Abstract
Experimental rat models and clinical trials in human patients with liver cirrhosis show evidence that supplementation with hepatotropic factors provides therapeutic benefits. This form of support has not yet been described in dogs with multiple acquired portosystemic shunts (MAPSS) despite similarities between both pathological conditions. Especially hepatocyte growth factor (HGF) and branched chain amino acids (BCAA) deserve closer attention. High-quality vegetable rather than animal proteins have been suggested to form an excellent dietary source of BCAA, and leucine seems the best candidate for supplementation given its stimulating effects on liver function in general and on HGF secretion specifically. Research on optimal ways of administration of HGF in dogs with MAPSS secondary to congenital portosystemic shunt attenuation is necessary before clinical trials can be initiated.
Highlights
Multiple acquired portosystemic shunts (MAPSS) have been described in various species including humans and dogs
Before addressing available research data in dogs, a synthesis concerning data gained in rats and human patients with liver disease will be made as most research on hepatotropic factors is performed in cell lines, experimental in vivo models and in human clinical trials rather than in dogs
Hepatocyte growth factor is produced in mesenchymal stromal cells and has mitogenic capacity; it has been identified as a protein that encourages initiation of cell division via de c-Met/hepatocyte growth factor (HGF)-receptor in a variety of cell types, including hepatocytes (Nakamura et al, 1984; Nakamura et al, 1989)
Summary
Multiple acquired portosystemic shunts (MAPSS) have been described in various species including humans and dogs They are considered to be a collection of embryonic vessels between the portal and systemic circulation, opening as a consequence of portal hypertension (Johnson, 1987; Berent and Tobias, 2009; Buob et al, 2011; Lipinski et al, 2018; Ramirez et al, 2019). Low albumin levels negatively affect the antioxidant activity as well as the capacity to bind fatty acids, bilirubin, hormones, toxic substances and other ligands (Nicholson et al, 2000) Both MAPSS and cirrhosis can be linked to impairment of liver function and other signs of chronic liver diseases (Rothuizen, 1993; Taboada and Dimski, 1995; Buob et al, 2011; Cullen and Stalker, 2015). Before addressing available research data in dogs, a synthesis concerning data gained in rats and human patients with liver disease will be made as most research on hepatotropic factors is performed in cell lines, experimental in vivo models and in human clinical trials rather than in dogs
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