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Raya Tonetti F, Eguileor A, Mrdjen M, Pathak V, Travers J, Nagy LE, Llorente C. Gut-liver axis: Recent concepts in pathophysiology in alcohol-associated liver disease. Hepatology 2024:01515467-990000000-00873. [PMID: 38691396 DOI: 10.1097/hep.0000000000000924] [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] [Received: 02/13/2024] [Accepted: 04/20/2024] [Indexed: 05/03/2024]
Abstract
The growing recognition of the role of the gut microbiome's impact on alcohol-associated diseases, especially in alcohol-associated liver disease, emphasizes the need to understand molecular mechanisms involved in governing organ-organ communication to identify novel avenues to combat alcohol-associated diseases. The gut-liver axis refers to the bidirectional communication and interaction between the gut and the liver. Intestinal microbiota plays a pivotal role in maintaining homeostasis within the gut-liver axis, and this axis plays a significant role in alcohol-associated liver disease. The intricate communication between intestine and liver involves communication between multiple cellular components in each organ that enable them to carry out their physiological functions. In this review, we focus on novel approaches to understanding how chronic alcohol exposure impacts the microbiome and individual cells within the liver and intestine, as well as the impact of ethanol on the molecular machinery required for intraorgan and interorgan communication.
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Affiliation(s)
- Fernanda Raya Tonetti
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Alvaro Eguileor
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Marko Mrdjen
- Department of Molecular Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
| | - Vai Pathak
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jared Travers
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Gastroenterology and Hepatology, University Hospital, Cleveland, Ohio, USA
| | - Laura E Nagy
- Department of Molecular Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Cristina Llorente
- Department of Medicine, University of California San Diego, La Jolla, California, USA
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Arumugam MK, Perumal SK, Rasineni K, Donohue TM, Osna NA, Kharbanda KK. Lipidomic Analysis of Liver Lipid Droplets after Chronic Alcohol Consumption with and without Betaine Supplementation. BIOLOGY 2023; 12:462. [PMID: 36979154 PMCID: PMC10045066 DOI: 10.3390/biology12030462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/04/2023] [Accepted: 03/08/2023] [Indexed: 03/19/2023]
Abstract
The earliest manifestation of alcohol-associated liver disease is hepatic steatosis, which is characterized by fat accumulation in specialized organelles called lipid droplets (LDs). Our previous studies reported that alcohol consumption elevates the numbers and sizes of LDs in hepatocytes, which is attenuated by simultaneous treatment with the methyl group donor, betaine. Here, we examined changes in the hepatic lipidome with respect to LD size and dynamics in male Wistar rats fed for 6 weeks with control or ethanol-containing liquid diets that were supplemented with or without 10 mg betaine/mL. At the time of sacrifice, three hepatic LD fractions, LD1 (large droplets), LD2 (medium-sized droplets), and LD3 (small droplets) were isolated from each rat. Untargeted lipidomic analyses revealed that each LD fraction of ethanol-fed rats had higher phospholipids, cholesteryl esters, diacylglycerols, ceramides, and hexosylceramides compared with the corresponding fractions of pair-fed controls. Interestingly, the ratio of phosphatidylcholine to phosphatidylethanolamine (the two most abundant phospholipids on the LD surface) was lower in LD1 fraction compared with LD3 fraction, irrespective of treatment; however, this ratio was significantly lower in ethanol LD fractions compared with their respective control fractions. Betaine supplementation significantly attenuated the ethanol-induced lipidomic changes. These were mainly associated with the regulation of LD surface phospholipids, ceramides, and glycerolipid metabolism in different-sized LD fractions. In conclusion, our results show that ethanol-induced changes in the hepatic LD lipidome likely stabilizes larger-sized LDs during steatosis development. Furthermore, betaine supplementation could effectively reduce the size and dynamics of LDs to attenuate alcohol-associated hepatic steatosis.
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Affiliation(s)
- Madan Kumar Arumugam
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Center for Molecular and Nanomedical Sciences, Sathyabama Institute of Science and Technology, Chennai 600119, India
| | - Sathish Kumar Perumal
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Karuna Rasineni
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Terrence M. Donohue
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Department of Biochemistry & Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Natalia A. Osna
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Kusum K. Kharbanda
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Department of Biochemistry & Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA
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Nazeer SS, Sreedevi TP, Jayasree RS. Autofluorescence spectroscopy and multivariate analysis for predicting the induced damages to other organs due to liver fibrosis. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2021; 257:119741. [PMID: 33872953 DOI: 10.1016/j.saa.2021.119741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
When our liver does not work well, it can induce damage to other organs causing their dysfunction. With this background, we aim to study the effect of liver fibrosis on other organs such as heart, lungs, kidney and spleen by assessing the variations in the inherent emission property of the tissue, using fluorescence spectroscopy. Fluorescence emission spectra from excised organs of liver fibrosis induced rats were collected at excitation wavelengths 320 and 410 nm. Optical redox ratio derived from the spectral data supported by multivariate statistical analysis, principal component analysis followed by linear discriminant analysis (PCA-LDA) distinguished between control and fibrosis induced groups. The two different excitation wavelength provided variations in the endogenous flurophores collagen, nicotinamide adenine dinucleotide (NADH), flavin adenine dinucleotide (FAD), lipopigments and porphyrins. Additionally, evaluation of redox ratio provided variations in tissue metabolic activity of different organs. The PCA-LDA modelling yielded a sensitivity of 85 to 97% and specificity of 80 to 96% on 320 nm excitation and a sensitivity of 72 to 100% and specificity of 59 to 100% on 410 nm excitation. Fluorescence emission spectral study along with multivariate analysis paved way to identify the biochemical alterations caused to other organs due to the development of liver fibrosis, which could lead to their damage and dysfunction.
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Affiliation(s)
- Shaiju S Nazeer
- Department of Chemistry, Indian Institute of Space Sciences and Technology, Thiruvananthapuram, Kerala, India; Division of Biophotonics and Imaging, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - T P Sreedevi
- Department of Optoelectronics and Communication, Thangal Kunju Musaliar Institute of Technology, Kollam, Kerala, India
| | - Ramapurath S Jayasree
- Division of Biophotonics and Imaging, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
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Jeon S, Carr R. Alcohol effects on hepatic lipid metabolism. J Lipid Res 2020; 61:470-479. [PMID: 32029510 DOI: 10.1194/jlr.r119000547] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/28/2020] [Indexed: 12/16/2022] Open
Abstract
Alcoholic liver disease (ALD) is the most prevalent type of chronic liver disease with significant morbidity and mortality worldwide. ALD begins with simple hepatic steatosis and progresses to alcoholic steatohepatitis, fibrosis, and cirrhosis. The severity of hepatic steatosis is highly associated with the development of later stages of ALD. This review explores the disturbances of alcohol-induced hepatic lipid metabolism through altered hepatic lipid uptake, de novo lipid synthesis, fatty acid oxidation, hepatic lipid export, and lipid droplet formation and catabolism. In addition, we review emerging data on the contributions of genetics and bioactive lipid metabolism in alcohol-induced hepatic lipid accumulation.
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Affiliation(s)
- Sookyoung Jeon
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA
| | - Rotonya Carr
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA
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Nazeer SS, Saraswathy A, Shenoy SJ, Jayasree RS. Fluorescence spectroscopy as an efficient tool for staging the degree of liver fibrosis: an in vivo comparison with MRI. Sci Rep 2018; 8:10967. [PMID: 30030510 PMCID: PMC6054616 DOI: 10.1038/s41598-018-29370-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 07/06/2018] [Indexed: 12/20/2022] Open
Abstract
The study utilizes autofluorescence spectroscopy (AFS) along with multivariate spectral analysis for differentiating various stages of hepatic fibrosis. AFS has recently emerged as an efficient tool for evaluating the variations in different endogenous flurophores. In this study, the potential of AFS for differentiating the stages of liver fibrosis is assessed and compared with the results of enzyme evaluation, histopathology and the most advanced diagnostic tool, MRI. Using a fiber optic probe, the emission profile of the flurophores such as flavin adenine dinucleotide (FAD), lipofuscin-like lipopigments (lipopigments), porphyrins and the variation in the total hemoglobin concentration are evaluated in vivo on liver fibrosis induced animal models adopting a minimally invasive technique. Significant difference (p < 0.05) in the level of these biomarkers was observed between different stages of liver fibrosis. Normal hepatic tissue could be distinguished from mild and moderate hepatic fibrosis with a sensitivity of 95 to 100% and specificity of 90 to 100% using multivariate spectral analysis. The results are favourable to consider this technique as a potential tool for diagnosing liver fibrosis at an early stage, which is monumental as it otherwise can lead to cirrhosis and liver failure.
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Affiliation(s)
- Shaiju S Nazeer
- Division of Biophotonics and Imaging, Biomedical Technology Wing Sree Chitra Tirunal Institute for Medical Sciences & Technology, Poojappura, Thiruvananthapuram, 695 012, Kerala, India.,Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ariya Saraswathy
- Division of Biophotonics and Imaging, Biomedical Technology Wing Sree Chitra Tirunal Institute for Medical Sciences & Technology, Poojappura, Thiruvananthapuram, 695 012, Kerala, India.,Department of Physics, NSS College, Pandalam, Kerala, India
| | - Sachin J Shenoy
- Division of In Vivo Models and Testing, Biomedical Technology Wing Sree Chitra Tirunal Institute for Medical Sciences & Technology, Poojappura, Thiruvananthapuram, 695 012, Kerala, India
| | - Ramapurath S Jayasree
- Division of Biophotonics and Imaging, Biomedical Technology Wing Sree Chitra Tirunal Institute for Medical Sciences & Technology, Poojappura, Thiruvananthapuram, 695 012, Kerala, India.
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Liu Y, Gu Y, Yu X. Assessing tissue metabolism by phosphorous-31 magnetic resonance spectroscopy and imaging: a methodology review. Quant Imaging Med Surg 2017; 7:707-726. [PMID: 29312876 PMCID: PMC5756783 DOI: 10.21037/qims.2017.11.03] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 11/11/2017] [Indexed: 01/11/2023]
Abstract
Many human diseases are caused by an imbalance between energy production and demand. Magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) provide the unique opportunity for in vivo assessment of several fundamental events in tissue metabolism without the use of ionizing radiation. Of particular interest, phosphate metabolites that are involved in ATP generation and utilization can be quantified noninvasively by phosphorous-31 (31P) MRS/MRI. Furthermore, 31P magnetization transfer (MT) techniques allow in vivo measurement of metabolic fluxes via creatine kinase (CK) and ATP synthase. However, a major impediment for the clinical applications of 31P-MRS/MRI is the prohibitively long acquisition time and/or the low spatial resolution that are necessary to achieve adequate signal-to-noise ratio. In this review, current 31P-MRS/MRI techniques used in basic science and clinical research are presented. Recent advances in the development of fast 31P-MRS/MRI methods are also discussed.
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Affiliation(s)
- Yuchi Liu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Yuning Gu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Xin Yu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH, USA
- Case Center for Imaging Research, Case Western Reserve University, Cleveland, OH, USA
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Puustinen L, Hakkarainen A, Kivisaari R, Boyd S, Nieminen U, Färkkilä M, Lundbom N, Arkkila P. 31Phosphorus magnetic resonance spectroscopy of the liver for evaluating inflammation and fibrosis in autoimmune hepatitis. Scand J Gastroenterol 2017; 52:886-892. [PMID: 28415898 DOI: 10.1080/00365521.2017.1315738] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Liver biopsy is the gold standard in evaluating inflammation and fibrosis in autoimmune hepatitis. AIMS In search of non-invasive follow-up tools in autoimmune hepatitis, we evaluated 31phosphorus magnetic resonance spectroscopy (31P MRS). METHODS Twelve consecutive AIH patients (mean age 42.8 years, 10 women) underwent liver biopsy, routine laboratory liver function tests, which were compared to findings in 31P MRS and transient elastography (TE). RESULTS Phosphoenolpuryvate (PEP) correlated with the grade of inflammation (r = 0.746, p = .005) and thromboplastin time (r = 0.592, p = .043). It also differentiated patients with active inflammation from patients without (t = 3.781, p = .009). There was no correlation between PEP and aminotransferase or immunoglobulin G levels. The phosphoethanolamine (PE)/phosphocholine (PC) ratio, PE/glyserophosphoethanolamine (GPE) ratio and PC/[total phosphomonoester (PME) + phosphodiester (PDE)] ratios correlated with immunoglobulin G (r = 0.764, p = .006; r = 0.618, p = .043; and r= -0.636, p = .035, respectively). PME/PDE and PE/GPE correlated with fibrosis (r = 0.668, p = .018 and r = 0.604, p = .037). PE/GPE also differentiated F3 from F0-2 patients (t = 3.810, p = .003). Phosphorus metabolites did not correlate with TE results and TE did not correlate with liver histology or laboratory parameters. CONCLUSIONS 31P MRS seems to detect active inflammation and advanced fibrosis in AIH patients. TE was ineffective in fibrosis quantification.
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Affiliation(s)
- Lauri Puustinen
- a Department of Gastroenterology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Antti Hakkarainen
- b HUS Helsinki Medical Imaging Center, Radiology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Reetta Kivisaari
- b HUS Helsinki Medical Imaging Center, Radiology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Sonja Boyd
- c Department of Pathology , Haartmann Institute, Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Urpo Nieminen
- a Department of Gastroenterology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Martti Färkkilä
- a Department of Gastroenterology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Nina Lundbom
- b HUS Helsinki Medical Imaging Center, Radiology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Perttu Arkkila
- a Department of Gastroenterology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
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Metabolic profile of liver damage in non-cirrhotic virus C and autoimmune hepatitis: A proton decoupled 31P-MRS study. Eur J Radiol 2017; 90:205-211. [PMID: 28583636 DOI: 10.1016/j.ejrad.2017.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/02/2017] [Accepted: 01/08/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE To study liver 31P MRS, histology, transient elastography, and liver function tests in patients with virus C hepatitis (HCV) or autoimmune hepatitis (AIH) to test the hypothesis that 31P MR metabolic profile of these diseases differ. MATERIALS AND METHODS 25 patients with HCV (n=12) or AIH (n=13) underwent proton decoupled 31P MRS spectroscopy performed on a 3.0T MR imager. Intensities of phosphomonoesters (PME) of phosphoethanolamine (PE) and phosphocholine (PC), phosphodiesters (PDE) of glycerophosphoethanolamine (GPE) and glycerophosphocholine (GPC), and γ, α and β resonances of adenosine triphosphate (ATP), and nicotinamide adenine dinucleotide phosphate (NADPH) were determined. Liver stiffness was measured by transient elastography. Inflammation and fibrosis were staged according to METAVIR from biopsy samples. Activities of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALT) and thromboplastin time (TT) were determined from serum samples. RESULTS PME had a stronger correlation with AST (z=1.73, p=0.04) and ALT (z=1.77, p=0.04) in HCV than in AIH patients. PME, PME/PDE, PE/GPE correlated positively and PDE negatively with inflammatory activity. PE, PC and PME correlated positively with liver function tests. CONCLUSION 31P-MRS suggests a more serious liver damage in HCV than in AIH with similar histopathological findings. 31P-MRS is more sensitive in detecting inflammation than fibrosis in the liver.
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Jeon MJ, Lee Y, Ahn S, Lee C, Kim OH, Oh BC, Yu U, Kim H. High resolution in vivo 31P-MRS of the liver: potential advantages in the assessment of non-alcoholic fatty liver disease. Acta Radiol 2015; 56:1051-60. [PMID: 25270373 DOI: 10.1177/0284185114550850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 08/15/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND Biopsy remains the current gold-standard for assessing non-alcoholic fatty liver disease (NAFLD). To develop a non-invasive means of assessing the disease, 31P magnetic resonance spectroscopy (31P-MRS) has been explored, but the severe spectral overlaps and low signal-to-noise-ratio in 31P-MRS spectra at clinical field strength are clearly limiting factors. PURPOSE To investigate potential advantages of high resolution in vivo 31P-MRS in assessing NAFLD. MATERIAL AND METHODS The study was conducted at 9.4T in control and carbon tetrachloride (CCl4)-treated rats. Rats were divided according to histopathologic findings into a control group (n = 15), a non-alcoholic steatohepatitis group (n = 17), and a cirrhosis group (n = 12). Data were presented with different reference peaks that are commonly used for peak normalization such as total phosphorous signal, phosphomonoester + phosphodiester (PME + PDE), and nucleotide triphosphate (NTP). Then, multivariate analyses were performed. RESULTS In all spectra PME and PDE were well resolved into phosphoethanolamine (PE) and phosphocholine (PC), and into glycerophosphorylethanolamine (GPE) and glycerophosphorylcholine (GPC), respectively. Those MRS measures quantifiable only in highly resolved spectra had higher correlations with histology than those conventional MRS measures such as PME, PDE, and NTP. The optimized partial least-squares discriminant analysis (PLS-DA) model correctly classified 79% (22/28) of the rats in the training set and correctly predicted 69% (11/16) of the rats in the test set. CONCLUSION PE, PC, GPE, GPC, and nicotinamide adenine dinucleotide phosphate (NADP) that can be separately quantifiable in highly resolved spectra may further improve the potential efficacy of 31P-MRS in the diagnosis of NAFLD.
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Affiliation(s)
- Min Jeong Jeon
- Department of Biomedical Sciences, Graduate School, Seoul National University, Seoul, Republic of Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yunjung Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sangdoo Ahn
- Department of Chemistry, Chung-Ang University, Seoul, Republic of Korea
| | - Chulhyun Lee
- Division of Magnetic Resonance Research, Korea Basic Science Institute, Ochang, Chungbuk, Republic of Korea
| | - Ok-Hee Kim
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, Republic of Korea
| | - Byung-Chul Oh
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, Republic of Korea
| | | | - Hyeonjin Kim
- Department of Biomedical Sciences, Graduate School, Seoul National University, Seoul, Republic of Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Suwon, Republic of Korea
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Wang XY, Luo JP, Chen R, Zha XQ, Pan LH. Dendrobium huoshanense polysaccharide prevents ethanol-induced liver injury in mice by metabolomic analysis. Int J Biol Macromol 2015; 78:354-62. [DOI: 10.1016/j.ijbiomac.2015.04.024] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 04/10/2015] [Accepted: 04/13/2015] [Indexed: 01/08/2023]
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Chmelík M, Valkovič L, Wolf P, Bogner W, Gajdošík M, Halilbasic E, Gruber S, Trauner M, Krebs M, Trattnig S, Krššák M. Phosphatidylcholine contributes to in vivo (31)P MRS signal from the human liver. Eur Radiol 2015; 25:2059-66. [PMID: 25576233 DOI: 10.1007/s00330-014-3578-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 11/13/2014] [Accepted: 12/18/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To demonstrate the overlap of the hepatic and bile phosphorus ((31)P) magnetic resonance (MR) spectra and provide evidence of phosphatidylcholine (PtdC) contribution to the in vivo hepatic (31)P MRS phosphodiester (PDE) signal, suggested in previous reports to be phosphoenolpyruvate (PEP). METHODS Phantom measurements to assess the chemical shifts of PEP and PtdC signals were performed at 7 T. A retrospective analysis of hepatic 3D (31)P MR spectroscopic imaging (MRSI) data from 18 and five volunteers at 3 T and 7 T, respectively, was performed. Axial images were inspected for the presence of gallbladder, and PDE signals in representative spectra were quantified. RESULTS Phantom experiments demonstrated the strong pH-dependence of the PEP chemical shift and proved the overlap of PtdC and PEP (~2 ppm relative to phosphocreatine) at hepatic pH. Gallbladder was covered in seven of 23 in vivo 3D-MRSI datasets. The PDE(gall)/γ-ATP(liver) ratio was 4.8-fold higher (p = 0.001) in the gallbladder (PDE(gall)/γ-ATP(liver) = 3.61 ± 0.79) than in the liver (PDE(liver)/γ-ATP(liver) = 0.75 ± 0.15). In vivo 7 T (31)P MRSI allowed good separation of PDE components. The gallbladder is a strong source of contamination in adjacent (31)P MR hepatic spectra due to biliary phosphatidylcholine. CONCLUSIONS In vivo (31)P MR hepatic signal at 2.06 ppm may represent both phosphatidylcholine and phosphoenolpyruvate, with a higher phosphatidylcholine contribution due to its higher concentration. KEY POINTS • In vivo (31)P MRS from the gallbladder shows a dominant biliary phosphatidylcholine signal at 2.06 ppm. • Intrahepatic (31)P MRS signal at 2.06 ppm may represent both intrahepatic phosphatidylcholine and phosphoenolpyruvate. • In vivo (31)P MRS has the potential to monitor hepatic phosphatidylcholine.
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Affiliation(s)
- Marek Chmelík
- MR Centre of Excellence, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
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Novak J, Wilson M, Macpherson L, Arvanitis TN, Davies NP, Peet AC. Clinical protocols for ³¹P MRS of the brain and their use in evaluating optic pathway gliomas in children. Eur J Radiol 2014; 83:e106-12. [PMID: 24331847 PMCID: PMC4029084 DOI: 10.1016/j.ejrad.2013.11.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 10/28/2013] [Accepted: 11/02/2013] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In vivo (31)P Magnetic Resonance Spectroscopy (MRS) measures phosphorus-containing metabolites that play an essential role in many disease processes. An advantage over (1)H MRS is that total choline can be separated into phosphocholine and glycerophosphocholine which have opposite associations with tumour grade. We demonstrate (31)P MRS can provide robust metabolic information on an acceptable timescale to yield information of clinical importance. METHODS All MRI examinations were carried out on a 3T whole body scanner with all (31)P MRS scans conducted using a dual-tuned (1)H/(31)P head coil. Once optimised on phantoms, the protocol was tested in six healthy volunteers (four male and two female, mean age: 25±2.7). (31)P MRS was then implemented on three children with optic pathway gliomas. RESULTS (31)P MRS on volunteers showed that a number of metabolite ratios varied significantly (p<0.05 ANOVA) across different structures of the brain, whereas PC/GPC did not. Standard imaging showed the optic pathway gliomas were enhancing on T1-weighted imaging after contrast injection and have high tCho on (1)H MRS, both of which are associated with high grade lesions. (31)P MRS showed the phosphocholine/glycerophosphocholine ratio to be low (<0.6) which suggests low grade tumours in keeping with their clinical behaviour and the histology of most biopsied optic pathway gliomas. CONCLUSION (31)P MRS can be implemented in the brain as part of a clinical protocol to provide robust measurement of important metabolites, in particular providing a greater understanding of cases where tCho is raised on (1)H MRS.
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Affiliation(s)
- Jan Novak
- School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom; Birmingham Children's Hospital, Birmingham, United Kingdom.
| | - Martin Wilson
- School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom; Birmingham Children's Hospital, Birmingham, United Kingdom.
| | | | - Theodoros N Arvanitis
- Birmingham Children's Hospital, Birmingham, United Kingdom; School of Electronic, Electrical and Computer Engineering, University of Birmingham, Birmingham, United Kingdom.
| | - Nigel P Davies
- School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom; Birmingham Children's Hospital, Birmingham, United Kingdom; University Hospitals Birmingham NHS Foundation Trust, Medical Physics RRPPS, Birmingham, United Kingdom.
| | - Andrew C Peet
- School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom; Birmingham Children's Hospital, Birmingham, United Kingdom.
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Quantitative profile of lipid classes in blood by normal phase chromatography with evaporative light scattering detector: Application in the detection of lipid class abnormalities in liver cirrhosis. Clin Chim Acta 2013; 421:132-9. [DOI: 10.1016/j.cca.2013.02.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 02/03/2013] [Accepted: 02/04/2013] [Indexed: 11/19/2022]
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Abstract
Little is known about how alcohol causes liver disease and cirrhosis. The strongest evidence of the causality between alcohol and liver disease stems from epidemiological observations. Factors contributing to alcohol-induced fibrosis and cirrhosis include cytokines, oxidative stress, and toxic metabolites of ethanol. Patients with alcoholic cirrhosis generally have complications at diagnosis, and cirrhotic complications should be actively assessed because they are closely associated with subsequent morbidity as well as mortality. Abstinence is strictly required to prevent disease progression and is critical for eventual liver transplantation. In addition, nutritional therapy remains the mainstay of managing alcoholic cirrhosis.
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Affiliation(s)
- Yi-Wen Huang
- Liver Center, Cathay General Hospital Medical Center, Taipei, Taiwan ; Division of Gastroenterology, Department of internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Sien-Sing Yang
- Liver Center, Cathay General Hospital Medical Center, Taipei, Taiwan ; Faculty of Medicine, Fu-Jen Catholic University College of Medicine, Taipei, Taiwan
| | - Jia-Horng Kao
- Division of Gastroenterology, Department of internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan ; Graduate institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan ; Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
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15
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Sevastianova K, Hakkarainen A, Kotronen A, Cornér A, Arkkila P, Arola J, Westerbacka J, Bergholm R, Lundbom J, Lundbom N, Yki-Järvinen H. Nonalcoholic Fatty Liver Disease: Detection of Elevated Nicotinamide Adenine Dinucleotide Phosphate with in Vivo 3.0-T 31P MR Spectroscopy with Proton Decoupling. Radiology 2010; 256:466-473. [DOI: 10.1148/radiol.10091351] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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16
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Evaluation of the 13C-octanoate breath test as a surrogate marker of liver damage in animal models. Dig Dis Sci 2010; 55:1589-98. [PMID: 19731033 DOI: 10.1007/s10620-009-0913-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Accepted: 07/09/2009] [Indexed: 12/13/2022]
Abstract
BACKGROUND Octanoate (also known as sodium octanoate), a medium-chain fatty acid metabolized in the liver, is a potential substrate for non-invasive breath testing of hepatic mitochondrial beta-oxidation. METHODS We evaluated the 13C-octanoate breath test (OBT) for assessing injury in acute hepatitis and two rat models of liver cirrhosis, first testing octanoate absorption (per os or intraperitoneally (i.p.)) in normal rats. We then induced acute hepatitis with thioacetamide (300 mg/kg/i.p., 24-h intervals). Liver injury end points were serum aminotransferase levels and 13C-OBT (24 and 48 h following initial injection). Thioacetamide (200 mg/kg/i.p., twice per week, 12 weeks) was used to induce liver cirrhosis. OBT and liver histological assessment were performed every 4 weeks. Bile duct ligation (BDL) was used to induce cholestatic liver injury. We completed breath tests with 13C-OBT and 13C-methacetin (MBID), liver biochemistry, and liver histology in BDL and sham-operated rats (baseline, 6, 14, 20 days post-BDL). RESULTS Octanoate absorbs well by either route. Peak amplitudes and cumulative percentage dose recovered at 30 and 60 min (CPDR30/60), but not peak time, correlated with acute hepatitis. Fibrosis stage 3 at week 8 significantly correlated with each OBT parameter. Cholestatic liver injury (serum bilirubin, ALP, gamma-GT, liver histology) was associated with significant suppression of the maximal peak values and CPDR30/60, respectively (P<0.05),using MBID but not 13C-octanoate. CONCLUSIONS OBT is sensitive for potentially evaluating liver function in rat models of acute hepatitis and thioacetamide-induced liver cirrhosis but not in cholestatic liver injury. The MBID test may be better for evaluation of cholestatic liver disease in this model.
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17
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Sijens PE. Parametric exploration of the liver by magnetic resonance methods. Eur Radiol 2009; 19:2594-607. [PMID: 19504103 PMCID: PMC2762052 DOI: 10.1007/s00330-009-1470-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 04/24/2009] [Accepted: 04/30/2009] [Indexed: 12/16/2022]
Abstract
MRI, as a completely noninvasive technique, can provide quantitative assessment of perfusion, diffusion, viscoelasticity and metabolism, yielding diverse information about liver function. Furthermore, pathological accumulations of iron and lipids can be quantified. Perfusion MRI with various contrast agents is commonly used for the detection and characterization of focal liver disease and the quantification of blood flow parameters. An extended new application is the evaluation of the therapeutic effect of antiangiogenic drugs on liver tumours. Novel, but already widespread, is a histologically validated relaxometry method using five gradient echo sequences for quantifying liver iron content elevation, a measure of inflammation, liver disease and cancer. Because of the high perfusion fraction in the liver, the apparent diffusion coefficients strongly depend on the gradient factors used in diffusion-weighted MRI. While complicating analysis, this offers the opportunity to study perfusion without contrast injection. Another novel method, MR elastography, has already been established as the only technique able to stage fibrosis or diagnose mild disease. Liver fat content is accurately determined with multivoxel MR spectroscopy (MRS) or by faster MRI methods that are, despite their widespread use, prone to systematic error. Focal liver disease characterisation will be of great benefit once multivoxel methods with fat suppression are implemented in proton MRS, in particular on high-field MR systems providing gains in signal-to-noise ratio and spectral resolution.
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Affiliation(s)
- Paul E Sijens
- Radiology, University Medical Center Groningen and University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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18
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Woodward JM, Priest AN, Hollingsworth KG, Lomas DJ. Clinical Application of Magnetic Resonance Spectroscopy of the Liver in Patients Receiving Long-Term Parenteral Nutrition. JPEN J Parenter Enteral Nutr 2009; 33:669-76. [DOI: 10.1177/0148607109332908] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Jeremy M. Woodward
- From the Departments of Gastroenterology, Radiology, and Medical Physics, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Andrew N. Priest
- From the Departments of Gastroenterology, Radiology, and Medical Physics, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Kieren G. Hollingsworth
- From the Departments of Gastroenterology, Radiology, and Medical Physics, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - David J. Lomas
- From the Departments of Gastroenterology, Radiology, and Medical Physics, Addenbrooke's Hospital, Cambridge, United Kingdom
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19
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Yu RS, Hao L, Dong F, Mao JS, Sun JZ, Chen Y, Lin M, Wang ZK, Ding WH. Biochemical metabolic changes assessed by 31P magnetic resonance spectroscopy after radiation-induced hepatic injury in rabbits. World J Gastroenterol 2009; 15:2723-30. [PMID: 19522022 PMCID: PMC2695887 DOI: 10.3748/wjg.15.2723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the features of biochemical metabolic changes detected by hepatic phosphorus-31 magnetic resonance spectroscopy (31P MRS) with the liver damage score (LDS) and pathologic changes in rabbits and to investigate the diagnostic value of 31P MRS in acute hepatic radiation injury.
METHODS: A total of 30 rabbits received different radiation doses (ranging 5-20 Gy) to establish acute hepatic injury models. Blood biochemical tests, 31P MRS and pathological examinations were carried out 24 h after irradiation. The degree of injury was evaluated according to LDS and pathology. Ten healthy rabbits served as controls. The MR examination was performed on a 1.5 T imager using a 1H/31P surface coil by the 2D chemical shift imaging technique. The relative quantities of phosphomonoesters (PME), phosphodiesters (PDE), inorganic phosphate (Pi) and adenosine triphosphate (ATP) were measured. The data were statistically analyzed.
RESULTS: (1) Relative quantification of phosphorus metabolites: (a) ATP: there were significant differences (P < 0.05) (LDS-groups: control group vs mild group vs moderate group vs severe group, 1.83 ± 0.33 vs 1.55 ± 0.24 vs 1.27 ± 0.09 vs 0.98 ± 0.18; pathological groups: control group vs mild group vs moderate group vs severe group, 1.83 ± 0.33 vs 1.58 ± 0.25 vs 1.32 ± 0.07 vs 1.02 ± 0.18) of ATP relative quantification among control group, mild injured group, moderate injured group, and severe injured group according to both LDS grading and pathological grading, respectively, and it decreased progressively with the increased degree of injury (r = -0.723, P = 0.000). (b) PME and Pi; the relative quantification of PME and Pi decreased significantly in the severe injured group, and the difference between the control group and severe injured group was significant (P < 0.05) (PME: LDS-control group vs LDS-severe group, 0.86 ± 0.23 vs 0.58 ± 0.22, P = 0.031; pathological control group vs pathological severe group, 0.86 ± 0.23 vs 0.60 ± 0.21, P = 0.037; Pi: LDS-control group vs LDS-severe group, 0.74 ± 0.18 vs 0.43 ± 0.14, P = 0.013; pathological control group vs pathological severe group, 0.74 ± 0.18 vs 0.43 ± 0.14, P = 0.005) according to LDS grading and pathological grading, respectively. (c) PDE; there were no significant differences among groups according to LDS grading, and no significant differences between the control group and experimental groups according to pathological grading. (2) The ratio of relative quantification of phosphorus metabolites: significant differences (P < 0.05) (LDS-moderate group and LDS-severe group vs LDS-control group and LDS-mild group, 1.94 ± 0.50 and 1.96 ± 0.72 vs 1.43 ± 0.31 and 1.40 ± 0.38) were only found in PDE/ATP between the moderate injured group, the severe injured group and the control group, the mild injured group. No significant difference was found in other ratios of relative quantification of phosphorus metabolites.
CONCLUSION: 31P MRS is a useful method to evaluate early acute hepatic radiation injury. The relative quantification of hepatic ATP levels, which can reflect the pathological severity of acute hepatic radiation injury, is correlated with LDS.
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Talwalkar JA, Yin M, Fidler JL, Sanderson SO, Kamath PS, Ehman RL. Magnetic resonance imaging of hepatic fibrosis: emerging clinical applications. Hepatology 2008; 47:332-42. [PMID: 18161879 DOI: 10.1002/hep.21972] [Citation(s) in RCA: 262] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Chronic liver disease and cirrhosis remains a major public health problem worldwide. While the majority of complications from chronic liver disease result from progressive hepatic fibrosis, the available diagnostic tests used in clinical practice are not sensitive or specific enough to detect occult liver injury at early or intermediate stages. While liver biopsy can stage the extent of fibrosis at diagnosis, its utility as a tool for longitudinal monitoring will be limited at the population level. To date, a number of methods including serum marker panels and ultrasound-based transient elastrography have been proposed for the non-invasive identification of hepatic fibrosis. Novel techniques including magnetic resonance (MR) spectroscopy, diffusion weighted MR, and MR elastography have also emerged for detecting fibrosis. In contrast to other non-invasive methods, MR imaging holds the promise of providing functional and biological information about hepatic pathophysiology as it relates to the natural history and future treatment of hepatic fibrosis. (HEPATOLOGY 2007.).
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Affiliation(s)
- Jayant A Talwalkar
- Advanced Liver Diseases Study Group, Miles and Shirley Fitterman Center for Digestive Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA.
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Abstract
Enthusiasm for liver support devices, particularly cell-based biological systems and albumin dialysis, increased over the last decade and there has been considerable clinical activity both within and without the construct of clinical trials. Most data have been generated on patients with acute liver failure or in patients with decompensation of chronic liver disease, often referred to as acute-on-chronic liver failure. In acute liver failure liver, liver support devices are more realistically being used as a 'bridge' to liver transplantation rather than to transplant-free survival. In acute-on-chronic liver failure the clinical objective of attaining clinical stability with treatment appears more achievable. The so-called bioartificial liver device, based on porcine hepatocytes, is the most extensively evaluated biological device. A sizeable clinical trial failed to demonstrate efficacy, but secondary analyses suggest it would be unwise to assume futility had been established with this device. Molecular adsorbent recirculating system leads the way in the non-biological category in terms of the number of patients treated, but data from large clinical trials are not yet available. One of the strongest conclusions of this review is that the amount of high-quality data available on liver support devices dramatically understates the effort and money that have been expended in their assessment. It is very clear that randomized controlled trials are mandatory to establish clinical efficacy, but it is less clear how the ideal trial should be constructed.
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Affiliation(s)
- J O'Grady
- Institute of Liver Studies, King's College Hospital, London, UK. john.o'
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22
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Kim SH, Lee JM, Han JK, Lee JY, Lee KH, Han CJ, Jo JY, Yi NJ, Suh KS, Shin KS, Jo SY, Choi BI. Hepatic macrosteatosis: predicting appropriateness of liver donation by using MR imaging--correlation with histopathologic findings. Radiology 2006; 240:116-29. [PMID: 16684918 DOI: 10.1148/radiol.2393042218] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE To retrospectively evaluate the diagnostic performance of magnetic resonance (MR) imaging in predicting the appropriateness of liver donation in potential living liver donors by using histopathologic results as the reference standard. MATERIALS AND METHODS This study was approved by institutional review board; all patients gave informed consent for the use of MR data for future research. Fifty-seven potential liver donors (40 male, 17 female; age range, 17-57 years; mean age, 32 years) underwent dual-echo 1.5-T MR imaging. Two radiologists qualitatively graded each MR image, with consensus for disagreements. Livers were assigned one of three degrees of hepatic steatosis on the basis of changes in hepatic signal intensity (SI) between in-phase and opposed-phase images. For quantitative analysis, a third radiologist calculated mean hepatic and mean splenic SI by averaging 25 hepatic regions of interest and three splenic regions of interest. Relative SI decrease (RSID) in the liver on opposed-phase images compared with in-phase images was calculated. Linear regression analysis was used to correlate RSID with the degree of total steatosis, macrosteatosis, and microsteatosis. Diagnostic performance for predicting the appropriateness of liver donation was analyzed. RESULTS Histologic findings of macrosteatosis resulted in 52 patients being categorized as appropriate donors, with the remaining five being categorized as inappropriate donors. RSID was correlated with total steatosis (r = 0.850). When the RSID criterion for inappropriateness of liver donation was set at 20%, the sensitivity, specificity, and accuracy were 100%, 92.3%, and 93%, respectively. When RSID was used, four livers that had been misclassified as inappropriate for transplantation were found to have microsteatosis of various degrees and a less than moderate degree of macrosteatosis at histologic analysis. Qualitative and quantitative analyses were comparably accurate. CONCLUSION When an RSID criterion of less than 20% was used, dual-echo MR imaging facilitated the correct prediction of appropriateness of liver donation in 53 of 57 patients.
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Affiliation(s)
- Se Hyung Kim
- Department of Radiology, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
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23
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Abstract
PURPOSE OF REVIEW To apprise the reader of advances in 2005 in the epidemiology, pathogenesis, prognosis and treatment of alcoholic liver disease. Alcohol use has declined in developed countries, but the opposite is true elsewhere; alcoholic liver disease is a considerable burden worldwide. RECENT FINDINGS Genetic mechanisms for alcoholic liver disease are being discovered in addition to aggravating cofactors, such as hepatitis C, obesity and iron overload, and ameliorating ones, like coffee and tea drinking. The involvement of the innate immune system and the mechanisms of apoptosis in alcoholic liver disease are better appreciated, especially the emerging role of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Steroid use and nutrition for alcoholic hepatitis are being refined, and the validity of the model for end-stage liver disease (MELD) score in predicting the outcome of alcoholic liver disease is upheld. Recidivism after liver transplantation for alcoholic liver disease adversely impacts long-term survival. SUMMARY Inroads are being made into the genetics of alcoholic liver disease and new phenomena are being uncovered in its pathogenesis, but safe and effective therapies for both alcoholic hepatitis and alcoholic cirrhosis are still wanting.
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Affiliation(s)
- Adrian Reuben
- Liver Service, Division of Gastroenterology/Hepatology and Liver Transplant Program, Medical University of South Carolina, Charleston, 29425, USA.
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24
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Seitz HK, Lieber CS, Stickel F, Salaspuro M, Schlemmer HP, Horie Y. Alcoholic liver disease: from pathophysiology to therapy. Alcohol Clin Exp Res 2006; 29:1276-81. [PMID: 16088984 DOI: 10.1097/01.alc.0000171896.37022.f7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Helmut K Seitz
- Department of Medicine, Salem Medical Center , Heidelberg, Germany.
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25
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Bachert P. Status und Zukunft der molekularen Bildgebung mit hochaufgelöster kernmagnetischer Resonanz. Z Med Phys 2005; 15:163-8. [PMID: 16171037 DOI: 10.1078/0939-3889-00267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The combination of high-resolution magnetic resonance spectroscopy (MRS) with MR imaging methods (e.g., phase-encoding gradients in two or three spatial directions or oscillating frequency-encoding gradients) for the purpose of chemical-shift imaging or spectroscopic imaging (SI) permits the acquisition of molecular images of the human body non-invasively and in vivo. These data show the distribution of specific intracellular metabolites of low molecular mass and high mobility e. g., cholines or high-energy phosphates, within a tissue region or a whole organ. Molecular imaging in whole-body MR tomographs has employed so far the spin-tracer nuclei 1H, 13C, 19F and 31P. To this end, 1H-SI of the human brain and prostate has already achieved a significant clinical value.
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Affiliation(s)
- Peter Bachert
- Abteilung Medizinische Physik in der Radiologie, Forschungsschwerpunkt Innovative Krebsdiagnostik und -therapie, Deutsches Krebsforschungszentrum, Heidelberg.
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