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Biomedicines
Special Issues
Liver Disease and Therapy
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Liver Disease and Therapy

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 15995

Special Issue Editor

Prof. Dr. Nahum Mendez-Sanchez

E-Mail Website
Guest Editor
1. Fundación Clínica Médica Sur, Ciudad de México, México
2. Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
Interests: nonalcoholic steatohepatitis; hepatitis C; cholestasis; liver disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

According to the global health estimates from 2015 of the World Health Organization, around 1.2 million people worldwide die each year from liver cirrhosis and subsequent complications, while 800,000 die of hepatocellular carcinoma, comprising 3.5% of all deaths worldwide. It has also been suggested that about 296 million people around the world were living with chronic hepatitis B infection in 2019, with 1.5 million new infections each year. On the other hand, the availability of direct-acting antivirals to treat chronic hepatitis C virus infection has significantly decreased the incidence rate of cirrhosis due to HCV, and therapy has changed the distribution of cirrhosis etiologies. In addition, metabolic dysfunction-associated fatty liver disease is the most common liver disease worldwide, affecting a quarter of the global population, and is often associated with adverse health outcomes. Importantly, alcohol-related liver diseases have remained as the major etiology of liver diseases in some European countries for decades. These data emphasize the importance of establishing an adequate standard of care, with the consideration of cirrhosis as a major comorbidity. Patients with cirrhosis who experience hepatic decompensation, such as with the development of portal hypertension, ascites, hepatic encephalopathy, portal vein thrombosis, hepatorenal syndrome, and spontaneous bacterial peritonitis, have a higher mortality risk. Management should be focused on the prevention of the recurrence of complications, some of which now involve specific treatment. Therefore, the aim of this Special Issue is to review the current novel treatments for liver disease.

Prof. Dr. Nahum Mendez-Sanchez
Guest Editor

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Keywords

  • liver cirrhosis
  • viral hepatitis B and C
  • MAFLD
  • alcoholic liver disease
  • cholestasis and autoimmune liver disease

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Published Papers (3 papers)

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Review

18 pages, 1425 KiB  
Review
Current Therapies for Cholestatic Diseases
by Nahum Méndez-Sánchez, Carlos E. Coronel-Castillo and Ana L. Ordoñez-Vázquez
Biomedicines 2023, 11(6), 1713; https://doi.org/10.3390/biomedicines11061713 - 15 Jun 2023
Cited by 3 | Viewed by 1935
Abstract
Cholestasis is a condition characterized by decrease in bile flow due to progressive pathological states that lead to chronic cholestatic liver diseases which affect the biliary tree at the intrahepatic level and extrahepatic level. They induce complications such as cirrhosis, liver failure, malignancies, [...] Read more.
Cholestasis is a condition characterized by decrease in bile flow due to progressive pathological states that lead to chronic cholestatic liver diseases which affect the biliary tree at the intrahepatic level and extrahepatic level. They induce complications such as cirrhosis, liver failure, malignancies, bone disease and nutritional deficiencies that merit close follow-up and specific interventions. Furthermore, as those conditions progress to liver cirrhosis, there will be an increase in mortality but also an important impact in quality of life and economic burden due to comorbidities related with liver failure. Therefore, it is important that clinicians understand the treatment options for cholestatic liver diseases. With a general view of therapeutic options and their molecular targets, this review addresses the pathophysiology of cholangiopathies. The objective is to provide clinicians with an overview of the safety and efficacy of the treatment of cholangiopathies based on the current evidence. Full article
(This article belongs to the Special Issue Liver Disease and Therapy)
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19 pages, 2059 KiB  
Review
Patient Blood Management in Liver Transplant—A Concise Review
by Angel Augusto Pérez-Calatayud, Axel Hofmann, Antonio Pérez-Ferrer, Carla Escorza-Molina, Bettina Torres-Pérez, Jed Raful Zaccarias-Ezzat, Aczel Sanchez-Cedillo, Victor Manuel Paez-Zayas, Raul Carrillo-Esper and Klaus Görlinger
Biomedicines 2023, 11(4), 1093; https://doi.org/10.3390/biomedicines11041093 - 4 Apr 2023
Cited by 5 | Viewed by 7557
Abstract
Transfusion of blood products in orthotopic liver transplantation (OLT) significantly increases post-transplant morbidity and mortality and is associated with reduced graft survival. Based on these results, an active effort to prevent and minimize blood transfusion is required. Patient blood management is a revolutionary [...] Read more.
Transfusion of blood products in orthotopic liver transplantation (OLT) significantly increases post-transplant morbidity and mortality and is associated with reduced graft survival. Based on these results, an active effort to prevent and minimize blood transfusion is required. Patient blood management is a revolutionary approach defined as a patient-centered, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient’s own blood while promoting patient safety and empowerment. This approach is based on three pillars of treatment: (1) detecting and correcting anemia and thrombocytopenia, (2) minimizing iatrogenic blood loss, detecting, and correcting coagulopathy, and (3) harnessing and increasing anemia tolerance. This review emphasizes the importance of the three-pillar nine-field matrix of patient blood management to improve patient outcomes in liver transplant recipients. Full article
(This article belongs to the Special Issue Liver Disease and Therapy)
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26 pages, 641 KiB  
Review
Treatment of Drug-Induced Liver Injury
by Rolf Teschke
Biomedicines 2023, 11(1), 15; https://doi.org/10.3390/biomedicines11010015 - 21 Dec 2022
Cited by 17 | Viewed by 5756
Abstract
Current pharmacotherapy options of drug-induced liver injury (DILI) remain under discussion and are now evaluated in this analysis. Needless to say, the use of the offending drug must be stopped as soon as DILI is suspected. Normal dosed drugs may cause idiosyncratic DILI, [...] Read more.
Current pharmacotherapy options of drug-induced liver injury (DILI) remain under discussion and are now evaluated in this analysis. Needless to say, the use of the offending drug must be stopped as soon as DILI is suspected. Normal dosed drugs may cause idiosyncratic DILI, and drugs taken in overdose commonly lead to intrinsic DILI. Empirically used but not substantiated regarding efficiency by randomized controlled trials (RCTs) is the intravenous antidote treatment with N-acetylcysteine (NAC) in patients with intrinsic DILI by N-acetyl-p-aminophenol (APAP) overdose. Good data recommending pharmacotherapy in idiosyncratic DILI caused by hundreds of different drugs are lacking. Indeed, a recent analysis revealed that just eight RCTs have been published, and in only two out of eight trials were DILI cases evaluated for causality by the worldwide used Roussel Uclaf Causality Assessment Method (RUCAM), representing overall a significant methodology flaw, as results of DILI RCTs lacking RUCAM are misleading since many DILI cases are known to be attributable erroneously to nondrug alternative causes. In line with these major shortcomings and mostly based on anecdotal reports, glucocorticoids (GCs) and other immuno-suppressants may be given empirically in carefully selected patients with idiosyncratic DILI exhibiting autoimmune features or caused by immune checkpoint inhibitors (ICIs), while some patients with cholestatic DILI may benefit from ursodeoxycholic acid use; in other patients with drug-induced hepatic sinusoidal obstruction syndrome (HSOS) and coagulopathy risks, the indication for anticoagulants should be considered. In view of many other mechanistic factors such as the hepatic microsomal cytochrome P450 with a generation of reactive oxygen species (ROS), ferroptosis with toxicity of intracellular iron, and modification of the gut microbiome, additional therapy options may be available in the future. In summation, stopping the offending drug is still the first line of therapy for most instances of acute DILI, while various therapies are applied empirically and not based on good data from RCTs awaiting further trials using the updated RUCAM that asks for strict exclusion and inclusion details like liver injury criteria and provides valid causality rankings of probable and highly probable grades. Full article
(This article belongs to the Special Issue Liver Disease and Therapy)
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