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Moore MP, Shryack G, Alessi I, Wieschhaus N, Meers GM, Johnson SA, Wheeler AA, Ibdah JA, Parks EJ, Rector RS. Relationship between serum β-hydroxybutyrate and hepatic fatty acid oxidation in individuals with obesity and NAFLD. Am J Physiol Endocrinol Metab 2024; 326:E493-E502. [PMID: 38381399 DOI: 10.1152/ajpendo.00336.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/22/2024]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is characterized by excess lipid accumulation that can progress to inflammation (nonalcoholic steatohepatitis, NASH), and fibrosis. Serum β-hydroxybutyrate (β-HB), a product of the ketogenic pathway, is commonly used as a surrogate marker for hepatic fatty acid oxidation (FAO). However, it remains uncertain whether this relationship holds true in the context of NAFLD in humans. We compared fasting serum β-HB levels with direct measurement of liver mitochondrial palmitate oxidation in humans stratified based on NAFLD severity (n = 142). Patients were stratified based on NAFLD activity score (NAS): NAS = 0 (no disease), NAS = 1-2 (mild), NAS = 3-4 (moderate), and NAS ≥ 5 (advanced). Moderate and advanced NAFLD is associated with reductions in liver 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2), serum β-HB, but not 3-hydroxy-3-methylglutaryl-CoA lyase (HMGCL) mRNA, relative to no disease. Worsening liver mitochondrial complete palmitate oxidation corresponded with lower HMGCS2 mRNA but not total (complete + incomplete) palmitate oxidation. Interestingly, we found that liver HMGCS2 mRNA and serum β-HB correlated with liver mitochondrial β-hydroxyacyl-CoA dehydrogenase (β-HAD) activity and CPT1A mRNA. Also, lower mitochondrial mass and markers of mitochondrial turnover positively correlated with lower HMGCS2 in the liver. These data suggest that liver ketogenesis and FAO occur at comparable rates in individuals with NAFLD. Our findings support the utility of serum β-HB to serve as a marker of liver injury and hepatic FAO in the context of NAFLD.NEW & NOTEWORTHY Serum β-hydroxybutyrate (β-HB) is frequently utilized as a surrogate marker for hepatic fatty acid oxidation; however, few studies have investigated this relationship during states of liver disease. We found that the progression of nonalcoholic fatty liver disease (NAFLD) is associated with reductions in circulating β-HB and liver 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2). As well, decreased rates of hepatic fatty acid oxidation correlated with liver HMGCS2 mRNA and serum β-HB. Our work supports serum β-HB as a potential marker for hepatic fatty acid oxidation and liver injury during NAFLD.
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Affiliation(s)
- Mary P Moore
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri, United States
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
| | - Grace Shryack
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri, United States
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
- NextGen Precision Health, Columbia, Missouri, United States
| | - Isabella Alessi
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri, United States
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
- NextGen Precision Health, Columbia, Missouri, United States
| | - Nicole Wieschhaus
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri, United States
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
- NextGen Precision Health, Columbia, Missouri, United States
| | - Grace M Meers
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri, United States
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
- NextGen Precision Health, Columbia, Missouri, United States
| | - Sarah A Johnson
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri, United States
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, Missouri, United States
| | - Andrew A Wheeler
- Department of Surgery, University of Missouri, Columbia, Missouri, United States
| | - Jamal A Ibdah
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri, United States
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, Missouri, United States
| | - Elizabeth J Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
- NextGen Precision Health, Columbia, Missouri, United States
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, Missouri, United States
| | - R Scott Rector
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri, United States
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
- NextGen Precision Health, Columbia, Missouri, United States
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, Missouri, United States
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Ramanathan R, Patwa SA, Ali AH, Ibdah JA. Thyroid Hormone and Mitochondrial Dysfunction: Therapeutic Implications for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Cells 2023; 12:2806. [PMID: 38132126 PMCID: PMC10741470 DOI: 10.3390/cells12242806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly termed nonalcoholic fatty liver disease (NAFLD), is a widespread global health concern that affects around 25% of the global population. Its influence is expanding, and it is anticipated to overtake alcohol as the leading cause of liver failure and liver-related death worldwide. Unfortunately, there are no approved therapies for MASLD; as such, national and international regulatory health agencies undertook strategies and action plans designed to expedite the development of drugs for treatment of MASLD. A sedentary lifestyle and an unhealthy diet intake are important risk factors. Western countries have a greater estimated prevalence of MASLD partly due to lifestyle habits. Mitochondrial dysfunction is strongly linked to the development of MASLD. Further, it has been speculated that mitophagy, a type of mitochondrial quality control, may be impaired in MASLD. Thyroid hormone (TH) coordinates signals from the nuclear and mitochondrial genomes to control mitochondrial biogenesis and function in hepatocytes. Mitochondria are known TH targets, and preclinical and clinical studies suggest that TH, thyroid receptor β (TR-β) analogs, and synthetic analogs specific to the liver could be of therapeutic benefit in treating MASLD. In this review, we highlight how mitochondrial dysfunction contributes to development of MASLD, and how understanding the role of TH in improving mitochondrial function paved the way for innovative drug development programs of TH-based therapies targeting MASLD.
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Affiliation(s)
- Raghu Ramanathan
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA; (R.R.); (A.H.A.)
- Harry S. Truman Memorial Veterans Medical Center, University of Missouri, Columbia, MO 65212, USA
| | - Sohum A. Patwa
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA; (R.R.); (A.H.A.)
| | - Ahmad Hassan Ali
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA; (R.R.); (A.H.A.)
- Harry S. Truman Memorial Veterans Medical Center, University of Missouri, Columbia, MO 65212, USA
| | - Jamal A. Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA; (R.R.); (A.H.A.)
- Harry S. Truman Memorial Veterans Medical Center, University of Missouri, Columbia, MO 65212, USA
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO 65212, USA
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Syed-Abdul MM, Moore MP, Wheeler AA, Ganga RR, Diaz-Arias A, Petroski GF, Rector RS, Ibdah JA, Parks EJ. Isotope Labeling and Biochemical Assessment of Liver-Triacylglycerol in Patients with Different Levels of Histologically-Graded Liver Disease. J Nutr 2023; 153:3418-3429. [PMID: 37774841 PMCID: PMC10843901 DOI: 10.1016/j.tjnut.2023.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/07/2023] [Accepted: 09/21/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) prevalence is rapidly growing, and fatty liver has been found in a quarter of the US population. Increased liver lipids, particularly those derived from the pathway of de novo lipogenesis (DNL), have been identified as a hallmark feature in individuals with high liver fat. This has led to much activity in basic science and drug development in this area. No studies to date have investigated the contribution of DNL across a spectrum of disease, although it is clear that inhibition of DNL has been shown to reduce liver fat. OBJECTIVES The purpose of this study was to determine whether liver lipid synthesis increases across the continuum of liver injury. METHODS Individuals (n = 49) consumed deuterated water for 10 d before their scheduled bariatric surgeries to label DNL; blood and liver tissue samples were obtained on the day of the surgery. Liver lipid concentrations were quantitated, and levels of protein and gene expression assessed. RESULTS Increased liver DNL, measured isotopically, was significantly associated with liver fatty acid synthase protein content (R = 0.470, P = 0.003), total steatosis assessed by histology (R = 0.526, P = 0.0008), and the fraction of DNL fatty acids in plasma very low-density lipoprotein-triacylglycerol (R = 0.747, P < 0.001). Regression analysis revealed a parabolic relationship between fractional liver DNL (percent) and NAFLD activity score (R = 0.538, P = 0.0004). CONCLUSION These data demonstrate that higher DNL is associated with early to mid stages of liver disease, and this pathway may be an effective target for the treatment of NAFLD and nonalcoholic steatohepatitis. This study was registered at clinicaltrials.gov as NCT03683589.
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Affiliation(s)
- Majid M Syed-Abdul
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Mary P Moore
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States; Research Services-Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, United States
| | - Andrew A Wheeler
- Department of Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Rama R Ganga
- Department of Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Alberto Diaz-Arias
- Boyce & Bynum Pathology Professional Services, Division of Gastrointestinal & Hepatobiliary Pathology, Columbia, MO, United States
| | - Gregory F Petroski
- Biostatistics Unit, School of Medicine, University of Missouri, Columbia, MO, United States
| | - R Scott Rector
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States; Research Services-Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, United States; Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Jamal A Ibdah
- Research Services-Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, United States; Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Elizabeth J Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States; Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine, University of Missouri, Columbia, MO, United States.
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Moore MP, Wang X, Shi H, Meroni M, Cherubini A, Ronzoni L, Parks EJ, Ibdah JA, Rector RS, Valenti L, Dongiovanni P, Tabas I. Circulating indian hedgehog is a marker of the hepatocyte-TAZ pathway in experimental NASH and is elevated in humans with NASH. JHEP Rep 2023; 5:100716. [PMID: 37035456 PMCID: PMC10074197 DOI: 10.1016/j.jhepr.2023.100716] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/08/2023] [Accepted: 02/11/2023] [Indexed: 04/11/2023] Open
Abstract
Background & Aims Non-alcoholic steatohepatitis (NASH)-induced liver fibrosis is emerging as the most common cause of liver disease. For evaluation of therapies, there is a pressing need to identify non-invasive, mechanism-based biomarkers. A pro-fibrotic process relevant to human NASH involves a pathway in which a transcriptional regulator called TAZ (WWTR1) in hepatocytes induces the secretion of pro-fibrotic Indian hedgehog (IHH). We therefore reasoned that circulating IHH may be a useful mechanism-based marker to assess changes in NASH fibrosis. Methods Circulating IHH was assessed in wild-type and hepatocyte-TAZ-silenced NASH mice and in three separate cohorts of patients with mild-moderate NASH. Results Circulating IHH was elevated in mice with diet-induced NASH compared with chow-fed mice or with NASH mice in which hepatocyte TAZ was silenced, which is an effective means to decrease NASH fibrosis. In patients with fatty liver disease with or without NASH, NASH fibrosis was associated with increased concentrations of circulating IHH. Conclusions The results of these analyses support further investigation to determine whether circulating IHH may be useful as a mechanism-based indicator of target engagement in anticipated future clinical trials testing NASH fibrosis therapies that block the IHH pathway. Impact and implications Non-alcoholic steatohepatitis (NASH)-induced liver fibrosis is a common cause of liver disease. Circulating biomarkers that reflect liver fibrosis in NASH would be very useful to evaluate therapies. One mechanism of NASH fibrosis with potential as a therapeutic target involves a liver-secreted protein called Indian hedgehog (IHH). We report that circulating levels of IHH in experimental and human NASH associates with NASH and NASH-associated liver fibrosis, providing the premise for further investigation into using circulating IHH to evaluate anticipated future NASH therapies that block the IHH pathway in liver.
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Affiliation(s)
- Mary Patricia Moore
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Xiaobo Wang
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Hongxue Shi
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Marica Meroni
- General Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Cherubini
- Precision Medicine Lab, Biological Resource Center, Department of Transfusion Medicine, Fondazione Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Luisa Ronzoni
- Precision Medicine Lab, Biological Resource Center, Department of Transfusion Medicine, Fondazione Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Elizabeth J Parks
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
- Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Jamal A Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, MO, USA
- Department of Medical Pharmacology and Physiology, School of Medicine, University of Missouri, Columbia, MO, USA
| | - R Scott Rector
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
- Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri, Columbia, MO, USA
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, MO, USA
| | - Luca Valenti
- Precision Medicine Lab, Biological Resource Center, Department of Transfusion Medicine, Fondazione Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
- Department of Pathophysiology and Transplantation, Universitádegli Studi di Milano, Milan, Italy
| | - Paola Dongiovanni
- General Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ira Tabas
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, USA
- Department of Physiology and Cellular Biophysics, Columbia University Irving Medical Center, New York, NY, USA
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Ali AH, Nallapeta NS, Yousaf MN, Petroski GF, Sharma N, Rao DS, Yin F, Davis RM, Bhat A, Swi AIA, Al-Juboori A, Ibdah JA, Hammoud GM. EUS-guided versus percutaneous liver biopsy: A prospective randomized clinical trial. Endosc Ultrasound 2023; 12:334-341. [PMID: 37693114 PMCID: PMC10437149 DOI: 10.1097/eus.0000000000000010] [Citation(s) in RCA: 1] [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: 11/14/2022] [Accepted: 04/12/2023] [Indexed: 09/12/2023] Open
Abstract
Background and Objectives Prospective studies comparing EUS-guided liver biopsy (EUS-LB) to percutaneous LB (PC-LB) are scarce. We compared the efficacy and safety of EUS-LB with those of PC-LB in a prospective randomized clinical trial. Methods Between 2020 and 2021, patients were enrolled and randomized (1:1 ratio). The primary outcome was defined as the proportion of patients with ≥11 complete portal tracts (CPTs). The sample size (n = 80) was calculated based on the assumption that 60% of those in the EUS-LB and 90% of those in the PC-LB group will have LB with ≥11 CPTs. The secondary outcomes included proportion of patients in whom a diagnosis was established, number of CPTs, pain severity (Numeric Rating Scale-Pain Intensity), duration of hospital stay, and adverse events. Results Eighty patients were enrolled (median age, 53 years); 67.5% were female. Sixty percent of those in the EUS-LB and 75.0% of those in the PC-LB group met the primary outcome (P = 0.232). The median number of CPTs was higher in the PC-LB (17 vs 13; P = 0.031). The proportion of patients in whom a diagnosis was established was similar between the groups (92.5% [EUS-LB] vs 95.0% [PC-LB]; P = 1.0). Patients in the EUS-LB group had less pain severity (median Numeric Rating Scale-Pain Intensity, 2.0 vs 3.0; P = 0.003) and shorter hospital stay (2.0 vs 4.0 hours; P < 0.0001) compared with the PC-LB group. No patient experienced a serious adverse event. Conclusions EUS-guided liver biopsy was safe, effective, better tolerated, and associated with a shorter hospital stay.
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Affiliation(s)
- Ahmad H. Ali
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Naren S. Nallapeta
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
- Division of Gastroenterology, Hepatology, and Nutrition, University of Buffalo, Buffalo, NY, USA
| | - Muhammad N. Yousaf
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Gregory F. Petroski
- Biostatistics and Research Design Unit, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Neal Sharma
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Deepthi S. Rao
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, MO, USA
| | - Feng Yin
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, MO, USA
| | - Ryan M. Davis
- Department of Radiology, Vascular and Interventional Radiology, University of Missouri, Columbia, MO, USA
| | - Ambarish Bhat
- Department of Radiology, Vascular and Interventional Radiology, University of Missouri, Columbia, MO, USA
| | - Ahmed I. A. Swi
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Alhareth Al-Juboori
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Jamal A. Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
- Research Service, Harry S. Truman Memorial Veterans Medical Center, Columbia, MO, USA
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA
| | - Ghassan M. Hammoud
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
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Mucinski JM, Perry AM, Fordham TM, Diaz-Arias A, Ibdah JA, Rector RS, Parks EJ. Labeled breath tests in patients with NASH: Octanoate oxidation relates best to measures of glucose metabolism. Front Physiol 2023; 14:1172675. [PMID: 37153214 PMCID: PMC10160408 DOI: 10.3389/fphys.2023.1172675] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023] Open
Abstract
In vivo methods to estimate human liver mitochondrial activity are lacking and this project's goal was to use a non-invasive breath test to quantify complete mitochondrial fat oxidation and determine how test results changed when liver disease state was altered over time. Patients with suspected non-alcoholic fatty liver disease (NAFLD; 9 men, 16 women, 47 ± 10 years, 113 ± 23 kg) underwent a diagnostic liver biopsy and liver tissue was histologically scored by a pathologist using the NAFLD activity score (0-8). To assess liver oxidation activity, a labeled medium chain fatty acid was consumed orally (23.4 mg 13C4-octanoate) and breath samples collected over 135 min. Total CO2 production rates were measured using breath 13CO2 analysis by isotope ratio mass spectrometry. Fasting endogenous glucose production (EGP) was measured using an IV infusion of 13C6-glucose. At baseline, subjects oxidized 23.4 ± 3.9% (14.9%-31.5%) of the octanoate dose and octanoate oxidation (OctOx) was negatively correlated with fasting plasma glucose (r = -0.474, p = 0.017) and EGP (r = -0.441, p = 0.028). Twenty-two subjects returned for repeat tests 10.2 ± 1.0 months later, following lifestyle treatment or standardized care. OctOx (% dose/kg) was significantly greater across all subjects (p = 0.044), negatively related to reductions in EGP (r = -0.401, p = 0.064), and tended to correlate with reduced fasting glucose (r = -0.371, p = 0.090). Subjects exhibited reductions in steatosis (p = 0.007) which tended to correlate with increased OctOx (% of dose/kg, r = -0.411, p = 0.058). Based on our findings, the use of an 13C-octanoate breath test may be an indicator of hepatic steatosis and glucose metabolism, but these relationships require verification through larger studies in NAFLD populations.
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Affiliation(s)
- Justine M. Mucinski
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Alisha M. Perry
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Talyia M. Fordham
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Alberto Diaz-Arias
- Boyce & Bynum Pathology Professional Services, Columbia, MO, United States
| | - Jamal A. Ibdah
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO, United States
- Research Service, Harry S. Truman Memorial Veterans Medical Center, Columbia, MO, United States
| | - R. Scott Rector
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO, United States
- Research Service, Harry S. Truman Memorial Veterans Medical Center, Columbia, MO, United States
- NextGen Precision Health, University of Missouri, Columbia, MO, United States
| | - Elizabeth J. Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO, United States
- NextGen Precision Health, University of Missouri, Columbia, MO, United States
- *Correspondence: Elizabeth J. Parks,
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Jurrissen TJ, Ramirez-Perez FI, Cabral-Amador FJ, Soares RN, Pettit-Mee RJ, Betancourt-Cortes EE, McMillan NJ, Sharma N, Rocha HNM, Fujie S, Morales-Quinones M, Lazo-Fernandez Y, Butler AA, Banerjee S, Sacks HS, Ibdah JA, Parks EJ, Rector RS, Manrique-Acevedo C, Martinez-Lemus LA, Padilla J. Role of adropin in arterial stiffening associated with obesity and type 2 diabetes. Am J Physiol Heart Circ Physiol 2022; 323:H879-H891. [PMID: 36083795 PMCID: PMC9602697 DOI: 10.1152/ajpheart.00385.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 01/16/2023]
Abstract
Adropin is a peptide largely secreted by the liver and known to regulate energy homeostasis; however, it also exerts cardiovascular effects. Herein, we tested the hypothesis that low circulating levels of adropin in obesity and type 2 diabetes (T2D) contribute to arterial stiffening. In support of this hypothesis, we report that obesity and T2D are associated with reduced levels of adropin (in liver and plasma) and increased arterial stiffness in mice and humans. Establishing causation, we show that mesenteric arteries from adropin knockout mice are also stiffer, relative to arteries from wild-type counterparts, thus recapitulating the stiffening phenotype observed in T2D db/db mice. Given the above, we performed a set of follow-up experiments, in which we found that 1) exposure of endothelial cells or isolated mesenteric arteries from db/db mice to adropin reduces filamentous actin (F-actin) stress fibers and stiffness, 2) adropin-induced reduction of F-actin and stiffness in endothelial cells and db/db mesenteric arteries is abrogated by inhibition of nitric oxide (NO) synthase, and 3) stimulation of smooth muscle cells or db/db mesenteric arteries with a NO mimetic reduces stiffness. Lastly, we demonstrated that in vivo treatment of db/db mice with adropin for 4 wk reduces stiffness in mesenteric arteries. Collectively, these findings indicate that adropin can regulate arterial stiffness, likely via endothelium-derived NO, and thus support the notion that "hypoadropinemia" should be considered as a putative target for the prevention and treatment of arterial stiffening in obesity and T2D.NEW & NOTEWORTHY Arterial stiffening, a characteristic feature of obesity and type 2 diabetes (T2D), contributes to the development and progression of cardiovascular diseases. Herein we establish that adropin is decreased in obese and T2D models and furthermore provide evidence that reduced adropin may directly contribute to arterial stiffening. Collectively, findings from this work support the notion that "hypoadropinemia" should be considered as a putative target for the prevention and treatment of arterial stiffening in obesity and T2D.
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Affiliation(s)
- Thomas J Jurrissen
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
| | | | | | - Rogerio N Soares
- Department of Medicine, Center for Precision Medicine, University of Missouri, Columbia, Missouri
| | - Ryan J Pettit-Mee
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | | | - Neil J McMillan
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Neekun Sharma
- Department of Medicine, Center for Precision Medicine, University of Missouri, Columbia, Missouri
| | - Helena N M Rocha
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
- Department of Physiology and Pharmacology, Fluminense Federal University, Niteroi, Brazil
| | - Shumpei Fujie
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Mariana Morales-Quinones
- Department of Medicine, Center for Precision Medicine, University of Missouri, Columbia, Missouri
| | - Yoskaly Lazo-Fernandez
- Department of Medicine, Center for Precision Medicine, University of Missouri, Columbia, Missouri
| | - Andrew A Butler
- Department of Pharmacology and Physiological Sciences, Saint Louis University, Saint Louis, Missouri
| | - Subhashis Banerjee
- Department of Pharmacology and Physiological Sciences, Saint Louis University, Saint Louis, Missouri
| | - Harold S Sacks
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Jamal A Ibdah
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Elizabeth J Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, Missouri
| | - R Scott Rector
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Camila Manrique-Acevedo
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri
- Division of Endocrinology and Metabolism, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Luis A Martinez-Lemus
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
- Department of Medicine, Center for Precision Medicine, University of Missouri, Columbia, Missouri
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri
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8
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Moore MP, Cunningham RP, Meers GM, Johnson SA, Wheeler AA, Ganga RR, Spencer NM, Pitt JB, Diaz-Arias A, Swi AIA, Hammoud GM, Ibdah JA, Parks EJ, Rector RS. Compromised hepatic mitochondrial fatty acid oxidation and reduced markers of mitochondrial turnover in human NAFLD. Hepatology 2022; 76:1452-1465. [PMID: 35000203 PMCID: PMC9270503 DOI: 10.1002/hep.32324] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS NAFLD and its more-advanced form, steatohepatitis (NASH), is associated with obesity and is an independent risk factor for cardiovascular, liver-related, and all-cause mortality. Available human data examining hepatic mitochondrial fatty acid oxidation (FAO) and hepatic mitochondrial turnover in NAFLD and NASH are scant. APPROACH AND RESULTS To investigate this relationship, liver biopsies were obtained from patients with obesity undergoing bariatric surgery and data clustered into four groups based on hepatic histopathological classification: Control (CTRL; no disease); NAFL (steatosis only); Borderline-NASH (steatosis with lobular inflammation or hepatocellular ballooning); and Definite-NASH (D-NASH; steatosis, lobular inflammation, and hepatocellular ballooning). Hepatic mitochondrial complete FAO to CO2 and the rate-limiting enzyme in β-oxidation (β-hydroxyacyl-CoA dehydrogenase activity) were reduced by ~40%-50% with D-NASH compared with CTRL. This corresponded with increased hepatic mitochondrial reactive oxygen species production, as well as dramatic reductions in markers of mitochondrial biogenesis, autophagy, mitophagy, fission, and fusion in NAFL and NASH. CONCLUSIONS These findings suggest that compromised hepatic FAO and mitochondrial turnover are intimately linked to increasing NAFLD severity in patients with obesity.
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Affiliation(s)
- Mary P. Moore
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, MO, USA, 65201
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA, 65211
| | - Rory P. Cunningham
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, MO, USA, 65201
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA, 65211
| | - Grace M. Meers
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, MO, USA, 65201
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA, 65211
| | - Sarah A. Johnson
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, MO, USA, 65201
- Department of Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia MO, USA, 65211
| | - Andrew A. Wheeler
- Department of Surgery, University of Missouri, Columbia MO, USA, 65211
| | - Rama R. Ganga
- Department of Surgery, University of Missouri, Columbia MO, USA, 65211
| | - Nicole M. Spencer
- Department of Surgery, University of Missouri, Columbia MO, USA, 65211
| | - James B. Pitt
- Department of Surgery, University of Missouri, Columbia MO, USA, 65211
| | | | - Ahmed I. A. Swi
- Department of Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia MO, USA, 65211
| | - Ghassan M. Hammoud
- Department of Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia MO, USA, 65211
| | - Jamal A. Ibdah
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, MO, USA, 65201
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA, 65211
- Department of Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia MO, USA, 65211
| | - Elizabeth J. Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA, 65211
- Department of Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia MO, USA, 65211
| | - R. Scott Rector
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, MO, USA, 65201
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA, 65211
- Department of Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia MO, USA, 65211
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9
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Ramanathan R, Ali AH, Ibdah JA. Mitochondrial Dysfunction Plays Central Role in Nonalcoholic Fatty Liver Disease. Int J Mol Sci 2022; 23:ijms23137280. [PMID: 35806284 PMCID: PMC9267060 DOI: 10.3390/ijms23137280] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 12/04/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a global pandemic that affects one-quarter of the world’s population. NAFLD includes a spectrum of progressive liver disease from steatosis to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis and can be complicated by hepatocellular carcinoma. It is strongly associated with metabolic syndromes, obesity, and type 2 diabetes, and it has been shown that metabolic dysregulation is central to its pathogenesis. Recently, it has been suggested that metabolic- (dysfunction) associated fatty liver disease (MAFLD) is a more appropriate term to describe the disease than NAFLD, which puts increased emphasis on the important role of metabolic dysfunction in its pathogenesis. There is strong evidence that mitochondrial dysfunction plays a significant role in the development and progression of NAFLD. Impaired mitochondrial fatty acid oxidation and, more recently, a reduction in mitochondrial quality, have been suggested to play a major role in NAFLD development and progression. In this review, we provide an overview of our current understanding of NAFLD and highlight how mitochondrial dysfunction contributes to its pathogenesis in both animal models and human subjects. Further we discuss evidence that the modification of mitochondrial function modulates NAFLD and that targeting mitochondria is a promising new avenue for drug development to treat NAFLD/NASH.
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Affiliation(s)
- Raghu Ramanathan
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA; (R.R.); (A.H.A.)
- Harry S. Truman Memorial Veterans Medical Center, Columbia, MO 65201, USA
| | - Ahmad Hassan Ali
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA; (R.R.); (A.H.A.)
- Harry S. Truman Memorial Veterans Medical Center, Columbia, MO 65201, USA
| | - Jamal A. Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA; (R.R.); (A.H.A.)
- Harry S. Truman Memorial Veterans Medical Center, Columbia, MO 65201, USA
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO 65212, USA
- Correspondence: ; Tel.: +573-882-7349; Fax: +573-884-4595
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10
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Khare S, Khare T, Ramanathan R, Ibdah JA. Hepatocellular Carcinoma: The Role of MicroRNAs. Biomolecules 2022; 12:biom12050645. [PMID: 35625573 PMCID: PMC9138333 DOI: 10.3390/biom12050645] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 12/12/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths worldwide. HCC is diagnosed in its advanced stage when limited treatment options are available. Substantial morphologic, genetic and epigenetic heterogeneity has been reported in HCC, which poses a challenge for the development of a targeted therapy. In this review, we discuss the role and involvement of several microRNAs (miRs) in the heterogeneity and metastasis of hepatocellular carcinoma with a special emphasis on their possible role as a diagnostic and prognostic tool in the risk prediction, early detection, and treatment of hepatocellular carcinoma.
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Affiliation(s)
- Sharad Khare
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO 65212, USA; (S.K.); (T.K.); (R.R.)
- Harry S. Truman Veterans Hospital, Columbia, MO 65201, USA
| | - Tripti Khare
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO 65212, USA; (S.K.); (T.K.); (R.R.)
| | - Raghu Ramanathan
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO 65212, USA; (S.K.); (T.K.); (R.R.)
- Harry S. Truman Veterans Hospital, Columbia, MO 65201, USA
| | - Jamal A. Ibdah
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO 65212, USA; (S.K.); (T.K.); (R.R.)
- Harry S. Truman Veterans Hospital, Columbia, MO 65201, USA
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO 65212, USA
- Correspondence: ; Tel.: 1-573-882-7349; Fax: 1-573-884-4595
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11
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Cunningham RP, Moore MP, Dashek RJ, Meers GM, Takahashi T, Sheldon RD, Wheeler AA, Diaz-Arias A, Ibdah JA, Parks EJ, Thyfault JP, Rector RS. Critical Role for Hepatocyte-Specific eNOS in NAFLD and NASH. Diabetes 2021; 70:2476-2491. [PMID: 34380696 PMCID: PMC8564406 DOI: 10.2337/db20-1228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/30/2021] [Indexed: 11/13/2022]
Abstract
Regulation of endothelial nitric oxide synthase (eNOS) in hepatocytes may be an important target in nonalcoholic fatty liver disease (NAFLD) development and progression to nonalcoholic steatohepatitis (NASH). In this study, we show genetic deletion and viral knockdown of hepatocyte-specific eNOS exacerbated hepatic steatosis and inflammation, decreased hepatic mitochondrial fatty acid oxidation and respiration, increased mitochondrial H2O2 emission, and impaired the hepatic mitophagic (BNIP3 and LC3II) response. Conversely, overexpressing eNOS in hepatocytes in vitro and in vivo increased hepatocyte mitochondrial respiration and attenuated Western diet-induced NASH. Moreover, patients with elevated NAFLD activity score (histology score of worsening steatosis, hepatocyte ballooning, and inflammation) exhibited reduced hepatic eNOS expression, which correlated with reduced hepatic mitochondrial fatty acid oxidation and lower hepatic protein expression of mitophagy protein BNIP3. The current study reveals an important molecular role for hepatocyte-specific eNOS as a key regulator of NAFLD/NASH susceptibility and mitochondrial quality control with direct clinical correlation to patients with NASH.
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Affiliation(s)
- Rory P Cunningham
- Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
| | - Mary P Moore
- Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
| | - Ryan J Dashek
- Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
- Comparative Medicine Program, University of Missouri, Columbia, MO
| | - Grace M Meers
- Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
| | - Takamune Takahashi
- Division of Nephrology and Hypertension, Vanderbilt University School of Medicine, Nashville, TN
| | - Ryan D Sheldon
- Metabolic and Nutritional Programming, Center for Cancer and Cell Biology, Van Andel Institute, Grand Rapids, MI
| | | | | | - Jamal A Ibdah
- Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO
| | - Elizabeth J Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO
| | - John P Thyfault
- Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS
- Kansas City VA Medical Center, Kansas City, MO
| | - R Scott Rector
- Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO
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12
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Khare T, Khare S, Angdisen JJ, Zhang Q, Stuckel A, Mooney BP, Ridenhour SE, Gitan RS, Hammoud GM, Ibdah JA. Defects in long-chain 3-hydroxy acyl-CoA dehydrogenase lead to hepatocellular carcinoma: A novel etiology of hepatocellular carcinoma. Int J Cancer 2020; 147:1461-1473. [PMID: 32115688 DOI: 10.1002/ijc.32943] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 01/02/2020] [Accepted: 02/17/2020] [Indexed: 12/14/2022]
Abstract
The incidence of both nonalcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC) have been increasing at an alarming rate. Little is known about NAFLD without cirrhosis as a risk for HCC. Here we report, for the first time, generation of a mouse model with a defect in long-chain 3-hydoxy acyl-CoA dehydrogenase (LCHAD). The LCHAD exon 15 deletion was embryonic lethal to the homozygous mice whereas heterozygous mice (HT) develop significant hepatic steatosis starting at young age (3 months old) and HCC at older age (>13 months old) without any evidence of fibrosis or cirrhosis. None of the wild-type (WT) mice developed steatosis and HCC (n = 39), whereas HT-LCHAD mice (n = 41) showed steatosis and ~20% (8/41) developed liver masses with histological features of HCC. Proteomic analysis of liver tissues from WT-mice and HT-mice with no signs of HCC was conducted. Proteins with significant changes in abundance were identified by mass spectrometry. Abundance of 24 proteins was significantly different (p < 0.01) between WT and HT-LCHAD mice. The proteins found to vary in abundance are associated with different cellular response processes ranging from intermediary metabolism of carbohydrate, protein and lipid to oxidative stress, signal transduction and the process of tumorigenesis. Protein expression pattern of the HT-LCHAD mouse liver indicates predisposition to HCC and suggests that impaired hepatic mitochondrial fatty acid oxidation plays an important role in the development and progression of HCC. To assess the implication of these studies in human disease, we demonstrated significant downregulation of HADHA transcripts in HCC patients.
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Affiliation(s)
- Tripti Khare
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO, USA
| | - Sharad Khare
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO, USA.,Harry S Truman Veterans' Hospital, Columbia, MO, USA
| | - Jerry J Angdisen
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO, USA
| | - Qiong Zhang
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO, USA
| | - Alexei Stuckel
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO, USA
| | - Brian P Mooney
- Gehrke Proteomics center, University of Missouri, Columbia, MO, USA
| | - Suzanne E Ridenhour
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO, USA
| | - Raad S Gitan
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO, USA
| | - Ghassan M Hammoud
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO, USA
| | - Jamal A Ibdah
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO, USA.,Harry S Truman Veterans' Hospital, Columbia, MO, USA.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA
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13
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Ali AH, Panchal S, Rao DS, Gan Y, Al-Juboori A, Samiullah S, Ibdah JA, Hammoud GM. The efficacy and safety of endoscopic ultrasound-guided liver biopsy versus percutaneous liver biopsy in patients with chronic liver disease: a retrospective single-center study. J Ultrasound 2020; 23:157-167. [PMID: 32141043 DOI: 10.1007/s40477-020-00436-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND AIMS There is limited literature on endoscopic ultrasound-guided liver biopsy (EUS-LB), a new method of obtaining liver biopsy (LB). METHODS We conducted a retrospective study of the efficacy and safety of EUS-LB compared to percutaneous liver biopsy (PC-LB) in patients with chronic liver disease at our center between January 2018 and August 2019. RESULTS Thirty patients underwent EUS-LB and 60 patients underwent PC-LB were identified (median follow-up post-LB was 8 days; interquartile range (IQR), 3-5 days). The median number of portal tracts was significantly higher in the PC-LB group (13 vs. 5; P < 0.0001). A histologic diagnosis was established in 93% of the EUS-LB group, compared to 100% in the PC-LB group (P = 0.841). Patients in EUS-LB group had significantly shorter hospital stay (median time of hospital stay was 3 vs. 4.2 h in the EUS-LB vs. PC-LB group, respectively; P = 0.004) and reported less pain compared to PC-LB group (median pain score was 0 vs. 3.5; P = 0.0009). EUS-LB were performed using a 19-gauge (n = 27) or 22-gauge (n = 3); there was a tendency towards higher number of portal tracts in the 22- vs. the 19-gauge needle group (6 vs. 5; P = 0.501). No patient in either group had significant adverse events such as bleeding or death. CONCLUSION EUS-LB is safe and is associated with less pain, shorter hospital stay, and high diagnostic yield (93%) compared to PC-LB. Randomized trials are needed to standardize the utility of EUS-LB.
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Affiliation(s)
- Ahmad Hassan Ali
- Department of Gastroenterology and Hepatology, University of Missouri-School of Medicine, One Hospital Drive, Columbia, MO, 65212, USA
| | - Sarjukumar Panchal
- Department of Gastroenterology and Hepatology, University of Missouri-School of Medicine, One Hospital Drive, Columbia, MO, 65212, USA
| | - Deepthi S Rao
- Department of Pathology and Anatomical Sciences, University of Missouri-School of Medicine, Columbia, MO, USA
| | - Yujun Gan
- Department of Pathology and Anatomical Sciences, University of Missouri-School of Medicine, Columbia, MO, USA
| | - Alhareth Al-Juboori
- Department of Gastroenterology and Hepatology, University of Missouri-School of Medicine, One Hospital Drive, Columbia, MO, 65212, USA
| | - Sami Samiullah
- Department of Gastroenterology and Hepatology, University of Missouri-School of Medicine, One Hospital Drive, Columbia, MO, 65212, USA
| | - Jamal A Ibdah
- Department of Gastroenterology and Hepatology, University of Missouri-School of Medicine, One Hospital Drive, Columbia, MO, 65212, USA
| | - Ghassan M Hammoud
- Department of Gastroenterology and Hepatology, University of Missouri-School of Medicine, One Hospital Drive, Columbia, MO, 65212, USA.
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14
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Sheldon RD, Meers GM, Morris EM, Linden MA, Cunningham RP, Ibdah JA, Thyfault JP, Laughlin MH, Rector RS. eNOS deletion impairs mitochondrial quality control and exacerbates Western diet-induced NASH. Am J Physiol Endocrinol Metab 2019; 317:E605-E616. [PMID: 31361543 PMCID: PMC6842915 DOI: 10.1152/ajpendo.00096.2019] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Dysregulated mitochondrial quality control leads to mitochondrial functional impairments that are central to the development and progression of hepatic steatosis to nonalcoholic steatohepatitis (NASH). Here, we identify hepatocellular localized endothelial nitric oxide synthase (eNOS) as a novel master regulator of mitochondrial quality control. Mice lacking eNOS were more susceptible to Western diet-induced hepatic inflammation and fibrosis in conjunction with decreased markers of mitochondrial biogenesis and turnover. The hepatocyte-specific influence was verified via magnetic activated cell sorting purified primary hepatocytes and in vitro siRNA-induced knockdown of eNOS. Hepatic mitochondria from eNOS knockout mice revealed decreased markers of mitochondrial biogenesis (PPARγ coactivator-1α, mitochondrial transcription factor A) and autophagy/mitophagy [BCL-2-interacting protein-3 (BNIP3), 1A/1B light chain 3B (LC3)], suggesting decreased mitochondrial turnover rate. eNOS knockout in primary hepatocytes exhibited reduced fatty acid oxidation capacity and were unable to mount a normal BNIP3 response to a mitophagic challenge compared with wild-type mice. Finally, we demonstrate that eNOS is required in primary hepatocytes to induce activation of the stress-responsive transcription factor nuclear factor erythroid 2-related factor 2 (NRF2). Thus, our data demonstrate that eNOS is an important regulator of hepatic mitochondrial content and function and NASH susceptibility.
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Affiliation(s)
- Ryan D Sheldon
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Grace M Meers
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - E Matthew Morris
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Melissa A Linden
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Rory P Cunningham
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Jamal A Ibdah
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, Missouri
| | - John P Thyfault
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas
- Kansas City Veterans Affairs Medical Center, Kansas City, Missouri
| | - M Harold Laughlin
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - R Scott Rector
- Research Service, Harry S Truman Memorial Veterans Medical Center, Columbia, Missouri
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, Missouri
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
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15
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Affiliation(s)
- Ghassan M Hammoud
- Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Jacob Quick
- Division of Acute Care Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Sami Samiullah
- Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Deepthi Rao
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Jamal A Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, Missouri, USA
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16
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Jalil AAA, Hammoud G, Ibdah JA, Samiullah S. Removal of Esophageal Variceal Bands to Salvage Complete Esophageal Obstruction. Clin Endosc 2018; 51:491-494. [PMID: 30130842 PMCID: PMC6182280 DOI: 10.5946/ce.2018.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 04/10/2018] [Indexed: 11/21/2022] Open
Abstract
Esophageal varices develop in almost half of the patients with cirrhosis, and variceal hemorrhage constitutes an ominous sign with an increased risk of mortality. Variceal banding is considered an effective and mostly safe measure for primary and secondary prophylaxis. Although adverse events related to banding including dysphagia, stricture formation, bleeding, and ligation-induced ulcers have been described, complete esophageal obstruction is rare, with only 10 reported cases in the literature. Among those cases, 6 were managed conservatively; 1 patient had esophageal intraluminal dissection from an attempt to remove the bands using biopsy forceps but ultimately recovered with conservative management. Three patients developed strictures following removal of the bands, requiring repeated sessions of dilation therapy. We report on a patient who developed absolute dysphagia and complete esophageal obstruction after variceal banding. We successfully used the endoloop cutter hook to release the bands intact and restore luminal integrity.
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Affiliation(s)
- Ala' A Abdel Jalil
- Division of Gastroenterology & Hepatology, University of Missouri-Columbia, Columbia, MO, USA
| | - Ghassan Hammoud
- Division of Gastroenterology & Hepatology, University of Missouri-Columbia, Columbia, MO, USA
| | - Jamal A Ibdah
- Division of Gastroenterology & Hepatology, University of Missouri-Columbia, Columbia, MO, USA
| | - Sami Samiullah
- Division of Gastroenterology & Hepatology, University of Missouri-Columbia, Columbia, MO, USA
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17
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Nassir F, Arndt JJ, Johnson SA, Ibdah JA. Regulation of mitochondrial trifunctional protein modulates nonalcoholic fatty liver disease in mice. J Lipid Res 2018; 59:967-973. [PMID: 29581157 PMCID: PMC5983392 DOI: 10.1194/jlr.m080952] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 03/21/2018] [Indexed: 12/15/2022] Open
Abstract
Mitochondrial trifunctional protein (MTP) plays a critical role in the oxidation of long-chain fatty acids. We previously reported that aging mice (>9 months old) heterozygous for an MTP defect (MTP+/-) develop nonalcoholic fatty liver disease (NAFLD). We tested whether a high-fat diet (HFD) accelerates NAFLD in young MTP+/-mice, and whether overexpression of the nicotinamide adenine dinucleotide (NAD+)-dependent deacetylase sirtuin 3 (SIRT3) deacetylates MTP and improves mitochondrial function and NAFLD. Three-month-old WT and MTP+/- mice were fed HFD (60% cal fat) for 16 weeks and livers were assessed for fatty acid oxidation (FAO) and NAFLD. Compared with WT, MTP+/- mice displayed reduced hepatic SIRT3 levels and reduced FAO, with increased hepatic steatosis and the inflammatory marker CD68. Hepatic overexpression of SIRT3 in HFD-fed MTP+/- mice increased hepatic MTP protein levels at the posttranscriptional level. Immunoprecipitation of MTP from liver mitochondria followed by Western blot with acetyl-lysine antibody showed higher acetylation of MTP in MTP+/- compared with WT mice. Overexpression of SIRT3 in MTP+/- mice significantly reduced the acetylation of MTP compared with β-galactosidase controls, increased mitochondrial FAO, and reduced hepatic steatosis, CD68, and serum ALT levels. Taken together, our data indicate that deacetylation of MTP by SIRT3 improves mitochondrial function and rescues NAFLD in MTP+/- mice.
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Affiliation(s)
- Fatiha Nassir
- Departments of Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO; Nutrition and Exercise Physiology, University of Missouri, Columbia, MO; United States Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
| | - Justin J Arndt
- Departments of Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO
| | - Sarah A Johnson
- Departments of Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO; United States Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
| | - Jamal A Ibdah
- Departments of Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO; Nutrition and Exercise Physiology, University of Missouri, Columbia, MO; Medical Pharmacology & Physiology, University of Missouri, Columbia, MO; United States Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO.
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Syed‐Abdul MM, Le NT, Jacome‐Sosa M, Hu Q, Oxler BM, Bingham K, Arreola R, Al Juboori AM, Gaballah AH, Bartholow BD, Ibdah JA, Parks EJ. Tailgate Study: A Pilot Study Measuring the Impact of Food and Alcohol Intake on Whole‐body and Liver Metabolism. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.760.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Nhan T. Le
- Department of Nutrition and Exercise PhysiologyUniversity of MissouriColumbiaMO
| | - Miriam Jacome‐Sosa
- Department of Nutrition and Exercise PhysiologyUniversity of MissouriColumbiaMO
| | - Qiong Hu
- Department of Nutrition and Exercise PhysiologyUniversity of MissouriColumbiaMO
| | - Bradford M. Oxler
- Department of Nutrition and Exercise PhysiologyUniversity of MissouriColumbiaMO
| | - Kimberlee Bingham
- Department of Nutrition and Exercise PhysiologyUniversity of MissouriColumbiaMO
| | - Ramiro Arreola
- Department of Nutrition and Exercise PhysiologyUniversity of MissouriColumbiaMO
| | | | | | | | - Jamal A. Ibdah
- Division of Gastroenterology and HepatologyUniversity of MissouriColumbiaMO
| | - Elizabeth J. Parks
- Department of Nutrition and Exercise PhysiologyUniversity of MissouriColumbiaMO
- Division of Gastroenterology and HepatologyUniversity of MissouriColumbiaMO
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19
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Natarajan SK, Ibdah JA. Role of 3-Hydroxy Fatty Acid-Induced Hepatic Lipotoxicity in Acute Fatty Liver of Pregnancy. Int J Mol Sci 2018; 19:ijms19010322. [PMID: 29361796 PMCID: PMC5796265 DOI: 10.3390/ijms19010322] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 01/16/2018] [Accepted: 01/16/2018] [Indexed: 12/16/2022] Open
Abstract
Acute fatty liver of pregnancy (AFLP), a catastrophic illness for both the mother and the unborn offspring, develops in the last trimester of pregnancy with significant maternal and perinatal mortality. AFLP is also recognized as an obstetric and medical emergency. Maternal AFLP is highly associated with a fetal homozygous mutation (1528G>C) in the gene that encodes for mitochondrial long-chain hydroxy acyl-CoA dehydrogenase (LCHAD). The mutation in LCHAD results in the accumulation of 3-hydroxy fatty acids, such as 3-hydroxy myristic acid, 3-hydroxy palmitic acid and 3-hydroxy dicarboxylic acid in the placenta, which are then shunted to the maternal circulation leading to the development of acute liver injury observed in patients with AFLP. In this review, we will discuss the mechanistic role of increased 3-hydroxy fatty acid in causing lipotoxicity to the liver and in inducing oxidative stress, mitochondrial dysfunction and hepatocyte lipoapoptosis. Further, we also review the role of 3-hydroxy fatty acids in causing placental damage, pancreatic islet β-cell glucolipotoxicity, brain damage, and retinal epithelial cells lipoapoptosis in patients with LCHAD deficiency.
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Affiliation(s)
- Sathish Kumar Natarajan
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE 68583-0806, USA.
| | - Jamal A Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA.
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO 65212, USA.
- Harry S. Truman Memorial Veterans Medical Center, Columbia, MO 65201, USA.
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20
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Winn NC, Liu Y, Rector RS, Parks EJ, Ibdah JA, Kanaley JA. Energy-matched moderate and high intensity exercise training improves nonalcoholic fatty liver disease risk independent of changes in body mass or abdominal adiposity - A randomized trial. Metabolism 2018; 78:128-140. [PMID: 28941598 DOI: 10.1016/j.metabol.2017.08.012] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/29/2017] [Accepted: 08/30/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE Exercise training is commonly prescribed for individuals diagnosed with nonalcoholic fatty liver disease (NAFLD); however, consensus regarding the volume and intensity of exercise for optimal benefits is lacking. Thus, we determined whether high intensity interval exercise training (HIIT) produced greater reductions in intrahepatic lipid (IHL) content and NAFLD risk factors compared with energy-matched moderate intensity continuous exercise training (MICT) in obese adults with liver steatosis. METHODS Eighteen obese adults were randomized to either 4weeks of HIIT (4min 80% VO2peak/3min, 50% VO2peak) or MICT (55% VO2peak, ~60min), matched for energy expenditure (~400kcal/session) and compared to five non-exercising age-matched control subjects. IHL was measured by 1H-MRS and frequent blood samples were analyzed for glucose, insulin, c-peptide, and NEFA levels during a liquid meal test (180min) to characterize metabolic phenotype. RESULTS Baseline body weight, visceral abdominal adiposity, and fasting insulin concentrations were greater in the MICT vs HIIT group (P<0.05), while IHL was tightly matched between MICT and HIIT subjects (P>0.05), albeit higher than control subjects (P<0.01). Visceral abdominal adiposity, body mass, liver aminotransferases (ALT, AST), and hepatic apoptotic/inflammatory markers (cytokeratin 18 and fetuin a) were not reduced with either exercise training intervention (P>0.05). Both HIIT and MICT lowered IHL (HIIT, -37.0±12.4%; MICT, -20.1±6.6%, P<0.05); however, the reduction in IHL was not statistically different between exercise intensities (P=0.25). Furthermore, exercise training decreased postprandial insulin, c-peptide, and lipid peroxidation levels (iAUC, P<0.05). CONCLUSIONS Collectively, these findings indicate that energy-matched high intensity and moderate intensity exercise are effective at decreasing IHL and NAFLD risk that is not contingent upon reductions in abdominal adiposity or body mass.
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Affiliation(s)
- Nathan C Winn
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Ying Liu
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - R Scott Rector
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States; Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, United States; Research Service, Harry S. Truman Memorial VA Hospital, University of Missouri, Columbia, MO, United States
| | - Elizabeth J Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Jamal A Ibdah
- Medicine-Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, United States
| | - Jill A Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States.
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21
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Heath RD, Ertem F, Romana BS, Ibdah JA, Tahan V. Hepatocyte transplantation: Consider infusion before incision. World J Transplant 2017; 7:317-323. [PMID: 29312860 PMCID: PMC5743868 DOI: 10.5500/wjt.v7.i6.317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 11/27/2017] [Accepted: 12/06/2017] [Indexed: 02/05/2023] Open
Abstract
Human hepatocyte transplantation is undergoing study as a bridge, or even alternative, to orthotopic liver transplantation (OLT). This technique has undergone multiple developments over the past thirty years in terms of mode of delivery, source and preparation of cell cultures, monitoring of graft function, and use of immunosuppression. Further refinements and improvements in these techniques will likely allow improved graft survival and function, granting patients higher yield from this technique and potentially significantly delaying need for OLT.
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Affiliation(s)
- Ryan D Heath
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
| | - Furkan Ertem
- Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15260, United States
| | - Bhupinder S Romana
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
| | - Jamal A Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
| | - Veysel Tahan
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
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22
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Yousef MH, Al Juboori A, Albarrak AA, Ibdah JA, Tahan V. Fatty liver without a large “belly”: Magnified review of non-alcoholic fatty liver disease in non-obese patients. World J Gastrointest Pathophysiol 2017; 8:100-107. [PMID: 28868179 PMCID: PMC5561430 DOI: 10.4291/wjgp.v8.i3.100] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 05/22/2017] [Accepted: 06/20/2017] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is well described as a common cause of chronic liver disease, mostly in the obese population. It refers to a spectrum of chronic liver disease that starts with simple steatosis than progresses to nonalcoholic steatohepatitis and cirrhosis in patients without significant alcohol consumption. NAFLD in the non-obese population has been increasingly reported and studied recently. The pathogenesis of nonobese NAFLD is poorly understood and is related to genetic predisposition, most notably patatin-like phospholipase domain-containing 33 G allele polymorphism that leads to intrahepatic triglyceride accumulation and insulin resistance. Non-obese NAFLD is associated with components of metabolic syndrome and, especially, visceral obesity which seems to be an important etiological factor in this group. Dietary factors and, specifically, a high fructose diet seem to play a role. Cardiovascular events remain the main cause of mortality and morbidity in NAFLD, including in the non-obese population. There is not enough data regarding treatment in non-obese NAFLD patients, but similar to NAFLD in obese subjects, lifestyle changes that include dietary modification, physical activity, and weight loss remain the mainstay of treatment.
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Ahmed KT, Almashhrawi AA, Ibdah JA, Tahan V. Is the 25-year hepatitis C marathon coming to an end to declare victory? World J Hepatol 2017; 9:921-929. [PMID: 28824743 PMCID: PMC5545137 DOI: 10.4254/wjh.v9.i21.921] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/04/2017] [Accepted: 07/10/2017] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) which was originally recognized as posttransfusion non-A, non-B hepatitis has been a major global health problem affecting 3% of the world population. Interferon/peginterferon and ribavirin combination therapy was the backbone of chronic HCV therapy for two decades of the journey. However, the interferon based treatment success rate was around 50% with many side effects. Many chronic HCV patients with psychiatric diseases, or even cytopenias, were ineligible for HCV treatment. Now, we no longer need any injectable medicine. New direct-acting antiviral agents against HCV allowed the advance of interferon-free and ribavirin-free oral regimens with high rates of response and tolerability. The cost of the medications should not be a barrier to their access in certain parts of the world. While we are getting closer, we should still focus on preventing the spread of the disease, screening and delivering the cure globally to those in need. In the near future, development of an effective vaccine against HCV would make it possible to eradicate HCV infection worldwide completely.
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24
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Winn JN, Sathyamurthy A, Kneib JL, Ibdah JA, Tahan V. Synchronous Gastrointestinal Carcinoid Tumor and Colon Adenocarcinoma: Case Reports and Literature Review. Am J Case Rep 2017; 18:626-630. [PMID: 28584225 PMCID: PMC5467669 DOI: 10.12659/ajcr.903580] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Case series Patient: Male, 40; Male, 70 Final Diagnosis: Synchronous gastrointestinal carcinoid tumor and colon adenocarcinoma Symptoms: Weakness Medication: — Clinical Procedure: Colonoscopy Specialty: Gastroenterology and Hepatology
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Affiliation(s)
- Jessica N Winn
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Anjana Sathyamurthy
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Jessica L Kneib
- Department of Pathology, University of Missouri, Columbia, MO, USA
| | - Jamal A Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Veysel Tahan
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
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25
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Winn JN, Sathyamurthy A, Kneib JL, Ibdah JA, Tahan V. Rapamycin Treatment for Benign Multicystic Peritoneal Mesothelioma: A Rare Disease with a Difficult Management. Am J Case Rep 2017; 18:632-636. [PMID: 28579603 PMCID: PMC5467669 DOI: 10.12659/ajcr.903548] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/30/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND Benign multicystic peritoneal mesothelioma (BMPM) is a rare intra-abdominal tumor. Although considered by many to be benign, this tumor has a high local recurrence rate. Because of its rarity, preoperative diagnosis is difficult and its origin and pathogenesis are uncertain. There are no evidence-based treatment strategies for BMPM. It is agreed that the best treatment strategy for BMPM is the combination of surgical cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC). An increasing body of evidence supports a pivotal role of the cytoplasmic serine/threonine kinase mTOR in the development and progression of several neoplastic diseases and specific mTOR inhibitors, including rapamycin, have been suggested as potential therapeutic options for different cancers. CASE REPORT A 65-year-old male with end-stage renal disease on hemodialysis for seven years presented with BMPM. He underwent surgery to remove multiple peritoneal cysts, but four months later he experienced a recurrence of the disease. Immunohistochemistry of the cysts demonstrated a high level of phosphorylation of p70S6 kinase, a downstream mTOR target, and since a target therapy that blocks PI3K/Akt/mTOR pathway has been shown to have a scientific and logical rationale to treat this rare intra-abdominal neoplasia, we started the patient on low dose rapamycin therapy, an mTOR inhibitor. Long-term mTOR inhibition resulted in a complete and stable remission of BMPM. CONCLUSIONS The current case is the first report of BMPM successfully treated with rapamycin, which resulted in a long-lasting response to mTOR inhibition.
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Affiliation(s)
- Jessica N. Winn
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, U.S.A
| | - Anjana Sathyamurthy
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, U.S.A
| | - Jessica L. Kneib
- Department of Pathology, University of Missouri, Columbia, MO, U.S.A
| | - Jamal A. Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, U.S.A
| | - Veysel Tahan
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, U.S.A
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Heath RD, Brahmbhatt M, Tahan AC, Ibdah JA, Tahan V. Coffee: The magical bean for liver diseases. World J Hepatol 2017; 9:689-696. [PMID: 28596816 PMCID: PMC5440772 DOI: 10.4254/wjh.v9.i15.689] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/11/2017] [Accepted: 04/20/2017] [Indexed: 02/06/2023] Open
Abstract
Coffee has long been recognized as having hepatoprotective properties, however, the extent of any beneficial effect is still being elucidated. Coffee appears to reduce risk of hepatocellular carcinoma, reduce advancement of fibrotic disease in a variety of chronic liver diseases, and perhaps reduce ability of hepatitis C virus to replicate. This review aims to catalog the evidence for coffee as universally beneficial across a spectrum of chronic liver diseases, as well as spotlight opportunities for future investigation into coffee and liver disease.
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27
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Rahman R, Simoes EJ, Schmaltz C, Jackson CS, Ibdah JA. Trend analysis and survival of primary gallbladder cancer in the United States: a 1973-2009 population-based study. Cancer Med 2017; 6:874-880. [PMID: 28317286 PMCID: PMC5387125 DOI: 10.1002/cam4.1044] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 01/22/2017] [Accepted: 01/23/2017] [Indexed: 12/18/2022] Open
Abstract
Primary gallbladder cancer is an aggressive and uncommon cancer with poor outcomes. Our study examines epidemiology, trend, and survival of gallbladder cancer in the United States from 1973 to 2009. We utilized the Surveillance Epidemiology and End Results database (SEER). Frequency and rate analyses on demographics, stage, and survival were compared among non-Hispanic whites, Hispanics, African American, and Asian/Pacific Islanders. A total of 18,124 cases were reported in SEER from 1973 to 2009 comprising 1.4% of all reported gastrointestinal cancers. Gallbladder cancer was more common in females than males (71 vs. 29%, respectively). The age-adjusted incidence rate was 1.4 per 100,000, significantly higher in females than males (1.7 vs. 1.0). Trend analysis showed that the incidence rate has been decreasing over the last three decades for males. However, among females, the incidence rate had decreased from 1973 to mid-90s but has remained stable since then. Trend analysis for stage at diagnosis showed that the proportion of late-stage cases has been increasing significantly since 2001 after a decreasing pattern since 1973. Survival has improved considerably over time, and survival is better in females than males and in Asian/Pacific Islanders than other racial groups. The highest survival was in patients who received both surgery and radiation. Trend analysis revealed a recent increase of the incidence of late-stage gallbladder cancer. Highest survival was associated with receiving both surgery and radiation.
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Affiliation(s)
- Rubayat Rahman
- Division of Gastroenterology and HepatologyUniversity of Missouri School of MedicineOne Hospital Drive, CE 405ColumbiaMissouri65212
| | - Eduardo J. Simoes
- Department of Health Management and InformaticsUniversity of Missouri School of MedicineOne Hospital DriveCE707 CS&E BldgColumbiaMissouri65212
| | - Chester Schmaltz
- Missouri Cancer Registry and Research CenterUniversity of Missouri at Columbia401 Clark HallColumbiaMissouri65211
| | | | - Jamal A. Ibdah
- Division of Gastroenterology and HepatologyUniversity of Missouri School of MedicineOne Hospital Drive, CE 405ColumbiaMissouri65212
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Mir F, Kahveci AS, Ibdah JA, Tahan V. Sofosbuvir/velpatasvir regimen promises an effective pan-genotypic hepatitis C virus cure. Drug Des Devel Ther 2017; 11:497-502. [PMID: 28260862 PMCID: PMC5330188 DOI: 10.2147/dddt.s130945] [Citation(s) in RCA: 14] [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] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Hepatitis C virus (HCV) is a global pandemic, with nearly 200 million infected patients worldwide. HCV is the most common blood-borne infection in the US with numerous health implications including liver fibrosis, cirrhosis, and hepatocellular cancer. Traditional genotype-based HCV therapies with interferon resulted in moderate success in the sustained elimination of viral genome. Recent clinical trials of the once-daily combination tablet of sofosbuvir, a nonstructural (NS) 5B polymerase inhibitor, and velpatasvir, an NS5A inhibitor, demonstrate sustained virologic response rates of about 95%, regardless of prior treatment experience or presence of cirrhosis across all HCV genotypes. Patients reported improvements in general health, fatigue, and emotional and mental well-being after completing combination therapy. The combination treatment is effective, but does need to be administered with caution in patients receiving certain medications or with certain diseases. Herein, we review the safety and efficacy of sofosbuvir/velpatasvir combination regimen for all HCV genotypes.
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Affiliation(s)
- Fazia Mir
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Alp S Kahveci
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Jamal A Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Veysel Tahan
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
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29
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Rao SC, Ashraf I, Mir F, Samiullah S, Ibdah JA, Tahan V. Dual Infection with Hepatitis B and Epstein-Barr Virus Presenting with Severe Jaundice, Coagulopathy, and Hepatitis B Virus Chronicity Outcome. Am J Case Rep 2017; 18:170-172. [PMID: 28202897 PMCID: PMC5322865 DOI: 10.12659/ajcr.901688] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Patient: Female, 34 Final Diagnosis: HBV and EBV dual infection Symptoms: Jaundice • fatigue • anorexia • subjective weight loss Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology
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Affiliation(s)
- Sirish C Rao
- Department of Internal Medicine, University of Missouri Hospital , Columbia, MO, USA
| | - Imran Ashraf
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Fazia Mir
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Sami Samiullah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Jamal A Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Veysel Tahan
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
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30
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Khare T, Khare S, Ibdah JA. Proteomics approaches for early detection and targeted therapy of hepatocellular carcinoma. World J Gastrointest Oncol 2017; 9:1-3. [PMID: 28144394 PMCID: PMC5241522 DOI: 10.4251/wjgo.v9.i1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 09/25/2016] [Accepted: 11/22/2016] [Indexed: 02/05/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer related mortality worldwide. HCC incidences have increased worldwide though more prevalent in Asia and Africa. Hepatitis B virus and hepatitis C virus infections are mostly responsible of increased number of HCC cases. Biomarkers can help early detection and improve treatment regimen in patients as advanced stage is chemo-refractive with limited treatment options. Potential of proteomics in finding new biomarkers for early detection has been explored more recently. Future developments in this area rely on how efficiently we manage vast amount of data generated by these techniques and speed up the clinical trials to improve patient care.
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Abstract
Mammalian sirtuins are seven members belonging to the silent information regulator 2 family, a group of Class III histone/protein deacetylases. Sirtuins (SIRT 1-7) have different subcellular localization and function and they regulate cellular protein function through various posttranslational modifications. SIRT1 and 3, the most studied sirtuins, use the product of cellular metabolism nicotinamide adenine dinucleotide as a cofactor to post-translationally deacetylate cellular proteins and consequently link the metabolic status of the cell to protein function. Sirtuins have been shown to play a key role in the development and rescue of various metabolic diseases including non-alcoholic fatty liver disease (NAFLD). NAFLD is currently the most chronic liver disease due mainly to high-calorie consumption and lower physical activity. No pharmacological approach is available to treat NAFLD, the current recommended treatment are lifestyle modification such as weight loss through calorie restriction and exercise. Recent studies have shown downregulation of sirtuins in human as well as animal models of NAFLD indicating an important role of sirtuins in the dynamic pathophysiology of NAFLD. In this review, we highlight the recent knowledge on sirtuins, their role in NAFLD and their unique potential role as novel therapeutic target for NAFLD treatment.
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Heath RD, Mir F, Ibdah JA, Tahan V. Microbiome alterations observed in liver diseases present opportunities for potential fecal transplantation. Turk J Gastroenterol 2016; 27:495-498. [PMID: 27852539 DOI: 10.5152/tjg.2016.160011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Many disease processes lead to chronic liver disease, however, progress has been made regarding common findings amongst these disease processes that may suggest a path forward for treatment. In particular, common alterations in the intestinal microflora of patients with different etiologies of liver disease may provide a clue as to the pathogenesis of these disorders as well a potential therapy. Data is still scant at this point, however, what is available suggests a promising opportunity for future studies to expand upon what has been demonstrated.
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Affiliation(s)
- Ryan D Heath
- Division of Gastroenterology and Hepatology, University of Missouri-Columbia 1 Hospital Drive, Columbia, MO, USA.
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33
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Morris EM, Meers GME, Koch LG, Britton SL, Fletcher JA, Fu X, Shankar K, Burgess SC, Ibdah JA, Rector RS, Thyfault JP. Aerobic capacity and hepatic mitochondrial lipid oxidation alters susceptibility for chronic high-fat diet-induced hepatic steatosis. Am J Physiol Endocrinol Metab 2016; 311:E749-E760. [PMID: 27600823 PMCID: PMC5241560 DOI: 10.1152/ajpendo.00178.2016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 08/30/2016] [Indexed: 12/24/2022]
Abstract
Rats selectively bred for high capacity running (HCR) or low capacity running (LCR) display divergence for intrinsic aerobic capacity and hepatic mitochondrial oxidative capacity, both factors associated with susceptibility for nonalcoholic fatty liver disease. Here, we tested if HCR and LCR rats display differences in susceptibility for hepatic steatosis after 16 wk of high-fat diets (HFD) with either 45% or 60% of kcals from fat. HCR rats were protected against HFD-induced hepatic steatosis, whereas only the 60% HFD induced steatosis in LCR rats, as marked by a doubling of liver triglycerides. Hepatic complete fatty acid oxidation (FAO) and mitochondrial respiratory capacity were all lower in LCR compared with HCR rats. LCR rats also displayed lower hepatic complete and incomplete FAO in the presence of etomoxir, suggesting a reduced role for noncarnitine palmitoyltransferase-1-mediated lipid catabolism in LCR versus HCR rats. Hepatic complete FAO and mitochondrial respiration were largely unaffected by either chronic HFD; however, 60% HFD feeding markedly reduced 2-pyruvate oxidation, a marker of tricarboxylic acid (TCA) cycle flux, and mitochondrial complete FAO only in LCR rats. LCR rats displayed lower levels of hepatic long-chain acylcarnitines than HCR rats but maintained similar levels of hepatic acetyl-carnitine levels, further supporting lower rates of β-oxidation, and TCA cycle flux in LCR than HCR rats. Finally, only LCR rats displayed early reductions in TCA cycle genes after the acute initiation of a HFD. In conclusion, intrinsically high aerobic capacity confers protection against HFD-induced hepatic steatosis through elevated hepatic mitochondrial oxidative capacity.
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Affiliation(s)
- E Matthew Morris
- Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Grace M E Meers
- Medicine and Division of Gastroenterology and Hepatology, University of Missouri, Columbia, Missouri
| | - Lauren G Koch
- Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | | | - Justin A Fletcher
- Pharmacology and Advanced Imaging Research, University of Texas Southwestern, Dallas, Texas
| | - Xiaorong Fu
- Pharmacology and Advanced Imaging Research, University of Texas Southwestern, Dallas, Texas
| | - Kartik Shankar
- Arkansas Children's Nutrition Center and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Shawn C Burgess
- Pharmacology and Advanced Imaging Research, University of Texas Southwestern, Dallas, Texas
| | - Jamal A Ibdah
- Medicine and Division of Gastroenterology and Hepatology, University of Missouri, Columbia, Missouri
| | - R Scott Rector
- Medicine and Division of Gastroenterology and Hepatology, University of Missouri, Columbia, Missouri; Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Research Service, Harry S. Truman Memorial Veterans Affairs Hospital, Columbia, Missouri
| | - John P Thyfault
- Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; Research Service, Kansas City Veterans Affairs Medical Center, Kansas City, Missourit; and
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Sathyamurthy A, Winn JN, Ibdah JA, Tahan V. Culprit for recurrent acute gastrointestinal massive bleeding: “Small bowel Dieulafoy’s lesions” - a case report and literature review. World J Gastrointest Pathophysiol 2016; 7:296-299. [PMID: 27574568 PMCID: PMC4981770 DOI: 10.4291/wjgp.v7.i3.296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/02/2016] [Accepted: 07/18/2016] [Indexed: 02/07/2023] Open
Abstract
A Dieulafoy's lesion is a dilated, aberrant, submucosal vessel that erodes the overlying epithelium without evidence of a primary ulcer or erosion. It can be located anywhere in the gastrointestinal tract. We describe a case of massive gastrointestinal bleeding from Dieulafoy’s lesions in the duodenum. Etiology and precipitating events of a Dieulafoy’s lesion are not well known. Bleeding can range from being self-limited to massive life- threatening. Endoscopic hemostasis can be achieved with a combination of therapeutic modalities. The endoscopic management includes sclerosant injection, heater probe, laser therapy, electrocautery, cyanoacrylate glue, banding, and clipping. Endoscopic tattooing can be helpful to locate the lesion for further endoscopic re-treatment or intraoperative wedge resection. Therapeutic options for re-bleeding lesions comprise of repeated endoscopic hemostasis, angiographic embolization or surgical wedge resection of the lesions. We present a 63-year-old Caucasian male with active bleeding from the two small bowel Dieulafoy’s lesions, which was successfully controlled with epinephrine injection and clip applications.
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Linden MA, Sheldon RD, Meers GM, Ortinau LC, Morris EM, Booth FW, Kanaley JA, Vieira-Potter VJ, Sowers JR, Ibdah JA, Thyfault JP, Laughlin MH, Rector RS. Aerobic exercise training in the treatment of non-alcoholic fatty liver disease related fibrosis. J Physiol 2016; 594:5271-84. [PMID: 27104887 DOI: 10.1113/jp272235] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/13/2016] [Indexed: 12/23/2022] Open
Abstract
KEY POINTS Physiologically relevant rodent models of non-alcoholic steatohepatitis (NASH) that resemble the human condition are limited. Exercise training and energy restriction are first-line recommendations for the treatment of NASH. Hyperphagic Otsuka Long-Evans Tokushima fatty rats fed a western diet high in fat, sucrose and cholesterol for 24 weeks developed a severe NASH with fibrosis phenotype. Moderate intensity exercise training and modest energy restriction provided some improvement in the histological features of NASH that coincided with alterations in markers of hepatic stellate cell activation and extracellular matrix remodelling. The present study highlights the importance of lifestyle modification, including exercise training and energy restriction, in the regulation of advanced liver disease. ABSTRACT The incidence of non-alcoholic steatohepatitis (NASH) is rising but the efficacy of lifestyle modifications to improve NASH-related outcomes remain unclear. We hypothesized that a western diet (WD) would induce NASH in the Otsuka Long-Evans Tokushima Fatty (OLETF) rat and that lifestyle modification would improve this condition. Eight-week-old Long-Evans Tokushima Otsuka (L) and OLETF (O) rats consumed a control diet (10% kcal fat, 3.5% sucrose) or a WD (45% kcal fat, 17% sucrose, 1% cholesterol) for 24 weeks. At 20 weeks of age, additional WD-fed OLETFs were randomized to sedentary (O-SED), food restriction (O-FR; ∼25% kcal reduction vs. O-SED) or exercise training (O-EX; treadmill running 20 m min(-1) with a 15% incline, 60 min day(-1) , 5 days week(-1) ) conditions for 12 weeks. WD induced a NASH phenotype in OLETFs characterized by hepatic fibrosis (collagen 1α1 mRNA and hydroxyproline content), as well as elevated inflammation and non-alcoholic fatty liver disease activity scores, and hepatic stellate cell activation (α-smooth muscle actin) compared to Long-Evans Tokushima Otsuka rats. FR and EX modestly improved NASH-related fibrosis markers (FR: hydroxyproline content, P < 0.01; EX: collagen 1α1 mRNA, P < 0.05; both: fibrosis score, P < 0.01) and inflammation (both: inflammation score; FR: interleukin-1β and tumor necrosis factor α) vs. O-SED. FR reduced hepatic stellate cell activation markers (transforming growth factor-β protein and α-smooth muscle actin mRNA), whereas EX increased the hepatic stellate cell senescence marker CCN1 (P < 0.01 vs. O-SED). Additionally, both FR and EX normalized extracellular matrix remodelling markers to levels similar to L-WD (P > 0.05). Although neither EX nor FR led to complete resolution of the WD-induced NASH phenotype, both independently benefitted liver fibrosis via altered hepatic stellate cell activation and extracellular matrix remodelling.
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Affiliation(s)
- Melissa A Linden
- Research Service, Harry S Truman Memorial VA Hospital.,Department of Nutrition and Exercise Physiology
| | - Ryan D Sheldon
- Research Service, Harry S Truman Memorial VA Hospital.,Department of Nutrition and Exercise Physiology
| | - Grace M Meers
- Research Service, Harry S Truman Memorial VA Hospital.,Department of Medicine-Division of Gastroenterology and Hepatology
| | | | - E Matthew Morris
- Department of Molecular and Integrative Physiology, University of Kansas Medical Centre, Kansas City, KS, USA
| | - Frank W Booth
- Department of Biomedical Sciences.,Department of Medical Pharmacology and Physiology.,Dalton Cardiovascular Research Centre
| | | | | | - James R Sowers
- Research Service, Harry S Truman Memorial VA Hospital.,Medicine-Division of Endocrinology, University of Missouri, Columbia, MO, USA
| | - Jamal A Ibdah
- Research Service, Harry S Truman Memorial VA Hospital.,Department of Medicine-Division of Gastroenterology and Hepatology.,Department of Medical Pharmacology and Physiology
| | - John P Thyfault
- Department of Molecular and Integrative Physiology, University of Kansas Medical Centre, Kansas City, KS, USA.,Kansas City VA Medical Centre, Kansas City, MO, USA
| | | | - R Scott Rector
- Research Service, Harry S Truman Memorial VA Hospital. .,Department of Medicine-Division of Gastroenterology and Hepatology. .,Department of Nutrition and Exercise Physiology.
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Linden MA, Sheldon RD, Meers GM, Ortinau LC, Morris EM, Vieira-Potter VJ, Kanaley JA, Booth FW, Sowers JR, Ibdah JA, Thyfault JP, Laughlin MH, Scott Rector R. Exercise Training As A Mitigator Of Liver Fibrosis In Western Diet Fed OLETF Rats. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000486456.42848.e4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Winn NC, Liu Y, Scott Rector R, Ibdah JA, Parks EJ, Kanaley JA. Moderate and High Intensity Exercise Training Matched for Energy Expenditure Reduces Intrahepatic Lipid in Obese Individuals with Hepatic Steatosis. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487724.47389.d5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Hepatocellular carcinoma (HCC) is a highly heterogenous disease and intratumor heterogeneity is a well-known fact within each individual tumor, and may involve morphological, immunohistochemical, and molecular heterogeneities. Understanding of intratumor heterogeneity of HCC should provide critical knowledge about prognosis of the disease and response to therapy. In a recent article by Friemel and colleagues, the investigators utilized a comprehensive approach in linking immunohistochemical markers and molecular changes to morphological intratumor heterogeneity in HCC. The study found that intratumor heterogeneity was detectable in 87% of HCC cases. Combined heterogeneities with respect to morphologic, immunohistochemical, and mutational status of the two most important driver mutations CTNNB1 and TP53 were seen in 22% of HCC cases. The study demonstrates the challenges facing therapeutic strategies targeting single molecules and may explain the limited success so far in developing molecular targeted therapy for HCC.
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Affiliation(s)
- Ghassan M Hammoud
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, University of Missouri, One Hospital Drive, Columbia, MO 65212, USA
| | - Jamal A Ibdah
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, University of Missouri, One Hospital Drive, Columbia, MO 65212, USA
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Tahan V, Almashhrawi A, Kahveci AM, Mutrux R, Ibdah JA. Extension for Community Health Outcomes-hepatitis C: Small steps carve big footprints in the allocation of scarce resources for hepatitis C virus treatment to remote developing areas. World J Hepatol 2016; 8:509-512. [PMID: 27099651 PMCID: PMC4832092 DOI: 10.4254/wjh.v8.i11.509] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/06/2016] [Accepted: 03/25/2016] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) infection is still a major health problem throughout the world. HCV patients living in rural areas are less fortunate than their counterparts residing in populous urbanized regions. The lack of medical resources and properly trained medical personnel in rural regions make it especially burdensome for HCV patients seeking treatment. Dr. Sanjeev Arora at the University of New Mexico Health Sciences Center took initiative to resolve the issue at hand by developing a model named Project Extension for Community Health Outcomes (ECHO). ECHO connects primary care providers (PCPs), usually family medicine physicians, in local communities with specialists. ECHO providers test the efficacy of treatment given using the ECHO model vs that at academic medical centers. The ECHO model has produced promising results such that the sustained virologic response rates for both types of sites were near-equivalent. Show Me ECHO was adapted from Project ECHO to train PCPs in Missouri and equip them with the tools and skills to properly treat and diagnose HCV in a timely manner. This healthcare model can be implemented for treating other common infections and chronic diseases. Telemedicine is the direction healthcare is headed for the next several decades. It has potential to be applied in developing countries to alleviate agony and despair resulting from limited resources and lack of access to expert medical care.
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Tahan V, Almashhrawi A, Mutrux R, A. Ibdah J. Show Me Echo – Hepatitis C: A telemedicine mentoring program for patients with hepatitis C in underserved and rural areas in Missouri as a model in developing countries. Turk J Gastroenterol 2015; 26:447-449. [PMID: 26510085 DOI: 10.5152/tjg.2015.159000] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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Rahman R, Schmaltz C, Jackson CS, Simoes EJ, Jackson-Thompson J, Ibdah JA. Increased risk for colorectal cancer under age 50 in racial and ethnic minorities living in the United States. Cancer Med 2015; 4:1863-70. [PMID: 26471963 PMCID: PMC5123715 DOI: 10.1002/cam4.560] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 01/09/2023] Open
Abstract
Colorectal cancer (CRC) is the second most common cause of cancer death in USA. We analyzed CRC disparities in African Americans, Hispanics, Asians/Pacific Islanders, and American Indians/Alaska Natives compared to non‐Hispanic Whites. Current guidelines recommend screening for CRC beginning at age 50. Using SEER (Surveillance, Epidemiology, and End Results) database 1973–2009 and North American Association of Central Cancer Registries (NAACCR) 1995–2009 dataset, we performed frequency and rate analysis on colorectal cancer demographics and incidence based on race/ethnicity. We also used the SEER database to analyze stage, grade, and survival based on race/ethnicity. Utilizing SEER database, the median age of CRC diagnosis is significantly less in Hispanics (66 years), Asians/Pacific Islanders (68 years), American Indians/Alaska Natives (64 years), and African Americans (64 years) compared to non‐Hispanic whites (72 years). Twelve percent of Asians/Pacific Islanders, 15.4% Hispanics, 16.5% American Indians/Alaska Natives, and 11.9% African Americans with CRC are diagnosed at age <50 years compared to only 6.7% in non‐Hispanic Whites (P < 0.0001). Minority groups have more advanced stages at diagnosis compared to non‐Hispanic Whites. Trend analysis showed age‐adjusted incidence rates of CRC diagnosed under the age of 50 years have significantly increased in all racial and ethnic groups but are stable in African Americans. These results were confirmed through analysis of NAACCR 1995–2009 dataset covering nearly the entire USA. A significantly higher proportion of minority groups in USA with CRC are diagnosed before age 50 compared to non‐Hispanic Whites, documenting that these minority groups are at higher risk for early CRC. Further studies are needed to identify the causes and risk factors responsible for young onset CRC among minority groups and to develop intervention strategies including earlier CRC screening, among others.
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Affiliation(s)
- Rubayat Rahman
- Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, One Hospital Drive, CE 405, Columbia, Missouri, 65212
| | - Chester Schmaltz
- Missouri Cancer Registry and Research Center, University of Missouri at Columbia, 401 Clark Hall, Columbia, Missouri, 65211
| | - Christian S Jackson
- Section of Gastroenterology, Loma Linda VA Medical Center, Loma Linda University Medical Center, Loma Linda, California
| | - Eduardo J Simoes
- Department of Health Management and Informatics, University of Missouri School of Medicine, One Hospital Drive, CE707 CS&E Bldg, Columbia, Missouri, 65212
| | - Jeannette Jackson-Thompson
- Missouri Cancer Registry and Research Center, University of Missouri at Columbia, 401 Clark Hall, Columbia, Missouri, 65211
| | - Jamal A Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, One Hospital Drive, CE 405, Columbia, Missouri, 65212
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Linden MA, Fletcher JA, Morris EM, Meers GM, Laughlin MH, Booth FW, Sowers JR, Ibdah JA, Thyfault JP, Rector RS. Treating NAFLD in OLETF rats with vigorous-intensity interval exercise training. Med Sci Sports Exerc 2015; 47:556-67. [PMID: 24983336 DOI: 10.1249/mss.0000000000000430] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND There is increasing use of high-intensity interval-type exercise training in the management of many lifestyle-related diseases. PURPOSE This study aimed to test the hypothesis that vigorous-intensity interval exercise is as effective as traditional moderate-intensity aerobic exercise training for nonalcoholic fatty liver disease (NAFLD) outcomes in obese, Otsuka Long-Evans Tokushima Fatty (OLETF) rats. METHODS OLETF rats (age, 20 wk; n = 8-10 per group) were assigned to sedentary (O-SED), moderate-intensity exercise training (O-MOD EX; 20 m·min(-1), 15% incline, 60 min·d(-1), 5 d·wk(-1) of treadmill running), or vigorous-intensity interval exercise training (O-VIG EX; 40 m·min(-1), 15% incline, 6 × 2.5 min bouts per day, 5 d·wk(-1) of treadmill running) groups for 12 wk. RESULTS Both MOD EX and VIG EX effectively lowered hepatic triglycerides, serum alanine aminotransferase (ALT), perivenular fibrosis, and hepatic collagen 1α1 messenger RNA (mRNA) expression (vs O-SED, P < 0.05). In addition, both interventions increased hepatic mitochondrial markers (citrate synthase activity and fatty acid oxidation) and suppressed markers of de novo lipogenesis (fatty acid synthase, acetyl coenzyme A carboxylase, Elovl fatty acid elongase 6, and steroyl CoA desaturase-1), whereas only MOD EX increased hepatic mitochondrial Beta-hydroxyacyl-CoA dehydrogenase (β-HAD) activity and hepatic triglyceride export marker apoB100 and lowered fatty acid transporter CD36 compared with O-SED. Moreover, whereas total hepatic macrophage population markers (CD68 and F4/80 mRNA) did not differ among groups, MOD EX and VIG EX lowered M1 macrophage polarization markers (CD11c, interleukin-1β, and tumor necrosis factor α mRNA) and MOD EX increased M2 macrophage marker, CD206 mRNA, compared with O-SED. CONCLUSIONS The accumulation of 15 min·d(-1) of VIG EX for 12 wk had similar effectiveness as 60 min·d(-1) of MOD EX in the management of NAFLD in OLETF rats. These findings may have important health outcome implications as we work to design better exercise training programs for patients with NAFLD.
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Affiliation(s)
- Melissa A Linden
- 1Research Service-Harry S. Truman Memorial Veterans Medical Center, Columbia, MO; 2Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO; 3Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO; 4Department of Biomedical Sciences, University of Missouri, Columbia, MO; 5Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO; 6Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO; and 7Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, MO
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Shukla SD, Restrepo R, Fish P, Lim RW, Ibdah JA. Different Mechanisms for Histone Acetylation by Ethanol and Its Metabolite Acetate in Rat Primary Hepatocytes. J Pharmacol Exp Ther 2015; 354:18-23. [DOI: 10.1124/jpet.115.223867] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Linden MA, Lopez KT, Fletcher JA, Morris EM, Meers GM, Siddique S, Laughlin MH, Sowers JR, Thyfault JP, Ibdah JA, Rector RS. Combining metformin therapy with caloric restriction for the management of type 2 diabetes and nonalcoholic fatty liver disease in obese rats. Appl Physiol Nutr Metab 2015; 40:1038-47. [PMID: 26394261 DOI: 10.1139/apnm-2015-0236] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [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: 12/15/2022]
Abstract
Weight loss is recommended for patients with nonalcoholic fatty liver disease (NAFLD), while metformin may lower liver enzymes in type 2 diabetics. Yet, the efficacy of the combination of weight loss and metformin in the treatment of NAFLD is unclear. We assessed the effects of metformin, caloric restriction, and their combination on NAFLD in diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats. Male OLETF rats (age 20 weeks; n = 6-8 per group) were fed ad libitum (AL), given metformin (300 mg·kg(-1)·day(-1); Met), calorically restricted (70% of AL; CR), or calorically restricted and given metformin (CR+Met) for 12 weeks. Met lowered adiposity compared with AL but not to the same magnitude as CR or CR+Met (p < 0.05). Although only CR improved fasting insulin and glucose, the combination of CR+Met was needed to improve post-challenge glucose tolerance. All treatments lowered hepatic triglycerides, but further improvements were observed in the CR groups (p < 0.05, Met vs. CR or CR+Met) and a further reduction in serum alanine aminotransferases was observed in CR+Met rats. CR lowered markers of hepatic de novo lipogenesis (fatty acid synthase, acetyl-CoA carboxylase (ACC), and stearoyl-CoA desaturase-1 (SCD-1)) and increased hepatic mitochondrial activity (palmitate oxidation and β-hydroxyacyl CoA dehydrogenase (β-HAD) activity). Changes were enhanced in the CR+Met group for ACC, SCD-1, β-HAD, and the mitophagy marker BNIP3. Met decreased total hepatic mTOR content and inhibited mTOR complex 1, which may have contributed to Met-induced reductions in de novo lipogenesis. These findings in the OLETF rat suggest that the combination of caloric restriction and metformin may provide a more optimal approach than either treatment alone in the management of type 2 diabetes and NAFLD.
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Affiliation(s)
- Melissa A Linden
- a Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201, USA.,b Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Kristi T Lopez
- a Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201, USA.,c Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA
| | - Justin A Fletcher
- a Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201, USA.,b Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - E Matthew Morris
- a Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201, USA.,c Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA
| | - Grace M Meers
- a Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201, USA.,c Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA
| | - Sameer Siddique
- a Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201, USA.,c Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA
| | - M Harold Laughlin
- e Department of Biomedical Sciences, University of Missouri, Columbia, MO 65211, USA
| | - James R Sowers
- a Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201, USA.,d Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, MO 65212, USA
| | - John P Thyfault
- a Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201, USA.,b Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA.,c Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA
| | - Jamal A Ibdah
- a Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201, USA.,b Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA.,c Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA
| | - R Scott Rector
- a Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201, USA.,b Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA.,c Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA
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Abstract
Gastric cancer (GC) is the fourth most common cancer in the world with more than 70% of cases occur in the developing world. More than 50% of cases occur in Eastern Asia. GC is the second leading cause of cancer death in both sexes worldwide. In Asia, GC is the third most common cancer after breast and lung and is the second most common cause of cancer death after lung cancer. Although the incidence and mortality rates are slowly declining in many countries of Asia, GC still remains a significant public health problem. The incidence and mortality varies according to the geographic area in Asia. These variations are closely related to the prevalence of GC risk factors; especially Helicobacter pylori (H. pylori) and its molecular virulent characteristics. The gradual and consistent improvements in socioeconomic conditions in Asia have lowered the H. pylori seroprevalence rates leading to a reduction in the GC incidence. However, GC remains a significant public health and an economic burden in Asia. There has been no recent systemic review of GC incidence, mortality, and H. pylori molecular epidemiology in Asia. The aim of this report is to review the GC incidence, mortality, and linkage to H. pylori in Asia.
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Affiliation(s)
- Rubayat Rahman
- Rubayat Rahman, Akwi W Asombang, Jamal A Ibdah, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65212, United States
| | - Akwi W Asombang
- Rubayat Rahman, Akwi W Asombang, Jamal A Ibdah, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65212, United States
| | - Jamal A Ibdah
- Rubayat Rahman, Akwi W Asombang, Jamal A Ibdah, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65212, United States
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Nassir F, Rector RS, Hammoud GM, Ibdah JA. Pathogenesis and Prevention of Hepatic Steatosis. Gastroenterol Hepatol (N Y) 2015; 11:167-175. [PMID: 27099587 PMCID: PMC4836586] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Hepatic steatosis is defined as intrahepatic fat of at least 5% of liver weight. Simple accumulation of triacylglycerols in the liver could be hepatoprotective; however, prolonged hepatic lipid storage may lead to liver metabolic dysfunction, inflammation, and advanced forms of nonalcoholic fatty liver disease. Nonalcoholic hepatic steatosis is associated with obesity, type 2 diabetes, and dyslipidemia. Several mechanisms are involved in the accumulation of intrahepatic fat, including increased flux of fatty acids to the liver, increased de novo lipogenesis, and/or reduced clearance through β-oxidation or very-low-density lipoprotein secretion. This article summarizes the mechanisms involved in the accumulation of triacylglycerols in the liver, the clinical implications, and the prevention of hepatic steatosis, with a focus on the role of mitochondrial function and lifestyle modifications.
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Affiliation(s)
- Fatiha Nassir
- Dr Nassir is an assistant research professor of medicine in the Division of Gastroenterology and Hepatology at the University of Missouri School of Medicine in Columbia, Missouri. Dr Rector is an assistant professor of medicine in the Division of Gastroenterology and Hepatology and the Department of Nutrition and Exercise Physiology at the University of Missouri School of Medicine; he is also a research health scientist in the Research Service at the Harry S. Truman Memorial Veterans' Hospital in Columbia, Missouri. Dr Hammoud is an associate professor of clinical medicine in the Division of Gastroenterology and Hepatol ogy at the University of Missouri School of Medicine. Dr Ibdah is a professor of medicine in the Division of Gastroenterology and Hepatology and the Department of Nutrition and Exercise Physiology at the University of Missouri School of Medicine, where he is also the director of the Division of Gastroenterology and Hepatology; in addition, he is a research health scientist in the Research Service at the Harry S. Truman Memorial Veterans' Hospital
| | - R Scott Rector
- Dr Nassir is an assistant research professor of medicine in the Division of Gastroenterology and Hepatology at the University of Missouri School of Medicine in Columbia, Missouri. Dr Rector is an assistant professor of medicine in the Division of Gastroenterology and Hepatology and the Department of Nutrition and Exercise Physiology at the University of Missouri School of Medicine; he is also a research health scientist in the Research Service at the Harry S. Truman Memorial Veterans' Hospital in Columbia, Missouri. Dr Hammoud is an associate professor of clinical medicine in the Division of Gastroenterology and Hepatol ogy at the University of Missouri School of Medicine. Dr Ibdah is a professor of medicine in the Division of Gastroenterology and Hepatology and the Department of Nutrition and Exercise Physiology at the University of Missouri School of Medicine, where he is also the director of the Division of Gastroenterology and Hepatology; in addition, he is a research health scientist in the Research Service at the Harry S. Truman Memorial Veterans' Hospital
| | - Ghassan M Hammoud
- Dr Nassir is an assistant research professor of medicine in the Division of Gastroenterology and Hepatology at the University of Missouri School of Medicine in Columbia, Missouri. Dr Rector is an assistant professor of medicine in the Division of Gastroenterology and Hepatology and the Department of Nutrition and Exercise Physiology at the University of Missouri School of Medicine; he is also a research health scientist in the Research Service at the Harry S. Truman Memorial Veterans' Hospital in Columbia, Missouri. Dr Hammoud is an associate professor of clinical medicine in the Division of Gastroenterology and Hepatol ogy at the University of Missouri School of Medicine. Dr Ibdah is a professor of medicine in the Division of Gastroenterology and Hepatology and the Department of Nutrition and Exercise Physiology at the University of Missouri School of Medicine, where he is also the director of the Division of Gastroenterology and Hepatology; in addition, he is a research health scientist in the Research Service at the Harry S. Truman Memorial Veterans' Hospital
| | - Jamal A Ibdah
- Dr Nassir is an assistant research professor of medicine in the Division of Gastroenterology and Hepatology at the University of Missouri School of Medicine in Columbia, Missouri. Dr Rector is an assistant professor of medicine in the Division of Gastroenterology and Hepatology and the Department of Nutrition and Exercise Physiology at the University of Missouri School of Medicine; he is also a research health scientist in the Research Service at the Harry S. Truman Memorial Veterans' Hospital in Columbia, Missouri. Dr Hammoud is an associate professor of clinical medicine in the Division of Gastroenterology and Hepatol ogy at the University of Missouri School of Medicine. Dr Ibdah is a professor of medicine in the Division of Gastroenterology and Hepatology and the Department of Nutrition and Exercise Physiology at the University of Missouri School of Medicine, where he is also the director of the Division of Gastroenterology and Hepatology; in addition, he is a research health scientist in the Research Service at the Harry S. Truman Memorial Veterans' Hospital
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Hammoud GM, Almashhrawi A, Ibdah JA. Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions. World J Gastrointest Oncol 2014; 6:420-429. [PMID: 25400873 PMCID: PMC4229785 DOI: 10.4251/wjgo.v6.i11.420] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/17/2014] [Accepted: 10/27/2014] [Indexed: 02/05/2023] Open
Abstract
Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of the liver is a safe procedure in the diagnosis and staging of hepatobiliary malignancies with a minimal major complication rate. EUS-FNA is useful for liver lesions poorly accessible to other imaging modalities of the liver. EUS-guided FNA of biliary neoplasia and malignant biliary stricture is superior to the conventional endoscopic brushing and biopsy.
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Hammoud GM, Ibdah JA. Utility of endoscopic ultrasound in patients with portal hypertension. World J Gastroenterol 2014; 20:14230-14236. [PMID: 25339809 PMCID: PMC4202351 DOI: 10.3748/wjg.v20.i39.14230] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 03/22/2014] [Accepted: 06/17/2014] [Indexed: 02/06/2023] Open
Abstract
Endoscopic ultrasound (EUS) has revolutionized the diagnostic and therapeutic approach to patients with gastrointestinal disorders. Its application in patients with liver disease and portal hypertension is increasing. Patients with chronic liver disease are at risk for development of portal hypertension sequale such as ascites, spontaneous bacterial peritonitis and gastroesophageal varices. Bleeding esophageal and gastric varices are among the most common causes of mortality in patients with cirrhosis. Thus, early detection and treatment improve the outcome in this population. EUS can improve the detection and diagnosis of gastroesophageal varices and collateral veins and can provide endoscopic therapy of gastroesophageal varices such as EUS-guided sclerotherapy of esophageal collateral vessels and EUS-guided cynoacrylate (Glue) injection of gastric varices. EUS can also provide knowledge on the efficacy of pharmacotherapy of portal hypertension. Furthermore, EUS can provide assessment and prediction of variceal recurrence after endoscopic therapy and assessment of portal hemodynamics such as E-Flow and Doppler study of the azygous and portal veins. Moreover, EUS-guided fine needle aspiration may provide cytologic diagnosis of focal hepatic tumors and analysis of free abdominal fluid. Using specialized EUS-guided needle biopsy, a sample of liver tissue can be obtained to diagnose and evaluate for chronic liver disease. EUS-guided fine needle injection can be used to study portal vein pressure and hemodynamics, and potentially could be used to assist in exact measurement of portal vein pressure and placement of intrahepatic portosystemic shunt.
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Hammoud GM, Ibdah JA. Preeclampsia-induced Liver Dysfunction, HELLP syndrome, and acute fatty liver of pregnancy. Clin Liver Dis (Hoboken) 2014; 4:69-73. [PMID: 30992924 PMCID: PMC6448736 DOI: 10.1002/cld.409] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 06/24/2014] [Accepted: 07/05/2014] [Indexed: 02/04/2023] Open
Affiliation(s)
- Ghassan M. Hammoud
- Division of Gastroenterology and HepatologyUniversity of MissouriColumbiaMO
| | - Jamal A. Ibdah
- Division of Gastroenterology and HepatologyUniversity of MissouriColumbiaMO
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Hammoud GM, Hammad H, Ibdah JA. Endoscopic assessment and management of early esophageal adenocarcinoma. World J Gastrointest Oncol 2014; 6:275-288. [PMID: 25132925 PMCID: PMC4133795 DOI: 10.4251/wjgo.v6.i8.275] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 04/08/2014] [Accepted: 07/17/2014] [Indexed: 02/05/2023] Open
Abstract
Esophageal carcinoma affects more than 450000 people worldwide and the incidence is rapidly increasing. In the United States and Europe, esophageal adenocarcinoma has superseded esophageal squamous cell carcinoma in its incidence. Esophageal cancer has a high mortality rates secondary to the late presentation of most patients at advanced stages. Endoscopic screening is recommended for patients with multiple risk factors for cancer in Barrett’s esophagus. These risk factors include chronic gastroesophageal reflux disease, hiatal hernia, advanced age, male sex, white race, cigarette smoking, and obesity. The annual risk of esophageal cancer is approximately 0.25% for patients without dysplasia and 6% for patients with high-grade dysplasia. Twenty percent of all esophageal adenocarcinoma in the United States is early stage with disease confined to the mucosa or submucosa. The significant morbidity and mortality of esophagectomy make endoscopic treatment an attractive option. The American Gastroenterological Association recommends endoscopic eradication therapy for patients with high-grade dysplasia. Endoscopic modalities for treatment of early esophageal adenocarcinoma include endoscopic resection techniques and endoscopic ablative techniques such as radiofrequency ablation, photodynamic therapy and cryoablation. Endoscopic therapy should be precluded to patients with no evidence of lymphovascular invasion. Local tumor recurrence is low after endoscopic therapy and is predicted by poor differentiation of tumor, positive lymph node and submucosal invasion. Surgical resection should be offered to patients with deep submucosal invasion.
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