Epigenetics in inflammatory liver diseases: A clinical perspective (Review)

Isac, Teodora; Isac, Sebastian; Rababoc, Razvan; Cotorogea, Mihail; Iliescu, Laura

doi:10.3892/etm.2022.11293

Cited by 10 publications

(10 citation statements)

References 66 publications

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“…The direct effect of anesthesia on the brain is still debatable [ 55 , 56 ]. Furthermore, specific novel biomarkers in cirrhosis could identify new predictive algorithms in patients at risk [ 14 ].…”

Section: Perioperative Cognitive Dysfunction Management In Cirrhotic ...mentioning

confidence: 99%

“…For clinical purposes, West Haven criteria are used to classify HE into four stages, but they are often used subjectively and fail to accurately identify minimal hepatic encephalopathy (mHE). Thus, further efforts should be made to identify novel predictive biomarkers in various subclinical cirrhosis-associated conditions that could lead to cognitive impairment [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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The Management of Postoperative Cognitive Dysfunction in Cirrhotic Patients: An Overview of the Literature

et al. 2023

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Background and objectives: Postoperative cognitive dysfunction (POCD) represents a decreased cognitive performance in patients undergoing general anesthesia for major surgery. Since liver cirrhosis is associated with high mortality and morbidity rates, cirrhotic patients also assemble many risk factors for POCD. Therefore, preserving cognition after major surgery is a priority, especially in this group of patients. The purpose of this review is to summarize the current knowledge regarding the effectiveness of perioperative therapeutic strategies in terms of cognitive dysfunction reduction. Data Collection: Using medical search engines such as PubMed, Google Scholar, and Cochrane library, we analyzed articles on topics such as: POCD, perioperative management in patients with cirrhosis, hepatic encephalopathy, general anesthesia in patients with liver cirrhosis, depth of anesthesia, virtual reality in perioperative settings. We included 115 relevant original articles, reviews and meta-analyses, and other article types such as case reports, guidelines, editorials, and medical books. Results: According to the reviewed literature, the predictive capacity of the common clinical tools used to quantify cognitive dysfunction in cirrhotic settings is reduced in perioperative settings; however, novel neuropsychological tools could manage to better identify the subclinical forms of perioperative cognitive impairments in cirrhotic patients. Moreover, patients with preoperative hepatic encephalopathy could benefit from specific preventive strategies aimed to reduce the risk of further neurocognitive deterioration. Intraoperatively, the adequate monitoring of the anesthesia depth, appropriate anesthetics use, and an opioid-sparing technique have shown favorable results in terms of POCD. Early recovery after surgery (ERAS) protocols should be implemented in the postoperative setting. Other pharmacological strategies provided conflicting results in reducing POCD in cirrhotic patients. Conclusions: The perioperative management of the cognitive function of cirrhotic patients is challenging for anesthesia providers, with specific and targeted therapies for POCD still sparse. Therefore, the implementation of preventive strategies appears to remain the optimal attitude. Further research is needed for a better understanding of POCD, especially in cirrhotic patients.

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Section: Perioperative Cognitive Dysfunction Management In Cirrhotic ...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Management of Postoperative Cognitive Dysfunction in Cirrhotic Patients: An Overview of the Literature

et al. 2023

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“…The intricacy of the underlying immunological processes is reflected in the diverse phenotypes of AIH (Isac et al, 2022). The observed risk of AIH surpasses the hereditary risk, and the discrepancy may be explained by epigenetic factors that change gene expression (Czaja, 2022).…”

Section: Roles Of Mirnas In Autoimmune Hepatitis (Aih)mentioning

confidence: 99%

MicroRNAs: Small molecules with big impacts in liver injury

Halim

Rudayni

Chaudhary

et al. 2022

Journal Cellular Physiology

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A type of small noncoding RNAs known as microRNAs (miRNAs) fine-tune gene expression posttranscriptionally by binding to certain messenger RNA targets.Numerous physiological processes in the liver, such as differentiation, proliferation, and apoptosis, are regulated by miRNAs. Additionally, there is growing evidence that miRNAs contribute to liver pathology. Extracellular vesicles like exosomes, which contain secreted miRNAs, may facilitate paracrine and endocrine communication between various tissues by changing the gene expression and function of distal cells.The use of stable miRNAs as noninvasive biomarkers was made possible by the discovery of these molecules in body fluids. Circulating miRNAs reflect the conditions of the liver that are abnormal and may serve as new biomarkers for the early detection, prognosis, and evaluation of liver pathological states. miRNAs are appealing therapeutic targets for a range of liver disease states because altered miRNA expression is associated with deregulation of the liver's metabolism, liver damage, liver fibrosis, and tumor formation. This review provides a comprehensive review and update on miRNAs biogenesis pathways and mechanisms of miRNAmediated gene silencing. It also outlines how miRNAs affect hepatic cell proliferation, death, and regeneration as well as hepatic detoxification. Additionally, it highlights the diverse functions that miRNAs play in the onset and progression of various liver diseases, including nonalcoholic fatty liver disease, alcoholic liver disease, fibrosis, hepatitis C virus infection, and hepatocellular carcinoma. Further, it summarizes the diverse liver-specific miRNAs, illustrating the potential merits and possible caveats of their utilization as noninvasive biomarkers and appealing therapeutic targets for liver illnesses.

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“…Conquanto os tratamentos terapêuticos sejam bem conhecidos nas hepatites, independentemente da etiologia, estratégias para identificar lesões hepáticas inflamatórias em estágios iniciais, desenvolver novas terapias epigenéticas devem ser priorizadas. As principais entidades da doença inflamatória hepática são: doença hepática gordurosa alcoólica e não alcoólica, hepatite autoimune, hepatite viral e doença de Wilson (ISAC et al, 2022).…”

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“Outras doenças do fígado”: morbidade no contexto do Brasil

Santos¹,

Cordeiro²,

Gratão³

et al. 2023

Braz. J. Hea. Rev.

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O fígado é o principal órgão para o metabolismo de proteínas, carboidratos, gordura e fármacos, bem como para a remoção de hormônios e outras substâncias. O objetivo desse estudo foi comparar os dados oficiais, disponíveis no DATASUS, no decorrer do ano de 2022 (janeiro, fevereiro, março, abril, maio, junho, julho, agosto, setembro, outubro) nas diferentes Regiões brasileiras sobre a prevalência das doenças do figado com abordagem literária para Hepatitie autoimune. As variáveis foram: Número de pacientes internados nas diferentes Regiões do Brasil; índice de pessoas internadas de janeiro a outubro do ano de 2022, para todas as Regiões do Brasil, com valores em porcentagem (%); Índice de pessoas internadas de janeiro a outubro do ano de 2022, para a Região Centro-Oeste com filtro para os Estados de Mato Grosso, Mato Grosso do Sul e Goiás, com valores em porcentagem (%); Total de pacientes internados por Região de estudo; Abordagem relacionadas a tratamentos terapeuticos. Conclusão: os dados obtidos são diferentes, tanto para os meses analisados, quanto para cada Região do Brasil no que tange à ‘Outras Doenças do Fígado”. Total de 36.353,0 internações. A Região Sudeste liderou com média de 1540,7; No Centro-Oeste, o número foi de 2305,0; O Estado de Goiás, obteve média com 85,90; A Região Sudeste índice de 42%; Regiões Nordeste e Sul, 26% e 19%; O Norte e Centro-Oeste, 7% e 6%. A Hepatite Autoimune é uma morbidade multifatorial que envolve condições genéticas e ambientais das pessoas afetadas; os tratamentos terapêuticos, dependem de cada situação individual e ampla anamnese.

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Epigenetics in inflammatory liver diseases: A clinical perspective (Review)

Cited by 10 publications

References 66 publications

The Management of Postoperative Cognitive Dysfunction in Cirrhotic Patients: An Overview of the Literature

The Management of Postoperative Cognitive Dysfunction in Cirrhotic Patients: An Overview of the Literature

MicroRNAs: Small molecules with big impacts in liver injury

“Outras doenças do fígado”: morbidade no contexto do Brasil

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