Cirrhosis Research Articles

Visualization of the protective role of estrogen against female liver fibrosis via an ER viscosity NIR fluorescent probe

Visualization of the protective role of estrogen against female liver fibrosis via an ER viscosity NIR fluorescent probe

Predictors of bleeding from esophagus veins in patients with liver cirrhosis

Aim: to identify clinical and laboratory predictors of bleeding from the esophageal veins in patients with liver cirrhosis and evaluate their practical significance. Materials and methods. The study materials were the results of an examination of 50 patients treated in the gastroenterology department for liver cirrhosis and 160 patients in surgical departments hospitalized for bleeding from esophageal varices due to liver cirrhosis. All patients were subjected to a standard set of general clinical examinations, ultrasound examination of the abdominal organs, and videoesophagogastroduodenoscopy. Results. When comparing patients with cirrhosis of the liver with and without bleeding from the veins of the esophagus, a statistically significant difference was revealed between the groups in the gender and age composition, blood bilirubin level, and de Ritis coefficient. At the same time, no differences were found in the etiology and severity of liver cirrhosis, blood protein levels, the diameter of the portal and splenic veins, and the proportion of patients with ascites. Conclusions. The detection of a de Ritis coefficient equal to or exceeding 1.8 in a patient with liver cirrhosis can be considered a predictor of a high risk of bleeding from the esophageal veins (sensitivity of the parameter 60.87%, specificity 93.94%) and can be recommended for identifying those in need of priority measures primary prevention.

Application of Nanotechnology in Liver Fibrosis: An Overview

Chronic liver disease constitutes a global health issue owning to their widespread prevalence and the scarcity of effective curative treatments. They are arising from various causes, both infectious and non-infectious diseases. A rapidly evolving field of interest is the use of nanoparticle (NP) systems for the safe administration of different medications and nucleic acid for the treatment of chronic liver disorder. The review examines the pathophysiology, diagnosis and new developments in nanoparticulate systems for the treatment of liver fibrosis related chronic liver disorder. Hepatic stellate cell (HSC) activation is thought to be the primary cause of liver fibrosis. Because of their unique abilities to transfer medications and other therapeutics moieties, liposomes, nanoparticulate systems have all been extensively researched. Currently, nanoparticle technology is used for liver fibrosis. Liver fibrosis can be caused by alcoholism, hepatitis viruses, genetic disorders, steatohepatitis, autoimmune, and other non-infectious conditions including fatty liver. Advanced liver fibrosis, or cirrhosis, is defined by the formation of nodules of regenerated hepatocytes after a fibrous scar caused by the accumulation of extracellular matrix (ECM) proteins disrupts the architecture of the liver. Keywords: Liver fibrosis,Nanomedicine,Therapy,Theranostics,Application

ACOMPANHAMENTO DE PACIENTES PORTADORES DE CIRROSE HEPÁTICA E OS DESAFIOS DA GESTÃO

Introduction: Liver cirrhosis is a chronic condition in which liver cells are destroyed or compromised, leading to the formation of scars, nodules or fibrosis. This factor contributes to a decrease in the partial or total functioning of the organ. Objectives: The main objective of this study was to investigate the challenges faced by management in the treatment and monitoring of patients with liver cirrhosis. Methodology: This is an integrative review of the literature searched in the following databases: PUMED and Virtual Health Library (VHL/SCIELO) between the years 2019 to 2023. Results: After the search and selection according with the inclusion and exclusion criteria, 09 articles were selected to compose this study. Conclusion: Public management faces challenges related to the shortage of specialized professionals, unequal distribution of these professionals and limited financial resources, along with restrictions on organs for liver transplantation. To face such obstacles, it is vital to prioritize the integration of health services, the efficient allocation of resources and the implementation of policies that raise awareness among the population about the causes and importance of early detection of the disease. These measures aim to ensure timely and effective treatment, in addition to improving the quality of life of patients with liver cirrhosis.

Body mass index of 23 or greater is relevant to hepatic steatosis and fibrosis in patients with harmful alcohol use.

Steatotic liver disease, characterized by a combination of metabolic dysfunction, alcohol use, or specific etiologies, is a leading cause of chronic liver disease. However, the role of metabolic dysfunction in chronic liver disease with harmful alcohol use remains unclear. This study aimed to investigate factors associated with hepatic steatosis and fibrosis in patients with harmful alcohol use. Over a 2-year period, we registered patients with harmful alcohol use, defined by an Alcohol Use Disorders Identification Test score of 8 or higher. We retrospectively analyzed background information, blood test results, ultrasound-guided attenuation parameter (attenuation coefficient), and liver stiffness measurement. Hepatic steatosis was defined as attenuation coefficient ≥0.65dB/cm/MHz, and fibrosis as liver stiffness measurement ≥7.5kPa. The study included 131 patients (82% men, median age 59years). Linear regression analysis revealed significant associations with attenuation coefficient for body mass index ≥23 (0.08, p<0.0001) and age (-0.002, p=0.002). Liver stiffness measurement was associated with body mass index ≥23 (2.52, p=0.001), aspartate aminotransferase (0.02, p=0.0189), gamma-glutamyl transpeptidase (0.008, p<0.0001), platelet count (-0.02, p=0.001), and prothrombin international normalized ratio (26.40, p<0.0001). Among the four groups classified by the presence or absence of steatosis and fibrosis, patients with fibrosis, but without steatosis, demonstrated the lowest liver reserve. In contrast, patients with both steatosis and fibrosis showed higher aspartate aminotransferase and gamma-glutamyl transpeptidase levels. Body mass index is associated with both hepatic steatosis and fibrosis in patients with harmful alcohol use.

VALUE OF AMINOTRANSFERASES IN LIVER CIRRHOSIS

Aim: To ditermine values of ASAT and ALAT and their ratio in different stages of liver cirrhosis. Material and methods: A retrospective study was conducted, including patients with newly diagnosed liver cirrhosis from 01.01. 2017 to 31.12. 2021. Of all, 258 (71%) were men and 103 (29%) were women. The mean age of the study population was 57±11.4 years, with alcohol as the leading etiology in 262 (72.6%) of all cases. AT were measured at an upper reference limit of 40UI/ml. All were staged by Child-Pough and MELD Na score. IBM SPSS 26 and Excel statistics for data processing were used at a significant level of p&lt; 0.05. Results: Of all 361 individuals, normal AT were measured at 89 (24.7%), at 96 (25.76%) only with normal ASAT and at 233 (66.77%) only with normal ALAT. The mean value of ASAT increases significantly depending on the Child stage (p=.004) and is close to the significance of MELD Na (p=.036). Mean ALAT values were minimal to moderately elevated, with no significant association with them (p=.647, p=.020). 90% of individuals had an ASAT/ALAT ratio above 1, which showed substantial dependence on Child and MELD Na (p=.000, p=.000). A ratio above 2 was found at 194 (53.7%) mainly in Child C, which was associated with alcohol etiology. Conclusion: The absolute values of ASAT and ALAT have no relationship with the severity of liver cirrhosis, unlike their ratio, which significantly increases.

Host cytokine genetic polymorphisms in a selected population of persons living with hepatitis B virus infection in the central region of Ghana.

Hepatitis B virus (HBV) infection is a public health concern in resource limited settings like Ghana. Over the past decades, it is noted that the natural course of HBV in persons infected are taking a worse turn leading to liver cirrhosis and cancer. The outcome of HBV infection is influenced by viral and host factors including genetics. Cytokine variations affect virus survival and progression and may even influence associated complications. Cytokines such as tumor necrosis factor alpha (TNF-α), interleukins (IL-4, IL-6, IL-8, IL-10, IL-18), interferon gamma (IFN)-γ, and tumor growth factor-beta (TGF-β) have key roles in HBV infection and modulation. In this study, polymorphisms occurring in five cytokines were analysed to understand how they can influence prognosis of HBV infection. The study is a single centre cross-sectional study involving 227 participants made up of HBV infected participants and HBV-negative controls. Recruitment was from March 2021 to April 2022. Blood samples were taken for full blood count, HBV antigen profile, liver function tests, HBV DNA quantification and cytokine genotyping. FIB score was calculated using available tools. Statistical analysis was undertaken with p < 0.05 set as statistically significant. The 20-39-year-old group formed majority of the HBV infected participants with 60% of all participants being classified as healthy HBsAg carriers. IL2 rs1479920 GG carriers ((1258.93; 0.00-5011.87) IU/mL had reduced HBV DNA in comparison to IL2 rs1479920 AA ((5011.87; 2113.49-5956.62) /AG (3548.13; 0.00-6309.57) IU/mL carriers. TNF-α rs1800629 AA carriers (1258.93; 0.00-3981.07) IU/mL had a reduction in HBV DNA levels in comparison to TNF-α rs1800629 GG carriers (1584.89; 0.00-5011.87) IU/mL. The results of univariate (OR = 0.08, 0.00-0.93; p = 0.043) and multivariate (OR = 0.02, 0.00-0.67; p = 0.029) analysis, showed that carrying TNF-α rs1800629 AA genotype reduce susceptibility to high FIB score compared with GG genotypes. In univariate analysis, subjects aged 20-39years (OR = 5.00, 1.13-6.10; p = 0.034) and 40-59years (OR = 41.99, 3.74-47.21; p = 0.0002) were more susceptible to high FIB score compared to subjects aged 1-19years. Being female (OR = 2.42, 1.03-5.71; p = 0.043) in the univariate models showed higher odds of having high levels of HBV DNA in the multivariate model. There was a reduced likelihood of herbal medicine usage influencing HBV DNA levels significantly (OR = 0.29, 0.10-0.86; p = 0.025). In conclusion, variations in IL2 rs1479920 GG and IL2 rs1479921 AA could offer protective effects by reducing HBV DNA. TNF-α rs179924CT may also cause elevation in HBV DNA levels whiles TNF-α -308A/G, showed a potential protective effect on liver scarring in HBV infected participants. It is therefore important to take a further look at such variations for understanding of HBV modulation in the Ghanaian population.

Association between changes in body composition and progression of liver fibrosis in patients with type 2 diabetes mellitus.

The correlation between type 2 diabetes mellitus (T2DM) and the occurrence of liver fibrosis is well-established. However, the longitudinal association between body composition and liver fibrosis progression in patients with T2DM remains incompletely explored. Total of 390 patients with T2DM underwent body composition assessments, followed by a median duration of 2.13 years. The calculated parameters included body mass index (BMI), fat mass index (FMI), trunk fat mass index (TFMI), appendicular skeletal muscle mass index (ASMI), muscle/fat mass ratio (M/F) and appendicular skeletal muscle mass/trunk fat mass ratio (A/T). Liver fibrosis was evaluated through liver stiffness measurement (LSM). Patients were classified according to BMI and body composition, followed by a comprehensive investigation into the impact of body composition changes on liver fibrosis outcomes. Among 72 patients with incident advanced liver fibrosis at readmission, ΔBMI, ΔFMI and ΔTFMI increased, while ΔM/F and ΔA/T decreased. Individuals who kept obese had a dramatically elevated hazard of incident advanced liver fibrosis compared to those who kept non-obese, with an adjusted odds ratio of 3.464. When TFMI heightened, the hazard of incident advanced liver fibrosis was 3.601 times higher compared to the decreased group. Additionally, individuals in increased ASMI and A/T groups showed a slight advantage in preventing incident advanced liver fibrosis compared to the stable groups. Stable obesity was associated with a greater hazard of liver fibrosis advancement, and an increase in TFMI may promote the progression of liver fibrosis. Maintaining a balanced muscle/fat ratio appeared to help prevent the progression.

A new perspective on risk factors for progressive liver fibrosis in patients with HIV, HBV, HCV superinfection

Topicality. One of the risk factors for the progression of the fibrotic process in the liver in triple superinfection with HIV/HBV/HCV may be the order of entry of viral pathogens into the human body, as well as the time interval between the entry of different pathogens. The aim of the study was to assess the effect on the course of liver fibrosis in HIV/HBV/HCV superinfection of the sequence of pathogens entering the human body and the time between superinfection.Materials and methods. 97 people with a verified diagnosis of HIV/HBV/HCV superinfection were subjected to a retrospective analysis depending on the timing of pathogen intake, the severity of liver fibrosis and antiviral therapy. Among the examined, 80% were men. The age category of 18-44 years included 84% and the remaining patients were in the category of 45–49 years. All patients received antiviral therapy. Liver fibrosis was assessed using dynamic liver elastography.Outcomes. The most favorable from the point of view of the progression of liver fibrosis was the primary HIV infection with an interval of 1–5 years between infection with hepatitis B and C viruses. The predominance of the progressive course of the fibrotic process in the liver occurred in cases where the first pathogen was HBV, and the interval between superinfection with another virus (HIV, HCV) exceeded 10 years. In cases not included in this category of patients, a HCV viral load above 1,700,000 copies/ml may be a risk factor for triple superinfection.Findings. 1. In HIV/HBV/HCV superinfection, a high risk of progressive liver fibrosis is associated with situations when: the first superinfecting pathogen is HIV at an interval of 1–5 years before superinfection with hepatitis B and/or C viruses; the first superinfecting pathogen is HBV with an interval of more than 10 years prior to HIV and/or HCV superinfection. 2. In HIV/HBV/HCV superinfection, in the absence of a priority for superinfection, a HCV viral load of more than 1700000 copies/ml may be a risk factor for advanced liver fibrosis. A rational regimen for antiretroviral therapy in triple superinfection with HIV/HBV/HCV is a combination of nucleotide inhibitors of HIV and HBV reverse transcriptase and HIV protease inhibitors.

α-Bisabolol and royal jelly differentially mitigate thioacetamide-induced hepatic fibrosis in rats associated with the inhibition of TGF-β1/FAK/α-SMA signaling

Hepatic fibrosis is a global health burden that accounts for high mortality. No definitive therapy to suppress the fibrosis so far. Thus, looking for an effective remedy to address the unmet medical need is crucial. We aimed to scrutinize the efficacy of royal jelly (RJ) and/or α-Bisabolol (BISA) in the regression of fibrosis provoked by thioacetamide (TAA), focusing on their action on redox status, NF-κBp65, apoptosis, and TGF-β1/FAK/α-SMA pathway. TAA was injected intraperitoneally twice weekly to trigger hepatic fibrosis. Rats were gavaged with RJ (100 mg/kg) and/or BISA (50 mg/kg) daily for 8 weeks. The findings elucidated that RJ and/or BISA alleviated TAA-provoked fibrosis mirrored by the improvement of hepatotoxicity serum indices, abolishing oxidative stress, and repair the morphological alterations. Additionally, RJ and BISA suppressed the hepatic inflammation induced by TAA through downregulating NF-κBp65 expression, reducing TNF-α and IL-6 concentrations, and elevating IL-10 level. Their anti-fibrotic effect was emphasized from the decline in FAK, Smad3, COL-III, hydroxyproline levels, and TGF-β1, α-SMA immunoexpression. BISA displayed better ameliorative action than RJ. Conclusively, RJ and/or BISA possess a hepatoprotective activity against TAA-mediated fibrosis by enhancing antioxidant defense, inhibiting NF-κBp65, and modulating TGF-β1/FAK/α-SMA signaling. RJ and BISA might be prospective candidates to combat hepatic fibrosis.

COMPARISON DIAGNOSTIC ACCURACY OF ULTRASONOGRAPHY ELASTOGRAPHY FOR DETECTING LIVER FIBROSIS COMPARED TO LIVER BIOPSY: A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS STUDIES

Background: Liver fibrosis significantly impacts disease outcomes in chronic liver disease. While liver biopsy has long been the gold standard for assessing and staging fibrosis, non-invasive ultrasound-based methods are emerging as valuable alternatives. The aim of this study is to systematically review and conduct a meta-analysis to compare the diagnostic accuracy of ultrasound elastography with liver biopsy for detecting liver fibrosis based on literatures in the last 10 years. Method: A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines using the PICO framework. Rigorous screening, data extraction, risk of bias assessment, and statistical analysis were performed to investigate diagnostic accuracy of ultrasonography elastography for detecting liver fibrosis compared to liver biopsy. Results: A total of 32 articles were retrieved from online databases (PubMed, SagePub, Nature and Cochrane). After three rounds of screening, seven articles directly relevant to the meta-analysis were selected for full-text reading and analysis. Conclusion: Liver fibrosis significantly impacts disease outcomes in chronic liver disease. While liver biopsy has long been the gold standard for assessing and staging fibrosis, non-invasive ultrasound-based methods like shear wave elastography are emerging as valuable alternatives.

ACEIs in high blood pressure: friend or enemy?

Optimal blood pressure control has been one of the fundamental objectives of primary care physicians and other medical specialties for many years. ACEIs (angiotensin-converting enzyme inhibitors) are one of the families of medications with an antihypertensive effect with the greatest experience in their use over decades. A 70-year-old patient previously diagnosed with high blood pressure and treated with ACEI, began in January 2013 with progressive worsening of kidney function.There are several mechanisms by which ACEIs produce an AKF (Acute Kidney Failure), such as efferent arteriolar vasodilatation because of blocking Angiotensin 2 effect or inmunoallergic mechanisms, or even different pathologies that could trigger it (congestive heart failure, liver cirrhosis with ascites and in presence of bilateral renal stenosis or unilateral stenosis of a single functioning kidney). The use of ACEIs as a first-line treatment for high blood pressure is supported by diverse clinical guidelines and by excellent results in a broad profile of patients. In a small percentage of cases, they have shown adverse effects that can affect the functioning of several systems involved in the correct control of the patient's cardiovascular risk, such as the renal system.

Streptomyces sp. from desert soil as a biofactory for antioxidants with radical scavenging and iron chelating potential

Iron homeostasis is vital for normal physiology, but in the majority of circumstances, like iron overload, this equilibrium is upset leading to free iron in the plasma. This condition with excess iron is known as hemochromatosis, which has been linked to many side effects, including cancer and liver cirrhosis. The current research aimed to investigate active molecules from Streptomyces sp. isolated from the extreme environment of Bahawalpur deserts. The strain was characterized using 16 S rRNA sequencing. Chemical analysis of the ethyl acetate cure extract revealed the presence of phenols, flavonoids, alkaloids, and tannins. Multiple ultraviolet (UV) active metabolites that were essential for the stated pharmacological activities were also demonstrated by thin layer chromatography (TLC) and high-performance liquid chromatography (HPLC). Additionally, Gas chromatography/mass spectrometry (GC-MS) analysis revealed the primary constituents of the extract to compose of phenol and ester compounds. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay was used to assess the extract’s antioxidant capacity, and the results showed a good half-maximal inhibitory concentration (IC50) value of 0.034 µg/mL in comparison to the positive control ascorbic acid’s 0.12 µg/mL. In addition, iron chelation activity of extract showed significant chelation potential at 250 and 125 µg/mL, while 62.5 µg/mL showed only mild chelation of the ferrous ion using ethylene diamine tetra acetic acid (EDTA) as a positive control. Likewise, the extract’s cytotoxicity was analyzed through 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay using varying concentrations of the extract and showed 51% cytotoxicity at 350 µg/mL and 65% inhibition of cell growth at 700 µg/mL, respectively. The bioactive compounds from Streptomyces sp. demonstrated strong antioxidant and iron chelating potentials and can prolong the cell survival in extreme environment.

Recent developments in non-invasive methods for assessing metabolic dysfunction-associated fatty liver disease

The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) is increasing, affecting over one-third of the global population and contributing to significant morbidity and mortality. Diagnosing MAFLD, especially with advanced fibrosis, remains challenging due to the limitations of liver biopsy, the current gold standard. Non-invasive tests are crucial for early detection and management. Among these, the fibrosis-4 index (Fib-4) is widely recommended as a first-line test for screening for liver fibrosis. Advanced imaging techniques, including ultrasound-based elastography and magnetic resonance elastography, offer high accuracy but are limited by cost and availability. Combining biomarkers, such as in the enhanced liver fibrosis score and FibroScan-AST score, enhances diagnostic precision and is recommended to further stratify patients who are considered to be intermediate or high risk from the Fib-4 score. We believe that the future lies in the combined use of biomarkers to improve diagnostic accuracy.

HCV genotype distribution in Istanbul: Adetailed 7 year epidemiological overview andimpact of Covid-19 pandemic.

Hepatitis C virus (HCV) is a leading cause of chronic liver disease, cirrhosis, and hepatocellular carcinomaworldwide. HCV has 8 genotypes (GT) and 86 subtypes and distribution of GTs varies based on geographical regions, transmission routes and even in cultural groups. The determination of viral genotype is crucial in choosing antiviral treatment, determining the duration of therapy, and monitoring treatment respose. Since 2014, with the usage of direct-acting antiviral agents (DAAs) in the treatment of HCV infections, a cure rate over 95% could be possible. Epidemiological data are important to combat a chronic HCV infections. Due to its geographical location, Turkey is like a bridge connecting Asia and Europe. Istanbul is the biggest and most crowded city of Turkey and has received immigration from many different countries, especially from Syria, in recent years and immigration still goes on. In addition, the COVID-19 pandemic has had devastating effects in our country. In this study, we determined the HCV genotypes in Health Sciences University Ümraniye Training and Research Hospital, in Istanbul between 2016 and 2022. Of the 322 patients analyzed during this 7-year period, HCV GT1b was the most prevalent GT in 65.2%, followed by GT3 in 15.5%, GT1a in 10.6%. Our data serve as a great mirror for HCV epidemiology in Turkey and contribute to global data.

Role of artificial intelligence in staging and assessing of treatment response in MASH patients.

The risk of disease progression in MASH increases proportionally to the pathological stage of fibrosis. This latter is evaluated through a semi-quantitative process, which has limited sensitivity in reflecting changes in disease or response to treatment. This study aims to test the clinical impact of Artificial Intelligence (AI) in characterizing liver fibrosis in MASH patients. The study included 60 patients with clinical pathological diagnosis of MASH. Among these, 17 received a medical treatment and underwent a post-treatment biopsy. For each biopsy (n = 77) a Sirius Red digital slide (SR-WSI) was obtained. AI extracts >30 features from SR-WSI, including estimated collagen area (ECA) and entropy of collagen (EnC). AI highlighted that different histopathological stages are associated with progressive and significant increase of ECA (F2: 2.6% ± 0.4; F3: 5.7% ± 0.4; F4: 10.9% ± 0.8; p: 0.0001) and EnC (F2: 0.96 ± 0.05; F3: 1.24 ± 0.06; F4: 1.80 ± 0.11, p: 0.0001); disclosed the heterogeneity of fibrosis among pathological homogenous cases; revealed post treatment fibrosis modification in 76% of the cases (vs 56% detected by histopathology). AI characterizes the fibrosis process by its true, continuous, and non-categorical nature, thus allowing for better identification of the response to anti-MASH treatment.

Elafibranor: A promising treatment for alcohol-associated liver disease?

We comment on an article by Koizumi et al . Elafibranor (EFN) is a dual pero-xisome proliferator-activated receptor α/δ agonist. The experimental results from Koizumi et al demonstrated that EFN significantly increases intestinal barrier function and ameliorates liver fibrosis. These positive outcomes suggest that EFN could be a promising therapeutic option for alcohol-associated liver disease (ALD). However, this study has limitations that necessitate further research to evaluate the efficacy of EFN. Future studies should consider the use of more appropriate animal models and cell types, optimize the administration routes and dosages of the drug, and conduct an in-depth investigation into the underlying mechanisms of action to determine the therapeutic effects of EFN in humans. With sustained and in-depth research, EFN has the potential to emerge as a novel therapeutic agent for the treatment of ALD.

No Difference in Liver Damage Induced by Isocaloric Fructose or Glucose in Mice with a High-Fat Diet

Background/Objectives: The diverse effects of fructose and glucose on the progression of metabolic dysfunction-associated steatotic liver disease remain uncertain. This study investigated the effects, in animal models, of high-fat diets (HFDs) supplemented with either glucose or fructose. Methods: Six-week-old, male C57BL/6J mice were randomly allocated to four groups: normal diet (ND), HFD, HFD supplemented with fructose (30% w/v, HFD + Fru), and HFD supplemented with glucose (initially 30%, HFD + Glu). After 24 weeks, liver and plasma samples were gathered for analysis. In addition, 39 patients with obesity undergoing bariatric surgery with wedge liver biopsy were enrolled in the clinical study. Results: The HFD + Glu group consumed more water than did the HFD and HFD + Fru groups. Thus, we reduced the glucose concentration from 30% at baseline to 15% at week 2 and 10% starting from week 6. The HFD + Fru and HFD + Glu groups had a similar average caloric intake (p = 0.463). The HFD increased hepatic steatosis, plasma lipid levels, lipogenic enzymes, steatosis-related oxidative stress, hepatic inflammation, and early-stage liver fibrosis. Supplementation with fructose or glucose exacerbated liver damage, but no significant differences were identified between the two. The expression patterns of hepatic ceramides in HFD-fed mice (with or without supplemental fructose or glucose) were similar to those observed in patients with obesity and severe hepatic steatosis or metabolic dysfunction–associated steatohepatitis. Conclusions: Fructose and glucose similarly exacerbated liver damage when added to an HFD. Ceramides may be involved in the progression of hepatic lipotoxicity.

Detection and validity of long non-coding RNAs HOST2, HOTAIR, HOXA-AS2, and MALAT1 as biomarkers for hepatocellular carcinoma

BackgroundHepatocellular carcinoma (HCC) is one of the most common cancers in the world. Long noncoding RNAs (lncRNAs) could contribute significantly to HCC development through diverse mechanisms, such as the recruitment of many regulatory protein complexes. This study aimed to evaluate the expression levels of the lncRNAs HOST2, HOTAIR, HOXA-AS2, and MALAT1 in liver cirrhosis and HCC and also assess their diagnostic performance as biomarkers for HCC. MethodsIn total, 180 participants were in this study, classified into three groups (60 participants in each): Group I (hepatocellular carcinoma patients), Group II (liver cirrhosis patients), and Group III (apparently healthy individuals). The expressions of the HOST2, HOTAIR, HOXA-AS2, and MALAT1 lncRNAs were detected using a reverse-transcriptase real-time polymerase chain reaction (qRT-PCR). ResultsThe expression levels of HOST2, HOTAIR, HOXA-AS2, and MALAT1 lncRNAs were markedly increased in the HCC patients compared with those in the cirrhotic patients and controls. They also exhibited greater sensitivity as diagnostic biomarkers than alpha-fetoprotein. ConclusionsThe HOTAIR, HOST2, HOXA-AS2, and MALAT1 lncRNAs exhibit promising potential as valuable diagnostic biomarkers of HCC and in differentiating HCC from liver cirrhosis. Furthermore, combining alpha-fetoprotein can yield higher accuracy.

Hepatitis C Infection Is Not a Cardiovascular Risk Factor in Young Adults.

Background: Cardiovascular diseases are one of the leading causes of hospitalization and death in Poland and around the world and are still an ongoing problem for modern medicine. Despite advances in diagnosis and treatment, both conservative and invasive, the prevention of cardiovascular disease directed at reducing risk factors remains a problem. The main classical risk factors for the development of cardiovascular disease in Poland include hypertension, lipid disorders, obesity, diabetes and smoking. A new non-classical risk factor is HCV infection. Most of the studies on the impact of HCV infection on cardiovascular disease involve elderly populations with long-term infections and advanced liver fibrosis. Methods: Hence, we set out to analyze the prevalence of risk factors and cardiovascular disease in a population of young adults under 45 years of age infected with HCV, according to gender, HCV genotype and the duration of infection. The study group consisted of 217 patients of both sexes aged 21 to 45 years (mean age 36 years). Results: No cardiovascular disease was found among the young adults infected with HCV in the study group. The most common risk factor was cigarette smoking, which affected 20.7% of the subjects, followed by hypertension (12%) and diabetes mellitus (5.5%); the prevalence was lower than in the general population. Most of the patients were characterized as overweight, with a mean BMI of 26.39 kg/m2. The mean values of other metabolic parameters-total cholesterol, LDL, HDL, uric acid and glucose-were within the population norm. The mean value of CRP was 1.43, which may indicate a moderate cardiovascular risk. Conclusions: Based on the conducted research, it was found that HCV infection in young individuals was not a risk factor for cardiovascular diseases, and the prevalence of risk factors was similar to that in the general population. The effect of HCV on the increase in C-reactive protein requires further study. The early detection of HCV infection and treatment can be considered as a prevention of cardiovascular disease.