Treatment and Prevention of Acute Hepatitis B Virus

Dekker, Simone E.; Green, Ellen W.; Ahn, Joseph

doi:10.1016/j.cld.2021.06.002

Cited by 15 publications

(17 citation statements)

References 44 publications

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“…However, early intervention of appropriate treatment based on an accurate diagnosis of etiology is thought to be a possible cause. Since prednisolone for AIH and nucleotide analogs for HBV infection are well‐documented as specific effective therapies for the indicated diseases, early intervention by these treatments will prevent disease progression and decrease the proportion of HE development 21–23 . Our previous study revealed that AIH, acute HBV infection, and oral transmitted viral hepatitis were identified as good prognostic factors in patients with ALI, whereas idiosyncratic DILI and HBV flare‐up were identified as poor prognostic etiologies 24 .…”

Section: Discussionmentioning

confidence: 99%

“…Since prednisolone for AIH and nucleotide analogs for HBV infection are well-documented as specific effective therapies for the indicated diseases, early intervention by these treatments will prevent disease progression and decrease the proportion of HE development. [21][22][23] Our previous study revealed that AIH, acute HBV infection, and oral transmitted viral hepatitis were identified as good prognostic factors in patients with ALI, whereas idiosyncratic DILI and HBV flare-up were identified as poor prognostic etiologies. 24 Therefore, the referral system could provide an opportunity to treat patients by appropriate medication as far as ALI has been accurately diagnosed using the ALI etiology.…”

Section: Relation Of Probability Of He Development By the Rjhep Model...mentioning

confidence: 99%

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Referral system has a diminished difference in the risk for hepatic encephalopathy development among each etiology in patients with acute liver injury

Kakisaka

Suzuki

Takahashi

et al. 2022

Hepatology Research

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Aim: Hepatic encephalopathy (HE) development is crucial in liver transplantation for patients with acute liver injury (ALI) and failure (ALF); to predict HE development, the Japan Hepatic Encephalopathy Prediction (JHEP) model, calculated using age, etiology, prothrombin time (PT), and total bilirubin, was established in 2004, and a referral system to the liver center was implemented using the JHEP model from April 2004. Methods:The JHEP model's ability to predict HE development in 460 consecutive patients with ALI between April 2004 and January 2021 using data from the referral system was evaluated, and the JHEP model was revised.Results: During the observation period, 7.8% patients developed HE. There was no difference in the proportion of HE development among the etiologies. In the Hosmer-Lemeshow test for HE development prediction, the JHEP model, revised JHEP (rJHEP) model, which was calculated without etiology data, and the modified JHEP model, which used the PT international ratio instead of PT in the rJHEP model, were good fitting models. Upon 30% random sampling from the total patients 60 times, the receiver operating curve analysis of both JHEP and rJHEP models for HE development was performed in all the datasets. The area under the curve of the JHEP model was subtracted from that of the rJHEP model (95% confidential interval, 0.000516-0.01793). Conclusions:The referral system using the JHEP model reduced the difference in the risk for HE development among each etiology; the rJHEP model had a better prediction ability for HE development than the JHEP model.

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Section: Discussionmentioning

confidence: 99%

Section: Relation Of Probability Of He Development By the Rjhep Model...mentioning

confidence: 99%

Referral system has a diminished difference in the risk for hepatic encephalopathy development among each etiology in patients with acute liver injury

Kakisaka

Suzuki

Takahashi

et al. 2022

Hepatology Research

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“…Hepatitis B and C viruses belong to hepatotropic viruses, which can infect hepatocytes and are the main types of viruses that cause AVH in clinical practice [ 104 ]. Symptoms of acute hepatitis C virus (HCV) infection are usually subclinical, whereas acute hepatitis B virus (HBV) infection tends to result in symptomatic hepatitis in adults, with patients' clinical presentation ranging from asymptomatic to fulminant liver failure [ 105 , 106 ]. Data show that 23.1% of patients with acute viral hepatitis B-related acute liver failure eventually die [ 107 ].…”

Section: Imbalance Of Liver Immune Microenvironment and Liver Diseasesmentioning

confidence: 99%

Mesenchymal stem cells-based therapy in liver diseases

Han

Jin

2022

Mol Biomed

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Multiple immune cells and their products in the liver together form a complex and unique immune microenvironment, and preclinical models have demonstrated the importance of imbalances in the hepatic immune microenvironment in liver inflammatory diseases and immunocompromised liver diseases. Various immunotherapies have been attempted to modulate the hepatic immune microenvironment for the purpose of treating liver diseases. Mesenchymal stem cells (MSCs) have a comprehensive and plastic immunomodulatory capacity. On the one hand, they have been tried for the treatment of inflammatory liver diseases because of their excellent immunosuppressive capacity; On the other hand, MSCs have immune-enhancing properties in immunocompromised settings and can be modified into cellular carriers for targeted transport of immune enhancers by genetic modification, physical and chemical loading, and thus they are also used in the treatment of immunocompromised liver diseases such as chronic viral infections and hepatocellular carcinoma. In this review, we discuss the immunological basis and recent strategies of MSCs for the treatment of the aforementioned liver diseases. Specifically, we update the immune microenvironment of the liver and summarize the distinct mechanisms of immune microenvironment imbalance in inflammatory diseases and immunocompromised liver diseases, and how MSCs can fully exploit their immunotherapeutic role in liver diseases with both immune imbalance patterns.

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“…Another example of infection-associated immunity leading to a deleterious (potentially fatal) immune-mediated outcome for the host is fulminant liver failure that occurs in a minority of human patients with acute hepatitis B infection. While most infected individuals develop jaundice, have elevated circulating liver transaminase levels but survive the infection, 5–10% raise a CTL-mediated immune response that is so rapid that it results in virtually total loss of hepatocyte mass, leading to acute liver failure . In a “proof-of-concept” study using a novel perforin inhibitor in a recognized mouse model of the disease, it has been shown that partial (50–70%) inhibition of perforin for just 1–2 days could attenuate the effector T cell response to greatly reduce liver damage and resultant mortality .…”

Section: The Role Of Perforin In Inflammatory Diseasesmentioning

confidence: 99%

“…Conversely, blocking the death of sinusoidal endothelial cells by perforin inhibition restored blood vessel integrity and attenuated the death of hepatocytes. Histologically, this was demonstrated by orderly CD31 staining restored in the sinusoidal channels in the livers of perforin inhibitor treated mice …”

Section: Activity Of Perforin Inhibitors In Vivomentioning

confidence: 99%

Small Molecule Inhibitors of Lymphocyte Perforin as Focused Immunosuppressants for Infection and Autoimmunity

et al. 2022

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New drugs that precisely target the immune mechanisms critical for cytotoxic T lymphocyte (CTL) and natural killer (NK) cell driven pathologies are desperately needed. In this perspective, we explore the cytolytic protein perforin as a target for therapeutic intervention. Perforin plays an indispensable role in CTL/NK killing and controls a range of immune pathologies, while being encoded by a single copy gene with no redundancy of function. An immunosuppressant targeting this protein would provide the first-ever therapy focused specifically on one of the principal cell death pathways contributing to allotransplant rejection and underpinning multiple autoimmune and postinfectious diseases. No drugs that selectively block perforin-dependent cell death are currently in clinical use, so this perspective will review published novel small molecule inhibitors, concluding with in vivo proof-of-concept experiments performed in mouse models of perforin-mediated immune pathologies that provide a potential pathway toward a clinically useful therapeutic agent.

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Treatment and Prevention of Acute Hepatitis B Virus

Cited by 15 publications

References 44 publications

Referral system has a diminished difference in the risk for hepatic encephalopathy development among each etiology in patients with acute liver injury

Referral system has a diminished difference in the risk for hepatic encephalopathy development among each etiology in patients with acute liver injury

Mesenchymal stem cells-based therapy in liver diseases

Small Molecule Inhibitors of Lymphocyte Perforin as Focused Immunosuppressants for Infection and Autoimmunity

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