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1.
Z Gastroenterol ; 57(10): 1196-1199, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31610582

RESUMO

Many patients with intrahepatic cholelithiasis need surgical treatment during their life. For patients with hepatolithiasis, conventional therapy methods suggest partial hepatectomy or hepatic transplantation, while both kinds of surgery carry a considerable risk and trauma. Under such conditions, percutaneous transhepatic cholangioscopic lithotripsy provides an alternative method for hepatolithiasis treatment. Conventional rigid choledochoscope applied in percutaneous transhepatic cholangioscopic lithotripsy often lack sufficient flexibility for complete intrahepatic bile duct inspection. In this article, we report a case of one patient with complex hepatolithiasis and choledocholithiasis who received percutaneous transhepatic cholangioscopic lithotripsy using the newly-developed soft fiber-optic choledochoscope. This treatment represents a safe and effective outcome. We came to the conclusion that soft fiber-optic choledochoscope guided percutaneous transhepatic cholangioscopic lithotripsy seems a promising treatment option for selected patients with hepatolithiasis, especially for those who cannot accept conventional methods.


Assuntos
Coledocolitíase , Litotripsia , Hepatopatias , Idoso , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Ductos Biliares Intra-Hepáticos/patologia , Ductos Biliares Intra-Hepáticos/cirurgia , Coledocolitíase/diagnóstico por imagem , Coledocolitíase/patologia , Coledocolitíase/cirurgia , Humanos , Laparoscopia/instrumentação , Litotripsia/instrumentação , Fígado/diagnóstico por imagem , Fígado/patologia , Fígado/cirurgia , Hepatopatias/diagnóstico por imagem , Hepatopatias/patologia , Hepatopatias/cirurgia , Masculino , Resultado do Tratamento
3.
Zhonghua Gan Zang Bing Za Zhi ; 27(7): 563-566, 2019 Jul 20.
Artigo em Chinês | MEDLINE | ID: mdl-31357787

RESUMO

Sarcopenia is the main constituent of malnutrition and is a frequent complication of chronic liver diseases, which affects up to 70% of patients with advanced liver diseases. It has been associated with adverse clinical outcomes and prognosis, including poor quality of life, development of other complications and reduction in survival rate of non-transplant patients and transplant recipients. Chronic liver disease causes alteration in glucose metabolism, lipid oxidation, ketogenesis and protein catabolism, leading to the loss of adipose and muscle tissue. In addition, inadequate nutrients intake and limited or lack of physical activity perpetuate the reduction of muscle mass. Recently, the roles and mechanisms of muscle growth-related hormones, hyperammonemia-mediated signaling pathways and gut microbiota have been recognized. In view of its impact in chronic liver disease, sarcopenia can be considered as a powerful prognostic factor and a useful additional tool in the global assessment of patients with advanced liver disease. Rational nutritional intervention, appropriate physical exercise, effective ammonia lowering strategies, hormone supplements and targeted molecular therapy (use of myostatin blockers), and liver transplantation, may improve sarcopenia, but still needs more studies for validation.


Assuntos
Hepatopatias/patologia , Sarcopenia/patologia , Sarcopenia/terapia , Humanos , Transplante de Fígado , Desnutrição/complicações , Qualidade de Vida , Sarcopenia/etiologia
4.
Acta Gastroenterol Belg ; 82(2): 309-313, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31314193

RESUMO

The study of glycomics is a novel and fascinating approach for the development of biomarkers. It has become clear that in the field of liver disease specific glycomic patters are present in specific disease states, which has led to the development of diagnostic biomarkers. In this manuscript, we will describe two new applications of this technology for the development of prognostic biomarkers. The first biomarker is associated with the risk of hepatocellular carcinoma development in patients with compensated cirrhosis. The second biomarker is present in perfusate and is related to the risk of primary non function occurrence after liver transplantation. The technology used for these biomarkers could easily be implemented on routine capillary electrophoresis equipment.


Assuntos
Glicômica , Hepatopatias/sangue , Transplante de Fígado , Biomarcadores Tumorais/análise , Humanos , Hepatopatias/complicações , Hepatopatias/patologia , Prognóstico
5.
Nat Commun ; 10(1): 2263, 2019 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-31118448

RESUMO

All memory T cells mount an accelerated response on antigen reencounter, but significant functional heterogeneity is present within the respective memory T-cell subsets as defined by CCR7 and CD45RA expression, thereby warranting further stratification. Here we show that several surface markers, including KLRB1, KLRG1, GPR56, and KLRF1, help define low, high, or exhausted cytokine producers within human peripheral and intrahepatic CD4+ memory T-cell populations. Highest simultaneous production of TNF and IFN-γ is observed in KLRB1+KLRG1+GPR56+ CD4 T cells. By contrast, KLRF1 expression is associated with T-cell exhaustion and reduced TNF/IFN-γ production. Lastly, TCRß repertoire analysis and in vitro differentiation support a regulated, progressive expression for these markers during CD4+ memory T-cell differentiation. Our results thus help refine the classification of human memory T cells to provide insights on inflammatory disease progression and immunotherapy development.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Citocinas/metabolismo , Hepatopatias/imunologia , Receptores Acoplados a Proteínas-G/metabolismo , Receptores Semelhantes a Lectina de Células NK/metabolismo , Idoso , Idoso de 80 Anos ou mais , Linfócitos T CD4-Positivos/metabolismo , Citocinas/imunologia , Humanos , Memória Imunológica , Fígado/patologia , Hepatopatias/sangue , Hepatopatias/patologia , Pessoa de Meia-Idade , Receptores Acoplados a Proteínas-G/imunologia , Receptores Semelhantes a Lectina de Células NK/imunologia
6.
Int J Mol Sci ; 20(9)2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31052525

RESUMO

Liver diseases are perpetuated by the orchestration of hepatocytes and other hepatic non-parenchymal cells. These cells communicate and regulate with each other by secreting mediators such as peptides, hormones, and cytokines. Extracellular vesicles (EVs), small particles secreted from cells, contain proteins, DNAs, and RNAs as cargos. EVs have attracted recent research interests since they can communicate information from donor cells to recipient cells thereby regulating physiological events via delivering of specific cargo mediators. Previous studies have demonstrated that liver cells secrete elevated numbers of EVs during diseased conditions, and those EVs are internalized into other liver cells inducing disease-related reactions such as inflammation, angiogenesis, and fibrogenesis. Reactions in recipient cells are caused by proteins and RNAs carried in disease-derived EVs. This review summarizes cell-to-cell communication especially via EVs in the pathogenesis of liver diseases and their potential as a novel therapeutic target.


Assuntos
Comunicação Celular , Vesículas Extracelulares/patologia , Hepatócitos/patologia , Hepatopatias/patologia , Animais , Vesículas Extracelulares/metabolismo , Hepatócitos/metabolismo , Humanos , Fígado/metabolismo , Fígado/patologia , Cirrose Hepática/metabolismo , Cirrose Hepática/patologia , Cirrose Hepática/terapia , Hepatopatias/metabolismo , Hepatopatias/terapia , Neovascularização Patológica/metabolismo , Neovascularização Patológica/patologia , Neovascularização Patológica/terapia
7.
Int J Mol Sci ; 20(9)2019 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-31083568

RESUMO

The liver and its zonation contribute to whole body homeostasis. Acute and chronic, not always liver, diseases impair proper metabolic zonation. Various underlying pathways, such as ß-catenin, hedgehog signaling, and the Hippo pathway, along with the physiologically occurring oxygen gradient, appear to be contributors. Interestingly, hypoxia and hypoxia-inducible transcription factors can orchestrate those pathways. In the current review, we connect novel findings of liver zonation in health and disease and provide a view about the dynamic interplay between these different pathways and cell-types to drive liver zonation and systemic homeostasis.


Assuntos
Hipóxia/metabolismo , Hipóxia/patologia , Hepatopatias/metabolismo , Hepatopatias/patologia , Fígado/metabolismo , Fígado/patologia , Fatores de Transcrição/metabolismo , Animais , Humanos , Oxirredução , Oxigênio/metabolismo
8.
Pan Afr Med J ; 32: 16, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31143321

RESUMO

Spontaneous subcapsular hematoma of the liver is an extremely rare but potentially life-threatening condition. We report a case of subcapsular hematoma of the liver without any apparent lesion and in the absence of coagulopathy or trauma. A CT scan of the abdomen demonstrated a huge subcapsular hematoma around the liver. The patient was treated conservatively and was discharged home after one week. Up to our knowledge, this is one of the very few reported cases of a spontaneous subcapsular hepatic hematoma.


Assuntos
Hematoma/diagnóstico por imagem , Hepatopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Tratamento Conservador/métodos , Hematoma/patologia , Hematoma/terapia , Humanos , Hepatopatias/patologia , Hepatopatias/terapia , Masculino
9.
N Engl J Med ; 380(19): 1834-1842, 2019 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-31067372

RESUMO

Mesenchymal hamartoma of the liver (MHL) is a benign tumor affecting children that is characterized by a primitive myxoid stroma with cystically dilated bile ducts. Alterations involving chromosome 19q13 are a recurrent underlying cause of MHL; these alterations activate the chromosome 19 microRNA cluster (C19MC). Other cases remain unexplained. We describe two children with MHLs that harbored germline DICER1 pathogenic variants. Analysis of tumor tissue from one of the children revealed two DICER1 "hits." Mutations in DICER1 dysregulate microRNAs, mimicking the effect of the activation of C19MC. Our data suggest that MHL is a new phenotype of DICER1 syndrome. (Funded by the Canadian Institutes of Health Research and others.).


Assuntos
Cromossomos Humanos Par 19 , RNA Helicases DEAD-box/genética , Mutação em Linhagem Germinativa , Hamartoma/genética , Hepatopatias/genética , MicroRNAs/metabolismo , Síndromes Neoplásicas Hereditárias/genética , Ribonuclease III/genética , Pré-Escolar , Feminino , Predisposição Genética para Doença , Hamartoma/diagnóstico por imagem , Hamartoma/patologia , Humanos , Fígado/diagnóstico por imagem , Fígado/patologia , Hepatopatias/diagnóstico por imagem , Hepatopatias/patologia , Masculino , Mesoderma , Linhagem , Fenótipo
10.
J Pediatr Endocrinol Metab ; 32(5): 533-536, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31026225

RESUMO

Background Gaucher disease (GD) is a lysosomal storage disorder caused by autosomal recessive mutations in the glucocerebrosidase (GBA) gene, which encodes acid ß-glucosidase. GD type 3c is a rare group characterised by cardiovascular involvement, and homozygous D448H is the most frequent mutation. Case presentation We describe two patients who had homozygous D448H mutations. The index patient had hepatosplenomegaly, liver insufficiency and cardiac involvement and her sister had severe cardiac involvement with cardiomyopathy and diffuse aortic calcification. The index case's liver was transplanted at the age of 6 months from a related donor and her sister who had severe cardiovascular disease died at the age of 12 years. Conclusions Our patients had clinical variability. We need to discuss whether liver involvement could be the initial signs in patients with GD type 3c.


Assuntos
Doenças Cardiovasculares/patologia , Doença de Gaucher/complicações , Glucosilceramidase/genética , Hepatopatias/patologia , Mutação , Doenças Cardiovasculares/etiologia , Criança , Feminino , Doença de Gaucher/enzimologia , Doença de Gaucher/genética , Homozigoto , Humanos , Lactente , Hepatopatias/etiologia , Prognóstico , Irmãos
11.
Methods Mol Biol ; 1981: 273-289, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31016661

RESUMO

Cholestasis is a condition that impairs bile flow, resulting in retention of bile fluid in the liver. It may cause significant morbidity and mortality due to pruritus, malnutrition, and complications from portal hypertension secondary to biliary cirrhosis. The zebrafish (Danio rerio) has emerged as a valuable model organism for studying cholestasis that complements with the in vitro systems and rodent models. Its main advantages include conserved mechanisms of liver development and bile formation, rapid external development, ease of monitoring hepatobiliary morphology and function in live larvae, and accessibility to genetic and chemical manipulations. In this chapter, we provide an overview of the existing zebrafish models of cholestatic liver diseases. We discuss the strengths and limitations of using zebrafish to study cholestasis. We also provide step-by-step descriptions of the methodologies for analyzing cholestatic phenotypes in zebrafish.


Assuntos
Colestase/patologia , Modelos Animais de Doenças , Hepatopatias/patologia , Peixe-Zebra , Animais , Ductos Biliares/metabolismo , Ductos Biliares/patologia , Colestase/metabolismo , Fígado/metabolismo , Fígado/patologia , Hepatopatias/metabolismo
12.
Gastroenterology ; 157(2): 481-491.e7, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31022403

RESUMO

BACKGROUND & AIMS: Polycystic liver disease is the most common extrarenal manifestation of autosomal dominant polycystic kidney disease (ADPKD). There is need for robust long-term evidence for the volume-reducing effect of somatostatin analogues. We made use of data from an open-label, randomized trial to determine the effects of lanreotide on height-adjusted liver volume (hTLV) and combined height-adjusted liver and kidney volume (hTLKV) in patients with ADPKD. METHODS: We performed a 120-week study comparing the reno-protective effects of lanreotide vs standard care in 305 patients with ADPKD (the DIPAK-1 study). For this analysis, we studied the 175 patients with polycystic liver disease with hepatic cysts identified by magnetic resonance imaging and liver volume ≥2000 mL. Of these, 93 patients were assigned to a group that received lanreotide (120 mg subcutaneously every 4 weeks) and 82 to a group that received standard care (blood pressure control, a sodium-restricted diet, and antihypertensive agents). The primary endpoint was percent change in hTLV between baseline and end of treatment (week 120). A secondary endpoint was change in hTLKV. RESULTS: At 120 weeks, hTLV decreased by 1.99% in the lanreotide group (95% confidence interval [CI], -4.21 to 0.24) and increased by 3.92% in the control group (95% CI, 1.56-6.28). Compared with the control group, lanreotide reduced the growth of hTLV by 5.91% (95% CI, -9.18 to -2.63; P < .001). Growth of hTLV was still reduced by 3.87% at 4 months after the last injection of lanreotide compared with baseline (95% CI, -7.55 to -0.18; P = .04). Lanreotide reduced growth of hTLKV by 7.18% compared with the control group (95% CI, -10.25 to -4.12; P < .001). CONCLUSIONS: In this subanalysis of a randomized trial of patients with polycystic liver disease due to ADPKD, lanreotide for 120 weeks reduced the growth of liver and combined liver and kidney volume. This effect was still present 4 months after the last injection of lanreotide. ClinicalTrials.gov, Number: NCT01616927.


Assuntos
Cistos/tratamento farmacológico , Rim/patologia , Hepatopatias/tratamento farmacológico , Fígado/patologia , Peptídeos Cíclicos/administração & dosagem , Rim Policístico Autossômico Dominante/tratamento farmacológico , Somatostatina/análogos & derivados , Adulto , Cistos/diagnóstico por imagem , Cistos/etiologia , Cistos/patologia , Esquema de Medicação , Feminino , Humanos , Injeções Subcutâneas , Rim/diagnóstico por imagem , Rim/efeitos dos fármacos , Fígado/diagnóstico por imagem , Fígado/efeitos dos fármacos , Hepatopatias/diagnóstico por imagem , Hepatopatias/etiologia , Hepatopatias/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão/efeitos dos fármacos , Rim Policístico Autossômico Dominante/complicações , Rim Policístico Autossômico Dominante/diagnóstico por imagem , Somatostatina/administração & dosagem , Resultado do Tratamento
13.
Biomed Res Int ; 2019: 8319465, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31019973

RESUMO

The pathogens Schistosoma mansoni and Paracoccidioides brasiliensis share common geographic areas, determining infectious diseases with high mortality rates worldwide. Histopathological and immunological changes induced by each pathogen are well understood; however, the host responses to S. mansoni and P. brasiliensis coinfection are still unknown. Thus, we investigated liver damage and cytokines production in a murine model acutely and chronically coinfected with these pathogens. Fourty male Swiss mice were infected with S. mansoni and P. brasiliensis alone or coinfected. The animals were euthanized with 50 (acute infection) and 120 (chronic infection) days of infection. All infected animals exhibited liver inflammation. Intense granulomatous inflammation was detected in animals infected with S. mansoni alone and those coinfected. Productive and involutive granulomas were clearly observed in acute and chronic infections, respectively. Granuloma size was reduced in the acute phase and increased in the chronic phase of S. mansoni and P. brasiliensis coinfection, compared with animals infected only with S. mansoni. In the chronic phase of infection, the granulomatous inflammation in coinfected animals was characterized by intense neutrophils accumulation and reduced eosinophils number. IFN-γ, IL-2, IL-4, and IL-5 circulating levels were increased in all infected groups. Coinfected animals presented attenuated IFN-γ and IL-4 production in the acute and chronic infections. Taken together, our findings indicate that coinfected animals exhibited a differential modulation of granulomatous inflammation during the acute and chronic phases of infection, which was potentially associated with a divergent profile of cytokines production and migration of neutrophils and eosinophils in response to S. mansoni and P. brasiliensis antigenic stimulation.


Assuntos
Coinfecção , Granuloma , Hepatopatias , Fígado , Paracoccidioides/imunologia , Paracoccidioidomicose , Schistosoma mansoni/imunologia , Esquistossomose mansoni , Animais , Coinfecção/imunologia , Coinfecção/microbiologia , Coinfecção/parasitologia , Coinfecção/patologia , Modelos Animais de Doenças , Granuloma/imunologia , Granuloma/microbiologia , Granuloma/parasitologia , Granuloma/patologia , Fígado/imunologia , Fígado/microbiologia , Fígado/parasitologia , Fígado/patologia , Hepatopatias/imunologia , Hepatopatias/microbiologia , Hepatopatias/parasitologia , Hepatopatias/patologia , Masculino , Camundongos , Paracoccidioidomicose/imunologia , Paracoccidioidomicose/microbiologia , Paracoccidioidomicose/patologia , Paracoccidioidomicose/fisiopatologia , Esquistossomose mansoni/imunologia , Esquistossomose mansoni/microbiologia , Esquistossomose mansoni/patologia
14.
Int J Mol Sci ; 20(8)2019 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-31013780

RESUMO

Hepatocyte growth factor (HGF) is an endogenously expressed bioactive substance that has a strong anti-apoptotic effect. In this study, we biochemically and histologically characterized the effects of rh-HGF on in vitro human hepatocyte injury and mouse acute liver failure (ALF) models, both of which were induced by antibody-mediated Fas signaling. rh-HGF inhibited intracellular caspase-3/7 activation and cytokeratin 18 (CK-18) fragment release in both models. Histologically, rh-HGF dramatically suppressed parenchymal damage and intrahepatic hemorrhage. Among the laboratory parameters, prothrombin time (PT) was strongly preserved by rh-HGF, and PT was well correlated with the degree of intrahepatic hemorrhage. These results showed that the anti-apoptotic effect of rh-HGF on hepatocytes coincided strikingly with the suppression of intrahepatic hemorrhage. PT was considered to be the best parameter that correlated with the intrahepatic hemorrhages associated with hepatocellular damage. The action of rh-HGF might derive not only from its anti-apoptosis effects on liver parenchymal cells but also from its stabilization of structural and vasculature integrity.


Assuntos
Apoptose/efeitos dos fármacos , Coagulação Sanguínea/efeitos dos fármacos , Hemorragia/metabolismo , Fator de Crescimento de Hepatócito/farmacologia , Hepatócitos/efeitos dos fármacos , Hepatócitos/metabolismo , Hepatopatias/metabolismo , Proteínas Recombinantes/farmacologia , Animais , Células Cultivadas , Modelos Animais de Doenças , Hemorragia/tratamento farmacológico , Hemorragia/etiologia , Humanos , Concentração Inibidora 50 , Hepatopatias/tratamento farmacológico , Hepatopatias/etiologia , Hepatopatias/patologia , Falência Hepática Aguda/sangue , Falência Hepática Aguda/tratamento farmacológico , Falência Hepática Aguda/etiologia , Falência Hepática Aguda/patologia , Masculino , Camundongos , Tempo de Protrombina , Receptor fas/metabolismo
15.
Radiol Clin North Am ; 57(3): 549-562, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30928077

RESUMO

Diffuse liver disease is a substantial world-wide problem. With the combination of conventional ultrasound of the abdomen and elastography-appropriate staging of the patient can be assessed. This information allows for the detection of fibrosis as well as prognosis, surveillance, and prioritization for treatment. With the potential for reversibility with appropriate treatment, accurate assessment for the stage of chronic liver disease is critical.


Assuntos
Hepatopatias/diagnóstico por imagem , Ultrassonografia/métodos , Diagnóstico Diferencial , Progressão da Doença , Técnicas de Imagem por Elasticidade/métodos , Humanos , Hepatopatias/patologia , Sensibilidade e Especificidade
16.
Transplant Proc ; 51(3): 790-793, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30979466

RESUMO

Cystic fibrosis (CF) is caused by a mutation in the CF transmembrane conductance regulator (CFTR) gene, deranging the activity of chloride channels on the epithelial cell surface. Herein we describe end-stage liver disease in 3 infants with rare CFTR gene mutations; 2 of them were heterozygous. Case 1 was a premature male infant with negative CF screening at birth who developed a small bowel obstruction in the neonatal period requiring an ileostomy, with subsequent cholestatic liver disease and portal hypertension. In addition, he was noted to have frequent respiratory infections prompting a sweat test, which was positive. Genetic testing revealed that he was heterozygous for P.1177F. He then underwent a successful liver transplant. Case 2 was a female infant who developed progressive cholestasis with poor weight gain and was found to have neonatal hepatitis on liver biopsy. A sweat test was negative and genetic testing revealed she was heterozygous for CFTR and PEX26 gene mutations. She subsequently developed pneumatosis involving the cecum that was treated conservatively, followed by a successful liver transplant. Case 3 was a male infant who developed progressive liver disease, with liver biopsy showing neonatal hepatitis. He was extensively investigated but had a negative sweat test on repeated studies. Genetic testing revealed that the patient was heterozygous P.K186N-variant in the AKRID1 gene and homozygous P.R75Q-variant in the CFTR gene. Unfortunately, he succumbed to an acute upper gastrointestinal hemorrhage. Rare and unusual CFTR mutations, even in the heterozygous form, may be a feature in otherwise undiagnosed end-stage liver disease of infancy.


Assuntos
Regulador de Condutância Transmembrana em Fibrose Cística/genética , Fibrose Cística/genética , Fibrose Cística/patologia , Hepatopatias/genética , Hepatopatias/patologia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Mutação
17.
Amino Acids ; 51(5): 795-803, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30879149

RESUMO

We aimed to evaluate whether two methionine-related compounds, S-adenosylmethionine (SAM), and selenomethionine (SM), could lessen liver damage induced by regurgitated bile in a model of rat bile duct ligation (BDL). Hepatoprotective potentials of S-adenosylmethionine and selenomethionine were estimated based on the changes of serum liver damage parameters (aminotransferases, alkaline phosphatase, gamma-glutamyltranspeptidase and lactate dehydrogenase activity, and bilirubin concentration), tissue oxidative [xanthine oxidase (XO) and catalase activity, thiobarbituric acid reactive substances (TBARS) levels] and inflammatory [tumor necrosis factor-alfa (TNF-α) concentration] parameters, and morphological liver tissue alterations that follow cholestasis. The treatment regimens proved themselves able to prevent significant liver damage induced by cholestasis. Both SAM and SM decreased XO activity and TBARS levels and increased catalase activity, while only SM significantly reduced TNF-α concentration. Morphological changes related to bile-induced liver damage were also found to be partially diminished by SAM and SM. In view of the mechanisms of action of the two tested methionine-derived compounds, one might say that SM predominantly acted as an antioxidant, while SAM exerted its activity by potentially modulating different gene expression and protein structures. It is also worth mentioning that this is the first study (to the best of our knowledge) that dealt with the effects of SM on BDL-induced liver injury in rats and of the findings that speak favorably of this powerful antioxidant.


Assuntos
Colestase/complicações , Hepatopatias/prevenção & controle , S-Adenosilmetionina/farmacologia , Selenometionina/farmacologia , Animais , Catalase/metabolismo , Hepatopatias/etiologia , Hepatopatias/metabolismo , Hepatopatias/patologia , Masculino , Ratos , Ratos Wistar , Substâncias Reativas com Ácido Tiobarbitúrico , Xantina Oxidase/metabolismo
18.
J Pediatr Surg ; 54(6): 1179-1183, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30885560

RESUMO

PURPOSE: The purpose of the study was to determine the accuracy of acoustic radiation force impulse (ARFI) ultrasound elastography in assessing the degree of liver disease in children with short bowel syndrome (SBS). METHODS: A prospective observational cohort study of patients with SBS who underwent a liver biopsy and ARFI elastography was performed. Mean shear wave speed (SWS) and stage of fibrosis was evaluated using t-tests. Receiver operating characteristic curves (ROC) were generated and the area under the curves (AUC) estimated in order to assess the accuracy of SWS measurements to discriminate between stages of fibrosis. RESULTS: Thirty-seven paired elastography and biopsy samples from 31 patients were included. The median age was 0.6 years, and 61% were male. There was a significant positive correlation between stage of fibrosis and mean SWS (ß=0.16 m/s increase per stage, p=<0.001). ROC analysis revealed that mean SWS had good accuracy for discriminating between mild liver fibrosis (F0-F1) and moderate to severe fibrosis (F2-F4) (AUC=0.80, 95% CI 0.65-0.95). In addition, ROC analysis demonstrated that mean SWS can also accurately discriminate between mild to moderate fibrosis (F0-F2) and more severe fibrosis (F3-F4) (AUC=0.84, 95% CI 0.71-0.96). CONCLUSION: ARFI elastography is an accurate, non-invasive method to monitor liver disease in children with SBS. TYPE OF STUDY: Retrospective Cohort Study LEVEL OF EVIDENCE: II.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Hepatopatias , Síndrome do Intestino Curto , Feminino , Humanos , Lactente , Hepatopatias/complicações , Hepatopatias/diagnóstico por imagem , Hepatopatias/patologia , Masculino , Estudos Prospectivos , Curva ROC , Síndrome do Intestino Curto/complicações , Síndrome do Intestino Curto/diagnóstico por imagem
19.
Am Surg ; 85(2): 234-244, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30819306

RESUMO

Chronic liver disease remains a prevalent and challenging comorbidity in the American population at large. Scarring and fibrosis cause physical and physiological changes that may prove challenging in both medical and surgical management. However, because there has been relevant improvements in preoperative diagnostic, perioperative hepatologic, and intensive care management, as well as in surgical techniques, patients with cirrhosis can safely be operated on but patient selection remains vital. Patients with chronic liver disease may present to a general surgeon for evaluation of a number of elective or emergent surgical conditions. Here, we review current literature on the perioperative management and operative strategies of seemingly routine general surgery issues and provide a review of the pathophysiology associated with chronic liver disease.


Assuntos
Tomada de Decisão Clínica , Hepatectomia , Hepatopatias/cirurgia , Seleção de Pacientes , Doença Crônica , Humanos , Hepatopatias/patologia , Hepatopatias/fisiopatologia
20.
Life Sci ; 223: 69-73, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30831126

RESUMO

Pyroptosis is a novel programmed cell death form which is distinct from other types of cell death. As an inherently inflammatory process, it plays a vital role in cellular lysis and release of pro-inflammatory cytokines when hosts defend against infections. Recent studies have reported that pyroptosis was involved in liver diseases and had important functions in the progress and development of liver diseases. Here, we addressed the potential role of pyroptosis in liver diseases on the basis of brief introduction of the morphological characteristics, molecular and pathophysiological mechanisms of pyroptosis.


Assuntos
Inflamassomos/metabolismo , Hepatopatias/etiologia , Piroptose/fisiologia , Animais , Dano ao DNA , Humanos , Inflamassomos/genética , Hepatopatias/genética , Hepatopatias/metabolismo , Hepatopatias/patologia , Piroptose/genética
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