Annals of hepatology最新文献

{"title":"Peripheral cellular immune alterations during excessive alcohol consumption","authors":"Karla Z. Medina-Avila ,&nbsp;Abigail Hernandez-Barragan ,&nbsp;Marisela Hernández-Santillan ,&nbsp;Isabel Villagómez-López ,&nbsp;Adrián Flores-Sanchez ,&nbsp;Melanie Acosta-Gutiérrez ,&nbsp;Viridiana Bautista-Nava ,&nbsp;Isaac B Flores-Islas ,&nbsp;Jesús A Dorantes-Álvarez ,&nbsp;Moisés Martinez-Castillo ,&nbsp;Fátima Higuera-de la Tijera ,&nbsp;José L Pérez-Hernández ,&nbsp;Gabriela Gutiérrez-Reyes","doi":"10.1016/j.aohep.2025.101847","DOIUrl":"10.1016/j.aohep.2025.101847","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The mechanisms that participate in the pathophysiology of chronic alcohol consumption and Alcoholic Liver Disease (ALD) include alterations of the innate and adaptive immune system, until now there is little information about the damage inducing mechanisms and their participation in the development of the disease. The objective was to determine the imbalance of peripheral cellular immunity according to the pattern of alcohol consumption.</div></div><div><h3>Materials and Patients</h3><div>Cross-sectional study included 5 groups of subjects with different patterns of alcohol consumption using AUDIT and DSM-IV. G1: Control with OH consumption&lt;10g/day (CT); G2: Risk (Ri) and G3: Abuse (A) with AUDIT&gt;8; G4: Alcoholism, without clinical or biochemical stigmata of damage (OH); G5: Patients with alcoholic liver cirrhosis (CiOH). T cells, T-CD4+, T-CD8+, B cells, NK and NKT were determined in peripheral blood by flow cytometry. For statistical analysis we performed U-Mann Whitney, considering p&lt;0.05 significant.</div></div><div><h3>Results</h3><div>In the study, 589 subjects were included, average age 32±11, 30±11, 23±3, 31.5±13 and 47.5±7.7 years CT, Ri, A, OH y CiOH respectively (p&lt;0.001). Alcohol consumption (g/day) was higher in OH 158(210,107), and CiOH 293(340,246) (p&lt;0.001,both). Cellular determination of NK we found elevated (15.4 and 13.3vs11.1) and NKT (3.7 and 2.5vs1.7) in groups A, OH and CiOH (p&lt;0.001), (p&lt;0.001), (p&lt;0.05) only in NK, during CiOH NKT decrease (1.4vs1.7)(p&lt;0.001). In T cells we observed a decrease in OH (62.3vs66.5) and CiOH (56.8vs66.5) (p&lt;0.001), the percentage of CD4+ cells decreased from the Ri group (35.7vs38.8)(p&lt;0.01) until OH (35.1vs38.8)(p&lt;0.01) while during CiOH they increase (41.8vs35.1)(p&lt;0.05). CD8+ cells increase during OH (24.5vs21.1)(p&lt;0.05) and decrease in CiOH (13.9vs21.1)(p&lt;0.001) respectively.</div></div><div><h3>Conclusions</h3><div>The immune abnormalities presented during risky consumption, abuse, dependence and cirrhosis due to alcohol are differential, the most significant changes are observed in the cytotoxic NK, NKT and CD8+ and regulatory CD4+ populations generating a cellular imbalance that could be related to development and progression of liver damage.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101847"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia in patients with liver cirrhosis according to hepatic functional reserve","authors":"Nayeli X. Ortiz-Olvera ,&nbsp;Josue G. Junco-Enciso ,&nbsp;Ricardo Cordova-Ramirez ,&nbsp;Vanesa J. Gutierrez-Bailon ,&nbsp;Segundo Moran-Villota","doi":"10.1016/j.aohep.2025.101855","DOIUrl":"10.1016/j.aohep.2025.101855","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Computed tomography (CT) is one of the most used and validated methods for the non-invasive diagnosis of sarcopenia; its measurement is not affected by the presence of obesity or ascites. The objective of the study was to know the frequency of sarcopenia in patients with liver cirrhosis with different degrees of liver reserve.</div></div><div><h3>Materials and Patients</h3><div>Patients who underwent liver function tests and an abdominal CT were included. The Child-Pugh index (CP) was obtained, and the skeletal muscle index (SMI) was calculated from the measurement of the cross-sectional area of the psoas muscle at the level of the third lumbar vertebra and normalized by the height of the patients (reference values for sarcopenia (Men &lt;50cm2/m2; women &lt;39cm2/m2).</div></div><div><h3>Results</h3><div>110 patients were included (75 women and 35 men) with an average age of 54±11 years, in CP A (n=21), CP B (n=53), and CP C (n=36); with a history of non-alcoholic fatty liver disease (n=36), hepatitis C virus infection (n=19), primary biliary cholangitis (n=15), excessive alcohol consumption (n=10), and other etiologies (n=30). The SMI was significantly higher in Child-Pugh A patients (48.15±9 cm2/m2) compared to Child-Pugh B (44.19±9 cm2/m2) and Child-Pugh C (41.20±7 cm2/m2) patients. The frequency of sarcopenia was 59% (CP A: 33.3%; CP B: 43.4%; CB C: 66.6%).</div></div><div><h3>Conclusions</h3><div>The results of the study confirm that sarcopenia is common in patients with liver cirrhosis and increases as liver reserve deteriorates.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101855"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization and determination of prevalence in autoimmune liver diseases in a tertiary center.","authors":"Ernesto J. Medina-Avalos ,&nbsp;Gabriela Rangel-Zavala ,&nbsp;Jose L. Pérez-Hernández ,&nbsp;Viridiana López-Ladrón de Guevara ,&nbsp;Fátima Higuera-De la Tijera","doi":"10.1016/j.aohep.2025.101879","DOIUrl":"10.1016/j.aohep.2025.101879","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Autoimmune Hepatic Diseases (AHD) involve a chronic immunomediated response towards hepatocytes and bile ducts, as seen in Primary Biliary Cholangitis (PBC), Autoimmune Hepatitis (AIH), and Primary Sclerosing Cholangitis (PSC). Their complex diagnosis, lack of studies, and irreversible liver damage pose significant challenges today due to increased mortality.</div></div><div><h3>Materials and Patients</h3><div>A retrospective (cross-sectional, retrolective) study was conducted. Patient records from men and women aged 18 and above attending the Liver Clinic from 2020 to 2023 were analyzed. Data included demographic, clinical, biochemical, serological, and histological variables compatible with EHAI diagnosis. Descriptive statistics such as frequency, percentages, measures of central tendency, and dispersion were employed for qualitative and quantitative variables.</div></div><div><h3>Results</h3><div>The prevalence of AHD during the evaluated period was 11.5% in our population. A total of 201 patients were identified, comprising 85 (42%) with PBC, 65 (32%) with AIH, 7 (4%) with PSC, and 44 (22%) with overlap (Figure 1). Among them, 177 (88%) were female. The mean age at diagnosis was 51 years ± 13.2. 28% had associated autoimmune diseases, with thyroid disease being the most common at 33%. Hepatic cirrhosis was the most frequent presentation (60%) at diagnosis, with 60% exhibiting decompensation (64% with variceal digestive bleeding) (Figure 2). PBC accounted for 47% of cirrhosis cases. Liver transplantation was performed in 6% of EHAI cases, mainly due to AIH.</div></div><div><h3>Conclusions</h3><div>The diagnosis of AHD shows a progressive increase. A high incidence of advanced stages of liver disease related to AHD is observed. Further research is needed to define the prevalence and characterize these patients, thus enhancing early and effective diagnosis.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101879"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral Assessment of a Novel Hepatic Encephalopathy Model using CCl₄ and Manganese in Mice","authors":"Claudia J. Frias-González ,&nbsp;Ana Sandoval-Rodríguez ,&nbsp;Carolina Díaz-Canul ,&nbsp;Mónica A. Ibarra-Hernández ,&nbsp;Jorge A. Salto-Sevilla ,&nbsp;Juan Armendáriz-Borunda","doi":"10.1016/j.aohep.2025.101880","DOIUrl":"10.1016/j.aohep.2025.101880","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Hepatic encephalopathy (HE), affecting around 40% of cirrhosis patients, impairs cognitive and motor functions. Developing HE experimental models is crucial for advancing our understanding of this condition. This study developed an HE models using intraperitoneal carbon tetrachloride (CCl₄) and manganese supplementation in mice, focusing on behavioral validation.</div></div><div><h3>Materials and Patients</h3><div>Two groups of male C57BL6 wild-type mice (8 mice per group), 10 weeks old, were used in this study. The first group (healthy controls) had access to standard food (Rodent Laboratory Chow* 5001, LabDiet, Richmond, IN, USA), and drinking water ad libitum and were euthanized at week</div><div>12. The second group (cirrhotic group) received the same diet but with 1 mg/ml of MnCl2 added to their drinking water. It was intraperitoneally injected twice a week with CCl4 for 12 weeks (1 ml/kg of body weight dissolved in olive oil for a final concentration of 30% in the first 5 weeks and 20% in the following 7 weeks). Behavioral tests, including the beam walking test and cylinder test, were conducted to assess motor coordination and motor asymmetry. Liver morphology changes were observed, and Hematoxylin-Eosin staining was used to determine inflammation. Data were analyzed using ANOVA for parametric data and the Kruskal-Wallis test for non-parametric data, with results presented as Mean ± SEM.</div></div><div><h3>Results</h3><div>Behavioral tests indicated signs of HE, such as gait abnormalities (tremor, rigidity), hind limb ataxia, and bristly hair. In the beam walking test, cirrhotic mice spent significantly longer to traverse the beam (P ≤ 0.05) and had a higher number of limb foot faults (P ≤ 0.001) compared to healthy mice. The cylinder test showed no significant difference in locomotor asymmetry. Morphological changes in the liver from healthy to cirrhotic were evident. Healthy livers had a smooth reddish-brown surface, regular shape, and firm texture. In contrast, cirrhotic livers appeared paler, with an irregular surface, and became harder and bumpy. Size alterations and the presence of leukocytic foci were also noted in cirrhotic livers.</div></div><div><h3>Conclusions</h3><div>The combination of CCl₄ and manganese successfully induced evidence of significant motor coordination impairments and distinct liver morphology changes, indicating a noticeable progress in developing the experimental model for HE.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101880"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact on survival of decompensated liver cirrhosis and large volume paracentesis: a retrospective cohort","authors":"Karla P. Perez-Lopez,&nbsp;Miriam G. Reyes-Zermeño","doi":"10.1016/j.aohep.2025.101804","DOIUrl":"10.1016/j.aohep.2025.101804","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Ascites is the most common complication of cirrhosis. Its presence represents a 40% mortality at 2 years. The objective of this study was to determine survival in patients with decompensated liver cirrhosis due to ascites undergoing large-volume paracentesis.</div></div><div><h3>Materials and Patients</h3><div>A retrospective, cross-sectional, observational, analytical study was conducted. Patients with liver cirrhosis over 18 years of age of both sexes, of any etiology, treated at Centro Médico Nacional 20 de Noviembre between January 2013 and June 2023, who underwent large volume paracentesis, were selected and matched 2:1 with controls who did not require high volume paracentesis, adjusted for disease severity, age, sex, and Child-Pugh stage. Exclusion criteria were pregnancy or lactation, under 18 years of age, and ascites of a different origin than chronic liver disease. The data was extracted from clinical records.</div></div><div><h3>Results</h3><div>A total of 226 patients were analyzed, 61.9% women (n=140) and 38.1% men (n=86). The average age was 64.28 years (SD=13.33). The minimum age was 19 years and maximum was 91 years. The most frequent etiology was hepatic steatosis in 34.07% (n=77), followed by hepatitis C in 19.91% (n=45), alcoholism in 12.38% (n=28), autoimmune hepatitis in 10.17% (n=23). The distribution of patients by Child-Pugh classification was B in 69% (n=156) and C in 31% (n=70). The average MELD-NA score was 16.93 (SD=7.10). The main comorbidities were 36.7% (n=83) type 2 diabetes mellitus, 24.8% (n=56) systemic arterial hypertension, 15% (n=34) chronic kidney disease, and 16.4% (n=37) obesity.</div><div>Out the 226 patients with liver cirrhosis with ascites, 33.2% (n=75) underwent large volume paracentesis while 66.8% (n=151) underwent paracentesis less than 5 liters. The mortality of patients undergoing large volume paracentesis was 32% compared to 20.5% RR 1.55, IC 95% (0.98-2.45) of patients who did not. In bivariate analysis by sex, there were no statistically significant differences in mortality. Stratified analysis by nutritional status with body mass index did not show differences in mortality in patients undergoing large volume paracentesis.</div></div><div><h3>Conclusions</h3><div>No statistically significant differences in mortality were observed between patients undergoing large volume paracentesis and those who did not. It is important to consider that factors other than paracentesis volume may influence patient survival.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101804"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HGF decreases ANIT-induced liver damage through modulation of redox status.","authors":"Maricruz García-Barrera ,&nbsp;Genaro J. Rosales-Muñoz ,&nbsp;Alejandro Escobedo-Calvario ,&nbsp;Roberto C. Lazzarini-Lechuga ,&nbsp;Natalia Nuño-Lámbarri ,&nbsp;Luis E. Gómez-Quiroz ,&nbsp;Leticia Bucio-Ortiz","doi":"10.1016/j.aohep.2025.101805","DOIUrl":"10.1016/j.aohep.2025.101805","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Intrahepatic cholestasis is the partial/total obstruction of bile flow, with inflammation and increased reactive oxygen species (ROS). Previous studies indicate that hepatocyte growth factor (HGF) generates hepatoprotective effects in alpha-naphthylisothiocyanate (ANIT)-induced cholestasis. We focused on characterizing the mechanisms of HGF-induced protection in cholestasis.</div></div><div><h3>Materials and Methods</h3><div>Male CD1 mice aged 8-10 weeks were randomly divided into 4 experimental groups: 1) untreated control group (NT), 2) ANIT-treated group via intragastric administration at a dose of 60 mg/kg, 3) ANIT+HGF-treated group, where HGF will be administered at a dose of 10 μg/kg intravenously 24 hours after ANIT administration, and 4) control group treated only with HGF. Mice were sacrificed at 30 h, 36 h, and 48 h post-treatment initiation for liver tissue and serum collection. The collected samples were used for biochemical assays, Western Blot, TBARS, and H&amp;E staining.</div></div><div><h3>Results</h3><div>The histological results suggest that HGF can reverse the cholestatic damage observed in time-independent H&amp;E stains, which impacts the architecture of the liver parenchyma, through the decrease in inflammatory infiltrate corroborated with the reversal of the size of the sinusoid area. It was also observed that pyknotic nuclei decrease, which suggests a decrease in cell death as well as an increase in proliferation. These results at the cellular level also impact the decrease in markers of damage at the serum level, such as transaminases, and the decrease in liver size to normal levels. It was also observed that HGF modulates the production of ROS through decreased lipoperoxidation over time, which may be one of the main causes of its hepatoprotective effect in experimental cholestasis. That is why we evaluated the effect of N-acelticistein (NAC) as a therapeutic proposal for cholestasis. The proteomic results indicated that NAC increases the protein content of the glutathione system to decrease damage.</div><div><strong><em>Conclusions:</em></strong> HGF regulates a hepatoprotective response by modulating ROS, which favors the reduction of tissue damage reduction and the antioxidant response through the glutathione system. On the other hand, NAC could be suggested as a therapeutic option in cholestatic disease.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101805"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of polypharmacy in patients with a diagnosis of liver cirrhosis treated in the Gastroenterology service of the La Raza National Medical Center","authors":"Martín Rivera-Huizar ,&nbsp;Javier I. Carrillo-Rojas ,&nbsp;Francisca Martinez-Silva","doi":"10.1016/j.aohep.2025.101812","DOIUrl":"10.1016/j.aohep.2025.101812","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;The need for multiple drugs to treat the complications associated with liver cirrhosis, as well as its comorbidities, places patients with chronic liver disease at high risk of polypharmacy with the possible use of unnecessary drugs and drug interactions. We propose to evaluate the prevalence of polypharmacy in patients with liver cirrhosis in our unit.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;In a descriptive, observational, retrospective study with the aim of evaluating men and women with a diagnosis of liver cirrhosis in follow-up by the gastroenterology service of the Hospital de Especialidades del CMN la Raza in the year 2023.&lt;/div&gt;&lt;div&gt;The prevalence of polypharmacy will be evaluated, taking as the definition established by the World Health Organization as the consumption of 5 or more drugs.&lt;/div&gt;&lt;div&gt;Drug interactions will be recorded and evaluated using the Lexicomp-online formulary tool, classifying them as X (said drug should be avoided), D (consider modification of therapy), C (requires therapy monitoring), B (no action required) A (no known interaction).&lt;/div&gt;&lt;div&gt;For qualitative variables, descriptive statistics will be used through measures of central tendency and measures of dispersion. To know the association between these variables, it will be evaluated using Pearson correlation and to know the level of association between variables, it will be evaluated with cross tables and Chi square. The analysis will be carried out through the SPSS25 program.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 100 patients were recruited, of which 35% were men and 65% were women, the average age was 57 years, the most frequent etiological entity associated with liver cirrhosis was MASLD, representing 45%, followed by 18% by primary biliary cholangitis and in third place chronic HCV infection with 13%. Among the most frequent comorbidities is type 2 diabetes (48%), followed by systemic arterial hypertension (32%), and hypothyroidism (18%). The classification of liver dysfunction found a predominance of Child Pugh B with 49%. The diagnosis of polypharmacy (use of more than 5 drugs) had a prevalence of 44%. The analysis of probable pharmacological interactions found a percentage of D and C interaction of 18% and 60%, with no X or A interactions reported.&lt;/div&gt;&lt;div&gt;Through Chi square analysis, no association was found between MASLD etiology and polypharmacy. By degree of liver dysfunction, an association was found between the Child Pugh C classification and polypharmacy with a P value of 0.002 and a relative risk of 6.25 (CI 1.73-25.27). The association between drug interactions D, and C were associated with polypharmacy with a statistically significant P with a RR of 9.1 and 9.7 respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The prevalence of polypharmacy in our population was higher than that reported in the international literature, placing patients with liver cirrhosis at high risk","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101812"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participation of the immune response and oxidative stress in alcoholism and liver cirrhosis due to alcohol","authors":"Leonardo S. Juárez-Chávez ,&nbsp;José L. Pérez-Hernández ,&nbsp;Abigail Hernández-Barragán ,&nbsp;Zaira Medina-Avila ,&nbsp;Marisela Hernandez-Santillan ,&nbsp;Moisés Martínez-Castillo ,&nbsp;Fátima Higuera-De la Tijera ,&nbsp;Gabriela Gutiérrez-Reyes","doi":"10.1016/j.aohep.2025.101861","DOIUrl":"10.1016/j.aohep.2025.101861","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The spectrum of alcoholic liver disease (ALD) includes steatosis, steatohepatitis, alcoholic hepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. The pathophysiology of liver damage due to chronic alcohol consumption is complex. It is partly a result of reactive oxygen species (ROS) and reactive nitrogen species (RNS), products of oxidative stress, which is one of the mechanisms that will activate the immune system creating a pro-inflammatory state, increasing the levels of several cytokines (TNF-α, IL-1, IL-6, IL-8, MCP-1 and TGF-1).</div></div><div><h3>Objective</h3><div>To study oxidative stress and the production of proinflammatory cytokines that intervene in the different stages of liver damage due to alcohol (alcoholism, alcohol-related liver cirrhosis, and alcoholic hepatitis).</div></div><div><h3>Material and Patients</h3><div>A cross-sectional, prospective, and analytical study that included patients from the Gastroenterology service and donors from the Blood Bank. Patients at different stages of the disease and a control group of healthy subjects (blood bank donors) were included. They were divided into 4 groups: Alcoholism (OH), alcoholic liver cirrhosis (CiOH), alcoholic hepatitis (HA), and healthy controls (CT). From each participant, 20 ml of peripheral blood was obtained for the relevant determinations. Normally distributed data were obtained and ANOVA and orthogonal analyses were performed to detect group differences. A U-Mann Whitney test was used. P &lt; 0.05 was taken as a significant difference.</div></div><div><h3>Results</h3><div>236 subjects were included: 67 patients in OH group; 40 patients with CiOH; 39 patients with Alcoholic Hepatitis (AH), and 90 subjects CT. The gender distribution in patients with ALD (CiOH, and HA) was 77.5% men and 22.5% women. The average alcohol consumption was 376.6±151.6 grams. The CiOH and HA groups presented alterations in platelets, bilirubin, and cytolysis markers at the expense of AST with a significant difference (p&lt;0.05). Regarding oxidative stress, lipoperoxidation was greater in patients with chronic disease (CiOH) and protein damage (protein carbonyls) was greater in HA with p&lt;0.05. Regarding cytokines and chemokines, TNF-α presented a higher level in CiOH and HA (p&lt;0.5), IL-6 presented an elevation in CiOH and HA (p&lt;0.05); IL-10 was elevated in OH, CiOH and HA, MCP-1 and IL-8 showed greater elevation in HA, p&lt;0.05.</div></div><div><h3>Conclusions</h3><div>Oxidative stress and the elevation of proinflammatory cytokines and chemokines have different behaviors in the various stages of alcohol liver disease, which influences the progression and prognosis of the disease. These findings could be considered as possible therapeutic targets.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101861"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoimmune hepatitis developed after acute liver failure due to hepatitis A. A case-report","authors":"Reina S. Velez-Ramirez ,&nbsp;Yenni Joseline Cruz-Ramirez ,&nbsp;Francisco I. Garcia-Juarez","doi":"10.1016/j.aohep.2025.101837","DOIUrl":"10.1016/j.aohep.2025.101837","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;In this report, the relationship between Hepatitis A Virus (HAV) and Autoimmune Hepatitis (HAI) will be analyzed, demonstrating the presence of HAI after an acute HAV infection, highlighting the time between diagnoses and seroconversion with antibodies, as well as clinical characteristics and evolution.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;30-year-old male patient, with no personal pathological history who presents with general malaise, fever and jaundice. The clinical examination was within normal limits except for slight jaundice. The admission biochemical analyzes were as follows: Hb 14.2 g/dL, Leukocytes 8,550 /mm3, Total bilirubin 9.5 mg/dL Direct bilirubin 2.2 mg/, ALT 6155 UI/L, AST 3940 UI/L, Alkaline Phosphatase 1 15U /L. and Prothrombin time 51.0 seconds; INR 4.95. a viral hepatitis profile with positive anti-HAV IgM antibodies and an imaging examination of the liver and bile ducts with inflammatory changes. The diagnosis of hepatitis A and acute liver failure was made.&lt;/div&gt;&lt;div&gt;The patient suffers rapid clinical and biochemical deterioration, with multiple organ failure requiring admission to an intensive care unit and advanced life management area due to acute respiratory failure syndrome, general support stockings and three sessions of single-step albumin dialysis were indicated. He showed stabilization and improvement in his general condition.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;27 days after initial evaluation, fatigue and fever of unknown origin were present. Liver function test with BT 25.58 mg/dl, BD 17.55.0 mg/dl, ALT 38 U/l, AST 100 U/l and ALP 105 U/l and INR 1.5. He presented positive antinuclear antibodies with a cytoplasmic pattern with a titer of 1:80, SMOOTH MUSCLE 3+ intermediate filament pattern. DILUTION 1:80 immunoglobulin G 3260 mg/dl. A liver biopsy was performed, which showed changes compatible with autoimmune hepatitis (fig. 1). In the previous context, the diagnosis of autoimmune hepatitis triggered by HAV was made and treatment was started with prednisone 50 mg every 24 hours PO in a reduced dose of azathioprine 50 mg every 24 hours. At one month of follow-up, PFH was found to have decreased and the established treatment continued.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Atypical courses of hepatitis A virus infection have a global prevalence of 7(1). Some case reports of HAI indicate that viruses that cause acute hepatitis, such as hepatitis A virus (HAV), hepatitis of hepatitis B (HBV) and Epstein-Barr virus, can trigger HAY (2) studies suggest a deficiency of suppressor T cells specific for the asialoglycoprotein receptor that would be involved in immunological abnormalities, including antigen presentations, were involved in the appearance of HAI after acute HA.(3)&lt;/div&gt;&lt;div&gt;Failure to normalize liver tests after OAB should raise concern for HAI, particularly in those with seroconversion to SMA positivity. (4) always having cholestasis that coul","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101837"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The neutrophil-to-lymphocyte ratio (NLR) can predict the presence of bacterial infections in hospitalized patients with decompensated cirrhosis.","authors":"Paloma M. Diego-Salazar,&nbsp;Diego F. Abendaño-Rivera,&nbsp;Cristian Y. Sánchez-Sánchez,&nbsp;Karina Cazarín-Chávez,&nbsp;Kevin S. Vázquez-Hernandez,&nbsp;Fátima Higuera-de-la-Tijera","doi":"10.1016/j.aohep.2025.101798","DOIUrl":"10.1016/j.aohep.2025.101798","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Liver cirrhosis can increase susceptibility to bacterial infections, which are often underestimated due to subtle or absent symptoms and the absence of additional biochemical markers. Early identification of these infections is limited in these patients. The objective is to determine the effectiveness of the Neutrophil-to-Lymphocyte Ratio (NLR) as a predictor of bacterial infections in hospitalized patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;The aim of this retrospective, observational, analytical, cross-sectional study was to validate a prognostic index for patients diagnosed with liver cirrhosis and hospitalized from October 2023 to March 2024. The study included variables such as age, sex, etiology of liver disease, decompensation events leading to hospitalization, and biochemical data to calculate MELD, Child-Pugh, MELD-Na scores, and the degree of acute-on-chronic liver failure upon admission using the EASL-CLIF-ACLF, European Association for the Study of the Liver - Chronic Liver Failure Acute-on-Chronic Liver Failure score. Additionally, the presence of bacterial infection was determined through laboratory tests, imaging studies, and corresponding cultures. The Neutrophil-to-Lymphocyte Ratio was established by dividing the respective total cell counts. The study summarized the variables using descriptive statistics and constructed the area under the curve (AUC-ROC) with 95% confidence intervals. A p-value &lt;0.01 was considered significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 183 patients were included in the study. There were 93 (50.8%) men, with an average age of 55.8 ± 10 years. The distribution by etiology was as follows: Alcohol 72 (39.3%), MASLD 55 (30.1%), Autoimmune 27 (14.8%), Hepatitis C Virus 16 (8.7%), MetALD 16 (8.7%). According to the Child-Pugh score, 91 (49.7%) were class C, 68 (37.2%) were class B, and 24 (13.1%) were class A. Acute decompensations reported were: Variceal bleeding in 90 patients (49.1%), Ascites in 79 (43.1%), and Hepatic Encephalopathy in 102 (55.7%). The degree of acute-on-chronic liver failure upon admission was established: Grade 1 in 30 patients (16.3%), grade 2 in 29 (15.8%), and grade 3 in 12 (6.5%). It was found that 111 (60.7%) patients had bacterial infections during hospitalization, which were urinary infections 69 (37.7%), spontaneous bacterial peritonitis 22 (12%), pneumonia 13 (7.1%), bacteremia 7 (3.8%). NLR ≤ 1.9 predicted bacterial infection with a sensitivity of 94% and specificity of 89% (AUC-ROC: 0.89, 95% CI 0.82-0.95, p &lt;0.0001), compared to other scales such as Child-Pugh, MELD, or MELD-Na with AUC-ROC of 0.69 (0.62-0.77), 0.68 (0.60-0.76), 0.64 (0.56-0.72) respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The Neutrophil-to-Lymphocyte Ratio (NLR) is highly effective in predicting bacterial infections in patients with liver cirrhosis, surpassing the Child-Pugh, MELD, and MELD-Na scales. This indicates","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101798"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}