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Sample records for ccl4-induced liver cirrhosis

  1. Herbal Supplement Ameliorates Cardiac Hypertrophy in Rats with CCl4-Induced Liver Cirrhosis

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    Ping-Chun Li

    2012-01-01

    Full Text Available We used the carbon tetrachloride (CCl4 induced liver cirrhosis model to test the molecular mechanism of action involved in cirrhosis-associated cardiac hypertrophy and the effectiveness of Ocimum gratissimum extract (OGE and silymarin against cardiac hypertrophy. We treated male wistar rats with CCl4 and either OGE (0.02 g/kg B.W. or 0.04 g/kg B.W. or silymarin (0.2 g/kg B.W.. Cardiac eccentric hypertrophy was induced by CCl4 along with cirrhosis and increased expression of cardiac hypertrophy related genes NFAT, TAGA4, and NBP, and the interleukin-6 (IL-6 signaling pathway related genes MEK5, ERK5, JAK, and STAT3. OGE or silymarin co-treatment attenuated CCl4-induced cardiac abnormalities, and lowered expression of genes which were elevated by this hepatotoxin. Our results suggest that the IL-6 signaling pathway may be related to CCl4-induced cardiac hypertrophy. OGE and silymarin were able to lower liver fibrosis, which reduces the chance of cardiac hypertrophy perhaps by lowering the expressions of IL-6 signaling pathway related genes. We conclude that treatment of cirrhosis using herbal supplements is a viable option for protecting cardiac tissues against cirrhosis-related cardiac hypertrophy.

  2. Oxidative stress modulation by Rosmarinus officinalis in CCl4-induced liver cirrhosis.

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    Gutiérrez, Rosalinda; Alvarado, José L; Presno, Manuel; Pérez-Veyna, Oscar; Serrano, Carmen J; Yahuaca, Patricia

    2010-04-01

    Rosmarinus officinalis (Lamiaceae) possesses antioxidant activity and hepatoprotective effects, and so may provide a possible therapeutic alternative for chronic liver disease. The effect produced by a methanolic extract of Rosmarinus officinalis on CCl(4)-induced liver cirrhosis in rats was investigated using both prevention and reversion models. Over the course of the development of cirrhosis, the increased enzymatic activities of gamma-glutamyl transpeptidase and alanine aminotransferase, and the rise in bilirubin levels caused by CCl(4) administration, were prevented by Rosmarinus officinalis co-administration. When the cirrhosis by oxidative stress was evaluated as an increase on liver lipoperoxidation, total lipid peroxides, nitric oxide in serum, and loss of erythrocyte plasma membrane stability, R. officinalis was shown to prevent such alterations. On cirrhotic animals treated with CCl(4), histological studies showed massive necrosis, periportal inflammation and fibrosis which were modified by R. officinalis. These benefits on experimental cirrhosis suggest a potential therapeutic use for R. officinalis as an alternative for liver cirrhosis.

  3. Estrogen reduces CCL4- induced liver fibrosis in rats

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    Jun-Wang Xu; Jun Gong; Xin-Ming Chang; Jin-Yan Luo; Lei Dong; Zhi-Ming Hao; Ai Jia; Gui-Ping Xu

    2002-01-01

    AIM: Chronic liver diseases, such as fibrosis or cirrhosis,are more common in men than in women. This genderdifference may be related to the effects of sex hormones onthe liver. The aim of the present work was to investigatethe effects of estrogen on CCL4-induced fibrosis of the liverin rats.METHODS: Liver fibrosis was induced in male, female andovariectomized rats by CCL4 administration. All the groupswere treated with estradiol(1 mg/kg) twice weekly. Andtamoxifen wasgiven to male fibrosis model. At the end of 8weeks, all therats were killed to study serum indicators andthe livers.RESULTS: Estradiol treatment reduced aspartateaminotransferase(AST), alanine aminotransferase (ALT),hyaluronic acid(HA) and type IV collagen(CIV) in sera,suppressed hepatic collagen content, decreased the areas ofhepatic stellate cells (HSC) positive for α-smooth muscle actin(α-SMA), and lowered the synthesis of hepatic type I collagensignificantly in both sexes and ovariectomy fibrotic rats inducedby CCL4 administration. Whereas, tamoxifen had the oppositeeffect. The fibrotic response of the female liver to CCL4treatment was significantly weaker than that of male liver.CONCLUSION: Estradiol reduces CCL4-induced hepaticfibrosis in rats. The antifibrogenic role of estrogen in theliver may be one reason for the sex associated differencesin the progression from hepatic fibrosis to cirrhosis.

  4. Fucoidan partly prevents CCl4-induced liver fibrosis

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    Hayashi, Shinji; Itoh, Ayano; Isoda, Katsuhiro; Kondoh, Masuo; KAWASE, Masaya; Yagi, Kiyohito

    2008-01-01

    Fucoidan, a sulfated polysaccharide extracted from brown algae, has a wide range of biological activities, including anti-inflammatory, anti-viral, and anti-tumor activities. In the present study, we investigated the effects of fucoidan on CCl4-induced liver fibrosis. Administration of fucoidan reduced CCl4-induced acute and chronic liver failure. Hepatic fibrosis induced by CCl4 was also attenuated by injection of fucoidan. Damage to hepatocytes and activation of hepatic stellate cells are k...

  5. Hepatoprotective Effect of Low Doses of Caffeine on CCl4-Induced Liver Damage in Rats.

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    Cachón, Andrés Uc; Quintal-Novelo, Carlos; Medina-Escobedo, Gilberto; Castro-Aguilar, Gaspar; Moo-Puc, Rosa E

    2017-03-04

    Several studies have shown the hepatoprotective effect of the consumption of coffee and tea, which is mainly attributed to caffeine. Many experimental studies have demonstrated this effect; however, these studies used high caffeine doses that are not related to human consumption. The aim of this study was to evaluate the hepatoprotective effect of low doses of caffeine on carbon tetrachloride (CCl4)-treated rats. Low doses of caffeine (CAFF) 5 and 10 mg/kg (CAFF5 and CAFF10) were evaluated in chronic liver damage induced by CCl4 (0.75 mL/kg) in rats. CAFF treatment was administered once a day and CCl4 administration was twice weekly for 10 weeks. Liver function tests (biochemical markers) and functional (sleeping time) and histological (hematoxylin-eosin and Masson trichrome stains) parameters were carried out at the end of damage treatment. Daily treatments of CAFF5 and CAFF10 exhibited a hepatoprotective effect supported by a decrease of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (AP) serum activities and bilirubin serum levels compared with control and also restored serum albumin levels and liver glutathione (GSH). Moreover, CAFF prevented CCl4-induced prolongation in pentobarbital sleeping time and a decrease of liver fibrosis and cell death. Our results demonstrated that low doses of CAFF exert a hepatoprotective effect against CCl4 -induced liver damage in rats.

  6. Effect of Platelet-Rich Plasma on CCl4-Induced Chronic Liver Injury in Male Rats

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    Zahra Hesami

    2014-01-01

    Full Text Available Platelet-rich plasma (PRP has been of great concern to the scientists and doctors who are involved in wound healing and regenerative medicine which focuses on repairing and replacing damaged cells and tissues. Growth factors of platelet-rich plasma are cost-effective, available, and is more stable than recombinant human growth factors. Given these valuable properties, we decided to assess the effect of PRP on CCl4-induced hepatotoxicity on rats. The rats received CCl4 (1 mL/kg, i.p. 1 : 1 in olive oil twice per week for 8 weeks. Five weeks after CCl4 injection, the rats also received PRP (0.5 mL/kg, s.c. two days a week for three weeks. Twenty-four hours after last CCl4 injection, the animals bled and their livers dissected for biochemical and histopathological studies. Blood analysis was performed to evaluate enzyme activity. The results showed that PRP itself was not toxic for liver and could protect the liver from CCl4-induced histological damages and attenuated oxidative stress by increase in glutathione content and decrease in lipid peroxidative marker of liver tissue. The results of the present study lend support to our beliefs in hepatoprotective effects of PRP.

  7. Protective effect of Sida cordata leaf extract against CCl(4) induced acute liver toxicity in rats.

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    Mistry, Sunil; Dutt, K R; Jena, J

    2013-04-13

    To investigate the hepatoprotective potential of Sida cordata (Malvaceae) (S. cordata) in experimental rats to validate its traditional claim. Wister albino rats were divided into 6 groups: Group I served as control; Group II served as hepatotoxic (CCl(4) treated) group; Group III, IV and V served as (100, 200 and 400 mg/kg b.w.) S. cordata leaf extract (SCLE) treated groups; Group VI served as positive control (Silymarin) treated group. Liver marker enzymes serum glutamate oxyloacetic transaminase, serum glutamic pyruvic transaminase, pancreatic enzymatic antioxidants superoxide dismutase (SOD), lipid peroxidation, catalase (CAT), reduced glutathione (GSH) were measured and compared along with histopathological studies. Obtained results show that the treatment with SCLE significantly (P<0.05-<0.001) and dose-dependently reduced CCl4 induced elevated serum level of hepatic enzymes. Furthermore, SCLE significantly (up to P<0.001) reduced the lipid peroxidation in the liver tissue and restored activities of defence antioxidant enzymes GSH, SOD and CAT towards normal levels, which was confirmed by the histopathological studies. The results of this study strongly indicate the protective effect of SCLE against CCl(4) induced acute liver toxicity in rats and thereby scientifically support its traditional use. Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  8. Protective effect of Sida cordata leaf extract against CCl4 induced acute liver toxicity in rats

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    Sunil Mistry; KR Dutt; J Jena

    2013-01-01

    Objective: To investigate the hepatoprotective potential of Sida cordata (Malvaceae) (S. cordata) in experimental rats to validate its traditional claim. Methods: Wister albino rats were divided into 6 groups: Group Ⅰ served as control; Group Ⅱ served as hepatotoxic (CCl4 treated) group;Group Ⅲ, Ⅳ and Ⅴ served as (100, 200 and 400 mg/kg b.w.) S. cordata leaf extract (SCLE) treated groups; Group Ⅵ served as positive control (Silymarin) treated group. Liver marker enzymes serum glutamate oxyloacetic transaminase, serum glutamic pyruvic transaminase, pancreatic enzymatic antioxidants superoxide dismutase (SOD), lipid peroxidation, catalase (CAT), reduced glutathione (GSH) were measured and compared along with histopathological studies. Results:Obtained results show that the treatment with SCLE significantly (P<0.05-<0.001) and dose-dependently reduced CCl4 induced elevated serum level of hepatic enzymes. Furthermore, SCLE significantly (up to P<0.001) reduced the lipid peroxidation in the liver tissue and restored activities of defence antioxidant enzymes GSH, SOD and CAT towards normal levels, which was confirmed by the histopathological studies. Conclusions: The results of this study strongly indicate the protective effect of SCLE against CCl4 induced acute liver toxicity in rats and thereby scientifically support its traditional use.

  9. MicroRNA Expression Profiling in CCl4-Induced Liver Fibrosis of Mus musculus

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    Jeongeun Hyun

    2016-06-01

    Full Text Available Liver fibrosis is a major pathological feature of chronic liver diseases, including liver cancer. MicroRNAs (miRNAs, small noncoding RNAs, regulate gene expression posttranscriptionally and play important roles in various kinds of diseases; however, miRNA-associated hepatic fibrogenesis and its acting mechanisms are poorly investigated. Therefore, we performed an miRNA microarray in the fibrotic livers of Mus musculus treated with carbon-tetrachloride (CCl4 and analyzed the biological functions engaged by the target genes of differentially-expressed miRNAs through gene ontology (GO and in-depth pathway enrichment analysis. Herein, we found that four miRNAs were upregulated and four miRNAs were downregulated more than two-fold in CCl4-treated livers compared to a control liver. Eight miRNAs were predicted to target a total of 4079 genes. GO analysis revealed that those target genes were located in various cellular compartments, including cytoplasm, nucleolus and cell surface, and they were involved in protein-protein or protein-DNA bindings, which influence the signal transductions and gene transcription. Furthermore, pathway enrichment analysis demonstrated that the 72 subspecialized signaling pathways were associated with CCl4-induced liver fibrosis and were mostly classified into metabolic function-related pathways. These results suggest that CCl4 induces liver fibrosis by disrupting the metabolic pathways. In conclusion, we presented several miRNAs and their biological processes that might be important in the progression of liver fibrosis; these findings help increase the understanding of liver fibrogenesis and provide novel ideas for further studies of the role of miRNAs in liver fibrosis.

  10. The protective effect of ENA Actimineral resource A on CCl4-induced liver injury in rats.

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    Hong, Il-Hwa; Ji, Hoon; Hwa, Sung-Yong; Jeong, Won-Il; Jeong, Da-Hee; Do, Sun-Hee; Kim, Ji-Min; Ki, Mi-Ran; Park, Jin-Kyu; Goo, Moon-Jung; Hwang, Ok-Kyung; Hong, Kyung-Sook; Han, Jung-Youn; Chung, Hae-Young; Jeong, Kyu-Shik

    2011-06-01

    ENA Actimineral Resource A (ENA-A) is alkaline water that is composed of refined edible cuttlefish bone and two different species of seaweed, Phymatolithon calcareum and Lithothamnion corallioides. In the present study, ENA-A was investigated as an antioxidant to protect against CCl(4)-induced oxidative stress and hepatotoxicity in rats. Liver injury was induced by either subacute or chronic CCl(4) administration, and the rats had free access to tap water mixed with 0% (control group) or 10% (v/v) ENA-A for 5 or 8 weeks. The results of histological examination and measurement of antioxidant activity showed that the reactive oxygen species production, lipid peroxidation, induction of CYP2E1 were decreased and the antioxidant activity, including glutathione and catalase production, was increased in the ENA-A groups as compared with the control group. On 2-DE gel analysis of the proteomes, 13 differentially expressed proteins were obtained in the ENA-A groups as compared with the control group. Antioxidant proteins, including glutathione S-transferase, kelch-like ECH-associated protein 1, and peroxiredoxin 1, were increased with hepatocyte nuclear factor 3-beta and serum albumin precursor, and kininogen precursor decreased more in the ENA-A groups than compared to the control group. In conclusion, our results suggest that ENA-A does indeed have some protective capabilities against CCl(4)-induced liver injury through its antioxidant function.

  11. Antioxidant and protective effect of inulin and catechin grafted inulin against CCl4-induced liver injury.

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    Liu, Jun; Lu, Jian-feng; Wen, Xiao-yuan; Kan, Juan; Jin, Chang-hai

    2015-01-01

    In this study, the antioxidant activity and hepatoprotective effect of inulin and catechin grafted inulin (catechin-g-inulin) against carbon tetrachloride (CCl4)-induced acute liver injury were investigated. Results showed that both inulin and catechin-g-inulin had moderate scavenging activity on superoxide radical, hydroxyl radical and H2O2, as well as lipid peroxidation inhibition effect. The antioxidant activity decreased in the order of Vc > catechin >catechin-g-inulin > inulin. Administration of inulin and catechin-g-inulin could significantly reduce the elevated levels of serum aspartate transaminase, alanine transaminase and alkaline phosphatase as compared to CCl4 treatment group. Moreover, inulin and catechin-g-inulin significantly increased the levels of hepatic superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, glutathione and total antioxidant capacity, whereas markedly decreased the malondialdehyde level when compared with CCl4 treatment group. Notably, catechin-g-inulin showed higher hepatoprotective effect than inulin. In addition, the hepatoprotective effect of catechin-g-inulin was comparable to positive standard of silymarin. Our results suggested that catechin-g-inulin had potent antioxidant activity and potential protective effect against CCl4-induced acute liver injury.

  12. Hepatoprotective effects of baicalein against CCl4-induced acute liver injury in mice

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    Hai-Li Huang; Ya-Jing Wang; Qing-Yu Zhang; Bin Liu; Fang-Yuan Wang; Jing-Jing Li; Run-Zhi Zhu

    2012-01-01

    AIM:To investigate the hepatoprotective effect of baicalein against carbon tetrachloride (CCl4)-induced liver damage in mice.METHODS:Mice were orally administered with baicalein after CCl4 injection,and therapeutic baicalein was given twice a day for 4 d.The anti-inflammation effects of baicalein were assessed directly by hepatic histology and serum alanine aminotranferease and aspartate aminotransferase measurement.Proliferating cell nuclear antigen was used to evaluate the effect of baicalein in promoting hepatocyte proliferation.Serum interleukin (IL)-6,IL-1β and tumor necrosis factor-α (TNF-α) levels were measured by enzyme-linked immunosorbent assay and liverIL-6,TNF-α,transforming growth factor-α (TGF-α),hepatocyte growth factor (HGF) and epidermal growth factor (EGF) genes expression were determined by quantitative real-time polymerase chain reaction.RESULTS:CCl4-induced acute liver failure model offers a survival benefit in baicalein-treated mice.The data indicated that the mRNA levels of IL-6 and TNF-α significantly increased within 12 h after CCl4 treatment in baicalein administration groups,but at 24,48 and 72h,the expression of IL-6 and TNF-α was kept at lower levels compared with the control.The expression of TGF-α,HGF and EGF was enhanced dramatically in baicalein administration group at 12,24,48 and 72 h.Furthermore,we found that baicalein significantly elevated the serum level of TNF-α and IL-6 at the early phase,which indicated that baicalein could facilitate the initiating events in liver regeneration.CONCLUSION:Baicalein may be a therapeutic candidate for acute liver injury.Baicalein accelerates liver regeneration by regulating TNF-α and IL-6 mediated pathways.

  13. Pharmacological investigation of Polyherbal formulation on Carbon tetrachloride (CCl4-induced liver damage in wistar rats

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    Hardik Soni

    2014-09-01

    Full Text Available Objective: To investigate effect of Polyherbal formulation on Carbon tetrachloride (CCl4-induced liver damage in wistar rats. Methods: Wistar albino rats weighing 180-230 g either sex were used. The selected animals were divided in to four groups where each group consisted of six animals. Experimentally liver damage was produced by intra-peritoneal administration of CCl4 and olive oil mixture (1:1 v/v (1 mL/kg, once daily, i.p. for 7 days. Test Drug, Polyherbal formulation was administered orally for 7 consecutive days at 3 mL/kg, once daily. On 8th day, Blood samples were collected to evaluate different serum biochemical parameters like Aspartate aminotransferase (AST, Alanine aminotransferase (ALT, Alkaline phosphatase (ALP, Total bilirubin and Total protein. Liver from animals of each group was dissected out for histopathological examination. Statistical analysis: Statistical calculation were done by analysis of variance (ANOVA followed by post hoc Dunnett’s test, with significant level of p<0.05. Results and dDiscussion: Polyherbal formulation showed significant effect on activity levels of serum AST, ALT, ALP and total bilirubin level while comparing test group to disease control group. It also showed significant elevation in decreased level of serum total protein. Pre-treatment of Polyherbal formulation restored the hepatic architecture and protected the liver tissue from fatty degenerative changes by preventing the toxic chemical reaction induced by CCl4. Conclusion: Finding of this study concludes that Polyherbal formulation (Vasuliv Syrup has promising hepatoprotective activity against CCl4-induced liver damage. It can be employed as safe and effective treatment for hepato-toxicity or liver damage.

  14. Improvement and optimization of CCl4 induced liver cirrhosis rats model accompanied with ascites%四氯化碳诱导大鼠肝硬化腹水模型的改进与优化

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    唐倩; 王卓; 赵雄; 吕茂贞; 吕茂民; 章金刚

    2012-01-01

    Objective To establish a stable, homogeneous, well-tolerated and efficient protocol to induce rat cirrhosis models accompanied with ascites using an improved carbon tetrachloride(CCl4) combined with phenobarbital sodium and alcohol method, thus establishing a basis for serum albumin effectiveness evaluation test. Methods Ninety male Wistar rats were randomly divided into five groups: blank control group containing 10 rats, CCl4 group, CC14 + phenobarbital sodium group, CCl4 + alcohol group and CC14 + phenobarbital sodium + alcohol group containing 20 rats respectively as model groups. The control group was given normal drinking water and injected with olive oil intraperitoneally. Rats in model groups were given different drinking water and an intraperitoneal injection of CC14 in a 2: 3 mixture with olive oil. The drugs given intraperitoneally were all at a dose of 2 ml/kg body mass, twice weekly for 12 weeks. We further measured the body mass and abdominal circumference, and tested the biochemical liver function indices as well as the colloid osmotic pressure ( COP) to evaluate the different processes in these groups. At the end of the induced operation the randomly selected rats in each group were sacrificed, and a section of right liver lobe was obtained and examined by histopathological method. The statistical analysis data were performed. Results Cirrhosis accompanied with ascites developed in all model groups between 8 and 12 weeks. However, at the end of the eighth week, rats in CCl4 + phenobarbital sodium + alcohol group were firstly detected to correspond with the model standards, CC14 + phenobarbital sodium group and CC14 + alcohol group were detected to have positive model signs at the ninth week. Only at the tenth week a few rats appeared to have ascites in CC14 group. All the model groups showed significant differences in the biochemical liver function indices, COP and body mass than the rats in control group, and the most significant differences were

  15. Diethylcarbamazine Reduces Chronic Inflammation and Fibrosis in Carbon Tetrachloride- (CCl4- Induced Liver Injury in Mice

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    Sura Wanessa Santos Rocha

    2014-01-01

    Full Text Available This study investigated the anti-inflammatory effects of DEC on the CCl4-induced hepatotoxicity in C57BL/6 mice. Chronic inflammation was induced by i.p. administration of CCl4 0.5 μL/g of body weight through two injections a week for 6 weeks. DEC (50 mg/kg was administered by gavage for 12 days before finishing the CCl4 induction. Histological analyses of the DEC-treated group exhibited reduced inflammatory process and prevented liver necrosis and fibrosis. Immunohistochemical and immunofluorescence analyses of the DEC-treated group showed reduced COX-2, IL1β, MDA, TGF-β, and αSMA immunopositivity, besides exhibiting decreased IL1β, COX-2, NFκB, IFNγ, and TGFβ expressions in the western blot analysis. The DEC group enhanced significantly the IL-10 expression. The reduction of hepatic injury in the DEC-treated group was confirmed by the COX-2 and iNOS mRNA expression levels. Based on the results of the present study, DEC can be used as a potential anti-inflammatory drug for chronic hepatic inflammation.

  16. Effects of platelet-rich plasma on liver regeneration in CCl4-induced hepatotoxicity model.

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    Mafi, Afsaneh; Dehghani, Farzaneh; Moghadam, Abbas; Noorafshan, Ali; Vojdani, Zahra; Talaei-Khozani, Tahereh

    2016-12-01

    Numerous bioactive growth factors and cytokines in platelet-rich plasma (PRP) have recently made it an attractive biomaterial for therapeutic purposes. These growth factors have the potential to regenerate the injured tissues. The aim of this study was to investigate the therapeutic effects of PRP in hepatotoxic animal model. Hepatotoxicity was induced in rats by oral administration of 4 mL/kg/week of CCl4 diluted 1:1 in corn oil for 10 weeks. To confirm the hepatotoxicity, 24 h after the last CCl4 administration, blood samples were collected via cardiac puncture to assess the serum levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, albumin, total protein, and total bilirubin. Twenty-four hours after blood collection, the experimental animals received a single injection of PRP (1 mL) via the anterior mesenteric vein. One week later, all biochemical tests were performed again, and the rats were scarified and their livers were removed, prepared histologically, and stained. The stereological analyses were performed to evaluate the effects of PRP on histopathological features of CCl4-treated livers. The results were compared statistically with the corresponding control and CCl4+normal saline (NS)-treated animals. A significant decrease in the number and volume of hepatocytes (p = 0.01), and also a reduction in the volume of sinusoids (p = 0.001) and connective tissue (p = 0.04), were observed in the PRP-treated animals compared with the CCl4+NS-treated ones. Our findings demonstrated that application of PRP had beneficial effects on CCl4-induced fibrosis; however, it had detrimental effects on the total number of hepatocytes and the volume of hepatocytes and sinusoidal spaces.

  17. Protective effect of Tetracera scandens L. leaf extract against CCl4-induced acute liver injury in rats

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    Tung Bui Thanh; Hai Nguyen Thanh; Hue Pham Thi Minh; Huong Le-Thi-Thu; Huong Duong Thi Ly; Loi Vu Duc

    2015-01-01

    Objective: To investigate the protective potential of ethanolic extracts of Tetracera scandens L. (T. scandens) against CCl4 induced oxidative stress in liver tissues. Methods: Dried leaf powder of T. scandens was extracted with ethanol and concentrated to yield a dry residue. Rats were administered with 100 mg/kg of ethanolic extracts orally once daily for one week. Animals were subsequently administered with a single dose of CCl4 (1 mL/kg body weight, intraperitoneal injection). Various ...

  18. Decorin prevents the development of CCl4-induced liver fibrosis in mice

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    Ma Rui; He Shilin; Liang Xiao; Yu Hong; Liang Yuelong; Cai Xiujun

    2014-01-01

    Background Liver fibrosis normally progresses to cirrhosis and destroys the normal architecture of the liver,resulting in liver dysfunction and irreversible cirrhosis.The aim of this study was to investigate the anti-fibrosis effect and the possible underlying mechanisms of decorin.Methods The mice model of liver fibrosis was induced by intraperitoneal injection of 50% (v/v) of carbon tetrachloride (CCl4) diluted in olive oil (1 ml/kg body weight) once every 2 days for 5 weeks.Three weeks after injecting CCl4 intraperitoneally,mice were randomly divided into normal control with vehicles only (olive oil),mouse model given CCl4 only,and CCl4 plus decorin (DCN,250 μg/kg).Two weeks later,all the mice were sacrificed and their liver tissues were analyzed for the expressions of genes related to liver fibrosis and under hematoxylin-eosin staining,Masson staining,and immunohistochemical staining of all groups.Aspartate transaminase,alanine transaminase,and total bilirubin of the serum were determined for evaluation of the liver function.Results Exogenous protein decorin could reduce liver fibrosis induced by CCl4 in mice.The degree of fibrosis in the experimental group was alleviated,and the contents of collagen fibers were lower in the experimental group than those of the control group.In addition,expressions of transforming growth factor β1 and α-smooth muscle actin decreased in the experimental group.Conclusions Taking liver fibrosis model of mouse as the experimental target and by injecting exogenous protein decorin into the model,we confirmed that decorin could inhibit the expression of proteins related to fibrosis and reduce the formation of liver fibrosis in mice.

  19. Effect of compound rhodiola sachalinensis A Bor on CCl4-induced liver fibrosis in rats and its probable molecular mechanisms

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    Xiao-Ling Wu; Wei-Zheng Zeng; Pi-Long Wang; Chun-Tao Lei; Ming-De Jiang; Xiao-Bin Chen; Yong Zhang; Hui Xu; Zhao Wang

    2003-01-01

    AIM: To explore the anti-fibrotic effect of a traditional Chinese medicine, compound rhodiola sachalinensis A Bor on CCl4-induced liver fibrosis in rats and its probable molecular mechanisms.METHODS: Ninety healthy male SD rats were randomly divided into three groups: normal group (n=10), treatment group of compound rhodiola sachalinensis A Bor (n=40) and CCl4-induced model group (n=40). The liver fibrosis was induced by CCl4 subcutaneous injection. Treatment group was administered with compound rhodiola sachalinensis A Bor (0.5 g/kg) once a day at the same time. Then the activities of several serum fibrosis-associated enzymes: alanine aminotransferase (ALT), aspartate aminotransferase (AST),N-acetyl-beta-D-glucosaminidase (β-NAG) and the levels of serum procollagen Ⅲ (PCⅢ), collagen IV (CIV), hyaluronic acid (HA) were assayed. The histopathological changes were observed with HE, VG and Masson stain. The expression of TGF-β1 mRNA, α1 (I) mRNA and Na+/Ca2+ exchanger (NCX)mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR) in situ.RESULTS: Compound rhodiola sachalinensis A Bor significantly reduced serum activities of ALT, AST, β-NAG and decreased the levels of PCⅢ, CIV, HA, improved the liver histopathological changes, inhibited the expression of TGFβ1 mRNA, α(I) mRNA and Na+/Ca2+ exchanger mRNA in rats.CONCLUSION: Compound rhodiola sachalinensis A Bor can intervene in CCl4-induced liver fibrosis in rats, in which potential mechanisms may be decreasing the production of TGF-β1, reducing the production of collagen, preventing the activation of hepatic stellate cell (HSC) and inhibiting the expression of TGF-β1 mRNA, α1(I) mRNA and Na+/Ca2+exchanger mRNA.

  20. Tyrosine kinase inhibitor BIBF1120 ameliorates inflammation, angiogenesis and fibrosis in CCl4-induced liver fibrogenesis mouse model

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    Öztürk Akcora, Büsra; Storm, Gert; Prakash, Jai; Bansal, Ruchi

    2017-01-01

    Hepatic fibrosis, a progressive chronic disease mainly caused by hepatitis viral infections, alcohol abuse or metabolic syndrome leading to liver dysfunction and is the growing cause of mortality worldwide. Tyrosine kinase inhibitor BIBF1120 (Nintedanib) has been evaluated in clinical trials for idiopathic pulmonary fibrosis and advanced Hepatocellular carcinoma, but has not been explored for liver fibrosis yet. In this study, we aimed to investigate the therapeutic effects and mechanism of BIBF1120 in liver fibrogenesis. The effects of BIBF1120 were evaluated in TGFβ-activated mouse 3T3 fibroblasts, LX2 cells, primary human hepatic stellate cells (HSCs) and CCl4-induced liver fibrogenesis mouse model. Fibroblasts-conditioned medium studies were performed to assess the paracrine effects on macrophages and endothelial cells. In-vitro in TGFβ-activated fibroblasts, BIBF1120 significantly inhibited expression of major fibrotic parameters, wound-healing and contractility. In vivo in CCl4-induced acute liver injury model, post-disease BIBF1120 administration significantly attenuated collagen accumulation and HSC activation. Interestingly, BIBF1120 drastically inhibited intrahepatic inflammation and angiogenesis. To further elucidate the mechanism of action, 3T3-conditioned medium studies demonstrated increased 3T3-mediated macrophage chemotaxis and endothelial cells tube formation and activation, which was significantly decreased by BIBF1120. These results suggests that BIBF1120 can be a potential therapeutic approach for the treatment of liver fibrosis. PMID:28291245

  1. Oligonol Ameliorates CCl4-Induced Liver Injury in Rats via the NF-Kappa B and MAPK Signaling Pathways

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    Jeonghyeon Bak

    2016-01-01

    Full Text Available Oxidative stress is thought to be a key risk factor in the development of hepatic diseases. Blocking or retarding the reactions of oxidation and the inflammatory process by antioxidants could be a promising therapeutic intervention for prevention or treatment of liver injuries. Oligonol is a low molecular weight polyphenol containing catechin-type monomers and oligomers derived from lychee fruit. In this study, we investigated the anti-inflammatory effect of oligonol on carbon tetrachloride- (CCl4- induced acute hepatic injury in rats. Oral administration of oligonol (10 or 50 mg/kg reduced CCl4-induced abnormalities in liver histology and serum AST and serum ALT levels. Oligonol treatment attenuated the CCl4-induced production of inflammatory mediators, including TNF-α, IL-1β, cyclooxygenase-2 (COX-2, and inducible nitric oxide synthase (iNOS mRNA levels. Western blot analysis showed that oligonol suppressed proinflammatory nuclear factor-kappa B (NF-κB p65 activation, phosphorylation of extracellular signal-regulated kinase (ERK, c-Jun NH2-terminal kinase (JNK, and p38 mitogen-activated protein kinases (MAPKs as well as Akt. Oligonol exhibited strong antioxidative activity in vitro and in vivo, and hepatoprotective activity against t-butyl hydroperoxide-induced HepG2 cells. Taken together, oligonol showed antioxidative and anti-inflammatory effects in CCl4-intoxicated rats by inhibiting oxidative stress and NF-κB activation via blockade of the activation of upstream kinases including MAPKs and Akt.

  2. Red Sea Suberea mollis Sponge Extract Protects against CCl4-Induced Acute Liver Injury in Rats via an Antioxidant Mechanism

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    Aymn T. Abbas

    2014-01-01

    Full Text Available Recent studies have demonstrated that marine sponges and their active constituents exhibited several potential medical applications. This study aimed to evaluate the possible hepatoprotective role as well as the antioxidant effect of the Red Sea Suberea mollis sponge extract (SMSE on carbon tetrachloride- (CCl4- induced acute liver injury in rats. In vitro antioxidant activity of SMSE was evaluated by 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH assay. Rats were orally administered three different concentrations (100, 200, and 400 mg/kg of SMSE and silymarin (100 mg/kg along with CCl4 (1 mL/kg, i.p., every 72 hr for 14 days. Plasma aspartate aminotransferase (AST, alanine aminotransferase (ALT, alkaline phosphatase (ALP, and total bilirubin were measured. Hepatic malondialdehyde (MDA, reduced glutathione (GSH, nitric oxide (NO, superoxide dismutase (SOD, glutathione peroxidase (GPx, and catalase (CAT were also measured. Liver specimens were histopathologically examined. SMSE showed strong scavenging activity against free radicals in DPPH assay. SMSE significantly reduced liver enzyme activities. Moreover, SMSE significantly reduced hepatic MDA formation. In addition, SMSE restored GSH, NO, SOD, GPx, and CAT. The histopathological results confirmed these findings. The results of this study suggested a potent protective effect of the SMSE against CCl4-induced hepatic injury. This may be due to its antioxidant and radical scavenging activity.

  3. Hepatocurative potential of Vitex doniana root bark, stem bark and leaves extracts against CCl4-induced liver damage in rats

    Institute of Scientific and Technical Information of China (English)

    James Dorcas Bolanle; Kadejo Olubukola Adetoro; Sallau Abdullahi Balarabe; Owolabi Olumuyiwa Adeyemi

    2014-01-01

    Objective: To evaluate the hepatocurative effects of aqueous root bark, stem bark and leaves ofVitex doniana in carbon tetrachloride (CCl albino rats.Methods:4) induced liver damage and non induced liver damage were assigned into liver damage and non liver damage groups of 6 rats in a group. The animals in the CCl4 induced liver damage groups, were induced by intraperitoneal injection with a single dose of CCl4 (1 mL/kg body weight) as a 1:1(v/v) solution in olive oil and were fasted for 36 h before the subsequent treatment with aqueous root bark, stem bark and leaves extracts of Vitex doniana and vitamin E as standard drug (100 mg/kg body weight per day) for 21 d, while the animals in the non induced groups were only treated with the daily oral administration of these extracts at the same dose. The administration of CCl4 was done once a week for a period of 3 weeks.Results:There was significant (P<0.05) increase in concentration of all liver marker enzymes, A total of 60 albino rats (36 induced liver damage and 24 non induced liver damage) alanine aminotransferase, aspartate aminotransferase and alkaline aminotransferase (ALT, AST and ALP) and significant (P<0.05) decrease in albumin in the CCl4 induced liver damage control when compared to the normal control. The extracts caused a significant (P<0.05) reduction in the serum activities of liver marker enzymes (ALT, AST and ALP) and a significant (P<0.05) increase in albumin of all the induced treated groups. Only stem bark extract and vitamin E significantly (P<0.05) increased total protein. All the extracts significantly (P<0.05) lowered serum creatinine whereas only root bark extract significantly (P<0.05) lowered serum level of urea in the rats with CCl4 induced liver damage.Conclusion:Hepatocurative study shows that all the plant parts (root bark, stem bark and leaves) possess significant hepatocurative properties among other therapeutic values justifying their use in folklore medicine.

  4. Protective effect of Tetracera scandens L.leaf extract against CCl4-induced acute liver injury in rats

    Institute of Scientific and Technical Information of China (English)

    Tung; Bui; Thanh; Hai; Nguyen; Thanh; Hue; Pham; Thi; Minh; Huong; Le-Thi-Thu; Huong; Duong; Thi; Ly; Loi; Vu; Duc

    2015-01-01

    Objective:To investigate the protective potential of ethanolic extracts of Tetracera scandens L.(T.scandens) against CCl4 induced oxidative stress in liver tissues.Methods:Dried leaf powder of T.scandens was extracted with ethanol and concentrated to yield a dry residue.Rats were administered with 100 mg/kg of ethanolic extracts orally once daily for one week.Animals were subsequently administered with a single dose of CCl4(I mL/kg body weight,intraperitoneal injection).Various assays,such as serum levels of alanine aminotransferase,aspartate aminotransferase,lipid peroxidation,protein oxidation(carbonyl protein group),tumor necrosis factor alpha,catalase,superoxide dismutase,and glutathione peroxidase,were used to assess damage caused by CCl4 and the protective effects of the ethanol extract on liver tissues.Results:Hepatotoxicity induced by CCl4 was evidenced by a significant increase in serum aspartate aminotransferase and alanine aminotransferase level,lipid peroxidation,protein carbonyl group,and tumor necrosis factor alpha,as well as decreased activity of the hepatic antioxidant enzymes(catalase.superoxide dismutase.and glutathione peroxidase).Treatment with ethanolic T.scandens extracts prevented all of these typically observed changes in CCl4-treated rats.Conclusions:Our findings indicate that T.scandens has a significant protective effect against CCl4 induced hepatotoxicity in rat.which may be due to its antioxidant properties.

  5. Curcumin or saikosaponin a improves hepatic antioxidant capacity and protects against CCl4-induced liver injury in rats.

    Science.gov (United States)

    Wu, Shu-Ju; Lin, Yun-Ho; Chu, Chia-Chou; Tsai, Ya-Hui; Chao, Jane C-J

    2008-06-01

    Curcumin and saikosaponin a, the bioactive phytochemicals of turmeric and Bupleurum, act as antioxidants. This study investigated the effects of supplementation with curcumin and/or saikosaponin a on hepatic lipids and antioxidant status in rats with CCl(4)-induced liver injury. Male Sprague-Dawley rats were randomly divided into control, CCl(4), CCl(4) + curcumin (0.005%; CU), CCl(4) + saikosaponin a (0.004%; SS), and CCl(4) + curcumin + saikosaponin a (0.005% + 0.004%; CU+SS) groups. CCl(4) (40% in olive oil) was injected intraperitoneally at a dose of 0.75 mL/kg once a week. Curcumin and/or saikosaponin a was administered orally 1 week before CCl(4) injection for 8 weeks. The pathological results showed that liver fibrosis was ameliorated in the SS and CU+SS groups. After 8 weeks, supplementation with curcumin and/or saikosaponin a significantly decreased plasma alanine aminotransferase and aspartate aminotransferase activities, as well as plasma and hepatic cholesterol and triglyceride levels. The CU+SS group showed reversal of the impaired hepatic superoxide dismutase activity and an increase in total glutathione level. Supplementation with curcumin and/or saikosaponin a significantly improved hepatic antioxidant status and suppressed malondialdehyde formation. Therefore, supplementation with curcumin and/or saikosaponin a protects against CCl(4)-induced liver injury by attenuating hepatic lipids and lipid peroxidation and enhancing antioxidant defense. Curcumin and saikosaponin a had no additive effects on hepatoprotection except for greater improvement in the total glutathione level and antioxidant status.

  6. Recovery of the Cell Cycle Inhibition in CCl4-Induced Cirrhosis by the Adenosine Derivative IFC-305

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    Victoria Chagoya de Sánchez

    2012-01-01

    Full Text Available Introduction. Cirrhosis is a chronic degenerative illness characterized by changes in normal liver architecture, failure of hepatic function, and impairment of proliferative activity. The aim of this study is to know how IFC-305 compound induces proliferation of the liver during reversion of cirrhosis. Methods. Once cirrhosis has been installed by CCl4 treatment for 10 weeks in male Wistar rats, they were divided into four groups: two received saline and two received the compound; all were euthanized at 5 and 10 weeks of treatment. Liver homogenate, mitochondria, and nucleus were used to measure cyclins, CDKs, and cell cycle regulatory proteins PCNA, pRb, p53, E2F, p21, p27, HGF, liver ATP, and mitochondrial function. Results. Diminution and small changes were observed in the studied proteins in the cirrhotic animals without treatment. The IFC-305-treated rats showed a clear increase in most of the proteins studied mainly in PCNA and CDK6, and a marked increased in ATP and mitochondrial function. Discussion/Conclusion. IFC-305 induces a recovery of the cell cycle inhibition promoting recovery of DNA damage through the action of PCNA and p53. The increase in energy and preservation of mitochondrial function contribute to recovering the proliferative function.

  7. Accelerated CCl4-induced liver fibrosis in Hjv-/- mice, associated with an oxidative burst and precocious profibrogenic gene expression.

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    Giada Sebastiani

    Full Text Available Hereditary hemochromatosis is commonly associated with liver fibrosis. Likewise, hepatic iron overload secondary to chronic liver diseases aggravates liver injury. To uncover underlying molecular mechanisms, hemochromatotic hemojuvelin knockout (Hjv-/- mice and wild type (wt controls were intoxicated with CCl(4. Hjv-/- mice developed earlier (by 2-4 weeks and more acute liver damage, reflected in dramatic levels of serum transaminases and ferritin and the development of severe coagulative necrosis and fibrosis. These responses were associated with an oxidative burst and early upregulation of mRNAs encoding α1-(I-collagen, the profibrogenic cytokines TGF-β1, endothelin-1 and PDGF and, notably, the iron-regulatory hormone hepcidin. Hence, CCl4-induced liver fibrogenesis was exacerbated and progressed precociously in Hjv-/- animals. Even though livers of naïve Hjv-/- mice were devoid of apparent pathology, they exhibited oxidative stress and immunoreactivity towards α-SMA antibodies, a marker of hepatic stellate cells activation. Furthermore, they expressed significantly higher (2-3 fold vs. wt, p<0.05 levels of α1-(I-collagen, TGF-β1, endothelin-1 and PDGF mRNAs, indicative of early fibrogenesis. Our data suggest that hepatic iron overload in parenchymal cells promotes oxidative stress and triggers premature profibrogenic gene expression, contributing to accelerated onset and precipitous progression of liver fibrogenesis.

  8. Hepatoprotective effect of manual acupuncture at acupoint GB34 against CCl4-induced chronic liver damage in rats

    Institute of Scientific and Technical Information of China (English)

    Yun-Kyoung Yim; Hyun Lee; Kwon-Eui Hong; Young-Il Kim; Byung-Ryul Lee; Tae-Han Kim; Ji-Young Yi

    2006-01-01

    AIM: To investigate the hepatoprotective effect of manual acupuncture at Yanglingquan (GB34) on CCl4-induced chronic liver damage in rats.METHODS: Rats were injected intraperitoneally with CCl4 (1 mL/kg) and treated with manual acupuncture using reinforcing manipulation techniques at left GB34(Yanglingquan) 3 times a week for 10 wk. A nonacupoint in left gluteal area was selected as a sham point. To estimate the hepatoprotective effect of manual acupuncture at GB34, measurement of liver index,biochemical assays including serum ALT, AST, ALP and total cholesterol, histological analysis and blood cell counts were conducted.RESULTS: Manual acupuncture at GB34 reduced the liver index, serum ALT, AST, ALP and total cholesterol levels as compared with the control group and the sham acupuncture group. It also increased and normalized the populations of WBC and lymphocytes.CONCLUSION: Manual acupuncture with reinforcing manipulation techniques at left GB34 reduces liver toxicity, protects liver function and liver tissue, and normalizes immune activity in CCl4-intoxicated rats.

  9. Protective effects of polyphenols-enriched extract from Huangshan Maofeng green tea against CCl4-induced liver injury in mice.

    Science.gov (United States)

    Cui, Yanmang; Yang, Xingbin; Lu, Xinshan; Chen, Jinwen; Zhao, Yan

    2014-09-01

    The study was to characterize the polyphenolic composition, antioxidant properties, and hepatoprotective effects of a polyphenols-enriched extract (HMTP) from Huangshan Maofeng green tea. HPLC analysis showed that three predominantly polyphenolic compounds present in HMTP were epigallocatechin (271.2 μg/mg extract), rutin (239.3 μg/mg) and epicatechin (89.3 μg/mg). HMTP was shown to exhibit strong scavenging activities against DPPH, O2(-), and OH, and ferric-reducing antioxidant power in vitro. Administration of HMTP at 200, 400 and 800 mg/kg bw in mice prior to CCl4 injury significantly decreased the CCl4-induced elevation of serum ALT, AST and ALP activities, and prevented an increase in hepatic MDA levels (p<0.05). Mice with HMTP pretreatment displayed a better profile of hepatosomatic index and the improved GSH-Px and SOD activities in the liver, relative to CCl4-intoxicated mice. Liver pathological observation also confirmed the protection on CCl4-caused histological alteration, suggesting that HMTP has potential to be explored as valuable hepatoprotective function food.

  10. Hepatoprotective potential of ether insoluble phenolic components of n-butanol fraction (EPC-BF of flaxseed against CCl 4 -induced liver damage in rats

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    D M Kasote

    2012-01-01

    Full Text Available Objective: to investigate the hepatoprotective potential of ether insoluble phenolic components of n-butanol fraction (EPC-BF of flaxseed against CCl 4 -induced liver damage in rats. Materials and Methods: Hepatotoxicity was induced to Wistar rats by administration of 0.2% CCl 4 in olive oil (8 mL/kg, i.p. on the seventh day of treatment. Hepatoprotective potential of EPC-BF at doses, 250 and 500 mg/kg, p.o. was assessed through biochemical and histological parameters. Results: EPC-BF and silymarin pretreated animal groups showed significantly decreased activities of Aspartate aminotransferase (AST, alanine aminotransferase (ALT, alkaline phosphatase (ALP, and level of total bilirubin, elevated by CCl 4 intoxication. Hepatic lipid peroxidation elevated by CCl 4 intoxication were also found to be alleviated at almost normal level in the EPC-BF and silymarin pretreated groups. Histological studies supported the biochemical findings and treatment of EPC-BF at doses 250 and 500 mg/kg, p.o. was found to be effective in restoring CCl 4 -induced hepatic damage. However, EPC-BF did not show dose-dependent hepatoprotective potential. EPC-BF depicted maximum protection against CCl 4 -induced hepatic damage at lower dose 250 mg/kg than higher dose (500 mg/ kg. Conclusion: EPC-BF possesses the significant hepatoprotective activity against CCl 4 induced liver damage, which could be mediated through increase in antioxidant defenses.

  11. Protective effect of selenium-enriched lactobacillus on CCl4-induced liver injury in mice and its possible mechanisms

    Institute of Scientific and Technical Information of China (English)

    Long Chen; Dao-Dong Pan; Juan Zhou; Ying-Zi Jiang

    2005-01-01

    AIM: To study the protective effects and mechanisms of Se-enriched lactobacillus on liver injury caused by carbon tetrachloride (CCl4) in mice.MWTHODS: Seventy-two ICR mice were randomly divided into four groups: normal group, CCl4-induced model group,low Se-enriched lactobacillus treatment group (L-Se group),and high Se-enriched lactobacillus treatment group (H-Se group). During a 3-wk experimental period, the common complete diet was orally provided daily for normal group and model group, and the mice in L-Se and H-Se groups were given a diet with 2 and 4 mg of organoselenium from Se-enriched lactobacillus per kg feed, respectively. From the 2nd wk of experiment, the model group, L-Se group,and H-Se group received abdominal cavity injection of olive oil solution containing 500 mL/L CCl4 (0.07 mL/100 g body mass) to induce liver injury, and the normal group was given olive oil on every other day for over 2 wk. In the first 2 wk post injection with CCl4, mice in each group were killed. The specimens of blood, liver tissue, and macrophages in abdominal cavity fluid were taken. Then the activities of the following liver tissue injury-associated enzymes including glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) as well as malondialdehyde (MDA) content were assayed. Changes of phagocytic rate and phagocytic index in macrophages were observed with Wright-Giemsa stain. Plasma TNF-α level was measured by radioimmunoassay. The level of intracellular free Ca2+ ([Ca2+]i) in hepatocytes was detected under a laser scanning confocal microscope.RESULTS: During the entire experimental period, the AST and ALT activities in liver were greatly enhanced by CCl4 and completely blunted by both low and high doses of Se-enriched lactobacillus. The Se-enriched lactobacillus-protected liver homogenate GSH-Px and SOD activities were higher or significantly higher than those in model group and were close to

  12. A novel fluorinated stilbene exerts hepatoprotective properties in CCl(4)-induced acute liver damage.

    Science.gov (United States)

    Rivera, Horacio; Morales-Ríos, Martha S; Bautista, Wendy; Shibayama, Mineko; Tsutsumi, Víctor; Muriel, Pablo; Pérez-Álvarez, Víctor

    2011-10-01

    There has been a recently increase in the development of novel stilbene-based compounds with in vitro anti-inflamatory properties. For this study, we synthesized and evaluated the anti-inflammatory properties of 2 fluorinated stilbenes on carbon tetrachloride (CCl₄)-induced acute liver damage. To achieve this, CCl₄ (4 g·kg(-1), per os) was administered to male Wistar rats, followed by either 2-fluoro-4'-methoxystilbene (FME) or 2,3-difluoro-4'-methoxystilbene (DFME) (10 mg·kg(-1), per os). We found that although both of the latter compounds prevented cholestatic damage (γ-glutamyl transpeptidase activity), only DFME showed partial but consistent results in the prevention of necrosis, as assessed by both alanine aminotransferase activity and histological analysis. Since inflammatory responses are mediated by cytokines, mainly tumour necrosis factor α (TNF-α), we used the Western blot technique to determine the action of FME and DFME on the expression level of this cytokine. The observed increase in the level of TNF-α caused by CCl₄ administration was only prevented by treatment with DFME, in agreement with our biochemical findings. This result was confirmed by measuring interleukin-6 (IL-6) levels, since the expression of this protein depends on the level of TNF-α. In this case, DFME completely blocked the CCl₄-induced increase of IL-6. Our results suggest that DFME possesses greater anti-inflammatory properties in vivo than FME. DFME constitutes a possible therapeutic agent for liver disease and could serve as a template for structure optimization.

  13. Glutamine inhibits CCl4 induced liver fibrosis in mice and TGF-β1 mediated epithelial-mesenchymal transition in mouse hepatocytes.

    Science.gov (United States)

    Shrestha, Nirajan; Chand, Lokendra; Han, Myung Kwan; Lee, Seung Ok; Kim, Chan Young; Jeong, Yeon Jun

    2016-07-01

    Glutamine, traditionally a non-essential amino acid, now has been considered as essential in serious illness and injury. It is a major precursor for glutathione synthesis. However, the anti-fibrotic effect of glutamine and its molecular mechanism in experimental liver fibrosis have not been explored. In the present study we aimed to examine the potential role of glutamine in carbon tetrachloride (CCl4) induced liver fibrosis and TGF-β1 mediated epithelial mesenchymal transition (EMT) and apoptosis in mouse hepatocytes. Liver fibrosis was induced by intraperitoneal injection of CCl4 three times a week for 10 weeks. Glutamine treatment effectively attenuated liver injury and oxidative stress. Collagen content was significantly decreased in liver sections of glutamine treated mice compared to CCl4 model mice. Furthermore, glutamine decreased expression level of α-SMA and TGF-β in liver tissue. Our in vitro study showed that TGF-β1 treatment in hepatocytes resulted in loss of E-cadherin and increased expression of mesenchymal markers and EMT related transcription factor. In addition, TGF-β1 increased the expression of apoptotic markers. However, glutamine interestingly suppressed TGF-β1 mediated EMT and apoptosis. In conclusion, our results suggest that glutamine ameliorates CCl4 induced liver fibrosis and suppresses TGF-β1 induced EMT progression and apoptosis.

  14. Hepatoprotective and antioxidant activity of methanolic extract of flowers ofNerium oleander against CCl4-induced liver injury in rats

    Institute of Scientific and Technical Information of China (English)

    Kumar Gaurav Singhal; Ghanshyam Das Gupta

    2012-01-01

    Objective:To investigate the antioxidant and hepatoprotective activity of methanolic flower extract ofNerium oleander againstCCl4-induced hepatotoxicity in rats.Methods:In vitro antioxidant activity of methanolic extract of flowers of Nerium oleander(MENO-F) was evaluated by various assays, including reducing power, lipid peroxidation,DPPH,ABTS, superoxide anion, hydroxyl radicals and metal chelation.The hepatoprotective andin vivo antioxidant activity ofMENO-F were evaluated againstCCl4-induced hepatic damage in rats.TheMENO-F at dose of100,200 and400 mg/kg were administered orally once daily for seven days.Serum enzymatic levels of serum glutamate oxaloacetate transaminase(AST), serum glutamate pyruvate transaminase(ALT), serum alkaline phosphatase(ALP) and total bilirubin were estimated along with estimation of superoxide dismutase(SOD) and malondialdehyde(MDA) levels in liver tissues.Further histopathological examination of the liver sections was carried out to support the induction of hepatotoxicity and hepatoprotective efficacy.Results:The extract showed potent activities on reducing power, lipid peroxide,DPPH,ABTS, superoxide anion, hydroxyl radical and metal chelation.The substantially elevated serum enzymatic levels ofAST,ALT,ALP and total bilirubin were found to be restored towards normalization significantly by theMENO-F in a dose dependent manner with maximum hepatoprotection at400 mg/kg dose level.The histopathological observations supported the biochemical evidences of hepatoprotection.Elevated level ofSOD and decreased level ofMDA further strengthen the hepatoprotective observations.Conclusions:The results of the present study strongly reveal thatMENO-F has potent antioxidant activity and hepatoprotective activity againstCCl4-induced hepatic damage in experimental animals.

  15. Mechanism of the Inhibitory Effects of Eucommia ulmoides Oliv. Cortex Extracts (EUCE in the CCl4-Induced Acute Liver Lipid Accumulation in Rats

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    Chang-Feng Jin

    2013-01-01

    Full Text Available Eucommia ulmoides Oliv. (EU has been used for treatment of liver diseases. The protective effects of Eucommia Ulmoides Oliv. cortex extracts (EUCE on the carbon tetrachloride- (CCl4- induced hepatic lipid accumulation were examined in this study. Rats were orally treated with EUCE in different doses prior to an intraperitoneal injection of 1 mg/kg CCl4. Acute injection of CCl4 decreased plasma triglyceride but increased hepatic triglyceride and cholesterol as compared to control rats. On the other hand, the pretreatment with EUCE diminished these effects at a dose-dependent manner. CCl4 treatment decreased glutathione (GSH and increased malondialdehyde (MDA accompanied by activated P450 2E1. The pretreatment with EUCE significantly improved these deleterious effects of CCl4. CCl4 treatment increased P450 2E1 activation and ApoB accumulation. Pretreatment with EUCE reversed these effects. ER stress response was significantly increased by CCl4, which was inhibited by EUCE. One of the possible ER stress regulatory mechanisms, lysosomal activity, was examined. CCl4 reduced lysosomal enzymes that were reversed with the EUCE. The results indicate that oral pretreatment with EUCE may protect liver against CCl4-induced hepatic lipid accumulation. ER stress and its related ROS regulation are suggested as a possible mechanism in the antidyslipidemic effect of EUCE.

  16. Comparison of the Treatment Efficiency of Bone Marrow-Derived Mesenchymal Stem Cell Transplantation via Tail and Portal Veins in CCl4-Induced Mouse Liver Fibrosis

    National Research Council Canada - National Science Library

    Truong, Nhung Hai; Nguyen, Nam Hai; Le, Trinh Van; Vu, Ngoc Bich; Huynh, Nghia; Nguyen, Thanh Van; Le, Huy Minh; Phan, Ngoc Kim; Pham, Phuc Van

    2016-01-01

    ...) on mouse liver cirrhosis induced by carbon tetrachloride. Portal and tail vein transplantations were examined to evaluate the effects of different injection routes on the liver cirrhosis model at 21 days after transplantation...

  17. In vivo antioxidant effect of aqueous root bark, stem bark and leaves extracts of Vitex doniana in CCl4 induced liver damage rats

    Institute of Scientific and Technical Information of China (English)

    Kadejo Olubukola Adetoro; James Dorcas Bolanle; Sallau Balarebe Abdullahi; Ozigi Abdulrahaman Ahmed

    2013-01-01

    Objective: The antioxidant effects of aqueous root bark, stem bark and leaves of Vitex doniana (V. doniana) were evaluated in carbon tetrachloride (CCl4) induced liver damage and non induced liver damage albino rats. Methods: A total of 60 albino rats (36 induced liver damage and 24 non induced liver damage) were assigned into liver damage and non liver damage groups of 6 rats in a group. The animals in the CCl4 induced liver damage groups, were induced by intraperitoneal injection with a single dose of CCl4 (148 mg·ml-1·kg-1 body weight) as a 1:1 (v/v) solution in olive oil and were fasted for 36 h before the subsequent treatment with aqueous root bark, stem bark and leaves extracts of V. doniana and vitamin E as standard drug (100 mg/kg body weighy per showed that the induction with CCl4, significantly (P0.05) difference between TBARS, SOD and CAT in the liver of the induced treated groups and normal control group. In the kidney, TBARS showed no significant (P>0.05) difference between the normal and the induced groups, SOD was significantly CAT compared with the normal control except in the kidney of animals treated with stem extract animals, there was no significant (P>0.05) change in the liver and kidney level of TBARS, SOD and not treated group. The studies also showed that when the extracts were administered to normal was significantly (P<0.05) increased in root and vitamin E groups when compared to induced (P<0.05) reduced in the CCl4 group compared to standard drug and normal control groups, CAT where TBARS was significantly (P<0.05) lowered compared to control group. Conclusion: The result of the present study suggests that application of V. doniana plant would play an important role in increasing the antioxidant effect and reducing the oxidative damage that formed both in liver and in kidney tissues. However stem bark has potential to improve renal function in normal rats.

  18. Hepatocyte-specific ablation of spermine/spermidine-N1-acetyltransferase gene reduces the severity of CCl4-induced acute liver injury

    Science.gov (United States)

    Barone, Sharon L.; Xu, Jie; Steinbergs, Nora; Schuster, Rebecca; Lentsch, Alex B.; Amlal, Hassane; Wang, Jiang; Casero, Robert A.; Soleimani, Manoocher

    2012-01-01

    Activation of spermine/spermidine-N1-acetyltransferase (SSAT) leads to DNA damage and growth arrest in mammalian cells, and its ablation reduces the severity of ischemic and endotoxic injuries. Here we have examined the role of SSAT in the pathogenesis of toxic liver injury caused by carbon tetrachloride (CCl4). The expression and activity of SSAT increase in the liver subsequent to CCl4 administration. Furthermore, the early liver injury after CCl4 treatment was significantly attenuated in hepatocyte-specific SSAT knockout mice (Hep-SSAT-Cko) compared with wild-type (WT) mice as determined by the reduced serum alanine aminotransferase levels, decreased hepatic lipid peroxidation, and less severe liver damage. Cytochrome P450 2e1 levels remained comparable in both genotypes, suggesting that SSAT deficiency does not affect the metabolism of CCl4. Hepatocyte-specific deficiency of SSAT also modulated the induction of cytokines involved in inflammation and repair as well as leukocyte infiltration. In addition, Noxa and activated caspase 3 levels were elevated in the livers of WT compared with Hep-SSAT-Cko mice. Interestingly, the onset of cell proliferation was significantly more robust in the WT compared with Hep-SSAT Cko mice. The inhibition of polyamine oxidases protected the animals against CCl4-induced liver injury. Our studies suggest that while the abrogation of polyamine back conversion or inhibition of polyamine oxidation attenuate the early injury, they may delay the onset of hepatic regeneration. PMID:22723264

  19. Efficacy of a traditional unani formulation Jawarish-e-Amla Sada against CCl 4 induced liver toxicity in Albino Wistar rats: Comparison with silymarin treatment

    Directory of Open Access Journals (Sweden)

    Sunita Shailajan

    2015-01-01

    Full Text Available Background: Jawarish-e-Amla Sada (JAS; a polyherbal Unani formulation, is claimed as a potential hepatoprotective agent in traditional Unani medicine treatise. Aims and Objectives: Though, JAS has its composition recorded in ancient Unani texts, there have been minimal attempts to scientifically validate its hepatoprotective potential. The present work is an attempt to evaluate the hepatoprotective activity of JAS in vivo. Materials and Methods: CCl 4 intoxicated Albino Wistar rats were used to evaluate the hepatoprotective activity of JAS (0.7 g/kg and 1.0 g/kg, p.o. and the results were compared with, silymarin. The efficacy was established on the basis of altered levels of biochemical markers and histopathological analysis of the liver tissue. Results and Discussion: Treatment with the aqueous slurry of JAS significantly reduced the level of biochemical markers in CCl 4 intoxicated rats. These findings were well-supported by the histopathological analysis of liver tissue. The effect shown by JAS was found to be at par with silymarin treatment. Conclusion: This study suggests that CCl 4 induced liver damage can be ameliorated by traditional Unani formulation JAS. This justifies the traditional claim of JAS being a hepatoprotective agent.

  20. «Evaluation of the anti-icterus effect of crude powdered leaf of Argemone mexicana L. (Papaveraceae against CCl4-induced liver injury in rats».

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    T.S. SOURABIE

    2012-10-01

    Full Text Available Leaves of Argemone mexicana L. (Papaveraceae are used in the folk medicine of Burkina Faso (West Africa to treat a variety of illness. Aqueous decoction of the drug is indicated in the treatment of malaria fever, abdominal pains, and jaundice. A preliminary study led by the authors showed a good anti-icterus (hepatoprotective activity of leaves extracts on intoxicated Wistar rats. The aim of the present investigation was to evaluate the anti-icterus activity of crude leaf powder against CCl4 induced hepatotoxicity in rats. Liver functions were assessed by the activities of liver marker enzymes, ASAT/GOT, ALAT/GPT, ALP, Total Bilirubin (TBIL and Direct Bilirubin (DBIL.A crude powdered leaf suspended in acacia gum solution (2% p/w was administered orally to the animal at doses of 125, 250 and 500 mg/kg attenuated significantly (p<0,05 the elevation of serum enzymes level and bilirubin (total and direct if compared to the CCl4 treated groups. Silymarin (100 mg/kg, p.o., a known antihepatoprotective drug was used as reference. The results showed a dose-dependent anti-hepatotoxic effect against liver injury induced by CCl4 in rats. These findings give an opportunity for a future elaboration of galenic formulation as phytomedicament.

  1. Balance between oxidative damage and proliferative potential in an experimental rat model of CCl4-induced cirrhosis: protective role of adenosine administration.

    Science.gov (United States)

    Hernández-Muñoz, R; Díaz-Muñoz, M; López, V; López-Barrera, F; Yáñez, L; Vidrio, S; Aranda-Fraustro, A; Chagoya de Sánchez, V

    1997-11-01

    Oxidative stress and its consequent lipid peroxidation (LP) exert harmful effects, which have been currently involved in the generation of carbon tetrachloride-induced cirrhosis. However, the recent report that "physiological" LP can be associated with liver regeneration (LR) makes it necessary to discriminate between oxidative stress-induced and LR-associated LP. In rats rendered cirrhotic by continuous CCl4 administration for 4 weeks, moderate cell necrosis and fine fatty infiltration were found. The histological abnormalities were accompanied by increased LP, mainly accounted for by the microsomal and cytosolic fractions and evidence of oxidative stress (decreased hepatic glutathione content and changes in xanthine oxidase and pentose phosphate pathway activities). After 8 weeks, a micronodular cirrhosis developed, but oxidative stress was greatly attenuated, only persisting in the enhanced LP confined to microsomes. Simultaneous administration of adenosine, a reliable hepatoprotector that readily prevents the onset of liver fibrosis, was able to block the oxidative stress induced by the long-term CCl4 treatment but elicited a selective subcellular distribution of increased LP, similar to that found during LR. The adenosine-induced changes in liver LP (mainly in the nuclear fraction) correlated with an increased activity of thymidine kinase. Therefore, data suggest that adenosine-mediated preservation of energy availability and mitochondrial function could participate in preventing the onset of oxidative stress in cirrhotic rats. The latter could induce a successful liver recovery, curtailing the sequence of events leading to fibrogenesis.

  2. Hepatoprotective effect ofSolanum xanthocarpum fruit extract against CCl4 induced acute liver toxicity in experimental animals

    Institute of Scientific and Technical Information of China (English)

    Ramesh K Gupta; Talib Hussain; G Panigrahi; Avik Das; Gireesh Narayan Singh; K Sweety; Md Faiyazuddin; Chandana Venkateswara Rao

    2011-01-01

    Objective:To investigate the hepatoprotective potential ofSolanum xanthocarpum (Solanaceae) (S. xanthocarpum) in experimental rats to validate its traditional claim.Methods: 50%ethanolic fruit extract ofS. xanthocarpum (SXE, 100, 200or400 mg/kg body weight) was administered daily for14days in experimental animals. Liver injury was induced chemically, byCCl4administration (1 mL/kg i.p.).The hepatoprotective activity was assessed using various biochemical parameters like aspartate aminotransferase (AST), alanine aminotransferase(ALT), Serum alkaline phosphatise (SALP) and total bilirubin. Meanwhile, in vivo antioxidant activities as lipid peroxidation (LPO), reduced glutathione(GSH), superoxide dismutase(SOD) and catalase(CAT) were screened along with histopathological studies.Results: Obtained results demonstrated that the treatment with SXE significantly (P<0.05- <0.001) and dose-dependently prevented chemically induced increase in serum levels of hepatic enzymes. Furthermore,SXE significantly (up toP<0.001) reduced the lipid peroxidation in the liver tissue and restored activities of defence antioxidant enzymes GSH, SOD and catalase towards normal levels. Histopathology of the liver tissue showed thatSXE attenuated the hepatocellular necrosis and led to reduction of inflammatory cells inflltration. Conclusions: The results of this study strongly indicate the protective effect ofSXE against acute liver injury which may be attributed to its hepatoprotective activity, and there by scientifically support its traditional use.

  3. Hepatoprotective effect of flavonol glycosides rich fraction from Egyptian Vicia calcarata Desf. against CCl4-induced liver damage in rats.

    Science.gov (United States)

    Singab, Abdel Nasser B; Youssef, Diaa T A; Noaman, Eman; Kotb, Saeed

    2005-07-01

    The hepatoprotective activity of flavonol glycosides rich fraction (F-2), prepared from 70% alcohol extract of the aerial parts of V. calcarata Desf., was evaluated in a rat model with a liver injury induced by daily oral administration of CCl4 (100 mg/kg, b.w) for four weeks. Treatment of the animals with F-2 using a dose of (25 mg/kg, b.w) during the induction of hepatic damage by CCl4 significantly reduced the indices of liver injuries. The hepatoprotective effects of F-2 significantly reduced the elevated levels of the following serum enzymes: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH). The antioxidant activity of F-2 markedly ameliorated the antioxidant parameters including glutathione (GSH) content, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), plasma catalase (CAT) and packed erythrocytes glucose-6-phosphate dehydrogenase (G6PDH) to be comparable with normal control levels. In addition, it normalized liver malondialdehyde (MDA) levels and creatinine concentration. Chromatographic purification of F-2 resulted in the isolation of two flavonol glycosides that rarely occur in the plant kingdom, identified as quercetin-3, 5-di-O-beta-D-diglucoside (5) and kaempferol-3, 5-di-O-beta-D-diglucoside (4) in addition to the three known compounds identified as quercetin-3-O-alpha-L-rhamnosyl- (1-->6)-beta-D-glucoside [rutin, 3], quercetin-3-O-beta-D-glucoside [isoquercitrin, 2] and kaempferol-3-O-beta-D-glucoside [astragalin, 1]. These compounds were identified based on interpretation of their physical, chemical, and spectral data. Moreover, the spectrophotometric estimation of the flavonoids content revealed that the aerial parts of the plant contain an appreciable amount of flavonoids (0.89%) calculated as rutin. The data obtained from this study revealed that the flavonol glycosides of F-2 protect the rat liver from hepatic damage induced by CCl4 through inhibition of

  4. Expression of VDAC Regulated by Extracts of Limonium sinense Ktze root Against CCl4-induced Liver Damage

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    Xiaoning Zhao

    2007-03-01

    Full Text Available The expression of mitochondrial voltage-dependent anion channels (VDAC mayunderlie the protective effects of Limonium sinense (Girard Ktze root extracts (LSE againstcarbon tetrachloride-induced liver damage. Pretreatment of mice with 100 mg/kg, 200mg/kg or 400 mg/kg LSE significantly blocked the carbon tetrachloride-induced increase inboth serum aspartate aminotransferase (sAST and serum alanine aminotransferase (sALTlevels. Ultrastructural observations by electron microscope confirmed hepatoprotection,showing decreased nuclear condensation, ameliorated mitochondrial fragmentation of thecristae and less lipid deposition. Pretreatment with LSE prevented the decrease of thedisruption of mitochondrial membrane potential (15.3% observed in the liver of the carbontetrachloride-insulted mice, further demonstrating the mitochondrial protection. In addition,LSE treatment (100-400 mg/kg significantly increased both transcription and translation ofVDAC. The above data suggests that LSE mitigates the damage to liver mitochondriainduced by carbon tetrachloride, possibly through regulation of mitochondrial VDAC, one ofthe most important proteins in the mitochondrial outer membrane.

  5. Effect of pumpkin seed (Cucurbita pepo) protein isolate on the activity levels of certain plasma enzymes in CCl4-induced liver injury in low-protein fed rats.

    Science.gov (United States)

    Nkosi, C Z; Opoku, A R; Terblanche, S E

    2005-04-01

    The effects of pumpkin seed (Cucurbita pepo) protein isolate on the activity levels of lactate dehydrogenase (LD), alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP) against carbon tetrachloride (CCl4)-induced acute liver injury in low-protein fed rats were investigated. A group of male Sprague-Dawley rats maintained on a low-protein diet for 5 days were divided into three subgroups. Two subgroups were injected with carbon tetrachloride and the other group with an equivalent amount of olive oil. Two hours after CCl4 intoxication one of the two subgroups was administered with pumpkin seed protein isolate. All three subgroups of rats were maintained on the low-protein diet for the duration of the investigation. Groups of rats from the different subgroups were killed at 24, 48 and 72 h after their respective treatments. After 5 days on the low-protein diet the activity levels of all four enzymes were significantly higher than their counterparts on a normal balanced diet. CCl4 intoxication resulted in significant increases in the activity levels of all four enzymes investigated. The administration of pumpkin seed protein isolate after CCl4 intoxication resulted in significantly reduced activity levels of all four enzymes. It is concluded that pumpkin seed protein isolate administration was effective in alleviating the detrimental effects associated with protein malnutrition.

  6. Cultured Mycelium Cordyceps sinensis allevi¬ates CCl4-induced liver inflammation and fibrosis in mice by activating hepatic natural killer cells.

    Science.gov (United States)

    Peng, Yuan; Huang, Kai; Shen, Li; Tao, Yan-yan; Liu, Cheng-hai

    2016-02-01

    Recent evidence shows that cultured mycelium Cordyceps sinensis (CMCS) effectively protects against liver fibrosis in mice. Here, we investigated whether the anti-fibrotic action of CMCS was related to its regulation of the activity of hepatic natural killer (NK) cells in CCl4-treated mice. C57BL/6 mice were injected with 10% CCl4 (2 mL/kg, ip) 3 times per week for 4 weeks, and received CMCS (120 mg·kg(-1)·d(-1), ig) during this period. In another part of experiments, the mice were also injected with an NK cell-deleting antibody ASGM-1 (20 μg, ip) 5 times in the first 3 weeks. After the mice were sacrificed, serum liver function, and liver inflammation, hydroxyproline content and collagen deposition were assessed. The numbers of hepatic NK cells and expression of NKG2D (activation receptor of NK cells) on isolated liver lymphocytes were analyzed using flow cytometry. Desmin expression and cell apoptosis in liver tissues were studied using desmin staining and TUNEL assay, respectively. The levels of α-SMA, TGF-β, RAE-1δ and RAE-1ε in liver tissues were determined by RT-qPCR. In CCl4-treated mice, CMCS administration significantly improved liver function, attenuated liver inflammation and fibrosis, and increased the numbers of hepatic NK cells and expression level of NKG2D on hepatic NK cells. Furthermore, CMCS administration significantly decreased desmin expression in liver tissues, and increased TUNEL staining adjacent to hepatic stellate cells. Injection with NK cell-deleting ASGM-1 not only diminished the numbers of hepatic NK cells, but also greatly accelerated liver inflammation and fibrosis in CCl4-treated mice. In CCl4-treated mice with NK cell depletion, CMCS administration decelerated the rate of liver fibrosis development, and mildly upregulated the numbers of hepatic NK cells but without changing NKG2D expression. CMCS alleviates CCl4-induced liver inflammation and fibrosis via promoting activation of hepatic NK cells. CMCS partially reverses ASGM

  7. Mutant MMP-9 and HGF gene transfer enhance resolution of CCl4-induced liver fibrosis in rats: role of ASH1 and EZH2 methyltransferases repression.

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    Hussein Atta

    Full Text Available Hepatocyte growth factor (HGF gene transfer inhibits liver fibrosis by regulating aberrant cellular functions, while mutant matrix metalloproteinase-9 (mMMP-9 enhances matrix degradation by neutralizing the elevated tissue inhibitor of metalloproteinase-1 (TIMP-1. It was shown that ASH1 and EZH2 methyltransferases are involved in development of liver fibrosis; however, their role in the resolution phase of liver fibrosis has not been investigated. This study evaluated the role of ASH1 and EZH2 in two mechanistically different therapeutic modalities, HGF and mMMP-9 gene transfer in CCl4 induced rat liver fibrosis. Liver fibrosis was induced in rats with twice a week intraperitoneal injection of CCl4 for 8 weeks. Adenovirus vectors encoding mMMP-9 or HGF genes were injected through tail vein at weeks six and seven and were sacrificed one week after the second injection. A healthy animal group was likewise injected with saline to serve as a negative control. Rats treated with mMMP-9 showed significantly lower fibrosis score, less Sirius red stained collagen area, reduced hydroxyproline and ALT concentration, decreased transforming growth factor beta 1 (TGF-β1 mRNA and lower labeling indices of α smooth muscle actin (α-SMA and proliferating cell nuclear antigen (PCNA stained cells compared with HGF- or saline-treated rats. Furthermore, TIMP-1 protein expression in mMMP-9 group was markedly reduced compared with all fibrotic groups. ASH1 and EZH2 protein expression was significantly elevated in fibrotic liver and significantly decreased in mMMP-9- and HGF-treated compared to saline-treated fibrotic livers with further reduction in the mMMP-9 group.Gene transfer of mMMP-9 and HGF reduced liver fibrosis in rats. ASH1 and EZH2 methyltransferases are significantly reduced in mMMP-9 and HGF treated rats which underlines the central role of these enzymes during fibrogenesis. Future studies should evaluate the role of selective pharmacologic inhibitors

  8. Comparison of the Treatment Efficiency of Bone Marrow-Derived Mesenchymal Stem Cell Transplantation via Tail and Portal Veins in CCl4-Induced Mouse Liver Fibrosis.

    Science.gov (United States)

    Truong, Nhung Hai; Nguyen, Nam Hai; Le, Trinh Van; Vu, Ngoc Bich; Huynh, Nghia; Nguyen, Thanh Van; Le, Huy Minh; Phan, Ngoc Kim; Pham, Phuc Van

    2016-01-01

    Because of self-renewal, strong proliferation in vitro, abundant sources for isolation, and a high differentiation capacity, mesenchymal stem cells are suggested to be potentially therapeutic for liver fibrosis/cirrhosis. In this study, we evaluated the treatment effects of mouse bone marrow-derived mesenchymal stem cells (BM-MSCs) on mouse liver cirrhosis induced by carbon tetrachloride. Portal and tail vein transplantations were examined to evaluate the effects of different injection routes on the liver cirrhosis model at 21 days after transplantation. BM-MSCs transplantation reduced aspartate aminotransferase/alanine aminotransferase levels at 21 days after injection. Furthermore, BM-MSCs induced positive changes in serum bilirubin and albumin and downregulated expression of integrins (600- to 7000-fold), transforming growth factor, and procollagen-α1 compared with the control group. Interestingly, both injection routes ameliorated inflammation and liver cirrhosis scores. All mice in treatment groups had reduced inflammation scores and no cirrhosis. In conclusion, transplantation of BM-MSCs via tail or portal veins ameliorates liver cirrhosis in mice. Notably, there were no differences in treatment effects between tail and portal vein administrations. In consideration of safety, we suggest transfusion of bone marrow-derived mesenchymal stem cells via a peripheral vein as a potential method for liver fibrosis treatment.

  9. Antioxidative effects of pumpkin seed (Cucurbita pepo) protein isolate in CCl4-induced liver injury in low-protein fed rats.

    Science.gov (United States)

    Nkosi, C Z; Opoku, A R; Terblanche, S E

    2006-11-01

    The effects of pumpkin seed (Cucurbita pepo) protein isolate on the plasma activity levels of catalase (CA), superoxide dismutase (SOD), glutathione peroxidase (GSHpx) and total antioxidant capacity (TAC) as well as glucose-6-phosphatase (G6Pase) in liver homogenates and lipid peroxidation (LPO-malondialdehyde-MDA) levels in liver homogenates and liver microsomal fractions against carbon tetrachloride (CCl(4))-induced acute liver injury in low-protein fed Sprague-Dawley rats (Rattus norvegicus) were investigated. A group of male Sprague-Dawley rats maintained on a low-protein diet for 5 days were divided into three subgroups. Two subgroups were injected with carbon tetrachloride and the other group with an equivalent amount of olive oil. Two hours after CCl(4) intoxication one of the two subgroups was administered with pumpkin seed protein isolate and thereafter switched onto a 20% pumpkin seed protein isolate diet. The other two groups of rats were maintained on the low-protein diet for the duration of the investigation. Groups of rats from the different subgroups were killed at 24, 48 and 72 h after their respective treatments. After 5 days on the low-protein diet the activity levels of all the enzymes as well as antioxidant levels were significantly lower than their counterparts on a normal balanced diet. However, a low-protein diet resulted in significantly increased levels of lipid peroxidation. The CCl(4) intoxicated rats responded in a similar way, regarding all the variables investigated, to their counterparts on a low-protein diet. The administration of pumpkin seed protein isolate after CCl(4) intoxication resulted in significantly increased levels of all the variables investigated, with the exception of the lipid peroxidation levels which were significantly decreased. From the results of the present study it is concluded that pumpkin seed protein isolate administration was effective in alleviating the detrimental effects associated with protein

  10. Preventative effects of prostaglandin E1 in combination with iodized olive oil on liver fibrosis after transcatheter arterial chemoembolization in a rabbit model of CCl4-induced liver fibrosis.

    Science.gov (United States)

    Jin, Shuqiang; Cao, Haili; Wang, Kaibing; Li, Ying; Bai, Bin

    2015-06-01

    To explore the preventative effects of prostaglandin E1 (PGE1) on a rabbit model of CCl4-induced liver fibrosis after transcatheter arterial chemoembolization (TACE), we generated a rabbit model of CCl4-induced liver fibrosis by treatment with 40% CCl4 in iodized olive oil for 16 weeks. Body mass and serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (ALB), albumin:globulin ratio (A:G), total bilirubin (TBIL), and direct bilirubin (DBIL) were measured. After TACE, the levels of hyaluronic acid (HA), procollagen III (PC III), laminin (LN), and collagen IV (IV-C) were measured, and the severity of liver fibrosis as well as the morphology of liver tissues were determined. Body mass in the model group was significantly decreased from 10 to 16 weeks, and the serum levels of ALT, AST, TP, TBIL, and DBIL levels were significantly increased while the model was being generated; the levels of ALB and A:G were significantly decreased. After TACE, serum levels of HA, PC III, and LN in the group injected with 1.0 mL iodized olive oil (Group B) were higher than in the group that were injected with 1.0 mL iodized olive oil + 0.2 mL PGE1 (Group C), whereas the serum levels of IV-C were lower. The severity of liver fibrosis was ameliorated in Group C. The combination of PGE1 and iodized olive oil prevented the development of liver fibrosis following TACE.

  11. Protective Effect of the Persian Gulf brittle star Ophiocoma Erinaceus extract on carbon tetrachloride (CCl4 induced liver damage in adult male Wistar rats

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    Aida Soheili

    2015-12-01

    Full Text Available Background and Aim:  Brittle star possess  bioactive compounds which confer the wound healing capacity and regenerative potency of damaged  arms and organisms to this creature. The aim of the current study was to assess the   protective  effect  of  the  star extract on liver damages induced by carbon tetrachloride in adult male Wistar rats. Materials and Methods: In this experimental study, 32 adult male rats were randomly divided into 4 equal groups: control, Sham exposed, experimental 1 (treated with %25 extract and experimental 2 (treated with %50 extract of star Ophiocoma Erinaceus. The control group received no treatment. The sham exposed groups received carbon tetrachloride .(50% in olive oil .0.5 ml/kg for 7 days. The experimental groups firstly received carbon tetrachloride, then received %25, %50 brittle star extract as intragastric for 7 days. Finally, the animals were sacrificed, and their bodies and livers were weighed. Then, the livers sections were prepared and were examined by means of light microscope. Finally, the obtained  quantitative data was analyzed using SPSS (V; 20, Mini Tab software, ANOVA, and Tukey. at the significant level of P<0.001. Results: Carbon tetrachloride significantly decreased the rats’ body weight, but it increased their livers weight (P<0.001. Histopathological evaluations showed .extensive liver damage. On the other hand, treatment with brittle star extract .ncreased liver weight, reduced. body weight and significantly altered other induced changes by carbon tetrachloride on liver structure such as hepatocytes number, Kupffer cells, and arteritis, which indicated  the improvement of damaged liver tissue (P<0.001. Conclusion: It was found that brittle star extract can exert protective effects on  liver damages induced by carbon tetrachloride on male Wistar rat.

  12. JNK1 and JNK2 regulate α-SMA in hepatic stellate cells during CCl4 -induced fibrosis in the rat liver.

    Science.gov (United States)

    Hong, Il-Hwa; Park, Sang-Joon; Goo, Moon-Jung; Lee, Hye-Rim; Park, Jin-Kyu; Ki, Mi-Ran; Kim, Sang-Hyeob; Lee, Eun-Mi; Kim, Ah-Young; Jeong, Kyu-Shik

    2013-10-01

    Following liver injuries, hepatic stellate cells (HSCs) express α-SMA. Mitogen activated protein kinase (MAPK) signaling pathways mediate α-SMA expression in distinct cell types. However, the regulation of α-SMA expression by MAPKs in HSCs has been rarely studied. We aimed to study the role of MAPKs in the activation of HSCs during liver fibrosis. Liver fibrosis of rats was induced by carbon tetrachloride. HSC-T6 cells, murine embryonic fibroblasts, JNK1(-/-) and JNK2(-/-) cells were used for in vitro studies. Immunohistochemistry and immunoblot analysis were used. We have found that the expression of JNK and α-SMA co-localized in HSCs during liver fibrosis, but ERK and p38 expressed in macrophages. The expression of α-SMA was up-regulated by JNK1 and JNK2 in non-stress condition. Under TGF-β stimulation, however, the level α-SMA expression was increased by only JNK1, but not significantly changed by JNK2. We suggest that JNKs are responsible for α-SMA regulation, and especially JNK1 has a major role in up-regulation of α-SMA expression in HSCs under stress condition induced by TGF-β during liver fibrosis. © 2013 The Authors. Pathology International © 2013 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

  13. Anti-fibrotic effects of pegylated interferon gamma in vitro and in vivo in acute CCL4-induced liver injury mouse model : Therapeutic efficacy and adverse effects

    NARCIS (Netherlands)

    Bansal, Ruchi; Prakash, Jai; Proost, Johannes H.; Post, Eduard; De Jager-Krikken, Alie; Beljaars, Leonie; Poelstra, Klaas

    2010-01-01

    Hepatic fibrosis is characterized by the excessive production of collagen and extracellular matrix proteins. Among cytokines, Interferon gamma (IFNγ) is recognized as a potent anti-fibrotic cytokine in liver and lung fibrosis models. However, its poor pharmacokinetics resulted in lack of efficacy an

  14. In vivo antioxidant effect of aqueous root bark, stem bark and leaves extracts of Vitex doniana in CCl4 induced liver damage rats

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    Kadejo Olubukola Adetoro

    2013-05-01

    Conclusion: The result of the present study suggests that application of V. doniana plant would play an important role in increasing the antioxidant effect and reducing the oxidative damage that formed both in liver and in kidney tissues. However stem bark has potential to improve renal function in normal rats.

  15. Methanolic Extract of Dill Leaves Inhibits AGEs Formation and Shows Potential Hepatoprotective Effects in CCl4 Induced Liver Toxicity in Rat

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    Ebrahim Abbasi Oshaghi

    2017-01-01

    Full Text Available The research was aimed at evaluating the antiglycation, antioxidant, and hepatoprotective properties of methanolic extract of Anethum graveolens (dill. The antioxidant properties, photochemical characteristics, and antiglycation effects of dill extract were measured. Carbon tetrachloride-induced hepatotoxic rats were used to show the hepatoprotective activity of dill leaves. Different concentration of dill extract (0.032, 0.065, 0.125, 0.25, 0.5, and 1 mg/mL showed potential antioxidant ability. The extract of dill leaves significantly reduced AGEs formation and also fructosamine and protein carbonyl levels in rats’ liver. Thiol groups’ oxidation, amyloid cross-β, and protein fragmentation (P<0.001 significantly reduced in treated rats. Liver damage markers significantly reduced in dill-treated animals (P<0.05. Dill with potential antioxidant, antiglycation, and hepatoprotective effects can be suggested for treatment of diabetes complications.

  16. The Effects of Taoren-Honghua Herb Pair on Pathological Microvessel and Angiogenesis-Associated Signaling Pathway in Mice Model of CCl4-Induced Chronic Liver Disease

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    Shengyan Xi

    2016-01-01

    Full Text Available Chronic liver disease is one of the most common diseases that threaten human health. Effective treatment is still lacking in western medicine. Semen Persicae (Taoren and Flos Carthami (Honghua are known to relieve acute hepatic injury and inflammation, improve microcirculation, and reduce tissue fiber. The aim of our study is to investigate the potential mechanisms of Taoren-Honghua Herb Pair (THHP in murine model of chronic liver disease caused by Carbon Tetrachloride (CCl4. Mice were randomly divided into seven groups: (1 blank, (2 model, (3 control (colchicine, 0.1 mg/kg, (4 THHP (5.53, 2.67, and 1.33 g/kg, and (5 Tao Hong Siwu Decoction (THSWD (8.50 g/kg. Histological change and microvessels density were examined by microscopy. Hepatic function, serum fibrosis related factors, and hepatic vascular endothelial growth factor (VEGF were measured with ELISA. VEGF, kinase insert domain-containing receptor (KDR, Flt-1, and Akt mRNA expression in hepatic tissue were determined with PCR. Tissues of Akt, pAkt, KDR, and Flt-1 were measured with western blotting. Data from this study showed that THHP improved hepatic function and restrained the hepatic inflammation and fibrosis. Its role in inhibiting pathological angiogenesis and hepatic fibrogenesis may be through affecting the angiogenesis-associated VEGF and its upstream and downstream signaling pathways.

  17. The Effects of Taoren-Honghua Herb Pair on Pathological Microvessel and Angiogenesis-Associated Signaling Pathway in Mice Model of CCl4-Induced Chronic Liver Disease.

    Science.gov (United States)

    Xi, Shengyan; Yue, Lifeng; Shi, Mengmeng; Peng, Ying; Xu, Yangxinzi; Wang, Xinrong; Li, Qian; Kang, Zhijun; Li, Hanjing; Wang, Yanhui

    2016-01-01

    Chronic liver disease is one of the most common diseases that threaten human health. Effective treatment is still lacking in western medicine. Semen Persicae (Taoren) and Flos Carthami (Honghua) are known to relieve acute hepatic injury and inflammation, improve microcirculation, and reduce tissue fiber. The aim of our study is to investigate the potential mechanisms of Taoren-Honghua Herb Pair (THHP) in murine model of chronic liver disease caused by Carbon Tetrachloride (CCl4). Mice were randomly divided into seven groups: (1) blank, (2) model, (3) control (colchicine, 0.1 mg/kg), (4) THHP (5.53, 2.67, and 1.33 g/kg), and (5) Tao Hong Siwu Decoction (THSWD) (8.50 g/kg). Histological change and microvessels density were examined by microscopy. Hepatic function, serum fibrosis related factors, and hepatic vascular endothelial growth factor (VEGF) were measured with ELISA. VEGF, kinase insert domain-containing receptor (KDR), Flt-1, and Akt mRNA expression in hepatic tissue were determined with PCR. Tissues of Akt, pAkt, KDR, and Flt-1 were measured with western blotting. Data from this study showed that THHP improved hepatic function and restrained the hepatic inflammation and fibrosis. Its role in inhibiting pathological angiogenesis and hepatic fibrogenesis may be through affecting the angiogenesis-associated VEGF and its upstream and downstream signaling pathways.

  18. Hydrogen sulfide attenuates carbon tetrachloride-induced hepatotoxicity, liver cirrhosis and portal hypertension in rats.

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    Gang Tan

    Full Text Available BACKGROUND: Hydrogen sulfide (H(2S displays vasodilative, anti-oxidative, anti-inflammatory and cytoprotective activities. Impaired production of H(2S contributes to the increased intrahepatic resistance in cirrhotic livers. The study aimed to investigate the roles of H(2S in carbon tetrachloride (CCl(4-induced hepatotoxicity, cirrhosis and portal hypertension. METHODS AND FINDINGS: Sodium hydrosulfide (NaHS, a donor of H(2S, and DL-propargylglycine (PAG, an irreversible inhibitor of cystathionine γ-lyase (CSE, were applied to the rats to investigate the effects of H(2S on CCl(4-induced acute hepatotoxicity, cirrhosis and portal hypertension by measuring serum levels of H(2S, hepatic H(2S producing activity and CSE expression, liver function, activity of cytochrome P450 (CYP 2E1, oxidative and inflammatory parameters, liver fibrosis and portal pressure. CCl(4 significantly reduced serum levels of H(2S, hepatic H(2S production and CSE expression. NaHS attenuated CCl(4-induced acute hepatotoxicity by supplementing exogenous H(2S, which displayed anti-oxidative activities and inhibited the CYP2E1 activity. NaHS protected liver function, attenuated liver fibrosis, inhibited inflammation, and reduced the portal pressure, evidenced by the alterations of serum alanine aminotransferase (ALT, aspartate aminotransferase (AST, hyaluronic acid (HA, albumin, tumor necrosis factor (TNF-α, interleukin (IL-1β, IL-6 and soluble intercellular adhesion molecule (ICAM-1, liver histology, hepatic hydroxyproline content and α-smooth muscle actin (SMA expression. PAG showed opposing effects to NaHS on most of the above parameters. CONCLUSIONS: Exogenous H(2S attenuates CCl(4-induced hepatotoxicity, liver cirrhosis and portal hypertension by its multiple functions including anti-oxidation, anti-inflammation, cytoprotection and anti-fibrosis, indicating that targeting H(2S may present a promising approach, particularly for its prophylactic effects, against liver

  19. Hepatoprotective properties of sesamin against CCl4 induced oxidative stress-mediated apoptosis in mice via JNK pathway.

    Science.gov (United States)

    Ma, Jie-Qiong; Ding, Jie; Zhang, Li; Liu, Chan-Min

    2014-02-01

    Sesamin (Ses), one of the major lignan derived from sesame seeds, has been reported to have many benefits and medicinal properties. However, its protective effects against carbon tetrachloride (CCl4) induced injury in liver have not been clarified. The aim of the present study was to investigate the hepatoprotective effects of sesamin on oxidative stress and apoptosis in mice exposed to CCl4. Our data showed that sesamin significantly prevented CCl4-induced hepatotoxicity in a dose-dependent manner, indicated by both diagnostic indicators of liver damage (serum aminotransferase activities) and histopathological analysis. Moreover, CCl4-induced profound elevation of reactive oxygen species (ROS) production and oxidative stress, as evidenced by increasing of lipid peroxidation level and depleting of the total antioxidant capacity (TAC) in liver, were suppressed by treatment with sesamin. Furthermore, TUNEL assay showed that CCl4-induced apoptosis in mouse liver was significantly inhibited by sesamin. In exploring the underlying mechanisms of sesamin action, we found that activities of caspase-3 were markedly inhibited by the treatment of sesamin in the liver of CCl4 treated mice. Sesamin increased expression levels of phosphorylated Jun N-terminal kinases (JNK) in liver, which in turn inactivated pro-apoptotic signaling events restoring the balance between mitochondrial pro- and anti-apoptotic Bcl-2 proteins and decreasing the release of mitochondrial cytochrome c in liver of CCl4 treated mice. JNK was also involved in the mitochondrial extrinsic apoptotic pathways of sesamin effects against CCl4 induced liver injury by regulating the expression levels of phosphorylated c-Jun proteins, necrosis factor-alpha (TNF-α) and Bak. In conclusion, these results suggested that the inhibition of CCl4-induced apoptosis by sesamin is due at least in part to its anti-oxidant activity and its ability to modulate the JNK signaling pathway.

  20. PROTECTIVE EFFECT OF Solanum Pubescens LINN ON CCL4 INDUCED HEPATOTOXICITY IN ALBINO RATS

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    M.Pushpalatha

    2012-01-01

    Full Text Available Ethanol extract of Solanum pubescens Linn was evaluated for hepato protective and antioxidant activities in rats. The plant extract (500mg/kg/day showed a remarkable hepatoprotective and antioxidant activity against Carbon tetrachloride (CCl4-induced hepatotoxicity as judged from the serum marker enzymes and antioxidant levels in liver tissues. CCl4 induced a significant rise in aspartate amino transferase (AST, alanine amino transferase (ALT, alkaline phosphatase (ALP, total bilirubin, LPO with a reduction of total protein, superoxide dismutase (SOD, catalase, and reduced glutathione (GSH. Treatment of rats with plant extract (500 mg/kg significantly (P<0.01 altered serum marker enzymes and antioxidant levels to near normal against CCl4 - treated rats. The activity of the extract at dose of 500 mg/kg was comparable to the standard drug, Silymarin (50 mg/kg, p.o.. Histopathological examination of the liver tissues supported the hepatoprotective activity of plant.

  1. Protective effects of L-carnosine on CCl4 -induced hepatic injury in rats.

    Science.gov (United States)

    Alsheblak, Mehyar Mohammad; Elsherbiny, Nehal M; El-Karef, Amro; El-Shishtawy, Mamdouh M

    2016-03-01

    The present study was undertaken to investigate the possible protective effect of L-carnosine (CAR), an endogenous dipeptide of alanine and histidine, on carbon tetrachloride (CCl4)-induced hepatic injury. Liver injury was induced in male Sprague-Dawley rats by intraperitoneal (i.p.) injections of CCl4, twice weekly for six weeks. CAR was administered to rats daily, at dose of 250 mg/kg, i.p. At the end of six weeks, blood and liver tissue specimens were collected. Results show that CAR treatment attenuated the hepatic morphological changes, necroinflammation and fibrosis induced by CCl4, as indicated by hepatic histopathology scoring. In addition, CAR treatment significantly reduced the CCl4-induced elevation of liver-injury parameters in serum. CAR treatment also combatted oxidative stress; possibly by restoring hepatic nuclear factor erythroid 2-related factor 2 (Nrf-2) levels. Moreover, CAR treatment prevented the activation of hepatic stellate cells (HSCs), as indicated by reduced α-smooth muscle actin (α-SMA) expression in the liver, and decreased hepatic inflammation as demonstrated by a reduction in hepatic tumor necrosis factor-α (TNF-α) and restoration of interleukin-10 (IL-10) levels. In conclusion, CCl4-induced hepatic injury was alleviated by CAR treatment. The results suggest that these beneficial, protective effects are due, at least in part, to its anti-oxidant, anti-inflammatory and anti-fibrotic activities.

  2. [Diabetes in liver cirrhosis].

    Science.gov (United States)

    García-Compeán, Diego; Jáquez-Quintana, Joel O; González-González, José A; Lavalle-González, Fernando J; Villarreal-Pérez, Jesús Z; Maldonado-Garza, Hector J

    2013-01-01

    The prevalence of overt diabetes mellitus (DM) in liver cirrhosis is about 30%. However, DM or impaired glucose tolerance can be observed in 90% after an oral glucose tolerance test in patients with normal fasting plasma glucose. Type 2 DM may produce cirrhosis, whereas DM may be a complication of cirrhosis. The latter is known as «hepatogenous diabetes». Overt and subclinical DM is associated with liver complications and death in cirrhotic patients. Treating diabetes is difficult in cirrhotic patients because of the metabolic impairments due to liver disease and because the most appropriate pharmacologic treatment has not been defined. It is also unknown if glycemic control with hypoglycemic agents has any impact on the course of the liver disease. Copyright © 2013 Elsevier España, S.L. y AEEH y AEG. All rights reserved.

  3. Isoflavones-Enriched Soy Protein Prevents CCL4-Induced Hepatotoxicity in Rats

    OpenAIRE

    Sarhan, Nesma A. Z.; Ezzeldein S. El-Denshary; Hassan, Nabila S.; Abu-Salem, Ferial M.; Abdel-Wahhab, Mosaad A.

    2012-01-01

    The burden of liver disease in Egypt is exceptionally high due to the highest prevalence of hepatitis C virus (HCV) resulting in rising rates of hepatocellular carcinoma (HCC). The aim of the current study was to determine the isoflavones in soy and to evaluate the protective role of soy against CCl4-induced liver damage in rats. Four experimental groups were treated for 8 weeks and included the control group, soy-supplemented diet (20% w/w) group, the group treated orally with CCl4 (100 mg/k...

  4. Liver cirrhosis and fatty liver

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970345 An experimental and clinical study on α1-adrenergic receptor of liver plasma membranes in cir-rhosis with portal hypertension. ZHANG Youcheng(张有成), et al. Dept Surg, People’s Hosp, Beijing MedUniv, Beijing, 100044 Chin J Dig 1996; 16(6): 332-335.

  5. Cirrhosis of the liver

    DEFF Research Database (Denmark)

    Bendtsen, Flemming; Larsen, Fin Stolze; Ott, Peter

    2014-01-01

    Cirrhosis of the liver is a frequent and dangerous disease that causes numerous clinical contacts due to its complications. Competent and fast clinical decisions are often necessary in the acute setting and a broad clinical approach for the long-term problems due to the co-morbidity. Danish...

  6. Hepatoprotective and antioxidant effects of single clove garlic against CCl4-induced hepatic damage in rabbits.

    Science.gov (United States)

    Naji, Khalid Mohammed; Al-Shaibani, Elham Shukri; Alhadi, Fatima A; Al-Soudi, Safa'a Abdulrzaq; D'souza, Myrene R

    2017-08-17

    The increase in demand and consumption of single clove garlic or 'Solo garlic' (Allium sativum) has resulted in an increase in research on its therapeutic properties. The present study aims to evaluate the antioxidant activities, oxidant-scavenging efficiency and preventive effects of SCG (single clove garlic) and MCG (multi clove garlic) on CCl4-induced acute hepatotoxicity in male rabbits. For this purpose, rabbits were orally administered with 3 ml of CCl4 /kg of body weight, followed by 0.8 g of MCG or SCG/kg twice a week for three successive weeks. Oxidative hepatotoxicity was then assessed. SCG extracts exhibited higher antioxidant capacity than the MCG extract. Scavenging ability of SCG showed significant (p garlic storage constituents varies with the number of cloves present. CCl4-induced hepatotoxicity demonstrated histological changes including severe damage in the structure of liver tissues which correlated well to oxidative stress levels. Simultaneously, administration of SCG resulted in a significant reduction of serum alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TB) levels in addition to improvement in some histological parameters. Low levels of lipid peroxidation (malondialdehyde, MDA) (p < 0.001), along with a huge reduction in peroxidase (POx) (p < 0.001) revealed protection against oxidative toxicity in the liver homogenate. Higher levels of catalase (CAT) (p < 0.001) and superoxide dismutase (SOD) (p < 0.05) when compared to the MCG test (TM) group indicates that removal of H2O2 is based on CAT activity in SCG test (TS) group rather than the POx activity demonstrated in the former group. The present study indicates that SCG possesses more protective ability than MCG against CCl4-induced liver injury and might be an effective alternative medicine against acute oxidative liver toxicity.

  7. Alterations of mast cells and TGF-β1 on the silymarin treatment for CCl4-induced hepatic fibrosis

    Institute of Scientific and Technical Information of China (English)

    Da-Hee Jeong; Gi-Ppeum Lee; Won-Il Jeong; Sun-Hee Do; Hai-Jie Yang; Dong-Wei Yuan; Ho-Yong Park; Kyu-Jong Kim; Kyu-Shik Jeong

    2005-01-01

    AIM: Silymarin is a potent antioxidant, antiinflammatory and anti-fibrogenic agent in the liver, which is mediated by alteration of hepatic Kupffer cell function, lipid peroxidation, and collagen production. Especially, in hepatic fibrogenesis, mast cells are expressed in chronic inflammatory conditions, and promote fibroblast growth and stimulate production of the extracellular matrix by hepatic stellate cells.METHODS: We examined the inhibitory mechanism of silymarin on CCl4-induced hepatic cirrhosis in rats. At 4, 8,and 12 wk, liver tissues were examined histopathologically for fibrotic changes produced by silymarin treatment.RESULTS: In the silymarin with CCl4-treated group,increase of hepatic stellate cells and TGF-β1 production were lower than in the CCl4-treated group at early stages.Additionally, at the late fibrogenic stage, expressions of TGF-β1 were weaker and especially not expressed in hepatocytes located in peripheral areas. Moreover, the number of mast cell in portal areas gradually increased and was dependent on the fibrogenic stage, but those of CCl4+silymarin-treated group decreased significantly.CONCLUSION: Anti-fibrotic and antiinflammatory effects of silymarin were associated with activation of hepatic stellate cells through the expression of TGF-β1 and stabilization of mast cells. These results suggest that silymarin prevent hepatic fibrosis through suppression of inflammation and hypoxia in the hepatic fibrogenesis.

  8. Ameliorative effects of 7-methylcoumarin and 7-methoxycoumarin against CCl4-induced hepatotoxicity in rats.

    Science.gov (United States)

    Sancheti, Sandesh; Sancheti, Shruti; Seo, Sung-Yum

    2013-01-01

    The available conventional remedies for the treatment of drug-induced liver diseases are highly inadequate and possess serious adverse effects; therefore, the development of new, effective drugs is considered necessary. This article explores the hepatoprotective and antioxidant potential of 7-methylcoumarin (MC) and 7-methoxycoumarin (MOC) in CCl(4)-induced hepatotoxicity in rats. MC and MOC individually, at doses of 50 and 100 mg/kg body weight, were administered orally once-daily for 7 days. The hepatoprotective activity was assessed using various biochemical parameters, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum bilirubin (TB), total protein (TP), and albumin (TA). Serum antioxidant enzyme [e.g., superoxide dismutase (SOD) and catalase (CAT)] levels were determined. Also, thiobarbituric-acid-related substances (TBARS) levels, along with histopathological studies of liver tissue, were scrutinized. Pretreatment with MC and MOC significantly decreased ALT, AST, and TB in the serum of CCl(4)-induced liver damaged rats in a dose-dependent manner. TA and TP levels in the serum were also restored significantly in all presupplemented MC and MOC groups. In addition, oxidative stress induced by CCl(4) was prevented significantly; thereby, increasing SOD and CAT levels and decreasing TBARS levels in liver homogenates. Histopathological studies revealed the ameliorative natures of both the compounds. This study demonstrates the strong hepatoprotective activity of MC and MOC, which could be attributed to their potent antioxidant effects.

  9. Liver cirrhosis and fatty liver

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930137 Effects of selective and non-selectiveβ-adrenoreceptor blockers on portal hemody-namics in patients with liver cirrhosis.HUANGTianwei(黄天卫),et al.1st Affili Hosp,DalianMed Coll.Chin J Digest 1992;12(3):145-147.Effects of selective(atenolol)and non-selec-tive(propranolol)β-adrenoreceptor blockerson portal hemodynamics in patients with livercirrhosis were measured by pulsed Doppler du-

  10. Ameliorative effect of alkaloid extract of Cyclea peltata (Poir.) Hook. f. & Thoms. roots (ACP) on APAP/CCl4 induced liver toxicity in Wistar rats and in vitro free radical scavenging property

    Institute of Scientific and Technical Information of China (English)

    Varghese Jancy Shine; Somasekharan Nair Rajam Suja; Gangadharan Indira Anuja; Gopan Raj; Sreedharan Nair Rajasekharan

    2014-01-01

    Objective: To evaluate the hepatoprotective and antioxidant properties of alkaloid extract of Cyclea peltata (C. peltata) against paracetamol/carbon tetra chloride induced liver damage in Wistar rats.Methods: In vivo paracetamol/carbon tetrachloride induced liver damage in Wistar rats, in vitro free radical scavenging studies, HPTLC estimation of tetrandrine and direct analysis in real time-mass spectrometry of alkaloid extract of C. peltata were used for the validation. Results: The results showed that pretreatment with alkaloid extract of C. peltata caused significant reduction of serum glutamate pyruvate transaminase, serum glutamate oxaloacetate transaminase, serum alkaline phosphatase, serum cholesterol, liver malondialdehyde levels. The reduced glutathione, catalase, superoxide dismutase levels in liver were increased with alkaloid extract of C. peltata treatment. These results were almost comparable to silymarin and normal control. Histopathological studies also substantiated the biochemical findings. The in vitro hydroxyl, superoxide and DPPH scavenging study of alkaloid extract of C. peltata showed significant free radical scavenging property.Conclusions:The hepatoprotective property of alkaloid extract of C. peltata against paracetamol/carbon tetrachloride may be due the synergistic action of alkaloids especially tetrandrine, fangchinoline through free radical scavenging and thus preventing oxidative stress.

  11. Ameliorative effect of Grewia tenax (Forssk) fiori fruit extract on CCl(4)-induced oxidative stress and hepatotoxicity in rats.

    Science.gov (United States)

    Al-Said, Mansour S; Mothana, Ramzi A; Al-Sohaibani, Mohammed O; Rafatullah, Syed

    2011-01-01

    The ethanol extract of Grewia tenax (GTE) fruit was tested for possible efficacy against carbon tetrachloride (CCl(4)) induced liver toxicity in Wistar albino rats. GTE at doses of 250 and 500 mg/kg were administered orally to CCl(4)-treated rats. Acute toxicity test and sleeping time determination were done with mice. The results showed that oral administration of GTE for 3 wk to rats significantly reduced the CCl(4)-induced elevated levels of serum glutamate oxaloacetate transaminase, glutamate pyruvate transaminase, gamma-glutamyl transferase, alkaline phosphatase, bilirubin, cholesterol, high-density lipoproteins, low-density lipoproteins, very low density lipoproteins, and triglycerides. Moreover, it was found that the treatment with GTE significantly elevated the hemoglobin level in serum and increased the nonprotein sulfhydryl and total protein contents in the liver tissue, and a significant diminution was observed in the CCl(4)-induced elevated levels of malondialdehyde in the liver tissue. The biochemical findings were supported by an evaluation with liver histopathology. Pentobarbital-induced prolongation of narcolepsy in mice was shortened significantly by the extract. The observed hepatoprotective effect is believed to occur due to antioxidant properties of the contents of G. tenax extract, which may provide a new drug to be used for fighting liver diseases and it validates its folkloric use in anemic and other conditions.

  12. Periodontal disease and liver cirrhosis

    DEFF Research Database (Denmark)

    Grønkjær, Lea Ladegaard

    2015-01-01

    OBJECTIVES: Studies suggest that periodontal disease, a source of subclinical and persistent infection, may be associated with various systemic conditions, including liver cirrhosis. The aim of this study was to examine the literature and determine the relationship between periodontal disease...... and liver cirrhosis and to identify opportunities and directions for future research in this area. METHODS: A systematic review of English articles in the PubMed, EMBASE, and Scopus databases was conducted using search terms including 'liver cirrhosis', 'end-stage liver disease', 'liver diseases', 'oral...... in patients with liver cirrhosis, measured with several different periodontal indices. The reported prevalence of periodontal disease in cirrhosis patients ranged from 25.0% to 68.75% in four studies and apical periodontitis was found in 49%-79% of the patients. One study found that mortality was lower among...

  13. Rebamipide retards CCl4-induced hepatic fibrosis in rats: Possible role for PGE2.

    Science.gov (United States)

    Zakaria, Sherin; El-Sisi, Alaa

    2016-07-01

    Prostaglandin E2 (PGE2) is a potent physiological suppressor of liver fibrosis. Because the anti-ulcer drug rebamipide can induce the formation of endogenous PGE2, this study investigated the potential effects of rebamipide on development of a hepatic fibrosis that was inducible by carbon tetrachloride (CCl4). Groups of Wistar rats received intraperitoneal (IP) injections of CCl4 (0.45 ml/kg [0.72 g CCl4/kg]) over the course of for 4 weeks. Sub-sets of CCl4-treated rats were also treated concurrently with rebamipide at 60 or 100 mg/kg. At 24 h after the final treatments, liver function and oxidative stress were indirectly assessed. The extent of hepatic fibrosis was evaluated using two fibrotic markers, hyaluronic acid (HA) and pro-collagen-III (Procol-III); isolated liver tissues underwent histology and were evaluated for interleukin (IL)-10 and PGE2 content. The results indicated that treatment with rebamipide significantly inhibited CCl4-induced increases in serum ALT and AST and also reduced oxidative stress induced by CCl4. Fibrotic marker assays revealed that either dose of rebamipide decreased the host levels of Procol-III and HA that had become elevated due to the CCl4. At the higher dose tested, rebamipide appeared to be able to permit the hosts to have a normal liver histology and to minimize any CCl4-induced collagen precipitation in the liver. Lastly, the use of rebamipide was seen to be associated with significant increases in liver levels of both PGE2 and the anti-inflammatory cytokine IL-10. Based on these findings, it is concluded that rebamipide can retard hepatic fibrosis induced by CCl4 and that this effect may, in part, be mediated by an induction of PGE2 and IL-10 in the liver itself.

  14. Inhibitory effects of four flavonoids on CCl4 induced liver fibrosis in mice%4种黄酮类化合物对CCl4致小鼠肝纤维化的防治作用

    Institute of Scientific and Technical Information of China (English)

    张硕; 洪波; 王庆林; 牛爱丽; 陈玉霜

    2012-01-01

    OBJECTIVE To study the effect of four flavonoids(apigenin,phloridzin,oligomeric proanthocyanidins and neohesperidin dihydrochaleone) on anti -hepatic fibrosis in mice. METHODS The experimental model mice of hepatic fibrosis was induced by CC14 105 male Kunming mice were randomly divided into 7 groups: normal control group, model group, colchicines group, apigenin group,phloridzin group,oligomeric proanthocyanidins group and neohesperidin dihydrochaleone group. All of them were sacrificed after five weeks of administration. The serum levels of ALT, AST,TP, ALB,HYP and liver index were determined. Liver tissue was handled with HE and Masson staining for hispathological study. RESULTS The four flavonoids significantly reduced the serum levels of ALT, AST,HYP and liver index. Histopathological observations showed that the four flavonoids could ameliorate the liver fibrosis in different degree. CONCLUSION The study showed that apigenin,phloridzin,oligomeric proanthocyanidins and neohesperidin dihydrochaleone had effect on preventing hepatic fibrosis.%目的 探讨芹菜素、根皮苷、原花青素和新橙皮苷二氢查尔酮等黄酮类化合物在CC14诱导的小鼠肝纤维化模型中的抗肝纤维化作用.方法 将♂昆明种小鼠105只随机均分为正常对照组、CCl4模型组、秋水仙碱组、芹菜素组、根皮苷组、原花青素组、新橙皮苷二氢查尔酮组.给药5周后采血并处死小鼠,测定并比较各组小鼠血清中丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)的活性,总蛋白(TP)、白蛋白(ALB)及肝组织中的羟辅氨酸(HYP)的含量,计算小鼠的肝指数,观察肝脏的病理变化.结果 4种黄酮类化合物均可使模型小鼠血清中ALT、AST的含量、肝组织中羟脯氨酸的含量降低;病检也证明各组小鼠的肝细胞变性、坏死和肝纤维化均有不同程度的减轻.结论 芹菜素、根皮苷、原花青素及新橙皮苷二氢查尔酮有抗CCl4致小鼠肝纤维化的作用.

  15. Liver cirrhosis and fatty liver

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930537 Preliminary report on portal hyperten-tion in liver cirrhosis treated by transjugular in-trahepatic portosystemic stent shunt(analysis of8 cases).XU Ke(徐克),et al.Dept Radiol,lst Hosp,China Med Univ,Shenyang,110001.Chin J Radiol 1993;25(5):294—297.Transjugular intrahepatic portosystemic stentshunt(TIPPS)was performed in 8 cases of livercirrhosis with portal hypertention.Moderate orsevere hemorrhage from gastroesophageal variceshad happened in all patients for 2~5 times beforTIPSS.The average pressure of portal veindropped from 3.80±0.50kPa to 2.58±0.26kPa.The diameter of the shunt established be-tween portal and hepatic veins was 10~12mm.Gastrointestinal bleeding and ascites were effec-

  16. Protective effect of alcoholic extract of Entada pursaetha DC. against CCl4-induced hepatotoxicity in rats.

    Science.gov (United States)

    Gupta, Gaurav; More, Amar Sunil; Kumari, Rashmi Rekha; Lingaraju, Madhu Cholenahalli; Kumar, Dhirendra; Kumar, Dinesh; Mishra, Santosh Kumar; Tandan, Surender Kumar

    2014-03-01

    The alcoholic extract of stem of E. pursaetha (PSE, 30, 100, 300 mg/kg body weight, po for 7 days) showed hepatoprotective activity against CCl4 (2 mL/kg body weight, ip)-induced hepatotoxicity. The extract exhibited a significant dose-dependent hepatoprotective effect comparable to standard drug silymarin, by preventing increase in serum levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total protein, and total bilirubin, lactate dehydrogenase; by lowering hepatic levels of malonaldehyde, nitrate-nitrite, myeloperoxidase activity; enhancing activities of antioxidant enzymes, superoxide dismutase, catalase and increasing reduced glutathione levels in liver, which suggests the antioxidant property of PSE. Histopathological studies also supported the above biochemical parameters. The results suggested that alcoholic extract of E. pursaetha possesses significant hepatoprotective activity in CCl4-induced acute hepatotoxicity in rats and this is likely to be mediated through its antioxidant activities.

  17. Attenuation of CCl4-induced hepatic fibrosis in mice by vaccinating against TGF-β1.

    Directory of Open Access Journals (Sweden)

    Xiaobao Fan

    Full Text Available Transforming growth factor β1 (TGF-β1 is the pivotal pro-fibrogenic cytokine in hepatic fibrosis. Reducing the over-produced expression of TGF-β1 or blocking its signaling pathways is considered to be a promising therapeutic strategy for hepatic fibrosis. In this study, we evaluated the feasibility of attenuating hepatic fibrosis by vaccination against TGF-β1 with TGF-β1 kinoids. Two TGF-β1 kinoid vaccines were prepared by cross-linking TGF-β1-derived polypeptides (TGF-β1(25-[41-65] and TGF-β1(30-[83-112] to keyhole limpet hemocyanin (KLH. Immunization with the two TGF-β1 kinoids efficiently elicited the production of high-levels of TGF-β1-specific antibodies against in BALB/c mice as tested by enzyme-linked immunosorbent assay (ELISA and Western blotting. The antisera neutralized TGF-β1-induced growth-inhibition on mink lung epithelial cells (Mv1Lu and attenuated TGF-β1-induced Smad2/3 phosphorylation, α-SMA, collagen type 1 alpha 2 (COL1A2, plasminogen activator inhibitor-1 (PAI-1 and tissue inhibitor of metalloproteinase-1 (TIMP-1 expression in the rat hepatic stellate cell (HSC line, HSC-T6. Vaccination against TGF-β1 with the kinoids significantly suppressed CCl4-induced collagen deposition and the expression of α-SMA and desmin, attenuated hepatocyte apoptosis and accelerated hepatocyte proliferation in BALB/c mice. These results demonstrated that immunization with the TGF-β1 kinoids efficiently attenuated CCl4-induced hepatic fibrosis and liver injury. Our study suggests that vaccination against TGF-β1 might be developed into a feasible therapeutic approach for the treatment of chronic fibrotic liver diseases.

  18. Oxymatrine improves intestinal epithelial barrier function involving NF-κB-mediated signaling pathway in CCl4-induced cirrhotic rats.

    Directory of Open Access Journals (Sweden)

    Jian-Bo Wen

    Full Text Available Accumulating evidence suggests that intestinal epithelial barrier dysfunction plays an important role in the pathogenesis of hepatic cirrhosis and its complications such as gastrointestinal injury and hepatic encephalopathy. To date, there is no cure for cirrhosis-associated intestinal mucosal lesion and ulcer. This study aimed to investigate the effect of oxymatrine on intestinal epithelial barrier function and the underlying mechanism in carbon tetrachloride (CCl4-induced cirrhotic rats. Thirty CCl4-induced cirrhotic rats were randomly divided into treatment group, which received oxymatrine treatment (63 mg/kg, and non-treatment group, which received the same dose of 5% glucose solution (vehicle. The blank group (n = 10 healthy rats received no treatment. Terminal ileal samples were collected for histopathological examination. The expression level of nuclear factor-κB (NF-κB p65 in ileal tissue was evaluated by immunohistochemistry. The gene and protein expression levels of tumor necrosis factor-α (TNF-α and interleukin 6 (IL-6 in ileal tissues were analyzed by reverse-transcriptase polymerase chain reaction (RT-PCR and enzyme-linked immunosorbent assay (ELISA, respectively. Additionally, plasma endotoxin level was determined. In comparison to the blank group, a significant alteration in the morphology of intestinal mucosal villi in the non-treatment group was observed. The intestinal mucosal villi were atrophic, shorter, and fractured, and inflammatory cells were infiltrated into the lamina propria and muscular layer. Besides, serious swell of villi and loose structure of mucous membrane were observed. Oxymatrine reversed the CCl4-induced histological changes and restored intestinal barrier integrity. Moreover, oxymatrine reduced the protein expression level of NF-κB p65, TNF-α, and IL-6, which were elevated in the vehicle-treated group. In addition, the serum endotoxin level was significantly decreased after oxymatrine treatment in

  19. Attenuation of CCl4-Induced Oxidative Stress and Hepatonephrotoxicity by Saudi Sidr Honey in Rats

    Directory of Open Access Journals (Sweden)

    Mohammed Al-Yahya

    2013-01-01

    Full Text Available The present study was undertaken to investigate the possible protective effect of Saudi Sidr honey (SSH on carbon tetrachloride (CCl4 induced oxidative stress and liver and kidney damage in rat. Moreover, the antioxidant activity and the phenolic and flavonoidal contents were determined. The hepatorenal protective activity of the SSH was determined by assessing biochemical, hematological, and histological parameters. Serum transaminases, ALP, GGT, creatinine, bilirubin urea, uric acid, and MDA level in liver and kidney tissues were significantly elevated, and the antioxidant status of nonprotein sulfhydryls, albumin, and total protein levels in liver and kidney were declined significantly in CCl4 alone treated animals. Pretreatment with SSH and silymarin prior to the administration of CCl4 significantly prevented the increase of the serum levels of enzyme markers and reduced oxidative stress. SSH also exhibited a significant lipid-lowering effect and caused an HDL-C enhanced level in serum. The histopathological evaluation of the liver and kidney also revealed that honey protected incidence of both liver and kidney lesions. Moreover, SSH showed a strong antioxidant activity in DPPH and β-carotene-linoleic acid assays. SSH was found to contain phenolic compounds. Additionally, the SSH supplementation restored the hepatocytes viability against 2′,7′-dichlorofluorescein (DCF toxicity in ex vivo test.

  20. Effect of Pleurotus citrinopileatus Polysaccharides on Antioxidant Enzyme Activities and Isozyme Profiles in Liver,Heart and Kidney of Mice with CCl_4-induced Acute Liver Injury%金顶侧耳多糖对CCl_4所致急性肝损伤小鼠肝、心、肾抗氧化酶活性及同工酶影响

    Institute of Scientific and Technical Information of China (English)

    刘俊; 陶明煊; 程光宇; 周斌

    2011-01-01

    Objective:To investigate the effect of Pleurotus citrinopileatus polysaccharides(PCP) on antioxidant enzyme activities and isozyme profiles in the liver,heart and kidney of mice with carbon tetrachloride-induced acute liver injury.Methods:Mice were randomly divided into 6 groups:control group,model group,drug group(bifendate pills,150 mg/(kg·d)),low-dose PCP group(100 mg/(kg·d)),medium-dose PCP group(200 mg/(kg·d)) and high-dose PCP group(400 mg/(kg·d)).All mice were administered for 30 consecutive days,and were fasted for 16 h after the end of the administration period before oral administration of CCl4 dispersed in salad oil for creating CCl4-inducedacute liver injury model.At 24 h postadministration,all mice were sacrificed to assay the activities of ALT,AST and antioxidant enzymes in the blood,liver,heart and kidney and analyze the isozyme profiles of CAT and SOD by gradientpolyacrylamide gel electrophoresis.Results:Compared with the control group,the model group exhibited a significant increase in the activities of serum ALT and AST and a significant decrease in the activities of the investigated antioxidant enzymes in the liver,heart and kidney of mice(P 0.05 or 0.01).PCP administration resulted in a significant decrease in the activities of serum ALT and AST,and the medium-dose and high-dose PCP group exhibited significantly increased activities of CAT,GSH-Px and MnSOD in the liver,heart and kidney and could resume their normal levels.One CAT band was detected in the liver,heart and kidney and CCl4-induced acute liver injury resulted in a significant decrease in its staining intensity.In contrast,the staining intensity of the band was restored to the normal level after PCP administration.Similarly,One MnSOD and three CuZnSOD were detected in the liver and kidney,and PCP administration resulted in an increase in the staining intensity of total SOD and MnSOD,one MnSOD and two CuZnSOD were detected in the

  1. Protective effect of Curcuma longa L. extract on CCl4-induced acute hepatic stress.

    Science.gov (United States)

    Lee, Geum-Hwa; Lee, Hwa-Young; Choi, Min-Kyung; Chung, Han-Wool; Kim, Seung-Wook; Chae, Han-Jung

    2017-02-01

    The Curcuma longa L. (CLL) rhizome has long been used to treat patients with hepatic dysfunction. CLL is a member of the ginger family of spices that are widely used in China, India, and Japan, and is a common spice, coloring, flavoring, and traditional medicine. This study was performed to evaluate the hepatoprotective activity of CLL extract and its active component curcumin in an acute carbon tetrachloride (CCl4)-induced liver stress model. Acute hepatic stress was induced by a single intraperitoneal injection of CCl4 (0.1 ml/kg body weight) in rats. CLL extract was administered once a day for 3 days at three dose levels (100, 200, and 300 mg/kg/day) and curcumin was administered once a day at the 200 mg/kg/day. We performed alanine transaminase (ALT) and aspartate transaminase (AST). activity analysis and also measured total lipid, triglyceride, and cholesterol levels, and lipid peroxidation. At 100 g CLL, the curcuminoid components curcumin (901.63 ± 5.37 mg/100 g), bis-demethoxycurcumin (108.28 ± 2.89 mg/100 g), and demethoxycurcumin (234.85 ± 1.85 mg/100 g) were quantified through high liquid chromatography analysis. In CCl4-treated rats, serum AST and ALT levels increased 2.1- and 1.2-fold compared with the control. AST but not ALT elevation induced by CCl4 was significantly alleviated in CLL- and curcumin-treated rats. Peroxidation of membrane lipids in the liver was significantly prevented by CLL (100, 200, and 300 mg/kg/day) on tissue lipid peroxidation assay and immunostaining with anti-4HNE antibody. We found that CLL extract and curcumin exhibited significant protection against liver injury by improving hepatic superoxide dismutase (p < 0.05) and glutathione peroxidase activity, and glutathione content in the CCl4-treated group (p < 0.05), leading to a reduced lipid peroxidase level. Our data suggested that CLL extract and curcumin protect the liver from acute CCl4-induced injury in a rodent model by suppressing hepatic

  2. A New Oleanolic Acid Derivative against CCl4-Induced Hepatic Fibrosis in Rats

    Directory of Open Access Journals (Sweden)

    Hongjun Xiang

    2017-03-01

    Full Text Available A novel hepatoprotective oleanolic acid derivative, 3-oxours-oleana-9(11, 12-dien-28-oic acid (Oxy-Di-OA, has been reported. In previous studies, we found that Oxy-Di-OA presented the anti-HBV (Hepatitis B Virus activity (IC50 = 3.13 µg/mL. Remarkably, it is superior to lamivudine in the inhibition of the rebound of the viral replication rate. Furthermore, Oxy-Di-OA showed good performance of anti-HBV activity in vivo. Some studies showed that liver fibrosis may affiliate with HBV gene mutations. In addition, the anti-hepatic fibrosis activity of Oxy-Di-OA has not been studied. Therefore, we evaluated the protective effect of Oxy-Di-OA against carbon tetrachloride (CCl4-induced liver injury in rats. Daily intraperitoneally administration of Oxy-Di-OA prevented the development of CCl4-induced liver fibrosis, which was evidenced by histological study and immunohistochemical analysis. The entire experimental protocol lasted nine weeks. Oxy-Di-OA significantly suppressed the increases of plasma aspartate aminotransferase (AST and alanine aminotransferase (ALT levels (p < 0.05. Furthermore, Oxy-Di-OA could prevent expression of transforming growth factor β1 (TGF-β1. It is worth noting that the high-dose group Oxy-Di-OA is superior to bifendate in elevating hepatic function. Compared to the model group, Oxy-Di-OA in the high-dose group and low-dose group can significantly reduce the liver and spleen indices (p < 0.05. The acute toxicity test showed that LD50 and a 95% confidence interval (CIs value of Oxy-Di-OA were 714.83 mg/kg and 639.73–798.73 mg/kg via intraperitoneal injection in mice, respectively. The LD50 value of Oxy-Di-OA exceeded 2000 mg/kg via gavage in mice. In addition, a simple and rapid high performance liquid chromatography-ultraviolet (HPLC-UV method was developed and validated to study the pharmacokinetic characteristics of the compound. After single-dose oral administration, time to reach peak concentration of Oxy-Di-OA (Cmax

  3. Protective effects of seed melon extract on CCl4-induced hepatic fibrosis in mice.

    Science.gov (United States)

    Zhan, Yuan-Yuan; Wang, Jin-Hui; Tian, Xing; Feng, Shi-Xiu; Xue, Lin; Tian, Li-Ping

    2016-12-04

    Citrullus lanatus ssp. vulgaris var. megalaspermus Lin et Chao, was also known as watermelon belongs to family Cucurbitaceae, variously used as healthy food and in the treatment of liver and lungs problems. Currently, Citrullus lanatus has become a major economic crop of medicinal and edible effects with regional characteristics. This study was designed to evaluate the hepatoprotective and antioxidant activity of the seed melon (Citrullus lanatus ssp. vulgaris var. megalaspermus Lin et Chao) extract (SME) against carbon tetrachloride (CCl4) induced hepatic fibrosis in mice. In this study, mice were randomly divided into 7 groups, including normal control, model, silymarin tablets as the positive control, SME 100, 200, 400, and 800mg/kg. After 8 weeks, activities of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglycerides (TG), hyaluronic acid (HA) and laminin (LN) were checked. The levels of antioxidant enzymes such as superoxide dismutase (SOD), glutataion (GSH) and glutathione peroxidase (GSH-Px) were determined after SME administration. The hydroxyproline (HYP) levels, malondialdehyde (MDA) levels and histopathologic examinations of hepatocyte fibrosis were also determined. Additionally, effects of SME on alpha-smooth muscle actin (α-SMA) and transforming growth factor beta-1(TGF-β1) protein expressions were determined. We found that SME could significantly lower the serum levels of hepatic enzyme markers AST, ALT, HA and LN (P<0.01). Compared with the CCl4-only treatment group, levels of hepatic SOD and GSH-Px were significantly increased, and the MDA levels were remarkably decreased in mice treated by SME at medium dose (400mg/kg) and high dose (800mg/kg) (P<0.01). A histological examination of the liver showed that lesions, including necrosis, lymphocyte infiltration and fatty degeneration, were partially healed by treatment with SME. The results of protein expressions studies displayed that SME could inhibit α-SMA and TGF-β1

  4. Hepatoprotective potential of kumaryasava and its concentrate against CCl4-induced hepatic toxicity in Wistar rats

    Science.gov (United States)

    Khan, Mohammad Ahmed; Gupta, Arun; Sastry, J. L. N.; Ahmad, Sayeed

    2015-01-01

    Objective: Kumaryasava (KS) is a marketed Ayurvedic formulation containing Aloe vera as the main ingredient. It has been used widely for the treatment of liver disorders; however, there is a lack of modern scientific data on hepatoprotection. The recommended dose of KS is high and up to 60 mL/day. The present study describes the preparation of new KS concentrate and evaluation of comparative hepatoprotective activity of KS and prepared KS concentrate at one-third of KS dose against CCl4-induced hepatic toxicity. Materials and Methods: Animals were divided into different groups (n = 6). The first group received normal saline (control) 1.0 mL/Kg/day p.o. for 10 days. The second group (toxicant) was given normal saline 1.0 mL/Kg/day p.o. for 10 days with CCl4 in olive oil (1:1 v/v) at 1.0 mL/Kg/day p.o. Third, fourth, and fifth groups received KS, KS concentrate and a marketed formulation as standard) at doses of 5.0 mL/Kg/day p.o., 1.6 mL/Kg/day p.o., and 100 mL/Kg/day p.o. (tablet suspended in water using 0.1% carboxymethyl cellulose) respectively for 10 days along with CCl4 as given to the toxicant group. On the 11th day, blood was withdrawn from retro-orbital plexus and serum was separated for biochemical estimation of serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), alkaline phosphatase (ALP), and albumin levels. Later, animals were sacrificed under high dose of anesthesia to remove liver tissue, which were removed and washed with ice cold saline for the estimation of lipid peroxidation. Liver tissue from each group was also fixed in 10% formalin for histopathological analysis. Results: Results demonstrated that both KS and KS concentrate showed the protection against CCl4-induced hepatic toxicity. This was evident from the reduction in serum SGOT, SGPT, ALP levels, and elevation in serum albumin levels observed post treatment of CCl4 treated rats with KS and KS concentrate, which were supported by histopathological data

  5. Effect of leaf extracts of Taraxacum officinale on CCl4 induced hepatotoxicity in rats, in vivo study.

    Science.gov (United States)

    Gulfraz, Muhammad; Ahamd, Dawood; Ahmad, Muhammad Sheeraz; Qureshi, Rehmatullah; Mahmood, Raja Tahir; Jabeen, Nyla; Abbasi, Kashif Sarfraz

    2014-07-01

    Taraxacum officinale L is a medicinal plant, which has enormous medicinal values against various types of liver disorders and it has traditionally been used for the treatment of liver problems by people from the South East Asia. Previously we have screened the crude methanolic extract of T. officinale against cytotoxicity induced by CCl4. Present study was designed to compare the protective effect of ethanolic and n-hexane extract of leaves in carbon tetrachloride (CCl4) induced liver toxicity in rats. The extract (200 mg/kg and 400mg/kg body weight) along with silymarin (100 mg/kg) a standard drug was administered to experimental animals. It was observed that ethanolic plant extract has significantly reduced the negative effect of CCl4 as compared to n-hexane extract and effect of extract was increased with increasing dose level. Although both leaf extracts decreased the concentration of TBARS, H2O2 and nitrite contents which enhance due to CCl4 toxicity but effect was higher in ethanolic extract. The results clearly indicated that Taraxacum officinale ethanolic leaves extract has better protective effect against CCl4 induced liver tissues toxicity. This claim was also supported by histopathological results obtained during this study and this might be due to presence of various polar phytochemicals that might be more prevent in this extract.

  6. Arrhythmia risk in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Ioana Mozos

    2015-01-01

    Interactions between the functioning of the heart andthe liver have been described, with heart diseasesaffecting the liver, liver diseases affecting the heart,and conditions that simultaneously affect both. Theheart is one of the most adversely affected organs inpatients with liver cirrhosis. For example, arrhythmiasand electrocardiographic changes are observed inpatients with liver cirrhosis. The risk for arrhythmia isinfluenced by factors such as cirrhotic cardiomyopathy,cardiac ion channel remodeling, electrolyte imbalances,impaired autonomic function, hepatorenal syndrome, metabolic abnormalities, advanced age, inflammatory syndrome, stressful events, impaired drug metabolism and comorbidities. Close monitoring of cirrhotic patients is needed for arrhythmias, particularly when QT intervalprolonging drugs are given, or if electrolyte imbalances or hepatorenal syndrome appear. Arrhythmia risk may persist after liver transplantation due to possible QT interval prolongation, persistence of the parasympathetic impairment, post-transplant reperfusion and chronic immunosuppression, as well as consideration of the fact that the transplant itself is a stressful event for the cardiovascular system. The aims of the present article were to provide a review of the most important data regarding the epidemiology, pathophysiology, and biomarkers of arrhythmia risk in patients with liver cirrhosis, to elucidate the association with long-term outcome, and to propose future research directions.

  7. Antioxidant Potential of Plumieride against CCl4-Induced Peroxidative Damage in Rats

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    Dharmendra Singh

    2014-11-01

    Full Text Available In search of a new potent as an antioxidant from natural sources, plumieride—an iridoid isolated from the methanol extract of the bark of Plumeria bicolor (family Apocynaceae was evaluated for its antioxidant potential against CCl4-induced peroxidative damage in liver of rats. The antioxidant potential was evaluated by using hepatic tissue for SOD (superoxide dismutase, CAT (catalase, GSH (reduced glutathione, GPx (glutathione peroxidase, GR (glutathione reductase and LPO (lipid peroxidation alongwith the concomitant blood serum for AST & ALT (aspartate and alanine transaminases, GGT (gamma glutamyl transpeptidase, ALP (alkaline phosphatase, total bilirubin and total protein contents. All the biochemical parameters were significantly (p ≤ 0.001 altered by CCl4 (0.3 mL/kg body weight/twice a week, intra-peritoneally for 30 days. Simultaneously, oral treatment with plumieride (5, 10 and 20 mg/kg body weight/day for 30 days, restored all the parameters towards a normal level, remarkably. The histological findings of liver sections further corroborated the antioxidant potential of plumieride compared with standard drug-silymarin. In conclusion, plumieride consists of sugar molecules, which have alcoholic groups. Therefore, the alcoholic groups of sugar increase its antioxidant potential through intermolecular hydrogen bonding along with the thiol(SH group of non-protein thiols and enzymes resulting in the restoration of the antioxidant system. Therefore, it might be considered a natural antioxidant against peroxidative damage in rats.

  8. Bamboo salt attenuates CCl4-induced hepatic damage in Sprague-Dawley rats.

    Science.gov (United States)

    Zhao, Xin; Song, Jia-Le; Kil, Jeung-Ha; Park, Kun-Young

    2013-08-01

    Bamboo salt, a Korean folk medicine, is prepared with solar salt (sea salt) and baked several times at high temperatures in a bamboo case. In this study, we compared the preventive effects of bamboo salt and purified and solar salts on hepatic damage induced by carbon tetrachloride in Sprague-Dawley rats. Compared with purified and solar salts, bamboo salts prevented hepatic damage in rats, as evidenced by significantly reduced serum levels of aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase (P Bamboo salt (baked 9×) triggered the greatest reduction in these enzyme levels. In addition, it also reduced the levels of the proinflammatory cytokines interleukin (IL)-6, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α. Histopathological sections of liver tissue demonstrated the protective effect of bamboo salt, whereas sections from animals treated with the other salt groups showed a greater degree of necrosis. We also performed reverse transcription-polymerase chain reaction and western blot analyses of the inflammation-related genes iNOS, COX-2, TNF-α, and IL-1β in rat liver tissues. Bamboo salt induced a significant decrease (~80%) in mRNA and protein expression levels of COX-2, iNOS, TNF-α, and IL-1β, compared with the other salts. Thus, we found that baked bamboo salt preparations could prevent CCl4-induced hepatic damage in vivo.

  9. Protective Effect of Cornus mas Fruits Extract on Serum Biomarkers in CCl4-Induced Hepatotoxicity in Male Rats.

    Science.gov (United States)

    Alavian, Seyed Moayed; Banihabib, Nafiseh; Es Haghi, Masoud; Panahi, Farid

    2014-04-01

    Nowadays attention to use herbs such as cornelian cherry (Cornus mas) is increasing, which contains high levels of antioxidants and anthocyanins. Cornus mas fruits have been used for gastrointestinal and excretory disorders for many years in traditional medicine, also may improve liver and kidney functions, and have protective effects such as anti-allergic, antidiabetic, antibacterial, antimicrobial, antihistamine and antimalarial properties. The aim of this study was to investigate protective effects of Cornus mas fruits extract on serum biomarkers in CCl4-induced hepatotoxicity in male rats. Hepatotoxicity was induced by administration of carbon tetrachloride (1 mL/kg i.p.) in 1:1 dilution with olive oil. To evaluate the effect of Cornus mas fruits extract on disease progression, serum marker enzymes, serum total protein and albumin and liver lipid peroxidation were determined in CCl4-induced hepatotoxicity. Oral administration of Cornus mas fruits extract to rats for 14 days provided a significant (P mas fruit extract effect may be due to including some antioxidant components, which caused membrane stabilizing and normalization of fluctuated biochemical profiles induced by CCl4 exposure. Our results validated the traditional use of Cornus mas in the treatment of liver disorders.

  10. Biochemical and molecular modulation of CCl4-induced peripheral and central damage by Tilia americana var. mexicanaextracts.

    Science.gov (United States)

    Coballase-Urrutia, Elvia; Cárdenas-Rodríguez, Noemí; González-García, María Carolina; Núñez-Ramírez, Eithan; Floriano-Sánchez, Esaú; González-Trujano, María Eva; Fernández-Rojas, Berenice; Pedraza-Chaverrí, José; Montesinos-Correa, Hortencia; Rivera-Espinosa, Liliana; Sampieri, Aristides Iii; Carmona-Aparicio, Liliana

    2017-03-01

    Around the world, species from the genus Tilia are commonly used because of their peripheral and central medicinal effects; they are prepared as teas and used as tranquilizing, anticonvulsant, and analgesic agents. In this study, we provide evidence of the protective effects of organic and aqueous extracts (100 mg/kg, i.p.) obtained from the leaves of Tilia americana var. mexicana on CCl4-induced liver and brain damage in the rat. Protection was observed in the liver and brain (cerebellum, cortex and cerebral hemispheres) by measuring the activity of antioxidant enzymes and levels of malondialdehyde (MDA) using spectrophotometric methods. Biochemical parameters were also assessed in serum samples from the CCl4-treated rats. The T. americana var. mexicana leaf extracts provided significant protection against CCl4-induced peripheral and central damage by increasing the activity of antioxidant enzymes, diminishing lipid peroxidation, and preventing alterations in biochemical serum parameters, such as the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), γ-globulin (γ-GLOB), serum albumin (ALB), total bilirubin (BB), creatinine (CREA) and creatine kinase (CK), relative to the control group. Additionally, we correlated gene expression with antioxidant activity in the experimental groups treated with the organic and aqueous Tilia extracts and observed a non-statistically significant positive correlation. Our results provide evidence of the underlying biomedical properties of T. americana var. mexicana that confer its neuro- and hepatoprotective effects.

  11. Biochemical and molecular modulation of CCl4-induced peripheral and central damage by Tilia americana var. mexicana

    Directory of Open Access Journals (Sweden)

    Elvia Coballase-Urrutia

    2017-03-01

    Full Text Available Around the world, species from the genus Tilia are commonly used because of their peripheral and central medicinal effects; they are prepared as teas and used as tranquilizing, anticonvulsant, and analgesic agents. In this study, we provide evidence of the protective effects of organic and aqueous extracts (100 mg/kg, i.p. obtained from the leaves of Tilia americana var. mexicana on CCl4-induced liver and brain damage in the rat. Protection was observed in the liver and brain (cerebellum, cortex and cerebral hemispheres by measuring the activity of antioxidant enzymes and levels of malondialdehyde (MDA using spectrophotometric methods. Biochemical parameters were also assessed in serum samples from the CCl4-treated rats. The T. americana var. mexicana leaf extracts provided significant protection against CCl4-induced peripheral and central damage by increasing the activity of antioxidant enzymes, diminishing lipid peroxidation, and preventing alterations in biochemical serum parameters, such as the levels of aspartate aminotransferase (AST, alanine aminotransferase (ALT, alkaline phosphatase (ALP, γ-globulin (γ-GLOB, serum albumin (ALB, total bilirubin (BB, creatinine (CREA and creatine kinase (CK, relative to the control group. Additionally, we correlated gene expression with antioxidant activity in the experimental groups treated with the organic and aqueous Tilia extracts and observed a non-statistically significant positive correlation. Our results provide evidence of the underlying biomedical properties of T. americana var. mexicana that confer its neuro- and hepatoprotective effects.

  12. Lygodium flexuosum extract down regulates the expression of proinflammatory cytokines in CCl4 -induced hepatotoxicity

    Institute of Scientific and Technical Information of China (English)

    Pallara Janardhanan Wills; Velikkakathu Vasumathi Asha

    2012-01-01

    Objective:To examine the downregulation of proinflammatory cytokines in a time dependant manner on carbon tetrachloride induced toxicity in experimental animals.Methods:CCl4(150 μL/100 g) was dissolved in corn oil(1:1 v/v%) and administered orally.GroupI was treated as normal control and received corn oil on8th day.GroupII was toxic control and was given a single dose ofCCl4 on8th days.GroupIII wastreated withLygodium flexuosum(L. flexuosum)n-hexane extract(200 mg/kg) for8 days and on8th day a single dose ofCCl4 was received.GroupIV(negative control) receivedL. flexuosumn-hexane extract(200 mg/kg) alone for8 days.Results:Treatment withn-hexane extract prior to the administration ofCCl4 significantly prevented an increase in serumAST,ALT,LDH activity and lipid peroxidation and prevented the depletion of glutathione (GSH).Rats treated withL. flexuosum had reduced mRNA levels ofTGF-β1,TNF-α andIL-1βgenes in liver ofCCl4 intoxicated rats when compared toCCl4 control as evidenced byRT-PCR. Conclusions:The data suggest that L. flexuosum, a widely available fern, significantly reduces CCl4 induced acute hepatotoxicity by down-regulating the expression of pro-inflammatory cytokines in rats.

  13. Snailase Preparation of Ginsenoside M1 from Protopanaxadiol-Type Ginsenoside and Their Protective Effects Against CCl4-Induced Chronic Hepatotoxicity in Mice

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    Li Chen

    2011-12-01

    Full Text Available To investigate the protective effects of protopanaxadiol-type ginsenoside (PDG and its metabolite ginsenoside M1 (G-M1 on carbon tetrachloride (CCl4-induced chronic liver injury in ICR mice, we carried out conversion of protopanaxadiol-type ginsenosides to ginsenoside M1 using snailase. The optimum time for the conversion was 24 h at a constant pH of 4.5 and an optimum temperature of 50 °C. The transformation products were identified by high-performance liquid chromatography and electrospray ion-mass spectrometry. Subsequently, most of PDG was decomposed and converted into G-M1 by 24 h post-reaction. During the study on hepatoprotective in a mice model of chronic liver injury, PDG or G-M1 supplement significantly ameliorated the CCl4-induced liver lesions, lowered the serum levels of select hepatic enzyme markers (alanine aminotransferase, ALT, and aspartate aminotransferase, AST and malondialdehyde and increased the activity of superoxide dismutase in liver. Histopathology of the liver tissues showed that PDG and G-M1 attenuated the hepatocellular necrosis and led to reduction of inflammatory cell infiltration. Therefore, the results of this study show that PDG and G-M1 can be proposed to protect the liver against CCl4-induced oxidative injury in mice, and the hepatoprotective effect might be attributed to amelioration of oxidative stress.

  14. Liver cirrhosis and fatty liver

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008075 Effect of Jiangzhi granules on expression of leptin receptor mRNA, P-JAK2 and P-STAT3 in rats with non-alcoholic fatty liver disease. MA Zansong(马赞颂), et al. Dept Gastroenterol, Instit Spleen and Stomach Dis, Longhua Hosp. Shanghai TCM Univ, Shanghai 200032.World Chin J Digestol 2007;15(32):3360-3366. Objective To study the effect of Jiangzhi granules on non-alcoholic fatty liver disease in rats, and on the expression of

  15. Insulin resistance in liver cirrhosis.

    Science.gov (United States)

    Goral, Vedat; Atalay, Roni; Kucukoner, Mehmet; Kucukoren, Mehmet

    2010-01-01

    Liver cirrhosis is a chronic disease by degeneration, regeneration and fibrosis in the liver parenchyma, caused by many diseases. Insulin resistance can be defined as any type of decrease in the effect that may occur at the phases following insulin's secretion from beta-cells of the pancreas, where it is produced, until it has the expected effects in the target cells. The aim of the present study is to demonstrate the presence of insulin resistance in LC, which is common in our country and region, and investigate the existence of association between insulin resistance occuring in LC and cytokine levels, age, gender, CRP, Hs-CRP, Child-Pugh score and etiology of LC. A total of 79 patients with liver cirrhosis (group 1) were included in the study, and 50 subjects as controls (group 2). Of liver cirrhosis patients, 49 (62%) were male and 30 (38%) were female, with a mean age of 54.71 +/- 14.68. Of the controls, 23 (46%) were male and 27 (54%) were female, with a mean age of 41.9 +/- 11.54. Severity of cirrhosis was assessed by Modified Child-Turcoutte-Pugh score. Seven cases (8.9%) were at the Child-Pugh stage A, 35 cases (44.3%) at the Child-Pough stage B, and 37 cases (46.8%) at the Child-Pough stage C. HOMA-IR was calculated and values > 2.7 were regarded as presence of insulin resistance (HOMA-IR +). Serum glucose, albumin, bilirubin values were studied with enzymatic method (Architect C-16000); serum CRP, Hs-CRP values with nephelometric method by Beckman Coulter Image Nephelometer (immunochemistry system); insulin, C-peptide with electrochemiluminance immunological method; prothrombin time with radiation method by ACL-Advance brand device. In this study, glucose (p = 0.004), insulin (p = 0.010), C-peptide (p 0.05) levels.

  16. Hemostatic abnormalities in liver cirrhosis

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    Kendal YALÇIN

    2009-06-01

    Full Text Available In this study, 44 patients with liver cirrhosis were investigated for hemostatic parameters. Patients with spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome and cholestatic liver diseases were excluded. Patients were classified by Child-Pugh criterion and according to this 4 patients were in Class A, 20 in Class B and 20 in C. Regarding to these results, it was aimed to investigate the haematological disturbances in liver cirrhotic patients.In the result there was a correlation between activated partial thromboplastin time, serum iron, ferritin, transferrin, haptoglobin and Child-Pugh classification. Besides there was no correlation between prothrombin time, factor 8 and 9, protein C and S, anti-thrombin 3, fibrinogen, fibrin degradation products, serum iron binding capacity, hemoglobin, leukocyte, mean corpuscular volume and Child-Pugh classification.There were significant difference, in terms of AST, ferritin, haptoglobulin, sex and presence of ascites between groups (p0.05. In the summary, we have found correlation between hemostatic abnormalities and disease activity and clinical prognosis in patients with liver cirrhosis which is important in the management of these patients. This is also important for identification of liver transplant candidiates earlier.

  17. Evaluation of protective effect of Sapindus mukorossi saponin fraction on CCl4-induced acute hepatotoxicity in rats

    Science.gov (United States)

    Rao, M Srinivasa; Asad, B Syed; Fazil, MA; Sudharshan, RD; Rasheed, SA; Pradeep, HA; Aboobacker, S; Thayyil, AH; Riyaz, AK; Mansoor, M; Aleem, MA; Zeeyauddin, K; Narasu, M Lakshmi; Anjum, A; Ibrahim, M

    2012-01-01

    Aim This investigation aimed to assess the hepatoprotective effect of saponin fraction isolated from the fruit pericarp of Sapindus mukorossi on carbon tetrachloride (CCl4)-induced hepatotoxicity. Methods Fruit of S. mukorossi was collected and authenticated, and dried pericarp powder subjected to extraction with cold ethanol (70%) by maceration followed by isolation of total saponin fraction. Hepatoprotective activity was demonstrated in the CCl4-damaged primary monolayer culture. In in vivo studies, pretreatment with total saponin fraction (50,100 and 150 mg/kg per os once a day for 4 days before CCl4 introduction and continued afterward for 3 days) attenuated the CCl4-induced acute increase in serum glutamic pyruvic transaminase, serum glutamic oxaloacetic transaminase, and alkaline phosphatase activities and considerably reduced histopathological alterations. Further, saponin fraction reduced thiopentone-induced (4 mg/kg, intraperitoneal) sleeping time in rats. Results Saponin fraction pretreatment improves bromsulphalein clearance and also increases cellular viability. Saponin administration replenished depleted hepatic glutathione and superoxide dismutase by improving the antioxidant status of the liver and liver function enzymes. These effects substantiate protection of cellular phospholipids from peroxidative damage induced by highly reactive toxic intermediate radicals formed during biotransformation of CCl4. Conclusion The above findings lead to the conclusion that the saponin fraction of S. mukorossi has a protective capability both in vitro on primary hepatocyte cultures and in vivo in a rat model of CCl4-mediated liver injury. Hence, we suggest that the inclusion of this S. mukorossi fruit pericarp in the management of liver disorders is justified. PMID:22888266

  18. Hepatoprotection with a chloroform extract of Launaea procumbens against CCl4-induced injuries in rats

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    Khan Rahmat A

    2012-08-01

    Full Text Available Abstract Background Launaea procumbens (Asteraceae is used as a folk medicine to treat hepatic disorders in Pakistan. The effect of a chloroform extract of Launaea procumbens (LPCE was evaluated against carbon-tetrachloride (CCl4-induced liver damage in rats. Methods To evaluate the hepatoprotective effects of LPCE, 36 male Sprague–Dawley rats were equally divided into six groups. Animals of group 1 (control had free access to food and water. Group II received 3 ml/kg of CCl4 (30% in olive oil v/v via the intraperitoneal route twice a week for 4 weeks. Group III received 1 ml of silymarin via gavage (100 mg/kg b.w. after 48 h of CCl4 treatment whereas groups IV and V were given 1 ml of LPCE (100 and 200 mg/kg b.w., respectively after 48 h of CCl4 treatment. Group VI received 1 ml of LPCE (200 mg/kg b.w. twice a week for 4 weeks. The activities of the antioxidant enzymes catalase, peroxidase (POD, superoxide dismutase (SOD, glutathione peroxidase (GSH-Px, glutathione S-transferase (GST, glutathione reductase (GSR, glutathione (GSH and lipid peroxidation (thiobarbituric acid reactive substances (TBARS were measured in liver homogenates. DNA damage, argyrophilic nucleolar organizer regions (AgNORs counts and histopathology were studied in liver samples. Serum was analyzed for various biochemical parameters. Phytochemical composition in LPCE was determined through high-performance liquid chromatography (HPLC. Results LPCE inhibited lipid peroxidation, and reduced the activities of aspartate transaminase, alanine transaminase, alkaline phosphatase, and lactate dehydrogenase in serum induced by CCl4. GSH contents were increased as were the activities of antioxidant enzymes (catalase, SOD, GST, GSR, GSH-Px when altered due to CCl4 hepatotoxicity. Similarly, absolute liver weight, relative liver weight and the number of hepatic lesions were reduced with co-administration of LPCE. Phyochemical analyses of LPCE indicated that it contained catechin

  19. Suppressive effects of 17β-estradiol on hepatic fibrosis in CCl4-induced rat model

    Institute of Scientific and Technical Information of China (English)

    Qing-Hua Liu; Ding-Guo Li; Xin Huang; Chun-Hua Zong; Qin-Fang Xu; Han-Ming Lu

    2004-01-01

    AIM: To investigate the pathway via which 17β-estradiol (β-Est) exerts suppressive effects on rat hepatic fibrosis.METHODS: In vivo study was done in CCl4-induced female hepatofibrotic rats. Fibrosis-suppressive effect of β-Est rat models. Six weeks after the treatment, all the rats were sacrificed and specimens of serum or liver tissue were collected for the studies. Serum liver enzymes,fibrosis markers and estradiol levels were determined by standard enzymatic methods, ELISA and RIA, respectively.Degrees of fibrosis and areas of hepatic stellate cells (HSCs) positive for alpha-smooth muscle actin (α-SMA) in the liver were determined by van Gieson (VG) stain and immunohistochemistry.In vitro studies, HSCs were isolated by a combination of pronase-collagenase perfusion and density gradient centrifugation. First-passage HSCs were randomly divided into 10 groups, and different concentrations of β-Est, 2-hydroxyestradiol (2OHE) or 2-methoxyestradiol (2MeOE) were separately added to the cell groups. After incubation for 72 h, the degree of cell proliferation, collagen production, α-SMA or estrogen receptor (ER) expression was determined by MTT assay, ELISA and immunohistochemistry,respectively.RESULTS: β-Est treatment reduced aspartate aminotransferase (AST), alanine aminotransferase (ALT), hyaluronic acid (HA) and type Ⅳ collagen (C Ⅳ) in sera, suppressed hepatic collagen content, decreased the areas of HSCs positive for α-SMA significantly in both intact and ovariectomized female hepatofibrotic rats. There was a negative correlation between the percentage of fibrotic area of liver tissue and the serum estradiol level; the calculated correlation coefficient was -0.57 (P<0.01). β-Est and its metabolites concentration-dependently (10-9 mol/L-10-7 mol/L) inhibited HSC proliferation and collagen synthesis. At the concentration of 10-7 mol/L, they could inhibit α-SMA expression. The order of potency was 2MeOE>2OHE>β-Est.CONCLUSION: β-Est may suppress

  20. The Protective Effect of Liquorice Plant Extract on CCl4-Induced Hepatotoxicity in Common Carp (Cyprinus carpio

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    Hassan Malekinejad

    2010-12-01

    Full Text Available The protective effect of liquorice plant extract (LPE on CCl4-induced hepatotoxicity in common carp was evaluated using fifty adult carps. The fish were cultured in a standard environment in terms of water flow rate, oxygen, pH, food and temperature. The fish were assigned into 5 groups (N = 10 as control, sham, and tests. The test groups were pre-treated for 3 h with various concentrations of LPE, 3 days before CCl4 exposure. The control and sham groups received normal saline before and after CCl4 exposure. To induce hepatotoxicity, animals in the sham and test groups were exposed against 100 l L-1 CCl4 for 45 min. The fish in all groups 1 h after CCl4 exposure were anesthetized and the blood samples were collected. Immediately the liver specimens were dissected out and were stored in 10 % formalin for further pathological studies. Determination of serum level of ALP and SGOT revealed that acute form of CCl4 exposure elevated significantly (P < 0.05 the serum level of either tested hepatic marker enzymes. While 3 days pretreatment with LPE prevented from ALP and SGOT enhancement. The pathological evaluation revealed that the CCl4 exposure resulted in a minor pathologic manifestation such as slight congestion, which the LPE pretreated groups showed the remarkable improvement. The anti-oxidant capacity of LPE was assayed by FRAP and DPPH methods. Both provided techniques showed that LPE exerts an excellent anti-oxidant effect. This data suggest that LPE exerts protective effect against CCl4-induced hepatotoxicity. Moreover, the hepatoprotective effect of LPE may attribute to its antioxidant capacity.

  1. Isorhamnetin-3-O-galactoside Protects against CCl4-Induced Hepatic Injury in Mice

    OpenAIRE

    Kim, Dong-Wook; Cho, Hong-Ik; Kim, Kang-Min; Kim, So-Jin; Choi, Jae Sue; Kim, Yeong Shik; Lee, Sun-Mee

    2012-01-01

    This study was performed to examine the hepatoprotective effect of isorhamnetin-3-O-galactoside, a flavonoid glycoside isolated from Artemisia capillaris Thunberg (Compositae), against carbon tetrachloride (CCl4)-induced hepatic injury. Mice were treated intraperitoneally with vehicle or isorhamnetin-3-O-galactoside (50, 100, and 200 mg/kg) 30 min before and 2 h after CCl4 (20 μl/kg) injection. Serum aminotransferase activities and hepatic level of malondialdehyde were significantly higher af...

  2. Smoking and risk of liver cirrhosis

    DEFF Research Database (Denmark)

    Dam, Marie Kamstrup; Flensborg-Madsen, Trine; Eliasen, Marie;

    2013-01-01

    Abstract Objective. Alcohol is the most acknowledged risk factor for liver cirrhosis. Smoking is rarely considered to be a cause of liver cirrhosis even though a few studies have suggested the opposite. The aim of this study was to assess the independent effect of smoking on alcoholic liver...... cirrhosis and liver cirrhosis in general. Materials and methods. The authors used data from the Copenhagen City Heart Study including a cohort of 9889 women and 8590 men from the Danish general population. Smoking and covariates were assessed at four consecutive examinations in 1976-78, 1981-83, 1991...... of liver cirrhosis occurred during follow-up. The hazard ratios (HR) of alcoholic liver cirrhosis was 3.9, 95% confidence interval (CI): 1.6, 9.4 for women and 1.6, 95% CI: 0.9, 3.0 for men smoking >10 g of tobacco per day compared with never-smokers. For liver cirrhosis, corresponding HRs were 2.2, 95% CI...

  3. Alcohol consumption and liver cirrhosis mortality

    DEFF Research Database (Denmark)

    Bentzen, Jan Børsen; Smith, Valdemar

    on the relationship between liver cirrhosis mortality and alcohol consumption is included. The conclusion is that the total level of alcohol consumption as well as the specific beverages - beer, wine and spirits - contributes to liver cirrhosis mortality, but the present study also reveals that directly addressing......Empirical evidence gives strong support to a close association between liver cirrhosis mortality and the intake of alcohol and most often a log-linear relationship is assumed in the econometric modeling. The present analysis investigates for unit roots in a panel data set for sixteen European...... countries - covering the period 1970-2006 - where both alcohol consumption and liver cirrhosis seem best described as trend-stationary variables. Therefore a fixed effects model including individual trends is applied in the analysis but also a more flexible non-linear functional form with fewer restrictions...

  4. Effects of Rhus tripartitum fruit extract on CCl4-induced hepatotoxicity and cisplatin-induced nephrotoxicity in rats.

    Science.gov (United States)

    Tlili, Nizar; Feriani, Anouar; Allagui, Mohamed Salah; Saadoui, Ezzeddine; Khaldi, Abdelhamid; Nasri, Nizar

    2016-08-01

    Rhus tripartitum D.C., Anacardiaceae, has traditionally been used in Tunisia against many illnesses. The present study investigates, for the first time, the protective effects of the methanol extract of Rhus tripartitum fruit (MERT) against CCl4-induced hepatotoxicity and cisplatin-induced nephrotoxicty in Wistar rats. ALT, AST, LDH, GGT, creatinin, urea, and uric acid levels were studied. The changes in antioxidant parameters such as malondialdehyde (MDA) and protein carbonyl contents were also determined. The increased levels of MDA (30.97 and 11.50 nmol MDA/mg protein in liver and kidney, respectively) and protein carbonyls (13.4 and 17.95 nmol/mg protein in liver and kidney, respectively) were attenuated by MERT pretreatment (19.35 and 6.1 nmol MDA/mg protein and 9.15 and 12 nmol/mg protein in liver and kidney, respectively). The MERT pretreatment significantly reduced the increased biochemical parameters of liver and kidney caused by CCl4 and cisplatin treatment. The histopathologic observation showed that MERT pretreatment restores the altered tissues. The observed results could be due to the high phenolic content and to MERT's important antioxidant potential. This study supports the hepatoprotective and nephroprotective effects of R. tripartitum.

  5. Evaluation of protective effect of Sapindus mukorossi saponin fraction on CCl4-induced acute hepatotoxicity in rats

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao M

    2012-07-01

    Full Text Available M Srinivasa Rao,1 B Syed Asad,1 MA Fazil,1 RD Sudharshan,1 SA Rasheed,1 HA Pradeep,1 S Aboobacker,2 AH Thayyil,1 AK Riyaz,1 M Mansoor,1 MA Aleem,1 K Zeeyauddin,3 M Lakshmi Narasu,4 A Anjum,1,5 M Ibrahim1,51Nizam Institute of Pharmacy, Andhra Pradesh; 2Department of Pharmacology, Jamiya Salafiya College of Pharmacy, Kerala; 3Department of Pharmacology, Deccan School of Pharmacy, Andhra Pradesh; 4Centre for Biotechnology, Jawaharlal Nehru Technological University, Andhra Pradesh; 5Asian Institute of Advanced Scientific and Pharmaceutical Research, Hyderabad, Andhra Pradesh, IndiaAim: This investigation aimed to assess the hepatoprotective effect of saponin fraction isolated from the fruit pericarp of Sapindus mukorossi on carbon tetrachloride (CCl4-induced hepatotoxicity.Methods: Fruit of S. mukorossi was collected and authenticated, and dried pericarp powder subjected to extraction with cold ethanol (70% by maceration followed by isolation of total saponin fraction. Hepatoprotective activity was demonstrated in the CCl4-damaged primary monolayer culture. In in vivo studies, pretreatment with total saponin fraction (50,100 and 150 mg/kg per os once a day for 4 days before CCl4 introduction and continued afterward for 3 days attenuated the CCl4-induced acute increase in serum glutamic pyruvic transaminase, serum glutamic oxaloacetic transaminase, and alkaline phosphatase activities and considerably reduced histopathological alterations. Further, saponin fraction reduced thiopentone-induced (4 mg/kg, intraperitoneal sleeping time in rats.Results: Saponin fraction pretreatment improves bromsulphalein clearance and also increases cellular viability. Saponin administration replenished depleted hepatic glutathione and superoxide dismutase by improving the antioxidant status of the liver and liver function enzymes. These effects substantiate protection of cellular phospholipids from peroxidative damage induced by highly reactive toxic intermediate

  6. NUTRITIONAL THERAPY AND LIVER CIRRHOSIS

    Institute of Scientific and Technical Information of China (English)

    唐振铎; 沈洪亮; 夏宗勤; 戴腾昌

    1993-01-01

    Among 18 patients diagnosed as posthepatitic cirrhosis of the liver at compen-sated stage, 12 were treated for 2 months with a vegetarian diet which provided a dailyintake of 2263 Kcal and 95g protein with 68g of it vegetable in origin, while the re-maining 6 patients were given a routine hospital diet and served as controls. After 2months of dietary treatment, there was a marked increase in the value of serum albuminand transferrin, an increase in 24 h urinary creatinine output and creatinine height indexwith a decrease in 24 h urinary output of urea nitrogen. The reverted A/G ratio was cor-rected and the negative nitrogen balance became positive. The protein synthetic rate turnedto become greater than the catabolic rate and the body protein flux decreased as mea-sured by the 15N-glycine tracer kinetic study. The paper concludes that a high caloric vege-tarian diet can influence favorably the whole body protein turnover in cirrhotic patientsand should thus be used at least as an adjuvant therapy in the management of these patients.

  7. Cirrhosis and autoimmune liver disease: Current understanding

    Science.gov (United States)

    Liberal, Rodrigo; Grant, Charlotte R

    2016-01-01

    Primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) constitute the classic autoimmune liver diseases (AILDs). While AIH target the hepatocytes, in PBC and PSC the targets of the autoimmune attack are the biliary epithelial cells. Persistent liver injury, associated with chronic AILD, leads to un-resolving inflammation, cell proliferation and the deposition of extracellular matrix proteins by hepatic stellate cells and portal myofibroblasts. Liver cirrhosis, and the resultant loss of normal liver function, inevitably ensues. Patients with cirrhosis have higher risks or morbidity and mortality, and that in the decompensated phase, complications of portal hypertension and/or liver dysfunction lead to rapid deterioration. Accurate diagnosis and monitoring of cirrhosis is, therefore of upmost importance. Liver biopsy is currently the gold standard technique, but highly promising non-invasive methodology is under development. Liver transplantation (LT) is an effective therapeutic option for the management of end-stage liver disease secondary to AIH, PBC and PSC. LT is indicated for AILD patients who have progressed to end-stage chronic liver disease or developed intractable symptoms or hepatic malignancy; in addition, LT may also be indicated for patients presenting with acute liver disease due to AIH who do not respond to steroids. PMID:27729952

  8. Protective Effect of Aframomum melegueta phenolics Against CCl4-Induced Rat Hepatocytes Damage; Role of Apoptosis and Pro-inflammatory Cytokines inhibition

    Science.gov (United States)

    El-Halawany, Ali M.; Dine, Riham Salah El; El Sayed, Nesrine S.; Hattori, Masao

    2014-01-01

    Aframomum melegueta is a commonly used African spice. Through a hepatoprotective bioassay-guided isolation, the chloroform fraction of A.melegueta seeds yielded one new diarylheptanoid named 3-(S)-acetyl-1-(4′-hydroxy-3′, 5′-di methoxyphenyl)-7-(3″,4″, 5″-trihydroxyphenyl)heptane (1), and two new hydroxyphenylalkanones, [8]-dehydrogingerdione (2) and [6]-dehydroparadol (3), in addition to six known compounds (4–9). The hepatoprotective effect of A. melegueta methanol extract, sub-fractions and isolated compounds was investigated using carbon tetrachloride (CCl4)-induced liver injury in a rat hepatocytes model. The methanol, chloroform extracts and compounds 1, 5, 8 and 9 of A. melegueta significantly inhibited the elevated serum alanine aminotransferase (ALT), thiobarbituric acid reactive substances (TBARS), tumor necrosis factor (TNFα), interleukin-1beta (Il-1β), caspase3 and 9 and enhanced the reduced liver glutathione (GSH) level caused by CCl4 intoxication. These results indicate that A.melegueta extracts, and isolated compounds play a protective role in CCl4 induced acute liver injury which might be due to elevated antioxidative defense potentials, suppressed inflammatory responses and apoptosis of liver tissue. PMID:25077538

  9. Involvement of the TNF and FasL produced by CD11b Kupffer cells/macrophages in CCl4-induced acute hepatic injury.

    Directory of Open Access Journals (Sweden)

    Atsushi Sato

    Full Text Available We previously reported that F4/80(+ Kupffer cells are subclassified into CD68(+ Kupffer cells with phagocytic and ROS producing capacity, and CD11b(+ Kupffer cells with cytokine-producing capacity. Carbon tetrachloride (CCl4-induced hepatic injury is a well-known chemical-induced hepatocyte injury. In the present study, we investigated the immunological role of Kupffer cells/macrophages in CCl4-induced hepatitis in mice. The immunohistochemical analysis of the liver and the flow cytometry of the liver mononuclear cells showed that clodronate liposome (c-lipo treatment greatly decreased the spindle-shaped F4/80(+ or CD68(+ cells, while the oval-shaped F4/80+ CD11b(+ cells increased. Notably, severe hepatic injury induced by CCl4 was further aggravated by c-lipo-pretreatment. The population of CD11b(+ Kupffer cells/macrophages dramatically increased 24 hour (h after CCl4 administration, especially in c-lipo-pretreated mice. The CD11b(+ Kupffer cells expressed intracellular TNF and surface Fas-ligand (FasL. Furthermore, anti-TNF Ab pretreatment (which decreased the FasL expression of CD11b(+ Kupffer cells, anti-FasL Ab pretreatment or gld/gld mice attenuated the liver injury induced by CCl4. CD1d-/- mouse and cell depletion experiments showed that NKT cells and NK cells were not involved in the hepatic injury. The adoptive transfer and cytotoxic assay against primary cultured hepatocytes confirmed the role of CD11b(+ Kupffer cells in CCl4-induced hepatitis. Interestingly, the serum MCP-1 level rapidly increased and peaked at six h after c-lipo pretreatment, suggesting that the MCP-1 produced by c-lipo-phagocytized CD68(+ Kupffer cells may recruit CD11b(+ macrophages from the periphery and bone marrow. The CD11b(+ Kupffer cells producing TNF and FasL thus play a pivotal role in CCl4-induced acute hepatic injury.

  10. Effect of schisandrin B and sesamin mixture on CCl(4)-induced hepatic oxidative stress in rats.

    Science.gov (United States)

    Chang, Chia-Yu; Chen, Ya-Ling; Yang, Suh-Ching; Huang, Guan-Cheng; Tsi, Daniel; Huang, Chi-Chang; Chen, Jiun-Rong; Li, Joe-Sharg

    2009-02-01

    To study the effects of schisandrin B and sesamin mixture on carbon tetrachloride (CCl(4))-induced hepatic oxidative stress in male Sprague-Dawley rats. The rats were randomly assigned to five groups: control group (olive oil injection), CCl(4) group (CCl(4) injection), silymarin group (CCl(4) injection combined with supplementation of silymarin, 7.5 mg/kg/day), low dose group (CCl(4) injection combined with supplementation of schisandrin B and sesamin mixture at a low dose, 43 mg/kg/day) and high dose group (CCl(4) injection combined with the supplementation of schisandrin B and sesamin mixture at a high dose, 215 mg/kg/day). The hepatic superoxide dismutase and glutathione peroxidase activities of rats in the low dose and high dose groups were increased significantly compared with those in the CCl(4) group. The hepatic reduced glutathione concentration in the silymarin, low dose and high dose groups were increased significantly (48%, 45% and 53%, respectively) when compared with those of the CCl(4) group. In addition, the concentration of glutathione in the erythrocytes of the low dose group was significantly higher than the CCl(4) group by 25%. These results suggest that the schisandrin B-sesamin mixture exerted a hepatoprotective effect by improving the antioxidative capacity in rats under CCl(4)-induced hepatic oxidative stress.

  11. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release of...

  12. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most......Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release...

  13. Inhibitory effects of saikosaponin-d on CCl4-induced hepatic fibrogenesis in rats

    Institute of Scientific and Technical Information of China (English)

    Shuang-Suo Dang; Bao-Feng Wang; Yan-An Cheng; Ping Song; Zhen-Guo Liu; Zong-Fang Li

    2007-01-01

    .5 IU/L vs 113.76± 14.91 IU/L, TG: 0.95 ± 0.16 mmol/L vs 0.51 ± 0.06 mmol/L, GLB: 35.62 ± 3.28 g/L vs 24.82 ± 2.73 g/L, HA:42.15 ± 8.25 ng/mL vs 19.83 ± 3.12 ng/mL, LN: 27.56 ± 4.21 ng/mL vs13.78 ± 2.57 ng/mL, HYP: 27.32 ± 4.32 μg/mg vs 16.20 ± 3.12 μg/mg, TNF-α: 4.38 ± 0.76 ng/L vs 1.94 ± 0.27 ng/L, IL-6:28.24 ± 6.37 pg/g vs 12.72 ± 5.26 pg/g, respectively, P < 0.01). SSd also decreased ALB in serum (28.49 ± 4.93 g/L vs 37.51 ± 3.17 g/L, P < 0.05). Moreover, the expression of NF-κB p65 in the liver of treated groups was lower than that in model groups while the expression of I-κBα was higher in treated group than in model group (P < 0.01). The expression of NF-κBp65 and TNF-α had a positive correlation with the level of HA in serum of rats after treatment with CCl4 (r = 0.862, P < 0.01; r = 0.928, P < 0.01, respectively).CONCLUSION: SSd attenuates CCl4-induced hepatic fibrosis in rats, which may be related to its effects of hepato-protective and anti-inflammation properties,the down-regulation of liver TNF-α, IL-6 and NF-κBp65 expression and the increased I-κBα activity in liver.

  14. Acute myopathy associated with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Ok-Jae Lee; Jee-Hyang Yoon; Eun-Jeong Lee; Hyun-Jin Kim; Tae-Hyo Kim

    2006-01-01

    AIM: Many cirrhotic patients have muscular symptoms and rhabdomyolysis. However, myopathy associated with liver cirrhosis has not been established as a disease entity. We evaluated the clinical significance of acute myopathy associated with liver cirrhosis.METHODS: We retrospectively reviewed the medical records of 5440 cirrhotic patients who had been admitted to Gyeongsang National University Hospital from August 1997 to January 2003. Among these, 99 developed acute myopathies, and they were analyzed with respect to clinical and laboratory parameters, and outcomes.RESULTS: The Child-Pugh classification at the time of myopathy onset was A in 3(3.1%) cases, B in 33(33.3%), and C in 63 (63.6%). Infection was identified as the most predisposing factor to myopathy. Fifty percent of 18 idiopathic cases who were tested for influenza antibody were positive. Forty-two of the 99 cases were complicated by acute renal failure, and 25 (59.5%) of these expired. Apart from 6 cases lost to follow-up, 64 of 93 recovered, giving a mortality rate of 31.2%. Mortality was higher in Child-Pugh class C than in B or A.CONCLUSION: Acute myopathy can develop as a serious complication in liver cirrhosis. Its frequency, severity and mortality depend on underlying liver function, and are higher in decompensated liver cirrhosis. Influenza should be considered as an etiologic factor in idiopathic cases. It is proposed that acute myopathy associated with liver cirrhosis be called 'hepatic myopathy', and that careful monitoring for hepatic myopathy is necessary in the patients with advanced liver cirrhosis.

  15. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...... likely includes the combination of vasodilatation and vasoconstriction in parallel. Arterial compliance; Central vascular filling; Chyperdynamic circulation; Kidney function, Nitric oxide; Blood pressure regulation; Renin–angiotensin–aldosterone system; Sympathetic nervous system; Vasodilatation...

  16. Camel milk and bee honey regulate profibrotic cytokine gene transcripts in liver cirrhosis induced by carbon tetrachloride.

    Science.gov (United States)

    Sadek, Kadry; Beltagy, Doha; Saleh, Ebeed; Abouelkhair, Reham

    2016-05-30

    The lack of studies regarding the mechanism of the protective effects of camel milk and bee honey against hepatotoxic compounds led us to perform this study. Thirty-six male rats were divided into two main groups. The first group (n = 9) comprised control non-cirrhotic rats. The rats of the second group (n = 27) were administered carbon tetrachloride (CCl4) by intraperitoneal injection to induce liver cirrhosis. The cirrhotic rats were then divided into three equal subgroups, each comprising nine animals, as follows: (i) cirrhotic rats, (ii) cirrhotic rats treated with camel milk, and (iii) cirrhotic rats treated with camel milk and bee honey. The present findings revealed that CCl4 elevated the activities of liver enzymes, blood glucose levels, non-esterified fatty acids (NEFA) in the serum and glycogen content in the liver. On the other hand, CCl4 significantly decreased phosphorylase activity in the liver tissue and significantly increased carbohydrate intolerance and insulin resistance index (HOMA-IR). Moreover, CCl4 induced a significant increase in oxidative stress, along with increased expression of the profibrotic cytokine genes TNF-α and TGF-β. However, camel milk either alone or in combination with bee honey ameliorated these toxic actions. The antioxidant properties of these protective agents and their effects of downregulating certain procirrhotic cytokine gene transcripts underlie this protection.

  17. Evaluation of chemopreventive effect ofFumaria indica against N-nitrosodiethylamine and CCl4-induced hepatocellular carcinoma in Wistar rats

    Institute of Scientific and Technical Information of China (English)

    Talib Hussain; Hefazat H Siddiqui; Sheeba Fareed; M Vijayakumar; Chandana V Rao

    2012-01-01

    Objective:To investigation the chemopreventive potential ofFumaria indica (F. indica) extract (FIE) on N-nitrosodiethylamine and CCl4-induced hepatocarcinogenesis in Wistar rats.Methods:The experimental animals were divided into six groups (n=6). Hepatocellular carcinoma was induced by single intraperitoneal injection ofN-nitrosodiethylamine (NDEA) in normal saline at a dose of 200 mg/kg body weight followed by weekly subcutaneous injections of CCl4 (3 mL/kg/week) for 6 weeks, as the promoter of carcinogenic effect. After administration of the carcinogen, 200 and 400 mg/kg of FIE were administered orally once a day throughout the study. At the end of 20 weeks, the body weight, liver weight and relative liver weight were measured. The percentage of nodule incidence and liver cancer markers such as aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP),γ-glutamyl transferase (γ-GT), total bilirubin level (TBL), α-feto protein (AFP) and carcinoembryonic antigen were estimated along with histopathological investigation in experimental groups of rats. Results: Obtained results demonstrated that the cotreatment with FIE significantly prevented the decrease of the body weight and also increased in relative liver weight caused by NDEA. The treatment with FIE significantly reduced the nodule incidence and nodule multiplicity in the rats after NDEA administration. The levels of liver cancer markers such as AST, ALT, ALP,γ-glutamyl transferase, TBL, AFP and carcinoembryonic antigen were substantially increased by NDEA treatment. However, FIE treatment significantly reduced the liver injury and restored the entire liver cancer markers. Histological observations of liver tissues too correlated with the biochemical observations.Conclusions: These finding powerfully supports thatF. indica exert chemopreventive effect by suppressing the tumor burden and restoring the activities of hepatic cancer marker enzymes on NDEA and CCl4-induced

  18. A STUDY OF HYPOXEMIA IN LIVER CIRRHOSIS

    Directory of Open Access Journals (Sweden)

    Gurinder

    2014-12-01

    Full Text Available INTRODUCTION: Pulmonary abnormalities and symptoms are common in patients with chronic liver disease. Hepatopulmonary syndrome is an important cause in a patient with hypoxemia and chronic liver disease. Hepatopulmonary syndrome consists of a triad of hepatic dysfunction and/or portal hypertension, intrapulmonary vascular dilatations and hypoxemia/ widened alveolar-arterial gradient. The present study evaluated the arterial blood gas levels and correlated these with 2D contrast echocardiographic findings in patients of liver cirrhosis. METHODS: 40 patients of liver cirrhosis were included in the study. All patients underwent ultrasonography, LFTs, biochemical tests and upper gastrointestinal endoscopy, chest X-ray, 2-D contrast enhanced transthoracic echocardiogram, viral markers and arterial blood gas analysis. The patients in whom arterial hypoxemia/ widened alveolar-arterial gradient was detected with a positive contrast echocardiogram were considered to have hepatopulmonary syndrome. Patients with intrinsic heart disease like patent foramen ovale, atrial septal defect, ventricular septal defect, haemoglobin less than 7gm% and history of COPD were excluded from the study. RESULTS: 4 patients of liver cirrhosis with hypoxemia had intrapulmonary vascular dilatations were labelled as hepatopulmonary syndrome. 2 additional patients with IPVDs had widened alveolar arterial gradient without hypoxemia and were also labelled as HPS. Dyspnoea (p=0.001, platypnea (p<0.001, clubbing (p=0.002 and cyanosis (p=0.001 were significantly commoner in the six patients of hepatopulmonary syndrome. Patients with cyanosis had poor prognosis. CONCLUSION: Hepatopulmonary syndrome is an important cause of hypoxemia in patients of liver cirrhosis. It is not uncommon in patients of liver cirrhosis. Platypnea is both sensitive as well as specific marker of the disease. Transthoracic contrast enhanced echocardiogram is a safe and accurate bedside tool for the detection

  19. Inflammasome activation in decompensated liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Inflammation participates in the pathogenesis of many liver diseases, including liver cirrhosis. Certaininflammatory citokines, such as interleukin (IL)-1β andIL-18, are produced after the activation of a multiproteincomplex known as the inflammasome. Activation of theinflammasome has been documented in several liverdiseases, but its role in the development and progressionof liver cirrhosis or the complications associated withthis disease is still largely unknown. We have recentlystudied the impact of the inflammasome in the sterileinflammatory response that takes place in the asciticfluid of patients with decompensated cirrhosis, providingevidence that activation of the absent in melanoma2 (AIM2) inflammasome is an important response inthese patients. Ascitic fluid-derived macrophages wereable to mount a very robust AIM2-mediated responseeven in the absence of a priming signal, which is usuallyrequired for the full activation of all the inflammasomes.In addition, high level of inflammasome activation inthese patients was associated with a higher degree ofliver disease and an increased incidence of spontaneousbacterial peritonitis. These results may help explain theexacerbated inflammatory response that usually occursin patients with decompensated cirrhosis in the absenceof detectable infections. Thus, inflammasomes shouldbe considered as possible therapeutic targets in sterileinflammatory complications in patients with cirrhosis.

  20. Liver cirrhosis and arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    Jens H Henriksen; Soren Moller

    2006-01-01

    Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system,sympathetic nervous system, release of vasopressin),and resistance to vasopressors. The vasodilatory state is mediated through adrenomedullin, calcitonin generelated peptide, nitric oxide, and other vasodilators,and is most pronounced in the splanchnic area.This constitutes an effective (although relative)counterbalance to increased arterial blood pressure.This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most likely includes the combination of vasodilatation and vasoconstriction in parallel.

  1. Oral health in patients with liver cirrhosis

    DEFF Research Database (Denmark)

    Ladegaard Grønkjær, Lea; Vilstrup, Hendrik

    2015-01-01

    Objective: The aim of this study was to describe the oral care habits and self-perceived oral health in patients with liver cirrhosis, as well as to evaluate the impact of oral health on well-being and the relation to nutritional status. Participants and methods: From October 2012 to May 2013, we...... carried out a prospective study on patients with liver cirrhosis. Questions on oral care habits and self-perceived oral health were answered, and the Oral Health Impact Profile questionnaire (OHIP-14) provided information on oral conditions. The findings were compared with The Danish Institute for Health......’ nutritional risk score (P=0.01). Conclusion: Our results showed that cirrhosis patients cared less for oral health than the background population. Their resulting problems may be contributing factors to their nutritional risk and decreased well-being. Oral health problems may thus have adverse prognostic...

  2. Isorhamnetin-3-O-galactoside Protects against CCl4-Induced Hepatic Injury in Mice.

    Science.gov (United States)

    Kim, Dong-Wook; Cho, Hong-Ik; Kim, Kang-Min; Kim, So-Jin; Choi, Jae Sue; Kim, Yeong Shik; Lee, Sun-Mee

    2012-07-01

    This study was performed to examine the hepatoprotective effect of isorhamnetin-3-O-galactoside, a flavonoid glycoside isolated from Artemisia capillaris Thunberg (Compositae), against carbon tetrachloride (CCl4)-induced hepatic injury. Mice were treated intraperitoneally with vehicle or isorhamnetin-3-O-galactoside (50, 100, and 200 mg/kg) 30 min before and 2 h after CCl4 (20 μl/kg) injection. Serum aminotransferase activities and hepatic level of malondialdehyde were significantly higher after CCl4 treatment, and these increases were attenuated by isorhamnetin-3-O-galactoside. CCl4 markedly increased serum tumor necrosis factor-α level, which was reduced by isorhamnetin-3-O-galactoside. The levels of inducible nitric oxide synthase (iNOS), cyclooxygenase- 2 (COX-2), and heme oxygenase-1 (HO-1) protein and their mRNA expression levels were significantly increased after CCl4 injection. The levels of HO-1 protein and mRNA expression levels were augmented by isorhamnetin-3-O-galactoside, while isorhamnetin- 3-O-galactoside attenuated the increases in iNOS and COX-2 protein and mRNA expression levels. CCl4 increased the level of phosphorylated c-Jun N-terminal kinase, extracellular signal-regulated kinase and p38, and isorhamnetin-3-O-galactoside reduced these increases. The nuclear translocation of nuclear factor kappa B (NF-κB), activating protein-1, and nuclear factor erythroid 2-related factor 2 (Nrf2) were signifi cantly increased after CCl4 administration. Isorhamnetin-3-O-galactoside attenuated the increases of NF-κB and c-Jun nuclear translocation, while it augmented the nuclear level of Nrf2. These results suggest that isorhamnetin-3-O-galactoside ameliorates CCl4-induced hepatic damage by enhancing the anti-oxidative defense system and reducing the inflammatory signaling pathways.

  3. Outcome after liver transplantation for NASH cirrhosis.

    Science.gov (United States)

    Malik, S M; deVera, M E; Fontes, P; Shaikh, O; Ahmad, J

    2009-04-01

    Nonalcoholic steatohepatitis (NASH) associated cirrhosis is an increasing indication for liver transplant (LT). The aim of this study was to determine outcome and poor predictive factors after LT for NASH cirrhosis. We analyzed patients undergoing LT from 1997 to 2008 at a single center. NASH was diagnosed on histopathology. LT recipients with hepatitis C, alcoholic or cholestatic liver disease and cryptogenic cirrhosis acted as matched controls. Ninety-eight LT recipients were identified with NASH cirrhosis. Compared to controls, NASH patients had a higher BMI (mean 32.3 kg/m2), and were more likely to be diabetic and hypertensive. Mortality after transplant was similar between NASH patients and controls but there was a tendency for higher earlier mortality in NASH patients (30-day mortality 6.1%, 1-year mortality 21.4%). Sepsis accounted for half of all deaths in NASH patients, significantly higher than controls. NASH patients > or =60 years, BMI > or =30 kg/m2 with diabetes and hypertension (HTN) had a 50% 1-year mortality. In conclusion, patients undergoing LT for NASH cirrhosis have a similar outcome to patients undergoing LT for other indications. The combination of older age, higher BMI, diabetes and HTN are associated with poor outcome after LT. Careful consideration is warranted before offering LT to these high-risk patients.

  4. Biosynthesis of silver nanoparticles from Premna serratifolia L. leaf and its anticancer activity in CCl4-induced hepato-cancerous Swiss albino mice

    Science.gov (United States)

    Arockia John Paul, J.; Karunai Selvi, B.; Karmegam, N.

    2015-11-01

    In this study, we report the biosynthesis of silver nanoparticles using the ethanolic leaf powder extract of Premna serratifolia L. and its anticancer activity in carbon tetra chloride (CCl4)-induced liver cancer in Swiss albino mice (Balb/c). The synthesized silver nanoparticles were characterized by SEM, FTIR and XRD analyses. The Debye-Scherrer equation was used to calculate particle size and the average size of silver nanoparticles synthesized from P. serratifolia leaf extract was 22.97 nm. The typical pattern revealed that the sample contained cubic structure of silver nanoparticles. FTIR analysis confirmed that the bioreduction of silver ions to silver nanoparticles is due to reduction by capping material of the plant extract. The silver nanoparticles of P. serratifolia leaf extract were effective in treating liver cancer in Swiss albino mice when compared with P. serratifolia leaf extract with isoleucine.

  5. Liver Cirrhosis and Intestinal Bacterial Translocation

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    Intestinal barrier dysfunction, facilitating translocation of bacteria and bacterial products, plays an important role in the pathophysiology of liver cirrhosis and its complications. Intestinal defense system including microbial barrier, immunologic barrier, mechanical barrier, chemical barrier, plays an important role in the maintenance of intestinal function. Under normal circumstances, the intestinal barrier can prevent intestinal bacteria through the intestinal wall from spreading to the body. Severe infection, trauma, shock, cirrhosis, malnutrition, immune suppression conditions, intestinal bacteria and endotoxin translocation, can lead to multiple organ dysfunction. The intestinal microlfora is not only involved in the digestion of nutrients, but also in local immunity, forming a barrier against pathogenic microorganisms. The derangement of the gut microlfora may lead to microbial translocation, deifned as the passage of viable microorganisms or bacterial products from the intestinal lumen to the mesenteric lymph nodes and other extraintestinal sites. In patients with cirrhosis, primary and intestinal lfora imbalance, intestinal bacterial overgrowth, intestinal mucosal barrier dysfunction, endotoxemia is associated with weakened immunity.

  6. Orthotopic Liver Transplantation for Alcoholic Cirrhosis

    Science.gov (United States)

    Starzl, Thomas E.; Van Thiel, David; Tzakis, Andreas G.; Iwatsuki, Shunzaburo; Todo, Satoru; Marsh, J. Wallis; Koneru, Babu; Staschak, Sandee; Stieber, Andrei; Gordon, Robert D.

    2010-01-01

    Fifteen patients with Laennec's cirrhosis underwent orthotopic liver transplantation between 1963 and the end of 1979. The first eight patients died perioperatively or within two months, but four of the next seven patients had long survival; three are still alive after 11 to 14 years. After the introduction of cyclosporine therapy, 41 more patients with alcoholic cirrhosis were treated with liver transplantation from 1980 to June 1987. The one-year survival is 73.2%, and, after one to three years, 28 (68%) of the recipients are living. Of the 35 patients in the combined old and new series who lived for six months or longer, only two returned to alcohol abuse. Social and vocational rehabilitation has been the rule in these recipients who were selected primarily because of urgency of need, because they or their families insisted on treatment, and because they and their families thereby committed themselves to long-standing programs of alcoholism care. PMID:3050180

  7. [Nutritional care for patients with liver cirrhosis].

    Science.gov (United States)

    Aceves-Martins, Magaly

    2014-02-01

    The liver is an important organ with specific functions that influence directly on the nutritional and physiological status of every person. At the presence of any illness or injury in this organ, liver cirrhosis is always its final phase. In this pathology, patients present carbohydrate utilization and storage diminishment, as well as protein and fat catabolism increase. This situation, plus a low ingest and a bad nutrient absorption, results in a high prevalence of malnutrition. Many studies prove the importance of an opportune nutritional treatment in these patients, bringing general benefits and improving their quality of life. It's important to considerate the possible nutritional risks and deficiencies that could appear in the course of the cirrhosis to take opportune actions. The nutritional assessment and treatment is transcendental both in compensated phase (without complications) and in decompensated phase (with complications) of the illness.

  8. Oral health in patients with liver cirrhosis

    DEFF Research Database (Denmark)

    Ladegaard Grønkjær, Lea; Vilstrup, Hendrik

    2015-01-01

    Objective: The aim of this study was to describe the oral care habits and self-perceived oral health in patients with liver cirrhosis, as well as to evaluate the impact of oral health on well-being and the relation to nutritional status. Participants and methods: From October 2012 to May 2013, we...... carried out a prospective study on patients with liver cirrhosis. Questions on oral care habits and self-perceived oral health were answered, and the Oral Health Impact Profile questionnaire (OHIP-14) provided information on oral conditions. The findings were compared with The Danish Institute for Health...... Services Research report on the Danish population’s dental status. Results: One hundred and seven patients participated. Their oral care habits and self-perceived oral health were poorer than the Danish population; the patients had fewer teeth (on average 19 vs. 26, P=0.0001), attended the dentist less...

  9. Malabsorption in cirrhosis of the liver

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    Patwardhan R

    1977-01-01

    Full Text Available Gastrointestinal function of absorption has been studied in twenty biopsy proved cases of cirrhosis of the liver. The gastro-intestinal function was assessed by means of glucose and lactose tolerance tests and by fecal fat, d-Xylose and Co 57 B 12 excretion tests. Steatorrhoea and lactose intolerance are common in cir-rhotics. The etiopathogenesis of this malabsorption in cirrhotics is discussed and appears multifactorial in origin.

  10. Nanoemulsified ethanolic extract of Pyllanthus amarus Schum & Thonn ameliorates CCl4 induced hepatotoxicity in Wistar rats.

    Science.gov (United States)

    Deepa, V; Sridhar, R; Goparaju, A; Reddy, P Neelakanta; Murthy, P Balakrishna

    2012-11-01

    Phyllanthus amarus (PA) is commonly used in traditional medicine for hepatoprotectivity. The major limitation is that, treatment requires a large quantity of herbal extract for a longer duration. Aim of the present study was to encapsulate ethanolic plant extract for sustained release of constituents in intestine and facilitate maximum absorption. The efficacy was compared for the hepatoprotective activity of nanoencapsulated ethanolic extract of P. amarus (NPA) and PA in carbon tetrachloride (CCl4) induced hepatotoxic male rats. Based on total phenol content (TPC), the loading efficiency of nanocapsules was 89% (pH 7.0) and optimum concentration was 2:18 (mg/mL) for plant extract: olive oil. Scanning electron microscopy (SEM) showed a spherical morphology, photon correlation spectroscopy (PCS) identified mean particle diameter as 213 nm and Fourier transform infrared spectroscopy (FT-IR) revealed that the phytoconstituents were stable. An oral dose of NPA (20 mg/kg body wt.) showed a better hepatoprotective activity than PA (100 mg/kg body wt.) and also repeated dose oral toxicity proved to be safe. These biochemical assessments were supported by rat biopsy examinations. In conclusion, the nanoemulsification method may be applied for poor water-soluble ethanolic herbal extracts to reduce the dosage and time.

  11. CCl4-induced hepatotoxicity: protective effect of rutin on p53, CYP2E1 and the antioxidative status in rat

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    Khan Rahmat A

    2012-10-01

    Full Text Available Abstract Background Rutin is a polyphenolic natural flavonoid which possesses antioxidant and anticancer activity. In the present study the hepatoprotective effect of rutin was evaluated against carbon tetrachloride (CCl4-induced liver injuries in rats. Methods and materials 24 Sprague–Dawley male rats were equally divided into 4 groups for the assessment of hepatoprotective potential of rutin. Rats of group I (control received only vehicles; 1 ml/kg bw of saline (0.85% and olive oil (3 ml/kg and had free access to food and water. Rats of group II, III and IV were treated with CCl4 (30% in olive oil, 3 ml/kg bw via the intraperitoneal route twice a week for four weeks. The rutin at the doses of 50 and 70 mg/kg were administered intragastrically after 48 h of CCl4 treatment to group III and IV, respectively. Protective effect of rutin on serum enzyme level, lipid profile, activities of antioxidant enzymes and molecular markers were calculated in CCl4-induced hepatotoxicity in rat. Results Rutin showed significant protection with the depletion of alanine aminotransferase (ALT, aspartate aminotransferase (AST, alkaline phosphatase (ALP, gamma glutamyl transpeptidase (γ-GT in serum as was raised by the induction of CCl4. Concentration of serum triglycerides, total cholesterol and low density lipoproteins was increased while high-density lipoprotein was decreased with rutin in a dose dependent manner. Activity level of endogenous liver antioxidant enzymes; catalase (CAT, superoxide dismutase (SOD, glutathione peroxidase (GSHpx, glutathione-S-transferase (GST and glutathione reductase (GSR and glutathione (GSH contents were increased while lipid peroxidation (TBARS was decreased dose dependently with rutin. Moreover, increase in DNA fragmentation and oxo8dG damages while decrease in p53 and CYP 2E1 expression induced with CCl4 was restored with the treatment of rutin. Conclusion From these results, it is suggested that rutin possesses

  12. [Endotoxinaemia in liver cirrhosis (author's transl)].

    Science.gov (United States)

    Nilius, R; Bernhardt, H; Zipprich, B; Knoke, M

    1980-01-01

    23 patients with liver cirrhosis of diverse etiology and of different activity levels and grades of compensation of the portal circulation were examined with regard to the systemic endotoxinaemia. The endotoxin was determined using the Limulus-Amoebocyte-Lysat-test. Endotoxin was traceable in the venous blood of 7 out of 23 patients (= 30,4%). No relation was found between endotoxaemia and the activity or grade of severity of liver cirrhosis; nor were there any accumulation of endotoxinaemia in patients with collateral circulation or portal decompensation. Consequently, as a result of our findings, the prognostic value of the symptom endotoxinaemia remains debatable, then endotoxinaemia does not always mean endotoxicosis. Particularly high immunoglobulin concentration and low albumin values in serum of endotoxin-positive cirrhotics indicate a "spillovet" of antigen substances and also of endotoxines in the body circulation resulting from insufficiency of the liver-RHS. Parallel analysis of microbian small bowel flora in 10 patients indicate that coli-dysbiosis appears to play a role in the development of systemic endoxinaemia, although the latter was also traceable in borderline cases of eubiosis/dysbiosis. Our findings strengthen the view that it is not possible to simply translate the findings in animals on to human liver diseases. Quite a number of the mechanisms being discussed are still with uncleared details and they give only a blurred picture of the pathophysiology of endotoxinaemia.

  13. Group IVA phospholipase A(2) deficiency prevents CCl4-induced hepatic cell death through the enhancement of autophagy.

    Science.gov (United States)

    Ishihara, Keiichi; Kanai, Shiho; Tanaka, Kikuko; Kawashita, Eri; Akiba, Satoshi

    2016-02-26

    Group IVA phospholipase A2 (IVA-PLA2), which generates arachidonate, plays a role in inflammation. IVA-PLA2-deficiency reduced hepatotoxicity and hepatocyte cell death in mice that received a single dose of carbon tetrachloride (CCl4) without any inhibitory effects on CCl4-induced lipid peroxidation. An immunoblot analysis of extracts from wild-type mouse- and IVA-PLA2 KO mouse-derived primary hepatocytes that transiently expressed microtubule-associated protein 1 light chain 3B (LC3) revealed a higher amount of LC3-II, a typical index of autophagosome formation, in IVA-PLA2-deficient cells, suggesting the enhancement of constitutive autophagy. IVA-PLA2 may promote CCl4-induced cell death through the suppression of constitutive autophagy in hepatocytes. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Effect of extracts from araticum (Annona crassiflora on CCl4-induced liver damage in rats

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    Roberta Roesler

    2011-03-01

    Full Text Available The influence of ethanolic extracts of Annona crassiflora on the activities of hepatic antioxidant enzymes was examined. Extracts of A. crassiflora seeds and peel were administered orally (50 mg of galic acid equivalents.kg-1 to Wistar rats for 14 consecutive days followed by a single oral dose of carbon tetrachloride (CCl4, 2 g.kg-1. Lipid peroxidation and the activities of hepatic catalase (CAT, cytochromes P450 (CP450 and b5, glutathione peroxidase (GPx, glutathione reductase (GRed, superoxide dismutase (SOD, and the content of glutathione equivalents (GSH were evaluated. The treatment with CCl4 increased lipid peroxidation, the level of GSH equivalents and the content of cytochrome b5 by 44, 140 and 32%, respectively, with concomitant reductions of 23, 34 and 39% in the activities of CAT, SOD, and CP450, respectively. The treatment with A. crassiflora seeds and peel extracts alone inhibited lipid peroxidation by 27 and 22%, respectively without affecting the CP450 content. The pretreatment with the A. crassiflora extracts prevented the lipid peroxidation, the increase in GSH equivalents and the decrease in CAT activity caused by CCl4, but it had no effect on the CCl4-mediated changes in CP450 and b5 and SOD. These results show that A. crassiflora seeds and peel contain antioxidant activity in vivo that could be of potential therapeutic use.

  15. Hepatoprotective activity of Ceriops decandra (Griff. Ding Hou mangrove plant against CCl4 induced liver damage

    Directory of Open Access Journals (Sweden)

    Murugesan Gnanadesigan

    2017-05-01

    Full Text Available In folklore medicine, Ceriops decandra is used to treat hepatitis. However, a scientific evaluation has not been performed. Thus, the present study was carried out to identify the hepatoprotective activity of plant parts (leaf, bark, collar, flower and hypocotyls of C. decandra. In vitro antioxidant studies were carried out with DPPH, HRSA, NO, FRAP and LPO assays. The LD50 was calculated and in vivo hepatoprotective activity was carried out with the leaf extract, which was found to be the most potent. The in vivo hepatoprotective activity was performed as follows: Group 1, control animals; Group 2, carbon tetrachloride (CCl4-treated animals; Group 3, silymarin (100 mg kg−1 bw p.o. treated animals; Groups 4, 5 and 6, C. decandra treatment groups (100, 200 and 400 mg kg−1 bw. Histopathological scores were calculated with standard protocols. Of the selected different plant parts, the leaf extract showed maximum antioxidant scavenging properties. A study of the oral acute toxicity found C. decandra extract to be non-toxic up to 2000 mg kg−1 bw. The in vivo hepatoprotective nature of the leaf extract was identified as dose dependent and the levels of SGOT, SGPT, ALP, bilirubin, CHL and LDH were found to be significantly decreased (p < 0.05 compared with hepatotoxin groups. Histopathological scores did not show any significant variations between control and high dose (400 mg kg−1 bw of leaf extract-treated animals. Preliminary phytochemical analysis of the leaf extract revealed the presence of phenolic groups, alkaloids, triterpenoids, flavonoids, catechin and anthraquinone. In conclusion, the hepatoprotective nature of the C. decandra leaf extract might be due to the occurrence of unique secondary metabolites and their antioxidant scavenging properties.

  16. Bacterial infections in patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Giacomo Zaccherini

    2011-07-01

    Full Text Available Bacterial infections represent a frequent complication of liver cirrhosis carrying a significantly greater risk of morbidity and mortality as compared to that observed in non-cirrhotic patients. Such unfavourable prognosis is related to the systemic complications (liver and renal failure, shock, coagulopathy, multiple organ failure induced by a series of pro-inflammatory and immunological systems which are activated by bacteria and their pathogenetic products.The epidemiology of bacterial infections in cirrhosis has changed in the last years with a marked increase of Gram+ infections and the emergence of multi-resistant bacteria.The severity of liver disease represents the major clinical factor predisposing to bacterial infections, which are asymptomatic or paucisymptomatic at presentation in almost half of the cases. Aim of this review is to summarise the clinical and therapeutic aspects of bacterial infections in cirrhotic patients. The most common sites of infection are the urinary tract, ascites, blood, lungs and soft tissues.Beside antibiotics, it has been proposed the administration of human albumin to prevent the development of renal failure in patients with spontaneous bacterial peritonitis and, more recently, the use of hydrocortisone to treat cirrhotic patients with septic shock.

  17. Pulmonary arteriovenous malformation in cryptogenic liver cirrhosis.

    Science.gov (United States)

    Afzal, Noureen; Akhtar, Saleem; Ahmed, Shakeel; Atiq, Mehnaz

    2013-09-01

    The cause in 10 - 20% cases of liver cirrhosis (LC) cannot be elucidated, and are thus termed cryptogenic. Pulmonary arteriovenous malformations (PAVMs) are relatively rare, but the most common anomaly involving the pulmonary tree. Although the rare correlation between LC and PAVM is well-known, there have been no reports of PAVMs occurring in cryptogenic LC. We report a case of PAVM that occurred in cryptogenic liver cirrhosis in a 3 years old male child. The child presented with complaints of malena, hematemesis and variceal bleed. The examination revealed a child with respiratory distress, irritability, tachycardia, clubbing and abdominal distention. He was worked up for recurrent variceal bleeding secondary to portal hypertension but the oxygen saturation during hospital stay kept deteriorating. The diagnosis of hepatopulmonary syndrome as the cause of persistent hypoxemia in the absence of other cardio-pulmonary causes was then made by enhanced echocardiogram using agitated saline. He improved significantly after liver transplantation performed abroad. At a 6 months follow-up, the child was stable with no evidence of intrapulmonary shunting on repeat echo.

  18. Osteoporosis and FRAX risk in patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Azucena I. Casanova-Lara

    2014-10-01

    Conclusions: The frequency of osteoporosis or osteopenia is 90.4% in Mexican patients with liver cirrhosis of different etiologies. The decreased levels of bone alkaline phosphatase and 25-hydroxyvitamin-D were correlated with the risk of bone disease in patients with liver cirrhosis.

  19. Schistosomiasis and hepatopulmonary syndrome: the role of concomitant liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Liana Gonçalves-Macedo

    Full Text Available BACKGROUND Hepatopulmonary syndrome (HPS is defined as an oxygenation defect induced by intrapulmonary vasodilation in patients with liver disease or portal hypertension. It is investigated in patients with liver cirrhosis and less frequently in those with portal hypertension without liver cirrhosis, as may occur in hepatosplenic schistosomiasis (HSS. OBJECTIVES To investigate the prevalence of HPS in patients with HSS, and to determine whether the occurrence of HPS is influenced by concomitant cirrhosis. METHODS We evaluated patients with HSS with or without concomitant liver cirrhosis. All patients underwent laboratory testing, ultrasound, endoscopy, contrast echocardiography, and arterial blood gas analysis. FINDINGS Of the 121 patients with HSS, 64 were also diagnosed with liver cirrhosis. HPS was diagnosed in 42 patients (35% and was more frequent among patients with concomitant liver cirrhosis than in those without cirrhosis (42% vs. 26%, but the difference was not significant (p = 0.069. HPS was more common in those with spider naevi, Child-Pugh classes B or C and high model for end stage liver disease (MELD scores (p < 0.05 each. MAIN CONCLUSIONS The prevalence of HPS was 35% in this study. The occurrence of liver cirrhosis concomitantly with HSS may have influenced the frequency of patients presenting with HPS.

  20. Laparoscopic liver resection for hepatocellular carcinoma in patients with cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Jai Young Cho; Ho-Seong Han

    2016-01-01

    Hepatocellular carcinoma (HCC) is a common malignant tumor and many cases occur in patients with liver cirrhosis. Although liver transplantation is the most effective treatment option, hepatectomy is still the ifrst curative treatment option because liver transplantation is limited by the donors and high cost. In recent years, laparoscopic liver resection (LLR) has increasingly been performed in patients with liver cirrhosis, and has several advantages over open liver resection. Besides less pain and shorter hospital stay, LLR in patients with liver cirrhosis is also associated with lower incidences of postoperative liver failure and ascites because of greater preservation of collateral veins and less liver manipulation. With increasing experience, LLR for HCC located in segments 7 or 8 is now feasible, and anatomic LLR could be performed in patients with cirrhosis. Many comparative studies have shown that LLR is better than open liver resection in patients with liver cirrhosis in terms of a lower incidence of postoperative liver failure and similar patient survival. In conclusion, LLR is a promising treatment modality for HCC in patients with liver cirrhosis.

  1. Peritoneoscopy of alcoholic liver cirrhosis in comparison with non-alcoholic liver cirrhosis.

    Directory of Open Access Journals (Sweden)

    Kitadai,Masahiro

    1985-04-01

    Full Text Available Peritoneoscopic findings of 39 patients with alcoholic liver cirrhosis (ALC were compared with those of 95 patients with non-alcoholic liver cirrhosis (NALC. They were selected from 245 patients with liver cirrhosis subjected to peritoneoscopy in the 7 year period from 1975 to 1981. Out of the 95 NALC patients, 24 had hepatitis B surface antigen. The ALC patients had nodules which varied in size (61%, large depressions (69%, and a markedly rounded edge of the liver (33% more often than NALC patients (18, 43 and 3%, respectively. Nodularity differed between the right and left lobes in ALC (41% more often than in NALC (16%. Interstitial reddish markings and patchy nodules were, however, more frequent in NALC (51 and 28%, respectively than in ALC (8 and 5%, respectively. Lymphatic vesicles were observed both in ALC (85% and NALC (78%. In conclusion, the peritoneoscopic features which suggested ALC were the coexistence of nodules of various sizes, large depressions and a markedly dull edge of the liver. Interstitial reddish markings and patchy nodules were more indicative of NALC than ALC.

  2. New prognostic markers in liver cirrhosis.

    Science.gov (United States)

    Di Martino, Vincent; Weil, Delphine; Cervoni, Jean-Paul; Thevenot, Thierry

    2015-05-28

    Determining the prognosis of cirrhotic patients is not an easy task. Prognostic scores, like Child-Pugh and Model of End-stage Liver Disease scores, are commonly used by hepatologists, but do not always reflect superimposed events that may strongly influence the prognosis. Among them, bacterial intestinal translocation is a key phenomenon for the development of cirrhosis-related complications. Several biological variables (C-reactive protein, serum free cortisol, copeptin, von Willebrand factor antigen) are surrogates of "inflammatory stress" and have recently been identified as potential prognostic markers in cirrhotic patients. Most of these above mentioned markers were investigated in pilot studies with sometimes a modest sample size but allow us to catch a glimpse of the pathophysiological mechanisms leading to the worsening of cirrhosis. These new data should generate further well-designed studies to better assess the benefit for liver function of preventing intestinal bacterial translocation and microvascular thrombosis. The control of infection is vital and among all actors of immunity, vitamin D also appears to act as an anti-infective agent and therefore has probably a prognostic value.

  3. New prognostic markers in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Determining the prognosis of cirrhotic patients is not aneasy task. Prognostic scores, like Child-Pugh and Modelof End-stage Liver Disease scores, are commonly usedby hepatologists, but do not always reflect superimposedevents that may strongly influence the prognosis.Among them, bacterial intestinal translocation is a keyphenomenon for the development of cirrhosis-relatedcomplications. Several biological variables (C-reactiveprotein, serum free cortisol, copeptin, von Willebrandfactor antigen) are surrogates of "inflammatory stress"and have recently been identified as potential prognosticmarkers in cirrhotic patients. Most of these abovementioned markers were investigated in pilot studieswith sometimes a modest sample size but allow us tocatch a glimpse of the pathophysiological mechanismsleading to the worsening of cirrhosis. These new datashould generate further well-designed studies to betterassess the benefit for liver function of preventingintestinal bacterial translocation and microvascularthrombosis. The control of infection is vital and amongall actors of immunity, vitamin D also appears to actas an anti-infective agent and therefore has probably aprognostic value.

  4. Hepatoprotective Effect of the Aqueous Extract of Simarouba amara Aublet (Simaroubaceae Stem Bark against Carbon Tetrachloride (CCl4-Induced Hepatic Damage in Rats

    Directory of Open Access Journals (Sweden)

    Hélida M. L. Maranhão

    2014-10-01

    Full Text Available Simarouba amara stem bark decoction has been traditionally used in Brazil to treat malaria, inflammation, fever, abdominal pain, diarrhea, wounds and as a tonic. In this study, we investigate the hepatoprotective effects of the aqueous extract of S. amara stem bark (SAAE on CCl4-induced hepatic damage in rats. SAAE was evaluated by high performance liquid chromatography. The animals were divided into six groups (n = 6/group. Groups I (vehicle—corn oil, II (control-CCl4, III, IV, V and VI were pretreated during 10 consecutive days, once a day p.o, with Legalon® 50 mg/kg b.w, SAAE at doses 100, 250 and 500 mg/kg b.w, respectively. The hepatotoxicity was induced on 11th day with 2 mL/kg of 20% CCl4 solution. 24 h after injury, the blood samples were collected and their livers were removed to biochemical and immunohistochemical analyzes. The SAAE decreased the levels of liver markers and lipid peroxidation in all doses and increased the catalase levels at doses 250 and 500 mg/kg. Immunohistochemical results suggested hepatocyte proliferation in all doses. These results may be related to catechins present in SAAE. Thus, SAAE prevented the oxidative damage at the same time that increased regenerative and reparative capacities of the liver.

  5. Periodontal disease and liver cirrhosis: A systematic review.

    Science.gov (United States)

    Grønkjær, Lea Ladegaard

    2015-01-01

    Studies suggest that periodontal disease, a source of subclinical and persistent infection, may be associated with various systemic conditions, including liver cirrhosis. The aim of this study was to examine the literature and determine the relationship between periodontal disease and liver cirrhosis and to identify opportunities and directions for future research in this area. A systematic review of English articles in the PubMed, EMBASE, and Scopus databases was conducted using search terms including 'liver cirrhosis', 'end-stage liver disease', 'liver diseases', 'oral health', 'periodontal disease', 'mouth disease', 'gingivitis', and 'periodontitis'. Thirteen studies published between 1981 and 2014 were found to include data on oral health and periodontal disease in cirrhotic patients. Studies indicated an increased incidence of periodontal disease in patients with liver cirrhosis, measured with several different periodontal indices. The reported prevalence of periodontal disease in cirrhosis patients ranged from 25.0% to 68.75% in four studies and apical periodontitis was found in 49%-79% of the patients. One study found that mortality was lower among patients who underwent dental treatment versus non-treated patients. Another study suggested an association between periodontal disease and the progression of liver cirrhosis, but data are sparse and conflicting as to whether periodontal disease is correlated to cirrhosis aetiology and severity. Despite the clinical reality of periodontal disease in liver cirrhosis patients, there are few published studies. Before clinical implications can be addressed, more data on the prevalence of and correlation between periodontal disease and liver cirrhosis aetiology, duration, and progression are needed.

  6. [Nutrition in liver cirrhosis: diagnostic aspects and treatment].

    Science.gov (United States)

    Gundling, F; Schepp, W

    2008-04-01

    Malnutrition is very common in patients with liver cirrhosis and includes especially protein-calorie malnutrition. The pathophysiological reasons vary and are caused by metabolic modifications and characteristics of enteral absorption and digestion cause by the cirrhosis. Malnutrition contributes to overall mortality and complication rate of the chronic liver disease. An adequate daily energy and protein supply should be ensured in patients with liver cirrhosis, which is higher than that in the normal population, because of higher amino-acid turnover. Ascites may benefit from daily low-salt fluid intake. Nutritional substitution of vitamins and trace elements is indicated when symptoms of deficiency occur.

  7. Prediction of liver cirrhosis, using diagnostic imaging tools

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Early diagnosis of liver cirrhosis is important. Ultrasoundguidedliver biopsy is the gold standard for diagnosis ofliver cirrhosis. However, its invasiveness and samplingbias limit the applicability of the method. Basic imagingfor the diagnosis of liver cirrhosis has developed overthe last few decades, enabling early detection ofmorphological changes of the liver by ultrasonography(US), computed tomography, and magnetic resonanceimaging (MRI). They are also accurate diagnosticmethods for advanced liver cirrhosis, for which earlydiagnosis is difficult. There are a number of ways tocompensate for this difficulty, including texture analysisto more closely identify the homogeneity of hepaticparenchyma, elastography to measure the stiffness andelasticity of the liver, and perfusion studies to determinethe blood flow volume, transit time, and velocity.Amongst these methods, elastography using US andMRI was found to be slightly easier, faster, and able toprovide an accurate diagnosis. Early diagnosis of livercirrhosis using MRI or US elastography is therefore arealistic alternative, but further research is still needed.

  8. Circulating microRNAs as a Fingerprint for Liver Cirrhosis.

    Directory of Open Access Journals (Sweden)

    Yan-Jie Chen

    Full Text Available Sensitive and specific detection of liver cirrhosis is an urgent need for optimal individualized management of disease activity. Substantial studies have identified circulation miRNAs as biomarkers for diverse diseases including chronic liver diseases. In this study, we investigated the plasma miRNA signature to serve as a potential diagnostic biomarker for silent liver cirrhosis.A genome-wide miRNA microarray was first performed in 80 plasma specimens. Six candidate miRNAs were selected and then trained in CHB-related cirrhosis and controls by qPCR. A classifier, miR-106b and miR-181b, was validated finally in two independent cohorts including CHB-related silent cirrhosis and controls, as well as non-CHB-related cirrhosis and controls as validation sets, respectively.A profile of 2 miRNAs (miR-106b and miR-181b was identified as liver cirrhosis biomarkers irrespective of etiology. The classifier constructed by the two miRNAs provided a high diagnostic accuracy for cirrhosis (AUC = 0.882 for CHB-related cirrhosis in the training set, 0.774 for CHB-related silent cirrhosis in one validation set, and 0.915 for non-CHB-related cirrhosis in another validation set.Our study demonstrated that the combined detection of miR-106b and miR-181b has a considerable clinical value to diagnose patients with liver cirrhosis, especially those at early stage.

  9. [Treatment of liver cirrhosis - actually possibility of ambulant internist].

    Science.gov (United States)

    Ehrmann, Jiří; Aiglová, Květa; Konečný, Michal; Procházka, Vlastimil; Vrzalová, Drahomíra

    There are 40 000-60 000 patients with cirrhosis in the Czech Republic. 2 000 die of this disease yearly. This group of patients needs a complex treatment and it is mostly an internist cooperating with other specialists. The most important for an ambulant internist is to diagnose the disease as soon as possible and start with treatment of chronic liver disease that could lead to a cirrhosis. It means especially chronic viral hepatitis, alcoholic or non-alcoholic steatosis/steatohepatitis, auto-immune liver damage and metabolic disease. The next step is to diagnose the cirrhosis in time when it is in no manifest stage. The third step is to diagnose and treat the liver decompensation. It means consequences of the portal hypertension, it is ascit, esophageal or gastric varices, hepatorenal syndrome. Next there are consequences of the metabolic insufficiency, it is icterus, coagulopathy and hepatic encephalopathy. It is necessary to diagnose and cure cholestasis from the very first extrahepatic causes. For a successful treatment of the hepatocellular carcinoma originated almost exclusively in the grounds of the cirrhosis must be early diagnosed. The ambulant internist respective hepatologist must diagnose the stage of the cirrhosis and decide when a hospitalization is necessary. Also a close cooperation with other specialists is urgent if it is about a liver transplantation. The treatment of successive stages of the cirrhosis is a topic of the showed educational article. compensated/decompensated liver cirrhosis - diet/nutrition in liver cirrhosis - etiology and diagnose of liver cirrhosis - treatment of liver insufficiency/failure - treatment of portal hypertension and its complications.

  10. High prevalence of diabetes mellitus in patients with liver cirrhosis

    NARCIS (Netherlands)

    N. Wlazlo; H.J.B.H. Beijers; E.J. Schoon; H.P. Sauerwein; C.D.A. Stehouwer; B. Bravenboer

    2010-01-01

    P>Aims The reported prevalence of Type 2 diabetes mellitus in patients with liver cirrhosis is five times higher than in the general population. However, these data were never adjusted for classical risk factors for Type 2 diabetes. We therefore investigated the association between cirrhosis and Typ

  11. Gut microbiota and host metabolism in liver cirrhosis.

    Science.gov (United States)

    Usami, Makoto; Miyoshi, Makoto; Yamashita, Hayato

    2015-11-07

    The gut microbiota has the capacity to produce a diverse range of compounds that play a major role in regulating the activity of distal organs and the liver is strategically positioned downstream of the gut. Gut microbiota linked compounds such as short chain fatty acids, bile acids, choline metabolites, indole derivatives, vitamins, polyamines, lipids, neurotransmitters and neuroactive compounds, and hypothalamic-pituitary-adrenal axis hormones have many biological functions. This review focuses on the gut microbiota and host metabolism in liver cirrhosis. Dysbiosis in liver cirrhosis causes serious complications, such as bacteremia and hepatic encephalopathy, accompanied by small intestinal bacterial overgrowth and increased intestinal permeability. Gut dysbiosis in cirrhosis and intervention with probiotics and synbiotics in a clinical setting is reviewed and evaluated. Recent studies have revealed the relationship between gut microbiota and host metabolism in chronic metabolic liver disease, especially, non-alcoholic fatty liver disease, alcoholic liver disease, and with the gut microbiota metabolic interactions in dysbiosis related metabolic diseases such as diabetes and obesity. Recently, our understanding of the relationship between the gut and liver and how this regulates systemic metabolic changes in liver cirrhosis has increased. The serum lipid levels of phospholipids, free fatty acids, polyunsaturated fatty acids, especially, eicosapentaenoic acid, arachidonic acid, and docosahexaenoic acid have significant correlations with specific fecal flora in liver cirrhosis. Many clinical and experimental reports support the relationship between fatty acid metabolism and gut-microbiota. Various blood metabolome such as cytokines, amino acids, and vitamins are correlated with gut microbiota in probiotics-treated liver cirrhosis patients. The future evaluation of the gut-microbiota-liver metabolic network and the intervention of these relationships using probiotics

  12. Management of Coagulopathy in Patients with Decompensated Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Pooja D. Amarapurkar

    2011-01-01

    Full Text Available Patients with decompensated liver cirrhosis have significantly impaired synthetic function. Many proteins involved in the coagulation process are synthesized in the liver. Routinely performed tests of the coagulation are abnormal in patients with decompensated liver cirrhosis. This has led to the widespread belief that decompensated liver cirrhosis is prototype of acquired hemorrhagic coagulopathy. If prothrombin time is prolonged more than 3 seconds over control, invasive procedures like liver biopsy, splenoportogram, percutaneous cholangiography, or surgery were associated with increased risk of bleeding, and coagulopathy should be corrected with infusion of fresh frozen plasma. These practices were without any scientific evidence and were associated with significant hazards of fresh frozen plasma transfusion. Now, it is realized that coagulation is a complex process involving the interaction of procoagulation and anticoagulation factors and the fibrinolytic system. As there is reduction in both anti and procoagulant factors, global tests of coagulation are normal in patients with acute and chronic liver disease indicating that coagulopathy in liver disease is more of a myth than a reality. In the last few years, surgical techniques have substantially improved, and complex procedures like liver transplantation can be done without the use of blood or blood products. Patients with liver cirrhosis may also be at increased risk of thrombosis. In this paper, we will discuss coagulopathy, increased risk of thrombosis, and their management in decompensated liver cirrhosis.

  13. Management of coagulopathy in patients with decompensated liver cirrhosis.

    Science.gov (United States)

    Amarapurkar, Pooja D; Amarapurkar, Deepak N

    2011-01-01

    Patients with decompensated liver cirrhosis have significantly impaired synthetic function. Many proteins involved in the coagulation process are synthesized in the liver. Routinely performed tests of the coagulation are abnormal in patients with decompensated liver cirrhosis. This has led to the widespread belief that decompensated liver cirrhosis is prototype of acquired hemorrhagic coagulopathy. If prothrombin time is prolonged more than 3 seconds over control, invasive procedures like liver biopsy, splenoportogram, percutaneous cholangiography, or surgery were associated with increased risk of bleeding, and coagulopathy should be corrected with infusion of fresh frozen plasma. These practices were without any scientific evidence and were associated with significant hazards of fresh frozen plasma transfusion. Now, it is realized that coagulation is a complex process involving the interaction of procoagulation and anticoagulation factors and the fibrinolytic system. As there is reduction in both anti and procoagulant factors, global tests of coagulation are normal in patients with acute and chronic liver disease indicating that coagulopathy in liver disease is more of a myth than a reality. In the last few years, surgical techniques have substantially improved, and complex procedures like liver transplantation can be done without the use of blood or blood products. Patients with liver cirrhosis may also be at increased risk of thrombosis. In this paper, we will discuss coagulopathy, increased risk of thrombosis, and their management in decompensated liver cirrhosis.

  14. Effect of splenectomy on liver cirrhosis and related surgical issues

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    KONG Degang

    2016-12-01

    Full Text Available Patients with liver fibrosis and cirrhosis experience certain changes in spleen morphology and function, and there is always a controversy over whether to perform splenectomy in patients with liver cirrhosis. As a surgical treatment of recurrent portal hypertension complicated by esophagogastric variceal bleeding, splenectomy can reduce portal venous pressure, reduce the possibility of gastrointestinal bleeding, and correct the reduced white blood cell count and platelet count. It can also protect the liver by improving liver function, promoting regeneration of hepatocytes, and inhibiting the progression of liver fibrosis. With reference to available clinical and laboratory data, this article reviews the effect of splenectomy on the cirrhotic liver and related issues such as selection of surgical procedures and prevention and treatment of postoperative complications, in order to promote splenectomy in patients with liver cirrhosis.

  15. CIRRHOSIS AND PRIMARY (LIVER CANCER CARCINOMA INCIDENCE IN IRAN

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    K. Armin

    1970-07-01

    Full Text Available The incidence of cirrhosis and primary hepatic carcinoma in the autopsy material is studied. in 4389 autopsies performed, during the last 9 years we found 134 (3% cases of cirrhosis and 24 (0.5% cases of primary hepatic carcinoma. The majority of the patients were from NorthWest and west part of the city. of the 134 cases of cirrhosis 90 correspond to the portal type, 24 to the post-necrotic type, 12 to the biliary cirrhosis, 6 to the post-hepatitis cirrhosis and two cardiac cisrhosis. 19 of our 134 cases of cirrhosis, occured in children between the age of 4months to 13 years. The liver of the 90 cases diagnosed, Portal cirrhosis were characterized grossely by weights from 510-2800 Gr and fine uniformly nodular surface. Micscopically there was marked, fatty change of hepatic cells, focal and spotty necrosis and delicated fibrillary tongue, interconnecting portal spaces. of the 24 cases post-necrotic cirrhosis 4 had had (26% an antecedent jaundice. The liver ranged, from 700-2500 gr., presenting broad scarring and coars nodules. In bur six cases, Post-hepatitic cirrhosis, the liver were redish brown, and presented uniform nodules, 0,5 to 1.5 Cm. in diameter. Liver weights varried form 850 to 1200 Gr. Microscopically 17 cases of carcinoma were hepato-carcinoma, two presented mixed structures of hepatoma and 5 cases were cholangio Carcinoma. Six of hepatomas showed previous portal cirrhosis and one mixed carcinoma showed previous portal cirrhosis.

  16. Hepatoprotective effects of Lycium chinense Miller fruit and its constituent betaine in CCl4-induced hepatic damage in rats.

    Science.gov (United States)

    Ahn, Meejung; Park, Jong Sang; Chae, Sungwook; Kim, Seungjoon; Moon, Changjong; Hyun, Jin Won; Shin, Taekyun

    2014-07-01

    The hepatoprotective activities of Lycium chinense Miller (LC) fruit extract and its component betaine were investigated under carbon tetrachloride (CCl4)-induced hepatotoxicity in rats. The treatment of LC fruit extract significantly suppressed the increase of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the sera of CCl4 injured rats, and restored the decreased levels of anti-oxidant enzymes such as total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) and suppressed the expression of inflammatory mediators including inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-1 and -2. To visualize the potential activity of betaine, a component of LC fruit, betaine was substituted for LC extract in CCl4 injured rats. The biochemical profile in CCl4 injured rats co-treated with betaine matched those of LC fruit treated CCl4 injured rats. The ameliorative effects of LC extract, as well as betaine, were also confirmed by histopathological examination. Collectively, the present findings imply that LC fruit, via its component betaine, mitigate CCl4-induced hepatic injury by increasing antioxidative activity and decreasing inflammatory mediators including iNOS and COX-1/COX-2.

  17. Biomechanics and functionality of hepatocytes in liver cirrhosis.

    Science.gov (United States)

    Sun, Shan; Song, Zhenyuan; Cotler, Scott J; Cho, Michael

    2014-06-27

    Cirrhosis is a life-threatening condition that is generally attributed to overproduction of collagen fibers in the extracellular matrix that mechanically stiffens the liver. Chronic liver injury due to causes including viral hepatitis, inherited and metabolic liver diseases and external factors such as alcohol abuse can result in the development of cirrhosis. Progression of cirrhosis leads to hepatocellular dysfunction. While extensive studies to understand the complexity underlying liver fibrosis have led to potential application of anti-fibrotic drugs, no such FDA-approved drugs are currently available. Additional studies of hepatic fibrogenesis and cirrhosis primarily have focused on the extracellular matrix, while hepatocyte biomechanics has received limited attention. The role of hepatocyte biomechanics in liver cirrhosis remains elusive, and how the cell stiffness is correlated with biological functions of hepatocytes is also unknown. In this study, we demonstrate that the biomechanical properties of hepatocytes are correlated with their functions (e.g., glucose metabolism), and that hepatic dysfunction can be restored through modulation of the cellular biomechanics. Furthermore, our results indicate the hepatocyte functionality appears to be regulated through a crosstalk between the Rho and Akt signaling. These novel findings may lead to biomechanical intervention of hepatocytes and the development of innovative tissue engineering for clinical treatment to target liver cells rather than exclusively focusing on the extracellular matrix alone in liver cirrhosis.

  18. Clinico-hemato-biochemical profile of dogs with liver cirrhosis

    Science.gov (United States)

    Elhiblu, M. A.; Dua, K.; Mohindroo, J.; Mahajan, S. K.; Sood, N. K.; Dhaliwal, P. S.

    2015-01-01

    Aim: The aim of this study was to determine the relevant tools in the diagnosis of liver cirrhosis in dogs. Material and Methods: A total of 140 dogs presented at Veterinary Teaching Hospital, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, showing clinical signs of hepatic insufficiency were subjected to clinico-hemato biochemical, urological, ultrasonographic (USG), and USG guided fine-needle biopsy examinations by standard methods. On the basis of these results, 6 dogs out of 140 dogs were found to be suffering from liver cirrhosis. Six clinically healthy dogs constituted the control group. Results: The dogs suffering from liver cirrhosis manifested inappetence, halitosis, abdominal distension, weight loss, melena, icterus, anemia, and neutrophilic leukocytosis with the left shift. Levels of hemoglobin, lymphocytes, packed cell volume, mean corpuscular volume, mean corpuscular Hb (MCH), and platelet count were significantly lower in liver cirrhosis group than control group while total leukocyte count, neutrophils, and MCH concentration were significantly higher. Glucose, total protein, albumin, A/G ratio, and fibrinogen were significantly lower, and creatinine, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, prothrombin time, and APTT were significantly higher than the control values. Ultrasound revealed diffuse increase in echogenicity with rounded and irregular liver margins. Cytological examination of the ascitic fluid and fine-needle aspiration biopsy of liver was not fruitful in the diagnosis of liver cirrhosis. Conclusions: Liver cirrhosis causes clinical and hemo-biochemical alterations, which require special consideration when treating diseased animals. USG, diffuse increase in echogenicity of liver, rounding and irregularity of liver margins and microhepatica were the consistent findings. It is suggested that USG along with hemo-biochemical alterations may be used as a diagnostic tool for liver cirrhosis

  19. Expression of β2-integrin on leukocytes in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Anatol Panasiuk; Janusz Zak; Elzbieta Maciorkowska; Bozena Panasiuk; Danuta Prokopowicz

    2006-01-01

    AIM: To analyze β2-integrin expression on blood leukocytes in liver cirrhosis.METHODS: In 40 patients with liver cirrhosis and 20healthy individuals, the evaluation of expression of CD11a (LFA-1α), CD11b (Mac-1α), CD11c (αX) and CD49d (VLA-4α) on peripheral blood leukocytes was performed using flow cytometry. The analysis was carried out in groups of patients divided into B and C according to Child-Pugh's classification.RESULTS: An increased CD11a, CD11b, CD11c and CD49d integrin expression was observed on peripheral blood leukocytes in liver cirrhosis. The integrin levels were elevated as the advancement of liver failure progressed. The highest expression of integrins occurred predominantly on monocytes. A slight expression of VLA-4 was found on lymphocytes and granulocytes and it increased together with liver failure. A positive correlation was noted between median intensity of fluorescence (MIF) expression on polymorphonuclear cells of CD11a and CD11c and CD49d (r = 0.42, P < 0.01; r = 053, P < 0.01, respectively) in liver cirrhosis stage C. However,no correlation was observed between integrin expression on leukocytes. The concentrations of sICAM-1, sVCAM-1,and TNFα, were significantly elevated in liver cirrhosis.CONCLUSION: β2-integrin expression on leukocytes increases in liver cirrhosis decompensated as the stage of liver failure increases, which is a result of permanent activation of leukocytes circulating through the inflamed liver environment. β2-integrin expression on circulating leukocytes can intensify liver cirrhosis.

  20. Clinico-hemato-biochemical profile of dogs with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    M. A. Elhiblu

    2015-04-01

    Full Text Available Aim: The aim of this study was to determine the relevant tools in the diagnosis of liver cirrhosis in dogs. Material and Methods: A total of 140 dogs presented at Veterinary Teaching Hospital, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, showing clinical signs of hepatic insufficiency were subjected to clinico-hemato biochemical, urological, ultrasonographic (USG, and USG guided fine-needle biopsy examinations by standard methods. On the basis of these results, 6 dogs out of 140 dogs were found to be suffering from liver cirrhosis. Six clinically healthy dogs constituted the control group. Results: The dogs suffering from liver cirrhosis manifested inappetence, halitosis, abdominal distension, weight loss, melena, icterus, anemia, and neutrophilic leukocytosis with the left shift. Levels of hemoglobin, lymphocytes, packed cell volume, mean corpuscular volume, mean corpuscular Hb (MCH, and platelet count were significantly lower in liver cirrhosis group than control group while total leukocyte count, neutrophils, and MCH concentration were significantly higher. Glucose, total protein, albumin, A/G ratio, and fibrinogen were significantly lower, and creatinine, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, prothrombin time, and APTT were significantly higher than the control values. Ultrasound revealed diffuse increase in echogenicity with rounded and irregular liver margins. Cytological examination of the ascitic fluid and fine-needle aspiration biopsy of liver was not fruitful in the diagnosis of liver cirrhosis. Conclusions: Liver cirrhosis causes clinical and hemo-biochemical alterations, which require special consideration when treating diseased animals. USG, diffuse increase in echogenicity of liver, rounding and irregularity of liver margins and microhepatica were the consistent findings. It is suggested that USG along with hemo-biochemical alterations may be used as a diagnostic tool for

  1. Nonalcoholic fatty liver disease after liver transplantation for cryptogenic cirrhosis or nonalcoholic fatty liver disease.

    Science.gov (United States)

    Yalamanchili, Kanthi; Saadeh, Sherif; Klintmalm, Göran B; Jennings, Linda W; Davis, Gary L

    2010-04-01

    Nonalcoholic steatohepatitis (NASH) may account for many cases of cryptogenic cirrhosis. If so, then steatosis might recur after liver transplantation. Two thousand fifty-two patients underwent primary liver transplantation for chronic liver disease between 1986 and 2004. Serial liver biopsy samples were assessed for steatosis and fibrosis. Two hundred fifty-seven patients (12%) had a pretransplant diagnosis of cryptogenic cirrhosis (239) or NASH (18). Fatty liver developed in 31% and was more common when the pretransplant diagnosis was NASH (45% at 5 years versus 23% for cryptogenic cirrhosis, P = 0.007). NASH developed in only 4% and occurred exclusively when steatosis had already occurred. Steatosis after liver transplantation was associated with the baseline body weight and body mass index by univariate analyses, but no pretransplant or posttransplant characteristic independently predicted steatosis after liver transplantation because obesity was so common in all groups. Five percent and 10% developed bridging fibrosis or cirrhosis after 5 and 10 years, respectively, and this was more common after NASH (31%) than in those who developed steatosis alone (6%) or had no fat (3%, P = 0.002). One-, 5-, and 10-year survival was the same in patients who underwent transplantation for cryptogenic cirrhosis or NASH (86%, 71%, and 56%) and in patients who underwent transplantation for other indications (86%, 71%, and 53%; not significant), but death was more often due to cardiovascular disease and less likely from recurrent liver disease. In conclusion, fatty liver is common after liver transplantation for cryptogenic cirrhosis or NASH but is twice as common in the latter group; this suggests that some cryptogenic cirrhosis, but perhaps not all, is caused by NASH. Posttransplant NASH is unusual, and steatosis appears to be a prerequisite. Advanced fibrosis is uncommon, and survival is the same as that of patients who undergo transplantation for other causes.

  2. FastStats: Chronic Liver Disease and Cirrhosis

    Science.gov (United States)

    ... Liver Disease and Cirrhosis Kidney Disease Oral and Dental Health Respiratory and Allergies Allergies and Hay Fever Asthma ... Day Services Centers Home Health Care Hospice Care Nursing Home Care Residential Care Communities Screenings Mammography Pap ...

  3. IMMUNOLOGICAL FEATURES IN LIVER CIRRHOSIS INDUCED BY HEPATITIS B VIRUS

    Directory of Open Access Journals (Sweden)

    O. I. Urazova

    2007-01-01

    Full Text Available Abstract. A comparative analysis of immunological data was performed in the patients with HBV-induced liver cirrhosis, and in a group of patients with acute and chronic viral hepatitis B (AVHB, CVHB. Activation of B cell immune compartment (increase in CD22+ lymphocytes and IL4, circulating immune complexes in blood was demonstrated in patients with liver cirrhosis, being also associated with increased numbers of CD16+ lymphocytes and T-cell deficiency. It was revealed that the differences are most expressed upon comparison of immunologic data from the patients with liver cirrhosis, and AVHB followed by clearance of the virus. When comparing these groups, the differences in immunological state between the patients with liver cirrhosis and CVHB did not depend on the phase of viral replication or integration.

  4. Advances in gene therapy of liver cirrhosis: a review

    Institute of Scientific and Technical Information of China (English)

    Wen Jie Dai; Hong Chi Jiang

    2001-01-01

    @@ INTRODUCTION Liver fibrosis or cirrhosis is a common progressively pathological lesion of chronic liver diseases in response to various liver-damaging factors. The main mechanisms of fibrotic or cirrhotic initiation and progression at the level of cellular and molecular events have been elucidated in the past two decades[1,2].

  5. Periodontal disease and liver cirrhosis: A systematic review

    OpenAIRE

    Lea Ladegaard Grønkjær

    2015-01-01

    Objectives: Studies suggest that periodontal disease, a source of subclinical and persistent infection, may be associated with various systemic conditions, including liver cirrhosis. The aim of this study was to examine the literature and determine the relationship between periodontal disease and liver cirrhosis and to identify opportunities and directions for future research in this area. Methods: A systematic review of English articles in the PubMed, EMBASE, and Scopus databases was conduct...

  6. Mobilization of hematopoietic progenitor cells in patients with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Ursula; M; Gehling; Marc; Willems; Kathleen; Schlagner; Ralf; A; Benndorf; Maura; Dandri; Jrg; Petersen; Martina; Sterneck; Joerg-Matthias; Pollok; Dieter; K; Hossfeld; Xavier; Rogiers

    2010-01-01

    AIM:To test the hypothesis that liver cirrhosis is associated with mobilization of hematopoietic progenitor cells. METHODS:Peripheral blood samples from 72 patients with liver cirrhosis of varying etiology were analyzed by flow cytometry.Identified progenitor cell subsets were immunoselected and used for functional assays in vitro. Plasma levels of stromal cell-derived factor-1(SDF-1) were measured using an enzyme linked immunosorbent assay.RESULTS:Progenitor cells with a CD133 + /CD45 + CD14 + phenotype we...

  7. EDTA-dependent pseudothrombocytopenia in a case of liver cirrhosis.

    Science.gov (United States)

    Matarazzo, M; Conturso, V; Di Martino, M; Chiurazzi, F; Guida, G; Morante, R

    2000-06-01

    Pseudothrombocytopenia (PTCP) is the consequence of an EDTA-activated platelet agglutination, resulting in a spuriously low platelet count. We report the case of a 54-year-old man with EDTA-dependent PTCP associated with liver cirrhosis. He couldn't undergo endoscopic examination and dental care for two years because of a previous diagnosis of severe thrombocytopenia secondary to liver cirrhosis. Lack of PTCP recognition may lead the physician to misdiagnosis and mismanagement of the patient.

  8. Treatment of Hepatitis B in Decompensated Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Richard Guan

    2011-01-01

    Full Text Available Chronic hepatitis B infection progresses from an asymptomatic persistently infected state to chronic hepatitis, cirrhosis, decompensated liver disease, and/or hepatocellular carcinoma. About 3% of patients with chronic hepatitis develop cirrhosis yearly, and about 5% of individuals with hepatitis B cirrhosis become decompensated annually. The outcome for patients with decompensated cirrhosis is bleak. Lamivudine, the first oral antiviral agent available for hepatitis B treatment is safe and effective and can improve or stabilize liver disease in patients with advanced cirrhosis and viraemia. Viral resistance restricts its prolonged use. Entecavir and tenofovir are newer agents with excellent resistance profile to date. These and some other antiviral agents are being investigated for optimal use in this rather challenging patient group.

  9. Chemopreventive effect of Fumaria indica that modulates the oxidant-antioxidant imbalance during N-nitrosodiethylamine and CCl4-induced hepatocarcinogenesis in Wistar rats

    Institute of Scientific and Technical Information of China (English)

    Talib Hussain; Hefazat H Siddiqui; Sheeba Fareed; K Sweety; M Vijayakumar; Chandana V Rao

    2012-01-01

    Objective: To investigation the chemopreventive efficiency of Fumaria indica extract (FIE) on the antioxidant status of N-nitrosodiethylamine (NDEA) and CCl4-induced hepatocarcinogenesis in Wistar rats. Methods: The experimental animals were divided into six groups (n = 6). HCC was induced by single intraperitoneal injection of NDEA in normal saline at a dose of 200 mg/kg body weight followed by weekly subcutaneous injections of CCl4 (3 mL/kg/week) for 6 weeks, as the promoter of carcinogenic effect. After administration of the carcinogen, 200 and 400 mg/kg of FIE were administered orally once a day throughout the study. At the end of 20 weeks, the body weight, liver weight and relative liver weight were measured. The level of hepatic malondialdehyde (MDA) formation, reduced glutathione (GSH) and the activities of antioxidant enzymes viz. CAT, SOD, GPx, and GST in the liver of NDEA and CCL4-treated rats were assessed. Results: Obtained results demonstrated that the cotreatment with FIE (200 and 400 mg/kg) significantly prevented the decrease of the body weight and also increased in relative liver weight caused by NDEA and CCl4 administration. FIE also significantly prevented hepatic malondialdehyde (MDA) formation and reduced glutathione (GSH) in NDEA-treated rats which were dose dependent. Additionally, FIE also markedly increased the activities of antioxidant enzymes such as CAT, SOD, GPx, and GST in the liver of NDEA and CCL4-treated rats. Conclusions: These finding powerfully supports thatFumaria indica exert a chemopreventive effect by reversing the oxidant-antioxidant imbalance during hepatocarcinogenesis induced by NDEA and CCl4.

  10. Recurrent disease following liver transplantation for nonalcoholic steatohepatitis cirrhosis.

    Science.gov (United States)

    Malik, Shahid M; Devera, Michael E; Fontes, Paulo; Shaikh, Obaid; Sasatomi, Eizaburo; Ahmad, Jawad

    2009-12-01

    Recurrence of the original disease following liver transplantation is not uncommon and can lead to graft failure. There are limited data on recurrent fatty liver disease following liver transplantation. The aim of this study was to determine the incidence of recurrent fatty liver disease in patients with biopsy-proven nonalcoholic steatohepatitis, its effect on survival, and whether there are any predictive factors for recurrence. We analyzed patients undergoing liver transplantation for nonalcoholic steatohepatitis cirrhosis from 1997 to 2008 at a single center. Patients undergoing transplantation for cholestatic disease, alcohol, hepatitis C, or cryptogenic cirrhosis were controls. Ninety-eight patients underwent transplantation for nonalcoholic steatohepatitis cirrhosis. Recurrent fatty liver disease was seen in 70%, 25% had recurrent nonalcoholic steatohepatitis, and 18% had stage II/IV or greater fibrosis at a mean of 18 months. No patients with recurrent nonalcoholic steatohepatitis developed graft failure or required retransplantation at a follow-up of 3 years. No recipient or donor factors were associated with disease recurrence, although patients with recurrent nonalcoholic steatohepatitis had a higher incidence of diabetes, weight gain, and dyslipidemia at the time of diagnosis of recurrence. One-third of patients with recurrent nonalcoholic steatohepatitis had normal liver enzymes at the time of diagnosis post-transplantation. In conclusion, recurrent fatty liver disease is common following liver transplantation for nonalcoholic steatohepatitis cirrhosis but does not lead to early allograft failure. Recurrent nonalcoholic steatohepatitis can occur despite normal liver enzymes, and features of metabolic syndrome are associated with disease recurrence.

  11. Disturbance of hepatic and intestinal microcirculation in experimental liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Sasa-Marcel Maksan; Eduard Ryschich; Zilfi (U)lger; Martha Maria Gebhard; Jan Schmidt

    2005-01-01

    AIM: To analyze hepatic, mesenteric and mucosal microcirculation and leukocyte-endothelium interaction (LEI) in a rat model with liver cirrhosis.METHODS: Hepatic cirrhosis was induced in Wistar rats by gavage with carbon tetrachloride, and intravital videomicroscopy was performed in liver, mesentery and small intestine mucosa. Special emphasis is given on microcirculatory and morphometric changes during cirrhotic portal hypertension.RESULTS: LEI was influenced significantly in the cirrhotic liver but not in the gut. Blood flow measurement showed significant differences among liver, main mesenteric vessels and the mucosa. The results of our study indicate that liver cirrhosis leads to alterations in hepatic and mesenteric blood flow but not in mucosal blood flow.CONCLUSION: The enhanced inflammatory response in hepatic microvessels may be caused by a decrease of antithrombin Ⅲ levels and could be responsible for disturbances of organ pathology.

  12. BIOCHEMICAL NUTRITIONAL PROFILE OF LIVER CIRRHOSIS PATIENTS WITH HEPATOCELLULAR CARCINOMA

    Directory of Open Access Journals (Sweden)

    Gabriela Zanatta PORT

    2014-03-01

    Full Text Available Context Liver cirrhosis patients with hepatocellular carcinoma present nutritional alterations and metabolic disorders that negatively impact the prognosis. Objective The objective is to identify alterations in the metabolism of macro and micronutrients among liver cirrhosis patients with and without hepatocellular carcinoma and their relation to the Child-Turcote-Pugh score and Barcelona Clinic Liver Cancer staging. Methods Analytical transversal study, with 31 hepatocellular carcinoma patients and 48 liver cirrhosis patients. Laboratorial exams were carried out. The existence of an association between the biochemical parameters and the disease severity as well as the presence of hepatocellular carcinoma was assessed. Results The metabolic-nutritional profile of liver cirrhosis patients caused by the hepatitis C virus and hepatocellular carcinoma showed alterations, specifically the lipid (total cholesterol, HDL and triglycerides, protein (albumin, creatinine and uric acid, iron (transferrin, iron and ferritin saturation, hematocrit and hemoglobin, zinc and B12 vitamin profiles. There is a relation between nutritional biochemical markers and the Child-Turcote-Pugh, as well as Barcelona Clinic Liver Cancer staging. Conclusions Considering the existence of alterations in the metabolism of nutrients in liver cirrhosis patients with and without hepatocellular carcinoma, and also that conventional nutritional assessment methods present limitations for this population, the biochemical laboratorial exams are valid to complement the diagnosis of the nutritional state in a quick and practical manner.

  13. Management of liver cirrhosis between primary care and specialists

    Institute of Scientific and Technical Information of China (English)

    Ignazio Grattagliano; Enzo Ubaldi; Leonilde Bonfrate; Piero Portincasa

    2011-01-01

    This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: "ascites", "liver fibrosis","cirrhosis", "chronic hepatitis", "chronic liver disease","decompensated cirrhosis", "hepatic encephalopathy","hypertransaminasemia", "liver transplantation" and "portal hypertension". Forty-nine papers were selected based on the highest quality of evidence for each section and type (original, randomized controlled trial, guideline, and review article), with respect to specialist setting (Gastroenterology,Hepatology, and Internal Medicine) and primary care. Liver cirrhosis from any cause represents an emerging health issue due to the increasing prevalence of the disease and its complications worldwide. Primary care physicians play a key role in early identification of risk factors, in the management of patients for improving quality and length of life, and for preventing complications.Specialists, by contrast, should guide specific treatments, especially in the case of complications and for selecting patient candidates for liver transplantation. An integrated approach between specialists and primary care physicians is essential for providing better outcomes and appropriate home care for patients with liver cirrhosis.

  14. Nutritional assessment and treatment of patients with liver cirrhosis.

    Science.gov (United States)

    Moctezuma-Velázquez, Carlos; García-Juárez, Ignacio; Soto-Solís, Rodrigo; Hernández-Cortés, Juan; Torre, Aldo

    2013-01-01

    Prevalence of chronic liver diseases, including liver cirrhosis, is increasing worldwide. The nutritional state assessment in these patients is complicated, and besides anthropometry is based on several other tools in order to be more accurate. Specific dietary recommendations are needed in patients with chronic liver diseases in order to help prevent and treat liver decompensation because malnutrition is an independent predictor of mortality. This review focuses on essential aspects in the nutritional assessment of cirrhotic patients and some general recommendations for their treatment.

  15. Detection of novel biomarkers of liver cirrhosis by proteomic analysis

    DEFF Research Database (Denmark)

    Mölleken, Christian; Sitek, Barbara; Henkel, Corinna;

    2009-01-01

    liver biopsy allows a reliable evaluation of the course of hepatitis C by grading inflammation and staging fibrosis, and thus serum biomarkers for hepatic fibrosis with high sensitivity and specificity are needed. To identify new candidate biomarkers for hepatic fibrosis, we performed a proteomic......Hepatic cirrhosis is a life-threatening disease arising from different chronic liver disorders. One major cause for hepatic cirrhosis is chronic hepatitis C. Chronic hepatitis C is characterized by a highly variable clinical course, with at least 20% developing liver cirrhosis within 40 years. Only...... approach of microdissected cirrhotic septa and liver parenchyma cells. In cirrhotic septa, we detected an increasing expression of cell structure associated proteins, including actin, prolyl 4-hydroxylase, tropomyosin, calponin, transgelin, and human microfibril-associated protein 4 (MFAP-4). Tropomyosin...

  16. Targeting the gut-liver axis in cirrhosis

    DEFF Research Database (Denmark)

    Madsen, Bjørn S; Havelund, Troels; Krag, Aleksander

    2013-01-01

    The gut-liver axis in cirrhosis and portal hypertension is gaining increasing attention as a key pathophysiological mechanism responsible for progression of liver failure and development of complications such as spontaneous infections and hepatocellular carcinoma. Antibiotics and non-selective β-...

  17. Efficacy of toivaptan for delusional hyponatremia in decompensated liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    阚晓

    2014-01-01

    Objective To investigate the efficacy and safety of vasopressin receptor antagonist tolvaptan for treating dilutional hyponatremia casused by decompensated liver cir-rhosis.Methods Ninety-six subjects with decompensated liver cirrhosis complicated by dilutional hyponatremia were divided into test group(n=56)and control group(n=40)by double blind method.

  18. Endocrine-Manifestations of Cirrhosis and Liver Disease

    Directory of Open Access Journals (Sweden)

    M Khalili

    2014-04-01

    Full Text Available The liver is involved in the synthesis and metabolism of many kinds of hormones, various abnormalities hormone levels are found in advanced liver disease. For example the liver is, extremely sensitive to changes in insulin or glucagon levels. The liver is the primary organ of iron storage is frequently involved, diabetes is common in patients with iron overload and may be seen in cirrhosis. Chronic infection with HCV is associated with insulin resistance. Thyroid disease often accompanies chronic hepatitis C infection .Anti thyroid autoantibodies are also found in chronic HCV infection. Nonalcoholic liver disease (NAFLDas a most common cause of chronic liver disease in western world ,as well accompanied by Type 2 diabetes and hyperlipidemia. Hypopituitarism and hypothyroidism also have been in NAFLD.The patients with NAFLD and Hypopituitarism may be susceptible to central obesity, dyslipidemia and insulin resistance leading to disease progression. Hepatic cirrhosis as the end stage of chronic liver disease is also associated with hypogonadism and signs of feminization. The peripheral metabolism of steroids is altered in many of hypogonadism, low testosterone level decreased libido, infertility, reduced secondary sex hair and gynecomastia, reduced spermatogenesis and peritubular fibrosis are found in men with cirrhosis .The normal function of the hypothalamic-pituitary gonadal axis is affected in liver disease. In cirrhotic patients the estrogen/androgen ratio is usually increased, the level of testosterone and dihydroepiandosteron are reduced while the estradiol level are normal or slightly elevated, these alterations are dependent on the severity of the liver disease.Succsesfull orthotropic liver transplantation  leads to improvement of the sex hormone disturbances. The pathogenesis of gynecomastia is due to the loss of equilibrium between estrogen and androgen caused by a feminizing state but it is due to increased estrogen precursor in

  19. Probiotics in Nonalcoholic Fatty Liver Disease, Nonalcoholic Steatohepatitis, and Cirrhosis.

    Science.gov (United States)

    Qamar, Amir A

    2015-01-01

    With the growing epidemic of obesity, the incidence of both nonalcoholic fatty liver disease (NAFL) and nonalcoholic steatohepatitis (NASH) is increasing. The intestinal microbiota differs between individuals who are obese or have normal body mass indices. Animal studies have shown increased intestinal permeability in NAFL, NASH, and cirrhosis. This increases the risk of oxidative and inflammatory injury to the liver from intestinal microbacteria. It may also increase the risk of fatty acid injury and fatty deposition. Bacterial translocation is associated with increased portal hypertension and hepatic encephalopathy in cirrhosis. By preventing bacterial adhesion and translocation, probiotics may have a role in the management of patients with NAFL, NASH, and cirrhosis. Multiple small studies have suggested that probiotics improve some of the clinical markers of activity in patients with NAFL and NASH. Controlled studies have also shown improved outcomes in patients with cirrhosis who were treated with probiotics.

  20. Gut microbiota dysbiosis is associated with inflammation and bacterial translocation in mice with CCl4-induced fibrosis.

    Directory of Open Access Journals (Sweden)

    Isabel Gómez-Hurtado

    Full Text Available BACKGROUND: Gut is the major source of endogenous bacteria causing infections in advanced cirrhosis. Intestinal barrier dysfunction has been described in cirrhosis and account for an increased bacterial translocation rate. HYPOTHESIS AND AIMS: We hypothesize that microbiota composition may be affected and change along with the induction of experimental cirrhosis, affecting the inflammatory response. ANIMALS AND METHODS: Progressive liver damage was induced in Balb/c mice by weight-controlled oral administration of carbon tetrachloride. Laparotomies were performed at weeks 6, 10, 13 and 16 in a subgroup of treated mice (n = 6/week and control animals (n = 4/week. Liver tissue specimens, mesenteric lymph nodes, intestinal content and blood were collected at laparotomies. Fibrosis grade, pro-fibrogenic genes expression, gut bacterial composition, bacterial translocation, host's specific butyrate-receptor GPR-43 and serum cytokine levels were measured. RESULTS: Expression of pro-fibrogenic markers was significantly increased compared with control animals and correlated with the accumulated dose of carbon tetrachloride. Bacterial translocation episodes were less frequent in control mice than in treated animals. Gram-positive anaerobic Clostridia spp count was decreased in treated mice compared with control animals and with other gut common bacterial species, altering the aerobic/anaerobic ratio. This fact was associated with a decreased gene expression of GPR43 in neutrophils of treated mice and inversely correlated with TNF-alpha and IL-6 up-regulation in serum of treated mice along the study protocol. This pro-inflammatory scenario favoured blood bacterial translocation in treated animals, showing the highest bacterial translocation rate and aerobic/anaerobic ratio at the same weeks. CONCLUSIONS: Gut microbiota alterations are associated with the development of an inflammatory environment, fibrosis progression and bacterial translocation in

  1. Muscle hematoma: A critically important complication of alcoholic liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Chiyo Sugiyama; Akifumi Akai; Noriyoshi Yamakita; Tsuneko Ikeda; Keigo Yasuda

    2009-01-01

    An iliopsoas hematoma can occur either spontaneously or secondary to trauma or bleeding tendency due to hemophilia and anticoagulant therapy. Although liver cirrhosis is commonly associated with coagulopathy, iliopsoas hematoma is very rare. We herein, present a case of bilateral iliopsoas hematoma in a patient with alcoholic cirrhosis, and review the literature on muscle hematoma associated with cirrhosis. A 56-year-old man with alcoholic cirrhosis was admitted in a state of shock with anemia. The cause of anemia could not be detected, and the patient was treated conservatively. The site of bleeding was not detected with either gastroduodenal endoscopy or upper abdominal computed tomography, the latter of which did not include the iliopsoas muscle. He died on the 10th day of admission and bilateral iliopsoas hematomas were found on autopsy. An iron stain was positive in the iliopsoas muscle. Eight cases of muscle hematoma associated with cirrhosis, including the present case, were found in a review of the literature. Four of these cases involved the rectus abdominis muscle, 3 involved the iliopsoas muscle and 1 involved combined muscles. Alcoholic cirrhosis accounted for 75% of the cases. One case (12.5%) was associated with virus-related cirrhosis, and another with combined virus-and alcohol-related cirrhosis. The mortality rate was 75% despite early diagnosis and low risk scores for cirrhosis. Muscle hematoma in patients with cirrhosis isclosely related to alcoholism, and the mortality rate of the condition is extremely high. In conclusion, muscle hematoma should be recognized as an important complication of cirrhosis.

  2. DNA Ploidy and Liver Cell Dysplasia in Liver Biopsies from Patients with Liver Cirrhosis

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    Sayed S El-Sayed

    2004-01-01

    Full Text Available There is controversy among pathologists when assessing the presence or absence of liver cell dysplasia in liver biopsies taken from cirrhotic patients. The objective of the present study was to determine the DNA ploidy pattern of hepatocytes of patients with liver cirrhosis and its relationship to liver cell dysplasia. A total of 48 male patients diagnosed with liver cirrhosis based on clinical, laboratory and histopathological criteria were included in the study. A liver biopsy was taken from each patient; one part of the biopsy was subjected to histopathology, and the other to flow cytometry. The histopathological examination revealed liver cell dysplasia in 60% of patients with liver cirrhosis (62% of them had large cell dysplasia [LCD] and 38% had small cell dysplasia [SCD]. Abnormal DNA content (aneuploidy was found in 81.5% of positive liver cell dysplasia specimens and found only in 11.1% of negative liver cell dysplasia specimens, with a statistically significant difference (P0.05 in comparison with SCD. In conclusion, SCD (similar to LCD is also associated with aneuploidy and elevated DNA index, and may carry the same risk for progression to hepatocellular carcinoma.

  3. Hepatoprotective efficacy of Hypnea muciformis ethanolic extract on CCl4 induced toxicity in rats

    Directory of Open Access Journals (Sweden)

    Giridharan Bupesh

    2012-12-01

    Full Text Available The ethanolic extract of Hypnea muciformis (red algae was tested for hepatoprotective activity against experimentally induced liver damage by Carbon tetrachloride (CCl4 in male albino rats. The levels of serum enzymatic and biochemical parameters such as serum glutamate oxaloacetate transaminase (SGOT, Serum glutamate pyruvate transaminase (SGPT, alkaline phosphatase (ALP, lactate dehydrogenase, 5' nucleotidase, bilirubin, creatinine, urea, triglycerides, lipid peroxides and albumin were determined. The CCI4 induced lesions in the liver significant increased the levels of serum marker enzymes SGPT and SGOT, bilirubin, creatinine and decreased urea. The oral treatment with ethanolic extract of H. muciformis exhibited significant hepatoprotective activity by reducing the CCL4 caused changes in the biochemical parameters such as total protein, total bilirubin, total cholesterol, triglycerides, and urea. These parameters were restored towards the normal levels as shown by the enzymatic tests. In addition, H. muciformis significantly decreased the liver weight of CCl4 intoxicated rats. Apparently the H. muciformis extract interfered with the free radical formation, which resulted in hepatoprotective activity. Acute toxicity studies revealed that the LD50 value was more than 3 g/kg body weight. These results clearly indicated that this seaweed contained some active principles in its ethanolic extract which acted as an antidote against the hepatotoxicity induced by CCl4.

  4. Portal hypertensive colopathy in patients with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Keiichi Ito; Katsuya Shiraki; Takahisa Sakai; Hitoshi Yoshimura; Takeshi Nakano

    2005-01-01

    AIM: In patients with liver cirrhosis and porlal hypertension, portal hypertensive colopathy is thought to be an important cause of lower gastrointestinal hemorrhage. In this study, we evaluated the prevalence of colonic mucosal changes in patients with liver cirrhosis and its clinical significance. METHODS: We evaluated the colonoscopic findings and liver function of 47 patients with liver cirrhosis over a 6-year period. The main cause of liver cirrhosis was post-viral hepatitis (68%) related to hepatitis B (6%) or C (62%)infection. All patients underwent upper gastrointestinal endoscopy to examine the presence of esophageal varices, cardiac varices, and congestive gastropathy, as well as a full colonoscopy to observe changes in colonic mucosa. Portal hypertensive colopathy was defined endoscopically in patients with vascular ectasia, redness, and blue vein. Vascular ectasia was classified into two types: type 1, solitary vascular ectasia; and type 2, diffuse vascular ectasia.RESULTS: Overall portal hypertensive colopathy was present in 31 patients (66%), including solitary vascular ectasia in 17 patients (36%), diffuse vascular ectasia in 20 patients (42%), redness in 10 patients (21%) and blue vein in 6 patients (12%). As the Child-Pugh class increased in severity, the prevalence of portal hypertensive colopathy rose. Child-Pugh class B and C were significantly associated with portal hypertensive colopathy. Portal hypertensive gastropathy, esophageal varices, ascites and hepatocellular carcinoma were not related to occurrence of portal hypertensive colopathy. Platelet count was significantly associated with portal hypertensive colopathy, but prothrombin time, serum albumin level, total bilirubin level and serum ALT level were not related to occurrence of portal hypertensive colopathy. CONCLUSION: As the Child-Pugh class worsens and platelet count decreases, the prevalence of portal hypertensive colopathy increases in patients with liver cirrhosis. A colonoscopic

  5. Beneficial effect of hyperbaric oxygenation on liver regeneration in cirrhosis.

    Science.gov (United States)

    Ozdogan, Mehmet; Ersoy, Eren; Dundar, Kadir; Albayrak, Levent; Devay, Seda; Gundogdu, Haldun

    2005-12-01

    Underlying hepatic injury and cirrhosis are leading factors that interfere with the post-operative liver regeneration and function. Hyperbaric oxygenation (HBO) has been reported to ameliorate the ischemia-reperfusion injury of the liver, to induce compensatory hypertrophy of the predicted remnant liver in rats after portal vein ligation and to augment liver regeneration after hepatectomy in non-cirrhotic rats. Our aim was to determine the effect of HBO treatment on liver regeneration after partial hepatectomy in normal and cirrhotic mice in this experimental study. The effect of HBO on liver regeneration was studied in a mice model combining carbon tetrachloride induced cirrhosis and partial hepatectomy. Mice were divided into four groups: Control, cirrhotic, non-cirrhotic HBO-treated, and cirrhotic HBO-treated. All animals underwent 40% hepatectomy. Liver regeneration was evaluated by the proliferating cell nuclear antigen-labeling index. Serum aspartate aminotransferase and alanine aminotransferase levels were measured to evaluate liver injury. Serum alanine aminotransferase and aspartate aminotransferase levels were significantly decreased in HBO-treated cirrhotic group compared to cirrhosis group after hepatectomy (P = 0.001 and P = 0.014, respectively). The proliferating cell nuclear antigen labeling index was significantly higher in HBO treated cirrhotic group than in cirrhotic group after hepatectomy (P = 0.022). Our results suggest that HBO treatment improves liver functions and augments hepatocyte regeneration in cirrhotic mice after hepatectomy. Post-operative HBO treatment may have a beneficial effect on post-operative liver function and regeneration in cirrhotic patients.

  6. THE ROLE OF ENALAPRIL IN PATHOGENESIS OF CCL4 INDUCED HEPATIC FIBROSIS

    Institute of Scientific and Technical Information of China (English)

    魏红山; 李定国; 陆汉明; 展玉涛; 王志荣; 黄新; 徐芹芳

    2001-01-01

    Objective The present study was designed to examine whether the renin-angiotensin system would be implicated in the development of hepatic fibrosis induced by CCl4. The effects of enalapril on the expression of platelet derived growth factor receptor (PDGFR) in liver tissue were also investigated. Methods 50 Sprague-Dawley rats were randomly divided into 5 groups (control group, model group, and 3 enalapril treated groups ). Except rats of the model group, all rats received subcutanous injection of 40% CCl4 (every 3d for 6 weeks). Rats of enalapril treated groups were given enalapril (10mg/kg, 5mg/kg, 2.5mg/kg per day, orally) for 6 weeks before they were killed. Serum levels of hyaluronic acid (HA) and laminin ( LN) were deterrnined by radioimmunoassay techniques. Van Gieson collagen staining was used to evaluate the extracellular matrix of the liver. The expressions of PDGFR and a-smooth muscle actin ( α-SMA ) were confirmed by immunohistochemical methods. Results Compared with those in the model group, it was found in enalapril treated groups: (1) serum levels of collagen type Ⅳ and LN were significantly reduced (P<0.01); (2) the progression of fibrosis was delayed (P<0.01); (3) the expressions of PDGFR and a-SMA were decreased. Conclusion The renin-angiotensin system was involved in the development of hepatic fibrosis induced by CCl4. Angiotensin-converting enzyme (ACE) inhibitor and enalapril could slow down the rate of hepatic fibrosis. This effect might be due to the ability of this drug in suppressing the expression of PDGFR of liver tissue.

  7. Cryptogenetic liver cirrhosis and prothrombotic mutations: a mere association?

    Directory of Open Access Journals (Sweden)

    María Monereo-Muñoz

    Full Text Available Thrombin activation and microthrombosis of intrahepatic portal venules is a common feature in liver cirrhosis, due in part to relative protein C deficiency and altered coagulation-anticoagulation-fibrinolysis balance. Extension of this microthrombotic process to larger portal vessels explains the increased incidence of portal vein thrombosis in liver cirrhosis. Thrombin not only leads to thrombosis, but also activates liver stellate cells and promotes fibrogenesis. Also, ischemia associated with thrombosis up-regulates the expression and secretion of growth factors involved in fibrogenesis. The coincidence in a given patient of prothrombotic mutations, such as factor V Leiden or PAI-1 polymorphisms, can accelerate the fibrogenetic process. We hereby present two cases of liver cirrhosis in which etiologic evaluation was negative except for the finding of a factor V Leiden mutation in one case and the 4G/5G PAI polymorphism in the second case. These observations support the hypothesis that these mutations may be involved in the etiology of some cases of cirrhosis, or, at least, accelerate the evolution of the disease. It is therefore convenient to search for the presence of prothrombotic mutations in patients with cryptogenetic cirrhosis.

  8. Oxidative Stress and Pulmonary Changes in Experimental Liver Cirrhosis

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    Renata Salatti Ferrari

    2012-01-01

    Full Text Available The use of carbon tetrachloride (CCl4 in rats is an experimental model of hepatic tissue damage; which leads to fibrosis, and at the long term, cirrhosis. Cirrhosis is the consequence of progressive continued liver damage, it may be reversible when the damaging noxae have been withdrawn. The aim of this study is to evaluate the changes caused by cirrhosis in lung and liver, through the experimental model of intraperitoneal CCI4 administration. We used 18 male Wistar rats divided into three groups: control (CO and two groups divided by the time of cirrhosis induction by CCI4: G1 (11 weeks, G2 (16 weeks. We found significant increase of transaminase levels and lipid peroxidation (TBARS in liver and lung tissue and also increased antioxidant enzymes SOD and CAT, as well as the expression of TNF-α and IL-1β in the lung of cirrhotic animals. We observed changes in gas exchange in both cirrhotic groups. We can conclude that our model reproduces a model of liver cirrhosis, which causes alterations in the pulmonary system that leads to changes in gas exchange and size of pulmonary vessels.

  9. Vitamin K status in cystic fibrosis patients with liver cirrhosis.

    Science.gov (United States)

    Krzyżanowska, Patrycja; Drzymała-Czyż, Sławomira; Pogorzelski, Andrzej; Duś-Żuchowska, Monika; Skorupa, Wojciech; Bober, Lyudmyla; Sapiejka, Ewa; Oralewska, Beata; Rohovyk, Nataliya; Moczko, Jerzy; Nowak, Jan; Wenska-Chyży, Ewa; Rachel, Marta; Lisowska, Aleksandra; Walkowiak, Jarosław

    2017-06-01

    The available data on the influence of liver cirrhosis on vitamin K status in CF patients is scarce. Therefore, the aims of the present study were to assess the prevalence of vitamin K deficiency in cirrhotic CF subjects and to determine whether it correlates with liver cirrhosis. The study group comprised of 27 CF patients with and 63 without liver cirrhosis. Vitamin K status was assessed using prothrombin induced by vitamin K absence (PIVKA-II) and the percentage of undercarboxylated osteocalcin (u-OC). PIVKA-II concentrations were higher in cirrhotic than in non-cirrhotic CF patients (median [1st-3rd quartile]: 3.2ng/ml [1.0-10.0] vs. 1.3ng/ml [0.2-2.6], p=0.0029). However, the differences in u-OC percentages between the studied groups did not reach the level of significance (49.4% [7.0-73.8] vs. 8.0% [2.6-59.1], p=0.0501). Based on multiple linear regression analysis the dose of vitamin K and F508del mutation were potentially defined as determinants of vitamin K deficiency. Liver cirrhosis was not documented to be an independent risk factor. In CF patients with liver cirrhosis vitamin K deficiency is not only more frequent, but also more severe. However, not liver cirrhosis, but the presence of a F508del CFTR mutation constitutes an independent risk factor for vitamin K deficiency. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  10. In vivo antioxidant and hepatoprotective potential of Glycyrrhiza glabra extract on carbon tetra chloride (CCl4 induced oxidative-stress mediated hepatotoxicity

    Directory of Open Access Journals (Sweden)

    Varsha Sharma

    2014-02-01

    Results: The results suggest that, the crude extract of root of G. glabra at the doses of 300 and 600mg/kg body wt. expressed significant hepatoprotective potential against CCl4 induced oxidative stress mediated hepatotoxicity in student ‘t’ test (p [Int J Res Med Sci 2014; 2(1.000: 314-320

  11. Oral testosterone load related to liver function in men with alcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Gluud, C; Bahnsen, M; Bennett, P;

    1983-01-01

    The relation between liver function and an oral testosterone load was examined in 42 consecutive patients with alcoholic liver cirrhosis. Administration of an oral load of 400 mg micronized free testosterone increased the serum concentration of testosterone (range, 31.9-694.4 nmol/l; median, 140.......8 nmol/l) in male patients with alcoholic liver cirrhosis to significantly (P less than 0.01) higher levels than in male subjects without liver disease (range, 25.4-106.6 nmol/l; median, 61.5 nmol/l). The increase of testosterone after the load (log delta testosterone) in patients correlated inversely...... in patients with alcoholic cirrhosis. This decrease seems to be due to decreased liver function, decreasing hepatic blood flow, and increased portosystemic shunting. Oral testosterone loading may therefore be of prognostic significance in patients with alcoholic liver cirrhosis....

  12. Update on adrenal insufficiency in patients with liver cirrhosis.

    Science.gov (United States)

    Trifan, Anca; Chiriac, Stefan; Stanciu, Carol

    2013-01-28

    Liver cirrhosis is a major cause of mortality worldwide, often with severe sepsis as the terminal event. Over the last two decades, several studies have reported that in septic patients the adrenal glands respond inappropriately to stimulation, and that the treatment with corticosteroids decreases mortality in such patients. Both cirrhosis and septic shock share many hemodynamic abnormalities such as hyperdynamic circulatory failure, decreased peripheral vascular resistance, increased cardiac output, hypo-responsiveness to vasopressors, increased levels of proinflammatory cytokines [interleukine(IL)-1, IL-6, tumor necrosis factor-alpha] and it has, consequently, been reported that adrenal insufficiency (AI) is common in critically ill cirrhotic patients. AI may also be present in patients with stable cirrhosis without sepsis and in those undergoing liver transplantation. The term hepato-adrenal syndrome defines AI in patients with advanced liver disease with sepsis and/or other complications, and it suggests that it could be a feature of liver disease per se, with a different pathogenesis from that of septic shock. Relative AI is the term given to inadequate cortisol response to stress. More recently, another term is used, namely "critical illness related corticosteroid insufficiency" to define "an inadequate cellular corticosteroid activity for the severity of the patient's illness". The mechanisms of AI in liver cirrhosis are not completely understood, although decreased levels of high-density lipoprotein cholesterol and high levels of proinflammatory cytokines and circulatory endotoxin have been suggested. The prevalence of AI in cirrhotic patients varies widely according to the stage of the liver disease (compensated or decompensated, with or without sepsis), the diagnostic criteria defining AI and the methodology used. The effects of corticosteroid therapy on cirrhotic patients with septic shock and AI are controversial. This review aims to summarize the

  13. Liver Cirrhosis: A Seven Year Follow-Up

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    TS Paul Tran

    1991-01-01

    Full Text Available The status of 121 patients who were found to have liver cirrhosis on liver biopsy in 1981 was assessed seven years later. The etiology of the cirrhosis was alcoholic in 52%, cryptogenic in 29.8%, hepatitis B-related in 9.1% and miscellaneous in 9.1%. In 1981, jaundice was present in 55 patients (45.8%, ascites in 52 (43%, gastrointestinal bleeding in 25 (20.7% and encephalopathy in 10 (8.3%. During the following seven years an additional 20 patients developed ascites, 15 gastrointestinal bleeding, 32 encephalopathy and three hepatocellular carcinoma. The mortality race was 43.8% at five years and 53.7% at seven years. The principal cause of death was liver failure (40%, followed by nonliver causes (32.3% and gastrointestinal bleeding (13.9%. One patient died of hepatocellular carcinoma. Patients who survived seven years had fewer complications when seen in 1981 than those who died during this period (P<0.025. It is concluded that, in Toronto, cirrhosis is often caused by ethanol abuse and hepatitis B infection; that it is associated with significant morbidity and mortality; and that the number of complications when the patient is first seen may be a useful indicator of prognosis. Since many cases of cirrhosis are preventable, the authors suggest that efforts directed towards prevention of cirrhosis may be more rewarding than those directed towards therapy.

  14. In-Vivo Antioxidant activity of ethanolic extract of Mentha pulegium leaf against CCl4 induced toxicity in rats

    Institute of Scientific and Technical Information of China (English)

    Sachin Jain; Dinesh Kumar Jain; Neelam Balekar

    2012-01-01

    Objective: To evaluate the in-vivo antioxidant potential of ethanolic extract of Mentha Pulegium against CCl4 induced toxicity in rats. Methods: Animals were treated with plant extract for 7 days and then toxicity was induced with a single CCl4 intraperitoneal injection. Pre-treatment with 600 mg/kg (p.o.) of ethanolic extract of Mentha Pulegium improved the glutathione, SOD, catalase, and peroxidase levels significantly as compared to control group. Results: The present studies revealed that Mentha Pulegium has significant in-vivo antioxidant activity and can be used to protect tissue from oxidative stress. The result showed that the activities of glutathione, SOD, catalase and peroxidase in group treated with CCl4 declined significantly than that of normal group. Conclusion: Ethanolic extract of Mentha Pulegium in the dose of 600 mg/kg, p.o., has improved the glutathione, SOD, catalase, and peroxidase levels significantly, which were comparable with Liv 52. Based on this study we conclude that Ethanolic extract of MenthaPulegium possesses in vivo antioxidant activity and can be employed in protecting tissue from oxidative stress.

  15. Antibiotics can ameliorate circulatory complications of liver cirrhosis

    DEFF Research Database (Denmark)

    Madsen, Bjørn Stæhr; Schaffalitzky de Muckadell, Ove B

    2011-01-01

    . This review focuses on how broad spectrum antibiotics can ameliorate the haemodynamic consequences of bacterial translocation. It is possible that the use of broad spectrum antibiotics in the future may be used to prevent other complications of liver cirrhosis than spontaneous bacterial peritonitis...

  16. Influence of unrecorded alcohol consumption on liver cirrhosis mortality.

    Science.gov (United States)

    Lachenmeier, Dirk W; Monakhova, Yulia B; Rehm, Jürgen

    2014-06-21

    Unrecorded alcohol includes illegally distributed alcohol as well as homemade or surrogate alcohol which is unintended for consumption by humans (e.g., cosmetics containing alcohol). The highest unrecorded alcohol consumption occurs in Eastern Europe and some of these countries have an over proportional liver cirrhosis mortality. Compounds besides ethanol have been hypothesized as being responsible for this observation. On the other hand, chemical investigations were unable to prove that unrecorded alcohol regularly contains contaminants above toxicological thresholds. However, illegally produced spirits regularly contain higher percentages of alcohol (above 45% by volume), but for considerably less costs compared with licit beverages, potentially causing more problematic patterns of drinking. In this review, it is investigated whether patterns of drinking rather than product composition can explain the liver cirrhosis mortality rates. Statistical examination of World Health Organization country data shows that the originally detected correlation of the percentage of unrecorded alcohol consumption and liver cirrhosis mortality rates disappears when the data is adjusted for the prevalence of heavy episodic drinking. It may be concluded that there is currently a lack of data to demonstrate causality between the composition of illicit spirits (e.g., higher levels of certain contaminants in home-produced products) and liver toxicity on a population scale. Exceptions may be cases of poisoning with antiseptic liquids containing compounds such as polyhexamethyleneguanidine, which were reported to be consumed as surrogate alcohol in Russia, leading to an outbreak of acute cholestatic liver injury, histologically different from conventional alcoholic liver disease.

  17. Liver cirrhosis as a result of chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    A. A. Sukhoruk

    2014-01-01

    Full Text Available The incidence of chronic hepatitis C in St. Petersburg is 124.4 per 100 000 population. The number of patients with liver cirrhosis is significant.Aim of this study: to examine the demographic, clinical and epidemiological characteristics of patients with cirrhosis in the results of chronic hepatitis C.Materials and methods: 100 patients with cirrhosis due to chronic hepatitis C in age 31–70 years were included. Patients with infection hepatitis viruses A and B, HIV, alcohol abuse, drug addicts, previously received antiviral therapy were excluded. Liver cirrhosis was diagnosed on the basis clinical, laboratory and instrumental investigations.Results: most patients (86,2% male and 81,7% female are socially adapted. In 23,2% of patients antibodies to hepatitis C virus were first detected simultaneously with the diagnosis of cirrhosis. Medical procedures were the most common route of infection (25,6% male and 57,1% female. Genotype 1 was dominant (65.7%. Viral load over 800 000 IU/ml was detected in 36,7% of patients. ALT activity was normal or not more than 2 upper limit of normal in 59% of patients, AST – 47%. Normal levels of total bilirubin were recorded in 37% of cases.Conclusions: the first detection of antibodies to hepatitis C virus at the stage of cirrhosis, absence of jaundice, normal or low cytolytic activity once again confirms the need for screening for markers of hepatitis C virus. Dominance of genotype 1 is probably due on the one hand with features routes of transmission, and the other – with the speed of transformation chronic hepatitis to cirrhosis.

  18. Hypothalamic-pituitary-gonadal function in men with liver cirrhosis before and after liver transplantation

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    Bruno T. Zacharias

    2014-12-01

    Full Text Available Objective: To evaluate the influence of end-stage liver disease and orthotopic liver transplantation in the pituitary function and hormone metabolism before and after liver transplantation. Methods: In a prospective study, serum levels of follicle stimulating hormone (FSH, luteinizing hormone (LH, estradiol (E2 and prolactin (PRL of 30 male patients with cirrhosis were determined two to four hours before and six months after liver transplantation. The results were compared according to the Model for End-stage Liver Disease (MELD. Results: male patients with liver cirrhosis have hypogonadism. FSH was normal, but inappropriately low due to androgen failure; E2 and PRL, on their turn, were high. After liver transplantation, FSH and LH levels increased (p 18. The severity of cirrhosis had no influence on FSH, PRL and LH.

  19. Cardiac and systemic haemodynamic complications of liver cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Møller, Søren

    2009-01-01

    by physical and pharmacological strain. Cardiac failure is an important cause of mortality after liver transplantation and stressful procedures as insertions of transjugular intrahepatic portal systemic shunt (TIPS), peritoneal venous shunting, and other types of surgery. Improvement of liver function has...... been shown to reverse the cardiovascular complications. The clinical significance is an important topic for future research. At present, no specific treatment can be recommended, and the cardiac failure in cirrhosis should be treated as in non-cirrhotic patients with sodium restriction, diuretics......Cardiovascular complications of liver cirrhosis include cardiac dysfunction and abnormalities in the central-, splanchnic,- and peripheral circulation. Vasodilatation prevails, but vascular beds with various degrees of reduced and increased haemodynamic resistance are the results of massive...

  20. Effect of liver cirrhosis on percutaneous selective portal vein embolization for primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    孙军辉

    2014-01-01

    Objective To evaluate the clinical value of PVE(portal vein embolism)prior to surgery in primary liver cancer(PLC)patients and the effect of liver cirrhosis on1iver lobe hyperplasia after PVE.Methods 13 patientswith primary liver cancer non-suitable for curative hepatectomy underwent k sequential transcatheter arterial chemoembolization(TACE)(1-3 times)

  1. Ultrasonography in predicting and screening liver cirrhosis in children: A preliminary study

    Institute of Scientific and Technical Information of China (English)

    Jia-An Zhu; Bing Hu

    2003-01-01

    AIM: To evaluate the value of ultrasonography in predicting and screening liver cirrhosis in children.METHODS: Twenty-eight children with liver cirrhosis of various etiologies were examined by routine ultrasonography.A percutaneous liver biopsy guided by ultrasound was also performed on each patient, and the results of liver biopsy and ultrasonography were compared.RESULTS: When compared with the biopsy results,ultrasonography in combination of clinical and laboratory findings gave accurate diagnoses of children liver cirrhosis.Although ultrasound imaging of children with liver cirrhosis revealed abnormal characteristics, these images were not specific to this disease, thus reinforcing the necessity of ultrasound-guided liver biopsy in the diagnosis of children liver cirrhosis.CONCLUSION: Ultrasonography is reliable in the diagnosis of children liver cirrhosis, and its usefulness should be stressed in the screening and follow-up of high-risk pediatric patients.

  2. Plasma and platelet serotonin levels in patients with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To analyze the relationship between plasmaand platelet serotonin levels and the degree of liverinsufficiency.METHODS: The prospective study included 30 patients with liver cirrhosis and 30 healthy controls. The degree of liver failure was assessed according to the Child-Pugh classification. Platelet and platelet poor plasma serotonin levels were determined.RESULTS: The mean plasma serotonin level was higher in liver cirrhosis patients than in healthy subjects (215.0± 26.1 vs 63.1 ± 18.1 nmol/L; P < 0.0001). The mean platelet serotonin content was not significantly different in patients with liver cirrhosis compared with healthy individuals (4.8 ± 0.6; 4.2 ± 0.3 nmol/platelet; P > 0.05).Plasma serotonin levels were significantly higher in ChildPugh grade A/B than in grade C patients (246.8 ± 35.0vs132.3 ± 30.7 nmol/L; P < 0.05). However, platelet serotonin content was not significantly different between Child-Pugh grade C and grade A/B (4.6 ± 0.7 vs 5.2 ± 0.8nmol/platelet; P > 0.05).CONCLUSION: Plasma serotonin levels are significantly higher in patients with cirrhosis than in the controls and represent the degree of liver insufficiency. In addition,platelet poor plasma serotonin estimation is a better marker for liver insufficiency than platelet serotonin content.

  3. Protective effects of Carissa opaca fruits against CCl4-induced oxidative kidney lipid peroxidation and trauma in rat

    Directory of Open Access Journals (Sweden)

    Sumaira Sahreen

    2015-09-01

    Full Text Available Background: Carbon tetrachloride (CCl4 is a potent nephrotoxin, as it causes acute as well as chronic toxicity in kidneys. Therefore, this study was carried out to assess the pharmacological potential of different fractions of Carissa opaca fruits on CCl4-induced oxidative trauma in the kidney. Methods: The parameters studied in this respect were the kidney function tests viz, serum profile, urine profile, genotoxicity, characteristic morphological findings, and antioxidant enzymatic level of kidneys. Result: The protective effects of various fractions of C. opaca fruits against CCl4 administration were reviewed by rat renal function alterations. Chronic toxicity caused by 8-week treatment of CCl4 to the rats significantly decreased the pH level, activities of antioxidant enzymes, and glutathione contents, whereas a significant increase was found in the case of specific gravity, red blood cells, white blood cells, level of urea, and lipid peroxidation in comparison to control group. Administration of various fractions of C. opaca fruit with CCl4 showed protective ability against CCl4 intoxication by restoring the urine profile, activities of antioxidant enzymes, and lipid peroxidation in rat. CCl4 induction in rats also caused DNA fragmentation and glomerular atrophy by means of dilation, disappearance of Bowmen's space, congestion in the capillary loops, dilation in renal tubules, and foamy look of epithelial cells of tubular region, which were restored by co-admiration of various fractions of C. opaca. Conclusion: Results revealed that the methanolic fractions of C. opaca are the most potent and helpful in kidney trauma.

  4. Management of liver cirrhosis between primary care and specialists

    OpenAIRE

    Grattagliano, Ignazio; Ubaldi, Enzo; Bonfrate, Leonilde; Portincasa, Piero

    2011-01-01

    This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: “ascites”, “liver fibrosis”, “cirrhosis”, “chronic hepatitis”, “chronic liver disease”, “deco...

  5. Neurosurgical procedures in patients with liver cirrhosis: A review

    Institute of Scientific and Technical Information of China (English)

    Ching-Chang; Chen; Yin-Cheng; Huang; Chun-Nan; Yeh

    2015-01-01

    Liver cirrhosis, a devastating liver fibrosis caused by hepatitis/inflammation or tumors, is a major comorbid factor in known surgery fields, such as cardiovascular and abdominal surgeries. It is important to review possible comorbid results in neurosurgical procedures in cirrhotic patients. In the reviewed literature, ChildPugh and model for end-stage liver disease scores are commonly used in the assessment of surgical risks for cirrhotic patients undergoing abdominal, cardiovascular or neurosurgical procedures. The major categories of neurosurgery are traumatic brain injury(TBI), spontaneous intracranial hemorrhage(SICH), brain tumors, and spinal instrumentation procedures. TBI was reported with surgical mortality as high as 34.5% and a complication rate of 87.2%. For SICH, mortality ranged from 22.7% to 47.0%, while complications were reported to be 43.2%. Less is discussed in brain tumor patients; still the postoperative hemorrhage rate approached 26.7%. In spinal fusion instrumentation procedures, the complication rate was as high as 41.0%. Preoperative assessment and correction could possibly decrease complications such as hemorrhage, wound infection and other cirrhosis-related complications(renal, pulmonary, ascites and encephalopathy). In this study, we reviewed the neurosurgical-related literature with regard to liver cirrhosis as a prognostic factor influencing neurosurgical outcomes.

  6. Non-invasive evaluation of liver cirrhosis using ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Goyal, N., E-mail: nimitgoyal@doctors.org.u [Department of Radiology, University Hospital of Wales, Cardiff (United Kingdom); Jain, N.; Rachapalli, V.; Cochlin, D.L. [Department of Radiology, University Hospital of Wales, Cardiff (United Kingdom); Robinson, M. [Department of Radiology, Royal Gwent Hospital, Newport, Wales (United Kingdom)

    2009-11-15

    Ultrasound (US) is essential in both assessment of the potentially cirrhotic liver and surveillance of selected patients with chronic hepatitis as liver biopsy can be misleading or inaccurate in up to 25% of cases. Various techniques are already in routine use, such as grey-scale imaging, Doppler US, and contrast-enhanced US (CEUS), while newer techniques such as elastography and hepatic vein transit time (HVTT) have the potential to exclude patients without significant fibrosis or cirrhosis; however, they are operator dependent and require specific software. Grey-scale imaging may demonstrate changes, such as volume redistribution, capsule nodularity, parenchymal nodularity, and echotexture changes. The Doppler findings in the hepatic and portal veins, hepatic artery, and varices allow assessment of liver cirrhosis. However, the operator needs to be aware of limitations of these techniques. Low mechanical index CEUS plays an important role in the assessment of complications of cirrhosis, such as hepatocellular carcinoma and portal vein thrombus. Optimized US technique is crucial for accurate diagnosis of the cirrhotic liver and its complications.

  7. Mouse model of carbon tetrachloride induced liver fibrosis: Histopathological changes and expression of CD133 and epidermal growth factor

    Directory of Open Access Journals (Sweden)

    Goodwin Jonathan M

    2010-07-01

    Full Text Available Abstract Background In the setting of chronic liver injury in humans, epidermal growth factor (EGF and EGF receptor (EGFR are up-regulated and have been proposed to have vital roles in both liver regeneration and development of hepatocellular carcinoma (HCC. Chronic liver injury also leads to hepatic stellate cell (HSC differentiation and a novel subpopulation of HSCs which express CD133 and exhibit properties of progenitor cells has been described in rats. The carbon tetrachloride (CCl4-induced mouse model has been historically relied upon to study liver injury and regeneration. We exposed mice to CCl4 to assess whether EGF and CD133+ HSCs are up-regulated in chronically injured liver. Methods CCl4 in olive oil was administered to strain A/J mice three times per week by oral gavage. Results Multiple well-differentiated HCCs were found in all livers after 15 weeks of CCl4 treatment. Notably, HCCs developed within the setting of fibrosis and not cirrhosis. CD133 was dramatically up-regulated after CCl4 treatment, and increased expression of desmin and glial fibrillary acidic protein, representative markers of HSCs, was also observed. EGF expression significantly decreased, contrary to observations in humans, whereas the expression of amphiregulin, another EGFR ligand, was significantly increased. Conclusions Species-specific differences exist with respect to the histopathological and molecular pathogenesis of chronic liver disease. CCl4-induced chronic liver injury in A/J mice has important differences compared to human cirrhosis leading to HCC.

  8. [Cardiomyopathy in liver cirrhosis--an undiagnosed entity?].

    Science.gov (United States)

    Burcă, Paula; Mihai, B; Mihai, Cătălina; Drug, V L; Dranga, Mihaela; Lăcătuşu, Cristina; Prelipcean, Cristina Cijevschi

    2010-01-01

    Cirrhotic cardiomyopathy is a condition recently known in liver cirrhosis consisting of systolic dysfunction to stress factors, diastolic dysfunction and electrophysiological abnormalities in the absence of cardiac disease. The prevalence of cirrhotic cardiomyopathy remains unknown until now. It can be diagnosed by using a combination of electrocardiograph, 2-dimensional echocardiography, and various serum markers (brain natriuretic factor--BNP, proBNP, TnI). Pathogenic mechanisms underlying cirrhotic cardiomyopathy development include abnormal signaling betaadrenergic, cardiomyocites membrane fluidity changes, interstitial fibrosis, myocardial hypertrophy, altered transmembrane ion channels as intervention with negative inotropic effect of different substances whose concentration is increased in cirrhosis. Major stresses on the cardiovasculary system such as liver transplantations, infections, insertion of transjugular portosystemic stent-shunt (TIPSS) have been demonstrated to put in evidence the presence of cirrhotic cardiomyopathy. Heart failure is a significant cause of mortality after liver transplantation but the improvement of liver function determines cardiac abnormalities reversal. Current management recommendations include empirical, nonspecific and mainly supportive measures, no specific treatment can be recommended, and cardiac failure should be treated as in non-cirrhotic patients with sodium restriction, diuretics, and oxygen therapy when necessary. The exact prognosis remains unclear. The extent of cirrhotic cardiomyopathy generally correlates to the degree of liver insufficiency. Reversibility is possible (either pharmacological or after liver transplantation), but further studies are needed.

  9. Bariatric surgery in individuals with liver cirrhosis: A narrative review

    Directory of Open Access Journals (Sweden)

    Everton Cazzo

    Full Text Available Summary Introduction: Bariatric surgery has become the gold standard treatment for morbid obesity, but there is no consensus regarding its safety and efficacy among individuals with chronic liver diseases. Objective: To critically evaluate the existing evidence on literature about bariatric surgery in individuals with liver cirrhosis. Method: Narrative review performed by means of an online search in the MEDLINE and LILACS databases. Results: Bariatric surgery is safe and effective in individuals with chronic liver disease without clinical decompensation or significant portal hypertension. Individuals with severe liver function impairment present significantly higher surgical morbidity and mortality. Among candidates to liver transplantation, surgery may be performed before, after and even during transplantation, and there is a predominant trend to perform it after. Vertical sleeve gastrectomy seems to be the most adequate technique in this group of subjects. Conclusion: Bariatric surgery is safe and effective in individuals with compensated cirrhosis without significant portal hypertension, but presents higher morbidity. Among candidates to liver transplantation and/or individuals with severe portal hypertension, morbidity and mortality are significantly higher.

  10. Nursing Assessment Tool for People With Liver Cirrhosis

    OpenAIRE

    GIMENES, Fernanda Raphael Escobar; Reis, Renata Karina; da Silva, Patrícia Costa dos Santos; Silva,Ana Elisa Bauer de Camargo; Atila, Elisabeth

    2015-01-01

    The aim of this study was to describe the process of developing a nursing assessment tool for hospitalized adult patients with liver cirrhosis. A descriptive study was carried out in three stages. First, we conducted a literature review to develop a data collection tool on the basis of the Conceptual Model of Wanda Horta. Second, the data collection tool was assessed through an expert panel. Third, we conducted the pilot testing in hospitalized patients. Most of the comments offered by the pa...

  11. Working Correlation Structures: Application in Liver Cirrhosis Therapeutic Effect Trial

    Directory of Open Access Journals (Sweden)

    Ramesh K. VISHWAKARMA

    2016-10-01

    Full Text Available Objective: Correlated responses are common in repeatedly measured clinical trial data. The generalized estimating equations (GEE method is popular for analyzing correlated responses. It is important to select a proper working correlation matrix because an inappropriate choice will lead to inefficient parameter estimation. In this paper, we examine criterion of quasi-likelihood information criterion (QIC for selecting a working correlation structure, and have compared with the performance of the correlation information criteria (CIC of the correlation structures on liver cirrhosis patients. Material and Methods: The computation code for CIC is performed into open source software R. The covariates like therapy and visit are used to predict Meld scores (It is continuous disease severities scale with highly predictive of the risk of dying from liver cirrhosis in GEE model to examine the performance of QIC and CIC after considering three different working correlation structures. Results: The GEE model has been performed to compare QIC and CIC after considering three working correlation structure. In case of AR (1 correlation structure, it is found that similar regression arameter estimates are observed for both information criteria techniques. Conclusion: The study indicates that the CIC is useful for selecting appropriate correlation structures for liver cirrhosis data from phase III clinical trial.

  12. Protein-protein interaction network analysis of cirrhosis liver disease.

    Science.gov (United States)

    Safaei, Akram; Rezaei Tavirani, Mostafa; Arefi Oskouei, Afsaneh; Zamanian Azodi, Mona; Mohebbi, Seyed Reza; Nikzamir, Abdol Rahim

    2016-01-01

    Evaluation of biological characteristics of 13 identified proteins of patients with cirrhotic liver disease is the main aim of this research. In clinical usage, liver biopsy remains the gold standard for diagnosis of hepatic fibrosis. Evaluation and confirmation of liver fibrosis stages and severity of chronic diseases require a precise and noninvasive biomarkers. Since the early detection of cirrhosis is a clinical problem, achieving a sensitive, specific and predictive novel method based on biomarkers is an important task. Essential analysis, such as gene ontology (GO) enrichment and protein-protein interactions (PPI) was undergone EXPASy, STRING Database and DAVID Bioinformatics Resources query. Based on GO analysis, most of proteins are located in the endoplasmic reticulum lumen, intracellular organelle lumen, membrane-enclosed lumen, and extracellular region. The relevant molecular functions are actin binding, metal ion binding, cation binding and ion binding. Cell adhesion, biological adhesion, cellular amino acid derivative, metabolic process and homeostatic process are the related processes. Protein-protein interaction network analysis introduced five proteins (fibroblast growth factor receptor 4, tropomyosin 4, tropomyosin 2 (beta), lectin, Lectin galactoside-binding soluble 3 binding protein and apolipoprotein A-I) as hub and bottleneck proteins. Our result indicates that regulation of lipid metabolism and cell survival are important biological processes involved in cirrhosis disease. More investigation of above mentioned proteins will provide a better understanding of cirrhosis disease.

  13. Unani Treatment Decreased Fibrosis and Improved Liver Functions in Decompensated Cirrhosis of Liver: A Case Series

    Directory of Open Access Journals (Sweden)

    Akhtar Siddiqui

    2016-03-01

    Full Text Available At present, liver transplantation remains the only curative option for the patients with cirrhosis and end-stage liver diseases. The survival rate and recurrent diseases remain the major issues in the patient post-transplantation. Unani medicine is one of the oldest traditional systems of medicine which has been treating chronic liver diseases and cirrhosis (Talayyaful-Kabid for centuries. The current study aimed to assess the impact of Unani treatment on decompensated cirrhosis and collect data to warrant further clinical trials. Authors conducted a case series on five patients with decompensated cirrhosis and portal hypertension. The disease was confirmed through FibroScan and ultrasound and treated with Unani treatment orally for seven months. Results were evaluated based on FibroScan, liver function test (LFT, EuroQol-5D (EQ5D, Child-Pugh and TTO-TIME (trade-off question. Significant improvements in LFT, fibrosis and quality of life were achieved in the studied patients. The literature related to the herbal constituents of chief medicines used to treat in this case was reviewed. The herbs proved their potential anti-oxidative, anti-inflammatory, hepato-protective, immuno-modulator and antiviral activities, suggesting plausible mechanisms of action in the cases. The preliminary findings indicated the potential therapeutic role of Unani treatment in decompensated cirrhosis. Clinical trials should be conducted to explore further therapeutic potential of Unani treatment in decompensated cirrhosis.

  14. Pulmonary Arteriovenous Malformation in Cryptogenic Liver Cirrhosis Associated with Turner's Syndrome.

    Science.gov (United States)

    Kim, Ji Hoon; Jung, Young Kul; Jeong, Eun Seok; Seo, Yeon Seok; Yim, Hyung Joon; Yeon, Jong Eun; Shim, Jae Jeong; Byun, Kwan Soo; Lee, Chang Hong

    2010-06-01

    Turner's syndrome is a genetic disorder of the sex chromosomes (e.g., 45,X or 45,X/46,XX) that manifests as various congenital anomalies. Despite its numerous extragonadal manifestations and frequent accompanying abnormalities in liver function tests, liver cirrhosis associated with Turner's syndrome has not been reported in Korea. Moreover, pulmonary arteriovenous malformations (PAVMs) have rarely been reported in association with liver cirrhosis, but there have been no reports of PAVMs occurring in cryptogenic liver cirrhosis associated with Turner's syndrome. We report a case of PAVM that occurred in cryptogenic liver cirrhosis associated with Turner's syndrome.

  15. Liver cirrhosis: a risk factor for gallstone disease in chronic hepatitis C patients in China.

    Science.gov (United States)

    Li, Xu; Wang, Zhongfeng; Wang, Le; Pan, Meng; Gao, Pujun

    2017-06-01

    We investigated the possible link between liver cirrhosis and gallstone risk in chronic hepatitis C (CHC) patients in China.To analyze the association between liver cirrhosis and gallstone development, we compared outcomes of 133 Chinese CHC patients with gallstones and an age-, sex-, and hepatitis C virus RNA level-matched control group of 431 CHC patients without gallstones.We found that liver cirrhosis was more prevalent in gallstone patients (40.6%) than in the control group (24.4%). Logistic regression analyses adjusting for demographic features and other gallstone risk factors revealed that liver cirrhosis increased the risk of gallstone development 2-fold (adjusted odds ratio [AOR]: 2.122; 95% confidence interval [CI]: 1.408-3.198). Moreover, multivariate analyses comparing the risk of gallstone development in liver cirrhosis patients with decompensated or compensated liver cirrhosis yielded an estimated AOR (95% CI) of 2.869 (1.277-6.450) in patients with decompensated liver cirrhosis. Gallstone risk also increased significantly with older age (>60 years) (AOR: 2.019; 95% CI: 1.017-4.009).Liver cirrhosis significantly correlates with increased risk of gallstone development in CHC patients in China. Decompensated liver cirrhosis and older age further heighten this risk in patients diagnosed with hepatitis C-related cirrhosis.

  16. Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology

    Institute of Scientific and Technical Information of China (English)

    Mikkel Malham; S(o)ren Peter J(o)rgensen; Peter Ott; J(o)rgen Agnholt; Hendrik Vilstrup; Mette Borre; Jens F Dahlerup

    2011-01-01

    AIM:To examine the vitamin D status in patients with alcoholic cirrhosis compared to those with primary biliary cirrhosis.METHODS:Our retrospective case series comprised 89 patients with alcoholic cirrhosis and 34 patients with primary biliary cirrhosis who visited our outpatient clinic in 2005 and underwent a serum vitamin D status assessment.RESULTS:Among the patients with alcoholic cirrhosis,85% had serum vitamin D levels below 50 nmol/L and 55% had levels below 25 nmol/L,as compared to 60% and 16% of the patients with primary biliary cirrhosis,respectively (P < 0.001).In both groups,serum vitamin D levels decreased with increasing liver disease severity,as determined by the Child-Pugh score.CONCLUSION:Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology,with lower levels of vitamin D in alcoholic cirrhosis than in primary biliary cirrhosis.

  17. Indications and technique for laparoscopic liver resection in patients with hepatocellular carcinoma and liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Yuichiro Otsuka; Masaru Tsuchiya; Toshio Katagiri; Yoshihisa Kubota; Jun Ishii; Tetsuya Maeda; Hironori Kaneko

    2016-01-01

    Liver resection is the preferred initial treatment option for solitary or limited multifocal hepatocellular carcinoma (HCC). However, because of the characteristics of HCC, including its high recurrence rate and the frequent presence of chronic hepatitis and cirrhosis, both curability and invasiveness must be considered when selecting a treatment for HCC. Laparoscopic liver resection (LLR) is minimally invasive and increasingly performed worldwide as a curative surgical option for treatment of liver tumors. The 2014 International Consensus Conference on LLR concluded that minor LLRs are now standard practice. Meta-analyses suggest that, as compared with open hepatectomy, LLR for patients with HCC, including those with cirrhosis, resulted in less blood loss, lower postoperative hospitalization rates, and similar oncological outcomes. Although candidates for this procedure should be carefully evaluated, LLR appears to be a feasible option for treatment of HCC with liver cirrhosis. This review describes the indications for LLR in this patient subgroup and offers guidance on appropriate surgical technique.

  18. Alcohol consumption and liver cirrhosis mortality

    DEFF Research Database (Denmark)

    Bentzen, Jan Børsen; Smith, Valdemar

    regarding per capita consumption of wine among the European countries. Also for the total consumption of alcohol, i.e. the per capita consumption of beer, wine and spirits, the hypothesis of convergence seems to hold. In the same time span the number of alcohol related diseases as e.g. liver diseases, have...... changed significantly in the same direction as the developments in alcohol consumption. The changes in the consumption levels of alcohol in general -- and wine in particular -- are influenced by many factors of which health arguments may have played a crucial role. The alcohol policies of the European...... countries have become more restrictive during the last decades. Using data on alcohol consumption, alcohol related diseases and alcohol policies of 16 European countries we discuss the questions of whether the intake of alcohol is associated with (liver) diseases. Our empirical analysis provides us...

  19. Oral testosterone load related to liver function in men with alcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Gluud, C; Bahnsen, M; Bennett, Patrick;

    1983-01-01

    The relation between liver function and an oral testosterone load was examined in 42 consecutive patients with alcoholic liver cirrhosis. Administration of an oral load of 400 mg micronized free testosterone increased the serum concentration of testosterone (range, 31.9-694.4 nmol/l; median, 140....

  20. Diagnosis and therapy of ascites in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Erwin Biecker

    2011-01-01

    Ascites is one of the major complications of liver cirrhosis and is associated with a poor prognosis. It is important to distinguish noncirrhotic from cirrhotic causes of ascites to guide therapy in patients with noncirrhotic ascites. Mild to moderate ascites is treated by salt restriction and diuretic therapy. The diuretic of choice is spironolactone. A combination treatment with furosemide might be necessary in patients who do not respond to spironolactone alone. Tense ascites is treated by paracentesis, followed by albumin infusion and diuretic therapy. Treatment options for refractory ascites include repeated paracentesis and transjugular intrahepatic portosystemic shunt placement in patients with a preserved liver function. Potential complications of ascites are spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome (HRS). SBP is diagnosed by an ascitic neutrophil count > 250 cells/mm3 and is treated with antibiotics. Patients who survive a first episode of SBP or with a low protein concentration in the ascitic fluid require an antibiotic prophylaxis. The prognosis of untreated HRS type 1 is grave. Treatment consists of a combination of terlipressin and albumin. Hemodialysis might serve in selected patients as a bridging therapy to liver transplantation. Liver transplantation should be considered in all patients with ascites and liver cirrhosis.

  1. [Effect of liver cirrhosis on pharmacokinetics and pharmacodynamics of drugs].

    Science.gov (United States)

    Perlík, F

    2013-07-01

    Metabolic liver functions are significantly involved in the total clearance of a number of drugs. In liver cirrhosis the reduced drug elimination is a result of the blood flow through the liver, hepatocytes function and volume of hepatic tissue. Pharmacokinetic and pharmacodynamic changes depend on the nature and degree of hepatic impairment and on the characteristics of the dosed drug. Hepatocytes have a different extraction ability with respect to the individual drugs. The following are examples of drugs with high hepatic extraction: anodyne, propranolol, metoprolol, verapamil and lidocaine. These drugs are significantly dependent on the first passage through the liver. Intrahepatic and extrahepatic collateral blood flows significantly increase their bio-logical availability and reduce the clearance. The reduction in hepatic clearance of drugs with low extraction coefficient, such as chlordiazepoxide, diazepam or furosemide, is a result of its own limited functional capacity to eliminate the drug. Predicting a hepatic metabolic disorder based on a common bio-chemical assessment of enzyme activities is not sufficient. In advanced liver cirrhosis a higher risk is demonstrated for drugs with a narrow therapeutic width. It is always necessary to take into account whether the pharmacotherapy is necessary, use small doses and cautiously monitor the patient.

  2. Hyponatremia in Patients with Cirrhosis of the Liver

    Directory of Open Access Journals (Sweden)

    Mauro Bernardi

    2014-12-01

    Full Text Available Hyponatremia is common in cirrhosis. It mostly occurs in an advanced stage of the disease and is associated with complications and increased mortality. Either hypovolemic or, more commonly, hypervolemic hyponatremia can be seen in cirrhosis. Impaired renal sodium handling due to renal hypoperfusion and increased arginine-vasopressin secretion secondary to reduced effective volemia due to peripheral arterial vasodilation represent the main mechanisms leading to dilutional hyponatremia in this setting. Patients with cirrhosis usually develop slowly progressing hyponatremia. In different clinical contexts, it is associated with neurological manifestations due to increased brain water content, where the intensity is often magnified by concomitant hyperammonemia leading to hepatic encephalopathy. Severe hyponatremia requiring hypertonic saline infusion is rare in cirrhosis. The management of asymptomatic or mildly symptomatic hyponatremia mainly rely on the identification and treatment of precipitating factors. However, sustained resolution of hyponatremia is often difficult to achieve. V2 receptor blockade by Vaptans is certainly effective, but their long-term safety, especially when associated to diuretics given to control ascites, has not been established as yet. As in other conditions, a rapid correction of long-standing hyponatremia can lead to irreversible brain damage. The liver transplant setting represents a condition at high risk for the occurrence of such complications.

  3. Detection of hepatopulmonary syndrome in patient with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Davorin Dajčman

    2006-12-01

    Full Text Available Background: Hepatopulmonary syndrome (HPS is a pulmonary vascular disorder, complicating hepatic disease, and is responsible for an increased morbidity and mortality among patients awaiting liver transplantation. Nowadays, it is recognized as an independent risk factor for death in this patient population. The severity of hypoxemia and the advanced stage of the liver dysfunction are determinants for the prognosis. Therefore, the possibility to be successful, thus improving survival, consists of addressing HPS at an earlier stage, giving more attention to moderate evidences of this pathology instead of the severe ones.Patients and methods: Between the year 2000 and first half of the year 2005 we observed 115 patients with liver cirrhosis B and C expressed as class of Child-Pough classification of different etiology and portal hypertension (63 men and 52 women. All patients were included on the basis of inclusion and eyclusion criterion.Results: Clinically we suspected on hepatopulmonary syndrome in 18 patients. With 100 % oxygen inhalation test we confirmed the hepatopulmonary syndrome in 9 patients (57.7 %, 6 men and 3 women, on the other hand contrast echosonography was positive in 8 patients (51.3 %, 5 men and 3 women. All these patients had liver cirrhosis grade C, expressed as class of Child-Pough.Conclusions: On the basis of scientific evidence, we suggest a sample for detecting HPS among patients with liver cirrhosis, founded on the integration of two main factors: the severity of hepatic disease, expressed as class of Child-Pough, and the severity of the hypoxemia. The key role in diagnosis of hepatopulmonary syndrome are anamnesis of platipnea and arterial blood oxygen analysis as a less invasive diagnostic methods. However final diagnosis is achieved with 100 % oxygen inhalation test and contrast echosonography.

  4. Alteration in membrane protein, antioxidant status and hexokinase activity in erythrocytes of CCl4- induced cirrhotic rats.

    Directory of Open Access Journals (Sweden)

    Amir Hossein Doustimotlagh

    2014-11-01

    Full Text Available Several studies have shown that hepatocyte membrane composition changes in patients with cholestasis and cirrhosis. These alterations that are because of intracellular oxidative stress are supposed to be reflected in erythrocyte membrane. The aim of this study was to investigate the modification of erythrocyte membrane along with hexokinase and antioxidant enzymes during development of cirrhosis. Cirrhosis was induced by intraperitoneal injection of CCl4 in male Wistar rats. The test groups were: baseline, cholestatic, early cirrhotic and advanced cirrhotic along with an equal number of sham-control animals. The erythrocyte membrane modifications (protein sulfhydryl, protein carbonyl, and lipid peroxidation, as well as NO metabolites, were assessed. Activities of GPX, CAT, SOD and HK were also measured. Protein sulfhydryl content of the erythrocyte membrane (after 2, 6 and 10 weeks of injection had significant progressive decrease. In contrast, protein carbonyls were remarkably increased 2 weeks after injection but significantly decreased after 6 weeks and returned to normal levels after 10 weeks. No significant difference in erythrocyte HK activity or MDA content was observed. Test groups showed significantly lower erythrocyte GPx activity after six weeks and CAT and SOD activities along with NO metabolites content after two weeks (P<0.05. This study indicates that the progression of cirrhosis is accompanied by alterations in antioxidant enzyme and decreased NO metabolites. Protein carbonyl alteration occurs in the early stages of cirrhosis while protein sulfhydryl alterations have a progressive decrease in advanced cirrhosis.

  5. Clinical characteristics,prognosis and indicators of glucose metabolism of liver cirrhosis complicated with diabetes

    Institute of Scientific and Technical Information of China (English)

    吴娟

    2013-01-01

    Objective To investigate clinical characteristics and outcome of patients with liver cirrhosis complicated with diabetes,and to explore the differences of clinical characteristics and prognosis between hepatogenous diabetes (HD) and type 2 diabetes mellitus (T2DM) .Methods From November 2010 to April 2012,246 patients with liver cirrhosis were collected and divided into liver cir-

  6. Plasma levels of PBEF/Nampt/visfatin are decreased in patients with liver cirrhosis

    NARCIS (Netherlands)

    de Boer, Jan Freark; Bahr, Matthias J.; Boeker, Klaus H. W.; Manns, Michael P.; Tietge, Uwe J. F.

    2009-01-01

    de Boer JF, Bahr MJ, Boker KHW, Manns MP, Tietge UJF. Plasma levels of PBEF/Nampt/visfatin are decreased in patients with liver cirrhosis. Am J Physiol Gastrointest Liver Physiol 296: G196-G201, 2009. First published December 12, 2008; doi:10.1152/ajpgi.00029.2008.-Liver cirrhosis is a catabolic dis

  7. Alcohol consumption and liver cirrhosis mortality

    DEFF Research Database (Denmark)

    Bentzen, Jan Børsen; Smith, Valdemar

    Since the 1960s wine consumption has decreased dramatically in especially the Southern European countries whereas the countries in the northern parts of Europe have experienced a substitution from beer and spirits toward wines. In this sense there has been a process of convergence taking place re...... with strong evidence of a significantly positive relationship between alcohol consumption and the development in liver diseases; this is in accordance with many other micro studies.......Since the 1960s wine consumption has decreased dramatically in especially the Southern European countries whereas the countries in the northern parts of Europe have experienced a substitution from beer and spirits toward wines. In this sense there has been a process of convergence taking place...... regarding per capita consumption of wine among the European countries. Also for the total consumption of alcohol, i.e. the per capita consumption of beer, wine and spirits, the hypothesis of convergence seems to hold. In the same time span the number of alcohol related diseases as e.g. liver diseases, have...

  8. Challenges and Management of Liver Cirrhosis: Practical Issues in the Therapy of Patients with Cirrhosis due to NAFLD and NASH.

    Science.gov (United States)

    Traussnigg, Stefan; Kienbacher, Christian; Halilbasic, Emina; Rechling, Christian; Kazemi-Shirazi, Lili; Hofer, Harald; Munda, Petra; Trauner, Michael

    2015-01-01

    Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome and comprises a liver disease spectrum ranging from steatosis to nonalcoholic steatohepatitis (NASH) with risk of progression to liver cirrhosis and hepatocellular carcinoma (HCC). Associated metabolic conditions and comorbidities such as obesity, diabetes and cardiovascular diseases are common and require concerted management. Adiponutrin (PNPLA3) variants may help to identify NAFLD patients at higher risk for liver disease progression towards advanced fibrosis and HCC. The therapeutic options in NAFLD/NASH include lifestyle modification, pharmacological treatment, bariatric surgery for patients with morbid obesity and treatment of complications of liver cirrhosis and HCC, including liver transplantation. Insulin sensitizers and antioxidative treatment strategies with vitamin E are among the best-established pharmacological approaches, but both drugs have long-term safety issues and there is limited evidence in cirrhotic patients. Treatment of concomitant/underlying metabolic conditions with statins or metformin may also have beneficial effects on portal hypertension, complications of liver cirrhosis and HCC prevention. The bile acid receptor FXR may be a promising novel therapeutic target for the treatment of NAFLD/NASH, fibrosis and portal hypertension, but the prognostic implications of associated changes in low- and high-density lipoprotein cholesterol require further studies. Morbidly obese NASH patients can benefit from bariatric surgery which may reduce liver fibrosis but carries a risk of decompensation in patients with advanced liver cirrhosis. When carefully selected, patients with NASH cirrhosis undergoing liver transplantation have a good outcome. This review summarizes recent progress in the management of patients with liver cirrhosis due to NASH.

  9. Recurrence of graft steatosis after liver transplantation for cryptogenic cirrhosis in recently commenced liver transplant program.

    Science.gov (United States)

    Siriwardana, Rohan C; Niriella, Madunil Anuk; Dassanayake, Anuradha Supun; Liyanage, Chandika Anuradha Habarakada; Gunetilleke, Bhagya; de Silva, Hithanadura Janaka

    2016-05-01

    Non-alcoholic fatty liver disease (NAFLD) seems to recur in at least one third of patients transplanted for non-alcoholic steatohepatitis (NASH)-related cirrhosis. While, NASH recurrence does not seem to affect overall graft and patient survival up to 10 years, cardiovascular and infection-related morbidity and mortality seem to be increased in these patients. This report looks at the graft histology in patients who were transplanted for NASH-related cirrhosis after short-term follow up. We report a high prevalence of recurrent NAFLD in liver grafts post-transplant among five patients. The degree of steatosis noted among the recipients is alarming.

  10. Model for End-Stage Liver Disease and liver cirrhosis-related complications.

    Science.gov (United States)

    Bertot, Luis Calzadilla; Gomez, Eduardo Vilar; Almeida, Linnet Alonso; Soler, Enrique Arus; Perez, Luis Blanco

    2013-06-01

    The Model for End-Stage Liver Disease (MELD) score has gained wide acceptance for predicting survival in patients undergoing liver transplantation. The strength of this score remains in the mathematical formula derived from a multivariate Cox regression analysis; it is a continuous scale and lacks a ceiling or a floor effect with a wide range of discrimination. It is based on objective, reproducible, and readily available laboratory data and the wide range of samples which have been validated. Liver cirrhosis complications such as ascites, encephalopathy, spontaneous bacterial peritonitis and variceal bleeding were not considered in the MELD score underestimating their direct association with the severity of liver disease. In this regard, several recent studies have shown that clinical manifestations secondary to portal hypertension are good prognostic markers in cirrhotic patients and may add additional useful prognostic information to the current MELD. We review the feasibility of MELD score as a prognostic predictor in patients with liver cirrhosis-related complications.

  11. Clinical studies of resistant ascites in liver cirrhosis.

    Directory of Open Access Journals (Sweden)

    Yuasa,Shiro

    1984-06-01

    Full Text Available Resistant ascites was studied in 34 patients with liver cirrhosis and ascites. The patients were initially divided into 3 groups on the basis of the weekly cumulative ascites retention curve: patients relieved of ascites within 3 weeks of admission, patients relieved between 4 and 12 weeks and patients with ascites persisting beyond 13 weeks. "Resistant ascites" was defined as "ascites persisting for more than 13 weeks after admission to the hospital". The patients were then reclassified into 3 groups : Group A being those patients relieved of ascites within 12 weeks, Group B being those with resistant ascites and group C being those who died within 12 weeks of admission. There were no differences in age and sex distribution, etiology of liver cirrhosis, past medical history or physical findings among the 3 groups. However, Group B had higher levels of serum creatinine and blood urea nitrogen than Group A on admission. Serum bilirubin was higher and serum albumin was lower in Group C than in Group B, which indicates that Group C had greater liver cell failure.

  12. Cryptogenic cirrhosis: Metabolic liver disease due to insulin resistance

    Directory of Open Access Journals (Sweden)

    Binay K De

    2010-01-01

    Full Text Available Objective: Etiopathogenesis of cryptogenic cirrhosis (CC is not yet well established. Up to 20% of non-alcoholic fatty liver disease (NAFLD may progress to cirrhosis, mostly termed as cryptogenic. Insulin resistance and altered metabolic parameters form a major pathogenic link between NAFLD and CC. CC may thus be actually a metabolic liver disease. Materials and Methods: Thirty-four patients of CC and 32 patients having cirrhosis due to chronic hepatitis B (Hep B were assessed in a cross-sectional study in a tertiary hospital for insulin resistance, % β-cell activity, obesity indices, plasma glucose, lipid profiles, and many other parameters. Results: CC patients had higher homeostasis model assessment (HOMA-IR compared to Hep B group (P = 0.000016. A positive correlation between IR values and Child-Pugh score among CC patients was found ("r" = 0.87; P < 0.00001. Out of 34 CC patients, 15 (44.1% had obesity contrary to 6 (18.8% in the control group (P = 0.0022. Differences were observed in subcutaneous fat (P = 0.0022, intra-abdominal fat (P = 0.0055, waist circumference (P = 0.014, and percentage body fat (P = 0.047 between the two groups. Significant differences were observed in the levels of triglyceride, total cholesterol, and very low density lipoprotein (VLDL. Conclusion: Most of the CC patients showed significantly higher prevalence of HOMA-IR, obesity indices, and various parameters of "lipotoxicity" and metabolic syndrome, suggesting that CC may be the long-term consequence of a type of "metabolic liver disease." Further studies are required to evaluate the role of therapeutic interventions to enhance insulin sensitivity in such patients.

  13. Doxazosin Treatment Attenuates Carbon Tetrachloride-Induced Liver Fibrosis in Hamsters through a Decrease in Transforming Growth Factor β Secretion

    Science.gov (United States)

    Muñoz-Ortega, Martin Humberto; Llamas-Ramírez, Raúl Wiliberto; Romero-Delgadillo, Norma Isabel; Elías-Flores, Tania Guadalupe; de Jesus Tavares-Rodríguez, Edgar; del Rosario Campos-Esparza, María; Cervantes-García, Daniel; Muñoz-Fernández, Luis; Gerardo-Rodríguez, Martin; Ventura-Juárez, Javier

    2016-01-01

    Background/Aims The development of therapeutic strategies for the treatment of cirrhosis has become an important focus for basic and clinical researchers. Adrenergic receptor antagonists have been evaluated as antifibrotic drugs in rodent models of carbon tetrachloride (CCl4)-induced cirrhosis. The aim of the present study was to evaluate the effects of carvedilol and doxazosin on fibrosis/cirrhosis in a hamster animal model. Methods Cirrhotic-induced hamsters were treated by daily administration of carvedilol and doxazosin for 6 weeks. Hepatic function and histological evaluation were conducted by measuring biochemical markers, including total bilirubin, aspartate aminotransferase, alanine aminotransferase and albumin, and liver tissue slices. Additionally, transforming growth factor β (TGF-β) immunohistochemistry was analyzed. Results Biochemical markers revealed that hepatic function was restored after treatment with doxazosin and carvedilol. Histological evaluation showed a decrease in collagen type I deposits and TGF-β-secreting cells. Conclusions Taken together, these results suggest that the decrease in collagen type I following treatment with doxazosin or carvedilol is achieved by decreasing the profibrotic activities of TGF-β via the blockage of α1- and β-adrenergic receptor. Consequently, a diminution of fibrotic tissue in the CCl4-induced model of cirrhosis is achieved. PMID:26573293

  14. Liver Cancer: Connections with Obesity, Fatty Liver, and Cirrhosis.

    Science.gov (United States)

    Marengo, Andrea; Rosso, Chiara; Bugianesi, Elisabetta

    2016-01-01

    The burden of hepatocellular carcinoma (HCC), the most common form of liver cancer, is steadily growing because obesity, type 2 diabetes, and nonalcoholic fatty liver disease (NAFLD) are replacing viral- and alcohol-related liver disease as major pathogenic promoters. The most worrisome aspects of these new risk factors are their large spread in the general population and their link with HCC arising in noncirrhotic livers. HCC may be the presenting feature of an asymptomatic nonalcoholic steatohepatitis (NASH), the progressive form of NAFLD. The HCC risk connected to metabolic factors has been underestimated so far, and a poorer surveillance has prevented an adequate treatment. Systemic and hepatic molecular mechanisms involved in obesity- and NAFLD-induced hepatocarcinogenesis as well as potential early markers of HCC are being extensively investigated. This review summarizes current evidence linking obesity, NAFLD and liver cancer, discusses its clinical impact and describes the main mechanisms underlying this complex relationship.

  15. Evaluation of T{sub 1ρ} as a potential MR biomarker for liver cirrhosis: Comparison of healthy control subjects and patients with liver cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Rauscher, Isabel, E-mail: isabel.raucher@tum.de [Department of Diagnostic and Interventional Radiology, Technical University Munich, Ismaninger Str. 22, 81675 Munich (Germany); Eiber, Matthias; Ganter, Carl [Department of Diagnostic and Interventional Radiology, Technical University Munich, Ismaninger Str. 22, 81675 Munich (Germany); Martirosian, Petros [Section on Experimental Radiology, University Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen (Germany); Safi, Wajima; Umgelter, Andreas [2nd Medical Department, Technical University Munich, Ismaninger Straße 22, 81675 Munich (Germany); Rummeny, Ernst J.; Holzapfel, Konstantin [Department of Diagnostic and Interventional Radiology, Technical University Munich, Ismaninger Str. 22, 81675 Munich (Germany)

    2014-06-15

    Objectives: The purpose of this study was to compare mean liver T{sub 1ρ} values in patients with liver cirrhosis and healthy control subjects in order to evaluate T{sub 1ρ} as a potential MR biomarker for liver cirrhosis. Materials and methods: Ten healthy control subjects (mean age 42.7 years; 6 female, 4 male) and 21 patients with clinically diagnosed liver cirrhosis (mean age 56.5 years; 5 female, 16 male) were examined at 1.5 T (Magnetom Avanto, Siemens). T{sub 1ρ}-weighted images were acquired using a 2D TurboFLASH sequence (TR/TE 3/1.31 ms, FA 8°, FoV 309 × 380 mm, resolution 2 × 2 × 6 mm, acquisition time 15 s, slice thickness 6 mm) with spin-lock preparation. T{sub 1ρ} maps were calculated from five breath-hold measurements, performed with different spin-lock times (4, 8, 16, 32 and 48 ms). Mean liver T{sub 1ρ} values of healthy control subjects and patients with liver cirrhosis were calculated and compared using Student t-test. In addition, a receiver operating characteristic (ROC) curve analysis was performed to evaluate the utility of mean liver T{sub 1ρ} values for the prediction of liver cirrhosis. Results: Mean liver T{sub 1ρ} values in patients with liver cirrhosis (57.4 ± 7.4 ms) were significantly higher than those of healthy subjects (47.8 ± 4.2 ms; p = 0.0007). According to the ROC analysis at a threshold value of 50.1 ms the sensitivity and specificity of mean liver T{sub 1ρ} in predicting liver cirrhosis were 90.5% and 90%, respectively. The area under the ROC curve was 0.90. Conclusion: Mean liver T{sub 1ρ} values in patients with liver cirrhosis were significantly higher than those in healthy subjects suggesting a potential role of liver T{sub 1ρ} as a MR biomarker for liver cirrhosis.

  16. Efficacy controlled observation on acupuncture and western medicine for gastrointestinal dysmotility in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    邓晶晶

    2013-01-01

    Objective To observe the therapeutic effect of acupuncture on gastrointestinal dysmotility in liver cirrhosis.Methods Forty cases of gastrointestinal dysmotility in liver cirrhosis were randomized into an acupuncture group and a motilium group,20 cases in each one.In the

  17. Colchicine for alcoholic and non-alcoholic liver fibrosis and cirrhosis

    DEFF Research Database (Denmark)

    Rambaldi, A; Gluud, C

    2001-01-01

    The majority of liver fibrosis and liver cirrhosis cases in the Western World is caused by alcohol and hepatotoxic viruses. Colchicine is an anti-inflammatory and anti-fibrotic medication. Several randomised clinical trials have addressed the question whether colchicine has any efficacy in patients...... with alcoholic as well as non-alcoholic fibrosis and cirrhosis....

  18. Spontaneous bacterial peritonitis - Detection, treatment and prophylaxis in patients with liver cirrhosis

    NARCIS (Netherlands)

    Jansen, PLM

    1997-01-01

    Spontaneous bacterial peritonitis (SBP) is a common complication in patients with liver cirrhosis and ascites. When a patient with liver cirrhosis and ascites presents with fever and/or abdominal pain, or a tender abdomen on physical examination, or with refractory ascites, an ascitic fluid aspirate

  19. Spontaneous bacterial peritonitis - Detection, treatment and prophylaxis in patients with liver cirrhosis

    NARCIS (Netherlands)

    Jansen, PLM

    1997-01-01

    Spontaneous bacterial peritonitis (SBP) is a common complication in patients with liver cirrhosis and ascites. When a patient with liver cirrhosis and ascites presents with fever and/or abdominal pain, or a tender abdomen on physical examination, or with refractory ascites, an ascitic fluid aspirate

  20. Adiponectin and its receptors in rodent models of fatty liver disease and liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Markus Neumeier; Jürgen Sch(o)lmerich; Christa Buechler; Claus Hellerbrand; Erwin G(a)bele; Roland Buettner; Cornelius Bollheimer; Johanna Weigert; Andreas Sch(a)ffler; Thomas S Weiss; Monika Lichtenauer

    2006-01-01

    AIM: To determine circulating and hepatic adiponectin in rodents with fatty liver disease or liver cirrhosis and investigate expression of the adiponectin receptors AdipoR1 on the mRNA and protein level and AdipoR2 on the mRNA level.METHODS: Fat fed rats were used as a model for fatty liver disease and bile duct ligation in mice to investigate cirrhotic liver. Expression of AdipoR1 and AdipoR2 mRNA was determined by real time RT-PCR. AdipoR1 protein was analysed by immunoblot. Adiponectin was measured by ELISA.RESULTS: Systemic adiponectin is reduced in fat fed rats but is elevated in mice after bile duct ligation (BDL). Hepatic adiponectin protein is lower in steatotic liver but not in the liver of BDL-mice when compared to controls. Adiponectin mRNA was not detected in human liver samples or primary human hepatocytes nor in rat liver but recombinant adiponectin is taken up by isolated hepatocytes in-vitro. AdipoR1 mRNA and AdipoR1 protein levels are similar in the liver tissue of control and fat fed animals whereas AdipoR2 mRNA is induced. AdipoR2 mRNA and AdipoR1 mRNA and protein is suppressed in the liver of BDL-mice.CONCLUSION: Our studies show reduced circulating adiponectin in a rat model of fatty liver disease whereas circulating adiponectin is elevated in a mouse model of cirrhosis and similar findings have been described in humans. Diminished hepatic expression of adiponectin receptors was only found in liver cirrhosis.

  1. Colchicine for alcoholic and non-alcoholic liver fibrosis or cirrhosis

    DEFF Research Database (Denmark)

    Rambaldi, A; Gluud, C

    2001-01-01

    Colchicine is an anti-inflammatory and anti-fibrotic drug. Several randomized clinical trials have addressed the question whether colchicine has any efficacy in patients with alcoholic as well as non-alcoholic fibrosis and cirrhosis. The objectives were to assess the efficacy of colchicine...... evaluated in randomized trials on mortality, liver related mortality, liver related complications, liver fibrosis markers, liver histology, alcohol consumption, quality of life, and health economics in patients with alcoholic and non-alcoholic fibrosis or cirrhosis....

  2. Impact of a CXCL12/CXCR4 Antagonist in Bleomycin (BLM) Induced Pulmonary Fibrosis and Carbon Tetrachloride (CCl4) Induced Hepatic Fibrosis in Mice

    Science.gov (United States)

    Chow, Leola N.; Schreiner, Petra; Ng, Betina Y. Y.; Lo, Bernard; Hughes, Michael R.; Scott, R. Wilder; Gusti, Vionarica; Lecour, Samantha; Simonson, Eric; Manisali, Irina; Barta, Ingrid; McNagny, Kelly M.; Crawford, Jason; Webb, Murray; Underhill, T. Michael

    2016-01-01

    Modulation of chemokine CXCL12 and its receptor CXCR4 has been implicated in attenuation of bleomycin (BLM)-induced pulmonary fibrosis and carbon tetrachloride (CCl4)-induced hepatic injury. In pulmonary fibrosis, published reports suggest that collagen production in the injured lung is derived from fibrocytes recruited from the circulation in response to release of pulmonary CXCL12. Conversely, in hepatic fibrosis, resident hepatic stellate cells (HSC), the key cell type in progression of fibrosis, upregulate CXCR4 expression in response to activation. Further, CXCL12 induces HSC proliferation and subsequent production of collagen I. In the current study, we evaluated AMD070, an orally bioavailable inhibitor of CXCL12/CXCR4 in alleviating BLM-induced pulmonary and CCl4-induced hepatic fibrosis in mice. Similar to other CXCR4 antagonists, treatment with AMD070 significantly increased leukocyte mobilization. However, in these two models of fibrosis, AMD070 had a negligible impact on extracellular matrix deposition. Interestingly, our results indicated that CXCL12/CXCR4 signaling has a role in improving mortality associated with BLM induced pulmonary injury, likely through dampening an early inflammatory response and/or vascular leakage. Together, these findings indicate that the CXCL12-CXCR4 signaling axis is not an effective target for reducing fibrosis. PMID:26998906

  3. TOP1 and 2, polysaccharides from Taraxacum officinale, attenuate CCl(4)-induced hepatic damage through the modulation of NF-kappaB and its regulatory mediators.

    Science.gov (United States)

    Park, Chung Mu; Youn, Hyun Joo; Chang, Hee Kyung; Song, Young Sun

    2010-05-01

    In this work, we estimate the inhibitory effect of two polysaccharides from Taraxacum officinale (TOP) on CCl(4)-induced oxidative stress and inflammation in Sprague-Dawley rats. TOP1 and 2 (304, 92 mg/kg bw) were administered for 7 days via a stomach sonde, and hepatitis was induced by a single dose of CCl(4) (50% CCl(4)/olive oil; 0.5 mL/kg bw) administration. CCl(4) significantly elevated serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities. Histopathological observation further revealed that CCl(4)-induced moderate levels of inflammatory cell infiltration, centrilobular fatty change, apoptosis, and necrosis. However, TOPs pretreatment markedly decreased AST and ALT activities as well as hepatic lesions. TOPs also increased free radical scavenging activity, as exhibited by a lowered TBARS concentration. TOPs pretreatment also reversed other hepatitis-associated symptoms, including GSH depletion, inhibited anti-oxidative enzyme activities, up-regulation of NF-kappaB and increased expression of its regulatory inflammatory mediators, such as inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-2, tumor necrosis factor (TNF)-alpha, and interleukin (IL)-1beta. These results suggest that TOPs have a hepatoprotective effect by modulating inflammatory responses and ameliorating oxidative stress.

  4. Quantitative Phytochemical Estimation and Evaluation of Hepatoprotective Activity of Methanolic Extract of Dendrobium ovatum (L. Kraenzl. Whole Plant against CCl4 Induced Hepatotoxicity

    Directory of Open Access Journals (Sweden)

    Seru Ganapaty

    2013-09-01

    Full Text Available A large number of populations suffer due to various reasons from hepatic diseases of unknown origin. The development of antihepatotoxic drugs being a major thrust area has drawn the attention of workers in the field of natural product research because synthetic drugs may cause serious side effects. The present research was aimed to study the in vivo hepatoprotective activity of methanolic extract of Dendrobium ovatum (L. Kraenzl. Whole plant, which was used traditionally in Chittoor and Khammam districts of Andhra Pradesh, by carbon tetrachloride (CCl4 induced hepatotoxicity animal model and standard drug silymarin. The level of serum aspartate aminotransferase (SGOT, alanine aminotransferase (SGPT, alkaline phosphatase (ALP and total bilirubin (T. BILI. were determined to assay hepatotoxicity. CCl4 administration caused severe hepatic damage in rats as evidenced by elevated serum SGOT, SGPT, ALP and T. BILI. Levels. The D. ovatum and silymarin administration prevented the toxic effect of CCl4 on the above serum parameters in both preventive and curative models. The present study concludes that, methanolic extract of D. ovatum has significant hepatoprotective activity against CCl4 induced hepatotoxicity, which support folkloric utilization and further confirmed by the histological investigation. The observed activity may be associated with its high bioactive compounds including flavonoids, alkaloids, triterpenoids, glycosides, steroids and carbohydrates.

  5. Risk for alcoholic liver cirrhosis after an initial hospital contact with alcohol problems

    DEFF Research Database (Denmark)

    Askgaard, Gro; Leon, David A; Kjaer, Mette S

    2017-01-01

    cirrhosis in these patients relative to the general population. Age and alcohol diagnosis were significant predictors of alcoholic liver cirrhosis risk in men and women, whereas civil status, education, and type of hospital care were not. In men, the 15-year absolute risk was 0.7% (95%CI 0.4, 0.8) for 20......Alcoholic liver cirrhosis is usually preceded by many years of heavy drinking, in which cessation in drinking could prevent the disease. Alcohol problems are not consistently managed in hospital patients. We followed all Danish patients with an initial hospital contact with alcohol problems...... (intoxication, harmful use, or dependence) during 1998-2002 for alcoholic liver cirrhosis development (n = 36,044). In this registry-based cohort we identified predictors of the absolute risk for alcoholic liver cirrhosis. Incidence rate ratios (IRR) were estimated as the incidence rate of alcoholic liver...

  6. alpha 2-Plasmin inhibitor metabolism in patients with liver cirrhosis.

    Science.gov (United States)

    Knot, E A; Drijfhout, H R; ten Cate, J W; de Jong, E; Iburg, A H; Kahlé, L H; Grijm, R

    1985-03-01

    We describe the metabolism of purified human alpha 2-plasmin inhibitor in patients with liver cirrhosis to determine whether low plasma concentrations of alpha 2-plasmin inhibitor are the result of impaired synthesis or increased catabolism or both. A kinetic study was performed with 131I-alpha 2-plasmin inhibitor as a sensitive parameter of fibrinolysis in 14 patients with histologically proved liver cirrhosis compared with six healthy control subjects. Eight patients had macronodular cirrhosis (with positive hepatitis B surface antigen), and six had micronodular cirrhosis as a result of alcohol abuse. None of the patients had clinical signs of ascites, and in all the disease was stabilized. alpha 2-Plasmin inhibitor levels biologically and immunologically measured were decreased in all patients. Ten microCi 131I-alpha 2PI was injected intravenously, the disappearance of plasma radioactivity was measured, and turnover data were calculated according to the function x(t) = A1e-alpha 1t + A2e-alpha 2t + Be-beta t. Mean (+/- SD) turnover data in the control subjects were plasma radioactivity half-life 60.1 +/- 5.3 hours, fractional catabolic rate constant of the plasma pool 0.0318 +/- 0.0106 hr-1, and absolute catabolic (synthetic) rate constant 2.10 +/- 0.60 mg/kg/day. The alpha 1-phase was 1.26 +/- 0.23, and the transcapillary influx constant (k2,1) was 0.974 +/- 0.109 hr-1. In the patients, plasma radioactivity half-life was 58.7 +/- 12.09 hr, and fractional catabolic rate constant of the plasma pool 0.0283 +/- 0.0043 hr-1. The alpha 1-phase 4.74 +/- 6.48 and the transcapillary influx (k2,1) 3.08 +/- 3.9 hr-1 were both significantly increased compared with control values (p less than 0.05 and p less than 0.05, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Nerve growth factor involvement in liver cirrhosis and hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To define NGF (nerve growth factor) and its highaffinity receptor trkANGF presence and distribution in fibrotic liver and in HCC, and to verify if NGF might have a role in fibrosis and HCC.METHODS: Intracellular distribution of NGF and trkANGF were assessed by immunohistochemistry and immunoelectron microscopy in liver specimens from HCC,cirrhosis or both. ELISA was used to measure circulating NGF levels.RESULTS: NGF and trkANGF were highly expressed in HCC tissue, mainly localized in hepatocytes, endothelial and some Kupffer cells. In the cirrhotic part of the liver they were also markedly expressed in bile ducts epithelial and spindle-shaped cells. Surprisingly, in cirrhotic tissue from patients without HCC, both NGF and trkANGF were negative. NGF serum levels in cirrhotic and/or HCC patient were up to 25-fold higher than in controls.CONCLUSION: NGF was only detected in liver tissue with HCC present. Intracellular distribution suggests paracrine and autocrine mechanisms of action. Better definition of mechanisms may allow for therapeutic and diagnostic/prognostic use of NGF.

  8. Behavior of Oxidative Stress Markers in Alcoholic Liver Cirrhosis Patients

    Directory of Open Access Journals (Sweden)

    Marina Galicia-Moreno

    2016-01-01

    Full Text Available Alcohol is the most socially accepted addictive substance worldwide, and its metabolism is related with oxidative stress generation. The aim of this work was to evaluate the role of oxidative stress in alcoholic liver cirrhosis (ALC. This study included 187 patients divided into two groups: ALC, classified according to Child-Pugh score, and a control group. We determined the levels of reduced and oxidized glutathione (GSH and GSSG and the GSH/GSSG ratio by an enzymatic method in blood. Also, protein carbonyl and malondialdehyde (MDA content were estimated in serum. MDA levels increased in proportion to the severity of damage, whereas the GSH and GSSG levels decreased and increased, respectively, at different stages of cirrhosis. There were no differences in the GSH/GSSG ratio and carbonylated protein content between groups. We also evaluated whether the active consumption of or abstinence from alcoholic beverages affected the behavior of these oxidative markers and only found differences in the MDA, GSH, and GSSG determination and the GSH/GSSG ratio. Our results suggest that alcoholic cirrhotic subjects have an increase in oxidative stress in the early stages of disease severity and that abstinence from alcohol consumption favors the major antioxidant endogen: GSH in patients with advanced disease severity.

  9. Changes in platelet functional parameters and CD62 P expression in liver cirrhosis.

    Science.gov (United States)

    Xianghong, G; Guanping, C; Fenghua, Y; Jiayin, W

    2013-12-01

    Hepatic impairment, portal hypertension, and multi-systemic damage could occur during liver cirrhosis's late stage. Bleeding is a complication of hepatic cirrhosis along with several changes including blood platelet count (BPC), mean platelet volume (MPV), platelet crit (PCT) and expression of platelet CD62P. Blood platelet count (BPC), mean platelet volume (MPV), platelet distribution width, and other indices are indirect reflections of CD62P parameters. To investigate the changes in platelet functional parameters and CD62 P expression in liver cirrhosis as a possible guide in clinical treatments and prognoses of liver cirrhosis. CD62P was tested by flow cytometry in liver cirrhosis. BPC, MPV, and PCT in peripheral blood were tested using an auto blood cell analyzer. Data were analyzed using SPSS11.0. The values of CD62P and MPV in patients was significantly higher than those of healthy donors (PPP, BPC, MPV, and platelet crit (PCT) show several changes in liver cirrhosis. It is useful to understand the relationship between hepatic cirrhosis severity and CD62P, BPC, MPV, PCT, timely monitoring of CD62P for treatment of hepatic cirrhosis in clinical treatment and prognosis.

  10. End-stage nonalcoholic fatty liver disease: evaluation of pathomorphologic features and relationship to cryptogenic cirrhosis from study of explant livers in a living donor liver transplant program.

    Science.gov (United States)

    Nayak, Nabeen C; Vasdev, Nandini; Saigal, Sanjiv; Soin, Arvinder S

    2010-03-01

    In a proportion of liver cirrhosis, the etiology continues to remain elusive. It is uncertain whether and to what extent cirrhosis evolving from nonalcoholic fatty liver disease contributes to this group of cryptogenic cirrhosis because the clinicopathologic features of nonalcoholic fatty liver disease cirrhosis are largely unknown. We explored these facets by examining the explant livers and clinical data in living donor liver transplant recipients. Among 103 adult liver transplant recipients with different types of chronic liver disease, 30 had a pre-liver transplant diagnosis of cryptogenic cirrhosis. A final categorization of the native liver disease was attempted in these cases on the basis of detail pathomorphological findings in adequately sampled explant liver correlated with careful review of pre-liver transplant clinical data. Of the 30 cryptogenic cirrhosis cases, 19 (63.3%) finally labeled as nonalcoholic fatty liver disease cirrhosis showed histologic features in several respects different from those reported for the early and established phases of nonalcoholic fatty liver disease. Steatosis was infrequent and focal or even absent, whereas variable grades of Mallory hyaline and inflammation were consistently present. Ductular proliferation and hydropic change of hepatocytes were also frequent. Only 9 (47%) of the 19 cases had nonalcoholic fatty liver disease associated risk factors like diabetes and obesity. It was concluded that appreciation of quantitative and qualitative differences in hepatic morphology between the cirrhotic and the early/established stage of nonalcoholic fatty liver disease will help in making a correct diagnosis of nonalcoholic fatty liver disease cirrhosis in the proper clinical setting. When appropriate criteria are used, nonalcoholic fatty liver disease appears to account for close to two thirds of cases currently labeled as cryptogenic cirrhosis.

  11. Anti-apoptotic effect of San Huang Shel Shin Tang cyclodextrin complex (SHSSTc) on CCl4 -induced hepatotoxicity in rats.

    Science.gov (United States)

    Yang, Cheng-Hsun; Ting, Wei-Jen; Shen, Chia-Yao; Hsu, Hsi-Hsien; Lin, Yueh-Min; Kuo, Chia-Hua; Tsai, Fuu-Jen; Tsai, Chang-Hai; Tsai, Yuhsin; Huang, Chih-Yang

    2016-06-01

    The metabolic loading is heavier in liver especially when injured or inflammation. San Huang Shel Shin Tang (SHSST) was an old traditional herbal decoction, which composed with Rheum officinale Baill, Scutellaria baicalnsis Geprgi and Coptis chinensis Franch (1:1:2 in weight), can provide a liver protection effects. We used a beta-cyclodextrin (β-CD) drug modification method in reduce of the necessary dose of the SHSST. As the results, the FAS-FADD expressions leaded apoptosis in CCl4 intraperitoneal (IP) injection induced acute liver injury in rats. Silymarin, baicalein, SHSST, and SHSST β-CD complex (SHSSTc) pretreatments protected liver through the decreasing of the expressions of FAS-FADD and downstream caspase-3 and caspase-8. Particularly, SHSSTc (30 mg/kg day) treatment enhanced cell survival pathway activation through the PI3K, Akt and Bad phosphorylation. Compared with SHSST as well as silymarin and baicalein, SHSSTc provided a magnificent liver protection effect, especially in survival pathway activation/TUNEL-apoptotic cell reduction/serum cholesterol level suppression. All these data suggested that β-CD complex modified the SHSST and promoted the bioavailability and liver protection effects. © 2014 Wiley Periodicals, Inc. Environ Toxicol 31: 663-670, 2016.

  12. Cirrhosis, liver transplantation and HIV infection are risk factors associated with hepatitis E virus infection.

    Directory of Open Access Journals (Sweden)

    Mar Riveiro-Barciela

    Full Text Available Acute and chronic hepatitis E have been associated with high mortality and development of cirrhosis, particularly in solid-organ recipients and patients infected by human immunodeficiency virus. However, data regarding the epidemiology of hepatitis E in special populations is still limited.Investigate seroprevalence and possible factors associated with HEV infection in a large cohort of immunosuppressed patients.Cross-sectional study testing IgG anti-HEV in serum samples from 1373 consecutive individuals: 332 liver-transplant, 296 kidney-transplant, 6 dual organ recipients, 301 non-transplanted patients with chronic liver disease, 238 HIV-infected patients and 200 healthy controls.IgG anti-HEV was detected in 3.5% controls, 3.7% kidney recipients, 7.4% liver transplant without cirrhosis and 32.1% patients who developed post-transplant cirrhosis (p<0.01. In patients with chronic liver disease, IgG anti-HEV was also statistically higher in those with liver cirrhosis (2% vs 17.5%, p<0.01. HIV-infected patients showed an IgG anti-HEV rate of 9.2%, higher than those patients without HIV infection (p<0.03. Multivariate analysis showed that the factors independently associated with anti-HEV detection were liver cirrhosis, liver transplantation and HIV infection (OR: 7.6, 3.1 and 2.4. HCV infection was a protective factor for HEV infection (OR: 0.4.HEV seroprevalence was high in liver transplant recipients, particularly those with liver cirrhosis. The difference in anti-HEV prevalence between Liver and Kidney transplanted cases suggests an association with advanced liver disease. Further research is needed to ascertain whether cirrhosis is a predisposing factor for HEV infection or whether HEV infection may play a role in the pathogeneses of cirrhosis.

  13. Cirrhosis, Liver Transplantation and HIV Infection Are Risk Factors Associated with Hepatitis E Virus Infection

    Science.gov (United States)

    Riveiro-Barciela, Mar; Buti, María; Homs, María; Campos-Varela, Isabel; Cantarell, Carmen; Crespo, Manuel; Castells, Lluís; Tabernero, David; Quer, Josep; Esteban, Rafael; Rodriguez-Frías, Francisco

    2014-01-01

    Background Acute and chronic hepatitis E have been associated with high mortality and development of cirrhosis, particularly in solid-organ recipients and patients infected by human immunodeficiency virus. However, data regarding the epidemiology of hepatitis E in special populations is still limited. Aims Investigate seroprevalence and possible factors associated with HEV infection in a large cohort of immunosuppressed patients. Methods Cross-sectional study testing IgG anti-HEV in serum samples from 1373 consecutive individuals: 332 liver-transplant, 296 kidney-transplant, 6 dual organ recipients, 301 non-transplanted patients with chronic liver disease, 238 HIV-infected patients and 200 healthy controls. Results IgG anti-HEV was detected in 3.5% controls, 3.7% kidney recipients, 7.4% liver transplant without cirrhosis and 32.1% patients who developed post-transplant cirrhosis (p<0.01). In patients with chronic liver disease, IgG anti-HEV was also statistically higher in those with liver cirrhosis (2% vs 17.5%, p<0.01). HIV-infected patients showed an IgG anti-HEV rate of 9.2%, higher than those patients without HIV infection (p<0.03). Multivariate analysis showed that the factors independently associated with anti-HEV detection were liver cirrhosis, liver transplantation and HIV infection (OR: 7.6, 3.1 and 2.4). HCV infection was a protective factor for HEV infection (OR: 0.4). Conclusions HEV seroprevalence was high in liver transplant recipients, particularly those with liver cirrhosis. The difference in anti-HEV prevalence between Liver and Kidney transplanted cases suggests an association with advanced liver disease. Further research is needed to ascertain whether cirrhosis is a predisposing factor for HEV infection or whether HEV infection may play a role in the pathogeneses of cirrhosis. PMID:25068388

  14. Protective effects of gomisin A isolated from Schisandra chinensis against CCl(4)-induced hepatic and renal injury.

    Science.gov (United States)

    Hwang, In Sik; Kim, Jee Eun; Lee, Yong Ju; Kwak, Moon Hwa; Choi, Young Hwan; Kang, Byeong Cheol; Hong, Jin Tae; Hwang, Dae Youn

    2013-04-01

    The aim of the present study was to investigate the protective effects of gomisin A, a lignan compound isolated from Schisandra chinensis, against liver and kidney damage induced by CCl(4) exposure. We assessed alterations in organ weights, levels of serum biochemical indicators, and activation of the caspase-3 and MAPK signaling pathways and carried out histological analysis of liver and kidney tissue in rats pretreated with gomisin A for four days. In the gomisin A/CCl(4)-treated group, only the liver experienced a significant increase in weight, whereas the other organs did not undergo any changes. Five biochemical indicators in serum indicated that liver and kidney toxicity dramatically decreased upon gomisin A pretreatment, although the decrease in ratios varied. Upon histological analysis, the gomisin A/CCl(4)-treated group showed less hepatocellular necrosis, a poorly dilated central vein in the liver section, decreased diameter of the glomerulus, a lower number of capillaries, and a convoluted tubule in the kidney section. Furthermore, the formation of active caspase-3 was inhibited by gomisin A pretreatment in the gomisin A/CCl(4)-treated group, whereas the expression level of Bax protein was slightly increased. Western blot analysis revealed that there were differences between the liver and kidney in terms of activation of the MAPK signaling pathway. In the liver, gomisin A pretreatment increased phosphorylation of three members of the MAPK pathway when compared to that in the vehicle pretreatment group. However, in the kidney, only the phosphorylation level of p38 was elevated upon gomisin A pretreatment, whereas levels of the other two members were decreased. These results suggest that gomisin A induces marked protective effects against hepatic and renal injury induced by CCl(4) exposure through differential regulation of the MAPK signal transduction pathway.

  15. Cryptogenic cirrhosis is the leading cause for listing for liver transplantation in Sri Lanka.

    Science.gov (United States)

    Siriwardana, R C; Niriella, M A; Liyanage, C A H; Wijesuriya, S R; Gunathilaka, B; Dassanayake, A S; De Silva, H J

    2013-11-01

    Hepatitis B and C are rare in Sri Lanka. Nonalcoholic fatty liver disease is increasing in the country. Eighty-one patients referred for liver transplantation (LT) over a period of 18 months were prospectively evaluated. Ninety-two percent (n = 74) were males. Cryptogenic cirrhosis was the leading indication for LT (58%, n = 47) followed by alcohol in 27% (n = 33). Hepatitis B and C were not seen in our cases. The liver biochemistry and clinical status of cirrhosis were similar in cryptogenic and alcoholic cirrhotics. Fourteen patients died while waiting for transplant, and nine transplants were performed. Cryptogenic cirrhosis is the leading cause for LT in Sri Lanka.

  16. Oxymatrine attenuates CCl4-induced hepatic fibrosis via modulation of TLR4-dependent inflammatory and TGF-β1 signaling pathways.

    Science.gov (United States)

    Zhao, Hong-Wei; Zhang, Zhen-Fang; Chai, Xuan; Li, Guang-Quan; Cui, He-Rong; Wang, Hong-Bo; Meng, Ya-Kun; Liu, Hui-Min; Wang, Jia-Bo; Li, Rui-Sheng; Bai, Zhao-Fang; Xiao, Xiao-He

    2016-07-01

    Oxymatrine (OMT) is able to effectively protect against hepatic fibrosis because of its anti-inflammatory property, while the underlying mechanism remains incompletely understood. In this study, forty rats were randomly divided into five groups: control group, model group (carbon tetrachloride, CCl4) and three OMT treatment groups (30, 60, 120mg/kg). After CCl4 alone, the fibrosis score was 20.2±0.8, and the level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), hydroxyproline content, and collagen I expression was elevated, but OMT blunted these parameters. Treatment with OMT prevented CCl4-induced increases in expression of pro-inflammatory and pro-fibrotic cytokines interleukin (IL)-6 and tumor necrosis factor (TNF)-α, meanwhile OMT promoted the expression of anti-inflammatory and anti-fibrotic factors such as interleukin (IL)-10 and bone morphogenetic protein and activin membrane-bound inhibitor (Bambi). Moreover, lipopolysaccharides (LPS) and high mobility group box-1 (HMGB1), which activates Toll-like receptor 4 (TLR4) and modulate hepatic fibrogenesis through hepatic stellate cells (HSCs) or Kupffer cells, were significantly decreased by OMT treatment. These results were further supported by in vitro data. First, OMT suppressed the expression of TLR4 and its downstream pro-inflammatory cytokines, lowered the level of HMGB1, TGF-β1 in macrophages. Then, OMT promoted Bambi expression and thereby inhibited activation of HSCs mediated by transforming growth factor (TGF)-β1. In conclusion, this study showed that OMT could effectively attenuate the CCl4-induced hepatic fibrosis, and this effect may be due to modulation of TLR4-dependent inflammatory and TGF-β1 signaling pathways.

  17. ACEI attenuates the progression of CCl4-induced rat hepatic fibrogenesis by inhibiting TGF-β1, PDGF-BB, NF-κB and MMP-2,9

    Institute of Scientific and Technical Information of China (English)

    Xu Li; Ying Meng; Xi-Shan Yang; Ling-Fei Mi; Shao-Xi Cai

    2005-01-01

    AIM: Angiotensin Ⅱ has pro-fibrotic function in the liver.Blockade of the renin-angiotensin-aldosterone-system (RAAS) attenuates hepatic fibrosis. The aim of the present study was to determine the mechanism of angiotensinconverting enzyme inhibitor (ACEI) on the progression of rat hepatic fibrosis.METHODS: Forty male Wistar rats were divided into three groups. Model group (Mo): The rats were injected subcutaneously with 40% of CCl4 0.25 mL/100 g. Perindopril group (Pe): The rats were injected subcutaneously with administrated. Control group (Nc): the rats were treated with olive oil only. After 4 and 6 wk, the rats were killed.The liver sections were stained with Masson. The protein expressions of AT1R, TGF-β1 and PDGF-BB were examined by Western blot. Nuclear factor κB (NF-κB) DNA binding activity was examined by EMSA (Electrophoretic gel mobility shift assay). Matrix metalloproteinase-2,9(MMP-2,9) activity was assessed by zymography. Serum laminin (LN) and hyaluronic acid (HA) were measured using radioimmunoassays.RESULTS: Using Western blot, we clearly provided direct evidence for the expression of AT1R in liver. The expression was up-regulated when fibrogenesis occurred. Perindopril treatment significantly reduced mean fibrosis score,protein levels of AT1R, TGF-β1 and PDGF-BB, serum levels of HA and LN, and the activity of MMP-2,9. NF-κB DNA binding activity markedly increased in model group, perindopril treatment considerably reduced NF-κB DNA binding activity.CONCLUSION: Perindopril attenuates CCl4-induced hepatic fibrogenesis of rat by inhibiting TGF-β1, PDGF-BB,NF-κB and MMP-2,9.

  18. Liver cirrhosis in selected autoimmune diseases: a nationwide cohort study in Taiwan.

    Science.gov (United States)

    Tung, Chien-Hsueh; Lai, Ning-Seng; Lu, Ming-Chi; Lee, Ching-Chih

    2016-02-01

    The association between autoimmune diseases and liver cirrhosis has rarely been explored in Asian populations, an endemic area of viral hepatitis. The aim of this study was to investigate the comparative risk of liver cirrhosis among a group of selective autoimmune diseases in Taiwanese patients and to identify groups of high risk. This retrospective study was a nationwide, population-based study and used Taiwan's National Health Insurance Research Database. A total of 29,856 patients with definite diagnosis of selected autoimmune diseases (Registry of Taiwan Catastrophic Illness Database, ACR classification) at the starting time point of January 1, 2005, were enrolled in this study. After tracked for a 5-year period, the endpoints were diagnosis of liver cirrhosis (in accordance with International Classification of Diseases, Ninth Revision, Clinical Modification, ICD-9-CM codes 571). The control group was composed of other patients in the same database and consisted of randomly selected 753,495 sex- and age-matched non-autoimmune disease patients. The Cox proportional hazard regression model was used to calculate the risk of liver cirrhosis after adjusting for certain variables such as comorbidity, living area, and socioeconomic status. Among the patients with selected autoimmune diseases, 1987 liver cirrhosis were observed. Patients with psoriasis had a significantly increased risk of liver cirrhosis (HR 1.87, 95 % CI 1.25-2.81) than control group without psoriasis. The risk of liver cirrhosis was significantly lower in patients with rheumatoid arthritis (HR 0.29, 95 % CI 0.19-0.44). There is a gradient of risk of liver cirrhosis among the autoimmune diseases; the specific risks need to be investigated on the basis of hypotheses. Conventional immunosuppressive drug administration should be carefully implemented by regular monitoring of liver condition in order to avoid causing an adverse effect of chronic liver fibrosis.

  19. An empirical analysis of the relationship between the consumption of alcohol and liver cirrhosis mortality

    DEFF Research Database (Denmark)

    Bentzen, Jan Børsen; Smith, Valdemar

    The question whether intake of alcohol is associated with liver cirrhosis mortality is analyzed using aggregate data for alcohol consumption, alcohol related diseases and alcohol policies of 16 European countries. The empirical analysis gives support to a close association between cirrhosis...

  20. PEGylation of interleukin-10 improves the pharmacokinetic profile and enhances the antifibrotic effectivity in CCl4-induced fibrogenesis in mice

    NARCIS (Netherlands)

    Mattos Pinto, Adriana; de Jager-Krikken, Alie; de Haan, Marianne; Beljaars, Leonie; Poelstra, Klaas

    2012-01-01

    Liver fibrosis represents a scar formation process as a response to chronic injury and a major cause of death worldwide. To date, no drug is available for this condition. Interleukin-10 (IL-10) has potent anti-inflammatory and antifibrotic properties but its short half-life in the circulation

  1. PEGylation of interleukin-10 improves the pharmacokinetic profile and enhances the antifibrotic effectivity in CCl4-induced fibrogenesis in mice

    NARCIS (Netherlands)

    Mattos Pinto, Adriana; de Jager-Krikken, Alie; de Haan, Marianne; Beljaars, Leonie; Poelstra, Klaas

    2012-01-01

    Liver fibrosis represents a scar formation process as a response to chronic injury and a major cause of death worldwide. To date, no drug is available for this condition. Interleukin-10 (IL-10) has potent anti-inflammatory and antifibrotic properties but its short half-life in the circulation hamper

  2. Prolonged T1 in patients with liver cirrhosis: an in vivo MRI study

    DEFF Research Database (Denmark)

    Thomsen, C; Christoffersen, P; Henriksen, O;

    1990-01-01

    of interest centrally located in the liver. T1 relaxation time was longer in the patients with liver cirrhosis than in the two reference groups. Ten patients had a liver biopsy taken prior to the MRI study. No correlation was found between histopathology and the measured relaxation times.......Fifteen patients with liver cirrhosis and two control groups were examined. The first control group consisted of 7 healthy volunteers, and the second group of 17 patients with nonfocal liver diseases. The T1 and T2 relaxation times were calculated from signal intensities read out from a region...

  3. IS THERE RECURRENCE OF PRIMARY BILIARY-CIRRHOSIS AFTER LIVER-TRANSPLANTATION - A CLINICOPATHOLOGICAL STUDY IN LONG-TERM SURVIVORS

    NARCIS (Netherlands)

    GOUW, ASH; HAAGSMA, EB; MANNS, M; KLOMPMAKER, IJ; SLOOFF, MJH; GERBER, MA

    1994-01-01

    Liver transplantation has been accepted as a successful therapeutic tool for irreversible liver diseases such as primary biliary cirrhosis. However, removal of the diseased liver may not eliminate this autoimmune disease, and recurrence of primary biliary cirrhosis in the liver graft has been report

  4. IS THERE RECURRENCE OF PRIMARY BILIARY-CIRRHOSIS AFTER LIVER-TRANSPLANTATION - A CLINICOPATHOLOGICAL STUDY IN LONG-TERM SURVIVORS

    NARCIS (Netherlands)

    GOUW, ASH; HAAGSMA, EB; MANNS, M; KLOMPMAKER, IJ; SLOOFF, MJH; GERBER, MA

    1994-01-01

    Liver transplantation has been accepted as a successful therapeutic tool for irreversible liver diseases such as primary biliary cirrhosis. However, removal of the diseased liver may not eliminate this autoimmune disease, and recurrence of primary biliary cirrhosis in the liver graft has been report

  5. Cirrhosis

    Science.gov (United States)

    ... cirrhosis: bilirubin, which tests the amount of bile pigment in the blood creatinine, which tests kidney function ... fluid from the abdomen and check for spontaneous bacterial peritonitis. A health care provider may prescribe bacteria- ...

  6. Impaired hepatic removal of interleukin-6 in patients with liver cirrhosis.

    Science.gov (United States)

    Wiest, Reiner; Weigert, Johanna; Wanninger, Josef; Neumeier, Markus; Bauer, Sabrina; Schmidhofer, Sandra; Farkas, Stefan; Scherer, Marcus N; Schäffler, Andreas; Schölmerich, Jürgen; Buechler, Christa

    2011-02-01

    Systemic concentrations of interleukin-6 (IL-6) are elevated in patients with liver cirrhosis, and impaired hepatic uptake of IL-6 was suggested to contribute to higher levels in these patients. To test this hypothesis IL-6 was measured in portal venous serum (PVS), hepatic venous serum (HVS) and systemic venous serum (SVS) of 41 patients with liver cirrhosis and four patients with normal liver function. IL-6 was higher in PVS than HVS of all blood donors and about 43% of portal vein derived IL-6 was extracted by the healthy liver, and 6.3% by the cirrhotic liver demonstrating markedly impaired removal of IL-6 by the latter. Whereas in patients with CHILD-PUGH stage A IL-6 in HVS was almost 25% lower than in PVS, in patients with CHILD-PUGH stage C IL-6 was similarly abundant in the two blood compartments. Ascites is a common complication in cirrhotic patients and was associated with higher IL-6 levels in all blood compartments without significant differences in hepatic excretion. Hepatic venous pressure gradient did not correlate with the degree of hepatic IL-6 removal excluding hepatic shunting as the principal cause of impaired IL-6 uptake. Furthermore, patients with alcoholic liver cirrhosis had higher IL-6 in all blood compartments than patients with cryptogenic liver cirrhosis. Aetiology of liver cirrhosis did not affect hepatic removal rate indicating higher IL-6 synthesis in patients with alcoholic liver cirrhosis. In summary, the current data provide evidence that impaired hepatic removal of IL-6 is explained by hepatic shunting and liver dysfunction in patients with liver cirrhosis partly explaining higher systemic levels.

  7. Prevalence and outcome of peptic ulcer bleeding in patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Ahmed Gado

    2014-06-01

    Conclusion: The commonest cause of NVUGIB in patients with liver cirrhosis was PUB. Mortality in patients with PUB was particularly high among males, patients who had adherent clot, bleeding recurrence, development of complications and a high Rockall score.

  8. The Evaluation of Adrenal Function in Two Cases of Hypocortisolism Accompanied by Liver Cirrhosis.

    Science.gov (United States)

    Yamashita, Maki; Kageyama, Kazunori; Murakami, Hiroshi; Sugiyama, Aya; Yanagimachi, Miyuki; Sato, Eri; Murasawa, Shingo; Matsui, Jun; Tamasawa, Naoki; Daimon, Makoto

    2016-01-01

    Adrenal insufficiency may occur in patients with liver cirrhosis. The assessment of hypothalamus-pituitary-adrenal function is important in such patients, but there is no consensus as to how it should be performed. We herein report the results of our evaluation of the adrenal function in two patients with hypocortisolism accompanied by liver cirrhosis. The patients lacked the typical features of hypocortisolism. One was diagnosed with hypocortisolism accompanied by liver cirrhosis while the other had secondary adrenal insufficiency caused by a hypothalamic disorder. Hypocortisolism accompanied by liver cirrhosis should be evaluated by endocrine tests to determine its pathogenesis. A low-dose adrenocorticotropic hormone test may be appropriate for non-critically ill cirrhotic patients.

  9. Dysregulation of ENaC in Animal Models of Nephrotic Syndrome and Liver Cirrhosis

    OpenAIRE

    Kim,Soo Wan

    2006-01-01

    Nephrotic syndrome and liver cirrhosis are common clinical manifestations, and are associated with avid sodium retention leading to the development of edema and ascites. However, the mechanism for the sodium retention is still incompletely understood and the molecular basis remains undefined. We examined the changes of sodium (co)transporters and epithelial sodium channels (ENaCs) in the kidneys of experimental nephrotic syndrome and liver cirrhosis. The results demonstrated that puromycin- o...

  10. Hepatic-associated immunoglobulin-A nephropathy in a child with liver cirrhosis and portal hypertension.

    Science.gov (United States)

    Alghamdi, Sharifa A; Saadah, Omar I; Almatury, Nesreen; Al-Maghrabi, Jaudah

    2012-01-01

    Hepatic-associated immunoglobulin A (IgA) nephropathy is a relatively common condition that occurs in adults with liver cirrhosis and portal hypertension. However, it is rare in children. This condition is characterized by the deposition of IgA in the renal glomeruli. The present report describes a 14-year-old boy with cryptogenic liver cirrhosis and portal hypertension who presented with hematuria and proteinuria associated with histological changes of IgA nephropathy.

  11. Hepatic-associated immunoglobulin-A nephropathy in a child with liver cirrhosis and portal hypertension

    Directory of Open Access Journals (Sweden)

    Sharifa A Alghamdi

    2012-01-01

    Full Text Available Hepatic-associated immunoglobulin A (IgA nephropathy is a relatively common condition that occurs in adults with liver cirrhosis and portal hypertension. However, it is rare in children. This condition is characterized by the deposition of IgA in the renal glomeruli. The present report describes a 14-year-old boy with cryptogenic liver cirrhosis and portal hypertension who presented with hematuria and proteinuria associated with histological changes of IgA nephropathy.

  12. Human umbilical cord mesenchymal stem cells improve liver function and ascites in decompensated liver cirrhosis patients.

    Science.gov (United States)

    Zhang, Zheng; Lin, Hu; Shi, Ming; Xu, Ruonan; Fu, Junliang; Lv, Jiyun; Chen, Liming; Lv, Sa; Li, Yuanyuan; Yu, Shuangjie; Geng, Hua; Jin, Lei; Lau, George K K; Wang, Fu-Sheng

    2012-03-01

    Decompensated liver cirrhosis (LC), a life-threatening complication of chronic liver disease, is one of the major indications for liver transplantation. Recently, mesenchymal stem cell (MSC) transfusion has been shown to lead to the regression of liver fibrosis in mice and humans. This study examined the safety and efficacy of umbilical cord-derived MSC (UC-MSC) in patients with decompensated LC. A total of 45 chronic hepatitis B patients with decompensated LC, including 30 patients receiving UC-MSC transfusion, and 15 patients receiving saline as the control, were recruited; clinical parameters were detected during a 1-year follow-up period. No significant side-effects and complications were observed in either group. There was a significant reduction in the volume of ascites in patients treated with UC-MSC transfusion compared with controls (P decompensated LC. UC-MSC transfusion, therefore, might present a novel therapeutic approach for patients with decompensated LC.

  13. Physiologic and laboratory correlates of depression, anxiety, and poor sleep in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Ko Fang-Yuan

    2013-01-01

    Full Text Available Abstract Background Studies have shown psychological distress in patients with cirrhosis, yet no studies have evaluated the laboratory and physiologic correlates of psychological symptoms in cirrhosis. This study therefore measured both biochemistry data and heart rate variability (HRV analyses, and aimed to identify the physiologic correlates of depression, anxiety, and poor sleep in cirrhosis. Methods A total of 125 patients with cirrhosis and 55 healthy subjects were recruited. Each subject was assessed through routine biochemistry, 5-minutes ECG monitoring, and psychological ratings of depression, anxiety, and sleep. HRV analysis were used to evaluate autonomic functions. The relationship between depression, sleep, and physiologic correlates was assessed using a multiple regression analysis and stepwise method, controlling for age, duration of illness, and severity of cirrhosis. Results Reduced vagal-related HRV was found in patients with severe liver cirrhosis. Severity of cirrhosis measured by the Child-Pugh score was not correlated with depression or anxiety, and only had a weak correlation with poor sleep. The psychological distress in cirrhosis such as depression, anxiety, and insomnia were correlated specifically to increased levels of aspartate aminotransferase (AST, increased ratios of low frequency to high frequency power, or reduced nonlinear properties of HRV (α1 exponent of detrended fluctuation analysis. Conclusions Increased serum AST and abnormal autonomic nervous activities by HRV analysis were associated with psychological distress in cirrhosis. Because AST is an important mediator of inflammatory process, further research is needed to delineate the role of inflammation in the cirrhosis comorbid with depression.

  14. The ethanolic extract of Juglans sinensis leaves and twigs attenuates CCl4-induced hepatic oxidative stress in rats

    Directory of Open Access Journals (Sweden)

    Heejung Yang

    2015-01-01

    Full Text Available Background: The nuts of Juglans sinensis Dode, walnut tree, are rich in unsaturated fatty acids and bioactive compounds with antioxidant activity on liver damages. However, hepatoprotective activity of the leaves and twigs of J. sinensis have not intensively studied yet. Objective: Hepatoprotective activity of the refined ethanolic extract of J. sinensis (JSE3 was evaluated using carbon tetrachloride (CCl4 intoxicated rats. Materials and Methods: Hepatotoxicity was induced in Sprague Dawley rats by intraperitoneal injection of CCl4 for 6 weeks in the presence or absence of JSE3 (100 and 200 mg/kg body weight. The hepatoprotective activity of JSE3 was assessed by biochemical parameters including plasma aspartate aminotransferase (AST, alanine aminotransferase (ALT, and antioxidant enzymes, such as superoxide dismutase (SOD, glutathione reductase, glutathione peroxide, reduced glutathione and oxidized glutathione, along with histopathological studies on hepatic tissue. Results: JSE3 significantly decreased the elevated levels of AST and ALT and restored the reduced levels of antioxidant enzymes. JSE3 also decreased the amounts of collagen content accumulated by CCl4 intoxication. Conclusion: These results suggested that the refined extract of J. sinensis may have a potential to be developed as a therapeutic agent to treat hepatic diseases, such as fatty liver and hepatic fibrosis.

  15. [Effects of acupuncture intervention on hepatic platelet-derived growth factor signaling pathway in CCl4-induced hepatic fibrosis rats].

    Science.gov (United States)

    Kong, De-Song; Ma, Jin; Lu, Yin; Ni, Guang-Xia; Ni, Chun-Yan; Zhang, Xue-Jiao; Wang, Ai-Yun; Chen, Wen-Xing; Zheng, Shi-Zhong

    2012-04-01

    To observe the effect of acupuncture stimulation of "Taichong" (LR 3), "Qimen" (LR 14), etc. on hepatic platelet-derived growth factor (PDGF) signal pathway activity at the protein and mRNA levels in hepatic fibrosis rats. Forty-six SD rats were randomly divided into control (10 rats), model (12 rats), acupuncture (12 rats) and non-acupoint (12 rats) groups. Hepatic fibrosis model was established by intraperitoneal injection of mixture solution of 50% CCl4 and olive oil [1:1, 3 times on the 1st week (W), twice/W thereafter for 5 more weeks]. During modeling, acupuncture stimulation of "Taichong" (LR 3), "Qimen" (LR 14), "Ganshu" (BL 18) and "Zusanli" (ST 36) was conducted simultaneously. At the end of the experiments, all the rats were sacrificed for collecting their liver and blood samples, followed by separation of the hepatic stellate cells (HSCs). ELISA, Western blot and Real-time quantitative PCR techniques were used to detect the content of serum PDGF and expression levels of PDGF-beta receptor (PDGF-beta R), extracellular signal-regulated kinase (ERK1/2), c-jun N-terminal kinase (JNK) and P 38 genes and proteins of HSCs, respectively. Compared to the control group, serum PDGF content, and expression levels of PDGF-beta R mRNA and protein, ERK mRNA and protein and P 38 protein of HSCs in the model group were upregulated significantly (P acupuncture group were down-regulated apparently (P acupuncture and non-acupoint groups in serum PDGF content and between the model group and non-acupoint group in the expression levels of PDGF-beta R mRNA and protein, ERK mRNA and protein, JNK protein and P 38 protein of HSCs, as well as between the model group and acupuncture group in the expression levels of JNK protein and P 38 protein of HSCs (P > 0.05). Acupuncture intervention can effectively down-regulate serum PDGF content, and expression levels of PDGF-beta R mRNA and protein, ERK mRNA and protein of HSCs in liver fibrosis rats, which may contribute to its effect in

  16. Clinical significance of serum IGF-Ⅰ,IGF-Ⅱ and IGFBP-3 in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Yun-Lin Wu; Jing Ye; Shu Zhang; Jie Zhong; Rong-Ping Xi

    2004-01-01

    AIM: To investigate the relationship between insulin-likegrowth factor-Ⅰ, -Ⅱ (IGF-Ⅰ and IGF-Ⅱ), IGF-binding protein 3 (IGFBP-3) and Child-Pugh score in patients with liver cirrhosis, and to search for potential clinical markers of liver function. METHODS: Forty-four patients with advanced liver cirrhosis of viral origin were divided into 3 groups according to severity of cirrhosis (Child-Pugh score) and 38 healthy subjectsserved as controls. Serum levels of IGF-Ⅰ, IGF-Ⅱ and IGFBP3 were measured by immunoradiometric assay.RESULTS: Serum IGF-Ⅰ, IGF-Ⅱ and IGFBP-3 levels weresignificantly lower in patients with cirrhosis than in controls, and serum concentrations of IGF-Ⅰ, IGF-Ⅱ and IGFBP-3 were associated with the severity of liver dysfunction, and dropped sharply during the progression of liver failure. Among these 3 parameters, serum IGF-Ⅱ was the most sensitive and effective indicator for liver dysfunction. Concentrations of IGF-Ⅰ<30 ng/mL, IGF-Ⅱ<200 ng/mL and IGFBP-3 <6 ng/mL implied a negative prognosis for patients with liver cirrhosis. CONCLUSION: Serum IGF-Ⅰ, IGF-Ⅱ and IGFBP-3 may provide a new dimension in the assessment of liver dysfunction. Combined detection of serum IGF-Ⅰ, IGF-Ⅱ and IGFBP-3 with Child-Pugh score is more effective in predicting prognosis than Child-Pugh score alone.

  17. Impact of liver cirrhosis on liver enhancement at Gd-EOB-DTPA enhanced MRI at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Verloh, N., E-mail: niklas.verloh@stud.uni-regensburg.de [Department of Radiology, University Hospital Regensburg, Regensburg (Germany); Haimerl, M.; Rennert, J.; Müller-Wille, R.; Nießen, C. [Department of Radiology, University Hospital Regensburg, Regensburg (Germany); Kirchner, G. [Department of Gastroenterology, University Hospital Regensburg, Regensburg (Germany); Scherer, M.N. [Department of Surgery, University Hospital Regensburg, Regensburg (Germany); Schreyer, A.G.; Stroszczynski, C.; Fellner, C.; Wiggermann, P. [Department of Radiology, University Hospital Regensburg, Regensburg (Germany)

    2013-10-01

    Purpose: The purpose of this study was to assess differences in enhancement effects of liver parenchyma between normal and cirrhotic livers on dynamic, Gd-EOB-DTPA enhanced MRI at 3 T. Materials and methods: 93 patients with normal (n = 54) and cirrhotic liver (n = 39; Child–Pugh class A, n = 18; B, n = 16; C, n = 5) underwent contrast-enhanced MRI with liver specific contrast media at 3 T. T1-weighted volume interpolated breath hold examination (VIBE) sequences with fat suppression were acquired before contrast injection, in the arterial phase (AP), in the late arterial phase (LAP), in the portal venous phase (PVP), and in the hepatobiliary phase (HBP) after 20 min. The relative enhancement (RE) of the signal intensity of the liver parenchyma was calculated for all phases. Results: Mean RE was significantly different among all evaluated groups in the hepatobiliary phase and with increasing severity of liver cirrhosis, a decreasing, but still significant reduction of RE could be shown. Phase depending changes of RE for each group were observed. In case of non-cirrhotic liver or Child–Pugh Score A cirrhosis mean RE showed a significant increase between AP, LAP, PVP and HBP. For Child–Pugh B + C cirrhosis RE increased until PVP, however, there was no change in case of B cirrhosis (p = 0.501) and significantly reduced in case of C cirrhosis (p = 0.043) during HBP. Conclusion: RE of liver parenchyma is negatively affected by increased severity of liver cirrhosis, therefore diagnostic value of HBP could be limited in case of Child Pugh B + C cirrhosis.

  18. Learning to Diagnose Cirrhosis with Liver Capsule Guided Ultrasound Image Classification

    Directory of Open Access Journals (Sweden)

    Xiang Liu

    2017-01-01

    Full Text Available This paper proposes a computer-aided cirrhosis diagnosis system to diagnose cirrhosis based on ultrasound images. We first propose a method to extract a liver capsule on an ultrasound image, then, based on the extracted liver capsule, we fine-tune a deep convolutional neural network (CNN model to extract features from the image patches cropped around the liver capsules. Finally, a trained support vector machine (SVM classifier is applied to classify the sample into normal or abnormal cases. Experimental results show that the proposed method can effectively extract the liver capsules and accurately classify the ultrasound images.

  19. Umbilical hernia in patients with liver cirrhosis: A surgical challenge.

    Science.gov (United States)

    Coelho, Julio C U; Claus, Christiano M P; Campos, Antonio C L; Costa, Marco A R; Blum, Caroline

    2016-07-27

    Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites. Hernia repair is indicated in patients in whom medical treatment is effective in controlling ascites. Patients who have a good perspective to be transplanted within 3-6 mo, herniorrhaphy should be performed during transplantation. Hernia repair with mesh is associated with lower recurrence rate, but with higher surgical site infection when compared to hernia correction with conventional fascial suture. There is no consensus on the best abdominal wall layer in which the mesh should be placed: Onlay, sublay, or underlay. Many studies have demonstrated several advantages of the laparoscopic umbilical herniorrhaphy in cirrhotic patients compared with open surgical treatment.

  20. Clinical studies of hepatocellular carcinoma with liver cirrhosis and ascites.

    Directory of Open Access Journals (Sweden)

    Yuasa,Shiro

    1984-06-01

    Full Text Available A comparison was made of the clinical findings of 59 patients with liver cirrhosis (LC accompanied with hepatocellular carcinoma (HCC (of which 35 had ascites and 24 did not at the time of admission and 164 patients with LC, but without HCC (of which 39 had ascites and 125 did not. HCC patients were older and more often had hepatomegaly, vascular spider and pleural effusion than LC patients. Ascites was more frequently observed in HCC than in LC patients when the serum albumin level and the indocyanine green disappearance rate were relatively well maintained and when peripheral edema was absent. There was no difference in the ascitic protein concentration between LC and HCC patients. Malignant cells were detected in ascites only in 14% of the HCC patients. These facts indicate the presence of ascites-inducing factors in HCC patients which have no direct relation to serum colloid osmotic pressure and effective hepatic blood flow. Almost all of the HCC patients with ascites (96% died with ascites, whereas 54% of the LC patients with ascites recovered from the ascitic condition.

  1. Umbilical hernia in patients with liver cirrhosis: A surgical challenge

    Institute of Scientific and Technical Information of China (English)

    Julio CU Coelho; Christiano MP Claus; Antonio CL Campos; Marco AR Costa; Caroline Blum

    2016-01-01

    Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites. Hernia repair is indicated in patients in whom medical treatment is effective in controlling ascites. Patients who have a good perspective to be transplanted within 3-6 mo, herniorrhaphy should be performed during transplantation. Hernia repair with mesh is associated with lower recurrence rate, but with higher surgical site infection when compared to hernia correction with conventional fascial suture. There is no consensus on the best abdominal wall layer in which the mesh should be placed: Onlay, sublay, or underlay. Many studies have demonstrated several advantages of the laparoscopic umbilical herniorrhaphy in cirrhotic patients compared with open surgical treatment.

  2. Nutrition and exercise in the management of liver cirrhosis.

    Science.gov (United States)

    Toshikuni, Nobuyuki; Arisawa, Tomiyasu; Tsutsumi, Mikihiro

    2014-06-21

    Liver cirrhosis (LC) patients often have protein-energy malnutrition (PEM) and decreased physical activity. These conditions often lead to sarcopenia, which is the loss of skeletal muscle volume and increased muscle weakness. Recent studies have demonstrated that PEM and sarcopenia are predictors for poor survival in LC patients. Nutrition and exercise management can improve PEM and sarcopenia in those patients. Nutrition management includes sufficient dietary intake and improved nutrient metabolism. With the current high prevalence of obesity, the number of obese LC patients has increased, and restriction of excessive caloric intake without the exacerbation of impaired nutrient metabolism is required for such patients. Branched chain amino acids are good candidates for supplemental nutrients for both obese and non-obese LC patients. Exercise management can increase skeletal muscle volume and strength and improve insulin resistance; however, nutritional status and LC complications should be assessed before an exercise management regimen is implemented in LC patients. The establishment of optimal exercise regimens for LC patients is currently required. In this review, we describe nutritional status and its clinical impact on the outcomes of LC patients and discuss general nutrition and exercise management in LC patients.

  3. Telomere Dysfunction in Nonalcoholic Fatty Liver Disease and Cryptogenic Cirrhosis.

    Science.gov (United States)

    Laish, Ido; Mannasse-Green, Batya; Hadary, Ruth; Biron-Shental, Tal; Konikoff, Fred M; Amiel, Aliza; Kitay-Cohen, Yona

    2016-01-01

    Nonalcoholic fatty liver disease (NAFLD) and cryptogenic cirrhosis (CC) are considered preneoplastic conditions that might progress to hepatocellular carcinoma. We evaluated parameters of telomere dysfunction in these patient groups to study the correlation between telomere length and the progression of NAFLD. We analyzed peripheral lymphocytes from 22 patients with NAFLD, 20 patients with CC, and 20 healthy, age-matched controls. Telomere length was analyzed using quantitative fluorescence in situ hybridization, and cellular senescence was evaluated by the percentage of cells with senescence-associated heterochromatin foci. The expression of telomerase reverse transcriptase (hTERT) mRNA was measured using polymerase chain reaction, and telomere capture (TC) was assessed with 2 Cytocell probes, 15qter and 13qter. Shorter telomere length and increased cellular senescence was demonstrated in patients with NAFLD, compared to the CC patients and healthy controls. While hTERT mRNA was significantly decreased, TC was increased in CC patients, compared to the NAFLD group and healthy individuals. Thus, there is a correlation between hTERT mRNA expression and telomere length in patients with NAFLD, which might be related to associated metabolic disorders and the risk of malignant transformation. Patients with CC, on the contrary, elongate their telomeres through the TC mechanism.

  4. The outcome of critical illness in decompensated alcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Kavli, M; Strøm, T; Carlsson, M;

    2012-01-01

    with the Child-Pugh score. METHODS: A single-centre retrospective cohort analysis was conducted in a university-affiliated ICU. Eighty-seven adult patients with decompensated liver alcoholic cirrhosis were admitted from January 2007 to January 2010. RESULTS: The patients were severely ill with median scores......: SAPS II 60, SOFA (day 1) 11, APACHE II 31, and Child-Pugh 12. Receiver operating characteristic curves area under curve was 0.79 for APACHE II, 0.83 for SAPS II, and 0.79 for SOFA (day1) compared with 0.59 for Child-Pugh. In patients only in need of mechanical ventilation, the 90-day mortality was 76......, SAPS II, and SOFA were better at predicting mortality than the Child-Pugh score. With three or more organ failures, the ICU mortality was > 90%. APACHE II > 30, SAPS II > 60, and SOFA at day 1 > 12 were all associated with a mortality of > 90%. Referral criteria of patients suffering from decompensated...

  5. Late nonalcoholic fatty liver disease with cirrhosis: a pathologic case of lost or mistaken identity.

    Science.gov (United States)

    Lefkowitch, Jay H; Morawski, John L

    2012-02-01

    Late-stage nonalcoholic fatty liver disease (NAFLD) may present clinically and/or pathologically as cryptogenic cirrhosis. The subject of this report, a middle-aged obese man with diabetes, underwent liver biopsy at the time of laparoscopic cholecystectomy because the liver surface appeared nodular and thickened. The biopsy showed relatively nondescript cirrhosis at initial low-power microscopic inspection, but glycogenated hepatocyte nuclei (consistent with diabetes), sparse macrovesicular fat, and very rare foci of residual mild steatohepatitis were later found. Slender fibrous septa (without significant inflammation and often enclosing microvessels) were present and interconnected to portal tracts. Immunostains for cytokeratin 7, ubiquitin, and glutamine synthetase provided additional histologic data supporting NAFLD as the cause of the cirrhosis in this case. A strategic pathologic approach is discussed, which can be utilized for the pathologic assessment of cirrhosis of unknown cause, particularly when late NAFLD is suspected.

  6. Experimental models for induction of liver cirrhosis in animals: a review

    Directory of Open Access Journals (Sweden)

    Cristiane Carlin Passos

    2010-06-01

    Full Text Available The liver plays a key role in the homeostatic balance of many biological processes. Cirrhosis is a syndrome in which chronic liver diseases converge, leading to hepatocellular injury, the exacerbated deposition of fibrous tissue, and eventually the disruption of the tissue architecture. The liver is subject to potential injury by a large quantity of pharmacological agents, toxic and/or microbiological. For the study of possible treatments for cirrhosis, it is necessary to establish animal models of induction of cirrhosis, especially in laboratory rodents which mimic the cirrhotic process found in animals and humans, that have high reproducibility and uniformity, with a low mortality rate. Thus, the induction of liver cirrhosis becomes essential to the investigation of chronic liver diseases, as well as to test possible therapeutic treatments for subsequent use in human and veterinary clinics. Currently, experimental studies have been conducted to collect data about the various hepatotoxic drug effects. Carbon tetrachloride -CCl4, Thioacetamide –TAA and dimethylnitrosamine -DMN were the drugs of choice for cirrhosis induction in experimental models in this study. The model using cirrhotic TAA seems to be the best model for the reason that it produces a histological pattern closest to that of human cirrhosis, leading to lower mortality with higher reproducibility and security, despite the longer period of induction (14 weeks.

  7. Rectal administration of 13N-ammonia in cirrhosis of the liver.

    Science.gov (United States)

    Hazenberg, H J; Gips, C H; Beekhuis, H; Vaalburg, W

    1976-01-01

    13N-ammonia, applied rectally, after absorption and transportation visualises the liver. After release of 13N-aminoacids and 13N-urea by the liver, 13N-activity can be measured over other organs. In patients with porta-systemic shunts, 13N-ammonia will appear in the systemic circulation as well. In 16 controls and 26 patients with cirrhosis, activities were measured for 20 minutes over liver, spleen, heart, lungs and forearm. In all subjects, the liver was visualised within a minute, in some patients with cirrhosis faintly, however. Release by the liver of 13N-ammonia metabolites started within a few minutes. Liver/heart activity ratios proved to be more discriminating between the control- and the cirrhosis group than liver/lung and liver/spleen ratios. In the control group, the 20 minutes' liver/heart ratio was most suitable for determining the normal range. The lower normal level was found to be 2.25. Fourteen of the 26 patients with cirrhosis had a normal, 12 an abnormally low 20 minutes' liver/heart ratio.

  8. Expression of antisense of microRNA-26a-5p in mesenchymal stem cells increases their therapeutic effects against cirrhosis

    Science.gov (United States)

    Chen, Li; Zeng, Wenhuan; Yang, Bo; Cui, Xiang; Feng, Cong; Wang, Lili; Wang, Hao; Zhou, Xuan; Li, Peng; Lv, Faqin; Li, Tanshi

    2017-01-01

    Hepatocyte growth factor (HGF) is a potent mitogen for mature hepatocytes, and has been shown to prevent cirrhosis during liver regeneration. Transplantation of mesenchymal stem cells (MSCs) reduces the development of cirrhosis after liver injury. However, the production and secretion of transplanted MSCs in liver were not studied yet. Here we found that the MSCs expressed low levels of HGF protein, but surprisingly high levels of HGF mRNA. Further investigation using bioinformatics analyses and luciferase reporter assay showed that MSCs expressed high levels of microRNA-26a-5p (miR-26a-5p), which targeted 3’-UTR of HGF mRNA to inhibit its protein translation. In vivo, miR-26a-5p-depleted MSCs were transplanted into mice with carbon tetrachloride (CCl4)-induced cirrhosis. We found that suppression of miR-26a-5p in MSCs further ameliorated the severity of liver fibrosis, reduced the portal hypertension and sodium retention, compared to transplantation of control MSCs. Hence, our study suggests that suppression of miR-26a-5p in MSCs may improve their therapeutic effects against cirrhosis through increasing HGF production.

  9. Beyond "cirrhosis": a proposal from the International Liver Pathology Study Group.

    Science.gov (United States)

    Hytiroglou, Prodromos; Snover, Dale C; Alves, Venancio; Balabaud, Charles; Bhathal, Prithi S; Bioulac-Sage, Paulette; Crawford, James M; Dhillon, Amar P; Ferrell, Linda; Guido, Maria; Nakanuma, Yasuni; Paradis, Valerie; Quaglia, Alberto; Theise, Neil D; Thung, Swan N; Tsui, Wilson M S; van Leeuwen, Dirk J

    2012-01-01

    "Cirrhosis" is a morphologic term that has been used for almost 200 years to denote the end stage of a variety of chronic liver diseases. The term implies a condition with adverse prognosis due to the well-known complications of portal hypertension, hepatocellular carcinoma, and liver failure. However, recent advances in the diagnosis and treatment of chronic liver diseases have changed the natural history of cirrhosis significantly. This consensus document by the International Liver Pathology Study Group challenges the usefulness of the word cirrhosis in modern medicine and suggests that this is an appropriate time to consider discontinuing the use of this term. The role of pathologists should evolve to the diagnosis of advanced stage of chronic liver disease, with emphasis on etiology, grade of activity, features suggestive of progression or regression, presence of other diseases, and risk factors for malignancy, within the perspective of an integrated clinicopathologic assessment.

  10. Etiology of liver cirrhosis in Brazil: chronic alcoholism and hepatitis viruses in liver cirrhosis diagnosed in the state of Espfrito Santo

    Directory of Open Access Journals (Sweden)

    Patricia Lofego Goncalves

    2013-01-01

    Full Text Available OBJECTIVES: To report the etiology of liver cirrhosis cases diagnosed at the University Hospital in Vitoria, Espirito Santo, Brazil. METHODS: The medical charts of patients with liver cirrhosis who presented to the University Hospital in Vitoria were reviewed. Chronic alcoholism and the presence of hepatitis B or C infections (HBV and HCV, respectively were pursued in all cases. RESULTS: The sample consisted of 1,516 cases (male:female ratio 3.5:1, aged 53.2±12.6 years. The following main etiological factors were observed: chronic alcoholism alone (39.7%, chronic alcoholism in association with HBV or HCV (16.1 %, HCV alone (14.5% and in association with alcoholism (8.6% (total, 23.1 %, and HBV alone (13.1% and in association with alcoholism (7.5%, total 20.6%. The remaining etiologies included cryptogenic cases (9.8% and other causes (6.0%. The mean patient age was lower and the male-to-female ratio was higher in the cirrhosis cases that were associated with alcoholism or HBV compared with other causes. Intravenous drug abuse and a history of surgery or blood transfusion were significantly associated with HCV infection. Hepatocellular carcinoma was present at the time of diagnosis in 15.4% of cases. Chronic alcoholism associated with HCV infection was significantly associated (p<0.001 with reduced age (at the time of cirrhosis diagnosis and increased prevalence of hepatocellular carcinoma (p = 0.052. CONCLUSION: Alcoholism, HCV and HBV are the main factors associated with liver cirrhosis in the state of Espirito Santo. Chronic alcoholism associated with HCV infection reduced the age of patients at the time of liver cirrhosis diagnosis.

  11. No Increased Risk for Primary Osteoarthritis in Liver Cirrhosis

    DEFF Research Database (Denmark)

    Deleuran, Thomas; Vilstrup, Hendrik; Overgaard, Søren

    2016-01-01

    OBJECTIVE: Chronic synovial inflammation causes primary osteoarthritis, but it is unknown whether chronic systemic inflammation does, too. Patients with cirrhosis have chronic systemic inflammation and therefore we examined the association between cirrhosis and primary osteoarthritis of the hip...... and knee. METHODS: In Danish healthcare databases we identified all residents over 60 years diagnosed with cirrhosis in 1994-2011, and for each of them we sampled five age- and gender-matched reference persons from the general population. We excluded everyone with risk factors for secondary osteoarthritis...... and computed incidence rates of primary osteoarthritis of the hip or knee. We used stratified Cox regression to estimate the hazard ratios of primary osteoarthritis for cirrhosis patients vs. reference persons in strata defined by gender, age, cirrhosis etiology, and ascites vs. no ascites. We also computed...

  12. Alcohol drinking pattern and risk of alcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Askgaard, Gro; Grønbæk, Morten; Kjær, Mette Skalshøi

    2015-01-01

    BACKGROUND & AIMS: Alcohol is the main contributing factor of alcoholic cirrhosis, but less is known about the significance of drinking pattern. METHODS: We investigated the risk of alcoholic cirrhosis among 55,917 participants (aged 50-64 years) in the Danish Cancer, Diet, and Health study (1993......-2011). Baseline information on alcohol intake, drinking pattern, and confounders was obtained from a questionnaire. Follow-up information came from national registers. We calculated hazard ratios (HRs) for alcoholic cirrhosis in relation to drinking frequency, lifetime alcohol amount, and beverage type. RESULTS......: We observed 257 and 85 incident cases of alcoholic cirrhosis among men and women, respectively, none among lifetime abstainers. In men, HR for alcoholic cirrhosis among daily drinkers was 3.65 (95% CI: 2.39; 5.55) compared to drinking 2-4 days/week. Alcohol amount in recent age periods (40-49 and 50...

  13. Clinical Characteristics in Patients with Liver Cirrhosis Induced by HBV Infection and Combined with Mild Alcohol Intake

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    Objective To investigate the differences of clinical and biochemical characteristics between patients with liver cirrhosis induced by HBV infection combined with and without mild alcohol intake. Methods Data of patients with liver cirrhosis who were hospitalized in the First Hospital Afifliated to Xinjiang Medical University were retrospectively analyzed. Patients were divided into three groups: patients with liver cirrhosis induced by HBV infection and combined with mild alcohol intake, patients with HBV-related cirrhosis, and patients with alcohol-related cirrhosis. Biochemical detections including liver function, fasting lipid proifles, lipoprotein, kidney function, glucose, uric acid and regular blood tests were carried out and results were compared among three groups. Data were analyzed through STATA software and co-variant analysis. Results Total of 2 350 patients with liver cirrhosis were included, 732 patients had cirrhosis induced by HBV infection combined with mild alcohol intake, 1 316 patients had HBV-related liver cirrhosis, 302 patients had alcohol-related cirrhosis. The highest mean level of white cell count, mean corpuscular volume,γ-glutamyltranspeptidase and uric acid were observed in HBV infection combined with mild alcohol intake group. Multivariate regression analysis revealed that HBV infection, excessive alcohol intake, male and age were risk factors for hepatocellular carcinoma (HCC) in patients with liver cirrhosis. Conclusions HBV infection combined with mild alcoholic-related liver cirrhosis group showed the highest oxidative stress compared with alcoholic liver cirrhosis group, which suggested that mild alcohol intake may increase the incidence of liver cirrhosis in HBV infected patients and may not increase the incidence of HCC.

  14. Hepatoprotective and antioxidant effects of Glycyrrhiza glabra extract against carbon tetrachloride (CCl(4))-induced hepatocyte damage in common carp (Cyprinus carpio).

    Science.gov (United States)

    Yin, Guojun; Cao, Liping; Xu, Pao; Jeney, Galina; Nakao, Miki; Lu, Chengping

    2011-03-01

    The present study is aiming at evaluating the hepatoprotective and antioxidant effects of Glycyrrhiza glabra extract (2.5, 5 and 10 μg/ml) on the carbon tetrachloride (CCl(4))-induced carp hepatocyte damage in vitro. Glycyrrhiza glabra extract was added to the carp primary hepatocytes before (pre-treatment), after (post-treatment) and both before and after (pre- and post-treatment) the incubation of the hepatocytes with CCl(4). CCl(4) at 8 mM in the culture medium produced significantly elevated levels of lactate dehydrogenase (LDH), glutamate oxalate transaminase (GOT), glutamate pyruvate transaminase (GPT) and malondialdehyde (MDA) and significantly reduced levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px). Pre-treatment (5 μg/ml) and pre- and post-treatment (5 and 10 μg/ml) of the hepatocytes with Glycyrrhiza glabra extract significantly reduced the elevated levels of LDH, GOT, GPT and MDA and increased the reduced levels of SOD and GSH-Px by CCl(4); post-treatment of the hepatocytes with Glycyrrhiza glabra extract at 5 μg/ml reduced the GPT and GOT levels and increased the GSH-Px level, but had no effect on the other parameters at all the studied concentrations. The results support the use of Glycyrrhiza glabra extract as a hepatoprotective and antioxidant agent in fish.

  15. New concepts in liver cirrhosis: clinical significance of sarcopenia in cirrhotic patients.

    Science.gov (United States)

    Montano-Loza, A J

    2013-06-01

    The natural history of cirrhotic patients is highly variable due to several factors including hepatic synthetic function, presence and degree of portal hypertension, the cause of cirrhosis, the possibility of resolution of the underlying damaging process, and the occurrence of liver cancer. Currently, D'Amico stage classification and Child-Pugh and Model for End-Stage Liver Disease (MELD) scores constitute the best tools to predict mortality in patients with cirrhosis; however, one of their main limitations is the lack of evaluation of the nutritional and functional status. Most widely recognized complications in cirrhotic patients include ascites, hepatic encephalopathy, variceal bleeding, kidney dysfunction, and hepatocellular carcinoma; however, sarcopenia or severe muscle wasting is one of the most common and frequently hidden complications which negatively impact survival, quality of life, and response to stressor, such as infection and surgery. In this review, we discuss the current accepted and new methods to evaluate prognosis in cirrhosis, and also analyze the current knowledge regarding incidence and clinical impact of malnutrition and sarcopenia in cirrhosis and their impact after liver transplantation. We also discuss existing and potential novel therapeutic strategies for malnutrition in cirrhosis, emphasizing the recognition of sarcopenia in cirrhosis in an effort to improve survival and reduced morbidity related to cirrhosis. Finally, we propose that future studies including sarcopenia with the MELD score may allow better prediction of mortality among cirrhotic patients waiting for liver transplantation; however, due to the worldwide shortage of organs for transplants, one of the vital clinical questions is the feasibility to treat sarcopenia in cirrhosis without the need of liver transplant.

  16. Proinflammatory Cytokines (IL-1α, IL-6 and Hepatocyte Growth Factor in Patients with Alcoholic Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Andrzej Prystupa

    2015-01-01

    Full Text Available Background. The aim of the study was to assess the activity of interleukin-1α, interleukin-6, and hepatocyte growth factor protein (HGF in serum of patients with alcoholic liver cirrhosis. Materials and Methods. Sixty patients with alcoholic liver cirrhosis treated in various hospitals were randomly enrolled. The stage of cirrhosis was assessed according to the Child-Turcotte-Pugh scoring system. The control group consisted of ten healthy persons without liver disease, who did not drink alcohol. Additionally, the group of alcoholics without liver cirrhosis was included in the study. The activity of interleukin-1α, interleukin-6, and HGF in blood plasma of patients and controls was measured using the sandwich enzyme immunoassay technique with commercially available quantitative ELISA test kits. Results. Higher concentrations of HGF protein were demonstrated in patients with Child class B and Child class C liver cirrhosis, compared to controls and alcoholics without liver cirrhosis. Moreover, significantly higher concentrations of HGF protein were found in patients with Child class C liver cirrhosis compared to patients with Child class A liver cirrhosis p<0.05. The concentrations of interleukin-1α in patients with Child class B and Child class C liver cirrhosis were significantly higher in comparison with controls. Significantly higher concentrations of interleukin-6 were demonstrated in Child class C, compared to Child class A.

  17. Phagocytic and oxidative burst activity of neutrophils in the end stage of liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Anatol Panasiuk; Jolanta Wysocka; Elzbieta Maciorkowska; Bozena Panasiuk; Danuta Prokopowicz; Janusz Zak; Karol Radomski

    2005-01-01

    AIM: To evaluate the phagocytic activity and neutrophil oxidative burst in liver cirrhosis.METHODS: In 45 patients with advanced postalcoholic liver cirrhosis (aged 45±14 years) and in 25 healthy volunteers (aged 38±5 years), the percentage of phagocytizing cells after in vitro incubation with E. coli (Phagotest Kit), phagocytic activity (mean intensity of fluorescence, MIF) and the percentage of neutrophil oxidative burst (Bursttest Kit), and the level of free oxygen radical production (MIF of Rodamine 123)were analyzed by flow cytometry. The levels of soluble sICAM-1, sVCAM-1, sP-selectin, sE-selectin, sL-selectin,and TNF-α were determined in blood serum.RESULTS: The percentage of E. coli phagocytizing neutrophils in liver cirrhosis patients was comparable to that in healthy subjects. MIF of neutrophil - ingested E. coli was higher in patients with liver cirrhosis. The oxidative burst in E. coli phagocytizing neutrophils generated less amount of active oxygen compounds in liver cirrhosis patients (MIF of R123:24.7±7.1 and 29.7±6.6 in healthy,P<0.01). Phorbol myristate acetate (PMA) - stimulated neutrophilsproduced less reactive oxidants in liver cirrhosis patients than in healthy subjects (MIF of R123: 42.7±14.6 vs 50.2±13.3, P<0.01). A negative correlation was observed between oxidative burst MIF of PMA-stimulated neutrophils and ALT and AST levels (r -0.35, P<0.05;r-0.4, P<0.03). sVCAM-1, sICAM-1, sE-selectin concentrations correlated negatively with the oxygen free radical production (MIF of R123) in neutrophils after PMA stimulation in liver cirrhosis patients (r-0.45, P<0.05;r-0.41, P<0.05; r-0.39, P<0.05, respectively).CONCLUSION: Neutrophil metabolic activity diminishes together with the intensification of liver failure. The metabolic potential of phagocytizing neutrophils is significantly lower in liver cirrhosis patients, which can be one of the causes of immune mechanism damage. The evaluation of oxygen metabolism of E. coli

  18. Contrast-enhanced ultrasound of hepatocarcinogenesis in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    WU Wei; CHEN Min-hua; SUN Maryellen; YAN Kun; YANG Wei; LI Ji-you

    2012-01-01

    Background Hepatocellular carcinoma (HCC) often occurs in association with liver cirrhosis.A stepwise carcinogenesis for HCC has been proposed.The purpose of this study was to observe the enhancement pattern of hepatocellular nodules in cirrhotic patients using contrast-enhanced ultrasound (CEUS) and to correlate patterns of enhancement at CEUS with the diagnosis of hepatocellular nodules using pathologic correlation as the gold standard.Methods Ninety-three cirrhotic patients with indeterminate hepatocellular nodules at ultrasound,underwent biopsy of each indeterminate nodule.Patients with nodules found to have pathologic diagnoses of regenerative nodules (RNs),dysplastic nodules (DNs),or DNs with focus of HCC (DN-HCC),were enrolled in this study.Enhancement patterns of all nodules were examined throughout the various vascular phases of CEUS and classified into five enhancement patterns:type Ⅰ,isoenhancement to hepatic parenchyma at all phases; type Ⅱ,hypoenhancement in the arterial phase,and isoenhancement in the portal venous phase and late phase; type Ⅲ,iso-to-hypoenhancement in arterial and portal venous phase,and hypoenhancement in the late phase (washout); type Ⅳ,slight hyperenhancement in the arterial and portal venous phase and hypoenhancement in the late phase (washout); and type Ⅴ,partial hyperenhancement in the arterial phase and hypoenhancement in the late phase; and another partial iso-to-hypoenhancement in the arterial and portal venous phase and hypoenhancement in the late phase (washout).The correlation between the contrast enhancement patterns and the pathological diagnoses was analyzed by the chi-squared test.Results Totally 132 lesions were examined with CEUS in 93 patients.Pathologic diagnoses included 45 DN,68 RN,and 19 DN-HCC.The enhancement patterns observed were as follows:type Ⅰ,49 (37.1%); type Ⅱ,27 (20.5%); type Ⅲ,28(21.2%); type Ⅳ,9 (6.8%); type Ⅴ,19 (14.4%).Nodules with type Ⅰ enhancement showed

  19. [Routes of resorption of peritoneal fluid in the diaphragm in liver cirrhosis (morphologic study)].

    Science.gov (United States)

    Khoroshaev, V A; Vorozheĭkin, V M; Baĭbekov, I M

    1991-01-01

    The diaphragm peritoneum from 12 operated patients and 34 patients who died from liver cirrhosis with or without ascites was studied by means of light microscopy and electron transmission and scanning microscopy. Considerable lesions are found in the peritoneum: cuboidization of mesothelial cells, basal membrane thickening, dilation of stomata, lymphatic lacunae and collectors lumina. Liver cirrhosis with ascites is frequently followed by lymphatic vessels thrombosis and firm attachment of the diaphragm to the liver resulting in the inhibition of the ascitic liquid elimination. Thus both the enhancement of liquid transudation into the abdominal cavity and the disturbance of the drainage function of the diaphragm peritoneum take place.

  20. Injurious effect on rat liver mitochondria by lymphocytes from patients with primary biliary cirrhosis.

    Science.gov (United States)

    Bootello, A; Fernandez-Cruz, E; Escartin, P; Blanco, M F; Gosalvez, M; Segovia De Arana, J M

    1976-01-01

    Lymphocytes from primary biliary cirrhosis (PBC) patients were shown to have an injurious effect on rat liver mitochondria, as was demonstrated by the inhibition of mitochondrial respiratory control by these cells. The incubation of the PBC patients' lymphocytes with isolated rat liver mitochondria produced a significant inhibition of mitochondrial respiration in the presence of ADP. However, no significant effect on respiration was seen with control lymphocytes of normal persons or with lymphocytes from patients with alcoholic cirrhosis and miscellaneous liver diseases. The results suggest that this injurious effect of PBC lymphocytes on mitochondria might be a consequence of sensitization in vivo of the PBC patients' lymphocytes by the mitochondrial antigens. PMID:1277585

  1. Prevalence of cholelithiasis in patients subjected to liver transplantation for cirrhosis.

    Science.gov (United States)

    Coelho, Julio Cu; Slongo, Julio; Dambroski Silva, Andrea; Dudeque Andriguetto, Leonardo; Ramos, Eduardo Jb; da Costa, Marco Ar; Matias, Jorge Ef

    2010-12-01

    The prevalence of cholelithiasis in patients subjected to liver transplantation has not been evaluated yet. This study examines the prevalence of cholelithiasis in patients subjected to liver transplantation due to cirrhosis compared to an age- and sex-matched control group. The electronic study protocols of 400 consecutive cirrhotic patients aged between 20 and 69 years who had undergone liver transplantation for cirrhosis were evaluated to determine the presence of gallstones. The overall prevalence of cholelithiasis was higher in transplant recipients (96 patients; 24%) than in controls (38 patients; 9.5%) (pcholelithiasis with age in the transplant recipients (p=0.332). Conversely, the prevalence of cholelithiasis increased with age in the control group (pcholelithiasis is higher in patients subjected to liver transplantation for cirrhosis. In contrast with the general population, the prevalence of cholelithiasis in cirrhotic patients is similar in both sexes and does not increase with age.

  2. Progress in application of branched-chain amino acids in patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    LYU Zheng

    2015-03-01

    Full Text Available The metabolism of amino acids mainly takes place in the liver, and patients with liver cirrhosis may develop metabolic disorders of proteins, carbohydrates, fats, and amino acids, which in turn causes dysfunction of multiple organs and systems, as well as complications like hepatic encephalopathy, esophageal variceal bleeding, and ascites, resulting in high mortality. This paper summarizes the metabolic characteristics of amino acids and the application of branched-chain amino acids (BCAAs in the treatment of liver cirrhosis, and it points out the significance of BCAAs in regulating serum aminogram, increasing the ratio of BCAAs to aromatic amino acids, preventing complications of liver cirrhosis, and improving the quality of life for patients with the disease.

  3. SPONTANEOUS BACTERIAL EMPYEMA: AN UNCOMMON COMPLICATION OF LIVER CIRRHOSIS

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    Vijay

    2015-07-01

    Full Text Available Spontaneous bacterial empyema (SBEM is an infection of a pre - existing hepatic hydrothorax in cirrhotic patients and scanty data in world literature. We analyzed that over last 5 years all cirrhotics with pleural effusion underwent thoracocentesis either on admission or when an infection susp ected. SBEM defined as culture positive PF with PMN count greater than 250 cells/micro L or PMN count greater than 500 cells/micro L, and exclusion of parapneumonic effusions. Out of total 2620 admissions with liver cirrhosis, 310(11.8% were having pleura l effusion, SBEM was diagnosed in 38(12.25 patients with various aetiologies’. In 25 (66% patients SBEM was associated with spontaneous bacterial peritonitis (SBP. SBP and SBEM when occurred together did not increase the mortality (OR=1.73, CI=0.43 - 6.7 , however SBE alone had the same outcome as SBP 18(52.6%, 15(42.9% p=0.815. Total 12 patients (31% died during same admission. Poor child’s score, low pleural fluid albumin and renal failure were associated with poor prognosis. For the assessment of mo rtality analysis, Mann Whitney U test and t test were used for continuous variables, while Fischer exact test/ chi square were used for categorical variables. On univariate analysis INR, Haemoglobin, Serum creatinine, MELD score and Pleural fluid protein w ere significantly associated predictors of high mortality if abnormal. However on multivariate regression. None of the factors were significant. Pleural fluid culture was positive in 21 (55%. Microorganisms identified in PF were Gram - negative bacilli in 1 3, and Gram positive cocci in 8 samples. Antibiotic sensitivity of organisms also reported.

  4. Hepatic venous oxygen content in alcoholic cirrhosis and non-cirrhotic alcoholic liver disease

    DEFF Research Database (Denmark)

    Bendtsen, F; Henriksen, Jens Henrik Sahl; Widding, A

    1987-01-01

    Blood gas analyses and hepatic blood flow were determined during hepatic vein catheterization in order to establish a possible hypoxic component in alcoholic liver disease. Fifty-six patients (9 non-cirrhotic liver disease, 14 cirrhosis Child-Turcotte class A, 23 class B, 10 class C) and 10 control...

  5. Left bisegmentectomy for liver cirrhosis associated primary hepatic carcinoma with preoperative chemoembolization

    Directory of Open Access Journals (Sweden)

    Molnar C.

    2014-12-01

    Full Text Available Introduction: Hepatocellular carcinoma is the most frequent primary malignant tumor of the liver, being linked in 80% of cases with viral hepatitis ”B” or “C”. Treatment remains a challenge especially in cases with associated hepatic cirrhosis, where preoperative arterial chemoembolization followed by liver resection is recommended.

  6. Alteration of liver glycopatterns during cirrhosis and tumor progression induced by HBV.

    Science.gov (United States)

    Qin, Yannan; Zhong, Yaogang; Ma, Tianran; Wu, Fei; Wu, Haoxiang; Yu, Hanjie; Huang, Chen; Li, Zheng

    2016-04-01

    The incidence of hepatocellular carcinoma (HCC) is closely correlated with hepatitis B virus (HBV)-induced liver cirrhosis. Structural changes in the glycans of serum and tissue proteins are reliable indicators of liver damage. However, little is known about the alteration of liver glycopatterns during cirrhosis and tumor progression induced by HBV infection. This study compared the differential expression of liver glycopatterns in 7 sets of normal pericarcinomatous tissues (PCTs), cirrhotic, and tumor tissues from patients with liver cirrhosis and HCC induced by HBV using lectin microarrays. Fluorescence-based lectin histochemistry and lectin blotting were further utilized to validate and assess the expression and distribution of certain glycans in 9 sets of corresponding liver tissue sections. Eight lectins (e.g., Jacalin and AAL) revealed significant difference in cirrhotic tissues versus PCTs. Eleven lectins (e.g., EEL and SJA) showed significant alteration during cirrhotic and tumor progression. The expression of Galα1-3(Fucα1-2)Gal (EEL) and fucosyltransferase 1 was mainly increasing in the cytoplasm of hepatocytes during PCTs-cirrhotic-tumor tissues progression, while the expression of T antigen (ACA and PNA) was decreased sharply in cytoplasm of tumor hepatocytes. Understanding the precision alteration of liver glycopatterns related to the development of hepatitis, cirrhosis, and tumor induced by HBV infection may help elucidate the molecular mechanisms underlying the progression of chronic liver diseases and develop new antineoplastic therapeutic strategies.

  7. Systematic review with meta-analyses of studies on the association between cirrhosis and liver metastases

    DEFF Research Database (Denmark)

    Dahl, Emilie; Rumessen, Jüri; Gluud, Lise L

    2011-01-01

    (Medline, Embase, and Web of Science) and manual searches were combined (October 2010) to identify observational studies on patients with malignant disease reporting the risk of liver metastases among cases (with cirrhosis) and controls (without liver disease). Meta-analysis was performed using random...

  8. Budd-Chiari like syndrome in decompensated alcoholic steatohepatitis and liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Carlos Robles-Medranda; Hannah Lukashok; Beatriz Biccas; Vera L Pannain; Homero S Fogaca

    2006-01-01

    A rare case of pseudo-Budd-Chiari Syndrome in a patient with decompensated alcoholic liver disease is reported.Although clinical and radiological findings suggested Budd-Chiari Syndrome, the liver biopsy revealed micronodular cirrhosis and absence of histological signs of hepatic outflow obstruction.

  9. Role of Chymase in the Development of Liver Cirrhosis and Its Complications: Experimental and Human Data

    Science.gov (United States)

    Sansoè, Giovanni; Aragno, Manuela; Mastrocola, Raffaella; Mengozzi, Giulio; Novo, Erica; Parola, Maurizio

    2016-01-01

    Background Tissue Angiotensin II (Ang-II), produced through local non ACE-dependent pathways, stimulates liver fibrogenesis, renal vasoconstriction and sodium retention. Aim To highlight chymase-dependent pathway of Ang-II production in liver and kidney during cirrhosis development. Methods Liver histology, portal pressure, liver and kidney function, and hormonal status were investigated in rat liver cirrhosis induced through 13 weeks of CCl4, with or without chymase inhibitor SF2809E, administered between 4th and 13th CCl4 weeks; liver and kidney chymase immunolocation and Ang-II content were assessed. Chymase immunohistochemistry was also assessed in normal and cirrhotic human liver, and chymase mRNA transcripts were measured in human HepG2 cells and activated hepatic stellate cells (HSC/MFs) in vitro. Results Rats receiving both CCl4 and SF2809E showed liver fibrotic septa focally linking portal tracts but no cirrhosis, as compared to ascitic cirrhotic rats receiving CCl4. SF2809E reduced portal pressure, plasma bilirubin, tissue content of Ang-II, plasma renin activity, norepinephrine and vasopressin, and increased glomerular filtration rate, water clearance, urinary sodium excretion. Chymase tissue content was increased and detected in α-SMA-positive liver myofibroblasts and in kidney tubular cells of cirrhotic rats. In human cirrhosis, chymase was located in hepatocytes of regenerative nodules. Human HepG2 cells and HSC/MFs responded to TGF-β1 by up-regulating chymase mRNA transcription. Conclusions Chymase, through synthesis of Ang-II and other mediators, plays a role in the derangement of liver and kidney function in chronic liver diseases. In human cirrhosis, chymase is well-represented and apt to become a future target of pharmacological treatment. PMID:27637026

  10. Circulating endogenous vasoactive intestinal polypeptide (VIP) in patients with uraemia and liver cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Staun-Olsen, P; Borg Mogensen, N;

    1986-01-01

    .0001) and positively correlated to serum creatinine concentration (r = 0.51, P less than 0.001). In 133 patients with liver cirrhosis peripheral venous VIP was slightly elevated (median 7.0 pmol l-1 range 0-86, P less than 0.01). Samples obtained during a central venous catheterization showed significant renal...... and patients with cirrhosis both the liver and kidneys are involved in the biodegradation of VIP. The elevated level of circulating VIP in uraemic patients may in part be due to decreased renal and hepatic biodegradation but increased neuronal release of VIP, especially in the splanchnic system, may also...... extraction of circulating VIP in control subjects (median extraction fraction 23%, P less than 0.05, n = 6) and in patients with cirrhosis (median 60%, P less than 0.02, n = 8), but not in uraemic patients (median 0%, NS n = 5). In control subjects and patients with cirrhosis the concentration of VIP...

  11. Autologous Stem Cells Transplantation in Egyptian Patients with Liver Cirrhosis on Top of Hepatitis C Virus

    Science.gov (United States)

    Al Tayeb, Hoda; El Dorry, Ahmed; Amer, Nehad; Mowafy, Nadia; Zimaity, Maha; Bayoumy, Essam; Saleh, Shereen A.

    2015-01-01

    Background and Objectives Use of pluripotent stem cells is an ideal solution for liver insufficiencies. This work aims is to evaluate the safety and feasibility of autologous stem cells transplantation (SCT) in Egyptian patients of liver cirrhosis on top of hepatitis C virus (HCV). Subjects and Results 20 patients with HCV induced liver cirrhosis were divided into 2 groups. Group I: included 10 patients with liver cirrhosis Child score ≥9, for whom autologous stem cell transplantation was done using granulocyte colony stimulating factor (G-CSF) for stem cells mobilization. Separation and collection of the peripheral blood stem cells was done by leukapheresis. G-CSF mobilized peripheral blood mononuclear cells (G-CSF PB-MNCs) were counted by flow cytometry. Stem cell injection into the hepatic artery was done. Group II: included 10 patients with HCV induced liver cirrhosis as a control group. Follow up and comparison between both groups were done over a follow up period of 6 months. The procedure was well tolerated. Mobilization was successful and the total number of G-CSF PB-MNCs in the harvests ranged from 25×106 to 191×106. There was improvement in the quality of life, serum albumin, total bilirubin, liver enzymes and the Child-Pugh score of group I over the first two-three months after the procedure. Conclusion SCT in HCV induced liver cirrhosis is a safe procedure. It can improve the quality of life and hepatic functions transiently with no effect on the life expectancy or the fate of the liver cirrhosis. PMID:26634069

  12. Serum Hyperamylasemia as a prognostic indicator of acute viral hepatitis and cirrhosis of liver

    Directory of Open Access Journals (Sweden)

    N. Kaur

    2014-06-01

    Full Text Available Liver disease is a condition that causes liver inflammation or tissue damage and affects liver function. Liver functions tests are abnormal in various liver diseases such as hepatitis, cirrhosis and end stage liver disease. The study of pancreatic enzymes for prognostic purpose in evolving liver disease is gaining ground and act as prognostic indicator for liver diseases. Present study has been planned to assess the serum amylase status in 50 patients of acute viral hepatitis and 50 patients of cirrhosis of liver in comparison to 50 normal healthy control subjects. Levels of serum amylase were determined by CNP- G3 kinetic method. The serum levels of amylase were significantly raised (p<0.0001 in patients compared to control group and levels were observed to be constantly increased with increased severity of liver diseases. The probable cause of variation in serum amylase enzymes in acute viral hepatitis and cirrhosis of liver is its anatomical proximity and common egress system through Ampulla of vater into the duodenum.

  13. Association Between TT Virus Infection and Cirrhosis in Liver Transplant Patients

    Directory of Open Access Journals (Sweden)

    Kazemi

    2015-09-01

    Full Text Available Background Cirrhosis is one of the most severe liver complications, with multiple etiologies. The torque teno virus (TTV, also known as transfusion transmitted virus, which has a high incidence in the world population, is one of the possible increasing risk factors in patients with idiopathic fulminant hepatitis and cryptogenic cirrhosis. Objectives The aim of this study was to evaluate solitary and co-infection with TTV, in patients with cryptogenic and determined cause of cirrhosis. Patients and Methods In this cross-sectional study, 200 liver transplant patients were consecutively recruited between years 2007 and 2011. Patients were classified, based on recognition of the etiology of cirrhosis to determined (n = 81 and cryptogenic (n = 119 patient groups. The existence of TTV infection was analyzed, using a semi-nested polymerase chain reaction method. The presence of hepatitis B virus (HBV infective markers, including HBV DNA, hepatitis B surface antigen (HBsAg, hepatitis B e antigen (HBeAg, hepatitis B core antibody (HBcAb, and hepatitis B e antibody (HBeAb, was evaluated using qualitative polymerase chain reaction and enzyme linked immunosorbent assay protocols, respectively. Results The TTV infection was found in 37 of 200 (18.5% and 53 of 200 (26.5% plasma and tissue samples of studied liver transplanted patients, respectively. The TTV genomic DNA was found in 32 (26.9% and 28 (23.5% of 119 liver tissue and plasma samples of transplanted patients with cryptogenic cirrhosis, respectively. The genomic DNA of TTV was also diagnosed in 21 (25.9% and nine (11.1% of the 81 liver tissue and plasma samples of patients with determined cirrhosis, respectively. Significant associations were found between TTV infection with HBV molecular and immunologic infective markers, in liver transplanted patients, with determined and cryptogenic cirrhosis. Conclusions The diagnosis of the high frequency of solitary TTV and co-infection with HBV, in both liver

  14. Large intestine permeability is increased in patients with compensated liver cirrhosis.

    Science.gov (United States)

    Pijls, Kirsten E; Koek, Ger H; Elamin, Elhaseen E; de Vries, Hanne; Masclee, Ad A M; Jonkers, Daisy M A E

    2014-01-01

    Intestinal barrier dysfunction, facilitating translocation of bacteria and bacterial products, plays an important role in the pathophysiology of liver cirrhosis and its complications. Increased intestinal permeability has been found in patients with liver cirrhosis, but data on small and large intestine permeability and tight junctions (TJs) in patients with compensated cirrhosis are scarce. We aimed to investigate both small and large intestine permeability in patients with stable compensated cirrhosis compared with healthy controls and evaluated the expression of TJ proteins in mucosal biopsies at duodenal and sigmoid level. Intestinal permeability was assessed in 26 patients with compensated cirrhosis and 27 matched controls using a multisugar test. Duodenal and sigmoid biopsies were available from a subgroup for analyses of gene transcription and expression of key TJ proteins by qRT-PCR and ELISA, respectively. Median 0-5-h urinary sucrose excretion and lactulose/rhamnose ratio were comparable between patients with compensated cirrhosis and controls, whereas 5-24-h urinary sucralose/erythritol ratio was increased in these patients. Downregulation of gene transcription was found for claudin-3 in duodenal biopsies and claudin-4 in sigmoid biopsies, and at the protein level occludin expression was significantly increased in both duodenal and sigmoid biopsies. This study shows that gastroduodenal and small intestine permeability are not altered, whereas large intestine permeability is increased in patients with stable compensated cirrhosis. Only limited alterations were found regarding the expression of TJ proteins in both the small and large intestine.

  15. Color Doppler velocity profile and contrast-enhanced ultrasonography in assessment of liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Li-Wu Lin; Xue-Jun Duan; Xiao-Yan Wang; En-Sheng Xue; Yi-Mi He; Shang-Da Gao; Li-Yun Yu

    2008-01-01

    BACKGROUND:This study was designed to probe the clinical value in assessing the degree of liver cirrhosis by using the arrival time of contrast agent in the right portal vein in contrast-enhanced ultrasonography, as well as the velocity and lfow volume in the right portal vein using the color Doppler velocity proifle technique. METHODS:Twenty-eight patients with HBV post-hepatic cirrhosis were grouped into compensated (13 patients) and decompensated cirrhosis (15); 30 patients without hepatic cirrhosis served as controls. Written informed consent was obtained from each patient. All the patients with hepatic cirrhosis were pathologically conifrmed by percutaneous biopsy. SonoVue was injected to detect the arrival time in the right portal vein. The velocity and lfow volume in the right portal vein were measured. The value of each parameter was compared for correlation analysis. RESULTS: The arrival time in the right portal vein in the cirrhosis group was much longer than that in the control group (24.92±1.34 vs. 20.81±0.55 sec, respectively, P CONCLUSIONS:With the development of liver cirrhosis, the arrival time of contrast agent in the right portal vein is gradually prolonged, whereas the velocity and lfow volume in this vein decreases markedly, and there is a negative correlation between the results of the two methods.

  16. Assessment of the hepatic microvascular changes in liver cirrhosis by perfusion computed tomography

    Institute of Scientific and Technical Information of China (English)

    Mai-Lin Chen; Qing-Yu Zeng; Jian-Wei Huo; Xiao-Ming Yin; Bao-Ping Li; Jian-Xin Liu

    2009-01-01

    AIM: To assess the hepatic microvascular parameters in patients with liver cirrhosis by perfusion computed tomography (CT). METHODS: Perfusion CT was performed in 29 patients without liver disease (control subjects) and 39 patients with liver cirrhosis, including 22 patients with compensated cirrhosis and 17 patients with decompensated cirrhosis, proved by clinical and laboratory parameters. CT cine-scans were obtained over 50 s beginning with the injection of 50 mL of contrast agent. Hepatic microvascular parameters, mean transit time (MTT) and permeability surface area product (PS) were obtained with the Perfusion 3 software (General Electric, ADW 4.2). RESULTS: The overall differences of MTT and PS between control subjects, patients with compensated cirrhosis and those with decompensated cirrhosis were statistically significant ( P = 0.010 and P = 0.002, respectively). MTT values were 15.613 ± 4.1746 s, 12.592 ± 4.7518 s, and 11.721 ± 4.5681 s for the three groups, respectively, while PS were 18.945 ± 7.2347 mL/min per 100 mL, 22.767 ± 8.3936 mL/min per 100 mL, and 28.735 ± 13.0654 mL/min per 100 mL. MTT in decompensated cirrhotic patients were significantly decreased compared to controls ( P = 0.017), whereas PS values were remarkably increased ( P = 0.001). CONCLUSION: The hepatic microvascular changes in patients with liver cirrhosis can be quantitatively assessed by perfusion CT. Hepatic microvascular parameters (MTT and PS), as measured by perfusion CT, were significantly altered in decompensated cirrhosis.

  17. Association between interleukin-10 gene promoter polymorphisms and susceptibility to liver cirrhosis.

    Science.gov (United States)

    Yao, Lanjie; Xing, Shuli; Fu, Xueqin; Song, Hongjie; Wang, Zhendong; Tang, Jianrong; Zhao, Yongjing

    2015-01-01

    We conducted a case-control study to investigate the association between three common SNPs in IL-10 gene (rs1800896, rs1800871 and rs1800872) and the development of liver cirrhosis in a Chinese population. Between January 2013 and December 2014, a total of 318 patients with liver cirrhosis and 318 health control subjects were enrolled into our study. The IL-10 rs1800896, rs1800871 and rs1800872 polymorphisms were analyzed using polymerase chain reaction (PCR) coupled with restriction fragment length polymorphism (RFLP). By multivariate logistic regression analysis, we found that individuals with the AA genotype and GA+AA genotype of IL-10 rs1800896 were more likely to have an increased risk of liver cirrhosis when compared with the GG genotype, and the ORs (95% CI) for the AA genotype and GA+AA genotype were 2.04 (1.20-3.50) and 1.41 (1.02-1.96), respectively. We found that the GA+AA genotype of IL-10 rs1800896 had higher risk of liver cirrhosis in individuals with chronic hepatitis B when compared with the GG genotype (OR = 1.95, 95% CI = 1.01-3.59). In conclusion, we found that IL-10 rs1800896 polymorphism was correlated with an increased risk of liver cirrhosis, especially in individuals with chronic hepatitis B.

  18. Association of Fasciola hepatica Infection with Liver Fibrosis, Cirrhosis, and Cancer: A Systematic Review

    Science.gov (United States)

    Machicado, Claudia; Machicado, Jorge D.; Maco, Vicente; Terashima, Angelica; Marcos, Luis A.

    2016-01-01

    Background Fascioliasis has been sporadically associated with chronic liver disease on previous studies. In order to describe the current evidence, we carried out a systematic review to assess the association between fascioliasis with liver fibrosis, cirrhosis and cancer. Methodology and Principal Findings A systematic search of electronic databases (PubMed, LILACS, Scopus, Embase, Cochrane, and Scielo) was conducted from June to July 2015 and yielded 1,557 published studies. Among 21 studies that met inclusion and exclusion criteria, 12 studies explored the association of F. hepatica with liver fibrosis, 4 with liver cirrhosis, and 5 with cancer. Globally these studies suggested the ability of F. hepatica to promote liver fibrosis and cirrhosis. The role of F. hepatica in cancer is unknown. Given the heterogeneity of the studies, a meta-analysis could not be performed. Conclusions Future high-quality studies are needed to determine the role of F. hepatica on the development of liver fibrosis, liver cirrhosis, and cancer in humans. PMID:27681524

  19. Dysregulation of ENaC in Animal Models of Nephrotic Syndrome and Liver Cirrhosis.

    Science.gov (United States)

    Kim, Soo Wan

    2006-03-01

    Nephrotic syndrome and liver cirrhosis are common clinical manifestations, and are associated with avid sodium retention leading to the development of edema and ascites. However, the mechanism for the sodium retention is still incompletely understood and the molecular basis remains undefined. We examined the changes of sodium (co)transporters and epithelial sodium channels (ENaCs) in the kidneys of experimental nephrotic syndrome and liver cirrhosis. The results demonstrated that puromycin- or HgCl2-induced nephrotic syndrome was associated with 1) sodium retention, decreased urinary sodium excretion, development of ascites, and increased plasma aldosterone level; 2) increased apical targeting of ENaC subunits in connecting tubule and collecting duct segments; and 3) decreased protein abundance of type 2 11β-hydroxysteroid dehydrogenase (11βHSD2). Experimental liver cirrhosis was induced in rats by CCl4 treatment or common bile duct ligation. An increased apical targeting of alpha-, beta-, and gamma-ENaC subunits in connecting tubule, and cortical and medullary collecting duct segments in sodium retaining phase of liver cirhosis but not in escape phase of sodium retention. Immunolabeling intensity of 11βHSD2 in the connecting tubule and cortical collecting duct was significantly reduced in sodium retaining phase of liver cirrhosis, and this was confirmed by immunoblotting. These observations therefore strongly support the view that the renal sodium retention associated with nephrotic syndrome and liver cirrhosis is caused by increased sodium reabsorption in the aldosterone sensitive distal nephron including the connecting tubule and collecting duct, and increased apical targeting of ENaC subunits plays a role in the development of sodium retention in nephrotic syndrome and liver cirrhosis.

  20. Surecut 0.6 mm liver biopsy in the diagnosis of cirrhosis

    DEFF Research Database (Denmark)

    Torp-Pedersen, S; Vyberg, Mogens; Smith, E

    1990-01-01

    Liver biopsy with the 0.6 mm (23 gauge) Surecut needle was compared to conventional Menghini biopsy in the diagnosis of cirrhosis. Seventy-seven consecutive patients (mainly alcoholics) with a clinical indication for liver biopsy had both biopsies performed simultaneously. In 71 patients sufficient...... material for a morphological diagnosis concerning liver architecture was obtained with both biopsy techniques (Surecut insufficient in 5 cases and Menghini insufficient in 2 cases). The biopsies were classified as cirrhosis or non-cirrhosis. There was agreement in 69 cases (97%, confidence limits 90......-100%). Using the result of the Menghini biopsy as the final diagnosis, the predictive values for a positive and negative diagnosis for the Surecut needle were 96% and 98%, respectively. There were no complications to either of the biopsies. It is suggested that the 0.6 mm Surecut biopsy may be used...

  1. Hepatic encephalopathy in patients with liver cirrhosis: Is there a role of malnutrition?

    Institute of Scientific and Technical Information of China (English)

    Evangelos Kalaitzakis; Einar Bj(o)rnsson

    2008-01-01

    Hepatic encephalopathy (HE) is a common complication in patients with liver cirrhosis but its pathogenesis remains incompletely understood.Malnutrition is commonly encountered in patients with liver cirrhosis and it has been reported to affect the quality of life of this group of patients.Experimental studies suggest that low energy intake and poor nutritional status may facilitate the development of HE but there are scarce data on the potential role of malnutrition in HE in patients with liver cirrhosis.Two recently published studies have evaluated the potential role of malnutrition in the development of HE in cirrhotic patients with conflicting results.In this letter to the editor we briefly present the results of the two studies as well as potential reasons for the conflicting results reported.

  2. Association of liver cirrhosis related IgA nephropathy with portal hypertension

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    A high incidence of IgA nephropathy has been reported in patients with liver cirrhosis, though, clinically evident nephrotic syndrome is very uncommon. Impaired hepatic clearance of circulating IgA immune complexes and subsequent deposition in renal glomeruli has been considered principally in the pathogenesis of liver cirrhosis associated IgA nephropathy. Here we report on a patient with cryptogenic liver cirrhosis and splenic vein thrombosis, who presented with nephrotic syndrome. Renal biopsy showed findings consistent with IgA nephropathy. Lower endoscopy showed features of portal hypertensive colopathy. Following initiation of propranolol and anticoagulant treatment to reduce portal pressure, a gradual decrease of proteinuria and hematuria to normal range was noted. The potential pathogenetic role of portal hypertension in the development of IgA nephropathy in cirrhotic patients is discussed.

  3. Association of liver cirrhosis related IgA nephropathy with portal hypertension.

    Science.gov (United States)

    Kalambokis, Georgios; Christou, Leonidas; Stefanou, Dimitrios; Arkoumani, Evdokia; Tsianos, Epameinondas V

    2007-11-21

    A high incidence of IgA nephropathy has been reported in patients with liver cirrhosis, though, clinically evident nephrotic syndrome is very uncommon. Impaired hepatic clearance of circulating IgA immune complexes and subsequent deposition in renal glomeruli has been considered principally in the pathogenesis of liver cirrhosis associated IgA nephropathy. Here we report on a patient with cryptogenic liver cirrhosis and splenic vein thrombosis, who presented with nephrotic syndrome. Renal biopsy showed findings consistent with IgA nephropathy. Lower endoscopy showed features of portal hypertensive colopathy. Following initiation of propranolol and anticoagulant treatment to reduce portal pressure, a gradual decrease of proteinuria and hematuria to normal range was noted. The potential pathogenetic role of portal hypertension in the development of IgA nephropathy in cirrhotic patients is discussed.

  4. Alcohol Abuse and Alcoholic Liver Cirrhosis Leading to Spontaneous Muscle Hematoma: An Event Fraught with Danger

    Directory of Open Access Journals (Sweden)

    Ankit Mangla

    2015-04-01

    Full Text Available Alcohol abuse is associated with both potentiating and antagonizing hemostatic states. Liver cirrhosis is an independent causal factor for many bleeding complications. The long-term effects of alcohol abuse coupled with advanced liver cirrhosis are additive in favor of bleeding. We report the case of a patient with a history of alcohol abuse who presented with liver cirrhosis and nontraumatic muscle hematoma diagnosed as a spontaneous hematoma of the gastrocnemius muscle. He was managed conservatively with infusions of fresh frozen plasma and platelets, which resulted in resolution of the hematoma. The pathogenesis of ‘spontaneous' muscle hematoma remains anecdotal, but since it is reported in patients on anticoagulant therapy or with hemostatic disorders, it is hypothetically related to severely deranged coagulation. Here we review the relevant literature pertaining to the pathogenesis, presentation and treatment options available for treating this often fatal complication of bleeding diatheses.

  5. [Protein catabolism and malnutrition in liver cirrhosis - impact of oral nutritional therapy].

    Science.gov (United States)

    Norman, K; Valentini, L; Lochs, H; Pirlich, M

    2010-07-01

    Malnutrition with loss of muscle is common in patients with liver cirrhosis and has negative impact on morbidity and mortality. The aetiology of malnutrition is multifactorial and includes inflammation, early onset of gluconeogenesis due to impaired glycogen storage and sometimes hypermetabolism. Reduced nutritional intake, however, plays the most important role in the pathogenesis of malnutrition. There is, however, ample evidence that nutritional intake and therapy are inadequate in liver cirrhosis although studies have clearly shown that dietary counselling and nutritional therapy with oral supplements improve intake in these patients. Protein requirement is considered to be increased in liver cirrhosis and high protein intake has been shown to be well tolerated and associated with an improvement of liver function and nutritional status. Protein intolerance on the other hand is uncommon and hepatic encephalopathy can thus rarely be attributed to high protein consumption. Recommendations for general protein restriction must therefore be considered obsolete and rather a risk factor for an impaired clinical outcome. Furthermore, the administration of late evening meals is highly beneficial in patients with liver disease since the rapid onset of the overnight catabolic state is counteracted. The serum concentration of branched-chain amino acids (BCAA) is decreased in patients with liver cirrhosis and long-term supplementation of BCAA has been shown to improve nutritional status and prolong event-free survival and quality of life.

  6. [Studies on the mechanism of elevation of serum PIVKA-II levels in alcoholic liver cirrhosis].

    Science.gov (United States)

    Sakizono, Kenji; Oita, Tatsuo; Eto, Masaaki; Bito, Sanae; Takegawa, Hiroshi; Kasakura, Shinpei

    2002-03-01

    We measured serum PIVKA-II concentrations in 18 patients with alcoholic liver cirrhosis. Alcoholic liver disease was diagnosed by the history of ethanol intake of more than 900 ml/day for over 10 years. Liver cirrhosis was diagnosed histologically. Infections with hepatitis B and C viruses were ruled out by assaying serum virus markers. No tumor was detected in liver by ultrasonography and computed tomography during observation period. None of the patients studied were positive for alpafetoprotein (AFP). Eight out of 18 (44.4%) patients with alcoholic liver cirrhosis showed elevated serum PIVKA-II levels. In contrast, only eight out of 93 (8.6%) patients with nonalcholic liver cirrhosis had elevated serum PIVKA-II levels. PIVKA-II is well known as a tumor marker of hepatocellular carcinoma (HCC). The rates of positive PIVKA-II found in alcoholic liver cirrhosis approached its rates in HCC. However, the time course for the elevation of serum PIVKA-II levels was different each other in alcoholic liver cirrhosis and HCC. In HCC, serum PIVKA-II "levels" continued to elevate until therapy. In contrast, its elevation was transient and its levels returned to baseline in alcoholic liver cirrhosis. The values of ALT (GPT), gamma-GTP, and ALP correlated poorly with serum PIVKA-II levels in patients with alcoholic liver cirrhosis. To investigate the mechanism by which elevation of serum PIVKA-II levels in patients with alcoholic liver cirrhosis occurred, we studied the effect of vitamin K on production of PIVKA-II and AFP by hepatocytes. Hepatocytes(Alexander PLC/PRF/F cell line) were cultured in the presence of various concentrations of vitamin K (Kaytwo, Eisai, Tokyo). Vitamin K had no effect on AFP production. In contrast, PIVKA-II production was inhibited by addition of vitamin K in a dose dependent manner. Moreover, elevation of serum PIVKA-II levels in patients with alcoholic liver cirrhosis was suppressed by administration of vitamin K (Kaytwo) to these patients. Taken

  7. Synthesis of platelet-activating factor and its receptor expression in Kupffer cells in rat carbon tetrachloride-induced cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Yin-Ying Lu; Chun-Ping Wang; Lin Zhou; Yan Chen; Shu-Hui Su; Yong-Yi Feng; Yong-Ping Yang

    2008-01-01

    AIM:To determine the platelet-activating factor (PAF)synthesis and its receptor expression in Kupffer cells in rat carbon tetrachloride-induce dcirrhosis.METHODS:Kupffer cells,isolated from the livers of control and CCl4-induced cirrhotic rats,were placed in serum-free medium overnight.PAF saturation binding,ET-1 saturation and competition binding were assayed.ET-1 induced PAF synthesis,mRNA expression of PAF,preproendothelin-1,endothelin A (ETA) and endothelin B (ETB) receptors were also determined.RESULTS:A two-fold increase of PAF synthesis (1.42±0.14 vs 0.66±0.04 pg/μg DNA) and a 1.48-fold increase of membrane-bound PAF (1.02±0.06 vs 0.69±0.07 Pg/μg DNA) were observed in activated Kupffer cells of cirrhotic rats.The application of ET-1 to Kupffer cells induced PAF synthesis in a concentration-dependent manner in both cirrhotic and normal rats via ETB receptor,but PAF synthesis in the activated Kupffer cells was more effective than that in the normal Kupffer cells.In activated Kupffer cells,PAF receptor expression and PAF binding capacity were markedly enhanced.Activated Kupffer cells raised the [125I]-ET-1 binding capacity,but changed neither the affinity of the receptors,nor the expression of ETA receptor.CONCLUSION:Kupffer cells in the course of CCl4-induced cirrhosis are the main source of increased PAF.ET-1 is involved endogenously in stimulating the PAF synthesis in activated Kupffer cells via ETB receptor by paracrine.ETA receptor did not appear in activated Kupffer cells,which may exacerbate the hepatic and extrahepatic complications of cirrhosis.

  8. Functional hepatic flow in patients with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Zheng Pan; Xing-Jiang Wu; Jie-Shou Li; Fang-Nan Liu; Wei-Su Li; Jian-Ming Han

    2004-01-01

    AIM: To evaluate hepatic reserve function by investigating the change of functional hepatic flow and total hepatic flow in cirrhotic patients with portal hypertension. METHODS: HPLC method was employed for the determination of concentration of D-sorbitol in human plasma and urine. The functional hepatic flow (FHF) and total hepatic flow (THF) were determined by means of modified hepatic clearance of D-sorbitol combined with duplex doppler color sonography in 20 patients with cirrhosis and 10 healthy volunteers. RESULTS: FHF, evaluated by means of bhe D-sorbitol dearance, was significantly reduced in patients wibh cirrhosis in comparison to controls (764.74±167.91 vs 1 195.04±242.97 mL/min, P<0.01). While THF was significantly increased in patients with cirrhosis in comparison to controls (1 605.23±279.99 vs 1 256.12±198.34 mL/min, P<0.01). Portal blood flow and hepatic artery flow all were increased in cirrhosis compared to controls (P<0.05 and P<0.01). D-sorbitol total clearance was significantly reduced in cirrhosis compared to control (P<0.01), while D-sorbitol renal clearance was significantly increased in cirrhosis (P<0.05). In controls FHF was similar to THF (1 195.05±242.97 vs1 256.12±198.34 mL/min, P=0.636), while FHF was significantly reduced compared with THF incirrhosis (764.74±167.91 vs 1 605.23±279.99 mL/min, P<0.01). CONCLUSION: Our method that combined modified hepatic clearance of D-sorbitol with duplex doppler color sonography is effective in the measurement of FHF and THF. FHF can be used to estimate hepatic reserve function.

  9. Human leucocyte antigens in patients with alcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Gluud, C; Aldershvile, J; Dietrichson, O;

    1980-01-01

    No significant differences in the frequencies of HLA-B8, -B40, and other HLA-A, -B, and -C phenotypes were found among patients with histologically verified alcoholic cirrhosis compared with normal controls when the p values were multiplied by the number of comparisons. This was found both...... in the present study of 45 patients and in the combined data of this and three other similar studies. However, these findings do not rule out that alcoholic cirrhosis might be associated with HLA factors (for example. HLA-D/DR antigens) controlling immune responses....

  10. Bacterial infections in alcoholic and nonalcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Sargenti, Konstantina; Prytz, Hanne; Bertilsson, Sara

    2015-01-01

    of 600,000 inhabitants) were retrospectively identified. All bacterial infections resulting in or occurring during an inpatient hospital episode during this period were registered. The etiology of cirrhosis (alcoholic vs. nonalcoholic), infection localization, and outcome as well as bacterial resistance...... predicted pneumonia and infections caused by Gram-positive bacteria in multivariate analysis (Pbacterial infections increased over time, which, in the case of alcoholic cirrhosis, was associated with pneumonia and bacterial resistance...... to antibiotics. However, alcoholic etiology was not related indepedently to the occurrence of bacterial infections....

  11. Hypothalamic-pituitary-gonadal function in relation to liver function in men with alcoholic cirrhosis

    DEFF Research Database (Denmark)

    Gluud, C; Bahnsen, M; Bennett, Patrick;

    1983-01-01

    affected liver function (no. = 18) had significantly (P less than 0.05) raised serum concentrations of testosterone, FSH, and LH when compared with both controls and patients with severely affected liver function (no. = 13). Serum concentrations of testosterone, FSH, and LH in the latter group showed......Serum concentrations of oestrone, oestradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) were significantly (P less than 0.01) raised in men with alcoholic liver cirrhosis (no. = 42) compared with age-matched controls (no. = 20......). No significant difference was observed when comparing serum testosterone concentrations. Patients were divided into three groups in accordance with the severity of liver cirrhosis, using biochemical and clinical criteria. Patients with the best-preserved liver function (no. = 11) and patients with moderately...

  12. CD14 promoter polymorphism in Chinese alcoholic patients with cirrhosis of liver and acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    You-Chen Chao; Heng-Cheng Chu; Wei-Kuo Chang; Hsin-Hung Huang; Tsai-Yuan Hsieh

    2005-01-01

    AIM: To investigate the relationship between genetic polymorphism of the CD14 promoter and the occurrence of alcoholic cirrhosis and alcoholic pancreatitis, and to challenge the conclusion made earlier that the patients with acute alcoholic pancreatitis and patients with alcoholic cirrhosis of liver are two different subpopulations.METHODS: Using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, we determined the polymorphism of CD14 gene and aldehyde dehydrogenase gene 2 (ALDH 2) in 335 alcoholic patients with different organ complications i.e., cirrhosis of liver (n = 100), acute pancreatitis (n = 100), esophageal cancer (n = 82) and avascular necrosis of hip joint (AVN) (n = 53)and 194 non-alcoholic controls in a Chinese group.RESULTS: The results showed that the carriage of T allele was not different among alcoholic patients with cirrhosis of liver, alcoholic patients with other complication and non-alcoholic controls. On the other hand, the carriage of the C allele was significantly more prevalent for alcoholic pancreatitis than for esophageal cancer (0.79 vs 0.60,P<0.001), alcoholic AVN (0.79 vs 0.65, P<0.025) and nonalcoholic controls (0.79 vs 0.68, P<0.025). Furthermore,when only subjects with ALDH2 1-1 genotype were examined, the C allele frequency was significantly more prevalent for alcoholic pancreatitis than for alcoholic liver cirrhosis (0.82 vs 0.69, P<0.025), esophageal cancer (0.82 vs 0.61, P<0.01), alcoholic AVN (0.82 vs 0.64,P<0.01) and non-alcoholic controls (0.82 vs 0.69, P<0.05).CONCLUSION: The C allele may be associated with some mechanism, which is important in the pathogenesis of alcoholic pancreatitis, and that alcoholic patients with acute pancreatitis and cirrhosis of liver are probably two different subpopulations.

  13. Temporal expression of hepatic inducible nitric oxide synthase in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Chang-Li Wei; Wei-Min Hon; Kang-Hoe Lee; Hoon-Eng Khoo

    2005-01-01

    AIM: Nitric oxide (NO) has been implicated in the pathogenesis of liver cirrhosis. We have found inducible nitric oxide synthase (iNOS) can be induced in hepatocytes of cirrhotic liver. This study further investigated the temporal expression and activity of hepatic iNOS in cirrhosis development.METHODS: Cirrhosis was induced in rats by chronic bile duct ligation (BDL). At different time points after the operation,samples were collected to examine NO concentration, liver function, and morphological changes. Hepatocytes were isolated for determination of iNOS mRNA, protein and enzymatic activity.RESULTS: Histological examination showed early cirrhosis 1-2 wk after BDL, with advanced cirrhosis at 3-4 wk.Bilirubin increased dramatically 3 d after BDL, but decreased by 47% on d 14. Three weeks after BDL, it elevated again. Systemic NO concentration did not increase significantly until 4 wk after BDL, when ascites developed.Hepatocyte iNOS mRNA expression was identified 3 d after BDL, and enhanced with time to 3 wk, but reduced thereafter. iNOS protein showed a similar pattern to mRNA expression. iNOS activity decreased from d 3 to d 7, but increased again thereafter till d 21.CONCLUSION: Hepatic iNOS can be induced in the early stage, which increases with time as cirrhosis develops. Its enzymatic activity is significantly correlated with protein expression and histological alterations of the liver, but not with systemic NO levels, nor with absolute values of liver function markers.

  14. Circulating Lipids Are Associated with Alcoholic Liver Cirrhosis and Represent Potential Biomarkers for Risk Assessment.

    Science.gov (United States)

    Meikle, Peter J; Mundra, Piyushkumar A; Wong, Gerard; Rahman, Khairunnessa; Huynh, Kevin; Barlow, Christopher K; Duly, Alastair M P; Haber, Paul S; Whitfield, John B; Seth, Devanshi

    2015-01-01

    Liver disease is the greatest cause of death related to alcohol and a major public health problem. While excessive alcohol intake results in hepatosteatosis in most individuals, this can progress in some to more severe forms of liver disease including fibrosis and cirrhosis. An ongoing challenge in the management of alcoholic liver disease is the identification of liver injury early in the disease process such that intervention strategies can prevent serious long term outcomes. Given that excessive alcohol consumption results in dysregulation of lipid metabolism we applied lipid profiling technology to characterise and compare serum lipid profiles from excessive chronic drinkers with no liver disease to those with advanced alcoholic cirrhosis. In a cohort of 59 excessive drinkers (31 with liver cirrhosis and 28 with no evidence of liver disease) we used electrospray ionisation tandem mass spectrometry to measure over 300 individual lipid species in serum, including species of the major phospholipid, sphingolipid, glycerolipid and sterol classes. Six of the 25 lipid classes and subclasses were significantly associated with alcoholic liver cirrhosis; these included dihexosylceramide, trihexosylceramide, alkylphosphatidylcholine, lysoalkylphosphatidylcholine, phosphatidylinositol and free cholesterol. Multivariate classification models created with only clinical characteristics gave an optimal model with an AUC of 0.847 and an accuracy of 79.7%. The addition of lipid measurements to the clinical characteristics resulted in models of improved performance with an AUC of 0.892 and accuracy of 81.8%. The gain in AUC and accuracy of the combined models highlight the potential of serum lipids as markers of liver injury in alcoholic liver disease.

  15. Incidence, predictors and outcomes of acute-on-chronic liver failure in outpatients with cirrhosis.

    Science.gov (United States)

    Piano, Salvatore; Tonon, Marta; Vettore, Elia; Stanco, Marialuisa; Pilutti, Chiara; Romano, Antonietta; Mareso, Sara; Gambino, Carmine; Brocca, Alessandra; Sticca, Antonietta; Fasolato, Silvano; Angeli, Paolo

    2017-07-19

    Acute-on-chronic liver failure (ACLF) is the most life-threatening complication of cirrhosis. Prevalence and outcomes of ACLF have recently been described in hospitalized patients with cirrhosis. However, no data is currently available on the prevalence and the risk factors of ACLF in outpatients with cirrhosis. The aim of this study was to evaluate incidence, predictors and outcomes of ACLF in a large cohort of outpatients with cirrhosis. A total of 466 patients with cirrhosis consecutively evaluated in the outpatient clinic of a tertiary hospital were included and followed up until death and/or liver transplantation for a mean of 45±44months. Data on development of hepatic and extrahepatic organ failures were collected during this period. ACLF was defined and graded according to the EASL-CLIF Consortium definition. During the follow-up, 118 patients (25%) developed ACLF: 57 grade-1, 33 grade-2 and 28 grade-3. The probability of developing ACLF was 14%, 29%, and 41% at 1year, 5years, and 10years, respectively. In the multivariate analysis, baseline mean arterial pressure (hazard ratio [HR] 0.96; p=0.012), ascites (HR 2.53; p=0.019), model of end-stage liver disease score (HR 1.26; p<0.001) and baseline hemoglobin (HR 0.07; p=0.012) were found to be independent predictors of the development of ACLF at one year. As expected, ACLF was associated with a poor prognosis, with a 3-month probability of transplant-free survival of 56%. Outpatients with cirrhosis have a high risk of developing ACLF. The degree of liver failure and circulatory dysfunction are associated with the development of ACLF, as well as low values of hemoglobin. These simple variables may help to identify patients at a high risk of developing ACLF and to plan a program of close surveillance and prevention in these patients. There is a need to identify predictors of acute-on-chronic liver failure (ACLF) in patients with cirrhosis in order to identify patients at high risk of developing ACLF and to

  16. Biliary liver cirrhosis secondary to cystic fibrosis: a rare indication for liver transplantation.

    Science.gov (United States)

    Sańko-Resmer, J; Paczek, L; Wyzgał, J; Ziółkowski, J; Ciszek, M; Alsharabi, A; Grzelak, I; Paluszkiewicz, R; Patkowski, W; Krawczyk, M

    2006-01-01

    As more effective therapies prolong the lives of patients with cystic fibrosis, there are now more patients in this population diagnosed with liver diseases. Secondary biliary cirrhosis is not a rare complication of mucoviscidosis. It is diagnosed in 20% of patients with mucoviscidosis; in 2% it is accompanied by portal hypertension. On average patients with portal hypertension and its complications are 12 years old. Liver transplantation is an accepted method of treatment for children with cystic fibrosis and portal hypertension. It eliminates the cause of the portal hypertension, decreases life-threatening medical conditions, and improves their nutritional status and quality of life. Despite immunosuppressive treatment they do not seem to beat increased risk of upper respiratory tract infections. On the contrary improved respiratory function and status are generally observed. We present our first case of orthotopic liver transplantation performed in a 29-year-old man with cystic fibrosis. The donor was a 42-year-old woman who died of a ruptured cerebral aneurysm. The surgery was performed in September 2004. The patient received immunosuppression based on steroids, basiliximab, tacrolimus, and mycophenolic acid due to renal insufficiency. Antibiotic (meropenem) and antiviral prophylaxis (gancyclovir) were used. A 6-month period of observation confirmed the clinical data from the pediatric population-a good prognosis with improved nutritional status, respiratory function, and quality of life.

  17. Survey of 2002 cases of liver cirrhosis: Identification of etiological factors and related complications

    Directory of Open Access Journals (Sweden)

    AI Min

    2013-05-01

    Full Text Available ObjectiveTo identify the etiologies and associated complications of liver cirrhosis for new cases emerging over the past decade in the region served by the Second Affiliated Clinical College of Chongqing University of Medical Sciences. MethodsThe institute′s inpatient medical record database was searched for all individuals admitted with a new diagnosis of liver cirrhosis between January 2002 and December 2011. Data on demographics and clinical findings were collected for retrospective analysis to determine the regional and temporal profiles of etiologies and complications. The count data, expressed as percent of total, was analyzed by the Chi-squared test. ResultsAmong the total 2002 liver cirrhosis cases, the most frequent etiologies (>1.5% of total were viral hepatitis type B (60.6%, fatty liver caused by both hepatitis B virus (HBV and alcohol (16.6%, alcoholic fatty liver (6.6%, autoimmune liver disease (3.4%, autoimmune liver disease and alcohol (3.2%, and nonalcoholic fatty liver (1.7%. From the first half of the decade to the second half (January 2002-December 2006 vs. January 2007-December 2011, the incidences of two etiologies significantly increased (HBV and alcohol: 13.6% vs. 17.7%, P<0.05 and autoimmune liver disease: 3.5% vs. 7.1%, P<0.05 and the incidence of HBV significantly decreased (641% vs. 59.3%, P<0.05. The most common major complications of cirrhosis were primary hepatocellular carcinoma (HCC; 221%, spontaneous peritonitis (21.3%, upper gastrointestinal bleeding (193%, hepatic encephalopathy (7.3%, and hepatorenal syndrome (4.0%. The incidence of liver cancer was significantly higher in patients with a family history of hepatitis B (31.1% vs. 222%, P<0.05 and positively correlated with HBV DNA load (χ2 = 10.88, P<0.05. ConclusionIn Chongqing, HBV remains a major cause of cirrhosis, even though alcoholism and autoimmune disease are rising in importance as etiological factors, and HCC is still the

  18. Hepatic myelopathy Morphology of the thoracic and lumbar cord in liver cirrhosis and non-cirrhosis corpses and comparison of neuron functional protein

    Institute of Scientific and Technical Information of China (English)

    Yu Lei; Zhen Liu; Huilong Huang; Suiliang Zhang; Yunheng Zhou; Shuai Wu; Xiaojun Hou; Jie Gong; Aiqun Wu

    2011-01-01

    The current study demonstrated that injury of the spinal cord lateral funiculus occurs in liver cirrhosis. This study sought to compare the morphology of the thoracic and lumbar cord, the expression of functional proteins, and changes in vessels between liver cirrhosis and non-cirrhosis corpses. Results showed that in the liver cirrhosis group, the hepatic vein expanded, the gastrointestinal tract was full of coagulated blood, blood-stasis was easily seen in the veniplex of the vertebral canal and the lumbar spinal cord, and the cell bodies of the anterior horn in the thoracic and lumbar cord were smaller than those in non-cirrhosis corpses. In addition, nerve cells shrank, Nissl bodies were concentrated with obscured nuclei, and neurofilament and synapsin containing cell bodies of the anterior horn and white matter decreased in the liver cirrhosis group. These experimental findings indicate that abnormal circulation of the spinal cord, resulting from hemodynamic change of cirrhotic portal hypertension, may be the most significant cause of hepatic myelopathy.

  19. Safety and Efficacy of Hepatitis B Vaccination in Cirrhosis of Liver

    Directory of Open Access Journals (Sweden)

    D. Ajith Roni

    2013-01-01

    Full Text Available Introduction. Patients with chronic liver disease (CLD are more likely to have severe morbidity and fatality rate due to superimposed acute or chronic hepatitis B (HBV infection. The literature has shown that hepatitis B vaccines are safe and effective in patients with CLD, but the data in cirrhosis liver is lacking. We assessed the safety and immunogenicity of HBV vaccine in patients with cirrhosis liver. Methods. CTP classes A and B CLD patients negative for hepatitis B surface antigen and antibody to hepatitis B core antigen were included. All patients received three doses of hepatitis B vaccine 20 mcg intramuscularly at 0, 30, and 60 days. Anti-HBs antibody was measured after 120 days. Results. 52 patients with mean age years were studied. Response rates in CTP classes A and B were 88% and 33.3%. We observed that the alcoholic chronic liver disease had less antibody response (44% than other causes of chronic liver disease such as cryptogenic 69% and HCV 75%. Conclusions. Patients with cirrhosis liver will have low antibody hepatitis B titers compared to general population. As the age and liver disease progress, the response rate for hepatitis B vaccination will still remain to be weaker.

  20. Nodular Regenerative Hyperplasia of Liver Mimicking Cirrhosis:a Case Report

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    A 34-year-old man with no history of any abdominal pain or fatigue was admitted to our hospital in June 2008 due to the cirrhosis found incidentally during a physical examination. Laboratory examination, electrocardiograph, abdominal ultrasonography and magnetic resonance imaging were carried out during his hospitalization. However, according to the results of the above measures, the diagnosis of nodular regenerative hyperplasia of the liver (NRHL) could not be made. The result of electrocardiograph showed there was no sinus bradycardia. The abdominal ultrasonography showed evidence of hepatosplenomegaly, and magnetic resonance imaging showed multiple non-enhancing hepatic nodules. Histologic conifrmation was available by means of liver biopsy and the deifnitive diagnosis of NRHL was conifrmed histologically by liver biopsy. NRHL always presents with signs of portal hypertension with little evidence of obvious liver disease, NRHL may mimick the cirrhosis of liver and be easily confused with cirrhosis of the liver nodules, so liver biopsy should be recommended for correct diagnosis. The clinical, radiological and pathologic features of this case with NRHL was reported in order to familiarize the physicians with its clinical manifestations.

  1. Efficacy of Boesenbergia rotunda Treatment against Thioacetamide-Induced Liver Cirrhosis in a Rat Model

    Directory of Open Access Journals (Sweden)

    Suzy M. Salama

    2012-01-01

    Full Text Available Background. Experimental research in hepatology has focused on developing traditional medicines into potential pharmacological solutions aimed at protecting liver from cirrhosis. Along the same line, this study investigated the effects of ethanol-based extract from a traditional medicine plant Boesenbergia rotunda (BR on liver cirrhosis. Methodology/Results. The BR extract was tested for toxicity on 3 groups of rats subjected to vehicle (10% Tween 20, 5 mL/kg and 2g/kg and 5g/kg doses of the extract, respectively. Next, experiments were conducted on a rat model of cirrhosis induced by thioacetamide injection. The rats were divided into five groups and, respectively, administered orally with 10% Tween-20 (5 mL/kg (normal control group, 10% Tween-20 (5 mL/kg (cirrhosis control group, 50 mg/kg of silymarin (reference control group, and 250 mg/kg and 500 mg/kg of BR extract (experimental groups daily for 8 weeks. The rats in normal group were intraperitoneally injected with sterile distilled water (1 mL/kg 3 times/week, and those in the remaining groups were injected intraperitoneally with thioacetamide (200 mg/kg thrice weekly. At the end of the 8 weeks, the animals were sacrificed and samples were collected for comprehensive histopathological, coagulation profile and biochemical evaluations. Also, the antioxidant activity of the BR extract was determined and compared with that of silymarin. Data from the acute toxicity tests showed that the extract was safe to use. Histological analysis of the livers of the rats in cirrhosis control group revealed uniform coarse granules on their surfaces, hepatocytic necrosis, and lymphocytes infiltration. But, the surfaces morphologically looked much smoother and the cell damage was much lesser in those livers from the normal control, silymarin and BR-treated groups. In the high-dose BR treatment group, the livers of the rats exhibited nearly normal looking lobular architecture, minimal inflammation

  2. Outcomes of liver transplantation in patients with cirrhosis due to nonalcoholic steatohepatitis versus patients with cirrhosis due to alcoholic liver disease.

    Science.gov (United States)

    Bhagat, Vishal; Mindikoglu, Ayse L; Nudo, Carmine G; Schiff, Eugene R; Tzakis, Andreas; Regev, Arie

    2009-12-01

    Nonalcoholic steatohepatitis (NASH) is becoming a common cause of liver cirrhosis requiring liver transplantation (LT). Cardiovascular complications related to metabolic syndrome and NASH recurrence in the transplanted liver may affect the outcome of LT in these patients. We compared the outcomes of LT for NASH cirrhosis and alcoholic cirrhosis (ETOH) in a large transplant center. A retrospective chart review was performed for all patients who underwent LT for cryptogenic cirrhosis with the NASH phenotype (the NASH group) or ETOH (the ETOH group) at the University of Miami from January 1997 to January 2007. There was no significant difference in survival between the NASH and ETOH groups, despite a trend toward lower survival in the former (P = 0.1699). Sepsis was the leading cause of posttransplant death in both groups, and it was followed by cardiovascular causes in the NASH group (26% versus 7% in the ETOH group, P = 0.21) and malignancies in the ETOH group (29% versus 0% in the NASH group, P = 0.024). Recurrent steatohepatitis (33% versus 0%, P < 0.0001) and acute rejection (41% versus 23%, P < 0.023) were significantly more frequent in the NASH group than in the ETOH group. There was no difference in graft failure between the groups (24% in the NASH group versus 18% in the ETOH group, P = 0.3973). In conclusion, despite a numerical trend favoring the ETOH group, there were no statistically significant differences in posttransplant survival and cardiovascular mortality between the NASH and ETOH groups. Acute rejection and recurrent steatohepatitis were significantly more frequent in the NASH group but did not lead to higher rates of retransplantation.

  3. Bone marrow mesenchymal stem cell transplantation via different approaches in treatment of liver cirrhosis in mice

    Directory of Open Access Journals (Sweden)

    ZHANG Lixia

    2016-10-01

    Full Text Available Objective To investigate the clinical effects of bone marrow mesenchymal stem cell (BMSC transplantation via different approaches in the treatment of liver cirrhosis in mice. Methods A total of 46 BALB/c mice were randomly divided into normal control group with 5 mice and liver cirrhosis model group with 41 mice. Subcutaneously injected carbon tetrachloride olive oil was used to establish the mouse model of liver cirrhosis. A total of 36 mice with liver cirrhosis were randomly divided into control group, caudal vein BMSC transplantation group, and spleen BMSC transplantation group, with 12 mice in each group. Whole bone marrow adherent culture was performed to obtain the third-generation BMSCs, and flow cytometry was used for cell surface identification. BMSCs were injected into the mice through the caudal vein or spleen. Blood samples were collected at 4 weeks after transplantation to measure liver function. HE and Masson staining and α-smooth muscle actin (α-SMA immunohistochemistry were performed for liver sections. Liver injury and fibrosis in mice were examined. A one-way analysis of variance was used for comparison between groups. Results At 8 weeks after the establishment of the model, the mice in the model group had sparse and dark yellow hair, reduced food consumption and activity, and a reduction in body weight. After transplantation, compared with the model control group, the caudal vein BMSC transplantation group and spleen BMSC transplantation group showed a significant increase in albumin and significant reductions in alanine aminotransferase and aspartate aminotransferase (all P<0.01. There were no significant differences between the two transplantation approaches (P>0.05. After transplantation, there were significant changes in diseased tissue, alleviated liver cirrhosis, reduced collagen fiber and necrotic area, and a good structure. Immunohistochemistry showed both transplantation groups showed significant reductions in

  4. Microbiota and the gut-liver axis: bacterial translocation, inflammation and infection in cirrhosis.

    Science.gov (United States)

    Giannelli, Valerio; Di Gregorio, Vincenza; Iebba, Valerio; Giusto, Michela; Schippa, Serena; Merli, Manuela; Thalheimer, Ulrich

    2014-12-07

    Liver disease is associated with qualitative and quantitative changes in the intestinal microbiota. In cirrhotic patients the alteration in gut microbiota is characterized by an overgrowth of potentially pathogenic bacteria (i.e., gram negative species) and a decrease in autochthonous familiae. Here we summarize the available literature on the risk of gut dysbiosis in liver cirrhosis and its clinical consequences. We therefore described the features of the complex interaction between gut microbiota and cirrhotic host, the so called "gut-liver axis", with a particular attention to the acquired risk of bacterial translocation, systemic inflammation and the relationship with systemic infections in the cirrhotic patient. Such knowledge might help to develop novel and innovative strategies for the prevention and therapy of gut dysbiosis and its complication in liver cirrhosis.

  5. Ultrasonography for diagnosis of alcoholic cirrhosis in people with alcoholic liver disease

    DEFF Research Database (Denmark)

    Pavlov, Chavdar S; Casazza, Giovanni; Semenistaia, Marianna

    2016-01-01

    system, and the endocrine and immune system, and can lead to cancer. Liver damage in turn, can present as multiple alcoholic liver diseases, including fatty liver, steatohepatitis, fibrosis, alcoholic cirrhosis, and hepatocellular carcinoma, with presence or absence of hepatitis B or C virus infection......, but people in whom hepatocellular carcinoma has developed are often co-infected with hepatitis B or C virus.Abstinence from alcohol may help people with alcoholic disease in improving their prognosis of survival at any stage of their disease; however, the more advanced the stage, the higher the risk...... biopsy as reference standard.To determine the diagnostic accuracy of any of the ultrasonography tests, B-mode or echo-colour Doppler ultrasonography, used singly or combined, or plus ultrasonography signs, or a combination of these, for detecting hepatic cirrhosis in people with alcoholic liver disease...

  6. Allocation of patients with liver cirrhosis and organ failure to intensive care

    DEFF Research Database (Denmark)

    Prier Lindvig, Katrine; Søgaard Teisner, Ane; Kjeldsen, Jens

    2015-01-01

    AIM: To propose an allocation system of patients with liver cirrhosis to intensive care unit (ICU), and developed a decision tool for clinical practice. METHODS: A systematic review of the literature was performed in PubMed, MEDLINE and EMBASE databases. The search includes studies on hospitalized...... patients with cirrhosis and organ failure, or acute on chronic liver failure and/or intensive care therapy. RESULTS: The initial search identified 660 potentially relevant articles. Ultimately, five articles were selected; two cohort studies and three reviews were found eligible. The literature...... on current available data we developed an algorithm, to determine if a patient is candidate to intensive care if needed, based on three scoring systems: premorbid Child-Pugh Score, Model of End stage Liver Disease score and the liver specific Sequential Organ Failure Assessment score. CONCLUSION...

  7. Optimizing the Clinical Use of Carvedilol in Liver Cirrhosis Using a Physiologically Based Pharmacokinetic Modeling Approach.

    Science.gov (United States)

    Rasool, Muhammad Fawad; Khalil, Feras; Läer, Stephanie

    2017-06-01

    Liver cirrhosis is a complex pathophysiological condition that can affect the pharmacokinetics (PK) and hereby dosing of administered drugs. The physiologically based pharmacokinetic (PBPK) models are a valuable tool to explore PK of drugs in cirrhosis patients. The objective of this study was to develop and evaluate a PBPK-carvedilol-cirrhosis model with the available clinical data in liver cirrhosis patients and to recommend model-based drug dosing after exploring the underlying differences in unbound and total (bound and unbound) systemic carvedilol concentrations with the different disease stages. A whole body PBPK model was developed using the population-based PBPK simulator, Simcyp(®). After model development and evaluation in healthy adults, system parameters were modified according to the pathophysiological changes that occur in liver cirrhosis, and predictions were compared to available experimental data from liver cirrhosis Child-Pugh [CP]-C patients. A two-fold error range for the observed/predicted ratios (ratioObs/Pred) of the pharmacokinetic parameters was used for model evaluation. Simulations were then extended to cirrhosis CP-A and CP-B populations were no experimental data that are available to explore changes in drug disposition in these patients. Finally, drug unbound and total (bound and unbound) exposure were predicted in cirrhotic patients of different disease severity, and the results were compared to those of healthy adults. The developed model has successfully described carvedilol PK in healthy and cirrhosis CP-C patients. The model predictions showed that, there was an ~13-fold increase in unbound and ~7-fold increase in total (bound and unbound) systemic exposure of carvedilol between healthy and CP-C populations. To have comparable predicted unbound drug exposure in cirrhosis CP-A, CP-B, and CP-C populations as in healthy subjects receiving a dose of 25 mg, reductions of administered doses to 9.375 mg in CP-A, 4.68 mg in CP-B, and 2

  8. Noninvasive assessment of esophageal-gastric varices by spleen stiffness in liver cirrhosis patients

    Institute of Scientific and Technical Information of China (English)

    李庭红

    2012-01-01

    Objective To investigate the value of spleen stiffness measured by transient elastography(FibroScan,FS) for diagnosing esophageal-gastric varices in liver cirrhosis patients. Methods A total of 259 cirrhotic patients in Tianjin Third Central Hospital rom Apr 2011 to Apr 2012,and 30 healthy controls were enrolled

  9. A Diagnostic Significance of Early Renal Impairment with Liver Cirrhosis through the Determination of Urinary Enzymes

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    @@ It is quite common for liver cirrhosis to be followed subsequently by kidney impairment,which,being recessive in state and showing no clinical symptoms,is trouble some in diagnosis.With the development of disease course,the injury gets worse,so an early diagnosis is necessary.

  10. Primary biliary cirrhosis : Dutch application of the Mayo model before and after orthotopic liver transplantation

    NARCIS (Netherlands)

    vanDam, GM; Verbaan, BW; Therneau, TM; Dickson, ER; Malinchoc, M; Murtaugh, PA; Huizenga, [No Value; Gips, CH

    1997-01-01

    Background/Aims: A retrospective study of primary biliary cirrhosis (PBC) was performed to study the Original Mayo Model for predicting survival by a Dutch data-set of patients, presentation of disease progression; assessment of liver transplantation, prediction of post-transplantation survival; and

  11. Simple scoring system for predicting cirrhosis in nonalcoholic fatty liver disease

    Science.gov (United States)

    Kessoku, Takaomi; Ogawa, Yuji; Yoneda, Masato; Imajo, Kento; Sumida, Yoshio; Eguchi, Yuichiro; Fujii, Hideki; Hyogo, Hideyuki; Ono, Masafumi; Suzuki, Yasuaki; Kawaguchi, Takumi; Chayama, Kazuaki; Tanaka, Saiyu; Fujimoto, Kazuma; Anzai, Keizo; Saibara, Toshiji; Sata, Michio; Itoh, Yoshito; Nakajima, Atsushi; (JSG-NAFLD), Takeshi Okanoue; Japan Study Group of NAFLD

    2014-01-01

    AIM: To investigate a simple noninvasive scoring system for predicting liver cirrhosis in nonalcoholic fatty liver disease (NAFLD) patients. METHODS: A total of 1048 patients with liver-biopsy-confirmed NAFLD were enrolled from nine hepatology centers in Japan (stage 0, 216; stage 1, 334; stage 2, 270; stage 3, 190; stage 4, 38). The weight and height of the patients were measured using a calibrated scale after requesting the patients to remove their shoes and any heavy clothing. Venous blood samples were obtained in the morning after the patients had fasted overnight for 12 h. Laboratory evaluation was performed in all patients. Statistical analysis was conducted using SPSS version 12.0. Continuous variables were expressed as mean ± SD. RESULTS: The optimal cutoff value of platelet count, serum albumin, and aminotransferase/alanine aminotransferase ratio (AAR) was set at 0.9, respectively, by the receiver operating characteristic curve. These three variables were combined in an unweighted sum (platelet count = 1 point, serum albumin = 1 point, AAR = 1 point) to form an easily calculated composite score for predicting cirrhosis in NAFLD patients, called the PLALA (platelet, albumin, AAR) score. The diagnosis of PLALA ≥ 2 had sufficient accuracy for detecting liver cirrhosis in NAFLD patients. CONCLUSION: The PLALA score may be an ideal scoring system for detecting cirrhosis in NAFLD patients with sufficient accuracy and simplicity to be considered for clinical use. PMID:25110437

  12. Colchicine for alcoholic and non-alcoholic liver fibrosis and cirrhosis

    DEFF Research Database (Denmark)

    Rambaldi, A; Gluud, C

    2005-01-01

    Alcohol and hepatotropic viruses cause the majority of liver cirrhosis cases in the Western World. Colchicine is an anti-inflammatory and anti-fibrotic medication. Several randomised clinical trials have addressed the question whether colchicine has any efficacy in patients with alcoholic or non-alcoholic...

  13. Should we give thromboprophylaxis to patients with liver cirrhosis and coagulopathy?

    NARCIS (Netherlands)

    Senzolo, Marco; Sartori, Maria Teresa; Lisman, Ton

    2009-01-01

    Patients with liver cirrhosis are characterized by decreased synthesis of both pro-and anticoagulant factors, and recently there has been evidence of normal generation of thrombin resulting in a near normal haemostatic balance. Although it is generally recognized that bleeding is the most common cli

  14. Multi-state models for bleeding episodes and mortality in liver cirrhosis

    DEFF Research Database (Denmark)

    Andersen, P K; Esbjerg, S; Sorensen, T I

    2000-01-01

    Data from a controlled clinical trial in liver cirrhosis are used to illustrate that multi-state models may be a useful tool in the analysis of data where survival is the ultimate outcome of interest but where intermediate, transient states are identified. We compare models for the marginal...

  15. Clinical relevance of recurrence of primary biliary cirrhosis after liver transplantation

    NARCIS (Netherlands)

    Haagsma, EB

    1999-01-01

    Review of the literature shows that recurrence of primary biliary cirrhosis occurs in about 10% of patients in the first few years after liver transplantation. The cumulative risk is expected to increase in time, The rate of recurrent disease may be affected by the immunosuppression used. Weaning fr

  16. Multi-state models for bleeding episodes and mortality in liver cirrhosis

    DEFF Research Database (Denmark)

    Andersen, P K; Esbjerg, S; Sorensen, T I

    2000-01-01

    Data from a controlled clinical trial in liver cirrhosis are used to illustrate that multi-state models may be a useful tool in the analysis of data where survival is the ultimate outcome of interest but where intermediate, transient states are identified. We compare models for the marginal survi...

  17. Living donor liver transplantation to patients with hepatitis C virus cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Yasuhiko Sugawara; Masatoshi Makuuchi

    2006-01-01

    Living donor liver transplantation (LDLT) is an alternative therapeutic option for patients with end-stage hepatitis C virus (HCV) cirrhosis because of the cadaveric organ shortage. HCV infection is now a leading indication for LDLT among adults worldwide, and there is a worse prognosis with HCV recurrence. The antivirus strategy after transplantation, however, is currently under debate.Recent updates on the clinical and therapeutic aspects of living donor liver transplantation for HCV are discussed in the present review.

  18. Ultrasound imaging in an experimental model of fatty liver disease and cirrhosis in rats

    Directory of Open Access Journals (Sweden)

    Campos de Carvalho Antonio

    2010-01-01

    Full Text Available Abstract Background Domestic dogs and cats are very well known to develop chronic hepatic diseases, including hepatic lipidosis and cirrhosis. Ultrasonographic examination is extensively used to detect them. However, there are still few reports on the use of the ultrasound B-mode scan in correlation with histological findings to evaluate diffuse hepatic changes in rodents, which represent the most important animal group used in experimental models of liver diseases. The purpose of this study was to determine the reliability of ultrasound findings in the assessment of fatty liver disease and cirrhosis when compared to histological results in Wistar rats by following up a murine model of chronic hepatic disease. Results Forty Wistar rats (30 treated, 10 controls were included. Liver injury was induced by dual exposure to CCl4 and ethanol for 4, 8 and 15 weeks. Liver echogenicity, its correlation to the right renal cortex echogenicity, measurement of portal vein diameter (PVD and the presence of ascites were evaluated and compared to histological findings of hepatic steatosis and cirrhosis. Liver echogenicity correlated to hepatic steatosis when it was greater or equal to the right renal cortex echogenicity, with a sensitivity of 90%, specificity of 100%, positive and negative predictive values of 100% and 76.9% respectively, and accuracy of 92.5%. Findings of heterogeneous liver echogenicity and irregular surface correlated to liver cirrhosis with a sensitivity of 70.6%, specificity of 100%, positive and negative predictive values of 100% and 82.1% respectively, and accuracy of 87.5%. PVD was significantly increased in both steatotic and cirrhotic rats; however, the later had greater diameters. PVD cut-off point separating steatosis from cirrhosis was 2.1 mm (sensitivity of 100% and specificity of 90.5%. One third of cirrhotic rats presented with ascites. Conclusion The use of ultrasound imaging in the follow-up of murine diffuse liver disease

  19. Of liver, whisky and plants: a requiem for colchicine in alcoholic cirrhosis?

    Science.gov (United States)

    Lonardo, Amedeo; Loria, Paola

    2002-04-01

    Colchicine decreases liver fibrosis in experimental and human disease, but a meta-analysis recently concluded that colchicine should not be used for liver fibrosis or cirrhosis irrespective of the aetiology. In this issue, Cortez-Pinto et al. confirm such negative conclusions in their series of 55 outpatients with biopsy-proven alcoholic cirrhosis followed for a median of 3.5 years. Although well tolerated, colchicine did not affect either the annual incidence rate of complications or liver function tests. Current treatment of alcoholic cirrhosis includes correction of nutritional deficiencies, exogenous administration of antioxidants (notably S-adenosylmethionine and polyenylphosphatidylcholine), and liver transplantation. In the future, preventive/therapeutic strategies will include campaigns to decrease alcohol abuse aimed at subjects genetically prone to develop alcoholic liver injury, prevention of liver fibrosis via inhibition of the Na+/H+ exchange, stimulation of apoptosis of stellate cells, antagonism of cytokines involved in liver injury, degradation of extracellular matrix, and reversal of ethanol-induced inflammatory and fibrotic changes via increased nitric oxide levels. On the grounds that it renders the hepatocyte more vulnerable to necrosis, steatosis has a key role in the pathogenesis of alcoholic and non-alcoholic liver disease. Conditions associated with insulin resistance have been recognized as risk factors for chronic liver disease and hepatocellular carcinoma in the alcoholic. This suggests that, through steatosis, insulin resistance could be a co-factor of alcoholic liver disease. Were such a hypothesis confirmed, it would unify our view of the pathogenesis of alcoholic and non-alcoholic liver disease, with all its inherent therapeutic implications.

  20. Mortality from liver cirrhosis in Espírito Santo State, Brazil.

    Science.gov (United States)

    Gonçalves, Patricia Lofego; Gonçalves, Carlos Sandoval; Pereira, Fausto Edmundo Lima

    2014-06-01

    To study mortality from liver cirrhosis in Espírito Santo State, Brazil, we reviewed death certificates (DC) from 2000-2010 and medical records of deceased patients with investigation of alcoholism and hepatitis B or C. From a total of 218,410 DC, 3,554 deaths from liver cirrhosis were retrieved. The annual mortality rate was 19.8/100,000 for men and 4.31/100,000 for women, without significant changes after correction for ICD-R98 and R99 and without a significant increase in the annual percentage change. In 49% of death certificates, the aetiology of cirrhosis was defined: of these alcoholism in 81.5% of cases and viral hepatitis in 15.7%. Aetiology was confirmed in 262 reviewed records, including alcoholism (40.5%); hepatitis B or C (26.7%); other (3.8%); and cryptogenic (10.6%). The mean annual potential years of life lost were 5,946 years and 1,739 years for men and women respectively. The mortality rate from cirrhosis in Espírito Santo State is intermediate in relationship to worldwide data; alcoholism and hepatitis B or C were the main aetiologies; probably alcoholism is overestimated and hepatitis B and C viruses are underestimated as causes of cirrhosis registered on death certificates.

  1. Mortality from liver cirrhosis in Espírito Santo State, Brazil

    Directory of Open Access Journals (Sweden)

    Patricia Lofego Gonçalves

    2014-06-01

    Full Text Available To study mortality from liver cirrhosis in Espírito Santo State, Brazil, we reviewed death certificates (DC from 2000-2010 and medical records of deceased patients with investigation of alcoholism and hepatitis B or C. From a total of 218,410 DC, 3,554 deaths from liver cirrhosis were retrieved. The annual mortality rate was 19.8/100,000 for men and 4.31/100,000 for women, without significant changes after correction for ICD-R98 and R99 and without a significant increase in the annual percentage change. In 49% of death certificates, the aetiology of cirrhosis was defined: of these alcoholism in 81.5% of cases and viral hepatitis in 15.7%. Aetiology was confirmed in 262 reviewed records, including alcoholism (40.5%; hepatitis B or C (26.7%; other (3.8%; and cryptogenic (10.6%. The mean annual potential years of life lost were 5,946 years and 1,739 years for men and women respectively. The mortality rate from cirrhosis in Espírito Santo State is intermediate in relationship to worldwide data; alcoholism and hepatitis B or C were the main aetiologies; probably alcoholism is overestimated and hepatitis B and C viruses are underestimated as causes of cirrhosis registered on death certificates.

  2. Nitric oxide synthase and heme oxygenase expressions in human liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Beatrice J Goh; Bee Tee Tan; Wei Min Hon; Kang Hoe Lee; Hoon Eng Khoo

    2006-01-01

    AIM: Portal hypertension is a common complication of liver cirrhosis. Intrahepatic pressure can be elevated in several ways. Abnormal architecture affecting the vasculature, an increase in vasoconstrictors and increased circulation from the splanchnic viscera into the portal system may all contribute. It follows that endogenous vasodilators may be able to alleviate the hypertension. We therefore aimed to investigate the levels of endogenous vasodilators, nitric oxide (NO) and carbon monoxide (CO) through the expression of nitric oxide synthase (NOS) and heme oxygenase (HO).METHOD: Cirrhotic (n= 20) and non-cirrhotic (n = 20) livers were obtained from patients who had undergone surgery. The mRNA and protein expressions of the various isoforms of NOS and HO were examined using competitive PCR, Western Blot and immunohistochemistry.RESULTS: There was no significant change in either inducible NOS (iNOS) or neuronal NOS (nNOS) expressions while endothelial NOS (eNOS) was upregulated in cirrhotic livers. Concomitantly, caveolin-1, an established down-regulator of eNOS, was up-regulated.Inducible HO-1 and constitutive HO-2 were found to show increased expression in cirrhotic livers albeit in different localizations.CONCLUSION: The differences of NOS expression might be due to their differing roles in maintaining liver homeostasis and/or involvement in the pathology of cirrhosis. Sheer stress within the hypertensive liver may induce increased expression of eNOS. In turn, caveolin-1 is also increased. Whether this serves as a defense mechanism against further cirrhosis or is a consequence of cirrhosis, is yet unknown. The elevated expression of HO-1 and HO-2 suggest that CO may compensate in its role as a vasodilator albeit weakly. It is possible that CO and NO have parallel or coordinated functions within the liver and may work antagonistically in the pathophysiology of portal hypertension.

  3. Could post-liver transplantation course be helpful for the diagnosis of so called cryptogenic cirrhosis?

    Science.gov (United States)

    Duclos-Vallée, Jean-Charles; Yilmaz, Funda; Johanet, Catherine; Roque-Afonso, Anne-Marie; Gigou, Michelle; Trichet, Catherine; Féray, Cyrille; Ballot, Eric; Dussaix, Elisabeth; Castaing, Denis; Bismuth, Henri; Samuel, Didier; Guettier, Catherine

    2005-10-01

    Cryptogenic cirrhosis (CC) is diagnosed in 5-30% of cirrhotic patients overall and 7% of patients who undergo liver transplantation for cirrhosis. In our series of patients transplanted for CC, pre-transplant clinical and histological data and the post-transplant course were reexamined in an attempt to identify the aetiology. Among the 881 patients transplanted in our centre between 1987 and 2000, 28 patients with a median age of 46 yr (range: 18-69) at transplantation were initially classified as having CC. Two patients were excluded because of intense ischaemic lesions caused by chemoembolization prevented histological analysis of the native liver (n = 1) and because of cryptic HBV infection (n = 1). Among the remaining 26 patients, four groups were individualized: (i) patients with chronic inflammatory liver disease with autoimmune features (n = 14, 54%); (ii) patients with features suggestive of non-alcoholic fatty liver disease (n = 3, 11.5%); (iii); patients with incomplete septal cirrhosis (ISC) and vascular liver disease (n = 3), and (iv) patients with unresolved CC (n = 6, 23%). In the autoimmune liver disease group, the median International Autoimmune Hepatitis score was 12.5 (range: 11-19) after reevaluation and review of the post-transplantation course was helpful to confirm the diagnosis with the occurrence of active graft hepatitis in nine patients, with autoantibodies in five patients. The vascular group was characterized by lesions of obliterative portal venopathy and ISC in all native livers. Diagnosis of NAFLD was based on the clinical background of obesity and/or type 2 diabetes and the presence of steatosis or steatohepatitis in native livers and graft biopsies. A definite aetiological diagnosis can be achieved in the majority of patients initially diagnosed with CC. Autoimmune liver disease emerged as the main aetiology (14 of 26 patients, 54%) and frequently recurred on the grafted liver (nine cases). In all cases a precise diagnosis is

  4. Activated hepatic stellate cells in liver cirrhosis. A morphologic and morphometrical study.

    Science.gov (United States)

    Carpino, Guido; Franchitto, Antonio; Morini, Sergio; Corradini, Stefano Ginanni; Merli, Manuela; Gaudio, Eugenio

    2004-01-01

    Hepatic stellate cells have been considered the most important cell-type involved in hepatic fibrogenesis. Proliferation and differentiation of hepatic stellate cells into myofibroblast-like cells has been related to the development of liver fibrosis. The alpha-actin expressed by hepatic stellate cells was considered a marker of their activation to myofibroblast-like cell. The aim of this study is to evaluate the changes in morphology, distribution, percentage and alpha-smooth muscle actin expression of hepatic stellate cells in normal and cirrhotic livers, and to correlate activated hepatic stellate cells with the progression of fibrosis. Human liver biopsies (n=121) were divided in five groups: 1) normal livers (controls); 2) cirrhosis post-HCV hepatitis; 3) cirrhosis post-HBV hepatitis; 4) non viral related cirrhosis; 5) recurrent HCV hepatitis after orthotopic liver transplantation. Samples immunostained with anti alpha-smooth muscle actin antibody by immunoperoxidase method were semi-quantitatively evaluated. Liver fibrosis was quantified by computer image analysis on specimens stained with Masson's trichrome. In normal adult livers stellate cells were very rarely stained for alpha-smooth muscle actin. In cirrhotic livers, a strongly enhanced percentage of stellate cells expressing alpha-smooth muscle actin was detected in cirrhotic fragments with respect to the control group, with a significant correlation between alpha-smooth muscle actin positive stellate cells and the volume fraction of fibrosis. Moreover, liver biopsies of recurrent hepatitis revealed an increased number of activated stellate cells compared to normal livers, and intermediate volume fraction of fibrosis. These results confirmed that a direct correlation existed between activated stellate cells and the progression of fibrosis. Alpha-smooth muscle actin confirmed to be a reliable marker of hepatic stellate cells activation also in precocious stages of the disease.

  5. Impaired conversion of prednisone to prednisolone in patients with liver cirrhosis

    DEFF Research Database (Denmark)

    Madsbad, S; Bjerregaard, B; Henriksen, Jens Henrik Sahl;

    1980-01-01

    Fourteen patients with liver cirrhosis received oral prednisone or prednisolone (0.3 mg per kg) randomised on two consecutive days. Serum prednisone and prednisolone were measured over the following four hours. Mean serum prednisolone concentration after oral prednisone decreased with impaired...... liver function estimated by galactose elimination capacity (r = 0.64, P less than 0.03). Mean serum prednisolone concentration after oral prednisone in the seven patients with severely impaired liver function was only 53% (P less than 0.05) of that observed in the seven patients with slightly impaired...... liver function. Conversely, mean serum prednisone concentration after oral prednisone in the patients with severely impaired liver function was 74% higher (P = 0.05) than in patients with slightly impaired liver function. Mean serum prednisolone after oral prednisolone was independent of liver function...

  6. Filtration as the main mechanism of increased protein extravasation in liver cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, J H; Parving, H H; Lassen, N A;

    1980-01-01

    albumin and 125I-labelled human IgG in eight patients with cirrhosis of the liver. The mean wedged hepatic venous pressure was 22 mmHg (range 13-34). TERalb and and TERIgG/TERalb ratio was on average 8.4 +/- 0.8%/h (SD), and 7.4 +/- 1.9%/h (SD), respectively and these values are significantly increased...... filtration (bulk flow) is the dominant process of the increase microvascular protein escape in cirrhosis, due most likely to increased hepatic, but also to increased extrahepatic splanchnic transcapillary protein flux....

  7. Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies

    Science.gov (United States)

    Acevedo, Juan

    2015-01-01

    Recently, important changes have been reported regarding the epidemiology of bacterial infections in liver cirrhosis. There is an emergence of multiresistant bacteria in many European countries and also worldwide, including the United States and South Korea. The classic empirical antibiotic treatment (third-generation cephalosporins, e.g., ceftriaxone, cefotaxime or amoxicillin-clavulanic acid) is still effective in infections acquired in the community, but its failure rate in hospital acquired infections and in some health-care associated infections is high enough to ban its use in these settings. The current editorial focuses on the different epidemiology of bacterial infections in cirrhosis across countries and on its therapeutic implications. PMID:25954474

  8. Hepatocyte Turnover in Chronic HCV-Induced Liver Injury and Cirrhosis

    Directory of Open Access Journals (Sweden)

    Nikolaos P. Karidis

    2015-01-01

    Full Text Available Chronic hepatitis C virus (HCV infection may eventually lead to progressive liver fibrosis and cirrhosis through a complex, multistep process involving hepatocyte death and regeneration. Despite common pathogenetic pathways present in all forms of liver cirrhosis irrespective of etiology, hepatocyte turnover and related molecular events in HCV-induced cirrhosis are increasingly being distinguished from even “similar” causes, such as hepatitis B virus- (HBV- related cirrhosis. New insights in HCV-induced hepatocellular injury, differential gene expression, and regenerative pathways have recently revealed a different pattern of progression to irreversible parenchymal liver damage. A shift to the significant role of the host immune response rather than the direct effect of HCV on hepatocytes and the imbalance between antiapoptotic and proapoptotic signals have been investigated in several studies but need to be further elucidated. The present review aims to comprehensively summarize the current evidence on HCV-induced hepatocellular turnover with a view to outline the significant trends of ongoing research.

  9. Spontaneous Bacterial Peritonitis and Henoch-Schönlein Purpura in a Patient with Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Neil Gupta

    2015-01-01

    Full Text Available Henoch-Schönlein purpura (HSP is a small vessel systemic vasculitis, predominantly affecting children, characterized by a tetrad of manifestations, specifically palpable purpura, arthralgia, abdominal pain, and renal disease. HSP in the adult population is rare, and no case has been described of HSP in liver cirrhosis with spontaneous bacterial peritonitis (SBP. We present the case of a 58-year-old male with liver cirrhosis, who was subsequently diagnosed with SBP and later HSP. In this patient, the diagnosis of HSP was demonstrated clinically by his palpable purpura, diarrhea, hematuria, and abdominal pain and confirmed pathologically by his renal and skin biopsies demonstrating leukocytoclastic vasculitis and IgA complexes. We believe that this is an example of altered IgA processing in cirrhosis leading to the development of IgA immune complexes and ultimately HSP. The patient additionally had SBP, which may have increased his risk for developing HSP given antigen processing by mucosa-associated lymphoid tissues leading to immune complex deposition, which may not have been effectively cleared in the context of his liver disease. The patient unfortunately died of gastrointestinal hemorrhage, which is unclear to be due to his underlying cirrhosis or a gastrointestinal manifestation of HSP itself.

  10. Human umbilical cord-derived mesenchymal stem cell tansplantation for liver fibrosis and cirrhosis%脐带源间充质干细胞移植治疗肝纤维化及肝硬化的相关机制

    Institute of Scientific and Technical Information of China (English)

    孙慧聪; 张国尊; 郭金波; 冯燕; 郑力搏; 张晓岚

    2015-01-01

    背景:肝硬化是多种原因引起的肝脏慢性病变,目前尚没有有效的治疗方法,很多研究表明,间充质干细胞对肝纤维化及肝硬化有一定的治疗作用。目的:研究人脐带源间充质干细胞移植对大鼠肝纤维化及肝硬化的治疗作用及其作用机制。方法:应用CCl4诱导制备肝纤维化及肝硬化模型,造模后经尾静脉注射人脐带间充质干细胞。细胞移植后采用Beckman Coulter analyzer检测人脐带源间充质干细胞移植对大鼠肝功能的影响;采用天狼猩红染色检测肝组织病理改变;应用免疫组织化学染色、Western blot和real-time Q-PCR方法检测Ⅰ、Ⅲ型胶原、基质金属蛋白酶2、基质金属蛋白酶抑制剂2蛋白与mRNA在大鼠肝组织中的表达。结果与结论:人脐带源间充质干细胞移植可以改善肝纤维化及肝硬化大鼠的肝功能。人脐带源间充质干细胞移植后,除肝纤维化细胞移植1周组与对应模型组相比差异无显著性意义外,其余各细胞移植组肝脏组织中基质金属蛋白酶2 mRNA及蛋白表达水平明显升高,而Ⅰ、Ⅲ型胶原、基质金属蛋白酶抑制剂2表达水平明显降低。人脐带源间充质干细胞通过上调基质金属蛋白酶2表达,下调基质金属蛋白酶抑制剂2表达,对肝纤维化及肝硬化起到治疗作用;在致病因素持续存在的情况下,人脐带源间充质干细胞移植并不能逆转肝纤维化或者肝硬化,只能延缓肝纤维化或肝硬化的进程。%BACKGROUND:Cirrhosis is a long-term consequence of chronic hepatic injury, which has no effective therapy. Mesenchymal stem cels have been shown to play a potential role in the treatment of liver fibrosis/cirrhosis. OBJECTIVE:To investigate the therapeutic effect and mechanism of human umbilical cord-derived mesenchymal stem cels on CCl4 induced liver fibrosis/cirrhosis in rats. METHODS:A CCl4-induced liver fibrotic

  11. Effect of long-term refeeding on protein metabolism in patients with cirrhosis of the liver

    DEFF Research Database (Denmark)

    Kondrup, J; Nielsen, K; Juul, A

    1997-01-01

    Patients with cirrhosis of the liver require an increased amount of protein to achieve N balance. However, the utilization of protein with increased protein intake, i.e. the slope from regression analysis of N balance v. intake, is highly efficient (Nielsen et al. 1995). In the present study......, protein requirement and protein utilization were investigated further by measuring protein synthesis and degradation. In two separate studies, five or six patients with cirrhosis of the liver were refed on a balanced diet for an average of 2 or 4 weeks. Protein and energy intakes were doubled in both...... a normal protein requirement with the patients who had an increased protein requirement suggests that the increased protein requirement is due to a primary increase in protein degradation. It is speculated that this is due to low levels of IGF-I secondary to impaired liver function, since initial plasma...

  12. The Expression of Embryonic Liver Development Genes in Hepatitis C Induced Cirrhosis and Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Behnke, Martha, E-mail: mbehnke@mcvh-vcu.edu [Transplant Program Administration, Virginia Commonwealth University Health System, 1200 E. Broad St., Richmond, VA 23298 (United States); Reimers, Mark [Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, 800 E Leigh St., Richmond, VA 23298 (United States); Fisher, Robert [Department of Surgery, Virginia Commonwealth University, 1200 E. Broad St., Richmond, VA 23298 (United States)

    2012-09-18

    Hepatocellular carcinoma (HCC) remains a difficult disease to study even after a decade of genomic analysis. Patient and disease heterogeneity, differences in statistical methods and multiple testing issues have resulted in a fragmented understanding of the molecular basis of tumor biology. Some researchers have suggested that HCC appears to share pathways with embryonic development. Therefore we generated targeted hypotheses regarding changes in developmental genes specific to the liver in HCV-cirrhosis and HCV-HCC. We obtained microarray studies from 30 patients with HCV-cirrhosis and 49 patients with HCV-HCC and compared to 12 normal livers. Genes specific to non-liver development have known associations with other cancer types but none were expressed in either adult liver or tumor tissue, while 98 of 179 (55%) genes specific to liver development had differential expression between normal and cirrhotic or HCC samples. We found genes from each developmental stage dysregulated in tumors compared to normal and cirrhotic samples. Although there was no single tumor marker, we identified a set of genes (Bone Morphogenetic Protein inhibitors GPC3, GREM1, FSTL3, and FST) in which at least one gene was over-expressed in 100% of the tumor samples. Only five genes were differentially expressed exclusively in late-stage tumors, indicating that while developmental genes appear to play a profound role in cirrhosis and malignant transformation, they play a limited role in late-stage HCC.

  13. Liver cirrhosis as a consequence of iron overload caused by hereditary nonspherocytic hemolytic anemia

    Institute of Scientific and Technical Information of China (English)

    Philip Hilgard; Guido Gerken

    2005-01-01

    Nonspherocytic hereditary anemias are occasionally accompanied by significant iron overload but the significance for the development of chronic liver disease is not clear. We described two cases of patients with chronic liver d isease and severeiron overload due to chronic hereditary hemolysis. Both patients have had signs of liver cirrhosis and severe hemolysis since childhood. A hereditary pyruvate kinase deficiency (PKD) was discovered as the underlying reason for the hemolysis.Sequencing of the pyruvate kinase gene showed a mutation within exon 11. Liver histology in both patients revealed cirrhosis and a severe iron overload but primary hemochromatosis was excluded by HFE-gene analysis.An iron reduction therapy with desferrioxamine led to significant decrease of serum ferritin and sustained clinical improvement. PKD-induced hemolysis may cause severe iron overload even in the absence of HFE-genotype abnormalities. This secondary iron overload can lead to chronic liver disease and cirrhosis. Therefore, the iron metabolism of PKD patients has to be closely monitored and iron overload should be consequently treated.

  14. Differential Kinetics of Coagulation Factors and Natural Anticoagulants in Patients with Liver Cirrhosis: Potential Clinical Implications.

    Directory of Open Access Journals (Sweden)

    Michael Tischendorf

    Full Text Available Advanced liver diseases are associated with profound alterations of the coagulation system increasing the risk not only of bleeding, but also of thromboembolic complications. A recent milestone study has shown that prophylactic anticoagulation in liver cirrhosis patients results in a reduced frequency of hepatic decompensation. Yet, INR measurement, one of the most widely applied tests to assess liver function, only inaccurately predicts the risk of hepatic decompensation related to alterations of the coagulation system. To assess the relationship between selected coagulation factors / natural anticoagulants with INR, MELD score, and hepatic decompensation, we performed the present pilot study. A total number of 92 patients with various stages of liver cirrhosis were included and prospectively followed for at least 6 months. We found that important natural anticoagulants, namely antithrombin and protein C, as well as factor XI (which may also serve as an anticoagulant decreased earlier and by a larger magnitude than one would expect from classical coagulation test results. The correlation between these factors and INR was only moderate. Importantly, reduced plasma activities of natural anticoagulants but not INR or MELD score were independent predictors of hepatic encephalopathy (P = 0.013 and 0.003 for antithrombin and protein C, respectively.In patients with liver cirrhosis plasma activities of several natural anticoagulants are earlier and stronger affected than routine coagulation tests. Reduced activities of natural anticoagulants may be predictive for the development of hepatic encephalopathy.

  15. Osteodystrophy in liver cirrhosis. Its demonstration by 99m Tc methylene diphosphonate bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Sezai, Shu-ichi; Ishizawa, Suguru; Yoshino, Katsumasa

    1987-10-01

    In order to investigate the osteodystrophy in liver cirrhosis, 21 liver cirrhotic patients having no malignancy and normal renal function were examined by 99m Tc Methylene Diphosphonate (MDP) bone scintigraphy. The cirrhotic subjects consisted of 14 males and 7 females. Their age was 31 - 80, average 55.7 years. The causes of their cirrhotic damage were 1 primary biliary cirrhosis, 9 alcoholic, 2 HB viral and 9 cryptogenic. The contents of their illness showed 9 cases in A, 4 in B and 8 in C of Child's classification. Abnormal hot spot(s) on bone in the cirrhotics could be observed very frequently in 99m Tc MDP bone scintigraphy (47.6 %; 10/21 cases). Those spots were seen more frequently in female and advanced stage of cirrhosis. The number of spot(s) increased also in advanced liver cirrhosis. Serum Ca, P and PTH were in normal range. All of three vitamin D/sub 3/ fractions decreased and especially 1,25 (OH)/sub 2/D/sub 3/ was depressed more in scinti-positive cases. Metacarpal bone X-p with an alumimum step wedge as a reference was analyzed by a microdensitometry (MD) method (Inoue T et al) and the pattern of osteopathy (i.e. porosis, malacia and poromalacia) was examined according to Sumi Y et al. MD method was not known yet if there was any definite correlation with bone scintigraphy and the osteopathic pattern belonged to border categories. In conclusion, more attension on hepatic osteodystrophy will be significantly necessary due to the fact that it has been found very frequently in liver cirrhosis. 99m Tc MDP bone scintigraphy is a good means for detection of the hepatic osteodystrophy.

  16. Liver cirrhosis and diabetes: Risk factors, pathophysiology, clinical implications and management

    Institute of Scientific and Technical Information of China (English)

    Diego Garcia-Compean; Joel Omar Jaquez-Quintana; Jose Alberto Gonzalez-Gonzalez; Hector Maldonado-Garza

    2009-01-01

    About 30% of patients with cirrhosis have diabetes mellitus (DM). Nowadays, it is a matter for debate whether type 2 DM in the absence of obesity and hypertriglyceridemia may be a risk factor for chronic liver disease. DM,which develops as a complication of cirrhosis, is known as "hepatogenous diabetes". Insulin resistance in muscular and adipose tissues and hyperinsulinemia seem to be the pathophysiologic bases of diabetes in liver disease. An impaired response of the islet β-cells of the pancreas and hepatic insulin resistance are also contributory factors. Non-alcoholic fatty liver disease, alcoholic cirrhosis, chronic hepatitis C (CHC) and hemochromatosis are more frequently associated with DM. Insulin resistance increases the failure of the response to treatment in patients with CHC and enhances progression of fibrosis. DM in cirrhotic patients may be subclinical.Hepatogenous diabetes is clinically different from that of type 2 DM, since it is less frequently associated with microangiopathy and patients more frequently suffer complications of cirrhosis. DM increases the mortality of cirrhotic patients. Treatment of the diabetes is complex due to liver damage and hepatotoxicity of oral hypoglycemic drugs. This manuscript will review evidence that exists in relation to: type 2 DM alone or as part of the metabolic syndrome in the development of liver disease;factors involved in the genesis of hepatogenous diabetes;the impact of DM on the clinical outcome of liver disease; the management of DM in cirrhotic patients and the role of DM as a risk factor for the occurrence and exacerbation of hepatocellular carcinoma.

  17. Effects of recombinant human growth hormone on remnant liver after hepatectomy in hepatocellular carcinoma with cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Shi-Min Luo; Li-Jian Liang; Jia-Ming Lai

    2004-01-01

    AIM: To explore the effects of recombinant human growth hormone (rhGH) on the remnant liver after hepatectomy in hepatocellular carcinoma with liver cirrhosis.METHODS: Twenty-four patients with hepatocellular carcinoma who underwent hepatectomy were randomly divided into 2groups: parenteral nutrition (PN) group (n=12) and rhGH+PN group (n=12). Liver function, blood glucose, AFP, serum prealbumin and transferrin were detected before operation,at post-operative d 1 and d 6. Albumin (ALB) mRNA in liver biopsy specimens was detected by RT-PCR at post-operative d 6. Liver Ki67 immunohistochemical staining was studied.RESULTS: On post-operative d 6, compared with PN group,the levels of blood glucose, serum prealbumin, transferrin,the expression of hepatic ALB mRNA and liver Ki67 labeling index were higher in rhGH+PN group.CONCLUSION: rhGH can improve protein synthesis and liver regeneration after hepatectomy in hepatocellular carcinoma with liver cirrhosis.

  18. Distribution of nitric oxide synthase positive neurons in the substantia nigra of rats with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND:Nitrogen monoxide plays an important role in the physiological activity and pathological process of striatum in substantia nigra, and the nitric oxide synthase in substantia nigra may have characteristic changes after liver cirrhosis.OBJECTIYE: To observe the distribution and forms of nitric oxide synthase (NOS) positive neurons and fibers in substantia nigra of rats with liver cirrhosis.DESIGN: A comparative observational experiment.SETTINGS: Beijing Friendship Hospital; Capital Medical University.MATERIALS: Twenty 4-month-old male Wistar rats (120 - 150 g) of clean grade, were maintained in a 12-hour light/dark cycle at a constant temperature with free access to standard diet and water. Cryostat microtome (LEICA, Germany); All the reagents were purchased from Sigma Company.METHODS: The experiment was carried out in the Department of Anatomy (key laboratory of Beijing city),Capital Medical University from July 2000 to March 2002. The rats were randomly divided into normal group (n=10) and liver fibrosis group (n=10). Rats in the liver fibrosis group were subcutaneously injected with 60% CCl4 oil at a dose of 5 mL/kg for the first time, and 3 mL/kg for the next 14 times, twice a week,totally 15 times. Liver fibrosis of grades 5 - 6 was taken as successful models. Whereas rats in the normal group were not given any treatment. Four months after CCl4 treatment, all the rats were anesthetized to remove brain, and frontal frozen serial sections were prepared. The expressions of nitric oxide synthase positive neurons in substantia nigra of rats were observed under inverted microscope. The number and gray scale of cell body of nitric oxide synthase positive neurons in substantia nigra were detected with NADPH-diaphorase staining.MAIN OUTCOME MEASURES: ①Number and gray scale of cell body of nitric oxide synthase positive neurons in substantia nigra; ②Expressions of nitric oxide synthase positive neurons in substantia nigra.RESULTS: All the 20 rats were

  19. Recombinant factor VIIa improves clot formation but not fibrolytic potential in patients with cirrhosis and during liver transplantation

    NARCIS (Netherlands)

    Lisman, T; Leebeek, FWG; Meijer, K; Van Der Meer, J; Nieuwenhuis, HK; De Groot, PG

    2002-01-01

    Cirrhosis is associated with a bleeding tendency, which is particularly pronounced during orthotopic liver transplantation (OLT). A novel approach to treating the bleeding diathesis of patients with cirrhosis is administration of recombinant factor VIIa (rFVIIa). This study examined whether the effi

  20. Dysregulation of vascular contractile signaling in liver cirrhosis : Rho-kinase as molecular basis for portal hypertension

    NARCIS (Netherlands)

    Hennenberg, Martin

    2007-01-01

    Cirrhosis of the liver is associated with the development of portal hypertension. The increase in portal pressure results from hernodynamic and vascular abnormalities ccurlng during cirrhosis (1-6). These are an increased splanchnic flaw due to persistent mesenteric vasodilation, and an impaired por

  1. Body Posture Angle Affects the Physiological Indices of Patients With Liver Cirrhosis Ascites.

    Science.gov (United States)

    Hsu, Wen-chuan; Ho, Lun-hui; Lin, Mei-hsiang; Chiu, Hsiu-ling

    2016-01-01

    The study objective was to compare the effect of different angles of lying positions on the physiological indices of patients with cirrhosis ascites. Chronic liver disease and cirrhosis were ranked 9th among the top 10 causes of death. Ascites is the most common cirrhosis comorbidity. Body posture can affect pulmonary ventilation and arterial oxygen partial pressure, making it an important clinical nursing intervention significantly affecting patient recovery. This was a quasi-experimental study design. From a medical center in Taiwan, 252 patients with cirrhosis ascites were recruited. Subjects were randomly divided into three groups by bed angle: 15°, 30°, and 45°. Physiological indices were measured at 5, 10, 15, 20, 25, and 30 minutes to determine any changes in heart rate, respiration rate, and oxygenation saturation. Data analysis included descriptive statistics and the generalized estimating equation for statistical analysis with significance set at α= 0.05. After controlling for confounding variables, the three groups differed significantly in heart rate at 20, 25, and 30 minutes, oxygenation saturations at 15 and 20 minutes, and respiration rate at 5 and 10 minutes (α< 0.05). Body posture can affect pulmonary ventilation and arterial oxygen partial pressure and is thus an important clinical nursing intervention that significantly affects the recovery of patients. When caring for patients with cirrhosis ascites, nurses should help patients to choose the most comfortable angle for them with no particular restrictions. Our results can be used to guide nurses in making a plan for health education and nursing that improves the quality of care for patients with chronic liver disease and cirrhosis patients with ascites.

  2. Is magnetic resonance imaging of hepatic hemangioma any different in liver fibrosis and cirrhosis compared to normal liver?

    Energy Technology Data Exchange (ETDEWEB)

    Duran, Rafael, E-mail: rafael.duran@chuv.ch [Centre Hospitalier Universitaire Vaudois, University of Lausanne, Diagnostic and Interventional Radiology, Lausanne (Switzerland); Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy (France); Ronot, Maxime, E-mail: Maxime.ronot@bjn.aphp.fr [Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy (France); University Paris Diderot, Sorbonne Paris Cité, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, CRB3 Paris (France); Di Renzo, Sara, E-mail: Direnzo.sara@gmail.com [Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy (France); Gregoli, Bettina, E-mail: Bettinagregoli@yahoo.it [Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy (France); Van Beers, Bernard E., E-mail: Bernard.van-beers@bjn.aphp.fr [Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy (France); Vilgrain, Valérie, E-mail: Valerie.vilgrain@bjn.aphp.fr [Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy (France); University Paris Diderot, Sorbonne Paris Cité, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, CRB3 Paris (France)

    2015-05-15

    Highlights: • Hemangiomas were similar in patients with or without chronic liver disease on MRI. • Decrease in size & number of hemangiomas could start before the onset of cirrhosis. • T2 shine-through effect was less frequently observed in cirrhosis. - Abstract: Purpose: To compare qualitative and quantitative magnetic resonance (MR) imaging characteristics of hepatic hemangiomas in patients with normal, fibrotic and cirrhotic livers. Materials and methods: Retrospective, institutional review board approved study (waiver of informed consent). Eighty-nine consecutive patients with 231 hepatic hemangiomas who underwent liver MR imaging for lesion characterization were included. Lesions were classified into three groups according to the patients’ liver condition: no underlying liver disease (group 1), fibrosis (group 2) and cirrhosis (group 3). Qualitative and quantitative characteristics (number, size, signal intensities on T1-, T2-, and DW MR images, T2 shine-through effect, enhancement patterns (classical, rapidly filling, delayed filling), and ADC values) were compared. Results: There were 160 (69%), 45 (20%), and 26 (11%) hemangiomas in groups 1, 2 and 3, respectively. Lesions were larger in patients with normal liver (group 1 vs. groups 2 and 3; P = .009). No difference was found between the groups on T2-weighted images (fat-suppressed fast spin-echo (P = .82) and single-shot (P = .25)) and in enhancement patterns (P = .56). Mean ADC values of hemangiomas were similar between groups 1, 2 and 3 (2.11 ± .52 × 10{sup −3} mm{sup 2}/s, 2.1 ± .53 × 10{sup −3} mm{sup 2}/s and 2.14 ± .44 × 10{sup −3} mm{sup 2}/s, P = 87, respectively). T2 shine-through effect was less frequently observed in cirrhosis (P = .02). Conclusion: MR imaging characteristics of hepatic hemangioma were similar in patients with normal compared to fibrotic and cirrhotic livers. Smaller lesion size was observed with liver disease and less T2 shine-through effect was seen in

  3. Hyperammonemia Is Associated with Increasing Severity of Both Liver Cirrhosis and Hepatic Encephalopathy

    Directory of Open Access Journals (Sweden)

    Abidullah Khan

    2016-01-01

    Full Text Available Background. Hyperammonemia resulting from chronic liver disease (CLD can potentially challenge and damage any organ system of the body, particularly the brain. However, there is still some controversy regarding the diagnostic or prognostic values of serum ammonia in patients with over hepatic encephalopathy, especially in the setting of acute-on-chronic or chronic liver failure. Moreover, the association of serum ammonia with worsening Child-Pugh grade of liver cirrhosis has not been studied. Objective. This study was conducted to solve the controversy regarding the association between hyperammonemia and cirrhosis, especially hepatic encephalopathy in chronically failed liver. Material and Methods. In this study, 171 cirrhotic patients had their serum ammonia measured and analyzed by SPSS version 16. Chi-squared test and one-way ANOVA were applied. Results. The study had 110 male and 61 female participants. The mean age of all the participants in years was 42.33±7.60. The mean duration (years of CLD was 10.15±3.53 while the mean Child-Pugh (CP score was 8.84±3.30. Chronic viral hepatitis alone was responsible for 71.3% of the cases. Moreover, 86.5% of participants had hepatic encephalopathy (HE. The frequency of hyperammonemia was 67.3%, more frequent in males (N=81, z-score = 2.4, and P<0.05 than in females (N=34, z-score = 2.4, and P<0.05, and had a statistically significant relationship with increasing CP grade of cirrhosis (χ2(2 = 27.46, P<0.001, Phi = 0.40, and P<0.001. Furthermore, serum ammonia level was higher in patients with hepatic encephalopathy than in those without it; P<0.001. Conclusion. Hyperammonemia is associated with both increasing Child-Pugh grade of liver cirrhosis and hepatic encephalopathy.

  4. Splenectomy Causes 10-Fold Increased Risk of Portal Venous System Thrombosis in Liver Cirrhosis Patients.

    Science.gov (United States)

    Qi, Xingshun; Han, Guohong; Ye, Chun; Zhang, Yongguo; Dai, Junna; Peng, Ying; Deng, Han; Li, Jing; Hou, Feifei; Ning, Zheng; Zhao, Jiancheng; Zhang, Xintong; Wang, Ran; Guo, Xiaozhong

    2016-07-19

    BACKGROUND Portal venous system thrombosis (PVST) is a life-threatening complication of liver cirrhosis. We conducted a retrospective study to comprehensively analyze the prevalence and risk factors of PVST in liver cirrhosis. MATERIAL AND METHODS All cirrhotic patients without malignancy admitted between June 2012 and December 2013 were eligible if they underwent contrast-enhanced CT or MRI scans. Independent predictors of PVST in liver cirrhosis were calculated in multivariate analyses. Subgroup analyses were performed according to the severity of PVST (any PVST, main portal vein [MPV] thrombosis >50%, and clinically significant PVST) and splenectomy. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported. RESULTS Overall, 113 cirrhotic patients were enrolled. The prevalence of PVST was 16.8% (19/113). Splenectomy (any PVST: OR=11.494, 95%CI=2.152-61.395; MPV thrombosis >50%: OR=29.987, 95%CI=3.247-276.949; clinically significant PVST: OR=40.415, 95%CI=3.895-419.295) and higher hemoglobin (any PVST: OR=0.974, 95%CI=0.953-0.996; MPV thrombosis >50%: OR=0.936, 95%CI=0.895-0.980; clinically significant PVST: OR=0.935, 95%CI=0.891-0.982) were the independent predictors of PVST. The prevalence of PVST was 13.3% (14/105) after excluding splenectomy. Higher hemoglobin was the only independent predictor of MPV thrombosis >50% (OR=0.952, 95%CI=0.909-0.997). No independent predictors of any PVST or clinically significant PVST were identified in multivariate analyses. Additionally, PVST patients who underwent splenectomy had a significantly higher proportion of clinically significant PVST but lower MELD score than those who did not undergo splenectomy. In all analyses, the in-hospital mortality was not significantly different between cirrhotic patient with and without PVST. CONCLUSIONS Splenectomy may increase by at least 10-fold the risk of PVST in liver cirrhosis independent of severity of liver dysfunction.

  5. Association of serum level of growth differentiation factor 15 with liver cirrhosis and hepatocellular carcinoma.

    Science.gov (United States)

    Liu, Xiuying; Chi, Xiumei; Gong, Qiaoling; Gao, Lei; Niu, Yuqiang; Chi, Xiaojing; Cheng, Min; Si, Youhui; Wang, Maorong; Zhong, Jin; Niu, Junqi; Yang, Wei

    2015-01-01

    Hepatocellular carcinoma (HCC) and liver cirrhosis are associated with high mortality worldwide. Currently, alpha-fetoprotein (AFP) is used as a standard serum marker for the detection of HCC, but its sensitivity and specificity are unsatisfactory, and optimal diagnostic markers for cirrhosis are lacking. We previously reported that growth differentiation factor 15 (GDF15) was significantly induced in HCV-infected hepatocytes. This study aimed to investigate GDF15 expression and its correlation with hepatitis virus-related liver diseases. A total of 412 patients with various liver diseases were studied. Healthy and Mycobacterium tuberculosis-infected subjects were included as controls. Serum and tissue GDF15 levels were measured. Serum GDF15 levels were significantly increased in patients with HCC (6.66±0.67 ng/mL, pcirrhosis (6.51±1.47 ng/mL, pHBV and HCV carriers were moderately elevated (1.34±0.19 ng/mL and 2.13±0.53 ng/mL, respectively). Compared with HBV or HCV carriers, GDF15 had a sensitivity of 63.1% and a specificity of 86.6% at the optimal cut-off point of 2.463 ng/mL in patients with liver cirrhosis or HCC. In HCC patients, the area under the receiver operating curve was 0.84 for GDF15 and 0.76 for AFP, but 0.91 for the combined GDF15 and AFP. Serum GDF15 levels did not significantly differ between the high-AFP and low-AFP groups. GDF15 protein expression in HCC was significantly higher than that in the corresponding adjacent paracarcinomatous tissue and normal liver. Using a combination of GDF15 and AFP will improve the sensitivity and specificity of HCC diagnosis. Further research and the clinical implementation of serum GDF15 measurement as a biomarker for HCC and cirrhosis are recommended.

  6. Low bone mineral density in noncholestatic liver cirrhosis: prevalence, severity and prediction

    Directory of Open Access Journals (Sweden)

    Figueiredo Fátima Aparecida Ferreira

    2003-01-01

    Full Text Available BACKGROUND: Metabolic bone disease has long been associated with cholestatic disorders. However, data in noncholestatic cirrhosis are relatively scant. AIMS: To determine prevalence and severity of low bone mineral density in noncholestatic cirrhosis and to investigate whether age, gender, etiology, severity of underlying liver disease, and/or laboratory tests are predictive of the diagnosis. PATIENTS/METHODS: Between March and September/1998, 89 patients with noncholestatic cirrhosis and 20 healthy controls were enrolled in a cross-sectional study. All subjects underwent standard laboratory tests and bone densitometry at lumbar spine and femoral neck by dual X-ray absorptiometry. RESULTS: Bone mass was significantly reduced at both sites in patients compared to controls. The prevalence of low bone mineral density in noncholestatic cirrhosis, defined by the World Health Organization criteria, was 78% at lumbar spine and 71% at femoral neck. Bone density significantly decreased with age at both sites, especially in patients older than 50 years. Bone density was significantly lower in post-menopausal women patients compared to pre-menopausal and men at both sites. There was no significant difference in bone mineral density among noncholestatic etiologies. Lumbar spine bone density significantly decreased with the progression of liver dysfunction. No biochemical variable was significantly associated with low bone mineral density. CONCLUSIONS: Low bone mineral density is highly prevalent in patients with noncholestatic cirrhosis. Older patients, post-menopausal women and patients with severe hepatic dysfunction experienced more advanced bone disease. The laboratory tests routinely determined in patients with liver disease did not reliably predict low bone mineral density.

  7. Impact of antithrombin Ⅲ on hepatic and intestinal microcirculation in experimental liver cirrhosis and bowel inflammation: An in vivo analysis

    Institute of Scientific and Technical Information of China (English)

    Sasa-Marcel Maksan; Zilfi (U)lger; Martha Maria Gebhard; Jan Schmidt

    2005-01-01

    AIM: To analyze the hepatic and intestinal microcirculation in an animal model of liver cirrhosis and inflammatory bowel disease (IBD) and to characterize the anti-inflammatory action of antithrombin Ⅲ (ATⅢ) on leukocyte kinetics and liver damage.METHODS: Hepatic and intestinal microcirculation was investigated by intravital videomicroscopy. Standardized models of experimental chronic liver cirrhosis and bowel inflammation were employed. Animals were divided into four groups (n = 6/group): controls, animals with cirrhosis,animals with cirrhosis and IBD, animals with cirrhosis and IBD treated with ATⅢ.RESULTS: Cirrhosis facilitated leukocyte rolling and sticking in hepatic sinusoids (1.91±0.28 sticker/μm vs0.5±0.5 sticker/μm in controls, P<0.05). The effect enhanced in animals with cirrhosis and IBD (5.4±1.65sticker/μm), but reversed agter ATⅢ application (3.97±1.04sticker/μm, P<0.05). Mucosal blood flow showed no differences in cirrhotic animals and controls (5.3±0.31nL/min vs5.4±0.25 nL/min) and was attenuated in animals with cirrhosis and IBD significantly (3.49±0.6 nL/min). This effect was normalized in the treatment group (5.13±0.4nL/min, P<0.05). Enzyme values rose during development of cirrhosis and bowel inflammation, and reduced after ATⅢ application (P<0.05).CONCLUSION: Liver cirrhosis in the presence of IBD leads to a significant reduction in mucosal blood flow and an increase in hepatic leukocyte adherence with consecutive liver injury, which can be prevented by administration of ATⅢ.

  8. Detection of hepatopulmonary syndrome in patient with liver cirrhosis

    OpenAIRE

    Davorin Dajčman

    2006-01-01

    Background: Hepatopulmonary syndrome (HPS) is a pulmonary vascular disorder, complicating hepatic disease, and is responsible for an increased morbidity and mortality among patients awaiting liver transplantation. Nowadays, it is recognized as an independent risk factor for death in this patient population. The severity of hypoxemia and the advanced stage of the liver dysfunction are determinants for the prognosis. Therefore, the possibility to be successful, thus improving survival, consists...

  9. A liver cirrhosis classification on B-mode ultrasound images by the use of higher order local autocorrelation features

    Science.gov (United States)

    Sasaki, Kenya; Mitani, Yoshihiro; Fujita, Yusuke; Hamamoto, Yoshihiko; Sakaida, Isao

    2017-02-01

    In this paper, in order to classify liver cirrhosis on regions of interest (ROIs) images from B-mode ultrasound images, we have proposed to use the higher order local autocorrelation (HLAC) features. In a previous study, we tried to classify liver cirrhosis by using a Gabor filter based approach. However, the classification performance of the Gabor feature was poor from our preliminary experimental results. In order accurately to classify liver cirrhosis, we examined to use the HLAC features for liver cirrhosis classification. The experimental results show the effectiveness of HLAC features compared with the Gabor feature. Furthermore, by using a binary image made by an adaptive thresholding method, the classification performance of HLAC features has improved.

  10. Expression of leptin and leptin receptor during the development of liver fibrosis and cirrhosis.

    Science.gov (United States)

    Otte, C; Otte, J-M; Strodthoff, D; Bornstein, S R; Fölsch, U R; Mönig, H; Kloehn, S

    2004-01-01

    Leptin is involved in the regulation of food intake and is mainly secreted by adipocytes. Major secretagogues are cytokines such as TNF-alpha or IL-1. Leptin in turn upregulates inflammatory immune responses. Elevated leptin serum levels have been detected in patients with liver cirrhosis, a disease frequently associated with elevated levels of circulating cytokines as well as hypermetabolism and altered body weight. Recently, leptin has been detected in activated hepatic stellate cells in vitro and an involvement of leptin in liver fibrogenisis has been suggested. The current study was designed to further clarify the role of leptin in liver disease by characterizing leptin and leptin receptor expression in the development and onset of experimental liver fibrosis. Liver fibrosis and cirrhosis was induced in rats by use of phenobarbitone and increasing doses of CCl (4). Leptin and leptin receptor mRNA expression was determined by semiquantitative RT-PCR, protein expression by Western blot analysis and localization of leptin and its receptor by immunohistochemistry. Normal liver tissue does not express leptin, but leptin receptor mRNA. Increasing levels of leptin mRNA were detected in fibrotic and cirrhotic livers correlated to the degree of fibrosis. Leptin receptor mRNA expression was not significantly altered in damaged livers. Increasing levels of leptin were detected in fibrotic and cirrhotic livers, whereas protein expression of the receptor remained unchanged. Throughout different stages of liver fibrosis, leptin immunoreactivity was localized in activated hepatic stellate cells only, whereas immunoreactivity for the receptor was mainly seen on hepatocytes. In conclusion, leptin is expressed at increasing levels in activated hepatic stellate cells in vivo, which may therefore be a source of increased leptin tissue and serum levels contributing to the pathophysiology and morphological changes of chronic liver disease.

  11. Effect of long-term refeeding on protein metabolism in patients with cirrhosis of the liver

    DEFF Research Database (Denmark)

    Kondrup, J; Nielsen, K; Juul, A

    1997-01-01

    studies. Initial and final whole-body protein metabolism was measured in the fed state by primed continuous [15N]glycine infusion. Refeeding caused a statistically significant increase of about 30% in protein synthesis in both studies while protein degradation was only slightly affected. The increase......Patients with cirrhosis of the liver require an increased amount of protein to achieve N balance. However, the utilization of protein with increased protein intake, i.e. the slope from regression analysis of N balance v. intake, is highly efficient (Nielsen et al. 1995). In the present study......, protein requirement and protein utilization were investigated further by measuring protein synthesis and degradation. In two separate studies, five or six patients with cirrhosis of the liver were refed on a balanced diet for an average of 2 or 4 weeks. Protein and energy intakes were doubled in both...

  12. [Gender difference of clinical features in Japanese patients with alcoholic liver cirrhosis].

    Science.gov (United States)

    Kawashima, Osamu; Ohata, Mitsuru; Sakamoto, Kazuhiko; Hashimoto, Kenichi; Nakajima, Hisato; Yamauchi, Masayoshi

    2003-02-01

    Gender difference of alcohol intake and laboratory data was investigated in 165 Japanese patients with alcoholic liver cirrhosis. Mean age of first drinking and habitual drinking were higher in female. Duration of drinking was shorter in female. Although cumulative alcohol intake was larger in male, mean daily alcohol intake did not differ in both gender. Moreover, daily alcohol intake adjusted to body weight was significantly larger in female. Body mass index, serum levels of total protein, albumin and cholinesterase were significantly decreased in female. Platelet counts on admission did not differ in both gender. However, it was significantly increased in female after one month abstinence. C reactive protein, ammonia and serum levels of total bilirubin were significantly higher in female as compared to male. In conclusion, female alcoholics seems to progress to liver cirrhosis earlier because of high daily alcohol intake adjusted to body weight, poor nutritional condition and inflammation caused by endotoxin.

  13. A Novel Fibrosis Index Comprising a Non-Cholesterol Sterol Accurately Predicts HCV-Related Liver Cirrhosis

    DEFF Research Database (Denmark)

    Ydreborg, Magdalena; Lisovskaja, Vera; Lagging, Martin

    2014-01-01

    Diagnosis of liver cirrhosis is essential in the management of chronic hepatitis C virus (HCV) infection. Liver biopsy is invasive and thus entails a risk of complications as well as a potential risk of sampling error. Therefore, non-invasive diagnostic tools are preferential. The aim of the pres......Diagnosis of liver cirrhosis is essential in the management of chronic hepatitis C virus (HCV) infection. Liver biopsy is invasive and thus entails a risk of complications as well as a potential risk of sampling error. Therefore, non-invasive diagnostic tools are preferential. The aim...... of the present study was to create a model for accurate prediction of liver cirrhosis based on patient characteristics and biomarkers of liver fibrosis, including a panel of non-cholesterol sterols reflecting cholesterol synthesis and absorption and secretion. We evaluated variables with potential predictive...

  14. Nutritional problems of patients suffering from cirrhosis of the liver

    Directory of Open Access Journals (Sweden)

    C. Passaglia

    2013-05-01

    Full Text Available BACKGROUND Liver plays a critical role in energetic metabolism and in many other biochemical processes; that’s why advanced liver disease is frequently associated with protein-calorie malnutrition, that compromises clinical outcome of these patients. Unfortunately, assessing nutritional status in patients with liver disease is difficult because of fluid excess and reduction of the protein synthesis. Multiple factors are involved in the cause of protein-calorie malnutrition; in addition to well-described factors of maldigestion and malabsorption, the importance of poor dietary intake cannot be overemphasized. CONCLUSIONS Nitrogen economy can be improved in the majority of patients by frequent small meals and by special dietary supplements in those who are intolerant of proteins. Nutrient intake can be increased by supplemental enteral nutrition and can be ensured by tube or parenteral feeding.

  15. Arterial embolization for traumatic lethal lateral abdomi-nal wall hemorrhage in a liver cirrhosis patient

    Institute of Scientific and Technical Information of China (English)

    Seiji Morita; Tomoatsu Tsuji; Takeshi Yamagiwa; Hiroyuki Otsuka; Sadaki Inokuchi

    2009-01-01

    @@ B lood loss due to abdominal wall hemorrhage is generally managed conservatively. Further, abdominal wall hemorrhage rarely develops into a life-threatening condition. However, it is difficult to sur-gically achieve hemostasis. We report the case of a liver cirrhosis patient with life-threatening abdominal wall hemorrhage that developed as a result of a minor trauma and was successfully treated with arterial embolization (AE).

  16. An unusual cause of spontaneous bacterial peritonitis due to Campylobacter fetus with alcoholic liver cirrhosis

    OpenAIRE

    Hadano, Yoshiro; Iwata, Hiroyoshi

    2013-01-01

    A 40-year-old man with severe alcoholic liver cirrhosis with a 2-day history of fatigue and abdominal pain was admitted. He reported eating sushi and sliced raw chicken a few days previously. His abdomen was distended, with shifting dullness. Based on the patient's history, physical examination and the results of abdominocentesis, he was diagnosed as having spontaneous bacterial peritonitis; blood and ascitic fluid cultures were positive for Campylobacter fetus. The patient was started on tre...

  17. Blood ammonia levels in liver cirrhosis: a clue for the presence of portosystemic collateral veins

    OpenAIRE

    Tripodi Francesca; Milan Graziella; de Leone Annalisa; Giaquinto Sabrina; Esposito Pasquale; Citro Vincenzo; Tarantino Giovanni; Cirillo Michele; Lobello Roberto

    2009-01-01

    Abstract Background Portal hypertension leads to the formation of portosystemic collateral veins in liver cirrhosis. The resulting shunting is responsible for the development of portosystemic encephalopathy. Although ammonia plays a certain role in determining portosystemic encephalopathy, the venous ammonia level has not been found to correlate with the presence or severity of this entity. So, it has become partially obsolete. Realizing the need for non-invasive markers mirroring the presenc...

  18. Comparative Study of TCM Syndrome Scale for Liver Disease and Chronic Liver Disease Questionnaire Based on Assessment of Posthepatitic Cirrhosis

    Directory of Open Access Journals (Sweden)

    Hua Zhang

    2012-01-01

    Full Text Available Objective. To compare and analyze the relevance and applied value of chronic liver disease questionnaire (CLDQ and Traditional Chinese Medicine liver disease questionnaire (TCMLDQ in patients with posthepatitic cirrhosis. Methods. The data of 146 patients' scales of CLDQ and TCMLDQ which based on the characteristics of chinese medical symptoms were collected. We made comparative analysis of the relationship between these two scales by the linear regression model and canonical correlation method and evaluated the advantages and disadvantages of two scales about its items setting and dimension definition. Result. There is a negative correlation in total scores between the two scales and the linear regression equation: CLDQ=239.38−1.232TCMLDQ. The further canonical correlation analysis was used to analyze the two extracted canonical correlative variables with significances (P<0.05, and the results showed that the overall negative correlation between the two scales mainly came from contributions of both the four dimensions of TCMLDQ (CS, GSYX, GYPX, and OS and the five dimensions of CLDQ (AS, FA, SS, AC, and EF. Conclusion. These two scales have good consistency in the evaluation of severity and life quality of liver cirrhosis patients, so we suggested that TCMLDQ can be used to evaluate the severity and life quality of patients with posthepatitic cirrhosis.

  19. Erythropoietin in liver cirrhosis: Two questions without answers

    Institute of Scientific and Technical Information of China (English)

    Cosimo Marcello Bruno; Claudio Sciacca; Danila Cilio; Gaetano Bertino; Rinaldo Pellicano

    2005-01-01

    @@ TO THE EDITOR In a recent paper[1], and in a subsequent letter[2], Tacke et al. reported the investigation of plasma erythropoietin (Epo) levels in patients affected by chronic liver disease of various aetiologies. The authors also compared[2] their data to our previous work[3]. The results show a substantial agreement but also some important differences between the two works. We would like to highlight, from our point of view, this issue. Both the papers demonstrated increased Epo values in anaemic cirrhotic subjects when compared to healthy controls and non-anemic patients with liver disease.

  20. Meta-Analysis of the Clinical Value of Danshen Injection and Huangqi Injection in Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Changtai Zhu

    2013-01-01

    Full Text Available Objective. To evaluate the clinical value of Danshen injection and Huangqi injection for the treatment of liver cirrhosis. Methods. The Chinese Biomedical Literature Database (CBM, Chinese Scientific Journals Full-Text Database (VIP, Wanfang Database, China National Knowledge Infrastructure (CNKI, PubMed, and EMBASE database were searched to collect the literatures about the randomized controlled trials involving the treatment of liver cirrhosis with Danshen injection combined with Huangqi injection, and the data analyses were performed using RevMan 4.2 software. Results. A total of 11 studies involving 1086 patients (trials group: 554 cases, control group: 532 cases were included in this study. Compared with those in control group, the meta-analysis showed-that the total effectiveness rate and the level of serum albumin increased, while serum total bilirubin, alanine transmninase, type III procollagen, hyaluronic acid, laminin, and type-IV collagen decreased in trials group. The Jadad score ranged from 1 to 2 and the funnel plot analysis suggests that publication bias may occur. Conclusions. Danshen injection combined with Huangqi injection may promote the curative efficacy of liver cirrhosis, which is a promising novel treatment approach. The exact outcome needs to perform rigorously designed, multicenter, and large randomized controlled trials.

  1. The role of lamivudine in the treatment of HBe antigen negative liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Simonović-Babić Jasmina

    2006-01-01

    Full Text Available Introduction. Lamivudine is effective in suppressing hepatitis B virus replication and hepatic necroinflammatory activity. Patients with HBV-related chronic liver disease often present with hepatic decompensation and are not eligible for interferon therapy. The effectiveness of antiviral therapy in preventing disease progression in patients with hepatitis B cirrhosis is unknown. The aim of this study was to evaluate the effectiveness of lamivudine treatment in patients with cirrhosis due to chronic hepatitis B. Material and methods. The study included 24 patients with cirrhosis B. During one year, all of them were treated with Lamivudine (100 mg/day. All patients undenvent routine laboratory tests and abdominal ultrasound. After that, they were followed-up from 1-15 months. Results and discussion. Most patients presented with improved general condition. We also noticed a reduction in SBP, ALT level, bilirubin level, hepatic encephalopathy and ascites. Five patients died, due to HCC, and two due to variceal bleeding. There was no significant improvement in liver synthetic function. Conclusion. Lamivudine is highly effective in reducing viral load in HBeAg-negative patients significantly improving the clinical and bio­chemical status of liver functions. .

  2. A nutritional risk screening model for patients with liver cirrhosis established using discriminant analysis

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    ZHU Binghua

    2017-06-01

    Full Text Available ObjectiveTo establish a nutritional risk screening model for patients with liver cirrhosis using discriminant analysis. MethodsThe clinical data of 273 patients with liver cirrhosis who were admitted to Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2015 to March 2016 were collected. Body height, body weight, upper arm circumference, triceps skinfold thickness, subscapular skinfold thickness, and hand grip strength were measured and recorded, and then body mass index (BMI and upper arm muscle circumference were calculated. Laboratory markers including liver function parameters, renal function parameters, and vitamins were measured. The patients were asked to complete Nutritional Risk Screening 2002 and Malnutrition Universal Screening Tool (MUST, and a self-developed nutritional risk screening pathway was used for nutritional risk classification. Observation scales of the four diagnostic methods in traditional Chinese medicine were used to collect patients′ symptoms and signs. Continuous data were expressed as mean±SD (x±s; an analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. Discriminant analysis was used for model establishment, and cross validation was used for model verification. ResultsThe nutritional risk screening pathway for patients with liver cirrhosis was used for the screening of respondents, and there were 49 patients (17.95% in non-risk group, 49 (17.95% in possible-risk group, and 175 (64.10% in risk group. The distance criterion function was used to establish the nutritional risk screening model for patients with liver cirrhosis: D1=-11.885+0.310×BMI+0150×MAC+0.005×P-Alb-0.001×Vit B12+0.103×Vit D-0.89×ascites-0.404×weakness-0.560×hypochondriac pain+0035×dysphoria with feverish sensation (note: if a patient has ascites, weakness, hypochondriac pain

  3. Irreformable hyponatremia: a case report of pituitary dysfunction with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    ZHONG Jing; CHEN Yan; WANG Liang-jing

    2011-01-01

    The diagnosis of pituitary dysfunction is very difficult in inpatients with liver cirrhosis, because the symptoms are intricate and similar. We here report a case of a male patient complaining of fatigue and anorexia for more than two years. On duration of hospital stay, hyponatremia was irreformable. Magnetic resonance imaging of the pituitary revealed the presence of cystic pituitary and abnormal signal in the left frontal lobe. The patient was also suspected to be infective endocarditis. Recognition of this unusual complication of this condition is important for the patients with chronic liver disease.

  4. Intestinal first pass metabolism of midazolam in liver cirrhosis --effect of grapefruit juice

    DEFF Research Database (Denmark)

    Andersen, Vibeke; Pedersen, Natalie; Larsen, Niels-Erik

    2002-01-01

    Grapefruit juice inhibits CYP3A4 in the intestinal wall leading to a reduced intestinal first pass metabolism and thereby an increased oral bioavailability of certain drugs. For example, it has been shown that the oral bioavailability of midazolam, a CYP3A4 substrate, increased by 52% in healthy...... subjects after ingestion of grapefruit juice. However, this interaction has not been studied in patients with impaired liver function. Accordingly, the effect of grapefruit juice on the AUC of midazolam and the metabolite alpha-hydroxymidazolam was studied in patients with cirrhosis of the liver....

  5. Clinical Analysis in 75 Patients with Decompensated Liver Cirrhosis of Hepatitis and Alcoholic Cirrhosis%75例肝炎肝硬化及酒精性肝硬化失代偿期临床比较分析

    Institute of Scientific and Technical Information of China (English)

    张泽进; 韦杏; 陈自仁; 吴朝文

    2013-01-01

    Objective To observe clinical manifestion of decompensated liver cirrhosis of hepatitis and alcoholic cirrhosis. Methods 75 patients with decompensateed liver cirrhosis was chosen, 38 cases of decompensated liver cirrhosis of hepatitis, and 37 cases of decompensated alcoholic cirrhosis. Then platelet,liver function,coagulative function and complication were examined. Results The data of decompensateed liver cirrhosis of platelet, liver function, coagulative function and complication were worse than those of alcoholic cirrhosis (P < 0.05). Conclusion The condition of patient with liver cirrhosis was worse than that of alcoholic cirrhosis, and the prognosis of liver cirrhosis was bad.%目的 比较肝炎肝硬化(viral cirrhosis,VC)失代偿期及酒精性肝硬化(alcoholic cirrhosis,AC)失代偿期临床特征.方法 选择38例为VC患者,37例AC患者,观察两组患者血小板(PLT)、肝功能[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)、胆碱酯酶(ChE)]、凝血功能[凝血酶原时间(PT)、凝血活酶时间(APTT)、凝血酶时间(TT)、血浆纤维蛋白原(FIB)]及并发症等,并进行比较分析.结果 VC组患者PLT、ALT、AST、ChE、TBil、PT、APTT、TT、FIB及并发症等项目均较AC组较差.结论 VC失代偿期患者较AC失代偿期病情重,预后差.

  6. Assessment of hepatic functional reserve by cirrhosis grading and liver volume measurement using CT

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To explore a method for quantitative assessment of hepatic functional reserve by combining computed tomography (CT) volumetry with CT grading of liver cirrhosis before liver resection in patients with hepatocellular carcinoma.METHODS: CT images of 55 patients undergoing liver resection were studied prospectively. The degree of liver cirrhosis was referred as "CT grade" and the percentage of remnant liver volume (PRLV) [PRLV = predicted RLV/predicted total liver volume (PTLV) × 100%;PTLV (mL) = 121.75 + 16.49 × body mass (kg)] were calculated by adding slice by slice of CT liver images.The postoperative RLV, pathologic stages of liver fibrosis in non-tumor area and survival time in these cases were analyzed.RESULTS: There was a significant difference in survival time between the group with PRLV ≤ 50% and the group with PRLV > 50% (χ2= 4.988, P = 0.026), and between the group with CT grade 0/1 and the group with CT grade 2/3 (χ2= 5.429, P = 0.026). With combination of the both parameters, an oblique line was identified according to the distribution of 32 survivors versus 23 deceased subjects. The mortality rate above the line was 7.1% (1/14), and that below the line was 53.7% (22/41),indicating a significant difference between the two rates (χ2 = 9.281, P = 0.002, P < 0.05).CONCLUSION: PRLV and CT grades are significantly correlated with hepatic functional reserve. The predicted line using these two parameters is useful in candidates undergoing liver resection for judging hepatic functional reserve.

  7. Differential distribution of age and HBV serological markers in liver cirrhosis and non-cirrhotic patients with primary liver cancer

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    XU Xiuhua

    2013-03-01

    Full Text Available ObjectiveTo compare the age distributions and presence of hepatitis B virus (HBV serological markers between primary hepatic cancer (PHC patients with and without liver cirrhosis. MethodsA total of 547 PHC cases were analyzed retrospectively. After dividing into two groups according to liver cirrhosis status, the between-group differences in age and HBV serological markers, such as hepatitis B e antigen (HBeAg status, were statistically compared using the Chi-squared test. ResultsThe number of cirrhotic and non-cirrhotic PHC patients was 265 and 282, respectively. HBV infection was present in 221 cirrhotic PHC patients and 256 non-cirrhotic PHC patients (834% vs. 90.8%. There was a substantial bias in the proportion of males to females in the cirrhotic PHC patients (7.83∶1. The number of PHC patients <60 years old was similar between the cirrhotic and non-cirrhotic groups, but the non-cirrhotic group had significantly more patients >60 years old (P<0.005. In cirrhotic PHC patients, the HBV infection rate was highest in the <40 years old age group (96.7% and the HBeAg serological conversion rate was highest in the 40-60 years old age group (89.5%. In non-cirrhotic PHC patients, the 40-60 years old age group showed the highest HBV infection rate (90.3% but the lowest HBeAg serological conversion rate (80.0%. ConclusionPHC with liver cirrhosis mainly occurred in males, with the HBV infection rate being higher in individuals <60 years old. Non-cirrhotic PHC patients were more often >60 years old. Many of the HBV-infected PHC patients with cirrhosis had high HBeAg serological conversion rate.

  8. Serum Concentrations of Selected Heavy Metals in Patients with Alcoholic Liver Cirrhosis from the Lublin Region in Eastern Poland

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    Andrzej Prystupa

    2016-06-01

    Full Text Available According to the WHO report, alcohol is the third most significant health risk factor for the global population. There are contrary reports about heavy metals concentrations in patients with alcoholic liver cirrhosis. The aim of this study was to investigate serum concentrations of selected heavy metals in patients with alcoholic liver cirrhosis living in the eastern part of Poland according to cirrhosis stage. The participants came from various hospitals of the Lublin region were enrolled. The study group included 46 male and 16 female patients. The control group consisted of 18 healthy individuals without liver disease. High Performance Ion Chromatography was used to determine the concentrations of metal ions (Cd, Zn, Cu, Ni, Co, Mn, and Pb in serum samples. The concentrations of copper, zinc, nickel, and cobalt were found to be significantly lower in patients with alcoholic liver cirrhosis compared to the control group. The serum concentration of cadmium was significantly higher in patients with advanced alcoholic liver cirrhosis compared to the control group. We hypothesize that disorders of metabolism of heavy metals seem to be the outcome of impaired digestion and absorption, which are common in cirrhosis, improper diet, environmental and occupational exposure.

  9. Occult Hepatitis B Virus Related Decompensated Cirrhosis of Liver in Young Males: First Report of Two Cases from Bangladesh

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    Mamun Al-Mahtab

    2008-05-01

    Full Text Available Cryptogenic cirrhosis is a diagnosis of exclusion. Polymerase chain reaction (PCR has demonstrated persistent hepatitis B virus (HBV infection in serum and liver tissue of HBsAg-negative chronic hepatitis, HBsAg-negative cirrhosis, and HBsAg-negative HCC patients. The entity of occult HBV infection is well established. We report two patients with occult HBV related decompensated cirrhosis of liver for the first time from Bangladesh. The first patient is a young male with jaundice and hepato-splenomegaly. The second patient is also a young male with ascites. Both had altered liver function tests. Diagnosis of decompensated cirrhosis of liver was established in both cases and in both the etiology was identified by PCR to be occult HBV infection. In areas with high prevalence of HBV, a diagnosis of "cryptogenic" cirrhosis based on HBsAg testing alone is not adequate. The so called "cryptogenic" but actually occult HBV cirrhotics are suitable candidates for antiviral treatment. Occult HBV infection must be considered in all patients with cryptogenic cirrhosis of liver in areas where HBV infection is prevalent.

  10. Magnitude of peripheral neuropathy in cirrhosis of liver patients from central rural India

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    Jyoti Jain

    2014-01-01

    Full Text Available Context: Cirrhosis of liver is an important cause of morbidity and mortality and if associated with peripheral neuropathy (PN it also poses a huge financial, psychological burden for the patients and their families. Aim: The aim of the present study was to study the magnitude of PN among subjects with cirrhosis of liver presenting to tertiary care teaching hospital in central rural India. Settings and Design: A cross-sectional study was performed in a tertiary care teaching hospital. Materials and Methods: In all patients of cirrhosis of liver irrespective of etiology, aged 15 and above, undergone clinical assessment for peripheral nervous systems damage and confirmed by nerve conduction studies. Statistical Analysis Used: We used chi square test to study associations. P value ≤0.05 was considered as significant. Crude odds ratios were computed to assess the strength of association between independent variables and dependent variables along with their 95% confidence intervals. Results: We included 207 of cirrhosis of liver patients admitted in medicine department from November 2010 through November 2013. Nearly 83% patients were male and 63.2% patients were under the age of 45 years. Common features in these patients were ascites (71% splenomegaly (63.3% pedal edema (61.4% icterus (46.4% tingling (44.9% gastrointestinal bleeding(39.1%, ataxia (26.6%,numbness(26.6%,distal motor weakness (21.7% and paresthesia(20.8%.Among the manifestation of peripheral nerve involvement, loss of ankle reflex was the most common feature in 51.7%, followed by loss of temperature sense 29.5%, loss of vibration sense 20.8%, loss of touch 16.4%, loss of position sense 14.5% and loss of pain in 6.3% of the patients. Peripheral neuropathy was found in 53.6% [95% CI: 46.58- 60.56] study subjects on electrophysiological study. Conclusions: Analysis of electrophysiological study shows that the PN is very common in study subjects with cirrhosis of liver, especially in

  11. Association of serum level of growth differentiation factor 15 with liver cirrhosis and hepatocellular carcinoma.

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    Xiuying Liu

    Full Text Available Hepatocellular carcinoma (HCC and liver cirrhosis are associated with high mortality worldwide. Currently, alpha-fetoprotein (AFP is used as a standard serum marker for the detection of HCC, but its sensitivity and specificity are unsatisfactory, and optimal diagnostic markers for cirrhosis are lacking. We previously reported that growth differentiation factor 15 (GDF15 was significantly induced in HCV-infected hepatocytes. This study aimed to investigate GDF15 expression and its correlation with hepatitis virus-related liver diseases. A total of 412 patients with various liver diseases were studied. Healthy and Mycobacterium tuberculosis-infected subjects were included as controls. Serum and tissue GDF15 levels were measured. Serum GDF15 levels were significantly increased in patients with HCC (6.66±0.67 ng/mL, p<0.0001 and cirrhosis (6.51±1.47 ng/mL, p<0.0001 compared with healthy controls (0.31±0.01 ng/mL, though the GDF15 levels in HBV and HCV carriers were moderately elevated (1.34±0.19 ng/mL and 2.13±0.53 ng/mL, respectively. Compared with HBV or HCV carriers, GDF15 had a sensitivity of 63.1% and a specificity of 86.6% at the optimal cut-off point of 2.463 ng/mL in patients with liver cirrhosis or HCC. In HCC patients, the area under the receiver operating curve was 0.84 for GDF15 and 0.76 for AFP, but 0.91 for the combined GDF15 and AFP. Serum GDF15 levels did not significantly differ between the high-AFP and low-AFP groups. GDF15 protein expression in HCC was significantly higher than that in the corresponding adjacent paracarcinomatous tissue and normal liver. Using a combination of GDF15 and AFP will improve the sensitivity and specificity of HCC diagnosis. Further research and the clinical implementation of serum GDF15 measurement as a biomarker for HCC and cirrhosis are recommended.

  12. Incidence of call stone in liver cirrhosis patients: comparison with genera population

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    Kim, Chul Jjoong; Park, Cheol Min; Park, Seung Chul; Chung, Kyoo Byung; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

    1994-12-15

    We investigated the incidence of gallstone detected by ultrasound in cirrhotic patients, and it was compared with that of the general population. One hundred and seventy seven patients with proven or suspected liver cirrhosis were evaluated sonographic ally to determine the presence of gallstone. We classified 177 cirrhotic patients into A,B, and C by Child classification and investigated the incidence of gallstone for each class. The control group was 363 general population with age distribution and sex-ratio similar to cirrhotic patients.Gallstone was visualized by ultrasound in 32(18.1%) of 177 cirrhotic patients. The incidence of gallstone was 13.1% in Child A, 21.0% in child B, and 20.0% in Child C cirrhotic patients. Overall incidence of gallstone was 3.9% in 363 general population. In summary, the incidence of gallstone was significantly higher in cirrhosis patients than in general population(p<0.01). The patients with moderate and severe cirrhosis showed higher incidence of gallstone than the patients with mild cirrhosis(20.5% vs 13.1%)

  13. Prevalence of Iron deficiency anemia in children with liver cirrhosis: A cross-sectional study

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    Zareifar, Soheila; Dehghani, Seyed Mohsen; Rahanjam, Najmeh; Farahmand Far, Mohammad Reza

    2015-01-01

    Background: Among the many complications reported for cirrhosis, iron deficiency anemia (IDA) has attracted much attention. This type of anemia, in contrast to other types of anemia, is easy to treat prophylactically, but if left untreated can lead to a poor quality of life. The aim of this study was to estimate the hemoglobin and serum iron levels among patients with liver cirrhosis for the early diagnosis of IDA and to avoid unnecessary testing and iron supplementation. Subjects and Methods: In this cross-sectional study, 88 children diagnosed with cirrhosis were included, and the values of hemoglobin, serum iron levels and relationship between serum iron (SI), total iron-binding capacity (TIBC), prothrombine time (PT), international normalization ratio (INR), total and direct bilirubin and hepatic enzymes were estimated using paired t test, Mann-Whitney, Chi-square and Kruskal-Wallis tests. Results: Forty-six (52.3%) of 88 children were girls and 42 (47.7%) were boys. Forty-eight (54.5%) patients had anemia and 8 (9%) had iron deficiency anemia (5 boys, 5.6%, and 3 girls, 3.4%). No relationships were observed between iron deficiency anemia and the patient’s age or gender, whereas there was a relationship between iron deficiency and severity and duration of the disease, although the correlation was not statistically significant. Conclusion: The high frequency of iron deficiency anemia in children with cirrhosis (9%) suggests that timely screening should be used for early diagnosis and treatment. PMID:26261697

  14. Behavior of liver cirrhosis at the "Arnaldo Milian Castro" Hospital from July 2007 to March 2009

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    María Herminia Fajardo González

    2010-08-01

    Full Text Available Background: Liver cirrhosis is among the top ten death causes in the developed world and also in Cuba, so it is important to know its clinical and epidemiological characteristics in order to propose appropriate preventive measures. Objective: To describe the behavior of liver cirrhosis in the "Arnaldo Milian Castro" hospital from July 2007 to March 2009. Method: A descriptive and cross-sectional study in all patients with a liver cirrhosis diagnosis that were undergoing follow-up in the hepatology consultation or died from this cause. As part of the study the medical records were consulted and patients in consultation were interviewed. After applying inclusion and exclusion criteria there was a final sample of 120 cases: 59 patients are alive and 61 of them died. Results: Groups of people from 40-49 years old (32.5%, male sex (60.8% and white skin (93.3% were predominant. The most frequent death cause was alcoholism (40% especially in men, followed by viral causes (24.16%.The most frequent complication was ascites (53.3%. The main cause of death was upper gastrointestinal bleeding from esophageal varices (52.45%, 44% of the cases presented Child-Pugh B and 46% died within the year after the diagnosis. Conclusion: cirrhosis has a high rate of incidence and prevalence mainly in the male sex due to the high consumption of alcohol and the viral infections that can be related. More comprehensive studies are needed to increase the amount of knowledge on this issue.

  15. Transient and 2-Dimensional Shear-Wave Elastography Provide Comparable Assessment of Alcoholic Liver Fibrosis and Cirrhosis

    DEFF Research Database (Denmark)

    Thiele, Maja; Detlefsen, Sönke; Møller, Linda Maria Sevelsted;

    2016-01-01

    BACKGROUND & AIMS: Alcohol abuse causes half of all deaths from cirrhosis in the West, but few tools are available for noninvasive diagnosis of alcoholic liver disease. We evaluated 2 elastography techniques for diagnosis of alcoholic fibrosis and cirrhosis; liver biopsy with Ishak score...... and collagen-proportionate area were used as reference. METHODS: We performed a prospective study of 199 consecutive patients with ongoing or prior alcohol abuse, but without known liver disease. One group of patients had a high pretest probability of cirrhosis because they were identified at hospital liver...... clinics (in Southern Denmark). The second, lower-risk group, was recruited from municipal alcohol rehabilitation centers and the Danish national public health portal. All subjects underwent same-day transient elastography (FibroScan), 2-dimensional shear wave elastography (Supersonic Aixplorer), and liver...

  16. No effect of long-term oral testosterone treatment on liver morphology in men with alcoholic cirrhosis

    DEFF Research Database (Denmark)

    Gluud, C; Christoffersen, Pernille Yde; Eriksen, J

    1987-01-01

    duration of 30 months demonstrated a significant (p less than 0.01) increase in the prevalence of macronodular cirrhosis (from 6 to 51%) and a significant (p less than 0.01) decrease in the prevalence of alcoholic hepatitis (to 21%) and of fatty liver (to 52%). Testosterone treatment did not significantly...... Budd-Chiari's syndrome. The degree of fatty liver and of alcoholic hepatitis in follow-up liver specimens were significantly (p less than 0.002) higher among patients who consumed ethanol during follow-up than in patients who abstained (76 versus 22% and 30 versus 6%). In conclusion, this study does......The effect of oral testosterone treatment (200 mg tid) on liver morphology was examined in a double-blind, placebo controlled study including men with alcoholic cirrhosis (n = 126). Liver biopsies obtained before randomization showed micronodular cirrhosis in 119 patients (94%), alcoholic hepatitis...

  17. Circulating vascular endothelial growth factor and its soluble receptors in patients with liver cirrhosis: possible association with hepatic function impairment.

    Science.gov (United States)

    Jaroszewicz, Jerzy; Januszkiewicz, Marcin; Flisiak, Robert; Rogalska, Magdalena; Kalinowska, Alicja; Wierzbicka, Iwona

    2008-10-01

    Recent studies provided in vivo evidences of an increased angiogenesis in animal model of portal hypertension and cirrhosis which was linked to increased expression of vascular endothelial growth factor. The aim of study was to evaluate the plasma concentration of VEGF and its receptors in liver cirrhosis and the possible association with the degree of liver insufficiency. Methods. Vascular endothelial growth factor (VEGF) and its soluble receptors: sVEGF-R1, sVEGF-R2 were measured in plasma of 78 patients with liver cirrhosis by ELISA. Results. The significant increase of plasma VEGF and sVEGF-R1 was observed in liver cirrhosis compared to healthy individuals (153.1+/-51.9 vs. 46.8+/-4.1pg/mL, P<0.05; 279.8+/-34.3 vs. 105.1+/-5.9pg/mL, P<0.001, respectively). Plasma VEGF and foremost sVEGF R1 showed significant associations with biochemical indices of liver function. Among clinical parameters, only ascites revealed significant association with plasma VEGR and sVEGF-R1. VEGF and sVEGF-R1 were increased respectively to the degree of liver insufficiency. It was demonstrated through a significant positive correlation with Child-Pugh score and MELD classification. In conclusion, our study suggests that serum VEGF and VEGF-R1 may reflect the hepatic function impairment in liver cirrhosis and seems to be associated with portal hypertension symptoms.

  18. TESTOSTERONE CHANGES IN PATIENTS WITH LIVER CIRRHOSIS BEFORE AND AFTER ORTHOTOPIC LIVER TRANSPLANTATION AND ITS CORRELATION WITH MELD

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    Rodrigo NITSCHE

    2014-03-01

    Full Text Available Context Hypogonadism is a common clinical situation in male patients with liver cirrhosis. Objectives The aim of the present study was to evaluate the effects of orthotopic liver transplantation on testosterone, free testosterone and sex hormone-binding globulin in male with advanced liver disease and also to determine the relationship of these changes with Model for End-stage Liver Disease (MELD score. Methods In a prospective study, serum levels of testosterone, free testosterone and sex hormone-binding globulin of 30 male adult patients with end-stage liver disease were measured 2 to 4 hours before and 6 months after orthotopic liver transplantation. Results Total testosterone levels increased after orthotopic liver transplantation and the number of patients with normal testosterone levels increased from 18 to 24. Free testosterone mean level in the pre-transplant group was 7.8 pg/mL and increased to 11.5 pg/mL (P = 0.10 and sex hormone-binding globulin level decreased after orthotopic liver transplantation returning to normal levels in MELD ≤18 - group (A (P<0.05. Conclusions Serum level changes of testosterone, free testosterone and sex hormone-binding globulin are more pronounced in cirrhotic males with MELD ≤18. Serum levels of testosterone and free testosterone increase and serum levels of sex hormone-binding globulin decrease after orthotopic liver transplantation.

  19. Utility of captopril renography in diagnosis of renal dysfunction in liver cirrhosis

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    Kim, S. H.; Chung, Y. A.; Yoo, I. R.; Kim, E. N.; Park, Y. H.; Sohn, Y. H.; Chugn, S. K. [The Catholic Univ., Seoul (Korea, Republic of)

    2000-07-01

    To evaluate the utility of captopril renography (CR) to detect early renal dysfunction in patients with different grades of liver cirrhosis. Thirty cirrhotic patients(19 men and 11 women with mean age of 55.7 yr) were included. The degree of cirrhosis was evaluated according to Child-Pugh classification; grade A in 3, B in 19 and C in 8. Baseline renography (BR) and CR were performed using {sup 99m}Tc-MAG3, and serum creatinine (Cr), renin aldosterone and 24 hr urine sodium (U-Na) were measured on the same day or 1 day before CR. The peak time (PT) and 3 min to 20 min activity ratio(K20/3) were obtained from the whole-kidney (WK) and parenchymal(P) renograms. We evaluated the difference between renogram indices in different grades of liver cirrhosis, and correlated laboratory data with renogram indices. The results were shown in table. The renogram indices became abnormal on CR in 5 out of 19 patients with grade B and in 7 out of 8 with grade C. There are significant correlations between renin and WK-PT on CR(r=0.625, p<0.01), and aldosterone and PT on CR(r=0.755, p<0.01). Captopril renography is capable of detecting early renal dysfunction in cirrhotic patients, which may explain the related pathogenesis.

  20. Identification and localization of xylose-binding proteins as potential biomarkers for liver fibrosis/cirrhosis.

    Science.gov (United States)

    Zhong, Yaogang; Sun, Xiu-Xuan; Zhang, Peixin; Qin, Xinmin; Chen, Wentian; Guo, Yonghong; Jia, Zhansheng; Bian, Huijie; Li, Zheng

    2016-02-01

    In our recent study, we found that the expression levels of total xylose-binding proteins (XBPs) were up-regulated significantly in activated hepatic stellate cells (HSCs); however, the denomination, distribution, and function of the XBPs were uncharted. Herein, 70 XBPs from activated HSCs and 64 XBPs from quiescent HSCs were isolated, identified and annotated. A total of 30 XBPs were up-regulated (all fold change ≥ 1.5, p ≤ 0.05) and 14 XBPs were down-regulated (all fold change ≤ 0.67, p ≤ 0.05) in the activated HSCs. The XBPs were localized at the cytoplasm and cytoplasmic membrane in HSCs and cirrhotic liver tissues by cy/histochemistry. The XBPs (i.e. PDIA6 and CFL2) responsible for the regulation of protein binding were up-regulated and those responsible for the regulation of catalytic activity (i.e. TUBB and MX1) were up-regulated in the activated HSCs. 2 candidates (i.e. PDIA6 and APOA1) were then selected for further verification in the sera of patients with HBV-induced chronic hepatitis/cirrhosis using western blotting and serum microarrays. PDIA6 showed a higher discrimination (Area Under Curves, AUCs = 0.8985, p cirrhosis may provide pivotal information needed to discover potential glycan-binding protein-related biomarkers for diagnosis of liver fibrosis/cirrhosis and for development of new anti-fibrotic strategies.

  1. Pulse Diagnosis Signals Analysis of Fatty Liver Disease and Cirrhosis Patients by Using Machine Learning

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    Wang Nanyue

    2015-01-01

    Full Text Available Objective. To compare the signals of pulse diagnosis of fatty liver disease (FLD patients and cirrhosis patients. Methods. After collecting the pulse waves of patients with fatty liver disease, cirrhosis patients, and healthy volunteers, we do pretreatment and parameters extracting based on harmonic fitting, modeling, and identification by unsupervised learning Principal Component Analysis (PCA and supervised learning Least squares Regression (LS and Least Absolute Shrinkage and Selection Operator (LASSO with cross-validation step by step for analysis. Results. There is significant difference between the pulse diagnosis signals of healthy volunteers and patients with FLD and cirrhosis, and the result was confirmed by 3 analysis methods. The identification accuracy of the 1st principal component is about 75% without any classification formation by PCA, and supervised learning’s accuracy (LS and LASSO was even more than 93% when 7 parameters were used and was 84% when only 2 parameters were used. Conclusion. The method we built in this study based on the combination of unsupervised learning PCA and supervised learning LS and LASSO might offer some confidence for the realization of computer-aided diagnosis by pulse diagnosis in TCM. In addition, this study might offer some important evidence for the science of pulse diagnosis in TCM clinical diagnosis.

  2. Eradication of Hepatitis C Virus Infection in Patients With Cirrhosis Reduces Risk of Liver and Non-Liver Complications.

    Science.gov (United States)

    Nahon, Pierre; Bourcier, Valérie; Layese, Richard; Audureau, Etienne; Cagnot, Carole; Marcellin, Patrick; Guyader, Dominique; Fontaine, Hélène; Larrey, Dominique; De Lédinghen, Victor; Ouzan, Denis; Zoulim, Fabien; Roulot, Dominique; Tran, Albert; Bronowicki, Jean-Pierre; Zarski, Jean-Pierre; Leroy, Vincent; Riachi, Ghassan; Calès, Paul; Péron, Jean-Marie; Alric, Laurent; Bourlière, Marc; Mathurin, Philippe; Dharancy, Sébastien; Blanc, Jean-Frédéric; Abergel, Armand; Serfaty, Lawrence; Mallat, Ariane; Grangé, Jean-Didier; Attali, Pierre; Bacq, Yannick; Wartelle, Claire; Dao, Thông; Benhamou, Yves; Pilette, Christophe; Silvain, Christine; Christidis, Christos; Capron, Dominique; Bernard-Chabert, Brigitte; Zucman, David; Di Martino, Vincent; Thibaut, Vincent; Salmon, Dominique; Ziol, Marianne; Sutton, Angela; Pol, Stanislas; Roudot-Thoraval, Françoise

    2017-01-01

    We performed a prospective study to investigate the effects of a sustained viral response (SVR) on outcomes of patients with hepatitis C virus (HCV) infection and compensated cirrhosis. We collected data from 1323 patients included in the prospective Agence Nationale pour la Recherche sur le SIDA et les hépatites virales (ANRS) viral cirrhosis (CirVir) cohort, recruited from 35 clinical centers in France from 2006 through 2012. All patients had HCV infection and biopsy-proven cirrhosis, were Child-Pugh class A, and had no prior liver complications. All patients received anti-HCV treatment before or after inclusion (with interferon then with direct antiviral agents) and underwent an ultrasound examination every 6 months, as well as endoscopic evaluations. SVR was considered as a time-dependent covariate; its effect on outcome was assessed by the Cox proportional hazard regression method. We used a propensity score to minimize confounding by indication of treatment and capacity to achieve SVR. After a median follow-up period of 58.2 months, 668 patients (50.5%) achieved SVR. SVR was associated with a decreased incidence of hepatocellular carcinoma (hazard ratio [HR] compared with patients without an SVR, 0.29; 95% confidence interval [CI], 0.19-0.43; P < .001) and hepatic decompensation (HR, 0.26; 95% CI, 0.17-0.39; P < .001). Patients with SVRs also had a lower risk of cardiovascular events (HR, 0.42; 95% CI, 0.25-0.69; P = .001) and bacterial infections (HR, 0.44; 95% CI, 0.29-0.68; P < .001). Metabolic features were associated with a higher risk of hepatocellular carcinoma in patients with SVRs, but not in patients with viremia. SVR affected overall mortality (HR, 0.27 compared with patients without SVR; 95% CI, 0.18-0.42; P < .001) and death from liver-related and non-liver-related causes. Similar results were obtained in a propensity score-matched population. We confirmed a reduction in critical events, liver-related or not, in a prospective study of

  3. Clinical effect of laparoscopic versus open liver resection in treatment of patients with hepatocellular carcinoma complicated by liver cirrhosis

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    MA Yiyun

    2016-10-01

    Full Text Available Objective To investigate the clinical effect of laparoscopic liver resection (LLR versus open liver resection (OLR in the treatment of patients with hepatocellular carcinoma (HCC complicated by liver cirrhosis. Methods A total of 136 patients who were diagnosed with HCC complicated by liver cirrhosis in Linxia Municipal People′s Hospital from January 2006 to December 2007 were enrolled and underwent LLR (LLR group, 64 patients or OLR (OLR group, 72 patients. The short-term outcome, pathological factors, and long-term outcome were compared between the two groups. The t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, and the log-rank test was used for comparison of survival functions. Results There were significant differences between the LLR group and the OLR group in time of operation ((86.43±23.55 min vs (62.31±19.61 min, t=8.539, P<0.001 and length of postoperative hospital stay ((7.22±3.45 d vs (12.27±5.31 d, t=2.764, P=0.024, while there were no significant differences in intraoperative blood loss, time of hepatic portal occlusion, and overall fatality rate(all P>0.05. There were also no significant differences in number of tumors, presence or absence of liver cirrhosis, microvascular invasion, resection margin, and maximum tumor diameter between the two groups (all P>0.05. As for long-term outcome, the 1-, 3-, and 5-year disease-free survival rates were 83.30%, 48.61%, and 38.29% in the LLR group and 78.64%, 51.26%, and 43.01% in the OLR group; the 1-, 3-, and 5-year overall survival rates were 97.42%, 95.13%, and 89.23% in the LLR group and 96.41%, 94.28%, and 90.06% in the OLR group. There were no significant differences in these survival rates between the two groups (all P>0.05. Conclusion In patients with HCC complicated by liver cirrhosis, LLR helps to achieve rapid postoperative recovery and similar long-term outcome compared

  4. Effect of artesunate supplementation on bacterial translocation and dysbiosis of gut microbiota in rats with liver cirrhosis.

    Science.gov (United States)

    Chen, Yun-Xia; Lai, Li-Na; Zhang, Hui-Ying; Bi, Yang-Hui; Meng, Li; Li, Xu-Jiong; Tian, Xiao-Xia; Wang, Li-Min; Fan, Yi-Min; Zhao, Zhong-Fu; Han, De-Wu; Ji, Cheng

    2016-03-14

    To evaluate the effect of artesunate (AS) supplementation on bacterial translocation (BT) and gut microbiota in a rat model of liver cirrhosis. Fifty-four male Sprague-Dawley rats were randomly divided into a normal control group (N), a liver cirrhosis group (M) and a liver cirrhosis group intervened with AS (MA). Each group was sampled at 4, 6 and 8 wk. Liver cirrhosis was induced by injection of carbon tetrachloride (CCl4), intragastric administration of 10% ethanol, and feeding a high fat diet. Rats in the MA group were intragastrically administered with AS (25 mg/kg body weight, once daily). Injuries of the liver and intestinal mucosa were assessed by hematoxylin-eosin or Masson's trichrome staining. Liver index was calculated as a ratio of the organ weight (g) to body weight (g). The gut microbiota was examined by automated ribosomal intergenic-spacer analysis of fecal DNA. BT was assessed by standard microbiological techniques in the blood, mesenteric lymph nodes (MLNs), liver, spleen, and kidney. Compared to group N, the body weight was reduced significantly in groups M and MA due to the development of liver cirrhosis over the period of 8 wk. The body weight was higher in group MA than in group M. The liver indices were significantly elevated at 4, 6 and 8 wk in groups M and MA compared to group N. AS supplementation partially decreased the liver indices in group MA. Marked histopathologic changes in the liver and small intestinal mucosa in group M were observed, which were alleviated in group MA. Levels of pro-inflammatory interleukin-6 and tumor necrosis factor-α were significantly elevated at 8 wk in ileal homogenates in group M compared to group N, which were decreased after AS supplementation in group MA. The dysbiosis of gut microbiota indicated by the mean diversity (Shannon index) and mean similarity (Sorenson index) was severe as the liver cirrhosis developed, and AS supplementation had an apparent intervention effect on the dysbiosis of gut

  5. Liver cirrhosis in patients newly diagnosed with neurological phenotype of Wilson's disease.

    Science.gov (United States)

    Przybyłkowski, Adam; Gromadzka, Grażyna; Chabik, Grzegorz; Wierzchowska, Agata; Litwin, Tomasz; Członkowska, Anna

    2014-01-01

    Wilson's disease (WD) can manifest itself in different clinical forms, the neurological and hepatic ones being the most common. It is suggested that neurological signs and psychiatric symptoms develop secondary to liver involvement. The aim of this study was to characterize the liver disease in patients newly diagnosed with the neurological form of WD. Treatment-naive patients diagnosed with WD were classified into three phenotypic groups: hepatic, neurological and pre-symptomatic. Liver involvement was ascertained through surrogate markers: abdominal ultrasound and laboratory parameters. In addition, study participants were screened for esophageal varices. Of 53 consecutively diagnosed WD patients, 23 individuals (43.4%) had a predominantly neurological presentation. In this group, cirrhosis was diagnosed in 11 (47.8%) subjects. Esophageal varices were present in all of them. In every patient with neurological WD, there was at least one sign of hepatic disease on ultrasound examination, indicating universal presence of liver involvement. The prevalence of surrogate signs of cirrhosis was similar in patients with the neurological and in those with the hepatic phenotype.

  6. Gallstones in patients with liver cirrhosis: Incidence, etiology, clinical and therapeutical aspects

    Science.gov (United States)

    Acalovschi, Monica

    2014-01-01

    Gallstones occur in about one third of the patients having liver cirrhosis. Pigment gallstones are the most frequent type, while cholesterol stones represent about 15% of all stones in cirrhotics. Increased secretion of unconjugated bilirubin, increased hydrolysis of conjugated bilirubin in the bile, reduced secretion of bile acids and phospholipds in bile favor pigment lithogenesis in cirrhotics. Gallbladder hypomotility also contributes to lithogenesis. The most recent data regarding risk factors for gallstones are presented. Gallstone prevalence increases with age, with a ratio male/female higher than in the general population. Chronic alcoholism, viral C cirrhosis, and non-alcoholic fatty liver disease are the underlying liver diseases most often associated with gallstones. Gallstones are often asymptomatic, and discovered incidentally. If asymptomatic, expectant management is recommended, as for asymptomatic gallstones in the general population. However, a closer follow-up of these patients is necessary in order to earlier treat symptoms or complications. For symptomatic stones, laparoscopic cholecystectomy has become the therapy of choice. Child-Pugh class and MELD score are the best predictors of outcome after cholecystectomy. Patients with severe liver disease are at highest surgical risk, therefore gallstone complications should be treated using noninvasive or minimally invasive procedures, until stabilization of the patient condition. PMID:24966598

  7. The endocannabinoid system in advanced liver cirrhosis: pathophysiological implication and future perspectives.

    Science.gov (United States)

    Baldassarre, Maurizio; Giannone, Ferdinando A; Napoli, Lucia; Tovoli, Alessandra; Ricci, Carmen S; Tufoni, Manuel; Caraceni, Paolo

    2013-10-01

    Endogenous cannabinoids (EC) are ubiquitous lipid signalling molecules providing different central and peripheral effects that are mediated mostly by the specific receptors CB1 and CB2. The EC system is highly upregulated during chronic liver disease and consistent experimental and clinical findings indicate that it plays a role in the pathogenesis of liver fibrosis and fatty liver disease associated with obesity, alcohol abuse and hepatitis C. Furthermore, a considerable number of studies have shown that EC and their receptors contribute to the pathogenesis of the cardio-circulatory disturbances occurring in advanced cirrhosis, such as portal hypertension, hyperdynamic circulatory syndrome and cirrhotic cardiomyopathy. More recently, the EC system has been implicated in the development of ascites, hepatic encephalopathy and the inflammatory response related to bacterial infection. Rimonabant, a selective CB1 antagonist, was the first drug acting on the EC system approved for the treatment of obesity. Unfortunately, it has been withdrawn from the market because of its neuropsychiatric side effects. Compounds able to target selectively the peripheral CB1 receptors are under evaluation. In addition, molecules stimulating CB2 receptor or modulating the activity of enzymes implicated in EC metabolism are promising areas of pharmacological research. Liver cirrhosis and the related complications represent an important target for the clinical application of these compounds.

  8. [Peptic ulcer disease in liver cirrhosis: role of Helicobacter pylori infection and therapeutic approach].

    Science.gov (United States)

    Mitrică, Dana; Constantinescu, R; Drug, V L; Stanciu, C

    2011-01-01

    Peptic ulcer has frequently been associated with liver cirrhosis. The death rate for peptic ulcer in cirrhotics has been reported to be five times higher than in general population. The underlying mechanisms are poorly understood. Different factors have been claimed to be involved, such as alterations in serum gastrin level, gastric acid secretions, mucosal blood flow and decreased prostaglandin production in gastric mucosa. Moreover, Helicobacter pylori infection, when accurately assessed, is detectable in most peptic ulcer cirrhotics. Since the H. pylori infection strongly correlates with peptic ulcer in general population, it is necessary to clarify the role of H. pylori in the pathogenesis of peptic ulcer in cirrhosis before eradication can be proposed as a preventive measure.

  9. Surgical risks and perioperative complications of instrumented lumbar surgery in patients with liver cirrhosis

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    Tung-Yi Lin

    2014-02-01

    Full Text Available Background: Patients with liver cirrhosis have high surgical risks due to malnutrition, impaired immunity, coagulopathy, and encephalopathy. However, there is no information in English literature about the results of liver cirrhotic patients who underwent instrumented lumbar surgery. The purpose of this study is to report the perioperative complications, clinical outcomes and determine the surgical risk factors in cirrhotic patients. Methods: We retrospectively reviewed 29 patients with liver cirrhosis who underwent instrumented lumbar surgery between 1997 and 2009. The hepatic functional reserves of the patients were recorded according to the Child-Turcotte-Pugh scoring system. Besides, fourteen other variables and perioperative complications were also collected. To determine the risks, we divided the patients into two groups according to whether or not perioperative complications developed. Results: Of the 29 patients, 22 (76% belonged to Child class A and 7 (24% belonged to Child class B. Twelve patients developed one or more complications. Patients with Child class B carried a significantly higher incidence of complications than those with Child class A (p = 0.011. In the Child class A group, patients with 6 points had a significantly higher incidence of complications than those with 5 points (p = 0.025. A low level of albumin was significantly associated with higher risk, and a similar trend was also noted for the presence of ascites although statistical difference was not reached. Conclusion: The study concludes that patients with liver cirrhosis who have undergone instrumented lumbar surgery carry a high risk of developing perioperative complications, especially in those with a Child-Turcotte-Pugh score of 6 or more.

  10. Correlation between leptin level with lipid profile and free fatty acid in liver cirrhosis patients

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    Siti Maryani

    2015-09-01

    Full Text Available Malnutrition is a common condition in liver cirrhotic patients. Leptin regulates body weightphysiologically by suppressing appetite and increasing energy expenditure. Leptin is higher in femalethan male. Studies have shown correlation between leptin with metabolic factors like body massindex (BMI and lipid profile in cirrhotic patients. This study was conducted to investigate thecorrelation between serum leptin levels with lipid profile and free fatty acid in male patients with livercirrhosis. This was a cross sectional study that conducted at Gastroentero-Hepatology Clinic andInternal Ward at Dr. Sardjito General Hospital, Yogyakarta. The inclusion criteria were patients withliver cirrhosis > 18 years old, male, with Child-Pugh classification B and C, and provided informedconsent. The exclusion criteria were liver cirrhotic patients with comorbidity chronic kidney disease,chronic heart failure, diabetic, cancer, infection/septic, pregnancy, breast feeding, and steroid use.Data collecting was performed by anamnesis, physical examination, abdominal ultrasonographyexamination, and blood chemistry test. Pearson test was used to evaluate the correlation betweenthe serum leptin level with the lipid profile and free fatty acid. The results showed that no significantnegative correlation was observed between the serum leptin level with the total cholesterol (r= -0.052; p=0.766, high-density lipoprotein/HDL (r= -0.078; p=0.658 and triglyceride (r= -0.170; p=0.328 in male patients with liver cirrhosis. Furthermore, no significant positive correlationwas observed between the serum leptin levels with the low-density lipoprotein/LDL (r= -0.013; p=0.942 and free fatty acid/FFA (r= 0.007; p=0.968. In conclusion, there was no correlationbetween serum leptin levels with lipid profile and FFA in male patients with liver cirrhosis.

  11. Effects of heme oxygenase-1 on pulmonary function and structure in rats with liver cirrhosis.

    Science.gov (United States)

    Guo, Shi-bin; Duan, Zhi-jun; Li, Qing; Sun, Xiao-yu

    2011-03-01

    The hepatopulmonary syndrome (HPS) is a severe vascular complication in lungs resulting in systemic hypoxemia in patients with cirrhosis and portal hypertension. The underlying structural change in HPS is intrapulmonary vasodilation, which can lead to impaired oxygenation of pulmonary venous blood. It has been demonstrated that the heme oxygenase-1/carbon monoxide (HO-1/CO) system plays an important role in the control of vascular tone. The aim of this study was to further investigate the role of HO-1 in the pathogenesis of HPS in animal model. Totally 35 rats were divided into liver cirrhosis, zinc protoporphyrin IX (ZnPP), cobalt protoporphyrin (CoPP) and sham groups. Biliary cirrhosis was established in the first three groups by bile duct ligation. Rats in the ZnPP and CoPP groups received once intraperitoneal injection of ZnPP and CoPP, respectively, 24 hours before sample collection. Expression of HO-1 mRNA in lung was detected by reverse-transcription polymerase chain reaction, while protein expression was determined by immunohistochemical analysis. Hematoxylin and eosin staining was performed to confirm the presence of liver cirrhosis and intrapulmonary vasodilation. Arterial blood gases, mean arterial pressure and portal vein pressure were also measured. Analysis of variance or Wilcoxon statistical methods were used to determine statistical significance. Compared with the sham group, the cirrhotic group demonstrated increased expression of pulmonary HO-1 mRNA and protein (P oxygen gradient (A-aPO2), mean arterial pressure, portal vein pressure (P portal vein pressure. Increased pulmonary HO-1 expression is an important contributor to the development of experimental HPS.

  12. Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

    Institute of Scientific and Technical Information of China (English)

    Luis Aparisi; Luis Sabater; Juan Del-Olmo; Juan Sastre; MigueI-Angel Serra; Ricardo Campello; Daniel Bautista; Abdalla Wassel; José-Manuel Rodrigo

    2008-01-01

    AIM: To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology, after excluding any other causes. METHODS: One hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (η = 53), LC (η = 57), and asymptomatic alcoholic (n = 30). Clinical, biochemical and morphological characteristics, Child-Pugh index, indocyanine green test, and fecal pancreatic elastase-1 test were assessed. RESULTS: In patients with cirrhosis, major clinical manifestations of CP such as pancreatic pain and steatorrhea, as well as imaging alterations of CP such as calcifications, duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% of cases, and elastase-1 test was altered in only 7%, and severely altered in none. In patients with CP, clinical characteristics of cirrhosis such as ascites, encephalopathy and gastrointestinal hemorrhage were present in one case, Child-Pugh grade > A in 5.7%, and altered indocyanine green test in 1.9% cases. In asymptomatic alcoholism, there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%, respectively, but other characteristics of cirrhosis or CP were absent. An inverse correlation (r=-0.746) between elastase-1 test and indocyanine test was found in alcoholic patients. CONCLUSION: There is a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology, but an inverse correlation between pancreatic and liver function tests. These findings support that these alcoholic diseases evolve in a different manner and have different etiopathogenesis.

  13. Progression of liver cirrhosis to HCC: an application of hidden Markov model

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    Serio Gabriella

    2011-04-01

    Full Text Available Abstract Background Health service databases of administrative type can be a useful tool for the study of progression of a disease, but the data reported in such sources could be affected by misclassifications of some patients' real disease states at the time. Aim of this work was to estimate the transition probabilities through the different degenerative phases of liver cirrhosis using health service databases. Methods We employed a hidden Markov model to determine the transition probabilities between two states, and of misclassification. The covariates inserted in the model were sex, age, the presence of comorbidities correlated with alcohol abuse, the presence of diagnosis codes indicating hepatitis C virus infection, and the Charlson Index. The analysis was conducted in patients presumed to have suffered the onset of cirrhosis in 2000, observing the disease evolution and, if applicable, death up to the end of the year 2006. Results The incidence of hepatocellular carcinoma (HCC in cirrhotic patients was 1.5% per year. The probability of developing HCC is higher in males (OR = 2.217 and patients over 65 (OR = 1.547; over 65-year-olds have a greater probability of death both while still suffering from cirrhosis (OR = 2.379 and if they have developed HCC (OR = 1.410. A more severe casemix affects the transition from HCC to death (OR = 1.714. The probability of misclassifying subjects with HCC as exclusively affected by liver cirrhosis is 14.08%. Conclusions The hidden Markov model allowing for misclassification is well suited to analyses of health service databases, since it is able to capture bias due to the fact that the quality and accuracy of the available information are not always optimal. The probability of evolution of a cirrhotic subject to HCC depends on sex and age class, while hepatitis C virus infection and comorbidities correlated with alcohol abuse do not seem to have an influence.

  14. Inflammatory hepatocellular adenomas developed in the setting of chronic liver disease and cirrhosis.

    Science.gov (United States)

    Calderaro, Julien; Nault, Jean C; Balabaud, Charles; Couchy, Gabrielle; Saint-Paul, Marie-Christine; Azoulay, Daniel; Mehdaoui, Dalila; Luciani, Alain; Zafrani, Elie S; Bioulac-Sage, Paulette; Zucman-Rossi, Jessica

    2016-01-01

    Hepatocellular adenoma is considered to occur exclusively in non-fibrotic livers. It is a heterogeneous entity and a molecular classification is now widely accepted. The most frequent hepatocellular adenoma subtype, namely inflammatory adenoma, harbor somatic activating mutations of genes involved in the interleukin-6 pathway that lead to high C-reactive protein and serum amyloid A expression. The aim of our study was to investigate a series of benign hepatocellular neoplasms developed on cirrhotic livers and characterized by an unequivocal histological diagnosis. We performed a clinical, pathological, and molecular study of 10 benign hepatocellular neoplasms developed in three patients with cirrhosis. Markers allowing hepatocellular adenoma classification were assessed by quantitative real-time PCR and immunohistochemistry. Samples were sequenced for CTNNB1, HNF1A, IL6ST, GNAS, STAT3, and TERT (promoter) mutations. A control series of 32 classical macronodules developed in cirrhosis related to various etiologies was screened by immunohistochemistry and gene sequencing. The three patients had cirrhosis related to metabolic syndrome and/or alcohol intake; two had a single tumor, while the third developed more than 30 lesions. Microscopic examination showed well-differentiated neoplasms sharing features with inflammatory adenoma including inflammatory infiltrates, sinusoidal dilatation, and dystrophic vessels. Sequencing revealed classical hotspot somatic mutations (IL6ST, n=8; STAT3, n=1; and GNAS, n=1) known to be responsible for IL-6/JAK/STAT pathway activation. Two classical high-grade macronodules demonstrated high serum amyloid A and/or C-reactive protein expression, without gene mutations. Altogether, our findings support the existence of rare inflammatory adenoma developed in cirrhosis.

  15. Plasma Cystatin C is a predictor of renal dysfunction, ACLF and mortality in patients with acutely decompensated liver cirrhosis

    DEFF Research Database (Denmark)

    Markwardt, Daniel; Holdt, Lesca M; Steib, Christian

    2017-01-01

    BACKGROUND: The development of acute-on-chronic liver failure (ACLF) in patients with liver cirrhosis is associated with high mortality rates. Renal failure is the most significant organ dysfunction that occurs in ACLF. So far there are no biomarkers predicting ACLF. AIM: To investigate whether C...

  16. NT pro BNP plasma level and atrial volume are linked to the severity of liver cirrhosis.

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    Anna Licata

    Full Text Available BACKGROUND AND AIMS: Plasma levels of NT-pro-BNP, a natriuretic peptide precursor, are raised in the presence of fluid retention of cardiac origin and can be used as markers of cardiac dysfunction. Recent studies showed high levels of NT pro BNP in patients with cirrhosis. We assessed NT pro-BNP and other parameters of cardiac dysfunction in patients with cirrhosis, with or without ascites, in order to determine whether the behaviour of NT pro BNP is linked to the stage of liver disease or to secondary cardiac dysfunction. METHODS: Fifty eight consecutive hospitalized patients mostly with viral or NAFLD-related cirrhosis were studied. All underwent abdominal ultrasound and upper GI endoscopy. Cardiac morpho-functional changes were evaluated by echocardiography and NT-pro-BNP plasma levels determined upon admission. Twenty-eight hypertensive patients, without evidence of liver disease served as controls. RESULTS: Fifty eight cirrhotic patients (72% men with a median age of 62 years (11% with mild arterial hypertension and 31% with type 2 diabetes had a normal renal function (mean creatinine 0.9 mg/dl, range 0.7-1.06. As compared to controls, cirrhotic patients had higher NT pro-BNP plasma levels (365.2±365.2 vs 70.8±70.6 pg/ml; p<0.001. Left atrial volume (LAV (61.8±26.3 vs 43.5±14.1 ml; p = 0.001, and left ventricular ejection fraction (62.7±6.9 vs. 65.5±4%,; p = 0.05 were also altered in cirrhotic patients that in controls. Patients with F2-F3 oesophageal varices as compared to F0/F1, showed higher e' velocity (0.91±0.23 vs 0.66±0.19 m/s, p<0.001, and accordingly a higher E/A ratio (1.21±0.46 vs 0.89±0.33 m/s., p = 0.006. CONCLUSION: NT-pro-BNP plasma levels are increased proportionally to the stage of chronic liver disease. Advanced cirrhosis and high NT-pro-BNP levels are significantly associated to increased LAV and to signs of cardiac diastolic dysfunction. NT pro-BNP levels could hence be an useful prognostic

  17. Portal vein omentin is increased in patients with liver cirrhosis but is not associated with complications of portal hypertension.

    Science.gov (United States)

    Eisinger, Kristina; Krautbauer, Sabrina; Wiest, Reiner; Karrasch, Thomas; Hader, Yvonne; Scherer, Marcus N; Farkas, Stefan; Aslanidis, Charalampos; Buechler, Christa

    2013-09-01

    Omentin is a visceral fat-derived adipokine associated with endothelium-dependent vasodilation. Impaired endothelial function is a major cause of portal hypertension in liver cirrhosis. The aim was to assess associations of omentin with systemic markers of endothelial function, namely arginine and asymmetric dimethylarginine (ADMA) and complications of portal hypertension in liver cirrhosis. Systemic omentin was measured by ELISA in portal venous serum (PVS), systemic venous serum (SVS) and hepatic venous serum (HVS) of 40 patients with liver cirrhosis and 10 liver-healthy controls. ADMA and arginine were determined in SVS of the patients by ELISA. Omentin is elevated in PVS and tends to be increased in SVS and HVS of patients with liver cirrhosis compared with controls. Omentin is principally expressed in visceral fat, and PVS omentin tends to be higher than SVS levels. Lower HVS than PVS omentin suggests that omentin may be partly removed from the circulation by the liver. Omentin in serum is not associated with stages of liver cirrhosis defined by CHILD-POUGH or MELD score and is not affected in patients with ascites. HVS omentin tends to be reduced in patients with large varices compared with patients without/with small varices. Arginine/ADMA ratio is reduced in patients with massive ascites but is not associated with variceal size. Further, Arginine/ADMA ratio does not correlate with omentin. Current data show that PVS omentin is increased in liver cirrhosis but is not associated with complications of portal hypertension. © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

  18. Weight loss during cirrhosis is related to the etiology of liver disease

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    Lucilene Rezende Anastácio

    2012-09-01

    Full Text Available CONTEXT: Malnutrition is widely described in patients waiting for liver transplantation (LTx. However, risk factors associated with weight loss during liver disease have not yet been well studied. OBJECTIVES: The aim of this study was to assess weight loss and its risk factors during liver disease and up to the first appointment after transplantation. Patients who underwent LTx were retrospectively assessed for weight loss during liver disease while on the waiting list for LTx. The usual weight of the patients before disease and their weight on the first outpatient appointment after transplant were considered. Demographic, socioeconomic, lifestyle and clinical variables were collected to assess risk factors using a linear regression analysis. We retrospectively evaluated 163 patients undergoing LTx between 1997 and 2008. RESULTS: Patients lost in average 7.7 ± 12.4 kg while ill. Variables independently associated with weight loss by multiple linear regression analyses were as follows: former smoker (P = 0.03, greater body mass index (P<0.01, overweight before liver disease (P = 0.02 and indication for LTx (P = 0.01. Among these indications, patients with alcoholic cirrhosis had lost significantly more weight (P<0.01, and those with hepatitis C virus (P = 0.01 and autoimmune hepatitis (P = 0.02 had lost significantly less weight. CONCLUSIONS: Patients experienced weight loss during liver disease independent of age, sex, schooling and income; however, the etiology of liver disease was related to weight loss.

  19. [A case of cryptococcal meningitis mimicking hepatic encephalopathy in a patient with liver cirrhosis caused by chronic hepatitis C].

    Science.gov (United States)

    Choi, Hye Mi; Jung, Gum Mo; Lee, Woong Ki; Lee, Hyeuk Soo; Kim, Byung Sun; Seong, Choong Sil; Yoon, So Hee; Cho, Yong Keun

    2014-11-01

    Cryptococcus neoformans, an encapsulated fungus, is an important opportunistic pathogen that can cause meningitis in im-munocompromised patients. Since patients with cryptococcemia have high mortality, it is essential to make an early diagnosis and promptly initiate antifungal therapy. However, it is often very difficult to differentiate between cryptococcal meningitis and hepatic encephalopathy in patients with liver cirrhosis, and there is delay in making the diagnosis. Therefore, these patients have a particularly grave prognosis and consequently many patients die before culture results become available. In one study, starting antifungal therapy within 48 hours of the blood culture was associated with improved survival, but patients with liver cirrhosis were significantly less likely to receive antifungal therapy within 48 hours compared to those without liver cirrhosis. Recently, the authors experience a case of a 68-year-old woman with liver cirrhosis who presented with fever and a drowsy mental status. She had a previous history of having been admitted for infection-associated hepatic encephlopathy. Cryptococcal meningitis and cryptococcemia were diagnosed by spinal puncture and culture of cerebrospinal fluid. In spite of adequate treatment, the patient developed multi-system organ failure and eventually expired. Herein, we report a case of cryptococcal meningitis mimicking hepatic encephalopathy in a patient with liver cirrhosis.

  20. Transforming growth factor-β genetic polymorphisms on development of liver cirrhosis in a meta-analysis.

    Science.gov (United States)

    Wu, Xiao-Dan; Zeng, Kai; Gong, Can-Sheng; Chen, Jinhua; Chen, Yan-Qing

    2013-01-01

    Transforming growth factor-β (TGF-β) protein has been supposed to be a risk factor for liver cirrhosis; however, the associations between its genes (TGF-β -509C>T and +869T>C) and liver cirrhosis remained unclear. This study was to quantitatively analyze the correlations by using a meta-analysis. Pubmed, Embase, Wanfang databases were retrieved up to November 1st, 2011. Odds ratio (OR) and 95 % confidence interval (95 %CI) were used to demonstrate the strength of association, and P T polymorphism, and eight studies were for +869T>C polymorphism. Combined results indicated that neither TGF-β -509C>T nor +869T>C polymorphisms were associated with risk of liver cirrhosis [OR (95 % CI): 0.79 (0.60-1.04) for CT vs. TT of -509C>T and 0.87 (0.68-1.12) for CT vs. CC of +869T>C], with no between-study heterogeneity. In addition, subgroups analyses still inferred that two polymorphisms were not associated with risk of liver cirrhosis for HBV-infected patients, Asians and for Population-based studies. This meta-analysis indicated that neither TGF-β -509C>T nor +869T>C polymorphisms were associated with risk of liver cirrhosis, regardless of HBV infection or not.

  1. Risk factors for HBV-related liver cirrhosis complicated by acute upper gastrointestinal bleeding

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    YU Zhirui

    2017-05-01

    Full Text Available ObjectiveTo investigate the risk factors for HBV-related liver cirrhosis complicated by acute upper gastrointestinal bleeding (AUGIB. MethodsA total of 58 patients with HBV-related liver cirrhosis complicated by AUGIB who were hospitalized in our hospital from January to December, 2011 were enrolled as study group, and 100 patients with HBV-related liver cirrhosis who did not experience upper gastrointestinal bleeding during the same period of time were enrolled as control group. Their general clinical data were collected. The t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, the multivariate Cox regression model was used to analyze the risk factors, and the life table method was used to analyze 1-, 2-, and 3-year cumulative survival rates and plot survival curves. ResultsThe 1-, 2-, and 3-year cumulative survival rates in the patients with HBV-related liver cirrhosis complicated by AUGIB were 72.2%, 51.9%, and 35.2%, respectively, with a median survival time of 24.7 months. The univariate analysis showed that AUGIB was associated with bleeding history (χ2=7.128, P=0008, course of disease (t=8.283, P<0.001, bad eating habits (χ2=7.612, P=0.006, Child-Pugh class (χ2=6.045, P=0049, degree of esophageal varices (χ2=46.241, P<0.001, gastric varices (χ2=14.211, P<0.001, and portal hypertension (χ2=6.846, P=0009. The multivariate Cox regression analysis revealed that course of disease (RR=0.745, 95%CI: 0.824-0967, P=0.026, bad eating habits (RR=1.426, 95%CI: 1.033-2.582, P=0.032, Child-Pugh class (RR=2.032, 95%CI: 1.05-2.34, P=0036, degree of esophageal varices (RR=0.796, 95%CI: 1.23-3.37, P=0.015, degree of gastric varices (RR=0825, 95%CI: 2.46-392, P=0.043, and portal hypertension (RR=0.983, 95%CI: 1.26-3.75, P=0.007 were independent risk factors for the prognosis of patients with HBV-related liver cirrhosis

  2. Risk Factors for Portal Vein Thrombosis in Patients With Cirrhosis Awaiting Liver Transplantation in Shiraz, Iran

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    Bagheri Lankarani

    2015-12-01

    Full Text Available Background Portal vein thrombosis is a fairly common and potentially life-threatening complication in patients with liver cirrhosis. The risk factors for portal vein thrombosis in these patients are still not fully understood. Objectives This study aimed to investigate the associations between various risk factors in cirrhotic patients and the development of portal vein thrombosis. Patients and Methods In this case-control study performed at the Shiraz organ transplantation center, Iran, we studied 219 patients (> 18 years old with liver cirrhosis, who were awaiting liver transplants in our unit, from November 2010 to May 2011. The patients were evaluated by history, physical examination, and laboratory tests, including factor V Leiden, prothrombin gene mutation, Janus Kinase 2 (JAK2 mutation, and serum levels of protein C, protein S, antithrombin III, homocysteine, factor VIII, and anticardiolipin antibodies. Results There was no statistically significant difference in the assessed hypercoagulable states between patients with or without portal vein thrombosis. A history of previous variceal bleeding with subsequent endoscopic treatment in patients with portal vein thrombosis was significantly higher than in those without it (P = 0.013, OR: 2.526, 95% CI: 1.200 - 5.317. Conclusions In our population of cirrhotic patients, treatment of variceal bleeding predisposed the patients to portal vein thrombosis, but hypercoagulable disorders by themselves were not associated with portal vein thrombosis.

  3. Endovascular obliteration of bleeding duodenal varices in patients with liver cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Zamora, Carlos Armando; Sugimoto, Koji; Tsurusaki, Masakatsu; Izaki, Kenta; Fukuda, Tetsuya; Matsumoto, Shinichi; Kawasaki, Ryota; Taniguchi, Takanori; Sugimura, Kazuro [Kobe University School of Medicine, Department of Radiology, Kobe-shi, Hyogo-ken (Japan); Kuwata, Yoichiro [Nishi-Kobe Medical Center, Department of Radiology, Kobe-shi, Hyogo-ken (Japan); Hirota, Shozo [Hyogo Medical College, Department of Radiology, Nishinomiya-shi, Hyogo-ken (Japan)

    2006-01-01

    The purpose of this paper is to describe our experience with endovascular obliteration of duodenal varices in patients with liver cirrhosis and portal hypertension. Balloon-occluded transvenous retrograde and percutaneous transhepatic anterograde embolizations were performed for duodenal varices in five patients with liver cirrhosis, portal hypertension, and decreased liver function. All patients had undergone previous endoscopic treatments that failed to stop bleeding and were poor surgical candidates. Temporary balloon occlusion catheters were used to achieve accumulation of an ethanolamine oleate-iopamidol mixture inside the varices. Elimination of the varices was successful in all patients. Retrograde transvenous obliteration via efferent veins to the inferior vena cava was enough to achieve adequate sclerosant accumulation in three patients. A combined anterograde-retrograde embolization was used in one patient with balloon occlusion of afferent and efferent veins. Transhepatic embolization through the afferent vein was performed in one patient under balloon occlusion of both efferent and afferent veins. There was complete variceal thrombosis and no bleeding was observed at follow-up. No major complications were recorded. Endovascular obliteration of duodenal varices is a feasible and safe alternative procedure for managing patients with portal hypertension and hemorrhage from this source. (orig.)

  4. Transjugular intrahepatic portosystemic shunt: results and prognostic factors in patients with post-necrotic liver cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Chung, Jin Wook; Han, Joon Koo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Yong Joo [Kyungbook National University College of Medicine, Taegu (Korea, Republic of)

    1997-01-01

    To evaluate the effectiveness of transjugular intrahepatic portosystemic shunt(TIPS) in the management of gastroesophageal variceal bleeding and predictive factors for long-term survival in patients with post-necrotic liver cirrhosis. A total of 49 patients with post-necrotic liver cirrhosis underwent TIPS over a recent three-year period. Forty-five had a history of hepatitis B viral infection, and four, of hepatitis C viral infection. In all patients, the indication for the procedure was variceal bleeding. Child-Pugh class was A in seven patients, B in 16 and C in 26 patients at the time of the last bleeding. The effectiveness of portal decompression and bleeding control was evaluated. Long-term survival was calculated by the Kaplan-Meier method and predictive factors were analyzed using the Wilcoxon test. The procedure was technically successful in all cases. The portosystemic pressure gradient decreased significantly from 21.4 {+-} 6.4 mmHg to 12.0 {+-} 5.1 mmHg(N=45). Active variceal bleeding was controlled in 34 of the 37 emergency patients. The total length of follow-up was from one day to three and a half years(mean : 383 {+-} 357 days). Rebleeding developed in 17 patients (35%). Hepatic encephalopathy, either newly developed or aggravated, occurred in 16 (32.7%). The thirty-day mortality rate was 20.4%, and the one-year survival rate was 63.8%. The significant predictive factors for poor prognosis were Child-Pugh class C and post-TIPS hepatic encephalopathy. TIPS is effective in portal decompression in the patients with variceal bleeding due to post-necrotic liver cirrhosis. The Child-Pugh classification and hepatic encephalopathy after TIPS are considered to be significant predictive factors for long-term survival.

  5. Species of pathogens and drug selection in liver cirrhosis patients with sepsis

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    ZHANG Lan

    2013-11-01

    Full Text Available ObjectiveTo identify the species of pathogens in liver cirrhosis patients with sepsis and screen out the effective antibiotics, and to provide a basis for effective clinical antimicrobial therapy. MethodsBlood samples were collected from liver cirrhosis patients with suspected bloodstream infections and were then injected into the blood culture bottles at the bedside. Blood was cultured using the BacT/Alert 3D system. The isolated strains were identified by the Vitec II or API system (BioMerieux, France. Drug susceptibility tests were performed by Kirby-Bauer method. The pathogens and effective drugs in recent 10 years were analyzed. ResultsA total of 8543 strains of pathogens were isolated from various samples in recent 10 years, and 2065 (24.2% of them were detected from cultured blood, including 1233 (59.7% Gram-negative bacillus strains, 787(38.1% Gram-positive coccus strains, 28(1.4% fungal strains, and 17(08% other pathogenic strains. The drug sensitivity tests showed that Gram-negative bacteria had relatively low resistance to meropenem (746%, imipenem (6.49%, and amikacin (5.27%, extended spectrum beta-lactamase (ESBL-producing strains were more resistant to beta-lactam antibiotics except carbapenems and cefmetazole than ESBL-negative strains, and Gram-positive bacteria were 100% sensitive to vancomycin and teicoplanin. ConclusionGram-negative bacteria are the main pathogens of bloodstream infections in liver cirrhosis patients in our hospital. The pathogens are characterized by diversity and high resistance to many antibiotics. In clinical practice, antimicrobial drugs should be properly used according to the species and drug sensitivity of pathogens, so as to improve the cure rate, and the changing trends in the species and drug sensitivity of pathogens need to be continuously monitored.

  6. Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry.

    Science.gov (United States)

    Violi, Francesco; Corazza, Roberto Gino; Caldwell, Stephen Hugh; Perticone, Francesco; Gatta, Angelo; Angelico, Mario; Farcomeni, Alessio; Masotti, Michela; Napoleone, Laura; Vestri, Annarita; Raparelli, Valeria; Basili, Stefania

    2016-12-01

    Portal vein thrombosis may occur in cirrhosis; nevertheless, its prevalence, and predictors are still elusive. To investigate this issue, the Italian Society of Internal Medicine undertook the "Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry" (PRO-LIVER). This prospective multicenter study includes consecutive cirrhotic patients undergoing Doppler ultrasound examination of the portal area to evaluate the prevalence and incidence of portal vein thrombosis over a 2-year scheduled follow-up. Seven hundred and fifty-three (68 % men; 64 ± 12 years) patients were included in the present analysis. Fifty percent of the cases were cirrhotic outpatients. Viral (44 %) etiology was predominant. Around half of the patients had a mild-severity disease according to the Child-Pugh score; hepatocellular carcinoma was present in 20 %. The prevalence of ultrasound-detected portal vein thrombosis was 17 % (n = 126); it was asymptomatic in 43 % of the cases. Notably, more than half of the portal vein thrombosis patients (n = 81) were not treated with anticoagulant therapy. Logistic step-forward multivariate analysis demonstrated that previous portal vein thrombosis (p portal vein thrombosis. Portal vein thrombosis is a frequent complication of cirrhosis, particularly in patients with moderate-severe liver failure. The apparent undertreatment of patients with portal vein thrombosis is a matter of concern and debate, which should be addressed by planning interventional trials especially with newer oral anticoagulants. Clinicaltrials.gov identifier NCT01470547.

  7. Mechanism of thrombocytopenia in liver cirrhosis: Kinetics of indium-111 tropolone labelled platelets

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    Aoki, Yoshinori; Hirai, Kenji; Tanikawa, Kyuichi (Kurume Univ., Fukuoka (Japan). 2. Dept. of Medicine)

    1993-02-01

    Using indium-111 tropolone-labelled platelets, a study of platelet kinetics was performed on the basis of the relationship between platelet count, platelet survival time, platelet dynamics, platelet-associated immunoglobulin G (PA-IgG) and splenic volume in 31 patients with liver cirrhosis and a platelet count of less than 100 x 10[sup 9]/1: The mean platelet count was 46.6 [+-] 25.3 x 10[sup 9]/1, and the mean platelet survival time was 6.50 [+-] 1.33 days. The mean uptake into the spleen was 43.2% [+-] 14.8% on the 1st day, and 53.7% [+-] 14.3% on the 7th day. The mean PA-IgG level was 107.6 [+-] 66.0 ng/10[sup 7] platelets in five patients with chronic active hepatitis who were studied as controls the mean platelet count was 197 [+-] 30 x 10[sup 9]/1, the mean platelet survival time 9.33 [+-] 0.78 days, and the mean PA-IgG 21.2 [+-] 2.9 ng/10[sup 7] platelets. The former two parameters were significantly higher, and the latter significantly lower. In liver cirrhosis, the platelet count showed a positive correlation with the platelet survival time and a negative correlation with PA-IgG and the splenic volume. These results suggest that the increases in both the splenic platelet pool and platelet destruction in the spleen through immunological mechanisms may influence thrombocytopenia in liver cirrhosis. (orig.).