المؤلفون: Lea Ladegaard Grønkjær, Mette Munk Lauridsen

المصدر: JHEP Reports, Vol 3, Iss 6, Pp 100370-(2021)
Grønkjær, L L & Lauridsen, M M 2021, ' Quality of life and unmet needs in patients with chronic liver disease : A mixed-method systematic review ', JHEP Reports, vol. 3, no. 6, 100370 . https://doi.org/10.1016/j.jhepr.2021.100370Test
JHEP Reports

مصطلحات موضوعية: PBC, Primary Biliary Cholangitis Questionnaire, Patient experience, Quality of life, medicine.medical_specialty, NAFLD, non-alcoholic fatty liver disease, NASH, non-alcoholic steatohepatitis, VAS, visual analogue scale, Population, EQ-5D, European Quality of Life, FACT-Hep, Functional Assessment of Cancer Therapy Hepatobiliary Carcinoma, HBQOL, Hepatitis B Quality of Life, Disease, CINAHL, RC799-869, Chronic liver disease, SIP, Sickness Impact Profile, Unmet needs, MELD, model for end-stage liver disease, Liver disease, CLDQ, Chronic Liver Disease Questionnaire, LC-PROM, Liver Cirrhosis Patient Reported Outcome Measure, Quality of life (healthcare), Internal Medicine, medicine, Immunology and Allergy, Intensive care medicine, education, PedsQL, Pediatric Quality of Life Inventory, Patient reported outcomes, education.field_of_study, Hepatology, WHOQOL-BREF, WHO Quality of Life, business.industry, JBI, Joanna Briggs Institute, Gastroenterology, Diseases of the digestive system. Gastroenterology, medicine.disease, SF, Short Form, Mixed method, Systematic review, business, HCC, hepatocellular carcinoma, Research Article, LDQOL, Liver Disease Quality of Life

الوصف: Background & Aims In an attempt to uncover unmet patient needs, this review aims to synthesise quantitative and qualitative studies on patients’ quality of life and their experience of having liver disease. Methods Three databases (CINAHL, Embase, and PubMed) were searched from January 2000 to October 2020. The methodological quality and data extraction of both quantitative and qualitative studies were screened and appraised using Joanna Briggs Institute instruments for mixed-method systematic reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A convergent, integrated approach to synthesis and integration was used. Studies including patients with autoimmune and cholestatic liver disease, chronic hepatitis B and C, non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, cirrhosis, and hepatocellular carcinoma were considered. Results The searches produced 5,601 articles, of which 95 (79 quantitative and 16 qualitative) were included in the review. These represented studies from 26 countries and a sample of 37,283 patients. The studies showed that patients´ quality of life was reduced. Unmet needs for information and support and perceived stigmatisation severely affected patients’ quality of life. Conclusions Our study suggests changes to improve quality of life. According to patients, this could be achieved by providing better education and information, being aware of patients’ need for support, and raising awareness of liver disease among the general population to reduce misconceptions and stigmatisation. Registration number PROSPERO CRD42020173501. Lay summary Regardless of aetiology, patients with liver diseases have impaired quality of life. This is associated with disease progression, the presence of symptoms, treatment response, and mental, physical, and social factors such as anxiety, confusion, comorbidities, and fatigue, as well as limitations in daily living, including loneliness, low income, stigmatisation, and treatment costs. Patients highlighted the need for information to understand and manage liver disease, and awareness and support from healthcare professionals to better cope with the disease. In addition, there is a need to raise awareness of liver diseases in the general population to reduce negative preconceptions and stigmatisation.
Graphical abstract
Highlights • Patients with liver disease regardless of aetiology and severity have impaired quality of life. • Patients call for better education and information to understand and manage their liver disease, and for increased awareness and support from healthcare professionals. • Owing to the limited knowledge of liver diseases among the general population, patients experience stigmatisation, resulting in loneliness and social isolation. • Addressing unmet needs of patients with liver disease could improve their quality of life.

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الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5347f777d34d635854930477dc42eccfTest
http://www.sciencedirect.com/science/article/pii/S2589555921001464Test

المؤلفون: Jérôme Boursier, Emmanuel Tsochatzis

المساهمون: Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)

المصدر: JHEP Reports Innovation in Hepatology
JHEP Reports Innovation in Hepatology, Elsevier, 2021, 3 (2), pp.100219. ⟨10.1016/j.jhepr.2020.100219⟩
JHEP Reports

مصطلحات موضوعية: Cirrhosis, Cost effectiveness, [SDV]Life Sciences [q-bio], NICE, National Institute of Clinical Excellence, Nice, Review, AST, aspartate aminotransferase, Disease, Patient pathway, ELF, enhanced liver fibrosis, 0302 clinical medicine, Immunology and Allergy, Medicine, NFS, NAFLD fibrosis score, ALD, alcohol-related liver disease, ComputingMilieux_MISCELLANEOUS, computer.programming_language, 0303 health sciences, NAS, NAFLD activity score, Case-finding, Fatty liver, Gastroenterology, Awareness, Primary care, TE, transient elastography, 3. Good health, Screening, FIB-4, 030211 gastroenterology & hepatology, Elastography, NAFLD, non-alcoholic fatty liver disease, medicine.medical_specialty, NASH, non-alcoholic steatohepatitis, Liver fibrosis, QALY, quality-adjusted life year, 03 medical and health sciences, ALT, alanine aminotransferase, Type 2 diabetes mellitus, NIT, non-invasive test, Internal Medicine, GP, general practitioner, FIB-4, fibrosis-4, Intensive care medicine, 030304 developmental biology, Hepatology, business.industry, Type 2 Diabetes Mellitus, T2DM, type 2 diabetes mellitus, medicine.disease, Quality-adjusted life year, Cost-effectiveness, Transient elastography, business, computer

الوصف: Summary Among the large population of patients with non-alcoholic fatty liver disease (NAFLD), identifying those with advanced disease remains challenging. Many patients are diagnosed late, following the development of liver-related complications, leading to poor clinical outcomes. Accumulating evidence suggests that using non-invasive tests for liver fibrosis in patients with metabolic risk factors improves the detection of patients in need of specialised management and is cost-effective. Because of the vast number of patients requiring evaluation, the active participation of general practitioners and physicians who manage patients with metabolic disorders, such as diabetologists, is crucial; this calls for the increased awareness of NAFLD beyond liver clinics. Non-invasive case-finding strategies will need to be further validated and generalised for upcoming drug therapies to have the required impact on the worldwide burden of NAFLD.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::998a5dc5ae8854bb83716af6e6873dc7Test
https://doi.org/10.1016/j.jhepr.2020.100219Test

المؤلفون: Yemi Oluboyede, Gulnar Fattakhova, Lorraine McSweeney, Luke Vale, Lynda C. Doward, Fiona Beyer, Clifford A. Brass, Quentin M. Anstee, Matthew Breckons, Laura Ternent, Maria-Magdalena Balp, Arun J. Sanyal

المصدر: JHEP Reports
JHEP Reports, Vol 2, Iss 3, Pp-(2020)

مصطلحات موضوعية: medicine.medical_treatment, Disease, Liver disease, 0302 clinical medicine, Immunology and Allergy, 030212 general & internal medicine, Non-alcoholic steatohepatitis, education.field_of_study, Gastroenterology, PRO, patient-reported outcome, LDSI, liver disease symptom index, 3. Good health, health-related quality of life, Cirrhosis, 030211 gastroenterology & hepatology, Patient-reported outcome, SF-36, short form health profile 36, Research Article, FDA, United States Food and Drug Administration, RI, researcher interpretation, HRQoL, health-related quality of life, NAFLD, non-alcoholic fatty liver disease, medicine.medical_specialty, SF-36, NASH, non-alcoholic steatohepatitis, Population, liver, digestive system, Support group, MS, multiple sclerosis, 03 medical and health sciences, Quality of life (healthcare), NAFLD, PHAQ, patient-reported outcome measurement information system health assessment questionnaire, Internal Medicine, medicine, NAFL, non-alcoholic fatty liver, CLDQ, chronic liver disease questionnaire, lcsh:RC799-869, Intensive care medicine, education, patient-reported outcome measures, Hepatology, business.industry, nutritional and metabolic diseases, medicine.disease, QoL, quality of life, Mental health, digestive system diseases, FIS, fatigue impact scale, PROM, patient-reported outcome measure, EMA, European Medicines Agency, COSMIN, The COnsensus-based Standards for the selection of health Measurement INstruments, lcsh:Diseases of the digestive system. Gastroenterology, business, LDQoL, liver disease quality of life questionnaire

الوصف: Background & Aims Non-alcoholic steatohepatitis (NASH) is known to have a negative impact on patients' health-related quality of life (HRQoL), even before progression to cirrhosis has occurred. The burden of NASH-related cirrhosis from the patient perspective remains poorly understood. Herein, we aimed to identify the burden of disease and HRQoL impairment among patients with NASH-related compensated cirrhosis. Methods This targeted literature review sought first to identify the humanistic burden of disease from the perspective of patients with diagnosed NASH-cirrhosis and, secondly, to identify generic or disease-specific patient-reported outcome measures (PROMs) used to assess the impact of NASH-cirrhosis. Searches were conducted in bibliographical databases, grey or unpublished literature, liver disease websites, support group websites and online blogs. A quality assessment of specific PROMs was conducted. Results Patients with NASH-cirrhosis are reported to suffer from lower HRQoL than patients with non-cirrhotic NASH and the general population with respect to physical health/functioning, emotional health and worry, and mental health. Thirteen PROMs were identified, of which 4 were liver-disease specific: CLDQ, CLDQ-NAFLD, LDQoL and LDSI. The most commonly used measures do not comply with current industry or regulatory standards for PROMs and/or are not validated for use in a cirrhotic NASH population. Conclusions Patients with NASH-cirrhosis have lower HRQoL and poorer physical health than patients with non-cirrhotic NASH. However, the literature lacked detail of the everyday impact on patients' lives. Currently, a number of PROMs are available to measure the impact of the disease in patients with chronic liver conditions. The lack of studies that include qualitative insights in this population mandates further exploration and research. Lay summary It is not well understood how having non-alcoholic fatty liver disease (NAFLD)-related cirrhosis affects a person's everyday wellbeing and quality of life. Some research has been done with patients who have early stages of liver disease but not people with cirrhosis. We found that patients with NAFLD-related cirrhosis tended to have poorer health than patients without cirrhosis. But there was not very much information from patients themselves and there were no tools or questionnaires just for this group of patients.
Graphical abstract
Highlights • The burden of cirrhotic NASH from the patient perspective remains poorly understood. • Patients with NASH-related compensated cirrhosis are reported to suffer from lower HRQoL. • Most commonly used PROMs are not validated for use in a cirrhotic NASH population.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ee751f2b6ffd99b10142118b951f0fcdTest
https://doi.org/10.1016/j.jhepr.2020.100099Test

المؤلفون: Luca Valenti, Elia Casirati, Cristiana Bianco, Francesco Malvestiti

المصدر: JHEP Reports
JHEP Reports, Vol 3, Iss 3, Pp 100284-(2021)

مصطلحات موضوعية: SREBP, sterol response element binding protein, Alcoholic liver disease, LDs, lipid droplets, MBOAT7, membrane bound O-acyltransferase domain-containing 7, AA, arachidonic acid, PPAR, peroxisome proliferator-activated receptor, RC799-869, Disease, Review, Bioinformatics, TNF-α, tumour necrosis factor-α, Liver disease, GPR55, G protein-coupled receptor 55, Immunology and Allergy, IL-, interleukin, HFE, homeostatic iron regulator, genetics, GCKR, glucokinase regulator, PNPLA3, patatin like phospholipase domain containing 3, Fatty liver, Gastroenterology, Diseases of the digestive system. Gastroenterology, FGF19, fibroblast growth factor 19, Lipotoxicity, ASH, alcoholic steatohepatitis, PRS, polygenic risk score, FFAs, free fatty acids, HSC, hepatic stellate cells, alcoholic liver disease, IL32, TAG, triacylglycerol, precision medicine, NASH, non-alcoholic steatohepatitis, interleukin-32, HSD17B13, hydroxysteroid 17-beta dehydrogenase 13, steatohepatitis, DNL, de novo lipogenesis, MBOAT7, ER, endoplasmic reticulum, FLD, fatty liver disease, FXR, farnesoid X receptor, Internal Medicine, medicine, Genetic predisposition, PNPLA3, therapy, LPI, lysophosphatidyl-inositol, Hepatology, business.industry, cirrhosis, PUFAs, polyunsaturated fatty acids, non-alcoholic fatty liver disease, medicine.disease, Mitochondrial amidoxime reducing component 1, MARC1, mitochondrial amidoxime reducing component 1, fatty liver disease, Steatohepatitis, business, HCC, hepatocellular carcinoma, DAG, diacylglycerol

الوصف: Summary: Fatty liver disease can be triggered by a combination of excess alcohol, dysmetabolism and other environmental cues, which can lead to steatohepatitis and can evolve to acute/chronic liver failure and hepatocellular carcinoma, especially in the presence of shared inherited determinants. The recent identification of the genetic causes of steatohepatitis is revealing new avenues for more effective risk stratification. Discovery of the mechanisms underpinning the detrimental effect of causal mutations has led to some breakthroughs in the comprehension of the pathophysiology of steatohepatitis. Thanks to this approach, hepatocellular fat accumulation, altered lipid droplet remodelling and lipotoxicity have now taken centre stage, while the role of adiposity and gut-liver axis alterations have been independently validated. This process could ignite a virtuous research cycle that, starting from human genomics, through omics approaches, molecular genetics and disease models, may lead to the development of new therapeutics targeted to patients at higher risk. Herein, we also review how this knowledge has been applied to: a) the study of the main PNPLA3 I148M risk variant, up to the stage of the first in-human therapeutic trials; b) highlight a role of MBOAT7 downregulation and lysophosphatidyl-inositol in steatohepatitis; c) identify IL-32 as a candidate mediator linking lipotoxicity to inflammation and liver disease. Although this precision medicine drug discovery pipeline is mainly being applied to non-alcoholic steatohepatitis, there is hope that successful products could be repurposed to treat alcohol-related liver disease as well.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::208fb7d0b5b574d80e6e97a913828e36Test

المؤلفون: Mariuca Vasa-Nicotera, Elsa Solà, Juan José Lozano, Pau Sancho-Bru, Sara Fernández, Jonel Trebicka, Elisa Pose, Pere Ginès, Pedro Castro, Delia Blaya, Julia Sidorova, Robert Schierwagen, Joan Caballería, Mar Coll, Christian Jansen, Isabel Graupera

المصدر: JHEP Reports
JHEP Reports, Vol 3, Iss 2, Pp 100233-(2021)
Blaya, D, Pose, E, Coll, M, Lozano, J J, Graupera, I, Schierwagen, R, Jansen, C, Castro, P, Fernandez, S, Sidorova, J, Vasa-Nicotera, M, Solà, E, Caballería, J, Trebicka, J, Ginès, P & Sancho-Bru, P 2021, ' Profiling circulating microRNAs in patients with cirrhosis and acute-on-chronic liver failure ', JHEP Reports, vol. 3, no. 2, 100233 . https://doi.org/10.1016/j.jhepr.2021.100233Test

مصطلحات موضوعية: medicine.medical_specialty, Cirrhosis, NASH, non-alcoholic steatohepatitis, Encephalopathy, AST, aspartate aminotransferase, Disease, FoxO, forkhead box O, Chronic liver disease, Gastroenterology, Non-coding RNAs, CXCL10, C-X-C motif chemokine ligand 10, MELD, model for end-stage liver disease, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Model for End-Stage Liver Disease, ALT, alanine aminotransferase, TIPS, transjugular intrahepatic portosystemic shunt, Internal medicine, Internal Medicine, medicine, Immunology and Allergy, Decompensation, lcsh:RC799-869, EF CLIF, European Foundation for the Study of Chronic Liver Failure, INR, International Normalised Ratio, TGF, transforming growth factor, 030304 developmental biology, PBMCs, peripheral blood mononuclear cells, PCA, principal component analysis, 0303 health sciences, LDH, lactate dehydrogenase, Hepatology, business.industry, medicine.disease, 3. Good health, Circulating MicroRNA, ACLF, acute-on-chronic liver failure, 030220 oncology & carcinogenesis, lcsh:Diseases of the digestive system. Gastroenterology, qPCR, quantitative PCR, business, Liver decompensation, Biomarkers, MAPK, mitogen-activated protein kinase, Research Article

الوصف: Background & Aims MicroRNAs (miRNAs) circulate in several body fluids and can be useful biomarkers. The aim of this study was to identify blood-circulating miRNAs associated with cirrhosis progression and acute-on-chronic liver failure (ACLF). Methods Using high-throughput screening of 754 miRNAs, serum samples from 45 patients with compensated cirrhosis, decompensated cirrhosis, or ACLF were compared with those from healthy individuals (n = 15). miRNA levels were correlated with clinical parameters, organ failure, and disease progression and outcome. Dysregulated miRNAs were evaluated in portal and hepatic vein samples (n = 33), liver tissues (n = 17), and peripheral blood mononuclear cells (PBMCs) (n = 16). Results miRNA screening analysis revealed that circulating miRNAs are dysregulated in cirrhosis progression, with 51 miRNAs being differentially expressed among all groups of patients. Unsupervised clustering and principal component analysis indicated that the main differences in miRNA expression occurred at decompensation, showing similar levels in patients with decompensated cirrhosis and those with ACLF. Of 43 selected miRNAs examined for differences among groups, 10 were differentially expressed according to disease progression. Moreover, 20 circulating miRNAs were correlated with model for end-stage liver disease and Child-Pugh scores. Notably, 11 dysregulated miRNAs were associated with kidney or liver failure, encephalopathy, bacterial infection, and poor outcomes. The most severely dysregulated miRNAs (i.e. miR-146a-5p, miR-26a-5p, and miR-191-5p) were further evaluated in portal and hepatic vein blood and liver tissue, but showed no differences. However, PBMCs from patients with cirrhosis showed significant downregulation of miR-26 and miR-146a, suggesting a extrahepatic origin of some circulating miRNAs. Conclusions This study is a repository of circulating miRNA data following cirrhosis progression and ACLF. Circulating miRNAs were profoundly dysregulated during the progression of chronic liver disease, were associated with failure of several organs and could have prognostic utility. Lay summary Circulating miRNAs are small molecules in the blood that can be used to identify or predict a clinical condition. Our study aimed to identify miRNAs for use as biomarkers in patients with cirrhosis or acute-on-chronic liver failure. Several miRNAs were found to be dysregulated during the progression of disease, and some were also related to organ failure and disease-related outcomes.
Graphical abstract
Highlights • Circulating miRNAs are dysregulated with cirrhosis progression and in patients with ACLF. • Patient decompensation is associated with important changes in the levels of circulating miRNAs. • A total of 11 circulating miRNAs were identified as associated with organ failure and 7 with poor outcome. • The miRNAs most dysregulated during cirrhosis progression were miR-146a, miR-26a, and miR-191. • miR-146a was dysregulated in PBMCs of patients with decompensated cirrhosis vs. compensated cirrhosis.

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الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::87d4e48212cb48cff68c240ced3c4227Test