scholarly journals Iron Overload andHFEGene Mutations in Czech Patients with Chronic Liver Diseases

2012 ◽  
Vol 32 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Marketa Dostalikova-Cimburova ◽  
Karolina Kratka ◽  
Jaroslav Stransky ◽  
Ivana Putova ◽  
Blanka Cieslarova ◽  
...  

The aim of the study was to identify the prevalence ofHFEgene mutations in Czech patients with chronic liver diseases and the influence of the mutations on iron status. The presence ofHFEgene mutations (C282Y, H63D, and S65C) analyzed by the PCR-RFLP method, presence of cirrhosis, and serum iron indices were compared among 454 patients with different chronic liver diseases (51 with chronic hepatitis B, 122 with chronic hepatitis C, 218 with alcoholic liver disease, and 63 patients with hemochromatosis). Chronic liver diseases patients other than hemochromatics did not have an increased frequency ofHFEgene mutations compared to controls. Although 33.3% of patients with hepatitis B, 43% of patients with hepatitis C, and 73.2% of patients with alcoholic liver disease had elevated transferrin saturation or serum ferritin levels, the presence ofHFEgene mutations was not significantly associated with iron overload in these patients. Additionally, patients with cirrhosis did not have frequencies ofHFEmutations different from those without cirrhosis. This study emphasizes the importance, not only of C282Y, but also of the H63D homozygous genetic constellation in Czech hemochromatosis patients. Our findings show that increased iron indices are common in chronic liver diseases butHFEmutations do not play an important role in the pathogenesis of chronic hepatitis B, chronic hepatitis C, and alcoholic liver disease.

2019 ◽  
Vol 11 (4) ◽  
pp. 189-191
Author(s):  
Amir Anushiravani ◽  
Sadaf Ghajarieh Sepanlou

There has been an increase in the burden of liver diseases in Iran, with an increasing trend from communicable to non-communicable diseases. Almost 5400 deaths were due to chronic liver diseases in 2017. We aim to provide a concise update on the epidemiological trends of liver diseases in Iran. Estimations of deaths, disability-adjusted life years, prevalence of chronic liver diseases and cirrhosis in Iran with its common etiologies have been reported. We investigated the major causes of chronic liver diseases in Iran, we have reported our hepatology research centers, and also we have depicted the future of liver diseases in Iran. In 2017, there was a rising trend in chronic liver diseases in Iran. The most common etiologies for chronic liver disease were chronic hepatitis B, chronic hepatitis C, and non-alcoholic steatohepatitis with highest mortalities due to liver cancer and hepatitis C. The prevalence of HBV infection has decreased from 2.9% to 1.3% with effective vaccination, but new cases are still seen due to perinatal transmission. Treatment of HCV has dramatically changed with new drugs which are being produced by local pharmaceuticals at a low cost. The main obstacle in its elimination is finding patients and linkage to care. More than a third of our population have non-alcoholic fatty liver disease in which central obesity had a stronger association than weight itself. Iran has a high burden of liver diseases. The Ministry of Health has effectively controlled hepatitis B and is working towards the World Health WHO’s goals for hepatitis C by 2030. This being said, non-alcoholic fatty liver disease is becoming a major threat to our nation’s health and quality of life.


2014 ◽  
Vol 28 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Giada Sebastiani ◽  
Peter Ghali ◽  
Philip Wong ◽  
Marina B Klein ◽  
Marc Deschenes ◽  
...  

OBJECTIVE: To determine practices among physicians in Canada for the assessment of liver fibrosis in patients with chronic liver diseases.METHODS: Hepatologists, gastroenterologists, infectious diseases specialists, members of the Canadian Gastroenterology Association and/or the Canadian HIV Trials Network who manage patients with liver diseases were invited to participate in a web-based, national survey.RESULTS: Of the 237 physicians invited, 104 (43.9%) completed the survey. Routine assessment of liver fibrosis was requested by the surveyed physicians mostly for chronic hepatitis C (76.5%), followed by autoimmune/cholestatic liver disease (59.6%) and chronic hepatitis B (52.9%). Liver biopsy was the main diagnostic tool for 46.2% of the respondents, Fibroscan (Echosens, France) for 39.4% and Fibrotest (LabCorp, USA) for 7.7%. Etiology-specific differences were observed: noninvasive methods were mostly used for hepatitis C (63% versus 37% liver biopsy) and hepatitis B (62.9% versus 37.1% liver biopsy). For 42.7% of respondents, the use of noninvasive methods reduced the need for liver biopsy by >50%. Physicians’ characteristics associated with higher use of noninvasive methods were older age and being based at a university hospital or in private practice versus community hospital. Physicians’ main concerns regarding noninvasive fibrosis assessment methods were access/availability (42.3%), lack of guidelines for clinical use (26.9%) and cost/lack of reimbursement (14.4%).CONCLUSIONS: Physicians who manage patients with chronic liver diseases in Canada require routine assessment of liver fibrosis stage. Although biopsy remains the primary diagnostic tool for almost one-half of respondents, noninvasive methods, particularly Fibroscan, have significantly reduced the need for liver biopsy in Canada. Limitations in access to and availability of the noninvasive methods represent a significant barrier. Finally, there is a need for clinical guidelines and a better reimbursement policy to implement noninvasive tools to assess liver fibrosis.


2015 ◽  
Vol 143 (1-2) ◽  
pp. 6-11 ◽  
Author(s):  
Sladjana Pavic ◽  
Neda Svirtlih ◽  
Dragan Delic ◽  
Aleksandra Radovanovic-Spurnic

Introduction. Pronounced symptoms of depression and disorders of cognitive functions can be observed in patients with chronic hepatitis B. Objective. The objective of the study was evaluation of the severity of symptoms and predictive factors for depression and the existence of cognitive disorders in patients with chronic hepatitis B. Methods. A total of 150 respondents were included in this prospective study (50 patients with chronic hepatitis B, 50 patients with other chronic liver diseases and 50 healthy persons). The patients with chronic hepatitis B were homogeneous by age compared to healthy subjects (p=0.566) and patients with other chronic liver diseases (p=0.528). Assessment of intensity of depression was determined by the Hamilton Depression Rating Scale (HAMD). A Mini Mental State Examination (MMSE) test was used to investigate the presence of cognitive disorders. Results. Significantly expressed depression was observed in patients with chronic hepatitis B compared with healthy persons as well as the occurrence of cognitive dysfunction (p=0.00), while in comparison with the patients with chronic nonviral liver diseases, depression was statistically significantly less markedly expressed (p=0.003). Depression and cognitive dysfunction were more noticeable in patients with chronic hepatitis B in the stage of liver cirrhosis in relation to the early stage of the disease. Multivariate analysis of variables related to the sociodemographic characteristics showed that the most significant positive predictor of depression was more expressed in older age (over 50 years) (B=0.276; SE=0.092; p=0.004). Conclusion. Patients with chronic hepatitis B have a higher intensity of depression compared to healthy people, which is intensified with the progression of the disease. The highest expression of depression is expected in the elderly. Patients with chronic hepatitis B have a lower intensity of depression and fewer disorders of cognitive functions than patients with other chronic liver diseases.


2000 ◽  
Vol 46 (7) ◽  
pp. 901-906 ◽  
Author(s):  
Giuseppe Castaldo ◽  
Giuseppe Calcagno ◽  
Raffaella Sibillo ◽  
Rosario Cuomo ◽  
Gerardo Nardone ◽  
...  

Abstract Background: Chronic liver diseases can progress to cirrhosis and to hepatocellular carcinoma. Timely and unequivocal recognition of the neoplastic evolution of cirrhosis is critical. To this aim, we used a noncompetitive reverse transcription-PCR procedure to analyze aldolase A mRNA in liver tissue from patients with chronic liver diseases at different stages. Methods: We studied 12 patients with hepatocellular carcinoma, 19 patients affected by chronic hepatitis C or cirrhosis, and 7 healthy controls. Aldolase A mRNA was reverse-transcribed to cDNA, which was then amplified by PCR. The amplified segments were “read” with a novel dot-blot procedure. A calibrator with the same sequence, synthesized in vitro using a T7 phage promoter, was processed at scalar dilutions in parallel to the target samples to generate a calibration curve and so quantify the target mRNA (detection limit, 0.03 amol; linearity spanning five orders of magnitude). Results: Aldolase A mRNA was ∼10-fold higher in liver biopsies from patients with hepatocellular carcinoma vs patients with chronic hepatitis C or cirrhosis, and healthy individuals. Furthermore, aldolase A mRNA concentrations were 1.2- to 21.3-fold higher in 12 liver biopsies compared with the paired surrounding cirrhotic tissue. Conclusions: The quantitative analysis of liver tissue aldolase A mRNA differentiates between nonneoplastic chronic liver diseases and hepatocellular carcinoma, which suggests that it has diagnostic potential.


2020 ◽  
Author(s):  
Huikun Wu ◽  
Gang Chen ◽  
Tianyuan Zhang ◽  
Mingzhong Xiao ◽  
Ye Xia ◽  
...  

Abstract Background: Hepatocellular carcinoma (HCC) is the most serious tumor in the world. It generally undergoes a series of processes from HBV infection, chronic hepatitis, cirrhosis, and HCC from early to late stages. Patients could benefit from early detection of chronic liver diseases (CLD). Tumor-Educated Platelets play an important role in tumor progression, which maybe a potential biomarker for CLD early diagnosis. Here, we developed a noninvasive liquid biopsy technique using platelet RNA for the early screening of patients with liver diseases. Methods: This study included a total of 163 individuals, including 50 healthy individuals, 39 chronic hepatitis B (CHB) patients, 40 liver cirrhosis (LC) and 34 patients with HCC. Blood was collected before initiation of treatment. Platelet RNA-Seq combined with Support Vector Machine (SVM), was used for the first time to distinguish the different stages of CLD in Asian patients.Results: Developed diagnostic model could distinguished with 92.4% accuracy between 34 HCC and 50 healthy, 89.92% accuracy between 34 patients HCC and 129 non-cancer individuals, and 83.67% between 50 healthy and 113 CLD. Across four different individual types, the accuracy of distinction (healthy/chronic hepatitis B/liver cirrhosis/hepatocellular carcinoma) was 65.31%. This model was internally validated, resulting in optimism-corrected AUC's of 86.8%.Conclusions: Our data indicate that the developed platelet RNA-Seq is a valuable platform for the diagnosis of CLD, providing an effective solution for its diagnosis.


2008 ◽  
Vol 149 (51) ◽  
pp. 2413-2418 ◽  
Author(s):  
János Fehér ◽  
Gabriella Lengyel

Az idült májbetegségek kezelésére csak a kóroki folyamatok ismeretében tudunk célzott terápiát választani. Az oxidatív stressz okozta májkárosodásban (alkoholos és nem alkoholos májbetegség, gyógyszer és vegyszer okozta megbetegedések) az antioxidáns tulajdonságú szerek, mint például a silymarin, a vírusos eredetű krónikus hepatitisekben (hepatitis B- és hepatitis C-vírus-fertőzés) pedig a kombinált peginterferon + nukleozidanalóg kezelés az elsődlegesen választandó szer. A silymarin fő tulajdonságai: membránstabilizáló és antioxidáns hatás, elősegíti a májsejt-regenerációt, csökkenti a gyulladásos aktivitást és gátolja a fibrogenezist. Mindezt kísérletes és klinikai vizsgálatok is igazolták. Nyílt vizsgálatok szerint a silymarin tartós alkalmazása az alkoholos eredetű májcirrhosisban szenvedő betegek túlélési idejét jelentős mértékben növelte. Legújabban kimutatták, hogy nagy dózisú silibinininfúzió hepatitis C-vírus okozta krónikus hepatitisben négyhetes kezelés során jelentős mértékben csökkentette a hepatitis C-vírus-számot. A legújabb molekuláris biológiai vizsgálatok igazolták, hogy a silymarin, a fenti korábban bizonyított hatása mellett, jelentős mértékben képes csökkenteni a daganatossejt-proliferációt, az angiogenezist, valamint az inzulinrezisztenciát. Mindezen tulajdonságok alapján a mai korszerű betegellátásban a silymarinkészítmények alkalmazása a krónikus májbetegségek kezelésében, elsősorban az alkoholos és nem alkoholos steatohepatitisben, helyénvaló és várhatóan a jövőben is az lesz. Bizonyos tumoros betegségekben pedig adjuváns kezelésként kerülhetnek alkalmazásra.


2011 ◽  
Vol 139 (3-4) ◽  
pp. 165-169
Author(s):  
Sladjana Pavic ◽  
Dragan Delic ◽  
Jasmina Simonovic ◽  
Neda Svirtlih

Introduction. Hepatitis C virus often causes chronic liver disease reducing physical, mental and social functions in these patients. Objective. The aim of this investigation was analysis of the quality of life in chronic hepatitis C patients compared to patients with other chronic liver diseases and healthy population, as well as investigation of the influence of socio-demographic factors on the quality of life in patients with chronic hepatitis C. Methods. A generic Short Form-36 (SF-36) questionnaire and Chronic Liver Diseases Questionnaire (CLDQ) were used in this prospective study for the investigation of the quality of life in 160 patients (100 patients with chronic hepatitis C, 30 patients with chronic hepatitis B, 30 patients with non-viral chronic liver diseases) and 50 healthy controls. Results. Reduced quality of life was noted in patients with chronic hepatitis C patients in comparison with healthy controls (p=0.00). Significant differences in SF-36 were found between patients with chronic hepatitis C and B regarding physical functions, activity, physical pain and emotional functions. Multivariate linear regression analysis revealed ages below 50 years as the most important positive variable in chronic hepatitis C patients for total score of the quality of life and physical component score (B=14.5; SE=5.16; p=0.049; and B=16.4; SE=5.94; p=0.003, respectively). The most important positive variable for the mental component of the quality of life was male gender (B=15.3; SE=5.81; p=0.003). Conclusion. Quality of life is reduced in patients with chronic hepatitis C in comparison with healthy population. The quality of life in chronic hepatitis C patients is better than in patients with other non-viral chronic liver diseases. In comparison with patients with chronic hepatitis B, reduction in some domains of the quality of life is noted. Younger age is the most predictable group for the lowest damage of the total quality of life in patients with chronic hepatitis C patients among other socio- demographic characteristics of these patients.


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