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Kovar J, Dusilova T, Sedivy P, Bruha R, Gottfriedova H, Pavlikova P, Pitha J, Smid V, Drobny M, Dezortova M, Hajek M. Acute responses of hepatic fat content to consuming fat, glucose and fructose alone and in combination in non-obese non-diabetic individuals with non-alcoholic fatty liver disease. J Physiol Pharmacol 2021; 72. [PMID: 34099584 DOI: 10.26402/jpp.2021.1.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 02/26/2021] [Indexed: 11/03/2022]
Abstract
We have recently demonstrated that a high-fat load can induce immediate increase in hepatic fat content (HFC) and that such an effect can be modified differently by co-administration of fructose or glucose in healthy subjects. Therefore, we addressed the question how consumption of these nutrients affects changes in HFC in subjects with non-alcoholic fatty liver disease (NAFLD). Eight male non-obese non-diabetic patients with NAFLD underwent 6 experiments each lasting 8 hours: 1. fasting, 2. high-fat load (150 g of fat (dairy cream) at time 0), 3. glucose (three doses of 50 g at 0, 2, and 4 hours), 4. high-fat load with three doses of 50 g of glucose, 5. fructose (three doses of 50 g at 0, 2, and 4 hours), 6. high-fat load with three doses of 50 g of fructose. HFC was measured using magnetic resonance spectroscopy prior to meal administration and 3 and 6 hours later. Plasma triglycerides, non-esterified fatty acids, glucose and insulin were monitored throughout each experiment. HFC increased by 10.4 ± 6.9% six hours after a high-fat load and by 15.2 ± 12.5% after high-fat load with fructose. When co-administering glucose with fat, HFC rose only transiently to return to baseline at 6 hours. Importantly, NAFLD subjects accumulated almost five times more fat in their livers than healthy subjects with normal HFC. Consumption of a high-fat load results in fat accumulation in the liver of NAFLD patients. Fat accumulation after a fat load is diminished by glucose but not fructose co-administration.
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Affiliation(s)
- J Kovar
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
| | - T Dusilova
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic.,Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
| | - P Sedivy
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - R Bruha
- Fourth Department of Internal Medicine, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - H Gottfriedova
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - P Pavlikova
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - J Pitha
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | | | - M Drobny
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - M Dezortova
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - M Hajek
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Kraslova I, Muchova L, Vitek L, Novotny A, Svestka T, Bruha R. Ticlopidine-Induced Cholestatic Inflammatory Hepatitis: New Insights into Pathogenetic Mechanisms of Drug-Related Hepatotoxicity. EUR J INFLAMM 2016. [DOI: 10.1177/1721727x0600400107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
In immune-induced liver damage the reactive metabolites may covalently bind or alter liver proteins such as cytochrome P450 enzymes, which leads to activation of the immune system. Ticlopidine is an inhibitor of CYP2C19 human liver cytochrome. We attempted to analyse the role of cytochrome CYP2C19 genetic polymorphism in the development of ticlopidine-induced cholestatic hepatitis and relate it with the specific immune reactivity to ticlopidine, different cytokine profiles and induction of necrosis and apoptosis within the liver tissue. Three patients with cholestatic hepatitis with ticlopidine-related liver injury, 3 patients with obstructive jaundice due to choledocholithiasis, 3 patients treated with ticlopidine without liver damage and 10 healthy individuals were studied. Genotyping for the following genotypes CYP2C19 (CYP2C19*1–3) were tested after polymerase chain reaction (PCR) by restriction fragment length polymorphism (RFLP) with Sma I and BamH I enzymes. The T cell reactivity to ticlopidine was analysed by T cell proliferation assay in PBMC against ticlopidine, tetanus toxoid antigen and phytohemagglutinin on days 0, 90, 150 and 210 after therapy withdrawal. The serum levels of INF-γ, IL-2, IL-4, IL-10, TNF-α, sFas and sFasL were measured by ELISA at the same time points. Apoptosis was analysed by TUNEL assay. All patients with cholestatic hepatitis had “slow metabolizers” genotypes in contrast to other groups. The T cell reactivity to ticlopidine was present only in all the cholestatic hepatitis patients together with substantial decrease in levels of INF-γ, IL-2 and TNF-α during all of the follow-up period. Cholestatic hepatitis patients had high apoptotic index in TUNEL assay. The genetic polymorphism of the cytochrome CYP2C19 gene is directly responsible for the susceptibility to the ticlopidine-induced liver damage. Th1 type of immune reactivity plays the key role in the pathogenesis of drug-induced hepatotoxicity.
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Affiliation(s)
- I. Kraslova
- Institute of Biochemistry and Laboratory Diagnostics, I Medical Faculty, Charles University, U nemocnice 2, Prague
- IV Department of Internal Medicine, General University Hospital, U nemocnice 2, Prague, Czech Republic
| | - L. Muchova
- Institute of Biochemistry and Laboratory Diagnostics, I Medical Faculty, Charles University, U nemocnice 2, Prague
- IV Department of Internal Medicine, General University Hospital, U nemocnice 2, Prague, Czech Republic
| | - L. Vitek
- Institute of Biochemistry and Laboratory Diagnostics, I Medical Faculty, Charles University, U nemocnice 2, Prague
- IV Department of Internal Medicine, General University Hospital, U nemocnice 2, Prague, Czech Republic
| | - A. Novotny
- IV Department of Internal Medicine, General University Hospital, U nemocnice 2, Prague, Czech Republic
| | - T. Svestka
- IV Department of Internal Medicine, General University Hospital, U nemocnice 2, Prague, Czech Republic
| | - R. Bruha
- IV Department of Internal Medicine, General University Hospital, U nemocnice 2, Prague, Czech Republic
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Urbanek P, Kreidlova M, Dusek L, Bruha R, Marecek Z, Petrtyl J. Anemia as a predictor of response to antiviral therapy in chronic hepatitis C. ACTA ACUST UNITED AC 2013; 114:213-7. [PMID: 23514554 DOI: 10.4149/bll_2013_044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The standard therapy for chronic HCV infection is the administration of pegylated interferons in combination with ribavirin. Anemia is a dose-dependent side-effect of ribavirin administration. The degree of anemia could be indicative of the individual exposure to ribavirin. AIMS 1) To evaluate the correlation of HGB level decreases at specified time-points with a sustained virological response during the antiviral treatment. 2) To compare these parameters with the virological predictors for responses. METHODS A retrospective analysis of cohort, which comprised 164 patients treated with standard therapy at a tertiary center in Prague, Czech Republic. RESULTS We identified several predictive factors for a sustained virological response in females: baseline HGB level ≤140 g/l (p=0.025), maximum drop from baseline >40 g (p=0.039), and a HGB drop in week 4 >30 g (p=0.044). There was only one predictor identified for males: reaching the lowest HGB level after week 19 (p=0.021). The strongest positive predictor of response was a rapid virological response. A low viral load (<600 000 IU/ml) at baseline was not associated with a sustained response in either gender. CONCLUSIONS The parameters of HGB decrease during antiviral treatment are better correlated with a sustained response in females. None of these response predicting parameters was as significant as that of rapid virological response as that of rapid virological response (Tab. 4, Fig. 1, Ref. 15).
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Affiliation(s)
- P Urbanek
- Department of Internal Medicine 1st Medical Faculty Charles University and Centrla Military Hospital Prague, Czech Republic.
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Affiliation(s)
- S Nevsimalova
- Department of Neurology, Charles University, 1st Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic.
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Ginès P, Wong F, Watson H, Terg R, Bruha R, Zarski JP, Dudley F. Clinical trial: short-term effects of combination of satavaptan, a selective vasopressin V2 receptor antagonist, and diuretics on ascites in patients with cirrhosis without hyponatraemia--a randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther 2010; 31:834-45. [PMID: 20102356 DOI: 10.1111/j.1365-2036.2010.04236.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND There is little information on the effects of vaptans in patients with cirrhosis. AIM To investigate the short-term effects of satavaptan, a selective vasopressin V2 receptor antagonist on ascites in cirrhosis without hyponatraemia. METHODS A total of 148 patients with cirrhosis, ascites and serum sodium >130 mmol/L were included in a multicentre, double-blind, randomized, controlled study of 14 days comparing three fixed doses of satavaptan (5 mg, 12.5 mg or 25 mg once daily) vs. placebo. Average MELD scores were: 13.4, 12.3, 13.8 and 13.1 respectively. All patients received spironolactone 100 mg/day plus furosemide 20-25 mg/day. RESULTS Satavaptan treatment was associated with a decrease in ascites (mean change in body weight was -0.36 kg (+/-3.03) for placebo vs. -2.46 kg (+/-3.11), -2.08 kg (+/-4.17) and -2.28 kg (+/-3.24) for the 5 mg, 12.5 mg and 25 mg doses respectively; P = 0.036, P = 0.041 and P = 0.036 for satavaptan 5, 12.5 and 25 mg/day vs. placebo respectively). Thirst and slight increases in serum sodium were more common in patients treated with satavaptan compared with placebo, while other adverse events were similar. CONCLUSIONS The administration satavaptan for a 14-day period is associated with reduction in ascites in patients with moderately severe cirrhosis without hyponatraemia under diuretic treatment.
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Affiliation(s)
- P Ginès
- Liver Unit, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), CIBER de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Catalunya, Spain.
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Bruha R, Marecek Z, Spicak J, Hulek P, Lata J, Petrtyl J, Urbanek P, Taimr P, Volfova M, Dite P. Double-blind randomized, comparative multicenter study of the effect of terlipressin in the treatment of acute esophageal variceal and/or hypertensive gastropathy bleeding. Hepatogastroenterology 2002; 49:1161-6. [PMID: 12143227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND/AIMS 1) To compare the effect of 2-day application of 0.2 mg terlipressin i.v. every 4 hours (group I) with that of 5-day application of 1 mg i.v. every 4 hours (group II) in the treatment of bleeding esophageal varices and portal gastropathy. 2) To assess the incidence of adverse events. METHODOLOGY Eighty-six patients with liver cirrhosis (54 men and 32 women, average age 51 years) were randomized over a period of 2 years into 2 groups. Acute bleeding was diagnosed endoscopically within 24 hours of its onset. The two groups fully comparable; treatment failure rated according to "Baveno II". RESULTS Success rate in group I was 78% at day 2 and 75% at day 5; in group II 89% and 79%, respectively (no statistical significance). Rebleeding had occurred by day 5 in 15% in group I, and in 16.3% in group II. Transfusion needs by day 2 were significantly lower in group II (2.4 units compare to 3.4 units in I). The 30-day mortality was 17.1% in group I and 20% in group II. No statistical difference between I and II in the occurrence of adverse events. CONCLUSIONS At a dosage of 1 mg i.v. every 4 hours, the success rate at day 2 was as much as 90% while blood consumption was significantly lower compared with the lower dosage. Rebleeding during first 48 hours occurred almost exclusively at lower dosage. There was no increase in the rate of adverse events relative to the higher dosage.
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Affiliation(s)
- R Bruha
- First Medical Department, Teaching Hospital Prague 2, Czech Republic.
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Bruha R, Petrtyl J, Kubecova M, Marecek Z, Dufek V, Urbanek P, Kodadova J, Chodounsky Z. Intraluminal brachytherapy and selfexpandable stents in nonresectable biliary malignancies--the question of long-term palliation. Hepatogastroenterology 2001; 48:631-7. [PMID: 11462891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND/AIMS To evaluate the effect of a combination of intraluminal brachytherapy and metallic stent implantation in the treatment of patients with nonresectable biliary tumors. METHODOLOGY Thirty-two patients aged 41-80 years with nonresectable biliary malignancies--Klatskin's tumor (n = 17), gallbladder carcinoma (n = 11) and carcinoma of papilla Vateri (n = 4)--were treated with a combination of intraluminal brachytherapy (source Ir192, high-dose radiation regimen, total dose 30 Gy) and metallic stent implantation. Intraluminal brachytherapy and stent insertion (metallic, spiral-Z stent) were performed percutaneously in all patients. RESULTS The mean survival in patients with Klatskin's tumor was 457 days (range: 64-1186; median: 358 days), in patients with gallbladder carcinoma 237 days (range: 92-609; median: 210 days) and in patients with carcinoma of papilla Vateri 850 days (range: 48-1518; median: 1277 days). The rate of 2-year survival in these groups as 27, 0 and 50%, respectively. The survival time differed significantly at the 5% level. The mean time of stent patency was 418, 220 and 850 days, respectively. No complications related directly to intraluminal brachytherapy were observed. CONCLUSIONS Intraluminal brachytherapy combined with stent implantation is a safe method and appears to prolong survival in inoperable patients with Klatskin's tumor and carcinoma of papilla Vateri compared with nontreated patients in previous studies. In contrast no similar effect should be expected in patients with gallbladder carcinoma.
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Affiliation(s)
- R Bruha
- 1st Medical Department and Department of Radiology, Charles University Teaching Hospital, Prague 2, Czech Republic.
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