Cholestasis, an impairment of bile outflux, frequently occurs in liver diseases. In this process, an overaccumulation of bile acids causes hepatocyte necrosis and apoptosis, leading to advanced hepatitis. Hepatocyte growth factor (HGF) is mitogenic toward hepatocytes, but it is still unclear whether HGF has physiological and therapeutic functions during the progression of cholestasis. Using anti-HGF IgG or recombinant HGF in mice that had undergone bile duct ligation (BDL), we investigated the involvement of HGF in cholestasis-induced hepatitis. After the BDL surgery, HGF and c-Met mRNA levels transiently increased in livers during the progression of cholestatic hepatitis. When c-Met tyrosine phosphorylation was blocked in the livers of BDL-treated mice by anti-HGF IgG, hepatic dysfunction became evident, associated with the acceleration of hepatocyte necrosis and apoptosis. Inversely, administration of recombinant HGF into the mice led to the prevention of cholestasis-induced inflammation: HGF suppressed the hepatic expression of intracellular adhesion molecule-1 and neutrophil infiltration in BDL-treated mice. As a result, parenchymal necrosis was suppressed in the HGF-injected BDL mice. In addition, HGF supplement therapy reduced the number of apoptotic hepatocytes in cholestatic mice, associated with the early induction of Bcl-xL. The administration of HGF enhanced hepatic repair, via accelerating G1/S progression in hepatocytes. Our study showed that 1) upregulation of HGF production is required for protective mechanisms against cholestatic hepatitis and 2) enhancement of the intrinsic defense system by adding HGF may be a reasonable strategy to attenuate hepatic inflammation, necrosis, and apoptosis under bile-congestive conditions.
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http://dx.doi.org/10.1152/ajpgi.00292.2006 | DOI Listing |
J Pediatr Gastroenterol Nutr
December 2024
Meyer Children's Hospital IRCCS, Florence, Italy.
Objective: We aimed to provide an evidence-supported approach to diagnose, monitor, and treat children with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC).
Methods: The core group formulated seven PICO-structured clinical questions. A systematic literature search from inception to December 2022 was conducted by a medical librarian using MEDLINE and EMBASE.
Mymensingh Med J
January 2025
Dr Subir Ananda Biswas, Resident, Department of Paediatric Gastroenterology & Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Cholestatic jaundice is a potentially serious condition that requires early diagnosis for proper management. Fat-soluble vitamin (FSV) deficiency develops as a consequence of cholestasis. Vitamin D deficiency is common and remains a challenge in patients with cholestasis.
View Article and Find Full Text PDFJ Hand Surg Glob Online
November 2024
Department of Orthopaedic Surgery, University of Massachusetts Chan Medical School, Worcester, MA.
In this case report, we present a novel occurrence of acute hepatitis 2 weeks after local bupivacaine injection for wide awake, local anesthesia, no tourniquet carpal tunnel release. Laboratory and biopsy analysis confirmed cholestatic, drug-induced hepatitis that was successfully managed with conservative treatment. With a paucity of potential bupivacaine-induced hepatitis cases reported within the literature, the importance of broad differential diagnosis, meticulous medication reconciliation, and consideration of this rare complication should not be understated by the astute hand surgeon.
View Article and Find Full Text PDFCureus
November 2024
Department of Gastroenterology, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, IND.
A 12-year-old female, resident of western India, presented with a history of pruritus associated with jaundice for two months. On presentation, she had icterus with mild palpable hepatomegaly. Investigations revealed direct hyperbilirubinemia and elevated transaminases, while gamma-glutamyl transferase levels were normal.
View Article and Find Full Text PDFCureus
November 2024
Internal Medicine, MedStar Franklin Square Medical Center, Baltimore, USA.
Drug-induced liver injury (DILI) presents significant diagnostic challenges, particularly in patients with multiple comorbidities. We report a case involving a 72-year-old female treated with cefepime for urosepsis, who developed markedly elevated liver enzymes after two weeks of therapy. After excluding other potential causes, including viral hepatitis, ischemia, and autoimmune hepatitis, cefepime-induced mixed pattern liver injury was determined to be the likely etiology of the elevated liver enzymes.
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