Cholinergic Anti-Inflammatory Pathway and the Liver

Hajiasgharzadeh, Khalil; Baradaran, Behzad

doi:10.15171/apb.2017.063

Cited by 24 publications

(22 citation statements)

References 61 publications

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“…Reduced HRV might mean lower activity in the neural anti-inflammatory pathway and hence higher chance of organ damage/failure after minor infection (38,39) . Although evidence for the contribution of this neural anti-inflammatory pathway in cirrhosis is emerging (40)(41)(42), the exact mechanistic link awaits further investigation. One limitation of our study is that the cause of death was not registered in our study.…”

Section: Discussionmentioning

confidence: 99%

Which heart rate variability index is an independent predictor of mortality in cirrhosis?

Bhogal

Rui

Pavanello

et al. 2019

Digestive and Liver Disease

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Background: Liver cirrhosis is associated with reduced heart rate variability (HRV), which indicates impaired integrity of cardiovascular control in this patient population. There are several different indices for HRV quantification. The present study was designed to: 1) determine which of the HRV indices is best at predicting mortality in patients with cirrhosis; 2) verify if such ability to predict mortality is independent of the severity of hepatic failure. Methods: Ten minutes electrocardiogram was recorded in 74 patients with cirrhosis. Heart rate fluctuations were quantified using statistical, geometrical and non-linear analysis. The patients were followed-up for 18 months and information was collected on the occurrence of death/liver transplantation. Results: During the follow-up period, 24 patients (32%) died or were transplanted for hepatic decompensation. Cox's regression analysis showed that SDNN (total HRV), cSDNN (corrected SDNN), SD1 (short-term HRV), SD2 (long-terms HRV) and spectral indices could predict survival in these patients. However, only SD2 and cSDNN were shown to be independent of MELD in predicting survival. The prognostic value of HRV indices was independent of age, gender, use of beta blockers, and the aetiology of liver disease. Conclusion: Two HRV indices were identified that could predict mortality in patients with cirrhosis, independently of MELD. These indices are potentially useful tools for survival prediction.

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Section: Discussionmentioning

confidence: 99%

Which heart rate variability index is an independent predictor of mortality in cirrhosis?

Bhogal

Rui

Pavanello

et al. 2019

Digestive and Liver Disease

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“…One understudied area of inter-organ crosstalk in ASH is the protective role of the vagus-a7nAChR (a7 nicotinic acetylcholine receptor coded by Chrna7) axis that has been explored in other models of liver disease. 61 Activation of the a7nAChR on Kupffer cells suppresses inflammation. 62 However, this anti-inflammatory effect of vagal innervation may be compromised by the autonomic dysfunction that is a common complication of cirrhosis.…”

Section: Systemic Effectsmentioning

confidence: 99%

“…62 However, this anti-inflammatory effect of vagal innervation may be compromised by the autonomic dysfunction that is a common complication of cirrhosis. 61 A second organ that may interact with the liver is the lung, 63 lung-liver interactions may indeed contribute to the interactions between cigarette smoking and ASH/ALD.…”

Section: Systemic Effectsmentioning

confidence: 99%

Inflammatory pathways in alcoholic steatohepatitis

Gao

Ahmad

Nagy

et al. 2019

Journal of Hepatology

263

284

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Inflammatory processes are primary contributors to the development and progression of alcoholic steatohepatitis (ASH), with severe alcoholic hepatitis characterised by non-resolving inflammation. Inflammation in the progression of ASH is a complex response to microbial dysbiosis, loss of barrier integrity in the intestine, hepatocellular stress and death, as well as inter-organ crosstalk. Herein, we review the roles of multiple cell types that are involved in inflammation in ASH, including resident macrophages and infiltrating monocytes, as well as other cell types in the innate and adaptive immune system. In response to chronic, heavy alcohol exposure, hepatocytes themselves also contribute to the inflammatory process; hepatocytes express a large number of chemokines and inflammatory mediators and can also release damage-associated molecular patterns during injury and death. These cellular responses are mediated and accompanied by changes in the expression of pro-and anti-inflammatory cytokines and chemokines, as well as by signals which orchestrate the recruitment of immune cells and activation of the inflammatory process. Additional mechanisms for cell-cell and inter-organ communication in ASH are also reviewed, including the roles of extracellular vesicles and microRNAs, as well as inter-organ crosstalk. We highlight the concept that inflammation also plays an important role in promoting liver repair and controlling bacterial infection. Understanding the complex regulatory processes that are disrupted during the progression of ASH will likely lead to better targeted strategies for therapeutic interventions.

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“…6 In addition, the cholinergic anti-inflammatory pathway was shown to play a role in modulating chronic hepatic disease. 7…”

Section: Introductionmentioning

confidence: 99%

Acupuncture stimulation attenuates TNF-α production via vagal modulation in the concanavalin A model of hepatitis

Lim

Kim

et al. 2020

Acupunct Med

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Background: A growing body of evidence shows that neuronal activity is involved in modulating the efficacy of acupuncture therapy. However, it has been seldom investigated whether neuronal activity following acupuncture stimulation is effective at regulating hepatic inflammation. Objective: Using the concanavalin A (ConA) model of hepatitis, we investigated the regulation of inflammatory cytokine tumor necrosis factor (TNF)-α in the liver tissue and the blood after acupuncture stimulation at ST36. Methods: Mice were subjected to ConA injection, acupuncture stimulation at ST36 by manual acupuncture (MA) or electroacupuncture (EA) procedures, and vagotomy (VNX). Liver tissue and blood were collected for TNF-α analysis. TNF-α mRNA was analyzed by real-time polymerase chain reaction (PCR), and TNF-α, CD11b, CD68, and Erk1/2 proteins were analyzed by Western blotting, immunofluorescence staining, and enzyme-linked immunosorbent assay. Results: TNF-α mRNA and protein were induced in CD11b-positive hepatic cells and the plasma at 6–24 h after ConA injection. The application of MA or EA was very effective at attenuating the production of TNF-α. Anti-inflammatory effects of acupuncture were greatly suppressed by VNX in ConA-injected animals, suggesting the requirement of vagus nerve activity in acupuncture-mediated anti-inflammatory responses. Electrical stimulation of the sciatic nerve (SNS) resulted in an anti-inflammatory effect similar to acupuncture stimulation. In parallel with TNF-α, production of phospho-Erk1/2, which was induced in the liver tissue, was downregulated by MA and EA in liver cells. Conclusion: The regulatory effects of acupuncture stimulation on inflammatory responses in the liver may be modulated through the activation of the vagus nerve pathway.

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Cholinergic Anti-Inflammatory Pathway and the Liver

Cited by 24 publications

References 61 publications

Which heart rate variability index is an independent predictor of mortality in cirrhosis?

Which heart rate variability index is an independent predictor of mortality in cirrhosis?

Inflammatory pathways in alcoholic steatohepatitis

Acupuncture stimulation attenuates TNF-α production via vagal modulation in the concanavalin A model of hepatitis

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