Acute-on-chronic liver failure in cirrhosis

Nature Reviews Disease Primers, Journal Year: 2016, Volume and Issue: 2(1)

Published: June 9, 2016

Language: Английский

---

Overview of pharmacological activities of Andrographis paniculata and its major compound andrographolide

Critical Reviews in Food Science and Nutrition, Journal Year: 2018, Volume and Issue: 59(sup1), P. S17 - S29

Published: July 25, 2018

Andrographis paniculata (A. paniculata) is a medicinal plant traditionally used as anti-inflammation and anti-bacteria herb. Andrographolide, the major active component of A. paniculata, exhibits diverse pharmacological activities, including anti-inflammation, anti-cancer, anti-obesity, anti-diabetes, other activities. In this article, we comprehensively review therapeutic potential andrographolide focusing on mechanisms action clinical application. We systemically discuss structure-activity relationship derivatives. Despite various activities formula andrographolide, propose further development more structural derivatives with reduced toxicity increased efficacy still needed for application ancient mighty herb its component.

Language: Английский

---

Liver failure determines the outcome in patients of acute-on-chronic liver failure (ACLF): comparison of APASL ACLF research consortium (AARC) and CLIF-SOFA models

Hepatology International, Journal Year: 2017, Volume and Issue: 11(5), P. 461 - 471

Published: Aug. 30, 2017

Language: Английский

---

The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis

Liver International, Journal Year: 2017, Volume and Issue: 38(4), P. 570 - 580

Published: Sept. 18, 2017

Abstract Patients with cirrhosis and portal hypertension often develop complications from a variety of organ systems leading to multiple failure. The combination liver failure results in hyperdynamic circulatory state partly owing simultaneous splanchnic peripheral arterial vasodilatation. Increases vasodilators are believed be due portosystemic shunting bacterial translocation redistribution the blood volume central hypovolemia. Portal per se increased flow mainly responsible for development perpetuation circulation associated changes cardiovascular function cirrhotic cardiomyopathy, autonomic dysfunction renal as part cardiorenal syndrome. Several reversible after transplantation point pathophysiological significance hypertension. In this paper, we aimed review current knowledge on pathophysiology vasodilatation cirrhosis.

Language: Английский

---

Terlipressin Is Superior to Noradrenaline in the Management of Acute Kidney Injury in Acute on Chronic Liver Failure

Hepatology, Journal Year: 2018, Volume and Issue: 71(2), P. 600 - 610

Published: Aug. 7, 2018

Hepatorenal syndrome (HRS) carries a high short-term mortality in patients with cirrhosis and acute on chronic liver failure (ACLF). Terlipressin noradrenaline are routinely used HRS have been found to be equally effective. There no data comparing the efficacy of terlipressin ACLF HRS. In an open-label, randomized controlled trial (RCT), consecutive diagnosed kidney injury (AKI) were albumin infusion (2-12 mg/day; n = 60) or (0.5-3.0 mg/h; 60). Response treatment, course AKI, outcome studied. Baseline characteristics, including AKI stage sepsis-related HRS-AKI, comparable between groups. Compared noradrenaline, achieved greater day 4 (26.1% vs. 11.7%; P 0.03) 7 (41.7% 20%; 0.01) response. Reversal was also better (40% 16.7%; 0.004), significant reduction requirement renal replacement therapy (RRT; 56.6% 80%; 0.006) improved 28-day survival (48.3% 0.001). Adverse events limiting use drugs higher than (23.3% 8.3%; 0.02), but reversible. On multivariate analysis, Model for End-Stage Liver Disease (MELD; odds ratio [OR], 1.10; confidence interval [CI] 1.009-1.20; compared (OR, 3.05; CI 1.27-7.33; predicted nonresponse therapy. Use predictive (hazard [HR], 2.08; 1.32-3.30; 0.002). Conclusion: mortality. Infusion gives earlier response HRS-AKI.

Language: Английский

---

The microbiota in cirrhosis and its role in hepatic decompensation

Journal of Hepatology, Journal Year: 2021, Volume and Issue: 75, P. S67 - S81

Published: May 23, 2021

Cirrhosis - the common end-stage of chronic liver disease is associated with a cascade events, which intestinal bacterial overgrowth and dysbiosis are central. Bacterial toxins entering portal or systemic circulation can directly cause hepatocyte death, while also affects gut barrier function increases translocation, leading to infections, inflammation vasodilation, contribute acute decompensation organ failure. Acute its severe forms, pre-acute-on-chronic failure (ACLF) ACLF, characterised by sudden dysfunction (and failure) high short-term mortality. Patients pre-ACLF ACLF present high-grade inflammation, usually precipitated proven infection and/or alcoholic hepatitis. However, no precipitant identified in 30% these patients, whom translocation from microbiota assumed be responsible for decompensation. Different profiles may influence rate thereby outcome patients. Thus, targeting promising strategy prevention treatment decompensation, ACLF. Approaches include use antibiotics such as rifaximin, faecal microbial transplantation enterosorbents (e.g. Yaq-001), bind factors without exerting direct effect on growth kinetics. This review focuses role strategies prevent

Language: Английский

---

Interleukin-22 ameliorates acute-on-chronic liver failure by reprogramming impaired regeneration pathways in mice

Journal of Hepatology, Journal Year: 2019, Volume and Issue: 72(4), P. 736 - 745

Published: Nov. 29, 2019

Language: Английский

---

Utilizing the gut microbiome in decompensated cirrhosis and acute-on-chronic liver failure

Nature Reviews Gastroenterology & Hepatology, Journal Year: 2020, Volume and Issue: 18(3), P. 167 - 180

Published: Nov. 30, 2020

Language: Английский

---

Systemic inflammatory regulators and risk of acute-on-chronic liver failure: A bidirectional mendelian-randomization study

Frontiers in Cell and Developmental Biology, Journal Year: 2023, Volume and Issue: 11

Published: Jan. 19, 2023

Inflammation plays a role in the pathogenesis of acute-on-chronic liver failure (ACLF), however, whether there is causal relationship between inflammation and ACLF remains unclear. A two-sample Mendelian randomization (MR) approach was used to investigate systemic inflammatory regulators ACLF. The study analyzed 41 cytokines growth factors from 8,293 individuals extracted genome-wide association (GWAS) meta-analysis database involving 253 cases 456,095 controls. Our results showed that lower stem cell factor (SCF) levels, basic fibroblast (bFGF) levels higher Interleukin-13 (IL-13) were associated with an increased risk (OR = 0.486, 95% CI 0.264-0.892, p 0.020; OR 0.323, 0.107-0.972, 0.044; 1.492, 1.111-2.004, 0.008, respectively). In addition, genetically predicted did not affect expression regulators. indicate play crucial Further studies are needed determine these biomarkers can be prevent treat

Language: Английский

---

Acute-on-chronic liver failure: Terminology, mechanisms and management

Clinical and Molecular Hepatology, Journal Year: 2023, Volume and Issue: 29(3), P. 670 - 689

Published: March 20, 2023

Acute-on-chronic liver failure is an acute deterioration of function manifesting as jaundice and coagulopathy with the development ascites, a high probability extrahepatic organ involvement 28-day mortality. The pathogenesis involves extensive hepatic necrosis, which associated severe systemic inflammation subsequently causes cytokine storm, leading to portal hypertension, dysfunction, failure. These patients have increased gut permeability, releasing lipopolysaccharide (LPS) damage-associated molecular patterns (DAMPS) in blood, hyper-immune activation secretion cytokines, followed by immune paralysis, causing infections proportion patients. Early detection institution treatment, especially "Golden Window" period 7 days, gives opportunity for reversal syndrome. Scores like Asian Pacific Association Study Liver (APASL) ACLF research consortium (AARC) score, model end stage disease (MELD), CLIF Consortium acute-on-chronic (CLIF-C ACLF) score can help prediction Treatment strategy includes treatment insult. Patients should be considered early transplant MELD >28, AARC >10, high-grade encephalopathy, absence >2 or overt sepsis improve survival up 80% at five years. Patients, no option transplant, treated emerging therapies faecal microbial plasma exchange, etc., need further evaluation.

Language: Английский

---