alcoholic steatohepatitis – Rogalevich http://rogalevich.org/ Sat, 26 Mar 2022 12:35:37 +0000 en-US hourly 1 https://wordpress.org/?v=5.9.3 https://rogalevich.org/wp-content/uploads/2021/10/icon-120x120.png alcoholic steatohepatitis – Rogalevich http://rogalevich.org/ 32 32 Mice experiments reveal females produce more than one protein that helps prevent non-alcoholic fatty liver disease https://rogalevich.org/mice-experiments-reveal-females-produce-more-than-one-protein-that-helps-prevent-non-alcoholic-fatty-liver-disease/ Thu, 17 Mar 2022 16:49:32 +0000 https://rogalevich.org/mice-experiments-reveal-females-produce-more-than-one-protein-that-helps-prevent-non-alcoholic-fatty-liver-disease/ One of the most common disorders in the world, non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of death worldwide. Its progressive form, called “non-alcoholic steatohepatitis” (NASH), affects around 30% of all NAFLD patients, and can lead to cirrhosis and liver cancer. Despite numerous research efforts, we still do not understand the […]]]>

One of the most common disorders in the world, non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of death worldwide. Its progressive form, called “non-alcoholic steatohepatitis” (NASH), affects around 30% of all NAFLD patients, and can lead to cirrhosis and liver cancer. Despite numerous research efforts, we still do not understand the underlying mechanisms of NAFLD/NASH and therefore lack an effective treatment.

One thing we do know, however, is that it seems to be more common in men than in women, especially premenopausal women. Why this is so is not entirely clear, but current evidence suggests that estrogen, a sex hormone, plays a protective role. On the other hand, the formyl-peptide protein receptor 2 (FPR2) is known to play an important role in mediating inflammatory responses in several organs. However, no studies to date have determined its role in the liver. Could FPR2 be implicated in sex-related differences in NAFLD prevalence and severity?

Addressing this question, a research team led by Prof. Youngmi Jung from Pusan ​​National University, Korea, recently conducted a study using a mouse model, shedding light on the role of FPR2 in NAFLD/NASH and its relationship to observed sex-based differences. This work is among the very few studies of NAFLD that rely on gender-balanced animal experiments rather than the more common male-only designs. This article was posted on January 31, 2022 and was published in Volume 13, Number 578, of the journal Nature Communication on January 31, 2022.

The researchers first found that Fpr2 was highly expressed in the healthy liver of female mice. Moreover, it was expressed differently in the liver of male and female mice fed a special NAFLD-inducing diet. Silence the Fpr2 The gene made male and female mice equally vulnerable to NAFLD, suggesting that FPR2 has a protective effect on the liver.

Interestingly, the researchers also found that the production of FPR2 in the liver is mediated by estrogen. Males supplemented with external estrogen produced more Fpr2 and were more resistant to NAFLD, while females whose ovaries had been removed had reduced liver Fpr2 levels. “Taken together, our results suggest that FPR2 is a potential therapeutic target for the development of pharmacological agents to treat NAFLD/NASH,” says Professor Jung. “Furthermore, our results could aid in the development of gender-based therapies for NASH.”

This unprecedented discovery of female-specific FPR2 production in the liver and its role in NAFLD/NASH resistance will hopefully pave the way not only for new treatments, but also for a more comprehensive and gender sensitive during scientific research. In this regard, Professor Jung remarks: “Our research highlights the pressing need to design and develop better gender-balanced animal experiments, given that sex-specific expression of FPR2 in the liver had been completely overlooked. in previous studies.

Hopefully this marks the beginning of a deeper understanding of NAFLD/NASH and the first steps towards effective sex-based therapies.

Source of the story:

Materials provided by Pusan ​​National University. Original written by Na-hyun Lee. Note: Content may be edited for style and length.

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High Fructose Intake May Trigger Fatty Liver Disease https://rogalevich.org/high-fructose-intake-may-trigger-fatty-liver-disease/ Mon, 07 Mar 2022 18:40:15 +0000 https://rogalevich.org/high-fructose-intake-may-trigger-fatty-liver-disease/ Adding high fructose beverages to a diet that already includes a high fat content may accelerate the risk of foie gras disease, according to scientists from the University of Barcelona. What there is to know: High Fructose Intake May Increase Risk of Non-Alcoholic Fatty Liver Diseasein which too much fat is stored in liver cells. […]]]>

Adding high fructose beverages to a diet that already includes a high fat content may accelerate the risk of foie gras disease, according to scientists from the University of Barcelona.

What there is to know:

  • High Fructose Intake May Increase Risk of Non-Alcoholic Fatty Liver Diseasein which too much fat is stored in liver cells.

  • High fructose corn syrup is one of the most common sweeteners in the food industry and is used for sweeten many products despite scientific evidence that it is associated with metabolic disorders that are risk factors for cardiovascular disease.

  • The researchers found that consumption a diet high in fructose for long periods of time may result in deterioration of the layer of cells that creates the intestinal barrier that prevents bacteria and toxins from entering the bloodstream and affecting the liver.

  • Fatty liver disease can lead to liver inflammation and liver damage, resulting in non-alcoholic steatohepatitis, one more aggressive disease which in turn can evolve into scarring of the liver (cirrhosis), liver cancerand liver failure.

  • Severe fatty liver disease and liver tumors deterioration of the intestinal barrier created by excessive consumption of fructose can be avoided with medications.

This is a summary of the article, “A New Study Relates Liquid Fructose Intake to Fatty Liver Disease“, published in Molecular Nutrition and Food Research on March 4, 2022. The full article can be found at newswise.com.

For more information, follow Medscape on Facebook, Twitter, instagramand YouTube.

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Supporting the 3rd leading cause of cancer-related death https://rogalevich.org/supporting-the-3rd-leading-cause-of-cancer-related-death/ Mon, 07 Mar 2022 15:18:52 +0000 https://rogalevich.org/supporting-the-3rd-leading-cause-of-cancer-related-death/ Liver cancer is the third leading cause of cancer-related death worldwide, and the incidence of primary liver cancer in the United States has tripled over the past four decades. While chronic viral hepatitis is the primary route to liver cancer in the United States, non-infectious causes such as morbid obesity, type 2 diabetes, non-alcoholic fatty […]]]>

Liver cancer is the third leading cause of cancer-related death worldwide, and the incidence of primary liver cancer in the United States has tripled over the past four decades. While chronic viral hepatitis is the primary route to liver cancer in the United States, non-infectious causes such as morbid obesity, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), and non-infectious steatohepatitis associated alcoholism (NASH) increased rapidly. We will describe each of these pathways, starting with viral hepatitis (HCV and HBV) and alcoholic cirrhosis.


There is a morbid saying that cancer eventually affects us all, unless something else affects us first.

While some cancers currently have no accessible prevention, some can be effectively prevented. Hepatocellular carcinoma (HCC) is one of those that can be prevented, but once HCC is established and symptomatic, survival rates drop sharply. While liver cancer is the 8and location of cancer site by prevalence (Figure 1), this is the 3rd leading cause of death (Figure 2). HCC has a high mortality profile with a median survival after diagnosis of 6-20 months, and in the United States it has a 5-year survival rate of only 10% (Golabi, et al., 2017)

Figure 1. Top 10 cancer sites by case (Sung et al, 2021)

Top 10 cancer sites by death

Figure 2. Top 10 cancer sites by death (Sung et al, 2021)

The COVID-19 pandemic has rightly occupied the minds and efforts of nearly everyone in healthcare for the past two years, but HCC has not gone away and continues to cause daily damage. . HCC was on 4and leading cause of cancer-related death in 2019 (Yang et al., 2019), and has been steadily increasing – it has tripled in the United States (Rawla, Sunkara, Muralidharan & Raj, 2018).

Although your daily chance of encountering a patient with HCC is still small, it increases year by year and there is a serious risk of missing the window of opportunity to prevent full-blown HCC.

This blog will describe how to be alert to the causes and cases of HCC, and we will provide you with tools and resources to help you identify HCC, ways to connect your patient with appropriate specialists, and help you find appropriate studies and trials for your patient.

There are four main HCC risk factors:

  1. Hepatitis B (HBV)
  2. Hepatitis C (HCV)
  3. Excessive consumption of alcohol
  4. Non-alcoholic fatty liver disease (NAFLD) resulting in non-alcoholic steatohepatitis (NASH)

How likely are you to encounter hepatocellular carcinoma in patients?

In the near future, it is unlikely that any specific patient you see will already have HCC. That’s great, but it’s also a problem because you’re less likely to recognize it immediately. For HCC, delay is the killer.

However, you are very likely to see a patient who, regardless of their primary complaint, is already on one or more of the four main HCC pathways. The picture is also skewed when race is taken into account – while the overall rate of HBV infection has declined significantly since 1991, it remains a concern for the African American population. In 2017, non-Hispanic African Americans were 1.5 times more likely to die from viral hepatitis than whites, and almost twice as likely to die from HCV. (HHS-OMH”Hepatitis and African Americans”)

Anything you can do to increase HBV vaccination rates and prevent HCV infection will help steer your patients away from the viral pathway. It is therefore important to use screening tests for HBV and HCV and to strongly encourage HBV vaccination even if patients are not in high-risk categories. Likewise, addressing alcohol use and encouraging your patients to follow guidelines will help steer them away from alcohol’s path to HCC.

the NAFLD/NASH pathway talks about lifestyle changes that are inherently healthier and worth discussing. Discussing healthy eating, limiting portion sizes, and maintaining a healthy weight with your patients can help steer them away from this path.

Patient history that should raise your index of suspicion includes past unprotected sex, use of needles, binge drinking or binge drinking, or increasing obesity. However, it is important to keep in mind that many patients who had no obvious risk factors in their history nevertheless went on to have HCC. Although atypical, HCC can be the result of maternal HBV infection or HCV transmitted to children. For an example, see “Better off bald: a life in 147 days

How to discuss staging with patients

Discussing staging with patients can be difficult, and the literature is often either aimed at clinicians or contains misleading information. Blue Faery provides clinically accurate yet understandable materials to help you describe the staging and help the patient understand where they are on the spectrum.

These materials include:

  • The HCC patient education brochures is written in plain language and intended to be read by the patient.
  • The Blue Faery and Exelixis staging discussion pad contains anatomical graphics and easy-to-understand text. Each double-sided sheet allows the doctor to add notes that his patient can use after the appointment.
  • the Liver Cancer Patient Resource Guide is a 20-page booklet containing relevant explanations and resources for HCC patients and their caregivers.

Blue Faery will send these documents free of charge to any doctor who requests them.

How to Find Hepatocellular Carcinoma Specialists, Treatment Options and Clinical Trials

Treatment of HCC is best approached with a multidisciplinary team coordinated by a primary care physician. The most effective approach will likely require the expertise of multiple healthcare professionals, including the primary care physician, and may include an oncologist with experience in HCC, gastroenterologist, hepatologist, radiologist interventionist, a radiation oncologist, a surgical oncologist and a transplant surgeon.

Where to find clinical trials specific to hepatocellular carcinoma

To find all clinical trials, the best option is clinicaltrials.gov, but this website can be confusing and difficult to navigate. To help physicians guide their patients to relevant trials, Blue Faery has a custom HCC clinical trial browser.

Where can patients find community support?

Patient communities are very helpful in providing patients with practical guidance for their care journey and are often a source of emotional support from people who understand the experience.

the Blue Fairy Liver Cancer Community is a free, HIPAA-compliant online community where patients and caregivers are invited to join and seek or exchange relevant information about HCC care. Members ask questions, discuss concerns and find common ground along their cancer journey. Forum moderators include Community Ambassadors who were former caregivers of HCC patients.

For individual patient support, Blue Faery has partnered with Imerman Angels, a non-profit organization that provides peer-to-peer support services to the liver cancer community. Blue Faery and Imerman Angels believe that no one should face cancer alone.

Conclusion

With proper screening, testing and inoculation, the viral pathway to HCC can often be interrupted. Blue Faery provides free, patient-readable and clinically accurate materials to help physicians discuss their patients’ staging, options and resources.

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Fatty liver disease: four signs of the disease explained https://rogalevich.org/fatty-liver-disease-four-signs-of-the-disease-explained/ Thu, 03 Mar 2022 15:08:11 +0000 https://rogalevich.org/fatty-liver-disease-four-signs-of-the-disease-explained/ Warning signs that suggest you are at risk of developing fatty liver disease. Accumulation of fat in the liver can cause non-alcoholic fatty liver disease (NAFLD), a condition seen in overweight or obese people. NAFLD is not caused by alcohol, but if left untreated, it can lead to cirrhosis resembling liver damage caused by excessive […]]]>

Warning signs that suggest you are at risk of developing fatty liver disease.

Accumulation of fat in the liver can cause non-alcoholic fatty liver disease (NAFLD), a condition seen in overweight or obese people.

NAFLD is not caused by alcohol, but if left untreated, it can lead to cirrhosis resembling liver damage caused by excessive alcohol consumption.

However, foods and drinks containing alcohol or sugar can make the situation worse, so it is advisable to limit their consumption.

NAFLD is the most common liver disease in the world.

More than 90% of obese people, 60% of diabetics and 20% of people with a healthy weight suffer from this disease.

The human liver normally contains some fat, but when fat exceeds 5% of liver weight, fatty liver can develop.

In the early stages, NAFLD usually has no symptoms, but it can be detected by a liver function test from the blood sample.

The warning signs appear when it progresses to non-alcoholic steatohepatitis (NASH) or fibrosis in which the liver has become inflamed.

A person with NASH may experience:

  1. extremely tired,
  2. tiredness,
  3. pain in the upper right of the belly on the lower right side of the ribs,
  4. and lose weight for no reason.

Prolonged fibrosis and persistent inflammation will cause cirrhosis where the liver is severely scarred and damaged.

Permanent damage can lead to liver cancer, liver failure, and ultimately death.

Symptoms of cirrhosis can include:

  • itchy skin,
  • edema (swelling of the legs or stomach),
  • and jaundice (the skin and the whites of the eyes turn yellow).

We don’t know how mild fatty liver disease develops into serious disease such as non-alcoholic steatohepatitis and liver fibrosis.

To understand the process, the researchers performed a genetic analysis of hepatocytes, the main functional cells of the liver.

Professor Stephan Herzig, co-author of the study, said:

“Understanding the mechanism by which this condition becomes fatal is essential in our quest to find therapeutic solutions and preventive measures.”

The research team developed a method targeting particular nodes of the protein network to halt disease progression or even prevent fibrosis.

A network of proteins called “transcription factors” is involved in the process of hepatocyte reprogramming.

Failure of the process could lead to dysfunction of hepatocyte cells.

For example, during the development of NASH, hepatocyte cells lose their identity.

Dr Ana Alfaro, the first author of the study, said:

“These findings are important because they unravel the cellular mechanisms underlying non-alcoholic steatohepatitis.

Knowing the role of protein networks and the loss of hepatocyte identity gives us potential intervention targets for the development of effective therapies.

The study was published in the journal Cell metabolism (Loft et al., 2021).

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Exercise reduces clotting risk in patients with non-alcoholic fatty liver disease https://rogalevich.org/exercise-reduces-clotting-risk-in-patients-with-non-alcoholic-fatty-liver-disease/ Tue, 01 Mar 2022 15:42:43 +0000 https://rogalevich.org/exercise-reduces-clotting-risk-in-patients-with-non-alcoholic-fatty-liver-disease/ Exercise may help some patients with non-alcoholic fatty liver disease (NAFLD) reduce their risk of developing blood clots, a new study finds Penn State College of Medicine researchers. While diet and physical activity have always been recommended treatments for these patients, the researchers said their findings confirm that exercise has a multitude of benefits, many […]]]>

Exercise may help some patients with non-alcoholic fatty liver disease (NAFLD) reduce their risk of developing blood clots, a new study finds Penn State College of Medicine researchers. While diet and physical activity have always been recommended treatments for these patients, the researchers said their findings confirm that exercise has a multitude of benefits, many of which extend beyond the liver, and should be included as part of NAFLD treatment.

The condition, NAFLD, where too much fat builds up in liver cells, affects almost a billion adults worldwide. Patients with NAFLD have an increased risk of heart disease, stroke, cancer, and blood clots. Currently, there are no approved drug treatments or cures for this common condition.

Dr Jonathan StineAssociate Professor of Medicine and Public Health Sciences at the Faculty of Medicine and Transplant Hepatologist at Penn State Health Milton S. Hershey Medical Center, conducted a clinical trial to study how exercise programs affect the health of patients with non-alcoholic steatohepatitis (NASH) – an aggressive form of NAFLD. Twenty-four patients completed the study, which required two-thirds of participants to complete a 20-week aerobic exercise program and dietary advice.

At the end of the trial, participants who completed the exercise program – which consisted of five 30-minute moderate-intensity exercise sessions per week – had a significantly reduced amount of activator inhibitor. plasminogen 1 (PAI-1), a protein that helps blood clots stay formed, compared to control group participants who received standard clinical care.

“NAFLD and NASH patients have an increased risk of developing blood clots in the veins of the legs, lungs, or liver,” said Stine, who noted that blood clots affect nearly 900,000 Americans each year. “If these occur, they can have serious consequences, including an increased risk of hospitalization or death. The results of our study illustrate the importance of prescribing physical activity to NAFLD and NASH patients as a means of improving their general state of health.

In addition to measuring the risk of clotting, the researchers also found that exercise led to a greater decrease in liver fat, a greater increase in the body’s ability to deliver oxygen to skeletal muscles during exercise. (cardiorespiratory fitness), changes in blood sugar and insulin levels, reduced body fat and improved quality of life. The research team noted that these benefits appeared to be independent of weight loss or dietary changes. the results were published in Hepatology.

To build on the findings, Stine, a Penn State Cancer Institute researcher, is conducting another clinical trial, sponsored by the National Institutes of Health, to study how different “doses” of exercise affect the metabolic function and health of NAFLD patients. Stine plans to launch the trial in May 2022.

“There is no cure or effective drug therapies for NAFLD,” Stine said. “Through this research, we hope to develop additional guidance for clinicians on the optimal amount of exercise for these patients and explore the biology that explains why physical activity is an effective therapy.”

Ian Schreibman, Alison Faust, Jessica DahmusBenajmin Stern, Christopher Soriano, Gloriany Rivas, Breianna Hummer, Scottish KimballNate Geyer, Vernon Chinchilli, Catherine Schmitz and Christophe Sciamanna from Penn State College of Medicine; and Rohit Loomba of the University of California, San Diego also contributed to this research. Information on conflicts of interest can be found in the manuscript.

This study was supported by funds from the National Institutes of Health and in part by a grant from the Pennsylvania Department of Health using Tobacco CURE funds. This project was also supported by Penn State Institute for Clinical and Translational Sciences through the National Center for Advancing Translational Sciences of the National Institutes of Health (grant numbers UL1 TR002014).

Learn more about liver disease research at Penn State College of Medicine.

Learn more about the hepatology study.

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Physical activity reduces the risk of clotting in patients with non-alcoholic fatty liver disease https://rogalevich.org/physical-activity-reduces-the-risk-of-clotting-in-patients-with-non-alcoholic-fatty-liver-disease/ Mon, 28 Feb 2022 13:00:38 +0000 https://rogalevich.org/physical-activity-reduces-the-risk-of-clotting-in-patients-with-non-alcoholic-fatty-liver-disease/ Exercise may help some patients with non-alcoholic fatty liver disease (NAFLD) reduce their risk of developing blood clots, a new study finds Penn State College of Medicine researchers. While diet and physical activity have always been recommended treatments for these patients, the researchers said their findings confirm that exercise has a multitude of benefits, many […]]]>

Exercise may help some patients with non-alcoholic fatty liver disease (NAFLD) reduce their risk of developing blood clots, a new study finds Penn State College of Medicine researchers. While diet and physical activity have always been recommended treatments for these patients, the researchers said their findings confirm that exercise has a multitude of benefits, many of which extend beyond the liver, and should be included as part of NAFLD treatment.

February 28, 2022Penn State College of Medicine News

The condition, NAFLD, where too much fat builds up in liver cells, affects almost a billion adults worldwide. Patients with NAFLD have an increased risk of heart disease, stroke, cancer, and blood clots. Currently, there is no approved drug treatment or cure for this common condition.

Dr Jonathan StineAssociate Professor of Medicine and Public Health Sciences at the Faculty of Medicine and Transplant Hepatologist at Penn State Health Milton S. Hershey Medical Center, conducted a clinical trial to study how exercise programs affect the health of patients with non-alcoholic steatohepatitis (NASH) – an aggressive form of NAFLD. Twenty-four patients completed the study, which required two-thirds of participants to complete a 20-week aerobic exercise program and dietary advice.

At the end of the trial, participants who completed the exercise program – which consisted of five 30-minute moderate-intensity exercise sessions per week – had a significantly reduced amount of activator inhibitor. plasminogen 1 (PAI-1), a protein that helps blood clots stay formed, compared to control group participants who received standard clinical care.

“NAFLD and NASH patients have an increased risk of developing blood clots in the veins of the legs, lungs, or liver,” said Stine, who noted that blood clots affect nearly 900,000 Americans each year. “If these occur, they can have serious consequences, including an increased risk of hospitalization or death. The results of our study illustrate the importance of prescribing physical activity to NAFLD and NASH patients as a means of improving their general state of health.

In addition to measuring the risk of clotting, the researchers also found that exercise led to a greater decrease in liver fat, a greater increase in the body’s ability to deliver oxygen to skeletal muscles during exercise. (cardiorespiratory fitness), changes in blood sugar and insulin levels, reduced body fat and improved quality of life. The research team noted that these benefits appeared to be independent of weight loss or dietary changes. the results were published in Hepatology.

To build on the findings, Stine, a Penn State Cancer Institute researcher, is conducting another clinical trial, sponsored by the National Institutes of Health, to study how different “doses” of exercise affect the metabolic function and health of NAFLD patients. Stine plans to launch the trial in May 2022.

“There is no cure or effective drug therapies for NAFLD,” Stine said. “Through this research, we hope to develop additional guidance for clinicians on the optimal amount of exercise for these patients and explore the biology that explains why physical activity is an effective therapy.”

Ian Schreibman, Alison Faust, Jessica DahmusBenajmin Stern, Christopher Soriano, Gloriany Rivas, Breianna Hummer, Scottish KimballNate Geyer, Vernon Chinchilli, Catherine Schmitz and Christophe Sciamanna from Penn State College of Medicine; and Rohit Loomba of the University of California, San Diego also contributed to this research. Information on conflicts of interest can be found in the manuscript.

This study was supported by funds from the National Institutes of Health and in part by a grant from the Pennsylvania Department of Health using Tobacco CURE funds. This project was also supported by Penn State Institute for Clinical and Translational Sciences through the National Center for Advancing Translational Sciences of the National Institutes of Health (grant numbers UL1 TR002014).

Learn more about liver disease research at Penn State College of Medicine.

Learn more about the hepatology study.

If you are having difficulty accessing this content, or would like it in an alternate format, please email Penn State Health Marketing & Communications.

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Non-Alcoholic Steatohepatitis Clinical Trials Market Report https://rogalevich.org/non-alcoholic-steatohepatitis-clinical-trials-market-report/ Tue, 22 Feb 2022 10:08:39 +0000 https://rogalevich.org/non-alcoholic-steatohepatitis-clinical-trials-market-report/ Dublin, 22 Feb. 2022 (GLOBE NEWSWIRE) — The “Non-Alcoholic Steatohepatitis Clinical Trials Market Size, Share and Trends Analysis Report by Phase (Phase I, II, III, IV), by Plan Study (Interventional, Expanded Access), By Region (APAC, Europe) and Segment Forecasts Report, 2022-2030″ has been added to from ResearchAndMarkets.com offer. The global non-alcoholic steatohepatitis clinical trial market […]]]>

Dublin, 22 Feb. 2022 (GLOBE NEWSWIRE) — The “Non-Alcoholic Steatohepatitis Clinical Trials Market Size, Share and Trends Analysis Report by Phase (Phase I, II, III, IV), by Plan Study (Interventional, Expanded Access), By Region (APAC, Europe) and Segment Forecasts Report, 2022-2030″ has been added to from ResearchAndMarkets.com offer.

The global non-alcoholic steatohepatitis clinical trial market size is expected to reach USD 4.2 billion by 2030, registering a CAGR of 6.5% over the forecast period.

Rising healthcare expenditure, obesity cases and prevalence of non-alcoholic steatohepatitis (NASH) are the growth factors of this market. Due to the COVID-19 pandemic, enrollment in new drug clinical trials for NASH patients has been halted, but people have turned to other means of data collection, such as virtual visits. Non-alcoholic steatohepatitis is fatty liver disease that causes scarring and damage to the liver.

NASH has no FDA-approved treatment and can go to the point where patients need liver transplants in extreme situations. NASH, like diabetes, is linked to obesity and high sugar diets. Some pharmaceutical companies are testing whether diabetes drugs could help NASH patients. However, the COVID-19 pandemic has thrown a wrench into every element of NASH clinical trials, from patient recruitment to intellectual property administration and safety oversight to data integrity. As clinical research monitors are not allowed to travel, remote electronic monitoring is a viable alternative to traditional on-site monitoring. Monitors could receive information from research locations by paper mail, email (allowing direct access to electronic medical records), or remote monitoring systems.

In December, the FDA issued guidelines urging the pharmaceutical industry to develop and confirm improved biomarkers for the diagnosis and progression of NASH. In many ways, breaking the biopsy barrier is important compared to a general lack of awareness of NASH, which is why it is essential that pharmaceutical companies invest in innovations (such as a variety of techniques for imaging) to ease this burden on the patient, and then persuade the FDA with positive data to accept these advances as appropriate endpoint markers for clinical trials.

Non-Alcoholic Steatohepatitis Clinical Trials Market Report Highlights

  • The phase III segment dominated the global market in 2021. These trials cost more than $100 million
  • The interventional study design segment held the largest revenue share in 2021. There were 84 ongoing interventional studies with patients enrolled in December 2019 to assess the therapeutic efficacy of NASH treatments
  • North America led the global market in 2021 owing to the increase in the number of NASH patients in the region
  • According to the US National Library of Medicine 2018, NASH cases in the US are expected to increase by 63% from 16.52 million to 27.00 million cases by 2030
  • Asia-Pacific is expected to register the fastest CAGR over the forecast period due to the increasing incidence of associated risk factors, such as obesity, type 2 diabetes (T2D), dyslipidemia and other metabolic diseases with substantial diagnostic improvements using ultrasound and biomarkers

Main topics covered:

Chapter 1 Methodology and Scope

Chapter 2 Executive Summary

Chapter 3 Non-Alcoholic Steatohepatitis (NASH) Clinical Trials Market: Variables, Trends and Scope
3.1 Market Segmentation and Scope
3.2 Market Dynamics
3.2.1 Market Driver Analysis
3.2.1.1 Increase investments in pharmaceutical R&D
3.2.1.2 Increase in the diabetic population and obesity
3.2.1.3 Increase in health expenditure
3.2.2 Market Restraint Analysis
3.2.2.1 Lack of awareness
3.2.2.2 Barriers to registration
3.2.2.3 Approval process for lethargic drugs
3.3 Mapping penetration and growth prospects
3.4 Impact of COVID-19 on the market
3.5 Analysis of major transactions and strategic alliances
3.6 NASH clinical trials: market analysis tools

Chapter 4 Non-Alcoholic Steatohepatitis (NASH) Clinical Trials Market: Phase Segment Analysis

Chapter 5 Non-Alcoholic Steatohepatitis (NASH) Clinical Trials Market: Study Design Segment Analysis

Chapter 6 Non-Alcoholic Steatohepatitis (NASH) Clinical Trials Market: Regional Analysis

Chapter 7 Company Profiles

  • Pfizer Inc.
  • Shire Plc
  • Novartis AG
  • Plc icon.
  • LabCorp
  • Allergan AG
  • Cadila Healthcare Ltd.
  • Eli Lily
  • Novo Nordisk
  • Glaxosmith Kline

For more information about this report visit https://www.researchandmarkets.com/r/qfzcnj

About ResearchAndMarkets.com
ResearchAndMarkets.com is the world’s leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, top companies, new products and the latest trends.

  • Global Non-Alcoholic Steatohepatitis Clinical Trials Market

        
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Effective diagnostics for liver disease are urgently needed https://rogalevich.org/effective-diagnostics-for-liver-disease-are-urgently-needed/ Thu, 17 Feb 2022 16:56:16 +0000 https://rogalevich.org/effective-diagnostics-for-liver-disease-are-urgently-needed/ The following article is an opinion piece written by Dr. Tram Tran. The views and opinions expressed in this article are those of the author and do not necessarily reflect the official position of Technology Networks. Due to the increasing incidence of diabetes, obesity, and metabolic diseases in the United States, it is estimated that […]]]>

The following article is an opinion piece written by Dr. Tram Tran. The views and opinions expressed in this article are those of the author and do not necessarily reflect the official position of Technology Networks.

Due to the increasing incidence of diabetes, obesity, and metabolic diseases in the United States, it is estimated that one in four patients has some form of fatty liver disease. The impact of this on the healthcare system has been realized and is likely to increase over time.

As primary care physicians continue to see increasing numbers of patients with fatty liver disease, it is important for them to be able to effectively triage these patients to ensure the best care possible. For many patients with non-alcoholic fatty liver disease (NAFLD), primary care would focus on diet and exercise to reduce the risk of liver disease progression.

However, many patients with NAFLD have a more severe inflammatory form of fatty liver disease called non-alcoholic steatohepatitis (NASH) which, if left untreated, could lead to significant complications including cirrhosis, liver cancer or dead.

It is therefore important for physicians to diagnose NASH, assess patients for stage or severity, monitor liver disease progression, and identify risk factors to initiate appropriate intervention.

Many primary care physicians may see patients in the early stages of liver disease when symptoms may be mild or non-existent, and therefore may not recognize the potentially progressive nature of NASH. Hepatologists and specialists who work with patients with advanced liver disease are aware, however, that the increase in NASH cases is expanding the list of patients who manifest serious disease and who may eventually need medical attention. liver transplant.

According to the results of a 2021 study,1 NASH was the second leading indication for liver transplantation in the United States and the largest increase since 2002. This overall burden on our healthcare system will only continue to grow.

The best way to prevent progression to advanced liver disease is to intervene early. However, the ability to effectively assess liver disease is limited by the primary diagnostic tool: liver biopsy.

A liver biopsy is a procedure in which a needle is inserted into the liver to remove a small piece of it for microscopic analysis and diagnosis. As one can imagine, many patients are reluctant to undergo this procedure. It’s invasive, carries the risk of bleeding and pain, and requires careful attention to the surrounding logistics that come with a procedure — getting time off work, being driven home, etc.

The nature of liver biopsy presents clinicians with a significant challenge. How can we effectively diagnose, stage and monitor fatty liver disease when patients are reluctant to routinely undergo the procedure?

From there, larger questions begin to emerge. How can you effectively triage patients to the appropriate treatment path? How can you monitor a patient’s response to treatment?

Fortunately, these types of questions are asked by many experts in the field.

Researchers have recently focused on measuring the properties of active liver disease biology, which is considered more beneficial than studying a single biopsy sample of the diseased liver. Indeed, liver injury can be heterogeneous and patchy in nature, and a small liver sample (approximately 1/50,000and) of the organ – as collected from a biopsy – might not accurately reflect the degree of damage. A dynamic biological measurement would provide a more systemic snapshot of disease state.

At the most recent American Association for the Study of Liver Diseases (AASLD) conference, Dr. Arun Sanyal (Virginia Commonwealth University), in collaboration with scientists from Glympse, presented data demonstrating the high precision (AUC 0 .97) of a biosensor blood test in predicting NASH compared to healthy patients.2 We achieved this by measuring the enzymatic activity of proteins a fundamental biopathology of NASH.

The activity of certain proteases, or enzymes involved in the cleavage of proteins, varies depending on the state of disease in the liver. By exposing these proteases to a selection of small protein fragments (peptides), we can measure this activity. Also, because liver proteases circulate in the bloodstream, we can measure this from a routine blood test sample.

We are at the forefront of understanding biomarkers in this field, driven by the promise of what this data could mean for patients in need.

In addition, the NIMBLE group made another important presentation at the AASLD conference. NIMBLE (Non-Invasive Biomarkers of Metabolic Liver Disease) is a joint effort between industry, academia and government. The group presented important data evaluating the performance of five different non-invasive tests with the aim of reducing the need for liver biopsy in this patient population, hopefully paving the way for the future use of clinical biomarkers.3

Any accurate, non-invasive diagnosis would have important implications for patients. Not only would a simple blood test improve both the patient experience and clinicians’ ability to monitor disease progression, but it would also improve access to experimental treatments for NASH and NAFLD in clinical trials, because researchers could better determine the right patients for studies.

Having a reliable tool for diagnosing liver disease would ensure that patients can access these experimental drugs in a timely manner, paving the way for better therapies and interventions before the most serious outcomes, such as liver transplants, are not necessary.

For everyone involved in liver disease biomarker research, our overarching goal is to optimize best practices for patient care. Of course, we recognize the urgent need for the healthcare system to triage patients with liver disease more efficiently, as the need for liver transplants continues to dramatically outstrip available donor organs.

At the heart of this research, however, is the individual patient and the need to effectively diagnose, monitor and prevent the progression of liver disease. Research at Glympse and elsewhere gives hope that this need will soon be met.

The references

1. Younossi, ZM et al. Non-alcoholic steatohepatitis is the fastest growing indication for liver transplantation in the United States. Clin. Gastroenterol. Hepatol. 2021; 19:580–589. do I: 10.1016/j.cgh.2020.05.064

2. Sanyal, Arun. Accurate diagnosis of NASH using a new protease-based liquid biopsy. Glympse at AASLD 2021. Nov. 2021. https://glympsebio.com/presentation-accurate-diagnosis-of-nash-using-novel-protease/. Accessed January 2022.

3. Sanyal A, et. al. Main results of the NIMBLE stage 1-NASH CRN study of circulating biomarkers of nonalcoholic steatohepatitis and its activity and stage of fibrosis. Summary of the AASLD meeting. Nov 2021. https://fnih.org/sites/default/files/2021-11/CWS_NIMBLE_Abstract.pdf. Accessed January 2022.

About the Author

Tram Tran, MD is the Chief Medical Officer of Glympse. She is a renowned liver and virus specialist with over 20 years of academic and industrial experience as a physician-scientist. Prior to Glympse, Dr. Tran worked at Gilead Sciences and before that at Cedars-Sinai Medical Center. She has authored and co-authored over 150 abstracts, published manuscripts, and book chapters, and has been extensively involved in clinical trials and research funded by the National Institutes of Health (NIH). Dr. Tran received his MD from New York Medical College.

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Liver cancer in Hispanic and Latino communities https://rogalevich.org/liver-cancer-in-hispanic-and-latino-communities/ Thu, 10 Feb 2022 23:15:32 +0000 https://rogalevich.org/liver-cancer-in-hispanic-and-latino-communities/ Liver cancer is cancer that starts in any part of the liver. The most common type of liver cancer is called hepatocellular carcinoma (HCC). Liver cancer rates are rising in the United States. In men, HCC is the fifth most common cause of cancer-related deaths. For women, he ranks seventh. According to American Cancer Society, […]]]>

Liver cancer is cancer that starts in any part of the liver. The most common type of liver cancer is called hepatocellular carcinoma (HCC). Liver cancer rates are rising in the United States. In men, HCC is the fifth most common cause of cancer-related deaths. For women, he ranks seventh.

According to American Cancer Society, Hispanics and Latinos have higher rates of liver cancer than non-white Hispanics. They also have higher death rates from liver cancer.

Many cases of liver cancer can be prevented. Better access to preventive care could reduce the risk. Language barriers and lack of health insurance are challenges to receiving care for many Latinos.

The liver is a large organ that has many jobs in the body. It plays a role in digestion. It also filters the blood to remove harmful substances.

Liver cancer is cancer that starts in any part of the liver. The most common form of liver cancer is HCC. This type of cancer starts in the cells that make up the body of the liver. Cancer can also start in the ducts of the liver, but this is less common. HCC rate keep going up in the USA.

In 2020, 4.7% of new cancer diagnoses worldwide were liver cancer. He represented 8.3% cancer deaths. In the United States, it is estimated that there will be approximately 41,260 people diagnosed with liver cancer in 2022. This is expected to increase.

Cirrhosis is a major risk factor for developing liver cancer. On 80 percent of people with liver cancer have cirrhosis.

Anything that damages the liver can increase the risk of cirrhosis and liver cancer. Whenever the liver is damaged, it tries to repair itself. Over time, the cycle of damage and repair causes scar tissue.

Cirrhosis is severe scarring of the liver. When there is too much damage and scar tissue builds up, the liver no longer functions properly.

Risk factors for cirrhosis and liver cancer include:

  • hepatitis B or C infection
  • heavy drinking
  • exposure to aflatoxin from contaminated food, water, or soil
  • smoking tobacco
  • non-alcoholic steatohepatitis (NASH)

Hispanics have much higher rates of liver cancer than non-Hispanic whites in the United States. Data from 2014 to 2019 shows that they have double non-Hispanic rates. Data from 2018 shows that 1 out of 5 people with liver cancer in the United States is Hispanic.

Although liver cancer rates are on the rise in all groups, they are much higher among Hispanics. This group saw a 4.7% increase per year since 2000.

Hispanics are also diagnosed with more advanced stages of liver cancer. This means there are often fewer treatment options available. Compared to non-Hispanic whites, Hispanics have lower rates liver transplants. One theory to explain the lower rate of transplants is lower rates health insurance.

There are differences in liver cancer survival among blacks, Hispanics, and whites. A 2019 study found that the median survival time was highest for whites at 16.3 months. Median survival time was lowest for blacks at 10.6 months. The survival time for Hispanics was 14.4 months.

A number of factors may contribute to higher rates of liver cancer in Hispanic and Latino populations.

Hepatitis C

Hepatitis C infection remains a major cause of liver cancer. In Florida, hepatitis C is the main cause cases of liver cancer among Hispanics. In the USA, 50 to 60 percent of people with liver cancer are living with hepatitis C.

Overall, hepatitis C infections are stable or declining. The exception is that from 2014 to 2018 there was an increase of 2 percent in Hispanic women.

Hepatitis C is a treatable disease. For many people, however, there are major barriers to accessing testing and treatment. Treatment is expensive, and many people don’t know they have it until it’s advanced.

Chronic hepatitis C can lead to cirrhosis and sometimes liver cancer. Without regular access to health care, hepatitis C may go undetected and untreated.

Non-alcoholic fatty liver disease

Another risk factor for liver cancer is non-alcoholic fatty liver disease (NAFLD). NAFLD can progress to another condition called non-alcoholic steatohepatitis (NASH). NASH is an advanced stage of fatty liver disease. Fat builds up around the liver, causing inflammation and scarring.

NAFLD is on the rise, affecting approximately 75 to 100 million people in the United States.

Hispanics have the highest rates of NAFLD compared to other ethnic groups. Various studies showed that between 8.4% and 45% of Hispanics have NAFLD. They are also more likely to progress to NASH, which increases the risk of cirrhosis and liver cancer.

A condition called metabolic syndrome is also associated with NAFLD. Metabolic syndrome is a group of conditions. These can include high blood pressure, diabetes or prediabetes, and low levels of HDL or good cholesterol. In the United States, Hispanics have the highest rates metabolic syndrome.

Cirrhosis

Liver cirrhosis is associated with 80 percent cases of liver cancer. There are different causes of cirrhosis. These include:

  • heavy drinking
  • NASH
  • hepatitis C infection

Hispanics have higher cirrhosis rates than other groups. A large study has shown that Hispanics have a 37 percent increased risk of cirrhosis compared to Caucasians. Hispanics are more likely have alcohol-related cirrhosis or NASH.

Liver cancer is usually not diagnosed at an early stage. Symptoms often only appear at an advanced stage, when it is more difficult to treat. In later stages, there are larger and more tumors, or the cancer has spread to other parts of the body.

When liver cancer is detected early, there are more treatment options. That’s why regular checkups and routine screenings are important, especially for people at high risk of developing liver cancer.

Access to appropriate care is necessary to prevent and manage liver cancer risk factors. However, research shows that Hispanics are less likely to access preventive care.

A number of factors can prevent Hispanic and Latino people with liver cancer from receiving proper care and treatment. These may include:

  • Socioeconomic status
  • lack of health insurance
  • Language barrier
  • lack of access to culturally appropriate care

People living in poverty have a much harder time getting the health care they need. In the USA, 16 percent of Hispanics lived in poverty in 2019, compared to 7% of non-Hispanic whites.

Hispanics are also the most likely to be uninsured. Among those aged 18 to 64, 26 percent lack health insurance. On 9 percent non-Hispanic whites are uninsured.

The Affordable Care Act has helped improve access for many people. It reduced the number of uninsured Hispanics by 11.9%. Medicaid is run by each state, so there are differences in criteria and access.

Over the past decade, several states have expanded their Medicaid programs. Other states have not, including Florida and Texas, which have large Hispanic populations. This leaves even more people without access to health insurance.

The cost of drugs is another issue in the United States. A large survey of Hispanics showed that 12.5% were unable to afford prescription drugs.

Lack of access to culturally appropriate care is also a potential barrier to liver cancer care for Hispanic and Latino people. Cultural competence means that healthcare professionals can provide care that meets the social, cultural and linguistic needs of their patients.

Hispanics and Latinos come from many countries. They have different traditions, foods and languages. Care and recommendations for people of one race or background will not work for everyone. Too often, people receive recommendations that don’t match their traditions.

Many things need to be improved for Hispanics and Latinos to have better access to health care. Access to culturally appropriate care can improve screening and preventive care. This may help reduce risk factors associated with cirrhosis and liver cancer.

In areas with large Hispanic or Latino populations, better access to health insurance coverage could reduce barriers to receiving care to help prevent and treat cancer.

To overcome language barriers, the services of an interpreter would be helpful. Another huge gap in care is the lack of Hispanic and Latino healthcare professionals. Hispanics and Latinos make up approximately 5 percent of physicians in the United States.

It is much less than the 17.4% of people in the United States who identify as Hispanic or Latino. We need ways to help more Hispanic and Latino people get started in medical careers. Getting treatment from someone who speaks your language and understands your culture can make a big difference.

Hispanic and Latino people have higher rates of liver cancer and liver cancer death. There are several possible reasons for this. Hispanic and Latino people have higher rates of metabolic syndrome, NAFLD, and NASH. These increase the risk of cirrhosis and liver cancer.

Hepatitis C is a treatable disease that increases the risk of liver cancer. Hispanic and Latino people are not always able to access the right care or get treatment for hepatitis C.

Language barriers, poverty and lack of health insurance can prevent access to health care.

Increasing culturally competent care and removing cost and language barriers can help. Through strategies to improve access to care, many cases of liver cancer can be prevented or treated.

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Fatty liver disease: Swollen legs could signal ‘advanced stage’ of liver scarring https://rogalevich.org/fatty-liver-disease-swollen-legs-could-signal-advanced-stage-of-liver-scarring/ Wed, 09 Feb 2022 08:00:00 +0000 https://rogalevich.org/fatty-liver-disease-swollen-legs-could-signal-advanced-stage-of-liver-scarring/ Non-alcoholic fatty liver disease details a range of conditions that have one thing in common – the buildup of fat in your liver. The early stages of fatty liver usually cause no problems. But problems can arise as the disease progresses. Here’s a sign that might help you spot it. If your liver is healthy, […]]]>

Non-alcoholic fatty liver disease details a range of conditions that have one thing in common – the buildup of fat in your liver. The early stages of fatty liver usually cause no problems. But problems can arise as the disease progresses. Here’s a sign that might help you spot it.

If your liver is healthy, it should contain only a small amount of fat.

When the fat reaches 5 to 10 percent of the organ’s weight, it becomes a “problem,” reports the Cleveland Clinic.

Having a fatty liver also increases your risk of other serious health problems, ranging from diabetes to high blood pressure.

The good news is that early detection and treatment can help prevent non-alcoholic fatty liver disease (NAFLD) from getting worse, says the NHS.

READ MORE: Cancer symptoms: two signs to look for when you go to the bathroom – seen in 90% of patients

As this condition usually does not trigger symptoms in the early stages, it can be difficult to spot.

At first, patients usually don’t know they have it unless they are tested for another reason.

However, more advanced stages of fatty liver can cause some symptoms.

This includes swollen legs, according to the Cleveland Clinic.

DO NOT MISS :

Before reaching cirrhosis, there are three earlier stages which include non-alcoholic steatohepatitis (NASH) and fibrosis.

According to the NHS, people in these stages may experience the following symptoms:

  • Dull or aching pain in the upper right of the belly
  • Extreme tiredness
  • Unexplained weight loss
  • Weakness.

The health service shares that the most “important” part of preventing the disease from getting worse is lifestyle changes.

So everything from a healthy diet to exercise could help reduce the amount of fat in your liver.

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