Liver Function Research Articles

Subacute Toxicity Study of Stem Extract of Telfairia occidentalis in Rats

Telfairia occidentalis Hook (Cucurbitaceae) is used in Ibibio ethnomedicine for the treatment of diverse diseases such as malaria, diabetes and gastrointestinal disorders. Evaluation of subacute administration of ethanol stem extract of Telfaira occidentalis for effect on hematological indices, liver and kidney functions as well as lipid profile of rats was carried out. The stem extract (200, 400, 600 mg/kg body weight) was orally administered to Wistar rats daily for 30 days and the rats were sacrificed under light diethyl ether anesthesia at the completion of the administration. Subacute administration of T. occidentalis stem extract resulted in insignificant increase in body weights of rats especially at high doses without any significant (p>0.05) effect on the weights of heart, brain, liver, kidney, spleen and testes when compared to control, but the weights of ovary was decreased significantly (p<0.01) at higher doses (400 and 600 mg/kg) relative to control. The stem extract treatment did not affect the WBC, RBC and platelets counts, hemoglobin concentration, lymphocytes, monocytes, eosinophil and basophil percentages as well as bleeding and clotting times significantly (p>0.05) relative to control. However, significant (p<0.05) increase of neutrophils percentage at low dose (200 mg/kg) and decreased PCV percentage at higher doses (400 and 600 mg/kg) when compared to control were recorded. The stem extract administration did not cause any significant (p>0.05) effect on total protein, albumin, ALP, total and conjugated bilirubin levels of rats except significantly (p<0.05-0.01) elevated ALT and AST levels at low dose (200 mg/kg) of the extract when compared to control. The stem extract did not cause any significant effect (p>0.05) on creatinine, potassium, sodium, chloride and bicarbonate levels of the treated rats except significantly (p<0.001) elevated urea level at low dose of the extract (200 mg/kg), but caused dose-dependent and insignificant (p>0.05) decreases in total cholesterol, triglyceride, HDL, LDL and VLDL levels when compared to control. The stem extract exerted mild to moderate effect on the histologies of brain, heart, spleen, livers, kidneys, testes and a severe effect on ovaries of rats. Chronic study is advocated to investigate the effect of prolonged administration of the stem extract organs and systems of rats.

P-40 A RARE PRESENTATION OF PROLONGED HYPOGLYCEMIA: CONGENITAL LEPTIN DEFICIENCY AND INSULIN INTOXICATION

Abstract Introduction Congenital leptin deficiency (CLD) is caused by mutations in the LEP gene with an incidence of 1 in 4.4 million, presenting with symptoms such as hyperphagia, obesity. Insulin intoxication is also a rare condition that usually occurs as a result of a suicide attempt or, a medication error. There is not an algorithm for the management of insulin intoxication. Here, we report the only case in the literature presenting with congenital leptin deficiency and insulin intoxication. Clinical Case A 33-year-old woman was admitted to the hospital with dizziness, nausea, and unconsciousness. She had applied nearly 300 IU insulin aspart of committing suicide. She had congenital leptin deficiency, hypothyroidism, and prediabetes. She had leptin replacement during 2020-2021 and didn’t have a replacement since then. Her body mass index was 62.2. Her blood pressure was 95/60 mm/Hg, Sp02 was 88 %, and heart rate was 120 per minute. Her blood glucose was 29 mg/dl, and there was respiratory acidosis. Liver and renal function tests, electrolytes, coagulation parameters, and thyroid hormones were normal. Chest x-ray and brain tomography were normal. Despite subsequent infusion of 20% dextrose solution via central catheter, serum glucose could only be kept at 70-80 mg/dl. In the following hours patient’s consciousness, pH level, and oxygen saturation returned to normal. We had to follow the patient with a high concentration of glucose (150-200cc/h %10 dextrose) for ten days because of reappearing hypoglycemia. On the 10th day of follow-up, we stopped IV glucose for a short time and measured the fasting hormones shown in Table 1. at 7.00 a.m. As there was hypocortisolemia, we applied 5mg prednisolone twice daily in the following days. Twenty-four hours after cortisol administration, we could easily stop the IV glucose. We followed the patient with 5mg prednisolone twice daily and oral carbohydrate intake for three days and didn’t observe hypoglycemia. Afterwards, we stopped prednisolone and the patient was normoglycemic for the following days. We again measured the fasting hormones shown in Table 2. At 7.00 a.m. three days after the last dose of prednisolone. The patient was not hypoglycemic or hypocortisolemic since then; vital parameters were all normal and we discharged the patient. Conclusion Prolonged hypoglycemia may have occurred in different mechanisms. Our patient had a thick subcutaneous fat tissue because of CLD; therefore, absorption of insulin may have increased and half life may be prolonged. Also, high dose exogenous insulin may have triggered the production of insulin antibodies causing prolonged duration of insulin action and hypoglycemia. Moreover, deep hypoglycemia may have affected the pituitary-adrenal cortisol axis causing relative adrenal insufficiency. The steroid decreased the insulin antibodies and also corrected the relative cortisol deficiency. More cases and data are needed to shed light on this subject.Table 1: Table 2:

Relation among zootechnical performance, biochemical indicators, water quality, and small invertebrates (zooplankton) abundance reared in biofloc-supplemented systems

The present study was conducted to investigate the interaction of biofloc water supplementations and potential zooplankton abundance and structure in Nile tilapia Oreochromis niloticus-rearing systems on zootechnical performance and biochemical indicators. Nile tilapia juveniles (13.30 g and 9.50 cm) were randomly distributed into 18 fiberglass tanks (500 L/tank with a stocking density of 40 fish/tank) to start the feeding experiment for 60 days. Fish weights were recorded weekly to adjust the feeding rate at 3% of their biomass using a commercial diet. Compared to the control group (T0, zero biofloc water supplementation), the influence of five biofloc supplementation levels was applied as follows: 14.2, 28.4, 42.6, 56.8, and 71 g L−1 (T1, T2, T3, T4, and T5, respectively). The biofloc was prepared in an external fermentor fiberglass tank (300 L) and added to the fish tanks to keep the biofloc levels constant during the experiment. After 30 and 60 days of the experiment, the number of zooplankton was 46,501 and 24,537 Ind. L−1, respectively, which included four families (Rotifera, Copepoda, Cladocera, and free-living nematodes) with the domination of family Rotifera at 81.65% and 93.89%, respectively. The water quality indicated was within the standard values recommended for fish culture. Compared to those of the control group, the values of growth performance, whole-body biochemical composition, and blood biochemical indicators were significantly higher in biofloc groups than in the control group. Group T3 achieved the highest significant growth performance values. In comparison with the control group, T3 achieved the lowest number of cultures and the abundance of small invertebrate prey after 60 days of culture. The fish reared in groups T0 and T1 showed the highest significant urea content and the highest concentrations of liver function enzyme activities. Interestingly, compared to all groups, T3 achieved the best feed conversion ratio (FCR) value (1.68). Principal component analysis (PCA) and Pearson’s correlation coefficient confidence (PCCC) clarified a close positive relationship between T0 and T3 with the total individual, Rotifera abundance, and FCR. The highest PCCC value with T0 was in group T3 (0.947). In conclusion, biofloc supplementation (42.6 g L−1) showed a sustainable clean aquadiet strategy and significantly improved Nile tilapia growth and FCR with regard to the culture of small prey invertebrates for 60 days.

Neurodevelopmental and Growth Follow-Up of an Infant Exposed to Rosuvastatin by Lactation: A Case Report.

Background: Usage of some medications while breastfeeding is supported with many clinical studies and proven to be safe for the mother-infant dyad, whereas knowledge on many medications' safety depends on pharmacokinetic data that are supported with only case series of real-life results. As data on rosuvastatin usage are limited, we present our case report with safe use of rosuvastatin in a breastfeeding mother of a 13-month-old infant. Case: Pretreatment assessments of the infant were performed. Complete blood count, kidney, and liver function tests were normal. The infant's lipid profile was evaluated before starting the mother's treatment, at 1 month of treatment, and at the fifth month of treatment in which the infant reached 18 months of age. All three evaluations resulted in normal ranges. At the 18-month follow-up of the infant of breastfeeding mother using rosuvastatin, no issues were detected in the child's development. Conclusions: In order for mothers with hypercholesterolemia not to neglect their own treatment while continuing to breastfeed, case reports should be included in the literature. In this case, it was shown that rosuvastatin treatment given to the mother did not affect the lipid profile and neurological development of the baby.

High metabolic dysfunction-associated steatotic liver disease prevalence in type 2 diabetes: Urgent need for integrated screening and lifestyle intervention.

This letter discusses the recent study by Mukherjee et al, which identifies a significant prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) among newly diagnosed type 2 diabetes mellitus (T2DM) patients in Bihar, India, and underscores the pressing need for integrated MASLD management within T2DM care. With 72.3% of the study cohort affected by MASLD, implementing routine liver function tests and ultrasound screenings is recommended as a standard practice in diabetes care, especially in regions with high prevalence rates. The study also advocates for dietary and lifestyle modifications, particularly the reduction of saturated fats, to slow MASLD progression. Patient education on monitoring body mass index and waist circumference, coupled with the integration of these metrics into digital health records, could enhance patient involvement and support proactive health management. Moreover, the letter emphasizes the advantages of developing a region-specific MASLD risk model that incorporates local dietary patterns and socioeconomic factors. Continued research into genetic and environmental determinants of MASLD remains essential for advancing our understanding of its etiology and informing targeted public health strategies.

Effects of Turmeric and Rosemary Extract on Oxidative Stress Markers in Goats

Background: Due to their versatility, goats are becoming popular as livestock on commercial farms. To obtain a high productivity, the maintenance of homeostasis in these organisms is needed. Some supplements that could help improve their health state have been tested recently. The study examines the effects of a turmeric–rosemary extract mixture on the antioxidant status of the blood of young castrated bucks. Results: Supplementation lowered lipoperoxidation and increased TAC, probably due to the improved neutralization of reactive oxygen species (ROS) by enhanced antioxidant pathways. Despite lowering lipid peroxidation, these products can increase protein oxidation. Thus, while enhancing lipid defense mechanisms may reduce lipid peroxidation, it may also increase the level of OMP, probably due to the accumulation of lipid peroxidation metabolites. The activities of SOD, GPx, and GR remained unchanged, whereas CAT activity decreased. CP, ALT, and AST remained stable, suggesting no adverse effects on key markers of liver function. Conclusions: The high antioxidant potential observed after supplementation indicates that the turmeric–rosemary extract mixture elicited a favorable biochemical response; the supplemented compounds effectively enhanced antioxidant defenses (by improving the neutralization of ROS) without negatively affecting liver enzyme activities. Turmeric–rosemary dry extract supplementation can help with homeostasis maintenance in goat organisms and, consequently, improve their productivity.

Exploration of the Combined Mechanism of Direct and Indirect Effects of Paeoniflorin in the Treatment of Cholestasis.

Cholestasis is a multifactorial hepatobiliary disorder, characterized by obstruction of bile flow and accumulation of bile, which in turn causes damage to liver cells and other tissues. In severe cases, it can result in the development of life-threatening conditions, including cirrhosis and liver cancer. Paeoniflorin (PF) has been demonstrated to possess favourable therapeutic potential for the treatment of cholestasis. The objective of this research was to examine the molecular mechanism of PF in the treatment of ANIT-induced cholestasis and to propose novel avenues for further research on the pharmacological effects of PF. In vivo and in vitro models of cholestasis were developed. The histopathological changes in the bile ducts and liver were evaluated through the use of hematoxylin and eosin (HE) staining. The extent of apoptosis was evaluated through the use of immunofluorescence (IF), immunoblotting (WB), and electron microscopy. The JNK signalling pathway was identified as the direct mechanism of action of PF through the utilisation of HuProt™ 20K chips and other technologies. The present study demonstrated that PF markedly alleviated liver injury in an ANIT-induced cholestasis model. Specifically, PF was observed to attenuate cholestasis-induced liver injury by reducing the abnormal elevation of liver function indices and suppressing the expression of inflammatory mediators. Furthermore, PF exhibited anti-apoptotic properties in both in vivo and in vitro experiments, thereby mitigating cholestasis-induced hepatocyte apoptosis. These protective effects are attributable to the fact that PF exerts its action through direct interaction with the JNK pathway. It has been demonstrated that PF is capable of binding directly to MAPK8 (JNK1) and MAPK9 (JNK2), thereby inhibiting JNK activation and reducing apoptosis. With regard to the protection of bile ducts, PF may indirectly inhibit hepatocyte apoptosis by maintaining the structural integrity and tight junctions of bile duct cells. PF improved cholestasis by inhibiting hepatocyte apoptosis directly by targeting the JNK signaling pathway and indirectly inhibited hepatocyte apoptosis by improving the tight junctions of bile duct cells to regulate the bile duct microenvironment.

O-10 AN OVARIAN THECOMA PRESENTING WITH POST-MENOPAUSAL VIRILIZATION

Abstract Introduction Virilizing ovarian tumors are a rare cause of hyperandrogenism in women, account for less than 5% of all ovarian neoplasms. In most cases presents with increased serum testosterone levels and normal dehydroepiandrosterone-sulfate levels. Ovarian thecoma is a rare, benign tumor of stromal cell origin which represents less than 1% of ovarian tumor. It occurs most often in perimenopausal and postmenopausal women. Here we present a postmenopausal women presenting with hirsutism. Clinical Case A 53 year old female patient was referred to the endocrine outpatient clinic with the complaint of progressive hirsutism started after menopause in the last year. She had no special past medical history and medical history. She was in post-menopausal period for one year. She had androgenic alopecia and deepening voice. Her hemogram analysis, renal and liver function tests were in normal range. Hormonal analysis revealed a markedly increased serum testosterone level, 654 ng/dl, normal dehydroepiandrosterone-sulfate levels. High testosterone levels were confirmed in repeated examinations. Transvaginal ultrasonography and examination were found to be normal. Magnetic Resonance Imaging was performed due to significantly high testosterone levels and 30x18 mm right ovarian mass was found compatible with thecoma. Patient was referred to gynecology for surgery. Conclusion Ovarian thecoma is a very rare tumor accounting about 1 % of solid ovarian tumors. The İncidence of this tumor is highest in pre and postmenopausal period. Thecomas are mostly benign and solid. During reproductive age, patient presents with hirsutism, acne, virilization findings. In postmenopausal period patient may present with mild virilization, post-menopausal bleeding and endometrial hyperplasia/cancer. Surgery is the primary treatment modality for virilizing thecoma.

Exploring the efficacy of fluorouracil and platinum based chemotherapy in advanced hepatocellular carcinoma to bridge the treatment gap in resource limited settings

Advanced hepatocellular carcinoma (HCC) poses treatment challenges, especially where access to multi-kinase inhibitors and ICIs is limited by high costs and lack of insurance. This study evaluates the effectiveness of 5-fluorouracil (5-FU) plus platinum-based chemotherapy as an alternative systemic treatment for advanced HCC. A retrospective analysis of advanced HCC patients treated with 5-FU plus platinum-based chemotherapy was conducted. The Kaplan-Meier method determined median progression-free survival (PFS) and overall survival (OS). From April 2009 to October 2023, 48 patients with advanced HCC were included in the study. Nearly all patients (97.9%) had extrahepatic metastasis and stable liver function, with three-quarters previously treated with sorafenib. At a median follow-up of 7.8 months, the median PFS was 4.2 months (95% CI, 1.3–7.1), and the median OS was 8.2 months (95% CI, 2.5–13.9). A high pretreatment neutrophil-to-lymphocyte ratio (≥ 3.0) adversely affected both PFS (HR = 1.79; 95% CI, 0.99–3.25; p = 0.034) and OS (HR = 2.02; 95% CI, 1.10–3.69; p = 0.011). Hematologic toxicities related to the treatment were substantial, with 62.5% of patients experiencing grade 3 or 4 events, primarily neutropenia, which affected 60.4% of them. Our findings suggest that 5-FU combined with platinum-based chemotherapy is a viable, cost-effective alternative for advanced HCC treatment in resource-limited settings, particularly compared to ICIs and multi-kinase inhibitors, with significant implications for developing countries.

DRESS is not a rare complication during the initial treatment of newly diagnosed multiple myeloma_the experience of two medical institutes.

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a severe hypersensitivity reaction rarely documented in patients with multiple myeloma (MM). In our retrospective study of 108 newly diagnosed MM (NDMM) patients from January 2021 to October 2023, we identified four cases of DRESS. The clinical characteristics such as clinical manifestations, laboratory results, treatment and outcome were analyzed. These patients presented with fever, persistent and recurrent, along with a widespread red rash characterized by diffuse erythematous macules or papules accompanied by intense itching, desquamation, and other dermatological manifestations. Multi-organ involvement was common, including hepatic impairment, acute kidney injury, and type I respiratory failure, alongside pleural effusion and multiple lymphadenopathy. Laboratory findings revealed elevated eosinophil counts, often exceeding 1.5 × 10^9/L, abnormal liver function tests, acute kidney injury, and inflammatory markers. Anti-MM treatment was promptly suspended, and all patients received corticosteroid therapy. Outcomes varied, with one patient succumbing to myeloma progression, another to multi-organ failure, while the remaining two patients survived. In NDMM patients undergoing induction therapy, occurrences of DRESS are infrequent but noteworthy, with an incidence higher than observed in the general population. It presents with significant morbidity and mortality, highlighting the crucial need for early recognition and management.

Lactobacillus extracellular vesicles alleviate alcohol-induced liver injury in mice by regulating gut microbiota and activating the Nrf-2 signaling pathway.

Lactobacillus derived extracellular vesicles (LAB-EVs) are nanosized particles secreted from Lactobacillus during fermentation, and therefore exist universally in fermented foods such as yogurt, pickles, and fermented beverages. In this study, three LAB-EVs were prepared using a simple scalable method, and then their structures, compositions, and biosafety properties were characterized. The protective properties and potential mechanisms of action of the LAB-EVs against alcoholic liver disease were studied. All three LAB-EVs alleviated alcohol-induced liver injury. It was shown by reduction of liver index, histological damage, liver function impairment, inflammation, and liver oxidative status. The results showed that three LAB-EVs positively promoted the diversity of intestinal flora in mice. Additionally, the relative hepatic protein level of Nrf-2, HO-1, and CYP2E1 was also regulated by LAB-EVs. In summary, these facts suggest that the three LAB-EVs can alleviate alcohol-induced liver damage, by positively modulating the intestinal flora and activation of the Nrf-2 signaling pathway. These results may facilitate the understanding of the composition and function of Lactobacillus fermented food and also the development of Lactobacillus fermented functional food.

Toripalimab: A new age in fighting Nasopharyngeal Carcinoma

Madam, Nasopharyngeal carcinomas (NPCs) lie amongst a group of malignant tumours whose incidence has steadily increased over the past 30 years.[1] These have a significantly higher incidence rate in Asian populations, which account for over 70% of new cases worldwide.[2] The leading risk factors associated with NPCs are tobacco and alcohol consumption, followed by HPV infections. Usually diagnosed at advanced stages, a combination of chemo and radiotherapy is the standard treatment. However, they have one of the lowest survival rates compared to other cancers.[1] Programmed cell death protein 1(PD - 1) is a receptor that is expressed on T cells, B cells, macrophages, dendritic cells and natural killer cells. Binding of PD-1 with its ligands, namely PD-L1 and PD-L2, transmits an inhibitory signal, which decreases the proliferation and production of cytokines by T cells, thereby inhibiting immune system stimulation. Toripalimab is a monoclonal antibody that blocks interactions between the PD - 1 and PD-L1 or PD-L2.[3] Toripalimab was approved by the FDA on 10/27/2023 with the following indications; first line treatment of locally advanced, recurrent or metastatic NPC(RM-NPC) in combination with standard chemotherapy using cisplatin plus gemcitabine, and as a lone agent in patients with RM-NPC showing disease progression despite being on or after platinum containing chemotherapy.[3] The approval was based off of two clinical trials; POLARIS-02 and JUPITER-02,[4][5] which suggested that toripalimab combined with standard chemotherapy provided statistically as well as clinically significant, progression free survival and overall survival benefits compared to standard chemotherapy alone. The aforementioned clinical trials showed a manageable safety profile with the overall rate of grade 3 or greater side effects being similar in the two groups- toripalimab plus standard chemotherapy versus standard chemotherapy alone and that the most common side effects were mainly due to standard chemotherapy itself. The main immune related adverse effects reported were hypothyroidism, hyperthyroidism, abnormal liver function, interstitial lung disease and dermatomyositis.[4][5] In recent years immunotherapy has emerged as a highly effective avenue when used in combination with targeted therapies. This combination enhances the immune cells’ attack capabilities and thereby enhances the efficacy of the treatment.[3] Toripalimab is the first FDA- approved immune checkpoint mediator for the treatment of RM-NPC and the promising results from the clinical trials alongside the tractable safety profile support the use of Toripalimab in combination with gemcitabine-cisplatin chemotherapy as the new standard of care for this population.

Red Beetroot and Its By-Products: A Comprehensive Review of Phytochemicals, Extraction Methods, Health Benefits, and Applications

Beetroot (Beta vulgaris), a root vegetable known for its vivid natural color and nutritional profile, is a source of a wide range of bioactive compounds, including betalains, phenolics, vitamins, and antioxidants. These bioactive compounds are associated with many health-promoting properties, including antihypertensive, antioxidant, anti-inflammatory, and anticancer effects. The beetroot processing industry produces substantial by-products abundant in phytochemicals and betalains, presenting valuable opportunities for utilization. Therefore, it can replace synthetic additives and enhance the nutritional value of foods. By reducing waste and supporting a circular economy, beetroot by-products improve resource efficiency, cut production costs, and lessen the food industry’s environmental impact. Beetroot and its by-products are rich in phytochemicals that provide various wellness advantages. They support cardiovascular health, inhibit microbe-induced food spoiling, aid liver function, and reduce inflammation and oxidative stress. This paper presents a detailed review of current knowledge on beetroot and its by-products, focusing on their biochemical components, extraction and stabilization techniques, health benefits, and potential applications in the food industry. It underscores the versatility and importance of red beetroot and its derivatives, advocating for further research into optimized processing methods and innovative uses to enhance their industrial and nutritional value. By providing valuable insights, this review aims to inspire food scientists, nutritionists, and the agricultural sector to integrate beetroot and its by-products into more sustainable and health-oriented food systems.

Nitrate induced hepatic fibrosis in tadpoles of Bufo gargarizans by mediating alterations in toll-like receptor signaling pathways.

The nitrate pollution has become an increasingly serious environmental problem worldwide, and the toxic effects of elevated nitrate levels in the environment on aquatic animals remain to be elucidated. The purpose of the present study was to investigate the mechanisms of liver injury to tadpoles after exposure to nitrate from embryonic to metamorphic climax and to assess the recovery process of liver function after cessation of exposure. In the group with continuous nitrate exposure, the livers and thyroid of tadpoles showed remarkably histological lesions, of this with structural disorganization of the hepatocytes, cellular atrophy, and fibrosis, as well as significant reduction in the follicular and colloidal area of the thyroid. Meanwhile, the expression levels of genes related to inflammatory signaling pathways, such as TLR2, TLR6 and NF-κB, were significant elevated. After termination of exposure at Gs23, liver damage (histologic, ultrastructural, and molecular levels) was almost completely recovered, whereas thyroid gland damage was irreversible. Overall, this study shed light on the harmful effects of nitrate pollution on amphibian health and emphasizes the importance of controlling nitrate emissions in the environment.

Impact of Intermediate-term Oral Contraceptive Use on Oxidative Stress, Lipid Profile, and Liver Function in Iraqi Women: A Comprehensive Biochemical Assessment

Impact of Intermediate-term Oral Contraceptive Use on Oxidative Stress, Lipid Profile, and Liver Function in Iraqi Women: A Comprehensive Biochemical Assessment

Bioelectrical Impedance Analysis as a Helpful Tool in Pediatric Obesity Monitoring: A Case Report

Background and Clinical Significance: Childhood obesity and its associated complications are an emerging public health problem; thus, non-communicable chronic disease prevention should be implemented as early as possible. On the other hand, obesity management in children is a challenge in terms of achieving fat tissue reduction without any adverse outcomes on overall development. This is why close cooperation with young patients and their parents is crucial for success. Moreover, non-invasive but detailed monitoring guaranties insight in this process’s progress and safety. As obesity is a chronic disease with a tendency for recurrence, further follow-up should also be considered. Case Presentation: We present a case of a 10-year-old boy who was referred to a dietitian due to concerns about a diagnosis of obesity and metabolic complications including abnormal lipid profile and liver function. During the dietary consultation, body composition assessment with bioelectrical impedance analysis was conducted, which confirmed obesity. A detailed interview allowed for the identification of improper dietary patterns. The implemented lifestyle education and qualitative diet modifications led to fat mass reduction without any significant muscle loss after just one month. The metabolic profile was also improved. The patient remained under the care of a dietitian for the next 4 years with constant body composition monitoring, which enabled the relevant parties to address if body mass gain was a part of his normal development or if he suffered from obesity recurrence. The patient and his parents benefited from an individualized, patient-centered approach including dietary education, overall lifestyle modification, and detailed body composition monitoring. This way, the patient succeeded in fat content reduction with the constant assessment of the safety of this process. Moreover, the dietary education impacted the whole family’s lifestyle. Conclusions: This case emphasizes the role of body composition assessment in children. Obesity and metabolic complications resulting from an improper lifestyle can affect pediatric patients. Bioelectrical impedance analysis is a non-invasive tool that can improve the safety and effectiveness of nutritional interventions and could be included in routine pediatric obesity assessment.

Unveiling the Dark Side of Flavonoid: Rutin Provokes Hepatotoxicity in Low-Dose 2-Amino-3-methylimidazo [4,5-f] Quinoline-Exposed Mice via Regulating Gut Microbiota and Liver Metabolism.

2-Amino-3-methylimidazole [4,5-f] quinoline (IQ) is a kind of heterocyclic amine (HCAs) with high carcinogenicity in hot processed meat. Rutin (Ru) is a flavonoid compound with anti-inflammatory and antioxidant properties. However, whether Ru is scatheless under IQ-stimulated potential unhealthy conditions, especially liver function, in vivo, is unknown. In this study, we explored the effects and underlying mechanism of Ru on liver injury induced by a low dose of IQ in mice. Results showed that Ru supplement led to liver injury upon low-dose IQ alone administration, as shown by histological analysis, inflammatory, and serum biochemical indexes. Additionally, nontargeted metabolomics analysis revealed that coexposure of Ru and IQ disrupted liver metabolic balance, leading to significant changes in metabolites and metabolic pathways, hinting at a possible relationship with intestinal microbiota. Furthermore, the 16S rRNA sequencing data indicated that a combination of Ru and IQ caused gut microbiota dysbiosis and decreased the level of short-chain fatty acids (SCFAs). Correlation analysis between gut microbiota, SCFAs, liver metabolites, and liver damage markers highlighted the crucial role of the gut-liver axis in IQ and Ru coexposure-induced liver injury in vivo. In general, this study offers a valuable perspective on flavones and HCA compounds in the realms of food safety and human health.

Evaluation of drug-drug interaction between rosuvastatin and tacrolimus and the risk of hepatic injury in rats.

Multimorbidity, therapeutic complexity, and polypharmacy, which greatly increases the risk of drug-drug interactions (DDIs) and adverse medical outcomes, have become important and growing challenges in clinical practice. Statins are frequently prescribed to manage post-transplant dyslipidemia and reduce overall cardiovascular risk in solid organ transplant recipients. This study aimed to determine whether rosuvastatin has significant DDIs with tacrolimus (the first-line immunosuppressant) and to evaluate the risk of hepatotoxicity associated with concomitant therapy. We first studied whether a rat model could be established to assess the magnitude of rosuvastatin-tacrolimus DDI. The liver function index and histopathological examination were performed to investigate the characteristics of hepatotoxicity in the presence and absence of DDI. The clinical DDI potential between rosuvastatin and tacrolimus was also explored. Single-dose intravenous administration of tacrolimus did not significantly affect the area under the plasma concentration-time curve (AUC0-∞), clearance (CL), and volume of distribution at steady-state (Vss) of rosuvastatin in rats, despite a 96.7% increase in the rosuvastatin maximum plasma concentration (P = 0.024). Multiple doses of intravenous tacrolimus had no effect on the systemic disposition of rosuvastatin, but significantly increased aspartate transaminase (AST) by 42.6% (P = 0.043). Multiple doses of intravenous tacrolimus and rosuvastatin significantly altered the disposition of rosuvastatin, reducing alanine aminotransferase(ALT) and AST by 38.3% (P = 0.040) and 31.6% (P = 0.019), respectively. Histological evaluation of the liver specimens revealed patterns of drug-induced liver injury in rats. At clinically relevant doses, tacrolimus was predicted to be unable to cause pharmacokinetic interactions with rosuvastatin through basic models. The concomitant administration of tacrolimus and rosuvastatin has a minor impact on rosuvastatin pharmacokinetics; however, mild hepatotoxicity has been observed in rats.

Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) and mortality among survivors of liver cirrhosis: a prospective cohort study

BackgroundCirrhosis is a medical condition marked by persistent liver damage, which leads to the development of fibrous tissue and compromised liver function. In the present study, we decided to investigate the possibility of a connection between the consumption of fermentable olig-, di-, monosaccharides, and polyols (FODMAPs) and mortality rates in cirrhotic patients by utilizing data obtained from a prospective cohort study.MethodsThis cohort study enrolled 166 ambulatory patients from two hospitals in Tehran, Iran, between 2016 and 2018, and followed them up for 5 48 months until April 30, 2022. During the 3,955 person-months of follow-up, 43 fatalities were recorded (36 men and 7 women). The study classified participants into three groups based on their FODMAPs consumption and assessed the risk of mortality using Cox proportional hazards regression models.ResultsTotal FODMAPs intake was associated with increased overall mortality risk (T3 vs. T1, HR = 3.5; 95%CI: 1.05, 11.7; P-trend = 0.036). This significant trend was also observed for total fructans (T3 vs. T1, HR = 5.15; 95% CI: 1.15, 23.2; P-trend = 0.006) and fructose (T3 vs. T1, HR = 5.55; 95% CI: 0.54, 57.14; P-trend = 0.018). Mortality risk was U-shaped with galactooligosaccharide intake, a lower mortality risk was observed with lactose intake and a higher mortality risk with polyols intake, although these associations did not reach statistical significance.ConclusionIn conclusion, this study highlights a higher risk of mortality with higher intake of fructans, excess fructose and total FODMAPs.

Mini review of plant products as food supplement against MSG-induced liver injury: antioxidant, oxidative stress and histological prospects

Monosodium glutamate (MSG) is an odorless white solid crystalline derived from the amino acid glutamic acid. It is widely used as a flavor enhancer, but its excessive consumption has been associated with toxicity to various organs. In MSG-induced liver injury, few mechanisms have been identified, which started with the generation of reactive oxygen species that leads to oxidative stress which further causes liver injury. In response to this health concern, there is growing interest in various plant products such as plant extracts, flavonoids and phenolic compounds that were able to minimize oxidative stress, serum transaminases and scavenge free radicals in the liver after MSG administration. This review explores the potential of various plant products as dietary supplements to MSG-induced liver injury, focusing on their antioxidant activities, modulatory effects on liver function markers, and histological outcomes. By compiling this evidence, this review provides insights into their potential as preventive strategies against MSG-related liver toxicity, supporting their inclusion in dietary regimens for the maintenance of liver function.