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Discover the most talked about and latest scientific content & concepts.

Concept: Cirrhosis

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Interferon (IFN)- free direct antiviral agents (DAAs) with rapid HCV eradication might evoke immunological reconstitutions, and some early recurrences of HCC after IFN-free DAAs have been reported. This study aimed to investigate whether natural killer group 2, member D (NKG2D) predicts early emergence of HCC after IFN-free DAAs.

Concepts: Immune system, Virus, Cirrhosis, Hepatitis, Hepatocellular carcinoma, Interferon, Hepatitis C, Hepatitis B

5

Recently, the roles of FAM83H in tumorigenesis have been interested and increased expression of FAM83H and MYC in hepatocellular carcinoma (HCC) have been reported. Therefore, we investigated the expression and role of FAM83H in 163 human HCCs and further investigated the relationship between FAM83H and oncogene MYC. The expression of FAM83H is elevated in liver cancer cells, and nuclear expression of FAM83H predicted shorter survival of HCC patients. In HLE and HepG2 HCC cells, knock-down of FAM83H inhibited proliferation and invasive activity of HCC cells. FAM83H induced expression of cyclin-D1, cyclin-E1, snail and MMP2 and inhibited the expression of P53 and P27. In hepatic tumor cells derived from Tet-O-MYC mice, the expression of mRNA and protein of FAM83H were dependent on MYC expression. Moreover, a chromatin immunoprecipitation assay demonstrated that MYC binds to the promotor of FAM83H and that MYC promotes the transcription of FAM83H, which was supported by the results of a dual-luciferase reporter assay. In conclusion, we present an oncogenic role of FAM83H in liver cancer, which is closely associated with the oncogene MYC. In addition, our results suggest FAM83H expression as a poor prognostic indicator of HCC patients.

Concepts: DNA, Gene expression, Cancer, Oncology, Cirrhosis, Hepatocellular carcinoma, Transcription factor, Oncogene

5

The beneficial effects of mineralocorticoid receptor blockade by spironolactone have been shown in animal models of nonalcoholic fatty liver disease (NAFLD). The aim of this 52-week randomized controlled trial was to compare the efficacy of low-dose spironolactone and vitamin E combination vs. vitamin E monotherapy on insulin resistance, noninvasive indices of hepatic steatosis and fibrosis, liver tests, circulating adipokines and hormones in patients with histologically confirmed NAFLD. Homeostasis model of assessment-insulin resistance (HOMA-IR) and noninvasive indices of steatosis and fibrosis were calculated. Analysis was intention-to-treat. NAFLD liver fat score, an index of steatosis, decreased significantly in the combination group (p = 0.028), but not in vitamin E group, and the difference for group*time interaction was significant (p = 0.047). Alanine aminotransferase (AST)-to-Platelet Ratio Index (APRI), an index of fibrosis, did not change. Insulin levels and HOMA-IR decreased significantly only within the combination group (p = 0.011 and p = 0.011, respectively). In conclusion, the combined low-dose spironolactone plus vitamin E regimen significantly decreased NAFLD liver fat score. Larger-scale trials are needed to clarify the effect of low dose spironolactone on hepatic histology.

Concepts: Insulin, Obesity, Cirrhosis, Liver function tests, Metabolic syndrome, Non-alcoholic fatty liver disease, Fatty liver, Steatosis

5

Primary biliary cholangitis (PBC) is a chronic inflammatory autoimmune cholestatic liver disease, which when untreated will culminate in end-stage biliary cirrhosis. Diagnosis is usually based on the presence of serum liver tests indicative of a cholestatic hepatitis in association with circulating antimitochondrial antibodies. Patient presentation and course can be diverse and risk stratification is important to ensure all patients receive a personalised approach to their care. The goals of treatment and management are the prevention of end-stage liver disease, and the amelioration of associated symptoms. Pharmacologic approaches in practice, to reduce the impact of the progressive nature of disease, currently include licensed therapies (ursodeoxycholic acid and obeticholic acid) and off-label therapies (fibric acid derivatives, budesonide). These clinical practice guidelines summarise the evidence for the importance of a structured, life-long and individualised, approach to the care of patients with PBC, providing a framework to help clinicians diagnose and effectively manage patients.

Concepts: Medical terms, Cirrhosis, Liver function tests, Hepatology, Cholestasis, Primary biliary cirrhosis, Primary sclerosing cholangitis, Jaundice

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2D shear wave elastography (2D-SWE) has proven to be efficient for the evaluation of liver fibrosis in small to moderate size clinical trials. We aimed at running a larger scale meta-analysis of individual data.

Concepts: Epidemiology, Clinical trial, Medical statistics, Cirrhosis, ClinicalTrials.gov, Evaluation methods

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Nonalcoholic steatohepatitis (NASH) is projected to be the leading cause of liver transplantation by 2020. Advanced fibrosis (stage F3-F4) on liver biopsy independently predicts all-cause and liver-related mortality in NASH. There are no known efficacious treatments for advanced fibrosis related to NASH. Thiazolidinedione therapy has been extensively evaluated in NASH, and new randomized clinical trials (RCTs) of its efficacy have been completed.

Concepts: Cirrhosis

5

The approval of all-oral direct acting antiviral (DAA) regimens for the treatment of hepatitis C virus (HCV) has led to the expansion of therapy to include patients with cirrhosis who have hepatocellular carcinoma (HCC). Data on the use of DAA’s in HCV+ patients with HCC is limited. The aim of this study was to assess the efficacy of all oral-DAA regimens in HCV+ cirrhotic patients who have or had HCC compared to those without HCC.

Concepts: Virus, Cirrhosis, Hepatitis, Hepatocellular carcinoma, Antiviral drug, Hepatitis C, Hepatitis B, Hepatitis C virus

5

Silymarin is the extract of Silybum marianum, or milk thistle, and its major active compound is silybin, which has a remarkable biological effect. It is used in different liver disorders, particularly chronic liver diseases, cirrhosis and hepatocellular carcinoma, because of its antioxidant, anti-inflammatory and antifibrotic power. Indeed, the anti-oxidant and anti-inflammatory effect of silymarin is oriented towards the reduction of virus-related liver damages through inflammatory cascade softening and immune system modulation. It also has a direct antiviral effect associated with its intravenous administration in hepatitis C virus infection. With respect to alcohol abuse, silymarin is able to increase cellular vitality and to reduce both lipid peroxidation and cellular necrosis. Furthermore, silymarin/silybin use has important biological effects in non-alcoholic fatty liver disease. These substances antagonize the progression of non-alcoholic fatty liver disease, by intervening in various therapeutic targets: oxidative stress, insulin resistance, liver fat accumulation and mitochondrial dysfunction. Silymarin is also used in liver cirrhosis and hepatocellular carcinoma that represent common end stages of different hepatopathies by modulating different molecular patterns. Therefore, the aim of this review is to examine scientific studies concerning the effects derived from silymarin/silybin use in chronic liver diseases, cirrhosis and hepatocellular carcinoma.

Concepts: Antioxidant, Cirrhosis, Hepatitis, Hepatology, Hepatitis C, Non-alcoholic fatty liver disease, Fatty liver, Silybum marianum

5

Non-Hodgkin lymphoma (NHL) is the most common AIDS-defining condition in the era of antiretroviral therapy (ART). Whether chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection promote NHL in HIV-infected patients is unclear.

Concepts: Cirrhosis, Hepatitis, Hepatocellular carcinoma, Antiviral drug, Hepatitis C, Hepatitis B, Hepatitis A, Hepatitis D

5

This study aimed to evaluate the effect of a lay health worker (LHW) telephone intervention on completing a series of hepatitis B virus (HBV) vaccinations among foreign-born Asian Americans in the Baltimore-Washington Metropolitan area.

Concepts: Randomized controlled trial, Cirrhosis, Hepatitis, Hepatitis B, Viruses, Hepatitis B virus, Hepadnaviridae, Hepatitis B vaccine