Progressive liver functional impairment is associated with an increase in AST/ALT ratio

Baicalin ameliorates insulin resistance and regulates hepatic glucose metabolism via activating insulin signaling pathway in obese pre-diabetic mice

BACKGROUND

Diabetes belongs to the most prevalent metabolic diseases worldwide, which is featured with insulin resistance, closely associated with obesity and urgently needs to be treated. Baicalin, belonging to natural flavonoids, has been reported to inhibit oxidative stress or inflammatoin.

PURPOSE

This study investigated the properties of baicalin on modulating abnormal glucolipid metabolism, as well as the underlying in-vitro and in-vivo mechanisms.

METHODS

Insulin-resistant (IR)-HepG2 cells were stimulated by dexamethasone (20 µM) and high glucose (50 mM) for 48 h and incubated with or without baicalin or metformin for another 16 h. Male C57BL/6 J mice were fed with a high-fat diet (HFD, 60 % kcal% fat) during the total 14 weeks. Obese mice were then administered with baicalin (50 and 100 mg/kg) or vehicle solution everyday through oral gavage during the last 4-week period. Moreover, baicalin metabolisms in vitro and in vivo were determined using UPLC/MS/MS to study its metabolism situation.

RESULTS

Exposure to dexamethasone and high glucose damaged the abilities of glycogen synthesis and glucose uptake with elevated oxidative stress and increased generation levels of advanced glycation end-products (AGEs) in HepG2 cells. These impairments were basically reversed by baicalin treatment. Four-week oral administration with baicalin ameliorated hyperglycemia and dyslipidemia in HFD-induced obese and pre-diabetic mice. Downregulation of IRS/PI3K/Akt signaling pathway accomplished with reduced GLUT4 expression and enhanced GSK-3β activity was observed in insulin resistant HepG2 cells as well as liver tissues from pre-diabetic mice; and such effect was prevented by baicalin. Moreover, baicalin and its matabolites were detected in IR-HepG2 cells and mouse plasma.

CONCLUSION

The study illustrated that baicalin alleviated insulin resistance by activating insulin signaling pathways and inhibiting oxidative stress and AGEs production, revealing the potential of baicalin to be a therapeutic natural flavonoid against hepatic insulin and glucose-lipid metabolic disturbance in pre-diabetes accompanied with obesity.

The aspartate aminotransferase to alanine aminotransferase ratio: A novel indicator for skeletal muscle mass in Chinese community adults

OBJECTIVES

The aspartate aminotransferase to alanine aminotransferase (AST/ALT) ratio, an indicator for liver fibrosis, could be easily detected in clinical practice. The aim of this study was to examine the association between the AST/ALT ratio and skeletal muscle mass among Chinese community adult residents.

METHODS

We enrolled 2644 participants, age ≥18 y, undergoing bioelectrical impedance analysis and liver function test. Univariate and multivariate logistic regression models were used to analyze the effect of the AST/ALT ratio on the presence of low muscle mass (LMM). Multiple linear regression analysis was used to assess the factors associated with the skeletal muscle mass index (SMI) and to construct a formula to calculate the SMI.

RESULTS

When the AST/ALT ratio was regarded as a categorical variable, AST/ALT quartiles 9-2.19) kept independent effects on the presence of LMM status. When it was regarded as a continuous variable, each unit of the AST/ALT ratio was significantly associated with a 49% (P < 0.01) augment of the prevalence of LMM. By multiple general linear regression analysis, the formula was constructed with an adjusted R2 of 0.72: SMI (kg/m2) = -0.14 AST/ALT ratio + 1.35 sex (male: 1; female: 0) + 0.72 overweight status (yes: 1; no: 0) - 0.14 age (≤65: 0; >65: 1) + 6.26.

CONCLUSION

In general, the high AST/ALT ratio was an independent adverse indicator of the presence of LMM.

Hepatoprotective effect of syringin combined with costunolide against LPS-induced acute liver injury in L-02 cells via Rac1/AKT/NF-κB signaling pathway

Acute liver injury (ALI) leads to abnormal liver function and damage to liver cells. Syringin (syr) and costunolide (cos) are the major extracts from Dolomiaea souliei (Franch.) C.Shih (D. souliei), showing diverse biological functions in various biological processes. We explored the underlying hepatoprotective effects of syr+cos against LPS-induced ALI. Cell viability and proliferation were assessed using an MTT assay and immunofluorescence staining. Flow cytometry analysis was used to detect cell cycle distribution and apoptosis. ELISA was utilized to measure liver function and antioxidant stress indexes. qRT-PCR and western blotting was performed to determine mRNA and protein levels respectively. Using shRNA approach to Rac1 analyzed transcriptional targets. The results showed that syr+cos promoted L-02 cell proliferation, inhibiting the cell apoptosis and blocking cell cycle in G1 and G2/M phase. Syr+cos decreased the production of ALT, AST, LDH, MDA and ROS while increased SOD and CAT activities. Pretreated with syr+cos may decrease expressions of caspase-3,7,9, NF-κB, TNF-α proteins, Cyclin B, CDK1 and p-IκB proteins while p-IκB increased. Silencing of Rac-1 may protect the liver by increasing AKT, S473, T308 and reducing p-AKT proteins. Syr+cos exhibits anti-ALI activity via Rac1/AKT/NF-κB signaling pathway which might act as an effective candidate drug for the treatment of ALI.

The protective effects of sesamol and/or the probiotic, Lactobacillus rhamnosus, against aluminum chloride-induced neurotoxicity and hepatotoxicity in rats: Modulation of Wnt/β-catenin/GSK-3β, JAK-2/STAT-3, PPAR-γ, inflammatory, and apoptotic pathways

Introduction: Aluminium (Al) is accumulated in the brain causing neurotoxicity and neurodegenerative disease like Alzheimer's disease (AD), multiple sclerosis, autism and epilepsy. Hence, attenuation of Al-induced neurotoxicity has become a "hot topic" in looking for an intervention that slow down the progression of neurodegenerative diseases. Objective: Our study aims to introduce a new strategy for hampering aluminum chloride (AlCl3)-induced neurotoxicity using a combination of sesamol with the probiotic bacteria; Lactobacillus rhamnosus (L. rhamnosus) and also to test their possible ameliorative effects on AlCl3-induced hepatotoxicity. Methods: Sprague-Dawley male rats were randomly divided into five groups (n = 10/group) which are control, AlCl3, AlCl3 + Sesamol, AlCl3 + L. rhamnosus and AlCl3 + Sesamol + L. rhamnosus. We surveilled the behavioral, biochemical, and histopathological alterations centrally in the brain and peripherally in liver. Results: This work revealed that the combined therapy of sesamol and L. rhamnosus produced marked reduction in brain amyloid-β, p-tau, GSK-3β, inflammatory and apoptotic biomarkers, along with marked elevation in brain free β-catenin and Wnt3a, compared to AlCl3-intoxicated rats. Also, the combined therapy exerted pronounced reduction in hepatic expressions of JAK-2/STAT-3, inflammatory (TNF-α, IL-6, NF-κB), fibrotic (MMP-2, TIMP-1, α-SMA) and apoptotic markers, (caspase-3), together with marked elevation in hepatic PPAR-γ expression, compared to AlCl3 -intoxicated rats. Behavioral and histopathological assessments substantiated the efficiency of this combined regimen in halting the effect of neurotoxicity. Discussion: Probiotics can be used as an add-on therapy with sesamol ameliorate AlCl3 -mediated neurotoxicity and hepatotoxicity.

Interleukin-19 Gene-Deficient Mice Promote Liver Fibrosis via Enhanced TGF-β Signaling, and the Interleukin-19-CCL2 Axis Is Important in the Direction of Liver Fibrosis

IL-19 is a cytokine discovered by homologous searching with IL-10 and is produced by non-immune cells, such as keratinocytes, in addition to immune cells, such as macrophages. Liver fibrosis results from the inflammation and activation of hepatic stellate cells via chronic liver injury. However, the participation of IL-19 in liver fibrosis remains to be sufficiently elucidated. Our group studied the immunological function of IL-19 in a mouse model of carbon tetrachloride (CCl₄)-induced liver fibrosis. IL-19 gene-deficient (KO) mice and body weight-matched wild-type (WT) mice were used. A liver fibrosis mouse model was created via CCl₄ administration (two times per week) for 8 weeks. In CCl₄-induced liver fibrosis, serum analysis revealed that IL-19 KO mice had higher ALT levels compared to WT mice. IL-19 KO mice had worse fibrosis, as assessed by morphological evaluation of total area stained positive with Azan and Masson trichrome. In addition, the expression of α-SMA was increased in liver tissues of IL-19 KO mice compared to WT mice. Furthermore, mRNA expression levels of TGF-β and α-SMA were enhanced in IL-19 KO mice compared to WT mice. In vitro assays revealed that IL-19-high expressing RAW264.7 cells inhibited the migration of NIH3T3 cells via the inhibited expression of CCL2 in the presence of CCl₄ and IL-4. These findings indicate that IL-19 plays a critical role in liver fibrosis by affecting TGF-β signaling and the migration of hepatic stellate cells during liver injury. Enhancement of the IL-19 signaling pathway is a potential treatment for liver fibrosis.

A study on the use of sorrel seed flour (Hibiscus sabdariffa) for improving functionality of wheat flour bread

Bread presents one of the easiest opportunities as a food vehicle for delivery of nutritional and health-promoting benefits to large segments of the world population. However, its low nutritional status due to lack of balance of essential amino acids and inadequate macro- and micronutrients has necessitated recent interest in the development of high-protein hybrid breads (HPHB). Sorrel seed, an underutilized, neglected protein-rich seed holds promising nutritional and antioxidant potentials as source of good quality protein, dietary fibre and bioactive compounds. Furthermore, germination of plant seeds increases the bioavailability of these nutritional and bioactive compounds. Hence, this study has investigated the influence of germination time on nutritional, and functional properties of sorrel seed flour. Further, the amino acid profile, dietary fibre and rheological functionality of wheat-germinated defatted sorrel seed bread were assessed. The sorrel seed was germinated for 24-48 h and defatted. Thereafter, the germinated defatted sorrel seed flours were used to partially replace wheat flour using a linear replacement (w/w) of 95-80% wheat (W) and 5-20% germinated defatted sorrel seed (GS) flours to obtain W95:GS5; W90:GS10, W85:GS15 and W80:GS20. These composite flours and 100% wheat flour (control) were used to produce breads using standard recipe and methods. Results showed significant increase (P < 0.05) in crude protein, dietary fibre and mineral contents after 24 and 48 h germination of sorrel seed. While 24 h germination significantly (P < 0.05) increased WAC from 93.75% to 103.13%, further germination (48 h) caused a reduction of 26.67% (from 93.75 to 68.75%). In vitro protein digestibility of wheat flour decreased significantly (P < 0.05) as supplementation of germinated defatted sorrel seed flour increased. Supplementation of wheat flour with germinated defatted sorrel seed flour in bread production resulted in 51.84-121.42% significant (p < 0.05) increase in the protein content of wheat bread. Similarly, total essential amino acids, dietary fibre, mineral, and ash contents followed the same increasing trend. The in-vivo biological value which ranged from 82.10 to 89.40% was significantly higher (p < 0.05) than 58.30% obtained for the control (100% wheat bread) Thus, inclusion of germinated defatted sorrel seed flour in bread production may serve as a low-cost nutritional supplement for enhancing the nutritional profile and functional benefits of wheat bread.

Lactobacillus plantarum-Derived Postbiotics Ameliorate Acute Alcohol-Induced Liver Injury by Protecting Cells from Oxidative Damage, Improving Lipid Metabolism, and Regulating Intestinal Microbiota

Here, the aim was to evaluate the protective effect of Lactobacillus plantarum-derived postbiotics, i.e., LP-cs, on acute alcoholic liver injury (ALI). After preincubation with LP-cs, HL7702 human hepatocytes were treated with alcohol, and then the cell survival rate was measured. C57BL/6 male mice were presupplemented with or without LP-cs and LP-cs-loaded calcium alginate hydrogel (LP-cs-Gel) for 3 weeks and given 50% alcohol gavage to establish the mouse model of ALI, LP-cs presupplementation, and LP-cs-Gel presupplementation. The histomorphology of the liver and intestines; the levels of serum AST, ALT, lipid, and SOD activity; liver transcriptomics; and the metagenome of intestinal microbiota were detected in all mouse models. In vitro, LP-cs significantly increased the survival rate of alcohol-treated cells. In vivo, presupplementation with LP-cs and LP-cs-Gel restored the levels of serum AST, ALT, and SOD activity, as well as TC and TG, after acute alcohol intake. In the LP-cs-presupplemented mice, the genes involved in fatty acid metabolic processes were upregulated and the genes involved in steroid biosynthesis were downregulated significantly as compared with the ALI mice. LP-cs significantly increased the abundance of intestinal microbiota, especially Akkermansia muciniphila. In conclusion, LP-cs ameliorates ALI by protecting hepatocytes against oxidative damage, thereby, improving lipid metabolism and regulating the intestinal microbiota. The effect of LP-cs-Gel is similar to that of LP-cs.

Gut microbiota and growth performance of offspring are influenced by wet nurse in pigs using cross-fostering trial

BACKGROUND

Nursing mom can regulate the gut microbiome succession in offspring. However, it remains unclear whether these effects are long-term and what effect it has on the growth performance of piglets. This study aimed to develop a cross-fostering model of piglets and investigate the effect of maternal environment on gut microbiota, even the growth performance of the offspring, and if this effect could be maintained in the long term.

RESULTS

Four groups of piglets were generated as follows (n = 12): Duroc piglets nursed by their birth mom (Dd) or Yorkshire sows (Yd), Yorkshire piglets nursed by Duroc sows (Dy) or their birth mom (Yy). The study found that cross-fostering improved the growth performance of piglets for a long time. The gut microbiota of piglets was mainly determined by the breeds of nursing moms before weaning, and it was more and more influenced by their breeds after weaning, but the influence of birth mom breeds still existed. The linear discriminant analysis (LDA) effect size (LEfSe) analysis and Spearman correlation analysis showed that Sutterella, Butyricimonas and Alistipes, which were affected by nursing mom before weaning, had a strong positive correlation with the growth performance of piglets before weaning. Candidatus_Soleaferrea and Treponema, which were affected by both nursing mom and piglet breed after weaning, were significantly negatively correlated with the growth performance of piglets long after weaning.

CONCLUSION

Our results revealed that both the breeds of piglets and their birth moms influence the gut microbiota of piglets for a long time, even after weaning. Additionally, this effect might be related to the growth performance of piglets. © 2022 Society of Chemical Industry.

Drinking Water Sources along the Banks of Buriganga River of Bangladesh are Polluted and Possess Serious Health Risks: A Comprehensive In Vivo Analysis

Background

The river Buriganga, one of the major dumping zones of industrial wastes in Bangladesh, is responsible for contaminating the drinking water sources along its length. This study aimed to assess the water quality from these sources by monitoring the changes in hematological, biochemical, and histological parameters caused in healthy rats due to their consumption.

Methods

Using ethylenediaminetetraacetic acid (EDTA) as an anticoagulant agent, hematological and biochemical analyses of Sprague-Dawley rat models were executed in this study. Following blood sampling, the rats were sacrificed, and the heart, lungs, kidneys, liver, and spleen were separated to carry out the histological analysis. Later, to perform the statistical analysis, SPSS, V.25.0 was utilized.

Results

A significant rise (p < 0.02) in body weight was recorded due to increased protein synthesis, inflammations; increased lymphocyte, white blood cell (WBC), and neutrophil count but hemoglobin (20.0 ± 1.39 g/dL vs. 15.25 ± 0.36 g/dL; p) and red blood cell (RBC) count ((6.24 ± 0.45) × 106/µL vs. (5.47 ± 0.34) × 106/µL)) decreased due to infections and hematopoietic stem cell poisoning by pathogens in water samples. Elevated (p < 0.01) serum urea, creatinine, alanine, and aspartate aminotransferase levels indicated kidney malfunction and hepatic tissue necrosis. Histological analysis revealed gross lesions, internal hemorrhages in the brain; inflammations, granulomas, migrating macrophages in the spleen; fibrosis (resulting in hypo-perfusion), and collagen formation in cardiac muscles.

Conclusions

The findings in this study provide comprehensive evidence, based on in vivo analysis, that the water bodies around the Buriganga river are likely to be contaminated with toxic chemicals and microbial entities making them unfit for human consumption.

A novel prognostic nomogram for older patients with acute-on-chronic liver diseases (AoCLD): a nationwide, multicentre, prospective cohort study

BACKGROUND

the incidence of acute-on-chronic liver disease (AoCLD) is increasing.

OBJECTIVE

to investigate the clinical features and risk factors of AoCLD and construct an effective prognostic nomogram model for older patients with AoCLD.

METHODS

data from 3,970 patients included in the CATCH-LIFE study were used, including 2,600 and 1,370 patients in the training and validation sets, respectively. Multivariate Cox regression analyses were performed to identify predictive risk factors in older individuals, and an easy-to-use nomogram was established. Performance was assessed using area under the curve, calibration plots and decision curve analysis (DCA).

RESULTS

of the 3,949 patients with AoCLD, 809 were older with a higher proportion of autoimmune-related abnormalities, hepatitis C viral infection and schistosomiasis. In the older patient group, the incidence of cirrhosis, hepatic encephalopathy (HE), infection, ascites and gastrointestinal bleeding; neutrophil-to-lymphocyte ratio (NLR), aspartate-to-alanine transaminase ratio (AST/ALT), creatinine and blood urea nitrogen levels were higher, whereas incidence of acute-on-chronic liver failure, white blood cell, platelet and haemoglobin levels; albumin, total bilirubin (TB), AST and ALT levels; international normalised ratio (INR), estimated glomerular filtration rate and blood potassium levels were lower than in the younger group. The final nomogram was developed based on the multivariate Cox analysis in training cohort using six risk factors: ascites, HE grades, NLR, TB, INR and AST/ALT. Liver transplantation-free mortality predictions were comparable between the training and validation sets. DCA showed higher net benefit for the nomograph than the treat-all or treat-none strategies, with wider threshold probabilities ranges.

CONCLUSIONS

our analysis will assist clinical predictions and prognoses in older patients with AoCLD.

De Ritis ratio and long-term major cardiovascular adverse events in patients undergoing elective percutaneous coronary intervention

BACKGROUND

The association of aspartate aminotransferase to alanine aminotransferase ratio (De Ritis ratio) with clinical outcomes in patients with chronic coronary syndromes (CCS) remains unclear. This study aims to assess the association of De Ritis ratio with adverse cardiovascular events in patients with CCS.

MATERIALS AND METHODS

The study included 5020 patients with CCS undergoing percutaneous coronary intervention. Patients were categorized into groups according to tertiles of the De Ritis ratio: tertile 1 (De Ritis ratio: <.75; n = 1688 patients), tertile 2 (De Ritis ratio: .75-1.08; n = 1666 patients) and tertile 3 (De Ritis ratio: >1.08; n = 1666 patients). The primary endpoint was 3-year mortality.

RESULTS

At 3 years, there were 384 deaths, 176 myocardial infarctions and 61 strokes. In groups with De Ritis in the 1st, 2nd and 3rd tertiles, deaths occurred in 5.0%, 7.5% and 14.5% of the patients, respectively (adjusted hazard ratio = 1.09, 95% confidence interval [1.06-1.12], p < .001); myocardial infarctions occurred in 2.6%, 3.5% and 5.1% of the patients, respectively (p < .001); strokes occurred in 1.0%, 1.2% and 1.9% of the patients, respectively (p = .030); bleeding at 30 days (n = 112) occurred in 1.4%, 1.6% and 3.7% of the patients, respectively (p < .001). The C-statistic of the Cox proportional hazards model for all-cause mortality with baseline data without the De Ritis ratio was .815 [.794-.836] and .818 [.797-.838] after the inclusion of the De Ritis ratio (delta C-statistic = .003; p = .005).

CONCLUSIONS

In patients with CCS undergoing percutaneous coronary intervention, an elevated De Ritis ratio was associated with long-term major adverse cardiovascular events.

Oxidized corn oil changes the liver lipid metabolism of broilers by upregulating peroxisome proliferators activate receptor-α

The objective of the following study was to investigate the effects of naturally oxidized corn oil on the antioxidant capacity and lipid metabolism of broilers. A total of 450, 1-day-old Arbor Acres male broilers were randomly divided into 5 treatments with 6 replicate cages and 15 birds/cage. The dietary treatment array consisted of ratios of naturally oxidized corn oil to non-oxidized corn oil from 0:100, 25:75, 50:50, 75:25, and 100:0, respectively. Serum, liver, and abdominal fat samples were taken at 42 d. The results showed that the liver organ index, liver catalase (CAT) activity, malondialdehyde (MDA) content, and the serum aspartate aminotransferase (AST) content had significant quadratic relationships with the ratio of naturally oxidized corn oil (P < 0.05). Inflammatory infiltrating cells appeared in the liver of the 50% and 75% oxidized corn oil group. The percentage of abdominal fat, and serum free fatty acids (FFA) content increased linearly with the increased proportion of oxidized corn oil (P < 0.05). The mRNA expression of NADH quinone oxidoreductase 1 (NQO-1), nuclear factor kappa B (NF-κB), toll-like receptor-4 (TLR-4), peroxisome proliferators activate receptor-α (PPARα), carnitine acyltransferase (CPT1), and acyl-coenzyme oxidase (ACO) of the liver increased linearly while oxidized corn oil increased in the diet (P < 0.05). Diets containing 100% oxidized corn oil significantly changed the mRNA expression of liver Caveolin compared with other treatment groups (P < 0.05). Taken together, this study demonstrated that naturally oxidized corn oil could change liver lipid metabolism and accelerate lipid deposition of broilers by upregulating PPARα.

The changes of hepatic bile acid synthesis and transport and bile acids profiles in isopsoralen-induced liver injury C57BL/6J mice

CONTEST

Isopsoralen, one of the main active and quality-control compounds in Psoralea corylifolia L. (Fabaceae), has antitumor and oestrogen-like effects. Previous studies demonstrated that isopsoralen induced hepatotoxicity and its long-term exposure led to cholestatic liver injury.

OBJECTIVE

This study investigates the effect of three- or seven-day exposure of low dose isopsoralen (80 mg/kg) on bile acid homeostasis in C57BL/6J mice.

MATERIALS AND METHODS

Forty-two C57BL/6J mice were randomly divided into control, three- and seven-day groups (n = 14 per group, half female and half male). Isopsoralen suspension was administrated intragastrically at 80 mg/kg once a day. Blood and liver samples were collected to measure biochemical indices and transport of BAs. The histopathology of the liver was also observed. HPLC-MS/MS was also used to measure the BAs profiles and transport activity.

RESULTS

In the study, isopsoralen increased the levels of serum AST, ALT in three- and seven-day groups, and caused vacuolar degeneration and swelling in the liver. Canalicular efflux transporters BSEP, OSTα, MRP2, MRP3, and basolateral uptake transporters NTCP, OATP4 were inhibited after seven-day-administration. Moreover, amino acid binding enzymes (BAAT and BACS) were also inhibited after seven-day-administration. The composition of BAs changed greatly and the concentration of some unconjugated-BAs which have stronger hydrophobicity, such as CA, CDCA, was significantly increased.

CONCLUSIONS

Isopsoralen (80 mg/kg) caused hepatotoxicity after short-term exposure by inhibiting the expression of efflux transporters, amino acid binding enzymes, and disrupting BAs spectrum.

Nutritional quality, functional property and acceptability of maize (Zea mays) based complementary foods enriched with defatted groundnut (Arachis hypogea L.) and ginger (Zinger officinale Roscoe) powder in Wistar rats

Traditional complementary foods in Africa are cereal-based, low in nutrient-density; hence, causing severe-acute-malnutrition. This study was aimed to formulate and evaluate nutritional quality of complementary foods (CF) using locally available food materials. Yellow maize (raw, germinated & fermented), defatted groundnut (DGF) and ginger flour (GGF) were blended to obtain RDG (76.7% raw yellow maize, 20.8% DGF and 2.5% GGF), GDG (74.4% germinated yellow maize, 23.1% DGF, 2.5% GGF), and FDG (72.6% fermented yellow maize, 24.9% DGF, 2.5% GGF). Food samples were evaluated for nutritional qualities and sensory attributes using standard methods. Protein (g/100 g), energy value (kCal/100 g), total amino acids and essential amino acids (g/100 g protein) of formulated CF ranged from 19.38 to 28.58, 373.49 to 394.53, 87.33 to 91.89 and 36.17 to 37.63, respectively, and were comparable to control (17.07, 401.22, 94.47 & 35.35). Minerals were present in appreciable amount in the foods, while phytate/mineral (Ca, Fe, Zn) and oxalate/calcium molar ratios were lower than critical levels. Bulk density (1.4 - 1.6 g/mL), least gelation (4 - 6%), water absorption capacity (10.5 - 15.8%) and swelling capacity (0.5 - 1.2%) were significantly (p < 0.05) lower in formulated CF than in control, except for bulk density. Biological value (78.44%) of FDG was significantly (P < 0.05) higher than GDG (78.4%) and RDG (75.87%), respectively, but lower than control (93.48%). Pack cell volume (22.50%), haemoglobin concentration (7.5 g/dL), red blood cell (3 ×  103 mm− 3), albumin (3.72 g/dL), total blood protein (5.62 g/dL) and globulin (1.9 g/dL) of rats fed on FDG were significantly (p < 0.05) higher than other diets, but comparable to that of control. Kidney (urea, 10.16 mg/dL; creatinine, 4.8 mg/dL) and liver function index (AST/ALT ratio, 0.38) of rats fed on FDG were lower than in those rats fed on RDG, GDG and control. For sensorial attributes, RDG was ranked best next by FDG in appearance, aroma, texture, taste and overall acceptability, but were significantly (p < 0.05) rated lower than control. Finally, the study established that FDG (72.6% fermented yellow maize, 24.9% defatted groundnut and 2.5% ginger) was the best in nutritional quality and growth performance in rats; hence, this CF may be suitable to mitigate expensive commercial infant formula in alleviating severe-acute-malnutrition in children.

Graphical abstract

Biodegradable gemcitabine-loaded microdevice with sustained local drug delivery and improved tumor recurrence inhibition abilities for postoperative pancreatic tumor treatment

At present, the 10-year survival rate of patients with pancreatic cancer is still less than 4%, mainly due to the high cancer recurrence rate caused by incomplete surgery and lack of effective postoperative adjuvant treatment. Systemic chemotherapy remains the only choice for patients after surgery; however, it is accompanied by off-target effects and server systemic toxicity. Herein, we proposed a biodegradable microdevice for local sustained drug delivery and postoperative pancreatic cancer treatment as an alternative and safe option. Biodegradable poly(l-lactic-co-glycolic acid) (P(L)LGA) was developed as the matrix material, gemcitabine hydrochloride (GEM·HCl) was chosen as the therapeutic drug and polyethylene glycol (PEG) was employed as the drug release-controlled regulator. Through adjusting the amount and molecular weight of PEG, the controllable degradation of matrix and the sustained release of GEM·HCl were obtained, thus overcoming the unstable drug release properties of traditional microdevices. The drug release mechanism of microdevice and the regulating action of PEG were studied in detail. More importantly, in the treatment of the postoperative recurrence model of subcutaneous pancreatic tumor in mice, the microdevice showed effective inhibition of postoperative in situ recurrences of pancreatic tumors with excellent biosafety and minimum systemic toxicity. The microdevice developed in this study provides an option for postoperative adjuvant pancreatic treatment, and greatly broadens the application prospects of traditional chemotherapy drugs.

Liver Enzymes in a Cohort of Community-Dwelling Older Persons: Focus on Sex Contribution

Dysfunctions in liver metabolic activities may increase the risk of cognitive impairment and dementia. In a cohort of community-dwelling older persons investigated for a suspected cognitive decline, we studied the association between liver status and dementia, considering sex and frailty contribution. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations, and the AST/ALT ratio were used to assess liver function in 419 older adults (248 persons with dementia and 171 age- and sex-matched subjects without cognitive decline). Although the serum concentrations of the liver enzymes were in the physiologic range, patients with dementia showed lower ALT concentrations (p = 0.005) and higher AST/ALT ratios (p = 0.003) compared to controls. The same differences were found when comparing men with and without dementia (ALT, p = 0.009; AST/ALT ratio, p = 0.003) but disappeared in women. Curiously, comparing women and men with the same diagnosis, the ALT concentrations were lower (p = 0.008), and the AST/ALT ratio was higher (p = 0.001) in control women than men, whereas no significant difference was found between persons with dementia. In conclusion, in our cohort of older people living in the community, the association between serum aminotransferases and dementia was remarked. Moreover, our results support attention to sex difference in liver function, suggesting a role in the pathogenesis of dementia.

Shallot-enriched amaranth-based extruded snack influences blood glucose levels, hematological parameters, and carbohydrate degrading enzymes in streptozotocin-induced diabetic rats

Diabetes mellitus affects different age groups, and it is popularly managed using synthetic drugs; however, recent research efforts focus on dietary intervention especially the use of fiber rich crops to circumvent the effects of drugs. Developed shallot-enriched amaranth-based extruded snacks, namely: GCB, Amaranth: shallot: soy cake (55:25:20) %; TYD, Amaranth: shallot: soy cake (75:14.81:10.19)%; DZU, Amaranth: shallot: soy cake (60.43:25:14.57)%; and JKL, Amaranth: shallot: soy cake (70:25:5)%, were evaluated for proximate composition, total phenol and flavonoid contents. Snacks ability to modulate carbohydrate hydrolyzing enzymes in streptozotocin induced diabetic rats were also investigated. AMT (100% amaranth grain extrudate) and CCS (commercial shallot-enriched snack) served as control. Protein contents of snacks provided up to 25% of daily protein requirements for adult. Snacks exhibited high total phenol and flavonoid contents. Animals fed with snacks showed ameliorative effects on hematological parameters, attenuates elevation of enzyme activities in kidney and liver homogenates, and displayed decreased α-glucosidase/α-amylase activities. PRACTICAL APPLICATIONS: Dietary intervention is capable of circumventing the adverse effects of synthetic drugs in the management of diabetes mellitus. The study established that developed shallot-enriched amaranth-based extruded snacks possess significant ability to hamper the activities of key carbohydrate hydrolyzing enzymes in streptozotocin induced diabetic rats, hence, has potential as a functional nutritious snack to curtail hyperglycemia and prevent diabetic complications.

The combination of serum oligosaccharide chain (G-test), alpha-fetoprotein, and aspartate aminotransferase to alanine aminotransferase ratio provides the optimal diagnostic value for early detection of hepatocellular carcinoma

Background

The purpose of this study was to compare the diagnostic value of serum oligosaccharide chain (G-test), alpha-fetoprotein (AFP) and aspartic aminotransferase to alanine aminotransferase ratios (AAR), both alone and in combination, for predicting hepatocellular carcinoma (HCC) onset.

Methods

Between Januarys 2020–2022, 152 subjects admitted to the First Affiliated Hospital of Nanchang University was enrolled in this study, of which 77 had HCC, 18 chronic hepatitis (CH), 37 liver cirrhosis (LC) and 20 were healthy. Data for patient characteristics were collected, and differences between groups were analyzed by either Mann-Whitney U or χ2 tests. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of AFP, G-test, and AAR for HCC.

Results

G-test, AFP, and AAR were all found to have close correlations with HCC among the different patient groups, with G-test being the most predictive for HCC among healthy and CL patients, as represented by respective areas under the curve (AUC) of 0.953 and 0.792 (P < 0.001). By contrast, AAR had the greatest diagnostic ability for HCC among CH patients (AUC = 0.850; P < 0.001). However, the combination of all 3 biomarkers obtained the most optimal results for predicting HCC onset, in terms of predictive capability for all 3 non-HCC patient groups, yielding AUCs of 0.958, 0.898, and 0.808 (P < 0.001) for, respectively, healthy, CH, and LC patients. Additionally, AFP had higher specificity, but lower sensitivity, with increased threshold values, as the recommended threshold of AFP ≥ 400 ng/mL yielded a missed diagnosis rate of 72.7%. For AFP-negative HCC (AFP-NHCC) patients, G-test alone had the greatest diagnostic capability (AUC = 0.855; P < 0.001), sensitivity (83.8%), and specificity (87.5%).

Conclusion

G-test has the greatest diagnostic capability for HCC and AFP-NHCC, with high sensitivity and specificity, among healthy and LC patients. However, AAR had the highest diagnostic capability and sensitivity for HCC in CH. Overall, though, the combination of G-test, AFP and AAR provided the most optimal outcomes for predicting HCC onset, no matter the patient pre-conditions.

Targeted Proteomics for Monitoring One-Carbon Metabolism in Liver Diseases

Liver diseases cause approximately 2 million deaths per year worldwide and had an increasing incidence during the last decade. Risk factors for liver diseases include alcohol consumption, obesity, diabetes, the intake of hepatotoxic substances like aflatoxin, viral infection, and genetic determinants. Liver cancer is the sixth most prevalent cancer and the third in mortality (second in males). The low survival rate (less than 20% in 5 years) is partially explained by the late diagnosis, which remarks the need for new early molecular biomarkers. One-carbon metabolism integrates folate and methionine cycles and participates in essential cell processes such as redox homeostasis maintenance and the regulation of methylation reactions through the production of intermediate metabolites such as cysteine and S-Adenosylmethionine. One-carbon metabolism has a tissue specific configuration, and in the liver, the participating enzymes are abundantly expressed—a requirement to maintain hepatocyte differentiation. Targeted proteomics studies have revealed significant differences in hepatocellular carcinoma and cirrhosis, suggesting that monitoring one-carbon metabolism enzymes can be useful for stratification of liver disease patients and to develop precision medicine strategies for their clinical management. Here, reprogramming of one-carbon metabolism in liver diseases is described and the role of mass spectrometry to follow-up these alterations is discussed.

Aspartate aminotransferase to alanine aminotransferase ratio and the risk of diabetic nephropathy progression in patients with type 2 diabetes mellitus: A biopsy-based study

PURPOSE

To study the relationship between baseline serum aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR) in both clinicopathological features and renal outcome among type 2 diabetes mellitus (T2DM) patients with biopsy-confirmed diabetic nephropathy (DN).

METHODS

As a retrospective cohort study, we included 253 patients with T2DM and biopsy-confirmed DN. For receiver operating characteristic (ROC) curve showed that the optimal cut-off for AAR to predict end stage renal disease (ESRD) was 1.22. So, patients were divided into two groups according to their AAR at the time of renal biopsy: high AAR Group (those with AAR > 1.22); low AAR Group (those with AAR ≤1.22). Association between AAR and clinicopathological features as well as renal outcome were analyzed.

RESULTS

Patients with higher AAR presented elder, more hypertensive, more insulin use, higher serum cholesterol, more proteinuria and lower estimated glomerular filtration rate (eGFR). Compared with low AAR group, patients with high AAR had more severe glomerular pathological lesions and interstitial fibrosis and tubular atrophy. For prognostic analysis, high AAR Group was associated with a higher risk of progression to ESRD in univariate analysis. No matter treated with continuous or categorical variate, higher AAR remained an independent predictor for ESRD after adjusted for various confounding factors: gender, age, the duration of diabetes, serum glucose level, hypertension, serum lipid level, smoking, insulin use, eGFR and proteinuria.

CONCLUSION

High AAR was associated with more severe renal pathologic lesions and worse renal function in patients with T2DM and DN, which might be a novel noninvasive predictor for ESRD.

CLINICAL RELEVANCE

To our knowledge, there was no biopsy-based cohort study. In our study, high AAR was associated with more severe renal pathologic lesions and worse renal function in patients with T2DM and DN, which might be a novel noninvasive predictor of ESRD for patients with DN.

Effects of prebiotics in combination with probiotics on intestinal hydrolase activity, microbial population and immunological biomarkers in SD rats fed an AIN-93G diet

BACKGROUND

Gastrointestinal microbiota, which comprises hundreds of different types of microbes, biologically plays crucial roles in the host's health. Probiotics (PRO) did not always have a positive benefit on the host, depending on strains of microbes and the physiochemical properties of prebiotics (PRE), indicating that the properties of PRE in combination with PRO might have different effects on the gut ecology. The aim of this study was to assess the effects of insoluble or soluble PRE with PRO on intestinal digestive hydrolase, the fecal microbes, and immunological biomarkers in SD rats fed an AIN-93G diet.

RESULTS

Forty, 8-week-old SD rats were randomly assigned to 4 groups with 10 replicates in each; cellulose (CELL), cellulose + probiotics (CELPRO), oatmeal (OATS), and oatmeal + probiotics (OATPRO) groups. After 4-week feeding trial, rats were treated with saline or lipopolysaccharide (LPS, 1 mg/kg) to examine the alleviating effects of PRO and PRE on immunological responses. There was a significant (p < 0.05) decrease in feed intake of rats fed the oatmeal supplemented diet without affecting growth performance. Blood triglyceride was significantly (p < 0.05) decreased in rats fed the oatmeal diet, and aspartate aminotransferase (AST) was significantly (p < 0.05) decreased in rats fed the PRO supplemented diet. Intestinal maltase, sucrose, and lactase activities were significantly (p < 0.05) higher in rats fed PRO compared with rats not fed PRO. Rats fed the oatmeal showed a significant (p < 0.01) increase in the fecal colony forming units (CFU) of Lactobacillus plantarum, Bacillus subtilis, and Saccharomyces cerevisiae compared with those fed cellulose. LPS-treated rats fed PRO showed a significant (p < 0.05) increase in blood secretory immunoglobulin A (sIgA) compared with those not fed PRO. The LPS-treated rats fed PRO resulted in decreased (p < 0.05) blood IL-6 compared with those not fed PRO, indicating that a dietary PRO alleviated inflammatory response in LPS-treated rats.

CONCLUSIONS

Dietary oatmeal increased fecal microbes, and PRO supplement resulted in increased intestinal hydrolase and immune functions of the host, demonstrating that soluble PRE with supplemented with PRO could be a more bioactive combination of synbiotics in SD rats.

Evaluation of the relationship between aspartate aminotransferase/alanine aminotransferase ratio and coronary slow-flow phenomenon

Aim: To assess the correlation between the ratio of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and slow coronary flow (SCF). Methods: A total of 119 patients with SCF and 121 age- and sex-matched patients with normal coronary flow were included in this retrospective cross-sectional study. Thrombolysis in myocardial infarction frame count of angiography images was marked by two interventionalists. In addition to AST and ALT levels, complete blood count; kidney, liver and thyroid function tests; age; sex; medication and medical history were recorded. Results: Significant spikes in AST/ALT ratio were discovered in the SCF group compared with the normal coronary flow group (p < 0.001). Thrombolysis in myocardial infarction frame count values were significantly higher in all coronaries for the SCF group compared with the normal coronary flow group (p < 0.001). Thrombolysis in myocardial infarction frame count values of the left anterior descending artery (r = 0.258; p < 0.001), left circumflex artery (r = 0.297; p < 0.001) and right coronary artery (r = 0.195; p = 0.002) were positively correlated with AST/ALT ratio. Conclusion: AST/ALT ratio is significantly correlated with SCF; therefore, this ratio may have predictive value.

Arrival-Time Parametric Imaging in Contrast-Enhanced Ultrasound for Diagnosing Fibrosis in Primary Biliary Cholangitis

Liver biopsy is usually required for diagnosing fibrosis in primary biliary cholangitis (PBC), but contrast-enhanced ultrasonography (CEUS) is a possible alternative. The aim of this study was to investigate arrival-time parametric imaging (At-PI) in for diagnosing fibrosis in PBC. Forty-eight patients (male/female, 8/40; mean age, 60 ± 13 years) with PBC diagnosed by liver biopsy underwent CEUS during 2009-2019. Of these, 27 who also underwent shear wave elastography (SWE) were further analyzed. Perflubutane was intravenously injected and CEUS performed. Contrast dynamics of hepatic segment V and the right kidney were recorded and At-PI generated. The ratio of red indicating contrast arrival time <5 seconds to the entire liver contrast-enhanced area was calculated and compared with shear wave velocity (Vs) measured by SWE by fibrosis stage (F0-F3), bile duct loss score, cholangitis activity, hepatitis activity (HA0-HA3), and disease stage, as determined by liver biopsy. Ratio of red significantly differed between F0 and F2-F3 and between F1 and F2-F3. Using ratio of red to diagnose ≥F1 (≥F2), area under the receiver operating characteristic curve was 0.77 (0.92) (cutoff, 36.7% [47.1%]; sensitivity, 0.75 [0.92]; specificity, 0.82 [0.81]). At-PI was useful for diagnosing fibrosis, especially F2 or worse, in PBC, suggesting that At-PI can correctly diagnose fibrosis regardless of hepatic inflammation.

Seasonal Changes of Growth, Immune Parameters and Liver Function in Wild Chinese Sturgeons Under Indoor Conditions: Implication for Artificial Rearing

Seasonality has a significant effect on the physiology of fish, especially the effect of water temperature changes. In the present study, the growth, innate immune parameters and liver function indices of two rescued wild adult Chinese sturgeons under captive conditions were monitored for 1 year. The results showed that the total annual weight loss rate of the male was −4.58% and the total weight gain rate of the female was 24.12%, in which the weight of both individuals registered highly significant differences in summer, fall and winter (p < 0.01). The male Chinese sturgeon also exhibited negative specific growth rates (−0.1 to −0.8%) during spring to fall, whereas positive specific growth rates, ranging from 0.03 to 0.11%, were recorded in the female. Seasonality also affected the innate immune parameters of the two Chinese sturgeons, in which leukocytes had been increasing since spring and C-reactive protein (CRP) content was significantly higher (p < 0.05) in summer than fall in both individuals. The CRP level of the male Chinese sturgeon showed a significant increase from fall to winter (p < 0.05), suggesting that it may have contracted infection or inflammation during this study period. With the analysis of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), transaminase (AST:ALT) ratio, alkaline phosphatase, albumin to globulin ratio and triglycerides, it was found that the liver function of the captive Chinese sturgeons was adversely affected along seasonal changes, with the highest degree of liver impairment in winter. In combining observations from growth performance and changes in innate immune and liver function parameters, the present findings deduced that the male Chinese sturgeon under study was more susceptible to seasonal changes than the female. For better indoor culture of adult Chinese sturgeons, monitoring of hematological parameters to detect early signs of inflammation and liver function abnormality should be conducted with routine veterinary care during prolonged captivity.

Surface carboxylation of iron oxide nanoparticles brings reduced macrophage inflammatory response through inhibiting macrophage autophagy

Macrophage autophagy is a common biological response triggered by nanomaterials, which is closely related to the regulation of inflammation. Superparamagnetic iron oxide (SPIO) nanoparticles have been used for study of autophagy response due to their broad biomedical applications. However, few reports have focused on how to regulate the macrophage autophagy response induced by SPIO nanoparticles. In this study, SPIO nanoparticles grafted with carboxyl groups were synthesized and for the comparison of macrophage autophagy with unmodified nanoparticles. The study on the correlation between autophagy and inflammation induced by the two kinds of SPIO nanoparticles was also included, and the one that grafted with carboxyl groups shows a reduction of autophagy and thereby caused a milder inflammatory response. We proposed that the increased amount of albumin adsorption on the surface of carboxylated SPIO nanoparticles, a protein previously proven to attenuate autophagy, can be considered an important reason for reducing autophagy and inflammation. In general, the carboxyl modification of SPIO nanoparticles has been demonstrated to reduce inflammation by inhibiting macrophage autophagy, which may provide some insights for the design of nanomaterials in the future.

Riboflavin Bioenriched Soymilk Alleviates Oxidative Stress Mediated Liver Injury, Intestinal Inflammation, and Gut Microbiota Modification in B2 Depletion-Repletion Mice

Epidemiological evidence emphasizes that ariboflavinosis can lead to oxidative stress, which in turn may mediate the initiation and progression of liver injury and intestinal inflammation. Although vitamin B₂ has gained worldwide attention for its antioxidant defense, the relationship between B₂ status, oxidative stress, inflammatory response, and intestinal homeostasis remains indistinct. Herein, we developed a B₂ depletion-repletion BALB/c mice model to investigate the ameliorative effects of B₂ bioenriched fermented soymilk (B₂FS) on ariboflavinosis, accompanied by oxidative stress, inflammation, and gut microbiota modulation in response to B₂ deficiency. In vivo results revealed that the phenotypic ariboflavinosis symptoms, growth rate, EGRAC status, and hepatic function reverted to normal after B₂FS supplementation. B₂FS significantly elevated CAT, SOD, T-AOC, and compromised MDA levels in the serum, simultaneously up-regulated Nrf2, CAT, and SOD2, and down-regulated Keap1 gene in the colon. The histopathological characteristics revealed significant alleviation in the liver and intestinal inflammation, confirmed by the downregulation of inflammatory (IL-1β and IL-6) and nuclear transcription (NF-κB) factors after B₂FS supplementation. B₂FS also increased the abundance and diversity of gut microbiota, increased the relative abundance of Prevotella and Absiella, as well as decreased Proteobacteria, Fusobacteria, Synergistetes, and Cyanobacteria in strong conjunction with antioxidant, anti-inflammatory properties, and gut homeostasis along with the remarkable increase in cecal SCFAs content. We hereby reveal that B₂FS can effectively alleviate deleterious ariboflavinosis associated with oxidative stress mediated liver injury, chronic intestinal inflammation, and gut dysbiosis in the B₂ depletion-repletion mice model via activation of the Nrf2 signaling pathway.

Nutritional, antioxidant, carbohydrate hydrolyzing enzyme inhibitory activities, and glyceamic index of wheat bread as influence by bambara groundnut substitution

The research was designed to ascertain the potential of bambara groundnut inclusion in wheat bread to improve antioxidant activity, modulate carbohydrate hydrolyzing enzyme activities, and lower glyceamic index/ load. Protein (g/100 g) (11.2—11.73) and energy value (kcal/100 g) (421.5—435.5) of the bread were significantly higher than commercial wheat flour bread (CWF—10.45; 388.7). However, developed experimental bread samples exhibited higher growth performance in rats, free radical scavenging potentials, inhibitory activities against carbohydrate hydrolyzing enzymes and low glycemic index than other bread samples. Nevertheless, experimental bread samples were rated lower compared with the controls samples as regards organoleptic properties. The study authenticates that WBO3—25% wheat, and 75% bamabara groundnut WBO3 exhibits higher potentials as regards nutritional composition, growth indices, free radical scavenging potentials, ability to modulate carbohydrate hydrolyzing enzyme and lower glycemic index/ load. Hence, WBO3 may be recommended as functional bread for hyperglycemia prevention/ management.

Acute upper gastrointestinal bleeding due to portal hypertension in children: What is the best timing of endoscopy?

OBJECTIVE

To compare initial clinical/laboratory parameters and outcomes of mortality/rebleeding of endoscopy performed <12 h(early UGIE) versus endoscopy performed after 12-24h(late UGIE) of ED admission in children with acute upper gastrointestinal bleeding(AUGIB) due to portal hypertension.

METHODS

This is a retrospective cohort study. From January 2010 to July 2017, medical records of all children admitted to a tertiary care hospital with AUGIB due to portal hypertension were reviewed until 60 days after ED admission.

RESULTS

A total of 98 ED admissions occurred from 73 patients. Rebleeding was identified in 8/98(8%) episodes, and 9 deaths were observed. UGIE was performed in 92(94%) episodes, and 53(58%) of them occurred within 12 h of ED admission. Episodes with early UGIE and late UGIE were similar in terms of history/complaints/laboratory data at admission, chronic liver disease associated, AUGIB duration, and initial management. No statistically significant associations were found between early UGIE and the outcomes of death/rebleeding and prevalence of endoscopic hemostatic treatment (band ligation or sclerotherapy) compared to late UGIE. In the multivariable logistic regression model, the endoscopic hemostatic treatment showed a negative association with early UGIE(OR=0.33;95%CI=0.1-0.9;p = 0.04).

CONCLUSIONS

This study suggests that in pediatric patients with AUGIB and portal hypertension, UGIE may be performed after 12-24 h without harm to the patient, facilitating better initial clinical stabilization/treatment and optimization of resources.

Predictive value of aspartate aminotransferase-to-alanine aminotransferase ratio for contrast-associated acute kidney injury in patients undergoing elective percutaneous coronary intervention

BACKGROUND

Pre-procedure liver insufficiency has been demonstrated as a poor prognostic factor after percutaneous coronary intervention (PCI). Recent research discovered that the aspartate aminotransferase-to-alanine aminotransferase ratio (De-Ritis ratio) reflects the severity of liver insufficiency and was associated with adverse outcomes. We aim to evaluate the predictive value of the De-Ritis ratio for contrast-associated acute kidney injury (CA-AKI) and long-term mortality in patients undergoing elective PCI.

METHODS

We retrospectively enrolled 5780 consenting patients undergoing elective PCI between January 2012 and December 2018. CA-AKI was defined as an increase in serum creatinine ≥0.3 mg/dl or ≥50% within 48 h after the administration of contrast media.

RESULTS

The incidence of CA-AKI was 6.3% (n = 363). The De-Ritis ratio >1.30 was identified as the best cut-off value for CA-AKI prediction. The De-Ritis ratio showed an area under the curve (AUC) of 0.636 [95% confidence interval (CI): 0.605-0.667] in predicting CA-AKI, which was significantly greater than alanine aminotransferase (p<0.001) and aspartate aminotransferase (p = 0.012) alone. Furthermore, compared to currently recognized liver function assessment tools, the predictive value of the De-Ritis ratio on CA-AKI was similar to the MELD score (AUC: 0.636 vs 0.626, p = 0.631) and higher than the MELD-XI score (AUC: 0.636 vs 0.561, p<0.001). Multivariate logistic analysis showed that the De-Ritis ratio >1.30 was independently associated with CA-AKI (odds ratio=1.551, 95% CI: 1.185-2.030, p = 0.001). The addition of the De-Ritis ratio to the fully adjusted logistic regression model has significant incremental effects on the risk prediction for CA-AKI with a continuous net reclassification improvement of 0.395 (p<0.001) and an integrated discrimination improvement of 0.005 (p = 0.018). Additionally, the De-Ritis ratio >1.30 was significantly associated with long-term mortality (hazard ratio=1.285, 95% CI: 1.007-1.641, p = 0.044).

CONCLUSIONS

The De-Ritis ratio was an independent risk factor for CA-AKI and long-term mortality in patients undergoing elective PCI.

Effects of Dietary Tea Powder on the Growth Performance, Carcass Traits, and Meat Quality of Tibetan Pig × Bama Miniature Pigs

This study was conducted to evaluate the effects of tea powder in diets on the growth performance, meat quality, muscular amino acid, fatty acid profile, and serum biochemical indices of pigs. A total of 120 local Chinese pigs (Tibetan × Bama miniature pigs) were randomly assigned to five treatment groups, each with six pens and four pigs per pen. During a 60-day experiment, these groups of pigs were fed the normal diet and the diet supplemented with 1%, 2%, 4%, and 6% tea powder, respectively. The results showed that the supplementation of tea powder did not affect the growth performance of pigs. However, the dietary tea powder inclusion decreased (p < 0.05) the average fat thickness, total fat, and abdominal fat, and increased (p < 0.05) the total muscle as well. In addition, the dietary 2% tea powder decreased (p < 0.05) the muscle lightness (L*) and yellowness (b*). Compared with the control group, the dietary supplementation with 1%, 2%, and 4% tea powder raised (p < 0.05) the total amino acids (TAA) and essential amino acids (EAA), and dietary 4% and 6% tea powder increased (p < 0.05) the C20:5n3 in the muscle tissue. Furthermore, the serum lipid metabolism-related biochemical indices and mRNA expression levels were improved with the addition of tea powder. These results indicated that dietary tea powder might improve the carcass traits and meat quality of the Chinese native finishing pigs, but it does not affect their growth performance. Tea powder could be fully developed and reasonably applied as a dietary supplement.

In vivo impact assessment of orally administered polystyrene nanoplastics: biodistribution, toxicity, and inflammatory response in mice

To assess the in vivo impact of nanoplastics (NP) and coagulation-based purified NP (PurNP), this study analyzed for alterations in the biodistribution, toxicity and inflammatory response in ICR mice exposed to three different doses of NP (5, 25, and 50 mg/kg) and PurNP for 2 weeks. Except water consumption, which was dose-dependently and significantly increased in all NP-treated groups, most factors assessed for feeding behaviors and excretions remained constant, without any significant change. Orally administered NP was detected in the intestine, kidneys, and liver at all concentrations, although the accumulation was higher in the intestine than in the kidneys and liver. No significant alterations were detected in the levels of serum biochemical markers and histopathological structures. However, compared to the vehicle group, expressions of the inflammatory response proteins (iNOS and COX-2) and mRNA levels of the inflammatory cytokines were remarkably increased in the liver, kidneys, and intestine of NP-treated mice. A similar increase was detected in the oxidative stress responses, including ROS concentration, SOD activity, and Nrf2 expression. Furthermore, similar inflammatory responses were observed in the PurNP-treated group, as compared to the vehicle-treated group. The results presented in this study provide the first strong evidence that oral administration of NP for 2 weeks results in high accumulation in the liver, kidneys, and intestine of ICR mice, and induces severe inflammatory and oxidative stress responses. These results additionally confirm the efficacy of water purification using the tannic acid-mediated coagulation removal technique.

Optimum biscuit from Musa sapientum L. and Vigna unguiculata L. composite flour: effect on pancreatic histology, biochemical and hematological parameters of diabetic rats

This study investigated the effect of consumption of an optimum biscuit from composite flour of Musa sapientum L. ('banana cochon') and Vigna unguiculata L. (cowpea) on the pancreatic histology, biochemical and hematological parameters of streptozotocin-induced diabetic Wistar rats. The optimum biscuit was evaluated for its chemical properties and glycaemic index. The weekly fasting blood glucose level, food intake and weight of the rats were recorded. The effect of 28 days' consumption of different percentages of optimum biscuit with/without Metformin was also evaluated on the pancreatic histology, biochemical and hematological parameters of rats. Results showed that, the optimum biscuit is rich in minerals (potassium, magnesium and calcium), dietary fibre (9.4%) and is a low glycaemic index product (50.91%). Also, the optimum biscuit significantly lowered/maintained the blood glucose level of diabetic rats even though the weekly weights of the rats were reduced while food intake increased. Nonetheless, the hematological parameters of the treated diabetic rats were significantly (P < 0.05) improved when compared to the untreated diabetic rats groups. With the exception of total serum protein, other biochemical parameters such as serum creatinine, urea, alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase and bilirubin in the treated diabetic groups were significantly (P < 0.05) reduced or closer to those of non-diabetic rats. The serum cholesterol, triglyceride, low-density lipoprotein levels were significantly (p < 0.05) reduced while the HDL level significantly increased in treated diabetic groups. Histological examination of the pancreas showed that treatment of diabetic groups with optimum biscuit was able to slow down the destruction (protection) of beta-cells. Thus, optimum biscuit could be used to improve the health status during the management and prevention of complications in diabetic patients.

Parkin-mediated mitochondrial quality control protects against aluminum-induced liver damage in mice

Aluminum (Al) is known to be hepatotoxic. Oxidative stress is the main mechanism of liver injury caused by Al, and can also lead to mitochondrial damage. Mitochondrial damage is a prerequisite for mitochondrial quality control (MQC) dysregulation. Parkin can activate MQC and maintain mitochondrial homeostasis. However, the role of Parkin-mediated MQC in Al-induced liver damage has not been elucidated. In this study, forty male wild type (WT) C57BL/6N mice were treated with 0, 44.825, 89.65 or 179.3 mg/kg body weight AlCl₃ in drinking water for 90 days, respectively. We found that Al induced mitophagy and disrupted mitochondrial dynamics and mitochondrial biogenesis. Then, twenty male WT C57BL/6N mice and twenty male Parkin knockout (Parkin^-/-) C57BL/6N mice were divided into four groups and treated with 0, 89.65, 0, 89.65 mg/kg body weight AlCl₃ in drinking water for 90 days, respectively. We found that Parkin^-/- inhibited mitophagy and further disrupted mitochondrial dynamics and mitochondrial biogenesis. These results indicated that Parkin-mediated MQC could be disrupted by Al and protected against Al-induced liver damage.

The association between AST/ALT ratio and all-cause and cardiovascular mortality in patients with hypertension

Previous studies had shown that an increased aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) was associated with cardiovascular disease. This study aimed to assess the relationship between AST/ALT ratio and all-cause and cardiovascular mortality in patients with hypertension.By March 31, 2020, a cohort of 14,220 Chinese hypertensive patients was followed up. The end point was all-cause and cardiovascular death. Hazard ratios (HRs) and 95% CIs were calculated for mortality associated with AST/ALT ratio, using Cox proportional hazards models and competing risk model.In an average of 1.7 years of follow-up, 1.39% (n = 198) of patients died, 55.5% (n = 110) of whom from cardiovascular disease. AST/ALT ratio was associated with increased risk of all-cause death (HR:1.37, 95% CI:1.15-1.63) and cardiovascular death (HR:1.32, 95% CI:1.03-1.68) after adjustment for other potential confounders. Compared with low AST/ALT ratio (Tertile 1), high AST/ALT ratio was associated with high cause mortality (Tertile 2: HR:1.35, 95% CI:0.86-2.10; Tertile 3: HR:2.10, 95% CI:1.37-3.21; P for trend <.001). Compared with low AST/ALT ratio (Tertile 1), a statistically significant increased risk of cardiovascular mortality was also observed (Tertile 2: HR:1.27, 95% CI:0.70-2.29; Tertile 3: HR:1.92, 95% CI:1.09-3.37; P for trend <.001). High AST/ALT ratio was also associated with high cardiovascular mortality (Tertile 2: HR:1.27, 95% CI:0.70-2.29; Tertile 3: HR:1.92, 95% CI:1.09-3.37; P for trend <.001).Present study indicated that increased AST/ALT ratio levels were predictive of all-cause and cardiovascular mortality among Chinese hypertensive patients.Trial registration: CHICTR, CHiCTR1800017274. Registered 20 July 2018.

In vivo and in silico studies of Dennettia tripetala essential oil reveal the potential harmful effects of habitual consumption of the plant seed

Dennettia tripetala G. Baker (Annonaceae), is a plant with nutritional, social economy, and medicinal values. Its rising medicinal profile makes this plant a prospect in drug discovery. However, the reported strong addictive potential among habitual consumers makes the need to establish its safety imperative. In this report, we evaluated the safety profile of the essential oil of the seed of D. tripetala (EODS) in nulliparous female Wistar rats using in vivo single and repeated dose toxicity profiling, as well as in silico toxicity profiling of its known seed oil derived phytoconstituents. Our results showed consistent significant dose-dependent alterations in relative body weights, organ-body and organ-brain weight ratios, haematological and biochemical indices, as well as liver and kidney histoarchitectures, following single and repeated oral administrations. Significant alterations in liver and kidney histoarchitectures were consistent with the observed significant increase in AST/ALT ratio, suggesting deleterious effects of EODS on the kidney and liver. However, the lack of alterations in the histoarchitectures of the hippocampus and hypothalamus suggests that the brain may not have been adversely affected. Also, the in silico analysis suggests that hepatotoxic effects of EODS may be linked to Benzylnitrile, Humulene, Linalool, (Z)-ß-Ocimene. In addition, the failure of ß-Phenylnitroethane, the most abundant phytoconstituent of EODS, to pass phases I and II in silico toxicity screening, and the presence of Caryophyllene oxide, a known toxic compound, coupled with the predicted binding of both to DNA and protein, low LD50 and high percent mortality at 250 mg/kg of repeated doses, further confirmed the potentially toxic nature of EODS. We concluded that based on our in vivo and in silico observations, there is an urgent need for public education to regulate the excessive consumption of the seeds of D. tripetala.

Transcriptome analysis reveals the hepatoprotective mechanism of soybean meal peptides against alcohol-induced acute liver injury mice

This study aimed was to explore the hepatoprotective potential of soybean meal peptides (SPs) against alcohol-induced liver injury and investigate the underlying mechanisms through transcriptome analysis. The chemical antioxidant analysis of SPs exhibited potent ABTS radical scavenging capacity (11.94 ± 0.41 mg TE/100 mg peptide), ferric reducing antioxidant power (6.42 ± 0.32 mmol Fe2+/100 mg peptide), and oxygen radical absorption capacity (14.78 ± 0.01 mg TE/100 mg peptide). Moreover, SPs increased cell viability and reduced intracellular reactive oxygen species levels in Caco-2 cells by H2O2-induced, and without cytotoxicity. In the mice model, preintervention with SPs reduced the levels of aspartate transaminase/alanine transaminase, total cholesterol, triglyceride and malondialdehyde by alcohol-induced, meanwhile, increased the levels of total superoxide dismutase, glutathione and catalase by alcohol-induced. Histological analysis showed that SPs alleviated the liver injury by alcohol-induced and no toxic effects on the kidneys. According to transcriptome analysis, 1737 genes were significantly differentially expressed (1076 up-regulated and 661 down-regulated) after SPs pretreatment. The main functions of these genes were related to inflammation, lipid metabolism and oxidation. The findings from the present study suggested that SPs produced positive hepatoprotection and showed potential to be used as a dietary supplement or an ingredient of functional food.

Liver Dysfunction Associated With In-Hospital Mortality in Adult Extracorporeal Membrane Oxygenation Support

OBJECTIVES:

Extracorporeal membrane oxygenator support is a powerful clinical tool that is currently enjoying a resurgence in popularity. Wider use of extracorporeal membrane oxygenator support is limited by its significant risk profile and extreme consumption of resources. This study examines the role of markers of liver dysfunction in predicting outcomes of adult patients requiring extracorporeal membrane oxygenator support.

DESIGN:

Retrospective review.

SETTING:

Large extracorporeal membrane oxygenator center, Chicago, IL.

PATIENTS:

This study reports a single institution experience examining all adult patients for whom extracorporeal membrane oxygenator support was used over an 8-year period. Data were collected regarding patient demographics, details of extracorporeal membrane oxygenator support provided, laboratory data, and outcomes. Trends in liver function were examined for their ability to predict survival.

INTERVENTION:

Extracorporeal membrane oxygenator support, critical care.

MEASUREMENTS AND MAIN RESULTS:

Mean age was 50 years (range, 19–82 yr). There were 86 male patients (56.6%) and 66 female patients (43.4%). Indications for initiation of extracorporeal membrane oxygenator support included cardiac 76 patients (50.0%), respiratory 48 patients (31.6%), extracorporeal cardiopulmonary resuscitation 21 patients (13.3%), and combined cardiac/respiratory seven patients (4.6%). Mean duration of extracorporeal membrane oxygenator support was 17 days (range 1–223 d) or median 8 days (interquartile range, 4–17 d). Overall, in-hospital mortality was 56% (86/152). Forty-five percent of adult patients (68/152) surpassed at least one of the following established liver dysfunction thresholds: total bilirubin greater than 15 mg/dL, aspartate aminotransferase greater than 20× upper limit of normal, and alanine aminotransferase greater than 20× upper limit of normal. The multivariable logistic analysis yielded three significant findings associated with in-hospital mortality: highest total bilirubin greater than 15 (adjusted odds ratio = 4.40; 95% CI, 1.19–21.87; p = 0.04), age (adjusted odds ratio = 1.03; 95% CI, 1.00–1.05; p = 0.04), and highest lactate (adjusted odds ratio = 1.15; 95% CI, 1.06–1.26; p = 0.002).

CONCLUSIONS:

Increases in age, highest total bilirubin, and lactate all correlated with in-hospital mortality in multivariable analysis of patients requiring extracorporeal membrane oxygenator support.

Nutritional, Biochemical and Haematological Indices of White Albino Rats Fed Complementary Diets Developed from Selected Cereals and Legumes

Background:

Childhood malnutrition is a common public health problem in Ethiopia. This animal study aims to evaluate the haematological, biochemical, and nutritional indices of weanling albino rats fed on complementary diets developed from selected cereals and legumes.

Methods:

The nutritional qualities of the formulated blends were assessed biologically by feeding white albino rats in order to determine feed intake, the growth rate, protein quality parameters, biochemical and haematological properties. The commercial weaning diet (cerifam) and casein were used as control diets. On the 28th day, blood samples were collected from three randomly selected rats by decapitation. Full blood count analysis was carried out using the Automated Haematologic Analyzer to determine haematological parameters. All the biochemical parameters were determined using Mindray diagnostic kits.

Results and Discussion:

The food intake pattern showed that animals placed on diet 3, diet 4, casein, and cerifam consumed more food than those fed on diet 1, diet 2, and diet 7. The mean growth rate of animals fed on diet 3 and diet 4 was significantly (p<0.05) higher than those placed on diet 1, diet 2, and diet 7 but similar to those fed with commercial diet and casein. The protein quality evaluation of the diets showed that the protein efficiency ratio ranged from 1.20 to 2.43 while the biological value was in the range of 54.53 to 69.48%. The net protein utilization and true digestibility were 65.62 to 70.21% and 59.01 to 64.01%, respectively. Serum total protein, albumin, and globulin levels in rats given diet 3 and diet 4 were comparable to the controls and within the normal range. Comparatively, the creatinine and urea levels of rats fed on the control and formulated diets were within the normal range. The serum alanine aminotransferase values of rats fed on the control and formulated diets ranged from 22.03 IU/L in diet 2 to 37.76 IU/L in diet 4 and were not significantly different from each other. In this study, the packed cell volume and haemoglobin values of the control and formulated diets were within the recommended range. Evidently, diet 3 and diet 4 gave the best growth performance after the feeding trials.

Conclusion:

The haematological and biochemical indices indicate that these diets can support effective growth and development in rats, and consumption of these diets has no detrimental effects on the liver and renal function.

Dipterocarpus tuberculatus Roxb. Ethanol Extract Has Anti-Inflammatory and Hepatoprotective Effects In Vitro and In Vivo by Targeting the IRAK1/AP-1 Pathway

Dipterocarpus tuberculatus Roxb. has been used traditionally as a remedy for many diseases, especially inflammation. Therefore, we analyzed and explored the mechanism of the anti-inflammatory effect of a Dipterocarpus tuberculatus Roxb. ethanol extract (Dt-EE). Dt-EE clearly and dose-dependently inhibited the expression of pro-inflammatory cytokines such as IL-6, TNF-α, and IL-1β in lipopolysaccharide (LPS)-treated RAW264.7 cells. Also, Dt-EE suppressed the activation of the MyD88/TRIF-mediated AP-1 pathway and the AP-1 pathway related proteins JNK2, MKK4/7, and TAK1, which occurred as a result of inhibiting the kinase activity of IRAK1 and IRAK4, the most upstream factors of the AP-1 pathway. Finally, Dt-EE displayed hepatoprotective activity in a mouse model of hepatitis induced with LPS/D-galactosamine (D-GalN) through decreasing the serum levels of alanine aminotransferase and suppressing the activation of JNK and IRAK1. Therefore, our results strongly suggest that Dt-EE could be a candidate anti-inflammatory herbal medicine with IRAK1/AP-1 inhibitory and hepatoprotective properties.

Effects of High Levels of Dietary Linseed Oil on the Growth Performance, Antioxidant Capacity, Hepatic Lipid Metabolism, and Expression of Inflammatory Genes in Large Yellow Croaker (Larimichthys crocea)

A growth experiment was conducted to evaluate the effects of dietary fish oil (FO) replaced by linseed oil (LO) on the growth performance, antioxidant capacity, hepatic lipid metabolism, and expression of inflammatory genes in large yellow croaker (Larimichthys crocea). Fish (initial weight: 15.88 ± 0.14 g) were fed four experimental diets with 0% (the control), 33.3%, 66.7%, and 100% of FO replaced by LO. Each diet was randomly attributed to triplicate seawater floating cages (1.0 × 1.0 × 2.0 m) with 60 fish in each cage. Results showed that the growth performance of fish fed the diet with 100% LO was markedly decreased compared with the control group (P < 0.05), while no remarkable difference was observed in the growth performance of fish fed diets within 66.7% LO (P > 0.05). The percentage of 18:3n-3 was the highest in the liver and muscle of fish fed the diet with 100% LO among the four treatments. When dietary FO was entirely replaced by LO, fish had a markedly higher total cholesterol, total triglyceride, low-density lipoprotein cholesterol content, and alanine transaminase activity in the serum than the control group (P < 0.05). The concentration of malondialdehyde was markedly higher, while the activity of catalase was markedly lower in fish fed the diet with 100% LO than the control group (P < 0.05). When dietary FO was entirely replaced by LO, hepatic lipid content, transcriptional levels of fatp1 and cd36, and CD36 protein expression were significantly higher, while transcriptional level of cpt-1 and CPT-1 protein expression were significantly lower than the control group (P < 0.05). As for the gene expression of cytokines, fish fed the diet with 100% LO had markedly higher transcriptional levels of il-1β, tnfα, and il-6 than the control group (P < 0.05). In conclusion, the substitution of 66.7% FO with LO had no significant effects on the growth performance of fish, while 100% LO decreased the growth performance and increased the inflammation and hepatic lipid content of fish. The increase of hepatic lipid content was probably due to the increased fatty acid uptake and decreased fatty acid oxidation in fish.

The Cook Score: A Novel Assessment for the Prediction of Liver-Associated Clinical Events in a Diverse Population

BACKGROUND AND AIMS

Transient elastography (TE) provides accurate quantification of liver fibrosis. Its usefulness could be significantly amplified in terms of predicting liver-associated clinical events (LACE). Our aim was to create a model that accurately predicts LACE by combining the information provided by TE with other variables in patients with chronic liver disease (CLD).

METHODS

We retrospectively reviewed the electronic medical records of patients who underwent liver elastography, at John H. Stroger Hospital in Cook County, Chicago, IL. The incidences of LACE were documented including decompensation of CLD, new hepatocellular carcinoma, and liver-associated mortality. Significant predicting factors were identified through a forward stepwise Cox regression model. We used the beta-coefficients of these risk factors to construct the Cook Score for prediction of LACE. Receiver-operating characteristic (ROC) curves were plotted for Cook Score to evaluate its efficiency in prediction, in comparison with MELD-Na Score and FIB-4 Score.

RESULTS

A total of 3097 patients underwent liver elastography at our institution. Eighty-eight LACE were identified. Age (hazard ratio (HR) 1.04, p = 0.002), aspartate aminotransferase to alanine aminotransferase ratio (HR 2.61, p < 0.001), platelet count (HR 0.98, p < 0.001), international normalized ration (INR) (HR 17.80, p < 0.001), and liver stiffness measurement (HR1.04, p < 0.001) were identified as significant predictors. The Cook Score was constructed with two optimal cut-off points to stratify patients into low-, intermediate-, and high-risk groups for LACE. The Cook Score proved superior than MELD-Na Score and FIB4 Score in predicting LACE with an area under curve of 0.828.

CONCLUSION

This novel score based on a large robust sample would provide accurate prediction of prognosis in patients with chronic liver disease and guide individualized surveillance strategy once validated with future studies.

Clinical features and risk factors of COVID-19-associated liver injury and function: A retrospective analysis of 830 cases

INTRODUCTION AND OBJECTIVES

The incidence of liver injury (LI) in hospitalized COVID-19 patients ranged from 14% to 53% based on sole or multiple elevated indexes for LI. The aims of our study were to investigate the changes of parameters (ALT, AST) in LI and determine the risk factors for LI in a cohort of 830 COVID-19 patients.

METHODS

Demographic information, clinical features, and laboratory testing outcomes on admission were compared between patients with and without liver biochemistry abnormality (LBA). The same comparisons were performed between the LBA and LI groups. The updated RUCAM was used to determine the causality between drugs application and LI. Univariable and multivariable logistic regression analyses were used to explore the potential risk factors associated with LBA and LI.

RESULTS

A total of 227 (27.3%) patients exhibited LBA and 32 (3.9%) patients were categorized as having LI based on the diagnostic criteria. 32.6% (74/227) of the LBA patients had RUCAM score >3, whereas the non-LBA patients had a slight lower at rate of 24.2% (146/603) (P?=?0.047). Multivariable regression showed that a higher incidence of LBA was associated with hepatic hypoattenuation on computed tomography (CT) (odds ratio: 2.243, 95% confidence interval: 1.410-3.592, p?=?0.001), lymphocyte proportion <20% (2.088, 1.476-2.954, p?1?mg/dL (2.650, 1.845-3.806, p?1 (2.558, 1.820-3.596, p?

CONCLUSIONS

CRP levels >1.0?mg/dL, lymphocyte proportion <20%, AST/ALT ratio <1, and triglyceride levels >1.7?mol/L are potential risk factors for LI.

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Key Words

• Betacoronavirus
• Drug induced liver injury
• Hepatic insufficiency
• Pneumonia
• Tomography
• X-ray

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MESH Headings

• Adult
• Aged
• Alanine Transaminase/blood
• Aspartate Aminotransferases/blood
• Biomarkers/blood
• C-Reactive Protein/metabolism
• COVID-19/complications
• COVID-19/epidemiology
• Female
• Humans
• Liver/metabolism
• Liver Diseases/diagnosis
• Liver Diseases/etiology
• Liver Function Tests
• Male
• Middle Aged
• Pandemics
• Retrospective Studies
• SARS-CoV-2
• Tomography, X-Ray Computed

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Affiliation(s)

Faxiang Chen Department of Radiology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, China.
Wei Chen Department of Otolaryngology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, China.
Jianpu Chen Department of Radiology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, China.
Dan Xu Department of Gastroenterology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, China.
Wei Xie Department of Radiology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, China.
Xiang Wang Department of Radiology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, China.
Yuanliang Xie Department of Radiology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, China.

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Salvianolic acid B protects against acute and chronic liver injury by inhibiting Smad2C/L phosphorylation

Salvianolic acid B (Sal B) has strong antioxidant and anti-fibrosis effects, which are related to the transforming growth factor β/Smad signaling pathway. However, how Sal B affects this antioxidant pathway and the phosphorylation (p-) of Smad2 at both the COOH-terminal (pSmad2C) and linker region (pSmad2L) are unknown. The aims of the present study were to investigate the underlying mechanisms of Sal B on acute and chronic liver injury induced by CCl₄ and H₂O₂, and its effects on p-Smad2C/L. In in vivo experiments, acute and chronic liver injury models were induced by CCl₄, and the oxidative damage cell model was established in vitro with H₂O₂. Liver histopathology was assessed using hematoxylin and eosin and Van Gieson's staining. Moreover, serum biochemical indicators were analyzed using specific assay kits. Furthermore, the present study evaluated the oxidant/antioxidant status in acute and chronic liver injury models by oxidative stress parameters such as malondialdehyde, glutathione and superoxide dismutase. In addition, western blot analysis was performed to analyze the protein expression levels of pSmad2C, pSmad2L, nuclear factor erythroid-2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1). It was found that Sal B improved liver histology, decreased the levels of aminotransferase and attenuated oxidative stress in acute and chronic liver injury models. Additionally, the protein expression levels of pSmad2C and pSmad2L were decreased, but Nrf2 and HO-1 expression levels were increased both in vivo and in vitro. Collectively, the present results suggested that Sal B may protect against acute and chronic liver injury via inhibition of Smad2C/L phosphorylation, and the Nrf2/HO-1 signaling pathway may play an important role in this process.

Effect of Fermentation on Nutritional Quality, Growth and Hematological Parameters of Rats Fed Sorghum-Soybean-Orange flesh Sweet Potato Complementary Diet

The protein quality of complementary foods developed from fermented and unfermented sorghum, soybeans, and orange-fleshed sweet potato (OFSP) flour blends was evaluated using rat model. The test diet was as follows: UF2: unfermented sorghum (56%), soybean (17%), and OFSP (27%); UF3: unfermented sorghum (59%), soybean (31%), and OFSP (10%); F2: fermented sorghum (56%), soybean (17%), and OFSP (27%); and F3: fermented sorghum (59%), soybean (31%), and OFSP (10%), while cerelac served as positive control, corn starch (basal diet), and ogi (negative control). Forty-nine Wistar albino rats were grouped and fed with diets for 28 days. The growth, hematological, serum parameters of animals, protein quality, and proximate composition of developed diet were determined. Fermentation significantly improved the protein content and nutritional indices of experimental animals. Moisture content ranged from 2.5% to 9.24%, protein (7.09%-25.29%), ash (1.09%-3.71%), fat (10.28%-15.24%), and fiber (0.85%-3.17%). The biological values (BV) ranged from 75.11% to 78.44%. The weight gained in rat fed the formulated diet ranged from 46.0 g to 77.3 g and was highest in F3. The packed cell volume (PCV), hemoglobin concentration (HBC), red blood cell (RBC), and lymphocytes were highest in F3. Urea nitrogen and creatinine of the rats fed with formulated diets ranged from 3.58 to 15.32 mg/dl and 1.56 to 6.15 mg/dl, respectively. Sample F3 is a protein-rich complementary food that is comparable to ogi and suitable to manage malnutrition and support growth in children. However, clinical trials on the formulated diet are needed to further substantiate its nutritional potentials.

Cordycepin attenuates high-fat diet-induced non-alcoholic fatty liver disease via down-regulation of lipid metabolism and inflammatory responses

Cordycepin (CRD), an adenosine analog derived from traditional Chinese medicine, is an active component in Cordyceps militaris. It has been shown to have many protective effects during liver injury and ameliorate liver disease progression, but little is known about its effect on non-alcoholic fatty liver disease (NAFLD). This study aims to explore the effects of CRD on obesity-induced NAFLD. In this experiment, C57BL/6 J mice were randomly assigned into normal control group (NC), high fat diet group (HFD) and HFD + CRD group for 8 weeks. The body weights were recorded weekly, at the end of the experiments, the liver and serum samples were collected. We found that CRD administration reduced body weight and decreased the weight of adipose and liver, and CRD relieved liver injure through diminishing of histopathological changes and decreasing serum levels of AST, ALT, TG, TC, LDL-C and increased the level of HDL-C. Furthermore, treatment with CRD significantly alleviated expression of inflammatory factors (TNF-α, IL-6 and Il-1β) and macrophage markers (MCP1, MIP2, mKC and VCAM1). On the other hand, compared with HFD group, the CRD treated group markedly down-regulated relative proteins of lipid anabolism (SREBP1-c, ACC, SCD-1, LXRα and CD36) and up-regulated relative proteins of β-oxidation (p-AMPK, AMPK, CPT-1 and PPARα). In summary, our results suggest that CRD can be a potential therapeutic agent in the prevention and treatment of NAFLD, which may be closely related to its effect on lipid metabolism and inflammatory responses.

Consensus Guidelines: Best Practices for Detection, Assessment and Management of Suspected Acute Drug-Induced Liver Injury During Clinical Trials in Adults with Chronic Viral Hepatitis and Adults with Cirrhosis Secondary to Hepatitis B, C and Nonalcoholic Steatohepatitis

With the widespread development of new drugs to treat chronic liver diseases (CLDs), including viral hepatitis and nonalcoholic steatohepatitis (NASH), more patients are entering trials with abnormal baseline liver tests and with advanced liver injury, including cirrhosis. The current regulatory guidelines addressing the monitoring, diagnosis, and management of suspected drug-induced liver injury (DILI) during clinical trials primarily address individuals entering with normal baseline liver tests. Using the same laboratory criteria cited as signals of potential DILI in studies involving patients with no underlying liver disease and normal baseline liver tests may result in premature and unnecessary cessation of a study drug in a clinical trial population whose abnormal and fluctuating liver tests are actually due to their underlying CLD. This position paper focuses on defining best practices for the detection, monitoring, diagnosis, and management of suspected acute DILI during clinical trials in patients with CLD, including hepatitis C virus (HCV) and hepatitis B virus (HBV), both with and without cirrhosis and NASH with cirrhosis. This is one of several position papers developed by the IQ DILI Initiative, comprising members from 16 pharmaceutical companies in collaboration with DILI experts from academia and regulatory agencies. It is based on an extensive literature review and discussions between industry members and experts from outside industry to achieve consensus regarding the recommendations. Key conclusions and recommendations include (1) the importance of establishing laboratory criteria that signal potential DILI events and that fit the disease indication being studied in the clinical trial based on knowledge of the natural history of test fluctuations in that disease; (2) establishing a pretreatment value that is based on more than one screening determination, and revising that baseline during the trial if a new nadir is achieved during treatment; (3) basing rules for increased monitoring and for stopping drug for potential DILI on multiples of baseline liver test values and/or a threshold value rather than multiples of the upper limit of normal (ULN) for that test; (4) making use of more sensitive tests of liver function, including direct bilirubin (DB) or combined parameters such as aspartate transaminase:alanine transaminase (AST:ALT) ratio or model for end-stage liver disease (MELD) to signal potential DILI, especially in studies of patients with cirrhosis; and (5) being aware of potential confounders related to complications of the disease being studied that may masquerade as DILI events.

Effects of lysine biomass supplementation on growth performance and clinical indicators in broiler chickens

Production of crystalline amino acids (AA) through microbial fermentation concomitantly provides an AA-enriched biomass that may serve as a cost-effective supplement for broiler chickens. We investigated the effects of feeding a fermentation biomass product containing approximately 62% Lys on growth performance, organ growth, and clinical outcomes of broilers. Beginning at 2 d post-hatch, a total of 360 Ross 308 chicks were randomly assigned to 1 of 5 treatments provided to 12 replicate cages of 6 birds. Practical corn-soybean meal-based dietary treatments included: negative control (NC; no supplementation of L-Lys, 1.01 and 0.86% standardized ileal digestible Lys in starter and grower phases, respectively), NC + 0.23% L-Lys HCl (positive control; PC), and NC supplemented with 0.30, 0.90, or 1.50% Lys biomass (LB) in both phases. Feed and water were provided ad libitum throughout the study. Individual bird and feeder weights were recorded on study day 0, 10, 21, and 35. At study conclusion, birds from each treatment were randomly selected to collect blood and tissue samples. The PC and 0.30% LB diets elicited similar overall (day 0–35) body weight gain and birds were heavier (P < 0.001) than the NC and other LB treatments. The PC, 0.30% LB, and 0.90% LB groups had better (P < 0.001) overall feed conversion ratio than NC. Some LB-supplemented treatments elicited increased (P < 0.001) relative spleen and ileum weight compared with NC and PC. Heterophils were increased (P < 0.001) in LB treatments compared with PC and NC. Lymphocytes were decreased (P < 0.001) in LB treatments compared with NC, and 1.50% LB was similar to PC. This resulted in an increased (P < 0.001) heterophil-to-lymphocyte ratio in some LB treatments, which may have resulted from general AA supplementation or the LB product. Collectively, these results suggest that addition of up to 0.30% LB restored growth performance when added to a Lys-deficient practical diet and elicited results identical to the Lys-adequate PC diet with no negative clinical effects.

Novel Prognostic Scores Based on Plasma Prothrombin Time and Fibrinogen Levels in Patients With AFP-Negative Hepatocellular Carcinoma

Noninvasive tools for the prognosis of α-fetoprotein negative hepatocellular carcinoma (HCC) are urgently needed. The present study proposed a prognostic system based on preoperative plasma prothrombin time and fibrinogen (PT/Fbg system). With respect to α-fetoprotein (AFP)-negative HCC, we compared the prognostic value in PT/Fbg system, Glasgow Prognostic Score, and aminotransferase/aspartate aminotransferase ratio. The present study retrospectively analyzed patient characteristics, clinicopathological factors, and the level of pretreatment biomarkers in 628 patients with HCC. Patients with increased PT and Fbg levels were allocated a score of 2, patients with only one of these abnormalities were assigned score 1, and patients with neither of these abnormalities were allocated a score of 0. The following distributions of the PT/Fbg system scores were observed: 187 (29.78%) patients had a score of 0, 305 (30.65%) had a score of 1, and 134 (22.69%) patients had a preoperative score of 2. The prognostic significance of the PT/Fbg system was determined using univariate and multivariate Cox hazard analyses in AFP-negative HCC. Multivariate analysis revealed that patients with a higher PT/Fbg system exhibited worse overall survival (OS) than patients with a lower PT/Fbg system. Our study proposes preoperative evaluation of the plasma PT/Fbg system to predict the OS of patients with AFP-negative HCC.

Correlation between hemolytic activity, cytotoxicity and systemic in vivo toxicity of synthetic antimicrobial peptides

The use of non-standard toxicity models is a hurdle in the early development of antimicrobial peptides towards clinical applications. Herein we report an extensive in vitro and in vivo toxicity study of a library of 24 peptide-based antimicrobials with narrow spectrum activity towards veterinary pathogens. The haemolytic activity of the compounds was evaluated against four different species and the relative sensitivity against the compounds was highest for canine erythrocytes, intermediate for rat and human cells and lowest for bovine cells. Selected peptides were additionally evaluated against HeLa, HaCaT and HepG2 cells which showed increased stability towards the peptides. Therapeutic indexes of 50–500 suggest significant cellular selectivity in comparison to bacterial cells. Three peptides were administered to rats in intravenous acute dose toxicity studies up to 2–8 × MIC. None of the injected compounds induced any systemic toxic effects in vivo at the concentrations employed illustrating that the correlation between the different assays is not obvious. This work sheds light on the in vitro and in vivo toxicity of this class of promising compounds and provides insights into the relationship between the different toxicity models often employed in different manners to evaluate the toxicity of novel bioactive compounds in general.