Browsing by Author "Pablo Arab, Juan"

Now showing 1 - 9 of 9
  • No Thumbnail Available
    Item
    A multisociety Delphi consensus statement on new fatty liver disease nomenclature
    (2023) Rinella, Mary E.; Lazarus, Jeffrey V.; Ratziu, Vlad; Francque, Sven M.; Sanyal, Arun J.; Kanwal, Fasiha; Romero, Diana; Abdelmalek, Manal F.; Anstee, Quentin M.; Pablo Arab, Juan; Arrese, Marco; Bataller, Ramon; Beuers, Ulrich; Boursier, Jerome; Bugianesi, Elisabetta; Byrne, Christopher D.; Castro Narro, Graciela E.; Chowdhury, Abhijit; Cortez-Pinto, Helena; Cryer, Donna R.; Cusi, Kenneth; El-Kassas, Mohamed; Klein, Samuel; Eskridge, Wayne; Fan, Jiangao; Gawrieh, Samer; Guy, Cynthia D.; Harrison, Stephen A.; Kim, Seung Up; Koot, Bart G.; Korenjak, Marko; Kowdley, Kris V.; Lacaille, Florence; Loomba, Rohit; Mitchell-Thain, Robert; Morgan, Timothy R.; Powell, Elisabeth E.; Roden, Michael; Romero-Gomez, Manuel; Silva, Marcelo; Singh, Shivaram Prasad; Sookoian, Silvia C.; Spearman, C. Wendy; Tiniakos, Dina; Valenti, Luca; Vos, Miriam B.; Wong, Vincent Wai-Sun; Xanthakos, Stavra; Yilmaz, Yusuf; Younossi, Zobair; Hobbs, Ansley; Villota-Rivas, Marcela; Newsome, Philip N.
    The principal limitations of the terms NAFLD and NASH are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content experts and patient advocates were in favor of a change in nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. The consensus was defined a priori as a supermajority (67%) vote. An independent committee of experts external to the nomenclature process made the final recommendation on the acronym and its diagnostic criteria. A total of 236 panelists from 56 countries participated in 4 online surveys and 2 hybrid meetings. Response rates across the 4 survey rounds were 87%, 83%, 83%, and 78%, respectively. Seventy-four percent of respondents felt that the current nomenclature was sufficiently flawed to consider a name change. The terms "nonalcoholic" and "fatty" were felt to be stigmatising by 61% and 66% of respondents, respectively. Steatotic liver disease was chosen as an overarching term to encompass the various aetiologies of steatosis. The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. The name chosen to replace NAFLD was metabolic dysfunction-associated steatotic liver disease. There was consensus to change the definition to include the presence of at least 1 of 5 cardiometabolic risk factors. Those with no metabolic parameters and no known cause were deemed to have cryptogenic steatotic liver disease. A new category, outside pure metabolic dysfunction-associated steatotic liver disease, termed metabolic and alcohol related/associated liver disease (MetALD), was selected to describe those with metabolic dysfunction-associated steatotic liver disease, who consume greater amounts of alcohol per week (140-350 g/wk and 210-420 g/wk for females and males, respectively). The new nomenclature and diagnostic criteria are widely supported and nonstigmatising, and can improve awareness and patient identification.
  • No Thumbnail Available
    Item
    Diagnosis of Alcohol-Associated Hepatitis When Is Liver Biopsy Required?
    (2021) Pablo Arab, Juan; Arrese, Marco; Singal, Ashwani K.
  • Thumbnail Image
    Item
    Effects of Japanese herbal medicine inchin-ko-to on endotoxin-induced cholestasis in the rat
    (MEXICAN ASSOC HEPATOLOGY, 2009) Pablo Arab, Juan; Ramirez, Carolina; Munoz, Pablo; Pizarro, Margarita; Solis, Nancy; Riquelme, Arnoldo; Arrese, Marco
    Background/Objective. Inchin-ko-to (ICKT) is an herbal medicine used in Japan to treat jaundice and liver fibrosis. We investigated the effect of oral ICKT supplementation on endotoxin-induced cholestasis in the rat. Material and methods. Lipopolysaccharide (LPS) injection (1 mg/kg body weight i.p.) was used as a model of sepsis-induced cholestasis. Bite flow, biliary bile salt secretion, biliary glutathione secretion and protein expression of the main hepatobiliary transporters Na(+)-taurocholate-cotransporting peptide (Ntcp), multidrug resistance protein 2 (Mrp2) and bile salt export pump (Bsep) were analyzed by conventional techniques in ICKT treated and non-treated animals. Results. Injection of LIDS induced a significant decrease of bite ftow (-24%), biliary bite salts (-40%) and glutathione excretion (-70%) as well as a significant decrease in Ntcp (-90%) and Mrp2 (-80%) protein levels. ICKT supplementation partially prevented the effects of LIPS determining a less intense reduction in bile flow (-10%), a normalization of glutathione excretion as well as a significant increase in Mrp2 protein levels to 60% of the levels observed in control animals. ICKT administration did not modify the effects of LPS on BS secretion or Ntcp protein levels. Conclusion. Our data show that oral. supplementation of ICKT partially prevents LPS-induced cholestasis by increasing Mrp2 protein levels and biliary glutathione excretion thus increasing bite salt-independent ftow.
  • No Thumbnail Available
    Item
    Extracellular vesicles derived from fat-laden hepatocytes undergoing chemical hypoxia promote a pro-fibrotic phenotype in hepatic stellate cells
    (2020) Hernandez, Alejandra; Reyes, Daniela; Geng, Yana; Pablo Arab, Juan; Cabrera, Daniel; Sepulveda, Rolando; Solis, Nancy; Buist-Homan, Manon; Arrese, Marco; Moshage, Han
    Background: The transition from steatosis to non-alcoholic steatohepatitis (NASH) is a key issue in non-alcoholic fatty liver disease (NAFLD). Observations in patients with obstructive sleep apnea syndrome (OSAS) suggest that hypoxia contributes to progression to NASH and liver fibrosis, and the release of extracellular vesicles (EVs) by injured hepatocytes has been implicated in NAFLD progression.
  • No Thumbnail Available
    Item
    Latin American Association for the study of the liver (ALEH) practice guidance for the diagnosis and treatment of non-alcoholic fatty liver disease
    (2020) Pablo Arab, Juan; Dirchwolf, Melisa; Alvares-da-Silva, Mario Reis; Barrera Martínez, Francisco; Benitez, Carlos; Castellanos-Fernandez, Marlene; Castro-Narro, Graciela; Chavez-Tapia, Norberto; Chiodi, Daniela; Cotrim, Helma; Cusi, Kenneth; Marques Souza de Oliveira, Claudia Pinto; Diaz, Javier; Fassio, Eduardo; Gerona, Solange; Girala, Marcos; Hernandez, Nelia; Marciano, Sebastian; Masson, Walter; Mendez-Sanchez, Nahum; Leite, Nathalie; Lozano, Adelina; Padilla, Martin; Panduro, Arturo; Parana, Raymundo; Parise, Edison; Perez, Marlene; Poniachik, Jaime; Carlos Restrepo, Juan; Ruf, Andres; Silva, Marcelo; Tagle, Martin; Tapias, Monica; Torres, Kenia; Vilar-Gomez, Eduardo; Costa Gil, Jose Eduardo; Gadano, Adrian; Arrese, Marco
    Non-alcoholic fatty liver disease (NAFLD) currently represents an epidemic worldwide. NAFLD is the most frequently diagnosed chronic liver disease, affecting 20-30% of the general population. Furthermore, its prevalence is predicted to increase exponentially in the next decades, concomitantly with the global epidemic of obesity, type 2 diabetes mellitus (T2DM), and sedentary lifestyle. NAFLD is a clinical syndrome that encompasses a wide spectrum of associated diseases and hepatic complications such as hepatocellular carcinoma (HCC). Moreover, this disease is believed to become the main indication for liver transplantation in the near future. Since NAFLD management represents a growing challenge for primary care physicians, the Asociacion Latinoamericana para el Estudio del Higado (ALEH) has decided to organize this Practice Guidance for the Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease, written by Latin-American specialists in different clinical areas, and destined to general practitioners, internal medicine specialists, endocrinologists, diabetologists, gastroenterologists, and hepatologists. The main purpose of this document is to improve patient care and awareness of NAFLD. The information provided in this guidance may also be useful in assisting stakeholders in the decision-making process related to NAFLD. Since new evidence is constantly emerging on different aspects of the disease, updates to this guideline will be required in future. (C) 2020 Published by Elsevier Espana, S.L.U. on behalf of Fundacion Cilnica Medica Sur, A.C.
  • No Thumbnail Available
    Item
    LDL particle size and antioxidant HDL function improve after sustained virological response in patients with chronic HCV
    (2022) Ignacio Vargas, Jose; Rivera, Katherine; Arrese, Marco; Benitez, Carlos; Barrera Martínez, Francisco; Hugo, Monrroy; Pablo Arab, Juan; Pino, Karla; Barrera, Aldo; Lopez-Lastra, Marcelo; Rigotti, Attilio; Soza, Alejandro
    HCV infection is associated with an increased incidence of cardiovascular (CV) events. Mechanisms underlying this association remain unknown. In our study, twenty HCV patients (median age 60.5 years, 65% male and 80% with cirrhosis) were evaluated prior, during and after direct-acting antiviral treatment. Ninety percent of patients achieved sustained virological response (SVR). Significant changes were observed in LDL particle size index, measured by LDL-C/apoB ratio, which increased after treatment (p = 0.023). In addition, HDL antioxidant capacity improved gradually from 34.4% at baseline to 42.4% at 4 weeks (p = 0.011), 65.9% at end of treatment EOT (p = 0.002) and remained elevated at 12-week (p = 0.001) after EOT compared to baseline values. Our findings suggest that a shift to a less atherogenic lipid profile may be a possible mechanism associated with CV risk reduction in patients with HCV infection achieving SVR. (c) 2021 Fundacion Clinica Medica Sur, A.C. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
  • Thumbnail Image
    Item
    Mild hypothermia does not affect liver regeneration after partial hepatectomy in mice
    (WILEY, 2009) Pablo Arab, Juan; Pizarro, Margarita; Solis, Nancy; Sun, Hongdan; Thevananther, Sundararajah; Arrese, Marco
    The use of mild hypothermia has been suggested to be therapeutically useful in treating acute liver failure. It is not known if hypothermia influences liver regeneration.
  • Thumbnail Image
    Item
    Reanimación cardiopulmonar básica: conocimiento teórico, desempeño práctico y efectividad de las maniobras en médicos generales
    (SOC MEDICA SANTIAGO, 2012) Rojas, Luis; Aizman, Andres; Pablo Arab, Juan; Utili, Franco; Andresen, Max
    Background: General physicians should be adequately trained to deliver effective resuscitation during ventricular fibrillation (VF). Aim: To assess the degree of knowledge, skills and practical effectiveness in cardiopulmonary resuscitation (CPR) of Chilean general physicians. Materials and Methods: Forty eight general physicians starting Anesthesiology or Internal Medicine residency programs were evaluated. They answered a modified American Heart Association Basic Life Support Course written test and individually participated in a witnessed VF cardiac arrest simulated scenario. Execution of resuscitation tasks in the correct order, the quality of the maneuvers and the use of defibrillator were registered. Results: All participants acknowledged the importance of uninterrupted CPR and early defibrillation. Seventy five percent knew the correct frequency of chest compressions, but only 6.25% knew all the effective chest compression characteristics. Ninety eight percent knew the recommended number of breaths per cycle. In practice, 58% performed effective ventilations, 33% performed uninterrupted compressions, 14% did them with adequate frequency and only 8% performed chest compressions adequately. Forty four percent requested a defibrillator within 30 seconds and 31% delivered the first defibrillation within 30 seconds of defibrillator arrival. Airway, breathing, circulation and defibrillation sequence was correctly performed by 12% of participants and 80% acknowledged that their medical training was inadequate or insufficient for managing a cardiac arrest. Conclusions: Despite an elevated degree of knowledge about key aspects of CPR, this group of Chilean physicians displayed suboptimal practical skills while performing CPR in a simulated scenario, specially delivering effective chest compressions and promptly asking for and using the defibrillator. (Rev Med Chile 2012; 140: 73-77).
  • Thumbnail Image
    Item
    Somatotropic Axis Dysfunction in Non-Alcoholic Fatty Liver Disease: Beneficial Hepatic and Systemic Effects of Hormone Supplementation
    (2018) Cabrera, Daniel; Cabello-Verrugio, Claudio; Solis, Nancy; San Martin, Diego; Cofre, Catalina; Pizarro, Margarita; Pablo Arab, Juan; Abrigo, Johanna; Campos, Fabian; Irigoyen, Betzabe; Carrasco-Avino, Gonzalo; Bezares, Katiuska; Riquelme, Valentina; Riquelme, Arnoldo; Arrese, Marco; Barrera Martínez, Francisco
    Background: Somatotropic axis dysfunction associated with non-alcoholic fatty liver disease (NAFLD) has potential multisystemic detrimental effects. Here, we analysed the effects of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) supplementation on liver histology, adipokine profile and muscle function in an NAFLD model. Methods: C57BL/6 mice were fed with a high fat diet (HFD) for 12 weeks and were separated into three groups treated for 4 weeks with: (1) High fat diet (HFD) (n = 10); (2) HFD + GH 9 g/g/d (n = 10); (3) HFD + IGF-1 0.02 mu g/g/d (n = 9). A control group fed a chow diet was included (n = 6). Liver histology, liver triglycerides content, serum alanine aminotransferase (ALT) activity, adiponectin and leptin serum levels, in vivo muscle strength, tetanic force and muscle fibre cross-sectional area (CSA) were measured. Results: HFD + GH and HFD + IGF-1 groups showed significantly lower ALT activity compared to HFD (p < 0.01). Liver triglyceride content in HFD + GH was decreased compared to HFD (p < 0.01). Histologic steatosis score was increased in HFD and HFD + GH group (p < 0.01), whereas HFD + IGF-1 presented no difference compared to the chow group (p = 0.3). HFD + GH group presented lower serum leptin and adiponectin levels compared to HFD. GH and IGF-1 supplementation therapy reverted HFD-induced reduction in muscle strength and CSA (sarcopenia). Conclusions: GH and IGF-1 supplementation induced significant improvement in liver steatosis, aminotransferases and sarcopenia in a diet-induced NAFLD model.