scholarly journals Modern aspects of hepatology: liver steatosis and fibrosis through the prism of comorbidity in pediatric practice

2021 ◽  
pp. 50-55
Author(s):  
Larysa Strashok ◽  
Svetlana Turchyna ◽  
Natalia Shevchenko ◽  
Zalina Yeloyeva ◽  
Olga Belousova ◽  
...  

The relevance of the topic is dictated by the growing prevalence of hepatic steatosis and fibrosis in the pediatric population, which is due to an increase in the number of pathologies of various organs and systems, which may be accompanied by the development of these liver lesions. The aim of the study: to analyze the data of modern sources of scientific literature regarding the prevalence and features of the course of pathology of various organs and systems, which is associated with the development of steatosis and liver fibrosis in the pediatric population. Materials and methods. A systematic search of scientific was carried out using Web of Science, Scopus, PubMed, scientific bases with key words: «hepatic steatosis», «hepatic fibrosis», «non-alcoholic fatty liver disease», «comorbid pathology», «children and adolescents». Conclusions. Currently, the number of children and adolescents who are diagnosed with steatosis and/or fibrosis of the liver is increasing in the world. In particular, the formation of this pathology is associated with the presence of metabolic syndrome and is associated with its main components, such as obesity, hypertension, disorders of carbohydrate and lipid metabolism. More and more studies indicate the role of non-alcoholic fatty liver disease, which is based on steatosis, as a comorbid pathology in systemic, cardiovascular, endocrine diseases, gastrointestinal tract pathology, and genetic disorders. Also, a number of drugs with steatogenic and fibrogenic effects on liver tissue have been established, which are widely used in pediatric practice. It is necessary to monitor the structural and functional state of the liver already in childhood and adolescence for adequate treatment of the underlying disease and prevention of the formation of comorbid pathology

2021 ◽  
Vol 25 (1-2) ◽  
pp. 50-56
Author(s):  
О.А. Пода

The article summarizes the knowledge about epidemiological data, clinical features, criteria for verification of the diagnosis, modern principles of diagnosis and treatment of non-alcoholic fatty liver disease (NAFLD) in children based on the analysis of literature sources using paper and electronic databases PubMed, CyberLeninka, Web of Science, MedLine, The Cochrane Library. A review of literary sources on the study of this pathology demonstrates that at the present stage NAFLD has become one of the most common causes of chronic liver disease in children and adolescents because of the growing worldwide epidemic of childhood obesity. The article presents the latest recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition and the American Association for the Study of Liver Diseases on the screening strategy and basic criteria for verification of the diagnosis, as well as the principles of treatment of this pathology in pediatric practice. Particular attention is paid to the description of the main imaging methods that play a key role in the diagnosis of NAFLD in children and adolescents. The role of lifestyle modification as the main method of NAFLD treatment according to current international recommendations is described in detail. The review also analyzes the main researches that have focused on alternative treatments targeting the basic pathogenic factors of pathology development. In conclusion, the author considered the problem of lack of accurate non-invasive markers of hepatocellular damage and fibrosis in the pediatric practice, as well as the lack of clinical trials to determine optimal approaches to the treatment of non-alcoholic fatty liver disease in children.


2019 ◽  
Vol 20 (9) ◽  
pp. 2325 ◽  
Author(s):  
Hua Li ◽  
Wonbeak Yoo ◽  
Hye-Mi Park ◽  
Soo-Youn Lim ◽  
Dong-Ha Shin ◽  
...  

Arazyme, a metalloprotease from the spider Nephila clavata, exerts hepatoprotective activity in CCL4-induced acute hepatic injury. This study investigated the hepatoprotective effects in high-fat diet (HFD)-induced non-alcoholic fatty liver disease-like C57BL/6J mice. The mice were randomly divided into four groups (n = 10/group): the normal diet group, the HFD group, the arazyme group (HFD with 0.025% arazyme), and the milk thistle (MT) group (HFD with 0.1% MT). Dietary supplementation of arazyme for 13 weeks significantly lowered plasma triglyceride (TG) and non-esterified fatty acid levels. Suppression of HFD-induced hepatic steatosis in the arazyme group was caused by the reduced hepatic TG and total cholesterol (TC) contents. Arazyme supplementation decreased hepatic lipogenesis-related gene expression, sterol regulatory element-binding transcription protein 1 (Srebf1), fatty acid synthase (Fas), acetyl-CoA carboxylase 1 (Acc1), stearoyl-CoA desaturase-1 (Scd1), Scd2, glycerol-3-phosphate acyltransferase (Gpam), diacylglycerol O-acyltransferase 1 (Dgat1), and Dgat2. Arazyme directly reduced palmitic acid (PA)-induced TG accumulation in HepG2 cells. Arazyme suppressed macrophage infiltration and tumor necrosis factor α (Tnfa), interleukin-1β (Il1b), and chemokine-ligand-2 (Ccl2) expression in the liver, and inhibited secretion of TNFα and expression of inflammatory mediators, Tnfa, Il1b, Ccl2, Ccl3, Ccl4, and Ccl5, in PA-induced RAW264.7 cells. Arazyme effectively protected hepatic steatosis and steatohepatitis by inhibiting SREBP-1-mediated lipid accumulation and macrophage-mediated inflammation.


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