About Us Contact Us

Contact Us

Send 

Search

Current Issue

April - June, 2002

Vol. 1 Issue 2

On the cover: Official Journal of the Mexican Association of Hepatology

CONCISE REVIEW

  • Dynamics of hepatitis C virus infection Stefan Zeuzem, Eva Herrmann Page 56-63

    Obesity-related non-alcoholic steatohepatitis and TGF-β1 serum levels in relation to morbid obesity "Viremia shows only minor fluctuations in untreated patients chronically infected with hepatitis C virus. The steady state situation of balanced viral production and clearance in untreated patients can be disturbed by active antiviral treatment. After initiating interferon-α therapy, a typical biphasic decline of viremia can be observed and analyzed. Evaluation of mathematical models of viral dynamics during the initial phase of antiviral treatment shows high turnover rates of pre-treatment viral production and clearance of about 1011 -1013 virions each day and in-vivo half-lives of a few hours for free hepatitis C virions. During the first 24 to 48 hours of therapy, a dose-dependent first phase of interferon-α induced viral kinetics is characterized by a rapid exponential decline of serum viral load. Then viral decline enters a second phase of a relatively slow exponential decay during the following weeks of therapy which mainly reflects the death rate of infected hepatocytes. This second phase decay is predictive for the virologic end-of-treatment and even more the sustained response. Non-responding patients typically show constant viremia or even a rebound during this second phase.

  • From blood to bile: recent advances in hepatobiliary transport Marco Arrese, Luigi Accatino Page 64-71

    Transport of endogenous and exogenous substances from blood to bile is an essential function of the liver. In the last decade a still growing number of specific transport proteins present at the sinusoidal and canalicular membrane domains of hepatocytes and cholangiocytes have been cloned and functionally characterized. Studies assessing the molecular expression and function of these hepatobiliary transport proteins under different experimental conditions has helped to define the adaptive responses of hepatocytes to certain physiological states and to cholestatic liver injury and to a better understanding of the physiology of bile formation and of the pathophysiology of certain cholestatic diseases. Particularly relevant is the elucidation of the molecular bases of several forms of inherited cholestatic liver disease, which may help to the development of better diagnostic tools or to the design of new therapeutic strategies. In the present review we summarize recent experimental and clinical data involving hepatobiliary transport mechanisms.

  • Pathophysiology, diagnosis and treatment of ascites in cirrhosis Vicente Arroyo Page 72-79

    The mechanism by which ascites develops in cirrhosis is multifactorial Severe sinusoidal portal hypertension and hepatic insufficiency are the initial factors. They lead to a circulatory dysfunction characterized by arterial vasodilation, arterial hypotension, high cardiac output and hypervolemia and to renal sodium and water retention. There are evidences that arterial vasodilation in cirrhosis occurs in the splanchnic circulation and is related to an increased synthesis of local vasodilators. Vascular resistance is normal or increased in the remaining major vascular territories (kidney, muscle and skin and brain). Splanchnic arterial vasodilation not only impairs systemic hemodynamics and renal function but also alters hemodynamics in the splanchnic microcirculation. The rapid and high inflow of arterial blood into the splanchnic microcirculation is the main factor increasing hydrostatic pressure in the splanchnic capillaries leading to an excessive production of splanchnic lymph over lymphatic return. Lymph leakage from the liver and other splanchnic organs is the mechanism of fluid accumulation in the abdominal cavity. Continuous renal sodium and water retention perpetuates ascites formation. Large volume paracentesis associated with albumin infusion is the treatment of choice of tense ascites because it is very effective and rapid and is associated with fewer complications that the traditional treatment (sodium restriction and diuretics). However, diuretic should be given after paracentesis to prevent reaccumulation of ascites. In patients with moderate ascites diuretics should be preferred as initial therapy. Patients with refractory ascites could be treated by paracentesis or percutaneous transjugular portacaval shunt (TIPS). TIPS is more effective in the long term control of ascites but may impair hepatic function and induce chronic hepatic encephalopathy.

ORIGINAL ARTICLES

  • Development of a liver unit in Latin America Linda Elsa Muñoz Espinosa, Paula Cordero-Pérez, Miguel Mariano Escobedo-Villarreal Page 80-84

    The Liver Unit at the "Dr. José E. González" University Hospital and School of Medicine of the Autonomous University of Nuevo León in Monterrey was founded in 1983. Over the years, it has become a referral center for the northeast of Mexico. The frequency of diagnosis has changed: in 1983, the most common liver disease seen was alcoholic liver disease, today it is chronic hepatitis C. Amebic liver abscess, which used to be common, was hardly seen in 2001. Non-alcoholic fatty liver disease was unidentified 18 years ago, whereas in 2001 it was seen in 10% of patients. The development of five laboratories within the unit has allowed us to implement basic and clinical research trials, and to offer a high quality diagnostic service. The experimental liver transplant program started in 1987 and a clinical program in humans in 1991: four patients received an orthotopic liver transplantation in its first phase. In the second phase, 20 patients received allografts from September 1999 to March 2002. Technical complications have been encountered in only one patient, with a biliary leak, and there have been three perioperative deaths. Infections occurred in eight patients; all resolved. Acute postoperative rejection occurred in two patients, and in the first seven months in another five; all of them resolved. The twoyear survival rate is 80%. This unit offers a highly specialized diagnosis, standardized specialized laboratory services and a transplant program that guarantees a higher quality of medical attention to patients with liver diseases." "Objective: It has been suggested that apo A-I can inhibit cholesterol crystal nucleation in vitro, and ursodeoxycholic acid (UDCA) is a safe and effective treatment for selected patients with cholesterol gallstones the aim of this study was to investigate the effect of UDCA on the steady-state levels (SSL) of apo A-I mRNA in the liver, as well as serum apo A-I, in patients with cholesterol gallstones. Design: Twenty Mexican patients with symptomatic radiolucent gallstones were randomized and assigned in a double blind fashion to groups that were administered either UDCA (4 mg/kg per day) or placebo for 10 to 15 days before cholecystectomy. Methods: Apo A- I mRNA levels in liver and gallbladder tissues were determined by northern blot and serum levels of apo A- I by turbidimetric method. Results: Apo A- I mRNA levels were higher in nine of the 10 patients who received UDCA and in comparison to those to the placebo group. In the gallbladder apo AI mRNA levels were undetected. Serum levels (mg/dL) of apo A- I were similar in both UDCA and placebo groups after treatment (111.7 ± 29.8 vs 115.6 ± 25.4). Conclusions: The results of this study shown that apo A- I mRNA gene express at the mRNA level in the liver but not in the gallbladder of patients with cholesterol gallstones treated with UDCA.

  • Hepatic apolipoprotein A-I gene expression in patients with cholesterol gallstones treated with ursodeoxycholic acid Nahum Méndez-Sánchez, Arturo Panduro, Daniel Murguía, Ana R. Rincón, Misael Uribe Page 85-89

    Objective: It has been suggested that apo A-I can inhibit cholesterol crystal nucleation in vitro, and ursodeoxycholic acid (UDCA) is a safe and effective treatment for selected patients with cholesterol gallstones the aim of this study was to investigate the effect of UDCA on the steady-state levels (SSL) of apo A-I mRNA in the liver, as well as serum apo A-I, in patients with cholesterol gallstones. Design: Twenty Mexican patients with symptomatic radiolucent gallstones were randomized and assigned in a double blind fashion to groups that were administered either UDCA (4 mg/kg per day) or placebo for 10 to 15 days before cholecystectomy. Methods: Apo A- I mRNA levels in liver and gallbladder tissues were determined by northern blot and serum levels of apo A- I by turbidimetric method. Results: Apo A- I mRNA levels were higher in nine of the 10 patients who received UDCA and in comparison to those to the placebo group. In the gallbladder apo AI mRNA levels were undetected. Serum levels (mg/dL) of apo A- I were similar in both UDCA and placebo groups after treatment (111.7 ± 29.8 vs 115.6 ± 25.4). Conclusions: The results of this study shown that apo A- I mRNA gene express at the mRNA level in the liver but not in the gallbladder of patients with cholesterol gallstones treated with UDCA.

IMAGES IN HEPATOLOGY

CASE REPORTS

  • Epithelioid granulomas in a patient with hepatitis C virus Raúl Pichardo-Bahena, Nahum Méndez-Sánchez Page 91-93

    Hepatitis C virus infection causes an epidemic disease. The morphologic aspects of hepatitis C infection (HCV) are well established with regards to necroinflammatory processes and consequences like fibrosis, cirrhosis, and related neoplasms. However, the presence of epithelioid granulomas has not been well described for this infection. We report a patient with HCV and granulomas without any other co-infection or history of drug abuse.

The Official Journal of the Mexican Association of Hepatology, the Latin-American Association for the Study of the Liver and the Canadian Association for the Study of the Liver

ALEH Hepatología CASL ACEF Médica Sur
Index Copernicus PubMed

© 2016 Annals of Hepatology. All rights reserved Privacy Policy