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Case Study #2: The Liver Read the case study below and answer the four questions attached

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Case Study #2: The Liver

Read the case study below and answer the four questions attached. NOTE that each point is worth 0.5 marks. This assignment is out of a total of 20 marks. The content is mainly focused on the Liver Regeneration Lecture but it not exclusive to other lecture content. Feel free to consult other resources to supplement your arguments

Precious is a not your average guy. He’s a 60-year-old body builder whose entire life has revolved around the evolution of his body. He is a 5x all world-body building champion. His daily routine consists of 3 workouts a day followed by a protein shake with muscle enhancing supplements. He is a certified chef who specializes on cooking lean protein meals with minimal lipid and carbohydrate components.  Over the past few years Precious has begun experiencing enhanced fatigue following training, abdominal pain and swelling as well as in his legs and ankles. With the competition of the year only two weeks away, Precious became incapable of completing his training regimen due to a worsening of the symptoms he had been attempting to manage for years.  Thus, Precious decided to visit his doctor to grasp what was occurring in hopes of being able to salvage his chance to compete for a 6^th body building championship.

The doctor conducted an MRI and after initial suspicions of liver abnormalities, a follow up biopsy to determine the degree of damage. The biopsy was followed by IHC for specific proteins and revealed high levels of fibrin, tumour necrosis factor (TNF), hepatocyte growth factor (HGF) and alanine aminotransferase (ALT).

1. What condition do you suspect John has and what is a likely explanation for John’s condition? What molecular events contribute to this diseased liver state? (4 marks)

The doctor says he will have to further analyze his medical history to determine if he is eligible for a transplant.

2. Based on what you already know would John be eligible for a liver transplant? Provide supporting details based on his case. (2 marks)

3. The doctor explains to John that liver failure is one of the most common diseases in the world and that there are greater than 550 ongoing clinical trials focused on the goal of restoring liver function without removing the liver. Two areas which shows potential therapeutic promise is the use of iPSC or Biliary Epithelial cells (BEC) to regenerate the liver.

1. Which approach do you think should be used in Precious’ case? What steps must be taken to properly rescue his diseased liver using this approach. List two ways you would assess the functional restoration of Precious’ liver and the specific points of interest you would use to investigate this. (5 marks)
2.  What sort of changes in gene expression could you look for to distinguish between the failing liver, recovering liver and a restored liver? (4 marks)

4. Scientists are always looking to explore new avenues of treatment for questions which have stumped the field. Research a novel possible liver regeneration treatment approach. Describe the process in detail and explain why this approach may be of greater promise than the ones which have previously been explored. Why might this approach be particularly applicable in Precious’ case for the current situation or if results are preliminary, the future, for people diagnosed with the same disease state? Ensure to cite the paper in your answer (5 marks).