Liver histopathological and oxidative stress assessment by a combination of formaldehyde and oxytetracycline in sea bass (Dicentrarchuslabrax L)

Background

Formaldehyde (FA) and oxytetracycline (OTC) are the chemicals commonly used in aquaculture to prevent or treat fish diseases due to protozoa, parasites, and bacteria.

Aim

The goal of the present study is to assess the liver injury and oxidative stress induced by exposure of sea bass (Dicentrarchuslabrax L) to therapeutic doses of FA (200 ml.m-3) and OTC (40 g.m-3) under the same conditions being applied in intensive aquaculture systems in Tunisia.

Methods

The liver histopathological survey was achieved after 5 and 10 days of exposure to FA, OTC separately or mixed. In parallel, liver catalase activity and malondialdehyde (MDA) were measured to assess oxidative stress.

Results

Results showed that treatment with FA and OTC used alone or in combinations induced liver damage as measured by sinusoid dilatation, intensive vacuolization, blood congestion, and focal necrosis. Significant elevation in catalyze activity and MDA levels were also observed in liver homogenates by the treatment (p ≤ 005).

Conclusion

Combined treatment induced higher effects suggesting the critical hazards associated with FA and OTC when released to the environment.

Histopathological changes and oxidative stress associated with Fascioliasis in bovines

Fascioliasis, a prevalent disease in livestock globally, is primarily caused by the trematode parasites Fasciola hepatica and Fasciola gigantica. This parasitic infection leads to significant economic repercussions. In this study, our objective was to gain insight into the pathophysiological consequences of Fascioliasis in cattle through the evaluation of metabolic, oxidative stress, and histological parameters. A thorough investigation was carried out on the liver of 197 bovines after their slaughter, which unveiled the occurrence of Fascioliasis, with a prevalence rate of 13.2% observed. The bovine that were infected exhibited notable increase in serum transaminases (ALT, AST, and ALP) and malondialdehyde (MDA) and catalase (CAT) while the decrease in glutathione (GSH) and superoxide dismutase (SOD) levels. The lipid profile analysis of infected cattle revealed alterations in the cholesterol and triglyceride levels. Moreover, the histopathological examination revealed a range of hepatic lesions associated with Fascioliasis, including necrosis, inflammation, fibrosis, and proliferative alterations. The bile ducts also displayed distinct pathological changes, including hyperplasia, thickening, and edema, and harbored various developmental stages of Fasciola spp. highlighting the parasitic infestation's effects on the biliary system. These results highlight the serious effects of Fascioliasis on lipid metabolism and the oxidative damage that is induced in the livers of cattle. Thus, Fasciola infestation in bovine causes alteration in biochemical and antioxidant activities, which are considered as important factors in the diagnosis of Fascioliasis.

Serum HBV RNA levels among untreated adults with chronic hepatitis B in distinct immune phases and liver histopathology statuses

HBV RNA is a novel serum biomarker that reflects intrahepatic HBV covalently closed circular DNA (cccDNA) transcription activity. Serum HBV RNA levels among treatment-naïve adults during the natural history of chronic hepatitis B (CHB) and distinct liver histopathology statuses remain elusive. In our study, we include a total of 411 treatment-naïve CHB patients, among which 43 patients were HBeAg-positive immune-tolerant [IT(e+)], 84 patients were HBeAg-positive immune active [IA(e+)], 65 patients in HBeAg-negative immune active phases [IA(e-)], 149 patients were HBeAg-negative inactive phases [IC(e-)], and 70 patients were in Gray Zone (GZ). HBV RNA was measured in this cohort and its potential correlation with traditional serological markers and liver histopathology were analyzed. Our data showed that HBV RNA was strongly correlated with HBV DNA, HBeAg, HBsAg and ALT. Further subgroup analysis revealed a close correlation between HBV RNA and HBV DNA in patients in the IA (e+) and IA (e-) phases, but neither in IT(e+) nor IC(e-) phase. HBV RNA levels were consistently increased with the advanced degrees of hepatic inflammation, but not hepatic fibrosis. Of note, HBV RNA from HBeAg-positive patients negatively correlated with liver fibrosis, whereas HBV RNA from HBeAg-negative patients was weakly associated with liver inflammation. To sum up, serum HBV RNA shows a distinct profile among CHB patients in different immune statuses and hepatic histopathology stages/grades. Simultaneous testing of HBV RNA and traditional indicators might provide a comprehensive clinical assessment of CHB patients.

Histopathology and antibody responses describe the seasonal pattern of dicrocoeliosis in small ruminants in the Himalayan ranges of Pakistan

In some parts of the world, Dicrocoelium spp. lancet flukes cause significant production loss in pastoral livestock, and accurate diagnosis of infection is important. The aims of the present study were to describe the histopathology and to investigate the transmission patterns of Dicrocoelium amongst ten sheep and goat farms in Khyber Pakhtunkhwa and Gilgit Baltistan, Pakistan. The liver histology and indirect enzyme-linked immunosorbent assay (ELISA) analyses followed standard procedures. The liver histopathology showed intensive tissue destruction and biliary hyperplasia associated with presence of adult flukes, severe inflammatory cell infiltration, congestion of blood vessels, damaged hepatocytes, and sinusoids in the infected areas. The time of onset of infection was investigated by ELISA detection of antibodies in sheep (n = 164) and goats (n = 152). Colostral transfer of Dicrocoelium antibodies from seropositive mothers was detected in sheep and goats up to 16 weeks of age. In both sheep and goats, the estimated time of infection differed between farms and years. Infection was seen in both sheep flocks and goat herds, with high variation between flocks and herds, and the highest infection rate in lambs. Dicrocoelium infection was most prevalent in sheep and goats in September (n = 84) and August (n = 63) respectively. This study concluded Dicrocoelium causes severe inflammation and necrosis of liver tissues in sheep and goats. Colostral transfer of antibodies can be detected up to about ten weeks of age. Higher infection rates are observed during August and September in sheep than in goats, putatively due to effects of different grazing and browsing behaviors on the ingestion of ants. The results will aid in the development of effective disease control strategies to ensure optimal growth and productivity of sheep and goats.

Vibration-controlled Transient Elastography for Assessment of Liver Fibrosis at a USA Academic Medical Center

BACKGROUND AND AIMS

Vibration-controlled transient elastography (VCTE) is a noninvasive tool that uses liver stiffness measurement (LSM) to assess fibrosis. Since real-life data during everyday clinical practice in the USA are lacking, we describe the patterns of use and diagnostic performance of VCTE in patients at an academic medical center in New York City.

METHODS

Patients who received VCTE scans were included if liver biopsy was performed within 1 year. Diagnostic performance of VCTE in differentiating dichotomized fibrosis stages was assessed via area under the receiver operating characteristics (AUROC). Fibrosis stage determined from VCTE LSM was compared to liver biopsy.

RESULTS

Of 109 patients, 49 had nonalcoholic fatty liver disease, 16 chronic hepatitis C, 15 congestive hepatopathy, and 22 at least two etiologies. AUROC was 0.90 for differentiating cirrhosis (stage 4) with a positive predictive value (PPV) range of 0.28 to 0.45 and negative predictive value range of 0.96 to 0.98. For 31 (32%) patients, VCTE fibrosis stage was at least two stages higher than liver biopsy fibrosis stage. Thirteen of thirty-five patients considered to have cirrhosis by VCTE had stage 0 to 2 and 12 stage 3 fibrosis on liver biopsy.

CONCLUSIONS

VCTE has reasonable diagnostic accuracy and is reliable at ruling out cirrhosis. However, because of its low PPV, caution must be exercised when used to diagnose cirrhosis, as misdiagnosis can lead to unnecessary health care interventions. In routine practice, VTCE is also sometimes performed for disease etiologies for which it has not been robustly validated.

Pathological findings in the postmortem liver of patients with coronavirus disease 2019 (COVID-19)

Although coronavirus disease 2019 (COVID-19) is transmitted via respiratory droplets, there are multiple gastrointestinal and hepatic manifestations of the disease, including abnormal liver-associated enzymes. However, there are not many published articles on the pathological findings in the liver of patients with COVID-19. We collected the clinical data from 17 autopsy cases of patients with COVID-19 including age, sex, Body mass index (BMI), liver function test (alanine aminotransaminase (ALT), aspartate aminotransaminase (AST), alkaline phosphatase (ALP), direct bilirubin, and total bilirubin), D-dimer, and anticoagulation treatment. We examined histopathologic findings in postmortem hepatic tissue, immunohistochemical (IHC) staining with antibody against COVID-19 spike protein, CD68 and CD61, and electron microscopy. We counted the number of megakaryocytes in liver sections from these COVID-19-positive cases. Abnormal liver-associated enzymes were observed in 12 of 17 cases of COVID-19 infection. With the exception of three cases that had not been tested for D-dimer, all 14 patients' D-dimer levels were increased, including the cases that received varied doses of anticoagulation treatment. Microscopically, the major findings were widespread platelet-fibrin microthrombi, steatosis, histiocytic hyperplasia in the portal tract, mild lobular inflammation, ischemic-type hepatic necrosis, and zone 3 hemorrhage. Rare megakaryocytes were found in sinusoids. COVID-19 IHC demonstrates positive staining of the histiocytes in the portal tract. Under electron microscopy, histiocyte proliferation is present in the portal tract containing lipid droplets, lysosomes, dilated ribosomal endoplasmic reticulum, microvesicular bodies, and coronavirus. The characteristic findings in the liver of patients with COVID-19 include numerous amounts of platelet-fibrin microthrombi, as well as various degrees of steatosis and histiocytic hyperplasia in the portal tract. Possible mechanisms are also discussed.

1: Liver histopathology

Within the framework of the international project DAIMON (Decision Aid for Marine Munitions), the impact of dumped chemical munitions on fish health was investigated. The Skagerrak Straight (North Sea, at 600 m depth) contains munitions with chemical warfare agents (CWA), scuttled after the end of World War II. Studies of liver histopathology in Atlantic hagfish (Myxine glutinosa) were carried out at three sampling sites: at a wreck with CWA in the Skagerrak (n = 82), a Skagerrak reference site considered to be free of CWA (n = 14) and at a reference site in the northern North Sea outside the Skagerrak (n = 17). Liver lesions were diagnosed and categorized according to standardized ICES and BEQUALM protocols and OSPAR guidelines. Non-specific liver lesions were found in 87.6% of 113 hagfish examined. The prevalence of pre-neoplastic lesions was 7.1% and of neoplastic lesions 6.2%. There was no statistically significant difference in prevalence between hagfish samples from the wreck site and from the reference site near the wrecks. However, at the reference site in the northern North Sea, the prevalence of non-specific lesions was low and neither pre-neoplastic nor neoplastic lesions were observed.

Analysis of pathological changes and related factors in liver tissue of HBeAg-negative patients with low HBsAg levels

The relationship between pathological changes in liver tissue and the level of hepatitis B surface antigen (HBsAg) remains unclear. This study aimed to analyze the pathological changes in liver tissue and its related factors in patients with low-level HBsAg in order to provide a basis for judging the condition of these patients. A retrospective study was performed on 96 chronic hepatitis B patients with HBsAg levels < 1400 IU/ml and > 0.05 IU/ml. The histopathological examination of these patients was conducted. Univariate and multivariate analyses were used to determine risk factors for pathological changes. Among the 96 patients, 57.3% (55) had inflammatory events ≥ G2 and 33.4% (33) had fibrosis ≥ S2. HBV infection duration (p = 0.001) and splenic vein diameter (p = 0.001) were independent risk factors of liver inflammation (≥ G2) in patients with low-level HBsAg, while AST (p = 0.006) and PLT (p = 0.005) were independent risk factors of liver fibrosis (≥ S2). Moreover, HBV infection duration (p < 0.001) and spleen vein (p = 0.001) were independent factors of potential antiviral treatment. Liver inflammation and fibrosis are still common in patients with low-level HBsAg; thus, the monitoring and appropriate antiviral treatment cannot be ignored.

Long-term effects of one-anastomosis gastric bypass on liver histopathology in NAFLD cases: a prospective study

PURPOSE

Weight reduction can effectively improve nonalcoholic fatty liver disease (NAFLD), which is a constant companion of severe obesity. This study aimed to determine the effect of one-anastomosis gastric bypass (OAGB) on pathological liver changes in severely obese cases with NAFLD.

METHODS

The present prospective research comprised 67 subjects with morbid obesity scheduled for OAGB during the period from February 2015 to August 2018. Clinical, biological, and histologic data were evaluated pre and 15 months postoperatively.

RESULTS

Fifteen months after surgery, a considerable reduction was noted in the grades of fat deposition, liver cell ballooning, and lobular inflammatory changes, in addition to the total NAS score. Fifteen months after surgery, nonalcoholic steatohepatitis (NASH) disappeared in 42% of the patients. A significant regression of fibrosis stage occurred after surgery in 79.1% of patients (p < 0.001). After surgery, patients had substantial reductions in aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, HbA1c, total cholesterol, and Low-density lipoprotein (p < 0.001, for all comparisons). Diabetes mellitus, hypertension, and dyslipidemia resolved in 54%, 59%, and 69% of the patients, respectively.

CONCLUSION

OAGB resolved NASH from nearly 42% of patients and reduced the histological features of NAFLD 15 months after surgery. Bariatric procedures might be adopted as a therapeutic modality in severely obese cases with NAFLD after the failure of lifestyle modifications.

Evaluation of histophysiological alterations associated with ketoprofen administration in albino NMRI mice

The aim of this study was to investigate the changes caused by the administration of ketoprofen to albino NMRI mice on some hematological, biochemical, and structural parameters. For this purpose, the mice were divided into two lots: a control batch and an experimental batch to which ketoprofen was administered subcutaneously at a dose of 10 mg/kg body weight per day for 7 days. A decrease in erythrocyte number and hemoglobin was observed altogether with the increase in white blood cells. Blood biochemistry indicates increased blood glucose, cholesterol, and triglyceride levels. Enzyme values (AST, ALT, and ALP) show a significant increase. Hepatic pathology reveals the enlargement of sinusoidal capillaries, the presence of leukocyte infiltrates associated with necrosis zones.

Assessment of histological liver alterations in dogs naturally infected with Leishmania infantum

Background

The liver plays a central role in the development of canine visceral leishmaniasis. Studies of natural infection in animals and humans indicate a direct relationship between resolution of infection and the formation and maturation of granulomas in the liver. However, in contrast to other reports in the literature, the present study found no differences in the characteristics of hepatic granulomas that could be related to resistance or susceptibility to Leishmania. Here, we describe the hepatic alterations observed in dogs with differing clinical manifestations of visceral leishmaniasis in an endemic area in the state of Bahia, Brazil.

Methods

We examined 148 animals in an endemic area. The animals were clinically examined, and the infection was determined by ELISA, spleen aspirate culture and quantitative PCR. The animals were grouped into asymptomatic or symptomatic based on the number of signs of LV. The histological liver evaluation was performed in a blinded way.

Results

Our results indicated no association between the characteristics of granulomas and clinical presentation. We found an association between the intensity of this inflammatory response and parasite load in the animals’ spleens. It is important to note that while hepatic alterations, such as portal and perivascular inflammation and the presence of larger amounts of granulomas, were linked with higher parasite loads, we found the inverse to be true with respect to intrasinusoidal lymphocytosis, the formation of intrasinusoidal inflammatory cell aggregates and Kupffer cell hypertrophy.

Conclusions

Our findings suggest that the presence of mononuclear inflammatory cells inside the sinusoids is more important than that of organized granulomas in terms of the containment of parasitism by the host. We suggest that the presence of granulomas indicates the failure of a first line of defense mechanism in the control of parasite infection, which could be related to the presence of inflammatory cells and Kupffer cell hypertrophy inside the sinusoids. We further demonstrated that dogs with active Leishmania spp. infection present a higher frequency of inflammatory changes in the liver. In addition to being correlated with the severity of clinical manifestation, these hepatic alterations were also associated with changes in hematological and biochemical parameters.

Toxicity of dietary selenomethionine in juvenile steelhead trout, Oncorhynchus mykiss: tissue burden, growth performance, body composition, hematological parameters, and liver histopathology

The steelhead trout (Oncorhynchus mykiss) is the species most at risk from selenium (Se) exposure in the San Francisco Bay Delta (SFBD). However, although steelhead trout are usually exposed to environmental Se in the juvenile stage, data to test their sensitivity to excess Se, especially its organic form, in the juvenile stage are scarce. Therefore, the objective of the current study was to assess the sensitivity of juvenile steelhead trout to ecologically relevant forms of Se using integrated sensitive endpoints. Fish (mean weight: 22.3 g) were fed one of five diets containing 1.1 (control), 8.8, 15.4, 30.8, and 61.6 μg Se/g diet dw (Se1.1, Se8.8, Se15.4, Se30.8, and Se61.6, respectively) in the form of selenomethionine for 4 weeks. After 4 weeks, Se significantly accumulated in a dose-dependent manner in all tissues at different rates. The growth rate and plasma cholesterol were significantly depressed in fish fed diets containing Se30.8 and above. Hematological parameters and mortality were significantly elevated in fish fed the Se61.6 diet. Marked histopathological alterations were observed in fish fed the Se8.8 diet (the lowest observed effect concentration, LOEC) and above. The current results suggest that the steelhead trout is more sensitive to excess Se than nonanadromous rainbow trout used in previous studies because of its lower LOEC despite the use of selenomethionine and the shorter experimental duration. Additionally, it should be noted that the current Se levels found in the SFBD are already a threat to the threatened population of steelhead trout on the central California coast.

Dynamics of thymol dietary supplementation in quail (Coturnix japonica): Dataset on thymol bioavailability, egg yolk fatty acids profile and performance traits

Dietary supplementation with thymol (2-isopropyl-5-methylphenol) has been proposed as a strategy to improve modern intensive poultry production. Moreover, its antioxidant properties and potential beneficial influence on lipid metabolism have fostered current research focusing on enhancing nutritional quality of meat and egg products. In general, studies have focused on the overall effects of dietary supplementation once the supplementation protocol has finished and using only one potential dose, without actually measuring bioactive compounds' concentration in the diet supplied or target tissues. Herein, we provide a unique dataset of the dynamics of thymol bioavailability and biological action, optimal dosage and duration of supplementation needed to achieve meaningful effects, as well as persistence of induced changes after chronic supplement withdrawal. Specifically, during a month-long supplementation period, 5 sampling points were evaluated separated by at least 1 week. Then, a last sampling point was studied after a 3-week withdrawal period. Three increasing doses of dietary thymol were used, and approximately 80 variables assessed. The measured variables were associated with free thymol concentration in feed, egg yolk and droppings, feed and egg yolk fatty acids profile (saturated, unsaturated, and polyunsaturated fatty acids), performance traits (body weight, feed intake, egg laying rate, egg physical characteristics), general welfare quality assessment (plumage state) and liver histopathology. The data can provide insights on the link between the dynamics of free thymol concentration and the changes in fatty acids profile in quail egg yolk, both during chronic thymol dietary supplementation and after supplement withdrawal. The comprehensive approach used herein for studying thymol supplementation outcome could help understanding the scope of its effects on a whole organism level.

Effects of Supplemental Epigallocatechin Gallate in the Diet of Broilers Exposed to Fluoride Intoxication

We evaluated the effects of dietary epigallocatechin gallate (EGCG) on the performance, biochemical parameters, and liver histopathology of fluoride-intoxicated broiler chickens. In total, 160 1-day-old male broiler chicks (Ross PM3 strain) were collected and assigned to four groups (40 animals each), with four replicates. The control group received a basal diet; the F group received 800 mg/kg fluoride; the EGCG group received 400 mg/kg EGCG; and the EGCG+F group received 400 mg/kg EGCG and 800 mg/kg fluoride. The live weight (LW) of F-treated chicks was significantly lower than that of the controls. In the F-treated groups, feed intake (FI) and LW values were lower, but the feed conversion ratio (FCR) was higher than those of the controls. The ratio of heart weight to LW was found to be the highest in the F-treated groups. Alkaline phosphatase (ALP), aspartate aminotransferase (AST), and total oxidant status (TOS) levels in the F-treated groups were significantly higher, whereas the increase in total cholesterol levels was insignificant than those in the control group. In the EGCG+F group, AST, total cholesterol, and TOS levels decreased to a level comparable to those in the control group. Histopathological evaluation revealed that there were mild changes in the portal region in the EGCG+F group; additionally, there was an improvement in liver morphology in the EGCG+F group compared to that in the F group. Thus, EGCG has potent antioxidant and regenerative effects that can ameliorate the detrimental effects of fluoride toxicity on blood parameters and the liver.

Behavior and histopathology as biomarkers for evaluation of the effects of paracetamol and propranolol in the neotropical fish species Phalloceros harpagos

Pharmaceutical drugs in the aquatic environment can induce adverse effects on nontarget organisms. This study aimed to assess the short-term effects of sublethal concentrations of both paracetamol and propranolol on the fish Phalloceros harpagos, specifically light/dark preference, swimming patterns, skin pigmentation, histopathology, and liver glycogen levels. Fish were acutely exposed to sublethal concentrations of both paracetamol (0.008, 0.08, 0.8, 8, 80 mg L^-1) and propranolol (0.0001, 0.001, 0.01, 0.1, 1 mg L^-1) under controlled conditions. For scototaxis, a significant preference for the dark compartment was observed for the group exposed to the highest concentration of paracetamol (80 mg L^-1). Propranolol exposure significantly altered the swimming pattern, especially in fish exposed to the 0.001 mg L^-1 concentration. Pigmentation was reduced in propranolol-exposed fish (0.1, 1 mg L^-1). The lowest concentration of propranolol (0.0001 mg L^-1) induced a decrease of histochemical reaction for hepatic glycogen. These data demonstrate that pharmaceuticals can induce sublethal effects in nontarget organisms, even at low concentrations, compromising specific functions of the individual with ecological relevance, such as energy balance and behavior.

Bone marrow-derived mesenchymal stem cells ameliorate liver injury in a rat model of sepsis by activating Nrf2 signaling

Sepsis is a fatal condition that leads to serious systemic inflammation and multiple organ dysfunction syndromes. This study was designed to investigate the possible therapeutic effect of bone marrow-derived mesenchymal stem cells (BMSCs) on sepsis-induced liver injury. We also aimed to examine the role of Nrf2 activation in modulating the response to sepsis following BMSCs treatment. Twenty-four adult male albino rats were assigned to: control, lipopolysaccharide (LPS) and LPS-stem cell groups. Liver samples were processed for light and electron microscope examinations. Immunohistochemical localization of BAX, proliferating cell nuclear antigen and nuclear factor-erythroid 2-related factor 2 (Nrf2) was carried out. Liver homogenates were prepared for assessment of reduced glutathione, glutathione peroxidase, tumor necrosis factor-alpha and interleukin-6 and also real-time PCR analysis of Nrf2 expression. BMSCs treatment improved the histopathological changes of the liver, enhanced tissue regeneration and decreased apoptosis following sepsis. We reported highly significant enhancement in Nrf2 expressions at mRNA and protein levels in the LPS-stem cell group compared with the LPS group. The up regulation of Nrf2 was probably implicated in decreasing inflammatory cytokine levels and counteracting oxidative stress induced by sepsis. Thus, BMSCs therapies could be a viable approach to treat sepsis-induced liver damage by activating Nrf2 signaling.

Biochemical and morphological biomarkers of the liver damage in the Neotropical fish, Piaractus mesopotamicus, injected with crude extract of cyanobacterium Radiocystis fernandoi

Cyanobacterial proliferation in river and lakes is the result of eutrophication. The cyanobacterium Radiocystis fernandoi strain R28 produces mostly two MC variants MC-RR and MC-YR and small amounts of other oligopeptides, but does not produce MC-LR. The present study investigated the hepatotoxic potential of the crude extract of the R. fernandoi strain R28 on the Neotropical fish, Piaractus mesopotamicus, at 3, 6, and 24 h after intraperitoneal injection (100 μg MC-LR equivalent per kg^-1 body mass) using biochemical and morphological biomarkers of liver damage. Although the protein phosphatases PP1 and PP2A were not inhibited during the 24-h treatment, liver parenchyma and hepatocyte structure were disrupted. Alkaline phosphatase increased at 3 h post-injection and decreased after 24 h; alanine aminotransferase and aspartate aminotransferase increased in a time-dependent manner up to 24 h indicating impaired liver function. Progressive histopathological changes were consistent with biochemical results demonstrating alterations in liver structure and function. In conclusion, the crude extract of R. fernandoi strain R28 has high hepatotoxic potential and can severely compromise fish health.

Epidemiologic features of 348 children with hepatitis C virus infection over a 30-year period: a nationwide survey in Japan

BACKGROUND

Although the epidemiology of hepatitis C virus (HCV) infection among children may be rapidly changing, few reports have characterized large nationwide cohorts of children with HCV infection. We, therefore, sought to clarify the epidemiology and natural history of HCV infection in Japanese children born over the last three decades.

METHODS

Sixty-five pediatric centers retrospectively and prospectively recruited consecutive, otherwise-healthy HCV-infected children born during 1986 to 2015.

RESULTS

Entry criteria were met by 348 children. Age at initial diagnosis of infection has decreased significantly in recent years. Cirrhosis and hepatocellular carcinoma were not identified. Prevalence of spontaneous clearance and of interferon treatment with/without ribavirin were 9 and 54%, respectively. Maternal transmission has increased significantly, representing over 99% of cases in the last decade. No transfusion-related cases have been seen after 1994. HCV genotype 2 has increased to become the most prevalent in Japanese children. Histopathology examination of liver specimens showed no or mild fibrosis in most children with chronic hepatitis C; none showed cirrhosis.

CONCLUSIONS

This largest nationwide cohort study of Asian children with HCV infection spanned the last three decades. None of these Japanese children developed cirrhosis or hepatocellular carcinoma. Maternal transmission increased to account for 99% of cases during the last decade. Genotype 2 now is most prevalent in these children. Histopathologically, most children with chronic hepatitis C showed mild fibrosis or none.

Liver histopathology and biochemical biomarkers in Gobius niger and Zosterisessor ophiocephalus from polluted and non-polluted Tunisian lagoons (Southern Mediterranean Sea)

The aim of this study was to appraise the response of a multi-marker approach in fish species, Gobius niger and Zosterisessor ophiocephalus, in a polluted lagoon (Bizerte lagoon: MB and ML sites) and in a reference site (Ghar-El-Melh lagoon entrance) by the analysis of physiological indexes, liver histopathology and some biochemical biomarkers. The results showed liver hypertrophy in fish collected from Bizerte lagoon as well as many non-specific lesions, unlike the reference site. All Bizerte lagoon sites had the same prevalence of histopathological lesions, but the mean intensity (MI) of parasites seemed to be more sensible as an indicator of pollution levels. Indeed, parasite MI was more important in MB site that has a higher pollution level. Also, biochemical biomarkers showed an induction in Bizerte lagoon sites with some differences within sites and species. The impact of the continuous release of pollution on the biomarker's response is discussed.

[Correlation of liver stiffness measured by FibroTouch and FibroScan with Ishak fibrosis score in patients with chronic hepatitis B]

Objective: To investigate the correlation of liver stiffness measured by FibroTouch (FT) and FibroScan (FS) with Ishak fibrosis score in patients with chronic hepatitis B. Methods: A total of 313 patients with chronic hepatitis B who visited Department of Liver Cirrhosis in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from November 2014 to May 2016 were enrolled. All the patients underwent liver biopsy, and FT and FS were used to determine liver stiffness measurement (LSM). Serum biochemical parameters were measured, and the aspartate aminotransferase-to-platelet ratio index (APRI) in a multi-parameter model of liver fibrosis and fibrosis-4 (FIB-4) index were calculated. The consistency between the results of four noninvasive examinations and Ishak fibrosis score was compared. The t-test was used for comparison of LSM determined by FT and FS. Pearson correlation analysis was used investigate the correlation between LSM determined by FT and FS; Spearman correlation analysis was used to investigate the correlation of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels and Knodell score with LSM determined by FT and FS; the correlation between LSM determined by FT and FS and fibrosis stage was analyzed by partial correlation analysis adjusted by Knodell score for liver inflammatory activity; Spearman correlation analysis was used for APRI, FIB-4, and fibrosis stage. Based on the Ishak fibrosis score, the receiver operating characteristic (ROC) curve was used to analyze the values of four noninvasive methods in the diagnosis of liver fibrosis. Results: There was no significant difference in LSM measured by FT and FS in all patients (15.75±9.42 kPa vs 15.42±10.52 kPa, P > 0.05) and Pearson correlation analysis indicated a significant positive correlation between them (r = 0.858, P < 0.01); serum ALT and AST levels and liver inflammatory activity were correlated with LSM determined by FT and FS. There was a significant positive correlation between LSM determined by FT and FS and fibrosis stage (r = 0.501 and 0.526, both P < 0.001), and APRI and FIB-4 were also positively correlated with fibrosis stage (r = 0.236 and 0.218, both P < 0.001). Based on the Ishak fibrosis score, in the diagnosis of fibrosis stages F3, F4, F5, and F6, the areas under the ROC curve were 0.915/0.856/0.839/0.816 for FT, 0.933/0.883/0.849/0.856 for FS, 0.618/0.630/0.608/0.638 for APRI, and 0.614/0.624/0.595/0.649 for FIB-4, and FT and FS had a significantly larger areas under the ROC curve than APRI and FIB-4. Conclusion: LSM determined by FT or FS has a good correlation with the Ishak fibrosis score, so FT and FS have a significantly better diagnostic performance for liver fibrosis than APRI and FIB-4.

Aqueous calyxes extract of Roselle or Hibiscus sabdariffa Linn supplementation improves liver morphology in streptozotocin induced diabetic rats

BACKGROUND AND STUDY AIMS

The complex series of deleterious events among diabetes patients leads to multiple organ failure. Therefore, a holistic approach of treatment is urgently required to prevent worsening of complications. The present investigation was carried out to study the possible protective effects of Roselle or Hibiscus sabdariffa Linn (HSL) calyxes aqueous extract, as an antidiabetic and antioxidant agent against oxidative liver injury in streptozotocin-induced diabetic rats.

MATERIAL AND METHODS

A single dose of streptozotocin (45mg/kg body weight, iv) was used to induced diabetes in male Sprague Dawley rats which were then divided into two groups: Diabetic control (DC) and HSL-treated diabetic (DR) group. Normal rats were divided into normal control (NC), HSL-treated control (NR). Aqueous calyxes extract of HSL (100mg/kg/day, orally) was given for 28 consecutive days in the treated group. Weight, biochemical and histopathological (light and electron microscopic) parameters were compared in all groups.

RESULTS

Supplementation of HSL significantly lowered the level of fasting blood glucose and increased plasma insulin level in DR group compared to DC group (p<0.05). Alanine aminotransaminases and aspartate aminotransferase enzymes level were found to be significantly reduced in DR compared to DC. Microscopic examination demonstrated destruction of the liver architecture, cytoplasmic vacuolation of the hepatocytes and signs of necrosis in diabetic rats. Moreover, dilatation and congestion of blood vessels with leucocytes adherence were detected. Ultrastructural study using electron microscope showed homogeneous substance accumulation in nuclear chromatin, a decrease of organelles and mitochondrial degeneration in the diabetic rats.

CONCLUSION

Administration of HSL in diabetic rats causes significant decrease in hepatocyte destruction and prevented the changes associated with the diabetic condition. Thus, our findings provide a scientific rationale for the use of HSL as promising agent in preventing liver injury in diabetes.

A pathological scoring system in the diagnosis and judgment of prognosis of biliary atresia

OBJECTIVE

The purpose of this study was to evaluate the diagnostic and prognostic value of a histological scoring system in biliary atresia (BA).

METHODS

From June 2013 to July 2014, 86 wedge liver biopsy specimens were obtained from infants with neonatal cholestasis (58 patients with biliary atresia and 28 patients with non-obstructive cholestasis as control) in our center. A pathologist, single-blinded to the final diagnosis, made the histological diagnosis individually based on an 8-feature (liver fibrosis, portal ductal proliferation, bile plugs in portal ductules, cholestasis, hepatocellular changes inflammatory cells infiltration in portal region, extramedullary hematopoiesis, and ductal plate malformation), 21-point (0 to 21) scoring system.

RESULTS

In this retrospective study, ductular reaction (bile ductular proliferation) and liver fibrosis in the portal area, bile plugs, and ductal plate malformation were the best indicators of BA. With the scoring system, a score of ≥8 had the best diagnostic utility to differentiate BA from other intrahepatic cholestasis histologically (sensitivity 94.7%, specificity 86.2%, accuracy 91.9%). Liver fibrosis and ductal plate malformation were confirmed to be related with the prognosis.

CONCLUSIONS

An 8-feature, 21-point histological scoring system has a good diagnostic accuracy in the interpretation of liver histology in neonatal cholestasis. The use of liver fibrosis and ductal plate malformation are also feasible to assess the prognosis.

Ecological risk assessment of impacted estuarine areas: integrating histological and biochemical endpoints in wild Senegalese sole

The analysis of multiple biomarker responses is nowadays recognized as a valuable tool to circumvent potential confounding factors affecting biomonitoring studies and allows a better understanding of the mechanisms underlying exposure to natural mixtures of toxicants. For the purpose of an environmental risk assessment (ERA) in an impacted estuary in SW Europe (the Sado, Portugal), juvenile Solea senegalensis from commercial fishing areas were surveyed for histopathological liver alterations and biochemical biomarkers. Although the findings revealed moderate differences in the patterns of histopathological traits between urban/industrial- and agricultural-influenced areas within the same estuary, no significant distinction was found between the cumulative alterations in animals from the two sites. The overall level of histopathological injury was low and severe traits like neoplasms or pre-neoplastic foci were absent. While metallothionein induction and lipid peroxidation could relate to histopathological condition indices, the activity of anti-oxidant enzymes appeared to be impaired in animals collected off the estuary's heavy-industry belt (the most contaminated site), which may partially explain some degree of hepatic integrity loss. Overall, the results are consistent with low-moderate contamination of the estuary and indicate that oxidative stress is the most important factor accounting for differences between sites. The study highlights the need of integrating multiple biomarkers when multiple environmental stressors are involved and the advantages of surveying toxicity effects in field-collected, foraging, organisms.

Pathological characteristics of chronic hepatitis B in HBeAg-positive and HBeAg-negative patients: An analysis of 158 cases

AIM: To find the differences in liver histopathology between HBeAg-positive and HBeAg -negative patients with chronic hepatitis B (CHB), and to analyze their relationship with clinical data.

METHODS: CHB patients ( n = 158) who were admitted to the Second Hospital of Hebei Medical University for a liver biopsy from January 2005 to December 2012 were enrolled. They were divided into an HBeAg-positive ( n = 86) and an HBeAg-negative group ( n = 72) based on the presence of HBeAg or not. Gender, age, alanine aminotransferase (ALT) and HBV DNA viral load were recorded and statistically analyzed with SPSS l3.0.

RESULTS: The age differed significantly between the HBeAg-positive group and HBeAg-negative group (t = -7.50, P < 0.01), although there was no statistically significant difference in sex ratio between the two groups (χ² = 0.10, P > 0.05). A significant difference was noted in the constituent ratio of liver fibrosis stages between the two groups (χ² = 20.79, P < 0.01). The fibrosis stage score in HBeAg-positive women was lower than that in men (1.48 ± 0.69 vs 2.09 ± 1.29, P < 0.05). For HBeAg-positive patients, both inflammation grade and fibrosis stage scores were significantly higher in the > 40 years age group than in the 30-40 years age group and < 30 years age group (2.93 ± 1.03 vs 2.09 ± 1.27, 2.16 ± 0.69; 2.67 ± 1.23 vs 1.86 ± 1.25, 1.65 ± 0.99, all P < 0.05). For HBeAg-negative patients, fibrosis stage score was significantly lower in the < 30 years age group than in the 30-40 years age group and > 40 years age group (1.57 ± 0.98 vs 2.73 ± 1.37, 3.03 ± 1.06, both P < 0.05). In the HBeAg-positive group, there was a positive correlation between age and inflammation grade or fibrosis stage score (r = 0.30, 0.34, both P < 0.01). In the HBeAg-negative group, there was also a positive correlation between age and inflammation grade or fibrosis stage score (r = 0.26, 0.34, both P < 0.05). In the HBeAg-positive group, ALT levels were positively correlated with inflammation grade or fibrosis stage score (r = 0.32, 0.24, both P < 0.05). In the HBeAg-negative group, ALT levels were positively correlated inflammation grade score (r = 0.33, P < 0.01). There was a significant difference in the constituent ratio of viral load between the two groups of patients (χ² = 38.63, P < 0.01). The positive rate of HBV DNA was significantly higher in the HBeAg-positive group (73/86) than in the HBeAg-negative group (37/72). In the HBeAg-positive group, viral load was negatively correlated with inflammation grade score (r = -0.25, P < 0.05). In the HBeAg-negative group, viral load was positively correlated with inflammation grade or fibrosis stage score (r = 0.40, 0.43, both P < 0.05).

CONCLUSION: There is a certain correlation between gender, age, ALT and HBV DNA viral load and liver pathological changes in both HBeAg-positive and -negative CHB patients. Liver injury may sometimes be heavier in HBeAg-negative CHB patients than in HBeAg-positive CHB patients.

Analysis of the histologic features in the differential diagnosis of intrahepatic neonatal cholestasis

AIM: To compare the histologic features of the liver in intrahepatic neonatal cholestasis (IHNC) with infectious, genetic-endocrine-metabolic, and idiopathic etiologies.

METHODS: Liver biopsies from 86 infants with IHNC were evaluated. The inclusion criteria consisted of jaundice beginning at 3 mo of age and a hepatic biopsy during the 1st year of life. The following histologic features were evaluated: cholestasis, eosinophilia, giant cells, erythropoiesis, siderosis, portal fibrosis, and the presence of a septum.

RESULTS: Based on the diagnosis, patients were classified into three groups: group 1 (infectious; n = 18), group 2 (genetic-endocrine-metabolic; n = 18), and group 3 (idiopathic; n = 50). There were no significant differences with respect to the following variables: cholestasis, eosinophilia, giant cells, siderosis, portal fibrosis, and presence of a septum. A significant difference was observed with respect to erythropoiesis, which was more severe in group 1 (Fisher’s exact test, P = 0.016).

CONCLUSION: A significant difference was observed in IHNC of infectious etiology, in which erythropoiesis was more severe than that in genetic-endocrine-metabolic and idiopathic etiologies, whereas there were no significant differences among cholestasis, eosinophilia, giant cells, siderosis, portal fibrosis, and the presence of a septum.

Comparative analysis of peripheral T-cell subsets and liver histopathology in asymptomatic hepatitis B virus carriers

AIM: To investigate the influences of serum hepatitis B virus DNA and HBeAg levels on the function of cellular immunity and the changes of liver histopathology in asymptomatic chronic HBV carriers, and to explore the mechanism involved in it.

METHODS: Peripheral T-cell subsets were determined in 109 asymptomatic chronic HBV carriers and 40 normal controls by flow cytometry. Of the 109 carriers, histopathological examinations were performed in 28 ones. HBV markers were detected by enzyme linked immunosorbent assay (ELISA), and serum HBV DNA levels were measured by polymerase chain reaction (PCR).

RESULTS: The rates of CD3+ and CD4+ cells and the value of CD4+/CD8+ were significantly reduced in HBV carriers as compared with those in the normal controls (67.2%±9.0% vs 71.0%±3.5%, P < 0.05; 33.1%±6.6% vs 40.3%±2.8%, P < 0.001; 1.1%±0.36 vs 2.01±0.19, P < 0.001), and the rate of CD8+ cells was significantly increased (33.8±8.4% vs 20.2±1.9%, P < 0.001). The rates of CD3+ cells in HBV DNA(+) and in HBeAg(+) carriers showed no significant difference from those of HBV DNA(-) and HBeAg(-) carriers, respectively; However, the rate of CD4+ cells (31.2±6.3% vs 37.2±5.4%, P < 0.001; 31.0±6.0% vs 35.8±6.5%, P < 0.001) and the value of CD4+/CD8+ (0.91±0.32 vs 1.35±0.26, P < 0.001; 0.89±0.30 vs 1.26±0.33, P < 0.001) were markedly decreased, while the rate of CD8+ cells (36.7±8.4% vs 27.9±4.2%, P < 0.001; 37.3±8.4% vs 29.5±6.0%, P < 0.001) was increased in HBV DNA(+) and in HBeAg(+) carriers. The pathological changes that reached G1S1 stage covered a percentage of 68.8% in HBV DNA(+) carriers, which was significantly higher than that (16.7%) in HBV DNA(-) ones (c² = 5.57, P < 0.01). The rate of CD3+ cells was notably reduced (F = 2.919, P < 0.05) in G1S1 carriers as compared with that in G1S0 ones, but the rate of CD4+ cells showed no significant difference between them. Compared with those in G1S0 carriers, the rates of CD3+ and CD4+ cells and the value of CD4+/CD8+ tended to reduce, but the rate of CD8+ cells was tended to increase in G2S1 ones.

CONCLUSION: HBV infection can lead to disorder of cellular immunity in chronic HBV carriers, and the disorder and liver damages can be promoted by the increased serum levels of HBV DNA and HBeAg.