Hepatic Enzyme Levels Research Articles

Evaluation of Hepatic Enzyme Levels and Haematological Profiles in Chikungunya Patients- An Institutional Study

Background: Chikungunya is a viral infection caused by the Chikungunya virus (CHIKV) belonging to the Togaviridae family. The transmission of the virus is taking place through the bite of infected daytime biting female mosquitoes – primarily Aedes aegypti and Aedes albopictus. There were many reports which highlighted the number of reported cases of Chikungunya has been increasing in India in recent years, especially since 2016-2017. 
 The aim and objective of the present study was to understand the relationship between the severity of Chikungunya infection and its impact on levels hepatic enzymes and haematological profiles of individuals.
 Materials and Methods: Blood samples were collected from patients diagnosed with having Chikungunya. Routine laboratory investigations were carried out for analysing haematological assays like platelets, hematocrit count, haemoglobin count, total leukocyte count. and serum enzyme profiles includes Liver Function Test. 
 Result: Our results highlighted that the alterations of haematological and hepatic dysfunction are prevalent in Chikungunya infection, where haematological indices were significantly different between the control and patient group. RBC count, Hb, and WBC count were significantly lower in the patients than in the healthy control group. Liver enzymes like SGPT rising significantly more than SGOT. Hepatic Enzymes levels appear to have a directly proportional correlation with severity of infections. 
 Conclusion: Our study demonstrated that haematological and hepatic enzymes levels should be explored as routine laboratory markers for assessing the severity of Chikungunya infection, as they will help in employing an appropriate patient therapy, and thus optimise the use of available resources.

Cosmetological competence of nail patches in combating onychomycosis-An approach to improve the quality of life

Onychomycosis (Tinea unguium) is said to be the most common cosmetological nail fungal infection. Dermatophyte is a type of fungus that causes this condition. Discoloration and thickening of the nail are found to be the common symptoms of all nail diseases. In this scenario, Onychomycosis is considered as one of the cosmetic problems that leads to cellulitis in adults and diabetic patients. Anatomical structure of the nail and disease manifestations made nail disorders as a difficult endeavor. Onychomycosis is chronic and difficult to eradicate. Many oral antifungal agents are available for the treatment of nail infections. The oral and parenteral administration of antifungal agents can elevate the serum hepatic enzyme levels and causes typical hepatocellular injury within a few weeks of therapy. The goal of this review is to study the role of transungal delivery systems (nail patches) as a promising tool for onychomycosis to encounter the clinical conditions of the patient. Longer therapies and technical treatment methods may frustrate the patients. This novel antifungal therapy helps to avoid the surgical removal of nail for onychomycosis patients. Eradication of issues with Onychomycosis can be achieved by an excellent delivery system with deeper drug release and drug retention in the nail cuticle. Patients who are suffered from onychomycosis are facing embarrassment and disfigurement in the society. So, this newer treatment solution can improve the quality of life of patients.1-3

Schisandrin B ameliorates non-alcoholic liver disease through anti-inflammation activation in diabetic mice.

Type 2 diabetes mellitus (T2DM) is a metabolic risk factor associated with non‐alcoholic liver disease (NAFLD). Schisandrin B (Sch B) is a promising agent for NAFLD. However, the actions of Sch B on diabetes‐associated NAFLD and the underlying mechanisms are not characterized. This study aimed to assess whether Sch B has beneficial effects on T2DM‐associated NAFLD. Sch B (50 mg/kg, gavage) was administrated to C57BL/KSJ db/db mice for 2 weeks. Body weight, liver weight, blood glucose, and insulin resistance were measured. Serum lipid level and liver function were detected using the biochemistry analyzer. Quantitative Real‐Time PCR assay was used to evaluate mRNA levers of lipid metabolism genes. Terminal‐deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL) staining was performed to measure apoptosis in the liver. Pathological analysis and immunohistochemistry assessment were used to analyze hepatic steatosis and inflammatory infiltration. Sch B supplementation significantly decrease body weight, related liver weight, blood glucose, and serum insulin, and improved insulin resistance in db/db mice. Sch B obviously corrected NAFLD phenotypes including lipid deposition, steatohepatitis, and high levels of hepatic enzymes and serum lipid. In addition, mRNA levels of Sterol response element‐bind protein 1c (SREBP‐1c), fatty acid synthetase (Fasn), and acetyl‐CoA carboxylase (ACC) were markedly downregulated by Sch B treatment. TUNEL‐positive cells were also decreased by Sch B. Furthermore, Sch B inhibited the Kupffer cells, IL‐1β, and TNF‐α infiltration to the liver. Sch B ameliorated insulin resistance and lipid accumulation under high glucose conditions, which was partly associated with its inhibition of apoptosis and anti‐inflammatory actions.

Glutathione-loaded non-ionic surfactant niosomes: A new approach to improve oral bioavailability and hepatoprotective efficacy of glutathione

Abstract A new formulation (niosomes) was prepared to enhance the bioavailability, hepatic tissue uptake, and hepatoprotective activity of glutathione (GSH). The GSH-loaded niosomes (nanoform, N-GSH) were formulated by the thin-film hydration technique using cholesterol/non-ionic surfactants (Span®40, Span®60, and Tween®80) at a componential ratio of 1:1 and 2:1. The hepatoprotective activity of N-GSH, GSH, and the standard silymarin against CCl4-induced liver damage and oxidative stress were tested on the rats’ model. The hepatic morphology and histopathological characters were also investigated. The tissue contents of N-GSH were analysed using a concurrently validated RP-HPLC method. The optimized niosomes, composed of glutathione (500 mg), cholesterol, and Span®60-Tween®80 at a molar ratio of 2:1 of cholesterol/non-ionic surfactant, displaying a particle size of 688.5 ± 14.52 nm, a zeta potential of −26.47 ± 0.158 mV, and encapsulation efficiency (EE) of 66 ± 2.8% was selected for in vivo testing. The levels of MDA, NO, SOD, NF-κB, IL-1β, and Bcl-2 were measured. The results demonstrated that hepatic tissue damage was ameliorated using N-GSH as confirmed by the morphological and histopathological examination compared to the CCl4 and control groups. The N-GSH significantly (p < 0.05) decreased the elevated levels of hepatic enzymes, oxidative parameters, and inflammatory mediators, as compared to silymarin and GSH. Also, N-GSH significantly (p < 0.05) increased GSH hepatocyte concentrations as compared to the control groups. The present study demonstrated that N-GSH remarkably improved glutathione oral bioavailability and hepatic tissue uptake, thereby introducing a new glutathione formulation to protect hepatic tissue from injury and restore its GSH contents.

Case Series of Steroid-Resistant Immune Checkpoint Inhibitor Associated Myocarditis: A Comparative Analysis of Corticosteroid and Tofacitinib Treatment.

Background: Immune checkpoint inhibitor (ICI)–associated myocarditis is an uncommon and potentially fatal immune-related adverse event (irAE). Although corticosteroids are recommended as the first-line treatment by current guidelines, patients still have variable responses to it, and the guidelines vary significantly in terms of treatment strategies. Objectives: In this study, we performed a retrospective analysis of ICI-associated myocarditis in our hospital to propose a new comparative analysis to aid individualized treatment. Methods: We reviewed detailed records of 24 patients with confirmed ICI-associated myocarditis in our hospital from July 1, 2019, to April 1, 2021. Although all the cases in our study received recommended initial corticosteroid treatment according to the guidelines, different responses to corticosteroid were observed during the process of subsequent corticosteroid tapering. Basing on troponin cardiac troponin T rebound during corticosteroid tapering, we propose a new classification analysis of ICI-associated myocarditis that included two subgroups: corticosteroid-sensitive (n = 8) and corticosteroid-resistant group (n = 16). Results: Compared with corticosteroid-sensitive patients, larger doses of corticosteroid, longer period of treatment, and higher mortality rate were found in corticosteroid-resistant patients. Corticosteroid-resistant patients were characterized by more prominent ptosis, muscle weakness, elevated cardiac biomarkers, creatine kinase, and hepatic enzymes levels than that in the corticosteroid-sensitive patients. Tofacitinib (5 mg twice a day) was used in 11 corticosteroid-resistant patients, with seven patients recovered from ICI-associated myocarditis, showing a promising therapeutic effect. Conclusion: Our group analysis of corticosteroid responsiveness in patients with ICI-associated myocarditis may help clinicians to apply individualized treatment in this high-risk cohort. In addition, tofacitinib could provide clinical benefits when used early in the corticosteroid-resistant patients and may provide a new option for the treatment of ICI-associated myocarditis.

1398. Gland Tuberculosis: A Rare Localization of Tuberculosis

BackgroundTuberculosis (TB) is a multisystem disease that might affect all organs. Gland TB is characterized with a misleading clinical presentation which often mimic a neoplastic process. The aim of our work was to study the clinical, therapeutic and evolutionary features of gland TB. MethodsWe conducted a retrospective study including all patients hospitalized for gland TB in the infectious disease department between 1999 and 2020.ResultsWe encountered 28 cases among which 24 were females (85.7%). The mean age was 39±14 years. A rural origin was noted in 15 cases (53.5%). Two patients were previously treated for TB (7.1%). Systemic symptoms of TB included fever (60.7%), asthenia (53.5%), loss of appetite (46.4%) and weight loss (25%). There were 18 cases of breast TB (64.3%), 4 cases of salivary gland TB (14.3%) and 3 cases of ovarian TB (10.7%). Two cases of pituitary TB (7.1%) and one case of adrenal TB (3.6%) were noted. Multifocal TB was noted in 7 cases (25%). Lymph node (17.8%), pulmonary (14.2%) and peritoneal (7.1%) TB were associated with gland TB. Tuberculin skin test was positive in 19 cases (67.8%). The diagnosis was based on histopathological proof in 23 cases (82.1%), microbiological proof in 4 cases (14.3%) and clinically confirmed in one case (3.6%). The median duration of antitubercular therapy was 10 [9-15] months. Patients received fixed-dose combination in 11 cases (39.2%). Adverse effects of antitubercular therapy were noted in 10 cases (35.7%) represented by gastrointestinal symptoms (14.3%), increase in hepatic enzyme levels (14.3%) and skin reactions (7.1%). The disease evolution was favorable in 26 cases (92.9%). Relapse was noted in two cases (7.1%). ConclusionGland TB included different sites. The presence of systemic symptoms of TB and the diagnosis of TB elsewhere in the body helped through the diagnosis process which requires high index of suspicion. It was mainly based on histological evidence.Disclosures All Authors: No reported disclosures

273. Neurological Involvement Caused by Intracellular Bacteria

BackgroundInfection of the central nervous system is a severe and fatal disease. Causative agents include bacteria, viruses or fungi. Intracellular bacteria are not only overlooked, but also underdiagnosed. We aimed to study the clinical, laboratory and evolutionary features of neurological involvement caused by intracellular bacteria.MethodsWe conducted a retrospective study including all patients hospitalized in the infectious disease department for neurological involvement caused by intracellular bacteria between 1995 and 2020. The diagnosis was confirmed by serology.ResultsWe encountered 76 cases among which 43 were males (56.6%). The mean age was 32±18 years. The revealing symptoms included fever (97.4%), cephalalgia (73.7%), vomiting (64.5%) and arthralgia (51.3%). Lumbar puncture revealed a median white blood cell count of 120[56-340]/mm3. Lymphocytic pleocytosis was noted in 62% of the cases. Elevated cerebrospinal fluid (CSF) protein level was noted in 37 cases (48.7%) with a median of 0.84[0.6-1.37] g/L. Low CSF fluid glucose level was noted in 14 cases (18.4%). There were 70 cases (92.1%) of meningitis and 6 cases of meningoencephalitis (7.9%). The causative agent included Rickettsia species in 47 cases (61.8%), Brucella species in 17 cases (22.4%) and Mycoplasma species in 12 cases (15.8%). Laboratory investigations included elevated C-reactive protein levels (40.7%), thrombocytopenia (32.8%) and increase in hepatic enzyme levels (21%). Anemia was noted in 27 cases (35.5%), leukocytosis in 24 cases (31.5%) and leucopoenia in 6 cases (7.8%). Blood and CSF cultures were positive for Brucella in 2 cases (2.6%) and 5 cases (6.5%), respectively. The mean duration of treatment was 156±94 days for brucellosis cases, 9±4 days for rickettsiosis cases and 10±6 days for Mycoplasma cases. The disease evolution was favorable in 72 cases (94.7%). Four patients were dead (5.3%). Complications were noted in 5 cases (6.5%) and sequelae in 2 cases (2.6%).ConclusionIntracellular bacteria including Brucella, Rickettsia and Mycoplasma species should be considered in front of neurological symptoms. Meningitis with lymphocytic pleocytosis was the most common clinical presentation. An early diagnosis followed by the adequate treatment might avoid complications and death.Disclosures All Authors: No reported disclosures

Effects of Ribes khorasanicum hydro-ethanolic extract on streptozotocin-induced diabetic complications in rats.

The anti-diabetic effects of Ribes khorasanicum as a traditional remedy were investigated in diabetic rats. Thirty-five male rats were divided into five groups: control, diabetic, diabetic treated with metformin (300 mg kg-1; D+Met), diabetic treated with 250 and 500 mg kg-1 of Ribes khorasanicum hydro-ethanolic extract (D+Rib250 and D+Rib500). After six weeks of treatment, sera of overnight fasted animals were collected and used for measurement of glucose, insulin, lipid profile, urea, creatinine, and hepatic enzymes levels. Moreover, liver and kidney of rats were removed and used for measurement of oxidative stress including malondialdehyde (MDA), thiol content, and the activity of catalase (CAT) and superoxide dismutase (SOD). Streptozotocin (STZ)-induced diabetes increased the levels of serum glucose, triglycerides (TG), total cholesterol (TC), and LDL-C, urea, creatinine, hepatic enzymes, and kidney and liver oxidative stress markers, while decreased insulin and HDL-C when compared to control group. In all treated groups serum levels of glucose, TC, LDL-C, TG, and urea were decreased, while liver SOD activity was increased compared to the diabetic group. The D+Rib500 group had lower Serum glutamic pyruvic transaminase (SGPT), creatinine, and kidney MDA levels, but higher insulin, HDL-C levels, liver CAT activity, and kidney thiol content, and CAT activity compared to diabetic group. In D+Met group, serum levels of serum glutamic-oxaloacetic transaminase (SGOT), creatinine, and MDA of liver and kidney were decreased, while liver SOD activity was increased compared to the diabetic group. Based on our findings, treatment with Ribes khorasanicum improved diabetic complications, while the effect of a higher dose of the extract was comparable to metformin’s.

Efficacy of nanomicelle curcumin, Nigella sativa oil, and their combination on bone turnover markers and their safety in postmenopausal women with primary osteoporosis and osteopenia: A triple-blind randomized controlled trial.

Literature supports the potential effects of nanomicelle curcumin and Nigella sativa on the amelioration of osteoporosis, a health concern of postmenopausal women. This study aimed to evaluate the impacts of nanomicelle curcumin (CUR), Nigella sativa oil (NS), and their combination on bone turnover biomarkers and assess their safety. This triple‐blind randomized controlled trial was performed on 120 postmenopausal women aged 50–65 with primary osteoporosis or osteopenia. The subjects were randomly allocated to receive microcrystalline cellulose (placebo), 80 mg of CUR, 1000 mg of NS, or their combination (CUR‐NS) for 6 months. All patients were also treated with alendronate (70 mg) and calcium (500 mg), vitamin D (400 IU) supplements. The serum levels of alkaline phosphatase (ALP), osteocalcin (OC), and osteopontin (OP) were measured at the baseline and after the intervention. For safety assessment, the hepatic enzyme levels of aspartate transaminase and alanine transaminase as well as serum urea and creatinine were evaluated. ALP levels were significantly reduced in the NS (p = .029) and CUR‐NS (p = .015) groups compared with those in the placebo. After adjustment for the covariates, this effect was still significant in the CUR‐NS group (p = .004). The OC levels were decreased in the placebo, CUR, and NS groups, and the OP concentration also was attenuated in all groups through the trial. However, the intergroup differences were not significant for both biomarkers. Evaluating the key renal metabolites and hepatic enzyme levels indicated no toxicity of the administered doses. This study reveals the beneficial effects of CUR‐NS on the improvement of some bone turnover biomarkers. These compounds seem to be safe at the current dosage for supplementation in postmenopausal women.

In Vitro and Clinical Compassionate Use Experiences with the Drug-Repurposing Approach CUSP9v3 in Glioblastoma.

Background: Glioblastoma represents the most common primary brain tumor in adults. Despite technological advances, patients with this disease typically die within 1–2 years after diagnosis. In the search for novel therapeutics, drug repurposing has emerged as an alternative to traditional drug development pipelines, potentially facilitating and expediting the transition from drug discovery to clinical application. In a drug repurposing effort, the original CUSP9 and its derivatives CUSP9* and CUSP9v3 were developed as combinations of nine non-oncological drugs combined with metronomic low-dose temozolomide. Methods: In this work, we performed pre-clinical testing of CUSP9v3 in different established, primary cultured and stem-like glioblastoma models. In addition, eight patients with heavily pre-treated recurrent glioblastoma received the CUSP9v3 regime on a compassionate use basis in a last-ditch effort. Results: CUSP9v3 had profound antiproliferative and pro-apoptotic effects across all tested glioblastoma models. Moreover, the cells’ migratory capacity and ability to form tumor spheres was drastically reduced. In vitro, additional treatment with temozolomide did not significantly enhance the antineoplastic activity of CUSP9v3. CUSP9v3 was well-tolerated with the most frequent grade 3 or 4 adverse events being increased hepatic enzyme levels. Conclusions: CUSP9v3 displays a strong anti-proliferative and anti-migratory activity in vitro and seems to be safe to apply to patients. These data have prompted further investigation of CUSP9v3 in a phase Ib/IIa clinical trial (NCT02770378).

Geniposide Ameliorates Liver Fibrosis Through Reducing Oxidative Stress and Inflammatory Respose, Inhibiting Apoptosis and Modulating Overall Metabolism.

Liver fibrosis is a progressive liver damage condition caused by various factors and may progress toward liver cirrhosis, and even hepatocellular carcinoma. Many studies have found that the disfunction in metabolism could contribute to the development of liver fibrosis. Geniposide, derived from Gardenia jasminoides J. Ellis, has been demonstrated with therapeutic effects on liver fibrosis. However, the exact molecular mechanisms of such liver-protection remain largely unknown. The aim of this study was to explored the effect of geniposide on metabolic regulations in liver fibrosis. We used carbon tetrachloride (CCl4) to construct a mouse model of liver fibrosis and subsequently administered geniposide treatment. Therapeutic effects of geniposide on liver fibrosis were accessed through measuring the levels of hepatic enzymes in serum and the pathological changes in liver. We also investigated the effects of geniposide on inflammatory response, oxidative stress and apoptosis in liver. Furthermore, serum untargeted metabolomics were used to explore the metabolic regulatory mechanisms behind geniposide on liver fibrosis. Our results demonstrated that geniposide could reduce the levels of hepatic enzymes in serum and ameliorate the pathological changes in liver fibrosis mice. Geniposide enhanced the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and decreased methane dicarboxylic aldehyde (MDA) levels in liver. Geniposide treatment also decreased the levels of interleukin (IL)-6, IL-1β, and tumor necrosis factor-alpha (TNF-a) in liver tissue homogenate. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL) staining demonstrated that geniposide could reduce the apoptosis of hepatocytes. Geniposide increased the protein expression of B-cell lymphoma-2 (Bcl-2) and downregulated the protein expression of Bcl-2 Associated X (Bax), cleaved-Caspase 3, and cleaved-Caspase 9. Serum untargeted metabolomics analysis demonstrated that geniposide treatment improved the metabolic disorders including glycerophospholipid metabolism, arginine and proline metabolism, and arachidonic acid (AA) metabolism. In conclusion, our study demonstrated the protective effects of geniposide on liver fibrosis. We found that geniposide could treat liver fibrosis by inhibiting oxidative stress, reducing inflammatory response and apoptosis in the liver, and modulating glycerophospholipid, and arginine, proline, and AA metabolism processes.

Modulatory effect of Persea Americana oil against diethylnitrosamine-induced hepatotoxicity in rats: a proposed mechanism

BackgroundThe purpose of this study was to investigate the effectiveness of Persea Americana (avocado) oil against diethylnitrosamine (DEN)-induced hepatotoxicity in rats.MethodsFor the induction of hepatotoxicity, DEN was administrated orally in a dose of 20 mg/kg B.wt for 6 successive weeks, and then the animals were gavaged with Persea Americana oil in a dose of 4 mL/kg b.wt. daily for another 6 weeks. Serum caspase-3 activity and poly (ADP-ribose) polymerase-1 (PARP-1) levels were estimated; in addition to gene expressions for NADPH oxidase, inducible nitric oxide synthase (iNOS), Bcl-2, and Bax were detected.ResultsThe DEN-intoxicated group exhibited a remarkable increase in NADPH oxidase and iNOS expression combined with over-activation of PARP-1 and increased antiapoptotic Bcl-2 gene expression, whereas the expression of apoptotic biomarkers significantly decreased. On the other hand, treatment with Persea Americana oil significantly suppressed the elevated levels of hepatic enzymes and improved histopathological alterations in the liver. Furthermore, these groups displayed marked downregulation in NADPH oxidase and iNOS expressions. Persea Americana oil suppressed the expression of the antiapoptotic Bcl-2, activated the intrinsic mitochondrial apoptosis pathway through upregulation of pro-apoptotic Bax, and induced an obvious increase in caspase-3 activity. Moreover, Persea Americana oil administration markedly inhibited the activity of PARP-1.ConclusionsThis study indicated the promising potential of Persea Americana oil against DEN-induced hepatic injury through its anti-oxidative activity and pro-apoptotic effect via caspase activation and PARP-1 inhibition.

Association of Fasting Lipid Profile with Insulin Resistance in Non-Alcoholic Fatty Liver Disease Patients

Back ground: Non-Alcoholic Fatty Liver Disease (NAFLD) is a common cause of Chronic Liver Disease (CLD) worldwide and is becoming a major public health problem. NAFLD has been recognized as a hepatic manifestation of Metabolic Syndrome (MetS) linked with Insulin Resistance (IR) and is currently considered as the hepatic component of the Metabolic Syndrome (MetS). NAFLD is strongly associated with IR and is mostly silent which is often discovered incidentally through elevated hepatic enzyme levels. The purpose of this study is to find out the association of Fasting Lipid Profile (FLP) with IR in NAFLD subjects.
 Materials and methods: A prospective hospital based cross sectional study was carried out in the Department Of Biochemistry, Institute of Nuclear Medicine and Allied Sciences (INMAS) and Chittagong Medical College Hospital. One hundred & fifty (150) subjects aging between 18-60 years were included in this study by non probability consecutive sampling method. Important variables in this study were Fasting Plasma Glucose (FPG) Fasting Serum Insulin (FPI) and Fasting Lipid Profile (FLP). IR was calculated by using Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index i.e. (FPI μIU x FPG mmol/L)/22.5.
 Results: In this study HOMA-IR was significantly higher in cases than that of controls (4.77±0.16) and showing Insulin Resistance (IR) in 90% of the cases. There was a significant association of HOMA-IR with increased serum Triglyceride (TG) in NAFLD cases.
 Conclusion: The findings of the current study suggest that independent variable such as increased Serum TG was associated with IR in NAFLD subjects.
 Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 3-7

The single or combined Silybum marianum and co-enzyme Q10 role in alleviating fluoride-induced impaired growth, immune suppression, oxidative stress, histological alterations, and reduced resistance to Aeromonas sobria in African catfish (Clarias gariepinus)

High fluoride (FL) concentration in many areas of the world is of great concern. It poses a threat to aquatic life. Therefore, the current study was operated to scrutinize the efficiency of Silybum marianum (SM) and/or coenzyme Q10 (CQ10) dietary supplementation to rescue FL negative effects on the growth, hematological indicators, liver and kidney function, serum protein profile, innate immune parameters, oxidative status, vital organ architecture, and disease resistance to Aeromonas sobria. Two hundred and forty healthy Clarias gariepinus fish were alienated into eight groups in triplicate. The control group was fed a non-supplemented basal diet. The SM, CQ10, and SM + CQ10 groups were fed a basal diet fortified with 10 g SM/kg diet, 40 mg CQ10/kg diet, or SM + CQ10, respectively. The FL group was exposed to 73.45 mg FL/L water. The FL + SM, FL + CQ10, and FL + SM + CQ10 were exposed to FL concomitantly with SM, CQ10, and SM + CQ10, respectively. The experiment continued for 60 successive days. The results showed lower weight gain and specific growth rate but higher hepatosomtic index in the FL-exposed fish. An obvious leukopenic and anemic condition was detected. Also, a significant increase in the serum levels of hepatic enzymes and kidney damage products was apparent in FL-exposed fish. Nevertheless, exhaustion of the non-enzymatic and enzymatic antioxidants but elevated lipid peroxidation product (MDA) was noted. The FL exposure exhausted lysozyme activity, complement 3, nitric oxide, total proteins, albumin, and γ globulin contents in the serum of C. gariepinus. Moreover, diverse pathological alterations were detected in the liver, kidney, and spleen. After 14 days of A. sobria challenge, the relative survival rate percentage was significantly reduced in FL-exposed fish. On the contrary, the SM and/or CQ10 addition significantly reduced most FL-associated negative impacts. Conclusively, SM and/or CQ10 dietary supplements could be beneficial for alleviating FL deleterious impacts, thus affording advantageous aqua feed additive for C. gariepinus.

Effect of Red Cabbage Juice as a Hepatoprotector on Liver Enzyme Levels

Background: Anthocyanin-rich red cabbage is known to reduce hepatic enzymes levels such as SGPT, SGOT, ALP, and GGT in drug-induced liver injury (DILI). Objective: This study aimed to determine the effect of red cabbage juice on SGOT, ALP, and GGT levels in acetaminophen-induced liver injury in rats.Methods: This was an experimental study using a post-test-only control group design. Thirty male Wistar rats were randomly divided into 5 groups. K1 was the negative control. K2, K3, K4, and K5 were pretreated with 300 mg acetaminophen. K3, K4, and K5 were treated with 0.5 g/ml of red cabbage juice, 0.7 g/ml of red cabbage juice, and 0.9 g/ml of red cabbage juice respectively. Data were analyzed using one-way ANOVA and post hoc LSD (p<0.05). Results: There was no significant difference in SGOT and GGT levels among the groups p=0.271(p>0.05) and p=0.053 (p>0.05) respectively. Whereas ALP levels showed significant differences among the groups p=0.000 (p<0,05) respectively. Conclusion: The administration of red cabbage in any dose had no effect on SGOT and GGT levels in acetaminophen-induced liver injury in rats whereas in ALP, the most effective dose to cause an effect is 0.5 g/ml.

Pathophysiological and diagnostic importance of fatty acid-binding protein 1 in heart failure with preserved ejection fraction

Elevated intracardiac pressure at rest and/or exercise is a fundamental abnormality in heart failure with preserved ejection fraction (HFpEF). Fatty acid-binding protein 1 (FABP1) is proposed to be a sensitive biomarker for liver injury. We sought to determine whether FABP1 at rest would be elevated in HFpEF and would correlate with echocardiographic markers of intracardiac pressures at rest and during exercise. In this prospective study, subjects with HFpEF (n = 22) and control subjects without HF (n = 23) underwent resting FABP1 measurements and supine bicycle exercise echocardiography. Although levels of conventional hepatic enzymes were similar between groups, FABP1 levels were elevated in HFpEF compared to controls (45 [25–68] vs. 18 [14–24] ng/mL, p = 0.0008). FABP1 levels were correlated with radiographic and blood-based markers of congestion, hemodynamic derangements during peak exercise (E/e’, r = 0.50; right atrial pressure, r = 0.35; pulmonary artery systolic pressure, r = 0.46), reduced exercise cardiac output (r = − 0.49), and poor exercise workload achieved (r = − 0.40, all p < 0.05). FABP1 distinguished HFpEF from controls with an area under the curve of 0.79 (p = 0.003) and had an incremental diagnostic value over the H2FPEF score (p = 0.007). In conclusion, FABP1 could be a novel hepatic biomarker that associates with hemodynamic derangements, reduced cardiac output, and poor exercise capacity in HFpEF.

Nature׳s gifts to medicine: The metabolic effects of extracts from cocoons of Larinus hedenborgi (Coleoptera: Curculionidae) and their host plant Echinops cephalotes (Asteraceae) in diabetic rats

Ethnopharmacological relevanceTrehala manna (TM), the edible cocoons of several weevil species, e.g. Larinus hedenborgi Boheman, 1845 (Coleoptera: Curculionidae) and their host plant, i.e. Echinops cephalotes DC. (EC) (Asteraceae), are traditionally used to treat pain, inflammation, infectious diseases, as well as respiratory, renal, reproductive and metabolic disorders.Aim of the study: This study investigated the metabolic effects of aqueous extracts from TM and EC on diabetic male Wistar albino rats. Materials and methodsAnimals were orally gavaged with the extracts (75, 150, and 300 mg/kg), normal saline, and glibenclamide (Glbn), for 28 days. The serum levels of glucose, insulin, lipid profile, and hepatic enzymes, plus the body weight of rats were measured at the beginning and the end of study. The proximate composition of the extracts was determined, additionally. The antioxidant and cytotoxic potency of the extracts were evaluated by radical scavenging/ferric reducing and viability assays, respectively. ResultsTreatment of diabetic rats with the extracts significantly altered metabolic biomarkers compared with diabetic, control and Glbn-treated groups, but not in a dose-dependent manner. However, the antihyperglycemic effects of TM75/EC300, the antiobesity effects of EC150, and the hepatoprotective effects of TM150/EC150 were even stronger than those of Glbn. TM/EC-treated groups represented normal cell architecture in the pancreatic and renal tissues. Nutrient analysis displayed that TM is rich in sugar and magnesium, whereas EC is abundant in protein, sodium, potassium, and calcium. The extracts showed no antioxidant and cytotoxic effects, as compared to the control groups. ConclusionsThe findings suggest that active ingredients in the extracts evaluated are responsible for the metabolic effects by lowering blood sugar and restoring the damaged islets of Langerhans. The close trophic relationship of the TM-producing beetle with the host thistle justifies the overlaps of the bioactivity of the TM and EC extracts.

Impact of the cardio-hepatic syndrome on outcomes after transcatheter mitral valve edge-to-edge repair

Abstract Background The prognostic value of impaired liver function in the presence of moderate-to-severe and severe mitral regurgitation (MR), also called cardio-hepatic syndrome (CHS), for outcomes in patients undergoing transcatheter edge-to-edge repair (TEER) has not been studied yet. Purpose In this work, we aimed at identifying the prognostic impact of the CHS on two-year all-cause mortality in patients undergoing TEER compared to established risk factors. Furthermore, we evaluated the change in hepatic function after TEER. Methods Hepatic function was assessed by laboratory parameters of liver function (bilirubin, gamma glutamyl transferase [GGT], alkaline phosphatase [AP], aspartate and alanine aminotransferase [AST and ALT]). We defined CHS as elevation of at least two out of three laboratory parameters of hepatic cholestasis (bilirubin, GGT, AP). The impact of CHS on two-year mortality was evaluated using a proportional hazards Cox model. The change in hepatic function after TEER was evaluated by repeat laboratory testing at follow-up. Results We included 1083 patients who underwent TEER for highly symptomatic primary or secondary MR at four high volume academic European centers between 2008 and 2019. In 66.4% of patients, we observed elevated levels of either bilirubin, GGT or AP. CHS was present in 23% of patients and showed strong association with a reduced two-year survival (52.9% vs. 87.0% in patients without CHS, p&amp;lt;0.01). In a multivariate Cox regression model, CHS was identified as a strong and independent predictor of increased two-year mortality (hazard ratio 1.49, p=0.03). In patients with successful MR reduction ≤2+ (90.7% of patients), parameters of hepatic function significantly improved from baseline to follow-up (−0.2 mg/dl for bilirubin; −21 U/l for GGT, respectively, p&amp;lt;0.01), while they did not in case of residual postprocedural MR &amp;gt;2+. Conclusions CHS can be observed in up to 25% of patients undergoing TEER and is associated with impaired two-year survival rates. Successful TEER is associated with decreased levels of hepatic enzymes at follow-up evaluation. Funding Acknowledgement Type of funding sources: None. Cardio-hepatic syndrome TEER

Hepatic Enzyme Effects of an Imperata cylindrica Extract

This study was performed to investigate the effects of aqueous Imperata cylindrica root extract on hepatic enzyme levels of alloxan-induced diabetic male Wistar rats. Forty (48) male wistar rats were divided into six groups consisting of eight animals each. Diabetes mellitus was induced using intraperitoneal administration 150 mg/kg body weight of alloxan and treatment was carried out for a period of 28 days. The first group served as the normal control and received only feed and water ad libitum. In Group 2 were diabetic rats without treatment with extracts. Group 3: diabetic rats treated with 200 mg/kg aqueous Imperata cylindrica root extract. Group 4: diabetic rats treated with 400mg/kg aqueous Imperata cylindrica root extract. Group 5: diabetic rats treated with 600mg/kg ethanol extract of aqueous Imperata cylindrica root extract. While Group 6 was diabetic rats treated with 0.5mg/kg Glibenclamide. The liver enzymes alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase levels were significantly (p &lt; 0.05) changed in rats treated with Alloxan (150mg/kg b.w.) while treatment with the respective dosages of extracts significantly changed the levels of these parameters to normal. The results obtained indicate that the different doses of aqueous Imperata cylindrica root extracts were beneficial in mending damages to the liver caused by Alloxan monohydrate in the male wistar rats.

Synthesis of silver nanoparticles by Galega officinalis and its hypoglycemic effects in type 1 diabetic rats

Objective(s): Diabetes is related with the higher blood levels of liver enzymes and inflammatory factors. Galega officinalis is used as a medicinal plant for treatment of diabetes traditionally. In this work, silver nanoparticles (Ag-NPs) were synthesized with green method using Galega officinalis extract.Materials and Methods: The synthesized green Ag-NPs were characterized completely. Intact or diabetic rats receieved intraperitoneal injection of saline or 2/5mg/Kg green synthesized Ag-NPs. Mean serum levels of glucose, hepatic enzymes and hematological parameter were determined. Gene expression of tumor necrotic factor alpha (TNF-α) was done by real-time PCR. Results: Synthesis of green synthesized Ag-NPs was confirmed by FT-IR, XRD and UV-vis analyses. The FESEM and TEM images showed spherical Ag-NPs with size of 25 nm. The hypoglycemic influence of Ag-NPs using Galega officinalis extract is reported for the first time in this study. Blood concentration of liver enzymes, urea, glucose, white blood cells count and TNF-α mRNA levels in visceral adipose tissue significantly declined in diabetic rats receiving Ag-NPs.Conclusion: The synthesized Ag-NPs using Galega officinalis extract may improve complication of diabetes via preventing liver hepatocyte damage and reducing inflammatory factors.