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Related Concept Videos

Autoimmune Disorders01:29

Autoimmune Disorders

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Autoimmune diseases are a group of disorders in which the body's immune system mistakenly attacks its own cells, tissues, and organs. This results from an overactive immune response against substances and tissues normally present in the body. Let's delve into the concept and mechanism of autoimmune diseases from an immune system point of view, explore different causes and examples of such diseases, and discuss potential solutions.
Concept and Mechanism of Autoimmune Diseases
The immune...
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Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

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Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
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Hepatic Portal System01:21

Hepatic Portal System

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The hepatic portal system, a critical part of our circulatory framework, transports nutrient-laden, deoxygenated blood from the gastrointestinal tract and spleen to the liver. This ingenious system plays an indispensable role in maintaining our body's metabolic equilibrium.
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is...
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Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

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Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
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Protein Complex Assembly02:41

Protein Complex Assembly

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Proteins can form homomeric complexes with another unit of the same protein or heteromeric complexes with different types.  Most protein complexes self-assemble spontaneously via ordered pathways, while some proteins need assembly factors that guide their proper assembly. Despite the crowded intracellular environment, proteins usually interact with their correct partners and form functional complexes.
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Protein Complexes with Interchangeable Parts01:57

Protein Complexes with Interchangeable Parts

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Groups of proteins may form a complex where each protein in this complex has a different role in the overall execution of the complex’s function. Often some of the proteins in the complex can be replaced by a closely related variant to give a complex that contains many of the same components yet is functionally distinct.
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The CYP2D6 Animal Model: How to Induce Autoimmune Hepatitis in Mice
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Autoimmune hepatitis and complexities in management.

Ashnila Janmohamed1,2, Gideon M Hirschfield1,2,3,4

  • 1Centre for Liver Research, NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK.

Frontline Gastroenterology
|January 18, 2019
PubMed
Summary
This summary is machine-generated.

Autoimmune hepatitis (AIH) management involves standard immunosuppression. This review addresses clinical dilemmas and competencies for difficult-to-treat AIH cases, focusing on non-responders and therapy intolerance.

Keywords:
autoimmune hepatitisautoimmune liver diseaseimmune-mediated liver damageimmunotherapyliver transplantation

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Area of Science:

  • Hepatology
  • Immunology
  • Gastroenterology

Background:

  • Autoimmune hepatitis (AIH) is a rare immune-mediated liver disease with generally good prognosis.
  • Standard treatment involves corticosteroids and azathioprine, but challenges arise in non-responders or those intolerant to therapy.
  • Expertise in managing AIH can be concentrated in specialized centers due to its rarity.

Purpose of the Study:

  • To review common clinical dilemmas in adult AIH management.
  • To address competencies related to AIH within the 2010 Gastroenterology curriculum.
  • To provide guidance on non-standardized second-line therapies for difficult-to-treat AIH.

Main Methods:

  • Case-based review approach.
  • Discussion of clinical scenarios in AIH management.
  • Analysis of treatment variations and efficacy.

Main Results:

  • Identified common clinical challenges in AIH patient care.
  • Highlighted variability in the use and effectiveness of second-line therapies.
  • Emphasized the need for standardized approaches for complex AIH cases.

Conclusions:

  • Effective management of AIH requires addressing challenges in non-responders and therapy intolerance.
  • Standardization of second-line treatments is needed for difficult-to-treat AIH.
  • Clinicians require specific competencies for managing this rare liver disease.