Efficacy and safety of PERIOdontal treatment versus usual care for Nonalcoholic liver disease: protocol of the PERION multicenter, two-arm, open-label, randomized trial

This study aims to investigate the effect of periodontal treatment for liver damage,P. gingivalis infection, and endotoxemia on patients with NAFLD.MethodsWe will include adult patients (20 –85 years old) with NAFLD, alanine aminotransferase (ALT) ≥ 40 IU/L, and equivalent steatosis grade ≥ 1 (target sample size,n = 40 patients; planned number of patients with outcome data,n = 32). Participants will be randomly assigned to one of two groups: a scaling and root-planing group or tooth-brushing as the usual group. The primary outcome will be the change in ALT levels from baseline to 12 weeks; the key secondary outcome will be the change in the serum immunoglobulin G (IgG) antibody titer forP. gingivalis at 12  weeks.DiscussionThis study should determine whether periodontal treatment decreases liver damage,P. gingivalis infection, and endotoxemia in patients with NAFLD.Trial registrationUniversity Hospital Medical Information Network (UMIN) Clinical Trials Registry, ID:UMIN000022079.
Source: Trials - Category: Research Source Type: clinical trials

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Nonalcoholic fatty liver disease (NAFLD) is common in older patients with type 2 diabetes. In older patients with type 2 diabetes, the presence of NAFLD is associated with a higher risk of hepatic (eg, nonalcoholic steatohepatitis, cirrhosis, and hepatocellular carcinoma) and extrahepatic (eg, cardiovascular disease, sarcopenia, and dementia) complications than that observed in other patient groups. For this reason, appropriate identification and management of NAFLD are clinically relevant particularly in the group of older patients with type 2 diabetes. In this regard, clinicians should consider the peculiar characteristi...
Source: Clinics in Geriatric Medicine - Category: Geriatrics Authors: Source Type: research
In this study, we show that perforin can act as an immune regulator to prevent the progression of NAFLD. Aged perforin-deficient (Prf−/−) mice have increased lipid accumulation in the liver compared to WT mice. With high-fat diet (HFD) challenge, Prf−/− mice have increased liver weight, more severe liver damage, and increased liver inflammation when compared with WT controls. Mechanistic studies revealed that perforin specifically regulates intrinsic IFN-γ production in CD4 T cells, not CD8 T cells. We found that CD4 T cell depletion reduces liver injury and ameliorates the inflammation and me...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Abstract The most common cause of liver disease worldwide is now non-alcoholic fatty liver disease (NAFLD). NAFLD refers to a spectrum of disease ranging from steatosis to non-alcoholic steatohepatitis, causing cirrhosis, and ultimately hepatocellular carcinoma. However, the impact of NAFLD is not limited to the liver. NAFLD has extra-hepatic consequences, most notably, cardiovascular and renal disease. NAFLD and chronic kidney disease share pathogenic mechanisms including insulin resistance, lipotoxicity, inflammation and oxidative stress. Not surprisingly, there has been a recent surge in efforts to manage NAFLD...
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
Chronic liver diseases (CLD) are a worldwide clinical problem, as they are related to high morbidity and mortality. The principal causes include viral, alcoholism, cholestatic, autoimmune and metabolic diseases such as non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). These CLD can evolve into cirrhosis and hepatocellular carcinoma (HCC) [1]. Patients with CLD showed significant health problems like ascites, spontaneous bacterial peritonitis, hepatic encephalopathy and persistent variceal bleeding concomitant with a decrease in health-related quality of life [1-3].
Source: Prostaglandins, Leukotrienes and Essential Fatty Acids - Category: Biomedical Science Authors: Source Type: research
In conclusion, carriage of the combination PNPLA3 minor allele and HSD17B13 major allele may represent a risk factor for HCC among HCV-infected patients. The interplay between the two genes may explain some of the controversy on this topic and may be exploited to stratify HCC risk in hepatitis C. PMID: 32382265 [PubMed]
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
by Helen Jarvis, Dawn Craig, Robert Barker, Gemma Spiers, Daniel Stow, Quentin M. Anstee, Barbara Hanratty BackgroundNon-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide. Many individuals have risk factors associated with NAFLD, but the majority do not develop advanced liver disease: cirrhosis, hepatic decompensation, or hepatocellular carcinoma. Identifying people at high risk of experiencing these complications is important in order to prevent disease progression. This review synthesises the evidence on metabolic risk factors and their potential to predict liver disease outcomes...
Source: PLoS Medicine - Category: Internal Medicine Authors: Source Type: research
This report reviews recent advances in our understanding of macrophage biology during the entire spectrum of MAFLD including steatosis, inflammation, fibrosis, and hepatocellular carcinoma, as well as for the extra-hepatic manifestations of MAFLD. We discuss the underlying molecular mechanisms of macrophage activation and polarization as well as cross talk with other cell types such as hepatocytes, hepatic stellate cells, and adipose tissue. We conclude with a discussion on the potential translational implications and challenges for macrophage based therapeutics for MAFLD. PMID: 32390698 [PubMed - in process]
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Abstract Nonalcoholic fatty liver disease (NAFLD) embraces histopathological entities ranging from the relatively benign simple steatosis to the progressive form nonalcoholic steatohepatitis (NASH), which is associated with fibrosis and an increased risk of progression to cirrhosis and hepatocellur carcinoma. NAFLD is the most common liver disease and is associated with extrahepatic comorbidities including a major cardiovascular disease burden. The non-invasive diagnosis of NAFLD and the identification of subjects at risk of progressive liver disease and cardio-metabolic complications are key in implementing perso...
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
ConclusionNAFLD is associated with a number of EHMs that increases its mortality and increased healthcare expenditure.
Source: Hepatology International - Category: Infectious Diseases Source Type: research
This webinar will investigate the increasing mortality rates of liver disease in the UK associated with obesity and the excess consumption of alcohol. It will give an overview of non-alcoholic fatty liver disease (NAFLD), which is now the most common  of liver disease affecting an estimated 25-30% of adults and 10% of children in the UK and worldwide. Both NAFLD and alcohol-related fatty liver can progress to severe liver disease including fibrosis, cirrhosis and hepatocellular carcinoma. The roles of genetics, obesity and dietary patterns i n the development and progression of liver disease will be dis...
Source: The Nutrition Society - Category: Nutrition Authors: Source Type: news
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