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Premkumar M, Anand AC. Porto-sinusoidal Vascular Disease: Classification and Clinical Relevance. J Clin Exp Hepatol 2024; 14:101396. [PMID: 38601747 PMCID: PMC11001647 DOI: 10.1016/j.jceh.2024.101396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/05/2024] [Indexed: 04/12/2024] Open
Abstract
Non-cirrhotic portal hypertension (NCPH) is a well-recognized clinico-pathological entity, which is associated with clinical signs and symptoms, imaging, and endoscopic features of portal hypertension (PHT), in absence of cirrhosis. In patients with NCPH without known risk factors of PHT or extrahepatic portal vein thrombosis, the condition is called idiopathic non-cirrhotic portal hypertension (INCPH). There are multiple infectious, immune related causes, systemic diseases, drug and toxin exposures, haematological disorders, and metabolic risk factors that have been associated with this INCPH. However, the causal pathogenesis is still unclear. The Vascular liver disorders interest group group recently proposed porto-sinusoidal vascular disease (PSVD) as a syndromic entity, which provides definite histopathological criteria for diagnosis of NCPH (table 1). The three classical histo-morphological lesions specific for PSVD include obliterative portal venopathy, nodular regenerative hyperplasia, and incomplete septal fibrosis. The PSVD definition includes patients with portal vein thrombosis, PVT, and even those without PHT, thus broadening the scope of diagnosis to include patients who may have presented early, prior to haemodynamic changes consistent with PHT. However, this new diagnosis has pros and cons. The cons include mandating invasive liver biopsy to assess the PSVD histological triad in all patients with NCPH, an erstwhile clinical diagnosis in Asian patients. In addition, the natural history of the subclinical forms of PSVD without PHT and linear progression to develop PHT is unknown yet. In this review, we discuss the diagnosis and treatment of INCPH/PSVD, fallacies and strengths of the old and new schema, pathobiology of this disease, and clinical correlates in an Asian context. Although formulation of standardised diagnostic criteria is useful for comparison of clinical cohorts with INCPH/PSVD, prospective clinical validation in global cohorts is necessary to avoid misclassification of vascular disorders of the liver.
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Affiliation(s)
- Madhumita Premkumar
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Anil C. Anand
- Department of Hepatology, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India
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Mellouki K, Fauter M, Gerfaud-Valentin M, Jamilloux Y, Sève P, Defuentes G. [Abdominal pain, vomiting and fever in a 25-year-old woman]. Rev Med Interne 2023; 44:462-464. [PMID: 37271684 DOI: 10.1016/j.revmed.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023]
Affiliation(s)
- K Mellouki
- Service de médecine interne, hôpital de la Croix Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 03, France
| | - M Fauter
- Service de médecine interne, hôpital de la Croix Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 03, France.
| | - M Gerfaud-Valentin
- Service de médecine interne, hôpital de la Croix Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 03, France
| | - Y Jamilloux
- Service de médecine interne, hôpital de la Croix Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 03, France
| | - P Sève
- Service de médecine interne, hôpital de la Croix Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 03, France
| | - G Defuentes
- Service de médecine interne, hôpital d'instruction des Armées Sainte-Anne, 2, boulevard Sainte-Anne, BP 600, 83800 Toulon cedex 9, France
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Quaglia A. Histopathology of Budd-Chiari Syndrome. Diagnostics (Basel) 2023; 13:2487. [PMID: 37568849 PMCID: PMC10417184 DOI: 10.3390/diagnostics13152487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 08/13/2023] Open
Abstract
The histopathological changes in Budd-Chiari syndrome (BCS) overlap with those of sinusoidal obstruction syndrome (SOS) and of cardiac or pericardiac disorders resulting in right cardiac failure. These conditions, however, are different on both clinical and pathological grounds and need to be differentiated from BCS. This review is centred on the three main aspects of BCS in diagnostic liver histopathology: (1) general histopathology of BCS; (2) implications for liver biopsy interpretation; and (3) BCS in the liver allograft. The histological features of BCS form a complex spectrum which is shaped differently in each individual case according to the topographical distribution and chronological evolution of the obliterative insult, its upstream effect of the hepatic vascularisation and the consequent parenchymal injury, scarring and remodelling. Sampling variation limits the use of liver biopsy for prognostication in patients with BCS.
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Affiliation(s)
- Alberto Quaglia
- Department of Cellular Pathology, Royal Free London NHS Foundation Trust, Pond Street, London NW3 2QG, UK;
- UCL Cancer Institute, London WC1E 6DD, UK
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Abstract
Syzygium polyanthum (Wight) Walp. var. polyanthum (serai kayu) leaves is a popular herb and widely used in traditional medicine. Despite the ethnomedicinal benefits, very limited studies have researched on the toxicity of this plant. The aim of the present study was to investigate the potential effects of methanolic extract of Syzygium polyanthum (MESP) leaves via 28-day repeated oral dosing in Sprague Dawley rats. MESP leaves was administered at doses of 0 (control), 400, 1000 or 2000 mg/kg to an equal number of male and female rats (n = 10/group). Results obtained indicated that MESP did not affect the general conditions (body weight, feed intake and oestrous cycle) and apparent behavioural changes of the rats. Biochemical parameters revealed a slight significant variation in the aspartate aminotransferase (AST) level between the male rats treated with the lowest and highest doses of MESP, but these findings were both statistically insignificant when compared to the control group. The liver of the males (dose 1000 and 2000 mg/kg/day) also exhibited histoarchitectural defects on the hepatocytes and cytoplasm when compared to those of the control group. In contrast, female rats did not encounter any significant findings in all parameters tested. In conclusion, this study suggests that the MESP leaves might exhibit sex-based variation effects and thus, the use of this extract particularly at higher doses should be thoroughly considered.
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Affiliation(s)
- Nor Hazliana Harun
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Nor Atiqah Rasdi
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Rabeta Mohd Salleh
- Food Technology Division, School of Industrial Technology, Universiti Sains Malaysia, 11800 USM Pulau Pinang, Malaysia
| | - Sabreena Safuan
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Wan Amir Nizam Wan Ahmad
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Wan Ezumi Mohd Fuad
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia
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Kmeid M, Liu X, Ballentine S, Lee H. Idiopathic Non-Cirrhotic Portal Hypertension and Porto-Sinusoidal Vascular Disease: Review of Current Data. Gastroenterology Res 2021; 14:49-65. [PMID: 34007347 PMCID: PMC8110235 DOI: 10.14740/gr1376] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/30/2021] [Indexed: 12/29/2022] Open
Abstract
Idiopathic non-cirrhotic portal hypertension (INCPH) is a clinicopathologic disease entity characterized by the presence of clinical signs and symptoms of portal hypertension (PH) in the absence of liver cirrhosis or known risk factors accountable for PH. Multiple hematologic, immune-related, infectious, hereditary and metabolic risk factors have been associated with this disorder. Still, the exact etiopathogenesis is largely unknown. The recently proposed porto-sinusoidal vascular disease (PSVD) scheme broadens the spectrum of the disease by also including patients without clinical PH who are found to have similar histopathologic findings on core liver biopsies. Three histomorphologic lesions have been identified as specific for PSVD to include obliterative portal venopathy, nodular regenerative hyperplasia and incomplete septal cirrhosis/fibrosis. However, these findings are often subtle, under-recognized and subjective with low interobserver agreement among pathologists. Additionally, the natural history of the subclinical forms of the disease remains unexplored. The clinical course is more favorable compared to cirrhosis patients, especially in the absence of clinical PH or liver dysfunction. There are no universally accepted guidelines in regard to diagnosis and treatment of INCPH/PSVD. Hence, this review emphasizes the need to raise awareness of this entity by highlighting its complex pathophysiology and clinicopathologic associations. Lastly, formulation of standardized diagnostic criteria with clinical validation is necessary to avoid misclassifying vascular diseases of the liver and to develop and implement targeted therapeutic strategies.
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Affiliation(s)
- Michel Kmeid
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | - Xiuli Liu
- Department of Pathology and Laboratory Medicine, University of Florida at Gainesville, FL, USA
| | - Samuel Ballentine
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Hwajeong Lee
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
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Dhurandhar D, Bharihoke V, Kalra S. A histological assessment of effects of sucralose on liver of albino rats. Morphologie 2018; 102:197-204. [PMID: 30078469 DOI: 10.1016/j.morpho.2018.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 07/08/2018] [Accepted: 07/10/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE OF THE STUDY Sucralose is an artificial sweetener freely available under different brand names over the counter. This study is aimed at evaluating the histopathological changes in the liver after administration of sub lethal dose of pure sucralose. MATERIALS AND METHODS Inbred adult Wistar albino rats weighing about 150-200g of either sex, were divided into 6 control rats and 6 experimental rats. Experimental rats were given sucralose orally by gavage in the dose of 3g/kg/day dissolved in distilled water for 30 days whereas Control rats received equal quantity of distilled water by the same route. The animals were anesthetized with anesthetic ether and then perfused with 10% formal saline. Livers were dissected out. Pieces each having thickness 5mm were taken for paraffin sectioning. 5 micron thick sections were cut using a rotary microtome. Hundred slides were made from each liver and stained with hematoxylin and eosin, periodic acid-schiff (PAS) and Masson's trichrome stain. Slides were evaluated for histomorphological changes. RESULTS Experimental rats showed features of patchy degeneration of hepatocytes along with Kupffer cells hyperplasia, lymphocytic infiltration, sinusoidal dilatation and fibrosis indicating a definite hepatic damage on regular ingestion of sucralose. Sinusoidal width was also found to be increased in experimental animals as compared to controls. CONCLUSION It is suggestive that sucralose should be taken with caution to avoid hepatic damage. Effects of ingestion of sucralose on human subjects should be investigated further.
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Sunjaya DB, Ramos GP, Braga Neto MB, Lennon R, Mounajjed T, Shah V, Kamath PS, Simonetto DA. Isolated hepatic non-obstructive sinusoidal dilatation, 20-year single center experience. World J Hepatol 2018; 10:417-424. [PMID: 29844855 PMCID: PMC5971228 DOI: 10.4254/wjh.v10.i5.417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/23/2018] [Accepted: 05/11/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To characterize isolated non-obstructive sinusoidal dilatation (SD) by identifying associated conditions, laboratory findings, and histological patterns.
METHODS Retrospectively reviewed 491 patients with SD between 1995 and 2015. Patients with obstruction at the level of the small/large hepatic veins, portal veins, or right-sided heart failure were excluded along with history of cirrhosis, hepatic malignancy, liver transplant, or absence of electrocardiogram/cardiac echocardiogram. Liver histology was reviewed for extent of SD, fibrosis, red blood cell extravasation, nodular regenerative hyperplasia, hepatic peliosis, and hepatocellular plate atrophy (HPA).
RESULTS We identified 88 patients with non-obstructive SD. Inflammatory conditions (32%) were the most common cause. The most common pattern of liver abnormalities was cholestatic (76%). Majority (78%) had localized SD to Zone III. Medication-related SD had higher proportion of portal hypertension (53%), ascites (58%), and median AST (113 U/L) and ALT (90 U/L) levels. Nineteen patients in our study died within one-year after diagnosis of SD, majority from complications related to underlying diseases.
CONCLUSION Significant proportion of SD and HPA exist without impaired hepatic venous outflow. Isolated SD on liver biopsy, in the absence of congestive hepatopathy, requires further evaluation and portal hypertension should be rule out.
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Affiliation(s)
- Dharma Budi Sunjaya
- School of Graduate Medical Education, Mayo Clinic, Rochester, MN 55905, United States
| | | | | | - Ryan Lennon
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905, United States
| | - Taofic Mounajjed
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, United States
| | - Vijay Shah
- Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
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Jasso-Villagomez EI, Garcia-Lorenzana M, Almanza-Perez JC, Fortis-Barrera MA, Blancas-Flores G, Roman-Ramos R, Prado-Barragan LA, Alarcon-Aguilar FJ. Beetle (Ulomoides dermestoides) fat improves diabetes: effect on liver and pancreatic architecture and on PPARγ expression. ACTA ACUST UNITED AC 2018; 51:e7238. [PMID: 29694509 PMCID: PMC5996452 DOI: 10.1590/1414-431x20187238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/15/2018] [Indexed: 11/22/2022]
Abstract
Ulomoides dermestoides is a beetle traditionally consumed to
treat diabetes. In this study, we performed a composition analysis of U.
dermestoides to obtain the principal fractions, which were used to
assess the effect on glycemia, liver and pancreatic architecture, and
PPARγ and GLUT4 expression. Normal mice
and alloxan-induced diabetic mice were administered fractions of chitin, protein
or fat, and the acute hypoglycemic effect was evaluated. A subacute study
involving daily administration of these fractions to diabetic mice was also
performed over 30 days, after which the liver and pancreas were processed by
conventional histological techniques and stained with hematoxylin and eosin to
evaluate morphological changes. The most active fraction, the fat fraction, was
analyzed by gas chromatography-mass spectrometry (GC-MS), and
PPARγ and GLUT4 mRNA expressions were
determined in 3T3-L1 adipocytes. The protein and fat fractions exhibited
hypoglycemic effects in the acute as well as in the 30-day study. Only the fat
fraction led to elevated insulin levels and reduced glycemia, as well as lower
intake of water and food. In the liver, we observed recovery of close hepatic
cords in the central lobule vein following treatment with the fat fraction,
while in the pancreas there was an increased density and percentage of islets
and number of cells per islet, suggesting cellular regeneration. The GC-MS
analysis of fat revealed three fatty acids as the major components. Finally,
increased expression of PPARγ and GLUT4 was
observed in 3T3-L1 adipocytes, indicating an antidiabetic effect.
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Affiliation(s)
- E I Jasso-Villagomez
- Laboratory of Pharmacology, Department of Health Sciences, Division of Health and Biological Sciences, Metropolitan Autonomous University of Iztapalapa, Mexico City, Mexico
| | - M Garcia-Lorenzana
- Laboratory of Tissue Neurobiology, Department of Reproduction Biology, Division of Health and Biological Sciences, Metropolitan Autonomous University of Iztapalapa, Mexico City, Mexico
| | - J C Almanza-Perez
- Laboratory of Pharmacology, Department of Health Sciences, Division of Health and Biological Sciences, Metropolitan Autonomous University of Iztapalapa, Mexico City, Mexico
| | - M A Fortis-Barrera
- Laboratory of Pharmacology, Department of Health Sciences, Division of Health and Biological Sciences, Metropolitan Autonomous University of Iztapalapa, Mexico City, Mexico
| | - G Blancas-Flores
- Laboratory of Pharmacology, Department of Health Sciences, Division of Health and Biological Sciences, Metropolitan Autonomous University of Iztapalapa, Mexico City, Mexico
| | - R Roman-Ramos
- Laboratory of Pharmacology, Department of Health Sciences, Division of Health and Biological Sciences, Metropolitan Autonomous University of Iztapalapa, Mexico City, Mexico
| | - L A Prado-Barragan
- Laboratory of Solid State Fermentation, Department of Biotechnology, Division of Health and Biological Sciences, Metropolitan Autonomous University of Iztapalapa, Mexico City, Mexico
| | - F J Alarcon-Aguilar
- Laboratory of Pharmacology, Department of Health Sciences, Division of Health and Biological Sciences, Metropolitan Autonomous University of Iztapalapa, Mexico City, Mexico
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Valla DC, Cazals-Hatem D. Vascular liver diseases on the clinical side: definitions and diagnosis, new concepts. Virchows Arch. 2018;473:3-13. [PMID: 29572606 DOI: 10.1007/s00428-018-2331-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/21/2018] [Accepted: 02/27/2018] [Indexed: 12/17/2022]
Abstract
The components of the hepatic vascular system (hepatic arteries, portal and hepatic veins, sinusoids, and lymphatics) can be damaged by various types of injury. Each of the resulting conditions is rare, which has limited knowledge and awareness. In the last two decades, international collaborations have allowed to reach critical masses of data, which has driven significant progresses in understanding and management of vascular disorders of the liver. The present paper discusses definitions, denominations, and diagnosis of such vascular disorders with the exception of those affecting hepatic arteries. Evolving pathogenic or pathophysiologic views relevant to the clinical aspects are also overviewed.
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Li W, Zou J, Yue F, Song K, Chen Q, McKeehan WL, Wang F, Xu G, Huang H, Yi J, Liu L. Defects in MAP1S-mediated autophagy cause reduction in mouse lifespans especially when fibronectin is overexpressed. Aging Cell 2016; 15:370-9. [PMID: 26750654 PMCID: PMC4783353 DOI: 10.1111/acel.12441] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2015] [Indexed: 02/02/2023] Open
Abstract
Autophagy is a cellular process that executes the turnover of dysfunctional organelles and misfolded or abnormally aggregated proteins. Microtubule‐associated protein MAP1S interacts with autophagy marker LC3 and positively regulates autophagy flux. LC3 binds with fibronectinmRNA and facilitates its translation. The synthesized fibronectin protein is exported to cell surface to initiate the assembly of fibronectin extracellular matrix. Fibronectin is degraded in lysosomes after it is engulfed into cytosol via endocytosis. Here, we show that defects in MAP1S‐mediated autophagy trigger oxidative stress, sinusoidal dilation, and lifespan reduction. Overexpression of LC3 in wild‐type mice increases the levels of fibronectin and γ‐H2AX, a marker of DNA double‐strand breakage. LC3‐induced fibronectin is efficiently degraded in lysosomes to maintain a balance of fibronectin levels in wild‐type mice so that the mice live a normal term of lifespan. In the LC3 transgenic mice with MAP1S deleted, LC3 enhances the synthesis of fibronectin but the MAP1S depletion causes an impairment of the lysosomal degradation of fibronectin. The accumulation of fibronectin protein promotes liver fibrosis, induces an accumulation of cell population at the G0/G1 stage, and further intensifies oxidative stress and sinusoidal dilatation. The LC3‐induced overexpression of fibronectin imposes stresses on MAP1S‐deficient mice and dramatically reduces their lifespans. Therefore, MAP1S‐mediated autophagy plays an important role in maintaining mouse lifespan especially in the presence of extra amount of fibronectin.
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Affiliation(s)
- Wenjiao Li
- Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M Health Science Center 2121 W. Holcombe Blvd. Houston TX 77030 USA
| | - Jing Zou
- Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M Health Science Center 2121 W. Holcombe Blvd. Houston TX 77030 USA
- Department of ophthalmology Xiangya Hospital Central South University Changsha Hunan 410008 China
- Jiangxi Research Institute of Ophthalmology and Visual Sciences The Affiliated Eye Hospital of Nanchang University Nanchang 330006 China
| | - Fei Yue
- Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M Health Science Center 2121 W. Holcombe Blvd. Houston TX 77030 USA
| | - Kun Song
- Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M Health Science Center 2121 W. Holcombe Blvd. Houston TX 77030 USA
| | - Qi Chen
- Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M Health Science Center 2121 W. Holcombe Blvd. Houston TX 77030 USA
| | - Wallace L. McKeehan
- Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M Health Science Center 2121 W. Holcombe Blvd. Houston TX 77030 USA
| | - Fen Wang
- Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M Health Science Center 2121 W. Holcombe Blvd. Houston TX 77030 USA
| | - Guibin Xu
- Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M Health Science Center 2121 W. Holcombe Blvd. Houston TX 77030 USA
| | - Hai Huang
- Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M Health Science Center 2121 W. Holcombe Blvd. Houston TX 77030 USA
- Department of Urology The Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou 510120 China
| | - Jinglin Yi
- Jiangxi Research Institute of Ophthalmology and Visual Sciences The Affiliated Eye Hospital of Nanchang University Nanchang 330006 China
| | - Leyuan Liu
- Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M Health Science Center 2121 W. Holcombe Blvd. Houston TX 77030 USA
- Jiangxi Research Institute of Ophthalmology and Visual Sciences The Affiliated Eye Hospital of Nanchang University Nanchang 330006 China
- Department of Molecular and Cellular Medicine College of Medicine Texas A&M Health Science Center College Station TX 77843 USA
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Ronot M, Kerbaol A, Rautou PE, Brancatelli G, Bedossa P, Cazals-Hatem D, Valla DC, Vilgrain V. Acute extrahepatic infectious or inflammatory diseases are a cause of transient mosaic pattern on CT and MR imaging related to sinusoidal dilatation of the liver. Eur Radiol 2015; 26:3094-101. [DOI: 10.1007/s00330-015-4124-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 11/09/2015] [Accepted: 11/16/2015] [Indexed: 10/22/2022]
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Raafat N, Abdel Aal SM, Abdo FK, El Ghonaimy NM. Mesenchymal stem cells: In vivo therapeutic application ameliorates carbon tetrachloride induced liver fibrosis in rats. Int J Biochem Cell Biol 2015; 68:109-18. [PMID: 26369870 DOI: 10.1016/j.biocel.2015.09.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 08/20/2015] [Accepted: 09/09/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Egypt has the highest prevalence of hepatitis C virus in the world with infection rate up to 60%, for which liver fibrosis or hepatic carcinoma is the final outcome. Stem cell therapy provides a new hope for hepatic repair instead of traditional treatment, liver transplantation, as it is safer, gives long term engraftment and avoid expensive immunosuppressive drugs and unexpected hazardous effects. AIM This work aimed at determining the therapeutic potential of mesenchymal stem cells (MSC) in hepatic repair as a new line of therapy for liver fibrosis. METHODS 33 female albino rats were divided into three groups: Group I: 10 rats injected subcutaneously with olive oil, Group II: 13 rats injected with carbon tetrachloride (CCl4) and Group III: 10 rats injected with CCl4 then bone marrow derived MSC from male rats. Blood and liver tissue samples were taken from all rats for biochemical and histological study. RESULTS Liver functions for group II rats showed significant deterioration in response to CCl4 in addition to significant histological changes in liver lobules and portal areas. Those parameters tend to be normal in MSC-treated group. Group III rats revealed normalized liver function and histological picture. Meanwhile, most of the pathological lesions were still detected in rats of second group. CONCLUSION Undifferentiated MSCs have the ability to ameliorate CCl4 induced liver injury in albino rats in terms of liver functions and histological features. So, stem cell therapy can be considered clinically to offer a hope for patients suffering from liver fibrosis.
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Affiliation(s)
- Nermin Raafat
- Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Zagazig University, Egypt.
| | - Sara M Abdel Aal
- Histology & Cell Biology Department, Faculty of Medicine, Zagazig University, Egypt
| | - Fadia K Abdo
- Histology & Cell Biology Department, Faculty of Medicine, Zagazig University, Egypt
| | - Nabila M El Ghonaimy
- Histology & Cell Biology Department, Faculty of Medicine, Zagazig University, Egypt
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13
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Marzano C, Cazals-Hatem D, Rautou PE, Valla DC. The significance of nonobstructive sinusoidal dilatation of the liver: Impaired portal perfusion or inflammatory reaction syndrome. Hepatology 2015; 62:956-63. [PMID: 25684451 DOI: 10.1002/hep.27747] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 02/08/2015] [Indexed: 12/21/2022]
Abstract
UNLABELLED Sinusoidal dilatation found in the absence of an impaired sinusoidal blood outflow has been so far of unclear significance. Sinusoidal dilatation may actually be a nonspecific feature of impaired portal venous blood inflow, whatever the cause, or a feature of severe systemic inflammatory reaction syndrome, whatever the cause. Sinusoidal dilatation is mainly located in the centrilobular area even in the absence of an outflow block. A predominantly periportal location is specifically found in oral contraceptive users, associated with an inflammatory condition. There is strong evidence for the association of sinusoidal dilatation and oxaliplatin-based chemotherapy but not for estroprogestative steroids or thiopurine derivatives. Exposure to anabolic androgen steroids appears to cause sinusoidal changes different from a mere sinusoidal dilatation. CONCLUSION There is evidence of activation of the interleukin-6 and vascular endothelial growth factor pathways in sinusoidal dilatation, but the mechanisms linking the activation of these pathways with the microvascular changes must be identified.
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Affiliation(s)
- Chiara Marzano
- Dipartimento di Medicina Clinica, UOC di Gastroenterologia, Umberto I Policlinico di Roma, Sapienza Università di Roma, Rome, Italy
| | - Dominique Cazals-Hatem
- DHU UNITY, Laboratoire Central d'Anatomie et de Cytologie Pathologiques, Hôpital Beaujon, HUPNVS, APHP, Clichy-la-Garenne, France
- DHU Unity, Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, Hôpital Beaujon, AP-HP, Clichy, France
- CRI Paris-Montmartre, UMR 1149, Université Paris Diderot, PRES SPC, Hôpital Bichat, Paris, France
| | - Pierre-Emmanuel Rautou
- DHU Unity, Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, Hôpital Beaujon, AP-HP, Clichy, France
- Inserm, U970, Paris Cardiovascular Research Center-PARCC, Université Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France
| | - Dominique-Charles Valla
- DHU Unity, Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, Hôpital Beaujon, AP-HP, Clichy, France
- CRI Paris-Montmartre, UMR 1149, Université Paris Diderot, PRES SPC, Hôpital Bichat, Paris, France
- Inserm U1149, Hôpital Bichat, Paris, France
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Bernard C, Bailly F, Craigherot F, Bancel B, Brevet M, Broussolle C, Sève P, Bélénotti P. [Asthenia, weight loss and abdominal pain in a 64-year-old woman]. Rev Med Interne 2015; 36:706-9. [PMID: 26140744 DOI: 10.1016/j.revmed.2015.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 06/09/2015] [Indexed: 11/18/2022]
Affiliation(s)
- C Bernard
- Service de médecine interne, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France; Université de Lyon, Villeurbanne 69622 cedex, France
| | - F Bailly
- Service d'hépato-gastroentérologie, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France
| | - F Craigherot
- Service de radiologie, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France
| | - B Bancel
- Service d'anatomopathologie, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France
| | - M Brevet
- Service d'anatomopathologie, hôpital Louis-Pradel, hospices civils de Lyon, Bron, France
| | - C Broussolle
- Service de médecine interne, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France; Université de Lyon, Villeurbanne 69622 cedex, France
| | - P Sève
- Service de médecine interne, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France; Université de Lyon, Villeurbanne 69622 cedex, France.
| | - P Bélénotti
- Service de médecine interne, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Cimbanassi S, Aseni P, Mariani A, Sammartano F, Bonacina E, Chiara O. Spontaneous hepatic rupture during pregnancy in a patient with peliosis hepatis. Ann Hepatol 2015; 14:553-8. [DOI: 10.1016/s1665-2681(19)31179-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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Sommacale D, Palladino E, Tamby EL, Diebold MD, Kianmanesh AR. Spontaneous hepatic rupture in a patient with peliosis hepatis: A report of one case. Int J Surg Case Rep 2013; 4:508-10. [PMID: 23562904 DOI: 10.1016/j.ijscr.2013.01.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 01/17/2013] [Accepted: 01/21/2013] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Liver rupture is a serious event that is most commonly due to blunt abdominal trauma. We present a case of peliosis hepatis in a patient admitted for acute pyelonephritis who developed hemoperitoneum due to spontaneous hepatic rupture from this rare liver condition. PRESENTATION OF CASE We report a 44 year-old woman who presented to our hospital with acute pyelonephrititis and hemoperitoneum due to spontaneous hepatic rupture from peliosis hepatis. Physicians should be aware of this rare condition in patients who present with non-traumatic hepatic rupture with hemoperitoneum. DISCUSSION PH should be considered in all patients with known risk factors who present with typical morphological changes or a hepatic mass, especially when the cause of sudden intraperitoneal hemorrhage is obscure. CONCLUSION Peliosis hepatis is most often asymptomatic and an incidental finding at autopsy. In symptomatic patients, surgery should be reserved for those patients whose hemorrhage is-life-threatening. Familiarity with the imaging characteristics can help in earlier diagnosis of peliosis hepatis.
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Affiliation(s)
- Daniele Sommacale
- Department of General, Digestive and Endocrine Surgery, Reims University Hospital, France
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Abd El Aziz DH, Metwally HG. Effect of stem cell therapy on amiodarone-induced liver injury in albino rats. The Egyptian Journal of Histology 2012; 35:272-282. [DOI: 10.1097/01.ehx.0000414591.19244.e3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Geri G, Saadoun D, Cacoub P. Manifestations hépatiques des maladies systémiques. Rev Med Interne 2011; 32:486-93. [DOI: 10.1016/j.revmed.2010.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Revised: 04/24/2010] [Accepted: 07/19/2010] [Indexed: 12/20/2022]
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Panos G, Farouk L, Stebbing J, Holmes P, Valero S, Randell P, Bower M, Gazzard B, Anderson M, Nelson M. Cryptogenic pseudocirrhosis: a new clinical syndrome of noncirrhotic portal hypertension (unassociated with advanced fibrosis) that can be detected by transient elastography in patients with HIV. J Acquir Immune Defic Syndr. 2009;52:525-527. [PMID: 19901620 DOI: 10.1097/qai.0b013e3181bb27b1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Mallet V, Blanchard P, Verkarre V, Vallet-Pichard A, Fontaine H, Lascoux-Combe C, Pol S. Nodular regenerative hyperplasia is a new cause of chronic liver disease in HIV-infected patients. AIDS 2007; 21:187-92. [PMID: 17197809 DOI: 10.1097/qad.0b013e3280119e47] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To describe and explain the syndrome of HIV-associated cryptogenic liver disease in eight consecutive patients suffering from portal hypertension. METHODS The study was undertaken at a liver disease centre in Paris and involved eight of 97 consecutive HIV-infected patients presenting abnormal liver function tests and/or symptomatic portal hypertension of unknown origin. Serology, pathology, and liver function tests were performed. RESULTS A clear nodular architecture corresponding to nodular regenerative hyperplasia was observed in seven patients and suggested in one, based on the presence of sinusoidal dilatation in a clinical context of portal hypertension, without overt liver disease. CONCLUSIONS Nodular regenerative hyperplasia appears to be a new cause of portal hypertension in HIV-infected patients. This syndrome can be of critical importance as patients can be exposed to the significant complications of portal hypertension and to refractory ascites which may require liver transplantation.
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MESH Headings
- Amyloidosis/diagnosis
- Amyloidosis/pathology
- Autoimmune Diseases/diagnosis
- Autoimmune Diseases/pathology
- Biopsy
- Humans
- Hyperplasia
- Hypertension, Portal/diagnosis
- Hypertension, Portal/etiology
- Hypertension, Portal/pathology
- Hypertension, Portal/therapy
- Liver/blood supply
- Liver/pathology
- Liver Circulation
- Liver Cirrhosis, Biliary/diagnosis
- Liver Cirrhosis, Biliary/pathology
- Liver Diseases/congenital
- Liver Diseases/diagnosis
- Liver Diseases/pathology
- Liver Diseases/physiopathology
- Liver Diseases, Parasitic/diagnosis
- Liver Diseases, Parasitic/pathology
- Microcirculation
- Sarcoidosis/diagnosis
- Sarcoidosis/pathology
- Schistosomiasis/diagnosis
- Schistosomiasis/pathology
- Tuberculosis, Hepatic/diagnosis
- Tuberculosis, Hepatic/pathology
- Venules/pathology
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Affiliation(s)
- Sophie Hillaire
- Réseau Val de Seine, Hôpital Foch, Suresnes Hôpital Beaujon, Clichy
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Abstract
PURPOSE OF REVIEW This review highlights recent publications on hepatobiliary pathology concerning several unusual types of hepatitis, fatty liver disease, disorders of the biliary tree and other topics that have a substantial impact on liver biopsy interpretation. RECENT FINDINGS In the outbreak of severe acute respiratory syndrome (SARS), many patients had abnormalities in liver function tests. Liver biopsy findings in three cases were reported that showed a generic picture of hepatitis, with exceptionally increased mitotic activity. The role of portal myofibroblasts in cirrhosis was examined in several studies. A newly described lesion, isolated ductular hyperplasia (IDH) was found in patients with prolonged abnormalities of liver function tests of uncertain origin. Hyperplastic, well-differentiated bile ductules were seen on liver biopsy in the absence of any identifiable biliary disease. Hereditary hemochromatosis is now a complex entity with various clinicopathological forms based on mutations in the HFE gene and other iron-homeostatic genes such as transferrin receptor 2 and ferroportin 1. In some of these heritable forms of primary iron overload, stainable iron is present in both hepatocytes and Kupffer cells. After liver transplantation, differentiating recurrent HCV infection from acute rejection on liver biopsy is problematic, with exceptionally low inter- and intra-observer reliability shown in one study. SUMMARY The hepatitis associated with the SARS coronavirus, Isolated Ductular Hyperplasia in patients with liver function test abnormalities and other topics with pathologic relevance are reviewed.
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Affiliation(s)
- Jay H Lefkowitch
- Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
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