A Review on the Update of Combined Hepatocellular Cholangiocarcinoma
Semin Liver Dis DOI: 10.1055/s-0039-3402515Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a primary liver tumor with neoplastic components of both hepatocytic and cholangiocytic differentiation. This unique neoplasm is gaining increasing recognition due to the intriguing pathology, tumor biology, and clinical behavior. It also poses challenges in diagnosis, treatment, and research, largely because of its histological and phenotypic diversity that lead to confusion in terminology and classification. There have been efforts attempting to unify the terminology of this neoplasm recently. Advances in investigation in ...
Source: Seminars in Liver Disease - December 29, 2019 Category: Gastroenterology Authors: Komuta, Mina Yeh, Matthew M. Tags: Review Article Source Type: research
NS5A-P32 Deletion in Hepatitis C Genotype 1b Infection is the Most Refractory Treatment-Mediated Amino Acid Change Exhibiting Resistance to all NS5A Inhibitors
Semin Liver Dis DOI: 10.1055/s-0039-3402001NS5A-P32 deletion (P32del) is a resistance-associated amino acid change that has recently gained popularity in direct-acting antiviral treatment for chronic hepatitis C. Although not yet detected in naive patients, it appears in 5 to 10% of hepatitis C genotype 1b patients who fail to respond to daclatasvir/asunaprevir and sofosbuvir/ledipasvir treatments. In contrast to signature resistance-associated substitutions, such as substitutions at the NS5A-L31 and NS5A-Y93 positions, it shows complete resistance to all NS5A inhibitors in replicon and cell culture. Studies of humanized l...
Source: Seminars in Liver Disease - December 12, 2019 Category: Gastroenterology Authors: Hikita, Hayato Takehara, Tetsuo Tags: Review Article Source Type: research
Impact of Viral Etiologies on the Development of Novel Immunotherapy for Hepatocellular Carcinoma
Semin Liver Dis DOI: 10.1055/s-0039-3399534Hepatocellular carcinoma (HCC), is the most common type of liver cancer which is derived mostly from the background of chronic inflammation. Chronic hepatitis viral infection remains one of the most common etiologies implicated in chronic liver inflammation, cirrhosis, and HCC. With such background inflammation, immunotherapy—particularly the checkpoint inhibitors—have been tested in HCC patients with unprecedented success. However, despite the initial enthusiasm, the response rate to immunotherapy remains modest in most clinical trials (approximately 20%), with mixed reports ...
Source: Seminars in Liver Disease - December 5, 2019 Category: Gastroenterology Authors: Lim, Chun Jye Chew, Valerie Tags: Review Article Source Type: research
Role of Biomarkers in Guiding Cure of Viral Hepatitis B
Semin Liver Dis DOI: 10.1055/s-0039-3401031Chronic hepatitis B (CHB) virus infection is a global public health threat affecting approximately 257 million individuals worldwide. Hepatitis B surface antigen (HBsAg) loss has been the classic endpoint to define functional cure and decrease the large pool of individuals with CHB. Current treatments with nucleos(t)ide analogues persistently suppress hepatitis B virus (HBV) deoxyribonucleic acid in most CHB patients, but rarely achieve functional cure. New viral biomarkers, such as quantitative HBsAg, hepatitis B core-related antigen, and HBV ribonucleic acid, and combinations of...
Source: Seminars in Liver Disease - December 4, 2019 Category: Gastroenterology Authors: Buti, Maria Riveiro-Barciela, Mar Rodr íguez-Frías, Francisco Tabernero, David Esteban, Rafael Tags: Review Article Source Type: research
Emerging Role of Palliative Care in Patients with Advanced Liver Disease
Semin Liver Dis DOI: 10.1055/s-0039-3400259Advanced liver disease is increasing in mortality and morbidity worldwide, as a result of growing alcohol consumption, obesity, and viral hepatitis infection. Alongside efforts to reduce these factors, it is clear that we must identify the considerable palliative care needs of these patients in order to improve quality of life and reduce symptom burden. Our review focuses on the current state of palliative and end-of-life care for patients with advanced liver disease, the significant associated symptom burden in this disease group, identified level of involvement and potential ben...
Source: Seminars in Liver Disease - November 14, 2019 Category: Gastroenterology Authors: Jordan, Roberta I. Tandon, Puneeta Tags: Review Article Source Type: research
Epidemiology of Liver Cancer in Africa: Current and Future Trends
We present a narrative review of HCC in Africa, discussing present and future trends. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Liver Disease)
Source: Seminars in Liver Disease - November 13, 2019 Category: Gastroenterology Authors: Okeke, Edith Davwar, Pantong Mark Roberts, Lewis Sartorius, Kurt Spearman, Wendy Malu, Abraham Duguru, Mary Tags: Review Article Source Type: research
Neutrophil Extracellular Traps and Liver Disease
Semin Liver Dis DOI: 10.1055/s-0039-3399562Neutrophil extracellular traps, or NETs, are heterogenous, filamentous structures which consist of extracellular DNA, granular proteins, and histones. NETs are extruded by a neutrophil in response to various stimuli. Although NETs were initially implicated in immune defense, subsequent studies have implicated NETs in a spectrum of disease processes, including autoimmune disease, thrombosis, and cancer. NETs also contribute to the pathogenesis of several common liver diseases, including alcohol-associated liver disease and portal hypertension. Although there is much interest in the...
Source: Seminars in Liver Disease - November 13, 2019 Category: Gastroenterology Authors: Hilscher, Moira B. Shah, Vijay H. Tags: Review Article Source Type: research
Early Liver Transplantation in Acute Alcoholic Hepatitis
Semin Liver Dis DOI: 10.1055/s-0039-3399560Alcohol-related liver disease (ALD) is currently the leading indication for liver transplantation in the United States. Among patients with ALD, those with acute alcoholic hepatitis who do not respond to medical treatment have a 6-month mortality of 70% without transplantation. Despite the high mortality, the majority of patients will not be eligible for transplant, given that most centers follow the 6-month abstinence rule. A handful of centers in Europe and the United States perform early liver transplantation (< 6 months abstinence) in these patients, as it provides a substa...
Source: Seminars in Liver Disease - November 10, 2019 Category: Gastroenterology Authors: Haugen, Christine E. Cameron, Andrew M. Tags: Review Article Source Type: research
Epidemiology of Liver Cancer in Latin America: Current and Future Trends
Semin Liver Dis DOI: 10.1055/s-0039-3399561Over 38,000 cases of hepatocellular carcinoma (HCC) are estimated to occur in Latin America annually. The region is characterized by sociocultural heterogeneity and economic disparities, which impose barriers in addressing this major health issue. A significant proportion of patients are still diagnosed in the later stages of the disease, although efforts to implement effective screening programs have been reported by referral centers. While viral hepatitis remains the predominant etiology of liver disease among HCC cases in Latin America, a high prevalence of fatty liver disease ...
Source: Seminars in Liver Disease - November 10, 2019 Category: Gastroenterology Authors: Carrilho, Flair Jose Paranagu á-Vezozzo, Denise Cerqueira Chagas, Aline Lopes Alencar, Regiane Saraiva de Souza Melo da Fonseca, Leonardo Gomes Tags: Review Article Source Type: research
Mechanotransduction in Liver Diseases
Semin Liver Dis DOI: 10.1055/s-0039-3399502Chronic liver diseases, such as fibrosis and cancer, lead to a rigid or stiff liver because of perpetual activation of hepatic stellate cells or portal fibroblasts into matrix-producing myofibroblasts. Mechanical forces, as determined by the mechanical properties of extracellular matrix or pressure of circulating blood flow/shear stress, are sensed by mechanoreceptors at the plasma membrane and transmitted into a cell to impact cell function. This process is termed as mechanotransduction. This review includes basic knowledge regarding how external forces are sensed, amplified, and...
Source: Seminars in Liver Disease - November 3, 2019 Category: Gastroenterology Authors: Kang, Ningling Tags: Review Article Source Type: research
Cholemic Nephropathy Reloaded
Semin Liver Dis DOI: 10.1055/s-0039-1698826Acute kidney injury (AKI) is a dreaded complication in patients with liver disease and jaundice, since it is associated with significant morbidity and mortality. Cholemic nephropathy (CN) is thought to represent a widely underestimated important cause of AKI in advanced liver diseases with jaundice. The umbrella term CN describes impaired renal function along with histomorphological changes consisting of intratubular cast formation and tubular epithelial cell injury directed primarily toward distal nephron segments. In cholestasis, biliary constituents may be excreted via the kidn...
Source: Seminars in Liver Disease - October 17, 2019 Category: Gastroenterology Authors: Fickert, Peter Rosenkranz, Alexander R. Tags: Review Article Source Type: research
The Pathogenesis of Primary Biliary Cholangitis: A Comprehensive Review
Semin Liver Dis DOI: 10.1055/s-0039-1697617Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease characterized by autoimmune destruction of small to medium size intrahepatic bile ducts. The etiology of PBC remains unknown and pathogenesis features immune-mediated biliary injury, alongside the consequences of chronic cholestasis. PBC is strongly associated with the loss of immune tolerance against mitochondrial antigens and the subsequent presence of an articulated immunologic response that involves both humoral and cellular responses. Both environmental factors and genetic variants increase PBC susceptib...
Source: Seminars in Liver Disease - September 18, 2019 Category: Gastroenterology Authors: Lleo, Ana Leung, Patrick S.C. Hirschfield, Gideon M. Gershwin, Eric M. Tags: Review Article Source Type: research
Peculiarities of Cirrhosis due to Nonalcoholic Steatohepatitis (NASH)
Semin Liver Dis DOI: 10.1055/s-0039-1697616The prevalence of cirrhosis due to nonalcoholic steatohepatitis (NASH) has increased 2.5-fold in the United States in the last decade. These patients pose new challenges to hepatologists given their older age and higher frequency of coexisting metabolic diseases such as obesity and diabetes compared with other etiologies of liver disease. Patients with NASH cirrhosis are at higher risk for renal and cardiovascular disease, and the presence of these extrahepatic comorbidities has a significant impact on outcomes and survival. This review outlines how NASH cirrhosis differs from oth...
Source: Seminars in Liver Disease - September 18, 2019 Category: Gastroenterology Authors: El-Sherif, Omar Armstrong, M.J. Tags: Review Article Source Type: research
Management of Lifestyle Factors in Individuals with Cirrhosis: A Pragmatic Review
Semin Liver Dis DOI: 10.1055/s-0039-1696639Lifestyle-related factors are major determinants/modifiers of prognosis in patients with cirrhosis. Accumulating evidence indicates that malnutrition, obesity, sedentary lifestyle, alcohol and smoking habits, and likely poor oral hygiene can increase the risk of progression of the disease, and some of them are linked to higher risk of hepatocellular carcinoma. Importantly, lifestyle-related factors can be largely corrected, and as such they represent an attractive approach to be added to etiological and pharmacological therapy in patients with cirrhosis. Nonetheless, lifestyle is ...
Source: Seminars in Liver Disease - August 29, 2019 Category: Gastroenterology Authors: Tandon, Puneeta Berzigotti, Annalisa Tags: Review Article Source Type: research
Assessment and Management of Infection in Alcoholic Hepatitis
Semin Liver Dis DOI: 10.1055/s-0039-1693402Severe alcoholic hepatitis (SAH) is a condition characterized by jaundice and liver failure that develops after heavy and prolonged alcohol consumption. Infection frequently complicates the natural history of the disease and is independently associated with mortality. Objective recognition and recording of infection are therefore essential in the evaluation of therapeutic interventions and for antibiotic stewardship. This review will evaluate infections that complicate SAH at admission and beyond. Factors that associate with the development of infection will be identified and clin...
Source: Seminars in Liver Disease - July 31, 2019 Category: Gastroenterology Authors: Vergis, Nikhil Atkinson, Stephen R. Thursz, Mark R. Tags: Review Article Source Type: research
