Non-cirrhotic portal hypertension is a poorly understood condition characterized by portal hypertension in the absence of conventional hepatic cirrhosis and described in association with blood coagulation disorders, m...Non-cirrhotic portal hypertension is a poorly understood condition characterized by portal hypertension in the absence of conventional hepatic cirrhosis and described in association with blood coagulation disorders, myeloproliferative and immunological diseases and with exposure to toxic drugs. Very recently, precise classification criteria have been proposed in order to define four distinct subcategories. The present case highlights how the clinical presentation, the confounding results from imaging studies, and the difficulties in the histological evaluation often render cases of non-cirrhotic portal hypertension a real diagnostic challenge. It also underscores the classification problems which can be faced once this diagnosis is performed. Indeed, the different subcategories proposed result from the prevalent subtypes in a spectrum of hepatic regenerative responses to a variety of injuries determining microcirculatory dis-turbances. More flexibility in classification should derive from this etiopathogenic background.展开更多
Leptin is one of the most important hormones secreted by adipocytes,with a variety of physiological roles related to the control of metabolism and energy homeostasis.Since its discovery in 1994,leptin has attracted in...Leptin is one of the most important hormones secreted by adipocytes,with a variety of physiological roles related to the control of metabolism and energy homeostasis.Since its discovery in 1994,leptin has attracted increasing interest in the scientific community for its pleiotropic actions.One of these functions is the relationship between nutritional status and immune competence.It structurally resembles proinflammatory cytokines,such as IL-6 and IL-12.The cytokine-like structural characteristic of leptin is implicative of its function in regulating immune responses.The role of leptin in regulating immune responses has been assessed in vitro as well as in clinical studies.It has been shown that disease conditions of reduced leptin production are associated with increased infection susceptibility.Conversely,immune-mediated disorders,such as autoimmune diseases,are associated with the increased secretion of leptin and the production of proinflammatory pathogenic cytokines.In this paper,we review the most recent advances of the role of leptin in immune-rheumatological diseases,and we discuss whether strategies aimed at modifying leptin levels could represent innovative and therapeutic tools for autoimmune disorders.展开更多
文摘Non-cirrhotic portal hypertension is a poorly understood condition characterized by portal hypertension in the absence of conventional hepatic cirrhosis and described in association with blood coagulation disorders, myeloproliferative and immunological diseases and with exposure to toxic drugs. Very recently, precise classification criteria have been proposed in order to define four distinct subcategories. The present case highlights how the clinical presentation, the confounding results from imaging studies, and the difficulties in the histological evaluation often render cases of non-cirrhotic portal hypertension a real diagnostic challenge. It also underscores the classification problems which can be faced once this diagnosis is performed. Indeed, the different subcategories proposed result from the prevalent subtypes in a spectrum of hepatic regenerative responses to a variety of injuries determining microcirculatory dis-turbances. More flexibility in classification should derive from this etiopathogenic background.
文摘Leptin is one of the most important hormones secreted by adipocytes,with a variety of physiological roles related to the control of metabolism and energy homeostasis.Since its discovery in 1994,leptin has attracted increasing interest in the scientific community for its pleiotropic actions.One of these functions is the relationship between nutritional status and immune competence.It structurally resembles proinflammatory cytokines,such as IL-6 and IL-12.The cytokine-like structural characteristic of leptin is implicative of its function in regulating immune responses.The role of leptin in regulating immune responses has been assessed in vitro as well as in clinical studies.It has been shown that disease conditions of reduced leptin production are associated with increased infection susceptibility.Conversely,immune-mediated disorders,such as autoimmune diseases,are associated with the increased secretion of leptin and the production of proinflammatory pathogenic cytokines.In this paper,we review the most recent advances of the role of leptin in immune-rheumatological diseases,and we discuss whether strategies aimed at modifying leptin levels could represent innovative and therapeutic tools for autoimmune disorders.
