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《医学前沿(英文)》 2015年 第9卷 第2期 页码 187-219 doi: 10.1007/s11684-015-0386-y
Autoimmune hepatitis is a chronic liver disease putatively caused by loss of tolerance to hepatocyte-specific autoantigens. It is characterized by female predilection, elevated aminotransferase levels, autoantibodies, increased γ-globulin or IgG levels and biopsy evidence of interface hepatitis. It is currently divided into types 1 and 2, based on expression of autoantibodies. Autoantigenic epitopes have been identified only for the less frequent type 2. Although autoimmune hepatitis occurs in childhood, this review focuses on disease in adults. In the absence of pathognomonic biomarkers, diagnosis requires consideration of clinical, biochemical, serological and histological features, which have been codified into validated diagnostic scoring systems. Since many features also occur in other chronic liver diseases, these scoring systems aid evaluation of the differential diagnosis. New practice guidelines have redefined criteria for remission to include complete biochemical and histological normalization on immunosuppressive therapy. Immunosuppression is most often successful using prednisone or prednisolone and azathioprine; however, the combination of budesonide and azathioprine for non-cirrhotic patients offers distinct advantages. Patients failing standard immunosuppression are candidates for alternative immunosuppressive regimens, yet none of the options has been studied in a randomized, controlled trial. Overlap syndromes with either primary sclerosing cholangitis or primary biliary cirrhosis occur in a minority. Liver transplantation represents a life-saving option for patients presenting with acute liver failure, severely decompensated cirrhosis or hepatocellular carcinoma. Transplant recipients are at risk for recurrent autoimmune hepatitis in the allograft, and de novo disease may occur in patients transplanted for other indications. Patients transplanted for AIH are also at risk for recurrent or de novo inflammatory bowel disease. Progress in our understanding of the immunopathogenesis should lead to identification of specific diagnostic and prognostic biomarkers and new therapeutic strategies.
关键词: autoimmune hepatitis autoantibodies diagnosis immunological diseases drug-induced liver injury therapy immunosuppression outcomes hepatocellular carcinoma liver transplantation
Yanli LIU, Rong LIU, Cheng ZHEN, Quanfang GUO, Liping WU, Zhaoxi DING, Yushun BI, Zhiyu LIU
《医学前沿(英文)》 2009年 第3卷 第1期 页码 91-95 doi: 10.1007/s11684-009-0011-z
关键词: Fuganling granula immunological liver injury bacille calmette guerin lipopolysaccharide mice
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《医学前沿(英文)》 2015年 第9卷 第4期 页码 457-467 doi: 10.1007/s11684-015-0417-8
Herbal medicines have recently been recognized as the second most common cause of drug-induced liver injury (DILI) in the United States. However, reliable methods to identify the DILI causality of some herbs, such as Heshouwu (dried root of Polygonum multiflorum), remain lacking. In this study, a total of 12 307 inpatients with liver dysfunction and 147 literature-reported cases of Heshouwu DILI were screened. A general algorithm indicated that only 22.5% (9/40) and 30.6% (45/147) of all hospitalization and literature case reports, respectively, demonstrate the high probability of DILI causality of Heshouwu. By contrast, 95% (19/20) of all cases prospectively investigated by pharmacognosy, phytochemistry, and metabolomic tests exhibited highly probable causality, including a patient who was previously incorrectly attributed and a case that was excluded from Heshouwu causality by pharmacognostic evidence. Toxin (heavy metals, pesticides, and mycotoxins) contamination was also excluded from Heshouwu DILI causality. The objectivity of these screening methods for Heshouwu DILI diagnosis addresses safety concerns regarding stilbene-containing herbal medicines and dietary supplements.
关键词: drug-induced liver injury pharmacognosy metabolomics stilbene Polygonum multiflorum Chinese herbal medicine
Xiaofang Cui, Benting Ma, Yan Wang, Yan Chen, Chunling Shen, Ying Kuang, Jian Fei, Lungen Lu, Zhugang Wang
《医学前沿(英文)》 2019年 第13卷 第1期 页码 104-111 doi: 10.1007/s11684-017-0568-x
关键词: retinol dehydrogenase 13 carbon tetrachloride acute liver injury Cyp2e1 Spot14
吴理茂,李连达,刘红,宁可永,李贻奎
《中国工程科学》 2004年 第6卷 第7期 页码 34-42
研究中药归元方与自体骨髓干细胞移植对急慢性肝损伤的治疗作用。研究方法:用肝脏局部注射乙醇的方法复制急性局限性肝损伤模型,复合因素(CCl4、乙醇、高脂、低蛋白)刺激复制大鼠肝纤维化模型,通过定量组织学、肝功能检查、免疫组化、肝组织羟脯氨酸含量、损伤或纤维区骨髓干细胞观察等综合评价中药、自体骨髓干细胞移植及两者合用的疗效。结果:归元方与自体骨髓干细胞移植可减小肝损伤区域,改善肝功能,使纤维肝组织表达μPA增强,降低血清ALT,AST,PCⅢ,HA和肝组织羟脯氨酸的含量,改善肝组织肝纤维化评分,骨髓干细胞能在肝损伤、肝纤维化形成环境中存活、增殖,并向肝细胞分化,表达肝脏特异的角蛋白CK18。结论:归元方与自体骨髓干细胞移植对急慢性肝损伤有明确的治疗作用,两者合用可优势互补,协同增效。临床上有良好的应用前景。
Glucagon-like peptide-2 exhibits protective effect on hepatic ischemia-reperfusion injury in rats
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《医学前沿(英文)》 2015年 第9卷 第3期 页码 368-373 doi: 10.1007/s11684-015-0403-1
Glucagon-like peptide-2 (GLP-2) has potent anti-inflammatory effects and protects against experimental ischemia/reperfusion (I/R) injury in pulmonary, intestinal, and myocardial tissue. However, its protective abilities against I/R injury in the liver are unknown. We investigated the potential role of GLP-2 pretreatment on hepatic I/R injury in rats. A total of 24 rats were randomly divided into three groups (n = 8). The first group was the control group; the second group was the vehicle-treated hepatic ischemia/reperfusion (HIR, vehicle saline-treated) group; and the third group was the GLP-2 pretreated I/R (GLP2-IR) group. Each rat in the third group was intraperitoneally administered 5 μg GLP-2 for 5 d before the procedure. A portal triad was created to induce ischemia with a vascular atraumatic clamp. After 40 min, the clamp was released to initiate hepatic reperfusion for 6 h. Blood samples and tissue specimens from the liver were obtained. Alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels significantly increased in the saline-treated HIR group (P<0.001), whereas GLP-2 pretreatment significantly decreased their levels (P<0.01). Our data suggested that GLP-2 pretreatment may have a protective effect on liver I/R injury. However, dose-response studies are necessary to determine the most effective dose.
关键词: ischemia/reperfusion liver glucagon-like peptide-2 alanine aminotransferase
利用CES1和DPP-IV的组织残余活性准确评估和追踪特异性肝损伤过程 Article
潘秋莎, 宋培放, 倪振华, 钱星凯, 王安琪, 邹立伟, 刘勇, 王平, 张卫东, 马红, 杨凌
《工程(英文)》 2022年 第19卷 第12期 页码 153-165 doi: 10.1016/j.eng.2021.09.014
准确评估和追踪特异性肝损伤及其进程仍然是当前生物标志物研究中的一大挑战。本研究建立了一种回顾追溯验证方法,用以表征α-萘异硫氰酸酯(ANIT)诱导的特异性肝脏胆管损伤后血清标志物与组织标志物之间的互动关系。研究发现羧酸酯酶1(CES1)作为肝内标志物和二肽基肽酶4(DPP-IV)作为肝外标志物可反映肝脏损伤的不同病理生理状态。CES1 和DPP-IV 水平可甄别肝损伤本身和炎症损伤之间的差异。相比之下,常规血清学标志物碱性磷酸酶(ALP)、丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)在ANIT诱导损伤后血清和组织水平同时升高,胆汁中胆汁酸水平下降,血清中胆汁酸水平升高,肝内组织中胆汁酸水平升高。尽管血清与组织中γ-谷氨酰基转肽酶(γ-GT)升降水平的变化方向相反,但其持续时间远短于CES1,并迅速恢复到正常水平。在上述生物标志物中,只有CES1 能够明确排除炎症干扰下的肝细胞损伤。CES1 还能准确评估熊去氧胆酸(UDCA;单成分药物)和清肺排毒汤(QFPDD;多组分药物)的抗胆汁淤积作用。研究发现QFPDD和UDCA均能减轻ANIT 诱导的肝损伤。UDCA在促进胆汁排泄方面的效果更强,但其抗损伤和抗炎作用相对较弱,而QFPDD在阻断肝脏炎症和修复肝损伤方面更有效。本文数据强调了联合使用CES1(作为肝内肝损伤标志物)和DPP-IV(作为肝外炎症作用标志物)可准确评估和追踪特异性肝损伤,并可区分肝损伤和炎症性肝损伤的差异。
《医学前沿(英文)》 2022年 第16卷 第1期 页码 111-125 doi: 10.1007/s11684-021-0854-5
关键词: COVID-19 chronic hepatitis B liver injury coagulation dysfunction
Emerging immunological strategies: recent advances and future directions
《医学前沿(英文)》 2021年 第15卷 第6期 页码 805-828 doi: 10.1007/s11684-021-0886-x
关键词: cancer immunotherapy bispecific antibodies small molecules chimeric antigen receptor T therapy cancer vaccines
Immunological effects of nano-enabled hyperthermia for solid tumors: opportunity and challenge
《化学科学与工程前沿(英文)》 2022年 第16卷 第3期 页码 333-344 doi: 10.1007/s11705-021-2059-5
关键词: nano-enabled hyperthermia immunogenic cell death heterogeneous immunological landscape tumor microenvironment
Bile duct injury repair — earlier is not better
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《医学前沿(英文)》 2015年 第9卷 第4期 页码 508-511 doi: 10.1007/s11684-015-0418-7
Bile duct injury is a common complication of cholecystectomy. The timing of bile duct injury repair remains controversial. A recent review conducted in France reported 39% complications and 64% failure after immediate repair in 194 patients compared with 14% complications and 8% failure after late repair in 133 patients. A national review of 139 consecutive early repairs conducted at five hepatopancreaticobiliary centers in Denmark reported 4% mortality, 36% morbidity, and 42 restrictures (30%) at a median follow-up of 102 months, and only 64 patients (46%) demonstrated uneventful short-term and long-term outcomes. Most patients with bile duct injury present with bile leak and sepsis; thus, early repair is not recommended. Percutaneous drainage of bile and endoscopic stenting are the mainstays of treatment of bile leak because they convert acute bile duct injury into a controlled external biliary fistula. The ensuing benign biliary stricture should be repaired by a biliary surgeon after a delay of 4–6 weeks once the external biliary fistula has closed.
关键词: bile duct injury cholecystectomy laparoscopic cholecystectomy
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《医学前沿(英文)》 2011年 第5卷 第1期 页码 1-7 doi: 10.1007/s11684-010-0105-7
Partial liver transplantation, including reduced-size liver transplantation, split liver transplantation, and living donor liver transplantation, has been developed with several innovative techniques because of donor shortage. Reduced-size liver transplantation is based on Couinaud’s anatomical classification, benefiting children and small adult recipients but failing to relieve the overall donor shortage. Split liver transplantation provides chances to two or even more recipients when only one liver graft is available. The splitting technique must follow stricter anatomical and physiological criteria either ex situ or in situto ensure long-term quality. The first and most important issue involving living donor liver transplantation is donor safety. Before surgery, a series of donor evaluations—including anatomical, liver volume, and liver function evaluations—is indispensable, followed by ethnic agreement. At different recipient conditions, auxiliary liver transplantation and auxiliary partial orthotopic liver transplantation, which employ piggyback techniques, are good alternatives. Partial liver transplantation enriches the practice and knowledge of the transplant society.
关键词: partial liver transplantation reduced-size liver transplantation split liver transplantation living donor liver transplantation
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《医学前沿(英文)》 2018年 第12卷 第3期 页码 262-268 doi: 10.1007/s11684-017-0584-x
γδ T cells display unique developmental, distributional, and functional patterns and can rapidly respond to various insults and contribute to diverse diseases. Different subtypes of γδ T cells are produced in the thymus prior to their migration to peripheral tissues. γδ T cells are enriched in the liver and exhibit liver-specific features. Accumulating evidence reveals that γδ T cells play important roles in liver infection, non-alcoholic fatty liver disease, autoimmune hepatitis, liver fibrosis and cirrhosis, and liver cancer and regeneration. In this study, we review the properties of hepatic γδ T cells and summarize the roles of γδ T cells in liver diseases. We believe that determining the properties and functions of γδ T cells in liver diseases enhances our understanding of the pathogenesis of liver diseases and is useful for the design of novel γδ T cell-based therapeutic regimens for liver diseases.
关键词: γδT cells liver infection non-alcoholic fatty liver disease autoimmune hepatitis liver fibrosis and cirrhosis liver cancer liver regeneration
Loss of monocarboxylate transporter 1 aggravates white matter injury after experimental subarachnoid
《医学前沿(英文)》 2021年 第15卷 第6期 页码 887-902 doi: 10.1007/s11684-021-0879-9
关键词: microRNAs monocarboxylate transporter 1 motor training subarachnoid hemorrhage white matter injury
Risk factors of prognosis after acute kidney injury in hospitalized patients
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《医学前沿(英文)》 2017年 第11卷 第3期 页码 393-402 doi: 10.1007/s11684-017-0532-9
The risk factors, especially laboratory indicators, of prognosis after acute kidney injury (AKI) remain unclear. We conducted a retrospective survey of Chinese People’s Liberation Army General Hospital from January 1, 2012 to December 31, 2012 according to the AKI diagnosis standard issued by Kidney Disease Improving Global Outcomes. The epidemiological features and factors influencing hospital mortality and renal function recovery were evaluated through logistic regression analysis. Among 77 662 cases of hospitalized patients, 1387 suffered from AKI. The incidence rate and mortality of AKI were 1.79% and 14.56%, respectively. Multivariate logistic regression analysis revealed that high AKI stage, age greater than 80 years, neoplastic disease, low cardiac output, increased white blood cell count, and decreased platelet count and serum albumin levels were the risk factors affecting the mortality of AKI patients. Conversely, body mass index between 28 and 34.9 was a protective factor. Increased AKI stage, tumor disease, post-cardiopulmonary resuscitation, and RRT were the risk factors of renal function recovery upon discharge. In addition to traditional risk factors, white blood cell count, platelet count, albumin, and BMI were the predictors of the mortality of AKI patients. No laboratory indicators were found to be the risk factors of renal function recovery in AKI patients.
标题 作者 时间 类型 操作
Experimental study on the efficacy of Fuganling granula on protecting against immunological hepatic injury
Yanli LIU, Rong LIU, Cheng ZHEN, Quanfang GUO, Liping WU, Zhaoxi DING, Yushun BI, Zhiyu LIU
期刊论文
Evidence chain-based causality identification in herb-induced liver injury: exemplification of a well-knownliver-restorative herb
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期刊论文
Rdh13 deficiency weakens carbon tetrachloride-induced liver injury by regulating Spot14 and Cyp2e1 expression
Xiaofang Cui, Benting Ma, Yan Wang, Yan Chen, Chunling Shen, Ying Kuang, Jian Fei, Lungen Lu, Zhugang Wang
期刊论文
Glucagon-like peptide-2 exhibits protective effect on hepatic ischemia-reperfusion injury in rats
null
期刊论文
Clinical characteristics and risk factors of COVID-19 patients with chronic hepatitis B: a multi-center retrospective cohort study
期刊论文
Loss of monocarboxylate transporter 1 aggravates white matter injury after experimental subarachnoid
期刊论文