Tubuloside A, a phenylethanoid glycoside, alleviates diclofenac induced hepato-nephro oxidative injury via Nrf2/HO-1.

The most prominent adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (DF) are hepato-renal damage. Natural antioxidants can be preferred as an alternative and/or combination to improve this damage. This present study was conducted to evaluate the protective effect of Tubuloside A (TA) against diclofenac (DF)-induced hepato-renal damage. TA (1 mg/kg, ip) was administered to male Sprague-Dawley rats for 5 days, and DF (50 mg/kg, ip) was administered on Days 4 and 5. Plasma aspartate amino transferase, alanine amino transferase, alkaline phosphatase, blood urea nitrogen and creatinine were measured to evaluate liver and kidney functions. Additionally, oxidative stress parameters (malondialdehyde, glutathione, superoxide dismutase, catalase, and 8-oxo-7,8-dihydro-2'-deoxyguanosine) in blood, liver, and kidney tissues, changes in mRNA expression of genes involved in the Nrf2/HO-1 signalling pathway (Nrf2, HO-1, NQO-1, IL-6, iNOS, Cox-2, TNF-α, IL1-ß and NFκB) and apoptotic process (Bcl-2, Cas-3 and Bax) in liver and kidney tissues were determined. Additionally, tissue sections were evaluated histopathologically. Biochemical, histopathological, and molecular results demonstrated the hepato-renal toxic effects of DF, and TA treatment protected the liver and kidney from DF-induced damage. This provides an explanation for the hepato-nephro damage caused by DF and offers new ideas and drug targets together with TA for the prevention and treatment of DF injury.

Post COVID-19 irritable bowel syndrome.

OBJECTIVES: The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalisation for SARS-CoV-2 infection. DESIGN: GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires. RESULTS: The study included 2183 hospitalised patients. The primary analysis included a total of 883 patients (614 patients with COVID-19 and 269 controls) due to the exclusion of patients with pre-existing gastrointestinal symptoms and/or surgery. At enrolment, gastrointestinal symptoms were more frequent among patients with COVID-19 than in the control group (59.3% vs 39.7%, p<0.001). At the 12-month follow-up, constipation and hard stools were significantly more prevalent in controls than in patients with COVID-19 (16% vs 9.6%, p=0.019 and 17.7% vs 10.9%, p=0.011, respectively). Compared with controls, patients with COVID-19 reported higher rates of irritable bowel syndrome (IBS) according to Rome IV criteria: 0.5% versus 3.2%, p=0.045. Factors significantly associated with IBS diagnosis included history of allergies, chronic intake of proton pump inhibitors and presence of dyspnoea. At the 6-month follow-up, the rate of patients with COVID-19 fulfilling the criteria for depression was higher than among controls. CONCLUSION: Compared with controls, hospitalised patients with COVID-19 had fewer problems of constipation and hard stools at 12 months after acute infection. Patients with COVID-19 had significantly higher rates of IBS than controls. TRIAL REGISTRATION NUMBER: NCT04691895.

Prevalence of Gastrointestinal Symptoms in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Results of the Prospective Controlled Multinational GI-COVID-19 Study.

INTRODUCTION: Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month. METHODS: The GI-COVID-19 is a prospective, multicenter, controlled study. Patients with and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire. RESULTS: The study included 2036 hospitalized patients. A total of 871 patients (575 COVID+ and 296 COVID-) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P < 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels. DISCUSSION: The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection.

Synergistic toxicity of 2,4-dichlorophenoxyacetic acid and arsenic alters biomarkers in rats.

2,4-dichlorophenoxyacetic acid (2,4-D) and arsenic cause severe and extensive biological toxicity in organisms. However, their interactions and toxic mechanisms in co-exposure remain to be fully elucidated. In this study, 28 four-week-old female rats were divided into four groups and exposed to 100 mg/L arsenic or/and 600 mg/L 2,4-D through drinking water for a period of 28 days. As a result, it was revealed that biochemical indicators (ALT, AST, ALP, blood urea nitrogen, and creatinine) were increased and decreased hormonal parameters (FSH, LH, PG, and E2) in arsenic and 2,4-D and arsenic combination-treated groups. Moreover, increased lipid peroxidation (malondialdehyde level) and decreased antioxidant status (superoxide dismutase and catalase activities) were found in the co-exposure groups compared with the individual-exposure groups. Meanwhile, severe DNA damage was observed in co-exposure groups. Additionally, the levels of apoptotic (Bax, Caspase-3, Caspase-8, Caspase-9, p53, and PARP) and inflammation (NFκB, Cox-2, TNF-α, and TGFßI) indexes in the co-exposure groups were markedly increased, whereas the levels of anti-apoptosis index (Bcl-2) were decreased. It was also observed that co-exposure with 2,4-D and arsenic caused more histopathological changes in tissues. Generally, these results show that co-exposure to 2,4-D and arsenic can seriously cause oxidative stress, DNA damage, apoptosis and inflammation while having toxicological risk for organisms.

Synergistic toxicity of ethanol and 2,4-dichlorophenoxyacetic acid enhances oxidant status, DNA damage, inflammation, and apoptosis in rats.

Clarifying the interactions between substances as a result of exposure to multiple xenobiotics and determining the impacts on health are important from the toxicological point of view. Therefore, the aim of the study was to investigate the synergistic toxic effects of ethanol and 2,4-dichlorophenoxyacetic acid (2,4-D) in male albino rats. A total number of 28 Wistar male rats were divided into 4 groups (7/each), and 2,4-D (5 mg/kg) and ethanol (3 g/kg) were administered orally to rats for 60 days, either alone or in combination. Co-administration of ethanol and 2,4-D increased liver functional enzyme levels and lipid peroxidation in blood and tissues while decreased glutathione and antioxidant enzyme activities when compared to individual applications. Furthermore, co-administration of ethanol and 2,4-D caused DNA damage as well as the increase in apoptotic and proinflammatory cytokine gene expressions. Furthermore, histopathological examination of the tissues especially liver and kidney revealed that these two substances induced more serious damage. In conclusion, co-administration of ethanol and 2,4-D resulted in strong toxic effects on tissues (especially liver) with a synergistic interaction and give rise to serious toxicological drawbacks.

The frequency of sacroileitis and ankylosing spondylitis in inflammatory bowel disease and HLA-B27 association.

BACKGROUND/AIMS: The aim of this study was to investigate the frequency of sacroileitis and ankylosing spondylitis in inflammatory bowel disease and the relationship between disease activity, joint symptoms and HLA-B27 antigen positivity. METHODS: Sacroiliac joint radiography and three phase bone scanning of 33 ulcerative colitis patients (17 active and 16 in remission) and 29 Crohn's disease patients (15 active and 14 in remission) was performed. HLA-B27 was determined in all patients and 60 control subjects. RESULTS: Sacroileitis was found in 10 out of 33 patients with ulcerative colitis (30. 30%) and seven out of 29 patients with Crohn's disease (24. 13%). Of these patients, eleven had active (17.73%) disease and six were in remission (9. 68%). The diagnosis of sacroileitis was made by bone radiography in seven patients (41.18%) and by bone scanning in the other 10 patients (58.82%). A diagnosis of ankylosing spondylitis was made in three patients (17. 64%) who had previously been diagnosed by bone radiography to have sacroileitis. HLA-B27 was positive in six patients (9.67%) with inflammatory bowel disease and three subjects (5%) of the control group. There were no significant differences between these two groups (p>0.05). Compared to the control group, all three patients with ankylosing spondylitis were HLA-B27 positive, the difference being significant (p>0. 01). CONCLUSIONS: The clinical course of sacroileitis is independent of the activitiy of inflammatory bowel disease. Accordingly, patients with inflammatory bowel disease, especially those with sacroileitis, should be investigated for the presence of anklylosing spondylitis.