Targeted Liposomes for Liver Fibrosis: In Vivo Liposome Delivery of siRNA to Stellate Cells to Silence TGF-B1 and VEGF Expression
Summary Over the last few decades, liver disease has become a growing burden in global health due to the limited efficacy of treatment and therapies for liver disease. One potential solution to the dilemma of curative treatment for liver disease is the emerging development and utilization of nanotechnology strategies for more effective liver disease diagnosis and therapy. This paper will propose using targeted liposomes as a system for delivering siRNA to hepatic stellate cells to impede and ultimately treat liver fibrosis.
The Growing Problem of Liver Cancer and Liver Fibrosis As the number of deaths from liver cancer are increasing worldwide, it is becoming more crucial to develop efficient and effective ways to combat liver cancer. Hepatocellular carcinoma (HCC) is the most prevalent form of primary liver cancer and it is often usually caused by severe chronic liver injury acquired through the progression of certain liver diseases such as hepatitis B and C, alcoholic liver disease and non-alcoholic fatty liver disease. Although the etiology of liver cancer varies worldwide depending on geographic location, a commonality that they share is that if left untreated they often lead to cirrhosis. Cirrhosis is distinguished by a reduction in the proliferation of hepatocytes, which significantly effects the replicative capacity of hepatocytes
“Each Year in the United States about one-hundred and fifty-thousand patients develop cancer of the colon or rectum. Around fifty percent of these patients will either have a cancer that has already spread to the liver or they will come back in future years with metastatic cancer to the liver.” Liver cancer, or other known as Hepatocellular Carcinoma, is a cancer residing in the liver. There are other cancers like metastatic cancer that starts at other organs then spreads to the liver. Being the third most common cancer in the world, it is also one of the deadliest. Twenty percent of the patients that are affected by liver cancer survive for a year after diagnosis. Sadly, five percentile of the survivors live for only five years or more.
B-12 is abundant in liver and is what made the liver therapy a success (Jacovino, 1998).
According to the American Liver Foundation, a healthy liver cleans blood, fights infection processes food and stores energy. The liver is able to regenerate itself, but when it becomes too damaged or is prevented from regenerating, it will fail and no longer be able to keep able to keep one alive (2015). Despite its ability to regenerate, chronic liver disease and cirrhosis is the twelfth leading cause of death of death in the United States. My interest in further exploring liver related deaths is the due to the impact that liver disease has had on my family. My young cousin was born with a malignant tumor on her liver and spent the first several years of her life undergoing surgeries and chemotherapy. She survived the treatment and at the age of 4 was free of cancer. At the age of 24 she was told that her liver was beginning the process of failure and she would need to be put on the transplant liver for long-term survival. My grandmother died of cirrhosis of the liver and my father, after 3 years of treatment for melanoma, was diagnosed with liver failure. He had a procedure to prolong the useful life of his liver, but the damage to his liver will not allow his liver to regenerate and it will likely be liver failure which leads to his death.
The MD Anderson Liver Tumor biospecimen resource has been invaluable for a large number of studies or clinical development. The sixth and subsequent editions of the American Joint Committee on Cancer (AJCC) staging of hepatocellular cancer, which was developed by an international consortium led by Jean-Nicolas Vauthey, MD, Professor of Surgery at MD Anderson and co-leader on project 2 of the SPORE, was based upon pathologic review of resected specimens in the Liver Tumor Bank (Vauthey JN J Clin Oncol 2002 20:1527-36). In addition, investigators at MD Anderson examined tissues in the Liver Tumor Bank to elucidate the prognostic significance of the ribonucleoprotein Human Antigen R (HuR) showing that patients with high HuR tumor expression had
Cirrhosis is a consequence of chronic liver disease characterized by replacement of normal, healthy liver tissue by fibrotic scar tissue, blocking the flow of blood through the organ and preventing it from working as it should, as well as regenerative nodules leading to progressive loss of liver function. The liver, the largest organ in the body, is vital in keeping the body functioning properly. It removes or neutralizes poisons from the blood, produces immune agents to control infection, and removes germs and bacteria from the blood. It
Additionally, many chronic liver diseases can lead to cirrhosis. For example, nonalcoholic fatty liver disease (NAFLD) can lead to cirrhosis and is associated with obesity, hyperlipidemia, metabolic syndrome and type 2 diabetes mellitus. Hereditary metabolic disorders such as hemochromatosis and Wilson disease can also lead to cirrhosis (McCance & Heuther, 2014). It seems the cause of cirrhosis is multifaceted. Additionally, many diseases can lead to cirrhosis and it is understandable why the etiology of cirrhosis has not been parsed out, especially because the cause can differ from a
Cirrhosis is the 12th leading cause of death in the United States. Cirrhosis affects one of the largest organs in the body, the liver. It is a condition that slowly worsens the liver and is unable to function normally due to chronic injury. Cirrhosis consists of four stages with the fourth stage being the most advanced stage of cirrhosis. When healthy liver cells are damaged and replaced by scar tissue (fibrosis) it’s known as a degenerative disease called cirrhosis. Chronic alcoholism is the leading cause of cirrhosis due to excessive drinking of alcohol, which causes the liver to swell. In sequence with alcoholism and hepatitis C, or alone obesity can be a risk factor in developing cirrhosis. Cirrhosis of the liver is a disease that can affect many individuals if the condition is not caught in early stages it can become deadly.
During chronic liver disease, hepatocyte cell death results in inflammation that leads to fibrosis. In addition, the loss of functional hepatocytes results in loss of liver functions, such as the ability to metabolize bilirubin and synthesize proteins (e.g., albumin and clotting factors). Under normal conditions, blood flows from splanchnic circulation to hepatic circulation (for removal of bacteria and toxins) via the portal vein, and blood is returned to systemic circulation via the hepatic vein. Because of liver fibrosis, the distortion of hepatic architecture increases resistance to blood flow, resulting in portal hypertension. The portal collaterals relieve some of the pressure in the portal system but may contribute to cirrhosis-related complications such as varices (Liou, 2014).
The World Gastroenterology Organization (WGO) has recently declared NALFD as most common cause of liver disease. Obesity is an increasing problem not only in the UK but worldwide. An estimated 26% of the adults in the UK are considered to be obese 1, 2. Obesity induced metabolic syndrome may lead to NAFLD, which can progress to Nonalcoholic Steatohepatitis (NASH), and in turn to advanced fibrosis and an increased risk of Hepatocellular Carcinoma (HCC) 2, 3.
In summary, is there is a relationship between developing Hepatitis B&C and HCC? If so, to what extent and whether the patients develop cirrhosis first. Thus, the goal of this study is to assess the current degree of coalition between Hepatitis B&C and Hepatocellular Carcinoma in addition to determine the involvement of Hepatitis induced Cirrhosis in the sample and its effect on Developing
The liver is a large organ of our body which is located beneath the right lung. It helps in the digestion of food and store the extra energy for future use. It also helps fights the infection and cleans your blood. Liver also has an amazing regenerative capacity after injury. All these activities ultimately provide a healthy life to us. Any alterations in the liver function will put our life in danger.1 Inflammation is the first sign of liver damage. During inflammation, the liver get enlarged and stiff. This is a sign that liver is trying the heal the damage. However, unlike inflammation of other organs of the body, it is hard to feel any change or pain when the liver
The liver is the largest gland and second largest organ in the human body. It is also the only internal organ capable of regeneration following injury. Located in the abdominal cavity, this reddish brown organ is divided into lobes of different size and shape. The liver plays a critical role in metabolism, digestion, elimination, and detoxification, among other processes. This organ performs a surprisingly large number of functions that influence virtually all other body systems. This is why diseases of the liver can be so devastating. One class of chronic diseases affecting the liver is cirrhosis. (Kasper, 2008)
Chronic liver diseases and liver biopsy. Chronic liver diseases encompass many different causes, including viral infections, nonalcoholic fatty liver disease (NAFLD), alcohol abuse, primary sclerosing cholangitis, primary hemochromatosis, and autoimmune disease. All of these precipitate chronic damage to the liver via necroinflammation and subsequent cellular injury and accumulation of extracellular matrix (ECM) proteins distorting the hepatic architecture by forming hepatic fibrosis with abnormal collagen deposition. Without treatment, the eventual development of cirrhosis (the end stage of fibrosis) can accelerate to hepatocellular dysfunction, hepatic insufficiency, portal hypertension, and hepatocellular carcinoma (HCC), thus
Chronic Hepatitis B is an infection that affects the liver, and if this disease is allowed in its progression, it can cause fibrosis, cirrhosis, liver failure and hepatocellular carcinoma. It is a worldwide problem that does not have a cure. This virus affects an estimated 400 billion people, and the number is growing at a rapid rate. It will kill approximately 25% of people who do not get treatment. In China, approximately 60% of the population have a history of HBV infection, and about 7% to 10% of the population have the disease. They are at high risk of having liver disease. Currently, there are few available drugs that can manage this epidemic, such as interferon-alfa, nucleos(t)ide analogue polymerase inhibitors,
Hepatic failure is a fatal disease that accounts for thousands of deaths annually, but currently the only long term solution for this problem is an orthotopic liver transplantation. The number of donors is decreasing whilst the number of people in need of transplantation is increasing and this therefore provides a very high demand for an alternative treatment. Regenerative medicine requires two main aspects; biologically compatible scaffolds to aid the regenerative process and suitable cells to replace the cells of the damaged tissue. Biologically compatible scaffolds can be defined as being adoptable by the host’s body system without causing harm and possessing the ability to be freely refined into target tissue shape. Scaffold