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1.
Zhonghua Gan Zang Bing Za Zhi ; 28(4): 302-307, 2020 Apr 20.
Artículo en Chino | MEDLINE | ID: mdl-32403881

RESUMEN

Domestic scholars recognize that patients have a "pre-hepatic failure" before they progress to sub-acute and acute-on-chronic liver failure stage, which is also the golden window for effective clinical intervention, so early identification and intervention during this period can reduce the incidence and mortality of liver failure. The Guidelines for the Diagnosis and Treatment of Liver Failure (2018 Edition) issued by the Chinese Medical Association clearly defines the "pre-stage" of liver failure. And from the perspective of pathophysiological mechanism, the pre-hepatic failure corresponds to the stage of acute liver injury/acute decompensation, inflammation factor/ immunologic derangement. This article briefly introduces the research progress on substantive connotation and pathogenesis of pre-hepatic failure, and puts forward some problems to be explored in the future.


Asunto(s)
Insuficiencia Hepática/diagnóstico , Insuficiencia Hepática/patología , Humanos , Inflamación
2.
Hepatology ; 72(6): 2165-2181, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32190913

RESUMEN

BACKGROUND AND AIMS: Hepatic crisis is an emergent complication affecting patients with sickle cell disease (SCD); however, the molecular mechanism of sickle cell hepatobiliary injury remains poorly understood. Using the knock-in humanized mouse model of SCD and SCD patient blood, we sought to mechanistically characterize SCD-associated hepato-pathophysiology applying our recently developed quantitative liver intravital imaging, RNA sequence analysis, and biochemical approaches. APPROACH AND RESULTS: SCD mice manifested sinusoidal ischemia, progressive hepatomegaly, liver injury, hyperbilirubinemia, and increased ductular reaction under basal conditions. Nuclear factor kappa B (NF-κB) activation in the liver of SCD mice inhibited farnesoid X receptor (FXR) signaling and its downstream targets, leading to loss of canalicular bile transport and altered bile acid pool. Intravital imaging revealed impaired bile secretion into the bile canaliculi, which was secondary to loss of canalicular bile transport and bile acid metabolism, leading to intrahepatic bile accumulation in SCD mouse liver. Blocking NF-κB activation rescued FXR signaling and partially ameliorated liver injury and sinusoidal ischemia in SCD mice. CONCLUSIONS: These findings identify that NF-κB/FXR-dependent impaired bile secretion promotes intrahepatic bile accumulation, which contributes to hepatobiliary injury of SCD. Improved understanding of these processes could potentially benefit the development of therapies to treat sickle cell hepatic crisis.


Asunto(s)
Anemia de Células Falciformes/complicaciones , Bilis/metabolismo , Colestasis/etiología , Insuficiencia Hepática/etiología , Hígado/patología , Adolescente , Adulto , Anemia de Células Falciformes/sangre , Anemia de Células Falciformes/tratamiento farmacológico , Anemia de Células Falciformes/genética , Animales , Conductos Biliares Intrahepáticos/diagnóstico por imagen , Conductos Biliares Intrahepáticos/patología , Colestasis/patología , Colestasis/prevención & control , Modelos Animales de Enfermedad , Femenino , Técnicas de Sustitución del Gen , Hemoglobina Falciforme/genética , Insuficiencia Hepática/patología , Insuficiencia Hepática/prevención & control , Humanos , Microscopía Intravital , Hígado/diagnóstico por imagen , Masculino , Ratones , Persona de Mediana Edad , FN-kappa B/antagonistas & inhibidores , FN-kappa B/efectos de los fármacos , FN-kappa B/metabolismo , Receptores Citoplasmáticos y Nucleares/metabolismo , Transducción de Señal/efectos de los fármacos , Adulto Joven
4.
Sci Rep ; 9(1): 11674, 2019 08 12.
Artículo en Inglés | MEDLINE | ID: mdl-31406146

RESUMEN

Statins reduce cardiovascular risk. However, "real-life" data on statin use in patients with chronic liver disease and its impact on overall and liver-related survival are limited. Therefore, we assessed 1265 CLD patients stratified as advanced (ACLD) or non-advanced (non-ACLD) stage. Statin indication was evaluated according to the 2013 ACC/AHA guidelines and survival-status was verified by national death registry data. Overall, 122 (9.6%) patients had an indication for statin therapy but did not receive statins, 178 (14.1%) patients were on statins and 965 (76.3%) patients had no indication for statins. Statin underutilization was 34.2% in non-ACLD and 48.2% in ACLD patients. In non-ACLD patients, survival was worse without a statin despite indication as compared to patients on statin or without indication (log-rank p = 0.018). In ACLD patients, statin use did not significantly impact on survival (log-rank p = 0.264). Multivariate cox regression analysis confirmed improved overall survival in patients with statin as compared to patients with indication but no statin (HR 0.225; 95%CI 0.053-0.959; p = 0.044) and a trend towards reduced liver-related mortality (HR 0.088; 95%CI 0.006-1.200; p = 0.068). This was not observed in ACLD patients. In conclusion, guideline-confirm statin use is often withhold from  patients with liver disease and this underutilization is associated with impaired survival in non-ACLD patients.


Asunto(s)
Anticolesterolemiantes/uso terapéutico , Dislipidemias/tratamiento farmacológico , Insuficiencia Hepática/tratamiento farmacológico , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Adulto , Anciano , Enfermedad Crónica , Dislipidemias/metabolismo , Dislipidemias/mortalidad , Dislipidemias/patología , Femenino , Insuficiencia Hepática/metabolismo , Insuficiencia Hepática/mortalidad , Insuficiencia Hepática/patología , Humanos , Hígado/efectos de los fármacos , Hígado/metabolismo , Hígado/patología , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Modelos de Riesgos Proporcionales , Sistema de Registros
5.
Hepatology ; 70(3): 995-1010, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31038762

RESUMEN

Hemorrhagic shock (HS) is a life-threatening condition associated with tissue hypoperfusion and often leads to injury of multiple organs including the liver. Pregnane X receptor (PXR) is a species-specific xenobiotic receptor that regulates the expression of drug-metabolizing enzymes (DMEs) such as the cytochrome P450 (CYP) 3A. Many clinical drugs, including those often prescribed to trauma patients, are known to activate PXR and induce CYP3A. The goal of this study is to determine whether PXR plays a role in the regulation of DMEs in the setting of HS and whether activation of PXR is beneficial or detrimental to HS-induced hepatic injury. PXR transgenic, knockout, and humanized mice were subject to HS, and the liver injury was assessed histologically and biochemically. The expression and/or activity of PXR and CYP3A were manipulated genetically or pharmacologically in order to determine their effects on HS-induced liver injury. Our results showed that genetic or pharmacological activation of PXR sensitized wild-type and hPXR/CYP3A4 humanized mice to HS-induced hepatic injury, whereas knockout of PXR protected mice from HS-induced liver injury. Mechanistically, the sensitizing effect of PXR activation was accounted for by PXR-responsive induction of CYP3A and increased oxidative stress in the liver. The sensitizing effect of PXR was attenuated by ablation or pharmacological inhibition of CYP3A, treatment with the antioxidant N-acetylcysteine amide, or treatment with a PXR antagonist. Conclusion: We have uncovered a function of PXR in HS-induced hepatic injury. Our results suggest that the unavoidable use of PXR-activating drugs in trauma patients has the potential to exacerbate HS-induced hepatic injury, which can be mitigated by the coadministration of antioxidative agents, CYP3A inhibitors, or PXR antagonists.


Asunto(s)
Inhibidores del Citocromo P-450 CYP3A/farmacología , Citocromo P-450 CYP3A/metabolismo , Insuficiencia Hepática/patología , Receptor X de Pregnano/genética , Choque Hemorrágico/genética , Animales , Modelos Animales de Enfermedad , Regulación de la Expresión Génica , Insuficiencia Hepática/etiología , Insuficiencia Hepática/genética , Humanos , Ratones , Ratones Noqueados , Ratones Transgénicos , Pronóstico , Distribución Aleatoria , Medición de Riesgo , Choque Hemorrágico/complicaciones , Choque Hemorrágico/tratamiento farmacológico , Tasa de Supervivencia , Resultado del Tratamiento , Regulación hacia Arriba
6.
Antioxid Redox Signal ; 30(14): 1760-1773, 2019 05 10.
Artículo en Inglés | MEDLINE | ID: mdl-30403148

RESUMEN

AIMS: Remote ischemic conditioning (RIC) protects against organ ischemia/reperfusion injury in experimental and clinical settings. We have demonstrated that RIC prevents liver and lung inflammation/injury after hemorrhagic shock/resuscitation (S/R). In this study, we used a murine model of S/R to investigate the role of nuclear factor (erythroid-derived 2)-like 2 (Nrf2) in mediating hepatoprotection. RESULTS: The combination of RIC with S/R caused a synergistic rise in Nrf2 and its translocation to the nucleus in the liver. Increased activation of Nrf2 by RIC augmented heme oxygenase-1 (HO-1) and autophagy and exerted hepatoprotection, concurrent with reductions in S/R-induced TNF-α (tumor necrosis factor alpha) and IL-6 (interleukin-6). In Nrf2 knockout (KO) animals, RIC did not exert hepatoprotection, and it failed to upregulate HO-1 and autophagy. Further, resuscitating wildtype (WT) animals with blood from donor WT animals undergoing RIC was hepatoprotective, but not in Nrf2 KO recipient animals. Interestingly, RIC blood from Nrf2 KO donor animals was also not protective when used to resuscitate WT animals, suggesting a role for Nrf2 both in the afferent arm of RIC where protective factors are generated and also in the efferent arm where organ protection is exerted. Finally, RIC plasma prevented oxidant-induced zebrafish mortality, but not in Nrf2a morpholino knockdown fish. INNOVATION: Activation of Nrf2 is an essential mechanism underlying the hepatoprotective effects of RIC. Nrf2 appears to play a role in the afferent limb of RIC protection, as its absence precludes the generation of the protective humoral factors induced by RIC. CONCLUSION: Our studies demonstrate the critical role of Nrf2 in the ability of RIC to prevent organ injury after S/R.


Asunto(s)
Precondicionamiento Isquémico , Hígado/irrigación sanguínea , Hígado/metabolismo , Factor 2 Relacionado con NF-E2/genética , Choque Hemorrágico/metabolismo , Animales , Autofagia/genética , Modelos Animales de Enfermedad , Hemo-Oxigenasa 1/genética , Hemo-Oxigenasa 1/metabolismo , Insuficiencia Hepática/etiología , Insuficiencia Hepática/metabolismo , Insuficiencia Hepática/patología , Peróxido de Hidrógeno/metabolismo , Peróxido de Hidrógeno/farmacología , Inmunohistoquímica , Inflamación/etiología , Inflamación/metabolismo , Inflamación/patología , Hígado/patología , Hígado/ultraestructura , Lesión Pulmonar/etiología , Lesión Pulmonar/metabolismo , Lesión Pulmonar/patología , Ratones , Ratones Noqueados , Factor 2 Relacionado con NF-E2/metabolismo , Choque Hemorrágico/complicaciones , Choque Hemorrágico/etiología , Transducción de Señal
7.
Khirurgiia (Mosk) ; (2): 39-44, 2018.
Artículo en Ruso | MEDLINE | ID: mdl-29460877

RESUMEN

AIM: To determine ALPPS advisability in small future remnant liver. MATERIAL AND METHODS: 22 ALPPS procedures were performed at the Center for Surgery and Transplantology for the period from 2011 to 2016. Indications were both tumoral and non-tumoral unresectable liver diseases. Postoperative complications were classified according to Clavien-Dindo, ISGLS. RESULTS: According to CT-volumetry future remnant liver before the 1st stage of ALPPS was from 17 to 25%, before the 2nd stage - from 28 to 49%. Both stages were carried out in all patients with R0-resection in 100%. Postoperative complications were diagnosed in 40.9%, 1 death was caused by severe pulmonary embolism. Follow-up varied from 3 to 48 months (median 17.5), 86% of patients are alive at present. CONCLUSION: ALPPS provides rapid and effective FLR growth and can be used for both tumoral and non-tumoral unresectable liver diseases. However, ALPPS should be performed strictly according to indications and only in specialized centers with extensive experience of advanced liver resection and transplantation after previous comprehensive selection of patients.


Asunto(s)
Hepatectomía , Insuficiencia Hepática , Neoplasias Hepáticas/cirugía , Hígado , Vena Porta/cirugía , Femenino , Hepatectomía/efectos adversos , Hepatectomía/métodos , Insuficiencia Hepática/etiología , Insuficiencia Hepática/patología , Insuficiencia Hepática/fisiopatología , Insuficiencia Hepática/prevención & control , Humanos , Ligadura/métodos , Hígado/irrigación sanguínea , Hígado/patología , Hígado/fisiopatología , Neoplasias Hepáticas/patología , Regeneración Hepática , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Evaluación de Procesos y Resultados en Atención de Salud , Complicaciones Posoperatorias/patología , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/prevención & control
8.
J Diet Suppl ; 15(3): 330-342, 2018 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-28816548

RESUMEN

Research findings that suggest beneficial health effects of dietary supplementation with virgin coconut oil (VCO) are limited in the published literature. This study investigated the in vivo effects of a 5-week VCO-supplemented diet on lipid profile, hepatic antioxidant status, hepatorenal function, and cardiovascular risk indices in normal rats. Rats were randomly divided into 3 groups: 1 control and 2 treatment groups (10% and 15% VCO-supplemented diets) for 5 weeks. Serum and homogenate samples were used to analyze lipid profile, hepatorenal function markers, hepatic activities of antioxidant enzymes, and malondialdehyde level. Lipid profile of animals fed VCO diets showed significant reduction in total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) levels; high-density lipoprotein (HDL) level increased significantly (p < .05) compared to control; and there were beneficial effects on cardiovascular risk indices. The level of malondialdehyde (MDA), a lipid peroxidation marker, remarkably reduced and activities of hepatic antioxidant enzymes-superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx)-were markedly increased in VCO diet-fed rats. The VCO diet significantly modulated creatinine, sodium (Na+), potassium (K+), chloride (Cl-), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) compared to control. The findings suggest a beneficial effect of VCO on lipid profile, renal status, hepatic antioxidant defense system, and cardiovascular risk indices in rats.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Aceite de Coco/uso terapéutico , Suplementos Dietéticos , Insuficiencia Hepática/prevención & control , Hígado/metabolismo , Estrés Oxidativo , Insuficiencia Renal/prevención & control , Animales , Biomarcadores/sangre , Biomarcadores/metabolismo , Enfermedades Cardiovasculares/metabolismo , Enfermedades Cardiovasculares/patología , Enfermedades Cardiovasculares/fisiopatología , Aceite de Coco/administración & dosificación , Aceite de Coco/normas , Calidad de los Alimentos , Insuficiencia Hepática/metabolismo , Insuficiencia Hepática/patología , Insuficiencia Hepática/fisiopatología , Humanos , Riñón/fisiología , Riñón/fisiopatología , Metabolismo de los Lípidos , Peroxidación de Lípido , Lípidos/sangre , Hígado/patología , Hígado/fisiología , Hígado/fisiopatología , Masculino , Tamaño de los Órganos , Oxidorreductasas/antagonistas & inhibidores , Oxidorreductasas/metabolismo , Distribución Aleatoria , Ratas Wistar , Insuficiencia Renal/metabolismo , Insuficiencia Renal/patología , Insuficiencia Renal/fisiopatología
9.
J Surg Res ; 220: 363-371, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-29180204

RESUMEN

BACKGROUND: It is not known whether simultaneous delivery of hydrogen and oxygen can reduce injury caused by hemorrhagic shock and resuscitation (HSR). This study investigated the therapeutic potential of hyperoxygenated hydrogen-rich solution (HHOS), a combined hydrogen/oxygen carrier, in a rat model of HSR-induced liver injury. MATERIALS AND METHODS: Rats (n = 60) were randomly divided into 5 groups (n = 6 per group at each time point). One group underwent sham operation, and the others were subjected to severe hemorrhagic shock and then treated with lactated Ringer's solution (LRS), hydrogen-rich solution, hyperoxygenated solution, or HHOS. At 2 and 6 h after resuscitation, blood samples (n = 6) were collected from the femoral artery and serum concentrations of alanine aminotransferase and aspartate aminotransferase (AST) were measured. Rats were then sacrificed, and histopathological changes in the liver were evaluated by quantifying the percentage of apoptotic cells by caspase-3 immunohistochemistry and terminal deoxynucleotidyl transferase dUTP nick-end labeling. Inflammation was assessed by assessing malondialdehyde content and tumor necrosis factor-α, and interleukin (IL)-6 expression. RESULTS: Compared to lactated Ringer's solution, hydrogen-rich solution, or hyperoxygenated solution groups, serum AST and alanine aminotransferase levels and IL-6, tumor necrosis factor-α, and malondialdehyde expression in liver tissue were decreased by HHOS treatment. The number of caspase-3- and terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells was decreased (P < 0.05) by HHOS treatment, 2 and 6 h after resuscitation. CONCLUSIONS: HHOS has protective effects against liver injury in a rat model of HSR.


Asunto(s)
Insuficiencia Hepática/prevención & control , Resucitación/efectos adversos , Choque Hemorrágico/complicaciones , Soluciones/uso terapéutico , Animales , Citocinas/metabolismo , Modelos Animales de Enfermedad , Insuficiencia Hepática/etiología , Insuficiencia Hepática/patología , Hidrógeno/uso terapéutico , Hígado/metabolismo , Hígado/ultraestructura , Masculino , Oxígeno/uso terapéutico , Distribución Aleatoria , Ratas Sprague-Dawley
10.
Am J Pathol ; 187(11): 2473-2485, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28807594

RESUMEN

The thyromimetic agent GC-1 induces hepatocyte proliferation via Wnt/ß-catenin signaling and may promote regeneration in both acute and chronic liver insufficiencies. However, ß-catenin activation due to mutations in CTNNB1 is seen in a subset of hepatocellular carcinomas (HCC). Thus, it is critical to address any effect of GC-1 on HCC growth and development before its use can be advocated to stimulate regeneration in chronic liver diseases. In this study, we first examined the effect of GC-1 on ß-catenin-T cell factor 4 activity in HCC cell lines harboring wild-type or mutated-CTNNB1. Next, we assessed the effect of GC-1 on HCC in FVB mice generated by hydrodynamic tail vein injection of hMet-S45Y-ß-catenin, using the sleeping beauty transposon-transposase. Four weeks following injection, mice were fed 5 mg/kg GC-1 or basal diet for 10 or 21 days. GC-1 treatment showed no effect on ß-catenin-T cell factor 4 activity in HCC cells, irrespective of CTNNB1 mutations. Treatment with GC-1 for 10 or 21 days led to a significant reduction in tumor burden, associated with decreased tumor cell proliferation and dramatic decreases in phospho-(p-)Met (Y1234/1235), p-extracellular signal-related kinase, and p-STAT3 without affecting ß-catenin and its downstream targets. GC-1 exerts a notable antitumoral effect on hMet-S45Y-ß-catenin HCC by inactivating Met signaling. GC-1 does not promote ß-catenin activation in HCC. Thus, GC-1 may be safe for use in inducing regeneration during chronic hepatic insufficiency.


Asunto(s)
Acetatos/farmacología , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/tratamiento farmacológico , Fenoles/farmacología , beta Catenina/metabolismo , Carcinoma Hepatocelular/tratamiento farmacológico , Carcinoma Hepatocelular/metabolismo , Proliferación Celular/efectos de los fármacos , Insuficiencia Hepática/patología , Humanos , Neoplasias Hepáticas/metabolismo
11.
Sci Rep ; 7(1): 3698, 2017 06 16.
Artículo en Inglés | MEDLINE | ID: mdl-28623253

RESUMEN

CCL5/RANTES, a chemoattractant for myeloid cells, is induced by hepatic ischemia/reperfusion injury (IRI). The roles of CCL5 in hepatic IRI were carried out by means of CCL5 immunodepletion, antagonistic competition by Met-CCL5, and treatment with recombinant murine CCL5 (rmCCL5). Depletion or inhibition of CCL5 reduced severity of hepatic IRI, whereas rmCCL5 treatment aggravated liver IRI as manifested in elevated serum alanine aminotransferase (ALT) and tissue myeloperoxidase (MPO) levels. Moreover, IRI severity was reduced in CCL5-knockout (CCL5-KO) mice versus wildtype (WT) mice, with drops in serum ALT level, intrahepatic MPO activity, and histological pathology. Bone marrow transplantion (BMT) studies show that myeloid cells and tissue cells are both required for CCL5-aggravated hepatic IRI. The profile of liver-infiltrating leukocyte subsets after hepatic reperfusion identified CD11b+ cells as the only compartment significantly reduced in CCL5-KO mice versus WT controls at early reperfusion phase. The role of CCL5 recruiting CD11b+ cells in early reperfusion was validated by in vitro transwell migration assay of murine primary macrophages (broadly characterized by their CD11b expression) in response to liver lysates after early reperfusion. Taken together, our results demonstrate a sequence of early events elicited by CCL5 chemoattracting macrophage that result in inflammatory aggravation of hepatic IRI.


Asunto(s)
Quimiocina CCL5/genética , Insuficiencia Hepática/etiología , Insuficiencia Hepática/metabolismo , Isquemia/metabolismo , Macrófagos/metabolismo , Daño por Reperfusión/etiología , Daño por Reperfusión/metabolismo , Animales , Biomarcadores , Antagonistas de los Receptores CCR5/farmacología , Proliferación Celular , Quimiocina CCL5/metabolismo , Modelos Animales de Enfermedad , Citometría de Flujo , Insuficiencia Hepática/tratamiento farmacológico , Insuficiencia Hepática/patología , Inmunohistoquímica , Inmunofenotipificación , Pruebas de Función Hepática , Macrófagos/inmunología , Macrófagos/patología , Masculino , Ratones , Ratones Noqueados , Receptores CCR5/genética , Receptores CCR5/metabolismo , Daño por Reperfusión/tratamiento farmacológico , Daño por Reperfusión/patología
12.
Cell Physiol Biochem ; 41(3): 1063-1071, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28245475

RESUMEN

BACKGROUND/AIMS: To analyze alterations of interferon-γ-induced protein 10 (IP-10) and thymus and activation-regulated chemokine (TARC) levels in early acute liver transplantation rejection. METHODS: Thirty-six patients with early acute liver transplantation rejection were classified as non-, mild, moderate, and severe rejection groups. The levels of serum IP-10 and TARC were determined on days 3, 2, 1, and 0 before biopsy. RESULTS: The IP-10 activities in all rejection groups were significantly higher (p < 0.05) than those in the non-rejection group at all time points and correlated with the extent of rejection (p < 0.05). The differences in TARC among the three rejection groups were significant (p < 0.05), and its highest level was found in the mild rejection group at all observed time points, whereas its lowest level was detected in the severe rejection group. The analysis of the TARC/IP-10 ratio revealed that the volume was correlated with the rejection degree. This ratio in the moderate and severe rejection groups on days 2, 1, and 0 before biopsy were 20% lower than that before transplantation. CONCLUSION: Serum IP-10 showed an increasing trend during early acute liver transplantation rejection. IP-10 increase or TARC/IP-10 ratio decrease combining with abnormal hepatic enzymatic alteration could be a valuable and specific sign for early rejection of the transplanted liver.


Asunto(s)
Quimiocina CCL17/sangre , Quimiocina CXCL10/sangre , Rechazo de Injerto/sangre , Rechazo de Injerto/diagnóstico , Trasplante de Hígado , Adolescente , Adulto , Alanina Transaminasa/sangre , Aspartato Aminotransferasas/sangre , Bilirrubina/sangre , Biomarcadores/sangre , Quimiocina CCL17/genética , Quimiocina CXCL10/genética , Enfermedad Crónica , Diagnóstico Precoz , Femenino , Expresión Génica , Rechazo de Injerto/inmunología , Rechazo de Injerto/patología , Insuficiencia Hepática/patología , Insuficiencia Hepática/cirugía , Humanos , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Adulto Joven
13.
Infect Dis (Lond) ; 49(4): 241-250, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28092214

RESUMEN

Hepatitis delta virus (HDV) is a defective satellite virus and propagates in the presence of Hepatitis B virus (HBV) surface antigen (HBsAg). Approximately 5% of the people who infected with HBV are also infected with HDV. Chronic hepatitis caused by delta is the most severe form of chronic viral hepatitis including accelerated fibrosis, liver decompensation and development of hepatocellular carcinoma. Interferon-based therapies still remain the only treatment option of the hepatitis delta. The beneficiary effects of the interferon-based therapies, however, stop frequently with termination of the given therapy and relapse rate is very high. Accordingly, the efficiency rate of this treatment does not exceed 30%. On the other hand, serious side effects of interferons are another troublesome leading to withdrawal of the therapy. The main goal of the current treatments is clearance of HBsAg. There is no available drug acting directly against the HDV. New therapies interacting with HDV life cycle are under investigation. While prenylation inhibitors act on merely HDV, viral entry inhibitors and HBsAg release inhibitors would be used in the treatment of both HBV and HDV. We hope that in the future, the use of novel therapies and HBV vaccination provide to clinicians to cope with this troublesome agent.


Asunto(s)
Antivirales/uso terapéutico , Hepatitis D/tratamiento farmacológico , Virus de la Hepatitis Delta/fisiología , Interferones/uso terapéutico , Antivirales/efectos adversos , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/virología , Enfermedad Crónica , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Insuficiencia Hepática/patología , Insuficiencia Hepática/virología , Antígenos de Superficie de la Hepatitis B/metabolismo , Hepatitis D/complicaciones , Hepatitis D/patología , Humanos , Interferones/efectos adversos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/patología , Cirrosis Hepática/virología , Neoplasias Hepáticas/etiología , Neoplasias Hepáticas/patología , Resultado del Tratamiento
14.
J Diabetes Complications ; 31(1): 186-194, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27742550

RESUMEN

AIM: To identify the prevalence and effect of hepatopathies of different etiologies among pediatric patients with type 1 diabetes mellitus (T1DM) using transient elastography (TE) and its relation to glycemic control. METHODS: One hundred T1DM patients were studied focusing on liver functions, fasting lipid profile, hemoglobin A1c (HbA1c), hepatitis C virus (HCV), serum immunoglobulins, autoimmune antibodies; anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA), and anti-liver kidney microsomal antibody (anti-LKM). Abdominal ultrasound was performed and TE was done for patients with HCV, positive autoimmune antibody and/or abnormal ultrasound findings. RESULTS: Thirty-one patients were found to have one or more hepatic abnormalities; clinical hepatomegaly in 8%, elevated alanine aminotransferase (ALT) in 10%, HCV in 6%, autoimmune hepatitis (AIH) in 11% (10 were positive for ASMA and 2 were positive for ANA while anti-LKM antibodies were negative) and abnormal hepatic ultrasound in 20% (12 non-alcoholic fatty liver disease, 5 AIH, 2 HCV, 1 Mauriac syndrome). Mean liver stiffness in those 31 patients was 7.0±2.1kPa (range, 3.1-11.8kPa); 24 were Metavir F0-F1, 7 were F2-F3 while none was F4. Type 1 diabetic patients with abnormal hepatic ultrasound had higher fasting blood glucose, HbA1c and total cholesterol than those with normal findings. Liver stiffness was significantly higher in patients with abnormal liver ultrasound compared with normal sonography. Liver stiffness was positively correlated to HbA1c and ALT. CONCLUSIONS: Hepatic abnormalities are prevalent in T1DM and related to poor metabolic control. TE provides a non-invasive method for detection of hepatopathy-induced fibrosis.


Asunto(s)
Diabetes Mellitus Tipo 1/complicaciones , Insuficiencia Hepática/diagnóstico por imagen , Hiperglucemia/prevención & control , Hipoglucemia/prevención & control , Hígado/diagnóstico por imagen , Adolescente , Biomarcadores/sangre , Biopsia , Estudios Transversales , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/terapia , Egipto/epidemiología , Diagnóstico por Imagen de Elasticidad , Femenino , Hemoglobina Glucada/análisis , Hepacivirus/aislamiento & purificación , Insuficiencia Hepática/complicaciones , Insuficiencia Hepática/patología , Insuficiencia Hepática/virología , Hepatitis C/complicaciones , Hepatitis C/epidemiología , Hepatitis C/patología , Hepatitis C/virología , Hepatitis Autoinmune/complicaciones , Hepatitis Autoinmune/epidemiología , Hepatitis Autoinmune/patología , Hepatitis Autoinmune/virología , Hepatomegalia/complicaciones , Hepatomegalia/diagnóstico por imagen , Hepatomegalia/epidemiología , Hepatomegalia/patología , Humanos , Incidencia , Hígado/patología , Hígado/virología , Masculino , Prevalencia , Ultrasonografía
15.
J Surg Res ; 206(2): 263-272, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27884318

RESUMEN

BACKGROUND: N-acetylcysteine (NAC) is an antioxidant with direct and indirect antioxidant actions used in the clinical setting. Oxidative stress is known to play a pivotal role in the intestinal ischemia reperfusion (IIR). Therefore, we studied the effect of different pretreatment regimens with NAC on the IIR injury in rats. MATERIALS AND METHODS: Thirty-five male Wistar rats were randomly assigned to five groups. In group sham, only laparotomy was performed. Group control underwent IIR without NAC. In the other groups, NAC was administered intraperitoneally with different regimens: 150 mg/kg before ischemia (NAC 150), 300 mg/kg before ischemia (NAC 300), and 150 mg/kg before ischemia plus 150 mg/kg 5 min before reperfusion (NAC 150 + 150). Measurements in tissues and blood were conducted at 4 h of reperfusion following exsanguination. RESULTS: Histological score of the liver was significantly improved in NAC 300 compared with control (1.7 ± 0.5 versus 2.9 ± 1.1, respectively, P = 0.05). In addition, NAC treatment significantly reduced liver transaminases in all groups of treatment, mostly in group NAC 300. Plasma malondialdehyde levels were lower with NAC treatment, although not statistically significant. Lung glutathione peroxidase was significantly increased in group NAC 300 (P = 0.04), while the other oxidation biomarkers showed no significant differences. CONCLUSIONS: NAC exerts a significant protective role in liver injury following IIR, which seems to be independent of an intestinal protective effect. Additional administration of NAC before reperfusion was of no further benefit. The most effective regimen among the compared regimens was that of 300 mg/kg before ischemia.


Asunto(s)
Acetilcisteína/uso terapéutico , Antioxidantes/uso terapéutico , Insuficiencia Hepática/prevención & control , Intestinos/irrigación sanguínea , Daño por Reperfusión/tratamiento farmacológico , Acetilcisteína/farmacología , Animales , Antioxidantes/farmacología , Biomarcadores/metabolismo , Insuficiencia Hepática/etiología , Insuficiencia Hepática/metabolismo , Insuficiencia Hepática/patología , Inyecciones Intraperitoneales , Hígado/efectos de los fármacos , Hígado/metabolismo , Hígado/patología , Pruebas de Función Hepática , Masculino , Estrés Oxidativo/efectos de los fármacos , Distribución Aleatoria , Ratas , Ratas Wistar , Daño por Reperfusión/metabolismo , Daño por Reperfusión/fisiopatología
16.
Toxicol Lett ; 260: 36-45, 2016 Oct 17.
Artículo en Inglés | MEDLINE | ID: mdl-27553672

RESUMEN

Sorbitol is a polyol used by the food industry as a sweetener. Women are consuming diet and light products containing sorbitol during pregnancy and in the postnatal period to prevent themselves from excessive weight gain and maintain a slim body. Although there is no evidence for the genotoxicity of sorbitol in the perinatal period, this study focused on evaluating the effects of the maternal intake of sorbitol on the biochemical and toxicological parameters of lactating Wistar rat offspring after 14days of mother-to-offspring exposure. A dose-dependent reduction of offspring length was observed. An increase in sorbitol levels determined in the milk was also observed. However, we detected an inverse relationship between the exposition dose in milk fructose and triacylglycerols concentrations. There was an increase in the plasmatic levels of ALT, AST and LDLc and a decrease in proteins, cholesterol and glucose levels in the offspring. Sorbitol exposure caused hepatocyte genotoxicity, including micronuclei induction. Maternal sorbitol intake induced myelotoxicity and myelosuppression in their offspring. The Comet assay of the blood cells detected a dose-dependent genotoxic response within the sorbitol-exposed offspring. According to our results, sorbitol is able to induce important metabolic alterations and genotoxic responses in the exposed offspring.


Asunto(s)
Trastornos del Crecimiento/etiología , Insuficiencia Hepática/etiología , Lactancia , Fenómenos Fisiologicos Nutricionales Maternos , Trastornos Mieloproliferativos/etiología , Edulcorantes no Nutritivos/efectos adversos , Sorbitol/efectos adversos , Animales , Biomarcadores/sangre , Femenino , Fructosa/análisis , Trastornos del Crecimiento/sangre , Trastornos del Crecimiento/patología , Trastornos del Crecimiento/fisiopatología , Células Hep G2 , Insuficiencia Hepática/sangre , Insuficiencia Hepática/patología , Insuficiencia Hepática/fisiopatología , Humanos , Hígado/fisiopatología , Masculino , Leche/química , Pruebas de Mutagenicidad , Mutágenos/efectos adversos , Trastornos Mieloproliferativos/sangre , Trastornos Mieloproliferativos/patología , Trastornos Mieloproliferativos/fisiopatología , Edulcorantes no Nutritivos/administración & dosificación , Edulcorantes no Nutritivos/análisis , Embarazo , Efectos Tardíos de la Exposición Prenatal/sangre , Efectos Tardíos de la Exposición Prenatal/etiología , Efectos Tardíos de la Exposición Prenatal/patología , Efectos Tardíos de la Exposición Prenatal/fisiopatología , Ratas Wistar , Sorbitol/administración & dosificación , Sorbitol/análisis , Triglicéridos/análisis
17.
Klin Khir ; (2): 5-7, 2016 Feb.
Artículo en Ruso | MEDLINE | ID: mdl-27244907

RESUMEN

Abstract The factors, determining possibility of early postoperative morbidity occurrence in patients, suffering gastro-esophageal zone cancer, were analyzed. After radical operation performance (gastrectomy, gastric and esophageal resection) 5.7% patients died. Insufficience of the anastomosis sutures with peritonitis occurrence, an acute hepato-renal insufficience, an acute coronary syndrome, pulmonary thromboembolism, pneumonia, the brain insult, pancreonecrosis and mesenterial thrombosis constituted the main morbidities. The complications occurrence depends upon the tumoral process course severity, morphological variant of cancer, presence of concomitant diaphragmatic hernia and the blood rheological properties. Initially high indices of the blood sera present a rheological properties of blood serum may serve as a prognostic criterion of the postoperative complications occurrence in the patients.


Asunto(s)
Neoplasias Esofágicas/cirugía , Esofagectomía , Gastrectomía , Hernia Diafragmática/cirugía , Complicaciones Posoperatorias/patología , Neoplasias Gástricas/cirugía , Síndrome Coronario Agudo/etiología , Síndrome Coronario Agudo/mortalidad , Síndrome Coronario Agudo/patología , Adulto , Anciano , Anciano de 80 o más Años , Anastomosis Quirúrgica , Biomarcadores/sangre , Neoplasias Esofágicas/complicaciones , Neoplasias Esofágicas/mortalidad , Neoplasias Esofágicas/patología , Femenino , Insuficiencia Hepática/etiología , Insuficiencia Hepática/mortalidad , Insuficiencia Hepática/patología , Hernia Diafragmática/complicaciones , Hernia Diafragmática/mortalidad , Hernia Diafragmática/patología , Humanos , Masculino , Isquemia Mesentérica/etiología , Isquemia Mesentérica/mortalidad , Isquemia Mesentérica/patología , Persona de Mediana Edad , Pancreatitis Aguda Necrotizante/etiología , Pancreatitis Aguda Necrotizante/mortalidad , Pancreatitis Aguda Necrotizante/patología , Peritonitis/etiología , Peritonitis/mortalidad , Peritonitis/patología , Neumonía/etiología , Neumonía/mortalidad , Neumonía/patología , Complicaciones Posoperatorias/mortalidad , Periodo Posoperatorio , Embolia Pulmonar/etiología , Embolia Pulmonar/mortalidad , Embolia Pulmonar/patología , Insuficiencia Renal/etiología , Insuficiencia Renal/mortalidad , Insuficiencia Renal/patología , Factores de Riesgo , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/mortalidad , Accidente Cerebrovascular/patología , Análisis de Supervivencia
18.
Klin Khir ; (2): 18-9, 2016 Feb.
Artículo en Ucraniano | MEDLINE | ID: mdl-27244911

RESUMEN

An acute postresection hepatic insufficiency (PHI) constitutes a necessary moment before the hepatic resection planning, permits in some situations to conduct prophylactic measures and to avoid this severe complication. Possibility of PHI occurrence was prognosticated for results of surgical treatment improvement in patients, suffering focal hepatic affection, using introduction of certain preoperative preparation and surgical tactics. The main task of the investigation was to determine the diagnostic and prognostic value of the investigation methods and elaboration of prognostic algorithm of an acute PHI occurrence.


Asunto(s)
Carcinoma Hepatocelular/diagnóstico , Equinococosis Hepática/diagnóstico , Insuficiencia Hepática/diagnóstico , Neoplasias Hepáticas/diagnóstico , Neoplasias/diagnóstico , Complicaciones Posoperatorias/patología , Enfermedad Aguda , Adulto , Anciano , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/cirugía , Equinococosis Hepática/mortalidad , Equinococosis Hepática/patología , Equinococosis Hepática/cirugía , Femenino , Hepatectomía/métodos , Insuficiencia Hepática/etiología , Insuficiencia Hepática/mortalidad , Insuficiencia Hepática/patología , Humanos , Hígado/patología , Hígado/cirugía , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/cirugía , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Neoplasias/patología , Neoplasias/cirugía , Complicaciones Posoperatorias/mortalidad , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia
19.
Klin Khir ; (1): 28-31, 2016 Jan.
Artículo en Ucraniano | MEDLINE | ID: mdl-27249922

RESUMEN

Basing on own material analysis (386 observations) and the literature date there was established, that hepatic resection occupies the first place in treatment of the organ focal affection, together--nontumoral and a tumoral one. The treatment of all kinds of focal hepatic affection must be expanded in a specialized clinic in the Ukraine. The main task of the investigation was to determine a permissible volume of hepatic resection, depending on functional state of the organ parenchyma, improvement of existing and elaboration of a new methods of operative intervention, directed on the complications prophylaxis and the hepatic function preservation.


Asunto(s)
Carcinoma Hepatocelular/cirugía , Colangiocarcinoma/cirugía , Hepatectomía/métodos , Insuficiencia Hepática/etiología , Neoplasias Hepáticas/cirugía , Complicaciones Posoperatorias , Sarcoma/cirugía , Adulto , Anciano , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/secundario , Colangiocarcinoma/mortalidad , Colangiocarcinoma/secundario , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/secundario , Neoplasias Colorrectales/cirugía , Femenino , Insuficiencia Hepática/mortalidad , Insuficiencia Hepática/patología , Humanos , Hígado/patología , Hígado/cirugía , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/mortalidad , Neoplasias Pancreáticas/secundario , Neoplasias Pancreáticas/cirugía , Sarcoma/mortalidad , Sarcoma/secundario , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/secundario , Neoplasias Gástricas/cirugía , Análisis de Supervivencia , Ucrania
20.
J Surg Res ; 202(2): 352-62, 2016 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-27229110

RESUMEN

BACKGROUND: Liver ischemia/reperfusion (I/R) injury is a type of uncontrolled inflammatory cascade in which neutrophils, an early infiltrating immune cell population, elicit significant tissue damage. However, the precise mechanism for neutrophil recruitment and infiltration remains to be fully characterized. METHODS: A hepatic partial I/R model was reproduced in wild-type, CCL2(-/-) and CCR2(-/-) mice. Tissue damage was evaluated by serum enzyme analysis, hematoxylin-eosin staining, and cytokine production measurement. Mobilization of neutrophils from the bone marrow and subsequent infiltration into the liver were measured by flow cytometry. C-C motif chemokine receptor 2 (CCR2) expression on neutrophils and C-C motif chemokine ligand 2 (CCL2) chemotaxis were measured using flow cytometry. The cellular source of CCL2 in the liver was determined by deleting specific cell groups and performing intracellular staining. RESULTS: Liver damage was ameliorated, and neutrophil recruitment and accumulation were decreased in both CCL2(-/-) and CCR2(-/-) mice compared with wild-type mice. Neutrophils displayed upregulated expression of CCR2 during I/R, and these cells were required for CCL2-induced chemotaxis. Depletion of Kupffer cells protected the liver from I/R injury. Furthermore, genetic ablation of CCL2 reduced liver injury, as demonstrated by decreases in the levels of alanine aminotransferase and aspartate aminotransferase and subsequent reductions in neutrophil recruitment and accumulation. CONCLUSIONS: Kupffer cells secrete CCL2 to promote CCR2-expressing neutrophil recruitment from the bone marrow and subsequent infiltration into the liver during I/R. These findings reveal a novel pro-inflammatory role of cell-mediated CCL2-CCR2 interactions during this sterile insult.


Asunto(s)
Quimiocina CCL2/metabolismo , Insuficiencia Hepática/etiología , Hígado/metabolismo , Receptores CCR2/metabolismo , Daño por Reperfusión/metabolismo , Animales , Biomarcadores/metabolismo , Ensayo de Inmunoadsorción Enzimática , Citometría de Flujo , Insuficiencia Hepática/metabolismo , Insuficiencia Hepática/patología , Macrófagos del Hígado/metabolismo , Hígado/patología , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Infiltración Neutrófila , Neutrófilos/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , Daño por Reperfusión/patología , Transducción de Señal , Regulación hacia Arriba
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