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Alcoholic Hepatitis

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141. Acute alcoholic hepatitis and cellular Th1 immune responses to alcohol dehydrogenase. (PubMed)

Acute alcoholic hepatitis and cellular Th1 immune responses to alcohol dehydrogenase. Alcoholic hepatitis is characterised by florid hepatic inflammation, liver failure, and death within 28 days in 35% of patients. We recently showed proliferative peripheral blood mononuclear cell (PBMC) responses to alcohol dehydrogenase (ADH) in patients with alcohol-related cirrhosis, associated with T-helper-type 1 (Th1) immunity and disease severity. We aimed to define whether ADH-specific cellular (...) immunity is present in alcoholic hepatitis.PBMCs were collected from 15 patients with alcoholic hepatitis (modified Maddrey's discriminant function >32), nine with alcohol-related cirrhosis (long-term alcohol abstinence), and three healthy controls. 25 overlapping peptides, spanning the human ADH β1 subunit, were constructed. Proliferation to ADH peptides (1 × 10(5) cells per well, cultured with 10 mM peptides for 7 days) was assessed by (3)H-thymidine incorporation. A stimulation index (SI) of 2·5

2015 Lancet

142. Ultrasonography for diagnosis of alcoholic cirrhosis in people with alcoholic liver disease. (PubMed)

alcoholic liver diseases, including fatty liver, steatohepatitis, fibrosis, alcoholic cirrhosis, and hepatocellular carcinoma, with presence or absence of hepatitis B or C virus infection. There are three scarring types (fibrosis) that are most commonly found in alcoholic liver disease: centrilobular scarring, pericellular fibrosis, and periportal fibrosis. When liver fibrosis progresses, alcoholic cirrhosis occurs. Hepatocellular carcinoma occurs in 5% to 15% of people with alcoholic cirrhosis (...) , but people in whom hepatocellular carcinoma has developed are often co-infected with hepatitis B or C virus.Abstinence from alcohol may help people with alcoholic disease in improving their prognosis of survival at any stage of their disease; however, the more advanced the stage, the higher the risk of complications, co-morbidities, and mortality, and lesser the effect of abstinence. Being abstinent one month after diagnosis of early cirrhosis will improve the chance of a seven-year life expectancy

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2016 Cochrane

143. Liver transplantation for alcoholic hepatitis: a systematic review and meta-analysis

Liver transplantation for alcoholic hepatitis: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing

2017 PROSPERO

144. Diagnostic accuracy of non-invasive methods for assessment of hepatic steatosis and fibrosis staging in adults suspected of non-alcoholic fatty liver diseases (NAFLD): a systematic review and meta-analysis

Diagnostic accuracy of non-invasive methods for assessment of hepatic steatosis and fibrosis staging in adults suspected of non-alcoholic fatty liver diseases (NAFLD): a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files

2017 PROSPERO

145. Metabolic risk factors are associated with non‐hepatitis B non‐hepatitis C hepatocellular carcinoma in Taiwan, an endemic area of chronic hepatitis B (PubMed)

Metabolic risk factors are associated with non‐hepatitis B non‐hepatitis C hepatocellular carcinoma in Taiwan, an endemic area of chronic hepatitis B Metabolic risk factors, such as obesity, fatty liver, high lipidemia, and diabetes mellitus are associated with increased risk for nonviral hepatocellular carcinoma (HCC); however, few nonviral HCC studies have stratified patients according to underlying etiologies. From 2005 to 2011, 3,843 patients with HCC were recruited into the Taiwan (...) Liver Cancer Network. Of these patients, 411 (10.69%) who were negative for hepatitis B virus (HBV), surface antigen, HBV DNA, and anti-hepatitis C virus (HCV) antibody were classified as non-HBV non-HCV (NBNC)-HCC. Detailed clinical analyses of these patients were compared with age- and sex-matched patients with HBV-HCC or HCV-HCC for the associated metabolic risk factors. For this comparison, 420 patients with HBV-HCC and 420 patients with HCV-HCC were selected from the 3,843 patients with HCC

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2018 Hepatology communications

146. Alcoholic liver disease

bleeding, ascites, coagulopathy, hepatic encephalopathy, and liver cancer. Definition Alcoholic liver disease (ALD) has 3 stages of liver damage: fatty liver (steatosis), alcoholic hepatitis (inflammation and necrosis), and alcoholic liver cirrhosis. All are caused by chronic heavy alcohol ingestion. History and exam presence of risk factors abdominal pain hepatomegaly haematemesis and melaena venous collaterals splenomegaly hepatic mass jaundice palmar erythema cutaneous telangiectasia asterixis (...) ascites weight loss weight gain malnutrition and wasting anorexia fatigue confusion pruritus fever nausea and vomiting finger clubbing Dupuytren's contracture leg swelling parotid gland enlargement gynaecomastia hypogonadism dementia peripheral neuropathy prolonged and heavy alcohol consumption hepatitis C female sex cigarette smoking obesity age >65 years Hispanic ethnicity genetic predisposition Diagnostic investigations serum AST, ALT serum AST/ALT ratio serum alkaline phosphatase serum bilirubin

2018 BMJ Best Practice

147. Overview of chronic alcohol use

. In: Rosen's emergency medicine: concepts and clinical practice. 6th ed. St. Louis, MO: Mosby, Inc; 2006:184. Comprises three stages of liver damage: fatty liver (steatosis), alcoholic hepatitis (inflammation and necrosis), and alcoholic liver cirrhosis (fibrosis) caused by chronic heavy alcohol ingestion. There are no specific signs and symptoms to diagnose ALD. Clinical presentation is highly variable. The pathological end stage of any chronic liver disease. The most common causes of cirrhosis (...) in the Western world are chronic hepatitis C and alcoholic liver disease, followed by non-alcoholic fatty liver disease (steatohepatitis) and chronic hepatitis B. The main complications of cirrhosis are related to the development of liver insufficiency and portal hypertension, and include ascites, variceal haemorrhage, jaundice, portosystemic encephalopathy, hepatorenal and hepatopulmonary syndromes, and the development of hepatocellular carcinoma. A rare syndrome defined by a rapid decline in hepatic

2018 BMJ Best Practice

148. Overview of chronic alcohol use

. In: Rosen's emergency medicine: concepts and clinical practice. 6th ed. St. Louis, MO: Mosby, Inc; 2006:184. Comprises three stages of liver damage: fatty liver (steatosis), alcoholic hepatitis (inflammation and necrosis), and alcoholic liver cirrhosis (fibrosis) caused by chronic heavy alcohol ingestion. There are no specific signs and symptoms to diagnose ALD. Clinical presentation is highly variable. The pathological end stage of any chronic liver disease. The most common causes of cirrhosis (...) in the Western world are chronic hepatitis C and alcoholic liver disease, followed by non-alcoholic fatty liver disease (steatohepatitis) and chronic hepatitis B. The main complications of cirrhosis are related to the development of liver insufficiency and portal hypertension, and include ascites, variceal haemorrhage, jaundice, portosystemic encephalopathy, hepatorenal and hepatopulmonary syndromes, and the development of hepatocellular carcinoma. A rare syndrome defined by a rapid decline in hepatic

2018 BMJ Best Practice

149. Is There Really Any Role For Steroids In Acute Alcoholic Hepatitis?

Is There Really Any Role For Steroids In Acute Alcoholic Hepatitis? Is There Really Any Role For Steroids In Acute Alcoholic Hepatitis? – Clinical Correlations Search Is There Really Any Role For Steroids In Acute Alcoholic Hepatitis? December 8, 2011 7 min read By Keri Herzog, MD Faculty Peer Reviewed The patient is a 48-year-old male with a history of heavy alcohol use (he drinks about 1 pint of vodka daily) who presented to the hospital when he noticed that he had become increasingly (...) jaundiced. The patient was hemodynamically stable on admission and afebrile, with jaundice and scleral icterus on exam. Laboratory data was significant for a total bilirubin of 6.6, an INR of 2.3, AST of 83, ALT 72, and a Maddrey’s discriminant function (MDF) that was calculated to be >32. The patient was diagnosed with alcoholic hepatitis. The question that we now seek to answer is if administration of corticosteroids would be of benefit in the management of alcoholic hepatitis in this patient

2011 Clinical Correlations

150. Standard Definitions and Common Data Elements for Clinical Trials in Patients With Alcoholic Hepatitis: Recommendation From the NIAAA Alcoholic Hepatitis Consortia (PubMed)

Standard Definitions and Common Data Elements for Clinical Trials in Patients With Alcoholic Hepatitis: Recommendation From the NIAAA Alcoholic Hepatitis Consortia 26921783 2016 08 08 2019 01 18 1528-0012 150 4 2016 Apr Gastroenterology Gastroenterology Standard Definitions and Common Data Elements for Clinical Trials in Patients With Alcoholic Hepatitis: Recommendation From the NIAAA Alcoholic Hepatitis Consortia. 785-90 10.1053/j.gastro.2016.02.042 S0016-5085(16)00233-X Crabb David W DW (...) Medical School, Worcester, Massachusetts. NIAAA Alcoholic Hepatitis Consortia eng U01 AA021883 AA NIAAA NIH HHS United States U01 AA021893 AA NIAAA NIH HHS United States U01 AA021901 AA NIAAA NIH HHS United States U01 AA021840 AA NIAAA NIH HHS United States P20 GM113226 GM NIGMS NIH HHS United States U01 AA021886 AA NIAAA NIH HHS United States P50 AA024337 AA NIAAA NIH HHS United States U01 AA 021840 AA NIAAA NIH HHS United States U01 AA021908 AA NIAAA NIH HHS United States U01 AA021890 AA NIAAA NIH

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2016 Gastroenterology

151. Effectiveness of alcohol and other drug interventions in at-risk Aboriginal youth

increased risk of contracting hepatitis C and human immunodeficiency virus (HIV) from injecting drug use, higher levels of psychological distress and an increased risk of suicide. Illicit drug use is also linked with social issues, such as harms to children and family, violence, crime and incarceration. 9 New South Wales Drug and Alcohol Population and Community Programs (DAPCP) wish to develop an Alcohol and Other Drug (AOD) prevention, early intervention and/or harm reduction program for young people (...) Effectiveness of alcohol and other drug interventions in at-risk Aboriginal youth An Evidence Check rapid review brokered by the Sax Institute for the NSW Ministry of Health. June 2017. Effectiveness of alcohol and other drug interventions in at-risk Aboriginal youth An Evidence Check rapid review brokered by the Sax Institute for the NSW Ministry of Health. June 2017 This report was prepared by: Christopher M Doran 1 , Irina Kinchin 1 , Roxanne Bainbridge 1 , Janya McCalman 1 and Anthony

2018 Sax Institute Evidence Check

152. What is the most accurate and cost-effective direct test (ELF test, hyaluronic acid, P3NP, Fibroscan or ARFI elastography) for detecting and staging liver fibrosis and/or cirrhosis in patients with diagnosed or suspected non-alcoholic fatty liver disease,

, Fibroscan® or ARFI elastography) for detecting and staging liver fibrosis and cirrhosis in patients with diagnosed or suspected non- alcoholic fatty liver disease, alcohol-related liver disease, or viral hepatitis? What is an evidence note? Evidence notes are rapid reviews of the evidence on health technologies under consideration by decision makers within NHSScotland. They are intended to provide information quickly to support time-sensitive decisions. Information is available to the topic referrer (...) of interest had sensitivity =70% for detection of fibrosis and cirrhosis in patients with hepatitis C or non-alcoholic fatty liver disease (NAFLD). ? In a meta-analysis of 13 studies (n=1,163) the direct imaging tests Fibroscan® and ARFI elastography had similar sensitivity and specificity for the detection of significant fibrosis and cirrhosis. ? In a meta-analysis of four studies (n=612) Fibroscan® imaging was slightly more sensitive and more specific for diagnosing cirrhosis compared with the ELF test™

2018 Evidence Notes from Healthcare Improvement Scotland

153. Reasons for drinking as predictors of alcohol involvement one year later among HIV-infected individuals with and without hepatitis C. (PubMed)

Reasons for drinking as predictors of alcohol involvement one year later among HIV-infected individuals with and without hepatitis C. Heavy drinking can be harmful for individuals with HIV, particularly those coinfected with hepatitis C virus (HCV). HIV patients' reasons for drinking predict short-term alcohol involvement, but whether they predict longer-term involvement is unknown. Also, it remains unknown whether these motives are differentially predictive for HIV monoinfected and HIV/HCV (...) , drinking motives predict alcohol involvement 12 months later. For HIV monoinfected patients, drinking to cope and drinking for social reasons predict 12-month alcohol involvement. For HIV/Hepatitis C coinfected patients, coping (but not social) motives predict 12-month alcohol involvement.

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2017 Annals of Medicine Controlled trial quality: uncertain

154. Current Management of Alcoholic Hepatitis and Future Therapies (PubMed)

Current Management of Alcoholic Hepatitis and Future Therapies Alcohol is one of the most common etiologies of liver disease, and alcoholic liver disease overall is the second most common indication for liver transplantation in the United States. It encompasses a spectrum of disease, including fatty liver disease, alcoholic hepatitis (AH), and alcoholic cirrhosis. AH can range from mild to severe disease, with severe disease being defined as: Discriminant Function (DF) ≥ 32, or Model for End (...) -stage Liver Disease (MELD) ≥ 21, or presence of hepatic encephalopathy. Management of the mild disease consists mainly of abstinence and supportive care. Severe AH is associated with significant mortality. Currently, there is no ideal medical treatment for this condition. Besides alcohol cessation, corticosteroids have been used with conflicting results and are associated with an inherent risk of infection. Overall steroids have shown short term benefit when compared to placebo, but they have

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2016 Journal of clinical and translational hepatology

155. The hepatic lipidome: a gateway to understanding the pathogenesis of alcohol-induced fatty liver (PubMed)

The hepatic lipidome: a gateway to understanding the pathogenesis of alcohol-induced fatty liver Chronic alcohol consumption can lead to the development of alcoholic fatty liver disease. The underlying pathogenic mechanisms however, have not been fully elucidated. Here, we review the current state of the art regarding the application of lipidomics to study alcohol's effect on hepatic lipids. It is clear that alcohol has a profound effect on the hepatic lipidome, with documented changes (...) in the major lipid categories (i.e. fatty acyls, glycerolipids, glycerophospholipids, sphingolipids, sterol lipids and prenol lipids). Alcohol's most striking effect is the marked change in the hepatic fatty acyl pool. This effect includes increased levels of 18-carbon fatty acyl chains incorporated into multiple lipid species, as well as a general shift toward increased unsaturation of fatty acyl moieties. In addition to our literature review, we also make several recommendations to consider when

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2017 Current molecular pharmacology

156. STRUCTURE, FUNCTION AND METABOLISM OF HEPATIC AND ADIPOSE TISSUE LIPID DROPLETS: IMPLICATIONS IN ALCOHOLIC LIVER DISEASE (PubMed)

STRUCTURE, FUNCTION AND METABOLISM OF HEPATIC AND ADIPOSE TISSUE LIPID DROPLETS: IMPLICATIONS IN ALCOHOLIC LIVER DISEASE For more than 30 years, lipid droplets (LDs) were considered as an inert bag of lipid for storage of energy-rich fat molecules. Following a paradigm shift almost a decade ago, LDs are presently considered an active subcellular organelle especially designed for assembling, storing and subsequently supplying lipids for generating energy and membrane synthesis (and in the case (...) of hepatocytes for VLDL secretion). LDs also play a central role in many other cellular functions such as viral assembly and protein degradation. Here, we have explored the structural and functional changes that occur in hepatic and adipose tissue LDs following chronic ethanol consumption in relation to their role in the pathogenesis of alcoholic liver injury.Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

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2017 Current molecular pharmacology

157. Bone marrow fat content is correlated with hepatic fat content in paediatric non-alcoholic fatty liver disease (PubMed)

Bone marrow fat content is correlated with hepatic fat content in paediatric non-alcoholic fatty liver disease To investigate the relationship between bone marrow fat content and hepatic fat content in children with known or suspected non-alcoholic fatty liver disease (NAFLD).This was an institutional review board-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant, cross-sectional, prospective analysis of data collected between October 2010 to March 2013 in 125 (...) children with known or suspected NAFLD. Written informed consent was obtained for same-day research magnetic resonance imaging (MRI) of the lumbar spine, liver, and abdominal adiposity. Lumbar spine bone marrow proton density fat fraction (PDFF) and hepatic PDFF were estimated using complex-based MRI (C-MRI) techniques and magnitude-based MRI (M-MRI), respectively. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SCAT) were quantified using high-resolution MRI. All images were acquired

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2017 Clinical Radiology

158. Dicer1/miR-29/HMGCR axis contributes to hepatic free cholesterol accumulation in mouse non-alcoholic steatohepatitis (PubMed)

Dicer1/miR-29/HMGCR axis contributes to hepatic free cholesterol accumulation in mouse non-alcoholic steatohepatitis Dicer1 is an enzyme essential for microRNA (miRNA) maturation. The loss of miRNAs resulted from Dicer1 deficiency greatly contributes to the progression of many diseases, including lipid dysregulation, but its role in hepatic accumulation of free cholesterol (FC) that is critical in the development of non-alcoholic steatohepatitis (NASH) remains elusive. In this study, we used (...) cell models (SMMC-7721 and HL-7702 cells) in vitro. Our results show that Dicer1/miR-29/HMGCR axis contributes to hepatic free cholesterol accumulation in mouse NASH, and miR-29 may serve as an important regulator of hepatic cholesterol homeostasis. Thus, miR-29a could be utilized as a potential therapeutic target for the treatment of non-alcoholic fatty liver disease as well as for other liver diseases associated with FC accumulation.

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2017 Acta pharmacologica Sinica

159. Genome-wide DNA methylation analysis during non-alcoholic steatohepatitis-related multistage hepatocarcinogenesis: comparison with hepatitis virus-related carcinogenesis (PubMed)

Genome-wide DNA methylation analysis during non-alcoholic steatohepatitis-related multistage hepatocarcinogenesis: comparison with hepatitis virus-related carcinogenesis The aim of this study was to clarify the significance of DNA methylation alterations during non-alcoholic steatohepatitis (NASH)-related hepatocarcinogenesis. Single-CpG-resolution genome-wide DNA methylation analysis was performed on 264 liver tissue samples using the Illumina Infinium HumanMethylation450 BeadChip. After (...) Bonferroni correction, 3331 probes showed significant DNA methylation alterations in 113 samples of non-cancerous liver tissue showing NASH (NASH-N) as compared with 55 samples of normal liver tissue (NLT). Principal component analysis using the 3331 probes revealed distinct DNA methylation profiles of NASH-N samples that were different from those of NLT samples and 37 samples of non-cancerous liver tissue showing chronic hepatitis or cirrhosis associated with hepatitis B virus (HBV) or hepatitis C virus

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2017 Carcinogenesis

160. Loss of Hepatic CEACAM1: A Unifying Mechanism Linking Insulin Resistance to Obesity and Non-Alcoholic Fatty Liver Disease (PubMed)

Loss of Hepatic CEACAM1: A Unifying Mechanism Linking Insulin Resistance to Obesity and Non-Alcoholic Fatty Liver Disease The pathogenesis of human non-alcoholic fatty liver disease (NAFLD) remains unclear, in particular in the context of its relationship to insulin resistance and visceral obesity. Work on the carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) in mice has resolved some of the related questions. CEACAM1 promotes insulin clearance by enhancing the rate of uptake (...) of the insulin-receptor complex. It also mediates a negative acute effect of insulin on fatty acid synthase activity. This positions CEACAM1 to coordinate the regulation of insulin and lipid metabolism. Fed a regular chow diet, global null mutation of Ceacam1 manifest hyperinsulinemia, insulin resistance, obesity, and steatohepatitis. They also develop spontaneous chicken-wire fibrosis, characteristic of non-alcoholic steatohepatitis. Reduction of hepatic CEACAM1 expression plays a significant role

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2017 Frontiers in endocrinology

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