后,对肝脏进行组织病理学检查。分光光度法测定转氨酶、白蛋白、胆红素、丙二醛、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、总抗氧化能力(TAC)、一氧化氮水平。采用ELISA法检测甲胎蛋白、癌抗原19-9、肿瘤坏死因子- α、白细胞介素-6、bcl -2相关X蛋白、caspase 3、caspase 8、p53。结果在体外,阿霉素与利福平联用的SI最高,为3.43;在体内,在测量的标志物中,TAC、CAT、SOD和p53水平下降(P <;0.001),其余测量的标志物水平升高(P <;0.001);各组治疗后,这些变化均随时间的变化向正常方向改善。阿霉素与利福平联合用药可优化两种单用药物的抗氧化效果,并发挥最佳的抗氧化作用。结论总的来说,与单独使用利福平或阿霉素相比,联合治疗效果较好。基于我们的结果,利福平联合阿霉素可能适用于肝癌化疗。
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引用次数: 0
In-depth analysis of de novo lipogenesis in non-alcoholic fatty liver disease: Mechanism and pharmacological interventions 深入分析非酒精性脂肪肝的新生脂肪生成:机制与药物干预
Q2 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.livres.2023.11.003
Zhixian Zhu , Xiaoxun Zhang , Qiong Pan , Liangjun Zhang , Jin Chai
Non-alcoholic fatty liver disease (NAFLD) is characterized by the abnormal buildup of lipids in the liver tissue. Non-alcoholic fatty liver (NAFL) may progress to non-alcoholic steatohepatitis. Triglycerides in the liver can originate from various sources, including de novo lipogenesis (DNL). Research indicates that DNL significantly escalates in NAFLD, worsening steatosis. However, the precise regulatory mechanism of DNL in the development of this disease is not fully understood. Therefore, the targeted reduction of DNL could be a crucial therapeutic strategy. Currently, numerous pharmaceutical agents targeting DNL have been developed, attracting significant attention. This review examines the mechanism of DNL upregulation in NAFLD, assessing its potential as a therapeutic target for hepatic steatosis. Furthermore, we thoroughly examine hepatocellular lipotoxicity and provide an extensive review of the application and limitations of relevant therapeutic drugs, with a focus on key enzymes involved in DNL. The implementation of these pharmacological strategies is expected to significantly improve the management and overall outcomes for patients with NAFLD.
非酒精性脂肪性肝病(NAFLD)的特点是肝组织中脂质异常积聚。非酒精性脂肪肝(NAFL)可发展为非酒精性脂肪性肝炎。肝脏中的甘油三酯可以有多种来源,包括新生脂肪生成(DNL)。研究表明,NAFLD中DNL显著升高,使脂肪变性恶化。然而,DNL在本病发展中的确切调控机制尚不完全清楚。因此,靶向减少DNL可能是一种至关重要的治疗策略。目前,许多针对DNL的药物制剂被开发出来,引起了人们的广泛关注。本文综述了NAFLD中DNL上调的机制,评估了其作为肝脂肪变性治疗靶点的潜力。此外,我们深入研究了肝细胞脂肪毒性,并对相关治疗药物的应用和局限性进行了广泛的回顾,重点是涉及DNL的关键酶。这些药理学策略的实施有望显著改善NAFLD患者的管理和总体结果。
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引用次数: 0
Sequential ultrasound molecular imaging for noninvasive identification and assessment of non-alcoholic steatohepatitis in mouse models 序列超声分子成像用于小鼠模型非酒精性脂肪性肝炎的无创鉴定和评估
Q2 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.livres.2023.11.002
Tingting Sha , Yujia You , Xiaoyan Miao , Huan Deng , Wei Zhang , Huolin Ye , Ping Wang , Rongqin Zheng , Jie Ren , Tinghui Yin

Background and objective

Noninvasive non-alcoholic steatohepatitis (NASH) assessment is a clinical challenge to the management of non-alcoholic fatty liver disease. We aim to develop diagnostic models based on sequential ultrasound molecular imaging (USMI) for the noninvasive identification of NASH in mouse models.

Methods

Animal experiments were approved by the Animal Ethics Committee of South China Agricultural University. Forty-nine C57BL/6 mice were divided into normal control, non-alcoholic fatty liver, NASH, and hepatitis groups. Sequential USMI was implemented using CD36-targeted microbubbles (MBs-CD36) and intercellular adhesion molecule-1 (ICAM-1)-targeted microbubbles (MBs-ICAM-1) to visualize hepatic steatosis and inflammation. The targeting signal of USMI was quantified as the normalized intensity difference (NID) with the destruction-replenishment method. Correlation analysis was conducted between the NID-MBs-CD36 and pathological steatosis score and between the NID-MBs-ICAM-1 and pathological inflammation score. Finally, diagnostic models combining NID-MBs-CD36 with NID-MBs-ICAM-1 were established for NASH diagnosis.

Results

MBs-CD36 and MBs-ICAM-1 were successfully prepared and used for sequential USMI in all mice. NID-MBs-CD36 values increased with the progression of steatosis, while NID-MBs-ICAM-1 values increased in parallel with the progression of inflammation. A strong positive correlation was identified between NID-MBs-CD36 and pathological steatosis grade (rs = 0.9078, P < 0.0001) and between NID-MBs-ICAM-1 and pathological inflammation grade (rs = 0.9071, P < 0.0001). Among various sequential USMI-based diagnostic models, the serial testing model showed high diagnostic performance in detecting NASH, with 95% sensitivity, 97% specificity, 95% positive predictive values, 97% negative predictive values, and 96% accuracy.

Conclusions

Sequential USMI using MBs-CD36 and MBs-ICAM-1 allows noninvasive grading of hepatic steatosis and inflammation. Sequential USMI-based diagnostic models hold great potential in the noninvasive identification of NASH.
背景与目的无创非酒精性脂肪性肝炎(NASH)评估是对非酒精性脂肪性肝病治疗的临床挑战。我们的目标是建立基于序列超声分子成像(USMI)的诊断模型,用于小鼠NASH模型的无创识别。方法动物实验经华南农业大学动物伦理委员会批准。49只C57BL/6小鼠分为正常对照组、非酒精性脂肪肝组、NASH组和肝炎组。序贯USMI使用靶向cd36的微泡(MBs-CD36)和靶向细胞间粘附分子-1 (ICAM-1)的微泡(MBs-ICAM-1)来观察肝脏脂肪变性和炎症。用破坏-补充法将USMI的目标信号量化为归一化强度差(NID)。对NID-MBs-CD36与病理性脂肪变性评分、NID-MBs-ICAM-1与病理性炎症评分进行相关性分析。最后,建立NID-MBs-CD36与NID-MBs-ICAM-1联合诊断NASH的模型。结果成功制备了smbs - cd36和MBs-ICAM-1,并用于所有小鼠的序贯USMI。NID-MBs-CD36值随着脂肪变性的进展而增加,而NID-MBs-ICAM-1值随着炎症的进展而平行增加。NID-MBs-CD36与病理性脂肪变性分级呈正相关(rs = 0.9078, P <;0.0001), NID-MBs-ICAM-1与病理性炎症分级之间存在差异(rs = 0.9071, P <;0.0001)。在各种基于序列usmi的诊断模型中,序列检测模型在检测NASH方面表现出较高的诊断性能,灵敏度为95%,特异性为97%,阳性预测值为95%,阴性预测值为97%,准确率为96%。结论:使用MBs-CD36和MBs-ICAM-1进行序贯USMI可以对肝脏脂肪变性和炎症进行无创分级。基于序列usmi的诊断模型在NASH的无创诊断中具有很大的潜力。
{"title":"Sequential ultrasound molecular imaging for noninvasive identification and assessment of non-alcoholic steatohepatitis in mouse models","authors":"Tingting Sha ,&nbsp;Yujia You ,&nbsp;Xiaoyan Miao ,&nbsp;Huan Deng ,&nbsp;Wei Zhang ,&nbsp;Huolin Ye ,&nbsp;Ping Wang ,&nbsp;Rongqin Zheng ,&nbsp;Jie Ren ,&nbsp;Tinghui Yin","doi":"10.1016/j.livres.2023.11.002","DOIUrl":"10.1016/j.livres.2023.11.002","url":null,"abstract":"<div><h3>Background and objective</h3><div>Noninvasive non-alcoholic steatohepatitis (NASH) assessment is a clinical challenge to the management of non-alcoholic fatty liver disease. We aim to develop diagnostic models based on sequential ultrasound molecular imaging (USMI) for the noninvasive identification of NASH in mouse models.</div></div><div><h3>Methods</h3><div>Animal experiments were approved by the Animal Ethics Committee of South China Agricultural University. Forty-nine C57BL/6 mice were divided into normal control, non-alcoholic fatty liver, NASH, and hepatitis groups. Sequential USMI was implemented using CD36-targeted microbubbles (MBs-CD36) and intercellular adhesion molecule-1 (ICAM-1)-targeted microbubbles (MBs-ICAM-1) to visualize hepatic steatosis and inflammation. The targeting signal of USMI was quantified as the normalized intensity difference (NID) with the destruction-replenishment method. Correlation analysis was conducted between the NID-MBs-CD36 and pathological steatosis score and between the NID-MBs-ICAM-1 and pathological inflammation score. Finally, diagnostic models combining NID-MBs-CD36 with NID-MBs-ICAM-1 were established for NASH diagnosis.</div></div><div><h3>Results</h3><div>MBs-CD36 and MBs-ICAM-1 were successfully prepared and used for sequential USMI in all mice. NID-MBs-CD36 values increased with the progression of steatosis, while NID-MBs-ICAM-1 values increased in parallel with the progression of inflammation. A strong positive correlation was identified between NID-MBs-CD36 and pathological steatosis grade (r<sub>s</sub> = 0.9078, <em>P</em> &lt; 0.0001) and between NID-MBs-ICAM-1 and pathological inflammation grade (r<sub>s</sub> = 0.9071, <em>P</em> &lt; 0.0001). Among various sequential USMI-based diagnostic models, the serial testing model showed high diagnostic performance in detecting NASH, with 95% sensitivity, 97% specificity, 95% positive predictive values, 97% negative predictive values, and 96% accuracy.</div></div><div><h3>Conclusions</h3><div>Sequential USMI using MBs-CD36 and MBs-ICAM-1 allows noninvasive grading of hepatic steatosis and inflammation. Sequential USMI-based diagnostic models hold great potential in the noninvasive identification of NASH.</div></div>","PeriodicalId":36741,"journal":{"name":"Liver Research","volume":"7 4","pages":"Pages 342-351"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139301470","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
Mutation of autophagy-related gene ATG7 increases the risk of severe disease in patients with non-alcoholic fatty liver disease 自噬相关基因ATG7突变增加非酒精性脂肪肝患者严重疾病的风险
Q2 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.livres.2023.10.001
Mary Miu Yee Waye
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引用次数: 0
Liver retransplants using living donors: An approach for management 使用活体供体进行肝脏再移植:一种管理方法
Q2 Medicine Pub Date : 2023-09-01 DOI: 10.1016/j.livres.2023.09.003
Hasan Al Harakeh, Christopher Hughes, Amit Tevar, Vikram Gunabushanam, Eishan Ashwat, Hao Liu, Abhinav Humar

Background and aims

Many centers do not offer living donor transplants for patients in need of a liver retransplant. We aimed to study our liver retransplant outcomes using living donors and compared them with those of retransplants performed using deceased donors.

Methods

This study retrospectively analyzed all retransplants performed at our center between 2009 and 2023, and outcomes of living donor retransplants were compared with deceased donor retransplants using standard statistical tests.

Results

Between January 2009 and March 2023, a total of 77 retransplants, 60 with deceased donors and 17 with living donors, were performed. Important demographic differences between the two groups included a higher model for end-stage liver disease score in the deceased donor group (32.1 ± 6.1 vs. 19.4 ± 5.7, P < 0.001) and a higher number of early retransplants (within 3 months of the initial transplant), which accounted for 35% of deceased donor transplants but 0 of living donor transplants (P < 0.01). Overall, the patient and graft survival rates were comparable between the two groups. The patient survival rates at 1 and 3 years after transplant were 73% and 67% in the deceased donor group and 84% and 73% in the living donor group, respectively (P = 0.57). The hospital length of stay and blood product use were both better in the living donor group. Biliary complications did not show significant different between the two groups (P = 0.33).

Conclusions

Living donors can provide acceptable outcomes for those in need of a retransplant, with results comparable to those seen with deceased donors. A systematic approach to the patient in the pre-, peri-, and post-transplantation period is important in these complicated cases.

背景和目的任何中心都不为需要再次肝移植的患者提供活体供体移植。我们旨在研究使用活体捐赠者进行的肝脏再移植结果,并将其与使用已故捐赠者进行的再移植结果进行比较。方法本研究回顾性分析了2009年至2023年间在我们中心进行的所有再移植,并使用标准统计检验将活体供体再移植与已故供体再移植的结果进行了比较。结果2009年1月至2023年3月,共进行了77例再移植,其中60例为已故捐赠者,17例为活体捐赠者。两组之间的重要人口统计学差异包括已故供体组的终末期肝病评分较高(32.1±6.1 vs.19.4±5.7,P<;0.001),以及早期再移植次数较高(在首次移植后3个月内),占已故供体移植的35%,但占活供体移植的0(P<;0.01)。总体而言,两组患者和移植物的存活率相当。移植后1年和3年的患者存活率在已故供体组分别为73%和67%,在活体供体组分别是84%和73%(P=0.57)。活体供体组的住院时间和血液制品使用情况都更好。两组的胆道并发症没有显著差异(P=0.33)。结论活体捐赠者可以为需要再次移植的人提供可接受的结果,其结果与已故捐赠者的结果相当。在这些复杂的病例中,在移植前、移植周和移植后对患者进行系统的治疗是很重要的。
{"title":"Liver retransplants using living donors: An approach for management","authors":"Hasan Al Harakeh,&nbsp;Christopher Hughes,&nbsp;Amit Tevar,&nbsp;Vikram Gunabushanam,&nbsp;Eishan Ashwat,&nbsp;Hao Liu,&nbsp;Abhinav Humar","doi":"10.1016/j.livres.2023.09.003","DOIUrl":"https://doi.org/10.1016/j.livres.2023.09.003","url":null,"abstract":"<div><h3>Background and aims</h3><p>Many centers do not offer living donor transplants for patients in need of a liver retransplant. We aimed to study our liver retransplant outcomes using living donors and compared them with those of retransplants performed using deceased donors.</p></div><div><h3>Methods</h3><p>This study retrospectively analyzed all retransplants performed at our center between 2009 and 2023, and outcomes of living donor retransplants were compared with deceased donor retransplants using standard statistical tests.</p></div><div><h3>Results</h3><p>Between January 2009 and March 2023, a total of 77 retransplants, 60 with deceased donors and 17 with living donors, were performed. Important demographic differences between the two groups included a higher model for end-stage liver disease score in the deceased donor group (32.1 ± 6.1 <em>vs</em>. 19.4 ± 5.7, <em>P</em> &lt; 0.001) and a higher number of early retransplants (within 3 months of the initial transplant), which accounted for 35% of deceased donor transplants but 0 of living donor transplants (<em>P</em> &lt; 0.01). Overall, the patient and graft survival rates were comparable between the two groups. The patient survival rates at 1 and 3 years after transplant were 73% and 67% in the deceased donor group and 84% and 73% in the living donor group, respectively (<em>P</em> = 0.57). The hospital length of stay and blood product use were both better in the living donor group. Biliary complications did not show significant different between the two groups (<em>P</em> = 0.33).</p></div><div><h3>Conclusions</h3><p>Living donors can provide acceptable outcomes for those in need of a retransplant, with results comparable to those seen with deceased donors. A systematic approach to the patient in the pre-, peri-, and post-transplantation period is important in these complicated cases.</p></div>","PeriodicalId":36741,"journal":{"name":"Liver Research","volume":"7 3","pages":"Pages 252-255"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50203041","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}
引用次数: 0
Clinical characteristics and risk factors of hepatitis B virus-related cirrhosis/hepatocellular carcinoma: A single-center retrospective study 乙型肝炎病毒相关性肝硬化/肝细胞癌的临床特征及危险因素:一项单中心回顾性研究
Q2 Medicine Pub Date : 2023-09-01 DOI: 10.1016/j.livres.2023.07.004
Feng Chen , Qianhui Li , Xiaomin Xu , Fei Wang

Background and aims

Hepatitis B virus (HBV) infection is a major global health problem which progresses to liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Early prediction of disease changes and intervention are essential to slow disease progression and protect liver function. This study aimed to analyze the clinical characteristics of patients with HBV-related LC and HCC at different serum alanine aminotransferase (ALT) levels and explore the risk factors of HBV infection progressing to LC/HCC.

Methods

A total of 379 patients with HBV infection treated in The Third People's Hospital of Shenzhen between January 2014 and December 2016 without any antiviral drug therapy were enrolled. Patients were divided into the LC/HCC and non-LC/HCC groups based on clinical diagnosis, which was determined through imaging and expressions of pathological and laboratory test markers, and patients with LC/HCC were further divided into three groups according to the serum ALT levels. Differences in general information, clinical symptoms, and expression levels of serological indices of the above groups were compared and analyzed, logistic regression was used to analyze the risk factors for LC/HCC development, and the clinical diagnostic efficacy of indicators was judged by the receiver operator characteristic (ROC).

Results

LC/HCC mainly occurred in the ALT normal and mildly elevated groups, with 70.83% of patients with HCC having an LC background. In the comparison of different ALT level groups, the moderately–severely elevated group had the highest proportion of patients with skin jaundice, abdominal varices, rebound tenderness, higher white blood cell and neutrophil (NEUT) counts; and higher levels of aspartate aminotransferase, glutamyl transpeptidase, total bilirubin, and direct bilirubin. The LC/HCC group was older and had significantly higher proportions of male patients, alcohol consumption, and combined hypertension than the non-LC/HCC group (all P < 0.05). Logistic regression analysis showed that age, combined hypertension, abdominal varicose veins, subcostal palpation, and NEUT count were risk factors for LC/HCC development; and the area under the curve for this model on the ROC analysis was 0.935 (95% confidence interval 0.899–0.972) with specificity and sensitivity of 97.4% and 70.7%, respectively.

Conclusions

Advanced age, combined hypertension, abdominal varicose veins, subcostal palpation, and high NEUT count are risk factors for LC/HCC development in patients with untreated HBV infection.

背景与目的乙型肝炎病毒(HBV)感染是一个主要的全球性健康问题,可发展为肝硬化(LC)和肝细胞癌(HCC)。早期预测疾病变化和干预对于减缓疾病进展和保护肝功能至关重要。本研究旨在分析不同血清丙氨酸氨基转移酶(ALT)水平的HBV相关LC和HCC患者的临床特征,探讨HBV感染进展为LC/HCC的危险因素已注册。根据临床诊断,通过影像学、病理学和实验室检测标志物的表达,将患者分为LC/HCC和非LC/HCC组,根据血清ALT水平,将LC/HCC患者进一步分为三组。比较分析上述各组在一般信息、临床症状和血清学指标表达水平方面的差异,采用逻辑回归分析LC/HCC发展的危险因素,结果LC/HCC主要发生在ALT正常组和轻度升高组,70.83%的HCC患者有LC背景。在不同ALT水平组的比较中,中度-重度升高组的皮肤黄疸、腹部静脉曲张、反弹压痛、白细胞和中性粒细胞(NEUT)计数较高的患者比例最高;天冬氨酸转氨酶、谷氨酰转肽酶、总胆红素和直接胆红素水平较高。LC/HCC组年龄较大,男性患者比例、饮酒量和合并高血压均显著高于非LC/HEC组(均P<;0.05)。Logistic回归分析显示,年龄、合并高血压、腹部静脉曲张、肋下触诊和NEUT计数是LC/HCC发展的危险因素;ROC分析中该模型的曲线下面积为0.935(95%置信区间0.899–0.972),特异性和敏感性分别为97.4%和70.7%。结论高龄、合并高血压、腹部静脉曲张、肋下触诊和高NEUT计数是未经治疗的HBV感染患者发生LC/HCC的危险因素。
{"title":"Clinical characteristics and risk factors of hepatitis B virus-related cirrhosis/hepatocellular carcinoma: A single-center retrospective study","authors":"Feng Chen ,&nbsp;Qianhui Li ,&nbsp;Xiaomin Xu ,&nbsp;Fei Wang","doi":"10.1016/j.livres.2023.07.004","DOIUrl":"10.1016/j.livres.2023.07.004","url":null,"abstract":"<div><h3>Background and aims</h3><p>Hepatitis B virus (HBV) infection is a major global health problem which progresses to liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Early prediction of disease changes and intervention are essential to slow disease progression and protect liver function. This study aimed to analyze the clinical characteristics of patients with HBV-related LC and HCC at different serum alanine aminotransferase (ALT) levels and explore the risk factors of HBV infection progressing to LC/HCC.</p></div><div><h3>Methods</h3><p>A total of 379 patients with HBV infection treated in The Third People's Hospital of Shenzhen between January 2014 and December 2016 without any antiviral drug therapy were enrolled. Patients were divided into the LC/HCC and non-LC/HCC groups based on clinical diagnosis, which was determined through imaging and expressions of pathological and laboratory test markers, and patients with LC/HCC were further divided into three groups according to the serum ALT levels. Differences in general information, clinical symptoms, and expression levels of serological indices of the above groups were compared and analyzed, logistic regression was used to analyze the risk factors for LC/HCC development, and the clinical diagnostic efficacy of indicators was judged by the receiver operator characteristic (ROC).</p></div><div><h3>Results</h3><p>LC/HCC mainly occurred in the ALT normal and mildly elevated groups, with 70.83% of patients with HCC having an LC background. In the comparison of different ALT level groups, the moderately–severely elevated group had the highest proportion of patients with skin jaundice, abdominal varices, rebound tenderness, higher white blood cell and neutrophil (NEUT) counts; and higher levels of aspartate aminotransferase, glutamyl transpeptidase, total bilirubin, and direct bilirubin. The LC/HCC group was older and had significantly higher proportions of male patients, alcohol consumption, and combined hypertension than the non-LC/HCC group (all <em>P</em> &lt; 0.05). Logistic regression analysis showed that age, combined hypertension, abdominal varicose veins, subcostal palpation, and NEUT count were risk factors for LC/HCC development; and the area under the curve for this model on the ROC analysis was 0.935 (95% confidence interval 0.899–0.972) with specificity and sensitivity of 97.4% and 70.7%, respectively.</p></div><div><h3>Conclusions</h3><p>Advanced age, combined hypertension, abdominal varicose veins, subcostal palpation, and high NEUT count are risk factors for LC/HCC development in patients with untreated HBV infection.</p></div>","PeriodicalId":36741,"journal":{"name":"Liver Research","volume":"7 3","pages":"Pages 237-243"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47219675","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}
引用次数: 0
Discordance among aggressiveness characteristics of hepatocellular carcinoma: Portal vein thrombosis and multifocality, related to tumor size, but not to serum alpha-fetoprotein level 肝癌侵袭性特征的不一致:门静脉血栓形成和多灶性与肿瘤大小有关,但与血清甲胎蛋白水平无关☆
Q2 Medicine Pub Date : 2023-09-01 DOI: 10.1016/j.livres.2023.07.003
Brian I. Carr , Vito Guerra , Volkan Ince , Burak Isik , Sezai Yilmaz

Background and aims

Hepatocellular carcinoma (HCC) is characterized by several clinically important prognostic parameters, including portal vein thrombosis (PVT), tumor multifocality, and serum alpha-fetoprotein (AFP) levels, in addition to maximum tumor diameter (MTD). However, associations among these parameters have not been thoroughly examined. Thus, the study aimed to investigate the correlations among these HCC characteristics in a prospectively collected database.

Methods

An 8080 HCC patient database derived from our weekly HCC council meeting was examined with respect to the correlations at baseline patient presentation between increases in MTD and changes in the percentage of patients with PVT, multifocality, or AFP levels.

Results

The percentage of patients with PVT and with multifocality (tumor nodule numbers ≥3) significantly increased with enlarging MTD, regardless of the serum AFP level, showing the independence of PVT and multifocality on AFP. The percentage of patients with multifocality increased with enlarging MTD, in the presence or absence of PVT, showing the independence of multifocality from PVT. Therefore, discordance was found between different tumor parameters.

Conclusions

A statistically significant association was found between PVT and MTD and between multifocality and MTD, all three of which are independent of AFP. PVT and multifocality appeared to be independent of each other. Although PVT and multifocality were independent of AFP, they were also augmented with high serum AFP levels. The results suggest the possibility of multiple pathways of tumor progression in the later stages of HCC development.

背景和目的肝细胞癌(HCC)具有几个临床重要预后参数的特征,包括门静脉血栓形成(PVT)、肿瘤多灶性、血清甲胎蛋白(AFP)水平以及最大肿瘤直径(MTD)。然而,这些参数之间的关联尚未得到彻底的研究。因此,本研究旨在通过前瞻性收集的数据库调查这些HCC特征之间的相关性。方法从我们每周的HCC理事会会议中获得的8080名HCC患者数据库中,检查MTD增加与PVT、多灶性或AFP水平患者百分比变化之间的相关性。结果无论血清AFP水平如何,PVT和多灶性(结节数≥3)患者的百分比均随MTD的增大而显著增加,表明PVT和多灶性与AFP无关。在PVT存在或不存在的情况下,多灶性患者的百分比随着MTD的增大而增加,显示出多灶性与PVT的独立性。因此,发现不同肿瘤参数之间存在不一致。结论PVT与MTD、多灶性与MTD之间存在显著的相关性,三者均独立于AFP。PVT和多焦性似乎是相互独立的。尽管PVT和多灶性与AFP无关,但它们也随着血清AFP水平的升高而增强。研究结果表明,在HCC发展的后期,肿瘤进展可能存在多种途径。
{"title":"Discordance among aggressiveness characteristics of hepatocellular carcinoma: Portal vein thrombosis and multifocality, related to tumor size, but not to serum alpha-fetoprotein level","authors":"Brian I. Carr ,&nbsp;Vito Guerra ,&nbsp;Volkan Ince ,&nbsp;Burak Isik ,&nbsp;Sezai Yilmaz","doi":"10.1016/j.livres.2023.07.003","DOIUrl":"10.1016/j.livres.2023.07.003","url":null,"abstract":"<div><h3>Background and aims</h3><p>Hepatocellular carcinoma (HCC) is characterized by several clinically important prognostic parameters, including portal vein thrombosis (PVT), tumor multifocality, and serum alpha-fetoprotein (AFP) levels, in addition to maximum tumor diameter (MTD). However, associations among these parameters have not been thoroughly examined. Thus, the study aimed to investigate the correlations among these HCC characteristics in a prospectively collected database.</p></div><div><h3>Methods</h3><p>An 8080 HCC patient database derived from our weekly HCC council meeting was examined with respect to the correlations at baseline patient presentation between increases in MTD and changes in the percentage of patients with PVT, multifocality, or AFP levels.</p></div><div><h3>Results</h3><p>The percentage of patients with PVT and with multifocality (tumor nodule numbers ≥3) significantly increased with enlarging MTD, regardless of the serum AFP level, showing the independence of PVT and multifocality on AFP. The percentage of patients with multifocality increased with enlarging MTD, in the presence or absence of PVT, showing the independence of multifocality from PVT. Therefore, discordance was found between different tumor parameters.</p></div><div><h3>Conclusions</h3><p>A statistically significant association was found between PVT and MTD and between multifocality and MTD, all three of which are independent of AFP. PVT and multifocality appeared to be independent of each other. Although PVT and multifocality were independent of AFP, they were also augmented with high serum AFP levels. The results suggest the possibility of multiple pathways of tumor progression in the later stages of HCC development.</p></div>","PeriodicalId":36741,"journal":{"name":"Liver Research","volume":"7 3","pages":"Pages 256-262"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48148863","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}
引用次数: 0
期刊
Liver Research
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