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Recent Advances in the Diagnosis and Treatment of Liver Disease

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A special issue of Biology (ISSN 2079-7737). This special issue belongs to the section "Medical Biology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 12514

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Special Issue Editors

Dr. Hiroaki Takaya

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Guest Editor

Department of Gastroenterology, Nara Medical University, Kashihara 634-8522, Nara, Japan
Interests: gastroenterology; liver cirrhosis; acute liver failure; hepatocellular carcinoma, ADAMTS13, von Willebrand factor
Special Issues, Collections and Topics in MDPI journals

Dr. Tadashi Namisaki

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Co-Guest Editor

Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan
Interests: liver fibrosis; diabetes mellitus; inflammation; steatosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Recently, the diagnosis and treatment of liver diseases, such as viral hepatitis, liver cirrhosis, and liver cancer, has been subject to considerable progress. However, diagnostic and treatment methods are still inadequate, and liver diseases represent a major cause of death. Further progress in the diagnosis and treatment of liver diseases is needed in order to reduce the number of deaths from liver diseases. We believe that further research on liver diseases will lead to new insights on this fascinating topic. It has recently been reported that sarcopenia, gut–liver axis, and blood coagulation are related to the pathophysiology of liver diseases, which may also prove useful for the diagnosis and treatment of liver diseases.

This Special Issue, titled "Recent Advances in the Diagnosis and Treatment of Liver Disease", welcomes a wide range of papers on basic research, clinical research, and review articles. We look forward to receiving high-quality papers from pertinent researchers.

Prof. Dr. Hiroaki Takaya
Dr. Tadashi Namisaki
Guest Editors

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

viral hepatitis
alcoholoc hepatitis
non-alcoholic steatohepatitis
autoimmune hepatitis
primary biliary cholangitis
liver cirrhosis
liver cancer

Published Papers (7 papers)

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Research

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11 pages, 1138 KiB

Open AccessArticle

Applicability of International Autoimmune Hepatitis Group (IAIHG) Scoring System for Autoimmune Hepatitis in Pediatrics

by Vorada Sakulsaengprapha, Paul Wasuwanich, Gayathri Naraparaju, Yelena Korotkaya, Supharerk Thawillarp, Kiyoko Oshima, Christine Karwowski, Ann O. Scheimann and Wikrom Karnsakul

Biology 2023, 12(3), 479; https://doi.org/10.3390/biology12030479 - 21 Mar 2023

Cited by 3 | Viewed by 1441 | Correction

Abstract

Introduction: Many hepatologic pathologies mimic autoimmune hepatitis (AIH). Researchers developed the International Autoimmune Hepatitis Group (IAIHG) scoring system to compensate for the lack of specific diagnostic tests for AIH. The scoring system was not designed with pediatric patients in mind, so there are limits to its pediatric use. Additionally, there is limited information on the value of a liver biopsy in conjunction with its use. Methods: In this retrospective study, we evaluated the effect of liver biopsy scores on the IAIHG scoring system in patients that were 0–18 years old with suspected AIH. We also analyzed demographic data and laboratory values associated with a final AIH diagnosis. Results: We found that interface hepatitis and predominant plasma cells found during the biopsy were significantly associated with a final AIH diagnosis. We also found that abnormal laboratory values were associated with an AIH diagnosis. We found that IAIHG scores calculated post-liver biopsy showed a greater area under the receiver operating characteristic curve (AUROC) of 0.95, which was compared to 0.88 for the scores calculated before a liver biopsy. Including biopsy metrics lowered the optimized cutoff score and test specificity. Conclusion: Incorporating liver histopathological features improved the performance of the IAIHG scoring system. Further studies to identify other potential elements in liver histology may improve the performance metrics of the IAIHG test in the pediatric population. Full article

(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Liver Disease)

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12 pages, 2785 KiB

Open AccessArticle

Reliability of Stereotactic Radiofrequency Ablation (SRFA) for Malignant Liver Tumors: Novice versus Experienced Operators

by Peter Schullian, Gregor Laimer, Edward Johnston, Daniel Putzer, Gernot Eberle, Gerlig Widmann, Yannick Scharll and Reto Bale

Biology 2023, 12(2), 175; https://doi.org/10.3390/biology12020175 - 22 Jan 2023

Cited by 2 | Viewed by 1638

Abstract

Purpose: To compare the results of a novice with those of experienced interventional radiologists (IRs) for stereotactic radiofrequency ablation (SRFA) of malignant liver tumors in terms of safety, technical success, and local tumor control. Methods: A database, including all SRFA procedures performed in a single center between January 2011 and December 2018 was retrospectively analyzed. A total of 39 ablation sessions performed by a novice IR were compared to the results of three more experienced IRs. Comparative SRFA sessions were selected using propensity score matching considering tumor type, age, sex, tumor size, and tumor number as matching variables. Overall, 549 target tumors were treated in 273 sessions. Median tumor size was 2.2 cm (1.0–8.5 cm) for 178 hepatocellular carcinomas (HCCs) and 3.0 cm (0.5–13.0 cm) for 371 metastases. A median of 2 (1–11) tumors were treated per session. Results: No significant differences were observed when comparing the results of more experienced IRs with those of a novice IR regarding the rates of major complications (6.8% [16/234] vs. 5.1% [2/39]; p = 0.477), mortality (1.3% [2/234] vs. 0% [0/39]; p = 0.690), primary technical efficacy (98.5% [525/533] vs. 98.9% [94/95]; p = 0.735), and local recurrence (5.6% [30/533] vs. 5.3% [5/95]; p = 0.886). However, the median planning/placement time was significantly shorter for the experienced IRs (92 min vs. 119 min; p = 0.002). Conclusions: SRFA is a safe, effective, and reliable treatment option for malignant liver tumors and favorable outcomes can be achieved even by inexperienced operators with minimal supervision. Full article

(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Liver Disease)

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12 pages, 2302 KiB

Open AccessArticle

The Ratio of von Willebrand Factor Antigen to ADAMTS13 Activity: Usefulness as a Prognostic Biomarker in Acute-on-Chronic Liver Failure

by Hiroaki Takaya, Tadashi Namisaki, Masahide Enomoto, Takahiro Kubo, Yuki Tsuji, Yukihisa Fujinaga, Norihisa Nishimura, Kosuke Kaji, Hideto Kawaratani, Kei Moriya, Takemi Akahane, Masanori Matsumoto and Hitoshi Yoshiji

Biology 2023, 12(2), 164; https://doi.org/10.3390/biology12020164 - 20 Jan 2023

Cited by 4 | Viewed by 1477

Abstract

Acute-on-chronic liver failure (ACLF) has a high risk of short-term mortality. A disintegrin-like and metalloproteinase with thrombospondin type-1 motifs 13 (ADAMTS13) is a metalloproteinase that specifically cleaves multimeric von Willebrand factor (VWF). Imbalance between ADAMTS13 and VWF is associated with portal hypertension, which induces ACLF development. A previous study reported that ADAMTS13 activity (ADAMTS13:AC) and VWF antigen (VWF:Ag) are predictive biomarkers of ACLF development in patients with cirrhosis. This study investigated the changes in ADAMTS13:AC and VWF:Ag levels from before to after the development of ACLF to determine their usefulness as a prognostic biomarker in patients with ACLF. In total, 101 patients with cirrhosis were enrolled in this study. The level of ADAMTS13:AC and VWF:Ag was determined by an enzyme-linked immunosorbent assay. Cox proportional hazard regression analysis was conducted to determine independent prognostic factors for patients with liver cirrhosis in the post-ACLF group. ADAMTS13:AC levels gradually decreased in the order of non-ACLF group, pre-ACLF group, and finally post-ACLF group. VWF:Ag and the ratio of VWF:Ag to ADAMTS13:AC (VWF:Ag/ADAMTS13:AC) levels gradually increased in the order of non-ACLF group, pre-ACLF group, followed by post-ACLF group. VWF:Ag/ADAMTS13:AC and CLIF-C ACLF scores were associated with prognosis in the post-ACLF group in multivariate analysis. The cumulative survival of the post-ACLF group was significantly lower for patients with high VWF:Ag/ADAMTS13:AC (>9) compared with those with low VWF:Ag/ADAMTS13:AC (≤9) (HR: 10.72, 95% confidence interval: 1.39–82.78, p < 0.05). The VWF:Ag/ADAMTS13:AC increased according to the progression of ACLF in patients with cirrhosis and predicted prognosis in patients with cirrhosis with ACLF. Full article

(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Liver Disease)

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11 pages, 918 KiB

Open AccessArticle

Liver Graft MicroRNAs Expression in Different Etiology of Acute Jaundice after Living Donor Liver Transplantation

by Shu-Hsien Lin, Kun-Ta Wu, Chih-Chi Wang, Kuang-Tzu Huang, Kuang-Den Chen, Li-Wen Hsu, Hock-Liew Eng and King-Wah Chiu

Biology 2022, 11(8), 1228; https://doi.org/10.3390/biology11081228 - 17 Aug 2022

Cited by 2 | Viewed by 1326

Abstract

Background: Acute jaundice remains a critical problem following liver transplantation. MicroRNAs (miRNAs) are involved in regulating gene expression related to various disease phenotypes and statuses. Aims: To differentiate acute jaundice etiology after living donor liver transplantation (LDLT), we examined the hepatic miRNA expression patterns in several liver graft pathologies. Methods: Eighty liver transplant recipients undergoing post-LDLT graft biopsy for the evaluation of acute jaundice were enrolled in this 1-year prospective study. Using a real-time quantitative reverse transcription-polymerase chain reaction profiling assay, we identified hepatic miRNA (miRNA-122, miRNA-301, miRNA-133a, and miRNA-21) signatures in various allografts pathologies. Results: Pathologic findings of the 80 recipients were as follows: acute cholangitis (AC), 37 (46%); acute rejection (AR), 20 (25%); recurrent hepatitis (RH), 12 (15%); non-specific pathological change, 6 (8%); and fatty change (FC), 5 (6%). None of these identified hepatic miRNAs expression pattern was significantly correlated with serum parameters, including neutrophil-lymphocyte ratio. In AC, hepatic miRNA-122, miRNA-301, miRNA-133a, and miRNA-21 expression was significantly downregulated (p < 0.05). MicroRNA-122 expression was elevated in cases of AR and RH (p < 0.05); miRNA-301 and miRNA-21 expression was higher in RH than in AC (p < 0.05); and miRNA-133a expression was higher in FC than in AR (p < 0.05). Conclusions: Our study suggests that specific hepatic miRNA expression patterns as a checklist may be useful for differential diagnosis of acute jaundice following liver transplantation. Full article

(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Liver Disease)

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Review

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13 pages, 1945 KiB

Open AccessReview

Recent Advances in Image-Guided Locoregional Therapies for Primary Liver Tumors

by Cody R. Criss and Mina S. Makary

Biology 2023, 12(7), 999; https://doi.org/10.3390/biology12070999 - 13 Jul 2023

Cited by 3 | Viewed by 1903

Abstract

Primary liver cancer is the leading cause of cancer-related deaths worldwide. with incidences predicted to rise over the next several decades. Locoregional therapies, such as radiofrequency or microwave ablation, are described as image-guided percutaneous procedures, which offer either a curative intent for early-stage hepatocellular carcinoma or bridging/downstaging for surgical resection or transplantation. Catheter-driven locoregional therapies, such as transarterial chemoembolization and radioembolization, induce tumor hypoxia, can be palliative, and improve survival for early-to-intermediate hepatocellular carcinoma and unresectable intrahepatic cholangiocarcinoma. Herein, we provide a comprehensive overview of the antineoplastic mechanisms underpinning locoregional therapies, different treatment approaches, and the current state of the literature for the efficacy of locoregional therapies for primary liver cancer. We also discuss emerging advancements, such as the adjuvant use of immunotherapies and molecular targeting agents with locoregional therapy, for the treatment of primary liver cancer. Full article

(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Liver Disease)

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Graphical abstract

12 pages, 781 KiB

Open AccessReview

Cholestatic Pruritus in Children: Conventional Therapies and Beyond

by Minna Rodrigo, Xinzhong Dong, Daphne Chien and Wikrom Karnsakul

Biology 2023, 12(5), 756; https://doi.org/10.3390/biology12050756 - 22 May 2023

Viewed by 2919

Abstract

Pruritus in the setting of cholestatic liver disease is difficult to treat and occurs in patients ranging in age from infancy to adulthood. Likely multifactorial in etiology, this symptom often involves multimodal therapy targeting several pathways and mechanisms proposed in the underlying etiology of cholestatic pruritus. Many patients in both the pediatric and adult populations continue to experience unrelenting pruritus despite maximal conventional therapy. Options are further limited in treating pediatric patients due to sparse data regarding medication safety and efficacy in younger patients. Conventional therapies for the treatment of cholestatic pruritus in children include ursodeoxycholic acid, cholestyramine, hydroxyzine, and rifampin. Certain therapies are more routinely used in the adult populations but with limited data available for use in child and adolescent patients, including opioid antagonists and selective serotonin reuptake inhibitors. Recently, ileal bile acid transport inhibitors have been shown to alleviate pruritus in many children with Alagille syndrome and progressive familial intrahepatic cholestasis and is an additional therapy available for consideration for these patients. Ultimately, surgical options such as biliary diversion or liver transplantation are considered in specific circumstances when medical therapies have been exhausted and pruritus remains debilitating. While further investigation regarding underlying etiologies and effective therapies are needed to better understand itch pathogenesis and treatment in pediatric cholestasis, current considerations beyond conventional management include the use of opioid antagonists, selective serotonin reuptake inhibitors, ileal bile acid transport inhibitors, and surgical intervention. Full article

(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Liver Disease)

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