De Kai Qiu

The role of entecavir in preventing hepatitis B recurrence after liver transplantation

OBJECTIVE:  Although hepatitis B recurrence after liver transplantation has been reduced to 0%–10% since the application of the combination therapy of hepatitis B immunoglobulin (HBIG) and lamivudine, the viral mutation resistance of lamivudine is still an obstacle to the outcome of liver transplantation. Here we evaluate the role of entecavir in preventing hepatitis B recurrence after liver transplantation.

Th17 cells: The emerging reciprocal partner of regulatory T cells in the liver

T helper cells that produce interleukin‐17 (IL‐17) (Th17 cells) have recently been identified as the third distinct subset of effector T cells, the differentiation of which depends on specific transcription nuclear factor retinoic acid‐related orphan nuclear receptor‐γt. Emerging data have suggested that Th17 cells play an important role in innate immunity, adaptive immunity and autoimmunity. Interestingly, there is a reciprocal relationship between Th17 cells and regulatory T cells (Treg), not only in development, but also in their effector function. Transforming growth factor (TGF)‐β induces Treg‐specific transcription factor Forkhead box P3(FOXP3), while the addition of IL‐6 to TGF‐β inhibits the generation of Treg cells and induces Th17 cells. It is proposed that the fine balance between Th17 and Treg cells is crucial for maintenance of immune homeostasis. In addition to IL‐6, other factors such as retinoic acid, rapamycin, or cytokines (e.g., IL‐2 and IL‐27) could dictate the balance between Th17 and Treg cells. Since Treg cells play an important role in hepatic immunity with overregulation in chronic viral hepatitis and hepatic carcinoma, and inadequate inhibition in autoimmune liver diseases, graft rejection and acute liver failure, it is reasonable to assume that Th17 cells may play a reciprocal role in these diseases. Thus, future research on the Treg/Th17 balance may provide an opportunity to illustrate the pathogenesis of hepatic inflammation and to explore new therapeutic targets for immune‐related liver diseases.

Bile acids and insulin resistance: implications for treating nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease is characterized by an accumulation of excess triglycerides in hepatocytes, and insulin resistance is now considered the fundamental operative mechanism throughout the prevalence and progression of the disease. Besides their role in dietary lipid absorption and cholesterol homeostasis, evidence has accumulated that bile acids are also signaling molecules that play two important roles in glucose and lipid metabolism: in the nuclear hormone receptors as farnesoid X receptors (FXR), as well as ligands for G‐protein‐coupled receptors TGR5. The activated FXR‐SHP pathway regulates the enterohepatic recycling and biosynthesis of bile acids and underlies the down‐regulation of hepatic fatty acid and triglyceride biosynthesis and very low density lipoprotein production mediated by sterol‐regulatory element‐binding protein‐1c. The bile acid‐TGR5‐cAMP‐D2 signaling pathway in human skeletal muscle in the fasting–feeding cycle increases energy expenditure and prevents obesity. Therefore, a molecular basis has been provided for a link between bile acids, lipid metabolism and glucose homeostasis, which can open novel pharmacological approaches against insulin resistance and nonalcoholic fatty liver disease.

Efficacy of fenofibrate in Chinese patients with primary biliary cirrhosis partially responding to ursodeoxycholic acid therapy

OBJECTIVE:  To investigate the efficacy of fenofibrate combination therapy in Chinese patients with primary biliary cirrhosis (PBC) who had a partial response to standard dose of ursodeoxycholic acid (UDCA) for at least one year.

Liver X receptors bridge hepatic lipid metabolism and inflammation.

Liver X receptors (LXRs) are members of the superfamily of metabolic nuclear receptors, which play central roles in the regulation of cholesterol absorption, efflux, transportation and excretion and many other processes correlating with lipid metabolism. LXRs can also regulate inflammation in vitro and in vivo. Accumulating evidence demonstrates that LXR are involved in the metabolism and inflammation in human diseases. Nonalcoholic fatty liver disease (NAFLD) is classically associated with lipid metabolic disorders and inflammatory responses, especially in the nonalcoholic steatohepatitis (NASH) phase. The effects of LXRs on cholesterol metabolism and inflammation make them attractive as a potential target for the treatment of NAFLD. Since the ability to synthesize triglycerides may be protective in obesity and fatty liver, the hepatic lipogenesis by LXRs should not rule out the possibility of the use of LXRs in NAFLD.

De novo hepatitis B virus infection from anti-HBc-positive donors in pediatric living donor liver transplantation.

The aim of this study was to analyze the incidence and risk factors of de novo hepatitis B virus (HBV) infection from hepatitis B core antibody (anti‐HBc)‐positive donors in pediatric living donor liver transplantation (LDLT).

Clinical and histological features of autoantibody-negative autoimmune hepatitis in Chinese patients: a single center experience.

This study aimed to define the clinical features of Chinese patients with autoantibody‐negative autoimmune hepatitis (AIH) and to refine the diagnosis and management of these atypical patients in a single Chinese center.

Comparison of survival and tumor recurrence rates in patients undergoing liver transplantation for hepatitis B-related hepatocellular carcinoma using Milan, Shanghai Fudan and Hangzhou criteria

To assess the performance of the Milan, Shanghai Fudan and Hangzhou criteria based on a preoperative evaluation in patients undergoing liver transplantation (LT) for hepatitis B‐related hepatocellular carcinoma (HCC).

Prevalence and significance of autoantibodies in patients with alcoholic liver disease

This study aimed to evaluate the prevalence and significance of serum autoantibodies in alcoholic liver disease (ALD) patients.

Cholesterol metabolism and expression of its relevant genes in cultured steatotic hepatocytes

OBJECTIVE:  To investigate the cholesterol metabolism and mRNA expression of the relevant genes in cholesterol synthesis of the cultured steatotic hepatocytes model.