New York - Researchers have identified a type of "good cholesterol" that protects the liver by blocking inflammatory signals produced by common gut bacteria.
High-density lipoprotein (HDL) is mostly known for mopping up cholesterol in the body and delivering it to the liver for disposal.
But researchers from the Washington University in St Louis, the US, found that a type of "good cholesterol" called HDL3, when produced in the intestine, protects the liver from inflammation and injury. If not blocked, these bacterial signals travel from the intestine to the liver, where they activate immune cells that trigger an inflammatory state, which leads to liver damage.
"Even though HDL has been considered 'good cholesterol,' drugs that increase overall HDL levels have fallen out of favour in recent years because of clinical trials that showed no benefit in cardiovascular disease," said Gwendalyn J. Randolph, Professor of Immunology at the University's School of Medicine.
"But our study suggests that raising levels of this specific type of HDL, and specifically raising it in the intestine, may hold promise for protecting against liver disease, which, like heart disease, also is a major chronic health problem," Randolph added.
The study, published in the journal Science, showed that HDL3 from the intestine protects the liver from inflammation in mice and in human blood samples.
Any sort of intestinal damage can impact how a group of microbes called Gram-negative bacteria can affect the body. Such microbes produce an inflammatory molecule called lipopolysaccharide that can travel to the liver via the portal vein.
The portal vein is the major vessel that supplies blood to the liver, and it carries most nutrients to the liver after food is absorbed in the intestine.
Substances from gut microbes may travel along with nutrients from food to activate immune cells that trigger inflammation. In this way, elements of the gut microbiome may drive liver disease, including fatty liver disease and liver fibrosis, in which the liver develops scar tissue.
"We are hopeful that HDL3 can serve as a target in future therapies for liver disease. We are continuing our research to better understand the details of this unique process," Randolph said. (IANS)
Lucknow, July 14 (IANS) A 43-year-old man, who underwent a liver transplant in the surgical gastroenterology department of King George's Medical University (KGMU) last month, has been discharged after recovery. This was the first liver transplant in the university after Covid-19 pandemic outbreak and done almost free.Prof Abhijeet Chandra, head, surgical gastroenterology, said, "It was a challenge to conduct the transplant in limited resources. Five more patients are waiting in the queue and next transplant will be done in another 15 days."The patient, who was discharged on Tuesday, is a small-time shopkeeper with meagre financial means.He was unable to afford the transplant at a private hospital where it costs between Rs 30-40 lakh.In KGMU, the transplant was funded by the UP government's Asadhya Rog scheme and another donation of Rs 4 lakh came from Awadh International Foundation.Prof Chandra said that the patient was suffering from advanced stage liver cirrhosis with severe jaundice and bleeding.His wife donated a part of her liver and was discharged after a week. Post-transplant, about four-six litres of fluid was drained daily from the patient's abdomen for a few days, till the liver grew to the normal size.KGMU spokesperson Dr Sudhir Singh said that KGMU has conducted 11 liver transplants so far with over 90 per cent success rate.It is the only medical institute in UP to perform multi-organ donation and has provided over 50 cadaveric organs to other institutes in north India for needy patients.The transplant team comprising over 100 doctors/staff was led by vice-chancellor Lt Gen (retd) Dr Bipin Puri.The surgical gastroenterology team included Prof Chandra and Prof Vivek Gupta.--IANS amita/skp/
New Delhi, July 8 (IANS) The Ministry of AYUSH has rejected a study published in the Journal of Clinical and Experimental Hepatology, a peer reviewed journal of the Indian National Association for the Study of the Liver.
This study mentions that use of the herb Tinospora Cordifolia (TC), commonly known as 'Giloy' or 'Guduchi', resulted in liver failure in six patients in Mumbai.
The ministry said "the authors of the study failed in placing all needful details of the cases in a systematic format. Apart from this, relating Giloy or TC to liver damage would be misleading and disastrous to the traditional medicine system of India as Guduchi or Giloy has been used in Ayurveda since long. The efficacy of TC in managing various disorders is well established."
"It becomes the responsibility of the authors to ascertain that the herb consumed by the patients is TC and not any other herb. To build upon the soundness, the authors would have taken the opinion of a botanist or would have consulted an Ayurveda expert.
"In fact, there are many studies that point out that not identifying the herb correctly could lead to wrong results. A similar looking herb TinosporoCrispa might have a negative effect on the liver. So, before labelling a herb such as Giloy with such toxic nature, the authors should have tried to correctly identify the plants following the standard guidelines, which they did not," the ministry said.
Publications based on "incomplete information" will open the door for misinformation and defame the age-old practices of Ayurveda, the ministry said.
"It would not be out of context to state here that scientific evidence on medical applications of TC or Giloy as protective to liver, nerves etc. is available," it said.
"There are other hundreds of studies on Giloy and its safe use. Giloy is one of the most commonly prescribed medicines in Ayurveda. It has proper pharmacopoeia standards in place for established safety of hepatoprotective properties. No adverse event is noted in any clinical practice by pharmacovigilance or in any clinical study," it said.
Read More ► Giloy Health Benefits, Uses, Dosage and Side Effects
Mandi, June 14 (IANS) A team of researchers from IIT Mandi has identified the underlying biochemical relationship between the consumption of excessive sugar and the development of afatty liver', medically known as Non-Alcoholic Fatty Liver Disease (NAFLD).
NAFLD is a condition in which excess fat deposits in the liver. The disease starts silently, with no overt symptoms for as much as two decades. If left untreated, the excess fat can irritate the liver cells, resulting in scarring of the liver (cirrhosis), and in advanced cases, can even lead to liver cancer. The treatment of advanced stages of NAFLD is difficult.
One of the causes for NAFLD is the overconsumption of sugar -- both table sugar (sucrose) and other forms of carbohydrates. The consumption of excess sugar and carbohydrates causes the liver to convert them into fat in a process called hepatic De Novo Lipogenesis or DNL, which leads to fat accumulation in the liver.
The molecular mechanisms that increase hepatic DNL due to overconsumption of sugar, which is is key to developing therapeutics for the NAFLD, have not been clear yet, said lead scientist Prosenjit Mondal, Associate Professor, School of Basic Sciences, IIT Mandi.
The team used a complementary experimental approach involving mice models, and identified the unknown link between the carbohydrate-induced activation of a protein complex called NF-KB and increased DNL.
"Our data indicates that the sugar-mediated shuttling of hepatic NF-KB p65 reduces the levels of another protein, sorcin, which in turn activates liver DNL through a cascading biochemical pathway," explained Mondal. The findings are published in the Journal of Biological Chemistry.
The team showed that drugs that can inhibit NF-KB can prevent sugar-induced hepatic fat accumulation. They have also shown that the knockdown of sorcin reduces the lipid-lowering ability of the NF-KB inhibitor.
The finding that NF-KB plays a key role in lipid accumulation in the liver opens up a new avenue of therapeutics for NAFLD. NF-KB also plays a role in other diseases that involve inflammation, such as cancer, Alzheimer's disease, atherosclerosis, IBS, stroke, muscle wasting and infections.
The research comes at a time when India has included NAFLD in the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS).
India is the first country in the world to identify the need for action on NAFLD and with good reason. The prevalence of NAFLD in India is about 9 per cent to 32 per cent of the population, with the state of Kerala alone having a prevalence of 49 per cent and a staggering 60 per cent prevalence among obese school-going children.
The study has conclusively shown that excessive sugar intake leads to a fatty liver. This should offer incentive to the public to reduce sugar intake to stop NAFLD in its early stages, the team said.
Chennai, June 10 (IANS) Perhaps in a first of its kind, doctors at the MGM Healthcare, on Thursday said they have successfully performed a live-donor liver transplant on a Covid positive national kabaddi player in coma with liver failure.The 26-year-old patient, Raghul Gandhi, hailing from Puducherry developed acute liver failure and his condition worsened due to sudden onset of jaundice.He slipped into a deep coma within two days after being diagnosed with the disease and was shifted to MGM Healthcare.The situation was complicated as Gandhi also tested positive for Covid-19. Fortunately, his lung was not affected by coronavirus."We took up the challenge to do the emergency liver transplant bearing in mind the complicated nature of the patient's health condition," Thiagarajan Srinivasan, Director, Institute of Liver Diseases, Transplant and HPB surgery said.Normally a liver transplant is performed on Covid free end stage liver disease patient or 4-5 weeks post Covid recovery with 2 successive negative RTPCR tests.However, Gandhi's condition was critical and the transplant had to be done within 24 hours.The other problem the doctors faced was the availability of liver as there was only one liver donation in May in Tamil Nadu.According to Srinivasan, it was then decided to do a living donor liver transplant in which a part of the donor's liver is transplanted after removal of the diseased liver.The live donor was Gandhi's brother.Srinivasan and his team conducted the emergency liver transplant within 12 hours.A bio-bubble was implemented in place to avoid non-mixture of donor and recipient teams, building of separate Covid-proof transport corridors, ICUs, wards and Operation Theatres throughout the entire hospital stay of 15 days for the patient and the team.Doctors said Gandhi has recovered well with the new liver and has successfully defeated Covid infection and his condition will be monitored for a few days.--IANSvj/in
Liver disease is a serious concern in India with more than 10 lakh cases being reported every year. Late diagnosis often leads to detection of the condition when it is at end-stage or liver cirrhosis has occurred, during which time it is difficult to treat and it could lead to death, says Rajiv Lochan, Lead Consultant HPB and Transplant Surgery, Aster RV Hospital.
The World Health Organisation has reported that liver disease is the tenth most common cause of death in India with liver cancer being the fourth common cause of cancer-related deaths.
"A pandemic like situation can be dangerous for people suffering from liver disease as they are at a higher risk of suffering from severe complications from a virus such as Covid-19. A case in point is the earlier SARS epidemic, during which liver damage was observed in more than half of the afflicted patients. During the ongoing Covid-19 pandemic, it has been observed that a significant percentage of patients develop liver dysfunction, particularly those suffering from severe Covid-19," says Lochan.
He adds, "While more research and observation is required to fully understand the link, possible reasons for this could be the impact of the virus on the liver, an undesirable immune response from the body which impacts the liver, sepsis, or medication-related liver injury. During the second wave of the pandemic, more people are reporting with GI symptoms which indicate the potential of the virus to infiltrate and attack organs in the body apart from the lungs. Needless to say, patients with liver conditions need to take extra care of their body and health during this time. People who indulge in certain lifestyle habits that contribute to liver damage but who haven't seen any outward symptoms of liver disease may also find that contracting the coronavirus results in more liver-related symptoms."
Individuals with pre-existing liver disease appear to be at a significant risk of complications from the Covid-19 infection. Various studies are underway to ascertain the exact impact of this virus infection on such patients.
According to Lochan, these are some simple ways to care for your liver, with particular relevance to the current pandemic:
Avoid binge-drinking alcohol at all costs
With more time on hand people are turning to unhealthy habits such as regular drinking/binge drinking which is a major cause of liver damage. Excessive alcohol puts the system on overdrive to process the toxins in the system, the brunt of which is taken up by the liver. Smoking is equally bad for the liver and heavy drinkers often tend to smoke. Use this time to ease off of these addictions.
Eat a liver-friendly diet
The liver's function is to detoxify. Consuming fruits and vegetables which help keep the liver healthy and functioning effectively are important to prevent liver damage. Some examples are antioxidant rich fruits such as berries, green tea, healthy fats such as olive oil, fatty fish, avocado, bananas, nuts, and green leafy vegetables like spinach, fibrous foods such as whole grains, garlic, etc are beneficial to the liver. Highly refined, processed, high sodium, loaded with artificial sugars such as most ready to eat food items, fried food, and excessive maida prepared items are unsuitable for liver health.
Also, Read► Health Hacks for the Work-From-Home Life
Do not forget to exercise
Please devote extra time to exercise. Medical studies increasingly show that exercise is most essential for liver health. Regular exercise which increases the heart rate to 80 per cent of the target heart rate, at least 4 times a week helps in keeping the liver healthy. If you have any specific illnesses, do discuss this exercise regime with your doctor before taking it on.
Obesity is a prime cause of non-alcoholic fatty liver disease. If you are overweight, use this time to reduce and maintain a healthy weight for your body type. If you are at a healthy weight, avoid turning to healthy foods to deal with boredom, stress etc and continue practising a healthy diet and lifestyle. Genetics can also play a role if liver disease runs in the family; use this time to get liver function tests.
Even seemingly skinny people can accumulate fat around the liver, leading to fatty liver disease as demonstrated by various studies in India. We are on the verge of a fatty liver disease epidemic and this can be easily accentuated by the current pandemic.
Practice safe behaviours and be responsible
Unsanitary needles and unprotected sex can lead to Hepatitis B and C, which is part of a group of viruses that can attack the liver. Unhygienic tattoo parlours, injecting drugs, basically any needles that have come in contact with an infected individual's blood and reintroduced into a healthy person can lead to liver disease. Taking vaccination can help reduce the risk of contracting the disease. Wearing a mask and maintaining social distancing is still the most effective way to not contract the disease. Given the long drawn out nature of this pandemic, its economic consequences and social isolation it demands, a nihilistic attitude has set in with society (including administrators and regulators) as a whole having developed fatigue and has thrown these simple measures out of the window. This attitude is partly responsible for the current surge in infections. Being responsible to oneself and to one another is key.
If eligible, take the Covid vaccine
It is strongly recommended that you take these vaccines if suffering from any chronic liver ailment or are otherwise eligible. Please discuss this with your treating doctor.
Identifying and arresting liver disease early is important to prevent the need for long-term management of the disease. In the middle of the ongoing pandemic, if you experience any of the following symptoms -- jaundice, water retention and swelling in the legs and feet, unexplainable fatigue, strong odour from urine and dark yellow colour, severe and unbearable abdominal pain, vomiting, itchy skin, please visit a doctor for consultation.
Read More► Stuck at home? Seven tips to get started with fitness