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Zhang C, Liu Y, Wang L, Liu X, Chen C, Zhang J, Zhang C, Wang G, Zhuang H, Zhao H. Dose-response relationship between serum N-glycan markers and liver fibrosis in chronic hepatitis B. Hepatol Int 2024:10.1007/s12072-024-10709-y. [PMID: 39017915 DOI: 10.1007/s12072-024-10709-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/14/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Evaluation of liver fibrosis played a monumental role in the diagnosis and monitoring of chronic hepatitis B (CHB). We aimed to explore the value of serum N-glycan markers in liver fibrosis. METHODS This multi-center (33 hospitals) study recruited 760 treatment-naïve CHB patients who underwent liver biopsy. Serum N-glycan markers were analyzed by DNA sequencer-assisted fluorophore-assisted with capillary electrophoresis (DSA-FACE) technology. First, we explore the relationship between 12 serum N-glycan markers and the fibrosis stage. Then, we developed a Px score for diagnosing significant fibrosis using the LASSO regression. Next, we compared the diagnostic performances between Px, LSM, APRI, and FIB-4. Finally, we explored the relationships between glycosyltransferase gene and liver fibrosis with RNA-transcriptome sequencing. RESULTS We included 622 CHB participants: male-dominated (69.6%); median age 42.0 (IQR 34.0-50.0); 287 with normal ALT; 73.0% with significant fibrosis. P5(NA2), P8(NA3), and P10(NA4) were opposite to the degree of fibrosis, while other profiles (except for P0[NGA2]) increased with the degree of fibrosis. Seven profiles (P1[NGA2F], P2[NGA2FB], P3[NG1A2F], P4[NG1A2F], P7[NA2FB], P8[NA3], and P9[NA3Fb]) were selected into Px score. Px score was associated with an increased risk of significant fibrosis (for per Px score increase, the risk of significant fibrosis was increased by 3.54 times (OR = 4.54 [2.63-7.82]) in the fully-adjusted generalized linear model. p for trend was <0.001. The diagnostic performance of the Px score was superior to others. Glycosyltransferase genes were overexpressed in liver fibrosis, and glycosylation and glycosyltransferase-related pathways were significantly enriched. CONCLUSIONS Serum N-glycan markers were positively correlated with liver fibrosis. Px score had good performance in distinguishing significant fibrosis.
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Affiliation(s)
- Chi Zhang
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, 100034, China
| | - Yiqi Liu
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, 100034, China
| | - Lin Wang
- Department of Clinical Laboratory, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xueen Liu
- Department of Microbiology & Center of Infectious Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Cuiying Chen
- Department of Research and Development, Sysdiagno (Nanjing) Biotech Co., Ltd, Nanjing, 210008, Jiangsu Province, China
| | - Junli Zhang
- Department of Research and Development, Sysdiagno (Nanjing) Biotech Co., Ltd, Nanjing, 210008, Jiangsu Province, China
| | - Chao Zhang
- Department of Research and Development, Sysdiagno (Nanjing) Biotech Co., Ltd, Nanjing, 210008, Jiangsu Province, China
| | - Guiqiang Wang
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, 100034, China.
- Department of Infectious Diseases, Peking University International Hospital, Beijing, 102206, China.
- Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing, China.
| | - Hui Zhuang
- Department of Microbiology & Center of Infectious Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China.
| | - Hong Zhao
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, 100034, China.
- Department of Infectious Diseases, Peking University International Hospital, Beijing, 102206, China.
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Vidili G, Arru M, Meloni P, Solinas G, Atzori S, Maida I. Comparison of 2D Shear Wave Elastography and Transient Elastography in Non-Invasive Evaluation of Liver Fibrosis in Hepatitis C Virus-Related Chronic Liver Disease. J Clin Med 2024; 13:4061. [PMID: 39064101 PMCID: PMC11278231 DOI: 10.3390/jcm13144061] [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: 06/04/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Transient Elastography (TE) is widely regarded as the most reliable non-invasive method for evaluating liver fibrosis. Recently, new techniques such as 2D Shear Wave Elastography (2D-SWE) have been developed. This study aimed to evaluate the correlation between TE and 2D-SWE in patients with HCV-related chronic liver disease and to redefine the cut-off values of 2D-SWE for predicting different stages of fibrosis based on our results. Methods: Both TE (Fibroscan, Echosens, Paris, France) and 2D-SWE (SuperSonic Imagine) were performed simultaneously in 170 patients, including those with active and eradicated HCV infection. Spearman's rank correlation coefficient was used to assess the correlation between the two measurements, and the concordance between the assigned METAVIR classes was calculated using Cohen's kappa coefficient. ROC curves were constructed to determine the optimal cut-off values for 2D-SWE. Results: Ten patients were excluded for invalid measurements. In the remaining 160 patients, TE and 2D-SWE demonstrated a high correlation (ρ = 0.83, p < 0.0001) and good agreement in METAVIR classification (k = 0.74). The optimal cut-off values identified for 2D-SWE were as follows: ≥ 7 kPa for F ≥ 2, ≥ 8.3 kPa for F ≥ 3, and ≥ 9.4 kPa for F4. Conclusions: 2D-SWE is a viable alternative to TE for patients with HCV-related chronic liver disease. Our data suggest that the currently accepted 2D-SWE cut-off values for cirrhosis (F4) should be reconsidered and potentially lowered.
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Affiliation(s)
- Gianpaolo Vidili
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (P.M.); (I.M.)
- Department of Internal Medicine, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, Italy;
- Centralized Day Hospital of the Medical Area, Azienda Ospedaliero Universitaria di Sassari, viale San Pietro 8, 07100 Sassari, Italy
| | - Marco Arru
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (P.M.); (I.M.)
- Department of Internal Medicine, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, Italy;
| | - Pierluigi Meloni
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (P.M.); (I.M.)
- Department of Internal Medicine, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, Italy;
| | - Giuliana Solinas
- Department of Biomedical Sciences, Public Health-Laboratory of Biostatistics, University of Sassari, 07100 Sassari, Italy;
| | - Sebastiana Atzori
- Department of Internal Medicine, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, Italy;
| | - Ivana Maida
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (P.M.); (I.M.)
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Li M, Yao M, Wang L, Liu Y, Ji D, Yang Y, Lu F. The Early On-treatment Stiffness Decline Attributed to the Improved Hepatic Inflammation in Fibrotic Chronic Hepatitis B. J Clin Gastroenterol 2024:00004836-990000000-00311. [PMID: 38990730 DOI: 10.1097/mcg.0000000000002032] [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: 12/27/2023] [Accepted: 05/05/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES Hepatic inflammation, the driver of fibrosis progression in liver disease, can impact the accuracy of liver stiffness measurement (LSM). We wondered whether the decline in LSM value during the early antiviral phase was mainly attributed to the control of hepatic inflammation or the regression of fibrosis in patients with fibrotic/cirrhotic chronic hepatitis B (CHB). PATIENTS AND METHODS The study cohort was composed of 82 patients with CHB who underwent antiviral and antifibrotic therapy at the Fifth Medical Center of PLA General Hospital. All patients had liver biopsies at both baseline and 72 weeks posttherapy. Liver pathology and clinical data, including the LSM value, were collected. RESULTS After 72 weeks of treatment, both the histologic activity index score and fibrosis score, as well as the LSM value, were significantly decreased (P < 0.001), compared with their baseline values. The pretreatment correlation of LSM value with either histologic activity index score (r = 0.526 vs r = 0.286) or fibrosis score (r = 0.677 vs r = 0.587) was attenuated at 72 weeks. Notably, logistic regression analysis revealed that the improvement in inflammation (odds ratio = 1.018, 95% CI: 1.002-1.031, P = 0.023) but not fibrosis (odds ratio = 0.994, 95% CI: 0.980-1.009, P = 0.414), had an impact on the change in LSM values between baseline and at 72-week treatment. CONCLUSIONS The findings of this study suggest that in patients with fibrotic CHB receiving antiviral medication, the early phase reduction in LSM value was related to improved hepatic inflammation rather than fibrosis regression.
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Affiliation(s)
- Mingwei Li
- Research Center for Clinical Medical Sciences, the Fourth Hospital of Shijiazhuang, Shijiazhuang, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Mingjie Yao
- Department of Anatomy and Embryology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
- Fujian Provincial Key Laboratory of Hepatic DrugResearch, Fuzhou, China
| | - Leijie Wang
- College of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yanna Liu
- Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Dong Ji
- Senior Department of Hepatology, the Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Yongping Yang
- Senior Department of Hepatology, the Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Fengmin Lu
- Department of Microbiology and Infectious Disease Center, School of Basic Medicine, Peking University Health Science Center, Beijing, China
- Center of Precision Medicine, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
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Zhi Y, Fan K, Liu S, Hu K, Zan X, Lin L, Yang Y, Gong X, Chen K, Tang L, Li L, Huang J, Zhang S, Zhang L. Deletion of GPR81 activates CREB/Smad7 pathway and alleviates liver fibrosis in mice. Mol Med 2024; 30:99. [PMID: 38982366 PMCID: PMC11234765 DOI: 10.1186/s10020-024-00867-y] [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: 11/17/2023] [Accepted: 06/24/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Enhanced glycolysis is a crucial metabolic event that drives the development of liver fibrosis, but the molecular mechanisms have not been fully understood. Lactate is the endproduct of glycolysis, which has recently been identified as a bioactive metabolite binding to G-protein-coupled receptor 81 (GPR81). We then questioned whether GPR81 is implicated in the development of liver fibrosis. METHODS The level of GPR81 was determined in mice with carbon tetrachloride (CCl4)-induced liver fibrosis and in transforming growth factor beta 1 (TGF-β1)-activated hepatic stellate cells (HSCs) LX-2. To investigate the significance of GPR81 in liver fibrosis, wild-type (WT) and GPR81 knockout (KO) mice were exposed to CCl4, and then the degree of liver fibrosis was determined. In addition, the GPR81 agonist 3,5-dihydroxybenzoic acid (DHBA) was supplemented in CCl4-challenged mice and TGF-β1-activated LX-2 cells to further investigate the pathological roles of GPR81 on HSCs activation. RESULTS CCl4 exposure or TGF-β1 stimulation significantly upregulated the expression of GPR81, while deletion of GPR81 alleviated CCl4-induced elevation of aminotransferase, production of pro-inflammatory cytokines, and deposition of collagen. Consistently, the production of TGF-β1, the expression of alpha-smooth muscle actin (α-SMA) and collagen I (COL1A1), as well as the elevation of hydroxyproline were suppressed in GPR81 deficient mice. Supplementation with DHBA enhanced CCl4-induced liver fibrogenesis in WT mice but not in GPR81 KO mice. DHBA also promoted TGF-β1-induced LX-2 activation. Mechanistically, GPR81 suppressed cAMP/CREB and then inhibited the expression of Smad7, a negative regulator of Smad3, which resulted in increased phosphorylation of Smad3 and enhanced activation of HSCs. CONCLUSION GPR81 might be a detrimental factor that promotes the development of liver fibrosis by regulating CREB/Smad7 pathway.
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Affiliation(s)
- Ying Zhi
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China
- Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, China
| | - Kerui Fan
- Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, China
- Department of Anatomy, Basic Medical College, Chongqing Medical University, Chongqing, China
| | - Shuang Liu
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China
| | - Kai Hu
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China
| | - Xinyan Zan
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China
| | - Ling Lin
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China
| | - Yongqiang Yang
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China
| | - Xianqiong Gong
- Hepatology Center, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, Fujian, China
| | - Kun Chen
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China
| | - Li Tang
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China
| | - Longjiang Li
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China
| | - Jiayi Huang
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China
| | - Shujun Zhang
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Li Zhang
- Department of Pathophysiology, Basic Medical College, Chongqing Medical University, 1 Yixueyuan Road, Chongqing, 400016, China.
- Laboratory of Integrated Traditional and Western Medicine, Chongqing Traditional Chinese Medicine Hospital, Chongqing, 400011, China.
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Philpott HT, Birmingham TB, Carter MM, Cecchini MJ, Giffin JR, Vasarhelyi EM, MacDonald SJ, Lanting BA, Appleton CT. Association between synovial tissue damage and pain in late-stage knee osteoarthritis: A cross-sectional study. Osteoarthritis Cartilage 2024:S1063-4584(24)01270-6. [PMID: 38971554 DOI: 10.1016/j.joca.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/25/2024] [Accepted: 06/27/2024] [Indexed: 07/08/2024]
Abstract
OBJECTIVE To identify the presence and distribution of histopathological features of synovial inflammation and tissue damage, and to test their associations with ultrasound (US) imaging measures of synovitis and patient-reported measures of pain in knee osteoarthritis (OA). DESIGN In the cross-sectional study of 122 patients undergoing surgery for painful late-stage (Kellgren-Lawrence Grade 3 or 4) knee OA, we compared US measures of synovitis (n = 118) and pain (Knee Injury and Osteoarthritis Outcome Score) to histopathological measures of inflammation vs. synovial tissue damage in synovial tissue biopsies. Associations of histopathological features with US measures of inflammation or pain were assessed using linear or logistic regression while controlling for covariates. RESULTS Histopathological features of inflammation were associated with higher odds of moderate/severe US synovitis (odds ratio [OR] = 1.34 [95%CI 1.04, 1.74), whereas features of synovial tissue damage were associated with lower odds of moderate/severe US synovitis (OR = 0.77 [95%CI 0.57, 1.03]). Worse histopathological scores for synovial tissue damage were associated with more pain (-1.47 [95%CI -2.88, -0.05]), even while adjusting for synovial inflammation (-1.61 [95%CI -3.12, -0.10]). CONCLUSIONS Synovial tissue damage is associated with pain in late-stage knee OA, independent from inflammation and radiographic damage. These novel findings suggest that preventing synovial tissue damage may be an important goal of disease-modifying OA therapy.
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Affiliation(s)
- Holly T Philpott
- Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada,; Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON N6A 5B5, Canada
| | - Trevor B Birmingham
- Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada,; Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON N6A 5B5, Canada
| | - McKenzie M Carter
- Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON N6A 5B5, Canada; Physiology & Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Matthew J Cecchini
- Pathology & Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - J Robert Giffin
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Edward M Vasarhelyi
- Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON N6A 5B5, Canada; Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Steven J MacDonald
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Brent A Lanting
- Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON N6A 5B5, Canada; Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - C Thomas Appleton
- Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON N6A 5B5, Canada; Physiology & Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
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Alkashash A, Zhang X, Vuppalanchi R, Lammert C, Saxena R. Distinction of autoimmune hepatitis from drug-induced autoimmune like hepatitis: The answer lies at the interface. J Hepatol 2024; 81:e45-e47. [PMID: 38309439 DOI: 10.1016/j.jhep.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/05/2024]
Affiliation(s)
- Ahmad Alkashash
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, USA.
| | - Xin Zhang
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, USA
| | - Raj Vuppalanchi
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, USA
| | - Craig Lammert
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, USA
| | - Romil Saxena
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, USA
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Kobayashi T, Nakatsuka T, Sato M, Soroida Y, Hikita H, Gotoh H, Iwai T, Tateishi R, Kurano M, Fujishiro M. Diagnostic performance of two-dimensional shear wave elastography and attenuation imaging for fibrosis and steatosis assessment in chronic liver disease. J Med Ultrason (2001) 2024:10.1007/s10396-024-01473-5. [PMID: 38951430 DOI: 10.1007/s10396-024-01473-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/14/2024] [Indexed: 07/03/2024]
Abstract
PURPOSE We investigated the diagnostic performance of two-dimensional shear wave elastography (2D-SWE) and attenuation imaging (ATI) in detecting fibrosis and steatosis in patients with chronic liver disease (CLD), comparing them with established methods. METHODS In 190 patients with CLD, 2D-SWE and vibration-controlled transient elastography (VCTE) were used for liver stiffness measurement (LSM), and ATI and controlled attenuation parameter (CAP) were used for steatosis quantification. The correlations between these new and established methods were analyzed. RESULTS Significant correlations were found between 2D-SWE and VCTE (r = 0.78, P < 0.001), and between ATI and CAP (r = 0.70, P < 0.001). Liver stiffness tended to be lower with 2D-SWE compared with that with VCTE, especially in cases with higher LSM, and ATI was less influenced by skin-capsular distance than CAP. Area under the receiver-operating characteristics curves (AUCs) and optimal cut-offs of 2D-SWE for diagnosing liver fibrosis stages F2, F3, and F4 were 0.73 (8.7 kPa), 0.79 (9.1 kPa), and 0.88 (11.6 kPa), respectively. The AUCs and optimal cut-offs of ATI for diagnosing hepatic steatosis grades S1, S2, and S3 were 0.91 (0.66 dB/cm/MHz), 0.80 (0.79 dB/cm/MHz), and 0.88 (0.86 dB/cm/MHz), respectively. A subgroup analysis of 86 patients with metabolic dysfunction-associated steatotic liver disease also demonstrated good performance for 2D-SWE and ATI. CONCLUSION 2D-SWE and ATI performed comparably with conventional VCTE and CAP in evaluating CLD, offering reliable alternatives for diagnosing liver fibrosis and steatosis.
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Affiliation(s)
- Tamaki Kobayashi
- Department of Clinical Laboratory Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Takuma Nakatsuka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
| | - Masaya Sato
- Department of Clinical Laboratory Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Yoko Soroida
- Department of Clinical Laboratory Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Hiromi Hikita
- Department of Clinical Laboratory Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Hiroaki Gotoh
- Department of Clinical Laboratory Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Tomomi Iwai
- Department of Clinical Laboratory Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Makoto Kurano
- Department of Clinical Laboratory Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
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8
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Bojmar L, Zambirinis CP, Hernandez JM, Chakraborty J, Shaashua L, Kim J, Johnson KE, Hanna S, Askan G, Burman J, Ravichandran H, Zheng J, Jolissaint JS, Srouji R, Song Y, Choubey A, Kim HS, Cioffi M, van Beek E, Sigel C, Jessurun J, Velasco Riestra P, Blomstrand H, Jönsson C, Jönsson A, Lauritzen P, Buehring W, Ararso Y, Hernandez D, Vinagolu-Baur JP, Friedman M, Glidden C, Firmenich L, Lieberman G, Mejia DL, Nasar N, Mutvei AP, Paul DM, Bram Y, Costa-Silva B, Basturk O, Boudreau N, Zhang H, Matei IR, Hoshino A, Kelsen D, Sagi I, Scherz A, Scherz-Shouval R, Yarden Y, Oren M, Egeblad M, Lewis JS, Keshari K, Grandgenett PM, Hollingsworth MA, Rajasekhar VK, Healey JH, Björnsson B, Simeone DM, Tuveson DA, Iacobuzio-Donahue CA, Bromberg J, Vincent CT, O'Reilly EM, DeMatteo RP, Balachandran VP, D'Angelica MI, Kingham TP, Allen PJ, Simpson AL, Elemento O, Sandström P, Schwartz RE, Jarnagin WR, Lyden D. Multi-parametric atlas of the pre-metastatic liver for prediction of metastatic outcome in early-stage pancreatic cancer. Nat Med 2024:10.1038/s41591-024-03075-7. [PMID: 38942992 DOI: 10.1038/s41591-024-03075-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/17/2024] [Indexed: 06/30/2024]
Abstract
Metastasis occurs frequently after resection of pancreatic cancer (PaC). In this study, we hypothesized that multi-parametric analysis of pre-metastatic liver biopsies would classify patients according to their metastatic risk, timing and organ site. Liver biopsies obtained during pancreatectomy from 49 patients with localized PaC and 19 control patients with non-cancerous pancreatic lesions were analyzed, combining metabolomic, tissue and single-cell transcriptomics and multiplex imaging approaches. Patients were followed prospectively (median 3 years) and classified into four recurrence groups; early (<6 months after resection) or late (>6 months after resection) liver metastasis (LiM); extrahepatic metastasis (EHM); and disease-free survivors (no evidence of disease (NED)). Overall, PaC livers exhibited signs of augmented inflammation compared to controls. Enrichment of neutrophil extracellular traps (NETs), Ki-67 upregulation and decreased liver creatine significantly distinguished those with future metastasis from NED. Patients with future LiM were characterized by scant T cell lobular infiltration, less steatosis and higher levels of citrullinated H3 compared to patients who developed EHM, who had overexpression of interferon target genes (MX1 and NR1D1) and an increase of CD11B+ natural killer (NK) cells. Upregulation of sortilin-1 and prominent NETs, together with the lack of T cells and a reduction in CD11B+ NK cells, differentiated patients with early-onset LiM from those with late-onset LiM. Liver profiles of NED closely resembled those of controls. Using the above parameters, a machine-learning-based model was developed that successfully predicted the metastatic outcome at the time of surgery with 78% accuracy. Therefore, multi-parametric profiling of liver biopsies at the time of PaC diagnosis may determine metastatic risk and organotropism and guide clinical stratification for optimal treatment selection.
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Affiliation(s)
- Linda Bojmar
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Constantinos P Zambirinis
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Jonathan M Hernandez
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jayasree Chakraborty
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lee Shaashua
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Junbum Kim
- Department of Physiology and Biophysics, Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | - Kofi Ennu Johnson
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Samer Hanna
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Gokce Askan
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jonas Burman
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Hiranmayi Ravichandran
- Department of Physiology and Biophysics, Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
- Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Jian Zheng
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joshua S Jolissaint
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rami Srouji
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yi Song
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ankur Choubey
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Han Sang Kim
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Michele Cioffi
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Elke van Beek
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Carlie Sigel
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jose Jessurun
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | | | - Hakon Blomstrand
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Pathology, Linköping University, Linköping, Sweden
| | - Carolin Jönsson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Anette Jönsson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Pernille Lauritzen
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Weston Buehring
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Yonathan Ararso
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Dylanne Hernandez
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Jessica P Vinagolu-Baur
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Madison Friedman
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Caroline Glidden
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Laetitia Firmenich
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Grace Lieberman
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Dianna L Mejia
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Naaz Nasar
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anders P Mutvei
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Doru M Paul
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Yaron Bram
- Division of Gastroenterology & Hepatology, Weill Cornell Medicine, New York, NY, USA
| | - Bruno Costa-Silva
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Olca Basturk
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nancy Boudreau
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Haiying Zhang
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Irina R Matei
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - Ayuko Hoshino
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA
| | - David Kelsen
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Irit Sagi
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Avigdor Scherz
- Department of Plant and Environmental Sciences, Weizmann Institute of Science, Rehovot, Israel
| | - Ruth Scherz-Shouval
- Department of Biomolecular Sciences, Weizmann Institute of Science, Rehovot, Israel
| | - Yosef Yarden
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Moshe Oren
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Mikala Egeblad
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, USA
| | - Jason S Lewis
- Radiology and Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Kayvan Keshari
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Radiology and Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paul M Grandgenett
- Eppley Institute for Research in Cancer and Allied Diseases, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael A Hollingsworth
- Eppley Institute for Research in Cancer and Allied Diseases, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Vinagolu K Rajasekhar
- Orthopedic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John H Healey
- Orthopedic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bergthor Björnsson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Diane M Simeone
- Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | | | - Christine A Iacobuzio-Donahue
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jaqueline Bromberg
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - C Theresa Vincent
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Eileen M O'Reilly
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Ronald P DeMatteo
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Vinod P Balachandran
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michael I D'Angelica
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - T Peter Kingham
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter J Allen
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amber L Simpson
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Olivier Elemento
- Department of Physiology and Biophysics, Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
- Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Per Sandström
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Robert E Schwartz
- Division of Gastroenterology & Hepatology, Weill Cornell Medicine, New York, NY, USA
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - William R Jarnagin
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David Lyden
- Departments of Pediatrics and Cell and Developmental Biology, Children's Cancer and Blood Foundation Laboratories, Drukier Institute for Children's Health, Meyer Cancer Center Weill Cornell Medicine, New York, NY, USA.
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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9
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Zúñiga-Hernandez J, Quiñones San Martin M, Figueroa B, Novoa U, Monsalve FA, Bacho M, San-Martin A, González DR. Azorella compacta Organic Extracts Exacerbate Metabolic Dysfunction-Associated Fatty Liver Disease in Mice Fed a High-Fat Diet. Pharmaceuticals (Basel) 2024; 17:746. [PMID: 38931413 PMCID: PMC11206875 DOI: 10.3390/ph17060746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/26/2024] [Accepted: 06/01/2024] [Indexed: 06/28/2024] Open
Abstract
Azorella compacta (A. compacta) is a shrub of the Andean Altiplano of Bolivia, Chile and Peru, consumed by local communities as a traditional medicine for several maladies such as diabetes, hepatic and inflammatory diseases. A. compacta is rich in mulinane- and azorellane-type diterpenoids. For two of these, acute hypoglycemic effects have been described, but the impact of A. compacta diterpenoids on fatty liver disease has not been investigated. Therefore, A. compacta organic fractions were prepared using petroleum ether, dichloromethane and methanol. Their content was characterized by UHPLC/MS, revealing the presence of ten diterpenoids, mainly mulinic acid, azorellanol and mulin-11,13-diene. Next, mice fed with a high-fat diet (HFD), a model of metabolic dysfunction-associated fatty liver disease (MAFLD), received one of the fractions in drinking water for two weeks. After this treatment, hepatic parameters were evaluated. The A. compacta fractions did not reduce hyperglycemia or body weight in the HFD-fed mice but increased the serum levels of hepatic transaminases (AST and ALT), reduced albumin and increased bilirubin, indicating hepatic damage, while histopathological alterations such as steatosis, inflammation and necrosis generated by the HFD were, overall, not ameliorated by the fractions. These results suggest that organic A. compacta extracts may generate hepatic complications in patients with MAFLD.
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Affiliation(s)
- Jessica Zúñiga-Hernandez
- Department of Basic Biomedical Sciences, Faculty of Health Sciences, Universidad de Talca, Talca 3460000, Chile; (J.Z.-H.)
| | - Matías Quiñones San Martin
- Department of Basic Biomedical Sciences, Faculty of Health Sciences, Universidad de Talca, Talca 3460000, Chile; (J.Z.-H.)
- Doctorado en Ciencias, Mención I+D de Productos Bioactivos, Instituto de Química de Recursos Naturales, Universidad de Talca, Talca 3341717, Chile
| | - Benjamín Figueroa
- Department of Basic Biomedical Sciences, Faculty of Health Sciences, Universidad de Talca, Talca 3460000, Chile; (J.Z.-H.)
| | - Ulises Novoa
- Department of Basic Biomedical Sciences, Faculty of Health Sciences, Universidad de Talca, Talca 3460000, Chile; (J.Z.-H.)
| | - Francisco A. Monsalve
- Department of Preclinical Sciences, Faculty of Medicine, Universidad Católica del Maule, Talca 3466706, Chile;
| | - Mitchell Bacho
- Departamento de Ciencias Químicas, Facultad de Ciencias Exactas, Laboratorio de Síntesis Orgánica y Organometálica, Universidad Andrés Bello, Santiago 8370146, Chile
| | - Aurelio San-Martin
- Departamento de Ciencias y Recursos Naturales, Facultad de Ciencias, Universidad de Magallanes, Punta Arenas 6200112, Chile
| | - Daniel R. González
- Department of Basic Biomedical Sciences, Faculty of Health Sciences, Universidad de Talca, Talca 3460000, Chile; (J.Z.-H.)
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10
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Liu Z, Zhu H, Zhao J, Yu L, Que S, Xu J, Geng L, Zhou L, Valenti L, Zheng S. Multi-omics analysis reveals a crosstalk between ferroptosis and peroxisomes on steatotic graft failure after liver transplantation. MedComm (Beijing) 2024; 5:e588. [PMID: 38868330 PMCID: PMC11167151 DOI: 10.1002/mco2.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 04/17/2024] [Accepted: 04/25/2024] [Indexed: 06/14/2024] Open
Abstract
To identify the mechanism underlying macrosteatosis (MaS)-related graft failure (GF) in liver transplantation (LT) by multi-omics network analysis. The transcriptome and metabolome were assayed in graft and recipient plasma in discovery (n = 68) and validation (n = 89) cohorts. Differentially expressed molecules were identified by MaS and GF status. Transcriptional regulatory networks were generated to explore the mechanism for MaS-related inferior post-transplant prognosis. The differentially expressed molecules associated with MaS and GF were enriched in ferroptosis and peroxisome-related pathways. Core features of MaS-related GF were presented on decreased transferrin and impaired anti-oxidative capacity dependent upon dysregulation of transcription factors hepatocyte nuclear factor 4A (HNF4A) and hypoxia-inducible factor 1A (HIF1A). Furthermore, miR-362-3p and miR-299-5p inhibited transferrin and HIF1A expression, respectively. Lower M2 macrophages but higher memory CD4 T cells were observed in MaS-related GF cases. These results were validated in clinical specimens and cellular models. Systemic analysis of multi-omics data depicted a panorama of biological pathways deregulated in MaS-related GF. Transcriptional regulatory networks centered on transferrin and anti-oxidant responses were associated with poor MaS graft quality, qualifying as potential targets to improve prognosis of patients after LT.
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Affiliation(s)
- Zhengtao Liu
- Shulan International Medical CollegeZhejiang Shuren UniversityHangzhouChina
- Key Laboratory of Artificial Organs and Computational Medicine in Zhejiang ProvinceShulan International Medical CollegeZhejiang Shuren UniversityHangzhouChina
- NHC Key Laboratory of Combined Multi‐Organ TransplantationKey Laboratory of the Diagnosis and Treatment of Organ TransplantationCAMS, First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
- Key Laboratory of Organ TransplantationFirst Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
- Shulan Hospital (Hangzhou)HangzhouChina
| | - Hai Zhu
- NHC Key Laboratory of Combined Multi‐Organ TransplantationKey Laboratory of the Diagnosis and Treatment of Organ TransplantationCAMS, First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
- Key Laboratory of Organ TransplantationFirst Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
- Department of Hepatobiliary SurgeryFirst Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Junsheng Zhao
- Shulan International Medical CollegeZhejiang Shuren UniversityHangzhouChina
- Key Laboratory of Artificial Organs and Computational Medicine in Zhejiang ProvinceShulan International Medical CollegeZhejiang Shuren UniversityHangzhouChina
| | - Lu Yu
- Shulan International Medical CollegeZhejiang Shuren UniversityHangzhouChina
- Shulan Hospital (Hangzhou)HangzhouChina
- School of MedicineZhejiang Chinese Medical UniversityHangzhouChina
| | | | - Jun Xu
- Division of Hepatobiliary and Pancreatic SurgeryDepartment of SurgeryFirst Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
| | - Lei Geng
- Division of Hepatobiliary and Pancreatic SurgeryDepartment of SurgeryFirst Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
| | - Lin Zhou
- NHC Key Laboratory of Combined Multi‐Organ TransplantationKey Laboratory of the Diagnosis and Treatment of Organ TransplantationCAMS, First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
- Key Laboratory of Organ TransplantationFirst Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
- Division of Hepatobiliary and Pancreatic SurgeryDepartment of SurgeryFirst Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
| | - Luca Valenti
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly
- Transfusion Medicine UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
- Biological Resource Center UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Shusen Zheng
- Shulan International Medical CollegeZhejiang Shuren UniversityHangzhouChina
- Key Laboratory of Artificial Organs and Computational Medicine in Zhejiang ProvinceShulan International Medical CollegeZhejiang Shuren UniversityHangzhouChina
- NHC Key Laboratory of Combined Multi‐Organ TransplantationKey Laboratory of the Diagnosis and Treatment of Organ TransplantationCAMS, First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
- Key Laboratory of Organ TransplantationFirst Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
- Shulan Hospital (Hangzhou)HangzhouChina
- Division of Hepatobiliary and Pancreatic SurgeryDepartment of SurgeryFirst Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina
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11
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Yalcin S, Lacin S, Kaseb AO, Peynircioğlu B, Cantasdemir M, Çil BE, Hurmuz P, Doğrul AB, Bozkurt MF, Abali H, Akhan O, Şimşek H, Sahin B, Aykan FN, Yücel İ, Tellioğlu G, Selçukbiricik F, Philip PA. A Post-International Gastrointestinal Cancers' Conference (IGICC) Position Statements. J Hepatocell Carcinoma 2024; 11:953-974. [PMID: 38832120 PMCID: PMC11144653 DOI: 10.2147/jhc.s449540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/14/2024] [Indexed: 06/05/2024] Open
Abstract
Hepatocellular carcinoma (HCC), the most prevalent liver tumor, is usually linked with chronic liver diseases, particularly cirrhosis. As per the 2020 statistics, this cancer ranks 6th in the list of most common cancers worldwide and is the third primary source of cancer-related deaths. Asia holds the record for the highest occurrence of HCC. HCC is found three times more frequently in men than in women. The primary risk factors for HCC include chronic viral infections, excessive alcohol intake, steatotic liver disease conditions, as well as genetic and family predispositions. Roughly 40-50% of patients are identified in the late stages of the disease. Recently, there have been significant advancements in the treatment methods for advanced HCC. The selection of treatment for HCC hinges on the stage of the disease and the patient's medical status. Factors such as pre-existing liver conditions, etiology, portal hypertension, and portal vein thrombosis need critical evaluation, monitoring, and appropriate treatment. Depending on the patient and the characteristics of the disease, liver resection, ablation, or transplantation may be deemed potentially curative. For inoperable lesions, arterially directed therapy might be an option, or systemic treatment might be deemed more suitable. In specific cases, the recommendation might extend to external beam radiation therapy. For all individuals, a comprehensive, multidisciplinary approach should be adopted when considering HCC treatment options. The main treatment strategies for advanced HCC patients are typically combination treatments such as immunotherapy and anti-VEGFR inhibitor, or a combination of immunotherapy and immunotherapy where appropriate, as a first-line treatment. Furthermore, some TKIs and immune checkpoint inhibitors may be used as single agents in cases where patients are not fit for the combination therapies. As second-line treatments, some treatment agents have been reported and can be considered.
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Affiliation(s)
- Suayib Yalcin
- Department of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sahin Lacin
- Department of Medical Oncology, Koç University Faculty of Medicine, İstanbul, Turkey
| | - Ahmed Omar Kaseb
- Department of Gastrointestinal Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Bora Peynircioğlu
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Barbaros Erhan Çil
- Department of Radiology, Koç University Faculty of Medicine, İstanbul, Turkey
| | - Pervin Hurmuz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Bülent Doğrul
- Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Murat Fani Bozkurt
- Department of Nuclear Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hüseyin Abali
- Department of Medical Oncology, Bahrain Oncology Center, Muharraq, Bahrain
| | - Okan Akhan
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Halis Şimşek
- Department of Gastroenterology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Berksoy Sahin
- Department of Medical Oncology, Cukurova University Faculty of Medicine, Adana, Türkiye
| | - Faruk N Aykan
- Department of Medical Oncology, Istinye University Faculty of Medicine Bahçeşehir Liv Hospital, İstanbul, Turkey
| | - İdris Yücel
- Medicana International Hospital Samsun, Department of Medical Oncology, Samsun, Turkey
| | - Gürkan Tellioğlu
- Department of General Surgery, Koç University Faculty of Medicine, İstanbul, Turkey
| | - Fatih Selçukbiricik
- Department of Medical Oncology, Koç University Faculty of Medicine, İstanbul, Turkey
| | - Philip A Philip
- Department of Medicine, Division of Hematology-Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
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12
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Korie U, Joldoshova A, Khandakar B, Zhang X, Liang Y. Histopathology and its clinical correlation of liver biopsy in patients with treated autoimmune hepatitis. Ann Diagn Pathol 2024; 73:152333. [PMID: 38820911 DOI: 10.1016/j.anndiagpath.2024.152333] [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: 04/11/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/02/2024]
Abstract
The diagnosis of autoimmune hepatitis (AIH) relies on well-established criteria encompassing histological, serological, and clinical features. Diagnosing AIH may become challenging when encountering patients who have undergone steroid therapy for other co-existing diseases. Thirty-nine liver biopsies from 25 patients with treated and untreated AIH were classified into three groups: 1) Newly diagnosed untreated biopsies (n = 16); 2) Newly diagnosed partially treated biopsies from patients already on steroid treatment for other co-existing diseases (n = 9); 3) Previously diagnosed biopsies from patients who had undergone complete treatment (n = 14). In the untreated AIH group, at least 50 % of the cases exhibited the following features: at least moderate portal inflammation (81 %), at least moderate lobular inflammation (56 %), ductular reaction (94 %), inflammation gradient from bile duct to interface (88 %), unequivocal interface hepatitis (100 %), emperipolesis (56 %), plasma cell cluster (88 %), apoptosis or necrosis (63 %), pericentral inflammation (63 %), and periportal fibrosis (88 %). Although all these diagnostically sensitive histologic features were present in significantly fewer cases after treatment (p < 0.05), the features of ductular reaction, inflammation gradient from bile duct to interface, pericentral inflammation, and periportal fibrosis were likely to persist after treatment, especially in partially treated cases; these features did not show a significant association with higher transaminase levels (P > 0.05) and were considered as indirect features of hepatocytic injury. Our data suggest categorizing AIH histological features into direct and indirect hepatocytic injuries. Direct hepatocytic injury features significantly correlate with transaminase levels and respond well to treatment, while indirect ones show weaker transaminase correlation and relative treatment resistance.
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Affiliation(s)
- Ujunwa Korie
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States of America
| | - Albina Joldoshova
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States of America; Division of Gastrointestinal Pathology, Porath/Sonic Healthcare Anatomic Pathology, Dallas, TX, United States of America
| | - Binny Khandakar
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States of America; Northwell Health Laboratories, Donald Barbara Zucker School of Medicine at Hofstra/Northwell Health, Greenvale, NY, United States of America
| | - Xuchen Zhang
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States of America
| | - Yuanxin Liang
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States of America.
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Papatheodoridi M, De Ledinghen V, Lupsor-Platon M, Bronte F, Boursier J, Elshaarawy O, Marra F, Thiele M, Markakis G, Payance A, Brodkin E, Castera L, Papatheodoridis G, Krag A, Arena U, Mueller S, Cales P, Calvaruso V, Delamarre A, Pinzani M, Tsochatzis EA. Agile scores in MASLD and ALD: External validation and their utility in clinical algorithms. J Hepatol 2024:S0168-8278(24)00356-8. [PMID: 38789011 DOI: 10.1016/j.jhep.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 04/05/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND & AIMS Agile scores, including liver stiffness measurements (LSM) and routine clinical/laboratory biomarkers, have been developed for advanced fibrosis (F≥3) and cirrhosis (F4), respectively, in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). We independently validated the diagnostic accuracy of these scores in MASLD, alcohol-related liver disease (ALD) and chronic hepatitis B or C (CHB/C) and assessed them in clinical algorithms with FIB-4 and LSM. METHODS We included 4,243 patients (MASLD: 912, ALD: 386, CHB: 597, CHC: 2,348) with LSM, liver biopsy and laboratory tests within 6 months. FIB-4, Agile 3+ and Agile 4 scores were calculated. RESULTS For F≥3, the diagnostic accuracy of Agile 3+ and LSM were similar in MASLD (AUC: 0.86 vs. 0.86, p = 0.831) and ALD (0.92 vs. 0.94, p = 0.123). For cirrhosis, Agile 4 was similar to LSM in MASLD (0.89 vs. 0.90, p = 0.412) and ALD (0.94 vs. 0.95, p = 0.513). Agile 3+/4 performed worse than LSM in CHB/C. Using predefined dual thresholds of 90% sensitivity/specificity, correct classification rates in MASLD were 66% vs. 61% using Agile 3+ vs. LS dual cut-offs and 71% vs. 67% in ALD, respectively. When using Agile 3+ or LSM as a second step after FIB-4 >1.3, correct classification rates were higher with Agile 3+ than LSM, both for MASLD (75% vs. 71%) and ALD (76% vs. 72%), with fewer indeterminate results. Positive agreement of LSM and Agile 3+/4 significantly increased the specificity of a diagnosis of advanced fibrosis/cirrhosis. CONCLUSION Agile 3+ and Agile 4 have equal diagnostic accuracy with LSM in both MASLD and ALD but result in fewer indeterminate results. Sequential use of FIB-4 and Agile 3+/4 or concurrent Agile 3+/4 and LSM can be used to further optimize F≥3 diagnosis. IMPACT AND IMPLICATIONS As of today, it is accepted that there will be no single non-invasive test or an isolated cut-off for identifying patients with advanced chronic liver disease. Here, we confirmed that Agile 3+ and Agile 4 scores are useful alternatives to simple liver stiffness measurement in diagnosing advanced fibrosis/cirrhosis in steatotic liver disease, but they do not perform as well in chronic viral hepatitis. Agile scores can help optimize the diagnosis of advanced fibrosis/cirrhosis in a dual cut-off strategy by reducing the number of indeterminate results either alone or in a sequential strategy after FIB-4. The combination of Agile scores and liver stiffness measurement can further increase our confidence in a positive diagnosis of advanced fibrosis/cirrhosis. These novel combination strategies can be useful tools to predict the likelihood of advanced stages of liver disease with the highest possible accuracy in a secondary/tertiary healthcare setting.
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Affiliation(s)
- Margarita Papatheodoridi
- Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, UK; Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Victor De Ledinghen
- Hepatology Unit, CHU Bordeaux & INSERM U1312, Bordeaux University, Bordeaux, France
| | - Monica Lupsor-Platon
- Department of Medical Imaging, Regional Institute of Gastroenterology and Hepatology, Octavian Fodor", University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj-Napoca, Romania
| | - Fabrizio Bronte
- Gastroenterology and Hepatology Unit, Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialities, Promise, University of Palermo, Italy
| | - Jerome Boursier
- Liver-Gastroenterology Department, University Hospital, Angers, France
| | - Omar Elshaarawy
- Center for Alcohol Research, University of Heidelberg, Germany; National Liver Institute, Menoufia University, Egypt; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK
| | - Fabio Marra
- University of Florence, Department of Experimental and Clinical Medicine, Florence, Italy
| | - Maja Thiele
- Center for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark
| | - Georgios Markakis
- Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Audrey Payance
- Service d'hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Edgar Brodkin
- Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, UK
| | - Laurent Castera
- Service d'hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Clichy, France; Université Paris-Cité, Inserm, Centre de recherche sur l'inflammation, UMR 1149, Paris, France
| | - George Papatheodoridis
- Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Aleksander Krag
- Center for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark
| | - Umberto Arena
- University of Florence, Department of Experimental and Clinical Medicine, Florence, Italy
| | | | - Paul Cales
- Liver-Gastroenterology Department, University Hospital, Angers, France
| | - Vincenza Calvaruso
- Gastroenterology and Hepatology Unit, Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialities, Promise, University of Palermo, Italy
| | - Adele Delamarre
- Hepatology Unit, CHU Bordeaux & INSERM U1312, Bordeaux University, Bordeaux, France
| | - Massimo Pinzani
- Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, UK
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Czekaj P, Król M, Kolanko E, Wieczorek P, Bogunia E, Hermyt M, Grajoszek A, Prusek A. Optimization of methods for intrasplenic administration of human amniotic epithelial cells in order to perform safe and effective cell-based therapy for liver diseases. Stem Cell Rev Rep 2024:10.1007/s12015-024-10735-1. [PMID: 38769232 DOI: 10.1007/s12015-024-10735-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2024] [Indexed: 05/22/2024]
Abstract
In animal experimental models the administration of stem cells into the spleen should ensure high effectiveness of their implantation in the liver due to a direct vascular connection between the two organs. The aim of this study was to update the methods of experimental intrasplenic cell transplantation using human amniotic epithelial cells (hAECs) which are promising cells in the treatment of liver diseases. BALB/c mice were administered intrasplenically with 0.5, 1, and 2 million hAECs by direct bolus injection (400 µl/min) and via a subcutaneous splenic port by fast (20 μl/min) and slow (10 μl/min) infusion. The port was prepared by translocating the spleen to the skin pocket. The spleen, liver, and lungs were collected at 3 h, 6 h, and 24 h after the administration of cells. The distribution of hAECs, histopathological changes in the organs, complete blood count, and biochemical markers of liver damage were assessed. It has been shown that the method of intrasplenic cell administration affects the degree of liver damage. The largest number of mice showing significant liver damage was observed after direct administration and the lowest after slow administration through a port. Liver damage increased with the number of administered cells, which, paradoxically, resulted in increased liver colonization efficiency. It was concluded that the administration of 1 × 106 hAECs by slow infusion via a subcutaneous splenic port reduces the incidence of complications at the expense of a slight decrease in the effectiveness of implantation of the transplanted cells in the liver.
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Affiliation(s)
- Piotr Czekaj
- Department of Cytophysiology, Chair of Histology and Embryology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18, Katowice, 40-752, Poland.
| | - Mateusz Król
- Department of Cytophysiology, Chair of Histology and Embryology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18, Katowice, 40-752, Poland
| | - Emanuel Kolanko
- Department of Cytophysiology, Chair of Histology and Embryology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18, Katowice, 40-752, Poland
| | - Patrycja Wieczorek
- Department of Cytophysiology, Chair of Histology and Embryology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18, Katowice, 40-752, Poland
| | - Edyta Bogunia
- Department of Cytophysiology, Chair of Histology and Embryology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18, Katowice, 40-752, Poland
| | - Mateusz Hermyt
- Department of Cytophysiology, Chair of Histology and Embryology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18, Katowice, 40-752, Poland
| | - Aniela Grajoszek
- Department of Experimental Medicine, Medical University of Silesia in Katowice, Medyków 4, Katowice, 40-752, Poland
| | - Agnieszka Prusek
- Department of Cytophysiology, Chair of Histology and Embryology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 18, Katowice, 40-752, Poland
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15
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Guo Y, Li T, Zhao Z, Sun Q, Chen M, Jiang Y, Yao Z, Hu B. Liver fibrosis automatic diagnosis utilizing dense-fusion attention contrastive learning network. Med Phys 2024. [PMID: 38753547 DOI: 10.1002/mp.17130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 04/07/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Liver fibrosis poses a significant public health challenge given its elevated incidence and associated mortality rates. Diffusion-Weighted Imaging (DWI) serves as a non-invasive diagnostic tool for supporting the identification of liver fibrosis. Deep learning, as a computer-aided diagnostic technology, can assist in recognizing the stage of liver fibrosis by extracting abstract features from DWI images. However, gathering samples is often challenging, posing a common dilemma in previous research. Moreover, previous studies frequently overlooked the cross-comparison information and latent connections among different DWI parameters. Thus, it is becoming a challenge to identify effective DWI parameters and dig potential features from multiple categories in a dataset with limited samples. PURPOSE A self-defined Multi-view Contrastive Learning Network is developed to automatically classify multi-parameter DWI images and explore synergies between different DWI parameters. METHODS A Dense-fusion Attention Contrastive Learning Network (DACLN) is designed and used to recognize DWI images. Concretely, a multi-view contrastive learning framework is constructed to train and extract features from raw multi-parameter DWI. Besides, a Dense-fusion module is designed to integrate feature and output predicted labels. RESULTS We evaluated the performance of the proposed model on a set of real clinical data and analyzed the interpretability by Grad-CAM and annotation analysis, achieving average scores of 0.8825, 0.8702, 0.8933, 0.8727, and 0.8779 for accuracy, precision, recall, specificity and F-1 score. Of note, the experimental results revealed that IVIM-f, CTRW-β, and MONO-ADC exhibited significant recognition ability and complementarity. CONCLUSION Our method achieves competitive accuracy in liver fibrosis diagnosis using the limited multi-parameter DWI dataset and finds three types of DWI parameters with high sensitivity for diagnosing liver fibrosis, which suggests potential directions for future research.
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Affiliation(s)
- Yuhui Guo
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, China
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
| | - Tongtong Li
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Ziyang Zhao
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Qi Sun
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Miao Chen
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Yanli Jiang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Zhijun Yao
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Bin Hu
- Gansu Provincial Key Laboratory of Wearable Computing, Lanzhou University, Lanzhou, China
- School of Medical Technology, Beijing Institute of Technology, Beijing, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
- Joint Research Center for Cognitive Neurosensor Technology of Lanzhou University & Institute of Semiconductors, Chinese Academy of Sciences, Lanzhou, China
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Lee A, Simon AA, Boyreau A, Allain-Courtois N, Lambert B, Pradère JP, Saltel F, Cognet L. Identification of Early Stage Liver Fibrosis by Modifications in the Interstitial Space Diffusive Microenvironment Using Fluorescent Single-Walled Carbon Nanotubes. NANO LETTERS 2024; 24:5603-5609. [PMID: 38669477 DOI: 10.1021/acs.nanolett.4c00955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
During liver fibrosis, recurrent hepatic injuries lead to the accumulation of collagen and other extracellular matrix components in the interstitial space, ultimately disrupting liver functions. Early stages of liver fibrosis may be reversible, but opportunities for diagnosis at these stages are currently limited. Here, we show that the alterations of the interstitial space associated with fibrosis can be probed by tracking individual fluorescent single-walled carbon nanotubes (SWCNTs) diffusing in that space. In a mouse model of early liver fibrosis, we find that nanotubes generally explore elongated areas, whose lengths decrease as the disease progresses, even in regions where histopathological examination does not reveal fibrosis yet. Furthermore, this decrease in nanotube mobility is a purely geometrical effect as the instantaneous nanotube diffusivity stays unmodified. This work establishes the promise of SWCNTs both for diagnosing liver fibrosis at an early stage and for more in-depth studies of the biophysical effects of the disease.
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Affiliation(s)
- Antony Lee
- Laboratoire Photonique Numérique et Nanosciences, Université de Bordeaux, 33400 Talence, France
- CNRS - UMR 5298, LP2N, Institut d'Optique Graduate School, 33400 Talence, France
- CNRS UMR168, Laboratoire Physique des Cellules et Cancer, Institut Curie, Université PSL, Sorbonne Université, 75005 Paris, France
| | - Apolline A Simon
- Laboratoire Photonique Numérique et Nanosciences, Université de Bordeaux, 33400 Talence, France
- CNRS - UMR 5298, LP2N, Institut d'Optique Graduate School, 33400 Talence, France
- CNRS, Bordeaux INP, ICMCB, UMR 5026, Univ. Bordeaux, 33600 Pessac, France
| | - Adeline Boyreau
- Laboratoire Photonique Numérique et Nanosciences, Université de Bordeaux, 33400 Talence, France
- CNRS - UMR 5298, LP2N, Institut d'Optique Graduate School, 33400 Talence, France
| | - Nathalie Allain-Courtois
- Inserm, UMR1312, BRIC, Bordeaux Institute of Oncology, University of Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
| | - Benjamin Lambert
- Laboratoire Photonique Numérique et Nanosciences, Université de Bordeaux, 33400 Talence, France
- CNRS - UMR 5298, LP2N, Institut d'Optique Graduate School, 33400 Talence, France
| | - Jean-Philippe Pradère
- Institut RESTORE - UMR 1301 - Inserm/5070-CNRS/EFS, Univ. P. Sabatier, 31037 Toulouse, France
| | - Frédéric Saltel
- Inserm, UMR1312, BRIC, Bordeaux Institute of Oncology, University of Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
| | - Laurent Cognet
- Laboratoire Photonique Numérique et Nanosciences, Université de Bordeaux, 33400 Talence, France
- CNRS - UMR 5298, LP2N, Institut d'Optique Graduate School, 33400 Talence, France
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Mai XF, Zhang H, Wang Y, Zhong WX, Zou LQ. Multiparametric MRI-based whole-liver radiomics for predicting early-stage liver fibrosis in rabbits. Br J Radiol 2024; 97:964-970. [PMID: 38552321 PMCID: PMC11075985 DOI: 10.1093/bjr/tqae063] [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: 01/13/2024] [Revised: 02/26/2024] [Accepted: 03/18/2024] [Indexed: 05/09/2024] Open
Abstract
OBJECTIVES To develop and validate a whole-liver radiomic model using multiparametric MRI for predicting early-stage liver fibrosis (LF) in rabbits. METHODS A total of 134 rabbits (early-stage LF, n = 91; advanced-stage LF, n = 43) who underwent liver magnetic resonance elastography (MRE), hepatobiliary phase, dynamic contrast enhanced (DCE), intravoxel incoherent motion (IVIM), diffusion kurtosis imaging, and T2* scanning were enrolled and randomly allocated to either the training or validation cohort. Whole-liver radiomic features were extracted and selected to develop a radiomic model and generate quantitative Rad-scores. Then, multivariable logistic regression was utilized to determine the Rad-scores associated with early-stage LF, and effective features were integrated to establish a combined model. The predictive performance was assessed by the area under the curve (AUC). RESULTS The MRE model achieved superior AUCs of 0.95 in the training cohort and 0.86 in the validation cohort, followed by the DCE-MRI model (0.93 and 0.82), while the IVIM model had lower AUC values of 0.91 and 0.82, respectively. The Rad-scores of MRE, DCE-MRI and IVIM were identified as independent predictors associated with early-stage LF. The combined model demonstrated AUC values of 0.96 and 0.88 for predicting early-stage LF in the training and validation cohorts, respectively. CONCLUSIONS Our study highlights the remarkable performance of a multiparametric MRI-based radiomic model for the individualized diagnosis of early-stage LF. ADVANCES IN KNOWLEDGE This is the first study to develop a combined model by integrating multiparametric radiomic features to improve the accuracy of LF staging.
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Affiliation(s)
- Xiao-Fei Mai
- Department of Radiology, Sixth Affiliated Hospital of Shenzhen University, Shenzhen 518052, China
| | - Hao Zhang
- Department of Radiology, Sixth Affiliated Hospital of Shenzhen University, Shenzhen 518052, China
| | - Yang Wang
- Department of Radiology, Sixth Affiliated Hospital of Shenzhen University, Shenzhen 518052, China
| | - Wen-Xin Zhong
- Department of Radiology, Sixth Affiliated Hospital of Shenzhen University, Shenzhen 518052, China
| | - Li-Qiu Zou
- Department of Radiology, Sixth Affiliated Hospital of Shenzhen University, Shenzhen 518052, China
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Wang J, Zhang S, Zhang Z, Wu C, Huang R. Letter: Use of liver stiffness measurement to identify liver cirrhosis in patients with chronic hepatitis D. Aliment Pharmacol Ther 2024; 59:1158-1159. [PMID: 38591798 DOI: 10.1111/apt.17923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 04/10/2024]
Abstract
LINKED CONTENTThis article is linked to Sandmann et al papers. To view these articles, visit https://doi.org/10.1111/apt.17878 and https://doi.org/10.1111/apt.17962
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Affiliation(s)
- Jian Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Shaoqiu Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Zhiyi Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
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Sandmann L, Wedemeyer H, Deterding K. Letter: Use of liver stiffness measurement to identify liver cirrhosis in patients with chronic hepatitis D-Authors' reply. Aliment Pharmacol Ther 2024; 59:1160-1161. [PMID: 38591804 DOI: 10.1111/apt.17962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 04/10/2024]
Abstract
LINKED CONTENTThis article is linked to Sandmann et al papers. To view these articles, visit https://doi.org/10.1111/apt.17878 and https://doi.org/10.1111/apt.17923
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Affiliation(s)
- Lisa Sandmann
- Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany
- D-SOLVE Consortium, an EU Horizon Europe Funded Project, Hannover, Germany
| | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany
- D-SOLVE Consortium, an EU Horizon Europe Funded Project, Hannover, Germany
- German Center for Infection Research (DZIF), Hannover/Braunschweig, Germany
- Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
| | - Katja Deterding
- Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany
- Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
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Liu L, Du J, Fan H, Yu Y, Luo Y, Gu F, Yu H, Liao X. Blueberry anthocyanins improve liver fibrosis by regulating NCOA4 ubiquitination through TRIM7 to affect ferroptosis of hepatic stellate cells. Am J Physiol Gastrointest Liver Physiol 2024; 326:G426-G437. [PMID: 38290991 DOI: 10.1152/ajpgi.00227.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/11/2024] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
This study aims to investigate the role and molecular mechanism of anthocyanin in improving liver fibrosis through ferroptosis, providing a basis for drug development and targeted therapy. In this study, a mouse model of liver fibrosis was established using CCl4, and the anthocyanin treatment groups were administered 100 mg/kg anthocyanin daily via gavage. Furthermore, real-time fluorescent quantitative PCR (qRT-PCR), Western blotting (WB), and enzyme-linked immunosorbent assay were used to assess liver fibrosis indicators and liver injury markers. Histopathological methods were used to confirm the morphology of liver injury in different treatment groups. The effects of anthocyanins on ferroptosis markers, NCOA4 and FTH1 expression, were examined through qRT-PCR, WB, and Co-IP. Confocal microscopy was used to validate the colocalization of ferritin and lysosomes. A differential expression model of TRIM7 was constructed to verify its impact on the progression of liver fibrosis. The present study demonstrates the hepatoprotective effects of anthocyanins in liver fibrosis, highlighting their ability to enhance hepatic stellate cell (HSC) ferroptosis and regulate ferritin autophagy. Moreover, TRIM7 is identified as a key mediator of anthocyanin-induced regulation of hepatic stellate cells activation for liver fibrosis treatment through modulation of ferroautophagy. Mechanistic investigations further reveal that TRIM7 exerts its influence on the process of ferroautophagy by controlling NCOA4 ubiquitination. Our study discovered that anthocyanins could improve liver fibrosis by regulating NCOA4 ubiquitination through TRIM7, thereby affecting hepatic stellate cells' ferroptosis levels.NEW & NOTEWORTHY This was the first study to demonstrate that anthocyanins can improve the progression of liver fibrosis by promoting hepatic stellate cell (HSC) ferroptosis. Anthocyanins could affect the content of Fe2+ by promoting ferroautophagy in HSCs, thereby promoting the level of ferroptosis. This study demonstrates for the first time that anthocyanins can inhibit the expression of TRIM7 and then affect the ubiquitination of NCOA4 to regulate the level of ferritin autophagy and ferroptosis.
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Affiliation(s)
- Likun Liu
- Department of Medical Imaging, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Jinhui Du
- Department of Medical Imaging, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Haiqing Fan
- Department of Medical Imaging, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Yue Yu
- Department of Medical Imaging, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Yilin Luo
- Department of Medical Imaging, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Fang Gu
- Department of Medical Imaging, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Hui Yu
- Department of Medical Imaging, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Xin Liao
- Department of Medical Imaging, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
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21
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Xiao L, Zhao H, Liu S, Dong W, Gao Y, Wang L, Huang B, Li Z. Staging liver fibrosis: comparison of radiomics model and fusion model based on multiparametric MRI in patients with chronic liver disease. Abdom Radiol (NY) 2024; 49:1165-1174. [PMID: 38219254 DOI: 10.1007/s00261-023-04142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVES To develop and compare radiomics model and fusion model based on multiple MR parameters for staging liver fibrosis in patients with chronic liver disease. MATERIALS AND METHODS Patients with chronic liver disease who underwent multiparametric abdominal MRI were included in this retrospective study. Multiparametric MR images were imported into 3D-Slicer software for drawing bounding boxes on MR images. By using a 3D-Slicer extension of SlicerRadiomics, radiomics features were extracted from these MR images. The z-score normalization method was used for post-processing radiomics features. The least absolute shrinkage and selection operator method (LASSO) was performed for selecting significant radiomics features. The logistic regression analysis was used for building the radiomics model. A fusion model was built by integrating serum fibrosis biomarkers of aspartate transaminase-to-platelet ratio index (APRI) and the fibrosis-4 index (FIB-4) with radiomics signatures. RESULTS In the training cohort, AUCs of radiomics and fusion model were 0.707-0.842 and 0.718-0.854 for differentiating different groups. In the testing cohort, AUCs were 0.514-0.724 and 0.609-0.728. For the training cohort, there was no significant difference of AUCs between radiomics and fusion model (p > 0.05). For the testing cohort, AUCs of fusion model were higher than those of radiomics model in differentiating F1-3 vs. F4 and F1-2 vs. F4 (p = 0.011 & 0.042). CONCLUSIONS Radiomics model and fusion model based on multiparametric MRI exhibited the feasibility for staging liver fibrosis in patients with CLD, and APRI and FIB-4 could improve the diagnostic performance of radiomics model in differentiating F1-3 vs. F4 and F1-2 vs. F4.
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Affiliation(s)
- Longyang Xiao
- Department of Radiology, The Affiliated Hospital of Qingdao University, No.59 Haier Road, Qingdao, 266000, China
| | - Haichen Zhao
- Department of Radiology, The Affiliated Hospital of Qingdao University, No.59 Haier Road, Qingdao, 266000, China
| | - Shunli Liu
- Department of Radiology, The Affiliated Hospital of Qingdao University, No.59 Haier Road, Qingdao, 266000, China
| | - Wenlu Dong
- Department of Radiology, The Affiliated Hospital of Qingdao University, No.59 Haier Road, Qingdao, 266000, China
| | - Yuanxiang Gao
- Department of Radiology, The Affiliated Hospital of Qingdao University, No.59 Haier Road, Qingdao, 266000, China
| | - Lili Wang
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Baoxiang Huang
- College of Computer Science and Technology of Qingdao University, No.308 Ningxia Road, Qingdao, 266071, China.
| | - Zhiming Li
- Department of Radiology, The Affiliated Hospital of Qingdao University, No.59 Haier Road, Qingdao, 266000, China.
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22
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Wang J, Ye W, Jiang M, Zhou Y, Zheng J. Therapeutic potential of exosome derived from hepatocyte growth factor-overexpressing adipose mesenchymal stem cells in TGFβ1-stimulated hepatic stellate cells. Cytotechnology 2024; 76:217-229. [PMID: 38495297 PMCID: PMC10940570 DOI: 10.1007/s10616-023-00611-0] [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: 07/18/2023] [Accepted: 12/14/2023] [Indexed: 03/19/2024] Open
Abstract
Cirrhosis is a familiar end-stage of multiple chronic liver diseases. The gene-modified mesenchymal stem cells (MSCs) have become one of the most promising schemes for the treatment of cirrhosis. MSCs exhibit their therapeutic role mainly by secreting hepatocyte growth factor (HGF). The aim of this research was to probe the anti-fibrosis role of exosomes secreted by HGF modified-mouse adipose MSCs (ADMSCs) on activated hepatic stellate cells (HSCs) and to preliminarily explore the possible mechanism. Firstly, mouse ADMSCs were isolated and identified. Quantitative real-time polymerase chain reaction verified the transfection efficiency of ADMSC transfected with HGF lentivirus. Exosomes derived from ADMSC transfecting negative control/HGF (ADMSCNC-Exo/ADMSCHGF-Exo) were extracted by density gradient centrifugation. HSCs were allocated to the control, TGF-β, TGF-β + ADMSC-Exo, TGF-β + ADMSCNC-Exo, and TGF-β + ADMSCHGF-Exo groups. Moreover, all mice were distributed to the control, CCl4 (40% CCl4 in olive oil), CCl4+ADMSC-Exo, CCl4+ADMSCNC-Exo, and CCl4+ADMSCHGF-Exo groups. Exosomes derived from ADMSCs with or without HGF transfection suppressed HSC activation, as evidenced by attenuating cell viability and cell cycle arrest at S phase but inducing apoptosis. Moreover, ADMSC-Exo, ADMSCNC-Exo, and ADMSCHGF-Exo effectively repressed the gene and protein levels of α-SMA, Col-I, Rho A, Cdc42, and Rac1 in TGF-β-treated HSCs, and ADMSCHGF-Exo had the best effect. ADMSCHGF-Exo had a stronger regulatory effect on serum liver index than ADMSCNC-Exo in CCl4-induced mice. In conclusion, ADMSCHGF-Exo alleviated liver fibrosis by weakening the Rho pathway, thus reducing collagen production.
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Affiliation(s)
- Jin Wang
- Department of Pancreatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People′s Hospital, No. 100 Minjiang Avenue, Kecheng District, 324000 Quzhou, Zhejiang China
| | - Weikang Ye
- Department of Pancreatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People′s Hospital, No. 100 Minjiang Avenue, Kecheng District, 324000 Quzhou, Zhejiang China
| | - Ming Jiang
- Department of Pancreatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People′s Hospital, No. 100 Minjiang Avenue, Kecheng District, 324000 Quzhou, Zhejiang China
| | - Yinong Zhou
- Department of Pancreatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People′s Hospital, No. 100 Minjiang Avenue, Kecheng District, 324000 Quzhou, Zhejiang China
| | - Jie Zheng
- Department of Pancreatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People′s Hospital, No. 100 Minjiang Avenue, Kecheng District, 324000 Quzhou, Zhejiang China
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23
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Oruc M, Gedik ME, Uner M, Ulug E, Unal RN, Gunaydin G, Dogrul AB. Effectiveness of metformin for the reversal of cold-ischemia-induced damage in hepatosteatosis. Clin Res Hepatol Gastroenterol 2024; 48:102314. [PMID: 38467276 DOI: 10.1016/j.clinre.2024.102314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/12/2024] [Accepted: 03/06/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Primary dysfunction and rejection are more common in donor liver tissues with steatosis. AMP-activated protein kinase (AMPK) assumes organ-protective functions during ischemia. Metformin was used for the activation of AMPK in hepatocytes. The aim of this study is to investigate the effectiveness of metformin administration for the reversal of cold-ischemia-induced damage in hepatosteatosis. MATERIAL AND METHODS Seven-week-old C7BL56 male-mice (n = 109) were separated into four groups depending on diet type and metformin use. A specific diet model was followed for 10 weeks to induce hepatosteatosis. A group of the animals was administered with metformin for the last four weeks via oral gavage. After resection, the liver tissues were perfused and kept for 0-6-12-24 h in the UW solution. Histopathological examinations were performed, and Western blot was utilized to analyze p-AMPK and AMPK expression levels. RESULTS Hepatosteatosis decreased significantly with metformin. The steatotic liver group had more prominent pericentral inflammation, necrosis as well as showing a decreased and more delayed AMPK response than the non-fat group. All these alterations could be corrected using metformin. CONCLUSION Metformin can increase the resistance of livers with hepatosteatosis to cold-ischemia-induced damage, which in turn may pave the way for successful transplantation of fatty living-donor livers.
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Affiliation(s)
- Mustafa Oruc
- Department of General Surgery, Faculty Of Medicine, School of Medicine, Hacettepe University, Floor B, 06230, Ankara, Altindag 06230, Turkey
| | - Mustafa Emre Gedik
- Department of Basic Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey
| | - Meral Uner
- Department of Pathology, Hacettepe University School of Medicine, Ankara 06230, Turkey
| | - Elif Ulug
- Department of Nutrition and Dietetics, Hacettepe University, Ankara 06230, Turkey
| | - Reyhan Nergiz Unal
- Department of Nutrition and Dietetics, Hacettepe University, Ankara 06230, Turkey
| | - Gurcan Gunaydin
- Department of Basic Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey
| | - Ahmet Bulent Dogrul
- Department of General Surgery, Faculty Of Medicine, School of Medicine, Hacettepe University, Floor B, 06230, Ankara, Altindag 06230, Turkey.
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24
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Fu CX, Qin XR, Chen JS, Zhong J, Xie YX, Li BD, Fu QQ, Li F, Zheng JF. Effect of an Airbag-selective Portal Vein Blood Arrester on the Liver after Hepatectomy: A New Technique for Selective Clamping of the Portal Vein. Curr Med Sci 2024; 44:380-390. [PMID: 38517675 DOI: 10.1007/s11596-024-2837-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 12/13/2023] [Indexed: 03/24/2024]
Abstract
OBJECTIVE A novel technique was explored using an airbag-selective portal vein blood arrester that circumvents the need for an intraoperative assessment of anatomical variations in patients with complex intrahepatic space-occupying lesions. METHODS Rabbits undergoing hepatectomy were randomly assigned to 4 groups: intermittent portal triad clamping (PTC), intermittent portal vein clamping (PVC), intermittent portal vein blocker with an airbag-selective portal vein blood arrester (APC), and without portal blood occlusion (control). Hepatic ischemia and reperfusion injury were assessed by measuring the 7-day survival rate, blood loss, liver function, hepatic pathology, hepatic inflammatory cytokine infiltration, hepatic malondialdehyde levels, and proliferating cell nuclear antigen levels. RESULTS Liver damage was substantially reduced in the APC and PVC groups. The APC animals exhibited transaminase levels similar to or less oxidative stress damage and inflammatory hepatocellular injury compared to those exhibited by the PVC animals. Bleeding was significantly higher in the control group than in the other groups. The APC group had less bleeding than the PVC group because of the avoidance of portal vein skeletonization during hepatectomy. Thus, more operative time was saved in the APC group than in the PVC group. Moreover, the total 7-day survival rate in the APC group was higher than that in the PTC group. CONCLUSION Airbag-selective portal vein blood arresters may help protect against hepatic ischemia and reperfusion injury in rabbits undergoing partial hepatectomy. This technique may also help prevent liver damage in patients requiring hepatectomy.
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Affiliation(s)
- Ce-Xiong Fu
- Department of Hepatobiliary and Pancreatic Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
- University of South China, Hengyang, 421001, China
| | - Xiao-Ri Qin
- Department of Gastroenterology, Gastroenterology Endoscopy Center, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
| | - Jin-Song Chen
- Department of Hepatobiliary and Pancreatic Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
| | - Jie Zhong
- Department of Hepatobiliary and Pancreatic Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
| | - Yu-Xu Xie
- Center of Clinical Laboratory, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
| | - Bi-Dan Li
- Department of Hepatobiliary and Pancreatic Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
| | - Qing-Qing Fu
- Department of Radiology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
| | - Fang Li
- Department of Gastroenterology, Gastroenterology Endoscopy Center, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China.
| | - Jin-Fang Zheng
- Department of Hepatobiliary and Pancreatic Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China.
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25
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Barr RG. Evaluation of Liver Stiffness Values Requires Consideration of Many Factors. Radiology 2024; 311:e240453. [PMID: 38591976 DOI: 10.1148/radiol.240453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Richard G Barr
- From the Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio; and Southwoods Imaging, 7623 Market St, Youngstown, OH 44512
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26
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Ketabchi F, Khoram M, Dehghanian A. Evaluation of Electrocardiogram Parameters and Heart Rate Variability During Blood Pressure Elevation by Phenylephrine in Cirrhotic Rats. Cardiovasc Toxicol 2024; 24:321-334. [PMID: 38409566 DOI: 10.1007/s12012-024-09839-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/07/2024] [Indexed: 02/28/2024]
Abstract
Cirrhotic cardiomyopathy is a myocardial disease that may go undetected in the early stages due to peripheral vasodilatation. The aim of the study was to evaluate the electrocardiogram (ECG) and heart rate variability (HRV) after raising blood pressure by phenylephrine injection in rats with liver cirrhosis. Twenty male Sprague-Dawley rats were divided into the Sham and common bile duct ligation (CBDL) groups. After 44 days, animals were anesthetized and the right femoral artery and vein catheterized. After a steady-state period, a bolus injection of phenylephrine (PHE, 10 μg/μl/IV, baroreflex maneuver) was followed by a slow injection of PHE (100 μg/ml/5 min/IV, sustained maneuver). Rapid and slow injections of PHE resulted in a greater increase in mean arterial pressure (MAP) and a weaker bradycardia response in the CBDL group than in the Sham group. ECG analysis showed increased QT, QTc, JT, and T peak to T end in the CBDL group, which remained unchanged after PHE injection. On the other hand, the parasympathetic indices of the HF band and RMSSD, and the sympathetic index of the LF band after PHE injection were lower in the CBDL group than in the Sham group.ECG data indicated prolonged ventricular depolarization and repolarization, independent of blood pressure levels in cirrhosis. On the other hand, after PHE injection, the parasympathetic and sympathetic components of HRV decreased, regardless of the duration of elevated blood pressure. We suggest that HRV analysis can provide a useful approach to assess cardiac dysfunction associated with elevated blood pressure in cirrhosis.
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Affiliation(s)
- Farzaneh Ketabchi
- Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammadreza Khoram
- Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirreza Dehghanian
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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27
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Moura Cunha G, Fan B, Navin PJ, Olivié D, Venkatesh SK, Ehman RL, Sirlin CB, Tang A. Interpretation, Reporting, and Clinical Applications of Liver MR Elastography. Radiology 2024; 310:e231220. [PMID: 38470236 PMCID: PMC10982829 DOI: 10.1148/radiol.231220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 03/13/2024]
Abstract
Chronic liver disease is highly prevalent and often leads to fibrosis or cirrhosis and complications such as liver failure and hepatocellular carcinoma. The diagnosis and staging of liver fibrosis is crucial to determine management and mitigate complications. Liver biopsy for histologic assessment has limitations such as sampling bias and high interreader variability that reduce precision, which is particularly challenging in longitudinal monitoring. MR elastography (MRE) is considered the most accurate noninvasive technique for diagnosing and staging liver fibrosis. In MRE, low-frequency vibrations are applied to the abdomen, and the propagation of shear waves through the liver is analyzed to measure liver stiffness, a biomarker for the detection and staging of liver fibrosis. As MRE has become more widely used in clinical care and research, different contexts of use have emerged. This review focuses on the latest developments in the use of MRE for the assessment of liver fibrosis; provides guidance for image acquisition and interpretation; summarizes diagnostic performance, along with thresholds for diagnosis and staging of liver fibrosis; discusses current and emerging clinical applications; and describes the latest technical developments.
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Affiliation(s)
- Guilherme Moura Cunha
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Boyan Fan
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Patrick J. Navin
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Damien Olivié
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Sudhakar K. Venkatesh
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Richard L. Ehman
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Claude B. Sirlin
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - An Tang
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
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Claes J, Agten A, Blázquez-Moreno A, Crabbe M, Tuefferd M, Goehlmann H, Geys H, Peng CY, Neyens T, Faes C. The influence of resolution on the predictive power of spatial heterogeneity measures as biomarkers of liver fibrosis. Comput Biol Med 2024; 171:108231. [PMID: 38422965 DOI: 10.1016/j.compbiomed.2024.108231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/23/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
Spatial heterogeneity of cells in liver biopsies can be used as biomarker for disease severity of patients. This heterogeneity can be quantified by non-parametric statistics of point pattern data, which make use of an aggregation of the point locations. The method and scale of aggregation are usually chosen ad hoc, despite values of the aforementioned statistics being heavily dependent on them. Moreover, in the context of measuring heterogeneity, increasing spatial resolution will not endlessly provide more accuracy. The question then becomes how changes in resolution influence heterogeneity indicators, and subsequently how they influence their predictive abilities. In this paper, cell level data of liver biopsy tissue taken from chronic Hepatitis B patients is used to analyze this issue. Firstly, Morisita-Horn indices, Shannon indices and Getis-Ord statistics were evaluated as heterogeneity indicators of different types of cells, using multiple resolutions. Secondly, the effect of resolution on the predictive performance of the indices in an ordinal regression model was investigated, as well as their importance in the model. A simulation study was subsequently performed to validate the aforementioned methods. In general, for specific heterogeneity indicators, a downward trend in predictive performance could be observed. While for local measures of heterogeneity a smaller grid-size is outperforming, global measures have a better performance with medium-sized grids. In addition, the use of both local and global measures of heterogeneity is recommended to improve the predictive performance.
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Affiliation(s)
- Jari Claes
- Data Science Institute, UHasselt - Hasselt University, Agoralaan 1, Diepenbeek, 3590, Belgium.
| | - Annelies Agten
- Data Science Institute, UHasselt - Hasselt University, Agoralaan 1, Diepenbeek, 3590, Belgium
| | - Alfonso Blázquez-Moreno
- Discovery Statistics, Global Development, Janssen Research and Development, Turnhoutseweg 30, Beerse, 2340, Belgium
| | - Marjolein Crabbe
- Discovery Statistics, Global Development, Janssen Research and Development, Turnhoutseweg 30, Beerse, 2340, Belgium
| | - Marianne Tuefferd
- Translational Biomarkers, Infectious Diseases, Janssen Research and Development, Turnhoutseweg 30, Beerse, 2340, Belgium
| | - Hinrich Goehlmann
- Translational Biomarkers, Infectious Diseases, Janssen Research and Development, Turnhoutseweg 30, Beerse, 2340, Belgium
| | - Helena Geys
- Discovery Statistics, Global Development, Janssen Research and Development, Turnhoutseweg 30, Beerse, 2340, Belgium
| | | | - Thomas Neyens
- Data Science Institute, UHasselt - Hasselt University, Agoralaan 1, Diepenbeek, 3590, Belgium; L-BioStat, KU Leuven, Kapucijnenvoer 35, Leuven, 3000, Belgium
| | - Christel Faes
- Data Science Institute, UHasselt - Hasselt University, Agoralaan 1, Diepenbeek, 3590, Belgium
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29
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Meng Q, Zhu H, Li Y, Peng X, Wang T, Huang H, Zhou H, Liu Y, Ru S, Wu J, Ma Y. Quantitative proteomics reveals the protective effects of Yinchenzhufu decoction against cholestatic liver fibrosis in mice by inhibiting the PDGFRβ/PI3K/AKT pathway. Front Pharmacol 2024; 15:1341020. [PMID: 38469403 PMCID: PMC10926276 DOI: 10.3389/fphar.2024.1341020] [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: 11/19/2023] [Accepted: 01/25/2024] [Indexed: 03/13/2024] Open
Abstract
Introduction: Yinchenzhufu decoction (YCZFD) is a traditional Chinese medicine formula with hepatoprotective effects. In this study, the protective effects of YCZFD against cholestatic liver fibrosis (CLF) and its underlying mechanisms were evaluated. Methods: A 3, 5-diethoxycarbonyl-1, 4-dihydro-collidine (DDC)-induced cholestatic mouse model was used to investigate the amelioration of YCZFD on CLF. Data-independent acquisition-based mass spectrometry was performed to investigate proteomic changes in the livers of mice in three groups: control, model, and model treated with high-dose YCZFD. The effects of YCZFD on the expression of key proteins were confirmed in mice and cell models. Results: YCZFD significantly decreased the levels of serum biochemical, liver injury, and fibrosis indicators of cholestatic mice. The proteomics indicated that 460 differentially expressed proteins (DEPs) were identified among control, model, and model treated with high-dose YCZFD groups. Enrichment analyses of these DEPs revealed that YCZFD influenced multiple pathways, including PI3K-Akt, focal adhesion, ECM-receptor interaction, glutathione metabolism, and steroid biosynthesis pathways. The expression of platelet derived growth factor receptor beta (PDGFRβ), a receptor associated with the PI3K/AKT and focal adhesion pathways, was upregulated in the livers of cholestatic mice but downregulated by YCZFD. The effects of YCZFD on the expression of key proteins in the PDGFRβ/PI3K/AKT pathway were further confirmed in mice and transforming growth factor-β-induced hepatic stellate cells. We uncovered seven plant metabolites (chlorogenic acid, scoparone, isoliquiritigenin, glycyrrhetinic acid, formononetin, atractylenolide I, and benzoylaconitine) of YCZFD that may regulate PDGFRβ expression. Conclusion: YCZFD substantially protects against DDC-induced CLF mainly through regulating the PDGFRβ/PI3K/AKT signaling pathway.
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Affiliation(s)
- Qian Meng
- Department of Pharmacology, School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Analytical Research Center for Organic and Biological Molecules, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Hongwen Zhu
- Analytical Research Center for Organic and Biological Molecules, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Yuanyuan Li
- Department of Pharmacology, School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaotian Peng
- Department of Pharmacology, School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tianming Wang
- Department of Pharmacology, School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Huang
- Analytical Research Center for Organic and Biological Molecules, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Hu Zhou
- Analytical Research Center for Organic and Biological Molecules, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yuejia Liu
- Analytical Research Center for Organic and Biological Molecules, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
- School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Sujie Ru
- Analytical Research Center for Organic and Biological Molecules, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
- School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jiasheng Wu
- Department of Pharmacology, School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yueming Ma
- Department of Pharmacology, School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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30
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Wang R, Lin Q, Lu Z, Wen H, Hu F, You J, He Y, Fang Y, Bian Z, Hou Q, Ju Z, Wang Y, Lian M, Xiao X, Sheng L, Guo C, Hua J, Tang R, You Z, Chen X, Gershwin ME, Huang Z, Wang Q, Miao Q, Ma X. Immunosuppression induces regression of fibrosis in primary biliary cholangitis with moderate-to-severe interface hepatitis. J Autoimmun 2024; 143:103163. [PMID: 38301505 DOI: 10.1016/j.jaut.2023.103163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/10/2023] [Accepted: 12/13/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND In patients with primary biliary cholangitis (PBC) treated with ursodeoxycholic acid (UDCA), the presence of moderate-to-severe interface hepatitis is associated with a higher risk of liver transplantation and death. This highlights the need for novel treatment approaches. In this study, we aimed to investigate whether combination therapy of UDCA and immunosuppressant (IS) was more effective than UDCA monotherapy. METHODS We conducted a multicenter study involving PBC patients with moderate-to-severe interface hepatitis who underwent paired liver biopsies. Firstly, we compared the efficacy of the combination therapy with UDCA monotherapy on improving biochemistry, histology, survival rates, and prognosis. Subsequently we investigated the predictors of a beneficial response. RESULTS This retrospective cohort study with prospectively collected data was conducted in China from January 2009 to April 2023. Of the 198 enrolled patients, 32 underwent UDCA monotherapy, while 166 received combination therapy, consisting of UDCA combined with prednisolone, prednisolone plus mycophenolate mofetil (MMF), or prednisolone plus azathioprine (AZA). The monotherapy group was treated for a median duration of 37.6 months (IQR 27.5-58.1), and the combination therapy group had a median treatment duration of 39.3 months (IQR 34.5-48.8). The combination therapy showed a significantly greater efficacy in reducing fibrosis compared to UDCA monotherapy, with an 8.3-fold increase in the regression rate (from 6.3% to 52.4%, P < 0.001). Other parameters, including biochemistry, survival rates, and prognosis, supported its effectiveness. Baseline IgG >1.3 × ULN and ALP <2.4 × ULN were identified as predictors of regression following the combination therapy. A predictive score named FRS, combining these variables, accurately identified individuals achieving fibrosis regression with a cut-off point of ≥ -0.163. The predictive value was validated internally and externally. CONCLUSION Combination therapy with IS improves outcomes in PBC patients with moderate-to-severe interface hepatitis compared to UDCA monotherapy. Baseline IgG and ALP are the most significant predictors of fibrosis regression. The new predictive score, FRS, incorporating baseline IgG and ALP, can effectively identify individuals who would benefit from the combination therapy.
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Affiliation(s)
- Rui Wang
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Qiuxiang Lin
- Department of Hepatology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
| | - Zhonghua Lu
- Department of Liver Disease, Affiliated Wuxi Fifth Hospital of Jiangnan University, Wuxi, China
| | - Haoyu Wen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Fangqin Hu
- Division of Hepatology, The Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Jia You
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yonghong He
- Cholestatic Liver Diseases Center, Department of Gastroenterology, Southwest Hospital of Army Medical University, Chongqing, China
| | - Yuan Fang
- Department of Hepatopathy, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Zhaolian Bian
- Department of Gastroenterology and Hepatology, Nantong Third People's Hospital, The Third Affiliated Hospital of Nantong University, Nantong, China
| | - Qiuchen Hou
- Department of Liver Disease, Affiliated Wuxi Fifth Hospital of Jiangnan University, Wuxi, China
| | - Zhaoxia Ju
- Department of Liver Disease, Affiliated Wuxi Fifth Hospital of Jiangnan University, Wuxi, China
| | - Yanyan Wang
- Department of Gastroenterology and Hepatology, Nantong Third People's Hospital, The Third Affiliated Hospital of Nantong University, Nantong, China
| | - Min Lian
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Xiao Xiao
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Li Sheng
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Canjie Guo
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Jing Hua
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Ruqi Tang
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Zhengrui You
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Xiaoyu Chen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - M Eric Gershwin
- Division of Rheumatology, Department of Medicine, Allergy and Clinical Immunology, University of California at Davis, Davis, CA, USA
| | - Zuxiong Huang
- Department of Hepatology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China.
| | - Qixia Wang
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China; Division of Infectious Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Qi Miao
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China.
| | - Xiong Ma
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China; Institute of Aging & Tissue Regeneration, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Wang L, Duan C, Wu X, Xie J, Zhao X, Si Y, Wu D, Wang Y, Zhao P, Chen J, Yin W, Li J. ADAR1 regulates macrophage polarization and is protective against liver ischemia and reperfusion injury. Immunobiology 2024; 229:152777. [PMID: 38113710 DOI: 10.1016/j.imbio.2023.152777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 11/24/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023]
Abstract
Liver ischemia and reperfusion injury (LIRI) is a major risk for the poor prognosis of patients receiving liver transplantation. The molecular mechanism involved in LIRI is complex and related to various cellular components. We previously reported that adenosine deaminase acting on RNA 1 (ADAR1) alleviated the allogeneic skin graft rejection by regulating macrophage polarization. However, the regulatory effects of ADAR1 on liver macrophages after LIRI remain largely unknown. In this study, we mainly adopted a mouse model of LIRI and cellular experiments with hypoxia and reoxygenation (HR) treatment to explore the regulatory roles of ADAR1 on liver macrophages under LIRI conditions. We found that IRI caused decreased ADAR1 in liver tissues and remarkable changes of liver macrophage polarization and profiles. ADAR1 supplementation alleviated the pathological injury caused by IRI and accelerated the activation of M2 macrophages in the liver of IRI mice. Increased hypoxia duration reduced ADAR1 expression levels in murine RAW264.7 macrophages at the transcriptional level. Further overexpression of ADAR1 significantly increased the expressions of anti-inflammatory cytokines and promoted M2 polarization of macrophages under HR exposure. ADAR1 knockdown exhibited opposite effects on macrophage polarization. Hence, ADAR1 promotes the M2 polarization of liver macrophages that may further alleviate LIRI. The protective effects of ADAR1 against LIRI provide a novel insight into the prevention and treatment of LIRI.
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Affiliation(s)
- Linxiao Wang
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China; College of Life Sciences, Northwest University, Xi'an, China
| | - Chujun Duan
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Xiuhua Wu
- Department of Respiratory and Clinical Care Medicine, Shanghai Sixth People's Hospital, Shanghai, China
| | - Jiangang Xie
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Xiaojun Zhao
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Yi Si
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Dan Wu
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Yifan Wang
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Peng Zhao
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Jijun Chen
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Wen Yin
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China.
| | - Junjie Li
- Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an, China.
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Yu T, Liu S, Zhao J, Jiang Y, Deng R. Comparison of the performance of four screening tools for sarcopenia in patients with chronic liver disease. Int J Nurs Sci 2024; 11:3-10. [PMID: 38352295 PMCID: PMC10859570 DOI: 10.1016/j.ijnss.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 02/16/2024] Open
Abstract
Objectives Early identification of sarcopenia in patients with chronic liver disease is crucial for patient management and prevention of severe complications. We aimed to assess the effectiveness of Ishii score, Strength, Assistance with Walking, Rise from a Chair, Climb Stairs and Falls (SARC-F), SARC-F and Calf Circumference (SARC-CalF), and Mini Sarcopenia Risk Assessment-7 (MSRA-7) to screen sarcopenia in patients with chronic liver disease. Methods This prospective study included patients with chronic liver disease in the infectious department of a tertiary hospital in Sichuan, China. Ishii score, SARC-F, SARC-CalF, and MSRA-7 were used to screen for sarcopenia risk. Sarcopenia was diagnosed according to the Asian Myometriosis Working Group (AWGS) 2019, which was used as the gold standard to compare the performance of the four screening tools. We completed clinical registration on the Chinese Clinical Trial Registration website (ChiCTR2100043910). Results A total of 366 patients with chronic liver disease (22.4% women, mean age 48.96 ± 11.88 years) were evaluated. Based on the AWGS 2019 standard, the prevalence of sarcopenia in patients with chronic liver disease was 17.5%. Among all participants, receiver operating characteristic (ROC) produced an area under the curve (AUC) of 0.82 for Ishii score (sensitivity 85.94%, specificity 78.15%), 0.53 for SARC-F (sensitivity 6.25%, specificity 99.34%), 0.64 for SARC-CalF (sensitivity 45.31%, specificity 83.11%), and 0.55 for MSRA-7 (sensitivity 87.50%, specificity 22.85%). Based on AUC, decision curve analysis, and calibration curves, we concluded that Ishii score was the most accurate screening tool and was superior to the other tools. Conclusions Ishii score is more suitable for screening sarcopenia in patients with chronic liver disease than the SARC-F, SARC-CalF, and MSRA-7, based on the AWGS 2019 criteria. Nursing professionals can use Ishii score as a clinical tool to screen for sarcopenia in patients with chronic liver disease, providing an indication cue for the final diagnosis of sarcopenia, improving diagnostic efficiency, and enabling early identification and prevention of complications resulting from sarcopenia.
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Affiliation(s)
- Ting Yu
- Department of Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Shanshan Liu
- Department of Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Jing Zhao
- Center of Infectious Diseases, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yan Jiang
- Department of Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Rong Deng
- Center of Infectious Diseases, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Romano-Munive AF, Moctezuma-Velázquez C, Sauma-Rodríguez J, Ramos-Martínez P, Torre-Delgadillo A. CD138 immunohistochemistry identifies more plasma cells compared with hematoxylin and eosin staining in autoimmune hepatitis. An observational study. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2024; 89:52-56. [PMID: 36973120 DOI: 10.1016/j.rgmxen.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/25/2022] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Autoimmune hepatitis (AIH) is associated with periportal infiltration by plasma cells. Plasma cell detection is routinely performed through hematoxylin and eosin (H&E) staining. The present study aimed to assess the utility of CD138, an immunohistochemical plasma cell marker, in the evaluation of AIH. MATERIALS AND METHODS A retrospective study was conducted, in which cases consistent with AIH, within the time frame of 2001 and 2011, were collected. Routine H&E-stained sections were used for evaluation. CD138 immunohistochemistry (IHC) was performed to detect plasma cells. RESULTS Sixty biopsies were included. In the H&E group, the median and interquartile range (IQR) was 6 (4-9) plasma cells/high power field (HPF) and was 10 (IQR 6-20) plasma cells/HPF in the CD138 group (p < 0.001). There was a significant correlation between the number of plasma cells determined by H&E and CD138 (p = 0.31, p = 0.01). No significant correlation was found between the number of plasma cells determined by CD138 and IgG level (p = 0.21, p = 0.09) or stage of fibrosis (p = 0.12, p = 0.35), or between IgG level and stage of fibrosis (p = 0.17, p = 0.17). No significant correlation was found between the treatment response and the number of plasma cells determined by H&E (p = 0.11, p = 0.38), CD138 (p = 0.07, p = 0.55), or stage of fibrosis (p = 0.16, p = 0.20). CD138 expression was different between the treatment response groups (p = 0.04). CONCLUSION CD138 increased the detection of plasma cells in liver biopsies of patients with AIH, when compared with routine H&E staining. However, there was no correlation between the number of plasma cells determined by CD138 and serum IgG levels, stage of fibrosis, or response to treatment.
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Affiliation(s)
- A F Romano-Munive
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Tlalpan, Mexico City, Mexico.
| | - C Moctezuma-Velázquez
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Tlalpan, Mexico City, Mexico
| | | | - P Ramos-Martínez
- Departamento de Patología, INCMNSZ, Tlalpan, Mexico City, Mexico
| | - A Torre-Delgadillo
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Tlalpan, Mexico City, Mexico
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Kang H, Luo J, Wang C, Hong Y, Ye M, Ding Y, Zhao Q, Chang Y. miR-192 inhibits the activation of hepatic stellate cells by targeting Rictor. Open Med (Wars) 2023; 18:20230879. [PMID: 38152335 PMCID: PMC10751890 DOI: 10.1515/med-2023-0879] [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: 07/19/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
The activation of hepatic stellate cells (HSCs) is regarded as the primary driving factor of liver fibrosis. miR-192, a miRNA associated with hepatocellular carcinoma and enriched in HSCs, has an undisclosed role in HSC activation and liver fibrosis. In this study, a CCl4-induced rat liver fibrosis model and transforming growth factor-beta 1 (TGF-β1)-treated HSC lines (LX-2 and HSC-T6) were used to detect miR-192 and Rictor levels in vivo and in vitro. Bioinformatic analysis and a dual luciferase assay were used to predict and confirm the interaction of Rictor with miR-192. Gain- and/or loss-of-function methods evaluated molecular changes and HSC activation phenotypes, detected by quantitative real-time PCR, western blotting, and immunofluorescence. We observed a gradual downregulation of miR-192 and upregulation of Rictor during CCl4-induced liver fibrosis/cirrhosis in rats. Enriched miR-192 was downregulated, while Rictor was upregulated in TGF-β1-activated HSCs. miR-192 inhibited the activation of HSCs by directly targeting Rictor. High miR-192/low Rictor expression attenuated the fibrotic-related gene expression by AKT/mTORC2 signaling. In conclusion, miR-192 could inhibit the activation of HSCs by directly targeting Rictor in the AKT/mTORC2 signaling pathway. This study provides insights into potential therapeutic targets for liver fibrosis and cirrhosis.
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Affiliation(s)
- Hui Kang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan430071, China
| | - Jie Luo
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan430071, China
| | - Chun Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan430071, China
| | - Yinghui Hong
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan430071, China
| | - Mingliang Ye
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan430071, China
| | - Yang Ding
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan430071, China
| | - Qiu Zhao
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan430071, China
| | - Ying Chang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan430071, China
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Liang Y, Khandakar B, Hao Y, Xiong Y, Liu BL, Zhang X. Histology and clinical correlations in autoimmune hepatitis, primary biliary cholangitis, and autoimmune hepatitis-primary biliary cholangitis overlap syndrome. Ann Diagn Pathol 2023; 67:152178. [PMID: 37468373 DOI: 10.1016/j.anndiagpath.2023.152178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/08/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES The diagnosis of autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and AIH-PBC overlap syndrome (OS) relies on their histologic features and clinical findings. In this study, we aimed to identify specific morphologic features of these diseases and evaluate their clinical correlation. METHODS We included initial biopsies from untreated patients with AIH (n = 14), PBC (n = 10), and OS (n = 7). Histologic features of the portal tract, portal-lobular interface, and hepatic lobule, fibrosis, as well as clinical data including serology, autoantibodies, treatment, and prognosis were reviewed and analyzed. RESULTS Our results showed that several histologic features differed significantly between AIH and PBC (p < 0.05). Among these features, OS cases were more likely to present with bile duct-centered processes (presence of bile duct damage while absence of inflammation gradient from bile duct to interface, plasma cell cluster and pericentral inflammation) unlike those seen in AIH (p < 0.05), and interface-centered processes (unequivocal interface hepatitis, ductular reaction, and periportal fibrosis) which were not seen in PBC (p < 0.05). We observed a significant correlation between transaminase levels and lobular inflammation, including numbers of lymphocyte, plasma cell and eosinophil. Our study also found that anti-smooth muscle antibody positivity was associated with interface hepatitis (p < 0.01), while antimitochondrial antibody positivity was associated with duct damage (including ductopenia) and granulomas (p < 0.05). CONCLUSION Our results highlight distinctive morphological features between AIH and PBC. The possibility of overlap syndrome should be considered when encountering AIH with bile duct-centered processes or PBC with interface-centered processes in morphology and correlation with autoantibodies.
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Affiliation(s)
- Yuanxin Liang
- Department of Pathology, Yale University School of Medicine, New Haven, CT, United States of America.
| | - Binny Khandakar
- Department of Pathology, Yale University School of Medicine, New Haven, CT, United States of America
| | - Yansheng Hao
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Yiqin Xiong
- Department of Pathology, University of Iowa, Iowa City, IA, United States of America
| | - Bella L Liu
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Xuchen Zhang
- Department of Pathology, Yale University School of Medicine, New Haven, CT, United States of America
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Quarleri J, Delpino MV. Editorial: Metabolomics in chronic hepatitis C: Decoding fibrosis grading and underlying pathways. World J Hepatol 2023; 15:1170-1173. [DOI: 10.4254/wjh.v15.i11.1170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
In the management of the growing population of hepatitis C virus-infected patients, a significant clinical challenge exists in determining the most effective methods for assessing liver impairment. The prognosis and treatment of chronic hepatitis C depend, in part, on the evaluation of histological activity, specifically cell necrosis and inflammation, and the extent of liver fibrosis. These parameters are traditionally obtained through a liver biopsy. However, liver biopsy presents both invasiveness and potential sampling errors, primarily due to inadequate biopsy size. To circumvent these issues, several non-invasive markers have been proposed as alternatives for diagnosing liver damage. Different imaging techniques and blood parameters as single markers or combined with clinical information are included. This Editorial discusses the identification of a set of six distinctive lipid metabolites in every fibrosis grade that appear to show a pronounced propensity to create clusters among patients who share the same fibrosis grade, thereby demonstrating enhanced efficacy in distinguishing between the different grades.
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Affiliation(s)
- Jorge Quarleri
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida, Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1121, Argentina
| | - M Victoria Delpino
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida, Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1121, Argentina
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Xu X, Wang X, Ding M, Zhao Y, Zhao L, Zhao L, Li M, Zhao F, Sun R, Wang Z, Zhang R, Zhang S, Ge L, Sun Y, Zhan J. Development and post-Kasai procedure prognostic relevance of histological features for biliary atresia. BMC Pediatr 2023; 23:589. [PMID: 37993876 PMCID: PMC10664255 DOI: 10.1186/s12887-023-04413-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023] Open
Abstract
OBJECTIVES To validate an appropriate evaluation method of liver fibrosis assessment based on the unique pathological features of biliary atresia (BA) that could well predict its prognosis. METHODS A total of 68 patients with BA who underwent Kasai procedure (KP) and an intraoperative liver biopsy, followed up from January 2019 to December 2021, were recruited in a retrospective analysis. Ishak, Metavir, and BA-specific staging systems in relation to outcomes were analyzed using logistic regression, COX proportional hazard regression, Kaplan-Meier analysis, etc. RESULTS: Kaplan-Meier analysis determined a significant difference in native liver survival according to the BA-specific stage (p = 0.002). The ROC curve analysis for predicting prognosis showed that the AUC of BA-specific staging combined with iBALF and severe bile duct proliferation (BDP) (0.811, 95% CI: 0.710-0.913, p < 0.0001) was higher than BA-specific staging alone (0.755, 95% CI: 0.639-0.872, p < 0.001). CONCLUSIONS The BA-specific staging system reflects the condition of the liver fibrosis, and its combination with iBALF and severe BDP helps to better evaluate the prognosis of patients with BA.
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Affiliation(s)
- Xiaodan Xu
- Graduate College, Tianjin Medical University, Tianjin, 300070, China
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China
| | - Xueting Wang
- Department of Pediatric Surgery, Xinjiang Yili Friendship Hospital, Yili, 835000, China
| | - Meiyun Ding
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China
| | - Yilin Zhao
- Graduate College, Tianjin Medical University, Tianjin, 300070, China
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China
| | - Li Zhao
- Department of Pathology, Tianjin Children's Hospital, Tianjin, 300134, China
| | - Linsheng Zhao
- Department of Pathology, Tianjin Children's Hospital, Tianjin, 300134, China
| | - Mengdi Li
- Department of Pediatric Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China
| | - Fangyuan Zhao
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China
| | - Rongjuan Sun
- Graduate College, Tianjin Medical University, Tianjin, 300070, China
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China
| | - Zhiru Wang
- Graduate College, Tianjin Medical University, Tianjin, 300070, China
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China
| | - Ruifeng Zhang
- Graduate College, Tianjin Medical University, Tianjin, 300070, China
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China
| | - Shujian Zhang
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China
| | - Liang Ge
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China
| | - Yan Sun
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China
| | - Jianghua Zhan
- Department of General Surgery, Tianjin Children's Hospital, LongYan Road 238, Beichen District, Tianjin, 300134, China.
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Li JR, Yang DL, Wang JM, Tian W, Wei W, Luo CP, Qi LN, Ma L, Zhong JH. Importance of optimizing duration of adjuvant immune checkpoint inhibitor therapy to treat postoperative hepatocellular carcinoma after conversion therapy: a case report. J Surg Case Rep 2023; 2023:rjad610. [PMID: 37965538 PMCID: PMC10641292 DOI: 10.1093/jscr/rjad610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/15/2023] [Indexed: 11/16/2023] Open
Abstract
Patients with hepatocellular carcinoma at high risk of recurrence after hepatic resection or local ablation often undergo adjuvant immunotherapy with immune checkpoint inhibitors for 1 year in randomized controlled trials, but the appropriateness of this duration is controversial, especially given the risk of adverse events. Here we report the case of a 52-year-old Chinese man with initially unresectable multinodular recurrent hepatocellular carcinoma who underwent two cycles of transarterial chemoembolization, followed by hepatic resection and 24 months of adjuvant therapy with the PD-1 inhibitor tislelizumab. The patient achieved a recurrence-free survival time of 24 months, but he experienced elevated alpha fetoprotein, Grade 2 hypothyroidism and pruritus while on adjuvant therapy. This case highlights the need to optimize the duration of adjuvant immunotherapy after curative treatment for hepatocellular carcinoma in order to minimize risk of not only recurrence but also adverse events.
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Affiliation(s)
- Jian-Rong Li
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning 530021, China
| | - Da-Long Yang
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning 530021, China
| | - Jin-Ming Wang
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning 530021, China
| | - Wei Tian
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning 530021, China
| | - Wei Wei
- Radiology Department, Guangxi Medical University Cancer Hospital, Nanning 530021, China
| | - Cheng-Piao Luo
- Pathology Department, Guangxi Medical University Cancer Hospital, Nanning 530021, China
| | - Lu-Nan Qi
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning 530021, China
| | - Liang Ma
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning 530021, China
| | - Jian-Hong Zhong
- Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning 530021, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, China
- Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Nanning 530021, China
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Cetinic I, de Lange C, Boström H, Ekvall N, Bennet W, Lagerstrand K, Hebelka H. Shear wave elastography and shear wave dispersion correlated to biopsy at the scheduled follow-up of pediatric liver grafts. Pediatr Transplant 2023; 27:e14591. [PMID: 37583096 DOI: 10.1111/petr.14591] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/20/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND It is unknown how shear wave dispersion (SWD) is displayed in pediatric liver transplant recipients and not fully elucidated how ultrasound shear wave elastography (2D-SWE) display within this cohort, which is important to determine to improve noninvasive surveillance of these patients. The study aimed to compare SWE and SWD values with histopathology in pediatric liver recipients. METHODS Forty-eight pediatric liver recipients were examined with SWE in conjunction with an elective liver biopsy (clinically without complication). Additionally, SWD values were measured in 21 children. SWE and SWD values were compared to histologically determined fibrosis graded as none-to-mild (F0-1) and moderate-to-severe (F2-4), and inflammation graded as low (grade 0-1) and high (grade 2-4). RESULTS Two children were excluded due to SWE IQR/median > 30% kPa. The mean age across 46 included patients was 10.9 years (range 1.4-18). The number of patients and median (range) SWE value (kPa) for each stage of fibrosis were: F0-1 [n = 23; 5.8 (3.2-16.1)], F2 [n = 22; 6.0 (4.5-25.9)], F3 [n = 1; 33.3], and F4 [n = 0]. Significantly higher SWE values and greater variability were registered in F2-4 vs. F0-1 (p = .05). Grade of fibrosis correlated weakly to SWE values (r = .3; p = .05), but not to SWD values (r = .2; p = .27). In patients with low-grade inflammation, median SWD was 13.7 m/s KHz (10.7-17.6). Only one patient had high-grade inflammation. CONCLUSIONS Uncomplicated transplanted liver grafts in a small pediatric cohort revealed slightly increased SWE and SWD values compared to previously reported values in healthy children. This likely reflect both the fibrotic and inflammatory elements in the grafts; however, other confounders impacting the liver's viscoelastic properties are also probable factors.
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Affiliation(s)
- Ivan Cetinic
- Department of Pediatric Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Charlotte de Lange
- Department of Pediatric Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Håkan Boström
- Department of Pediatric Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nils Ekvall
- Department of Pediatric Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - William Bennet
- Department of Transplantation Surgery, Sahlgrenska University Hospital Gothenburg, Gothenburg, Sweden
| | - Kerstin Lagerstrand
- Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanna Hebelka
- Department of Pediatric Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Goand UK, Patel I, Verma S, Yadav S, Maity D, Singh N, Vishwakarma S, Rathaur S, Garg R, Gayen JR. Immunometabolic impact of pancreastatin inhibitor PSTi8 in MCD induced mouse model of oxidative stress and steatohepatitis. Cytokine 2023; 171:156354. [PMID: 37672864 DOI: 10.1016/j.cyto.2023.156354] [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: 07/17/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
AIM Pancreastatin, a dysglycemic hormone that encourages inflammation and steatosis in a variety of metabolic disorder animal models. The purpose of this study is to determine the effect of the pancreastatin inhibitor PSTi8 on immunometabolic changes in the liver of MCD-induced NASH mice. MAIN METHODS Methionine and choline-deficient (MCD) diet was used for the development of NASH. Liver enzymes like SGOT, SGPT, and ALP and lipid profiles were also performed in the serum. Further, immunophenotyping study was performed in the liver through flowcytometer. Subsequently, Hematoxylin and Eosin, Picro Sirius Red and Masson's Trichrome staining were done to check the liver morphology and collagen staining, respectively. Inflammatory cytokines were measured through ELISA and gene expression through RT-PCR. The expression of α-SMA was examined using immunohistochemistry and immunofluorescence staining. KEY FINDINGS PSTi8 inhibited the expression of lipogenic genes in the liver and attenuated bad cholesterol, SGOT, SGPT, and ALP in the serum. PSTi8 improved the liver morphology and attenuated collagen deposition. Subsequently, PSTi8 attenuated inflammatory M1-macrophages, CD8+T, CD4+T cells and increased anti-inflammatory M2 macrophages, T-reg and eosinophil populations in the liver. It also attenuated the expression of pro-inflammatory genes like Mcp1, Tnfα, and Il6. Apart from this, PSTi8 attenuated the oxidative stress marker, like ROS, and MDA and fibrosis marker α-SMA in the liver. It also decreased the apoptosis and ROS and MDA level in the liver. SIGNIFICANCE Overall, these compressive studies revealed that PSTi8 exhibited beneficial effect on the liver of MCD-induced NASH mice by attenuating inflammation and oxidative stress.
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Affiliation(s)
- Umesh K Goand
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Inklisan Patel
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Saurabh Verma
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Shubhi Yadav
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Debalina Maity
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Naveen Singh
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Sachin Vishwakarma
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Shivam Rathaur
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Richa Garg
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Jiaur R Gayen
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India; Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
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Zhang JB, Li MT, Lin SZ, Cheng YQ, Fan JG, Chen YW. Therapeutic Effect of Prolyl Endopeptidase Inhibitor in High-fat Diet-induced Metabolic Dysfunction-associated Fatty Liver Disease. J Clin Transl Hepatol 2023; 11:1035-1049. [PMID: 37577240 PMCID: PMC10412699 DOI: 10.14218/jcth.2022.00110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/13/2023] [Accepted: 02/27/2023] [Indexed: 07/03/2023] Open
Abstract
Background and Aims Prolyl endopeptidase (PREP) is a serine endopeptidase that participates in many pathological processes including inflammation, oxidative stress, and autophagy. Our previous studies found that PREP knockout exhibited multiple benefits in high-fat diet (HFD) or methionine choline-deficient diet-induced metabolic dysfunction-associated fatty liver disease (MAFLD). However, cumulative studies have suggested that PREP performs complex functions during disease development. Therefore, further understanding the role of PREP in MAFLD development is the foundation of PREP intervention. Methods In this study, an HFD-induced MAFLD model at different time points (4, 8, 12, and 16 weeks) was used to explore dynamic changes in the PREP proline-glycine-proline (PGP)/N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) system. To explore its potential value in MAFLD treatment, saline, or the PREP inhibitor, KYP-2047, was administered to HFD-induced MAFLD mice from the 10th to 16th weeks. Results PREP activity and expression were increased in HFD-mice compared with control mice from the 12th week onwards, and increased PREP mainly resulted in the activation of the matrix metalloproteinase 8/9 (MMP8/9)-PREP-PGP axis rather than the thymosin β4-meprin α/PREP-AcSDKP axis. In addition, KYP-2047 reduced HFD-induced liver injury and oxidative stress, improved lipid metabolism through the suppression of lipogenic genes and the induction of β-oxidation-related genes, and attenuated hepatic inflammation by decreasing MMP8/9 and PGP. Moreover, KYP2047 restored HFD-induced impaired autophagy and this was verified in HepG2 cells. Conclusions These findings suggest that increased PREP activity/expression during MAFLD development might be a key factor in the transition from simple steatosis to steatohepatitis, and KYP-2047 might possess therapeutic potential for MAFLD treatment.
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Affiliation(s)
- Jian-Bin Zhang
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Gastroenterology, Huadong Hospital, Fudan University, Shanghai, China
| | - Meng-Ting Li
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Gastroenterology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Shuang-Zhe Lin
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu-Qing Cheng
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jian-Gao Fan
- Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuan-Wen Chen
- Department of Gastroenterology, Huadong Hospital, Fudan University, Shanghai, China
- Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
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Li Q, Li X, Kan S, Zhu TJ, Li C, Du XY, Wang X, Yan HB, Wu CY, Chen GJ, Qian MB, Yan M, Wang ZJ. Clonorchis sinensis calcium-binding protein Cs16 causes acute hepatic injury possibly by reprogramming the metabolic pathway of bone marrow-derived monocytes. Front Cell Infect Microbiol 2023; 13:1280358. [PMID: 37920448 PMCID: PMC10619745 DOI: 10.3389/fcimb.2023.1280358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 09/25/2023] [Indexed: 11/04/2023] Open
Abstract
Introduction Clonorchis sinensis infection results in various complications in the liver and biliary systems and is a neglected tropical disease in Eastern Asia. In this study, we report that C. sinensis calcium-binding protein Cs16 activates host immune cells and induces immunopathology in liver. Methods Immunohistochemistry was used to detect the localization of Cs16 in C. sinensis adult worms. ELISA was used to detect the serum levels of anti-Cs16 IgG antibody in infected humans and mice. Bile duct injection model was used to figure out the role of Cs16 in vivo. RT-qPCR and ELISA were used to detect the cytokine production from Cs16-treated BMMs in vitro. Seahorse assay was used to detect the metabolic pathway of Cs16-treated BMMs in vitro. Result Cs16 localizes in the tegument and gut of C. sinensis. Humans and mice with C. sinensis infection exhibited increased levels of anti-Cs16-specific antibody. Using the bile duct injection technique, we found that Cs16 induced obvious inflammation and hepatic necrosis in vivo. Cs16 treatment caused the upregulation of inflammatory cytokines in innate immune cells. Moreover, Cs16-treated monocytes relied more on the glycolytic metabolic pathway. Discussion Our findings suggest that Cs16 is a potential pathogenic factor derived from C. sinensis adult worm. By reprogramming the metabolic pathway of innate immune cells, Cs16 triggers pro-inflammatory responses in the liver, and therefore, Cs16 is a potential target for the prevention and treatment of clonorchiasis.
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Affiliation(s)
- Qi Li
- Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao Li
- Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, China
| | - Shuo Kan
- Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting-Jun Zhu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), World Health Organization (WHO) Collaborating Centre for Tropical Diseases, National Health Commission (NHC) Key Laboratory of Parasite and Vector Biology; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Chang Li
- Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, China
| | - Xin-Yue Du
- Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Wang
- Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, China
| | - Hui-Bo Yan
- Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen-Yun Wu
- Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guang-Jie Chen
- Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), World Health Organization (WHO) Collaborating Centre for Tropical Diseases, National Health Commission (NHC) Key Laboratory of Parasite and Vector Biology; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Min Yan
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, China
| | - Zhao-Jun Wang
- Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Agten A, Blázquez-Moreno A, Crabbe M, Tuefferd M, Goehlmann H, Geys H, Peng CY, Claes J, Neyens T, Faes C. Measures of spatial heterogeneity in the liver tissue micro-environment as predictive factors for fibrosis score. Comput Biol Med 2023; 165:107382. [PMID: 37634463 DOI: 10.1016/j.compbiomed.2023.107382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/02/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023]
Abstract
The organization and interaction between hepatocytes and other hepatic non-parenchymal cells plays a pivotal role in maintaining normal liver function and structure. Although spatial heterogeneity within the tumor micro-environment has been proven to be a fundamental feature in cancer progression, the role of liver tissue topology and micro-environmental factors in the context of liver damage in chronic infection has not been widely studied yet. We obtained images from 110 core needle biopsies from a cohort of chronic hepatitis B patients with different fibrosis stages according to METAVIR score. The tissue sections were immunofluorescently stained and imaged to determine the locations of CD45 positive immune cells and HBsAg-negative and HBsAg-positive hepatocytes within the tissue. We applied several descriptive techniques adopted from ecology, including Getis-Ord, the Shannon Index and the Morisita-Horn Index, to quantify the extent to which immune cells and different types of liver cells co-localize in the tissue biopsies. Additionally, we modeled the spatial distribution of the different cell types using a joint log-Gaussian Cox process and proposed several features to quantify spatial heterogeneity. We then related these measures to the patient fibrosis stage by using a linear discriminant analysis approach. Our analysis revealed that the co-localization of HBsAg-negative hepatocytes with immune cells and the co-localization of HBsAg-positive hepatocytes with immune cells are equally important factors for explaining the METAVIR score in chronic hepatitis B patients. Moreover, we found that if we allow for an error of 1 on the METAVIR score, we are able to reach an accuracy of around 80%. With this study we demonstrate how methods adopted from ecology and applied to the liver tissue micro-environment can be used to quantify heterogeneity and how these approaches can be valuable in biomarker analyses for liver topology.
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Affiliation(s)
- Annelies Agten
- Data Science Institute, UHasselt - Hasselt University, Agoralaan 1, BE 3590 Diepenbeek, Belgium.
| | - Alfonso Blázquez-Moreno
- Discovery Statistics, Global Development, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Marjolein Crabbe
- Discovery Statistics, Global Development, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Marianne Tuefferd
- Translational Biomarkers, Infectious Diseases, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Hinrich Goehlmann
- Translational Biomarkers, Infectious Diseases, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Helena Geys
- Discovery Statistics, Global Development, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium
| | | | - Jari Claes
- Data Science Institute, UHasselt - Hasselt University, Agoralaan 1, BE 3590 Diepenbeek, Belgium
| | - Thomas Neyens
- Data Science Institute, UHasselt - Hasselt University, Agoralaan 1, BE 3590 Diepenbeek, Belgium; L-BioStat, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium
| | - Christel Faes
- Data Science Institute, UHasselt - Hasselt University, Agoralaan 1, BE 3590 Diepenbeek, Belgium
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Li S, Shi L, Xu X, Wang H, You H, Jia J, Kong Y. Systematic review with meta-analysis: Significant histological changes among treatment-naïve chronic hepatitis B patients with normal alanine aminotransferase levels by different criteria. Aliment Pharmacol Ther 2023; 58:648-658. [PMID: 37551720 DOI: 10.1111/apt.17658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/21/2023] [Accepted: 07/21/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND The upper limits of normal (ULNs) of ALT are not consistent across the major international guidelines which may affect the eligibility for antiviral therapy for chronic hepatitis B (CHB). AIM To estimate the proportions of histological changes among treatment-naïve patients with CHB within differently defined ALT ULNs. METHODS We searched PubMed and Embase up to May 15th, 2023, to identify studies of treatment-naïve CHB patients with liver biopsies. We pooled proportions of moderate to severe necroinflammation, significant fibrosis, and cirrhosis in those patients within different ALT ULNs by using random-effect models. RESULTS We included 23 studies with 4010 participants. Within ALT ULN at 40 IU/L, the pooled proportions of moderate to severe necroinflammation, significant fibrosis, and cirrhosis were 33% (95% CI: 26%-42%), 32% (95% CI: 27%-38%), and 3% (95% CI: 1%-5%), respectively. Within ALT ULN at 30 IU/L for men and 19 IU/L for women, the pooled proportion of significant fibrosis remained at 30% (95% CI: 25%-34%; 432 participants). However, it was 21% (95% CI: 11%-37%; 361 participants) even in those within ALT ULN at 20 IU/L. Subgroup analyses suggested a significantly higher proportion of significant fibrosis among studies with prospective design or enrolled patients' mean age >35 or >40 years. CONCLUSIONS Significant histological changes occurred in approximately 1/3 of treatment-naïve CHB patients within ALT ULN at 40 IU/L, whereas the proportion of significant fibrosis was approximately 1/5 even in those within ALT ULN at 20 IU/L.
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Affiliation(s)
- Shun Li
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Clinical Epidemiology and EBM Unit, Beijing Clinical Research Institute, Beijing, China
| | - Lichen Shi
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Clinical Epidemiology and EBM Unit, Beijing Clinical Research Institute, Beijing, China
| | - Xiaoqian Xu
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Clinical Epidemiology and EBM Unit, Beijing Clinical Research Institute, Beijing, China
| | - Hao Wang
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Clinical Epidemiology and EBM Unit, Beijing Clinical Research Institute, Beijing, China
| | - Hong You
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yuanyuan Kong
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Clinical Epidemiology and EBM Unit, Beijing Clinical Research Institute, Beijing, China
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Gong J, Yu R, Hu X, Luo H, Gao Q, Li Y, Tan G, Luo H, Qin B. Development and Validation of a Novel Prognosis Model Based on a Panel of Three Immunogenic Cell Death-Related Genes for Non-Cirrhotic Hepatocellular Carcinoma. J Hepatocell Carcinoma 2023; 10:1609-1628. [PMID: 37781718 PMCID: PMC10540790 DOI: 10.2147/jhc.s424545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023] Open
Abstract
Purpose The accurate prediction of non-cirrhotic hepatocellular carcinoma (NCHCC) risk facilitates improved surveillance strategy and decreases cancer-related mortality. This study aimed to explore the correlation between immunogenic cell death (ICD) and NCHCC prognosis using The Cancer Genome Atlas (TCGA) datasets, and the potential prognostic value of ICD-related genes in NCHCC. Methods Clinical and transcriptomic data of patients with NCHCC patients were retrieved from TCGA database. Weighted gene co-expression network analysis was performed to obtain the NCHCC phenotype-related module genes. Consensus clustering analysis was performed to classify the patients into two clusters based on intersection genes among differentially expressed genes (DEGs) between cancer and adjacent tissues, NCHCC phenotype-related genes, and ICD-related genes. NCHCC-derived tissue microarray was used to evaluate the correlation of the expression levels of key genes with NCHCC prognosis using immunohistochemical staining. Results Cox regression analyses were performed to construct a prognostic risk score model comprising three genes (TMC7, GRAMD1C, and GNPDA1) based on DEGs between two clusters. The model stratified patients with NCHCC into two risk groups. The overall survival (OS) of the high-risk group was significantly lower than that of the low-risk group. Univariable and multivariable Cox regression analyses revealed that these signature genes are independent predictors of OS. Functional analysis revealed differential immune status between the two risk groups. Next, a nomogram was constructed, which demonstrated the potent distinguishing ability of the developed model based on receiver operating characteristic curves. In vitro functional validation revealed that the migration and invasion abilities of HepG2 and Huh7 cells were upregulated upon GRAMD1C knockdown but downregulated upon TMC7 knockdown. Conclusion This study developed a prognostic model comprising three genes, which can aid in predicting the survival of patients with NCHCC and guide the selection of drugs and molecular markers for NCHCC.
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Affiliation(s)
- Jiaojiao Gong
- Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Nephrology, Bishan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Renjie Yu
- Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xiaoxia Hu
- Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Huating Luo
- Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qingzhu Gao
- Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yadi Li
- Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Guili Tan
- Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Haiying Luo
- Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Bo Qin
- Department of Infectious Diseases, Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
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Kato K, Umetsu S, Togawa T, Ito K, Kawabata T, Arinaga-Hino T, Tsumura N, Yasuda R, Mihara Y, Kusano H, Ito S, Imagawa K, Hayashi H, Inui A, Yamashita Y, Mizuochi T. Clinicopathologic Features, Genetics, Treatment, and Long-Term Outcomes in Japanese Children and Young Adults with Benign Recurrent Intrahepatic Cholestasis: A Multicenter Study. J Clin Med 2023; 12:5979. [PMID: 37762919 PMCID: PMC10532077 DOI: 10.3390/jcm12185979] [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: 07/30/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Few reports of benign recurrent intrahepatic cholestasis (BRIC) have focused on East Asian patients. We describe the clinicopathologic features, genetics, treatment, and outcomes in Japanese BRIC patients. METHODS We recruited patients with BRIC type 1 (BRIC-1) or 2 (BRIC-2) treated at four pediatric centers and one adult center between April 2007 and March 2022. Demographics, clinical course, laboratory results, molecular genetic findings concerning ATP8B1 and ABCB11 genes, histopathology, and treatment response were examined retrospectively. RESULTS Seven Japanese patients with BRIC were enrolled (four male, three female; four BRIC-1 and three BRIC-2). The median age at onset for BRIC-1 was 12 years; for BRIC-2, it was 1 month. Intermittent cholestatic attacks numbered from one to eight during the 11 years of median follow-up. Six patients received a mainstream education; only one patient attended special education. None developed cirrhosis. Three with BRIC-1 showed compound heterozygosity for a variant ATP8B1 gene, while one was heterozygous; two BRIC-2 patients showed compound heterozygosity in ABCB11 and one was heterozygous. Liver biopsy specimens obtained during cholestatic attacks showed fibrosis varying from none to moderate; inflammation was absent or mild. Rifampicin administered to three patients for cholestatic attacks was effective in all, as was cholestyramine in two of three. CONCLUSIONS To our knowledge, this is the first East Asian multicenter study of BRIC patients. Onset age and number of cholestatic attacks varied. Rifampicin and cholestyramine were effective against attacks. No patient developed cirrhosis; most had normal growth and development. The long-term outcomes were satisfactory.
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Affiliation(s)
- Ken Kato
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Shuichiro Umetsu
- Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohamashi Tobu Hospital, Yokohama 230-0012, Japan
| | - Takao Togawa
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Koichi Ito
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Takayoshi Kawabata
- Department of Pediatrics, Ishikawa Prefectural Central Hospital, Kanazawa 920-8530, Japan
| | - Teruko Arinaga-Hino
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Naoya Tsumura
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Ryosuke Yasuda
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Yutaro Mihara
- Department of Pathology, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Hironori Kusano
- Department of Pathology, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Shogo Ito
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Kazuo Imagawa
- Department of Child Health, Institute of Medicine, University of Tsukuba, Tsukuba 305-8546, Japan
| | - Hisamitsu Hayashi
- Laboratory of Molecular Pharmacokinetics, Graduate School of Pharmaceutical Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - Ayano Inui
- Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohamashi Tobu Hospital, Yokohama 230-0012, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Tatsuki Mizuochi
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume 830-0011, Japan
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Guo Y, Shen B, Xue Y, Li Y. Development and validation of a non-invasive model for predicting significant fibrosis based on patients with nonalcoholic fatty liver disease in the United States. Front Endocrinol (Lausanne) 2023; 14:1207365. [PMID: 37732127 PMCID: PMC10507901 DOI: 10.3389/fendo.2023.1207365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023] Open
Abstract
Background Liver fibrosis is closely related to abnormal liver function and liver cancer. Accurate noninvasive assessment of liver fibrosis is of great significance for preventing disease progression and treatment decisions. The purpose of this study was to develop and validate a non-invasive predictive model for the asses`sment of significant fibrosis in patients with non-alcoholic fatty liver disease. Methods Information on all participants for 2017-2018 was extracted from the NHANES database. The eligible patients with significant fibrosis (n=123) and non-significant fibrosis (n=898) were selected to form the original dataset. Variable selection was performed using least absolute shrinkage and selection operator (Lasso) regression, and multivariate logistic regression analysis was used to develop a prediction model. The utility of the model is assessed in terms of its discrimination, calibration and clinical usability. Bootstrap-resampling internal validation was used to measure the accuracy of the prediction model. Results This study established a new model consisting of 9 common clinical indicators and developed an online calculator to show the model. Compared with the previously proposed liver fibrosis scoring system, this model showed the best discrimination and predictive performance in the training cohort (0.812,95%CI 0.769-0.855) and the validation cohort (0.805,95%CI 0.762-0.847), with the highest area under curve. Specificity(0.823), sensitivity(0.699), positive likelihood ratio(3.949) and negative likelihood ratio(0.366) were equally excellent. The calibration plot of the predicted probability and the actual occurrence probability of significant fibrosis shows excellent consistency, indicating that the model calibration is outstanding. Combined with decision curve analysis, this model has a great benefit in the range of 0.1-0.8 threshold probability, and has a good application value for the diagnosis of clinical significant fibrosis. Conclusion This study proposes a new non-invasive diagnostic model that combines clinical indicators to provide an accurate and convenient individualized diagnosis of significant fibrosis in patients with non-alcoholic fatty liver disease.
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Affiliation(s)
- Yuanhui Guo
- Endocrine and Metabolic Disease Center, Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang Sub-center of National Clinical Research Center for Metabolic Diseases, First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Baixuan Shen
- Endocrine and Metabolic Disease Center, Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang Sub-center of National Clinical Research Center for Metabolic Diseases, First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yanli Xue
- Department of Pharmacy, First Affiliated Hospital of Henan University of Science and Technology, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Ying Li
- Department of Pharmacy, First Affiliated Hospital of Henan University of Science and Technology, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
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Gong X, Guo Y, Zhu T, Xing D, Shi Q, Zhang M. Noninvasive assessment of significant liver fibrosis in rabbits by spectral CT parameters and texture analysis. Jpn J Radiol 2023; 41:983-993. [PMID: 37071251 DOI: 10.1007/s11604-023-01423-0] [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: 01/20/2023] [Accepted: 03/29/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE Noninvasive assessment of significant liver fibrosis in rabbits by spectral CT parameters and texture analysis. MATERIALS AND METHODS Thirty-three rabbits were randomly divided into 27 carbon tetrachloride-induced liver fibrosis group and 6 control group. Spectral CT contrast-enhanced scan was performed in batches, and the liver fibrosis was staged according to the histopathological results. The portal venous phase spectral CT parameters [70 keV CT value, normalized iodine concentration (NIC), spectral HU curve slope (λHU)] were measured, and MaZda texture analysis was performed on 70 keV monochrome images. Three dimensionality reduction methods and four statistical methods in B11 module were used to perform discriminant analysis and calculate misclassified rate (MCR), and ten texture features under the lowest combination of MCR were statistically analyzed. Receiver operating characteristic curve (ROC) was used to calculate the diagnostic performance of spectral parameters and texture features for significant liver fibrosis. Finally, the binary logistic regression was used to further screen independent predictors and establish model. RESULTS A total of 23 experimental rabbits and 6 control rabbits were included, of which 16 had significant liver fibrosis. Three spectral CT parameters with significant liver fibrosis were significantly lower than those of non-significant liver fibrosis (p < 0.05), and the AUC ranged from 0.846 to 0.913. The combination analysis of mutual information (MI) and nonlinear discriminant analysis (NDA) had the lowest MCR, which with 0%. In the filtered texture features, four were statistically significant and AUC > 0.5, ranges from 0.764 to 0.875. The logistic regression model showed that Perc.90% and NIC could be used as independent predictors, the overall prediction accuracy of the model was 89.7% and the AUC was 0.976. CONCLUSION Spectral CT parameters and texture features have high diagnostic value for predicting significant liver fibrosis in rabbits, and the combination of the two can improve its diagnostic efficiency.
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Affiliation(s)
- Xiuru Gong
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China
| | - Yaxin Guo
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China
| | - Tingting Zhu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China
| | - Dongwei Xing
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China
| | - Qi Shi
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China.
| | - Minguang Zhang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Jing 'an District, Shanghai, 200071, China.
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Bedair AF, Wahid A, El-Mezayen NS, El-Yazbi AF, Khalil HA, Hassan NW, Afify EA. Nicorandil/ morphine crosstalk accounts for antinociception and hepatoprotection in hepatic fibrosis in rats: Distinct roles of opioid/cGMP and NO/KATP pathways. Biomed Pharmacother 2023; 165:115068. [PMID: 37392650 DOI: 10.1016/j.biopha.2023.115068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023] Open
Abstract
Previous report indicated that nicorandil potentiated morphine antinociception and attenuated hepatic injury in liver fibrotic rats. Herein, the underlying mechanisms of nicorandil/morphine interaction were investigated using pharmacological, biochemical, histopathological, and molecular docking studies. Male Wistar rats were injected intraperitoneally (i.p.) with carbon tetrachloride (CCl4, 40%, 2 ml/kg) twice weekly for 5 weeks to induce hepatic fibrosis. Nicorandil (15 mg/kg/day) was administered per os (p.o.) for 14 days in presence of the blockers; glibenclamide (KATP channel blocker, 5 mg/kg, p.o.), L-NG-nitro-arginine methyl ester (L-NAME, nitric oxide synthase inhibitor, 15 mg/kg, p.o.), methylene blue (MB, guanylyl cyclase inhibitor, 2 mg/kg, i.p.) and naltrexone (opioid antagonist, 20 mg/kg, i.p.). At the end of the 5th week, analgesia was evaluated using tail flick and formalin tests along with biochemical determinations of liver function tests, oxidative stress markers and histopathological examination of liver tissues. Naltrexone and MB inhibited the antinociceptive activity of the combination. Furthermore, combined nicorandil/morphine regimen attenuated the release of endogenous peptides. Docking studies revealed a possible interaction of nicorandil on µ, κ and δ opioid receptors. Nicorandil/morphine combination protected against liver damage as evident by decreased liver enzymes, liver index, hyaluronic acid, lipid peroxidation, fibrotic insults, and increased superoxide dismutase activity. Nicorandil/morphine hepatoprotection and antioxidant activity were inhibited by glibenclamide and L-NAME but not by naltrexone or MB. These findings implicate opioid activation/cGMP versus NO/KATP channels in the augmented antinociception, and hepatoprotection, respectively, of the combined therapy and implicate provoked cross talk by nicorandil and morphine on opioid receptors and cGMP signaling pathway. That said, nicorandil/morphine combination provides a potential multitargeted therapy to alleviate pain and preserve liver function.
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Affiliation(s)
- Asser F Bedair
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt
| | - Ahmed Wahid
- Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt
| | - Nesrine S El-Mezayen
- Department of Pharmacology, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, Egypt
| | - Amira F El-Yazbi
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt
| | - Hadeel A Khalil
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt
| | - Nayera W Hassan
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt
| | - Elham A Afify
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt.
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Yamamoto S, Sato I, Fujii M, Kakimoto M, Honma K, Kirihara S, Nakayama H, Fukuoka T, Tamura S, Ueda M, Hirohata S, Watanabe S. Therapeutic effect of ouabagenin, a novel liver X receptor agonist, on atherosclerosis in nonalcoholic steatohepatitis in SHRSP5/Dmcr rat model. Can J Physiol Pharmacol 2023; 101:455-465. [PMID: 37224568 DOI: 10.1139/cjpp-2022-0532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The liver X receptor (LXR) can enhance cholesterol transporters, which could remove excess cholesterol from foam cells in atheromas. LXR has two subtypes: LXRα, which aggravates hepatic lipid accumulation, and LXRβ, which does not. In 2018, ouabagenin (OBG) was reported as a potential LXRβ-specific agonist. We aimed to examine whether OBG specifically affects LXRβ in nonalcoholic steatohepatitis (NASH); it did not aggravate hepatic steatosis and can suppress the development of atherosclerosis. SHRSP5/Dmcr rats fed a high-fat and high-cholesterol diet were divided into four groups as follows: (I) L-NAME group, (II) L-NAME/OBG group, (III) OBG (-) group, and (IV) OBG (+) group. All groups' rats were intraperitoneally administered L-NAME. The L-NAME/OBG group's rats were intraperitoneally administered OBG and L-NAME simultaneously. After L-NAME administration, the OBG (+) group's rats were administered OBG, while the OBG (-) group's rats were not. Although all rats developed NASH, OBG did not exacerbate steatosis (L-NAME/OBG and OBG (+) groups). In addition, endothelial cells were protected in the L-NAME/OBG group and foam cells in the atheroma were reduced in the OBG (+) group. OBG is an LXRβ-specific agonist and has a potential therapeutic effect on atherosclerosis without developing lipid accumulation in the liver.
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Affiliation(s)
- Shusei Yamamoto
- Faculty of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
- Department of Medical Technology, Graduate School of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Ikumi Sato
- Faculty of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
- Department of Medical Technology, Graduate School of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Moe Fujii
- Department of Medical Technology, Graduate School of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, 543 Takoda, Tobe-cho, Iyo-gun, Ehime 791-2101, Japan
| | - Mai Kakimoto
- Department of Medical Technology, Graduate School of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Koki Honma
- Department of Medical Technology, Graduate School of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Sora Kirihara
- Department of Medical Technology, Graduate School of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Hinako Nakayama
- Department of Medical Technology, Graduate School of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Taketo Fukuoka
- Department of Medical Technology, Faculty of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Satoru Tamura
- School of Pharmaceutical Sciences, Wakayama Medical University, 25-1 Shichibancho, Wakayama-shi, Wakayama 640-8156, Japan
| | - Minoru Ueda
- Department of Chemistry, Graduate School of Life Science, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai-shi, Miyagi 980-8578, Japan
| | - Satoshi Hirohata
- Faculty of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Shogo Watanabe
- Faculty of Health Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
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