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Jiang YL, Li J, Zhang PF, Fan FX, Zou J, Yang P, Wang PF, Wang SY, Zhang J. Staging liver fibrosis with various diffusion-weighted magnetic resonance imaging models. World J Gastroenterol 2024; 30:1164-1176. [PMID: 38577177 PMCID: PMC10989501 DOI: 10.3748/wjg.v30.i9.1164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/15/2024] [Accepted: 02/07/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) has been developed to stage liver fibrosis. However, its diagnostic performance is inconsistent among studies. Therefore, it is worth studying the diagnostic value of various diffusion models for liver fibrosis in one cohort. AIM To evaluate the clinical potential of six diffusion-weighted models in liver fibrosis staging and compare their diagnostic performances. METHODS This prospective study enrolled 59 patients suspected of liver disease and scheduled for liver biopsy and 17 healthy participants. All participants underwent multi-b value DWI. The main DWI-derived parameters included Mono-apparent diffusion coefficient (ADC) from mono-exponential DWI, intravoxel incoherent motion model-derived true diffusion coefficient (IVIM-D), diffusion kurtosis imaging-derived apparent diffusivity (DKI-MD), stretched exponential model-derived distributed diffusion coefficient (SEM-DDC), fractional order calculus (FROC) model-derived diffusion coefficient (FROC-D) and FROC model-derived microstructural quantity (FROC-μ), and continuous-time random-walk (CTRW) model-derived anomalous diffusion coefficient (CTRW-D) and CTRW model-derived temporal diffusion heterogeneity index (CTRW-α). The correlations between DWI-derived parameters and fibrosis stages and the parameters' diagnostic efficacy in detecting significant fibrosis (SF) were assessed and compared. RESULTS CTRW-D (r = -0.356), CTRW-α (r = -0.297), DKI-MD (r = -0.297), FROC-D (r = -0.350), FROC-μ (r = -0.321), IVIM-D (r = -0.251), Mono-ADC (r = -0.362), and SEM-DDC (r = -0.263) were significantly correlated with fibrosis stages. The areas under the ROC curves (AUCs) of the combined index of the six models for distinguishing SF (0.697-0.747) were higher than each of the parameters alone (0.524-0.719). The DWI models' ability to detect SF was similar. The combined index of CTRW model parameters had the highest AUC (0.747). CONCLUSION The DWI models were similarly valuable in distinguishing SF in patients with liver disease. The combined index of CTRW parameters had the highest AUC.
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Affiliation(s)
- Yan-Li Jiang
- Department of Magnetic Resonance Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
- Second Clinical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
| | - Juan Li
- Department of Hepatology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
| | - Peng-Fei Zhang
- Department of Magnetic Resonance Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
- Second Clinical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
| | - Feng-Xian Fan
- Department of Magnetic Resonance Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
| | - Jie Zou
- Department of Magnetic Resonance Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
| | - Pin Yang
- Department of Magnetic Resonance Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
| | - Peng-Fei Wang
- Department of Magnetic Resonance Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
| | - Shao-Yu Wang
- MR Scientific Marketing, Siemens Healthineers, Xi’an 710065, Shaanxi Province, China
| | - Jing Zhang
- Department of Magnetic Resonance Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu Province, China
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Li QY, Gong T, Huang YK, Kang L, Warner CA, Xie H, Chen LM, Duan XQ. Role of noncoding RNAs in liver fibrosis. World J Gastroenterol 2023; 29:1446-1459. [PMID: 36998425 PMCID: PMC10044853 DOI: 10.3748/wjg.v29.i9.1446] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/27/2022] [Accepted: 02/27/2023] [Indexed: 03/07/2023] Open
Abstract
Liver fibrosis is a wound-healing response following chronic liver injury caused by hepatitis virus infection, obesity, or excessive alcohol. It is a dynamic and reversible process characterized by the activation of hepatic stellate cells and excess accumulation of extracellular matrix. Advanced fibrosis could lead to cirrhosis and even liver cancer, which has become a significant health burden worldwide. Many studies have revealed that noncoding RNAs (ncRNAs), including microRNAs, long noncoding RNAs and circular RNAs, are involved in the pathogenesis and development of liver fibrosis by regulating signaling pathways including transforming growth factor-β pathway, phosphatidylinositol 3-kinase/protein kinase B pathway, and Wnt/β-catenin pathway. NcRNAs in serum or exosomes have been reported to tentatively applied in the diagnosis and staging of liver fibrosis and combined with elastography to improve the accuracy of diagnosis. NcRNAs mimics, ncRNAs in mesenchymal stem cell-derived exosomes, and lipid nanoparticles-encapsulated ncRNAs have become promising therapeutic approaches for the treatment of liver fibrosis. In this review, we update the latest knowledge on ncRNAs in the pathogenesis and progression of liver fibrosis, and discuss the potentials and challenges to use these ncRNAs for diagnosis, staging and treatment of liver fibrosis. All these will help us to develop a comprehensive understanding of the role of ncRNAs in liver fibrosis.
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Affiliation(s)
- Qing-Yuan Li
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Tao Gong
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Yi-Ke Huang
- Center for Transfusion-transmitted Infectious Diseases, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, Sichuan Province, China
| | - Lan Kang
- Center for Transfusion-transmitted Infectious Diseases, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, Sichuan Province, China
| | - Charlotte A Warner
- Liver Center and Gastrointestinal Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - He Xie
- Department of Clinical Laboratory, The Hospital of Xidian Group, Xi’an 710077, Shaanxi Province, China
| | - Li-Min Chen
- Center for Transfusion-transmitted Infectious Diseases, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, Sichuan Province, China
- Department of Clinical Laboratory, The Hospital of Xidian Group, Xi’an 710077, Shaanxi Province, China
| | - Xiao-Qiong Duan
- Center for Transfusion-transmitted Infectious Diseases, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, Sichuan Province, China
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Liu X, Zhou J, Zhu L, Zhang X, Li F. Diagnostic accuracy of apparent diffusion coefficient values combined with γ-glutamyl transpeptidase-to-platelet ratio parameters for predicting hepatitis B-related fibrosis. Clin Res Hepatol Gastroenterol 2022; 46:101968. [PMID: 35649482 DOI: 10.1016/j.clinre.2022.101968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/12/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The accuracy of non-invasive liver fibrosis diagnosis based on the apparent diffusion coefficient (ADC) value combined with the γ-glutamyl transpeptidase-to-platelet ratio (GPR) model to predict the stage of hepatitis B-related fibrosis has not been reported. This study aimed to evaluate the diagnostic efficacy of ADC value combined with GPR for liver fibrosis grading. METHODS The data of 180 patients with chronic hepatitis B (CHB) diagnosed by liver biopsy were analyzed. The ADC value, GPR, and their combination were assessed in different cirrhosis stages using receiver operating characteristic curve analysis to evaluate their value in diagnosing liver fibrosis. RESULTS We observed that liver fibrosis stages were inversely associated with ADC values (r=-0.691, P<0.001), and positively associated with GPR (r=0.502, P<0.001). The area under the curve for diagnostic efficacy of ADC values, GPR, and their combination for F≥2 liver fibrosis was 0.831, 0.749, and 0.858, respectively, and for F≥3 was 0.872, 0.771, and 0.903, respectively. The diagnostic cutoffs of the combination for each stage were -7.07, -12.21 and -37.75, respectively. CONCLUSIONS The combined diagnostic tool of ADC and GPR may improve the accuracy of hepatitis B-related liver fibrosis diagnosis, especially for F≥3.
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Affiliation(s)
- Xingxiang Liu
- Department of Laboratory Medicine, Huai'an Infectious Disease Hospital, Jiangsu, China
| | - Jian Zhou
- Department of Gastroenterology, Huai'an Hospital of Huai'an City, Jiangsu, China
| | - Liyao Zhu
- Department of Hepatology, Huai'an Infectious Disease Hospital, Jiangsu, China
| | - Xin Zhang
- Department of Medical Imaging, Huai'an Infectious Disease Hospital, Jiangsu, China.
| | - Feng Li
- Department of Medical Imaging, Huai'an Infectious Disease Hospital, Jiangsu, China.
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Tsai YS, Huang CI, Tsai PC, Yeh ML, Huang CF, Hsieh MH, Liu TW, Lin YH, Liang PC, Lin ZY, Chen SC, Huang JF, Chuang WL, Dai CY, Yu ML. Circulating Let-7 Family Members as Non-Invasive Biomarkers for Predicting Hepatocellular Carcinoma Risk after Antiviral Treatment among Chronic Hepatitis C Patients. Cancers (Basel) 2022; 14:2023. [PMID: 35454929 PMCID: PMC9030777 DOI: 10.3390/cancers14082023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/26/2022] [Accepted: 04/14/2022] [Indexed: 02/01/2023] Open
Abstract
HCC, a leading cause of cancer-related mortality, is diagnosed at advanced stages. Although antiviral therapy has reduced the risk of HCC among chronic hepatitis C (CHC) patients, the risk of HCC remains, thus, highlighting the unmet need for continuous surveillance. Therefore, stable and cost-effective biomarkers, such as circulating microRNAs, must be identified. We aimed to clarify whether serum levels of the Let-7 family can predict HCC risk in patients with CHC using univariate and multivariate Cox’s proportional hazards model. We analyzed the sera of 54 patients with CHC who developed HCC after antiviral therapy and compared the data with those of 173 patients without HCC development. The Let-7 family (except for let-7c) exhibited significant negative correlations with the fibrosis score (r = −0.2736 to −0.34, p = 0.0002 to <0.0001). After Cox’s regression model was used to adjust for age, sex, HCV genotype, and FIB-4 ≥ 3.25, patients with CHC with let-7i median ≥ −1.696 (adjusted hazard ratio [aHR] = 0.31, 95% CI: 0.08−0.94, p = 0.0372) in the sustained virologic response (SVR) groups and ≥−1.696 (aHR = 0.09, 95% CI: 0.08−0.94, p = 0.0022) in the non-SVR group were less likely to develop HCC. Thus, circulating let-7i can be used for early CHC surveillance in patients with HCC risk after antiviral treatment.
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Affiliation(s)
- Yi-Shan Tsai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
| | - Ching-I Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Pei-Chien Tsai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
| | - Ming-Lun Yeh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
| | - Chung-Feng Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Meng-Hsuan Hsieh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ta-Wei Liu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
| | - Yi-Hung Lin
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
| | - Po-Cheng Liang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
| | - Zu-Yau Lin
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Shinn-Cherng Chen
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Jee-Fu Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-S.T.); (C.-I.H.); (P.-C.T.); (M.-L.Y.); (C.-F.H.); (M.-H.H.); (T.-W.L.); (Y.-H.L.); (P.-C.L.); (Z.-Y.L.); (S.-C.C.); (J.-F.H.); (W.-L.C.); (C.-Y.D.)
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Sequential HBV treatment with tenofovir alafenamide for patients with chronic hepatitis B: week 96 results from a real-world, multicenter cohort study. Hepatol Int 2022; 16:282-293. [DOI: 10.1007/s12072-021-10295-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 12/24/2021] [Indexed: 02/06/2023]
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Qiao J, Zhao C. Therapeutic effect of adenosylmethionine on viral hepatitis and related factors inducing diseas. Am J Transl Res 2021; 13:9485-9494. [PMID: 34540070 PMCID: PMC8430085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/01/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To analyze the therapeutic efficacy of adenosylmethionine on viral hepatitis and the related factors inducing disease. METHODS From May 2018 to April 2019, 137 patients with viral hepatitis who received treatment in our hospital were selected and assigned to two groups according to different treatment methods. In the control group (CG), 61 cases were treated with routine liver protection and enzyme reduction. In the research group, 76 cases were treated with adenosylmethionine on the basis of the CG. After therapy, the total response rate was analyzed in both groups, and the adverse reactions were observed during the treatment. The liver function indexes [albumin (ALB), alanine aminotransferase (ALT), glutamic acid transaminase (AST) and total bilirubin (TBIL)], liver fiber indicators [hyaluronic acid (HA), laminin (LN), type III procollagen (PCIII), type IV collagen (IV-C)], inflammatory factors [interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)] were compared in both groups before and after therapy. ELISA was applied to detect inflammatory factors in both groups before and after treatment. Logistic analysis was applied to analyze the independent risk factors affecting the curative effect of patients with viral hepatitis. RESULTS After therapy, the total response rate of patients in RG was obviously higher than that in CG; The total incidence of adverse effects in RG was obviously lower than that in CG; The improvement of liver function indexes and liver fiber indicators in RG was better than that in CG; The expression of inflammatory factors in RG was obviously lower than that in CG. Logistic analysis revealed that patients' age (>40 years old), drinking history, family history, low improvement of hepatic function and hepatic fibrosis, high level of inflammatory cytokines and routine treatment were independent prognostic factors affecting patients with viral hepatitis. CONCLUSION Adenosylmethionine intervention can promote disease recovery, reduce inflammation level and improve liver function damage for patients with viral hepatitis.
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Affiliation(s)
- Jinggui Qiao
- Department of Gastroenterology, Xi'an Gaoxing Hospital Xi'an 710000, Shaanxi Province, China
| | - Congya Zhao
- Department of Gastroenterology, Xi'an Gaoxing Hospital Xi'an 710000, Shaanxi Province, China
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Kuipers H, Hoogwater FJH, Holtman GA, van der Hoorn A, de Boer MT, de Haas RJ. Clinical value of diffusion-weighted MRI for differentiation between benign and malignant gallbladder disease: a systematic review and meta-analysis. Acta Radiol 2021; 62:987-996. [PMID: 32830511 DOI: 10.1177/0284185120950115] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Radiological differentiation between benign and malignant gallbladder disease is important but remains challenging. Furthermore, the clinical value of diffusion-weighted imaging (DWI) remains unclear. PURPOSE To determine the value of DWI in discriminating benign from malignant gallbladder disease by conducting a systematic review and meta-analysis. MATERIAL AND METHODS The literature was systematically searched. Studies analyzing diagnostic value of DWI in gallbladder disease with histopathology or follow-up as reference standard were included. Study selection and data extraction were done by two reviewers independently. Methodological quality was assessed using the QUADAS-2 tool. Sensitivity and specificity were calculated and displayed in a forest plot. A sensitivity analysis was performed in case of outliers. Pooled sensitivity and specificity of DWI were plotted on a hierarchical summary receiver operating characteristic curve. If available, the added value of DWI to conventional magnetic resonance imaging (MRI) sequences was analyzed. RESULTS Out of 2456 articles, eight studies fulfilled the inclusion criteria; 592 patients with 221 malignant lesions were included. Pooled sensitivity and specificity rates were 0.87 and 0.84, respectively. In two studies, diagnostic accuracy rates improved after adding DWI to conventional MRI (64% and 75% for conventional MRI vs. 89% and 94% after combining conventional MRI with DWI). In another study, the area under the curve increased from 0.92 to 0.95. CONCLUSION DWI appears to be an accurate imaging technique in discriminating benign from malignant gallbladder disease. To achieve optimal patient care, it should be part of multiparametric MRI and should be combined with other imaging modalities.
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Affiliation(s)
- Hendrien Kuipers
- Department of Surgery, Section Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Frederik JH Hoogwater
- Department of Surgery, Section Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gea A Holtman
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anouk van der Hoorn
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marieke T de Boer
- Department of Surgery, Section Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Robbert J de Haas
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Zhang W, Huang J, Tang Y, Yang Y, Hu H. Inhibition of fatty acid synthase (FASN) affects the proliferation and apoptosis of HepG2 hepatoma carcinoma cells via the β-catenin/C-myc signaling pathway. Ann Hepatol 2021; 19:411-416. [PMID: 32536483 DOI: 10.1016/j.aohep.2020.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Research in the last few years has proven that inhibition of fatty acid synthase (FASN) suppresses the migration and invasion of hepatoma carcinoma cells. This study aims to explore the effect of fatty acid synthase knockdown on the apoptosis and proliferation of HepG2 cells. MATERIALS AND METHODS The human liver cancer cell line HepG2 was cultured and then transfected with FASN-specific siRNA and negative control RNAi. After 48h, cells and protein lysates were used for western blotting, CCK-8 (cell counting kit-8) assays, flow cytometry and other tests. To assess cell apoptosis, Bax, Bcl-2 and caspase-3 were detected; to assess proliferation, CDK4 (cyclin-dependent kinases 4) and P21 were detected; and to determine the signaling pathway involved, β-catenin and C-myc were also detected. RESULTS Inhibition of FASN in HepG2 cells can decrease proliferation and promote apoptosis. Flow cytometry and CCK-8 assays demonstrated that the apoptosis rate of FASN-specific siRNA-transfected cells was significantly increased compared to that of the control cells (p<0.01). In addition, the cell cycle analysis revealed that FASN-specific siRNA-transfected cells induced G1 phase arrest (p<0.05), but an increasing trend in G2 (p<0.05). Compared with expression in negative RNAi-transfected cells, the expression of Bcl-2 and CDK-4 was reduced and the expression of Bax, caspase-3 and P21 was increased in FASN-specific siRNA-transfected cells (p<0.05). Regarding the signaling pathway, the expression of β-catenin and C-myc was significantly reduced when compared to that in negative control cells (p<0.05). CONCLUSIONS Inhibition of FASN suppressed the cell survival of HepG2 cells by inhibiting the β-catenin/C-myc pathway. This result suggests the potential treatment value of FASN for hepatoma carcinoma (HCC).
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Affiliation(s)
- Wenyue Zhang
- Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Juan Huang
- Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yao Tang
- Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yixuan Yang
- Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Huaidong Hu
- Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
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9
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Lin Y, Li L, Yu D, Liu Z, Zhang S, Wang Q, Li Y, Cheng B, Qiao J, Gao Y. A novel radiomics-platelet nomogram for the prediction of gastroesophageal varices needing treatment in cirrhotic patients. Hepatol Int 2021; 15:995-1005. [PMID: 34115257 DOI: 10.1007/s12072-021-10208-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 05/05/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Highly accurate noninvasive methods for predicting gastroesophageal varices needing treatment (VNT) are desired. Radiomics is a newly emerging technology of image analysis. This study aims to develop and validate a novel noninvasive method based on radiomics for predicting VNT in cirrhosis. METHODS In this retrospective-prospective study, a total of 245 cirrhotic patients were divided as the training set, internal validation set and external validation set. Radiomics features were extracted from portal-phase computed tomography (CT) images of each patient. A radiomics signature (Rad score) was constructed with the least absolute shrinkage and selection operator algorithm and tenfold cross-validation in the training set. Combined with independent risk factors, a radiomics nomogram was built with a multivariate logistic regression model. RESULTS The Rad score, consisting of 14 features from the gastroesophageal region and 5 from the splenic hilum region, was effective for VNT classification. The diagnostic performance was further improved by combining the Rad score with platelet counts, achieving an AUC of 0.987 (95% CI 0.969-1.00), 0.973 (95% CI 0.939-1.00) and 0.947 (95% CI 0.876-1.00) in the training set, internal validation set and external validation set, respectively. In efficacy and safety assessment, the radiomics nomogram could spare more than 40% of endoscopic examinations with a low risk of missing VNT (< 5%), and no more than 8.3% of unnecessary endoscopic examinations still be performed. CONCLUSIONS In this study, we developed and validated a novel, diagnostic radiomics-based nomogram which is a reliable and noninvasive method to predict VNT in cirrhotic patients. CLINICAL TRIALS REGISTRATION NCT04210297.
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Affiliation(s)
- Yiken Lin
- Department of Gastroenterology, Qilu Hospital, Cheloo College of Medicine, Shandong University, Wenhua Xi Road, 107, Jinan, 250012, Shandong, China
| | - Lijuan Li
- Shandong Province Key Laboratory of Medical Physics and Image Processing Technology, School of Physics and Electronics, Shandong Normal University, Jinan, Shandong, China
| | - Dexin Yu
- Department of Radiology, Qilu Hospital, Cheloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zhuyun Liu
- Department of Radiology, Qilu Hospital, Cheloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Shuhong Zhang
- Department of Hepatology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qiuzhi Wang
- Department of Hepatology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yueyue Li
- Department of Gastroenterology, Qilu Hospital, Cheloo College of Medicine, Shandong University, Wenhua Xi Road, 107, Jinan, 250012, Shandong, China
| | - Baoquan Cheng
- Department of Gastroenterology, Qilu Hospital, Cheloo College of Medicine, Shandong University, Wenhua Xi Road, 107, Jinan, 250012, Shandong, China
| | - Jianping Qiao
- Shandong Province Key Laboratory of Medical Physics and Image Processing Technology, School of Physics and Electronics, Shandong Normal University, Jinan, Shandong, China.
| | - Yanjing Gao
- Department of Gastroenterology, Qilu Hospital, Cheloo College of Medicine, Shandong University, Wenhua Xi Road, 107, Jinan, 250012, Shandong, China.
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10
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Cao Y, Tao Q, Kao X, Zhu X. Hsa-circRNA-103809 Promotes Hepatocellular Carcinoma Development via MicroRNA-1270/PLAG1 Like Zinc Finger 2 Axis. Dig Dis Sci 2021; 66:1524-1532. [PMID: 32683589 DOI: 10.1007/s10620-020-06416-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 06/14/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death in the worldwide. A great number of reports manifested that circular RNA hsa-circRNA-103809 (circRNA-103809) could work in several cancers. AIMS This study aimed to explore the function and mechanism of circRNA-103809 in HCC. METHODS Gene expressions were detected by quantitative real-time polymerase chain reaction. Colony formation, cell counting kit-8, transwell and wound healing assays were implemented to check the role of circRNA-103809 in HCC. Subcellular fractionation analysis was designed to figure out the cellular location of circRNA-103809. Luciferase reporter assay and RNA pull down assay were employed to verify the relationships among RNAs. RESULTS CircRNA-103809 was highly expressed in HCC cell lines. After interfering circRNA-103809, the proliferation, migration, invasion and epithelial-to-mesenchymal transition process were all hindered in HCC cells. Significantly, circRNA-103809 competed with PLAG1 like zinc finger 2 (PLAGL2) for binding with microRNA-1270 (miR-1270), which formulated a competing endogenous RNA network in HCC. Thereafter, we verified the tumor-facilitating effect of circRNA-103809/miR-1270/PLAGL2 axis on biological behaviors of HCC cells. CONCLUSION Hsa-circRNA-103809 promoted development of HCC via sequestering miR-1270 and up-regulating PLAGL2.
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Affiliation(s)
- Yajuan Cao
- Department of General Surgery, Nanjing Drum Tower Hospital, No. 321 Zhongshan Road, Nanjing, 210000, Jiangsu, China
| | - Qingsong Tao
- Department of General Surgery, Zhongda Hospital, Clinical School of Southeast University, Nanjing, 210000, Jiangsu, China
| | - Xiaoming Kao
- Department of General Surgery, Jinling Hospital, Nanjing Medical School of Nanjing University, Nanjing, 210000, Jiangsu, China
| | - Xinhua Zhu
- Department of General Surgery, Nanjing Drum Tower Hospital, No. 321 Zhongshan Road, Nanjing, 210000, Jiangsu, China.
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11
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Kang SH, Lee M, Kim MY, Lee JH, Jun BG, Kim TS, Choi DH, Suk KT, Kim YD, Cheon GJ, Kim DJ, Baik SK. The longitudinal outcomes of applying non-selective beta-blockers in portal hypertension: real-world multicenter study. Hepatol Int 2021; 15:424-436. [PMID: 33860898 DOI: 10.1007/s12072-021-10160-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM We investigated the effect of non-selective β-blockers (NSBB) in real-world situations and whether low-dose NSBB is beneficial compared to maximally tolerated doses. METHODS We performed a retrospective study of 740 patients with cirrhosis requiring prophylactic treatment of esophageal varices: 473 primary prophylaxis (PP: NSBB = 349, non-NSBB = 124) and 267 secondary prophylaxis (SP: NSBB = 200, non-NSBB = 67). The NSBB group was divided into low-dose (≤ 80 mg/day) and high-dose (> 80 mg/day). RESULTS In the PP group, NSBB treatment reduced mortality and showed the most pronounced effect in patients with moderate/severe ascites (hazard ratio [HR], 0.46; p < 0.01), HVPG ≥ 16 mmHg (HR, 0.53; p = 0.04), or CTP class B/C (HR, 0.46; p < 0.01) but not in those with no/mild ascites, HVPG < 16 mmHg, or CTP class A. Low-dose NSBB group showed a significant reduction in mortality compared with non-NSBB (moderate/severe ascites: HR, 0.61; p = 0.02 and CTP class B/C: HR, 0.41; p < 0.01) and the effect size was stronger than the high-dose NSBB. NSBB was associated with a reduced risk of infection (HR, 0.36; p = 0.01). In the SP group, NSBB prolonged survival in patients with moderate/severe ascites (HR, 0.56; p = 0.02), HVPG ≥ 16 mmHg (HR, 0.42; p < 0.01), or CTP class B/C (HR, 0.52; p < 0.01). Low-dose NSBB was more beneficial with 56% risk reduction (p < 0.01) of mortality compared with 33% risk reduction in the high-dose NSBB (p = 0.05). CONCLUSION NSBB therapy was associated with longer survival in PP and SP groups who had an advanced stage of cirrhosis. Moreover, low-dose NSBB exhibited a better benefit than a standard-titrated high-dose NSBB with better tolerability.
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Affiliation(s)
- Seong Hee Kang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, 26426, Korea.,Regenerative Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea.,Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Minjong Lee
- School of Medicine, Ewha Womans University, Seoul, Korea.,Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Moon Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, 26426, Korea. .,Regenerative Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea. .,Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
| | - Jun Hyeok Lee
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Baek Gyu Jun
- Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung, Korea.,Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Tae Suk Kim
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Dae Hee Choi
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Ki Tae Suk
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Young Don Kim
- Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung, Korea
| | - Gab Jin Cheon
- Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung, Korea
| | - Dong Joon Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Soon Koo Baik
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, 26426, Korea.,Regenerative Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea.,Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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Liu GM, Zeng HD, Zhang CY, Xu JW. Identification of METTL3 as an Adverse Prognostic Biomarker in Hepatocellular Carcinoma. Dig Dis Sci 2021; 66:1110-1126. [PMID: 32333311 DOI: 10.1007/s10620-020-06260-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 04/08/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION N6-methyladenosine (m6A), the most prominent mRNA modification, plays a critical role in many physiological and pathological processes. However, the roles of m6A RNA modification in hepatocellular carcinoma (HCC) remain largely unknown. MATERIALS AND METHODS We investigated the mRNA expression and clinical significance of m6A-related genes using data from The Cancer Genome Atlas (TCGA) liver hepatocellular carcinoma cohort. Mutation, copy number variation (CNV), methylation, differential expression, and gene ontology analyses, gene set enrichment analysis and the construction of a competing endogenous RNA (ceRNA) regulatory network were performed to investigate the underlying mechanisms of the aberrant expression of m6A-related genes. RESULTS m6A-related genes were frequently dysregulated in cancers but with a cancer-specific pattern. METTL3, YTHDF2, and ZC3H13 were found to be independent prognostic factors of overall survival (OS); however, only METTL3 was found to be an independent prognostic factor of recurrence-free survival (RFS). Joint effects analysis showed the predictive capacity of combining METTL3, YTHDF2, and ZC3H13 for HCC OS. Then the potential mechanisms of METTL3 were further explored due to its prognostic role in both OS and RFS. CNV and DNA methylation, but not somatic mutations, might contribute to the abnormal upregulation of METTL3 in HCC. Significantly altered genes, microRNAs, and lncRNAs were identified, and a ceRNA regulatory network was constructed to explain the upregulation of METTL3 in HCC. CONCLUSIONS Our study identified several m6A-related genes, especially METTL3, that could be potential prognostic biomarkers in HCC.
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Affiliation(s)
- Gao-Min Liu
- Department of Hepatobiliary Surgery, Meizhou People's Hospital, No. 63 Huangtang Road, Meizhou, 514000, China. .,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China.
| | - Hua-Dong Zeng
- Department of Hepatobiliary Surgery, Meizhou People's Hospital, No. 63 Huangtang Road, Meizhou, 514000, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China
| | - Cai-Yun Zhang
- Department of Hepatobiliary Surgery, Meizhou People's Hospital, No. 63 Huangtang Road, Meizhou, 514000, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China
| | - Ji-Wei Xu
- Department of Hepatobiliary Surgery, Meizhou People's Hospital, No. 63 Huangtang Road, Meizhou, 514000, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China
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13
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Attenuation Imaging with Ultrasound as a Novel Evaluation Method for Liver Steatosis. J Clin Med 2021; 10:jcm10050965. [PMID: 33801163 PMCID: PMC7957732 DOI: 10.3390/jcm10050965] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Abstract
In recent years, ultrasound attenuation imaging (ATI) has emerged as a new method to detect liver steatosis. However, thus far, no studies have confirmed the clinical utility of this technology. Using a retrospective database analysis of 28 patients with chronic liver disease who underwent ultrasound liver biopsy and ATI, we compared the presence and degree of steatosis measured by ATI with the results obtained through liver biopsy. The area under the receiver operating characteristic curve (AUROC) of the ATI for differentiating between normal and hepatic steatosis was 0.97 (95% confidence interval: 0.83–1.00). The AUROC of the ATI was 0.99 (95% confidence interval: 0.86–1.00) in grade ≥2 liver steatosis and 0.97 (95% confidence interval: 0.82–1.00) in grade 3. ATI showed good consistency and accuracy for the steatosis grading of liver biopsy. Therefore, ATI represents a novel diagnostic measurement to support the diagnosis of liver steatosis in non-invasive clinical practice.
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14
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Validation of original, expanded Baveno VI, and stepwise & platelet-MELD criteria to rule out varices needing treatment in compensated cirrhosis from various etiologies. Ann Hepatol 2021; 19:209-213. [PMID: 31607647 DOI: 10.1016/j.aohep.2019.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/31/2019] [Accepted: 08/07/2019] [Indexed: 02/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES The Baveno VI criteria to rule out varices needing treatment (VNT) was introduced in 2015. Soon after, the expanded Baveno VI and stepwise platelet-MELD criteria were proposed to be equal/more accurate in ruling out VNT; however, neither has been widely validated. We aimed to validate all 3 criteria in compensated cirrhosis from assorted causes. MATERIALS AND METHODS We conducted a cross-sectional study including all adult compensated cirrhotic patients who underwent endoscopic surveillance at our center from 2014 to 2018 and had transient elastography (TE), and laboratory data for criteria calculation within 6 months of endoscopies. Exclusion criteria were previous decompensation, unreliable/invalid TE results, and liver cancer. The diagnostic performances of all criteria were evaluated. RESULTS A total of 128 patients were included. The major cirrhosis etiologies were hepatitis C and B (37.5% and 32.8%, respectively). VNT was observed in 7.8%. All criteria yielded high negative predictive values (NPVs)>95%, missed VNT was observed in 2%, 2.7%, and 2.8% in the original, expanded Baveno VI, and platelet-MELD criteria, respectively. The expanded Baveno VI and the platelet-MELD criteria yielded significantly better specificities and could spare more endoscopies than the original Baveno VI criteria. CONCLUSIONS All 3 criteria showed satisfactorily high NPVs in ruling out VNT in compensated cirrhosis from various causes. The expanded Baveno VI and the platelet-MELD criteria could spare more endoscopies than the original Baveno VI criteria. From a public health standpoint, the platelet-MELD criteria might be useful in a resource-limited setting where TE is not widely available.
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15
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Tsurusaki M, Sofue K, Hori M, Sasaki K, Ishii K, Murakami T, Kudo M. Dual-Energy Computed Tomography of the Liver: Uses in Clinical Practices and Applications. Diagnostics (Basel) 2021; 11:diagnostics11020161. [PMID: 33499201 PMCID: PMC7912647 DOI: 10.3390/diagnostics11020161] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/10/2021] [Accepted: 01/20/2021] [Indexed: 02/06/2023] Open
Abstract
Dual-energy computed tomography (DECT) is an imaging technique based on data acquisition at two different energy settings. Recent advances in CT have allowed data acquisitions and simultaneous analyses of X-rays at two energy levels, and have resulted in novel developments in the field of abdominal imaging. The use of low and high X-ray tube voltages in DECT provide fused images that improve the detection of liver tumors owing to the higher contrast-to-noise ratio (CNR) of the tumor compared with the liver. The use of contrast agents in CT scanning improves image quality by enhancing the CNR and signal-to-noise ratio while reducing beam-hardening artifacts. DECT can improve detection and characterization of hepatic abnormalities, including mass lesions. The technique can also be used for the diagnosis of steatosis and iron overload. This article reviews and illustrates the different applications of DECT in liver imaging.
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Affiliation(s)
- Masakatsu Tsurusaki
- Department of Radiology, Faculty of Medicine, Kindai University, Osakasayama 589-8511, Japan;
- Correspondence: ; Tel.: +81-72-366-0221 (ext. 3133); Fax: +81-72-367-1685
| | - Keitaro Sofue
- Department of Radiology, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (K.S.); (M.H.); (T.M.)
| | - Masatoshi Hori
- Department of Radiology, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (K.S.); (M.H.); (T.M.)
| | - Kosuke Sasaki
- CT Research Group, GE Healthcare Japan, Hino 191-8503, Japan;
| | - Kazunari Ishii
- Department of Radiology, Faculty of Medicine, Kindai University, Osakasayama 589-8511, Japan;
| | - Takamichi Murakami
- Department of Radiology, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (K.S.); (M.H.); (T.M.)
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University, Faculty of Medicine, Osakasayama 589-8511, Japan;
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Zhou LY, Lin SN, Rieder F, Chen MH, Zhang SH, Mao R. Noncoding RNAs as Promising Diagnostic Biomarkers and Therapeutic Targets in Intestinal Fibrosis of Crohn's Disease: The Path From Bench to Bedside. Inflamm Bowel Dis 2020; 27:971-982. [PMID: 33324986 PMCID: PMC8344842 DOI: 10.1093/ibd/izaa321] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Indexed: 12/12/2022]
Abstract
Fibrosis is a major pathway to organ injury and failure, accounting for more than one-third of deaths worldwide. Intestinal fibrosis causes irreversible and serious clinical complications, such as strictures and obstruction, secondary to a complex pathogenesis. Under the stimulation of profibrotic soluble factors, excessive activation of mesenchymal cells causes extracellular matrix deposition via canonical transforming growth factor-β/Smads signaling or other pathways (eg, epithelial-to-mesenchymal transition and endothelial-to-mesenchymal transition) in intestinal fibrogenesis. In recent studies, the importance of noncoding RNAs (ncRNAs) stands out in fibrotic diseases in that ncRNAs exhibit a remarkable variety of biological functions in modulating the aforementioned fibrogenic responses. In this review, we summarize the role of ncRNAs, including the emerging long ncRNAs and circular RNAs, in intestinal fibrogenesis. Notably, the translational potential of ncRNAs as diagnostic biomarkers and therapeutic targets in the management of intestinal fibrosis is discussed based on clinical trials from fibrotic diseases in other organs. The main points of this review include the following: • Characteristics of ncRNAs and mechanisms of intestinal fibrogenesis • Wide participation of ncRNAs (especially the emerging long ncRNAs and circular RNAs) in intestinal fibrosis, including transforming growth factor-β signaling, epithelial-to-mesenchymal transition/endothelial-to-mesenchymal transition, and extracellular matrix remodeling • Translational potential of ncRNAs in the diagnosis and treatment of intestinal fibrosis based on clinical trials from fibrotic diseases in other organs.
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Affiliation(s)
- Long-Yuan Zhou
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Si-Nan Lin
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Florian Rieder
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Min-Hu Chen
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Sheng-Hong Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China,Address correspondence to: Ren Mao, MD, Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2nd, Guangzhou 510080, People’s Republic of China; Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, OH (); and Sheng-Hong Zhang, MD, Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2nd, Guangzhou 510080, People’s Republic of China ()
| | - Ren Mao
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China,Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA,Address correspondence to: Ren Mao, MD, Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2nd, Guangzhou 510080, People’s Republic of China; Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, OH (); and Sheng-Hong Zhang, MD, Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2nd, Guangzhou 510080, People’s Republic of China ()
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The miR-21 potential of serving as a biomarker for liver diseases in clinical practice. Biochem Soc Trans 2020; 48:2295-2305. [PMID: 33119045 DOI: 10.1042/bst20200653] [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: 07/05/2020] [Revised: 09/18/2020] [Accepted: 10/05/2020] [Indexed: 12/11/2022]
Abstract
The role of miR-21 in the pathogenesis of various liver diseases, together with the possibility of detecting microRNA in the circulation, makes miR-21 a potential biomarker for noninvasive detection. In this review, we summarize the potential utility of extracellular miR-21 in the clinical management of hepatic disease patients and compared it with the current clinical practice. MiR-21 shows screening and prognostic value for liver cancer. In liver cirrhosis, miR-21 may serve as a biomarker for the differentiating diagnosis and prognosis. MiR-21 is also a potential biomarker for the severity of hepatitis. We elucidate the disease condition under which miR-21 testing can reach the expected performance. Though miR-21 is a key regulator of liver diseases, microRNAs coordinate with each other in the complex regulatory network. As a result, the performance of miR-21 is better when combined with other microRNAs or classical biomarkers under certain clinical circumstances.
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Gotlieb N, Schwartz N, Zelber-Sagi S, Chodick G, Shalev V, Shibolet O. Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis. World J Gastroenterol 2020; 26:5849-5862. [PMID: 33132639 PMCID: PMC7579756 DOI: 10.3748/wjg.v26.i38.5849] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/10/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver cirrhosis is a significant source of morbidity and mortality worldwide. The disease is usually indolent and asymptomatic early in its course while many cirrhotic patients are diagnosed late when severe complications occur. A major challenge is to diagnose advanced fibrosis as early as possible, using simple and non-invasive diagnostics tools. Thrombocytopenia represents advanced fibrosis and portal hypertension (HTN) and most non-invasive scores that predict liver fibrosis incorporate platelets as a strong risk factor. However, little is known about the association between longitudinal changes in platelet counts (PTC), when still within the normal range, and the risk of cirrhosis.
AIM To explore whether platelet counts trajectories over time, can predict advanced liver fibrosis across the different etiologies of liver diseases.
METHODS A nested case-control study utilizing a large computerized database. Cirrhosis cases (n = 5258) were compared to controls (n = 15744) matched for age and sex at a ratio of 1:3. All participants had multiple laboratory measurements prior to enrollment. We calculated the trends of PTC, liver enzymes, bilirubin, international normalized ratio, albumin and fibrosis scores (fibrosis-4 and aspartate transaminase-to-platelet ratio index) throughout the preceding 20 years prior to cirrhosis diagnosis compared to healthy controls. The association between PTC, cirrhosis complications and fibrosis scores prior to cirrhosis diagnosis was investigated.
RESULTS The mean age in both groups was 56 (SD 15.8). Cirrhotic patients were more likely to be smokers, diabetic with chronic kidney disease and had a higher prevalence of HTN. The leading cirrhosis etiologies were viral, alcoholic and fatty liver disease. The mean PTC decreased from 240000/μL to 190000/μL up to 15 years prior to cirrhosis diagnosis compared to controls who’s PTC remained stable around the values of 240000/μL. This trend was consistent regardless of sex, cirrhosis etiology and was more pronounced in patients who developed varices and ascites. Compared to controls whose values remained in the normal range, in the cirrhosis group aspartate aminotransferase and alanine aminotransferase, increased from 40 U/L to 75 U/L and FIB-4 increased gradually from 1.3 to 3 prior to cirrhosis diagnosis. In multivariable regression analysis, a decrease of 50 units in PTC was associated with 1.3 times odds of cirrhosis (95%CI 1.25-1.35).
CONCLUSION In the preceding years before the diagnosis of cirrhosis, there is a progressive decline in PTC, within the normal range, matched to a gradual increase in fibrosis scores.
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Affiliation(s)
- Neta Gotlieb
- Department of Gastroenterology and Hepatology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Naama Schwartz
- School of Public Health, University of Haifa, Haifa 3498838, Israel
| | - Shira Zelber-Sagi
- Department of Gastroenterology and Hepatology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- School of Public Health, University of Haifa, Haifa 3498838, Israel
| | - Gabriel Chodick
- Institute for Research and Innovation, Maccabi Health Services, Tel Aviv 6812509, Israel
| | - Varda Shalev
- Institute for Research and Innovation, Maccabi Health Services, Tel Aviv 6812509, Israel
| | - Oren Shibolet
- Department of Gastroenterology and Hepatology, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Medeiros AK, Barbisan CC, Cruz IR, de Araújo EM, Libânio BB, Albuquerque KS, Torres US. Higher frequency of hepatic steatosis at CT among COVID-19-positive patients. Abdom Radiol (NY) 2020; 45:2748-2754. [PMID: 32683613 PMCID: PMC7368629 DOI: 10.1007/s00261-020-02648-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 02/07/2023]
Abstract
Purpose Recent studies have demonstrated that obesity is significantly associated with increased disease severity, hospitalizations and mortality in COVID-19, with a potential role in the pathogenesis and prevalence in the new pandemic. The association with hepatic steatosis, however, a condition closely related to obesity within the spectrum of systemic metabolic dysfunctions, remains to be elucidated. We aimed to evaluate the frequency of hepatic steatosis as incidentally detected in chest CT examinations of COVID-19 positive patients in comparison to non-infected controls. Methods A retrospective study was performed with 316 patients (204 RT-PCR positive; 112 RT-PCR negative and chest CT negative). Steatosis was measured with placement of a single ROI in the right lobe of the liver (segments VI-VII) and defined as a liver attenuation value ≤ 40 HU. Results The frequency of hepatic steatosis was higher in the RT-PCR positive group in comparison to controls (31.9% vs. 7.1%, p < 0.001). Logistic linear regression analysis showed a 4.7 times odds of steatosis in the COVID-19 positive group as compared to controls after adjusting for age and sex (OR 4.698; 95% IC 2.12–10.41, p < 0.001). Conclusion A significantly higher prevalence of steatosis was found among COVID-19 positive individuals. These findings are in accordance with other recent studies linking obesity and COVID-19 infection, as there is an intricate relationship between liver steatosis, metabolic syndrome and obesity. Further studies are required to confirm if such association remains after accounting for multiple variables, as well as possible relationships with disease severity and worst clinical outcomes.
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Affiliation(s)
| | | | | | | | | | | | - Ulysses S Torres
- Grupo Fleury, Rua Cincinato Braga, 282, Bela Vista, São Paulo, SP, 01333-010, Brazil.
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Su W, Tai Y, Tang SH, Ye YT, Zhao C, Gao JH, Tuo BG, Tang CW. Celecoxib attenuates hepatocyte apoptosis by inhibiting endoplasmic reticulum stress in thioacetamide-induced cirrhotic rats. World J Gastroenterol 2020; 26:4094-4107. [PMID: 32821072 PMCID: PMC7403803 DOI: 10.3748/wjg.v26.i28.4094] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/21/2020] [Accepted: 06/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Endoplasmic reticulum (ER) stress is an important mechanism in the progression of chronic and acute liver diseases, especially in the progression and recovery of liver fibrosis. Excessive and long-term ER stress induces apoptosis. ER stress-induced apoptosis is considered to be an important pathway in the development of liver fibrosis. Cyclooxygenase-2 (COX-2) induction is also closely related to ER stress. In our previous studies, we showed that celecoxib, a COX-2 inhibitor, improves liver fibrosis and portal hypertension. However, the role and mechanism of celecoxib in alleviating liver fibrosis remain unclear.
AIM To investigate whether celecoxib alleviates liver fibrosis by inhibiting hepatocyte apoptosis via the ER stress response.
METHODS Cirrhosis was induced by intraperitoneal injections of thioacetamide (TAA) for 16 wk (injection dose is 200 mg/kg per 3 d for the first 8 wk and 100 mg /kg per 3 d after 8 wk). Thirty-six male Sprague-Dawley rats were randomly divided into three groups, namely, control group, TAA group, and TAA + celecoxib group. In the last 8 wk, TAA-induced cirrhotic rats received celecoxib (20 mg/kg/day) or the vehicle by gastric gavage. After 16 wk, the rats were sacrificed, and serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB) were detected. The hepatic fibrosis areas were evaluated by Sirius red staining and the degree of fibrosis was assessed by measuring the level of hydroxyproline. ER stress levels were evaluated by detecting the marker proteins glucose-regulated protein 78 (GRP78), CCAAT/enhancer binding protein homologous protein (CHOP), PKR-like ER protein kinase (PERK), activating transcription factor 6 (ATF6), and inositol-requiring enzyme 1 alpha (IRE1α). Apoptosis levels were evaluated by detecting caspase-12 and caspase-3.
RESULTS The serum ALT and AST levels in the liver were significantly reduced by celecoxib; however, the serum ALB had no significant changes. Celecoxib significantly reduced the degree of liver fibrosis and the levels of hydroxyproline (-38% and -25.7%, respectively, P < 0.01). Celecoxib ameliorated ER stress by reducing the level of GRP78 compared to the TAA group (P < 0.05). Consistently, after celecoxib administration, the upregulation of TAA-induced hepatic apoptosis markers (caspase-12 and caspase-3) and CHOP were significantly inhibited. In addition, after celecoxib treatment, the expression of key molecules associated with ER stress (PERK, ATF6, and IRE1) was decreased (P < 0.05).
CONCLUSION Therapeutic administration of celecoxib effectively reduces hepatic apoptosis in TAA-induced cirrhotic rats. The mechanism of action may be attributed to the suppression of CHOP expression, which subsequently inhibits ER stress.
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Affiliation(s)
- Wei Su
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Department of Gastroenterology, Affiliated Hospital, Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Yang Tai
- Laboratory of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Shi-Hang Tang
- Laboratory of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yan-Ting Ye
- Laboratory of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chong Zhao
- Laboratory of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jin-Hang Gao
- Laboratory of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bi-Guang Tuo
- Department of Gastroenterology, Affiliated Hospital, Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Cheng-Wei Tang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Laboratory of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Yao QY, Feng YD, Han P, Yang F, Song GQ. Hepatic microenvironment underlies fibrosis in chronic hepatitis B patients. World J Gastroenterol 2020; 26:3917-3928. [PMID: 32774066 PMCID: PMC7385564 DOI: 10.3748/wjg.v26.i27.3917] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 05/15/2020] [Accepted: 06/30/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chronic hepatitis B virus (HBV) infection is a leading cause of liver morbidity and mortality worldwide. Liver fibrosis resulting from viral infection-associated inflammation and direct liver damage plays an important role in disease management and prognostication. The mechanisms underlying the contribution of the liver microenvironment to fibrosis in HBV patients are not fully understood. There is an absence of effective clinical treatments for liver fibrosis progression; thus, establishing a suitable in vitro microenvironment in order to design novel therapeutics and identify molecular biomarkers to stratify patients is urgently required.
AIM To examine a subset of pre-selected microenvironment factors of chronic HBV patients that may underlie fibrosis, with a focus on fibroblast activation.
METHODS We examined the gene expression of key microenvironment factors in liver samples from patients with more advanced fibrosis compared with those with less severe fibrosis. We also used the human stellate cell line LX-2 in the in vitro study. Using different recombinant cytokines and growth factors or their combination, we studied how these factors interacted with LX-2 cells and pinpointed the cross-talk between the aforementioned factors and screened the most important factors.
RESULTS Of the secreted factors examined, transforming growth factor (TGF)-β1, interleukin (IL)-1β and tumor necrosis factor (TNF)-α were increased in patients with advanced fibrosis. We found that besides TGF-β1, IL-1β can also induce a profibrotic cascade by stimulating the expression of connective tissue growth factor and platelet-derived growth factor (PDGF) in LX-2 cells. Furthermore, the proinflammatory response can be elicited in LX-2 cells following treatment with IL-1β and TNF-α, suggesting that stellate cells can respond to proinflammatory stimuli. By combining IL-1β and TGF-β1, we observed not only fibroblast activation as shown by αlpha-smooth muscle actin and PDGF induction, but also the inflammatory response as shown by increased expression of IL-1β.
CONCLUSION Collectively, our data from HBV patients and in vitro studies demonstrate that the hepatic microenvironment plays an important role in mediating the crosstalk between profibrotic and proinflammatory responses and modulating fibrosis in chronic HBV patients. For the establishment of a suitable in vitro microenvironment for HBV-induced liver fibrosis, not only TGF-β1 but also IL-1β should be considered as a necessary environmental factor.
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Affiliation(s)
- Qun-Yan Yao
- Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 201332, China
- Shanghai Institute of Liver Diseases, Shanghai 201332, China
| | - Ya-Dong Feng
- Otsuka Shanghai Research Institute, Shanghai 201318, China
| | - Pei Han
- Otsuka Shanghai Research Institute, Shanghai 201318, China
| | - Feng Yang
- Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Guang-Qi Song
- Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 201332, China
- Shanghai Institute of Liver Diseases, Shanghai 201332, China
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22
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Ye Z, Wei Y, Chen J, Yao S, Song B. Value of intravoxel incoherent motion in detecting and staging liver fibrosis: A meta-analysis. World J Gastroenterol 2020; 26:3304-3317. [PMID: 32684744 PMCID: PMC7336331 DOI: 10.3748/wjg.v26.i23.3304] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/26/2020] [Accepted: 05/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver fibrosis (LF) is a common pathological feature of all chronic liver diseases. With the accumulation of extracellular matrix in the fibrotic liver, true molecular water diffusion and perfusion-related diffusion are restricted. Intravoxel incoherent motion (IVIM) can capture the information on tissue diffusivity and microcapillary perfusion separately and reflect the fibrotic severity with diffusion coefficients.
AIM To investigate the diagnostic performance of IVIM in detecting and staging LF with histology as a reference standard.
METHODS A comprehensive literature search was conducted to identify studies on the diagnostic accuracy of IVIM for assessment of histologically proven LF. The stages of LF were classified as F0 (no fibrosis), F1 (portal fibrosis without septa), F2 (periportal fibrosis with few septa), F3 (septal fibrosis), and F4 (cirrhosis) according to histopathological findings. Data were extracted to calculate the pooled sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio, as well as the area under the summary receiver operating characteristic curve (AUC) in each group.
RESULTS A total of 12 studies with 923 subjects were included in this meta-analysis with 5 studies (n = 465) for LF ≥ F1, 9 studies (n = 757) for LF ≥ F2, 4 studies (n = 413) for LF ≥ F3, and 6 studies (n = 562) for LF = F4. The pooled sensitivity and specificity were estimated to be 0.78 (95% confidence interval: 0.73-0.82) and 0.81 (0.74-0.86) for LF ≥ F1 detection with IVIM; 0.82 (0.79-0.86) and 0.80 (0.75-0.84) for staging F2 fibrosis; 0.85 (0.79-0.90) and 0.83 (0.77-0.87) for staging F3 fibrosis, and 0.90 (0.84-0.94) and 0.75 (0.70-0.79) for detecting F4 cirrhosis, respectively. The AUCs for LF ≥ F1, F2, F3, F4 detection were 0.862 (0.811-0.914), 0.883 (0.856-0.909), 0.886 (0.865-0.907), and 0.899 (0.866-0.932), respectively. Moderate to substantial heterogeneity was observed with inconsistency index (I2) ranging from 0% to 77.9%. No publication bias was detected.
CONCLUSION IVIM is a noninvasive tool with good diagnostic performance in detecting and staging LF. Optimized and standardized IVIM protocols are needed to further improve its diagnostic accuracy in clinical practice.
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Affiliation(s)
- Zheng Ye
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi Wei
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jie Chen
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Shan Yao
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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23
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Liver Imaging Reporting and Data System Version 2018: What Radiologists Need to Know. J Comput Assist Tomogr 2020; 44:168-177. [PMID: 32195795 DOI: 10.1097/rct.0000000000000995] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In this article, we aim to review Liver Imaging Reporting and Data System version 18 (LI-RADS v2018). Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy. Liver Imaging Reporting and Data System developed for standardizing interpreting, reporting, and data collection of HCC describes 5 major features for accurate HCC diagnosis and several ancillary features, some favoring HCC in particular or malignancy in general and others favoring benignity. Untreated hepatic lesions LI-RADS affords 8 unique categories based on imaging appearance on computed tomography and magnetic resonance imaging, which indicate the possibility of HCC or malignancy with or without tumor in vein. Furthermore, LI-RADS defines 4 treatment response categories for treated HCCs after different locoregional therapy. These continuous recent updates on LI-RADS improve the communication between the radiologists and the clinicians for better management and patient outcome.
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Noda Y, Goshima S, Okuaki T, Akamine Y, Kajita K, Kawai N, Kawada H, Tanahashi Y, Matsuo M. Hepatocyte fraction: correlation with noninvasive liver functional biomarkers. Abdom Radiol (NY) 2020; 45:83-89. [PMID: 31552466 DOI: 10.1007/s00261-019-02238-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate the correlation between HeF obtained from gadoxetic acid-enhanced MR imaging and clinical biomarkers for the assessment of liver function. METHODS This prospective study was approved by our Institutional Review Board, and written informed consent was obtained from the patients. We recruited 48 patients carrying a known or suspected liver disease to undergo gadoxetic acid-enhanced MR imaging. The new model of the HeF was calculated from ΔR1 values of the liver and spleen. The HeF, quantitative liver-to-spleen contrast ratio (Q-LSC), and ΔT1 value (the reduction rate of the T1 value between the pre- and post-contrast images) were compared with the Child-Pugh and end-stage liver disease (MELD) scores. RESULTS Among 48 patients, 40 were in Child-Pugh class A and 8 were in class B. The median HeF (P = 0.0001), Q-LSC (P = 0.015), and ΔT1 value (P = 0.0023) in patients in Child-Pugh class A were significantly higher than those in class B. The sensitivities, specificities, and area under the receiver-operating-characteristic curves for differentiating Child-Pugh class A and B were 95.0%, 87.5%, and 0.93 in the HeF; 77.5%, 75.0%, and 0.78 in the Q-LSC; and 57.5%, 100.0%, and 0.84 in the ΔT1 value, respectively. The HeF was significantly correlated with Child-Pugh (r = - 0.58, P < 0.0001) and MELD score (r = - 0.57, P < 0.0001). CONCLUSIONS The HeF was well correlated with Child-Pugh and MELD score and could be a new biomarker to assess liver function.
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Affiliation(s)
- Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Satoshi Goshima
- Department of Diagnostic Radiology & Nuclear Medicine, Hamamatsu University, Hamamatsu, Japan
| | | | | | - Kimihiro Kajita
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Nobuyuki Kawai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Hiroshi Kawada
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yukichi Tanahashi
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
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Fan B, Jin Y, Zhang H, Zhao R, Sun M, Sun M, Yuan X, Wang W, Wang X, Chen Z, Liu W, Yu N, Wang Q, Liu T, Li X. MicroRNA‑21 contributes to renal cell carcinoma cell invasiveness and angiogenesis via the PDCD4/c‑Jun (AP‑1) signalling pathway. Int J Oncol 2019; 56:178-192. [PMID: 31789394 DOI: 10.3892/ijo.2019.4928] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 10/14/2019] [Indexed: 12/17/2022] Open
Abstract
Accumulating evidence has demonstrated that microRNAs are associated with malignant biological behaviour, including tumorigenesis, cancer progression and metastasis via the regulation of target gene expression. Our previous study demonstrated that programmed cell death protein 4 (PDCD4), which is a tumour suppressor gene, is a target of microRNA‑21 (miR‑21), which affects the proliferation and transformation capabilities of renal cell carcinoma (RCC) cells. However, the role of miR‑21 in the molecular mechanism underlying the migration, invasion and angiogenesis of RCC remains poorly understood. The effects of miR‑21 on the invasion, migration and angiogenesis of RCC cells was determined through meta‑analysis and regulation of miR‑21 expression in vitro. After searching several databases, 6 articles including a total of 473 patients met the eligibility criteria for this analysis. The combined results of the meta‑analysis revealed that increased miR‑21 expression was significantly associated with adverse prognosis in patients with RCC, with a pooled hazard ratio estimate of 1.740. In in vitro experiments, we demonstrated that a miR‑21 inhibitor decreased the number of migrating and invading A498 and 786‑O RCC cells, along with a decrease in PDCD4, c‑Jun, matrix metalloproteinase (MMP)2 and MMP9 expression. Additionally, inhibition of miR‑21 was revealed to reduce tube formation and tube junctions in the endothelial cell line HMEC‑1 by affecting the expression of angiotensin‑1 and vascular endothelial growth factor A, whereas PDCD4 small interfering RNA exerted opposite effects on the same cells. Overall, these findings, along with evidence‑based molecular biology, demonstrated that miR‑21 expression promoted the migration, invasion and angiogenic abilities of RCC cells by directly targeting the PDCD4/c‑Jun signalling pathway. The results may help elucidate the molecular mechanism underlying the development and progression of RCC and provide a promising target for microRNA‑based therapy.
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Affiliation(s)
- Bo Fan
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Yiying Jin
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Hongshuo Zhang
- Department of Biochemistry, Institute of Glycobiology, Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Rui Zhao
- Department of Pharmacy, Zhongshan College of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Man Sun
- Department of Clinical Medicine, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Mengfan Sun
- Department of Pharmacy, Zhongshan College of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Xiaoying Yuan
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Wei Wang
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Xiaogang Wang
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Zhiqi Chen
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Wankai Liu
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Na Yu
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Qun Wang
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Tingjiao Liu
- Department of Oral Pathology, College of Stomatology of Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Xiancheng Li
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
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Wei H, Decker K, Nguyen H, Cao S, Tsai TY, Dianne Guy C, Bashir M, Liu C. Imaging diamagnetic susceptibility of collagen in hepatic fibrosis using susceptibility tensor imaging. Magn Reson Med 2019; 83:1322-1330. [PMID: 31633237 DOI: 10.1002/mrm.27995] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/22/2019] [Accepted: 08/24/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE To characterize the magnetic susceptibility changes of liver fibrosis using susceptibility tensor imaging. METHODS Liver biopsy tissue samples of patients with liver fibrosis were obtained. Three-dimensional gradient-echo and diffusion-weighted images were acquired at 9.4 T. Susceptibility tensors of the samples were calculated using the gradient-echo phase signal acquired at 12 different orientations relative to the B0 field. Susceptibility anisotropy of the liver collagen fibers was quantified and compared with diffusion anisotropy, measured by DTI. For validation, a comparison was made to histology including hematoxylin and eosin staining, iron staining, and Masson's trichrome staining. RESULTS Areas with strong diamagnetic susceptibility were observed in the tissue samples forming fibrous patterns. This diamagnetic susceptibility was highly anisotropic. Both the mean magnetic susceptibility and susceptibility anisotropy of collagen fibers exhibited a strong contrast against the surrounding nonfibrotic tissues. The same regions also showed an elevated diffusion anisotropy but with much lower tissue contrast. Masson's trichrome staining identified concentrated collagens in the fibrous regions with high susceptibility anisotropy, and a linear correlation was found between the susceptibility anisotropy and the histology-based staging. CONCLUSION Diamagnetic susceptibility indicates the presence of collagen in the fibrotic liver tissues. Mapping magnetic susceptibility anisotropy may serve as a potential marker to quantify collagen fiber changes in patients with liver fibrosis.
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Affiliation(s)
- Hongjiang Wei
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.,Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California
| | - Kyle Decker
- Center for In Vivo Microscopy, Duke University, Durham, North Carolina
| | - Hien Nguyen
- Department of Pathology, Duke University, Durham, North Carolina
| | - Steven Cao
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | | | - Mustafa Bashir
- Department of Radiology, Duke University, Durham, North Carolina.,Center for Advanced Magnetic Resonance Development, Duke University, Durham, North Carolina.,Division of Gastroenterology, Department of Medicine, Duke University, Durham, North Carolina
| | - Chunlei Liu
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California.,Helen Wills Neuroscience Institute, University of California, Berkeley, California
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Zhangdi HJ, Su SB, Wang F, Liang ZY, Yan YD, Qin SY, Jiang HX. Crosstalk network among multiple inflammatory mediators in liver fibrosis. World J Gastroenterol 2019; 25:4835-4849. [PMID: 31543677 PMCID: PMC6737310 DOI: 10.3748/wjg.v25.i33.4835] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/24/2019] [Accepted: 08/07/2019] [Indexed: 02/06/2023] Open
Abstract
Liver fibrosis is the common pathological basis of all chronic liver diseases, and is the necessary stage for the progression of chronic liver disease to cirrhosis. As one of pathogenic factors, inflammation plays a predominant role in liver fibrosis via communication and interaction between inflammatory cells, cytokines, and the related signaling pathways. Damaged hepatocytes induce an increase in pro-inflammatory factors, thereby inducing the development of inflammation. In addition, it has been reported that inflammatory response related signaling pathway is the main signal transduction pathway for the development of liver fibrosis. The crosstalk regulatory network leads to hepatic stellate cell activation and proinflammatory cytokine production, which in turn initiate the fibrotic response. Compared with the past, the research on the pathogenesis of liver fibrosis has been greatly developed. However, the liver fibrosis mechanism is complex and many pathways involved need to be further studied. This review mainly focuses on the crosstalk regulatory network among inflammatory cells, cytokines, and the related signaling pathways in the pathogenesis of chronic inflammatory liver diseases. Moreover, we also summarize the recent studies on the mechanisms underlying liver fibrosis and clinical efforts on the targeted therapies against the fibrotic response.
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Affiliation(s)
- Han-Jing Zhangdi
- Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Si-Biao Su
- Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Fei Wang
- Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Zi-Yu Liang
- Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Yu-Dong Yan
- Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Shan-Yu Qin
- Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Hai-Xing Jiang
- Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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