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Johnny Amer, Ahmad Salhab, Mazen Noureddin, Sarit Doron, Lina Abu-Tair, Rami Ghantous, Mahmud Mahamid, Rifaat Safadi
Insulin resistance is a key risk factor in the progression of nonalcoholic fatty liver disease (NAFLD) and may lead to liver fibrosis. Natural killer (NK) cells are thought to exert an antifibrotic effect through their killing of activated hepatic stellate cells (HSCs). Here, we investigated how the interplay between NK cells and HSCs are modified by insulin resistance in NAFLD. Fresh peripheral blood NK cells (clusters of differentiation [CD]56dim , CD16+ ) were collected from 22 healthy adults and 72 patients with NAFLD not currently taking any medications and without signs of metabolic syndrome...
March 2018: Hepatology Communications
Shazia Mehmood Siddique, Meghan Lane-Fall, Matthew J McConnell, Neha Jakhete, James Crismale, Stefanie Porges, Vandana Khungar, Shivan J Mehta, David Goldberg, Zhiping Li, Thomas Schiano, Linda Regan, Clinton Orloski, Judy A Shea
Patients with cirrhosis have high admission and readmission rates, and it is estimated that a quarter are potentially preventable. Little data are available regarding nonmedical factors impacting triage decisions in this patient population. This study sought to explore such factors as well as to determine provider perspectives on low-acuity clinical presentations to the emergency department, including ascites and hepatic encephalopathy. A survey was distributed in four liver transplant centers to both emergency medicine and hepatology providers, who included attending physicians, house staff, and advanced practitioners; 196 surveys were returned (estimated response rate 50...
March 2018: Hepatology communications
Bradley Reuter, Kara Walter, Julien Bissonnette, Michael D Leise, Jennifer Lai, Puneeta Tandon, Patrick S Kamath, Scott W Biggins, Christopher F Rose, James B Wade, Jasmohan S Bajaj
Hepatic encephalopathy (HE) is a major cause of morbidity in cirrhosis. However its severity assessment is often subjective, which needs to be studied systematically. AIM: To determine how accurately trainee and non-trainee practitioners grade and manage HE patients throughout its severity. METHODS: We performed a survey study using standardized simulated patient videos at 4 US and 3 Canadian centers. Participants were trainees (gastroenterology/hepatology fellows) and non-trainees (faculty, nurse practitioners, physician assistants)...
February 19, 2018: Liver Transplantation
Kerui Xu, Li-Ming Liu, Paraskevi A Farazi, Hongmei Wang, Fedja A Rochling, Shinobu Watanabe-Galloway, Jian-Jun Zhang
BACKGROUND: Globally, of the 248 million people chronically infected with the hepatitis B virus (HBV), 74 million reside in China. Five oral nucleot(s)ide analogs (NUCs) have been approved for the treatment of chronic hepatitis B (CHB) in China. OBJECTIVES: The aims of this study were to determine rates of adherence to NUC therapy in patients with CHB, to identify the self-perceived barriers to adherence, and to examine the factors associated with adherence. METHODS: Questionnaire-based interviews were administered among Chinese patients with CHB at hepatology clinics of a tertiary hospital in the city of Wuhan, China...
2018: Global Health Action
Michael Praktiknjo, Jennifer Lehmann, Mette J Nielsen, Robert Schierwagen, Frank E Uschner, Carsten Meyer, Daniel Thomas, Christian P Strassburg, Flemming Bendtsen, Søren Møller, Aleksander Krag, Morten A Karsdal, Diana J Leeming, Jonel Trebicka
Patients with end-stage liver disease develop acute decompensation (AD) episodes, which become more frequent and might develop into acute-on-chronic liver failure (ACLF). However, it remains unknown how AD induces acceleration of liver disease. We hypothesized that remodeling of collagen type III plays a role in the acceleration of liver cirrhosis after AD and analyzed its formation (Pro-C3) and degradation (matrix metalloproteinase-degraded type III collagen [C3M]) markers in animal models and human disease...
February 2018: Hepatology communications
Sakkarin Chirapongsathorn, Chayakrit Krittanawong, Felicity T Enders, Richard Pendegraft, Kristin C Mara, Bijan J Borah, Sue L Visscher, Conor G Loftus, Vijay H Shah, Jayant A Talwalkar, Patrick S Kamath
We examined risks for first hospitalization and the rate, risk factors, costs, and 1-year outcome of 30-day readmission among patients admitted for complications of cirrhosis. Data were retrospectively analyzed for adult patients with cirrhosis residing in Minnesota, Iowa, or Wisconsin and admitted from 2010 through 2013 at both campuses of the Mayo Clinic Hospital in Rochester, MN. Readmission was captured at the two hospitals as well as at community hospitals in the tristate area within the Mayo Clinic Health System...
February 2018: Hepatology communications
Ajay C Donepudi, Jessica M Ferrell, Shannon Boehme, Hueng-Sik Choi, John Y L Chiang
Alcoholic fatty liver disease (AFLD) is a major risk factor for cirrhosis-associated liver diseases. Studies demonstrate that alcohol increases serum bile acids in humans and rodents. AFLD has been linked to cholestasis, although the physiologic relevance of increased bile acids in AFLD and the underlying mechanism of increasing the bile acid pool by alcohol feeding are still unclear. In this study, we used mouse models either deficient of or overexpressing cholesterol 7α-hydroxylase (Cyp7a1), the rate-limiting and key regulatory enzyme in bile acid synthesis, to study the effect of alcohol drinking in liver metabolism and inflammation...
January 2018: Hepatology Communications
Esther Nuñez-Durán, Mariam Aghajan, Manoj Amrutkar, Silva Sütt, Emmelie Cansby, Sheri L Booten, Andrew Watt, Marcus Ståhlman, Norbert Stefan, Hans-Ulrich Häring, Harald Staiger, Jan Borén, Hanns-Ulrich Marschall, Margit Mahlapuu
Nonalcoholic fatty liver disease (NAFLD) contributes to the pathogenesis of type 2 diabetes and cardiovascular disease, and patients with nonalcoholic steatohepatitis (NASH) are also at risk of developing cirrhosis, liver failure, and hepatocellular carcinoma. To date, no specific therapy exists for NAFLD/NASH, which has been recognized as one of the major unmet medical needs of the twenty-first century. We recently identified serine/threonine protein kinase (STK)25 as a critical regulator of energy homeostasis and NAFLD progression...
January 2018: Hepatology Communications
Yohei Masugi, Tokiya Abe, Hanako Tsujikawa, Kathryn Effendi, Akinori Hashiguchi, Masanori Abe, Yasuharu Imai, Keisuke Hino, Shuhei Hige, Miwa Kawanaka, Gotaro Yamada, Masayoshi Kage, Masaaki Korenaga, Yoichi Hiasa, Masashi Mizokami, Michiie Sakamoto
Accurate staging of liver fibrosis is crucial to guide therapeutic decisions for patients with nonalcoholic fatty liver disease (NAFLD). Digital image analysis has emerged as a promising tool for quantitative assessment of fibrosis in chronic liver diseases. We sought to determine the relationship of histologic fibrosis stage with fiber amounts quantified in liver biopsy specimens for the better understanding of NAFLD progression. We measured area ratios of collagen and elastin fibers in Elastica van Gieson-stained biopsy tissues from 289 patients with NAFLD from four hospitals using an automated computational method and examined their correlations with Brunt's fibrosis stage...
January 2018: Hepatology Communications
Nipun Verma, Shreya Singh, Gitesh Sawatkar, Virendra Singh
Sofosbuvir is an imperative drug used in treatment regimens for hepatitis C virus (HCV). It is considered relatively safe with fewer adverse effects than other treatments. Here, we report a rare and potentially serious, dermatologic, adverse effect following the use of sofosbuvir. A 35-year-old man with genotype 3-related HCV cirrhosis presented with decompensated ascites and jaundice following 7 weeks of therapy with peginterferon alpha-2a and oral ribavirin. After peginterferon withdrawal and stabilization, oral sofosbuvir and ribavirin were started; 10 days later, he developed itching over the trunk and legs, followed by multiple papules and vesicles over an erythematous base...
January 2018: Hepatology Communications
Paul Adams, Christopher Howlett, Anargyros Xenocostas, Subrata Chakrabarti
A 42-year-old man with hemochromatosis and cirrhosis developed aplastic anemia. He underwent liver transplantation from a female donor and splenectomy, and his aplastic anemia spontaneously resolved. A bone marrow examination 6 months after the liver transplant showed 17.5% female cells. He did well for 13 years without the need for any blood product support but then developed bone pain and was found to have metastatic hepatocellular carcinoma in the vertebral bodies. Molecular analysis demonstrated that the tumor cells were from his original liver...
January 2018: Hepatology Communications
Sandra J Page, Maria M Rivera, David E Kleiner, Xiongce Zhao, Sungyoung Auh, Elaine F Remmers, Theo Heller
Approximately 71 million people are chronically infected with the hepatitis C virus (HCV), a potentially lethal pathogen. HCV generates oxidative stress correlating with disease severity. HCV proteins increase reactive oxygen species production by stimulating nicotinamide adenine dinucleotide phosphate oxidase (NOX) activity. Reactive oxygen species are necessary for host defense and cell signaling; however, elevated NOX activity contributes to cancer, and NOX overexpression is associated with hepatic fibrosis...
November 2017: Hepatology Communications
Kyoko Yoshikawa, Motoh Iwasa, Akiko Eguchi, Shinichi Kojima, Naohiko Yoshizawa, Mina Tempaku, Ryosuke Sugimoto, Norihiko Yamamoto, Kazushi Sugimoto, Yoshinao Kobayashi, Hiroshi Hasegawa, Yoshiyuki Takei
Chronic liver disease patients often have complications, such as hepatocellular carcinoma (HCC) and acute bacterial infection. Model for end-stage liver disease and Child-Pugh scores are useful prognostic factors for chronic liver diseases but not for all chronic conditions, such as HCC. Our investigative aim targeted the prognostic abilities of neutrophil gelatinase-associated lipocalin (NGAL) in rat and human chronic liver diseases. Blood NGAL levels were measured by enzyme-linked immunosorbent assay in rats with cirrhosis and 96 patients with chronic liver disease and HCC...
November 2017: Hepatology Communications
Nancy Reau, Michael N Robertson, Hwa-Ping Feng, Luzelena Caro, Wendy W Yeh, Bach-Yen T Nguyen, Janice Wahl, Eliav Barr, Peggy Hwang, Stephanie O Klopfer
Concomitant proton pump inhibitor (PPI) use reduces plasma concentrations of certain nonstructural protein 5A inhibitors, which are key components of modern hepatitis C infection (HCV) treatments. These reduced concentrations may decrease efficacy, leading to challenging treatment failures due to the development of resistance-associated substitutions. This post-hoc analysis assessed 12-week sustained viral response (SVR12) and pharmacokinetics of fixed-dose combination elbasvir/grazoprevir (EBR/GZR) in patients with HCV infection and self-reported PPI use...
October 2017: Hepatology Communications
Xiao-Dong Zhou, Qin-Fen Chen, Dan-Qin Sun, Chen-Fei Zheng, Dong-Jie Liang, Jian Zhou, Song-Jie Wang, Wen-Yue Liu, Sven Van Poucke, Xiao-Dong Wang, Ke-Qing Shi, Wei-Jian Huang, Ming-Hua Zheng
Serum creatinine measurement demonstrates a poor specificity and sensitivity for the early diagnosis of acute kidney injury (AKI) in patients with cirrhosis. The existing model for end-stage liver disease (MELD) score reveals multiple pitfalls in critically ill patients with cirrhosis and acute kidney injury (CAKI). The aim of this study was to re-evaluate the role of creatinine values in the existing MELD score and to develop a novel score for CAKI, named the "acute kidney injury-model for end-stage liver disease score" (AKI-MELD score)...
October 2017: Hepatology communications
Koichi Fujisawa, Taro Takami, Toshihiko Matsumoto, Naoki Yamamoto, Isao Sakaida
Liver cirrhosis can disturb circadian rhythms, decreasing patient quality of life. Changes in metabolic products in cirrhosis are poorly understood. We evaluated changes in liver metabolism products using a thioacetamide-induced mouse model of liver cirrhosis exhibiting circadian rhythm disturbance. Principal component analysis indicated that the circular progression found in the control group was disrupted in the thioacetamide group, and Jonckheere-Terpstra-Kendall analysis showed an imbalanced pattern of oscillating metabolic products...
September 2017: Hepatology Communications
Takashi Matsuda, Taro Takami, Ryo Sasaki, Tatsuro Nishimura, Yuki Aibe, Bruno Diaz Paredes, Luiz Fernando Quintanilha, Toshihiko Matsumoto, Tsuyoshi Ishikawa, Naoki Yamamoto, Kenji Tani, Shuji Terai, Yasuho Taura, Isao Sakaida
We have been developing a therapy for liver cirrhosis using cultured autologous bone marrow-derived mesenchymal stem cells (BMSCs). Before human clinical trials can be considered, the safety and efficacy of BMSC infusion in medium to large animals must be confirmed; thus, we developed a canine liver fibrosis model. A small amount of bone marrow fluid was aspirated from the canine humerus to assess the characteristics of BMSCs. We implanted a venous catheter in the stomach and a subcutaneous infusion port in the back of the neck of each canine...
September 2017: Hepatology Communications
Guillaume Wettstein, Jean-Michel Luccarini, Laurence Poekes, Patrick Faye, Francine Kupkowski, Vanessa Adarbes, Evelyne Defrêne, Céline Estivalet, Xavier Gawronski, Ingrid Jantzen, Alain Philippot, Julien Tessier, Pascale Tuyaa-Boustugue, Fiona Oakley, Derek A Mann, Isabelle Leclercq, Sven Francque, Irena Konstantinova, Pierre Broqua, Jean-Louis Junien
IVA337 is a pan-peroxisome proliferator-activated receptor (PPAR) agonist with moderate and well-balanced activity on the three PPAR isoforms (α, γ, δ). PPARs are regulators of lipid metabolism, inflammation, insulin resistance, and fibrogenesis. Different single or dual PPAR agonists have been investigated for their therapeutic potential in nonalcoholic steatohepatitis (NASH), a chronic liver condition in which steatosis coexists with necroinflammation, potentially leading to liver fibrosis and cirrhosis...
August 2017: Hepatology communications
Sergio A Sánchez-Luna, Kyle E Brown
Hereditary hemochromatosis (HH) can cause cirrhosis and hepatocellular carcinoma (HCC), but the frequency of these complications is controversial. To address this question, we reviewed the experience with HH at an academic medical center that is the sole liver transplantation center in a state with a population that is >90% Caucasian. The records of all subjects with International Classification of Diseases, Ninth Revision, code 275, "disorders of iron metabolism" seen at the University of Iowa Hospitals and Clinics between January 1, 2004 and December 31, 2014 were reviewed, and HFE C282Y homozygotes and C282Y/H63D compound heterozygotes were identified...
July 2017: Hepatology Communications
Nancy Reau, Francis Vekeman, Eric Wu, Yanjun Bao, Yuri Sanchez Gonzalez
Despite guideline recommendations, access to hepatitis C virus (HCV) treatment is frequently restricted, with some payers approving therapy for only those with advanced disease or cirrhosis. However, delaying potentially curative treatment until the development of advanced liver disease may have costly consequences in terms of both hepatic complications and extrahepatic manifestations (EHMs) of HCV. Using a large claims database from the United States, we measured the risks and medical costs of 20 EHMs and investigated the role of treatment in different stages of liver fibrosis for mitigating the clinical and economic burden of these EHMs...
July 2017: Hepatology Communications
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