clove and Liver-Cirrhosis

Hepatocellular carcinoma (HCC) arising from fibrosis/cirrhosis is the most common type of primary liver cancer. Conversely, a higher intake of fruits and vegetables might play a protective role in HCC risk. Recently, Myrtaceae family tropical fruits have raised great interest due to the high levels of anthocyanins especially in their peels, which are usually discarded upon consumption. Anthocyanins are antioxidant pigments known to have beneficial effects in vivo/in vitro cancer bioassays. Thus, we evaluated whether dietary Myrciaria jaboticaba, Syzygium cumini, and Syzygium malaccense fruit peel powders reduce fibrosis and hepatocarcinogenesis in mice. Female C3H/HeJ mice were submitted to the model of diethylnitrosamine/carbon tetrachloride-induced liver fibrosis and carcinogenesis. Concomitantly, mice received a basal diet containing 2% of M. jaboticaba, S. cumini, or S. malaccense fruit peel powders, obtained by convective drying, for 10 weeks. M. jaboticaba peel powder showed the highest levels of total anthocyanins, while S. cumini peel powder displayed the greatest diversity of these pigments. All Myrtaceae family peel powders reduced the serum levels of the liver injury marker alanine aminotransferase. M. jaboticaba peel feeding reduced the incidence of liver preneoplastic foci, hepatocyte proliferation (Ki-67), and the protein levels of hepato-mitogen tumor necrosis factor-alpha (TNF-α). M. jaboticaba peel feeding also diminished liver lipid peroxidation and increased total glutathione levels. S. cumini peel feeding reduced hepatic collagen, lipid peroxidation, and TNF-α levels while increased catalase activity. Although S. malaccense peel powder, which displayed the lowest anthocyanin levels, decreased oxidative stress, and cytokine levels, no effects were observed on liver fibrosis or preneoplastic lesion outcomes. Findings indicate a protective effect of anthocyanin-rich M. jaboticaba and S. cumini peel powder feeding on preneoplastic lesion development and fibrosis, respectively. Results indicate that differential biological responses may be attributed to distinct anthocyanin profiles and levels, assigning a functional/market value to the underutilized peel fraction.

Topics: Animals; Anthocyanins; Carcinogenesis; Carcinoma, Hepatocellular; Female; Fruit; Liver Cirrhosis; Liver Neoplasms; Mice; Mice, Inbred C3H; Myrtaceae

A cross-sectional survey was performed to estimate the prevalence of periportal fibrosis in children based on ultrasound examination in the Marolambo district of the Atsinanana region of Madagascar. This is a remote area known to have a high prevalence of intestinal schistosomiasis.. School-aged children (5-14 y) were selected from six villages for parasitological and sonographic examination. Circulating cathodic antigen (CCA) tests and Kato Katz (KK) stool microscopy were performed. Video-clips of liver views were recorded with a SonoSite iViz and interpreted in the UK by comparison with standardised images (WHO protocol).. The prevalence of schistosomiasis according to CCA testing was 97.8% (269/275) and 73.8% (203/275) by KK. Sonographic evidence of periportal fibrosis was observed in 11.3% (31/275). The youngest children with fibrosis were aged 6 y. Fibrosis was more common in older children (p=0.03) but was not associated with either infection intensity category (p=0.07) or gender (p=0.67).. Findings of periportal fibrosis among children in these hard-to-reach villages suggests chronic Schistosoma mansoni infection from a very young age. This may reflect other similarly remote schistosomiasis-endemic areas and reinforces the need to investigate morbidity in neglected communities to understand the true extent of disease burden in endemic countries.

Topics: Animals; Antigens, Helminth; Child; Cross-Sectional Studies; Feces; Humans; Liver Cirrhosis; Madagascar; Prevalence; Schistosoma mansoni; Schistosomiasis mansoni; Schools

Activated hepatic stellate cells (HSC) are the major source of collagen I in liver fibrosis. Eugenia uniflora L. is a tree species that is widely distributed in South America. E. uniflora L. fruit-popularly known as pitanga-has been shown to exert beneficial properties. Autophagy contributes to the maintenance of cellular homeostasis and survival under stress situation, but it has also been suggested to be an alternative cell death pathway. Mitochondria play a pivotal role on signaling cell death. Mitophagy of damaged mitochondria is an important cell defense mechanism against organelle-mediated cell death signaling. We previously found that purple pitanga extract induced mitochondrial dysfunction, cell cycle arrest, and death by apoptosis and necrosis in GRX cells, a well-established activated HSC line. We evaluated the effects of 72-h treatment with crescent concentrations of purple pitanga extract (5 to 100 μg/mL) on triggering autophagy in GRX cells, as this is an important mechanism to cells under cytotoxic conditions. We found that all treated cells presented an increase in the mRNA expression of autophagy-related protein 7 (ATG7). Concomitantly, flow cytometry and ultrastructural analysis of treated cells revealed an increase of autophagosomes/autolysosomes that consequentially led to an increased mitophagy. As purple pitanga extract was previously found to be broadly cytotoxic to GRX cells, we postulated that autophagy contributes to this scenario, where cell death seems to be an inevitable fate. Altogether, the effectiveness on inducing activated HSC death can make purple pitanga extract a good candidate on treating liver fibrosis.

Topics: Animals; Apoptosis; Autophagosomes; Autophagy; Cell Line; Eugenia; Hepatic Stellate Cells; Liver Cirrhosis; Lysosomes; Mice; Mitochondria; Phytotherapy; Plant Extracts

Cirrhotic patients have poorer life expectancy than the general population. The purpose of this study was to identify causes of death in a sample of cirrhotic patients from Madagascar.. A retrospective analytic and descriptive study was conducted on the files of cirrhotic inpatients admitted to the gastroenterology department of the Joseph Raseta Befelatanana University Hospital Center in Antananarivo, Madagascar from January 1, 2003 to June 30, 2007.. The files of 117 patients were reviewed. Death occurred in 31 cases for a mortality rate of 26.5%. The main causes of death were disorders of consciousness (51.6%) and hypovolemic shock (25.8%). Jaundice, encephalopathy, and gastrointestinal bleeding were predictive factors for mortality.. Cirrhotic patients in this study were hospitalized at a late stage of disease. Further prospective study in a larger sample will be needed to standardize the management protocol in Madagascar.

Topics: Cause of Death; Female; Fever; Gastrointestinal Hemorrhage; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Madagascar; Male; Middle Aged

Ultrasound (US) is a quite economical and noninvasive technique for morbidity assessment in intestinal schistosomiasis and it is widely used in order to detect organ-specific schistosomiasis-associated changes even if it may be invalidated by low reproducibility of measurements and high interobserver variance. Reports on histological assessment in patients with intestinal schistosomiasis mansoni are unusual because liver biopsy is not commonly feasible in endemic areas and it is not warranted for ethical reasons. This short report is a retrospective analysis of sonographic and histologic findings in patients with early liver pathology, in view of the pathogenesis and morbidity assessment of intestinal schistosomiasis, in a European hospital setting.. Seven immigrants from Madagascar with chronic diarrhea or Schistosoma mansoni egg detection in feces were admitted to our department. All of them were subjected to clinical, biochemical and ultrasound examination following current World Health Organization (WHO) guidelines. Each patient underwent percutaneous liver biopsy.. Abdominal ultrasonography showed schistosomiasis image patterns or US signs of liver involvement only in one out of seven patients while histological findings showed dense discrete fibrous tissue formation in five out of seven patients. In three out of seven patients liver biopsy also showed inflammatory infiltration of eosinophils and macrophages with periportal granulomas with S. mansoni eggs. Considering the mean egg intensity of three stool specimens as the gold standard, US showed a sensitivity of 16% with a negative predictive value (NPV) of 16% and a specificity of 100% with a positive predictive value (PPV) of 100%. Liver biopsy showed a sensitivity of 83% with a NPV of 50% and a specificity of 100% with a PPV of 100%.. In our small study, US seemed to underestimate hidden liver fibrosis in intestinal schistosomiasis. In some European clinical settings, histological evaluation by liver biopsy may be a useful tool to detect early liver pathology in schistosomiasis mansoni. These findings could provide additional information for studies from endemic areas where US is commonly used for morbidity assessment.

Topics: Adult; Animals; Emigrants and Immigrants; Female; Humans; Italy; Liver; Liver Cirrhosis; Liver Diseases, Parasitic; Madagascar; Parasite Egg Count; Schistosoma mansoni; Schistosomiasis mansoni; Ultrasonography; Young Adult

Before the sonographic era, clinics or parasitology even autopsy have been the only sources of basic principles on the morbidity due to Schistosoma mansoni. The exploration of inner organs and their pathologies became easier. The organ's size as well as their echogenicity permit grading. Up till now, any classification is not appropriate. Attempts of standardization haven't yet succeeded, thus any comparison among different endemic regions is not possible. A simple method based on qualitative observation of the periportal fibrosis is proposed to help sonographist for the diagnosis of presumption in front of evocative image and to be a guideline for later investigation.

Topics: Adult; Cohort Studies; Endemic Diseases; Female; Forecasting; Humans; Liver Cirrhosis; Madagascar; Male; Practice Guidelines as Topic; Rural Health; Schistosomiasis mansoni; Sensitivity and Specificity; Severity of Illness Index; Ultrasonography

Topics: Asian People; Black People; Humans; Liver Cirrhosis; Madagascar