Gynura segetum induces hepatic sinusoidal obstruction syndrome in mice by impairing autophagy

ABSTRACT Purpose: To investigate the underlying mechanism of hepatic sinusoidal obstruction syndrome (HSOS) induced by Gynura segetum by measuring autophagy in mouse models. Methods: The model group was administered G. segetum (30 g/kg/d) by gavage, while the normal control group was administered an equal volume of saline daily for five weeks. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatic histopathological examinations, and Masson staining were performed to evaluate liver injury. Liver intercellular adhesion molecule-1 (ICAM-1) and P-selectin were evaluated by immunohistochemistry. Hepatocellular apoptosis was assessed using the terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay. Protein expression levels of autophagy markers were measured using Western blot analysis. Results: Gynura segetum was found to significantly induce liver injury compared with control mice, as evidenced by the increase of serum transaminases, a decrease in triglyceride levels, and histopathological changes in mice. Gynura segetum remarkably induced hepatocellular apoptosis and upregulated the expressions of ICAM-1 and P-selectin and also downregulated the protein expression levels of LC3, Atg12 and cytoplasmic polyadenylation element binding protein. Conclusions: Our results suggested that G. segetum induced liver injury with HSOS, and it was partly due to its ability to impair the autophagy pathway.

Hepatic Sinusoidal Obstruction Syndrome Caused by Herbal Medicine: CT and MRI Features

OBJECTIVE: To describe the CT and MRI features of hepatic sinusoidal obstruction syndrome (HSOS) caused by herbal medicine Gynura segetum. MATERIALS AND METHODS: The CT and MRI features of 16 consecutive Gynura segetum induced HSOS cases (12 men, 4 women) were analyzed. Eight patients had CT; three patients had MRI, and the remaining five patients had both CT and MRI examinations. Based on their clinical presentations and outcomes, the patients were classified into three categories: mild, moderate, and severe. The severity of the disease was also evaluated radiologically based on the abnormal hepatic patchy enhancement in post-contrast CT or MRI images. RESULTS: Ascites, patchy liver enhancement, and main right hepatic vein narrowing or occlusion were present in all 16 cases. Hepatomegaly and gallbladder wall thickening were present in 14 cases (87.5%, 14/16). Periportal high intensity on T2-weighted images was present in 6 cases (75%, 6/8). Normal liver parenchymal enhancement surrounding the main hepatic vein forming a clover-like sign was observed in 4 cases (25%, 4/16). The extent of patchy liver enhancement was statistically associated with clinical severity classification (kappa = 0.565). CONCLUSION: Ascites, patchy liver enhancement, and the main hepatic veins narrowing were the most frequent signs of herbal medicine induced HSOS. The grade of abnormal patchy liver enhancement was associated with the clinical severity.

Doença veno-oclusiva hepática: relato de um caso / Hepatic veno-occlusive disease: report of a case

Objetivo: Alertar os pediatras para uma doença decorrente do uso de ervas consideradas inócuas. Métodos: Descriçä de um caso de hipertensäo porta de início súbito, secundária à Doença Veno-Oclusiva Hepátiaca em um paciente de 2 anos e 5 meses, proveniente de Cruz Alta, RS, após uso crônico de chás de "maria-mole" (Senecio brasiliensis), que contém alcalóides pirrolizidínicos, sabidamente hepatotóxicos. após tratamento adequado, apresentou recuperaçäo clínica e laboratorial completa e hoje encontra-se assintomático. Conclusöes: A prevençäo dessa doença depende da sua divulgaçäo entre médicos e populaçäo em geral, bem como do conhecimento dos efeitos tóxicos de muitos chás.

Enfermedad venooclusiva hepática asociada a terapia con azatioprina en un paciente trasplantado renal / Hepatic veno-occlusive disease associated to the use of azathioprine in a renal transplant recipient

We report a 30 years old male, recipient of a kidney allograft and treated with azathioprine, who 18 days after transplantation had a clinically asymptomatic elevation of total bilirrubin and alkaline phosphatases. Nineteen months later, he presented with mild ascites, with a total bilirrubin of 3.5 mg/dl, alkaline phosphatases of 308 U/L (normal <170 U/L) and a prothrombin time at 55 percent of control. A liver biopsy showed sinusoidal and perivenular fibrosis without inflammation, compatible with chronic venous obstruction. Hepatic veno-occlusive disease is an infrequent complication of azathioprine use

Doença venoclusiva hepática (DVOH) na infância: relato de caso / Hepatic veno-occlusive disease in infancy: a case report

Os autores apresentam um caso de doença venoclusiva hepática em um paciente de 1 mês e 28 anos de idade, possivelmente causada por ingesta de chás contaminados por alcalóides da pirrolizidina (SENECIO). Outras causas potenciais foram afastadas. O diagnóstico foi confirmado por exame anátomo-patológico, com retirada de fragmento por biópsia hepática. Säo enfatizados aspectos epidemiológicos e as possíveis razöes do número reduzido de casos relatados de doença venoclusiva hepática em nosso estado