Association between thymosin beta4 and non-alcoholic fatty liver disease.

BACKGROUND AND AIMS: non-alcoholic fatty liver disease (NAFLD) is the most common type of chronic liver injury worldwide. Some studies have shown that thymosin beta4 (Tß4) is closely related to liver diseases. Nevertheless, only a few published studies have reported the relationship between Tß4 and NAFLD. The purpose of this study was to evaluate the levels of Tß4 in patients with NAFLD compared with controls and to validate their relationship in a larger cohort. PATIENTS AND METHODS: a total of 76 NAFLD patients and 130 healthy controls were included in the study. Serum levels of Tß4, IL-6 and adiponectin were determined by ELISA. Serum glucose, insulin and lipids, as well as liver function were measured. Multivariate statistical analyses were performed via logistic regression modelling to determine the predictors with a significant relevance to NAFLD. The association between serum Tß4 and study variables was tested using correlation coefficients calculations. RESULTS: serum Tß4 content was 3.20 ± 0.98 mg/l in NAFLD patients (n = 76) and 5.53 ± 1.24 mg/l in healthy controls (n = 130); the difference between the two groups was statistically significant (p = 0.000). Multivariate logistic regression analysis identified Tß4 (OR = 0.343, 95% CI 0.240-0.491, p < 0.001), LDL (OR = 1.019, 95% CI 1.007-1.030, p = 0.001), ALT (OR = 1.021, 95% CI 1.001-1.041, p = 0.040) and IL-6 (OR = 1.443, 95% CI 1.079-1.929, p = 0.013) as independent predictors of NAFLD diagnosis. Serum Tß4 levels had a significant negative correlation with total cholesterol, TG, AST, GGT and IL-6 (p < 0.05 for all) and the correlation coefficient values were -0.163, -0.253, -0.143, -0.245 and -0.155, respectively. Serum Tß4 levels were positively correlated with serum adiponectin levels, with a correlation coefficient value of 0.143. CONCLUSION: serum Tß4 may play a defensive role in the development of NAFLD. Further studies are needed to confirm the role of Tß4 in NAFLD.

Serum thymosin beta4 as a noninvasive biomarker in patients with nonalcoholic steatohepatitis.

OBJECTIVE: The aim of the study was to determine whether serum thymosin beta4 (Tß4) can be a useful noninvasive biomarker to differentiate between nonalcoholic steatohepatitis (NASH) and nonalcoholic fatty liver (NAFL). METHODS: The study included 24 NAFL patients and 21 NASH patients. The levels of Tß4, 8-hydroxydeoxyguanosine acid (8-OhdG), liver function parameters, blood lipid, and glucose were detected in the venous blood of all patients. The NAFLD histological activity score (NAS) was examined in biopsy specimens from all patients. Statistical analysis was performed in order to find differences between the two abovementioned groups. In addition, receiver operator characteristic (ROC) analyses for alanine aminotransferase (ALT) and Tß4 levels were performed in NAFL and NASH patients and the cut-off value was determined. Associations between the variables were tested using correlation coefficient calculations. Statistical significance was set at a p value of < 0.05. RESULTS: Serum Tß4 content was 5.12 ± 1.87 mg/l in the NAFL group and 2.98 ± 1.35 mg/l in the NASH group (p < 0.001). Serum Tß4 content and NAS, histological features of hepatic steatosis, lobular inflammation and ballooning, ALT, glucose and 8-OhdG levels were negatively correlated (p < 0.05 for all) in the NASH group. The correlation coefficient values were -0.530, -0.562, -0.574, -0.438, -0.446, -0.426 and -0.563, respectively. On the basis of ROC analysis, the best predictive Tß4 cut-off value for detecting NASH was 3.94 mg/l (85.7% sensitivity and 79.2% specificity, which were higher than those of ALT). CONCLUSION: Serum Tß4 level can be used as a biomarker for the diagnosis of NASH and was negatively correlated with the oxidation state of the liver.

Potential role of thymosin beta 4 in the treatment of nonalcoholic fatty liver disease.

As a result of increased prevalence of obesity worldwide, non-alcoholic fatty liver disease (NAFLD) has become one of the most common causes of chronic liver disease. Although most NAFLD cases remain benign, some progress to end-stage liver diseases such as cirrhosis and hepatocellular carcinoma. Therefore, treatment should be considered for NAFLD patients who are likely to progress to nonalcoholic steatohepatitis (NASH) or fibrosis. Thymosin beta 4 (Tß4), a G-actin sequestering peptide, regulates actin polymerization in mammalian cells. In addition, studies have reported anti-inflammatory, insulin-sensitizing, and anti-fibrotic effects of Tß4. However, no research has been done to investigate the effects of Tß4 on NAFLD. Based on the findings above mentioned, we hypothesize that Tß4 may represent an effective treatment for NAFLD.

Comparison of maintenance effect of probiotics and aminosalicylates on ulcerative colitis: A meta-analysis of randomized controlled trials.

OBJECTIVE: To evaluate the maintenance effect of probiotics versus that of aminosalicylates on ulcerative colitis. METHODS: MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and the Chinese Biomedical Database were searched in English or Chinese. Data extracted were selected with strict criteria. RESULTS: In six randomized controlled trials (RCTs), a total of 721 participants were enrolled and the maintenance effect of probiotics (n = 364) versus that of aminosalicylates (n = 357) on ulcerative colitis was investigated. No significant difference was observed between probiotics and aminosalicylate groups (relative risk (RR) = 1.08; 95% confidence interval (CI): 0.91-1.28; P = 0.40). Three RCTs compared the incidence of adverse events with probiotics versus those with aminosalicylates. No significant difference was observed in the incidence of adverse events between the two groups (RR = 1.20; 95% CI: 0.92-1.56; P = 0.17). CONCLUSIONS: Probiotics and aminosalicylates both showed a maintenance effect on ulcerative colitis. However, more well-designed RCTs are required.

Long-term follow-up after laparoscopic versus open distal gastrectomy for advanced gastric cancer.

This study aimed to compare the long-term outcomes of laparoscopic and open distal gastrectomy for advanced gastric cancer. Between January 2007 and December 2014, patients with advanced gastric cancer underwent distal gastrectomy by laparoscopic or open approach were identified. Patients in both groups were selected after being matched by age, gender, American Society of Anesthesiologists (ASA) class and clinical TNM stage using propensity score method, to create two comparable groups: laparoscopy and open groups, and prognosis were compared between these two groups. After the patients were matched, 86 patients in each group were selected for analysis. There were no significant differences in the clinicopathological features between the two groups. There were significant differences between the laparoscopy and open groups in terms of blood loss, duration of surgery, and hospital stay. The 5-year overall survival rate was 59% in laparoscopy group, and 56% in open group (P=0.523). The 5-year disease-free survival rate was 52% and 46%, respectively (P=0.362). According to the univariate and multivariate analysis, this type of surgical approach was not a prognostic factor for long-term outcomes. The current results indicated that laparoscopic distal gastrectomy is associated with similar overall survival and disease-free survival for advanced gastric cancer.