[The importance of AST / ALT rate in nonalcoholic steatohepatitis diagnosis]

The effects of probiotic-based additives on aflatoxin intoxication in Piaractus mesopotamicus: a study of liver histology and metabolic performance

Mycotoxins, produced by fungi, can contaminate fish food and harm their health. Probiotics enhance immune balance and primarily function in the animal intestine. This study aimed to assess aflatoxin's impact on Piaractus mesopotamicus and explore probiotic-based additive (PBA) benefits in mitigating these effects, focusing on antioxidant activity, biochemical indices, and hepatic histopathology. Two experiments were conducted using P. mesopotamicus fry. The first experimental assay tested various levels of aflatoxin B1 (0.0, 25.0, 50.0, 100.0, 200.0, and 400.0 µg kg-1) over a 10-day period. The second experimental assay examined the efficacy of the probiotic (supplemented at 0.20%) in diets with different levels of aflatoxin B1 (0.0, 25.0, and 400.0 µg kg-1) for 15 days. At the end of each assay, the fish underwent a 24-hour fasting period, and the survival rate was recorded. Six liver specimens from each treatment group were randomly selected for metabolic indicator assays, including superoxide dismutase, catalase, alanine aminotransferase, aspartate aminotransferase, and albumin. Additionally, histopathological analysis was performed on six specimens. The initial study discovered that inclusion rates above 25.0 µg kg-1 resulted in decreased activity of AST (aspartate aminotransferase), ALT (alanine aminotransferase), ALB (albumin), CAT (catalase), and SOD (superoxide dismutase), accompanied by liver histopathological lesions. In the second study, the inclusion of PBA in diets contaminated with AFB1 improved the activity of AST and ALT up to 25.0 µg kg-1 of AFB1, with no histopathological lesions observed. The study demonstrated the hepatoprotective effects of PBA in diets contaminated with AFB1. The enzyme activity and hepatic histopathology were maintained, indicating a reduction in damage caused by high concentrations of AFB1 (400.0 µg kg-1 of AFB1). The adverse effects of AFB1 on biochemical and histopathological parameters were observed from 25.0 µg kg-1 onwards. Notably, PBA supplementation enhanced enzymatic activity at a concentration of 25 µg kg-1 of AFB1 and mitigated the effects at 400.0 µg kg-1 of AFB1. The use of PBAs in pacu diets is highly recommended as they effectively neutralize the toxic effects of AFB1 when added to diets containing 25.0 µg kg-1 AFB1. Dietary inclusion of aflatoxin B1 at a concentration of 25.0 µg kg-1 adversely affects the liver of Piaractus mesopotamicus (Pacu). However, the addition of a probiotic-based additive (PBA) to the diets containing this concentration of aflatoxin neutralized its toxic effects. Therefore, the study recommends the use of PBAs in Pacu diets to mitigate the adverse effects of aflatoxin contamination.

Metabolomics in chronic hepatitis C: Decoding fibrosis grading and underlying pathways

BACKGROUND

Chronic Hepatitis C (CHC) affects 71 million people globally and leads to liver issues such as fibrosis, cirrhosis, cancer, and death. A better understanding and prognosis of liver involvement are vital to reduce morbidity and mortality. The accurate identification of the fibrosis stage is crucial for making treatment decisions and predicting outcomes. Tests used to grade fibrosis include histological analysis and imaging but have limitations. Blood markers such as molecular biomarkers can offer valuable insights into fibrosis.

AIM

To identify potential biomarkers that might stratify these lesions and add information about the molecular mechanisms involved in the disease.

METHODS

Plasma samples were collected from 46 patients with hepatitis C and classified into fibrosis grades F1 (n = 13), F2 (n = 12), F3 (n = 6), and F4 (n = 15). To ensure that the identified biomarkers were exclusive to liver lesions (CHC fibrosis), healthy volunteer participants (n = 50) were also included. An untargeted metabolomic technique was used to analyze the plasma metabolites using mass spectrometry and database verification. Statistical analyses were performed to identify differential biomarkers among groups.

RESULTS

Six differential metabolites were identified in each grade of fibrosis. This six-metabolite profile was able to establish a clustering tendency in patients with the same grade of fibrosis; thus, they showed greater efficiency in discriminating grades.

CONCLUSION

This study suggests that some of the observed biomarkers, once validated, have the potential to be applied as prognostic biomarkers. Furthermore, it suggests that liquid biopsy analyses of plasma metabolites are a good source of molecular biomarkers capable of stratifying patients with CHC according to fibrosis grade.

Beneficial Effects of Tamarind Trypsin Inhibitor in Chitosan-Whey Protein Nanoparticles on Hepatic Injury Induced High Glycemic Index Diet: A Preclinical Study

Several studies have sought new therapies for obesity and liver diseases. This study investigated the effect of the trypsin inhibitor isolated from tamarind seeds (TTI), nanoencapsulated in chitosan and whey protein isolate (ECW), on the liver health status of the Wistar rats fed with a high glycemic index (HGLI) diet. The nanoformulations without TTI (CW) and ECW were obtained by nanoprecipitation technique, physically and chemically characterized, and then administered to the animals. The adult male Wistar rats (n = 20) were allocated to four groups: HGLI diet + water; standard diet + water; HGLI diet + ECW (12.5 mg/kg); and HGLI diet + CW (10.0 mg/kg), 1 mL per gagave, for ten days. They were evaluated using biochemical and hematological parameters, Fibrosis-4 Index for Liver Fibrosis (FIB-4), AST to Platelet Ratio Index (APRI) scores, and liver morphology. Both nanoparticles presented spherical shape, smooth surface, and nanometric size [120.7 nm (ECW) and 136.4 nm (CW)]. In animals, ECW reduced (p < 0.05) blood glucose (17%), glutamic oxalacetic transaminase (39%), and alkaline phosphatase (24%). Besides, ECW reduced (p < 0.05) APRI and FIB-4 scores and presented a better aspect of hepatic morphology. ECW promoted benefits over a liver injury caused by the HGLI diet.

Serum biochemistry of Trachemys scripta elegans and Trachemys dorbignyi (Testudines: Emydidae) bred in captivity in the Northeastern semiarid region of Brazil

Aim:

This study aimed to assess fundamental biochemical values of healthy animals and to provide useful data on comparative physiologies of Testudines, being assessed the serum biochemistry profiles, and body and tail biometry of Trachemys scripta elegans and Trachemys dorbignyi bred in interaction in the semiarid region of the São Francisco river valley.

Materials and Methods:

Serum biochemistry variables (urea, creatinine, glucose, total serum protein, albumin, globulin, and albumin/globulin ratio), and biometry values of the body (mass [body mass (BM)], maximum curvilinear length [carapace length (CL)], and width [carapace width (CW)] of the carapace, maximum curvilinear length [plastron length (PL)], and width [plastron width PW] of the plastron), and the tail (total length of the tail [TLT], pre-cloacal tail length [PrCL], post-cloacal tail length [PoCL]) were measured after 24 h fasting.

Results:

T. s. elegans displayed higher BM, CL, CW, PL, PW, AST, TP, albumin, and globulin values. T. dorbignyi displayed higher values of glucose, TLT, and PrCL. Variables aspartate aminotransferase (AST) and total protein (TP) in T. s. elegans and glucose in T. dorbignyi explained most of the variance between the species and could serve to distinguish them.

Conclusion:

We conclude that most of the differences between T. s. elegans and T. dorbignyi shall be explained by biometric variables, AST, TP, and glucose, which characterize interspecific differences. Our results point out terms of reference for these species bred in captivity in the semiarid region of Brazilian Northeastern region and serve as a model for the comparative intra- and inter-species physiology and as a base for the health assessment of these species.

Fagonia indica Repairs Hepatic Damage through Expression Regulation of Toll-Like Receptors in a Liver Injury Model

Fagonia indica is a traditionally used phytomedicine to cure hepatic ailments. However, efficient validation of its hepatoprotective effect and molecular mechanisms involved are not yet well established. Therefore, the present study was designed to evaluate the hepatoprotective activity of Fagonia indica and to understand the molecular mechanisms involved in the reversal of hepatic injury. The liver injury mouse model was established by thioacetamide followed by oral administration of plant extract. Serum biochemical and histological analyses were performed to assess the level of hepatic injury. Expression analysis of proinflammatory, hepatic, and immune regulatory genes was performed with RT-PCR. Results of serological and histological analyses described the restoration of normal liver function and architecture in mice treated with plant extract. In addition, altered expression of proinflammatory (IL-1β, IL-6, TNF-α, and TGF-β) and hepatic (krt-18 and albumin) markers further strengthens the liver injury reversal effects of Fagonia indica. Furthermore, a significant expression regulation of innate immunity components such as toll-like receptors 4 and 9 and MyD-88 was observed suggesting an immune regulatory role of the plant in curing liver injury. In conclusion, the current study not only proposes Fagonia indica, a strong hepatoprotective candidate, but also recommends an immune regulatory toll-like receptor pathway as an important therapeutic target in liver diseases.

Benefits of Fish Oil Consumption over Other Sources of Lipids on Metabolic Parameters in Obese Rats

This study evaluated the effect of the consumption of different levels and sources of lipids on metabolic parameters of Wistar rats. Animals were fed with high-fat diet (HFD) containing 20% of lard for 12 weeks to cause metabolic obesity. Subsequently, the animals were divided into six groups and were fed diets with lipid concentrations of 5% or 20% of lard (LD), soybean oil (SO) or fish oil (FO), for 4 weeks. Data were submitted to analysis of variance (two-way) followed by Tukey post hoc test (p < 0.05). The groups that consumed FO showed less weight gain and lower serum levels of triacylglycerol (TAG), total cholesterol and fractions, aspartate aminotransferase (AST) activity, atherogenic index, less amount of fat in the carcass, decreased Lee index and lower total leukocyte counting (p < 0.05). These same parameters were higher in LD treatment (p < 0.05). In the concentration of 20%, carcass fat content, blood glucose levels, as well as alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) decreased in FO groups (p < 0.05). The SO group had intermediate results regarding the other two treatments (FO and LD). We concluded that fish oil intake was able to modulate positively the metabolic changes resulting from HFD.

Evaluation of liver regeneration diet supplemented with omega-3 fatty acids: experimental study in rats

OBJECTIVE

to evaluate liver regeneration in rats after partial hepatectomy of 60% with and without action diet supplemented with fatty acids through the study of the regenerated liver weight, laboratory parameters of liver function and histological study.

METHODS

thirty-six Wistar rats, males, adults were used, weighing between 195 and 330 g assigned to control and groups. The supplementation group received the diet by gavage and were killed after 24h, 72h and seven days. Evaluation of regeneration occurred through analysis of weight gain liver, serum aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltranspeptidase, and mitosis of the liver stained with H&E.

RESULTS

the diet supplemented group showed no statistical difference (p>0.05) on the evolution of weights. Administration of fatty acids post-hepatectomy had significant reduction in gamma glutamyltransferase levels and may reflect liver regeneration. Referring to mitotic index, it did not differ between period of times among the groups.

CONCLUSION

supplementation with fatty acids in rats undergoing 60% hepatic resection showed no significant interference related to liver regeneration.

Liver regeneration with l-glutamine supplemented diet: experimental study in rats

OBJECTIVE

To assess liver regeneration in rats after 60% hepatectomy with and without supplementation of L-glutamine through liver weight changes, laboratory parameters and histological study.

METHODS

36 male rats were divided into two groups: glutamine group and control group. Each group was subdivided into three subgroups, with death in 24h, 72h and seven days. The glutamine group received water and standard diet supplemented with L-glutamine, and the control recieved 0.9% saline. In all subgroups analysis of liver regeneration was made by the Kwon formula, study of liver function (AST, ALT, GGT, total bilirubin, indirect and indirect bilirubin and albumin) and analysis of cell mitosis by hematoxylin-eosin.

RESULTS

In both groups there was liver regeneration by weight gain. Gamma-GT increased significantly in the control group (p < 0.05); albumin increased in the glutamine group. The other indicators of liver function showed no significant differences. Histological analysis at 72h showed a higher number of mitoses in the glutamine group, with no differences in other subgroups.

CONCLUSION

Diet supplementation with L glutamine is beneficial for liver regeneration.

Molecular basis of alcoholic fatty liver disease: From incidence to treatment

Alcoholic liver diseases have complex and multiple pathogenic mechanisms but still no effective treatment. Steatosis or alcoholic fatty liver disease (AFLD) has a widespread incidence and is the first step in the progression to more severe stages of alcoholic liver disease, with concomitant increases in morbidity and mortality rates. The ways in which this progression occurs and why some individuals are susceptible are still unanswered scientific questions. Research with animal models and clinical evidence have shown that it is a multifactorial disease that involves interactions between lipid metabolism, inflammation, the immune response and oxidative stress. Each of these pathways provides a better understanding of the pathogenesis of AFLD and contributes to the development of therapeutic strategies. This review emphasizes the importance of research on alcoholic steatosis based on incidence data, key pathogenic mechanisms and therapeutic interventions, and discusses perspectives on the progression of this disease.

Diagnostic value of serum prolidase enzyme activity to predict the liver histological lesions in non-alcoholic fatty liver disease: a surrogate marker to distinguish steatohepatitis from simple steatosis

Determination of the liver histological lesions with noninvasive tests is an important part of the diagnostic work-up of patients with non-alcoholic fatty liver disease (NAFLD). We aimed to determine the predictive value of noninvasive biochemical markers, serum prolidase enzyme activity (SPEA), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and AST/ALT ratio for the liver histological lesions. Fifty-four liver biopsy-proven patients with NAFLD and 37 healthy controls were enrolled to the study. The diagnostic accuracies of biochemical markers were evaluated by receiver operating characteristic (ROC) curves and multiple linear regression analysis to predict the degree of fatty infiltration, lobular inflammation, NAFLD activity score, and stage of fibrosis. The SPEA of patients with steatohepatitis is significantly increased compared with the patients with simple steatosis and controls (1,338 [1,138-1,624] U/l; 974 [768-1,160] U/l; 972 [862-1,122] U/l, shown as median [25th-75th interquartile range], respectively, P < 0.0001). SPEA was positively correlated with the grade of liver fatty infiltration, lobular inflammation and NAFLD activity score, and stage of fibrosis, (r = 0.377, P < 0.005; r = 0.443, P < 0.001; r = 0.457, P < 0.001; r = 0.321, P < 0.018, respectively). SPEA was the best predictor for distinguishing steatohepatitis from simple steatosis according to the ROC analysis (area under the curve [AUC]: 0.85). Multivariate analysis revealed that the most useful single test for predicting lobular inflammation, NAFLD activity score, and fibrosis was SPEA, and for predicting the fatty infiltration, it was ALT (P < 0.00001, P < 0.001, P < 0.0001, P < 0.0001, respectively). This study demonstrated that SPEA can accurately predict the degree and stage of all histological lesions in NAFLD. It could be helpful for distinguishing steatohepatitis from simple steatosis and reducing the need for liver biopsy in the majority of patients with NAFLD.

Adherence to the Mediterranean diet moderates the association of aminotransferases with the prevalence of the metabolic syndrome; the ATTICA study

Background

Elevated liver enzymes are markers of liver steatosis and metabolic syndrome. We aimed to investigate the association of Mediterranean diet on the relationship between aminotransferases (i.e., AST, ALT, gGT) and the metabolic syndrome.

Methods

The ATTICA study has randomly enrolled 1514 adult males (18–87 yrs) and 1528 females (18–89 yrs) from the greater area of Athens. Adherence to Mediterranean diet was assessed through the MedDietScore. According to NCEP III criteria, participants were classified into those with or without the metabolic syndrome.

Results

Women with metabolic syndrome had higher γGT (p = 0.02) and lower AST/ALT levels (p = 0.018) than those without, and men with metabolic had a lower AST/ALT ratio (p = 0.01) compared to those without metabolic syndrome. The AST/ALT ratio was also positively correlated with MedDietScore (rho = 0.17, p < 0.001), while higher MedDietScore was associated with lower likelihood of having the metabolic syndrome in a multi-adjusted analysis (OR = 0.34, 95% CI: 0.16–0.73). Stratified analysis by the level of adherence to the Mediterranean diet, revealed that only in subjects away or with moderate adherence to the Mediterranean diet, an increase in the AST/ALT ratio was associated with lower likelihood of having the metabolic syndrome (OR = 0.33, p < 0.05 and OR = 0.34, p < 0.09, respectively); however, when we focused in those with greater adherence to the Mediterranean diet, AST/ALT ratio was not associated with the presence of the syndrome (OR = 0.51, p = 0.55). These findings remained similar in both genders, and even when the quantity of alcohol drinking was taken into account.

Conclusion

Aminotransferases ratio constitutes a marker of the metabolic syndrome among healthy adults; however, this relationship is moderated when individuals are close to the Mediterranean dietary pattern.

Doença hepática não-alcoólica: evolução após derivação gastrojejunal em Y-de-Roux pela técnica de fobi-capella

RACIONAL: A doença hepática não-alcoólica apresenta alta prevalência entre pacientes com obesidade mórbida, podendo evoluir de esteatose hepática até esteatohepatite e cirrose. OBJETIVO: Determinar o efeito da derivação gástrica na incidência de doença hepática não-alcoólica e co-morbidades relacionadas em pacientes com obesidade mórbida. MÉTODOS: Os pacientes foram prospectivamente avaliados no pré-operatório e, no mínimo, após 6 meses de pós-operatório. Foram analisados: dados antropométricos, co-morbidades, medicamentos em uso, colesterol, triglicerídeos, provas hepáticas e incidência de doença hepática não-alcoólica. Todos os pacientes com alteração de provas hepáticas foram submetidos a biopsia hepática no peroperatório. RESULTADO: Vinte e oito pacientes com doença hepática não-alcoólica foram incluídos no estudo com índice de massa corpórea médio de 42 ± 4 kg/m². Vinte e cinco pacientes apresentaram 59 co-morbidades, sendo as mais freqüentes: elevação de triglicerídeos (n = 23), elevação de colesterol total (n = 13) e hipertensão arterial (n = 11). Foram submetidos a biopsia 22 pacientes: 10 apresentaram esteatose macrogoticular moderada, 5 esteatose macrogoticular discreta e 7 esteatohepatite. Os doentes foram analisados em média após 230 dias de pós-operatório. Apresentaram perda de 64% do excesso de peso, redução do índice de massa corpórea médio para 29,6 ± 3 kg/m² e 21 co-morbidades em 13 pacientes. Houve diminuição estatisticamente significante do número dos acometidos de elevação de triglicerídeos, elevação de colesterol total, hipertensão arterial e na incidência de doença hepática não-alcoólica. CONCLUSÃO: A perda de peso proporcionada pela derivação gastrojejunal em Y-de-Roux pela técnica de Fobi-Capella em pacientes com doença hepática não-alcoólica está associada à diminuição de sua incidência e de outras co-morbidades.

Comparison of the natural history of alcoholic and nonalcoholic fatty liver disease

Fatty liver disease represents a common clinical entity. It is classically divided into alcoholic fatty liver disease (AFLD) and nonalcoholic fatty liver disease (NAFLD). Whereas AFLD occurs in as many as 10 million Americans, NAFLD represents the most common chronic liver disease and is the most common cause of liver enzyme abnormalities in the United States. Both diseases encompass the clinical spectrum of steatosis, steatohepatitis, and cirrhosis. Although they are histologically indistinct, AFLD and NAFLD follow different clinical courses. This article compares the natural history of these diseases.