Liver Disease

2019 ◽  
pp. 485-508
Author(s):  
Catiele Antunes ◽  
Alia S. Dadabhai
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Liver Failure ◽  
Liver Diseases ◽  
The Internet ◽  
Milk Thistle ◽  
Mechanism Of Injury ◽  
Wide Range ◽  
Natural Remedies ◽  
Standard Medical Treatment

Herbal and dietary supplements (HDS) have been increasingly popularized by the internet to augment or serve as alternatives to standard medical treatment in a variety of diseases. With respect to the liver, milk thistle is among the most popular, but a wide range of other therapies are also being used to treat liver diseases, from fatty liver to viral hepatitis. In this chapter, the effects of natural remedies on the liver are outlined as solo or complementary therapies. Hepatotoxicity and acute liver failure from unregulated use of these HDS are also discussed. Natural alternatives used to treat other medical conditions that can adversely affect the liver (via metabolic breakdown or direct hepatic injury) are summarized, along with the proposed mechanism of injury. Increased awareness on the part of the hepatologist or PCP to include an HDS evaluation can be a valuable tool to treat and diagnose liver injury.

A polysaccharide of PFP-1 from Pleurotus geesteranus attenuates alcoholic liver diseases via Nrf2 and NF-κB signaling pathways

2021 ◽  
Author(s):  
Xinling Song ◽  
Wenxue Sun ◽  
Wenxin Cai ◽  
Le Jia ◽  
Jianjun Zhang
Keyword(s):  
Oxidative Stress ◽  
Liver Disease ◽  
Liver Injury ◽  
Signaling Pathways ◽  
Alcoholic Liver Disease ◽  
Fruiting Body ◽  
Liver Diseases ◽  
Alcoholic Liver Diseases

A polysaccharide named as PFP-1 was isolated from Pleurotus geesteranus fruiting body, and the potential investigations on ameliorating oxidative stress and liver injury against alcoholic liver disease (ALD) were processed...

scholarly journals Metabolic Spectrum of Liver Failure in Type 2 Diabetes and Obesity: From NAFLD to NASH to HCC

2021 ◽  
Vol 22 (9) ◽  
pp. 4495
Author(s):  
Hyunmi Kim ◽  
Da Som Lee ◽  
Tae Hyeon An ◽  
Hyun-Ju Park ◽  
Won Kon Kim ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Liver Failure ◽  
Fatty Liver Disease ◽  
Liver Diseases ◽  
Biological Processes ◽  
Chronic Liver Diseases ◽  
Nonalcoholic Fatty Liver ◽  
Diabetes And Obesity

Liver disease is the spectrum of liver damage ranging from simple steatosis called as nonalcoholic fatty liver disease (NAFLD) to hepatocellular carcinoma (HCC). Clinically, NAFLD and type 2 diabetes coexist. Type 2 diabetes contributes to biological processes driving the severity of NAFLD, the primary cause for development of chronic liver diseases. In the last 20 years, the rate of non-viral NAFLD/NASH-derived HCC has been increasing rapidly. As there are currently no suitable drugs for treatment of NAFLD and NASH, a class of thiazolidinediones (TZDs) drugs for the treatment of type 2 diabetes is sometimes used to improve liver failure despite the risk of side effects. Therefore, diagnosis, prevention, and treatment of the development and progression of NAFLD and NASH are important issues. In this review, we will discuss the pathogenesis of NAFLD/NASH and NAFLD/NASH-derived HCC and the current promising pharmacological therapies of NAFLD/NASH. Further, we will provide insights into “adipose-derived adipokines” and “liver-derived hepatokines” as diagnostic and therapeutic targets from NAFLD to HCC.

Hepatology after Hepatitis C

2016 ◽  
Vol 34 (5) ◽  
pp. 603-606 ◽  
Author(s):  
J. Gregory Fitz
Keyword(s):  
Liver Disease ◽  
Hepatitis C ◽  
Liver Injury ◽  
Early Detection ◽  
Liver Diseases ◽  
Population Level ◽  
Success Stories ◽  
Risk Variants ◽  
Complications Of Cirrhosis ◽  
Direct Acting

The ∼90% probability of curing individual patients with hepatitis C virus (HCV)using direct-acting antivirals represents one of the most dramatic medical success stories of the modern era, and the journey from viral discovery to treatment occurred over just ∼25 years. The realities of the global burden of disease (2-3% of the world's population is infected), limited access to care and cost of treatment mean that HCV will continue to be a major problem for the next 25 years. But what if HCV (and hepatitis B) could be eradicated? Since liver transplantation and HCV management have been the mainstays of academic hepatology practice, where do we go from here? Unfortunately, we are in an era where the incidence and prevalence of liver diseases around the globe is increasing, and death from complications of cirrhosis is now among the top 10 causes in most countries; so hepatologists are expected to play a major role in the future. Despite remarkable progress, success at the population level is limited by the resource-intensive nature of caring for patients with end-stage disease. Accordingly, the major advances in the next decade are likely to focus on (i) the earlier identification of individuals and populations at higher risk for liver diseases, and (ii) initiation in high-risk populations of specific strategies for early detection and treatment of fibrosis, cancer and cirrhosis. The answers will lie in large part in the further exploration of the human genome in carefully phenotyped patients. Risk variants in the PNPLA3 gene represent the best example to date. The risk variants are common and are enriched in certain populations around the globe; and individuals that possess risk variants are more likely to have liver injury from fatty liver disease (even as children), alcohol and viral hepatitis. Further, those with liver injury are more likely to progress to cirrhosis and hepatoma. Similarly, in those with established liver disease, use of biomarkers and other strategies for early detection of fibrosis and hepatoma will pay dividends as the next generation of treatments focusing on (i) anti-fibrotic strategies and (ii) liver regeneration move to the forefront. There remains an important need to invest in hepatology as a growth industry even after the (unlikely) eradication of HCV.

scholarly journals Imaging Software-Based Sarcopenia Assessment in Gastroenterology: Evolution and Clinical Meaning

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Giovanni Marasco ◽  
Sinan Sadalla ◽  
Giulio Vara ◽  
Rita Golfieri ◽  
Davide Festi ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Liver Disease ◽  
Liver Failure ◽  
Chronic Liver Disease ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Sarcopenia is gaining attention as a negative prognostic factor in different fields of medicine, including chronic liver failure. However, the assessment of sarcopenia in patients with liver diseases is often neglected due to unawareness of reliable tools and methods and thus is limited to research studies. Cross-sectional imaging is a diffuse diagnostic tool and is commonly performed in patients with chronic liver failure. The last advancements in radiology image analysis using dedicated software allow an easy and standardized method to assess skeletal muscle volume. Several measures can be obtained from cross-sectional imaging analysis to evaluate sarcopenia in patients affected by chronic liver disease. We aimed to review the recent advances in imaging-based sarcopenia assessment, in particular in patients with chronic liver diseases. As a result, we found that the skeletal muscle index (SMI) seems to be a reliable method to assess sarcopenia in cirrhotic patients. Even if further studies are needed to validate proper cut-offs for each clinical endpoint, physicians are invited to consider the assessment of sarcopenia in the work-up of patients with chronic liver disease.

Liver failure

2020 ◽  
pp. 3089-3100
Author(s):  
Jane Macnaughtan ◽  
Rajiv Jalan
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Organ Failure ◽  
Clinical Manifestations ◽  
Chronic Liver ◽  
Chronic Liver Failure

Liver failure occurs when loss of hepatic parenchymal function exceeds the capacity of hepatocytes to regenerate or repair liver injury. Acute liver failure is characterized by jaundice and prolongation of the prothrombin time in the context of recent acute liver injury, with hepatic encephalopathy occurring within 8 weeks of the first onset of liver disease. Acute-on-chronic liver failure is characterized by hepatic and/or extrahepatic organ failure in patients with cirrhosis associated with an identified or unidentified precipitating event. The commonest causes of acute liver failure are acute viral hepatitis and drugs. Acute-on-chronic liver failure is most commonly precipitated by infection, alcohol abuse, and superimposed viral infection. The main clinical manifestations are hepatic encephalopathy, coagulopathy, jaundice, renal dysfunction, and haemodynamic instability. Infection and systemic inflammation contribute to pathogenesis and critically contribute to prognosis. Specific therapy for the underlying liver disease is administered when available, but this is not possible for most causes of liver failure. Treatment is predominantly supportive, with particular emphasis on (1) correction or removal of precipitating factors; (2) if encephalopathy is present, using phosphate enemata, nonhydrolysed disaccharide laxatives, and/or rifaximin; (3) early detection and prompt treatment of complications such as hypoglycaemia, hypokalaemia, cerebral oedema, infection, and bleeding. The onset of organ failure should prompt discussion with a liver transplantation centre. The mortality of acute liver failure (without liver transplantation) is about 40%. Patients with acute liver failure who do not develop encephalopathy can be expected to recover completely. Those who recover from an episode of acute-on-chronic liver failure should be considered for liver transplantation because otherwise their subsequent mortality remains high.

scholarly journals Stem Cell-Related Studies and Stem Cell-Based Therapies in Liver Diseases

2019 ◽  
Vol 28 (9-10) ◽  
pp. 1116-1122 ◽  
Author(s):  
Wei Zhou ◽  
Erek D. Nelson ◽  
Anan A. Abu Rmilah ◽  
Bruce P. Amiot ◽  
Scott L. Nyberg
Keyword(s):  
Liver Transplantation ◽  
Stem Cell ◽  
Liver Disease ◽  
Liver Failure ◽  
Effective Treatment ◽  
Liver Diseases ◽  
Immunosuppressive Agents ◽  
End Stage Liver Disease ◽  
Effective Interventions ◽  
End Stage

Owing to the increasing worldwide burden of liver diseases, the crucial need for safe and effective interventions for treating end-stage liver failure has been a very productive line of inquiry in the discipline of hepatology for many years. Liver transplantation is recognized as the most effective treatment for end-stage liver disease; however, the shortage of donor organs, high medical costs, and lifelong use of immunosuppressive agents represent major drawbacks and demand exploration for alternative treatments. Stem cell-based therapies have been widely studied in the field of liver diseases and are considered to be among the most promising therapies. Herein, we review recent advances in the application of stem cell-related therapies in liver disease with the aim of providing readers with relevant knowledge in this field and inspiration to spur further inquiry.

Liver disorders

2016 ◽  
Author(s):  
Chris Verslype ◽  
David Cassiman ◽  
Johan Verhaeghe
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Liver Failure ◽  
Liver Diseases ◽  
Systematic Approach ◽  
Liver Disorders ◽  
Diagnostic Characteristics ◽  
Mother And Child ◽  
Prognostic Implications ◽  
In Pregnancy

Liver disease can complicate 5% of pregnancies, putting mother and child at risk for increased morbidity and mortality. Cholestasis, portal hypertension, and liver failure represent three major clinical entities that should be recognized early because of the prognostic implications. Liver disease in pregnancy is generally separated into disorders that are unique to pregnancy and those that coincide with pregnancy. This chapter recommends a systematic approach that focuses on the major differential diagnostic characteristics of pregnancy-related liver diseases and a limited set of tests for pregnancy-unrelated liver diseases. Management of these conditions should be performed by a multidisciplinary team and ranges from simple medical therapies to immediate termination of the pregnancy.

scholarly journals Toll-Like Receptor 3 in Liver Diseases

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Shi Yin ◽  
Bin Gao
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Injury ◽  
Immune Cells ◽  
Liver Diseases ◽  
Human Liver ◽  
Toll Like Receptor ◽  
Double Stranded Rna ◽  
Nonparenchymal Cells

Toll-like receptor 3 (TLR3) is a member of the TLR family that can recognize double-stranded RNA (dsRNA), playing an important role in antiviral immunity. Recent studies have shown that TLR3 is also expressed on parenchymal and nonparenchymal cells in the liver as well as on several types of immune cells. In this review, we summarize the role of TLR3 in liver injury, inflammation, regeneration, and liver fibrosis, and discuss the implication of TLR3 in the pathogenesis of human liver diseases including viral hepatitis and autoimmune liver disease.

scholarly journals Potential Effects of Coronaviruses on the Liver: An Update

2021 ◽  
Vol 8 ◽  
Author(s):  
Xinyi Wang ◽  
Jianyong Lei ◽  
Zhihui Li ◽  
Lunan Yan
Keyword(s):  
Clinical Trials ◽  
Liver Disease ◽  
Liver Injury ◽  
Severe Acute Respiratory Syndrome ◽  
Respiratory Tract ◽  
Liver Diseases ◽  
Direct Damage ◽  
Animal Trials ◽  
Immune Mediated ◽  
Coronavirus Infection

The coronaviruses that cause notable diseases, namely, severe acute respiratory syndrome (SARS), middle east respiratory syndrome (MERS) and coronavirus disease 2019 (COVID-19), exhibit remarkable similarities in genomic components and pathogenetic mechanisms. Although coronaviruses have widely been studied as respiratory tract pathogens, their effects on the hepatobiliary system have seldom been reported. Overall, the manifestations of liver injury caused by coronaviruses typically involve decreased albumin and elevated aminotransferase and bilirubin levels. Several pathophysiological hypotheses have been proposed, including direct damage, immune-mediated injury, ischemia and hypoxia, thrombosis and drug hepatotoxicity. The interaction between pre-existing liver disease and coronavirus infection has been illustrated, whereby coronaviruses influence the occurrence, severity, prognosis and treatment of liver diseases. Drugs and vaccines used for treating and preventing coronavirus infection also have hepatotoxicity. Currently, the establishment of optimized therapy for coronavirus infection and liver disease comorbidity is of significance, warranting further safety tests, animal trials and clinical trials.

scholarly journals Increased burden of cardiovascular disease in people with liver disease: unequal geographical variations, risk factors and excess years of life lost

2021 ◽  
Author(s):  
Wai Hoong Chang ◽  
Stefanie Mueller ◽  
Sheng-Chia Chung ◽  
Graham R Foster ◽  
Alvina G Lai
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Hepatitis ◽  
Liver Disease ◽  
Kidney Disease ◽  
Incidence Rate ◽  
Liver Diseases ◽  
Autoimmune Liver Disease ◽  
Years Of Life Lost ◽  
Geographical Variations ◽  
Wide Range

Background People with liver disease are at increased risk of developing cardiovascular disease (CVD), however, there has yet been an investigation of incidence burden, risk, and premature mortality across a wide range of liver conditions and cardiovascular outcomes. Methods We employed population-wide electronic health records (EHRs; from 1998-2020) consisting of almost 4 million adults to assess regional variations in disease burden of five liver conditions, alcoholic liver disease (ALD), autoimmune liver disease, chronic hepatitis B infection (HBV), chronic hepatitis C infection (HCV) and NAFLD, in England. We analysed regional differences in incidence rates for 17 manifestations of CVD in people with or without liver disease. The associations between biomarkers and comorbidities and risk of CVD in patients with liver disease were estimated using Cox models. For each liver condition, we estimated excess years of life lost (YLL) attributable to CVD (i.e., difference in YLL between people with or without CVD). Results The age-standardised incidence rate for any liver disease was 114.5 per 100,000 person years. The highest incidence was observed in NAFLD (85.5), followed by ALD (24.7), HCV (6.0), HBV (4.1) and autoimmune liver disease (3.7). Regionally, the North West and North East regions consistently exhibited high incidence burden. Age-specific incidence rate analyses revealed that the peak incidence for liver disease of non-viral aetiology is reached in individuals aged 50-59 years. Patients with liver disease had a 2-fold higher incidence burden of CVD (2,634.6 per 100,000 persons) compared to individuals without liver disease (1,339.7 per 100,000 persons). When comparing across liver diseases, atrial fibrillation was the most common initial CVD presentation while hypertrophic cardiomyopathy was the least common. We noted strong positive associations between body mass index and current smoking and risk of CVD. Patients who also had diabetes, hypertension, proteinuric kidney disease, chronic kidney disease, diverticular disease and gastro-oesophageal reflex disorders had a higher risk of CVD, as do patients with low albumin, raised C-reactive protein and raised International Normalized Ratio levels. All types of CVD were associated with shorter life expectancies. When evaluating excess YLLs by age of CVD onset and by liver disease type, differences in YLLs, when comparing across CVD types, were more pronounced at younger ages. Conclusions We developed a public online app (https://lailab.shinyapps.io/cvd_in_liver_disease/) to showcase results interactively. We provide a blueprint that revealed previously underappreciated clinical factors related to the risk of CVD, which differed in the magnitude of effects across liver diseases. We found significant geographical variations in the burden of liver disease and CVD, highlighting the need to devise local solutions. Targeted policies and regional initiatives addressing underserved communities might help improve equity of access to CVD screening and treatment.

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