Increased Alanine Aminotransferase Research Articles

Toxicity and Anti-Trypanosomal Studies of Aqueous and Methanol Leaf Extracts of Acacia Nilotica on Trypanosoma Brucei-Induced Infection in Mice

African Animal Trypanosomiasis constitutes one of the greatest threats to the health of animals and socioeconomic status of people, particularly in developing countries. Chemotherapy, the main means of controlling the disease is limited due to parasite resistance and toxicity of the current anti-trypanosomal drugs. The development of a vaccine has been thwarted by antigenic variation of the parasite. Thus, plant extracts are one of the strategies being explored to address some of the problems encountered. The main objective of the current study was to investigate the toxicity and anti-trypanosomal activity of methanol and aqueous extracts of Acacia nilotica through in vivo assays against Trypanosoma brucei brucei. The chosen plants' healthy, fresh, matured leaves were air dried under shade, pulverized with mortar and pestle into powder, and passed through a 0.5mm mesh to standardize their particles. The plant samples were extracted using aqueous, methanol solvents. Qualitative and quantitative phytochemical analysis of the active chemical constituents of the extracts was conducted to determine saponins, flavonoids, tannins, terpenoids, steroids, and cardiac glycosides according to standard procedure. It was established that aqueous and methanol leaf extracts of the selected plants were safe in rats at dose levels of 1000, 3000, and 5000 mg/kg body weight for 72 hours. However, Sedation and abnormal movement were observed for both A. nilotica and Z. mucronata as manifestations of clinical toxicity at 5000mg/kg body weight. The fatal dose of all extracts exceeds the maximum dose of 5000mg/kg. Prolonged oral administration of the extracts for 21 days with A. nilotica extracts did not reveal major changes in body and organs weights, liver and kidney functions, the biochemical analysis showed a slight, non-significant increase in Alanine transaminase, Aspatate transaminase, and Alkaline phosphatase at (4000mg/kg) in rats, the average creatinine and urea levels were within the normal range, the relative organ weight and isolated organ are within the normal reference value. The photomicrographs of the liver and kidney sections showed mild histological changes. The in vivo assay showed the aqueous and methanol extracts from A. nilotica at 200mg/kg, 100mg/kg, and positive control (diminazine aceturate 3.5mg) reduced parasitaemia (p < 0.05), improved anaemia (p < 0.05), prevented body weight loss (p < 0.05) compared to the negative control. This study showed that the leaf of A. nilotica is safe and possess antitrypanosomal properties, suggesting that they may be a source of novel drugs for treatment of tropical diseases caused by trypanosomes.

Phase Ib study of the oral PI3Kδ inhibitor linperlisib in patients with advanced solid tumors.

Patients with advanced solid tumors have a suboptimal prognosis. This study investigated the safety and feasibility of linperlisib, a selective phosphatidylinositol 3-kinase delta isoform (PI3Kδ) inhibitor, for treating patients with advanced solid tumors. In this phase Ib, single-arm, open-label, multi-center clinical trial, patients with histologically confirmed advanced solid tumors from eight centers in China were enrolled to receive oral linperlisib (80mg/day). The primary endpoint was safety. Between August 2019 and June 2022, 94 patients were enrolled in the trial and received the study treatment. The most common (≥ 20%) treatment emergent adverse events (TEAEs) of all grades irrespective of causality were increased aspartate aminotransferase (AST) (26.6%), proteinuria (26.6%), decreased appetite (25.5%), increased alanine aminotransferase (ALT) (22.3%), weight loss (21.3%), and anemia (21.3%). The most common grade ≥ 3 TEAEs were diarrhea (4.3%), increased AST (3.2%), increased ALT (3.2%), neutropenia (3.2%), anemia (3.2%), increased blood alkaline phosphatase (3.2%). The objective response rate (ORR) was 1.1% (95% confidence interval [CI] 0.0-5.8), and the disease control rate (DCR) was 37.2% (95% CI 27.5-47.8). As of the data cutoff, the median follow-up time was 4.2months (95% CI 2.8-6.9). The median progression-free survival (PFS) was 1.85months (95% CI 1.79-1.88). The median overall survival (OS) was not reached. Linperlisib showed an acceptable safety profile and preliminary clinical benefit in patients with a range of advanced solid tumors. Further studies of linperlisib safety and efficacy are warranted.

Phase Ib clinical and pharmacodynamic study of the TIE2 kinase inhibitor rebastinib with paclitaxel or eribulin in HER2-negative metastatic breast cancer.

Breast cancer cells disseminate to distant sites via Tumor Microenvironment of Metastasis (TMEM) doorways. The TIE2 inhibitor rebastinib blocks TMEM doorway function in the PyMT mouse model of breast cancer. We aimed to assess the safety and pharmacodynamics of rebastinib plus paclitaxel or eribulin in patients with HER2-negative metastatic breast cancer (MBC). This phase Ib trial enrolled 27 patients with MBC who received 50 mg or 100 mg of rebastinib PO BID in combination with weekly paclitaxel 80 mg/m2 (if ≤ 2 prior non-taxane regimens) or eribulin 1.4 mg/m2 on days 1 & 8 (if ≥ 1 prior regimen). Safety, tolerability and pharmacodynamic parameters indicating TIE2 kinase inhibition and TMEM doorway function were evaluated. No dose-limiting toxicities in cycle 1 or 2 were observed among the first 12 patients at either rebastinib dose level. The most common treatment-emergent adverse events (AEs) were anemia (85%), fatigue (78%), anorexia (67%), leukopenia (67%), increased alanine aminotransferase (59%), hyperglycemia (56%), nausea (52%), and neutropenia (52%). AEs attributed to rebastinib include muscular weakness and myalgias. Intraocular pressure increased at the 100 mg rebastinib dose level, whereas angiopoietin-2 levels increased at both dose levels, providing pharmacodynamic evidence for TIE2 blockade. Circulating tumor cells decreased significantly with the combined treatment. Objective response occurred in 5/23 (22%) evaluable patients. In patients with MBC, the recommended phase 2 dose of rebastinib associated with pharmacodynamic evidence of TIE2 inhibition is either 50 or 100 mg PO BID in combination with paclitaxel or eribulin.

Maternal and cord blood levels of metals and fetal liver function

Exposure to metals during pregnancy has been associated with adverse birth outcomes, but its impact on fetal liver function remains poorly understood. This study for the first time aimed to investigate the association between maternal and umbilical cord blood Metals levels and umbilical liver enzymes. A comprehensive analysis was conducted on 450 mother-newborn pairs in 2022, measuring 13 Metals in serum samples from pregnant women during the third trimester and umbilical cord blood samples. Regression analyses were utilized to examine the relationship between levels of maternal and umbilical cord blood Metals and the levels of gamma-glutamyl transferase (GGT), umbilical alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST). G-comp analyses evaluated the combined effect of metals exposure on umbilical liver enzymes. Elevated levels of certain Metals in cord blood and maternal samples were positively linked with increased umbilical GGT, ALP, ALT, and AST levels. Notably, zinc (Zn) levels in cord blood exhibited an inverse correlation with umbilical liver enzyme levels. Furthermore, g-comp analyses revealed significant positive associations between exposure to metals mixtures and umbilical liver enzyme levels. An increase of one quartile in the mixture of maternal and umbilical Metals was linked with 99.45 U/L (95% CI:37.72, 161.19, p < 0.01), 2.79 (95% CI: 0.92, 4.65, p < 0.01), and 87.17 (95% CI: 53.96, 120.38, p < 0.01) increase in ALP, ALT and GGT levels. Further examination of the weight of Metals revealed As, Cd, Ni, Pb, Hg and Cr with the highest positive effects and Zn with the highest negative effect in the mixture effect on the umbilical liver enzyme. In summary, our results underscore the potential influence of prenatal heavy metal exposure on fetal liver function.

PROTECTIVE EFFECT OF COMBINATION OF ETHANOLIC EXTRACTS OF XIMENIA AMERICANA AND TERMINALIA MACROPTERA AGAINST ALCOHOL-INDUCED HEPATOTOXICITY IN RATS

Objective: The aim of this study was to evaluate the hepatoprotective effect of the combination. Methods: Serum liver markers, tissue antioxidant activity, and histological changes in the livers of rats from the blank, negative (distilled water), positive (silymarin 100 mg/kg bw), and test (combination 500 mg/kg bw) groups were measured after 7 days of pretreatment and induction of hepatotoxicity by 10 g/kg bw alcohol every 12 h for 48 h. Results: Rats in the negative control group showed a highly significant (p&lt;0.001) increase in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (BT) levels by 281.13%, 221.7%, and 93.44%, respectively, compared to rats in the blank group. Pretreatment with the combination resulted in a highly significant (p&lt;0.001) decrease in AST, ALT, and BT levels of 69.19%, 62.24%, and 41.52%, respectively. The study of tissue oxidative stress parameters revealed a very significant (p&lt;0.01) increase in superoxide dismutase (123.08%), glutathione (131.66%), and catalase (49.01%) activities and a significant (p&lt;0.05) decrease in malondialdehyde concentration (59.72%) in the group pretreated with the combination compared with the negative control group. Steatosis and necrosis estimated at 50% were observed in rats in the negative control group. In contrast, necrosis observed in the group pre-treated with the combination was &lt;10%. Conclusion: These data suggest that the combination is effective in preventing the elevation of biochemical markers and the imbalance of enzymatic and non-enzymatic antioxidant systems caused by alcohol.

Effect of ethyl acetate extract from Usnea longissima on chemotherapy-associated multiple organ dysfunction in rats

BackgroundThe toxic effects of doxorubicin and cisplatin in various organs have been associated with oxidative stress. Studies have shown that Usnea longissima has strong antioxidant effects. This study aimed to investigate the protective effect of ethyl acetate extract from Usnea longissima (ULE), which is known to have strong antioxidant effects, on chemotherapeutic-induced heart, kidney, liver, and ovarian toxicity. MethodsAlbino Wistar female rats were divided into five groups (12 rats per group): healthy (HG), doxorubicin (DOX), Cisplatin (CIS), Doxorubicin+ ULE (DULE), Cisplatin+ ULE (CULE). In this experiment, ULE was given 100 mg/kg orally. After 1 hour, 2.5 mg/kg doxorubicin and 2.5 mg/kg cisplatin were administered intraperitoneally. Drug treatments continued once a day for seven days. At the end of seven days, six rats from each group were euthanized and heart, kidney, liver, and ovary tissues were analyzed biochemically. The remaining rats were left in the laboratory with male rats for 45 days for reproduction. ResultsULE inhibited chemotherapeutic-induced increase in malondialdehyde, tumor necrosis factor-alpha, and interleukin 6 and a decrease in total glutathione in liver, kidney, and ovarian tissues. ULE also inhibited the increase of blood urea nitrogen, creatinine, alanine aminotransferase, and aspartate aminotransferase in serum. ULE treatment had no protective effect against doxorubicin and cisplatin cardiac toxicity. On the other hand, ULE also decreased the delay in pregnancy induced by chemotherapy. ConclusionULE may be considered an adjuvant therapy in patients receiving chemotherapy to reduce liver, kidney, and ovarian toxicity.

Investigation of hematological, biochemical and coagulological markers, their diagnostic effectiveness in toxic hepatitis in patients with COVID‑19

This article discusses hematological, biochemical and coagulological markers for the diagnosis of toxic hepatitis in patients with COVID-19. The analysis of the effectiveness of these markers in a large sample of patients confirmed their importance for the early detection of toxic hepatitis b in patients with COVID-19. Blood parameters such as platelets, ALT, AST, bilirubin, as well as coagulograms and markers of protein metabolism (albumin) conducted among patients divided into control and experimental groups were analyzed. It was found that in patients with concomitant toxic hepatitis c COVID-19, the tendency of thrombocytopenia is most common in clinical blood analysis. Among the biochemical parameters of blood, liver markers increase (ALT, GGT, alkaline phosphatase, etc.). It should be noted that in 1/3 of patients, the activity of liver enzymes alanine aminotransferase and aspartate aminotransferase increases, which indicates a violation of liver function.The analysis of these data using ROC analysis showed high diagnostic accuracy of these markers in the detection of toxic hepatitis in patients with COVID-19. These studies may be important for more effective screening and further monitoring of appropriately selected treatment in such clinical situations and contributes to more effective management of this condition, leading to an improved prognosis of this disease. This study is important in the context of understanding the effects of COVID-19 on liver function.

Investigating the Safety Profile of Fast-Track COVID-19 Drugs Using the FDA Adverse Event Reporting System Database: A Comparative Observational Study.

The US Food and Drug Administration (US FDA) granted emergency use authorization (EUA) for multiple coronavirus disease 2019 (COVID-19) drugs as a medical countermeasure during the COVID-19 pandemic. Despite these drugs' fast-track nature, concerns persist regarding their efficacy and potential adverse effects. Thus, the continuous surveillance and understanding of these drugs' safety profiles are crucial in such scenarios. Using the FDA Adverse Event Reporting System (FAERS) database, we aimed to compare the adverse drug reactions (ADRs) of four fast-track COVID-19 drugs to explore the potential of real-world data for providing prompt feedback in clinical settings. To evaluate the post-marketing safety of fast-track COVID-19 drugs, we descriptively evaluated the ADRs of four COVID-19 drugs (bebtelovimab, molnupiravir, nirmatrelvir/ritonavir, and remdesivir) using FAERS data reported from January 2020 to June 2022. We examined FAERS case records of COVID-19 drugs reported as the "primary suspect drug" as a case group and the records of other drugs as the control. "Serious adverse drug reactions (SADRs)" were defined based on FDA guidelines. Using reporting odds ratios, disproportionality analysis was conducted to determine significant signals for ADRs related to each of the four drugs compared with those of others, both at the preferred term (PT) and system organ class (SOC) levels. To explore the occurrence of reporting each serious outcome reported to the four drugs, we fitted logistic regression models, adjusting for age and sex. During the study period, 5 248 221 cases were submitted to FAERS, including 17 275 cases of the four COVID-19 drugs: bebtelovimab (532 cases), molnupiravir (1106 cases), nirmatrelvir/ritonavir (9217 cases), and remdesivir (6420 cases). A total of 64, 46, 116, and 207 PTs with significant disproportionality were identified for each drug, respectively. "Infusion-related reaction" (18.4%), "diarrhea" (7.4%), "dysgeusia" (11.4%), and "increased alanine aminotransferase" (14.5%) were the most frequently reported SADRs for bebtelovimab, molnupiravir, nirmatrelvir/ritonavir, and remdesivir, respectively. Among the 27 SOCs, statistically significant signals were observed in 10, 3, 0, and 8 SOCs for bebtelovimab, molnupiravir, nirmatrelvir/ritonavir, and remdesivir, respectively. Remdesivir showed a higher occurrence for the reporting of death or life-threatening ADRs compared with the control (adjusted odds ratio (OR) = 2.44, 95% confidence interval (CI) = 2.23-2.59; adjusted OR = 1.82, 95% CI = 1.64-2.02, respectively). We identified potential ADRs associated with COVID-19 drugs and provided insights into their real-world safety. This study demonstrated that real-world data and real-time safety reviews could be effective methods for the timely detection of ADR signals of drugs that have received fast-track approval, as exemplified by COVID-19 drugs. These findings underscore the importance of the continued surveillance, efficient data processing, and establishment of automated pipelines for real-time safety reviews.

Long-Term Impact of Lumacaftor/Ivacaftor Treatment on Cystic Fibrosis Disease Progression in Children 2-5 Years of Age Homozygous for F508del-CFTR: A Phase 2, Open-Label Clinical Trial.

Rationale: Clinical trials show that lumacaftor/ivacaftor (LUM/IVA) treatment has the potential to modify early cystic fibrosis (CF) disease progression in children as young as 2 years of age. Objectives: To assess the long-term impact of LUM/IVA treatment on CF disease progression in children aged 2-5 years. Methods: This phase 2 trial had two parts: part 1, a 48-week, randomized, double-blind, placebo-controlled study of LUM/IVA in children aged 2-5 years (previously reported) was followed by a 48-week open-label treatment period in which all children received LUM/IVA (part 2; reported here). Endpoints assessed in part 2 included absolute changes from baseline in chest magnetic resonance imaging (MRI) global score at Week 96; weight-for-age, stature-for-age, and body mass index (BMI)-for-age z-scores at Week 96; lung clearance index based on lung volume turnover required to reach 2.5% of starting N2 concentration (LCI2.5) through Week 96; chest MRI morphological score, chest MRI perfusion score, weight, stature, BMI, and microbiology cultures (oropharyngeal swabs) at Week 96; sweat chloride, amount of immunoreactive trypsinogen, fecal elastase-1 concentration, and fecal calprotectin through Week 96; and number of pulmonary exacerbations, time to first pulmonary exacerbation, and number of CF-related hospitalizations. Results: Forty-nine children received one or more doses of LUM/IVA in the open-label period (33 in the LUM/IVA to LUM/IVA group and 16 in the placebo to LUM/IVA group), with a mean exposure of 47.1 (standard deviation [SD], 5.2) weeks. The mean absolute change in MRI global score (negative value indicates improvement) from baseline at Week 96 was -2.7 (SD, 7.0; 95% confidence interval [CI], -5.2 to -0.1) in the LUM/IVA to LUM/IVA group and -5.6 (SD, 6.9; 95% CI, -9.2 to -1.9) in the placebo to LUM/IVA group. Improvements in LCI2.5, sweat chloride concentration, and markers of pancreatic function and intestinal inflammation were also observed in both groups. Growth parameters remained stable in both groups. The majority of children had adverse events considered mild (38.8%) or moderate (40.8%). Two (4.1%) children discontinued LUM/IVA treatment because of adverse events (distal intestinal obstruction syndrome [n = 1] and alanine aminotransferase increase [n = 1]). Conclusions: These findings confirm the potential for early LUM/IVA treatment to alter the trajectory of CF disease progression, including CF lung disease, in children as young as 2 years of age. Clinical trial registered with ClinicalTrials.gov (NCT03625466).

Effects of Dietary Ferroporphyrin Supplementation on Growth Performance, Antioxidant Capacity, Immune Response, and Oxygen-Carrying Capacity in Gibel Carp (Carassius auratus gibelio).

An eight-week experiment was conducted to study the effects of dietary ferroporphyrin (FPR) supplementation on growth performance, antioxidant capacity, immune response, and oxygen-carrying capacity in gibel carp. The results demonstrated that the addition of FPR increased the moisture content of the whole fish body. Supplementation with 0.01% FPR significantly increased the plasma albumin (ALB), total protein (TP), and total cholesterol (TC) contents. The addition of 0.03% and 0.04% FPR significantly increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, respectively, while the glucose (GLU), TC, and total triglyceride (TG) levels showed opposite trends. In terms of antioxidant capacity, the 0.03% and 0.04% dietary FPR supplementation increased malondialdehyde (MDA) levels. The activity of glutathione peroxidase (GPx) exhibited an opposite trend to MDA levels. The supplementation of 0.03% of FPR resulted in a notable reduction in mRNA expression levels of nrf2, keap1, cat, and gpx. Regarding immunity, 0.01% FPR supplementation down-regulated the expression levels of il-1β mRNA, while 0.02% FPR down-regulated il-6 and nf-κb expression levels. Furthermore, 0.02% FPR supplementation significantly up-regulated the il-10 mRNA expression levels. In terms of oxygen-carrying capacity, high levels of FPR (0.03% and 0.04%) were found to influence the epo and vegf mRNA expression. In conclusion, the incorporation of dietary 0.01-0.02% FPR improved the immune system of gibel carp without affecting their antioxidant and oxygen-carrying capacity. However, supplementation with higher levels of FPR (0.03-0.04%) led to decreased antioxidant and oxygen-carrying capacity.

The benefit and risk of addition of chemotherapy to EGFR tyrosine kinase inhibitors for EGFR-positive non-small cell lung cancer patients with brain metastases: a meta-analysis based on randomized controlled trials.

Combining epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) with chemotherapy (ETC) offers more advantages for patients with EGFR-positive non-small cell lung cancer (NSCLC) than using EGFR TKIs alone (ET). However, whether this conclusion applies to patients with brain metastases (BM) remains controversial. This meta-analysis was performed to evaluate the benefits and risks of the two groups. Six databases were systematically searched for relevant literatures comparing ETC versus ET in treating EGFR-positive NSCLC patients with BM. The primary outcome assessed was overall survival (OS), while secondary outcomes included progression-free survival (PFS), and central nervous system (CNS)-PFS, responses, progression status and safety. Seven studies based on five randomized clinical trials with 550 patients were included. The ETC group exhibited better OS (hazard ratio [HR]: 0.64 [0.48, 0.87]), PFS (HR: 0.42 [0.34, 0.52]), and CNS-PFS (HR: 0.42 [0.31, 0.57]). The benefits in survival for OS, PFS, and CNS-PFS were validated in nearly all subgroups. Meanwhile, the overall objective response rate (ORR) (risk ratio [RR]: 1.25 [1.02, 1.52]) and CNS-ORR (RR: 1.19 [0.93, 1.51]) also tended to favor the ETC group. However, the addition of chemotherapy also brought about more grade 3-5/serious adverse events (AEs). The top five grade 3-5 AEs in the ETC group were alanine aminotransferase increase (11.25%), neutropenia (7.5%), nausea (7.5%), anorexia (5%), and diarrhea (5%). ETC appears to be better than ET in treating EGFR-positive NSCLC patients with BM, with better OS, PFS, CNS-PFS, and responses. However, its poorer safety profile also needs to be taken into consideration. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024551073.

Edaravone’s Hepatoprotective Effects Against Oxidative Stress in Valproic acid –induced rat model

In this experimental study, the effect of edaravone (EDA) on liver damage caused by valproic acid (VPA) was investigated. The antioxidant, oxidative stress, and inflammation indicators such as glutathione (GSH), total lipid (TL), sialic acid (SA), aspartate (AST) and alanine transaminase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione-S-transferase (GST) were examined. Male Sprague Dawley rats were used in the experiment and randomly divided into 4 groups. The experiment lasted for 7 days. Group I: control group rats; Group II: rats receiving 0.5 g/kg VPA intraperitoneally daily. Group III: rats receiving 30 mg/kg EDA intraperitoneally daily. Group IV: rats receiving 0.5 g/kg VPA and 30 mg/kg EDA intraperitoneally daily (at the same time). On day 8, all animals were sacrificed under anesthesia, and liver tissues were removed. VPA caused the decreases in GSH, CAT, SOD, GPx, GR, and GST values and the increases in AST, ALT, ALP, GGT, sialic acid, and total lipid values. EDA reversed the in all values. These results suggest that EDA administration potentially reduces liver injury in VPA-induced hepatotoxicity.

Effects of Gingko Biloba Extract and L-Ascorbic Acid on Some Hematological, Biochemical, and Hepatic-Architectural Alterations in Mercury Chloride Intoxicated Adult Wistar Rat.

The study investigated the effects of Ginkgo biloba and Ascorbic acid (A.A) on mercury chloride (HgCl2) toxicity in Wistar rats. Forty-two adult Wistar rats were randomly divided into seven groups (n=6). Group I served as control. Groups II–VII received 5 mg/kg of HgCl2. Groups III and IV received 100 mg/kg and 500 mg/kg of A.A respectively, while groups V and VI daily received 100 mg/kg and 500 mg/kg of EGB761 respectively. Group VII received 100 mg/kg of A.A and EGB761. All administration were done orally, once daily for 21 days. Mercury exposure caused significant (p&lt;0.05) decreases in RBC (3.62.00±0.75), hemoglobin (8.67±0.14), and PCV (32.93±0.47) in group II when compared to the control group, while significantly (p&lt;0.05) increasing white blood cell count (18.57±1.51). Liver function tests significantly (p&lt;0.05) increased Alanine transaminase (1.38±1.51), Aspartate Transaminase (10.11±4.21), and Alkaline Phosphatase (1.89±0.51) in group II when compared to Control. Biochemical analysis revealed a significant (p&lt;0.05) increase in malondialdehyde levels and a significant (P&lt;0.05) decrease in superoxide dismutase (3.86 ± 0.69), glutathione (10.08 ± 2.13), and catalase (3.65 ± 0.2) levels in group II. However, treatment with ascorbic acid and EGB761 significantly (P&lt;0.05) increased in Groups IV (6.15 ± 0.38); VI (6.28 ± 0.40), and VII (6.19 ± 0.41), SOD levels in Groups IV (6.15 ± 0.38); VI (6.28 ± 0.40) and VII (6.19 ± 0.41) and GSH level when compared to the HgCl2 group. Histological examination showed moderate hepatocyte necrosis in group II, while treatment with EGB761 and A.A showed moderate healing, binucleate nuclei, and a slight decrease of distorted sinusoids and normalization of liver structure. The study concludes that EGB761 and A.A have hepatoprotective effects on mercury-induced hepatotoxicity in a dose-dependent manner. The findings suggest that these antioxidants may be useful in mitigating the harmful effects of mercury exposure on the liver.

Prognostic value of elevated transaminase levels as predictors of adverse outcomes in patients with acute myocardial infarction

Aim. To assess the prevalence of elevated serum liver transaminases (LTs), including alanine aminotransferase (ALT) and aspartate aminotransferase (ALT), and their impact on in-hospital and long-term mortality in patients with acute myocardial infarction (AMI).Materials and methods. The prospective observational study included 416 consecutive AMI patients (median age 65 years, 40.9% female, 46.9% with ST elevation) without prior liver diseases, who underwent coronary angiography within 24 hours after hospitalization. AST and ALT levels were measured upon admission. LTs were considered as abnormal when their levels exceeded the local upper limit of normal. Clinical endpoints were all-cause in-hospital and 18-month mortality. Associations between clinical endpoints and various risk factors, including LT levels, were assessed by the multivariate logistic regression analysis.Results. Elevated LT levels were seen in 28.6% of AMI patients: an isolated increase in ALT was noted in 17.8% of patients, while an isolated increase in AST was registered in 25% of cases. In-hospital and 18-month mortality was 5.8 and 11.3%, respectively. Abnormal LT levels were associated with the presence of ST elevation (odds ratio (OR) 1.873, 95% confidence interval (CI) 1.218–2.881, p = 0.004), lower systolic and diastolic blood pressure (OR 0.993, 95% CI 0.986–1.0, p = 0.04 and 0.979, 95% CI 0.964–0.994, p = 0.007, respectively), higher Killip class (OR 1.510, 95% CI 1.142–1.999, p = 0.004), and higher creatinine level (OR 1.010, 95% CI 1.003–1.016, p = 0.004). In the multivariate analysis, elevated LT levels were independently associated with in-hospital and 18-month mortality (OR 3.607, 95% CI 1.199–10.848, p = 0.022 and 2.182, 95% CI 1.011–4.708, p = 0.047, respectively).Conclusion. Elevated LT levels were present in about a third of patients with AMI. They were associated with specific clinical, biological, and prognostic features, including in-hospital and long-term mortality in AMI patients.

Exploring the Relationship between Canine Paraoxonase-1 (PON-1) Serum Activity and Liver Disease Classified by Clinico-Pathological Evaluation.

Paraoxonase-1 (PON-1), a liver-synthesized enzyme, acts as a negative acute-phase reactant during systemic inflammation in dogs. Given the hepatic synthesis of this enzyme, the presence of liver diseases may influence PON-1, thus affecting its reliability as a biomarker for inflammatory/oxidative systemic diseases. The aim of this study is to investigate PON-1 activity variations among dogs suspected of liver injury or failure, evaluating the influence of hepatic diseases on PON-1 activity. A total of one-hundred-sixty dogs were retrospectively enrolled and categorized into three groups based on clinical presentation and laboratory results: control (C = 20), suspected liver injury (INJ = 114), and suspected liver failure (FAIL = 26). The INJ group was further divided into subgroups based on the severity of the alanine aminotransferase (ALT) increase. Both the INJ and FAIL groups were further divided based on serum macroscopic appearance. The PON-1 activity was quantified using a paraoxon-based method, which is already validated in dogs. No significant difference in PON-1 activity was observed between the C and INJ groups, despite a significant increase in the subgroups with moderate and severe elevations of ALT. The dogs with icteric serum exhibited decreased PON-1 activity, while lipemic serum was associated with an increased PON-1 activity. A significant reduction in PON-1 activity was noted in the FAIL group, compared to both C and INJ groups (p < 0.0001), regardless of serum appearance. Given the retrospective nature of this study, additional evaluations (e.g., histopathology, imaging) were not performed. The results obtained here suggest the importance of interpreting PON-1 activity cautiously in dogs with suspected liver disease.

6420 Organokines and Liver Enzymes in Adolescent Girls with Polycystic Ovary Syndrome During Randomized Treatments

Abstract Disclosure: C. Garcia-Beltran: None. M. Peyrou: None. F.E. de Zegher: None. A. López-Bermejo: None. F. Villarroya: None. L. Ibanez: None. Introduction: Polycystic ovary syndrome (PCOS) is often related to metabolic associated fatty liver disease (MAFLD). MAFLD has been associated with altered hepatic function and systemic dysmetabolism and with abnormal circulating levels of signaling molecules, so-called organokines. Here, we assessed the effects of two randomized treatments on a set of organokines in adolescent girls with PCOS and without obesity, and report the associations with circulating biomarkers of liver damage which were assessed longitudinally in the aforementioned studies as safety markers. Materials and Methods: Liver enzymes [aspartate aminotransferase (AST), alanine amino transferase (ALT) and gamma-glutamyl transferase (GGT)] were assessed as safety markers in previous randomized pilot studies comparing the effects of an oral contraceptive (OC) to those of a low-dose combination of spironolactone-pioglitazone-metformin (spiomet) for 1 yr. As a post-hoc endpoint, the organokines fibroblast growth factor-21 (FGF21), diazepam-binding protein-1 (DBI) and meteorin-like protein (METRNL), were assessed by ELISA after 6 months on OC (N=26) or spiomet (N= 28). Auxological, endocrine-metabolic, body composition (by DXA) and abdominal fat partitioning (by MRI) were also evaluated. Healthy age-matched adolescent girls (N=17) served as controls. Results: Circulating ALT and GGT levels raised during OC treatment and returned to baseline concentrations in the post-treatment phase; in contrast, spiomet treatment elicited no detectable changes in ALT and GGT concentrations. In relation to organokines after 6 mo on treatment, (1) FGF21 levels were significantly higher in PCOS adolescents than in control girls; (2) DBI levels were lower in OC-treated girls as compared to controls and spiomet-treated girls; (3) no differences were observed in METRNL concentrations between PCOS girls and controls. Serum ALT and GGT levels directly correlated with circulating METRNL levels only in OC-treated girls (R=0.449; P=0.036 and R=0.552; P=0.004, respectively). Conclusion: The on-treatment increase in ALT and GGT levels occurring only in OC-treated girls associates with circulating METRNL levels suggesting an enhanced METRNL synthesis as a reaction to the hepatic changes elicited by OC treatment. Trial registration numbers: ISRCTN29234515 (https://doi.org/10.1186/ISRCTN29234515) and ISRCTN11062950 (https://doi.org/10.1186/ISRCTN11062950) Presentation: 6/2/2024

6420 Organokines and Liver Enzymes in Adolescent Girls with Polycystic Ovary Syndrome During Randomized Treatments

Abstract Disclosure: C. Garcia-Beltran: None. M. Peyrou: None. F.E. de Zegher: None. A. López-Bermejo: None. F. Villarroya: None. L. Ibanez: None. Introduction: Polycystic ovary syndrome (PCOS) is often related to metabolic associated fatty liver disease (MAFLD). MAFLD has been associated with altered hepatic function and systemic dysmetabolism and with abnormal circulating levels of signaling molecules, so-called organokines. Here, we assessed the effects of two randomized treatments on a set of organokines in adolescent girls with PCOS and without obesity, and report the associations with circulating biomarkers of liver damage which were assessed longitudinally in the aforementioned studies as safety markers. Materials and Methods: Liver enzymes [aspartate aminotransferase (AST), alanine amino transferase (ALT) and gamma-glutamyl transferase (GGT)] were assessed as safety markers in previous randomized pilot studies comparing the effects of an oral contraceptive (OC) to those of a low-dose combination of spironolactone-pioglitazone-metformin (spiomet) for 1 yr. As a post-hoc endpoint, the organokines fibroblast growth factor-21 (FGF21), diazepam-binding protein-1 (DBI) and meteorin-like protein (METRNL), were assessed by ELISA after 6 months on OC (N=26) or spiomet (N= 28). Auxological, endocrine-metabolic, body composition (by DXA) and abdominal fat partitioning (by MRI) were also evaluated. Healthy age-matched adolescent girls (N=17) served as controls. Results: Circulating ALT and GGT levels raised during OC treatment and returned to baseline concentrations in the post-treatment phase; in contrast, spiomet treatment elicited no detectable changes in ALT and GGT concentrations. In relation to organokines after 6 mo on treatment, (1) FGF21 levels were significantly higher in PCOS adolescents than in control girls; (2) DBI levels were lower in OC-treated girls as compared to controls and spiomet-treated girls; (3) no differences were observed in METRNL concentrations between PCOS girls and controls. Serum ALT and GGT levels directly correlated with circulating METRNL levels only in OC-treated girls (R=0.449; P=0.036 and R=0.552; P=0.004, respectively). Conclusion: The on-treatment increase in ALT and GGT levels occurring only in OC-treated girls associates with circulating METRNL levels suggesting an enhanced METRNL synthesis as a reaction to the hepatic changes elicited by OC treatment. Trial registration numbers: ISRCTN29234515 (https://doi.org/10.1186/ISRCTN29234515) and ISRCTN11062950 (https://doi.org/10.1186/ISRCTN11062950) Presentation: 6/2/2024

8599 Development of an androgen receptor transgenic mouse that displays the complete attributes of Metabolic Syndrome

Abstract Disclosure: C. Alvarado: None. L.K. Beitel: None. M. Paliouras: None. M.A. Trifiro: None. The mouse androgen receptor (AR) shares over 90% homology with the human ortholog, but it lacks the CAG encoded poly-Q tract; instead, it contains a mixed glutamine/histidine tract. To study AR functionality in a more structured fashion, we created a knock-in mouse model that has only the equivalent of human poly-Q tract while maintaining the remaining mouse receptor sequence intact. Our humanized androgen receptor mouse (AR-19Q) displays a phenotype that is best described as Metabolic Syndrome (MetS). The mice gain excess weight, have hypertension, hyperglycemia, pancreatic islet cell abnormalities, and progressive non-alcoholic fatty liver disease (NAFLD). Features of MetS begin at approximately 4 months and progress till 12-14 months. Obesity: AR-19Q mice are significantly heavier, with a 35% gain of weight vs C57BL/6 mice. However, these mice are not hyperphagic at any time and eat identical quantities of chow. To assess obesity status, and found AR-19Q mice to have a significantly higher depositions of total white adipose visceral, lingual and subcutaneous vs age-matched controls. NAFLD: The progression of NAFLD is observed in AR-19Q mice. AR-19Q Histological analysis and immunohistochemistry reveal microvesicular steatosis, superseded by macrovesicular steatosis with hepatocyte balloon degeneration, scattered lobular inflammation (macrophages and lymphocytes) (6-9 months) and further superseded by perisinusoidal fibrosis (12 months). Biochemical blood analysis confirms. that there is a significant increase in alanine aminotransferase (ALT) levels, indicative of liver damage. With time classical NASH hepatitis and subsequent NASH fibrosis ensues; with several mice developing hepatocellular carcinoma (overall 20% of mice). Gene expression profiling AR-19Q mice for fatty liver genes, we observe an upregulation of inflammation genes Il-6, Il-10 and Tnf. In addition, increased Lpl (lipoprotein lipase) is indicative of increased blood triglyceride levels. On the other hand, down-regulation of G6pc (glucose-6-phosphatase) could be linked to glycogen storage disease. Down-regulation of Slc2a2 and Slc2a4, that encode GLUT2 and GLUT4, should have an influence on glucose levels, glucose homeostasis and insulin sensitivity, as insulin promotes glucose uptake through GLUT4. Type 2 Diabetes: Glucose intolerance is observed by 3-4 months followed by fasting hyperglycemia. Pancreases show advanced islet hyperplasia, concurrent with insulin resistance and type 2 diabetes. Pancreases of middle-age AR-19Q mice present with a significant islet hyperplasia, suggesting peripheral insulin resistance. We propose the use of the AR-19Q mice as a model to study the metabolic dysfunction/ deficiency leading to the MetS. The model will allow us to a better understanding into the mechanisms responsible for T2D and NAFLD-related disorders. Presentation: 6/2/2024

9285 Development of an androgen receptor transgenic mouse that displays the complete attributes of Metabolic Syndrome

Abstract Disclosure: C. Alvarado: None. L.K. Beitel: None. M. Paliouras: None. M.A. Trifiro: None. The mouse androgen receptor (AR) shares over 90% homology with the human ortholog, but it lacks the CAG encoded poly-Q tract; instead, it contains a mixed glutamine/histidine tract. To study AR functionality in a more structured fashion, we created a knock-in mouse model that has only the equivalent of human poly-Q tract while maintaining the remaining mouse receptor sequence intact. Our humanized androgen receptor mouse (AR-19Q) displays a phenotype that is best described as Metabolic Syndrome (MetS). The mice gain excess weight, have hypertension, hyperglycemia, pancreatic islet cell abnormalities, and progressive non-alcoholic fatty liver disease (NAFLD). Features of MetS begin at approximately 4 months and progress till 12-14 months. Obesity: AR-19Q mice are significantly heavier, with a 35% gain of weight vs C57BL/6 mice. However, these mice are not hyperphagic at any time and eat identical quantities of chow. To assess obesity status, and found AR-19Q mice to have a significantly higher depositions of total white adipose visceral, lingual and subcutaneous vs age-matched controls. NAFLD: The progression of NAFLD is observed in AR-19Q mice. AR-19Q Histological analysis and immunohistochemistry reveal microvesicular steatosis, superseded by macrovesicular steatosis with hepatocyte balloon degeneration, scattered lobular inflammation (macrophages and lymphocytes) (6-9 months) and further superseded by perisinusoidal fibrosis (12 months). Biochemical blood analysis confirms. that there is a significant increase in alanine aminotransferase (ALT) levels, indicative of liver damage. With time classical NASH hepatitis and subsequent NASH fibrosis ensues; with several mice developing hepatocellular carcinoma (overall 20% of mice). Gene expression profiling AR-19Q mice for fatty liver genes, we observe an upregulation of inflammation genes Il-6, Il-10 and Tnf. In addition, increased Lpl (lipoprotein lipase) is indicative of increased blood triglyceride levels. On the other hand, down-regulation of G6pc (glucose-6-phosphatase) could be linked to glycogen storage disease. Down-regulation of Slc2a2 and Slc2a4, that encode GLUT2 and GLUT4, should have an influence on glucose levels, glucose homeostasis and insulin sensitivity, as insulin promotes glucose uptake through GLUT4. Type 2 Diabetes: Glucose intolerance is observed by 3-4 months followed by fasting hyperglycemia. Pancreases show advanced islet hyperplasia, concurrent with insulin resistance and type 2 diabetes. Pancreases of middle-age AR-19Q mice present with a significant islet hyperplasia, suggesting peripheral insulin resistance. We propose the use of the AR-19Q mice as a model to study the metabolic dysfunction/ deficiency leading to the MetS. The model will allow us to a better understanding into the mechanisms responsible for T2D and NAFLD-related disorders. Presentation: 6/2/2024

The Effect of Cinnamomum Burmanii Ethanol Extract on Isoniazid-induced Serum Levels of Serum Glutamate Piruvate Transaminase (SGPT) Wistar Strain Male Rats

Hepatotoxicity can be caused by excessive drug use, triggered by increased oxidative stress which is considered as the initial mechanism of Drug Induced Liver Injury (DILI). One of the causes of DILI is Isoniazid. One of the plants acting as a hepatoprotector in protecting liver cells is cinnamon (Cinamommum burmanii). This study aims to determine the effect of 96% ethanolic cinnamon extract as a hepatoprotector against an increase in Alanine Transaminase (ALT) levels induced by isoniazid. The parameters used to assess liver damage were rat plasma ALT. The sample used in this study was rat plasma, which was taken through the retro orbital sinus. This research is an experimental study with a sample of 25 experimental animals divided into five groups, namely negative control (K1), positive control l (K2), and experimental group with cinnamon ethanolic extract at a dose of 100 mg/kgbw (K3), 200 mg/kgbw(K4), and 400 mg/kgbw(K5). The research used a post-test-only control group design. The results were analyzed using the One-way ANOVA test followed by the post hoc Tukey test. The results proved that cinnamon ethanolic extract at doses of 100 mg/kgbw (P = 0.029), 200 mg/kgbw (P = 0.001), and 400 mg/kgbw (P = 0.000) was effective in reducing plasma SGPT levels in isoniazid-induced rats when compared with the positive control group (K2). The most effective dose was at 200 mg/kgbw (K4). Thus, this proves that all of the doses in experimental groups have a hepatoprotective effect against isoniazid-induced liver damage. Keywords: Alanine Transaminase (ALT), cinnamon ethanol extract, Drug Induced Liver Injury (DILI), isoniazid