Coffee and Tea May Contribute to a Healthy Liver

 — Surprise! Your morning cup of tea or coffee may be doing more than just perking you up before work.

An international team of researchers led by Duke-NUS Graduate Medical School (Duke-NUS) and the Duke University School of Medicine suggest that increased caffeine intake may reduce fatty liver in people with non-alcoholic fatty liver disease (NAFLD).

Worldwide, 70 percent of people diagnosed with diabetes and obesity have NAFLD, the major cause of fatty liver not due to excessive alcohol consumption. It is estimated that 30 percent of adults in the United States have this condition, and its prevalence is rising in Singapore. There are no effective treatments for NAFLD except diet and exercise.

Using cell culture and mouse models, the study authors -- led by Paul Yen, M.D., associate professor and research fellow, and Rohit Sinha, Ph.D of the Duke-NUS Graduate Medical School's Cardiovascular and Metabolic Disorders Program in Singapore -- observed that caffeine stimulates the metabolization of lipids stored in liver cells and decreased the fatty liver of mice that were fed a high-fat diet. These findings suggest that consuming the equivalent caffeine intake of four cups of coffee or tea a day may be beneficial in preventing and protecting against the progression of NAFLD in humans.

The findings will be published in the September issue of the journal Hepatology.

"This is the first detailed study of the mechanism for caffeine action on lipids in liver and the results are very interesting," Yen said. "Coffee and tea are so commonly consumed and the notion that they may be therapeutic, especially since they have a reputation for being "bad" for health, is especially enlightening."

The team said this research could lead to the development of caffeine-like drugs that do not have the usual side effects related to caffeine, but retain its therapeutic effects on the liver. It could serve as a starting point for studies on the full benefits of caffeine and related therapeutics in humans.

In addition to Yen and Sinha, collaborators included Christopher Newgard, PhD, director of the Sarah W. Stedman Nutrition and Metabolism Center at Duke University School of Medicine, where the metabolomics analysis of the data was conducted.

The study was supported by funding from Singapore's Agency for Science, Technology, and Research; the Ministry of Health; and the Ministry of Education.

How to Stop Bleeding in the ER Caused by Warfarin

 — Prothrombin complex concentrates (PCCs) are faster and more effective than fresh frozen plasma at reversing hemorrhage caused by the anti-coagulant warfarin, despite plasma being the most commonly used therapy. A literature review published last month in Annals of Emergency Medicinesuggests that physicians in the United States should join those around the world in following recommendations of multiple specialty organizations to use PCCs as the first line of defense in this common and life-threatening emergency ("Rapid Reversal of Warfarin-Associated Hemorrhage in the Emergency Department by Prothrombin Complex Concentrates").

"The typical remedies for hemorrhage caused by warfarin are slow and unpredictable," said author Kenneth Frumkin, PhD, MD of the Naval Medical Center in Portsmouth, Va. "By contrast, prothrombin complex concentrates reverse warfarin anticoagulation in minutes rather than hours. Its relative underuse in the U.S. compared to other countries seems to derive from lack of familiarity and infrequent availability."

PCCs (products made from pooled human plasma) were initially developed to treat hemophilia. They can be infused rapidly and generally reverse anticoagulation three to five times faster than fresh frozen plasma, which must be thawed. Recombinant Activated Factor VII (Factor rVIIa), while approved in the United States only for surgery or bleeding in hemophiliacs, has been used to reverse warfarin-associated bleeding. Factor rVIIa works faster than fresh frozen plasma, but carries more risk and costs much more.

"The April 2013 approval by the Food and Drug Administration of a form of PCC specifically intended for warfarin reversal should expand the use of these life-saving products," said Dr. Frumkin.

The views expressed by Dr. Frumkin are his own, and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.

                             courtesy:science daily