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Ann Hepatol ; 19(6): 614-621, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32920162


INTRODUCTION: COVID-19 caused by the SARS-CoV-2 continues to spread rapidly across the world. In our study, we aim to investigate the relationship between the liver enzymes on admission (AST, ALT, ALP, GGT) and severity of COVID-19. We evaluated course of disease, hospital stay, liver damage and mortality. MATERIALS AND METHODS: Our study included 614 patients who were hospitalized with the diagnosis of COVID-19 between 03.16.20 and 05.12.20. Patients with liver disease, hematological and solid organ malignancy with liver metastases were excluded, resulting in 554 patients who met our inclusion criteria. We retrospectively evaluated liver transaminase levels, AST/ALT ratio, cholestatic enzyme levels and R ratio during hospital admission and these were compared in terms of morbidity, mortality and clinical course. RESULTS: Mean age of 554 subjects were 66.21±15.45 years, 328 (59.2%) were men. The mean values of liver enzymes on admission were AST (36.2±33.6U/L), ALT (34.01±49.34U/L), ALP (78.8±46.86U/L), GGT (46.25±60.05U/L). Mortality rate and need for intensive care unit were statistically significant in subjects that had high ALT-AST levels during their admission to the hospital (p=0.001). According to the ROC analysis AST/ALT ratio was a good marker of mortality risk (AUC=0.713: p=0.001) and expected probability of intensive care unit admission (AUC=0.636: p=0.001). R ratio, which was used to evaluate prognosis, showed a poor prognosis rate of 26.5% in the cholestatic injury group, 36.1% in the mixed pattern group and 30% in the hepato-cellular injury group (p 0.001). CONCLUSIONS: ALT-AST elevation and AST/ALT ratio >1 was associated with more severe course and increased mortality in COVID-19.

Alanina Transaminase/metabolismo , Aspartato Aminotransferases/metabolismo , Betacoronavirus , Infecções por Coronavirus/enzimologia , Infecções por Coronavirus/mortalidade , Hepatopatias/virologia , Pneumonia Viral/enzimologia , Pneumonia Viral/mortalidade , Adulto , Idoso , COVID-19 , Infecções por Coronavirus/complicações , Feminino , Hospitalização , Humanos , Hepatopatias/diagnóstico , Hepatopatias/mortalidade , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Prognóstico , Estudos Retrospectivos , SARS-CoV-2 , Sensibilidade e Especificidade , Taxa de Sobrevida , Turquia
Proc Natl Acad Sci U S A ; 115(32): E7632-E7641, 2018 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-30037999


Enterochromaffin (EC) cells constitute the largest population of intestinal epithelial enteroendocrine (EE) cells. EC cells are proposed to be specialized mechanosensory cells that release serotonin in response to epithelial forces, and thereby regulate intestinal fluid secretion. However, it is unknown whether EE and EC cells are directly mechanosensitive, and if so, what the molecular mechanism of their mechanosensitivity is. Consequently, the role of EE and EC cells in gastrointestinal mechanobiology is unclear. Piezo2 mechanosensitive ion channels are important for some specialized epithelial mechanosensors, and they are expressed in mouse and human EC cells. Here, we use EC and EE cell lineage tracing in multiple mouse models to show that Piezo2 is expressed in a subset of murine EE and EC cells, and it is distributed near serotonin vesicles by superresolution microscopy. Mechanical stimulation of a subset of isolated EE cells leads to a rapid inward ionic current, which is diminished by Piezo2 knockdown and channel inhibitors. In these mechanosensitive EE cells force leads to Piezo2-dependent intracellular Ca2+ increase in isolated cells as well as in EE cells within intestinal organoids, and Piezo2-dependent mechanosensitive serotonin release in EC cells. Conditional knockout of intestinal epithelial Piezo2 results in a significant decrease in mechanically stimulated epithelial secretion. This study shows that a subset of primary EE and EC cells is mechanosensitive, uncovers Piezo2 as their primary mechanotransducer, defines the molecular mechanism of their mechanotransduction and mechanosensitive serotonin release, and establishes the role of epithelial Piezo2 mechanosensitive ion channels in regulation of intestinal physiology.

Células Enterocromafins/fisiologia , Canais Iônicos/metabolismo , Jejuno/fisiologia , Mecanotransdução Celular/fisiologia , Serotonina/metabolismo , Animais , Células Cultivadas , Canais Iônicos/genética , Jejuno/citologia , Camundongos , Camundongos Transgênicos , Organoides/fisiologia , Cultura Primária de Células , RNA Interferente Pequeno/metabolismo , Análise de Célula Única
J Trop Pediatr ; 50(6): 372-4, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15537727


Chronic meningococcaemia is a very rare clinical manifestation of invasive infection by Neisseria meningitidis. A 9-year-old girl was admitted to our clinic with complaints of fever, headache, arthralgia, and maculopapular rash. The diagnosis was made by the growth of Neisseria meningitidis in the blood cultures. Four days after admission, liver function tests were increased and were compatible with cholestatic hepatitis. Thereafter, the patient was successfully treated and symptoms were completely resolved. To our knowledge, there have been no previous reports of Neisseria meningitidis causing cholestatic hepatitis. Herein, we present an unusual child patient with chronic meningococcaemia associated with cholestatic hepatitis.

Bacteriemia/complicações , Bacteriemia/diagnóstico , Icterícia Obstrutiva/complicações , Infecções Meningocócicas/complicações , Infecções Meningocócicas/diagnóstico , Bacteriemia/tratamento farmacológico , Criança , Doença Crônica , Feminino , Seguimentos , Humanos , Icterícia Obstrutiva/microbiologia , Infecções Meningocócicas/tratamento farmacológico , Neisseria meningitidis/efeitos dos fármacos , Neisseria meningitidis/isolamento & purificação , Penicilina G/uso terapêutico , Doenças Raras , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento , Turquia