How to Identify Advanced Nonalcoholic Fatty Liver Disease in the Primary Care Setting
Semin Liver Dis DOI: 10.1055/s-0043-1770984 Nonalcoholic fatty liver disease (NAFLD) affects 30 to 40% of the population globally and is increasingly considered the most common liver disease. Patients with type 2 diabetes, obesity, and cardiovascular diseases are at especially increased risk for NAFLD. Although most patients with NAFLD do not have progressive liver disease, some patients progress to cirrhosis, liver cancer, and liver mortality. Given the sheer number of patients with NAFLD, the burden of disease is enormous. Despite this large and increasing burden, identification of NAFLD patients at risk for progressive ...
Source: Seminars in Liver Disease - July 6, 2023 Category: Gastroenterology Authors: Golabi, Pegah Shah, Dipam Younossi, Zobair M. Tags: Review Article Source Type: research
Genetic and Epigenetic Basis of Drug-Induced Liver Injury
In conclusion, these studies provide useful information in risk alleles identification and on implementation of personalized medicine. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Liver Disease)
Source: Seminars in Liver Disease - July 5, 2023 Category: Gastroenterology Authors: Singh, Snigdha Kumar, P.V.S.N. Kiran Kumar, J. Pradeep Tomo, Sojit Yadav, Dharamveer Sharma, Praveen Rao, Mahadev Banerjee, Mithu Tags: Review Article Source Type: research
HNF4 α in Hepatocyte Health and Disease
Semin Liver Dis DOI: 10.1055/a-2097-0660 Hepatocyte nuclear factor 4 α (HNF4α) is a highly conserved member of the nuclear receptor superfamily expressed at high levels in the liver, kidney, pancreas, and gut. In the liver, HNF4α is exclusively expressed in hepatocytes, where it is indispensable for embryonic and postnatal liver development and for normal liver function in adults. It is considered a master regulator of hepatic differentiation because it regulates a significant number of genes involved in hepatocyte-specific functions. Loss of HNF4α expression and function is associated with the progression of chronic l...
Source: Seminars in Liver Disease - July 5, 2023 Category: Gastroenterology Authors: Kotulkar, Manasi Robarts, Dakota R. Apte, Udayan Tags: Review Article Source Type: research
To TIPS or Not to TIPS in High Risk of Variceal Rebleeding and Acute-on-Chronic Liver Failure
Semin Liver Dis DOI: 10.1055/a-2107-0576 Variceal bleeding is a consequence of severe portal hypertension in patients with liver cirrhosis. Although the rate of bleeding has decreased over time, variceal bleeding in the presence of acute-on-chronic liver failure (ACLF) carries a high risk of treatment failure and short-term mortality. Treatment and/or removal of precipitating events (mainly bacterial infection and alcoholic hepatitis) and decrease of portal pressure may improve outcome of patients with acute decompensation or ACLF. Transjugular intrahepatic portosystemic shunts (TIPSs), especially in the preemptive situati...
Source: Seminars in Liver Disease - July 5, 2023 Category: Gastroenterology Authors: Gu, Wenyi Kimmann, Markus Laleman, Wim Praktiknjo, Michael Trebicka, Jonel Tags: Review Article Source Type: research
Mast Cell and Innate Immune Cell Communication in Cholestatic Liver Disease
In conclusion, dysregulation of MC-innate immune cell communications during liver injury and inflammation can lead to chronic liver injury and cancer. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Liver Disease)
Source: Seminars in Liver Disease - July 5, 2023 Category: Gastroenterology Authors: Bernard, Jessica K. Marakovits, Corinn Smith, Leah G. Francis, Heather Tags: Review Article Source Type: research
Critical Care Management of Acute-on-Chronic Liver Failure: Certainties and Unknowns
Semin Liver Dis DOI: 10.1055/s-0043-1769907 Intensive care unit (ICU) admission is frequently required in patients with decompensated cirrhosis for organ support. This entity, known as acute-on-chronic liver failure (ACLF), is associated with high short-term mortality. ICU management of ACLF is complex, as these patients are prone to develop new organ failures and infectious or bleeding complications. Poor nutritional status, lack of effective liver support systems, and shortage of liver donors are also factors that contribute to increase their mortality. ICU therapy parallels that applied in the general ICU population in ...
Source: Seminars in Liver Disease - June 27, 2023 Category: Gastroenterology Authors: Reverter, Enric Toapanta, David Bassegoda, Octavi Zapatero, Juliana Fernandez, Javier Tags: Review Article Source Type: research
Endoscopic Advances in Hepatology
Semin Liver Dis DOI: 10.1055/s-0043-1769009 Endoscopy is and remains an indispensable tool in diagnosing and managing liver disease and its complications. Due to the progress in advanced endoscopy, endoscopy has become an alternative route for many surgical, percutaneous, and angiographic interventions, not only as a backup tool when conventional interventions fail but increasingly as a first-line choice. The term endo-hepatology refers to the integration of advanced endoscopy in the practice of hepatology. Endoscopy is key in the diagnosis and management of esophageal and gastric varices, portal hypertensive gastropathy, ...
Source: Seminars in Liver Disease - May 16, 2023 Category: Gastroenterology Authors: Vanderschueren, Emma Trebicka, Jonel Laleman, Wim Tags: Review Article Source Type: research
Screening for At-Risk Nonalcoholic Fatty Liver Disease in the Primary Care Setting
In conclusion, screening for advanced nonalcoholic fatty liver disease in the primary care setting is a crucial part of identifying high-risk patients who may benefit from aggressive intervention while avoiding overtreatment of patients at low risk of liver-related complications. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Liver Disease)
Source: Seminars in Liver Disease - May 16, 2023 Category: Gastroenterology Authors: Urias, Esteban Chen, Vincent L. Tags: Review Article Source Type: research
Hepatic Innervations and Nonalcoholic Fatty Liver Disease
Semin Liver Dis DOI: 10.1055/s-0043-57237Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disorder. Increased sympathetic (noradrenergic) nerve tone has a complex role in the etiopathomechanism of NAFLD, affecting the development/progression of steatosis, inflammation, fibrosis, and liver hemodynamical alterations. Also, lipid sensing by vagal afferent fibers is an important player in the development of hepatic steatosis. Moreover, disorganization and progressive degeneration of liver sympathetic nerves were recently described in human and experimental NAFLD. These structural alterations likely com...
Source: Seminars in Liver Disease - May 8, 2023 Category: Gastroenterology Authors: Adori, Monika Bhat, Sadam Gramignoli, Roberto Valladolid-Acebes, Ismael Bengtsson, Tore Uhl èn, Mathias Adori, Csaba Tags: Review Article Source Type: research
Targeting Fibroblast Growth Factor Receptor Pathway: Precision Medicine for Biliary Cancer and Beyond
Semin Liver Dis DOI: 10.1055/a-2049-3149 Fibroblast growth factor receptor 2 (FGFR2) inhibitors are now being included in the treatment guidelines of multiple countries for patients with advanced cholangiocarcinoma (CCA). Activation of the FGF–FGFR pathway is related to proliferation and tumor progression. Targeting the FGF–FGFR pathway is effective and can yield durable responses in patients with CCA harboring FGFR2 fusions or rearrangements. In this review article, we address molecules and clinical trials evaluating FGFR inhibitors in advanced CCA. We will further discuss identified mechanisms of resistance and the s...
Source: Seminars in Liver Disease - March 29, 2023 Category: Gastroenterology Authors: Uson Junior, Pedro Luiz Serrano Borad, Mitesh J. Tags: Review Article Source Type: research
Cirrhosis Management in the Intensive Care Unit
Semin Liver Dis DOI: 10.1055/a-2015-1290 Patients with cirrhosis frequently require admission to the intensive care unit as complications arise in the course of their disease. These admissions are associated with high short- and long-term morbidity and mortality. Thus, understanding and characterizing complications and unique needs of patients with cirrhosis and acute-on-chronic liver failure helps providers identify appropriate level of care and evidence-based treatments. While there is no widely accepted critical care admission criteria for patients with cirrhosis, the presence of organ failure and primary or nosocomial ...
Source: Seminars in Liver Disease - February 13, 2023 Category: Gastroenterology Authors: Smith, Thomas N. Gallo de Moraes, Alice Simonetto, Douglas A. Tags: Review Article Source Type: research
Growth Hormone Signaling in Liver Diseases: Therapeutic Potentials and Controversies
Semin Liver Dis DOI: 10.1055/a-2015-1359 Growth hormone (GH) and downstream insulin-like growth factor 1 (IGF1) signaling mediate growth and metabolism. GH deficiency causes short stature or dwarfism, and excess GH causes acromegaly. Although the association of GH/IGF1 signaling with liver diseases has been suggested previously, current studies are controversial and the functional roles of GH/IGF1 signaling are still undefined. GH supplementation therapy showed promising therapeutic effects in some patients, such as non-alcoholic fatty liver disease, but inhibition of GH signaling may be beneficial for other liver diseases...
Source: Seminars in Liver Disease - February 10, 2023 Category: Gastroenterology Authors: Oxley, Madisyn Francis, Heather Sato, Keisaku Tags: Review Article Source Type: research
Update on Hepatobiliary Plasticity
Semin Liver Dis DOI: 10.1055/s-0042-1760306 The liver field has been debating for decades the contribution of the plasticity of the two epithelial compartments in the liver, hepatocytes and biliary epithelial cells (BECs), to derive each other as a repair mechanism. The hepatobiliary plasticity has been first observed in diseased human livers by the presence of biphenotypic cells expressing hepatocyte and BEC markers within bile ducts and regenerative nodules or budding from strings of proliferative BECs in septa. These observations are not surprising as hepatocytes and BECs derive from a common fetal progenitor, the hepat...
Source: Seminars in Liver Disease - February 10, 2023 Category: Gastroenterology Authors: Kim, Minwook Rizvi, Fatima Shin, Donghun Gouon-Evans, Valerie Tags: Review Article Source Type: research
Emerging Links between Nonalcoholic Fatty Liver Disease and Neurodegeneration
Semin Liver Dis DOI: 10.1055/s-0043-1762585 The association between liver and brain health has gained attention as biomarkers of liver function have been revealed to predict neurodegeneration. The liver is a central regulator in metabolic homeostasis. However, in nonalcoholic fatty liver disease (NAFLD), homeostasis is disrupted which can result in extrahepatic organ pathologies. Emerging literature provides insight into the mechanisms behind the liver–brain health axis. These include the increased production of liver-derived factors that promote insulin resistance and loss of neuroprotective factors under conditions of ...
Source: Seminars in Liver Disease - February 10, 2023 Category: Gastroenterology Authors: Kelty, Taylor J. Dashek, Ryan J. Arnold, W. David Rector, R. Scott Tags: Review Article Source Type: research
The Changing Epidemiology of Alcohol-Associated Liver Disease: Gender, Race, and Risk Factors
In conclusion, ALD rates are rising, with young people and women particularly impacted. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Liver Disease)
Source: Seminars in Liver Disease - February 10, 2023 Category: Gastroenterology Authors: Anouti, Ahmad Mellinger, Jessica L. Tags: Review Article Source Type: research
