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Abstract
A variety of observational studies have demonstrated that coffee, likely acting through caffeine, improves health outcomes in patients with chronic liver disease. The primary pharmacologic role of caffeine is to act as an inhibitor of adenosine receptors. Because key liver cells express adenosine receptors linked to liver injury, regeneration, and fibrosis, it is plausible that the biological effects of coffee are explained by effects of caffeine on adenosinergic signaling in the liver. This review is designed to help the reader make sense of that hypothesis, highlighting key observations in the literature that support or dispute it.
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Affiliation(s)
- Jonathan A Dranoff
- Yale University School of Medicine and VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 06515, USA.
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Sridharan B, Devarajan N, Jobanputra R, Gowd GS, Anna IM, Ashokan A, Nair S, Koyakutty M. nCP:Fe Nanocontrast Agent for Magnetic Resonance Imaging-Based Early Detection of Liver Cirrhosis and Hepatocellular Carcinoma. ACS APPLIED BIO MATERIALS 2021; 4:3398-3409. [PMID: 35014424 DOI: 10.1021/acsabm.1c00001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Early detection of liver tumors and cirrhotic lesions by magnetic resonance imaging (MRI) remains a great challenge. Here, we report a biomineral nanocontrast agent based on iron-doped nanocalcium phosphate (nCP:Fe-CA) for magnetic resonance imaging of early-stage liver cirrhotic and hepatocellular carcinoma nodules using rat models. We have optimized an intravenously injectable, aqueous suspension of nCP:Fe-CA having an average size of 137.6 nm, a spherical shape, magnetic relaxivity of 63 mM-1S-1, and colloidal stability for 48 h, post-resuspension in an aqueous phase. Compared to superparamagnetic iron oxide nanoparticles (SPIONs), the optimized nCP:Fe-CA could detect liver tumor lesions as small as ∼0.25 cm, whereas the current clinical detection limit is ∼1 cm. In addition, multiple cirrhotic nodules of size <0.2 cm could be detected by nCP:Fe-CA-assisted MRI. The number of nodules observed after injecting nCP:Fe-CA was ∼3 times higher than that without CA (5-10 nodules). A biocompatibility study on healthy rats injected with nCP:Fe-CA showed unaltered liver transaminases, blood urea nitrogen, serum creatinine, and insignificant hemolysis. Furthermore, hepatobiliary clearance of nCP:Fe-CA was observed in 72 h compared to prolonged retention of SPIONs for 30 days when tested under identical conditions. Overall, the nCP:Fe-CA nanoparticles showed promising results as a biocompatible, MR contrast (T2) agent for the early-stage imaging of liver cirrhosis and hepatocellular carcinoma.
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Affiliation(s)
- Badrinathan Sridharan
- Amrita Center for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Healthcare Campus, Kochi 682041, Kerala, India
| | - Naveen Devarajan
- Amrita Center for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Healthcare Campus, Kochi 682041, Kerala, India
| | - Rupal Jobanputra
- Amrita Center for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Healthcare Campus, Kochi 682041, Kerala, India
| | - Genekehal Siddaramana Gowd
- Amrita Center for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Healthcare Campus, Kochi 682041, Kerala, India
| | - Ida Mulayirikkal Anna
- Amrita Center for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Healthcare Campus, Kochi 682041, Kerala, India
| | - Anusha Ashokan
- Amrita Center for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Healthcare Campus, Kochi 682041, Kerala, India
| | - Shantikumar Nair
- Amrita Center for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Healthcare Campus, Kochi 682041, Kerala, India
| | - Manzoor Koyakutty
- Amrita Center for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Healthcare Campus, Kochi 682041, Kerala, India
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Lee WS, Karthik SV, Ng RT, Ong SY, Ong C, Chiou FK, Wong SY, Quak SH, Aw MM. Characteristics and outcome of primary sclerosing cholangitis associated with inflammatory bowel disease in Asian children. Pediatr Neonatol 2019; 60:396-404. [PMID: 31409456 DOI: 10.1016/j.pedneo.2018.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/04/2018] [Accepted: 09/28/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Current knowledge on the clinical features and natural history of childhood primary sclerosing cholangitis - inflammatory bowel disease in Asia is limited. We described the presenting features and natural history of primary sclerosing cholangitis-inflammatory bowel disease seen in a cohort of Southeast Asian children. METHODS We conducted a retrospective review of childhood primary sclerosing cholangitis-inflammatory bowel disease from three tertiary centers in Singapore and Malaysia. RESULTS Of 24 patients (boys, 58%; median age at diagnosis: 6.3 years) with primary sclerosing cholangitis-inflammatory bowel disease (ulcerative colitis, n = 21; Crohn's disease, n = 1; undifferentiated, n = 2), 63% (n = 15) were diagnosed during follow-up for colitis, and 21% (n = 5) presented with acute or chronic hepatitis, 17% (n = 4) presented simultaneously. Disease phenotype of liver involvement showed 79% had sclerosing cholangitis-autoimmune hepatitis overlap, 54% large duct disease, and 46% small duct disease. All patients received immunosuppression therapy. At final review after a median [±S.D.] duration follow-up of 4.7 [±3.8] years, 12.5% patients had normal liver enzymes, 75% persistent disease, and 12.5% liver failure. The proportion of patients with liver cirrhosis increased from 13% at diagnosis to 29%; 21% had portal hypertension, and 17% had liver dysfunction. One patient required liver transplant. Transplant-free survival was 95%. For colitis, 95% had pancolitis, 27% rectal sparing, and 11% backwash ileitis at initial presentation. At final review, 67% patients had quiescent bowel disease with immunosuppression. One patient who had UC with pancolitis which was diagnosed at 3 years old developed colorectal cancer at 22 years of age. All patients survived. CONCLUSIONS Liver disease in primary sclerosing cholangitis-inflammatory bowel disease in Asian children has variable severity. With immunosuppression, two-thirds of patients have quiescent bowel disease but the majority have persistent cholangitis and progressive liver disease.
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Affiliation(s)
- Way Seah Lee
- Department of Paediatrics, University Malaya Medical Center, Kuala Lumpur, Malaysia; Paediatric and Child Health Research Group, University Malaya, Kuala Lumpur, Malaysia.
| | | | - Ruey Terng Ng
- Department of Paediatrics, University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Sik Yong Ong
- Department of Paediatrics, University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Christina Ong
- Gastroenterology Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Bukit Timah Road, Singapore
| | - Fang K Chiou
- Gastroenterology Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Bukit Timah Road, Singapore
| | - Shin Yee Wong
- Department of Paediatrics, University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Seng Hock Quak
- Khoo Teck Puat National University Children's Medical Institute, National University Hospital, Singapore; Department of Paediatrics, National University of Singapore, Kent Ridge Road, Singapore
| | - Marion Margaret Aw
- Khoo Teck Puat National University Children's Medical Institute, National University Hospital, Singapore; Department of Paediatrics, National University of Singapore, Kent Ridge Road, Singapore
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Pal P, Ray S. Alcoholic Liver Disease: A Comprehensive Review. EUROPEAN MEDICAL JOURNAL 2016. [DOI: 10.33590/emj/10312346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Alcoholic liver disease, a leading cause of morbidity, mortality, and cirrhosis, can range from simple steatosis to hepatocellular carcinoma. Multiple mechanisms such as oxidative stress, mitochondrial dysfunction, and alteration in gut-liver axis have been proposed for the pathogenesis of alcoholic liver disease. Based on different prognostic models, alcoholic hepatitis patients can be stratified into sub-groups and specific pharmacological therapy can be started. Alcohol abstinence has a clear cut mortality benefit and nutritional support is very important as most of the patients are malnourished and in a hypercatabolic state. Other than conventional glucocorticoids and pentoxifylline, newer agents and combination therapy can be used in severe alcoholic hepatitis in patients not responsive to conventional glucocorticoid therapy. Liver transplantation improves survival in advanced alcoholic cirrhosis and it can be an option in severe alcoholic hepatitis patients who are not responding to other medical therapies. Whether early transplantation can improve the survival compared with the conventional waiting period of 6 months is an active area of investigation. This is due to the fact that most of the disease-related mortality occurs in the first 2 months.
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Affiliation(s)
- Partha Pal
- Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Sayantan Ray
- Department of Endocrinology, Institute of Post Graduate Medical Education & Research (IPGMER) and SSKM Hospital, Kolkata, India
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Panaro F, Ramos J, Gallix B, Mercier G, Herrero A, Niampa H, Pageaux GP, Navarro F. Hepatic artery complications following liver transplantation. Does preoperative chemoembolization impact the postoperative course? Clin Transplant 2014; 28:598-605. [DOI: 10.1111/ctr.12358] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Fabrizio Panaro
- Department of General and Liver Transplant Surgery; University of Montpellier; Hôpital Saint Eloi; Montpellier-Cedex 5 France
| | - Jeanne Ramos
- Department of Pathology and Laboratory Medicine; University of Montpellier; Hôpital Gui de Chauliac; Montpellier-Cedex 5 France
| | - Benoit Gallix
- Department of Abdominal Imaging; University of Montpellier; Hôpital Saint Eloi; Montpellier-Cedex 5 France
| | - Grégoire Mercier
- Statistical Analysis Unit; University of Montpellier; Montpellier-Cedex 5 France
| | - Astrid Herrero
- Department of General and Liver Transplant Surgery; University of Montpellier; Hôpital Saint Eloi; Montpellier-Cedex 5 France
| | - Halidou Niampa
- Department of General and Liver Transplant Surgery; University of Montpellier; Hôpital Saint Eloi; Montpellier-Cedex 5 France
| | - Georges-Philippe Pageaux
- Department of Hepatology; University of Montpellier; Hôpital Saint Eloi; Montpellier-Cedex 5 France
| | - Francis Navarro
- Department of General and Liver Transplant Surgery; University of Montpellier; Hôpital Saint Eloi; Montpellier-Cedex 5 France
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Lee SL, Chang ED, Na SJ, Kim JS, An HJ, Ko YH, Won HS. Pseudocirrhosis of breast cancer metastases to the liver treated by chemotherapy. Cancer Res Treat 2014; 46:98-103. [PMID: 24520229 PMCID: PMC3918533 DOI: 10.4143/crt.2014.46.1.98] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 02/06/2013] [Indexed: 12/28/2022] Open
Abstract
Pseudocirrhosis refers to a condition that shows changes in hepatic contour that mimic cirrhosis radiographically in the absence of the typical histopathological findings of cirrhosis. This condition has been observed in patients with cancer metastatic to the liver, both in those who have undergone prior systemic chemotherapy and those who have not. Pseudocirrhosis may cause difficulty in interpretation of the response to chemotherapy and hepatic decompression and complication of portal hypertension have a negative effect on the prognosis. We report on a case of breast cancer with liver metastases that showed cirrhotic changes during disease progression. Progression of liver metastases was confirmed by F18 fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT). We also performed ultrasound-guided liver biopsy and confirmed tumor infiltration with severe desmoplastic fibrosis. This case suggests the pathogenesis of pseudocirrhosis through histopathological findings and the role of PET-CT in evaluation of the response to chemotherapy in patients with pseudocirrhosis.
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Affiliation(s)
- Su Lim Lee
- Department of Radiology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Eun Deok Chang
- Department of Hospital Pathology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Sae Jung Na
- Department of Nuclear Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Jeong Soo Kim
- Department of Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Ho Jung An
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Yoon Ho Ko
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Hye Sung Won
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
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Huang LH, Qiu YW, Hua HY, Niu XH, Wu PF, Wu HY, Zhu HY, Yang XJ, Yao SZ, Li YG. The efficacy and safety of entecavir in patients with advanced schistosomiasis co-infected with hepatitis B virus. Int J Infect Dis 2013; 17:e606-9. [PMID: 23490092 DOI: 10.1016/j.ijid.2013.01.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 01/24/2013] [Accepted: 01/25/2013] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of entecavir (ETV) in patients with advanced schistosomiasis and hepatitis B virus (HBV) co-infection. METHODS Sixty-seven patients with advanced schistosomiasis and HBV co-infection were enrolled in this study. The patients were randomly divided into the ETV treatment group (n=35) and the control group (n=32). The patients in the control group adopted routine supportive therapy for 52 weeks, and those in the ETV treatment group received ETV at a dose of 0.5mg once daily on the basis of routine supportive therapy for 52 weeks. Hepatic fibrosis markers (hyaluronic acid, type III procollagen, type IV collagen, laminin, and fibronectin), Ishak fibrosis score, alanine transaminase (ALT), HBV DNA, and Child-Pugh score were compared between the two groups. The intention to treat (ITT) population was used for the analysis. The measurement data and count data were analyzed by t-test and Chi-square test, respectively. RESULTS After 52 weeks of treatment, the hepatic fibrosis markers (hyaluronic acid, type III procollagen, type IV collagen, laminin, and fibronectin) were significantly improved in the ETV treatment group compared to the control group (all p<0.05). A ≥1-point improvement in the Ishak fibrosis score was found in 25.7% (9/35) of the ETV group, and the mean change from the baseline in the Ishak fibrosis score was a 0.3-point reduction. The control group showed disease progression in the Ishak fibrosis score. More patients in the ETV group than in the control group had undetectable serum HBV DNA levels (82.9% vs. 3.1%, p<0.05) and ALT normalization (68.6% vs. 18.3%, p<0.05). The ETV treatment group demonstrated an improvement in Child-Pugh score at week 52 (-3.7 vs. 0.3, p<0.05). In addition, no obvious adverse reactions were observed during ETV treatment. CONCLUSION ETV is safe and effective in patients with advanced schistosomiasis and HBV co-infection.
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Affiliation(s)
- Li-Hua Huang
- Institute of Liver Diseases in Wuxi City, The Fifth People's Hospital of Wuxi, Wuxi, China
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