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4.
Mol Genet Genomic Med ; 7(8): e824, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31309745

RESUMO

BACKGROUND: Some genetic association studies tried to investigate potential associations of transmembrane 6 superfamily member 2 (TM6SF2) polymorphisms with chronic liver disease. However, the results of these studies were not consistent. Thus, we performed the present meta-analysis to explore associations between TM6SF2 polymorphisms and chronic liver disease in a larger pooled population. METHODS: Systematic literature research of PubMed, Web of Science, Embase, and CNKI was performed to identify eligible studies for pooled analyses. I2 statistics were employed to assess between-study heterogeneities. If I2 was greater than 50%, random-effect models (REMs) would be used to pool the data. Otherwise, fixed-effect models (FEMs) would be applied for synthetic analyses. RESULTS: Totally 28 studies were included for analyses (13,137 cases and 11,010 controls). The pooled analyses showed that rs58542926 polymorphism was significantly associated with chronic liver disease in overall population (dominant model: p < 0.0001, OR = 0.70, 95% CI = 0.64-0.76, I2  = 47%; recessive model: p < 0.0001, OR = 2.94, 95% CI = 2.05-4.20, I2  = 0%; over-dominant model: p < 0.0001, OR = 1.34, 95% CI = 1.23-1.47, I2  = 0%; allele model: p < 0.0001, OR = 0.68, 95% CI = 0.63-0.73, I2  = 47%), and these significant findings were further confirmed in both Asians and Caucasians. Stratified analyses by type of disease revealed similar positive results in hepatocellular carcinoma (HCC), cirrhosis, alcoholic liver disease (ALD) and NAFLD (Nonalcoholic fatty liver disease), but not in chronic hepatitis B infection (CHB) and chronic hepatitis C infection (CHC). CONCLUSIONS: These results suggested that TM6SF2 rs58542926 could be used to identify individuals at higher susceptibility to chronic liver disease, especially for HCC, cirrhosis, ALD, and NAFLD.


Assuntos
Carcinoma Hepatocelular/genética , Fígado Gorduroso Alcoólico/genética , Cirrose Hepática/genética , Neoplasias Hepáticas/genética , Proteínas de Membrana/genética , Hepatopatia Gordurosa não Alcoólica/genética , Grupo com Ancestrais do Continente Asiático/genética , Carcinoma Hepatocelular/diagnóstico , Estudos de Casos e Controles , Doença Crônica , Grupo com Ancestrais do Continente Europeu/genética , Fígado Gorduroso Alcoólico/diagnóstico , Estudos de Associação Genética , Predisposição Genética para Doença , Hepatite B Crônica/genética , Hepatite C Crônica/genética , Humanos , Cirrose Hepática/diagnóstico , Neoplasias Hepáticas/diagnóstico , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Polimorfismo de Nucleotídeo Único
5.
Top Antivir Med ; 27(2): 75-82, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31136997

RESUMO

The leading cause of non-HIV-related mortality is liver disease. Fatty liver disease can be characterized as alcoholic or nonalcoholic in nature. Alcohol use is prevalent among individuals with HIV infection and can lead to medication nonadherence, lower CD4+ cell count, inadequate viral suppression, and disease progression. The pathogenesis of nonalcoholic fatty liver disease (NAFLD) in individuals with HIV infection includes metabolic syndrome, hyperuricemia, HIV-related lipodystrophy, genetic polymorphisms, medications, HIV itself, and the gut microbiome. The prevalence of NAFLD in persons with HIV infection ranges from 30% to 65% depending on the modality of diagnosis. Individuals with HIV infection and NAFLD are at higher risk of cardiovascular disease; however, there is a dearth of longitudinal outcomes studies on this topic. Current therapies for NAFLD, such as vitamin E and pioglitazone, have not been studied in persons with HIV infection. There are several drugs in phase II and III clinical trials that specifically target NAFLD in HIV, including CC chemokine receptor 5 inhibitors, growth hormone-releasing factor agonists, and stearoyl-CoA desaturase inhibitors. Persons with HIV should be screened for NAFLD while pursuing aggressive risk factor modification and lifestyle changes, given the increased risk of cardiovascular mortality.


Assuntos
Fígado Gorduroso Alcoólico/epidemiologia , Infecções por HIV/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Contagem de Linfócito CD4 , Doenças Cardiovasculares/diagnóstico , Fígado Gorduroso Alcoólico/complicações , Fígado Gorduroso Alcoólico/diagnóstico , Infecções por HIV/epidemiologia , Humanos , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Prevalência , Fatores de Risco
6.
Exp Mol Pathol ; 108: 156-163, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30951700

RESUMO

As the fifth most common cancer and the second leading cause of cancer related deaths worldwide, hepatocellular carcinoma (HCC) causes up to one million deaths annually. Alcoholic steatohepatitis (ASH) and non-alcoholic steatohepatitis (NASH) are becoming the two major risk factors because both may develop liver fibrosis and hepatocellular carcinoma (HCC) if left untreated. However, compared with 3-10% of patients with ASH may progress to HCC annually, about only 0.5% NASH patients may progress to HCC annually. The present study is to clarify the protein expression differences of tumor suppressor genes (TSGs) between ASH and NASH. In liver biopsied specimens from NASH and ASH patients, using an immunofluorescence method and morphometrically quantitating the fluorescence intensity, we studied the protein expression within hepatocytes cytoplasm of candidate TSGs including RUNX3, GSTP1, and RASSF1A. Compared with the control group of patients, the expression levels of all three proteins were upregulated in the ASH group of patients (p < .001 in all molecules). While RUNX3 was upregulated, GSTP1 and RASSF1 did not change in the NASH group of patients. The most important finding is that compared with the ASH group of patients, the expression levels of all three TSG proteins, RUNX3, GSTP1, and RASSF1, were significantly lower in the NASH group of patients (p < .001 in all three molecules). These results confirmed our previous finding that there are significant differences of many molecules including TSGs that changed in NASH compared to ASH. Thus, we conclude that there are significantly different TSGs and pathways involved during the pathogenesis of HCC development in NASH compared to ASH that may help to develop different strategies for prevention and treatment of NASH and ASH patients.


Assuntos
Subunidade alfa 3 de Fator de Ligação ao Core/metabolismo , Fígado Gorduroso Alcoólico/metabolismo , Glutationa S-Transferase pi/metabolismo , Hepatopatia Gordurosa não Alcoólica/metabolismo , Proteínas Supressoras de Tumor/metabolismo , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/metabolismo , Progressão da Doença , Fígado Gorduroso Alcoólico/diagnóstico , Imunofluorescência/métodos , Humanos , Fígado/metabolismo , Fígado/patologia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/metabolismo , Hepatopatia Gordurosa não Alcoólica/diagnóstico
7.
J Gastroenterol ; 54(3): 218-225, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30643981

RESUMO

Alcohol and high-fat diet are two major risk factors responsible for metabolic diseases, which are manifested as steatohepatitis and liver cancer in the liver, and chronic pancreatitis and pancreatic adenocarcinoma (PDAC) in the pancreas. These metabolic diseases are becoming increasingly prevalent around the globe, and more importantly, their two major etiologies commonly coexist to precipitate the disease processes. To highlight the importance of these metabolic diseases, Japanese Society of Gastroenterology (JSGE) and National Institute on Alcoholism and Alcohol Abuse of National Institute of Health cosponsored the JSGE's 7th International Forum jointly held with the 12th International Symposium on ALPD and Cirrhosis. Toward the main theme of "Frontiers in ASH, NASH, NBNC-HCC and PDAC", this platform showcased presentations by 12 invited international and Japanese speakers on brain-gut-liver interactions, emerging mechanisms of ASH and NASH, metabolic reprogramming, and new therapeutic targets for cirrhosis, HCC, and PDAC. This editorial discusses the most recent data on global statistics on how alcohol and obesity impact health and longevity as a prelude to a brief summary of the symposium presentations and discussions, primarily focusing on the first two session themes.


Assuntos
Fígado Gorduroso Alcoólico/epidemiologia , Carga Global da Doença/estatística & dados numéricos , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adolescente , Idoso , Alcoolismo/complicações , Alcoolismo/epidemiologia , Índice de Massa Corporal , Estudos Transversais , Fígado Gorduroso Alcoólico/diagnóstico , Fígado Gorduroso Alcoólico/prevenção & controle , Feminino , Carga Global da Doença/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Obesidade/complicações , Obesidade/epidemiologia , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
8.
Drug Alcohol Depend ; 194: 225-229, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30463051

RESUMO

OBJECTIVE: To evaluate the longitudinal relationship between repeated measures of alcohol consumption and risk of developing fatty liver. PATIENTS AND METHODS: This study includes 5407 men and women from a British population-based cohort, the Whitehall II study of civil servants, who self-reported alcohol consumption by questionnaire over approximately 30 years (1985-1989 through to 2012-2013). Drinking typologies during midlife were linked to measures of fatty liver (the fatty liver index, FLI) when participants were in older age (age range 60-84 years) and adjusted for age, socio-economic position, ethnicity, and smoking. RESULTS: Those who consistently drank heavily had two-fold higher odds of increased FLI compared to stable low-risk moderate drinkers after adjustment for covariates (men: OR = 2.04, 95%CI = 1.53-2.74; women: OR = 2.24, 95%CI = 1.08-4.55). Former drinkers also had an increased FLI compared to low-risk drinkers (men: OR = 2.09, 95%CI = 1.55-2.85; women: OR = 1.68, 95%CI = 1.08-2.67). There were non-significant differences in FLI between non-drinkers and stable low-risk drinkers. Among women, there was no increased risk for current heavy drinkers in cross sectional analyses. CONCLUSION: Drinking habits among adults during midlife affect the development of fatty liver, and sustained heavy drinking is associated with an increased FLI compared to stable low-risk drinkers. After the exclusion of former drinkers, there was no difference between non-drinkers and low-risk drinkers, which does not support a protective effect on fatty liver from low-risk drinking. Cross-sectional analyses among women did not find an increased risk of heavy drinking compared to low-risk drinkers, thus highlighting the need to take a longitudinal approach.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/tendências , Fígado Gorduroso Alcoólico/epidemiologia , Vigilância da População , Autorrelato , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Fígado Gorduroso Alcoólico/diagnóstico , Feminino , Humanos , Londres/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Fatores de Risco , Autorrelato/normas , Fumar/epidemiologia , Fumar/tendências , Fatores de Tempo
9.
Liver Int ; 39(3): 531-539, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30427105

RESUMO

BACKGROUND & AIMS: With the rising prevalence of alcoholism, obesity and metabolic syndrome, steatohepatitis will become the leading cause of end-stage liver disease and hepatocellular carcinoma in the United States by 2025. Patients with non-alcoholic steatohepatitis and alcoholic liver disease have similar clinical and histopathological presentations, whether these similarities persist in non-alcoholic steatohepatitis and alcoholic liver disease patients with hepatocellular carcinoma remains unknown. METHODS: A retrospective analysis of the clinical features of adult patients from a large transplant center who underwent liver transplantation for steatohepatitis due to non-alcoholic steatohepatitis and alcoholic causes (alcoholic liver disease) between 1/1/02 and 1/1/12 was performed. Clinical features, explant histopathology, and clinical outcomes were compared. RESULTS: Hepatocellular carcinoma was present in 80 of 317 patients, who underwent liver transplantation for steatohepatitis with equivalent distribution in non-alcoholic steatohepatitis and alcoholic liver disease patients (24% vs 26%; P = 0.8). On multivariate analysis, significant predictors of hepatocellular carcinoma included age, ethnicity (Hispanic), and diabetes, but not BMI, hypertension or smoking. A lower risk of hepatocellular carcinoma was associated with a clinical history of hyperlipidemia. Clinical parameters were similar between patients with alcoholic liver disease - hepatocellular carcinoma and non-alcoholic steatohepatitis-hepatocellular carcinoma, except sex and presence of metabolic syndrome. non-alcoholic steatohepatitis-hepatocellular carcinoma livers retained histopathological features of non-alcoholic steatohepatitis such as ballooning and Mallory bodies, while alcoholic liver disease-hepatocellular carcinoma livers did not. There were no significant differences in hepatocellular carcinoma recurrence rates or post-transplant overall survival. CONCLUSIONS: We report the largest single-center study evaluating clinical, histopathological and outcome measures of patients undergoing liver transplantation for steatohepatitis. Older patients, diabetics, and Hispanics may warrant more frequent cancer screening due to increased risk of hepatocellular carcinoma.


Assuntos
Carcinoma Hepatocelular/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Fígado Gorduroso Alcoólico/epidemiologia , Hiperlipidemias/epidemiologia , Neoplasias Hepáticas/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Fatores Etários , Idoso , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Diabetes Mellitus Tipo 2/diagnóstico , Fígado Gorduroso Alcoólico/diagnóstico , Fígado Gorduroso Alcoólico/mortalidade , Fígado Gorduroso Alcoólico/cirurgia , Feminino , Hispano-Americanos , Humanos , Hiperlipidemias/diagnóstico , Hiperlipidemias/mortalidade , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Transplante de Fígado , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/mortalidade , Hepatopatia Gordurosa não Alcoólica/cirurgia , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Resultado do Tratamento
10.
Surg Pathol Clin ; 11(2): 267-285, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29751874

RESUMO

Nonalcoholic fatty liver disease (NAFLD) is a major health concern and the prevalence continues to increase in many industrialized and developing countries around the world. NAFLD affects adults and children. NAFLD-related cirrhosis is expected to become the top indication for liver transplantation in the near future, and the incidence of NAFLD-related hepatocellular carcinoma is also increasing. Nonalcoholic steatohepatitis is the more severe form of NAFLD. The pathogenesis of NALFD/nonalcoholic steatohepatitis is complex and new concepts continue to evolve. The diagnosis and categorization of nonalcoholic steatohepatitis currently rests on hepatopathologists. Accurate morphologic interpretation is important for therapeutic, prognostic, and investigational purposes.


Assuntos
Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/patologia , Biópsia , Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Diagnóstico Diferencial , Fígado Gorduroso Alcoólico/diagnóstico , Degeneração Hepatolenticular/diagnóstico , Humanos , Fígado/patologia , Cirrose Hepática/etiologia , Cirrose Hepática/patologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/terapia , Prognóstico , Índice de Gravidade de Doença
12.
World J Gastroenterol ; 22(14): 3735-45, 2016 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-27076758

RESUMO

AIM: To investigate the protein expression of phosphatase and tensin homolog (PTEN) in human liver biopsies of patients with alcoholic and non-alcoholic liver disease. METHODS: PTEN protein expression was assessed by immunohistochemistry in formalin-fixed, paraffin-embedded liver sections of patients with non-alcoholic fatty liver disease (NAFLD) (n = 44) or alcoholic liver disease (ALD) (n = 25). Liver resections obtained from 3 healthy subjects candidate for partial liver donation served as controls. Histological evaluations were performed by two experienced pathologists, and diagnoses established based on international criteria. The intensity of the PTEN staining in nuclei was compared between steatotic and non-steatotic areas of each liver fragment analyzed. For each liver specimen, the antibody-stained sections were examined and scored blindly by three independent observers, who were unaware of the patients' clinical history. RESULTS: In healthy individuals, PTEN immunostaining was intense in both the cytoplasm and nuclei of all hepatocytes. However, PTEN was strongly downregulated in both the nucleus and the cytoplasm of hepatocytes from steatotic areas in patients with NAFLD, independently of the disease stage. In contrast, no changes in PTEN protein expression were observed in patients with ALD, regardless of the presence of steatosis or the stage of the disease. The degree of PTEN downregulation in hepatocytes of patients with NAFLD correlated with the percentage of steatosis (r = 0.3061, P = 0.0459) and the BMI (r = 0.4268, P = 0.0043). Hovewer, in patients with ALD, PTEN expression was not correlated with the percentage of steatosis with or without obesity as a confounding factor (P = 0.5574). Finally, PTEN expression level in steatotic areas of ALD patients was significantly different from that seen in steatotic areas of NAFLD patients (P < 0.0001). CONCLUSION: PTEN protein expression is downregulated early in NAFLD, but not in ALD. PTEN immunohistochemical detection could help in the differential diagnosis of NAFLD and ALD.


Assuntos
Fígado Gorduroso Alcoólico/diagnóstico , Fígado/enzimologia , Hepatopatia Gordurosa não Alcoólica/diagnóstico , PTEN Fosfo-Hidrolase/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/análise , Biópsia , Estudos de Casos e Controles , Diagnóstico Diferencial , Regulação para Baixo , Fígado Gorduroso Alcoólico/enzimologia , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/enzimologia , Variações Dependentes do Observador , Valor Preditivo dos Testes , Reprodutibilidade dos Testes
14.
Ann Hepatol ; 15(2): 183-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26845595

RESUMO

BACKGROUND AND OBJECTIVE: Steatohepatitis is a common cause of liver disease due to alcohol (ALD) or non-alcoholic fatty liver disease (NAFLD). We performed this study to compare natural history of ALD and NAFLD. MATERIAL AND METHODS: Retrospective analysis of ALD or NAFLD patients managed at our center (2007-2011). ALD diagnosed by excluding other liver diseases (except HCV) and alcohol abuse of > 40 g/d in women and > 60 g/d in men for > 5 years. NAFLD diagnosed by excluding other liver diseases and a history of alcohol use of < 10 g/d. Cirrhosis was diagnosed using biopsy for uncertain clinical diagnosis. RESULTS: Compared to patients with NAFLD (n = 365; mean age 50 yrs; 43% males; 53% diabetic), ALD patients (n = 206; mean age 51 yrs; 68% males; 24% diabetic) presented more often with cirrhosis or complications(46vs. 12%; P< 0.0001) with a higher MELD score (13 ± 7 vs. 8 ± 8; P<0.0001). On logistic regression, ALD diagnosis was associated with presence of cirrhosis by over 4-fold (4.1 [1.8-9.1]) even after excluding 23 patients with concomitant HCV. Over median follow up of about 3 and 4 yrs among ALD and NAFLD patients respectively, ALD patients more frequently developed cirrhosis or its complications including HCC with worse transplant free survival (90 vs. 95%; P = 0.038). CONCLUSIONS: Compared to NAFLD, ALD patients present at an advanced stage of liver disease with a faster progression on follow-up. Prospective multicenter studies are needed to identify potential barriers to early referral of ALD patients as basis for development of strategies to improve outcome of patients with ALD.


Assuntos
Fígado Gorduroso Alcoólico/fisiopatologia , Cirrose Hepática Alcoólica/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Adulto , Comorbidade , Progressão da Doença , Fígado Gorduroso Alcoólico/diagnóstico , Fígado Gorduroso Alcoólico/epidemiologia , Feminino , Humanos , Cirrose Hepática/diagnóstico , Cirrose Hepática/epidemiologia , Cirrose Hepática/fisiopatologia , Cirrose Hepática Alcoólica/diagnóstico , Cirrose Hepática Alcoólica/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença
15.
Am J Pathol ; 186(4): 748-60, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26835538

RESUMO

Alcohol-induced liver damage is a major burden for most societies, and murine studies can provide a means to better understand its pathogenesis and test new therapies. However, there are many models reported with widely differing phenotypes, not all of which fully regenerate the spectrum of human disease. Thus, it is important to understand the implications of these variations to efficiently model human disease. This review critically appraises key articles in the field, detailing the spectrum of liver damage seen in different models, and how they relate to the phenotype of disease seen in patients. A range of different methods of alcohol administration have been studied, ranging from ad libitum consumption of alcohol and water to modified diets (eg, Lieber deCarli liquid diet). Other feeding regimens have taken more invasive routes using intragastric feeding tubes to infuse alcohol directly into the stomach. Notably, models using wild-type mice generally produce a milder phenotype of liver damage than those using genetically modified mice, with the exception of the chronic binge-feeding model. We recommend panels of tests for consideration to standardize end points for the evaluation of the severity of liver damage-key for comparison of models of injury, testing of new therapies, and subsequent translation of findings into clinical practice.


Assuntos
Etanol/farmacologia , Fígado Gorduroso Alcoólico/patologia , Hepatite Alcoólica/diagnóstico , Hepatite Alcoólica/patologia , Hepatopatias Alcoólicas/patologia , Doença Aguda , Animais , Modelos Animais de Doenças , Fígado Gorduroso Alcoólico/diagnóstico , Humanos , Hepatopatias Alcoólicas/diagnóstico
16.
Eksp Klin Gastroenterol ; (5): 45-50, 2016.
Artigo em Russo | MEDLINE | ID: mdl-28614644

RESUMO

The aim of the study was to increase the efficiency of the treatment of acute ethanol intoxication in patients with alcoholic fatty liver disease. The article presents the results which received during the investigation and treatment of 166 patients with acute ethanol in- toxication on the background of alcoholic fatty liver disease Patients were assessed by the severity scale APACHE-Il. Were studied the dynamics of clinical, laboratory, biochemical parameters, the state of the antioxidant system activity and lipid peroxidation. The study found the effect of the combination hepatoprotective drug remaxol on the many links of metabolism, which was confirmed by the dynamics of biochemical parameters. There was a quick correction of hyperlactatemia, an effective reduction of ALT activity, the absence of reduction of albumin and urea concentration in the somatic period of ethanol poisoning. Period of using remaxol there was improvement in the clinical course of the disease, which manifested by the reduce the incidence of delirium tremens and shorten the duration of treatment of patients.


Assuntos
Intoxicação Alcoólica/tratamento farmacológico , Fígado Gorduroso Alcoólico/tratamento farmacológico , Fígado/efeitos dos fármacos , Substâncias Protetoras/uso terapêutico , Succinatos/uso terapêutico , APACHE , Doença Aguda , Intoxicação Alcoólica/complicações , Intoxicação Alcoólica/diagnóstico , Intoxicação Alcoólica/metabolismo , Quimioterapia Combinada , Fígado Gorduroso Alcoólico/complicações , Fígado Gorduroso Alcoólico/diagnóstico , Fígado Gorduroso Alcoólico/metabolismo , Feminino , Humanos , Fígado/metabolismo , Testes de Função Hepática , Masculino , Substâncias Protetoras/administração & dosagem , Succinatos/administração & dosagem , Resultado do Tratamento
17.
Diagn Interv Radiol ; 22(1): 13-21, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26627137

RESUMO

PURPOSE: We aimed to evaluate the ability of 1H-magnetic resonance spectroscopy (1H-MRS) to detect and quantify hepatic fat content in vivo and ex vivo in an experimental rat model of alcoholic fatty liver using histopathology, biochemistry, and laboratory analyses as reference. METHODS: Alcoholic fatty liver was induced within 48 hours in 20 Lewis rats; 10 rats served as control. Intrahepatic fat content determined by 1H-MRS was expressed as the percent ratio of the lipid and water peaks and was correlated with intrahepatic fat content determined histologically and biochemically. Liver enzymes were measured in serum. RESULTS: Fatty liver could be detected in vivo as well as ex vivo using 1H-MRS, in all 20 animals. Histologic analysis showed a fatty liver in 16 of 20 animals. Histology and 1H-MRS results were highly correlated (in vivo, r=0.93, P = 0.0005; ex vivo, r=0.92, P = 0.0006). Also a strong correlation was noted between in vivo 1H-MRS measurements and the fat content determined biochemically (r=0.96, P = 0.0003). Ex vivo results showed a similarly strong correlation between 1H-MRS and biochemistry (r=0.89, P = 0.0011). CONCLUSION: 1H-MRS can be carried out in ex vivo models, as well as in vivo, to detect and quantify intrahepatic fat content in the acute fatty liver.


Assuntos
Fígado Gorduroso Alcoólico/diagnóstico , Espectroscopia de Prótons por Ressonância Magnética/métodos , Animais , Biomarcadores/metabolismo , Estudos de Casos e Controles , Modelos Animais de Doenças , Fígado Gorduroso Alcoólico/metabolismo , Fígado Gorduroso Alcoólico/patologia , Feminino , Ratos , Sensibilidade e Especificidade
18.
World J Gastroenterol ; 21(39): 11044-52, 2015 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-26494961

RESUMO

Alcoholic liver disease (ALD) consists of a broad spectrum of disorders, ranging from simple steatosis to alcoholic steatohepatitis and cirrhosis. Fatty liver develops in more than 90% of heavy drinkers, however only 30%-35% of them develop more advanced forms of ALD. Therefore, even if the current "gold standard" for the assessment of the stage of alcohol-related liver injury is histology, liver biopsy is not reasonable in all patients who present with ALD. Currently, although several non-invasive fibrosis markers have been suggested as alternatives to liver biopsy in patients with ALD, none has been sufficiently validated. As described in other liver disease, the diagnostic accuracy of such tests in ALD is acceptable for the diagnosis of significant fibrosis or cirrhosis but not for lesser fibrosis stages. Existing data suggest that the use of non-invasive tests could be tailored to first tier screening of patients at risk, in order to diagnose early patients with progressive liver disease and offer targeted interventions for the prevention of decompensation. We review these tests and critically appraise the existing evidence.


Assuntos
Diagnóstico por Imagem , Fígado Gorduroso Alcoólico/diagnóstico , Cirrose Hepática Alcoólica/diagnóstico , Testes de Função Hepática , Fígado/metabolismo , Fígado/patologia , Biomarcadores/sangue , Biópsia , Diagnóstico por Imagem/métodos , Técnicas de Imagem por Elasticidade , Fígado Gorduroso Alcoólico/sangue , Humanos , Cirrose Hepática Alcoólica/sangue , Testes de Função Hepática/métodos , Contagem de Plaquetas , Valor Preditivo dos Testes , Prognóstico , Reprodutibilidade dos Testes , Índice de Gravidade de Doença
19.
Rev Gastroenterol Peru ; 35(3): 236-42, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-26397280

RESUMO

OBJECTIVES: Describe the clinical and biochemical characteristics of patients with histopathological findings compatible with steatohepatitis of HNAL patients between 2010-2012. Determine the frequency of alcoholic and non-alcoholic steatohepatitis, presence of metabolic syndrome and other factors associated to non-alcoholic steatohepatitis, its main indications for liver biopsy and biochemical characteristics according to the severity of the histological findings. MATERIALS AND METHODS: We evaluated all histological slides of liver biopsies of the period between 2010-2012, of which, those with the diagnosis of steatohepatitis were selected. Their medical records were then reviewed. RESULTS: 32 patients met inclusion criteria. 28 were female and 4 male, the average age was 49±12 years. Two patients had a history of chronic alcohol consumption, representing the group of alcoholic steatohepatitis. The more frequent clinical finding in patients with NASH (non-alcoholic steatohepatitis), was obesity (37%). 50% of patients had AST/ALT ratio <1. CONCLUSIONS: Among population studied, non-alcoholic steatohepatitis was more common than alcoholic steatohepatitis, being obesity the most associated factor.


Assuntos
Fígado Gorduroso Alcoólico/diagnóstico , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Fígado Gorduroso Alcoólico/etiologia , Fígado Gorduroso Alcoólico/patologia , Feminino , Humanos , Fígado/patologia , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/etiologia , Hepatopatia Gordurosa não Alcoólica/patologia , Obesidade/complicações , Peru , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
20.
Nutr. hosp ; 32(2): 702-709, ago. 2015. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-140005

RESUMO

The significance of polyphenol intake for the prevention of chronic diseases is controversial. Objective: this study investigated the chemical composition and antioxidant potential of an anthocyanin-rich extract from Euterpe edulis fruits (LPEF) and its effects on liver steatosis in dyslipidemic apoE-/- knockout mice. Materials and methods: mice were divided into G1 (C57BL/6) standard diet; G2 (apoE-/-) standard diet, G3 (apoE-/-) 2% LPEF, G4 (apoE-/-) 6% LPEF, G5 (apoE-/-) 10% LPEF, G6 (apoE-/-) 2% α-tocopherol acetate. After 75 days of treatment, the animals were euthanized. The LPEF contained a high level of monomeric anthocyanins (301.4 mg/100g) and marked antioxidant activity. Results: Catalase activity was reduced in G3, G4, G5 and G6 compared to G2. Superoxide dismutase was reduced only in G4. The animals in G4, G5, and G6 showed low HDL and triglycerides levels compared to G2. The proportion of lipid droplets in liver tissue was reduced in G4 and G5 compared to G2, G3, and G6. Conclusion: The results indicated that E. edulis pulp is rich in anthocyanins and the LPEF dietary consumption can reduce the severity of liver steatosis in apoE-/- mice, an effect that is potentially mediated by the antioxidant activity of this extract and modulation of triglyceride serum levels (AU)


El papel de los polifenoles en la prevención de enfermedades crónicas es controvertido. Objetivo: este estudio investigó la composición química y el potencial antioxidante de un extracto del fruto de Euterpe edulis rico en antocianinas (LPEF) y sus efectos en la esteatosis hepática en ratones apoE-/- knockout con dislipidemia. Material y métodos: los ratones fueron divididos en los siguientes grupos; G1 (C57BL/6) con una dieta estándar; G2 (apoE-/-) con dieta estándar; G3 G3 (apoE-/-) con 2% de LPEF; G4 (apoE-/-) con 6% de LPEF; G5 (apoE-/-) con 10% de LPEF y G6 (apoE-/-) con 2% acetato α-tocoferol (α-tocopherol acetate). Después de 75 días de tratamiento, los animales fueron eutanizados. El LPEF contenía un alto nivel de antocianinas monoméricas (301,4 mg/100 g) con notable actividad antioxidante. Resultados: la actividad catalasa fue reducida en los grupos G3, G4, G5 y G6 comparada con G2. La superoxidasa dismutasa solo se redujo en el grupo G4. Los animales de G4, G5 y G6 mostraron bajos niveles de HDL triglicéridos, comparados con G2. La proporción de lípidos en el tejido hepático fue reducida en G4 y G5, comparado con G2, G3 y G6. Conclusión: los resultados indicaron que la pulpa de E. edulis es rica en antocianinas, y que el consumo de LPEF en la dieta puede reducir la severidad de la esteatosis hepática en ratones apoE-/-, un efecto que es potencialmente mediado por la actividad antioxidante de este extracto y la modulación en los niveles séricos de triglicéridos (AU)


Assuntos
Animais , Feminino , Masculino , Camundongos , Composição de Alimentos , Antocianinas/análise , Antocianinas/química , Dislipidemias/tratamento farmacológico , Dislipidemias/metabolismo , Fígado Gorduroso Alcoólico/diagnóstico , Fígado Gorduroso Alcoólico/tratamento farmacológico , Fígado Gorduroso Alcoólico/veterinária , Antioxidantes/uso terapêutico , Alimento Funcional , Euterpe , Análise de Variância , Apolipoproteínas E/análise , Apolipoproteínas E/uso terapêutico
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