International Journal of Hepatology最新文献

{"title":"Clinical Profile and Limitations in the Management of HBV Patients Attending Clinic at a District Hospital in Ghana.","authors":"Amoako Duah, Yvonne A Nartey","doi":"10.1155/2023/4424718","DOIUrl":"10.1155/2023/4424718","url":null,"abstract":"<p><strong>Background: </strong>Chronic hepatitis B (CHB) is estimated to cause between 500,000 and 1.2 million deaths worldwide every year through cirrhosis and hepatocellular carcinoma (HCC). Liver cirrhosis and HCC are the commonest liver diseases causing death in Ghana. The most critical problem in the management of CHB in sub-Saharan Africa is the high cost of investigations and antiviral drugs. There is scanty information concerning newly diagnosed CHB patients and their management challenges in Ghana. This study sought to determine the clinical characteristics and management challenges of CHB patients in Ghana. <i>Methodology</i>. A prospective cohort study was conducted involving newly diagnosed CHB patients being managed at St. Dominic Hospital. Patient demographic and clinical features were abstracted using a standardized questionnaire. The proportion of patients able to undertake investigations and treatment were determined, and the limitations to standard management were recorded. The performance of APRI score in the diagnosis of cirrhosis was also investigated.</p><p><strong>Results: </strong>Of the 334 patients with newly diagnosed CHB, the median age at diagnosis was 35 (IQR 28-44) years. Less than a quarter (22.2%) were able to undertake viral load testing and 23.4% were eligible for treatment. Of those who were eligible for treatment, only 42.3% were able to initiate treatment. Almost a third of cases (32.1%) reported late with liver-related complications. The sensitivity of APRI score with cut-off value of 2 in the diagnosis of liver cirrhosis was 70.2% and specificity was 97.9%.</p><p><strong>Conclusion: </strong>A high proportion of newly diagnosed CHB patients presented late and with liver-related complications. Majority were not able to afford viral load testing and antiviral medication. Screening of hepatitis B among the general population and inclusion of CHB management in the National Health Insurance Scheme should be encouraged.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2023 ","pages":"4424718"},"PeriodicalIF":1.5,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9833894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10539949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive Familial Intrahepatic Cholestasis: A Descriptive Study in a Tertiary Care Center.","authors":"Fahad I Alsohaibani,&nbsp;Musthafa C Peedikayil,&nbsp;Abdulaziz F Alfadley,&nbsp;Mohamed K Aboueissa,&nbsp;Faisal A Abaalkhail,&nbsp;Saleh A Alqahtani","doi":"10.1155/2023/1960152","DOIUrl":"https://doi.org/10.1155/2023/1960152","url":null,"abstract":"<p><strong>Background: </strong>Progressive familial intrahepatic cholestasis (PFIC) is a rare genetic disorder that results from defective mechanisms of bile secretion. We aim to describe different types of PFIC and their clinical features, treatment modalities, and outcomes in Saudi Arabia. <i>Patients and Methods</i>. This is a retrospective study of all patients diagnosed with PFIC at King Faisal Specialist Hospital and Research Center in Riyadh from January 1, 2002, to December 31, 2021. All relevant information was collected from patient charts and transferred into the REDcap® database for statistical analysis.</p><p><strong>Results: </strong>A total of 79 patients were identified with PFIC, and PFIC type 3 was the most common (59.5%), followed by PFIC type 2 (34.2%), PFIC type 1 (5.1%), and PFIC type 4 (1.3%). Males and females were affected in 54.4% and 45.6%, respectively. Mutations in ATP8B1, ABCB11, and ABCB4 genes were observed in PFIC type 1, PFIC type 2, and PFIC type 3, and loss of function in a variant of TJP2 was detected in PFIC type 4, respectively. A total of 51 (64.6%) patients underwent liver transplantation: three patients (3/4) with PFIC type 1 (75%), twenty patients (20/27) with PFIC type 2 (74.1%), twenty-seven patients (27/47) with PFIC type 3 (57.4%), and one patient with PFIC type 4 (100%). The mean duration of disease before transplantation was 53.9 ± 67 months with a median of 30 months. Following liver transplantation, symptomatic control was achieved in 47 patients (92.2%). Recurrence after transplantation occurred in 4 patients (7.8%) within an average of 22.5 months and a median of 17 months.</p><p><strong>Conclusion: </strong>PFIC is considered a rare disorder in Saudi Arabia; however, early recognition of the disease is important for appropriate management and early referral for liver transplantation evaluation. The overall rate of liver transplantation in our cohort was 64.6% with an excellent five-year survival rate.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2023 ","pages":"1960152"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver Segment Disposition of Hepatocellular Carcinoma Predicts Microvascular Invasion.","authors":"Arnold Nongmoh Forlemu,&nbsp;Raissa Nana Sede Mbakop,&nbsp;Praneeth Bandaru,&nbsp;Vijay Gayam,&nbsp;Hamsika Moparty,&nbsp;Tomoki Sempokuya,&nbsp;Faruq Pradhan,&nbsp;Madhavi Reddy,&nbsp;Marco Olivera","doi":"10.1155/2023/5727701","DOIUrl":"https://doi.org/10.1155/2023/5727701","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a leading cause of cancer morbidity and mortality. Findings of microvascular invasion (MVI) in patients with HCC have emerged as an important prognostic factor for poor survival after tumor resection.</p><p><strong>Aim: </strong>This study evaluated the relation between MVI and HCC within various anatomical Couinaud's segments of the liver.</p><p><strong>Method: </strong>A multicenter retrospective review of HCC records was conducted from 2012 to 2017. HCC cases were identified using ICD-9 and 10 codes 155, C22.0, and C22.8. HCC patients who underwent liver transplants were included in this study. Liver segment of the location of HCC was obtained from radiographic records, and MVI information was obtained from pathology reports. Segmental distributions of HCC in MVI versus non-MVI groups were compared using Wilcoxon rank sum tests. <i>p</i> value was set at <0.05.</p><p><strong>Results: </strong>We analyzed 120 HCC patients who underwent liver transplantation. The mean age of our cohort was 57 years, and the most common etiology of liver disease was hepatitis C at 58.3%. The median HCC size was 3.1 cm, and MVI was present in 23.3% of the explanted specimens. MVI was 2 to 3 times significantly higher in patients with HCC affecting segments 2 and 3 and segments 4b and 5 (<i>p</i> = 0.01). Moreover, median survival was significantly lower in patients with MVI versus those without MVI (50 vs. 137 months, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>MVI was significantly higher in HCC tumors located in liver segments 2 and 3 and 4b and 5, and survival was lower in patients with MVI compared with those without.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2023 ","pages":"5727701"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibition of Gluconeogenesis by Boldine in the Perfused Liver: Therapeutical Implication for Glycemic Control.","authors":"Laís Cristina Lima Silva,&nbsp;Gustavo Henrique de Souza,&nbsp;Vanesa de Oliveira Pateis,&nbsp;Ana Paula Ames-Sibin,&nbsp;Beatriz Paes Silva,&nbsp;Lívia Bracht,&nbsp;Jurandir Fernando Comar,&nbsp;Rosane Marina Peralta,&nbsp;Adelar Bracht,&nbsp;Anacharis Babeto Sá-Nakanishi","doi":"10.1155/2023/1283716","DOIUrl":"https://doi.org/10.1155/2023/1283716","url":null,"abstract":"<p><p>The alkaloid boldine occurs in the Chilean boldo tree (<i>Peumus boldus</i>). It acts as a free radical scavenger and controls glycemia in diabetic rats. Various mechanisms have been proposed for this effect, including inhibited glucose absorption, stimulated insulin secretion, and increased expression of genes involved in glycemic control. Direct effects on glucose synthesis and degradation were not yet measured. To fill this gap, the present study is aimed at ensuring several metabolic pathways linked to glucose metabolism (e.g., gluconeogenesis) in the isolated perfused rat liver. In order to address mechanistic issues, energy transduction in isolated mitochondria and activities of gluconeogenic key enzymes in tissue preparations were also measured. Boldine diminished mitochondrial ROS generation, with no effect on energy transduction in isolated mitochondria. It inhibited, however, at least three enzymes of the gluconeogenic pathway, namely, phosphoenolpyruvate carboxykinase, fructose-bisphosphatase-1, and glucose 6-phosphatase, starting at concentrations below 50 <i>μ</i>M. Consistently, in the perfused liver, boldine decreased lactate-, alanine-, and fructose-driven gluconeogenesis with IC₅₀ values of 71.9, 85.2, and 83.6 <i>μ</i>M, respectively. Conversely, the compound also increased glycolysis from glycogen-derived glucosyl units. The hepatic ATP content was not affected by boldine. It is proposed that the direct inhibition of hepatic gluconeogenesis by boldine, combined with the increase of glycolysis, could be an important event behind the diminished hyperglycemia observed in boldine-treated diabetic rats.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2023 ","pages":"1283716"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10089784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9304993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver Injury Patterns and Hepatic Toxicity among People Living with and without HIV and Attending Care in Urban Uganda.","authors":"Clara Wekesa,&nbsp;Rosalind Parkes-Ratanshi,&nbsp;Gregory D Kirk,&nbsp;Ponsiano Ocama","doi":"10.1155/2023/6717854","DOIUrl":"https://doi.org/10.1155/2023/6717854","url":null,"abstract":"<p><strong>Introduction: </strong>The evaluation of the patterns of liver injury, derived from liver chemistry panels, often may narrow on probable causes of the liver insult especially when coupled with clinical history, examination, and other diagnostic tests.</p><p><strong>Methods: </strong>Among people living with and without HIV and attending care, we used the <i>R</i> ratio to evaluate for liver injury patterns. Liver injury patterns were defined as cholestatic (<i>R</i> < 2), mixed (<i>R</i> = 2-5), and hepatocellular (<i>R</i> > 5).</p><p><strong>Results: </strong>Overall, the proportions of participants with cholestatic liver injury, mixed liver injury, and hepatocellular liver injury were 55%, 34%, and 4%, respectively, with similar distribution when stratified by HIV status. Alcohol use among participants without HIV was associated with all patterns of liver injury (cholestatic liver injury (OR = 4.9 CI (1.0-24.2); <i>p</i> = 0.054), mixed liver injury (OR = 5.3 CI (1.1-27.3); <i>p</i> = 0.043), and hepatocellular liver injury (OR = 13.2 CI (1.0-167.3); <i>p</i> = 0.046)). Increasing age was associated with cholestatic liver injury among participants with HIV (OR = 2.3 CI (1.0-5.3); <i>p</i> = 0.038). Despite a high hepatitis B prevalence among participants with HIV, there was no association with liver injury.</p><p><strong>Conclusions: </strong>Liver injury is prevalent among both people living with and without HIV in care, and cholestatic liver injury is the most common pattern. Alcohol is associated with all patterns of liver injury and increasing age associated with cholestatic liver injury among people living without HIV and people living with HIV, respectively.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2023 ","pages":"6717854"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9899141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10660545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma-Glutamyl Transferase: A Friend against Cholestatic Itch? A Retrospective Observational Data Analysis in Patients with Extrahepatic Cholestasis.","authors":"Floris W Haijer,&nbsp;Cornelis B Van Vliet,&nbsp;Marjolein G J Brusse-Keizer,&nbsp;Job A M Van der Palen,&nbsp;Marjo J Kerbert-Dreteler,&nbsp;Jeroen J Kolkman","doi":"10.1155/2023/2903171","DOIUrl":"https://doi.org/10.1155/2023/2903171","url":null,"abstract":"<p><strong>Methods: </strong>We included 235 patients with chronic extrahepatic cholestasis due to pancreatic cancer, cholangiocarcinoma, or papillary carcinoma.</p><p><strong>Results: </strong>GGT was significantly higher in patients without pruritus (median 967, IQR 587-1571) compared to patients with pruritus (median 561 IQR 266-1084 IU/l) (<i>p</i> < 0.01). In contrast, median alkaline phosphatase (AP) was 491 U/L (IQR; 353-684) in patients with pruritus and was not significantly different from 518 U/L (IQR; 353-726) in patients without pruritus (<i>p</i> = 0.524). Direct bilirubin was significantly higher in patients with pruritus compared to patients without pruritus (168 <i>μ</i>mol/L (IQR; 95-256) vs. 120 <i>μ</i>mol/L (IQR; 56.75-185.5)) (<i>p</i> < 0.01). After correcting for the extent of cholestasis <i>via</i> direct bilirubin, the negative association between GGT and pruritus remained significant and became stronger (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Serum GGT activity is inversely associated with the presence of cholestatic itch in patients with chronic extrahepatic cholestasis.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2023 ","pages":"2903171"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10766164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis C Seroconversion Remains High among Patients with Regular Hemodialysis: Study of Associated Risk Factors.","authors":"Ni Wayan Wina Dharmesti, I Dewa Nyoman Wibawa, Yenny Kandarini","doi":"10.1155/2022/8109977","DOIUrl":"10.1155/2022/8109977","url":null,"abstract":"<p><strong>Methods: </strong>An analytical cross-sectional study involving patients from 2 dialysis units (1 referral hospital and 1 private dialysis unit) in Denpasar, Bali, Indonesia, from January 2020 to December 2021. We evaluated age, gender, duration of hemodialysis, vascular access, history of transfusion, history of surgery, diabetes mellitus, hepatitis B, human immunodeficiency virus (HIV) infection, and type of dialyzer as possible risk factors of hepatitis C seroconversion among hemodialysis patients.</p><p><strong>Results: </strong>A total of 338 hemodialysis patients were enrolled in this study. We found hepatitis C seroconversion in 94 patients (27.8%), all of which occurred after regular dialysis was started. Vascular access type (OR 42.07, 95% CI 5.757-307.472) and dialyzer reuse (OR 8.324, 95% CI 4.319-16.044) were showing a statistically significant association with hepatitis C seroconversion. A separate analysis on each dialysis unit found common evidence that the duration of dialysis was significantly associated with hepatitis C infection among hemodialysis patients.</p><p><strong>Conclusion: </strong>Hepatitis C seroconversion among dialysis patients remains high. Factors related to the dialysis procedure itself played a major role in transmitting the virus.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2022 ","pages":"8109977"},"PeriodicalIF":1.5,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9815928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10507632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serological Evidence of Hepatitis B and E and Dengue Coinfection in Chadian Patients and Impact on Lipidemia Profile.","authors":"Alexandre Kanga Djasrabe,&nbsp;Borris Rosnay Tietcheu Galani,&nbsp;Moussa Mahamat Ali,&nbsp;Fissou Henry Yandai,&nbsp;Bessimbaye Nadlaou,&nbsp;Mayann Habkreo,&nbsp;Nicolas Yanou Njintang","doi":"10.1155/2022/8373061","DOIUrl":"https://doi.org/10.1155/2022/8373061","url":null,"abstract":"<p><strong>Objective: </strong>Viral hepatitis is an endemic disease in Chad. However, few studies have documented coinfection cases and their impact on cardiovascular risk. This study is aimed at analyzing hepatitis B, E and dengue coinfection in a Chadian cohort and gauge its effect on lipidemia. <i>Patients and Methods</i>. From February to May 2021, 179 subjects were recruited from the Department of Gastroenterology and Internal Medicine of the National Reference University Hospital of N'Djamena and tested for viral hepatitis markers, including HBsAg and IgM/IgG anti-HEV and dengue infection, using the NS1/IgM/IgG kit. Serum transaminases and biomarkers of lipid profiles were assayed by colorimetry, and atherogenic indexes (AI) and coronary risk (CRI) were calculated.</p><p><strong>Results: </strong>Of the 179 subjects surveyed, 21.22% (38/179) tested positive for hepatitis B, 20% (27/135) for hepatitis E, and 1.66% (2/120) for dengue. However, most of the patients were found to be asymptomatic. Hepatitis B/E coinfection was more frequent in the study population (5.02%; 9/179) than dengue/hepatitis E coinfection (0.83%; 1/120; IgM). The prevalence of anti-HEV IgG antibodies was higher (18.52%) than that of IgM (1.48%). Furthermore, IgG antibodies levels in HEV-monoinfected subjects (11.05 ± 1.93 IU/mL, <i>N</i> = 15) were significantly higher (<i>p</i> < 0.05) than in coinfected patients (5.40 ± 1.31 IU/mL, <i>N</i> = 9). Subjects coinfected with HEV/HBV were associated with a significantly higher risk of lipodystrophy (coronary risk: 88.89% vs. 35.3%, relative risk (RR) = 2.55; <i>p</i> = 0.014), than HEV-monoinfected subjects, as evidenced by higher mean levels of triglycerides levels (219.88 ± 14.67 mg/dL vs. 191.82 ± 4.66  mg/dL, <i>p</i> < 0.05), more reduced HDL-C levels (9.05 ± 1.62 mg/dL vs. 18.93 ± 2.35 mg/dL, <i>p</i> < 0.05), increased mean CRI (13.81 ± 2.39 vs. 6.89 ± 1.93, <i>p</i> < 0.01), and AI (1.46 ± 0.10 vs. 1.05 ± 0.05, <i>p</i> < 0.01) values. However, they had normal transaminase values and a lower risk of developing a liver injury, although not significant (alanine aminotransferase: 0% vs. 29.4%, RR = 1, <i>p</i> = 0.128; aspartate aminotransferase: 0% vs. 5.88%, <i>p</i> = 1) than this group.</p><p><strong>Conclusion: </strong>HBV/HEV coinfection is frequent in the Chadian cohort and associated with an important risk of dyslipidemia. Further research is required to elucidate the mechanism of action.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":" ","pages":"8373061"},"PeriodicalIF":1.8,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spleen and Liver Stiffness Evaluation by ARFI Imaging: A Reliable Tool for a Short-Term Monitoring of Portal Hypertension?","authors":"Andreas Binzberger,&nbsp;Mark Hänle,&nbsp;Matthias Pfahler,&nbsp;Wolfgang Kratzer,&nbsp;Thomas Seufferlein,&nbsp;Eugen Zizer","doi":"10.1155/2022/7384144","DOIUrl":"https://doi.org/10.1155/2022/7384144","url":null,"abstract":"<p><strong>Background: </strong>Assessment of hepatic venous pressure gradient (HVPG) is the most reliable, though invasive method for evaluation of portal hypertension. Non-invasive, elastography-based techniques are well established in diagnosis, but not in monitoring of portal hypertension. The aim of our prospective study was to determine the value of acoustic radiation force impulse (ARFI) elastography technique of the liver and spleen in diagnosis and monitoring of portal hypertension.</p><p><strong>Methods: </strong>We prospectively assessed portal hypertension by HVPG and corresponding elastography of the liver and spleen in 31 patients with liver cirrhosis and an indication for primary prophylaxis by non-cardio selective beta-blockers. Investigations were performed at baseline and a follow-up visit after 6-8 weeks. To address the known large variability of values for spleen elastography, well-defined corresponding areas in the spleen were used for baseline and follow-up elastography. Sensitivity, specificity, and AUC-ROC values for both spleen and liver elastography monitoring of portal hypertension were calculated.</p><p><strong>Results: </strong>Liver but not spleen elastography significantly correlated with HVPG results and was suitable for initial evaluation of portal hypertension. However, changes in HVPG results did not show any correlation with alterations of ARFI values from baseline to follow-up visits both for liver and spleen elastography. Spleen stiffness results were not homogeneous across the whole organ differing significantly between the upper, hilar, and bottom placed investigation areas.</p><p><strong>Conclusions: </strong>In this prospective study ARFI-based assessment of liver elastography showed itself suitable for initial assessment but not for monitoring of portal hypertension. Spleen elastography was not appropriate for both, evaluation and monitoring of portal hypertension. A possible explanation for this new data that are in some contrast to previously published results is the degree of portal hypertension in our study, a comparatively short follow-up period, and well-defined investigation areas for spleen elastography in repetitive ARFI investigations. This trial is registered with NCT03315767.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":" ","pages":"7384144"},"PeriodicalIF":1.8,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40365413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arsenic-Induced Injury of Mouse Hepatocytes through Lysosome and Mitochondria: An In Vitro Study.","authors":"Amal Santra,&nbsp;Debasree Bishnu,&nbsp;Suman Santra,&nbsp;Subhadip Ghatak,&nbsp;Partha Sarathi Mukherjee,&nbsp;Gopal Krishna Dhali,&nbsp;Abhijit Chowdhury","doi":"10.1155/2022/1546297","DOIUrl":"https://doi.org/10.1155/2022/1546297","url":null,"abstract":"<p><strong>Background and aims: </strong>The cellular mechanism of liver injury related to arsenic toxicity is ill defined. It is thought that oxidative stress and mitochondrial dysfunction may play some role in arsenic-induced liver damage. In this study, we evaluated subcellular events within the primary cultured mouse hepatocytes when exposed to inorganic arsenic.</p><p><strong>Methods: </strong>Primary cultured mouse hepatocytes were treated with 10 <i>μ</i>M arsenic for different time periods. Reactive oxygen species (ROS) formation, functional changes of the lysosome and mitochondria, and mode of hepatocytes death were studied by laser confocal microscopy, fluorescence spectroscopy, and flow cytometry. Expression of proapoptotic member of the BCL-2 family of genes BAX and antiapoptotic BCL-2 mRNA expression were studied by real-time PCR. Cytochrome c expression was studied by Western blotting.</p><p><strong>Results: </strong>Fluorescence spectroscopy as well as flow cytometric analysis revealed that arsenic-induced formation of ROS was time dependent. Confocal microscopy showed initiation of ROS formation from periphery of the hepatocytes at 30 min of arsenic exposure that progressed to central part of the hepatocytes at 3 h of arsenic exposure. The ROS formation was found to be NADPH oxidase (NOX) dependent. This low level of intracellular ROS induced lysosomal membrane permeabilization (LMP) and subsequently released cathepsin B to the cytosol. The LMP further increased intracellular ROS which in turn triggered induction of mitochondrial permeability transition (MPT). Pretreatment of hepatocytes with LMP inhibitor bafilomycin A (BafA) significantly decreased, and LMP inducer chloroquine (ChQ) significantly increased the production of ROS suggesting that LMP preceded enhanced ROS generation in response to arsenic. MPT was accompanied with increase in BAX : BCL2 mRNA ratio resulting in upregulation of caspase 3 and increased hepatocyte apoptosis.</p><p><strong>Conclusion: </strong>Although arsenic-related oxidative liver injury is well established, neither the site of origin of ROS nor the early sequence of events in arsenic toxicity due to ROS is known. We believe that our study provides evidences elucidating the early sequence of events that culminates in the death of the mouse hepatocytes during arsenic exposure.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":" ","pages":"1546297"},"PeriodicalIF":1.8,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40365412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}