scholarly journals Identification of Serum Biomarkers in End Stage Liver Disease

2010 ◽  
Vol 3 (1) ◽  
pp. 1-6
Author(s):  
D. Koutsogiannis ◽  
K. Summers ◽  
B. George ◽  
P. Adams ◽  
P. Marotta ◽  
...  

Background: Progressive fibrosis and cirrhosis, clinically presenting as end-stage liver disease are common outcomes in alcoholic hepatitis as well as non-alcoholic fatty liver disease(NAFLD). In these processes, a series of changes occurs in liver tissues leading to cell death, remodeling, fibrosis and regeneration. The aim of this study is to identify potential novel biomarkers for non-invasive diagnosis of cirrhosis due to alcoholic etiology or NAFLD. Methods: Serum from patients with biopsy proven end-stage liver disease of various etiologies, namely NAFLD(n=9), alcohol( n=5), and other end-stage liver diseases(n=6), who underwent liver transplant during the first six months of 2007 were utilized for retrospective analysis. Serum samples were also collected from a group of healthy volunteers (n=7). The samples were analysed using Luminex technology or ELISA for 27 biomarkers that are known to be involved in pathologic processes such as cell death, regeneration and fibrosis. Results: Of the 27 serum markers examined, 16 were elevated in the serum in all groups with end-stage liver diseases compared with the control group. They include adipokines, apoptosis and inflammatory mediators and growth factors. Interestingly, the serum of NAFLD patients showed significantly elevated HGF levels and trend towards increase in sFAS, TGF􀀁1, TNFR-1, TNFR-2 and leptin. The level of serum markers showed excellent correlation with each other indicating a complex interdependent pathogenetic mechanism. Conclusions: The data from this study indicate that a large number of serum markers are altered in end-stage liver diseases. A panel of such markers may potentially be useful in assessing advanced fibrosis and cirrhosis in patients with chronic end stage liver diseases.

2021 ◽  
Vol 14 (9) ◽  
pp. e244805
Author(s):  
Eman Alabsawy ◽  
Yassen Serry ◽  
Sreelakshmi Kotha ◽  
Philip Berry ◽  
Giovanni Tritto

Hepatopulmonary syndrome (HPS) is characterised by the development of intrapulmonary arteriovenous blood shunts and vascular dilatation with consequent hypoxaemia, usually in the context of end-stage liver disease (ESLD). The estimated incidence of HPS in ESLD has been reported to be 13%–47%. Chronic liver disease has been described in patients with hypothalamic–pituitary dysfunction, mainly in the form of non-alcoholic fatty liver disease due to metabolic syndrome, with occasional progression to cirrhosis. We report a challenging case of a 27-year-old man with a background of hypopituitarism with no known liver disease who presented with progressive dyspnoea and hypoxaemia and was eventually diagnosed with severe HPS.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Masatsugu Kawahira ◽  
Takahisa Yamada ◽  
Tetsuya Watanabe ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
...  

Background: Cardiohepatic interactions have been a focus of attention in heart failure(HF), and the model for end-stage liver disease excluding INR (MELD-XI) has been shown to be useful for prediction of poor outcome in patients (pts) with acute decompensated heart failure (ADHF). Furthermore, it has been reported that liver stiffness predicts adverse prognosis in pts with HF. Liver fibrosis is assessed by non-invasive fibrosis markers such as Fibrosis-4 (FIB4) index, non-alcoholic fatty liver disease fibrosis score (NFS) and aminotransferase to platelet ratio index (APRI). Recently, a new group of HF pts with mid-range ejection fraction (HFmrEF) has been defined, separated from reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). However, there is little information available on the comparison of prognostic significance of MELD-XI and liver fibrosis scores in ADHF pts, relating to LVEF. Methods: We prospectively studied 466 consecutive ADHF pts (HFrEF (LVEF≦40%): n=164, HFmrEF (40<LVEF<50): n=104 and HFpEF (LVEF≧50%): n=198). At the discharge, we calculated MELD-XI, FIB4 index , NFS, and APRI. The endpoint was all cause death (ACD). Results: During a follow-up period of 2.8±1.5 years, 143 pts had ACD. At multivariate Cox analysis, MELD-XI and FIB4 index was independently associated with ACD irrespective of LVEF. The pts with both greater MELD-XI ([HFrEF]≥25.8, [HFmrEF]≥33.2, [HFpEF]≥30.1) and greater FIB4 index ([HFrEF]≥2.58, [HFmrEF]≥2.58, [HFpEF]≥2.22) had a significantly increased risk of ACD than those with either and none of them in all three groups. Conclusions: The combination of MELD-XI and FIB4 index might be useful for stratifying pts at risk for ACD in ADHF pts with irrespective of LVEF.


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

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.


2006 ◽  
Vol 12 (S3) ◽  
pp. S124-S127 ◽  
Author(s):  
Sue McDiarmid ◽  
Robert G. Gish ◽  
Simon Horslen ◽  
George V. Mazariegos

Author(s):  
R. Mark Beattie ◽  
Anil Dhawan ◽  
John W.L. Puntis

Demographics 406Pathophysiology 406Differential diagnoses 407Presenting features 407Investigation 408Management 409Fatty liver disease is now increasingly recognized in children, particularly in the setting of obesity.The term non-alcoholic steatohepatitis (NASH) was first coined in 1980 by Ludwig to describe a pattern of liver injury in adults in which the liver histology was consistent with alcoholic hepatitis, but in whom significant alcohol consumption was denied. NASH can be considered as part of a broader spectrum of non-alcoholic fatty liver disease that extends from simple steatosis through steatohepatitis that is characterized by the potential to progress to fibrosis, cirrhosis and subsequent end stage liver disease....


Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2971 ◽  
Author(s):  
Maria Corina Plaz Torres ◽  
Alessio Aghemo ◽  
Ana Lleo ◽  
Giorgia Bodini ◽  
Manuele Furnari ◽  
...  

Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and is expected to become the leading cause of end-stage liver disease worldwide over the next few decades. In fact, NAFLD encompasses different clinical scenarios, from the simple accumulation of fat (steatosis) to steatohepatitis (NASH), NASH-cirrhosis, and cirrhosis complications. In this context, it is fundamental to pursue strategies aimed at both preventing the disease and reducing the progression of liver fibrosis once liver damage is already initiated. As of today, no pharmacological treatment has been approved for NAFLD/NASH, and the only recommended treatment of proven efficacy are life-style modifications, including diet and physical exercise pointing at weight loss of 5%–7%. Different dietetic approaches have been proposed in this setting, and in this review, we will discuss the evidence regarding the efficacy of the Mediterranean Diet as a treatment for NAFLD. In particular, we will report the effects on liver-related outcomes.


2017 ◽  
Vol 312 (5) ◽  
pp. G407-G412 ◽  
Author(s):  
Robert Schierwagen ◽  
Frank Erhard Uschner ◽  
Fernando Magdaleno ◽  
Sabine Klein ◽  
Jonel Trebicka

The evolution of chronic liver injuries from benign and manageable dysfunction to life threatening end-stage liver disease with severe complications renders chronic liver disease a global health burden. Because of the lack of effective medication, transplantation remains the only and final curative option for end-stage liver disease. Since the demand for organ transplants by far exceeds the supply, other treatment options are urgently required to prevent progression and improve end-stage liver disease. Statins are primarily cholesterol-lowering drugs used for primary or secondary prevention of cardiovascular diseases. In addition to the primary effect, statins act beneficially through different pleiotropic mechanisms on inflammation, fibrosis, endothelial function, thrombosis, and coagulation to improve chronic liver diseases. However, concerns remain about the efficacy and safety of statin treatment because of their potential hepatotoxic risks, and as of now, these risks impede broader use of statins in the treatment of chronic liver diseases. The aim of this review is to comprehensively describe the mechanisms by which statins improve prospects for different chronic liver diseases with special focus on the pathophysiological rationale and the clinical experience of statin use in the treatment of liver diseases.


Author(s):  
María Mendoza-Avendaño ◽  
Ana Ramírez-Carvajal ◽  
Iván Barreto-Herrera ◽  
Karen Muñoz-Báez ◽  
Yancarlos Ramos-Villegas ◽  
...  

AbstractLiver diseases constitute a group of pathologies of extraordinary importance, because of the large number of patients who suffer from these as well as the consequences that they can have on these individuals if they undergo any surgical procedure. Therefore, these patients have greater risk of suffering unfavorable outcomes than a healthy person undergoing emergency neurosurgical procedures (ENP) for neurotrauma. For this reason, there is a need to classify these patients according to their surgical risk based on risk factors secondary to the concurrent hepatic derangements. Among the possible tools that allow us to stage patients with liver disease are the Child–Turcotte–Pugh (CTP) and model for end-stage liver disease (MELD) scales, which have proven utility in effectively predicting the outcomes, including morbidity and mortality in hepatic disease patients who are undergoing surgery. They also help to predict the risk of complications such as intracranial hemorrhage secondary to coagulopathy due to hepatic derangement.


2021 ◽  
Vol 14 (02) ◽  
pp. 985-991
Author(s):  
D.A. Sindhughosa ◽  
I.K. Mariadi ◽  
I.D.N. Wibawa ◽  
I.G.A. Suryadarma ◽  
N. Purwadi ◽  
...  

Background:The model for end stage liver disease (MELD) score considered as a reliable predictor of survival for advanced liver diseases patients. Among several chemistry laboratorium examinations, albumin, bilirubin and platelet reflect the function of the liver. Objectives: To investigate the correlation of albumin-bilirubin (ALBI), platelet-albumin-bilirubin (PALBI), and fibrosis-4 (FIB-4) scores with mortality risk based on MELD score and evaluate their role in predictingcirrhosis mortality risk. Methods: The analytic cross-sectional study designrecruited adults with liver cirrhosis of any etiology during the period of November 2018 through January 2019. Descriptive and correlative analyses were done before proceeding to diagnostic abilityanalysis. Results: Sixty-two patients with mean age of 52.95 ± 12.05 were included in the analysis. The ALBI, PALBI, and FIB-4 scores were significantly correlated with higher mortality risk based on MELD score. The three scoressignificantly predicted higher mortality risk with varying sensitivity and specificity. Conclusion: Positivecorrelation between ALBI, PALBI, and FIB-4 scores with MELD score was found. ALBI (≥-1.26), PALBI (≥-2.05), and FIB-4 (≥5.84) values higher than the thresholdcould predict mortality risk in cirrhosis.


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