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Sharifi S, Bagherniya M, Khoram Z, Ebrahimi Varzaneh A, Atkin SL, Jamialahmadi T, Sahebkar A, Askari G. Efficacy of curcumin plus piperine co-supplementation in moderate-to-high hepatic steatosis: A double-blind, randomized, placebo-controlled clinical trial. Phytother Res 2023. [PMID: 36799355 DOI: 10.1002/ptr.7764] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/29/2022] [Accepted: 01/02/2023] [Indexed: 02/18/2023]
Abstract
Non-alcoholic Fatty Liver Disease (NAFLD) is a global health problem that can progress to steatohepatitis and cirrhosis. The aim of this study was to determine the effect of curcumin + piperine on cardiometabolic risk factors, as well as hepatic steatosis and fibrosis in NAFLD patients with moderate-to-high hepatic steatosis. Patients diagnosed with moderate-to-high NAFLD by liver sonography were randomized to either curcumin + piperine (500 mg/day curcumin plus 5 mg/day piperine) for 12 weeks (n = 30) or placebo groups (n = 30). Liver fibroscan, anthropometric measurements, dietary intake, physical activity, blood pressure, lipid profile, high-sensitivity C-reactive protein, fasting blood glucose (FBG), and liver enzymes were assessed at baseline and after 12 weeks of follow-up. Intention-to-treat analysis was undertaken. Curcumin + piperine decreased waist circumference (p = 0.026), systolic blood pressure (p = 0.001), total cholesterol (p = 0.004), low-density lipoprotein-cholesterol (p = 0.006), FBG (p = 0.002), alanine transaminase (p = 0.007) and aspartate transaminase (p = 0.012) compared with placebo. However, fibroscan measurement did not differ between curcumin + piperine and placebo groups (p > 0.05). Fibroscan measurement as a marker of NAFLD improvement did not differ after 12 weeks of curcumin + piperine; however, curcumin + piperine may be considered as an adjunct therapy to improve anthropometric measures, blood pressure, lipid profile, blood glucose, and liver function in NAFLD patients.
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Affiliation(s)
- Shima Sharifi
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Bagherniya
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.,Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ziba Khoram
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Stephen L Atkin
- School of Postgraduate Studies and Research, RCSI Medical University of Bahrain, Busaiteen, Bahrain
| | - Tannaz Jamialahmadi
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Medicine, The University of Western Australia, Perth, Australia.,Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gholamreza Askari
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.,Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Flower B, McCabe L, Le Ngoc C, Le Manh H, Le Thanh P, Dang Trong T, Vo Thi T, Vu Thi Kim H, Nguyen Tat T, Phan Thi Hong D, Nguyen Thi Chau A, Dinh Thi T, Tran Thi Tuyet N, Tarning J, Kingsley C, Kestelyn E, Pett SL, Thwaites G, Nguyen Van VC, Smith D, Barnes E, Ansari MA, Turner H, Rahman M, Walker AS, Day J, Cooke GS. High Cure Rates for Hepatitis C Virus Genotype 6 in Advanced Liver Fibrosis With 12 Weeks Sofosbuvir and Daclatasvir: The Vietnam SEARCH Study. Open Forum Infect Dis 2021; 8:ofab267. [PMID: 34337093 PMCID: PMC8320300 DOI: 10.1093/ofid/ofab267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/16/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Genotype 6 is the most genetically diverse lineage of hepatitis C virus, and it predominates in Vietnam. It can be treated with sofosbuvir with daclatasvir (SOF/DCV), the least expensive treatment combination globally. In regional guidelines, longer treatment durations of SOF/DCV (24 weeks) are recommended for cirrhotic individuals, compared with other pangenotypic regimens (12 weeks), based on sparse data. Early on-treatment virological response may offer means of reducing length and cost of therapy in patients with liver fibrosis. METHODS In this prospective trial in Vietnam, genotype 6-infected adults with advanced liver fibrosis or compensated cirrhosis were treated with SOF/DCV. Day 14 viral load was used to guide duration of therapy: participants with viral load <500 IU/mL at day 14 were treated with 12 weeks of SOF/DCV and those ≥500 IU/mL received 24 weeks. Primary endpoint was sustained virological response (SVR). RESULTS Of 41 individuals with advanced fibrosis or compensated cirrhosis who commenced treatment, 51% had genotype 6a and 34% had 6e. The remainder had 6h, 6k, 6l, or 6o. One hundred percent had viral load <500 IU/mL by day 14, meaning that all received 12 weeks of SOF/DCV. One hundred percent achieved SVR12 despite a high frequency of putative NS5A inhibitor resistance-associated substitutions at baseline. CONCLUSIONS Prescribing 12 weeks of SOF/DCV results in excellent cure rates in this population. These data support the removal of costly genotyping in countries where genotype 3 prevalence is <5%, in keeping with World Health Organization guidelines. NS5A resistance-associated mutations in isolation do not affect efficacy of SOF/DCV therapy. Wider evaluation of response-guided therapy is warranted.
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Affiliation(s)
- Barnaby Flower
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
- Department of Infectious Disease, Imperial College London, United Kingdom
| | - Leanne McCabe
- MRC Clinical Trials Unit at UCL, University College London, United Kingdom
| | - Chau Le Ngoc
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Hung Le Manh
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | | | - Thu Vo Thi
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Hang Vu Thi Kim
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Thanh Nguyen Tat
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Dao Phan Thi Hong
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - An Nguyen Thi Chau
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Tan Dinh Thi
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Nga Tran Thi Tuyet
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Joel Tarning
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
| | - Cherry Kingsley
- Department of Infectious Disease, Imperial College London, United Kingdom
| | - Evelyne Kestelyn
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Sarah L Pett
- MRC Clinical Trials Unit at UCL, University College London, United Kingdom
| | - Guy Thwaites
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | | | | | | | | | - Hugo Turner
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, United Kingdom
| | - Motiur Rahman
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Ann Sarah Walker
- Department of Infectious Disease, Imperial College London, United Kingdom
| | - Jeremy Day
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Graham S Cooke
- Department of Infectious Disease, Imperial College London, United Kingdom
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Wang Y, Jiang J. A two-dimensional (2D) systems biology-based discrete liver tissue model: A simulation study with implications for ultrasound elastography of liver fibrosis. Comput Biol Med 2018; 104:227-234. [PMID: 30529712 DOI: 10.1016/j.compbiomed.2018.11.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/30/2018] [Accepted: 11/30/2018] [Indexed: 12/18/2022]
Abstract
Continuum tissue models that were often used to simulate or analyze the mechanical properties of tissues being imaged may not be biologically realistic. Our primary objective was to establish the feasibility of using systems biology to construct biologically relevant tissue models linking tissue structure, composition and architecture to the ultrasound measurements directly. The first application was designated to model fibrotic liver tissues. The proposed liver tissue model leveraged established histopathology knowledge of fibrotic liver tissues. Particularly, rules of systems biology derived from molecular histopathology were first implemented into an agent-based software platform SPARK to reflect progressions of liver fibrosis with/without steatosis. Then, microscopic compositions of tissues (e.g. cellular components) were converted to computing grids (at the 50-100 μm scale) for wave simulations using an open-source K-Wave. To verify the physical soundness of the proposed model, virtual wave speed measurements (i.e. shear wave speed [SWS] and the speed of sound [SOS]) were performed. Our initial results demonstrated that the simulated SWS values increased with the progression of liver fibrosis (from 1.5 m/s [Fibrosis stage 1] to 4 m/s [Fibrosis stage 4]). Similarly, the simulated SOS values were within the range of clinical data (from 1575 m/s [Fibrosis stage 0-3] to 1594 m/s [Fibrosis stage 4]). In summary, we found that those systems biology simulated fibrotic liver tissues with and without steatosis can reflect spatial characteristics of relevant histology. Also, their mechanical characteristics (i.e. shear/compressional wave speed) were in good agreement with data reported in the clinical literature.
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Affiliation(s)
- Yu Wang
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI, 49931, USA
| | - Jingfeng Jiang
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI, 49931, USA; Department of Mechanical Engineering and Engineering Mechanics, Michigan Technological University, Houghton, MI, 49931, USA.
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Omran D, Zayed RA, Nabeel MM, Mobarak L, Zakaria Z, Farid A, Hassany M, Saif S, Mostafa M, Saad OK, Yosry A. Evaluating Diagnostic Accuracy of Noninvasive Tests in Assessment of Significant Liver Fibrosis in Chronic Hepatitis C Egyptian Patients. Viral Immunol 2018; 31:315-320. [PMID: 29630460 DOI: 10.1089/vim.2017.0134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Stage of liver fibrosis is critical for treatment decision and prediction of outcomes in chronic hepatitis C (CHC) patients. We evaluated the diagnostic accuracy of transient elastography (TE)-FibroScan and noninvasive serum markers tests in the assessment of liver fibrosis in CHC patients, in reference to liver biopsy. One-hundred treatment-naive CHC patients were subjected to liver biopsy, TE-FibroScan, and eight serum biomarkers tests; AST/ALT ratio (AAR), AST to platelet ratio index (APRI), age-platelet index (AP index), fibrosis quotient (FibroQ), fibrosis 4 index (FIB-4), cirrhosis discriminant score (CDS), King score, and Goteborg University Cirrhosis Index (GUCI). Receiver operating characteristic curves were constructed to compare the diagnostic accuracy of these noninvasive methods in predicting significant fibrosis in CHC patients. TE-FibroScan predicted significant fibrosis at cutoff value 8.5 kPa with area under the receiver operating characteristic (AUROC) 0.90, sensitivity 83%, specificity 91.5%, positive predictive value (PPV) 91.2%, and negative predictive value (NPV) 84.4%. Serum biomarkers tests showed that AP index and FibroQ had the highest diagnostic accuracy in predicting significant liver fibrosis at cutoff 4.5 and 2.7, AUROC was 0.8 and 0.8 with sensitivity 73.6% and 73.6%, specificity 70.2% and 68.1%, PPV 71.1% and 69.8%, and NPV 72.9% and 72.3%, respectively. Combined AP index and FibroQ had AUROC 0.83 with sensitivity 73.6%, specificity 80.9%, PPV 79.6%, and NPV 75.7% for predicting significant liver fibrosis. APRI, FIB-4, CDS, King score, and GUCI had intermediate accuracy in predicting significant liver fibrosis with AUROC 0.68, 0.78, 0.74, 0.74, and 0.67, respectively, while AAR had low accuracy in predicting significant liver fibrosis. TE-FibroScan is the most accurate noninvasive alternative to liver biopsy. AP index and FibroQ, either as individual tests or combined, have good accuracy in predicting significant liver fibrosis, and are better combined for higher specificity.
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Affiliation(s)
- Dalia Omran
- 1 Department of Endemic Medicine and Hepato-Gastroenterology, Faculty of Medicine, Cairo University , Cairo, Egypt
| | - Rania A Zayed
- 2 Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University , Cairo, Egypt
| | - Mohammed M Nabeel
- 1 Department of Endemic Medicine and Hepato-Gastroenterology, Faculty of Medicine, Cairo University , Cairo, Egypt
| | - Lamiaa Mobarak
- 3 Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute , Cairo, Egypt
| | - Zeinab Zakaria
- 1 Department of Endemic Medicine and Hepato-Gastroenterology, Faculty of Medicine, Cairo University , Cairo, Egypt
| | - Azza Farid
- 3 Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute , Cairo, Egypt
| | - Mohamed Hassany
- 3 Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute , Cairo, Egypt
| | - Sameh Saif
- 3 Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute , Cairo, Egypt
| | - Muhammad Mostafa
- 4 Endemic Medicine Department, Ahmed Maher Hospital , Cairo, Egypt
| | | | - Ayman Yosry
- 1 Department of Endemic Medicine and Hepato-Gastroenterology, Faculty of Medicine, Cairo University , Cairo, Egypt
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