Hepatoprotective therapy with low molecular weight sugar drug for pregnant women with liver dysfunction amid early toxicosis and hepatotoxicity

Objective. To assess the efficacy and safety of low molecular weight sugar solution as a hepatoprotector in the first trimester of pregnancy in patients with liver functional disorders against the background of early toxicosis and / or hepatotoxicity. Patients and methods. The study included 70 patients: the main group (n = 30) – pregnant women with functional hepatopathies who received therapy with drug Heptrong; the control group (n = 30) – pregnant women who received standard treatment, of which 15 patients had hepatotoxicity (essential phospholipid therapy) and 15 patients with early toxicosis (intravenous saline fluid therapy, Cerucal), as well as 10 pregnant women with early toxicosis who were treated without drugs (the placebo group). Results. Pregnant women with early toxicosis noted a decrease in its clinical manifestations against the use of the drug Heptrong after 2.3 ± 0.8 days from the onset of therapy; by the end of therapy, all patients had no vomiting, and nausea stopped in 80%, which was not observed in comparison groups. The normalization of alanine aminotransferase (≤40 U/L) occurred in 80% of pregnant women in the main group (p < 0.01) and in 66% (p < 0.01) when treating with essential phospholipids. The normalization of alanine aminotransferase (≤40 U/L) occurred in 90% (p < 0.01) and 33.3% (p = 0.03), respectively. A significant decrease in the level of bile acids (from 8.49 ± 2.1 μmol/L to 2.74 ± 1.1 μmol/L; p < 0.05) and improvement in the indicators of the antioxidant system – an increase in total antiradical activity (from 804.0.0 ± 10.5 μmol/L to 839.0 ± 11.0 μmol/L; p < 0.05) and a decrease in the level of conjugated dienes (from 3.77 ± 0.2 μmol/L to 3.26 ± ± 0.1 μmol/L; p < 0.05) – were observed only in the main group. A number of other indicators of the “liver panel” tended to improve only in the main group. Conclusion. Heptrong is an effective hepatoprotective drug, which considerably improves the state of pregnant women during early toxicosis and helps to reduce liver transaminases and bile acids in pregnant women with hepatotoxicity. Due to the antiinflammatory and pronounced antioxidant effect, which is not observed in standard pharmacological treatment, Heptrong can be used to prevent late obstetric complications. Key words: Heptrong, drug-induced hepatopathies, “liver panel” indicators, early toxicosis

Download Full-text

Estimation of the efficiency of using interferon inducer in children with Epstein-Barr viral infection

Siberian medical review ◽

10.20333/25000136-2021-6-74-78 ◽

2021 ◽

Vol 6 ◽

pp. 74-78

Author(s):

R.F. Makhmutov ◽

Keyword(s):

Molecular Weight ◽

Viral Infection ◽

Main Group ◽

Control Group ◽

Low Molecular Weight ◽

Interferon Inducer ◽

Basic Therapy ◽

Interferon Inducers ◽

Epstein Barr ◽

Primary Form

The aim of the research. To evaluate the effectiveness of synthetic low-molecular interferon inducers in children with Epstein-Barr viral infection. Material and methods. The study included 68 children aged 7 to 17 years with primary Epstein-Barr viral infection: 38 children in the main group received basic therapy against the primary form of Epstein-Barr viral infection in age-specific dosages in combination with a synthetic low-molecular interferon inducer; 30 children of the control group received the conventional basic therapy with age-specific dosages. Results. It has been established that clinical manifestation of Epstein-Barr viral infection is based on immunopathological inflammation mediated by the factors of cellular immunity. As a result of the therapy, 78.95 % of children in the main group had a normal rate of functional recovery of the liver. In the control group, however, the recovery was delayed in 60.00 % of children: rapid recovery was only noted in the main group. Administration of synthetic lowmolecular weight interferon inducers in addition to basic symptomatic therapy facilitated the reduction of intoxication symptoms duration by 4.7±1.9 days (p < 0.05) and the duration of the icteric period by 5.3±0.9 days (p < 0.05), as well as 5.1±1.3 days earlier normalisation of liver size (p < 0.05). Conclusion. Thus, the use of synthetic low molecular weight interferon inducers in combination with basic therapy against the primary form of Epstein-Barr viral infection in children contributes to a faster restoration of the functional state of the liver. The conducted clinical and biochemical studies indicate high efficiency of synthetic low molecular weight interferon inducers in the complex therapy of Epstein-Barr viral infection in children.

Download Full-text

Prospective evaluation of coagulation activation in pregnant women receiving low-molecular weight heparin

Thrombosis and Haemostasis ◽

10.1160/th03-11-0719 ◽

2004 ◽

Vol 91 (05) ◽

pp. 935-940 ◽

Cited By ~ 14

Author(s):

Matthias Hoke ◽

Paul Kyrle ◽

Karl Philipp ◽

Ingrid Pabinger ◽

Alexandra Kaider ◽

...

Keyword(s):

Molecular Weight ◽

Pregnant Women ◽

Low Molecular Weight Heparin ◽

Activated Protein C ◽

Normal Pregnancy ◽

Coagulation System ◽

Control Group ◽

Low Molecular Weight ◽

Coagulation Activation ◽

D Dimer

SummaryPregnancy is a major risk factor for venous thromboembolism (VTE), and low-molecular weight heparin (LMWH) seems to be safe and effective in pregnant women. Normal pregnancy is accompanied by a state of hypercoagulability, indicated by an increase in markers of coagulation activation. In a prospective cohort study, we followed 61 women who received LMWH thromboprophylaxis throughout pregnancy because of a history of VTE, hereditary thrombophilia and/or previous pregnancyrelated complications. The control group consisted of 113 healthy pregnant women without antithrombotics. D-Dimer, prothrombin fragment F1+2 (F1+2) and the resistance to activated protein C (APC-ratio) were measured in all women during the first, second and third trimester. Patients and controls did not significantly differ with regard to baseline characteristics and pregnancy outcome. A (recurrent)VTE was seen in one patient despite LMWH. D-Dimer levels significantly increased among patients and controls during pregnancy (p <0.0001), and were significantly higher among patients compared with the controls (p <0.0001) [395 ng/ml (95% CI 340-458) and 249 ng/ml (95%CI 234-266); 710 ng/ml (95% CI 602-838) and 475 ng/ml (95% CI 431-523); 1089 ng/ml (95% CI 931-1273) and 822 ng/ml (95% CI 741-911); respectively]. Levels of F1+2 significantly increased while the APC-ratio significantly decreased during pregnancy among patients and controls. Despite LMWH, pregnancy is accompanied by a substantial activation of the coagulation system.

Download Full-text

Essential phospholipids use in the treatment of drug-induced liver injury in pregnant women

Journal of obstetrics and women s diseases ◽

10.17816/jowd66214-23 ◽

2017 ◽

Vol 66 (2) ◽

pp. 14-23 ◽

Cited By ~ 1

Author(s):

Liudmila K Palgova ◽

Irina V Borisova ◽

Natalia V Zhestkova ◽

Marina A Tarasova

Keyword(s):

Liver Disease ◽

Pregnant Women ◽

Main Group ◽

Control Group ◽

Gamma Glutamyl Transpeptidase ◽

Drug Induced ◽

Drug Induced Liver Injury ◽

Essential Phospholipids ◽

Rate Of Decline ◽

Glutamyl Transpeptidase

The aim of the study was evaluation the efficiency of essential phospholipids for the treatment of drug-induced liver disease in pregnant women. In the research group included 67 pregnant women with clinical and biochemical manifestations of drug-induced cytolytic syndrome, 58 pregnant women (the main group) were treated with hepatoprotectors, 9 women (the control group) the treatment of essential phospholipids wasn’t carried out. Patients of both groups were eliminated hormonal drugs and other drugs or their dosage is reduced as much as possible. Drug liver disease in pregnancy is manifested by increased transaminase, in some cases accompanied by increased level of gamma glutamyl transpeptidase, liver glutamate dehydrogenase. Against the background of the treatment in both groups decrease in transaminases have been reported. But the rate of decline of aminotransferases was differed, so in the main group decrease of ALT and AST was occurred faster than in the control group.

Download Full-text

Thrombogenesis in Thrombophilic Pregnancy: Evaluation of Low-Molecular-Weight Heparin Prophylaxis

Acta Haematologica ◽

10.1159/000467385 ◽

2017 ◽

Vol 137 (4) ◽

pp. 201-206 ◽

Cited By ~ 2

Author(s):

Roberto Simeone ◽

Roberta Giacomello ◽

Germano Bruno ◽

Sergio Parco ◽

Natalia Maximova ◽

...

Keyword(s):

Molecular Weight ◽

Pregnant Women ◽

Low Molecular Weight Heparin ◽

Factor V Leiden ◽

Control Group ◽

Low Molecular Weight ◽

Factor V ◽

Protein C Deficiency ◽

Factor V Leiden Mutation ◽

Heparin Prophylaxis

The aim of this study is to investigate thrombogenesis and the hypercoagulable changes in pregnant women affected by thrombophilia who received low-molecular-weight heparin (LWMH) prophylaxis. We included 21 pregnant women affected by thrombophilia treated with LWMH and 20 nontreated normal pregnant women as the control group. The sample group of thrombophilic pregnant women included different conditions (factor V Leiden mutation, protein C deficiency, protein S deficiency, antiphospholipid antibodies syndrome, and combined defects). Three blood samples were collected during pregnancy (i.e., at 16, 20, and 24 weeks) and tested for activated partial thromboplastin time and prothrombin fragment F1 + 2 (F1 + 2); anti-FXa activity was tested only in treated thrombophilic pregnant women. F1 + 2 levels progressively increased during pregnancy in both study groups. However, the F1 + 2 increase in women exposed to heparin prophylaxis was significantly lower than that in normal pregnant women in all 3 measurements carried out during gestation (p < 0.05); a statistically significant inverse correlation between F1 + 2 levels and anti-Xa activity (R = -0.8575, p < 0.05) was observed in treated women during pregnancy. Our findings suggest that F1 + 2 in addition to anti-Xa measurement could be used to adjust LWMH prophylaxis, at least in high-risk pregnant women.

Download Full-text

Systemic Thrombin Generation and Activity Resistant to Low Molecular Weight Heparin Administered Prior to Streptokinase in Patients with Acute Myocardial Infarction

Thrombosis and Haemostasis ◽

10.1055/s-0038-1655907 ◽

1997 ◽

Vol 77 (01) ◽

pp. 057-061 ◽

Cited By ~ 7

Author(s):

Dennis W T Nilsen ◽

Lasse Gøransson ◽

Alf-Inge Larsen ◽

Øyvind Hetland ◽

Peter Kierulf

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Molecular Weight ◽

Body Weight ◽

Low Molecular Weight Heparin ◽

Troponin T ◽

Bleeding Complications ◽

Control Group ◽

Low Molecular Weight ◽

Creatine Kinase Mb

SummaryOne hundred patients were included in a randomized open trial to assess the systemic factor Xa (FXa) and thrombin inhibitory effect as well as the safety profile of low molecular weight heparin (LMWH) given subcutaneously in conjunction with streptokinase (SK) in patients with acute myocardial infarction (MI). The treatment was initiated prior to SK, followed by repeated injections every 12 h for 7 days, using a dose of 150 anti-Xa units per kg body weight. The control group received unfractionated heparin (UFH) 12,500 IU subcutaneously every 12 h for 7 days, initiated 4 h after start of SK infusion. All patients received acetylsalicylic acid (ASA) initiated prior to SK.Serial blood samples were collected prior to and during the first 24 h after initiation of SK infusion for determination of prothrombin fragment 1+2 (Fl+2), thrombin-antithrombin III (TAT) complexes, fibrinopeptide A (FPA) and cardiac enzymes. Bleeding complications and adverse events were carefully accounted for.Infarct characteristics, as judged by creatine kinase MB isoenzyme (CK-MB) and cardiac troponin T (cTnT), were similar in both groups of patients.A comparable transient increase in Fl+2, TAT and FPA was noted irrespective of heparin regimen. Increased anti-Xa activity in patients given LMWH prior to thrombolytic treatment had no impact on indices of systemic thrombin activation.The incidence of major bleedings was significantly higher in patients receiving LMWH as compared to patients receiving UFH. However, the occurrence of bleedings was modified after reduction of the initial LMWH dose to 100 anti-Xa units per kg body weight.In conclusion, systemic FXa- and thrombin activity following SK-infusion in patients with acute MI was uninfluenced by conjunctive LMWH treatment.

Download Full-text

Thrombocytopenia in pregnant women with thrombophilia treated with low-molecular-weight heparin

Obstetrica şi Ginecologia ◽

10.26416/obsgin.67.1.2019.2295 ◽

2019 ◽

Vol 1 (67) ◽

pp. 30

Author(s):

Melinda-Ildiko Mitranovici ◽

Smaranda Ilea ◽

Mihai Morariu ◽

Daniel Mureşan ◽

Izabella Petre

Keyword(s):

Molecular Weight ◽

Pregnant Women ◽

Low Molecular Weight Heparin ◽

Low Molecular Weight

Download Full-text

Inhibitory effect of low-molecular-weight peptides (0–3 kDa) from Spirulina platensis on H2O2-induced oxidative damage in L02 human liver cells

Bioresources and Bioprocessing ◽

10.1186/s40643-021-00388-0 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Jun Ma ◽

Xiankun Zeng ◽

Min Zhou ◽

Le Cheng ◽

Difeng Ren

Keyword(s):

Molecular Weight ◽

Oxidative Damage ◽

Spirulina Platensis ◽

Radical Scavenging ◽

Inhibitory Effect ◽

Control Group ◽

Low Molecular Weight ◽

Sod Activity ◽

Liver Health ◽

L02 Cells

AbstractSpirulina platensis protein hydrolysates were prepared by digesting protein extracts with papain, and the hydrolysates were separated into 30, 10, and 3 kDa weights using membrane ultrafiltration. The 0–3 kDa low-molecular-weight Spirulina peptides (LMWSPs) proved the highest chemical antioxidant activity by 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging ability, hydroxyl radical (·OH) scavenging activities and total antioxidant capacity. Cellular antioxidant ability of LMWPs fractions against 2000 μg/mL H2O2 induced oxidative damage of L02 cells were investigated. The MTT assay results displayed that LMWSPs at different concentrations (0–1000 μg/mL) had proliferation effect on the L02 cells and that treatment of the L02 cells with the 1000 μg/mL LMWSPs (0–3 kDa) significantly prevented H2O2-induced oxidative damage compared with control cells. Moreover, the 2′,7′-dichlorofluorescein diacetate (DCFH-DA) fluorescent probe assay showed that the levels of ROS and NO were significantly lower in the experimental group that was treated with the peptides for 24 h than in the control group. Furthermore, using the corresponding kits, the treatment inhibited the reduction of SOD activity and the increase of MDA contents in the L02 cells. Therefore, LMWSPs (0–3 kDa) may have potential applications in antioxidant and liver health products.

Download Full-text

Anti-Factor Xa Plasma Levels in Pregnant Women Receiving Low Molecular Weight Heparin Thromboprophylaxis

Obstetrics and Gynecology ◽

10.1097/aog.0b013e31819b3b38 ◽

2009 ◽

Vol 113 (3) ◽

pp. 740 ◽

Cited By ~ 2

Author(s):

Ingrid Pabinger ◽

Andreas Greinacher

Keyword(s):

Molecular Weight ◽

Pregnant Women ◽

Plasma Levels ◽

Low Molecular Weight Heparin ◽

Factor Xa ◽

Low Molecular Weight

Download Full-text

Thrombin generation and low-molecular-weight heparin prophylaxis in pregnant women with thrombophilia

Thrombosis and Haemostasis ◽

10.1160/th14-05-0452 ◽

2015 ◽

Vol 113 (02) ◽

pp. 283-289 ◽

Cited By ~ 3

Author(s):

Anna Selmeczi ◽

Rachel E. J. Roach ◽

Csaba Móré ◽

Zoltán Batta ◽

Jolán Hársfalvi ◽

...

Keyword(s):

Molecular Weight ◽

Pregnant Women ◽

Low Molecular Weight Heparin ◽

Thrombin Generation ◽

Factor Xa ◽

Peak Effect ◽

Low Molecular Weight ◽

Endogenous Thrombin Potential ◽

Increased Risk ◽

Optimal Approach

SummaryPregnancy is associated with increased risk of venous thromboembolism, especially in the presence of thrombophilia. However, there is no consensus on the optimal approach for thromboprophylaxis in this population. Recent evidence suggests that thrombin generation correlates with the overall procoagulant state of the plasma. Our aim was to evaluate thrombin generation in a prospective cohort of thrombophilic pregnant women, and investigate the effectiveness of low-molecular- weight heparin (LMWH) prophylaxis in pregnancy. Women with severe (n=8), mild (n=47) and no (n=15) thrombophilia were followed throughout their pregnancies. Thrombin generation was evaluated in each trimester as well as five days and eight weeks postpartum (as a reference category). In women undergoing LMWH prophylaxis, thrombin generation and anti-Factor-Xa activity were measured just before and 4 hours after administration (peak effect). Thrombin generation was determined using Technothrombin TGA assay system. For the analysis, median peak thrombin and endogenous thrombin potential were used. Peak thrombin and endogenous thrombin potential were increased during pregnancy compared to the non-pregnant state with the highest results in the severe thrombophilia group. In women receiving LMWH prophylaxis a decrease was observed in thrombin generation at peak effect but over the progression of pregnancy the extent of this decrease reduced in a stepwise fashion. Our results show that thrombin generation demonstrates the hypercoagulable state in thrombophilic pregnancies. In addition, we found the effect of LMWH prophylaxis to progressively decrease with advancing stages of pregnancy.

Download Full-text