New Therapies of Liver Diseases: Hepatic Encephalopathy

Mangini, Chiara; Montagnese, Sara

doi:10.3390/jcm10184050

Cited by 7 publications

(14 citation statements)

References 80 publications

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“…Moreover, Et promote the synthesis of endothelin and nitric oxide in HSCs and ECs, which results in increased portal blood pressure [ 40 ]. Because the hemodynamic effects of portal hypertension (PHT) can induce hepatic encephalopathy [ 41 ], HRS [ 42 ], and ascites [ 43 ], it is possible that ADAMTS13:AC and VWF:Ag are associated with these conditions through Et-induced development of hepatic encephalopathy, HRS, ascites, and subsequent PHT.…”

Section: Discussionmentioning

confidence: 99%

ADAMTS13, VWF, and Endotoxin Are Interrelated and Associated with the Severity of Liver Cirrhosis via Hypercoagulability

Takaya

Namisaki

Asada

et al. 2022

JCM

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ADAMTS13 specifically cleaves the multimeric von Willebrand factor (VWF), and an imbalance between ADAMTS13 activity (ADAMTS13:AC) and VWF antigen (VWF:Ag) levels is associated with the severity of liver cirrhosis (LC). However, the reason for this imbalance in patients with LC is unknown. This study investigated the relationship among ADAMTS13:AC, VWF:Ag, and endotoxin (Et) levels in patients with LC. ADAMTS13:AC and VWF:Ag levels were determined using ELISA, whereas Et levels were estimated using a chromogenic substrate assay. The levels of ADAMTS13 inhibitor (ADAMTS13:INH) were evaluated by measuring the extent that heat-inactivated patient’s plasma reduces the ADAMTS13:AC of the control. The status (degraded, normal, or unusually large [UL]) of the VWF multimer (VWFM) was determined through vertical agarose gel electrophoresis. ADAMTS13:AC, VWF:Ag, and Et levels decreased, increased, and increased, respectively, with the severity of LC. Patients with cirrhosis with high Et levels had lower and higher ADAMTS13:AC and VWF:Ag levels, respectively, than those with low Et levels. Patients with cirrhosis with detectable ADAMTS13:INH had higher Et levels than those with undetectable ADAMTS13:INH. Patients whose VWFM was either normal or UL had higher Et levels than those with degraded VWFM. In conclusion, ADAMTS13, VWF, and Et may be interrelated and associated with the severity of LC via hypercoagulability.

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Section: Discussionmentioning

confidence: 99%

ADAMTS13, VWF, and Endotoxin Are Interrelated and Associated with the Severity of Liver Cirrhosis via Hypercoagulability

Takaya

Namisaki

Asada

et al. 2022

JCM

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“…The clinical manifestations of HE are diverse, manifesting only as reduced attention, memory, or abnormal brain electrophysiology in the early stages of the disease, and as the disease progresses, symptoms of neurological dysfunction such as drowsiness, delirium, or even coma may appear [ 15 ]. Studies [ 16 , 17 ] have shown that HE can cause serious pathological changes related to cerebral edema, gastrointestinal bleeding, renal insufficiency, etc. If patients do not receive timely and effective treatment, it can cause sequelae of multisystem functional disruption and affect their normal life.…”

Section: Discussionmentioning

confidence: 99%

Impact of Optimizing the Emergency Care Process on the Emergency Effect and Prognosis of Patients with Hepatic Encephalopathy

Wei

Tan

et al. 2022

Emergency Medicine International

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Hepatic encephalopathy (HE) is a serious complication caused by liver disease and is one of the leading causes of death in patients. Studies have shown that proper emergency care for patients after the occurrence of HE can improve their prognosis and quality of life. Therefore, this study focuses on the effect of optimizing the emergency care process on the effectiveness and prognosis of emergency care for patients with hepatic encephalopathy. In this study, we set 32 patients with HE admitted to receive routine emergency care between May 2020 and March 2021 as the control group and 34 patients with HE admitted to receive optimized emergency care processes between April 2021 and February 2022 as the observation group. The satisfaction of patients’ families with this care was assessed using a self-administered nursing satisfaction questionnaire to record the outcome of emergency care, quality of care, and prognosis of patients in the two groups of palliative care. The data collected were analyzed using SPSS17.0 software, and the results showed that the time spent on diagnosis, resuscitation, DTP, and DTT was much lower in the observation group than in the control group, and the scores related to the quality of care, such as ambulance technique, humanistic care, resuscitation efficiency, and resuscitation effect, were all higher than those of the control group, and the satisfaction of the family members in the observation group was also significantly higher than that of the control group ( P < 0.05 ). The success rate of first aid in the observation group was 100.00%, which was higher than 93.72% in the control group, but the difference between the two groups was not significant ( P > 0.05 ). It can be seen that the application of an optimized emergency nursing process in HE patients is effective, which can effectively improve the success rate of HE resuscitation, shorten the resuscitation time and condition diagnosis, improve the resuscitation effect, improve the quality of nursing care, and improve the prognosis of patients to a certain extent.

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“…This is difficult operatively, as these patients struggle to cope with three main meals and three snacks (frequent hyporexia, dysgeusia, early satiety and prescription of unpalatable diets 104 ), and has not been consistently shown to be beneficial, with the exception of iatrogenic malnutrition deriving from inappropriate or excessively strict dietary prescriptions. 108 A circadian perspective of fasting/feeding patterns may help to explain the difficulties in managing malnutrition in advanced liver disease. Firstly, and as already discussed, the circadian timing system allows to anticipate food intake and the timing of such anticipatory/ preparatory behaviour is not easily modified.…”

Section: Circ Adian Dis Rup Tion In Cirrhos Ismentioning

confidence: 99%

“…Accordingly, malnourished patients with cirrhosis are encouraged to avoid long periods of fasting and to split their food intake into small, frequent meals. This is difficult operatively, as these patients struggle to cope with three main meals and three snacks (frequent hyporexia, dysgeusia, early satiety and prescription of unpalatable diets 104 ), and has not been consistently shown to be beneficial, with the exception of iatrogenic malnutrition deriving from inappropriate or excessively strict dietary prescriptions 108 . A circadian perspective of fasting/feeding patterns may help to explain the difficulties in managing malnutrition in advanced liver disease.…”

Section: Circadian Disruption In Cirrhosismentioning

confidence: 99%

Circadian rhythms and the liver

Costa

Mangini

Domenie

et al. 2023

Liver International

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This narrative review briefly describes the mammalian circadian timing system, the specific features of the liver clock, also by comparison with other peripheral clocks, the role of the liver clock in the preparation of food intake, and its relationship with energy metabolism. It then goes on to provide a chronobiological perspective of the pathophysiology and management of several types of liver disease, with a particular focus on metabolic‐associated fatty liver disease (MAFLD), decompensated cirrhosis and liver transplantation. Finally, it provides some insight into the potential contribution of circadian principles and circadian hygiene practices in preventing MAFLD, improving the prognosis of advanced liver disease and modulating liver transplantation outcomes.

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New Therapies of Liver Diseases: Hepatic Encephalopathy

Cited by 7 publications

References 80 publications

ADAMTS13, VWF, and Endotoxin Are Interrelated and Associated with the Severity of Liver Cirrhosis via Hypercoagulability

ADAMTS13, VWF, and Endotoxin Are Interrelated and Associated with the Severity of Liver Cirrhosis via Hypercoagulability

Impact of Optimizing the Emergency Care Process on the Emergency Effect and Prognosis of Patients with Hepatic Encephalopathy

Circadian rhythms and the liver

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