Portal Hypertension & Cirrhosis最新文献

{"title":"The Chinese Herbal TiaoGanXiaoZhi Formula Alleviates the Progression of Metabolic‐Associated Fatty Liver Disease by Regulating the Gut Microbiota","authors":"Wenying Qi, Xu Cao, Yue Chen, Hening Chen, Xiaoke Li, Ningyi Zhang, R.H. Liu, Wei Wang, Shihao Zheng, Size Li, Qiyao Liu, Xiaobin Zao, Yongan Ye","doi":"10.1002/poh2.70000","DOIUrl":"https://doi.org/10.1002/poh2.70000","url":null,"abstract":"ABSTRACT Aims The TiaoGanXiaoZhi formula (TGXZ), a traditional Chinese medicine, has been shown to alleviate the progression of metabolic‐associated fatty liver disease (MAFLD) clinically. However, its underlying mechanism remains unclear. This study aimed to investigate the effects and mechanisms of TGXZ in treating MAFLD in mouse models. Methods The MAFLD mouse model was established using a high‐fat diet and 5% fructose water over 16 weeks. At Week 8, mice exhibited significant steatosis, inflammation, and insulin resistance. A total of 42 mice were divided into the normal feed diet (NFD) group ( n = 18) and the high‐fat feed diet (HFD) group ( n = 24). Six mice from each group were killed at Week 8 for serological and histopathological assessments. The remaining mice were allocated into NFD ( n = 6), HFD ( n = 6), HFD + TGXZ ( n = 6), NFD + TGXZ ( n = 6), and HFD + Placebo ( n = 6) groups. TGXZ (or placebo) was administered at a clinical equivalent dose of 7.699 g/(kg·d) to the respective groups, while NFD and HFD groups received distilled water. Daily gavage started in Week 9. At Week 16, after fasting, body weight and liver condition were recorded, and mice were euthanized with pentobarbital sodium. Liver tissue was collected for further analysis, and the remaining tissue and feces were stored at −80°C. Data were graphed using GraphPad Prism 8.0.0 and analyzed with SPSS Statistics 25.0. Results are expressed as mean ± standard deviation. Statistical comparisons were made using Student's t ‐test for two groups and one‐way ANOVA for more than two groups, with significance set at p < 0.05. Results Compared to the MAFLD mouse model group, TGXZ treatment significantly downregulated the weight of white adipose tissue (1.61 ± 0.66 vs. 3.06 ± 0.34 g, p < 0.0010), liver weight (1.22 ± 0.16 vs. 1.98 ± 0.39 g, p = 0.0031), and the levels of alanine aminotransferase (20.6 ± 3.4 vs. 46.1 ± 12.3 U/L, p < 0.0010), aspartate aminotransferase (99.9 ± 19.1 vs. 168.4 ± 34.3 U/L, p = 0.0014), cholesterol (2.95 ± 0.56 vs. 4.38 ± 0.34 mmol/L, p = 0.0053), triglycerides (2.25 ± 0.41 vs. 4.18 ± 0.67 mmol/L, p < 0.0010), low‐density lipoprotein (0.66 ± 0.11 vs. 1.41 ± 0.52 mmol/L, p = 0.0073), and total bile acid (0.71 ± 0.41 vs. 2.18 ± 0.61 mmol/L, p = 0.0017), except for high‐density lipoprotein (2.41 ± 0.81 vs. 2.55 ± 0.31 mmol/L, p = 0.5655). The liver transcriptome, fecal microbiota sequencing, and fecal lipidomics analysis demonstrated that TGXZ treatment improved the expression of genes related to lipid metabolism, alleviated intestinal microbiota disorders, and mitigated lipid disturbances caused by MAFLD. Conclusions Our study demonstrated that TGXZ treatment effectively alleviated the progression of MAFLD. The inhibitory effects of TGXZ on MAFLD may be attributed to its regulation of gut microbiota, lipid metabolism, and hepatic inflammation.","PeriodicalId":471681,"journal":{"name":"Portal Hypertension & Cirrhosis","volume":"4 1","pages":"26-43"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/poh2.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147914124","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":"Tumor budding is a meaningful prognostic marker in patients with hepatocellular carcinoma after curative hepatectomy","authors":"Kaibo Yang, Kunjin Wu, Zitong Lei, Tong Liu, Xing Zhang, Jing Li, Kun Yang, Qiuting Peng, Ting Lin, Chang Liu, Kai Qu","doi":"10.1002/poh2.85","DOIUrl":"https://doi.org/10.1002/poh2.85","url":null,"abstract":"Abstract Aim Tumor budding (TB) has excellent prognostic value in many solid tumors, but there is little research on it in hepatocellular carcinoma (HCC). This study assessed the prognostic value of TB in patients with HCC who received hepatectomy. Methods This retrospective study included 210 patients with HCC who received curative hepatectomy at the First Affiliated Hospital of Xi'an Jiaotong University, between 2016 and 2018. TB was evaluated on hematoxylin‐ and eosin‐stained slides according to the criteria established by the 2016 International Tumor Budding Consensus Conference. t ‐tests, Chi‐squared tests, and rank‐sum tests were used to correlate the extent of TB with clinicopathological parameters. Prognostic analysis was performed using Cox regression models and the Kaplan–Meier method. Results The positive detection rate of TB was 45.2% (95/210) in 210 patients with HCC. Patients positive for TB always exhibit lower tumor differentiation, higher hepatitis B virus DNA levels, and more severe liver fibrosis. Multivariate Cox analysis identified TB (hazard ratio [HR]: 2.232, 95% confidence interval [CI]: 1.479–3.368, p < 0.001) as an independent prognostic factor for patients' recurrence‐free survival (RFS), similar to tumor size (HR: 1.070, 95% CI: 1.070–1.142, p = 0.042) and satellite nodule (HR: 2.266, 95% CI: 1.298–3.956, p = 0.004). Kaplan–Meier analysis also demonstrated that TB‐positive patients had a significantly worse RFS. Interestingly, subgroup analysis revealed that among HCC patients with negative microvascular invasion (MVI), TB was also strongly associated with RFS (HR: 3.206, 95% CI: 1.667–6.168, p < 0.001). These findings suggest that TB may serve as a supplemental prognostic biomarker for HCC‐negative MVI. Conclusions TB is an adverse prognostic biomarker for HCC, particularly in patients negative for MVI. TB evaluation should be considered in the postoperative pathological examination of HCC in clinical practice.","PeriodicalId":471681,"journal":{"name":"Portal Hypertension & Cirrhosis","volume":"3 2","pages":"86-95"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/poh2.85","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147895797","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":"Dual neovascular targets of vascular endothelial growth factor receptors and platelet‐derived growth factor receptor ameliorate thioacetamide induced liver fibrosis in rats","authors":"Bin Xiong, Yaowei Bai, Jiacheng Liu, Tongqiang Li, Yingliang Wang, Chen Zhou","doi":"10.1002/poh2.75","DOIUrl":"https://doi.org/10.1002/poh2.75","url":null,"abstract":"Abstract Aims Neovascularization plays a crucial role in liver fibrosis (LF), and blocking vascular endothelial growth factor receptors (VEGFR) has been shown to improve fibrosis. The aim of our study was to investigate the role of dual neovascularization targets, VEGFR, and platelet‐derived growth factor receptor (PDGFR), in ameliorating fibrosis. Methods In vitro, we observed the effects of apatinib (APA) (a VEGFR inhibitor) and donafenib (DON) (a VEGFR and PDGFR inhibitor) on the activation, proliferation, and apoptosis of hepatic stellate cells (HSCs) from rats and humans. In vivo, we established a thioacetamide (TAA)‐induced liver fibrosis rat model to explore the antifibrosis effect of APA and DON. We used the method of random table to randomly divide the rats into 4 groups. We detected the expression of angiogenesis‐related proteins using Western blot and immunohistochemistry. Results APA and DON inhibited the proliferation and activation of HSCs, promoted apoptosis of HSCs, and arrested the S phase of the cell cycle in vitro. We also found that DON had a stronger inhibitory effect on HSCs. In vivo, APA and DON ameliorated liver fibrosis, reduced collagen deposition and α‐SMA expression in rats, and DON had a stronger improvement effect. APA and DON downregulated the expression of VEGFR2 while inhibiting the phosphorylation of Akt and ERK1/2. DON can act through both VEGF and PDGF pathways, whereas APA can only act through the VEGF pathway. Conclusion Antiangiogenesis is a promising approach for the treatment of fibrosis. Compared with a single‐target drug (APA), the dual‐target drug (DON) can achieve better therapeutic effects.","PeriodicalId":471681,"journal":{"name":"Portal Hypertension & Cirrhosis","volume":"3 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/poh2.75","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147914417","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":"Fenofibrate in a patient with primary biliary cholangitis with an inadequate response to bezafibrate","authors":"Yangyang Zhou, Haonan Gao, Yuhu Song","doi":"10.1002/poh2.59","DOIUrl":"https://doi.org/10.1002/poh2.59","url":null,"abstract":"A 48-year-old male patient presented to our hospital with abnormal liver function. The results of his liver function tests were as follows: alanine transaminase, 118 U/L (normal range, 5–35 U/L); aspartate transaminase, 86 U/L (8–40 U/L); alkaline phosphatase (ALP), 246 U/L (40–150 U/L); and γ glutamyl transferase (γ-GT), 792 U/L (17–53 U/L). His immunoglobulin (Ig) G and IgM levels were 13.0 g/L (7.51–15.60 g/L) and 2.44 g/L (0.460–3.040 g/L), respectively, and his autoimmune antibody tests were positive for antinuclear antibodies and M2 subtype antimitochondrial antibodies. The patient was treated with ursodeoxycholic acid (UDCA) (250 mg three times/day), with an inadequate biochemical response. He subsequently received UDCA and bezafibrate (200 mg twice daily); however, liver function tests still revealed an inadequate biochemical response. Finally, the patient was treated with UDCA and fenofibrate (200 mg/day), leading to a significant reduction in ALP and γ-GT during the 9-month follow-up period (Figure 1). Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease.1, 2 UDCA is the first line of treatment for PBC,3 with obeticholic acid and fibric acid derivatives (bezafibrate and fenofibrate) as second-line therapies in patients with an incomplete response to UDCA.4, 5 In the current case, fenofibrate reduced the patient's ALP and γ-GT levels, suggesting that it could be an alternative choice for treating patients with PBC who had an inadequate response to UDCA plus bezafibrate. Peroxisome proliferator-activated receptor α (PPARα) is a molecular target of fibrates. Fenofibrate has a stronger and more specific affinity to PPARα than bezafibrate,6, 7 which may contribute to its efficacy for the treatment of PBC. However, further prospective studies are needed to confirm our findings. Yangyang Zhou wrote the manuscript and Haonan Gao collected the data. Yangyang Zhou, Haonan Gao, and Yuhu Song were responsible for data analysis. Yuhu Song supervised the study. All authors have read and approved the final version to be published. This study was supported by the National Natural Science Foundation of China (No. 82070631). The authors declare no conflict of interest. The need for ethical approval for this study was waived by the institutional ethics committee of Tongji Medical College, Huazhong University of Science and Technology. The patient was invited to participate and provided written informed consent. All relevant data are included within the paper.","PeriodicalId":471681,"journal":{"name":"Portal Hypertension & Cirrhosis","volume":"288 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135475474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of transjugular intrahepatic portosystemic shunt therapy for symptomatic portal biliopathy","authors":"Feng Zhang, Xixuan Wang, Wei Zhang, Ming Zhang, Lei Wang, Yuzheng Zhuge","doi":"10.1002/poh2.54","DOIUrl":"https://doi.org/10.1002/poh2.54","url":null,"abstract":"Portal biliopathy (PB) is characterized by an abnormality in the extrahepatic biliary system in patients with chronic portal vein occlusion or cavernous transformation of the portal vein. It is a rare biliary complication secondary to portal hypertension.1 Symptomatic PB refers to recurrent cholangitis and chronic cholestasis with pain caused by biliary strictures or stones. The management of symptomatic PB is limited to case reports, including endoscopic, interventional radiology, and surgical procedures. Transjugular intrahepatic portosystemic shunt (TIPS), an effective therapy for portal hypertension, has been indicated for the cavernous transformation of the portal vein in patients with cirrhosis; however, its role in the management of PB remains unclear. This study aimed to evaluate the efficacy of covered TIPS in patients with symptomatic PB. Patients with symptomatic PB who underwent TIPS between January 2017 and June 2022 were retrospectively screened using a prospectively maintained database. The study protocol was approved by the Ethics Committee of Nanjing Drum Tower Hospital. Informed consent was obtained from all the patients. Laboratory examinations and imaging tests, such as abdominal computed tomography, doppler ultrasonography, and magnetic resonance cholangiopancreatography, were performed. Obstructive jaundice or cholangitis are considered necessary symptoms of symptomatic PB. Outcomes included technical success, procedure-related complications, cholangitis recurrence, portal hypertension complication recurrence, and overall survival. Data are described as frequencies and percentages, means and standard deviations, or medians (ranges), as appropriate. The Statistical Package for Social Sciences (version 22.0, SPSS, IBM, Chicago, IL, USA) was used for statistical analysis. In total, six patients were analyzed. All six patients experienced recurrent cholangitis before undergoing TIPS therapy. The patient characteristics are shown in Supplementary Table S1. Portal vein thrombosis in four patients was secondary to noncirrhotic causes, including leukemia and abdominal surgery, while two patients had liver cirrhosis and a history of splenectomy. Beta-blockers were not administered to these patients. Three patients underwent endoscopic retrograde cholangiopancreatography (ERCP) before TIPS, while two patients suffered from severe hemobilia. Two patients had a history of esophagogastric variceal bleeding and underwent endoscopy. Among them, two patients received percutaneous transhepatic cholangial drainage (PTCD)–TIPS–ERCP continuation treatment because of severe intrahepatic bile duct dilatation combined with severe esophagogastric varices (Figure 1). Technical success was achieved in five patients with TIPS. All procedures were performed using a RUPS-100 (COOK) under local anesthesia. Indirect portal vein angiography combined with the introduction of a microcatheter into the hepatic artery as a marker was used in three patients, whi","PeriodicalId":471681,"journal":{"name":"Portal Hypertension & Cirrhosis","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135433487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia and sarcopenic obesity in patients awaiting liver transplantation","authors":"Liang Fang, Xuechun Liu, Zibin Tian, Yueping Jiang, Xueli Ding, Lingyun Zhang, Xue Jing","doi":"10.1002/poh2.52","DOIUrl":"https://doi.org/10.1002/poh2.52","url":null,"abstract":"Sarcopenia includes the presence of both low skeletal muscle mass and low skeletal muscle function (strength and/or physical performance). A consensus definition of sarcopenia in cirrhosis patients is the phenotypic manifestation of the loss of muscle mass.1 On the basis of body composition analyses, sarcopenic obesity (SO) is defined as a combination of obesity and sarcopenia.2 Sarcopenia and SO have been detected associating with poor prognosis, including frailty, poor survival, infection, and a greater length of hospital stay, physical impairment, and mortality.3 Patients with end-stage liver disease have reduced energy metabolism and protein synthesis. This causes muscle depletion and increases the risk of sarcopenia. Liver transplantation (LT) remains the curative treatment for patients with end-stage liver disease and is associated with mortality, failure to rescue, increased length of hospital and intensive care unit stay, posttransplantation infection, or the occurrence of sepsis.4 Sarcopenia is considered a new predictor of nutritional risk under complicated clinical conditions. However, the model for end-stage liver disease (MELD) and Child–Turcotte–Pugh (CTP) scoring systems do not include nutritional evaluation and physical function of patients.5 Therefore, this study aimed to systematically examine the relationship between end-stage liver disease, sarcopenia, and SO in patients awaiting LT. We retrospectively analyzed 101 patients awaiting LT due to end-stage liver disease (including liver cirrhosis, liver failure, and hepatic carcinoma) at our institution between June 2015 and September 2020 (group L). To confirm whether patients had hepatocellular carcinoma (HCC), we adopted the diagnostic criteria of the 2019 HCC Guidelines in China.6 Because stomach function includes digestion and absorption, it can affect the nutritional condition. Nutritional intake can be influenced by the digestive tract function after gastrointestinal surgery. To compare the prevalence rates of sarcopenia and SO between patients with end-stage liver disease and those with digestive tract cancer, gastric cancer (GC) was selected as the control group. The GC group (group G, n = 101) was matched for gender and age (±2 years) in a 1:1 ratio with group L. The healthy control group (group H) included 51 patients. The inclusion criteria of group L were as follows: (1) Patients with end-stage liver disease based on clinical, laboratory, or radiological findings, with indications for LT including liver failure, hepatic carcinoma, and without responses to any medical treatment; (2) All patients underwent LT at our hospital and computed tomography (CT) scans before they received LT; and (3) Laboratory parameters were acquired before LT. The diagnostic criteria for GC were determined according to pathology. All patients who underwent gastrointestinal surgery during the same period at our hospital were in stage II or III according to the TNM stage. All the patients in th","PeriodicalId":471681,"journal":{"name":"Portal Hypertension & Cirrhosis","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135433953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity and safety of a booster COVID‐19 vaccination in patients with chronic liver disease: A multicenter study","authors":"Jitao Wang, Jingwen Ai, Huiling Xiang, Yanliang Zhang, Zhiyun Hou, Qiran Zhang, Jiaojian Lv, Shubo Chen, Chuan Liu, Qianqian Li, Jing Liang, Faren Xie, Shujun Jiang, Nina Zhang, Aiguo Zhang, Xiaolin Lan, Xuying Zhang, Jinlong Li, Dengxiang Liu, Wenchuan Wang, Wei Rao, Zhang Qun, Qiuju Tian, Xiaolong Qi, Wenhong Zhang","doi":"10.1002/poh2.57","DOIUrl":"https://doi.org/10.1002/poh2.57","url":null,"abstract":"Abstract Aim Patients with chronic liver disease (CLD), especially cirrhosis, are at a high risk of severe illness or death from coronavirus disease‐2019 (COVID‐19) and may have a suboptimal immune response to the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccine. This study aimed to evaluate the safety and immunogenicity of the COVID‐19 booster vaccination in patients with CLD. Methods The study protocol was prospectively registered at ClinicalTrials.gov (No. NCT05204602) after approval by the Ethics Committee. Adult participants with CLD were enrolled in this multicenter prospective study. They completed two doses of the inactivated COVID‐19 vaccine and received booster doses at least 6 months later. Adverse reactions were recorded within 14 days after the booster dose. Serum samples of the enrolled patients were collected before and after booster vaccination and tested for SARS‐CoV‐2 receptor‐binding domain (RBD) immunoglobulin G and neutralizing antibodies. The chi‐squared or Fisher's exact test was used to compare categorical data, and the Mann–Whitney U test was used to compare continuous variables. Two‐sided p < 0.05 were considered statistically significant. Results In total, 63 patients were enrolled from four hospitals in China, including 29 patients with cirrhosis. The median age of all patients was 55 years, and 61.9% (39/63) were male. The vaccines were well tolerated; most adverse reactions were mild and transient, and injection site pain (6.4%; 4/63) and fatigue (3.2%, 2/63) were the most frequent local and systemic adverse events. Following the booster vaccination, our results showed that in the whole cohort, the levels and positive rates of anti‐RBD IgG and neutralizing antibodies were significantly higher than baseline levels (all p < 0.05). Conclusions The inactivated COVID‐19 booster vaccine was safe and significantly increased antibody levels and positivity rates following standard vaccination regimens in patients with CLD, especially those with cirrhosis.","PeriodicalId":471681,"journal":{"name":"Portal Hypertension & Cirrhosis","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134961764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma copeptin concentration is a predictor of tolvaptan efficacy in patients with hepatic ascites","authors":"Fumimasa Tomooka, Kei Moriya, Takahiro Kubo, Akihiko Shibamoto, Jyunya Suzuki, Satoshi Iwai, Soichi Takeda, Yuki Fujimoto, Masahide Enomoto, Koji Murata, Yuki Tsuji, Yukihisa Fujinaga, Koh Kitagawa, Norihisa Nishimura, Hiroaki Takaya, Kosuke Kaji, Hideto Kawaratani, Tadashi Namisaki, Takemi Akahane, Akira Mitoro, Hitoshi Yoshiji","doi":"10.1002/poh2.55","DOIUrl":"https://doi.org/10.1002/poh2.55","url":null,"abstract":"Abstract Aims No solid evidence‐based opinion was raised regarding predictors of the degree of ascites reduction with tolvaptan. This retrospective cohort study aimed to examine whether serum copeptin concentration is a useful predictor of this. Methods The study population consisted of 80 patients with liver cirrhosis treated with tolvaptan for hepatic ascites effusions at Nara Medical University Hospital from May 2014 to December 2018. Forty‐three patients who lost >1.5 kg of body weight in the first week after starting tolvaptan were classified as good responders and the remaining 37 as poor responders. Various laboratory parameters were measured immediately before the start of tolvaptan therapy to examine factors associated with predicting its efficacy. Results In the univariate analysis, no significant differences with respect to age (67.6 vs. 69.8 years, p > 0.05), sex, body mass index (24.8 vs. 23.7 kg/m 2 , p > 0.05), Child–Pugh score (9.4 vs. 9.7, p > 0.05), and Model for End‐stage Liver Disease score (11 vs. 12, p > 0.05) were found between the two groups. Conversely, aspartate transferase and alanine transaminase (ALT) levels were significantly lower in the good response group (52.9 ± 56.3 vs. 68.8 ± 50.7 U/L, p < 0.05; 26.2 ± 30.6 vs. 40.5 ± 33.5 U/L, p < 0.01), whereas serum copeptin and serum sodium concentrations were significantly higher (57.1 ± 15.0 vs. 45.8 ± 16.0 pg/mL, p < 0.01; 136.3 ± 3.4 vs. 133.8 ± 5.8 mEq/L, p < 0.05). In the multivariate analysis, serum copeptin concentration and ALT were statistically significant factors ( p < 0.01, p < 0.05). Regression analysis of the association between the tolvaptan efficacy for refractory ascites and pretreatment serum copeptin concentration showed that a copeptin concentration cutoff of 45.9 pg/mL could predict treatment efficacy with a sensitivity, specificity, and area under the curve of 76.7%, 59.5%, and 0.71%, respectively. Conclusion Serum copeptin concentration may be a predictor of tolvaptan efficacy for refractory ascites effusion in Japanese patients with liver cirrhosis.","PeriodicalId":471681,"journal":{"name":"Portal Hypertension & Cirrhosis","volume":"371 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135348133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of prevention and treatment of portal vein thrombosis between proximal splenic vein ligation followed by postoperative transcatheter anticoagulant therapy and systemic anticoagulant therapy in patients with cirrhotic portal hypertension","authors":"Yang Bu, Kejun Liu, Mingguo Tian, Baoding Li, Liyun Wang, Dong Jia, Yong Yang, Junhao Liu","doi":"10.1002/poh2.58","DOIUrl":"https://doi.org/10.1002/poh2.58","url":null,"abstract":"Abstract Aims Splenectomy combined with pericardial devascularization is one of the important methods to treat hypersplenism, gastrointestinal bleeding, and other complications caused by liver cirrhosis; however, it is accompanied by a high risk of portal vein thrombosis (PVT). This study aimed to explore the preventive and therapeutic effects of proximal splenic vein ligation (PSVL) with postoperative transcatheter anticoagulant therapy (TCAT) on PVT. Methods This study retrospectively selected 143 patients with liver cirrhosis and portal hypertension, who received splenectomy combined with pericardial devascularization from June 30, 2018 to June 30, 2021. According to computed tomography photography, within 1 week before the operation, the patients were divided into a prevention group (without preoperative PVT, n = 112) and a treatment group (preoperative PVT, n = 31). Then, each group was subdivided based on the treatment and prevention measures into PSVL + TCAT ( n = 70) and systemic anticoagulant therapy (SAT) subgroups ( n = 73). The preventive and therapeutic effects of PSVL followed by TCAT on PVT were analyzed. Results The operation time in the PSVL + TCAT subgroups was longer than that in the SAT subgroups (185 ± 76 min vs. 161 ± 55 min; p < 0.01). There was no difference between the two subgroups in terms of operative bleeding (345 ± 82 mL vs. 336 ± 65 mL; p > 0.50). There was no operative death, and all patients recovered uneventfully. In the prevention group, procedure‐related complications occurred in two patients in the PSVL + TCAT subgroup (3.7% [2/54]), including one patient with slight pancreatitis and one patient with chylous leakage, owing to mobilization of the pancreas. The PVT incidence in the prevention group was significantly different between the two subgroups at postoperative 7th day, 3rd month, and 6th month (PSVL + TCAT: 0%, 11.1%, and 5.6% vs. SAT: 39.7%, 31.0%, and 20.7%, respectively; all p < 0.05). In the treatment group, the thrombus regression rate at postoperative 7th day and disappearance rates at the 3rd month and the 6th month of the PSVL + TCAT subgroup were significantly higher than those in the SAT subgroup after anticoagulant and thrombolysis therapy (PSVL + TCAT: 75.0%, 68.8%, and 87.5% vs. SAT: 20.0%, 26.7%, and 40.0%; all p < 0.05). Conclusions PSVL + TCAT reduces the risk of PVT after splenectomy and is safe and effective in treating PVT during surgery for portal hypertension.","PeriodicalId":471681,"journal":{"name":"Portal Hypertension & Cirrhosis","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134961897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MicroRNAs as critical regulators in liver fibrosis","authors":"Xiaolin Wang, Qiuhong Zai, Yong He, Qing Xie","doi":"10.1002/poh2.56","DOIUrl":"https://doi.org/10.1002/poh2.56","url":null,"abstract":"Abstract Liver fibrosis, a common characteristic of chronic liver diseases, is a major challenge to global health. The progression of liver fibrosis is responsible for liver‐related morbidity and mortality. Nevertheless, the pathogenesis of liver fibrosis remains unclear and an effective therapy has not yet been developed. Activation of hepatic stellate cells (HSCs) is well‐known to act as a central driver of liver fibrosis, while resident and infiltrating inflammatory cells further modulate HSC activation via extracellular signals. MicroRNAs (miRNAs) are small, noncoding RNAs that are critical regulators for liver physiological and pathological processes by negatively regulating target gene expression and facilitating intercellular communication. Here, we review the involvement of miRNAs in the development and progression of liver fibrosis in various hepatic cells, including HSCs, hepatocytes, and inflammatory cells, and discuss the potential of miRNAs as biomarkers and therapeutic targets for liver fibrosis.","PeriodicalId":471681,"journal":{"name":"Portal Hypertension & Cirrhosis","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135349214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}