Molecular changes in hepatic metabolism and transport incirrhosis and their functional importance

查看全文 作　　者：Christoph G [1]Dietrich;Oliver [2]Götze;Andreas [2]Geier

机构地区：[1]Bethlehem Center of Health,Department of Internal Medicine,D-52222 Stolberg(Rhineland),Germany;[2]University of Würzburg,Division of Hepatology,Department of Internal Medicine II,D-97080 Würzburg,Germany

出　　处：《World Journal of Gastroenterology》索引2016年第22卷第1期,共17页

摘　　要：Liver cirrhosis is the common endpoint of many hepatic diseases and represents a relevant risk for liver failure and hepatocellular carcinoma.The progress of liver fibrosis and cirrhosis is accompanied by deteriorating liver function.This review summarizes the regulatory and functional changes in phase Ⅰ and phaseⅡmetabolic enzymes as well as transport proteins and provides an overview regarding lipid and glucose metabolism in cirrhotic patients.Interestingly,phase Ⅰ enzymes are generally down regulated transcriptionally,while phaseⅡenzymes are mostly preserved transcriptionally but are reduced in their function.Transport proteins are regulated in a specific way that resembles the molecular changes observed in obstructive cholestasis.Lipid and glucose metabolism are characterized by insulin resistance and catabolism,leading to the disturbance of energy expenditure and wasting.Possible non-invasive tests,especially breath tests,for components of liver metabolism are discussed.The heterogeneity and complexity of changes in hepatic metabolism complicate the assessment of liver function in individual patients.Additionally,studies in humans are rare,and species differences preclude the transferability of data from rodents to humans.In clinical practice,some established global scores or criteria form the basis for the functional evaluation of patients with liver cirrhosis,but difficult treatment decisions such as selection for transplantation or resection require further research regarding the application of existing non-invasive tests and the development of more specific tests. 关键词：liver CIRRHOSIS drug METABOLISM transport BREATH tests LIPID METABOLISM GLUCOSE METABOLISM

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Molecular changes in hepatic metabolism and transport incirrhosis and their functional importance

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