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1.
BMC Infect Dis ; 21(1): 14, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407216

RESUMO

BACKGROUND: The levels of serum D-dimer (D-D) in children with Mycoplasma pneumoniae pneumonia (MPP) were assessed to explore the clinical significance of D-D levels in refractory MPP (RMPP). METHOD: A total of 430 patients with MPP were enrolled between January 2015 and December 2015 and divided into a general MPP (GMPP) group (n = 306) and a RMPP group (n = 124). Clinical data, D-D level, white blood cell (WBC) count, proportion of neutrophils (N%), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine transaminase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) were compared between the two groups. Multivariate logistic regression was performed to identify independent predictors of RMPP. RESULTS: (1) Hospitalization time, preadmission fever duration, total fever duration, WBC, N %, CRP, LDH, ESR, ALT, AST, and D-D were significantly higher in the RMPP group than those in the GMPP group (all P < 0.05). (2) Correlation analysis showed that D-D was positively correlated with WBC, CRP, ESR, and LDH, and could be used to jointly evaluate the severity of the disease. (3) Multivariate logistic regression analysis identified preadmission fever duration, CRP, LDH and DD as independent risk factors for RMPP (all P < 0. 05). D-D had the highest predictive power for RMPP (P < 0.01). The D-D level also had a good ability to predict pleural effusion and liver injury (all P < 0.01). CONCLUSION: Serum D-D levels were significantly increased in patients with RMPP, indicating that excessive inflammatory response and vascular endothelial injury with prolonged duration existed in this patient population. Increased levels of serum D-D may be used as an early predictor of RMPP and the occurrence of complications. Our findings provide a theoretical basis for the early diagnosis of RMPP, early intervention and excessive inflammatory response in the pathogenesis of mycoplasma.


Assuntos
Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/sangue , Pneumonia por Mycoplasma/diagnóstico , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Sedimentação Sanguínea , Proteína C-Reativa/análise , Criança , Pré-Escolar , Feminino , Humanos , L-Lactato Desidrogenase/sangue , Contagem de Leucócitos , Modelos Logísticos , Masculino , Mycoplasma pneumoniae/isolamento & purificação , Neutrófilos/patologia , Derrame Pleural/etiologia , Pneumonia por Mycoplasma/complicações , Pneumonia por Mycoplasma/microbiologia , Estudos Retrospectivos , Fatores de Risco
2.
Ecotoxicol Environ Saf ; 208: 111475, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33068975

RESUMO

Cocaine is one of the most widely used illicit drugs in the world, and as a result of incomplete removal by sewage treatment plants it is found in surface waters, where it represents a new potential risk for aquatic organisms. In this study we evaluated the influence of environmental concentrations of cocaine on the liver and the kidney of the European eel (Anguilla anguilla). The eels were exposed to 20 ng L-1 of cocaine for fifty days, after which, three and ten days after the interruption of cocaine exposure their livers and kidneys were compared to controls. The general morphology of the two organs was evaluated, as well as the following parameters: cytochrome oxidase (COX) and caspase-3 activities, as markers of oxidative metabolism and apoptosis activation, respectively; glucose-regulated protein (GRP)78 levels, as a marker of endoplasmic reticulum (ER)-stress; blood glucose level, as stress marker; serum levels of alanine aminotransferase (ALT), as a marker of liver injury and serum levels of C-reactive protein (CRP), as a marker of the inflammatory process. The liver showed morphologic alterations such as necrotic areas, karyolysis and pyknotic nuclei, while the kidneys had dilated glomeruli and the renal tubules showed pyknotic nuclei and karyolysis. In the kidney, the alterations persisted after the interruption of cocaine exposure. In the liver, COX and caspase-3 activities increased (COX: P = 0.01; caspase-3: P = 0.032); ten days after the interruption of cocaine exposure, COX activity returned to control levels (P = 0.06) whereas caspase-3 activity decreased further (P = 0.012); GRP78 expression increased only in post-exposure recovery specimens (three days: P = 0.007 and ten days: P = 0.008 after the interruption of cocaine exposure, respectively). In the kidney, COX and caspase-3 activities increased (COX: P = 0.02; caspase-3: P = 0.019); after the interruption of cocaine exposure, COX activity remained high (three days: P = 0.02 and ten days: P = 0.029 after the interruption of cocaine exposure, respectively) whereas caspase-3 activity returned to control values (three days: P = 0.69 and ten days: P = 0.67 after the interruption of cocaine exposure, respectively). Blood glucose and serum ALT and CRP levels increased (blood glucose: P = 0.01; ALT: P = 0.001; CRP: 0.015) and remained high also ten days after the interruption of cocaine exposure (blood glucose: P = 0.009; ALT: P = 0.0031; CRP: 0.036). These results suggest that environmental cocaine concentrations adversely affected liver and kidney of this species.


Assuntos
Anguilla/fisiologia , Cocaína/toxicidade , Poluentes Químicos da Água/toxicidade , Alanina Transaminase/metabolismo , Anguilla/sangue , Animais , Glicemia , Proteína C-Reativa/metabolismo , Caspase 3/metabolismo , Cocaína/análise , Complexo IV da Cadeia de Transporte de Elétrons/metabolismo , Drogas Ilícitas , Rim/metabolismo , Fígado/metabolismo
3.
Eur J Clin Invest ; 51(1): e13427, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33043447

RESUMO

Increased concentrations of serum aspartate transaminase (AST) and alanine transaminase (ALT) are common in COVID-19 patients. However, their capacity to predict mortality, particularly the AST/ALT ratio, commonly referred to as the De Ritis ratio, is unknown. We investigated the association between the De Ritis ratio on admission and in-hospital mortality in 105 consecutive patients with coronavirus disease of 2019 (COVID-19) admitted to three COVID-19 referral centres in Sardinia, Italy. The De Ritis ratio was significantly lower in survivors than nonsurvivors (median: 1.25; IQR: 0.91-1.64 vs 1.67; IQR: 1.38-1.97, P = .002) whilst there were no significant between-group differences in ALT and AST concentrations. In ROC curve analysis, the AUC value of the De Ritis ratio was 0.701 (95% CI 0.603-0.787, P = .0006) with sensitivity and specificity of 74% and 70%, respectively. Kaplan-Meier survival curves showed a significant association between the De Ritis ratio and mortality (logrank test P = .014). By contrast, no associations were observed between the ALT and AST concentrations and mortality (logrank test P = .83 and P = .62, respectively). In multivariate Cox regression analysis, the HR in patients with De Ritis ratios ≥1.63 (upper tertile of this parameter) remained significant after adjusting for age, gender, smoking status, cardiovascular disease, intensity of care, diabetes, respiratory diseases, malignancies and kidney disease (HR: 2.46, 95% CI 1.05-5.73, P = .037). Therefore, the De Ritis ratio on admission was significantly associated with in-hospital mortality in COVID-19 patients. Larger studies are required to confirm the capacity of this parameter to independently predict mortality in this group.


Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Mortalidade Hospitalar , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/metabolismo , /terapia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Humanos , Itália/epidemiologia , L-Lactato Desidrogenase/sangue , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Ventilação não Invasiva , Oxigenoterapia , Prognóstico , Modelos de Riscos Proporcionais , Curva ROC , Respiração Artificial
4.
Ecotoxicol Environ Saf ; 208: 111426, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33096358

RESUMO

Environmental mercury is a concern for coastal ecosystem health, and exerts adverse effects on human health. Despite the growing body of evidence showing the hepatoprotective roles of curcumin on mercury, the knowledge between the macroscopic descriptions and the actual mechanism(s) underlying these processes is getting larger remains elusive. Herein, mice received single injection of mercuric chloride (HgCl2) (5 mg/kg body weight) and/or curcumin (50 mg/kg, body weight, p.o.). Firstly, the results showed curcumin could decline HgCl2-induced up-regulated the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Additionally, we also found that curcumin could suppress inflammatory damage, unbalance of trace elements (including sodium, magnesium, kalium, calcium overload), oxidative burst induced by HgCl2, which could be associated with cytochrome P450 (CYP450) signaling. Secondly, we found that curcumin could prevent HgCl2-induced cell death both in vivo and in vitro. Furthermore, curcumin significantly increased the nuclear translocation of nuclear factor E2-related factor 2 (Nrf2) and consequently upregulated the expression of heme oxygenase 1 (HO-1) under HgCl2 treatment. Meanwhile, inhibition of HO-1 by zinc protoporphyria could abolish the cytoprotective effects of curcumin in HgCl2-treated L02 hepatocytes. In conclusion, our data identify that curcumin could enhance Nrf2-mediated HO-1 to upregulate antioxidant ability, which might be associate with CYP450 signaling to suppress liver damage induced by HgCl2. The present study further enriches and perfects the mechanism theory of HgCl2 toxicity and suggest that the CYP450 signaling and Nrf2/HO-1 pathway is important in shedding light on curcumin's hepatoprotective effects in HgCl2 toxicity.


Assuntos
Curcumina/farmacologia , Sistema Enzimático do Citocromo P-450/metabolismo , Substâncias Perigosas/toxicidade , Cloreto de Mercúrio/toxicidade , Substâncias Protetoras/farmacologia , Alanina Transaminase/metabolismo , Animais , Antioxidantes/metabolismo , Doença Hepática Crônica Induzida por Substâncias e Drogas/metabolismo , Ecossistema , Heme Oxigenase-1/genética , Hepatócitos/efeitos dos fármacos , Humanos , Camundongos , Fator 2 Relacionado a NF-E2/metabolismo , Oxirredução , Estresse Oxidativo/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Regulação para Cima/efeitos dos fármacos
6.
Ann Hepatol ; 20: 100271, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33099028

RESUMO

INTRODUCTION AND OBJECTIVES: Liver function tests (LFT) abnormalities are reported in up to 50% of COVID-19 patients, and metabolic comorbidities are associated with poorer outcomes. The aim of the study was to determine the prevalence of liver steatosis and fibrosis in patients with COVID-19 and their association with clinical outcomes. MATERIAL AND METHODS: Retrospective study in hospitalized COVID-19 patients was conducted. The risk for liver steatosis was estimated by HSI > 36, and risk for advanced liver fibrosis with APRI > 1.0, NAFLD FS > 0.675 and/or FIB-4 > 3.25. Clinical outcomes were admission to Intensive Care Unit (ICU) and mortality. RESULTS: Of 155 patients, 71.6% were male (n = 111), and 28.4% (n = 44) were obese. Abnormal LFT were present in 96.8% (n = 150), prevalence of steatosis was 42.6% (n = 66) and of significative liver fibrosis was 44.5% (n = 69). Liver fibrosis by FIB-4 was associated with risk of ICU admission (OR 1.74 [95%CI 1.74-2.68; p = 0.023]) and mortality (OR 6.45 [95%CI 2.01-20.83, p = 0.002]); no independent associations were found. CONCLUSIONS: The prevalence of steatosis and significant liver fibrosis was high in COVID-19 patients but was not associated with clinical outcomes.


Assuntos
/epidemiologia , Unidades de Terapia Intensiva/estatística & dados numéricos , Cirrose Hepática/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Biomarcadores/sangue , Comorbidade , Estudos Transversais , Feminino , Seguimentos , Humanos , Cirrose Hepática/sangue , Cirrose Hepática/diagnóstico , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Estudos Retrospectivos , Índice de Gravidade de Doença
7.
Chemosphere ; 266: 128947, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33220986

RESUMO

AIM: We evaluated the associations between blood Cadmium (Cd) concentrations and risk of suspected NAFLD using nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2013, 2016 and 2017. METHODS: This cross-sectional study included 12,099 adults for the serum alanine aminotransferase (ALT) and hepatic steatosis index (HSI) analyses and 2,904 adults for the serum gamma-glutamyl transferase (GGT) and fatty liver index (FLI) analyses, without significant alcohol consumption. Blood Cd concentrations were measured by graphite furnace atomic absorption spectrometry. Data were analyzed using survey logistic regression models. RESULTS: Odds ratios (ORs) of suspected NAFLD increased significantly per unit of natural log-transformed blood Cd concentration (OR [95% (CI)], for ALT, overall: 1.50 [1.34, 1.68], men: 1.64 [1.40, 2.10] and women: 1.29 [1.08, 1.47]; for GGT, overall: 1.77 [1.33, 2.35], men: 2.28 [1.53, 3.41] and women: 1.27 [0.82, 1.97]; for FLI, overall: 1.84 [1.32, 2.57], men: 1.91 [1.24, 2.94] and women: 1.58 [0.87, 2.86]; for HSI, overall: 1.19 [1.07, 1.32], men: 1.17 [1.01, 1.37] and women: 1.14 [0.99, 1.32]). The blood Cd concentrations associated with risk of suspected NAFLD were lower than those previously reported (for ALT, > 0.64 µg/L, for GGT, > 1.41 µg/L, for FLI, > 0.96 µg/L, and for HSI, > 1.41 µg/L). CONCLUSIONS: This study suggests that the reference level of blood Cd should probably be lower than the previously recommended value to prevent adverse health effects due to Cd exposure.


Assuntos
Cádmio , Hepatopatia Gordurosa não Alcoólica , Adulto , Alanina Transaminase , Estudos Transversais , Exposição Ambiental , Feminino , Humanos , Masculino , Hepatopatia Gordurosa não Alcoólica/induzido quimicamente , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Inquéritos Nutricionais , República da Coreia/epidemiologia
8.
Am J Infect Control ; 49(1): 82-89, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32540370

RESUMO

OBJECTIVE: We aimed to investigate the relationship between clinical characteristics, outcomes and the severity of severe acute respiratory syndrome coronavirus 2 pneumonia. METHODS: We performed a systematic review and meta-analysis using PubMed, Embase, and Cochrane Library databases to assess the clinical characteristics and outcomes of confirmed COVID-19 cases and compared severe (ICU) and nonsevere (non-ICU) groups. RESULTS: We included 12 cohort studies including 2,445 patients with COVID-19. Compared with nonsevere (non-ICU) patients, severe (ICU) disease was associated with a smoking history (P = .003) and comorbidities including chronic obstructive pulmonary disease (OR = 5.08, P < .001), diabetes (OR = 3.17, P < .001), hypertension (OR = 2.40, P < .001), coronary heart disease (OR = 2.66, P < .001), cerebrovascular diseases (OR = 2.68, P = .008), and malignancy (OR=2.21, P = .040). We found significant differences between the 2 groups for fever, dyspnea, decreased lymphocyte and platelet counts, and increased leukocyte count, C-creative protein, procalcitonin, lactose dehydrogenase, aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and creatinine levels (P < .05). Significant differences were also observed for multiple treatments (P < .05). Patients in the severe (ICU) group were more likely to have complications and had a much higher mortality rate and lower discharge rate than those with nonsevere (non-ICU) disease (P < .05). CONCLUSIONS: Investigation of clinical characteristics and outcomes of severe cases of COVID-19 will contribute to early prediction, accurate diagnosis, and treatment to improve the prognosis of patients with severe illness.


Assuntos
/fisiopatologia , Dispneia/fisiopatologia , Febre/fisiopatologia , Leucocitose/fisiopatologia , Linfopenia/fisiopatologia , Trombocitopenia/fisiopatologia , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Proteína C-Reativa/metabolismo , /mortalidade , Transtornos Cerebrovasculares/epidemiologia , Comorbidade , Doença das Coronárias/epidemiologia , Creatina Quinase/sangue , Creatinina/sangue , Diabetes Mellitus/epidemiologia , Humanos , Hipertensão/epidemiologia , Unidades de Terapia Intensiva , L-Lactato Desidrogenase/sangue , Leucocitose/sangue , Linfopenia/sangue , Pró-Calcitonina/sangue , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Índice de Gravidade de Doença , Fumar/epidemiologia , Trombocitopenia/sangue
9.
Int J Dermatol ; 60(1): 88-92, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33017043

RESUMO

BACKGROUND: In approximately 13% of systemic lupus erythematosus (SLE) patients, a hallmark of primary biliary cirrhosis (PBC) can be detected: antimitochondrial M2 antibodies (AMA-M2). It has not been determined if the presence of AMA-M2 in SLE patients results in a higher risk of PBC in comparison to those with AMA but no SLE. Until now, there have been no such analyses among individuals with subacute cutaneous lupus erythematosus (SCLE). METHODS: To assess the seropositivity rates for AMA-M2 and autoantibodies associated with autoimmune hepatitis in patients with newly diagnosed SCLE and to determine the coexistence and risk of development of autoimmune liver disease in these patients within 1 year of follow-up, data from 33 patients with newly diagnosed SCLE were analyzed. RESULTS: AMA-M2 was found in 20% of SCLE patients. Patients from the AMA-M2-positive group were characterized by significantly higher levels of cholestatic liver enzymes when compared to those without AMA-M2 (P < 0.05). After introducing therapy with hydroxychloroquine and prednisone, the levels of hepatocellular enzymes increased significantly only in AMA-M2 positive patients (P < 0.05). CONCLUSIONS: A high prevalence of AMA-M2 was found in patients with SCLE. Patients with SCLE and AMA-M2 had significantly higher values of cholestatic enzymes than patients without AMA. Newly diagnosed patients with SCLE should be screened for the presence of AMA and should be clinically followed up. Avoiding drugs with potential liver toxicity should be recommended in patients with SCLE and AMA.


Assuntos
Autoanticorpos/sangue , Hepatite Autoimune/epidemiologia , Cirrose Hepática Biliar/epidemiologia , Lúpus Eritematoso Cutâneo/sangue , Lúpus Eritematoso Cutâneo/epidemiologia , Mitocôndrias/imunologia , Adulto , Idoso , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Anti-Inflamatórios/uso terapêutico , Antirreumáticos/uso terapêutico , Aspartato Aminotransferases/sangue , Comorbidade , Progressão da Doença , Quimioterapia Combinada , Feminino , Hepatite Autoimune/sangue , Humanos , Hidroxicloroquina/uso terapêutico , Cirrose Hepática Biliar/sangue , Lúpus Eritematoso Cutâneo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Músculo Liso/imunologia , Polônia/epidemiologia , Prednisona/uso terapêutico , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , gama-Glutamiltransferase/sangue
10.
Medicine (Baltimore) ; 99(50): e22867, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327227

RESUMO

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) has emerged as a major health problem worldwide; according to statistics, 10% to 25% of patients with NAFLD can progress to nonalcoholic steatohepatitis (NASH). A link between the composition and metabolites of intestinal microbiota and the development of NAFLD is becoming clearer. It is believed that microbiota factors are driving forces of hepatic steatosis and inflammation. The formulated food that contains prebiotics and dietary fiber may improve NAFLD by altering the intestinal flora and its metabolites. METHODS: The study plan to recruit adult patients (18-75 years, n = 120) with NAFLD, range of alanine aminotransferase is 1.5 to 5 times upper limit of normal (ULN) or liver biopsy is confirmed as NASH. Participants will be randomly allocated into 2 groups: formulated food (n = 80) and a placebo group (n = 40) for 24 weeks. Both groups will receive lifestyle and nutritional advice. The primary endpoint is a decrease in MRS-PDFF by more than 30% from baseline at 24 weeks. The secondary endpoints include the change of anthropometric, liver function, glycolipid metabolism, and systemic inflammation at 4, 12, and 24 weeks. In addition, we consider the changes in intestinal microbiota as an exploration to assess the abundance and diversity at 24 weeks. Weeks 24 to 36 are the follow-up period of drug withdrawal. DISCUSSION: This clinical trial will provide evidence of efficacy and safety of formulated food as a potential new therapeutic agent for NAFLD patients. TRIAL REGISTRATION: The trial is registered in the China Clinical Trial Center (ChiCTR1800016178).


Assuntos
Alimentos Formulados/efeitos adversos , Microbioma Gastrointestinal/fisiologia , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Adulto , Idoso , Alanina Transaminase/análise , Bactérias/metabolismo , Estudos de Casos e Controles , China/epidemiologia , Fígado Gorduroso/dietoterapia , Fígado Gorduroso/microbiologia , Feminino , Seguimentos , Alimentos Formulados/microbiologia , Alimentos Formulados/provisão & distribução , Humanos , Inflamação/dietoterapia , Inflamação/microbiologia , Metabolismo dos Lipídeos/fisiologia , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/dietoterapia , Hepatopatia Gordurosa não Alcoólica/patologia , Segurança , Resultado do Tratamento
11.
PLoS One ; 15(12): e0238540, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33347507

RESUMO

BACKGROUND: Autoimmune hepatitis (AIH) is a disorder of unknown etiology in which immune-mediated liver injury progress to cirrhosis or hepatocellular carcinoma (HCC). The aim of the present study was to determine whether circulating soluble TIM3 (sTIM3) is elevated in patients with AIH patients and whether sTIM-3 levels are associated with clinical parameters of AIH. METHODS: We enrolled 123 Japanese patients with AIH who were identified from the National Hospital Organization-AIH-liver-network database, as well as 32 patients with chronic hepatitis C (CHC), 30 patients with primary biliary cholangitis (PBC) and healthy control subjects. Serum sTIM-3 concentrations were quantified by ELISA. RESULTS: Serum levels of sTIM-3 were significantly higher in AIH patients (median 4865 pg/ml; [interquartile range (IQR); 3122-7471]) compared to those in CHC (1026 pg/ml [IQR: 806-1283] p<0.001), PBC (2395 pg/ml [IQR: 2012-3422] p<0.001) or healthy controls (1285 pg/ml [IQR: 1098-1812] p<0.001). In AIH group, serum sTIM-3 were correlated with alanine aminotransferase (ALT), or total bilirubin (TB) and negatively correlated with serum levels of albumin (Alb). Serum levels of sTIM-3 were also strongly correlated with Mac-2 binding protein glycosylation isomer (M2BPGi) levels, but did not correlate with the histological grade of liver fibrosis. Steroid treatment of AIH patients significantly reduced serum sTIM-3 levels (2147±623pg/ml versus 1321±378pg/ml, p<0.001). CONCLUSIONS: Circulating sTIM-3 levels were elevated in AIH patients and are associated with AIH disease activity and AIH-related liver damage. These findings indicate that serum sTIM-3 correlated with disease status of AIH and could be useful biomarkers to detect autoimmune-mediated liver injury. Our data suggest a possible link between the TIM-3/GAL-9 pathway and AIH severity or phenotype, and further investigations of the TIM-3 pathway and AIH pathophysiology is warranted.


Assuntos
Galectina 3/metabolismo , Hepatite Autoimune/imunologia , Hepatite Autoimune/metabolismo , Domínios de Imunoglobulina/imunologia , Fígado/imunologia , Mucina-3/metabolismo , Linfócitos T/imunologia , Idoso , Alanina Transaminase/imunologia , Albuminas/metabolismo , Bilirrubina/metabolismo , Feminino , Glicosilação , Hepatite C Crônica/imunologia , Hepatite C Crônica/metabolismo , Humanos , Fígado/metabolismo , Masculino , Pessoa de Meia-Idade , Linfócitos T/metabolismo
12.
Med Sci Monit ; 26: e928849, 2020 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-33339813

RESUMO

BACKGROUND Emerging studies noted that liver injury in coronavirus disease 2019 (COVID-19) patients may be induced by virus-mediated inflammation, which was confirmed by liver pathology. The aim of this study was to observe clinical characteristics and explore risk factors in COVID-19 patients with liver injury. MATERIAL AND METHODS In this retrospective study, 40 confirmed COVID-19 patients with normal alanine transaminase (ALT) on admission were divided into a group of normal ALT patients whose ALT was always less than 40 U/l during hospitalization and a group of elevated ALT patients whose ALT was at least once more than 40 U/l after admission. Clinical data, especially virus-induced inflammatory parameters, were analyzed for risk factors and predictive value. The Mann-Whitney U test and t test for comparing means and logistic regression were performed for analysis of risk factors. Area under the ROC curve was used for predictive values. RESULTS Sixteen of 40 (40.0%) patients developed elevated ALT, many of them with more severe COVID-19. The highest ALT level was 101 U/l. The risk factors for liver injury were C-reactive protein (CRP), interleukin 6 (IL6), erythrocyte sedimentation rate (ESR), CD8+T cell count, and severity of disease, and CRP (OR 1.13, 95% CI 1.045-1.222, p=0.002) was the independent risk factor. CONCLUSIONS Liver injury in COVID-19 patients was mild and associated with inflammatory markers, especially CRP, which suggests that liver injury may be induced by virus-mediated inflammation in COVID-19 patients.


Assuntos
/epidemiologia , Fígado/metabolismo , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Biomarcadores , Sedimentação Sanguínea , Proteína C-Reativa/análise , China/epidemiologia , Coronavirus/patogenicidade , Feminino , Hospitalização , Humanos , Interleucina-6/análise , Fígado/lesões , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Estudos Retrospectivos , Fatores de Risco , /patogenicidade
13.
Eur Rev Med Pharmacol Sci ; 24(24): 13072-13088, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33378061

RESUMO

OBJECTIVE: Liver involvement of SARS-CoV-2 infection has been reported in several papers, but without homogeneous findings. We aimed to systematically review the prevalence of liver involvement in patients with SARS-CoV-2 infection at their hospital admission, and its correlation with disease severity and clinical outcomes in patients with or without pre-existing chronic liver disease. MATERIALS AND METHODS: We systematically searched PubMed, Embase, Web of Science, Medline, PMC, clinical trial registries, and other Coronavirus family publications for studies reporting data on SARS-CoV-2 infection or COVID-19 and liver function tests (LFTs) alterations, as well as clinical course of patients with chronic liver disease or cirrhosis. Case reports, preprints, editorials, reviews were excluded. We also revised literature to describe the background of liver involvement during SARS-CoV-2 infection. RESULTS: 36 studies, including 20724 patients with SARS-CoV-2 infection, were included. The pooled prevalence of LFTs abnormalities at admission was 46.9% (AST 26.5%, ALT 22.8%, GGT 22.5%, ALP 5.7%, tBIL 8.0%). ALT, AST, tBIL were independent predictors of disease severity (ALT OR 1.54, 95% CI 1.17-2.03; AST OR 3.17, 95% CI 2.10-4.77; tBIL OR 2.32, 95% CI 1.18-4.58) and in-hospital mortality (ALT OR 1.48, 95% CI 1.12-1.96; AST OR 4.39, 95% CI 2.68-7.18; tBIL OR 7.75, 95% CI 2.28-26.40). Heterogeneity among studies was high. The few available data also reported that COVID-19 was associated with increased risk of liver decompensation and mortality in patients with liver cirrhosis. CONCLUSIONS: LFTs alterations were reported in up to 47% of unselected patients with COVID-19 and were associated with severe disease or in-hospital mortality. In cirrhotic patients, COVID-19 was associated with high risk of liver decompensation or mortality.


Assuntos
/epidemiologia , Hepatopatias/epidemiologia , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Aspartato Aminotransferases/sangue , Bilirrubina/sangue , /mortalidade , Mortalidade Hospitalar , Humanos , Hepatopatias/sangue , Testes de Função Hepática , Razão de Chances , Prevalência , Prognóstico , Índice de Gravidade de Doença , gama-Glutamiltransferase/sangue
14.
Zhonghua Yi Xue Za Zhi ; 100(44): 3494-3497, 2020 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-33256290

RESUMO

Objective: To investigate the clinical characteristics and related factors of acute tubular necrosis (ATN) in patients with minimal change disease (MCD). Methods: Patients from Chinese PLA General Hospital who were pathologically diagnosed with MCD and had clinical manifestations of nephrotic syndrome from January 1, 2013 to December 31, 2019 were included. The clinical and pathological data of patients were retrospectively analyzed. Meanwhile, the incidence and clinical characteristics of ATN in different age groups were compared. The risk factors for ATN were assessed using binary logistic regression. Results: A total of 525 patients were included, with a gender ratio of 1.56∶1 (male: female), aged 33 (21, 48) years old. ATN occurred in 49 (9.3%) of 525 patients, of which 34 were male and 15 were female. The incidence of ATN increased with age in MCD patients of different age groups (χ(2)=31.442, P<0.001). The incidence of ATN in groups of age≤20 years, 21-40 years, 41-60 years, and >60 years was 2.4% (3/123), 5.2% (10/192), 13.2% (20/152) and 27.6% (16/58), respectively. Elevations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT) and serum IgE occurred in 92 patients (17.5%), 53 patients (10.1%), 99 patients (18.9%), and 303 patients (57.7%), respectively. There were significant differences in age, ALT, serum creatinine, serum urea nitrogen, history of diabetes and history of hypertension between non-ATN group and ATN group (all P<0.05). The results of logistic regression analysis showed that>40 years old (OR=6.283, 95% CI: 2.695-14.649, P<0.001) and serum albumin (OR=0.924, 95% CI: 0.857-0.997, P=0.040) was independently associated with ATN in MCD patients. Conclusion: Age>40 years is an independent risk factor and serum albumin is a protective factor for ATN in MCD patients.


Assuntos
Nefrose Lipoide , Síndrome Nefrótica , Adulto , Alanina Transaminase , Aspartato Aminotransferases , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nefrose Lipoide/epidemiologia , Estudos Retrospectivos
15.
Biomed Res Int ; 2020: 6342598, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33294449

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children accounts for a small proportion of all infections and is usually mild or asymptomatic. There are few studies on the clinical characteristics of SARS-CoV-2 infection in children, and the causes of the low prevalence in children remain unclear. Herein, we compared the epidemiological and clinical characteristics of SARS-CoV-2 infection between adults and children. Fifty-two patients with Coronavirus Disease 2019 (COVID-19) were retrospectively analyzed, including 38 adults and 14 children. Their clinical information such as epidemiological exposure history, laboratory indicators, chest computed tomography (CT) performance, and number of SARS-CoV-2 positive days were analyzed and compared. In children, 5 (35.71%) had mild COVID-19 and 9 (64.29%) had common type, while, in adults, 9 (23.68%) cases were mild, and 29 (76.32%) were common COVID-19. Among them, family clustering infection accounted for 50% (7/14) of child cases and 23.68% (9/36) of adult cases. Epidemiological exposure history, clinical classification, clinical symptoms, chest CT manifestations, and number of SARS-CoV-2-positive days were not significantly different between children and adults. However, the percentage of neutrophils in adults was significantly higher than that in children (P < 0.05). The percentage and absolute value of lymphocytes, platelet counts, aspartate aminotransferase, and aspartate aminotransferase/alanine aminotransferase in adults were lower than those in children (P < 0.05). Conclusively, children infected with SARS-CoV-2 show the characteristics of family clustering, and the proportion of mild and asymptomatic infections is higher. For families with a history of epidemiological exposure, routine SARS-CoV-2 nucleic acid testing and chest CT examination should be performed in asymptomatic children to determine whether they are infected. Unlike adults, although the reduction of lymphocytes and platelets in children is not common, it is necessary to be alert to the increased risk of liver damage in children.


Assuntos
Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Plaquetas/metabolismo , /diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos/metabolismo , Contagem de Plaquetas
16.
Zhongguo Zhong Yao Za Zhi ; 45(21): 5256-5264, 2020 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-33350243

RESUMO

Ophiocordyceps lanpingensis is mainly used as an ethnic medicine to treat the diseases of liver, kidney and other diseases, but the pharmacological mechanism is not clear yet. In this study, the components and contents of monosaccharides in the O.lanpingensis polysaccharides(OLP) were analyzed. The results showed that the OLP were composed of mannose, glucose, galactose and arabinose, with mass percentages of 19.1%, 21.8%, 21.1%, and 38.0%, respectively. Based on the hepatic fibrosis model induced by CCl_4 in mice, OLP could significantly relieve the inflammation and fibrosis levels of hepatic tissues, reverse the CCl_4-induced increasing levels of alanine aminotransferase(ALT) and aspartate aminotransferase(AST) in mice serum, and recover the functions of liver to a normal state. This study proved that OLP significantly decreased the mRNA expression levels of fibrotic genes, alpha-smooth muscle actin(α-SMA) and collagen type 1(Col-1), as well as the content of hydroxyproline(HYP) in the liver tissues; meanwhile, the contents of antioxidants superoxide dismutase(SOD) and glutathione(GSH) were enhanced and the production of lipid peroxide malondialdehyde(MDA) was reduced. Moreover, OLP inhibited the gene expression levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and nuclear factor kappa B(NF-κB) in the livers of mice. Further study indicated that OLP could restrain the apoptosis of hepatic cells due to the decrease of the apoptosis index and down-regulations of protein expression levels of Bcl-2 associated X protein(Bax), cysteinyl aspartate specific proteinase-3(caspase-3) and cysteinyl aspartate specific proteinase-9(caspase-9), and the promotion of protein expression level of B-cell lymphoma-2(Bcl-2) in livers. To sum up, the mechanism of OLP for alleviating hepatic fibrosis was likely related to the synergy by remitting the oxidative stress of the body, alleviating inflammatory response, anti-apoptosis of hepatic cells, and so on.


Assuntos
Tetracloreto de Carbono , Cirrose Hepática , Alanina Transaminase/metabolismo , Animais , Aspartato Aminotransferases/metabolismo , Tetracloreto de Carbono/metabolismo , Hypocreales , Fígado/metabolismo , Cirrose Hepática/tratamento farmacológico , Cirrose Hepática/genética , Cirrose Hepática/metabolismo , Malondialdeído/metabolismo , Camundongos , Estresse Oxidativo , Polissacarídeos/metabolismo
17.
South Med J ; 113(12): 618-622, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33263129

RESUMO

OBJECTIVES: The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) epidemic is characterized by a global sense of uncertainty, partly driven by the paucity of real-life clinical data. This study assessed whether admission patient characteristics were associated with need for intensive care unit (ICU) care. METHODS: The observational study included consecutive patients admitted to a large community teaching hospital with a diagnosis of SARS-CoV-2 between March 6, 2020 and March 31, 2020. Comparisons were made based on the need for ICU admission. RESULTS: A total of 156 patients were admitted, 42 of whom (26.9%) required ICU admission and 114 (73.1%) did not. No difference in age (61.9 years vs 60.5 years, P = 0.67), race/ethnicity, or comorbidities were noted, except that patients requiring ICU care had lower serum albumin levels and lymphocyte counts and higher liver function tests, white blood cell count, and absolute neutrophil count on admission. The average time from admission to death was similar (10 days in an ICU subset vs 9.2 days in a non-ICU subset, P = 0.78), yet patients necessitating ICU care had longer hospital lengths of stay (10.2 vs 5.1 days, P = 0.0002). At the time of data extraction, 15 patients in the ICU had died, 7 were discharged from the hospital, and 20 were still admitted while 5 patients died in the non-ICU cohort with 97 discharged and 12 patients admitted. CONCLUSIONS: This is the largest study assessing clinical differences based on the need for ICU admission in inpatients with SARS-CoV-2. It found few major differences in clinical variables between subsets. Among patients admitted to the ICU, outcomes were generally poor.


Assuntos
/sangue , Mortalidade Hospitalar , Unidades de Terapia Intensiva/estatística & dados numéricos , Respiração Artificial/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , /fisiopatologia , Eletrocardiografia , Grupos Étnicos/estatística & dados numéricos , Feminino , Hospitalização , Hospitais Comunitários , Hospitais de Ensino , Humanos , Tempo de Internação/estatística & dados numéricos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Prognóstico , Estudos Retrospectivos , Albumina Sérica/metabolismo , Índice de Gravidade de Doença , Fatores de Tempo
18.
BMC Infect Dis ; 20(1): 931, 2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33287722

RESUMO

BACKGROUND: Evaluate the safety and efficacy of 104-week regimen of Telbivudine(LdT)-based optimization strategy for Chinese patients who have chronic hepatits B(CHB) with HBeAg-negative. METHODS: This multi-center, open-label, prospective study enrolled 108 HBeAg-negative CHB patients who received LdT (600 mg/day) for 24 weeks, Adefovir (ADV) was added if HBV DNA remained detectable at week 24, otherwise LdT was maintained to use until 104 weeks. HBV DNA, alanine amino transferase (ALT), hepatitis B surface antigen(HBsAg), creatinine kinase(CK), and estimated glomerular filtration rate (eGFR) were measured, safety was assessed. RESULTS: Eighty-eight patients (81%) had HBV-DNA undetectable at 24 weeks and maintained to receive LdT monotherapy until 104 weeks, whereas the other 20 patients had HBV-DNA detectable and ADV was used in combination. For all patients, 72% of patients reached ALT normalization at 24 weeks, which increased to 80% at 52 weeks and 104 weeks, respectively.. 81% of total patients had undetectable HBV-DNA at 24 weeks, 92% at 52 weeks, and 94% at 104 weeks. The HBsAg titre declined steadily from baseline to 104 weeks (3.62 vs. 2.98 log10 IU/mL, p < 0.05), and the eGFR increased steadily from baseline to 104 weeks (92.9 vs. 104.4 mL/min/1.73 m2, p < 0.05). Although 79 patients (73%) had at least one time of elevated CK, most of these patients had CK elevated in Grade 1/2. CONCLUSIONS: LdT was well tolerated and effective, and 94% of patients achieved virological suppression after 104 weeks. TRIAL REGISTRATION: This study was registered in clinicaltrials.gov on January 31, 2012 and the ID No. was NCT01521975 .


Assuntos
Adenina/análogos & derivados , Antivirais/efeitos adversos , Antígenos E da Hepatite B/sangue , Vírus da Hepatite B/genética , Hepatite B Crônica/tratamento farmacológico , Organofosfonatos/administração & dosagem , Telbivudina/efeitos adversos , Adenina/administração & dosagem , Adulto , Alanina Transaminase/sangue , Antivirais/administração & dosagem , China/epidemiologia , Creatinina/sangue , DNA Viral/análise , Quimioterapia Combinada , Feminino , Taxa de Filtração Glomerular , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Antígenos E da Hepatite B/imunologia , Hepatite B Crônica/sangue , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resposta Viral Sustentada , Telbivudina/administração & dosagem
19.
PLoS One ; 15(11): e0242431, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33216778

RESUMO

BACKGROUND AND AIM: We sought to determine the association between alanine aminotransferase (ALT) in the normal range and mortality in the absence of liver dysfunction to better understand ALT's clinical significance beyond liver injury and inflammation. METHODS: A cohort of 2,708 male and 3,461 female adults aged 20-75 years without liver dysfunction (ALT<30 in males & <19 in females, negative viral serologies, negative ultrasound-based steatosis, no excess alcohol consumption) from the National Health and Nutrition Examination Survey (NHANES)-III (1988-1994) were linked to the National Death Index through December 31, 2015. Serum ALT levels were categorized into sex-specific quartiles (Females: <9, 9-11, 11-14, ≥14 IU/L, Male: <12, 12-15, 15-20, ≥20 U/L). The primary outcome was all-cause mortality. Hazard ratios (HRs) were estimated, adjusting for covariates and accounting for the complex survey design. RESULTS: Relative to males in the lowest quartile (Q1), males in the highest quartile (Q4) had 44% decreased risk of all-cause mortality (aHR [95% CI]: 0.56 [0.42, 0.74]). Females in Q4 had 45% decreased risk of all-cause mortality (aHR [95% CI]: 0.55 [0.40, 0.77]). Males with BMI <25 kg/m2 in Q4 had significantly lower risk of all-cause mortality than Q1; however, this association did not exist in males with BMI ≥25 (BMI<25: 0.36 [0.20, 0.64], BMI≥25: 0.77 [0.49, 1.22]). Risk of all-cause mortality was lower in males ≥50 years than in males<50 (age≥50: 0.55 [0.39, 0.77], age<50: 0.81 [0.39, 1.69]). These age- and BMI-related differences were not seen in females. CONCLUSION: ALT within the normal range was inversely associated with all-cause mortality in U.S. adults.


Assuntos
Alanina Transaminase/sangue , Hepatopatias/sangue , Hepatopatias/mortalidade , Adulto , Idoso , Biomarcadores/sangue , Índice de Massa Corporal , Causas de Morte , Estudos de Coortes , Feminino , Humanos , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Modelos de Riscos Proporcionais , Adulto Jovem
20.
Respir Med ; 175: 106218, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33181413

RESUMO

OBJECTIVE: There were COVID-19 patients with SARS-COV-2 nucleic acid long-term positive. This article aims to understand the relevant factors that affect SARS-COV-2 clearance time. METHODS: The clinical data of 115 COVID-19 patients with SARS-COV-2 nucleic acid positive time exceeding 14 days were collected retrospectively, and the relationship between clinical characteristics, chest CT scans, blood cells, biochemical indicators, and the time of viral nucleic acid turning negative were analyzed. RESULTS: The time from symptom onsets to nucleic acid turning negative was (32.5 ± 8.7) days in this group of patients. The time of nucleic acid turning negative: no fever group was longer than fever group, diabetes group was longer than no comorbidity group, elevated levels of ALT (alanine aminotransferase), or GLU (fasting blood glucose) group, decreased levels of ALB (albumin) group or HDLC (high-density lipoprotein cholesterol) group was longer than it's normal group separately (P < 0.05). Cox multivariate regression analysis showed that ALT [odds ratio (OR): 2.164 (95% CI: 1.276-3.670), P = 0.004], GLU [OR: 2.064 (95% CI: 1.195-3.566), P = 0.009] and HDLC [OR: 0.527 (95% CI: 0.307-0.907), P = 0.021] were independent factors which affected the time of nucleic acid turning negative. CONCLUSIONS: ALT, GLU and HDLC were independent factors that influenced the time of nucleic acid turning negative. Although diabetes or hyperglycemia is a known risk factor, HDLC is the first to be identified, clinicians should be aware of dyslipidemia in covid-19 patients.


Assuntos
/sangue , HDL-Colesterol/sangue , /genética , Idoso , Alanina Transaminase/análise , Glicemia/análise , /virologia , Estudos de Casos e Controles , China/epidemiologia , Comorbidade , Jejum/sangue , Feminino , Humanos , Hipoalbuminemia/sangue , Masculino , Pessoa de Meia-Idade , RNA Viral/isolamento & purificação , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Eliminação de Partículas Virais/genética
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