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Medicina
Special Issues
Mechanisms of Liver Cirrhosis: Identifying New Therapeutic Targets
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Mechanisms of Liver Cirrhosis: Identifying New Therapeutic Targets

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 4277

Special Issue Editors

Dr. Jan Sperl

E-Mail Website
Guest Editor
1. Department of Hepatogastroentrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
2. Department of Medicine of the 1st Faculty of Medicine and Military University Hospital Charles University, Prague, Czech Republic
Interests: chronic hepatitis B; liver transplantation; hepatitis C; liver cirrhosis
Dr. Sona Frankova

E-Mail Website
Co-Guest Editor
Department of Hepatogastroentrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
Interests: hepatitis C; liver transplantation; chronic hepatitis B; liver cirrhosis

Special Issue Information

Dear Colleagues,

Liver cirrhosis is considered to be the terminal stage of chronic liver disease of various etiologies. There are two main therapeutic approaches: the first approach is the causative treatment targeting the underlying liver disease in order to impede progression of liver cirrhosis. The second approach is the treatment and prevention of complications of liver cirrhosis. Both have seen huge progress in the last decade, i.e., antivirals for hepatitis C and hepatitis E, synthetic bile acids for treatment of primary biliary cholangitis or treatment variceal bleeding, and finally, the new concept of acute on chronic liver failure. Early detection of hepatocellular carcinoma is also a topic strongly associated with liver cirrhosis.

The aim of this Special Issue is to attract the authors active both in the field of clinical and laboratory science to show the changing approach to the mechanisms involved in the pathophysiology od liver cirrhosis progression. Cutting-edge research of interest involves genes modifying progression of liver cirrhosis, molecular mechanisms in cholestatic liver diseases, new drugs or bariatric surgery for non-alcoholic steatohepatitis, and severe bacterial infections in liver cirrhosis.

We are seeking research papers, reviews, meta-analysis, and case reports are solicited.

Dr. Jan Sperl
Dr. Sona Frankova
Guest Editors

Manuscript Submission Information

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. Medicina 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 1800 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

  • liver cirrhosis
  • liver fibrosis
  • portal hypertension
  • acute on chronic liver failure
  • hepatocellular carcinoma
  • non-alcoholic steatohepatitis
  • cholestatic liver disease
  • variceal bleeding
  • hepatorenal syndrome

Published Papers (2 papers)

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Research

12 pages, 2004 KiB  
Article
Transient Elastography as the First-Line Assessment of Liver Fibrosis and Its Correlation with Serum Markers
by Nikola Uzlova, Katerina Mnozil Stridova, Dusan Merta, Ivan Rychlik and Sona Frankova
Medicina 2023, 59(4), 752; https://doi.org/10.3390/medicina59040752 - 12 Apr 2023
Viewed by 1460
Abstract
Background and objectives: Recently, rapid progress has been made in the development of noninvasive methods for liver fibrosis assessment. The study aimed to assess the correlation between LSM and serum fibrosis markers to identify patients with advanced liver fibrosis in daily clinical [...] Read more.
Background and objectives: Recently, rapid progress has been made in the development of noninvasive methods for liver fibrosis assessment. The study aimed to assess the correlation between LSM and serum fibrosis markers to identify patients with advanced liver fibrosis in daily clinical practice. Methods: Between 2017 and 2019, 89 patients with chronic liver disease of various etiology, 58 males and 31 females, were enrolled in the study and underwent ultrasound examination, vibration-controlled transient elastography (VCTE), AST to Platelet Ratio Index (APRI score), Fibrosis-4 (FIB-4) score, and enhanced liver fibrosis (ELF) test. Results: The diagnoses were as follows: NAFLD (30.3%), HCV (24.3%), HBV (13.1%), ALD (10.1%), other (7.8%). Their median age was 49 (21–79), and their median BMI was 27.5 (18.4–39.5). The median liver stiffness measurement (LSM) was 6.7 kPa (2.9–54.2 kPa), the median of the ELF test was 9.0 (7.3–12.6), and the median APRI was 0.40 (0.13–3.13). Advanced fibrosis assessed by LSM was present in 18/89 (20.2%) patients. The LSM values correlated with the ELF test results (r2 = 0.31, p < 0.0001), with the APRI score (r2 = 0.23, p < 0.0001), the age of the patients (r2 = 0.14, p < 0.001), and with the FIB-4 values (r2 = 0.58, p < 0.0001). The ELF test values correlated with the APRI score (r2 = 0.14, p = 0.001), the age (r2 = 0.38, p < 0.0001), and the FIB-4 (r2 = 0.34, p < 0.0001). By determining the confidence intervals of the linear model, we proved that patients younger than 38.1 years have a 95% probability of absence of advanced liver fibrosis when assessed by VCTE. Conclusions: We identified APRI and FIB-4 as simple tools for screening liver disease in primary care in an unselected population of patients. The results also showed that individuals younger than 38.1 years had a negligible risk of advanced liver fibrosis. Full article
(This article belongs to the Special Issue Mechanisms of Liver Cirrhosis: Identifying New Therapeutic Targets)
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11 pages, 1537 KiB  
Article
Etiopathogenetic Factors of Hepatocellular Carcinoma, Overall Survival, and Their Evolution over Time—Czech Tertiary Center Overview
by Petr Hříbek, Johana Klasová, Tomáš Tůma, Tomáš Kupsa and Petr Urbánek
Medicina 2022, 58(8), 1099; https://doi.org/10.3390/medicina58081099 - 14 Aug 2022
Cited by 4 | Viewed by 2111
Abstract
Background and Objectives: Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer with a highly unfavorable prognosis. Aims: Retrospective statistical analysis of patients with HCC in the field of liver cirrhosis treated at our center from the perspective [...] Read more.
Background and Objectives: Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer with a highly unfavorable prognosis. Aims: Retrospective statistical analysis of patients with HCC in the field of liver cirrhosis treated at our center from the perspective of demography, and the effects of key changes in diagnostic and therapeutic procedures in the last 10 years on overall survival (OS) and earlier diagnosis. Materials and Methods: This study included 170 cirrhotic patients with HCC (136 men, 80%). Demographic and etiological factors and OS were analyzed based on distribution into three groups according to the period and key changes in diagnostic and therapeutic approaches (BCLC classification staging; standardization of protocol for transarterial chemoembolization (TACE) and the introduction of direct-acting antivirals (DAA) for the treatment of chronic viral hepatitis C (HCV); expansion of systemic oncological therapy). Results: The mean age at the time of diagnosis was 69.3 years (SD = 8.1), and etiology was as follows: non-alcoholic steatohepatitis (NASH) 39%, alcoholic liver disease (ALD) 36%, HCV 18%, cryptogenic liver cirrhosis 3%, chronic hepatitis B infection (HBV) 2%, and other etiology 2%. Distribution of stages according to the BCLC: 0 + A 36%, B 31%, C 22%, and D 11%. However, the distribution in the first studied period was as follows: 0 + A 15%, B 34%, C 36%, and D 15%; and in the last period: 0 + A 45%, B 27%, C 17%, and D 11%, and difference was statistically significant (p < 0.05). The median OS for stages 0 + A, B, C, and D was 58, 19, 6, and 2 months, respectively. During the monitored period, there was a visible increase in the etiology of ALD from 30% to 47% and a decrease in HCV from 22% to 11%. In patients treated with TACE (stage B), the median OS grew from 10 to 24 months (p < 0.0001) between the marginal monitored periods. Conclusions: We described a decreasing number of patients with HCV-related HCC during follow-up possibly linked with the introduction of DAA. In our cohort, an improvement in early-stage diagnosis was found, which we mainly concluded as a result of proper ultrasound surveillance, the institution of a HCV treatment center, and increased experience of our sonographers with an examination of cirrhotic patients. Lastly, we described significantly improved overall survival in patients with intermediate HCC treated by TACE, due to the increased experience of interventional radiologists with the method at our facility and an earlier switch to systemic therapy in case of non-response to TACE. Full article
(This article belongs to the Special Issue Mechanisms of Liver Cirrhosis: Identifying New Therapeutic Targets)
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