• Title/Summary/Keyword: liver cirrhosis

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The role of hepatic macrophages in nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

  • Cha, Ji-Young;Kim, Da-Hyun;Chun, Kyung-Hee
    • Laboraroty Animal Research
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    • v.34 no.4
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    • pp.133-139
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    • 2018
  • Nonalcoholic steatohepatitis (NASH) is becoming common chronic liver disease because of the increasing global prevalence of obesity and consequently Nonalcoholic fatty liver disease (NAFLD). However, the mechanism for progression of NAFLD to NASH and then cirrhosis is not completely understood, yet. The triggering of these hepatic diseases is thought from hepatocyte injury caused by over-accumulated lipid toxicity. Injured hepatocytes release damage-associated molecular patterns (DAMPs), which can stimulate the Kupffer cells (KCs), liver-resident macrophages, to release pro-inflammatory cytokines and chemokines, and recruit monocyte-derived macrophages (MDMs). The increased activation of KCs and recruitment of MDMs accelerate the progression of NAFLD to NASH and cirrhosis. Therefore, characterization for activation of hepatic macrophages, both KCs and MDMs, is a baseline to figure out the progression of hepatic diseases. The purpose of this review is to discuss the current understanding of mechanisms of NAFLD and NASH, mainly focusing on characterization and function of hepatic macrophages and suggests the regulators of hepatic macrophages as the therapeutic target in hepatic diseases.

Effect of Yinjinchunggan-tang(YJCGT) on Fibrogenesis in Thioacetamide(TAA)-induced Rat Liver Tissue (TAA로 유발된 간섬유화 동물모델에서 인진청간탕의 효과)

  • Park, Shin-Myoung;Lee, Jang-Hoon;Kim, Young-Chul;Woo, Hong-Jung
    • The Journal of Internal Korean Medicine
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    • v.30 no.2
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    • pp.270-287
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    • 2009
  • Objective : Yinjinchunggan-tang(YJCGT) is reported previously as having theraputic effects on hepatitis such as anti-implammatory, anti-apoptotic, anti-viral(HBV), etc. Though this prescription is not studied on its anti-fibrogenic effect, it is still expected to have the effect in the liver. Thus, this study was performed to investigate the anti-fibrogenic effect of YJCGT on thioacetamide(TAA)-induced liver fibrosis in rats. Method: Rat liver fibrosis was induced by intraperitoneal TAA injection(150mg/kg) 3 times a week for 5 weeks. After the YJCGT (YJCGT 1g/kg, YJCGT 2g/kg)-treatment, body weight, liver and spleen weights, liver function test, the complete blood count and the portal pressure were studied. In addition, gene expressions of ASMA, procollagen type Ia2, MMP2, TIMP1 and TIMP2, all of which are known to be associated with liver fibrosis, were analyzed by RT-PCR. After YJCGT (YJCGT 1g/kg, YJCGT 2g/kg) treatment, percentages of collagen in TAA-induced rat liver tissue were measured by image analyzer. Results : The body weight of the normal group increased more than that of the control and YJCGT-treated groups. The AST level of the YJCGT lg/kg-treated group significantly decreased compared to that of the control. The ALT and the GGT levels of the YJCGT 2g/kg-treated group significantly increased compared to those of the control. In the YJCGT-treated groups. WBC, RBC and Hgb elevated by TAA injection decreased but platelet count increased. In the YJCGT lg/kg-treated group, the portal pressure elevated by TAA injection significantly decreased. The significant decreases in the gene expressions of procollagen type Ia2, MMP2 and TIMP2 were observed in the YJCGT-treated groups. In histological findings. TAA injections caused severe liver fibrosis, but the YJCGT treatment significantly reduced the amounts of hepatic collagens. Conclusions: These results suggest that YJCGT has beneficial effects on the treatment of patients with liver cirrhosis as well as chronic hepatitis. Further study should be done to decide the optimal concentration of the YJCGT for the treatment of liver cirrhosis.

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A study of Sexual Function, Sleep Quality and Depression in Male Patients with Liver Cirrhosis (남성 간경변 환자의 성기능, 수면의 질, 우울에 관한 연구)

  • Kim, Dohee;Park, Hyojung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.311-320
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    • 2019
  • This study is a descriptive study to investigate the relationship between sexual function, sleep quality, and depression in male cirrhosis patients. Data were collected from a structured questionnaire from August 16, 2017 to January 30, 2018. Data were collected by t-test, ANOVA, Scheffe test, Pearson correlation. AS a result, the lower the sexual function of male cirrhosis patients, the lower the quality of sleep (r=-.232, p =.005) and the higher the depression score (r=-.381, p<.001) The lower the score, the higher the score of depression (r=.561, p<.001). Sexual function, quality of sleep and depression were found to be statistically significant. The results of this study can be used as basic data for the development of nursing intervention for male cirrhosis patients.

Vitamin D Improves Intestinal Barrier Function in Cirrhosis Rats by Upregulating Heme Oxygenase-1 Expression

  • Wang, Peng-fei;Yao, Dan-hua;Hu, Yue-yu;Li, Yousheng
    • Biomolecules & Therapeutics
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    • v.27 no.2
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    • pp.222-230
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    • 2019
  • Intestinal barrier dysfunction always accompanies cirrhosis in patients with advanced liver disease and is an important contributor facilitating bacterial translocation (BT), which has been involved in the pathogenesis of cirrhosis and its complications. Several studies have demonstrated the protective effect of Vitamin D on intestinal barrier function. However, severe cholestasis leads to vitamin D depletion. This study was designed to test whether vitamin D therapy improves intestinal dysfunction in cirrhosis. Rats were subcutaneously injected with 50% sterile $CCl_4$ (a mixture of pure $CCl_4$ and olive oil, 0.3 mL/100 g) twice a week for 6 weeks. Next, $1,25(OH)_2D_3$ ($0.5{\mu}g/100g$) and the vehicle were administered simultaneously with $CCl_4$ to compare the extent of intestinal histologic damage, tight junction protein expression, intestinal barrier function, BT, intestinal proliferation, apoptosis, and enterocyte turnover. Intestinal heme oxygenase-1 (HO-1) expression and oxidative stress were also assessed. We found that vitamin D could maintain intestinal epithelial proliferation and turnover, inhibit intestinal epithelial apoptosis, alleviate structural damage, and prevent BT and intestinal barrier dysfunction. These were achieved partly through restoration of HO-1 and inhibition of oxidative stress. Taken together, our results suggest that vitamin D ameliorated intestinal epithelial turnover and improved the integrity and function of intestinal barrier in $CCl_4$-induced liver cirrhotic rats. HO-1 signaling activation was involved in these above beneficial effects.

Diagnostic Imaging of Liver Cirrhosis in a Shih-Tzu Dog (시츄견에서 발생한 간경화의 영상 진단)

  • Choi, Ho-Jung;Lee, Ki-Ja;Chang, Jin-Hwa;An, Ji-Young;O, I-Se;Ahn, Se-Joon;Jeong, Seong-Mok;Park, Seong-Jun;Cho, Sung-Whan;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.367-370
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    • 2009
  • A 5-year-old, intact female Shih-Tzu dog was presented with 1 year history of icterus, ascites and anorexia. The serum biochemistry revealed elevated liver enzyme levels. Microhepatica and decreased serosal detail were detected in abdominal radiography. Abdominal ultrasonographic findings included irregular liver margins, multifocal hypoechoic nodules in the liver parenchyma, and ascites. Computed tomography (CT) showed multifocal hypodense nodules with ring-like contrast enhancement. Cytologic and histopathologic examination by liver core biopsy revealed fibrosis. Cirrhosis was diagnosed based on above results. This report focuses on the imaging characteristics of ultrasonography and CT for liver cirrhosis in a dog.

The Effects of Acupuncture on the Insomnia, Anxiety and Depression of Liver Cancer Patients: Pilot study

  • Lee, Chang-Hyeong;Kim, Byung-Seok;Kim, Ji-Suk;Kwon, Hyo-Jung;Choi, Ae-Ryun;Kwak, Min-A;Kim, Seung-Mo
    • The Journal of Korean Medicine
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    • v.33 no.2
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    • pp.34-46
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    • 2012
  • Objectives: Most patients who have cancer suffer from anxiety and depression. Because most liver cancer patients have cirrhosis, medication can aggravate their liver function. We need the most effective treatment such that the anxiety and depression can be improved without causing deterioration of liver function. The purpose of this study is to examine the effects of acupuncture on the anxiety and depression of liver cancer patients. Methods: 8 liver cancer patients who complained of distress were treated by acupuncture three times a week for four weeks (12 times in total). Evaluation of the anxiety, depression and insomnia was measured by NCC (National Cancer Center) score. On visits 1, 4, 7, 10, and 13 we had patients check NCC score after acupuncture treatment. To check deterioration of liver cancer, we checked their abdominal CT, Child-Pugh score and blood test. Results: After 12 treatments, NCC of the anxiety, depression and insomnia were significantly decreased in all of the patients without causing deterioration of liver function. In particular, symptoms were almost completely improved in 6 patients. Conclusions: This study suggests that acupuncture treatment will be beneficial for liver cancer patients to reduce anxiety, depression and insomnia. For liver cancer patients with cirrhosis or chronic hepatitis, a large-scale study to confirm efficacy and safety of acupuncture is needed.

Natural History of Chronic Hepatitis in Korea (한국(韓國)에 만연(蔓延)하고 있는 만성간염(慢性肝炎)의 자연병력(自然病歷))

  • Chung, Whan-Kook
    • The Journal of the Korean life insurance medical association
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    • v.2 no.1
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    • pp.34-36
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    • 1985
  • Korea is an endemic area of chronic hepatitis in the world. Liver cirrhosis and liver cell carcinoma, presumed to be related to such chronic hepatitis, are the major causes of death in this country. The purpose of this study is disclosing the sources of chronic hepatitis in Korea establishing its histologic characteristics, disclosing the patterns of progression in chronic hepatitis, delineating its prognosis and finally speculating its etiology. The study group was composed of 183 patients with biopsy-proven acute icteric viral hepaticis, 32 patients with biopsy- proven anicteric hepatitis and 260 patients with biopsy- proven chronic hepatitis. These patients submitted to long-term follow-up by means of liver needle biopsy and/or clinicolaboratory evaluation. The period of follow-up ranged from two months to 18 years. The histological features of the initial biopsy specimens of chronic hepatitis permitted a division of the cases cases into the following five types: Type I. Persisting portal hepatitis : so called persisting hepatitis 43 Type II. Chronic inactive hepatitis with incomplete strand septal fibrosis. This type has thin fibrotic septation in addition to Type I with portal sclerosis 38 Type III. Chronic active periportal hepatitis(CAPH) : so called aggressive hepatitis, characterized by marked piecemeal necrosis. This type has been subdivided further into three groups: AB and C on the basis of histologic features. A CAPH without cirrhosis 15 B CAPH with cirrhosis 99 C CAPH with diffuse acinus type parenchymal nodules; characterized by rosette-forming micronodules 21 Type IV. Subacute hepatic necrosis; characterized by multilobular and/or bridging necrosis. 14 Type V. Persisting lobular hepatitis; characterized by spotty necrosis, which looks very similar to acute viral hepatitis. Such histologic changes should be persisted for more than six months 30 In Korea the main source of chronic hepatitis is the anicteric type. Of the chronic hepatitis observed in the hospital, Type IIIb was the most frequent in its incidence and occasionally exhibited development of hepatocellular carcinoma, but the mortality was highest in Type IIIc during the period of follow-up. Histologic characteristics of these five types suggest a spectrum of chronic hepatitis in Korea from an early and mild stage to advanced and fatal cirrhosis, which is occasionally associated with primary hepatic cell carcinoma. It seems that Type IV can be followed by flare-up of various stages of acute and chronic hepatitis with HBsAg and that many cases of liver cirrhosis prevalent in Korea occur through such an active process of Type IV. The etiology is not established, but in Korea it is mainly related to HBsAg.

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Usefulness of Median Modified Wiener Filter Algorithm for Noise Reduction in Liver Cirrhosis Ultrasound Image (간경변 초음파 영상에서의 노이즈 제거를 위한 Median Modified Wiener Filter 알고리즘의 유용성)

  • Seung-Yeon Kim;Soo-Min Kang;Youngjin Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.6
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    • pp.911-917
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    • 2023
  • The method of observing nodular changes on the liver surface using clinical ultrasonography is useful for diagnosing cirrhosis. However, the speckle noise that inevitably occurs in ultrasound images makes it difficult to identify changes in the liver surface and echo patterns, which has a negative impact on the diagnosis of cirrhosis. The purpose of this study is to model the median modified Wiener filter (MMWF), which can efficiently reduce noise in cirrhotic ultrasound images, and confirm its applicability. Ultrasound images were acquired using an ACR phantom and an actual cirrhotic patient, and the proposed MMWF algorithm and conventional noise reduction algorithm were applied to each image. Coefficient of variation (COV) and edge rise distance (ERD) were used as quantitative image quality evaluation factors for the acquired ultrasound images. We confirmed that the MMWF algorithm improved both COV and ERD values compared to the conventional noise reduction algorithm in both ACR phantom and real ultrasound images of cirrhotic patients. In conclusion, the proposed MMWF algorithm is expected to contribute to improving the diagnosis rate of cirrhosis patients by reducing the noise level and improving spatial resolution at the same time.

Bile Duct Obstruction Stimulates Lipid Peroxidation and Liver Fibrosis (Cirrhosis) in Rat (랫드에서 담도폐쇄에 의한 지질과산화와 간섬유화(경화) 촉진에 관한 연구)

  • 김기영;서의석;임진아
    • Toxicological Research
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    • v.17 no.3
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    • pp.187-194
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    • 2001
  • The oxidative stress causes the cell damage and death and thereby, stimulates membrane lipid peroxidation. In this study, the correlation between the lipid peroxidation product and the parameter of liver fibrosis (cirrhosis) was investigated in cholestasis induced rats. The Sprague-Dawley rats were divided into 3 groups (sham: sham operation, BDL/S-I and BDL/S-II : bile duct ligation/scission) and were observed for 2 or 4 weeks. After observation period, the organs were weighed and the ratio of organ weight/body weight was calculated. Sera and liver tissue were used for the measurement of malondealdehyde (MDA), parameter of clinical biochemistry, total collagen content and the staining. The ratio of organ weight/body weight in BDL/S-I and BDL/S-II was significantly increased compared to sham operated group. Serological parameters (Alanine transaminase, Aspartate transaminase, Alkaline phosphatase and Total bilirubin) in BDL/S-I and BDL/S-II group were significantly higher than those in sham operated group. Concentration of MDA in BDL/S-I (261%) and BDL/S-II(790%) was significantly increased compared to MDA in sham operated group. And the content of hydroxyproline (hyp) in BDL/S-I and BDL/S-II group was significantly increased 2~4 times than in sham operated group. The good correlations between hyp in liver tissue and MDA in sera of sham operated group and all operated group were found (r=0.825). The significantly higher value of MDA, hyp and serological parameters in BDL/S-I and BDL/S-II group suggests the stimulation of lipid peroxidation and chronic liver damage. Especially the activation of lipid peroxidation and the stimulation of liver fibrosis was stronger in BDL/S-II group than in BDL/S-I group. The stronger fibrosis, portal-portal septum formation, the more massive bile duct proliferation in portal triads and stroma, and hepatocytes swelling were observed in liver tissue of and BDL/S-II group compared to BDL/S-I group. Conclusively, a good correlation between MDA as a lipid peroxidation marker and hyp as a liver fibrotic parameter could be connected with the process of liver fibrosis. Moreover, cholestasis condition may cause jaundice, activation of lipid peroxidation, and collagen accumulation in liver. Additionally, optimal observation period of bile duct obstruction for the screening of antioxidant and antifibrotic effect in rats would be four weeks.

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The Studies on Search of Antifibrotic Effect by Several Herbs Extract in Rat Liver Tissue (수종(數種)의 한약재(韓藥材) 전탕액(煎湯液)이 동물 간조직내 항섬유효능검색에 관한 실험적 연구)

  • Seo Dong-Jin;Lee Chun-Woo;Kim Hong-Gi;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.5 no.1
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    • pp.116-133
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    • 2001
  • Antifibrotic drugs could be delayed or inhibited massive collagen deposition in liver tissue or inhibited collagen synthesis. we investigated antifibrotic effects by several herbs(Schisnadra chinensis, Ganoderma japonicum, Sedum sarmentosum, Alisma canaliculatum, Plantago asiatica) extract with observations of collagen accumulation in liver tissue and collagen synthesis in sera. Rats were used for experimental animal that were devided 3 groups(sham control, BDL/S, BDL/S-ER). Rats were operated for inducing liver fibrosis(cirrhosis) by bile duct obstruction. Several herbs were prepared by water extraction and were applicated p. o. $3ml/day$ during 4 weeks. After observation period, rats were sacrificed and liver tissue and sera were collected. In result, the mortality of rats was 35% in BDL/S group and 20% in BDL/S-ER The color of bile juice in BDL/S-ER was bright yellow and murky yellow in BDL/S group. The significantly lower weight of liver($16.21g{\pm}5.3,\;20.58{\pm}2.4$) and spleen($1.96g{\pm}0.96,\;3.93{\pm}0.21$) were shown in BDL/S-ER than that of BDL/S(p<0.05) group. The value of collagen in liver tissue(25.7%) in BDL/S-ER was observed significantly lower than that of BDL/S group (Tab. 2). AST. ALT, ALP, t-bilirubin, BUN levels were low in BDL/S-ER as compared with those of BDL/S group, but the significance was not proven. The trichrome stained liver tissue in BDL/S-ER group was observed mild bile duct proliferation and fibrosis compared with BDL/S group. In conclusion, natural products inhibited new collagen synthesis and delayed massive collagen deposition in liver tissue, so that they have noticeable antifibrotic effects in experimental liver fibrosis(cirrhosis).

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