scholarly journals HEPATIC MANIFESTATIONS IN COVID-19: APPROACHES ON THE MECHANISMS, LIVER INJURIES AND DRUG INTERACTIONS

2021 ◽  
Vol 2 (6) ◽  
pp. e26442
Author(s):  
Débora Dantas Nucci Cerqueira ◽  
Giuliene Rocha de Medeiros ◽  
João Victor Cordeiro Farias ◽  
Penelopy Rodrigues de Macedo
Keyword(s):  
Liver Damage ◽  
Liver Enzymes ◽  
Gastrointestinal Symptoms ◽  
Drug Effects ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Liver Injuries ◽  
Severe Liver Damage ◽  
Qualitative Nature

The current pandemic caused by SARS-CoV-2 originated in the city of Wuhan, China with an outbreak of pneumonia. The reported symptoms were mostly respiratory, but mounting evidence began to indicate that COVID-19 could reach other organs and systems. Among the gastrointestinal symptoms, liver involvement appears to be more common, with changes in liver enzymes (ALT and AST) being the first sign. Therefore, the present study aims to evaluate and discuss the hepatic manifestations in COVID-19 as the infection, manifestations, and drug effects. The study was based on a literature review, of a qualitative nature and an exploratory type. The mechanism that SARS-CoV-2 uses to reach the liver is still uncertain, there are currently 3 hypotheses: ACE2 receptors in cholangiocytes, cytokine storm, and drug-induced liver injury, due to the increase in the indiscriminate use of hepatotoxic drugs without scientific comprovation, hydroxychloroquine can lead to fulminant hepatic failure and azithromycin potentiates these effects, the role of remdesivir on the liver are still uncertain. Liver damage in mild cases of COVID-19 can be transient, but doctors should monitor and be alert to any changes in liver enzymes. When severe liver damage occurs, liver protective drugs have usually been given to these patients. Thus, this review provides a review of hepatic impairment and the management of patients considering the main studies carried out to date.

scholarly journals Drug Induced Hepatotoxicity – An Ongoing Challenge

2020 ◽  
Vol 10 (3) ◽  
pp. 244-248
Author(s):  
Mehr Fatima ◽  
Syed Zaidi
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Liver Damage ◽  
Obese People ◽  
Drug Induced ◽  
Pharmacological Agents ◽  
Drug Induced Liver Injury ◽  
High Incidence ◽  
Inflammatory Drugs

Drug induced liver injury is one of the main factor of liver failure and acute liver damage world wide with high incidence in western countries. Liver injury can be intrinsic (dose dependant) or idiosyncratic (dose independent). However idiosyncratic type is considered to be mainly responsible for drug induced liver damage. Binding of reactive metabolites of drugs to tissue proteins and oxidative stress is the possible cellular mechanism involved in this process. Moreover, some antibiotics, anti-epileptics, nonsteroidal anti-inflammatory drugs etc are more likely to induce liver damage in high risks groups that includes females, elderly and obese people. HLA halotype and variation in protein expression also plays an important role in this context. Various studies are available regarding clinical features, histopathological features, diagnosis and management related to antibiotics and acetaminophen induced liver damage. N acetylcysteine is commonly available antidote for drug induced hepatic damage. Role of other pharmacological agents as an antidote requires further studies. However, liver transplantation should be considered with drug induced lethal liver failure

scholarly journals Multi-component infusion hepatoprotectors for liver damage

2019 ◽  
pp. 84-88
Author(s):  
E. I. Sas ◽  
V. B. Grinevich
Keyword(s):  
Liver Damage ◽  
Eradication Therapy ◽  
Underlying Disease ◽  
Duration Of Treatment ◽  
Drug Induced ◽  
Over The Counter ◽  
Atp Production ◽  
Liver Injuries ◽  
Severe Liver Damage ◽  
Metabolic Type

Drug-induced liver injuries (DILI) remain today one of the most pressing problems not only in gastroenterology, but also in all therapy. Up to 10% of the changes in laboratory parameters can be attributed to the use of drugs. The importance of DILI has increased significantly in recent years, due to the increase in the number of over-the-counter medicines on the pharmaceutical market, as well as non-compliance with the methods and modes of administration. There are common links in the pathogenesis of DILI, including hypoxia, de-energization (deficit of ATP production), damage to hepatocyte membranes and suppression of antioxidant protection. Therefore, pathogenetic pharmacotherapy and prevention of liver damage are based on drugs with an action mechanism aimed at eliminating one or more links in the pathogenesis. One of these drugs is Remaxol, which includes antihypoxantantioxidants of metabolic type: natural metabolites, substrates and cofactors involved in energy metabolism. Remaxol was administered to 30 patients with duodenal ulcer (DU) in the acute phase in addition to the main eradication therapy in the case of cytolytic syndrome by the end of the first week of therapy intravenously dripping at a rate of 40-60 drops/min in a daily dose of 400 ml for 10 days a day. Against the background of Remaxol application, the patients with DILI had stabilization of the main biochemical parameters: the level of AST, ALT, direct bilirubin, GGT and alkaline phosphatase. These changes were accompanied by a positive dynamics of the general state of health. The use of Remaxol in patients with DILI will allow to achieve clinical and biochemical remission, preventing the development of severe liver damage, and contributes to the preservation of the recommended duration of treatment of the underlying disease.

scholarly journals Analysis of common causes of liver damage among children 12 years and younger in Weifang

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110066
Author(s):  
Qinghong Meng ◽  
Na Li ◽  
Lianmei Yuan ◽  
Xiaona Gao
Keyword(s):  
Liver Damage ◽  
Epstein Barr Virus ◽  
Metabolic Diseases ◽  
Unknown Etiology ◽  
Severe Liver ◽  
Drug Induced ◽  
Barr Virus ◽  
Common Causes ◽  
Severe Liver Damage ◽  
Epstein Barr

Aims To explore the causes of liver damage among children 12 years and younger in Weifang and to provide a theoretical basis for early diagnosis of liver damage in children. Methods Retrospective study of clinical data from pediatric patients (age ≤12 years) with liver damage in diagnosed at Weifang People's Hospital from June 2010 to May 2020. Results A total of 2632 children (1572 boys, 1060 girls) aged ≤12 years were diagnosed with liver damage including infectious liver damage (2100 cases), non-infectious liver damage (446 cases) and liver damage of unknown etiology (86 cases). The most common causes of infectious liver damage were viral infection (1515 cases), Mycoplasma pneumoniae infection (343 cases), and bacterial infection (197 cases). The most common causes of viral liver damage were Epstein–Barr virus, cytomegalovirus, and enterovirus. The most common causes of non-infectious liver damage were drug-induced liver damage, Kawasaki disease, and genetic metabolic diseases. There were 31 cases of severe liver damage. Conclusion There were many causes of liver damage among children in Weifang. Infections, and especially viral infections such as Epstein–Barr virus, were the most common causes of liver damage. Severe liver damage was primarily caused by drugs or poisons.

scholarly journals Immune-Mediated Drug-Induced Liver Injury: Immunogenetics and Experimental Models

2021 ◽  
Vol 22 (9) ◽  
pp. 4557
Author(s):  
Alessio Gerussi ◽  
Ambra Natalini ◽  
Fabrizio Antonangeli ◽  
Clara Mancuso ◽  
Elisa Agostinetto ◽  
...  
Keyword(s):  
Liver Injury ◽  
Experimental Models ◽  
Clinical Event ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Immune Mediated ◽  
Liver Injuries ◽  
Immunological Mechanisms ◽  
Molecular Aspects ◽  
Therapeutic Tools

Drug-induced liver injury (DILI) is a challenging clinical event in medicine, particularly because of its ability to present with a variety of phenotypes including that of autoimmune hepatitis or other immune mediated liver injuries. Limited diagnostic and therapeutic tools are available, mostly because its pathogenesis has remained poorly understood for decades. The recent scientific and technological advancements in genomics and immunology are paving the way for a better understanding of the molecular aspects of DILI. This review provides an updated overview of the genetic predisposition and immunological mechanisms behind the pathogenesis of DILI and presents the state-of-the-art experimental models to study DILI at the pre-clinical level.

scholarly journals BML-257, a small molecule that protects against drug induced liver injury in zebrafish

2022 ◽  
Author(s):  
Urmila Jagtap ◽  
Sandeep Basu ◽  
Lavanya Lokhande ◽  
Nikhil Bharti ◽  
Chetana Sachidanandan
Keyword(s):  
Liver Injury ◽  
Small Molecule ◽  
Liver Damage ◽  
Protective Action ◽  
Damage Model ◽  
Akt Inhibitor ◽  
Drug Induced ◽  
Specific Expression ◽  
Drug Induced Liver Injury ◽  
Chemical Screen

The use of many essential drugs is restricted due to their deleterious effects on the liver. Molecules that can prevent or protect the liver from drug induced liver injury (DILI) would be valuable in such situations. We used hepatocyte-specific expression of bacterial nitroreductase in zebrafish to cause temporally controlled liver damage. This transgenic line was used to run a whole organism based chemical screen in zebrafish larvae. In this screen we identified BML-257, a potent small molecule AKT inhibitor, that protected the liver against metronidazole-induced liver injury. BML-257 also showed potent prophylactic and pro-regenerative activity in this liver damage model. BML-257 also showed remarkable protective action in two independent toxicological models of liver injury caused by acetaminophen and Isoniazid. This suggests that BML-257 may have the potential to protect against multiple kinds of drug induced liver injury.

Drugs and liver damage

2010 ◽  
pp. 2527-2537
Author(s):  
J. Neuberger
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Pulmonary Tuberculosis ◽  
Liver Damage ◽  
Case History ◽  
Genetic Component ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Almost All

Case History—A 22 yr old man, being treated for pulmonary tuberculosis, now presenting with confusion and jaundice. Drug-induced liver injury (DILI) is relatively uncommon but can very rarely be fatal. Almost all patterns of liver disease can be induced by drugs, and some drugs may be associated with more than one type of reaction. Some cases of DILI have a genetic component. Most cases present with jaundice and/or hepatitis....

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