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Burger K, Jung F, Staufer K, Ladurner R, Trauner M, Baumann A, Brandt A, Bergheim I. MASLD is related to impaired alcohol dehydrogenase (ADH) activity and elevated blood ethanol levels: Role of TNFα and JNK. Redox Biol 2024; 71:103121. [PMID: 38493749 PMCID: PMC10957403 DOI: 10.1016/j.redox.2024.103121] [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: 02/14/2024] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024] Open
Abstract
Elevated fasting ethanol levels in peripheral blood frequently found in metabolic dysfunction-associated steatohepatitis (MASLD) patients even in the absence of alcohol consumption are discussed to contribute to disease development. To test the hypothesis that besides an enhanced gastrointestinal synthesis a diminished alcohol elimination through alcohol dehydrogenase (ADH) may also be critical herein, we determined fasting ethanol levels and ADH activity in livers and blood of MASLD patients and in wild-type ± anti-TNFα antibody (infliximab) treated and TNFα-/- mice fed a MASLD-inducing diet. Blood ethanol levels were significantly higher in patients and wild-type mice with MASLD while relative ADH activity in blood and liver tissue was significantly lower compared to controls. Both alterations were significantly attenuated in MASLD diet-fed TNFα-/- mice and wild-type mice treated with infliximab. Moreover, alcohol elimination was significantly impaired in mice with MASLD. In in vitro models, TNFα but not IL-1β or IL-6 significantly decreased ADH activity. Our data suggest that elevated ethanol levels in MASLD patients are related to TNFα-dependent impairments of ADH activity.
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Affiliation(s)
- Katharina Burger
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, Vienna, Austria
| | - Finn Jung
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, Vienna, Austria
| | - Katharina Staufer
- Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Medical University of Vienna, Vienna, Austria; Department of Surgery, Division of Transplantation, Medical University of Vienna, Vienna, Austria
| | - Ruth Ladurner
- Department of General, Visceral and Transplant Surgery, Eberhard-Karls-University Tuebingen, Tuebingen, Germany
| | - Michael Trauner
- Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Medical University of Vienna, Vienna, Austria
| | - Anja Baumann
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, Vienna, Austria
| | - Annette Brandt
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, Vienna, Austria
| | - Ina Bergheim
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, Vienna, Austria.
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Mahboubi Kancha M, Alizadeh M, Mehrabi M. Comparison of the protective effects of CS/TPP and CS/HPMCP nanoparticles containing berberine in ethanol-induced hepatotoxicity in rat. BMC Complement Med Ther 2024; 24:39. [PMID: 38225618 PMCID: PMC10789080 DOI: 10.1186/s12906-023-04318-9] [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: 04/28/2023] [Accepted: 12/16/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Alcoholic liver disease (ALD) is a globally critical condition with no available efficient treatments. METHODS Herein, we generated chitosan (CS) nanoparticles cross-linked with two different agents, hydroxypropyl methylcellulose phthalate (HPMCP; termed as CS/HPMCP) and tripolyphosphate (TPP; termed as CS/TPP), and loaded them with berberine (BBr; referred to as CS/HPMCP/BBr and CS/TPP/BBr, respectively). Alongside the encapsulation efficiency (EE) and loading capacity (LC), the releasing activity of the nanoparticles was also measured in stimulated gastric fluid (SGF) and stimulated intestinal fluid (SIF) conditions. The effects of the prepared nanoparticles on the viability of mesenchymal stem cells (MSCs) were also evaluated. Ultimately, the protective effects of the nanoparticles were investigated in ALD mouse models. RESULTS SEM images demonstrated that CS/HPMCP and CS/TPP nanoparticles had an average size of 235.5 ± 42 and 172 ± 21 nm, respectively. The LC and EE for CS/HPMCP/BBr were calculated as 79.78% and 75.79%, respectively; while the LC and EE for CS/TPP/BBr were 84.26% and 80.05%, respectively. pH was a determining factor for releasing BBr from CS/HPMCP nanoparticles as a higher cargo-releasing rate was observed in a less acidic environment. Both the BBr-loaded nanoparticles increased the viability of MSCs in comparison with their BBr-free counterparts. In vivo results demonstrated CS/HPMCP/BBr and CS/TPP/BBr nanoparticles protected enzymatic liver functionality against ethanol-induced damage. They also prevented histopathological ethanol-induced damage. CONCLUSIONS Crosslinking CS nanoparticles with HPMCP can mediate controlled drug release in the intestine improving the bioavailability of BBr.
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Affiliation(s)
- Maral Mahboubi Kancha
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Morteza Alizadeh
- Department of Tissue Engineering, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohsen Mehrabi
- Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
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Jung JH, Kim SE, Suk KT, Kim DJ. Gut microbiota-modulating agents in alcoholic liver disease: Links between host metabolism and gut microbiota. Front Med (Lausanne) 2022; 9:913842. [PMID: 35935787 PMCID: PMC9354621 DOI: 10.3389/fmed.2022.913842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Alcoholic liver disease (ALD) involves a wide spectrum of diseases, including asymptomatic hepatic steatosis, alcoholic hepatitis, hepatic fibrosis, and cirrhosis, which leads to morbidity and mortality and is responsible for 0.9% of global deaths. Alcohol consumption induces bacterial translocation and alteration of the gut microbiota composition. These changes in gut microbiota aggravate hepatic inflammation and fibrosis. Alteration of the gut microbiota leads to a weakened gut barrier and changes host immunity and metabolic function, especially related to bile acid metabolism. Modulation and treatment for the gut microbiota in ALD has been studied using probiotics, prebiotics, synbiotics, and fecal microbial transplantation with meaningful results. In this review, we focused on the interaction between alcohol and gut dysbiosis in ALD. Additionally, treatment approaches for gut dysbiosis, such as abstinence, diet, pro-, pre-, and synbiotics, antibiotics, and fecal microbial transplantation, are covered here under ALD. However, further research through human clinical trials is warranted to evaluate the appropriate gut microbiota-modulating agents for each condition related to ALD.
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Affiliation(s)
- Jang Han Jung
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
| | - Sung-Eun Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, South Korea
| | - Ki Tae Suk
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, South Korea
| | - Dong Joon Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, South Korea
- *Correspondence: Dong Joon Kim,
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Lin Y, Kong DX, Zhang YN. Does the Microbiota Composition Influence the Efficacy of Colorectal Cancer Immunotherapy? Front Oncol 2022; 12:852194. [PMID: 35463305 PMCID: PMC9023803 DOI: 10.3389/fonc.2022.852194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/07/2022] [Indexed: 12/12/2022] Open
Abstract
Colorectal cancer (CRC) is the second most common malignancy globally, and many people with CRC suffer the fate of death. Due to the importance of CRC and its negative impact on communities, treatment strategies to control it or increase patient survival are being studied. Traditional therapies, including surgery and chemotherapy, have treated CRC patients. However, with the advancement of science, we are witnessing the emergence of novel therapeutic approaches such as immunotherapy for CRC treatment, which have had relatively satisfactory clinical outcomes. Evidence shows that gastrointestinal (GI) microbiota, including various bacterial species, viruses, and fungi, can affect various biological events, regulate the immune system, and even treat diseases like human malignancies. CRC has recently shown that the gut microorganism pattern can alter both antitumor and pro-tumor responses, as well as cancer immunotherapy. Of course, this is also true of traditional therapies because it has been revealed that gut microbiota can also reduce the side effects of chemotherapy. Therefore, this review summarized the effects of gut microbiota on CRC immunotherapy.
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Affiliation(s)
- Yan Lin
- Health Management Center, Department of General Practice, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
- *Correspondence: Yan Lin, ; You-Ni Zhang,
| | - De-Xia Kong
- Health Management Center, Department of General Practice, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - You-Ni Zhang
- Department of Laboratory Medicine, Tiantai People’s Hospital, Taizhou, China
- *Correspondence: Yan Lin, ; You-Ni Zhang,
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Kim DH, Sim Y, Hwang JH, Kwun IS, Lim JH, Kim J, Kim JI, Baek MC, Akbar M, Seo W, Kim DK, Song BJ, Cho YE. Ellagic Acid Prevents Binge Alcohol-Induced Leaky Gut and Liver Injury through Inhibiting Gut Dysbiosis and Oxidative Stress. Antioxidants (Basel) 2021; 10:antiox10091386. [PMID: 34573017 PMCID: PMC8465052 DOI: 10.3390/antiox10091386] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/16/2022] Open
Abstract
Alcoholic liver disease (ALD) is a major liver disease worldwide and can range from simple steatosis or inflammation to fibrosis/cirrhosis, possibly through leaky gut and systemic endotoxemia. Many patients with alcoholic steatohepatitis (ASH) die within 60 days after clinical diagnosis due to the lack of an approved drug, and thus, synthetic and/or dietary agents to prevent ASH and premature deaths are urgently needed. We recently reported that a pharmacologically high dose of pomegranate extract prevented binge alcohol-induced gut leakiness and hepatic inflammation by suppressing oxidative and nitrative stress. Herein, we investigate whether a dietary antioxidant ellagic acid (EA) contained in many fruits, including pomegranate and vegetables, can protect against binge alcohol-induced leaky gut, endotoxemia, and liver inflammation. Pretreatment with a physiologically-relevant dose of EA for 14 days significantly reduced the binge alcohol-induced gut barrier dysfunction, endotoxemia, and inflammatory liver injury in mice by inhibiting gut dysbiosis and the elevated oxidative stress and apoptosis marker proteins. Pretreatment with EA significantly prevented the decreased amounts of gut tight junction/adherent junction proteins and the elevated gut leakiness in alcohol-exposed mice. Taken together, our results suggest that EA could be used as a dietary supplement for alcoholic hepatitis patients.
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Affiliation(s)
- Dong-ha Kim
- Department of Food and Nutrition, Andong National University, Andong 36729, Korea; (D.-h.K.); (Y.S.); (J.-h.H.); (I.-S.K.)
| | - Yejin Sim
- Department of Food and Nutrition, Andong National University, Andong 36729, Korea; (D.-h.K.); (Y.S.); (J.-h.H.); (I.-S.K.)
| | - Jin-hyeon Hwang
- Department of Food and Nutrition, Andong National University, Andong 36729, Korea; (D.-h.K.); (Y.S.); (J.-h.H.); (I.-S.K.)
| | - In-Sook Kwun
- Department of Food and Nutrition, Andong National University, Andong 36729, Korea; (D.-h.K.); (Y.S.); (J.-h.H.); (I.-S.K.)
| | - Jae-Hwan Lim
- Department of Biological Science, Andong National University, Andong 36729, Korea;
| | - Jihoon Kim
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA 30332, USA;
| | - Jee-In Kim
- Department of Biochemistry and Cell Biology, School of Medicine, Kyungpook National University, Daegu 41944, Korea;
| | - Moon-Chang Baek
- Department of Molecular Medicine, School of Medicine, Cell & Matrix Research Institute, Kyungpook National University, Daegu 41944, Korea;
| | - Mohammed Akbar
- Division of Neuroscience and Behavior, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA;
| | - Wonhyo Seo
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, Korea;
| | - Do-Kyun Kim
- Korea Zoonosis Research Institute, Jeonbuk National University, Iksan 54531, Korea;
| | - Byoung-Joon Song
- Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health Bethesda, Bethesda, MD 20892, USA
- Correspondence: (B.-J.S.); (Y.-E.C.)
| | - Young-Eun Cho
- Department of Food and Nutrition, Andong National University, Andong 36729, Korea; (D.-h.K.); (Y.S.); (J.-h.H.); (I.-S.K.)
- Correspondence: (B.-J.S.); (Y.-E.C.)
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Abstract
OBJECTIVES We examined how patient perceptions of alcohol risk, provider discussions about alcohol, and treatment of hepatitis C virus (HCV) differed among HIV-HCV coinfected patients in primary care. METHODS Between April, 2016 and April, 2017, we conducted a screening survey with patients in an HIV primary care clinic in Seattle, Washington, who had chronic HCV coinfection or a history of chronic HCV infection who had successfully cleared their infection with treatment. RESULTS Of 225 participants, 84 (37%) were active drinkers (drank ≥2-4 times/mo in past 3 months). Of those with little to no use for ≥3 months, 65 (29%) were former drinkers with a history of alcohol use and 76 were abstainers with no such history. Former drinkers and abstainers were more likely than active drinkers to perceive that any drinking was unsafe (69% vs 58% vs 31%; P < 0.001). Former drinkers were more likely to report a physician's recommendation to stop drinking than active drinkers (63% vs 47%; P = 0.05). The great majority (87%) of former drinkers decided to stop or reduce drinking on their own (most often in response to a nonhealth life event) and only 13% acknowledged doing so on their doctor's prompting. HCV treatment was not associated with former or active drinking status. CONCLUSIONS Our findings underscore the importance of educating not only HIV-HCV patients about the effects of alcohol use but also HIV clinicians about delivering consistent counseling about alcohol avoidance. Understanding the reasons that HIV-HCV coinfected persons make changes in their alcohol use could drive novel interventions that reduce the negative consequences of drinking.
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Luo L, Zhang J, Liu M, Qiu S, Yi S, Yu W, Liu T, Huang X, Ning F. Monofloral Triadica Cochinchinensis Honey Polyphenols Improve Alcohol-Induced Liver Disease by Regulating the Gut Microbiota of Mice. Front Immunol 2021; 12:673903. [PMID: 34093575 PMCID: PMC8175904 DOI: 10.3389/fimmu.2021.673903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/04/2021] [Indexed: 12/12/2022] Open
Abstract
Honey produced from medicinal plants holds great promise for human health. Increasing evidence suggests that the gut microbiota plays an important role in liver pathology after alcohol intake. The aim of this study was to identify the polyphenol composition of triadica cochinchinensis honey (TCH), and to study the potential effect of honey polyphenols on the regulation of gut microbes in mice with alcohol-induced liver injury and the improvement of alcohol-induced liver disease. For these purposes, a total of 190 compounds were identified and 27 of them were quantified by ultraperformance liquid chromatography coupled with quadrupole/time-of-flight mass spectrometry (UPLC-Q/TOF-MS) and we successfully established a mouse model of alcohol-induced liver injury. The results show that TCH polyphenols can significantly restore the levels of ALT and AST, and TCH intervention can significantly improve the pathological changes of liver tissue in alcohol-exposed mice. Additionally, a significant decrease was observed in Firmicutes/Bacteroidetes after TCH treatment. Moreover, KEGG pathways of ATP-binding cassette (ABC) transporters, two-component system and biosynthesis of amino acids enriched the most differentially expressed genes after TCH intervention for 8 weeks. Our results may have important implications for the use of TCH as a functional food component with potential therapeutic utility against alcohol-induced liver disease.
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Affiliation(s)
- Liping Luo
- School of Life Sciences, Nanchang University, Nanchang, China.,State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
| | - Jinping Zhang
- School of Life Sciences, Nanchang University, Nanchang, China
| | - Mingyan Liu
- School of Life Sciences, Nanchang University, Nanchang, China
| | - Shengrong Qiu
- School of Life Sciences, Nanchang University, Nanchang, China
| | - Shengxiang Yi
- School of Life Sciences, Nanchang University, Nanchang, China
| | - Wenjie Yu
- School of Life Sciences, Nanchang University, Nanchang, China
| | - Tao Liu
- School of Life Sciences, Nanchang University, Nanchang, China
| | - Xueyong Huang
- School of Life Sciences, Nanchang University, Nanchang, China
| | - Fangjian Ning
- School of Life Sciences, Nanchang University, Nanchang, China.,State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
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Sangineto M, Grabherr F, Adolph TE, Grander C, Reider S, Jaschke N, Mayr L, Schwärzler J, Dallio M, Moschen AR, Moschetta A, Sabbà C, Tilg H. Dimethyl fumarate ameliorates hepatic inflammation in alcohol related liver disease. Liver Int 2020; 40:1610-1619. [PMID: 32306456 PMCID: PMC7383968 DOI: 10.1111/liv.14483] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/25/2020] [Accepted: 04/14/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Alcohol-related liver disease (ALD) comprises different liver disorders which impose a health care issue. ALD and particularly alcoholic steatohepatitis, an acute inflammatory condition, cause a substantial morbidity and mortality as effective treatment options remain elusive. Inflammation in ALD is fuelled by macrophages (Kupffer cells [KCs]) which are activated by intestinal pathogen associated molecular patterns, eg lipopolysaccharide (LPS), disseminated beyond a defective intestinal barrier. We hypothesized that the immunomodulator dimethyl-fumarate (DMF), which is approved for the treatment of human inflammatory conditions such as multiple sclerosis or psoriasis, ameliorates the course of experimental ALD. METHODS Dimethyl-fumarate or vehicle was orally administered to wild-type mice receiving a Lieber-DeCarli diet containing 5% ethanol for 15 days. Liver injury, steatosis and inflammation were evaluated by histology, biochemical- and immunoassays. Moreover, we investigated a direct immunosuppressive effect of DMF on KCs and explored a potential impact on ethanol-induced intestinal barrier disruption. RESULTS Dimethyl-fumarate protected against ethanol-induced hepatic injury, steatosis and inflammation in mice. Specifically, we observed reduced hepatic triglyceride and ALT accumulation, reduced hepatic expression of inflammatory cytokines (Tnf-α, Il-1β, Cxcl1) and reduced abundance of neutrophils and macrophages in ethanol-fed and DMF-treated mice when compared to vehicle. DMF protected against ethanol-induced barrier disruption and abrogated systemic LPS concentration. In addition, DMF abolished LPS-induced cytokine responses of KCs. CONCLUSIONS Dimethyl-fumarate counteracts ethanol-induced barrier dysfunction, suppresses inflammatory responses of KCs and ameliorates hepatic inflammation and steatosis, hallmarks of experimental ALD. Our data indicates that DMF treatment might be beneficial in human ALD and respective clinical trials are eagerly awaited.
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Affiliation(s)
- Moris Sangineto
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria,Department of Interdisciplinary MedicineUniversity of BariBariItaly
| | - Felix Grabherr
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria
| | - Timon E. Adolph
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria
| | - Christoph Grander
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria
| | - Simon Reider
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria,Christian Doppler Laboratory for Mucosal ImmunologyMedical University InnsbruckInnsbruckAustria
| | - Nikolai Jaschke
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria
| | - Lisa Mayr
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria
| | - Julian Schwärzler
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria
| | - Marcello Dallio
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria,Department of Precision MedicineUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Alexander R. Moschen
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria,Christian Doppler Laboratory for Mucosal ImmunologyMedical University InnsbruckInnsbruckAustria
| | | | - Carlo Sabbà
- Department of Interdisciplinary MedicineUniversity of BariBariItaly
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & MetabolismMedical University InnsbruckInnsbruckAustria
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Wang X, Zhao Y, Luo J, Xu L, Li X, Jin Y, Li C, Feng M, Wang Y, Chen J, Hou Y, Zhao Q, Zhao J, Ning B, Zheng Y, Yu D. MicroRNA hsa-miR-1301-3p Regulates Human ADH6, ALDH5A1 and ALDH8A1 in the Ethanol-Acetaldehyde-Acetate Metabolic Pathway. Mol Pharmacol 2020; 98:120-129. [PMID: 32499331 DOI: 10.1124/mol.120.119693] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/27/2020] [Indexed: 12/15/2022] Open
Abstract
Alcohol dehydrogenases (ADHs) and aldehyde dehydrogenases (ALDHs) are vital enzymes involved in the metabolism of a variety of alcohols. Differences in the expression and enzymatic activity of human ADHs and ALDHs correlate with individual variability in metabolizing alcohols and drugs and in the susceptibility to alcoholic liver disease. MicroRNAs (miRNAs) function as epigenetic modulators to regulate the expression of drug-metabolizing enzymes. To characterize miRNAs that target ADHs and ALDHs in human liver cells, we carried out a systematic bioinformatics analysis to analyze free energies of the interaction between miRNAs and their cognate sequences in ADH and ALDH transcripts and then calculated expression correlations between miRNAs and their targeting ADH and ALDH genes using a public data base. Candidate miRNAs were selected to evaluate bioinformatic predictions using a series of biochemical assays. Our results showed that 11 miRNAs have the potential to modulate the expression of two ADH and seven ALDH genes in the human liver. We found that hsa-miR-1301-3p suppressed the expression of ADH6, ALDH5A1, and ALDH8A1 in liver cells and blocked their induction by ethanol. In summary, our results revealed that hsa-miR-1301-3p plays an important role in ethanol metabolism by regulating ADH and ALDH gene expression. SIGNIFICANCE STATEMENT: Systematic bioinformatics analysis showed that 11 microRNAs might play regulatory roles in the expression of two alcohol dehydrogenase (ADH) and seven aldehyde dehydrogenase (ALDH) genes in the human liver. Experimental evidences proved that hsa-miR-1301-3p suppressed the expression of ADH6, ALDH5A1, and ALDH8A1 in liver cells and decreased their inducibility by ethanol.
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Affiliation(s)
- Xubing Wang
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Yanjie Zhao
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Jiao Luo
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Lin Xu
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Xinmei Li
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Yuan Jin
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Chuanhai Li
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Meiyao Feng
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Ying Wang
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Jing Chen
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Yufei Hou
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Qianwen Zhao
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Jinquan Zhao
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Baitang Ning
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Yuxin Zheng
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
| | - Dianke Yu
- School of Public Health, Qingdao University, Qingdao, China (X.W., Ya.Z., J.L., L.X., X.L., Y.J., C.L., M.F., Y.W., J.C., Y.H., Q.Z., J.Z., Yu.Z., D.Y.) and National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas (B.N.)
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10
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Long-term outcomes in patients with decompensated alcohol-related liver disease, steatohepatitis and Maddrey's discriminant function <32. J Hepatol 2020; 72:636-642. [PMID: 31954208 DOI: 10.1016/j.jhep.2019.12.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/05/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Patients with alcoholic hepatitis and a modified Maddrey's discriminant function (mDF) <32 have a low risk of short-term mortality. However, few data exist concerning long-term outcomes. The aims of this study were to evaluate 5-year survival rates and to identify predictive factors for long-term prognosis in this patient population. METHODS We studied patients from 2 centers who were admitted for hepatic decompensation (ascites, hepatic encephalopathy, or jaundice) and who had histological findings of steatohepatitis and an mDF <32. Clinical and biological parameters were recorded at the time of liver biopsy and alcohol consumption was recorded during follow-up. We performed Cox proportional hazard survival analysis to identify factors associated with 5-year survival. RESULTS One hundred and twenty-one patients were included (male: 64%, mean age: 51.5 ± 10.3 years, presence of cirrhosis: 84%). The median model for end-stage liver disease and mDF scores were 14 (IQR 11.7-16.1) and 19 (IQR 11.1-24), respectively. During follow-up, 30% of the patients remained abstinent. Survival rates at 1, 6, 12, 24, and 60 months were 96.7 ± 1.6%, 90.1 ± 2.7%, 80.8 ± 3.6%, 69.9 ± 4.3%, and 50.7 ± 4.9%, respectively. The majority of deaths (80%) were liver related. In multivariable analysis, encephalopathy at baseline and alcohol abstinence were predictive of 5-year survival. The 5-year survival rates of patients without and with encephalopathy at baseline were 60.5 ± 5.8% and 29.7 ± 8.0%, respectively, and the 5-year survival rates of abstinent and non-abstinent patients were 74.0 ± 8.0% and 40.9 ± 5.8%, respectively. CONCLUSIONS The mortality rate of patients with alcoholic hepatitis and an mDF <32 is around 50% at 5 years. Hepatic encephalopathy at baseline and lack of alcohol abstinence impair long-term prognosis. New treatment strategies, including measures to ensure abstinence, are required. LAY SUMMARY Patients with alcoholic hepatitis that is of intermediate severity have a low risk of short-term mortality but not much is known regarding long-term outcomes for these patients. This study clearly indicates that patients with intermediate disease characteristics have poor long-term outcomes. The presence of hepatic encephalopathy at the time of diagnosis and the absence of alcohol abstinence during follow-up are factors that predict poor long-term mortality.
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11
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Addolorato G, Vassallo GA, Mirijello A, Gasbarrini A. Diagnosis and Management of Alcohol Use Disorder in Patients with Liver Disease: Lights and Shadows. Neurotherapeutics 2020; 17:127-141. [PMID: 31713188 PMCID: PMC7007485 DOI: 10.1007/s13311-019-00802-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Alcohol use disorder is the most common cause of advanced liver disease in the Western world. Diagnosis of alcohol use disorder can be difficult because patients with liver disease tend to deny alcohol intake for the fear of being excluded from treatment and because available biomarkers of alcohol intake have poor specificity in these patients. Alcohol abstinence is the cornerstone of the therapy in these patients. However, pharmacological treatments for alcohol use disorders have not been formally tested in patients with advanced liver disease, except for baclofen. Psychosocial intervention became crucial in these patients considering the limited pharmacological choice. However, psychosocial approach and an appropriate team to manage these patients are not still well defined. In this review, we critically discuss the diagnosis and the management of alcohol use disorder in patients with liver disease.
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Affiliation(s)
- Giovanni Addolorato
- "Internal Medicine and Alcohol Related Disease" Unit, Department of Internal Medicine and Gastroenterology, Catholic University of Rome, Rome, Italy.
- Fondazione Policlinico Universitario A Gemelli IRCCS Research Hospital, Rome, Italy.
| | - Gabriele A Vassallo
- "Internal Medicine and Alcohol Related Disease" Unit, Department of Internal Medicine and Gastroenterology, Catholic University of Rome, Rome, Italy
- Department of Internal Medicine, Barone Lombardo Hospital, Canicattì, Italy
| | - Antonio Mirijello
- "Internal Medicine and Alcohol Related Disease" Unit, Department of Internal Medicine and Gastroenterology, Catholic University of Rome, Rome, Italy
- Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Antonio Gasbarrini
- Fondazione Policlinico Universitario A Gemelli IRCCS Research Hospital, Rome, Italy
- Department of Internal Medicine and Gastroenterology, Catholic University of Rome, Rome, Italy
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12
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Morley KC, Lagopoulos J, Logge W, Baillie A, Adams C, Haber PS. Brain GABA levels are reduced in alcoholic liver disease: A proton magnetic resonance spectroscopy study. Addict Biol 2020; 25:e12702. [PMID: 30561840 DOI: 10.1111/adb.12702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Baclofen, a selective γ-aminobutyric acid (GABA)B receptor agonist, has emerged as a potential treatment for alcohol use disorder with much unexplained variation in response to treatment efficacy and dose regimen. Several positive studies include patients with alcoholic liver disease (ALD) and/or history of heavy drinking. The aim of this paper was to examine the association of cortical GABA+ concentration with severity of liver disease (including markers of liver injury) and other clinical characteristics in alcohol patients. METHODS Proton magnetic resonance spectroscopy (1 H-MRS), from the parietal lobe, was analyzed to yield absolute concentration of GABA in 24 alcohol-dependent individuals. Diagnosis of ALD, markers of liver injury, severity of liver disease (Model for End-Stage Liver Disease [MELD]), and alcohol history were assessed. Covariates included concurrent medication, age, and recent alcohol consumption. RESULTS Multiple linear regression revealed that GABA+ concentration was significantly predicted by MELD scores (F = 5.02, R2 = 0.59, P = 0.01; MELD: B = -0.63, P = 0.02), when controlling for covariates concurrent medication, age, and recent alcohol consumption. CONCLUSION Severity of ALD is associated with lower cortical concentrations of GABA+. These results may explain variations in response to the GABAB agonist, baclofen, in the alcohol-dependent population.
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Affiliation(s)
- Kirsten C. Morley
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Faculty of Medicine and HealthUniversity of Sydney Sydney Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience‐Thompson InstituteUniversity of Sunshine Coast Birtinya Australia
| | - Warren Logge
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Faculty of Medicine and HealthUniversity of Sydney Sydney Australia
| | - Andrew Baillie
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Faculty of Health SciencesUniversity of Sydney Sydney Australia
| | - Claire Adams
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Faculty of Medicine and HealthUniversity of Sydney Sydney Australia
| | - Paul S. Haber
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Faculty of Medicine and HealthUniversity of Sydney Sydney Australia
- Drug Health ServicesRoyal Prince Alfred Hospital Sydney Australia
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13
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Morikawa T, Xie H, Pan Y, Ninomiya K, Yuan D, Jia X, Yoshikawa M, Nakamura S, Matsuda H, Muraoka O. A Review of Biologically Active Natural Products from a Desert Plant Cistanche tubulosa. Chem Pharm Bull (Tokyo) 2019; 67:675-689. [PMID: 31257323 DOI: 10.1248/cpb.c19-00008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
An Orobanchaceae plant Cistanche tubulosa (SCHENK) WIGHT (Kanka-nikujuyou in Japanese), which is one of the authorized plant resources as Cistanches Herba in both Japanese and Chinese Pharmacopoeias, is a perennial parasitic plant growing on roots of sand-fixing plants. The stems of C. tubulosa have traditionally been used for treatment of impotence, sterility, lumbago, and body weakness as well as a promoting agent of blood circulation. In recent years, Cistanches Herba has also been widely used as a health food supplement in Japan, China, and Southeast Asian countries. Here we review our recent studies on chemical constituents from the stems of C. tubulosa as well as their bioactivities such as vasorelaxtant, hepatoprotective, and glucose tolerance improving effects.
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Affiliation(s)
- Toshio Morikawa
- Pharmaceutical Research and Technology Institute, Kindai University.,Antiaging Center, Kindai University
| | - Haihui Xie
- Kyoto Pharmaceutical University.,South China Botanical Garden, Chinese Academy of Sciences
| | - Yingni Pan
- Pharmaceutical Research and Technology Institute, Kindai University.,School of Traditional Chinese Medicines, Shenyang Pharmaceutical University
| | - Kiyofumi Ninomiya
- Pharmaceutical Research and Technology Institute, Kindai University.,Antiaging Center, Kindai University
| | - Dan Yuan
- School of Traditional Chinese Medicines, Shenyang Pharmaceutical University
| | - Xiaoguang Jia
- Kyoto Pharmaceutical University.,Xinjiang Institute of Chinese Materia Medica and Ethnodrug
| | - Masayuki Yoshikawa
- Pharmaceutical Research and Technology Institute, Kindai University.,Kyoto Pharmaceutical University
| | | | | | - Osamu Muraoka
- Pharmaceutical Research and Technology Institute, Kindai University.,Antiaging Center, Kindai University
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14
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Li YM, Fan JG. Guidelines of prevention and treatment for alcoholic liver disease (2018, China). J Dig Dis 2019; 20:174-180. [PMID: 30450822 DOI: 10.1111/1751-2980.12687] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 11/12/2018] [Accepted: 11/15/2018] [Indexed: 12/11/2022]
Affiliation(s)
- You Ming Li
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Jian Gao Fan
- Department of Gastroenterology, XinHua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Children's Digestion and Nutrition, Shanghai, China
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15
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Park S, Kim DS, Wu X, J Yi Q. Mulberry and dandelion water extracts prevent alcohol-induced steatosis with alleviating gut microbiome dysbiosis. Exp Biol Med (Maywood) 2019; 243:882-894. [PMID: 30105955 DOI: 10.1177/1535370218789068] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Chronic alcohol intake causes hepatic steatosis and changes the body composition and glucose metabolism. We examined whether water extracts of mulberry (WMB) and white flower dandelion ( Taraxacum coreanum Nakai, WTC) can prevent and/or delay the symptoms of chronic ethanol-induced hepatic steatosis in male Sprague Dawley rats, and explored the mechanisms. Ethanol degradation was examined by orally administering 3 g ethanol/kg bw after giving them 0.3 g/kg bw WMB or WTC. All rats were continuously provided about 7 g ethanol/kg bw/day for four weeks and were given either of 0.1% dextrin (control), WMB, WTC, or water extracts of Hovenia dulcis Thunb fruit (positive-control) in high-fat diets. Area under the curve of serum ethanol levels was lowered in descending order of control, WTC and positive-control, and WMB in acute ethanol challenge. WMB and WTC prevented alcohol intake-related decrease in bone mineral density and lean body mass compared to the control. After glucose challenge, serum glucose levels increased more in the control group than other groups in the first part and the rate of decrease after 40 min was similar among all groups. These changes were associated with decreasing serum insulin levels. WMB had the greatest efficacy for decreasing triglyceride and increasing glycogen deposits. WMB and WTC prevented the disruption of the hepatic cells and nuclei while reducing malondialdehyde contents in rats fed alcohol, but the prevention was not as much as the normal-control. The ratio of Firmicutes to Bacteroidetes in the gut was much higher in the control than the normal-control, but WTC and WMB decreased the ratio compared to the control. WMB and WTC separated the gut microbiota community from the control. In conclusion, WMB and WTC protected against alcoholic liver steatosis by accelerating ethanol degradation and also improved body composition and glucose metabolism while alleviating the dysbiosis of gut microbiome by chronic alcohol intake. Impact statement Excessive alcohol consumption is associated with serious pathologies and is common in much of the world. Pathologies include liver damage, glucose intolerance, and loss of lean body mass and bone mass. These pathologies are mediated by changes in metabolism as well as toxic metabolic byproducts, and possibly by gut dysbiosis. In this study, we demonstrate that aqueous extracts of mulberry and dandelion protected rats against ethanol-induced losses in lean body and bone masses, improved glucose tolerance and partially normalized gut bacterial populations, with mulberry extract being generally more effective. This research suggests that mulberry and dandelion extracts may have the potential to improve some of the pathologies associated with excess alcohol consumption, and that further clinical research is warranted.
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Affiliation(s)
- Sunmin Park
- Department of Food and Nutrition, Obesity/Diabetes Center, Hoseo University, Asan 336-795, Korea
| | - Da S Kim
- Department of Food and Nutrition, Obesity/Diabetes Center, Hoseo University, Asan 336-795, Korea
| | - Xuangao Wu
- Department of Food and Nutrition, Obesity/Diabetes Center, Hoseo University, Asan 336-795, Korea
| | - Qiu J Yi
- Department of Food and Nutrition, Obesity/Diabetes Center, Hoseo University, Asan 336-795, Korea
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16
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Logge WB, Morley KC, Haber PS, Baillie AJ. Executive Functioning Moderates Responses to Appetitive Cues: A Study in Severe Alcohol Use Disorder and Alcoholic Liver Disease. Alcohol Alcohol 2018; 54:38-46. [DOI: 10.1093/alcalc/agy083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 10/31/2018] [Indexed: 12/12/2022] Open
Affiliation(s)
- Warren B Logge
- Department of Psychology, NHMRC Centre of Research Excellence in Mental Health and Substance Use, Macquarie University, NSW, Australia
| | - Kirsten C Morley
- Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of Sydney, NSW, Australia
| | - Paul S Haber
- Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of Sydney, NSW, Australia
- Drug Health Services, Royal Prince Alfred Hospital, NSW, Australia
| | - Andrew J Baillie
- Department of Psychology, NHMRC Centre of Research Excellence in Mental Health and Substance Use, Macquarie University, NSW, Australia
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17
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Gao J, Cao J, Guo T, Xiao Y. Association between alcoholic interventions and abstinence rates for alcohol use disorders: A meta-analysis. Medicine (Baltimore) 2018; 97:e13566. [PMID: 30558020 PMCID: PMC6320082 DOI: 10.1097/md.0000000000013566] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The aim of present study is to quantitatively evaluate the association between different interventions and abstinence rates based on network meta-analysis. METHOD Following PRISMA guidelines, randomized clinical trials that compared different alcoholic interventions for alcohol use disorders associated with abstinence rates in treatment sessions or/and follow-up sessions were recruited. Main data synthesis was performed by Bayesian random-effects network meta-analyses, and the relative ranking of interventions was estimated by cumulative probability P values (SUCRA). Funnel plot symmetry was used to detect publication bias. Moreover, pair-wised comparison was also conducted to determine the statistical difference and forest plots were generated to calculate the differences between the groups. The Grades of Recommendations Assessment, Development and Evaluation (GRADE) criteria were utilized for the recommendations of evidence from pairwise direct comparisons. RESULTS A total of 137 RCTs containing 27,282 participants and 8 variations of psychotherapy, pharmacotherapy, contingency management, and brief intervention used as treatment interventions were included. In summary, contingency management plus psychotherapy was demonstrated to be effective and possessed the best rank of achieving the highest abstinence rate in treatment sessions (SUCRA, 0.61). Pharmacotherapy plus psychotherapy also revealed its efficacy and was associated with the highest abstinence rate in follow-up sessions (SUCRA, 0.40). More importantly, psychotherapy alone was demonstrated not to be associated with higher abstinence rates in both treatment (OR, 1.052; 95% CI, 0.907-1.220) and follow-up sessions (OR, 0.967; 95% CI, 0.552-1.693), yet pharmacotherapy seemed to be the only intervention associated with higher abstinence rates compared to controls in both sessions (treatment session: OR, 1.074; 95% CI, 1.002-1.152) (follow-up session: OR, 1.442; 95% CI, 1.094-1.900). CONCLUSIONS Contingency management plus psychotherapy and pharmacotherapy plus psychotherapy were demonstrated to be associated with the highest abstinence rates in treatment sessions and follow-up sessions, respectively. However, contingency management and pharmacotherapy seemed to be the substantial crucial factors allowing for the maintenance of the highest abstinence rates in respective sessions, although we need more evidence for further validation.
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Affiliation(s)
- Jiamin Gao
- Department of Emergency, Huashan Hospital, Fudan University, Shanghai
| | - Jun Cao
- Department of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan
| | - Tao Guo
- Department of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan
| | - Yunyue Xiao
- Department of Clinical Psychology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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18
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Lenhart A, Hussain S, Salgia R. Chances of Renal Recovery or Liver Transplantation After Hospitalization for Alcoholic Liver Disease Requiring Dialysis. Dig Dis Sci 2018; 63:2800-2809. [PMID: 29934721 DOI: 10.1007/s10620-018-5170-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/12/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Acute kidney injury in the setting of alcoholic liver disease portends a poor prognosis without liver transplant. AIMS Using a tertiary care population, we aimed to evaluate the outcomes of renal replacement therapy in patients with alcoholic liver disease and acute kidney injury with < 6 months sobriety. METHODS A retrospective review of hospitalized patients with alcoholic hepatitis/acute on chronic alcoholic cirrhosis and hepatorenal syndrome or acute tubular necrosis was performed. Analyzed variables included patient comorbidities, mode of dialysis, MELD-Na score, CLIF-C ACLF score, and CLIF-C OF score. RESULTS Forty-seven patients were included, 21.3% of which survived 6 months of sobriety to be eligible for transplant evaluation. Despite renal replacement therapy, mortality was 78.7%. Of survivors, 4 received transplants and 6 recovered without transplant. Lower CLIF-C ACLF (p < 0.001) and CLIF-C OF (p = 0.001) predicted 6-month survival and lower MELD-Na (p = 0.016), CLIF-C ACLF (p < 0.001), and CLIF-C OF (p = 0.006) predicted renal recovery. There was no difference in survival or renal recovery between etiologies of kidney injury. Modality of initial dialysis with intermittent hemodialysis compared to continuous renal replacement therapy predicted improved survival (41.2 vs. 10.0%, p = 0.01) and nearly reached significance for renal recovery (23.5 vs. 6.7%, p = 0.054). CONCLUSIONS Although severe alcoholic liver disease with acute kidney injury is associated with a high mortality irrespective of the etiology of renal failure, over 20% of patients in this study survived 6 months to be evaluated for liver transplant and 12.8% recovered renal function. These outcomes should be considered when weighing the decision of initiating dialysis.
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Affiliation(s)
- Adrienne Lenhart
- Department of Internal Medicine, Henry Ford Health System, Henry Ford Hospital, Detroit, MI, 48202, USA.
| | - Salwa Hussain
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, 2799 W Grand Blvd., Detroit, MI, 48202, USA
| | - Reena Salgia
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, 2799 W Grand Blvd., Detroit, MI, 48202, USA
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19
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Vassallo GA, Tarli C, Rando MM, Mosoni C, Mirijello A, Agyei-Nkansah A, Antonelli M, Sestito L, Perotti G, Di Giuda D, Agnes S, Grieco A, Gasbarrini A, Addolorato G. Liver Transplantation in Patients with Alcoholic Liver Disease: A Retrospective Study. Alcohol Alcohol 2018; 53:151-156. [PMID: 29206894 DOI: 10.1093/alcalc/agx097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 11/14/2017] [Indexed: 12/20/2022] Open
Abstract
Aim Alcoholic liver disease (ALD) is the most common liver disease in the Western World. Liver transplantation (LT) is the treatment for end-stage ALD. However, many transplant centers are still reluctant to transplant these patients because of the risk of alcohol relapse, recurrence of the primary liver disease and associated post-transplant complications. We examined survival rate, prevalence of primary liver disease recurrence, re-transplantation and post-transplant complications among transplanted patients for alcoholic cirrhosis compared with those transplanted for viral cirrhosis. Methods data about patients transplanted for alcoholic and viral cirrhosis at the Gemelli Hospital from January 1995 to April 2016 were retrospectively collected. Survival rate was evaluated according to the Kaplan-Meier method. Recurrence was defined as histological evidence of primary liver disease. Data on the onset of complication, causes of death and graft failure after liver transplant were analyzed. Results There was no statistically significant difference regarding survival rate between the two groups. Only patients transplanted for viral cirrhosis presented with primary liver disease recurrence. There was a higher rate of cancer development in patients transplanted for alcoholic cirrhosis. Cancer was the major cause of death in this population. Risk factors associated with the onset of cancer were a high MELD score at the transplant time and smoking after transplantation. Conclusion ALD is a good indication for LT. Patients transplanted for alcoholic cirrhosis should receive regular cancer screening and should be advised against smoking. Short Summary No difference was found between patients transplanted for alcoholic cirrhosis and viral cirrhosis in term of survival rate. Only patients transplanted for viral cirrhosis presented primary liver disease recurrence. A higher rate of cancer development was found in patients transplanted for alcoholic cirrohosis. This complication was associated with post-trasplant smoking.
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Affiliation(s)
- Gabriele A Vassallo
- Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Claudia Tarli
- Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Maria M Rando
- Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Carolina Mosoni
- Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Antonio Mirijello
- Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza Hospital, viale Cappuccini, 71013 San Giovanni Rotondo, Italy
| | - Adwoa Agyei-Nkansah
- Department of Internal Medicine, University of Ghana, P .O. BOX LG 23, UGMC, Accra, Ghana
| | - Mariangela Antonelli
- Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Luisa Sestito
- Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Germano Perotti
- Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Daniela Di Giuda
- Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Salvatore Agnes
- Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Antonio Grieco
- Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
| | - Giovanni Addolorato
- Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy
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20
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Cho YE, Song BJ. Pomegranate prevents binge alcohol-induced gut leakiness and hepatic inflammation by suppressing oxidative and nitrative stress. Redox Biol 2018; 18:266-278. [PMID: 30071471 PMCID: PMC6080577 DOI: 10.1016/j.redox.2018.07.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/28/2018] [Accepted: 07/19/2018] [Indexed: 01/13/2023] Open
Abstract
Alcoholic liver disease (ALD) is a major chronic liver disease worldwide and can range from simple steatosis, inflammation to fibrosis/cirrhosis possibly through leaky gut and systemic endotoxemia. We investigated whether pomegranate (POM) protects against binge alcohol-induced gut leakiness, endotoxemia, and inflammatory liver damage. After POM pretreatment for 10 days, rats were exposed to 3 oral doses of binge alcohol (5 g/kg/dose) or dextrose (as control) at 12-h intervals. Binge alcohol exposure induced leaky gut with significantly elevated plasma endotoxin and inflammatory fatty liver by increasing the levels of oxidative and nitrative stress marker proteins such as ethanol-inducible CYP2E1, inducible nitric oxide synthase, and nitrated proteins in the small intestine and liver. POM pretreatment significantly reduced the alcohol-induced gut barrier dysfunction, plasma endotoxin and inflammatory liver disease by inhibiting the elevated oxidative and nitrative stress marker proteins. POM pretreatment significantly restored the levels of intestinal tight junction (TJ) proteins such as ZO-1, occludin, claudin-1, and claundin-3 markedly diminished after alcohol-exposure. In addition, the levels of gut adherent junction (AJ) proteins (e.g., β-catenin and E-cadherin) and desmosome plakoglobin along with associated protein α-tubulin were clearly decreased in binge alcohol-exposed rats but restored to basal levels in POM-pretreated rats. Immunoprecipitation followed by immunoblot analyses revealed that intestinal claudin-1 protein was nitrated and ubiquitinated in alcohol-exposed rats, whereas these modifications were significantly blocked by POM pretreatment. These results showed for the first time that POM can prevent alcohol-induced gut leakiness and inflammatory liver injury by suppressing oxidative and nitrative stress.
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Affiliation(s)
- Young-Eun Cho
- Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Byoung-Joon Song
- Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA.
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Umbelliferone alleviates hepatic injury in diabetic db/db mice via inhibiting inflammatory response and activating Nrf2-mediated antioxidant. Biosci Rep 2018; 38:BSR20180444. [PMID: 29967293 PMCID: PMC6131207 DOI: 10.1042/bsr20180444] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/27/2018] [Accepted: 07/02/2018] [Indexed: 01/01/2023] Open
Abstract
The current study was designed to investigate the protective effect and possible mechanisms of umbelliferone (Umb) on liver injury in diabetic C57BL/KsJ-db/db (dbdb) mice. Mice were divided into five groups: wild-type mice group (WY), dbdb mice group, dbdb mice + Metformin (100 mg/kg) group, dbdb mice + Umb (20, 40 mg/kg) group. Blood glucose regulation was assessed by an oral glucose tolerance test (OGTT). At 28 days after drug administration, blood samples were obtained for the analysis of lipids and enzymes related to hepatic function, including alanine aminotransferase (ALT), aspartate aminotransaminase (AST) and total cholesterol (TC) and triglyceride (TG). Expression levels of inflammatory cytokines (TNF-α, IL-1β, and IL-6) and oxidative stress indicators (SOD and MDA) were measured with ELISA kit. The expressions of high-mobility group box 1 (HMGB1), Toll-like receptor (TLR) 4 (TLR4), Myd88, NF-κB, IκB, Nrf2, and HO-1 proteins were also evaluated by Western blotting analysis. The results showed that Umb significantly restored the blood glucose in OGTT, and inhibited the levels of insulin, TG, TC, as well as activities of ALT and AST. Moreover, Umb inhibited diabetic inflammation through down-regulating the expression of HMGB1, TLR4, NF-κB, and IκB. In addition, Umb alleviated oxidative damage in the liver by activating Nrf2-mediated signal pathway. These findings demonstrated that Umb exhibited protective effect against diabetic live injury, which may be through inhibiting HMGB1-induced inflammatory response and activating Nrf2-mediated antioxidant.
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Proskynitopoulos PJ, Rhein M, Jäckel E, Manns MP, Frieling H, Bleich S, Thum T, Hillemacher T, Glahn A. Leptin Expression and Gene Methylation Patterns in Alcohol-Dependent Patients with Ethyltoxic Cirrhosis—Normalization After Liver Transplantation and Implications for Future Research. Alcohol Alcohol 2018; 53:511-517. [DOI: 10.1093/alcalc/agy038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 05/12/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- P J Proskynitopoulos
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hanover Medical School, Hanover, Germany
| | - M Rhein
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hanover Medical School, Hanover, Germany
- Laboratory for Molecular Neuroscience, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - E Jäckel
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hanover Medical School, Hanover, Germany
- Department of Gastroenterology, Hepatology, and Endocrinology, Hanover Medical School, Hanover, Germany
| | - M P Manns
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hanover Medical School, Hanover, Germany
- Department of Gastroenterology, Hepatology, and Endocrinology, Hanover Medical School, Hanover, Germany
| | - H Frieling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hanover Medical School, Hanover, Germany
- Laboratory for Molecular Neuroscience, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - S Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hanover Medical School, Hanover, Germany
| | - T Thum
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hanover Medical School, Hanover, Germany
- Institute of Molecular and Translational Therapeutic Strategies, Hanover Medical School, Hanover, Germany
| | - T Hillemacher
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hanover Medical School, Hanover, Germany
- Department of Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - A Glahn
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hanover Medical School, Hanover, Germany
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Morley KC, Baillie A, Fraser I, Furneaux-Bate A, Dore G, Roberts M, Abdalla A, Phung N, Haber PS. Baclofen in the treatment of alcohol dependence with or without liver disease: multisite, randomised, double-blind, placebo-controlled trial. Br J Psychiatry 2018; 212:362-369. [PMID: 29716670 DOI: 10.1192/bjp.2018.13] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND There are no available medications for the management of alcohol dependence for patients with alcoholic liver disease (ALD).AimsTo conduct a multisite, double blind, placebo-controlled, randomised clinical trial of baclofen in the treatment of alcohol dependence, with or without liver disease (trial registration: ClinicalTrials.gov, NCT01711125). METHOD Patients (n = 104) were randomised to placebo, baclofen 30 mg/day or 75 mg/day for 12 weeks. Primary outcomes included survival time to lapse (any drinking), relapse (≥5 drinks per day in men and ≥4 in women), and the composite outcome of drinks per drinking day, number of heavy drinking days, and percentage days abstinent. RESULTS There was a significant effect of baclofen (composite groups) on time to lapse (χ2 = 6.44, P<0.05, Cohen's d = 0.56) and relapse (χ2 = 4.62, P<0.05, d = 0.52). A significant treatment effect of baclofen was observed for percentage days abstinent (placebo 43%, baclofen 30 mg 69%, baclofen 75 mg 65%; P<0.05). There was one serious adverse event (overdose) directly related to medication (75 mg). CONCLUSIONS Baclofen may be an effective treatment option for patients with ALD. However, given the profile of adverse events, the role for this medication might be best limited to specialist services.Declaration of interestNone.
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Affiliation(s)
- Kirsten C Morley
- NHMRC Centre of Research Excellence in Mental Health and Substance Use,Central Clinical School, Sydney Medical School, University of Sydney,New South Wales,Australia
| | - Andrew Baillie
- NHMRC Centre of Research Excellence in Mental Health and Substance Use,Department of Psychology,Macquarie University,New South Wales,Australia
| | - Isabel Fraser
- NHMRC Centre of Research Excellence in Mental Health and Substance Use,Central Clinical School, Sydney Medical School, University of Sydney,New South Wales,Australia
| | - Ainsley Furneaux-Bate
- NHMRC Centre of Research Excellence in Mental Health and Substance Use,Central Clinical School, Sydney Medical School, University of Sydney,New South Wales,Australia
| | - Glenys Dore
- Herbert St Alcohol Clinic,Royal North Shore Hospital,Sydney,New South Wales,Australia
| | - Michael Roberts
- School of Pharmacy and Medical Sciences,University of South Australia,Adelaide and Therapeutics Research Centre,Diamantina Institute,The University of Queensland,Translational Research Institute,Brisbane,Australia
| | - Ahmed Abdalla
- School of Pharmacy and Medical Sciences,University of South Australia,Adelaide,Australia
| | - Nghi Phung
- Centre for Addiction Medicine, Westmead Hospital,Sydney,New South Wales,Australia
| | - Paul S Haber
- Drug Health Services,Royal Prince Alfred Hospital,New South Wales,Australia
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Li Z, Zhao J, Zhang S, Weinman SA. FOXO3-dependent apoptosis limits alcohol-induced liver inflammation by promoting infiltrating macrophage differentiation. Cell Death Discov 2018. [PMID: 29531813 PMCID: PMC5841311 DOI: 10.1038/s41420-017-0020-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Alcohol consumption is generally well tolerated by the liver but in some individuals it results in persistent inflammation and liver disease. The mechanisms that regulate alcohol-induced liver inflammation are poorly understood. The transcription factor FOXO3 has previously been shown to be involved in suppressing alcohol-induced liver injury. In this study we demonstrate that in response to alcohol, approximately 10% of mouse hepatic macrophages undergo FOXO3-dependent apoptosis. By 3 days of alcohol exposure total hepatic macrophage numbers declined by 30% but these were restored to normal after 10 days of continued exposure. Whole body or myeloid specific Foxo3-/- mice failed to show this apoptotic response. After 10 days of alcohol exposure, Foxo3−/− mice had an increased basal inflammatory phenotype and an increase in the proportion of pro-inflammatory CD11b+, Ly6C+ infiltrating macrophages (IMs) infiltrating. This led to marked sensitivity to LPS with a 5-fold ALT elevation and liver injury after LPS challenge in Foxo3−/− but not WT mice. Restoring the early macrophage apoptosis burst with a pulse of intravenous GdCl3 at day 2 had no effect on the day 10 phenotype of WT mice but it corrected the hyper-inflammatory phenotype in Foxo3−/− mice. In conclusion, FOXO3-dependent hepatic macrophage apoptosis in response to ethanol serves to promote differentiation of infiltrating macrophages thus limiting the magnitude of the inflammatory response to ethanol.
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Affiliation(s)
- Zhuan Li
- 1Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS USA
| | - Jie Zhao
- 1Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS USA
| | - Shujun Zhang
- 2Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Steven A Weinman
- 1Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS USA.,3Liver Center, University of Kansas Medical Center, Kansas City, KS USA
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Schueller F, Roy S, Vucur M, Trautwein C, Luedde T, Roderburg C. The Role of miRNAs in the Pathophysiology of Liver Diseases and Toxicity. Int J Mol Sci 2018; 19:ijms19010261. [PMID: 29337905 PMCID: PMC5796207 DOI: 10.3390/ijms19010261] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/12/2018] [Accepted: 01/13/2018] [Indexed: 12/12/2022] Open
Abstract
Both acute and chronic liver toxicity represents a major global health burden and an important cause of morbidity and lethality worldwide. Despite epochal progress in the treatment of hepatitis C virus infections, pharmacological treatment strategies for most liver diseases are still limited and new targets for prevention or treatment of liver disease are urgently needed. MicroRNAs (miRNAs) represent a new class of highly conserved small non-coding RNAs that are involved in the regulation of gene expression by targeting whole networks of so called “targets”. Previous studies have shown that the expression of miRNAs is specifically altered in almost all acute and chronic liver diseases. In this context, it was shown that miRNA can exert causal roles, being pro- or anti-inflammatory, as well as pro- or antifibrotic mediators or being oncogenes as well as tumor suppressor genes. Recent data suggested a potential therapeutic use of miRNAs by targeting different steps in the hepatic pathophysiology. Here, we review the function of miRNAs in the context of acute and chronic liver diseases. Furthermore, we highlight the potential role of circulating microRNAs in diagnosis of liver diseases and discuss the major challenges and drawbacks that currently prevent the use of miRNAs in clinical routine.
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Affiliation(s)
- Florian Schueller
- Department of Medicine III, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Sanchari Roy
- Department of Medicine III, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Mihael Vucur
- Department of Medicine III, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Christian Trautwein
- Department of Medicine III, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Tom Luedde
- Department of Medicine III, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
- Division of Gastroenterology, Hepatology and Hepatobiliary Oncology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Christoph Roderburg
- Department of Medicine III, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
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Different Dietary Proportions of Fish Oil Regulate Inflammatory Factors but Do Not Change Intestinal Tight Junction ZO-1 Expression in Ethanol-Fed Rats. Mediators Inflamm 2017; 2017:5801768. [PMID: 29386752 PMCID: PMC5745723 DOI: 10.1155/2017/5801768] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/30/2017] [Accepted: 10/15/2017] [Indexed: 12/18/2022] Open
Abstract
Sixty male Wistar rats were fed a control or an ethanol-containing diet in groups C or E. The fat compositions were adjusted with 25% or 57% fish oil substituted for olive oil in groups CF25, CF57, EF25, and EF57. Hepatic thiobarbituric acid-reactive substance (TBARS) levels, cytochrome P450 2E1 protein expression, and tumor necrosis factor- (TNF-) α, interleukin- (IL-) 1β, IL-6, and IL-10 levels, as well as intracellular adhesion molecule (ICAM)-1 levels were significantly elevated, whereas plasma adiponectin level was significantly reduced in group E (p < 0.05). Hepatic histopathological scores of fatty change and inflammation, in group E were significantly higher than those of group C (p < 0.05). Hepatic TBARS, plasma ICAM-1, and hepatic TNF-α, IL-1β, and IL-10 levels were significantly lower, and plasma adiponectin levels were significantly higher in groups EF25 and EF57 than those in group E (p < 0.05). The immunoreactive area of the intestinal tight junction protein, ZO-1, showed no change between groups C and E. Only group CF57 displayed a significantly higher ZO-1 immunoreactive area compared to group C (p = 0.0415). 25% or 57% fish oil substituted for dietary olive oil could prevent ethanol-induced liver damage in rats, but the mechanism might not be related to intestinal tight junction ZO-1 expression.
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Crosstalk of liver immune cells and cell death mechanisms in different murine models of liver injury and its clinical relevance. Hepatobiliary Pancreat Dis Int 2017; 16:245-256. [PMID: 28603092 PMCID: PMC7172563 DOI: 10.1016/s1499-3872(17)60014-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Liver inflammation or hepatitis is a result of pluripotent interactions of cell death molecules, cytokines, chemokines and the resident immune cells collectively called as microenvironment. The interplay of these inflammatory mediators and switching of immune responses during hepatotoxic, viral, drug-induced and immune cell-mediated hepatitis decide the fate of liver pathology. The present review aimed to describe the mechanisms of liver injury, its relevance to human liver pathology and insights for the future therapeutic interventions. DATA SOURCES The data of mouse hepatic models and relevant human liver diseases presented in this review are systematically collected from PubMed, ScienceDirect and the Web of Science databases published in English. RESULTS The hepatotoxic liver injury in mice induced by the metabolites of CCl4, acetaminophen or alcohol represent necrotic cell death with activation of cytochrome pathway, formation of reactive oxygen species (ROS) and mitochondrial damage. The Fas or TNF-alpha induced apoptotic liver injury was dependent on activation of caspases, release of cytochrome c and apoptosome formation. The ConA-hepatitis demonstrated the involvement of TRAIL-dependent necrotic/necroptotic cell death with activation of RIPK1/3. The alpha-GalCer-induced liver injury was mediated by TNF-alpha. The LPS-induced hepatitis involved TNF-alpha, Fas/FasL, and perforin/granzyme cell death pathways. The MHV3 or Poly(I:C) induced liver injury was mediated by natural killer cells and TNF-alpha signaling. The necrotic ischemia-reperfusion liver injury was mediated by hypoxia, ROS, and pro-inflammatory cytokines; however, necroptotic cell death was found in partial hepatectomy. The crucial role of immune cells and cell death mediators in viral hepatitis (HBV, HCV), drug-induced liver injury, non-alcoholic fatty liver disease and alcoholic liver disease in human were discussed. CONCLUSIONS The mouse animal models of hepatitis provide a parallel approach for the study of human liver pathology. Blocking or stimulating the pathways associated with liver cell death could unveil the novel therapeutic strategies in the management of liver diseases.
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Goh ET, Morgan MY. Review article: pharmacotherapy for alcohol dependence - the why, the what and the wherefore. Aliment Pharmacol Ther 2017; 45:865-882. [PMID: 28220511 DOI: 10.1111/apt.13965] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 11/29/2016] [Accepted: 01/12/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND The development of alcohol dependence is associated with significant morbidity and mortality. For the majority of affected people the most appropriate goal, in terms of drinking behaviour, is abstinence from alcohol. Psychosocial intervention is the mainstay of the treatment but adjuvant pharmacotherapy is also available and its use recommended. AIM To provide an updated analysis of current and potential pharmacotherapeutic options for the management of alcohol dependence. In addition, factors predictive of therapeutic outcome, including compliance and pharmacogenetics, and the current barriers to treatment, including doctors' unwillingness to prescribe these agents, will be explored. METHODS Relevant papers were selected for review following extensive, language- and date-unrestricted, electronic and manual searches of the literature. RESULTS Acamprosate and naltrexone have a substantial evidence base for overall efficacy, safety and cost-effectiveness while the risks associated with the use of disulfiram are well-known and can be minimised with appropriate patient selection and supervision. Acamprosate can be used safely in patients with liver disease and in those with comorbid mental health issues and co-occurring drug-related problems. A number of other agents are being investigated for potential use for this indication including: baclofen, topiramate and metadoxine. CONCLUSION Pharmacotherapy for alcohol dependence has been shown to be moderately efficacious with few safety concerns, but it is substantially underutilised. Concerted efforts must be made to remove the barriers to treatment in order to optimise the management of people with this condition.
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Affiliation(s)
- E T Goh
- UCL Institute for Liver & Digestive Health, Division of Medicine, Royal Free Campus, University College London, London, UK
| | - M Y Morgan
- UCL Institute for Liver & Digestive Health, Division of Medicine, Royal Free Campus, University College London, London, UK
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Ninomiya K, Chaipech S, Kunikata Y, Yagi R, Pongpiriyadacha Y, Muraoka O, Morikawa T. Quantitative Determination of Stilbenoids and Dihydroisocoumarins in Shorea roxburghii and Evaluation of Their Hepatoprotective Activity. Int J Mol Sci 2017; 18:E451. [PMID: 28230758 PMCID: PMC5343985 DOI: 10.3390/ijms18020451] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 02/13/2017] [Accepted: 02/15/2017] [Indexed: 12/19/2022] Open
Abstract
A simultaneous quantitative analytical method for 13 stilbenoids including (-)-hopeaphenol (1), (+)-isohopeaphenol (2), hemsleyanol D (3), (-)-ampelopsin H (4), vaticanols A (5), E (6), and G (7), (+)-α-viniferin (8), pauciflorol A (9), hopeafuran (10), (-)-balanocarpol (11), (-)-ampelopsin A (12), and trans-resveratrol 10-C-β-d-glucopyranoside (13), and two dihydroisocoumarins, phayomphenols A₁ (14) and A₂ (15) in the extract of Shorea roxburghii (dipterocarpaceae) was developed. According to the established protocol, distributions of these 15 polyphenols (1-15) in the bark and wood parts of S. roxburghii and a related plant Cotylelobium melanoxylon were evaluated. In addition, the principal polyphenols (1, 2, 8, 13-15) exhibited hepatoprotective effects against d-galactosamine (d-galN)/lipopolysaccharide (LPS)-induced liver injury in mice at a dose of 100 or 200 mg/kg, p.o. To characterize the mechanisms of action, the isolates were examined in in vitro studies assessing their effects on (i) d-GalN-induced cytotoxicity in primary cultured mouse hepatocytes; (ii) LPS-induced nitric oxide (NO) production in mouse peritoneal macrophages; and (iii) tumor necrosis factor-α (TNF-α)-induced cytotoxicity in L929 cells. The mechanisms of action of these polyphenols (1, 2, and 8) were suggested to be dependent on the inhibition of LPS-induced macrophage activation and reduction of sensitivity of hepatocytes to TNF-α. However, none of the isolates reduced the cytotoxicity caused by d-GalN.
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Affiliation(s)
- Kiyofumi Ninomiya
- Pharmaceutical Research and Technology Institute, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan.
- Antiaging Center, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan.
| | - Saowanee Chaipech
- Pharmaceutical Research and Technology Institute, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan.
- Faculty of Agro-Industry, Rajamangala University of Technology Srivijaya, Thungyai, Nakhon Si Thammarat 80240, Thailand.
| | - Yusuke Kunikata
- Pharmaceutical Research and Technology Institute, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan.
| | - Ryohei Yagi
- Pharmaceutical Research and Technology Institute, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan.
| | - Yutana Pongpiriyadacha
- Faculty of Science and Technology, Rajamangala University of Technology Srivijaya, Thungyai, Nakhon Si Thammarat 80240, Thailand.
| | - Osamu Muraoka
- Pharmaceutical Research and Technology Institute, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan.
- Antiaging Center, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan.
| | - Toshio Morikawa
- Pharmaceutical Research and Technology Institute, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan.
- Antiaging Center, Kindai University, 3-4-1 Kowakae, Higashi-osaka, Osaka 577-8502, Japan.
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Ma ZL, Hou T, Shi W, Liu WW, Ibrahim SA, He H. Purification and identification of corn peptides that facilitate alcohol metabolism by semi-preparative high-performance liquid chromatography and nano liquid chromatography with electrospray ionization tandem mass spectrometry. J Sep Sci 2016; 39:4234-4242. [DOI: 10.1002/jssc.201600554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/25/2016] [Accepted: 09/01/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Zhi-Li Ma
- College of Food Science and Technology, Huazhong Agricultural University & Key Laboratory of Environment Correlative Dietology; Ministry of Education
| | - Tao Hou
- College of Food Science and Technology, Huazhong Agricultural University & Key Laboratory of Environment Correlative Dietology; Ministry of Education
| | - Wen Shi
- College of Food Science and Technology, Huazhong Agricultural University & Key Laboratory of Environment Correlative Dietology; Ministry of Education
| | - Wei-Wei Liu
- College of Food Science and Technology, Huazhong Agricultural University & Key Laboratory of Environment Correlative Dietology; Ministry of Education
| | - Salam A. Ibrahim
- Department of Family and Consumer Sciences; North Carolina A&T State University; Greensboro NC USA
| | - Hui He
- College of Food Science and Technology, Huazhong Agricultural University & Key Laboratory of Environment Correlative Dietology; Ministry of Education
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Addolorato G, Mirijello A, Barrio P, Gual A. Treatment of alcohol use disorders in patients with alcoholic liver disease. J Hepatol 2016; 65:618-30. [PMID: 27155530 DOI: 10.1016/j.jhep.2016.04.029] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 03/24/2016] [Accepted: 04/25/2016] [Indexed: 12/18/2022]
Abstract
Alcohol use disorders (AUDs) is one of the leading causes of disease and disability in almost all European countries. Among the alcohol-related diseases, alcoholic liver disease (ALD) is the most common. At present, alcohol is the most frequent cause of liver cirrhosis in the Western world. The cornerstone of treatment for ALD is achieving total alcohol abstinence and preventing relapse; medical and surgical treatments for ALD are limited when drinking continues. This narrative review summarizes current treatments for AUDs with a particular emphasis to the treatment of AUDs in patients with ALD. Medical management, psychosocial and pharmacological interventions are analyzed, underlying limits and options in AUD patients. Finally, this review discusses the most appropriate setting for the management of AUD patients with advanced liver disease as well as the indications for liver transplantation in AUD patients.
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Affiliation(s)
- Giovanni Addolorato
- Alcohol Use Disorders Unit, Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of Rome, Italy.
| | - Antonio Mirijello
- Alcohol Use Disorders Unit, Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of Rome, Italy; Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, FG, Italy
| | - Pablo Barrio
- Department of Psychiatry, Neurosciences Institute, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Antoni Gual
- Department of Psychiatry, Neurosciences Institute, Hospital Clínic, IDIBAPS, Barcelona, Spain.
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Andrade P, Silva M, Rodrigues S, Lopes J, Lopes S, Macedo G. Alcoholic hepatitis histological score has high accuracy to predict 90-day mortality and response to steroids. Dig Liver Dis 2016; 48:656-60. [PMID: 27026082 DOI: 10.1016/j.dld.2016.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 02/21/2016] [Accepted: 03/02/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION/OBJECTIVES A histological classification system (AHHS) has been recently proposed to predict 90-day mortality in patients with alcoholic hepatitis (AH). We analyzed the spectrum of histological features in patients with AH and assessed the ability of AHHS for predicting both response to steroids and 90-day mortality. METHODS Retrospective study of patients admitted to our tertiary centre between 2010 and 2014 with biopsy-proven AH. Histological features were analyzed and AHHS value was calculated. Kaplan-Meyer curves were calculated to assess the ability of AHHS to predict response to steroids and 90-day mortality. RESULTS We included 34 patients (70.6% men, mean age 48.5±8.9 years). Transjugular liver biopsy was performed 3.5±2.9 days after admission. Presence of bilirubinostasis (p=0.049), degree of bilirubinostasis (p<0.001), absence of megamitochondria (p<0.001) and degree of polymorphonuclear infiltration (p=0.018) were significantly associated with higher mortality at 90 days. Patients who responded to steroids had a significantly lower AHHS value than non-responders (5.4±0.9 vs 8.1±1.1, p=0.003). AAHS value was significantly higher in patients who died compared to patients who survived at 90 days (9.0±0.7 vs 5.0±0.9, p<0.001). AHHS predicted response to steroids [AUROC 0.90 (CI95% 0.742-1.000), p=0.004] and 90-day mortality [AUROC 1.0 (CI95% 1.0-1.0), p<0.001] with high accuracy. CONCLUSIONS In this cohort of patients, presence and degree of bilirubinostasis, absence of megamitochondria and degree of PMN infiltration were significantly associated with 90-day mortality. AHHS had a high accuracy for predicting response to steroids and 90-day mortality in this cohort of patients.
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Affiliation(s)
- Patrícia Andrade
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal.
| | - Marco Silva
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
| | - Susana Rodrigues
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
| | - Joanne Lopes
- Pathology Department, Centro Hospitalar São João, Porto, Portugal
| | - Susana Lopes
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
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Liu Q, Li X, Li C, Zheng Y, Wang F, Li H, Peng G. 1-Deoxynojirimycin Alleviates Liver Injury and Improves Hepatic Glucose Metabolism in db/db Mice. Molecules 2016; 21:279. [PMID: 26927057 PMCID: PMC6274115 DOI: 10.3390/molecules21030279] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 02/21/2016] [Accepted: 02/23/2016] [Indexed: 12/30/2022] Open
Abstract
The present study investigated the effect of 1-Deoxynojirimycin (DNJ) on liver injury and hepatic glucose metabolism in db/db mice. Mice were divided into five groups: normal control, db/db control, DNJ-20 (DNJ 20 mg·kg−1·day−1), DNJ-40 (DNJ 40 mg·kg−1·day−1) and DNJ-80 (DNJ 80 mg·kg−1·day−1). All doses were treated intravenously by tail vein for four weeks. DNJ was observed to significantly reduce the levels of serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and liver TG, as well as activities of serum alanine aminotransferase (ALT), and aspartate transaminase (AST); DNJ also alleviated macrovesicular steatosis and decreased tumor necrosis factor α (TNF-α), interleukin-1 (IL-1), interleukin-6 (IL-6) levels in liver tissue. Furthermore, DNJ treatment significantly increased hepatic glycogen content, the activities of hexokinase (HK), pyruvate kinase (PK) in liver tissue, and decreased the activities of glucose-6-phosphatase (G6Pase), glycogen phosphorylase (GP), and phosphoenolpyruvate carboxykinase (PEPCK). Moreover, DNJ increased the phosphorylation of phosphatidylinositol 3 kinase (PI3K) on p85, protein kinase B (PKB) on Ser473, glycogen synthase kinase 3β (GSK-3β) on Ser9, and inhibited phosphorylation of glycogen synthase (GS) on Ser645 in liver tissue of db/db mice. These results demonstrate that DNJ can increase hepatic insulin sensitivity via strengthening of the insulin-stimulated PKB/GSK-3β signal pathway and by modulating glucose metabolic enzymes in db/db mice. Moreover, DNJ also can improve lipid homeostasis and attenuate hepatic steatosis in db/db mice.
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Affiliation(s)
- Qingpu Liu
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Xuan Li
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Cunyu Li
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing 210023, China.
| | - Yunfeng Zheng
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing 210023, China.
| | - Fang Wang
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Hongyang Li
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Guoping Peng
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing 210023, China.
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Wang ZG, Dou XB, Zhou ZX, Song ZY. Adipose tissue-liver axis in alcoholic liver disease. World J Gastrointest Pathophysiol 2016; 7:17-26. [PMID: 26909225 PMCID: PMC4753183 DOI: 10.4291/wjgp.v7.i1.17] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/07/2015] [Accepted: 11/25/2015] [Indexed: 02/06/2023] Open
Abstract
Alcoholic liver disease (ALD) remains an important health problem worldwide. The disease spectrum is featured by early steatosis, steatohepatitis (steatosis with inflammatory cells infiltration and necrosis), with some individuals ultimately progressing to fibrosis/cirrhosis. Although the disease progression is well characterized, no effective therapies are currently available for the treatment in humans. The mechanisms underlying the initiation and progression of ALD are multifactorial and complex. Emerging evidence supports that adipose tissue dysfunction contributes to the pathogenesis of ALD. In the first part of this review, we discuss the mechanisms whereby chronic alcohol exposure contributed to adipose tissue dysfunction, including cell death, inflammation and insulin resistance. It has been long known that aberrant hepatic methionine metabolism is a major metabolic abnormality induced by chronic alcohol exposure and plays an etiological role in the pathogenesis of ALD. The recent studies in our group documented the similar metabolic effect of chronic alcohol drinking on methionine in adipose tissue. In the second part of this review, we also briefly discuss the recent research progress in the field with a focus on how abnormal methionine metabolism in adipose tissue contributes to adipose tissue dysfunction and liver damage.
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Functional Capacity, Respiratory Muscle Strength, and Oxygen Consumption Predict Mortality in Patients with Cirrhosis. Can J Gastroenterol Hepatol 2016; 2016:6940374. [PMID: 27559536 PMCID: PMC4983318 DOI: 10.1155/2016/6940374] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/18/2016] [Accepted: 05/31/2016] [Indexed: 01/02/2023] Open
Abstract
Introduction. Liver diseases influence musculoskeletal functions and may negatively affect the exercise capacity of patients with cirrhosis. Aim. To test the relationship between the six-minute walk test (6MWT), maximal inspiratory pressure (MIP), and exercise capacity (VO2peak) measures and the survival rate of patients with cirrhosis. Methods. This prospective cohort study consisted of 86 patients diagnosed with cirrhosis with the following aetiology: hepatitis C virus (HCV), hepatitis B virus (HBV), and/or alcoholic cirrhosis (AC). All patients were followed up for three years and submitted to the 6MWT, pressure measurements with a compound gauge, and an exercise test (VO2peak). Results. The survival analysis showed that the individuals who covered a distance shorter than 410 m during the 6MWT had a survival rate of 55% compared with a rate of 97% for the individuals who walked more than 410 m (p = 0.0001). Individuals with MIPs below -70 cmH2O had a survival rate of 62% compared with a rate of 93% for those with MIPs above -70 cmH2O (p = 0.0001). The patients with values below 17 mL/kg had a survival rate of 55% compared with a rate of 94% for those with values above 17 mL/kg (p = 0.0001). Conclusion. The 6MWT distance, MIP, and oxygen consumption are predictors of mortality in patients with cirrhosis.
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Tian L, Prasad N, Jang YY. In Vitro Modeling of Alcohol-Induced Liver Injury Using Human-Induced Pluripotent Stem Cells. Methods Mol Biol 2016; 1353:271-83. [PMID: 25520290 PMCID: PMC5881111 DOI: 10.1007/7651_2014_168] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Alcohol consumption has long been associated with a majority of liver diseases and has been found to influence both fetal and adult liver functions. In spite of being one of the major causes of morbidity and mortality in the world, currently, there are no effective strategies that can prevent or treat alcoholic liver disease (ALD), due to a lack of human-relevant research models. Recent success in generation of functionally active mature hepatocyte-like cells from human-induced pluripotent cells (iPSCs) enables us to better understand the effects of alcohol on liver functions. Here, we describe the method and effect of alcohol exposure on multistage hepatic cell types derived from human iPSCs, in an attempt to recapitulate the early stages of liver tissue injury associated with ALD. We exposed different stages of iPSC-induced hepatic cells to ethanol at a pathophysiological concentration. In addition to stage-specific molecular markers, we measured several key cellular parameters of hepatocyte injury, including apoptosis, proliferation, and lipid accumulation.
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Affiliation(s)
- Lipeng Tian
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Neha Prasad
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Yoon-Young Jang
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
- Cellular and Molecular Medicine Graduate Program, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, 1550 Orleans Street, CRB2 Rm552, Baltimore, MD, 21231, USA.
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Choi JY, Lee K, Lee SM, Yoo SH, Hwang SG, Choi JY, Lee SW, Hwang JS, Kim KK, Kang HC, Cheon GJ, Park YM. Efficacy and safety of human placental extract for alcoholic and nonalcoholic steatohepatitis: an open-label, randomized, comparative study. Biol Pharm Bull 2015; 37:1853-9. [PMID: 25590055 DOI: 10.1248/bpb.b13-00979] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Human placental extract (HPE) is a traditional medicine that has been used for the symptomatic treatment of liver disease without any verifying clinical evidence. This study aimed to evaluate the efficacy and safety of HPE in patients with alcoholic or nonalcoholic steatohepatitis (ASH or NASH). We designed this clinical trial as a multicenter, open-label, randomized, comparative noninferiority study to improve the reliability of analyses. The enrollment criteria were limited to ASH or NASH patients with serum alanine aminotransferase (ALT) 1.5-fold higher than the normal level. Patients in the control group were treated with a commercially available mixture of liver extract and flavin adenine dinucleotide (LE–FAD). Intention-to-treat (ITT) analysis was applied to 194 patients, and per-protocol (PP) analysis was available for 154 patients. The rate of primary goal achievement of treatment efficacy was arbitrarily defined as 20% or greater improvement in ALT level compared with the pretreatment level and did not differ significantly between the HPE and control groups [62.9% (44/70) vs. 48.8% (41/84); p=0.0772]. ITT and modified ITT analysis showed results similar to those of PP analysis. Adverse drug reactions (ADRs) of minimal to moderate degree occurred in 3.1% of patients. The ADR and treatment compliance rates were similar in both groups. In conclusion, the clinical value of HPE in the treatment of ASH and NASH is equivalent to that of LE–FAD.
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Affiliation(s)
- Jin Young Choi
- Hepatology Center, Bundang Jesaeng General Hospital; Seongnam 463–774, Republic of Korea
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Vassallo G, Mirijello A, Ferrulli A, Antonelli M, Landolfi R, Gasbarrini A, Addolorato G. Review article: Alcohol and gut microbiota - the possible role of gut microbiota modulation in the treatment of alcoholic liver disease. Aliment Pharmacol Ther 2015; 41:917-27. [PMID: 25809237 DOI: 10.1111/apt.13164] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 07/25/2014] [Accepted: 02/27/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Alcohol abuse represents the most common cause of liver disease in the Western countries. Pre-clinical and clinical studies showed that alcohol consumption affects amount and composition of gut microbiota. Moreover, gut flora plays an important role in the pathogenesis of alcoholic liver injury. AIM To review the relationship between alcohol administration and changes on gut microbiota, its involvement in the pathogenesis of alcoholic liver disease, and how gut microbiota modulation could be a target for the treatment of alcoholic liver disease. METHODS Articles were identified using the PubMed database with the search terms 'Alcohol', 'Gut Microbiota', 'Alcoholic liver disease', 'Probiotic', 'Prebiotic', 'Symbiotic' and 'Antibiotic'. English-language articles were screened for relevance. Full review of publications for the relevant studies was conducted, including additional publications that were identified from individual article reference lists. RESULTS Alcohol abuse induces changes in the composition of gut microbiota, although the exact mechanism for this alteration is not well known. The translocation of bacterial products into the portal blood appears to play a key role in alcohol-induced liver damage. Several studies show that the modulation of gut microbiota seem to be a promising strategy to reduce alcohol-induced liver injury. CONCLUSIONS Further studies are needed to better understand the relationship between alcohol administration and changes in gut microbiota, and its involvement in alcoholic liver disease. Moreover larger studies are needed to confirm the preliminary results on the therapeutic effects of gut microbiota modulation.
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Affiliation(s)
- G Vassallo
- Department of Internal Medicine, Catholic University of Rome, Rome, Italy
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Abstract
Alcohol use disorder is a heterogeneous illness with a complex biology that is controlled by many genes and gene-by-environment interactions. Several efficacious, evidence-based treatments currently exist for treating and managing alcohol use disorder, including a number of pharmacotherapies that target specific aspects of biology that initiate and maintain dangerous alcohol misuse. This article reviews the neurobiological and neurobehavioral foundation of alcohol use disorder, the mechanisms of action and evidence for the efficacy of currently approved medications for treatment, and the literature on other emerging pharmacotherapies.
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Affiliation(s)
- Robert M Swift
- From the Department of Psychiatry and Human Behavior, Brown University Alpert School of Medicine (Dr. Swift); Center for Alcohol and Addiction Studies, Brown University School of Public Health (Drs. Swift and Aston); VA Medical Center, Providence, RI (Dr. Swift)
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Kim JW, Yang H, Cho N, Kim B, Kim YC, Sung SH. Hepatoprotective constituents of Firmiana simplex stem bark against ethanol insult to primary rat hepatocytes. Pharmacogn Mag 2015; 11:55-60. [PMID: 25709211 PMCID: PMC4329633 DOI: 10.4103/0973-1296.149704] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/27/2014] [Accepted: 01/21/2015] [Indexed: 12/25/2022] Open
Abstract
Background: Ethanol causes hepatic cellular damage by alterations in biological functions. This study evaluated the hepatoprotective potential of the methanolic extract originating from Firmiana simplex (Sterculiaceae) stem bark against the ethanol-induced hepatotoxicity in rat primary hepatocytes. Materials and Methods: The extract of F. simplex stem bark was successively fractionated into n-hexane, chloroform, ethyl acetate (EtOAc), and n-butanol. Column chromatography with silica gel and sephadex LH-20 was used to isolate the EtOAc fraction. Rat primary hepatocytes were cultured to study the hepatoprotective activity of isolated substances against ethanol-induced toxicity. Intracellular reactive oxygen species (ROS) levels, the antioxidant activities of glutathione reductase (GR) and glutathione peroxidase (GSH-PX) enzymes, and the GSH content were measured to examine the antioxidative property of the isolated compounds. Results: Two flavonoid glycosides, quercitrin (1) and tamarixetin 3-O-rhamnopyranoside (2), were isolated from the active EtOAc fraction. Compound 1 significantly protected rat primary hepatocytes against ethanol-induced oxidative stress by reducing the intracellular ROS level and preserving antioxidative defense systems such as GR, GSH-PX, and total GSH. Conclusion: This is the first report on the hepatoprotective activities of the extract of F. simplex. The EtOAc fraction of F. simplex stem bark and its major constituent quercitrin (1) could function as hepatoprotective agents to attenuate the development of alcoholic liver disease.
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Affiliation(s)
- Jung Wha Kim
- Department of Pharmacy, College of Pharmacy and Research Institute of Pharmaceutical Science, Seoul National University, Republic of Korea
| | - Heejung Yang
- Department of Pharmacy, College of Pharmacy, Kangwon National University, Republic of Korea
| | - Namki Cho
- Department of Pharmacy, College of Pharmacy and Research Institute of Pharmaceutical Science, Seoul National University, Republic of Korea
| | - Bitnarae Kim
- Department of Pharmacy, College of Pharmacy and Research Institute of Pharmaceutical Science, Seoul National University, Republic of Korea
| | - Young Choong Kim
- Department of Pharmacy, College of Pharmacy and Research Institute of Pharmaceutical Science, Seoul National University, Republic of Korea
| | - Sang Hyun Sung
- Department of Pharmacy, College of Pharmacy and Research Institute of Pharmaceutical Science, Seoul National University, Republic of Korea
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Protective effects of hydroxysafflor yellow A (HSYA) on alcohol-induced liver injury in rats. J Physiol Biochem 2015; 71:69-78. [PMID: 25626885 DOI: 10.1007/s13105-015-0382-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 01/14/2015] [Indexed: 12/24/2022]
Abstract
Hydroxysafflor yellow A (HSYA), the main active natural constituent extracted from Carthamus tinctorius L., has been widely used for the treatment of cerebrovascular and cardiovascular diseases. The aim of this study is to explore the effect of HSYA on alcohol-induced liver injury and the underlying mechanism. Male Sprague-Dawley rats were used to establish the liver injury model induced by alcohol. HSYA treatment ameliorated serum biochemical indicators by reducing the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), hyaluronan (HA), laminin (LN), and type III precollagen (III-C) in rats. HSYA efficiently increased the activity and messenger RNA (mRNA) of superoxide dismutase (SOD) and glutathione peroxidase (GPx) in rat liver tissue compared with those of model group, which was obviously reduced by alcohol. HSYA also apparently decreased the levels of reactive oxygen species (ROS) and malondialdehyde (MDA) in rat liver tissue compared with those of model group, which was obviously enhanced by alcohol. Histological studies demonstrated that HSYA substantially reduced the number of macro- and micro-vesicular steatosis, suppressed hepatic fibrogenesis and shrunk ballooning degeneration areas, ameliorated the severity of liver damage induced by long-term drinking, and finally improved the liver architecture. In addition, immunohistochemistry study indicated that the activation of transforming growth factor β1 (TGF-β1) stimulated by alcohol in rat liver tissue was significantly blocked by HSYA. Collectively, these data demonstrated that HSYA can effectively protect the liver of rats from long-term alcohol injury, which relates with the enhanced antioxidant capacity of liver tissues and inhibition of TGF-β1 expression.
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Chen P, Torralba M, Tan J, Embree M, Zengler K, Stärkel P, van Pijkeren JP, DePew J, Loomba R, Ho SB, Bajaj JS, Mutlu EA, Keshavarzian A, Tsukamoto H, Nelson KE, Fouts DE, Schnabl B. Supplementation of saturated long-chain fatty acids maintains intestinal eubiosis and reduces ethanol-induced liver injury in mice. Gastroenterology 2015; 148:203-214.e16. [PMID: 25239591 PMCID: PMC4274236 DOI: 10.1053/j.gastro.2014.09.014] [Citation(s) in RCA: 214] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 08/08/2014] [Accepted: 09/11/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Alcoholic liver disease is a leading cause of mortality. Chronic alcohol consumption is accompanied by intestinal dysbiosis, and development of alcoholic liver disease requires gut-derived bacterial products. However, little is known about how alterations to the microbiome contribute to pathogenesis of alcoholic liver disease. METHODS We used the Tsukamoto-French mouse model, which involves continuous intragastric feeding of isocaloric diet or alcohol for 3 weeks. Bacterial DNA from the cecum was extracted for deep metagenomic sequencing. Targeted metabolomics assessed concentrations of saturated fatty acids in cecal contents. To maintain intestinal metabolic homeostasis, diets of ethanol-fed and control mice were supplemented with saturated long-chain fatty acids (LCFA). Bacterial genes involved in fatty acid biosynthesis, amounts of lactobacilli, and saturated LCFA were measured in fecal samples of nonalcoholic individuals and patients with active alcohol abuse. RESULTS Analyses of intestinal contents from mice revealed alcohol-associated changes to the intestinal metagenome and metabolome, characterized by reduced synthesis of saturated LCFA. Maintaining intestinal levels of saturated fatty acids in mice resulted in eubiosis, stabilized the intestinal gut barrier, and reduced ethanol-induced liver injury. Saturated LCFA are metabolized by commensal Lactobacillus and promote their growth. Proportions of bacterial genes involved in fatty acid biosynthesis were lower in feces from patients with active alcohol abuse than controls. Total levels of LCFA correlated with those of lactobacilli in fecal samples from patients with active alcohol abuse but not in controls. CONCLUSIONS In humans and mice, alcohol causes intestinal dysbiosis, reducing the capacity of the microbiome to synthesize saturated LCFA and the proportion of Lactobacillus species. Dietary approaches to restore levels of saturated fatty acids in the intestine might reduce ethanol-induced liver injury in patients with alcoholic liver disease.
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Affiliation(s)
- Peng Chen
- Department of Medicine, University of California San Diego, La Jolla, CA
| | | | - Justin Tan
- Department of Bioengineering, University of California San Diego, La Jolla, CA
| | - Mallory Embree
- Department of Bioengineering, University of California San Diego, La Jolla, CA
| | - Karsten Zengler
- Department of Bioengineering, University of California San Diego, La Jolla, CA
| | - Peter Stärkel
- St. Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | | | | | - Rohit Loomba
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Samuel B. Ho
- Department of Medicine, University of California San Diego, La Jolla, CA,Department of Medicine, VA San Diego Healthcare System, San Diego, CA
| | - Jasmohan S. Bajaj
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, VA
| | - Ece A. Mutlu
- Department of Medicine, Rush University Medical Center, Chicago, IL
| | - Ali Keshavarzian
- Department of Medicine, Rush University Medical Center, Chicago, IL
| | - Hidekazu Tsukamoto
- Southern California Research Center for Alcoholic Liver and Pancreatic Diseases and Cirrhosis, Department of Pathology, Keck School of Medicine of the University of Southern California, Greater Los Angeles VA Healthcare System, Los Angeles, CA
| | | | | | - Bernd Schnabl
- Department of Medicine, University of California San Diego, La Jolla, California.
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Lu KH, Tseng HC, Liu CT, Huang CJ, Chyuan JH, Sheen LY. Wild bitter gourd protects against alcoholic fatty liver in mice by attenuating oxidative stress and inflammatory responses. Food Funct 2014; 5:1027-37. [PMID: 24664243 DOI: 10.1039/c3fo60449g] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bitter gourd (Momordica charantia L.) is a common vegetable grown widely in Asia that is used as a traditional medicine. The objective of this study was to investigate whether wild bitter gourd possessed protective effects against chronic alcohol-induced liver injury in mice. C57BL/6 mice were fed an alcohol-containing liquid diet for 4 weeks to induce alcoholic fatty liver. Meanwhile, mice were treated with ethanol extracts from four different wild bitter gourd cultivars: Hualien No. 1', Hualien No. 2', Hualien No. 3' and Hualien No. 4'. The results indicated that the daily administration of 500 mg kg body weight(-1) of a Hualien No. 3' extract (H3E) or a Hualien No. 4' extract (H4E) markedly reduced the steatotic alternation of liver histopathology. In addition, the activation of serum aminotransferases (AST and ALT) and the accumulation of hepatic TG content caused by alcohol were ameliorated. The hepatoprotective effects of H3E and H4E involved the enhancement of the antioxidant defence system (GSH, GPx, GRd, CAT and SOD), inhibition of lipid peroxidation (MDA) and reduction of pro-inflammatory cytokines (TNF-α, IL-1β and IL-6) in the liver. Moreover, H3E and H4E supplementation suppressed the alcohol-induced elevation of CYP2E1, SREBP-1, FAS and ACC protein expression. These results demonstrated that ethanol extracts of Hualien No. 3' and Hualien No. 4' have beneficial effects against alcoholic fatty liver, in which they attenuate oxidative stress and inflammatory responses.
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Affiliation(s)
- Kuan-Hung Lu
- Institute of Food Science and Technology, College of Bio-Resources and Agriculture, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, Taiwan 10617.
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Cheng J, Zhou ZW, Sheng HP, He LJ, Fan XW, He ZX, Sun T, Zhang X, Zhao RJ, Gu L, Cao C, Zhou SF. An evidence-based update on the pharmacological activities and possible molecular targets of Lycium barbarum polysaccharides. DRUG DESIGN DEVELOPMENT AND THERAPY 2014; 9:33-78. [PMID: 25552899 PMCID: PMC4277126 DOI: 10.2147/dddt.s72892] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Lycium barbarum berries, also named wolfberry, Fructus lycii, and Goji berries, have been used in the People’s Republic of China and other Asian countries for more than 2,000 years as a traditional medicinal herb and food supplement. L. barbarum polysaccharides (LBPs) are the primary active components of L. barbarum berries and have been reported to possess a wide array of pharmacological activities. Herein, we update our knowledge on the main pharmacological activities and possible molecular targets of LBPs. Several clinical studies in healthy subjects show that consumption of wolfberry juice improves general wellbeing and immune functions. LBPs are reported to have antioxidative and antiaging properties in different models. LBPs show antitumor activities against various types of cancer cells and inhibit tumor growth in nude mice through induction of apoptosis and cell cycle arrest. LBPs may potentiate the efficacy of lymphokine activated killer/interleukin-2 combination therapy in cancer patients. LBPs exhibit significant hypoglycemic effects and insulin-sensitizing activity by increasing glucose metabolism and insulin secretion and promoting pancreatic β-cell proliferation. They protect retinal ganglion cells in experimental models of glaucoma. LBPs protect the liver from injuries due to exposure to toxic chemicals or other insults. They also show potent immunoenhancing activities in vitro and in vivo. Furthermore, LBPs protect against neuronal injury and loss induced by β-amyloid peptide, glutamate excitotoxicity, ischemic/reperfusion, and other neurotoxic insults. LBPs ameliorate the symptoms of mice with Alzheimer’s disease and enhance neurogenesis in the hippocampus and subventricular zone, improving learning and memory abilities. They reduce irradiation- or chemotherapy-induced organ toxicities. LBPs are beneficial to male reproduction by increasing the quality, quantity, and motility of sperm, improving sexual performance, and protecting the testis against toxic insults. Moreover, LBPs exhibit hypolipidemic, cardioprotective, antiviral, and antiinflammatory activities. There is increasing evidence from preclinical and clinical studies supporting the therapeutic and health-promoting effects of LBPs, but further mechanistic and clinical studies are warranted to establish the dose–response relationships and safety profiles of LBPs.
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Affiliation(s)
- Jiang Cheng
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China ; Department of Pharmaceutical Science, College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Zhi-Wei Zhou
- Department of Pharmaceutical Science, College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Hui-Ping Sheng
- Department of Infectious Diseases, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Lan-Jie He
- Department of Endocrinology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Xue-Wen Fan
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Zhi-Xu He
- Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center and Sino-US Joint Laboratory for Medical Sciences, Guiyang Medical University, Guiyang, Guizhou, People's Republic of China
| | - Tao Sun
- Key Laboratory of Craniocerebral Diseases of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Xueji Zhang
- Research Center for Bioengineering and Sensing Technology, University of Science and Technology Beijing, Beijing, People's Republic of China
| | - Ruan Jin Zhao
- Center for Traditional Chinese Medicine, Sarasota, FL, USA
| | - Ling Gu
- School of Biology and Chemistry, University of Pu'er, Pu'er, Yunnan, People's Republic of China
| | - Chuanhai Cao
- Department of Pharmaceutical Science, College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Shu-Feng Zhou
- Department of Pharmaceutical Science, College of Pharmacy, University of South Florida, Tampa, FL, USA ; Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center and Sino-US Joint Laboratory for Medical Sciences, Guiyang Medical University, Guiyang, Guizhou, People's Republic of China
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Shirazi M, Ameri A, Shafaroodi H, Motahhary P, Saleh T, Ghasemi M, Dehpour AR. Orthodontic tooth movement in cholestatic and cirrhotic rats. J Orthod 2014; 35:119-25; discussion 110-1. [DOI: 10.1179/146531207225022536] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Zhang P, Qiang X, Zhang M, Ma D, Zhao Z, Zhou C, Liu X, Li R, Chen H, Zhang Y. Demethyleneberberine, a natural mitochondria-targeted antioxidant, inhibits mitochondrial dysfunction, oxidative stress, and steatosis in alcoholic liver disease mouse model. J Pharmacol Exp Ther 2014; 352:139-47. [PMID: 25362106 DOI: 10.1124/jpet.114.219832] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Excessive alcohol consumption induces oxidative stress and lipid accumulation in the liver. Mitochondria have long been recognized as the key target for alcoholic liver disease (ALD). Recently, the artificial mitochondria-targeted antioxidant MitoQ has been used to treat ALD effectively in mice. Here, we introduce the natural mitochondria-targeted antioxidant demethyleneberberine (DMB), which has been found in Chinese herb Cortex Phellodendri chinensis. The protective effect of DMB on ALD was evaluated with HepG2 cells and acutely/chronically ethanol-fed mice, mimicking two common patterns of drinking in human. The results showed that DMB, which is composed of a potential antioxidant structure, could penetrate the membrane of mitochondria and accumulate in mitochondria either in vitro or in vivo. Consequently, the acute drinking-caused oxidative stress and mitochondrial dysfunction were significantly ameliorated by DMB. Moreover, we also found that DMB suppressed CYP2E1, hypoxia inducible factor α, and inducible nitric oxide synthase, which contributed to oxidative stress and restored sirtuin 1/AMP-activated protein kinase/peroxisome proliferator-activated receptor-γ coactivator-1α pathway-associated fatty acid oxidation in chronic ethanol-fed mice, which in turn ameliorated lipid peroxidation and macrosteatosis in the liver. Taking these findings together, DMB could serve as a novel and potential therapy for ALD in human beings.
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Affiliation(s)
- Pengcheng Zhang
- State Key Laboratory of Natural Medicines, Department of Biochemistry, China Pharmaceutical University, Nanjing, China; and Institute of Toxicology, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Xiaoyan Qiang
- State Key Laboratory of Natural Medicines, Department of Biochemistry, China Pharmaceutical University, Nanjing, China; and Institute of Toxicology, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Miao Zhang
- State Key Laboratory of Natural Medicines, Department of Biochemistry, China Pharmaceutical University, Nanjing, China; and Institute of Toxicology, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Dongshen Ma
- State Key Laboratory of Natural Medicines, Department of Biochemistry, China Pharmaceutical University, Nanjing, China; and Institute of Toxicology, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Zheng Zhao
- State Key Laboratory of Natural Medicines, Department of Biochemistry, China Pharmaceutical University, Nanjing, China; and Institute of Toxicology, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Cuisong Zhou
- State Key Laboratory of Natural Medicines, Department of Biochemistry, China Pharmaceutical University, Nanjing, China; and Institute of Toxicology, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Xie Liu
- State Key Laboratory of Natural Medicines, Department of Biochemistry, China Pharmaceutical University, Nanjing, China; and Institute of Toxicology, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Ruiyan Li
- State Key Laboratory of Natural Medicines, Department of Biochemistry, China Pharmaceutical University, Nanjing, China; and Institute of Toxicology, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Huan Chen
- State Key Laboratory of Natural Medicines, Department of Biochemistry, China Pharmaceutical University, Nanjing, China; and Institute of Toxicology, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Yubin Zhang
- State Key Laboratory of Natural Medicines, Department of Biochemistry, China Pharmaceutical University, Nanjing, China; and Institute of Toxicology, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
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Higuera-de la Tijera F, Servín-Caamaño AI, Pérez-Torres E, Salas-Gordillo F, Abdo-Francis JM, Pérez-Hernández JL, Kershenobich D. Main clinical factors influencing early mortality in a cohort of patients with severe alcoholic hepatitis, and evaluation trough ROC curves of different prognostic scoring systems. REVISTA MÉDICA DEL HOSPITAL GENERAL DE MÉXICO 2014. [DOI: 10.1016/j.hgmx.2014.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Vuittonet CL, Halse M, Leggio L, Fricchione SB, Brickley M, Haass-Koffler CL, Tavares T, Swift RM, Kenna GA. Pharmacotherapy for alcoholic patients with alcoholic liver disease. Am J Health Syst Pharm 2014; 71:1265-76. [PMID: 25027533 PMCID: PMC4170837 DOI: 10.2146/ajhp140028] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE An update on pharmacotherapy for achieving and maintaining abstinence and mitigating hepatic damage in patients with alcoholic liver disease (ALD) is presented. SUMMARY Currently there are limited pharmacotherapy options for managing ALD, which encompasses a broad spectrum of disorders ranging from steatosis and alcoholic hepatitis to fibrosis, cirrhosis, and hepatocellular cancer. Individual variation in the severity, presentation, and complex pathologenesis of ALD defines barriers to effective treatment. Scoring of disease severity using validated assessment instruments should guide treatment approaches; abstinence and proper nutrition continue to be the cornerstones of management. A literature search (through December 31, 2013) identified no reports of randomized controlled trials using Food and Drug Administration (FDA)-approved medications for the treatment of alcohol dependence in ALD-spectrum disorders. Disulfiram, acamprosate, and naltrexone (oral and intramuscular), while approved by FDA for treatment of alcohol dependence, are not currently approved for use in patients with ALD. Baclofen (also not FDA-approved for use in ALD) is the only medication available in the United States with demonstrated safety and efficacy in reducing alcoholic behavior that has been formally tested in clinical trials in patients with ALD. Pharmacotherapy of alcoholic hepatitis using glucocorticoids or pentoxifylline has shown promise, but these options are reserved for severe ALD only. CONCLUSION Although various treatments have been investigated for ALD in patients with alcoholism, complete abstinence from alcohol is currently the only recommended form of hepatoprotection for the entire spectrum of ALD diagnoses.
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Affiliation(s)
- Cynthia L Vuittonet
- Cynthia L. Vuittonet, M.D., is Resident Physician, Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, RI. Michael Halse, Pharm.D., is Resident Pharmacist, South County Hospital, Wakefield, RI. Lorenzo Leggio, M.D., Ph.D., M.Sc., is Section Chief, Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, and Section Chief, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, and Adjunct Associate Professor, Center for Alcohol and Addiction Studies, Brown University. Samuel B. Fricchione, B.A., is Research Assistant; Michael Brickley, B.A., is Research Assistant; Carolina L. Haass-Koffler, Pharm.D., is Post-Doctoral Fellow; and Tonya Tavares, M.A., is Senior Research Assistant, Center for Alcohol and Addiction Studies, Brown University. Robert M. Swift, M.D., Ph.D., is Deputy Chief of Research, Center for Alcohol and Addiction Studies, Brown University, Deputy Director of Research, Providence Veterans Affairs Medical Center, Providence, RI, and Professor of Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University. George A. Kenna, Ph.D., B.S.Pharm., is Assistant Professor of Psychiatry (Research), Center for Alcohol and Addiction Studies, and Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - Michael Halse
- Cynthia L. Vuittonet, M.D., is Resident Physician, Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, RI. Michael Halse, Pharm.D., is Resident Pharmacist, South County Hospital, Wakefield, RI. Lorenzo Leggio, M.D., Ph.D., M.Sc., is Section Chief, Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, and Section Chief, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, and Adjunct Associate Professor, Center for Alcohol and Addiction Studies, Brown University. Samuel B. Fricchione, B.A., is Research Assistant; Michael Brickley, B.A., is Research Assistant; Carolina L. Haass-Koffler, Pharm.D., is Post-Doctoral Fellow; and Tonya Tavares, M.A., is Senior Research Assistant, Center for Alcohol and Addiction Studies, Brown University. Robert M. Swift, M.D., Ph.D., is Deputy Chief of Research, Center for Alcohol and Addiction Studies, Brown University, Deputy Director of Research, Providence Veterans Affairs Medical Center, Providence, RI, and Professor of Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University. George A. Kenna, Ph.D., B.S.Pharm., is Assistant Professor of Psychiatry (Research), Center for Alcohol and Addiction Studies, and Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - Lorenzo Leggio
- Cynthia L. Vuittonet, M.D., is Resident Physician, Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, RI. Michael Halse, Pharm.D., is Resident Pharmacist, South County Hospital, Wakefield, RI. Lorenzo Leggio, M.D., Ph.D., M.Sc., is Section Chief, Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, and Section Chief, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, and Adjunct Associate Professor, Center for Alcohol and Addiction Studies, Brown University. Samuel B. Fricchione, B.A., is Research Assistant; Michael Brickley, B.A., is Research Assistant; Carolina L. Haass-Koffler, Pharm.D., is Post-Doctoral Fellow; and Tonya Tavares, M.A., is Senior Research Assistant, Center for Alcohol and Addiction Studies, Brown University. Robert M. Swift, M.D., Ph.D., is Deputy Chief of Research, Center for Alcohol and Addiction Studies, Brown University, Deputy Director of Research, Providence Veterans Affairs Medical Center, Providence, RI, and Professor of Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University. George A. Kenna, Ph.D., B.S.Pharm., is Assistant Professor of Psychiatry (Research), Center for Alcohol and Addiction Studies, and Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - Samuel B Fricchione
- Cynthia L. Vuittonet, M.D., is Resident Physician, Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, RI. Michael Halse, Pharm.D., is Resident Pharmacist, South County Hospital, Wakefield, RI. Lorenzo Leggio, M.D., Ph.D., M.Sc., is Section Chief, Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, and Section Chief, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, and Adjunct Associate Professor, Center for Alcohol and Addiction Studies, Brown University. Samuel B. Fricchione, B.A., is Research Assistant; Michael Brickley, B.A., is Research Assistant; Carolina L. Haass-Koffler, Pharm.D., is Post-Doctoral Fellow; and Tonya Tavares, M.A., is Senior Research Assistant, Center for Alcohol and Addiction Studies, Brown University. Robert M. Swift, M.D., Ph.D., is Deputy Chief of Research, Center for Alcohol and Addiction Studies, Brown University, Deputy Director of Research, Providence Veterans Affairs Medical Center, Providence, RI, and Professor of Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University. George A. Kenna, Ph.D., B.S.Pharm., is Assistant Professor of Psychiatry (Research), Center for Alcohol and Addiction Studies, and Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - Michael Brickley
- Cynthia L. Vuittonet, M.D., is Resident Physician, Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, RI. Michael Halse, Pharm.D., is Resident Pharmacist, South County Hospital, Wakefield, RI. Lorenzo Leggio, M.D., Ph.D., M.Sc., is Section Chief, Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, and Section Chief, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, and Adjunct Associate Professor, Center for Alcohol and Addiction Studies, Brown University. Samuel B. Fricchione, B.A., is Research Assistant; Michael Brickley, B.A., is Research Assistant; Carolina L. Haass-Koffler, Pharm.D., is Post-Doctoral Fellow; and Tonya Tavares, M.A., is Senior Research Assistant, Center for Alcohol and Addiction Studies, Brown University. Robert M. Swift, M.D., Ph.D., is Deputy Chief of Research, Center for Alcohol and Addiction Studies, Brown University, Deputy Director of Research, Providence Veterans Affairs Medical Center, Providence, RI, and Professor of Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University. George A. Kenna, Ph.D., B.S.Pharm., is Assistant Professor of Psychiatry (Research), Center for Alcohol and Addiction Studies, and Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - Carolina L Haass-Koffler
- Cynthia L. Vuittonet, M.D., is Resident Physician, Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, RI. Michael Halse, Pharm.D., is Resident Pharmacist, South County Hospital, Wakefield, RI. Lorenzo Leggio, M.D., Ph.D., M.Sc., is Section Chief, Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, and Section Chief, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, and Adjunct Associate Professor, Center for Alcohol and Addiction Studies, Brown University. Samuel B. Fricchione, B.A., is Research Assistant; Michael Brickley, B.A., is Research Assistant; Carolina L. Haass-Koffler, Pharm.D., is Post-Doctoral Fellow; and Tonya Tavares, M.A., is Senior Research Assistant, Center for Alcohol and Addiction Studies, Brown University. Robert M. Swift, M.D., Ph.D., is Deputy Chief of Research, Center for Alcohol and Addiction Studies, Brown University, Deputy Director of Research, Providence Veterans Affairs Medical Center, Providence, RI, and Professor of Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University. George A. Kenna, Ph.D., B.S.Pharm., is Assistant Professor of Psychiatry (Research), Center for Alcohol and Addiction Studies, and Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - Tonya Tavares
- Cynthia L. Vuittonet, M.D., is Resident Physician, Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, RI. Michael Halse, Pharm.D., is Resident Pharmacist, South County Hospital, Wakefield, RI. Lorenzo Leggio, M.D., Ph.D., M.Sc., is Section Chief, Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, and Section Chief, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, and Adjunct Associate Professor, Center for Alcohol and Addiction Studies, Brown University. Samuel B. Fricchione, B.A., is Research Assistant; Michael Brickley, B.A., is Research Assistant; Carolina L. Haass-Koffler, Pharm.D., is Post-Doctoral Fellow; and Tonya Tavares, M.A., is Senior Research Assistant, Center for Alcohol and Addiction Studies, Brown University. Robert M. Swift, M.D., Ph.D., is Deputy Chief of Research, Center for Alcohol and Addiction Studies, Brown University, Deputy Director of Research, Providence Veterans Affairs Medical Center, Providence, RI, and Professor of Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University. George A. Kenna, Ph.D., B.S.Pharm., is Assistant Professor of Psychiatry (Research), Center for Alcohol and Addiction Studies, and Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - Robert M Swift
- Cynthia L. Vuittonet, M.D., is Resident Physician, Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, RI. Michael Halse, Pharm.D., is Resident Pharmacist, South County Hospital, Wakefield, RI. Lorenzo Leggio, M.D., Ph.D., M.Sc., is Section Chief, Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, and Section Chief, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, and Adjunct Associate Professor, Center for Alcohol and Addiction Studies, Brown University. Samuel B. Fricchione, B.A., is Research Assistant; Michael Brickley, B.A., is Research Assistant; Carolina L. Haass-Koffler, Pharm.D., is Post-Doctoral Fellow; and Tonya Tavares, M.A., is Senior Research Assistant, Center for Alcohol and Addiction Studies, Brown University. Robert M. Swift, M.D., Ph.D., is Deputy Chief of Research, Center for Alcohol and Addiction Studies, Brown University, Deputy Director of Research, Providence Veterans Affairs Medical Center, Providence, RI, and Professor of Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University. George A. Kenna, Ph.D., B.S.Pharm., is Assistant Professor of Psychiatry (Research), Center for Alcohol and Addiction Studies, and Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - George A Kenna
- Cynthia L. Vuittonet, M.D., is Resident Physician, Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, RI. Michael Halse, Pharm.D., is Resident Pharmacist, South County Hospital, Wakefield, RI. Lorenzo Leggio, M.D., Ph.D., M.Sc., is Section Chief, Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, and Section Chief, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, and Adjunct Associate Professor, Center for Alcohol and Addiction Studies, Brown University. Samuel B. Fricchione, B.A., is Research Assistant; Michael Brickley, B.A., is Research Assistant; Carolina L. Haass-Koffler, Pharm.D., is Post-Doctoral Fellow; and Tonya Tavares, M.A., is Senior Research Assistant, Center for Alcohol and Addiction Studies, Brown University. Robert M. Swift, M.D., Ph.D., is Deputy Chief of Research, Center for Alcohol and Addiction Studies, Brown University, Deputy Director of Research, Providence Veterans Affairs Medical Center, Providence, RI, and Professor of Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University. George A. Kenna, Ph.D., B.S.Pharm., is Assistant Professor of Psychiatry (Research), Center for Alcohol and Addiction Studies, and Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University.
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Vonghia L, Michielsen P, Dom G, Francque S. Diagnostic challenges in alcohol use disorder and alcoholic liver disease. World J Gastroenterol 2014; 20:8024-8032. [PMID: 25009373 PMCID: PMC4081672 DOI: 10.3748/wjg.v20.i25.8024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/07/2014] [Accepted: 02/17/2014] [Indexed: 02/06/2023] Open
Abstract
Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of various organs, including the liver. Alcoholic liver disease includes different injuries ranging from steatosis to cirrhosis and implicates a diagnostic assessment of the liver disease and of its possible complications. There is growing interest in the possible different tools for assessing previous alcohol consumption and for establishing the severity of liver injury, especially by non-invasive methods.
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Thin LWY, Lawrance IC, Spilsbury K, Kava J, Olynyk JK. Detection of liver injury in IBD using transient elastography. J Crohns Colitis 2014; 8:671-7. [PMID: 24529605 DOI: 10.1016/j.crohns.2013.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 11/14/2013] [Accepted: 12/12/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Up to 5% of inflammatory bowel disease (IBD) patients are thought to have clinically significant liver disease due to multifactorial causes, however, this figure may be an underestimate due to reliance on abnormal liver tests (LTs) and/or liver biopsies. AIMS Our aim was to evaluate the prevalence of clinically significant liver disease in IBD patients as defined by an increased liver stiffness measurement (LS) ≥8kPa using transient elastography (TE). METHODS 110 IBD patients, and 55 non-IBD control subjects, had their LS recorded using FibroScan® (EchoSense, Paris, France) by a single blinded operator trained in TE. RESULTS 71 Crohn's disease and 39 ulcerative colitis subjects were included. All demographic variables were similar between the IBD and control groups apart from a significantly higher proportion of IBD patients who smoked (17.3% vs 3.6%, P=0.013). Seven IBD patients (6.4%) had an LS over 8 kPa and 3 had persistently elevated LS 6 months later. One patient had compensated cirrhosis. No significant differences in overall LS were observed between the IBD and control groups. Increased BMI and age, however, were independently associated with a higher LS in the IBD but not in the control group (P<0.001 and 0.010 respectively). CONCLUSION Using TE, the prevalence of clinically significant liver disease in IBD patients is low. The association of increased BMI and age with increased LS in IBD suggests fatty liver disease being the prevailing aetiology in these patients.
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Affiliation(s)
- L W Y Thin
- Centre for Inflammatory Bowel Diseases, Fremantle Hospital, Fremantle, WA, Australia; Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia
| | - I C Lawrance
- Centre for Inflammatory Bowel Diseases, Fremantle Hospital, Fremantle, WA, Australia; University Department of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, WA, Australia; Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia.
| | - K Spilsbury
- Centre for Population Health Research, Curtin University, Bentley, WA, Australia
| | - J Kava
- Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia
| | - J K Olynyk
- Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia; Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia; Institute for Immunology & Infectious Diseases, Murdoch University, Murdoch, WA, Australia
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