Zheng Shusen

Solitary Fibrous Tumor of the Liver: Retrospective Study of Reported Cases

A solitary fibrous liver tumor is a rare disease that is difficult to diagnose. Radiological findings are not specific and cannot confirm benignity or malignancy. Immunohistologically, CD 34, Vimentin, and Desmin should be used as markers to precisely diagnose solitary fibrous tumors. In most cases, there is low cellularity with no cellular atypia or necrosis, making this a benign lesion. Occasionally, a large size, high mitotic rate, cellular pleomorphism and atypia, and necrosis are interpreted as features suggestive of an increase malignant potential. The outcome of solitary fibrous tumor mostly is related to resectability, although correlated with neither pathological grade nor tumor size. Thus, total surgical resection of the neoplasm is most commonly proposed. Physicians should be alerted that solitary fibrous tumor of the liver can be malignant and can metastasize.

Longitudinal fluctuations in PD1 and PD-L1 expression in association with changes in anti-viral immune response in chronic hepatitis B

BackgroundControversy exists regarding the role of PD1 and its ligand PD-L1 in chronic hepatitis B infection. In some studies, persistent HBV infection has been attributed to high levels of PD-1 and PD-L1 expression on HBV-specific T-cells and antigen-presenting cells (APCs) respectively. Other studies revealed that the up-regulation of PD-1 and PD-L1 during an acute inflammation phase is required to offset increasing positive co-stimulatory signals to avoid severe damage by an over-vigorous immune response.MethodsFifteen chronic hepatitis B patients, with inflammatory flare episode, were recruited prospectively. Based on serum HBV-DNA, HBsAg load, and ALT values, inflammatory flare episode were divided into initial, climax, decline and regression phase. Blood sample and liver biopsy tissues from each individual were taken in these 4 phases respectively. Circulating and intra-hepatic PD1 and PD-L1 expression levels were monitored throughout the inflammatory flare episode by flow cytometry and immunostaining and these expression levels were related to the HBV-specific T-cell changes, expression of pro-inflammatory cytokines, HBV-DNA replication and HBV antigen load.Results]The levels of PD-1 and PD-L1 expressions were significantly up-regulated in the inflammation ascending phase, initial and climax period and in parallel with HBV-specific colon expansion. It showed increasing the level of serum ALT and decreasing the HBV-DNA loads. As the level of inflammation reduced, the circulating and intra-hepatic PD1 and circulating PD-L1 decreased progressively in concordance with serum ALT, HBV-DNA and HBsAg loads decreased except intra-hepatic PD-1 expression. Intra-hepatic PD-L1 expression did not decrease significantly during the regression phase of inflammation compared to that in prior period. The intra-hepatic PD-L1 expression remained relatively on higher level when serum HBV-DNA load and ALT decreased to approximately normal range.ConclusionThe relatively high level of intra-hepatic PD-L1 expression during the inflammatory regression period may contribute to constitute an immunosuppressive microenvironment, which facilitate persistent HBV infection via the inhibition of HBV-specific T cell clonal expansion.

Identification of genes differentially expressed in monocyte-derived dendritic cells with 1α,25-dihydroxyvitamin D3 using cDNA arrays

In order to study the molecular mechanism of the inhibitory effect of 1,25-dihydroxyvitamin D3 on dendritic cells, experiments were performed using Atlas cDNA expression arrays from Clonetech to identify the differentially expressed genes of dendritic cells by 1,25-dihydroxyvitamin D3. Analysis of cDNA arrays revealed changes in the expression of 9 genes, including those involved in DNA binding and transcription, extracellular cell signaling and communication, intracellular transducers, as well as cell adhesions. The results indicated that a multiple molecular network is involved in the inhibitory role of 1,25-dihydroxyvitamin D3 on dendritic cells. The Atlas Array technology may facilitate the elucidation of complex pharmacological process of 1,25-dihydroxyvitamin D3 on dendritic cells.

A proteomic analysis of allograft rejection in rats after liver transplantation.

In order to understand the allograft rejection in orthotopic liver transplantation (OLT), an allograft rejection rat model was established and studied by proteomic approach. The protein expression profiles of liver tissues were acquired by fluorescence two-dimensional difference gel electrophoresis (2D DIGE) that incorporated a pooled internal standard and reverse fluorescent labeling method. The expression levels of 27 protein spots showed significant changes in acute rejection rats. Among these spots, 19 were identified with peptide mass fingerprinting using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) after tryptic in-gel digestion. The results of the present paper could be helpful for our better understanding of allograft rejection in organ transplantation.

Honokiol, a novel antitumour candidate

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Evaluation of orthotopic liver transplantation with no veno-venous bypass

Objective: To assess the feasibility and outcome of orthotopic liver transplantation (OLT) with no veno-venous bypass(v-v bypass) in adult patients. Methods: Between 1999 and 2001, 43 adult patients underwent OLT with v-v bypass, 33 with no v-v bypass. The operation time, anhepatic time, amount of blood loss, amount of blood transfusion, ICU stay days of the two groups were compared; renal function and gastrointestinal function in the two groups were examined. Results: There was no significant difference in mean serum creatinine on day 3 and gas discharge time in patients with v-v bypass or not. With no v-v bypass, the average operation time was 5.7±1.3 hours, anhepatic time was 64±13 minutes, median amount of blood loss in operation was 4000±820 mL, median amount of blood transfused intraoperatively was 4650±910 mL, median ICU stay was 5.7 days; all those were lower or shorter than those with v-v bypass; and these differences between the two groups had statistical significances. Conclusion: OLT with no v-v bypass is safe and can be performed in the majority of adult patients. The practice of liver transplantation with no v-v bypass is associated with shorter total operation time, shorter anhepatic time, lower blood product usage, and shorter ICU stay compared with standard technique of OLT with routine use of v-v bypass.