The Liver and Haemostasis

The functions of the livers

carbohydrate metabolism

fat metabolism

endocrine

storage of vitamin B12

protein metabolism

detoxification

iron storage

Haemostasis: the stopping of bleeding in an organ/stagnation of the blood

the liver senses changes in iron requirements and regulates the concentration of iron by controlling the production of iron regulatory genes. Dysregulation of iron leads to iron related disorders. the liver is found to be the central role of iron homeostasis due to the discovery of several mutations in liver derived genes. Whenever there is excess iron. the liver increases the storage of iron, protecting other organs like the heart and pancreas from suffering iron-induced cellular damage. a chronic increase in liver iron stores can lead to excess reactive oxygen species production and liver injury. excess liver iron is one of the leading mechanisms to fibrosis, cirrhosis and hepatocellular carcinoma

the liver plays a major role in the metabolism of proteins and amino acids. If the liver is diseased, there will be manifestations of disturbed protein metabolism, which vary and change with disease etiology and severity. Indications of protein and amino acid metabolism in liver disease are lowered concentrations of circulating branched-chain and increased concentrations of circulating aromantic amino acids with collectively altered amino acids.

The endocrine system depends on the collection of signals from the hypothalamic-pituitary axis and secondary endocrine organs such as the liver while secondary endocrine organs depend on the primary endocrine organs for hormonal production and secretion. this means the proper hepatic function is maintained through hormonal signaling and that the endocrine system and the liver are codependent. Diseases affecting one organ will alter in function with its counterparts.

The liver maintains carbohydrate metabolism by regulating glucose concentrations in a normal range. this is done by a rigidly regulated system of enzymes and kinases regulating either glucose breakdown or synthesis in hepatocytes.

The liver plays a major role in protecting the body from toxic chemical products when it's converting lipophiles into more water-soluble metabolites which are then eliminated from the body through urine. The liver expresses this protective ability using a variety of xenobiotic bio transforming enzymes which have the ability to catalyse the oxidation, reduction, and hydrolysis and/or conjugation of functional groups on drug and chemical molecules

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the liver is the central organ that is responsible for changing fats taken from diets to types of fats that can be used and stored in the body (to the imbalance of high-calorie diets and dietary fat consumption). the liver plays a key role in various features of lipid metabolism. the accumulation of lipid droplets into the hepatocytes can lead to hepatic steatosis, which can lead to other illnesses. the process of lipid metabolism can be disrupted by factors such as malnutrition, pregnancy, or alcoholism.

causes of liver dysfunction

Altered intestinal microbiota composition and function

The intestinal microbiome consists of trillions of microbes such as bacteria and viruses that all live in the gastrointestinal tract. there are several factors that can affect the composition of the intestinal microbiome such as age, sex, race, hormonal status, and the intestinal immune system. the microbiota live in a harmonious diversity with the host. this leads to a mutual exchange that results in many advantageous roles such as the maintenance of a normal immune system, prevention of pathogen colonization, and nutrient digestion and absorption. They all have a significant impact on the physiological and pathological processes of the host.
Regardless of the microbiome's diversity, there are common functional properties that are shared across bacterial subcommunities. If there are any changes in one sector of the subpopulation, their roles will be compensated by other sectors which share a similar purpose. this is usually determined by their preference for metabolic substrate and the metabolites they produce.
Nonalcoholic fatty liver disease is the most aggressive form of the disease comapred to alcoholic fatty liver disease. It's also a growing contributor to the burden of end stage liver disease, as well as resulting to cirrhosis which can affect up to 20% of individuals.
The intestinal microbiome plays a crucial role in the metabolism of dietary choline. Nonalcoholic steatohepatitis (NASH) is known to be a result of choline deficiency which is due to high-fat diets and low-choline diets. two bacterias that are usually identified in choline deficiency-induced fatty liver are Firmicutes/Erysipelotrichi and Proteobacteria/Gammaproteobacteria.


There is more just keep researching and rephrasing

Excessive alcohol consumption

implications of altered liver function for haemostasis and haematological disorders

Haemostasis is closely related to liver function due to the synthesis of most coagulation factors by liver parenchymal cells and the liver's reticuloendothelial system. this is significant to the clearance of activation products. Liver parenchymal cells produce. disrupted liver parenchymal cell function negatively impact the haemostasis system to the point of it leading to liver disease. the disruption will result to the decrease of levels of procoagulant, anticoagulant, profibrinolytic and antifibrinolytic factors in plasma. the effects of this varies in patients, minor in patients with mild liver disease and severe in patients with cirrhosis.

Platelets are used in blood clotting and without it, it will lead to bleeding disorders such as thrombocytopenia. thrombocytopenia is the lack of platelets/less production of platelets. Excessive platelet activation will lead to thrombosis and vessel occlusion, such as heart attacks and strokes. The normal amount of platelets will be able to maintain haemostasis through both blood components and endothelial cells that secrete inhibitory or stimulatory molecules to regulate thrombus formation.

Patients with liver disease tend to have a more fragile haemostatic balance than individuals with normal livers. it is discovered that that patients with liver disease experience both a hypocoagulable state/haemtostasis-related bleeding and thrombotic events.

CIRRHOSIS

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Overconsumption of alcohol can lead to stress and damage to the liver. Alcohol, e.g. ethanol, is mostly metabolized in the main liver parenchymal cells of the liver, such as hepatocytes, which make up 70% of the liver's mass. as the liver is the primary site of ethanol metabolism, it sustains a great degree of injury, resulting to a wide variety of hepatic lesions such as steaotsis, hepatitis, and fibrosis/cirrhosis. Steatosis is the earliest sign to excessive alcohol intake and it is characterized by the accumulation of fat in the hepatocytes. Steatosis can evolve into steatohepatits, which is a more severe, inflammatory type of liver injury. this phase of liver disease can lead to the development of fibrosis,which causes an excessive deposition of extracellular matrix proteins. This response will begin with an active pericellular fibrosis, which will evolve into cirrhosis. Cirrhosis is identified by the extreme liver scarring, vascular alterations, and ultimately liver failure.

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Current and new treatments for liver disease and blood disorders

To effectively treat a blood disorder such as Haemophilia is to have the missing blood clotting factor to be restored so that blood can clot. The treatment is usually injections of clotting factor concentrates, which are usually products for episodic or prophylactic care. Prophylactic care is to prevent bleeding occurences from happening while episodic care is done during a bleeding occurence to stop it. For the clotting factor concentrates, there are two types: plasma-derived factor concentrates and recombinant factor concentrates. Plasma-derived factor concentrates are one of the products available made from human plasma proteins. The human plasma proteins is made from collecting plasma from many people when testing for any viruses. the plasma goes through several processes to be separated into different components such as clotting proteins, which are then turned into a freeze-dried product.The freeze-dried product is then tested and treated to kill any potential virses before packaging. the recombinant factor concentrates were made not from human plasma, but being genetically engineered using DNA technology. Factors VIII and IX do not have plasma or albumin within them, meaning they cannot spread any bloodborne viruses. There are instances that some people develop an inhibitor when taking clotting factor concentrates, making it difficult to stop a bleeding occurence. The best choice that is often suggested for care is treatment at a comprehensive hemophilia treatment center (HTC).