liver love slides ahg 2016

Liver Lovin’with Camille Freeman

Where is the liver located?

"Hepatic structure2" by Originally by Frevert U, Engelmann S, Zougbédé S, Stange J, Ng B, et al. Converted to SVG by Viacheslav Vtyurin who was hired to do so by User:Eug. - Based on the research article "Intravital Observation of Plasmodium berghei Sporozoite Infection of the Liver", PLoS Biology, doi:10.1371/journal.pbio.0030192.g011. Licensed under CC BY 2.5 via Wikimedia Commons -http://commons.wikimedia.org/wiki/File:Hepatic_structure2.svg#mediaviewer/File:Hepatic_structure2.svg

"2104 Three Major Capillary Types" by OpenStax College - Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013.. Licensed under CC BY 3.0 via Wikimedia Commons -

http://commons.wikimedia.org/wiki/File:2104_Three_Major_Capillary_Types.jpg#mediaviewer/File:2104_Three_Major_Capillary_Types.jpg

"2423 Microscopic Anatomy of Liver" by OpenStax College - Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013.. Licensed under CC

BY 3.0 via Wikimedia Commons -https://commons.wikimedia.org/wiki/File:2423_Microscopic_Anatomy_of_Liver.jpg#/media/F

ile:2423_Microscopic_Anatomy_of_Liver.jpg

Hepatic Portal Vein

Major Functions of the Liver

Formation & secretion of bileNutrient & vitamin metabolism

Storage

Detoxification

Synthesis of hormones and plasma proteins

Immunity

Bile

• Water

• Pigments

• Bile acids

• Other: cholesterol, fatty acids, inorganic salts, hormones…

Image by Boumphreyfr - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=7006980

Figure 1

Cell Metabolism 2009 10, 162-164DOI: (10.1016/j.cmet.2009.08.005)

Copyright © 2009 Elsevier Inc. Terms and Conditions

Herbal Notes

• Saponins: may bind to bile salts, increase fecal excretion

• Cholagogues

• Choleretics

• Bitters

• Cynara scolymus

• Chelidonium majus

• Mentha spp?

• Curcuma longa

• Berberis vulgaris, B. aquifolium, Chionanthus, Taraxacum radix

Major Functions of the Liver

Formation & secretion of bile

Nutrient & vitamin metabolism

DetoxificationSynthesis of hormones and

plasma proteins

Immunity

Detoxification

• Phase I: CYP450 enzymes can make substances more toxic than the parent molecule

• Phase II: sulfotransferase, methyltransferase or glutathione-S-transferases make molecule more easily excreted in urine/bile• Nrf2 is a transcription factor that

regulates genetic expression of many phase II enzymes. When Nrf2 is upregulated, phase II detoxification increases

Herbal Notes

• May increase phase II:• Curcumin, garlic, green tea,

rosemary, schisandra, broccoli sprouts

• Hepatoprotective/antioxidant:• Silybum

• Cynara

• Ginkgo (?)

Major Functions of the Liver

Formation & secretion of bile

Nutrient & vitamin metabolismStorage

Detoxification

Synthesis of hormones and plasma proteins

Immunity

• Stores glucose as glycogen

• Makes new glucose/releases glucose into blood

• Builds new proteins

• Re-packages fats and cholesterol

• Synthesizes cholesterol

• Stores B12, D, etc.

Major Functions of the Liver

Formation & secretion of bile

Nutrient & vitamin metabolism

Storage

Detoxification

Synthesis of hormones and plasma proteins

Immunity

• Acute phase proteins

• Sex Hormone Binding Globulin (SHBG)

• Albumin

• Complement proteins

• + more!

Major Functions of the Liver

Formation & secretion of bile

Nutrient & vitamin metabolism

Storage

Detoxification

Synthesis of hormones and plasma proteins

Immunity

• See previous slide for image citation

Transaminases

•ALT: alanine transaminase

•AST: aspartate transaminase

Measured by liver function tests

Herbal Ideas

• Thuja occidentalis & Echinacea purpureastimulate Kupffer cell phagocytosis in vitro

• Silybum may decrease fibrotic activity by decreasing stellate cell activation

• Cynara appears to reduce AST/ALT (preliminary evidence)

The Rhythms of the Liver

• Hepatocytes express many genes rhythmically

• Must be entrained to body’s circadian rhythm using zeitgebers

Strategies to Support the Liver

• Use hepatoprotective herbs

• Strengthen integrity of epithelial mucosa in GI

• Maintain regular movement through the GI

• Encourage bile production & secretion

• Promote healthy microbiota in colon

• Decrease inflammatory inputs

• Follow a daily, predictable rhythm

Liver Overview

Hepatic vein

• Nutrients• Bilirubin• Drugs• antigens

• Hormone/drug metabolites

• Nutrients (esp. fatty acids)

• bilirubin

• Glucose• Plasma proteins• Urea• Vitamin D• Metabolites for

excretion

• Bile salts• Bilirubin• Water/ions• Phospholipids