Favorable effect of corticosteroids in treating acute-on-chronic liver failure underlying chronic hepatitis B

Kim, Hyeji; Kwon, Jung Hyun; Kim, Yong Hee; Nam, Soon Woo; Lee, Jong Yul; Jang, Jeong Won

doi:10.3350/cmh.2017.0016

Cited by 3 publications

(2 citation statements)

References 18 publications

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“… 7 Glucocorticoid therapy is recommended as a first-line treatment strategy for severe alcoholic hepatitis and hepatic encephalopathy, 8 and it is attracting attention as a possible therapy for ACHBLF because of its rapid beneficial effect. 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Hypomethylation of thymosin β4 promoter is associated with glucocorticoid therapy in patients with acute-on-chronic hepatitis B-induced liver failure

Wang

et al. 2022

International Health

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Background We aimed to determine whether the methylation status of thymosin β4 (Tβ4) promoter reflects the severity of acute-on-chronic hepatitis B liver failure (ACHBLF) and whether glucocorticoids affect this status. Methods Fifty-six patients with ACHBLF, 45 with chronic hepatitis B (CHB) and 32 healthy controls (HCs), were retrospectively enrolled. Methylation-specific PCR and real-time PCR were used to detect Tβ4 methylation frequency and mRNA level. The expression of Tβ4 was measured before and after glucocorticoid treatment in patients with ACHBLF. Clinical and laboratory parameters were obtained. Results Tβ4 mRNA expression of patients with ACHBLF was lower than in patients with CHB or HCs, but the methylation frequency was higher. Tβ4 promoter methylation frequency was correlated with serum total bilirubin, prothrombin activity and model for end-stage liver disease score. Moreover, Tβ4 promoter methylation frequency decreased and demethylation occurred during glucocorticoid therapy. After glucocorticoid therapy, Tβ4 mRNA expression and liver function were better in patients with low levels of methylation than in those with higher levels. After 90 d, the survival of patients with low levels of methylation was significantly higher than those with high levels. Conclusions Patients with ACHBLF who have low levels of Tβ4 methylation may show a more favorable response to glucocorticoid treatment.

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Section: Introductionmentioning

confidence: 99%

Hypomethylation of thymosin β4 promoter is associated with glucocorticoid therapy in patients with acute-on-chronic hepatitis B-induced liver failure

Wang

et al. 2022

International Health

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“…Very limited exceptions include reactivation of hepatitis B virus (HBV), autoimmune hepatitis (AIH) as well as Wilson's disease (WD). 6,8,9 Relative data indicate that up to 30% of patients with chronic hepatitis B experience HBV reactivation each year, and up to 8% of patients develop severe acute exacerbation and may progress to ACLF; 10,11 flare-ups of chronic hepatitis B can progress to ACLF with high short-term mortality. 11,12 Etiology is quite heterogeneous and encompasses a wide variety of possible causative factors (Table 1), depending mainly on geographical distribution; ALF varies according to the etiology and center responsible for patient management.…”

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confidence: 99%

Acute Liver Failure

Doulberis¹,

Kotronis

Gialamprinou

et al. 2019

Journal of Clinical Gastroenterology

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Acute liver failure is a rare hepatic emergent situation that affects primarily young people and has often a catastrophic or even fatal outcome. Definition of acute liver failure has not reached a universal consensus and the interval between the appearance of jaundice and hepatic encephalopathy for the establishment of the acute failure is a matter of debate. Among the wide variety of causes, acetaminophen intoxication in western societies and viral hepatitis in the developing countries rank at the top of the etiology list. Identification of the clinical appearance and initial management for the stabilization of the patient are of vital significance. Further advanced therapies, that require intensive care unit, should be offered. The hallmark of treatment for selected patients can be orthotopic liver transplantation. Apart from well-established treatments, novel therapies like hepatocyte or stem cell transplantation, additional new therapeutic strategies targeting acetaminophen intoxication and/or hepatic encephalopathy are mainly experimental, and some of them do not belong, yet, to clinical practice. For clinicians, it is substantial to have the alertness to timely identify the patient and transfer them to a specialized center, where more treatment opportunities are available. FIGURE 1. The 3 main well-established classifications for ALF. (i) Williams-Schalm and O'Grady system (ii) Bernuau system, and (iii) Mochida (Japanese) system. ALF indicates acute liver failure.

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Critically Ill COVID-19 Patient with Chronic Liver Disease - Insights into a Comprehensive Liver Intensive Care

Philips¹,

Kakkar²,

Joseph³

et al. 2021

Journal of Clinical and Translational Hepatology

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This eleventh review of global reporting of ADRs for drugs used to treat COVID-19 is as before mainly descriptive in nature. It includes reviews for the drugs that were initially included in WHO Solidarity trial to find an effective COVID-19 treatment and other drugs used for a COVID-19 indication where the number of reports in VigiBase exceeds 100. Regarding remdesivir, a major increase in reports was seen in this review. Notable numbers of reports for several non-labelled ADR terms have been shared within the system, described in the remdesivir section of the document. Concerning the other drugs reviewed, ADR-patterns are consistent with those described in earlier reports and mostly within the labelling for the respective drugs. Reports have been shared from all WHO regions, with the largest number now originating in the WHO region of the Americas with 45% of the shared reports (Table 2). WHO has announced the discontinuation of the hydroxychloroquine (HCQ) and lopinavir;ritonavir arms of the Solidarity trial as per the recommendation from the international steering committee 1 . The decision applies only to the conduct of the Solidarity trial in hospitalized patients and does not affect the possible evaluation in other studies of hydroxychloroquine or lopinavir;ritonavir in nonhospitalized patients or as pre-or post-exposure prophylaxis for COVID-19.

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Favorable effect of corticosteroids in treating acute-on-chronic liver failure underlying chronic hepatitis B

Cited by 3 publications

References 18 publications

Hypomethylation of thymosin β4 promoter is associated with glucocorticoid therapy in patients with acute-on-chronic hepatitis B-induced liver failure

Hypomethylation of thymosin β4 promoter is associated with glucocorticoid therapy in patients with acute-on-chronic hepatitis B-induced liver failure

Acute Liver Failure

Critically Ill COVID-19 Patient with Chronic Liver Disease - Insights into a Comprehensive Liver Intensive Care

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