MECHANISM OF SARS-COV-2 INVASION INTO THE LIVER AND HEPATIC INJURY IN PATIENTS WITH COVID-19

A large number of studies have shown that patients with Coronavirus disease 2019 (COVID-19) have different degrees of liver injury. However, the mechanisms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion into the liver are still not fully understood. This review mainly summarizes the recently published works on the abnormal liver biochemical indicators and the mechanism of viral invasion with liver injury in COVID-19 patients. Generally, SARS-CoV-2 infection of the liver was caused by blood circulation or retrograde infection of digestive tract, which led to the liver injury through direct cytopathic effect induced by virus or immunopathological effect caused by excessive inflammation. Besides these, hypoxia, endothelial injury and drug-induced jury were also the main reasons of liver injury in COVID-19 patients. In the liver function indicators, elevated alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, and lactate dehydrogenase levels with reduced albumin levels were observed in COVID-19 patients.

Method for diagnosing non-alcoholic liver steatosis

Purpose of the study. Development of a non-invasive method for the diagnosis of non-alcoholic hepatic steatosis.Material and methods. The study involved 21 patients with confrmed non-alcoholic hepatic steatosis on ultrasound examination with an average age of 42.1 ± 10.1 years. The control group consisted of 10 apparently healthy individuals. The following indicators were determined: body mass index (BMI), the level of gamma-glutamyl transpeptidase (GGTP), vasculoendothelial growth factor (VEGF) and interleukin-6 (IL-6) in serum, and the steatosis index (IS) was calculated using the formula IS = –1.2390 + 0.0575 × BMI + 0.0064 × GGTP +0.0006 × VEGF + 0.0001 × IL-6. The index of the presence of hepatic steatosis according to liver ultrasound data was used as a dependent variable.Results. According to the examination results, BMI and serum concentrations of GGTP, VEGF, and IL-6 in patients with steatosis were signifcantly higher than in the control group (p < 0.001, p < 0.001, p < 0.001, and p < 0.001, respectively), which indicates the presence of cholestasis syndrome, signs of inflammation and endothelial dysfunction. The correlation coeffcient between BMI and the presence of non-alcoholic hepatic steatosis was 0.9; between GGTP and the presence of steatosis was 0.80; between VEGF and the presence of steatosis was 0.85; between IL-6 and the presence of steatosis was 0.80. The predictive value of each parameter of the model was assessed using a scale of values of the area under the ROC-curve (AUC). The model is effective (multiple correlation coeffcient R = 0.809; the share of the influence of the sum of the factors included in the model is R2 • 100 = 65.5%), statistically signifcant (criterion F = 12.318; p < 0.0001) and has excellent diagnostic characteristics.Conclusion. The proposed non-invasive method makes it possible to diagnose hepatic steatosis with a sensitivity of 95.2% and a specifcity of 97.0%: with IS equal to 0.5 or more, the presence of non-alcoholic hepatic steatosis is diagnosed, with IS less than 0.5 is not.

Rotating night shift work, sleep duration and elevated gamma-glutamyl transpeptidase among steelworkers: cross-sectional analyses from a Chinese occupational cohort

ObjectivesThis study aimed to evaluate the separate and combined effects of rotating night shift work and lifestyle factors with elevated gamma-glutamyl transpeptidase (GGT) among steelworkers.Design, setting and participantsThis cross-sectional study used the baseline information from a Chinese occupational cohort. The in-service workers of the production department of Tangsteel Company who participated in the occupational health examination in Tangshan from February to June 2017 were selected as the research objects.Main outcome measuresThe separate and combined effects of rotating night shift work and lifestyle factors with elevated GGT among steelworkers.ResultsThe information of 7031 subjects from the production department of Tangsteel Company was analysed. Results showed that the current shift workers and the workers with the duration of night shifts>19 years, the cumulative number of night shifts>1774 nights, the average frequency of night shifts≤7 nights/month and the average frequency of night shifts>7 nights/month had elevated odds of elevated GGT, compared with those who never worked night shifts, and ORs, (95% CIs) were 1.39, (1.10 to 1.75), 1.46, (1.15 to 1.86), 1.46, (1.15 to 1.85), 1.34, (1.04 to 1.73) and 1.37, (1.09 to 1.74) after adjustment for potential confounders. The independent effect of shorter sleep duration (<7 hours/day) on elevated GGT was not statistically significant. Among workers who had shorter sleep duration, the association between rotating night shift work and elevated GGT was statistically significant, but no associations were found among workers with the sleep duration of ≥7 hours/day. In addition, other lifestyle factors affected the association between rotating night shift work and elevated GGT.ConclusionsRotating night shift work is associated with elevated GGT among steelworkers. In particular, the effect of rotating night shift work on elevated GGT was affected by sleep duration and other lifestyle factors.

γ-Glutamyl-Transpeptidase-Resistant Glutathione Analog Attenuates Progression of Alzheimer’s Disease-like Pathology and Neurodegeneration in a Mouse Model

Oxidative stress in Alzheimer’s disease (AD) is mediated, in part, by the loss of glutathione (GSH). Previous studies show that γ-glutamyl transpeptidase (GGT)-resistant GSH analog, Ψ-GSH, improves brain GSH levels, reduces oxidative stress markers in brains of APP/PS1 transgenic mice, a mouse model of AD, and attenuates early memory deficits in the APP/PS1 model. Herein, we examined whether Ψ-GSH can attenuate the disease progression when administered following the onset of AD-like pathology in vivo. Cohorts of APP/PS1 mice were administered Ψ-GSH for 2 months starting at 8 month or 12 months of age. We show that Ψ-GSH treatment reduces indices of oxidative stress in older mice by restoration of enzyme glyoxalase-1 (Glo-1) activity and reduces levels of insoluble Aβ. Quantitative neuropathological analyses show that Ψ-GSH treatment significantly reduces Aβ deposition and brain inflammation in APP/PS1 mice compared to vehicle-treated mice. More importantly, Ψ-GSH treatment attenuated the progressive loss of cortical TH+ afferents and the loss of TH+ neurons in the locus coeruleus (LC). Collectively, the results show that Ψ-GSH exhibits significant antioxidant activity in aged APP/PS1 mice and chronic Ψ-GSH treatment administered after the onset of AD pathology can reverse/slow further progression of AD-like pathology and neurodegeneration in vivo.

A Case Report of Alcoholic Liver Disease with Jaundice Treated with Korean Medicine

Objective: This study aimed to report a case of alcoholic liver disease with jaundice that was improved with Korean medicine treatment.Methods: A patient who developed jaundice due to continuous drinking was treated with herbal medicine, acupuncture, moxibustion, and cupping. Blood tests were performed to measure the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (γ-GTP), total bilirubin, albumin, and total protein; AST/ALT ratio; and mean corpuscular volume (MCV). Jaundice parameters were subjectively recorded at 3-day intervals.Results: After treatment, the AST, ALT, ALP, γ-GTP, and total bilirubin levels; MCV; and jaundice were decreased.Conclusion: Korean medicine treatment appeared to be an effective method for alcoholic liver disease with jaundice.

Serum FGF21 levels are altered with various factors including lifestyle behaviors

Fibroblast growth factor (FGF) 21 has various functions, including glucose and lipid metabolism, yet the biology of FGF21 remains unclear. This study aimed to investigate specific conditions that might affect the functions of FGF21. Subjects included 398 healthy men who underwent health examinations to obtain information on physical and biochemical parameters and lifestyle behaviors. Associations of serum FGF21 levels with each parameter were assessed in the study. FGF21 levels correlated with age, body mass index, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure, aspartate aminotransferase, alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (γ-GTP), uric acid, total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, and HbA1c. Moreover, FGF21 levels were significantly associated with lifestyle behaviors, including smoking status and breakfast and alcohol consumption frequency. Multivariable regression analysis showed that age, ALT, γ-GTP, smoking status, and breakfast and alcohol consumption frequency were independent variables for FGF21 levels. Assessment among the non-obese and obese groups showed that FGF21 levels correlated with WC, SBP, and TC only in the non-obese group. Thus, serum FGF21 levels were affected by several factors, including lifestyle behaviors, age, and liver function. To assess the functions of FGF21 in individuals, considering these factors would be essential. (199 words)

Helicobacter cyclurae sp. Nov., Isolated From Endangered Blue Iguanas (Cyclura lewisi)

Blue iguanas (Cyclura lewisi) are endangered reptiles found only on Grand Cayman. Previously, DNA for a novel Helicobacter species GCBI1 was detected in sick and dead iguanas. In the current study, fecal and cloacal swab samples were obtained from 25 iguanas. Through molecular and microbiological techniques, a novel Helicobacter species was cultured from feces and characterized, for whom we propose the name Helicobacter cyclurae. This novel helicobacter had a prevalence of 56% by PCR and 20% by culture in samples analyzed. The type strain MIT 16-1353 was catalase, oxidase, and gamma-glutamyl transpeptidase positive. By electron microscopy, H. cyclurae has a curved rod morphology and a single sheathed polar flagellum. Phylogenetic analysis using 16S rRNA, gyrB, and hsp60 indicated that these strains were most closely related to Helicobacter sp. 12502256-12 previously isolated from lizards. H. cyclurae has a 1.91-Mb genome with a GC content of 33.37%. There were 1,969 genes with four notable virulence genes: high temperature requirement-A protein-secreted serine protease, gamma-glutamyl transpeptidase, fibronectin/fibrinogen binding protein, and neutrophil-activating protein. Whole-genome phylogeny, average nucleotide identity, and digital DNA–DNA hybridization analysis confirmed that H. cyclurae is a novel species, and the first helicobacter cultured and characterized from blue iguanas.