1
|
Sun PP, Liao SX, Sang P, Liu MM, Yang JB. Lysosomal transmembrane protein 5: Impact on immune cell function and implications for immune-related deficiencies. Heliyon 2024; 10:e36705. [PMID: 39281638 PMCID: PMC11401081 DOI: 10.1016/j.heliyon.2024.e36705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 09/18/2024] Open
Abstract
Lysosomal transmembrane protein 5 (LAPTM5) is a lysosomal-associated protein that interacts with surface receptors on various immune cells, including B cells, T cells, macrophages and dendritic cells. Dysregulated expression of LAPTM5 is implicated in the development of multiple immune system-related diseases. In the context of tumors, elevated LAPTM5 levels in immune cells are associated with decreased cell membrane levels of T cell receptors (TCR) or B cell receptors (BCR), leading to impaired antigen presentation and immune escape, thereby promoting tumor progression. Besides, LAPTM5 is critical for inducing non-apoptotic cell death in tumor parenchymal cells since its downregulation leads to inhibition of the cell death pathway in the tumor parenchyma and subsequent enhanced tumorigenesis. LAPTM5 also affects the cell cycle as the elevated LAPTM5 expression in solid tumors causes its inability to block the G0/G1 stage. In non-solid tumors, abnormal LAPTM5 expression disrupts blood cell development and causes irregular proliferation. Furthermore, in the nervous system, aberrant LAPTM5 expression in microglia is correlated with Alzheimer's disease severity. In this context, further preclinical research is essential to validate LAPTM5 as a potential target for diagnosis, therapy, and prognosis in immune-related disorders and tumors. This review summarized the current insights into LAPTM5's role in tumors and immune-related deficits, highlighting its potential as a valuable biomarker and therapeutic target.
Collapse
Affiliation(s)
- Peng-Peng Sun
- Department of Orthopedics Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Shi-Xia Liao
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Peng Sang
- Department of Orthopedics Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Mao-Mao Liu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ji-Bin Yang
- Department of Orthopedics Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| |
Collapse
|
2
|
Greco S, Campigotto M, D’Amuri A, Fabbri N, Passaro A. Dyslipidemia, Cholangitis and Fatty Liver Disease: The Close Underexplored Relationship: A Narrative Review. J Clin Med 2024; 13:2714. [PMID: 38731243 PMCID: PMC11084647 DOI: 10.3390/jcm13092714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
In assessing individual cardiovascular risk, dyslipidemia is known for emerging as a pivotal factor significantly contributing to major cardiovascular events. However, dyslipidemic patients frequently present with concurrent medical conditions, each with varying frequencies of occurrence; cholangitis, whether acute or chronic, and hepatic steatosis, along with associated conditions, are strongly associated with specific forms of dyslipidemia, and these associations are reasonably well elucidated. Conversely, evidence linking biliary disease to hepatic steatosis is comparatively scant. This narrative review aims to bridge this gap in knowledge concerning the interplay between dyslipidemia, cholangitis, and hepatic steatosis. By addressing this gap, clinicians can better identify patients at heightened risk of future major cardiovascular events, facilitating more targeted interventions and management strategies. The review delves into the intricate relationships between dyslipidemia and these hepatic and biliary clinical conditions, shedding light on potential mechanisms underlying their associations. Understanding these complex interactions is crucial for optimizing cardiovascular risk assessment as well and devising tailored treatment approaches for patients with dyslipidemia and associated hepatic disorders. Moreover, elucidating these connections empowers clinicians with the knowledge needed to navigate the multifaceted landscape of cardiovascular risk assessment and management effectively. By exploring the intricate relationships between dyslipidemia, cholangitis, and hepatic steatosis (without forgetting the possible clinical consequences of hepatic steatosis itself), this review not only contributes to the existing body of knowledge but also offers insights into potential avenues for further research and clinical practice. Thus, it serves as a valuable resource for healthcare professionals striving to enhance patient care and outcomes in the context of cardiovascular disease and associated hepatic conditions.
Collapse
Affiliation(s)
- Salvatore Greco
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, FE, Italy;
- Department of Internal Medicine, Ospedale del Delta, Via Valle Oppio 2, 44023 Lagosanto, FE, Italy
| | - Michele Campigotto
- Gastroenterology and Digestive Endoscopy Unit, ASUGI, Cattinara University Hospital, Strada di Fiume 447, 34149 Trieste, TS, Italy;
| | - Andrea D’Amuri
- General Medicine Unit, Medical Department, ASST Mantova, Ospedale Carlo Poma, Strada Lago Paiolo 10, 46100 Mantova, MN, Italy;
| | - Nicolò Fabbri
- Department of General Surgery, Ospedale del Delta, Via Valle Oppio 2, 44023 Lagosanto, FE, Italy;
| | - Angelina Passaro
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, FE, Italy;
| |
Collapse
|
3
|
Clinical and Safety Evaluation of Liv.52 in Alcoholic Liver Disease: A Review. GASTROENTEROLOGY INSIGHTS 2022. [DOI: 10.3390/gastroent13040037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Alcoholic liver disease (ALD) has been a growing concern in developed and developing nations. Oxidative stress and lipid peroxidation are the most common cause of the development and progression of ALD. Due to paucity in the number and efficacy of hepatoprotective drugs currently available, and with the easy availability of natural therapy and herbal medicines, ALD is managed using a combination of pharmaceutical interventions and herbal medications. However, the effectiveness of these hepatoprotectives is controversial. Preclinical and clinical studies have demonstrated that Liv.52 modulates the lipotropic activity of hepatocytes, reduces inflammation, enhances alcohol and acetaldehyde metabolism, and protects the hepatic parenchyma by restoring the antioxidant levels of hepatocytes. Clinical studies further support that there is improvement in the subjective symptoms of patients as well as improvements in liver function test parameters. Studies suggest that Liv.52 is well tolerated and has no reported side effects.
Collapse
|
4
|
Warner JB, Zirnheld KH, Hu H, Floyd A, Kong M, McClain CJ, Kirpich IA. Analysis of alcohol use, consumption of micronutrient and macronutrients, and liver health in the 2017-2018 National Health and Nutrition Examination Survey. Alcohol Clin Exp Res 2022; 46:2025-2040. [PMID: 36124871 PMCID: PMC9722540 DOI: 10.1111/acer.14944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Alcohol use is a major global healthcare burden that contributes to numerous adverse health outcomes, including liver disease. Many factors influence individual susceptibility to alcohol-associated diseases, including nutritional factors. The objective of the current study was to examine inter-relations among alcohol, dietary micronutrients and macronutrient consumption, and liver health by analyzing data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). METHODS Based on self-reported alcohol consumption, NHANES respondents were assigned to one of four categories: never drinkers (lifetime abstainers), non-drinkers (past-year abstainers), moderate drinkers (1/2 drinks per day for females/males, respectively), and heavy drinkers (>1/>2 drinks per day for females/males, respectively, and/or frequent binge drinking). Survey-weighted regression analyses (adjusted for gender, age, race, education, and body mass index) were performed to examine associations between alcohol intake, dietary, and liver health characteristics. RESULTS Individuals categorized as heavy drinkers were significantly younger, most often well-educated males with low incidences of diabetes and other comorbidities. They consumed the most overall calories and various micronutrients, indicating a diet that was not necessarily nutrient poor. Neither moderate nor heavy drinkers had liver steatosis or fibrosis as measured by liver elastography, although heavy drinkers had modestly elevated plasma biomarkers of liver injury, including ALT, AST, and GGT, compared with the other groups. CONCLUSIONS Our findings suggest that the category of heavy drinkers in the 2017-2018 NHANES consisted of generally healthy individuals with high-energy intake and no evidence of liver steatosis or fibrosis. However, slightly increased plasma liver markers may indicate a risk of future progression to more advanced stages of liver disease over time in some individuals. Several limitations should be considered when interpreting these data, including the potential misclassification of drinking categories and the lack of standardized cutoff scores for fatty liver as assessed by elastography, among others.
Collapse
Affiliation(s)
- Jeffrey B. Warner
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
- Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
| | - Kara H. Zirnheld
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
| | - Huirong Hu
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, 485 East Gray Street, Louisville, KY 40202, United States
| | - Alison Floyd
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
| | - Maiying Kong
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, 485 East Gray Street, Louisville, KY 40202, United States
- Robley Rex Veterans Affairs Medical Center, 800 Zorn Avenue, Louisville, KY 40206, United States
| | - Craig J. McClain
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
- Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
- Alcohol Research Center, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
- Hepatobiology and Toxicology Center, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
- Robley Rex Veterans Affairs Medical Center, 800 Zorn Avenue, Louisville, KY 40206, United States
| | - Irina A. Kirpich
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
- Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
- Alcohol Research Center, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
- Hepatobiology and Toxicology Center, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
- Department of Microbiology and Immunology, School of Medicine, University of Louisville, 505 South Hancock Street, Louisville KY, 40202, United States
| |
Collapse
|
5
|
Nelaturi P, Kademani SP, Siva Subramanian V, Ravikumar S. Increased Risk of Hypertension in Alcohol Use Disorder of alcohol-related Liver disease-A Hospital Based Case Control Study. ALCOHOLISM TREATMENT QUARTERLY 2022. [DOI: 10.1080/07347324.2022.2135472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Prabhudas Nelaturi
- Multi-Disciplinary Centre for Biomedical Research, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to Be University), Puducherry, India
| | - Sangeetha P Kademani
- Multi-Disciplinary Centre for Biomedical Research, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to Be University), Puducherry, India
| | - Vithiavathi Siva Subramanian
- Department of General Medicine, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to Be University), Puducherry, India
| | - Sambandam Ravikumar
- Multi-Disciplinary Centre for Biomedical Research, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to Be University), Puducherry, India
| |
Collapse
|
6
|
Vidal‐Cevallos P, Torre A, Mendez‐Sanchez N, Uribe M, Chavez‐Tapia NC. Epidemiological and Genetic Aspects of NAFLD and NASH in Mexico. Clin Liver Dis (Hoboken) 2022; 19:68-72. [PMID: 35308477 PMCID: PMC8912226 DOI: 10.1002/cld.1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Content available: Author Interview and Audio Recording.
Collapse
Affiliation(s)
| | - Aldo Torre
- Metabolic UnitDepartment of GastroenterologyInsituto Nacional de Ciencias Médicas y Nutrición “Slavador Zubirán”Tlalpan, Ciudad de MéxicoMexico
| | - Nahum Mendez‐Sanchez
- Liver Research Unit, Medica Sur Clinic & Foundation and Faculty of MedicineNational Autonomous University of MexicoMexico CityMexico
| | - Misael Uribe
- Gastroenterology and Obesity ClinicMedica Sur Clinic and FoundationMexico CityMexico
| | | |
Collapse
|
7
|
Ivancovsky-Wajcman D, Fliss-Isakov N, Webb M, Bentov I, Shibolet O, Kariv R, Zelber-Sagi S. Ultra-processed food is associated with features of metabolic syndrome and non-alcoholic fatty liver disease. Liver Int 2021; 41:2635-2645. [PMID: 34174011 DOI: 10.1111/liv.14996] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND & AIMS High consumption of ultra-processed food (UPF) is associated with mortality and chronic morbidity but has not been studied concerning to non-alcoholic fatty liver disease (NAFLD). We aimed to test the association of UPF consumption with metabolic syndrome, NAFLD and related-liver damage. METHODS A cross-sectional study among volunteers who underwent abdominal ultrasound (AUS), anthropometrics, blood pressure measurements, and fasting blood tests including FibroMax for non-invasive assessment of NASH and significant fibrosis. A food-frequency questionnaire was used to evaluate UPF consumption using the NOVA classification. RESULTS A total of 789 subjects were included in the total sample (mean age 58.83 ± 6.58 years, 52.60% men), a reliable FibroMax test was obtained from 714 subjects, 305 subjects were diagnosed with NAFLD. High consumption of UPF was associated with higher odds for metabolic syndrome (OR = 1.88, 95% CI 1.31-2.71, P = .001) and its components; hypertension, hypertriglyceridemia, and low HDL, among the entire sample (OR = 1.53, 1.07-2.19, P = .026; OR = 1.51, 1.08-2.11, P = .017; OR = 1.55, 1.05-2.29, P = .028). In addition, it was associated with higher odds for NASH and hypertension (OR = 1.89, 1.07-3.38, P = .030; OR = 2.26, 1.20-4.26, P = .012 respectively) among subjects with NAFLD. Stratification by smoking status revealed an association between high UPF consumption and significant fibrosis among ever smokers in the entire sample and among subjects with NAFLD (OR = 1.89, 95% CI 1.03-3.45, P = .039; OR = 2.85, 1.14-7.14, P = .026 respectively). CONCLUSIONS High UPF consumption is associated with metabolic syndrome in the general population, and among those with NAFLD it is associated with NASH marker. Ever-smoking may act synergistically with UPF to amplify the risk for fibrosis.
Collapse
Affiliation(s)
| | - Naomi Fliss-Isakov
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Muriel Webb
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Itay Bentov
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Oren Shibolet
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Revital Kariv
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shira Zelber-Sagi
- School of Public Health, University of Haifa, Haifa, Israel.,Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv, Israel
| |
Collapse
|
8
|
Rhodes FA, Cococcia S, Patel P, Panovska-Griffiths J, Tanwar S, Westbrook RH, Rodger A, Rosenberg W. Is there scope to improve the selection of patients with alcohol-related liver disease for referral to secondary care? A retrospective analysis of primary care referrals to a UK liver centre, incorporating simple blood tests. BMJ Open 2021; 11:e047786. [PMID: 34088709 PMCID: PMC8183275 DOI: 10.1136/bmjopen-2020-047786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES Twenty per cent of people with alcohol use disorders develop advanced fibrosis and warrant referral to secondary care. Improving outcomes in alcohol-related liver disease (ArLD) relies on its earlier detection in primary care with non-invasive tests (NIT). We aimed to determine the proportion of alcohol-related referrals who were diagnosed with advanced fibrosis in secondary care, the prevalence of both alcohol and fatty liver disease ('BAFLD') and the potential impact of NIT on referral stratification. DESIGN/SETTING Retrospective analysis of all general practitioner-referrals with suspected ArLD/non-alcoholic fatty liver disease (NAFLD) to a UK hepatology-centre between January 2015 and January 2018. PARTICIPANTS Of 2944 new referrals, 762 (mean age 55.5±13.53 years) met inclusion criteria: 531 NAFLD and 231 ArLD, of which 147 (64%) could be reclassified as 'BAFLD'. PRIMARY OUTCOME MEASURE Proportion of referrals with suspected ArLD/NAFLD with advanced fibrosis as assessed by tertiary centre hepatologists using combinations of FibroScan, imaging, examination and blood tests and liver histology, where indicated. SECONDARY OUTCOME MEASURES Included impact of body mass index/alcohol consumption on the odds of a diagnosis of advanced fibrosis, and performance of NIT in predicting advanced fibrosis in planned post-hoc analysis of referrals. RESULTS Among ArLD referrals 147/229 (64.2%) had no evidence of advanced fibrosis and were judged 'unnecessary'. Advanced fibrosis was observed in men drinking ≥50 units per week (U/w) (OR 2.74, 95% CI 1.51 to 5, p=0.001) and ≥35 U/w in women (OR 5.11, 95% CI 1.31 to 20.03, p=0.019). Drinking >14 U/w doubled the likelihood of advanced fibrosis in overweight/obesity (OR 2.11; 95% CI 1.44 to 3.09; p<0.001). Use of fibrosis 4 score could halve unnecessary referrals (OR 0.50; 95% CI 0.32 to 0.79, p=0.003) with false-negative rate of 22%, but was rarely used. CONCLUSIONS The majority of referrals with suspected ArLD were deemed unnecessary. NIT could improve identification of liver damage in ArLD, BAFLD and NAFLD in primary care. Anecdotal thresholds for harmful drinking (35 U/w in women and 50 U/w in men) were validated. The impact of alcohol on NAFLD highlights the importance of multi-causality in chronic liver disease.
Collapse
Affiliation(s)
- Freya Alison Rhodes
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, UK
| | - Sara Cococcia
- First Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Preya Patel
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, UK
| | | | - Sudeep Tanwar
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, UK
- Department of Gastroenterology, Barts Health NHS Trust, London, UK
| | - Rachel H Westbrook
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, UK
| | - Alison Rodger
- Department of Infection and Population Health, UCL, London, UK
| | - William Rosenberg
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, UK
| |
Collapse
|
9
|
Benedé-Ubieto R, Estévez-Vázquez O, Guo F, Chen C, Singh Y, Nakaya HI, Gómez Del Moral M, Lamas-Paz A, Morán L, López-Alcántara N, Reissing J, Bruns T, Avila MA, Santamaría E, Mazariegos MS, Woitok MM, Haas U, Zheng K, Juárez I, Martín-Villa JM, Asensio I, Vaquero J, Peligros MI, Argemi J, Bataller R, Ampuero J, Romero Gómez M, Trautwein C, Liedtke C, Bañares R, Cubero FJ, Nevzorova YA. An Experimental DUAL Model of Advanced Liver Damage. Hepatol Commun 2021; 5:1051-1068. [PMID: 34141989 PMCID: PMC8183170 DOI: 10.1002/hep4.1698] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/22/2021] [Accepted: 02/07/2021] [Indexed: 12/11/2022] Open
Abstract
Individuals exhibiting an intermediate alcohol drinking pattern in conjunction with signs of metabolic risk present clinical features of both alcohol-associated and metabolic-associated fatty liver diseases. However, such combination remains an unexplored area of great interest, given the increasing number of patients affected. In the present study, we aimed to develop a preclinical DUAL (alcohol-associated liver disease plus metabolic-associated fatty liver disease) model in mice. C57BL/6 mice received 10% vol/vol alcohol in sweetened drinking water in combination with a Western diet for 10, 23, and 52 weeks (DUAL model). Animals fed with DUAL diet elicited a significant increase in body mass index accompanied by a pronounced hypertrophy of adipocytes, hypercholesterolemia, and hyperglycemia. Significant liver damage was characterized by elevated plasma alanine aminotransferase and lactate dehydrogenase levels, extensive hepatomegaly, hepatocyte enlargement, ballooning, steatosis, hepatic cell death, and compensatory proliferation. Notably, DUAL animals developed lobular inflammation and advanced hepatic fibrosis. Sequentially, bridging cirrhotic changes were frequently observed after 12 months. Bulk RNA-sequencing analysis indicated that dysregulated molecular pathways in DUAL mice were similar to those of patients with steatohepatitis. Conclusion: Our DUAL model is characterized by obesity, glucose intolerance, liver damage, prominent steatohepatitis and fibrosis, as well as inflammation and fibrosis in white adipose tissue. Altogether, the DUAL model mimics all histological, metabolic, and transcriptomic gene signatures of human advanced steatohepatitis, and therefore serves as a preclinical tool for the development of therapeutic targets.
Collapse
Affiliation(s)
- Raquel Benedé-Ubieto
- Department of Physiology, Genetics and MicrobiologyFaculty of BiologyComplutense University MadridMadridSpain.,Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Olga Estévez-Vázquez
- Department of Physiology, Genetics and MicrobiologyFaculty of BiologyComplutense University MadridMadridSpain.,Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Feifei Guo
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Chaobo Chen
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Youvika Singh
- Department of Clinical and Toxicological AnalysesSchool of Pharmaceutical SciencesUniversity of São PauloSão PauloBrazil
| | - Helder I Nakaya
- Department of Clinical and Toxicological AnalysesSchool of Pharmaceutical SciencesUniversity of São PauloSão PauloBrazil.,Scientific Platform PasteurUniversity of São PauloSão PauloBrazil
| | | | - Arantza Lamas-Paz
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Laura Morán
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Nuria López-Alcántara
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,Institute for Endocrinology and DiabetesCenter of Brain Behavior & MetabolismUniversity of LübeckLübeckGermany
| | - Johanna Reissing
- Department of Internal Medicine IIIUniversity Hospital RWTHAachenGermany
| | - Tony Bruns
- Department of Internal Medicine IIIUniversity Hospital RWTHAachenGermany
| | - Matías A Avila
- Hepatology ProgramCIMAUniversity of NavarraPamplonaSpain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Instituto de Investigaciones Sanitarias de NavarraPamplonaSpain
| | - Eva Santamaría
- Hepatology ProgramCIMAUniversity of NavarraPamplonaSpain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain
| | - Marina S Mazariegos
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | | | - Ute Haas
- Department of Internal Medicine IIIUniversity Hospital RWTHAachenGermany
| | - Kang Zheng
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,12 de Octubre Health Research InstituteMadridSpain.,Department of AnesthesiologyZhongda HospitalSchool of MedicineSoutheast UniversityNanjingChina
| | - Ignacio Juárez
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - José Manuel Martín-Villa
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain
| | - Iris Asensio
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain.,Servicio de Aparato DigestivoHospital General Universitario Gregorio MarañónMadridSpain
| | - Javier Vaquero
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain.,Servicio de Aparato DigestivoHospital General Universitario Gregorio MarañónMadridSpain
| | - Maria Isabel Peligros
- Servicio de Anatomía PatológicaHospital General Universitario Gregorio MarañónMadridSpain
| | - Josepmaria Argemi
- Division of Gastroenterology, Hepatology and NutritionCenter for Liver DiseasesUniversity of PittsburghPittsburghPAUSA.,Liver UnitClinica Universidad de Navarra, University of NavarraPamplonaSpain.,Hepatology ProgramCentro de Investigación Médica AplicadaUniversidad de NavarraPamplonaSpain
| | - Ramón Bataller
- Division of Gastroenterology, Hepatology and NutritionCenter for Liver DiseasesUniversity of PittsburghPittsburghPAUSA.,Pittsburgh Liver Research CenterUniversity of PittsburghPittsburghPAUSA
| | - Javier Ampuero
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Biomedical Research Networking Center in Hepatic and Digestive DiseasesInstituto de Biomedicina de SevillaHospital Universitario Virgen del Rocío de SevillaUniversity of SevillaSevillaSpain
| | - Manuel Romero Gómez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Biomedical Research Networking Center in Hepatic and Digestive DiseasesInstituto de Biomedicina de SevillaHospital Universitario Virgen del Rocío de SevillaUniversity of SevillaSevillaSpain
| | | | - Christian Liedtke
- Department of Internal Medicine IIIUniversity Hospital RWTHAachenGermany
| | - Rafael Bañares
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain.,Servicio de Aparato DigestivoHospital General Universitario Gregorio MarañónMadridSpain
| | - Francisco Javier Cubero
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,12 de Octubre Health Research InstituteMadridSpain
| | - Yulia A Nevzorova
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,Department of Internal Medicine IIIUniversity Hospital RWTHAachenGermany.,12 de Octubre Health Research InstituteMadridSpain
| |
Collapse
|
10
|
Duseja A, De A, Taneja S, Choudhury AK, Devarbhavi H, Hu J, Hamid SS, Butt AS, Jafri SMW, Ghazinian H, Chawla YK, Dhiman RK, Duan Z, Chen Y, Tan SS, Lee GH, Lim SG, Kim DJ, Sahu M, Sollano JD, Carpio G, Mohan Prasad VG, Abbas Z, Lesmana LA, Lesmana CR, Eapen CE, Goel A, Sood A, Midha V, Goyal O, Dokmeci AK, Ning Q, Chen T, Ma K, Payawal DA, Lau GKK, Al Mahtab M, Rahman S, Alam MS, Shukla A, Shrestha A, Shah S, Kalal CR, Kumar G, Jain P, Paulson I, Sarin SK. Impact of metabolic risk factors on the severity and outcome of patients with alcohol-associated acute-on-chronic liver failure. Liver Int 2021; 41:150-157. [PMID: 32970356 DOI: 10.1111/liv.14671] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Metabolic risk factors may impact the severity and outcome of alcoholic liver disease. The present study evaluated this effect in patients with alcohol-associated acute-on-chronic liver failure (ACLF). METHODOLOGY One thousand two hundred and sixteen prospectively enrolled patients with ACLF (males 98%, mean age 42.5 ± 9.4 years, mean CTP, MELD and AARC scores of 12 ± 1.4, 29.7 ± 7 and 9.8 ± 2 respectively) from the Asian Pacific Association for the Study of the Liver (APASL) ACLF Research Consortium (AARC) database were analysed retrospectively. Patients with or without metabolic risk factors were compared for severity (CTP, MELD, AARC scores) and day 30 and 90 mortality. Information on overweight/obesity, type 2 diabetes mellitus (T2DM), hypertension and dyslipidaemia were available in 1028 (85%), 1019 (84%), 1017 (84%) and 965 (79%) patients respectively. RESULTS Overall, 392 (32%) patients died at day 30 and 528 (43%) at day 90. Overweight/obesity, T2DM, hypertension and dyslipidaemia were present in 154 (15%), 142 (14%), 66 (7%) and 141 (15%) patients, respectively, with no risk factors in 809 (67%) patients. Patients with overweight/obesity had higher MELD scores (30.6 ± 7.1 vs 29.2 ± 6.9, P = .007) and those with dyslipidaemia had higher AARC scores (10.4 ± 1.2 vs 9.8 ± 2, P = .014). Overweight/obesity was associated with increased day 30 mortality (HR 1.54, 95% CI 1.06-2.24, P = .023). None of other metabolic risk factors, alone or in combination, had any impact on disease severity or mortality. On multivariate analysis, overweight or obesity was significantly associated with 30-day mortality (aHR 1.91, 95% CI 1.41-2.59, P < .001), independent of age, CTP, MELD and AARC scores. CONCLUSION Overweight/obesity and dyslipidaemia increase the severity of alcohol-associated ACLF, and the former also increases the short-term mortality in these patients.
Collapse
Affiliation(s)
- Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arka De
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Taneja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Harshad Devarbhavi
- Department of Gastroenterology, St John's Medical College Hospital, Bangalore, India
| | - Jinhua Hu
- Liver Failure Treatment and Research Center, 302 Military Hospital of China, Beijing, China
| | | | | | | | - Hasmik Ghazinian
- Department of Hepatology, Nork Clinical Hospital of Infectious Diseases, Yerevan, Armenia
| | - Yogesh K Chawla
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radha K Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Zhongping Duan
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yu Chen
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Soek Siam Tan
- Department of Hepatology, Selayang Hospital, Selangor, Malaysia
| | - Guan Huei Lee
- Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Seng Gee Lim
- Medicine, Yong Loo Lin School of Medicine, Singapore
| | | | - Manoj Sahu
- ISM and SUM Hospital, Bhubaneswar, India
| | | | - Gian Carpio
- University of Santo Tomas, Manila, Philippines
| | | | - Zaigham Abbas
- Department of Hepatogastroenterology, Ziauddin University, Karachi, Pakistan
| | | | | | | | | | - Ajit Sood
- Dayanand Medical College and Hospital, Ludhiana, India
| | - Vandana Midha
- Dayanand Medical College and Hospital, Ludhiana, India
| | - Omesh Goyal
- Dayanand Medical College and Hospital, Ludhiana, India
| | | | - Qin Ning
- Tongji Medical College, Wuhan, China
| | - Tao Chen
- Tongji Medical College, Wuhan, China
| | - Ke Ma
- Tongji Medical College, Wuhan, China
| | | | | | | | - Salimur Rahman
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mohd Shahinul Alam
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Akash Shukla
- Seth GS Medical College & Kem Hospital, Mumbai, India
| | | | - Samir Shah
- Hepatology, Global Hospital, Mumbai, India
| | | | - Guresh Kumar
- Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Priyanka Jain
- Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Irene Paulson
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | | |
Collapse
|
11
|
Weerakoon SM, Jetelina KK, Knell G. Longer time spent at home during COVID-19 pandemic is associated with binge drinking among US adults. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 47:98-106. [DOI: 10.1080/00952990.2020.1832508] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Sitara M. Weerakoon
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) and Children’s Health System of Texas, Dallas, TX, USA
| | - Katelyn K. Jetelina
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) and Children’s Health System of Texas, Dallas, TX, USA
| | - Gregory Knell
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) and Children’s Health System of Texas, Dallas, TX, USA
- Children’s Health Andrews Institute for Orthopaedics and Sports Medicine, Plano, TX, USA
| |
Collapse
|
12
|
Thomaides-Brears HB, Lepe R, Banerjee R, Duncker C. Multiparametric MR mapping in clinical decision-making for diffuse liver disease. Abdom Radiol (NY) 2020; 45:3507-3522. [PMID: 32761254 PMCID: PMC7593302 DOI: 10.1007/s00261-020-02684-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/12/2020] [Accepted: 07/22/2020] [Indexed: 02/07/2023]
Abstract
Accurate diagnosis, monitoring and treatment decisions in patients with chronic liver disease currently rely on biopsy as the diagnostic gold standard, and this has constrained early detection and management of diseases that are both varied and can be concurrent. Recent developments in multiparametric magnetic resonance imaging (mpMRI) suggest real potential to bridge the diagnostic gap between non-specific blood-based biomarkers and invasive and variable histological diagnosis. This has implications for the clinical care and treatment pathway in a number of chronic liver diseases, such as haemochromatosis, steatohepatitis and autoimmune or viral hepatitis. Here we review the relevant MRI techniques in clinical use and their limitations and describe recent potential applications in various liver diseases. We exemplify case studies that highlight how these techniques can improve clinical practice. These techniques could allow clinicians to increase their arsenals available to utilise on patients and direct appropriate treatments.
Collapse
Affiliation(s)
| | - Rita Lepe
- Texas Liver Institute, 607 Camden St, Suite 101, San Antonio, TX, 78215, USA
| | | | - Carlos Duncker
- Perspectum, 600 N. Pearl St. Suite 1960, Plaza of The Americas, Dallas, TX, 75201, USA
| |
Collapse
|
13
|
Mitra S, De A, Chowdhury A. Epidemiology of non-alcoholic and alcoholic fatty liver diseases. Transl Gastroenterol Hepatol 2020; 5:16. [PMID: 32258520 PMCID: PMC7063528 DOI: 10.21037/tgh.2019.09.08] [Citation(s) in RCA: 278] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/05/2019] [Indexed: 12/12/2022] Open
Abstract
Liver diseases are fast emerging as global health priorities. Fatty liver is described in the setting of non-alcoholic fatty liver disease (NAFLD) as well as alcoholic liver disease (ALD), the pathogenesis of excess fat being different in the two conditions while both are important components of the changing face of burden of liver diseases worldwide. They are intimately associated with a globalized economy and an increasingly homogenous socio- cultural order with a westernized lifestyle. The accompanying adoption of a progressively sedentary life, consumption of diet dense in calories facilitate development of NAFLD while a spiraling upward trend in alcohol use along with earlier age of drinking as well as increased amount of per capita alcohol consumption increases the prevalence of ALD globally. Adverse health outcomes in NAFLD as well as ALD are caused not only by progressive liver fibrosis that is the most significant factor for liver related and all-cause mortality in both but also by non-liver (cardiovascular, cancer, accidents, neurological) clinical outcomes that calls for a multidisciplinary and social approach to these conditions. We present here an outline of facets of epidemiology of both NAFLD as well as ALD along with its' public health implications. A broad-based integrated approach that incorporates social, behavioral as well as biological targets need to be undertaken at a health system level in a planned manner for these evolving liver health priorities that disproportionately challenges the low- and middle-income countries of Asia, South America and Africa.
Collapse
Affiliation(s)
- Souveek Mitra
- Indian Institute of Liver and Digestive Sciences Sitala (east), Jagadishpur, Sonarpur, Kolkata, India
| | - Arka De
- Department of Hepatology, Post Graduate Institute of Medical Education and Research Chandigarh, Chandigarh, India
| | - Abhijit Chowdhury
- Indian Institute of Liver and Digestive Sciences Sitala (east), Jagadishpur, Sonarpur, Kolkata, India
- Department of Hepatology School of Digestive and Liver Diseases Institute of Post Graduate Medical Education & Research Kolkata, India
| |
Collapse
|
14
|
Hou L, Deng Y, Wu H, Xu X, Lin L, Cui B, Zhao T, Fan X, Mao L, Hou J, Sun H, Wang B, Sun C. Low psoas muscle index associates with long-term mortality in cirrhosis: construction of a nomogram. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:358. [PMID: 32355802 PMCID: PMC7186727 DOI: 10.21037/atm.2020.02.49] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background To develop a nomogram incorporating indicator of muscle waste to prognosticate long-term mortality in liver cirrhosis (LC), and identify the prognostic impact of psoas muscle index (PMI). Methods A total of 251 LC patients who underwent computed tomography were included in this study. Multiple Cox regression was performed, and sex-specific nomogram models incorporating PMI were developed. The utility of the proposed models were evaluated by Harrell’s concordance index (C-index), calibration curve and decision curve analysis. X-tile was used to determine optimal cutpoint for stratifying subjects with distinct outcomes. Subgroup analysis was implemented in terms of age and MELD score. The correlation between PMI and gait speed was also evaluated. Results On multiple analysis, independent predictors for 3-year all-cause mortality were age, BMI, PMI and MELD for males, and age, PMI and MELD for females. Both nomogram models gave rise to moderately strong discrimination, with a C-index of 0.792 (95% CI: 0.723–0.861) in males and 0.715 (95% CI: 0.637–0.793) in females, respectively. The calibration curve implied predicted survival corresponding optimally with the actual outcomes. The proposed models were feasible in clinical settings based on decision curve analysis. On subgroup analysis, PMI might confer valid predictive value on LC patients with MELD <15. Moreover, a definitely positive correlation between PMI and gait speed was revealed. Conclusions Our proposed nomogram embedding PMI rendered an individualized predictive tool for long-term mortality in LC. The diminishing value of PMI is likely indicative of muscle dysfunction.
Collapse
Affiliation(s)
- Lijun Hou
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - You Deng
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Huanhuan Wu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xin Xu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Lin Lin
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin 300308, China
| | - Binxin Cui
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin 300308, China
| | - Tianming Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xiaofei Fan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Lihong Mao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Junjie Hou
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Haoran Sun
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Bangmao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Chao Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin 300052, China
| |
Collapse
|
15
|
Cardiovascular effects of alcohol: A double-edged sword / how to remain at the nadir point of the J-Curve? Alcohol 2019; 76:117-129. [PMID: 30735906 DOI: 10.1016/j.alcohol.2018.08.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/19/2018] [Accepted: 08/21/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND In addition to its established harmful effects on the liver and other organs, heavy alcohol use confers deleterious effects on the cardiovascular (CV) system, as well. However, data have emerged that light/moderate alcohol consumption (1 drink/day for women and 1-2 drinks/day for men) may be protective against CV disease. OBJECTIVE/METHODS English articles regarding the CV effects of alcohol/ethanol were reviewed by search in Medline, Scopus, and Google Scholar. RESULTS A J-shaped curve has been proposed to illustrate a differential effect of alcohol on the CV system with the lowest point on the curve (light/moderate drinking) corresponding to optimal exposure to alcohol, which may confer cardioprotection, the rather neutral effect of non-drinking, and the highest risk of heavy and/or binge drinking reflecting the consequence of harmful exposure. However, staying at the nadir of this J-shaped curve appears difficult. Furthermore, concern and distrust have also been raised about the quality of evidence for such "cardioprotection", emphasizing the need for further randomized controlled trials. Another concern relates to the risk of moderate drinking leading to problem drinking, since alcohol is the most common addictive substance. CONCLUSION Optimal exposure to alcohol (light/moderate use) means that one needs to stay at the nadir of the J-shaped curve for alcohol use to avail oneself of possible cardioprotection, and this may not be an easy thing to accomplish and/or adhere to, especially if one "likes" alcohol drinking. However, the evidence of "cardioprotection" conferred by alcohol has also been refuted, due to lack of randomized controlled trials.
Collapse
|