Histamine is a natural amine derived from L-histidine. Although it seems that our knowledge about this molecule is wide and diverse, the importance of histamine in many regulatory processes is still enigmatic. The interplay between different types of histamine receptors and the compound may cause ample effects, including histamine intoxication and so-called histamine intolerance or non-allergic food intolerance, leading to disturbances in immune regulation, manifestation of gastroenterological symptoms, and neurological diseases. Most cases of clinical manifestations of histamine intolerance are non-specific due to tissue-specific distribution of different histamine receptors and the lack of reproducible and reliable diagnostic markers. The diagnosis of histamine intolerance is fraught with difficulties, in addition to challenges related to the selection of a proper treatment strategy, the regular course of recovery, and reduced amelioration of chronic symptoms due to inappropriate treatment prescription. Here, we reviewed a history of histamine uptake starting from the current knowledge about its degradation and the prevalence of histamine precursors in daily food, and continuing with the receptor interactions after entering and the impacts on the immune, central nervous, and gastrointestinal systems. The purpose of this review is to build an extraordinarily specific method of histamine cycle assessment in regard to non-allergic intolerance and its possible dire consequences that can be suffered.

Aim:localization of the new nomenclature of steatotic liver disease in Russian clinical practice.Key points.In 2023, international consensus decided to introduce a new nomenclature for steatotic liver disease. The article discusses the reasons for the change in nomenclature and the new terms adopted: steatotic liver disease, metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction and alcohol associated steatotic liver disease. Adapting new terms to Russian healthcare poses a certain problem. The results of voting by Russian doctors on the introduction of new terms and their optimal translation are presented. A comparison of existing classifiers with new terms was carried out and the formulation of diagnoses was discussed taking into account the new nomenclature.Conclusions.Adaptation and implementation of new nomenclature into clinical practice is an important and complex task, in which it is necessary to maintain a balance between a progressive concept and the interests of practical healthcare.

A joint council of experts in the field of hepatology reviewed the results of experimental and clinical studies evaluating the efficacy of hepatotropic drugs (ademetionine, ursodeoxycholic acid, ornithine, bicyclol, morpholinium tiazotate, phospholipids, a fixed combination of inosine + meglumine + methionine + nicotinamide + succinic acid), glucocorticoids, extracorporeal detoxification methods in drug-induced liver injury (DILI); inclusion of these medications and treatment methods in clinical guidelines in various countries was analyzed. Indications for the use of hepatotropic drugs were formulated depending on the pattern of DILI (hepatocellular, cholestatic, mixed), as well as in some DILI phenotypes.

Aim. The clinical guidelines are intended to provide information support for making decisions by gastroenterologists, general practitioners and internists that will improve the quality of medical care for patients with drug-induced liver injury, taking into account the latest clinical data and principles of evidence-based medicine. Key points. Clinical guidelines contain information about current views on etiology, risk factors and pathogenesis of drug-induced liver injury, peculiarities of its clinical course. Also, the recommendations provide information on current methods of laboratory and instrumental diagnostics, invasive and non-invasive tools for drug-induced liver injury disease and its clinical phenotypes assessment; approaches to its treatment, considering the presence of comorbidities, features of dispensary monitoring and prophylaxis. The information is illustrated with algorithms of differential diagnosis and physician’s actions. In addition, there is information for the patient and criteria for assessing the quality of medical care. Conclusion. Awareness of specialists in the issues of diagnosis, treatment and follow-up of patients with drug- induced liver injury contributes to the timely diagnosis and initiation of treatment, which in the long term will significantly affect their prognosis and quality of life.

Introduction. As a result of portal hypertension (sequestration of platelets in an enlarged spleen) and liver failure (decreased production of thrombopoietin in the liver) in liver cirrhosis, thrombocytopenia develops, which is associated with the risk of periprocedural/perioperative bleeding complications. There are still unresolved questions regarding risk stratification of bleeding complications, the prognostic role of thrombocytopenia, as well as the need for treatment of thrombocytopenia and its methods.Materials and methods. The Russian Scientific Liver Society selected a panel of experts in the field of therapeutic and surgical hepatology, hematology, transfusion medicine to make reasoned statements and recommendations on the issue of treatment of thrombocytopenia before elective surgery / invasive procedures in patients with liver cirrhosis.Results. Relevant clinical issues were determined based on the PICO principle (patient or population, intervention, comparison, outcome). The Delphi panel made five questions and gave reasoned answers, framed as ‘clinical practice recommendations and statements’ with evidence-based comments. The questions and statements were based on the results of search and critical analysis of medical literature using keywords in English- and Russian-language databases. The formulated questions could be combined into four categories: bleeding risk stratification, the prognostic value of thrombocytopenia, the necessity and methods of thrombocytopenia drug correction, and bleeding risk reduction.Conclusions. The results of experts' work are directly related to high-quality management of patients with liver cirrhosis and thrombocytopenia, who have scheduled invasive procedures/surgery. Thus, this recommendations and statements can be used in clinical practice.