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Liver resection is widely accepted as a treatment option for primary liver cancer and metastases. The goal of surgery is to resect all tumours with negative histological margins while preserving sufficient functional hepatic parenchyma and reducing postoperative complications. The use of Indocyanine green (ICG) for liver function assessment and fluorescence image-guided surgery could be used to achieve that goal.

Non-alcoholic fatty liver disease (NAFLD) is one of the most frequent chronic liver disorders worldwide. It is closely associated with metabolic syndrome components, including type 2 diabetes, hyperlipidaemia and obesity. To date, no effective drug treatment is available for NAFLD but several clinical trials suggested that silymarin, the active milk thistle extract, has well-documented antioxidant and hepatoprotective properties. In this case report, silymarin 140 mg twice daily decreased liver enzyme activity with a good safety profile in a patient with NAFLD and overweight, supporting silymarin as a promising supportive intervention aimed at normalizing liver activity in NAFLD. This article is part of the Current clinical use of silymarin in the treatment of toxic liver diseases: a case series Special Issue: https://www.drugsincontext.com/special_issues/current-clinical-use-of-silymarin-in-the-treatment-of-toxic-liver-diseases-a-case-series

The transition period is defined as the period from three week before calving until three weeks after calving; however, there is insufficient available data reflecting changes in this period in buffaloes. The present study is carried out in Assuit Governorate, Egypt on 30 Egyptian buffalo cows from 4 to 6 years old. The average body weight between 350 and, 450 kg and her average daily milk yield was 10 kg per animal/day during the transition period. Whole blood samples were collected from these buffaloes for determination of Liver function enzymes (Aspartate aminotransferase, Alanine aminotransferase, lactate dehydrogenase, Total bilirubin and Total proteins), Kidney function test (Blood urea nitrogen and Creatinine), some Lipid profile (Total cholesterol and Triglyceride) and Minerals (Calcium, Potassium and Chloride). Blood samples were collected seven times from every animal every week three times before, after and during parturition. The result appeared that a highly significant increase in Aspartate aminotransferase, Alanine aminotransferase, Creatinine, Total cholesterol, Triglyceride and calcium in the Prepartum period. But Lactate dehydrogenase, Total bilirubin, Total protein and, Blood urea nitrogen were a highly significant increase in Post-partum period. Non-significant changes in Potassium and Chloride along transition period.

Losartan has become a hot spot in the treatment of non-alcoholic fatty liver disease (NAFLD) among angiotensin receptor blocker drugs. We sought to conduct a systematic examination and meta-analysis to examine the effects of losartan on patients with NAFLD. We searched for potentially randomized controlled trials in PubMed, Embase, China National Knowledge Infrastructure, Wanfang, and the Cochrane database up to October 09, 2022. We used the Cochrane risk of bias tool to evaluate the study quality. Analysis of subgroups, sensitivity analysis, and publishing bias were explored. The quality of the included studies was moderate to high. Six trials involving 408 patients were included. The meta-analysis demonstrated that aspartate transaminase was significantly affected by losartan therapy (mean difference [MD] = −5.34, 95% confidence interval [CI] [−6.54, −4.13], Z = 8.70, P < 0.01). The meta-analysis subgroup showed that losartan 50 mg once daily could lower the level of alanine aminotransferase (MD = −18.92, 95% CI [−21.18, −16.66], Z = 16.41, P < 0.01). There was no statistically significant difference in serum total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein.

Objective To explore the efficacy, safety, and factors that might influence the efficacy of antiPD-1 antibody-based therapy in advanced hepatocellular carcinoma in the real world. Methods The clinical features, efficacy, and safety in patients with advanced hepatocellular carcinoma who received anti-PD-1 antibody-based therapy were retrospectively analyzed. The survival status was followed-up. Results The objective response and the disease control rate were 21.8% and 76.4%, respectively. The overall incidence of adverse events during treatment was 81.8%, of which the incidence of grade 3/4 adverse events was 14.5%. The incidence of immune-related adverse events was 58.2% and the incidence of grade 3/4 immune-related adverse events was 3.6%, and no treatment-related death was observed. The median PFS of the 55 patients was 5.0 (95%CI: 3.9-6.1) months, and the median OS was 11.4 (95%CI: 6.5-16.3) months. Univariate and multivariate analyses showed that liver function Child-Pugh scores and performance status ECOG score were the influencing factors of the objective response rate and survival. Conclusion In the real world anti-PD-1 antibody-based therapy is safe and effective in patients with advanced hepatocellular carcinoma, in which the performance status ECOG score and liver function Child-Pugh score before treatment are independent prognostic factors influencing survival.

Long-term hepatic damage is associated with human morbidity and mortality owing to numerous pathogenic factors. A variety of studies have focused on improving liver health using natural products and herbal medicines. We aimed to investigate the effect of enzyme-treated Zizania latifolia ethanol extract (ETZL), which increases the content of tricin via enzymatic hydrolysis, for 8 weeks on liver-related outcomes, lipid metabolism, antioxidant activity, and fatigue compared to a placebo. Healthy Korean adult males aged 19–60 years were randomized into ETZL treatment and placebo groups, and alcohol consumption was 24.96 and 28.64 units/week, respectively. Alanine transaminase, a blood marker associated with liver cell injury, significantly decreased after 8 weeks compared to the baseline in the ETZL treatment group (p = 0.004). After 8 weeks, the treatment group showed significant changes in the levels of high-density lipoprotein and hepatic steatosis index compared to the baseline (p = 0.028 and p = 0.004, respectively). ETZL treatment tended to reduce antioxidant-activity-related factors, total antioxidant status, and malondialdehyde, but there was no significant difference. In the multidimensional fatigue scale, ETZL treatment showed a significant reduction in general fatigue and total-fatigue-related values after 8 weeks compared to the baseline (p = 0.012 and p = 0.032, respectively). Taken together, the 8-week treatment of enzyme-treated Zizania latifolia ethanol extract demonstrated positive effects on liver-related outcomes, lipid metabolism, and mental fatigue without adverse effects on safety-related parameters.

Limited knowledge exists regarding gasoline and diesel exhaust effects on lipid metabolism. This study collected gasoline and diesel exhaust under actual driving conditions and conducted inhalation exposure on male young and middle-aged C57BL/6J mice for 4 h/day for 5 days to simulate commuting exposure intensity. Additionally, PM2.5 from actual roadways, representing gasoline and diesel vehicles, was generated for exposure to human umbilical vein endothelial cells (HUVECs) and normal liver cells (LO2) for 24, 48, and 72 h to further investigate exhaust particle toxicity. Results showed that diesel exhaust reduced total cholesterol and low-density lipoprotein cholesterol levels in young mice, indicating disrupted lipid metabolism. Aspartate aminotransferase and alanine aminotransferase levels increased by 53.7% and 21.7%, respectively, suggesting potential liver injury. Diesel exhaust exposure decreased superoxide dismutase and increased glutathione peroxidase levels. Cell viability decreased, and reactive oxygen species levels increased in HUVECs and LO2 following exposure to exhaust particles, with dose- and time-dependent effects. Diesel exhaust particles exhibited more severe inhibition of cell proliferation and oxidative damage compared to gasoline exhaust particles. These findings provide novel evidence of the risk of disrupted lipid metabolism due to gasoline and diesel exhaust, emphasizing the toxicity of diesel exhaust.

The aim of this experiment was to investigate the effects of dietary Phytosterol Ester (PSE) supplementation on egg characteristics, eggshell ultrastructure, antioxidant capacity, liver function, hepatic metabolites, and its mechanism of action in Hy-Line Brown laying hens during peak laying period. A total of 256 healthy Hy-Line Brown laying hens were randomly allocated into four groups. The hens in the control group were fed a basal diet, while those in the experimental groups were fed a basal diet further supplemented with 10, 20, and 40 mg/kg PSE, respectively. It was found that the addition of 20 mg/kg and 40 mg/kg PSE to the diets increased egg weight, but decreased egg breaking strength (p < 0.05). The addition of PSEs to the diets increased albumen height and Haugh unit in all experimental groups (p < 0.05). Electron microscopic observation revealed that the mammillary thickness increased significantly at doses of 20 and 40 mg/kg, but the total thickness decreased, and the effective thickness also thinned (p < 0.05). The mammillary width narrowed in all experimental groups (p < 0.001). Dietary supplementation with 40 mg/kg PSE significantly increased egg yolk Phenylalanine, Leucine, and Isoleucine levels (p < 0.05). In untargeted liver metabolomic analyses, L-Phenylalanine increased significantly in all experimental groups. Leucyl-Lysine, Glutamyl-Leucyl-Arginine, and L-Tryptophan increased significantly at doses of 10 and 20 mg/kg (p < 0.05), and L-Tyrosine increased significantly at doses of 10 and 40 mg/kg (p = 0.033). Aspartyl-Isoleucine also increased significantly at a dose of 10 mg/kg (p = 0.044). The concentration of total protein in the liver was significantly higher at doses of 20 and 40 mg/kg than that of the control group, and the concentrations of total cholesterol and low-density lipoprotein cholesterol were significantly reduced (p < 0.05). The concentration of triglyceride and alkaline phosphatase were significantly reduced in all experimental groups (p < 0.05). Steatosis and hemorrhage in the liver were also improved by observing the H&E-stained sections of the liver. Concerning the antioxidant capacity in the liver, malondialdehyde concentration was significantly reduced (p < 0.05) at a dose of 40 mg/kg. In the ovary, malondialdehyde and nitric oxide concentrations were significantly reduced (p < 0.001). In all the experimental groups, plasma nitric oxide concentration was significantly decreased while superoxide dismutase was significantly increased, and total antioxidant capacity concentration was significantly increased (p < 0.05) in the 10 mg/kg and 40 mg/kg doses. Metabolomics analyses revealed that PSEs play a role in promoting protein synthesis by promoting Aminoacyl-tRNA biosynthesis and amino acid metabolism, among other pathways. This study showed that the dietary addition of PSEs improved egg characteristics, antioxidant capacity, liver function, and symptoms of fatty liver hemorrhagic syndrome in Hy-Line Brown laying hens at peak laying stage. The changes in liver metabolism suggest that the mechanism of action may be related to pathways such as Aminoacyl-tRNA biosynthesis and amino acid metabolism. In conclusion, the present study demonstrated that PSEs are safe and effective dietary additives as an alternative to antibiotics.

Huntington’s disease (HD), a congenital neurodegenerative disorder, extends its pathological damages beyond the nervous system. The systematic manifestation of HD has been extensively described in numerous studies, including dysfunction in peripheral organs and peripheral inflammation. Gut dysbiosis and the gut–liver–brain axis have garnered greater emphasis in neurodegenerative research, and increased plasma levels of pro-inflammatory cytokines have been identified in HD patients and various in vivo models, correlating with disease progression. In the present study, we investigated hepatic pathological markers in the liver of R6/2 mice which convey exon 1 of the human mutant huntingtin gene. Furthermore, we evaluated the impact of intravenously administered Mesenchymal Stromal Cells (MSCs) on the liver enzymes, changes in hepatic inflammatory markers, as well as brain pathology and behavioral deficits in R6/2 mice. Our results revealed altered enzyme expression and increased levels of inflammatory mediators in the liver of R6/2 mice, which were significantly attenuated in the MSC-treated R6/2 mice. Remarkably, neuronal pathology and altered motor activities in the MSC-treated R6/2 mice were significantly ameliorated, despite the absence of MSCs in the postmortem brain. Our data highlight the importance of hepatic pathological changes in HD, providing a potential therapeutic approach. Moreover, the data open new perspectives for the search in blood biomarkers correlating with liver pathology in HD.

Liver function reserve (LFR) is the sum of remnant functional hepatic cells after liver injury. In the pathologic process of liver fibrosis (LF), LFR is impaired. LFR assessment can help determine the safe scope of liver resection or drug regimen and predict prognosis of patients with liver disease. Here, we used a photoacoustic imaging (PAI) system to assess LF and LFR in rabbit models. We performed PAI, ultrasound elastography and biopsy for 21 rabbits developing none (n = 6) and LF (n = 15). In vivo indocyanine green (ICG) measurements by PAI showed that LF group presented a significantly attenuated ICG clearance compared to control group, indicating LFR impairment of LF. Another finding was a significantly higher collagen photoacoustic signal intensity value was observed in LF both in vivo and in vitro. Our findings demonstrated that PAI was potentially effective to evaluate LFR and collagen accumulation of LF.

Background: Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver disorder worldwide. According to several previous studies, the treatment of patients with NAFLD using medicinal and food-homologous substances has consistent effects on the levels of blood lipids and blood glucose and liver function. Objective: This systematic review was conducted to investigate the impact of medicinal and food homologous substances on blood lipid and glucose levels as well as liver function in patients with NAFLD. Methods: A thorough search was conducted in eight databases, including China Science and Technology Journal Database (VIP), Chinese National Knowledge Infrastructure(CNKI), China Biomedical Literature Database (SinoMed), Wanfang Database, PubMed, Cochrane Library, Web of Science and Embase, for articles published from database inception until June 24, 2023. The methodological quality of the included studies was evaluated utilizing Cochrane Randomized Trial Risk Bias Tool, Edition 2 and GRADE methodology for assessment. Results: A total of 13 randomized controlled trials, involving 829 patients with NAFLD, were included in the analysis, these studies included a total of 9 medicinal and food homologous substances. In the 13 studies, hawthorn (2), sea buckthorn (1), ginger (2), turmeric (4) (1 with chicory seeds), cinnamon (1), cardamom (1), purslane (1) and saffron (1) were included. The results of the included studies showed that medicinal and food homologous substances could improve high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TGs), fasting blood glucose (FBG) and liver enzyme levels in patients with NAFLD to a certain extent, but the effect of turmeric on TC, liver enzyme levels is controversial. Conclusion: In patients with NAFLD, dietary intervention using medicinal and food homologous substances can ameliorate blood lipid and blood glucose levels and liver enzymes to some extent. In clinical work, medicinal and food homologous substances can be used to provide patients with NAFLD with a safe and effective dietary plan to help prevent and treat disease onset and progression. [ABSTRACT FROM AUTHOR]

(1) Background: This study aimed to correlate the indocyanine green clearance (ICG) test with histopathological grades of liver fibrosis and liver cirrhosis to assess its diagnostic accuracy in differentiating normal liver parenchyma from liver fibrosis and liver cirrhosis. (2) Methods: A total of 82 patients who received a histopathological liver examination, imaging, and ICG test within three months were included in this retrospective study. The histopathological level of fibrosis was graded using the Ishak scoring system, and the patients were divided into five categories: no liver fibrosis (NLF), mild liver fibrosis (MLF), advanced liver fibrosis (ALF), severe liver fibrosis (SLF), and liver cirrhosis (LC). The non-parametric Kruskal–Wallis test with post hoc pairwise comparison utilizing Mann–Whitney U tests and Bonferroni adjustment was used to analyze differences in the ICG test results between the patient groups. Cross correlation between the individual fibrosis/cirrhosis stages and the score of the ICG test was performed, and the sensitivity, specificity, and positive and negative predictive values were calculated for each model predicting liver fibrosis/cirrhosis. (3) Results: A significant difference (p ≤ 0.001) between stages of NLF, LF, and LC was found for the ICG parameters (ICG plasma disappearance rate (ICG-PDR) and ICG retention percentage at 15 min (ICG-R15)). The post hoc analysis revealed that NLF significantly differed from SLF (ICG-PDR: p = 0.001; ICG-R15: p = 0.001) and LC (ICG-PDR: p = 0.001; ICG-R15: p = 0.001). ALF also significantly differed from SLF (ICG-PDR: p = 0.033; ICG-R15: p = 0.034) and LC (ICG-PDR: p = 0.014; ICG-R15: p = 0.014). The sensitivity for detection of an initial stage of liver fibrosis compared to no liver fibrosis (Ishak  ≥  1) was 0.40; the corresponding specificity was 0.80. The differentiation of advanced liver fibrosis or cirrhosis (Ishak ≥ 4) compared to other stages of liver fibrosis was 0.75, with a specificity of 0.81. (4) Conclusions: This study shows that the ICG test, as a non-invasive diagnostic test, is able to differentiate patients with no liver fibrosis from patients with advanced liver fibrosis and liver cirrhosis. The ICG test seems to be helpful in monitoring patients with liver fibrosis regarding compensation levels, thus potentially enabling physicians to both detect progression from compensated liver fibrosis to advanced liver fibrosis and cirrhosis and to initiate antifibrotic treatment at an earlier stage. [ABSTRACT FROM AUTHOR]

Background: MBOAT7 rs641738 variant is a risk factor for nonalcoholic fatty liver disease (NAFLD) and liver fibrosis, but the relationship between this polymorphism and early liver dysfunction remains uncertain. Methods: Eighty outpatients underwent blood analyses, liver imaging by ultrasound and acoustic radiation force impulse shear wave elastography and were genotyped for MBOAT7 (wild‐type [WT], rs641738 heterozygous or homozygous) polymorphism using TaqMan assays. Results: NAFLD was confirmed in 53 patients. Portal uptake and hepatocyte microsomal metabolization of (13C)‐methacetin were explored by measuring 13CO2 appearance in exhaled air. The distribution of the MBOAT7 genotypes was comparable in subjects with or without NAFLD. The majority of subjects with or without NAFLD had fibrosis ≤ F1 but decreased portal extraction of (13C)‐methacetin, i.e. 78.6% in homozygous, 45.0% in heterozygous and 46.2% in WT for the MBOAT7 variant. Both substrate extraction and microsomal metabolization were mostly defective in the homozygous carriers. The extraction efficiency from portal blood flow was minimal in subjects with both homozygous rs641738 polymorphism and NAFLD, as compared to those with WT/heterozygous polymorphism, with or without NAFLD. Conclusions: The homozygous MBOAT7 rs641738 polymorphism per se is associated with a reduced extraction efficiency of (13C)‐methacetin from the portal flow pointing to subclinical liver dysfunction independently from liver fibrosis. Liver steatosis worsens (13C)‐methacetin extraction efficiency. We urge to better explore the mechanisms of interaction between external factors and multiple gene polymorphisms (including MBOAT7), paving the road to primary prevention and novel therapeutic strategies. [ABSTRACT FROM AUTHOR]

Dairy cows usually face negative energy balance and disorders of normal organ function due to a mismatch between energy intake and energy demand. Negative energy balance directly affects liver function and blood metabolites because the liver is used as source of energy supply and a center of metabolic activity. This study was aimed to determine the effect of pre-calving energy density and rumen-protected lysine on blood metabolites and biomarkers of liver functions in the dairy cows during the transition period. Forty 3rd lactation Holstein cows going to enter their 4th lactation were randomly allocated to one of the four dietary treatments (high energy with rumen-protected lysine (HERPL) = 1.53NEL plus 40 g Lys, high energy without lysine (HECK) = 1.53NEL, low energy with rumen-protected lysine (LERPL) = 1.37NEL plus 40 g Lys, and low energy without lysine (LECK) = 1.37NEL arranged in a 2 × 2 factorial design. Blood samples were collected during the transition period, and concentrations of blood metabolites and biomarkers of liver function were measured. Interaction between pre-calving high-energy diet and rumen-protected lysine tended to increase plasma albumin, numerically increased glucose, decreased triglyceride, total bilirubin, and aspartate aminotransferase concentrations. The result revealed that pre-calving high-energy density increased insulin, albumin and decreased blood urea nitrogen and total bilirubin concentrations and substantial favor liver functions during the transition period. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to explore the association of immune and liver functions' alteration in mycoplasma pneumoniae pneumonia (MPP) children with the therapeutic effect of andrographolide sulfonate's curative outcome. Methods: From January 2019 to April 2021, a group of 102 MPP child patients was divided into severe and mild cases in the light of the disease's severity, and involvement of 57 healthy child patients during the identical period was as the control. Comparison of immune function among three groups [immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM)] and liver function indexes [Alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (GGT)] was to analyze its association and assessment value for the illness's severity. Results: IgA and IgM in MPP child patients were declined with the illness's severity, while ALT, AST and GGT were elevated with it (p < 0.05). AUC of combined detection of immune and liver function indexes in assessing MPP's severity in children was augmented vs. each index's alone examination (p < 0.05). IgA was negatively associated with MPP's severity in children, while ALT, AST, and GGT were positively associated with it (p < 0.05). IgA in the effective was augmented vs. the noneffective, while ALT, AST, and GGT were declined vs. the noneffective (p < 0.05). Conclusions: The immune and liver functions of MPP child patients are associated with the illness's severity and provide an assessment value for the disease's severity and Andro-S's curative outcome. [ABSTRACT FROM AUTHOR]

Background: The benefits and harms of vitamin D supplementation in the treatment of COVID-19 have not yet been fully documented. In this study, we aimed to evaluate the effects of high-dose vitamin D supplementation on liver function tests in COVID-19. Method: This double-blinded randomized clinical trial was conducted on 140 hospitalized patients aged > 30 years. Patients were randomly allocated to receive either intervention group (n = 70 receiving 50,000 IU of vitamin D capsules orally as a single dose and then 10,000 IU syrup daily from the second day of admission for 30 days) and the control group (n = 70 receiving 1000 IU vitamin D syrup orally per day). Liver function tests (LFT), including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and Lactate Dehydrogenase (LDH) were evaluated at baseline and at the end of the intervention. Decision tree analysis was performed to identify the predictors for change in liver enzymes. Results: Among COVID-19 patients, a significant decrease was observed in serum level of ALP between intervention and placebo groups (p = 0.04). In addition, decision tree analysis revealed that GGT, temperature, serum magnesium level at baseline and gender were the most important predictors of ALT changes in COVID-19 patients. Conclusion: High-dose vitamin D supplementation improved ALP markers among COVID-19 patients. More randomized controlled trials with longer follow-up times will be required. [ABSTRACT FROM AUTHOR]

Introduction: Liver surgery leads to a high degree of heterogeneity in the prognosis of hepatocellular carcinoma (HCC) patients. However, most previous studies focused on the postoperative therapeutic effects of other treatments, with relatively few studies on the impacts on liver function. This study investigated the impact of transarterial chemoembolization (TACE) and hepatic artery infusion chemotherapy (HAIC) on liver function after HCC resection from various angles. Methods: 138 HCC patients were enrolled, including 27 patients who received TACE and 80 patients who received HAIC. Besides routine treatment such as liver protection and antiviral therapy, 31 patients received no other treatment. The different groups were compared with various biological parameters with four types of scoring methods. Results: In the short term after TACE, the mean (±SD) alanine transaminase and aspartate transaminase values increased by 79.22 ± 117.43 U/L and 66.33 ± 94.54 U/L, respectively (p < 0.01). The mean (±SD) total bilirubin (TBIL) values increased by 4.02 ± 6.08 μmol/L (p < 0.01). The mean (±SD) albumin (ALB) values decreased by 3.54 ± 2.93 g/L (p < 0.001). The mean (±SD) albumin bilirubin (ALBI) scores increased by 0.39 ± 0.22 (p < 0.001). In the short term after HAIC, the mean (±SD) TBIL values increased by 2.11 ± 5.57 μmol/L (p < 0.01). The mean (±SD) ALB values decreased by 2.52 ± 3.26 g/L (p < 0.001), and the mean (±SD) ALBI scores increased by 0.21 ± 0.42 (p < 0.001). In both treatment groups, the long-term liver function was not significantly different from that before treatment and also from that of the untreated group (p > 0.05). Conclusion: TACE after HCC resection has a significant impact on short-term liver function, whereas HAIC has a relatively small impact, but neither has a major impact on long-term liver function. [ABSTRACT FROM AUTHOR]

Aims: Both diet and exercise counseling are recommended for patients with fatty liver, including nonalcoholic fatty liver disease (NAFLD), to achieve weight loss goals. However, data evaluating treatment efficacy are limited. Methods: The subjects of this retrospective cohort study were 186 consecutive Japanese cases with fatty liver diagnosed by abdominal ultrasonography. Treatment efficacy and predictive factors of "Hospitalization Program for Improvement Purpose for Fatty Liver" as a combined diet and aerobic and resistance exercise program were evaluated according to the hospitalization group (153 cases) or the no hospitalization group (33 cases). To balance the confounding biases, treatment efficacy was evaluated using propensity score‐matched analysis. In the hospitalization group, a diet of 25–30 kcal/kg multiplied by ideal body weight (BW) daily and aerobic and resistance exercise (exercise intensity of 4–5 metabolic equivalents daily, respectively) were performed for 6 days. Results: In liver function tests and BW at 6 months compared with baseline, the rates of decrease of the hospitalization group (24 cases) were significantly higher than those of the no hospitalization group (24 cases), using propensity score‐matched analysis. In markers of glycolipid metabolism and ferritin levels, the rates of the hospitalization group were not different from those of the no hospitalization group. In the hospitalization group (153 cases), multivariate regression analysis identified the etiology of non‐NAFLD, the presence of diabetes mellitus, and large waist circumference as independent predictors of decreased rates of hemoglobin A1c levels. Conclusion: The diet and exercise program for fatty liver improved liver function tests and BW. Further study should be performed to develop a feasible and suitable program. [ABSTRACT FROM AUTHOR]

Plant protein ingredients are increasingly included in mullet feeds and are expected to be contaminated with mycotoxins (AFB1). Thus, this study investigated the protective role of Saccharomyces cerevisiae against oxidative stress and hepato-renal malfunction induced by AFB1 contamination in mullets. Four diets were formulated, where the first was kept as the control diet, and the second was supplemented with S. cerevisiae at 5 × 106 cells/g. The third diet was supplied with AFB1 at 1 mg/kg, and the fourth was supplemented with S. cerevisiae and AFB1. Mullet fed the control or both AFB1 and S. cerevisiae (yeast/ AFB1) had similar FBW, WG, SGR, and FCR (P˃0.05). Mullet treated with S. cerevisiae without AFB1 contamination showed the highest FBW, WG, and SGR (P<0.05), while fish in the AFB1 group had lower FBW, WG, and SGR and higher FCR than fish in the control and yeast/ AFB1 groups (P<0.05). Using yeast with AFB1 prevented pathological hazards and improved intestinal structure. Further, yeast combined with AFB1 reduced the degenerative changes and enhanced the histological structure except for a mild inflammatory reaction around the bile duct. Fish in the control or yeast/ AFB1 group had higher HB, PCV, RBCs, and WBCs than fish in the AFB1 group (P<0.05). Fish fed the control, or the yeast/ AFB1 diets had similar total protein and albumin levels with higher values than fish contaminated with AFB1 (P<0.05). Fish fed the control and yeast/ AFB1 diets had similar ALT, AST, urea, and creatinine levels (P˃0.05) and were lower than fish contaminated with AFB1. Additionally, fish fed the control and yeast/ AFB1 diets had similar CAT, GPx, SOD, and MDA (P˃0.05) and were lower than fish contaminated with AFB1 (P<0.05). In conclusion, incorporating S. cerevisiae ameliorated the negative impacts of AFB1 toxicity on mullets' growth, hepato-renal function, and antioxidative capacity. [ABSTRACT FROM AUTHOR]

The study was conducted on 65 samples, 40 samples from patients with corona virus infection and 30 samples from the control group and their ages ranged between (35-55) years and the samples were collected for one year and the samples were collected from Samarra General Hospital(isolation unit), outpatient medical clinics, as well as centers for sonar and spiral units from the period. After that, blood was collected from patients and healthy people and separated by centrifugation. The Variables were measured, including (CRP, AST, ALT, ALP). The results of the current research showed a significant elevated in each of the levels (CRP, AST, ALT,ALP), in the patients with COVID-19 compered a control. [ABSTRACT FROM AUTHOR]

Plant protein ingredients are increasingly included in mullet feeds and are expected to be contaminated with mycotoxins (AFB1). Thus, this study investigated the protective role of Saccharomyces cerevisiae against oxidative stress and hepato-renal malfunction induced by AFB1 contamination in mullets. Four diets were formulated, where the first was kept as the control diet, and the second was supplemented with S. cerevisiae at 5 × 106 cells/g. The third diet was supplied with AFB1 at 1 mg/kg, and the fourth was supplemented with S. cerevisiae and AFB1. Mullet fed the control or both AFB1 and S. cerevisiae (yeast/ AFB1) had similar FBW, WG, SGR, and FCR (P˃0.05). Mullet treated with S. cerevisiae without AFB1 contamination showed the highest FBW, WG, and SGR (P<0.05), while fish in the AFB1 group had lower FBW, WG, and SGR and higher FCR than fish in the control and yeast/ AFB1 groups (P<0.05). Using yeast with AFB1 prevented pathological hazards and improved intestinal structure. Further, yeast combined with AFB1 reduced the degenerative changes and enhanced the histological structure except for a mild inflammatory reaction around the bile duct. Fish in the control or yeast/ AFB1 group had higher HB, PCV, RBCs, and WBCs than fish in the AFB1 group (P<0.05). Fish fed the control, or the yeast/ AFB1 diets had similar total protein and albumin levels with higher values than fish contaminated with AFB1 (P<0.05). Fish fed the control and yeast/ AFB1 diets had similar ALT, AST, urea, and creatinine levels (P˃0.05) and were lower than fish contaminated with AFB1. Additionally, fish fed the control and yeast/ AFB1 diets had similar CAT, GPx, SOD, and MDA (P˃0.05) and were lower than fish contaminated with AFB1 (P<0.05). In conclusion, incorporating S. cerevisiae ameliorated the negative impacts of AFB1 toxicity on mullets' growth, hepato-renal function, and antioxidative capacity. [ABSTRACT FROM AUTHOR]

Hepatic dysfunction is commonly observed in subjects with hyperthyroidism. Hepassocin is a hepatokine playing an important role in metabolic diseases and exhibiting a hepatic protective effect. Nevertheless, the relationship between hepassocin and hyperthyroidism was still unknown. In the present study, a total of 36 subjects with Graves' disease were enrolled, and we found that the alanine aminotransferase (ALT) levels were significantly decreased in parallel with the decrement in serum hepassocin concentrations at 6 months after standard treatment for hyperthyroidism. In addition, HepG2 cell line was used to investigate the role of hepassocin in hyperthyroidism-induced hepatic dysfunction. Treatment of hepassocin recombinant protein in HepG2 cells dose-dependently decreased triiodothyronine (T3)-induced ALT and aspartate aminotransferase (AST) elevation. Moreover, hepassocin significantly increased the expression of phosphoenolpyruvate carboxykinase (PEPCK) in a dose-dependent manner. Deletion of hepassocin in HepG2 cells reversed the effects of T3 on PEPCK expressions. Furthermore, we found that T3 increased the expression of hepassocin through a hepatocyte nuclear factor 1α-dependent pathway. Taken together, these results indicated a compensatory increase in serum hepassocin might have a protective role in hyperthyroidism-induced hepatic dysfunction. [ABSTRACT FROM AUTHOR]

The potential mechanisms underlying the association between copper (Cu) exposure and impaired liver function are unclear. This study aimed to investigate the potential associations of dietary Cu intake and plasma Cu levels with liver function biomarkers. A cross-sectional study was performed to assess liver function biomarkers—namely, levels of total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), alanine transaminase (ALT), and aspartate transaminase (AST)—in 2376 subjects in Guangxi, China. Dietary Cu intake was determined from a food frequency questionnaire containing 109 common foods. Plasma Cu concentrations were determined by inductively coupled plasma‒mass spectrometry. Multiple linear regression and multivariate restricted cubic splines (RCS) were used to evaluate the correlations of plasma Cu levels and dietary Cu levels with liver function biomarkers. The covariate-adjusted results of the linear regression analysis showed that plasma Cu levels were significantly negatively correlated with serum IBIL (β = − 0.37), DBIL (β = − 0.22), and TBIL levels (β = − 0.32) (all p < 0.05), and dietary Cu was negatively correlated with serum AST levels (β = − 0.12, p < 0.05). The RCS analysis further indicated a negative linear relationship between dietary Cu levels and AST levels. In summary, our results suggested that the plasma Cu level is associated with serum bilirubin levels and that dietary Cu intake is associated with serum AST levels. Further studies are needed to validate these associations and elucidate the underlying mechanisms. [ABSTRACT FROM AUTHOR]

This study evaluated the comparative hepatoprotective property of Vernonia amygdalina leaf solvent extracts: (aqueous (AQE), ethanol (ETH), methanol (METH), toluene (TOL), and benzene (BENZ) in alloxan-induced diabetic rats. The study consisted of forty Wistar albino rats segregated into eight groups of five rats each (n=5); the negative control (NC), diabetic control (DC), and standard (STD) were designated Group 1, Group 2, and Group 8 respectively. Groups 3-8 designated as AQE, ETH, METH, TOL, BENZ, and STD respectively were induced with 120 mgKg-1 body weight alloxan. After induction, hyperglycemic rats were treated with 250 mgKg-1 body weight V. amygdalina leaf aqueous, ethanol, methanol, toluene, benzene extract, and metformin 200 mg/Kg b. wt. via intubation for 14 days. At the end of the 14 days administration, serum enzyme activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) activity, total bilirubin concentration, and histopathology of liver tissues were examined using standard methods. The result indicated a consistent increase in body weight among diabetic rats within the study period; except for the benzene extract treated group. ALT, AST, and ALP activity in the groups receiving aqueous extract, ethanol, toluene, and benzene extract was significantly (p<0.05) reduced compared to the diabetic control group. Histopathological examination results indicate a reversal of degeneration of the liver tissues by methanolic and ethanolic extract treatment. The overall results showed that the methanol extract presented stronger protection against diabetes-induced hepatic damage in rats compared to the other solvent extracts. [ABSTRACT FROM AUTHOR]

Most studies have focused on the pulmonary toxicity of inhaled PAHs to date; therefore, their hepatotoxic consequences are yet unknown. The main aim of this study is to examine the association between urinary polycyclic aromatic hydrocarbons (PAHs) and liver function parameters among the US population. The data included in this study were from the National Health and Nutritional Examination Survey (NHANES) 2003–2016. Finally, we included 2515 participants from seven cycles of the NHANES. Logistic regression was performed to calculate the association between each PAH and liver function parameters (elevated vs. normal) with odds ratio (OR) and 95% confidence intervals (CIs), along with adjustment for confounding variables. P < 0.05 was considered to indicate a statistically significant difference. All analyses were performed using R software 4.0.1. In the present study, all 2515 individuals were aged ≥ 18 years, 1211 males, and 1304 females. The average age normal was 45.56 ± 20.20, and the elevated was 46.04 ± 19.73 years, respectively. The results of logistic regression indicated that increased 9-hydroxyfluorene (OR = 2.11, 95% CI = [1.52, 2.95], P < 0.001), 2-hydroxyfluorene (OR = 1.61, 95% CI = [1.23, 2.11], P < 0.001), and 3-hydroxyfluorene (OR = 1.54, 95% CI = [1.21, 1.95], P < 0.001) were associated with elevated GGT. In conclusion, 9-hydroxyfluorene is associated with elevated GGT level, and the effect of 9-hydroxyfluorene on GGT is modified by other PAHs, which means that 9-hydroxyfluorene has a greater influence on GGT when other PAHs are increased. [ABSTRACT FROM AUTHOR]

Background: Liver-to-spleen signal intensity ratio (LSR) is evaluated by magnetic resonance imaging (MRI) in the hepatobiliary phase and has been reported as a useful radiological assessment of regional liver function. However, LSR is a passive (non-time-associated) assessment of liver function, not a dynamic (time-associated) assessment. Moreover, LSR shows limitations such as a dose bias of contrast medium and a timing bias of imaging. Previous studies have reported the advantages of time-associated liver functional assessment as a precise assessment of liver function. For instance, the indocyanine green (ICG) disappearance rate, which is calculated from serum ICG concentrations at multiple time points, reflects a precise preoperative liver function for predicting post-hepatectomy liver failure without the dose bias of ICG or the timing bias of blood sampling. The aim of this study was to develop a novel time-associated radiological liver functional assessment and verify its correlation with traditional liver functional parameters. Methods: A total of 279 pancreatic cancer patients were evaluated to clarify fundamental time-associated changes to LSR in normal liver. We defined the time-associated radiological assessment of liver function, calculated using information on LSR from four time points, as the "LSR increasing rate" (LSRi). We then investigated correlations between LSRi and previous liver functional parameters. Furthermore, we evaluated how timing bias and protocol bias affect LSRi. Results: Significant correlations were observed between LSRi and previous liver functional parameters such as total bilirubin, Child-Pugh grade, and albumin-bilirubin grade (P < 0.001 each). Moreover, considerably high correlations were observed between LSRi calculated using four time points and that calculated using three time points (r > 0.973 each), indicating that the timing bias of imaging was minimal. Conclusions: This study propose a novel time-associated radiological assessment, and revealed that the LSRi correlated significantly with traditional liver functional parameters. Changes in LSR over time may provide a superior preoperative assessment of regional liver function that is better for predicting post-hepatectomy liver failure than LSR using the hepatobiliary phase alone. [ABSTRACT FROM AUTHOR]

Simple Summary: The liver function reserve of patients with hepatocellular carcinoma (HCC) is heterogeneous. The preoperative accurate evaluation of liver function has a vital role in the prevention of unfavorable postoperative complications such as post-hepatectomy liver failure. In this study, unsupervised clustering analysis of radiomics features extracted from preoperative gadoxetic-acid-enhanced MRIs was performed for liver function stratification on 276 HCC patients. Two distinct subgroups were identified (i.e., subgroups 1 and 2). Subgroup 2 had impaired liver function as presented by older age, more albumin–bilirubin grades 2 and 3, and a higher indocyanine green retention rate than that of subgroup 1 (all p < 0.05). Compared with subgroup 1, subgroup 2 was associated with a higher risk of postoperative liver failure, postoperative complications, and longer hospital stays (all p < 0.05). Our findings indicate the potential for the use of radiomics features based on preoperative gadoxetic-acid-enhanced MRI for noninvasive liver function assessment in HCC patients. Objective: To identify subgroups of patients with hepatocellular carcinoma (HCC) with different liver function reserves using an unsupervised machine-learning approach on the radiomics features from preoperative gadoxetic-acid-enhanced MRIs and to evaluate their association with the risk of post-hepatectomy liver failure (PHLF). Methods: Clinical data from 276 consecutive HCC patients who underwent liver resections between January 2017 and March 2019 were retrospectively collected. Radiomics features were extracted from the non-tumorous liver tissue at the gadoxetic-acid-enhanced hepatobiliary phase MRI. The reproducible and non-redundant features were selected for consensus clustering analysis to detect distinct subgroups. After that, clinical variables were compared between the identified subgroups to evaluate the clustering efficacy. The liver function reserve of the subgroups was compared and the correlations between the subgroups and PHLF, postoperative complications, and length of hospital stay were evaluated. Results: A total of 107 radiomics features were extracted and 37 were selected for unsupervised clustering analysis, which identified two distinct subgroups (138 patients in each subgroup). Compared with subgroup 1, subgroup 2 had significantly more patients with older age, albumin–bilirubin grades 2 and 3, a higher indocyanine green retention rate, and a lower indocyanine green plasma disappearance rate (all p < 0.05). Subgroup 2 was also associated with a higher risk of PHLF, postoperative complications, and longer hospital stays (>18 days) than that of subgroup 1, with an odds ratio of 2.83 (95% CI: 1.58–5.23), 2.41(95% CI: 1.15–5.35), and 2.14 (95% CI: 1.32–3.47), respectively. The odds ratio of our method was similar to the albumin–bilirubin grade for postoperative complications and length of hospital stay (2.41 vs. 2.29 and 2.14 vs. 2.16, respectively), but was inferior for PHLF (2.83 vs. 4.55). Conclusions: Based on the radiomics features of gadoxetic-acid-enhanced MRI, unsupervised clustering analysis identified two distinct subgroups with different liver function reserves and risks of PHLF in HCC patients. Future studies are required to validate our findings. [ABSTRACT FROM AUTHOR]

Background: Dexmedetomidine (DEX), an adjuvant anesthetic, may improve the clinical outcomes of liver transplantation (LT). Methods: Wesummarized the relevant clinical trials of DEX in patients undergoing LT. As of 30 January 2023, we searched The Cochrane Library, MEDLINE, EMBASE, Clinical Trial.gov and the WHO ICTRP. The main outcomes were postoperative liver and renal function. The random effect model or fixed effect model was used to summarize the outcomes across centers based on the differences in heterogeneity. Results: The meta-analysis included nine studies in total. Compared with the control group, the DEX group had a reduced warm ischemia time (MD-4.39; 95% CI-6.74-2.05), improved postoperative liver (peak aspartate transferase: MD-75.77, 95% CI-112.81-38.73; peak alanine transferase: MD-133.51, 95% CI-235.57-31.45) and renal function (peak creatinine: MD-8.35, 95% CI-14.89-1.80), and a reduced risk of moderate-to-extreme liver ischemia-reperfusion injury (OR 0.28, 95% CI 0.14-0.60). Finally, the hospital stay of these patientswas decreased (MD-2.28, 95%CI-4.00-0.56). Subgroup analysis of prospective studies showed that DEX may have better efficacy in living donors and adult recipients. Conclusion: DEX can improve short-term clinical outcomes and shorten the hospital stay of patients. However, the long-term efficacy of DEX and its interfering factors deserves further study. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the value of MRI T1 mapping with Gd-EOB-DTPA for assessing liver function. Methods: Seventy-two patients who underwent Gd-EOB-DTPA-enhanced MRI for focal liver lesions at Beijing Friendship Hospital from August 2020 to March 2022 were prospectively enrolled, and variable-flip-angle T1 mapping was performed before and 20 min after enhancement. The Child–Pugh (C-P) score and albumin-bilirubin (ALBI) grade of liver function were assessed using the clinical data of the patients. Correlation analysis was used to evaluate the correlation between T1 mapping parameters and liver function grading and laboratory tests. Nonparametric tests were used to compare the differences among different liver function groups. The liver function classification efficiency of each image index was evaluated with receiver operating characteristic (ROC) curves. Results: T1post was positively correlated with the C-P grade and the ALBI grade (r = 0.717 and r = 0.652). ΔT1 was negatively correlated with the C-P grade and the ALBI grade (r = -0.790 and r = -0.658). T1post and ΔT1 significantly differed among different liver function grades (p < 0.05). For the C-P grade, T1post and ΔT1 were significantly different between each pair of groups (p < 0.05), and ΔT1 had a better diagnostic efficiency than T1post. For the ALBI grade, ΔT1 and T1post were significantly different between the NLF and ALBI1 groups (p < 0.05), and ΔT1 had a better diagnostic efficacy than T1post. T1post significantly differed between the ALBI1 and ALBI2 + 3 groups (p < 0.05), while ΔT1 had a weak ability to differentiate between these two groups. Conclusion: T1post and ΔT1 were strongly correlated with the two liver function grades and can be noninvasive imaging indexes for evaluating liver function. [ABSTRACT FROM AUTHOR]

Policosanol consumption has been associated with treating blood pressure and dyslipidemia by increasing the level of high-density lipoproteins-cholesterol (HDL-C) and HDL functionality. Although policosanol supplementation also ameliorated liver function in animal models, it has not been reported in a human clinical study, particularly with a 20 mg doage of policosanol. In the current study, twelve-week consumption of Cuban policosanol (Raydel®) significantly enhanced the hepatic functions, showing remarkable decreases in hepatic enzymes, blood urea nitrogen, and glycated hemoglobin. From the human trial with Japanese participants, the policosanol group (n = 26, male 13/female 13) showed a remarkable decrease in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) from baseline up to 21% (p = 0.041) and 8.7% (p = 0.017), respectively. In contrast, the placebo group (n = 26, male 13/female 13) showed almost no change or slight elevation. The policosanol group showed a 16% decrease in γ-glutamyl transferase (γ-GTP) at week 12 from the baseline (p = 0.015), while the placebo group showed a 1.2% increase. The policosanol group exhibited significantly lower serum alkaline phosphatase (ALP) levels at week 8 (p = 0.012), week 12 (p = 0.012), and after 4-weeks (p = 0.006) compared to those of the placebo group. After 12 weeks of policosanol consumption, the ferric ion reduction ability and paraoxonase of serum were elevated by 37% (p < 0.001) and 29% (p = 0.004) higher than week 0, while placebo consumption showed no notable changes. Interestingly, glycated hemoglobin (HbA1c) in serum was lowered significantly in the policosanol group 4 weeks after consumption, which was approximately 2.1% (p = 0.004) lower than the placebo group. In addition, blood urea nitrogen (BUN) and uric acid levels were significantly lower in the policosanol group after 4 weeks: 14% lower (p = 0.002) and 4% lower (p = 0.048) than those of the placebo group, respectively. Repeated measures of ANOVA showed that the policosanol group had remarkable decreases in AST (p = 0.041), ALT (p = 0.008), γ-GTP (p = 0.016), ALP (p = 0.003), HbA1c (p = 0.010), BUN (p = 0.030), and SBP (p = 0.011) from the changes in the placebo group in point of time and group interaction. In conclusion, 12 weeks of 20 mg consumption of policosanol significantly enhanced hepatic protection by lowering the serum AST, ALT, ALP, and γ-GTP via a decrease in glycated hemoglobin, uric acid, and BUN with an elevation of serum antioxidant abilities. These results suggest that improvements in blood pressure by consumption of 20 mg of policosanol (Raydel®) were accompanied by protection of liver function and enhanced kidney function. [ABSTRACT FROM AUTHOR]

Simple Summary: The combination of atezolizumab plus bevacizumab (Atz/Bev) is now widely used in clinical practice as a first-line treatment for patients with advanced hepatocellular carcinoma (HCC). However, the established regimen for post-treatment after Atz/Bev is unknown. We investigated the efficacy and safety of cabozantinib in patients previously treated with Atz/Bev in real clinical practice, with a focus on whether patients met criteria of Child–Pugh Class A and Eastern Cooperative Oncology Group performance status (ECOG-PS) score 0/1 at baseline. Our results suggest that cabozantinib in patients with advanced HCC previously treated with Atz/Bev can be expected to yield similar outcomes to those seen in the CELESTIAL trial conducted using cabozantinib for post-sorafenib treatment if patients have good liver function and are in good general condition. (1) Background: This study aimed to investigate clinical outcomes for cabozantinib in clinical practice in patients with advanced hepatocellular carcinoma (HCC) previously treated with atezolizumab plus bevacizumab (Atz/Bev), with a focus on whether patients met criteria of Child–Pugh Class A and Eastern Cooperative Oncology Group performance status (ECOG-PS) score 0/1 at baseline. (2) Methods: Eleven patients (57.9%) met the criteria of both Child–Pugh class A and ECOG-PS score 0/1 (CP-A+PS-0/1 group) and eight patients (42.1%) did not (Non-CP-A+PS-0/1 group); efficacy and safety were retrospectively evaluated. (3) Results: Disease control rate was significantly higher in the CP-A+PS-0/1 group (81.1%) than in the non-CP-A+PS-0/1 group (12.5%). Median progression-free survival, overall survival and duration of cabozantinib treatment were significantly longer in the CP-A+PS-0/1 group (3.9 months, 13.4 months, and 8.3 months, respectively) than in the Non-CP-A+PS-0/1 group (1.2 months, 1.7 months, and 0.8 months, respectively). Median daily dose of cabozantinib was significantly higher in the CP-A+PS-0/1 group (22.9 mg/day) than in the non-CP-A+PS-0/1 group (16.9 mg/day). (4) Conclusions: Cabozantinib in patients previously treated with Atz/Bev has potential therapeutic efficacy and safety if patients have good liver function (Child–Pugh A) and are in good general condition (ECOG-PS 0/1). [ABSTRACT FROM AUTHOR]

To decrease the climbing rate of alcoholic liver disease, the protective effect in subacute alcoholic liver injury of newly isolated Lactiplantibacillus pentosus CQZC01 has been investigated. Lactiplantibacillus pentosus CQZC01 (1 × 109 CFU/kgbw) administered orally could keep weight of mice at 30.54 ± 1.15 g; alleviate alcoholic damage on hepatic morphology; decrease the activities of hyaluronidase (147 ± 19 U/L), procollagen III (4.82 ± 0.54 ng/mL), alanine transaminase (10.66 ± 2.32 U/L), and aspartate aminotransferase (15.18 ± 1.98 U/L); enhance the activities of alcohol dehydrogenase (65.15 ± 3.2 U/mgprot), aldehyde dehydrogenase (16.50 ± 0.96 U/mgprot), superoxide dismutase (623 ± 39 U/mgprot), and glutathione (19.54 ± 2.46 µmol/gprot); and decrease liver total cholesterol (3.59 ± 0.50 mmol/gprot) and triglyceride (0.88 ± 0.24 mmol/gprot) (p < 0.05). Moreover, L. pentosus CQZC01 elevated the level of interleukin‐10 (IL‐10; 807 ± 44 pg/mL) but significantly decreased the levels of IL‐1β (29.75 ± 5.27pg/mL), IL‐6 (58 ± 8 pg/mL), and tumor necrosis factor‐α (TNF‐α, 564 ± 13 pg/mL). Liver malondialdehyde was also significantly decreased by treatment with L. pentosus CQZC01 from 3.61 ± 0.14 to 2.03 ± 0.49 nmol/mgprot. The relative expression of C‐Jun N‐terminal kinase, extracellular regulated protein kinases, and cyclooxygenase‐1 was downregulated, and the SOD1, SOD2, peroxisome proliferator‐activated receptor‐α, glutathione peroxidase, catalase, nuclear factor erythroid‐2‐related factor 2, heme oxygenase‐1 and nicotinamide adenine dinucleotide phosphate were upregulated by L. pentosus CQZC01. The overall protective effect of L. pentosus CQZC01 was comparable to commercial Lactobacillus delbrueckii subsp. Bulgaricus. Lactobacillus pentosus CQZC01 might be a suitable hepatoprotective measure for people who frequently ingest alcoholic drinks. Practical Application: L. pentosus CQZC01 can alleviate subacute alcoholic liver injury by raising the antioxidant status and upregulating the antioxidant‐related genes. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate the factors associated with improvement of liver functional reserve after sustained virological response using interferon‐free, direct‐acting antiviral combination treatment in patients with compensated, severe fibrosis. Methods: Between September 2014 and April 2020, 492 patients received direct‐acting antiviral combination treatment in our hospital. Among them, 173 patients who had severe fibrosis based on a fibrosis‐4 index ≥3.25, showed sustained virological response after treatment. We investigated the dynamic change in albumin‐bilirubin score and the baseline factors associated with its improvement, 48 weeks after treatment. Results: The baseline significant factors associated with albumin‐bilirubin ≦ −0.5 were lower albumin (HR: 15.625, 95% CI: 4.273–58.824, P <.001), higher hepatitis C virus RNA (HR: 4.995, 95% CI: 1.882–13.260, P =.001), and higher alpha‐fetoprotein (HR: 1.033, 95% CI: 1.011–1.055, P =.003). Patients with alpha‐fetoprotein ≧10 ng/mL showed significant improvement of albumin‐bilirubin score from baseline to 48 weeks after treatment compared to those with alpha‐fetoprotein <10 ng/mL (P <.001). Conclusions: Baseline serum alpha‐fetoprotein might be a predictive factor for improvement of liver function after sustained virological response in patients with severe fibrosis. [ABSTRACT FROM AUTHOR]

Sheng-En Chou,1 Cheng-Shyuan Rau,2 Wei-Ti Su,1 Ching-Hua Tsai,1 Shiun-Yuan Hsu,1 Ching-Hua Hsieh1 1Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 2Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanCorrespondence: Ching-Hua Hsieh, Tel +886-7-7327476, Email m93chinghua@gmail.comIntroduction: The albumin-bilirubin (ALBI) grade objectively assesses liver function with better performance than the Child-Pugh and end-stage liver disease scores. However, the evidence is lacking on the ALBI grade in trauma cases. This study aimed to identify the association between the ALBI grade and mortality outcomes in trauma patients with liver injury.Methods: Data from 259 patients with traumatic liver injury at a level I trauma center between January 1, 2009, and December 31, 2021 were retrospectively analyzed. Independent risk factors for predicting mortality were identified using multiple logistic regression analysis. Participants were characterized by ALBI score into grade 1 (≤ − 2.60, n = 50), grade 2 (− 2.60 < and ≤ − 1.39, n = 180), and grade 3 (> − 1.39, n = 29).Results: Compared to survival (n = 239), death (n = 20) was associated with a significantly lower ALBI score (2.8± 0.4 vs 3.4± 0.7, p < 0.001). The ALBI score was a significant independent risk factor for mortality (OR, 2.79; 95% CI, 1.27– 8.05; p = 0.038). Compared with grade 1 patients, grade 3 patients had a significantly higher mortality rate (24.1% vs 0.0%, p < 0.001) and a longer hospital stay (37.5 days vs 13.5 days, p < 0.001).Discussion: This study showed that ALBI grade is a significant independent risk factor and an useful clinical tool to discover liver injury patients who are more susceptible to death.Keywords: trauma, liver injury, mortality, albumin-bilirubin grade, ALBI grade, liver function

Abstract Metabolism, is a complex process involving the gut and the liver tissue, is difficult to be reproduced in vitro with conventional single cell culture systems. To tackle this challenge, we developed a gut-liver-axis chip consisting of the gut epithelial cell chamber and three-dimensional (3D) uniform-sized liver spheroid chamber. Two cell culture chamber compartments were separated with a porous membrane to prevent microorganisms from passing through the chamber. When the hepG2 spheroids cultured with microbiota-derived metabolites, we observed the changes in the physiological function of hepG2 spheroids, showing that the albumin and urea secretion activity of liver spheroids was significantly enhanced. Additionally, the functional validation of hepG2 spheroids treated with microbiota-derived exosome was evaluated that the treatment of the microbiota-derived exosome significantly enhanced albumin and urea in hepG2 spheroids in a gut-liver axis chip. Therefore, this gut-liver axis chip could be a potentially powerful co-culture platform to study the interaction of microbiota and host cells. Graphical Abstract

Abstract Background Phthalate exposure is ubiquitous due to the widespread use of plastic products in daily life, and affects several health outcomes, including metabolic diseases. In this study, we evaluated the effects of phthalate exposure in childhood on liver function in adolescence. Methods Among 164 Ewha Birth and Growth Cohort Study participants followed up during two exposure periods (when the children were aged 3–5 and 7–9 years), 126 were followed up at age 10–15 years. To investigate the relationship between phthalate exposure during the two periods and liver enzyme levels (ALT, AST, γ-GTP) in adolescence, differences between groups and the dose–response relationship were analyzed. In addition, we investigated differences in liver enzymes between groups based on the combined exposure levels (high or low) during the two periods. The interaction effect between phthalates and BMI on liver enzyme levels was evaluated, stratified by sex. Results In the 3–5 year-old exposure period, ALT levels tended to increase as MECPP levels increased, while γ-GTP levels tended to increase as MiBP, MnBP, and ∑DBP levels increased. In addition, the group exposed to consistently high levels of phthalates at both time points had higher liver enzyme levels compared to the group that had lower exposure. In particular, the interaction effect between some phthalate metabolites and BMI in 3–5 year olds affected AST and γ-GTP levels in adolescence only in girls. Conclusions Exposure to phthalates in daily life during childhood affects liver enzyme levels in adolescence. Elevated liver enzyme levels are associated with the development of metabolic syndrome, implying that attention should be paid to phthalate exposure during childhood.

Abstract Background Pre-eclampsia (PE) is a pregnancy disorder that is related to an enhanced immune response. Immune cell characteristics such as neutrophil or monocyte to lymphocyte ratios (NLR, MLR) are known to be related to kidney and liver dysfunction in hypertensive patients. Here, we aimed to analyze the correlations between NLR, MLR and platelet to lymphocyte ratio (PLR) and liver, renal and coagulation functional parameters and the impacts of these immune cell profiles to the prognostic significance in PE patients. Methods Pre-delivery hematological and biochemical parameters of 320 first-time pregnant women registered at the Obstetrics Department of Yanbian University Hospital from 2016 to 2019 were analyzed retrospectively. Patients were divided into normal pregnancy (normal, n = 161), mild PE (mPE, n = 28) and severe PE (sPE, n = 131) groups according to diagnostic criteria. Pearson correlation analysis were performed and area under the curve (AUC) were conducted for the diagnostic values of NLR, MLR and PLR. Results were validated with data from the Department of Obstetrics and Gynecology of Seoul National University Hospital (SNUH). Results Kidney functional indexes were adversative in mPE and sPE and liver and coagulation indexes were worse in sPE compared to normal groups. Among immune cells, lymphocytes were increased in mPE and sPE patients, resulted in reduced NLR, MLR and PLR in PE groups, more significant difference were shown in sPE. NLR and PLR were associated with CREA and/or BUN negatively and positive associations were observed with total protein (TP) and albumin (ALB) in sPE. Only NLR showed positive associations with coagulation indexes (PT and APTT) in sPE. AUC analysis for NLR, MLR and PLR were 0.700, 0.656, 0.643, respectively, and NLR

Multicenter case series has reported patients with hepatic injury following COVID-19 vaccination, which raised concern for the possibility of vaccine-induced liver dysfunction. We aimed to assess the impact of COVID-19 vaccination on liver function of pregnant women, who may be uniquely susceptible to vaccine-induced liver dysfunction. We conducted a retrospective cohort study at a tertiary hospital in Shanghai, China. Vaccine administration was obtained from the electronic vaccination record. Serum levels of alanine transaminase (ALT), aspartate transaminase (AST), total bile acid (TBA) and total bilirubin (TBIL) in early pregnancy were determined by enzymatic methods. Among the 7745 included pregnant women, 3832 (49.5%) received at least two doses of an inactivated vaccine. COVID-19 vaccination was significantly associated with higher levels of maternal serum TBA. Compared with unvaccinated pregnant women, the mean TBA levels increased by 0.17 μmol/L (β = 0.17, 95% CI, 0.04, 0.31) for women who had been vaccinated within 3 months before the date of conception. Moreover, COVID-19 vaccination was significantly associated with an increased risk of maternal hyperbileacidemia. The risk of hyperbileacidemia increased by 113% (RR = 2.13; 95% CI, 1.17-3.87) for pregnant women who had been vaccinated within 3 months before conception compared with unvaccinated pregnant women. However, when the interval from complete vaccination to conception was prolonged to more than 3 months, COVID-19 vaccination was not associated with serum TBA levels or maternal hyperbileacidemia. Our findings suggest that vaccination with inactivated COVID-19 vaccines more than 3 months before conception have no detrimental effects on maternal liver function in early pregnancy.

Alcoholic liver disease (ALD) has been a growing concern in developed and developing nations. Oxidative stress and lipid peroxidation are the most common cause of the development and progression of ALD. Due to paucity in the number and efficacy of hepatoprotective drugs currently available, and with the easy availability of natural therapy and herbal medicines, ALD is managed using a combination of pharmaceutical interventions and herbal medications. However, the effectiveness of these hepatoprotectives is controversial. Preclinical and clinical studies have demonstrated that Liv.52 modulates the lipotropic activity of hepatocytes, reduces inflammation, enhances alcohol and acetaldehyde metabolism, and protects the hepatic parenchyma by restoring the antioxidant levels of hepatocytes. Clinical studies further support that there is improvement in the subjective symptoms of patients as well as improvements in liver function test parameters. Studies suggest that Liv.52 is well tolerated and has no reported side effects.

Purpose: To evaluate the dynamic changes in liver function after transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with cirrhosis and to explore its association with clinical outcomes. Methods: This retrospective study included patients who underwent TIPS between August 2016 and December 2020. Liver function was primarily evaluated using the model for end-stage liver disease (MELD) score, which was analyzed at baseline, 1 week, 1 month, 3 months, 6 months, and 12 months using one-way repeated measures ANOVA. The Kaplan-Meier method, log-rank test, and multivariate analysis were used as appropriate. Results: In total, 235 patients were included in this study. The MELD score was significantly higher at 1 week (11.8 ​± ​3.1 vs 13.5 ​± ​3.5, p ​ ​0.05). At 12 months, the MELD score was higher than the baseline level (11.8 ​± ​3.1 vs 12.4 ​± ​3.2, p ​

Abstract Background Portal hypertensive gastropathy (PHG) is often underestimated in clinical diagnosis. Gastrointestinal bleeding in cirrhosis of PHG accounts for approximately 10% of upper gastrointestinal bleeding. However, the relationship between PHG and gender, laboratory parameters, liver function and varices is still controversial. In the present study, we aimed to retrospectively evaluate the incidence of PHG and to explore the relationship between PHG and gender, laboratory parameters, liver function and varicose veins. Methods A retrospective analysis of 325 patients with cirrhosis who underwent esophagogastroduodenoscopy (EGD) in the Department of Gastroenterology of the Second Hospital of Hebei Medical University from 1 January 2018 to 31 December 2020 was performed. The relationships among age, gender, laboratory parameters, Child–Pugh stage, oesophageal varices (EV), gastric varices (GV) and ascites with PHG were analysed with univariate and multivariate logistic regression. Results The occurrence of PHG was significantly associated with gender, haemoglobin, platelet count, prothrombin time, albumin, Child–Pugh stage, EV, GV and ascites (P

Obesity is a major public health problem in developing countries and is a significant risk factor for metabolic disorders. Microalgae Scenedesmus dimorphus (S. dimorphus) contains bioactive compounds such as pigment function as antioxidants, and omega-3 and omega-6 PUFAs have potential as nutraceuticals. The study aimed to evaluate the lipid profile and liver function after the administration of S. dimorphus in obese mice. The research design uses mice which are divided into 6 groups; Group 1 (G1) normal control, G2 control Obesity, G3 treatment with Orlistat, G4 treatment S. dimorphus (0.25mg/g BW), G5 treatment S. dimorphus (0.5 mg/g BW) and G6 treatment S. dimorphus (0.75 mg/g BW) each group consisted of 5 mice and 21 days of observation time. The parameters observed were lipid profile and liver function of mice. Based on the results of the study, the effective dose for treating obesity is a dose of S. dimorphus 0.75 mg/g (BW) can reduce cholesterol, triglycerides, and LDL levels, respectively 67.7 mg/dl, 49.2 mg/dl, 10 , 2 mg/dl, and increased HDL, 68.32 mg/dl compared to control of obesity (G2), respectively 108.7 mg/dl, 139.1 mg/dl, 20.6 mg/dl and HDL 60, 28 mg/dl, this dose is also effective for improving the function of blood pressure by reducing AST and ALT 15.6 U/L and 18.8 U/L, respectively, compared to the obesity group (G2), which is 26.6 U/L, and 29,7 U/L. Based on the results of the study it can be concluded that S. dimorphus is useful for anti-obesity for mice (Mus musculus).

Background: The growth and development of children affect biochemical variables. This population-based study was designed to evaluate the reference interval for alkaline phosphatase (ALP) routinely measured in the clinical laboratory. Methods: For this examination, 873 cases were selected among the healthy children and adolescents aged 1-18 years who referred to the endocrinology clinic of Amirkola Children's Hospital for growth evaluation. After overnight fasting, early morning blood samples were obtained to measure the ALP level and other biochemical parameters using an automatic biochemical analyzer. Subjects were categorized by age, sex, and body mass index (BMI) values. The age groups were categorized as follows: 1-4 years, 5-8 years, 9-13 years, and 14-18 years. Results: There was a significant difference among the age and sex categories; on the contrary, there was no meaningful variation between the two groups categorized by BMI. The reference range for ALP was 474.14-517.71 U/L for children aged 1-4 years, 273.47-871.44 U/L for 5-8 years, 215.04-893.69 U/L for 9-13 years, and 228.9-739.22 U/L for 14-18 years. Also, significant positive correlation was found between ALP with length (P=0.000, r=0.134), weight (=0.04, r=0.073), phosphorus (P) (P=0.001, r=0.122), and alanine aminotransferase (SGPT) (P=0.000, r=0.142) respectively. Conclusion: This project's data established a reference interval for ALP in healthy children and adolescents, which will prepare a basis for diagnosis and monitoring liver- or bone-related disorders.

The effectiveness of the Mediterranean diet (MD) in non-alcoholic fatty liver disease (NAFLD) subjects has been evaluated in several randomized controlled trials (RCTs). This systematic review and meta-analysis aimed to evaluate the overall effects of MD intervention in a cohort of NAFLD patients targeting specific markers such as central obesity, lipid profile, liver enzymes and fibrosis, and intrahepatic fat (IHF). Google Scholar, PubMed, and Scopus were explored to collect relevant studies from the last 10 years. RCTs with NAFLD subjects were included in this systematic review with a mean intervention duration from 6 weeks to 1 year, and different intervention strategies, mainly including energy restriction MD (normal or low glycaemic index), low-fat MD with increased monounsaturated and polyunsaturated fatty acids, and increased exercise expenditure. The outcomes measured in this meta-analysis were gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), total cholesterol (TC), waist circumference (WC), and liver fibrosis. Ten randomized controlled trials, which involved a total of 737 adults with NAFLD, were included. According to the results, the MD seems to decrease the liver stiffness (kPa) by –0.42 (CI95% –0.92, 0.09) (p = 0.10) and significantly reduce the TC by –0.46 mg/dl (CI95% –0.55, −0.38) (p = 0.001), while no significant findings were documented for liver enzymes and WC among patients with NAFLD. In conclusion, the MD might reduce indirect and direct outcomes linked with NAFLD severity, such as TC, liver fibrosis, and WC, although it is important to consider the variations across trials. Further RCTs are necessary to corroborate the findings obtained and provide further evidence on the role of the MD in the modulation of other disorders related to NAFLD. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the significance of portal vein reconstruction in segment IV of the liver on early postoperative liver function recovery in split liver transplantation. The clinical data of patients of right trilobe split liver transplantation in our center were analyzed and divided into two groups, including a group without portal vein reconstruction and a group with portal vein reconstruction. Clinical data of alanine aminotransferase (ALT), aspartate transaminase (AST), albumin (ALB), creatinine (Cr), total bilirubin (TB), alkaline phosphatase (ALP), gamma-glutamyl Transferase (GGT), lactic acid (Lac), and international normalized ratio (INR) levels were analyzed. The technique of segment IV portal vein reconstruction is beneficial to the early postoperative recovery of liver function. Statistically, there was no significant effect of portal vein reconstruction in the IV segment of the liver on the recovery of liver function within 1 week after split liver transplantation. There was no significant difference in survival rate between the control group and reconstruction group over the 6 months follow-up period after surgery. [ABSTRACT FROM AUTHOR]