SciCombinator

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

Concept: Cirrhosis

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The development of non invasive biomarkers of disease has become a major focus of interest in nonalcoholic fatty liver disease (NAFLD). The large prevalence of the disease and the invasive nature of the investigation means that screening with liver biopsy is impractical. In addition to screening, the differentiation of those with simple steatosis vs steatohepatitis and fibrosis is clinically important as the prognosis of each differs. Serum biomarkers may be a combination of simple markers derived from large data sets or direct markers of disease activity. Serum markers of inflammation, apoptosis and oxidative stress in addition to fibrosis have been extensively studied in patients with NAFLD. Other techniques such as transient elastography, magnetic resonance elastography and acoustic radiation force imaging are becoming more established as noninvasive methods of detecting fibrosis in a variety of chronic liver conditions in addition to NAFLD. Newer high throughput methods such as proteomics and glycomics allow the nonhypothesis-driven identification of novel markers and may also potentially contribute to our understanding of the pathogenesis of the condition. This review addresses some of the methodological issues which need to be considered in the search for the ideal biomarker. It is likely that a combination of serum biomarkers and techniques such as transient elastography may provide the optimal diagnostic discrimination however this remains to be proven in large studies.

Concepts: Cancer, Obesity, Cirrhosis, Hepatitis, Metabolic syndrome, Non-alcoholic fatty liver disease, Fatty liver, Steatosis

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To establish a model to predict long-term survival of hepatocellular carcinoma (HCC) patients after liver transplantation (MHCAT).

Concepts: Cancer, Prediction, Futurology, Cirrhosis, Liver, Liver transplantation

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To investigate if loss of epithelial cell adhesion molecule (EpCAM) is associated with microinvasion in hepatocellular carcinomas (HCCs) in the presence of chronic hepatitis B.

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

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To compare the recurrence-free survival (RFS) and overall survival (OS) of hepatitis B virus (HBV)-positive hepatocellular carcinoma (HCC) after living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT).

Concepts: Cancer, Cirrhosis, Hepatitis, Hepatocellular carcinoma, Hepatitis C, Hepatitis B, Hepatitis A, Hepadnaviridae

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Recently, a genome-wide association study conducted in Chinese reported a single nucleotide polymorphism at KIF1B, rs17401966, associated with the susceptibility of hepatitis B virus-related hepatocellular carcinoma. In this study, we aim to investigate the effect of rs17401966 on the prognosis of hepatitis B virus-related hepatocellular carcinoma patients at intermediate or advanced stages.

Concepts: DNA, Genetics, Bioinformatics, Cirrhosis, Hepatitis, SNP array, Genome-wide association study, Hepatitis B

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Chronic passive hepatic congestion (congestive hepatopathy) leads to hepatic fibrosis; however the mechanisms involved in this process are not well understood. We developed a murine experimental model of congestive hepatopathy through partial ligation of the inferior vena cava (pIVCL). C57BL/6 and transgenic mice overexpressing tissue factor pathway inhibitor (SM22α -TFPI) were subjected to pIVCL or SHAM. Liver and blood samples were collected and analyzed in immunohistochemical, morphometric, real-time polymerase chain reaction and western blot assays. Hepatic fibrosis and portal pressure were significantly increased after pIVCL concurrent with hepatic stellate cell (HSC) activation. Liver stiffness, as assessed by magnetic resonance elastography, correlated with portal pressure and preceded fibrosis in our model. Hepatic sinusoidal thrombosis as evidenced by fibrin deposition was demonstrated both in mice after pIVCL as well as in humans with congestive hepatopathy. Warfarin treatment and TFPI overexpression both had a protective effect on fibrosis development and HSC activation after pIVCL. In vitro studies show that congestion stimulates HSC fibronectin (FN) fibril assembly through direct effects of thrombi as well as by virtue of mechanical strain. Pretreatment with either Mab13 or Cytochalasin-D, to inhibit β-integrin or actin polymerization, respectively, significantly reduced fibrin and stretch induced FN fibril assembly. Conclusion: Chronic hepatic congestion leads to sinusoidal thrombosis and strain, which in turn promote hepatic fibrosis. These studies mechanistically link congestive hepatopathy to hepatic fibrosis. (Hepatology 2014;).

Concepts: Gene expression, Molecular biology, Cirrhosis, Vein, Inferior vena cava, Hepatic stellate cell, Factor X, Factor VII

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Liver transplantation (LT) has become an established therapeutic option for patients with acute and chronic liver failure. Overall survival has dramatically increased over the last decades, mainly due to improved surgical techniques, the introduction of new immunosuppressive and anti-infective drugs but also due to continuous progress in the pre- and post-operative intensive care management of these patients.

Concepts: Medicine, Cirrhosis, Liver, Hepatology, Organ transplant, Introduction, Liver transplantation

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Backgrounds/Aims:Serum fibrosis markers such as Enhanced Liver Fibrosis (ELF) test, have been suggested as alternatives for liver biopsy (LB) in assessing liver fibrosis. We investigated the efficacy of ELF test in predicting development of liver-related events (LRE) in patients with chronic hepatitis B (CHB). Methods:A total of 170 patients (103 men, 60.6%) with CHB who underwent LB and serological tests for determining ELF were enrolled. All patients were followed-up to monitor LRE development, defined as hepatic decompensation, hepatocellular carcinoma, and/or liver-related death. Results:The mean age was 45.3 years. During follow-up period (median, 41 months), 39 (22.9%) patients experienced LRE. In patients with LRE, age, proportion of male gender, ELF test results, age-spleen-platelet ratio (ASPRI), liver stiffness (LS) value, and histological fibrosis stage were significantly higher than those in patients without LRE (all P<0.05). Areas under receiver-operating characteristic curves to predict LRE development were 0.808 for ELF test, 0.732 for LS value, 0.713 for histological fibrosis stages using Batts and Ludwig scoring system, and 0.687 for ASPRI. On multivariate analysis, along with age, ELF test was an independent predictor of LRE development (adjusted hazard ratio [HR] 1.438, P<0.001). When we applied a three-tier stratification of our study population using cut-off ELF values of 8.10 and 10.40, patients with low (P=0.002; adjusted HR 0.045, 95% confidence interval [CI] 0.006-0.330) and intermediate (P<0.001; adjusted HR 0.239, 95% CI 0.122-0.469) ELF range were found less likely to develop LRE compared to those with high ELF range. Conclusion:ELF is useful in a non-invasive prediction of LRE development. TE showed statistically similar prognostic performance for LRE as ELF, but other non-invasive tests were inferior. (Hepatology 2014;).

Concepts: Cancer, Cirrhosis, Hepatitis, Liver, Hepatocellular carcinoma, Hepatitis C, Hepatitis B, Hepatitis A

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Use of generic tacrolimus in liver transplantation (LT) could result in cost savings. Generic tacrolimus has been shown to be bioequivalent to innovator tacrolimus in healthy volunteers, and renal transplant patients. There are limited data on the de novo use of generic tacrolimus in LT. This study aimed to determine if the de novo use of generic tacrolimus (Adoport, Sandoz,UK) was associated with differences in outcomes, safety and cost compared to innovator tacrolimus (Prograf, Astellas, Japan).

Concepts: Kidney, Cirrhosis, Liver, Organ transplant, Generic drug, Transplant rejection, Tacrolimus, Astellas Pharma

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The term “hepatic encephalopathy” (HE) covers the neuropsychiatric syndrome associated with acute, chronic and acute-on-chronic liver disease (CLD). This paper deals with clinical features and diagnosis of HE in patients with liver cirrhosis and portal hypertension or porto-systemic shunts. The possible impact of concomitant disorders and the cirrhosis underlying liver disease upon brain function is described emphasizing the need of a detailed diagnostic work up of every individual case before diagnosing HE. Currently used methods for diagnosing minimal or covert hepatic encephalopathy are compared with regard to their sensitivity and specificity for diagnosing HE against the background of a multitude of concomitant disorders and diseases that could contribute to brain dysfunction.

Concepts: Sensitivity and specificity, Cirrhosis, Liver, Hepatology, Hepatic encephalopathy