Leveraging The Livers Ability To Heal Scarred Tissue
A reversal in thinking about the reversibility of liver damage is changing the field of hepatology.
In medical school, Cliff Brass was interested in the brain. He and a friend, who favored the liver, used to argue about which organ was smarter. They are both hepatologists now.
I guess that answers that question, says Brass, Senior Global Program Medical Director at Novartis Pharmaceuticals. The liver is an amazing organ.
For instance, it is possible to take a hunk of one persons liver and transplant it into another person. The partial organ will grow to fit the space available, suggesting that the liver has unusual regenerative capabilities.
It is one thing for a healthy liver to have such powers, but can a scarred liver heal itself? For a long time, the answer was quick and clear: No.
Despite the fact that evidence of the reversibility of liver scarring started accumulating in the 1960s, the prevailing wisdom was that once you get scar tissue in the liver, its permanent, says Chinwe Ukomadu, a hepatologist and Senior Translational Medicine Specialist at the Novartis Institutes for BioMedical Research.
In these cases, something is getting better, says Ukomadu. But is it the liver? Researchers have argued that it could be anything.
In some cases, you couldnt tell that the patients had been sick, says Ukomadu. Their cirrhosis had completely disappeared.
Types Of Fatty Liver Disease
Health care providers divide fatty liver disease into two types. If you just have fat but no damage to your liver, the disease is called nonalcoholic fatty liver disease . If you have fat in your liver plus signs of inflammation and liver cell damage, the disease is called nonalcoholic steatohepatitis .
About 10% to 20% of Americans have NAFLD. About 2% to 5% have NASH.
Causes Of Liver Cirrhosis
Common causes of liver injury that lead to cirrhosis include:
- Viral Hepatitis: Hepatitis B and hepatitis C are viral infections that cause hepatic inflammation and liver damage.
- Nonalcoholic Steatohepatitis: Steatosis describes the accumulation of fat in the liver, and steatohepatitis describes the development of fatty liver and subsequent inflammation. Nonalcoholic steatohepatitis is also known as nonalcoholic fatty liver disease and is precipitated by poor diet, obesity, and metabolic syndrome.
- Autoimmune Hepatitis: Chronic hepatitis can occur when your immune system malfunctions and attacks your liver, instead of foreign invaders like viruses and bacteria.
- Alcoholic Liver Disease: Certain neurological and psychological factors lead to alcohol addiction, chronic alcohol abuse, and liver damage.
These illnesses inflict damage on the liver through a complex biological cascade. Hepatic cellular injury often precipitates apoptosis or cell death. Byproducts of hepatic injury include cellular waste like reactive oxygen species, which interfere with the function of other liver cells. The resulting condition is oxidative stress, which impairs normal liver function, aggravates the immune system, and creates a state of chronic inflammation.
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Lifestyle And Diet For Cirrhosis
When the direct cause of liver damage has been mitigated, therapeutic lifestyle and diet alterations can be introduced for maximum impact.
As a foundation, wipe your diet clean of all processed foods, replacing them with vegetables, fruits, legumes, and whole grains. Processed foods contain high levels of sugar, salt, and chemicals like artificial sweeteners and preservatives all of which are hard on your liver. Processed foods tend to be empty calories with no nutritional value. Instead, opt for nutrient-dense, fiber-rich foods that support healing.
Examples of foods that support liver health include:
- kale, collard greens, spinach
- nuts and seeds
There are also many specific foods and herbs with potent anti-inflammatory and antioxidant effects that benefit your liver and encourage healing. Consider adding some of these to your daily routine.
How Is Cirrhosis Of The Liver Diagnosed
Your healthcare provider will first ask about your medical history and over-the-counter and prescription drug use. They will also ask about any supplements or herbal products you may take. Your provider may suspect you have cirrhosis if you have a long history of alcohol abuse, injectable drug abuse or have had hepatitis B or C and have the symptoms listed in this article.
To diagnosis cirrhosis, your provider will perform a physical exam and may order one or more of the following tests:
- Physical exam: Your doctor will examine you, looking for the signs and symptoms of cirrhosis including: the red, spider-like blood vessels on your skin yellowing of your skin or whites of your eyes bruises on your skin redness on your palms swelling, tenderness or pain in your abdomen enlarged firmer-feeling, bumpy texture to the lower edge of your liver .
- Blood tests: If your doctor suspects cirrhosis, your blood will be checked for signs of liver disease. Signs of liver damage include:
- Lower than normal levels of albumin and blood clotting factors .
- Raised levels of liver enzymes .
- Higher level of iron .
- Presence of autoantibodies .
- Raised bilirubin level .
- High white blood cell count .
- High creatinine level .
- Lower levels of sodium .
- Raised level of alpha-fetoprotein .
In addition, other blood work will include a complete blood count to look for signs of infection and anemia caused by internal bleeding and a viral hepatitis test to check for hepatitis B or C.
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Apoptosis Or Inactivation Of Hscs
Activation of HSCs in response to chronic liver injury is a key step in the pathogenesis of liver fibrosis. Recently, clinical and experimental studies have demonstrated that fibrosis resolution may occur upon eradication of the liver insult . Experimental models of fibrosis recovery have consistently reported that elimination of activated HSCs by apoptosis or inactivation of fibrolytic pathways led to the regression of fibrosis. This suggests that clearance of activated HSCs is a fundamental step in the onset of fibrosis regression . Myofibroblasts produce fibrous scars in hepatic fibrosis. In the CCl4 model of liver fibrosis, quiescent HSCs are activated and transformed into myofibroblasts. When the underlying etiological agent is removed, clinical and experimental fibrosis undergo a remarkable regression, with complete disappearance of these myofibroblasts. However, it was shown that a subset of the myofibroblasts escaped apoptosis during regression of liver fibrosis, down-regulated fibrogenic genes, and acquired a phenotype similar to, but distinct from, quiescent HSCs they were able to more rapidly reactivate into myofibroblasts in response to fibrogenic stimuli and strongly contribute to liver fibrosis. Inactivation of HSCs was associated with up-regulation of antiapoptotic genes, such as Hspa1a/b, which participate in the survival of HSCs in culture and in vivo .
Myth: Because I Dont Drink Alcohol Cirrhosis Cant Affect Me
Fact: Cirrhosis is simply severe scarring of the liver caused by various injuries over time. There can be several causes of those injuries, including hepatitis B or C, hereditary disorders of iron or copper overload, liver diseases caused by an overactive immune system, nonalcoholic fatty liver disease or drinking too much alcohol.
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Can You Reverse Liver Cirrhosis Naturally
As with scar tissue anywhere on or in your body, while you can’t reverse the damage, you may be able to minimize its impact on your life and live around it. What follows now are natural ways to cleanse your liver, support its health and functioning, and strengthen your body so you have the resources to cope with any complications that may arise.
Liver Cirrhosis From Inherited Conditions
Some inherited conditions damage the liver and this leads to the scarring that can contribute to cirrhosis. These conditions include:
- haemochromatosis the body accumulates iron, which can damage many organs, including the liver
- Wilson disease the tissues of the body accumulate copper
- galactosaemia the body is unable to process galactose so it accumulates in the blood and can result in liver damage
- cystic fibrosis mainly affects the lungs, but can also cause scarring of the liver
- alpha-1 antitrypsin deficiency can cause lung damage but can also affect liver function and lead to cirrhosis and liver failure.
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Is It Possible To Reverse Liver Cirrhosis Naturally
The liver is one of the most unique organs in our bodies, with an ability to heal in a way that other vital organs cannot. Damage done to the heart, for example, is damage that cannot be undone by your body or by medical technology it can only be worked around. Likewise with the kidneys: ground lost in kidney functioning is ground that is permanently ceded. However, some people do require liver transplants, indicating that as much as the liver can recover from damage, it can’t completely regenerate after a certain point. Where is the line between reversible damage and irreversible damage? Can you reverse liver cirrhosis naturally, without medications or a transplant? This article explores that question.
Identify And Properly Treat Existing Complications As Well As Prevent Further Complications
A healthy liver performs many important tasks in the body. It clears out toxins from your blood, as well as breaks down alcohol and certain drugs. The liver also makes proteins that are vital for clot formation and digestion among many other things.
As such, when your liver cant function properly, there will be complications. One of the goals of treatment is to find out the existing complications, treat them, and prevent other complications from occurring.
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Symptoms Of Liver Cirrhosis
Symptoms depend on the severity of the cirrhosis, but may include:
- appetite loss
- spidery red veins on the skin
- easily bruised skin
- yellowing of the skin and eyes
- reddened palms
- fluid retention in the abdomen and legs
- internal bleeding presenting as dark-coloured stools or vomiting blood
- hormone disruptions that could cause a range of problems, including testicular atrophy and impotence in males or amenorrhoea in women
- disturbed sleep patterns
- cognitive problems such as memory loss, confusion or concentration difficulties.
Take Any Necessary Supplements
Malnutrition associated with liver damage makes micronutrient deficiency common in liver cirrhosis. Deficiencies in vitamin B, vitamin C, vitamin D, magnesium, and zinc can exacerbate oxidative stress and impair immune function, and cause added stress on your liver. Your physician may recommend a daily multivitamin to counteract insufficient micronutrient levels.
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What Are Some Of The Symptoms Of Liver Disease
The most important thing to recognize about liver disease is that up to 50 percent of individuals with underlying liver disease have no symptoms. The most common symptoms are very non-specific and they include fatigue or excessive tiredness, lack of drive, and sometimes itching. Signs of liver disease that are more prominent are jaundice or yellowing of the eyes and skin, dark urine, very pale or light colored stool, bleeding from the GI tract, mental confusion, and retention of fluids in the abdomen or belly.
Complications Of Liver Cirrhosis
Without medical treatment, cirrhosis of the liver can lead to a range of potentially life-threatening complications including:
- bleeding from enlarged blood vessels in the oesophagus or stomach
- build-up of fluid within the abdominal cavity
- infection of the fluid found within the abdominal cavity
- liver failure loss of liver cells and disruption of blood flow through the liver by scar tissue can impair liver function
- impaired functioning of the brain caused by toxins that the liver has failed to remove .
- primary liver cancer the most common type of cancer caused by cirrhosis is hepatocellular carcinoma
Tests used to diagnose liver cirrhosis may include:
- medical history
- blood tests, including liver function tests
- urine tests
- imaging studies, including ultrasound, computed tomography or magnetic resonance imaging
- transient elastography , this test uses an ultrasound-based technique to detect liver cirrhosis. This test is less accurate in people with obesity issues unless specially designed XL probes are used.
- liver biopsy, obtaining liver tissue for laboratory examination.
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Consume The Right Balance Of Amino Acids
Amino acids are the building blocks of protein and combat malnutrition, muscle loss, and hepatic encephalopathy associated with liver cirrhosis. Benefits extend beyond muscle synthesis amino acids are also critical for immune function and hepatic function. Research demonstrates that essential branched-chain amino acids decrease the number of reactive oxygen species in liver cells, mitigate fibrosis, and elongate the lifespans of rats with late-stage liver cirrhosis. Other studies reveal that branched-chain amino acids have anti-inflammatory properties and effectively improve the quality of life for human subjects with cirrhosis. To ensure that youre consuming enough essential amino acids, incorporate protein-rich foods like meats, nuts, seeds, quinoa, brown rice, beans, and lentils into your diet. Supplementation with an optimal ratio of essential amino acids may enhance liver function.
Immune Responses: Variable Roles In Hepatic Fibrosis
Immune interactions play an important role in driving fibrogenesis, as persistent inflammation usually precedes fibrosis.
Responses of the diverse cells of the liver
Activated HSCs secrete inflammatory cytokines, interact directly with immune cells by expressing different adhesion molecules, and modulate the adaptive immune system by functioning as antigen presenting cells . Therefore, a positive feedback loop exists in which inflammatory and fibrogenic cells stimulate each other to amplify fibrosis. Other cell types that regulate the progression and resolution of fibrosis include liver sinusoidal endothelial cells , Kupffer cells, hepatocytes, natural killer cells, T cells, monocytes, cholangiocytes, ductular cells, portal fibroblasts, and various other inflammatory cells .
Hepatic revascularization with LSEC activation and proliferation is highly associated with perisinusoidal fibrosis. During perisinusoidal fibrosis, activated LSECs contribute to ECM production including synthesis of basement membrane components, fibronectin, and interstitial collagen type I. They also produce cytokines that activate HSCs and secrete factors that contribute to intrahepatic vasoconstriction, which contributes to portal hypertension in cirrhosis .
Responses during systemic inflammation and intestinal dysbiosis
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Whats The Life Expectancy For People With Cirrhosis
Life expectancy depends on several factors including the cause and severity of your cirrhosis, your response to treatments, presence of cirrhosis complications, your age and any other existing general health problems. Ask your liver specialist about your life expectancy since every person is unique, with unique overall health issues and specific liver health issues.
If your cirrhosis is advanced, liver transplantation may be an option. You and your doctors will discuss if this is an option for you.
What Is Liver Cirrhosis
To better understand liver cirrhosis, lets first examine what happens when you sustain an external injury. When you have a wound on your skin, your bodys repair mechanisms are triggered: bleeding stops, white blood cells rush to the scene, scab forms in a few days, and the wound heals. Depending on the severity of the injury, you may develop scar tissue. Repeated injury to the same area of the skin causes even more distortion and scarring.
Internal injuries follow the same path as external injuries. Chronic injury to your liver causes fibrosis, which is the development of scar tissue as your liver works to repair itself. After a long period, usually 15-20 years, fibrosis leads to cirrhosis- a condition in which scar tissue damages both the structure and function of the liver.
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I Have Cirrhosis Of The Liver Is That Reversible
More than 2 million Americans suffer from alcohol- related liver disease. The most common condition is alcoholic hepatitis, or inflammation of the liver as a result of heavy drinking over a long period of time. The symptoms of hepatitis may include fever abnormal yellowing of the skin, eyeballs, and urine known medically as jaundice and abdominal pain. These more commonly go unnoticed until a lab test reveals elevated liver enzymes. Alcoholic hepatitis can cause death if drinking continues. If drinking stops, the condition may be reversible. About 10% to 20% of alcoholics develop alcoholic cirrhosis, or scarring of the liver, which is the result of chronic hepatitis. People with cirrhosis should not drink alcohol.
More than 2 million Americans suffer from alcohol- related liver disease.
Hepatitis a liver disease due to a viral infection.
Cirrhosis a liver disease where there is widespread disruption of normal liver functions. It is a chronic progressive condition that can eventually lead to death.
Vascular Changes In Cirrhosis A Bridge Too Far
Alterations in the hepatic vasculature are a crucial component in the development of the cirrhotic state , and accompany the basic pathogenetic processes at play in the development of cirrhosis. These include: parenchymal cell damage and death, fibrogenesis and hepatocellular regeneration. Important forms of fibrosis during cirrhogenesis include septal and perisinusoidal fibrosis.
refers to the development of three-dimensional vascularized connective tissue sheets which
Can Cirrhosis Be Reversed Of Course Not They Say But What If
Sometimes what everyone knows is just wrong. Can cirrhosis improve? Care to join me for a walk down cirrhosis lane?
First what is cirrhosis? In simple terms, it is the formation of scars everywhere in the liver which causes it to fail.
OK, what then are scars? We all know them, we can see scars on our body where we have been wounded.
When liver cells are injured the same process occurs as when you cut yourself. Scar forming processes move in and try to repair the wound. This happens at the cell level so scar tissue forms everywhere within the liver and when it gets bad enough to disrupt the normal function of the liver we call it cirrhosis. That leads to ESLD, end stage liver disease, and death.
So what is a scar really? In the liver, inflammation is a typical culprit. Something, lets say too much fat or alcohol for example, damage liver cells and some of them die. That degeneration of cells causes clotting processes to start and platelets and the other wound healing chemicals move into the area. This process is crucial to your health but it is a balancing act. If the debris removal systems are able to clear out the dead cells all is well and that brief episode of cell death and inflammation is gone and all is well. Liver cells die by the millions every day and this is the normal process.