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Tang Q, Xing X, Huang H, Yang J, Li M, Xu X, Gao X, Liang C, Tian W, Liao L. Eliminating senescent cells by white adipose tissue-targeted senotherapy alleviates age-related hepatic steatosis through decreasing lipolysis. GeroScience 2024; 46:3149-3167. [PMID: 38217637 PMCID: PMC11009221 DOI: 10.1007/s11357-024-01068-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/28/2023] [Indexed: 01/15/2024] Open
Abstract
Cellular senescence is an important risk factor in the development of hepatic steatosis. Senolytics present therapeutic effects on age-related hepatic steatosis without eliminating senescent hepatocytes directly. Therefore, it highlights the need to find senolytics' therapeutic targets. Dysfunction of adipose tissue underlies the critical pathogenesis of lipotoxicity in the liver. However, the correlation between adipose tissue and hepatic steatosis during aging and its underlying molecular mechanism remains poorly understood. We explored the correlation between white adipose tissue (WAT) and the liver during aging and evaluated the effect of lipolysis of aged WAT on hepatic steatosis and hepatocyte senescence. We screened out the ideal senolytics for WAT and developed a WAT-targeted delivery system for senotherapy. We assessed senescence and lipolysis of WAT and hepatic lipid accumulation after treatment. The results displayed that aging accelerated cellular senescence and facilitated lipolysis of WAT. Free fatty acids (FFAs) generated by WAT during aging enhanced hepatic steatosis and induced hepatocyte senescence. The combined usage of dasatinib and quercetin was screened out as the ideal senolytics to eliminate senescent cells in WAT. To minimize non-specific distribution and enhance the effectiveness of senolytics, liposomes decorated with WAT affinity peptide P3 were constructed for senotherapy in vivo. In vivo study, WAT-targeted treatment eliminated senescent cells in WAT and reduced lipolysis, resulting in the alleviation of hepatic lipid accumulation and hepatocyte senescence when compared to non-targeted treatment, providing a novel tissue-targeted, effective and safe senotherapy for age-related hepatic steatosis.
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Affiliation(s)
- Qi Tang
- National Engineering Laboratory for Oral Regenerative Medicine & Engineering Research Center of Oral Translational Medicine, Ministry of Education & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, West China School of Public Health & West China Fourth Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China
| | - Xiaotao Xing
- National Engineering Laboratory for Oral Regenerative Medicine & Engineering Research Center of Oral Translational Medicine, Ministry of Education & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, West China School of Public Health & West China Fourth Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China
- Key laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Laboratory Center of Stomatology, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Haisen Huang
- National Engineering Laboratory for Oral Regenerative Medicine & Engineering Research Center of Oral Translational Medicine, Ministry of Education & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, West China School of Public Health & West China Fourth Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China
| | - Jian Yang
- National Engineering Laboratory for Oral Regenerative Medicine & Engineering Research Center of Oral Translational Medicine, Ministry of Education & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, West China School of Public Health & West China Fourth Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China
| | - Maojiao Li
- National Engineering Laboratory for Oral Regenerative Medicine & Engineering Research Center of Oral Translational Medicine, Ministry of Education & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, West China School of Public Health & West China Fourth Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China
| | - Xun Xu
- National Engineering Laboratory for Oral Regenerative Medicine & Engineering Research Center of Oral Translational Medicine, Ministry of Education & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, West China School of Public Health & West China Fourth Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China
| | - Xin Gao
- National Engineering Laboratory for Oral Regenerative Medicine & Engineering Research Center of Oral Translational Medicine, Ministry of Education & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, West China School of Public Health & West China Fourth Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China
| | - Cheng Liang
- National Engineering Laboratory for Oral Regenerative Medicine & Engineering Research Center of Oral Translational Medicine, Ministry of Education & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, West China School of Public Health & West China Fourth Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China
| | - Weidong Tian
- National Engineering Laboratory for Oral Regenerative Medicine & Engineering Research Center of Oral Translational Medicine, Ministry of Education & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, West China School of Public Health & West China Fourth Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China.
| | - Li Liao
- National Engineering Laboratory for Oral Regenerative Medicine & Engineering Research Center of Oral Translational Medicine, Ministry of Education & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, West China School of Public Health & West China Fourth Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China.
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Yang L, He Y, Liu S, Gan L, Ni Q, Dai A, Mu C, Liu Q, Chen H, Lu H, Sun R. Adipocyte-derived exosomes from obstructive sleep apnoea rats aggravate MASLD by TCONS_00039830/miR-455-3p/Smad2 axis. Commun Biol 2024; 7:492. [PMID: 38654054 DOI: 10.1038/s42003-024-06171-z] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
A correlation exists between obstructive sleep apnoea (OSA) and the severity of metabolic dysfunction-associated steatotic liver disease (MASLD), OSA can induce more severe MASLD. However, the underlying regulatory mechanism between the two is unclear. To this end, this study explored the role and possible molecular mechanisms of adipocyte-derived exosomes under OSA in aggravating MASLD. Through sequencing technology, miR-455-3p was identified as a co-differentially expressed miRNA between the MASLD + OSA and Control groups and between the MASLD + OSA and MASLD groups. Upregulation of TCONS-00039830 and Smad2 and downregulation of miR-455-3p in the MASLD and MASLD + OSA groups were validated in vivo and in vitro. TCONS-00039830, as a differentially expressed LncRNA in exosomes found in the sequencing results, transfection notably downregulated miR-455-3p and upregulated Smad2 in hepatocytes. TCONS_00039830 overexpression increased fat, triglyceride and cholesterol levels, while miR-455-3p overexpression decreased these levels. Furthermore, exosome administration promoted the accumulation of fat, triglyceride and cholesterol, upregulated TCONS_00039830 and Smad2, and downregulated miR-455-3p. Overexpression of miR-455-3p reversed the increased fat accumulation and upregulated TCONS_00039830 and Smad2. In conclusion, OSA-derived exosomes promoted hepatocyte steatosis by regulating TCONS_00039830/miR-455-3p/Smad2 axis, thereby aggravating liver damage in MASLD.
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Affiliation(s)
- Li Yang
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China.
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China.
| | - Yan He
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China
| | - Shijie Liu
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China
| | - Lulu Gan
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China
| | - Qing Ni
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China
| | - Anni Dai
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China
| | - Changhuan Mu
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China
| | - Qian Liu
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China
| | - Hongyan Chen
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China
| | - Hongying Lu
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China
| | - Ruixue Sun
- Hypertension Center, Yan 'an Hospital of Kunming, Kunming, China
- Kunming Technical Diagnosis and Treatment Center for Refractory Hypertension, Kunming, China
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Singh S, Dwivedi S, Khan AA, Jain A, Dwivedi S, Yadav KK, Dubey I, Trivedi A, Trivedi SP, Kumar M. Oxidative stress, inflammation, and steatosis elucidate the complex dynamics of HgCl 2 induced liver damage in Channa punctata. Sci Rep 2024; 14:9161. [PMID: 38644412 PMCID: PMC11033285 DOI: 10.1038/s41598-024-59917-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 04/23/2024] Open
Abstract
Water bodies are highly pollution-prone areas in which mercury (Hg) is considered as a major menace to aquatic organisms. However, the information about the toxicity of mercuric chloride (HgCl2) in a vital organ such as the liver of fish is still inadequate. This study aimed to assess the impact of mercuric chloride (HgCl2) exposure on the liver of Channa punctata fish over 15, 30, and 45 days, at two different concentrations (0.039 mg/L and 0.078 mg/L). Mercury is known to be a significant threat to aquatic life, and yet, information regarding its effects on fish liver remains limited. The results of this study demonstrate that exposure to HgCl2 significantly increases oxidative stress markers, such as lipid peroxidation (LPO) and protein carbonyls (PC), as well as the levels of serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) in the fish. Additionally, the transcriptional and protein analysis of specific genes and molecules associated with necroptosis and inflammation, such as ABCG2, TNF α, Caspase 3, RIPK 3, IL-1β, Caspase-1, IL-18, and RIPK1, confirm the occurrence of necroptosis and inflammation in the liver. Histopathological and ultrastructural examinations of the liver tissue further reveal a significant presence of liver steatosis. Interestingly, the upregulation of PPARα suggests that the fish's body is actively responding to counteract the effects of liver steatosis. This study provides a comprehensive analysis of oxidative stress, biochemical changes, gene expression, protein profiles, and histological findings in the liver tissue of fish exposed to mercury pollution in freshwater environments.
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Affiliation(s)
- Shefalee Singh
- Environmental Toxicology and Bioremediation Laboratory (ETBL), Department of Zoology, University of Lucknow, Lucknow, 226007, India
| | - Shikha Dwivedi
- Environmental Toxicology and Bioremediation Laboratory (ETBL), Department of Zoology, University of Lucknow, Lucknow, 226007, India
| | - Adeel Ahmad Khan
- Environmental Toxicology and Bioremediation Laboratory (ETBL), Department of Zoology, University of Lucknow, Lucknow, 226007, India
| | - Anamika Jain
- Environmental Toxicology and Bioremediation Laboratory (ETBL), Department of Zoology, University of Lucknow, Lucknow, 226007, India
| | - Shraddha Dwivedi
- Department of Zoology, Government Degree College, Haripur-Nihastha, Raebareli, 229208, India
| | - Kamlesh Kumar Yadav
- Department of Zoology, Government Degree College, Bakkha Kheda, Unnao, 209801, India
| | - Indrani Dubey
- Department of Zoology, DBS College, Kanpur, Uttar Pradesh, 208006, India
| | - Abha Trivedi
- Department of Zoology, Mahatma Jyotiba Phule Rohilkhand University, Bareilly, Uttar Pradesh, 243006, India
| | - Sunil P Trivedi
- Environmental Toxicology and Bioremediation Laboratory (ETBL), Department of Zoology, University of Lucknow, Lucknow, 226007, India
| | - Manoj Kumar
- Environmental Toxicology and Bioremediation Laboratory (ETBL), Department of Zoology, University of Lucknow, Lucknow, 226007, India.
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Li Y, Dai C, Ruan Y, Yang H, Zeng H, Huang R, Wang J, Dai M, Hao J, Wang L, Li J, Yan X, Lu Z, Ji F. Metabolic dysfunction-associated fatty liver disease and nonalcoholic fatty liver disease from clinical to pathological characteristics: a multi-center cross-sectional study in real world. Postgrad Med J 2024; 100:319-326. [PMID: 38272486 DOI: 10.1093/postmj/qgae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/17/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND The evaluation of patients with fatty liver as defined by metabolic dysfunction-associated fatty liver disease (MAFLD) in the real world remains poorly researched. This study aimed to analyse the clinical and histological features of patients with MAFLD and nonalcoholic fatty liver disease (NAFLD) and to characterize each metabolic subgroup of MAFLD. METHODS A total of 2563 patients with fatty liver confirmed by ultrasonography and/or magnetic resonance tomography and/or liver biopsy-proven from three hospitals in China were included in the study. Patients were divided into different groups according to diagnostic criteria for MAFLD and NAFLD, and MAFLD into different subgroups. RESULTS There were 2337 (91.2%) patients fitting the MAFLD criteria, and 2095 (81.7%) fitting the NAFLD criteria. Compared to patients with NAFLD, those with MAFLD were more likely to be male, had more metabolic traits, higher liver enzyme levels, and noninvasive fibrosis scores. Among the patients with liver biopsy, the extent of advanced fibrosis in cases with MAFLD was significantly higher than those with NAFLD, 31.8% versus 5.2% (P < .001); there was no significant difference in advanced fibrosis between obese cases and lean individuals in MAFLD (P > .05); MAFLD complicated with diabetes had significantly higher advanced fibrosis than those without diabetes (43.3% and 17.2%, respectively; P < .001). CONCLUSIONS Patients with MAFLD have a higher degree of liver fibrosis than NAFLD patients. In addition, diabetic patients should be screened for fatty liver and liver fibrosis degree.
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Affiliation(s)
- Yan Li
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Changyong Dai
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Department of Infectious Diseases, Huaian Hospital of Huaian City, Huaian, Jiangsu, 223200, China
| | - Yuhua Ruan
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Haiqing Yang
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Huang Zeng
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, 210008, China
| | - Jialu Wang
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Mingjia Dai
- Department of Infection and Hepatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, China
| | - Jungui Hao
- Department of Infection and Hepatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, China
| | - Liping Wang
- Department of Infection and Hepatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, China
| | - Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, 210008, China
| | - Xuebing Yan
- Department of Infection and Hepatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, China
| | - Zhonghua Lu
- Department of Liver Disease, Affiliated Wuxi Fifth Hospital of Jiangnan University, Wuxi, Jiangsu, 214011, China
| | - Fang Ji
- Department of Infection and Hepatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, China
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Lin H, Lee HW, Yip TCF, Tsochatzis E, Petta S, Bugianesi E, Yoneda M, Zheng MH, Hagström H, Boursier J, Calleja JL, Goh GBB, Chan WK, Gallego-Durán R, Sanyal AJ, de Lédinghen V, Newsome PN, Fan JG, Castéra L, Lai M, Harrison SA, Fournier-Poizat C, Wong GLH, Pennisi G, Armandi A, Nakajima A, Liu WY, Shang Y, de Saint-Loup M, Llop E, Teh KKJ, Lara-Romero C, Asgharpour A, Mahgoub S, Chan MSW, Canivet CM, Romero-Gomez M, Kim SU, Wong VWS. Vibration-Controlled Transient Elastography Scores to Predict Liver-Related Events in Steatotic Liver Disease. JAMA 2024; 331:1287-1297. [PMID: 38512249 PMCID: PMC10958386 DOI: 10.1001/jama.2024.1447] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/30/2024] [Indexed: 03/22/2024]
Abstract
Importance Metabolic dysfunction-associated steatotic liver disease (MASLD) is currently the most common chronic liver disease worldwide. It is important to develop noninvasive tests to assess the disease severity and prognosis. Objective To study the prognostic implications of baseline levels and dynamic changes of the vibration-controlled transient elastography (VCTE)-based scores developed for the diagnosis of advanced fibrosis (Agile 3+) and cirrhosis (Agile 4) in patients with MASLD. Design, Setting, and Participants This cohort study included data from a natural history cohort of patients with MASLD who underwent VCTE examination at 16 tertiary referral centers in the US, Europe, and Asia from February 2004 to January 2023, of which the data were collected prospectively at 14 centers. Eligible patients were adults aged at least 18 years with hepatic steatosis diagnosed by histologic methods (steatosis in ≥5% of hepatocytes) or imaging studies (ultrasonography, computed tomography or magnetic resonance imaging, or controlled attenuation parameter ≥248 dB/m by VCTE). Main Outcomes and Measures The primary outcome was liver-related events (LREs), defined as hepatocellular carcinoma or hepatic decompensation (ascites, variceal hemorrhage, hepatic encephalopathy, or hepatorenal syndrome), liver transplant, and liver-related deaths. The Agile scores were compared with histologic and 8 other noninvasive tests. Results A total of 16 603 patients underwent VCTE examination at baseline (mean [SD] age, 52.5 [13.7] years; 9600 [57.8%] were male). At a median follow-up of 51.7 (IQR, 25.2-85.2) months, 316 patients (1.9%) developed LREs. Both Agile 3+ and Agile 4 scores classified fewer patients between the low and high cutoffs than most fibrosis scores and achieved the highest discriminatory power in predicting LREs (integrated area under the time-dependent receiver-operating characteristic curve, 0.89). A total of 10 920 patients (65.8%) had repeated VCTE examination at a median interval of 15 (IQR, 11.3-27.7) months and were included in the serial analysis. A total of 81.9% of patients (7208 of 8810) had stable Agile 3+ scores and 92.6% of patients (8163 of 8810) had stable Agile 4 scores (same risk categories at both assessments). The incidence of LREs was 0.6 per 1000 person-years in patients with persistently low Agile 3+ scores and 30.1 per 1000 person-years in patients with persistently high Agile 3+ scores. In patients with high Agile 3+ score at baseline, a decrease in the score by more than 20% was associated with substantial reduction in the risk of LREs. A similar trend was observed for the Agile 4 score, although it missed more LREs in the low-risk group. Conclusions and Relevance Findings of this study suggest that single or serial Agile scores are highly accurate in predicting LREs in patients with MASLD, making them suitable alternatives to liver biopsy in routine clinical practice and in phase 2b and 3 clinical trials for steatohepatitis.
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Affiliation(s)
- Huapeng Lin
- Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Hye Won Lee
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Terry Cheuk-Fung Yip
- Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Emmanuel Tsochatzis
- University College London Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, United Kingdom
| | - Salvatore Petta
- Sezione di Gastroenterologia, PROMISE, University of Palermo, Italy
| | - Elisabetta Bugianesi
- Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hannes Hagström
- Department of Medicine, Huddinge, Karolinska Institutet, Sweden
- Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Jérôme Boursier
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory, SFR ICAT 4208, Angers University, Angers, France
| | - José Luis Calleja
- Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - George Boon-Bee Goh
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Rocio Gallego-Durán
- Digestive Diseases Unit and CIBERehd, Virgen Del Rocío University Hospital, Seville, Spain
| | - Arun J. Sanyal
- Stravitz-Sanyal Institute for Liver Disease and Metabolic Health, VCU School of Medicine, Richmond, Virginia
| | - Victor de Lédinghen
- Centre d’Investigation de la Fibrose Hépatique, Haut-Lévêque Hospital, University Hospital of Bordeaux, Pessac, France
| | - Philip N. Newsome
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, United Kingdom
| | - Jian-Gao Fan
- Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Laurent Castéra
- Université Paris Cité, UMR1149 (CRI), INSERM, Paris, France; Service d’Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Clichy, France
| | - Michelle Lai
- Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Stephen A. Harrison
- Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Pinnacle Clinical Research, San Antonio, Texas
| | | | - Grace Lai-Hung Wong
- Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Grazia Pennisi
- Sezione di Gastroenterologia, PROMISE, University of Palermo, Italy
| | - Angelo Armandi
- Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Wen-Yue Liu
- Department of Endocrinology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ying Shang
- Department of Medicine, Huddinge, Karolinska Institutet, Sweden
| | - Marc de Saint-Loup
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France
| | - Elba Llop
- Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Kevin Kim-Jun Teh
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Carmen Lara-Romero
- Digestive Diseases Unit and CIBERehd, Virgen Del Rocío University Hospital, Seville, Spain
| | - Amon Asgharpour
- Stravitz-Sanyal Institute for Liver Disease and Metabolic Health, VCU School of Medicine, Richmond, Virginia
| | - Sara Mahgoub
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, United Kingdom
| | | | - Clemence M. Canivet
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory, SFR ICAT 4208, Angers University, Angers, France
| | - Manuel Romero-Gomez
- Digestive Diseases Unit and CIBERehd, Virgen Del Rocío University Hospital, Seville, Spain
| | - Seung Up Kim
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Vincent Wai-Sun Wong
- Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
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González IA, Saeed O, Mustafa M, Segura SE, Collins K, Hou T, Mesa H, Lee SM, Zhang D, Lin J, Cummings OW. Incidental findings during donor liver assessment: Single center experience. Ann Diagn Pathol 2024; 69:152266. [PMID: 38266545 DOI: 10.1016/j.anndiagpath.2024.152266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/26/2024]
Abstract
Intraoperative consultation of donor liver is an important part of transplant evaluation and determination of liver eligibility. In this study, we describe incidental pathologic findings discovered during the pretransplant evaluation of liver donors in our Institution from 1/2010 to 12/2022. During this 13-year period 369 intraoperative consultations from 262 liver donors were performed. Of those cases, incidental findings were identified in 22 cases (5.9 %) from 19 donors (7.3 %); two donors had more than one lesion. The median age of this subset of patients was 53 years (range: 18-70) and females predominated (63 %). Sixteen of the donors had abnormal findings in the liver: 6 bile duct hamartoma (BDH), 5 hyalinized nodule with Histoplasma capsulatum, 5 focal nodular hyperplasia (FNH), 2 bile duct adenomas (BDA), 1 biliary cyst and 1 hemangioma. One donor had both FNH and a BDH. One BDH and 1 BDA case was misdiagnosed as malignancy during the frozen section evaluation. Three donors had extrahepatic pathologies: a pancreatic tail schwannoma, a low-grade appendiceal mucinous neoplasm, and a lymph node with metastatic endometrial endometrioid adenocarcinoma. Of the 19 livers, the final organ disposition was available for 9: 6 were transplanted (67 %) and 3 were discarded (33 %). Two of the 3 discarded organs were misdiagnosed BDH and BDA cases, and one was incorrectly reported as having 90 % microvesicular steatosis during the frozen assessment. We present the clinicopathologic characteristics of liver donors with incidental findings during the pre-transplant evaluation which could lead to unwarranted graft dismissal if misdiagnosed. Additionally, incidental fungal infections can have implications for immunosuppressive therapy and the decision to use or reject the graft.
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Affiliation(s)
- Iván A González
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America.
| | - Omer Saeed
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
| | - Mohamed Mustafa
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
| | - Sheila E Segura
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
| | - Katrina Collins
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
| | - Tieying Hou
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
| | - Hector Mesa
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
| | - Sun M Lee
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
| | - Dongwei Zhang
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
| | - Jingmei Lin
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
| | - Oscar W Cummings
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America
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7
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Woo C, Jeong WI. Immunopathogenesis of liver fibrosis in steatotic liver disease. Clin Mol Hepatol 2024; 30:299-302. [PMID: 38373420 PMCID: PMC11016481 DOI: 10.3350/cmh.2024.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/21/2024] Open
Affiliation(s)
- Chaerin Woo
- Laboratory of Liver Research, Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Won-Il Jeong
- Laboratory of Liver Research, Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
- Center for the Hepatic Glutamate and Its Function, KAIST, Daejeon, Korea
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8
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Tian X, Wu L, Li X, Zheng W, Zuo H, Song H. Exosomes derived from bone marrow mesenchymal stem cells alleviate biliary ischemia reperfusion injury in fatty liver transplantation by inhibiting ferroptosis. Mol Cell Biochem 2024; 479:881-894. [PMID: 37243945 PMCID: PMC11016128 DOI: 10.1007/s11010-023-04770-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 05/15/2023] [Indexed: 05/29/2023]
Abstract
Fatty liver grafts are susceptible to ischemia reperfusion injury (IRI), increasing the risk of biliary complications after liver transplantation (LT). Ferroptosis, a newly recognized programmed cell death, is expected to be a novel therapeutic target for IRI. We investigated whether exosomes derived from heme oxygenase 1-modified bone marrow mesenchymal stem cells (HExos) relieve ferroptosis and protect biliary tracts from IRI in a rat fatty liver transplantation model. Rats were fed with a methionine choline deficient (MCD) diet for 2 weeks to induce severe hepatic steatosis. Steatotic grafts were implanted and HExos were administered after liver transplantation. A series of functional assays and pathological analysis were performed to assess ferroptosis and biliary IRI. The HExos attenuated IRI following liver transplantation, as demonstrated by less ferroptosis, improved liver function, less Kupffer and T cell activation, and less long-term biliary fibrosis. MicroRNA (miR)-204-5p delivered by HExos negatively regulated ferroptosis by targeting a key pro-ferroptosis enzyme, ACSL4. Ferroptosis contributes to biliary IRI in fatty liver transplantation. HExos protect steatotic grafts by inhibiting ferroptosis, and may become a promising strategy to prevent biliary IRI and expand the donor pool.
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Affiliation(s)
- Xuan Tian
- School of Medicine, Nankai University, Tianjin, People's Republic of China
| | - Longlong Wu
- School of Medicine, Nankai University, Tianjin, People's Republic of China
| | - Xiang Li
- Tianjin First Central Hospital Clinic Institute, Tianjin Medical University, Tianjin, 300070, People's Republic of China
| | - Weiping Zheng
- Department of Organ Transplantation, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin, 300192, People's Republic of China
- NHC Key Laboratory of Critical Care Medicine, Tianjin, 300192, People's Republic of China
| | - Huaiwen Zuo
- Tianjin First Central Hospital Clinic Institute, Tianjin Medical University, Tianjin, 300070, People's Republic of China
| | - Hongli Song
- Department of Organ Transplantation, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin, 300192, People's Republic of China.
- Tianjin Key Laboratory of Organ Transplantation, Tianjin, People's Republic of China.
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9
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Williams EE, Mladenovic A, Ranginani D, Weber R, Samala N, Gawrieh S, Vilar-Gomez E, Chalasani N, Vuppalanchi R. Role of Spleen Stiffness Measurement in the Evaluation of Metabolic Dysfunction-Associated Steatotic Liver Disease. Dig Dis Sci 2024; 69:1444-1453. [PMID: 38332211 DOI: 10.1007/s10620-024-08272-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 12/09/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Spleen stiffness measurement (SSM) correlates with the severity of portal hypertension. AIMS We investigated the utility of SSM in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) for detecting cirrhosis, esophageal varices (EV), and high-risk EV. METHODS 154 study participants with MASLD underwent simultaneous liver stiffness measurement (LSM) and SSM. 96 (62%) participants had an upper endoscopy (73 participants, i.e., 47% undergoing within a year). The diagnostic performance of SSM, as well as the BAVENO VII proposed SSM cutoffs (≥ 21 kPa, > 40 kPa, and > 50 kPa), was examined. RESULTS The failure rate for SSM was 19% compared to 5% for LSM. An invalid SSM was statistically significantly associated with a higher body mass index, a larger waist circumference, and a lower fibrosis stage. The area under the receiver operating characteristics for SSM to diagnose cirrhosis, EV, and high-risk EV was 0.78 (95% CI 0.70-0.85), 0.74 (95% CI 0.61-0.84), and 0.82 (95% CI 0.75-0.98), respectively. SSM ≥ 21 kPa cutoff had a sensitivity > 96% for all three outcomes, with a positive predictive value (PPV) of 88% for cirrhosis. In contrast, SSM > 40 kPa and SSM > 50 kPa cutoffs had better diagnostic abilities for identifying EV, particularly high-risk EV (sensitivity of 100% and 93% with NPV of 100% and 96%, respectively). CONCLUSION SSM has a higher failure rate in individuals who are non-cirrhotic or have a higher BMI, or larger waist circumference. Although useful for diagnosing NASH cirrhosis, SSM is most reliable in excluding EV and high-risk EV.
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Affiliation(s)
- Elizabeth E Williams
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN, 46202, USA
| | - Andrea Mladenovic
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN, 46202, USA
| | - Dheeksha Ranginani
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN, 46202, USA
| | - Regina Weber
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN, 46202, USA
| | - Niharika Samala
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN, 46202, USA
| | - Samer Gawrieh
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN, 46202, USA
| | - Eduardo Vilar-Gomez
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN, 46202, USA
| | - Naga Chalasani
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN, 46202, USA
| | - Raj Vuppalanchi
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN, 46202, USA.
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Pennisi G, Enea M, Romero-Gomez M, Bugianesi E, Wai-Sun Wong V, Fracanzani AL, de Ledinghen V, George J, Berzigotti A, Viganò M, Sebastiani G, Cannella R, Delamarre A, Di Maria G, Lange NF, Tulone A, Di Marco V, Cammà C, Petta S. Risk of liver-related events in metabolic dysfunction-associated steatohepatitis (MASH) patients with fibrosis: A comparative analysis of various risk stratification criteria. Hepatology 2024; 79:912-925. [PMID: 37796137 DOI: 10.1097/hep.0000000000000616] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND AND AIMS International regulatory agencies recommend testing drug therapy for patients with noncirrhotic high-risk metabolic dysfunction-associated steatohepatitis (MASH) because they are at risk of liver-related events (LRE). We aimed to compare the risk of LRE in patients with MASLD stratified for F2-F4 fibrosis and MASH. APPROACH AND RESULTS Overall, 1938 consecutive patients with biopsy-proven MASLD were enrolled. High-risk MASH was defined as MASH with F2-F4 fibrosis. LSM was measured by transient elastography. LRE were recorded during follow-up. Cox multivariate models were used to assess the association between high-risk MASH or F2-F4 fibrosis without MASH, of LSM (≥8 or ≥10 Kpa), and of AGILE 3+ with LRE. The diagnostic performance for the prediction of LRE was assessed using the area under the receiver operating characteristic curves. The observed 5-year actuarial rate of LRE was 0.4%, 0.2%, 5.1%, and 6.6% in patients with F0-F1 fibrosis without MASH, F0-F1 fibrosis with MASH, F2-F4 fibrosis without MASH, and high-risk MASH, respectively. At multivariate Cox regression analysis using F0-F1 fibrosis without MASH as a reference, both F2-F4 fibrosis without MASH [adjusted HR (aHR) 9.96] and high-risk MASH (aHR 10.14) were associated with LRE. In the 1074 patients with available LSM, LSM ≥ 10 kPa (aHR 6.31) or AGILE 3+ > 0.67 (aHR 27.45) independently predicted the development of LRE and had similarly acceptable 5-year area under the receiver operating characteristic to high-risk MASH and F2-F4 fibrosis (0.772, 0.818, 0.739, and 0.780, respectively). CONCLUSIONS The risk of LRE is similar in patients with high-risk MASH and with F2-F4 fibrosis without MASH. The use of LSM ≥ 10 kPa or AGILE 3+ > 0.67 could be an accurate option to identify patients with MASLD worthy to be included in clinical trials.
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Affiliation(s)
- Grazia Pennisi
- Dipartimento Di Promozione Della Salute, Section of Gastroenterology and Hepatology, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), University of Palermo, Italy
| | - Marco Enea
- Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), University of Palermo, Italy
| | - Manuel Romero-Gomez
- Digestive Diseases Unit, Hospital Universitario Virgen del Rocío, Biomedical Research Networking Center in Hepatic and Digestive Diseases, Instituto de Biomedicina de Sevilla, University of Seville, Seville, Spain
| | - Elisabetta Bugianesi
- Department of Medical Sciences, Division of Gastroenterology, University of Torino, Turin, Italy
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Anna Ludovica Fracanzani
- Department of Pathophysiology and Transplantation, Ca' Granda IRCCS Foundation, Policlinico Hospital, University of Milan, Milan, Italy
| | - Victor de Ledinghen
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Bordeaux University Hospital, Pessac, & INSERM U1053, Université de Bordeaux, France
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, NSW, Australia
| | - Annalisa Berzigotti
- Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mauro Viganò
- Hepatology Unit, Ospedale San Giuseppe, University of Milan, Milan, Italy
| | - Giada Sebastiani
- Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Roberto Cannella
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Italy
| | - Adèle Delamarre
- Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut-Lévêque, Bordeaux University Hospital, Pessac, & INSERM U1053, Université de Bordeaux, France
| | - Gabriele Di Maria
- Dipartimento Di Promozione Della Salute, Section of Gastroenterology and Hepatology, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), University of Palermo, Italy
| | - Naomi F Lange
- Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Adele Tulone
- Dipartimento Di Promozione Della Salute, Section of Gastroenterology and Hepatology, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), University of Palermo, Italy
| | - Vito Di Marco
- Dipartimento Di Promozione Della Salute, Section of Gastroenterology and Hepatology, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), University of Palermo, Italy
| | - Calogero Cammà
- Dipartimento Di Promozione Della Salute, Section of Gastroenterology and Hepatology, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), University of Palermo, Italy
| | - Salvatore Petta
- Dipartimento Di Promozione Della Salute, Section of Gastroenterology and Hepatology, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), University of Palermo, Italy
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Gopalakrishna H, Nair GB, Roghani RS, Ravendhran N, Rotman Y. Optimizing surveillance of low-risk metabolic dysfunction associated steatotic liver disease using transient elastography. Eur J Gastroenterol Hepatol 2024; 36:476-481. [PMID: 38407839 PMCID: PMC10923068 DOI: 10.1097/meg.0000000000002713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
BACKGROUND Most people with metabolic dysfunction-associated steatotic liver disease (MASLD) lack significant fibrosis and are considered low-risk. Surveillance strategy for low-risk MASLD remains uncertain. AIM Identify which low-risk subjects can avoid follow-up vibration-controlled transient elastography (VCTE) within 1 year. METHODS Retrospective analysis of two independent low-risk MASLD cohorts (baseline liver stiffness [LS] < 8kPa) with routine 6-12 months follow-up VCTE. The primary outcome was LS ≥ 8kPa on follow-up, requiring referral and further work-up according to current guidance. Predictors of the primary outcome on univariate and multivariate logistic regression were incorporated into a decision algorithm, and validated in an independent cohort. RESULTS Of 206 subjects in the derivation cohort, 96 were low-risk. After a median of 10 months, 24 (25%) low-risk subjects had LS ≥ 8kPa. Baseline LS ( P < 0.01) and ALT change from baseline ( P = 0.02) (multivariate AUROC = 0.84 [0.74-0.94]) predicted the primary outcome, and were incorporated to a two-step decision algorithm. Low-risk subjects with baseline LS < 5.5 kPa can avoid repeating VCTE in a year, while those with LS > 6.8 kPa require one. For intermediate baseline LS (5.5-6.8kPa), repeat VCTE is only indicated when ALT increase > 6 U/L. The algorithm had 92% negative predictive value, 78% specificity, and 78% accuracy in the derivation cohort. In the validation cohort (n = 64), it had 91% NPV, 72% specificity, and 71% accuracy. CONCLUSION In low-risk MASLD, a simple algorithm combining baseline LS and ALT change can be used to safely avoid a repeat VCTE in a year.
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Affiliation(s)
- Harish Gopalakrishna
- Liver & Energy Metabolism Section, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Gayatri B Nair
- Department of Pulmonary and Sleep Medicine, Medstar Georgetown University Hospital, Washington DC, USA
| | - Roham Salman Roghani
- Liver & Energy Metabolism Section, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
- Department of Internal Medicine, Eisenhower Health, Rancho Mirage, CA, USA
| | - Natarajan Ravendhran
- Digestive Disease Associates, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Yaron Rotman
- Liver & Energy Metabolism Section, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
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12
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Duparc T, Gore E, Combes G, Beuzelin D, Pires Da Silva J, Bouguetoch V, Marquès MA, Velazquez A, Viguerie N, Tavernier G, Arner P, Rydén M, Langin D, Sioufi N, Nasser M, Cabou C, Najib S, Martinez LO. P2Y13 receptor deficiency favors adipose tissue lipolysis and worsens insulin resistance and fatty liver disease. JCI Insight 2024; 9:e175623. [PMID: 38470490 DOI: 10.1172/jci.insight.175623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/05/2024] [Indexed: 03/13/2024] Open
Abstract
Excessive lipolysis in white adipose tissue (WAT) leads to insulin resistance (IR) and ectopic fat accumulation in insulin-sensitive tissues. However, the impact of Gi-coupled receptors in restraining adipocyte lipolysis through inhibition of cAMP production remained poorly elucidated. Given that the Gi-coupled P2Y13 receptor (P2Y13-R) is a purinergic receptor expressed in WAT, we investigated its role in adipocyte lipolysis and its effect on IR and metabolic dysfunction-associated steatotic liver disease (MASLD). In humans, mRNA expression of P2Y13-R in WAT was negatively correlated to adipocyte lipolysis. In mice, adipocytes lacking P2Y13-R displayed higher intracellular cAMP levels, indicating impaired Gi signaling. Consistently, the absence of P2Y13-R was linked to increased lipolysis in adipocytes and WAT explants via hormone-sensitive lipase activation. Metabolic studies indicated that mice lacking P2Y13-R showed a greater susceptibility to diet-induced IR, systemic inflammation, and MASLD compared with their wild-type counterparts. Assays conducted on precision-cut liver slices exposed to WAT conditioned medium and on liver-specific P2Y13-R-knockdown mice suggested that P2Y13-R activity in WAT protects from hepatic steatosis, independently of liver P2Y13-R expression. In conclusion, our findings support the idea that targeting adipose P2Y13-R activity may represent a pharmacological strategy to prevent obesity-associated disorders, including type 2 diabetes and MASLD.
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Affiliation(s)
- Thibaut Duparc
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
| | - Emilia Gore
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
| | - Guillaume Combes
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
- Institut Hospitalo-Universitaire HealthAge, (IHU HealthAge), INSERM, Toulouse University Hospital, Toulouse, France
| | - Diane Beuzelin
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
- Lifesearch SAS, Toulouse, France
| | - Julie Pires Da Silva
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
| | - Vanessa Bouguetoch
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
- Institut Hospitalo-Universitaire HealthAge, (IHU HealthAge), INSERM, Toulouse University Hospital, Toulouse, France
- Lifesearch SAS, Toulouse, France
| | | | - Ana Velazquez
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
| | - Nathalie Viguerie
- MetaDiab, I2MC, University of Toulouse, INSERM, UPS, UMR1297, Toulouse, France
| | - Geneviève Tavernier
- MetaDiab, I2MC, University of Toulouse, INSERM, UPS, UMR1297, Toulouse, France
| | - Peter Arner
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Mikael Rydén
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Dominique Langin
- Institut Hospitalo-Universitaire HealthAge, (IHU HealthAge), INSERM, Toulouse University Hospital, Toulouse, France
- MetaDiab, I2MC, University of Toulouse, INSERM, UPS, UMR1297, Toulouse, France
- Biochemistry Laboratory, Toulouse University Hospital, Toulouse, France
- Institut Universitaire de France (IUF), Paris, France
| | - Nabil Sioufi
- Institut Hospitalo-Universitaire HealthAge, (IHU HealthAge), INSERM, Toulouse University Hospital, Toulouse, France
- Lifesearch SAS, Toulouse, France
| | - Mohamad Nasser
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
- Institut Hospitalo-Universitaire HealthAge, (IHU HealthAge), INSERM, Toulouse University Hospital, Toulouse, France
| | - Cendrine Cabou
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
- Institut Hospitalo-Universitaire HealthAge, (IHU HealthAge), INSERM, Toulouse University Hospital, Toulouse, France
| | - Souad Najib
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
- Institut Hospitalo-Universitaire HealthAge, (IHU HealthAge), INSERM, Toulouse University Hospital, Toulouse, France
| | - Laurent O Martinez
- LiMitAging, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse, INSERM, Université Toulouse III - Paul Sabatier (UPS), UMR1297, Toulouse, France
- Institut Hospitalo-Universitaire HealthAge, (IHU HealthAge), INSERM, Toulouse University Hospital, Toulouse, France
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13
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Özer G, Özcan HN, Oğuz B, Haliloğlu M. Focal fatty sparing areas of the pediatric steatotic liver: pseudolesions on hepatobiliary phase magnetic resonance images. Diagn Interv Radiol 2024; 30:135-138. [PMID: 38032244 PMCID: PMC10916532 DOI: 10.4274/dir.2023.232447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Focal fatty sparing in liver can be detected as hyperintense pseudolesions on hepatobiliary phase magnetic resonance imaging (MRI). Distinguishing these pseudolesions from liver lesions may make diagnosis challenging. The aim of this study was to evaluate the imaging features of fatty sparing areas on liver MRI in pediatric patients who have been administered gadoxetate disodium. METHODS A total of 63 patients between January 2018 and June 2023 underwent gadoxetate disodium-enhanced liver MRI, and 9 (14%) patients with a focal fatty sparing were included in the study. The fat spared areas were evaluated qualitatively and quantitatively including signal intensity measurements and fat fraction calculations. RESULTS The liver MRI examinations of 9 patients (5 boys, 4 girls; aged 8-18 years, median age: 14.4) using gadoxetate disodium were evaluated. Based on in-phase and opposed-phase sequences, 13 areas of focal fatty sparing were identified. The mean fat fraction of the liver and fat spared areas were 26.2% (range, 15-47) and 9% (range, 2-17), respectively. All fat spared areas were hyperintense in the hepatobiliary phase images. The mean relative enhancement ratios of the liver and fat spared areas were 0.78 (range, 0.35-1.6) and 1.11 (range, 0.45-1.9), respectively. CONCLUSION Focal fatty sparing in liver in children was observed as hyperintense on hepatobiliary phase MRI, and it should not be identified as a focal liver lesion.
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Affiliation(s)
- Gözde Özer
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Türkiye
| | - H. Nursun Özcan
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Türkiye
| | - Berna Oğuz
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Türkiye
| | - Mithat Haliloğlu
- Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Türkiye
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Gambella A, Salvi M, Molinaro L, Patrono D, Cassoni P, Papotti M, Romagnoli R, Molinari F. Improved assessment of donor liver steatosis using Banff consensus recommendations and deep learning algorithms. J Hepatol 2024; 80:495-504. [PMID: 38036009 DOI: 10.1016/j.jhep.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/23/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND & AIMS The Banff Liver Working Group recently published consensus recommendations for steatosis assessment in donor liver biopsy, but few studies reported their use and no automated deep-learning algorithms based on the proposed criteria have been developed so far. We evaluated Banff recommendations on a large monocentric series of donor liver needle biopsies by comparing pathologists' scores with those generated by convolutional neural networks (CNNs) we specifically developed for automated steatosis assessment. METHODS We retrospectively retrieved 292 allograft liver needle biopsies collected between January 2016 and January 2020 and performed steatosis assessment using a former intra-institution method (pre-Banff method) and the newly introduced Banff recommendations. Scores provided by pathologists and CNN models were then compared, and the degree of agreement was measured with the intraclass correlation coefficient (ICC). RESULTS Regarding the pre-Banff method, poor agreement was observed between the pathologist and CNN models for small droplet macrovesicular steatosis (ICC: 0.38), large droplet macrovesicular steatosis (ICC: 0.08), and the final combined score (ICC: 0.16) evaluation, but none of these reached statistically significance. Interestingly, significantly improved agreement was observed using the Banff approach: ICC was 0.93 for the low-power score (p <0.001), 0.89 for the high-power score (p <0.001), and 0.93 for the final score (p <0.001). Comparing the pre-Banff method with the Banff approach on the same biopsy, pathologist and CNN model assessment showed a mean (±SD) percentage of discrepancy of 26.89 (±22.16) and 1.20 (±5.58), respectively. CONCLUSIONS Our findings support the use of Banff recommendations in daily practice and highlight the need for a granular analysis of their effect on liver transplantation outcomes. IMPACT AND IMPLICATIONS We developed and validated the first automated deep-learning algorithms for standardized steatosis assessment based on the Banff Liver Working Group consensus recommendations. Our algorithm provides an unbiased automated evaluation of steatosis, which will lay the groundwork for granular analysis of steatosis's short- and long-term effects on organ viability, enabling the identification of clinically relevant steatosis cut-offs for donor organ acceptance. Implementing our algorithm in daily clinical practice will allow for a more efficient and safe allocation of donor organs, improving the post-transplant outcomes of patients.
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Affiliation(s)
- Alessandro Gambella
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy; Division of Liver and Transplant Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
| | - Massimo Salvi
- Department of Electronics and Telecommunications, PolitoBIOMed Lab, Politecnico di Torino, Biolab, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Luca Molinaro
- Division of Pathology, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Damiano Patrono
- General Surgery 2U, Liver Transplant Center, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mauro Papotti
- Division of Pathology, Department of Oncology, University of Turin, Turin, Italy
| | - Renato Romagnoli
- General Surgery 2U, Liver Transplant Center, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
| | - Filippo Molinari
- Department of Electronics and Telecommunications, PolitoBIOMed Lab, Politecnico di Torino, Biolab, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
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15
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Tang H, Jiao J, Lin JD, Zhang X, Sun N. Detection of Large-Droplet Macrovesicular Steatosis in Donor Livers Based on Segment-Anything Model. J Transl Med 2024; 104:100288. [PMID: 37977550 DOI: 10.1016/j.labinv.2023.100288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/15/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
Liver transplantation is an effective treatment for end-stage liver disease, acute liver failure, and primary hepatic malignancy. However, the limited availability of donor organs remains a challenge. Severe large-droplet fat (LDF) macrovesicular steatosis, characterized by cytoplasmic replacement with large fat vacuoles, can lead to liver transplant complications. Artificial intelligence models, such as segmentation and detection models, are being developed to detect LDF hepatocytes. The Segment-Anything Model, utilizing the DEtection TRansformer architecture, has the ability to segment objects without prior knowledge of size or shape. We investigated the Segment-Anything Model's potential to detect LDF hepatocytes in liver biopsies. Pathologist-annotated specimens were used to evaluate model performance. The model showed high sensitivity but compromised specificity due to similarities with other structures. Filtering algorithms were developed to improve specificity. Integration of the Segment-Anything Model with rule-based algorithms accurately detected LDF hepatocytes. Improved diagnosis and treatment of liver diseases can be achieved through advancements in artificial intelligence algorithms for liver histology analysis.
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Affiliation(s)
- Haiming Tang
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Jingjing Jiao
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Jian Denny Lin
- Department of Management Information System, College of Business, University of Houston Clear Lake, Houston, Texas
| | - Xuchen Zhang
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut.
| | - Nanfei Sun
- Department of Management Information System, College of Business, University of Houston Clear Lake, Houston, Texas.
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Suresh D, Li A, Miller MJ, Wijarnpreecha K, Chen VL. Associations between metabolic hyperferritinaemia, fibrosis-promoting alleles and clinical outcomes in steatotic liver disease. Liver Int 2024; 44:389-398. [PMID: 37971775 PMCID: PMC10872664 DOI: 10.1111/liv.15787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND & AIMS Ferritin has been investigated as a biomarker for liver fibrosis and iron in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). However, whether metabolic hyperferritinaemia predicts progression of liver disease remains unknown. In this study, we sought to understand associations between hyperferritinaemia and (1) adverse clinical outcomes and (2) common genetic variants related to iron metabolism and liver fibrosis. METHODS This was a retrospective analysis of adults with MASLD seen at the University of Michigan Health System, where MASLD was defined by hepatic steatosis on imaging, biopsy or vibration-controlled transient elastography, plus metabolic risk factors in the absence of chronic liver diseases other than hemochromatosis. The primary predictor was serum ferritin level, which was dichotomized based on a cut-off of 300 or 450 mcg/L for women or men. Primary outcomes included (1) incident cirrhosis, liver-related events, congestive heart failure (CHF), and mortality and (2) distribution of common genetic variants associated with hepatic fibrosis and hereditary hemochromatosis. RESULTS Of 7333 patients with MASLD, 1468 (20%) had elevated ferritin. In multivariate analysis, ferritinaemia was associated with increased mortality (HR 1.68 [1.35-2.09], p < .001) and incident liver-related events (HR 1.92 [1.11-3.32], p = .019). Furthermore, elevated ferritin was associated with carriage of cirrhosis-promoting alleles including PNPLA3-rs738409-G allele (p = .0068) and TM6SF2-rs58542926-T allele (p = 0.0083) but not with common HFE mutations. CONCLUSIONS In MASLD patients, metabolic hyperferritinaemia was associated with increased mortality and higher incidence of liver-related events, and cirrhosis-promoting alleles but not with iron overload-promoting HFE mutations.
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Affiliation(s)
- Deepika Suresh
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashley Li
- School of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthew J Miller
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Karn Wijarnpreecha
- Department of Gastroenterology and Hepatology, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Bech KT, Lindvig KP, Thiele M, Castera L. Algorithms for Early Detection of Silent Liver Fibrosis in the Primary Care Setting. Semin Liver Dis 2024; 44:23-34. [PMID: 38262447 DOI: 10.1055/s-0043-1778127] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
More than one-third of the adult world population has steatotic liver disease (SLD), with a few percent of individuals developing cirrhosis after decades of silent liver fibrosis accumulation. Lack of systematic early detection causes most patients to be diagnosed late, after decompensation, when treatment has limited effect and survival is poor. Unfortunately, no isolated screening test in primary care can sufficiently predict advanced fibrosis from SLD. Recent efforts, therefore, combine several parameters into screening algorithms, to increase diagnostic accuracy. Besides patient selection, for example, by specific characteristics, algorithms include nonpatented or patented blood tests and liver stiffness measurements using elastography-based techniques. Algorithms can be composed as a set of sequential tests, as recommended by most guidelines on primary care pathways. Future use of algorithms that are easy to interpret, cheap, and semiautomatic will improve the management of patients with SLD, to the benefit of global health care systems.
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Affiliation(s)
- Katrine Tholstrup Bech
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense C, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Katrine Prier Lindvig
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense C, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Maja Thiele
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense C, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Laurent Castera
- Service d'Hépatologie, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Beaujon, Clichy, France
- Faculté de Médecine, Université Paris Cité, UMR1149 (CRI), INSERM, Paris, France
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Navarro-Meza M, Díaz-Muñoz M, Cruz-Ramos JA, Trinidad Gallardo JR, Rodríguez Oseguera MC, Bello-Medina PC, De Los Ríos-Arellano EA. Hepatocyte ballooning and steatosis in early and late gestation without liver malfunction: Effects of low protein/high carbohydrate diet. PLoS One 2024; 19:e0294062. [PMID: 38166013 PMCID: PMC10760903 DOI: 10.1371/journal.pone.0294062] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/24/2023] [Indexed: 01/04/2024] Open
Abstract
Pregnancy is a challenging metabolic and physiological condition. The aim of this study was to include a second demanding situation as a low protein/high carbohydrate diet (LPHCD) to characterize the histological and functional responses of the maternal liver. It is unknown how the maternal liver responds during early and late pregnancy to LPHCD intake. We explored early pregnancy (3 and 8 gestational age, G) and late pregnancy (15 and 20 G). The results indicated that pregnant rats under control diet showed an evident presence of ballooned hepatocytes, lipid vesicles and edema at late pregnancy (15G); in contrast, pregnant rats under LPHCD showed similar pattern of histological modification but at early pregnancy (3G). Unexpectedly, the serum biomarkers didn't display functional alterations in either group, despite of the evident histological changes no liver malfunction was detected. We conclude that pregnant rats fed with control diet and experimental LPHCD, are subjected to metabolic and physiological conditions that impact the histopathological condition of the maternal liver. Control diet promoted the histological modifications during late pregnancy whereas LPCHCD advanced the onset of these changes. Further experiments are needed to explore the biochemical mechanisms that underlie these histological modifications. Our results are also an example of the resilience associated with the pregnancy: since no functional hepatic alterations accompanied the histopathological changes, another conclusion is that no evident pathological condition was detected in this nutritional protocol.
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Affiliation(s)
- Mónica Navarro-Meza
- Departamento de Promoción, Preservación y Desarrollo de la Salud, División Ciencias de la Salud, Laboratorio C de Memoria y Neuronutrición. Centro Universitario del Sur, Universidad de Guadalajara, Ciudad Guzmán, Jalisco, México
| | - Mauricio Díaz-Muñoz
- Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, México
| | - José Alfonso Cruz-Ramos
- Departamento de Clínicas Médicas, Universidad de Guadalajara, Guadalajara, Jalisco, México
- Coordinación de Investigación, Subdirección de Desarrollo institucional, Instituto Jalisciense de Cancerología, Guadalajara, Jalisco, México
| | - Jonathan Rafael Trinidad Gallardo
- Departamento de Promoción, Preservación y Desarrollo de la Salud, División Ciencias de la Salud, Laboratorio C de Memoria y Neuronutrición. Centro Universitario del Sur, Universidad de Guadalajara, Ciudad Guzmán, Jalisco, México
| | - María Conchita Rodríguez Oseguera
- Departamento de Promoción, Preservación y Desarrollo de la Salud, División Ciencias de la Salud, Laboratorio C de Memoria y Neuronutrición. Centro Universitario del Sur, Universidad de Guadalajara, Ciudad Guzmán, Jalisco, México
| | - Paola C. Bello-Medina
- Facultad de Ciencias e Instituto de Educación a distancia IDEAD, Universidad del Tolima, Ibagué, Tolima, Colombia
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Wang X, Pan X, Zhou W, Jing Z, Yu F, Wang Y, Zeng J, Wu J, Zeng X, Zhang J. Quantification of Hepatic Steatosis on Dual-Energy CT in Comparison With MRI mDIXON-Quant Sequence in Breast Cancer. J Comput Assist Tomogr 2024; 48:64-71. [PMID: 37558648 DOI: 10.1097/rct.0000000000001529] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
OBJECTIVE The study aimed to evaluate the correlation and diagnostic value of liver fat quantification in unenhanced dual-energy CT (DECT) using quantitative magnetic resonance imaging (MRI) mDIXON-Quant sequence as reference standard in patients with breast cancer. METHODS Patients with breast cancer were prospectively recruited between June 2018 and April 2020. Each patient underwent liver DECT and MRI mDIXON-Quant examination. The DECT-fat volume fraction (FVF) and liver-spleen attenuation differences were compared with the MRI-proton density fat fraction using scatterplots, Bland-Altman plots, and concordance correlation coefficient. Receiver operating characteristic curves were established to determine the diagnostic accuracy of hepatic steatosis by DECT. RESULTS A total of 216 patients with breast cancer (mean age, 50.08 ± 9.33 years) were evaluated. The DECT-FVF correlated well with MRI-proton density fat fraction ( r2 = 0.902; P < 0.001), which was higher than the difference in liver-spleen attenuation ( r2 = 0.728; P < 0.001). Bland-Altman analysis revealed slight positive bias; the mean difference was 3.986. The DECT-FVF yielded an average concordance correlation coefficient of 0.677, which was higher than the difference of liver-spleen attenuation (-0.544). The DECT-FVF and the difference in liver-spleen attenuation both lead to mild overestimation of hepatic steatosis. The areas under the curve of DECT-FVF (0.956) were higher than the difference in liver-spleen attenuation (0.807) in identifying hepatic steatosis ( P < 0.001). CONCLUSIONS Dual-energy CT-FVF may serve as a reliable screening and quantitative tool for hepatic steatosis in patients with breast cancer.
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Affiliation(s)
- Xiaoxia Wang
- From the Department of Radiology, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC)
| | - Xianjun Pan
- Breast Cancer Center, Chongqing University Cancer Hospital, Chongqing
| | - Wenqi Zhou
- Breast Cancer Center, Chongqing University Cancer Hospital, Chongqing
| | - Zhouhong Jing
- Breast Cancer Center, Chongqing University Cancer Hospital, Chongqing
| | - Feng Yu
- Breast Cancer Center, Chongqing University Cancer Hospital, Chongqing
| | - Yali Wang
- Breast Cancer Center, Chongqing University Cancer Hospital, Chongqing
| | - Junjie Zeng
- Breast Cancer Center, Chongqing University Cancer Hospital, Chongqing
| | | | - Xiaohua Zeng
- Breast Cancer Center, Chongqing University Cancer Hospital, Chongqing
| | - Jiuquan Zhang
- From the Department of Radiology, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC)
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Yeo YH, Yang JD. Correspondence on Letter regarding "Assessing the performance of ChatGPT in answering questions regarding cirrhosis and hepatocellular carcinoma". Clin Mol Hepatol 2024; 30:124-125. [PMID: 37957812 PMCID: PMC10776292 DOI: 10.3350/cmh.2023.0470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 11/15/2023] Open
Affiliation(s)
- Yee Hui Yeo
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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21
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Zhang Y, Wu L, Mu Z, Ren L, Chen Y, Liu H, Xu L, Wang Y, Wang Y, Cheng S, Tham YC, Sheng B, Wong TY, Ji H. Letter 2 regarding "Assessing the performance of ChatGPT in answering questions regarding cirrhosis and hepatocellular carcinoma". Clin Mol Hepatol 2024; 30:113-117. [PMID: 37946373 PMCID: PMC10776295 DOI: 10.3350/cmh.2023.0440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 11/12/2023] Open
Affiliation(s)
- Yiwen Zhang
- Department of Endocrinology and Metabolic Hepatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Liwei Wu
- Department of Gastroenterology and Hepatology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Zepeng Mu
- Department of Endocrinology and Metabolic Hepatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Linlin Ren
- Department of Gastroenterology and Hepatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ying Chen
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hanyun Liu
- Department of Infectious Disease and Hepatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lili Xu
- Department of Endocrinology and Metabolic Hepatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yangang Wang
- Department of Endocrinology and Metabolic Hepatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yaxing Wang
- Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Yih Chung Tham
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Bin Sheng
- Department of Computer Science and Engineering, Shanghai JiaoTong University, Shanghai, China
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Hongwei Ji
- Tsinghua Medicine, Tsinghua University, Beijing, China
- Department of Internal Medicine, Beijing Tsinghua Changgung Hospital, Beijing, China
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Kobayashi T, Iwaki M, Nogami A, Kawamura N, Honda Y, Ogawa Y, Imajo K, Yoneda M, Saito S, Nakajima A. Prediction of outcomes in patients with metabolic dysfunction-associated steatotic liver disease based on initial measurements and subsequent changes in magnetic resonance elastography. J Gastroenterol 2024; 59:56-65. [PMID: 37845417 PMCID: PMC10764489 DOI: 10.1007/s00535-023-02049-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND The prognosis of metabolic dysfunction-associated steatotic liver disease (MASLD) is strongly associated with liver fibrosis. We aimed to investigate whether liver stiffness measurement (LSM) and changes in LSM (ΔLSM) on magnetic resonance elastography (MRE) can predict clinical events in patients with MASLD. METHODS We included 405 patients with MASLD who underwent at least two MREs. The patients were divided into five groups corresponding to fibrosis stages (0-4) based on initial LSM and classified as progressors (ΔLSM ≥ 19%) or non-progressors (ΔLSM < 19%) based on the difference between the first and last LSM. RESULTS The mean follow-up period was 72.6 months, and the mean interval between MREs was 23.5 months. There were 52 (12.8%) progressors and 353 (87.2%) non-progressors. The initial LSM was significantly associated with the cumulative probabilities of decompensated cirrhosis, hepatocellular carcinoma (HCC), liver-related events, extrahepatic malignancies, and overall mortality but not with cardiovascular disease. Progressors had significantly higher hazard ratios (HRs) for decompensated cirrhosis, HCC, and liver-related events but not for extrahepatic malignancies, cardiovascular disease, or overall mortality. Among patients without cirrhosis, the HR for developing cirrhosis among progressors was 60.15. Progressors had a significantly higher risk of liver-related events, even in the low initial LSM (fibrosis stage 0-2) subgroups. CONCLUSIONS Both initial LSM and ΔLSM can predict liver-related events in patients with MASLD, even for low initial LSM. This integrated assessment can allow more detailed risk stratification compared with single LSM assessments and identify high-risk patients with MASLD among those previously considered as low risk.
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Affiliation(s)
- Takashi Kobayashi
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Michihiro Iwaki
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Asako Nogami
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Nobuyoshi Kawamura
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
- Department of Gastroenterology, Shin-Yurigaoka General Hospital, Kawasaki, Japan
| | - Yasushi Honda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Yuji Ogawa
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
- Gastroenterology Division, National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - Kento Imajo
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
- Department of Gastroenterology, Shin-Yurigaoka General Hospital, Kawasaki, Japan
| | - Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan.
| | - Satoru Saito
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
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Arenas-Pinto A, Bakewell N, Milinkovic A, Williams I, Vera J, Post FA, Anderson J, Beynon M, O'Brien A, Doyle N, Gilson R, Pett SL, Winston A, Sabin CA. Hepatic steatosis in people older and younger than fifty who are living with HIV and HIV-negative controls: A cross-sectional study nested within the POPPY cohort. HIV Med 2024; 25:95-106. [PMID: 37670375 DOI: 10.1111/hiv.13540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/16/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Hepatic steatosis is a major cause of chronic liver disease associated with several negative health outcomes. We compared the prevalence of and factors associated with steatosis in people living with and without HIV. METHODS Older (>50 years) and younger (<50 years) people with HIV and older HIV-negative controls (>50 years) underwent liver transient elastography examination with controlled attenuation parameter (steatosis ≥238 dB/m, moderate/severe steatosis ≥280 dB/m, liver fibrosis ≥7.1 kPa). We compared groups using logistic regression/Chi-squared/Fisher's exact/Kruskal-Wallis tests. RESULTS In total, 317 participants (109 older people with HIV; 101 younger people with HIV; 107 HIV-negative controls) were predominantly white (86%) and male (76%), and 21% were living with obesity (body mass index ≥30 kg/m2 ). Most (97%) people with HIV had undetectable HIV RNA. The prevalence of fibrosis was 8.4%, 3.0%, and 6.5% in the three groups, respectively (p = 0.26). Fibrosis was predominately (>65%) mild. The prevalence of steatosis was the same in older people with HIV (66.4%) and controls (66.4%) but lower in younger people with HIV (37.4%; p < 0.001). After adjustment, younger people with HIV were less likely to have steatosis (odds ratio [OR] 0.26; 95% confidence interval [CI] 0.14-0.52) than controls, but male sex (OR 2.45; 95% CI 1.20-4.50) and high waist-to-hip ratio (OR 3.04; 95% CI 1.74-5.33) were associated with an increased odds of steatosis. We found no association between steatosis and HIV-related variables. CONCLUSIONS The prevalence of hepatic steatosis and fibrosis was similar between older participants regardless of HIV status. Age, sex, and abdominal obesity, but not HIV-related variables, were associated with steatosis. Interventions for controlling obesity should be integrated into routine HIV care.
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Affiliation(s)
- Alejandro Arenas-Pinto
- Institute for Global Health, University College London, London, UK
- MRC Clinical Trials Unit at University College London, London, UK
- Central and North-West London NHS Foundation Trust, London, UK
| | | | - Ana Milinkovic
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Ian Williams
- Institute for Global Health, University College London, London, UK
- Central and North-West London NHS Foundation Trust, London, UK
| | - Jaime Vera
- Brighton and Sussex Medical School, Brighton, UK
| | - Frank A Post
- King's College Hospital NHS Foundation Trust, London, UK
| | | | - Michelle Beynon
- Institute for Global Health, University College London, London, UK
- Central and North-West London NHS Foundation Trust, London, UK
| | - Alastair O'Brien
- Institute of Liver and Digestive Health, University College London, London, UK
| | | | - Richard Gilson
- Institute for Global Health, University College London, London, UK
- Central and North-West London NHS Foundation Trust, London, UK
| | - Sarah L Pett
- Institute for Global Health, University College London, London, UK
- MRC Clinical Trials Unit at University College London, London, UK
- Central and North-West London NHS Foundation Trust, London, UK
| | | | - Caroline A Sabin
- Institute for Global Health, University College London, London, UK
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Srinivas AN, Suresh D, Chidambaram SB, Santhekadur PK, Kumar DP. Apoptosis antagonizing transcription factor-mediated liver damage and inflammation to cancer: Therapeutic intervention by curcumin in experimental metabolic dysfunction associated steatohepatitis-hepatocellular carcinoma. J Cell Physiol 2024; 239:135-151. [PMID: 37942831 DOI: 10.1002/jcp.31151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023]
Abstract
In tandem with the expanding obesity pandemic, the prevalence of metabolic dysfunction associated steatohepatitis (MASH, formerly known as NASH)- driven hepatocellular carcinoma (HCC) is predicted to rise globally, creating a significant need for therapeutic interventions. We previously identified the upregulation of apoptosis antagonizing transcription factor (AATF), which is implicated in facilitating the progression from MASH to HCC. The objective of this study was to examine whether the intervention of curcumin could alleviate AATF-mediated MASH, inhibit tumor growth, and elucidate the underlying mechanism. A preclinical murine model mimicking human MASH-HCC was employed, subjecting mice to either a chow diet normal water (CDNW) or western diet sugar water (WDSW) along with very low dose of carbon tetrachloride (CCl4 - 0.2 μL/g, weekly). Mice receiving curcumin (CUR) alongside WDSW/CCl4 exhibited significant improvements, including reduced liver enzymes, dyslipidemia, steatosis, inflammation, and hepatocellular ballooning. Curcumin treatment also suppressed hepatic expression of inflammatory, fibrogenic, and oncogenic markers. Of note, there was a significant reduction in the expression of AATF upon curcumin treatment in WDSW/CCl4 mice and human HCC cells. In contrast, curcumin upregulated Kruppel-like factor 4 (KLF4) in MASH liver and HCC cells, which is known to downregulate sp1 (specificity protein-1) expression. Thus, curcumin treatment effectively inhibited the progression of MASH to HCC by downregulating the expression of AATF via the KLF4-Sp1 signaling pathway. These preclinical findings establish a novel molecular connection between curcumin and AATF in reducing hepatocarcinogenesis, and provide a strong rationale for the development of curcumin as a viable treatment for MASH-HCC in humans.
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Affiliation(s)
- Akshatha N Srinivas
- Department of Biochemistry, CEMR lab, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Diwakar Suresh
- Department of Biochemistry, CEMR lab, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Saravana B Chidambaram
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Prasanna K Santhekadur
- Department of Biochemistry, CEMR lab, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Divya P Kumar
- Department of Biochemistry, CEMR lab, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
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Labayen I, Cadenas-Sánchez C, Idoate F, Medrano M, Tobalina I, Villanueva A, Rodríguez-Vigil B, Álvarez de Eulate N, Osés M, Cabeza R. Liver Fat, Bone Marrow Adipose Tissue, and Bone Mineral Density in Children With Overweight. J Clin Endocrinol Metab 2023; 109:e253-e258. [PMID: 37490040 DOI: 10.1210/clinem/dgad429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/21/2023] [Accepted: 07/21/2023] [Indexed: 07/26/2023]
Abstract
CONTEXT Hepatic steatosis is associated with decreased bone mineral density (BMD). Bone marrow fat fraction (BMFF) could play a role in this relationship in children with obesity. OBJECTIVE The objectives of this work were (i) to examine the relationship between the lumbar spine (LS) BMFF and BMD, and (ii) to explore the mediating role of LS-BMFF on the relationship between percentage hepatic fat with LS-BMD in preadolescent children with overweight/obesity. METHODS Hepatic fat and LS-BMFF (magnetic resonance imaging) and areal LS-BMD (LS-aBMD, dual-energy x-ray absorptiometry) were measured in 106 children (aged 10.6 ± 1.1 years, 53.8% girls) with overweight/obesity. RESULTS LS-BMFF was inversely associated with LS-aBMD (r = -0.313; P = .001) and directly related with percentage hepatic fat (r = 0.276; P = .005). LS-BMFF was significantly greater in children with than without hepatic steatosis (P = .003; Cohen's d: 0.61; 95% CI, -0.21 to 1.0), while no significant difference was seen between children with overweight and those with obesity (P = .604; Cohen's d: 0.16; 95% CI, -0.21-0.55). Mediating analysis indicated that LS-BMFF is an important mediator (50%) in the association of hepatic fat with lower LS-aBMD (indirect effect: β = -.076; 95% CI, -0.143 to -0.015). CONCLUSION These findings suggest that hepatic steatosis, rather than overall excess adiposity, is associated with greater bone marrow adipose tissue in preadolescent children with overweight/obesity, which in turn, is related to lower BMD. Hepatic steatosis could be a potential biomarker of osteoporosis risk, and a therapeutic target for interventions that aim to reduce not only hepatic steatosis, but for those designed to improve bone health in such children.
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Affiliation(s)
- Idoia Labayen
- Institute for Sustainability & Food Chain Innovation (ISFOOD), Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Navarre, Spain
- IdiSNA, Navarra Institute for Health Research, 31006 Pamplona, Navarre, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Cristina Cadenas-Sánchez
- Institute for Sustainability & Food Chain Innovation (ISFOOD), Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Navarre, Spain
- IdiSNA, Navarra Institute for Health Research, 31006 Pamplona, Navarre, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada 18071, Spain
| | - Fernando Idoate
- Radiology Department, Mutua Navarra, Department of Health Sciences, Public University of Navarre, 31012 Pamplona, Navarre, Spain
| | - María Medrano
- Institute for Sustainability & Food Chain Innovation (ISFOOD), Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Navarre, Spain
- IdiSNA, Navarra Institute for Health Research, 31006 Pamplona, Navarre, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ignacio Tobalina
- Department of Nuclear Medicine, University Hospital of Araba (HUA), Bioaraba Health Research Institute, 01004 Vitoria-Gasteiz, Alava, Spain
- Department of Medicine, University of the Basque Country, UPV/EHU, 01006 Vitoria-Gasteiz, Spain
| | - Arantxa Villanueva
- Department of Electrical, Electronic and Communications Engineering, Smart Cities Institute, Public University of Navarre, 31006 Pamplona, Spain
| | - Beatriz Rodríguez-Vigil
- Department of Magnetic Resonance Imaging, University Hospital of Araba (HUA), Osakidetza Basque Health Service, Osatek, Bioaraba Health Research Institute, 01004 Vitoria-Gasteiz, Alava, Spain
| | | | - Maddi Osés
- Institute for Sustainability & Food Chain Innovation (ISFOOD), Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Navarre, Spain
- IdiSNA, Navarra Institute for Health Research, 31006 Pamplona, Navarre, Spain
| | - Rafael Cabeza
- Department of Electrical, Electronic and Communications Engineering, Smart Cities Institute, Public University of Navarre, 31006 Pamplona, Spain
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Molangiri A, Varma S, Hridayanka KSN, Srinivas M, Kona SR, Ibrahim A, Duttaroy AK, Basak S. Gestational exposure to bisphenol S induces microvesicular steatosis in male rat offspring by modulating metaflammation. Sci Total Environ 2023; 904:166775. [PMID: 37660821 DOI: 10.1016/j.scitotenv.2023.166775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/09/2023] [Accepted: 08/31/2023] [Indexed: 09/05/2023]
Abstract
Prenatal exposure to endocrine-disrupting bisphenol A (BPA) shows a long-lasting programming effect on an organ's metabolic function and predisposes it to the risk of adult metabolic diseases. Although a reduced contaminant risk due to "BPA-free" exposure is proposed, limited data on a comparative assessment of gestational exposure to BPS and BPA and their effects on metaflammation in predisposing liver metabolic disease is reported. Pregnant Wistar rats were exposed to BPS and BPA (0.0, 0.4, 4.0 μg/kg bw) via gavage from gestational day 4 to 21, and effects were assessed in the 90 d male offspring. Prenatal BPS-exposed offspring showed a more obesogenic effect than BPA, including changes in body fat distribution, feed efficiency, and leptin signalling. The BPS exposure induced the adipocyte hypertrophy of visceral adipose to a greater extent than BPA. The adipose hypertrophy was augmented by tissue inflammation, endoplasmic reticulum (ER) stress, and apoptosis due to increased expression of pro-inflammatory (IL6, IL1β, CRP, COX2) cytokines, ER stress modulator (CHOP), and apoptotic effector (Caspase 3). The enlarged, stressed, inflamed adipocytes triggered de novo lipogenesis in the bisphenol-exposed offspring liver due to increased expression of cholesterol and lipid biogenesis mediators (srebf1, fasn, acaca, PPARα) concomitant with elevated triacylglycerol (TG) and cholesterol (TC), resulted in impaired hepatic clearance of lipids. The lipogenic effects were also promoted by increased expression of HSD11β1. BPS exposure increased absolute liver weight, discoloration, altered liver lobes more than in BPA. Liver histology showed numerous lipid droplets, and hepatocyte ballooning, upregulated ADRP expression, an increased expression of pro-inflammatory mediators (IL6, CRP, IL1β, TNFα, COX2), enhanced lipid peroxidation in the BPS-exposed offspring's liver suggest altered metaflammation leads to microvesicular steatosis. Overall, gestational BPS exposure demonstrated a higher disruption in metabolic changes than BPA, involving excess adiposity, liver fat, inflammation, and predisposition to steatosis in the adult male offspring.
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Affiliation(s)
- Archana Molangiri
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Saikanth Varma
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | | | - Myadara Srinivas
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Suryam Reddy Kona
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Ahamed Ibrahim
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Asim K Duttaroy
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Sanjay Basak
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India.
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27
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Orcel T, Chau HT, Turlin B, Chaigneau J, Bannier E, Otal P, Frampas E, Leguen A, Boulic A, Saint-Jalmes H, Aubé C, Boursier J, Bardou-Jacquet E, Gandon Y. Evaluation of proton density fat fraction (PDFF) obtained from a vendor-neutral MRI sequence and MRQuantif software. Eur Radiol 2023; 33:8999-9009. [PMID: 37402003 DOI: 10.1007/s00330-023-09798-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 03/29/2023] [Accepted: 04/21/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To validate the proton density fat fraction (PDFF) obtained by the MRQuantif software from 2D chemical shift encoded MR (CSE-MR) data in comparison with the histological steatosis data. METHODS This study, pooling data from 3 prospective studies spread over time between January 2007 and July 2020, analyzed 445 patients who underwent 2D CSE-MR and liver biopsy. MR derived liver iron concentration (MR-LIC) and PDFF was calculated using the MRQuantif software. The histological standard steatosis score (SS) served as reference. In order to get a value more comparable to PDFF, histomorphometry fat fraction (HFF) were centrally determined for 281 patients. Spearman correlation and the Bland and Altman method were used for comparison. RESULTS Strong correlations were found between PDFF and SS (rs = 0.84, p < 0.001) or HFF (rs = 0.87, p < 0.001). Spearman's coefficients increased to 0.88 (n = 324) and 0.94 (n = 202) when selecting only the patients without liver iron overload. The Bland and Altman analysis between PDFF and HFF found a mean bias of 5.4% ± 5.7 [95% CI 4.7, 6.1]. The mean bias was 4.7% ± 3.7 [95% CI 4.2, 5.3] and 7.1% ± 8.8 [95% CI 5.2, 9.0] for the patients without and with liver iron overload, respectively. CONCLUSION The PDFF obtained by MRQuantif from a 2D CSE-MR sequence is highly correlated with the steatosis score and very close to the fat fraction estimated by histomorphometry. Liver iron overload reduced the performance of steatosis quantification and joint quantification is recommended. This device-independent method can be particularly useful for multicenter studies. CLINICAL RELEVANCE STATEMENT The quantification of liver steatosis using a vendor-neutral 2D chemical-shift MR sequence, processed by MRQuantif, is well correlated to steatosis score and histomorphometric fat fraction obtained from biopsy, whatever the magnetic field and the MR device used. KEY POINTS • The PDFF measured by MRQuantif from 2D CSE-MR sequence data is highly correlated to hepatic steatosis. • Steatosis quantification performance is reduced in case of significant hepatic iron overload. • This vendor-neutral method may allow consistent estimation of PDFF in multicenter studies.
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Affiliation(s)
- T Orcel
- Department of Radiology, Rennes University Hospital, 2 Rue H. Le Guilloux, 35033, Rennes, France
| | - H T Chau
- Department of Radiology, Rennes University Hospital, 2 Rue H. Le Guilloux, 35033, Rennes, France
- NUMECAN, INSERM U1099, Rennes University Hospital, 2 Rue H. Le Guilloux, 35033, Rennes, France
| | - B Turlin
- NUMECAN, INSERM U1099, Rennes University Hospital, 2 Rue H. Le Guilloux, 35033, Rennes, France
- Department of Pathology, Rennes University Hospital, 2 Rue H. Le Guilloux, 35033, Rennes, France
| | - J Chaigneau
- HIFIH, UPRES EA3859, Angers University Hospital, 4 Rue Larrey, 49993, Angers, France
| | - E Bannier
- Department of Radiology, Rennes University Hospital, 2 Rue H. Le Guilloux, 35033, Rennes, France
- EMPENN U746 Unit/Project, INSERM/INRIA, IRISA, University of Rennes, Beaulieu Campus, UMR CNRS 6074, 35042, Rennes, France
| | - P Otal
- Department of Radiology, Toulouse University Hospital, 1 Av Pr J. Poulhes, 31059, Toulouse, France
| | - E Frampas
- Department of Radiology, Nantes University Hospital, 1 Pl. Alexis-Ricordeau, 44000, Nantes, France
| | - A Leguen
- Department of Radiology, Bretagne-Atlantique Hospital, 20 Bd Général Maurice Guillaudot, 56000, Vannes, France
| | - A Boulic
- Department of Radiology, Bretagne Sud Hospital, 5 Avenue de Choiseul, 56322, Lorient, France
| | - H Saint-Jalmes
- INSERM U1099, LTSI, University of Rennes, Beaulieu Campus, 35042, Rennes, France
| | - C Aubé
- HIFIH, UPRES EA3859, Angers University Hospital, 4 Rue Larrey, 49993, Angers, France
- Department of Radiology, Angers University Hospital, 4 Rue Larrey, 49993, Angers, France
| | - J Boursier
- HIFIH, UPRES EA3859, Angers University Hospital, 4 Rue Larrey, 49993, Angers, France
- Department of Hepatology-GastoeEnterology, Angers University Hospital, 4 Rue Larrey, 49993, Angers, France
| | - E Bardou-Jacquet
- NUMECAN, INSERM U1099, Rennes University Hospital, 2 Rue H. Le Guilloux, 35033, Rennes, France
- Department of Hepatology, Rennes University Hospital, 2 Rue H. Le Guilloux, 35033, Rennes, France
| | - Y Gandon
- Department of Radiology, Rennes University Hospital, 2 Rue H. Le Guilloux, 35033, Rennes, France.
- NUMECAN, INSERM U1099, Rennes University Hospital, 2 Rue H. Le Guilloux, 35033, Rennes, France.
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Lee DH, Jo I, Lee HS, Kang J. Combined impact of myosteatosis and liver steatosis on prognosis in stage I-III colorectal cancer patients. J Cachexia Sarcopenia Muscle 2023; 14:2908-2915. [PMID: 37964719 PMCID: PMC10751431 DOI: 10.1002/jcsm.13369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/15/2023] [Accepted: 10/06/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Myosteatosis and liver steatosis (LS) have been recognized as patient-derived image biomarkers that correlate with prognosis in colorectal cancer (CRC) patients. However, the significance of considering fat deposition in multiple body areas simultaneously has been underestimated. This study aimed to investigate the combined effect of myosteatosis and LS in stage I-III CRC patients. METHODS A total of 616 stage I-III CRC patients were included in the study. Myosteatosis was assessed using skeletal muscle radiodensity (SMD), and LS was estimated by calculating the Hounsfield unit of the liver and spleen ratio (LSR). Cox proportional hazard models were utilized to evaluate disease-free survival (DFS). A combination of myosteatosis and LS was proposed, and its discriminatory performance was compared using the C-index. RESULTS Among the 616 participants, the median (interquartile) age was 64 (55-72) years, and 240 (38.9%) were female. The median and interquartile range of LSR were determined as 1.106 (0.967-1.225). The optimal cutoff value for LSR was identified as 1.181, leading to the classification of patients into low (410, 66.5%) and high LSR (206, 33.4%) groups. Among the patients, 200 were categorized into the low SMD group, while 416 were allocated to the high SMD group. Both myosteatosis and LS were identified as independent prognostic factors in the multivariable analysis. The combination of these two variables resulted in a three-group classification: high SMD with low LSR group, high SMD with high LSR group, and low SMD group. When comparing the C-index values, the three-group classification exhibited superior discriminatory performance compared with considering myosteatosis and LS separately. CONCLUSIONS Myosteatosis was associated with poorer survival, while the presence of LS was linked to a better prognosis in non-metastatic CRC patients. Simultaneously considering fat infiltration can serve as a more effective prognosticator in non-metastatic CRC patients.
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Affiliation(s)
- Dong Hee Lee
- Department of Surgery, Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea
| | - Il Jo
- Department of Surgery, Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration UnitYonsei University College of MedicineSeoulRepublic of Korea
| | - Jeonghyun Kang
- Department of Surgery, Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea
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29
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Cho BS, Fligor SC, Fell GL, Secor JD, Tsikis ST, Pan A, Yu LJ, Ko VH, Dao DT, Anez-Bustillos L, Hirsch TI, Lund J, Rustan AC, Fraser DA, Gura KM, Puder M. A medium-chain fatty acid analogue prevents hepatosteatosis and decreases inflammatory lipid metabolites in a murine model of parenteral nutrition-induced hepatosteatosis. PLoS One 2023; 18:e0295244. [PMID: 38039287 PMCID: PMC10691711 DOI: 10.1371/journal.pone.0295244] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Parenteral (intravenous) nutrition is lifesaving for patients with intestinal failure, but long-term use of parenteral nutrition often leads to liver disease. SEFA-6179 is a synthetic medium-chain fatty acid analogue designed to target multiple fatty acid receptors regulating metabolic and inflammatory pathways. We hypothesized that SEFA-6179 would prevent hepatosteatosis and lipotoxicity in a murine model of parenteral nutrition-induced hepatosteatosis. METHODS Two in vivo experiments were conducted. In the first experiment, six-week-old male mice were provided an ad lib fat-free high carbohydrate diet (HCD) for 19 days with orogastric gavage of either fish oil, medium-chain triglycerides, or SEFA-6179 at a low (0.3mmol/kg) or high dose (0.6mmol/kg). In the second experiment, six-week-old mice were provided an ad lib fat-free high carbohydrate diet for 19 days with every other day tail vein injection of saline, soybean oil lipid emulsion, or fish oil lipid emulsion. Mice then received every other day orogastric gavage of medium-chain triglyceride vehicle or SEFA-6179 (0.6mmol/kg). Hepatosteatosis was assessed by a blinded pathologist using an established rodent steatosis score. Hepatic lipid metabolites were assessed using ultra-high-performance liquid chromatography-mass spectrometry. Effects of SEFA-6179 on fatty acid oxidation, lipogenesis, and fatty acid uptake in human liver cells were assessed in vitro. RESULTS In the first experiment, mice receiving the HCD with either saline or medium-chain triglyceride treatment developed macrovesicular steatosis, while mice receiving fish oil or SEFA-6179 retained normal liver histology. In the second experiment, mice receiving a high carbohydrate diet with intravenous saline or soybean oil lipid emulsion, along with medium chain triglyceride vehicle treatment, developed macrovescular steatosis. Treatment with SEFA-6179 prevented steatosis. In each experiment, SEFA-6179 treatment decreased arachidonic acid metabolites as well as key molecules (diacylglycerol, ceramides) involved in lipotoxicity. SEFA-6179 increased both β- and complete fatty oxidation in human liver cells, while having no impact on lipogenesis or fatty acid uptake. CONCLUSIONS SEFA-6179 treatment prevented hepatosteatosis and decreased toxic lipid metabolites in a murine model of parenteral nutrition-induced hepatosteatosis. An increase in both β- and complete hepatic fatty acid oxidation may underlie the reduction in steatosis.
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Affiliation(s)
- Bennet S. Cho
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Scott C. Fligor
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Gillian L. Fell
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jordan D. Secor
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Savas T. Tsikis
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Amy Pan
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Lumeng J. Yu
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Victoria H. Ko
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Duy T. Dao
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Lorenzo Anez-Bustillos
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Thomas I. Hirsch
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jenny Lund
- Department of Pharmacy, Section for Pharmacology and Pharmaceutical Biosciences, University of Oslo, Oslo, Norway
| | - Arild C. Rustan
- Department of Pharmacy, Section for Pharmacology and Pharmaceutical Biosciences, University of Oslo, Oslo, Norway
| | | | - Kathleen M. Gura
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Pharmacy and the Division of Gastroenterology and Nutrition, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Mark Puder
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
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Zhang X, Dutton M, Liu R, Ali AA, Sherbeny F. Deep Learning-Based Survival Analysis for Receiving a Steatotic Donor Liver Versus Waiting for a Standard Liver. Transplant Proc 2023; 55:2436-2443. [PMID: 37872066 DOI: 10.1016/j.transproceed.2023.09.032] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/12/2023] [Accepted: 09/22/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND An emerging strategy to expand the donor pool is the use of a steatotic donor liver (SDLs; ≥ 30% macrosteatosis on biopsy). With the obesity epidemic and prevalence of nonalcoholic fatty liver disease, SDLs have been reported in 59% of all deceased donors. Many potential candidates need to decide whether to accept an SDL offer or remain on the waitlist for a nonsteatotic donor liver (non-SDL). The objective of this study was to compare the survival of accepting an SDL vs using a non-SDL after waiting various times. METHODS Using data from the United States' organ procurement and transplantation network, deep survival learning predictive models were built to compare post-decision survival after accepting an SDL vs waiting for a non-SDL. The comparison subjects contain simulated 20,000 different scenarios of a candidate either accepting an SDL immediately or receiving a non-SDL after waiting various times. The research variables were selected using the LASSO-Cox and Random Survival Forest (RSF) models. The Cox proportional hazards and RSF models were also comparatively included for survival prediction. In addition, personalized survival curves for randomly selected candidates were generated. RESULT Deep survival learning outperformed Cox proportional hazards and RSF in predicting the survival of liver transplants. Among the simulations, 25% to 30% of scenarios demonstrated a higher 3-year survival post-decision for candidates accepting an SDL than waiting and receiving a non-SDL. The difference was only 1.43% in 3-year survival post-decision between accepting an SDL and waiting 260 days (mean waitlist time) for a non-SDL. As the number of days on the waitlist increases, the difference in survival between accepting SDLs and waiting for non-SDLs decreases. CONCLUSIONS Appropriately used SDLs could expand the donor pool and relieve the candidates' unmet need for donor livers, which presents long-term survival benefits for recipients.
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Affiliation(s)
- Xiao Zhang
- Economic, Social and Administrative Pharmacy, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, Florida.
| | - Matthew Dutton
- Economic, Social and Administrative Pharmacy, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, Florida
| | - Rongjie Liu
- Department of Statistics, Florida State University, Tallahassee, Florida
| | - Askal A Ali
- Economic, Social and Administrative Pharmacy, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, Florida
| | - Fatimah Sherbeny
- Economic, Social and Administrative Pharmacy, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, Florida
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31
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Zhou C, Ruiz HH, Ling L, Maurizi G, Sakamoto K, Liberini CG, Wang L, Stanley A, Egritag HE, Sanz SM, Lindtner C, Butera MA, Buettner C. Sympathetic overdrive and unrestrained adipose lipolysis drive alcohol-induced hepatic steatosis in rodents. Mol Metab 2023; 78:101813. [PMID: 37777008 PMCID: PMC10590866 DOI: 10.1016/j.molmet.2023.101813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023] Open
Abstract
OBJECTIVE Hepatic steatosis is a key initiating event in the pathogenesis of alcohol-associated liver disease (ALD), the most detrimental organ damage resulting from alcohol use disorder. However, the mechanisms by which alcohol induces steatosis remain incompletely understood. We have previously found that alcohol binging impairs brain insulin action, resulting in increased adipose tissue lipolysis by unrestraining sympathetic nervous system (SNS) outflow. Here, we examined whether an impaired brain-SNS-adipose tissue axis drives hepatic steatosis through unrestrained adipose tissue lipolysis and increased lipid flux to the liver. METHODS We examined the role of lipolysis, and the brain-SNS-adipose tissue axis and stress in alcohol induced hepatic triglyceride accumulation in a series of rodent models: pharmacological inhibition of the negative regulator of insulin signaling protein-tyrosine phosphatase 1β (PTP1b) in the rat brain, tyrosine hydroxylase (TH) knockout mice as a pharmacogenetic model of sympathectomy, adipocyte specific adipose triglyceride lipase (ATGL) knockout mice, wildtype (WT) mice treated with β3 adrenergic agonist or undergoing restraint stress. RESULTS Intracerebral administration of a PTP1b inhibitor, inhibition of adipose tissue lipolysis and reduction of sympathetic outflow ameliorated alcohol induced steatosis. Conversely, induction of adipose tissue lipolysis through β3 adrenergic agonism or by restraint stress worsened alcohol induced steatosis. CONCLUSIONS Brain insulin resistance through upregulation of PTP1b, increased sympathetic activity, and unrestrained adipose tissue lipolysis are key drivers of alcoholic steatosis. Targeting these drivers of steatosis may provide effective therapeutic strategies to ameliorate ALD.
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Affiliation(s)
- Chunxue Zhou
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Henry H Ruiz
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Li Ling
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giulia Maurizi
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenichi Sakamoto
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Endocrinology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Claudia G Liberini
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ling Wang
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adrien Stanley
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hale E Egritag
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sofia M Sanz
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Claudia Lindtner
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mary A Butera
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Endocrinology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Christoph Buettner
- Department of Medicine and Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Endocrinology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
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Zwierz M, Chabowski A, Sztolsztener K. α-Lipoic acid - a promising agent for attenuating inflammation and preventing steatohepatitis in rats fed a high-fat diet. Arch Biochem Biophys 2023; 750:109811. [PMID: 37926405 DOI: 10.1016/j.abb.2023.109811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/23/2023] [Accepted: 11/02/2023] [Indexed: 11/07/2023]
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver disorder affecting a significant part of the global population. This study aimed to investigate the potential therapeutic effects of α-lipoic acid (α-LA) on the inflammatory response during simple steatosis development and progression into steatohepatitis. The study used the MASLD model in male Wistar rats that were fed a standard diet or a high-fat diet (HFD) for 8 weeks. Throughout the entire experiment, half of the animals received α-LA supplementation. The hepatic activity of pro-inflammatory n-6 and anti-inflammatory n-3 polyunsaturated fatty acid (PUFA) pathways and the concentration of arachidonic acid (AA) in selected lipid fractions were determined by the gas-liquid chromatography (GLC). The hepatic expression of proteins from inflammatory pathway was measured by the Western blot technique. The level of eicosanoids, cytokines and chemokines was assessed by the ELISA or multiplex assay kits. The results showed that α-LA supplementation attenuated the activity of n-6 PUFA pathway in FFA and DAG and increased the activity of n-3 PUFA pathway in PL, TAG and DAG. In addition, the administration of α-LA decreased the concentration of AA in DAG and FFA, indicating its potential protective effect on the deterioration of simple hepatic steatosis. The supplementation of α-LA also increased the expression of COX-1 and COX-2 with the lack of significant changes in prostaglandins profile. We observed an increase in the expression of 12/15-LOX, which was reflected in an increase in lipoxin A4 (LXA4) level. A decrease in pro-inflammatory cytokines and an increase in anti-inflammatory cytokines was also noticed in the liver of rats treated with HFD and α-LA. Our observations confirm that α-LA treatment has potential protective effects on inflammation development in the MASLD model. We believe that α-LA has a preventive impact when it comes to the progression of simple steatosis lesions to steatohepatitis.
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Affiliation(s)
- Mateusz Zwierz
- Department of Physiology, Medical University of Bialystok, Mickiewicz Str. 2C, 15-222, Bialystok, Poland.
| | - Adrian Chabowski
- Department of Physiology, Medical University of Bialystok, Mickiewicz Str. 2C, 15-222, Bialystok, Poland.
| | - Klaudia Sztolsztener
- Department of Physiology, Medical University of Bialystok, Mickiewicz Str. 2C, 15-222, Bialystok, Poland.
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Ma YN, Jiang X, Tang W, Song P. Influence of intermittent fasting on autophagy in the liver. Biosci Trends 2023; 17:335-355. [PMID: 37661370 DOI: 10.5582/bst.2023.01207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Studies have found that intermittent fasting (IF) can prevent diabetes, cancer, heart disease, and neuropathy, while in humans it has helped to alleviate metabolic syndrome, asthma, rheumatoid arthritis, Alzheimer's disease, and many other disorders. IF involves a series of coordinated metabolic and hormonal changes to maintain the organism's metabolic balance and cellular homeostasis. More importantly, IF can activate hepatic autophagy, which is important for maintaining cellular homeostasis and energy balance, quality control, cell and tissue remodeling, and defense against extracellular damage and pathogens. IF affects hepatic autophagy through multiple interacting pathways and molecular mechanisms, including adenosine monophosphate (AMP)-activated protein kinase (AMPK), mammalian target of rapamycin (mTOR), silent mating-type information regulatory 2 homolog-1 (SIRT1), peroxisomal proliferator-activated receptor alpha (PPARα) and farnesoid X receptor (FXR), as well as signaling pathways and molecular mechanisms such as glucagon and fibroblast growth factor 21 (FGF21). These pathways can stimulate the pro-inflammatory cytokines interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α), play a cytoprotective role, downregulate the expression of aging-related molecules, and prevent the development of steatosis-associated liver tumors. By influencing the metabolism of energy and oxygen radicals as well as cellular stress response systems, IF protects hepatocytes from genetic and environmental factors. By activating hepatic autophagy, IF has a potential role in treating a variety of liver diseases, including non-alcoholic fatty liver disease, drug-induced liver injury, viral hepatitis, hepatic fibrosis, and hepatocellular carcinoma. A better understanding of the effects of IF on liver autophagy may lead to new approaches for the prevention and treatment of liver disease.
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Affiliation(s)
- Ya-Nan Ma
- Department of Gastroenterology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Xuemei Jiang
- Department of Gastroenterology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Wei Tang
- International Health Care Center, National Center for Global Health and Medicine, Tokyo, Japan
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Peipei Song
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Cuño-Gómiz C, de Gregorio E, Tutusaus A, Rider P, Andrés-Sánchez N, Colell A, Morales A, Marí M. Sex-based differences in natural killer T cell-mediated protection against diet-induced steatohepatitis in Balb/c mice. Biol Sex Differ 2023; 14:85. [PMID: 37964320 PMCID: PMC10644614 DOI: 10.1186/s13293-023-00569-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/06/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Metabolic dysfunction-associated steatotic liver disease (MASLD) is prevalent in Western countries, evolving into metabolic dysfunction-associated steatohepatitis (MASH) with a sexual dimorphism. Fertile women exhibit lower MASLD risk than men, which diminishes post-menopause. While NKT-cell involvement in steatohepatitis is debated, discrepancies may stem from varied mouse strains used, predominantly C57BL6/J with Th1-dominant responses. Exploration of steatohepatitis, encompassing both genders, using Balb/c background, with Th2-dominant immune response, and CD1d-deficient mice in the Balb/c background (lacking Type I and Type II NKT cells) can clarify gender disparities and NKT-cell influence on MASH progression. METHODS A high fat and choline-deficient (HFCD) diet was used in male and female mice, Balb/c mice or CD1d-/- mice in the Balb/c background that exhibit a Th2-dominant immune response. Liver fibrosis and inflammatory gene expression were measured by qPCR, and histology assessment. NKT cells, T cells, macrophages and neutrophils were assessed by flow cytometry. RESULTS Female mice displayed milder steatohepatitis after 6 weeks of HFCD, showing reduced liver damage, inflammation, and fibrosis compared to males. Male Balb/c mice exhibited NKT-cell protection against steatohepatitis whereas CD1d-/- males on HFCD presented decreased hepatoprotection, increased liver fibrosis, inflammation, neutrophilic infiltration, and inflammatory macrophages. In contrast, the NKT-cell role was negligible in early steatohepatitis development in both female mice, as fibrosis and inflammation were similar despite augmented liver damage in CD1d-/- females. Relevant, hepatic type I NKT levels in female Balb/c mice were significantly lower than in male. CONCLUSIONS NKT cells exert a protective role against experimental steatohepatitis as HFCD-treated CD1d-/- males had more severe fibrosis and inflammation than male Balb/c mice. In females, the HFCD-induced hepatocellular damage and the immune response are less affected by NKT cells on early steatohepatitis progression, underscoring sex-specific NKT-cell influence in MASH development.
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Affiliation(s)
- Carlos Cuño-Gómiz
- Department of Cell Death and Proliferation, IIBB, CSIC, IDIBAPS, 08036, Barcelona, Spain
- Departament de Biomedicina, Facultat de Medicina, Universitat de Barcelona, 08036, Barcelona, Spain
| | - Estefanía de Gregorio
- Department of Cell Death and Proliferation, IIBB, CSIC, IDIBAPS, 08036, Barcelona, Spain
| | - Anna Tutusaus
- Department of Cell Death and Proliferation, IIBB, CSIC, IDIBAPS, 08036, Barcelona, Spain
| | - Patricia Rider
- Department of Cell Death and Proliferation, IIBB, CSIC, IDIBAPS, 08036, Barcelona, Spain
- Departament de Biomedicina, Facultat de Medicina, Universitat de Barcelona, 08036, Barcelona, Spain
| | - Nuria Andrés-Sánchez
- Institute of Molecular Genetics of Montpellier (IGMM), University of Montpellier, CNRS, INSERM, 34293, Montpellier, France
| | - Anna Colell
- Department of Cell Death and Proliferation, IIBB, CSIC, IDIBAPS, 08036, Barcelona, Spain
| | - Albert Morales
- Department of Cell Death and Proliferation, IIBB, CSIC, IDIBAPS, 08036, Barcelona, Spain.
| | - Montserrat Marí
- Department of Cell Death and Proliferation, IIBB, CSIC, IDIBAPS, 08036, Barcelona, Spain.
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Carrión JA, Graupera I, Vergara M, Morillas RM, Pericàs JM, Poca M, Amador A, Fernández R, Monllor T, Muñoz L, Bartres C, Genescà J, Ginés P, Forns X. Clinical practice guidelines of the Catalan Society of Gastroenterology about hepatic elastography 2022. Gastroenterol Hepatol 2023; 46:732-746. [PMID: 36435378 DOI: 10.1016/j.gastrohep.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/03/2022] [Accepted: 11/15/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION After almost 20 years using transient elastography (TE) for the non-invasive diagnosis of liver fibrosis, its use has been extended to population screening, evaluation of steatosis and complications of cirrhosis. For this reason, the «Catalan Society of Gastroenterology» commissioned a group of experts to update the first document carried out in 2011. MATERIAL AND METHODS The working group (8 doctors and 4 nurses) prepared a panel of questions based on the online survey «Hepatic Elastography in Catalonia 2022» following the PICO structure and the Delphi method. RESULTS The answers are presented with the level of evidence, the degree of recommendation and the final consensus after being evaluated by two external reviewers. CONCLUSION Transient elastography uses the simplest and most reliable elastographic method to quantify liver fibrosis, assess steatosis, and determine the risk of complications in patients with cirrhosis. The document has been endorsed by the "Catalan Society of Gastroenterology" and the "Col·legi Oficial d'Infermeres i Infermers de Barcelona".
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Affiliation(s)
- José Antonio Carrión
- Sección de Hepatología, Servicio de Digestivo, Hospital del Mar, Barcelona, España; IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, España; Departament de Medicina i Ciències de la Vida, Universitat Pompeu Fabra, Barcelona, España.
| | - Isabel Graupera
- Servicio de Hepatología, Hospital Clínic, Barcelona, España; Institut D'investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, España; Centros de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Departamento de Medicina, Facultad de Medicina i Ciencias de la Salud, Universidad de Barcelona, Barcelona, España
| | - Mercedes Vergara
- Centros de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Unidad de Hepatología, Servicio de Digestivo, Parc Taulí Hospital Universitario, Instituto de Investigación e Innovación Parc Taulí I3PT, Sabadell, España; Departamento de Medicina, Facultad de Medicina i Ciencias de la Salud, Universidad Autónoma de Barcelona, Barcelona, España
| | - Rosa Maria Morillas
- Centros de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Departamento de Medicina, Facultad de Medicina i Ciencias de la Salud, Universidad Autónoma de Barcelona, Barcelona, España; Unidad de Hepatología, Servicio de Aparato Digestivo, Hospital Germans Trias i Pujol, Badalona, España; Instituto de Investigación en Ciéncias de la Salud Germans Trias i Pujol (IGTP), Badalona, España
| | - Juan Manuel Pericàs
- Centros de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Servicio de Hepatología, Hospital Universitario Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, España; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - Maria Poca
- Centros de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Departamento de Medicina, Facultad de Medicina i Ciencias de la Salud, Universidad Autónoma de Barcelona, Barcelona, España; Servicio de Digestivo, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Institut de Recerca Hospital de Sant Pau-IIB Sant Pau, Barcelona, España
| | - Alberto Amador
- Departamento de Medicina, Facultad de Medicina i Ciencias de la Salud, Universidad de Barcelona, Barcelona, España; Unidad de Hepatología, Hospital Universitario de Bellvitge, Barcelona, España; IDIBELL, Barcelona, España
| | - Rosa Fernández
- Sección de Hepatología, Servicio de Digestivo, Hospital del Mar, Barcelona, España; IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, España
| | - Teresa Monllor
- Unidad de Hepatología, Servicio de Digestivo, Parc Taulí Hospital Universitario, Instituto de Investigación e Innovación Parc Taulí I3PT, Sabadell, España
| | - Laura Muñoz
- Unidad de Hepatología, Servicio de Aparato Digestivo, Hospital Germans Trias i Pujol, Badalona, España; Instituto de Investigación en Ciéncias de la Salud Germans Trias i Pujol (IGTP), Badalona, España
| | | | - Joan Genescà
- Centros de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Departamento de Medicina, Facultad de Medicina i Ciencias de la Salud, Universidad Autónoma de Barcelona, Barcelona, España; Servicio de Hepatología, Hospital Universitario Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, España; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - Pere Ginés
- Servicio de Hepatología, Hospital Clínic, Barcelona, España; Institut D'investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, España; Centros de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Departamento de Medicina, Facultad de Medicina i Ciencias de la Salud, Universidad de Barcelona, Barcelona, España
| | - Xavier Forns
- Servicio de Hepatología, Hospital Clínic, Barcelona, España; Institut D'investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, España; Centros de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Departamento de Medicina, Facultad de Medicina i Ciencias de la Salud, Universidad de Barcelona, Barcelona, España
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Zhao F, Zhang G, Tan Z, Liang T, Xing F. A 3D Quantification Technique for Liver Fat Fraction Distribution Analysis Using Dixon Magnetic Resonance Imaging. J Vis Exp 2023. [PMID: 37930005 DOI: 10.3791/66121] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
This study presents a 3D quantification methodology for the distribution of liver fat fraction (LFF) through the utilization of Dixon MRI image analysis. The central aim is to offer a highly accurate and non-invasive means of evaluating liver fat content. The process involves the acquisition of In-phase and Water-phase images from a Dixon sequence. LFF maps are then meticulously computed voxel by voxel by dividing the Lipid Phase images by the In-phase images. Simultaneously, 3D liver contours are extracted from the In-phase images. These crucial components are seamlessly integrated to construct a comprehensive 3D-LFF distribution model. This technique is not limited to healthy livers but extends to those afflicted by hepatic steatosis. The results obtained demonstrate the remarkable effectiveness of this approach in both visualizing and quantifying liver fat content. It distinctly discerns patterns that differentiate between normal and steatotic livers. By harnessing Dixon MRI to extract the 3D structure of the liver, this method offers precise LFF assessments spanning the entirety of the organ, thereby holding great promise for the diagnosis of hepatic steatosis with remarkable effectiveness.
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Affiliation(s)
- Fan Zhao
- Department of Infectious Diseases, Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Genming Zhang
- The First Clinical College, Beijing University of Chinese Medicine
| | - Zhongjian Tan
- Department of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Tengxiao Liang
- Fever Clinics, Dongzhimen Hospital, Beijing University of Chinese Medicine;
| | - Fangliang Xing
- Beijing Intelligent Entropy Science & Technology Co Ltd.;
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Dumont C, Lanthier N, Dahlqvist G. Fibrosis and steatosis of the liver graft: Are non-invasive tests useful? A short review. Clin Res Hepatol Gastroenterol 2023; 47:102194. [PMID: 37567467 DOI: 10.1016/j.clinre.2023.102194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023]
Abstract
As life expectancy of liver transplanted patients improves, new questions are arising to avoid progressive graft loss. The spectrum of chronic inflammation and fibrosis are known to be important triggers in the alteration of graft function. Liver biopsy remains the gold standard to better understand progressive, normal, and abnormal histological modifications of the graft. In parallel, the interest for metabolic steatosis development in post-transplantation is also growing. Long-term survival of these patients involves the management of comorbidities including metabolic syndrome and cardiovascular diseases. Early detection of altered graft parenchyma, and monitoring of its evolution are undoubtedly essential. Non-invasive methods including transient elastography and fibrosis biomarkers are attractive tools to avoid drawbacks and complications of liver biopsy. Accuracy of these methods are well-known in a pre-transplantation setting, but evidence is lacking in post-transplantation setting. We review current knowledge of progressive liver fibrosis and steatosis development after transplantation and non-invasive methods of their assessment.
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Affiliation(s)
- Colin Dumont
- Department of Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Nicolas Lanthier
- Department of Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium; Laboratory of Gastroenterology and Hepatology, Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium
| | - Géraldine Dahlqvist
- Department of Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.
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Zhou R, Yang L, Zhang B, Gu Y, Kong T, Zhang W, Sun L, Liu C, Kong N, Li J, Shi J. Clinical impact of hepatic steatosis on chronic hepatitis B patients in Asia: A systematic review and meta-analysis. J Viral Hepat 2023; 30:793-802. [PMID: 37533208 DOI: 10.1111/jvh.13872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/07/2023] [Indexed: 08/04/2023]
Abstract
Chronic hepatitis B (CHB) and hepatic steatosis (HS) are two prevalent chronic liver diseases in Asia. The incidence of CHB combined with HS is increasing due to the rising obesity rates. However, the impact of HS on CHB remains a topic of debate. Hereby, this meta-analysis aims to examine the effect of HS on Asian patients with CHB. Searches were conducted on four databases to identify articles published from 2005 to 2023. The random-effects or fixed-effects model was used to calculate pooled odds ratios (ORs), weighted mean difference (WMD), and confidence intervals (CIs) for the included articles. Of the 15,959 records screened, 88 studies were included in the analysis of HS prevalence in Asian CHB patients with a prevalence of 36.5% (95% CI: 33.7%-39.3%). In addition, age, sex, body mass index (BMI), waist circumference (WC), alanine aminotransferase (ALT) and combined metabolic diseases have varying degrees of impact on HS in CHB patients. Furthermore, the coexistence of HS was negatively associated with the response to antiviral therapy, including hepatitis B surface antigen (HBeAg) seroconversion (OR = 0.69, 95% CI: 0.53-0.89) and ALT normalization (OR = 0.75, 95% CI: 0.61-0.92) in CHB patients after 48 weeks of treatment. Regarding disease prognosis, HS was not significantly associated with fibrosis or cirrhosis in CHB patients, while an inverse association was observed between HS and hepatocellular carcinoma (HCC) (OR = 2.93, 95% CI: 1.23-6.99). This implies that the coexistence of HS in CHB patients may exacerbate the progression of HCC, which needs to be verified by further studies.
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Affiliation(s)
- Run Zhou
- College of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Luping Yang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Binbin Zhang
- The Department of Translational Medicine Platform, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
- Department of School of Life Sciences, Zhejiang University of Traditional Chinese Medicine, Hangzhou, China
| | - Yunpeng Gu
- School of Nursing, Henan University of Chinese Medicine, Zhengzhou, China
| | - Tingting Kong
- College of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Wei Zhang
- Department of Teaching, Hangzhou Normal University, Hangzhou, China
| | - Lei Sun
- College of Clinical Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Chunlan Liu
- College of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Ningjia Kong
- College of Clinical Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Jie Li
- Department of Infectious Disease, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Junping Shi
- College of Clinical Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
- The Department of Infectious disease and Hepatology, The Affiliated Hospital & Institute of Hepatology and Metabolic Disease, Hangzhou Normal University, Hangzhou, China
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Kotsiliti E. Liver steatosis and fibrosis in China. Nat Rev Gastroenterol Hepatol 2023; 20:631. [PMID: 37495719 DOI: 10.1038/s41575-023-00824-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
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40
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Leone P, Arenas YM, Balzano T, Mincheva G, Martinez-Garcia M, Montoliu C, Llansola M, Felipo V. Patients who died with steatohepatitis or liver cirrhosis show neuroinflammation and neuronal loss in hippocampus. Eur J Neurol 2023; 30:3032-3046. [PMID: 37340928 DOI: 10.1111/ene.15935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Neuroinflammation in the cerebral cortex of patients who died with liver cirrhosis and neuroinflammation, and neuronal death in the cerebellum of patients who died with steatohepatitis or cirrhosis, were reported. Hippocampal neuroinflammation could contribute to cognitive decline in patients with liver disease, but this has yet to be studied. The study aims were to assess if hippocampus from patients who died with steatohepatitis or cirrhosis showed: (i) glial activation, (ii) altered cytokine content, (iii) immune cell infiltration, (iv) neuronal apoptosis and (v) neuronal loss. METHODS Post-mortem hippocampus was obtained from 6 controls, 19 patients with steatohepatitis (SH) and 4 patients with liver cirrhosis. SH patients were divided into SH1 (n = 9), SH2 (n = 6) and SH3 (n = 4) groups depending on disease severity. Glial activation, IL-1β and TNFα content, CD4 lymphocyte and monocyte infiltration, neuronal apoptosis and neuronal loss were analyzed by immunohistochemistry. RESULTS Patients who died in SH1 showed astrocyte activation, whereas those who died in SH2 also showed microglial activation, CD4 lymphocyte and monocyte infiltration, neuronal apoptosis and neuronal loss. These changes remained in patients in SH3, who also showed increased IL-1β and TNFα. Patients who died of liver cirrhosis did not show CD4 lymphocyte infiltration, neuronal apoptosis or increase in TNFα, but still showed glial activation, increased IL-1β and neuronal loss. CONCLUSIONS Patients with steatohepatitis showed glial activation, immune cell infiltration, apoptosis and neuronal loss. Glial activation and neuronal loss remained in cirrhotic patients. This may explain the irreversibility of some cognitive alterations in hepatic encephalopathy. Cognitive reserve may contribute to different grades of cognitive impairment despite similar neuronal loss.
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Affiliation(s)
- Paola Leone
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Yaiza M Arenas
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Tiziano Balzano
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
- Centro Integral de Neurociencias, Hospital Universitario Puerta del Sur CINAC, Madrid, Spain
| | - Gergana Mincheva
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Mar Martinez-Garcia
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Carmina Montoliu
- Departamento de Patología, Facultad de Medicina, Universidad Valencia, Valencia, Spain
- Instituto de Investigación Sanitaria-INCLIVA, Valencia, Spain
| | - Marta Llansola
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Vicente Felipo
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
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Zhang M, Chen S, Wu X, Zhou J, Wang T, Liu H, Zhao X, Wang B, Zhao X, Kong Y, Soon GST, Ou X, Jia J, Chen W, Sun Y, You H. Persistent steatosis correlates with decreased fibrosis regression during anti-HBV treatment in patients with chronic HBV infection. J Med Virol 2023; 95:e29156. [PMID: 37822064 DOI: 10.1002/jmv.29156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/23/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
Despite the increasing prevalence of steatosis in patients with chronic hepatitis B (CHB), whether the changes in steatosis impact fibrosis regression during antiviral therapy remain unclear. We aimed to identify the association between histological changes of steatosis and fibrosis in patients undergone antiviral treatment. Patients with paired liver biopsies before and after 78 weeks of antiviral therapy were enrolled in this study. Liver fibrosis was assessed by the Ishak score combined with Beijing Classification predominantly progressive, indeterminate, and predominately regressive score. Steatosis was evaluated by the nonalcoholic fatty liver disease activity score. Collagen in each site was quantitated by second harmonic generation/two photon excitation fluorescence technology. Serum proteomic changes after treatment were characterized by mass-based spectrometry. A total of 239 CHB patients were included and divided into four groups according to the changes in steatosis: 162 (67.8%) had no steatosis throughout, 24 (10.0%) developed new-onset steatosis, 21 (8.8%) had initial steatosis which disappeared, and 32 (13.4%) had persistent steatosis. The persistent steatosis group showed the lowest rate of fibrosis regression (14/32, 43.8%). Persistent steatosis correlated with decreased fibrosis regression significantly after adjusting for age, sex, fibrosis stage, and metabolic factors at baseline, as well as the viral response (adjusted odds ratio = 0.380, 95% confidence interval 0.145-0.996, p = 0.049). This decreased fibrosis regression was associated with accumulated collagen in the perisinusoidal area. Patients with persistent steatosis showed unique changes in glycolipid metabolism according to the serum proteomic atlas. Persistent steatosis correlated with decreased fibrosis regression during antiviral therapy in patients with CHB.
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Affiliation(s)
- Mengyang Zhang
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
| | - Shuyan Chen
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
| | - Xiaoning Wu
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
| | - Jialing Zhou
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
| | - Tailing Wang
- Department of Pathology, China-Japan Friendship Hospital, Beijing, China
| | - Hui Liu
- Department of Pathology, Beijing You-an Hospital, Capital Medical University, Beijing, China
| | - Xinyan Zhao
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
| | - Bingqiong Wang
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
| | - Xinyu Zhao
- Clinical Epidemiology and EBM Unit, Beijing Friendship Hospital, Capital Medical University, Beijing Clinical Research Institute, Beijing, China
| | - Yuanyuan Kong
- Clinical Epidemiology and EBM Unit, Beijing Friendship Hospital, Capital Medical University, Beijing Clinical Research Institute, Beijing, China
| | | | - Xiaojuan Ou
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
| | - Wei Chen
- Experimental and Translational Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Clinical Research Institute, Beijing, China
| | - Yameng Sun
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
| | - Hong You
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
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Banerjee P, Gaddam N, Chandler V, Chakraborty S. Oxidative Stress-Induced Liver Damage and Remodeling of the Liver Vasculature. Am J Pathol 2023; 193:1400-1414. [PMID: 37355037 DOI: 10.1016/j.ajpath.2023.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 06/26/2023]
Abstract
As an organ critically important for targeting and clearing viruses, bacteria, and other foreign material, the liver operates via immune-tolerant, anti-inflammatory mechanisms indispensable to the immune response. Stress and stress-induced factors disrupt the homeostatic balance in the liver, inflicting tissue damage, injury, and remodeling. These factors include oxidative stress (OS) induced by viral infections, environmental toxins, drugs, alcohol, and diet. A recurrent theme seen among stressors common to multiple liver diseases is the induction of mitochondrial dysfunction, increased reactive oxygen species expression, and depletion of ATP. Inflammatory signaling additionally exacerbates the condition, generating a proinflammatory, immunosuppressive microenvironment and activation of apoptotic and necrotic mechanisms that disrupt the integrity of liver morphology. These pathways initiate signaling pathways that significantly contribute to the development of liver steatosis, inflammation, fibrosis, cirrhosis, and liver cancers. In addition, hypoxia and OS directly enhance angiogenesis and lymphangiogenesis in chronic liver diseases. Late-stage consequences of these conditions often narrow the outcomes for liver transplantation or result in death. This review provides a detailed perspective on various stress-induced factors and the specific focus on role of OS in different liver diseases with special emphasis on different molecular mechanisms. It also highlights how resultant changes in the liver vasculature correlate with pathogenesis.
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Affiliation(s)
- Priyanka Banerjee
- Department of Medical Physiology, Texas A&M Health Science Center, Bryan, Texas.
| | - Niyanshi Gaddam
- Department of Medical Physiology, Texas A&M Health Science Center, Bryan, Texas
| | - Vanessa Chandler
- Department of Medical Physiology, Texas A&M Health Science Center, Bryan, Texas
| | - Sanjukta Chakraborty
- Department of Medical Physiology, Texas A&M Health Science Center, Bryan, Texas.
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Trapani L, Beaufrère A, Hobeika C, Codjia T, Albuquerque M, Bouattour M, Lesurtel M, Cauchy F, Paradis V. Pathological overview of steatohepatitic hepatocellular carcinoma in a surgical series. Histopathology 2023; 83:526-537. [PMID: 37222200 DOI: 10.1111/his.14941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/29/2023] [Accepted: 05/01/2023] [Indexed: 05/25/2023]
Abstract
AIMS According to the last WHO classification, steatohepatitic hepatocellular carcinoma (SH-HCC) is recognized as a distinct HCC subtype, even though a consensual definition is still lacking. The objectives of the study were to carefully describe the morphological features of SH-HCC and evaluate its impact on prognosis. METHODS AND RESULTS We conducted a single-centre retrospective study including 297 surgically resected HCC. Pathological features including SH criteria (steatosis, ballooning, Mallory-Denk bodies, fibrosis, and inflammation) were assessed. SH-HCC was defined by the presence of at least four of the five SH criteria and the SH component represented >50% of the tumour area. According to this definition, 39 (13%) HCC cases corresponded to SH-HCC and 30 cases (10%) corresponded to HCC with an SH component (<50%). SH criteria in SH-HCC and non-SH-HCC were distributed as follows: ballooning (100% versus 11%), fibrosis (100% versus 81%), inflammation (100% versus 67%), steatosis (92% versus 8%), and Mallory-Denk bodies (74% versus 3%). Inflammation markers (c-reactive protein [CRP] and serum amyloid A [SAA]) were significantly more expressed in SH-HCC compared to non-SH-HCC (82% versus 14%, P = <0.001). Five-year recurrence-free survival (RFS) and 5-year overall survival (OS) were similar for SH-HCC and non-SH-HCC (P = 0.413 and P = 0.866, respectively). The percentage of SH component does not impact OS and RFS. CONCLUSION We confirm in a large cohort the relatively high prevalence (13%) of SH-HCC. Ballooning is the most specific criteria for this subtype. The percentage of the SH component does not impact prognosis.
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Affiliation(s)
- Loïc Trapani
- Université Paris Cité, Paris, France
- AP-HP.Nord, Department of Pathology, FHU MOSAIC, Beaujon Hospital, Clichy, France
| | - Aurélie Beaufrère
- Université Paris Cité, Paris, France
- AP-HP.Nord, Department of Pathology, FHU MOSAIC, Beaujon Hospital, Clichy, France
- Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France
| | - Christian Hobeika
- AP-HP, Department of HPB and digestive surgery, Pitié-Salpétrière Hospital, Paris, France
| | - Tatiana Codjia
- Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France
- AP-HP.Nord, Department of HPB surgery, Beaujon Hospital, Clichy, France
| | - Miguel Albuquerque
- AP-HP.Nord, Department of Pathology, FHU MOSAIC, Beaujon Hospital, Clichy, France
- Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France
| | - Mohamed Bouattour
- Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France
- AP-HP.Nord, Department of Hepatology, Beaujon Hospital, Clichy, France
| | - Mickael Lesurtel
- Université Paris Cité, Paris, France
- AP-HP.Nord, Department of HPB surgery, Beaujon Hospital, Clichy, France
| | - François Cauchy
- Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France
| | - Valérie Paradis
- Université Paris Cité, Paris, France
- AP-HP.Nord, Department of Pathology, FHU MOSAIC, Beaujon Hospital, Clichy, France
- Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France
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Kinzler MN, Schulze F, Reitz A, Gretser S, Ziegler P, Shmorhun O, Friedrich-Rust M, Bojunga J, Zeuzem S, Schnitzbauer AA, Bechstein WO, Reis H, Barreiros AP, Wild PJ. Fluorescence confocal microscopy on liver specimens for full digitization of transplant pathology. Liver Transpl 2023; 29:940-951. [PMID: 37016761 DOI: 10.1097/lvt.0000000000000142] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/01/2023] [Indexed: 04/06/2023]
Abstract
Fluorescence confocal microscopy (FCM) is a rapidly evolving tool that provides real-time virtual HE images of native tissue. Data about the potential of FCM as an alternative to frozen sections for the evaluation of donor liver specimens are lacking so far. The aim of the current study was to determine the value of FCM in liver specimens according to the criteria of the German Society for Organ Procurement. In this prospective study, conventional histology and FCM scans of 50 liver specimens (60% liver biopsies, 26% surgical specimens, and 14% donor samples) were evaluated according to the German Society for Organ Procurement. A comparison of FCM scans and conventional frozen sections revealed almost perfect levels of agreement for cholangitis (κ = 0.877), fibrosis (κ = 0.843), and malignancy (κ = 0.815). Substantial levels of agreement could be obtained for macrovesicular steatosis (κ = 0.775), inflammation (κ = 0.763), necrosis (κ = 0.643), and steatohepatitis (κ = 0.643). Levels of agreement were moderate for microvesicular steatosis (κ = 0.563). The strength of agreement between frozen sections and FCM was superior to the comparison of conventional HE and FCM imaging. We introduce FCM as a potential alternative to the frozen section that may represent a novel approach to liver transplant pathology where timely feedback is crucial and the deployment of human resources is becoming increasingly difficult.
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Affiliation(s)
- Maximilian N Kinzler
- Department of Internal Medicine I, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Falko Schulze
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Alexandra Reitz
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Steffen Gretser
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Paul Ziegler
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Oleksandr Shmorhun
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Mireen Friedrich-Rust
- Department of Internal Medicine I, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Jörg Bojunga
- Department of Internal Medicine I, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine I, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Andreas A Schnitzbauer
- Department of General, Visceral, Transplant and Thoracic Surgery, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Wolf Otto Bechstein
- Department of General, Visceral, Transplant and Thoracic Surgery, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Henning Reis
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
| | - Ana Paula Barreiros
- German Organ Procurement Organization (DSO), 60594 Frankfurt am Main, Germany
| | - Peter J Wild
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
- Frankfurt Institute for Advanced Studies (FIAS), Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany
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Palte E, Duong JK, Remotti H, Burt J, Makkar J, Samstein B, Verna EC, Marratta D, Emond JC, Fox AN. Vibration Controlled Transient Elastography to Evaluate Steatosis in Candidate Living Donors for Liver Transplantation. Transplantation 2023; 107:1991-1998. [PMID: 36959124 DOI: 10.1097/tp.0000000000004581] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
BACKGROUND The ability of vibration controlled transient elastography (VCTE) to reliably exclude significant steatosis in living donor candidates could obviate the need for invasive liver biopsies, expedite the donor approval process, and reduce recipient wait time. We therefore aimed to determine whether VCTE controlled attenuation parameter (CAP) could be used to detect steatosis in potential living donors. METHODS Living donor candidates who presented for evaluation between 2016 and 2019 underwent standard donor workup, VCTE, and liver biopsy if indicated. CAP scores were compared with MRI-Fat Fraction and, when available, histologic fat fraction from liver biopsy. Receiver operating characteristic curves were used to identify cutoffs with appropriate sensitivity and specificity for screening. Statistical analysis was conducted using R (version 3.6.0). RESULTS Seventy-nine candidate living donors presented during the study period, of whom 71 were included in the final analysis and of whom 20 underwent liver biopsy. There was a positive correlation between MRI-Fat Fraction and CAP scores with an observed Spearman correlation coefficient of 0.424 ( P < 0.01). A CAP score of 271.5 dB/m or less was determined to have 89.8% sensitivity and 75% specificity for detecting <5% steatosis on MRI. The correlation between CAP and steatosis of available histologic samples had a Pearson correlation coefficient of 0.603 ( P = 0.005). A CAP cutoff of 276.0 dB/m demonstrated 66.7% sensitivity and 85.7% specificity for detecting <15% histopathologic steatosis and positive and negative predictive values of 71.5% and 82.7%, respectively. CONCLUSIONS VCTE can be integrated into living donor evaluation to accurately screen for hepatic steatosis.
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Affiliation(s)
- Eytan Palte
- Department of Medicine, Columbia University Irving Medical Center, New York City, NY
| | - Jimmy K Duong
- Columbia University Mailman School of Public Health, New York City, NY
| | - Helen Remotti
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York City, NY
| | - Joseph Burt
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York City, NY
| | - Jasnit Makkar
- Department of Radiology, Columbia University Irving Medical Center, New York City, NY
| | | | - Elizabeth C Verna
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York City, NY
| | - Douglas Marratta
- Department of Medicine, Columbia University Irving Medical Center, New York City, NY
| | - Jean C Emond
- Department of Surgery, Columbia University Irving Medical Center, New York City, NY
| | - Alyson N Fox
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York City, NY
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Auld FM, Parai JL, Milroy CM. Subnuclear renal tubular vacuoles in alcohol use disorder. J Forensic Sci 2023; 68:1759-1767. [PMID: 37409637 DOI: 10.1111/1556-4029.15321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 07/07/2023]
Abstract
Subnuclear vacuoles in the proximal renal tubules have been reported as a histologic sign of ketoacidosis. Originally described in diabetic ketoacidosis, renal vacuoles can be found in other ketogenic states such as alcoholic ketoacidosis (AKA), starvation, and hypothermia, underpinned by deranged fatty acid metabolism. A retrospective analysis of 133 deaths associated with alcohol use disorder (AUD) examined at autopsy between 2017 and 2020 was undertaken. This study aimed to determine the prevalence of subnuclear vacuoles in deaths of those with AUD and their specificity for deaths from AKA, and to elucidate what demographic, biochemical, and pathologic findings are associated with subnuclear vacuoles. In each case, vitreous humor biochemistry including electrolytes, glucose, and beta-hydroxybutyrate (BHB) was analyzed alongside postmortem hemoglobin A1c and renal and liver histology. Renal histology was graded for the presence of vacuoles as absent (0), scanty (1), or easily identifiable (2). Liver histology was graded for steatosis and for fibrosis if Masson trichrome staining was available. Vacuoles were commonly seen in the deaths of those with AUD. They were seen in deaths due to AKA but were not specific to that cause of death. With vacuoles present, lower vitreous sodium (139 vs. 142 mmol/L; p = 0.005), higher vitreous BHB (1.50 vs. 1.39 mmol/L; p = 0.04), severe hepatic steatosis, and severe hepatic fibrosis were seen, compared with those without renal vacuoles.
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Affiliation(s)
- Finn M Auld
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jaqueline L Parai
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Anatomical Pathology, The Ottawa Hospital, Eastern Ontario Regional Forensic Pathology Unit, Ontario Forensic Pathology Service, Ottawa, Ontario, Canada
| | - Christopher M Milroy
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Anatomical Pathology, The Ottawa Hospital, Eastern Ontario Regional Forensic Pathology Unit, Ontario Forensic Pathology Service, Ottawa, Ontario, Canada
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Tipirneni-Sajja A, Brasher S, Shrestha U, Johnson H, Morin C, Satapathy SK. Quantitative MRI of diffuse liver diseases: techniques and tissue-mimicking phantoms. MAGMA 2023; 36:529-551. [PMID: 36515810 DOI: 10.1007/s10334-022-01053-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
Quantitative magnetic resonance imaging (MRI) techniques are emerging as non-invasive alternatives to biopsy for assessment of diffuse liver diseases of iron overload, steatosis and fibrosis. For testing and validating the accuracy of these techniques, phantoms are often used as stand-ins to human tissue to mimic diffuse liver pathologies. However, currently, there is no standardization in the preparation of MRI-based liver phantoms for mimicking iron overload, steatosis, fibrosis or a combination of these pathologies as various sizes and types of materials are used to mimic the same liver disease. Liver phantoms that mimic specific MR features of diffuse liver diseases observed in vivo are important for testing and calibrating new MRI techniques and for evaluating signal models to accurately quantify these features. In this study, we review the liver morphology associated with these diffuse diseases, discuss the quantitative MR techniques for assessing these liver pathologies, and comprehensively examine published liver phantom studies and discuss their benefits and limitations.
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Affiliation(s)
- Aaryani Tipirneni-Sajja
- Department of Biomedical Engineering, The University of Memphis, Memphis, TN, USA.
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Sarah Brasher
- Department of Biomedical Engineering, The University of Memphis, Memphis, TN, USA
| | - Utsav Shrestha
- Department of Biomedical Engineering, The University of Memphis, Memphis, TN, USA
| | - Hayden Johnson
- Department of Biomedical Engineering, The University of Memphis, Memphis, TN, USA
| | - Cara Morin
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sanjaya K Satapathy
- Northwell Health Center for Liver Diseases and Transplantation, Northshore University Hospital/Northwell Health, Manhasset, NY, USA
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48
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Song Y, Li WB, Saleem N, Tian G, Ruan L, Zhang H. Viscoelastic Characteristics in Mouse Model of Hepatic Steatosis With Inflammation by Kelvin-Voigt Fractional Derivative Modeling. Ultrasound Med Biol 2023; 49:1811-1816. [PMID: 37225609 DOI: 10.1016/j.ultrasmedbio.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The aim of the work described here was to measure the characteristics of viscoelasticity and fluidity in a mouse model of hepatic steatosis and inflammation using a nano-indentation test and the Kelvin-Voigt fractional derivative (KVFD) model and to explore the viscoelasticity and fluidity characteristics in mice with different degrees of hepatic steatosis with inflammation. METHODS Twenty-five ApoE mice were randomly divided into an experimental high-fat diet group (n = 15) and an ordinary-food control group (n = 10), then subdivided into four subgroups based on pathological degree of hepatic steatosis: S0 (normal), S1 (mild), S2 (moderate) and S3 (severe). The 25 liver specimens from these mice were evaluated by a slope-keeping relaxation nano-indentation test. RESULTS Elasticity (E0) was significantly higher in the S3 group than in the S1 and S2 groups, while fluidity (α) and viscosity (τ) were significantly lower in S3 than in S1 and S2 (all p values < 0.05). The following cutoff values for the diagnosis of hepatic steatosis >33% with inflammation were also determined: E0 > 85.01 Pa (area under the curve [AUC]: 0.917, 95% confidence interval [CI]: 0.735-0.989), α ≤ 0.38 (AUC: 0.885, 95% CI: 0.695-0.977),\ and τ ≤ 3.92 (AUC: 0.813, 95% CI: 0.607-0.939). CONCLUSION Increases in the degree of hepatic steatosis with inflammation in mice paralleled gradual increases in the stiffness of the liver and gradual decreases in the fluidity and viscosity of the liver.
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Affiliation(s)
- Yan Song
- Department of Ultrasound, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Wen-Bin Li
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Nimra Saleem
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Gang Tian
- Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Litao Ruan
- Department of Ultrasound, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hongmei Zhang
- Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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49
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Villena Salinas J, Montellano Fenoy AJ, Sanz Viedma S, Suárez Muñoz MÁ. Steatotic hepatocellular adenoma: an unusual cause of a hypermetabolic liver lesion. Rev Esp Enferm Dig 2023; 115:452-453. [PMID: 35791794 DOI: 10.17235/reed.2022.9026/2022] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 22-year-old woman with a history of surgically treated pelvic teratoma and solid liver lesion in the extension study. Radiological follow-up was decided. This liver lesion experienced a progressive increase in size, reaching 6 cm. Contrast-enhanced liver MRI was performed, revealing a heterogeneous mass in the right hepatic lobe with non-hepatocyte-like behaviour. With this information, the following entities were ruled out: haemangioma, adenoma, hepatocarcinoma and focal nodular hyperplasia. Given that it could be a teratoma metastasis, a tumour of any other origin or a non-tumoral lesion with no hepatocyte component, it was decided to perform a 2-[18F]FDG PET/CT scan. It showed the liver mass with notable glycolytic hypermetabolism, suggestive of malignancy. In a multidisciplinary committee, it was decided to perform a laparoscopic right hepatectomy. Pathological examination revealed a benign hepatocytic lesion compatible with a steatotic adenoma.
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Affiliation(s)
| | | | - Salomé Sanz Viedma
- UGC Medicina Nuclear, Hospital Universitario Virgen de la Victoria, ESPAÑA
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50
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Dardanelli EP, Orozco ME, Oliva V, Lutereau JF, Ferrari FA, Bravo MG, Ruvinsky S, Roel M, Barvosa PC, Armeno M, Kaplan JS. Ultrasound attenuation imaging: a reproducible alternative for the noninvasive quantitative assessment of hepatic steatosis in children. Pediatr Radiol 2023; 53:1618-1628. [PMID: 36869263 DOI: 10.1007/s00247-023-05601-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/21/2022] [Accepted: 01/11/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Pediatric hepatic steatosis is a global public health concern, as an increasing number of children are affected by this condition. Liver biopsy is the gold standard diagnostic method; however, this procedure is invasive. Magnetic resonance imaging (MRI)-derived proton density fat fraction has been accepted as an alternative to biopsy. However, this method is limited by cost and availability. Ultrasound (US) attenuation imaging is an upcoming tool for noninvasive quantitative assessment of hepatic steatosis in children. A limited number of publications have focused on US attenuation imaging and the stages of hepatic steatosis in children. OBJECTIVE To analyze the usefulness of ultrasound attenuation imaging for the diagnosis and quantification of hepatic steatosis in children. MATERIAL AND METHODS Between July and November 2021, 174 patients were included and divided into two groups: group 1, patients with risk factors for steatosis (n = 147), and group 2, patients without risk factors for steatosis (n = 27). In all cases, age, sex, weight, body mass index (BMI), and BMI percentile were determined. B-mode US (two observers) and US attenuation imaging with attenuation coefficient acquisition (two independent sessions, two different observers) were performed in both groups. Steatosis was classified into four grades (0: absent, 1: mild, 2: moderate and 3: severe) using B-mode US. Attenuation coefficient acquisition was correlated with steatosis score according to Spearman's correlation. Attenuation coefficient acquisition measurements' interobserver agreement was assessed using intraclass correlation coefficients (ICC). RESULTS All attenuation coefficient acquisition measurements were satisfactory without technical failures. The median values for group 1 for the first session were 0.64 (0.57-0.69) dB/cm/MHz and 0.64 (0.60-0.70) dB/cm/MHz for the second session. The median values for group 2 for the first session were 0.54 (0.51-0.56) dB/cm/MHz and 0.54 (0.51-0.56) dB/cm/MHz for the second. The average attenuation coefficient acquisition was 0.65 (0.59-0.69) dB/cm/MHz for group 1 and 0.54 (0.52-0.56) dB/cm/MHz for group 2. There was excellent interobserver agreement at 0.94 (95% CI 0.92-0.96). There was substantial agreement between both observers (κ = 0.77, with a P < 0.001). There was a positive correlation between ultrasound attenuation imaging and B-mode scores for both observers (r = 0.87, P < 0.001 for observer 1; r = 0.86, P < 0.001 for observer 2). Attenuation coefficient acquisition median values were significantly different for each steatosis grade (P < 0.001). In the assessment of steatosis by B-mode US, the agreement between the two observers was moderate (κ = 0.49 and κ = 0.55, respectively, with a P < 0.001 in both cases). CONCLUSION US attenuation imaging is a promising tool for the diagnosis and follow-up of pediatric steatosis, which provides a more repeatable form of classification, especially at low levels of steatosis detectable in B-mode US.
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Affiliation(s)
- Esteban P Dardanelli
- Department of Radiology, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881 (C 1245 AAM), Buenos Aires, Argentina.
| | - María Eugenia Orozco
- Department of Radiology, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881 (C 1245 AAM), Buenos Aires, Argentina
| | - Vanesa Oliva
- Department of Radiology, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881 (C 1245 AAM), Buenos Aires, Argentina
| | - Juan Francisco Lutereau
- Department of Radiology, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881 (C 1245 AAM), Buenos Aires, Argentina
| | - Facundo Agustín Ferrari
- Department of Radiology, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881 (C 1245 AAM), Buenos Aires, Argentina
| | - Mónica G Bravo
- Department of Radiology, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881 (C 1245 AAM), Buenos Aires, Argentina
| | - Silvina Ruvinsky
- Department of Research and Development, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881 (C 1245 AAM), Buenos Aires, Argentina
| | - Macarena Roel
- Department of Research and Development, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881 (C 1245 AAM), Buenos Aires, Argentina
| | - Pablo C Barvosa
- Department of Pediatrics, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881, Buenos Aires, Argentina
| | - Marisa Armeno
- Department Nutrition, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881, Buenos Aires, Argentina
| | - Julio S Kaplan
- Department of Radiology, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881 (C 1245 AAM), Buenos Aires, Argentina
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