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Seminars in Liver Disease

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https://www.readbyqxmd.com/read/29871022/hepatic-dendritic-cells-the-tolerogenic-liver-environment-and-liver-disease
#1
Lei Dou, Yoshihiro Ono, Yi-Fa Chen, Angus W Thomson, Xiao-Ping Chen
The unique liver immune microenvironment favors resistance to inflammation that promotes normal physiological function. At the same time, it endows the liver with tolerogenic properties that may promote pathological processes. Hepatic dendritic cells (HDCs) initiate and orchestrate immune responses depending on signals they receive from the local environment and are thought to contribute to liver tolerance. Thus, HDCs facilitate impaired T cell responses that are observed in persistent hepatitis C virus (HCV) infection, hepatocellular carcinoma progression, and liver allograft transplantation...
May 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29871021/emerging-technologies-for-the-diagnosis-of-perihilar-cholangiocarcinoma
#2
Sumera Rizvi, John Eaton, Ju Dong Yang, Vinay Chandrasekhara, Gregory J Gores
The diagnosis of malignant biliary strictures remains problematic, especially in the perihilar region and in primary sclerosing cholangitis (PSC). Conventional cytology obtained during endoscopic retrograde cholangiography (ERC)-guided brushings of biliary strictures is suboptimal due to limited sensitivity, albeit it remains the gold standard with a high specificity. Emerging technologies are being developed and validated to address this pressing unmet patient need. Such technologies include enhanced visualization of the biliary tree by cholangioscopy, intraductal ultrasound, and confocal laser endomicroscopy...
May 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29871020/endoscopic-ultrasound-for-the-hepatologist-a-comprehensive-review
#3
Mihai Rimbaş, Luca Di Maurizio, Gianenrico Rizzatti, Antonio Gasbarrini, Guido Costamagna, Alberto Larghi
In the last few years, the diagnostic and therapeutic utilization of endoscopic ultrasound (EUS) for a variety of liver conditions has exponentially grown. We performed a thorough search for all available studies on the performance of diagnostic and therapeutic EUS in the field of hepatology. This article reviews the indication of EUS in the evaluation and treatment of portal hypertension, portal vein pressure measurement, focal liver lesions, and parenchymal liver diseases, and presents all the clinical evidences available so far in this regard...
May 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29871019/bacterial-infections-in-acute-on-chronic-liver-failure
#4
Lingling Yang, Tianzhou Wu, Jiang Li, Jun Li
Acute-on-chronic liver failure (ACLF) is a newly recognized clinical syndrome characterized by preexisting chronic liver disease or cirrhosis with organ failure and high 28-day mortality (50-90%). Bacterial infections (BIs) play pivotal roles in the development and progression of ACLF either as a main precipitating event or a specific complication. The main organisms isolated as triggering ACLF are Gram-positive bacteria, followed by Gram-negative bacteria. Spontaneous bacterial peritonitis, pneumonia, urinary tract infections, and skin infections are prevalent infections that trigger and complicate ACLF...
May 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29871018/management-of-hcv-related-liver-disease-in-hemophilia-and-thalassemia
#5
Maria Grazia Rumi, Vito Di Marco, Massimo Colombo
Chronic infection with the hepatitis C virus (HCV) has long been the dominant complication of substitution therapy in patients with inherited blood disorders and the cause of anticipated death due to end-stage liver disease. In hemophilia, transmission of HCV with clotting factors concentrates started to be curbed in the mid-1980s following the adoption of procedures of virus inactivation of concentrates based on heat, whereas in the 1990s treatment of HCV infection with interferon monotherapy was attempted, however, with little success...
May 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29871017/a-primer-on-systematic-reviews-and-meta-analyses
#6
Nghia H Nguyen, Siddharth Singh
With the rapid growth of biomedical literature, there is increasing need to make meaningful inferences from a comprehensive and complex body of evidence. Systematic reviews with or without meta-analyses offer an objective and summative approach to synthesize knowledge and critically appraise evidence to inform clinical practice. Systematic reviews also help identify key knowledge gaps for future investigation. In this review, the authors provide a step-by-step approach to conducting a systematic review. These include: (1) formulating a focused and clinically-relevant question; (2) designing a detailed review protocol with explicit inclusion and exclusion criteria; (3) performing a systematic literature search of multiple databases and unpublished data, in consultation with a medical librarian, to identify relevant studies; (4) meticulous data abstraction by at least two sets of investigators independently; (5) assessing risk of bias in individual studies; (6) quantitative synthesis with meta-analysis; and (7) critically and transparently ascertaining quality of evidence...
May 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29871016/noninferiority-clinical-trials-the-good-the-bad-and-the-ugly
#7
Emmanuel Lesaffre
For decades, the superiority trial has been the most popular design to assess the efficacy of newly developed drugs in a randomized controlled clinical trial. In a superiority trial, the aim is to show that the new (experimental) treatment is better than the standard treatment or placebo. However, it becomes increasingly difficult to improve the efficacy upon that of existing drugs. For this reason, noninferiority designs have been suggested. In a noninferiority study, one aims to show that the experimental treatment does not lower the efficacy of the standard treatment too much, but this loss of efficacy should be compensated by other better properties...
May 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29566408/surgical-complications-after-right-hepatectomy-for-live-liver-donation-largest-single-center-western-world-experience
#8
Andre Gorgen, Nicolas Goldaracena, Wei Zhang, Roizar Rosales, Anand Ghanekar, Les Lilly, Mark Cattral, Paul Greig, Stuart McCluskey, Ian McGilvray, Nazia Selzner, Mamatha Bhat, Markus Selzner, Gary Levy, David Grant, Gonzalo Sapisochin
The authors assessed the incidence, management, and risk factors for postoperative complications after right lobe (RL) live donor hepatectomy in a high-volume center in North America. All donors undergoing an RL live donor hepatectomy between 2000 and 2017 at our institution were included. The primary outcome was the development of complications (both medical and surgical). Predictors of postoperative complications were determined by logistic regression. A total of 587 patients underwent RL live donor hepatectomy...
March 22, 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29471569/does-transjugular-intrahepatic-portosystemic-shunt-stent-differentially-improve-survival-in-a-subset-of-cirrhotic-patients
#9
Jonel Trebicka
Does transjugular intrahepatic portosystemic shunt stent (TIPS) improve survival in a subgroup of patients? Yes. TIPS nearly halves portal pressure and increases the effective blood volume. In cases of acute variceal hemorrhage and with a high risk of treatment failure, defined as either hepatic venous pressure gradient higher than 20 mm Hg, Child B with active bleeding at the endoscopy, or Child C with less than 14 points, early or preemptive placement of TIPS (within 72 hours) improves survival. Also, in suitable patients with intractable or refractory ascites, TIPS improves survival if placed early in the course of treatment...
February 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29471568/the-receptor-interacting-protein-kinases-in-the-liver
#10
Lily Dara
The receptor interacting serine/threonine kinase1 and 3 (RIPK1, RIPK3) are regulators of cell death and survival. RIPK1 kinase activity is required for necroptosis and apoptosis, while its scaffolding function is necessary for survival. Although both proteins can mediate apoptosis, RIPK1 and RIPK3 are most well-known for their role in the execution of necroptosis via the mixed lineage domain like pseudokinase. Necroptosis is a caspase-independent regulated cell death program which was first described in cultured cells with unknown physiologic relevance in the liver...
February 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29471567/targeting-hepatitis-d
#11
Mario Rizzetto
New therapeutic strategies to treat chronic hepatitis D are directed to deprive the hepatitis D virus (HDV) of functions necessary to complete its life cycle that are provided by the hepatitis B virus (HBV) and by the host. Current options are (1) the block by the synthetic peptide Myrcludex B of HBV surface antigen (HBsAg) entry into cells through the inhibition of the sodium taurocholate cotransporting receptor; (2) the inhibition with lonafarnib of the farnesylation of the large HD antigen, required for virion assembly; (3) the presumed reduction by the nucleic acid polymer REP 2139 of the release of the HBsAg and subviral HBV particles necessary for HD virion morphogenesis...
February 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29471566/mucosal-associated-invariant-t-cells-in-chronic-inflammatory-liver-disease
#12
Fabian J Bolte, Barbara Rehermann
The broadening field of microbiome research has led to a substantial reappraisal of the gut-liver axis and its role in chronic liver disease. The liver is a central immunologic organ that is continuously exposed to food and microbial-derived antigens from the gastrointestinal tract. Mucosal-associated invariant T (MAIT) cells are enriched in the human liver and can be activated by inflammatory cytokines and microbial antigens. In chronic inflammatory liver disease, MAIT cells are depleted suggesting an impaired MAIT cell-dependent protection against bacterial infections...
February 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29471565/fibrolamellar-carcinoma-recent-advances-and-unresolved-questions-on-the-molecular-mechanisms
#13
Gadi Lalazar, Sanford M Simon
Fibrolamellar hepatocellular carcinoma (FLC) is a rare form of primary liver cancer that affects adolescents and young adults without underlying liver disease. Surgery remains the mainstay of therapy; however, most patients are either not surgical candidates or suffer from recurrence. There is no approved systemic therapy and the overall survival remains poor. Historically classified as a subtype of hepatocellular carcinoma (HCC), FLC has a unique clinical, histological, and molecular presentation. At the genomic level, FLC contains a single 400kB deletion in chromosome 19, leading to a functional DNAJB1-PRKACA fusion protein...
February 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29471564/genetic-and-epigenetic-heterogeneity-in-normal-liver-homeostasis-and-its-implications-for-liver-disease-and-hepatocellular-cancer
#14
Ryan A Hlady, Keith D Robertson
Hepatocellular carcinoma (HCC) is the most prevalent primary tumor of the liver, and is steadily becoming one of the most lethal cancers worldwide. Liver resection, which is the recommended procedure for early localized HCC, results in frequent recurrence (50-70%), while the standard of care for late-stage HCC, multikinase inhibitors, only improves survival by a few months. The lack of success for these treatment modalities is attributable, at least in part, to marked phenotypic heterogeneity within the tumor...
February 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29471563/hepatic-damage-by-natural-remedies
#15
Raul J Andrade, Inmaculada Medina-Caliz, Andres Gonzalez-Jimenez, Miren Garcia-Cortes, M Isabel Lucena
The rising burden of herbal and dietary supplement hepatotoxicity (HILI) is a growing concern in Western countries. The estimated incidence of HILI in well-designed prospective studies ranges from less than 1 to 3 individuals per 100,000 inhabitants/year. Herbal hepatotoxicity has a particular signature encompassing female predominance, hepatocellular type of damage with markedly elevated transaminases on presentation, more common unintentional rechallenge, and a greater risk of death/liver transplantation...
February 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29471562/can-elastography-differentiate-isolated-fatty-liver-from-nonalcoholic-steatohepatitis
#16
Veeral Ajmera, Rohit Loomba
Ultrasound and magnetic resonance (MR)-based elastography have demonstrated excellent performance for noninvasive staging of fibrosis in patients with nonalcoholic fatty liver disease (NAFLD); however, their ability to differentiate isolated fatty liver from nonalcoholic steatohepatitis (NASH) is unclear. In this review, the authors provide background on elastography and review the ability of elastography to discriminate between isolated steatosis and NASH. Studies with available data on the diagnosis of NASH histology are limited to vibration-controlled transient elastography and MR elastography...
February 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29471561/nonalcoholic-fatty-liver-disease-in-children
#17
Jake P Mann, Luca Valenti, Eleonora Scorletti, Christopher D Byrne, Valerio Nobili
Nonalcoholic steatohepatitis, a progressive form of nonalcoholic fatty liver disease (NAFLD), is one of the most common hepatic diseases in children who present with particular risk factors including obesity, sedentary lifestyle, and/or a predisposing genetic background. The worldwide prevalence of NAFLD in children is a worrying phenomenon because this disease is closely associated with the development of both cirrhosis and cardiometabolic syndrome in adulthood. To date, the etiopathogenesis of primary NAFLD in children is unknown...
February 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29272899/systematic-review-and-meta-analysis-prevalence-of-small-intestinal-bacterial-overgrowth-in-chronic-liver-disease
#18
Ayesha Shah, Erin Shanahan, Graeme A Macdonald, Linda Fletcher, Pegah Ghasemi, Mark Morrison, Mike Jones, Gerald Holtmann
The authors conducted a meta-analysis of the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with chronic liver disease (CLD) and controls. Using the search terms "small intestinal bacterial overgrowth (SIBO)" and "chronic liver disease (CLD)" or "cirrhosis," 19 case-control studies were identified. Utilizing breath tests, the prevalence of SIBO in CLD was 35.80% (95% CI, 32.60-39.10) compared with 8.0% (95% CI, 5.70-11.00) in controls. Using culture techniques, the prevalence was 68...
November 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29272898/liver-sinusoidal-endothelial-cell-an-update
#19
Laurie D DeLeve, Ana C Maretti-Mira
This update focuses on two main topics. First, recent developments in our understanding of liver sinusoidal endothelial cell (LSEC) function will be reviewed, specifically elimination of blood-borne waste, immunological function of LSECs, interaction of LSECs with liver metastases, LSECs and liver regeneration, and LSECs and hepatic fibrosis. Second, given the current emphasis on rigor and transparency in biomedical research, the update discusses the need for standardization of methods to demonstrate identity and purity of isolated LSECs, pitfalls in methods that might lead to a selection bias in the types of LSECs isolated, and questions about long-term culture of LSECs...
November 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29272897/multifunctional-yy1-in-liver-diseases
#20
Mengjie Zhang, Yi Zhang, Shuang Yang, Jian Zhou, Weiwu Gao, Xia Yang, Di Yang, Zhiqiang Tian, Yuzhang Wu, Bing Ni
The transcription factor Yin Yang 1 (YY1) is a multifunctional protein that can activate or repress gene expression, depending on the cellular context. While YY1 is ubiquitously expressed and highly conserved between species, its role varies among the diverse cell types and includes proliferation, differentiation, and apoptosis. Upregulated YY1 expression is found in pathogenic conditions, such as human hepatocellular carcinoma and hepatitis B virus infection, and its roles in the molecular pathogenic mechanisms in liver (i...
November 2017: Seminars in Liver Disease
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