1
|
Ranjbar M, Shab-Bidar S, Mohammadi H, Djafarian K. Effect of Intermittent Fasting on Liver Function Tests: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Nutr Rev 2024:nuae070. [PMID: 38917447 DOI: 10.1093/nutrit/nuae070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
CONTEXT Intermittent fasting (IF) is a diet strategy with alternate intervals of calorie reduction and normal eating. Despite its beneficial effects on weight loss and cardiometabolic risk factors, the effect of IF on liver function tests (LFTs) remains unclear. OBJECTIVE This study aimed to investigate the effect of IF on LFTs through a systematic review and meta-analysis of randomized clinical trials. DATA SOURCES An electronic search was performed using predefined search terms in databases including PubMed, Scopus, and ISI Web of Science until February 2023. DATA EXTRACTION The studies were selected according to PRISMA guidelines, and the risk of bias was assessed for the randomized controlled trials. DATA ANALYSIS The results of this study are reported as weighted mean differences (WMDs) with 95% CIs. Fourteen RCTs were included in the meta-analysis, with a total sample size of 908. IF significantly reduced alanine aminotransferase (ALT) (WMD: -2.88, 95% CI: -4.72 to -1.04, P-value = .002) and aspartate aminotransferase (AST) levels (WMD: -1.67, 95% CI: -3.12 to -0.22, P-value = .024). The results of the subgroup analysis showed that the impact of IF was significant in both the nonalcoholic fatty liver disease and the healthy groups for ALT. The effects of IF on the serum gamma-glutamyl transpeptidase (GGT) level were significant (WMD: -3.19, 95% CI: -6.00 to -0.39, P-value = .026), but there were no significant changes in the alkaline phosphatase (ALP) level (WMD: 1.06, 95% CI: -0.23 to 2.34, P-value = .106). Furthermore, no substantial heterogeneity between studies was reported. CONCLUSION IF can improve ALT, AST, and GGT levels but not ALP enzyme levels and may have a benefit on liver function. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42023396211.
Collapse
Affiliation(s)
- Mahsa Ranjbar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
- Neuroscience Institute, Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, 4395-578, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
- Neuroscience Institute, Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, 4395-578, Iran
| |
Collapse
|
2
|
Majewski M, Piwko K, Ordak M, Muszynska E, Nasierowski T, Bujalska-Zadrozny M. Magnetic Resonance Imaging and Manganism: A Narrative Review and Laboratory Recommendations. J Clin Med 2024; 13:2823. [PMID: 38792364 PMCID: PMC11122624 DOI: 10.3390/jcm13102823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
In recent years, a series of articles has been published concerning magnetic resonance imaging (MRI) studies in a group of patients exposed to manganism, specifically factory workers, welders, and individuals with liver diseases, as well as those abusing home-produced ephedrone. Some potential symptoms of manganese toxicity include motor disturbances, neurocognitive problems, sleep disorders, and psychosocial changes. Despite various publications on MRI research in individuals with an elevated risk of manganism, there is a noticeable absence of a comprehensive review in this field. The detection of the accumulation of manganese in the brain through MRI can confirm the diagnosis and guide appropriate treatment. Due to the high cost of determining manganese ion levels in biological material, an additional aim of the manuscript was to identify simple medical laboratory parameters that, when performed concurrently with MRI, could assist in the diagnosis of manganism. Among these types of parameters are the levels of bilirubin, magnesium, liver enzymes, creatinine, hemoglobin, and hematocrit.
Collapse
Affiliation(s)
- Michal Majewski
- Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1 Str., 02-097 Warsaw, Poland; (M.M.); (K.P.); (M.B.-Z.)
| | - Karolina Piwko
- Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1 Str., 02-097 Warsaw, Poland; (M.M.); (K.P.); (M.B.-Z.)
| | - Michal Ordak
- Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1 Str., 02-097 Warsaw, Poland; (M.M.); (K.P.); (M.B.-Z.)
| | - Elzbieta Muszynska
- Department of Medical Biology, Medical University of Bialystok, Mickiewicza 2c Str., 15-222 Bialystok, Poland;
| | - Tadeusz Nasierowski
- Department of Psychiatry, Faculty of Pharmacy, Medical University of Warsaw, Nowowiejska 27 Str., 00-665 Warsaw, Poland;
| | - Magdalena Bujalska-Zadrozny
- Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1 Str., 02-097 Warsaw, Poland; (M.M.); (K.P.); (M.B.-Z.)
| |
Collapse
|
3
|
Condon S, Hu H, Kong M, Cave MC, McClain CJ. ALT poorly predicts Nonalcoholic Fatty Liver Disease (NAFLD) and liver fibrosis as determined by vibration-controlled transient elastography in adult National Health and Nutrition Examination Survey 2017-2018. Am J Med Sci 2024; 367:310-322. [PMID: 38307172 DOI: 10.1016/j.amjms.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Non-alcoholic fatty liver disease is a growing problem in the United States, contributing to a range of liver disease as well as cardiovascular disease. ALT is the most widely used liver chemistry for NAFLD evaluation. We hypothesized that the normal range many laboratories use was too high, missing many patients with clinically important steatosis and/or fibrosis. METHODS This study utilized 2017-2018 NHANES data including 9254 participants. We compared four different upper limits of normal for ALT with specific measurements of steatosis and liver stiffness as determined by liver elastography with FibroScan®. Liver stiffness was further characterized as showing any fibrosis or advanced fibrosis. After exclusions, our final pool was 4184 for liver stiffness measurement and 4183 for steatosis grade as measured by Controlled Attenuation Parameter (CAP). Using these variables, we performed logistic regression between ALT and CAP, and ALT and fibrosis/advanced fibrosis, and did a Receiver Operating Characteristic curve. RESULTS Based on three of the most widely used cut off values for ALT, we found that ALT does not reliably rule out NAFLD in over 50% of cases. It also missed 45.9-64.2% of patients with liver fibrosis. CONCLUSIONS Our study revealed that ALT is an inaccurate marker for NAFLD as measured by FibroScan® with CAP greater than or equal to 300 dB/m. Accuracy improved specific risk factors were considered. These data also showed that ALT was a poor marker for liver fibrosis. We conclude that there is no single ALT level that accurately predicts hepatic steatosis or fibrosis.
Collapse
Affiliation(s)
- Sally Condon
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville, Louisville, KY, USA; The Liver Transplant Program at UofL Health - Jewish Hospital Trager Transplant Center, Louisville, KY, USA
| | - Huirong Hu
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA
| | - Maiying Kong
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA
| | - Matthew C Cave
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville, Louisville, KY, USA; The Liver Transplant Program at UofL Health - Jewish Hospital Trager Transplant Center, Louisville, KY, USA; University of Louisville Alcohol Research Center, Louisville, KY, USA; Hepatobiology & Toxicology Center, Louisville, KY, USA; Robley Rex VA Medical Center, Louisville, KY, USA
| | - Craig J McClain
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville, Louisville, KY, USA; The Liver Transplant Program at UofL Health - Jewish Hospital Trager Transplant Center, Louisville, KY, USA; University of Louisville Alcohol Research Center, Louisville, KY, USA; Hepatobiology & Toxicology Center, Louisville, KY, USA; Robley Rex VA Medical Center, Louisville, KY, USA.
| |
Collapse
|
4
|
Mohd Nasir S, Ismail AF, Tuan Ismail TS, Wan Abdul Rahman WF, Wan Ahmad WAN, Tengku Din TADAA, Sirajudeen KNS. Hepatic and renal effects of oral stingless bee honey in a streptozotocin-induced diabetic rat model. World J Exp Med 2024; 14:91271. [PMID: 38590306 PMCID: PMC10999067 DOI: 10.5493/wjem.v14.i1.91271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/24/2024] [Accepted: 03/01/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Diabetes is known damage the liver and kidney, leading to hepatic dysfunction and kidney failure. Honey is believed to help in lowering the blood glucose levels of diabetic patients and reducing diabetic complications. However, the effect of stingless bee honey (SBH) administration in relieving liver and kidney damage in diabetes has not been well-studied. AIM To investigate the effect of SBH administration on the kidney and liver of streptozotocin-induced (STZ; 55 mg/kg) diabetic Sprague Dawley rats. METHODS The rats were grouped as follows (n = 6 per group): non-diabetic (ND), untreated diabetic (UNT), metformin-treated (MET), and SBH+metformin-treated (SBME) groups. After successful diabetic induction, ND and UNT rats were given normal saline, whereas the treatment groups received SBH (2.0 g/kg and/or metformin (250 mg/kg) for 12 d. Serum biochemical parameters and histological changes using hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) staining were evaluated. RESULTS On H&E and PAS staining, the ND group showed normal architecture and cellularity of Bowman's capsule and tubules, whereas the UNT and MET groups had an increased glomerular cellularity and thickened basement membrane. The SBH-treated group showed a decrease in hydropic changes and mild cellularity of the glomerulus vs the ND group based on H&E staining, but the two were similar on PAS staining. Likewise, the SBME-treated group had an increase in cellularity of the glomerulus on H&E staining, but it was comparable to the SBH and ND groups on PAS staining. UNT diabetic rats had tubular hydropic tubules, which were smaller than other groups. Reduced fatty vacuole formation and dilated blood sinusoids in liver tissue were seen in the SBH group. Conversely, the UNT group had high glucose levels, which subsequently increased MDA levels, ultimately leading to liver damage. SBH treatment reduced this damage, as evidenced by having the lowest fasting glucose, serum alanine transaminase, aspartate transaminase, and alkaline phosphatase levels compared to other groups, although the levels of liver enzymes were not statistically significant. CONCLUSION The cellularity of the Bowman's capsule, as well as histological alteration of kidney tubules, glomerular membranes, and liver tissues in diabetic rats after oral SBH resembled those of ND rats. Therefore, SBH exhibited a protective hepatorenal effect in a diabetic rat model.
Collapse
Affiliation(s)
- Suriati Mohd Nasir
- Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Anis Farihan Ismail
- Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Tuan Salwani Tuan Ismail
- Endocrinology Laboratory, Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Wan Faiziah Wan Abdul Rahman
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Wan Amir Nizam Wan Ahmad
- Biomedicine Program, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | | | | |
Collapse
|
5
|
Yun J, Kwon SC. The Association of Perfluoroalkyl Substance Exposure and a Serum Liver Function Marker in Korean Adults. TOXICS 2023; 11:965. [PMID: 38133366 PMCID: PMC10748130 DOI: 10.3390/toxics11120965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
Perfluoroalkyl substances (PFAS), widely used throughout industry and daily life, are currently one of the environmental pollutants garnering the most attention worldwide. Recently, environmental pollutants have had a high profile as one of the main causes of chronic liver disease, such as non-alcoholic fatty liver disease. Research on PFAS is actively underway. Although Korea has a remarkably high prevalence of chronic liver disease, and it continues to increase, only a few studies have revealed the relationship between PFAS and liver disease. In addition, regulations on PFAS in Korea are delayed compared to developed countries, such as Europe and the United States, and public interest is insufficient compared to others. Therefore, we would like to investigate the exposure of Koreans to PFAS in the blood and examine the relationship between these substances and markers of liver function (AST, ALT, and GGT). This study was based on the results of the Korean National Environmental Health Survey (KoNEHS) 2018–2020 (Cycle 4), and a total of 2961 subjects were selected. The concentration of PFAS in the blood of Korean adults was measured to be significantly higher based on the geometric mean compared to the results of recently investigated American adults based on the National Health and Nutrition Examination Survey (NHANES, 2017-2018). A multivariable linear regression analysis adjusted for age, sex, body mass index (BMI), smoking status, alcohol intake, and regular exercise was performed to examine changes in three liver function markers as the serum PFAS concentration increased. We found that some of the five PFAS (PFOA, PFOS, PFHxS, PFNA, and PFDeA) were significantly associated with increased liver enzymes. It is necessary to recognize the threat of PFAS to the human body and to discuss regulations and alternatives in earnest. Continuous follow-up studies are required through a well-designed cohort.
Collapse
Affiliation(s)
| | - Soon-Chan Kwon
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Republic of Korea;
| |
Collapse
|
6
|
Ozturk A, Kumar V, Pierce TT, Li Q, Baikpour M, Rosado-Mendez I, Wang M, Guo P, Schoen S, Gu Y, Dayavansha S, Grajo JR, Samir AE. The Future Is Beyond Bright: The Evolving Role of Quantitative US for Fatty Liver Disease. Radiology 2023; 309:e223146. [PMID: 37934095 PMCID: PMC10695672 DOI: 10.1148/radiol.223146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a common cause of morbidity and mortality. Nonfocal liver biopsy is the historical reference standard for evaluating NAFLD, but it is limited by invasiveness, high cost, and sampling error. Imaging methods are ideally situated to provide quantifiable results and rule out other anatomic diseases of the liver. MRI and US have shown great promise for the noninvasive evaluation of NAFLD. US is particularly well suited to address the population-level problem of NAFLD because it is lower-cost, more available, and more tolerable to a broader range of patients than MRI. Noninvasive US methods to evaluate liver fibrosis are widely available, and US-based tools to evaluate steatosis and inflammation are gaining traction. US techniques including shear-wave elastography, Doppler spectral imaging, attenuation coefficient, hepatorenal index, speed of sound, and backscatter-based estimation have regulatory clearance and are in clinical use. New methods based on channel and radiofrequency data analysis approaches have shown promise but are mostly experimental. This review discusses the advantages and limitations of clinically available and experimental approaches to sonographic liver tissue characterization for NAFLD diagnosis as well as future applications and strategies to overcome current limitations.
Collapse
Affiliation(s)
- Arinc Ozturk
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Viksit Kumar
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Theodore T Pierce
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Qian Li
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Masoud Baikpour
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Ivan Rosado-Mendez
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Michael Wang
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Peng Guo
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Scott Schoen
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Yuyang Gu
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Sunethra Dayavansha
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Joseph R Grajo
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| | - Anthony E Samir
- From the Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 3rd Floor, 323G, Boston, MA 02114 (A.O., V.K., T.T.P., Q.L., M.B., P.G., S.S., Y.G., S.D., A.E.S.); Harvard Medical School, Boston, Mass (A.O., V.K., T.T.P, Q.L., A.E.S.); Departments of Medical Physics and Radiology, University of Wisconsin, Madison, Wis (I.R.M.); GE HealthCare, Milwaukee, Wis (M.W.); and Department of Radiology, University of Florida, Gainesville, Fla (J.R.G.)
| |
Collapse
|
7
|
Khalid S, Arshad M, Raza K, Mahmood S, Siddique F, Aziz N, Khan S, Khalid W, AL‐Farga A, Aqlan F. Assessment of hepatoprotective, nephroprotective efficacy, and antioxidative potential of Moringa oleifera leaf powder and ethanolic extract against PCOS-induced female albino mice ( Mus Musculus). Food Sci Nutr 2023; 11:7206-7217. [PMID: 37970416 PMCID: PMC10630814 DOI: 10.1002/fsn3.3646] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/03/2023] [Accepted: 08/13/2023] [Indexed: 11/17/2023] Open
Abstract
Moringa oleifera is a medicinal plant that has anti-inflammatory, antihypertensive, antidiabetic, tissue-protective, and antioxidant activities. Here, we evaluated the protective effect of M. oleifera leaf powder (MoLP) and 70% ethanol M. oleifera leaf extract (MoLE) on mitigating polycystic ovary syndrome (PCOS)-induced liver and kidney dysfunction via regulating oxidative stress in female albino mice (Mus musculus). The efficacy of M. oleifera was compared with metformin (standard medicine used to treat infertility in women). PCOS was induced by intramuscular injection of testosterone enanthate at 1.0 mg/100 g BW for 35 days. PCOS-induced mice were treated with MoLP (250 and 500 mg/Kg), MoLE (250 and 500 mg/kg), and metformin (250 mg/kg) orally for 14 days. Renal function test (RFT), liver function test (LFT), and oxidative stress biomarker malondialdehyde (MDA) were quantified in serum at 0, 7, and 14 days of intervention. Mice treated with M. oleifera and metformin showed a significant decrease (p < .001) in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphate (ALP), total bilirubin, urea, creatinine, and a significant increase (p < .001) in total protein, albumin, globulin, and albumin/globulin (A/G) ratio. Oxidative stress decreased significantly (p = .00) with respect to treatments, exposure days, and their interaction in metformin and all M. oleifera-treated groups. M. oleifera leaf powder and extract reduce oxidative stress and enhance nephron-hepatic activity in PCOS-induced female albino mice.
Collapse
Affiliation(s)
| | | | - Komal Raza
- Liver CenterDistrict Headquarter HospitalFaisalabadPakistan
| | - Shahid Mahmood
- Institute of Food Science and NutritionUniversity of SargodhaSargodhaPakistan
| | - Farzana Siddique
- Institute of Food Science and NutritionUniversity of SargodhaSargodhaPakistan
| | - Nida Aziz
- Department of ZoologyUniversity of SargodhaSargodhaPakistan
| | - Sarfraz Khan
- Department of ChemistryAir Base CollegeSargodhaPakistan
| | - Waseem Khalid
- University Institute of Food Science and TechnologyThe University of LahoreLahorePakistan
| | - Ammar AL‐Farga
- Department of Biochemistry, College of SciencesUniversity of JeddahJeddahSaudi Arabia
| | - Faisal Aqlan
- Department of Chemistry, College of SciencesIbb UniversityIbbYemen
| |
Collapse
|
8
|
Scott JA, Jones AM, Jokl E, Gordon-Walker T, Barry PJ, Hanley NA, Piper Hanley K, Athwal VS. Improving detection of cystic fibrosis related liver disease using liver fibrosis assessment tools. Heliyon 2023; 9:e21861. [PMID: 38053913 PMCID: PMC10694159 DOI: 10.1016/j.heliyon.2023.e21861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 10/06/2023] [Accepted: 10/30/2023] [Indexed: 12/07/2023] Open
Abstract
Background & aims Cystic Fibrosis related liver disease (CFLD) is the 3rd largest cause of death in Cystic Fibrosis (CF). As advances in pulmonary therapies have increased life-expectancy, CFLD has become more prevalent. Current guidelines may underdiagnose liver fibrosis, particularly in its early stages. Newer modalities for the assessment of fibrosis may provide a more accurate assessment. FibroScan is validated in assessing fibrosis for several aetiologies including alcohol and fatty liver, the CFLD cohort have an entirely different phenotype so the cut off values are not transferrable. We appraised fibrosis assessment tools to improve diagnosis of CFLD. Methods A prospective cohort (n = 114) of patients from the Manchester Adult Cystic Fibrosis Centre, UK were identified at annual assessment. Demographic data including co-morbidity, CFTR genotyping, biochemistry and imaging were used alongside current guidelines to group into CFLD and CF without evidence of liver disease. All patients underwent liver stiffness measurement (LSM) and assessment of serum-based fibrosis biomarker panels. A new diagnostic criterion was created and validated in a second, independent cohort. Results 12 of 114 patient classified as CFLD according to the European Cystic Fibrosis Society best practice guidelines. No specific risk factors for development of CFLD were identified. Liver enzymes were elevated in patients with CFLD. Serum biomarker panels did not improve diagnostic criteria. LSM accurately predicted CFLD. A new diagnostic criterion was proposed and validated in a separate cohort, accurately predicating CFLD in 10 of 32 patients (31 %). Conclusion We present a cohort of patients with CF assessed for the presence of liver fibrosis using blood biomarkers and LSM based platforms. We propose a new, simplified diagnostic criteria, capable of accurately predicting liver disease in patients with CF.Clinical trials number: NCT04277819.
Collapse
Affiliation(s)
- Jennifer A. Scott
- Division of Diabetes, Endocrine and Gastroenterology, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
- Division of Gastroenterology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Andrew M. Jones
- Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - Elliot Jokl
- Division of Diabetes, Endocrine and Gastroenterology, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - Timothy Gordon-Walker
- Department of Hepatology, Scotland Liver Transplant Unit, Royal Infirmary Edinburgh, Edinburgh, UK
| | - Peter J. Barry
- Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - Neil A. Hanley
- Division of Diabetes, Endocrine and Gastroenterology, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
- Directorate of Research and Innovation, Manchester University NHS Foundation Trust, Manchester, UK
| | - Karen Piper Hanley
- Division of Diabetes, Endocrine and Gastroenterology, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
- Directorate of Research and Innovation, Manchester University NHS Foundation Trust, Manchester, UK
- Wellcome Trust Centre for Cell Matrix Research, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - Varinder S. Athwal
- Division of Diabetes, Endocrine and Gastroenterology, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
- Division of Gastroenterology, Manchester University NHS Foundation Trust, Manchester, UK
- Directorate of Research and Innovation, Manchester University NHS Foundation Trust, Manchester, UK
| |
Collapse
|
9
|
Younis MA, Sato Y, Elewa YHA, Harashima H. Reprogramming activated hepatic stellate cells by siRNA-loaded nanocarriers reverses liver fibrosis in mice. J Control Release 2023; 361:592-603. [PMID: 37579975 DOI: 10.1016/j.jconrel.2023.08.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 08/16/2023]
Abstract
We report on a novel strategy for treating liver fibrosis through reprogramming activated Hepatic Stellate Cells (aHSCs) into quiescent Hepatic Stellate Cells (qHSCs) using siRNA-loaded lipid nanoparticles (LNPs). The in vivo screening of an array of molecularly-diverse ionizable lipids identified two candidates, CL15A6 and CL15H6, with a high siRNA delivery efficiency to aHSCs. Optimization of the composition and physico-chemical properties of the LNPs enabled the ligand-free, selective, and potent siRNA delivery to aHSCs post intravenous administration, with a median effective siRNA dose (ED50) as low as 0.08 mg/Kg. The biosafety of the LNPs was confirmed by escalating the dose to 50-fold higher than the ED50 or by chronic administration. The recruitment of the novel LNPs for the simultaneous knockdown of Hedgehog (Hh) and Transforming Growth Factor Beta 1 (TGFβ1) signaling pathways using an siRNA cocktail enabled the reversal of liver fibrosis and the restoration of the normal liver function in mice. Analysis of the key transcription factors in aHSCs suggested that the reprogramming of aHSCs into qHSCs mediated the therapeutic outcomes. The scalable ligand-free platform developed in this study as well as the novel therapeutic strategy reported herein are promising for clinical translation.
Collapse
Affiliation(s)
- Mahmoud A Younis
- Faculty of Pharmaceutical Sciences, Hokkaido University, Kita-12, Nishi-6, Kita-ku, Sapporo 060-0812, Japan; Department of Industrial Pharmacy, Faculty of Pharmacy, Assiut University, Assiut 71526, Egypt.
| | - Yusuke Sato
- Faculty of Pharmaceutical Sciences, Hokkaido University, Kita-12, Nishi-6, Kita-ku, Sapporo 060-0812, Japan
| | - Yaser H A Elewa
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44511, Egypt; Graduate School of Veterinary Medicine, Hokkaido University, Kita-18, Nishi-9, Kita-ku, Sapporo 060-0818, Japan
| | - Hideyoshi Harashima
- Faculty of Pharmaceutical Sciences, Hokkaido University, Kita-12, Nishi-6, Kita-ku, Sapporo 060-0812, Japan.
| |
Collapse
|
10
|
Gallaher H, Mehkri S. Advanced Stage Hepatic Fibrosis With Normal Liver Chemistries: A Case Report. Cureus 2023; 15:e40732. [PMID: 37485218 PMCID: PMC10360978 DOI: 10.7759/cureus.40732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
This is a case report on a patient with biopsy-proven stage 2 hepatic fibrosis who routinely has had normal liver chemistries. This is important because liver chemistry tests are the standard physicians use to assess general liver health. There is not an abundance of research on patients with advanced hepatic fibrosis who have normal liver chemistries, but the research that is available all agree that liver biopsy is the better way to get a clear picture of the disease state of the liver. Biopsies of the liver are not as easily accessible or as cost-effective as simple blood work though. Patients are also less likely to agree to undergo a procedure than to get blood drawn. These are all obstacles in regard to changing the standard in determining liver health from laboratory work to liver biopsies, in addition to liver chemistries. This case report aids in the research already available on how normal liver chemistries should not automatically rule out hepatic fibrosis. This patient proves that fibrosis can be happening, and the blood tests are not reflecting that change. Due to this, further research and investigation on liver fibrosis and normal liver chemistries should be done.
Collapse
Affiliation(s)
- Haley Gallaher
- Medicine, Saint James School of Medicine, The Quarter, AIA
| | - Sumyra Mehkri
- Family Medicine, ASAS Health Valley Regional Diagnostics, Edinburg, USA
| |
Collapse
|
11
|
Chang W, Cai L, Chen T, Ni W, Xie Z, Yang C, Liao J. Current Helicobacter pylori Infection Is Associated with Early Liver Injury: A Cross-Sectional Study in the General Population. Am J Trop Med Hyg 2023; 108:684-692. [PMID: 36878209 PMCID: PMC10076991 DOI: 10.4269/ajtmh.22-0340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/05/2022] [Indexed: 03/08/2023] Open
Abstract
Early prevention of liver injury by controlling risk factors deserves concern because of the heavy liver disease burden. Helicobacter pylori (HP) infection affects half of the world's population and the relationship between it and early liver damage is unclear. This study focuses on assessing the correlation between them in the general population to provide clues to prevent liver disease. A total of 12,931 individuals underwent liver function and imaging tests as well as 13C/14C-urea breath tests. Results showed that the detection rate of HP was 35.9%, and the HP-positive group had a higher rate of liver injury (47.0% versus 44.5%, P = 0.007). Specifically, Fibrosis-4 (FIB-4) and alpha-fetoprotein levels in the HP-positive group were higher whereas the serum albumin level was lower. HP infection would raise the percentage of elevated aspartate aminotransferase (AST; 2.5% versus 1.7%, P = 0.006), elevated FIB-4 (20.2% versus 17.9%, P = 0.002), and abnormal liver imaging (31.0% versus 29.3%, P = 0.048). Most of these results remained stable after covariate adjustment but, for liver injury and liver imaging, the conclusions only held in young people (ORliver injury, odds ratio of liver injury, 1.127, P = 0.040; ORAST, 1.33, P = 0.034; ORFIB-4, 1.145, P = 0.032; ORimaging, 1.149, P = 0.043). Overall, HP infection might be associated with early liver injury, particularly in youth, suggesting that people with early liver injury should pay more attention to HP infection to prevent the occurrence of severe liver diseases.
Collapse
Affiliation(s)
- Wenling Chang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lin Cai
- Department of Gastroenterology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Non-Communicable Diseases Research Center, West China-Peking Union Medical College C. C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Tingting Chen
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Weigui Ni
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zhihao Xie
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chunxia Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Non-Communicable Diseases Research Center, West China-Peking Union Medical College C. C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Juan Liao
- Department of Gastroenterology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Non-Communicable Diseases Research Center, West China-Peking Union Medical College C. C. Chen Institute of Health, Sichuan University, Chengdu, China
| |
Collapse
|
12
|
Cancino J, Lazo S, Fonseca D. [Stomatological management of patients with liver disease: a review of the literature]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e153. [PMID: 38288454 PMCID: PMC10809970 DOI: 10.21142/2523-2754-1102-2023-153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/28/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction The liver is the organ responsible for the metabolism of nutrients, some drugs, and the production of coagulation factors. According to the World Health Organization, approximately 23 million people worldwide are diagnosed with liver disease each year. As a result, it is common for dentists to encounter these patients on a daily basis in their practice. The objective of this review is to establish the dental management of patients with liver disease. Material and methods A manual literature search was conducted using the indexed articles in PUBMED and EBSCO databases using the keywords "oral surgery," AND "liver disease," AND "hepatic cirrhosis," AND "dental management". Results Patients with liver disease present important characteristics for the dentist, which must be recognized in order to perform procedures with the lowest risk of intraoperative and postoperative complications. A patient with poorly controlled underlying liver disease is more prone to infections and bleeding, which implies a high risk of morbidity. Conclusions Dental care for patients with liver disease should be assessed according to the reason for consultation, control of the disease, the complexity of the procedure to be performed, and both intraoperative and postoperative hemostatic measures. All necessary hemostatic measures should be considered and dose adjustments should be considered in the use of NSAIDs.
Collapse
Affiliation(s)
- Javiera Cancino
- Facultad de Odontología, Universidad Finis Terrae. Santiago, Chile. Universidad Finis Terrae Facultad de Odontología Universidad Finis Terrae Santiago Chile
| | - Sebastián Lazo
- Facultad de Odontología, Universidad Finis Terrae. Santiago, Chile. Universidad Finis Terrae Facultad de Odontología Universidad Finis Terrae Santiago Chile
| | - Diego Fonseca
- Facultad de Odontología, Universidad del Desarrollo. Santiago, Chile. Universidad del Desarrollo Facultad de Odontología Universidad del Desarrollo Santiago Chile
| |
Collapse
|
13
|
Goyal A, Dalia T, Ranka S, Sauer AJ, Hu J, Cernik C, Nuqali A, Chandler J, Parimi N, Dennis K, Majmundar M, Tayeb T, Haglund J, Shah Z, Vidic A, Gupta B, Haglund NA. Impact of Biopsy Proven Liver Fibrosis on Patients Undergoing Evaluation and Treatment for Advanced Heart Failure Surgical Therapies. Am J Cardiol 2023; 194:46-55. [PMID: 36947946 DOI: 10.1016/j.amjcard.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/28/2023] [Accepted: 02/06/2023] [Indexed: 03/24/2023]
Abstract
There is a paucity of data regarding the impact of liver fibrosis on patients with stage D heart failure (HF). We conducted a retrospective study (January 1, 2017 to December 12, 2020) in patients with stage D HF who underwent liver biopsy as part of their advanced HF therapy evaluation. Baseline characteristics and 1-year outcomes were compared between no- or mild-to-moderate-fibrosis (grade 0 to 2) and advanced-fibrosis (grade 3 to 4) groups. Of 519 patients with stage D HF, 136 who underwent liver biopsy (113 [83%] no or mild-to-moderate fibrosis and 23 [17%] advanced fibrosis) were included. A total of 71 patients (52%) received advanced HF therapies (23 heart transplantation, 48 left ventricular assist devices). One-year mortality was higher among patients with advanced fibrosis (52% vs 18%, p <0.001). Further subgroup analysis suggested a trend toward increased 1-year mortality among patients with advanced fibrosis who underwent advanced therapies (37% vs 13%, p = 0.09). There was a trend of lower likelihood of receiving advanced HF therapies in the advanced-fibrosis group, only 1 heart transplantation and 7 left ventricular assist devices, but it did not reach statistical significance (35% vs 56%, p = 0.06). After adjustment for confounders, degree of liver fibrosis was an independent predictor of mortality (odds ratio 6.2; 95% 1.27 to 30.29, p = 0.02). We conclude that advanced liver fibrosis is common among patients with stage D HF who undergo evaluation for advanced HF surgical therapies and significantly increases 1-year mortality. Further larger studies are needed to support our findings.
Collapse
Affiliation(s)
- Amandeep Goyal
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Tarun Dalia
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Sagar Ranka
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Andrew J Sauer
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Jinxiang Hu
- Departments of Biostatistics and Data Science, The University of Kansas Health System, Kansas City, Kansas
| | - Colin Cernik
- Departments of Biostatistics and Data Science, The University of Kansas Health System, Kansas City, Kansas
| | - Abdulelah Nuqali
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Jonathan Chandler
- Departments of Internal Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Nikhil Parimi
- Departments of Internal Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Katie Dennis
- Departments of Pathology, The University of Kansas Health System, Kansas City, Kansas
| | - Monil Majmundar
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Taher Tayeb
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Jennifer Haglund
- Departments of Gastroenterology and Hepatology, The University of Kansas Health System, Kansas City, Kansas
| | - Zubair Shah
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Andrija Vidic
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Bhanu Gupta
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas
| | - Nicholas A Haglund
- Departments of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas.
| |
Collapse
|
14
|
Zhang X, Zhou S, Liang Y, Xie G, Zhu M, Wang Z, Qu Q, Long Y, Lv Y, Peng J, Yuan Y, Huang Y, Wang W. Effects of Astragalus, Epimedium, and Fructus Ligustri Lucidi extractive on antioxidant capacity, production performance, and immune mechanism of breeding pigeons under stress. Poult Sci 2022; 102:102350. [PMID: 36577268 PMCID: PMC9803782 DOI: 10.1016/j.psj.2022.102350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/07/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022] Open
Abstract
With the large-scale and intensive development of pigeon breeding industry and the improvement of production level, stress factors have an important impact on the immune, antioxidant capacity, and productivity of pigeons. In this study, the extenuating effect of Astragalus, Epimedium, and Ligustrum lucidum (AEF) on the antioxidant, production performance, and immune mechanism was investigated in breeding pigeons. Eighty pairs of 11-month-old healthy breeding pigeons with the same egg production batch were randomly divided into 4 groups: control group (C group), treated with AEF (AEF group), in restraint stress (S group) and treated with AEF and in restraint stress (S+AEF group). Results showed that AEF reduces weight loss during lactation and increases spleen weight, increased IgA, IgG, T4, GSH-Px, and SOD in serum and decreased T3 and MDA (P < 0.05). Furthermore, treatment with AEF declined HSP60, HSP70, HSP90, GR levels in liver and cFOS, GR mRNA levels in the Hypothalamus, GR mRNA levels in the pituitary (P < 0.05). Meanwhile, the results of the intestine studies showed that AEF promoted relative abundances of Firmicutes and relieve intestinal injury in the colon of pigeons. These results indicated AEF enhanced stress resistance, immunity, production performance and antioxidant capacity of pigeons.
Collapse
Affiliation(s)
- Xue Zhang
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Shuo Zhou
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Yayan Liang
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Gaijie Xie
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Mingqiang Zhu
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Zifan Wang
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Qing Qu
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Yifei Long
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Yantao Lv
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Jie Peng
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China
| | - Yaohui Yuan
- Shenyang Weijia Biotechnology Co., Ltd, Shenyang 110027, Shenyang, Liaoning, China
| | - Yanhua Huang
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China,Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, Guangdong 510640, China
| | - Wei Wang
- College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, Guangdong 510225, China,Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, Guangdong 510640, China,Corresponding author:
| |
Collapse
|
15
|
Tunruttanakul S, Verasmith K, Patumanond J, Mingmalairak C. Development of a Predictive Model for Common Bile Duct Stones in Patients With Clinical Suspicion of Choledocholithiasis: A Cohort Study. Gastroenterology Res 2022; 15:240-252. [PMID: 36407811 PMCID: PMC9635785 DOI: 10.14740/gr1560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Current choledocholithiasis guidelines heavily focus on patients with low or no risk, they may be inappropriate for populations with high rates of choledocholithiasis. We aimed to develop a predictive scoring model for choledocholithiasis in patients with relevant clinical manifestations. METHODS A multivariable predictive model development study based on a retrospective cohort of patients with clinical suspicion of choledocholithiasis was used in this study. The setting was a 700-bed public tertiary hospital. Participants were patients who had completed three reference tests (endoscopic retrograde cholangiography, magnetic resonance cholangiopancreatography, and intraoperative cholangiography) from January 2019 to June 2021. The model was developed using logistic regression analysis. Predictor selection was conducted using a backward stepwise approach. Three risk groups were considered. Model performance was evaluated by area under the receiver operating characteristic curve, calibration, classification measures, and decision curve analyses. RESULTS Six hundred twenty-one patients were included; the choledocholithiasis prevalence was 59.9%. The predictors were age > 55 years, pancreatitis, cholangitis, cirrhosis, alkaline phosphatase level of 125 - 250 or > 250 U/L, total bilirubin level > 4 mg/dL, common bile duct size > 6 mm, and common bile duct stone detection. Pancreatitis and cirrhosis each had a negative score. The sum of scores was -4.5 to 28.5. Patients were categorized into three risk groups: low-intermediate (score ≤ 5), intermediate (score 5.5 - 14.5), and high (score ≥ 15). Positive likelihood ratios were 0.16 and 3.47 in the low-intermediate and high-risk groups, respectively. The model had an area under the receiver operating characteristic curve of 0.80 (95% confidence interval: 0.76, 0.83) and was well-calibrated; it exhibited better statistical suitability to the high-prevalence population, compared to current guidelines. CONCLUSIONS Our scoring model had good predictive ability for choledocholithiasis in patients with relevant clinical manifestations. Consideration of other factors is necessary for clinical application, particularly regarding the availability of expert physicians and specialized equipment.
Collapse
Affiliation(s)
- Suppadech Tunruttanakul
- Department of Surgery, Sawanpracharak Hospital, Nakhon Sawan 60000, Thailand,Corresponding Author: Suppadech Tunruttanakul, Department of Surgery, Sawanpracharak Hospital, Muang, Nakhon Sawan 60000, Thailand.
| | | | - Jayanton Patumanond
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chatchai Mingmalairak
- Department of Surgery, Faculty of Medicine, Thammasat University, Pathum Thani 10120, Thailand
| |
Collapse
|
16
|
Fernandes-Breitenbach F, Peres-Ueno MJ, Santos LFG, Brito VGB, Castoldi RC, Louzada MJQ, Chaves-Neto AH, Oliveira SHP, Dornelles RCM. Analysis of the femoral neck from rats in the periestropause treated with oxytocin and submitted to strength training. Bone 2022; 162:116452. [PMID: 35654351 DOI: 10.1016/j.bone.2022.116452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022]
Abstract
Among the interventions used to prevent osteoporosis in female organisms, strength training (ST) and oxytocin (OT) stand out, as a promising hormone with anabolic action on bone. This study aimed to verify whether the combined action of OT and ST, compared to isolated interventions, potentiates the bone remodeling process of the femoral neck of Wistar rats during periestropause. Forty Wistar rats (18 months) with irregular estrous cycle were randomly distributed into groups: 1-Vehicle (Veh; NaCl 0.15 mol/L ip); 2-Oxytocin (Ot; 134 μg/kg/ip); 3-Strength training (St); 4-Ot + St. The animals of the 1, 2 and 4 groups received two intraperitoneal injections with an interval of 12 h every 30 days, totaling 8 injections at the end of the experimental period (18 to 21 months). The animals in the St and Ot + St groups performed ST on a ladder 3 times a week, maximal voluntary carrying capacity (MVCC) test monthly. After 120 days, the animals were euthanized; the femur was collected for analysis of biomechanical testing, densitometry, bone microtomography, Raman spectroscopy, tissue PCR, and blood for analysis of bone biomarkers, liver damage, and oxidative stress. The main effects in the Ot group were observed in the maximum load and energy in the compression testing (femoral head), and stiffness and energy in the three-points bending testing (femur diaphysis). In addition, the main effects occurred on the bone mineral density (BMD), cortical thickness (Ct.Th), number of pores (Po.N), polar moment of inertia (J), trabecular thickness (Tb.Th), and connectivity density (Conn.Dn), Bone alkaline phosphatase (Alp), Tumor necrosis factor receptor superfamily member 11b (Opg), Tumor necrosis factor ligand superfamily member 11 (Rankl) and Cathepsin K (Ctsk) expression. There was an effect in the tartrate-resistant acid phosphatase (TRAP) and alkaline phosphatase (ALP). In the St group, the main effect was observed on the energy (compression and the three-points bending), stiffness, aBMD, BMD, cortical bone area (Ct.Ar), Po.N, trabecular bone volume (BV/TV), Tb.Th and in the mineralization ratio (ѵ1PO4/proline), Runt-related transcription factor 2 (Runx2), Bone morphogenetic protein 2 (Bmp2), Alp, Osteopontin/secreted phosphoprotein 1 (Opn/Spp1), Opg, Tumor necrosis factor receptor superfamily member 11ª (Rank), Rankl, Ctsk expression. There was an effect in the TRAP and ALP. The interaction in the combination of therapies in the Ot + St group was verified in energy to maximum load (compression and three-points bending testing), stiffness, BMD, Ct.Th, J, Tb.Th and ѵ1PO4/proline. In the gene analysis there was interaction in the Runx2, Osterix/Sp7 transcription factor (Osx/Sp7), Bmp2, Alp, Osteocalcin/Bone gamma-carboxyglutamate protein (Ocn/Bglap), Opg, Rankl and Acid phosphatase 5, tartrate resistant (Trap/Acp5) expression. In addition, the combination of OT and ST resulted in a higher maximum load compared to the Veh group, with higher BV/TV than the Ot group, higher Rankl and Ctsk expression than Veh and Ot groups, and lower Po.N and lower activity of TRAP than the other groups. In oxidative stress, total antioxidant capacity (TAC) was lower. These results showed that the combination of interventions is a promising anabolic strategy for the prevention of osteoporosis in the period of periestropause, standing out from the effects of isolated interventions.
Collapse
Affiliation(s)
- Fernanda Fernandes-Breitenbach
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Melise Jacon Peres-Ueno
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Luís Fernando Gadioli Santos
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Victor Gustavo Balera Brito
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Robson Chacon Castoldi
- Postgraduate Program in Movement Sciences, Federal University of Mato Grosso do Sul - UFMS
| | - Mário Jeferson Quirino Louzada
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Antonio Hernandes Chaves-Neto
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil; Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Sandra Helena Penha Oliveira
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil; Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Rita Cássia Menegati Dornelles
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil; Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
| |
Collapse
|
17
|
Yoshida EM, Swain MG, Tsien C, Tam E, Bailey RJ, Grbic D, Hin Ko H, Ramji A, Hilzenrat N, Elkhashab M, Kim E, O’Brien M, Amedeo Puglia M, Peltekian KM. Clinical characterization of patients with primary biliary cholangitis: A report from multiple Canadian centres. CANADIAN LIVER JOURNAL 2022; 5:372-387. [PMID: 36133904 PMCID: PMC9473559 DOI: 10.3138/canlivj-2021-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/15/2022] [Indexed: 08/30/2023]
Abstract
BACKGROUND Primary biliary cholangitis (PBC) is a rare, chronic autoimmune, cholestatic liver disease affecting approximately 318 per million Canadians. There is limited information regarding the characterization of this patient population in Canada. Consequently, we aim to describe a cohort of PBC patients managed across liver centres serving this type of population. METHODS A cross-sectional examination of 1,125 PBC patient charts at 15 liver centres across Canada was conducted between January 2016 and September 2017. RESULTS Data from 1,125 eligible patients were collected from 7 Canadian provinces. The patient population was largely female (90.2%), had a median overall age of 61.3 years, and a median overall time since diagnosis of 6.4 years. Of the patients included in the study, 89% were on ursodeoxycholic acid (UDCA) therapy at a median dose of 14.0 mg/kg/day and 4.4% were previously treated with UDCA, whereas 6.6% were never treated with UDCA. Of the patients with available data (n = 1067), 289 (27.1%) presented with alkaline phosphatase (ALP) levels ≥200 IU/L and/or total bilirubin levels ≥21 µmol/L. Assessment of UDCA treatment response revealed that 26.6% and 38.3% of patients were inadequate responders according to the Toronto and Paris-II criteria, respectively. Mortality occurred in 1.2% (14) of patients, with liver-related adverse outcomes being more commonly observed in patients who discontinued UDCA compared to those who are currently on treatment (36.3% and 19.6%, respectively). CONCLUSION This study showed that Canadian PBC patients present with demographics and features commonly reported in the literature for this disease. Over one third of PBC patients had inadequate response to UDCA treatment or were not currently being treated with UDCA. Consequently, there is a significant unmet therapeutic need in this Canadian PBC population.
Collapse
Affiliation(s)
- Eric M Yoshida
- Department of Medicine, Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark Gordon Swain
- Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Cynthia Tsien
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Edward Tam
- Pacific Gastroenterology Associates, Vancouver, British Columbia, Canada
| | | | - Dusanka Grbic
- CIUSSS de l’Estrie CHUS, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Hin Hin Ko
- Liver Diseases Clinic, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | | | - Nir Hilzenrat
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Magdy Elkhashab
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Euiseok Kim
- Hepatology and Gastroenterology, McMaster University, Hamilton, Ontario, Canada
| | - Meaghan O’Brien
- Division of Digestive Care and Endoscopy, QEII, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Marco Amedeo Puglia
- Division of Digestive Care and Endoscopy, QEII, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Kevork M Peltekian
- Division of Digestive Care and Endoscopy, QEII, Nova Scotia Health, Halifax, Nova Scotia, Canada
| |
Collapse
|
18
|
Obmann VC, Catucci D, Berzigotti A, Gräni C, Ebner L, Heverhagen JT, Christe A, Huber AT. T1 reduction rate with Gd-EOB-DTPA determines liver function on both 1.5 T and 3 T MRI. Sci Rep 2022; 12:4716. [PMID: 35304554 PMCID: PMC8933426 DOI: 10.1038/s41598-022-08659-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/01/2022] [Indexed: 11/10/2022] Open
Abstract
Magnetic resonance T1 mapping before and after Gd-EOB-DTPA administration allows quantification of the T1 reduction rate as a non-invasive surrogate marker of liver function. A major limitation of T1 relaxation time measurement is its dependency on MRI field strengths. Since T1 reduction rate is calculated as the relative shortening of T1 relaxation time before and after contrast administration, we hypothesized that the T1 reduction rate is comparable between 1.5 and 3 T. We thus compared liver T1 relaxation times between 1.5 and 3 T in a total of 243 consecutive patients (124, 1.5 T and 119, 3 T) between 09/2018 and 07/2019. T1 reduction rates were compared between patients with no cirrhosis and patients with cirrhosis Child-Pugh A-C. There was no significant difference of T1 reduction rate between 1.5 and 3 T in any patient group (p-value 0.126-0.861). On both 1.5 T and 3 T, T1 reduction rate allowed to differentiate between patients with no cirrhosis and patients with liver cirrhosis Child A-C (p < 0.001). T1 reduction rate showed a good performance to predict liver cirrhosis Child A (AUC = 0.83, p < 0.001), Child B (AUC = 0.83, p < 0.001) and Child C (AUC = 0.92, p < 0.001). In conclusion, T1 reduction rate allows to determine liver function on Gd-EOB-DTPA MRI with comparable values on 1.5 T and 3 T.
Collapse
Affiliation(s)
- Verena Carola Obmann
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Damiano Catucci
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Annalisa Berzigotti
- Hepatology, Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lukas Ebner
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Johannes Thomas Heverhagen
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Andreas Christe
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland
| | - Adrian Thomas Huber
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland.
| |
Collapse
|
19
|
Khursheed R, Singh SK, Kumar B, Wadhwa S, Gulati M, A A, Awasthi A, Vishwas S, Kaur J, Corrie L, K R A, Kumar R, Jha NK, Gupta PK, Zacconi F, Dua K, Chitranshi N, Mustafa G, Kumar A. Self-nanoemulsifying composition containing curcumin, quercetin, Ganoderma lucidum extract powder and probiotics for effective treatment of type 2 diabetes mellitus in streptozotocin induced rats. Int J Pharm 2022; 612:121306. [PMID: 34813906 DOI: 10.1016/j.ijpharm.2021.121306] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/05/2021] [Accepted: 11/14/2021] [Indexed: 01/06/2023]
Abstract
Liquid self-nanoemulsifying drug delivery system (L-SNEDDS) of curcumin and quercetin were prepared by dissolving them in isotropic mixture of Labrafil M1944CS®, Capmul MCM®, Tween-80® and Transcutol P®. The prepared L-SNEDDS were solidified using Ganoderma lucidum extract, probiotics and Aerosil-200® using spray drying. These were further converted into pellets using extrusion-spheronization. The mean droplet size and zeta potential of L-SNEDDS were found to be 63.46 ± 2.12 nm and - 14.8 ± 3.11 mV while for solid SNEDDS pellets, these were 72.46 ± 2.16 nm and -38.7 ± 1.34 mV, respectively. The dissolution rate for curcumin and quercetin each was enhanced by 4.5 folds while permeability was enhanced by 5.28 folds (curcumin) and 3.35 folds (quercetin) when loaded into SNEDDS pellets. The Cmax for curcumin and quercetin containing SNEDDS pellets was found 532.34 ± 5.64 ng/mL and 4280 ± 65.67 ng/mL, respectively. This was 17.55 and 3.48 folds higher as compared to their naïve forms. About 50.23- and 5.57-folds increase in bioavailability was observed for curcumin and quercetin respectively, upon loading into SNEDDS pellets. SNEDDS pellets were found stable at accelerated storage conditions. The developed formulation was able to normalize the levels of blood glucose, lipids, antioxidant biomarkers, and tissue architecture of pancreas and liver in streptozotocin induced diabetic rats as compared to their naïve forms.
Collapse
Affiliation(s)
- Rubiya Khursheed
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India.
| | - Bimlesh Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Sheetu Wadhwa
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Monica Gulati
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Anupriya A
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Ankit Awasthi
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Sukriti Vishwas
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Jaskiran Kaur
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Leander Corrie
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Arya K R
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Rajan Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Plot No.32-34 Knowledge Park III, Greater Noida, Uttar Pradesh 201310, India
| | - Piyush Kumar Gupta
- Department of Life Sciences, School of Basic Sciences and Research, Sharda University, Plot no. 32 - 34, Knowledge Park III, Greater Noida 201310, Uttar Pradesh, India
| | - Flavia Zacconi
- Departamento de Química Orgánica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Santiago, Chile; Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul, Santiago 7820436, Chile
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia; Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Nitin Chitranshi
- Faculty of Medicine, Health and Human Sciences, Macquarie University, F10A, 2 Technology Place, North Ryde, NSW 2109, Australia
| | - Gulam Mustafa
- Department of Pharmaceutical Sciences, College of Pharmacy, Aldawadmi, Shaqra University, King Saud University
| | - Ankit Kumar
- Amity Institute of Pharmacy, Amity University Madhya Pradesh, Maharajpura, Gwalior, Madhya Pradesh 474005, India
| |
Collapse
|
20
|
Abstract
The liver comprises both parenchymal and non-parenchymal cells with varying functions. Cirrhosis is often complicated by the development of portal hypertension and its associated complications. Hence, assessment of liver in cirrhosis should include assessment of its structural, function of both hepatic and non-hepatic tissue and haemodynamic assessment of portal hypertension. There is no single test that can evaluate all functions of liver and assess prevalence and severity of portal hypertension. Commonly available tests like serum bilirubin, liver enzymes (alanine [ALT] and aspartate aminotransferase [AST], serum alkaline phosphatase [ALP], gamma glutamyl transpeptidase [GGT]), serum albumin and prothrombin time for assessment of liver functions partly assess liver functions. quantitative liver functions like indocyanine clearance tests [ICG-K], methacetin breath test [MBT] were developed to assess dynamic status of liver but has its own limitation and availability. Imaging based assessment of liver by transient elastography, MRI based 99 mTc-coupled asialoglycoprotein mebrofenin scan help the clinician to assess liver function, functional volume of liver left after surgery and portal hypertension [PH]. Hepatic venous pressure gradient still remains the gold standard for the assessment of portal hypertension but is invasive and not available in all centres. Combinations of blood parameters in form of various indices like fibrosis score of 4 [FIB-4], Lok index, scores like model for end stage liver disease (MELD) and Child-Turcotte Pugh score are commonly used for assessing liver function in clinical practice.
Collapse
Key Words
- 99mTc-GSA, technetium-99m galactosyl human serum albumin
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- ARFI, Acoustic Radiation Force Impulse
- AST, aspartate aminotransferase
- BUN, blood urea nitrogen
- CLD, chronic liver disease
- ESLD, end-stage liver disease
- FIB-4, fibrosis score of 4
- GGT, gamma glutamyl transpeptidase
- HVPG, Hepatic venous pressure gradient
- ICG-K, indocyanine clearance tests
- INR, International normalised ratio
- LFTs, liver function tests
- MBT, methacetin breath test
- NAFLD, non-alcoholic fatty liver disease
- PBS, primary biliary cholangitis
- PHT, portal hypertension
- PSC, primary Sclerosing cholangitis
- cirrhosis
- liver function tests
- portal hypertension
Collapse
Affiliation(s)
- Praveen Sharma
- Address for correspondence: Praveen Sharma, Associate Professor, Department of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India.
| |
Collapse
|
21
|
Association of Two Indices of Insulin Resistance Marker with Abnormal Liver Function Tests: A Cross-Sectional Population Study in Taiwanese Adults. Medicina (B Aires) 2021; 58:medicina58010004. [PMID: 35056312 PMCID: PMC8781419 DOI: 10.3390/medicina58010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background and objectives: Insulin resistance (IR) is frequently associated with chronic low-grade inflammation and has an important role as a mediator in the development of liver disease. Thus, this study aimed to explore the relationship between two indexes of IR and abnormal liver function parameters. Materials and Methods: This cross-sectional study obtained data of 41,510 men and 92,357 women aged ≥30 years from a private health screening institute in Taiwan. Two IR indexes namely triglyceride-glucose (TyG) index and triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio were used to examine their relationship to predict abnormal liver function parameters (aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP)). Results: Positive trend was shown for the association of TyG index in the highest quintile (Q5) and risk of high AST (OR = 1.45, 95% CI: 1.33–1.57), high ALT (OR = 1.85, 95% CI: 1.73–1.97), high GGT (OR = 2.04, 95% CI: 1.93–2.15), and high ALP (OR = 1.13, 95% CI: 1.07–1.19) compared with the median quintile (Q3) in the fully adjusted model. Similarly, participants in the Q5 of the TG/HDL-C ratio were associated with 1.38 (95% CI: 1.27–1.49), 1.71 (95% CI: 1.61–1.82), 1.75 (95% CI: 1.66–1.84), and 1.21 (1.16–1.27) odds for having high AST, ALT, GGT, and ALP respectively. The AUC (95% CI) value of the TyG index for predicting high AST, high ALT, and high GGT was 0.699 (0.692–0.705), 0.738 (0.734–0.742), and 0.752 (0.749–0.755), respectively. Meanwhile, the AUC (95% CI) of the TG/HDL-C ratio for predicting high AST, high ALT, and high GGT was 0.680 (0.673–0.686), 0.738 (0.734–0.742), 0.734 (0.731–0.738), respectively. Conclusions: Our study supported that the TyG index and TG/HDL-C ratio may be useful as non-invasive methods to predict the existence of impaired liver function in the early stage.
Collapse
|
22
|
Mihai F, Trifan A, Stanciu C, Huiban L, Muzîca C, Lupașcu-Ursulescu C, Negru D, Savin ML, Gîrleanu I, Cuciureanu T, Sîngeap AM. L3 Skeletal Muscle Index Dynamics in Patients with HCV-Related Compensated Cirrhosis Following Sustained Virological Response after Direct Acting Antiviral Treatment. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111226. [PMID: 34833444 PMCID: PMC8623211 DOI: 10.3390/medicina57111226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/27/2021] [Accepted: 11/08/2021] [Indexed: 02/05/2023]
Abstract
Background and Objectives: Sarcopenia is commonly associated with liver cirrhosis and predicts clinical outcome. Our aim was to identify the changes in skeletal muscle index (SMI) on computed tomography (CT) examination, as a quantitative marker of sarcopenia, in patients with HCV-related cirrhosis after direct acting antivirals (DAAs) treatment and to assess predictive factors for the evolution of SMI. Materials and Methods: This is a single center retrospective study in patients with HCV-related compensated cirrhosis who obtained sustained virological response (SVR) after DAAs. CT examinations were performed in 52 patients before and within 5-24 months after treatment. The total muscle area (TMA) of abdominal muscle at the level of third lumbar vertebra (L3) was measured at baseline and after SVR. The L3-SMI was calculated from TMA divided by body height squared (cm2/m2). We assessed changes in L3-SMI after SVR according to baseline body mass index (BMI) and laboratory data. Predictive factors were assessed by linear regression model. Results: Patients with L3-SMI above the gender-specific cut-off value at baseline had higher values of serum creatinine (median 0.73) compared to patients with low L3-SMI (median 0.68, p = 0.031). After SVR, 14 patients showed increase of L3-SMI, and 38 patients had a decrease of L3-SMI. BMI in the decreased L3-SMI group was significantly lower (median 26.17) than those without decreased L3-SMI (median 28.84, p = 0.021). ALT values in the decreased L3-SMI group (median 66.5) were significantly lower than those without a decrease in L3-SMI (median 88, p = 0.045). Conclusions: Low creatinine serum level correlates with sarcopenia. SMI was partially influenced by the viral clearance. Lower BMI and ALT serum levels at baseline were predictive for no benefit in terms of muscle mass dynamics. Understanding all the mechanisms involved in sarcopenia and identifying the most vulnerable patients could ensure optimal adapted care strategies.
Collapse
Affiliation(s)
- Florin Mihai
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Department of Radiology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Anca Trifan
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
- Correspondence: ; Tel.: +40-762-278-575
| | - Carol Stanciu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Laura Huiban
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Cristina Muzîca
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Corina Lupașcu-Ursulescu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Department of Radiology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Dragoș Negru
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Department of Radiology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Marius Lucian Savin
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Department of Radiology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Irina Gîrleanu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Tudor Cuciureanu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Ana Maria Sîngeap
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (F.M.); (C.S.); (L.H.); (C.M.); (C.L.-U.); (D.N.); (M.L.S.); (I.G.); (T.C.); (A.M.S.)
- Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| |
Collapse
|
23
|
Synergistic Interaction of Dietary Pattern and Concordance Lifestyle with Abnormal Liver Function among Young Adults in Taiwan: A Population-Based Longitudinal Study. Nutrients 2021; 13:nu13103591. [PMID: 34684598 PMCID: PMC8539530 DOI: 10.3390/nu13103591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 01/14/2023] Open
Abstract
While diet and lifestyle are independently implicated in the etiology of liver disease, the interaction of diet and lifestyle may be more helpful for determining the risk of liver abnormality. Thus, our study aimed to evaluate the interaction between the dietary pattern associated with liver biomarkers and lifestyle factors among Taiwanese adults with abnormal liver enzymes. A liver-associated dietary pattern, generated using reduced rank regression, was characterized by high intake of soy sauce or other dips, sugar sweetened beverages, and preserved and processed foods, but low intake of seafood, fruits, eggs, and dark-colored vegetables. In the fully adjusted model, liver-associated dietary patterns or unhealthy concordance lifestyle factors were associated with an increased risk of having liver function abnormality (OR = 1.08, 95% CI: 1.04, 1.12 and OR = 1.42, 95% CI: 1.31, 1.53, respectively). Moreover, the interaction between liver-associated dietary pattern and unhealthy concordance lifestyle factors showed more significant correlation, with an elevated risk of abnormal liver function (OR = 2.14, 95% CI: 2.02, 2.26). Therefore, our study suggests that participants who have a strong liver-associated dietary pattern along with unhealthy concordance lifestyles are likely to have increased odds of abnormal liver function.
Collapse
|
24
|
Lindvig KP, Hansen TL, Madsen BS, Kjaergaard M, Møller L, Detlefsen S, Krag A, Thiele M. Diagnostic accuracy of routine liver function tests to identify patients with significant and advanced alcohol-related liver fibrosis. Scand J Gastroenterol 2021; 56:1088-1095. [PMID: 34415817 DOI: 10.1080/00365521.2021.1929450] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS Alcohol is the leading cause of cirrhosis, but most patients go undetected until decompensation occurs despite frequent contacts with the healthcare system. We aimed to evaluate the diagnostic accuracy of routine liver function tests compared with indirect and direct fibrosis markers and to assess doctors' abilities to diagnose significant and advanced alcohol-related liver fibrosis. METHODS This study was a retrospective evaluation of liver function tests for diagnosing alcohol-related liver disease compared to indirect fibrosis tests, the ELF test, and transient elastography. We also surveyed nine doctors who were presented with 225 patient cases from a cross-sectional, biopsy-controlled, single-centre study that evaluated diagnostic tools for alcohol-related liver fibrosis. The doctors assessed each case for significant (≥F2) or advanced (≥F3) fibrosis. We assessed inter-rater variability with Fleiss' kappa. RESULTS Routine liver function tests had poor diagnostic accuracy (highest area under the ROC curve for platelet count = 0.752) and poor sensitivities (10%-67%) when using the upper or lower normal limits as cut-offs. Indirect fibrosis indices performed significantly better but were still inferior to the ELF test and transient elastography. The nine doctors disagreed substantially in their predictions, with Fleiss' kappa of 0.24 (95% CI0.22-0.26) and 0.51 (0.44-0.55) for significant and advanced fibrosis. All nine doctors exhibited poor case-finding abilities with sensitivities of 22-93%. CONCLUSIONS When using routine liver function tests, doctors may fail to diagnose more than half of all alcohol-overusing patients with advanced fibrosis, probably because they rely on upper and lower normal limits of routine liver function tests.
Collapse
Affiliation(s)
- Katrine P Lindvig
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Open Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Thor L Hansen
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Open Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Bjørn S Madsen
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Open Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Maria Kjaergaard
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Open Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Linda Møller
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sönke Detlefsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Aleksander Krag
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Maja Thiele
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Open Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| |
Collapse
|
25
|
Lin CY, Adhikary P, Cheng K. Cellular protein markers, therapeutics, and drug delivery strategies in the treatment of diabetes-associated liver fibrosis. Adv Drug Deliv Rev 2021; 174:127-139. [PMID: 33857552 DOI: 10.1016/j.addr.2021.04.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/18/2021] [Accepted: 04/08/2021] [Indexed: 02/08/2023]
Abstract
Liver fibrosis is the excessive accumulation of extracellular matrix due to chronic injuries, such as viral infection, alcohol abuse, high-fat diet, and toxins. Liver fibrosis is reversible before it progresses to cirrhosis and hepatocellular carcinoma. Type 2 diabetes significantly increases the risk of developing various complications including liver diseases. Abundant evidence suggests that type 2 diabetes and liver diseases are bidirectionally associated. Patients with type 2 diabetes experience more severe symptoms and accelerated progression of live diseases. Obesity and insulin resistance resulting from hyperlipidemia and hyperglycemia are regarded as the two major risk factors that link type 2 diabetes and liver fibrosis. This review summarizes possible mechanisms of the association between type 2 diabetes and liver fibrosis. The cellular protein markers that can be used for diagnosis and therapy of type 2 diabetes-associated liver fibrosis are discussed. We also highlight the potential therapeutic agents and their delivery systems that have been investigated for type 2 diabetes-associated liver fibrosis.
Collapse
|
26
|
Buchanan R, Sinclair JMA. Alcohol use disorder and the liver. Addiction 2021; 116:1270-1278. [PMID: 32710592 DOI: 10.1111/add.15204] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/19/2020] [Accepted: 07/17/2020] [Indexed: 12/23/2022]
Abstract
Alcohol use disorders (AUD) cause a range of physical harms, but the major cause of alcohol-related mortality is alcohol-related liver disease (ALD), in some countries accounting for almost 90% of alcohol-related deaths. The risk of ALD has an exponential relationship with increasing alcohol consumption, but is also associated with genetic factors, other life-style factors and social deprivation. ALD includes a spectrum of progressive pathology, from liver steatosis to fibrosis and liver cirrhosis. There are no specific treatments for liver cirrhosis, but abstinence from alcohol is key to limit progression of the disease. Over time, cirrhosis can progress (often silently) to decompensated cirrhosis and hepatocellular carcinoma (HCC). Liver transplantation may be suitable for patients with decompensated liver cirrhosis and may also be used as a curative intervention for HCC, but only for a few selected patients, and complete abstinence is a prerequisite. Patients with AUD are also at risk of developing alcoholic hepatitis, which has a high mortality and limited evidence for effective therapies. There is a strong evidence base for the effectiveness of psychosocial and pharmacological interventions for AUD, but very few of these have been trialled in patients with comorbid ALD. Integrated specialist alcohol and hepatology collaborations are required to develop interventions and pathways for patients with ALD and ongoing AUD.
Collapse
Affiliation(s)
- Ryan Buchanan
- Department of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Julia M A Sinclair
- Department of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| |
Collapse
|
27
|
Association between Dietary Patterns and Serum Hepatic Enzyme Levels in Adults with Dyslipidemia and Impaired Fasting Plasma Glucose. Nutrients 2021; 13:nu13030987. [PMID: 33803758 PMCID: PMC8003213 DOI: 10.3390/nu13030987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 12/17/2022] Open
Abstract
We investigated the association between dietary patterns and serum hepatic enzyme levels in adults with dyslipidemia and impaired fasting glucose in Taiwan. A total of 15,005 subjects (5452 men and 9553 women) aged 35–69 years were selected. Two major dietary patterns were identified by principal component analysis: Western dietary pattern and Mediterranean dietary pattern. Subjects in the highest quartile (Q4) of the Western dietary pattern showed an increased risk of elevated serum alanine aminotransferase (ALT) levels (OR: 1.24, 95% CI: 1.06–1.45, p-trend = 0.01). Fur-thermore, in the highest quartile of the Western dietary pattern, subjects with high waist circum-ference were observed to have a greater risk for developing abnormal serum ALT levels compared to those in the lowest quartile (Q1) (OR: 1.43, 95% CI: 1.04–1.97, p-trend = 0.01). In the highest quartile of the Western dietary pattern, only women were at an increased risk for having abnormal serum ALT levels (OR: 1.28, 95% CI: 1.04–1.59, p-trend = 0.03). By contrast, in the highest quartile of the Mediterranean dietary pattern, only men were at a reduced risk for having abnormal serum gamma-glutamyl transferase (GGT) levels (OR: 0.72, 95% CI: 0.53–0.97, p-trend = 0.048). We report a positive association between the Western dietary pattern and abnormal serum ALT levels.
Collapse
|
28
|
Le BH, Aggarwal G, Douglas C, Green M, Nicoll A, Ahmedzai S. Oxycodone/naloxone prolonged-release tablets in patients with moderate-to-severe, chronic cancer pain: Challenges in the context of hepatic impairment. Asia Pac J Clin Oncol 2021; 18:13-18. [PMID: 33660420 DOI: 10.1111/ajco.13561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 12/29/2020] [Indexed: 01/13/2023]
Abstract
Opioids such as oxycodone are recommended in the management of moderate-to-severe, chronic cancer pain. All opioids can potentially cause constipation, which may be a significant barrier to their use. Multiple randomised clinical trials have shown that the use of naloxone as a peripherally acting mu-opioid receptor antagonist, in combination with oxycodone can prevent or reduce opioid-induced constipation while having equivalent analgesic efficacy to oxycodone alone. However, clinical experience has shown that unexpected events may occur in some patients when unrecognized liver impairment is present. We describe the underlying biological reasons and propose simple, but effective steps to avoid this unusual but potentially serious occurrence. In healthy individuals, naloxone undergoes extensive hepatic first pass metabolism resulting in low systemic bioavailability. However, in patients with hepatic impairment, porto-systemic shunting can increase systemic bioavailability of naloxone, potentially compromising the analgesic efficacy of oral naloxone-oxycodone combinations. This reduced first pass effect can occur in a range of settings that may not always be apparent to the treating clinician, including silent cirrhosis, non-cirrhotic portal hypertension and disruption of liver internal vasculature by metastases. Hepatic function test results correlate poorly with presence and extent of liver disease, and are not indicative of porto-systemic shunting. Presence of hepatic impairment should thus be considered when medication-related outcomes with oxycodone-naloxone combination are not as expected, even if liver function test results are normal.
Collapse
Affiliation(s)
- Brian H Le
- The Royal Melbourne Hospital, Parkville Integrated Palliative Care Service, Victoria, Australia.,Department of Medicine, The University of Melbourne, Victoria, Australia
| | - Ghauri Aggarwal
- Concord Hospital, Concord Centre for Palliative Care, New South Wales, Australia
| | - Carol Douglas
- Royal Brisbane and Women's Hospital Health Service, Palliative Care, Queensland, Australia
| | - Michael Green
- Department of Medicine, The University of Melbourne, Victoria, Australia.,Sunshine Hospital, Medical Oncology, Victoria, Australia.,Peter MacCallum Cancer Centre, Medical Oncology, Melbourne, Victoria, Australia
| | - Amanda Nicoll
- Box Hill Hospital, Gastroenterology, Victoria, Australia
| | - Sam Ahmedzai
- The University of Sheffield, Oncology, Western Bank, Sheffield, UK
| |
Collapse
|
29
|
Luan D, Zhao Z, Xia D, Zheng Q, Gao X, Xu K, Tang B. Hydrogen selenide, a vital metabolite of sodium selenite, uncouples the sulfilimine bond and promotes the reversal of liver fibrosis. SCIENCE CHINA. LIFE SCIENCES 2021; 64:443-451. [PMID: 32880866 DOI: 10.1007/s11427-019-1761-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/20/2020] [Indexed: 11/26/2022]
Abstract
Sodium selenite has alleviating effects on liver fibrosis; however, its therapeutic molecular mechanism remains unclear. Herein, hydrogen selenide, a major metabolite of Na2SeO3, was tested to uncouple the sulfilimine bond in collagen IV, the biomarker of liver fibrosis. A mouse model of liver fibrosis was constructed via a CCl4-induced method, followed by the administration of 0.2 mg kg-1 Na2SeO3 via gavage three times per week for 4 weeks. Changes in H2Se, NADPH, and H2O2 levels were monitored in real time by using NIR-H2Se, DCI-MQ-NADPH, and H2O2 probes in vivo, respectively. H2Se continuously accumulated in the liver throughout the Na2SeO3 treatment period, but the levels of NADPH and H2O2 decreased. The expression of collagen IV was analyzed through Western blot and liquid chromatography-mass spectrometry. Results confirmed that the sulfilimine bond of collagen IV in the fibrotic mouse livers could be broken by H2Se with the Na2SeO3 treatment. Therefore, the therapeutic effect of Na2SeO3 on liver fibrosis could be mainly attributed to H2Se that uncoupled the sulfilimine bond to induce collagen IV degradation. This study provided a reasonable explanation for the molecular mechanism of the in vivo function of Na2SeO3 and the prevention of liver fibrosis by administering inorganic selenium.
Collapse
Affiliation(s)
- Dongrui Luan
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Molecular and Nano Science, Shandong Normal University, Jinan, 250014, China
| | - Zengteng Zhao
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Molecular and Nano Science, Shandong Normal University, Jinan, 250014, China
| | - Dandan Xia
- Department of Pharmaceutical Analysis, School of Pharmacy, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Qiuling Zheng
- Department of Pharmaceutical Analysis, School of Pharmacy, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Xiaonan Gao
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Molecular and Nano Science, Shandong Normal University, Jinan, 250014, China
| | - Kehua Xu
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Molecular and Nano Science, Shandong Normal University, Jinan, 250014, China.
| | - Bo Tang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institute of Molecular and Nano Science, Shandong Normal University, Jinan, 250014, China
| |
Collapse
|
30
|
Anticandidal efficacy of Brassica juncea seeds extract: characterization, in vitro and in vivo studies. ADVANCES IN TRADITIONAL MEDICINE 2021. [DOI: 10.1007/s13596-020-00440-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
31
|
Tarapure S, Tubaki BR, Khot S. Elastographic liver evaluation of Katukyadi churna in the management of Non-Alcoholic Steatohepatitis (NASH) - A single arm clinical trial. J Ayurveda Integr Med 2021; 12:136-142. [PMID: 33579578 PMCID: PMC8039359 DOI: 10.1016/j.jaim.2020.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 12/31/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023] Open
Abstract
Non Alcoholic Steatohepatitis (NASH) is the most severe histological form of non-alcoholic fatty liver disease (NAFLD). It progress to cirrhosis in 20% population and 40% will have death due to liver pathology. Still consensus on pharmacotherapy is yet to be evolved and till date there is no US FDA approved drug for NASH. Ayurveda formulation Katukyadi churna is explored in the possible management of NASH. Study is a single arm with pre and post test design. Sonologically diagnosed patients of fatty liver (n = 30) were screened. 11 patients meeting elastoghraphic criteria (6.4-11.7 kPa) were enrolled in the study. K. churna was administered in the dose of 6 g twice a day with water at the middle of the meal for a period of 6 months. Subjective parameters were Aruchi (Anorexia), Agnimandhya (loss of appetite), Ajeerna (indigestion), Gouravata. Follow up assessments were done on every 30th day. Study showed that K. churna produced significant improvement in various parameters. Significant decrease in weight, (p < 0.001), BMI (p < 0.001), Elastography (p = 0.001), total bilirubin (p = 0.02), Alanine Aminotransferase (ALT) (p < 0.001), Aspartate Aminotransferase (AST) (p = 0.001), Albumin (p = 0.04), Triglycerides (p = 0.005) were observed. Subjective symptoms like Ajeerna (p = 0.002), Agnimandhya (p = 0.004), Arochaka (p = 0.001), Gouvravata (p = 0.002) showed significant improvement. K. churna showed clinical significance in terms of improvement from pathological ranges to normative ranges in elastography, total bilirubin, AST, Albumin. K. churna reduced weight, BMI, hardness and stiffness of the liver, liver function derangements, triglycerides and improved other subjective clinical parameters. Drug has promising results in NASH and warrants further studies.
Collapse
Affiliation(s)
- Shruti Tarapure
- Department of Kayachikitsa, Seth Govindji Raoji Ayurved Medical College, Solapur, Maharashtra, 413001, India
| | - Basavaraj R Tubaki
- Department of Kayachikitsa, Shri BMK Ayurveda Mahavidyalaya, A Constituent Unit of KLE Academy of Higher Education & Research, Belagavi, Karnataka, India.
| | - Siddhi Khot
- Department of Kayachikitsa, Shri BMK Ayurveda Mahavidyalaya, A Constituent Unit of KLE Academy of Higher Education & Research, Belagavi, Karnataka, India
| |
Collapse
|
32
|
Eltellawy YA, El-Kayal M, Abdel-Rahman RF, Salah S, Shaker DS. Optimization of transdermal atorvastatin calcium - Loaded proniosomes: Restoring lipid profile and alleviating hepatotoxicity in poloxamer 407-induced hyperlipidemia. Int J Pharm 2020; 593:120163. [PMID: 33309831 DOI: 10.1016/j.ijpharm.2020.120163] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/28/2020] [Accepted: 12/05/2020] [Indexed: 01/22/2023]
Abstract
In an attempt to optimize the anti- hyperlipidemic effect and reduce statins induced hepatotoxicity, Atorvastatin Calcium (ATC) transdermal proniosomal gel (PNG) was developed. Different non-ionic surfactants (NISs) (Spans, Tweens, Cremophor RH 40 and Brij 52) were incorporated in the vesicle's lipid bilayer, in combination with lecithin. PNG formulae were characterized for encapsulation efficiency percent (% EE), vesicle size, polydispersity index (PDI) and zeta potential (ZP). Ex-vivo permeation study was performed using full thickness rat skin measuring drug flux and skin permeability coefficients. The pharmacodynamic performance of optimized transdermal ATC- PNG on both lipid profile and liver biomarkers was assessed and compared to oral ATC administration in poloxamer 407-induced hyperlipidemic rats. The liver tissues were subjected to histological examination as well. The results revealed nano-size range vesicles with relatively high ATC entrapment efficiency. Ex-vivo results demonstrated the permeation superiority of ATC proniosomes over free drug. Pharmacodynamic study revealed that transdermal administration of ATC- PNG succeeded in retaining the anti-hyperlipidemic efficacy of orally administered ATC without elevating liver biomarkers. The histological examination signified the role of optimized ATC-PNG in hindering statin- induced hepatocellular damage. The obtained results suggested a promising, easy-to-manufacture and effective ATC proniosomal gel for safe treatment of hyperlipidemia.
Collapse
Affiliation(s)
- Yasmin A Eltellawy
- Department of Pharmaceutics & Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt (FUE), Cairo, Egypt.
| | - Maha El-Kayal
- Department of Pharmaceutics & Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt (FUE), Cairo, Egypt
| | | | - Salwa Salah
- Department of Pharmaceutics & Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
| | - Dalia S Shaker
- Department of Pharmaceutics & Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt (FUE), Cairo, Egypt.
| |
Collapse
|
33
|
Emu M, Kamal FB, Choudhury S, Alves de Oliveira TE. Assisting the Non-invasive Diagnosis of Liver Fibrosis Stages using Machine Learning Methods. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:5382-5387. [PMID: 33019198 DOI: 10.1109/embc44109.2020.9176542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Fibrosis is a significant indication of chronic liver diseases often due to hepatitis C Virus. It is becoming a global concern as a result of the rapid increase in the number of HCV infected patients, the high cost and flaws associated with the assessment process of liver fibrosis. This study aims to determine the features that significantly contribute to the identification of the stages of liver fibrosis and to generate rules to assist physicians during the treatment of the patients as a clinically non-invasive approach. Also, the performance of different Multi-layered Perceptron (MLP), Random Forest, and Logistic Regression classifiers are estimated and compared for the full and reduced feature sets. Decision Tree produced 28 rules in contrast with previous research work where 98002 rules had been generated from the same dataset with an accuracy rate of approximately 99.97%. The resulting rules of this study achieved a prediction accuracy for the histological staging of liver fibrosis of 97.45%. Among all the machine learning methods, MLP achieved the highest accuracy rate.
Collapse
|
34
|
El-Ashmawy NE, Al-Ashmawy GM, Fakher HE, Khedr NF. The role of WNT/β-catenin signaling pathway and glutamine metabolism in the pathogenesis of CCl 4-induced liver fibrosis: Repositioning of niclosamide and concerns about lithium. Cytokine 2020; 136:155250. [PMID: 32882667 DOI: 10.1016/j.cyto.2020.155250] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Liver fibrosis is a serious health problem which may lead to advanced liver cirrhosis and hepatocellular carcinoma. OBJECTIVE The present study aimed to investigate the role of Wnt/β-catenin signaling pathway and glutamine aminohydrolase enzyme (l-glutaminase) in the pathogenesis of liver fibrosis and the potential benefits of niclosamide in treating liver fibrosis. METHODS Ninety male Albino rats were divided into 6 equal groups (n = 15) as follows: a normal control group (NC), CCl4-only treated group (Fib.) which received 1 mg/kg CCl4 two times weekly, niclosamide-treated group (Niclo.) which received 5 mg/kg of niclosamide one time daily, lithium chloride-treated group (LiCl) which received 100 mg/kg of LiCl one time daily, niclosamide-and-CCl4-treated group (Niclo. + Fib.) which received same doses of niclosamide and CCl4 given to other groups, and finally lithium chloride-and-CCl4-treated rat group (LiCl + Fib.) which received same doses of LiCl and CCl4 given to other groups. All treatments were administered orally for 8 weeks. Liver tissue was assessed for l-hydroxyproline, beta-catenin (β-catenin), l-glutaminase activity, as well as the gene expression of transforming growth factor beta-1 (TGF-β1) and Dishevelled-2 (Dvl2). Histopathological and immunohistochemical analyses of alpha smooth muscle actin α-SMA were performed. Serum alanine transaminase (ALT), aspartate transaminase (AST), and total bilirubin were measured. RESULTS The group of niclosamide-and-CCl4-treated rats showed a significant decrease in total bilirubin, ALT and AST, β-catenin, l-hydroxyproline, l-glutaminase activity, and gene expression of TGF-β1 and Dvl2. Moreover, the liver tissue in this group of rats showed mild α-SMA reactivity compared with the rats treated with CCl4 only (fibrosis group). On the other hand, lithium chloride-and-CCl4-treated rats showed a significant increase in liver indices, TGF-β1 expression, β-catenin, l-hydroxyproline, and l-glutaminase activity with severe α-SMA reactivity and apoptosis in the liver tissue. CONCLUSIONS Niclosamide protected rats against liver fibrosis by inhibiting the Wnt/β-catenin pathway and glutaminolysis.
Collapse
Affiliation(s)
- Nahla E El-Ashmawy
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Postal code: 31527, Egypt
| | - Ghada M Al-Ashmawy
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Postal code: 31527, Egypt
| | - Hoda E Fakher
- Department of Biochemistry, Faculty of Pharmacy, Menoufia University, Postal code: 32511, Egypt.
| | - Naglaa F Khedr
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Postal code: 31527, Egypt
| |
Collapse
|
35
|
Providing Care for Fatty Liver Disease Patients: Primary Care Nurse Practitioners' Knowledge, Actions, and Preparedness. Gastroenterol Nurs 2020; 43:E184-E189. [PMID: 32889968 DOI: 10.1097/sga.0000000000000487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The increasing prevalence of nonalcoholic fatty liver disease requires primary care providers to serve on the front lines of care for patients with nonalcoholic fatty liver disease. Knowledge gaps regarding nonalcoholic fatty liver disease exist among primary care physicians, but it is unknown whether primary care nurse practitioners demonstrate similar gaps because they are under-represented in the literature. The purpose of this study was to evaluate primary care nurse practitioners' clinical approaches regarding nonalcoholic fatty liver disease, their knowledge regarding diagnosis and management, and their preparedness level regarding care for patients with nonalcoholic fatty liver disease. Adequate knowledge was demonstrated in some, but not all, areas. The knowledge did not necessarily translate into clinical practice behaviors, however. In addition, only 35% of the participants agreed that they felt prepared to care for patients with nonalcoholic fatty liver disease. Implications are limited by the small sample size but provide some insight into primary care nurse practitioners' preparedness to care for this important epidemic.
Collapse
|
36
|
Oh SK, Lim BG, Kim YS, Kim SS. Comparison of the Postoperative Liver Function Between Total Intravenous Anesthesia and Inhalation Anesthesia in Patients with Preoperatively Elevated Liver Transaminase Levels: A Retrospective Cohort Study. Ther Clin Risk Manag 2020; 16:223-232. [PMID: 32308400 PMCID: PMC7147612 DOI: 10.2147/tcrm.s248441] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 03/23/2020] [Indexed: 12/22/2022] Open
Abstract
Background Anesthesia and surgery may deteriorate liver function in patients with elevated liver enzyme levels; therefore, in these patients, choosing anesthetics with less hepatotoxicity is important. Methods This retrospective study investigated the effect of total intravenous anesthesia (TIVA) versus inhalation anesthesia (INHA) on the postoperative liver function in patients with preoperatively elevated liver enzyme levels (aspartate transaminase [AST] or alanine transaminase [ALT] >40 U/L) who underwent non-hepatic surgery under general anesthesia. We compared the changes in enzyme levels within 24 hrs before and after surgery. Results In 730 patients (TIVA: n=138; INHA: n=592), the baseline characteristics were comparable, except for higher comorbidity rates in the TIVA group. The median anesthesia and operation times were significantly longer in the TIVA group because approximately 50% of the TIVA group (vs 19.7% of the INHA group) underwent neurosurgery, which had a relatively longer operation time than other surgeries. Intraoperative hypotensive events and vasopressor use were more frequent in the TIVA group. After 1:4 propensity score matching (TIVA: n=94; INHA: n=376), the baseline characteristics and surgical variables were comparable, except for longer anesthesia time. Before matching, postoperative AST and ALT changes were significantly lower in the TIVA group than in the INHA group. After matching, only the ALT change was significantly lower after TIVA than after INHA [median (interquartile range), -16.7 (-32 to -4) % vs -12.0 (-28.6-6.5) %, P=0.025]. Conclusion TIVA may be safer for patients with preoperatively elevated liver transaminase levels.
Collapse
Affiliation(s)
- Seok Kyeong Oh
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Byung Gun Lim
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young Sung Kim
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seong Shin Kim
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
37
|
Gatsou Djibersou D, Rosnay Tietcheu Galani B, Dieudonne Djamen Chuisseu P, Yanou Njintang N. Anti-oxidant and anti-inflammatory potential of aqueous extracts of leaves, barks and roots of Bixa orellana L. (Bixaceae) on acetaminophen-induced liver damage in mice. AVICENNA JOURNAL OF PHYTOMEDICINE 2020; 10:428-439. [PMID: 32850299 PMCID: PMC7430966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Bixa orellana is a plant from the Bixaceae family, for which, limited information is available on hepatoprotective properties. This study aimed at evaluating the protective effects of this plant on sub-acute acetaminophen (APAP)-induced liver injury in mice. MATERIALS AND METHODS Various aqueous extracts were prepared from roots, leaves, and barks. Albino mice were divided into six groups: a control group, an APAP group; a silymarin group (positive control) and three test groups. Mice were treated orally with APAP (250 mg/kg) followed 3 hr later by plant extracts, silymarin (50 mg/kg) or distilled water (10 ml/kg) administration once daily, for seven days. After treatment, animals were sacrificed, the liver was collected and different biochemical parameters were measured. Histological analyses were performed using hematoxylin/eosin staining and the qualitative phytochemical content of plant extracts was evaluated using conventional methods. RESULTS Administration of B. orellana barks decoction (250 mg/kg) significantly reduced alanine aminotransferase levels (p<0.001), unlike leaves and roots extracts. Moreover, the bark infusion had the highest activity compared to macerate and decoction. It significantly reduced malondialdehyde levels (p<0.001) and increased the levels of glutathione, superoxide dismutase and catalase, at doses of 250 and 500 mg/kg compared to the APAP group. A significant (p<0.001) decrease of tumor necrosis factor-α levels and leukocyte infiltration was found following treatment with bark infusion. The infusion content evaluation revealed the presence of polyphenols, saponins, tannins, sterols, anthraquinones, and coumarins and the absence of alkaloids. CONCLUSION These results show that infusion from B. orellana barks is hepatoprotective against APAP-induced toxicity via antioxidant and anti-inflammatory mechanisms.
Collapse
Affiliation(s)
- David Gatsou Djibersou
- Laboratory of Applied Biochemistry, Department of Biological Sciences, Faculty of Science, University of Ngaoundere, PO Box 454 Ngaoundere, Adamawa, Cameroon
| | - Borris Rosnay Tietcheu Galani
- Laboratory of Applied Biochemistry, Department of Biological Sciences, Faculty of Science, University of Ngaoundere, PO Box 454 Ngaoundere, Adamawa, Cameroon,Corresponding Author: Tel: +237 698615724,
| | | | - Nicolas Yanou Njintang
- Laboratory of Applied Biochemistry, Department of Biological Sciences, Faculty of Science, University of Ngaoundere, PO Box 454 Ngaoundere, Adamawa, Cameroon
| |
Collapse
|
38
|
Shim S, Won S, Reza A, Kim S, Ahn S, Jung B, Yoon B, Ra C. In Vivo Toxicity and In Vitro Solubility Assessment of Pre-Treated Struvite as A Potential Alternative Phosphorus Source in Animal Feed. Animals (Basel) 2019; 9:ani9100785. [PMID: 31614549 PMCID: PMC6826386 DOI: 10.3390/ani9100785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/07/2019] [Accepted: 10/07/2019] [Indexed: 12/29/2022] Open
Abstract
Apart from using as fertilizer for plants, the application of struvite may be expanded to animal feed industries through proper pre-treatment. This study aimed to investigate the safety and efficacy of using pre-treated struvite (microwave irradiated struvite (MS) and incinerated struvite (IS)) in animal feeds. For safety assessment, an in vivo toxicity experiment using thirty female Sprague Dawley rats (average body weight (BW) of 200 ± 10 g) was conducted. The rats were randomly divided into five groups, including a control. Based on the BW, MS and IS were applied daily by oral administration with 1 and 10 mg kg-1-BW (MS1 and MS10; IS1 and IS10) using dimethyl sulfoxide (DMSO) as a vehicle. A series of jar tests were conducted for four hours to check the solubility of the MS and IS at different pH (pH 2, 4, and 5) and compared to a commercial P source (monocalcium phosphate, MCP, control). The toxicity experiment results showed no significant differences among the treatments in BW and organ (liver, kidney, heart, and lung) weight of rats (p > 0.05). There were no adverse effects on blood parameters and the histopathological examination showed no inflammation in the organ tissues in MS and IS treated groups compared to the control. In an in vitro solubility test, no significant difference was observed in ortho-phosphate (O-P) solubility from the MCP and MS at pH 2 and 4 (p > 0.05), while O-P solubility from MS at pH 5 to 7 was higher than MCP and found to be significantly different (p < 0.05). O-P solubility from IS was the lowest among the treatments and significantly different from MCP and MS in all the experiments (p < 0.05). The results of this study not only suggest that the struvite pre-treated as MS could be a potential alternative source of P in animal feed but also motivate further studies with more stringent designs to better examine the potential of struvite application in diverse fields.
Collapse
Affiliation(s)
- Soomin Shim
- Department of Animal Industry Convergence, College of Animal Life Sciences, Kangwon National University, Chuncheon 24341, Korea.
| | - Seunggun Won
- Department of Animal Resources, College of Life and Environmental Science, Daegu University, Gyeongsan 38453, Korea.
| | - Arif Reza
- Department of Animal Industry Convergence, College of Animal Life Sciences, Kangwon National University, Chuncheon 24341, Korea.
- Department of Environmental Science, College of Agricultural Sciences, IUBAT-International University of Business Agriculture and Technology, Dhaka 1230, Bangladesh.
| | - Seungsoo Kim
- Department of Animal Industry Convergence, College of Animal Life Sciences, Kangwon National University, Chuncheon 24341, Korea.
| | - Sungil Ahn
- Department of Animal Industry Convergence, College of Animal Life Sciences, Kangwon National University, Chuncheon 24341, Korea.
| | - Baedong Jung
- Department of Veterinary Science, Kangwon National University, Chuncheon 24341, Korea.
| | - Byungil Yoon
- Department of Veterinary Science, Kangwon National University, Chuncheon 24341, Korea.
| | - Changsix Ra
- Department of Animal Industry Convergence, College of Animal Life Sciences, Kangwon National University, Chuncheon 24341, Korea.
| |
Collapse
|
39
|
Nerdy N, Ritarwan K. Hepatoprotective Activity and Nephroprotective Activity of Peel Extract from Three Varieties of the Passion Fruit ( Passiflora Sp.) in the Albino Rat. Open Access Maced J Med Sci 2019; 7:536-542. [PMID: 30894908 PMCID: PMC6420947 DOI: 10.3889/oamjms.2019.153] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The Passion Fruit (Passiflora sp.) that grows in the Indonesian region generally has three varieties, namely purple passion fruit (Passiflora edulis Sims.), red passion fruit (Passiflora ligularis Juss.), and yellow passion fruit (Passiflora verrucifera Lindl.). The passion fruit peel is an economic waste that has not been utilised optimally, but has many efficacious phytochemical contents. AIM The objectives of this research are to examine scientifically hepatoprotective activity (with paracetamol-induced hepatotoxic) and nephroprotective activity (with gentamicin-induced nephrotoxic) from three varieties of the passion fruit (purple passion fruit peel extract, red passion fruit peel extract and yellow passion fruit peel extract) in the albino rat (Rattus norvegicus). METHODS Three varieties of passion fruit peels were extracted by maceration method. The experimental animals used were the albino rat (Rattus norvegicus). Hepatoprotective activity was done by the liver biochemical (alanine transaminase and aspartate transaminase) analysis with paracetamol (hepatotoxic compound) induced after 10 days of treatment with extract. Nephroprotective activity was done by the kidney biochemical (urea and creatinine) analysis with gentamicin (nephrotoxic compound) induced after 10 days of treatment with extract. RESULTS The hepatoprotective activity for positive control was similar to the 250 mg of purple passion fruit peel extract per kg of body weight, 250 mg of red passion fruit peel extract per kg of body weight, and 500 mg of yellow passion fruit peel extract per kg of body weight. The nephroprotective activity for positive control (50 mg of silymarin per kg of body weight) was similar to the 250 mg of purple passion fruit peel extract per kg of body weight, 500 mg of red passion fruit peel extract per kg of body weight, and 500 mg of yellow passion fruit peel extract per kg of body weight. CONCLUSIONS The extracts were shown hepatoprotective activity and nephroprotective activity with a dose-dependent activity. The hepatoprotective activity and nephroprotective activity of purple passion fruit peel extract were the best compared to red passion fruit peel extract and yellow passion fruit peel extract.
Collapse
Affiliation(s)
- Nerdy Nerdy
- Department of Pharmacy, Academy of Pharmacy Yayasan Tenaga Pembangunan Arjuna, Pintubosi, Laguboti, Toba Samosir, Sumatera Utara, 22381, Indonesia
| | - Kiking Ritarwan
- Department of Neurology, Faculty of Medicine, University of Sumatera Utara, Padang Bulan, Medan Baru, Medan, Sumatera Utara, 20155, Indonesia
| |
Collapse
|