RESUMO
SUMMARY: Paracetamol (known as acetaminophen, or APAP) poisoning causes acute liver damage that can lead to organ failure and death. We sought to determine that APAP overdose can augment tumor necrosis factor-alpha (TNF-α)/ nuclear factor kappa B (NF-kB)/induced nitic oxide synthase (iNOS) axis-mediated hepatotoxicity in rats, and the anti-inflammatory polyphenolic compounds, quercetin (QUR) plus resveratrol (RES) can ameliorate these parameters. Therefore, we induced acute hepatotoxicity in rats using APAP overdose (2 g/kg, orally) and the protective group of rats were treated with 50 mg/kg QUR plus 30 mg/kg RES for one week before APAP ingestion. Animals were killed at day 8. APAP poisoning caused the induction of hepatic tissue levels of TNF-α, NF-kB, and iNOS, which were significantly (p<0.05) decreased by QUR+RES. QUR+RES, also inhibited liver injury biomarkers, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Additionally, a link between liver injury and TNF-α /NF-kB / iNOS axis mediated hepatotoxicity was observed. Thus, the presented data backing the conclusion that intoxication by paracetamol increases TNF-α / NF-kB / iNOS axis -mediated hepatotoxicity, and is protected by a combination of quercetin and resveratrol.
El envenenamiento por paracetamol (conocido como acetaminofeno o APAP) causa daño hepático agudo que puede provocar una insuficiencia orgánica y la muerte. El objetivo de este trabajo fue determinar si la sobredosis de APAP puede aumentar la hepatotoxicidad mediada por el eje del factor de necrosis tumoral alfa (TNF-α)/factor nuclear kappa B (NF-kB)/óxido nítico sintasa inducida (iNOS) en ratas, y si el polifenólico antiinflamatorio compuesto por quercetina (QUR) más resveratrol (RES) pueden mejorar estos parámetros. Por lo tanto, inducimos hepatotoxicidad aguda en ratas usando una sobredosis de APAP (2 g/kg, por vía oral). El grupo protector de ratas se trató con 50 mg/ kg de QUR más 30 mg/kg de RES durante una semana antes de la ingestión de APAP. Los animales se sacrificaron el día 8. El envenenamiento con APAP en el tejido hepático provocó la inducción de niveles de TNF-α, NF-kB e iNOS, que se redujeron significativamente (p<0,05) con QUR+RES. QUR+RES, también inhibió los biomarcadores de daño hepático, la alanina aminotransferasa (ALT) y el aspartato aminotransferasa (AST). Además, se observó una relación entre la lesión hepática y la hepatotoxicidad mediada por el eje TNF-α /NF-kB/iNOS. Por lo tanto, los datos presentados respaldan la conclusión de que la intoxicación por paracetamol aumenta la hepatotoxicidad mediada por el eje TNF-α /NF-kB / iNOS, y está protegida por una combinación de quercetina y resveratrol.
Assuntos
Animais , Ratos , Quercetina/administração & dosagem , Doença Hepática Crônica Induzida por Substâncias e Drogas/tratamento farmacológico , Resveratrol/administração & dosagem , Acetaminofen/toxicidade , Doença Aguda , NF-kappa B/antagonistas & inibidores , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Ratos Sprague-Dawley , Óxido Nítrico Sintase/antagonistas & inibidores , Substâncias Protetoras , Quimioterapia Combinada , Overdose de DrogasRESUMO
Since the spread of the first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection much progress has been made in understanding the disease process. However, we are still facing the complications of coronavirus disease 19 (COVID-19). Multiple sequelae may appear as a consequence of acute infection. This set of entities called post-COVID-19 syndrome involves a wide variety of new, recurrent or persistent symptoms grouped together as a consequence of the acute disease process. One of those that has attracted the most attention is the liver and bile duct involvement called post-COVID-19 cholangiopathy. This is characterized by elevation of liver markers such as alkaline phosphatase, bilirubin and transaminases as well as alterations in the bile ducts in imaging studies. Thus, a narrative review of the cases reported until the end of 2021 was carried out. From the findings found, we concluded that patients who have had COVID-19 or during the process have required hospitalization should remain under follow-up for at least 6 months by a multidisciplinary team.
Assuntos
COVID-19 , Colangite Esclerosante , Humanos , Colangite Esclerosante/diagnóstico , Síndrome de COVID-19 Pós-Aguda , COVID-19/complicações , SARS-CoV-2 , Ductos BiliaresRESUMO
Abstract Liver ischemia-reperfusion (IR) injury is a major clinical trouble encountered in clinical practice. This study aimed to examine the therapeutic effects of silymarin (SM) plus glutathione (GSH) on hepatic IR injury using a rat model of liver IR. Fifty male rats were randomly divided into five groups, each consisting of 10 rats as follows: Sham, IR, SM-IR, GSH-IR and SM plus GSH-IR. All groups except sham were subjected to 30-min ischemia and 24-h reperfusion. The treated groups received 100 mg/kg of SM, GSH and a mixture of SM plus GSH, 60 min prior to the IR. After a period of 24 h, blood and liver samples were collected for biochemical and histopathological evaluations. Pretreatment with SM, GSH and SM plus GSH before hepatic IR significantly decreased IR-induced elevations of aminotransferases, and significantly reduced the histopathological damage scores of the liver in the late phase of IR injury. Moreover, SM plus GSH treatment prior to liver IR significantly suppressed inflammatory process and oxidative stress as demonstrated by attenuations in tumor necrosis factor-α, myeloperoxidase and the thiobarbituric acid-reactive substances. These findings suggest that administration of SM plus GSH prior to liver IR may protect the liver parenchyma from the effects of an IR injury
Assuntos
Animais , Masculino , Ratos , Silimarina/efeitos adversos , Traumatismo por Reperfusão/patologia , Prevenção de Doenças , Glutationa/efeitos adversos , Isquemia/patologia , Ferimentos e Lesões , Usos TerapêuticosRESUMO
INTRODUCTION AND OBJECTIVES: Acute liver failure (ALF) is a severe disease which is associated with a high mortality rate. As mild hypothermia has been shown to have protective effects on the brain, this study aimed to determine whether it also provides protection to the liver in rats with ALF and to explore its underlying mechanism. MATERIALS AND METHODS: In total, 72 rats were divided into 3 groups: control group (CG, treated with normal saline), normothermia group (NG, treated with d-galactosamine and lipopolysaccharide; d-GalN/LPS), and mild hypothermia group (MHG, treated with d-GalN/LPS and kept in a state of mild hypothermia, defined as an anal temperature of 32-35°C). The rats were examined at 4, 8, and 12h after treatment. RESULTS: Mild hypothermia treatment significantly reduced serum alanine transaminase and aspartate transaminase levels and improved the liver condition of rats with d-GalN/LPS-induced ALF at 12h. Serum tumor necrosis factor-alpha levels were significantly lower in the MHG than in the NG at 4h, but no significant differences were observed in the interleukin-10 levels between the NG and MHG at any time. The serum and hepatic levels of high mobility group box 1 were significantly lower in the MHG than in the NG at 8 and 12h. The protein expression levels of cytochrome C and cleaved-caspase 3 in hepatic tissues were significantly lower in the MHG than in the NG at 8h. CONCLUSION: Mild hypothermia improved the liver conditions of rats with ALF via its anti-inflammatory and anti-apoptotic effects.
Assuntos
Hipotermia Induzida/métodos , Falência Hepática Aguda/terapia , Fígado/patologia , Alanina Transaminase/sangue , Animais , Apoptose , Aspartato Aminotransferases/sangue , Biomarcadores/metabolismo , Temperatura Corporal , Modelos Animais de Doenças , Feminino , Interleucinas/sangue , Fígado/metabolismo , Falência Hepática Aguda/metabolismo , Falência Hepática Aguda/patologia , Ratos , Ratos Sprague-DawleyRESUMO
Abstract The leaves of Syringa oblata Lindl., Oleaceae, had been extensively used as a folk medicine to treat various infections, heal inflammations, icteric hepatitis and acute mastitis. The study was designed to evaluate the hepatoprotective activity of S. oblata leaves ethanol extract against CCl4-induced hepatotoxicity in primary hepatocytes and mice with the indicator of glutathione S-transferase alpha 1. The hepatoprotective effects of S. oblata leaves ethanol extract were evaluated on the basis of liver histopathology and biochemical parameters as well as hepatic oxidative stress markers. The results showed that CCl4 negatively modulated biochemical parameters and liver antioxidant activities. However, the use of S. oblata leaves ethanol extract restored altered-serum biochemical parameters and liver antioxidant activities in a dose-dependent manner. Importantly, the trends in S-transferase alpha 1 were similar to alanine aminotransferase and aspartate aminotransferase level, and S-transferase alpha 1 was suggested to be a marker for the evaluation of hepatoprotective activity of S. oblata leaves ethanol extract. Histopathological examination showed that CCl4 causes significant hepatic injury relative to control group. The above findings suggested that S. oblata leaves ethanol extract has hepatoprotective effects against CCl4-induced hepatic injury and S-transferase alpha 1 may be an indicator to evaluate the protective effects of S. oblata leaves ethanol extract.
RESUMO
Studies focusing on possible genotoxic effects of excess fluoride are contradictory and inconclusive. Currently, studies have reported a probable link to oxidative stress, DNA damage and apoptosis induced by fluoride in rat hepatocytes. We developed an in vivo study administering three doses of fluoride by gavage given to rats for 60 day. Micronucleus test was applied to investigate genotoxic potential of fluoride. The TUNEL method determined DNA fragmentation and apoptosis. Biochemical parameters to investigate mitochondrial swelling and oxidative stress. Semi-quantitative RT-PCR and immunostaining to determine mRNA and protein expression of antioxidant enzymes. Analyses of the hepatic function and morphology were performed. Our results revealed the genotoxic potential of fluoride but did not confirm mitochondrial swelling nor an increase of positive TUNEL labelling induced by fluoride, indicating absence of apoptosis. Oxidative stress induction was confirmed and is probably associated to DNA damage. Cell death events such as empty nuclear spaces, cytoplasm degeneration, nuclear pyknosis, karyorrhexis and karyorrhexis followed by karyolysis were observed. Hepatic function did not appear to be significantly modified makes no evidence of necrosis and suggesting other cell death pathway, the autophagic. In conclusion, prolonged fluoride intake at chosen concentrations caused imbalance of the cellular oxidative state, affected DNA and disrupted cellular homeostasis. It is recommended that fluoride supplementation requires a fresh consideration in light of the current study.
Assuntos
Dano ao DNA/efeitos dos fármacos , Fígado/efeitos dos fármacos , Fígado/patologia , Mutagênicos/toxicidade , Estresse Oxidativo/efeitos dos fármacos , Fluoreto de Sódio/toxicidade , Animais , Apoptose/efeitos dos fármacos , Morte Celular/efeitos dos fármacos , Regulação para Baixo/efeitos dos fármacos , Eritrócitos/efeitos dos fármacos , Eritrócitos/metabolismo , Eritrócitos/patologia , Glutationa Transferase/genética , Hepatócitos/efeitos dos fármacos , Hepatócitos/metabolismo , Hepatócitos/patologia , Fígado/metabolismo , Masculino , Testes para Micronúcleos , Mutagênicos/administração & dosagem , Ratos , Ratos Wistar , Fluoreto de Sódio/administração & dosagem , Superóxido Dismutase/genéticaRESUMO
Existe un interés creciente en prevenir la enfermedad y mejorar la salud, por lo que se han desarrolladosuplementos nutricionales percibidos por la población como inofensivos, sin embargo, las plantas son productorasde sustancias químicas que pueden inducir a daño hepático. Los suplementos usados para fisicoculturismo yreducción de peso son los productos naturales que más han reportado hepatotoxicidad en los últimos tiempos.El diagnóstico de la lesión hepática asociado a productos naturales debe hacerse de forma sistematizada ydebe incluir información sobre el inicio del consumo del producto natural, el periodo de tratamiento y el periodode latencia. Comúnmente, el cuadro clínico es agudo y los síntomas en su mayoría son inespecíficos. Se handefinido criterios de hepatotoxicidad a través de la medición de los niveles de la alanina aminotransferasa (ALT)y la fosfatasa alcalina (FA) y la relación entre estas dos variables. Con la cesación del agente implicado, lossignos clínicos generalmente ceden y se da una marcada disminución de los niveles de las enzimas hepáticas. Lapositividad de la reexposición no intencionada del producto es el gold standard para confirmar la hepatotoxicidadpor sustancias naturales. No existen hallazgos histológicos específicos de lesión hepática, por lo que la biopsiano forma parte de los algoritmos para diagnósitico. Con el fin de objetivizar la valoración de efectos adversos seutiliza la escala de CIOMS/RUCAM (Council for International Organizations of Medical Sciences/Roussel UclafCausality Assesment Method) que permite determinar la probabilidad de lesión hepática secundaria al producto.Además de la hepatotoxicidad directa producida por sustancias de origen botánico, se han descrito interaccionesentre medicamentos convencionales y los productos herbales, por lo que el médico tratante debe indagar sobreel uso de estos productos...
here is a growing interest in prevention of diseases and improvement of health. That is why nutritional supplementshave been developed and perceived by people as harmless, but plants produce chemical substances that can leadto liver damage. The supplements used for bodybuilding and weight reduction constituted the most common naturalproducts accounting for hepatotoxicity in last times. The diagnosis of liver injury associated to natural productsshould be done in a systematic way and should include information about the first use of the substance, the treatmentperiod and latency. Commonly, the clinic is an acute condition with nonspecific symptoms. The measurement oflevels of alanine aminotransferase (ALT), alkaline phosphatase (PA) and relationship between these variables serveas criteria of liver injury. With cessation of the agent involved, clinical signs usually yield and there is a markeddecrease in the liver biomarkers levels. Positive results for no intentional reexposure is the gold standard to confirmhepatotoxicity to natural substances. There are no specific histologic findings for liver damage, so biopsy cannotbe used for diagnosis. In order to objectify the adverse effects we use the CIOMS/RUCAM Scale (Council forInternational Organizations of Medical Sciences/ Roussel Uclaf Causality Assesment Method). In addition to thepotential for direct hepatotoxicity, some of the herbs may have interactions with certain prescription medications, sophysicians should ask for using natural products and prevention of concomitant use...
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Humanos , Produtos Biológicos , Suplementos Nutricionais , FígadoRESUMO
The current study aimed to investigate the effects of perinatal exposure to nonylphenol (NP) on delivery outcome of pregnant rats and subsequent inflammatory hepatic injury in newborn rats. The pregnant rats were divided into 2 groups: control group (corn oil) and NP exposure group. Thirty-four pregnant rats were administered NP or corn oil by gavage from the sixth day of pregnancy to 21 days postpartum, with blood samples collected at 12 and 21 days of pregnancy and 60 days after delivery. The NP concentration was measured by HPLC, with chemiluminescence used for detection of estrogen and progesterone levels. Maternal delivery parameters were also observed. Liver and blood of the newborn rats were collected and subjected to automatic biochemical detection of liver function and blood lipid analyzer (immunoturbidimetry), and ultrastructural observation of the hepatic microstructure, with the TNF-α and IL-1β hepatic tissue levels evaluated by immunohistochemistry. Compared with the control group, the pregnant and postpartum serum NP and estradiol levels of the mother rats in the NP group were significantly increased, together with lowered progesterone level, increased number of threatened abortion and dystocia, and fewer newborn rats and lower litter weight. Serum and hepatic NP levels of the newborn rats measured 60 days after birth were significantly higher than those of the control group, as well as lower testosterone levels and increased estradiol levels. When observed under electron microscope, the hepatocyte nuclei of the control group were large and round, with evenly distributed chromatin. The chromatin of hepatocytes in the NP group presented deep staining of the nuclei, significant lipid decrease in the cytoplasm, and the majority of cells bonded with lysate. The results of immunohistochemistry showed that there was almost no TNF-α or IL-1β expression in the hepatocytes of the control group, while the number of TNF-α-, PCNA-, and IL-1β-positive cells in the NP group was increased, with higher integral optical density than the control group. Compared to the control group, the serum levels of alanine aminotransferase, aspartate aminotransferase, triglyceride and low-density lipoprotein in the newborn rats of the NP group were significantly increased. There was no significant difference in the serum level of high-density lipoprotein or cholesterol between the groups. Perinatal exposure to NP can interfere with the in vivo estrogen and progesterone levels of pregnant rats, resulting in threatened abortion, dystocia and other adverse delivery outcomes. High liver and serum NP levels of the newborn rats led to alteration of liver tissue structure and function. The NP-induced hepatotoxicity is probably mediated by inflammatory cytokines TNF-α and IL-1α.
Assuntos
Animais , Feminino , Ratos , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Fenóis/toxicidade , Animais Recém-Nascidos , Doença Hepática Induzida por Substâncias e Drogas/patologia , Modelos Animais de Doenças , Interleucina-1/análise , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Ratos Sprague-Dawley , Fator de Necrose Tumoral alfa/análiseRESUMO
Liver disease is highly prevalent in the world. Oxidative stress (OS) and inflammation are the most important pathogenetic events in liver diseases, regardless the different etiology and natural course. N-acetyl-l-cysteine (the active form) (NAC) is being studied in diseases characterized by increased OS or decreased glutathione (GSH) level. NAC acts mainly on the supply of cysteine for GSH synthesis. The objective of this review is to examine experimental and clinical studies that evaluate the antioxidant and anti-inflammatory roles of NAC in attenuating markers of inflammation and OS in hepatic damage. The results related to the supplementation of NAC in any form of administration and type of study are satisfactory in 85.5% (n = 59) of the cases evaluated (n = 69, 100%). Within this percentage, the dosage of NAC utilized in studies in vivo varied from 0.204 up to 2 g/kg/day. A standard experimental design of protection and treatment as well as the choice of the route of administration, with a broader evaluation of OS and inflammation markers in the serum or other biological matrixes, in animal models, are necessary. Clinical studies are urgently required, to have a clear view, so that, the professionals can be sure about the effectiveness and safety of NAC prescription.
Assuntos
Acetilcisteína/farmacologia , Acetilcisteína/uso terapêutico , Inflamação/patologia , Hepatopatias/patologia , Estresse Oxidativo/efeitos dos fármacos , Acetilcisteína/química , Animais , Biomarcadores/metabolismo , Humanos , Modelos BiológicosRESUMO
Frequent exposure to cadmium (Cd) in low doses is common; however, the long-lasting effects of this exposure are still poorly understood. Therefore in this study we have evaluated long-lasting hepatic morphofunctional adaptations in rats exposed to low and moderate doses of Cd. Five experimental groups were tested: control (0.9% saline) and other four receiving single intraperitoneal doses of 0.67, 0.74, 0.86 and 1.1 mg of Cd/kg. The animals were killed after eight weeks and the following parameters were analysed: biometrics, oedema, Cd bio-accumulation, collagen, glycogen, lipid droplets, superoxide dismutase (SOD) and catalase (CAT), serum transaminases, liver histopathology and stereology. In all groups exposed to Cd there was significant increase in SOD and CAT activities, ALP levels, proportion of binucleated hepatocytes, nuclei/cytoplasm ratio, macrophages (Kupffer cells) and collagen fibres. In these groups, glycogen accumulation by hepatocytes and the proportion of sinusoidal capillaries were significantly reduced compared with controls. The liver somatic index was increased, and liver oedema was evident in animals exposed to higher dose of Cd. Areas of necrosis were found in animals exposed to the three highest doses. These results indicate that Cd is an extremely toxic bioactive heavy metal, which even at low doses is able to disrupt liver homeostasis. At low and moderate doses, Cd exposure induces morphofunctional pathological remodelling of the hepatic stroma and parenchyma, which remain active after eight weeks. In response to injury, the liver tissue triggers a reactive process by enhancing activation of antioxidant enzymes and collagenogenesis.
Assuntos
Cádmio/farmacologia , Hepatócitos/efeitos dos fármacos , Hepatócitos/patologia , Fígado/patologia , Fígado/fisiopatologia , Células Estromais/efeitos dos fármacos , Células Estromais/patologia , Animais , Cádmio/administração & dosagem , Catalase/metabolismo , Colágeno/metabolismo , Relação Dose-Resposta a Droga , Edema/epidemiologia , Edema/patologia , Hepatócitos/metabolismo , Homeostase/efeitos dos fármacos , Incidência , Injeções Intraperitoneais , Fígado/metabolismo , Masculino , Modelos Animais , Necrose/epidemiologia , Necrose/patologia , Ratos , Ratos Wistar , Células Estromais/metabolismo , Superóxido Dismutase/metabolismo , Fatores de TempoRESUMO
This study was undertaken to evaluate the relationship and effects of diabetes on liver morphology, architecture and function. The hepatic effects of diabetes were evaluated in vivo using streptozotocin (STZ)-induced diabetic rats as an experimental model. The degree of hepatic dysfunction was measured by using biochemical parameters like serum transaminases (ALT and AST), alkaline phosphatase (ALP)and pseudocholinesterase (PChE) while the histopathological studies were carried out to support the enzymic Parameters. The aim of the study was to investigate the association between diabetic hepatic complications and liver enzyme alterations. This study was performed in the Department of Anatomy; Institute of Pharmaceutical Sciences and Institute of Diabetology and endocrinology of Baqai Medical University, Karachi. Diabetes was induced by a single dose of STZ (45 mg/kg, b.w.) given intraperitoneally in sodium citrate buffer at pH 4.5. Eighty albino rats were divided into five groups: control (A) and STZ treated (B, C, D, and E) which were sacrificed 2, 4, 6 and 8 weeks post treatment respectively. Histopathological examination of liver showed accumulation of lipid droplets, lymphocytic infiltration, increased fibrous content, dilatation and congestion of portal vessels and proliferation of bile ducts. Increased levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), ALP and PChE were observed in the liver. It seems that the diabetic complications in the liver like hepatocyte destruction etc. are likely to be due to alterations in enzyme levels.
Este estudio se realizó para evaluar la relación y los efectos de la diabetes sobre la morfología, arquitectura y la función del hígado. Los efectos hepáticos de la diabetes se evaluaron in vivo utilizando estreptozotocina (STZ) para inducir diabetes en ratas como un modelo experimental. El grado de disfunción hepática se midió mediante el uso de parámetros bioquímicos, como las transaminasas séricas (ALT y AST), fosfatasa alcalina (ALP) y pseudocolinesterasa (PChE), mientras que los estudios histopatológicos se llevaron a cabo para apoyar los parámetros enzimáticos. El objetivo del estudio fue investigar la asociación entre las complicaciones hepáticas diabéticas y la alteración de enzimas hepáticas. Este estudio se realizó en el Departamento de Anatomía, Instituto de Ciencias Farmacéuticas y el Instituto de Diabetología y Endocrinología de la Baqai Medical University, Karachi. La diabetes fue inducida por una dosis única de STZ (45 mg/kg de peso corporal) administrada por vía intraperitoneal en tampón citrato de sodio a pH 4,5. Ochenta ratas albinas se dividieron en cinco grupos: control (A) y tratados con STZ (B, C, D y E), las que se sacrificaron a las 2, 4, 6 y 8 semanas después del tratamiento. El examen histopatológico de hígado mostró acumulación de gotitas de lípidos, infiltración linfocítica, aumento del contenido de fibras, dilatación y congestión de los vasos portales, y la proliferación de conductos biliares. Aumento de los niveles de aspartato aminotransferasa (AST), alanina aminotransferasa (ALT), ALP y PChE fueron observados en el hígado. Parece que las complicaciones de la diabetes en el hígado como la destrucción de los hepatocitos etc., son probablemente debido a alteraciones en los niveles de las enzimas.
Assuntos
Animais , Camundongos , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/metabolismo , Estreptozocina/efeitos adversos , Estreptozocina/metabolismo , Fígado , Ratos/fisiologia , Ratos/metabolismoRESUMO
El hígado es el principal órgano que sirve de primer paso en la biotransformación de la mayoría de los medicamentos, los cuales en algunos casos pueden conllevar a toxicidad hepática, debido a la acción tóxica directa y/o factores idiosincráticos. El diagnóstico suele ser difícil y por ello se han establecido escalas para evaluar daño hepático inducido por medicamentos. El objetivo de nuestro estudio consiste en describir las características clínicas, bioquímicas y epidemiológicas de los casos de hepatotoxicidad medicamentosa documentadas en las historias clínicas de los pacientes evaluados por la unidad de hepatología de un hospital de cuarto nivel en la ciudad de Medellín, Hospital Pablo Tobón Uribe (HPTU), entre enero 2001 y enero 2008. Se presenta un análisis estadístico de 42 casos de hepatotoxicidad medicamentosa atribuida a fármacos como los antibióticos, inmunosupresores, anticonvulsivantes, analgésicos, entre otros. Todos fueron evaluados por la escala de daño hepático inducida por medicamentos y tuvieron desenlaces como hepatitis aguda, falla hepática, trasplante, etc.
The liver is the main first-step organ involved in the metabolism of most medications. Therefore it is vulnerable to drug toxicity in some cases, due to direct toxic action and/or to idiosyncratic factors. The diagnosis is usually difficult; therefore there are some scales whose purpose is to assess hepatic damage induced by drugs. The objective of our study is to describe the clinical, biochemical and epidemiological characteristics of cases of hepatotoxicity documented in the case histories of patients evaluated by the hepatology unit of a fourth-level hospital in the city of Medellin, Hospital Pablo Tobón Uribe (HPTU), between January 2001 and January 2008. A statistical analysis is presented of 42 cases of liver toxicity ascribed to drugs such as antibiotics, immunosuppressants, antiepileptics, and analgesics, among others. All were evaluated using the scale of hepatic damage induced by medications, and they had outcomes like acute hepatitis, hepatic failure, transplant, etc.
RESUMO
Os compostos fenólicos são substâncias amplamente distribuídas no reino vegetal, em particular nas frutas e em outros vegetais. Estes compostos, destacando-se flavonóides e os ácidos fenólicos, devido à estrutura molecular, podem apresentar a capacidade de inibir processos oxidativos. Além do mais, estão relacionados com a redução de risco de doenças crônicas não transmissíveis tais como: cardiovasculares, câncer, aterosclerose, entre outras. Considerando a elevada produção de caju em território brasileiro e a possibilidade da existência de compostos com potencial antioxidante no pedúnculo de caju, este trabalho teve por objetivo avaliar quantitativa e qualitativamente os compostos fenólicos, particularmente os ácidos fenólicos, e identificar a participação destes em processos metabólicos do organismo animal. Foram caracterizados quimicamente três clones distintos de pedúnculos de caju (CCP-76, CCP-09, BRS-189 e CCP-76 tratado) e na análise química, apresentaram um elevado teor de ácidos graxos monoinsaturados, predominando o ácido oléico, e de fenólicos totais. Os ácidos fenólicos identificados foram: gálico, protocatecuíco, 'rô'-cumárico, ferúlico, caféico e salicílico. Foram obtidos extratos aquoso (EAq) e alcoólico (EAlc) e frações de ácidos fenólicos a partir dos pedúnculos e, avaliados em sistemas modelo 'beta'-caroteno/ácidolinoléico e em Rancimat As frações de ácidos fenólicos exibiram expressiva atividade antioxidante no primeiro sistema e os extratos, no segundo, demonstraram fatores de proteção superior ao antioxidante sintético BHT. Pôde-se também verificar a capacidade antioxidante dos extratos e frações do clone CCP-76 no sistema de varredura do radical DPPH. Em ensaio experimental com ratos, em condição normal, foi administrado EAq (80 e 240 mg/kg, v.o.) ou fração de ácidos fenólicos livres (40 e 120 mg/kg, v.o.) obtidos do pedúnculo de caju CCP-76...
Phenolic compounds are widely distributed in the plant kingdom, particularly fruits and vegetables. Due to their chemical structure, these compounds, in particular flavonoids and phenolic acids, are able to inhibit oxidative processes. Furthermore, can be used to reduce the risk of non-transmissible chronic diseases such as cardiovascular diseases, cancer and atherosclerosis. Taking into consideration the large production of cashew in Brazil and the possible existence of potentially antioxidant compounds present in the cashew apples, the aim of this study was to quantitatively and qualitatively evaluate the presence of phenolic compounds in cashew apple, particularly phenolic acids, and identify their role in metabolic processes in animals. The cashew apples of three distinct clones (CCP-76, CCP-09, BRS-189 and CCP-76 (processed)) were studied. The determination of fatty acids yielded a high concentration of monounsaturated fatty acids, mainly oleic acid, and of total phenolic compound. The phenolic acids found were: gallic, proteocatechuic, p-cumaric, ferulic, caffeic and salicylic acids. Both aqueous (EAq) and ethanolic (EAlc) extracts and phenolic acid fractions were obtained from the cashew apples and were evaluated in a ß-carotene/linoleate model system and Rancimat test. The phenolic acid fractions presented an expressive antioxidant activity in the ß-carotene/linoleate model system and the extracts, by the Rancimat test presented a protection factor higher than that of antioxidant additive, BHT. We also observed the antioxidant capacity of the extracts and fractions of the CCP-76 clone in the DPPH radical scavenging assay. In an experimental assay with rats, the EAq (80 and 240 mg/kg) or the free phenolic acid fraction (40 and 120 mg/kg) obtained from the cashew apple of CCP-76 clone was administered via the oral route. In this study, the enhancement of enzymatic antioxidants (superoxide dismutase, catalase, glutathione peroxidase and reductase) was not observed, nevertheless, a decrease in the amount of lipoperoxidation in the brain tissue was observed, suggesting that the ingestion of cashew might increase the antioxidative state in animals. Also, the antioxidant activity of EAq and of the free phenolic acid fraction from the cashew apple of CCP-76 clone was verified on the liver damage induced by carbon tetrachloride. The liver damage caused by the administration of carbon tetrachloride was detected by biochemical parameters, namely, the increase in the serum concentrations of alanine transaminase (ALT) and aspartate transaminase (AST) as well as a decrease in the activities of antioxidant enzymes and an increase in peroxidation in the liver. Rats who received EAq (480 mg/kg, p.o.) did not present alterations in any of the parameters evaluated, compared to the animals treated with carbon tetrachloride. On the other hand, the administration of free the phenolic acid fraction in doses of 40 and 120 mg/kg, p.o., had a pronounced effect in protecting against hepatic lesion, which was evidenced by the decrease in plasma ALT and AST, enhancing the activity of antioxidant enzymes and preventing lipoperoxidation mediated by the CCl3⢠radical generated by carbon tetrachloride. Histological studies were able to confirm the biochemical alterations observed in that the liver tissue obtained from rats treated with phenolic acid fractions extracted from cashew apple of CCP-76 clone presented a preserved tissue structure and suppression of macro and microgoticular vacuolar degeneration as well as of signs of necrosis.