Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death

Douglas M. Heuman, Souheil G. Abou‐assi, Adil Habib, Leslie M. Williams, R. Todd Stravitz, Arun J. Sanyal, Robert A. Fisher, Anastasios A. Mihas – 23 February 2009 – Despite the adoption of “sickest first” liver transplantation, pretransplant death remains common, and many early deaths occur despite initially low Model for End‐stage Liver Disease (MELD) scores. From 1997–2003, we studied 507 cirrhotic United States veterans referred for consideration of liver transplantation to identify additional predictors of early mortality.

Peptide antibiotic human beta‐defensin‐1 and ‐2 contribute to antimicrobial defense of the intrahepatic biliary tree

Kenichi Harada, Kazuo Ohba, Satoru Ozaki, Kumiko Isse, Toshiya Hirayama, Akihiro Wada, Yasuni Nakanuma – 23 February 2009 – Human beta‐defensins (hBDs) are important antimicrobial peptides that contribute to innate immunity at mucosal surfaces. This study was undertaken to investigate the expression of hBD‐1 and hBD‐2 in intrahepatic biliary epithelial cells in specimens of human liver, and 4 cultured cell lines (2 consisting of biliary epithelial cells and 2 cholangiocarcinoma cells). In addition, hBD‐1 and hBD‐2 were assayed in specimens of bile.

Interleukin 6 alleviates hepatic steatosis and ischemia/reperfusion injury in mice with fatty liver disease

Feng Hong, Svetlana Radaeva, Hong‐na Pan, Zhigang Tian, Richard Veech, Bin Gao – 23 February 2009 – Fatty liver, formerly associated predominantly with excessive alcohol intake, is now also recognized as a complication of obesity and an important precursor state to more severe forms of liver pathology including ischemia/reperfusion injury. No standard protocol for treating fatty liver exists at this time.

Predicting in‐hospital mortality in patients with cirrhosis: Results differ across risk adjustment methods

Robert P. Myers, Hude Quan, James N. Hubbard, Abdel Aziz M. Shaheen, Gilaad G. Kaplan – 28 January 2009 – Risk‐adjusted health outcomes are often used to measure the quality of hospital care, yet the optimal approach in patients with liver disease is unclear. We sought to determine whether assessments of illness severity, defined as risk for in‐hospital mortality, vary across methods in patients with cirrhosis. We identified 258,731 patients with cirrhosis hospitalized in the Nationwide Inpatient Sample between 2002 and 2005.

Transcription factor 7–like 2 polymorphism modulates glucose and lipid homeostasis, adipokine profile, and hepatocyte apoptosis in NASH

Giovanni Musso, Roberto Gambino, Giovanni Pacini, Gianfranco Pagano, Marilena Durazzo, Maurizio Cassader – 28 January 2009 – Genetic factors underlying the association of NAFLD with diabetes and atherosclerosis are unknown. Recent human studies suggest transcription factor 7–like 2 (TCF7L2) polymorphism predisposes to diabetes through modulation of β‐cell function and modulates lipid levels in familial dyslipidemia. Emerging experimental evidence connects TCF7L2 to adipocyte metabolism and lipid homeostasis, as well.

Missense mutations and single nucleotide polymorphisms in ABCB11 impair bile salt export pump processing and function or disrupt pre‐messenger RNA splicing

Jane A. Byrne, Sandra S. Strautnieks, Gudrun Ihrke, Franco Pagani, A.S. Knisely, Kenneth J. Linton, Giorgina Mieli‐Vergani, Richard J. Thompson – 28 January 2009 – The gene encoding the human bile salt export pump (BSEP), ABCB11, is mutated in several forms of intrahepatic cholestasis. Here we classified the majority (63) of known ABCB11 missense mutations and 21 single‐nucleotide polymorphisms (SNPs) to determine whether they caused abnormal ABCB11 pre‐messenger RNA splicing, abnormal processing of BSEP protein, or alterations in BSEP protein function.

Reduction of hepatic steatosis in rats and mice after treatment with a liver‐targeted thyroid hormone receptor agonist

Edward E. Cable, Patricia D. Finn, Jeffrey W. Stebbins, Jinzhao Hou, Bruce R. Ito, Paul D. van Poelje, David L. Linemeyer, Mark D. Erion – 28 January 2009 – Non‐alcoholic fatty liver disease (NAFLD) is one of the most common forms of chronic liver disease, with a prevalence ranging from 10% to 30%. The use of thyroid hormone receptor (TR) agonists for the treatment of NAFLD has not been considered viable because thyroid hormones increase free fatty acid (FFA) flux from the periphery to the liver, induce hepatic lipogenesis, and therefore could potentially cause steatosis.

Using an immune functional assay to differentiate acute cellular rejection from recurrent hepatitis C in liver transplant patients

Roniel Cabrera, Miguel Ararat, Consuelo Soldevila‐Pico, Lisa Dixon, Jen‐Jung Pan, Roberto Firpi, Victor Machicao, Cynthia Levy, David Nelson, Giuseppe Morelli – 28 January 2009 – In transplant recipients transplanted for hepatitis C, presentation of abnormal transaminases can herald the presentation of recurrent hepatitis C, cellular rejection, or both. Given the sometimes ambiguous histology with these 2 entities, the ability to distinguish them is of great importance because misinterpretation can potentially affect graft survival.

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