Tauroursodeoxycholic Acid (TUDCA) Relieves Streptozotocin (STZ)-Induced Diabetic Rat Model via Modulation of Lipotoxicity, Oxidative Stress, Inflammation, and Apoptosis.

Tauroursodeoxycholic acid (TUDCA) is approved for the treatment of liver diseases. However, the antihyperglycemic effects/mechanisms of TUDCA are still less clear. The present study aimed to evaluate the antidiabetic action of TUDCA in streptozotocin (STZ)-induced type 2 diabetes mellitus (T2DM) in rats. Fifteen adult Wistar albino male rats were randomly divided into three groups (n = five in each): control, diabetic (STZ), and STZ+TUDCA. The results showed that TUDCA treatment significantly reduced blood glucose, HbA1c%, and HOMA-IR as well as elevated the insulin levels in diabetic rats. TUDCA therapy increased the incretin GLP-1 concentrations, decreased serum ceramide synthase (CS), improved the serum lipid profile, and restored the glycogen content in the liver and skeletal muscles. Furthermore, serum inflammatory parameters (such as TNF-α, IL-6, IL-1ß, and PGE-2) were substantially reduced with TUDCA treatment. In the pancreas, STZ+TUDCA-treated rats underwent an obvious enhancement of enzymatic (CAT and SOD) and non-enzymatic (GSH) antioxidant defense systems and a marked decrease in markers of the lipid peroxidation rate (MDA) and nitrosative stress (NO) compared to STZ-alone. At the molecular level, TUDCA decreased the pancreatic mRNA levels of iNOS and apoptotic-related factors (p53 and caspase-3). In conclusion, TUDCA may be useful for diabetes management and could be able to counteract diabetic disorders via anti-hyperlipidemic, antioxidant, anti-inflammatory, and anti-apoptotic actions.

Ginkgo biloba extract protects against tartrazine-induced testicular toxicity in rats: involvement of antioxidant, anti-inflammatory, and anti-apoptotic mechanisms.

The use of additives, especially colorants, in food and pharmaceutical industry is increasing dramatically. Currently, additives are classified as contaminants of emerging concern (CECs). Concerns have been raised about the potential hazards of food additives to reproductive organs and fertility. The present study investigates the reproductive toxicity of tartrazine (TRZ), a synthetic colorant, in male rats and aims to explore the curative effect of Ginkgo biloba extract (EGb) against TRZ-induced testicular toxicity. Twenty-four rats were divided into four groups: the control (0.5 ml distilled water), the EGb group (100 mg/kg EGb alone), the TRZ group (7.5 mg/kg TRZ alone), and the TRZ-EGb group (7.5 mg/kg TRZ plus 100 mg/kg EGb). The doses were administered orally in distilled water once daily for 28 days. Toxicity studies of TRZ investigated testicular redox state, serum gonadotropins, and testosterone levels, testicular 17 ß-hydroxysteroid dehydrogenase activity, sperm count and quality, levels of inflammatory cytokines, and caspase-3 expression as an apoptotic marker. Also, histopathological alterations of the testes were examined. TRZ significantly affected the testicular redox status as indicated by the increase in malondialdehyde and the decrease in reduced glutathione, superoxide dismutase, and catalase. It also disrupted serum gonadotropins (follicle stimulating hormone and luteinizing hormone) and testosterone levels and the activity of testicular 17ß-hydroxysteroid dehydrogenase. Additionally, TRZ adversely affected sperm count, motility, viability, and abnormality. Levels of tumor necrosis factor-α, interleukin-1ß, interleukin-6, and expression of caspase-3 were increased in the testes. Histopathological examination of the testes supported the alterations mentioned above. Administration of EGb significantly ameliorated TRZ-induced testicular toxicity in rats. In conclusion, EGb protected against TRZ-induced testicular toxicity through antioxidant, anti-inflammatory, and anti-apoptotic mechanisms.

Comparison of bihemispheric and unihemispheric M1 transcranial direct current stimulations during physical therapy in subacute stroke patients: A randomized controlled trial.

BACKGROUND: Despite the central origin of stroke affecting the primary motor cortex M1, most physical and occupational rehabilitation programs focus on peripheral treatments rather than addressing the central origin of the problem. This highlights the urgent need for effective protocols to improve neurological rehabilitation and achieve better long-term functional outcomes. OBJECTIVES: Our hypothesis was that the bihemispheric delivery of transcranial direct current stimulation (tDCS) is superior to unihemispheric in enhancing motor function after stroke, in both the upper and lower extremities. METHODS: 35 sub-acute ischemic stroke survivors were randomly divided into three groups: bihemispheric and unihemispheric treatment groups, or sham groups. Each participant received a 20-minute session of tDCS with an intensity of 2 mA during physical therapy sessions, three days a week, for four weeks. The outcomes were measured using Fugl-Meyer assessment scale, modified Ashworth scale, Berg balance scale, and serum brain-derived neurotrophic factor (BDNF) levels. RESULTS: One-way ANOVA test indicated a significant effect of both treatment protocols on the upper extremity (p = < 0.001) and lower extremity (p = .034) for motor measures, but there was no difference between the two (p = .939). Kruskal Wallis test for spasticity showed a significant improvement in both treatment groups for elbow (p = .036) and wrist flexors (p = .025), compared to the sham group. However, there was no statistically significant difference in spasticity between uni- and bihemispheric stimulation for elbow (p = .731) or wrist flexors (p = .910). CONCLUSION: There is no statistically significant difference in efficacy between bihemispheric and unihemispheric tDCS in patients presenting with acute ischemic stroke. .

ASSESSING PREDICTORS OF DIRECTLY ACTING ANTIVIRALS' FAILURE AS A FURTHER STEP TOWARDS MORE EFFICIENT HCV ELIMINATION PROGRAMS: IL28B (IFNL4) GENE POLYMORPHISM HAS NO ROLE WHILE HIGHER ESTIMATED CREATININE CLEARANCE IS A FORGOTTEN FACTOR.

BACKGROUND: Sustained virologic response (SVR) rates after directly acting antivirals (DAAs) for hepatitis C virus (HCV) exceed 95%. This encouraged policymakers to put plans to achieve HCV elimination by 2030. The remaining percentage of non-SVR12 can affect HCV eradication strategies in the real-world especially the compliance of large numbers of treated persons to follow up for assessment of virologic response cannot be guaranteed. OBJECTIVE: We aimed to assess predictors of failure to achieve SVR after receiving sofosbuvir plus NS5A inhibitor as an important step towards achieving better HCV eradication strategies. METHODS: During the period from 1st November 2018 to 1st November 2019, 1581 treatment-naive patients received sofosbuvir plus daclatasvir ± ribavirin at our unit and 10 patients were referred to us with HCV relapse after the same regimens. A total of 163 out of the 1581 patients were lost for follow-up before assessment of virologic response and excluded from the analysis. 20 out of the remaining patients failed to achieve SVR12. Data from the 30 patients with non-SVR12 were included in the case-control analysis. RESULTS: Every unit increase in estimated creatinine clearance using modification of diet in renal disease study (MDRD) score, total bilirubin, and INR was associated with 1.03, 13.92, and 80.08 times greater odds of non-SVR12 (P<0.001, P=0.0016, P=0.02) respectively. The presence of liver cirrhosis on ultrasonography increases the odds by 10.03. (P=0.009). CONCLUSION: Higher MDRD score, INR, total bilirubin, and presence of sonographic features of liver cirrhosis are predictors of failure to achieve SVR12 using sofosbuvir plus NS5A inhibitor.

Avaliação dos preditores da falha dos antivirais de ação direta como mais um passo para programas de eliminação de VHC mais eficiente: o polimorfismo genético IL28B (IFNL4) não tem destaque, enquanto maior liberação estimada do "clearence" de creatinina é um fator esquecido / Assessing predictors of directly acting antivirals' failure as a further step towards more efficient hcv elimination programs: il28b (ifnl4) gene polymorphism has no role while higher estimated creatinine clearance is a forgotten factor

ABSTRACT Background: Sustained virologic response (SVR) rates after directly acting antivirals (DAAs) for hepatitis C virus (HCV) exceed 95%. This encouraged policymakers to put plans to achieve HCV elimination by 2030. The remaining percentage of non-SVR12 can affect HCV eradication strategies in the real-world especially the compliance of large numbers of treated persons to follow up for assessment of virologic response cannot be guaranteed. Objective: We aimed to assess predictors of failure to achieve SVR after receiving sofosbuvir plus NS5A inhibitor as an important step towards achieving better HCV eradication strategies. Methods: During the period from 1st November 2018 to 1st November 2019, 1581 treatment-naive patients received sofosbuvir plus daclatasvir ± ribavirin at our unit and 10 patients were referred to us with HCV relapse after the same regimens. A total of 163 out of the 1581 patients were lost for follow-up before assessment of virologic response and excluded from the analysis. 20 out of the remaining patients failed to achieve SVR12. Data from the 30 patients with non-SVR12 were included in the case-control analysis. Results: Every unit increase in estimated creatinine clearance using modification of diet in renal disease study (MDRD) score, total bilirubin, and INR was associated with 1.03, 13.92, and 80.08 times greater odds of non-SVR12 (P<0.001, P=0.0016, P=0.02) respectively. The presence of liver cirrhosis on ultrasonography increases the odds by 10.03. (P=0.009). Conclusion: Higher MDRD score, INR, total bilirubin, and presence of sonographic features of liver cirrhosis are predictors of failure to achieve SVR12 using sofosbuvir plus NS5A inhibitor.

RESUMO Contexto: As taxas de resposta virológica sustentada (SVR) após ação direta de antivirais (DAAs) para o vírus da hepatite C (VHC) excedem 95%. Isso encorajou os formuladores de políticas a colocar planos para alcançar a eliminação do VHC até 2030. O percentual remanescente de não-respondedores pode afetar as estratégias de erradicação do VHC no mundo real, especialmente a conformidade de um grande número de pessoas tratadas para acompanhamento para avaliação da resposta virológica não pode ser garantida. Objetivo: Nosso objetivo foi avaliar os preditores de não atingir o SVR após receber o inibidor sofosbuvir mais NS5A como um passo importante para alcançar melhores estratégias de erradicação do VHC. Métodos: No período de 1º de novembro de 2018 a 1º de novembro de 2019, 1581 pacientes receberam sofosbuvir mais daclatasvir ± ribavirin em nossa unidade e 10 pacientes foram encaminhados por recaída do VHC após os mesmos regimes. Um total de 163 dos 1581 pacientes foram perdidos para o acompanhamento antes da avaliação da resposta virológica e excluídos da análise. 20 dos demais pacientes não conseguiram a resposta virológica sustentada (SVR12). Os dados de 30 pacientes com não SVR12 foram incluídos na análise caso-controle. Resultados: Cada unidade aumentada no clearence estimado de creatinina usando o escore do estudo Modificação da Dieta em Doença Renal (MDRD), bilirrubina total e INR foram associadas a 1,03, 13,92 e 80,08 vezes maiores chances de não-SVR12 (P<0,001, P=0,0016, P=0,02) respectivamente. A presença de cirrose hepática na ultrassonografia aumenta as chances em 10,03. (P=0,009). Conclusão: Maior escore de MDRD, INR, bilirrubina total e presença de características sonográficas de cirrose hepática são preditores de falha na realização do SVR12 utilizando o inibidor sofosbuvir mais NS5A.

Tolloid-like 1 gene variant rs17047200, pretreatment FIB-4, ALBI and PALBI scores as predictors of hepatocellular carcinoma occurrence after directly acting antivirals.

Aim of the study: Identifying persons at increased risk of developing hepatocellular carcinoma (HCC) after exposure to directly acting antivirals (DAAs) is of utmost importance. Our aim was to identify the predictors of de novo HCC occurrence among cirrhotic patients after hepatitis C virus (HCV) treatment using DAAs. Material and methods: 529 cirrhotic patients who initiated treatment for HCV using DAAs were followed up for 2 years from the end of treatment for development of HCC. Pretreatment clinical and laboratory data were assessed as possible predictors for HCC occurrence. Genotyping for tolloid-like 1 gene (TLL1) variant rs17047200 was assessed in all patients who developed HCC and in the matched control group. Results: Pretreatment bilirubin, FIB-4 and platelet-albumin-bilirubin (PALBI) scores were significantly higher among those who developed HCC than those who did not develop HCC during the 2-year follow-up period while hemoglobin level was significantly lower. ROC curve analysis revealed that at a cut-off ≥ 3.07, pretreatment FIB-4 had a sensitivity of 76.5%, and negative predictive value (NPV) of 92%. At a cut-off ≥ -2.5, pretreatment PALBI score had a sensitivity of 82.4%, and NPV of 93.2%. Regarding genotyping for TLL1 rs17047200 there were no statistically significant differences between those who developed HCC during follow-up and the matched control group. Conclusions: TLL1 rs17047200 genotyping is not helpful in predicting HCC occurrence after DAAs. On the other hand, lower pretreatment hemoglobin level and higher pretreatment bilirubin, FIB-4 and PALBI scores are associated with higher risk of HCC development after DAAs.

Hepatoprotective effect of Spirulina platensis against carbon tetrachloride-induced liver injury in male rats.

OBJECTIVES: Spirulina platensis (SP) is an edible Cyanobacterium with ethnomedicinal significance. This study aims at evaluating the beneficial effect of SP against carbon tetrachloride (CCl4)-induced liver toxicity in male rats. METHODS: Rats received intraperitoneal injections of CCl4 (2 ml/kg body weight [b.w.] per every other day) for 40 days, alone or in combination with oral treatments of SP (400 mg/kg b.w. per day). KEY FINDINGS: SP attenuated haematological disturbances, serum liver markers, hepatic necrosis and inflammation, and dyslipidemia in CCl4-intoxicated rats. SP also reduced CCl4-induced oxidative stress by increasing the activities of antioxidant enzymes, such as glutathione peroxidase, superoxide dismutase and catalase and glutathione content, and inhibiting lipid peroxidation products and nitric oxide levels in the rat liver. Further investigations revealed that SP counteracted CCl4-induced increased hepatic levels of Ki-67 (a parameter of cell proliferation), interleukin-6, and tumour necrosis factor-alpha and cyclooxygenase-2 messenger RNA expression. Noticeably, the supplementation of SP restored the decrease of proapoptotic p53 protein levels in the liver of rats treated with CCl4. CONCLUSIONS: SP prevented liver damage in CCl4-treated rats via augmentation of antioxidant defense mechanisms and inhibition of inflammatory cytokines/mediators and antiproliferative effects.

Ameliorative effects of bee pollen and date palm pollen on the glycemic state and male sexual dysfunctions in streptozotocin-Induced diabetic wistar rats.

This study aimed to assess the effects of bee pollen (BP) and/or date palm pollen (DPP) suspensions on the glycemic state, testicular dysfunctions, oxidative stress and antioxidant defense system in streptozotocin (STZ)-induced diabetic male Wistar rats. Diabetes mellitus was induced by single intraperitoneal injection of STZ to overnight-fasted rats at dose of 40mg/kg body weight. After 1 week of STZ injection, diabetic rats were treated with BP and/or DPP suspensions at dose levels of 100mg/kg body weight/day for 4 weeks. The STZ-induced diabetes significantly increased blood glucose levels and testicular nitric oxide (NO) and malondialdehyde (MDA) levels parallel with disrupted testicular and pancreatic histological architecture and integrity. On the other hand, STZ-induced diabetes significantly decreased body weight, testis and pancreas weights, levels of serum insulin, testosterone, luteinizing hormone (LH) & follicle stimulating hormone (FSH) as well as sperm count, motility and viability. The administration of BP and DPP suspensions resulted in a significant recovery of the above mentioned parameters as compared to the diabetic control group. These improvements were associated with enhancement of the testicular antioxidant system manifested by an increase in the lowered glutathione content (GSH) and glutathione-S-transferase (GST), glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities in diabetic rats as a result of treatments with BP and DPP suspensions. Thus, it can be concluded that BP and/or DPP suspensions may have potential protective role against diabetes-induced pituitary testicular axis dysfunction and testicular histological deleterious changes in association with antihyperglycemic actions via their antioxidant properties and their efficiency to improve blood insulin level and beta cell function.

The effect of melatonin and/or complex vitamin B1,B6,B12 in modulating epinephrine-induced stress in male rats

This study was undertaken to determine the modulating effects of intramuscular administration of melatonin (MT)(1mg/ kg) and/or Tri-B (B 1 , B 6 and B 12 ) (20mg/kg) on body weight and some biochemical changes in rats induced by Epinephrine (Epi) injection. The data showed that MT and/or Tri-B treatment effectively improved the changes in malondialdehyde, lipid profile, blood sugar level and insulin. MT and/or Tri-B administration following Epi improved partially the decrease in body weight and liver glycogen levels. Tri B injection following Epi partialy improved all the tested parameters except malondialdehyde and blood sugar level that completely improved in stressed rats. It was evident that a combination of MT and vitamin B complex had protective actions and further it was better than either of them introduced alone in stressed rats. The possible interaction between MT and Tri B provided further support to MT synergistic actions with the aim of advocating MT and Tri B as a possible synergistic therapy.