Therapeutic Effect of Modified Yinchenhao Tang on Cholestatic Liver Disease in Rats / 中国实验方剂学杂志

Objective::To investigate the protective effect of modified Yinchenhao Tang on α-isothiocyanate(ANIT)-induced cholestatic liver disease (CSLD). Method::Wistar rats were randomly divided into 7 groups: blank control group, model control group, compound Glycyrrhizin capsules group(22.5, 45 mg·kg-1), modified Yinchenhao Tang low, middle and high dose groups(4.1, 8.1, 16.2 g·kg-1). A model of cholestatic liver injury was prepared by intragastric administration of ANIT (100 mg·kg-1). Glycyrrhizin capsules and modified Yinchenhao Tang were administered intragastrically on the second day of modeling for 4 consecutive days. And bile duct intubation was performed on the fifth day to measure the bile flow rate of the rats, and serum was taken to test the total bilirubin(TBIL), direct bilirubin(DBIL), indirect bilirubin(IBIL), alanine aminotransferase(ALT) and total bile acid(TBA) serological indicators of each group. Pathological changes of liver tissues were observed by hematoxylin-eosin (HE) staining. The expression levels of G protein-coupled bile acid receptor(TGR5), nucleotide binding oligomerization domain-like receptor 3(NLRP3) and cysteinyl aspartate specific proteinase-1(Caspase-1) proteins in the iver tissues were detected by Western blot. Result::Compared with the blank control group, bile flow rate in the model group decreased significantly(P<0.01). TBIL, DBIL, IBIL, ALT and TBA level in serum were significantly increased(P<0.01), liver tissue lesions were severe, and significantly increased the expression of liver tissue TGR5 and Caspase-1.Compare with model group, the compound Glycyrrhizin capsules group had no significant effect on bile flow rate and TBIL, DBIL, IBIL, ALT and TBA level in serum. Bile flow rate increased and TBIL, DBIL, IBIL, ALT and TBA level in serum decreased significantly in modified Yinchenhao Tang high dose group. The compound Glycyrrhizin capsules group and modified Yinchenhao Tang group have different extents of improvement the pathological changes of the lung tissues, and the protein expression of TGR5 and Caspase-1 were significantly decreased in the liver tissue(P<0.01). Conclusion::Modified Yinchenhao Tang can effectively treat CSLD in rats, and its mechanism may be related to bile acid and bile acid receptor TGR5-mediated inflammatory factors.

Nutritional management of infantile cholestatic liver disease / 中华实用儿科临床杂志

Cholestatic liver disease is the most common type of infantile liver disease,and malnutrition is very common in infantile cholestatic liver disease,which may seriously affect the growth and development of infants,and even lead to neuro-cognitive impairment.Some children with chronic cholestatic liver disease need liver transplantation at the end of the disease,while malnutrition might cause more complications and higher mortality.In order to improve the prognosis,active and appropriate nutritional management is considerably needed.

Treatment of infantile cholestatic hepatopathy / 中国小儿急救医学

Cholestatic liver disease is one of the common reason of infant jaundice,and with numer-ous etiology and complicated pathogenesis. The treatment of cholestatic hepatopathy concentrates on promo-ting the recovery of liver function,improving bile acid flow,preventing metabolic disorders,reducing occur-rence of complications,finaly improving the quality of life. This review mainly summarized the recent treat-ment progress of infant cholestatic liver disease.

Severe liver dysfunction in an infant with cystic fibrosis masquerading as metabolic liver disease.

We present a rare presentation of cystic fibrosis with neonatal cholestasis. Histological features of mucoviscidosis were present in liver involving the biliary tract, intestinal mucosa, pancreas, and lung. Besides, there was a rare association with autosomal dominant type of polycystic renal disease.

Cyclooxygenase-2 Inhibitor Reduces Hepatic Stiffness in Pediatric Chronic Liver Disease Patients Following Kasai Portoenterostomy

PURPOSE: The purpose of this study was to define the role of cyclooxygenase-2 inhibitors (COX-2i) in reducing hepatic fibrosis in pediatric patients with chronic liver disease. MATERIALS AND METHODS: From September 2009 to September 2010, patients over 2 years old who visited our outpatient clinic for follow-up to manage their chronic liver disease after Kasai portoenterostomy for biliary atresia, were included in this study. Volunteers were assigned to the study or control groups, according to their preference. A COX-2i was given to only the study group after obtaining consent. The degree of hepatic fibrosis (liver stiffness score, LSS) was prospectively measured using FibroScan, and liver function was examined using serum analysis before and after treatment. After 1 year, changes in LSSs and liver function were compared between the two groups. RESULTS: Twenty-five patients (18 females and 7 males) were enrolled in the study group. The control group included 44 patients (26 females and 18 males). After 1 year, the least square mean values for the LSSs were significantly decreased by 3.91±0.98 kPa (p=0.004) only in the study group. Serum total bilirubin did not decrease significantly in either group. CONCLUSION: COX-2i treatment improved the LSS in patients with chronic liver disease after Kasai portoenterostomy for biliary atresia.

Effect of probiotics on intestinal flora and related cytokines in infants with cholestatic liver disease / 中华实用儿科临床杂志

Objective To explore the effects of application of probiotics on intestinal flora and related cytokines in infants with cholestatic liver disease.Methods (1) Eighty-four infants with cholestatic liver disease had been hospitalized from October 2010 to June 2011 in the First Hospital of Guangxi Medical University.The infants with cholestatic liver disease were randomly divided into the probiotic intervention group and the non-probiotic intervention group.Quantification of intestinal bacteria was detected by SYBR Green Ⅰ real-time fluorescent quantitative polymerase chain reaction,then the number of 3 kinds of bacteria before and after the treatment was compared.(2) The indices of liver function,blood ammonia,cholesterol were detected.The levels of serum transforming growth factor-β1,tumor necrosis factor-α(TNF-α)and interleukin-6 (IL-6) were measured by enzyme linked immunosorbent assay.Results (1) The number of bifidobacterium,lactobacillus and bifidobacterium/escherichia coli (B/E) were significantly increased (all P ＜ 0.01),whereas the number of escherichia coli was significantly decreased in the probiotic intervention group(P ＜ 0.05),however,there were no differences in the non-probiotic intervention group(all P ＞ 0.05).(2)The indices of total billirubin,direct billirubin,γ-Glutamyltransferase,total bile acid,alanine aminotransferase,blood ammonia,alkaline phosphatase were significantly improved after therapy in 2 groups (all P ＜ 0.05).The levels of TNF-α and IL-6 were significantly decreased in the probiotic intervention group (t--7.31,P =0.00;t =-2.90,P =0.01),but there were no differences in the non-probiotic intervention group.The level of BA was significantly decreased in the probiotic intervention group than the non probiotic intervention group (t =-8.37,P =0.00).(3) The B/E value were significantly inverse correlated with level of serum IL-6 (r =-0.796,P =0.01).Conclusions It may help to restore the intestinal flora and balance the immune function in infants with cholestatic liver disease after application of probiotics.

Research progress on Nrf2-ARE signaling pathway involved in liver disease pathological mechanism / 中国药理学通报

Nuclear factor erythroid-2 related factor 2 ( Nrf2 ) is an important nuclear transcription factor which protects cells a-gainst oxidative stress injury. Upon exposure to reactive oxygen species ( ROS) or electrophilic stress, Nrf2 can translocate into the nucleus, and then bind to the antioxidant response element ( ARE) , regulating the expression of several antioxidant enzymes and phase Ⅱ detoxifying enzymes which aimed at the detoxifica-tion and elimination of harmful exogenous chemicals, resulting in the facilitation of hepatoprotection. Oxidative stress is the com-mon pathogenesis of many liver diseases, while the Nrf2-ARE signaling pathway is extremely important in the prevention and progression of many liver diseases. Nrf2 has more recently been implicated as a new therapeutic target in treating liver diseases. Here, we focus on the most common liver diseases and the devel-opment of these conditions where activation of Nrf2 may alleviate disease progression, so as to provide reference for related re-search in the future.

Research progress in role and mechanism of endogenous cannabinoid system in hepatic disease / 中国药学杂志

OBJECTIVE: To analyze recent studies on the role of the endocannabinoid system in liver disease and related mechanism. METHODS: Reading domestic and international documents in recent years, we concluded a comprehensive integrated about them. RESULTS: This paper reviews the important role of the endocannabinoid in the development of liver disease, which focuses on the prevention and protection of the endocannabinoid on viral hepatitis, alcoholic fatty liver disease, non-alcoholic fatty liver disease, cholestatic liver disease and liver ischemia-reperfusion injury and the development of hepatic fibrosis and hepatic encephalopathy. CONCLUSION: Endocannabinoid system plays an important role in the treatment of liver disease. But for its complex mechanism of action, we need further research.

Living Donor Liver Transplantation for an Infant with Osteogenesis Imperfecta and Intrahepatic Cholestasis: Report of a Case

Osteogenesis imperfecta (OI) is a group of genetic disorders characterized by bone fragility and connective tissue manifestations. We report a successful liver transplantation (LT) in an 8-month-old boy with OI and cholestatic biliary cirrhosis. After 4 cycles of intravenous pamidronate, LT was performed under intravenous anesthesia using a left lateral section from his mother without mechanical retractors. The operation time was 420 min and estimated blood loss was 520 mL requiring one unit of RBC transfusion. He was discharged without surgical complications. Therefore, LT should be considered for patients with end stage liver disease and OI under organic multidisciplinary cooperation.

The nutritional therapy of cholestatic liver disease in infants / 临床儿科杂志

There are various causes of cholestatic liver disease in infants that include extrahepatic biliary tract diseases, liver diseases, anatomical abnormality, metabolic or endocrine diseases, poisoning, infection, and so on. The causes leads to re-duction or interruption in bile lfow and thus results in nutrients malabsorption and comprehensive metabolic disorder. The aims of nutritional therapy for cholestatic liver disease are to reduce the risk of cholestasis related complications, to promote recov-ery of liver diseases, to restore bile flow, to promote growth and improve the comprehensive metabolic disorders, to improve quality of life and to prepare children for liver transplantation.