The Effect of Nutritional Status  on Outcome of Hospitalization in  Paediatric Liver Disease Patients

Mansi, Yasmeen; Ghaffar, S. Abdel; Sayed, Shaymaa; El‐Karaksy, Hanaa

doi:10.7860/jcdr/2016/21606.8956

Cited by 8 publications

(7 citation statements)

References 30 publications

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“…There is no effective treatment for acute liver failure at present. Immune inflammation plays an important role in acute liver injury [21][22][23]. In the course of acute liver injury, a large number of lymphoid T cells are found [24].…”

Section: Discussionmentioning

confidence: 99%

Protective effects of specific cannabinoid receptor 2 agonist GW405833 on concanavalin A-induced acute liver injury in mice

Huang

Zheng

et al. 2019

Acta Pharmacol Sin

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Cannabinoid receptor 2 (CB2R) is highly expressed in immune cells and plays an important role in regulating immune responses. In the current study, we investigated the effects of GW405833 (GW), a specific CB2R agonist, on acute liver injury induced by concanavalin A (Con A). In animal experiments, acute liver injury was induced in mice by injection of Con A (20 mg/kg, i.v.). The mice were treated with GW (20 mg/kg, i.p., 30 min after Con A injection) or GW plus the selective CB2R antagonist AM630 (2 mg/kg, i.p., 15 min after Con A injection). We found that Con A caused severe acute liver injury evidenced by significantly increased serum aminotransferase levels, massive hepatocyte apoptosis, and necrosis, as well as lymphocyte infiltration in liver tissues. Treatment with GW significantly ameliorated Con A-induced pathological injury in liver tissue, decreased serum aminotransferase levels, and decreased hepatocyte apoptosis. The therapeutic effects of GW were prevented by AM630. In cell experiments, we showed that CB2Rs were highly expressed in Jurkat T cells, but little expression in L02 liver cells. Treatment with GW (10−40 μg/mL) dosedependently decreased the viability of Jurkat T cells and induced cell apoptosis, which was reversed by AM630. In the coculture of Jurkat T cells with L02 liver cells, GW dose-dependently protected L02 cells from apoptosis induced by Con A (5 μg/mL). The protective effect of GW was reversed by AM630 (1 μg/mL). Our results suggest that GW protects against Con A-induced acute liver injury in mice by inhibiting Jurkat T-cell proliferation through the CB2Rs.

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Section: Discussionmentioning

confidence: 99%

Protective effects of specific cannabinoid receptor 2 agonist GW405833 on concanavalin A-induced acute liver injury in mice

Huang

Zheng

et al. 2019

Acta Pharmacol Sin

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“…Liver transplantation is currently the definitive treatment for most types of liver failure in both children and adults (73)(74)(75)(76). Split grafts, live donations, immunosuppressive regimen upgrades, infectious prophylaxis protocols, and innovative surgical techniques have made it possible to reduce complications and improve survival and quality of life (55)(56)(57)(58)(59)(60)(61)77).…”

Section: Nutritional Interventionmentioning

confidence: 99%

Secondary Malnutrition and Nutritional Intervention in Cholestatic Liver Diseases in Infants

Larrosa‐Haro

Caro-Sabido²

2021

Front. Nutr.

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We aimed to conduct an updated review on the pathophysiology, diagnosis, and nutritional intervention of CCLD and secondary malnutrition in infants. Protein-energy malnutrition, impaired linear growth, fat-soluble vitamin deficiencies, and hepatic osteodystrophy can occur in up to 80% of cases. The proposed pathophysiological mechanisms include insufficient energy intake, lipid- and fat-soluble vitamin malabsorption, increased energy expenditure, altered intermediate metabolism, hormonal dysregulation, and systemic inflammation. The current approach to diagnosis is the identification of the deviation of growth parameters, body composition, and serum concentration of micronutrients, which determines the type and magnitude of malnutrition. Currently, liver transplantation is the best therapeutic alternative for the reversal of nutritional impairment. Early and effective portoenteroanatomosis can extend survival in patients with biliary atresia. Medical and dietary interventions in some storage and metabolic diseases can improve liver damage and thus the nutritional status. A proportion of patients with biliary atresia have fat-soluble vitamin deficiencies despite receiving these vitamins in a water-soluble form. With aggressive enteral nutrition, it may be possible to increase fat stores and preserve muscle mass and growth. The nutritional issues identified in the pre- and post-transplantation stages include muscle mass loss, bone demineralization, growth retardation, and obesity, which seems to correspond to the natural history of CCLD. Due to the implications for the growth and development of infants with CCLD with this complex malnutrition syndrome, innovative projects are required, such as the generation of prediction and risk models, biomarkers of growth and body composition, and effective strategies for nutritional prevention and intervention.

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“…Severe malnutrition affects approximately 40–70% of the children with chronic cholestatic liver diseases [ 1 – 3 ]. The impacts of malnutrition on children’s outcomes include increased risks of pre- and post liver transplantation morbidity and mortality, immune suppression, and impaired neurocognitive development [ 4 – 6 ]. Therefore, it is important to perform nutritional management, including nutritional assessment, intervention, and follow-up, to prevent negative health outcomes among children.…”

Section: Introductionmentioning

confidence: 99%

Feeding practices in 6–24-month-old children with chronic cholestatic liver diseases: a mixed-method study

Chen

Wang

et al. 2020

BMC Pediatr

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Background: Children with chronic cholestatic liver diseases have a high risk of malnutrition. However, nutritional management in China has received little attention, and there has been limited evidence regarding improving these practices. This study aimed to evaluate the feeding status of chronic cholestatic children aged 6-24 months and to explore their parents' experiences with feeding practices. Methods: A mixed-method study was conducted among parents of 74 children with chronic cholestatic liver diseases. The Infant and Young Child Feeding Index (ICFI) was used to collect quantitative data of feeding practices. In-depth interviews with parents were performed to generate qualitative data. Multivariate analysis was conducted to identify predictors of inappropriate feeding practices. Qualitative data were analyzed using thematic analysis. Results: Only 16.2% of the children had appropriate feeding practices. In terms of dairy products, the rate of breastfeeding, medium-chain triglyceride formula feeding, and regular formula feeding were 25.7, 39.2 and 44.6% respectively. The complementary feeding rate was 68.8%, and the age of adding complementary foods was 6.9 ± 1.7 months. Consumption of foods from animal sources was suboptimal, 66.7% of the children aged 6-8 months and 45.5% of the children aged 9-11 months had carbohydrates as a single source of complementary foods and had no intake of meat, eggs or bean products, while in the age group 12-24 months, 52.0% of the children had eggs less than 2 days/week, 60.0% had meat less than 2 days/week, and 60.0% had no intake of bean products. Low literacy of the primary care provider was significantly related to inappropriate feeding practices (adjusted OR 5.52; 95% CI 1.29, 23.66). The result of the interviews indicated that parents generally lacked the scientific knowledge of feeding and thought that the intake of animal source foods and oils would be a burden to the liver and cause damage to the liver functions. Conclusion: Parents generally lacked science-based feeding knowledge and the feeding practices in 6-24-monthold children diagnosed with chronic cholestatic liver diseases fell short of the recommendations in current nutritional guidelines. Appropriate interventions targeting social and cultural family circumstances should therefore be included in supporting parents in feeding practices to improve children's clinical outcomes.

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The Effect of Nutritional Status on Outcome of Hospitalization in Paediatric Liver Disease Patients

Cited by 8 publications

References 30 publications

Protective effects of specific cannabinoid receptor 2 agonist GW405833 on concanavalin A-induced acute liver injury in mice

Protective effects of specific cannabinoid receptor 2 agonist GW405833 on concanavalin A-induced acute liver injury in mice

Secondary Malnutrition and Nutritional Intervention in Cholestatic Liver Diseases in Infants

Feeding practices in 6–24-month-old children with chronic cholestatic liver diseases: a mixed-method study

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