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[Immunohistochemical studies on the occurrence of HBs antigen in alcoholic fatty liver and alcoholic fatty liver hepatitis].

120 liver biopsies of alcoholic fatty liver, alcoholic hepatitis and cirrhosis were studied immunohistochemically with regard to the occurrence of HBs-antigen. In no instance HBs-antigen was detected. These findings suggest neither a major influence of hepatitis B-virus on the progression of alcoholic liver cell damage nor a defect in immunologic responsiveness to hepatitis B-virus component in the alcoholic.

Adult↗

The transcriptional and DNA binding activity of peroxisome proliferator-activated receptor alpha is inhibited by ethanol metabolism. A novel mechanism for the development of ethanol-induced fatty liver.

Fatty acids are ligands for the peroxisome proliferator-activated receptor alpha (PPAR alpha). Fatty acid levels are increased in liver during the metabolism of ethanol and might be expected to activate PPAR alpha. However, ethanol inhibited PPAR alpha activation of a reporter gene in H4IIEC3 hepatoma cells expressing alcohol-metabolizing enzymes but not in CV-1 cells, which lack these enzymes. Ethanol also reduced the ability of the PPAR alpha ligand WY14,643 to activate reporter constructs in the hepatoma cells or cultured rat hepatocytes. This effect of ethanol was abolished by the alcohol dehydrogenase inhibitor 4-methylpyrazole and augmented by the aldehyde dehydrogenase inhibitor cyanamide, indicating that acetaldehyde was responsible for the action of ethanol. PPAR alpha/retinoid X receptor extracted from hepatoma cells exposed to ethanol or acetaldehyde bound poorly to an oligonucleotide containing peroxisome proliferator response elements. This effect was also blocked by 4-methylpyrazole and augmented by cyanamide. Furthermore, in vitro translated PPAR alpha exposed to acetaldehyde failed to bind DNA. Thus, ethanol metabolism blocks transcriptional activation by PPAR alpha, in part due to impairment of its ability to bind DNA. This effect of ethanol may promote the development of alcoholic fatty liver and other hepatic consequences of alcohol abuse.

Acetaldehyde↗

The visibly fatty liver.

Fatty infiltration of the liver has been identified roentgenographically in several young children. Awareness of this possibility will sometimes allow a radiologist to contribute to the understanding of the patient's metabolic and nutritional state. If a child's liver is shown to be abnormally radiolucent, cystic fibrosis should be considered.

Child, Preschool↗

Role of scintigraphy in focally abnormal sonograms of fatty livers.

Fatty infiltration of the liver may cause a range of focal abnormalities on hepatic sonography which may simulate hepatic nodular lesions. Discrete deposits of fat or islands of normal tissue which are uninvolved by fatty infiltration may stand out as potential space-occupying lesions on the sonograms. Twelve patients with such focally abnormal ultrasound images were referred for liver scintigraphy with 133Xe and 99mTc colloidal SPECT studies to clarify the issue. These examinations helped identify, in nine of 12 patients, the innocent nature of the sonographic abnormalities which were simply related to the fat deposition process. Further, [99mTc]RBC scans defined the additional pathologic process in three patients in whom actual space-occupying lesions were indeed present in the liver. Scintigraphy has an important role to play in the understanding of focal hepatic ultrasound abnormalities particularly in unsuspected hepatic steatosis.

Aged↗

[Therapy effects of fenofibrate on alcoholic fatty liver and drug-induced fatty liver in rats].

OBJECTIVE: To investigate the fat decreasing effects of fenofibrate on alcoholic fatty liver and drug-induced fatty liver in rats. METHODS: Alcoholic fatty liver and drug-induced fatty liver rats models were established. The two kinds of rats with fatty liver were seperatedly divided into fenofibrate treatment group (80 mg/kg daily) and control group without treatment. Rats were killed after four weeks, then the levels of serum triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL) and malondialdehyde (MDA), hepatic lipase (HL), lipoprotein lipase (LPL) both in serum and liver tissue were measured according to the Test Kits. Histopathological changes in liver was dyed with HE and observed under light microscope. RESULTS: After treatment by fenofibrate, in the serum of rats with alcoholic fatty liver, the level of TG decreased significantly (1.07 mmol/L 0.06 mmol/L vs 1.56 mmol/L 0.29 mmol/L, t=5.115, p<0.001), while the level of TC had no alteration. The levels of MDA both in serum and liver tissue decreased (1.10 nmol/L 0.22 nmol/L vs 1.26 nmol/L 0.21 nmol/L, t=0.592, p<0.05; 5.92 nmol/g 1.24 nmol/g vs 7.42 nmol/g 1.22 nmol/g, t=3.477, p<0.05, respectively), while the levels of HL, LPL in serum and liver tissue increased significantly (Serum: 0.053muEq/ml/h 0.006muEq/ml/h vs 0.037 muEq/ml/h 0.006muEq/ml/h, t=-5.086, p<0.001; 0.018 muEq/ml/h 0.004 muEq/ml/h vs 0.014muEq/ml/h 0.004muEq/ml/h, t=-2.485, p<0.05. Liver tissue: 0.075muEq/ml/h 0.010muEq/ml/h vs 0.065muEq/ml/h 0.007muEq/ml/h, t=-2.437, p<0.05; 0.022 muEq/ml/h 0.014 muEq/ml/h vs 0.008 muEq/ml/h 0.002 muEq/ml/h, t=-2.876, p<0.05). Fat content in liver decreased (26.01 mg/g 1.69 mg/g vs 71.45 mg/g 2.66 mg/g, t=-43.224, p<0.001). The pathological changes of liver in fenofibrate-treated rats with alcoholic fatty liver were improved. For the drug-induced fatty liver rats, fenofibrate treatment group had no difference from the untreated control group. CONCLUSION: Fenofibrate can significantly decrease the fat content in liver tissue of rats with alcoholic fatty liver, as well as ameliorating liver pathological changes. But fenofibrate has no effect on drug-induced fatty liver.

Animals↗

Disrupted signaling and inhibited regeneration in obese mice with fatty livers: implications for nonalcoholic fatty liver disease pathophysiology.

The impaired regenerative capacity of fatty livers might promote the progression of nonalcoholic fatty liver disease (NAFLD). To identify mechanisms involved, regenerative responses were compared in normal mice and ob/ob mice (a model for NAFLD) after partial hepatectomy (PH). We hypothesized that the usual PH activation of oxidant-sensitive, growth-regulatory kinase cascades would be abnormal in fatty hepatocytes, which have adapted to chronic oxidant stress, and expected that this might interfere with the induction of proliferative- and stress-related genes. The normal coordinated induction of Jun N-terminal kinases (Jnks) and extracellular regulated kinases (Erks) does not occur after PH in ob/ob mice, which cannot activate Jnks but can superinduce Erks. Jnk inhibition is associated with enhanced activation of Akt, which inhibits phosphoenolpyruvate carboxykinase (PEPCK) induction, causing severe hypoglycemia and increased lethality in the ob/ob group. Activation of nuclear factor kappaB (NF-kappaB) is also inhibited, but liver damage is increased only modestly, perhaps because Akt-regulated survival factors are protective. Despite enhanced Erk activity, induction of cyclin D-1, an NF-kappaB target gene, is abolished and this, together with hyperphosphorylated signal transducer and activator of transcription-3 (Stat-3) and reduced adenosine triphosphate (ATP) levels, arrests fatty hepatocytes in G(1). Thus, in mice with NAFLD that have adapted hepatocyte signaling mechanisms to survive chronic oxidative stress, the cellular response to an acute regenerative stimulus is altered. This contributes to NAFLD pathophysiology by inhibiting proliferation, increasing injury, and limiting function in fatty livers.

Adenosine Triphosphate↗

[The expression and the significance of L-FABP and FATP4 in the development of nonalcoholic fatty liver disease in rats].

OBJECTIVE: To study the effect of liver fatty acid binding protein(L-FABP) and fatty acid transport protein (FATP4) in the development of nonalcoholic fatty liver disease (NAFLD) in rats. METHODS: The expression of L-FABP and FATP4 genes was examined in fatty liver rats by reverse transcription and polymerase chain reaction amplification and Western blot methods. RESULTS: In the high fat diet group (F), mRNA and protein expression of L-FABP and FATP4 were increased at 2 weeks, and they increased remarkably at 12 weeks (P < 0.05; L-FABP mRNA F=124.9, protein expression F=92.6; FATP4 mRNA F=602.9, protein expression F=108.8). CONCLUSION: The high expression of L-FABP and FATP4 at the early stage is an adaptive reaction of the body, With the advanced expression of the L-FABP and FATP4, it can lead to a fatty acid disequilibrium and then result in nonalcoholic fatty liver disease in the rats.

Animals↗

Liver tumors in fatty liver: difficulty in ultrasonographic interpretation.

BACKGROUND: Fatty liver and liver tumors are very frequent diseases. Sonography (US) currently is the initial diagnostic tool for hepatic exploration. However, there is a marked paucity of US findings of tumors in fatty liver. METHODS: We studied the US findings of 41 lesions (31 patients) with this combination, with special attention paid to internal echoes, marginal echoes, and especially the mode of back echoes, and compared them with the US results of 64 lesions (38 patients) without fatty liver. RESULTS: Comparing the group having liver tumor without fatty liver with the group having liver tumor with fatty liver showed that (a) the number of hypoechoic lesions increased (29 of 41, 70.7%, vs. 16 of 64, 25.0.%), (2) the tumor margin appeared indistinct (32 of 41, 78.0%, vs. nine of 64, 14.1%), and (c) the lesions showing posterior echo enhancement increased (34 of 41, 82.9%, vs. eight of 64, 12.5%). CONCLUSION: Liver tumors in fatty liver are expected to show unusual patterns on US, so we should consider this difficulty when interpreting these US findings and we should not make a conclusion without including other imaging modalities.

Adult↗

Lipid metabolism and liver inflammation. II. Fatty liver disease and fatty acid oxidation.

Fatty liver disease (FLD), whether it is alcoholic FLD (AFLD) or nonalcoholic FLD (NAFLD), encompasses a morphological spectrum consisting of hepatic steatosis (fatty liver) and steatohepatitis. FLD has the inherent propensity to progress toward the development of cirrhosis and hepatocellular carcinoma. It is generally difficult to distinguish AFLD from NAFLD on morphological grounds alone despite the distinctions implied by these etiological designations. The indistinguishable spectrum of histological features of both AFLD and NAFLD suggests a possible convergence of pathogenetic mechanisms at some critical juncture that enables the progression of steatohepatitis toward cirrhosis and liver cancer. From a pathogenetic perspective, FLD may be considered a single disease with multiple etiologies. Excess energy consumption and reduced energy combustion appear to be critical events that culminate in lipid storage in the liver. Energy combustion in the liver is controlled by peroxisome proliferator-activated receptor (PPAR)-alpha-regulated mitochondrial and peroxisomal fatty acid beta-oxidation systems and the microsomal omega-oxidation system. PPAR-alpha, a receptor for peroxisome proliferators, functions as a sensor for fatty acids (lipid sensor), and ineffective PPAR-alpha sensing can lead to reduced energy burning resulting in hepatic steatosis and steatohepatitis. Delineation of the pathogenetic aspects of FLD is necessary for developing novel therapeutic strategies for this disease.

Fatty Acids↗

Reduced hepatic extraction of palmitate in steatosis correlated to lower level of liver fatty acid binding protein.

Nonalcoholic fatty liver disease is the most common of all liver diseases. The hepatic disposition [(3)H]palmitate and its low-molecular-weight metabolites in perfused normal and steatotic rat liver were studied using the multiple indicator dilution technique and a physiologically based slow diffusion/bound pharmacokinetic model. The steatotic rat model was established by administration of 17 alpha-ethynylestradiol to female Wistar rats. Serum biochemistry markers and histology of treated and normal animals were assessed and indicated the presence of steatosis in the treatment group. The steatotic group showed a significantly higher alanine aminotransferase-to-aspartate aminotransferase ratio, lower levels of liver fatty acid binding protein and cytochrome P-450, as well as microvesicular steatosis with an enlargement of sinusoidal space. Hepatic extraction for unchanged [(3)H]palmitate and production of low-molecular-weight metabolites were found to be significantly decreased in steatotic animals. Pharmacokinetic analysis suggested that the reduced extraction and sequestration for palmitate and its metabolites was mainly attributed to a reduction in liver fatty acid binding protein in steatosis.

Animals↗

Fenofibrate, a peroxisome proliferator-activated receptor alpha agonist, reduces hepatic steatosis and lipid peroxidation in fatty liver Shionogi mice with hereditary fatty liver.

BACKGROUND AND AIMS: The fatty liver Shionogi (FLS) mouse, a unique model for nonalcoholic fatty liver disease (NAFLD), is an inbred strain that develops spontaneous hepatic steatosis without obesity or diabetes mellitus. Peroxisome proliferator-activated receptor (PPAR) alpha controls fatty acid metabolism. In the present study, we investigated the effect of fenofibrate, a PPARalpha agonist, on hepatic steatosis in FLS mice. METHODS: Thirteen-week-old FLS mice were fed a diet with 0.1% fenofibrate (w/w) for 12 days. The degree of hepatic steatosis was estimated by histological examination and hepatic triglyceride levels. Expression levels of genes involved in fatty acid turnover, including Acox1, Cpt1a, Fabp1, Acadl, and Acadm, were determined by Northern blot analyses. We measured levels of lipid peroxidation, glutathione, and anti-oxidative enzymes, such as superoxide dismutase, catalase, and glutathione peroxidase, in the liver. RESULT: Treatment of FLS mice with fenofibrate improved hepatic steatosis by activating expression of genes involved in fatty acid turnover and decreased hepatic lipid peroxidation. Fenofibrate increased the activity of catalase by upregulating its mRNA levels. CONCLUSION: Fenofibrate, which is currently used in therapy of hyperlipidemia, might also be useful for treating patients with NAFLD even in cases where NAFLD is not associated with obesity or diabetes mellitus.

Animals↗