Extracts of Poria cocos polysaccharides improves alcoholic liver disease in mice via CYP2E1 and NF-κB inflammatory pathways / 中国中药杂志

The present study investigated the effect of extract of Poria cocos polysaccharides(PCP) on cytochrome P450 2 E1(CYP2 E1) and nuclear factor κB(NF-κB) inflammatory signaling pathways in alcoholic liver disease(ALD) mice and explored its protective effect and mechanism. Sixty male C57 BL/6 N mice of SPF grade were randomly divided into a control group, a model group, a positive drug group(bifendate, 200 mg·kg~(-1)), and high-(200 mg·kg~(-1)) and low-dose(50 mg·kg~(-1)) PCP groups. Gao-binge mo-del was induced and the mice in each group were treated correspondingly. Liver morphological and pathological changes were observed and organ index was calculated. Serum levels of alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were detected. Malondialdehyde(MDA) and superoxide dismutase(SOD) in liver tissues were detected by assay kits. The levels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were detected by ELISA. The activation of macrophages was observed by immunofluorescence staining and protein expression of CYP2 E1, Toll-like receptor 4(TLR4), NF-κB p65, and phosphorylated NF-κB p65(p-NF-κB p65) were analyzed by Western blot. The ALD model was properly induced. Compared with the model group, the PCP groups significantly improved the pathological injury of liver tissues. Immunofluorescence staining revealed that compared with the model group, the groups with drug intervention showed decreased macrophages in liver tissues. Additionally, the PCP groups showed reduced ALT, AST, MDA, IL-6, and TNF-α(P<0.05), and potentiated activity of SOD(P<0.01). PCP extract has the protective effect against alcoholic liver injury in mice, and the underlying mechanism may be related to the regulation of the expression of CYP2 E1 and inhibition of TLR4/NF-κB inflammatory signaling pathway to reduce oxidative stress and inflammatory injury, thereby inhibiting the development of ALD.

Percepção materna quanto aos filhos recém-nascidos hospitalizados / Maternal perception regarding hospitalized newborns / Percepción materna con respecto a hijos recién nacidos hospitalizados

Estudo transversal e descritivo, desenvolvido em unidade neonatal de um hospital público de ensino do estado de São Paulo, Brasil, em que se objetivou verificar a percepção das mães quanto aos filhos recém-nascidos hospitalizados. A amostra foi constituída por 100 mulheres, questionadas, por meio do Inventário de Percepção Neonatal de Broussard, sobre quanta dificuldade esperavam que os bebês da unidade, em geral, apresentassem para comportamentos como: chorar; alimentar; regurgitar ou vomitar; evacuar; dormir e estabelecer uma rotina. Em seguida, as mesmas perguntas foram repetidas sobre o próprio filho. Noventa mães consideraram os filhos com menos dificuldades que os outros bebês da unidade. As mulheres mais jovens e as mães de bebês com maiores pesos tenderam a considerar seus filhos com mais dificuldade. O Inventário é de fácil aplicação e pode ser útil no processo de avaliação da interação mãe-filho, embora seu resultado não possa ser considerado de forma isolada.

Cross-sectional descriptive study conducted in the neonatal unit of a public teaching hospital in the state of São Paulo, Brazil, which aimed to determine the perceptions of mothers about their newborns hospitalized children. The sample consisted of 100 women questioned, through the Neonatal Perception Inventory Broussard, about how much trouble was expected to be presented by babies of the general unit, on behaviors such as crying; feeding; regurgitate or vomit; evacuate; sleep and have a routine. Then, the same questions were repeated about their own babies. Ninety mothers considered their children with fewer difficulties than other babies at the unit. Younger women and mothers of infants with higher weights tended to consider their children with more difficulty. The Inventory is easy to apply and may be useful in the evaluation of mother-child interaction, although its result cannot be considered in isolation.

Estudio descriptivo transversal realizado en la unidad neonatal de un hospital público de enseñanza en el estado de São Paulo, Brasil, que tuve como objetivo determinar las percepciones de las madres con respecto a sus hijos recién nacidos hospitalizados. La muestra consistió en 100 mujeres a quien, a través del Inventario de Percepción Neonatal Broussard, se preguntó por la cantidad de problemas esperaban que los bebés de la unidad general presentasen respecto a comportamientos como el llanto; alimentos; regurgitar o vomitar; evacuar; dormir y establecer una rutina. Entonces, las mismas preguntas se repitieron a respecto de su propio hijo. Noventa madres consideraran a sus hijos con menos dificultad que los otros bebés en la unidad. Las mujeres más jóvenes y las madres de los recién nacidos con pesos mayores tendían a ver a sus hijos con más dificultades. El inventario es fácil de aplicar y puede ser útil en la evaluación del proceso de interacción madre-hijo, aunque sus resultados no pueden ser considerados aisladamente.

Inflammation and MMPs in alcohol-induced liver diseases and protective action of antioxidants.

The consumption of alcohol causes several liver-associated diseases all over the world. Alcoholic liver diseases (ALD) include hepatic inflammation, fatty liver, hepatitis, liver cirrhosis and fibrosis and finally hepatocellular carcinoma. Although the cellular, metabolic and biochemical mechanisms for these diseases are quite explicable, the roles of matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs) are still under investigation. The present review describes the roles and regulation of MMPs and TIMPs in different ALDs along with the involvement of other pathways. This review also summarizes the present knowledge on clinical and experimental trials with different antioxidants that help against alcohol associated liver diseases.

Hfe mutations add iron overload in patients with alcoholic liver disease

Context Alcoholic liver disease (ALD) is generally associated with iron overload, which may contribute to its pathogenesis, through increased oxidative stress and cellular damage. There are conflicting reports in literature about hemochromatosis (HFE) gene mutations and the severity of liver disease in alcoholic patients. Objectives To compare the prevalence of mutations in the hemochromatosis (HFE) gene between patients with ALD and healthy controls; to assess the relation of HFE mutations with liver iron stores and liver disease severity. Methods Liver biopsy specimens were obtained from 63 ALD patients (during routine treatment) and 52 healthy controls (during elective cholecystectomy). All individuals underwent routine liver function tests and HFE genotyping (to detect wild-type sequences and C282Y, H63D, S65C, E168Q, E168X, V59M, H63H, P160delC, Q127H, Q283P, V53M and W164X mutations). Associations between HFE mutations and risk of excessive liver iron stores, abnormal serum ferritin, liver fibrosis, or necroinflammatory activity were assessed by multivariate logistic regression analysis. Results ALD patients had significantly higher serum ferritin and transferrin saturation than controls (both P<0.05), but the distribution of HFE mutations was similar between the two groups. For ALD patients, the odds ratio for having at least one HFE mutation and excessive liver iron stores was 17.23 (95% confidence interval (CI): 2.09-142.34, P = 0.008). However, the presence of at least one HFE mutation was not associated with an increased risk of liver fibrosis or necroinflammatory activity. Active alcohol ingestion showed the strongest association to increased serum ferritin (OR = 8.87, 95% CI: 2.11-34.78, P = 0.003). Conclusions ALD patients do not present with a differential profile of HFE mutations from healthy controls. In ALD patients, however, ...

Contexto A doença hepática alcoólica (DHA) está geralmente associada à sobrecarga de ferro, que pode contribuir para a sua patogênese, através do aumento do estresse oxidativo e dano celular. As descrições existentes na literatura sobre a associação entre mutações HFE e a gravidade da DHA nem sempre são concordantes. Objetivos Comparar a prevalência de mutações HFE entre um grupo de pacientes com DHA e uma população de controle. Avaliar a relação entre mutações HFE e os depósitos de ferro hepático. Avaliar se a presença dessas mutações está associada com a gravidade da DHA. Métodos Compararam-se 63 pacientes com DHA que efetuaram biopsia hepática com 52 controles saudáveis. A genotipagem HFE (wild type, C282Y, H63D, S65C, E168Q, E168X, V59M, H63H, P160delC, Q127H, Q283P, V53M, W164X) e uma avaliação laboratorial de rotina (incluindo cinética do ferro) foram feitos em todos os indivíduos. Realizou-se regressão logística multivariada nos casos para avaliar se a presença de mutações HFE estava relacionada com risco aumentado de depósitos de ferro hepático aumentados, ferritina sérica anormal, fibrose hepática significativa ou atividade necroinflamatória. Resultados Os pacientes apresentaram ferritina sérica e saturação da transferrina mais elevadas que os controles, mas não existiram diferenças significativas na distribuição de mutações HFE entre pacientes e controles. Considerando apenas os pacientes, o risco relativo de estes apresentarem pelo menos uma mutação HFE e depósitos de ferro hepático significativos foi de 17.23 (CI 95% 2.09-142.34, P = 0.008). Contudo, a presença ...

Epidemiología de la osteoporosis en una población masculina / Epidemiology of osteoporosis in a male population

La prevalencia de osteoporosis en hombres se estima en 7% en blancos, 5% en negros y 3% en hispanos. El envejecimiento incrementará el diagnóstico cerca del 50% en los pró-ximos 15 años. Conocer la frecuencia de la osteoporosis masculina en una población que asiste al Hospital General del Oeste, “Dr. José Gregorio Hernández” de Caracas, Venezuela. Se diseñó un estudio de casos, descriptivo, observacional y transversal de 49 hombres con edad entre 40 y 70 años, de la consulta externa u hospitalización del Hospital General del Oeste y reclutados entre enero y junio del 2009. Se excluyeron los pacientes con fractura de fémur o columna o bajo tratamiento para la osteoporosis. Se dividieron en dos grupos: 1) Con factores de riesgo (Desnutrición, uso de glucocorticoides u hormona tiroidea, sedentarismo y/o encamamiento, Hepatopatía, diabetes mellitus), 2) Sin factores de riesgo. El análisis estadístico se realizó a través de estadística descriptiva y la comparación entre grupos por el método de chi cuadrado, modificado para el tamaño de la muestra. La edad promedio del grupo total fue 57,73 años, con una DS: ±2,56, el grupo con osteopenia tuvo un promedio de edad de 57,04 años; y DS: ±2,345 y el grupo con osteoporosis 61,16 años, DS: ±1,67; el 42% tuvo osteopenia y el 24% osteoporosis. Se encontró osteopenia de fémur en 54,5% y en columna lumbar en 63,6%; la osteoporosis fue de 27,3% vs 24,3% respectivamente. Los estados comórbidos importantes fueron: hipertensión arterial 28,6%, diabetes mellitus 22,4%, desnutrición en 10% y cardiopatías 10%, no se encontraron diferencias estadísticamente significativas entre los grupos. Sólo el 14,3% estaba sano. Los factores de riesgo más importantes fueron uso de esteroides 11%, desnutrición en 18,5%, hepatopatía alcohólica 29,6%, diabetes mellitus 40,8%. Se demostró osteoporosis y/o osteopenia en el 66% de los pacientes, utilizando la densitometría ósea como método diagnóstico

The prevalence of osteoporosis in men is estimated in 7% for caucasian, 5% black and 3% in hispanics. Aging will increment this diagnosis in approximately 50% in the next 15 years. To determine the frequency of osteoporosis in a sample of male patients from the Hospital General del Oeste, Caracas, Venezuela. This is a descriptive, transverse and observational study of 49 men, ages 40-70 years-old, who consulted or were admitted to the hospital between january and june 2009. Patients with femur or spine fractures, as well as those who were being treated with alendronates were excluded. The sample was distributed in 2 groups: 1) Patients with the following risk factors for osteoporosis: malnutrition, treatment with glucocorticoids or Levothyroxin, bed-ridden or sedentary, liver disese and Diabetes Mellitus. Group 2: no risk factors for osteoporosis. Statistical methods applied were descriptive and intergroup comparison was calculated by T ìs Student. The average age was 57,73 years, SD ±2,56 years. The group with osteopenia had an average age of 57,04 and SD ±2,345, while the group with osteoporosis had an average age of 61,16 years, SD: ±1,67; Osteopenia was present in 42% and osteoporosis in 24%. Femur Osteopenia was found in 54,5% and in lumbar spine in 63,6%. Osteoporosis was present in 27,3 vs 24,3% respectively. The following major associated illnesses were present: hypertension 28,6%, DM 22,4%, malnutrition 10% and heart disease 10%. Only 14,3% of the subjects was healthy. Major risk factors for osteoporosis were steroid treatment 11%, malnutrition in 18,5%, alcohol liver disease 29,6% and DM 40,8%. Osteoporosis and/or osteopenia diagnosed by DEXA were found in 66% of these patients

Abnormal Electron Microscopic Findings of Nonalcoholic Steatohepatitis and Related Factors / 대한소화기학회지

BACKGROUND/AIMS: In spite of increasing interests about nonalcoholic steatohepatitis (NASH), there are few reports about the ultrastructure of hepatocyte in this disease. The aim of this study was to clarify abnormal electron microscopic (EM) findings and related factors in NASH. METHODS: Total of fourteen patients who underwent liver biopsy due to steatohepatitis were included. Precise personal history was taken and variable blood tests such as liver function test, lipid profile, and serum iron study were done. Pathologic examination with light and electron microscopy was done by single pathologist. RESULTS: Eleven men and three women were included and mean age was 33.7+/-12.8 years. Nine patients drinking less than 40 g/week was grouped as "NASH group" and other 5 patients drinking more than 40 g/week and body mass index less than 25 was grouped as "ASH (Alcoholic Steatohepatitis) group". Polymorphism of mitochondria such as megamitochondria or loss of cristae was major abnormal EM findings and was more common in "NASH group" than "ASH group" (p=0.027). There was no significant clinical or pathological factors related with the presence of these abnormal EM findings. CONCLUSIONS: Polymorphism of mitochondria is major abnormal EM finding of steatohepatitis and is more common in NASH than ASH. And there is no significant clinical or pathological factors which could predict the presence of these abnormal EM findings.

Diagnosis and treatment of viral liver fibrosis

This review summarized the diagnostic value of fibrosis biomarkers and the efficacy of anti-viral treatments on fibrosis progression. Non-invasive biomarkers can facilitate the screening and management of chronic hepatitis C and B. Screening for significant fibrosis is mandatory as very effective anti-viral treatments are available, permitting to stop or to reduce the fibrosis progression. The reduction of fibrosis progression will decrease the mortality due to complications of cirrhosis. In patients with chronic hepatitis C, pegylated interferons combined with ribavirin are effective in reducing fibrosis progression. In patients with chronic hepatitis B, lamivudine, adefovir and pegylated interferon are also effective in reducing fibrosis progression. In patients with chronic hepatitis Delta, pegylated interferon is also effective in reducing fibrosis progression

Prevalence of hepatitis B and hepatitis C markers in alcoholics with and without clinically evident hepatic cirrhosis

Nos avaliamos a frequencia de marcadores sorologicos das hepatites B e C em 365 alcoolistas, determinando pelo metodo ELISA, a presenca de HBsAg, anti-HBc, anti-HBs e anti-HCV. Cinquenta deles eram cirroticos e 315 nao tinham evidencias de cirrose hepatica; nestes ultimos determinamos HBsAg em todos, anti-HBc e anti-HBs em 130, e anti-HCV em 210. Entre os alcoolistas as frequencias de HBsAg (1,9 por cento), anti-HBc (28,3 por cento) e anti-HCV (3,8 por cento) foram maiores (p<0,001) do que entre os controles (N=17,059), 0,4 por cento, 4,0 por cento e 0,4 por cento respectivamente. A frequencia de HBsAg+ no grupo de alcoolistas sem cirrose (0,95 por cento) foi semelhante a do grupo controle (0,4 por cento) e menores (p<0,001) do que no grupo cirrotico (8,0 por cento)...

Retopexia transacral para o tratamento de procidência retal sangrante em pacientes hepatopata grave: relato de caso / Transacral rectopexy for treatment of bleeding rectal prolapse in a patient with severe liver disease: case report

A procidencia do reto e afeccao pouco frequente, acometendo geralmente pacientes idosos e com significantes patologias associadas. A incontinencia fecal se constitui em problema frequente, ocorrendo na maior parte dos casos, ja as outras complicacoes tais como ulceracoes da mucosa, hemorragia, encarceramento, estrangulamento e rotura tem ocorrencia pequena. A retopexia transabdominal, com ou sem resseccao do sigmoide, tem o menor indice de recorrencia (2-4), mas morbidade e mortalidade consideraveis...

Virus de hepatitis B y C en alcoholicos cronicos: prevalencia e influencia sobre el dano hepatico / Hepatitis B and C virus in chronic alcoholic patients: prevalence and influence in the liver injury

Se presenta un estudio prospectivo sobre 115 alcohólicos crónicos destinado a conocer la prevalencia de marcadores séricos de virus de hepatitis B y C (HBV) (HCV) en ese tipo de pacientes, la asociación de las infecciones por HBV y HCV con diversas variables epidemiológicas y la influencia de esos virus sobre el grado de lesión hepatica. Se halló una prevalencia de marcadores de HBV del 13.9 por ciento de Anti HCV del 20.0 por ciento ambas significativamente mayores a las de los donantes de sangre. La alta prevalencia de Anti HCV en esta serie de alcohólicos, con un 69.6 por ciento de formas espor dicas de infección, resulta difícil de justificar. El diagnóstico histológico de hepatitis crónica (HC) realizado en 3 de los 115 pacientes estudiados, recayó la totalidad de las veces sobre pacientes Anti HCV (R), demonstrando una clara asociación de las HC con el HCV en los alcohólicos crónicos. Con respecto a los otros diagnósticos histológicos, no se halló diferencias entre los pacientes con sueros reactivos para algún marcador del HBV o para el Anti HCV y aquellos con sueros no reactivos; sugiriendo que el HBV y el HCV no influyen en el grado de lesión hep tica de los alcohólicos crónicos. No hallamos que la relación de positividad del Anti HCV en los 23 pacientes fuera diferente según los distintos diagnósticos histopatológicos. Tampoco apreciamos en esta serie, que la cirrosis acurriera mas tempranamente en los Anti HCV R que en los NR; discrepando con algunas comunicaciones recientes.

Estudio histopatológico de glándulas salivales menores en alcohólicos / Histopathological study of minor salivary glands in alcoholics

A qualitative and quantitative histological analysis of minor salivary glands was carried out in 60 alcoholics and 20 matched control patients. Minor salivary glands biopsies were obtained and samples were processed for conventional light microscopy. A quantitative morphometrical assessment was carried out by counting the number of acinar cells present in an area by means of a squared grid eye piece. Neither hipertrophic nor atrophic responses were found in the quantitative analysis. Histological changes such as acinar degeneration, hyperemia, mononuclear inflammatory and fat infiltration were found in both experimental and control samples. None of these findings reached statistical significance. Eleven adult alcoholics with liver damage (ASD) presented duct dilatation. On the other hand, only 3 adult alcoholics with liver damage (ACD) developed this response. This difference was statistically significant (p=0.02). Perhaps no difference was found when we compared ASD group with its respective control group (p=0.699). Whe could not differentiate if this change was due to alcoholism or another undeterminated factor. At least under the scope of this study, we may conclude that minor salivary glands are acarcely affected by alcoholism even when liver damage has been established

Alteraçöes hepáticas em pacientes portadores de retocolite ulcerativa inespecífica / Hepatic changes in patients with inespecific ulcerative colitis

A prsença de alteraçöes hepáticas em portadores de retocolite ulcerativa inespecífica varia de 4,7 por cento a 90 por cento e os mecanismos näo säo esclarecidos. Este estudo teve por objetivos observar a freqüência com que aparecem alteraçöes hepáticas em pacientes portadores de retocolite ulcerativa inespecífica, conhecer suas repercussöes, observar a relaçäo entre a forma intestinal da doença e as lesöes hepáticas e identificar as possíveis alteraçöes histológicas do fígado. Constituiu-se grupo de 21 pacientes portadores de retocolite ulcerativa inespecífica (Grupo 1, subdividido conforme a ausência ou presença de alcoolismo, em Grupo 1A e Grupo 1B), que foram comparados com 10 pacientes portadores de colopatia funcional (Grupo 2). O estudo compreendeu observaçäo clínica quanto à manifestaçöes de doenças hepáticas, ultra-sonografia, provas de funçäo hepática e, nos pacientes com alteraçöes dos parâmetros fixados como normais procedeu-se à laparoscopia com biópsia hepática. Alteraçöes clínicas estavam presentes em três pacientes. O estudo ultra-sonográfico se mostrou alterado em 14,3 por cento dos pacientes do Grupo 1A e em 57,1 por cento dos pacientes do Grupo 1B. A albumina e a colinesterase foram as provas de funçäo hepática que mais se alteraram no grupo de portadores de retocolite ulcerativa inespecífica quando comparadas ao grupo de pacientes com colopatia funcional. A pesquisa do vírus B e do vírus C resultou negativa em todos os casos realizados. Nos pacientes portadores de colopatia funcional (Grupo 2), os exames resultaram normais. Do total de 21 pacientes com retocolite ulcerativa inespecífica, em 15 se obteve fragmentos hepáticos. Algum grau de alteraçäo histológica ocorreu em todos os pacientes biopsiados

Hepatopatia alcoholica en Venezuela comportamiento clinico, funcional hepatico e histopatologico / Alcoholic liver disease in Venezuela. Clinical, hepatic functional and histopathologic behavior

24 pacientes con ingesta alcohólica fueron clasificados según la cantidad de alcohol ingerido y tiempo ingiriéndolo, se les registraron signos, síntomas y complicaciones de hepatopatía alcohólica, les fue practicado transminasas, bilirrubina y actividad protrombínica. A todos se les practicó también Bx hepática percutánea las cuales fueron coloreadas con hematoxilina-eosina, reticulina de Wilder y tricrómico de Mallory investigándose en ellas 9 criterios histológicos asociados a hepatopatía alcohólica. Según la lesión predominante fueron divididos en 4 grupos: grupo 1 (5 pacientes): hígado graso o fibrosis hepática; grupo 2 (5 pacientes): hepatitis alcohólica; grupo 3 (10 pacientes): cirrosis hepática y grupo 4 (4 pacientes): Bx hepática normal. El 20%de los pacientes con hígado graso ingería más de 10 g de etanol/día, al igual que el 80%de los pacientes con hepatitis alcohólica y el 100%de los cirróticos, quedando demostrada así la relación cantidad de alcohol ingerida/severidad de alteración histológica. La telangiectasia fue el signo más frecuentemente encontrado, viéndose en todos los casos de hepatitis alcohólica...

Contribuição ao diagnóstico da hepatopatia crônica alcoólica: estudo das alterações ultraestruturais em 62 biópsias hepáticas / Contribution to the diagnosis of chronic alcoholic liver disease: study of ultrastructural changes in 62 liver biopsies

Foram estudadas 62 biópsias hepáticas de pacientes a finalidade de se caracterizar alterações morfológicas que comprovassem a ação do etanol sobre o tecido hepático. Foi particularmente investigado o processo de fibroplasia envolvendo a vênula hepática terminal, a parede sinusoidal, as células sinusoidais e peri-sinusoidais e o espaço de Disse. Pelo exame ao microscópio óptico os casos foram divididos em cinco grupos, a saber: oito com lesão mínim~ 21 com fibrose hepática, 15 com hepatite alcoólica, oito com hepatite alcoólica e cirrose e 10 com cirrose. Nossos estudos permitiram algumas importantes conclusões. Os exames clínicos e laboratoriais não posslbl1ltaram uma avaliação confiável do grau de comprometimento hepático, havendo pouca correlação entre a duração e a intensidade da doença hepática e a gravidade do quadro histológico. Tal fato tornou-se mais evidente quando se analisou a alta freqüência de casos nos quais lesões mínimas ou inespecíficas foram constatadas. As alterações hepatoce1ulares causadas pelo etanol predominaram na zona acinar 3 e foram mais evidentes nos casos de hepatite alcoólica. O estudo do processo fibrótico demonstrou que a fibrose peri-sinusoidal resulta da ativação das células peri-sinusoidais pelo etanol e que estas células são transformadas em células semelhantes a miofibroblastos ou fibroblastos durante esse processo. Este fenômeno, observado em todos os casos, foi considerado o principal elemento para a caracterização da ação do etanol sobre o tecido hepático. A lesão da parede da vênula hepática terminal pareceu secundária ao processo necroinflamatório da zona acinar 3, que estimularia os miofibroblastos da parede venular a fabricar colágeno...