We sought to: 1) summarize effective aerobic and resistance exercise protocols for NAFLD and 2) compare the effects and energy consumption of aerobic and resistance exercises.
This finding suggests that stimulation with combined anti-fibrotic cytokines is a potential approach in the development of a novel therapy for the recovery of liver fibrosis.īACKGROUND & AIMS: Exercise is a first-line therapy for patients with non-alcoholic fatty liver disease (NAFLD). In conclusion, the combined treatment of TNF-α and IL-1α on HSCs had an enhanced effect on the expression of the fibrotic genes, MMP1 and α-smooth muscle actin, so appears to be an important regulator for tissue regeneration. Of these cytokines, TNF-α and IL-1α were found to be the key cytokines for not only inducing MMP1 expression, but also increasing α-smooth muscle actin gene expression. We observed that the combination of all five cytokines induced higher levels of MMP1 gene expression. We first examined the effect of individual cytokines and then the simultaneous exposure of different cytokines, including interleukin-6 (IL-6), IL-1 alpha (IL-1α), platelet-derived growth factor (PDGF), tumour necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-ß), on matrix metalloproteinase-1 (MMP1) gene expression in primary HSCs. Here, we report the effect of multiple cytokine combinations on primary HSCs. Although the effects of individual cytokines on many cell types have been investigated in various conditions, such as inflammation and tissue fibrosis, investigating the effect of combined cytokines would further our understanding of the regulatory mechanisms in tissue fibrosis. These phenomena involve inflammatory cytokines released from non-parenchymal liver cells such as Kupffer cells. Hepatic stellate cells (HSCs) are key players in liver fibrosis and regeneration via collagen degradation and synthesis. CONCLUSIONS: Local treatment using New-FP is a potentially superior initial treatment compared with sorafenib as a multidisciplinary treatment in locally progressed HCC without EHS. In the subgroup analyses, the OS was significantly longer the New-FP group in cohort-2. Sorafenib treatment, and severe MVI and EHS were poor prognostic factors. RESULTS: New-FP prolonged OS than sorafenib after PSM (New-FP, 12 months sorafenib, 7.9 months p < 0.001). Additionally, the patients were categorized into four groups: cohort-1, cohort-2 (with MVI), cohort-3 (with EHS), and cohort-4 (with MVI and EHS) to clarify the efficacy of each treatment. After propensity score matching (PSM), overall survival (OS) and prognostic factors were assessed (n = 344 each).
In total, 1709 consecutive patients with HCC initially treated with New-FP or sorafenib 1624 (New-FP, n = 644 sorafenib n = 980) were assessed. METHODS: To avoid selection bias, we corrected the data from different facilities that did or did not perform New-FP therapy. We investigated whether New-FP (fine-powder cisplatin and 5-fluorouracil), a hepatic arterial infusion chemotherapy regimen, is more favorable than sorafenib as an initial treatment for locally progressed HCC. BACKROUND: Not all patients with hepatocellular carcinoma (HCC) benefit from treatment with molecular targeted agents such as sorafenib.
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