Fibrosis and hepatic regeneration mechanism

Zúñiga-Aguilar, E.; Ramírez-Fernández, O.

doi:10.21037/tgh.2020.02.21

Cited by 18 publications

(9 citation statements)

References 110 publications

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“…Відомо, що регенерація печінки відбувається у три етапи, які регулюються різними факторами: 1) фаза ініціації регулюється інтерлейкіном 6 (IL-6) та фактором некрозу пухлин (TNFα), 2) фаза збільшення популяції гепатоцитів (експансії) відбувається під впливом фактора росту гепатоцитів (HGF) і трансформуючого фактора росту альфа (TGFα); 3) кінцева (термінальна) фаза регенерації печінки -збільшення клітинної маси та проліферація клітин регулюється трансформуючим фактором росту бета (TGFβ) і активінами [6]. Відкритими залишаються механізми впливу АМК на різні етапи регенеративних процесів у печінці.…”

Section: вступunclassified

The Effect of Automesoconcentrate of Platelets on the Stages of Regeneration of the Liver Remnant of Rats Under the Conditions of Performing Volumetric Experimental Liver Resections

Salyutin,

Yuzvyk

2024

Clin. and prev. med.

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Introduction. Liver regeneration occurs in three stages, each of which is regulated by different factors: the initiation phase is regulated by interleukin 6 (IL-6) and tumor necrosis factor (TNFα); expansion phase – by hepatocyte growth factor (HGF) and transforming growth factor alpha (TGFα); the terminal phase – transforming growth factor beta (TGFβ) and activins. The work determined the level of markers of the main stages of liver regeneration after resection of 65-70% of the parenchyma of this organ in rats under the conditions of using different doses and schemes of administration of automesoconcentrate of platelets (AMС). The purpose of the study is to establish the characteristics of changes in the level of cytokines and growth factors in the homogenate of the liver of rats after resection of 65-70% of the parenchyma of this organ under the conditions of the use of different doses and schemes of AMС administration. Materials and methods. The study was conducted on white Wistar rats aged 1.5-2 months, weighing 150-180 g. AMС was injected: into the parenchyma of the liver remnant during resection at a dose of 0.5 ml/kg (group I); into the tail vein in the postoperative period at a dose of 0.5 ml/kg 3 hours and 48 hours after liver resection (group II); into the tail vein in the postoperative period at a dose of 1.0 ml/kg 3 hours and 48 hours after resection. Research results and discussion. It was shown that on the 7th day after liver resection, the level of TNF-α and IL-6 increased in all experimental groups, followed by a decrease on the 10th day to control values in the group of animals that received AMA intravenously at a dose of 1 ml/kg masses of animals. It was established that the values of HGF and TGFα in the liver homogenate of animals that underwent liver resection were significantly higher than in the control group on the 7th day of the experiment. At the later stages of the experiment, a decrease in the levels of HGF and TGFα in the liver homogenate was observed in the animals of groups I and III, but the studied indicators did not reach control values. In animals of group II, indicators of HGF and TGFα content remained at the highest level. The increase in the content of TGFβ and activins in the homogenate of the liver of rats in all experimental groups indicates the intensification of the terminal phase of liver regeneration on the 10th day after liver resection. Conclusions. Therefore, under the action of a dose of АМС equal to 1 ml/kg, the regeneration processes occur most intensively, the peak of which occurs 7-10 days after the resection. Administration of AMA into the liver parenchyma at a lower dose of 0.5 ml/kg or intravenous administration of the same dose does not contribute to the complete restoration of regenerative processes in the liver, as indicated by increased levels of TGFα and HGF on the 10th day after liver resection and administration of AMA.

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Section: вступunclassified

The Effect of Automesoconcentrate of Platelets on the Stages of Regeneration of the Liver Remnant of Rats Under the Conditions of Performing Volumetric Experimental Liver Resections

Salyutin,

Yuzvyk

2024

Clin. and prev. med.

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“…Patients with cirrhosis are at substantial risk of liver failure, hepatocellular carcinoma (HCC), and complications related to portal hypertension, including ascites, variceal bleeding, and hepatic encephalopathy. Management focuses on mitigating these risks and providing comprehensive care to improve overall outcomes [25].…”

Section: Stages Of Fibrosis and Their Clinical Significancementioning

confidence: 99%

Uncovering the Cardiovascular Threat: A Comprehensive Examination of Liver Fibrosis and Subclinical Atherosclerosis in Non-alcoholic Fatty Liver Disease

Sharma,

Chakole,

Wandile

2023

Cureus

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Non-alcoholic fatty liver disease (NAFLD) has emerged as a global epidemic intricately linked to the rising tide of obesity and metabolic syndrome. This comprehensive review delves into the complex web of relationships between NAFLD, liver fibrosis, and subclinical atherosclerosis, shedding light on their interplay, shared risk factors, and clinical implications. NAFLD encompasses a spectrum of liver conditions, from the benign non-alcoholic fatty liver (NAFL) to the more severe non-alcoholic steatohepatitis (NASH), characterized by inflammation and hepatocellular injury. Central to the discussion is the insidious development of liver fibrosis, the ominous harbinger of progressive liver damage, cirrhosis, and hepatocellular carcinoma. The increasing prevalence of NAFLD, now affecting a quarter of the global population, poses a significant public health challenge. Its association with obesity, insulin resistance, and metabolic syndrome highlights the multifactorial nature of this disease. However, NAFLD's repercussions extend beyond the liver. This review unveils a potent connection between NAFLD and subclinical atherosclerosis, the early precursor to cardiovascular disease. Individuals with NAFLD face an elevated risk of atherosclerosis, even without traditional cardiovascular risk factors. The intricate link between these two conditions is illuminated through shared pathophysiological pathways, including systemic inflammation, insulin resistance, and dyslipidemia. Understanding the interplay between liver fibrosis and subclinical atherosclerosis has profound clinical implications. Patients with advanced fibrosis or cirrhosis are not only at risk of liver-related complications but also of cardiovascular events. This necessitates a holistic approach to patient care, with lifestyle modifications and pharmacological interventions simultaneously managing both conditions. Physicians must prioritize early detection and collaborate across disciplines to provide comprehensive care. Looking ahead, the future holds promising avenues of research. Emerging areas include genetics and precision medicine, microbiome research, and epigenetics, which may unveil new therapeutic targets. Innovations in diagnostics and therapeutics, such as non-invasive biomarkers and combination therapies, offer hope for more effective management. Long-term outcomes and survivorship research will provide insights into the lasting impact of interventions.In conclusion, this review underscores the imperative of addressing liver fibrosis and atherosclerosis in the context of NAFLD. It is a call to action for healthcare professionals, researchers, and policymakers to work collaboratively, promote early detection, and advance our understanding of these interconnected conditions. By doing so, we can enhance patient outcomes and chart a course toward a healthier future for those grappling with NAFLD and its intricate web of consequences.

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“…Multiple physiological changes are associated with cirrhosis that have an effect on wound healing. These changes include impaired immune function, fluctuations in blood flow and nutrient levels and disruptions in collagen synthesis and deposition 5,6 . Patients in this category frequently endure protracted and complex recovery periods, which can result in heightened morbidity and potentially fatal complications 7 .…”

Section: Introductionmentioning

confidence: 99%

“…These changes include impaired immune function, fluctuations in blood flow and nutrient levels and disruptions in collagen synthesis and deposition. 5 , 6 Patients in this category frequently endure protracted and complex recovery periods, which can result in heightened morbidity and potentially fatal complications. 7 Hence, comprehending and enhancing wound management in individuals with cirrhosis is consequential not only for improved clinical results but also for cost savings in healthcare and enhancement of life standards.…”

Section: Introductionmentioning

confidence: 99%

Optimising wound care for patients with cirrhosis: A study of the effect of combination therapy on wound healing

Lin,

Su,

Yang

2024

International Wound Journal

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Cirrhosis, a chronic liver disease, significantly impairs wound healing due to complex alterations in physiology, including compromised immune function, poor nutritional status and altered blood flow. This prospective observational cohort study aimed to evaluate the effectiveness of the multidimensional combination therapy approach in enhancing wound healing among patients diagnosed with cirrhosis. The study was conducted from February to November 2023 in Shanghai, China, including 248 patients with cirrhosis experiencing poor wound healing. The combination therapy consisted of tailored pharmacological treatments, advanced wound dressings, dietitian‐directed dietary regimens and supplementary therapies like negative pressure wound therapy (NPWT), stem cell and hyperbaric oxygen therapy. The interventions were customised based on comprehensive initial assessments of liver function, nutritional status and wound characteristics. Follow‐ups were conducted to monitor response and adjust treatments accordingly. The patient demographic was varied, predominantly 41–60 years old, with the slight male predominance. The study demonstrated that after 3 months of treatment, wound sizes decreased significantly across all cirrhosis severity levels: mild (2.4–1.7 cm2), moderate (4.1–2.6 cm2) and severe (6.2–4.4 cm2). Healing rates improved to 90% in mild, 75% in moderate and 45% in severe cases over 6 months. Albumin levels increased by the average of +0.3 g/dL to +0.4 g/dL post‐treatment across the severity spectrum. However, complication rates escalated with severity: Mild cases had a 10% infection rate, while severe cases had up to 30% infection rate. Combination therapy significantly improved wound healing in cirrhosis patients, with the extent of improvement correlated with the severity of the condition. Tailored, multidisciplinary approaches are critical in managing the intricate wound healing process in cirrhosis, effectively reducing healing times and improving overall treatment outcomes. These findings advocate for personalised care strategies and highlight the potential of integrating various treatment modalities to address the complex needs of this population.

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Fibrosis and hepatic regeneration mechanism

Cited by 18 publications

References 110 publications

The Effect of Automesoconcentrate of Platelets on the Stages of Regeneration of the Liver Remnant of Rats Under the Conditions of Performing Volumetric Experimental Liver Resections

The Effect of Automesoconcentrate of Platelets on the Stages of Regeneration of the Liver Remnant of Rats Under the Conditions of Performing Volumetric Experimental Liver Resections

Uncovering the Cardiovascular Threat: A Comprehensive Examination of Liver Fibrosis and Subclinical Atherosclerosis in Non-alcoholic Fatty Liver Disease

Optimising wound care for patients with cirrhosis: A study of the effect of combination therapy on wound healing

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