scholarly journals New Therapies of Liver Diseases: Hepatic Encephalopathy

2021 ◽  
Vol 10 (18) ◽  
pp. 4050
Author(s):  
Chiara Mangini ◽  
Sara Montagnese
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Liver Diseases ◽  
Management Strategies ◽  
New Drugs ◽  
Common Complication ◽  
Advanced Liver Disease ◽  
The Past ◽  
Significant Burden ◽  
Management Challenge

Hepatic encephalopathy (HE) is a common complication of advanced liver disease which has profound implications in terms of the patients’ ability to fulfil their family and social roles, to drive and to provide for themselves. Recurrent and persistent HE is still a serious management challenge, translating into a significant burden for patients and their families, health services and society at large. The past few years have been characterized by significantly more attention towards HE and its implications; its definition has been refined and a small number of new drugs/alternative management strategies have become available, while others are underway. In this narrative review we summarize them in a pragmatic and hopefully useful fashion.

Phytosterols and Triterpenoids for Prevention and Treatment of Metabolic-related Liver Diseases and Hepatocellular Carcinoma

2019 ◽  
Vol 20 (3) ◽  
pp. 197-214 ◽  
Author(s):  
Isabel Sánchez-Crisóstomo ◽  
Eduardo Fernández-Martínez ◽  
Raquel Cariño-Cortés ◽  
Gabriel Betanzos-Cabrera ◽  
Rosa A. Bobadilla-Lugo
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Anticancer Agents ◽  
Liver Diseases ◽  
Membrane Receptors ◽  
New Drugs ◽  
Sexual Hormones ◽  
Steroid Nucleus ◽  
Alcoholic Fatty Liver ◽  
Prevention And Treatment

Background: Liver ailments are among the leading causes of death; they originate from viral infections, chronic alcoholism, and autoimmune illnesses, which may chronically be precursors of cirrhosis; furthermore, metabolic syndrome may worsen those hepatopathies or cause Non-alcoholic Fatty Liver Disease (NAFLD) that may advance to non-alcoholic steatohepatitis (NASH). Cirrhosis is the late-stage liver disease and can proceed to hepatocellular carcinoma (HCC). Pharmacological treatment options for liver diseases, cirrhosis, and HCC, are limited, expensive, and not wholly effective. The use of medicinal herbs and functional foods is growing around the world as natural resources of bioactive compounds that would set the basis for the development of new drugs. Review and Conclusion: Plant and food-derived sterols and triterpenoids (TTP) possess antioxidant, metabolic-regulating, immunomodulatory, and anti-inflammatory activities, as well as they are recognized as anticancer agents, suggesting their application strongly as an alternative therapy in some chronic diseases. Thus, it is interesting to review current reports about them as hepatoprotective agents, but also because they structurally resemble cholesterol, sexual hormones, corticosteroids and bile acids due to the presence of the steroid nucleus, so they all can share pharmacological properties through activating nuclear and membrane receptors. Therefore, sterols and TTP appear as a feasible option for the prevention and treatment of chronic metabolic-related liver diseases, cirrhosis, and HCC.

scholarly journals Recent advances in managing chronic HCV infection: focus on therapy in patients with severe liver disease

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 367 ◽  
Author(s):  
Raoel Maan ◽  
Adriaan J. van der Meer
Keyword(s):  
Liver Disease ◽  
Treatment Options ◽  
Public Health Problem ◽  
Hcv Infection ◽  
New Drugs ◽  
European Medicines Agency ◽  
Major Public Health Problem ◽  
Advanced Liver Disease ◽  
Specific Patient ◽  
Chronic Hcv

Chronic hepatitis C virus (HCV) infection still represents a major public health problem, as it is thought to be responsible for more than 350,000 deaths around the globe on a yearly basis. Fortunately, successful eradication of the virus has been associated with improved clinical outcome and reduced mortality rates. In the past few years, treatment has improved considerably by the implementation of direct-acting antivirals (DAAs). From 2014 onwards, sofosbuvir, simeprevir, daclatasvir, ledipasvir, paritaprevir, ombitasvir, and dasabuvir have been approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA). Regimens with various combinations of these new drugs, without the use of interferon (IFN), proved to be very effective and well tolerated, even among patients with advanced liver disease. Moreover, treatment duration could be shortened to 12 weeks in the majority of patients. The high costs of these DAAs, however, limit the availability of IFN-free therapy worldwide. Even in wealthy countries, it is deemed necessary to prioritize DAA treatment in order to limit the immediate impact on the health budget. As patients with advanced liver disease are in most need of HCV clearance, many countries decided to treat those patients first. In the current review, we focus on the currently available IFN-free treatment options for patients with cirrhosis. We discuss the virological efficacy as well as the clinical relevance of these regimens among this specific patient population.

scholarly journals Contemplating a challenging future: A public management approach to health services

Curationis ◽  
1992 ◽  
Vol 15 (1) ◽  
Author(s):  
E. Schwella
Keyword(s):  
Public Sector ◽  
Health Services ◽  
Public Management ◽  
Management Strategies ◽  
Management Approach ◽  
Health Trends ◽  
The Past ◽  
Management Challenge ◽  
Public Sector Service ◽  
Sector Service

A varying proportion of health services in alt societies is delivered by public sector institutions. Managing these public sector service institutions for performance represents a major management challenge. This management challenge is amplified for South Africa as a country which is contemplating major changes while being simultaneously confronted with having to cope with problematic results of the past and the challenges of development. In this article a public management model is used to analyse relevant health trends and provisional management strategies are provided to assist health managers to cope with these challenges. Finally a checklist for personal survival is presented for personal evaluation and future planning.

Animal models of chronic liver diseases

2013 ◽  
Vol 304 (5) ◽  
pp. G449-G468 ◽  
Author(s):  
Yan Liu ◽  
Christoph Meyer ◽  
Chengfu Xu ◽  
Honglei Weng ◽  
Claus Hellerbrand ◽  
...  
Keyword(s):  
Liver Disease ◽  
Animal Models ◽  
Liver Diseases ◽  
Human Liver ◽  
Chronic Liver ◽  
New Drugs ◽  
Limiting Factors ◽  
Rodent Models ◽  
Chronic Liver Diseases ◽  
Underlying Mechanisms

Chronic liver diseases are frequent and potentially life threatening for humans. The underlying etiologies are diverse, ranging from viral infections, autoimmune disorders, and intoxications (including alcohol abuse) to imbalanced diets. Although at early stages of disease the liver regenerates in the absence of the insult, advanced stages cannot be healed and may require organ transplantation. A better understanding of underlying mechanisms is mandatory for the design of new drugs to be used in clinic. Therefore, rodent models are being developed to mimic human liver disease. However, no model to date can completely recapitulate the “corresponding” human disorder. Limiting factors are the time frame required in humans to establish a certain liver disease and the fact that rodents possess a distinct immune system compared with humans and have different metabolic rates affecting liver homeostasis. These features account for the difficulties in developing adequate rodent models for studying disease progression and for testing new pharmaceuticals to be translated into the clinic. Nevertheless, traditional and new promising animal models that mimic certain attributes of chronic liver diseases are established and being used to deepen our understanding in the underlying mechanisms of distinct liver diseases. This review aims at providing a comprehensive overview of recent advances in animal models recapitulating different features and etiologies of human liver diseases.

scholarly journals Assessing Toxicity in Drug Trials in Liver Disease

2021 ◽  
Author(s):  
Morris Sherman
Keyword(s):  
Clinical Trials ◽  
Liver Disease ◽  
Liver Injury ◽  
Viral Hepatitis ◽  
Liver Diseases ◽  
New Drugs ◽  
Drug Trials ◽  
Drug Induced ◽  
Drug Induced Liver Injury

AbstractSince the early trials in viral hepatitis, more and more new drugs are being tested for use in various liver diseases. Since drug hepatotoxicity is a major cause of drugs under investigation not making it to market, the assessment of drug-induced liver injury in clinical trials of new drugs is crucial. This review will focus on the systems that are used to assess drug-induced liver injury in clinical trials and will discuss how some of these criteria are inappropriate or inaccurate in this function together with suggestions for improvement.

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