Liver Enzymes Alanine Aminotransferase Research Articles

Presence of Antibodies to SARS-CoV-2 in Domestic Cats in Istanbul, Turkey, Before and After COVID-19 Pandemic.

Recent studies demonstrated that domestic cats can be naturally and experimentally infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This study was performed to investigate the presence of SARS-CoV-2-specific antibodies within the domestic cat population in Istanbul, Turkey, before the coronavirus disease 2019 (COVID-19) and during the COVID-19 pandemic. Overall, from 155 cat sera analyzed, 26.45% (41/155) tested positive in the spike protein-ELISA (S-ELISA), 28.38% (44/155) in the receptor-binding domain-ELISA (RBD-ELISA), and 21.9% (34/155) in both, the S- and RBD-ELISAs. Twenty-seven of those were also positive for the presence of antibodies to feline coronavirus (FCoV). Among the 34 SARS-CoV-2-positive sera, three of those were positive on serum neutralization assay. Six of the 30 cats before COVID-19 and 28 of the 125 cats during COVID-19 were found to be seropositive. About 20% of ELISA-positive cats exhibited mainly respiratory, gastrointestinal, and renal signs and skin lesions. Hematocrit, hemoglobin, white blood cells, lymphocyte, and platelet numbers were low in about 30% of ELISA-positive cats. The number of neutrophils and monocytes were above normal values in about 20% of ELISA-positive cats. The liver enzyme alanine aminotransferase levels were high in 23.5% ELISA-positive cats. In conclusion, this is the first report describing antibodies specific to SARS-CoV-2 antigens (S and RBD) in cats in Istanbul, Turkey, indicating the risk for domestic cats to contract SARS-CoV-2 from owners and/or household members with COVID-19. This study and others show that COVID-19-positive pet owners should limit their contact with companion animals and that pets with respiratory signs should be monitored for SARS-CoV-2 infections.

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 < 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.

S2817 Glycopenic Hepatopathy in a Patient With Recurrent Diabetic Ketoacidosis: A Rare Complication of Poorly Controlled Type 1 Diabetes Mellitus

Introduction: Glycogenic hepatopathy (GH) is a rare condition predominately seen in patients with poorly controlled type 1 diabetes mellitus. This condition develops due to excessive accumulation of glycogen in the hepatocytes, leading to significant hepatomegaly and transient liver dysfunction with elevated liver enzymes. Case Description/Methods: A 24-year-old female with a history of poorly controlled type 1 diabetes mellitus complicated by multiple admissions for diabetic ketoacidosis (DKA) presented with acute onset abdominal pain, nausea and vomiting. Physical exam was significant for tender hepatomegaly. Admission laboratory results were significant for serum glucose 189 mg/dL, bicarbonate 5 mmol/L, anion gap 35 mmol/L, beta-hydroxybutyrate 6.5 mmol/L, and HbA1c 11.4%. Admission hepatic panel was significant for alanine aminotransferase 31 U/L, aspartate aminotransferase 56 U/L, alkaline phosphatase 138 U/L with normal bilirubin and prothrombin time. Patient was treated with insulin and intravenous fluids with resolution of her DKA. However, her clinical course was complicated by persistent abdominal pain with an acute rise in liver enzymes (alanine aminotransferase 216 U/L, aspartate aminotransferase 249 U/L, alkaline phosphatase 116 U/L with normal bilirubin and prothrombin time). Triglyceride level was elevated at 214mg/dL. Abdominal computed tomography was notable for hepatomegaly with liver size of 24 cm. Workup for hepatitis, HIV, COVID-19, autoimmune hepatitis, hemochromatosis, and Wilson's disease were negative. Patient underwent liver biopsy that demonstrated diffuse hepatocyte cytoplasmic clearing, consistent with GH. The patient was medically managed with strict glycemic control, diabetic diet and endocrinology input throughout admission. One week after hospital discharge, the patient remained asymptomatic and liver function tests returned to normal limits. Discussion: GH is a rare condition that should be considered in patients with poorly controlled diabetes mellitus who present with hepatomegaly and acute liver injury. While GH presents similarly to NAFLD, it can only be differentiated and definitely diagnosed by liver biopsy. This condition should not be overlooked as it is a favorable diagnosis with a good prognosis compared to other liver disease associated with diabetes mellitus. Further studies are needed to better understand the characteristics of this disease, and future development of non-invasive, rapid diagnostic testing could help avoid extensive and costly workups. (Figure Presented).

Mechanism of antibacterial effect for different venoms (Naja haje, Cerastes cerastes, Apis mellifera) on Staphylococcus aureus

Abstract The overuse and misuse of antibiotic without going to doctor leading to antibiotic resistant strains that represent a serious problem in the field of health protection, Staphylococcus aureus (S. aureus) remains one of the main causes for hospital infections specially in the intensive care unit (ICU), so that many researches directed to natural products as alternative antibiotic drug, nowadays special attention towards venoms as (elapids, viprides, honey bee venom, etc….) which contain molecules with antibacterial properties such as phospholipase A2 (PLA2), L-amino acids (LAAO) and melittin. The present study aimed to evaluate in vitro and in vivo antibacterial effect of three different venoms the Egyptian Cobra (Naja haje), the horned viper (Cerastes cerastes) and honey bee (Apis mellifera) on S. aureus. There were tested in vitro by Minimum inhibitory concentration (MIC) test and disc diffusion method. In vivo evaluation was performed by infecting groups of mice by S. aureus, then treated with these three venoms and standard antibiotic. The hematological studied showed that effect on Hb and RBCs not all groups like others compared to control. Biochemical analysis of mice sera, liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and kidney function (urea and creatinine) as well as cardiac enzyme creatinine phosphokinase (CPK) showed that all treated and untreated groups in biochemical studies recorded a significant increase in all liver, kidney and cardiac functions. Histological examination illustrated that liver and kidney tissue in untreated group with inflammatory cells infiltration, degree of inflammation decrease in both N. haje and C. cerastes groups, while A. mellifera and antibiotic groups approximately normal in both mice liver and kidney.

Comparative Study on the Effects of Paullinia cupana, PC-18 and Magnesium Chloride on Solid Ehrlich Tumor.

New perspectives arise in the therapeutic practice for cancer, with the objective to not only treat patients, but also improve their quality of life. Guarana, a plant from Brazilian Amazon presents a wide range of pharmacological actions. This study evaluated the effect of Guarana (Paullinia cupana) extract, pure and dry Guarana (PC-18) extract and magnesium chloride (MgCl2) in mice of the Balb/c strain inoculated with the Ehrlich tumor regarding gene expression of inflammatory markers transforming growth factor-β1 and tumor necrosis factor alpha and oxidative stress (OS) and fatigue, superoxide dismutase, catalase, and glutathione peroxidase 4 and analyzed myelotoxicity and hepatotoxicity. After euthanasia, blood was collected to analyze the complete blood count and measured the levels of liver enzymes (alanine aminotransferase and aspartate aminotransferase). Hepatoprotective actions of the crude extract of P. cupana and PC-18 extract were noticed. The PC-18 and MgCl2 group showed the best result regarding animal welfare. There were no associations between compounds and gene expression regarding fatigue and OS. PC-18 reduced the tumor and may have an antitumor action. The crude extract of Guarana presented hepatoprotective action.

PREPARATION OF SALVIA OFFICINALIS L. EXTRACT AND STUDY OF ITS EFFECT ON SOME PHYSIOLOGICAL VARIABLES IN ALBINO RATS

Salvia officinalis is one of the most valued herbs because of its high amount of essential oil and its many components. It has many health-related uses such as improving cognition, as well as reducing the amount of nursing mother's milk during weaning, also recommended for the gargling of the infectious throat, and to treat cardiovascular diseases and nervous disturbance, depression, cerebral ischemia and acts as an antiseptic for wounds. This study aim was to prepare the plant extract of Salvia officinalis L. from the Iraq local areas, determine its chemical properties and study its effect on some physiological and immunological variables in white rats. The plant leave Extract was Prepared and its effects were assessed on several physiological parameters using 20 male rats. The rats were divided into four groups. the control group(G1) received standard food and water; the negative control group (G2) received fat rich diet; G3 rats were given Salvia officinalis with a concentration of 100 mg\ kg\day. G4: rats were given Salvia officinalis 100mg/kg body weight and received fat rich diet. Roche/Hitachi, cobas c 501/502 were used to evaluate the levels of aminotransferase Enzymes, Aspartate transaminase (AST), Alanine aminotransferase (ALT), alkaline phosphatase enzyme (ALP), serum creatinine, serum urea, total protein, albumin, cholesterol, triglyceride, and high-density lipoprotein (HDL). While Globulin concentration, very Low-Density Lipoprotein (VLDL), and Low-Density Lipoprotein (LDL) were calculated according to some referred equations. The phytochemical analysis showed that the compounds identified in the sample were found to be alkaloids, phenols, tannins, coumarins glycosides, flavonoids, quinines, Carbohydrates and steroids. The results showed a significant increase (P <0.01) in the level of liver enzymes ALT, AST and ALP, in the G2 treated with the high fat diet compared with a control group and showed a significant increase (P <0.01) in the level of urea an

Longitudinal Changes in Liver Enzyme Levels Among Transgender People Receiving Gender Affirming Hormone Therapy

BackgroundThe effect of gender affirming hormone therapy (GAHT) on clinical laboratory parameters, including levels of liver enzymes alanine aminotransferase (ALT) and aspartate transaminase (AST), is an area of uncertainty in transgender health. AimWe sought to estimate the distribution parameters of liver enzyme levels among transmasculine (TM) and transfeminine (TF) persons receiving GAHT relative to the corresponding measures in cisgender reference groups, and to evaluate longitudinal changes in these laboratory measures following GAHT initiation. MethodsThe data for this longitudinal study included 624 TF and 438 transmasculine (TM) people as well as 4,090 cisgender males and 4,797 cisgender females enrolled in 3 integrated health systems. Time under observation was divided into 2 intervals: from the first blood test to the date of the first filled GAHT prescription and from GAHT initiation to the most recent ALT or AST measurement. Linear mixed models were used to compare changes in log-transformed ALT and AST values among transgender cohort members before and after GAHT initiation, and relative to the reference groups. The results were expressed as relative differences (in %) and the ratios of these differences (ratios-of-ratios) along with the 95% confidence intervals (CIs). OutcomesChanges in ALT and AST levels among transgender people over time and relative to the corresponding changes in cisgender referents. ResultsAmong TM study participants, the post GAHT ratios-of-ratios for AST were 1.61 (95% CI: 1.13, 2.31) and 1.57 (95% CI: 1.06, 2.31) relative to cisgender males and females respectively. For ALT, the corresponding comparisons yielded the ratios-of-ratios (95% CIs) of 2.06 (1.67, 2.54) and 1.90 (1.50, 2.40). No statistically significant changes were observed among TF participants. Other factors associated with higher liver enzyme levels included alcohol use/abuse and obesity. Clinical ImplicationsTM persons may experience modest increases in ALT and AST concentrations following testosterone initiation; however, clinical significance of the observed association remains unclear and requires further investigation. By contrast, feminizing GAHT is unlikely to induce appreciable changes in liver enzyme levels. Strength and LimitationsThe strengths of this study are the longitudinal design and the ability to assemble an unselected cohort nested within large health systems. The main limitations include the lack of information on hormone levels and the inability to take into account GAHT doses and routes of administration. ConclusionThe influence of long-term GAHT on ALT and AST levels appears modest and not likely to reflect clinically meaningful changes in liver function. Hashemi L, Zhang Q, Getahun D, et al. Longitudinal Changes in Liver Enzyme Levels Among Transgender People Receiving Gender Affirming Hormone Therapy. J Sex Med 2021;18:1662–1675.

Human adrenomedullin and its binding protein attenuate tissue injury and inflammation following hepatic ischemia reperfusion in rabbits

BackgroundLiver injury caused by ischemia reperfusion (I/R) during surgical procedures, such as liver resection or liver transplantation, is a major cause of liver damage and graft failure. The current method of treatment is mostly preventative (i.e., ischemic preconditioning). While a number of pharmacological modalities have been studied to reduce hepatic I/R injury, none have been entirely successful. It has been demonstrated that the administration of adrenomedullin (AM) in combination with AM-binding protein (AM/AMBP-1) exerts significant protective effects in various pathological conditions. In an effort to develop AM/AMBP-1 as a novel therapeutic for hepatic I/R injury, the present study examined the effect of a low dose of human AM, which does not induce hypotension, in combination with human AMBP-1 in a rabbit model of hepatic I/R (i.e., non-rodent species). MethodsIschemia of 70% of the liver was induced by placing a microvascular clip across the hilum of the left and median lobes for 60 min. The clip was then removed to commence reperfusion. At 15 min following clip removal (i.e., reperfusion), human AM/AMBP-1 was administered intravenously via the ear marginal vein continuously for 30 min. At 20 h, blood and tissue samples were collected for various measurements. ResultsThe serum levels of liver enzymes (alanine aminotransferase and aspartate aminotransferase) and lactate dehydrogenase, were elevated following hepatic I/R. The administration of AM/AMBP-1 significantly decreased these levels by 58, 44, 41%, respectively. Hepatic I/R increased the direct and total bilirubin levels, whereas treatment with human AM/AMBP-1 decreased these levels by 60% and 69%, respectively. Treatment with AM/AMBP-1 also inhibited interleukin-6 gene expression by 95%. There were no changes in tumor necrosis factor-α (TNF-α) gene expression and myeloperoxidase activity (MPO), lactate and Suzuki scores after treatment. The treatment, however, reduced apoptosis post-hepatic I/R in the ischemic portion of the liver. ConclusionAdditional experiments with AM and AMBP-1 alone are needed to completely interpret the experimental results in this non-rodent species of hepatic I/R injury. The present study suggests that human AM/AMBP-1 may be developed as a novel therapeutic to attenuate hepatic I/R associated inflammation and liver injury.

Association of Various Biomarkers and Liver Enzymes with Severity of COVID-19

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing novel coronavirus (COVID-19) outbreak has an impact on the liver enzymes. The study aimed to determine the serum markers and liver enzymes and their association in COVID-19 patients admitted to hospital. Methods: It was a retrospective, observational study conducted at the Gastroenterology Department of Lahore General Hospital, from April 2020-July 2020. Total 495 patients were divided into two groups. Group A (318) comprised of patients with moderate symptoms and group B (177) with severe symptoms. Records were obtained from the hospital laboratory in which Lactate dehydrogenase (LDH), Aspartate aminotransferase, (AST), Alanine aminotransferase (ALT), Gamma glutamyl transferase (GGT) and Alkaline phosphatase (ALP) were assessed using an automated biochemistry analyzer. Serum C-reactive protein test was performed by the immunoturbidimetric assays. Serum Ferritin was determined using the ELISA technique. Results: The mean age of moderate cases was 48.57±16.84 years and of severe cases were 62.51±9.76 years. In both moderate and severe cases, males [200(63%), 98(55.36%)] were more affected than females [118(37.10%), 79(44.63%)]. Furthermore, 79(16%) of severe cases were associated with medical profession. The levels of CRP, Ferritin and LDH were increased significantly in severe COVID-19 cases (p<0.05) compared to moderate ones. On the other hand, liver enzymes ALT, AST, GGT and ALP were non-significantly raised in severe cases compared to moderate cases (p> 0.05). Conclusion: Serum ferritin, C-reactive protein and lactate dehydrogenase acts as prognostic biochemical parameters based on severity. In addition, levels of liver enzymes were also raised indicating liver derangement; however, the results were not significant. Keywords: Ferritin; C-Reactive Protein; Lactate Dehydrogenase; Gama Glutamyl Transferase; Covid-19.

Testosterone Deficiency, Long-Term Testosterone Therapy, and Inflammation.

We aimed to evaluate the association of testosterone deficiency with inflammation and how long-term testosterone therapy affects inflammation biomarkers over time. We conducted a 2-component study. First, we conducted a cross-sectional study using the recently released 2015-2016 National Health and Nutrition Examination Survey (NHANES) data to examine the association between testosterone deficiency and inflammation biomarkers including high sensitivity C-reactive protein (hsCRP), liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the US general population. Then we conducted a longitudinal study to investigate the longitudinal effect of testosterone therapy on inflammation biomarkers and the risk of cardiovascular events, using data from 776 hypogonadal men based on a registry study in Germany with up to 11 years' follow-up. The adjusted odds ratios (ORs) describing the associations between testosterone deficiency and hsCRP ≥ 3mg/L, ALT > 40U/L, and AST > 40U/L were 1.81 (P-value < 0.001), 1.46 (P-value = 0.009), and 0.99 (P-value = 0.971), respectively. In the control group, CRP, ALT, and AST levels increased by 0.003 (95%CI: -0.001, 0.007) mg/L, 0.157 U/L (95%CI: 0.145, 0.170), and 0.147 (95%CI: 0.136, 0.159) U/L per month, while in the treatment group, CRP, ALT, and AST levels decreased by 0.05 (95%CI: -0.055, -0.046) mg/L, 0.142 U/L (95%CI: -0.154, -0.130), and 0.148 (95%CI: -0.158, -0.137) U/L per month. Testosterone deficiency was associated with an increased level of inflammation; long-term testosterone therapy alleviated inflammation among hypogonadal men, which may contribute to the reduced cardiovascular risk. Future large trials are warranted to confirm our observational study findings.

A Comparative Study of the Antihypertensive Agents on Serum Liver Enzymes ALT, AST and ALP of Hypertensive and cardiac Patients

Present study is done to compare serum Liver enzymes including Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST) and Alkaline Phosphatase (ALP) in hypertensive and cardiac patients. 24 patients were divided into 4 groups according to their treatment with 4 different types of antihypertensive drugs. Group I treated with Beta-blockers (1+1). Group II treated with ACE-Inhibitor once a day. Group III treated with Nitrates once a day. Group IV is taking Diuretics once a day. Data showed non-significant difference in serum ALT concentration in all groups. A significant rise (p&lt; 0.05) in serum AST and ALP levels among hypertensive and cardiac patients is observed, ranging from 24.63-47.33U/L and 110-2484 U/L respectively when compared with normal controls. Thus, not only the risk of cardiac diseases in future might be predicted by altered levels of enzymes ALT, AST and ALP in serum but their concentrations should be monitored during the treatment of cardiac diseases to minimize the risk of cardiac arrest.

Antifibrotic potential of carvedilol and cilostazol on liver fibrosis in rats

Objective The aim was to investigate possible prophylactic and therapeutic effects of carvedilol and cilostazol on liver fibrosis induced by thioacetamide in rats. Background Liver fibrosis is a major public health problem worldwide. Materials and methods A total of 50 adult male rats weighing 200–250 g were used and distributed in five groups (10 rats each): group I (control), group II (thioacetamide), group III (carvedilol + thioacetamide), group IV (cilostazol + thioacetamide), and group V (carvedilol + cilostazol + thioacetamide). At the end of the experiment, rats were killed, and blood samples were used for measuring serum levels of aspartate aminotransferase, alanine aminotransferase, tumor necrosis factor-α, malondialdehyde, and glutathione peroxidase. Results Carvedilol, cilostazol, and their combination significantly decrease elevated liver enzymes alanine aminotransferase and aspartate aminotransferase by 18, 24, and 29% (P = 0.003 for all) and 25, 27, and 29% (P = 0.034 for all), respectively; decrease biomarkers of oxidative stress such as malondialdehyde and tumor necrosis factor-α by 62, 65, and 68% (P Conclusions Carvedilol and cilostazol may play a role in hepatic protection in thioacetamide-induced hepatic fibrosis. Combined treatment showed a better hepatoprotective effect than either treatment alone did.

Coffee Consumption and Liver Health: Results From the UK Biobank

ObjectivesPrevious studies suggest a positive association between coffee consumption and liver health, yet the evidence available is not unequivocal. Given the burden of liver disease, we studied the relationship of habitual coffee consumption with serum biomarkers of liver health and non-alcoholic fatty liver disease (NAFLD) incidence. MethodsWe included 209,575 participants from the UK Biobank cohort (mean age 56.1 and 68% women, median coffee consumption per day 1.00 cup [0.50, 3.00]), free of disease at baseline. Firstly, we studied cross-sectional associations of coffee consumption with serum concentrations of the liver enzymes alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), and total bilirubin using multivariable linear regressions. Secondly, we analyzed associations with elevated enzyme concentrations according to clinical cutoffs to monitor liver damage, using logistic regressions. Lastly, in a longitudinal analysis, we assessed the association of coffee consumption and incident NAFLD in cox proportional hazard models. Models were adjusted for sociodemographic, lifestyle and health-related factors. Results are reported as β log transformed IU/L, odds ratio (OR) or hazard ratio (HR) with their 95% confidence intervals [95% CI] per one cup increase in coffee intake. ResultsOver a median follow up of 10.9 years, 2258 cases of incident NAFLD occurred in the population. Higher coffee consumption was associated with lower concentrations of log-transformed ALP (–0.005 [95% CI –0.006, –0.005]), ALT (–0.004 [–0.005, –0.003]), AST (–0.005 [–0.005, –0.004]), GGT (–0.008 [–0.009, –0.007]) and total bilirubin (–0.009 [–0.010, –0.008]). Secondly, higher coffee consumption was associated with lower odds of having elevated levels of all studied liver enzymes (OR from 0.91, [0.89, 0.92] for total bilirubin to 0.98 [0.97, 0.98] for GGT). Finally, higher coffee consumption was associated with lower risk of developing NAFLD (HR 0.98 [0.96, 0.99]). ConclusionsIn this large cohort we observed an inverse association between higher coffee consumption and serum concentrations of baseline liver enzymes and NAFLD risk. These findings suggest that habitual consumption of coffee may be protective of liver health. Funding SourcesN/A.

Girl with left-sided hip pain and fever.

A previously healthy 13-year-old girl presented to the pediatric emergency department (PED) with 5 days of progressively worsening left-sided hip pain and 4 days of fever. Although she was able to bear weight on the left leg, she walked with a limp. There was no preceding trauma or illness. In the PED, she was febrile to 39.5°C and tachycardic with other vital signs appropriate for her age. On examination, she had full range of motion of the left hip with significant tenderness only to palpation over the left iliac crest and left gluteal region. Examination was otherwise unremarkable with no overlying skin changes, warmth, edema, or breaks in the skin. Initial laboratory studies revealed abnormalities, including pancytopenia (WBC 2.5 k/uL, hemoglobin 11.5 g/dL, and platelets 32 k/uL), elevated inflammatory markers (C-reactive protein 12.6 mg/dL and erythrocyte sedimentation rate 31 mm/hour), and elevated liver enzymes (alanine aminotransferase 153 U/L and aspartate aminotransferase 221 U/L). The working diagnosis at this point was acute osteomyelitis of the iliac bone. Magnetic resonance imaging (MRI) of the pelvis was performed with and without contrast and revealed abnormal signal intensity and contrast enhancement of the left iliacus and gluteal musculature surrounding the left iliac wing without evidence of abscess (Figure 1). In addition, diffusely increased T2 signal and slightly decreased T1 signal intensity was noted throughout all visible osseous structures (Figure 2). Hours after initial presentation, blood culture resulted positive for methicillin-sensitive staph aureus (MSSA). This patient's MRI findings were consistent with myositis. Given her MSSA bacteremia and imaging finding consistent with soft-tissue infection, the most likely diagnosis is pyomyositis without abscess formation. Acute bacterial myositis can be caused by contiguous spread from a soft-tissue infection, penetrating trauma, or hematogenous spread. When the source is hematogenous, it is referred to as pyomyositis and is often associated with abscess formation. MSSA is the most common pathogen in these cases.1 Although primary pyomyositis is rare in temperate climates, its incidence outside of tropical climates has been increasing in recent years. Risk factors include immunodeficiency (eg, HIV), diabetes mellitus, malignancy, and local muscle trauma. MRI is the imaging modality of choice, and treatment includes drainage of the abscess with pathogen identification when possible, followed by targeted antibiotic therapy.2 This patient's abnormal bone marrow enhancement on MRI and significant cytopenia initially raised suspicion for a malignant process such as leukemic infiltration of the bone marrow. However, given that the patient's cytopenia resolved with antibiotic treatment, bone marrow abnormalities were likely secondary to infection. The patient completed a 3-week course of cephalexin and made a full recovery.

Protective Effect of Resveratrol against Hepatotoxicity of Cadmium in Male Rats: Antioxidant and Histopathological Approaches

Cadmium (Cd) is widely used in some industries and emitted from fossil fuels. It is a heavy metal with a number of side effects, including hepatotoxicity. Resveratrol (Rs) is considered an important polyphenol, which is a secondary plant metabolite and has the ability to scavenge free radicals. The study was designed to evaluate the effects of resveratrol on Cd, which induced hepatotoxicity, by the assessment of some histopathological and biochemical alterations. Forty male albino rats were divided into four groups: the 1st group was the control group, the 2nd group was treated with Cd (5 mg/kg), the 3rd group was given Rs (20 mg/kg), and the 4th group was treated with Cd in combination with Rs intraperitoneally for 30 successive days. The results indicate that Cd increased liver enzymes alanine aminotransferase and aspartate aminotransferase (AST and ALT), alkaline phosphatase ALP and gamma-glutamyl transferase (γ-GT) while reducing the total protein level; Cd increased the malondialdhyde (MDA) level while decreasing the levels of other antioxidant enzymes super oxide dismutase, catalase and glutathione peroxidase (SOD, CAT and GPx). Serious congestion and hemorrhage related to the hepatic tissues were noticed in the Cd group, and Rs plays a major role in alleviating histopathological injuries and hepatic oxidative damage. It is clear that Rs has the ability to minimize the hepatotoxicity induced by Cd in male rats.

Leptin Receptors Are Not Required for Roux-en-Y Gastric Bypass Surgery to Normalize Energy and Glucose Homeostasis in Rats.

Sensitization to the adipokine leptin is a promising therapeutic strategy against obesity and its comorbidities and has been proposed to contribute to the lasting metabolic benefits of Roux-en-Y gastric bypass (RYGB) surgery. We formally tested this idea using Zucker fatty fa/fa rats as an established genetic model of obesity, glucose intolerance, and fatty liver due to leptin receptor deficiency. We show that the changes in body weight in these rats following RYGB largely overlaps with that of diet-induced obese Wistar rats with intact leptin receptors. Further, food intake and oral glucose tolerance were normalized in RYGB-treated Zucker fatty fa/fa rats to the levels of lean Zucker fatty fa/+ controls, in association with increased glucagon-like peptide 1 (GLP-1) and insulin release. In contrast, while fatty liver was also normalized in RYGB-treated Zucker fatty fa/fa rats, their circulating levels of the liver enzyme alanine aminotransferase (ALT) remained elevated at the level of obese Zucker fatty fa/fa controls. These findings suggest that the leptin system is not required for the normalization of energy and glucose homeostasis associated with RYGB, but that its potential contribution to the improvements in liver health postoperatively merits further investigation.

Body Adiposity, But Not Elements of Objectively Measured Sedentary Behavior or Physical Activity, Is Associated With Circulating Liver Enzymes in Adults With Overweight and Obesity.

ObjectiveWe studied the associations between accelerometer-measured sedentary behavior (SB) and habitual physical activity (PA) as well as markers of body adiposity and other cardiometabolic risk factors with liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyltransferase (GGT).MethodsA total of 144 middle-aged adults (mean age 57 (SD 6.5) years) with overweight or obesity (mean body mass index [BMI] 31.8 [SD 3.9] kg/m2) participated. Different components of SB (sitting, lying) and PA (standing, breaks in SB, daily steps, light PA, moderate-to-vigorous PA and total PA) were measured with validated hip-worn accelerometers for four consecutive weeks (mean 25 days, [SD 4]). Fasting venous blood samples were analysed using standard assays. The associations were examined with Pearson’s partial correlation coefficient test and linear mixed model.ResultsAmong 102 women and 42 men accelerometer measured SB or the elements of PA were not associated with circulating liver enzymes. When adjusted for age and sex, liver enzymes correlated positively with BMI and waist circumference (WC) (ALT r=0.34, p<0.0001, r=0.41, < 0.0001, AST r=0.17, p=0.049, r=0.26, p=0.002, GGT r=0.29, p=0.0005, r=0.32, p < 0.0001, respectively). SB proportion associated positively with BMI (r=0.21, p=0.008) and WC (r=0.27, p=0.001). Components of PA associated negatively with BMI (MVPA r=-0.23, p=0.005, daily steps r=-0.30, p<0.0001 and breaks in sedentary time r=-0.32, p<0.0001), as well as with WC (breaks in SB r=-0.35, p<0.0001, MVPA r=-0.26, p=0.002, daily steps r=-0.31, p<0.0001, standing time r=-0.27, p=0.001). Liver enzymes associated positively with common cardiometabolic markers such as resting heart rate (ALT; β=0.17, p=0.03, AST; β=0.25, p=0.002, GGT; β=0.23, p=0.004) and systolic/diastolic blood pressure (ALT β=0.20, p=0.01, β=0.22, p=0.005, AST (only diastolic) β=0.23, p=0.006, GGT β=0.19, p=0.02, = 0.23, p=0.004, respectively), fasting insulin (ALT β=0.41, p<0.0001, AST β=0.36, p=0.0003, GGT β=0.20, p=0.04) and insulin resistance index (ALT β=0.42, p<0.0001, AST β=0.36, p=0.0003, GGT β=0.21, p=0.03), even after adjustment with BMI.ConclusionsLiver enzymes correlate with body adiposity and appear to cluster with other common cardiometabolic risk factors, even independently of body adiposity. SB and PA appear not to be essential in modulating the levels of circulating liver enzymes.

Current approaches to the use of artificial sweetener aspartame

With the recommendation of the World Health Organization (WHO) to reduce the sugar consumption of children and adults to less than 10% of the total energy intake, many people turned to sweeteners. Aspartame (E951), an artificial sweetener, is synthesized from L-phenylalanine or methyl ester of L-phenylalanine with L-aspartic acid. It is an amphoteric dipeptide composed of aspartic acid and phenylalanine. Apart from chemical peptide synthesis, aspartame can also be synthesized enzymatically commercially. 1 gr of it gives 4 Kcal energy. The taste perception of aspartame appears delayed and lasts a long time. Since it is not heat resistant during cooking, it can only be used as a sweetener in cold drinks and food, coffee, tea. Although there were some scientific objections after the introduction of aspartame to the market, animal and human experiments and investigations started to increase. In another study; Consumption of 40, 75, 500 mg/kg/day aspartame have increased oxidative stress parameters and has been reported to damage liver antioxidant capacity. Also, in some other studies in which negative effects on experimental animals were discussed, 250, 500, 1000 mg/kg/day aspartame consumption was found to significantly increase the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Besides, studies showing that aspartame does not have negative effects on health, 240 mg/kg/day aspartame consumption did not make a significant difference in alanine aminotransferase (ALT) value, and there was no significant difference between the groups in fasting blood glucose with 4% aspartame solution daily consumption. On the other hand, studies on aspartame toxicity also have conflicting results. Some studies using in vivo and in vitro tests have shown that aspartame does not cause genotoxicity, DNA damage, and mutagenesis, but does stimulate chromosome aberrations and micronucleus formation. Many studies have been done to show the safety of aspartame. The European Food Safety Authority stated in its 2013 re-evaluation that aspartame is safe for human consumption at current exposure levels. In a review evaluating the data obtained from aspartame studies, it is supported that aspartame is a safe sweetener when used within the recommended dose limits. For aspartame, this value (ADI) has been recommended as 40 mg/kg body weight/day. Considering its association with age, gender, personal metabolism, and metabolic diseases, it was concluded that the use of aspartame is safe, with the fact that it has some harmful effects depending on the exposure time and dose.

Toxicity of Cadmium Chloride on White Rats Liver and the Protective Role of Brassica Nigra Seed Extract

The study designed for the toxic role of cadmium chloride on the liver of mice from both a physiologicaland histological aspects. The animals were treated with a dose of 5 mg/kg of body weight for 30 days. Andthe protective role of Brassica nigra seed extract against cadmium chloride toxicity. This pilot study wasconducted on 20 adult white rats divided into 4 equivalent groups including the control group: Animals inthis group received a dosed of distilled water for 30 days. The placebo group was treated with cadmiumchloride at a dose of 5 mg/kg of body weight for 30 days and returned as an infected control group. Whilein the third group, animals treated with cadmium chloride were dosed with Brassica nigra seed extractat a dose of 200 mg/kg of body weight for 30 days. The fourth group was dosed with Brassica nigraseed extract at a dose of 200 mg/kg of body weight for 30 days. After 30 days, liver enzymes includingaminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were measuredby spectrophotometric method. In addition to making tissue sections of the liver. The treatment of ratsled to a significant increase (P?0.05) in liver enzymes compared with the control group. It also led tohistopathology in the liver tissue, while the Brassica nigra seed extract acted as a protective role against thetoxicity of cadmium chloride.

ω-Imidazolyl-alkyl derivatives as new preclinical drug candidates for treating non-alcoholic steatohepatitis.

Cytochrome P450 2E1 (CYP2E1)‐associated reactive oxygen species production plays an important role in the development and progression of inflammatory liver diseases such as alcoholic steatohepatitis. We developed two new inhibitors for this isoenzyme, namely 12‐imidazolyl‐1‐dodecanol (I‐ol) and 1‐imidazolyldodecane (I‐an), and aimed to test their effects on non‐alcoholic steatohepatitis (NASH). The fat‐rich and CYP2E1 inducing Lieber‐DeCarli diet was administered over 16 weeks of the experimental period to induce the disease in a rat model, and the experimental substances were administered simultaneously over the last four weeks. The high‐fat diet (HFD) pathologically altered the balance of reactive oxygen species and raised the activities of the liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AP) and γ‐glutamyl‐transferase (γ‐GT); lowered the level of adiponectine and raised the one of tumor necrosis factor (TNF)‐α; increased the hepatic triglyceride and phospholipid content and diminished the serum HDL cholesterol concentration. Together with the histological findings, we concluded that the diet led to the development of NASH. I‐ol and, to a lesser extent, I‐an shifted the pathological values toward the normal range, despite the continued administration of the noxious agent (HFD). The hepatoprotective drug ursodeoxycholic acid (UDCA), which is used off‐label in clinical practice, showed a lower effectiveness overall. I‐ol, in particular, showed extremely good tolerability during the acute toxicity study in rats. Therefore, cytochrome P450 2E1 may be considered a suitable drug target, with I‐ol and I‐an being promising drug candidates for the treatment of NASH.