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1.
Braz. j. biol ; 84: e253061, 2024. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1364520

ABSTRACT

Liver fibrosis is initial stage of any chronic liver disease and its end stage is develops into cirrhosis. Chronic liver diseases are a crucial global health issue and the cause of approximately 2 million deaths per year worldwide. Cirrhosis is currently the 11th most common cause of death globally. Mesenchymal stem cell (MSCs) treatment is the best way to treat acute and chronic liver disease. The aim of this study is to improve the therapeutic potential of MSCs combined with melatonin (MLT) to overcome CCl4-induced liver fibrosis and also investigate the individual impact of melatonin and MSCs against CCl4-induced liver impairment in animal model. Female BALB/c mice were used as CCL4-induced liver fibrotic animal model. Five groups of animal model were made; negative control, Positive control, CCl4+MSCs treated group, CCl4+MLT treated group and CCl4+MSCs+MLT treated group. Cultured MSCs from mice bone marrow were transplanted to CCl4-induced liver injured mice model, individually as well as together with melatonin. Two weeks after MSCs and MLT administration, all groups of mice were sacrificed for examination. Morphological and Histopathological results showed that combined therapy of MSCs+MLT showed substantial beneficial impact on CCl4-induced liver injured model, compared with MSCs and MLT individually. Biochemically, considerable reduction was observed in serum bilirubin and ALT levels of MLT+MSC treated mice, compared to other groups. PCR results shown down-regulation of Bax and up-regulation of Bcl-xl and Albumin, confirm a significant therapeutic effect of MSCs+MLT on CCI4-induced liver fibrosis. From the results, it is concluded that combined therapy of MSCs and MLT show strong therapeutic effect on CCL4-induced liver fibrosis, compared with MSCs and MLT individually.


A fibrose hepática é a fase inicial de qualquer doença hepática crônica, e em sua fase final desenvolve-se para cirrose. As doenças hepáticas crônicas são uma questão de saúde global crucial e a causa de aproximadamente 2 milhões de mortes por ano em todo o mundo. A cirrose, hoje em dia, é a 11ª causa mais comum de morte globalmente. O tratamento da célula-tronco mesenquimal (MSCs) é uma maneira eletiva de tratar a doença hepática aguda e crônica. O objetivo deste estudo é melhorar o potencial terapêutico dos MSCs combinados com a melatonina (MLT) para superar a fibrose hepática induzida por CCl4 e também investigar o impacto individual da melatonina e MSCs contra o comprometimento do fígado induzido por CCl4 no modelo animal. Os ratos BALB / C fêmeas foram usados ​​como modelo de animal fibrótico de fígado induzido por CCl4. Cinco grupos de modelo animal foram feitos: Controle Negativo, Controle Positivo, CCl4 + MSCs Tratados Grupo, Grupo Tratado CCl4 + MLT e Grupo Tratado CCl4 + MSCs + MLT. MSCs cultivados da medula óssea dos ratos foram transplantados para o modelo de camundongos de fígado induzido por CCl4, individualmente, bem como em conjunto com a melatonina. Duas semanas após a administração MSCs e MLT, todos os grupos de camundongos foram sacrificados para o exame. Os resultados morfológicos e histopatológicos mostraram que a terapia combinada do MSCs + MLT mostrou impacto benéfico substancial no modelo ferido no fígado induzido pelo CCl4, em comparação com o MSCs e o MLT individualmente. A redução bioquimicamente considerável foi observada em bilirrubina sérica e níveis ALT de ratinhos tratados com MLT + MSCs, em comparação com outros grupos. Os resultados de PCR mostraram regulação negativa do BAX e regulação positiva do BCL-XL e da albumina, confirmando um efeito terapêutico significativo do MSCs + MLT na fibrose hepática induzida por CCl4. Dos resultados, conclui-se que a terapia combinada de MSCs e MLT mostram um forte efeito terapêutico na fibrose hepática induzida por CCl4, em comparação com MSCs e MLT individualmente.


Subject(s)
Rats , Stem Cells , Fibrosis , Liver , Liver Diseases , Melatonin
3.
Rev. colomb. gastroenterol ; 37(2): 136-143, Jan.-June 2022. tab, graf
Article in English, Spanish | LILACS | ID: biblio-1394942

ABSTRACT

Abstract Introduction: Cirrhosis of the liver is a significant cause of morbidity and mortality in Latin America; the increased prevalence of metabolic syndrome in our population could be changing the epidemiological profile of patients with advanced chronic liver disease. Aim: To characterize a group of patients with cirrhosis of the liver at an outpatient hepatology care center in Cartagena de Indias, Colombia, and determine the contribution of nonalcoholic steatohepatitis (NASH) as an etiological factor in this population. Materials and methods: Retrospective, cross-sectional, analytical study. All patients who attended the hepatology follow-up with a diagnosis of cirrhosis of the liver were in the six-monthly follow-up protocol that included screening for hepatocellular carcinoma (HCC) and esophageal varices. Results: 346 patients were included, most were women (54.3 %). The first and second causes of cirrhosis were cryptogenic (35 %) and NASH (30.9 %), respectively, followed by viral hepatitis (17 %) and autoimmune diseases (9 %). Of these patients, 87.4 % were within categories A and B of the Child-Turcotte-Pugh score, and only 12.5 % (33 patients) were in stage C. Also, 60 % had at least one clinical decompensation, 38 % a history of variceal hemorrhage, and 4 % a diagnosis of HCC; 80.6 % of patients with NASH cirrhosis had diabetes, and 46.7 % were overweight. Conclusion: NASH cirrhosis is an emerging cause of advanced chronic liver disease in Colombia.


Resumen Introducción: la cirrosis hepática es una importante causa de morbimortalidad en América Latina; el incremento de la prevalencia del síndrome metabólico en nuestra población podría estar cambiando el perfil epidemiológico de los pacientes con enfermedad hepática crónica avanzada. Objetivos: caracterizar un grupo de pacientes con cirrosis hepática y determinar la contribución de la esteatohepatitis no alcohólica (NASH) como factor etiológico de esta población en la ciudad de Cartagena de Indias, Colombia, en un centro de atención ambulatoria de hepatología. Métodos: estudio retrospectivo, transversal, analítico. Se incluyeron todos los pacientes que acudieron al seguimiento de hepatología con diagnóstico de cirrosis hepática que se encontraban en el protocolo de seguimiento semestral que incluía el cribado de hepatocarcinoma y várices esofágicas. Resultados: se incluyeron 346 pacientes. La mayoría fueron mujeres (54,3 %). La primera y segunda causa de cirrosis fue la criptogénica (35 %) y la NASH (30,9 %), respectivamente; seguidas de las hepatitis virales (17 %) y enfermedades autoinmunes (9 %). De estos pacientes, el 87,4 % se encontraba dentro de las categorías A y B de la escala pronóstica de Child-Turcotte-Pugh, y solo el 12,5 % (33 pacientes) en estadio C. El 60 % había presentado al menos una descompensación clínica, 38 % tenía antecedentes de hemorragia por várices y 4 %, diagnóstico de hepatocarcinoma. El 80,6 % de los pacientes con cirrosis NASH era diabético y el 46,7 % tenía exceso de peso. Conclusión: La cirrosis NASH es una causa emergente de enfermedad hepática crónica avanzada en Colombia.


Subject(s)
Humans , Male , Female , Metabolic Syndrome , Non-alcoholic Fatty Liver Disease , Liver , Liver Cirrhosis , Varicose Veins , Hepatitis , Liver Diseases
4.
Rev. colomb. gastroenterol ; 37(2): 193-199, Jan.-June 2022. tab, graf
Article in English, Spanish | LILACS | ID: biblio-1394948

ABSTRACT

Abstract Introduction: Severe acute respiratory syndrome type 2 coronavirus infection (SARS-CoV-2) is receiving the most attention now. The asymptomatic elevation of transaminases is typical in the liver, and liver involvement varies from 14 % to 78 %. The assessment of liver comorbidities is scarce, with prevalence ranging between 2 % and 11 %. Aim: To describe the behavior of a cohort of patients with liver diseases who fell ill with coronavirus disease 2019 (COVID-19). Materials and methods: This retrospective observational study analyzed the behavior of a cohort of patients with liver diseases who fell ill with COVID-19. Results: 543 patients became ill with COVID-19, of which 300 were women (55.3 %). The median age at diagnosis of liver disease was 52 years. The leading causes of liver disease were nonalcoholic steatohepatitis (49.5 %), cholestatic disease (7.7 %), and hepatitis C and B viruses (6.3 %). Alanine aminotransferase (ALT) had a median of 52 U/L (interquartile range [IQR]: 30-98) and aspartate aminotransferase (AST) 32 U/L (IQR: 23-62). Mortality due to viral infection was 5.7 %, with an incidence rate of 2.9 (95 % confidence interval [CI]: 2-4.2). Conclusions: It is a retrospective study but, until the preparation of the manuscript, it had been the first cohort in Colombia to describe the behavior of liver diseases in patients who become ill with COVID-19. No statistically significant differences were found between the causes of liver disease that confer a higher risk of mortality; however, having decompensated cirrhosis is the only condition related to mortality.


Resumen Introducción: la infección por coronavirus del síndrome respiratorio agudo grave de tipo 2 (SARS-CoV-2) concentra la mayor atención en el momento. En el hígado es frecuente la elevación asintomática de transaminasas y la afectación hepática varía del 14 % al 78 %. La evaluación de las comorbilidades hepáticas es escasa, con prevalencias que oscilan entre el 2 % y el 11 %. Objetivo: describir el comportamiento de una cohorte de pacientes con enfermedades hepáticas que presentaron el coronavirus de 2019 (COVID-19). Materiales y métodos: estudio observacional retrospectivo que analizó el comportamiento de una cohorte de pacientes con hepatopatías que enfermaron por COVID-19. Resultados: 543 pacientes padecieron por COVID-19, de los cuales 300 fueron mujeres (55,3 %). La mediana de edad al diagnóstico de la enfermedad hepática fue de 52 años. Las principales causas de las hepatopatías fueron esteatohepatitis no alcohólica (49,5 %), enfermedad colestásica (7,7 %), virus de la hepatitis C y B (6,3 %). La alanina-aminotransferasa (ALT) presentó una mediana de 52 U/L (rango intercuartílico [RIC]: 30-98) y aspartato-aminotransferasa (AST) 32 U/L (RIC: 23-62). La mortalidad por la infección viral fue del 5,7 % con una tasa de incidencia de 2,9 (intervalo de confianza [IC] 95 %: 2-4,2). Conclusiones: es un estudio de carácter retrospectivo; sin embargo, hasta la elaboración del manuscrito es la primera cohorte en Colombia en describir el comportamiento de las enfermedades hepáticas en pacientes que enferman de COVID-19. No se encontraron diferencias estadísticamente significativas entre las causas de hepatopatía que confieran un mayor riesgo de mortalidad; sin embargo, tener una descompensación de cirrosis es la única condición que tiene una relación con la mortalidad.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Fibrosis , Retrospective Studies , SARS-CoV-2 , COVID-19 , Prevalence , Causality , Mortality , Hepatitis C , Diagnosis , Non-alcoholic Fatty Liver Disease , Liver Diseases
5.
Medicina UPB ; 41(1): 3-11, mar. 2022. tab
Article in English | LILACS, COLNAL | ID: biblio-1362378

ABSTRACT

Objetivo: este estudio busca describir los individuos evaluados por sobredosis de acetaminofén entre 2019 y 2020 en un centro de referencia de trasplante hepático en Colombia. Metodología: estudio derivado del análisis secundario de historias clínicas entre el 1.º de enero de 2019 y el 31 de diciembre de 2020. Los criterios de inclusión abarcan individuos con ingestión aguda y voluntaria de dosis tóxicas de acetaminofén (>4 g/día). Resultados: sesenta y tres casos, 68% mujeres, 67% menores de 18 años y 54% estudiantes. Reportó historia personal de enfermedad psiquiátrica el 60% y el 35% al menos un intento de suicidio previo. La mediana de dosis de acetaminofén fue 15g, 46% refirieron co-ingesta de otras sustancias y 13% estaba bajo efecto de sustancias psicoactivas. El 57% tenía la intención clara de suicidarse, así como 81% vomitó antes de acudir al servicio de urgencias, 22% recibió medidas de descontaminación y 10% no recibió N - acetilcisteína. Quince individuos desarrollaron lesión hepática aguda, nueve con criterios de severidad. Conclusiones: la población era predominantemente joven, la historia de enfermedad psiquiátrica fue muy prevalente y la mayoría refirieron un evento vital que explicara el comportamiento impulsivo de consumo. Ninguno desarrolló criterios para trasplante hepático, lo cual podría explicarse por la edad de los individuos, los episodios de vómito temprano, y la ausencia de enfermedad hepática crónica o de consumo de sustancias hepatotóxicas.


Objective: this study aims to describe patients with overdose intake of acetaminophen between 2019 and 2020 at a reference center for liver transplantation in Colombia. Methodology: study derived from a secondary analysis of the clinical records between January 1st, 2019, to December 31st, 2020. Inclusion criteria were individuals with voluntary acute ingestion of toxic doses of acetaminophen (>4 g/day). Results: sixty-three cases, 68% women, 67% <18-year-old, and 54% students. 60% had personal history of psychiatric illness and 35% reported at least one previous suicide attempt. The median dose of acetaminophen was 15g, 46% referred to co-ingestion with other substances and 13% were under the effect of any psychoactive substance. 57% had a clear intention of suicide. 81% vomited before the arrival to the emergency room, 22% received decontamination intervention with gastric lavage or activated charcoal, and 10% did not receive any dose of N-Acetylcysteine. Fifteen individuals developed an acute liver injury, nine with severity criteria. Conclusions: the population was predominantly young, the personal history of psychiatric disease was highly prevalent, and most of the cases referred a vital event that explains the impulsive behavior in acetaminophen consumption. None developed criteria for liver transplantation, and this could be explained by the young age of the individuals, the episodes of early vomiting, and the absence of chronic liver disease or hepatotoxic substance consumption.


Objetivo:este estudo busca descrever os indivíduos avaliados por sobredose de acetaminofen entre 2019 e 2020 num centro de referência de transplante hepático na Colômbia. Metodologia: estudo derivado da análise secundário de histórias clínicas entre o dia 1.º de janeiro de 2019 e 31 de dezembro de 2020. Os critérios de inclusão abrangem indivíduos com ingestão aguda e voluntária de dose tóxicas de acetaminofen (>4 g/dia).Resultados:sessenta e três casos, 68% mulheres, 67% menores de 18 anos e 54% estudantes. Reportou história pessoal de doença psiquiátrica, 60% e 35% pelo menos uma tentativa de suicídio prévio. A média de dose de acetaminofen foi de 15g, 46% referiram com ingestão de outras sustâncias e 13% estava sob efeito de sustâncias psicoativas. 57% tinham a intenção clara de suicidar-se, assim como 81% vomitou antes de acudir ao serviço de urgências, 22% receberam medidas de descontaminação e 10% não recebeu N - acetilcisteína. Quinze indivíduos desenvolveram lesão hepática aguda, nove com critérios de severidade. Conclusões: a população era predominantemente jovem, a história de doençapsiquiátrica foi muito prevalente e a maioria referiram um evento vital que explicasse o comportamento impulsivo de consumo. Nenhum desenvolveu critérios para transplantehepático, o qual se poderia explicar pela idade dos indivíduos, os episódios de vómito precoce, e a ausência de doença hepática crónica ou de consumo de sustâncias hepatotóxicas.


Subject(s)
Humans , Acetaminophen , Acetylcysteine , Suicide, Attempted , Vomiting, Anticipatory , Charcoal , Decontamination , Emergency Service, Hospital , Dosage , Gastric Lavage , Liver Diseases , Mental Disorders
6.
Rev. colomb. gastroenterol ; 37(1): 24-32, Jan.-Mar. 2022. tab, graf
Article in English | LILACS | ID: biblio-1376902

ABSTRACT

Abstract Introduction: Cirrhosis is the final stage of chronically progressive liver diseases of various etiologies. It is a common disease, with a variable prevalence in each country. Its peak incidence occurs between 40 and 50 years of age, predominantly in men. Aims: To compare a cohort of patients diagnosed with cirrhosis, evaluate their complications and survival according to etiology, describe clinical and laboratory aspects, and determine the role of a fatty liver. Materials and methods: A retrospective cohort study was carried out with patients who held a specialized hepatology consultation in the center of liver and digestive diseases (CEHYD) in Bogotá, Colombia, between January 2010 and June 2019. Results: We reviewed a total of 1,200 medical records (56.8 % women). There were no statistically significant differences in median survival between groups by etiology, sex, presence or absence of complications, or Child. We noted that the older the age at the diagnosis of cirrhosis, the higher the risk of death; HR 1.04 (95 % CI 1.02-1.075). For each month that follow-up increases, the risk of death decreases by 90 %; HR 0.1 (95 % CI 0.03-0.29). For each month that the follow-up of complications increases, the risk of death is reduced by 2 %; HR 0.98 (95 % CI 0.97-0.99). Conclusions: Survival by etiology was similar in the different groups. Nonalcoholic steatohepatitis (NASH) was the leading cause of cirrhosis in this cohort. Efforts should focus on its diagnosis and management in the early stages.


Resumen Introducción: la cirrosis es el estadio final de enfermedades hepáticas crónicamente progresivas de diferentes etiologías. Es una enfermedad frecuente, con una prevalencia variable en cada país. Su pico de incidencia se presenta entre los 40 y 50 años, predominantemente en hombres. Objetivos: comparar una cohorte de pacientes con diagnóstico de cirrosis, evaluar sus complicaciones y sobrevida de acuerdo con su etiología, describir los aspectos clínicos y de laboratorio, y determinar el papel del hígado graso. Materiales y métodos: se realizó un estudio de cohorte retrospectiva, en donde se incluyeron pacientes que asistieron a consulta especializada de hepatología en el centro de enfermedades hepáticas y digestivas (CEHYD), en la ciudad de Bogotá, durante enero de 2010 y junio de 2019. Resultados: se revisaron un total de 1200 historias clínicas (56,8 % mujeres). No se evidenció diferencias estadísticamente significativas en las medianas de sobrevida entre los grupos por etiologías, sexo, presencia o no de complicaciones, o Child. Se evidenció que entre mayor edad en el diagnóstico de cirrosis, el riesgo de muerte es mayor; HR 1,04 (IC 95 % 1,02-1,075). Por cada mes que aumenta el seguimiento se reduce el riesgo de muerte en 90 %; HR 0,1 (IC 95 % 0,03-0,29). Por cada mes que aumenta el seguimiento de las complicaciones se reduce el riesgo de muerte en 2 %; HR 0,98 (IC 95 % 0,97-0,99). Conclusiones: La sobrevida por etiología fue similar en los diferentes grupos. La esteatohepatitis no alcohólica (NASH) fue la principal causa de cirrosis en esta cohorte. Se deben orientar esfuerzos a su diagnóstico y manejo en fases tempranas.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Survival , Fibrosis , Fatty Liver , Non-alcoholic Fatty Liver Disease , Patients , Medical Records , Disease , Incidence , Cohort Studies , Death , Liver Diseases
8.
Rev. Eugenio Espejo ; 16(1): 39-49, 20220111.
Article in Spanish | LILACS | ID: biblio-1352995

ABSTRACT

La hepatopatía crónica más prevalente en el mundo es la esteatosis hepática no alcohólica. Así, se realizó una investigación con el objetivo de determinar los factores asociados a esa patología en pacientes atendidos en el Centro de salud tipo B Chambo, Ecuador, durante 2020. Se realizó un estudio con enfoque cuantitativo, de tipo no experimental, correlacional y retrospectivo. Las historias clínicas seleccionadas aportaron los datos de las variables de interés. La media de la edad de los involucrados fue de 54,43 ± 8,10 años. El 60,38% tenía hipertensión arterial, el 52,83% diabetes mellitus, el 62,26% sobrepeso u obesidad y el 49,06% dislipidemia, determi-nando que estas comorbilidades tuvieron una relación significativa con la enfermedad objeto de estudio, la que resultó más incidente en edades mayores de 50 años. Las personas sedentarias o con bajos niveles de actividad física mostraron de ALT y AST.


The most prevalent chronic liver disease in the world is nonalcoholic fatty liver disease. Thus, research aimed to determine the factors associated with this pathology in patients treated at the Type B Chambo Health Center, Ecuador, during 2020. A study was carried out with a quantitati-ve, non-experimental, correlational, and retrospective approach. The selected medical records provided the information for the variables of interest. The mean age of the population was 54.43 ± 8.10 years of age. 60.38% had arterial hypertension, 52.83% diabetes mellitus, 62.26% overweight or obesity and 49.06% dyslipidemia. It was determined that these comorbidities had a significant relationship with the disease under study, which was more incident in ages older than 50. Sedentary people or those ones with low levels of physical activity showed ALT and AST.


Subject(s)
Humans , Male , Female , Middle Aged , Comorbidity , Abiotic Factors , Liver Diseases , Exercise , Cholesterol , Overweight
9.
Hepatología ; 3(2): 143-154, 2022. ilus, tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1396059

ABSTRACT

La enfermedad COVID-19, causada por el coronavirus tipo 2 (SARS-CoV-2), ha tenido un gran impacto en la salud a nivel mundial. A pesar de considerarse una enfermedad principalmente respiratoria, el virus SARS-CoV-2 también es responsable de otro tipo de manifestaciones extrapulmonares, como son las enfermedades hepatobiliares. En esta revisión se describen los posibles mecanismos de patogénesis implicados en la lesión hepática causada por el SARS-CoV-2. Adicionalmente, se analiza la relación entre COVID-19 y la enfermedad hepática crónica, las implicaciones que tiene en el carcinoma hepatocelular y en el trasplante hepático, así como las recomendaciones para la vacunación contra el SARS-CoV-2 en los pacientes afectados por enfermedad hepática. Por último, se proponen algunas estrategias para superar el reto al que se enfrenta el médico en el manejo delos pacientes con enfermedades hepatobiliares y COVID-19.


COVID-19, caused by the type 2 coronavirus (SARS-CoV-2), has had a major impact on health worldwide. Despite being mainly a respiratory disease, the SARS-CoV-2 virus is also responsible for other types of extrapulmonary manifestations, such as hepatobiliary diseases. This review describes the possible mechanisms of pathogenesis involved in liver injury caused by SARS-CoV-2, the relationship between COVID-19 and chronic liver disease, the effects that it has on hepatocellular carcinoma and liver transplantation, as well as the recommendations for vaccination against SARS-CoV-2 in patients affected by liver disease. Finally, some strategies are suggested to overcome the challenge faced by the clinician in the management of patients with hepatobiliary disease and COVID-19.


Subject(s)
Humans , SARS-CoV-2 , COVID-19 , Liver Diseases , Vaccination , Carcinoma, Hepatocellular , Digestive System Diseases , Liver
10.
Hepatología ; 3(2): 191-202, 2022. ilus, tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1396103

ABSTRACT

ntroducción. El glutamato es un aminoácido que está implicado en numerosas reacciones relacionadas con el metabolismo hepático, por lo que la sobreactivación de los receptores de glutamato por acción de la ingesta de glutamato monosódico (GMS) proveniente de la dieta, podría llevar a daño del tejido hepático. Este estudio se realizó con el objetivo de evaluar los cambios histológicos producidos en el hígado de ratas sometidas a la administración crónica de GMS. Metodología. Se trabajó con dos lotes de animales, uno experimental y otro control, cada uno de ellos constituido por seis ratas machos cepa Wistar de cinco semanas de edad. Al grupo experimental se le administró diariamente 0,1 g de queso de bajas calorías que contenía GMS monohidrato de 99% de pureza (grado alimentario puro), diluido en 50 µL de agua desionizada (0,3 g/100 g de peso corporal). Al grupo control se le administró la misma cantidad de sodio que el que contenía el GMS del grupo tratado, pero bajo la forma de NaCl. Al concluir el tratamiento, las ratas pertenecientes a ambos grupos se pesaron y sacrificaron, y se les extrajo el hígado para el estudio histológico. Se obtuvieron cortes histológicos que fueron coloreados con hematoxilina-eosina, PAS y coloración con tricrómico de Masson. El análisis de los cortes histológicos se llevó a cabo por observación directa en microscopio óptico con objetivo de 40x. Resultados. Se observó en general, conservación y apariencia normal de las características histológicas de los acinos hepáticos en el grupo control, en tanto que el hígado de las ratas tratadas con GMS presentó diferentes grados de degeneración hidrópica, cantidades variables de cuerpos hialinos eosinófilos, infiltración inflamatoria de células mononucleares y necrosis focal, principalmente en la zona 1 del acino hepático. Conclusión. Los resultados encontrados permiten aportar evidencias en torno a las alteraciones histopatológicas que la ingesta crónica de GMS provoca sobre el tejido hepático. Se recomienda alertar a la población para reducir la ingesta de alimentos que poseen GMS como saborizante.


Introduction. Glutamate is an amino acid that is involved in numerous reactions related to liver metabolism, so the overactivation of glutamate receptors due to the ingestion of monosodium glutamate (MSG) from the diet could lead to liver tissue damage. The aim of this study was to evaluate the histological changes produced in the liver of rats subjected to chronic administration of MSG. Methodology. Two sets of animals were used, an experimental and a control group, each consisting of six five-week-old Wistar male rats. The experimental group was administered 0.1 g of low-calorie cheese containing 99% purity MSG monohydrate (pure food grade) diluted in 50 µL of deionized water (0.3 g/100 g of weight) daily. The control group was administered the same amount of sodium as that contained in the MSG of the treated group, but in the form of NaCl. At the end of the treatment, the rats belonging to both groups were weighed and sacrificed, and their liver was removed for histological analysis. Histological sections were obtained and stained with hematoxylineosin, PAS and Masson's trichrome. The analysis of the histological sections was carried out by direct observation with an optical microscope and a 40x objective. Results. In general, conservation and normal appearance of the histological characteristics of the liver acini were observed in the control group, while the liver of the rats treated with MSG presented different degrees of hydropic degeneration, variable amounts of eosinophilic hyaline bodies, inflammatory infiltration of mononuclear cells and focal necrosis, that affected mainly zone 1 of the liver acinus. Conclusion. The results allow us to provide evidence about the histopathological alterations that the chronic intake of MSG causes on the liver tissue. It is recommended to alert the population to reduce the intake of foods that have GMS for flavoring.


Subject(s)
Animals , Sodium Glutamate , Liver Diseases , Toxicity , Liver
11.
Hepatología ; 3(1): 29-39, 2022. ilus, tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1396214

ABSTRACT

La hepatopatía congestiva comprende el espectro de manifestaciones a nivel del hígado, con injuria inducida como consecuencia de la congestión venosa hepática por una alteración en el flujo venoso del tracto de salida hepático. La etiología más frecuente es la falla cardiaca derecha, que por aumento de la presión venosa central, lleva retrógradamente al aumento de la presión venosa hepática, disminución del flujo hepático y disminución de la saturación de oxígeno, con congestión a nivel sinusoidal y particular compromiso de los hepatocitos de la zona 3. Generalmente tiene una presentación subclínica en cuanto a manifestaciones hepáticas que son enmascaradas por los signos y síntomas de falla cardiaca. El diagnóstico comprende la suma de hallazgos serológicos, imagenológicos e histológicos, luego de una exclusión de otras patologías con posible injuria hepática. El tratamiento se basa en el manejo de la falla cardiaca de base, y el pronóstico a su vez, queda supeditado a la fase de la enfermedad cardiaca de base. Se realizó una búsqueda de la literatura con el fin de construir una revisión de esta entidad, con conceptos actualizados a partir de la evidencia reciente.


Congestive liver disease comprises the spectrum of manifestations secondary to liver injury as a consequence of hepatic venous congestion due to a disturbance in the hepatic venous outflow. The most frequent cause is right heart failure, which, due to an increase in central venous pressure, leads retrogradely to an increase in hepatic venous pressure, a decrease in liver inflow and a decrease in oxygen saturation, with sinusoidal congestion and characteristic compromise of zone 3 hepatocytes. Its presentation is usually subclinical in terms of liver manifestations, masked by the signs and symptoms of heart failure. The diagnosis includes the sum of serological, imaging and histological findings, after exclusion of other entities involving liver injury. Treatment is based on the management of the underlying heart failure and the prognosis is as well dependent on the stage of the underlying heart disease. A literature search was carried out in order to create a review of this entity with updated concepts based on recent evidence.


Subject(s)
Cardiomyopathy, Dilated , Liver Diseases , Central Venous Pressure , Heart Transplantation , Heart Diseases , Heart Failure
12.
Hepatología ; 3(1): 40-56, 2022. ilus, tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1396216

ABSTRACT

El trasplante de hígado es el último recurso para el tratamiento de hepatopatías. Para evitar el rechazo del injerto se requieren esquemas de inmunosupresión que han ido evolucionando a lo largo de los años. Se realizó una revisión bibliográfica en la base de datos PubMed sobre las terapias inmunosupresoras disponibles para evitar el rechazo del injerto en el trasplante hepático, los esquemas utilizados, efectos adversos, interacciones y sus modificaciones desde la fase de inducción hasta el seguimiento posterior. Se encontró que la inducción habitual es con esteroides o terapia inmunológica clonal. En el mantenimiento, los inhibidores de la calcineurina son los más utilizados, las dosis se deben ajustar según sus niveles séricos y la presencia de efectos adversos como nefrotoxicidad o diabetes. Por otra parte, los inhibidores del mTOR han sido considerados como agentes reductores del riesgo de recidiva de cáncer hepatocelular. Las características del paciente y sus comorbilidades (embarazo, insuficiencia renal, diabetes, sepsis, carcinoma hepatocelular) requieren modificar el tratamiento e individualizarlo


Liver transplantation is the last option for the treatment of liver disease. Immunosuppression schemes are required to avoid graft rejection, which have evolved over the years. A literature review was carried out in PubMed on the immunosuppressive therapies available to avoid graft rejection in liver transplantation, as well as on the schemes used, adverse effects, interactions and their modifications from the induction phase to subsequent follow-up. The usual induction was found to be with steroids or clonal immune therapy. In maintenance, calcineurin inhibitors are the most widely used, and their doses should be adjusted according to their serum levels and the presence of adverse effects such as nephrotoxicity or diabetes. On the other hand, mTOR inhibitors have been considered to reduce the risk of hepatocellular cancer recurrence. The characteristics of the patient and their comorbidities (pregnancy, kidney failure, diabetes, sepsis, hepatocellular carcinoma) require modification and individualization of the treatment.


Subject(s)
Humans , Immunosuppression Therapy , Liver Transplantation , Carcinoma, Hepatocellular , Calcineurin Inhibitors , Graft Rejection , Liver Diseases , Liver Neoplasms
13.
Article in Chinese | WPRIM | ID: wpr-939648

ABSTRACT

OBJECTIVES@#To summarize the clinical features of liver damage in children in the acute stage of Kawasaki disease (KD), and to investigate the clinical value of liver damage in predicting coronary artery lesion and no response to intravenous immunoglobulin (IVIG) in children with KD.@*METHODS@#The medical data were collected from 925 children who were diagnosed with KD for the first time in Beijing Children's Hospital from January 1, 2016 to December 31, 2017. According to the presence or absence of abnormal alanine aminotransferase (ALT) level on admission, the children were divided into a liver damage group (n=284) and a non-liver damage group (n=641). A logistic regression analysis was used to investigate the clinical value of the indicators including liver damage in predicting coronary artery lesion and no response to IVIG in children with KD.@*RESULTS@#Compared with the non-liver damage group, the liver damage group had a significantly earlier admission time and significantly higher serum levels of inflammatory indicators (P<0.05). The liver damage group had a significantly higher incidence rate of coronary artery lesion on admission than the non-liver damage group (P=0.034). After initial IVIG therapy, the liver damage group had a significantly higher proportion of children with no response to IVIG than the non-liver damage group (P<0.001). In children with KD, coronary artery lesion was associated with the reduction in the hemoglobin level and the increases in platelet count, C-reactive protein, and ALT (P<0.05), and no response to IVIG was associated with limb changes, the reduction in the hemoglobin level, the increases in platelet count, C-reactive protein, and ALT, and coronary artery lesion (P<0.05).@*CONCLUSIONS@#Compared with those without liver damage, the children in the early stage of KD with liver damage tend to develop clinical symptoms early and have higher levels of inflammatory indicators, and they are more likely to have coronary artery lesion and show no response to IVIG treatment.


Subject(s)
C-Reactive Protein/analysis , Child , Coronary Vessels/pathology , Hemoglobins/analysis , Humans , Immunoglobulins, Intravenous/therapeutic use , Liver Diseases , Mucocutaneous Lymph Node Syndrome/drug therapy , Retrospective Studies
14.
Chinese Journal of Hepatology ; (12): 447-451, 2022.
Article in Chinese | WPRIM | ID: wpr-935965

ABSTRACT

Mitochondrial DNA is the mitochondria's own genetic material located within the mitochondrial matrix and is involved in cellular metabolism and energy supply. Mitochondrial DNA damage exacerbates oxidative stress by increasing the release of reactive oxygen species, while mitochondrial DNA release also triggers apoptosis and activates immune inflammatory responses through damage-related molecular patterns. Mitochondrial autophagy regulates mitochondrial DNA damage and release through a negative feedback mechanism to maintain intracellular homeostasis. Recent studies have shown that the occurrence and development of chronic liver disease are closely related to mitochondrial DNA-mediated immune inflammatory responses and oxidative stress.


Subject(s)
Apoptosis , Autophagy , DNA, Mitochondrial/metabolism , Humans , Liver Diseases , Mitochondria , Oxidative Stress , Reactive Oxygen Species/metabolism
15.
Chinese Journal of Hepatology ; (12): 362-366, 2022.
Article in Chinese | WPRIM | ID: wpr-935955

ABSTRACT

The liver is abundant in blood supply and receives 25% of the cardiac output via the hepatic artery and portal vein. Circulatory disorders may cause hepatic injury, resulting in congestive hepatopathy(CH) and ischemic hepatitis(IH). Hepatic congestion arising from increased hepatic venous pressure and decreased cardiac output is the common pathophysiological basis of both CH and IH. In addition, extensive arteriovenous shunts affect portal pressure and cardiac function, leading to alterations of hepatic blood supply. The current review summarizes the pathophysiology, clinical manifestations and therapeutic interventions of the above diseases, in order to provide reference for clinical practice.


Subject(s)
Cardiovascular Diseases , Hepatic Artery , Humans , Liver , Liver Diseases , Portal Pressure , Portal Vein
16.
Chinese Journal of Hepatology ; (12): 352-356, 2022.
Article in Chinese | WPRIM | ID: wpr-935953

ABSTRACT

As a secondary endocrine organ, the liver is closely related to the endocrine system. Liver involvement is not uncommon in endocrine diseases, such as hyper/hypothyroidism, diabetes, dysfunction of adrenal and gonadal. It can be manifested in a variety of forms, including hepatocyte injury (elevated transaminase), bile duct injury (cholestasis), hepatocyte steatosis, vascular injury and liver tumor. Direct and indirect liver injury caused by abnormal hormone levels and side effects of drugs for the treatment of endocrine diseases are common pathogenesis. In addition, endocrine diseases can be concomitant with liver diseases, such as autoimmune thyroiditis and autoimmune hepatitis. Systemic diseases can also involve the endocrine system and liver at the same time, such as systemic lupus erythematosus and IgG4 related diseases. For patients with unexplained liver injury, endocrine system diseases should be considered as the differential diagnosis.


Subject(s)
Cholestasis/pathology , Endocrine System Diseases/pathology , Hepatitis, Autoimmune/pathology , Humans , Liver/pathology , Liver Diseases/pathology
17.
Chinese Journal of Hepatology ; (12): 285-289, 2022.
Article in Chinese | WPRIM | ID: wpr-935939

ABSTRACT

Objective: To study the diagnostic value of immediate color Doppler ultrasonography on traumatic hepatic hemorrhage after tissue sampling with ultrasound-guided liver biopsy and the clinical effect of its-directed local compression hemostasis at puncture-site. Methods: 132 hospitalized patients with various liver diseases underwent ultrasound-guided hepatic puncture-biopsies, including 61 cases with diffuse parenchymal and 71 cases with focal liver lesions. Immediate postoperative color Doppler ultrasonography was performed following liver biopsy. Abnormal blood flow signal was observed at hepatic puncture biopsy site, and if there were hemorrhagic signals, ultrasound-directed local compression hemostasis was performed until the bleeding signal disappeared. F-test and Chi-square test were used for statistical analysis. Results: Immediate color Doppler ultrasonography showed traumatic hemorrhage in 36.1% (22/61) and 40.8% (29/71) cases of diffuse liver disease and focal liver disease group, respectively. All hemorrhagic signals were eventually disappeared after ultrasound-directed local compression hemostasis. The median hemostasis time was 2 min in both groups, and there was no statistically significant difference in bleeding rate and hemostasis time between the two groups (P>0.05). There were no serious complications and deaths. Conclusion: Traumatic hepatic hemorrhage along the needle puncture tract is a common accompanying condition during liver biopsy. Immediate postoperative color Doppler ultrasonography can trace bleeding signals in timely manner and direct effective compression hemostasis, so it should be used routinely to help avoid occurrence of severe hemorrhagic complications.


Subject(s)
Biopsy , Hemorrhage/etiology , Hemostasis/physiology , Humans , Liver/pathology , Liver Diseases/pathology , Ultrasonography , Ultrasonography, Doppler, Color/adverse effects
18.
Chinese Journal of Hepatology ; (12): 237-243, 2022.
Article in Chinese | WPRIM | ID: wpr-935934

ABSTRACT

The high incidence of chronic liver disease is a serious threat to public health, and the current comprehensive internal medicine treatment is ineffective. Liver transplantation is limited by the shortage of liver source and post-transplant rejection, and thus unmet the clinical needs. More importantly, cell therapy shows great promise for the treatment of chronic liver disease. Over recent years, domestic and foreign scholars have carried out a variety of cell therapy preclinical and clinical trials for critical liver disease, and achieved certain results, providing new methods for the treatment of chronic liver diseases. This review discusses the cell therapy research status and application progress, various existing problems and challenges, and key issues of mesenchymal stem cells in the treatment of chronic liver diseases.


Subject(s)
Cell- and Tissue-Based Therapy , Humans , Liver Diseases/therapy , Liver Transplantation/methods , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells
19.
Chinese Journal of Hepatology ; (12): 233-236, 2022.
Article in Chinese | WPRIM | ID: wpr-935933

ABSTRACT

There are increasing number of clinical studies on the use of stem cells in the treatment of liver diseases. Most studies have shown that stem cells can significantly improve liver function and prolong survival in patients with decompensated cirrhosis and liver failure. However, the current study has high heterogeneity and few mechanistic research data, which cannot answer many key questions about stem cell therapy for liver diseases. This paper reviews the research status of stem cells, in order to clarify the existing problems and challenges, and puts forward some reflections and countermeasures, with hope to promote the clinical application of stem cells in the treatment of liver diseases.


Subject(s)
Cell- and Tissue-Based Therapy , Humans , Liver Cirrhosis/therapy , Liver Diseases/therapy
20.
Chinese Journal of Hepatology ; (12): 220-223, 2022.
Article in Chinese | WPRIM | ID: wpr-935930

ABSTRACT

Objective: To investigate the practicability and safety of transjugular liver biopsy (TJLB). Methods: Data of 53 cases with transjugular liver biopsy from June 2015 to June 2020 were collected. LABS-100 was used in all patients who underwent transjugular liver biopsy. Among them, 45 cases and eight were biopsied via hepatic vein and intrahepatic segment of the inferior vena cava. The surgical indications, related complications, and postoperative pathological diagnosis were analyzed and summarized. Results: TJLB was successful in all patients, with an average of 2.8 punctures per case. Satisfactory liver tissue and histopathological diagnosis was obtained in all patients. Two cases developed a cervical hematoma that was improved spontaneously, and one patient developed an intrahepatic hematoma that was improved after conservative treatment. Conclusion: TJLB is a practical and safe method for patients with contraindications to percutaneous liver biopsy.


Subject(s)
Biopsy/methods , Biopsy, Needle/methods , Humans , Jugular Veins , Liver Diseases/pathology
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