Ioannis Androulakis

Ioannis Androulakis
  • PhD
  • Professor (Full) at Rutgers, The State University of New Jersey

About

295
Publications
44,787
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7,719
Citations
Introduction
quantitative systems pharmacology, circadian rhythms, systems biology, endocrine system
Skills and Expertise
Current institution
Rutgers, The State University of New Jersey
Current position
  • Professor (Full)

Publications

Publications (295)
Article
Full-text available
Quantitative Systems Pharmacology (QSP) models capture the physiological underpinnings driving the response to a drug and express those in a semi-mechanistic way, often involving ordinary differential equations (ODEs). The process of developing a QSP model generally starts with the definition of a set of reasonable hypotheses that would support a m...
Article
Full-text available
Quantitative systems pharmacology (QSP) modeling is applied to address essential questions in drug development, such as the mechanism of action of a therapeutic agent and the progression of disease. Meanwhile, machine learning (ML) approaches also contribute to answering these questions via the analysis of multi-layer 'omics' data such as gene expr...
Article
Full-text available
Quantitative systems pharmacology (QSP) modeling is applied to address essential questions in drug development, such as the mechanism of action of a therapeutic agent and the progression of disease. Meanwhile, machine learning (ML) approaches also contribute to answering these questions via the analysis of multi-layer ‘omics’ data such as gene expr...
Article
Gout, the most common inflammatory arthritis worldwide, is an auto-inflammatory metabolic disease that leads to monosodium urate crystal deposition. Hyperuricaemia is a significant risk factor for the development of gout; however, hyperuricaemia alone is not sufficient to induce gout.Gout flares have circadian rhythms. Gout flares vary during the d...
Article
Full-text available
The suprachiasmatic nucleus (SCN) functions as the central pacemaker aligning physiological and behavioral oscillations to day/night (activity/inactivity) transitions. The light signal entrains the molecular clock of the photo-sensitive ventrolateral (VL) core of the SCN which in turn entrains the dorsomedial (DM) shell via the neurotransmitter vas...
Article
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Circadian rhythms describe physiological systems that repeat themselves with a cycle of approximately 24 h. Our understanding of the cellular and molecular origins of these oscillations has improved dramatically, allowing us to appreciate the significant role these oscillations play in maintaining physiological homeostasis. Circadian rhythms allow...
Article
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A computational framework is developed to enable the characterization of genome-wide, multi-tissue circadian dynamics at the level of “functional groupings of genes” defined in the context of signaling, cellular/genetic processing and metabolic pathways in rat and mouse. Our aim is to identify how individual genes come together to generate orchestr...
Article
Full-text available
The evolution of complex genetic networks is shaped over the course of many generations through multiple mechanisms. These mechanisms can be broken into two predominant categories: adaptive forces, such as natural selection, and non-adaptive forces, such as recombination, genetic drift, and random mutation. Adaptive forces are influenced by the env...
Article
The circadian timing system comprises a network of time-keeping clocks distributed across a living host whose responsibility is to allocate resources and distribute functions temporally to optimize fitness. The molecular structures generating these rhythms have evolved to accommodate the rotation of the earth in an attempt to primarily match the li...
Chapter
The inflammatory response initiates the healing and recovery from injury. When successful, this leads to the restoration of homeostasis; however, if homeostasis cannot be restored, elevated levels of inflammatory activity may exert a deleterious effect. Given the complexity inherent in the redundant and interacting components of the inflammatory re...
Article
Full-text available
Circadian rhythms play a vital role in metabolic, hormonal, and immunologic function and are often disrupted in patients in the ICU. Circadian rhythms modulate the molecular machinery that responds to injury and illness which can impact recovery. Potential factors contributing to the alteration in circadian rhythmicity in intensive care unit (ICU)...
Article
Full-text available
A model-based approach for the assessment of pathway dynamics is explored to characterize metabolic and signaling pathway activity changes characteristic of the dosing-dependent differences in response to methylprednisolone in muscle. To consistently compare dosing-induced changes we extend the principles of pharmacokinetics and pharmacodynamics an...
Article
Chronic skin wounds are hypoxic and are stalled in a pro-inflammatory state. Hemoglobin (Hb)-based oxygen carriers have shown potential in increasing oxygen delivery to aid wound healing. Macrophages also take up Hb, thus altering their phenotype and the regulation of inflammation. Herein, we compared the effect of Hb and polymerized Hbs (PolyHbs)...
Article
Drug research and development has a high attrition rate, with many promising drugs failing for efficacy or safety in the clinic. Increased use of detailed modeling approaches like quantitative systems pharmacology (QSP) may help in reducing overall failure rate, by helping the industry in decisions to fail early and cheaply, or to focus on patients...
Article
The hypothalamic-pituitary-adrenal (HPA) axis orchestrates the physiological response stress. Moreover, the HPA axis exhibits prominent circadian activity and synchronizes peripheral circadian clocks to daily environmental cycles, thereby promoting homeostasis. Persistent disruption of homeostatic glucocorticoid circadian rhythmicity due to chronic...
Article
Endogenous glucocorticoids have diverse physiological effects and are important regulators of metabolism, immunity, cardiovascular function, musculoskeletal health and central nervous system activity. Synthetic glucocorticoids have received widespread attention for their potent anti-inflammatory activity and have become an important class of drugs...
Article
Full-text available
Nutrient metabolism is under circadian regulation. Disruption of circadian rhythms by lifestyle and behavioral choices such as work schedules, eating patterns, and social jetlag, seriously impacts metabolic homeostasis. Metabolic dysfunction due to chronic misalignment of an organism's endogenous rhythms is detrimental to health, increasing the ris...
Article
Full-text available
The hypothalamic-pituitary-adrenal (HPA) axis orchestrates the physiological response to unpredictable acute stressors. Moreover, the HPA axis exhibits prominent circadian activity and synchronizes peripheral circadian clocks to daily environmental cycles, thereby promoting homeostasis. Persistent disruption of homeostatic glucocorticoid circadian...
Article
Full-text available
This study describes a new approach to discern early divergence in stem cell lineage progression via temporal dynamics of the cytoskeletal protein, F-actin. The approach involves real-time labeling of human mesenchymal stem cells (MSCs) and longitudinal tracking of the turnover dynamics of a fluorogenic F-actin specific probe, SiR-actin (SA). Cells...
Article
Disruption of circadian rhythms has been associated with metabolic syndromes, including obesity and diabetes. A variety of metabolic activities are under circadian modulation, as local and global clock gene knockouts result in glucose imbalance and increased risk of metabolic diseases. Insulin release from the pancreatic β cells exhibits daily vari...
Article
The shift towards non-communicable, chronic, diseases has placed emphasis on understanding the dominant role our everyday activities and broader environment as a major determinant of health. The realization that genetics is but one of the drivers of maintaining health and developing chronic diseases, necessitates that we refocus our attention on th...
Article
Full-text available
Pharmacological time-series data, from comparative dosing studies, are critical to characterizing drug effects. Reconciling the data from multiple studies is inevitably difficult; multiple in vivo high-throughput -omics studies are necessary to capture the global and temporal effects of the drug, but these experiments, though analogous, differ in (...
Data
Edited_SuppMaterials_010819_xyz14186da01b6ae_(1) – Supplemental material for Pathway-Based Analysis of the Liver Response to Intravenous Methylprednisolone Administration in Rats: Acute Versus Chronic Dosing
Article
Circadian time-keeping mechanisms preserve homeostasis by synchronizing internal physiology with predictable variations in the environment and temporally organize the activation of physiological signaling mechanisms to promote survival and optimize the allocation of energetic resources. In this paper, we highlight the importance of the robust circa...
Article
Glucocorticoids influence a wide array of metabolic, anti-inflammatory, immunosuppressive, and cognitive signaling processes, playing an important role in homeostasis and preservation of normal organ function. Synthesis is regulated by the hypothalamic-pituitary-adrenal (HPA) axis of which cortisol is the primary glucocorticoid in humans. Synthetic...
Article
Full-text available
The dysregulation of inflammation, normally a self-limited response that initiates healing, is a critical component of many diseases. Treatment of inflammatory disease is hampered by an incomplete understanding of the complexities underlying the inflammatory response, motivating the application of systems and computational biology techniques in an...
Article
Pharmacokinetic models are particularly useful to study the underlying and complex physiological mechanisms contributing to clinical differences across patient subgroups or special populations. Unfortunately, the inherent variability of biological systems and knowledge gaps in physiological data limit confidence in model predictions for special pop...
Article
Full-text available
Cancer is a devastating disease that takes the lives of hundreds of thousands of people every year. Due to disease heterogeneity, standard treatments, such as chemotherapy or radiation, are effective in only a subset of the patient population. Tumors can have different underlying genetic causes and may express different proteins in one patient vers...
Article
Natural glucocorticoids, a class of cholesterol-derived hormones, modulate an array of metabolic, anti-inflammatory, immunosuppressive and cognitive signaling. The synthesis of natural glucocorticoids, largely cortisol in humans, is regulated by the hypothalamic-pituitary-adrenal (HPA) axis and exhibits pronounced circadian variation. Considering t...
Article
Full-text available
Parameter sensitivity and uncertainty analysis for physiologically based pharmacokinetic (PBPK) models are becoming an important consideration for regulatory submissions, requiring further evaluation to establish the need for global sensitivity analysis. To demonstrate the benefits of an extensive analysis, global sensitivity was implemented for th...
Article
Synchronization of biological functions to environmental signals enables organisms to anticipate and appropriately respond to daily external fluctuations and is critical to the maintenance of homeostasis. Misalignment of circadian rhythms with environmental cues is associated with adverse health outcomes. Cortisol, the downstream effector of hypoth...
Article
The circadian rhythms influence the metabolic activity from molecular level to tissue, organ, and host level. Disruption of the circadian rhythms manifest to the host's health as metabolic syndromes including obesity, diabetes, and elevated plasma glucose, eventually leading to cardiovascular diseases. Therefore, it is imperative to understand the...
Chapter
Breakthroughs in high-throughput technologies have provided vast information related to the genome, transcriptome, proteome, and metabolome that enable human physiology to be described mathematically. The collection of biological data at various organizationally complex levels may be translated into a network which describes how these genes, transc...
Article
The triterpenoid ursolic acid (UA) has been proposed as a potential cancer chemopreventive agent in many preclinical and clinical studies. In the present work, we aimed to characterize the pharmacokinetics (PK) of UA and to quantitatively assess the anti-oxidative and anti-inflammatory effects of UA, which are potentially linked to its chemoprevent...
Article
Full-text available
Cortisol dynamics are governed by the integration of influences from the suprachiasmatic nucleus (SCN), the hypothalamic-pituitary-adrenal (HPA) axis, and metabolic enzymes, such as the 11β–hydroxysteroid dehydrogenase (HSD) family, which are highly expressed in hepatic and renal tissue. The coordinated regulation of cortisol dynamics is essential...
Article
Significant sex differences exist in the activity of the hypothalamic-pituitary-adrenal (HPA) axis. These differences are thought to contribute to the disparity in the prevalence of various autoimmune and infectious diseases between males and females. We use a mathematical model of the HPA axis to evaluate the hypothesis that differential sensitivi...
Article
Full-text available
Homeostasis posits that physiological systems compensate setpoint deviations in an attempt to maintain a state of internal constancy. Allostasis, on the other hand, suggests that physiological regulation is more appropriately described by predictive modulatory actions that, by adjusting setpoints, anticipate and react to changes in internal and ext...
Article
The use of models in biology has become particularly relevant as it enables investigators to develop a mechanistic framework for understanding the operating principles of living systems as well as in quantitatively predicting their response to both pathological perturbations and pharmacological interventions. This application has resulted in a syne...
Article
Full-text available
The feeding and fasting cycles are strong behavioral signals that entrain biological rhythms of the periphery. The feeding rhythms synchronize the activities of the metabolic organs, such as liver, synergistically with the light/dark cycle primarily entraining the suprachiasmatic nucleus. The likely phase misalignment between the feeding rhythms an...
Article
Full-text available
In this paper, we discuss approaches for integrating biological information reflecting diverse physiologic levels. In particular, we explore statistical and model-based methods for integrating transcriptomic, proteomic and metabolomics data. Our case studies reflect responses to a systemic inflammatory stimulus and in response to an anti-inflammato...
Article
Oscillations are an important feature of cellular signaling that result from complex combinations of positive- and negative-feedback loops. The encoding and decoding mechanisms of oscillations based on amplitude and frequency have been extensively discussed in the literature in the context of intercellular and intracellular signaling. However, the...
Chapter
In this chapter we explore the characteristics underlying the development of mechanistic-based models of inflammation. The discussion covers the three basic arms of developing mechanistic models. We begin by exploring the likely experimental analogues producing critical information, we then review modeling alternatives for representing the biologic...
Article
Full-text available
Personalized medicine strives to deliver the ‘right drug at the right dose’ by considering inter-person variability, one of the causes for therapeutic failure in specialized populations of patients. Physiologically-based pharmacokinetic (PBPK) modeling is a key tool in the advancement of personalized medicine to evaluate complex clinical scenarios,...
Article
Seasonal changes in environmental conditions are accompanied by significant adjustment of multiple biological processes. In temperate regions, the day fraction, or photoperiod, is a robust environmental cue that synchronizes seasonal variations in neuroendocrine and metabolic function. In this work, we propose a semi-mechanistic mathematical model...
Article
Full-text available
Quantitative Systems Pharmacology (QSP) is receiving increased attention. As the momentum builds and the expectations grow it is important to (re)assess and formalize the basic concepts and approaches. In this short review, I argue that QSP, in addition to enabling the rational integration of data and development of complex models, maybe more impor...
Article
Circadian rhythms play an important role in maintaining homeostasis and solid organ function. The purpose of this study is to assess the implications of burn injury in rats on the underlying circadian patterns of gene expression in liver. Circadian-regulated genes and burn-induced genes were identified by applying consensus clustering methodology t...
Article
The circadian dynamics of important neuroendocrine-immune mediators have been implicated in progression of rheumatoid arthritis pathophysiology both clinically as well as in animal models. We present a mathematical model that describes the circadian interactions between mediators of the HPA axis and the proinflammatory cytokines. Model predictions...
Article
In this short review, we discuss evidence supporting the modulation of peripheral circadian systems as a therapeutic strategy for rheumatoid arthritis (RA). We first review the role of proinflammatory cytokines and oxidative stress, two of the primary mediators of chronic inflammation in RA, and their regulation by circadian clock machinery. We fur...
Article
3,3'-Diindolylmethane (DIM) has been investigated as a potential anti-cancer chemopreventive agent in many preclinical and clinical studies. In this study, we sought to characterize the pharmacokinetics of DIM and to build a pharmacokinetic (PK) and pharmacodynamic (PD) model of the DIM-induced gene expression of phase II drug metabolizing enzymes...
Article
Quantitative systems pharmacology aims at systematizing, in a model-based manner, the integration of systems biology and pharmacology in an effort to rationalize the process of assessing the ability of a drug to enhance well-being by off-setting the effects of a disease. Systems engineering, on the other hand, has enabled us to develop principles a...
Article
Full-text available
We simulate the pathophysiology of severe burn trauma and burn-induced sepsis, using rat models of experimental burn injury and cecal ligation and puncture (CLP) either individually (singe-hit model) or in combination (double-hit model). The experimental burn injury simulates a systemic but sterile pro-inflammatory response, while the CLP simulates...
Article
Full-text available
Introduction: Two recent, independent, studies conducted novel metabolomics analyses relevant to human sepsis progression; one was a human model of endotoxin (lipopolysaccharide (LPS)) challenge (experimental endotoxemia) and the other was community acquired pneumonia and sepsis outcome diagnostic study (CAPSOD). The purpose of the present study wa...
Article
Corticosteroids (CS) such as methylprednisolone (MPL) affect almost all liver functions through multiple mechanisms of action, and long-term use results in dysregulation causing diverse side effects. The complexity of involved molecular mechanisms necessitates a systems approach. Integration of information from the transcriptomic and proteomic resp...
Article
Chemical process systems engineering considers complex supply chains which are coupled networks of dynamically interacting systems. The quest to optimize the supply chain while meeting robustness and flexibility constraints in the face of ever changing environments necessitated the development of theoretical and computational tools for the analysis...
Conference Paper
With our increasing understanding of life’s multi-scale complexity, we suggest that living systems share characteristics common to engineering, and chemical engineering in particular. A chemical plant can be perceived as a complex network of interacting sub-systems, with their dynamics constrained to tight requirements of robustness (to maintain sa...
Article
In this work we explore a semi-mechanistic model that considers cortisol's permissive and suppressive effects through the regulation of cytokine receptors and cytokines respectively. Our model reveals the proactive role of cortisol during the resting period and its reactive character during the body's activity phase. Administration of an acute LPS...
Article
In this work we propose a semi-mechanistic model that describes the photic signal transduction to the HPA axis that ultimately regulates the synchronization of peripheral clock genes (PCGs). Our HPA axis model predicts that photic stimulation induces a type-1 phase response curve (PRC) to cortisol's profile with increased cortisol sensitivity to li...
Article
In this meta-study, we aimed to integrate biological insights gained from two levels of -omics analyses on the response to systemic inflammation induced by LPS in humans. We characterized the interplay between plasma metabolite compositions and transcriptional response of leukocytes through integration of transcriptomics with plasma metabonomics. W...
Article
A novel computational framework that enables reactive flow simulation without using an a priori reaction mechanism is proposed in this work. The proposed computational framework is based on the integration of automated mechanism generation and on-the-fly reduction based on element flux analysis. Stepwise implementation of the integrated framework i...
Book
Full-text available
“Brain Disorders in Critical Illness”, edited by Robert Stevens, Tarek Sharshar and Wes Ely, offers an overview of critical illness brain dysfunction (delirium, coma, encephalopathy), a major problem in intensive care with potentially debilitating long-term consequences. Chapters on epidemiology, outcomes, relevant behavioral neurology and biologic...
Article
Analysis of heart rate variability (HRV) is a promising diagnostic technique due to the noninvasive nature of the measurements involved and established correlations with disease severity, particularly in inflammation-linked disorders. However, the complexities underlying the interpretation of HRV complicate understanding the mechanisms that cause v...
Article
Full-text available
It has been argued that circadian dysregulation is not only a critical inducer and promoter of adverse health effects, exacerbating symptom burden, but also hampers recovery. Therefore understanding the health-promoting roles of regulating (i.e., restoring) circadian rhythms, thus suppressing harmful effects of circadian dysregulation, would likely...
Article
Full-text available
The circadian clock is a critical regulator of biological functions controlling behavioral, physiological and biochemical processes. Because the liver is the primary regulator of metabolites within the mammalian body and the disruption of circadian rhythms in liver is associated with severe illness, circadian regulators would play a strong role in...
Article
Full-text available
Although corticosteroids (CSs) affect gene expression in multiple tissues, the array of genes that are regulated by these catabolic steroids is diverse, highly tissue specific, and depends on their functions in the tissue. Liver has many important functions in performing and regulating diverse metabolic processes. Muscle, in addition to its mechani...
Chapter
2.1 BACKGROUND Circadian rhythms are 24 hour oscillations in many behavioural, physiological, cellular and molecular processes that are controlled by an endogenous clock which is entrained to environmental factors including light, food and stress [1]. These oscillations synchronize biological processes with changes in environmental factors thus all...
Article
Full-text available
Severe traumas are associated with hypercortisolemia due to both disruption of cortisol secretion rhythm and increase in its total concentration. Understanding the effects of altered cortisol levels and rhythms on immune function is of great clinical interest, to prevent conditions such as sepsis from complicating the recovery. This in vivo study a...
Conference Paper
Elective administration of bacterial endotoxin (LPS) to healthy human subjects has been used as a reproducible experimental procedure providing mechanistic insights into how cells, tissues and organs respond to systemic inflammation. Low doses of LPS transiently alter many physiologic and metabolic processes in a qualitatively similar manner to tho...
Conference Paper
The detailed chemical kinetic models are becoming increasingly important in combustion research and development. Kinetic models allow us to study the reaction mechanisms and predict the chemical kinetics of combustion process under complex conditions. In recent years, great progress has been made in developing detailed chemical kinetic models for l...
Article
Endotoxemia induced by the administration of low-dose lipopolysaccharide (LPS) to healthy human volunteers is a well-established experimental protocol and has served as a reproducible platform for investigating the responses to systemic inflammation. Since metabolic composition of a tissue or body fluid is uniquely altered by stimuli and provide in...
Article
Full-text available
There is increasing evidence that the immune system is regulated by circadian rhythms. A wide range of immune parameters, such as the number of red blood cells and peripheral blood mononuclear cells as well as the level of critical immune mediators, such as cytokines, undergo daily fluctuations. Current experimental data indicate that circadian inf...
Article
Full-text available
Engineered systems are coupled networks of interacting sub-systems, whose dynamics are constrained to requirements of robustness and flexibility. They have evolved by design to optimize function in a changing environment and maintain responses within ranges. Analysis, synthesis, and design of complex supply chains aim to identify and explore the la...
Article
The human body can be viewed as a dynamical system, with physiological states such as health and disease broadly representing steady states. From this perspective, and given inter- and intra-individual heterogeneity, an important task is identifying the propensity to transition from one steady state to another, which in practice can occur abruptly....
Article
Over the past several decades, to develop a fundamental understanding of inflammation's progression, research has focused on extracellular mediators, such as cytokines, as characteristic components of inflammatory response. These efforts have recently been complemented by advances in proteomics that allow analysis of multiple signaling proteins in...
Article
The changes that occur in mammalian systems following trauma and sepsis, termed systemic inflammatory response syndrome, elicit major changes in carbohydrate, protein, and energy metabolism. When these events persist for too long they result in a severe depletion of lean body mass, multiple organ dysfunction, and eventually death. Nutritional suppl...
Article
Inflammation is a critical component in the body’s response to injury. A dysregulated inflammatory response, in which either the injury is not repaired or the inflammatory response does not appropriately self-regulate and end, is associated with a wide range of inflammatory diseases such as sepsis. Clinical management of sepsis is a significant pro...
Article
The inflammatory response initiates the healing and recovery from injury. When successful, this leads to the restoration of homeostasis; however, if homeostasis cannot be restored, elevated levels of inflammatory activity may exert a deleterious effect. Given the complexity inherent in the redundant and interacting components of the inflammatory re...
Article
A hybrid kinetic mechanism reduction approach combining global reduction and dynamic reduction methods is proposed in the present work. The approach is based on the dynamic flux-based on-the-fly reduction and the globally applied quasi-steady-state approximation (QSSA). Globally identified quasi-steady-state (QSS) species are separated from the kin...
Article
Previously, we have shown that systemic insults in single injury models produced immunosuppressive effects in burn, and a strong acute phase response in sepsis through hepatic gene expression. In order to investigate the implications of these effects on a combined injury, a double hit model was explored to mimic the progression of clinical burn-sep...
Article
Full-text available
Liver metabolism is altered after systemic injuries such as burns and trauma. These changes have been elucidated in rat models of experimental burn injury where the liver was isolated and perfused ex vivo. Because these studies were performed in fasted animals to deplete glycogen stores, thus simplifying quantification of gluconeogenesis, these obs...
Data
Measured release rates of extracellular metabolites. (DOC)
Data
Calculated internal fluxes based on the assumption that short pathways tend to gain higher weight values. (DOC)
Data
The maximum and minimum values of measured extracellular fluxes used in metabolic model. (DOC)
Article
Full-text available
As cellular variability and circadian rhythmicity play critical roles in immune and inflammatory responses, we present in this study an agent-based model of human endotoxemia to examine the interplay between circadian controls, cellular variability and stochastic dynamics of inflammatory cytokines. The model is qualitatively validated by its abilit...
Data
Model architecture of the programming. There are two general classes (SimpleAgent and SimpleCompartment) which are inherited by other classes in the system. Connecting lines ending with the empty triangle reflect the inheritance between the general class and a specific class while those ending with the solid parallelogram exhibit an aggregation of...
Data
Pseudo-code of the implemented model. (DOC)
Data
System responses under a bolus injection of endotoxin at different times of the day. Each case includes the average system behaviors of inflammatory cytokines and stress hormones from N simulations (N = 100 in this study), the corresponding pattern of variability-based fitness, and the synchronization level of pro- and anti-inflammatory responses f...
Article
Systems biology has primarily focused on studying genomics, transcriptomics, and proteomics and their dynamic interactions. These, however, represent only the potential for a biological outcome since the ultimate phenotype at the level of the eventually produced metabolites is not taken into consideration. The emerging field of metabolomics provide...
Article
Extracting biological insight from high-throughput genomic studies of human diseases remains a major challenge, primarily due to our inability to recognize, evaluate and rationalize the relevant biological processes recorded from vast amounts of data. We will discuss an integrated framework combining fine-grained clustering of temporal gene express...
Article
Full-text available
Dysregulation of the inflammatory response is a critical component of many clinically challenging disorders such as sepsis. Inflammation is a biological process designed to lead to healing and recovery, ultimately restoring homeostasis; however, the failure to fully achieve those beneficial results can leave a patient in a dangerous persistent infl...
Article
Full-text available
The liver has many complex physiological functions, including lipid, protein and carbohydrate metabolism, as well as bile and urea production. It detoxifies toxic substances and medicinal products. It also plays a key role in the onset and maintenance of abnormal metabolic patterns associated with various disease states, such as burns, infections a...

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