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Kim SY, Ong Q, Liao Y, Ding Z, Tan AQL, Lim LTR, Tan HM, Lim SL, Lee QY, Han W. Genetic Ablation of LAT1 Inhibits Growth of Liver Cancer Cells and Downregulates mTORC1 Signaling. Int J Mol Sci 2023; 24:ijms24119171. [PMID: 37298123 DOI: 10.3390/ijms24119171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
Through a comprehensive analysis of the gene expression and dependency in HCC patients and cell lines, LAT1 was identified as the top amino acid transporter candidate supporting HCC tumorigenesis. To assess the suitability of LAT1 as a HCC therapeutic target, we used CRISPR/Cas9 to knockout (KO) LAT1 in the epithelial HCC cell line, Huh7. Knockout of LAT1 diminished its branched chain amino acid (BCAA) transport activity and significantly reduced cell proliferation in Huh7. Consistent with in vitro studies, LAT1 ablation led to suppression of tumor growth in a xenograft model. To elucidate the mechanism underlying the observed inhibition of cell proliferation upon LAT1 KO, we performed RNA-sequencing analysis and investigated the changes in the mTORC1 signaling pathway. LAT1 ablation resulted in a notable reduction in phosphorylation of p70S6K, a downstream target of mTORC1, as well as its substrate S6RP. This reduced cell proliferation and mTORC1 activity were rescued when LAT1 was overexpressed. These findings imply an essential role of LAT1 for maintenance of tumor cell growth and additional therapeutic angles against liver cancer.
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Affiliation(s)
- Sun-Yee Kim
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02, Helios, Singapore 138667, Singapore
| | - Qunxiang Ong
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02, Helios, Singapore 138667, Singapore
| | - Yilie Liao
- Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
| | - Zhaobing Ding
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02, Helios, Singapore 138667, Singapore
| | - Alicia Qian Ler Tan
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02, Helios, Singapore 138667, Singapore
| | - Ler Ting Rachel Lim
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02, Helios, Singapore 138667, Singapore
| | - Hui Min Tan
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02, Helios, Singapore 138667, Singapore
| | - Siew Lan Lim
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02, Helios, Singapore 138667, Singapore
| | - Qian Yi Lee
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02, Helios, Singapore 138667, Singapore
| | - Weiping Han
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 11 Biopolis Way, #02-02, Helios, Singapore 138667, Singapore
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van Dijk AM, Bruins Slot AS, Portincasa P, Siegerink SN, Chargi N, Verstraete CJR, de Bruijne J, Vleggaar FP, van Erpecum KJ. Systematic review with meta-analysis: Branched-chain amino acid supplementation in liver disease. Eur J Clin Invest 2023; 53:e13909. [PMID: 36394355 DOI: 10.1111/eci.13909] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/04/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Dietary supplementation with branched-chain amino acids (BCAA) is often used in cirrhotic patients to improve nutritional status. We wanted to explore the evidence for BCAA supplementation in chronic liver disease. METHODS We searched MEDLINE and EMBASE for studies with BCAA supplementation with the presence of a disease-control group (placebo or no intervention) using search terms 'liver cirrhosis', 'hepatocellular carcinoma', 'branched chain amino acids' and relevant synonyms. Risk of bias was assessed using ROBINS-I and RoB 2.0 tools. Meta-analyses were performed with a random-effects model. Results were reported following EQUATOR guidelines. RESULTS Of 3378 studies screened by title and abstract, 54 were included (34 randomized controlled trials, 5 prospective case-control studies, 13 retrospective case-control studies: in total 2308 patients BCAA supplementation, 2876 disease-controls). Risk of bias was high/serious for almost all studies. According to meta-analyses, long-term (at least 6 months) BCAA supplementation in cirrhotic patients significantly improved event-free survival (p = .008; RR .61 95% CI .42-.88) and tended to improve overall survival (p = .05; RR .58 95% CI .34-1.00). Two retrospective studies suggested the beneficial effects during sorafenib for hepatocellular carcinoma. Available studies reported no beneficial effects or contradictory results of BCAA after other specific therapeutic interventions (resection or radiological interventions for hepatocellular carcinoma, liver transplantation, paracentesis or variceal ligation). No convincing beneficial effects of BCAA supplementation on liver function, nutritional status or quality of life were found. No study reported serious side effects of BCAA. CONCLUSIONS Prophylactic BCAA supplementation appears safe and might improve survival in cirrhotic patients.
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Affiliation(s)
- Anne M van Dijk
- Department of Internal Medicine and Dermatology, Dietetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alexandra S Bruins Slot
- Department Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Piero Portincasa
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Sebastiaan N Siegerink
- Department Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Najiba Chargi
- Department of Head and Neck Surgical Oncology, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Carina J R Verstraete
- Department Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Joep de Bruijne
- Department Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Frank P Vleggaar
- Department Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Karel J van Erpecum
- Department Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands
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Sideris GA, Tsaramanidis S, Vyllioti AT, Njuguna N. The Role of Branched-Chain Amino Acid Supplementation in Combination with Locoregional Treatments for Hepatocellular Carcinoma: Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:926. [PMID: 36765884 PMCID: PMC9913329 DOI: 10.3390/cancers15030926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Branched-chain amino acid (BCAA) supplementation has been linked with favorable outcomes in patients undergoing surgical or palliative treatments for hepatocellular carcinoma (HCC). To date, there has been no systematic review investigating the value of BCAA supplementation in HCC patients undergoing locoregional therapies. MATERIALS AND METHODS A systematic search of the literature was performed across five databases/registries using a detailed search algorithm according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. The search was conducted on March 23, 2022. RESULTS Sixteen studies with a total of 1594 patients were analyzed. Most patients were male (64.6%) with a mean age of 68.2 ± 4.1 years, Child-Pugh score A (67.9%) and stage II disease (40.0%). Locoregional therapy consisted of radiofrequency ablation, transarterial chemoembolization or hepatic artery infusion chemotherapy. BCAA supplementation was in the form of BCAA granules or BCAA-enriched nutrient. Most studies reported improved albumin levels, non-protein respiratory quotient and quality of life in the BCAA group. Results pertaining to other outcomes including overall survival, recurrence rate, and Child-Pugh score were variable. Meta-analysis showed significantly higher levels of post-treatment serum albumin in the BCAA group (SMD = 0.54, 95% CI 0.20-0.87) but no significant differences in mortality rate (RR = 0.81, 95% CI: 0.65-1.02) and AST (SMD = -0.13, 95% CI: -0.43-0.18). CONCLUSION BCAA supplementation is associated with higher post-treatment albumin levels. There are currently not sufficient data to support additional benefits. Further studies are needed to elucidate their value.
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Affiliation(s)
- Georgios A. Sideris
- Baystate Medical Center, Department of Radiology, University of Massachusetts Medical School, Springfield, MA 01199, USA
- Radiology Working Group, Society of Junior Doctors, 11527 Athens, Greece
| | - Savvas Tsaramanidis
- Radiology Working Group, Society of Junior Doctors, 11527 Athens, Greece
- Department of Surgery, Ippokrateio General Hospital of Thessaloniki, Aristotle University of Thessaloniki School of Medicine, 54642 Thessaloniki, Greece
| | | | - Njogu Njuguna
- Baystate Medical Center, Department of Radiology, University of Massachusetts Medical School, Springfield, MA 01199, USA
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4
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Bonvini A, Rogero MM, Coqueiro AY, Raizel R, Bella LM, Fock RA, Borelli P, Tirapegui J. Effects of different branched-chain amino acids supplementation protocols on the inflammatory response of LPS-stimulated RAW 264.7 macrophages. Amino Acids 2021; 53:597-607. [PMID: 33715068 DOI: 10.1007/s00726-021-02940-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 01/07/2021] [Indexed: 12/30/2022]
Abstract
Although branched-chain amino acids (BCAA) are commonly used as a strategy to recover nutritional status of critically ill patients, recent findings on their role as immunonutrients have been associated with unfavorable outcomes, especially in obese patients. The present study aimed to explore the effects of different BCAA supplementation protocols in the inflammatory response of LPS-stimulated RAW 264.7 macrophages. Cell cultures were divided into five groups, with and without BCAA supplementation, (2 mmol/L of each amino acid). Then, cell cultures followed three different treatment protocols, consisting of a pretreatment (PT), an acute treatment (AT), and a chronic treatment (CT) with BCAA and LPS stimulation (1 µg/mL). Cell viability was analyzed by MTT assay, NO production was assessed by the Griess reaction and IL-6, IL-10, TNF-α and PGE2 synthesis, was evaluated by ELISA. BCAA significantly increased cell viability in AT and CT protocols, and NO and IL-10 synthesis in all treatment protocols. IL-6 synthesis was only increased in PT and CT protocols. TNF-α and PGE2 synthesis were not altered in any of the protocols and groups. BCAA supplementation was able to increase both pro and anti-inflammatory mediators synthesis by RAW 264.7 macrophages, which was influenced by the protocol applied. Moreover, these parameters were significantly increased by isoleucine supplementation, highlighting a potential research field for future studies.
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Affiliation(s)
- Andrea Bonvini
- Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Avenida Professor Lineu Prestes, 580, Butantã, Sao Paulo, 05508-000, Brazil.
| | - Marcelo Macedo Rogero
- Department of Nutrition, Faculty of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Audrey Yule Coqueiro
- Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Avenida Professor Lineu Prestes, 580, Butantã, Sao Paulo, 05508-000, Brazil
| | - Raquel Raizel
- Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Avenida Professor Lineu Prestes, 580, Butantã, Sao Paulo, 05508-000, Brazil
| | - Leonardo Mendes Bella
- Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Ricardo Ambrosio Fock
- Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Primavera Borelli
- Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Julio Tirapegui
- Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Avenida Professor Lineu Prestes, 580, Butantã, Sao Paulo, 05508-000, Brazil
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5
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Siddik MAB, Shin AC. Recent Progress on Branched-Chain Amino Acids in Obesity, Diabetes, and Beyond. Endocrinol Metab (Seoul) 2019; 34:234-246. [PMID: 31565875 PMCID: PMC6769348 DOI: 10.3803/enm.2019.34.3.234] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/16/2019] [Accepted: 09/21/2019] [Indexed: 12/22/2022] Open
Abstract
Branched-chain amino acids (BCAAs) are essential amino acids that are not synthesized in our body; thus, they need to be obtained from food. They have shown to provide many physiological and metabolic benefits such as stimulation of pancreatic insulin secretion, milk production, adipogenesis, and enhanced immune function, among others, mainly mediated by mammalian target of rapamycin (mTOR) signaling pathway. After identified as a reliable marker of obesity and type 2 diabetes in recent years, an increasing number of studies have surfaced implicating BCAAs in the pathophysiology of other diseases such as cancers, cardiovascular diseases, and even neurodegenerative disorders like Alzheimer's disease. Here we discuss the most recent progress and review studies highlighting both correlational and potentially causative role of BCAAs in the development of these disorders. Although we are just beginning to understand the intricate relationships between BCAAs and some of the most prevalent chronic diseases, current findings raise a possibility that they are linked by a similar putative mechanism.
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Affiliation(s)
- Md Abu Bakkar Siddik
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX, USA
| | - Andrew C Shin
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX, USA.
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6
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Bonvini A, Coqueiro AY, Tirapegui J, Calder PC, Rogero MM. Immunomodulatory role of branched-chain amino acids. Nutr Rev 2018; 76:840-856. [DOI: 10.1093/nutrit/nuy037] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Andrea Bonvini
- Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Audrey Y Coqueiro
- Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Julio Tirapegui
- Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Marcelo M Rogero
- Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
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7
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Ruiz-Margáin A, Méndez-Guerrero O, Román-Calleja BM, González-Rodríguez S, Fernández-Del-Rivero G, Rodríguez-Córdova PA, Torre A, Macías-Rodríguez RU. Dietary management and supplementation with branched-chain amino acids in cirrhosis of the liver. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2018; 83:424-433. [PMID: 30292583 DOI: 10.1016/j.rgmx.2018.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/17/2018] [Accepted: 05/21/2018] [Indexed: 12/12/2022]
Abstract
One of the most important characteristics of malnutrition is the loss of muscle mass and the severe depletion of the protein reserve, secondarily affecting energy metabolism. That impacts nutritional status and the progression of disease-related complications. Nutritional treatment is one of the main factors in the comprehensive management of those patients. Achieving adequate energy intake that provides the macronutrients and micronutrients necessary to prevent or correct malnutrition is attempted through dietary measures. ESPEN, the European Society for Clinical Nutrition and Metabolism, recommends a caloric intake of 30-40kcal/kg/day, in which carbohydrates provide 45-60% of the daily energy intake and proteins supply 1.0-1.5g/kg/day. The remaining portion of the total energy expenditure should be covered by lipids. The administration of branched-chain amino acids has been shown to be beneficial not only in counteracting malnutrition, but also as a coadjuvant treatment in specific complications, thus playing a favorable role in outcome and quality of life. Therefore, branched-chain amino acids should be considered part of nutritional treatment in patients with advanced stages of cirrhosis of the liver, particularly in the presence of complications.
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Affiliation(s)
- A Ruiz-Margáin
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
| | - O Méndez-Guerrero
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - B M Román-Calleja
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - S González-Rodríguez
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - G Fernández-Del-Rivero
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - P A Rodríguez-Córdova
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - A Torre
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - R U Macías-Rodríguez
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
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8
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Dietary management and supplementation with branched-chain amino acids in cirrhosis of the liver. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2018. [DOI: 10.1016/j.rgmxen.2018.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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9
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Hirota K, Kawaguchi T, Hashida R, Koya S, Bekki M, Goshima N, Yoshiyama T, Otsuka T, Nozoe R, Nakano D, Shirono T, Shimose S, Iwamoto H, Niizeki T, Matsuse H, Koga H, Shiba N, Torimura T. Profiles Associated with Sarcopenia in Hepatoma Patients Underwent Transcatheter Arterial Chemoembolization: A Data-Mining Analysis. JCSM CLINICAL REPORTS 2018. [DOI: 10.17987/jcsm-cr.v3i2.66] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background & Aims: Sarcopenia is a prognostic factor in patients with hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE) may aggravate sarcopenia because of post-embolization syndrome. The aims of this study are to investigate changes in skeletal muscle mass after TACE and its risk profiles in patients with HCC.Methods: We enrolled 104 HCC patients (age 73.5 [41.0-88.0] years, female/male 35/69, body mass index 22.4 [16.0-32.7]). Changes in skeletal muscle mass were evaluated by Δskeletal muscle index (SMI) using computed tomography before and after TACE. Factors correlated with ΔSMI were evaluated. Independent factors and profiles associated with a decrease in SMI were evaluated by multivariate analysis and decision-tree analysis, respectively.Results: SMI was significantly decreased after TACE in patients with HCC (32.8 vs. 30.6 cm2/m2; P=0.0001). However, there was no significant correlation between the ΔSMI and other variables including Δalbumin. In the logistic regression analysis, no factor was significantly associated with a decrease in SMI. In the decision-tree analysis, sex was selected as the initial split and, in female, 74% of subjects showed a decrease in SMI. While, in male, an estimated glomerular filtration rate (eGFR) ≤81.7 ml/min/1.73 m2 was the second split; of these patients, 74% of subjects had a decreased SMI.Conclusions: We demonstrated that skeletal muscle mass was decreased after TACE in patients with HCC. “female” and “male who had a lower eGFR” were profile for a decrease in skeletal muscle mass. Thus, such patients who have HCC treated with TACE may benefit from preventive treatment for sarcopenia.
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10
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Ooi PH, Gilmour SM, Yap J, Mager DR. Effects of branched chain amino acid supplementation on patient care outcomes in adults and children with liver cirrhosis: A systematic review. Clin Nutr ESPEN 2018; 28:41-51. [PMID: 30390892 DOI: 10.1016/j.clnesp.2018.07.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 07/27/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS Malnutrition is highly prevalent in chronic liver disease (CLD) due to alterations in nutrient utilization, malabsorption and poor intake. Low serum concentrations of branched chain amino acids (BCAA) in the presence of elevated aromatic acid concentrations is commonly observed in adult and children with liver cirrhosis and is associated with malnutrition and other adverse patient outcomes. The efficacy of BCAA supplementation has not been well established in adults and children with CLD. The purpose of this review was to critically evaluate the literature regarding the impact of BCAA supplementation related to changes in body composition, muscle strength, liver biomarkers, medical and hepatic complications (hepatic encephalopathy (HE), ascites, edema) and patient care outcomes (event free survival, health related quality of life, length of hospitalization). METHODS A total of 40 articles retrieved from PubMed or Web of Science databases (1989-2017) were included. RESULTS BCAA supplementation may be beneficial in improving muscle strength, ascites and edema with potential clinically significant improvements in HE in adult liver patients. In children, limited data have shown that BCAA supplementation may exert favourable effects on weight, fat mass, fat free mass and serum albumin level. CONCLUSIONS Heterogeneity of study findings attributed to variability in BCAA dose (total, relative proportions), duration, disease severity and lack of uniformity in tools used for assessing patient outcomes limit overall conclusions. Longitudinal studies examining the efficacy of BCAA supplementation as a therapeutic treatment of malnutrition in chronic liver disease is warranted.
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Affiliation(s)
- P H Ooi
- Department of Agricultural, Food & Nutritional Sciences, University of Alberta, Canada
| | - S M Gilmour
- Department of Pediatrics, University of Alberta, Canada; Division of Pediatric Gastroenterology & Nutrition/Transplant Services, The Stollery Children's Hospital, Alberta Health Services, Edmonton, Alberta, Canada
| | - J Yap
- Department of Pediatrics, University of Alberta, Canada; Division of Pediatric Gastroenterology & Nutrition/Transplant Services, The Stollery Children's Hospital, Alberta Health Services, Edmonton, Alberta, Canada
| | - D R Mager
- Department of Agricultural, Food & Nutritional Sciences, University of Alberta, Canada; Department of Pediatrics, University of Alberta, Canada.
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11
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Shiozawa S, Usui T, Kuhara K, Tsuchiya A, Miyauchi T, Kono T, Asaka S, Yamaguchi K, Yokomizo H, Shimakawa T, Yoshimatsu K, Katsube T, Naritaka Y. Impact of Branched-Chain Amino Acid-Enriched Nutrient on liver Cirrhosis with Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization in Barcelona Clinic Liver Cancer Stage B: A Prospective Study. J NIPPON MED SCH 2017; 83:248-256. [PMID: 28133005 DOI: 10.1272/jnms.83.248] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In decompensated liver cirrhosis, hypoalbuminemia still persists even after they have been treated with branched-chain amino acid (BCAA) granules. We prospectively evaluated whether BCAA enriched nutrient switched from BCAA granules would increase the serum albumin level, and consequently extend the survival time after hepatocellular carcinoma (HCC) treatment. METHODS This study included 77 patients treated for liver cirrhosis with HCC. After the nutritional assessment, all patients initially received BCAA granules. In patients with unchanged or decreased serum albumin levels, BCAA granules were discontinued and BCAA enriched nutrient was started. Transcatheter arterial chemembolization (TACE) for HCC were performed in those with an improved Child-Pugh score. RESULTS TACE were performed following the aggressive intervention with BCAA nutritional education in 54 of 77 (70.1%) patients. Finally, survival time was significantly extended in the TACE group (P<0.0001). CONCLUSION Timely aggressive nutritional intervention in Barcelona Clinic Liver Cancer stage B HCC, namely, early partial replacement with BCAA enriched nutrient may consequently improve the treatment outcome of HCC.
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Affiliation(s)
- Shunichi Shiozawa
- Department of Surgery, Tokyo Women's Medical University Medical Center East
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12
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IWASA M, SUGIMOTO R, ISHIHARA T, SEKOGUCHI-FUJIKAWA N, YOSHIKAWA K, MIFUJI-MOROKA R, TANAKA H, KOBAYASHI Y, HASEGAWA H, TAKEI Y. Usefulness of Levocarnitine and/or Branched-Chain Amino Acids during Invasive Treatment for Hepatocellular Carcinoma. J Nutr Sci Vitaminol (Tokyo) 2015; 61:433-40. [DOI: 10.3177/jnsv.61.433] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Motoh IWASA
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine
| | - Ryosuke SUGIMOTO
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine
| | - Tomoaki ISHIHARA
- Department of Gastroenterology and Hepatology, Yokkaichi Digestive Disease Center
| | | | - Kyoko YOSHIKAWA
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine
| | - Rumi MIFUJI-MOROKA
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine
| | - Hideaki TANAKA
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine
| | - Yoshinao KOBAYASHI
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine
| | - Hiroshi HASEGAWA
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine
| | - Yoshiyuki TAKEI
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine
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13
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Adjuvant and chemopreventive therapies for resectable hepatocellular carcinoma: a literature review. Tumour Biol 2014; 35:9459-68. [PMID: 25119592 DOI: 10.1007/s13277-014-2443-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 08/04/2014] [Indexed: 01/27/2023] Open
Abstract
The recurrence rate of hepatocellular carcinoma (HCC) after potentially curative hepatic resection (HR) is very high. Many clinical trials have explored the efficacy of several treatment modalities to prevent recurrence, including adjuvant and chemopreventive therapy, but they have often reported contradictory findings. As a result, most liver guidelines and liver seminars do not unequivocally endorse adjuvant or chemopreventive therapy for HCC patients after potentially curative HR. To examine the available evidence on this question, we comprehensively searched PubMed for controlled studies that included a supportive care or placebo control arm, and we used the GRADE system to classify and assess the results.
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