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1.
Rev Med Suisse ; 16(N° 691-2): 845-848, 2020 Apr 29.
Artigo em Francês | MEDLINE | ID: mdl-32348050

RESUMO

The current epidemic of SARS-CoV-2 infection poses new challenges in the management of patients with gastrointestinal or liver disease. Consultations with patients with chronic diseases should ideally be done via telemedicine and treatments administered at home if possible. The latter should be maintained in non-infected subjects to limit the risk of decompensation of their underlying disease. In the event of proven infection, immunomodulatory or biological treatments will tend to be reduced or discontinued unless the disease is in a severely active phase. Elective endoscopy should be postponed, and urgent procedures should be performed with appropriate personal protective equipment.


Assuntos
Infecções por Coronavirus , Gastroenteropatias , Hepatopatias , Pandemias , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Procedimentos Cirúrgicos Eletivos , Gastroenteropatias/complicações , Gastroenteropatias/terapia , Humanos , Hepatopatias/complicações , Hepatopatias/terapia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia
3.
Internist (Berl) ; 61(2): 140-146, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31938816

RESUMO

Benign liver tumors form a heterogeneous group. The most frequent forms include simple cysts, hemangiomas, focal nodular hyperplasia and hepatocellular adenomas. They are often incidentally detected during routine sonography. The diagnosis of a liver tumor not uncommonly causes anxiety and insecurity in those affected, which is why a rapid and reliable diagnostic procedure should be carried out. Because some tumors, particularly hepatocellular adenomas, are of prognostic relevance due to the potential risk of malignant transformation, a correct classification should always be strived for. The type and extent of diagnostic clarification depend on the clinical and patient-related risk factors. This article describes the most important benign space-occupying lesions. The etiology, clinical manifestations and diagnostics as well as possible necessary treatment measures are presented.


Assuntos
Cistos , Hiperplasia Nodular Focal do Fígado , Hemangioma , Hepatopatias , Neoplasias Hepáticas , Cistos/diagnóstico , Cistos/terapia , Diagnóstico Diferencial , Hiperplasia Nodular Focal do Fígado/diagnóstico , Hiperplasia Nodular Focal do Fígado/terapia , Hemangioma/diagnóstico , Hemangioma/terapia , Humanos , Hepatopatias/diagnóstico , Hepatopatias/terapia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/terapia
4.
Gastroenterology ; 158(1): 76-94.e2, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31593701

RESUMO

Since 2010, substantial progress has been made in artificial intelligence (AI) and its application to medicine. AI is explored in gastroenterology for endoscopic analysis of lesions, in detection of cancer, and to facilitate the analysis of inflammatory lesions or gastrointestinal bleeding during wireless capsule endoscopy. AI is also tested to assess liver fibrosis and to differentiate patients with pancreatic cancer from those with pancreatitis. AI might also be used to establish prognoses of patients or predict their response to treatments, based on multiple factors. We review the ways in which AI may help physicians make a diagnosis or establish a prognosis and discuss its limitations, knowing that further randomized controlled studies will be required before the approval of AI techniques by the health authorities.


Assuntos
Inteligência Artificial , Diagnóstico por Computador/métodos , Gastroenterologia/métodos , Gastroenteropatias/diagnóstico , Hepatopatias/diagnóstico , Tomada de Decisão Clínica/métodos , Sistemas de Apoio a Decisões Clínicas , Árvores de Decisões , Gastroenteropatias/mortalidade , Gastroenteropatias/terapia , Humanos , Hepatopatias/mortalidade , Hepatopatias/terapia , Prognóstico , Resultado do Tratamento
5.
Gastroenterology ; 158(1): 95-110, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31626754

RESUMO

Glycans are sequences of carbohydrates that are added to proteins or lipids to modulate their structure and function. Glycans modify proteins required for regulation of immune cells, and alterations have been associated with inflammatory conditions. For example, specific glycans regulate T-cell activation, structures, and functions of immunoglobulins; interactions between microbes and immune and epithelial cells; and malignant transformation in the intestine and liver. We review the effects of protein glycosylation in regulation of gastrointestinal and liver functions, and how alterations in glycosylation serve as diagnostic or prognostic factors, or as targets for therapy.


Assuntos
Gastroenteropatias/diagnóstico , Hepatopatias/diagnóstico , Biomarcadores/metabolismo , Gastroenteropatias/mortalidade , Gastroenteropatias/terapia , Trato Gastrointestinal/imunologia , Trato Gastrointestinal/metabolismo , Glicômica , Glicosilação/efeitos dos fármacos , Humanos , Fígado/imunologia , Fígado/metabolismo , Hepatopatias/mortalidade , Hepatopatias/terapia , Polissacarídeos/metabolismo , Prognóstico , Proteômica , Linfócitos T/efeitos dos fármacos , Linfócitos T/imunologia , Linfócitos T/metabolismo , Fatores de Tempo
6.
Chirurg ; 90(12): 1033-1046, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31784769

RESUMO

Benign liver tumors are often detected during routine ultrasound examinations or as an incidental finding in radiological imaging. Only very few benign liver tumors are at risk of becoming malignant. In the majority of cases the differentiation from malignant tumors is currently carried out using imaging procedures. In a few cases of diagnostic uncertainty, a transcutaneous liver biopsy can lead to clarification. If the suspicion of malignancy is substantiated or this cannot be excluded with absolute certainty, the tumor should be removed by partial liver resection.


Assuntos
Hepatopatias , Neoplasias Hepáticas , Biópsia , Diagnóstico Diferencial , Hepatectomia , Humanos , Achados Incidentais , Hepatopatias/diagnóstico , Hepatopatias/terapia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/terapia , Ultrassonografia
7.
Gastroenterol. hepatol. (Ed. impr.) ; 42(10): 657-676, dic. 2019. ilus, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-188200

RESUMO

La enfermedad hepática alcohólica (EHA) es la causa más prevalente de enfermedad hepática avanzada y cirrosis hepática en Europa incluyendo a España. De acuerdo con la Organización Mundial de la Salud la fracción de cirrosis hepática atribuible al uso de alcohol en España es del 73,8% entre varones y del 56,3% entre mujeres. La EHA incluye diversos estadios como la esteatohepatitis, la cirrosis y el cáncer hepatocelular. Además, enfermos con EHA de base e ingesta abundante de alcohol pueden desarrollar hepatitis alcohólica, que cursa con una elevada mortalidad. Hasta la fecha, el único tratamiento efectivo para tratar la EHA es la abstinencia prolongada. No existen tratamientos específicos, y el único tratamiento que aumenta la esperanza de vida en la hepatitis alcohólica es la prednisolona. Para enfermos con hepatitis alcohólica que no responden al tratamiento, algunos centros ofrecen la posibilidad de un trasplante precoz. Estas guías de práctica clínica tienen como objetivo proponer recomendaciones sobre la EHA teniendo en cuenta su relevancia como causa de hepatopatía crónica avanzada y cirrosis hepática en nuestro medio. En el presente trabajo se propone como objetivo responder las preguntas claves para la práctica clínica de Gastroenterología, Hepatología, así como de Medicina Interna y centros de salud primaria, poniendo al servicio del profesional de la salud la información más actualizada respecto al manejo y tratamiento de la EHA. Estas guías proporcionan recomendaciones basadas en la evidencia para el manejo clínico de esta enfermedad


Alcohol-related liver disease (ARLD) is the most prevalent cause of advanced liver disease and liver cirrhosis in Europe, including Spain. According to the World Health Organization the fraction of liver cirrhosis attributable to alcohol use in Spain is 73.8% among men and 56.3% among women. ARLD includes various stages such as steatohepatitis, cirrhosis and hepatocellular cancer. In addition, patients with underlying ARLD and heavy alcohol intake may develop alcoholic hepatitis, which is associated with high mortality. To date, the only effective treatment to treat ARLD is prolonged withdrawal. There are no specific treatments, and the only treatment that increases life expectancy in alcoholic hepatitis is prednisolone. For patients with alcoholic hepatitis who do not respond to treatment, some centres offer the possibility of an early transplant. These clinical practice guidelines aim to propose recommendations on ARLD taking into account their relevance as a cause of advanced chronic liver disease and liver cirrhosis in our setting. This paper aims to answer the key questions for the clinical practice of Gastroenterology, Hepatology, as well as Internal Medicine and Primary Health Centres, making the most up-to-date information regarding the management and treatment of ARLD available to health professionals. These guidelines provide evidence-based recommendations for the clinical management of this disease


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Hepatite Alcoólica/epidemiologia , Consenso , Hepatopatias/epidemiologia , Alcoolismo/epidemiologia , Espanha/epidemiologia , Hepatopatias/diagnóstico , Hepatopatias/terapia , Saúde Pública , História Natural , Cirrose Hepática/complicações , Fatores de Risco
8.
Ann Biol Clin (Paris) ; 77(6): 605-618, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31859638

RESUMO

Inborn errors of metabolism (IEM) are rare diseases caused by mutations in genes encoding enzymes or carriers. Qualitative or quantitative protein deficiency induces both an accumulation of precursor metabolites and a lack of products downstream of the blockade. Pregnancy in patients with IEM is a condition likely to promote metabolic decompensation. In this review, we presented liver symptoms described during pregnancy in a context of hepatic IEM. In particular, we detailed clinical and biological abnormalities specifically occurring in tyrosinemia type I, Wilson disease, and main urea cycle defects. In the case of hepatic IEM, depending on the deficit, pregnant women have an increased risk of pre-eclampsia and HELLP syndrome, as well as hyperammonemia. Wilson disease, and principal urea cycle defects. Multidisciplinary consultation is essential for the optimal management of pregnant women with IEM as well as newborns.


Assuntos
Hepatopatias/etiologia , Erros Inatos do Metabolismo/complicações , Complicações na Gravidez/etiologia , Criança , Feminino , Humanos , Recém-Nascido , Comunicação Interdisciplinar , Hepatopatias/epidemiologia , Hepatopatias/terapia , Doenças Metabólicas/complicações , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/genética , Doenças Metabólicas/terapia , Erros Inatos do Metabolismo/epidemiologia , Erros Inatos do Metabolismo/terapia , Equipe de Assistência ao Paciente/organização & administração , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/terapia , Fatores de Risco
9.
Vasc Health Risk Manag ; 15: 309-316, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692533

RESUMO

Experimentally induced injury triggers up-regulation and mobilization of stem cells in Apoe -/- mice that causes accelerated atherosclerosis. Abca1 -/- Abcg1-/- mice have chronic activation of stem cell up-regulation/mobilization and accelerated atherosclerosis. In addition, the Abca1 -/- Abcg1-/- mice have elevation of serum cytokines G-CSF, IL-17 and IL-23, each necessary for stem cell mobilization. IL-17 and IL-23 are elevated in two human illnesses that have cardiovascular (CV) risk independent of traditional risk factors-SLE and psoriasis. Serum G-CSF, which can be elevated in liver disease, predicts major adverse cardiovascular events in humans. These serum cytokine elevations suggest activation of the stem cell mobilization mechanism in humans that results, as in mice, in accelerated atherosclerosis. Efforts to reduce CV disease in these patient populations should include mitigation of the diseases that trigger stem cell mobilization. Since activation of the stem cell up-regulation/mobilization mechanism appears to accelerate human atherosclerosis, use of stem cells as therapy for arterial occlusive disease should distinguish between direct administration of stem cells and activation of the stem cell up-regulation/mobilization mechanism.


Assuntos
Doenças Cardiovasculares/patologia , Movimento Celular , Hepatopatias/patologia , Psoríase/patologia , Células-Tronco/patologia , Transportador 1 de Cassete de Ligação de ATP/deficiência , Transportador 1 de Cassete de Ligação de ATP/genética , Membro 1 da Subfamília G de Transportadores de Cassetes de Ligação de ATP/deficiência , Membro 1 da Subfamília G de Transportadores de Cassetes de Ligação de ATP/genética , Animais , Doenças Cardiovasculares/genética , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/prevenção & controle , Modelos Animais de Doenças , Progressão da Doença , Humanos , Mediadores da Inflamação/metabolismo , Hepatopatias/genética , Hepatopatias/metabolismo , Hepatopatias/terapia , Lúpus Eritematoso Sistêmico/genética , Lúpus Eritematoso Sistêmico/metabolismo , Lúpus Eritematoso Sistêmico/patologia , Lúpus Eritematoso Sistêmico/terapia , Camundongos Knockout para ApoE , Fenótipo , Prognóstico , Psoríase/genética , Psoríase/metabolismo , Psoríase/terapia , Fatores de Risco , Células-Tronco/metabolismo
10.
Medicine (Baltimore) ; 98(39): e17305, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574858

RESUMO

Until now, the recognition of sodium taurocholate cotransporting polypeptide (NTCP) deficiency has been mainly based on sporadic case reports. It was previously believed to be mildly symptomatic and resulting in mild liver dysfunction. However, to our knowledge, there have been no reports about the histopathologic and ultrastructural pathologic characteristics of the disease. The aim of the study was to analyze the clinical, histopathologic and ultrastructural pathologic characteristics of NTCP deficiency in 13 pediatric patients.From August 2012 to October 2018, this retrospective study conducted in the Department of Pediatrics of Tongji Hospital, China analyzed the data of 13 NTCP deficient patients with an SLC10A1 gene mutation. Except for NTCP deficiency, no other liver diseases were present in the patients, which was determined by both a genetic testing panel for jaundice and by reviewing medical records. The laboratory results, imaging, histopathologic, and ultrastructural pathologic information were recorded for analysis.The serum level of total bile acid was high in all 13 patients. All patients had adequate growth and development. Eight of the patients (8/13) presented with visible jaundice and 12 (12/13) were found to have hyperbilirubinemia. A needle liver biopsy was performed in 11 cases, which revealed slightly chronic inflammation in all 11 patients. One of the patients (1/13) was found to be suffering from gallstones.The data showed that although NTCP deficiency was often asymptomatic, some of the patients showed obvious clinical expressions, such as jaundice. Among the 13 pediatric patients with NTCP deficiency, both the biochemical and histopathologic features were similar to those of mild hepatocellular jaundice. In addition, it was determined that the clinical features in the patient with gallstones may have been caused by NTCP deficiency.


Assuntos
Ácidos e Sais Biliares/sangue , Icterícia , Hepatopatias , Fígado , Transportadores de Ânions Orgânicos Dependentes de Sódio , Simportadores , Desenvolvimento Infantil , Pré-Escolar , China/epidemiologia , Testes Genéticos/métodos , Humanos , Biópsia Guiada por Imagem/métodos , Lactente , Icterícia/diagnóstico , Icterícia/etiologia , Fígado/metabolismo , Fígado/patologia , Hepatopatias/diagnóstico , Hepatopatias/genética , Hepatopatias/fisiopatologia , Hepatopatias/terapia , Testes de Função Hepática/métodos , Glicoproteínas de Membrana/metabolismo , Mutação , Transportadores de Ânions Orgânicos Dependentes de Sódio/deficiência , Transportadores de Ânions Orgânicos Dependentes de Sódio/genética , Pediatria/métodos , Estudos Retrospectivos , Simportadores/deficiência , Simportadores/genética
11.
Med Clin North Am ; 103(6): 991-1003, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582009

RESUMO

Genetic causes of liver disease lead to a wide range of presentations. This article describes hereditary hemochromatosis, Gilbert syndrome, alpha-1 antitrypsin deficiency, Wilson disease, PFIC, BRIC, and LAL-D. The most common cause of hereditary hemochromatosis is a C282Y mutation in the HFE gene. Gilbert syndrome is a benign cause of indirect hyperbilirubinemia. Alpha-1 antitrypsin deficiency causes both lung and liver disease. Wilson disease can cause neurologic disease and liver disease. Progressive familial intrahepatic cholestasis and benign recurrent intrahepatic cholestasis are rare causes of cholestasis. LAL-D is a rare disease that can appear similar to NAFLD in adults.


Assuntos
Testes Genéticos , Hepatopatias , Administração dos Cuidados ao Paciente/métodos , Humanos , Hepatopatias/genética , Hepatopatias/terapia
13.
Eur Cytokine Netw ; 30(2): 39-42, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31486398

RESUMO

Since the pro-inflammatory cytokine IL-33 and its receptor (ST2) are closely involved in regulating both innate and adaptive immune responses, it is conceivable that they may play an important role in organ transplantation. IL-33 is broadly expressed by multiple cell types such as fibroblasts, epithelial cells, and endothelial cells. As a strong inducer of type 2 helper T (Th2) cellular immune responses, IL-33 can significantly prolong allograft survival in organ transplantation partially via altering gene expression profiles and increasing frequency of regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs). Nevertheless, the IL-33 signaling pathway and its underlying mechanisms remain largely undefined in transplant biology. This present mini-review summarizes recent advances in the studies concerning the IL-33/ST2 signaling pathway and the analysis of its biological function in the field transplantation. The literature points to a deleterious role of activation of the IL-33/ST2 signaling pathway, giving rise to ischemia/reperfusion, acute kidney injury and failure, acute heart rejection, as well as liver fibrosis. Under pro-inflammatory conditions, IL-33 expression is upregulated. Alteration of IL-33 levels has been suggested as a biomarker for predicting organ injury and ongoing allogeneic transplant outcome. These studies have deepened our understanding of immunobiological role of IL-33 and its receptor in organ transplantation. Modulation of the IL-33/ST2 signaling pathway might be utilized as a therapeutic target in the clinic.


Assuntos
Interleucina-33/metabolismo , Transplante de Órgãos , Animais , Cardiopatias/terapia , Humanos , Nefropatias/terapia , Hepatopatias/terapia
14.
Int J Mol Sci ; 20(17)2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31480433

RESUMO

Osteoporosis is a frequently observed complication in patients with chronic liver disease, particularly liver cirrhosis and cholestatic liver diseases. In addition, osteoporosis is critical in patients receiving a liver transplant. Nevertheless, few studies have evaluated bone diseases in patients with more frequently observed chronic liver disease, such as chronic viral hepatitis, nonalcoholic fatty liver disease and alcoholic liver disease. Osteoporosis is a disease caused by an imbalance in the activities of osteoblasts and osteoclasts. Over the last few decades, many advances have improved our knowledge of the pathogenesis of osteoporosis. Importantly, activated immune cells affect the progression of osteoporosis, and chronic inflammation may exert an additional effect on the existing pathophysiology of osteoporosis. The microbiota of the intestinal tract may also affect the progression of bone loss in patients with chronic liver disease. Recently, studies regarding the effects of chronic inflammation on dysbiosis in bone diseases have been conducted. However, mechanisms underlying osteoporosis in patients with chronic liver disease are complex and precise mechanisms remain unknown. The following special considerations in patients with chronic liver disease are reviewed: bone diseases in patients who underwent a liver transplant, the association between chronic hepatitis B virus infection treatment and bone diseases, the association between sarcopenia and bone diseases in patients with chronic liver disease, and the association between chronic liver disease and avascular necrosis of the hip. Few guidelines are currently available for the management of low bone mineral density or bone diseases in patients with chronic liver disease. Due to increased life expectancy and therapeutic advances in chronic liver disease, the importance of managing osteoporosis and other bone diseases in patients with chronic liver disease is expected to increase. Consequently, specific guidelines need to be established in the near future.


Assuntos
Doenças Ósseas/complicações , Hepatopatias/complicações , Animais , Doenças Ósseas/patologia , Doenças Ósseas/terapia , Doença Crônica , Gerenciamento Clínico , Humanos , Hepatopatias/patologia , Hepatopatias/terapia , Transplante de Fígado
16.
Immunol Med ; 42(2): 71-78, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31498713

RESUMO

Results of recent studies have shown that disease models using human induced pluripotent stem (iPS) cells have recapitulated the pathophysiology of genetic liver diseases, viral hepatitis and hepatic fibrosis. The utilization of human iPS cells as a model of liver diseases has several substantial advantages compared with primary hepatocytes and cancer cell lines, such as the potential for unlimited expansion and similarity of biological characteristics to normal liver cells. In this review, we have focused on modeling liver diseases using human iPS cells and discussed the experimental evidence that supports the utility of such disease models, including that in our recent studies. Genetically modified or patient-derived human iPS cells can mimic congenital liver disease phenotypes. Human iPS-derived hepatic cells can be infected with the hepatitis viruses. The co-culture of human iPS-derived hepatocytes and mesenchyme partially mimics the process of liver fibrosis. Human iPS cell-derived hepatic cells and the co-culture system of such cells will contribute to the progress of studies on the pathophysiology of genetic and non-genetic liver diseases and development of novel therapeutic strategies for treating liver diseases.


Assuntos
Células-Tronco Pluripotentes Induzidas , Hepatopatias , Hepatite Viral Humana/genética , Hepatite Viral Humana/terapia , Humanos , Cirrose Hepática/genética , Cirrose Hepática/terapia , Hepatopatias/genética , Hepatopatias/terapia
18.
Eur J Haematol ; 103(5): 519-522, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31389104

RESUMO

We present a case series of 3 patients to highlight the fact that PTLD post-transplant can mimic GVHD, and should be part of the differential diagnosis for diarrhea post allo-HCT. Awareness of this presentation has important therapeutic implications, as increased immune suppression for the management of GVHD, can worsen clinical features of PTLD. Diagnostic imaging and tissue biopsies should be undertaken early in post-transplant patients presenting with diarrhea or hepatic abnormalities, especially with atypical presentations like fever, and EBV PCR monitoring can expedite clinical decision-making in such complicated scenarios while awaiting results of gut biopsies.


Assuntos
Infecções por Vírus Epstein-Barr , Transplante de Células-Tronco Hematopoéticas , Herpesvirus Humano 4 , Transtornos Linfoproliferativos , Doença Aguda , Aloenxertos , Biópsia , Tomada de Decisão Clínica , Diarreia/diagnóstico , Diarreia/patologia , Diarreia/terapia , Infecções por Vírus Epstein-Barr/diagnóstico , Infecções por Vírus Epstein-Barr/patologia , Infecções por Vírus Epstein-Barr/terapia , Feminino , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/patologia , Doença Enxerto-Hospedeiro/terapia , Humanos , Hepatopatias/diagnóstico , Hepatopatias/patologia , Hepatopatias/terapia , Transtornos Linfoproliferativos/diagnóstico , Transtornos Linfoproliferativos/patologia , Transtornos Linfoproliferativos/terapia , Masculino , Pessoa de Meia-Idade
19.
Cells ; 8(8)2019 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-31426422

RESUMO

During foetal life, the liver plays the important roles of connection and transient hematopoietic function. Foetal liver cells develop in an environment called a hematopoietic stem cell niche composed of several cell types, where stem cells can proliferate and give rise to mature blood cells. Embryologically, at about the third week of gestation, the liver appears, and it grows rapidly from the fifth to 10th week under WNT/ß-Catenin signaling pathway stimulation, which induces hepatic progenitor cells proliferation and differentiation into hepatocytes. Development of new strategies and identification of new cell sources should represent the main aim in liver regenerative medicine and cell therapy. Cells isolated from organs with endodermal origin, like the liver, bile ducts, and pancreas, could be preferable cell sources. Furthermore, stem cells isolated from these organs could be more susceptible to differentiate into mature liver cells after transplantation with respect to stem cells isolated from organs or tissues with a different embryological origin. The foetal liver possesses unique features given the co-existence of cells having endodermal and mesenchymal origin, and it could be highly available source candidate for regenerative medicine in both the liver and pancreas. Taking into account these advantages, the foetal liver can be the highest potential and available cell source for cell therapy regarding liver diseases and diabetes.


Assuntos
Feto/metabolismo , Hepatócitos/transplante , Hepatopatias/terapia , Fígado , Medicina Regenerativa , Transplante de Células-Tronco , Animais , Diabetes Mellitus/terapia , Hepatócitos/citologia , Humanos , Fígado/citologia , Fígado/metabolismo , Regeneração Hepática , Camundongos , Pancreatopatias/terapia , Células-Tronco/citologia
20.
Immunology ; 158(4): 296-303, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31436861

RESUMO

Hepatic fibrosis induced by schistosomes is regulated by a complex network of cytokines. T helper type 9 (Th9) cells are a new type of effector T helper cells, which mainly secrete the specific cytokine interleukin-9 (IL-9). Interleukin-9 has been shown to contribute to liver fibrosis in patients with chronic hepatitis B and in a mouse model due to carbon tetrachloride. However, the role of IL-9 in schistosomiasis fibrosis remains unknown. In this study, we investigated the roles of IL-9 in schistosomiasis through in vivo and in vitro studies. The in vivo studies found that neutralization of IL-9 reduced liver granulomatous inflammation and collagen deposition around parasite eggs. The in vitro studies found that the treatment of primary hepatic stellate cells with IL-9 induced a significant increase of collagen and α-smooth-muscle actin. Moreover, we also described the dynamics and relevance of IL-9 and IL-4 in mice infected with Schistosoma japonicum. We found that IL-9 might appear more quickly and at higher levels than IL-4. Hence, our findings indicated that IL-9 might play a role in regulating hepatic fibrosis in early-stage schistosomiasis and become a promising approach for regulating hepatic fibrosis caused by S. japonicum.


Assuntos
Granuloma/terapia , Inflamação/terapia , Interleucina-9/metabolismo , Hepatopatias/terapia , Schistosoma japonicum/fisiologia , Esquistossomose Japônica/terapia , Linfócitos T Auxiliares-Indutores/imunologia , Animais , Células Cultivadas , Colágeno/metabolismo , Modelos Animais de Doenças , Feminino , Fibrose , Granuloma/imunologia , Humanos , Inflamação/imunologia , Interleucina-4/metabolismo , Interleucina-9/antagonistas & inibidores , Hepatopatias/imunologia , Camundongos , Camundongos Endogâmicos , Contagem de Ovos de Parasitas , Esquistossomose Japônica/imunologia
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