Comparison of simvastatin with Eugenia Jambolana fruit pulp in their effects on alanine transferase, aspartate aminotransferase and creatinine phosphokinase levels of hyperlipidaemic rats

OBJECTIVES

To compare the effects of Eugenia Jambolana fruit extract with simvastatin on liver enzymes, aspartate aminotransferase (AST), alanine transferase (ALT) and muscle enzyme creatinine phosphokinase (CPK) in diet induced hyperlipidaemic rats.

METHODS

An experimental randomized control study was conducted on seventy five male albino rats, divided into five groups labelled A, B, C, D and E with fifteen rats in each group. Group A was kept as normal control, groups B, C, D and E were given hyperlipidaemic diet for six weeks. In group B no further intervention was done, group C and group D were given ethanolic extract of Eugenia Jambolana and Simvastatin respectively for eight weeks. Group E was given combination of both for same duration. Serum Total Cholesterol (TC), Low density lipoprotein (LDL), High density lipoprotein (HDL), Triglycerides (TG), ALT. AST and CPK were measured at zero, six and fourteen weeks.

RESULTS

At fourteenth week significant reductions in serum ALT , AST and CPK levels were observed in hyperlipidaemic group C as compared to other hyperlipidaemic groups B, D and E (p<0.05). Serum ALT level which is considered to be the most important parameter of hepatotoxicity returned to normal after 8 weeks in group C fed on Eugenia Jambolana fruit pulp only and the values were equal to control group A. There was no significant difference at baseline (zero weeks) serum TC, LDL, HDL, TG, ALT, AST and CPK of groups A, B, C, D and E; p>0.24, p>0.37, p>0.89, respectively. On sixth week, serum ALT, AST and CPK levels of hyperlipidaemic groups B,C,D and E were found to be significantly higher as compared to group A (p<0.05).

CONCLUSION

Ethanolic extract of Eugenia Jambolana fruit caused a reduction in serum ALT, AST and CPK level in male albino rats when compared with simvastatin.

PLP-dependent enzymes as potential drug targets for protozoan diseases

The chemical properties of the B(6) vitamers are uniquely suited for wide use as cofactors in essential reactions, such as decarboxylations and transaminations. This review addresses current efforts to explore vitamin B(6) dependent enzymatic reactions as drug targets. Several current targets are described that are found amongst these enzymes. The focus is set on diseases caused by protozoan parasites. Comparison across a range of these organisms allows insight into the distribution of potential targets, many of which may be of interest in the development of broad range anti-protozoan drugs. This article is part of a Special Issue entitled: Pyridoxal Phosphate Enzymology.

Biochemical stress responses in tissues of the cichlid fish Cichlasoma dimerus exposed to a commercial formulation of endosulfan

Median lethal concentration (LC(50)) and sublethal effects of the commercial endosulfan formulation Zebra Ciagro(®) on the fish Cichlasoma dimerus were studied. The 96-h LC(50) was estimated as 17.7 μg/L. In order to investigate sublethal effects, fish were exposed to 25% and 50% LC(1) (3.4 and 6.8 μg/L, respectively). Endosulfan (ED) significantly increased the hemoglobin concentration and white blood cell count after 96 h. Differential leukocytes count was also altered, due to an increase in the percentage of neutrophils in exposed fish. The hepatopancreatic tissue of fish under ED treatment showed a decrease in aspartate aminotransferase and alanine aminotransferase and an increase in alkaline phosphatase. Lipid peroxidation levels in the 6.8-μg/L ED-containing group were higher than those in control fish for all organs tested (gills, hepatopancreas, and brain).

Antioxidant properties of Amaranthus hypochondriacus seeds and their effect on the liver of alcohol-treated rats

Amaranth constitutes a valuable pseudocereal, due to its nutritional quality and its nutraceutical properties, which contribute to improve human health. This work evaluated the effect of a diet based on Amaranthus hypochondriacus (Ah) seed on oxidative stress and antioxidant status in the liver of rats sub-chronically exposed to ethanol. The seed extract was investigated for antioxidant capacity in vitro, showing an adequate content of total phenols and antioxidant activity elevated. For in vivo assays, four groups of six rats each were fed with an AIN-93 M diet for 28 days. In groups III and IV casein was replaced by Ah as the protein source; groups II and IV were received ethanol in the drinking water (20% v/v). When comparing groups IV and II, the following was observed: significant decrease in the activity of aspartate aminotransferase and content of malondialdehyde (p<0.001) in serum; decrease of malondialdehyde and increase in the activity and gene expression of Cu,Zn-superoxide dismutase, also, decrease in the NADPH oxidase transcript levels (p<0.05) in liver. Our data suggest that Ah is a good source of total phenols and exerts a protective effect in serum and in liver of rats intoxicated with ethanol.

Coffee consumption could affect the activity of some liver enzymes and other biochemical parameters in healthy drinkers

OBJECTIVE

To investigate the effect of coffee consumption on some liver function indices in adult male and female Nigerians.

SUBJECTS AND METHODS

Thirty apparently healthy subjects, consisting of 18 men and 12 women, were made to consume 2 g of coffee daily for a total of 30 days. Activities of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and plasma concentrations of total and conjugated bilirubin, total protein and albumin were determined using standard methods.

RESULTS

Relative to baseline values, coffee consumption raised mean levels of ALT by 4 IU/l (p < 0.001), AST by 2.0 1 U/l (p < 0.001), ALP by 3.0 1 U/l (p < 0.01), total bilirubin by 0.90 mg/dl (p < 0.05) and total protein by 1.1 g/l (p < 0.05). Gender differences were observed. Significantly higher mean ALP concentration was only seen in male subjects, while mean bilirubin concentration was significantly raised in female volunteers alone. On the other hand, the mean total protein and albumin concentrations in individual male and female groups were not significantly altered (p > 0.05 in each case).

CONCLUSION

The result obtained from the study suggests that short-term consumption of coffee might have a significant effect on the integrity of the liver function tests studied.

Alternation between dietary protein depletion and normal feeding cause liver damage in mouse

The effect of frequent protein malnutrition on liver function has not been intensively examined. Thus, the effects of alternating 5 days of a protein and amino acid-free diet followed by 5 days of a complete diet repeated three times (3 PFD-CD) on female mouse liver were examined. The expression of carbonic anhydrase III (CAIII), fatty acid synthase (FAS), glyceraldehyde 3-phosphate dehydrogenase (GAPDH) and glutathione S-transferase P1 (GSTP1) in liver were assessed by proteomics, reverse transcriptase-polymerase chain reaction and Northern blotting. The activities of liver GSTs, glutathione reductase (GR) and catalase (CAT), as well as serum glutamic-oxaloacetic transaminase (SGOT) and glutamic-pyruvic transaminase (SGPT) were also tested. Additionally, oxidative damage was examined by measuring of protein carbonylation and lipid peroxidation. Liver histology was examined by light and electron microscopy. Compared with control mice, 3 PFD-CD increased the content of FAS protein (+90%) and FAS mRNA (+30%), while the levels of CAIII and CAIII mRNAs were decreased (-48% and -64%, respectively). In addition, 3 PFD-CD did not significantly change the content of GSTP1 but produced an increase in its mRNA level (+20%), while it decreased the activities of both CAT (-66%) and GSTs (-26%). After 3 PFD-CD, liver protein carbonylation and lipid peroxidation were increased by +55% and +95%, respectively. In serum, 3 PFD-CD increased the activities of both SGOT (+30%) and SGPT (+61%). In addition, 3 PFD-CD showed a histological pattern characteristic of hepatic damage. All together, these data suggest that frequent dietary amino acid deprivation causes hepatic metabolic and ultrastructural changes in a fashion similar to precancerous or cancerous conditions.

Discontinuation of hormone replacement therapy in young GH-treated hypopituitary women increases liver enzymes

OBJECTIVE

Hypopituitarism, often characterized by hypogonadism, is associated with central obesity, increased cardiovascular and endocrine morbidity and mortality. In Turner syndrome, which is also characterized by hypogonadism liver enzymes are often elevated, but readily suppressed by a short course of hormone replacement therapy (HRT). We investigated the effect of HRT on liver enzymes, lipid levels and measures of insulin sensitivity 26 in hypopituitary women.

DESIGN

We studied 26 hypopituitary women (age 38.8+/-11.0 (mean+/-SD years), BMI 27.4+/-5.1kg/m(2)) during HRT and 28days off therapy.

METHODS

We measured liver enzymes, fasting levels of lipids, insulin and glucose as well as adiponectin and leptin levels. Body composition was assessed by means of anthropometry and bioimpedance.

RESULTS

Alanine transaminase (ALT) and aspartate transaminase (AST) increased after discontinuation of HRT (ALT; treated: 22.3+/-11.5 vs. untreated: 27.1+/-11.1 (U/L) (P<0.02); AST; treated: 20.4+/-6.1 vs. untreated: 24.6+/-8.9 (U/L) (P<0.002)), whereas other liver function tests remained unchanged. Measures of insulin sensitivity and fasting lipids were also unaffected by HRT, whereas leptin levels decreased with cessation of HRT (leptin; treated: 23 (8-71) vs. untreated: 20 (8-64) (mug/L) (P<0.0005)).

CONCLUSION

Short time discontinuation of HRT in young hypopituitary women increased liver enzymes, whereas measures of insulin sensitivity and lipid levels remained unchanged. We speculate that the estrogen component of HRT has beneficial effects on hepatic metabolism through various pathways. Further studies including liver imaging and with a time-dependent design are needed to clarify the role of HRT on liver enzyme levels, metabolic variables and liver fat content.

Efficacy analysis of methylprednisolone plus adrenaline to treat wasp sting injury

OBJECTIVE

To observe the effect of methylprednisolone (MP) plus adrenaline to treat patients injured by wasp stings.

METHODS

This study was carried out at The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei Province, China, from June to November 2008. A total of 45 cases were divided into 2 groups. The MP was used alone in the control group, and MP plus adrenaline was used in the observation group. We compared the clinical effect between the 2 groups.

RESULTS

The alanine aminotransferase (ALT) (64.05 +/- 59.31 versus 124.14 +/- 80.01 U/L), and creatine kinase isoenzyme (CKMB) (90.32 +/- 85.19 versus 216.68 +/- 277.58 umol/L) levels of the observation group were significantly lower than those of the control group. The length of hospital stay of the observation group was significantly shorter than that of the control group (7.23 +/- 2.93 versus 11.23 +/- 8.02), while complications from the wasp sting were fewer than those of the control group. In addition, the level of peripheral blood leukocytes was positively correlated with the number of stings (r=0.733, p=0.001), levels of ALT and CKMB (r=0.627, p=0.001, and r=0.705, p=0.001), and length of hospital stay (r=0.667, p=0.001).

CONCLUSION

Allergic and inflammatory responses play an important role in addition to the direct effect of wasp venom on the human body. Compared with MP alone, early combination of adrenaline helps to further inhibit the diffusion of allergy and inflammatory cytokines, and therefore reduce the severity of injury.

Toxic effects of copper on antioxidative and metabolic enzymes of the marine gastropod, Onchidium struma

The goals of this study were to evaluate the acute and sublethal toxicity of copper (Cu(2+)) on the marine gastropod, Onchidium struma, and to examine the utility of enzymatic parameters as indicators of Cu(2+) exposure. In a semistatic renewal test, the 96-hour median lethal concentration of Cu(2+) for O. struma, 74.80 mg/L, was higher than that for other intertidal species. The activities of the antioxidative enzymes, Cu/Zn superoxide dismutase (Cu/Zn-SOD) and catalase (CAT), and those of the metabolic enzymes-acid phosphatase (ACP), alkaline phosphatase (AKP), glutamic-oxaloacetic transaminase (GOT), and glutamic-pyruvic transaminase (GPT) -in both hepatopancreas and muscle were determined after a 1-week exposure to Cu(2+) (range 1.35 to 4.20 mg/L). The activities of both Cu/Zn-SOD and CAT were higher in hepatopancreas than muscle. In addition, there was a negative correlation between Cu(2+) concentration and Cu/Zn-SOD activity in hepatopancreas, whereas a positive correlation was observed for CAT activity. Concentration-dependent changes in ACP and AKP activity showed a similar trend in hepatopancreas, increasing then decreasing and, finally, a slight increase. In contrast, ACP activity was positively correlated with Cu(2+) across the concentration range tested. In both hepatopancreas and muscle, both GOT and GPT were activated by lower concentrations of Cu(2+) and inhibited at higher concentrations.

Transferrin fails to provide protection against Fas-induced hepatic injury in mice with deletion of functional transferrin-receptor type 2

We reported previously that Fas-induced hepatic failure in normal mice was attenuated or prevented by exogenous transferrin (Tf), particularly apoTf. Here we show in C57BL6J/129 mice with genetic inactivation of transferrin receptor 2 (TfR2(Y245X)), that Fas-induced hepatotoxicity (apoptosis; rise in plasma aspartate aminotransferase (AST) levels) was comparable to that in wild-type mice, but was not modified by pretreatment with Tf. Rises in plasma AST were preceded by a decline in serum iron levels. AST elevations and iron declines were more profound in female than in male mice. Female mice also showed higher baseline levels of Bcl-xL in hepatocytes, which declined significantly upon treatment with agonistic anti-Fas antibody. These data confirm the cytoprotective function of Tf, and show a novel property of TfR2. Both apoptotic Fas responses and cytoprotective effects of Tf were associated with significant shifts in plasma iron levels, which quantitatively differed between male and female mice.

Statins and elevated liver tests: what's the fuss?

Order liver function tests before starting statin therapy, 12 weeks after initiation, with any dose increase, and periodically for long-term maintenance therapy. Mild elevations of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) (<3 times the upper limit of normal [ULN]) following statin therapy do not appear to lead to significant liver toxicity over time. Other medications that lower low-density lipoprotein (LDL), and might be substituted for statins, may not improve morbidity and mortality.

Juvenile Hormone Analogues, methoprene and fenoxycarb dose-dependently enhance certain enzyme activities in the silkworm Bombyx mori (L)

Use of Juvenile Hormone Analogues (JHA) in sericulture practices has been shown to boost good cocoon yield; their effect has been determined to be dose-dependent. We studied the impact of low doses of JHA compounds such as methoprene and fenoxycarb on selected key enzymatic activities of the silkworm Bombyx mori. Methoprene and fenoxycarb at doses of 1.0 microg and 3.0 fg/larvae/48 hours showed enhancement of the 5th instar B. mori larval muscle and silkgland protease, aspartate aminotransaminase (AAT) and alanine aminotransaminase (ALAT), adenosine triphosphate synthase (ATPase) and cytochrome-c-oxidase (CCO) activity levels, indicating an upsurge in the overall oxidative metabolism of the B.mori larval tissues.

Ameliorative effect of curcumin on aflatoxin-induced toxicity in serum of mice

The present investigation was an attempt to evaluate the ameliorative effect of curcumin on aflatoxin-induced toxicity on serum and blood of mice. Aflatoxin was obtained by growing Aspergillus parasiticus in SMKY liquid medium. Pure curcumin (97% purity) was purchased from Hi-Media Laboratories Pvt. Ltd., Mumbai, India. Young adult male albino mice were orally administered with low dose and high dose (750 and 1500 microg/kg body weight) with and without curcumin (2 mg/0.2 mL olive oil/animal/day) for 45 days. On 46th day the animals were sacrificed by cervical dislocation. For serum parameters blood was collected in non-EDTA containing vails from heart of the dissected mice. Serum parameters are creatinine, protein, AST and ALT. The results revealed dose dependent increase in creatinine, AST and ALT and decrease in protein in serum parameters of mice. Treatment with curcumin along with aflatoxin ameliorates aflatoxin-induced changes in serum parameters.

Effect of hydroalcoholic extracts of Nasturtium officinale leaves on lipid profile in high-fat diet rats

AIM OF THE STUDY

Nasturtium officinale R. Br. (Brassicaceae) is used as a home remedy in Iran as a cardioprotective agent without any scientific background. In this investigation an attempt was made to study the effect of Nasturtium officinale hydroalcoholic extract (NOE) on serum lipid profile which is closely associated with many cardiovascular diseases.

MATERIALS AND METHODS

Accordingly, serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were among the parameters investigated. We also evaluated the activities of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels as a measure of hepatic cell damages.

RESULTS

Intragastric administration of NOE (500 mg/kg body weight per day) to groups of hypercholesterolaemic rats for 10 days lowered their serum TC, TG and LDL-C by 34.2, 30.1, and 52.9%, respectively, while raised the serum HDL-C level by 27.0% after 10 days of treatments. Treatment with NOE reduced serum ALT and AST levels compared to high-fat diet groups.

CONCLUSIONS

Based on these data, it is concluded that the NOE has definite cardioprotective potential and these results constitute a valid scientific basis for consuming Nasturtium officinale for medicinal application.

Increase of ceramide in the liver and plasma after carbon tetrachloride intoxication in the rat

In fulminant hepatic failure, various toxins causing multi-organ failure increase in plasma. As a novel toxin, levels of ceramide, a well-studied lipid mediator of apoptosis, were determined by LC-MS/MS in the liver and plasma of carbon tetrachloride (CCl4)-intoxicated rats. After 6 h of oral administration of CCl4 (4 mL/kg body weight as a 1:1 mixture of CCl4 and mineral oil) to rats, extensive hepatic failure occurred as evidenced by a severe elevation in plasma AST and ALT. The liver concentration of major ceramide components (C16:0, C24:0, C24:1, C18:0, C22:0, and C24:2 in decreasing order), and the sum of these ceramides increased significantly 2 h after CCl4 intoxication compared to that in the control group given mineral oil. The total ceramide concentration in the plasma was also increased to 4.1 times that in the control 24 h after administration of CCl4. In conclusion, the early increase in liver ceramides may contribute to hepatic cell death and the increase in plasma ceramides during fulminant hepatic failure may cause damage in other organs including the brain and kidney.

Effect on body weight and safety of RC-1291, a novel, orally available ghrelin mimetic and growth hormone secretagogue: results of a phase I, randomized, placebo-controlled, multiple-dose study in healthy volunteers

PURPOSE

RC-1291 is a novel, oral ghrelin mimetic and growth hormone (GH) secretagogue being developed to increase appetite and lean muscle mass in patients with cancer-associated anorexia/cachexia. This randomized, double-blind, placebo-controlled, multiple-dose, dose-escalation phase I study in healthy volunteers evaluated RC-1291 once daily (qd) and twice daily (bid) for effect on body weight and safety.

METHODS

The study was conducted with three sequential groups of volunteers. Panel A subjects (n = 8) received placebo or RC-1291, 25 mg qd, for 5 days. Panel B subjects received RC-1291, 25 mg bid or 50 mg qd, for 6 days then crossed over to the other dosage for 5 days (n = 12); three subjects received placebo for all 11 doses to maintain double-blinding. Panel C subjects (n = 9) received placebo or RC-1291, 75 mg qd, for 6 days.

RESULTS

Subjects who received RC-1291, 50 or 75 mg, had significant dose-related weight gain after 6 days versus placebo, with the greatest increases seen with daily dosing. The mean increase in weight from baseline after 50 mg qd was 1.25 +/- 0.725 kg (p = .0022 versus placebo), and after 75 mg qd it was 1.16 +/- 0.651 kg (p = .0022 versus placebo). One subject in the 50 mg qd group had moderate transient elevation in aspartate aminotransferase and alanine aminotransferase levels. No other laboratory or clinical adverse events of consequence were reported.

CONCLUSIONS

Results indicate that RC-1291 produces dose-related increases in body weight with no dose-limiting adverse effects, and may be an effective treatment for anorexia/cachexia.

Restoration of histoarchitecture in the paracetamol-induced liver damaged rat by earthworm extract, Lampito mauritii (Kinberg)

Lampito mauritii, an earthworm widely used in Siddha as well as Ayurveda, has been reported to have anti-inflammatory, anti-ulceral and anti-oxidative properties. The present investigation shows its hepatoprotective role. Whole tissue extract of Lampito mauritii protect the paracetamol (2 g/kg body weight. p.o.) induced liver damage rat as a dose dependent manner (100, 200 and 300 mg/kg body weight p.o.) by significantly (P < 0.05) decreasing the hepatic marker enzymes--aspartate transaminase, alanine transaminase and alkaline phosphatase similar to silymarin (150 mg/kg b.w. p.o.). Histopathological observations of liver tissues corroborated these findings.

Incidence of hepatic dysfunction is equivalent in burn patients receiving oxandrolone and controls

Oxandrolone has been shown to improve lean muscle mass in patients with burns. Hepatic dysfunction is a known side effect of treatment with oxandrolone. The purpose of this study was to examine the incidence of hepatic dysfunction in our series of burn patients receiving oxandrolone. Fourteen patients who received oxandrolone (5 mg, n = 8; 10 mg, n = 6) were identified from our prospectively collected burn database. The records of 61 control patients also were reviewed. Demographics such as age, comorbidities, and burn size were recorded. The incidence of hepatic dysfunction was determined by the presence of abnormal liver function tests. The study and control groups were similar in age and burn size. Two of the eight (25%) oxandrolone patients receiving 5 mg and four of the six (67%) oxandrolone patients receiving 10 mg had evidence of hepatic dysfunction. Twenty six of the 61 (43%) control patients had evidence of hepatic dysfunction (P = NS). There appears no significant increased incidence of hepatic dysfunction in burn patients who received oxandrolone compared to those who did not.

Effect of Hibiscus sabdariffa on obesity in MSG mice

The aim of the present investigation was determine whether a standardized Hibiscus sabdariffa calyces aqueous extract has an effect on body weight in an obese animal model induced by the administration of monosodium glutamate. Hibiscus sabdariffa aqueous extract, containing 33.64 mg of total anthocyanins per each 120 mg of extract, was orally administered (120 mg/kg/day) for 60 days to healthy and obese mice, and body weight gain, food and liquid intake, aspartate aminotransferase (AST), alanine aminotransferase (ALT), cholesterol, and triglycerides levels were measured. Hibiscus sabdariffa administration significantly reduced body weight gain in obese mice and increased liquid intake in healthy and obese mice. ALT levels were significantly increased on the 15th and 45th days in obese mice, but AST levels did not show significant changes. Mortality was not observed in the Hibiscus sabdariffa treated groups. Triglycerides and cholesterol levels showed non-significant reductions in animals treated with Hibiscus sabdariffa. Our data confirm the anti-obesity effect of Hibiscus sabdariffa reported by the Mexican population.

Relationship of blood mercury levels to health parameters in the loggerhead sea turtle (Caretta caretta)

BACKGROUND

Mercury is a pervasive environmental pollutant whose toxic effects have not been studied in sea turtles in spite of their threatened status and evidence of immunosuppression in diseased populations.

OBJECTIVES

In the present study we investigate mercury toxicity in loggerhead sea turtles (Caretta caretta) by examining trends between blood mercury concentrations and various health parameters.

METHODS

Blood was collected from free-ranging turtles, and correlations between blood mercury concentrations and plasma chemistries, complete blood counts, lysozyme, and lymphocyte proliferation were examined. Lymphocytes were also harvested from free-ranging turtles and exposed in vitro to methylmercury to assess proliferative responses.

RESULTS

Blood mercury concentrations were positively correlated with hematocrit and creatine phosphokinase activity, and negatively correlated with lymphocyte cell counts and aspartate amino-transferase. Ex vivo negative correlations between blood mercury concentrations and B-cell proliferation were observed in 2001 and 2003 under optimal assay conditions. In vitro exposure of peripheral blood leukocytes to methylmercury resulted in suppression of proliferative responses for B cells (0.1 microg/g and 0.35 microg/g) and T cells (0.7 microg/g).

CONCLUSIONS

The positive correlation between blood mercury concentration and hematocrit reflects the higher affinity of mercury species for erythrocytes than plasma, and demonstrates the importance of measuring hematocrit when analyzing whole blood for mercury. In vitro immunosuppression occurred at methylmercury concentrations that correspond to approximately 5% of the individuals captured in the wild. This observation and the negative correlation found ex vivo between mercury and lymphocyte numbers and mercury and B-cell proliferative responses suggests that subtle negative impacts of mercury on sea turtle immune function are possible at concentrations observed in the wild.

Liver dysfunction in paediatric obesity: a randomized, controlled trial of metformin

AIM

In a previous study we showed that metformin reduced BMI z-scores and fasting glucose and insulin concentrations, and increased whole body insulin sensitivity in obese adolescents with fasting hyperinsulinemia and a family history of type 2 diabetes. We analyzed the data from this study to determine (a) if metformin reduced serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations during the 6-month trial, and (b) if the response to pharmacotherapy varied along gender or ethnic lines.

METHODS

The 6-month trial was randomized, double blinded and placebo controlled; a total of 14 metformin-treated (500 mg bid) and 15 placebo-treated subjects completed the study. There were no dietary restrictions.

RESULTS

In obese adolescents fed ad libitum, metformin (a) prevented the rise in ALT concentrations that were observed in placebo-treated subjects at the 3 to 5 month time-points (p < 0.05); (b) reduced (p < 0.01) the percentage of all ALT values exceeding 40 U/L; and (c) caused a modest (10%) but statistically significant (p < 0.05) reduction in serum ALT in Caucasian subjects. Metformin had no effect on ALT levels or the ALT to AST ratio in the five African American adolescents enrolled in the study but reduced their fasting insulin concentrations from 26.1 to 19.5 muU/mL (p < 0.05).

CONCLUSIONS

Our findings suggest that metformin might reduce the rates or severity of liver dysfunction in selected high-risk adolescents.

Dietary amino acid taurine ameliorates liver injury in chronic hepatitis patients

The effect of dietary amino acid taurine on the liver function of chronic hepatitis patients was investigated. The 24 chronic hepatitis patients with 2-5 times over normal activities of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) were selected and equally divided into taurine treatment and control groups. In taurine treatment group, each patient took 2 g taurine 3 times a day for three months, and then stopped treatment for 1 month. Patients taking placebo without taurine for 4 months served as a control group. ALT and AST activities and levels of cholesterol, triglyceride and thiobarbituric acid relative substances of serum plasma in the taurine group were all decreased at the end of three month treatment. The study suggested that dietary amino acid taurine may ameliorate liver injury for chronic hepatitis patients.

Metabolic effects of two years of exenatide treatment on diabetes, obesity, and hepatic biomarkers in patients with type 2 diabetes: an interim analysis of data from the open-label, uncontrolled extension of three double-blind, placebo-controlled trials

BACKGROUND

Exenatide, an incretin mimetic for adjunctive treatment of type 2 diabetes mellitus (T2DM), reduced glycosylated hemoglobin (HbA(1c)) and weight in 30-week placebo-controlled trials. Some patients were followed up in open-label extensions to provide 'real-world' exenatide clinical experience.

OBJECTIVE

The purpose of this study was to examine the metabolic effects of 2 years of exenatide treatment in patients with T2DM.

METHODS

For this interim analysis, data were pooled from patients who completed 1 of three 30-week, multicenter, double-blind, placebo-controlled trials and their open-label extensions. In the initial trials, subjects were randomized to BID 5-microg exenatide, 10-microg exenatide, or placebo for 30 weeks. All subjects who enrolled in the extension phase then received 5-pg exenatide BID for 4 weeks, followed by open-label treatment with 10-pg exenatide BID. Subjects continued their existing metformin and/or sulfonylurea regimens. Analyses were conducted on data from all subjects who had the opportunity to achieve 2 years of exenatide exposure, irrespective of their treatment arm in the 30-week placebo-controlled trials.

RESULTS

A total of 974 patients entered the open-label, extension phase of the trial. Two hundred eighty-three subjects (mean [SD] age, 57 [10] years; mean [SD] weight, 100[19] kg; sex, 63% male; mean [SD] body mass index, 34 [6] kg/m(2); mean [SD] HbA(1c), 8.3% [1.0%]) completed 2 years of exenatide treatment. Reductions in mean (SE) HbA(1c) from baseline to week 30 (-0.9% [0.1%]) were sustained through 2 years (-1.1% [0.1%]; P < 0.05 vs baseline), with 50% of the population achieving HbA(1c) < or = 7%. At week 30, exenatide was associated with a significant reduction in mean (SD) body weight from baseline (-2.1 [0.2] kg), with progressive reductions after 2 years (-4.7 [0.3] kg; P < 0.001 vs baseline). Patients with normal baseline alanine aminotransferase (ALT) (132/283 [47%]; normal: female < or =19 IU/L; male < or =30 IU/L) had no significant ALT change. However, patients with elevated ALT at baseline (151/283 [53%]) had a mean (SEM) reduction of ALT (-11 [1] IU/L from baseline 38 [1] IU/1; P < 0.05) and 39% achieved normal ALT by week 104. Patients with elevated ALT at baseline lost significantly more weight than patients with normal ALT at baseline (P = 0.04). However, weight change was minimally correlated with baseline ALT (r = -0.09) or ALT change (r = 0.31). Also, homeostasis model assessment of the beta-cell function (HOMA-B), blood pressure, and aspartate aminotransferase (AST) all improved. The most frequently reported adverse event was mild-to-moderate nausea.

CONCLUSIONS

In these patients with T2DM, adjunctive exenatide treatment for 2 years was generally well tolerated and resulted in a sustained reduction of HbA(1c), progressive reduction in weight, and improvements in HOMA-B, blood pressure, and the hepatic injury biomarkers, AST and ALT.

[Modifications of hepatic transaminases in workers exposed to low doses of isopropanol]

Isopropanol (IPA) is a volatile solvent that is used in many industrial process. The major symptoms of acute isopropanol toxicity include dizziness, incoordination, headache, hypothermia, eye ataxia, irritation of upper respiratory tract and shortness of breath. Vomiting, hematemesis, diarrhoea and hypotension may occur following accidental ingestion of IPA. No data regarding subchronic or chronic toxicity of IPA were identified. The aim of this study was to measure the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and of gamma-glutamyltransferase (gamma-GT) of the last five years in 40 printer workers after the removal of IPA from the industry. The serum levels of ALT, AST and gamma-GT were higher in the exposed workers than in non exposed. In conclusion, the results of this study show that the removal of IPA from the industry had a positive health effect improving the hepatic function of the workers.

Effect of dimethyl sulphoxide on oxidative stress, activation of mitogen activated protein kinase and necrosis caused by thioacetamide in the rat liver

Thioacetamide (400 mg/kg body weight, i.p.) was administered to rats. After 12 h the activity of plasma glutamate-oxaloacetate transaminase (GOT) and glutamate-pyruvate transaminase (GPT) was significantly higher than that of the control group, and after 24 h plasma GOT and GPT activities strongly increased. These results indicated that the necrotic process was initiated at about 12 h and developed thereafter. By co-administration of dimethyl sulphoxide (DMSO, 18 and 1 h before, and 8 h after administration of thioacetamide: each time, 2.5 ml/kg body weight, p.o.), plasma GOT and GPT were significantly decreased and were even comparable to the control group, showing that DMSO totally prevented the necrotic action of thioacetamide. After 12 and 24 h of thioacetamide administration, the hepatic level of vitamin C, the most sensitive chemical indicator of oxidative stress, decreased significantly, indicating that oxidative stress was significantly enhanced 12 h after thioacetamide intoxication and thereafter. DMSO totally restored the liver vitamin C level, demonstrating that DMSO effectively ameliorated the oxidative stress caused by thioacetamide, resulting in the prevention of necrosis of the liver. Phosphorylated c-Jun NH(2)-terminal kinase (JNK) significantly increased transiently 12 h after treatment with thioacetamide. These results indicated that oxidative stress and the activation of JNK took place almost simultaneously. Phosphorylated extracellular signal-related kinase (ERK) 2 was significantly increased 6-12 h after thioacetamide injection. Phosphorylated p38 MAPK (mitogen activated protein kinase) was significantly decreased 24 h after administration of thioacetamide. DMSO treatment inhibited the change of these MAPKs by thioacetamide, corresponding with the prevention of the liver necrosis as well as the attenuation of oxidative stress.