P38γ modulates the lipid metabolism in non-alcoholic fatty liver disease by regulating the JAK-STAT signaling pathway.

Non-alcoholic fatty liver disease (NAFLD) is a major health problem in Western countries and has become the most common cause of chronic liver disease. Although NAFLD is closely associated with obesity, inflammation, and insulin resistance, its pathogenesis remains unclear. The disease begins with excessive accumulation of triglycerides in the liver, which in turn leads to liver cell damage, steatosis, inflammation, and so on. P38γ is one of the four isoforms of P38 mitogen-activated protein kinases (P38 MAPKs) that contributes to inflammation in different diseases. In this research, we investigated the role of P38γ in NAFLD. In vivo, a NAFLD model was established by feeding C57BL/6J mice with a methionine- and choline-deficient (MCD) diet and adeno-associated virus (AAV9-shRNA-P38γ) was injected into C57BL/6J mice by tail vein for knockdown P38γ. The results indicated that the expression level of P38γ was upregulated in MCD-fed mice. Furthermore, the downregulation of P38γ significantly attenuated liver injury and lipid accumulation in mice. In vitro, mouse hepatocytes AML-12 were treated with free fatty acid (FFA). We found that P38γ was obviously increased in FFA-treated AML-12 cells, whereas knockdown of P38γ significantly suppressed lipid accumulation in FFA-treated AML-12 cells. Furthermore, P38γ regulated the Janus Kinase-Signal transducers and activators of transcription (JAK-STAT) signaling pathway. Inhibition of P38γ can inhibit the JAK-STAT signaling pathway, thereby inhibiting lipid accumulation in FFA-treated AML-12 cells. In conclusion, our results suggest that targeting P38γ contributes to the suppression of lipid accumulation in fatty liver disease.

Deletion of p38γ attenuates ethanol consumption- and acetaminophen-induced liver injury in mice through promoting Dlg1.

Acetaminophen (APAP) is one of the major causes of drug-induced acute liver injury, and ethanol may aggravate APAP-induced liver injury. The problem of ethanol- and APAP-induced liver injury becomes increasingly prominent, but the mechanism of ethanol- and APAP-induced liver injury remains ambiguous. p38γ is one of the four isoforms of P38 mitogen activated protein kinases, that contributes to inflammation in different diseases. In this study we investigated the role of p38γ in ethanol- and APAP-induced liver injury. Liver injury was induced in male C57BL/6 J mice by giving liquid diet containing 5% ethanol (v/v) for 10 days, followed by gavage of ethanol (25% (v/v), 6 g/kg) once or injecting APAP (200 mg/kg, ip), or combined the both treatments. We showed that ethanol significantly aggravated APAP-induced liver injury in C57BL/6 J mice. Moreover, the expression level of p38γ was up-regulated in the liver of ethanol-, APAP- and ethanol+APAP-treated mice. Knockdown of p38γ markedly attenuated liver injury, inflammation, and steatosis in ethanol+APAP-treated mice. Liver sections of p38γ-knockdown mice displayed lower levels of Oil Red O stained dots and small leaky shapes. AML-12 cells were exposed to APAP (5 mM), ethanol (100 mM) or combined treatments. We showed that P38γ was markedly increased in ethanol+APAP-treated AML-12 cells, whereas knockdown of p38γ significantly inhibited inflammation, lipid accumulation and oxidative stress in ethanol+APAP-treated AML-12 cells. Furthermore, we revealed that p38γ could combine with Dlg1, a member of membrane-associated guanylate kinase family. Deletion of p38γ up-regulated the expression level of Dlg1 in ethanol+APAP-treated AML-12 cells. In summary, our results suggest that p38γ functions as an important regulator in ethanol- and APAP-induced liver injury through modulation of Dlg1.

Emerging role of RNF2 in cancer: From bench to bedside.

RNF2 (also known as ding, Ring1B or Ring2) is a member of the Ring finger protein family, which functions as E3 ubiquitin ligase for monoubiquitination of histone H2A at lysine 119 (H2AK119ub). RNF2 gene is located at the 1q25.3 site of human chromosome and the coding region is composed of 9 exons, encoding 336 amino acids in total. Many studies have demonstrated that overexpressed RNF2 was involved in the pathological progression of multiple cancers and has an impact on their clinical features. For instance, the upregulated expression level of RNF2 is positively correlated with the occurrence and progression of hepatocellular carcinoma, melanoma, prostate cancer, breast cancer, pancreatic cancer, gastric cancer, and bladder urothelial carcinoma, as well as with the radioresistance of lung cancer and chemoresistance of ovarian cancer. This review provides an up-to-date perspective on the relationship between RNF2 and several cancers and highlights recent studies on RNF2 regulation. In particular, the relevant cellular signaling pathways and potential clinical value of RNF2 in cancers are also discussed, suggesting its potential as an epigenetic biomarker and therapeutic target for these cancers.

TMEM88 modulates the secretion of inflammatory factors by regulating YAP signaling pathway in alcoholic liver disease.

OBJECTIVE: Transmembrane protein 88 (TMEM88), a new protein of increasing concern existed in cell membrane, inhibits the typical Wnt/ß-catenin signaling pathway to play a regulatory role on cell proliferation by binding to Dishevelled-1. Until recently, the connection between TMEM88 and alcoholic liver disease is unknown. In this research, we explored the effect of TMEM88 on the secretion of inflammatory cytokines in ethanol (EtOH)-induced RAW264.7 cells, moreover, the function of YAP signaling pathway in EtOH-induced RAW264.7 cells were investigated. METHODS: We administered TMEM88 adenovirus (ADV-TMEM88) by tail vein injection into C57BL/6J mice in vivo. In vitro, RAW264.7 murine macrophages were stimulated with EtOH and were transfected with pEGFP-C1-TMEM88 and TMEM88 siRNA, respectively, protein expression and mRNA expression of IL-6 and IL-1ß were assessed by Western Blotting and RT-qPCR, respectively. RESULTS: Our group found that the overexpression of TMEM88 led to an up-regulation of IL-6 and IL-1ß secretion, hinting that it had the possibility of linking with the initiation, the development, and the end of inflammation. In addition to that, TMEM88 silencing reduced the secretion of IL-6 and IL-1ß in RAW264.7 cells. Moreover, we demonstrated that the YAP signaling pathway under the action of EtOH was activated by TMEM88. CONCLUSIONS: All in all, these experimental outcomes indicated that TMEM88 had an indispensable impact on EtOH-induced secretion of inflammatory cytokines (IL-6 and IL-1ß) in RAW264.7 cells through YAP signaling pathway.

Molecular epidemiology of Coxiella burnetii infection in sheep and goats in Henan province, China.

Q fever is a significant zoonotic disease caused by Coxiella burnetii, an obligate intracellular gram-negative bacterium. Although C. burnetii infection has been identified in various animal species, domestic ruminants serve as the primary reservoirs and main sources of human infection. Understanding of the epidemiology of C. burnetii in domestic ruminants is crucial for preventing and controlling of C. burnetii infection in humans. In this study, spleen tissues from sheep and goats were collected in Hennan province, China. Through PCR screening, C. burnetii was detected in sheep and goats in Henan province with an overall infection rate of 6.8 %. Sequence comparison and phylogenetic analysis revealed that all newly identified C. burnetii strains shared a close genetic relationship with those found in humans worldwide. These findings highlight the high risk of C. burnetii infection among slaughterhouse workers and emphasize the importance of epidemiological studies that investigate samples from both humans and animals within the "One Health" framework. Such surveillance will contribute to a better understanding of the epidemic situation and aid in the development of effective prevention and control strategies for C. burnetii infections in humans.

["Load-Unload" Effect of Manganese Oxides on Phosphorus in Surface Water of the Pearl River Estuary].

Phosphorus (P) conveyed by surface runoff plays an essential role in regulating nutrient balance and primary production in estuarine waters. In this study, basic physiochemical properties, total phosphorus (TP, including speciation), particulate iron (PFe), particulate manganese (PMn), and particulate aluminum (PAl) of the surface water in the Pearl River Estuary (PRE) in different seasons were determined to investigate the spatiotemporal distribution characteristics of P and to identify the crucial factor controlling P migration and transformation in the freshwater-saltwater interaction zone. TP concentrations (28.88-233.68 µg·L-1) decreased with increasing salinity gradient owing to deposition and dilution. The proportions of P speciation followed a decreasing order as dissolved inorganic phosphorus (DIP, 37.3%) > particulate inorganic phosphorus (PIP, 22.7%) > dissolved organic phosphorus (DOP, 21.0%) > particulate organic phosphorus (POP, 19.0%). PIP was positively related to PFe, PMn, and PAl (P < 0.05), confirming their concurrent migration behaviors. In addition, the increase in salinity promoted the desorption of phosphate on the suspended particulate matters, which mainly took place near the freshwater-saltwater interface. A significant positive correlation (P < 0.001) between the solid-liquid phase partitioning coefficient (Kd) of phosphate and salinity indicated that PIP was present mainly in more stable forms in the brackish water. Most importantly, a better relationship between Kd and PMn (P < 0.01) supported our scientific hypothesis of the "load-unload" effect of Mn oxides on P:particulate-carrying phosphates transported from the freshwater zone tend to be desorbed and released into the brackish water.

The Therapeutic Effect of Traditional Chinese Medicine on Inflammatory Diseases Caused by Virus, Especially on Those Caused by COVID-19.

Inflammasomes are large multimolecular complexes best recognized because of their ability to control activation of caspase-1, which in turn regulates the maturation of interleukin-18 (IL-18) and interleukin-1 ß (IL-1ß). IL-1ß was originally identified as a pro-inflammatory cytokine, capable of inducing local and systemic inflammation as well as a fever response reaction in response to infection or injury. Excessive production of IL-1ß is related to inflammatory and autoimmune diseases. Both coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) are characterized by excessive inflammatory response. For SARS, there is no correlation between viral load and worsening symptoms. However, there is no specific medicine which is available to treat the disease. As an important part of medical practice, TCM showed an obvious therapeutic effect in SARS-CoV-infected patients. In this article, we summarize the current applications of TCM in the treatment of COVID-19 patients. Herein, we also offer an insight into the underlying mechanisms of the therapeutic effects of TCM, as well as introduce new naturally occurring compounds with anti-coronavirus activity, in order to provide a new and potential drug development strategy for the treatment of COVID-19.

Synthesis of calcium zincate powders by a chemical Co-precipitation method and their electrochemical performances.

Calcium zincate powders used as active materials for a secondary Zn electrode were prepared by a chemical precipitation (CP) method. The characteristic properties of calcium zincate powders were examined by thermal gravimetric analysis (TGA), X-ray diffraction (XRD) analysis, Brunauer-Emmett-Teller (BET) measurement, Transmission electron microscope (TEM) and micro-Raman spectroscopy. For comparison, the secondary Zn electrodes using CP-calcium zincate powders, so-called the CP-ZnCa, were obtained and examined. The electrochemical performances of the secondary Zn electrodes were investigated by galvanostatic charge/discharge measurements. As a result, the best performance of the CP-ZnCa powders were synthesized at pH 12 with a mole ratio of Zn:Ca = 2.5:1. The experimental results indicated that the secondary Zn electrode based on the CP-ZnCa powders exhibited better charge/discharge reversibility and longer cycle-life performance.

The Role of IL-35 in the Pathophysiological Processes of Liver Disease.

It is known that liver diseases have several characteristics of massive lipid accumulation and lipid metabolic disorder, and are divided into liver inflammation, liver fibrosis, liver cirrhosis (LC), and hepatocellular carcinoma (HCC) in patients. Interleukin (IL)-35, a new-discovered cytokine, can protect the liver from the environmental attack by increasing the ratio of Tregs (T regulatory cells) which can increase the anti-inflammatory cytokines and inhibit the proliferation of immune cellular. Interestingly, two opposite mechanisms (pro-inflammatory and anti-inflammatory) have connection with the ultimate formation of liver diseases, which suggest that IL-35 may play crucial function in the process of liver diseases through immunosuppressive regulation. Besides, some obvious advantages also imply that IL-35 can be considered as a new therapeutic target to control the progression of liver diseases, while its mechanism of function still needs further research.

MicroRNA-26a-5p inhibits breast cancer cell growth by suppressing RNF6 expression.

MicroRNA-26a-5p (miR-26a-5p) has been reported to be involved in the tumorigenesis of several tumors, but its function in breast cancer is still unknown. In this study, miR-26a-5p was found significantly downregulated in both of the breast cancer tissues and cell lines, and low expression of miR-26a-5p predicted a poor prognosis for breast cancer patients. Overexpression of miR-26a-5p could significantly inhibit breast cancer cell growth. Further studies revealed that overexpression of miR-26a-5p downregulated the protein levels of Cyclin D1, CDK4, and CDK6, but upregulated the expression levels of p21, p27, and p53. In mechanism, miR-26a-5p targeted the 3'UTR of ring finger protein 6 (RNF6) mRNA and inhibited RNF6 expression in breast cancer cells. Moreover, overexpression of miR-26a-5p inhibited RNF6/ERα/Bcl-xL axis in breast cancer cells. In contrast, inhibiting miR-26a-5p upregulated RNF6/ERα/Bcl-xL axis. Further studies indicated that miR-26a-5p mediated RNF6/ERα/Bcl-xL axis through regulating the stability of ERα protein. Collectively, downregulation of miR-26a-5p plays essential roles in breast cancer by mediating RNF6/ERα/Bcl-xL axis, which might provide important implications for the therapeutics of breast cancer.

[Analysis of Transport and Transformation Characteristics Between Dissolved Phosphorus and Particulate Phosphorus in Water of the Three Gorges Reservoir].

To understand the difference between transport coefficients of water runoff, sand discharge, and phosphorus flux in each subsection of a river, a judgement method for analyzing the characteristics of phosphorus transport and transformation in water of rivers was established in this study. Based on the measured data of water runoff, sand discharge, and phosphorus fraction concentrations in the water of the Three Gorges Reservoir (TGR) in January and July 2015, characteristics of phosphorus transport and transformation in the water were analyzed by using the conceptual method. The results showed that the predominant phosphorus fraction in water of the TGR was total dissolved phosphorus (TDP), which accounted for 51%-96% of total phosphorus in water. The TDP flux relative to runoff in the TGR decreased in January 2015 That was caused by the adsorption of TDP by suspended particles in the dry season. In contrast, TDP flux showed additive effect relative to water runoff in July 2015 due to exogenous water inputs with high TDP concentrations in the wet season. Both sand and total particulate phosphorus (TPP) presence in the water showed obvious sediment and retention characteristics during the two periods. The TPP flux presented an additive effect relative to sand discharge, meaning that the major transformation direction of phosphorus fractions was from TDP to TPP. The subsection between Qingxichang and Wanzhou was the main retention area of water, sand, and phosphorus in the TGR, which can be associated with the enhancement of phosphorus adsorption capacity caused by particle size reduction of suspended particles in the subsection.

ZEB1 regulates the activation of hepatic stellate cells through Wnt/ß-catenin signaling pathway.

Zinc finger E-box binding homeobox 1 (ZEB1) (previously known as TCF8), a transcriptional repressor, is a member of the zinc-finger family of proteins. Numerous studies have demonstrated that abnormal expression of ZEB1 in many types of liver disease including hepatocellular carcinoma (HCC). Liver fibrosis is the basis and central link in the progression of liver disease. Thereby, the function of ZEB1 in liver fibrosis has been investigated. The aim of the present study was to investigate the role of ZEB1 in liver fibrosis and to elucidate the mechanism. In this study, we explored the effect of ZEB1 in hepatic stellate cells (HSCs) activation and the regulatory mechanism of the Wnt/ß-catenin signaling pathway. Additionally, ZEB1 positively regulated the expression levels of α-SMA and Col.I in vivo and in vitro, which were correlated with the activated HSCs. Furthermore, overexpression of ZEB1 could inhibit HSCs apoptosis and promote IL-6 and TNF-α secretion in LX-2 cells. Conversely, ZEB1 silencing led to the promotion of cell proliferation and the reduction of IL-6 and TNF-α secretion in LX-2 cells. Mechanically, canonical Wnt/ß-catenin signaling pathway could be regulated by ZEB1. Collectively, the data suggested that ZEB1 might play a significant role in the activation of LX-2 cells, and Wnt/ß-catenin signaling pathway might participate in this progression.

[Distribution of Phosphorus Fractions in Surface Sediments of Minjiang Mainstreams].

In recent years, the total phosphorus pollution in Minjiang River was serious, and the surface sediments of the Minjiang River also threatened water quality. To study the spatial distributions of phosphorus in the surface sediments of the Minjiang River, samples of surface sediments were collected upstream (Aba District) and downstream (Yibin District) of the Minjiang River in December, 2016. The sediments were analyzed with the modified sequential extraction method (SEDEX) to obtain six forms of phosphorus, including exchangeable phosphorus (Ex-P), exchangeable organic phosphorus (Org-P), iron-bound phosphorus (Fe-P), authigenic phosphorus (Ca-P), detrital phosphorus (De-P), and refractory phosphorus (Res-P). The results indicated that the contents of total phosphorus (TP) in surface sediments ranged from 522.17 µg ·g-1 to 979.22 µg ·g-1, which were far more than the soil phosphorus background values (700 µg ·g-1). The spatial distribution characteristics of the TP of surface sediments indicated that the TP concentrations in sediments at the Meishan sections (the middle reach of the Minjiang River) were higher than those in the other sections. This was related to the smaller particle size and higher OM contents in sediments in the Meishan sections. The main phosphorus forms in the sediments in the Minjiang River were Ca-P and De-P, with their concentrations accounting for 75% of TP in the sediments. The bio-available phosphorus, which included Ex-P, Org-P, and Fe-P, accounted for 0.31%-29.62% of TP in the sediments of the Minjiang River. The concentrations of bio-available phosphorus in sediments at the Meishan sections and Leshan sections (the middle reach) were highest, indicating that bio-available phosphorus in the surface sediments was high, and its potential environmental impact risks were higher.

Individual and combined inhibition of phenol and thiocyanate on microbial activity of partial nitritation.

This study evaluated the individual and interactive effect of phenol and thiocyanate (SCN-) on partial nitritation (PN) activity using batch test and response surface methodology. The IC50 of phenol and SCN- on PN sludge were 5.6 and 351 mg L-1, respectively. The PN sludge was insensitive to phenol and SCN- at levels lower than 1.77 and 43.3 mg L-1, respectively. A regression model equation was developed and validated to predict the relative specific respiration rate (RSRR) of PN sludge exposed to different phenol and SCN- concentrations. In the range of independent variables, the most severe inhibition was observed with a valley value (17%) for RSRR, when the phenol and SCN- concentrations were 4.08 and 198 mg L-1, respectively. An isobole plot was used to judge the combined toxicity of phenol and SCN-, and the joint inhibitory effect was variable depending on the composition and concentration of the toxic components. Furthermore, the toxic compounds showed independent effects, which is the most common type of combined toxicity.

Inhibition of the partial nitritation by roxithromycin and Cu(II).

To facilitate the application of partial nitritation (PN) - anaerobic ammonium oxidation process in nitrogen removal from livestock wastewater, the inhibition of roxithromycin (ROX) and Cu(II) on the PN sludge was examined using a respirometric method. The results showed that the IC50 of ROX and Cu(II) on PN sludge were 346 and 74.3mgL(-1), respectively. The relative specific respiration rate (SRR) of ammonia-oxidizing bacteria (AOB) decreased from 87.4% to 17.7% with the ROX concentration increased from 0 to 500mgL(-1). When the concentration of Cu(II) increased from 0 to 160mgL(-1), the SRRs of AOB and nitrite-oxidizing bacteria decreased by 85.5% and 11.2%, respectively. According to the isobole plots analysis, combined suppression by ROX and Cu(II) was synergistic. Fourier transform infrared spectroscopy analyses showed that ROX exposure altered the positions of CO bonds, and the intensity of the absorption peak at 2100cm(-1) changed under Cu(II) exposure.

KIAA1377 is associated with lymph node metastasis in esophageal squamous cell carcinoma.

KIAA1377, of which there are few studies regarding cell biology and neurological diseases, has been found to be significantly amplified in esophageal squamous cell carcinoma (ESCC) with lymph node metastasis compared with ESCC without lymph node metastasis. This suggests that KIAA1377 may play a role in the lymph node metastasis of ESCC. There has, to the best of our knowledge, been no study performed to investigate the role of KIAA1377 in ESCC. In the present study, the expression of KIAA1377 was detected by immunohistochemistry, and its expression was statistically analyzed with clinicopathological parameters, using commercially obtained tissue arrays consisting of 86 cases of ESCC and 79 paired controls. KIAA1377 was knocked down ex vivo using transient transfection with specific small hairpin RNA (shRNA) vectors into ESCC TE-1 and EC9706 cell lines whose endogenous KIAA1377 level was highest. The variation of proliferation, migration and invasion were evaluated using methyl thiazolyl tetrazolium, wound healing and Transwell assay, respectively. It was found in vivo that KIAA1377 expression was significantly associated with lymph node metastasis and differentiation, and ex vivo that knockdown of KIAA1377 cannot significantly affect proliferation and mobility in the ESCC cell line TE-1. Overall, this is the first study suggesting that KIAA1377 may play a role in the lymph node micrometastasis of ESCC.

Anaerobic ammonium oxidation (anammox) under realistic seasonal temperature variations: Characteristics of biogranules and process performance.

In this study, the effects of realistic seasonal temperatures on the nitrogen removal performance of anaerobic ammonium oxidation (anammox) and the properties of the anammox granules were comparatively investigated for 330 days. The results demonstrated that the nitrogen removal efficiency (NRE), nitrogen loading rate (NLR) and nitrogen removal rate (NRR) were decreased dramatically, as the temperature decreased from 31.2 to 2.5 °C. However, the nitrogen removal performance recovered andante as the temperature increased gradually. After low temperature exposure, the settleability tended to worsen, and granules appeared to be more irregular with a smaller average granule diameter, and the extracellular polymeric substances (EPS) content increased slightly, while the specific anammox activity (SAA) decreased obviously. This realistic seasonal temperatures based research was an illation of the actual operation, and could be potentially implemented to maintain stability for the application of anammox technology.

[Input Characteristics and Pollution Assessment of Nutrients Pollution in the Primary Pollution Source of the Daliao River].

A total of 13 surface water samples were collected from sewage outfalls and 3 main tributaries ( Hunhe River, Taizi River and Haicheng River) of the Daliao River to clarify the pollution characteristics of various species of nitrogen and phosphorus in July 2013, respectively. The results showed that the concentrations of DON in the Hunhe River, NO3(-)-N in the Taizi River, NH4(+) -N, PO4(3-) -P and DOP in the Haicheng River were higher than others. In water samples from the 3 main tributaries of the Daliao River, the TN and TP contents were above the national environmental quality standards for surface water (GB 3838-2002, grade V) except for the TP that was classified as grade IV in the Taizi River. The percentages of various N species showed that NO3(-) -N was the major N species in the Taizi River and Haicheng River, meanwhile DON was the major N species in the Hunhe River. The percentages of various P species showed that TPP was the major P species in the Hunhe River and Taizi River, and DOP was the major P species in the Haicheng River. TN content was above the national environmental quality standards for surface water (GB 3838-2002, grade V) in sewage outfalls. But TP content was classified as grade IV to above grade V. And the concentrations of NH4(+) -N, TN and TP in sewage outfalls of Shachang and Gangjian were higher than those in other sewage outfalls. The percentages of various N species in sewage outfalls showed that DIN was the major N species in sewage outfalls. There were higher level of TN and TP content in the Daliao River than those of tribtaries, and NO3(-) -N and TPP were the major N and P species, respectively. In general, the nutrients analysis of tributaries, sewage outfalls and the Daliao River showed that nutrients of the Daliao River were affected by sewage outfalls. And the effect was significant and non-ignorable.

Association of serum gamma-glutamyl transferase with treatment outcome in chronic hepatitis B patients.

AIM: To investigate the association of serum gamma-glutamyl transferase (GGT) levels with chronic hepatitis B infection and hepatitis B e antigen (HBeAg) seroconversion. METHODS: A retrospective study was performed on clinical data collected from patients who had been positive for hepatitis B surface antigen for > 6 mo and who were antiviral-treatment naïve (n = 215) attending the Hepatitis Clinic at Nanjing Drum Tower Hospital between August 2010 and December 2013. Healthy individuals without liver disease (n = 83) were included as controls. Patients were categorized into four groups based on disease status as recommended by the European Association for the Study of the Liver: immune tolerance (IT; n = 47), HBeAg-positive hepatitis (EPH; n = 93), HBeAg-negative hepatitis (ENH; n = 20), and inactive carrier (IC; n = 55). Prediction of complete response (CR) based on serum GGT was also examined in EPH patients (n = 33) treated for 48 wk with nucleos(t)ide analogue (NA) therapy, including lamivudine plus adefovir combination therapy (n = 20) or entecavir monotherapy (n = 13). CR was defined as a serum hepatitis B virus DNA level < 500 copies/mL and HBeAg seroconversion by 48 wk of treatment. RESULTS: Serum GGT levels were significantly increased in EPH and ENH patients relative to the IT, IC, and healthy control groups (P < 0.01 for all). However, no significant difference in serum GGT levels was found between the EPH and ENH groups. Baseline serum GGT levels were significantly higher in patients who achieved CR (7/33; 21.2%) compared to patients in the non-CR group (26/33; 78.8%; P = 0.011). In addition, the decline in serum GGT was greater in CR patients compared to non-CR patients after 24 wk and 48 wk of treatment (P = 0.012 and P = 0.008, respectively). The receiver operating characteristic curve yielded a sensitivity of 85.71% and a specificity of 61.54% at a threshold value of 0.89 times the upper limit of normal for baseline serum GGT in the prediction of CR following NA therapy. CONCLUSION: Serum GGT is significantly elevated in EPH and ENH patients and is a potential biomarker for the prediction of HBeAg seroconversion following NA therapy.