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Li XY, Liu SH, Liu C, Zu HM, Guo XQ, Xiang HL, Huang Y, Yan ZL, Li YJ, Sun J, Song RX, Yan JQ, Ye Q, Liu F, Huang L, Meng FP, Zhang XN, Yang SS, Hu SJ, Ruan JG, Li YL, Wang NN, Cui HP, Wang YM, Lei C, Wang QH, Tian HL, Qu ZS, Yuan M, Shi RC, Yang XT, Jin D, Su D, Liu YJ, Chen Y, Xia YX, Li YZ, Yang QH, Li H, Zhao XL, Tian ZM, Yu HJ, Zhang XJ, Wu CX, Wu ZJ, Li SS, Shen Q, Liu XM, Hu JP, Wu MQ, Dang T, Wang J, Meng XM, Wang HY, Jiang ZY, Liu YY, Liu Y, Qu SX, Tao H, Yan DM, Liu J, Fu W, Yu J, Wang FS, Qi XL, Fu JL. [Impact of different diagnostic criteria for assessing mild micro-hepatic encephalopathy in liver cirrhosis: an analysis based on a prospective, multicenter, real-world study]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:961-968. [PMID: 37872092 DOI: 10.3760/cma.j.cn501113-20220602-00298] [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] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Objective: To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test. Methods: This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ (2) test. A kappa test was used to compare the consistency between groups. Results: After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea (Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences (P < 0.001). Conclusion: The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.
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Affiliation(s)
- X Y Li
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China Medical School of Chinese PLA, Beijing 100853, China
| | - S H Liu
- The First School of Clinical Medicine of Lanzhou University, Lanzhou 730000, China
| | - C Liu
- Department of Radiology, Affiliated Zhongda Hospital, Southeast University, Nanjing 210000, China
| | - H M Zu
- Department of Gastroenterology, Qinghai Provincial Fourth People's Hospital, Xining 810000, China
| | - X Q Guo
- Department of Hepatology, the Third People's Hospital of Taiyuan, Taiyuan 030000, China
| | - H L Xiang
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Institute of Hepatobiliary Disease, Tianjin 300000, China
| | - Y Huang
- Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha 410000, China
| | - Z L Yan
- Department of Gastroenterology, Qinghai Provincial Fourth People's Hospital, Xining 810000, China
| | - Y J Li
- Department of Gastroenterology, Qinghai Provincial Fourth People's Hospital, Xining 810000, China
| | - J Sun
- Department of Hepatology, the Third People's Hospital of Taiyuan, Taiyuan 030000, China
| | - R X Song
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Institute of Hepatobiliary Disease, Tianjin 300000, China
| | - J Q Yan
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Institute of Hepatobiliary Disease, Tianjin 300000, China
| | - Q Ye
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Institute of Hepatobiliary Disease, Tianjin 300000, China
| | - F Liu
- Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha 410000, China
| | - L Huang
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China Medical School of Chinese PLA, Beijing 100853, China
| | - F P Meng
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China Medical School of Chinese PLA, Beijing 100853, China
| | - X N Zhang
- Medical School of Chinese PLA, Beijing 100853, China
| | - S S Yang
- Department of Gastroenterology, General Hospital of Ningxia Medical University, Yinchuan 750000, China
| | - S J Hu
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750000, China
| | - J G Ruan
- Branch Hospital for Diseases of the Heart, Brain, and Blood Vessels of General Hospital of Ningxia Medical University, Yinchuan 750000, China
| | - Y L Li
- Department of Gastroenterology, the First Affiliated Hospital of China Medical University, Shenyang 110000, China
| | - N N Wang
- Department of Gastroenterology, the First Affiliated Hospital of China Medical University, Shenyang 110000, China
| | - H P Cui
- Department of Gastroenterology, the First Affiliated Hospital of China Medical University, Shenyang 110000, China
| | - Y M Wang
- Department of Gastroenterology, the First Affiliated Hospital of China Medical University, Shenyang 110000, China
| | - C Lei
- Department of Hepatology, the First People's Hospital of Changde City, Changde 415000, China
| | - Q H Wang
- Department of Hepatology, the First People's Hospital of Changde City, Changde 415000, China
| | - H L Tian
- Department of Hepatology, the First People's Hospital of Changde City, Changde 415000, China
| | - Z S Qu
- Department of Infectious Diseases, Xiangxi People's Hospital, Jishou 416000, China
| | - M Yuan
- Department of Infectious Diseases, Xiangxi People's Hospital, Jishou 416000, China
| | - R C Shi
- Department of Gastroenterology, Wuzhong People's Hospital, Wuzhong 751100, China
| | - X T Yang
- Department of Gastroenterology, Wuzhong People's Hospital, Wuzhong 751100, China
| | - D Jin
- Department of Gastroenterology, Wuzhong People's Hospital, Wuzhong 751100, China
| | - D Su
- Department of Gastroenterology, Wuzhong People's Hospital, Wuzhong 751100, China
| | - Y J Liu
- Department of Hepatology, Hunan Provinces Directly Affiliated Traditional Chinese Medicine Hospital, Zhuzhou 412000, China
| | - Y Chen
- Department of Hepatology, Hunan Provinces Directly Affiliated Traditional Chinese Medicine Hospital, Zhuzhou 412000, China
| | - Y X Xia
- Department of Hepatology, Hunan Provinces Directly Affiliated Traditional Chinese Medicine Hospital, Zhuzhou 412000, China
| | - Y Z Li
- Department of Infectious Diseases, the First People's Hospital, Huaihua City, Huaihua 418000, China
| | - Q H Yang
- Department of Infectious Diseases, the First People's Hospital, Huaihua City, Huaihua 418000, China
| | - H Li
- Department of Infectious Diseases, the First People's Hospital, Huaihua City, Huaihua 418000, China
| | - X L Zhao
- Department of Hepatology, Chongqing Public Health Medical Center, Chongqing 400000, China
| | - Z M Tian
- Department of Hepatology, Chongqing Public Health Medical Center, Chongqing 400000, China
| | - H J Yu
- Department of Hepatology, Chongqing Public Health Medical Center, Chongqing 400000, China
| | - X J Zhang
- Department of Hepatology, Chongqing Public Health Medical Center, Chongqing 400000, China
| | - C X Wu
- Liver Disease Diagnosis and Treatment Center, the Fourth People's Hospital of Yiyang City, Yiyang 413000, China
| | - Z J Wu
- Liver Disease Diagnosis and Treatment Center, the Fourth People's Hospital of Yiyang City, Yiyang 413000, China
| | - S S Li
- Liver Disease Diagnosis and Treatment Center, the Fourth People's Hospital of Yiyang City, Yiyang 413000, China
| | - Q Shen
- Department of Gastroenterology, Yinchuan Second People's Hospital, Yinchuan 750000, China
| | - X M Liu
- Department of Gastroenterology, Yinchuan Second People's Hospital, Yinchuan 750000, China
| | - J P Hu
- Department of Gastroenterology, Yinchuan First People's Hospital, Yinchuan 750000, China
| | - M Q Wu
- Department of Gastroenterology, Yinchuan First People's Hospital, Yinchuan 750000, China
| | - T Dang
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014000, China
| | - J Wang
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014000, China
| | - X M Meng
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014000, China
| | - H Y Wang
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014000, China
| | - Z Y Jiang
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014000, China
| | - Y Y Liu
- Department of Gastroenterology, Dandong Central Hospital, Dandong 118000, China
| | - Y Liu
- Department of Gastroenterology, Dandong Central Hospital, Dandong 118000, China
| | - S X Qu
- Department of Gastroenterology, Dandong Central Hospital, Dandong 118000, China
| | - H Tao
- Department of Gastroenterology, Dandong Central Hospital, Dandong 118000, China
| | - D M Yan
- Department of Hepatology, Shenyang 739 Hospital, Shenyang 110000, China
| | - J Liu
- Department of Hepatology, Shenyang 739 Hospital, Shenyang 110000, China
| | - W Fu
- Department of Hepatology, Shenyang 739 Hospital, Shenyang 110000, China
| | - J Yu
- Department of Hepatology, Shenyang 739 Hospital, Shenyang 110000, China
| | - F S Wang
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China Medical School of Chinese PLA, Beijing 100853, China
| | - X L Qi
- The First School of Clinical Medicine of Lanzhou University, Lanzhou 730000, China Department of Radiology, Affiliated Zhongda Hospital, Southeast University, Nanjing 210000, China
| | - J L Fu
- Medical School of Chinese PLA, Beijing 100853, China Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
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Zhang DD, Zhang CY, Zhang YX, Cui HP, Jiao Chen, Wen-Zhi Ma, Jia H. G-CSF reduces loss of dopaminergic neurons by inhibiting TNF-α and IL-1β in mouse model of Parkinson's disease. Int J Neurosci 2023; 133:278-289. [PMID: 33781148 DOI: 10.1080/00207454.2021.1910259] [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] [Indexed: 10/21/2022]
Abstract
PURPOSE OF THE STUDY granulocyte-colony stimulating factor (G-CSF) is a hematopoietic growth factor existing in neutrophils, glial cells and neurons. Increasing researches discovered that G-CSF improved cell survival in neurodegenerative diseases by its anti-inflammatory effect. However, the effect of G-CSF in suppressing inflammation in Parkinson's disease (PD) remains unclear. Thus, the purpose of this study is to explored the anti-inflammatory effect of G-CSF in mouse model of PD. MATERIALS AND METHODS G-CSF was administrated in the PD model induced by MPTP. Subsequently, the protein of tyrosine hydroxylase (TH), ionized calcium-binding adaptor molecule 1 (Iba-1) and the inflammatory cytokines including tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) in the midbrain were examined. In addition, the phosphorylated mitogen-activated protein kinases (MAPK) including c-Jun NH2-terminal kinase (JNK), extracellular signal-regulated kinase (ERK) and p38 MAPK in the midbrain were investigated. RESULTS Compared with the MPTP group, the protein of TH in the midbrain was increased, while the Iba-1 and the inflammatory factors were decreased. In addition, the expression of phosphorylated JNK (p-JNK) in the midbrain of the MPTP + G-CSF group was decreased, while the phosphorylated ERK (p-ERK) levels were elevated. CONCLUSIONS These findings emphasize that G-CSF inhibited the degradation of DA neurons. The protective effect is associated with the reduction of the inflammatory factors caused by the inhibition of the microglial activation. Moreover, G-CSF may decrease the inflammatory factors through the decrease of P-JNK and the increase of P-ERK.
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Affiliation(s)
- Dan-Dan Zhang
- Department of Human Anatomy and Histoembryology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China.,Department of physiology, School of Basic Medical Sciences, Chengde Medical University, Chengde, China
| | - Cheng-Yun Zhang
- Department of Human Anatomy, School of Basic Medical Sciences, Chengde Medical University, Chengde, China
| | - Yu-Xin Zhang
- Department of Human Anatomy, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, China
| | - Hai-Peng Cui
- Department of Pathophysiology, School of Basic Medical Sciences, Chengde Medical University, Chengde, China
| | - Jiao Chen
- Department of Human Anatomy and Histoembryology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Wen-Zhi Ma
- Department of Human Anatomy and Histoembryology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China.,Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Key Laboratory of Reproduction and Genetics of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China.,Center for Reproductive Biology and Health, School of Agricultural Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Hua Jia
- Department of Human Anatomy and Histoembryology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China.,Center for Reproductive Biology and Health, School of Agricultural Sciences, The Pennsylvania State University, University Park, PA, USA
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Wang AG, Song YN, Chen J, Li HL, Dong JY, Cui HP, Yao L, Li XF, Gao WT, Qiu ZW, Wang FJ, Wang JY. Activation of RAS/ERK alone is insufficient to inhibit RXRα function and deplete retinoic acid in hepatocytes. Biochem Biophys Res Commun 2014; 452:801-7. [PMID: 25218146 DOI: 10.1016/j.bbrc.2014.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 08/19/2014] [Accepted: 09/01/2014] [Indexed: 12/19/2022]
Abstract
Activation of RAS/ERK signaling pathway, depletion of retinoid, and phosphorylation of retinoid X receptor alpha (RXRα) are frequent events found in liver tumors and thought to play important roles in hepatic tumorigenesis. However, the relationships among them still remained to be elucidated. By exploring the transgenic mouse model of hepatic tumorigenesis induced by liver-specific expression of H-ras12V oncogene, the activation of RAS/ERK, the mRNA expression levels of retinoid metabolism-related genes, the contents of retinoid metabolites, and phosphorylation of RXRα were determined. RAS/ERK signaling pathway was gradually and significantly activated in hepatic tumor adjacent normal liver tissues (P) and hepatic tumor tissues (T) of H-ras12V transgenic mice compared with normal liver tissues (Wt) of wild type mice. On the contrary, the mRNA expression levels of retinoid metabolism-related genes were significantly reduced in P and T compared with Wt. Interestingly, the retinoid metabolites 9-cis-retinoic acid (9cRA) and all-trans-retinoic acid (atRA), the well known ligands for nuclear transcription factor RXR and retinoic acid receptor (RAR), were significantly decreased only in T compared with Wt and P, although the oxidized polar metabolite of atRA, 4-keto-all-trans-retinoic-acid (4-keto-RA) was significantly decreased in both P and T compared with Wt. To our surprise, the functions of RXRα were significantly blocked only in T compared with Wt and P. Namely, the total protein levels of RXRα were significantly reduced and the phosphorylation levels of RXRα were significantly increased only in T compared with Wt and P. Treatment of H-ras12V transgenic mice at 5-week-old or 5-month-old with atRA had no effect on the prevention of tumorigenesis or cure of developed nodules in liver. These events imply that the depletion of 9cRA and atRA and the inhibition of RXRα function in hepatic tumors involve more complex mechanisms besides the activation of RAS/ERK pathway.
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Affiliation(s)
- Ai-Guo Wang
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China.
| | - Ya-Nan Song
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China
| | - Jun Chen
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China
| | - Hui-Ling Li
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China
| | - Jian-Yi Dong
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China
| | - Hai-Peng Cui
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China
| | - Liang Yao
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China
| | - Xue-Feng Li
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China
| | - Wen-Ting Gao
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China
| | - Ze-Wen Qiu
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China
| | - Fu-Jin Wang
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China
| | - Jing-Yu Wang
- Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning 116044, PR China.
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