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Borsoi FT, Neri-Numa IA, de Oliveira WQ, de Araújo FF, Pastore GM. Dietary polyphenols and their relationship to the modulation of non-communicable chronic diseases and epigenetic mechanisms: A mini-review. Food Chem (Oxf) 2023; 6:100155. [PMID: 36582744 DOI: 10.1016/j.fochms.2022.100155] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/18/2022] [Accepted: 12/11/2022] [Indexed: 12/14/2022]
Abstract
Chronic Non-Communicable Diseases (NCDs) have been considered a global health problem, characterized as diseases of multiple factors, which are developed throughout life, and regardless of genetics as a risk factor of important relevance, the increase in mortality attributed to the disease to environmental factors and the lifestyle one leads. Although the reactive species (ROS/RNS) are necessary for several physiological processes, their overproduction is directly related to the pathogenesis and aggravation of NCDs. In contrast, dietary polyphenols have been widely associated with minimizing oxidative stress and inflammation. In addition to their antioxidant power, polyphenols have also drawn attention for being able to modulate both gene expression and modify epigenetic alterations, suggesting an essential involvement in the prevention and/or development of some pathologies. Therefore, this review briefly explained the mechanisms in the development of some NCDs, followed by a summary of some evidence related to the interaction of polyphenols in oxidative stress, as well as the modulation of epigenetic mechanisms involved in the management of NCDs.
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Key Words
- 8-oxodG, 8-oxo-2́deosyguanosine
- ABCG, ATP Binding Cassette Subfamily G Member
- ADAM10, α-secretase
- ADRB3, adrenoceptor Beta 3
- APP, amyloid-β precursor protein
- ARF, auxin response factor
- ARH-I, aplysia ras homology member I
- ARHGAP24, Rho GTPase Activating Protein 24
- ATF6, activating transcription factor 6
- ATP2A3, ATPase Sarcoplasmic/Endoplasmic Reticulum Ca2+ Transporting 3
- BCL2L14, apoptosis facilitator Bcl-2-like protein 14
- Bioactive compounds
- CDH1, cadherin-1
- CDKN, cyclin dependent kinase inhibitor
- CPT, carnitine palmitoyltransferase
- CREBH, cyclic AMP-responsive element-binding protein H
- DANT2, DXZ4 associated non-noding transcript 2, distal
- DAPK1, death-associated protein kinase 1
- DNA methylation
- DNMT, DNA methyltransferase
- DOT1L, disruptor of telomeric silencing 1-like
- EWASs, epigenome-wide association studies
- EZH2, Enhancer of zeste homolog 2
- FAS, Fas cell Surface Death Receptor
- GDNF, glial cell line-derived neurotrophic factor
- GFAP, glial fibrillary acid protein
- GSTP1, Glutathione S-transferases P1
- Gut microbiota modulation
- HAT, histone acetylases
- HDAC, histone deacetylases
- HSD11B2, 11 beta-hydroxysteroid dehydrogenase type 2
- Histone modifications
- IGFBP3, insulin-like growth factor-binding protein 3
- IGT, impaired glucose tolerance
- KCNK3, potassium two pore domain channel subfamily K Member 3
- MBD4, methyl-CpG binding domain 4
- MGMT, O-6-methylguanine-DNA methyltransferase
- NAFLD, Non-alcoholic fatty liver disease
- OCT1, Organic cation transporter 1
- OGG1, 8-Oxoguanine DNA Glycosylase
- Oxidative stress
- PAI-1, plasminogen activator inhibitor 1
- PHOSPHO1, Phosphoethanolamine/Phosphocholine Phosphatase 1
- PLIN1, perilipin 1
- POE3A, RNA polymerase III
- PPAR, peroxisome proliferator-activated receptor
- PPARGC1A, PPARG coactivator 1 alpha
- PRKCA, Protein kinase C alpha
- PTEN, phosphatase and tensin homologue
- Personalized nutrition
- RASSF1A, Ras association domain family member 1
- SAH, S -adenosyl-l-homocysteine
- SAM, S-adenosyl-methionine
- SD, sleep deprivation
- SOCS3, suppressor of cytokine signaling 3
- SREBP-1C, sterol-regulatory element binding protein-1C
- TBX2, t-box transcription factor 2
- TCF7L2, transcription factor 7 like 2
- TET, ten-eleven translocation proteins
- TNNT2, cardiac muscle troponin T
- TPA, 12-O-tetradecanoylphorbol-13-acetate
- lncRNA, long non-coding RNA
- ncRNA, non-coding RNA
- oAβ-induced-LTP, oligomeric amyloid-beta induced long term potentiation
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Bashir A, Duseja A, Verma A, De A, Tiwari P. Lysosomal Acid Lipase Activity in Non-alcoholic Fatty Liver Disease as a Novel Diagnostic and Therapeutic Target: A Systematic Literature Review of Current Evidence and Future Directions. J Clin Exp Hepatol 2022; 12:1535-1546. [PMID: 36340307 PMCID: PMC9630019 DOI: 10.1016/j.jceh.2022.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/14/2022] [Accepted: 04/10/2022] [Indexed: 12/12/2022] Open
Abstract
Background and aim Non-alcoholic fatty liver disease (NAFLD) presents with the accumulation of excessive intra-hepatic fat without significant alcohol intake. Multifactorial pathogenesis is reported to be involved. Reduced lysosomal acid lipase (LAL) activity is suggested as one of the novel-involved pathogenic mechanisms. This review summarizes the available evidence on the role of LAL activity in NAFLD pathogenesis. Methods Four databases namely, PubMed/Medline, Science direct, Cochrane Library, and Google scholar were searched to identify relevant observational records evaluating the role of LAL activity in the pathogenesis of NAFLD. All studies were assessed for their quality by using Newcastle-Ottawa Scale or The Joanna Briggs Institute Critical Appraisal tools for cohort and cross-sectional studies, respectively. The estimates of LAL activity and other clinical outcomes were expressed as mean (SD) and number (%) as presented in the primary studies. Results A total of nine good quality studies with 1711 patients with NAFLD and 877 controls from different groups (healthy volunteers, alcoholics, cryptogenic cirrhosis, and HCV-positive) were included. From the NAFLD group, 59.55% were males and the overall mean age ranged between the studies from 12.6 ± 8.5 months in pediatrics to 58.90 ± 13.82 years in adults. In the NAFLD group, the LAL activity varied from 0.53 ± 0.08 to 1.3 ± 0.70 (nmol/spot/hr) between the studies which was less than all control groups except cryptogenic cirrhosis patients (0.5 ± 0.15 nmol/spot/hr). Of the other outcomes of interest, ALT, AST, total cholesterol, triglyceride, and LDL cholesterol were found elevated in NAFLD patients than in controls. Conclusion The current evidence suggests a potential correlation of reduced LAL activity with NAFLD pathogenesis according to its severity. Large-scale studies are recommended, more importantly in patients with NAFLD having no metabolic or genetic involvement. Further LAL can act as a new non-invasive diagnostic biomarker to identify that specific NAFLD subgroup.
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Key Words
- ALT, Alanine aminotransferase
- AST, Aspartate aminotransferase
- CESD, Cholesterol ester storage disease
- HCC, Hepatocellular carcinoma
- JBI, Joanna Briggs Institute
- LAL
- LAL, Lysosomal acid lipase
- MAFLD, Metabolic (dysfunction)-associated fatty liver disease
- NAFLD
- NAFLD, Non-alcoholic fatty liver disease
- NASH
- NASH, Non-alcoholic steatohepatitis
- NOS, Newcastle–Ottawa Scale
- PNPLA3, Patatin-like phospholipase domain containing 3 protein
- WD, Wolman disease
- pathogenesis
- systematic review
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Affiliation(s)
- Aamir Bashir
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar Mohali, Punjab, 160062, India
| | - Ajay Duseja
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Ashish Verma
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar Mohali, Punjab, 160062, India
| | - Arka De
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Pramil Tiwari
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar Mohali, Punjab, 160062, India
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Ikewaki N, Levy GA, Kurosawa G, Iwasaki M, Dedeepiya VD, Vaddi S, Senthilkumar R, Preethy S, Abraham SJ. Hepatoprotective Effects of Aureobasidium pullulans Derived β 1,3-1,6 Glucans in a Murine Model of Non-alcoholic Steatohepatitis. J Clin Exp Hepatol 2022; 12:1428-1437. [PMID: 36340302 PMCID: PMC9630018 DOI: 10.1016/j.jceh.2022.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 03/08/2022] [Accepted: 06/21/2022] [Indexed: 12/12/2022] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are highly prevalent conditions characterized by inflammation and fibrosis of the liver, which can progress to cirrhosis and hepatocellular carcinoma if left untreated. Conventional modalities are mainly symptomatic, with no definite solution. Beta-glucan-based biological response modifiers are a potential strategy in lieu of their beneficial metabolic effects. Aureobasidium pullulans strains AFO-202 and N-163 beta-glucans were evaluated for anti-fibrotic and anti-inflammatory hepatoprotective potentials in a NASH animal model in this study. Methods In the STAM™ murine model of NASH, five groups were studied for 8 weeks: (1) vehicle (RO water), (2) AFO-202 beta-glucan; (3) N-163 beta-glucan, (4) AFO-202+N-163 beta-glucan, and (5) telmisartan (standard pharmacological intervention). Evaluation of biochemical parameters in plasma and hepatic histology including Sirius red staining and F4/80 immunostaining were performed. Results AFO-202 beta-glucan significantly decreased inflammation-associated hepatic cell ballooning and steatosis. N-163 beta-glucan decreased fibrosis and inflammation significantly (P value < 0.05). The combination of AFO-202 with N-163 significantly decreased the NAFLD Activity Score (NAS) compared with other groups. Conclusion This preclinical study supports the potential of N-163 and AFO-202 beta-glucans alone or in combination as potential preventive and therapeutic agent(s), for NASH.
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Key Words
- ALT, Alanine aminotransferase
- ARRIVE, Animal Research: Reporting of In Vivo Experiments
- IL, Interleukin
- MCP-1, Monocyte chemoattractant protein-1
- NAFLD, Non-alcoholic fatty liver disease
- NAS, NAFLD Activity Score
- NASH, Non-alcoholic steatohepatitis
- PPAR, Peroxisome proliferator-activated receptor
- STAM, Stelic Animal Model
- TGF-β, Transforming growth factor beta
- TIMPs, Tissue inhibitors of matrix metalloproteinases
- TNF-α, Tumor necrosis factor alpha
- anti-fibrotic
- anti-inflammatory
- beta-glucans
- hepatoprotective
- non-alcoholic fatty liver disease (NAFLD)
- non-alcoholic steatohepatitis (NASH)
- telmisartan
- αSMA, Smooth muscle alpha-actin
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Affiliation(s)
- Nobunao Ikewaki
- Department of Medical Life Science, Kyushu University of Health and Welfare, Japan
- Institute of Immunology, Junsei Educational Institute, Nobeoka, Miyazaki, Japan
| | - Gary A. Levy
- Medicine and Immunology, University of Toronto, Ontario, Canada
| | - Gene Kurosawa
- Department of Academic Research Support Promotion Facility, Center for Research Promotion and Support, Fujita Health University, Aichi, Japan
- MabGenesis KK, Nagoya, Japan
| | - Masaru Iwasaki
- Centre for Advancing Clinical Research (CACR), University of Yamanashi - School of Medicine, Chuo, Japan
| | - Vidyasagar D. Dedeepiya
- Mary-Yoshio Translational Hexagon (MYTH), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India
| | | | - Rajappa Senthilkumar
- Fujio-Eiji Academic Terrain (FEAT), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India
| | - Senthilkumar Preethy
- Fujio-Eiji Academic Terrain (FEAT), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India
| | - Samuel J.K. Abraham
- Centre for Advancing Clinical Research (CACR), University of Yamanashi - School of Medicine, Chuo, Japan
- Mary-Yoshio Translational Hexagon (MYTH), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India
- Antony- Xavier Interdisciplinary Scholastics (AXIS), GN Corporation Co. Ltd., Kofu, Japan
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Shukla A, Patkar S, Sundaram S, Shah SR, Ingle M, Gupta A, Gopan A, Kamat M, Mohanka R, Singh S, Walke S, Pandey V, Goel M. Clinical Profile, Patterns of Care & adherence to Guidelines in Patients with Hepatocellular Carcinoma: Prospective multi-center Study. J Clin Exp Hepatol 2022; 12:1463-1473. [PMID: 36340319 PMCID: PMC9630010 DOI: 10.1016/j.jceh.2022.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/03/2021] [Accepted: 05/27/2022] [Indexed: 12/12/2022] Open
Abstract
Background and aims Increasing incidence of hepatocellular carcinoma (HCC) in India is a matter of concern and need for adequate profiling and streamlining management strategies cannot be over-emphasized. Methods This is a prospective multi-centric observational cohort study comprising of an oncology center, one university tertiary hospital with specialized hepatology service, one public hospital with gastroenterology service, and a private liver transplant center located within a 3-km radius. The demographic and clinical parameters were recorded on a prospectively maintained database. The clinical profile, demographics, characteristics of HCC and the allocated treatment were noted and compared among the four centers. Results In total, 672 patients were enrolled from June 2016 till January 2020. Abdominal pain (64.3%) and weight loss (47.3%) were the most common symptoms. Most common identified etiology was hepatitis B (39%). The cancer center received lesser patients with hepatitis C and those with advanced stage of HCC. The private transplant center reported the highest proportion of NASH, which was also significantly higher in those belonging to higher socioeconomic strata, and lowest proportion of alcoholic cirrhosis. Metastasis was seen in almost one-fifth (19%) cases at diagnosis. Portal vein thrombosis was evident in 40%. Adherence to treatment guidelines was seen in three-fourth cases (76%). Conclusions Hepatitis B is the most common underlying cause for HCC, whereas other causes like NASH are on the rise. Etiologic profile may vary with selective specialization of centers catering to patients with HCC. Adherence to guideline while allocating treatment was high among all centers with highest non-adherence in BCLC A.
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Key Words
- AASLD, American Association of Study of Liver Disease
- AFP, Alpha fetoprotein
- ALP, Alkaline phosphatase
- ALT, Alanine transaminase
- AST, Aspartate transaminase
- BCLC, Barcelona Clinic Liver Cancer staging
- BCS, Budd Chiari syndrome
- CT, Computed tomography
- EASL, European Association for Study of Liver
- GGT, Gamma glutamyl transpeptidase
- HBV, Hepatitis B virus
- HCC, Hepatocellular carcinoma
- HCV, Hepatitis C virus
- HKLC, Hong-Kong Liver Cancer staging
- HVPG, Hepatic venous pressure gradient
- INR, International normalized ratio
- MDT, Multidisciplinary team
- MRI, Magnetic resonance imaging
- NAFLD, Non-alcoholic fatty liver disease
- PHT, Portal hypertension
- PVTT, Portal venous tumor thrombosis
- clinical profile
- hepatocellular carcinoma
- milan criteria
- multicenter
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Affiliation(s)
- Akash Shukla
- Department of Gastroenterology, Seth G.S Medical College and King Edward Memorial Hospital, Mumbai, India
| | - Shraddha Patkar
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Sridhar Sundaram
- Department of Gastroenterology, Seth G.S Medical College and King Edward Memorial Hospital, Mumbai, India
| | - Samir R. Shah
- Department of Hepatology, Institute of Liver Disease, Hepato-pancreatico-biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - Meghraj Ingle
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - Amit Gupta
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Amrit Gopan
- Department of Gastroenterology, Seth G.S Medical College and King Edward Memorial Hospital, Mumbai, India
| | - Mrunal Kamat
- Department of Hepatology, Institute of Liver Disease, Hepato-pancreatico-biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - Ravi Mohanka
- Department of Hepatology, Institute of Liver Disease, Hepato-pancreatico-biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - Sandeep Singh
- Department of Hepatology, Institute of Liver Disease, Hepato-pancreatico-biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - Swapnil Walke
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - Vikas Pandey
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - Mahesh Goel
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
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Abstract
While outcomes after liver transplantation have increased over the last two decades, this is primarily as a consequence of a reduction in early deaths and survival of those who survive the first 6 months has not significantly changed. Causes of premature death and graft loss include cardiovascular disease, renal impairment, malignancy and some infections. As the number of transplant recipients increase, care is being given by primary and secondary care clinicians. Management of the well patient is crucially dependent on careful assessment and where appropriate intervention, especially of cardiovascular risk - such as advice about avoidance of weight gain; management of hypertension, hyperlipidaemia and diabetes; and provision of appropriate lifestyle advice. Other interventions include surveillance for de novo malignancies, active management of immunosuppressive regimen with the need to tailor immunosuppression to the individual. Prompt investigation of abnormalities of liver function is essential. Immune-mediated graft damage still occurs but is less common as a cause for graft loss. Adherence is sometimes an issue, especially in teenagers and young adults, and should be considered and support given where needed. Immunisations (avoiding live and attenuated vaccines) should be encouraged. Recurrence of disease remains an issue, and some interventions (such as appropriate use of antiviral therapy for those grafted with viral hepatitis, use of ursodeoxycholic acid for those grafted for primary biliary cholangitis or long-term steroids for those grafted for autoimmune disease) may improve and maintain graft function. Close collaboration between recipient and the attending clinicians in primary, secondary and tertiary care and close attention to modifiable conditions will lead to improved outcomes.
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Key Words
- CMV, Cytomegalovirus
- CNI, Calcineurin inhibitor
- DRR-4i, dipeptidyl peptidase-4 inhibitor
- GLP 1RA, glucagon-like peptide-1 receptor agonists
- HBIG, Hepatitis B Immunoglobulin
- HBV, Hepatitis B Virus
- HCC, Hepatocellular carcinoma
- HCV, Hepatitis C virus
- LDL-C, Low-density lipoprotein cholesterol
- LT, Liver transplant
- MDRD, Modification of Diet in Renal Disease
- MRC, Magnetic resonance cholangiography
- NAFLD, Non-alcoholic fatty liver disease
- NIDDK, National Institute of Diabetes and Digestive and Kidney Diseases
- NODAT, New onset diabetes after transplant
- NUC, Nucleos(t)ide analogues
- PBC, Primary Biliary Cholangitis
- PSC, Primary Sclerosing Cholangitis
- SGLT2i, sodium–glucose cotransporter 2 inhibitors
- SRTR, Scientific Registry of Transplant Recipients
- TMPT, Thiopurine S-methyltransferase
- USA, United States of America
- cardiovascular disease
- follow-up
- liver transplant
- mRNA, messenger Ribonucleic acid
- mTORi, mammalian Target of rapamycin inhibitor
- malignancy
- recurrent disease
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Affiliation(s)
- James Neuberger
- Liver Unit, Queen Elizabeth Hospital, Birmingham, B15 2TH, UK
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Balcar L, Scheiner B, Urheu M, Weinberger P, Paternostro R, Simbrunner B, Hartl L, Jachs M, Bauer D, Semmler G, Willheim C, Pinter M, Ferenci P, Trauner M, Reiberger T, Stättermayer AF, Mandorfer M. Alpha-1 antitrypsin Pi∗Z allele is an independent risk factor for liver transplantation and death in patients with advanced chronic liver disease. JHEP Rep 2022; 4:100562. [PMID: 36176936 PMCID: PMC9513767 DOI: 10.1016/j.jhepr.2022.100562] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 04/05/2022] [Revised: 07/21/2022] [Accepted: 08/09/2022] [Indexed: 11/28/2022] Open
Abstract
Background & Aims Alpha-1 antitrypsin (AAT) deficiency causes/predisposes individuals to advanced chronic liver disease (ACLD). However, the role of the SERPINA1 Pi∗Z allele in patients who have already progressed to ACLD is unclear. Thus, we aimed to evaluate the impact of the Pi∗Z allele on the risk of liver transplantation/liver-related death in patients with ACLD, while adjusting for the severity of liver disease at inclusion. Methods A total of 1,118 patients with ACLD who underwent hepatic venous pressure gradient (HVPG) measurement and genotyping for the Pi∗Z/Pi∗S allele at the Vienna Hepatic Hemodynamic Lab were included in this retrospective analysis. The outcome of interest was liver transplantation/liver-related death, while non-liver-related death and removal/suppression of the primary etiological factor were considered as competing risks. Results Viral hepatitis was the most common etiology (44%), followed by alcohol-related (31%) and non-alcoholic fatty liver disease (11%). Forty-two (4%) and forty-six (4%) patients harboured the Pi∗Z and Pi∗S variants, respectively. Pi∗Z carriers had more severe portal hypertension (HVPG: 19±6 vs.15±7 mmHg; p <0.001) and hepatic dysfunction (Child-Turcotte-Pugh: 7.1±1.9 vs. 6.5±1.9 points; p = 0.050) at inclusion, compared to non-carriers. Contrarily, the Pi∗S allele was unrelated to liver disease severity. In competing risk regression analysis, harbouring the Pi∗Z allele was significantly associated with an increased probability of liver transplantation/liver-related death, even after adjusting for liver disease severity at inclusion. The detrimental impact of the common Pi∗MZ genotype (adjusted subdistribution hazard ratio: ≈1.56 vs. Pi∗MM) was confirmed in a fully adjusted subgroup analysis. In contrast, Pi∗S carriers had no increased risk of events. Conclusion Genotyping for the Pi∗Z allele identifies patients with ACLD at increased risk of adverse liver-related outcomes, thereby improving prognostication. Therapies targeting the accumulation of abnormal AAT should be evaluated as disease-modifying treatments in Pi∗Z allele carriers with ACLD. Lay summary Alpha-1 antitrypsin deficiency is a genetic disease that affects the lung and the liver. Carrying two dysfunctional copies of the gene causes advanced liver disease. Harbouring one dysfunctional copy increases disease severity in patients with other liver illness. However, the significance of this genetic defect in patients who already suffer from advanced liver disease is unclear. Our study found that harbouring at least one dysfunctional copy of the alpha-1 antitrypsin gene increases the risk of requiring a liver transplantation or dying from a liver disease. This indicates the need for medical therapies aimed at treating the hepatic consequences of this genetic defect. Pi∗Z allele is significantly associated with liver-related events in patients with ACLD. This finding extends to patients harbouring the Pi∗MZ genotype. Genotyping for the Pi∗Z allele might improve prognostication in patients with ACLD. Therapies targeting accumulation of abnormal AAT should be assessed in Pi∗Z carriers with ACLD.
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Key Words
- (a[S])HR, (Adjusted [subdistribution]) hazard ratio
- AAT, Alpha-1 antitrypsin
- AATD
- AATD, Alpha-1 antitrypsin deficiency
- ACLD, Advanced chronic liver disease
- CTP, Child-turcotte-pugh score
- ER, Endoplasmic reticulum
- GWAS, Genome wide association studies
- HCC, Hepatocellular carcinoma
- HVPG, Hepatic venous pressure gradient
- NAFLD, Non-alcoholic fatty liver disease
- SERPINA1, Serpin family a member 1
- UNOS MELD (2016), United network for organ sharing model for end-stage liver disease
- cirrhosis
- genetic risk
- prognostication
- rare disease
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Affiliation(s)
- Lorenz Balcar
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Bernhard Scheiner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Markus Urheu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Patrick Weinberger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Rafael Paternostro
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Benedikt Simbrunner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Lukas Hartl
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Mathias Jachs
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - David Bauer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Georg Semmler
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Claudia Willheim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Matthias Pinter
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Peter Ferenci
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Thomas Reiberger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Albert Friedrich Stättermayer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
| | - Mattias Mandorfer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, Vienna, Austria
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Lazarus JV, Castera L, Mark HE, Allen AM, Adams LA, Anstee QM, Arrese M, Alqahtani SA, Bugianesi E, Colombo M, Cusi K, Hagström H, Loomba R, Romero-Gómez M, Schattenberg JM, Thiele M, Valenti L, Wong VWS, Yilmaz Y, Younossi ZM, Francque SM, Tsochatzis EA. Real-world evidence on non-invasive tests and associated cut-offs used to assess fibrosis in routine clinical practice. JHEP Rep 2022; 5:100596. [PMID: 36644239 PMCID: PMC9832273 DOI: 10.1016/j.jhepr.2022.100596] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 01/18/2023] Open
Abstract
Background & Aims Non-invasive tests (NITs) offer a practical solution for advanced fibrosis identification in non-alcoholic fatty liver disease (NAFLD). Despite increasing implementation, their use is not standardised, which can lead to inconsistent interpretation and risk stratification. We aimed to assess the types of NITs and the corresponding cut-offs used in a range of healthcare settings. Methods A survey was distributed to a convenience sample of liver health experts who participated in a global NAFLD consensus statement. Respondents provided information on the NITs used in their clinic with the corresponding cut-offs and those used in established care pathways in their areas. Results There were 35 respondents from 24 countries, 89% of whom practised in tertiary level settings. A total of 14 different NITs were used, and each respondent reported using at least one (median = 3). Of the respondents, 80% reported using FIB-4 and liver stiffness by vibration-controlled transient elastography (Fibroscan®), followed by the NAFLD fibrosis score (49%). For FIB-4, 71% of respondents used a low cut-off of <1.3 (range <1.0 to <1.45) and 21% reported using age-specific cut-offs. For Fibroscan®, 21% of respondents used a single liver stiffness cut-off: 8 kPa in 50%, while the rest used 7.2 kPa, 7.8 kPa and 8.7 kPa. Among the 63% of respondents who used lower and upper liver stiffness cut-offs, there were variations in both values (<5 to <10 kPa and >7.5 to >20 kPa, respectively). Conclusions The cut-offs used for the same NITs for NAFLD risk stratification vary between clinicians. As cut-offs impact test performance, these findings underscore the heterogeneity in risk-assessment and support the importance of establishing consistent guidelines on the standardised use of NITs in NAFLD management. Lay summary Owing to the high prevalence of non-alcoholic fatty liver disease (NAFLD) in the general population it is important to identify those who have more advanced stages of liver fibrosis, so that they can be properly treated. Non-invasive tests (NITs) provide a practical way to assess fibrosis risk in patients. However, we found that the cut-offs used for the same NITs vary between clinicians. As cut-offs impact test performance, these findings highlight the importance of establishing consistent guidelines on the standardised use of NITs to optimise clinical management of NAFLD.
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Affiliation(s)
- Jeffrey V. Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Corresponding author. Address: Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle del Rosselló 171, ENT-2, ES-08036 Barcelona, Spain. Tel.: +34 608 703 573.
| | - Laurent Castera
- Université de Paris, UMR1149 (CRI), Inserm, Paris, France & Service d’Hépatologie, AP-HP, Hôpital Beaujon, Clichy, France
| | - Henry E. Mark
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Alina M. Allen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Leon A. Adams
- Department of Hepatology and Liver Transplant Unit, Sir Charles Gairdner Hospital, Medical School, University of Western Australia, Perth, Australia
| | - Quentin M. Anstee
- Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle NIHR Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, UK
| | - Marco Arrese
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Envejecimiento y Regeneración (CARE), Departamento de Biología Celular y Molecular, Facultad de Ciencias Biologicas, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Saleh A. Alqahtani
- Division of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, USA
- Organ Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Elisabetta Bugianesi
- Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | | | - Kenneth Cusi
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA
| | - Hannes Hagström
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Rohit Loomba
- Department of Medicine, NAFLD Research Center, La Jolla, CA, USA
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Manuel Romero-Gómez
- Virgen del Rocio University Hospital, Institute of Biomedicine of Seville (HUVR/CSIC/US), CIBEREHD, University of Seville, Seville, Spain
| | - Jörn M. Schattenberg
- Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany
| | - Maja Thiele
- Liver Research Center, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Precision Medicine, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Vincent Wai-Sun Wong
- Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Yusuf Yilmaz
- Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
- Liver Research Unit, Institute of Gastroenterology, Marmara University, Istanbul, Turkey
| | | | - Sven M. Francque
- Department of Gastroenterology Hepatology, University Hospital Antwerp & Translational Sciences in Inflammation and Immunology TWI2N, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Emmanuel A. Tsochatzis
- University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom
- Sheila Sherlock Liver Centre, Royal Free Hospital, London, United Kingdom
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8
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Agrahari AK, Dikshit M, Asthana S. Crystallographic mining of ASK1 regulators to unravel the intricate PPI interfaces for the discovery of small molecule. Comput Struct Biotechnol J 2022; 20:3734-54. [PMID: 35891784 DOI: 10.1016/j.csbj.2022.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/04/2022] [Accepted: 07/04/2022] [Indexed: 11/22/2022] Open
Abstract
Protein seldom performs biological activities in isolation. Understanding the protein–protein interactions’ physical rewiring in response to pathological conditions or pathogen infection can help advance our comprehension of disease etiology, progression, and pathogenesis, which allow us to explore the alternate route to control the regulation of key target interactions, timely and effectively. Nonalcoholic steatohepatitis (NASH) is now a global public health problem exacerbated due to the lack of appropriate treatments. The most advanced anti-NASH lead compound (selonsertib) is withdrawn, though it is able to inhibit its target Apoptosis signal-regulating kinase 1 (ASK1) completely, indicating the necessity to explore alternate routes rather than complete inhibition. Understanding the interaction fingerprints of endogenous regulators at the molecular level that underpin disease formation and progression may spur the rationale of designing therapeutic strategies. Based on our analysis and thorough literature survey of the various key regulators and PTMs, the current review emphasizes PPI-based drug discovery’s relevance for NASH conditions. The lack of structural detail (interface sites) of ASK1 and its regulators makes it challenging to characterize the PPI interfaces. This review summarizes key regulators interaction fingerprinting of ASK1, which can be explored further to restore the homeostasis from its hyperactive states for therapeutics intervention against NASH.
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Key Words
- ASK1
- ASK1, Apoptosis signal-regulating kinase 1
- CFLAR, CASP8 and FADD-like apoptosis regulator
- CREG, Cellular repressor of E1A-stimulated genes
- DKK3, Dickkopf-related protein 3
- Interaction fingerprint
- NAFLD, Non-alcoholic fatty liver disease
- NASH
- NASH, Nonalcoholic steatohepatitis
- PPI, Protein-protein interaction
- PTM, Post-trancriptional modification
- PTMs
- Protein-protein interaction
- TNFAIP3, TNF Alpha Induced Protein 3
- TRAF2/6, Tumor necrosis factor receptor (TNFR)-associated factor2/6
- TRIM48, Tripartite Motif Containing 48
- TRX, Thioredoxin
- USP9X, Ubiquitin Specific Peptidase 9 X-Linked
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Abaci N, Senol Deniz FS, Orhan IE. Kombucha - An ancient fermented beverage with desired bioactivities: A narrowed review. Food Chem X 2022; 14:100302. [PMID: 35434600 PMCID: PMC9011011 DOI: 10.1016/j.fochx.2022.100302] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Received: 02/05/2022] [Revised: 03/24/2022] [Accepted: 04/04/2022] [Indexed: 12/18/2022] Open
Abstract
Kombucha is a fermented beverage usually prepared with black or green tea. Fermentation is caused by SCOBY that is biofilm made of bacteria and yeasts. It is quite rich in tea catechins, flavonoids, and other polyphenols. Fermentation conditions, i.e. pH, duration, sugar rate, cause variation. The main acidic compound is acetic acid in kombucha.
Kombucha, originated in China 2000 years ago, is a sour and sweet-tasted drink, prepared traditionally through fermentation of black tea. During the fermentation of kombucha, consisting of mainly acidic compounds, microorganisms, and a tiny amount of alcohol, a biofilm called SCOBY forms. The bacteria in kombucha has been generally identified as Acetobacteraceae. Kombucha is a noteworthy source of B complex vitamins, polyphenols, and organic acids (mainly acetic acid). Nowadays, kombucha is tended to be prepared with some other plant species, which, therefore, lead to variations in its composition. Pre-clinical studies conducted on kombucha revealed that it has desired bioactivities such as antimicrobial, antioxidant, hepatoprotective, anti-hypercholestorelomic, anticancer, anti-inflammatory, etc. Only a few clinical studies have been also reported. In the current review, we aimed to overhaul pre-clinical bioactivities reported on kombucha as well as its brief compositional chemistry. The literature data indicate that kombucha has valuable biological effects on human health.
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Key Words
- ABTS, 2,2-azinobis-(3-ethylbenzotiazoline-6-sulfonic acid)
- ACE, Angiotensin-converting enzyme
- AHA, Alpha hydroxy acid
- ALP, Alkaline phosphatase
- ALT, Alanine aminotransferase
- AMPK, Adenosine monophosphate-activated protein kinase
- AST, Aspartate aminotransferase
- ATCC, American type culture collection
- BBB, Blood-brain barrier
- Bioactivity
- Biofilm
- CAT, Catalase
- COVID-19, Coronavirus disease of 2019
- DNA, Deoxyribonucleic Acid
- DPPH, 2,2-diphenyl-1-picrylhydrazyl
- DSL, d-Saccharic acid-1,4-lactone
- EGCG, Epigallocatechin gallate
- FRAP, Ferric reducing antioxidant power
- Fermented drink
- GC–MS, Gas chromatography- mass spectrometry
- GGT, Gamma glutamyl transferase
- GPx, Glutathione peroxidase
- GRx, Glutathione reductase
- GST, Glutathione S-transferase
- HDL, High density lipoprotein
- HPLC, High-performance liquid chromatography
- HPLC-MS/MS, High-performance liquid chromatography- mass spectrometry/ mass spectrometry
- HPLC-UV-ESI-MS, High-performance liquid chromatography-ultraviolet- electrospray ionization-mass spectrometry
- HPLC/ESI–MS, High-performance liquid chromatography/electrospray ionization-mass spectrometry
- HbA1c, Glycosylated Hemoglobin, Type A1C
- IC50, Half maximal ınhibitory concentration
- IL, Interleukin
- Kombucha
- LC-MS, Liquid chromatography–mass spectrometry
- LDH, Lactate dehydrogenase
- LDL, Low-density lipoprotein
- LOX, Lipoxygenase
- LPS, Lipopolysaccharide
- MCD, Methionine/choline-deficient diet
- MCDM, Multi-criteria decision-making MDA, Malondialdehyde
- MIC, Minimum inhibitory concentration
- Microorganism
- NAD, Nicotinamide adenine dinucleotide
- NAFLD, Non-alcoholic fatty liver disease
- NO, Nitric oxide
- ORAC, Oxygen radical absorbance capacity
- RNS, Reactive nitrogen species
- ROS, Reactive oxygen species
- SASP, Senescence-associated secretory phenotype
- SCOBY, Symbiotic culture of bacteria and yeast
- SMC, Synthetic microbial community
- SOD, Superoxide dismutase
- SPF, Sun Protection Factor
- TAA, Thioacetamide
- TE, Trolox equivalent
- TEAC, Trolox-equivalent antioxidant capacity
- TG, Triglyceride
- TLC, Thin-layer chromatography
- TNF-α, Tumour necrosis factor alpha
- UVB, Ultraviolet radiation-B
- VLDL, Very low-density lipoprotein
- WGJ, Wheatgrass juice
- WoS, Web of Science
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Affiliation(s)
- Nurten Abaci
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, 06330 Ankara, Turkey
| | | | - Ilkay Erdogan Orhan
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, 06330 Ankara, Turkey.,Turkish Academy of Sciences (TÜBA), Vedat Dalokay Cad., No. 112, 06670 Ankara, Turkey
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Abstract
Portal hypertension is the cause of the clinical complications associated with cirrhosis. The primary complications of portal hypertension are ascites, acute variceal bleed, and hepatic encephalopathy. Hepatic venous pressure gradient measurement remains the gold standard test for diagnosing cirrhosis-related portal hypertension. Hepatic venous pressure gradient more than 10 mmHg is associated with an increased risk of complications and is termed clinically significant portal hypertension (CSPH). Clinical, laboratory, and imaging methods can also aid in diagnosing CSPH non-invasively. Recently, deep learning methods have been demonstrated to diagnose CSPH effectively. The management of portal hypertension is always individualized and is dependent on the etiology, the availability of therapies, and the degree of portal hypertension complications. In this review, we discuss the diagnosis and management of cirrhosis-related portal hypertension in detail. Also, we highlight the history of portal hypertension and future research areas in portal hypertension.
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Key Words
- ACLF, acute-on-chronic liver failure
- AKI, acute kidney injury
- APRI, AST to platelet ratio
- AST, aspartate transaminase
- BB, Beta blocker
- BRTO, balloon occluded retrograde transvenous obliteration
- CKD, chronic kidney disease
- CSPH, clinically significant portal hypertension
- CT, computed tomography
- GFR, glomerular filtration rate
- GOV, gastrpoesopahegal varices
- HE, hepatic encephalopathy
- HRS, hepatorenal syndrome
- HVPG, hepatic venous pressure gradient
- ICG, indocyanine green
- LOLA, l-ornithine l-aspartate
- NAFLD, Non-alcoholic fatty liver disease
- SBP, spontaneous bacterial peritonitis
- SGLT2I, sodium glucose co-transporter 2 inhibitors
- SSM, splenic stiffness measurement
- TE, transient elastography
- TIPS, transjugular intrahepatic portosystemic shunt
- VITRO, von Willebrand factor to platelet counts
- acute kidney injury
- ascites
- hemodynamics
- history
- vasoconstrictors
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Affiliation(s)
- Anand V. Kulkarni
- Department of Hepatology, AIG Hospitals, Hyderabad, India,Address for correspondence: Dr. Anand V. Kulkarni, MD, DM., Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
| | | | - Arpan Mohanty
- Boston University School of Medicine, Boston, MA, USA
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11
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Anand A, Singh AA, Elhence A, Vaishnav M, Biswas S, Gunjan D, Gamanagatti SR, Nayak B, Kumar R, Shalimar. Prevalence and Predictors of Nonalcoholic Fatty Liver Disease in Family Members of Patients With Nonalcoholic Fatty Liver Disease. J Clin Exp Hepatol 2022; 12:362-371. [PMID: 35535086 PMCID: PMC9077183 DOI: 10.1016/j.jceh.2021.07.013] [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: 04/26/2021] [Accepted: 07/25/2021] [Indexed: 12/12/2022] Open
Abstract
Background and aims Nonalcoholic fatty liver disease (NAFLD) is the commonest cause of chronic liver disease worldwide. Despite the high prevalence, no screening recommendations yet exist. We designed a prospective observational study to estimate the prevalence of NAFLD in the family of patients with NAFLD and develop a predictive model for identifying it. Methodology The prevalence of NAFLD in patients' family members was estimated using ultrasonography, and univariate and multivariate odds were calculated for its predictors. A model was created using the significant parameters on multivariate odds, and its performance was tested using the area under the receiver operating characteristic (AUROC). Results Among 447 family members of 191 patients with NAFLD, the prevalence of NAFLD was 55.9%. Family members with NAFLD were younger and had lower serum levels of aspartate aminotransferase, alanine aminotransferase (ALT), triglycerides. The liver stiffness measurement and controlled attenuation parameter values were also lesser in family members compared to the index cases. Age, body mass index (BMI), and ALT were independent predictors of NAFLD in the family members. A model combining age and BMI had an AUROC of 0.838 [95% confidence interval (CI) 0.800-0.876, P < 0.001]. Age ≥30 years and BMI ≥25 kg/m2 had an odds ratio of 33.5 (95% CI 17.0-66.0, P < 0.001) for prediction of NAFLD, in comparison to BMI <25 kg/m2 and age <30 years. Conclusion Family members of patients with NAFLD are at increased risk of NAFLD. Screening strategies using BMI and age ensure early identification and could be beneficial in clinical practice.
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Key Words
- ALT, Alanine aminotransferase
- APRI, AST to platelet ratio index
- AST, Aspartate aminotransferase
- AUROC, Area under ROC
- BMI
- BMI, Body mass index
- CAP, Controlled attenuation parameter
- CI, Confidence interval
- EASL, European Association for the Study of the Liver
- FAST, FibroScan-AST
- FDRs, First-degree relatives
- FIB-4, Fibrosis-4
- HDL-C, High-density lipoprotein-cholesterol
- HbA1C, Glycosylated hemoglobin
- LSM, Liver stiffness measure
- MetS, Metabolic syndrome
- NAFLD, Non-alcoholic fatty liver disease
- NASH, Non-alcoholic steatohepatitis
- NCEP-ATP, National Cholesterol Education Program- Adult Treatment Panel
- NFS, NAFLD fibrosis score
- OR, Odds ratio
- ROC, Receiver operating curve
- family members
- nonalcoholic fatty liver disease
- predictors
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Affiliation(s)
- Abhinav Anand
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Amit A. Singh
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Anshuman Elhence
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Manas Vaishnav
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Sagnik Biswas
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Gunjan
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | | | - Baibaswata Nayak
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Ramesh Kumar
- Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Shalimar
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India,Address for correspondence: Dr Shalimar, Additional Professor, Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, 110029, India. Tel.: +91 9968405815; Fax: +91 11 26588663, +91 11 26588641.
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12
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Jothimani D, Danielraj S, Narasimhan G, Kaliamoorthy I, Rajakumar A, Palaniappan K, Palanichamy S, Rammohan A, Ramachandran H, Rajalingam R, Rela M. Nonalcoholic Steatohepatitis: A Rapidly Increasing Indication for Liver Transplantation in India. J Clin Exp Hepatol 2022; 12:908-16. [PMID: 35677507 DOI: 10.1016/j.jceh.2021.09.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/17/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND AIMS Recently, there has been a considerable increase in patients with nonalcoholic fatty liver disease. Availability of high-efficacy drugs for hepatitis B and hepatitis C virus (HCV) infection may have changed the disease prevalence. We aimed to study the impact of this changing epidemiology in patients undergoing liver transplantation (LT) over a 10-year period. METHODS The study population was stratified into Period 1 (2009-2014) and Period 2 (2015-2019). Demographics, indications for LT and changes in the epidemiology between two periods were analysed. Aetiology-based posttransplant survival analysis was carried out. RESULTS Indication for LT among 1017 adult patients (277 in Period 1 and 740 in Period 2) showed a significant increase in nonalcoholic steatohepatitis (NASH; 85 [30.7%] and 311 [42%]; P = 0.001), decrease in hepatitis C (49 [17.7%] and 75 [10.1%]; P = 0.002), and increase in hepatocellular carcinoma from Period 1 to Period 2 (13 [26.5%] to 38 [50.7%]; P = 0.009) among HCV patients. Patients transplanted for NASH had a lower 5-year survival compared with viral hepatitis (75.9% vs 87.4%; P = 0.03). There was a strong association between coronary artery disease and NASH (hazard ratio = 1.963, 95% confidence interval, 1.19-3.22). CONCLUSION NASH is the leading indication for liver transplantation in India, surpassing viral hepatitis in recent years.
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Key Words
- ASH, Non-alcoholic steatohepatitis
- CAD, Coronary artery disease
- CLD, Chronic liver disease
- DAA, Direct acting antiviral drugs
- DM, Diabetes mellitus
- HBV, Hepatitis B virus infection
- HCC, Hepatocellular carcinoma
- HCV, Hepatitis C virus infection
- LT, Liver transplantation
- NAFLD, Non-alcoholic fatty liver disease
- SVR, Sustained virological response
- cardiovascular disease
- hepatocellular carcinoma
- liver transplantation
- nonalcoholic steatohepatitis
- viral hepatitis
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Chhabra S, Singh SP, Singh A, Mehta V, Kaur A, Bansal N, Sood A. Diabetes Mellitus Increases the Risk of Significant Hepatic Fibrosis in Patients With Non-alcoholic Fatty Liver Disease. J Clin Exp Hepatol 2022; 12:409-416. [PMID: 35535092 PMCID: PMC9077176 DOI: 10.1016/j.jceh.2021.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 04/19/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Diabetes mellitus is associated with an increased risk of development of non-alcoholic fatty liver disease (NAFLD). However, the risk posed by diabetes mellitus in progression of liver disease is uncertain. This study compared the severity of hepatic fibrosis in patients with NAFLD with and without diabetes mellitus. Methods Consecutive adult patients with NAFLD undergoing transient elastography [FibroScan Touch 502 (Echosens, Paris, France)] at a tertiary care center in north India were analyzed for severity of hepatic fibrosis. The aspartate aminotransferase (AST) to platelet ratio index (APRI), fibrosis index based on 4 factors (FIB-4), and NAFLD Fibrosis Score (NFS) were calculated. The degree of hepatic fibrosis as determined by FibroScan and non-invasive serum fibrosis models in patients with and without diabetes mellitus were compared. Results A total of two hundred patients [118 (59%) males, mean age 50.30 ± 11.13 years] were enrolled. Significant hepatic fibrosis was present in 86 (43%) patients [mean age 50.66 ± 10.96 years, 56 (65.11%) males]. The mean FibroScan, APRI, FIB-4, and NFS scores were 9.86 ± 2.97, 0.75 ± 0.47, 2.41 ± 1.41 and -0.24 ± 1.43 in patients with diabetes compared to 5.31 ± 1.09, 0.49 ± 0.27, 1.55 ± 0.85, and -2.12 ± 1.88 in patients without diabetes, respectively (P=<0.0001). There was a fair correlation between FibroScan and non-invasive serum fibrosis models (P=<0.0001). Conclusion Presence of diabetes increases the risk of significant hepatic fibrosis in patients with NAFLD. FIB-4 correlates fairly with FibroScan in patients with diabetes and can be used as a screening tool to detect significant hepatic fibrosis.
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Key Words
- ALT, Alanine aminotransferase
- APRI, Aspartate aminotransferase to platelet ratio index
- AST, Aspartate aminotransferase
- DM, Diabetes Mellitus
- FIB-4, Fibrosis index based on 4 factors
- HDL, High-density lipoprotein
- HbA1C, Glycosylated hemoglobin
- IFG, Impaired fasting glucose
- LDL, Low-density lipoprotein
- NAFLD, Non-alcoholic fatty liver disease
- NASH, Non-alcoholic steatohepatitis
- NFS, NAFLD Fibrosis Score
- TE, Transient Elastography
- diabetes mellitus
- fibrosis
- liver cirrhosis
- non-alcoholic fatty liver disease
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Affiliation(s)
- Sandeep Chhabra
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | - Sukhraj P. Singh
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | - Arshdeep Singh
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Varun Mehta
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India,Address for correspondence. Varun Mehta, Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India.
| | - Amninder Kaur
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India
| | - Namita Bansal
- Department of Research and Development, Dayanand Medical College and Hospital, Ludhiana, India
| | - Ajit Sood
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India
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14
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Abstract
Chronic liver disease (CLD) is one of the leading causes of disability-adjusted life years in many countries. A recent understanding of nuclear bile acid receptor pathways has increased focus on the impact of crosstalk between the gut, bile acids, and liver on liver pathology. While conventionally used in cholestatic disorders and to dissolve gallstones, the discovery of bile acids' influence on the gut microbiome and human metabolism offers a unique potential for their utility in early and advanced liver diseases because of diverse etiologies. Based on these findings, preclinical studies using bile acid-based molecules have shown encouraging results at addressing liver inflammation and fibrosis. Emerging data also suggest that bile acid profiles change distinctively across various causes of liver disease. We summarize the current knowledge and evidence related to bile acids in health and disease and discuss culminated and ongoing therapeutic trials of bile acid derivatives in CLD. In the near future, further evidence in this area might help clinicians better detect and manage liver diseases.
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Key Words
- AD, Acute decompensation
- ALP, Alkaline phosphatase
- AMACR, α-methylacyl-CoA racemase (AMACR)
- ASBT, Apical sodium dependent bile salt transporter
- BA, Bile acid
- BSEP, Bile salt export pump
- BSH, Bile salt hydrolase
- CA, Cholic acid
- CDCA, Chenodeoxycholic acid
- CLD
- CLD, Chronic Liver Disease
- CTP, Child-Turcotte-Pugh
- CYP7A1, Cholesterol 7 α hydroxylase
- DCA, Deoxycholic acid
- DR5, Death receptor 5
- ELF, Enhanced Liver Fibrosis
- FGF-19, Fibroblast growth factor-19
- FGFR4, FGF receptor 4
- FXR, Farnesoid X receptor
- GCA, Glycocholic acid
- GDCA, Glycodeoxycholic acid
- GLP-1, Glucagon-like peptide1
- HBV, Hepatitis B virus
- HCV, Hepatitis C virus
- HVPG, Hepatic Venous Pressure Gradient
- LCA, Lithocholic acid
- LPS, Lipopolysaccharide
- MELD, Model for End-Stage Liver Disease (MELD)
- MRI-PDFF, Magnetic resonance imaging derived proton density fat fraction
- NAFLD
- NAFLD, Non-alcoholic fatty liver disease
- NAS, NAFLD activity score
- NASH, Nonalcoholic steatohepatitis
- NTCP, Sodium taurocholate cotransporting polypeptide
- OCA, Obeticholic acid
- OST, Organic solute transporter
- PBC, Primary biliary cirrhosis
- PFIC, Progressive familial intrahepatic cholestasis
- PSC, Primary sclerosing cholangitis
- PXR, Pregnane X receptor
- SHP, Small heterodimer partner
- TBA, Total bile acids
- TGR5, Takeda G-protein coupled receptor 5
- TRAIL, TNF-related apoptosis-inducing ligand
- UDCA, Ursodeoxycholic acid
- UPLC-MS, Ultra-performance liquid chromatography with tandem mass spectrometry
- VDR, Vitamin D receptor
- bile acids
- cirrhosis
- microbiome
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Affiliation(s)
- Naba Farooqui
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Anshuman Elhence
- Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Shalimar
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
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Shalimar, Elhence A, Bansal B, Gupta H, Anand A, Singh TP, Goel A. Prevalence of Non-alcoholic Fatty Liver Disease in India: A Systematic Review and Meta-analysis. J Clin Exp Hepatol 2022; 12:818-829. [PMID: 35677499 PMCID: PMC9168741 DOI: 10.1016/j.jceh.2021.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/04/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) contributes to a large proportion of liver disease burden in the world. Several groups have studied the prevalence of NAFLD in the Indian population. AIM A systematic review of the published literature and meta-analysis was carried out to estimate the prevalence of NAFLD in the Indian population. METHODS English language literature published until April 2021 was searched from electronic databases. Original data published in any form which had reported NAFLD prevalence in the Indian population were included. The subgroup analysis of prevalence was done based on the age (adults or children) and risk category, i.e., average-risk group (community population, participants of control arm, unselected participants, hypothyroidic individuals, athletes, aviation crew, and army personnel) and high-risk group (obesity or overweight, diabetes mellitus, coronary artery disease, etc.). The prevalence estimates were pooled using the random-effects model. Heterogeneity was assessed with I2. RESULTS Sixty-two datasets (children 8 and adults 54) from 50 studies were included. The pooled prevalence of NAFLD was estimated from 2903 children and 23,581 adult participants. Among adults, the estimated pooled prevalence was 38.6% (95% CI 32-45.5). The NAFLD prevalence in average-risk and high-risk subgroups was estimated to be 28.1% (95% CI 20.8-36) and 52.8% (95% CI 46.5-59.1), respectively. The estimated NAFLD prevalence was higher in hospital-based data (40.8% [95% CI 32.6-49.3%]) than community-based data (28.2% [95% CI 16.9-41%]). Among children, the estimated pooled prevalence was 35.4% (95% CI 18.2-54.7). The prevalence among non-obese and obese children was 12.4 (95% CI 4.4-23.5) and 63.4 (95% CI 59.4-67.3), respectively. CONCLUSION Available data suggest that approximately one in three adults or children have NAFLD in India.
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Key Words
- ALT, Alanine aminotransferase
- AST, Aspartate aminotransferase
- BMI, Body mass index
- CAD, Coronary artery disease
- CI, Confidence interval
- DM, Diabetes mellitus
- GBD, Global burden of disease
- GDM, Gestational diabetes mellitus
- GDP, Gross domestic product
- HC, Healthy control
- IGT, Impaired glucose tolerance
- NAFLD, Non-alcoholic fatty liver disease
- NASH, Non-alcoholic steatohepatitis
- NPCDCS, National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke
- OSA, Obstructive sleep apnea
- PCOS, Polycystic ovarian syndrome
- UT, Union Territories
- diabetes mellitus
- fatty liver
- metabolic syndrome
- obesity
- steatohepatitis
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Affiliation(s)
- Shalimar
- All India Institute of Medical Sciences, New Delhi, India
| | - Anshuman Elhence
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Bhavik Bansal
- All India Institute of Medical Sciences, New Delhi, India
| | - Hardik Gupta
- All India Institute of Medical Sciences, New Delhi, India
| | - Abhinav Anand
- All India Institute of Medical Sciences, New Delhi, India
| | - Thakur P. Singh
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Amit Goel
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India,Address for correspondence: Amit Goel, Additional Professor, Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
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16
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Huang DC, Fricker ZP, Alqahtani S, Tamim H, Saberi B, Bonder A. The influence of equitable access policies and socioeconomic factors on post-liver transplant survival. EClinicalMedicine 2021; 41:101137. [PMID: 34585128 PMCID: PMC8452797 DOI: 10.1016/j.eclinm.2021.101137] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 04/30/2021] [Revised: 08/27/2021] [Accepted: 09/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Survival following liver transplant (LT) is influenced by a variety of factors, including donor risk factors and recipient disease burden and co-morbidities. It is difficult to separate these effects from those of socioeconomic factors, such as income or insurance. The United Network for Organ Sharing (UNOS) created equitable access policies, such as Share 35, to ensure that organs are distributed to individuals with greatest medical need; however, the effect of Share 35 on disparities in post-LT survival is not clear. This study aimed to (1) characterize associations between post-transplant survival and race and ethnicity, income, insurance, and citizenship status, when adjusted for other clinical and demographic factors that may influence survival, and (2) determine if the direction of associations changed after Share 35. METHODS A retrospective, cohort study of adult LT recipients (n = 83,254) from the UNOS database from 2005 to 2019 was conducted. Kaplan-Meier survival graphs and stepwise multivariate cox-regression analyses were performed to characterize the effects of socioeconomic status on post-LT survival, adjusted for recipient and donor characteristics, across the time period and after Share 35. FINDINGS Male sex (HR: 0.93 (95% CI: 0.90-0.96)), private insurance (0.91 (0.88-0.94)), income (0.82 (0.79-0.85)), U.S. citizenship, and Asian (0.81 (0.75-0.88)) or Hispanic (0.82 (0.79-0.86)) race and ethnicity were associated with higher post-transplant survival, after adjustment for clinical and demographic factors (Table 3). These associations were found across the entire time period studied and many persisted after the implementation of Share 35 in 2013 (Table 3; male sex (0.84 (0.79-0.90)), private insurance (0.94 (0.89-1.00)), income (0.82 (0.77-0.89)), and Asian (0.87 (0.73-1.02)) or Hispanic (0.88 (0.81-0.96)) race and ethnicity). INTERPRETATION Recipients' socioeconomic factors at time of transplant may impact long-term post-transplant survival, and a single policy may not significantly alter these structural health inequalities. FUNDING None.
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Key Words
- DDLT, deceased donor living transplant
- DM, diabetes mellitus
- DRI, donor risk index
- HCC, hepatocellular carcinoma
- HCV, hepatitis c virus
- HE, hepatic encephalopathy
- Health disparities
- IQR, interquartile range
- IRB, institutional review board
- LT, liver transplant
- Liver transplant
- MELD, Model for End-Stage Liver Disease
- NAFLD, Non-alcoholic fatty liver disease
- OPTN, Organ Procurement and Transplantation Network
- STAR, Standard Transplant Analysis and Research
- Socioeconomic factors
- UNOS, United Network for Organ Sharing
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Affiliation(s)
- Dora C Huang
- Department of Internal Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, United States
| | - Zachary P Fricker
- Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Saleh Alqahtani
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Behnam Saberi
- Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Alan Bonder
- Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
- Corresponding author.
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17
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Bischoff J, Gu W, Schwarze-Zander C, Boesecke C, Wasmuth JC, van Bremen K, Dold L, Rockstroh JK, Trebicka J. Stratifying the risk of NAFLD in patients with HIV under combination antiretroviral therapy (cART). EClinicalMedicine 2021; 40:101116. [PMID: 34522873 PMCID: PMC8427211 DOI: 10.1016/j.eclinm.2021.101116] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [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: 05/11/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND De novo steatosis is the main criteria for non-alcoholic fatty liver disease (NAFLD), which is becoming a clinically relevant comorbidity in HIV-infected patients. This may be due to the HIV virus itself, as well as long-term toxicities deriving from antiretroviral therapy. Therefore, HIV infected patients require prevention and monitoring regarding NAFLD. METHODS This study investigated the differential role of body mass index (BMI) and combination antiretroviral treatment (cART) drugs on NAFLD progression. This single center prospective longitudinal observational study enrolled HIV monoinfected individuals between August 2013 to December 2018 with yearly visits. Each visit included liver stiffness and steatosis [defined as controlled attenuation parameter (CAP)>237 dB/m] assessment by annually transient elastography using an M- or XL-probe of FibroScan, and calculation of the novel FibroScan-AST (FAST) score. Risk factors for denovo/progressed steatosis and tripling of FAST-score increase were investigated using Cox regression model with time-dependent covariates. FINDINGS 319 monoinfected HIV positive patients with at least two visits were included into the study, of which 301 patients had at least two valid CAP measurements. 51·5%(155) patients did not have steatosis at first assessment, of which 45%(69) developed steatosis during follow-up. A BMI>23 kg/m2 (OR: 4·238, 95% CI: 2·078-8·938; p < 0·0001), tenofovir-alafenamid (TAF) (OR: 5·073, 95% CI: 2·362-10·899); p < 0·0001) and integrase strand transfer inhibitors (INSTI) (OR: 2·354, 95% CI: 1·370-4·048; p = 0·002), as well as type 2 diabetes mellitus (OR: 7·605, 95% CI: 2·315-24·981; p < 0·0001) were independent predictors of de novo steatosis in multivariable analysis. Tenofovir disoproxilfumarate (TDF) was associated with a lower risk for weight gain and steatosis progression/onset using CAP value (HR: 0·28, 95% CI: 0·12-0·64; p = 0·003) and FAST scores (HR: 0·31, 95% CI: 0·101-0·945; p = 0·04). INTERPRETATION Steatosis can develop despite non-obese BMI in patients with HIV monoinfection under cART, especially in male patients with BMI over 23 kg/m2. While TAF and INSTI increase the risk of progression of steatosis, TDF was found to be independently associated with a lower risk of a clinically significant weight gain and thereby, might slow down development and progression of steatosis. FUNDING There was no additional funding received for this project. All funders mentioned in the 'declaration of interests' section had no influence on study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Key Words
- APRI, AST to platelet ratio index
- ART, antiretroviral treatment
- AST, aspartate aminotransferase
- BMI, body mass index
- CAP, controlled attenuation parameter
- Cap
- DAA, direct-acting antiviral
- FAST, FibroScan-AST
- FIB4, fibrosis-4
- HCV, chronic hepatitis C
- Hiv
- INSTI, integrase strand transfer inhibitors
- NAFLD, Non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- Nafld
- PLHIV, people living with HIV
- PrEP, pre-exposure prophylaxis
- Steatosis
- TAF, tenofovir-alafenamid
- TDF, Tenofovir disoproxilfumarate
- TE, transient elastography
- cART
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Affiliation(s)
- Jenny Bischoff
- Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, 53127 Bonn Germany,
| | - Wenyi Gu
- Department of Internal Medicine I, University Hospital Frankfurt, Germany
| | - Carolynne Schwarze-Zander
- Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, 53127 Bonn Germany,
- German Center for Infection Research (DZIF), partner site Cologne-Bonn, Bonn, Germany
| | - Christoph Boesecke
- Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, 53127 Bonn Germany,
- German Center for Infection Research (DZIF), partner site Cologne-Bonn, Bonn, Germany
| | - Jan-Christian Wasmuth
- Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, 53127 Bonn Germany,
- German Center for Infection Research (DZIF), partner site Cologne-Bonn, Bonn, Germany
| | - Kathrin van Bremen
- Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, 53127 Bonn Germany,
| | - Leona Dold
- Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, 53127 Bonn Germany,
- German Center for Infection Research (DZIF), partner site Cologne-Bonn, Bonn, Germany
| | - Jürgen K Rockstroh
- Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, 53127 Bonn Germany,
- German Center for Infection Research (DZIF), partner site Cologne-Bonn, Bonn, Germany
| | - Jonel Trebicka
- Department of Internal Medicine I, University Hospital Frankfurt, Germany
- Corresponding author.
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Jabeen A, Vijayram R, Ranganathan S. A two-stage computational approach to predict novel ligands for a chemosensory receptor. Curr Res Struct Biol 2021; 2:213-221. [PMID: 34235481 PMCID: PMC8244491 DOI: 10.1016/j.crstbi.2020.10.001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/29/2020] [Accepted: 10/03/2020] [Indexed: 11/01/2022] Open
Abstract
Olfactory receptor (OR) 1A2 is the member of largest superfamily of G protein-coupled receptors (GPCRs). OR1A2 is an ectopically expressed receptor with only 13 known ligands, implicated in reducing hepatocellular carcinoma progression, with enormous therapeutic potential. We have developed a two-stage screening approach to identify novel putative ligands of OR1A2. We first used a pharmacophore model based on atomic property field (APF) to virtually screen a library of 5942 human metabolites. We then carried out structure-based virtual screening (SBVS) for predicting the potential agonists, based on a 3D homology model of OR1A2. This model was developed using a biophysical approach for template selection, based on multiple parameters including hydrophobicity correspondence, applied to the complete set of available GPCR structures to pick the most appropriate template. Finally, the membrane-embedded 3D model was refined by molecular dynamics (MD) simulations in both the apo and holo forms. The refined model in the apo form was selected for SBVS. Four novel small molecules were identified as strong binders to this olfactory receptor on the basis of computed binding energies.
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Key Words
- APF, Atomic property field
- Amber, Assisted model Building with Energy Refinement
- Atomic property field
- Binding free energy calculation
- CSF, Cerebrospinal fluid
- ECL, Extracellular loop
- GPCR, G protein coupled receptor
- HCMV, Human cytomegalovirus
- HMDB, Human metabolome database
- Hydrophobicity correspondence
- LBVS, Ligand based virtual screening
- LC, Lung carcinoids
- MD, Molecular dynamics
- MMGBSA, Molecular mechanics generalized born surface area
- MMPBSA, Molecular mechanics Poisson–Boltzmann surface area
- Molecular dynamics
- NAFLD, Non-alcoholic fatty liver disease
- NASH, Nonalcoholic steatohepatitis
- OR, olfactory receptor
- OR1A2
- Olfactory receptor
- PMEMD, Particle-Mesh Ewald Molecular Dynamics
- POPC, 1-palmitoyl-2-oleoyl-sn-glycero- 3-phosphatidylcholine
- RMSD, Root mean square deviation
- RMSF, Root mean square fluctuation
- SBVS, Structure based virtual screening
- SSD, Sum of squared difference
- TM, Transmembrane
- Virtual ligand screening
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Affiliation(s)
- Amara Jabeen
- Department of Molecular Sciences, Macquarie University, Sydney, NSW 2109, Australia
| | - Ramya Vijayram
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai 600036, Tamilnadu, India
| | - Shoba Ranganathan
- Department of Molecular Sciences, Macquarie University, Sydney, NSW 2109, Australia
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19
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Ayonrinde OT. Historical narrative from fatty liver in the nineteenth century to contemporary NAFLD - Reconciling the present with the past. JHEP Rep 2021; 3:100261. [PMID: 34036255 PMCID: PMC8135048 DOI: 10.1016/j.jhepr.2021.100261] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 09/28/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disorder worldwide. This historical narrative traces the evolution from basic descriptions of fatty liver in the nineteenth century to our contemporary understanding of NAFLD in the twentieth and twenty-first centuries. A detailed historiographic review of fatty liver from 1800s onwards was performed alongside a brief review of contemporary associations. Archived published literature dating back to the 1800s describe clinicopathological features of fatty liver. In the nineteenth century, doyens of medicine associated fatty liver with alcohol, malnutrition or wasting conditions, and subsequently adiposity, unhealthy diets and sedentary lifestyle. Microscopically, fatty liver was described when 5% or more hepatocytes were distended with fat. Recommendations to reverse fatty liver included reducing consumption of fat, sugar, starchy carbohydrates and alcohol, plus increasing physical exercise. Fatty liver was associated with liver fibrosis and cirrhosis in the late 1800s, and with diabetes in the early 1900s. The diagnostic labels NAFLD and non-alcoholic steatohepatitis (NASH) were introduced in the late 1900s. Metabolic dysfunction-associated fatty liver disease (MAFLD) was recently proposed to update the nosology of fatty liver, recognising the similar metabolic pathogenesis evident in individuals with typical NAFLD and those with heterogenous "secondary" co-factors including alcohol and other aetiologies. Fatty liver has emerged from being considered a disorder of nutritional extremes or alcohol excess to contemporary recognition as a complex metabolic disorder that risks progression to cirrhosis and hepatocellular carcinoma. The increasing prevalence of NAFLD and our growing understanding of its lifestyle and metabolic determinants justify the current exercise of re-examining the evolution of this common metabolic disorder.
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Affiliation(s)
- Oyekoya T. Ayonrinde
- Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
- Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
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20
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Yoon SJ, Kim SK, Lee NY, Choi YR, Kim HS, Gupta H, Youn GS, Sung H, Shin MJ, Suk KT. Effect of Korean Red Ginseng on metabolic syndrome. J Ginseng Res 2020; 45:380-389. [PMID: 34025131 PMCID: PMC8134847 DOI: 10.1016/j.jgr.2020.11.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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] [Received: 03/31/2020] [Revised: 09/24/2020] [Accepted: 11/02/2020] [Indexed: 12/27/2022] Open
Abstract
Metabolic syndrome (MS) refers to a clustering of at least three of the following medical conditions: high blood pressure, abdominal obesity, hyperglycemia, low high-density lipoprotein level, and high serum triglycerides. MS is related to a wide range of diseases which includes obesity, diabetes, insulin resistance, cardiovascular disease, dyslipidemia, or non-alcoholic fatty liver disease. There remains an ongoing need for improved treatment strategies for MS. The most important risk factors are dietary pattern, genetics, old age, lack of exercise, disrupted biology, medication usage, and excessive alcohol consumption, but pathophysiology of MS has not been completely identified. Korean Red Ginseng (KRG) refers to steamed/dried ginseng, traditionally associated with beneficial effects such as anti-inflammation, anti-fatigue, anti-obesity, anti-oxidant, and anti-cancer effects. KRG has been often used in traditional medicine to treat multiple metabolic conditions. This paper summarizes the effects of KRG in MS and related diseases such as obesity, cardiovascular disease, insulin resistance, diabetes, dyslipidemia, or non-alcoholic fatty liver disease based on experimental research and clinical studies.
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Key Words
- ACC, Acetyl-Coenzyme A carboxylase
- ADP, adenosine diphosphate
- AG, American ginseng extract
- AGE, advanced glycation end product
- ALT, alanine aminotransferase
- AMPK, AMP-activated protein kinase
- AST, aspartate aminotransferase
- Akt, protein kinase B
- BMI, body mass index
- C/EBPα, CCAAT/enhancer-binding protein alpha
- COX-2, cyclooxygenase-2
- CPT, current perception threshold
- CPT-1, carnitine palmitoyl transferase 1
- CRP, C-reactive protein
- CVD, Cardiovascular disease
- DBP, diastolic blood pressure
- DEN, diethyl nitrosamine
- EAT, epididymis adipose tissue
- EF, ejection fraction
- FABP4, fatty acid binding protein 4
- FAS, Fatty acid synthase
- FFA, free fatty acid
- FR, fine root concentration
- FS, fractional shortening
- GBHT, ginseng-plus-Bai-Hu-Tang
- GLUT, glucose transporter type
- GPx, glutathione peroxidase
- GS, ginsenoside
- GST, glutathione S-transferase
- GST-P, glutathione S-transferase placental form
- GTT, glucose tolerance test
- HCC, hepatocellular carcinoma
- HCEF-RG, hypotensive components-enriched fraction of red ginseng
- HDL, high-density lipoprotein
- HFD, High fat diet
- HOMA-IR, homeostasis model assessment of insulin resistance index
- HbA1c, glycosylated hemoglobin
- I.P., intraperitoneal injection
- IL, interleukin
- IR, insulin resistance
- ITT, insulin tolerance test
- Insulin resistance
- KRG, Korean Red Ginseng
- LDL, low-density lipoprotein
- LPL, lipoprotein lipase
- Lex, lower extremities
- MDA, malondialdehyde
- MMP, Matrix metallopeptidases
- MS, Metabolic syndrome
- Metabolic syndrome
- NAFLD, Non-alcoholic fatty liver disease
- NF-кB, nuclear factor kappa-light-chain-enhancer of activated B cells
- NK cell, Natural killer cell
- NMDA-NR1, N-methyl-D-aspartate NR1
- NO, nitric oxide
- NRF1, Nuclear respiratory factor 1
- Non-alcoholic fatty liver disease
- Nrf2, Nuclear factor erythroid 2-related factor 2
- OLETF rat, Otsuka Long-Evans Tokushima fatty rat
- PCG-1α, PPAR-γ coactivator-1α
- PI3K, phosphoinositide 3-kinase
- PPAR, peroxisome proliferator-activated receptors
- PPD, protopanaxadiol
- PPT, protopanaxatriol
- Panax ginseng
- REKRG, Rg3-enriched KRG
- ROS, Reactive oxygen species
- Rg3-KGE, Rg3-enriched KRG extract
- SBP, systolic blood pressure
- SCD, Stearoyl-Coenzyme A desaturase
- SHR, spontaneously hypertensive rat
- SREBP-1C, Sterol regulatory element-binding protein 1
- STAT5, Signal transducer and activator of transcription 5
- STZ, streptozotocin
- TBARS, thiobarbituric acid reactive substances
- TC, total cholesterol
- TG, triglyceride
- TNF, tumor necrosis factor
- UCP, Mitochondrial uncoupling proteins
- VLDL, very low-density lipoprotein
- iNOS, inducible nitric oxide synthase
- t-BHP, tert-butyl hyperoxide
- tGST, total glutathione
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Affiliation(s)
- Sang Jun Yoon
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea
| | - Seul Ki Kim
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea
| | - Na Young Lee
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea
| | - Ye Rin Choi
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea
| | - Hyeong Seob Kim
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea
| | - Haripriya Gupta
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea
| | - Gi Soo Youn
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea
| | - Hotaik Sung
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Min Jea Shin
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea
| | - Ki Tae Suk
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea
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Yu C, Wan Y, Piao L, Wu Cheng X. Can cysteinyl cathepsin activity control diet-induced NAFLD? Int J Cardiol Heart Vasc 2020; 28:100516. [PMID: 32373709 PMCID: PMC7195526 DOI: 10.1016/j.ijcha.2020.100516] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/04/2020] [Accepted: 04/09/2020] [Indexed: 11/25/2022]
Key Words
- CSTB, cathepsin B
- CTSB+/+, wild-type
- CTSB−/−, cathepsin B deficiency
- CTSs, cathepsins
- FABP4, fatty acid binding protein 4
- FPC, fructose-palmitate-cholesterol
- LDL, low density lipoprotein
- MMP, metalloproteinase
- NAFLD, Non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- Scad, short-chain acyl dehydrogenase-1
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Affiliation(s)
| | | | - Limei Piao
- Department of Cardiology and Hypertension, Yanbian University Hospital, Yanji, China
| | - Xian Wu Cheng
- Department of Cardiology and Hypertension, Yanbian University Hospital, Yanji, China
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Abby Philips C, Agarwal M, Phadke N, Rajesh S, Padsalgi G, Ahamed R, Augustine P. A Novel Phosphoinositide-3-kinase Adapter Protein 1 Gene Missense Mutation in Familial Cirrhosis. J Clin Exp Hepatol 2019; 9:652-656. [PMID: 31695254 PMCID: PMC6823681 DOI: 10.1016/j.jceh.2019.02.002] [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: 10/25/2018] [Accepted: 02/03/2019] [Indexed: 12/12/2022] Open
Abstract
Familial cirrhosis is a condition that is associated with the presence of liver disease with genetic linkage among multiple family members in a generation or in multiple generations. With cirrhosis, most of these disease pathogeneses are related to a defect of an enzyme/transport protein leading to a deranged metabolic pathway with variable prevalence. Many studies and high-quality metanalyses have shed light on genetic linkage associated with nonalcoholic fatty liver disease and steatohepatitis such as the PNPLA3, MBOAT7, and TM6SF2 variants. In this report, we shed light on a novel missense mutation associated with cirrhosis in a family of brothers associated with phosphoinositide-3-kinase adapter protein 1 gene through high-output whole exosome gene sequencing methodology.
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Key Words
- CCDS, Consensus Coding Sequence
- DNA, Deoxyribonucleic acid
- EWAS, Epigenome wide association study
- GWAS, Genome-wide association studies
- HCC, Hepatocellular carcinoma
- HGVS, Human Genome Variation Society
- MBOAT7, Membrane bound O-acyltransferase domain-containing 7
- NAFLD, Non-alcoholic fatty liver disease
- NGS, Next generation sequencing
- OMIM, Online Mendelian Inheritance in Man
- PBC, Primary biliary cholangitis
- PI3K
- PIK3AP1, Phosphoinositide-3-Kinase Adapter Protein 1
- PNPLA3
- PNPLA3, Patatin-like phospholipase domain containing 3
- RNA, Ribosomal nucleic acid
- RefSeq, Reference Sequence Database
- TMC4, Transmembrane channel-like 4 gene
- chronic liver disease
- epigenetics
- exosome
- familial cirrhosis
- gene mutation
- genomics
- illumina
- linkage
- metagenome
- missense mutation
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Affiliation(s)
- Cyriac Abby Philips
- The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Kochi, Kerala, India
| | | | - Nikhil Phadke
- Molecular, Cellular and Developmental Biology, Genepath-Dx, Pune, Maharashtra, India
| | - Sasidharan Rajesh
- The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Kochi, Kerala, India
| | - Guruprasad Padsalgi
- The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Kochi, Kerala, India
| | - Rizwan Ahamed
- The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Kochi, Kerala, India
| | - Philip Augustine
- The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Kochi, Kerala, India
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Gouda W, Ashour E, Shaker Y, Ezzat W. MTP genetic variants associated with non-alcoholic fatty liver in metabolic syndrome patients. Genes Dis 2017; 4:222-228. [PMID: 30258926 PMCID: PMC6147179 DOI: 10.1016/j.gendis.2017.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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] [Received: 08/29/2017] [Accepted: 09/27/2017] [Indexed: 02/08/2023] Open
Abstract
This study was performed for investigation the relationship between variants of MTP gene polymorphism and the development of NAFLD in patients with and without MS. The study was included 174 NAFLD patients (106 with MS and 68 without MS), and 141 healthy control subjects. The 493 G/T polymorphism of MTP gene was evaluated by PCR-RFLP method. The frequency of MTP TT genotype and T allele were significantly higher in NAFLD patients when compared to healthy controls. Moreover, a significant association in MTP gene polymorphism was observed in NAFLD patients with MS compared to NAFLD patients without MS and controls. Our study suggested that MTP 493 G/T gene polymorphism may act as susceptibility biomarker for NAFLD and MS.
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Affiliation(s)
- Weaam Gouda
- Biochemistry Dept., National Research Center, Dokki, Giza, Egypt
| | - Esmat Ashour
- Biochemistry Dept., National Research Center, Dokki, Giza, Egypt
| | - Yehia Shaker
- Biochemistry Dept., National Research Center, Dokki, Giza, Egypt
| | - Wafaa Ezzat
- Internal Medicine Dept., National Research Center, Dokki, Giza, Egypt
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Kizawa H, Nagao E, Shimamura M, Zhang G, Torii H. Scaffold-free 3D bio-printed human liver tissue stably maintains metabolic functions useful for drug discovery. Biochem Biophys Rep 2017; 10:186-91. [PMID: 28955746 DOI: 10.1016/j.bbrep.2017.04.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/10/2017] [Accepted: 04/12/2017] [Indexed: 01/01/2023] Open
Abstract
The liver plays a central role in metabolism. Although many studies have described in vitro liver models for drug discovery, to date, no model has been described that can stably maintain liver function. Here, we used a unique, scaffold-free 3D bio-printing technology to construct a small portion of liver tissue that could stably maintain drug, glucose, and lipid metabolism, in addition to bile acid secretion. This bio-printed normal human liver tissue maintained expression of several kinds of hepatic drug transporters and metabolic enzymes that functioned for several weeks. The bio-printed liver tissue displayed glucose production via cAMP/protein kinase A signaling, which could be suppressed with insulin. Bile acid secretion was also observed from the printed liver tissue, and it accumulated in the culture medium over time. We observed both bile duct and sinusoid-like structures in the bio-printed liver tissue, which suggested that bile acid secretion occurred via a sinusoid-hepatocyte-bile duct route. These results demonstrated that our bio-printed liver tissue was unique, because it exerted diverse liver metabolic functions for several weeks. In future, we expect our bio-printed liver tissue to be applied to developing new models that can be used to improve preclinical predictions of long-term toxicity in humans, generate novel targets for metabolic liver disease, and evaluate biliary excretion in drug development.
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Key Words
- 3D
- 8CPT-cAMP, 8-(4-Chlorophenylthio)adenosine 3′,5′-cyclic monophosphate
- Bio-printing
- Dex, Dexamethasone
- Drug discovery
- ECM, Extracellular matrix
- HE, hematoxylin and eosin
- Liver
- MRP2, multidrug resistance-associated protein 2
- MT, Masson's trichrome
- Metabolism
- NAFLD, Non-alcoholic fatty liver disease
- NASH, Non-alcoholic steatohepatitis
- OAT, organic anion-transporting
- Scaffold-free
- TUNEL, TdT-mediated dUTP nick end labeling
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25
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Fitzpatrick JA, Kim JU, Cobbold JF, McPhail MJ, Crossey MM, Bak-Bol AA, Zaky A, Taylor-Robinson SD. Changes in Liver Volume in Patients with Chronic Hepatitis C Undergoing Antiviral Therapy. J Clin Exp Hepatol 2016; 6:15-20. [PMID: 27194891 DOI: 10.1016/j.jceh.2015.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 11/27/2015] [Indexed: 12/12/2022] Open
Abstract
AIM Liver volumetric analysis has not been used to detect hepatic remodelling during antiviral therapy before. We measured liver volume (LV) changes on volumetric magnetic resonance imaging during hepatitis C antiviral therapy. METHODS 22 biopsy-staged patients (median [range] age 45(19-65) years; 9F, 13M) with chronic hepatitis C virus infection were studied. LV was measured at the beginning, end of treatment and 6 months post-treatment using 3D T1-weighted acquisition, normalised to patient weight. Liver outlines were drawn manually on 4 mm thick image slices and LV calculated. Inter-observer agreement was analysed. Patients were also assessed longitudinally using biochemical parameters and liver stiffness using Fibroscan™. RESULTS Sustained viral response (SVR) was achieved in 13 patients with a mean baseline LV/kg of 0.022 (SD 0.004) L/kg. At the end of treatment, the mean LV/kg was 0.025 (SD 0.004, P = 0.024 cf baseline LV/kg) and 0.026 (SD 0.004, P = 0.008 cf baseline LV/kg) 6 months post-treatment (P = 0.030 cf baseline, P = 0.004). Body weight-corrected end of treatment LV change was significantly higher in patients with SVR compared to patients not attaining SVR (P = 0.050). End of treatment LV change was correlated to initial ALT (R (2) = 0.479, P = 0.037), but not APRI, AST, viral load or liver stiffness measurements. There was a correlation of 0.89 between observers for measured slice thickness. CONCLUSIONS LV increased during anti-viral treatment, while the body weight-corrected LV increase persisted post-antiviral therapy and was larger in patients with SVR.
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Key Words
- ALT, Alanine aminotransferase
- APRI, Aspartate transaminase to platelet ratio index
- AST, Aspartate transaminase
- CHC, Chronic hepatitis C
- CLD, Chronic liver disease
- CT, Computed tomography
- EASL, European Association for the Study of the Liver
- HCC, Hepatocellular carcinoma
- HCV, Hepatitis C virus
- LV, Liver volume
- MRI, Magnetic resonance imaging
- NAFLD, Non-alcoholic fatty liver disease
- NI, Necroinflammatory
- SVR, Sustained viral response
- hepatitis C virus
- liver volume
- magnetic resonance imaging
- sustained viral response
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Pardina E, Ferrer R, Rossell J, Baena-Fustegueras JA, Lecube A, Fort JM, Caubet E, González Ó, Vilallonga R, Vargas V, Balibrea JM, Peinado-Onsurbe J. Diabetic and dyslipidaemic morbidly obese exhibit more liver alterations compared with healthy morbidly obese. BBA Clin 2016; 5:54-65. [PMID: 27051590 PMCID: PMC4802404 DOI: 10.1016/j.bbacli.2015.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/17/2015] [Accepted: 12/22/2015] [Indexed: 12/14/2022]
Abstract
Background & aims To study the origin of fat excess in the livers of morbidly obese (MO) individuals, we analysed lipids and lipases in both plasma and liver and genes involved in lipid transport, or related with, in that organ. Methods Thirty-two MO patients were grouped according to the absence (healthy: DM − DL −) or presence of comorbidities (dyslipidemic: DM − DL +; or dyslipidemic with type 2 diabetes: DM + DL +) before and one year after gastric bypass. Results The livers of healthy, DL and DM patients contained more lipids (9.8, 9.5 and 13.7 times, respectively) than those of control subjects. The genes implicated in liver lipid uptake, including HL, LPL, VLDLr, and FAT/CD36, showed increased expression compared with the controls. The expression of genes involved in lipid-related processes outside of the liver, such as apoB, PPARα and PGC1α, CYP7a1 and HMGCR, was reduced in these patients compared with the controls. PAI1 and TNFα gene expression in the diabetic livers was increased compared with the other obese groups and control group. Increased steatosis and fibrosis were also noted in the MO individuals. Conclusions Hepatic lipid parameters in MO patients change based on their comorbidities. The gene expression and lipid levels after bariatric surgery were less prominent in the diabetic patients. Lipid receptor overexpression could enable the liver to capture circulating lipids, thus favouring the steatosis typically observed in diabetic and dyslipidaemic MO individuals. The criteria used to define the “metabolically healthy” obese is not applicable to morbidly obese patients. Virtually no studies of how bariatric surgery affects depending on comorbidities and less how affect to the liver. Anthropometrics, fat, lipid profile and inflammation parameters are different depending of comorbidities, not only in plasma but also in liver. The extent of lipases and lipids in the liver biopsies could help not only the diagnosis but also to follow the course of recovery after surgery. The morbidly obese individuals with diabetes and dyslipidemia have more altered metabolic profiles than the other two groups.
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Key Words
- ALT, Alanine transaminase
- AST, Aspartate transaminase
- ATGL, Adipose Tissue Glycerol Lipase
- ApoA1, Apolipoprotein A1
- BMI, Body Mass Index
- CPT1a, Carnitine Palmitoyltransferase 1a
- CRP, C-reactive protein
- CYP7a1, Cholesterol 7 Alpha-Hydroxylase
- DL, Dyslipidaemia
- DM, Type 2 diabetes mellitus
- DM + DL +, Obese patients with type 2 diabetes and dyslipidaemia
- DM − DL +, Dyslipidemic obese patients
- DM − DL −, “Healthy” obese patients, or patients without type 2 diabetes or dyslipidaemia
- Diabetes
- FAT/CD36, Fatty Acid Translocase or Cluster of Differentiation 36
- GGT, gamma-glutaryl transferase
- HL, Hepatic lipase
- HMGCR, 3-Hydroxy-3-Methylglutaryl-CoA Reductase
- HOMA-IR, Homeostasis Model Assessment of Insulin Resistance
- HSL, Hormone-sensitive lipase
- HTA, Hypertension
- IL6, Interleukin-6
- IR, Insulin resistance
- KBs, Ketone bodies
- LDLr, Low-Density Lipoprotein receptor
- Lipases
- Lipids
- Liver
- MO, Morbidly obese
- NAFLD
- NAFLD, Non-alcoholic fatty liver disease
- NASH, Non-alcoholic liver steatohepatitis
- NEFA, Non-esterified fatty acid
- PAI1, Plasminogen Activator Inhibitor of Type 1
- PLs, Phospholipids
- PPARα, Peroxisome Proliferator-Activated Receptor alpha
- PPARα, Peroxisome Proliferator-Activated Receptor gamma Coactivator 1-alpha
- QMs, Chylomicrons
- RYGBP, Roux-en-Y gastric bypass
- SAT, Subcutaneous adipose tissue
- SCARB1, Scavenger Receptor Class B, Member 1
- Steatosis
- TAGs, Triacylglycerides
- TC, Total cholesterol
- TNFα, Tumour Necrosis Factor-alpha
- UCP2, Uncoupling Protein 2
- VAT, Visceral adipose tissue
- VLDLr, Very-Low-Density Lipoprotein receptor
- apoB, Apolipoprotein B
- cHDL, High-Density Lipoprotein Cholesterol
- cLDL, Low-Density Lipoprotein Cholesterol
- eNOS3, Endothelial Nitric Oxide Synthase 3
- iNOS2, Inducible Nitric Oxide Synthase 2
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Affiliation(s)
- Eva Pardina
- Biochemistry and Molecular Biology Department, Biology Faculty, Barcelona University, Spain
| | - Roser Ferrer
- Biochemistry Department, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Joana Rossell
- Biochemistry and Molecular Biology Department, Biology Faculty, Barcelona University, Spain
| | | | - Albert Lecube
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital (UdL), Diabetes and Metabolism Research Unit (VHIR, UAB), CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM) del Instituto de Salud Carlos III, Spain
| | - Jose Manuel Fort
- Endocrinology Surgery Unit, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Enric Caubet
- Endocrinology Surgery Unit, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Óscar González
- Endocrinology Surgery Unit, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Ramón Vilallonga
- Endocrinology Surgery Unit, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Víctor Vargas
- CIBER de Enfermedades Hepáticas y Digestivas (CIBEREHD) del Instituto de Salud Carlos III (ISCIII), Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - José María Balibrea
- Endocrinology Surgery Unit, Hospital Universitari Vall D'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Julia Peinado-Onsurbe
- Biochemistry and Molecular Biology Department, Biology Faculty, Barcelona University, Spain
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Singh SP, Singh A, Misra D, Misra B, Pati GK, Panigrahi MK, Kar SK, Bhuyan P, Pattnaik K, Meher C, Agrawal O, Rout N, Swain M, Aich P. Risk Factors Associated With Non-Alcoholic Fatty Liver Disease in Indians: A Case-Control Study. J Clin Exp Hepatol 2015; 5:295-302. [PMID: 26900270 PMCID: PMC4723647 DOI: 10.1016/j.jceh.2015.09.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [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: 03/27/2015] [Accepted: 09/01/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS NAFLD has today emerged as the leading cause of liver disorder. There is scanty data on risk factors associated with NAFLD emanating from India. The present study was conducted to identify the risk factors associated with NAFLD. METHODS 464 consecutive NAFLD patients and 181 control patients were subjected to detailed questionnaire regarding their lifestyle and dietary risk factors. Anthropometric measurements were obtained and biochemical assays were done. Comparison of different variables was made between NAFLD patients and controls using principal component analysis (PCA). RESULTS NAFLD patients had higher BMI [26.25 ± 3.80 vs 21.46 ± 3.08 kg/m(2), P = 0.000], waist-hip ratio [0.96 ± 0.12 vs 0.90 ± 0.08, P = 0.000] and waist-height ratio [0.57 ± 0.09 vs 0.50 ± 0.06, P = 0.000] compared to controls. Fasting blood sugar [101.88 ± 31.57 vs 90.87 ± 10.74 mg/dl] and triglyceride levels [196.16 ± 102.66 vs 133.20 ± 58.37 mg/dl] were significantly higher in NAFLD group. HOMA-IR was also higher in NAFLD group [2.53 ± 2.57 vs 1.16 ± 0.58, P = 0.000]. Majority (90.2%) of NAFLD patients were sedentary. Family history of metabolic syndrome (MS) was positively correlated with NAFLD. Dietary risk factors associated with NAFLD were non-vegetarian diet [35% vs 23%, P = 0.002], fried food [35% vs 9%, P = 0.000], spicy foods [51% vs 15%, P = 0.001] and tea [55% vs 39%, P = 0.001]. Diabetes, hypertension, snoring and sleep apnoea syndrome were common factors in NAFLD. On multivariate PCA, waist/height ratio and BMI were significantly higher in the NAFLD patients. CONCLUSION The risk factors associated with NAFLD are sedentary lifestyle, obesity family history of MS, consumption of meat/fish, spicy foods, fried foods and tea. Other risk factors associated with NAFLD included snoring and MS.
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Key Words
- ALT, Alanine Transaminase
- AST, Aspartate Transaminase
- BMI, Body Mass Index
- FBG, fasting blood glucose
- HC, hip circumference
- HCC, hepatocellular carcinoma
- HDL, high-density lipoprotein
- HOMA, Homeostatic Model Assessment
- HOMA-B, beta-cell function
- IR, insulin resistance
- MS, Metabolic syndrome
- NAFLD, Non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- PCA, Principal Component Analysis
- SD, standard deviation
- WC, waist circumference
- anthropometry
- diet
- fatty liver
- lifestyle
- metabolic syndrome
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Affiliation(s)
- Shivaram P. Singh
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India,Address for correspondence: Shivaram P. Singh, Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India. Tel.: +91 671 2505466; fax: +91 671 2433865.Department of Gastroenterology, S.C.B. Medical CollegeCuttack753007India
| | - Ayaskanta Singh
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Debasis Misra
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Bijay Misra
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Girish K. Pati
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Manas K. Panigrahi
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Sanjib K. Kar
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India
| | - Pallavi Bhuyan
- Department of Pathology, S.C.B. Medical College, Cuttack 753007, India
| | - Kaumudee Pattnaik
- Department of Pathology, S.C.B. Medical College, Cuttack 753007, India
| | - Chudamani Meher
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, Cuttack 753001, India
| | - Omprakash Agrawal
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, Cuttack 753001, India
| | - Niranjan Rout
- Department of Oncopathology, A.H. Regional Cancer Center, Cuttack 753001, India
| | - Manoroma Swain
- Department of Biochemistry, S.C.B. Medical College, Cuttack 753007, India
| | - Palok Aich
- National Institute of Science Education & Research (NISER), Jatni, Khurdha 752050, India
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Pivovarova O, von Loeffelholz C, Ilkavets I, Sticht C, Zhuk S, Murahovschi V, Lukowski S, Döcke S, Kriebel J, de las Heras Gala T, Malashicheva A, Kostareva A, Lock JF, Stockmann M, Grallert H, Gretz N, Dooley S, Pfeiffer AFH, Rudovich N. Modulation of insulin degrading enzyme activity and liver cell proliferation. Cell Cycle 2015; 14:2293-300. [PMID: 25945652 DOI: 10.1080/15384101.2015.1046647] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 01/07/2023] Open
Abstract
Diabetes mellitus type 2 (T2DM), insulin therapy, and hyperinsulinemia are independent risk factors of liver cancer. Recently, the use of a novel inhibitor of insulin degrading enzyme (IDE) was proposed as a new therapeutic strategy in T2DM. However, IDE inhibition might stimulate liver cell proliferation via increased intracellular insulin concentration. The aim of this study was to characterize effects of inhibition of IDE activity in HepG2 hepatoma cells and to analyze liver specific expression of IDE in subjects with T2DM. HepG2 cells were treated with 10 nM insulin for 24 h with or without inhibition of IDE activity using IDE RNAi, and cell transcriptome and proliferation rate were analyzed. Human liver samples (n = 22) were used for the gene expression profiling by microarrays. In HepG2 cells, IDE knockdown changed expression of genes involved in cell cycle and apoptosis pathways. Proliferation rate was lower in IDE knockdown cells than in controls. Microarray analysis revealed the decrease of hepatic IDE expression in subjects with T2DM accompanied by the downregulation of the p53-dependent genes FAS and CCNG2, but not by the upregulation of proliferation markers MKI67, MCM2 and PCNA. Similar results were found in the liver microarray dataset from GEO Profiles database. In conclusion, IDE expression is decreased in liver of subjects with T2DM which is accompanied by the dysregulation of p53 pathway. Prolonged use of IDE inhibitors for T2DM treatment should be carefully tested in animal studies regarding its potential effect on hepatic tumorigenesis.
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Key Words
- CCNG2, Cyclin G2 gene, CDKN1A/P21, Cyclin-dependent kinase inhibitor 1A (p21, Cip1) gene
- CDKN1B/P27, Cyclin-dependent kinase inhibitor 1B (p27, Kip1) gene
- FAS, Fas cell surface death receptor gene
- FBS, Fetal bovine serum
- IDE, Insulin-degrading enzyme
- MCM2, Minichromosome maintenance complex component 2 gene
- MKI67, Marker of proliferation Ki-67 gene
- NAFLD, Non-alcoholic fatty liver disease
- NAS, Non-alcoholic fatty liver disease score
- OGTT, Oral glucose tolerance test
- PCNA, Proliferating cell nuclear antigen gene
- SESN1, Sestrin 1 gene
- T2DM, Type 2 diabetes mellitus.
- TP53, Tumor protein p53 gene
- TP53I3, Tumor protein p53 inducible protein 3 gene
- hepatocellular carcinoma
- insulin-degrading enzyme
- non-alcoholic fatty liver disease
- proliferation
- qRT-PCR, Quantitative real-time PCR
- type 2 diabetes mellitus
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Affiliation(s)
- Olga Pivovarova
- a Department of Clinical Nutrition ; German Institute of Human Nutrition Potsdam-Rehbruecke ; Nuthetal , Germany
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29
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Duseja A, Singh SP, Saraswat VA, Acharya SK, Chawla YK, Chowdhury S, Dhiman RK, Jayakumar RV, Madan K, Misra SP, Mishra H, Modi SK, Muruganathan A, Saboo B, Sahay R, Upadhyay R. Non-alcoholic Fatty Liver Disease and Metabolic Syndrome-Position Paper of the Indian National Association for the Study of the Liver, Endocrine Society of India, Indian College of Cardiology and Indian Society of Gastroenterology. J Clin Exp Hepatol 2015; 5:51-68. [PMID: 25941433 PMCID: PMC4415196 DOI: 10.1016/j.jceh.2015.02.006] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [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: 10/09/2014] [Accepted: 02/27/2015] [Indexed: 02/07/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. Prevalence of metabolic risk factors including diabetes mellitus, obesity, etc. is rapidly increasing in India putting this population at risk for NAFLD. Patients with NAFLD are at increased risk for liver-related morbidity and mortality and also cardiovascular disease risk and increased incidence of diabetes mellitus on long-term follow-up. Management of patients with NAFLD may require a multi-disciplinary approach involving not only the hepatologists but also the internists, cardiologists, and endocrinologists. This position paper which is a combined effort of the Indian National Association for Study of the Liver (INASL), Endocrine Society of India (ESI), Indian College of Cardiology (ICC) and the Indian Society of Gastroenterology (ISG) defines the spectrum of NAFLD and the association of NAFLD with insulin resistance and metabolic syndrome besides suggesting preferred approaches for the diagnosis and management of patients with NAFLD in the Indian context.
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Key Words
- ALT, Alanine Aminotransferase
- APO C3, Apolipoprotein C3
- ARFI, Acoustic Radiation Forced Impulse
- AST, Aspartate Aminotransferase
- ATPIII, Adult Treatment Panel III
- BMI, Body mass index
- CAD, Coronary artery disease
- CC, Cryptogenic Cirrhosis
- CIMT, Carotid Intima Media Thickness
- CK 18, Cytokeratin 18
- CT, Computed Tomography
- DM, Diabetes Mellitus
- EBP, Enhancer-Binding Protein
- EMA, Anti-Endomysial antibodies
- FFA, Free Fatty Acids
- FMD, Flow-Mediated Vasodilatation
- FPG, Fasting Plasma Glucose
- GTT, Glucose Tolerance Test
- HCC, Hepatocellular Carcinoma
- HOMA-IR, Homeostasis Model Assessment for Insulin Resistance
- HTG, Hepatic triglyceride
- HTN, Hypertension
- IFG, Impaired Fasting Glucose
- IGT, Impaired Glucose Tolerance
- IKK-β, Inhibitor of nuclear factor kappa-B kinase beta
- IR, Insulin resistance
- IRS-1, Insulin Receptor Substrate-1
- ITT, Insulin Tolerance Test
- LFTs, Liver Function Tests
- MRE, Magnetic Resonance Elastography
- MS, Metabolic syndrome
- NAFLD
- NAFLD, Non-alcoholic fatty liver disease
- NASH
- NASH, Non-Alcoholic Steatohepatitis
- NF-κβ, Nuclear Factor Kappa Β
- PCOS, Polycystic Ovarian Syndrome
- PPG, Post-Prandial Glucose
- PROCAM, Prospective Cardiovascular Munster study
- SREBP, Sterol-Regulatory Element-Binding Protein
- T2DM, Type 2 Diabetes Mellitus
- TE, Transient elastography
- TG, Triglycerides
- TTG, Anti-tissue transglutaminase
- VHCC, Virus-related HCC
- VLDL, Very Low Density Lipoprotein
- WHO, World Health Organization
- cryptogenic cirrhosis
- insulin resistance
- nonalcoholic steatohepatitis
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Affiliation(s)
- Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shivaram P. Singh
- Department of Gastroenterology, SCB Medical College, Cuttack, Odisha, India
- Address for correspondence: Shivaram P. Singh, Professor and Head, Department of Gastroenterology, SCB Medical College, Cuttack 753007, Odisha, India. Tel.: +91 671 2433865.
| | - Vivek A. Saraswat
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Subrat K. Acharya
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Yogesh K. Chawla
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Subhankar Chowdhury
- Department of Endocrinology, Institute of Postgraduate Medical Education & Research and SSKM Hospital, Kolkata, West Bengal, India
| | - Radha K. Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Kaushal Madan
- Medanta Institute of Digestive and Hepatobiliary Sciences, Medanta—The Medicity, Gurgaon, Haryana, India
| | - Sri P. Misra
- Department of Gastroenterology, MotiLal Nehru Medical College, Allahabad, Uttar Pradesh, India
| | - Hrudananda Mishra
- Department of Cardiology, SCB Medical College, Cuttack, Odisha, India
| | - Sunil K. Modi
- Department of Cardiology, Indraprastha Apollo Hospital, New Delhi, India
| | - Arumugam Muruganathan
- The Tamil Nadu Dr. M.G.R. Medical University & AG Hospital, Tirupur, Tamil Nadu, India
| | - Banshi Saboo
- Department of Endocrinology, Diabetes Care & Hormone Clinic, Ahmedabad, Gujarat, India
| | - Rakesh Sahay
- Osmania Medical College & Osmania General Hospital, Hyderabad, Andhra Pradesh & MediCiti Hospital, Hyderabad, Andhra Pradesh, India
| | - Rajesh Upadhyay
- Department of Gastroenterology, Max Super Speciality Hospital, Shalimar Bagh, New Delhi, India
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