Analogy between non-alcoholic steatohepatitis (NASH) and hypertension: a stepwise patient-tailored approach for NASH treatment

Ilan, Yaron

doi:10.20524/aog.2018.0248

Cited by 10 publications

(7 citation statements)

References 117 publications

(138 reference statements)

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“…High hs-CRP values was found in hypertensive patients and it was considered as an independent risk factor for HT. Authors concluded that this biomarker can aggravate hypertension by participating in local and systemic inflammatory responses [8]. Significant differences in the CRP level obtained during the examination of patients with comorbid and isolated NAFLD course also confirm this statement.…”

Section: Tablementioning

confidence: 74%

Non-Alcoholic Fatty Liver Disease and Hypertension: Clinical Variability of Comorbidity

Rozhdestvenska¹,

Babak²,

Zhelezniakova³

2020

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Introduction. Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases; and considerable attention is paid to the comorbidity of NAFLD with hypertension (HT), which affects around one-third of the world's population. The combination of NAFLD with hypertension has been suggested to have a mutual potentiating effect, and hypertension affects the severity of NAFLD. The purpose: to study the features of the clinical manifestation of NAFLD in patients with hypertension. Materials and methods. The study included 115 patients with NAFLD at the stage of nonalcoholic steatohepatitis. The main group consisted of 63 patients with NAFLD and HT, the comparison group included 52 patients with isolated NAFLD, and the control group was composed of 20 healthy volunteers. The patients underwent anthropometric measurements, evaluation of biochemical markers of liver functional activity, lipid profile and carbohydrate metabolism changes, C-reactive protein (CRP) levels. Results. A significant increase in the proportion of patients with active complaints in the group of patients with NAFLD with HT (subjective signs of liver damage, manifestations of dyspeptic and asthenic syndrome) was detected. Significant differences were found in almost all anthropometric indicators in both groups of patients with NAFLD in comparison with the control group. The level of CRP had significant differences and was 7.90 mg/l (95% CI = 7.96-8.75 mg/l), 6.55 mg/l (95% CI = 6.47-7.57 mg/l) and 2.07 (95% CI = 1.83-2.85 mg/l) in patients with NAFLD and HT, isolated NAFLD and the control group, respectively (p <0.001). Fasting glucose levels were significantly higher in both groups of examined patients with NAFLD compared with controls. Significant differences were found in the levels of total cholesterol, VLDL cholesterol, HDL cholesterol and atherogenic factor in patients with NAFLD depending on concomitant HT. There was no significant difference between LDL cholesterol and triglycerides in the two groups of patients with NAFLD. Conclusions. Based on the obtained data, it can be stated that GC in patients with NAFLD determines important deviations in the clinical manifestation of the disease and can be considered as a trigger factor for the progression of NAFLD.

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Section: Tablementioning

confidence: 74%

Non-Alcoholic Fatty Liver Disease and Hypertension: Clinical Variability of Comorbidity

Rozhdestvenska¹,

Babak²,

Zhelezniakova³

2020

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“…It is well-known that previously diagnosed hypertensive patients become normotensive during the progression of liver fibrosis, due to vasodilatation with low overall systemic vascular resistance and high arterial compliance. However, high blood pressure was incriminated as an independent risk factor for NAFLD and nonalcoholic steatohepatitis, a direct correlation being already proven in multiple studies [35, 49, 50]. Taken into account that these two clinical entities can progress to liver fibrosis or even cirrhosis, the dynamic evaluation of syndecan-1 serum levels in patients with these chronic disorders seems reasonable.…”

Section: Possible Diagnosis and Prognosis Role Of Syndecan-1 In Pmentioning

confidence: 97%

Syndecan-1: A Review on Its Role in Heart Failure and Chronic Liver Disease Patients’ Assessment

Miftode

Șerban

Timpau

et al. 2019

Cardiology Research and Practice

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The close connection and interaction between the cardiac and the liver functions are well-known, as cirrhotic cardiomyopathy is an important clinical entity which best describes the mutual pathogenical influence between these two organs. Due to the fact that cardiac dysfunction in patients with chronic hepatic disorders is oligosymptomatic or even asymptomatic, an early diagnosis represents a challenge for every physician. Syndecan-1—a transmembrane proteoglycan that exerts its functions mainly via its heparane sulfate chains—is a very promising biomarker, correlated not only with the degree of cardiac fibrosis but also with the severity of liver fibrosis. Many studies highlighted its role in the development of cardiac fibrosis or atherogenesis, being significantly correlated with the activity of angiotensin II. Multiple evidence revealed that syndecan-1 is also associated with tissue injury and may regulate inflammatory and regenerative responses, being considered a protective molecule that limits the inflammation and reduces cardiac remodelling and dysfunction after a myocardial infarction. Syndecan-1 may also be used as a reliable biomarker for the noninvasive assessment of liver fibrosis. Under various fibrogenetic conditions, shedding of syndecan's extracellular domain took place, becoming a soluble form that binds different growth factors and inhibits further fibrosis. This complex molecule is also involved in the lipid metabolism, by altering the clearance of cholesterol particles, and in chronic hepatitis, by enhancing the viral invasion of hepatocytes. Due to the growing interest in this biomarker, multiple studies aimed at revealing syndecan-1's potential benefits in the diagnosis and prognosis assessment in patients with heart failure or chronic liver disorders. In this review, we review the mechanisms by which syndecan-1 exerts its effects and the possible perspectives opened by its use as a dual cardio-hepatic biomarker.

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“…Finding an answer may require sub classifying a disease into categories or sub classifying the patient population into segments. Similarly, if the problem to be solved concerns the partial success of an existing solution, next-generation translational research will investigate combination therapy, which is commonly used with checkpoint inhibitor combination therapy [ 17 , 18 ]. Similarly, if side effects from checkpoint inhibitors present an obstacle to their use, alleviating the side effects rather than focusing solely on the clinical outcome of the combined technology may offer an answer to an unmet need, which is highly likely to be used by patients and supported by clinicians and payers alike.…”

Section: Next-generation Translational Research: Translating the Innomentioning

confidence: 99%

“…An additional factor that is highly relevant for nextgeneration translational research is the often-ignored factor of the body's compensatory response to triggers induced by a drug or any type of intervention [18,19]. Ignoring this problem is associated with lower effectiveness in many drugs used for chronic conditions, Ilan J Transl Med (2021) 19:55 sometimes in up to 40% of patients, such as those with epilepsy or depression, where many patients develop drug resistance [20,21].…”

Section: Next-generation Translational Research: Translating the Innomentioning

confidence: 99%

Why scientists, academic institutions, and investors fail in bringing more products to the bedside: the Active Compass model for overcoming the innovation paradox

Ilan

2021

J Transl Med

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The vast majority of good science and excellent ideas do not translate into products. Many good products that have the potential to assist in diagnosis and therapy do not mature into everyday care. This often becomes a source of frustration for innovators, academic institutions, companies both small and large, and investors. The “innovation paradox” , wherein excellent ideas and good science fail to reach the bedside, is a major challenge. This study presents the Active Compass model as a way to overcome this obstacle. The model is designed to assist projects at early stages by redirecting and reshaping them in a way that increases their chances of reaching the markets. The model is based on the use of next-generation translational research and on creating differentiators at the early stages of development. The proposed model’s implementation by innovators, scientists, technology transfer offices, academic institutions, analysts, and investors can help move forward high-potential projects to improve the quality of life and alleviate the burdens of disease.

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Analogy between non-alcoholic steatohepatitis (NASH) and hypertension: a stepwise patient-tailored approach for NASH treatment

Cited by 10 publications

References 117 publications

Non-Alcoholic Fatty Liver Disease and Hypertension: Clinical Variability of Comorbidity

Non-Alcoholic Fatty Liver Disease and Hypertension: Clinical Variability of Comorbidity

Syndecan-1: A Review on Its Role in Heart Failure and Chronic Liver Disease Patients’ Assessment

Why scientists, academic institutions, and investors fail in bringing more products to the bedside: the Active Compass model for overcoming the innovation paradox

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