Aspartate Aminotransferase Values Research Articles

Investigation of Liver Function Test Findings in COVID-19 Patients Considering the Disease Timeline

Background: Several lines of evidence suggest that SARS-CoV-2 infection impacts liver function; however, the evaluation of these changes over time according to the disease timeline remains unclear. Objectives: The objective of this study was to identify potential alterations in liver function parameters during the first to fifth waves of COVID-19 and compare these alterations with the demographic and clinical outcomes of patients across the waves. Methods: This cross-sectional study included 1501 hospitalized patients with a confirmed RT-PCR diagnosis of COVID-19, referred to Shahid Sadoughi Hospital, Yazd, Iran, between November 20, 2019, and November 20, 2021. Liver function parameters, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin, direct bilirubin, and albumin, were assessed using standard clinical laboratory methods. Statistical analyses were conducted to evaluate differences in liver function parameters across the five pandemic waves, with significance set at P < 0.05. Results: The median age of the hospitalized patients (N = 1501) was 61 ± 21.8 years, with the majority being male (816, 54.3%). The Kruskal-Wallis test showed a significant increase in the median levels of ALP, total bilirubin, and direct bilirubin in the first wave; the AST and ALT in the third wave; and serum albumin in the second wave (P < 0.001). The median serum levels of total bilirubin and direct bilirubin were significantly higher in older patients compared to younger patients (P < 0.001), and the median ALT and serum albumin were significantly lower in older patients (P < 0.0001). In males, the median values of AST, ALT, total bilirubin, and direct bilirubin were significantly higher than in females (P < 0.0001). The median values of all parameters, except serum albumin, in deceased patients were significantly higher compared to discharged patients, and serum albumin was significantly lower. Conclusions: In this descriptive study, we observed that older and male patients were more frequently hospitalized than females. Our findings showed variations in liver parameters across different pandemic waves, suggesting distinct behaviors of various SARS-CoV-2 strains.

Increased ferritin, serum lactate dehydrogenase, and aspartate aminotransferase levels predict macrophage activation syndrome complicating systemic lupus erythematosus: a retrospective study

BackgroundThis study aimed to assess the diagnosis of macrophage activation syndrome (MAS) at the onset of active childhood-onset systemic lupus erythematosus (cSLE), which is under-researched, and to compare the characteristics of cSLE with and without MAS, hypothesizing the existence of possible predictors of MAS in active cSLE.MethodsThis study enrolled 157 patients diagnosed with cSLE, with or without MAS, from Nanjing Medical University between January 2018 and May 2023. Data analysis was performed using an independent samples t-test or the Mann–Whitney U-test, the χ2 test, the Youden index to determine the optimal cutoff values for diagnosis, and binary logistic regression analysis to determine the predicted probability.ResultsFifteen patients (9%) had MAS in the active phase, with an SLE disease activity index of 16.6 (range, 6–32). Bone marrow aspirations revealed hemophagocytosis in 8/15 cases (53%). Fever was the most common feature of MAS patients. Lactate dehydrogenase (LDH) and ferritin levels were elevated in the patients. Lower leukocyte, neutrophil, and platelet counts, including serum sodium and fibrinogen, and increased alanine aminotransferase, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), ferritin, triglyceride, and D-dimer levels occurred in MAS patients, unlike those without MAS. Optimal cutoff values for ferritin (≥607.35 ng/ml), LDH (≥424 U/L), and AST (≥61 U/L) were predictors of MAS occurrence in cSLE. No MAS patients experienced recurrence during an 18-month mean follow-up.ConclusionsDespite the narrow scope of the study, elevated levels of ferritin, LDH, and AST may represent indicators of cSLE complicated by MAS. Early diagnosis and treatment may improve outcomes.

Determination of Haptoglobin, Serum Amyloid A, Some Other Acute Phase Proteins, and Biochemical Parameters in Cattle with Hydatid Cysts

The aim of this study is to determine some acute phase proteins and biochemical parameter levels in cattle infected with the hydatid cysts. In the study, a total of 30, Brown Swiss cattle including 15 infected with the hydatid cysts in the study group and 15 in the control group were used. Haptoglobin, serum amyloid A (SAA), ceruloplasmin, interleukin (IL)-6, total protein, albumin, aspartate amino transferase (AST), gamma glutamyl transferase (GGT) and alkaline phosphatase (ALP) activity, urea, creatinine, iron (Fe) levels were determined colorimetrically. When the animals infected with hydatid cysts and control group were compared, it was determined that haptoglobin, SAA, IL-6, AST, ALP, GGT activity, urea, creatinine levels and acute phase protein index values increased, while albumin levels decreased. In addition, it was determined that the ceruloplasmin and total protein levels increased, globulin, albumin/globulin and Fe levels decreased, but they were statistically insignificant. In conclusion, it was determined that there were significant changes in the biochemical parameters and increased haptoglobin and SAA synthesis in the animals infected with the hydatid cysts, and it is thought that these parameters may contribute to the pathogenesis and diagnosis of the disease.

The Role of Aspartate Aminotransferase / Platelet Ratio Index Score in Predicting Intrahepatic Cholestasis of Pregnancy and its Relationship with Total Bile Acid Level: A Case-Control Study from a Tertiary Center

OBJECTIVES: The aim of this study is to examine the value of the first-trimester aspartate aminotransferase to platelet ratio index (APRI) score in predicting intrahepatic cholestasis of pregnancy (ICP) occurring later in pregnancy. Another aim of the study is to determine the relationship between APRI scores and total bile acid (TBA) levels in pregnant women with ICP. STUDY DESIGN: This retrospective case-control study was conducted by examining the hospital records of women diagnosed with ICP (n=66) and healthy controls (n=70) among women followed during pregnancy. Hemoglobin (Hb), platelet count (PLT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) values of all patients were obtained from routine blood test data taken in the first and third trimesters. The first and third-trimester APRI scores of the patients were calculated. Demographic data, laboratory findings, and APRI scores of women with and without ICP during pregnancy were compared. Using Roc analysis, the values of AST, ALT, PLT values, and APRI scores were examined in predicting ICP among the first trimester findings of the patients. In addition, TBA levels of patients with ICP at the time of diagnosis were obtained from hospital records. The relationship between the first and third-trimester APRI scores and TBA levels in patients with ICP was evaluated using correlation analysis. RESULTS: In the first and third-trimester laboratory values, AST and ALT levels and APRI scores were found to be higher and PLT values were lower in patients with ICP compared to healthy controls. Among the first trimester measurements of these data, the APRI score had the highest predictive value in predicting ICP (AUC values are 0.648 for AST, 0.655 for ALT, 0.633 for PLT, and 0.705 for APRI). In an examination of patients with ICP, the APRI score calculated in the first and third trimesters showed a positive correlation with the TBA level at diagnosis (r=0.435 p<0.001 for the first trimester and r=0.433 p<0.001 for the third trimester in the Spearman analysis). CONCLUSIONS: In the future, the APRI score calculated in the first trimester of pregnancy may be used as a tool to predict ICP that may occur in the following weeks. There may be a positive correlation between APRI score and serum TBA level in patients with ICP.

Ethanol crude leaf extract of weeping fig (Ficus benjamina) causes mild hepatotoxicity in Sprague dawley rats

Weeping fig (Ficus benjaminaeaf extract has diverse medicinal properties but little is reported about its hepatotoxicity. This study determined the mean lethal dose (LD50) and investigated the effects of F. benjamina ethanol crude leaf extract on biochemical parameters and liver histology of Sprague Dawley rats. Twenty-nineemale rats weighing 133-204 g were used. The LD50 was determined with nine rats based on Lorke’s method. The experimental groups consisted of twenty rats, divided into four groups of five. Each group received treatment as follows: Control (feed and water only) and low, medium, and high doses (500, 1000, 1500 mg/kg respectively) of the extract orally for 21 days. All animals were weighed and sacrificed using Ketamine intra-peritoneal injection. Blood samples were collected for biochemical parameters of total bilirubin, conjugated bilirubin, aspartate aminotransferase (AST) alanine aminotransferase (ALT), and alkaline phosphatase (ALP). Liver tissues were removed and processed by the formalin-fixed-paraffin wax-embedding method. The tissue blocks were sectioned and subjected to Hematoxylin/Eosin and Masson trichrome staining. The extract’s LD50 was >5000 mg/kg. The rats’ body weights did not change statistically (p=0.985). Total bilirubin (p=0.003), conjugated bilirubin, AST, ALT, and ALP values (p=0.001) increased significantly. The AST high-doseroup had the highest fold increase (4.8). The liver histology showed mild sinusoidal dilation at 500 mg/kg. There was marked hemorrhage and fibrosis at medium and high doses. Although the extract had relatively low acute toxicity, 1000 and 1500 mg/kg doses were associated with mild hepatotoxicity characterized by veno-occlusion disease. The 500 mg/kg dose is safer for medicinal purposes.

Decreased hepatic CT value on immediate postmortem CT after CPR: Comparison with antemortem CT and correlation with liver enzymes changes

Purpose We compared hepatic antemortem CT (AMCT) and postmortem CT (PMCT) values obtained in the same subjects. The correlations between the changes in hepatic CT values and changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) values were also investigated.Materials and methods Fifty subjects (20 males, 30 females; mean age: 85.9 ± 7.9 years; range: 67–100 years) who were transported to the emergency room in cardiopulmonary arrest (CPA) and underwent PMCT immediately after unsuccessful cardiopulmonary resuscitation (CPR) comprised the study population. The hepatic AMCT and PMCT values were both measured, and the differences between the two were calculated. The differences between AST, ALT, and LDH values at CPR and antemortem were also calculated. The correlations between the hepatic CT value differences and AST, ALT, and LDH value differences also were assessed.Results The hepatic AMCT and PMCT values of 61.7 ± 6.8 Hounsfield Unit (HU) and 46.2 ± 8.2 HU, respectively, were significantly different. The AST, ALT, and LDH values were significantly higher at CPR than at antemortem. The differences in the hepatic CT values and in the AST, ALT, and LDH values were moderately correlated.Conclusion The hepatic values were significantly lower on PMCT than on AMCT. The changes in hepatic CT values correlated with the changes in the liver deviation enzyme values. These results indicate the possibility that ischemic, hypoxic injury, and anerobic glycolysis of the liver at CPR after CPA are the cause of decreased hepatic PMCT values.

Investigation of serum biochemical responses in White Leghorn layer birds following acute avian toxicity screening using indoxacarb

The experiment was undertaken to study the effect of indoxacarb on various biochemical parameters in White Leghorn layer birds for a period of 14 days following a single oral administration. The study follows OECD guideline no. 223. White Leghorn layer birds (n=30) weighing between 1.2 to 1.6 kg were used for the study. Six birds were kept as the control group and approximately 2 ml of blood was collected in EDTA tubes on days 7 and 14 of the experiment. Biochemical parameters such as alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine and blood urea nitrogen (BUN) were estimated. The mean values of ALP, AST, ALT and BUN were found significantly higher on days 7 and 14 of the acute toxicity study of indoxacarb in layers as compared to that of the control group. Keywords: Biochemical, layers, indoxacarb

Comparison of clinical and laboratory characteristics of COVID-19 and influenza in hospitalized children.

COVID-19 and influenza infections have similar modes of transmission and clinical symptoms but have different prognoses and treatment methods; therefore, it is important to make a final diagnosis. Herein, we aimed to compare the demographic, clinical, and laboratory differences in hospitalized pediatric patients with COVID-19 and influenza. This retrospective study comprised patients with COVID-19 managed between March 2020 to February 2022, and patients with influenza managed between December 2017 to February 2022, at a tertiary care hospital. The clinical data and laboratory parameters were obtained from the medical records of the hospital. Pediatric intensive care unit (PICU) admission, need for oxygen support, and the mortality rates of the patients were recorded and compared statistically. Overall, 107 patients with COVID-19 and 250 patients with influenza were included. Underlying chronic disease (UCD) rates were statistically higher in patients with COVID-19 (p < 0.001). When the symptoms were compared, fever, cough, and runny nose were more common in patients with influenza, and abdominal pain and rash were more common in patients with COVID-19 (p < 0.05). In patients with influenza, white blood cell count and absolute neutrophil count values were lower (p = 0.021 and p = 0.037, respectively), and aspartate aminotransferase and creatinine kinase values were higher (p = 0.007 and p < 0.001, respectively). PICU admission rates and oxygen support needs were similar in both groups (p > 0.05). When the virus was COVID-19, it had 7.8 times higher risk of mortality compared to influenza (p = 0.002). There were statistically significant risk for mortality when the virus was COVID-19, the risk of mortality was 6.9 times higher in those with UCD, 8.5 times higher in those with admission to PICU and 3.8 times higher in those with needing mechanical ventilation (MV) compared to when the virus was influenza (p = 0.004, p = 0.006 and p = 0.049, respectively). The mortality rate was higher in patients with COVID-19 (p = 0.007). This study showed that COVID-19 might negatively affect the survival times and increase mortality rates, especially in children with an UCD, admitted to the PICU and in need of MV.

The role of saroglitazar in the treatment of metabolic dysfunction-associated steatohepatitis in non-diabetic patients: A prospective observational study

Metabolic dysfunction-associated steatohepatitis (MASH) is a metabolic disease characterized by hepatic fat accumulation and significant inflammation. Patients with hepatic steatosis who also have at least one of the five cardiometabolic risk markers are considered to have metabolic dysfunction-associated steatotic liver disease. MASH is diagnosed when a microscopic examination of liver tissue reveals fat accumulation in hepatocytes along with inflammation and destruction of liver cells. This study aims to assess the role of saroglitazar, a dual proliferator peroxisome-activated receptor agonist, in the medical therapy of MASH in non-diabetic patients. A prospective observational study was carried out in a tertiary care facility in north India. A total of 51 non-diabetic MASH patients (males and females, 18 &amp;ndash; 75 years of age, body mass index &amp;ge;18.5 kg/m2) were included in this study. Diagnosis of MASH was based on liver FibroScan (controlled attenuation parameter [CAP] score &gt;238, liver stiffness measurement [LSM] value &gt;7kPa) along with raised liver enzymes (serum glutamic-oxaloacetic transaminase [SGOT], serum glutamic-pyruvic transaminase [SGPT] &gt; upper value of normal limits). All these 51 patients received 4 mg once-daily dose of saroglitazar for the treatment of MASH for 24 weeks. In this study, a standard treatment protocol was used. The percentage changes in aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase, triglyceride, low-density lipoprotein (LDL), and LSM with CAP were evaluated using an analysis of variance test and multiple regression analysis. About 72.5% of these patients were male and 27.5% were female (male: female ratio of 2.6). The mean age of patients was 51 &amp;plusmn; 13.13 years. Pre- and post-treatment values of different parameters were compared. Pre-treatment mean values of ALT and AST were 93.83 &amp;plusmn; 6.16 U/L and 76.13 &amp;plusmn; 4.1 U/L, respectively, while their post-treatment mean values were 32.97 &amp;plusmn; 2.15 U/L and 34.57 &amp;plusmn; 1.65 U/L, respectively (P-value for AST and ALT &lt;0.001). In conclusion, saroglitazar is effective in the medical management of MASH by reducing liver stiffness and suppressing elevated liver enzymes (SGOT/SGPT) as well as serum LDL levels over 6 months.

A-111 “Activation” Of macro-ast by pyridoxal phosphate supplementation

Abstract Background Type 1 macro-AST is a high molecular weight AST (Aspartate Aminotransferase) formed between an AST monomer and immunoglobulins in plasma, which can cause elevated AST values. It is believed that reduced clearance or excretion of macro-AST can cause elevated AST results. Here we report a case of macro-AST that produced high AST values only by the AST assay that includes pyridoxal phosphate (PLP), not by the one without PLP. Case description A 54 year-old male patient diagnosed with disseminated Bartonellosis was monitored with ‘liver function” tests on a monthly basis, with AST varying between 24 to 73 U/L (Reference interval, 13-47 U/L). The patient’s AST value suddenly jumped to 378 U/L when the laboratory switched to an AST assay supplemented with PLP (named ASTPM) on Roche Cobas c702 analyzer (c702). When the same patient sample was tested using the previous AST assay which does not include PLP, a result of 14 U/L was obtained. Macro-AST was suspected, as all other “liver function” tests were within reference interval. Methods Protein-A and Protein-G were used to remove immunoglobulins from the patient sample and another sample with matching AST as a control, respectively. Three hundred microliters of washed Protein-A or Protein-G Sepharose bead slurry was mixed with 300 microliters of each sample, respectively. Each mixture was incubated at 37oC for 3 hours on a rocker. After centrifugation, the supernatant was transferred to a new tube. AST, ASTPM, and all other tests were performed on c702, and results corrected for dilution. The recovery of enzyme activity or immunoglobulin concentration after the removal of immunoglobulins was calculated, respectively. Results In the original sample, the ratio of ASTPM to AST was 28 (389 U/L vs. 14 U/L) for the patient, and 1.1 (304 U/L vs. 275 U/L) for the control. After the complete removal of immunoglobulin G (IgG), the recovery of ASTPM for the patient was 3% and for the control was 74%. The recovery of ALTPM (supplemented with PLP) was 89% for the patient and 85% for the control, showing the expected loss of enzymatic activity by Protein-A or Protein-G treatment. Conclusions The significant reduction of ASTPM activity (recovery of 3%) after removal of IgG in the patient sample proved that the AST enzyme was associated with IgG. The slight increase of ASTPM activity compared to AST (ratio of 1.1) in the control sample was an expected effect of supplementing PLP in the AST assay, however, the huge increase of ASTPM activity (ASTPM/AST ratio of 28) in the patient sample suggests that PLP “activated” the macro-AST and produced high AST result. This is a concerning effect of supplementing PLP in AST assays because it can cause spurious AST elevations in cases of macro-AST. As more laboratories begin to employ the PLP supplemented aminotransferase assays, it is important to acknowledge the interactions between PLP and macro-AST and the role of the laboratory to identify macro-AST in order to avoid unnecessary, costly, and time-consuming testing and procedures for these patients.

A-098 Reducing Hemolyzed Specimen Rejection for Aspartate Aminotransferase (AST): A Quality Improvement Initiative to Further Optimize Concentration-Specific H-index Thresholds

Abstract Background Serum aspartate aminotransferase (AST) is a commonly ordered test useful for diagnosing and monitoring hepatocellular damage. The hemolysis (H) index interference threshold for the Roche Cobas AST reagent is H=20, which is the lowest of all tests on Roche chemistry platforms (Cobas c701, c502, and e801). Previous optimization studies supported the implementation of an AST concentration-specific tiered hemolysis interference threshold schema: AST&amp;lt;100 U/L (H=50), AST=100-200 U/L (H=100), AST=201-300 U/L (H=200) and AST&amp;gt;301 U/L (H=500). This schema significantly reduced redraws; however, a significant number of rejected samples were noted to have AST results within the reference interval (RI). The aim of this study was to establish an H-index threshold for samples with AST results within the RI. Methods Twelve pools of residual serum samples were created with AST concentrations ranging from 17-66 U/L. Each pool was split into 2 aliquots, receiving either 10% of a lab-produced hemolysate solution generating H-indices from 62-508 or 10% of a 0.9% saline control. Aliquots were mixed in equal portions to create a series of 5 samples with increasing hemolysis according to CLSI guideline EP-07 and analyzed in EP Evaluator. Median(interquartile range (IQR)) H-index thresholds were calculated for error limits beginning at +5 U/L and increasing incrementally (+1 U/L) to +10 U/L. Clinical cases with an H-index slightly above the hemolysis interference threshold (50≤H≤70) and results within the RIs (Male:8-48U/L; Female:8-43U/L) were reviewed by the Chemistry Resident/Fellow on-call (n=68) over a period of 8 months. Results were released with a comment if risk of clinical misinterpretation due to a falsely elevated result was low. Previous, non-hemolyzed AST results were compared within 45 days, if available, by paired-Wilcoxon test (Graphpad Prism). Results The median(range) of initial AST results in the serum pools was 20(17-66) U/L. The calculated H-index thresholds (median(IQR)) using error limits of +5, +6, +7, +8, +9, +10 U/L were 49(43-53), 56(52-63), 66(61-78), 78(72-81), 91(84-91) and 101 (96-107), respectively. All slightly hemolyzed AST results (50≤H≤70) within the RI were released with a comment upon chart review. Previously reported AST values (n=23) were compared to current (hemolyzed) concentrations and found to be statistically significantly increased relative to previous results from the same patient (median(range) difference: 3.7(-3.6-11)U/L, p=0.009). However, the median difference was &amp;lt;5U/L or 10%, the laboratory’s criteria used to define a clinically significant difference. Conclusions A median H-index limit of up to 100 can be applied to samples when AST is within the RI. The risk of misinterpretation for results with mild-moderate hemolysis was low in the cases reviewed. Sample rejection rates and reporting delays can be diminished by implementing this practice. Interpretation can be further enhanced by appending the following comment to hemolyzed samples: “Specimen was received with hemolysis slightly above the accepted threshold. This degree of hemolysis is associated with a false increase of approximately 5-10 U/L. Interpret in conjunction with other laboratory and clinical findings.”

A-130 Intercomparison of Methods between Atellica Solution® and CI® Analyzers for Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST)

Abstract Background Objectives: To verify that the results of ALT and AST measured by the Atellica Solution® analyzer (and the new CI® analyzer (Siemens Healthineers) are interchangeable. Methods For each assay, 40 patient samples were selected, covering the entire measurement range, and analyzed by both instruments. To determine the degree of agreement between the instruments, Bland Altman analysis of mean differences and Passing Bablok regression were performed. Statistics are expressed with their 95% confidence intervals (CI). The evaluation of results was carried out using the statistical program Method Validator. Results ALT: In Bland-Altman analysis, no constant systematic error was found as the 95% confidence interval of the mean difference includes zero. Similarly, in Passing Bablok regression analysis, the confidence interval of the intercept includes zero. No systematic proportional differences were observed based on the slope, as the 95% confidence interval includes the value one. AST: In both Bland-Altman and Passing Bablok regression analyses, a constant systematic error was detected as the 95% confidence interval of the observed mean difference Bland-Altman and the 95% confidence interval of the intercept of the regression line do not include zero. A slight systematic proportional difference was also observed based on the slope, as the 95% confidence interval does not include one. Conclusions Based on the observed data, we can conclude that the Atellica Solution® and CI® analyzers are interchangeable for the ALT assay. There are constant systematic differences and a slight proportional systematic error for the AST assay, which should be re-evaluated after a new calibration of the method. It is noteworthy that this variation in the data is more pronounced for high AST values, not being clinically significant differences at these concentrations; nor as pronounced in clinical decision values. Therefore, we can conclude that the Atellica Solution® and CI® analyzers are interchangeable for AST.

Absence of Survival Impact from Hepatitis During Immunotherapy in 193 Patients with Advanced Hepatocellular Carcinoma - An Observational Study from Taiwan.

Hepatitis often occurs after initiating immune checkpoint inhibitor (ICI) treatment. The time and grade of hepatitis after ICI starts and the prognostic role of immune-related hepatitis in patients with advanced hepatocellular carcinoma (aHCC) remain unclear. In this real-world analysis, we enrolled aHCC patients receiving ICIs, documented the highest level of liver enzymes during/after ICIs, and analyzed the survival impact of different hepatitis patterns. One hundred and ninety-three aHCC patients receiving ICIs were recruited. During ICIs, 88.6% of patients experienced aspartate transaminase (AST) elevations (Grade III/IV: 7.8%). For alanine transaminase (ALT), 81.3% had elevated levels (Grade III/IV: 3.6%), and 41.5% of patients had elevated bilirubin levels (Grade 3/4: 6.7%). The median AST, ALT, and total bilirubin values significantly increased after ICI treatment initiated (all p < 0.001) and, similarly, after excluding progressive disease (p = 0.014, p = 0.002, p < 0.001). The median time of hepatitis occurrence is from the 4.0th to 15.9th weeks. Multivariable analysis showed that patterns of liver enzyme change of AST and total bilirubin in patients receiving ICIs significantly correlate to overall survival (OS, p = 0.009 and 0.001, respectively). After ICI termination, patients with elevated bilirubin (p = 0.003) and AST (p = 0.005) would indicate poor survival, with adjustment of viral hepatitis and ICI responses. Hepatitis emerges between the 4th and 20th weeks post-ICI initiation. Changes in liver enzymes during ICI therapy do not directly affect OS, implying the safety of ICI use when corticosteroids are promptly administered if clinically indicated.

Investigation of the protective effect of Lavandula stoechas against the damage caused by Bisphenol A in the liver tissue of rats

The present study aims to explore the hepatoprotective potential of Lavandula stoechas (LS) against Bisphenol A (BPA)-induced liver toxicity. In this experiment, 32 male rats were utilized and categorized into control, LS, BPA, and BPA + LS groups for the study. Each group received 50 mg/kg of the respective substance. Throughout the 28-day experiment, the control group did not receive any applications. The LS oil was administered intraperitoneally, while BPA was given through oral gavage. At the end of the experiment, rats were anesthetized, and blood was taken from the heart. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TB) values were measured from serum samples. Malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) measurements were performed in liver tissue. The histological structure was observed using hematoxylin and eosin staining methods. The BPA group showed higher AST levels compared to the control group, but the BPA + LS group exhibited a significant decrease in AST levels compared to the BPA group. Additionally, TB levels were lower in the BPA + LS group compared to the BPA group. MDA levels increased in BPA-treated groups compared to others. The LS-treated groups showed higher SOD levels compared to the control group. Furthermore, an evident increase was noted in the BPA + LS group in comparison to the BPA group. The BPA group exhibited a significant rise in OSI value compared to the control. It was concluded that LS has a protective impact against BPA-induced liver toxicity. The LS-treated groups showed higher SOD levels compared to the control group. Furthermore, a significant increase was noted in the BPA + LS group in comparison to the BPA group. The BPA group exhibited a significant rise in OSI value compared to the control. It was concluded that LS has a protective impact against BPA-induced liver toxicity.

Comparison of the Effects of Hesperidin Over 30- and 60-Day Intervals on Rainbow Trout: A Potential Biostimulant to Promote Growth, Immunological and Antioxidant Responses, and Disease Resistance

Abstract The current research evaluated the effects of dietary hesperidin (HSP) on growth parameters, digestive enzyme activities, innate immune markers, and antioxidant responses in rainbow trout, Oncorhynchus mykiss after the 30- and 60-day feeding trial. Then, specimens were subjected to Yersinia ruckeri infection for 14 days. For this, six hundred rainbow trout juveniles (initial weight; 25.49±0.40 g) were fed with different levels of HSP including 0 (HSP0; control), 50 (HSP50), 100 (HSP100), 150 (HSP150), and 200 (HSP200) mg/kg feed. After 60 days, dietary HSP100 supplementation significantly improved growth and feed efficiency indices. The optimal dose of HSP based on the regression test for WG and FCR detected 122 and 131 mg/kg, respectively. At the end of the 30th day, dietary HSP150 supplementation markedly boosted serum lysozyme (LYZ), myeloperoxidase (MPO), complement component C3, and immunoglobulin (Ig) levels, but decreased malondialdehyde (MDA) content. In the same period, dietary administration of HSP at the different concentrations markedly increased complement component C4 (HSP150 and HSP200), superoxide dismutase (SOD), skin mucus alkaline phosphatase (ALP) (HSP100–HSP200), skin mucus LYZ and catalase (CAT) (HSP100 and HSP 150), and skin mucus Ig level (HSP50–HSP200). After 60 days, all dietary HSP supplementation significantly improved lipase, serum C3, glutathione peroxidase (GPX), and skin mucus ALP, LYZ, and Ig levels, but decreased MDA, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) values. After 60 days, dietary administration of HSP150 induced a significant discrepancy in the activity of serum LYZ, MPO, respiratory burst (RB), and lactate dehydrogenase (LDH) compared to the control group. In the same period, dietary HSP supplementation at different levels induced a remarkable increase in digestive protease activity (HSP100), serum ACH50 and CAT activities (HSP100 and HSP150), skin mucus peroxidase and serum SOD levels (HSP100–HSP200), and serum C4 value (HSP50, HSP150, and HSP200), but markedly decreased ALP activity (HSP150 and HSP200). In addition, dietary HSP supplementation, especially HSP150, markedly boosted disease resistance against Y. ruckeri infection. The current data demonstrated that the oral administration of 100–150 mg/kg HSP has a high potential to promote growth performance, disease resistance, and faster induction of immune and antioxidant responses.

Impact of Silver Nanoparticles (Ag-NPs) as a Dietary Supplement on Growth Performance, Carcass Traits, Blood Metabolites, Digestive Enzymes, and Cecal Microbiota of Growing Rabbits

Abstract The present study investigated the impact of silver nanoparticles (Ag-NPs) on growth performance, carcass traits, liver and kidney functions, immunity and antioxidant indicators, digestive enzymes, and cecum bacteriology of growing rabbits. One hundred 5-week-old New Zealand White (NZW) male rabbits were randomly divided into 5 equal groups and fed for 8 weeks on the basal diet only or on the basal diet supplemented with different levels of Ag-NPs (0.25, 0.50, 0.75, or 1.00 mg/kg diet). Animals in each group were randomly distributed in 10 cages (replicates), with two rabbits each. Different dietary concentrations of Ag-NPs significantly increased live body weight (LBW) and feed conversion ratio (FCR). Also, body weight gain (BWG) increased dramatically during all experimental periods except 11–13 weeks of age. Levels of 0.25 and 1 mg of Ag-NPs/kg diet showed the highest increase in LBW, BWG, and FCR. All studied carcass traits, except liver %, were not affected by Ag-NPs levels. Rabbits fed diet supplemented with 1 mg Ag-NPs had the highest liver %. Serum total protein, albumin, and globulin levels were increased (P&lt;0.05) in groups treated with 0.25 and 0.75 mg Ag-NPs. In contrast, serum values of aspartate transaminase (AST) and alanine transaminase (ALT), urea and creatinine were significantly reduced with the supplementation of Ag-NPs up to 0.75 mg/kg diet. The immunoglobulins M, G, and A (IgM, IgG, and IgA), complement 3 (C3) and lysozyme activity were improved with the inclusion of nano-silver in the rabbit feeds, particularly at the level of 0.25 mg Ag-NPs/kg feed. The inclusion of Ag-NPs in rabbit diets at different concentrations increased the total antioxidant capacity and the activities of superoxide dismutase, catalase, and glutathione peroxidase. Growing rabbits fed on diets supplemented with Ag-NPs had higher levels of digestive enzymes than the control group. The addition of Ag-NPs reduced the load of E. coli, Salmonella spp. and coliform in the rabbit cecum. Overall, the inclusion of 0.25–1 mg Ag-NPs/kg to NZW rabbit diets has shown beneficial effects on health and performance.

Liver Function Test Results Correlate With Spleen Size in Patients With Infectious Mononucleosis.

We aimed to evaluate the efficacy of measuring transaminase levels to determine the resolution of splenomegaly in athletes diagnosed with infectious mononucleosis (IM). Wecollected serial aspartate aminotransferase (AST) and alanine transaminase (ALT) levelsand ultrasound-measured spleen sizes in university athletes who had been diagnosed with IM. Our study included seven university-aged athletes from a single institution. Patients received serial liver function tests (LFT) and splenic ultrasound testing until resolution of symptoms and full return to sport. The effects of AST, ALT, and days from symptom onset were analyzed using multivariable mixed-effects linear regression models. Levels of AST and ALT were significantly correlated with spleen size. For each 10-unit increase in AST and ALT values, spleen size increased by 0.1 cm (p = 0.007) and 0.09 cm (p = 0.008), respectively. Decreasing levels of ALT and AST correlated with a decrease in spleen size. Normalization of AST/ALT values correlated with return of spleen size to baseline. Liver function testing may be useful in the return-to-play decision-making process for athletes with IM.

Clinical Effects and Safety of Intra-Arterial Infusion Chemotherapy with Lipiodol versus Intra-Arterial Infusion Chemotherapy Alone for Treatment of Advanced Hepatocellular Carcinoma

Introduction: This study aimed to assess the effectiveness and safety of hepatic arterial infusion chemotherapy (HAIC) in 2 groups of patients: those who receive lipiodol (referred to as the lipiodol group) and those who do not receive lipiodol (referred to as the control group). Methods: From January 2016 through December 2023, 85 patients with advanced hepatocellular carcinoma were enrolled in this retrospective study. In total, 40 patients received HAIC with lipiodol, while 45 patients were given HAIC without lipiodol. The modified response evaluation criteria for solid tumors were used to evaluate the tumor response, which was assessed through an imaging study. The two groups were compared regarding their overall survival (OS), progression-free survival (PFS), and safety. Results: The outcomes between the lipiodol group and control group demonstrated no significant difference: the objective response rates (p = 0.066) were 32.5% and 15.6%; the disease control rates (p = 0.556) were 67.5% and 73.3%; the median OS times (p = 0.339) were 224 days and 398 days; the median PFS (p = 0.334) times were 191 days and 286 days in the lipiodol group and the control group, respectively. Adverse events also showed no significant difference between the two groups: elevation of total bilirubin (p = 0.834) rates were 40.0% and 37.8%; elevation of alanine aminotransferase (p = 0.191) percentages were 35.0% and 22.2%; and elevation of aspartate aminotransferase values (p = 0.058) were 65.0% and 44.4% in the lipiodol group and the control group, respectively. Conclusions: HAIC without lipiodol was non-inferior to HAIC with lipiodol in the clinical outcome.

DIETARY EFFECT OF COPPER SULPHATE ON BLOOD AND SERUM BIOCHEMICAL INDICES OF GROWING GOATS

An in-depth analysis of blood gives a reflection of animal’s responsiveness to their internal and external environment. Hence, a 56-day study was carried out using fifteen West African Dwarf (WAD) bucks of about 12-18months, with an average body weight of 6.09±0.58kg, to evaluate their nutrient intake, haematological and serum biochemical indices when fed copper sulphate (CuSO4) supplemented diets. A concentrate diet was formulated and divided into five equal portions and CuSO4 was added to the diets at 0, 5, 10, 15 and 20 mg/kg diets representing treatments T-control), T2, T3, T4) and T5, respectively and fed to the goats in a Completely Randomized Design experiment. Nutrient composition and nutrient intake were determined. Blood was collected from each goat and sera were harvested from each blood sample collected. The blood samples were analyzed for whole blood count, mean corpuscular volume, mean corpuscular haemoglobin, while sera for total protein (TP), aspartate aminotransferase (AST), alkaline phosphatase. Data generated were subjected to statistical analysis. From the results, supplementation of CuSO4 did not significantly (P&gt;0.05) influence DMI by the goats, while goats fed T5 (20 mg/kg CuSO4) had the highest CPI (61.00g/day). Goats fed T4 and T5 had statistical similar values for PCV. Goats fed T5 had the highest value of RBC (15.70x106/µL), WBC (11.33x103/µL), Hb (12.70g/100mL), MCHC (33.13g/dL), TP (6.82g/dL) and AST (63.83IU/L). Conclusively, the study revealed that copper sulphate supplementation in growing goats’ diet has potentials to improve blood components without deleterious effects on their health status, and could be supplemented even up to 20mg/kg.

Assessment of abnormal liver function tests and associated factors among COVID-19-infected patients in Addis Ababa, Ethiopia, 2022: a facility-based comparative cross-sectional study

ObjectiveLiver function test (LFT) abnormalities are higher in patients with severe COVID-19. Most of the studies on this theme were conducted in foreign nations, and the association with LFT abnormalities...