Assessment of Serious Acute and Chronic Idiosyncratic Drug-Induced Liver Injury in Clinical Practice
Semin Liver Dis DOI: 10.1055/s-0039-1685519Drug-induced liver injury (DILI) is the leading cause of acute liver failure (ALF) in developed countries. The extremely variable phenotype of DILI, both in presentation and in severity, is one of the distinctive characteristics of the disease and one of the major challenges that hepatologists face when assessing hepatotoxicity cases. A new Hy's law that more accurately predicts the risk of ALF related to DILI has been proposed and validated. Other prognostic scoring algorithms for the early identification of DILI patients who may go on to develop ALF have been developed as it is ...
Source: Seminars in Liver Disease - May 1, 2019 Category: Gastroenterology Authors: Bessone, Fernando Robles-Diaz, Mercedes Hernandez, Nelia Medina-Caliz, Inmaculada Lucena, M. Isabel Andrade, Raul J. Tags: Review Article Source Type: research
Magnetic Resonance Imaging in Primary Sclerosing Cholangitis —Current State and Future Directions
Semin Liver Dis DOI: 10.1055/s-0039-1687853Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by biliary inflammation and fibrosis leading to bile duct strictures, cirrhosis, and carries an increased risk of hepatobiliary malignancies. Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) is the imaging modality of choice in PSC. As an evolving technology, MRI has other potential applications in the care and study of those patients with PSC. In this review, the authors aim to provide a technical overview on MRI/MRCP and related technologies, summariz...
Source: Seminars in Liver Disease - April 29, 2019 Category: Gastroenterology Authors: Zenouzi, Roman Welle, Christopher L. Venkatesh, Sudhakar K. Schramm, Christoph Eaton, John E. Tags: Review Article Source Type: research
Lipid Droplet Formation and Lipophagy in Fatty Liver Disease
Semin Liver Dis DOI: 10.1055/s-0039-1685524Lipid droplets (LDs) are key sites of neutral lipid storage that can be found in all cells. Metabolic imbalances between the synthesis and degradation of LDs can result in the accumulation of significant amounts of lipid deposition, a characteristic feature of hepatocytes in patients with fatty liver disease, a leading indication for liver transplant in the United States. In this review, the authors highlight new literature related to the synthesis and autophagic catabolism of LDs, discussing key proteins and machinery involved in these processes. They also discuss recent findings...
Source: Seminars in Liver Disease - April 29, 2019 Category: Gastroenterology Authors: Schulze, Ryan J. McNiven, Mark A. Tags: Review Article Source Type: research
Retreatment of Hepatitis C Virus-Infected Patients with Direct-Acting Antiviral Failures
This article discusses virological failure rates with the successive waves of HCV combination regimens, the reasons for failure, the role of HCV resistance, and current retreatment options. The triple combination of sofosbuvir, velpatasvir, and voxilaprevir for 12 weeks is the first-line retreatment strategy in patients previously exposed to DAAs. Difficult-to-retreat patients may benefit from the combination of sofosbuvir plus glecaprevir/pibrentasvir and/or the addition of ribavirin and/or longer retreatment duration. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:...
Source: Seminars in Liver Disease - April 29, 2019 Category: Gastroenterology Authors: Pawlotsky, Jean-Michel Tags: Review Article Source Type: research
Mutational Processes in Hepatocellular Carcinoma: The Story of Aristolochic Acid
Semin Liver Dis DOI: 10.1055/s-0039-1685516Each hepatocellular carcinoma displays dozens of mutations in driver and passenger genes. The analysis of the types of substitutions and their trinucleotide context defines mutational signatures that recapitulate the endogenous and exogenous mutational processes operative in tumor cells. Aristolochic acid is present in plants from the genus Aristolochia and causes chronic nephropathy. Moreover, aristolochic acid has genotoxic properties responsible for the occurrence of urothelial carcinoma. Metabolites of aristolochic acid form DNA adducts on adenine residues leading to a specifi...
Source: Seminars in Liver Disease - April 29, 2019 Category: Gastroenterology Authors: Nault, Jean-Charles Letouz é, Eric Tags: Review Article Source Type: research
Immunosuppressive Drug Levels in Liver Transplant Recipients: Impact in Decision Making
Semin Liver Dis DOI: 10.1055/s-0039-1688443To prevent rejection, liver transplant providers largely base their management decisions on their clinical impression and pharmacokinetics. Clinical impression relies on assessing graft function, liver enzymes, and biopsy. High immunosuppressive drug levels, although minimizing rejection, are related to significant side effects such as nephrotoxicity and metabolic syndrome, contributing to long-term morbidity and mortality. Similarly, levels that are lower than necessary can decrease the rate of side effects with a potential toll on rejection and graft survival. Herein, the author...
Source: Seminars in Liver Disease - April 29, 2019 Category: Gastroenterology Authors: Kourkoumpetis, Themistoklis Levitsky, Josh Tags: Review Article Source Type: research
Macrophages as Key Players during Adipose Tissue –Liver Crosstalk in Nonalcoholic Fatty Liver Disease
Semin Liver Dis DOI: 10.1055/s-0039-1687851Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries that could lead to serious health problems including liver failure, cancer, or death. The term NAFLD includes a spectrum of disease states with histological features ranging from simple steatosis to nonalcoholic steatohepatitis (NASH). A key aspect within this research field is the identification of pathogenic factors that trigger inflammation, thus fueling the transition from nonalcoholic fatty liver to NASH. These inflammatory triggers may originate from within the liv...
Source: Seminars in Liver Disease - April 29, 2019 Category: Gastroenterology Authors: Korf, Hannelie Boesch, Markus Meelberghs, Lore van der Merwe, Schalk Tags: Review Article Source Type: research
Long-Term Impact of Direct-Acting Antiviral Agent Therapy in HCV Cirrhosis: Critical Review
Semin Liver Dis DOI: 10.1055/s-0039-1685538More than 70 million people are chronically infected with hepatitis C virus (HCV) worldwide. Chronic hepatitis C is associated with progressive liver fibrosis, which can result in cirrhosis, liver failure, and hepatocellular carcinoma (HCC). HCV-related liver disease has been the most common indication for liver transplantation in the past decade. The development of direct-acting antiviral agents (DAAs) that are simple, well-tolerated, and highly effective means that most people living with hepatitis C can now be cured, leading the World Health Organization to set targets for redu...
Source: Seminars in Liver Disease - April 29, 2019 Category: Gastroenterology Authors: Fehily, Sasha R. Papaluca, Tim Thompson, Alexander J. Tags: Review Article Source Type: research
Clinical Trials in PBC Going Forward
Semin Liver Dis DOI: 10.1055/s-0039-1687852New treatments for primary biliary cholangitis (PBC) are progressively emerging, including first and second generations of farnesoid X receptor and peroxisome proliferator-activated receptors agonists. Even though ursodeoxycholic acid monotherapy remains the standard of care treatment for PBC, these additional therapeutic options, already or soon to be available, lead us to revise our priorities and strategies with respect to future clinical trials. The present article is a personal view of where we currently stand in this field and where and how we should be going to achieve new ...
Source: Seminars in Liver Disease - April 29, 2019 Category: Gastroenterology Authors: Corpechot, Christophe Tags: Review Article Source Type: research
Erratum: Novel Targets in the Immune Microenvironment of the Hepatic Sinusoids for Treating Liver Diseases
Semin Liver Dis DOI: 10.1055/s-0039-1688409 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Full text (Source: Seminars in Liver Disease)
Source: Seminars in Liver Disease - April 15, 2019 Category: Gastroenterology Authors: Patten, Daniel A. Shepherd, Emma L. Weston, Christopher Shetty, Shishir Tags: Erratum Source Type: research
Direct-Acting Oral Anticoagulants (DOACs) in Cirrhosis and Cirrhosis-Associated Portal Vein Thrombosis
This article reviews the current Food and Drug Administration-approved DOACs, hepatic metabolism of DOACs, pharmacokinetics of DOACs in patients with cirrhosis, safety of DOACs (including bleeding, hepatotoxicity, and pregnancy), current treatment guidelines for PVT in cirrhosis, and studies evaluating the use of DOACs in cirrhosis and for the treatment of PVT in cirrhosis. The potential use of DOACs for PVT primary prophylaxis in at-risk patients with cirrhosis and the possible antifibrotic effects of DOACs are also discussed. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJ...
Source: Seminars in Liver Disease - April 11, 2019 Category: Gastroenterology Authors: Weinberg, Ethan M. Palecki, Julia Reddy, K. Rajender Tags: Review Article Source Type: research
Current Knowledge of Occult Hepatitis B Infection and Clinical Implications
Semin Liver Dis DOI: 10.1055/s-0039-1678728Occult hepatitis B infection (OBI) is a status of undetectable serum hepatitis B surface antigen (HBsAg) yet detectable serum and/or intrahepatic hepatitis B virus (HBV) DNA. Mutations in the preS1, preS2, and S regions of the HBsAg gene may result in undetectable HBsAg. OBI may either result from a self-limiting acute hepatitis, or in patients with chronic hepatitis B who achieved HBsAg seroclearance, which refers to the loss of detectability of serum HBsAg with or without antibody to HBsAg (anti-HBs) in chronic hepatitis B (CHB) patients. HBsAg seroclearance contributes to a sig...
Source: Seminars in Liver Disease - March 24, 2019 Category: Gastroenterology Authors: Yip, Terry Cheuk-Fung Wong, Grace Lai-Hung Tags: Review Article Source Type: research
Genetics of Nonalcoholic Fatty Liver Disease: From Pathogenesis to Therapeutics
Semin Liver Dis DOI: 10.1055/s-0039-1679920Here, the authors review the remarkable genetic discoveries that have illuminated the biology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). The authors integrate genes associated with NAFLD and NASH into regulatory pathways to elucidate the disease pathogenesis. They review the evidence for molecular mediators of chronic liver damage, which suggests that convergent pathophenotypes, including inflammation and fibrosis, share common genetic modifiers. They further demonstrate that genes involved in the genetic susceptibility of NAFLD and NASH p...
Source: Seminars in Liver Disease - March 24, 2019 Category: Gastroenterology Authors: Sookoian, Silvia Pirola, Carlos J. Tags: Review Article Source Type: research
Balloon Tamponade and Esophageal Stenting for Esophageal Variceal Bleeding in Cirrhosis: A Systematic Review and Meta-analysis
Semin Liver Dis DOI: 10.1055/s-0039-1678726Failure to control variceal bleeding with current recommendations occurs in 10 to 20% of cases. This systematic review and meta-analysis analyzes the experience, results, and complications of “bridge” therapies for failure to control acute variceal bleeding: balloon tamponade and esophageal stents. The main outcomes assessed were failure to control bleeding and mortality in the short-term and medium-term follow-up, and adverse events. Balloon tamponade studies had a pooled rate of short-term failure to control bleeding of 35.5%, and adverse events in over 20% of cases; 9.7% re...
Source: Seminars in Liver Disease - March 24, 2019 Category: Gastroenterology Authors: Rodrigues, Susana G. C árdenas, Andrés Escorsell, Àngels Bosch, Jaime Tags: Review Article Source Type: research
Novel Targets in the Immune Microenvironment of the Hepatic Sinusoids for Treating Liver Diseases
Semin Liver Dis DOI: 10.1055/s-0039-1678727Immune dysregulation and accumulation of leukocytes is a hallmark of adult chronic liver diseases. Progressive hepatic inflammation can lead to fibrosis and cirrhosis with a high risk of liver failure or hepatocellular cancer (HCC). Recent advances have been made in the treatment of liver disease including the development of highly effective antiviral therapy for hepatitis C and the potential of immunotherapy for HCC. Despite this, the majority of other chronic liver diseases including alcoholic liver disease, fatty liver disease, and cholestatic diseases do not respond to convent...
Source: Seminars in Liver Disease - March 24, 2019 Category: Gastroenterology Authors: Patten, Daniel A. Shepherd, Emma L. Weston, Christopher J. Shetty, Shishir Tags: Review Article Source Type: research
