Damage related to the initial ischemic insult and the early phases of reperfusion are secondary to reactive oxygen species generation, decreased adenosine triphosphate production, and increased mitochondrial permeability transition.5, 6 However, after the initial insult, I/R is perpetuated by an innate KU57788 immune response. This response is mediated not only by the classical proinflammatory cytokines, such as tumor necrosis factor-α and IL-1β, but also by the recently described endogenous danger signals or damage-associated molecular pattern (DAMP) molecules. Examples

of DAMP molecules that lead to increased inflammation include the canonical DAMP, HMGB1, in addition to more recently described molecules such as histones.6, 7 Additionally, pattern recognition receptors have been shown to be necessary for the

I/R-associated innate immune response. Pattern recognition receptors such as TLR4, TLR9, and NALP3 have all been shown to be key components in I/R-associated injury, with significant protection afforded to mice that lack these receptors.7-10 The activation of the innate immune response via PRRs leads to the expression of chemokines Akt inhibitor and intercellular adhesion molecules with the subsequent infiltration of neutrophils and other inflammatory cells into the liver, resulting in further I/R-associated injury. The study by Ji et al. is the first to demonstrate the role of an intrinsic neuropeptide in maintaining hepatic homeostasis in inflammation and organ damage following liver I/R. The use of PACAP to regulate immune responses and activate cytoprotective mechanisms should be investigated further as a novel therapy to manage 上海皓元医药股份有限公司 liver inflammation associated with I/R. “
“With the increasing use of potent immunosuppressive therapy, reactivation of hepatitis B virus (HBV) in endemic regions is becoming a clinical problem requiring special attention. A recent annual nationwide survey clarified

that HBV reactivation related to immunosuppressive therapy has been increasing in patients with malignant lymphoma, other hematological malignancies, oncological or rheumatological disease. In the survey, rituximab plus steroid-containing chemotherapy was identified as a risk factor for HBV reactivation in hepatitis B surface antigen (HBsAg) negative patients with malignant lymphoma. In this setting, HBV reactivation resulted in fatal fulminant hepatitis regardless of the treatment of nucleoside analog. The Intractable Hepatobiliary Disease Study Group and the Study Group for the Standardization of Treatment of Viral Hepatitis Including Cirrhosis jointly developed guidelines for preventing HBV reactivation. The essential features of the guideline are as follows. All patients should be screened for HBsAg by a sensitive method before the start of immunosuppressive therapy.